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Delaware
ADAP FORMULARIES
New drugs added since June 2002 indicated in bold.
ANTIRETROVIRALS
NRTIs- abacavir (Ziagen), abacavir/lamivudine/zidovudine (Trizivir), didanosine (ddI, Videx, Videx EC), emtricitabine (Emtriva),
lamivudine (Epivir, 3TC), lamivudine/zidovudine (Combivir), stavudine (d4T, Zerit), tenofovir (Viread), zidovudine (AZT, Retrovir).
PIs- amprenavir (Agenerase), atazanavir (Reyataz), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), ritonavir
(Norvir), saquinavir (Fortovase, Invirase). NNRTIs- delavirdine (Rescriptor), efavirenz (Sustiva), nevirapine (Viramune).
Entry Inhibitor- enfuvirtide (Fuzeon).
OI DRUGS
PHS “A1 OI”s- acyclovir (Zovirax), azithromycin (Zithromax), cidofovir (Vistide), clarithromycin (Biaxin), famciclovir (Famvir),
fluconazole (Diflucan), foscarnet (Foscavir), ganciclovir (Cytovene), isoniazid (INH), itraconazole (Sporonox), leucovorin
(Wellcovorin), pyrimethamine (Daraprim), sulfadiazine (Microsulfon), TMP/SMX (Bactrim, Septra).
Other OIs- amoxicillin (Amoxil, Polymox, Trimox), amoxicillin/pot. clavulante (Augmentin), ampicillin (Omnipen, Principen),
atovaquone (Mepron), cefixime (Suprax), cefuroxime (Ceftin), cephalexin (Keflex, Biocef, Keftab), ciprofloxacin (Cipro), clindamycin
(Cleocin), clotrimazole (Mycelex), clotrimazole vaginal (Gyne-Lortimin), dapsone (Avo-Sulfon), dicloxacillin (Dycil, Dynapen,
Pathocill), doxycycline (Doxy, Doxychel, Monodox, Vibramycin), epoetin alfa (Procrit, Epo), ethambutol (Myambutol), filgrastim
(Neupogen), gatifloxacin (Tequin), ketoconazole (Nizoral), levofloxacin (Levaquin), miconazole cream (Monistat), ofloxacin (Floxin),
paromomycin (Humatin), penicillin (Pen Vee K, Veetids, Beepen-VK, V-Cillin K), pentamidine (Nebupent), pyrazinamide, pyridoxine
(Vitamine B-6), prednisone (Deltasone), rifabutin (Mycobutin), rifampin, valganciclovir (Valcyte). Hepatitis C- ribiavirin and interferon
(Rebetron), peg-interferon alfa-2b & ribavirin (Peg-Intron/Rebetol), peg-interferon alfa-2a & ribavirin (Pegasys/Copegus).
TREATMENTS FOR METABOLIC DISORDERS
Cardiac- amlodipine (Norvasc), aspirin (all formulations, all generics), atenolol (Tenormin, all generics), carvedilol (Coreg), clonidine
(Catapres, all formulations, all generics), digoxin (all manufacturers), dilitiazem (Cardizem, CD, SR, Cardia XT, Tiazac), enalapril
(Vasotec, all generics), furosemide (Lasix, generics), hydrochlorothiazide (generics), levothyroxine (Synthroid, Levothyroid, Levoxyl,
generics), lisinopril (Prinivil, Zestril, all generics), metolazone (Mykrox, Zarosolyn, all generics), metoprolol (Lopressor, Toprol SL, all
formulations, all generics), nifedipine (Adalat, CC, Procardia, XL, all generics), propranolol (Inderal, all generics), spironolactone
(Aldactone, all generics), triameterene (Dyrenium, generics, all comibinations), valsartan (Diovan), verapamil (Calan, SR, Covera,
Isoptin, Verelan, generics). Diabetic- acarbose (Precose), clorpropamide (Diabinese), glimepiride (Amaryl), glipizide (Glucotrol),
glyburide (Diabeta, Micronase), insulin (all types), metformin (Glucophage), pioglitazone (Actos), rosiglitazone (Avandia), tolazamide
(Tolinase), tolbutamide (Orinase). Hyperlipidemia- atorvastatin (Lipitor), cholestyramine (Questran), colesevelam (Welchol),
ezetimibe (Zetia), fenofibrate (Tricor), gemfibrozil (Lopid), niacin (Niaspan, Nicotinic Acid, Slo-Niacin), pravastatin (Pravachol).
Wasting- carafate (Sucralfate), cyproheptadine (Periactin), diphen-atopine (Lomotil), dronabinol (Marinol), esomeprazole (Nexium),
famotidine (Pepcid), lansoprazole (Prevacid), megestrol acetate (Megace), omerprazole (Prilosec), pancrease Enzymes (all formulations,
generics), pantoprazole (Protonix), rabeprazole (Aciphex), ranitidine (Zantac), testosterone replacement products (All types).
ALL OTHERS
albuterol inhaler (Ventolin), albuterol/ipratropium (Combivent), alprazolam (Xanax), amitriptyline (Elavil), amoxapine (Asendin),
azelastine (Astelin), beclomethasone (Beclovent, Vanceril), brompheniramine (Dimetapp, various), budesonide (Pulmicort),
buproprion (Zyban, Wellbutrin), carbamazepine (Tegretol), celecoxib (Celebrex), cetirizine (Zyrtec), chlordiazepoxide (Librium),
citalopram (Celexa), clemastine (Tavist), clomipramine (Anafranil), clorazepate (Tranxene), codine pain relievers, desipramine
(Norpramin), desloratadine (Clarinex), dexamethasone (all forms), dexchlorpheniramine (Polaramine, various), diazepam (Valium),
diclofenac (Cataflam, Voltaren, generics), diphenhydramine (Benadryl), estazolam (Prosom), ethosuximide (Zaronton), etodolac
(Lodine, generics), fenoprofen (Nalfon, generics), fentanyl Transdermal (Duragesic), fexofenadine (Allegra), flunisolide (Aerobid),
fluoxetine (Prozac), flurazepam (Dalmane), flurbiprofen (Ansaid, generics), fluticasone (Flovent), fluticasone/salmeterol (Advair
Disdus), fluvoxamine (Luvox), gabapentin (Neurontin), hemorrhoidal creams & suppository, hepatitis A, B vaccine (Havrix, Vaqta,
Energix-B, Recombivax HB, Comvax, Twinrix), hydrocodone and derivatives, hydroxyzine (Vistaril, generics), ibuprofen (Motrin),
imipramine (Tofranil), ipratropium (Atrovent), isoproterenol (Isuprel), ketoprofen (Orudis, generics), klonopin (Clonazepam),
lamotrigine (Lamictal), lexapro (Escitalopram), lithium (Eskalith, Lithobid), loperamide HCL (Imodium), lorazepam (Ativan),
loratadine (Claritin), maprotiline (Ludiomil), meclofenamate (generics), meloxicam (Mobic), meperidine (Demerol, generics),
metaproterenol (Alupent), mirtazapine (Rameron), montelukast (Singulair), morphine (MSIR, Oramorph SR, MS Contin), naproxen
(Aleve, Anaprox, Naprosyn, Anprelan), nabumetone (Relafen), nefazodone (Serzone), nembutal (Pentobarbital), nicotene replacement
products - all forms, nizatidine (Axid), nortriptyline (Aventyl, Pamelor), nystatin/triamcinolone cream, olanzapine (Zyprexa), oxaprozin
(Daypro), oxazepam (Serax), oxycodone (Endocodone, Oxycontin, Roxicodone, OxyIR, OxyFAST, M-oxy), paroxetine HCL (Paxil),
phenytoin (Dilantin), probenecid, prochloparazine (Compazine), promethazine (Phenergan, generics), propoxyphene (Darvon),
protriptyline (Vivactil), quetiapine (Seroquel), rofecoxib (Bioxx), salmeterol (Serevent), sertraline (Zoloft), sulindac (Clinoril),
temazepam (Restoril). terbutaline (Brethine, Brethaire), tiagabine (Gabitril), tolmentin (Tolectin), triazolam (Halcion), triamcinolone
(Azmacort), trimipramine (Surmontil), valdecoxib (Bextra), valproic Acid (Depakote, Depakene), venlaxifine HCL (Effexor), zolpidem
(Ambien). Removed 2003- zalcitabine (ddC, Hivid), hydromorphone and derivatives, piroxicam (Felldene, generics).