dru g formulary - Kern Health Systems

OVER THE COUNTER DRUGS44 KFHC DRUG FORMULARY*See Healthy Families Exception Warning on Page 41GENERIC BRAND FORMSOphthalmic – Antihistamine/OTC G Ketotifen Zaditor® 0.025% Ophth solnOphthalmic – Decongestant/OTC G Naphazoline Albalon® 0.1% Ophth solnOphthalmic – Decongestant – Antihistamine/OTC G Naphazoline & Pheniramine Naphcon-A® 0.025%-0.3% ophth soln G Naphazoline & Antazoline Vasocon-A® 0.05% - 0.5% ophth solnOtic/ OTC G Carbamide Peroxide Debrox® 6.5% solnRectal – Hemorrhoidal/OTC G Hemorrhoidal Suppos Anusol-HC® suppositoryw/HydrocortisoneRespiratory – Antihistamine/OTCThe FDA does not recommend antihistamines and other cough cold products in individuals under the ageof 2 years old. These products are restricted to members 2 years old and older. G Brompheniramine2mg/5ml elixir G Chlorpheniramine Chlortrimeton® 1mg/5ml liquid, 2mg/5ml syrup, 2mg, 4mg chewable tablet,4mg tablet, 8mg, 12mg cr tablet,6mg, 8mg, 12mg cr capsule G Diphenhydramine Benadryl® 12.5mg/5ml elixir or syrup, 25mg, 50mg capsule or tablet G Loratadine Claritin® 10mg tablet, 5mg/5ml syrupRestricted: Liquid allowed < 5 yo.Respiratory – Antihistamine – Decongestant/OTCRestricted: This whole category allowed for members between the age of 4-21 years old. G Brompheniramine & Dimetapp® 1mg-15mg/5ml elixirPseudoephedrineold formualtion G Brompheniramine &Dimetapp®Phenylephrine new formualtion 1m-2.5mg/5ml elixirContinued on next page