maxwell air force base drug formulary

MAXWELL AIR FORCE BASE DRUG FORMULARY
42 MDSS/SGSAP
300 South Twinning St. Bldg 760
Maxwell AFB, AL 36112-6219
Main Pharmacy: 953-8732
Refill Center: 953-6868
Gunter Refill Satellite: 416-5455
Refill Call-in System: 953-7971or 953-7978 or (800) 732-6117
Website:
http://www.maxwell.af.mil/library/factsheets/factsheet.asp?id=14581
Note: The pharmacy closes at noon on the third Thursday of every
month for training.
Last revision: 30 April 2012
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Frequently Asked Questions
Q. I was seen by a provider in the 42 MDG. Why aren’t my
medications filled ahead of me checking in?
A. Due to patient safety, we require that every patient seen by a
42 MDG provider check in with a pharmacy technician
following an appointment or phone consult. This step is to
ensure our patients are receiving the correct medication and
dosing along with verifying patient allergies.
Q. Why are patients not able to pick up their refilled
prescriptions at the drive thru at Maxwell Clinic?
A. This is a security and safety issue for the base. If the
pharmacy allowed refill pickups at the window, traffic flow on
the adjacent road would be backed up and make traveling
down this road very dangerous. We must ensure this road
remains clear for emergency response teams. (However, the
pharmacy does extend this service to our disabled patrons
because we understand that walking from the parking lot may
be difficult.)
TRICARE Mail Order Pharmacy:
- Save money and time by ordering up to a 90-day supply of
your medication
- Register for home delivery with ease online, by phone or
mail
- Prescriptions are delivered directly to you with free
standard shipping
- Order refills easily online, by phone or mail
- For information, call 1-877-363-1433 or ask the pharmacy
technician or pharmacist the next time you come in

Acetaminophen 325 & 500mg tabs, 120 & 650mg supp, 80mg/0.8ml
drops & 160mg/5ml susp
Acetazolamide (Diamox) 250mg tab & 500mg sequel
Acetic Acid 2% otic sol
Actifed tabs
Actoplus Met (Actos/Metformin) 15/500 & 15/850mg tabs
Acyclovir (Zovirax) 200mg cap, 800mg tabs & 200mg/5ml susp
Acyclovir (Zovirax) 5% oint
Advair Diskus 100/50, 250/50 & 500/50mg
Aggrenox 25/200 mg caps
Albuterol Sulfate (Ventolin HFA)
Albuterol 0.5% sol, 0.083% sol & MDI
Albuterol (Proventil) 0.083% pre-mixed vials & 2mg/5ml syrup
Alcohol pads
Alendronate (Fosamax) 10, 35 & 70mg tabs
Alendronate (Fosamax + D) 2800 & 5600 tabs
Alesse/Levlite tabs
Aluminum chloride (Drysol) 20% sol
Alfuzosin (Uroxatral) 10mg tabs
Allopurinol (Zyloprim) 100 & 300mg tabs
Alprazolam (Xanax) 0.25, 0.5 & 1mg tabs
Amantadine (Symmetrel) 100mg cap
Amiodarone (Cordarone) 200mg tab
Amitriptyline (Elavil) 10 & 25mg tabs
Amlodipine besylate (Norvasc) 2.5, 5 & 10mg tabs
Ammonium lactate (Lac-Hydrin) 12% lotion
Amoxicillin 250 & 500mg cap, 875mg tab, 250mg chew, 125mg/5ml,
250mg/5ml & 400mg/5ml susp
Armour Thyroid 0.25, 0.5 & 1gr tabs
Artificial tears oint & sol
Aspirin EC 325mg tabs
Aspirin 81mg EC & chew tab
Atenolol (Tenormin) 25 & 50mg tab
Atomoxetine (Strattera) 10, 18, 25, 40 & 60mg caps
Atorvastatin (Lipitor) 10, 20, 40 & 80mg
Atropine 1% opth sol & oint
Augmentin 250, 500 & 875mg tabs, 200 & 400mg chew tabs, 200mg/5ml &
400mg/5ml susp
Augmentin ES 600mg/5ml susp
Auralgan otic drop
Azathioprine (Imuran) 50mg tab
Azelastine (Astelin) 137 mcg nasal spray
Azithromycin (Zithromax) 250mg tab, 100mg/5ml & 200mg/5ml susp
Bacitracin top oint
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Bacitracin ophth oint
Baclofen (Lioresal) 10mg tabs
Bactrim/Septra DS, SS tabs & 200/40 mg per 5ml susp
Benzaclin gel (clindamycin phos/benzoyl peroxide) 50mg pump
Benzonatate (Tessalon) 100mg
Benzoyl Peroxide 10% gel & 5% wash
Benztropine (Cogentin) 2mg tab
Betamethasone 0.05% lotion, 0.1% cream & oint
Betaxolol (Betoptic S) 0.25% drops
Bicitra soln
Bimatoprost (Lumigan) 0.03% sol
Bisacodyl (Dulcolax) 5mg tab & 10mg supp
Bismuth subsalicylate (Pepto-Bismol) 262mg tab
Brimonidine (Alphagan-P) 0.15% drops
Bromocriptine (Parlodel) 2.5mg tabs
Budesonide (Pulmicort Respules) 0.25mg/2ml & 0.5mg/2ml
Bupropion (Wellbutrin) 100 & 150mg SR tabs
Bupropion XL (Wellbutrin XL) 150 & 300mg tabs
Buspirone (Buspar) 10 & 15mg tabs
Calcitriol (Rocaltrol) 0.5mg cap
Candesartan (Atacand) 4, 8, 16 & 32mg tabs
Canesartan HCT (Atacand HCT) 16/12.5mg & 32/12.5mg
Captopril (Capoten) 25 & 50mg tabs
Carbamazepine (Tegretol) 100mg chew, 200mg tabs & 100mg/5ml susp
Carbamazepine (Tegretol) XR 100 & 200mg tabs
Carvedilol (Coreg) 3.125, 6.25, 12.5 & 25mg tabs
Carvedilol Phosphate (Coreg CR) 10, 20, 40 & 80mg tabs
Cefdinir (Omnicef) 125mg/5ml & 250mg/5ml susp
Cefixime (Suprax) 400mg tabs
Cefprozil (Cefzil) 250, 500mg tabs & 250mg/5ml susp
Cefuroxime (Ceftin) 250mg tabs
Celecoxib (Celebrex) 100 & 200mg caps
Cephalexin (Keflex) 250, 500mg caps, 125mg/5ml & 250mg/5ml susp
Cetirizine (Zyrtec) 10 mg tab & 1mg/ml syrup
Chlordiazepoxide (Librium) 25mg caps
Chlorhexidine gluconate (Periogard) oral rinse
Chloroquine phosphate (Aralen) 500mg tabs
Chlorpheniramine (CTM) 4mg tabs & 2mg/5ml syrup
Chlorthalidone (Hygroton) 25 & 50mg tabs
Ciclopirox (Penlac 8%) nail lacquer
Cimetidine (Tagamet) 400mg tabs
Ciprofloxacin (Cipro) 250 & 500mg tabs
Ciprofloxacin (Ciloxan) 0.3% drops
Citalopram (Celexa) 10, 20 & 40mg tabs
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Clarithromycin (Biaxin) 500mg tabs
Clarithromycin XL (Biaxin XL) 500mg tabs
Clindamycin (Cleocin T) 1% sol
Clindamycin (Cleocin) 150mg caps
Clindamycin (Cleocin) vaginal cream
Clobetasol (Temovate) 0.05% oint & cream
Clomiphene (Clomid) 50mg tabs
Clomipramine (Anafranil) 50mg cap
Clonazepam (Klonopin) 0.5, 1 & 2mg tabs
Clonidine (Catapres) 0.1 & 0.2mg tabs
Clopidogrel (Plavix) 75mg tabs
Clotrimazole (Mycelex) 10mg troches
Clotrimazole (Mycelex) 1% vaginal cream
Clotrimazole (Mycelex) 1% top cream
Codeine Sulfate 30mg tabs
Colchicine (Colcrys) 0.6mg tabs
Colestipol (Colestid) 1 gram tabs
Colytely PEG Sol
Combigan (brimonidine/timolol) opth sol
Conjugated Estrogens (Premarin) 0.3, 0.625, 0.9, 1.25mg tabs &
0.625 vaginal cream
Cortisone Acetate 25mg tabs
Cortisporin opth oint
Cortisporin otic susp
Dorzolamide/Timolol (Cosopt) opth sol
Cyanocobalamin (B12) 1000mcg/ml inj
Cyclobenzaprine (Flexeril) 10mg tabs
Cyclobenzaprine ER (Amrix) 15 & 30mg cap
Cyclopentolate (Cylogyl) 1 & 2% opth sol
Cyclophosphamide (Cytoxan) 50mg tabs
Cyclosporin (Restasis) 0.05% sol
Cyproheptadine (Periactin) 4mg tabs
Dabigatran Etexilate (Pradaxa) 75 & 150mg caps
Dapsone (DDS) 25 & 100mg tabs
Demulen tabs
Depo-Provera
Desmopressin (DDAVP) nasal spray
Desogen tabs
Desoximethasone 0.05% top cream
Dexamethasone (Decadron) 4mg tab & 0.5ml/5ml syrup
Dextroamphetamine (Dexedrine) 5mg tabs & 10mg spansule
Dextroamphet/Amphet (Adderall) 5, 10, 20 & 30mg tabs
Dextroamphet/Amphet (Adderall XR) 5, 10, 15, 20, 25 & 30mg caps
Diazepam (Valium) 5mg tabs
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Dibucaine 1% top oint
Diclofenac (Voltaren) 50, 75mg tab & 1% gel
Dicyclomine (Bentyl) 20mg tabs
Digoxin (Lanoxin) 0.125 & 0.25mg tabs & 0.05mg/ml susp
Diltiazem (Cardizem) 60mg tabs
Diltazem SR (Tiazac) 120, 180, 240, 300 & 360mg caps
Diphenhydramine (Benadryl) 25, 50mg caps &12.5mg/5ml elixir
Dipyridamole (Persantine) 25 & 75mg tabs
Disopyramide (Norpace) 100 & 150mg tabs
Disulfiram (Antabuse) 250mg tabs
Divalproex (Depakote) 125mg sprinkles, 125mg & 250mg tabs
Divalproex (Depakote ER) 250 & 500mg tabs
Dicloxacillin (Dynapen) 250mg caps
Dihydroergotamine Mesylate (DHE 45) 1mg/ml inj
Docusate sodium (Colace) 100mg caps
Donepezil (Aricept) 5 & 10mg tabs
Donnatal (or gen eq) tab & elixer
Dorzolamide (Trusopt) 2% opth sol
Doxazosin (Cardura) 2, 4 & 8mg tabs
Doxepin (Sinequan) 25mg caps
Doxycycline (Vibramycin) 100mg caps
Enoxaparin (Lovenox) 30, 40, 60, 80 & 100mg inj
Epipen Jr. (0.15mg auto-inj.) 2/pack
Epipen (0.3mg auto-inj.) 2/pack
Ergocalciferol (Vitamin D) 50,000u
Erythromycin (Ilotycin) 5mg/gm opth oint
Erythromycin (E.E.S.) 200mg/5ml susp
Erythromycin EC (Ery-tab) 250 & 333mg tabs
Esomeprazole magnesium (Nexium) 20 & 40mg caps
Estradiol (Climara) 0.0025, 0.0375, 0.05 & 0.1mg/d patches
Estradiol (Estrace) 1mg tabs
Estratest tabs
Estratest Half-Strength tabs
Ethambutol (Myambutol) 400mg tabs
Etidronate (Didronel) 400mg tabs
Etonogestrel/Ethinyl Estradiol Vaginal Ring (NuvaRing)
Eucerin top cream
Exenatide (Byetta) 5 & 10mcg prefilled pen inj
Ezetimibe (Zetia) 10mg tabs
Felodipine (Plendil) 2.5, 5 & 10mg tabs
Fenofibrate (Tricor) 48, 54, 67,134,145,160 & 200mg tabs
Femhrt 1mg/5mcg tabs
Ferrous sulfate 75mg/0.6ml drops
Ferrous Sulfate 325mg tabs
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Fexofenadine (Allegra) 180mg tabs
Fexofenadine/pseudoephedrine (Allegra-D) 12 hour tabs
Fioricet (acetaminophen, butalbital, caffeine) tabs
Finasteride (Proscar) 5mg tabs
Fiorinal (aspirin, butalbital, caffeine) tabs
Flavoxate (Urispas) 100mg tabs
Flecainide (Tambocor) 100mg tabs
Fleets Enema
Fluconazole (Diflucan) 100, 150, 200mg tabs, 10mg/ml & 40mg/ml susp
Fludrocortisone (Florinef) 0.1mg tabs
Fluocinolone 0.01% sol
Fluocinolone 0.01% (Derma Smoothe/FS Scalp Oil)
Fluocinonide (Lidex) 0.05% cream & gel
Fluoride (Luride) 1mg tabs
Fluorometholone (FML) 0.1% ophth susp
Fluoxetine (Prozac) 10 & 20mg caps
Fluphenazine (Prolixin) 2.5mg tabs
Flutamide 125 mg cap
Fluticasone (Flonase) nasal spray
Fluticasone (Flovent) 44, 110 & 220mcg/sp
Folic acid 1mg tabs
Fosinopril (Monopril) 10, 20 & 40mg tabs
Furosemide (Lasix) 20 & 40mg tabs
Gabapentin (Neurontin) 100, 300, 400, 600 & 800mg caps
Gemfibrozil (Lopid) 600mg tabs
Gentamycin (Garamycin) 0.3% opth sol & oint
Glipizide (Glucotrol) 5 & 10mg tabs
Glipizide (Glucotrol XL) 5 & 10mg tabs
Glucagon 1mg/ml inj
Glucovance 5/500mg tabs
Glyburide 5mg tabs
Glyburide, micronized (Glynase) 1.5, 3 & 6mg tabs
Glycopyrrolate (Robinul) 1mg tabs
Goserilin (Zoladex) 3.6 & 10.8mg implant
Griseofulvin 250mg tab &125mg/5ml susp
Guaifenesen LA (Humabid) 600mg tabs
Haloperidol (Haldol) 2 & 5mg tabs
Hydralazine (Apresoline) 25 & 50mg tabs
Hydrochlorothiazide 12.5, 25 & 50mg tabs
Hydrochlorothiazide/Triamterene (Maxide) 25mg tabs
Hydrocortisone (Cortef) 20mg tabs
Hydrocortisone (Hytone) 1% top cream & Oint
Hydrocortisone (Cortenema) 100mg enema
Hydrocortisone (Anusol-HC) 2.5% cream
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Hydrocortisone 25mg (Anumed-HC) supp
Hydroquinone (Eldoquin Forte) 4% top cream
Hydromorphone (Dilaudid) 2 & 4mg tabs
Hydroxychloroquine (Plaquenil) 200mg tabs
Hydroxyurea (Hydrea) 500mg caps
Hydroxyzine (Atarax) 10, 25mg tabs & 10mg per 5ml syrup
Hypromellose (Genteal) opth sol & gel
Ibandronate (Boniva) 150mg tabs
Ibuprofen (Motrin) 400, 600, 800mg tabs & 100mg/5ml susp
Imipramine (Tofranil) 10 & 25 mg tabs
Imiquimod (Aldara) 5% cream
Indapamide (Lozol) 2.5mg tabs
Indomethacin (Indocin) 25 & 50mg caps
Insulin aspart (NovoLog) vial, flexpen, cartridge & 70/30
Insulin detemir (Levemir) vial & flexpen
Insulin glargine (Lantus) 100 units/ml & solostar
Insulin NPH (Novolin N)
Insulin regular (Novolin R)
Insulin NPH/regular (Novolin 70/30)
Insulin Syringes ½ & 1ml
Ipratropium (Atrovent) 0.03 & 0.06% nasal spray
Ipratropium (Atrovent) MDI
Ipratropium (Atrovent) 0.2% inhalation sol
Ipratropium/Albuterol (Combivent) MDI
Isoniazid (INH) 100 & 300mg tabs
Isosorbide Dinitrate 2.5, 5 & 10mg tabs
Isosorbide Dinitrate 40mg SR tabs
Isosorbide Mononitrate (IMDUR) 30 & 60 mg tab
Janumet 50/500mg & 50/1000mg tabs
Jolessa (Seasonale)
Ketoconazole (Nizoral) 2% cream & shampoo
Ketorolac (Toradol) 10mg tabs
Ketotifen (Zaditor) opth sol
Labetalol (Normodyne/Trandate) 200mg tab
Lactulose 10Gm/15ml Syrup
Lamotrigine (Lamictal) 25, 100, 150 & 200mg tabs
Lancets
Latanoprost (Xalatan) 0.005% opth
Leucovorin 5mg tabs
Leukeran (Chlorambucil) 2mg tabs
Leuprolide (Lupron) 3.75, 7.5, 11.25 & 22.5mg inj
Levafloxacin (Levaquin) 250, 500 & 750mg tabs
Levobunolol Hydrochloride (Betagan) 0.5% sol
Levolbuterol (Xopenex) HFA, 0.31mg/ml & 0.63mg/ml inh sol
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Levonorgestrel (Plan B) 1.5mg – Available without a prescription to
female beneficiaries over 17 years of age after pharmacist counseling
Levothyroxine 0.025, 0.05, 0.075, 0.088, 0.1, 0.112, 0.125, 0.137,
0.15, 0.175 & 0.2mcg tabs
Librax caps
Lidocaine 2% viscous, 5% oint & 2% jelly
Lidocaine (Lidoderm) 700mg patch
Lindane 1% lotion & shampoo
Lisinopril (Zestril) 5, 10, 20 & 40mg tabs
Lithium Carbonate 300mg caps
Loestrin FE 1/20 & 1.5/30 tabs
Lomotil tabs
Lo-Ovral tabs
Loperamide (Imodium) 2mg caps
Loratadine (Claritin) 10mg tab & 10mg/10ml syrup
Lorazepam (Ativan) 0.5, 1 & 2mg tabs
Lortab (hydrocodone/acetaminophen) 5, 7.5mg tabs & 7.5/500 per 15ml elixir
Lorcet Plus(hydrocodone/acetaminphen) 7.5/650mg tabs
Losartan (Cozaar) 25, 50 & 100mg tabs
Losartan/HCTZ (Hyzaar) 50/12.5, 100/12.5 & 100/25mg tabs
Lotrel 5/10, 5/20, 5/40, 10/20 & 10/40 mg caps
Lotrisone Cream
Lubiprostone (Amitiza) 24 mcg
Meclizine (Antivert) 12.5 & 25mg tabs
Medroxyprogesterone (Provera) 5 & 10mg tabs
Mefloquine (Lariam) 250mg tabs
Megestrol (Megace) 40mg tab & 40mg/ml susp
Meloxicam (Mobic) 7.5 & 15mg tabs
Melphalan (Alkeran) 2mg tabs
Meperidine (Demerol) 50mg tabs
Mercaptopurine (Purinethol) 50 mg tabs
Mesalamine (Asacol) 400mg tabs
Mesalamine (Rowasa) 4mg enema
Metanx
Metformin (Glucophage) 500, 850 & 1000mg tabs
Metformin (Glucophage XR) 500mg tabs
Methadone 5 &10mg tabs
Methazolamide (Neptazane) 25 & 50mg tabs
Methocarbamol (Robaxin) 500 & 750mg tabs
Methotrexate 2.5mg tab & 2mg/ml inj
Methyldopa (Aldomet) 250mg tabs
Methylergonovine (Methergine) 0.2mg tabs
Methylphenidate (Ritalin) 5, 10, 20mg tab & 20mg SR tabs
Methylphenidate (Concerta) 18, 27, 36 & 54mg tabs
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Methylprednisolone (Medrol Dosepak) 4mg tabs
Metoclopramide (Reglan) 10mg tab & 5mg/5ml syrup
Metolazone (Zaroxolyn) 2.5 & 5mg tabs
Metoprolol (Lopressor) 25, 50 & 100mg tabs
Metoprolol (Toprol XL) 25, 50 & 100mg tabs
Metronidazole (Flagyl) 250 & 500mg tabs
Metronidazole 0.75% vaginal cream
Metronidazole (Metrogel) 1% top
Miconazole 2% vaginal cream
Miconazole (Monistat-Derm) 2% top cream
Minocycline (Minocin) 50 & 100mg caps
Minoxidil (Loniten) 2.5 & 10mg tabs
Mircette tabs
Mometasone DPI (Asmanex Twisthaler) 110 & 220mcg inhaler
Mometasone Furoate (Nasonex) nasal spray
Mometasone/Formoterol (Dulera) 100 & 200mcg inhaler
Montelukast (Singulair) 4, 5mg chew, 10mg tab & 4mg granules
Morphine (MS Contin) 15, 30 & 60mg SR tabs
Moxifloxacin (Vigamox) 0.5% ophth sol
Mucinex D (guaifensin/pseudoephedrine) 600mg/30mg tabs
Mupirocin (Bactroban) 2% top oint & cream
Mycolog (nystatin/triamcinolone) cream
Mycophenolate (Cellcept) 250mg caps
Nabumetone (Relafen) 500mg tabs
Naftifine (Naftin) 1% gel & cream
Naproxen (Naprosyn) 250 & 500mg tabs
Naproxen Sodium (Anaprox) 275 & 550mg tabs
Napafenac (Nevanac) 0.1% opth sol
Neomycin Sulfate 500mg tabs
Neosporin ophth sol & oint
Niacin (Niaspan) 500, 750 & 1000mg tabs
Nifedipine (Adalat CC) 30, 60 & 90mg tabs
Nitrofurantoin (Macrodantin) 50mg, 100mg cap & 25mg/5ml susp
Nitroglycerin (Nitro-Dur) 0.2. 0.4 & 0.6mg/hr patch
Nitroglycerin (Nitrostat) 0.3, 0.4 & 0.6mg SL
Nitroglycerin (Nitrolingual) 0.4mg/spray
Nitroglycerin (Nitrol) 2% top oint
Nordette tabs
Norethindrone Acetate (Aygestin) 5mg
Norinyl (Ortho Novum) 1/35 tabs
Nor-QD tabs
Nortriptyline (Pamelor) 25mg caps
Nystatin vaginal supp
Nystatin (Mycostatin) top cream, oint & powder
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Nystatin 500,000 unit tab & 100,000U/ml susp
Ofloxacin (Floxin) 0.3% otic sol
Olopatadine (Patanol) 0.1% opth sol
Omega-3 Acid (Lovaza) 1gm caps
Omeprazole (Prilosec) 20 & 40mg caps
Ondansetron 4 & 8mg tabs
Optichamber spacer
Orphenadrine (Norflex) 100mg XL tabs
Ortho-Cyclen
Ortho-Evra patches
Ortho-Novum 7/7/7
Ortho-Tri-Cyclen
Ortho-Tri-Cyclen Lo
Oseltamivir (Tamiflu) 75mg caps & 12mg/ml susp
Oxybutynin (Ditropan) 5mg tabs
Oxybutynin ER (Ditropan XL) 5 & 10mg tabs
Oxymetazoline (Afrin) 0.05% nasal spray
Pancrelipase (Pancreaze)
Paroxetine (Paxil) 10, 20, 30 & 40mg tabs
Pediazole susp
Pen VK 250, 500mg tabs & 250mg/5ml susp
Pencillamine (Cuprimine) 250mg caps
Pentoxifylline (Trental) 400mg tabs
Percocet (oxycodone/acetaminophen) 5/325mg tabs
Permethrin (Elimite) 5% cream
Permethrin (Nix) 1% rinse 60ml
Phenazopyridine (Pyridium) 100mg tabs
Phenylephrine 2.5% opth sol
Phenobarbital 30mg tabs
Phenytoin (Dilantin) 100mg caps, 50mg chew & 125mg/5ml susp
Phytonadione (Vitamin K) 5mg tabs
Pilocarpine 1, 2 & 4% ophth sol
Pimecrolimus (Elidel) 1% cream
Pindolol (Visken) 5 & 10mg tabs
Pioglitazone (Actos) 15, 30 & 45mg tabs
Piroxicam (Feldene) 20mg cap
Podofilox (Condylox) 0.5% sol
Polyethylene Glycol 3350 (Miralax) powder
Polytrim (or gen eq) ophth sol
Poly-Vi-Sol with iron drops
Potassium chloride (K-Dur) 10 & 20mEq tabs
Potassium chloride SR (Klor-Con) 8mEq tabs
Potassium citrate (Urocit-K) 1080mg tabs
Potassium Iodide 1gm/ml sol
11

Povidone-Iodine (Betadine) 5% opth sol
Pramipexole (Mirapex) 0.125, 0.25, 0.5, 1 & 1.5mg tabs
Pravastatin (Pravachol) 10, 20, 40 & 80mg tabs
Prazosin (Minipress) 1mg, 2mg & 5mg caps
Precision Xtra Test Strips
Prednisolone Acetate (Pred Forte) 1% susp
Prednisolone (Prelone) 15mg/5ml sol
Prednisolone orally disintegrating (Orapred ODT) 10 & 15mg tabs
Prednisone 1, 2.5, 5, 10, 20 & 50mg tabs
PremPro 0.625/2.5, 0.625/5 & 0.45/1.5mg tabs
Prenatal-Plus Vitamin tabs
Prevident 1.1% gel & 5000 Plus
Primaquine 15mg base tabs
Primidone (Mysoline) 50 & 250mg tabs
Probenecid (Benemid) 500mg tabs
Prochlorperazine (Compazine) 5mg tab & 25mg supp
Proctofoam-HC
Promethazine (Phenergan) 25mg tab, supp & syrup
Propantheline (Pro-banthine) 15mg tabs
Propranolol (Inderal) 10, 20 & 40mg caps
Propranolol (Inderal LA) 60, 80 & 120mg caps
Propylthiouracil (PTU) 50mg tabs
Pseudoephedrine (Sudafed) 30mg tabs & 30mg/5ml sol
Pyrazinamide 500mg tabs
Pyridostigmine (Mestinon) 60 & 180mg ST tabs
Pyridoxine (Vitamin B6) 50mg tabs
Quetiapine (Seroquel) 25, 100, 200 & 300mg tabs
Quetiapine fumarate (Seroquel XR) 200, 300 & 400mg tabs
Quinidine Gluconate 324mg SR tabs
Raloxifene (Evista) 60mg tabs
Ramipril (Altace) 2.5, 5 & 10mg caps
Ranitidine 150mg tabs & 15mg/ml sol
Refresh tears
Rifampin 300mg caps
Rimexolone (Vexol) 1% opth susp
Risperidone (Risperdal) 0.25, 0.5, 1, 2, 3, 4mg tabs & 1mg/ml sol
Rizatriptan (Maxalt MLT) 5 & 10mg tabs
Rizatriptan (Maxalt) 5 &10mg regular tabs
Robitussin AC (or gen eq)
Robitussin DM (or gen eq)
Rosuvastatin (Crestor) 5,10, 20 & 40mg tabs
Salicylic Acid (Duofilm)
Salmeterol (Serevent) Diskus
Salsalate (Disalcid) 500 & 750mg tabs
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Selegiline (Eldepryl) 5mg tabs
Selenium sulfide 2.5% shampoo
Sertraline (Zoloft) 25, 50 & 100mg tabs
Silver sulfadiazine (Silvadene) 1% cream
Simethicone (Mylicon) 80mg chew tabs & infant drops
Simvastatin (Zocor) 5, 10, 20, 40 & 80mg tabs
Sinemet 10/100, 25/100 & 25/250mg tabs
Sitagliptin (Januvia) 25, 50 & 100mg tabs
Sodium Chloride 0.9% neb amps
Sodium Chloride 0.65% nasal drops
Sodium Chloride (Muro-128) 5% opth oint & sol
Sodium Sulfacetamide 10% opth oint & sol
Sorbital 70% sol
Sotalol (Betapace) 80mg tabs
Spironolactone (Aldactone) 25mg tabs
Sucralfate (Carafate) 1 gm tab & 1gm/10ml sol
Sulfasalazine (Azulfadine EN) enteric coated 500mg tabs
Sulindac (Clinoril) 200mg tab
Sumatriptan (Imitrex) 25, 50,100mg tabs & 6mg/0.5ml inj
Symbicort (Bedesonide/Formoterol) 80/4.5mcg & 160/4.5mcg inh
Tamoxifen (Nolvadex) 10mg tabs
Tamsulosin (Flomax) 0.4mg caps
Telmisartan (Micardis) 20, 40 & 80mg tabs
Telmisartan/HCTZ (Micardis HCT) 40/12.5, 80/12.5 & 80/25mg tab
Temazepam (Restoril) 15 & 30mg caps
Terazosin (Hytrin) 1, 2, 5 & 10mg caps
Terbinafine (Lamisil) 250mg tabs
Terbutaline (Brethine) 5mg tabs
Testosterone (Androgel 1%) 2.5, 5g packet &1% pump
Testosterone (Androderm) 2 & 4mg patch
Testosterone (Testim 1% gel) 50mg tube
Testosterone Cypionate 200mg/ml vial
Testosterone Enanthate 200mg/ml vial
Tetracycline 250mg caps
Theophylline (Slo-Bid) 200mg tab
Thioguanine 40mg tabs
Thioridazine 25mg
Timolol (Timoptic) opth 0.25 & 0.5% drops
Timolol (Timoptic XE) opth 0.25% & 0.5% sol
Tiotropium (Spiriva) inhaler
Tobramycin (TobraDex) susp & oint
Tobramycin (Tobrex) 0.3% sol & oint
Tolterodine Tartrate (Detrol LA ) 2 & 4mg caps
Topiramate (Topamax) 25, 50, 100 & 200mg tabs
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Tramadol (Ultram) 50mg tabs
Trazodone (Desyrel) 50mg tabs
Tretinoin (Retin A) 0.25, 0.05% cream & 0.01% gel
Triamcinolone (Kenalog) 0.1% cream & oint
Triamcinolone 0.1% dental paste
Triazolam (Halcion) 0.25mg tabs
Treximet (Sumatriptan/Naproxen) 85mg/500mg tabs
Trifluridine (Viroptic) 1% opth sol
Trihexphenidyl (Artane) 2mg tabs
Tri-Levlen
Trimethobenzamide (Tigan) 300mg caps
Tropicamide (Mydriacyl) opth 0.5% & 1% sol
True Test glucose strips
Twinject auto-injector (epinephrine) 0.15 & 0.3mg inj
Tylenol #3 (Acetaminophen & codeine) 300/30mg tab
Tylenol with codeine elixir (120/12mg per 5ml)
Tylox (acetaminophen/oxycodone) 500/50mg cap
Valacyclovir (Valtrex) 500 & 1,000mg tabs
Valproic Acid (Depakene) 250mg/5ml liq
Valsartan (Diovan) 40, 80, 160 & 320mg tabs
Valsartan HCT (Diovan HCT) 80/12.5, 160/12.5, 160/25, 320/12.5 &
320/25mg tab
Vardenafil (Levitra) 10 & 20mg tabs
Venlafaxine (Effexor XR) 37.5, 75 & 150mg caps
Venlafaxine (Effexor) 37.5mg tabs
Verapamil (Calan) 80, 120 tabs & 120, 180 & 240mg SR tabs
(Vytorin) Ezetimibe/simvastatin 10/10, 10/20, 10/40 & 10/80mg tab
Warfarin (Coumadin) 1, 2, 2.5, 3, 5, 7.5 & 10mg tabs
Yasmin
Yaz
Zanamivir diskhaler (Relenza) 5mg
Zestoretic 10/12.5, 20/12.5 & 20/25mg tabs
Ziprasidone (Geodon) 20, 40, 60 & 80mg caps
Zolmitriptan (Zomig) 2.5 & 5mg tabs
Zolmitriptan (Zomig) ZMT 2.5 & 5mg tabs
Zolpidem tartrate (Ambien) 5 & 10mg tabs
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Deletions:
Carbachol opth
Cafergott supp
Calcitonin inj
Dicloxacillin susp
Mebendazole
FORMULARY CHANGES
Additions:
Bupropion XL (Wellbutrin XL) 150 & 300mg tabs
Ciclopirox (Penlac 8%) nail lacquer
Clomipramine (Anafranil) 50 mg cap
Cyclobenzaprine ER (Amrix) 15 & 30mg cap
Diclofenac (Voltaren 1% gel, 50 & 75mg tabs
Flutamide 125mg cap
Jolessa (Seasonale)
Metanx
Levonorgestrel 1.5mg (Plan B)
Testosterone (Androgel 1%) 2.5 & 5g packet, 1% pump
Testosterone (Androderm) 2 & 4mg patch
Testosterone (Testim 1% gel) 50mg tube
Notes :
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For more information please call: (334) 953-6868
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