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NATIONAL ADAP MONITORING PROJECT - AIDS United

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Washington<br />

<strong>ADAP</strong> FORMULARIES<br />

ANTIRETROVIRALS<br />

NRTIs- abacavir (Ziagen), abacavir/lamivudine/zidovudine (Trizivir), didanosine (ddI, Videx), lamivudine (Epivir, 3TC),<br />

lamivudine/zidovudine (Combivir), stavudine (d4T, Zerit), tenofovir (Viread), zalcitabine (ddC, HIVID), zidovudine (AZT, Retrovir).<br />

PIs- amprenavir (Agenerase), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), ritonavir (Norvir), saquinavir<br />

(Fortovase, Invirase). NnRTIs- delavirdine (Rescriptor), efavirenz (Sustiva), nevirapine (Viramune). Other- hydroxyurea (Hydrea).<br />

OI DRUGS<br />

PHS “A1 OI”s- acyclovir (Zovirax), azithromycin (Zithromax), cidofovir (Vistide), clarithromycin (Biaxin), famciclovir (Famvir),<br />

fluconazole (Diflucan), foscarnet (Foscavir), ganciclovir (Cytovene), itraconazole (Sporonox), leucovorin, pyrimethamine (Daraprim,<br />

Fansidar), rifampim (Rifadin), sulfadiazine (Microsulfon), TMP/SMX (Bactrim, Septra, CoTrim). Other OIs- albendazole, atovaquone<br />

(Mepron), ciprofloxacin (Cipro), clindamycin, clofazimine (Lamprene), clotrimazole (Lotrimin, Mycelex), dapsone, ethambutol<br />

(Myambutol), ketoconazole (Nizoral), metronidazole (Flagyl, Metrogel), miconazole, nystatin, oflaxacin, paromomycin (Humatin),<br />

pentamidine (NebuPent), primaquine, rifabutin (Mycobutin), terconazole (Terazol), trimethoprim, valacyclovir (Valtrex), valganciclovir.<br />

Hepatitis C- none.<br />

TREATMENTS FOR METABOLIC DISORDERS<br />

Diabetic- acarbose (Precose), insulin, injection kits, glucose test strips, glipizide (Glucotrol), glyburide (DiaBeta), metformin<br />

(Glucophage), pioglitazone (Actos), repaglinide (Prandin), rosiglitazone (Avandia). Hyperlipidemia- atorvastatin (Lipitor),<br />

cholestyramine (Questran), gemfibrozil (Lopid), lovastatin (Mevacor), niacin, pravastatin (Pravachol), simvastatin (Zocor),<br />

Wasting- dronabinol (Marinol), megestrol acetate (Megace), testosterone.<br />

ALL OTHERS<br />

aciphex (Raberprazole), amoxicillin, amoxicillin/potassium (Augmentin), ampicillin, carbamazepine (Tegretol), cefixime (Suprax),<br />

ceftriaxone, cephalexin (keflex), cimetidine, clotrimazole / betamethasone (Lotrisone cream), clozapine (Clozaril), dicloxacin, diphenoxylate<br />

/ atropine (Lomotil), divalproex Sodium (Depakote), doxyclcline, erythromycin, estrogen (Premarin), famotidine (Pepcid),<br />

gabapentin (Neurontin), Hep B Immune Globulin, Imiquimod cream, Immune Globulin IM (IGIM), lamotrigine (Lamictal),<br />

lindane, lithium, loperamide (Imodium), Mediset fills, medroxyprogesterone (Depo-Provera), metoclopramide (Reglan), nexium<br />

(Espmeprazole), nizatidine (Axid), olanzapine (Zyprexa), ondansetron (Zofran), opium, tincture of, oxcarbazepine (Trileptal),<br />

penicillin, peridex, permethrin, phenazopyridine (Pyridin, Pyridium), podofilox (Condylox), prevacid (Lansoprazole), prilosec<br />

(Omeprazole), prochlorperazine (Compazine), promethazine (Phenergan), protonix (Pantoprazole), ranitidine (Zantac), risperidone<br />

(Risperdal), selenium sulfide, tetracycline, topical steroids -all drugs in the class, topiramate (Topamax), valproic acid (Depakene),<br />

vancomycin oral, VZIG (Varicella Zoster Immune Globulin). The following classes of drugs are covered as groups. A drug’s class<br />

is defined by the medical community and endorsed by the federal Food and Drug Administration. Analgesic - oral only (e.g.)<br />

NSAIDs, Narcotics. Antianxiety - (e.g.)buspirone (Buspar), clonazepam (Klonopin), diazepam (Valium), hydroxyzine (Vistaril),<br />

lorazepam (Ativan). Antidepressant - (e.g.)amitriptyline (Elavil), bupropion (Wellbutrin), citalopram (Celexa), clomipramine (Anafranil),<br />

desipramine, doxepin, fluoxetine (Prozac), fluvoxamine (Luvox), imipramine, nefazodone (Serzone), nortriptyline, paroxetine (Paxil),<br />

sertraline (Zoloft), trazodone, venlafaxine (Effexor).<br />

West Virginia<br />

ANTIRETROVIRALS<br />

NRTIs- abacavir (Ziagen), abacavir/lamivudine/zidovudine (Trizivir), didanosine (ddI, Videx), lamivudine (Epivir, 3TC),<br />

lamivudine/zidovudine (Combivir), stavudine (d4T, Zerit), tenofovir (Viread), zalcitabine (ddC, HIVID), zidovudine (AZT, Retrovir).<br />

PIs- amprenavir (Agenerase), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), ritonavir (Norvir), saquinavir<br />

(Fortovase). NnRTIs- delavirdine (Rescriptor), efavirenz (Sustiva), nevirapine (Viramune).<br />

OI DRUGS<br />

PHS “A1 OI”s- azithromycin (Zithromax), TMP/SMX (Bactrim). Other OIs- clotrimazole (Mycelex), dapsone, ketoconazole (Nizoral),<br />

nystatin (Mucostatin), pentamidine (NebuPent, Pentam). Hepatitis C- none.

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