L.A. Care Covered Drug Formulary (pdf)

Commercial FormularyTetracyclinesT1 demeclocycline hcl DECLOMYCINT2 doxycycline calcium VIBRAMYCINT1 doxycycline hyclate DORYXT1 doxycycline hyclate DOXYCYCLINEHYCLATET1 doxycycline hyclate MORGIDOXT1 doxycycline hyclate VIBRAMYCINT3 doxycyclineADOXA CKmonohy/skin clnsr9T3 doxycyclineADOXA TTmonohy/skin clnsr9T1 doxycycline ADOXAmonohydrateT1 doxycycline ADOXA PAK QL, STmonohydrateT1 doxycycline AVIDOXYmonohydrateT3 doxycyclinemonohydrateMONODOX(CAP)(100MG)T3 doxycyclinemonohydrateMONODOX(CAP)(50MG)T1 doxycyclinemonohydrateMONODOX(CAP)(75MG)T3 doxycyclinemonohydrateORACEAAGE,QL, STT1 doxycycline VIBRAMYCINmonohydrateT3 doxycycline/omega-3 NUTRIDOX#1/eye mskT3 doxycycline/salicy/oct/ AVIDOXY DKzinc oxT3 doxycycline/skin MORGIDOXcleanser #19T1 minocycline hcl DYNACINT1 minocycline hcl MINOCINT3 minocycline hcl SOLODYN(TAB ER24H)(105 MG)AGE,QL, STT3 minocycline hcl SOLODYN(TAB ER24H)(115MG)AGE,QL, STT1 minocycline hcl SOLODYN(TAB ER24H)(135 MG)AGE,QLT1 minocycline hcl SOLODYN(TAB ER24H)(45 MG)AGE,QLT3 minocycline hcl SOLODYN(TAB ER24H)(55 MG)AGE,QL, STT3 minocycline hcl SOLODYN(TAB ER24H)(65 MG)AGE,QL, STT3 minocycline hcl SOLODYN(TAB ER24H)(80 MG)AGE,QL, STT1 minocycline hcl SOLODYN(TAB ER24H)(90 MG)AGE,QLT3 minocycline hcl/skin cl MINOCINno.4T1 tetracycline hcl ALA-TETT1 tetracycline hcl TETRACYCLINE HCLINFECTIOUS DISEASE - FUNGALAntifungal AgentsT1 clotrimazoleCLOTRIMAZOLET1 fluconazoleT1 flucytosineT3 itraconazoleT1 itraconazoleT2 itraconazoleT1 ketoconazoleT3 miconazoleT3 posaconazoleT2 terbinafine hclT1 terbinafine hclT3 terbinafine/hydroxychitosanT1 triacetinT2 voriconazoleT1 voriconazoleAntifungal AntibioticsDIFLUCANANCOBONONMELSPORANOX(CAP)SPORANOX(SOLUTION)KETOCONAZOLEORAVIGNOXAFILLAMISIL(GRANPACK)LAMISIL(TAB)TERBINEXTRIACETINVFEND(SUSPRECON)VFEND(TAB)T1 griseofulvin GRIS-PEGultramicrosizeT3 griseofulvin,microsize FULVICIN U/FT1 griseofulvin,microsiz GRIFULVIN VeT1 nystatinMYCOSTATINT1 nystatinNYSTATINAntifungal-antibiotic-steroid-antihistamineCombT3 nystatin/tcn/hc/diphenhFIRST-MARY'SydraminAntifungal-anti-inflammatory SteroidantihistamineT3 nystatin/hydrocortisoneFIRST-DUKE'S/diphenAntifungal-local Anesthetic-antihistamineCombT3 nystatin/lidocaine/diphenhydFIRST-BXNINFECTIOUS DISEASE -MISCELLANEOUSAminoglycosidesT1 neomycin sulfateT4 tobramycin in 0.225%naclNEOMYCIN SULFATETOBIPAAntibacterial Agents,miscellaneousT3 glycineT3 urologic solution-gT3 urologic solution-gGLYCINEIRRIGATINGSOLUTION GUROLOGICSOLUTION GPage 39 of 91