dru g formulary - Kern Health Systems

14GENERIC BRAND FORMSKFHC DRUG FORMULARYCardiovascular – Calcium Channel Blocker, continued • SEE PREVIOUS PAGE G Felodipine Plendil® 2.5mg, 5mg, 10mg cr tablet G Nifedipine Adalat®, Adalat CC® 10mg, 20mg capsule, 30mg, 60mg, 90mg cr tablet G Nisoldipine Sular® 8.5mg, 20mg, 30mg, 40mg tablet G Verapamil Calan®, Calan SR® 40mg, 80mg, 120mg tablet, 120mg cr tablet,180mg cr tablet, 240mg cr tabletCardiovascular – Diuretic G Cholrthalidone Thalitone® 15mg, 25mg, 50mg tablet G Furosemide Lasix® 8mg/ml, 10mg/ml soln, 20mg, 40mg, 80mg tablet G Hydrochlorothiazide Esidrix® 25mg, 50mg, 100mg tablet G Indapamide Lozol® 1.25mg, 2.5mg tablet G Metolazone Zaroxolyn® 2.5mg, 5mg, 10mg tabletRestriction: Restricted to pts. on furosemide therapy. G Spironolactone Aldactone® 25mg, 50mg, 100mg tablet G Triamterene Dyrenium® 50mg, 100mg capsule G Triamterene & Hydrochlorothiazide Dyazide®, Maxide® 37.5mg-25mg, 50mg-25mg capsule,75mg-50mg tabletCardiovascular – Electrolyte G Calcium Acetate PhosLo® 667mg capsuleRestriction: For renal patients only. G Potassium Chloride8mEq,10mEq, 20mEq cr tablet, 10%, 20% liquidSevelamar Renagel® 400mg, 800mg tabletsRestriction: Maximum of 6 tablets daily. Higher doses require prior authorization, support with lab values.Sevelamar Renvella® 800mg tabletRestriction: Maximum of 6 tablets daily. Higher doses require prior authorization, support with lab values. G Sodium Polystyrene Sulfonate Kayexalate® 25% susp onlyCardiovascular – Vasodilator G Hydralazine Apresoline® 10mg, 25mg, 50mg, 100mg tablet G Isosorbide Dinitrate Isordil® 5mg, 10mg, 20mg, 30mg, 40mg tablet,2.5mg, 5mg sl tablet, 5mg, 10mg chewable tabletContinued on next page