04 Formulary in pdf format - HIV/AIDS Information provided by ...

Indiana
Iowa
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), zalcitabine (ddC, Hivid),
zidovudine (AZT, Retrovir). PIs- amprenavir (Agenerase), atazanavir (Reyataz), fosamprenavir (Lexiva), indinavir (Crixivan),
lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), ritonavir (Norvir), saquinavir (Fortovase, Invirase). NNRTIs- delavirdine
(Rescriptor), efavirenz (Sustiva), nevirapine (Viramune).
OI DRUGS
PHS “A1 OI”s- acyclovir (Zovirax), azithromycin (Zithromax), clarithromycin (Biaxin), famciclovir (Famvir), fluconazole (Diflucan),
ganciclovir (Cytovene), itraconazole (Sporonox), leucovorin, TMP/SMX (Bactrim, Septra). Other OIs- atovaquone (Mepron), clotrimazole
(Mycelex, Gyne-Lotrimum), dapsone, flucytosine (Ancobon),ketoconazole (Nizoral), metronidazole (Flagyl), nystatin (Mycostatin),
pentamidine (NebuPent, Pentam), rifabutin (Mycobutin), valganciclovir (Valcyte).
Hepatitis C- none.
TREATMENTS FOR METABOLIC DISORDERS
Hyperlipidemia- atorvastatin (Lipitor), fenofibrate (Tricor), simvastatin (Zocor). Wasting- Testosterone.
ALL OTHERS
cetaminophen + codeine (Tylenol #3, Tylenol + codeine), amantadine (Symmetrel), amitriptyline (Elavil), bupropion (Wellbutrin),
buspirone (BuSpar), chlorhexidine gluconate (Peridex), clonidine hydrochloride (ApoClonidine, Catapress, Nu-Clonidine),
carbamazepine (Tegretol), citalopram (Celexa), desipramine (Norpramine, Pertofrane), diphenhydramine (Benadryl), diphenoxylate
atropine (Lomotil), fluoxetine (Prozac), hydroxyzine (Vistaril, Atarax), klonopin (Clonazepam),lithium carbonate, morphine sulfate
(Oramorph analgesic patches), nefazodone (Serzone), paroxetine (Paxil), premarin, phenobarbital (Solfoton), phenytoin (Dilantin),
prochlorperazine (Compazine), promethazine, (Phenergan), propoxyphene N/APAP (Darvocet), propranolol (Inderal), provera,
sertraline (Zoloft), sodium valproate (Depakote), tramadol hydrochloride (Ultrarn), trazodone (Desyreo), tricyclic antidepressants
(Sinequan, Tofranil), venlafaxine (Effexor).
ANTIRETROVIRALS
NRTIs- abacavir (Ziagen), abacavir/lamivudine/zidovudine (Trizivir), didanosine (ddI, Videx), emtricitabine (Emtriva),lamivudine
(Epivir, 3TC),lamivudine/zidovudine (Combivir), stavudine (d4T, Zerit), tenofovir (Viread), zalcitabine (ddC, Hivid), zidovudine (AZT,
Retrovir). PIs- amprenavir (Agenerase), atazanavir (Reyataz), fosamprenavir (Lexiva), indinavir (Crixivan), lopinavir/ritonavir
(Kaletra), nelfinavir (Viracept), ritonavir (Norvir), saquinavir (Fortovase). NNRTIs- delavirdine (Rescriptor), efavirenz (Sustiva), nevirapine
(Viramune). Other- hydroxyurea (Hydrea). Entry Inhibitor- enfuvirtide (Fuzeon).
OI DRUGS
PHS “A1 OI”s- acyclovir (Zovirax), azithromycin (Zithromax), clarithromycin (Biaxin), fluconazole (Diflucan), itraconazole
(Sporonox), TMP/SMX (Bactrim, Septra). Other OIs- atovaquone (Mepron), clotrimazole (Mycelex), dapsone, ethambutol
(Myambutol), ketoconazole (Nizoral), nystatin (Mycostatin), pentamidine (Pentam), rifabutin (Mycobutin). Hepatitis C- none.
Kansas
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), zalcitabine (ddC, Hivid), zidovudine
(AZT, Retrovir). PIs- amprenavir (Agenerase), atazanavir sulfate (Reyataz), fosamprenavir (Lexiva), indinavir (Crixivan),
lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), ritonavir (Norvir), saquinavir (Fortovase, Invirase). NNRTIs- delavirdine
(Rescriptor), efavirenz (Sustiva), nevirapine (Viramune). Other- hydroxyurea (Hydrea). Entry Inhibitor- enfuvirtide (Fuzeon).
OI DRUGS
PHS “A1 OI”s- acyclovir (Zovirax), azithromycin (Zithromax),clarithromycin (Biaxin), famciclovir (Famvir), fluconazole (Diflucan),
itraconazole (Sporonox), TMP/SMX (Bactrim, Septra). Other OIs- atovaquone (Mepron), cephalexin (Keflex), cephalexin hydrochloride
(Keftab), clindamycin (Cleocin), clotrimazole (Mycelex), dapsone, ethambutol (Myambutol), ketoconazole (Nizoral), Metronidazole
(Flagyl), nystatin (Mycostatin), paromomycin (Humatin), pentamidine (Nebupent), rifabutin (Mycobutin), valacyclovir (Valtrex),
valganciclovir (Valcyte). Hepatitis C- none.
TREATMENTS FOR METABOLIC DISORDERS
Wasting- dronabinol (Marinol), megestrol acetate (Megace), oxandrolone (Oxandrin).
ALL OTHERS
amitriptyline, clonazepam (Klonopin), trazodone (Desyrel). Removed 2003- ganciclovir (Cytovene),