OSAN AB OUTPATIENT PHARMACY FORMULARY - Osan Air Base

Page 4Desonide 0.05% Ointment DesowenBCF Dexamethasone/Neomycin/Polymyxin Opthalmic Oint MaxitrolCIIDexamethasone 4mg TabletDextroamphetamine 5mg Tablet DexedrineCIV/BCF Diazepam 5mg Tablet ValiumCIV Diazepam 10mg Tablet ValiumBCF Dicloxacillin 250mg Capsule DynapenDicloxacillin 62.5mg/5mL Suspension DynapenBCF Dicyclomine 20mg Tablet BentylBCF Digoxin 0.125mg, 0.25mg Tablet LanoxinDiltiazem 60mg Tablet CardizemMax 30 D/S (90 D/S for ADHD);no refillsMax Qty 30 D/S (90 D/S forseizure & ADHD)Max Qty 30 D/S (90 D/S forseizure & ADHD)BCF Diltiazem, Extended-Release 120mg, 180mg, 240mg Capsule TiazacDiphenhydramine 25mg Capsule Benadryl OTC-BX/CommissaryDiphenhydramine 12.5mg/5mL Oral Elixir Benadryl OTC-BX/CommissaryDisulfiram 250mg Tablet AntabuseBCF Divalproex Sodium, Delayed-Release 250mg Tablet DepakoteBCF Divalproex Sodium, Extended-Release 250mg, 500mg Tablet Depakote-ERBCF Divalproex Sodium, Sprinkle 125mg Capsule DepakoteDocusate Sodium 100mg Capsule Colace OTC-BX/CommissaryDorzolamide 2% Ophthalmic Soln Trusopt 10mLDoxepin 25mg, 100mg Capsule SinequanDoxycycline monohydrate 25mg/5ml Oral suspension VibramycinBCF Doxycycline hyclate 100mg Capsule/Tablet VibramycinEnoxaparin30mg/0.3mL,40mg/0.4ml,80mg/0.8ml, 100mg/ml SyringeLovenoxBCF Epinephrine 0.3mg, 0.15mg Prefilled Syringe Epipen, Epipen JrBCF Erythromycin 0.5% (5mg/g) Ophthalmic Oint Erythromycin 3.5gBCF Erythromycin 2% Topical Solution A/T/S, T-StatBCF Erythromycin Base 250mg TabletErythromycin, DR 250mg Tablet Ery-TabBCF Erythromycin Ethylsuccinate 200mg/5mL Oral Suspension EES, EryPed 200mLBCF Esomeprazole 20mg, 40mg Capsule NexiumEstradiol 1mg Tablet EstraceBCF Estradiol transdermal0.025mg, 0.05mg,0.075mg, 0.1mg/hr Transdermal patch Climara #4/box - once a weekBCF Estrogen, conjugated0.3mg, 0.625mg,1.25mg Tablet PremarinBCF Estrogen, conjugated 0.625mg/g Vaginal Cream Premarin 42.5gBCFEstrogen,conjugated/medroxyprogesterone0.3/1.5mg, 0.45/1.5mg,0.625/2.5mg,0.625/5mgTabletPremproBCF Ethambutol 100mg, 400mg Tablet MyambutolBCF Ethinyl estradiol/Drospirenone 30mcg/3mg Tablet YasminBCF Ethinyl estradiol/Drospirenone 20mcg/3mg Tablet YazEthinyl estradiol/Ethynodiol diacetate 35mcg/1mg Tablet Demulen 1/35, Kelnor 1/35 Zovia equivalent; 1/35E onlyEthinyl estradiol/Etonogestrel 0.12mg/0.015mg/day Vaginal Ring Nuva Ring 1 ring (21days on/7day off)BCF Ethinyl estradiol/Levonorgestrel 20mcg/0.1mg Tablet Alesse Levlite, LessinaBCF Ethinyl estradiol/Levonorgestrel 30mcg/0.15mg Tablet Nordette

Page 5Ethinyl estradiol/Levonorgestrel30,40,30mcg/0.05,0.075,0.125mgTablet Tri-Levlen Tri-Phasil equivalent, TrivoraEthinyl estradiol/Norelgestromin0.75mg/6mg Transdermal patch Ortho EvraBCF Ethinyl estradiol/Norethindrone 35mcg/1mg Tablet Norinyl 1/35 Ortho Novum 1/35 equivalentEthinyl estradiol/NorethindroneEthinyl estradiol/Norethindrone/ Ferrousfumarate35mcg/0.5, 0.75, 1mg Tablet Ortho Novum 7/7/7 Necon 7/7/720mcg/1mg/75mg,30mcg/1.5mg/75mgTablet Loestrin Fe 1/20, 1.5/30BCF Ethinyl estradiol/Norgestimate 35mcg/0.25mg Tablet Ortho CyclenBCF Ethinyl estradiol/NorgestimateEthinyl estradiol/Norgestimate35mcg/0.18,0.215,0.25mg25mcg/0.18,0.215,0.25mgTablet Ortho Tri-Cyclen Trinessa equivalentTabletOrtho Tri-Cyclen LoEthinyl estradiol/Norgestrel 30mcg/0.3mg Tablet Lo/Ovral Low OgestrolEucerin Topical Cream Eucerin OTC-BXFelodipine 2.5mg, 5mg, 10mg Tablet PlendilFenofibrate Nanocrystallized 48mg, 145mg Tablet TricorFerrous Sulfate 15mg/0.6mL Oral Drops Feosol 50mLFerrous Sulfate 325mg Tablet FeSO4 OTC-BX/CommissaryFexofenadine 180mg Tablet Allegra 2nd line to ClaritinFexofenadine 30mg/5mL Oral Suspension AllegraFexofenadine/Pseudoephedrine 60mg/120mg Tablet Allegra-D 12 Hour 2nd line to ClaritinBCF Finasteride 5mg Tablet ProscarFluconazole 40mg/mL Oral Suspension Diflucan 35mLBCF Fluconazole 150mg Tablet Diflucan Restriction: Max 1 per 30 daysFluconazole 200mg Tablet DiflucanFluocinolone 0.01% Topical Oil Derma-Smoothe FSBCF Fluocinonide 0.05% Topical Cream LidexFluorescein sodium 1mg Ophthalmic strip AK-FluorFluoride, sodium 2.2mg Chewable Tablet LurideFluoride, sodium 1.1mg/mL Drops Pediaflor 50mLFluoride, sodium 1.1% Toothpaste Prevident 5000 Plus 106g, Dental Clinic OnlyOphthalmicFluorometholone 0.1%Soln/Susp FMLBCF Fluoxetine 10mg, 20mg Capsule ProzacFlurbiprofen 0.03% Ophthalmic Soln Ocufen 2.5mLBCF Fluticasone 50mcg/Dose Nasal Spray Flonase44mcg, 110mcg,BCF Fluticasone220mcg Oral Inhaler Flovent HFA 120 metered dosesFluticasone/SalmeterolBCFFluticasone/SalmeterolBCF100/50mcg,250/50mcg,500/50mcg45/21mcg,115/21mcg,230/21mcgBCF Folic Acid 1mg Tablet FolviteBCF Furosemide 20, 40mg Tablet LasixOral Inhaler Advair Diskus 60 metered doses; BID dosingOral Inhaler Advair HFA 120 metered doses; BID dosingBCF Gabapentin 100mg, 300mg, 400mg Capsule NeurontinBCF Gemfibrozil 600mg Tablet LopidBCF Gentamicin 0.3% Ophthalmic Oint Garamycin 3.5gBCF Gentamicin 0.3% Ophthalmic Soln Garamycin 5mL, GentaxBCF Glipizide 10mg Tablet GlucotrolGlipizide, extended release 10mg Tablet Glucotrol XLGlucose control solutions Solutions Medisense 1xHI, 1xLOBCF Glyburide 2.5mg, 5mg Tablet Micronase, DiabetaGlyburide Micronized 1.5mg, 3mg Tablet Glynase PresTab

Page 6Glycerin, Adult size 2.1g Suppository GlycerinGlycerin, Pediatric size 1.2g Suppository GlycerinBCF Goserelin 3.6mg, 10.8mg Pre-filled syringe ZoladexBCF Griseofulvin Microsize 125mg/5mL Oral Suspension Grifulvin V 120mLBCF Griseofulvin Ultramicrosize 125mg Tablet Gris-PegGuaifenesin ER 600mg Tablet MucinexCV Guaifenesin/Codeine 100mg/10mg Oral Syrup Robitussin AC 120mLGuaifenesin/Dextromethorphan 100mg/10mg Oral Syrup Robitussin DM OTC-BX/Commissary, Q-TussinGuaifenesin/Pseudoephedrine ER 600mg/60mg Tablet Mucinex D #18/boxHaloperidol 1mg, 2mg, 5mg Tablet HaldolHomatropine 5% Ophthalmic Soln Isopto Homatropine 5mLBCF Hydralazine 25mg Tablet ApresolineBCF Hydrochlorothiazide 25mg, 50mg Tablet HCTZBCF Hydrochlorothiazide/Triamterene 50mg/75mg Tablet Maxzide-50CIII Hydrocodone/Acetaminophen 5/500, 7.5/500, 10/500 Tablet Lortab, Vicodin Max Qty 30 D/SHydrocortisone 1% Topical Cream Cortaid OTC-BX/CommissaryBCF Hydrocortisone Acetate 2.5% Rectal Cream ProctosolBCF Hydrocortisone Acetate 25mg Rectal Suppository Anusol-HC Annucort-HC, 24 supp/boxHydrocortisone Valerate 0.2% Cream WestcortHydrocortisone Valerate 0.2% Ointment WestcortCII Hydromorphone 4mg Tablet Dilaudid Max 30 D/S; no refillsHydroxychloroquine 200mg Tablet PlaquenilHydroxypropyl methylcellulose 2.5% Ophthalmic Soln GoniosolBCF Hydroxyzine HCl 10mg/5mL Oral Syrup AtaraxBCF Hydroxyzine HCl 10mg, 25mg Tablet AtaraxHypromellose 2.50% Ophthalmic sol GoniosolHypromellose/Dextran 0.3% Ophthalmic Soln Bion TearsPreservative-Free; 28 vials/box;OTC-BX/CommissaryHypromellose/Dextran/Glycerin 0.3% Ophthalmic Soln Tears Naturale Forte OTC-BX/CommissaryBCF Ibandronate, once-monthly 150mg Tablet BonivaIbuprofen 100mg/5mL Oral Suspension Motrin OTC-BX/CommissaryBCF Ibuprofen 400mg, 600mg, 800mg Tablet MotrinImipramine 25mg Tablet TofranilBCF Indomethacin 25mg Capsule IndocinBCF Insulin Aspart 100Units/mL Injection NovologBCF Insulin Glargine 100Units/mL Injection LantusBCF Insulin Human, 70/30 100Units/mL Injection Novolin 70/30 10mL vial10mL vial, 5X3mL Flexpen; rapidacting10mL vial, 5X3mL Solostar pen;long actingBCF Insulin Human, NPH 100Units/mL Injection Novolin N 10mL vial; intermediate actingBCF Insulin Human, Regular 100Units/mL Injection Novolin R, Humulin R 10mL vial; rapid actingInsulin syringes, 28.5G 0.3cc, 0.5cc, 1cc Syringe B-D Insulin Syringes Box of 100BCF Ipratropium 0.02% Inhalation Solution Atrovent 25-2mL Unit dose VialsBCF Ipratropium 17mcg/Dose Oral Inhaler Atrovent HFA 200 metered dosesIrrigating eye solution Isotonic Solution Eye solution Eye Wash Sterile isotonic buffered solutionCIV Isometheptene/Dichlorphenazone/Acetaminophen65/100/325mg Capsule MidrinIsoniazid 50mg/5mL Oral Syrup INHBCF Isoniazid 100mg, 300mg Tablet INHIsopropyl alcohol pad Pad Alcohol prep pad Box of 200Max Qty 30 D/S (60 D/S forseizure & ADHD)

Page 7Isopropyl alcohol, rubbing 70% Topical Solution Alcohol solutionBCF Isosorbide Dinitrate 10mg Tablet IsordilBCFIsosorbide Dinitrate, Sustained-Release 40mg Capsule Dilatrate-SRIsosorbide Mononitrate 20mg Tablet IsmoBCF Isosorbide Mononitrate, ER 60mg ImdurKetoconazole 2% Shampoo NizoralKetoconazole 200mg Tablet NizoralKetoconazole 2% Topical Cream Nizoral 30gBCF Lactulose 10g/15mL Oral Syrup Lactulose 473mLLancets N/A Misc Lancets Box of 100; OTC-BXLatanoprost 0.005% Ophthalmic Soln Xalatan 2.5mLBCF Levofloxacin 500mg, 750mg Tablet LevaquinLevonorgestrel 52mg IUD Mirena To be given in clinicBCF Levonorgestrel 0.75mg Tablet Plan B, Next Choice #2 tablets/cardBCF Levothyroxine25mcg, 50mcg,75mcg, 88mcg,100mcg, 112mcg,125mcg, 150mcg Tablet SynthroidLidocaine 2% Topical Jelly Xylocaine 30mLLidocaine 4% Topical solutionLidocaine 4% Topical cream LMX4Lidocaine 5% Topical Patch Lidoderm 30 patches/boxLidocaine 5% Topical Ointment XylocaineLidocaine, Viscous 2% Oral Solution Xylocaine 100mLLidocaine/hydrocortisone/aloe 2.8%/0.55% Gel SolarcaineBCF Lisinopril5mg, 10mg, 20mg,40mg Tablet Zestril, PrinivilBCF Lisinopril/HCTZ10/12.5mg, 20/12.5mg,20/25mg Tablet Zestoretic, PrinzideBCF Lithium Carbonate 300mg Capsule LithonateBCF Loperamide 2mg Capsule Imodium OTC-BX/CommissaryLoratadine 10mg Tablet Claritin, Alavert OTC-BX/CommissaryTablet, extendedLoratadine/Pseudoephedrine5mg/120mgreleaseClaritin-D 12 Hour, AlevertCIV Lorazepam 0.5mg, 1mg, 2mg Tablet Ativan Max 30 day supply up to 5 refillsBCF Losartan 25mg, 50mg Tablet CozaarBCF Losartan/hydrochlorothiazide50/12.5mg,100/12.5mg, 100/25mg TabletHyzaarLoteprednol/Tobramycin 0.5/0.3% Ophthalmic Susp Zylet 5mLMagnesium citrate Oral solution CitromaMebendazole 100mg Chewable Tablet VermoxMeclizine 25mg Chewable Tablet Antivert Travel SicknessBCF Medroxyprogesterone 2.5mg, 10mg Tablet ProveraMedroxyprogesterone Acetate 150mg/mL Injection Depo-Provera To be given in clinicMefloquine 250mg Tablet Lariam prophylaxis once weeklyMegestrol 20mg Tablet MegaceBCF Meloxicam 7.5mg, 15mg Tablet MobicMenthol lozenges Lozenges Cepacol OTC-BX/CommissaryCII Meperidine 50mg Tablet Demerol Max 30 D/S; no refills500mg, 850mg,BCF Metformin1000mg Tablet GlucophageBCF Metformin ER 500mg, 750mg Tablet Glucophage XRMethimazole 10mg Tablet TapazoleBCF Methocarbamol 500mg Tablet Robaxin

Page 8BCF Methotrexate 2.5mg Tablet MethotrexateCII/BCF Methylphenidate 5mg, 10mg Tablet RitalinCII Methylphenidate 20mg Tablet Ritalin18mg, 27mg, 36mg,CII Methylphenidate, Extended-Release 54mg SR Tablet ConcertaMax 30 D/S (90 D/S for ADHD);no refillsMax 30 D/S (90 D/S for ADHD);no refillsMax 30 D/S (90 D/S for ADHD);no refillsMethylprednisolone 4mg Tablet Medrol Dosepak and TabletsBCF Metoclopramide 5mg/5mL Oral Syrup ReglanBCF Metoclopramide 10mg Tablet ReglanTablet, extendedBCF Metoprolol succinate, ER25mg, 50mg, 100mg releaseToprol XLBCF Metoprolol Tartrate 50mg, 100mg Tablet LopressorBCF Metronidazole 250mg Tablet FlagylBCF Metronidazole 0.75% Topical Gel Metrogel 45gBCF Metronidazole 0.75% Vaginal Gel Metrogel 70gMinocycline 50mg, 100mg Capsule MinocinMirtazapine 15mg, 30mg, 45mg Tablet RemeronBCF Mometasone 110mcg, 220mcg Twisthaler AsmanexMono/Di Basic NaPO4 7.2 gram/2.7 gram Oral Solution Fleet Phospho-Soda OTC-BX/CommissaryMono/Di Basic NaPO4 Enema Fleet enema 133mlMono/Di Basic NaPO4 Pediatric Enema Fleet pedia-laxMono/Di Basic NaPO4, bisacodyltab/supp7.2 gram/2.7 gram oralsoln, 5mg tab, 10 mgsupp Fleet Prep Kit #1 OTC-BX/CommissaryBCF Montelukast 4mg Chewable Tablets SingulairBCF Montelukast 5mg Chewable Tablets Singulair For 6-14 y/o patients onlyBCF Montelukast 4mg Granules SingulairBCF Montelukast 10mg Tablet SingulairCII/BCFMorphine Sulfate, Controlled-Release 15mg, 30mg, 60mg Tablet MS Contin Max 30 D/S; no refillsMoxifloxacin 0.5% Ophthalmic Soln Vigamox 3mLMultivitamin Oral Drops Poly-Vi-Sol OTC-BX/CommissaryBCF Mupirocin 2% Topical Ointment BactrobanNaphazoline/pheniramine 0.025%/0.3% Ophthalmic Soln Naphcon A 15mLBCF Naproxen 250mg, 500mg Tablet NaprosynNeedles 30G Needle NovofineBCF Neomycin/Polymyxin B/BacitracinNeomycin/Polymyxin B/BacitracinBCF Neomycin/Polymyxin B/GramicidinBCF Neomycin/Polymyxin B/HydrocortisoneBCF Niacin Extended Release3.5mg/10,000/400Units Opthalmic Oint Neosporin 3.5g3.5mg/10,000/400Units Ophthalmic soln Neosporin1.75mg/10,000U/0.025mg/ml Ophthalmic soln NeosporinCortisporin OticOtic Suspension Suspension10mL500mg, 750mg,1000mg Tablet NiaspanNicotine buccal 2mg, 4mg Gum Nicorette #110/boxNicotine Transdermal 7mg, 14mg, 21mg Patches NicodermBCF Nifedipine, Extended-Release 30mg, 60mg, 90mg Tablet Adalat CCBCF Nitrofurantoin macrocrystals 50mg Capsule MacrodantinNitrofurantoinBCF monohydrate/macrocrystals 100mg Capsule MacrobidNitrofurantoin 25mg/5mL Oral Suspension FuradantinNitroglycerin 2% Topical Ointment Nitro-BidBCF Nitroglycerin Aerosol, Lingual spray 0.4mg/Metered dose Sublingual Spray Nitrolingual Spray 200 metered doses

Page 9BCF Nitroglycerin Sublingual 0.4mg (1/150 grain) Tablet Nitrostat #25/bottleBCF Nitroglycerin Transdermal 0.4mg/hr Transdermal patch NitrodurBCF Norethindrone 0.35mg Tablet Nor-QD Micronor equivalentBCF Nortriptyline 25mg Capsule PamelorBCF Nystatin 100,000 Units/mL Oral Suspension Mycostatin 60mLNystatin 500,000 Units Tablet MycostatinBCF Nystatin 100,000 Units/g Topical Cream Mycostatin 15gBCF Nystatin 100,000 Units/g Topical Ointment Mycostatin 30gNystatin 100,000 Units/g Topical Powder Nystop 30gNystatin/Triamcinolone 100,000/1mg/g Topical Ointment Mycolog 15gOfloxacin 0.3% Otic Solution FloxinBCF Olopatadine 0.1% Ophthalmic Soln PatanolOlopatadine 0.2% Ophthalmic Soln PatadayBCF Omeprazole 20mg Capsule PrilosecOndansetron 8mg Tablet ZofranOndansetron, ODT 4mg Tablet Zofran ODTOndansetron 4mg/5ml Oral solution ZofranOseltamivir phosphate 75mg Tablet TamifluOseltamivir 12mg/ml Oral suspension TamifluBCF Oxybutynin 5mg Tablet DitropanCII/BCF Oxycodone/Acetaminophen 5mg/325mg Tablet Percocet Max 30 D/S; no refillsOxymetazoline 0.05% Nasal Spray Afrin OTC-BX/CommissaryParoxetine 20mg Tablet PaxilBCF Penicillin V Potassium 250mg/5mL Oral Suspension Pen VK 200mLBCF Penicillin V Potassium 250mg, 500mg Tablet Pen VKPermethrin 5% Topical Cream Elimite 60gPetrolatum/Min Oil 56.8%/42.5% Ophthalmic Oint Lacri-Lube 3.5gBCF Phenazopyridine 100mg Tablet PyridiumCIV/BCF Phenobarbital 30mg Tablet PhenobarbitalPhenobarbital/belladonna alkaloids Elixir DonnatalBCF Phenytoin Sodium, Extended 100mg Capsule DilantinBCF Phenytoin Sodium 50mg Chewable Tablet Dilantin InfatabsBCF Phenytoin Sodium 125mg/5mL Oral Suspension DilantinOphthalmicBCF Pilocarpine 1, 2, 4%Solution Pilocar 15mLBCF Pilocarpine 4% Ophthalmic Gel Pilopine HS 4gBCF Pimecrolimus 1% Topical Cream Elidel 30gPioglitazone 15mg, 30mg, 45mg Tablet ActosPiroxicam 20mg Capsule FeldenePodofilox 0.5% Topical Solution CondyloxPowder for oralPolyethylene glycol3350NFsolution Miralax 527gPolyethylene glycol/electrolyte 4 L Powder Colyte, GolytelyPolymyxin B/trimethoprim 10,000U/1mg/ml Opthalmic solution Polytrim 10mlPotassium Chloride 20% Oral elixir Kaon Cl 40mEq/15mlMax Qty 30 D/S (60 D/S forseizure & ADHD)BCF Potassium Chloride, ER 20mEq Tablet K-Dur Klor-Con M20Pramoxine/Hydrocortisone 1%/1% Aerosol ProctoFoam HC 10gBCF Pravastatin 20, 40mg Tablet PravacholPrazosin 1mg, 2mg Capsule MinipressBCF Prednisolone 15mg/5mL Oral Syrup OraPredPrednisolone Acetate 1% Ophthalmic Soln Pred Forte 5mLBCF Prednisone 1mg, 5mg, 20mg Tablet Deltasone

Page 10Prenatal Vitamin incl. 1mg folic acid Tablet Prenatal VitaminPrilocaine/Lidocaine 2.5%/2.5% Cream EmlaPrimaquine phosphate 26.3mg Tablet PrimaquinPrimidone 50mg, 250mg Tablet MysolineBCF Probenecid 500mg Tablet Benemidwomen < 45 years old; OTC-CommissaryProchlorperazine 25mg Rectal Suppository Compazine #12/boxPromethazine 25mg Rectal Suppository Phenergan #12/boxBCFBCF Promethazine 6.25mg/5mL Oral Syrup PhenerganBCF Promethazine 25mg Tablet Phenerganproparacaine 0.5% Ophthalmic Soln OphthainePropranolol 40mg Tablet InderalPropranolol Extended-Release 80mg, 120mg Capsule Inderal LABCF Propylthiouracil 50mg Tablet PTUPseudoephedrine 30mg/5mL Oral Syrup SudafedPseudoephedrine 30mg Tablet SudafedBCF Pyrazinamide 500mg Tablet PyrazinamidePyridoxine 50mg Tablet Vitamin B625mg, 50mg, 100mg,BCF Quetiapine200mg Tablet SeroquelBCF Quetiapine extended release 200mg, 300mg Tablet Seroquel XRBCF Raloxifene 60mg Tablet EvistaBCF Ranitidine 150mg Tablet ZantacBCF Ranitidine 15mg/mL Oral Syrup ZantacBCF Rifampin 300mg Capsule RifadinBCF Risperidone 1mg, 2mg Tablet RisperdalBCF Risperidone 1mg/ml Oral solution Risperdal 30mlBCF Rizatriptan ODT 10mg Tablet Maxalt-MLTSalicylic acid 40% Plaster MediplastBCF Salmeterol 50mcg/Dose Diskus Serevent 60 metered doses; BID dosingBCF Salsalate 500mg Tablet DisalcidScopolamine 15mg Patches Transderm ScopBCF Selenium Sulfide 2.5% Topical Lotion Selsun OTC-BXSelenium Sulfide 2.5% Shampoo Selsun OTC-BXBCF Sertraline 50mg, 100mg Tablet ZoloftBCF Sildenafil 25mg, 50mg, 100mg Tablet Viagra Mandatory 40 years or olderSilver nitrate applicator Misc Silver NitrateSilver Sulfadiazine 1% Topical Cream Silvadene 20gSimethicone 40mg/0.6mL Oral Drops Mylicon OTC-BX/CommissarySimethicone/Aluminum Hydroxide/Magnesium hydroxideBCF SimvastatinSimvastatin/ezetimibe20mg/200mg/200mg/5mL Suspension Maalox OTC-BX/Commissary5mg, 10mg, 20mg,40mg, 80mg Tablet Zocor10/10, 20/10, 40/10,80/10mg Tablet VytorinBCF Sitagliptin 50mg, 100mg Tablet JanuviaBCF Sitagliptin/Metformin 50mg/500mg JanumetSodium Chloride 0.90% Inhalation Solution Sodium Chloride 5mlSodium Chloride 0.65% Nasal Spray Ocean Saline, Saline mist OTC-BX/CommissarySodium citrate/citric acid 500mg,334mg Oral solutionSpacer Device Misc Aerochamber, EasiventSpacer with Mask Device Misc AerochamberBCF Spironolactone 25mg Tablet Aldactonesmall (infant) or medium (child)sizeSucralfate 1g/10mL Suspension Carafate 420mL per bottle

Page 11Sucralfate 1g Tablet CarafateBCF Sulfacetamide 10% Ophthalmic Soln Bleph-10 10mL, 15mlSulfacetamide/Prednisone 10%/0.2% Ophthalmic Susp BlephamideBCF Sulfasalazine 500mg Tablet AzulfidineSulfisoxazole 500mg/5mL Suspension GantrisinSulfisoxazole/Erythromycin 600mg/200mg Suspension PediazoleBCF Sumatriptan 6mg/0.5mL Injection Imitrex Inj. RF KitSumatriptan 50mg, 100mg Tablet ImitrexSyrup base Syrup base Ora-SweetBCF Tamoxifen 10mg Tablet NolvadexBCF Tamsulosin 0.4mg Capsule FlomaxBCF Telmisartan 20mg, 40mg, 80mg Tablet Micardis #30/box40/12.5mg, 80/12.5mg,BCF Telmisartan/Hydrochlorothiazide 80/25mg Tablet Micardis HCT #30/boxCIV/BCF Temazepam 15mg Tablet Restoril Max Qty 30 D/SBCF Terazosin 1mg, 2mg, 5mg Capsule HytrinTerbinafine 250mg Tablet LamisilTerbutaline 5mg Tablet BrethineTerconazole 0.4% Vaginal Cream Terazol 7CIII Testosterone 200mg/mL Injection Testosteron cypionate Max Qty 30 D/STetracaine 0.50% Ophthalmic sol PointocaineBCF Tetracycline 250mg Capsule TetracyclineBCF Theophylline 80mg/15mL Oral elixir ElixophyllinBCF Theophylline, Extended-Release 200mg, 300mg, 400mg Tablet Theo-DurThiamine 50mg Tablet Vitamin B 1 OTC-BX/CommissaryBCF Timolol 0.25%, 0.5% Ophthalmic Gel Timoptic XE 5mLBCF Timolol 0.25%, 0.5% Ophthalmic Soln Timoptic 15mLTiotropium 18mcg Oral Inhaler Spiriva 30 Capsules per InhalerTobramycin/Dexamethasone 0.3%/0.1% Ophthalmic Susp Tobradex 5mLBCF Tolterodine, Extended-Release 2mg, 4mg Capsule Detrol LATopiramate 25mg, 50mg, 100mg Tablet TopamaxBCF Tramadol 50mg Tablet UltramBCF Trazodone 50mg, 100mg Tablet DesyrelBCF Tretinoin 0.025%, 0.05% Topical Cream Retin-ATretinoin, microsphere 0.04%, 0.1% Gel Retina-A micro 20gBCF Triamcinolone Acetonide 0.1% Oral Paste Kenalog 5gTriamcinolone Acetonide 0.5% Ointment 15gBCF Triamcinolone Acetonide 0.1% Topical Cream Aristocort, Kenalog 15g, 80gTrifluridine 1% Ophthalmic Soln ViropticBCF Trihexyphenidyl 2mg Tablet ArtaneBCF Trimethoprim/Polymyxin B 10,000U/0.1%/ml Ophthalmic Soln Polytrim 10mLBCF Trimethoprim/Sulfamethoxazole 40mg/200mg/5mL Oral Suspension Septra, BactrimBCF Trimethoprim/Sulfamethoxazole 160mg/800mg Tablet Septra DS, Bactrim DSTropicamide 1% Ophthalmic Soln Mydriacyl 15mLValacyclovir 500mg, 1000mg Tablet Valtrex40mg, 80mg, 160mg,BCF Valsartan320mg Tablet DiovanBCF Valsartan/hydrochlorothiazide160/12.5mg,160/25mg, 320/12.5mg TabletDiovan HCTVarenicline 1mg Tablet Chantix 2nd line to 12 weeks of bupropion

Page 12Varenicline 0.5mg, 1mg Tablet Chantix Starter PackVaseline petroleum Surgical lubricant Surgilubecontains 4 weeks of medication;2nd line to 12 weeks of bupropionBCF Venlafaxine, Extended-Release 37.5mg, 75mg, 150mg Capsule Effexor XRBCF Verapamil, Extended-Release 120mg, 180mg, 240mg Tablet Calan SRVitamin D (Ergocalciferol 1.25mg) 50,000 Units Capsule DrisdolVitamin E 50IU/mL Oral Solution Auqasol E1mg, 2mg, 2.5mg,BCF Warfarin sodium5mg, 10mg Tablet Coumadin Must be checked by pharmacistWitch Hazel 50% v/v Pad Relief Hemorrhoidal astringentBCF Zaleplon 10mg Capsule sonata Hemorrhoidal astringentZolmitriptan 2.5mg, 5mg Tablet Zomig ODT 2.5mg, 5mgCIV/BCF Zolpidem 10mg Tablet Ambien

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