naval medical center portsmouth outpatient formulary...

Naval Medical Center Portsmouth Outpatient Formulary

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Alphabetical Listing by Name

Th is docume nt is curre nt a s of December 19, 2019The availability of formulary items is subject to change.

AbataceptOutpatient Dosage FormsInjection, solution [preservative free]:Orencia: 125 mg/mL (1 mL) [contains sucrose 170 mg/mL]

AcarboseOutpatient Dosage FormsTablet, Oral:Generic: 25 mg, 50 mg, 100 mg

AcetaminophenOutpatient Dosage FormsCaplet, Oral:Generic: 500 mg

Suppository, Rectal:Generic: 120 mg (12s); 325 mg (12s); 650 mg (12s)

Suspension, Oral:Generic: 160 mg/5 mL (120 mL)

Tablet, Oral:Generic: 325 mg

Tablet, Chewable, Oral:Generic: 80 mg

Acetaminophen and CodeineOutpatient Dosage FormsSolution, Oral [C-V]:Generic: Acetaminophen 120 mg and codeine phosphate 12 mg per 5 mL(473 mL) [BCF]

Tablet, Oral [C-III]:Generic: Acetaminophen 300 mg and codeine phosphate 30 mg [BCF]

AcetaZOLAMIDEOutpatient Dosage FormsCapsule Extended Release 12 Hour, Oral:Diamox Sequels: 500 mg

Tablet, Oral:Generic: 125 mg, 250 mg

Acetic Acid (Otic)Outpatient Dosage FormsSolution, Otic:Generic: 2% (15 mL, 60 mL [DSC])

Acetic Acid, Propylene Glycol Diacetate, and HydrocortisoneOutpatient Dosage FormsSolution, Otic:Generic: Acetic acid 2%, propylene glycol diacetate 3%, and hydrocortisone1% (10 mL)

Acetic Acid (Topical)Outpatient Dosage FormsGel, Vaginal:Generic: 0.92% (85 g)

AcetylcysteineOutpatient Dosage FormsSolution, Inhalation:Generic: 10% [100 mg/mL] (30 mL); 20% [200 mg/mL] (30 mL)

Acyclovir (Systemic)Outpatient Dosage FormsCapsule, Oral:Generic: 200 mg [BCF]

Suspension, Oral:Generic: 200 mg/5 mL (473 mL) [BCF]

Tablet, Oral:Generic: 400 mg [BCF], 800 mg [BCF]

AdalimumabOutpatient Dosage FormsInjection, solution [preservative free]:Humira: 40 mg/0.8 mL (0.8 mL) [contains natural rubber/natural latex inpackaging, polysorbate 80; prefilled syringe] [ECF]

Humira Pen: 40 mg/0.8 mL (0.8 mL) [contains natural rubber/natural latex inpackaging, polysorbate 80] [ECF]

Injection, solution [pediatric, preservative free]:Humira: 20 mg/0.4 mL (0.4 mL) [contains natural rubber/natural latex inpackaging, polysorbate 80] [ECF]

AlbendazoleOutpatient Dosage FormsTablet, oral:Albenza: 200 mg

AlbuterolOutpatient Dosage FormsAerosol Solution, Inhalation:ProAir HFA: 108 (90 Base) mcg/actuation (8.5 g) [BCF]

Nebulization Solution, Inhalation [preservative free]:Generic: 0.083% [2.5 mg/3 mL] (25s, 30s, 60s) [BCF]; 0.5% [2.5 mg/0.5mL] (30s)

Alcohol (Isopropyl)Outpatient Dosage FormsPad, External:Generic: 70% (100s)

AlendronateOutpatient Dosage FormsSolution, Oral:Fosamax: 70 mg/75 mL (75 mL) [raspberry flavor] [BCF]

Tablet, Oral:Generic: 5 mg [BCF], 10 mg [BCF], 35 mg [BCF], 70 mg [BCF]

Alendronate and CholecalciferolOutpatient Dosage FormsTablet, Oral:Fosamax Plus D: 70/5600: Alendronate 70 mg and cholecalciferol 5600 int.units

AlfuzosinOutpatient Dosage FormsTablet Extended Release 24 Hour, Oral, as hydrochloride:Generic: 10 mg [BCF]

AllopurinolOutpatient Dosage FormsTablet, Oral:Generic: 100 mg [BCF], 300 mg [BCF]

ALPRAZolamOutpatient Dosage FormsTablet, Oral:Generic: 0.25 mg, 0.5 mg, 1 mg

AlprostadilOutpatient Dosage FormsInjection, powder for reconstitution:Edex: 10 mcg, 20 mcg, 40 mcg [contains lactose 51.06 mg; cartridge; suppliedwith diluent]

Pellet, urethral:Muse: 125 mcg (1s); 250 mcg (1s); 500 mcg (1s); 1000 mcg (6s)

Aluminum AcetateOutpatient Dosage FormsPacket, External:Aluminum sulfate 1191 mg and calcium acetate 839 mg per packet (100s)

Aluminum Chloride HexahydrateOutpatient Dosage FormsSolution, External:Drysol: 20% (37.5 mL) [contains ethanol 93%]

Aluminum HydroxideOutpatient Dosage FormsSuspension, Oral:Generic: 600 mg/5 mL (355 mL)

AmantadineOutpatient Dosage FormsCapsule, Oral, as hydrochloride:Generic: 100 mg [BCF]

Syrup, Oral, as hydrochloride:Generic: 50 mg/5 mL (10 mL, 473 mL) [BCF]

Aminocaproic AcidOutpatient Dosage FormsSyrup, Oral:Amicar: 1.25 g/5 mL (473 mL) [raspberry flavor]


AmiodaroneOutpatient Dosage FormsTablet, Oral, as hydrochloride:Generic: 200 mg [BCF]

AmitriptylineOutpatient Dosage FormsTablet, Oral, as hydrochloride:Generic: 10 mg [BCF], 25 mg [BCF], 50 mg [BCF], 75 mg [BCF]

Amitriptyline and PerphenazineOutpatient Dosage FormsTablet, Oral:Generic: Amitriptyline hydrochloride 25 mg and perphenazine 2 mg, Amitripty-line hydrochloride 25 mg and perphenazine 4 mg

ABATACEPT

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AmLODIPineOutpatient Dosage FormsTablet, Oral:Generic: 2.5 mg [BCF], 5 mg [BCF], 10 mg [BCF]

Amlodipine and BenazeprilOutpatient Dosage FormsCapsule, Oral:Generic:2.5/10: Amlodipine 2.5 mg and benazepril hydrochloride 10 mg [BCF]5/10: Amlodipine 5 mg and benazepril hydrochloride 10 mg [BCF]5/20: Amlodipine 5 mg and benazepril hydrochloride 20 mg [BCF]5/40: Amlodipine 5 mg and benazepril hydrochloride 40 mg [BCF]10/20: Amlodipine 10 mg and benazepril hydrochloride 20 mg [BCF]10/40: Amlodipine 10 mg and benazepril hydrochloride 40 mg [BCF]

AmoxicillinOutpatient Dosage FormsCapsule, Oral:Generic: 250 mg [BCF], 500 mg [BCF]

Powder for Suspension, Oral:Generic: 125 mg/5 mL (150 mL); 250 mg/5 mL (80 mL, 100 mL, 150 mL)[BCF]; 400 mg/5 mL (50 mL, 75 mL, 100 mL) [BCF]


Tablet, Chewable, Oral:Generic: 125 mg, 250 mg

Amoxicillin and ClavulanateOutpatient Dosage FormsPowder for Suspension, Oral:Generic:200: Amoxicillin 200 mg and clavulanate potassium 28.5 mg per 5 mL (50mL, 75 mL, 100 mL) [BCF]

250: Amoxicillin 250 mg and clavulanate potassium 62.5 mg per 5 mL (75mL, 100 mL, 150 mL) [BCF]

400: Amoxicillin 400 mg and clavulanate potassium 57 mg per 5 mL (50 mL,75 mL, 100 mL) [BCF]

600: Amoxicillin 600 mg and clavulanate potassium 42.9 mg per 5 mL (75mL, 125 mL, 200 mL) [BCF]

Tablet, Oral:Generic:250: Amoxicillin 250 mg and clavulanate potassium 125 mg [BCF]500: Amoxicillin 500 mg and clavulanate potassium 125 mg [BCF]875: Amoxicillin 875 mg and clavulanate potassium 125 mg [BCF]

Tablet, Chewable, Oral:Generic:200: Amoxicillin 200 mg and clavulanate potassium 28.5 mg400: Amoxicillin 400 mg and clavulanate potassium 57 mg

Tablet Extended Release 12 Hour, Oral:Generic: Amoxicillin 1000 mg and clavulanate acid 62.5 mg

Amyl NitriteOutpatient Dosage FormsLiquid, for inhalation: USP: 85% to 103% (0.3 mL)

AnakinraOutpatient Dosage FormsSolution Prefilled Syringe, Subcutaneous [preservative free]:Kineret: 100 mg/0.67 mL (0.67 mL) [contains disodium edta, polysorbate 80]

AnastrozoleOutpatient Dosage FormsTablet, Oral:Generic: 1 mg

AnthralinOutpatient Dosage FormsCream, External:Dritho-Scalp: 0.5% (50 g)

ApixabanOutpatient Dosage FormsTablet, Oral:Eliquis: 2.5 mg, 5 mg

ApraclonidineOutpatient Dosage FormsSolution, Ophthalmic:Generic: 0.5% (5 mL)

ARIPiprazoleOutpatient Dosage FormsTablet, Oral:Abilify: 2 mg, 5 mg, 10 mg, 15 mg, 20 mg, 30 mg

ArmodafinilOutpatient Dosage FormsTablet, Oral:Nuvigil: 50 mg, 150 mg, 250 mg

Artificial TearsOutpatient Dosage FormsOintment, Ophthalmic [preservative free]:Generic: 3.5 g

Solution, Ophthalmic:Polyvinyl alcohol 1% and polyethylene glycol 400 1% (30 mL) [containsbenzalkonium chloride]

Ascorbic AcidOutpatient Dosage FormsTablet, Oral:Generic: 500 mg

AspirinOutpatient Dosage FormsSuppository, Rectal:Generic: 300 mg (12s)



Tablet, Enteric Coated, Oral:Generic: 81 mg, 325 mg

Aspirin and DipyridamoleOutpatient Dosage FormsCapsule Extended Release 12 Hour, Oral:Aggrenox: Aspirin 25 mg [immediate release] and dipyridamole 200 mg[extended release]

AtenololOutpatient Dosage FormsTablet, Oral:Generic: 25 mg [BCF], 50 mg [BCF], 100 mg [BCF]

AtoMOXetineOutpatient Dosage FormsCapsule, Oral:Strattera: 10 mg, 18 mg, 25 mg, 40 mg, 60 mg, 100 mg

AtorvaSTATinOutpatient Dosage FormsTablet, Oral:Generic: 10 mg [BCF], 20 mg [BCF], 40 mg [BCF], 80 mg [BCF]

Atropine (Ophthalmic)Outpatient Dosage FormsOintment, Ophthalmic, as sulfate:Generic: 1% (3.5 g)

Solution, Ophthalmic, as sulfate:Generic: 1% (15 mL)

AzaTHIOprineOutpatient Dosage FormsTablet, Oral:Generic: 50 mg

Azelaic AcidOutpatient Dosage FormsGel, External:Finacea: 15% (50 g) [contains benzoic acid, disodium edta, polysorbate 80,propylene glycol]

Azelastine (Nasal)Outpatient Dosage FormsSolution, Nasal, as hydrochloride:Generic: 0.1% [137 mcg/spray] (30 mL)

Azithromycin (Systemic)Outpatient Dosage FormsPacket, Oral:Generic: 1 g/packet (3s) [BCF]

Suspension Reconstituted, Oral:Generic: 100 mg/5 mL (15 mL) [BCF]; 200 mg/5 mL (15 mL)

Tablet, Oral, as monohydrate [strength expressed as base]:Generic: 250 mg [BCF], 500 mg [BCF]

Bacitracin and Polymyxin B (Ophthalmic)Outpatient Dosage FormsOintment, Ophthalmic:Generic: Bacitracin 500 units and polymyxin B 10,000 units per g (3.5 g)

Bacitracin and Polymyxin B (Topical)Outpatient Dosage FormsOintment, External:Generic: Bacitracin 500 units and polymyxin B 10,000 units per g (15 g)

BACITRACIN AND POLYMYXIN B (TOPICAL)

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Bacitracin, Neomycin, and Polymyxin B (Ophthalmic)Outpatient Dosage FormsOintment, Ophthalmic:Generic: Bacitracin 400 units, neomycin 3.5 mg, and polymyxin B 10,000 unitsper g (3.5 g) [BCF]

Bacitracin, Neomycin, and Polymyxin B (Topical)Outpatient Dosage FormsOintment, External:Generic: Bacitracin 400 units, neomycin 3.5 mg, and polymyxin B 5000 unitsper g (15 g)

Bacitracin (Ophthalmic)Outpatient Dosage FormsOintment, Ophthalmic:Generic: 500 units/g (3.5 g)

Bacitracin (Topical)Outpatient Dosage FormsOintment, External, as zinc [strength expressed as base]:Generic: 500 units/g (30 g)

BaclofenOutpatient Dosage FormsTablet, Oral:Generic: 10 mg

Balanced Salt SolutionOutpatient Dosage FormsSolution, Ophthalmic [irrigation; preservative free]:Generic: Sodium chloride 0.64%, potassium chloride 0.075%, calcium chloride0.048%, magnesium chloride 0.03%, sodium acetate 0.39%, sodium citrate0.17% (18 mL, 500 mL)

Belladonna and OpiumOutpatient Dosage FormsSuppository, Rectal:Generic: Belladonna extract 16.2 mg and opium 60 mg (12s)

BenazeprilOutpatient Dosage FormsTablet, Oral, as hydrochloride:Generic: 5 mg, 10 mg, 20 mg, 40 mg

BenzocaineOutpatient Dosage FormsLozenge, Mouth/Throat:Generic: 15 mg (16s)

BenzonatateOutpatient Dosage FormsCapsule, Oral:Generic: 100 mg

Benzoyl PeroxideOutpatient Dosage FormsGel, External:Generic: 5% (45 g); 10% (45 g)

Liquid, External:Generic: 5% (140 g); 10% (140 g)

BenztropineOutpatient Dosage FormsTablet, Oral, as mesylate:Generic: 0.5 mg [BCF], 1 mg [BCF], 2 mg [BCF]

Betamethasone and ClotrimazoleOutpatient Dosage FormsCream, External:Generic: Betamethasone dipropionate 0.05% (base) and clotrimazole 1%(15 g, 45 g)

Betamethasone (Topical)Outpatient Dosage FormsCream, External, as valerate [strength expressed as base]:Generic: 0.1% (15 g)

Lotion, External, as valerate [strength exprssed as base]:Generic: 0.1% (60 mL)

Ointment, External, as valerate [strength expressed as base]:Generic: 0.1% (15 g, 45 g)

BethanecholOutpatient Dosage FormsTablet, Oral, as chloride:Generic: 5 mg, 10 mg, 25 mg, 50 mg

BicalutamideOutpatient Dosage FormsTablet, Oral:Generic: 50 mg

BimatoprostOutpatient Dosage FormsSolution, Ophthalmic:Lumigan: 0.01% (2.5 mL, 5 mL) [contains benzalkonium chloride]

BisacodylOutpatient Dosage FormsSuppository, Rectal:Generic: 10 mg (50 ea)

Tablet Delayed Release, Oral:Generic: 5 mg

Bismuth SubsalicylateOutpatient Dosage FormsLiquid, Oral, as subsalicylate:Generic: 262 mg/15 mL (473 mL)

Tablet, Chewable, Oral, as subsalicylate:Generic: 262 mg

Brimonidine and TimololOutpatient Dosage FormsSolution, Ophthalmic [drops]:Combigan: Brimonidine tartrate 0.2% and timolol 0.5% (5 mL,10 mL) [containsbenzalkonium chloride]

Brimonidine (Ophthalmic)Outpatient Dosage FormsSolution, Ophthalmic, as tartrate:Generic: 0.15% (5 mL, 10 mL, 15 mL) [BCF]; 0.2% (5 mL, 10 mL, 15mL) [BCF]

BrinzolamideOutpatient Dosage FormsSuspension, Ophthalmic:Azopt: 1% (10 mL) [contains benzalkonium chloride]

BromfenacOutpatient Dosage FormsSolution, Ophthalmic:Generic: 0.09% (1.7 mL, 2.5 mL)

BromocriptineOutpatient Dosage FormsTablet, Oral:Generic: 2.5 mg

Budesonide (Oral Inhalation)Outpatient Dosage FormsSuspension, Inhalation:Generic: 0.25 mg/2 mL (30s); 0.5 mg/2 mL (30s); 1 mg/2 mL (30s)

BuPROPionOutpatient Dosage FormsTablet, Oral, as hydrochloride:Generic: 75 mg [generic for Wellbutrin] [BCF], 100 mg [generic for Well-butrin] [BCF]

Tablet, Extended Release, Oral, as hydrochloride:Generic: 100 mg [generic for Wellbutrin SR] [BCF], 150 mg [generic forZyban] [BCF], 150 mg [generic for Wellbutrin XL] [BCF], 200 mg [genericfor Wellbutrin SR] , 300 mg [generic for Wellbutrin XL] [BCF]

Tablet, Sustained Release, Oral, as hydrochloride:Wellbutrin SR: 100 mg [BCF]

BusPIRoneOutpatient Dosage FormsTablet, Oral, as hydrochloride:Generic: 5 mg [BCF], 10 mg [BCF], 15 mg [BCF]

Butalbital, Acetaminophen, and CaffeineOutpatient Dosage FormsTablet, Oral:Generic: Butalbital 50 mg, acetaminophen 325 mg, and caffeine 40 mg [BCF]

CalamineOutpatient Dosage FormsSuspension, External:Generic: 8% (118 mL)

Calcitriol (Systemic)Outpatient Dosage FormsCapsule, softgel, oral:Generic: 0.25 mcg, 0.5 mcg

Calcium and Vitamin DOutpatient Dosage FormsTablet, Oral:Generic: Calcium 600 mg and vitamin D 200 int. units

BACITRACIN, NEOMYCIN, AND POLYMYXIN B (OPHTHALMIC)

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Calcium CarbonateOutpatient Dosage FormsTablet, Oral:Generic: 1250 mg [equivalent to elemental calcium 500 mg]

Calcium GlubionateOutpatient Dosage FormsSyrup, Oral:Generic: 1.8 g/5 mL (473 mL) [contains benzoic acid; caramel-orange flavor;equivalent to elemental calcium 115 mg/5 mL]

Camphor and MentholOutpatient Dosage FormsLotion, External:Generic: Camphor 0.5% and menthol 0.5% (222 mL)

CandesartanOutpatient Dosage FormsTablet, Oral, as cilexetil:Atacand: 4 mg, 8 mg, 16 mg, 32 mg [scored]

Candesartan and HydrochlorothiazideOutpatient Dosage FormsTablet, Oral:Atacand HCT: 32/25: Candesartan cilexetil 32 mg and hydrochlorothiazide25 mg, 16/12.5: Candesartan cilexetil 16 mg and hydrochlorothiazide12.5 mg, 32/12.5: Candesartan cilexetil 32 mg and hydrochlorothiazide12.5 mg [scored]

CapecitabineOutpatient Dosage FormsTablet, Oral:Generic: 150 mg, 500 mg

CaptoprilOutpatient Dosage FormsTablet, Oral:Generic: 12.5 mg [BCF], 25 mg [BCF], 50 mg [BCF], 100 mg [BCF]

CarbacholOutpatient Dosage FormsSolution, Ophthalmic:Isopto Carbachol: 3% (15 mL) [contains benzalkonium chloride]

CarBAMazepineOutpatient Dosage FormsSuspension, Oral:Generic: 100 mg/5 mL (10 mL, 450 mL) [BCF]

Tablet, Oral:Generic: 200 mg [BCF]

Tablet, Chewable, Oral:Generic: 100 mg [BCF]

Tablet Extended Release 12 Hour, Oral:Generic: 400 mg [BCF]

Carbamide PeroxideOutpatient Dosage FormsSolution, Otic:Generic: 6.5% (15 mL)

Carbidopa and LevodopaOutpatient Dosage FormsTablet, Oral:Generic:10/100: Carbidopa 10 mg and levodopa 100 mg [BCF]25/100: Carbidopa 25 mg and levodopa 100 mg [BCF]25/250: Carbidopa 25 mg and levodopa 250 mg [BCF]

Tablet Extended Release, Oral:Generic:25/100: Carbidopa 25 mg and levodopa 100 mg50/200: Carbidopa 50 mg and levodopa 200 mg

CarboxymethylcelluloseOutpatient Dosage FormsSolution, Ophthalmic, as sodium:Generic: 0.5% (15 mL)

Solution, Ophthalmic, as sodium [preservative free]:Generic: 0.5% (0.4 mL); 1% (0.4 mL) [available in packages of 30]

Carteolol (Ophthalmic)Outpatient Dosage FormsSolution, Ophthalmic, as hydrochloride:Generic: 1% (15 mL) [contains benzalkonium chloride]

CarvedilolOutpatient Dosage FormsCapsule, Extended Release, Oral, as phosphate:Coreg CR: 10 mg, 20 mg, 40 mg, 80 mg

Tablet, Oral:Generic: 3.125 mg [BCF], 6.25 mg [BCF], 12.5 mg [BCF], 25 mg [BCF]

CefadroxilOutpatient Dosage FormsCapsule, Oral, as monohydrate [strength expressed as base]:Generic: 500 mg

Suspension Reconstituted, Oral:Generic: 250 mg/5 mL (100 mL)

CefdinirOutpatient Dosage FormsSuspension Reconstituted, Oral:Generic: 125 mg/5 mL (60 mL); 250 mg/5 mL (100 mL)

CefiximeOutpatient Dosage FormsSuspension Reconstituted, Oral:Suprax: 100 mg/5 mL (100 mL) [contains sodium benzoate; strawberry flavor]

CefpodoximeOutpatient Dosage FormsTablet, Oral:Generic: 100 mg, 200 mg

CefprozilOutpatient Dosage FormsSuspension Reconstituted, Oral:Generic: 125 mg/5 mL (50 mL); 250 mg/5 mL (100 mL)

CefuroximeOutpatient Dosage FormsTablet, Oral, as axetil [strength expressed as base]:Generic: 500 mg

CelecoxibOutpatient Dosage FormsCapsule, Oral:Generic: 100 mg, 200 mg

CephalexinOutpatient Dosage FormsCapsule, Oral:Generic: 250 mg [BCF], 500 mg [BCF]

Suspension Reconstituted, Oral:Generic: 125 mg/5 mL (100 mL); 250 mg/5 mL (100 mL, 200 mL) [BCF]

Cetirizine (Systemic)Outpatient Dosage FormsSyrup, Oral, as hydrochloride:Generic: 5 mg/5 mL (120 mL)

Tablet, Oral, as hydrochloride:Generic: 5 mg, 10 mg

Charcoal, ActivatedOutpatient Dosage FormsSuspension, oral: 25 g (120 mL)Suspension, oral [with sorbitol]: 25 g (120 mL)

Chloral HydrateOutpatient Dosage FormsSyrup, Oral:Generic: 500 mg/5 mL (473 mL)

ChlorambucilOutpatient Dosage FormsTablet, Oral:Leukeran: 2 mg

ChlordiazePOXIDEOutpatient Dosage FormsCapsule, Oral, as hydrochloride:Generic: 10 mg, 25 mg

Chlorhexidine Gluconate (Oral)Outpatient Dosage FormsSolution, Mouth/Throat:Generic: 0.12% (473 mL) [BCF]

ChloroquineOutpatient Dosage FormsTablet, Oral, as phosphate:Generic: 500 mg [equivalent to chloroquine base 300 mg]

ChlorpheniramineOutpatient Dosage FormsSyrup, Oral, as maleate:Generic: 2 mg/5 mL (118 mL)

Tablet, Oral, as maleate:Generic: 4 mg

CHLORPHENIRAMINE

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ChlorproMAZINEOutpatient Dosage FormsTablet, Oral, as hydrochloride:Generic: 25 mg, 50 mg, 100 mg

ChlorthalidoneOutpatient Dosage FormsTablet, Oral:Generic: 25 mg [BCF], 50 mg [BCF]

ChlorzoxazoneOutpatient Dosage FormsTablet, Oral:Generic: 500 mg

CholecalciferolOutpatient Dosage FormsLiquid, Oral:Generic: 400 units/mL (50 mL)

Cholestyramine ResinOutpatient Dosage FormsPowder, Oral:Generic: 4 g/dose (210 g, 239.4 g, 378 g)

CiclopiroxOutpatient Dosage FormsSolution, External:Generic: 8% (6.6 mL)

CimetidineOutpatient Dosage FormsSolution, Oral, as hydrochloride [strength expressed as base]:Generic: 300 mg/5 mL (473 mL)

Ciprofloxacin and DexamethasoneOutpatient Dosage FormsSuspension, Otic:Ciprodex: Ciprofloxacin 0.3% and dexamethasone 0.1% (7.5 mL) [containsbenzalkonium chloride]

Ciprofloxacin (Ophthalmic)Outpatient Dosage FormsOintment, Ophthalmic, as hydrochloride:Ciloxan: 3.33 mg/g (3.5 g) [equivalent to ciprofloxacin base 0.3%]

Solution, Ophthalmic, as hydrochloride:Generic: 3.5 mg/mL (5 mL) [equivalent to ciprofloxacin base 0.3%]

Ciprofloxacin (Systemic)Outpatient Dosage FormsSuspension Reconstituted, Oral:Cipro: 250 mg/5 mL (100 mL) [BCF]Generic: 250 mg/5 mL (100 mL) [BCF]

Tablet, Oral, as hydrochloride [strength expressed as base]:Generic: 100 mg, 250 mg [BCF], 500 mg [BCF], 750 mg

CitalopramOutpatient Dosage FormsSolution, Oral:Generic: 10 mg/5 mL (240 mL) [BCF]

Tablet, Oral:Generic: 10 mg [BCF], 20 mg [BCF], 40 mg [BCF]

ClarithromycinOutpatient Dosage FormsSuspension Reconstituted, Oral:Generic: 125 mg/5 mL (100 mL); 250 mg/5 mL (100 mL)

Tablet, Oral:Generic: 250 mg, 500 mg

Clindamycin and Benzoyl PeroxideOutpatient Dosage FormsGel, External:Generic: Clindamycin phosphate 1% and benzoyl peroxide 5% (50 g)

Clindamycin (Systemic)Outpatient Dosage FormsCapsule, Oral, as hydrochloride [strength expressed as base]:Generic: 150 mg [BCF], 300 mg

Solution Reconstituted, Oral, as palmitate hydrochloride [strength expressed asbase]:Generic: 75 mg/5 mL (100 mL)

Clindamycin (Topical)Outpatient Dosage FormsCream, Vaginal, as phosphate [strength expressed as base]:Generic: 2% (40 g) [BCF]

Gel, External, as phosphate [strength expressed as base]:Generic: 1% (30 g)

Lotion, External, as phosphate [strength expressed as base]:Generic: 1% (60 mL)

Solution, External as phosphate [strength expressed as base]:Generic: 1% (30 mL, 60 mL) [BCF]

ClobetasolOutpatient Dosage FormsCream, External, as propionate:Generic: 0.05% (15 g, 45 g)

Cream, External, as propionate [emollient-based]:Generic: 0.05% (15 g, 30 g, 60 g)

Ointment, External, as propionate:Generic: 0.05% (15 g, 30 g, 45 g)

Solution, External, as propionate [for scalp application]:Generic: 0.05% (25 mL)

ClomiPHENEOutpatient Dosage FormsTablet, Oral, as citrate:Generic: 50 mg

ClonazePAMOutpatient Dosage FormsTablet, Oral:Generic: 0.5 mg [BCF], 1 mg, 2 mg

CloNIDineOutpatient Dosage FormsPatch Weekly, Transdermal:Generic: 0.1 mg/24 hours (4s); 0.2 mg/24 hours (4s); 0.3 mg/24 hours (4s)

Tablet, Oral, as hydrochloride:Generic: 0.1 mg [BCF], 0.2 mg [BCF], 0.3 mg [BCF]

ClopidogrelOutpatient Dosage FormsTablet, Oral:Plavix: 75 mg [BCF], 300 mg [BCF]Generic: 75 mg [BCF], 300 mg [BCF]

Clotrimazole (Oral)Outpatient Dosage FormsTroche, Oral:Generic: 10 mg

Clotrimazole (Topical)Outpatient Dosage FormsCream, External:Generic: 1% (30 g)

Cream, Vaginal:Generic: 1% (45 g)

Solution, External:Generic: 1% (10 mL, 30 mL) [BCF]

Coal TarOutpatient Dosage FormsOil, External:Generic: Coal tar 2.5% (221 mL)

Coal Tar and Salicylic AcidOutpatient Dosage FormsGel, External [shampoo]:Generic: Coal tar solution 10% [equivalent to coal tar 2%] and salicylic acid(120 mL, 240 mL)

CodeineOutpatient Dosage FormsTablet, Oral, as sulfate:Generic: 30 mg

ColchicineOutpatient Dosage FormsTablet, Oral:Generic: 0.6 mg

ColesevelamOutpatient Dosage FormsTablet, Oral, as hydrochloride:Welchol: 625 mg

ColestipolOutpatient Dosage FormsGranules, Oral, as hydrochloride:Generic: 5 g/scoop (300 g, 500 g)

Tablet, Oral, as hydrochloride [micronized]:Generic: 1 g

CortisoneOutpatient Dosage FormsTablet, Oral, as acetate:Generic: 25 mg

CHLORPROMAZINE

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Cromolyn (Ophthalmic)Outpatient Dosage FormsSolution, Ophthalmic, as sodium:Generic: 4% (10 mL)

CrotamitonOutpatient Dosage FormsCream, External:Eurax: 10% (60 g)

CyanocobalaminOutpatient Dosage FormsSolution, Injection:Generic: 1000 mcg/mL (1 mL)

CyclobenzaprineOutpatient Dosage FormsTablet, Oral, as hydrochloride:Generic: 5 mg, 10 mg [BCF]

CyclopentolateOutpatient Dosage FormsSolution, Ophthalmic, as hydrochloride:Generic: 1% (2 mL, 5 mL, 15 mL)

CyclophosphamideOutpatient Dosage FormsTablet, Oral:Generic: 50 mg

CycloSPORINE (Ophthalmic)Outpatient Dosage FormsEmulsion, Ophthalmic [preservative free]:Restasis: 0.05% (1 ea) [contains polysorbate 80]

CycloSPORINE (Systemic)Outpatient Dosage FormsCapsule, Oral:Gengraf: 25 mg, 100 mg [contains ethanol 12.8%]SandIMMUNE: 25 mg, 100 mg

Solution, Oral:SandIMMUNE: 100 mg/mL (50 mL) [contains ethanol 12.5%]Generic: 100 mg/mL (50 mL)

CyproheptadineOutpatient Dosage FormsSyrup, Oral, as hydrochloride:Generic: 2 mg/5 mL (473 mL) [BCF]

Tablet, Oral, as hydrochloride:Generic: 4 mg [BCF]

Dabigatran EtexilateOutpatient Dosage FormsCapsule, Oral:Pradaxa: 75 mg, 150 mg

DanazolOutpatient Dosage FormsCapsule, Oral:Generic: 50 mg, 200 mg

DantroleneOutpatient Dosage FormsCapsule, Oral, as sodium:Generic: 25 mg, 100 mg

Dapsone (Systemic)Outpatient Dosage FormsTablet, Oral:Generic: 25 mg, 100 mg

DesipramineOutpatient Dosage FormsTablet, Oral, as hydrochloride:Generic: 10 mg, 25 mg, 50 mg

DesmopressinOutpatient Dosage FormsSolution, Nasal, as acetate:Generic: 0.1 mg/mL (5 mL)

Tablet, Oral, as acetate:Generic: 0.1 mg, 0.2 mg

DexAMETHasone (Ophthalmic)Outpatient Dosage FormsSolution, Ophthalmic, as phosphate:Generic: 0.1% (5 mL)

DexAMETHasone (Systemic)Outpatient Dosage FormsElixir, Oral:Generic: 0.5 mg/5 mL (237 mL)

Tablet, Oral:Generic: 0.5 mg, 0.75 mg, 4 mg

DexmethylphenidateOutpatient Dosage FormsCapsule Extended Release 24 Hour, Oral, as hydrochloride:Generic: 5 mg, 10 mg, 15 mg, 20 mg, 25 mg, 30 mg, 35 mg, 40 mg

Tablet, Oral, as hydrochloride:Generic: 2.5 mg, 5 mg, 10 mg

DextroamphetamineOutpatient Dosage FormsCapsule Extended Release 24 Hour, Oral, as sulfate:Generic: 10 mg, 15 mg

Tablet, Oral, as sulfate:Generic: 5 mg

Dextroamphetamine and AmphetamineOutpatient Dosage FormsCapsule, Extended Release, Oral:Generic:5 mg [dextroamphetamine sulfate 1.25 mg, dextroamphetamine saccharate1.25 mg, amphetamine aspartate monohydrate 1.25 mg, amphetaminesulfate 1.25 mg (equivalent to amphetamine base 3.1 mg)] [BCF]

10 mg [dextroamphetamine sulfate 2.5 mg, dextroamphetamine saccharate2.5 mg, amphetamine aspartate monohydrate 2.5 mg, amphetamine sul-fate 2.5 mg (equivalent to amphetamine base 6.3 mg)] [BCF]

15 mg [dextroamphetamine sulfate 3.75 mg, dextroamphetamine saccha-rate 3.75 mg, amphetamine aspartate monohydrate 3.75 mg, amphet-amine sulfate 3.75 mg (equivalent to amphetamine base 9.4 mg)] [BCF]

20 mg [dextroamphetamine sulfate 5 mg, dextroamphetamine saccharate5 mg, amphetamine aspartate monohydrate 5 mg, amphetamine sulfate5 mg (equivalent to amphetamine base 12.5 mg)] [BCF]

25 mg [dextroamphetamine sulfate 6.25 mg, dextroamphetamine saccha-rate 6.25 mg, amphetamine aspartate monohydrate 6.25 mg, amphet-amine sulfate 6.25 mg (equivalent to amphetamine base 15.6 mg)] [BCF]

30 mg [dextroamphetamine sulfate 7.5 mg, dextroamphetamine saccharate7.5 mg, amphetamine aspartate monohydrate 7.5 mg, amphetamine sul-fate 7.5 mg (equivalent to amphetamine base 18.8 mg)] [BCF]

Tablet, Oral:Generic:5 mg [dextroamphetamine sulfate 1.25 mg, dextroamphetamine saccharate1.25 mg, amphetamine aspartate monohydrate 1.25 mg, amphetaminesulfate 1.25 mg (equivalent to amphetamine base 3.13 mg)]

7.5 mg [dextroamphetamine 1.875 mg, dextroamphetamine saccharate1.875 mg, amphetamine aspartate monohydrate 1.875 mg, amphetaminesulfate 1.875 mg (equivalent to amphetamine base 4.7 mg)]

10 mg [dextroamphetamine sulfate 2.5 mg, dextroamphetamine saccharate2.5 mg, amphetamine aspartate monohydrate 2.5 mg, amphetamine sul-fate 2.5 mg (equivalent to amphetamine base 6.3 mg)]

12.5 mg [dextroamphetamine sulfate 3.125 mg, dextroamphetamine sac-charate 3.125 mg, amphetamine aspartate monohydrate 3.125 mg,amphetamine sulfate 3.125 mg (equivalent to amphetamine base 7.8 mg)]

15 mg [dextroamphetamine sulfate 3.75 mg, dextroamphetamine saccha-rate 3.75 mg, amphetamine aspartate monohydrate 3.75 mg, amphet-amine sulfate 3.75 mg (equivalent to amphetamine base 9.4 mg)]

20 mg [dextroamphetamine sulfate 5 mg, dextroamphetamine saccharate5 mg, amphetamine aspartate monohydrate 5 mg, amphetamine sulfate5 mg (equivalent to amphetamine base 12.6 mg)]

30 mg [dextroamphetamine sulfate 7.5 mg, dextroamphetamine saccharate7.5 mg, amphetamine aspartate monohydrate 7.5 mg, amphetamine sul-fate 7.5 mg (equivalent to amphetamine base 18.8 mg)]

Diabetic SuppliesOutpatient Dosage FormsGlucose meter/kit:FreeStyle Freedom Lite Kit with device [BCF]

Lancet [ultra thin]: 200/boxSolution [for use with MediSense meter]:MediSense Glucose Control Solution: 3 mL (2s)

Syringe and needle:BD Syringe 0.3 mL 30 gauge x 1/2" [100/box]BD Syringe 0.5 mL 31 gauge x 5/16" [100/box][BCF]BD Syringe 0.5 mL 30 gauge x 1/2" [100/box]BD Syringe 1 mL 25 gauge x 1"BD Syringe 1 mL 31 gauge x 5/16" [100/box][BCF]BD Syringe 1 mL 30 gauge x 1/2" [100/box]BD Ultra-Fine II Short (1/2 unit) 31 gauge [100/box]Pen Needle 32 gauge x 4 mm (5/32") [100/box]

Test Strips:Bayer Contour: [100/box] RESTRICTED: See NMC Comments aboveDiastix Reagent Strips: [100/box]FreeStyle: [100/box] RESTRICTED: See NMC Comments aboveFreeStyle Lite: [50/box] [BCF]Ketostix Strips: [50/box]

DIABETIC SUPPLIES

7

Multistix: 100/bottle [10 SG]Precision Xtra: [100/box] (new starts will be FreeStyle Lite)

DiazePAMOutpatient Dosage FormsSolution, Oral:Generic: 5 mg/5 mL (500 mL)


DibucaineOutpatient Dosage FormsOintment, External:Generic: 1% [10 mg/g] (30 g)

Diclofenac (Ophthalmic)Outpatient Dosage FormsSolution, Ophthalmic, as sodium:Generic: 0.1% (5 mL)

Diclofenac (Systemic)Outpatient Dosage FormsTablet Delayed Release, Oral, as sodium:Generic: 50 mg, 75 mg

Diclofenac (Topical)Outpatient Dosage FormsGel, Transdermal, as sodium:Voltaren: 1% (100 g) [contains isopropyl alcohol, propylene glycol]

DicloxacillinOutpatient Dosage FormsCapsule, Oral:Generic: 250 mg [BCF], 500 mg [BCF]

DicyclomineOutpatient Dosage FormsCapsule, Oral, as hydrochloride:Generic: 10 mg [BCF]

Syrup, Oral, as hydrochloride:Bentyl: 10 mg/5 mL (480 mL) [contains propylene glycol]


DiflunisalOutpatient Dosage FormsTablet, Oral:Generic:500 mg

DigoxinOutpatient Dosage FormsSolution, Oral:Generic: 50 mcg/mL (60 mL)

Tablet, Oral:Generic:125 mcg [BCF], 250 mcg [BCF]

DihydroergotamineOutpatient Dosage FormsSolution, Nasal, as mesylate:Generic: 4 mg/mL (1 mL)

DilTIAZemOutpatient Dosage FormsCapsule Extended Release 24 Hour, Oral, as hydrochloride:Generic: 120 mg [BCF], 180 mg [BCF], 240 mg [BCF], 300 mg [BCF],360 mg [BCF], 420 mg [BCF]

Tablet, Oral, as hydrochloride:Generic: 30 mg, 60 mg, 90 mg

DiphenhydrAMINE (Systemic)Outpatient Dosage FormsCapsule, Oral, as hydrochloride:Generic: 25 mg, 50 mg

Solution, Oral, as hydrochloride:Generic: 12.5 mg/5 mL (480 mL)

Diphenoxylate and AtropineOutpatient Dosage FormsSolution, Oral:Generic: Diphenoxylate hydrochloride 2.5 mg and atropine sulfate 0.025 mgper 5 mL (60 mL)

Tablet, Oral:Generic: 2.5/0.025: Diphenoxylate hydrochloride 2.5 mg and atropine sulfate0.025 mg

DipyridamoleOutpatient Dosage FormsTablet, Oral:Generic: 25 mg, 50 mg, 75 mg

DisopyramideOutpatient Dosage FormsCapsule, Oral:Generic: 100 mg, 150 mg

Capsule Extended Release 12 Hour, Oral:Norpace CR: 100 mg, 150 mg

DisulfiramOutpatient Dosage FormsTablet, Oral:Generic: 250 mg

DocusateOutpatient Dosage FormsCapsule, Oral, as calcium:Generic: 240 mg

Capsule, Oral, as sodium:Generic: 100 mg

Liquid, Oral, as sodium:Generic: 50 mg/5 mL (473 mL)

DonepezilOutpatient Dosage FormsTablet, Oral, as hydrochloride:Generic: 5 mg, 10 mg

DorzolamideOutpatient Dosage FormsSolution, Ophthalmic:Generic: 2% (10 mL)

Dorzolamide and TimololOutpatient Dosage FormsSolution, Ophthalmic:Generic: Dorzolamide hydrochloride 2% [strength expressed as base] andtimolol maleate 0.5% mg [strength expressed as base] (10 mL)

DoxazosinOutpatient Dosage FormsTablet, Oral:Generic: 1 mg, 2 mg, 4 mg, 8 mg

Doxepin (Systemic)Outpatient Dosage FormsCapsule, Oral:Generic: 10 mg [BCF], 25 mg [BCF], 50 mg [BCF], 75 mg [BCF]

Concentrate, Oral:Generic: 10 mg/mL (118 mL, 120 mL) [BCF]

DoxycyclineOutpatient Dosage FormsCapsule, Oral, as hyclate [strength expressed as base]:Generic: 100 mg [BCF]

Tablet, Oral, as hyclate [strength expressed as base]:Generic: 100 mg [BCF]

DoxylamineOutpatient Dosage FormsTablet, Oral, as succinate:Unisom: 25 mg

DulaglutideOutpatient Dosage FormsSolution Pen-injector, Subcutaneous [preservative free]:Trulicity: 0.75 mg/0.5 mL (0.5 mL); 1.5 mg/0.5 mL (0.5 mL) [contains poly-sorbate 80]

DULoxetineOutpatient Dosage FormsCapsule Delayed Release Particles, Oral:Generic: 20 mg, 30 mg, 60 mg

DutasterideOutpatient Dosage FormsCapsule, Oral:Generic: 0.5 mg

EconazoleOutpatient Dosage FormsCream, External, as nitrate:Generic: 1% (30 g)

EmollientsOutpatient Dosage FormsCream, External:Generic: (28 g, 454 g)

Liquid, External:Generic: (562 mL)

Lotion, External:Generic: (90 mL)

DIABETIC SUPPLIES

8

Ointment, External:Generic: (454 g)

EmpagliflozinOutpatient Dosage FormsTablet, Oral:Jardiance: 10 mg, 25 mg

Empagliflozin and MetforminOutpatient Dosage FormsTablet, Oral:Synjardy: Empagliflozin 5 mg and metformin hydrochloride 500 mg, Empagli-flozin 5 mg and metformin hydrochloride 1000 mg, Empagliflozin 12.5 mgand metformin hydrochloride 500 mg, Empagliflozin 12.5 mg and metforminhydrochloride 1000 mg [contains corn starch]

Tablet Extended Release 24 Hour, Oral:Synjardy XR: Empagliflozin 5 mg and metformin hydrochloride 1000 mg,Empagliflozin 10 mg and metformin hydrochloride 1000 mg [scored]

Synjardy XR: Empagliflozin 25 mg and metformin hydrochloride 1000 mg,Empagliflozin 12.5 mg and metformin hydrochloride 1000 mg [scored; con-tains fd&c blue #2 aluminum lake]

EnoxaparinOutpatient Dosage FormsSolution, Injection, as sodium:Lovenox: 300 mg/3 mL (3 mL) [contains benzyl alcohol; vial] [BCF]

Solution, Subcutaneous, as sodium [preservative free]:Generic: 30 mg/0.3 mL (0.3 mL) [BCF]; 40 mg/0.4 mL (0.4 mL) [BCF]; 60 mg/0.6 mL (0.6 mL) [BCF]; 80 mg/0.8 mL (0.8 mL) [BCF]; 100 mg/mL (1 mL)[BCF]; 120 mg/0.8 mL (0.8 mL) [BCF]; 150 mg/mL (1 mL) [BCF]

EPINEPHrine (Systemic)Outpatient Dosage FormsInjection, solution:Twinject: 0.15 mg/0.15 mL (1.1 mL) [contains chlorobutanol, sodium bisulfite;1:1000 solution; delivers 0.15 mg per injection]

Twinject: 0.3 mg/0.3 mL (1.1 mL) [contains chlorobutanol, sodium bisulfite;1:1000 solution; delivers 0.3 mg per injection]

ErgocalciferolOutpatient Dosage FormsCapsule, Oral:Generic: 50,000 iunits

Ergoloid MesylatesOutpatient Dosage FormsTablet, Oral:Generic: 1 mg

ErgotamineOutpatient Dosage FormsTablet Sublingual, Sublingual, as tartrate:Ergomar: 2 mg [contains fd&c blue #1 aluminum lake, fd&c yellow #10aluminum lake, saccharin sodium]

Erythromycin (Ophthalmic)Outpatient Dosage FormsOintment, Ophthalmic:Generic: 5 mg/g (1 g, 3.5 g) [BCF]

Erythromycin (Systemic)Outpatient Dosage FormsSuspension Reconstituted, Oral, as ethylsuccinate:EryPed: 200 mg/5 mL (100 mL) [fruit flavor] [BCF]EryPed 400: 400 mg/5 mL (100 mL) [banana flavor]

Tablet, Oral, as stearate:Erythrocin Stearate: 250 mg [BCF]

Tablet Delayed Release, Oral, as base:Ery-Tab: 250 mg [BCF], 500 mg

Erythromycin (Topical)Outpatient Dosage FormsGel, External:Generic: 2% (30 g, 60 g) [BCF]

Pad, External:Generic: 2% (60s)

Solution, External:Generic: 2% (60 mL) [BCF]

EscitalopramOutpatient Dosage FormsTablet, Oral:Lexapro: 10 mg, 20 mg [scored]Generic: 10 mg, 20 mg

Estradiol and LevonorgestrelOutpatient Dosage FormsPatch, Transdermal:ClimaraPro: Estradiol 0.045 mg and levonorgestrel 0.015 mg per 24 hours(4s) [22 cm2; contains estradiol 4.4 mg and levonorgestrel 1.39 mg]

Estradiol (Systemic)Outpatient Dosage FormsPatch Weekly, Transdermal:Generic: 0.025 mg/24 hours (4s) [BCF]; 0.0375 mg/24 hours (4s) [BCF];0.05 mg/24 hours (4s) [BCF]; 0.06 mg/24 hours (4s) [BCF]; 0.075 mg/24hours (4s) [BCF]; 0.1 mg/24 hours (4s) [BCF]

Tablet, Oral:Generic: 0.5 mg, 1 mg, 2 mg

Estradiol (Topical)Outpatient Dosage FormsRing, Vaginal, as base:Estring: 2 mg (1 ea)

Tablet, Vaginal, as base:Generic: 10 mcg

Estrogens (Conjugated/Equine) and MedroxyprogesteroneOutpatient Dosage FormsTablet, Oral:Premphase: conjugated estrogens 0.625 mg [14 tablets] and conjugatedestrogen 0.625 mg/medroxyprogesterone acetate 5 mg [14 tablets] [containsfd&c blue #2 (indigotine), fd&c red #40]

Prempro: 0.3/1.5: Conjugated estrogens 0.3 mg and medroxyprogesteroneacetate 1.5 mg [BCF]

Prempro: 0.45/1.5: Conjugated estrogens 0.45 mg and medroxyprogesteroneacetate 1.5 mg [BCF]

Prempro: 0.625/2.5: Conjugated estrogens 0.625 mg and medroxyprogester-one acetate 2.5 mg [BCF]

Prempro: 0.625/5: Conjugated estrogens 0.625 mg and medroxyprogesteroneacetate 5 mg [BCF]

Estrogens (Conjugated/Equine, Systemic)Outpatient Dosage FormsTablet, Oral:Premarin: 0.3 mg [BCF], 0.45 mg [BCF], 0.625 mg [BCF], 0.9 mg,1.25 mg [BCF]

Estrogens (Conjugated/Equine, Topical)Outpatient Dosage FormsCream, Vaginal:Premarin: 0.625 mg/g (30 g) [BCF]

Estrogens (Esterified)Outpatient Dosage FormsTablet, Oral:Menest: 0.625 mg

Estrogens (Esterified) and MethyltestosteroneOutpatient Dosage FormsTablet, Oral:Generic: Esterified estrogen 0.625 mg and methyltestosterone 1.25 mg;esterified estrogens 1.25 mg and methyltestosterone 2.5 mg

EtanerceptOutpatient Dosage FormsSolution Auto-injector, Subcutaneous [preservative free]:Enbrel SureClick: 50 mg/mL (0.98 mL)

Solution Prefilled Syringe, Subcutaneous [preservative free]:Enbrel: 50 mg/mL (0.98 mL)

Solution Reconstituted, Subcutaneous:Enbrel: 25 mg (1 ea) [contains benzyl alcohol]

EthambutolOutpatient Dosage FormsTablet, Oral, as hydrochloride:Generic: 100 mg [BCF], 400 mg [BCF]

Ethinyl Estradiol and DesogestrelOutpatient Dosage FormsTablet, Oral:Apri: Ethinyl estradiol 0.03 mg and desogestrel 0.15 mgAzurette:Day 1-21: Ethinyl estradiol 0.02 mg and desogestrel 0.15 mg [21 whitetablets]

Day 22-23: 2 inactive green tabletsDay 24-28: Ethinyl estradiol 0.01 mg [5 blue tablets] (28s)

Ethinyl Estradiol and DrospirenoneOutpatient Dosage FormsTablet, Oral:Yasmin: Ethinyl estradiol 0.03 mg and drospirenone 3 mg [21 yellow activetablets and 7 white inactive tablets] (28s) [BCF]

Yaz: Ethinyl estradiol 0.02 mg and drospirenone 3 mg [24 light pink activetablets and 4 white inactive tablets] (28s) [BCF]

Ethinyl Estradiol and EtonogestrelOutpatient Dosage FormsRing, Vaginal:NuvaRing: Ethinyl estradiol 0.015 mg and etonogestrel 0.12 mg per 24 hours(1 ea) [latex free]

ETHINYL ESTRADIOL AND ETONOGESTREL

9

Ethinyl Estradiol and LevonorgestrelOutpatient Dosage FormsTablet, Oral:Jolessa: Ethinyl estradiol 0.03 mg and levonorgestrel 0.15 mg (91s) [84 pinktablets and 7 white inactive tablets] [BCF]

Lessina: Ethinyl estradiol 0.02 mg and levonorgestrel 0.1 mg [21 pink tabletsand 7 white inactive tablets] (28s) [BCF]

Levora: Ethinyl estradiol 0.03 mg and levonorgestrel 0.15 mg (28s) [21 whitetablets and 7 peach inactive tablets] [BCF]

Ethinyl Estradiol and NorelgestrominOutpatient Dosage FormsPatch, Transdermal:Ortho Evra: Ethinyl estradiol 0.75 mg and norelgestromin 6 mg [releasesethinyl estradiol 20 mcg and norelgestromin 150 mcg per day] (3s)

Ethinyl Estradiol and NorethindroneOutpatient Dosage FormsTablet, Oral:Loestrin Fe 1.5/30: Ethinyl estradiol 0.03 mg and norethindrone acetate1.5 mg [21 pink tablets] and ferrous fumarate 75 mg [7 brown tablets] (28s)

Norinyl 1+35: Ethinyl estradiol 0.035 mg and norethindrone 1 mg (28s) [21yellow-green tablets and 7 orange inactive tablets] [BCF]

Ethinyl Estradiol and NorgestimateOutpatient Dosage FormsTablet, Oral:MonoNessa: Ethinyl estradiol 0.035 mg and norgestimate 0.25 mg [21 bluetablets and 7 green inactive tablets] [BCF]

Ortho Tri-Cyclen Lo:Day 1-7: Ethinyl estradiol 0.025 mg and norgestimate 0.18 mg [7 whitetablets]

Day 8-14: Ethinyl estradiol 0.025 mg and norgestimate 0.215 mg [7 light bluetablets]

Day 15-21: Ethinyl estradiol 0.025 mg and norgestimate 0.25 mg [7 darkblue tablets]

Day 22-28: 7 green inactive tablets (28s)TriNessa [BCF]:Day 1-7: Ethinyl estradiol 0.035 mg and norgestimate 0.18 mg [7 whitetablets]

Day 8-14: Ethinyl estradiol 0.035 mg and norgestimate 0.215 mg [7 light bluetablets]

Day 15-21: Ethinyl estradiol 0.035 mg and norgestimate 0.25 mg [7 bluetablets]

Day 22-28: 7 green inactive tablets

Ethinyl Estradiol and NorgestrelOutpatient Dosage FormsTablet, Oral:Ogestrel: Ethinyl estradiol 0.05 mg and norgestrel 0.5 mg [21 tablets and 7inactive tablets]

Tablet, Oral [monophasic formulation]:Lo/Ovral-28: Ethinyl estradiol 0.03 mg and norgestrel 0.3 mg [21 white tabletsand 7 pink inactive tablets]

EthosuximideOutpatient Dosage FormsCapsule, Oral:Generic: 250 mg

Syrup, Oral:Generic: 250 mg/5 mL (473 mL)

ExenatideOutpatient Dosage FormsAuto-injector, Subcutaneous:Bydureon BCise: 2 mg/0.85 mL (0.85 mL) [BCF]

Pen-injector, Subcutaneous:Bydureon: 2 mg (1 ea) [BCF]

Suspension Reconstituted, Subcutaneous:Bydureon: 2 mg [BCF] [4 vials per kit]

EzetimibeOutpatient Dosage FormsTablet, Oral:Zetia: 10 mg

Ezetimibe and SimvastatinOutpatient Dosage FormsTablet, Oral:Vytorin 10/10: Ezetimibe 10 mg and simvastatin 10 mgVytorin 10/20: Ezetimibe 10 mg and simvastatin 20 mgVytorin 10/40: Ezetimibe 10 mg and simvastatin 40 mgVytorin 10/80: Ezetimibe 10 mg and simvastatin 80 mg

FamotidineOutpatient Dosage FormsTablet, Oral:Generic: 20 mg

Fenofibrate and DerivativesOutpatient Dosage FormsTablet, Oral, as fenofibrate:TriCor: 48 mg [BCF], 145 mg [BCF] [contains soybean lecithin]Generic: 54 mg, 160 mg

FentaNYLOutpatient Dosage FormsPatch, Transdermal, as base:Generic: 12 [delivers 12.5 mcg/hr] (5s); 100 [delivers 100 mcg/hr] (5s); 25[delivers 25 mcg/hr] (5s); 50 [delivers 50 mcg/hr] (5s); 75 [delivers 75 mcg/hr] (5s)

Ferrous SulfateOutpatient Dosage FormsLiquid, Oral:Generic: 75 mg/mL (50 mL) [elemental iron 15 mg/mL]

Tablet, Oral:Generic: 325 mg [elemental iron 65 mg]

FexofenadineOutpatient Dosage FormsTablet, Oral, as hydrochloride:Generic: 60 mg, 180 mg

FinasterideOutpatient Dosage FormsTablet, Oral:Generic: 5 mg [BCF]

FlecainideOutpatient Dosage FormsTablet, Oral, as acetate:Generic: 50 mg, 100 mg, 150 mg

FluconazoleOutpatient Dosage FormsTablet, Oral:Generic: 50 mg, 100 mg, 150 mg [BCF], 200 mg

FludrocortisoneOutpatient Dosage FormsTablet, Oral, as acetate:Generic: 0.1 mg

Fluocinolone (Topical)Outpatient Dosage FormsOil, External, as acetonide:Generic: 0.01% (118 mL)

FluocinonideOutpatient Dosage FormsCream, External:Generic: 0.05% (15 g, 30 g, 60 g, 120 g) [BCF]

Gel, External:Generic: 0.05% (15 g, 60 g)

Ointment, External:Generic: 0.05% (15 g, 60 g)

Solution, External:Generic: 0.05% (60 mL)

FluorideOutpatient Dosage FormsCream, Oral, as sodium [toothpaste]:Generic: 1.1% (51 g) [equivalent to fluoride 2.5 mg/dose]

Gel, External, as sodium:Generic: 1.1% (56 g) [equivalent to fluoride 2 mg/dose]

Solution, Oral, as sodium:Generic: 1.1 mg/mL (50 mL) [equivalent to fluoride 0.5 mg/mL]

Tablet, Chewable, Oral, as sodium:Generic: 2.2 mg [equivalent to fluoride 1 mg]

FluorometholoneOutpatient Dosage FormsOintment, Ophthalmic, as base:FML: 0.1% (3.5 g)

Suspension, Ophthalmic, as acetate:Flarex: 0.1% (5 mL) [contains benzalkonium chloride]

Fluorouracil (Topical)Outpatient Dosage FormsCream, External:Generic: 5% (40 g)

FLUoxetineOutpatient Dosage FormsCapsule, Oral:Generic: 10 mg [BCF], 20 mg [BCF], 40 mg [BCF]

Solution, Oral:Generic: 20 mg/5 mL (5 mL, 120 mL) [BCF]

ETHINYL ESTRADIOL AND LEVONORGESTREL

10


FluoxymesteroneOutpatient Dosage FormsTablet, Oral:Androxy: 10 mg [scored]

FluPHENAZineOutpatient Dosage FormsConcentrate, Oral, as hydrochloride:Generic: 5 mg/mL (118 mL)

Tablet, Oral, as hydrochloride:Generic: 1 mg, 2.5 mg, 5 mg

FlurandrenolideOutpatient Dosage FormsTape, External:Cordran: 4 mcg/cm2 (1 ea)

Flurbiprofen (Ophthalmic)Outpatient Dosage FormsSolution, Ophthalmic, as sodium:Generic: 0.03% (2.5 mL)

Flurbiprofen (Systemic)Outpatient Dosage FormsTablet, Oral:Generic: 100 mg

FlutamideOutpatient Dosage FormsCapsule, Oral:Generic: 125 mg

Fluticasone and SalmeterolOutpatient Dosage FormsAerosol, for Oral Inhalation:Advair HFA: 45/21: Fluticasone propionate 45 mcg and salmeterol 21 mcg perinhalation (12 g) [chlorofluorocarbon free; 120 metered actuations] [BCF]

Advair HFA: 115/21: Fluticasone propionate 115 mcg and salmeterol 21 mcgper inhalation (12 g) [chlorofluorocarbon free; 120 metered actuations] [BCF]

Advair HFA: 230/21: Fluticasone propionate 230 mcg and salmeterol 21 mcgper inhalation (12 g) [chlorofluorocarbon free; 120 metered actuations] [BCF]

Powder, for Oral Inhalation:Advair Diskus: 100/50: Fluticasone propionate 100 mcg and salmeterol 50mcg (14s, 60s) [contains lactose] [BCF]

Advair Diskus: 250/50: Fluticasone propionate 250 mcg and salmeterol 50mcg (14s, 60s) [contains lactose] [BCF]

Advair Diskus: 500/50: Fluticasone propionate 500 mcg and salmeterol 50mcg (14s, 60s) [contains lactose] [BCF]

Fluticasone (Nasal)Outpatient Dosage FormsSuspension, Nasal, as propionate:Generic: 50 mcg/inhalation (16 g) [BCF]

Fluticasone (Oral Inhalation)Outpatient Dosage FormsAerosol, Inhalation, as propionate:Flovent HFA: 44 mcg/inhalation (10.6 g) [chlorofluorocarbon free; 120 meteredactuations] [BCF]

Flovent HFA: 110 mcg/inhalation (12 g) [chlorofluorocarbon free; 120 meteredactuations] [BCF]

Flovent HFA: 220 mcg/inhalation (12 g) [chlorofluorocarbon free; 120 meteredactuations] [BCF]

Aerosol Powder Breath Activated, Inhalation, as propionate:Flovent Diskus: 50 mcg (60s) [contains lactose] [BCF]Flovent Diskus: 100 mcg (60s) [contains lactose] [BCF]Flovent Diskus: 250 mcg (60s) [contains lactose] [BCF]

Folic AcidOutpatient Dosage FormsTablet, Oral:Generic: 1 mg [BCF]

FormoterolOutpatient Dosage FormsCapsule, Inhalation, as fumarate:Foradil Aerolizer: 12 mcg [DSC] [contains milk protein]

FurosemideOutpatient Dosage FormsSolution, Oral:Generic: 10 mg/mL (60 mL, 120 mL) [BCF]


GabapentinOutpatient Dosage FormsCapsule, Oral:Generic: 100 mg [BCF], 300 mg [BCF], 400 mg [BCF]

Solution, Oral:Generic: 250 mg/5 mL (470 mL)


GemfibrozilOutpatient Dosage FormsTablet, Oral:Generic: 600 mg [BCF]

Gentamicin (Ophthalmic)Outpatient Dosage FormsOintment, Ophthalmic:Gentak: 0.3% (3.5 g) [BCF]Generic: 0.3% (3.5 g) [BCF]

Solution, Ophthalmic:Generic: 0.3% (5 mL, 15 mL) [BCF]

GlimepirideOutpatient Dosage FormsTablet, Oral:Generic: 1 mg, 2 mg, 4 mg

GlipiZIDEOutpatient Dosage FormsTablet, Oral:Generic: 5 mg [BCF], 10 mg [BCF]

Tablet Extended Release 24 Hour, Oral:Generic: 2.5 mg, 5 mg, 10 mg

GlucagonOutpatient Dosage FormsKit, Injection:Glucagon Emergency: 1 mg [contains lactose]

GlyBURIDEOutpatient Dosage FormsTablet, Oral:Generic: 1.25 mg [BCF], 2.5 mg [BCF], 5 mg [BCF]

Tablet, Oral [micronized]:Generic: 1.5 mg [BCF], 3 mg [BCF], 5 mg [BCF], 6 mg [BCF]

Glyburide and MetforminOutpatient Dosage FormsTablet, Oral:Generic:1.25 mg/250 mg: Glyburide 1.25 mg and metformin hydrochloride 250 mg2.5 mg/500 mg: Glyburide 2.5 mg and metformin hydrochloride 500 mg5 mg/500 mg: Glyburide 5 mg and metformin hydrochloride 500 mg

GlycerinOutpatient Dosage FormsSuppository, Rectal [adult]:Generic: 82.5% (12s, 25s, 50s, 100s)

Suppository, Rectal [pediatric]:Generic: 82.5% (12s)

Glycopyrrolate (Systemic)Outpatient Dosage FormsTablet, Oral:Generic: 1 mg

GranisetronOutpatient Dosage FormsTablet, Oral:Generic: 1 mg

GriseofulvinOutpatient Dosage FormsSuspension, Oral:Generic: 125 mg/5 mL (120 mL) [BCF]

Tablet, Oral:Gris-PEG: 125 mg [BCF], 250 mg [BCF] [scored]Generic: 125 mg [BCF], 250 mg [BCF]

GuaiFENesinOutpatient Dosage FormsTablet Extended Release 12 Hour, Oral:Generic: 600 mg

Guaifenesin and CodeineOutpatient Dosage FormsSolution, Oral:Generic: Guaifenesin 100 mg and codeine phosphate 10 mg per 5 mL(118 mL)

GUAIFENESIN AND CODEINE

11

Guaifenesin and DextromethorphanOutpatient Dosage FormsSyrup, Oral:Generic: Guaifenesin 100 mg and dextromethorphan hydrobromide 10 mg per5 mL (120 mL)

Tablet, Extended Release, Oral:Generic: Guaifenesin 600 mg and dextromethorphan hydrobromide 30 mg

Guaifenesin and PseudoephedrineOutpatient Dosage FormsTablet Extended Release 12 Hour, Oral:Generic: Guaifenesin 600 mg and pseudoephedrine hydrochloride 60 mg

GuanFACINEOutpatient Dosage FormsTablet Extended Release 24 Hour, Oral:Generic: 1 mg, 2 mg, 3 mg, 4 mg

HaloperidolOutpatient Dosage FormsConcentrate, Oral, as lactate [strength expressed as base]:Generic: 2 mg/mL (120 mL)

Tablet, Oral:Generic: 0.5 mg, 1 mg, 2 mg, 5 mg

HeparinOutpatient Dosage FormsSolution, Injection, as sodium:Generic: 10,000 units/mL (1 mL)

HydrALAZINEOutpatient Dosage FormsTablet, Oral, as hydrochloride:Generic: 10 mg [BCF], 25 mg [BCF], 50 mg [BCF]

HydroCHLOROthiazideOutpatient Dosage FormsCapsule, Oral:Generic:12.5 mg [BCF]


Hydrochlorothiazide and TriamtereneOutpatient Dosage FormsTablet, Oral:Generic: Hydrochlorothiazide 25 mg and triamterene 37.5 mg [BCF]; hydro-chlorothiazide 50 mg and triamterene 75 mg [BCF]

Hydrocodone and AcetaminophenOutpatient Dosage FormsSolution, Oral (C-II):Generic: Hydrocodone bitartrate 7.5 mg and acetaminophen 325 mg per 15mL (473 mL)

Tablet, Oral (C-II):Generic:Hydrocodone bitartrate 5 mg and acetaminophen 325 mgHydrocodone bitartrate 7.5 mg and acetaminophen 325 mgHydrocodone bitartrate 10 mg and acetaminophen 325 mg

Hydrocodone and ChlorpheniramineOutpatient Dosage FormsSuspension, Extended Release, Oral (C-II):Generic: Hydrocodone polistirex [equivalent to hydrocodone bitartrate 10 mg]and chlorpheniramine polistirex [equivalent to chlorpheniramine maleate8 mg] per 5 mL (115 mL)

Hydrocortisone (Systemic)Outpatient Dosage FormsSolution Reconstituted, Injection, as sodium succinate [strength expressed asbase, preservative free]:Solu-CORTEF: 100 mg (1 ea)

Tablet, Oral, as base:Generic: 5 mg, 20 mg

Hydrocortisone (Topical)Outpatient Dosage FormsCream, External, as base:Generic: 1% (28.4 g); 2.5% (30 g) [BCF]

Cream, External, as valerate:Generic: 0.2% (15 g)

Lotion, External, as base:Generic: 1% (118 mL)

Ointment, External, as valerate:Generic: 0.2% (45 g)

Suppository, Rectal, as acetate:Generic: 25 mg (12s) [BCF]

Suspension, Rectal, as base:Generic: 100 mg/60 mL (60 mL)

HYDROmorphoneOutpatient Dosage FormsTablet, Oral, as hydrochloride:Generic: 2 mg, 8 mg

HydroxychloroquineOutpatient Dosage FormsTablet, Oral, as sulfate:Generic: 200 mg [equivalent to 155 mg base]

Hydroxypropyl CelluloseOutpatient Dosage FormsInsert, Ophthalmic [preservative free]:Lacrisert: 5 mg (60 ea)

Hydroxypropyl MethylcelluloseOutpatient Dosage FormsGel, Ophthalmic:Generic: 0.3% (3.5 g, 10 g)

Solution, Ophthalmic [preservative free]:Generic: 0.3% (15 mL)

HydroxyureaOutpatient Dosage FormsCapsule, Oral:Generic: 500 mg

HydrOXYzineOutpatient Dosage FormsSyrup, Oral, as hydrochloride:Generic: 10 mg/5 mL (118 mL, 473 mL) [BCF]

Tablet, Oral, as hydrochloride:Generic: 10 mg [BCF], 25 mg [BCF], 50 mg [BCF]

Hyoscyamine, Atropine, Scopolamine, and PhenobarbitalOutpatient Dosage FormsTablet, Oral:Generic: Hyoscyamine sulfate 0.1037 mg, atropine sulfate 0.0194 mg, scopol-amine hydrobromide 0.0065 mg, and phenobarbital 16.2 mg

IbandronateOutpatient Dosage FormsTablet, Oral:Boniva: 150 mg

IbuprofenOutpatient Dosage FormsSuspension, Oral:Generic: 100 mg/5 mL (120 mL)


ImipramineOutpatient Dosage FormsCapsule, Oral, as pamoate:Generic: 75 mg [BCF]


IndomethacinOutpatient Dosage FormsCapsule, Oral:Generic: 25 mg [BCF], 50 mg [BCF]

Capsule, Extended Release, Oral:Generic: 75 mg

Suppository, Rectal:Indocin: 50 mg (30s)

Inhalation DevicesOutpatient Dosage FormsHolding Chamber with Mask:AeroChamber: Small, medium, or large mask

Inhalation Kit:InspirEase

Insulin AspartOutpatient Dosage FormsSolution, Subcutaneous:NovoLOG: 100 units/mL (10 mL) [contains metacresol, phenol] [BCF]

Solution Cartridge, Subcutaneous:NovoLOG Penfill: 100 units/mL (3 mL) [contains metacresol, phenol] [BCF]

Solution Pen-injector, Subcutaneous:NovoLOG FlexPen: 100 units/mL (3 mL) [contains metacresol, phenol] [BCF]

Insulin Aspart Protamine and Insulin AspartOutpatient Dosage FormsInjection, Suspension:NovoLOG Mix 70/30: Insulin aspart protamine suspension 70% [intermediateacting] and insulin aspart solution 30% [rapid acting]: 100 units/mL (10 mL)

GUAIFENESIN AND DEXTROMETHORPHAN

12

NovoLOG Mix 70/30 FlexPen: 100 units/mL: Insulin aspart protamine suspen-sion 70% [intermediate acting] and insulin aspart solution 30% [rapid-acting](3 mL) [BCF]

Insulin DetemirOutpatient Dosage FormsSolution, Injection:Levemir: 100 units/mL (10 mL)

Insulin GlargineOutpatient Dosage FormsSolution, Subcutaneous:Lantus: 100 units/mL (10 mL) [contains metacresol] [BCF]

Solution Pen-injector, Subcutaneous:Lantus Solostar: 100 units/mL (3 mL) [BCF]

Insulin NPHOutpatient Dosage FormsSuspension, Subcutaneous:NovoLIN N: 100 units/mL (10 mL) [contains metacresol, phenol] [BCF]

Insulin NPH and Insulin RegularOutpatient Dosage FormsSuspension, Subcutaneous:NovoLIN 70/30: Insulin NPH suspension 70% [intermediate acting] and insulinregular solution 30% [short acting]: 100 units/mL (10 mL) [contains meta-cresol, phenol] [BCF]

Insulin RegularOutpatient Dosage FormsSolution, Injection:NovoLIN R: 100 units/mL (10 mL) [contains metacresol] [BCF]

Interferon Beta-1bOutpatient Dosage FormsKit, Subcutaneous:Betaseron: 0.3 mg [contains albumin human] [BCF]

Ipratropium and AlbuterolOutpatient Dosage FormsSolution for Nebulization:Generic: Ipratropium bromide 0.5 mg and albuterol (base) 2.5 mg per 3mL (30s)

Solution, for Oral Inhalation [spray]:Combivent Respimat: Ipratropium bromide 20 mcg and albuterol (base) 100mcg per inhalation (4 g) [contains benzalkonium chloride; 120 meteredactuations]

Ipratropium (Oral Inhalation)Outpatient Dosage FormsAerosol Solution, Inhalation, as bromide:Atrovent HFA: 17 mcg/actuation (12.9 g) [contains alcohol, usp] [BCF]

Solution, Inhalation, as bromide [preservative free]:Generic: 0.02% (2.5 mL)

IsoniazidOutpatient Dosage FormsSolution, Oral:Generic: 50 mg/5 mL (473 mL)


Isosorbide DinitrateOutpatient Dosage FormsCapsule Extended Release, Oral:Dilatrate-SR: 40 mg


Tablet Extended Release, Oral:Generic: 40 mg [BCF]

Isosorbide MononitrateOutpatient Dosage FormsTablet, Extended Release, Oral:Generic: 30 mg [BCF], 60 mg [BCF], 120 mg [BCF]

ISOtretinoin (Systemic)Outpatient Dosage FormsCapsule, Oral:Amnesteem: 40 mg [contains soybean oil]Claravis: 10 mg, 20 mg [contains soybean oil]

IvabradineOutpatient Dosage FormsTablet, Oral:Corlanor: 5 mg [scored]Corlanor: 7.5 mg

Ketoconazole (Systemic)Outpatient Dosage FormsTablet, Oral:Generic: 200 mg

Ketoconazole (Topical)Outpatient Dosage FormsShampoo, External:Generic: 2% (120 mL)

Ketorolac (Ophthalmic)Outpatient Dosage FormsSolution, Ophthalmic, as tromethamine:Generic: 0.4% (5 mL)

Ketotifen (Ophthalmic)Outpatient Dosage FormsSolution, Ophthalmic:Generic: 0.025% (5 mL)

LabetalolOutpatient Dosage FormsTablet, Oral, as hydrochloride:Generic: 100 mg, 200 mg, 300 mg

Lactic Acid and Ammonium HydroxideOutpatient Dosage FormsCream, External:Generic: Lactic acid 12% with ammonium hydroxide (280 g, 385 g)

LactobacillusOutpatient Dosage FormsCapsule, Oral:Generic: L. acidophilus 100 active units

LactuloseOutpatient Dosage FormsSolution, Oral:Generic: 10 g/15 mL (15 mL, 30 mL, 236 mL, 237 mL, 473 mL, 500 mL, 946mL, 1892 mL) [BCF]

LamoTRIgineOutpatient Dosage FormsTablet, Oral:Generic: 25 mg, 100 mg, 150 mg, 200 mg

Tablet, Chewable, Oral:Generic: 5 mg, 25 mg

LanolinOutpatient Dosage FormsOintment, External:Generic: 30 g

LatanoprostOutpatient Dosage FormsSolution, Ophthalmic:Generic: 0.005% (2.5 mL) [BCF]

LeflunomideOutpatient Dosage FormsTablet, Oral:Generic: 10 mg, 20 mg

LetrozoleOutpatient Dosage FormsTablet, Oral:Generic: 2.5 mg

Leucovorin CalciumOutpatient Dosage FormsTablet, Oral [strength expressed as base]:Generic: 5 mg

LevETIRAcetamOutpatient Dosage FormsTablet, Oral:Generic: 250 mg, 500 mg, 750 mg, 1000 mg

LevOCARNitineOutpatient Dosage FormsSolution, Oral:Generic: 100 mg/mL (118 mL)


LevoFLOXacin (Systemic)Outpatient Dosage FormsSolution, Oral:Generic: 25 mg/mL (100 mL, 200 mL, 480 mL) [BCF]

LEVOFLOXACIN (SYSTEMIC)

13


Levonorgestrel (Systemic)Outpatient Dosage FormsTablet, Oral:Plan B One-Step: 1.5 mg

LevothyroxineOutpatient Dosage FormsTablet, Oral, as sodium:Generic: 25 mcg [BCF], 50 mcg [BCF], 75 mcg [BCF], 88 mcg [BCF], 100mcg [BCF], 112 mcg [BCF], 125 mcg [BCF], 137 mcg [BCF], 150 mcg[BCF], 175 mcg [BCF], 200 mcg [BCF], 300 mcg [BCF]

Lidocaine (Topical)Outpatient Dosage FormsCream, External:Generic: 4% (5 g, 15 g, 30 g)

Gel, External, as hydrochloride:Generic: 2% (30 mL)

Ointment, External:Generic: 5% (35.4 g, 50 g)

Patch, External:Generic: 5% (30 ea)

Solution, Mouth/Throat, as hydrochloride:Generic: 2% (100 mL)

LiothyronineOutpatient Dosage FormsTablet, Oral:Generic: 5 mcg, 25 mcg

LisdexamfetamineOutpatient Dosage FormsCapsule, Oral, as dimesylate:Vyvanse: 20 mg, 30 mg, 40 mg, 50 mg, 60 mg, 70 mg

LisinoprilOutpatient Dosage FormsTablet, Oral:Generic: 2.5 mg [BCF], 5 mg [BCF], 10 mg [BCF], 20 mg [BCF], 30 mg[BCF], 40 mg [BCF]

Lisinopril and HydrochlorothiazideOutpatient Dosage FormsTablet, Oral:Generic:10/12.5: Lisinopril 10 mg and hydrochlorothiazide 12.5 mg [BCF]20/12.5: Lisinopril 20 mg and hydrochlorothiazide 12.5 mg [BCF]20/25: Lisinopril 20 mg and hydrochlorothiazide 25 mg [BCF]

LithiumOutpatient Dosage FormsCapsule, Oral, as carbonate:Generic: 150 mg [BCF], 300 mg [BCF]

Solution, Oral, as citrate:Generic: 300 mg/5 mL (5 mL, 500 mL) [equivalent to amount of lithium inlithium carbonate] [BCF]

Tablet Extended Release, Oral, as carbonate:Generic: 300 mg

LomustineOutpatient Dosage FormsCapsule, Oral:CeeNU: 10 mg, 40 mg, 100 mg

LoperamideOutpatient Dosage FormsCapsule, Oral, as hydrochloride:Generic: 2 mg [BCF]

LoratadineOutpatient Dosage FormsSyrup, Oral:Generic: 5 mg/5 mL (120 mL)


LORazepamOutpatient Dosage FormsTablet, Oral:Generic: 0.5 mg, 1 mg

LosartanOutpatient Dosage FormsTablet, Oral, as potassium:Generic: 25 mg [BCF], 50 mg [BCF], 100 mg [BCF]

Losartan and HydrochlorothiazideOutpatient Dosage FormsTablet, Oral:Generic:50/12.5: Losartan potassium 50 mg and hydrochlorothiazide 12.5 mg [BCF]100/12.5: Losartan potassium 100 mg and hydrochlorothiazide12.5 mg [BCF]

100/25: Losartan potassium 100 mg and hydrochlorothiazide 25 mg [BCF]

LurasidoneOutpatient Dosage FormsTablet, Oral, as hydrochloride:Latuda: 20 mg, 40 mg, 60 mgLatuda: 80 mg [contains fd&c blue #2 aluminum lake]Latuda: 120 mg

Magnesium CitrateOutpatient Dosage FormsSolution, Oral:Generic: 290 mg/5 mL (296 mL)

Magnesium HydroxideOutpatient Dosage FormsSuspension, Oral:Generic: 400 mg/5 mL (30 mL, 360 mL, 473 mL)

Magnesium OxideOutpatient Dosage FormsTablet, Oral:Generic: 400 mg [equivalent to elemental magnesium 240 mg]

MeclizineOutpatient Dosage FormsTablet, Oral, as hydrochloride:Generic: 12.5 mg, 25 mg

Medium Chain TriglyceridesOutpatient Dosage FormsOil, Oral:Generic: 14 g/15 mL (960 mL)

MedroxyPROGESTERoneOutpatient Dosage FormsSuspension, Intramuscular, as acetate:Generic: 150 mg/mL (1 mL)

Tablet, Oral, as acetate:Generic: 2.5 mg [BCF], 5 mg [BCF], 10 mg [BCF]

MegestrolOutpatient Dosage FormsSuspension, Oral, as acetate:Megace ES: 125 mg/mL (150 mL) [contains ethanol 0.06%, sodium benzoate;lemon-lime flavor]

Generic: 40 mg/mL (240 mL)Tablet, Oral, as acetate:Generic: 20 mg, 40 mg

MeloxicamOutpatient Dosage FormsTablet, Oral:Generic: 7.5 mg [BCF], 15 mg [BCF]

MelphalanOutpatient Dosage FormsTablet, Oral:Alkeran: 2 mg

MeperidineOutpatient Dosage FormsSolution, Injection, as hydrochloride:Demerol: 75 mg/mL (1 mL); 100 mg/mL (1 mL)

Solution, Oral, as hydrochloride:Generic: 50 mg/5 mL (500 mL)

Tablet, Oral, as hydrochloride:Generic: 50 mg

MercaptopurineOutpatient Dosage FormsTablet, Oral:Generic: 50 mg

MesalamineOutpatient Dosage FormsCapsule Extended Release 24 Hour, Oral:Apriso: 0.375 g [contains aspartame]

Suppository, Rectal:Canasa: 1000 mg (30s) [contains saturated vegetable fatty esters]

Suspension, Rectal:Generic: 4 g/60 mL (7s)

LEVOFLOXACIN (SYSTEMIC)

14

Tablet Delayed Release, Oral:Lialda: 1.2 g [BCF]

MetFORMINOutpatient Dosage FormsTablet, Oral, as hydrochloride:Generic: 500 mg [BCF], 850 mg [BCF], 1000 mg [BCF]

Tablet Extended Release 24 Hour, Oral, as hydrochloride:Generic: 500 mg [BCF], 750 mg [BCF]

MethadoneOutpatient Dosage FormsTablet, Oral, as hydrochloride:Generic: 5 mg

MethazolAMIDEOutpatient Dosage FormsTablet, Oral:Generic: 50 mg

MethenamineOutpatient Dosage FormsTablet, Oral, as hippurate:Generic: 1 g

MethIMAzoleOutpatient Dosage FormsTablet, Oral:Generic: 5 mg, 10 mg

MethocarbamolOutpatient Dosage FormsTablet, Oral:Generic: 500 mg [BCF]

MethotrexateOutpatient Dosage FormsSolution, Injection:Generic: 25 mg/mL (10 mL)

Tablet, Oral:Generic: 2.5 mg [BCF]

Methoxsalen (Systemic)Outpatient Dosage FormsCapsule, Oral:Oxsoralen-Ultra: 10 mg [soft-gelatin capsule]

MethyldopaOutpatient Dosage FormsTablet, Oral:Generic: 250 mg, 500 mg

MethylergonovineOutpatient Dosage FormsTablet, Oral, as maleate:Generic: 0.2 mg

MethylphenidateOutpatient Dosage FormsCapsule Extended Release, Oral, as hydrochloride:Metadate CD: 10 mg [contains sucrose; 3 mg immediate release, 7 mgextended release]

Metadate CD: 20 mg [contains sucrose; 6 mg immediate release, 14 mgextended release]

Metadate CD: 30 mg [contains sucrose; 9 mg immediate release, 21 mgextended release]

Patch, Transdermal:Daytrana: 10 mg/9 hours (30s) [12.5 cm2, total methylphenidate 27.5 mg]Daytrana: 15 mg/9 hours (30s) [18.75 cm2, total methylphenidate 41.3 mg]Daytrana: 20 mg/9 hours (30s) [25 cm2, total methylphenidate 55 mg]Daytrana: 30 mg/9 hours (30s) [37.5 cm2, total methylphenidate 82.5 mg]


Tablet Extended Release 24 Hour, Oral, as hydrochloride:Generic: 18 mg [BCF], 27 mg [BCF], 36 mg [BCF], 54 mg [BCF]

MethylPREDNISoloneOutpatient Dosage FormsTablet, Oral:Generic: 4 mg, 8 mg, 32 mg

Tablet Therapy Pack, Oral:Generic: 4 mg [21 ea]

MetoclopramideOutpatient Dosage FormsSolution, Oral:Generic: 5 mg/5 mL (10 mL, 473 mL) [BCF]


MetOLazoneOutpatient Dosage FormsTablet, Oral:Generic: 2.5 mg, 5 mg

MetoprololOutpatient Dosage FormsTablet, Oral, as tartrate:Generic: 25 mg [BCF], 50 mg [BCF], 100 mg [BCF]

Tablet Extended Release 24 Hour, Oral, as succinate:Generic: 25 mg [BCF], 50 mg [BCF], 100 mg [BCF], 200 mg [BCF]

MetroNIDAZOLE (Systemic)Outpatient Dosage FormsTablet, Oral:Generic: 250 mg [BCF], 500 mg [BCF]

MetroNIDAZOLE (Topical)Outpatient Dosage FormsCream, External:Generic: 0.75% (45 g)

Gel, External:Generic: 1% (60 g)

Gel, Vaginal:Generic: 0.75% (70 g) [BCF]

Miconazole (Topical)Outpatient Dosage FormsCream, External, as nitrate:Generic: 2% (30 g)

Kit, Vaginal, as nitrate:Generic: Cream, topical: 2% (9 g) and Suppository, vaginal: 200 mg (3s)

MidazolamOutpatient Dosage FormsSyrup, Oral:Generic: 2 mg/mL (118 mL)

MidodrineOutpatient Dosage FormsTablet, Oral, as hydrochloride:Generic: 2.5 mg, 5 mg

MilnacipranOutpatient Dosage FormsMiscellaneous, Oral:Savella Titration Pack: 12.5 & 25 & 50 mg (55 ea) [contains fd&c blue #2aluminum lake]

Tablet, Oral:Savella: 12.5 mg [contains fd&c blue #2 aluminum lake]Savella: 25 mg, 50 mgSavella: 100 mg [contains fd&c red #40 aluminum lake]

Mineral OilOutpatient Dosage FormsEnema, Rectal:Generic: (135 mL)

Oil, Oral:Generic: 100% (3840 mL)

Minocycline (Systemic)Outpatient Dosage FormsCapsule, Oral:Generic: 50 mg, 100 mg

Minoxidil (Systemic)Outpatient Dosage FormsTablet, Oral:Generic: 2.5 mg, 10 mg

MirabegronOutpatient Dosage FormsTablet Extended Release 24 hour, Oral:Myrbetriq: 25 mg, 50 mg

MirtazapineOutpatient Dosage FormsTablet, Oral:Generic: 15 mg, 30 mg, 45 mg

MiSOPROStolOutpatient Dosage FormsTablet, Oral:Generic: 100 mcg, 200 mcg

Mometasone (Oral Inhalation)Outpatient Dosage FormsAerosol Powder Breath Activated, Inhalation, as furoate:Asmanex: 110 mcg (30 units) [contains lactose; delivers 100 mcg/actuation]

MOMETASONE (ORAL INHALATION)

15

Asmanex: 220 mcg (14 units, 30 units, 60 units, 120 units) [contains lactose;delivers 200 mcg/actuation]

MontelukastOutpatient Dosage FormsPacket, Oral:Singulair: 4 mg/packet (30s) [BCF]Generic: 4 mg/packet (1s, 30s) [BCF]

Tablet, Oral:Singulair: 10 mg [contains lactose 89.3 mg/tablet] [BCF]Generic: 10 mg [BCF]

Tablet Chewable, Oral:Singulair: 4 mg [contains phenylalanine 0.67 mg/tablet; cherry flavor] [BCF]Singulair: 5 mg [contains phenylalanine 0.84 mg/tablet; cherry flavor] [BCF]Generic: 4 mg [BCF], 5 mg [BCF]

Morphine (Systemic)Outpatient Dosage FormsSolution, Injection, as sulfate:Generic: 10 mg/mL (1 mL)

Solution, Oral, as sulfate:Generic: 10 mg/5 mL (500 mL); 100 mg/5 mL (120 mL)

Tablet, Oral, as sulfate:Generic: 15 mg, 30 mg

Tablet Extended Release, Oral, as sulfate:Generic: 15 mg [BCF], 30 mg [BCF], 60 mg [BCF], 100 mg [BCF],200 mg [BCF]

Moxifloxacin (Ophthalmic)Outpatient Dosage FormsSolution, Ophthalmic:Vigamox: 0.5% (3 mL)

Moxifloxacin (Systemic)Outpatient Dosage FormsTablet, Oral:Avelox: 400 mg

MupirocinOutpatient Dosage FormsCream, External, as calcium [strength expressed as base]:Bactroban Cream: 2% (15 g, 30 g) [contains benzyl alcohol]

Ointment, External:Generic: 2% (22 g) [BCF]

MycophenolateOutpatient Dosage FormsCapsule, Oral, as mofetil:Generic: 250 mg

NadololOutpatient Dosage FormsTablet, Oral:Generic: 20 mg, 40 mg, 80 mg

NaloxoneOutpatient Dosage FormsLiquid, Nasal:Narcan: 4 mg/0.1 mL (1 ea) [contains benzalkonium chloride, edetate diso-dium] [BCF]

Naphazoline and PheniramineOutpatient Dosage FormsSolution, Ophthalmic:Generic: Naphazoline hydrochloride 0.027% and pheniramine maleate 0.3%(15 mL) [contains benzalkonium chloride]

NaproxenOutpatient Dosage FormsSuspension, Oral:Generic: 125 mg/5 mL (500 mL) [BCF]

Tablet, Oral:Generic: 250 mg [BCF], 375 mg, 500 mg [BCF]

Tablet, Oral, as sodium:Generic: 275 mg [equivalent to naproxen base 250 mg], 550 mg [equivalent tonaproxen base 500 mg]

NebivololOutpatient Dosage FormsTablet, Oral:Bystolic: 5 mg, 10 mg, 20 mg

NeomycinOutpatient Dosage FormsTablet, Oral, as sulfate:Generic: 500 mg

Neomycin, Polymyxin B, and DexamethasoneOutpatient Dosage FormsOintment, Ophthalmic:Generic: Neomycin 3.5 mg, polymyxin B sulfate 10,000 units, and dexame-thasone 0.1% per g (3.5 g)

Suspension, Ophthalmic [drops]:Generic: Neomycin 3.5 mg, polymyxin B sulfate 10,000 units, and dexame-thasone 0.1% per 1 mL (5 mL)

Neomycin, Polymyxin B, and GramicidinOutpatient Dosage FormsSolution, Ophthalmic [drops]:Generic: Neomycin 1.75 mg, polymyxin B 10,000 units, and gramicidin0.025 mg per 1 mL (10 mL) [BCF]

Neomycin, Polymyxin B, and Hydrocortisone (Otic)Outpatient Dosage FormsSuspension, Otic:Generic: Neomycin 3.5 mg, polymyxin B 10,000 units, and hydrocortisone10 mg per 1 mL (10 mL) [BCF]

NeostigmineOutpatient Dosage FormsTablet, Oral, as bromide:Prostigmin: 15 mg [scored]

NiacinOutpatient Dosage FormsTablet Extended Release, Oral:Niaspan: 500 mg [BCF], 750 mg [BCF], 1000 mg [BCF]

NicotineOutpatient Dosage FormsGum, Mouth/Throat, as polacrilex:Generic: 2 mg (110s) [BCF]; 4 mg (110s) [BCF]

Patch 24 Hour, Transdermal:Generic: 7 mg/24 hours (7s) [BCF]; 14 mg/24 hours (7s) [BCF]; 21 mg/24hours (7s) [BCF]

NIFEdipineOutpatient Dosage FormsTablet Extended Release 24 Hour, Oral:Generic: 30 mg [BCF], 60 mg [BCF], 90 mg [BCF]

NitrofurantoinOutpatient Dosage FormsCapsule, Oral, as macrocrystals:Macrodantin: 25 mg [BCF]Generic: 50 mg [BCF]

Capsule, Oral, as monohydrate/macrocrystals:Generic: 100 mg [BCF]

Suspension, Oral:Generic: 25 mg/5 mL (230 mL)

NitroglycerinOutpatient Dosage FormsCapsule Extended Release, Oral:Generic: 2.5 mg

Ointment, Transdermal:Nitro-Bid: 2% (60 g) [~15 mg/inch]

Patch 24 Hour, Transdermal:Generic: 0.1 mg/hour (30s) [BCF]; 0.2 mg/hour (30s) [BCF]; 0.4 mg/hour(30s) [BCF]; 0.6 mg/hour (30s) [BCF]

Solution, Translingual:Generic: 0.4 mg/spray (12 g) [BCF]

Tablet, Sublingual:Nitrostat: 0.3 mg, 0.4 mg [BCF], 0.6 mg

NorethindroneOutpatient Dosage FormsTablet, Oral:Generic: 0.35 mg [BCF]

Tablet, Oral, as acetate:Generic: 5 mg

NortriptylineOutpatient Dosage FormsCapsule, Oral:Generic: 10 mg [BCF], 25 mg [BCF], 50 mg [BCF], 75 mg

Solution, Oral:Generic: 10 mg/5 mL (473 mL, 480 mL) [BCF]

Nystatin and TriamcinoloneOutpatient Dosage FormsCream, External:Generic: Nystatin 100,000 units and triamcinolone acetonide 0.1% (15 g)

MOMETASONE (ORAL INHALATION)

16

Nystatin (Oral)Outpatient Dosage FormsSuspension, Mouth/Throat:Generic: 100,000 units/mL (5 mL, 60 mL, 473 mL) [BCF]

Tablet, Oral:Generic: 500,000 units

Nystatin (Topical)Outpatient Dosage FormsCream, External:Generic: 100,000 units/g (15 g, 30 g) [BCF]

Ointment, External:Generic: 100,000 units/g (15 g, 30 g) [BCF]

Oatmeal (Colloidal)Outpatient Dosage FormsPacket, ExternalGeneric: (8 ea)

Ofloxacin (Ophthalmic)Outpatient Dosage FormsSolution, Ophthalmic:Generic: 0.3% (5 mL)

OLANZapineOutpatient Dosage FormsTablet, Oral:Generic: 2.5 mg, 5 mg, 7.5 mg, 10 mg, 15 mg, 20 mg

OlodaterolOutpatient Dosage FormsAerosol Solution, Inhalation:Striverdi Respimat: 2.5 mcg/actuation (4 g) [contains benzalkonium chloride,edetate disodium]

Olopatadine (Ophthalmic)Outpatient Dosage FormsSolution, Ophthalmic:Patanol: 0.1% (5 mL) [contains benzalkonium chloride] [BCF]Generic: 0.1% (5 mL) [BCF]

Omega-3 Fatty AcidsOutpatient Dosage FormsCapsule, Oral:Generic: 1 g

OmeprazoleOutpatient Dosage FormsCapsule Delayed Release, Oral:Generic: 10 mg [BCF], 20 mg [BCF]

OndansetronOutpatient Dosage FormsTablet, Oral:Generic: 4 mg, 8 mg

Tablet Disintegrating, Oral:Generic: 4 mg, 8 mg

OseltamivirOutpatient Dosage FormsCapsule, Oral, as phosphate:Generic: 30 mg, 45 mg, 75 mg

Suspension Reconstituted, Oral, as base:Generic: 6 mg/mL (60 mL)

OxaprozinOutpatient Dosage FormsTablet, Oral:Generic: 600 mg

OxazepamOutpatient Dosage FormsCapsule, Oral:Generic: 10 mg, 15 mg

OXcarbazepineOutpatient Dosage FormsSuspension, Oral:Generic: 300 mg/5 mL (250 mL)

Tablet, Oral:Generic: 150 mg, 300 mg, 600 mg

OxybutyninOutpatient Dosage FormsSyrup, Oral, as chloride:Generic: 5 mg/5 mL (473 mL)

Tablet, Oral, as chloride:Generic: 5 mg

Tablet Extended Release 24 Hour, Oral, as chloride:Generic: 5 mg [BCF], 10 mg [BCF], 15 mg [BCF]

OxyCODONEOutpatient Dosage FormsTablet, Oral, as hydrochloride [immediate release]:Generic: 5 mg, 15 mg, 30 mg

Oxycodone and AcetaminophenOutpatient Dosage FormsTablet, Oral:Generic: 5/325: Oxycodone hydrochloride 5 mg and acetaminophen325 mg [BCF]

Oxymetazoline (Nasal)Outpatient Dosage FormsSolution, Nasal, as hydrochloride:Generic: 0.05% (15 mL)

PancrelipaseOutpatient Dosage FormsCapsule, Delayed Release, Enteric Coated Microspheres, Oral [porcinederived]:Creon: Lipase 6000 units, protease 19,000 units, and amylase 30,000units [BCF]

Creon: Lipase 12,000 units, protease 38,000 units, and amylase 60,000units [BCF]

Creon: Lipase 24,000 units, protease 76,000 units, and amylase 120,000units [BCF]

Capsule, Delayed Release, Enteric Coated Microtablets [porcine derived]:Pancreaze: Lipase 4200 units, protease 10,000 units, and amylase 17,500units

Pancreaze: Lipase 10,500 units, protease 25,000 units, and amylase 43,750units



PantoprazoleOutpatient Dosage FormsTablet Delayed Release, Oral:Generic: 20 mg, 40 mg

PARoxetineOutpatient Dosage FormsTablet, Oral, as hydrochloride [strength expressed as base]:Generic: 10 mg, 20 mg, 30 mg, 40 mg

Tablet Extended Release 24 hour, Oral, as hydrochloride [strength expressedas base]:Generic: 12.5 mg, 25 mg, 37.5 mg

Penicillin V PotassiumOutpatient Dosage FormsSolution Reconstituted, Oral:Generic: 125 mg/5 mL (100 mL, 200 mL) [BCF]; 250 mg/5 mL (100 mL, 200mL) [BCF]


PentoxifyllineOutpatient Dosage FormsTablet Extended Release, Oral:Generic: 400 mg

PermethrinOutpatient Dosage FormsCream, External:Generic: 5% (60 g) [BCF]

Lotion, External:Generic: 1% (60 mL)

PerphenazineOutpatient Dosage FormsTablet, Oral:Generic: 2 mg, 4 mg, 16 mg

PhenazopyridineOutpatient Dosage FormsTablet, Oral, as hydrochloride:Generic: 100 mg [BCF], 200 mg [BCF]

PHENobarbitalOutpatient Dosage FormsElixir, Oral:Generic: 20 mg/5 mL (473 mL) [BCF]


PhenolOutpatient Dosage FormsSolution, External:Generic: 240 mL

PHENOL

17

PhenoxybenzamineOutpatient Dosage FormsCapsule, Oral, as hydrochloride:Generic: 10 mg

Phenylephrine (Nasal)Outpatient Dosage FormsSolution, intranasal, as hydrochloride [spray]: 0.25% (15 mL); 0.5% (15 mL)

Phenylephrine (Ophthalmic)Outpatient Dosage FormsSolution, Ophthalmic, as hydrochloride:AK-Dilate: 10% (5 mL) [contains benzalkonium chloride]Generic: 2.5% (15 mL)

PhenytoinOutpatient Dosage FormsCapsule, Oral, as sodium:Generic: 100 mg [BCF]

Suspension, Oral:Generic: 100 mg/4 mL (4 mL) [BCF]; 125 mg/5 mL (237 mL, 240 mL) [BCF]

Tablet Chewable, Oral:Dilantin: 50 mg [scored] [BCF]Generic: 50 mg [BCF]

PhytonadioneOutpatient Dosage FormsTablet, Oral:Mephyton: 5 mg [scored]

Pilocarpine (Ophthalmic)Outpatient Dosage FormsGel, Ophthalmic, as hydrochloride:Pilopine HS: 4% (4 g) [contains benzalkonium chloride] [BCF]

Solution, Ophthalmic, as hydrochloride:Generic: 1% (15 mL) [BCF]; 2% (15 mL) [BCF]; 4% (15 mL) [BCF]

Pilocarpine (Systemic)Outpatient Dosage FormsTablet, Oral, as hydrochloride:Generic: 5 mg

PimecrolimusOutpatient Dosage FormsCream, External:Elidel: 1% (30 g) [BCF] [contains benzyl alcohol]Generic: 1% (30 g) [BCF]

PioglitazoneOutpatient Dosage FormsTablet, Oral:Generic: 15 mg, 30 mg, 45 mg

Pioglitazone and GlimepirideOutpatient Dosage FormsTablet, Oral:Generic: 30/2: Pioglitazone 30 mg and glimepiride 2 mg, 30/4: Pioglitazone30 mg and glimepiride 4 mg

Pioglitazone and MetforminOutpatient Dosage FormsTablet, Oral:Generic: 15/500: Pioglitazone 15 mg and metformin hydrochloride 500 mg;15/850: Pioglitazone 15 mg and metformin hydrochloride 850 mg

Piroxicam (Systemic)Outpatient Dosage FormsCapsule, Oral:Generic: 20 mg

PodofiloxOutpatient Dosage FormsGel, External:Condylox: 0.5% (3.5 g)

Polyethylene Glycol 3350Outpatient Dosage FormsPowder, Oral:Generic: 17 g/dose (238 g)

Polyethylene Glycol-Electrolyte SolutionOutpatient Dosage FormsPowder for Solution, Oral:Generic: PEG 3350 240 g, sodium sulfate 22.72 g, sodium bicarbonate6.72 g, sodium chloride 5.84 g, and potassium chloride 2.98 g (4000 mL)

Potassium ChlorideOutpatient Dosage FormsCapsule Extended Release, Oral:Generic: 10 mEq [BCF]

Packet, Oral:Epiklor: 20 mEq/packet (30s, 100s) [sugar free; orange flavor] [BCF]Klor-Con: 20 mEq/packet (30s, 100s) [sugar free; fruit flavor] [BCF]Generic: 20 mEq (30 ea, 100 ea) [BCF]

Solution, Oral:Generic: 20 mEq/15 mL (15 mL, 30 mL, 473 mL) [BCF]

Tablet Extended Release, Oral:Generic: 10 mEq [BCF]; 20 mEq [BCF]

Potassium CitrateOutpatient Dosage FormsTablet, Extended Release, Oral:Generic: 540 mg, 1080 mg

Potassium Phosphate and Sodium PhosphateOutpatient Dosage FormsTablet, Oral:K-Phos Neutral: Monobasic potassium phosphate 155 mg, dibasic sodiumphosphate 852 mg, and monobasic sodium phosphate 130 mg [scored;equivalent to elemental phosphorus 250 mg (8 mmol), sodium 298 mg (13mEq), and potassium 45 mg (1.1 mEq)]

Povidone-Iodine (Topical)Outpatient Dosage FormsOintment, External:Generic: 10% (30 g)

Solution, External:Generic: 10% (473 mL)

PramipexoleOutpatient Dosage FormsTablet, Oral, as dihydrochloride monohydrate:Generic: 0.125 mg, 0.25 mg, 0.5 mg, 1 mg, 1.5 mg

PramoxineOutpatient Dosage FormsLotion, External, as hydrochloride:Generic: 1% (240 mL)

Pramoxine and HydrocortisoneOutpatient Dosage FormsAerosol, Foam, External:Epifoam: Pramoxine hydrochloride 1% and hydrocortisone acetate 1% (10 g)

Cream, External:Generic: Pramoxine hydrochloride 1% and hydrocortisone acetate 1% (30 g)

PrasugrelOutpatient Dosage FormsTablet, Oral:Effient: 5 mg, 10 mg

PravastatinOutpatient Dosage FormsTablet, Oral, as sodium:Generic: 10 mg [BCF], 20 mg [BCF], 40 mg [BCF], 80 mg [BCF]

PrazosinOutpatient Dosage FormsCapsule, Oral:Generic: 1 mg, 2 mg, 5 mg

PrednisoLONE (Ophthalmic)Outpatient Dosage FormsSuspension, Ophthalmic, as acetate [drops]:Pred Mild: 0.12% (5 mL, 10 mL) [contains benzalkonium chloride, sodiumbisulfite] [BCF]

Generic: 1% (5 mL, 10 mL, 15 mL) [BCF]

PrednisoLONE (Systemic)Outpatient Dosage FormsSolution, Oral, as sodium phosphate [strength expressed as base]:Pediapred: 5 mg/5 mL (120 mL) [dye free; raspberry flavor]Generic: 15 mg/5 mL (237 mL) [alcohol free, dye free] [BCF]

PredniSONEOutpatient Dosage FormsSolution, Oral:Generic: 1 mg/mL (500 mL)

Tablet, Oral:Generic: 1 mg [BCF], 5 mg [BCF], 10 mg [BCF], 20 mg [BCF], 50 mg

PregabalinOutpatient Dosage FormsCapsule, Oral:Lyrica: 25 mg, 50 mg, 75 mg, 100 mg, 150 mg, 200 mg, 225 mg, 300 mg

PrimaquineOutpatient Dosage FormsTablet, Oral, as phosphate:Generic: 26.3 mg [15 mg base]

PHENOXYBENZAMINE

18

PrimidoneOutpatient Dosage FormsTablet, Oral:Generic: 50 mg, 250 mg

ProbenecidOutpatient Dosage FormsTablet, Oral:Generic: 500 mg [BCF]

ProcarbazineOutpatient Dosage FormsCapsule, Oral, as hydrochloride:Matulane: 50 mg

ProchlorperazineOutpatient Dosage FormsSuppository, Rectal:Generic: 25 mg (12s)

Tablet, Oral, as maleate [strength expressed as base]:Generic: 5 mg

ProgesteroneOutpatient Dosage FormsGel, Vaginal:Crinone: 8% (1.45 g) [contains palm oil; 90 mg/dose]

Suppository, Vaginal [compounding kit]:First-Progesterone VGS 25: 25 mg (30s)First-Progesterone VGS 50: 50 mg (30s)First-Progesterone VGS 100: 100 mg (30s)First-Progesterone VGS 200: 200 mg (30s)

PromethazineOutpatient Dosage FormsSuppository, Rectal, as hydrochloride:Generic: 12.5 mg (12s) [BCF]; 25 mg (12s) [BCF]

Syrup, Oral, as hydrochloride:Generic: 6.25 mg/5 mL (118 mL, 473 mL) [BCF]


PropanthelineOutpatient Dosage FormsTablet, Oral, as bromide:Generic: 15 mg

PropranololOutpatient Dosage FormsCapsule, Extended Release, Oral, as hydrochloride:Generic: 60 mg, 80 mg, 120 mg, 160 mg

Solution, Oral, as hydrochloride:Generic: 4 mg/mL (500 mL)

Tablet, Oral, as hydrochloride:Generic: 10 mg, 20 mg, 40 mg, 80 mg

PropylthiouracilOutpatient Dosage FormsTablet, Oral:Generic: 50 mg [BCF]

ProtriptylineOutpatient Dosage FormsTablet, Oral, as hydrochloride:Generic:5 mg, 10 mg

PseudoephedrineOutpatient Dosage FormsSyrup, Oral, as hydrochloride:Generic: 30 mg/5 mL (118 mL)


PyrazinamideOutpatient Dosage FormsTablet, Oral:Generic: 500 mg [BCF]

PyridostigmineOutpatient Dosage FormsTablet, Oral, as bromide:Generic: 60 mg

Tablet, Sustained Release, Oral, as bromide:Mestinon Timespan: 180 mg [scored]

PyridoxineOutpatient Dosage FormsTablet, Oral, as hydrochloride:Generic: 50 mg

QUEtiapineOutpatient Dosage FormsTablet, oral: 25 mg [BCF], 50 mg [BCF], 100 mg [BCF], 200 mg [BCF],300 mg [BCF], 400 mg [BCF]

Tablet, extended release, oral:SEROquel XR®: 50 mg [BCF], 150 mg [BCF], 200 mg [BCF], 300 mg [BCF],400 mg [BCF]

QuiNIDineOutpatient Dosage FormsTablet, oral, as sulfate: 200 mgTablet, extended release, oral, as gluconate: 324 mg [equivalent to quinidinebase 202 mg]

Tablet, extended release, oral, as sulfate: 300 mg [equivalent to quinidine base249 mg]

RABEprazoleOutpatient Dosage FormsTablet Delayed Release, Oral, as sodium:AcipHex: 20 mgGeneric: 20 mg

RaloxifeneOutpatient Dosage FormsTablet, Oral, as hydrochloride:Evista: 60 mg [BCF]Generic: 60 mg [BCF]

RamelteonOutpatient Dosage FormsTablet, Oral:Rozerem: 8 mg

RamiprilOutpatient Dosage FormsCapsule, Oral:Generic: 1.25 mg [BCF], 2.5 mg [BCF], 5 mg [BCF], 10 mg [BCF]

RaNITIdineOutpatient Dosage FormsSyrup, Oral:Generic: 15 mg/mL (480 mL) [BCF]


ReserpineOutpatient Dosage FormsTablet, Oral:Generic: 0.25 mg

Ribavirin (Oral Inhalation)Outpatient Dosage FormsSolution Reconstituted, Inhalation [preservative free]:Virazole: 6 g (1 ea)

RifAMPinOutpatient Dosage FormsCapsule, Oral:Generic: 150 mg, 300 mg [BCF]

Rifampin and IsoniazidOutpatient Dosage FormsCapsule, Oral:Rifamate: Rifampin 300 mg and isoniazid 150 mg

RiluzoleOutpatient Dosage FormsTablet, Oral:Generic: 50 mg

RisperiDONEOutpatient Dosage FormsSolution, Oral:Generic: 1 mg/mL (30 mL) [BCF]

Tablet, Oral:Generic: 0.25 mg [BCF], 0.5 mg [BCF], 1 mg [BCF], 2 mg [BCF], 3 mg[BCF], 4 mg [BCF]

Tablet, Orally Disintegrating, Oral:Generic: 0.5 mg, 1 mg, 2 mg

RivaroxabanOutpatient Dosage FormsTablet, Oral:Xarelto: 15 mg, 20 mg

Tablet Therapy Pack, Oral:Xarelto Starter Pack: 15 mg (42 ea) and 20 mg (9 ea)

RIVAROXABAN

19

RizatriptanOutpatient Dosage FormsTablet, Oral:Maxalt: 5 mg [BCF], 10 mg [BCF]Generic: 5 mg [BCF], 10 mg [BCF]

Tablet Dispersible, Oral:Maxalt-MLT: 5 mg [BCF],10 mg [BCF] [contains aspartame; peppermintflavor]

Generic: 5 mg [BCF], 10 mg [BCF]

ROPINIRoleOutpatient Dosage FormsTablet, Oral:Generic: 5 mg [BCF], 10 mg [BCF] 0.25 mg, 0.5 mg, 1 mg, 2 mg, 3 mg,4 mg, 5 mg

Sacubitril and ValsartanOutpatient Dosage FormsTablet, Oral:Entresto: Sacubitril 24 mg and valsartan 26 mg, Sacubitril 49 mg and valsar-tan 51 mg, Sacubitril 97 mg and valsartan 103 mg

Salicylic AcidOutpatient Dosage FormsGel, External:Generic: 6% (40 g); 17.6% (7 g)

SalmeterolOutpatient Dosage FormsAerosol Powder Breath Activated, Inhalation:Serevent Diskus: 50 mcg (28s, 60s) [contains lactose] [BCF]

SalsalateOutpatient Dosage FormsTablet, Oral:Disalcid: 500 mg [BCF], 750 mg [BCF]Generic: 500 mg [BCF], 750 mg [BCF]

Scopolamine (Ophthalmic)Outpatient Dosage FormsSolution, Ophthalmic, as hydrobromide [drops]:Isopto Hyoscine: 0.25% (5 mL) [contains benzalkonium chloride]

Scopolamine (Systemic)Outpatient Dosage FormsPatch 72 Hour, Transdermal:Transderm Scōp: 1.5 mg (4s) [contains metal; releases ~1 mg over 72 hours]

SelegilineOutpatient Dosage FormsCapsule, Oral, as hydrochloride:Generic: 5 mg


Selenium SulfideOutpatient Dosage FormsLotion, External:Generic: 2.5% (120 mL) [BCF]

SennaOutpatient Dosage FormsTablet, Oral:Sennosides 8.6 mg

SertralineOutpatient Dosage FormsConcentrate, Oral:Generic: 20 mg/mL (60 mL) [BCF]


SevelamerOutpatient Dosage FormsTablet, Oral, as carbonate:Generic: 800 mg

SildenafilOutpatient Dosage FormsTablet, Oral:Viagra: 25 mg [BCF], 50 mg [BCF], 100 mg [BCF]Generic: 20 mg [ECF]

Silver SulfadiazineOutpatient Dosage FormsCream, External:Generic: 1% (20 g, 400 g) [BCF]

SimethiconeOutpatient Dosage FormsSuspension, Oral [drops]:Generic: 40 mg/0.6 mL (30 mL)


SimvastatinOutpatient Dosage FormsTablet, Oral:Generic: 5 mg [BCF], 10 mg [BCF], 20 mg [BCF], 40 mg [BCF], 80 mg

SitaGLIPtinOutpatient Dosage FormsTablet, Oral:Januvia: 25 mg [BCF], 50 mg [BCF], 100 mg [BCF]

Sitagliptin and MetforminOutpatient Dosage FormsTablet, Oral:Janumet 50/500: Sitagliptin 50 mg and metformin hydrochloride500 mg [BCF]

Janumet 50/1000: Sitagliptin 50 mg and metformin hydrochloride1000 mg [BCF]

Tablet, Extended Release, Oral:Janumet XR: 50/500: Sitagliptin 50 mg and metformin hydrochloride 500 mgJanumet XR: 50/1000: Sitagliptin 50 mg and metformin hydrochloride1000 mg

Janumet XR: 100/1000: Sitagliptin 100 mg and metformin hydrochloride1000 mg

Sodium BicarbonateOutpatient Dosage FormsTablet, Oral:Generic: 650 mg [7.6 mEq]

Sodium ChlorideOutpatient Dosage FormsOintment, Ophthalmic [preservative free]:Generic: 5% (3.5 g)

Solution, for Inhalation [preservative free]:Generic: 0.9% (3 mL); 10% (15 mL)

Solution, Intranasal [spray]:Generic: 0.65% (45 mL)

Solution, Ophthalmic [drops]:Generic: 5% (15 mL)

Sodium Citrate and Citric AcidOutpatient Dosage FormsSolution, Oral:Generic: Sodium citrate 500 mg and citric acid 334 mg per 5 mL (473 mL)[equivalent to bicarbonate 1 mEq/mL]

Sodium PhosphatesOutpatient Dosage FormsSolution, Rectal [enema]:Generic: Monobasic sodium phosphate monohydrate 19 g and dibasic sodiumphosphate heptahydrate 7 g per 118 mL delivered dose (133 mL)

Solution, Rectal [enema, pediatric]:Generic: Monobasic sodium phosphate monohydrate 9.5 g and dibasicsodium phosphate heptahydrate 3.5 g per 59 mL delivered dose (66 mL)[contains sodium 2.2 g/59 mL]

Sodium Polystyrene SulfonateOutpatient Dosage FormsSuspension, Oral:Generic: 15 g/60 mL (60 mL)

SorbitolOutpatient Dosage FormsSolution, Oral:Generic: 70% (480 mL)

SotalolOutpatient Dosage FormsTablet, Oral, as hydrochloride:Generic: 80 mg, 120 mg, 160 mg

SpironolactoneOutpatient Dosage FormsTablet, Oral:Generic: 25 mg [BCF], 100 mg

SucralfateOutpatient Dosage FormsSuspension, Oral:Generic: 1 g/10 mL (10 mL, 420 mL)

Tablet, Oral:Generic: 1 g

RIZATRIPTAN

20

Sulfacetamide and PrednisoloneOutpatient Dosage FormsSuspension, Ophthalmic [drops]:Blephamide: Sulfacetamide sodium 10% and prednisolone acetate 0.2% (5mL) [contains benzalkonium chloride]

Sulfacetamide (Ophthalmic)Outpatient Dosage FormsSolution, Ophthalmic, as sodium [drops]:Generic: 10% (15 mL) [BCF]

Sulfamethoxazole and TrimethoprimOutpatient Dosage FormsSuspension, Oral:Generic: Sulfamethoxazole 200 mg and trimethoprim 40 mg per 5 mL (20 mL,473 mL) [BCF]

Tablet, Oral:Generic: Sulfamethoxazole 400 mg and trimethoprim 80 mg [BCF]; Sulame-thoxazole 800 mg and trimethoprim 160 mg [BCF]

SulfanilamideOutpatient Dosage FormsCream, Vaginal:AVC Vaginal: 15% (120 g) [contains methylparaben, propylene glycol, propyl-paraben, trolamine (triethanolamine)]

SulfaSALAzineOutpatient Dosage FormsTablet, Oral:Generic: 500 mg [BCF]

Tablet Delayed Release, Oral:Generic: 500 mg [BCF]

Sulfur and Salicylic AcidOutpatient Dosage FormsShampoo, External:Generic: Micropulverized sulfur 2% and salicylic acid 2% (120 mL, 240 mL)

Sulfur and SulfacetamideOutpatient Dosage FormsLotion, External:Generic: Sulfur 5% and sulfacetamide sodium 10% (30 g)

SulindacOutpatient Dosage FormsTablet, Oral:Generic: 200 mg

SUMAtriptanOutpatient Dosage FormsSolution Auto-injector, Subcutaneous, as succinate [strength expressed asbase]:Generic: 6 mg/0.5 mL (0.5 mL) [BCF]

Solution, Nasal:Generic: 5 mg/0.1 mL (6s); 20 mg/0.1 mL (6s)

Tablet, Oral, as succinate [strength expressed as base]:Generic: 25 mg [BCF], 50 mg [BCF], 100 mg [BCF]

Surgical LubricantOutpatient Dosage FormsGel, External:Generic: 128 g

Tacrolimus (Systemic)Outpatient Dosage FormsCapsule, Oral:Generic: 0.5 mg, 1 mg, 5 mg

TamoxifenOutpatient Dosage FormsTablet, Oral:Generic: 10 mg [BCF], 20 mg [BCF]

TamsulosinOutpatient Dosage FormsCapsule, Oral, as hydrochloride:Generic: 0.4 mg [BCF]

TapentadolOutpatient Dosage FormsTablet, Oral:Nucynta: 50 mg, 75 mg, 100 mg

TelmisartanOutpatient Dosage FormsTablet, Oral:Micardis: 20 mg, 40 mg [scored], 80 mg [scored]

Telmisartan and HydrochlorothiazideOutpatient Dosage FormsTablet, Oral:Micardis HCT: 40/12.5: Telmisartan 40 mg and hydrochlorothiazide 12.5 mgMicardis HCT: 80/12.5: Telmisartan 80 mg and hydrochlorothiazide 12.5 mgMicardis HCT: 80/25: Telmisartan 80 mg and hydrochlorothiazide 25 mg

TemazepamOutpatient Dosage FormsCapsule, Oral:Generic: 15 mg [BCF], 30 mg [BCF]

TemozolomideOutpatient Dosage FormsCapsule, Oral:Generic: 5 mg, 20 mg, 100 mg, 250 mg

TerazosinOutpatient Dosage FormsCapsule, Oral:Generic: 1 mg [BCF], 2 mg [BCF], 5 mg [BCF], 10 mg [BCF]

Terbinafine (Topical)Outpatient Dosage FormsCream, External, as hydrochloride:Generic: 1% (30 g)

TerbutalineOutpatient Dosage FormsSolution, Injection, as sulfate:Generic: 1 mg/mL (1 mL)

Tablet, Oral, as sulfate:Generic: 2.5 mg, 5 mg

TerconazoleOutpatient Dosage FormsSuppository, Vaginal:Generic: 80 mg (3 ea)

TestosteroneOutpatient Dosage FormsGel, Transdermal:Fortesta: 10 mg/actuation (60 g) [contains ethanol; 0.5 g gel/actuation; 120metered actuations] [BCF]

Solution, Intramuscular, as cypionate:Generic : 200 mg/mL (1 mL)

Solution, Intramuscular, as enanthate:Generic: 200 mg/mL (5 mL)

Solution, Transdermal:Axiron: 30 mg/actuation (90 mL)

Tetracycline (Systemic)Outpatient Dosage FormsCapsule, Oral, as hydrochloride:Generic: 250 mg [BCF], 500 mg [BCF]

TheophyllineOutpatient Dosage FormsCapsule, Extended Release, Oral:Theo-24: 300 mg [BCF], 400 mg [BCF] [24 hours]

Solution, Oral:Generic: 80 mg/15 mL (473 mL) [BCF]

Tablet, Extended Release, Oral:Generic: 100 mg, 200 mg [BCF], 300 mg [BCF], 400 mg [BCF]

ThiamineOutpatient Dosage FormsTablet, Oral, as hydrochloride:Generic: 50 mg

ThioguanineOutpatient Dosage FormsTablet, Oral:Tabloid: 40 mg [scored]

ThioridazineOutpatient Dosage FormsTablet, Oral, as hydrochloride:Generic: 10 mg, 25 mg, 50 mg

ThiothixeneOutpatient Dosage FormsCapsule, Oral:Generic: 1 mg, 2 mg, 5 mg, 10 mg

Thrombin (Topical)Outpatient Dosage FormsPowder for Reconstitution, Topical [bovine derived]:Thrombin-JMI: 5000 int. units [supplied with diluent]Thrombin-JMI Pump Spray Kit: 20,000 int. units [supplied with diluent]

THROMBIN (TOPICAL)

21

TicagrelorOutpatient Dosage FormsTablet, Oral:Brilinta: 90 mg

Timolol (Ophthalmic)Outpatient Dosage FormsGel Forming Solution, Ophthalmic, as maleate [strength expressed as base]:Generic: 0.25% (5 mL) [BCF]; 0.5% (5 mL) [BCF]

Solution, Ophthalmic, as maleate [strength expressed as base]:Generic: 0.25% (5 mL, 10 mL, 15 mL) [BCF]; 0.5% (5 mL, 10 mL, 15mL) [BCF]

TiotropiumOutpatient Dosage FormsCapsule, Inhalation:Spiriva HandiHaler: 18 mcg [contains milk protein] [BCF]

Tiotropium and OlodaterolOutpatient Dosage FormsAerosol Solution, Inhalation:Stiolto Respimat: Tiotropium 2.5 mcg and olodaterol 2.5 mcg per actuation(4 g) [contains benzalkonium chloride, edetate disodium]

TiZANidineOutpatient Dosage FormsTablet, Oral:Generic: 2 mg, 4 mg

Tobramycin and DexamethasoneOutpatient Dosage FormsSuspension, Ophthalmic:Generic: Tobramycin 0.3% and dexamethasone 0.1%

Tobramycin (Ophthalmic)Outpatient Dosage FormsSolution, Ophthalmic:Generic: 0.3% (5 mL)

TolmetinOutpatient Dosage FormsCapsule, Oral:Generic: 400 mg

TolterodineOutpatient Dosage FormsCapsule Extended Release 24 Hour, Oral, as tartrate:Detrol LA: 2 mg [BCF], 4 mg [BCF]Generic: 2 mg [BCF], 4 mg [BCF]

TopiramateOutpatient Dosage FormsCapsule Sprinkle, Oral:Generic: 15 mg, 25 mg

Tablet, Oral:Generic: 25 mg, 50 mg, 100 mg, 200 mg

TorsemideOutpatient Dosage FormsTablet, Oral:Generic: 20 mg

TraMADolOutpatient Dosage FormsTablet, Oral, as hydrochloride:Generic: 50 mg [BCF]

TraZODoneOutpatient Dosage FormsTablet, Oral, as hydrochloride:Generic: 50 mg [BCF], 100 mg [BCF], 150 mg [BCF], 300 mg [BCF]

Tretinoin (Topical)Outpatient Dosage FormsCream, External:Generic: 0.025% (20 g, 45 g) [BCF]; 0.05% (20 g, 45 g) [BCF]

Gel, External:Generic: 0.025% (15 g, 20 g, 45 g)

Triamcinolone (Topical)Outpatient Dosage FormsAerosol Solution, External, as acetonide:Generic: 0.147 mg/g (63 g)

Cream, External, as acetonide:Generic: 0.1% (15 g, 30 g, 80 g, 454 g) [BCF]; 0.5% (15 g)

Ointment, External, as acetonide:Generic: 0.1% (15 g, 80 g, 454 g)

Paste, Mouth/Throat, as acetonide:Generic: 0.1% (5 g)

TriazolamOutpatient Dosage FormsTablet, Oral:Generic: 0.25 mg

TrifluoperazineOutpatient Dosage FormsTablet, Oral:Generic: 2 mg, 5 mg, 10 mg

TrifluridineOutpatient Dosage FormsSolution, Ophthalmic:Generic: 1% (7.5 mL)

TrihexyphenidylOutpatient Dosage FormsElixir, Oral, as hydrochloride:Generic: 0.4 mg/mL (473 mL) [BCF]


TrimethoprimOutpatient Dosage FormsTablet, Oral:Generic: 100 mg

Trimethoprim and Polymyxin BOutpatient Dosage FormsSolution, Ophthalmic:Generic: Trimethoprim 1 mg and polymyxin B sulfate 10,000 units per 1 mL(10 mL) [BCF]

Triprolidine and PseudoephedrineOutpatient Dosage FormsTablet, Oral:Generic: Triprolidine hydrochloride 2.5 mg and pseudoephedrine hydrochlor-ide 60 mg [scored]

TropicamideOutpatient Dosage FormsSolution, Ophthalmic:Generic: 1% (15 mL)

Umeclidinium and VilanterolOutpatient Dosage FormsAerosol Powder Breath Activated, Inhalation:Anoro Ellipta: Umeclidinium 62.5 mcg and vilanterol 25 mcg per inhalation (7dose, 30 dose) [contains milk protein]

Urea (Topical)Outpatient Dosage FormsCream, topical: 20% (90 g)Lotion, topical: 10% (180 mL)

ValACYclovirOutpatient Dosage FormsTablet, Oral:Generic: 500 mg, 1 g

Valproic Acid and DerivativesOutpatient Dosage FormsCapsule, Oral, Immediate Release, as valproic acid:Generic: 250 mg

Capsule, Sprinkle, Oral [strength expressed as valproic acid]:Generic: 125 mg [BCF]

Syrup, Oral, as valproate sodium:Generic: 250 mg/5 mL (473 mL) [strength expressed as valproic acid]

Tablet Delayed Release, Oral, as divalproex sodium:Generic: 125 mg [BCF], 250 mg [BCF], 500 mg [BCF]

Tablet Extended Release 24 Hour, Oral, as divalproex sodium:Generic: 250 mg [BCF], 500 mg [BCF]

ValsartanOutpatient Dosage FormsTablet, Oral:Diovan: 40 mg [scored] [BCF], 80 mg [BCF], 160 mg [BCF], 320 mg [BCF]Generic: 40 mg [BCF], 80 mg [BCF], 160 mg [BCF], 320 mg [BCF]

Valsartan and HydrochlorothiazideOutpatient Dosage FormsTablet, Oral:Diovan HCT: 80 mg/12.5 mg: Valsartan 80 mg and hydrochlorothiazide12.5 mg [BCF]

Diovan HCT: 160 mg/12.5 mg: Valsartan 160 mg and hydrochlorothiazide12.5 mg [BCF]

Diovan HCT: 160 mg/25 mg: Valsartan 160 mg and hydrochlorothiazide25 mg [BCF]

Diovan HCT: 320 mg/12.5 mg: Valsartan 320 mg and hydrochlorothiazide12.5 mg [BCF]

TICAGRELOR

22

Diovan HCT: 320 mg/25 mg: Valsartan 320 mg and hydrochlorothiazide25 mg [BCF]

Generic: 80 mg/12.5 mg: Valsartan 80 mg and hydrochlorothiazide12.5 mg [BCF]


Generic: 160 mg/25 mg: Valsartan 160 mg and hydrochlorothiazide25 mg [BCF]


Generic: 320 mg/25 mg: Valsartan 320 mg and hydrochlorothiazide25 mg [BCF]

VenlafaxineOutpatient Dosage FormsCapsule, Extended Release, Oral:Generic: 37.5 mg [BCF], 75 mg [BCF], 150 mg [BCF]

Tablet, Oral:Generic: 25 mg [BCF], 37.5 mg [BCF], 50 mg [BCF], 75 mg [BCF],100 mg [BCF]

Tablet, Extended Release, Oral:Generic: 225 mg [BCF]

VerapamilOutpatient Dosage FormsTablet, Oral, as hydrochloride:Generic: 80 mg

Tablet Extended Release, Oral, as hydrochloride:Calan SR: 120 mg [BCF], 180 mg [scored] [BCF], 240 mg [scored] [BCF]Generic: 120 mg [BCF], 180 mg [BCF], 240 mg [BCF]

Vitamin B Complex CombinationsOutpatient Dosage FormsContent varies depending on product used.Capsule, Oral: 100sTablet, Oral

Vitamin E (Systemic)Outpatient Dosage FormsCapsule, Oral:Generic: 200 units

Solution, Oral:Generic: 15 units/0.3 mL (30 mL)

Vitamins (Multiple/Pediatric)Outpatient Dosage FormsContent varies depending on product used.

Liquid, Oral [drops]:Generic: (50 mL)

Vitamins (Multiple/Prenatal)Outpatient Dosage FormsContent varies depending on product used.Tablet, Oral:Generic: 27 mg-0.8 mg (100 ea)

WarfarinOutpatient Dosage FormsTablet, Oral, as sodium:Generic: 1 mg [BCF], 2 mg [BCF], 2.5 mg [BCF], 3 mg [BCF], 4 mg [BCF],5 mg [BCF], 6 mg [BCF], 7.5 mg [BCF], 10 mg [BCF]

Zinc OxideOutpatient Dosage FormsOintment, External:Generic: 20% (30 g)

Zinc SulfateOutpatient Dosage FormsCapsule, Oral:Generic: 220 mg [elemental zinc 50 mg]

ZiprasidoneOutpatient Dosage FormsCapsule, Oral, as hydrochloride:Generic: 20 mg, 40 mg, 60 mg, 80 mg

ZOLMitriptanOutpatient Dosage FormsTablet, Oral:Generic: 2.5 mg [BCF], 5 mg [BCF]

Tablet Dispersible, Oral:Generic: 2.5 mg [BCF], 5 mg [BCF]

ZolpidemOutpatient Dosage FormsTablet, Oral, as tartrate:Generic: 5 mg [BCF], 10 mg [BCF]

ZonisamideOutpatient Dosage FormsCapsule, Oral:Generic: 25 mg, 50 mg, 100 mg

ZONISAMIDE

23

Therapeutic Category Index

25

Acetylcholinesterase InhibitorNeostigmine ............................................................................................16Pyridostigmine ........................................................................................19

Acetylcholinesterase Inhibitor (Central)Donepezil ..................................................................................................8

Acne ProductsBenzoyl Peroxide ..................................................................................... 4Clindamycin and Benzoyl Peroxide ......................................................... 6Erythromycin (Topical) ..............................................................................9ISOtretinoin (Systemic) .......................................................................... 13Salicylic Acid .......................................................................................... 20Sulfur and Sulfacetamide .......................................................................21Tretinoin (Topical) ...................................................................................22

Adrenergic Agonist AgentOxymetazoline (Nasal) ...........................................................................17

Aldehyde Dehydrogenase InhibitorDisulfiram ..................................................................................................8

Alkalinizing AgentSodium Bicarbonate ...............................................................................20

Alkalinizing Agent, OralPotassium Citrate ...................................................................................18Sodium Citrate and Citric Acid ...............................................................20

Alkylamine DerivativeChlorpheniramine ..................................................................................... 5Hydrocodone and Chlorpheniramine ..................................................... 12Naphazoline and Pheniramine ...............................................................16Triprolidine and Pseudoephedrine ......................................................... 22

Alpha1 AgonistMidodrine ................................................................................................15Naphazoline and Pheniramine ...............................................................16

Alpha1 BlockerAlfuzosin ...................................................................................................2Doxazosin .................................................................................................8Phenoxybenzamine ................................................................................18Prazosin ..................................................................................................18Tamsulosin ............................................................................................. 21Terazosin ................................................................................................ 21

Alpha2-Adrenergic AgonistCloNIDine ................................................................................................. 6GuanFACINE ..........................................................................................12Methyldopa .............................................................................................15TiZANidine ..............................................................................................22

Alpha2 Agonist, OphthalmicApraclonidine ............................................................................................3Brimonidine and Timolol ...........................................................................4Brimonidine (Ophthalmic) .........................................................................4

Alpha-Adrenergic AgonistPhenylephrine (Nasal) ............................................................................18Phenylephrine (Ophthalmic) ...................................................................18

Alpha/Beta AgonistEPINEPHrine (Systemic) ..........................................................................9Guaifenesin and Pseudoephedrine ........................................................12Pseudoephedrine ................................................................................... 19Triprolidine and Pseudoephedrine ......................................................... 22

5 Alpha-Reductase InhibitorDutasteride ............................................................................................... 8Finasteride ..............................................................................................10

AmebicideMetroNIDAZOLE (Systemic) .................................................................. 15

Aminoquinoline (Antimalarial)Chloroquine .............................................................................................. 5Hydroxychloroquine ................................................................................12Primaquine ............................................................................................. 18

5-Aminosalicylic Acid DerivativeMesalamine ............................................................................................ 14SulfaSALAzine ........................................................................................21

Ammonium DetoxicantLactulose ................................................................................................ 13Neomycin ................................................................................................16

Analgesic Combination (Opioid)Acetaminophen and Codeine ...................................................................2Belladonna and Opium ............................................................................ 4Hydrocodone and Acetaminophen .........................................................12Oxycodone and Acetaminophen ............................................................17

Analgesic, NonopioidAcetaminophen .........................................................................................2Aspirin .......................................................................................................3Butalbital, Acetaminophen, and Caffeine .................................................4Celecoxib ..................................................................................................5Diclofenac (Systemic) ...............................................................................8Diflunisal ...................................................................................................8Flurbiprofen (Systemic) .......................................................................... 11Ibuprofen ................................................................................................ 12Indomethacin ..........................................................................................12Meloxicam .............................................................................................. 14Naproxen ................................................................................................16Oxaprozin ............................................................................................... 17Piroxicam (Systemic) ..............................................................................18Sulindac ..................................................................................................21Tolmetin .................................................................................................. 22

Analgesic, OpioidAcetaminophen and Codeine ...................................................................2Belladonna and Opium ............................................................................ 4Codeine .................................................................................................... 6FentaNYL ............................................................................................... 10Hydrocodone and Acetaminophen .........................................................12Hydrocodone and Chlorpheniramine ..................................................... 12HYDROmorphone .................................................................................. 12Meperidine ..............................................................................................14Methadone ..............................................................................................15Morphine (Systemic) .............................................................................. 16OxyCODONE ......................................................................................... 17Oxycodone and Acetaminophen ............................................................17Tapentadol ..............................................................................................21TraMADol ............................................................................................... 22

Analgesic, TopicalBenzocaine ...............................................................................................4Lidocaine (Topical) ................................................................................. 14

Analgesic, UrinaryPhenazopyridine .....................................................................................17

AndrogenDanazol .................................................................................................... 7Fluoxymesterone .................................................................................... 11Testosterone ...........................................................................................21

Anesthetic/CorticosteroidPramoxine and Hydrocortisone ..............................................................18

Anesthetic, TopicalPhenol .................................................................................................... 17

Angiotensin II Receptor BlockerCandesartan .............................................................................................5Candesartan and Hydrochlorothiazide .....................................................5Losartan ..................................................................................................14Losartan and Hydrochlorothiazide ......................................................... 14Sacubitril and Valsartan ......................................................................... 20Telmisartan ............................................................................................. 21Telmisartan and Hydrochlorothiazide .....................................................21Valsartan .................................................................................................22Valsartan and Hydrochlorothiazide ........................................................ 22

Angiotensin-Converting Enzyme (ACE) InhibitorAmlodipine and Benazepril ...................................................................... 3Benazepril .................................................................................................4Captopril ................................................................................................... 5Lisinopril ................................................................................................. 14Lisinopril and Hydrochlorothiazide ......................................................... 14Ramipril .................................................................................................. 19

Anilidopiperidine OpioidFentaNYL ............................................................................................... 10

AntacidAluminum Hydroxide ................................................................................ 2Calcium Carbonate ...................................................................................5Magnesium Hydroxide ............................................................................14Sodium Bicarbonate ...............................................................................20

AnthelminticAlbendazole ..............................................................................................2

Antianginal AgentAmLODIPine .............................................................................................3Amlodipine and Benazepril ...................................................................... 3Amyl Nitrite ...............................................................................................3Atenolol .....................................................................................................3DilTIAZem .................................................................................................8Isosorbide Dinitrate ................................................................................ 13Isosorbide Mononitrate ...........................................................................13Metoprolol ...............................................................................................15

ACETYLCHOLINESTERASE INHIBITOR

26

Nadolol ................................................................................................... 16NIFEdipine ..............................................................................................16Nitroglycerin ............................................................................................16Propranolol ............................................................................................. 19Verapamil ............................................................................................... 23

Antianxiety Agent, MiscellaneousBusPIRone ............................................................................................... 4

Antiarrhythmic Agent, Class IaDisopyramide ............................................................................................8QuiNIDine ...............................................................................................19

Antiarrhythmic Agent, Class IcFlecainide ............................................................................................... 10

Antiarrhythmic Agent, Class IIPropranolol ............................................................................................. 19Sotalol .....................................................................................................20

Antiarrhythmic Agent, Class IIIAmiodarone .............................................................................................. 2Sotalol .....................................................................................................20

Antiarrhythmic Agent, Class IVDilTIAZem .................................................................................................8Verapamil ............................................................................................... 23

Antiarrhythmic Agent, MiscellaneousDigoxin ......................................................................................................8

Antibiotic, AminoglycosideGentamicin (Ophthalmic) ........................................................................11Neomycin ................................................................................................16Tobramycin (Ophthalmic) ....................................................................... 22

Antibiotic, Cephalosporin (First Generation)Cefadroxil ................................................................................................. 5Cephalexin ................................................................................................5

Antibiotic, Cephalosporin (Second Generation)Cefprozil ................................................................................................... 5Cefuroxime ............................................................................................... 5

Antibiotic, Cephalosporin (Third Generation)Cefdinir ..................................................................................................... 5Cefixime ....................................................................................................5Cefpodoxime ............................................................................................ 5

Antibiotic/Corticosteroid, OphthalmicNeomycin, Polymyxin B, and Dexamethasone ......................................16Sulfacetamide and Prednisolone ........................................................... 21Tobramycin and Dexamethasone .......................................................... 22

Antibiotic/Corticosteroid, OticCiprofloxacin and Dexamethasone .......................................................... 6Neomycin, Polymyxin B, and Hydrocortisone (Otic) ..............................16

Antibiotic, FluoroquinoloneCiprofloxacin (Ophthalmic) .......................................................................6Ciprofloxacin (Systemic) ...........................................................................6LevoFLOXacin (Systemic) ......................................................................13Moxifloxacin (Ophthalmic) ......................................................................16Moxifloxacin (Systemic) ..........................................................................16Ofloxacin (Ophthalmic) ...........................................................................17

Antibiotic, LincosamideClindamycin (Systemic) ............................................................................6Clindamycin (Topical) ............................................................................... 6

Antibiotic, MacrolideAzithromycin (Systemic) ...........................................................................3Clarithromycin ...........................................................................................6Erythromycin (Ophthalmic) .......................................................................9Erythromycin (Systemic) .......................................................................... 9Erythromycin (Topical) ..............................................................................9

Antibiotic, MiscellaneousDapsone (Systemic) .................................................................................7Methenamine ..........................................................................................15MetroNIDAZOLE (Systemic) .................................................................. 15Nitrofurantoin ..........................................................................................16Rifampin and Isoniazid ...........................................................................19Sulfamethoxazole and Trimethoprim ..................................................... 21Trimethoprim .......................................................................................... 22

Antibiotic, OphthalmicBacitracin and Polymyxin B (Ophthalmic) ................................................3Bacitracin, Neomycin, and Polymyxin B (Ophthalmic) ............................ 4Bacitracin (Ophthalmic) ............................................................................4Ciprofloxacin (Ophthalmic) .......................................................................6Erythromycin (Ophthalmic) .......................................................................9Gentamicin (Ophthalmic) ........................................................................11

Moxifloxacin (Ophthalmic) ......................................................................16Neomycin, Polymyxin B, and Gramicidin ...............................................16Ofloxacin (Ophthalmic) ...........................................................................17Sulfacetamide (Ophthalmic) ...................................................................21Tobramycin (Ophthalmic) ....................................................................... 22Trimethoprim and Polymyxin B .............................................................. 22

Antibiotic, Oral RinseChlorhexidine Gluconate (Oral) ............................................................... 5

Antibiotic, OticCiprofloxacin and Dexamethasone .......................................................... 6Neomycin, Polymyxin B, and Hydrocortisone (Otic) ..............................16

Antibiotic, PenicillinAmoxicillin .................................................................................................3Amoxicillin and Clavulanate ..................................................................... 3Dicloxacillin ...............................................................................................8Penicillin V Potassium ............................................................................17

Antibiotic, Respiratory FluoroquinoloneLevoFLOXacin (Systemic) ......................................................................13Moxifloxacin (Systemic) ..........................................................................16

Antibiotic, Sulfonamide DerivativeSulfamethoxazole and Trimethoprim ..................................................... 21Sulfur and Sulfacetamide .......................................................................21

Antibiotic, Tetracycline DerivativeDoxycycline .............................................................................................. 8Minocycline (Systemic) ...........................................................................15Tetracycline (Systemic) .......................................................................... 21

Antibiotic, TopicalBacitracin and Polymyxin B (Topical) ...................................................... 3Bacitracin, Neomycin, and Polymyxin B (Topical) ................................... 4Bacitracin (Topical) ...................................................................................4Erythromycin (Topical) ..............................................................................9MetroNIDAZOLE (Topical) ..................................................................... 15Mupirocin ................................................................................................16Silver Sulfadiazine ..................................................................................20

Anticholinergic AgentBenztropine .............................................................................................. 4Dicyclomine .............................................................................................. 8Glycopyrrolate (Systemic) ...................................................................... 11Hyoscyamine, Atropine, Scopolamine, and Phenobarbital ....................12Ipratropium and Albuterol .......................................................................13Ipratropium (Oral Inhalation) .................................................................. 13Propantheline ......................................................................................... 19Scopolamine (Ophthalmic) .....................................................................20Scopolamine (Systemic) .........................................................................20Tiotropium ...............................................................................................22Tiotropium and Olodaterol ......................................................................22Tolterodine ..............................................................................................22Trihexyphenidyl ...................................................................................... 22Umeclidinium and Vilanterol ...................................................................22

Anticholinergic Agent, Long-ActingTiotropium ...............................................................................................22Tiotropium and Olodaterol ......................................................................22Umeclidinium and Vilanterol ...................................................................22

Anticholinergic Agent, OphthalmicAtropine (Ophthalmic) .............................................................................. 3Cyclopentolate ..........................................................................................7Scopolamine (Ophthalmic) .....................................................................20

AnticoagulantApixaban ...................................................................................................3Dabigatran Etexilate .................................................................................7Enoxaparin ............................................................................................... 9Heparin ...................................................................................................12Rivaroxaban ........................................................................................... 19Warfarin .................................................................................................. 23

Anticoagulant, Direct Thrombin InhibitorDabigatran Etexilate .................................................................................7

Anticoagulant, Factor Xa InhibitorApixaban ...................................................................................................3Rivaroxaban ........................................................................................... 19

Anticoagulant, HeparinHeparin ...................................................................................................12

Anticoagulant, Low Molecular Weight HeparinEnoxaparin ............................................................................................... 9

Anticoagulant, Vitamin K AntagonistWarfarin .................................................................................................. 23

ANTICOAGULANT, VITAMIN K ANTAGONIST

27

Anticonvulsant, BarbituratePHENobarbital ........................................................................................17

Anticonvulsant, BenzodiazepineClonazePAM .............................................................................................6DiazePAM .................................................................................................8LORazepam ........................................................................................... 14Midazolam .............................................................................................. 15

Anticonvulsant, HydantoinPhenytoin ................................................................................................18

Anticonvulsant, MiscellaneousAcetaZOLAMIDE ......................................................................................2CarBAMazepine ....................................................................................... 5Gabapentin ............................................................................................. 11LamoTRIgine ..........................................................................................13LevETIRAcetam ..................................................................................... 13OXcarbazepine .......................................................................................17Pregabalin .............................................................................................. 18Primidone ............................................................................................... 19Topiramate ..............................................................................................22Valproic Acid and Derivatives ................................................................ 22Zonisamide .............................................................................................23

Anticonvulsant, SuccinimideEthosuximide ..........................................................................................10

Antidepressant, Alpha-2 AntagonistMirtazapine .............................................................................................15

Antidepressant, Dopamine/Norepinephrine-Reuptake InhibitorBuPROPion .............................................................................................. 4

Antidepressant, Monoamine Oxidase InhibitorSelegiline ................................................................................................20

Antidepressant, Selective Serotonin Reuptake InhibitorCitalopram ................................................................................................ 6Escitalopram .............................................................................................9FLUoxetine ............................................................................................. 10PARoxetine .............................................................................................17Sertraline ................................................................................................ 20

Antidepressant, Serotonin/Norepinephrine Reuptake InhibitorDULoxetine ...............................................................................................8Milnacipran ............................................................................................. 15Venlafaxine .............................................................................................23

Antidepressant, Serotonin Reuptake Inhibitor/AntagonistTraZODone .............................................................................................22

Antidepressant, Tricyclic (Secondary Amine)Desipramine ............................................................................................. 7Nortriptyline ............................................................................................ 16Protriptyline .............................................................................................19

Antidepressant, Tricyclic (Tertiary Amine)Amitriptyline ..............................................................................................2Amitriptyline and Perphenazine ............................................................... 2Doxepin (Systemic) .................................................................................. 8Imipramine ..............................................................................................12

Antidiabetic Agent, Alpha-Glucosidase InhibitorAcarbose .................................................................................................. 2

Antidiabetic Agent, BiguanideEmpagliflozin and Metformin ....................................................................9Glyburide and Metformin ........................................................................11MetFORMIN ........................................................................................... 15Pioglitazone and Metformin ................................................................... 18Sitagliptin and Metformin ....................................................................... 20

Antidiabetic Agent, Dipeptidyl Peptidase 4 (DPP-4) InhibitorSitaGLIPtin ............................................................................................. 20Sitagliptin and Metformin ....................................................................... 20

Antidiabetic Agent, Dopamine AgonistBromocriptine ........................................................................................... 4

Antidiabetic Agent, Glucagon-Like Peptide-1 (GLP-1) ReceptorAgonist

Dulaglutide ................................................................................................8Exenatide ................................................................................................10

Antidiabetic Agent, Sodium-Glucose Cotransporter 2 (SGLT2)Inhibitor

Empagliflozin ............................................................................................ 9Empagliflozin and Metformin ....................................................................9

Antidiabetic Agent, SulfonylureaGlimepiride ..............................................................................................11GlipiZIDE ................................................................................................ 11

GlyBURIDE .............................................................................................11Glyburide and Metformin ........................................................................11Pioglitazone and Glimepiride ................................................................. 18

Antidiabetic Agent, ThiazolidinedionePioglitazone ............................................................................................18Pioglitazone and Glimepiride ................................................................. 18Pioglitazone and Metformin ................................................................... 18

AntidiarrhealBismuth Subsalicylate .............................................................................. 4Diphenoxylate and Atropine .....................................................................8Loperamide .............................................................................................14

AntidoteAcetylcysteine ...........................................................................................2Aluminum Hydroxide ................................................................................ 2Amyl Nitrite ...............................................................................................3Calcium Carbonate ...................................................................................5Charcoal, Activated .................................................................................. 5Glucagon ................................................................................................ 11Leucovorin Calcium ................................................................................13Naloxone ................................................................................................ 16Phenoxybenzamine ................................................................................18Sodium Polystyrene Sulfonate ...............................................................20

Antidote, ExtravasationNitroglycerin ............................................................................................16Terbutaline ..............................................................................................21

Antidote, HypoglycemiaGlucagon ................................................................................................ 11

AntiemeticDexAMETHasone (Systemic) ...................................................................7Granisetron .............................................................................................11HydrOXYzine ..........................................................................................12Meclizine .................................................................................................14Metoclopramide ......................................................................................15Ondansetron ...........................................................................................17Perphenazine ......................................................................................... 17Prochlorperazine .................................................................................... 19Promethazine ......................................................................................... 19

Antifibrinolytic AgentAminocaproic Acid ....................................................................................2

AntiflatulentSimethicone ............................................................................................20

Antifungal Agent, Azole DerivativeTerconazole ............................................................................................ 21

Antifungal Agent, Imidazole DerivativeClotrimazole (Oral) ................................................................................... 6Clotrimazole (Topical) ...............................................................................6Econazole .................................................................................................8Ketoconazole (Systemic) ........................................................................13Ketoconazole (Topical) ...........................................................................13Miconazole (Topical) .............................................................................. 15

Antifungal Agent, OralFluconazole ............................................................................................ 10Griseofulvin .............................................................................................11Ketoconazole (Systemic) ........................................................................13

Antifungal Agent, Oral NonabsorbedClotrimazole (Oral) ................................................................................... 6

Antifungal Agent, Oral Nonabsorbed/Partially AbsorbedClotrimazole (Topical) ...............................................................................6Miconazole (Topical) .............................................................................. 15Nystatin (Oral) ........................................................................................ 17

Antifungal Agent, ParenteralFluconazole ............................................................................................ 10

Antifungal Agent, TopicalBetamethasone and Clotrimazole ............................................................4Ciclopirox ..................................................................................................6Clotrimazole (Topical) ...............................................................................6Econazole .................................................................................................8Ketoconazole (Topical) ...........................................................................13Miconazole (Topical) .............................................................................. 15Nystatin and Triamcinolone ....................................................................16Nystatin (Topical) ....................................................................................17Terbinafine (Topical) ............................................................................... 21

Antifungal Agent, VaginalClotrimazole (Topical) ...............................................................................6Miconazole (Topical) .............................................................................. 15

ANTICONVULSANT, BARBITURATE

28

Sulfanilamide ..........................................................................................21Terconazole ............................................................................................ 21

Antigout AgentAllopurinol .................................................................................................2Colchicine .................................................................................................6

Antihemophilic AgentAminocaproic Acid ....................................................................................2Desmopressin ...........................................................................................7

Antihemorrhoidal AgentDibucaine ..................................................................................................8Hydrocortisone (Topical) ........................................................................ 12Pramoxine .............................................................................................. 18

AntihypertensiveAmLODIPine .............................................................................................3Amlodipine and Benazepril ...................................................................... 3Atenolol .....................................................................................................3Benazepril .................................................................................................4Candesartan .............................................................................................5Candesartan and Hydrochlorothiazide .....................................................5Captopril ................................................................................................... 5Carvedilol ..................................................................................................5Chlorthalidone .......................................................................................... 6CloNIDine ................................................................................................. 6DilTIAZem .................................................................................................8Doxazosin .................................................................................................8Furosemide .............................................................................................11GuanFACINE ..........................................................................................12HydrALAZINE .........................................................................................12HydroCHLOROthiazide .......................................................................... 12Hydrochlorothiazide and Triamterene .................................................... 12Labetalol .................................................................................................13Lisinopril ................................................................................................. 14Lisinopril and Hydrochlorothiazide ......................................................... 14Losartan ..................................................................................................14Losartan and Hydrochlorothiazide ......................................................... 14Methyldopa .............................................................................................15Metoprolol ...............................................................................................15Minoxidil (Systemic) ............................................................................... 15Nadolol ................................................................................................... 16Nebivolol .................................................................................................16NIFEdipine ..............................................................................................16Prazosin ..................................................................................................18Propranolol ............................................................................................. 19Ramipril .................................................................................................. 19Spironolactone ....................................................................................... 20Telmisartan ............................................................................................. 21Telmisartan and Hydrochlorothiazide .....................................................21Terazosin ................................................................................................ 21Torsemide ...............................................................................................22Valsartan .................................................................................................22Valsartan and Hydrochlorothiazide ........................................................ 22Verapamil ............................................................................................... 23

Anti-inflammatory AgentDexAMETHasone (Systemic) ...................................................................7

Anti-inflammatory Agent, OphthalmicDexAMETHasone (Ophthalmic) ...............................................................7

Anti-inflammatory, Locally AppliedCarbamide Peroxide .................................................................................5

Antilipemic Agent, 2-AzetidinoneEzetimibe ................................................................................................10Ezetimibe and Simvastatin .....................................................................10

Antilipemic Agent, Bile Acid SequestrantCholestyramine Resin .............................................................................. 6Colesevelam .............................................................................................6Colestipol ..................................................................................................6

Antilipemic Agent, Fibric AcidFenofibrate and Derivatives ................................................................... 10Gemfibrozil ..............................................................................................11

Antilipemic Agent, HMG-CoA Reductase InhibitorAtorvaSTATin ............................................................................................3Ezetimibe and Simvastatin .....................................................................10Pravastatin ..............................................................................................18Simvastatin .............................................................................................20

Antilipemic Agent, MiscellaneousNiacin ......................................................................................................16

Antilipemic Agent, Omega-3 Fatty AcidsOmega-3 Fatty Acids ............................................................................. 17

Antimalarial AgentChloroquine .............................................................................................. 5Hydroxychloroquine ................................................................................12Primaquine ............................................................................................. 18QuiNIDine ...............................................................................................19

Antimanic AgentChlorproMAZINE ...................................................................................... 6Lithium ....................................................................................................14OLANZapine ...........................................................................................17RisperiDONE ..........................................................................................19Valproic Acid and Derivatives ................................................................ 22

Antimigraine AgentDihydroergotamine ................................................................................... 8Ergotamine ............................................................................................... 9Rizatriptan .............................................................................................. 20SUMAtriptan ........................................................................................... 21ZOLMitriptan ...........................................................................................23

Antineoplastic Agent, Alkylating AgentChlorambucil .............................................................................................5Cyclophosphamide ...................................................................................7Lomustine ...............................................................................................14Melphalan ...............................................................................................14Procarbazine .......................................................................................... 19

Antineoplastic Agent, Alkylating Agent (Nitrogen Mustard)Chlorambucil .............................................................................................5Cyclophosphamide ...................................................................................7Melphalan ...............................................................................................14

Antineoplastic Agent, Alkylating Agent (Nitrosourea)Lomustine ...............................................................................................14

Antineoplastic Agent, Alkylating Agent (Triazene)Temozolomide ........................................................................................ 21

Antineoplastic Agent, AntiandrogenBicalutamide .............................................................................................4Flutamide ................................................................................................11

Antineoplastic Agent, AntimetaboliteCapecitabine .............................................................................................5Fluorouracil (Topical) ..............................................................................10Mercaptopurine .......................................................................................14Thioguanine ............................................................................................21

Antineoplastic Agent, Antimetabolite (Antifolate)Methotrexate ...........................................................................................15

Antineoplastic Agent, Antimetabolite (Purine Analog)Mercaptopurine .......................................................................................14Thioguanine ............................................................................................21

Antineoplastic Agent, Antimetabolite (Pyrimidine Analog)Capecitabine .............................................................................................5Fluorouracil (Topical) ..............................................................................10

Antineoplastic Agent, Aromatase InhibitorAnastrozole ...............................................................................................3Letrozole .................................................................................................13

Antineoplastic Agent, Estrogen Receptor AntagonistTamoxifen ............................................................................................... 21

Antineoplastic Agent, HormoneMegestrol ................................................................................................14

Antineoplastic Agent, MiscellaneousHydroxyurea ........................................................................................... 12

Antineoplastic Agent, Retinoic Acid DerivativeISOtretinoin (Systemic) .......................................................................... 13

Antiparasitic Agent, TopicalPermethrin ..............................................................................................17

Anti-Parkinson Agent, AnticholinergicBenztropine .............................................................................................. 4Trihexyphenidyl ...................................................................................... 22

Anti-Parkinson Agent, Decarboxylase InhibitorCarbidopa and Levodopa .........................................................................5

Anti-Parkinson Agent, Dopamine AgonistAmantadine .............................................................................................. 2Bromocriptine ........................................................................................... 4Pramipexole ............................................................................................18ROPINIRole ............................................................................................20

Anti-Parkinson Agent, Dopamine PrecursorCarbidopa and Levodopa .........................................................................5

ANTI-PARKINSON AGENT, DOPAMINE PRECURSOR

29

Anti-Parkinson Agent, MAO Type B InhibitorSelegiline ................................................................................................20

Antiplatelet AgentAspirin .......................................................................................................3Aspirin and Dipyridamole ......................................................................... 3Clopidogrel ............................................................................................... 6Dipyridamole .............................................................................................8Prasugrel ................................................................................................ 18Ticagrelor ................................................................................................22

Antiplatelet Agent, CyclopentyltriazolopyrimidineTicagrelor ................................................................................................22

Antiplatelet Agent, ThienopyridineClopidogrel ............................................................................................... 6Prasugrel ................................................................................................ 18

Antiprotozoal, NitroimidazoleMetroNIDAZOLE (Systemic) .................................................................. 15

Antipsoriatic AgentAnthralin ................................................................................................... 3

Antirheumatic, Disease ModifyingAbatacept ................................................................................................. 2Adalimumab ..............................................................................................2Anakinra ................................................................................................... 3Etanercept ................................................................................................ 9Leflunomide ............................................................................................13Methotrexate ...........................................................................................15

Antirheumatic MiscellaneousCyclophosphamide ...................................................................................7

Antiseborrheic Agent, TopicalSelenium Sulfide .................................................................................... 20Sulfur and Salicylic Acid .........................................................................21Sulfur and Sulfacetamide .......................................................................21

Antiseptic, TopicalAlcohol (Isopropyl) ....................................................................................2Povidone-Iodine (Topical) .......................................................................18

Antiseptic, VaginalPovidone-Iodine (Topical) .......................................................................18

Antispasmodic Agent, GastrointestinalHyoscyamine, Atropine, Scopolamine, and Phenobarbital ....................12

Antispasmodic Agent, UrinaryBelladonna and Opium ............................................................................ 4Oxybutynin ..............................................................................................17

Antithyroid AgentMethIMAzole ...........................................................................................15Propylthiouracil .......................................................................................19

Antitubercular AgentEthambutol ............................................................................................... 9Isoniazid ................................................................................................. 13Pyrazinamide ..........................................................................................19RifAMPin .................................................................................................19

AntitussiveBenzonatate ............................................................................................. 4Codeine .................................................................................................... 6Guaifenesin and Codeine .......................................................................11Guaifenesin and Dextromethorphan ...................................................... 12Hydrocodone and Chlorpheniramine ..................................................... 12

Antiviral AgentAcyclovir (Systemic) .................................................................................2Amantadine .............................................................................................. 2Oseltamivir ..............................................................................................17Ribavirin (Oral Inhalation) ...................................................................... 19ValACYclovir ...........................................................................................22

Antiviral Agent, AdamantaneAmantadine .............................................................................................. 2

Antiviral Agent, OphthalmicTrifluridine ...............................................................................................22

Antiviral Agent, OralValACYclovir ...........................................................................................22

Appetite StimulantMegestrol ................................................................................................14

BarbiturateButalbital, Acetaminophen, and Caffeine .................................................4PHENobarbital ........................................................................................17Primidone ............................................................................................... 19

BenzodiazepineALPRAZolam ............................................................................................2ChlordiazePOXIDE ...................................................................................5ClonazePAM .............................................................................................6DiazePAM .................................................................................................8LORazepam ........................................................................................... 14Midazolam .............................................................................................. 15Oxazepam .............................................................................................. 17Temazepam ............................................................................................21Triazolam ................................................................................................22

Beta2-Adrenergic AgonistIpratropium and Albuterol .......................................................................13

Beta2-Adrenergic Agonist, Long-ActingFluticasone and Salmeterol ....................................................................11Formoterol .............................................................................................. 11Olodaterol ...............................................................................................17Salmeterol .............................................................................................. 20Umeclidinium and Vilanterol ...................................................................22

Beta2 AgonistAlbuterol ................................................................................................... 2Fluticasone and Salmeterol ....................................................................11Formoterol .............................................................................................. 11Olodaterol ...............................................................................................17Salmeterol .............................................................................................. 20Terbutaline ..............................................................................................21Tiotropium and Olodaterol ......................................................................22Umeclidinium and Vilanterol ...................................................................22

Beta2 Agonist, Long-ActingTiotropium and Olodaterol ......................................................................22

Beta3 AgonistMirabegron ............................................................................................. 15

Beta-Adrenergic Blocker, NonselectiveDorzolamide and Timolol ......................................................................... 8Propranolol ............................................................................................. 19Sotalol .....................................................................................................20

Beta-Blocker, Beta-1 SelectiveAtenolol .....................................................................................................3Metoprolol ...............................................................................................15Nebivolol .................................................................................................16

Beta-Blocker, NonselectiveBrimonidine and Timolol ...........................................................................4Nadolol ................................................................................................... 16Timolol (Ophthalmic) .............................................................................. 22

Beta-Blocker With Alpha-Blocking ActivityCarvedilol ..................................................................................................5Labetalol .................................................................................................13

Bisphosphonate DerivativeAlendronate .............................................................................................. 2Alendronate and Cholecalciferol .............................................................. 2Ibandronate ............................................................................................ 12

Blood Product DerivativeThrombin (Topical) ................................................................................. 21

Blood Viscosity Reducer AgentPentoxifylline .......................................................................................... 17

Calcineurin InhibitorCycloSPORINE (Ophthalmic) ...................................................................7CycloSPORINE (Systemic) ...................................................................... 7Pimecrolimus ..........................................................................................18Tacrolimus (Systemic) ............................................................................ 21

Calcium Channel BlockerAmLODIPine .............................................................................................3Amlodipine and Benazepril ...................................................................... 3DilTIAZem .................................................................................................8NIFEdipine ..............................................................................................16Verapamil ............................................................................................... 23

Calcium Channel Blocker, DihydropyridineAmLODIPine .............................................................................................3Amlodipine and Benazepril ...................................................................... 3NIFEdipine ..............................................................................................16

Calcium Channel Blocker, NondihydropyridineDilTIAZem .................................................................................................8Verapamil ............................................................................................... 23

Calcium SaltCalcium and Vitamin D ............................................................................ 4Calcium Carbonate ...................................................................................5Calcium Glubionate ..................................................................................5

ANTI-PARKINSON AGENT, MAO TYPE B INHIBITOR

30

Carbonic Anhydrase InhibitorAcetaZOLAMIDE ......................................................................................2MethazolAMIDE ......................................................................................15

Carbonic Anhydrase Inhibitor (Ophthalmic)Brinzolamide .............................................................................................4Dorzolamide ............................................................................................. 8Dorzolamide and Timolol ......................................................................... 8

Cardiac GlycosideDigoxin ......................................................................................................8

Cardiovascular Agent, MiscellaneousIvabradine ...............................................................................................13

CatharticSodium Phosphates ............................................................................... 20

Central Monoamine-Depleting AgentReserpine ............................................................................................... 19

Central Nervous System StimulantArmodafinil ................................................................................................3Dexmethylphenidate .................................................................................7Dextroamphetamine ................................................................................. 7Dextroamphetamine and Amphetamine .................................................. 7Lisdexamfetamine .................................................................................. 14Methylphenidate ..................................................................................... 15

Chemotherapy Modulating AgentLeucovorin Calcium ................................................................................13

Cholinergic AgonistBethanechol ..............................................................................................4Carbachol ................................................................................................. 5Pilocarpine (Systemic) ............................................................................18

ContraceptiveEthinyl Estradiol and Desogestrel ............................................................9Ethinyl Estradiol and Drospirenone ......................................................... 9Ethinyl Estradiol and Etonogestrel ...........................................................9Ethinyl Estradiol and Levonorgestrel ..................................................... 10Ethinyl Estradiol and Norelgestromin .....................................................10Ethinyl Estradiol and Norethindrone ...................................................... 10Ethinyl Estradiol and Norgestimate ........................................................10Ethinyl Estradiol and Norgestrel ............................................................ 10Levonorgestrel (Systemic) ......................................................................14MedroxyPROGESTERone ..................................................................... 14Norethindrone .........................................................................................16

Corticosteroid, Inhalant (Oral)Budesonide (Oral Inhalation) ................................................................... 4Fluticasone and Salmeterol ....................................................................11Fluticasone (Oral Inhalation) .................................................................. 11Mometasone (Oral Inhalation) ............................................................... 15

Corticosteroid, NasalFluticasone (Nasal) .................................................................................11

Corticosteroid, OphthalmicDexAMETHasone (Ophthalmic) ...............................................................7Fluorometholone .................................................................................... 10PrednisoLONE (Ophthalmic) ..................................................................18

Corticosteroid, OticCiprofloxacin and Dexamethasone .......................................................... 6DexAMETHasone (Ophthalmic) ...............................................................7Neomycin, Polymyxin B, and Hydrocortisone (Otic) ..............................16

Corticosteroid, RectalHydrocortisone (Topical) ........................................................................ 12

Corticosteroid, SystemicCortisone .................................................................................................. 6DexAMETHasone (Systemic) ...................................................................7Fludrocortisone .......................................................................................10Hydrocortisone (Systemic) ..................................................................... 12MethylPREDNISolone ............................................................................ 15PrednisoLONE (Systemic) ..................................................................... 18PredniSONE ...........................................................................................18

Corticosteroid, TopicalBetamethasone and Clotrimazole ............................................................4Betamethasone (Topical) ......................................................................... 4Clobetasol .................................................................................................6Fluocinolone (Topical) ............................................................................ 10Fluocinonide ........................................................................................... 10Flurandrenolide .......................................................................................11Hydrocortisone (Topical) ........................................................................ 12Nystatin and Triamcinolone ....................................................................16Triamcinolone (Topical) .......................................................................... 22

DecongestantOxymetazoline (Nasal) ...........................................................................17Phenylephrine (Nasal) ............................................................................18Pseudoephedrine ................................................................................... 19Triprolidine and Pseudoephedrine ......................................................... 22

Diagnostic AgentGlucagon ................................................................................................ 11

Diagnostic Agent, OphthalmicHydroxypropyl Methylcellulose ...............................................................12

Dietary SupplementLactobacillus ...........................................................................................13LevOCARNitine ...................................................................................... 13

Direct Oral Anticoagulant (DOAC)Apixaban ...................................................................................................3Dabigatran Etexilate .................................................................................7Rivaroxaban ........................................................................................... 19

Diuretic, Carbonic Anhydrase InhibitorAcetaZOLAMIDE ......................................................................................2MethazolAMIDE ......................................................................................15

Diuretic, LoopFurosemide .............................................................................................11Torsemide ...............................................................................................22

Diuretic, Potassium-SparingHydrochlorothiazide and Triamterene .................................................... 12Spironolactone ....................................................................................... 20

Diuretic, ThiazideCandesartan and Hydrochlorothiazide .....................................................5HydroCHLOROthiazide .......................................................................... 12Hydrochlorothiazide and Triamterene .................................................... 12Lisinopril and Hydrochlorothiazide ......................................................... 14Losartan and Hydrochlorothiazide ......................................................... 14Telmisartan and Hydrochlorothiazide .....................................................21Valsartan and Hydrochlorothiazide ........................................................ 22

Diuretic, Thiazide-RelatedChlorthalidone .......................................................................................... 6MetOLazone ...........................................................................................15

Dopamine AntagonistMetoclopramide ......................................................................................15

Electrolyte Supplement, OralCalcium and Vitamin D ............................................................................ 4Calcium Carbonate ...................................................................................5Magnesium Oxide .................................................................................. 14Potassium Chloride ................................................................................ 18Potassium Phosphate and Sodium Phosphate ..................................... 18Sodium Bicarbonate ...............................................................................20

Electrolyte Supplement, ParenteralPotassium Chloride ................................................................................ 18Sodium Bicarbonate ...............................................................................20Sodium Chloride .....................................................................................20Sodium Phosphates ............................................................................... 20

EnzymePancrelipase ...........................................................................................17

Ergot DerivativeBromocriptine ........................................................................................... 4Dihydroergotamine ................................................................................... 8Ergoloid Mesylates ...................................................................................9Ergotamine ............................................................................................... 9Methylergonovine ................................................................................... 15

Estrogen and Androgen CombinationEstrogens (Esterified) and Methyltestosterone ........................................9

Estrogen and Progestin CombinationEstradiol and Levonorgestrel ................................................................... 9Estrogens (Conjugated/Equine) and Medroxyprogesterone ....................9Ethinyl Estradiol and Desogestrel ............................................................9Ethinyl Estradiol and Drospirenone ......................................................... 9Ethinyl Estradiol and Etonogestrel ...........................................................9Ethinyl Estradiol and Levonorgestrel ..................................................... 10Ethinyl Estradiol and Norelgestromin .....................................................10Ethinyl Estradiol and Norethindrone ...................................................... 10Ethinyl Estradiol and Norgestimate ........................................................10Ethinyl Estradiol and Norgestrel ............................................................ 10

Estrogen DerivativeEstradiol (Systemic) ................................................................................. 9Estradiol (Topical) .....................................................................................9Estrogens (Conjugated/Equine, Systemic) .............................................. 9

ESTROGEN DERIVATIVE

31

Estrogens (Conjugated/Equine, Topical) ..................................................9Estrogens (Esterified) ...............................................................................9

Ethanolamine DerivativeDiphenhydrAMINE (Systemic) ..................................................................8Doxylamine ...............................................................................................8

ExpectorantGuaiFENesin .......................................................................................... 11Guaifenesin and Codeine .......................................................................11Guaifenesin and Dextromethorphan ...................................................... 12Guaifenesin and Pseudoephedrine ........................................................12

First Generation (Typical) AntipsychoticAmitriptyline and Perphenazine ............................................................... 2ChlorproMAZINE ...................................................................................... 6FluPHENAZine ....................................................................................... 11Haloperidol ............................................................................................. 12Perphenazine ......................................................................................... 17Prochlorperazine .................................................................................... 19Thioridazine ............................................................................................21Thiothixene .............................................................................................21Trifluoperazine ........................................................................................22

GABA AnalogGabapentin ............................................................................................. 11Pregabalin .............................................................................................. 18

Gastrointestinal Agent, MiscellaneousAdalimumab ..............................................................................................2Sucralfate ............................................................................................... 20

Gastrointestinal Agent, ProkineticMetoclopramide ......................................................................................15

General AnestheticFentaNYL ............................................................................................... 10

Genitourinary IrrigantSodium Chloride .....................................................................................20Sorbitol ................................................................................................... 20

Glutamate InhibitorRiluzole ...................................................................................................19

Hemostatic AgentAluminum Chloride Hexahydrate ............................................................. 2Aminocaproic Acid ....................................................................................2Desmopressin ...........................................................................................7Thrombin (Topical) ................................................................................. 21

Histamine H1 AntagonistAzelastine (Nasal) .................................................................................... 3Cetirizine (Systemic) ................................................................................ 5Chlorpheniramine ..................................................................................... 5Cyproheptadine ........................................................................................ 7DiphenhydrAMINE (Systemic) ..................................................................8Doxylamine ...............................................................................................8Fexofenadine ..........................................................................................10Hydrocodone and Chlorpheniramine ..................................................... 12HydrOXYzine ..........................................................................................12Ketotifen (Ophthalmic) ............................................................................13Loratadine ...............................................................................................14Meclizine .................................................................................................14Naphazoline and Pheniramine ...............................................................16Olopatadine (Ophthalmic) ...................................................................... 17Promethazine ......................................................................................... 19Triprolidine and Pseudoephedrine ......................................................... 22

Histamine H1 Antagonist, First GenerationChlorpheniramine ..................................................................................... 5Cyproheptadine ........................................................................................ 7DiphenhydrAMINE (Systemic) ..................................................................8Doxylamine ...............................................................................................8Hydrocodone and Chlorpheniramine ..................................................... 12HydrOXYzine ..........................................................................................12Meclizine .................................................................................................14Naphazoline and Pheniramine ...............................................................16Promethazine ......................................................................................... 19Triprolidine and Pseudoephedrine ......................................................... 22

Histamine H1 Antagonist, Second GenerationAzelastine (Nasal) .................................................................................... 3Cetirizine (Systemic) ................................................................................ 5Fexofenadine ..........................................................................................10Ketotifen (Ophthalmic) ............................................................................13Loratadine ...............................................................................................14Olopatadine (Ophthalmic) ...................................................................... 17

Histamine H2 AntagonistCimetidine .................................................................................................6

Famotidine ..............................................................................................10RaNITIdine ............................................................................................. 19

Histone Deacetylase InhibitorValproic Acid and Derivatives ................................................................ 22

Hormone, Posterior PituitaryDesmopressin ...........................................................................................7

Hypnotic, MiscellaneousChloral Hydrate ........................................................................................ 5Ramelteon .............................................................................................. 19Zolpidem .................................................................................................23

Imidazoline DerivativeNaphazoline and Pheniramine ...............................................................16Oxymetazoline (Nasal) ...........................................................................17

Immunosuppressant AgentAzaTHIOprine ...........................................................................................3Cyclophosphamide ...................................................................................7CycloSPORINE (Ophthalmic) ...................................................................7CycloSPORINE (Systemic) ...................................................................... 7Mercaptopurine .......................................................................................14Methotrexate ...........................................................................................15Mycophenolate ....................................................................................... 16Pimecrolimus ..........................................................................................18Tacrolimus (Systemic) ............................................................................ 21

Inhalation, MiscellaneousInhalation Devices ..................................................................................12

Insulin, CombinationInsulin Aspart Protamine and Insulin Aspart ......................................... 12Insulin NPH and Insulin Regular ............................................................13

Insulin, Intermediate-ActingInsulin NPH ............................................................................................ 13

Insulin, Long-ActingInsulin Detemir ....................................................................................... 13Insulin Glargine ...................................................................................... 13

Insulin, Rapid-ActingInsulin Aspart ..........................................................................................12

Insulin, Short-ActingInsulin Regular ....................................................................................... 13

InterferonInterferon Beta-1b .................................................................................. 13

Interleukin-1 Receptor AntagonistAnakinra ................................................................................................... 3

Iron PreparationsFerrous Sulfate .......................................................................................10

IrrigantSodium Chloride .....................................................................................20

Irrigating SolutionBalanced Salt Solution .............................................................................4

Keratolytic AgentAnthralin ................................................................................................... 3Podofilox .................................................................................................18Salicylic Acid .......................................................................................... 20Urea (Topical) .........................................................................................22

LaxativeMagnesium Hydroxide ............................................................................14

Laxative, Bowel EvacuantSodium Phosphates ............................................................................... 20

Laxative, LubricantMineral Oil .............................................................................................. 15

Laxative, OsmoticGlycerin ...................................................................................................11Lactulose ................................................................................................ 13Polyethylene Glycol 3350 ...................................................................... 18Polyethylene Glycol-Electrolyte Solution ............................................... 18Sorbitol ................................................................................................... 20

Laxative, SalineMagnesium Citrate ................................................................................. 14

Laxative, StimulantBisacodyl .................................................................................................. 4Senna ..................................................................................................... 20

Leukotriene-Receptor AntagonistMontelukast ............................................................................................ 16

ESTROGEN DERIVATIVE

32

Local AnestheticBenzocaine ...............................................................................................4Dibucaine ..................................................................................................8Lidocaine (Topical) ................................................................................. 14Pramoxine .............................................................................................. 18

Lubricant, OcularHydroxypropyl Methylcellulose ...............................................................12Sodium Chloride .....................................................................................20

Lysine AnalogAminocaproic Acid ....................................................................................2

Magnesium SaltMagnesium Citrate ................................................................................. 14Magnesium Hydroxide ............................................................................14Magnesium Oxide .................................................................................. 14

Mast Cell StabilizerCromolyn (Ophthalmic) ............................................................................ 7Ketotifen (Ophthalmic) ............................................................................13

Melatonin Receptor AgonistRamelteon .............................................................................................. 19

Mineralocorticoid (Aldosterone) Receptor AntagonistsSpironolactone ....................................................................................... 20

Miscellaneous ProductDiabetic Supplies ......................................................................................7

Monoclonal AntibodyAdalimumab ..............................................................................................2

Mucolytic AgentAcetylcysteine ...........................................................................................2

Neprilysin InhibitorSacubitril and Valsartan ......................................................................... 20

Neuraminidase InhibitorOseltamivir ..............................................................................................17

Nonsteroidal Anti-inflammatory Drug (NSAID)Diclofenac (Ophthalmic) ...........................................................................8Diclofenac (Systemic) ...............................................................................8Diclofenac (Topical) ..................................................................................8

Nonsteroidal Anti-inflammatory Drug (NSAID), COX-2 SelectiveCelecoxib ..................................................................................................5

Nonsteroidal Anti-inflammatory Drug (NSAID), OphthalmicBromfenac ................................................................................................ 4Diclofenac (Ophthalmic) ...........................................................................8Flurbiprofen (Ophthalmic) .......................................................................11Ketorolac (Ophthalmic) ...........................................................................13

Nonsteroidal Anti-inflammatory Drug (NSAID), OralAspirin .......................................................................................................3Diclofenac (Systemic) ...............................................................................8Diflunisal ...................................................................................................8Flurbiprofen (Systemic) .......................................................................... 11Ibuprofen ................................................................................................ 12Indomethacin ..........................................................................................12Meloxicam .............................................................................................. 14Naproxen ................................................................................................16Oxaprozin ............................................................................................... 17Piroxicam (Systemic) ..............................................................................18Sulindac ..................................................................................................21Tolmetin .................................................................................................. 22

Nonsteroidal Anti-inflammatory Drug (NSAID), ParenteralIbuprofen ................................................................................................ 12Indomethacin ..........................................................................................12

Nonsteroidal Anti-inflammatory Drug (NSAID), TopicalDiclofenac (Topical) ..................................................................................8

Norepinephrine Reuptake Inhibitor, SelectiveAtoMOXetine ............................................................................................ 3

Nutritional SupplementFluoride ...................................................................................................10Medium Chain Triglycerides ...................................................................14

Ophthalmic Agent, AntiglaucomaAcetaZOLAMIDE ......................................................................................2Bimatoprost .............................................................................................. 4Brimonidine and Timolol ...........................................................................4Brimonidine (Ophthalmic) .........................................................................4Brinzolamide .............................................................................................4Carbachol ................................................................................................. 5Carteolol (Ophthalmic) ............................................................................. 5Dorzolamide ............................................................................................. 8

Dorzolamide and Timolol ......................................................................... 8Latanoprost .............................................................................................13MethazolAMIDE ......................................................................................15Phenylephrine (Ophthalmic) ...................................................................18Pilocarpine (Ophthalmic) ........................................................................18Timolol (Ophthalmic) .............................................................................. 22

Ophthalmic Agent, MioticCarbachol ................................................................................................. 5Pilocarpine (Ophthalmic) ........................................................................18

Ophthalmic Agent, MiscellaneousArtificial Tears ...........................................................................................3Balanced Salt Solution .............................................................................4Carboxymethylcellulose ............................................................................5Hydroxypropyl Cellulose .........................................................................12

Ophthalmic Agent, MydriaticAtropine (Ophthalmic) .............................................................................. 3Phenylephrine (Ophthalmic) ...................................................................18Scopolamine (Ophthalmic) .....................................................................20Tropicamide ............................................................................................22

Ophthalmic Agent, VasoconstrictorNaphazoline and Pheniramine ...............................................................16

Opioid AntagonistNaloxone ................................................................................................ 16

Otic Agent, Anti-infectiveAcetic Acid (Otic) ......................................................................................2Acetic Acid, Propylene Glycol Diacetate, and Hydrocortisone ................2

Otic Agent, CerumenolyticCarbamide Peroxide .................................................................................5

Ovulation StimulatorClomiPHENE ............................................................................................6

PediculocidePermethrin ..............................................................................................17

Phenothiazine DerivativeAmitriptyline and Perphenazine ............................................................... 2ChlorproMAZINE ...................................................................................... 6FluPHENAZine ....................................................................................... 11Perphenazine ......................................................................................... 17Prochlorperazine .................................................................................... 19Promethazine ......................................................................................... 19Thioridazine ............................................................................................21Trifluoperazine ........................................................................................22

Phosphate BinderCalcium Carbonate ...................................................................................5Sevelamer .............................................................................................. 20

Phosphodiesterase-5 Enzyme InhibitorSildenafil .................................................................................................20

Phosphodiesterase Enzyme Inhibitor, NonselectiveTheophylline ........................................................................................... 21

Piperazine DerivativeCetirizine (Systemic) ................................................................................ 5HydrOXYzine ..........................................................................................12Meclizine .................................................................................................14

Piperidine DerivativeCyproheptadine ........................................................................................ 7Fexofenadine ..........................................................................................10Ketotifen (Ophthalmic) ............................................................................13Loratadine ...............................................................................................14Olopatadine (Ophthalmic) ...................................................................... 17

Potassium BinderSodium Polystyrene Sulfonate ...............................................................20

ProbioticLactobacillus ...........................................................................................13

ProgestinLevonorgestrel (Systemic) ......................................................................14MedroxyPROGESTERone ..................................................................... 14Megestrol ................................................................................................14Norethindrone .........................................................................................16Progesterone ..........................................................................................19

ProstaglandinAlprostadil .................................................................................................2MiSOPROStol .........................................................................................15

Prostaglandin, OphthalmicBimatoprost .............................................................................................. 4Latanoprost .............................................................................................13

PROSTAGLANDIN, OPHTHALMIC

33

Protectant, TopicalAluminum Hydroxide ................................................................................ 2

Proton Pump InhibitorOmeprazole ............................................................................................17Pantoprazole .......................................................................................... 17RABEprazole ..........................................................................................19

PsoralenMethoxsalen (Systemic) .........................................................................15

Rauwolfia AlkaloidReserpine ............................................................................................... 19

Rescue Agent (Chemotherapy)Leucovorin Calcium ................................................................................13

Retinoic Acid DerivativeISOtretinoin (Systemic) .......................................................................... 13Tretinoin (Topical) ...................................................................................22

RifamycinRifAMPin .................................................................................................19

SalicylateAspirin .......................................................................................................3Salsalate .................................................................................................20

Scabicidal AgentCrotamiton ................................................................................................7Permethrin ..............................................................................................17

Second Generation (Atypical) AntipsychoticARIPiprazole .............................................................................................3Lurasidone ..............................................................................................14OLANZapine ...........................................................................................17QUEtiapine ............................................................................................. 19RisperiDONE ..........................................................................................19Ziprasidone .............................................................................................23

Selective 5-HT3 Receptor AntagonistGranisetron .............................................................................................11Ondansetron ...........................................................................................17

Selective Estrogen Receptor Modulator (SERM)ClomiPHENE ............................................................................................6Raloxifene ...............................................................................................19Tamoxifen ............................................................................................... 21

Selective T-Cell Costimulation BlockerAbatacept ................................................................................................. 2

Serotonin 5-HT1B, 1D Receptor AgonistRizatriptan .............................................................................................. 20SUMAtriptan ........................................................................................... 21ZOLMitriptan ...........................................................................................23

Serotonin 5-HT4 Receptor AgonistMetoclopramide ......................................................................................15

Skeletal Muscle RelaxantBaclofen ....................................................................................................4Chlorzoxazone ..........................................................................................6Cyclobenzaprine .......................................................................................7Dantrolene ................................................................................................7Methocarbamol .......................................................................................15

Skin and Mucous Membrane Agent, MiscellaneousEmollients .................................................................................................8

Smoking Cessation AidBuPROPion .............................................................................................. 4Nicotine ...................................................................................................16

Sodium-Glucose Cotransporter 2 (SGLT2) InhibitorEmpagliflozin ............................................................................................ 9Empagliflozin and Metformin ....................................................................9

Sodium SaltSodium Chloride .....................................................................................20

Stool SoftenerDocusate .................................................................................................. 8

Substituted BenzimidazoleOmeprazole ............................................................................................17Pantoprazole .......................................................................................... 17RABEprazole ..........................................................................................19

ThioamideMethIMAzole ...........................................................................................15Propylthiouracil .......................................................................................19

Thyroid ProductLevothyroxine ......................................................................................... 14Liothyronine ............................................................................................14

Topical Skin ProductAcetic Acid (Topical) .................................................................................2Aluminum Acetate .................................................................................... 2Aluminum Chloride Hexahydrate ............................................................. 2Benzoyl Peroxide ..................................................................................... 4Calamine .................................................................................................. 4Camphor and Menthol ............................................................................. 5Clindamycin and Benzoyl Peroxide ......................................................... 6Coal Tar .................................................................................................... 6Coal Tar and Salicylic Acid ...................................................................... 6Emollients .................................................................................................8Erythromycin (Topical) ..............................................................................9Fluorouracil (Topical) ..............................................................................10Lactic Acid and Ammonium Hydroxide ..................................................13Lanolin ....................................................................................................13Oatmeal (Colloidal) .................................................................................17Pimecrolimus ..........................................................................................18Podofilox .................................................................................................18Povidone-Iodine (Topical) .......................................................................18Selenium Sulfide .................................................................................... 20Surgical Lubricant ...................................................................................21Urea (Topical) .........................................................................................22Zinc Oxide .............................................................................................. 23

Topical Skin Product, AcneAzelaic Acid ..............................................................................................3Benzoyl Peroxide ..................................................................................... 4Clindamycin and Benzoyl Peroxide ......................................................... 6Clindamycin (Topical) ............................................................................... 6Erythromycin (Topical) ..............................................................................9Salicylic Acid .......................................................................................... 20Sulfur and Sulfacetamide .......................................................................21Tretinoin (Topical) ...................................................................................22

Trace ElementZinc Sulfate ............................................................................................ 23

Tumor Necrosis Factor (TNF) Blocking AgentAdalimumab ..............................................................................................2Etanercept ................................................................................................ 9

Uricosuric AgentProbenecid ............................................................................................. 19

VasodilatorAlprostadil .................................................................................................2Amyl Nitrite ...............................................................................................3Dipyridamole .............................................................................................8HydrALAZINE .........................................................................................12Isosorbide Dinitrate ................................................................................ 13Isosorbide Mononitrate ...........................................................................13Nitroglycerin ............................................................................................16

Vasodilator, Direct-ActingMinoxidil (Systemic) ............................................................................... 15

Vasopressin Analog, SyntheticDesmopressin ...........................................................................................7

VitaminVitamin B Complex Combinations ......................................................... 23Vitamins (Multiple/Pediatric) ...................................................................23Vitamins (Multiple/Prenatal) ................................................................... 23

Vitamin D AnalogAlendronate and Cholecalciferol .............................................................. 2Calcitriol (Systemic) ..................................................................................4Cholecalciferol ..........................................................................................6Ergocalciferol ............................................................................................9

Vitamin, Fat SolubleCalcium and Vitamin D ............................................................................ 4Phytonadione ......................................................................................... 18Vitamin E (Systemic) ..............................................................................23

Vitamin, Water SolubleAscorbic Acid ............................................................................................3Cyanocobalamin .......................................................................................7Folic Acid ................................................................................................11Leucovorin Calcium ................................................................................13Niacin ......................................................................................................16Pyridoxine ...............................................................................................19Thiamine .................................................................................................21

Xanthine Oxidase InhibitorAllopurinol .................................................................................................2

PROTECTANT, TOPICAL

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