Attachment_Formulary.pdf

ATTACHMENT FORMULARY

HOPI HEALTH CARE CENTER

DRUG FORMULARY

Last update: 3/2015

THE FORMULARY REPRESENTS THE AGENTS APPROVED FOR USE BY THE

PHARMACY AND THERAPEUTICS COMMITTEE

CLINICAL DIRECTOR: DARREN VICENTI, MD

PHARMACY AND THERAPEUTICS COMMITTEE CHAIRPERSON:

KEITH ADCOCK, CHIEF PHARMACIST

(APPENDICES AT END OF FORMULARY DRUG LIST):

APPENDIX I ANTIDOTES

APPENDIX II ANTI-INFECTIVES, ORAL

APPENDIX III ANTI-INFECTIVES, PARENTERAL

APPENDIX IV CARDIOVASCULAR, ORAL

APPENDIX V CARDIOVASCULAR, INJECTABLE

APPENDIX VI CORTICOSTEROIDS

APPENDIX VII EAR, NOSE, THROAT PREPARATIONS

APPENDIX VIII NON-STEROIDAL ANTI-INFLAMMATORIES

APPENDIX IX OPHTHALMIC PREPARATIONS

APPENDIX X ORAL / INJECTABLE CONTRACEPTIVES

APPENDIX XI PSYCHOTHERAPEUTIC AGENTS

APPENDIX XII POTASSIUM CONTAINING IV FLUIDS

APPENDIX XIII IV FLUIDS

APPENDIX XIV RESPIRATORY AGENTS

APPENDIX XV RHEMATOLOGY FORMULARY

Abilify – see Aripiprazole Accutane – see Isotretinoin Accuzyme - see Papain-urea

ACETAMINOPHEN (Tylenol) Tablet, 325 mg Solution, 80mg/0.8ml, 15 ml and 160mg/5ml, 120ml Chewable tablet, 80 mg Suppositories, 120 mg, 325 mg, 650 mg

ACETAZOLAMIDE (Diamox) Tablet, 250 mg

ACETIC ACID

Solution, 0.25%, 1000 ml for irrigation Solution, 5% - used for colpo procedure

ACETIC ACID IN AQUEOUS ALUMINUM ACETATE SOLUTION (Domeboro Otic) Otic solution, 2%, 60 ml

ACETYLCYSTEINE (Mucomyst) Solution, 20%, 30 ml Injection 200mg/ml, 30ml vials

Actidose – see Charcoal Activated Actigall – see Ursodiol Activated Charcoal - see Charcoal, Activated Actos - see Pioglitazone Acular – see Ketorolac Tromethamine

ACYCLOVIR (Zovirax) Tablet, 400 mg Injection, 500 mg/vial Suspension, 200 mg/5ml Note: Suspension to be used for prophylaxis or treatment of chickenpox in pediatric patients taking steroids.

Adalat CC – see Nifedipine Adderall - see Amphetamine, mixed Adenocard - see Adenosine

ADENOSINE (Adenocard) Injection 6mg/2ml vial

Adrenalin – see Epinephrine Advair MDI – see Fluticasone/Salmederol MDI

Afrin – see Oxymetazoline AK-Cide – see Sulfacetamide with prednisolone

ALBUMIN, HUMAN

Injection 25%, 50 ml Injection 5%, 50 ml

ALBUTEROL (Proventil, Ventolin) Metered Dose Inhaler (200 doses), 17 gm Solution for Inhalation, 0.5%, 20 ml Unit Dose Nebulizer Solution – * for use in ER, Inpt, and Clinics only. Not for outpatient dispensing.

Aldactone – see Spironolactone Aldomet – see Methyldopa Allegra – see Fexofenadine

ALENDRONATE (Fosamax) Tablets, 70mg

Allergen – see Antipyrine and benzocaine

ALLOPURINOL (Zyloprim) Tablets, 100mg, 300 mg

Alomide – see Lodoxamide Alphagan-P - see Brimonidine

ALPROSTADIL (Prostin VR Pediatric)

500mcg/ml ampules * refrigerated

ALTEPLASE (Cathflo Activase) Injection, 2 mg *for use with central venous access devices

ALUMINUM SULFATE AND CALCIUM ACETATE POWDER PACKETS

(Domeboro, Bluboro) Powder packets, effervescent for solution

ALUMINUM & MAGNESIUM HYDROXIDES & SIMETHICONE

(Mi-Acid) Suspension, 355 ml, per 5 ml:

Aluminum hydroxide 200 mg Simethicone 20 mg Magnesium hydroxide 200 mg

AMANTADINE (Symmetrel) Capsules, 100 mg

Amidate - see Etomidate

AMIODORONE (Cordarone, Pacerone) Tablets, 200mg Injection, 150mg, 50 mg/ml

AMITRIPTYLINE (Elavil) Tablets, 10 mg, 25 mg, 50 mg

AMLODIPINE (Norvasc) Tablets, 5mg, 10mg

AMMONIA INHALANT SOLUTION, AROMATIC

Ampule, 1/3 ml

Amnesteem – see Isotretinoin

AMOXICILLIN

Capsules 250 mg, 500 mg Suspension 250mg/5ml

AMOXICILLIN/CLAVULANATE (Augmentin) Tablets 875 mg. Amoxicillin + 125 mg. Clavulanic Acid Suspension 400 mg Amoxicillin + 57 mg. Clavulanic Acid/5ml

AMPHETAMINE, MIXED (Adderall) Tablets, 5 mg *Schedule II Controlled Substance

AMPHOTERICIN B (Fungizone) Injection, 50 mg vial *Refrigerated

AMPICILLIN

Injection, 500 mg, 1gram vials

AMPICILLIN/SULBACTAM (Unasyn) Injection, 1.5 gm, 3 gm ADD-Vantage vials

Injection, 1.5 gm vial AMYL NITRATE - see Cyanide Antidote Kit Ampule, 1/3 ml

Ancef - see Cefazolin Anectine – see Succinylcholine Antabuse – see Disulfiram Androgel - see Testosterone Antilirium – see Physostigmine Salicylate

ANTIPYRINE AND BENZOCAINE (Auralgan, Allergen) Otic Solution:

Antipyrine 5.4%, Benzocaine 1.4%, Oxyquinolone Sulfate, Glycerin

ANTIVENIN (Latrodectus Mactans) BLACK WIDOW SPIDER ANTIVENIN Injection, 6000 antivenin units/ vial (Equine)

ANTIVENIN (Crotalidae) POLYVALENT RATTLESNAKE IMMUNE Fab (CroFab) Injection , 1 gm protein/vial (ovine)

Antivert - see Meclizine Antizol- see Fomepizole Anusol – see Hemorrhoidal Suppositories Apresoline – see Hydralazine Aqua-Mephyton – see Phytonadione Aranesp - see Darbepoetin

Aristocort – see Triamcinolone Artane - see Trihexylphenidyl

ARIPIPRAZOLE (Abilify) Tablet, 10mg *Requires psychiatry consult prior to initiation, 1st line for Adult ADHD

ARTIFICIAL TEARS

Polyvinyl Chloride 1/4% ophthalmic solution, 15ml

ASCORBIC ACID (Vitamin C) Tablets, 500 mg

ASPIRIN

Tablets, chewable, 81 mg Tablets, enteric coated, 81 mg, 325 mg Tablets, plain, 325mg

Asmanex – see Mometasone Atarax – see Hydroxyzine

ATENOLOL (Tenormin) Tablets, 25mg, 50mg

Ativan - see Lorazepam

ATOMOXETINE (Strattera) Tablets 18mg, 40mg, 60mg *Requires psychiatry consult prior to initiation

ATORVASTATIN (Lipitor) Tablet 20mg, 40mg

ATROPINE

Injection, 0.4 mg/ml, 1 mg/10ml (Bristoject), 1 mg/ml Ointment, ophthalmic 1%, 3.5 gm Solution, ophthalmic 1%, 15ml

Atrovent – see Ipratropium Atripla – see Efavirenz, Emtrictabine, & Tenofovir Augmentin – see Amoxicillin/Clavulanate Auralgan –see Antipyrine and Benzocaine Avapro – see Irbesartan

AZATHIOPRINE (Imuran) Tablets, 50 mg

AZITHROMYCIN (Zithromax) Powder packet, 1 gm *Restricted to use in chlamydia. Direct observed therapy preferred.

500mg vials for injection (for tx of pneumonia) 250mg tablets (for tx of pneumonia) 200mg/5ml suspension (for tx of pneumonia)

Azulfidine – see Sulfasalazine

BACITRACIN

Ointment, USP 500 units per gm., 30 gm BACITRACIN AND POLYMIXIN B (Polysporin) Ophthalmic ointment 500/10,000 units per gm., 3.5 gm

BACLOFEN (Lioresal) Tablets, 10 mg, Bactrim DS – see Cotrimoxazole Bactroban - see Mupirocin

“Banana Bag” NS 1000ml with 10ml MVI, 1mg Folic Acid, 100mg Thiamine and 2gm Magnesium

Sulfate

BARIUM SULFATE

Oral suspension 2.1% * ordered and stocked by Radiology

Benadryl – see Diphenhydramine Benemid – see Probenecid Bentyl – see Dicyclomine

BENZOCAINE/ BUTYL AMINOBENZOATE/ TETRACAINE (Cetacaine) Topical Anesthetic Spray Benzocaine 14%, Butyl Aminobenzoate 2%, Tetracaine 2%

BENZOIN TINTURE, COMPOUND

Liquid, USP formula, 120 ml (77% alcohol) *Flammable cabinet

BENZOYL PEROXIDE

Gel, 10%

BENZTROPINE (Cogentin) Tablets, 1 mg Injection, 1 mg/ml, 2 ml

Berocca - see Multivitamin B + C with Folate Betadine - see Povidone Iodine

BETAMETHASONE PHOS & ACETATE (Celestone Soluspan) Injectable, 6mg/ml, 5ml MDV

BETHANECHOL (Urecholine) Tablets, 25 mg

Biaxin – see Clarithromycin *Restricted to H.Pylori protocol only Bicillin LA – see Penicillin G, Benzathine

BISACODYL (Dulcolax) Suppositories, 10 mg

Tablets, enteric coated, 5 mg

BLACK WIDOW ANTIVENIN – see Antivenin Black Widow

Bluboro – see Aluminum sulfate and calcium acetate powder packets Boostrix – see Tdap Brethine – see Terbutaline

BRIMONIDINE TARTRATE (Alphagan) Ophthalmic solution, 0.2%, 15ml bottle

BUPIVACAINE (Marcaine) Injection, 0.5% 10ml vial preservative-free Injection, 0.5% 50ml vial multi-dose

BUPROPION HCL (Wellbutrin) Tablet, sustained release, 100mg, 150 mg *Initiation restricted to psych/ psych consult

BUSPIRONE (Buspar) Tablet, 5mg, 10mg

Cafergot – see Ergotamine-Caffeine Calan – see Verapamil

CALCITRIOL (Rocaltrol) Capsule, 0.25 mcg

CALCIUM ACETATE (Phoslo) Capsules, 667 mg *For Phosphate binding

CALCIUM CARBONATE (Oyst-cal, Tums) Tablet, 1250 mg (500 mg elemental calcium) Tablet, 1250 mg (500 mg elemental calcium) plus VITAMIN D 200 units Tablet, chewable, 1000 mg (400 mg elemental calcium)

CALCIUM CHLORIDE

Injection, 1 gm/10ml 270 mg (14 mEq) calcium/10 ml

CALCIUM GLUCONATE

Injection, 10%, 1 gm/10ml 93 mg (4.65 mEq) calcium/10 ml

CALFACTANT (Infasurf) 6ml * refrigerated

CANDIDA ALBICANS SKIN TEST

Injection, 1000 PNU/ml *Refrigerated

CAPSAICIN (Trixaicin) Topical cream, 0.025%, 60gm

Carafate – see Sucralfate

CARBAMAZEPINE (Tegretol) Tablet, 200 mg Tablet, chewable, 100 mg Suspension, oral, 100 mg/5ml

CARBAMIDE PEROXIDE (Debrox) Otic solution, 6.5%, 15 ml

CARBIDOPA-LEVODOPA (Sinemet) Tablet, 10/100 25/100 25/250 Carbidopa 10 mg 25 mg 25 mg Levodopa 100 mg 100 mg 250 mg

CARBOPROST TROMETHAMINE (Hemabate) Injection, 250 mcg, 1 ml ampule *Refrigerated

CARBOXYMETHYLCELLULOSE (Celluvisc and Refresh Tears) Ophthalmic solution, preservative-free, 1%, 30 unit of use Ophthalmic solution 0.5% l5ml Restricted to initiation by eye

Cardizem CD - see Diltiazem

CARVEDILOL (Coreg) Tablet, 3.125mg, 12.5mg, 25mg *Restricted to initiation by Cardiology only

Catapres – see Clonidine Cathflo-Activase - see Alteplase

CEFAZOLIN (Ancef, Kefzol) Injection, 1 gm Injection, 1 gm ADD-Vantage vials

CEFDINIR (Omnicef) Tablets, 300mg For Oral Suspension, 250mg/5ml, 60ml

CEFOTAXIME (Claforan) Injection, 1 gm vial (for use in neonates <30 days old)

CEFOXITIN ( Mefoxin) Injection, 2 gm vial

Ceftin - see Cefuroxime

CEFTRIAXONE (Rocephin) Injection, 250 mg, 1gm vial Injection 1gm, 2gm ADD-Vantage vial

CEFUROXIME (Ceftin, Zinacef)

Suspension, oral, 250 mg/5ml *Resistant OM, pneumonia (PCN allergy) only Injection, 750mg, 1.5gm ADD-Vantage vial

Celestone Soluspan – see Betamethasone Phos & Acetate Celexa – see Citalopram Cellcept- see Mycophenolate Celluvisc - see Carboxymethylcellulose

CEPHALEXIN (Keflex) Capsules, 250 mg, 500 mg Suspension, oral, 250 mg/5 ml

Cephulac – see Lactulose Cerebyx - see Fosphenytoin Cetacaine – see Benzocaine/Butyl Aminobenzoate/Tetracaine Chantix – see Varenicline

CHARCOAL ACTIVATED (Actidose, Actidose Aqua) Suspension, oral, 50 gm in 240 ml of 70% (96 gm) sorbitol solution Suspension, oral, 50 gm in 240 ml of aqueous solution

Chlor-Trimeton – see Chlorpheniramine

CHLORDIAZEPOXIDE (Librium) Capsule, 25 mg *Schedule IV Controlled Substance

CHLORHEXIDINE (Hibiclens, Periogard, Peridex) Skin cleanser, 4%, 120 ml Oral rinse, 0.12%, 480 ml *Dental Use Only

CHLORPHENIRAMINE (Chlor-Trimeton) Tablet, 4 mg

CHLORPROMAZINE (Thorazine) Injection, 50mg/2 ml Tablet, 25 mg, 50 mg

Chronulac – see Lactulose Ciloxan – see Ciprofloxacin Cipro- see Ciprofloxacin

CIPROFLOXACIN (Ciloxan) Solution, ophthalmic 0.3%, 5ml Ointment, ophthalmic 0.3%, 3.5gm *Restricted to ENT/Optometry consult Tablets, 500 mg

CITALOPRAM (Celexa) Tablet, 20 mg

Citrate of Magnesia – see Magnesium Citrate Solution Claforan – see Cefotaxime

Claritin - see Loratadine

CLARITHROMYCIN (Biaxin) Tablet, 500 mg *Restricted to H.Pylori Protocol

Cleocin – see Clindamycin

CLINDAMYCIN (Cleocin) Capsules 150 mg Injection, 900 mg/6ml Injection, 600mg, 900mg ADD-Vantage vial Solution, 1%

Clinoril - see Sulindac

CLONAZEPAM (Klonopin) Tablets, 1 mg *Schedule IV Controlled Substance

CLONIDINE (Catapres) Tablets, 0.1 mg, 0.2mg

CLOPIDOGREL BISULFATE (Plavix) Tablet, 75 mg *Restricted to patients who develop a CAD event while on ASA treatment

CLOTRIMAZOLE (Lotrimin, Mycelex, Gyne-Lotrimin) Cream, 1%, 30 gm Cream, vaginal, 1%, 7 doses/tube

COAL TAR (Estar, Tegrin) Topical gel, 5% coal tar, 90 gm Shampoo, 1.1% coal tar, 120 ml Bottle

CODEINE

Tablet, 30 mg *Schedule II Controlled Substance Tablet, 30 mg with Acetaminophen 325 mg. *Schedule III Controlled Substance

Cogentin – see Benztropine Colace – see Docusate Sodium

COLCHICINE

Tablets, 0.6 mg. (600 mcg)

Injection, 1 mg/2ml

COLLAGENASE (Santyl) Ointment, 250 units/gm, 30gm tube

Colyte – see Polyethylene Glycol Electrolyte lavage solution Combivir - see Lamivudine/zidovudine Compazine – see Prochlorperazine Comvax - see Haemophilus B + Hepatitis B Vaccine

Concerta - see Methylphenidate

CONDOMS Individually wrapped, lubricated with nonoxynol-9

Cordarone - see Amiodorone Coreg – see Carvedilol Cortef – see Hydrocortisone Cortisol – see Hydrocortisone Cortisporin – see Neomycin-Polymyxin-Hydrocortisone

COSYNTROPIN (Cortrosyn) Injection 0.25 mg/vial Note: 0.25 mg is pharmacologically equivalent to 25 units of corticotropin (ACTH)

COTRIMOXAZOLE (Bactrim DS, Septra DS) Contains DS Tablet Suspension, 5 ml Trimethoprim 160 mg 40 mg Sulfamethoxazole 800 mg 200 mg

Cortrosyn - see Cosyntropin Coumadin – see Warfarin CroFab - see Antivenim Crotalide

CROMOLYN (Nasalcrom, Intal) Inhalation solution for nebulizer, 20 mg per 2 ml ampule Nasal spray, 5.2 mg/spray (Nasalcrom) MDI (Intal)

CYANIDE ANTIDOTE KIT

Injection, Sodium Nitrite, 300 mg in 10 ml, 2x10 ml.

Injection, Sodium Thiosulfate, 12.5 gm in 50 ml, 2x50 ml Inhalant, Amyl Nitrite, 0.3 ml, 12 each

* Kit also contains instructions, stomach tube, tourniquet, syringes and needles

CYANOCOBALAMIN (Vitamin B-12) Injection, 1000 mcg/ml, 1 ml, 10 ml vial Tablets, 1000 mcg

CYCLOBENZAPRINE (Flexeril) Tablets, 10 mg

Cyclogyl – see Cyclopentolate

CYCLOPENTOLATE (Cyclogyl) Solution ophthalmic, 0.5%, 1%, 15 ml

Cytotec - see Misoprostol

DARBEPOETIN (Aranesp) Injection, 40 mcg, 60 mcg, 100 mcg per vial

DDAVP - see Desmopressin

Debrox - see Carbamide peroxide Decadron – see Dexamethasone

DEFEROXAMINE (Desferal) Injection, 500mg/ml

Depakote – see Divalproex Sodium Depo-Medrol - see Methylprednisolone Depo-Provera – see Medroxyprogesterone Depo-Testosterone - see Testosterone Dermagran-B – see Hydrophilic Wound Dressing with Zinc + Vit A&B Desenex - see Miconazole Desferal – see Deferoxamine

DESIPRAMINE (Norpramin) Tablets, 10 mg, 25 mg, 50 mg

DESMOPRESSIN ACETATE (DDAVP)

Spray, nasal 0.01%, 50 doses of 10 mcg

Desyrel – see Trazodone Dexedrine - see Dextroamphetamine

DEXAMETHASONE (Decadron) Tablets, 1 mg, 4 mg Injection, 10mg/ml Ophthalmic solution, 0.1%, 5ml Elixir, oral 0.5mg/5ml

Dexferrum - see Iron Dextran

DEXTROAMPHETAMINE (Dexedrine) Tablets, 5 mg Spansule, 5 mg, 10 mg *Schedule II Controlled Substance

DEXTROSE

Injection, 50%, 50 ml prefilled syringe Injection, 25%, 10 ml prefilled syringe

D.H.E. – see Dihydroergotamine Diamox – see Acetazolamide

DIATRIZOATE MEGLUMINE 66%/DIATRIZOATE Na+ 10% (Gastrografin) Solution oral, 120 ml

* Contains 37% organically bound iodine

DIAZEPAM (Valium) Injection, 10 mg/ 2 ml Tablets, 5 mg (NON-FORMULARY)

* Schedule IV Controlled Substance

DIBUCAINE (Nupercainal)

Ointment, 1%, 30 gm

DICLOXACILLIN (Dynapen) Capsules, 250 mg

DICYCLOMINE (Bentyl) Injection, 10 mg/ml Tablets, 20 mg

Diflucan –see Fluconazole

DIGOXIN (Lanoxin) Elixir, 50 mcg/ml, 60 ml Injection, 500 mcg/2 ml, (0.5 mg/2 ml) Tablets, 0.125 mg, 0.25 mg

DIHYDROERGOTAMINE (D.H.E. 45)

Injection, 1 mg/ml., 1 ml ampule

Dilacor – see Diltiazem Dilantin – see Phenytoin

DILTIAZEM (Cardizem) Injection 5 mg/ml, 5 ml vial *Refrigerated

DILTIAZEM XR (Cardizem CD, Dilacor) Capsules, 120mg, 180 mg, 240 mg

DIPHENHYDRAMINE (Benedryl) Capsules, 25 mg Elixir/syrup, 12.5 mg/5 ml, 120 ml Injection, 50 mg/ml, 1 ml

DIPTHERIA AND TETANUS TOXOID AND ACELLULAR PERTUSSUS VACCINE

ABSORBED (DTaP) Injection, 0.5ml, pediatric *Refrigerated

DIPTHERIA, TETANUS, ACELLULAR PERTUSSUS, POLIOVIRUS INACTIVED,

HEPATITIS B (Pediarix = DTaP-Hep B-IPV) Injection, pediatric, 0.5 ml *Refrigerated

DIPIVEFRIN (Propine) Ophthalmic solution 0.1%, 10 ml

Disalcid– see Salsalate

DISULFIRAM (Antabuse) Tablets, 250mg

Ditropan – see Oxybutynin

DIVALPROEX SODIUM (Depakote) Tablets, 250 mg ER Tablets, 500mg ER

Capsules, 125 mg sprinkles

DOBUTAMINE (Dobutrex) Injection, 250mg/20ml

Dobutrex - see Dobutamine

DOCUSATE SODIUM (Colace) Capsule, 100 mg Syrup, 50 mg/5 ml

Dolophine- see Methadone Domeboro – see Acetic Acid in Aqueous Aluminum Acetate Otic Solution Domeboro - see Aluminum Sulfate and Calcium Acetate Solution Powder Packets

DOPAMINE (Intropin) Injection, 400 mg/5 ml vial Infusion pre-mix, 400mg/250ml D5W Note: 1600 mcg/ml

DORZOLAMIDE (Trusopt) Ophthalmic Solution, 2%, 10ml

DOXEPIN (Sinequan) Capsule, 10 mg, 25 mg, 50 mg

DOXYCYCLINE (Vibramycin) Tablets, 100 mg Injection, 100 mg/vial

Drisdol – see Ergocalciferol DTaP – see Diptheria and Tetanus Toxoids and Acellular Pertussis Vaccine, Absorbed Dulera – see Mometasone/Formoterol Dulcolax – see Bisacodyl Duofilm– see Salicylic Acid in Flexible Collodion Duragesic – see Fentanyl Patch Dynapen – see Dicloxacillin

ECONAZOLE NITRATE (Spectazole) Cream, 1%, 85 gram tube *Restricted to initiation by Podiatry only

EDROPHONIUM CHLORIDE (Enlon) Injection, 10 mg/ml

EFFAVIRENZ / EMTRICITABINE / TENOFOVIR

Tablet, 600mg/200mg/300mg

Effexor – see Venlafaxine HCl ELA-Max - see Lidocaine Elavil – see Amitriptyline Eldepryl – Selegiline

ELECTROLYTE SOLUTION, ORAL (W.H.O. FORMULA)

Packet contains: to make one liter solution Sodium 90 mEq Potassium 20 mEq Bicarbonate 30 mEq Dextrose 20 gm Chloride 80 mEq

Elimite– see Permethrin

EMTRICITABINE /TENOFOVIR (Truvada) Tablet, Emtricitabine 200mg /Tenofovir 300mg

*Restricted to use with Sexual Assault Nurse Examiner (SANE) program only

Energix-B - see Hepatitis B Vaccine Enlon - see Edrophonium

ENOXAPARIN (Lovenox) Injection, 30 mg, 60 mg, 100mg per syringe

EPINEPHRINE (Adrenaline, Epi-Pen) Injection, 1:1000, 1 mg/ml Injection, 1:10,000, 0.1 mg/ml, 10 ml prefilled syringe Solution, Nebulizer (racemic) 2.25%, 0.5ml vials * Refrigerated Autoinjector, 0.3 mg (adult Epi-Pen) Autoinjector, 0.15 mg (pediatric Epi-Pen) Note: Epi-Pen stocked with oral medications in alphabetical order

Epi-Pen- see Epinephrine, Autoinjector Epivir – see Lamivudine

ERGOCALCIFEROL (Drisdol) Capsule, 50,000 international units

ERGOTAMINE (Cafergot) Tablets, oral contains:

Ergotamine Tartrate 1 mg and Caffeine 100 mg

ERYTHROMYCIN (Ilotycin, Erymax, Ery-tab) Ophthalmic ointment, 0.5%, 3.5 gm Suspension, 200 mg/5ml (ethylsuccinate salt) Tablets, 250 mg (enteric coated) Topical Solution or Gel, 2%, 60 ml Injection, 500 mg/vial (lactobionate)

Eskalith – see Lithium Carbonate Estar – see Coal Tar

ESTROGENS, CONJUGATED (Premarin, Prempro) Injection, 25 mg Tablet, 0.3 mg, 0.625 mg, 1.25 mg Tablet, 0.625mg with 2.5mg medroxyprogesterone (Prempro) Cream, vaginal 0.625 mg/gm, 42.5 gm

ETHAMBUTOL (Myambutol) Tablets, 400 mg

ETHANOL – see Ethyl Alcohol

Ethezyme - see Papain-urea

ETHINYL ESTRADIOL / ETONOGESTREL (NuvaRing) Vaginal Insert, 0.015mg/day ethinyl estradiol and 0.12mg/day etonogestrel

ETHINYL ESTRADIOL / LEVONORGESTREL (Portia/Levlen) Tablet,(Portia/Levlen) 0.03 mg ethinyl estradiol / 0.15 mg levonorgestrel, 28-day packs

ETHINYL ESTRADIOL/NORELGESTROMIN (Ortho Evra) Transdermal system: 20mcg ethinyl estradiol and 150 mcg norelgestromin/24 hrs

ETHINYL ESTRADIOL / NORETHINDRONE (Microgestin/LoEstrin 1/20) Tablets, 0.02 mg ethinyl estradiol / 1mg norethindrone – 21 tabs per pack

ETHINYL ESTRADIOL / NORETHINDRONE (Ortho Novum 1/35, Norinyl 1/35) Tablets, 0.035 mg Ethinyl Estradiol / 1 mg norethindrome - 28 days packs

ETOMIDATE (Amidate) Injection, 2 mg/ml *for Rapid Sequence intubation

ETONORGESTREL IMPLANT (Nexplanon) *Restricted to placement by privileged provider only.

Eucerin - see Hydrophilic ointment

EZETIMIBE (VYTORIN and ZETIA) Tablets, 10 mg (single entity) Tablets combination with simvastatin, 10 mg ezetimibe/40 mg simvastatin

Feldene – see Piroxicam

FENTANYL (Sublimaze, Duragesic) Injection, 0.05 mg/ml Patches, 25, 50, 75, 100 mcg/hr

* Schedule II Controlled Substance

FEXOFENADINE (Allegra) Tablets 60mg Tablets, Extended Release 180mg

FERRIC SUBSULFATE (Monsels solution) Solution, * Flammable cabinet

FERROUS SULFATE

Solution pediatric, 25 mg elemental iron/ml, 50 ml Tablets, 325 mg (65mg elemental iron)

FINASTERIDE (Propecia, Proscar) Tablets 5mg

Fish Oil – see Omega-3 Fatty Acids Flagyl – see Metronidazole Fleets – see Sodium Phosphate Fleets Enema – see Sodium Phosphate and Biphosphate Enema Flexeril – See Cyclobenzaprine Flintstones Children Vitamins with Iron - see Multivitamins, Children with Iron Flomax--see Tamsulosin Florinef – see Fludrocortisone Flovent - see Fluticasone

FLUCONAZOLE (Diflucan) Tablets, 150 mg, 1 dose cards for resistant vaginal candidiasis Tablets 200 mg

FLUDROCORTISONE (Florinef) Tablet, 0.1 mg, (100 mcg)

FLUMAZENIL (Romazicon) Injection 0.5 mg/5 ml

FLUOCINONIDE (Lidex) Cream, 0.05%, 30 gm

FLUORESCEIN SODIUM (Fluress, Flurets) Strips, ophthalmic staining Solution, ophthalmic 0.25% with Benoxinate 0.4%

FLUORIDE SODIUM

Drops, 0.25 mg Fl per drop

FLUOROMETHOLONE (FML)

Ophthalmic suspension 0.1% *Restricted to Optometry

FLUOXETINE (Prozac) Capsules, 10 mg, 20 mg Solution, oral, 20 mg/5ml

FLUPHENAZINE (Prolixin) Injection, 25 mg/ml (decanoate), 5 ml Tablets, 5 mg

Fluress – see Fluorescein Sodium

FLUTICASONE (Flovent) Inhalation Aerosol (MDI), 44mcg * For use in children <4 y/o only. For adults, use

Mometasone.

FML – see Fluorometholone

FORMOCRESOL

*Dental use *Flammable cabinet

FOLIC ACID

Injection, 5 mg/ml, 10 ml (folate sodium) Tablets, 1 mg

FOMEPIZOLE (Antizol) Injection 1gm/ml , 1.5ml vials

Fosamax - see Alendronate

FOSPHENYTOIN (Cerebyx) Injection, 50 mg PE/ml Note: PE = phenytoin equivalents i.e. dose the same as phenytoin *Restricted to IM use when IV cannot be established. * Refrigerated

Fulvicin P/G – see Griseofulvin, Ultramicrosize Fungizone – see Amphotericin Furadantin – see Nitrofurantoin

FUROSEMIDE (Lasix) Tablets, 20 mg, 40 mg Liquid, oral 10 mg/ml Injection, 10 mg/ml

GABAPENTIN ( Neurontin) Capsule, 100 mg., 300 mg, 400 mg Tablets, 600 mg

Gamma Globulin – see Globulin, Immune Serum Garamycin – see Gentamicin Gardasil – see Human Papillomavirus, quadrivalent (HPV) Gastrografin – see Diatrizoate

GEMFIBROZIL (Lopid) Tablet, 600 mg

GENTAMICIN (Garamycin) Injection, 80 mg/2ml Solution, ophthalmic, 0.3%, 5 ml Ointment, ophthalmic, 3 mg/gm, 3.5 gm

Gentian Violet - see Methylrosaniline Chloride

GLIPIZIDE (Glucotrol) Tablet, 5 mg, 10 mg

GLOBULIN, IMMUNE SERUM (Gamma Globulin) Injection 10 ml, IM and IV Note: IV product is not routinely stocked.

GLUCAGON

Injection, 1 mg

Glucophage – see Metformin Glucotrol – see Glipizide

GLUCOSE TEST STRIPS (Advantage) Test Strips, 50 strips/bottle

GLYCERIN

Suppositories, adult and pediatric *Refrigerated

GLYBURIDE (Micronase) Tablets, 5mg

GLYCOPYRROLATE (Robinul) Injection, 0.2mg/ml Tablets, 1mg

Golytely – see Polyethylene Glycol with Electrolytes Goniosol - see Hydroxypropyl Methylcellulose

GRISEOFULVIN (Fulvicin P/G, Grifulvin V) Tablets, 250 mg (Ultramicrosize) Suspension, oral, 125mg/5ml (microsize) Note: 250 mg ultramicrosize is therapeutically equivalent to 330 mg microsize

Gyne-Lotrimin – see Clotrimazole

HAEMOPHILUS B CONJUGATE VACCINE (PedvaxHIB) Injection, 5 ml (Meningococcal Protein Conjugate)

HAEMOPHILUS B CONJUGATE / HEPATITIS B VACCINE (Comvax) Injection, pediatric, 0.5ml

Haldol – see Haloperidol

HALOPERIDOL (Haldol) Tablet, 1 mg, 2mg, 5 mg Injection, 5 mg/ml Injection, (Decanoate), 100 mg./ml

Havrix - see Hepatitis A Vaccine HCTZ – see Hydrochlorothiazide

Hemabate – see Carboprost Tromethamine HEMORRHOIDAL SUPPOSITORIES (Anusol, Anusol HC) Suppositories, plain contain 0.25% phenylephrine Suppositories , HC contains 25mg hydrocortisone

HEPARIN

Infusion, pre-mix, 25,000 units/ 500 ml Injection, 5000 units/ml, 1 ml vials

Injection, 10 units/ml *for heparin lock flush Injection,100 units/ml *used in PIC Line protocol for flush

Injection, 10,000 units/ml, 4ml vials *For subcutaneous use only - stored in pharmacy, not for clinic use

HEPATITIS A VACCINE, INACTIVATED (Havrix) Injection, pediatric/adolescent, 720 EL.U/ 0.5 ml Injection, adult, 1440 IL.U/ml

HEPATITIS B IMMUNE GLOBULIN

Injection, 0.5ml neonates, 5ml adults

HEPATITIS B VIRUS VACCINE, RECOMBINANT (Engerix-B) Injection, adult 20 mcg/ml Injection, pediatric 10 mcg/0.5 ml Note: Not indicated for dialysis or immunocompromised patients-must use Recombivax HB Dialysis Formulation.

Hibiclens – see Chlorhexidine

HOMATROPINE

Ophthalmic solution, 5% *Restricted to Optometry

Human Papillomavirus, Quadrivalent (HPV) (restricted to 18 years of age and under: supplied thru State-VFC)

HYALURONATE (Synvisc) Injection, solution, intra-articular, 8mg/ml prefilled syringes *Restricted to use by Orthopedist only

HYDRALAZINE (Apresoline) Tablet, 10mg and 25 mg Injection, 20 mg/ml

HYDROCHLOROTHIAZIDE (HCTZ, Hydrodiuril, Oretic) Tablet, 25 mg

HYDROCHLOROTHIAZIDE WITH TRIAMTERENE (Maxzide ½ strength) Tablet, 25 mg Hydrochlorothiazide and 37.5 mg Triamterene

HYDROCODONE/ACETAMINOPHEN (Vicodin) Tablets, 500 mg hydrocodone/ 325 mg acetaminophen

* Schedule III Controlled Substance

HYDROCORTISONE (Cortisol, Cortril, Solu-Cortef, Cortef) Tablet, 10mg, 20 mg Cream, 1%, 30 gm Injection, 100 mg, (Sodium Succinate Salt) Suppositories-see Hemorrhoidal suppositories

Hydrodiuril – see Hydrochlorothiazide

HYDROGEN PEROXIDE

Solution, 3%

HYDROPHILIC OINTMENT (Eucerin) 454 gm

HYDROPHILIC WOUND DRESSING with Zinc, Vit A, & Vit B (DermaGran-B) Cream, 85gm tube

HYDROPHILIC WOUND DRESSING CREAM (Triad) 71 gm

HYDROXYCHLOROQUINE (Plaquenil) Tablet, 200 mg

HYDROXYPROPYL METHYLCELLULOSE (Goniosol) Solution, ophthalmic, 2.5 %

* For professional use in goniotropic examinations

HYDROXYZINE (Atarax, Vistaril) Tablet, 25 mg Injection, 50 mg/ml Syrup, 10 mg/5 ml

Hytrin - see Terazosin

IBUPROFEN (Motrin) Tablet, 200 mg, 400 mg, 600 mg, 800 mg Suspension, 100 mg/5 ml

Ilotycin – see Erythromycin

IMIPRAMINE (Tofranil) Tablet, 25 mg, 50 mg

Imitrex – see Sumatriptan

Immune Serum Globulin – see Globulin, Immune Serum Imodium - see Loperamide Imuran – see Azathioprine Inderal – see Propranolol Indocin – see Indomethacin Imdur – see Isosorbide Mononitrate, Ext Rel

INDOMETHACIN (Indocin) Capsule, 25 mg

Infasurf – see Calfactant

INFLIXIMAB (Remicade) Injection, 100 mg/vial *Refrigerated

INFLUENZA VACCINE

* Formulation varies yearly

INH – see Isoniazid

INSULIN, HUMAN (rDNA origin) Injection, Aspart (NovoLog) 100 units/ml, 10ml vl Injection, Aspart (NovoLog FlexPen) 100 units/ml, 15ml/5 Pen pkg Injection, Detemir (Levemir) 100 units/ml, 10 ml vl Injection, Detemir (Levemir Flexpen) 100mg/ml, 15ml/5Pen pkg Injection, Regular 100 units/ml, 10 ml vl Injection, Suspension, NPH Isophane 100 units/ml., 10 ml vl Injection, Suspension, 70/30, 70% NPH Isophane 30% Regular, 100 units/ml 10ml vl

* Refrigerated

Intal – see Cromolyn

INTRAUTERINE DEVICE (IUD)

Paragard (copper, MDL T 380A) Mirena (levonorgestel-releasing intrauterine device) - see levonorgestrel

Intropin – see Dopamine

IOVERSOL injection 74% (Optiray) 350mg/ml 125ml syringes (ordered and stocked by Radiology)

IPECAC SYRUP

Syrup, oral, 30 ml

IPRATROPIUM (Atrovent) Solution, nebulizer 0.02% (0.5mg/vial) Inhalation aerosol (MDI) 200 actuations/14.7gm

IPV - see Poliovirus Vaccine

IRBESARTAN (Avapro) Tablet, 75 mg, 300 mg *Restricted to patients who developed cough on lisinopril

Iron - see Ferrous Sulfate

IRON DEXTRAN (Dexferrum) Injection, 50 mg elemental iron/2 ml, 2ml vial

IRON SUCROSE (Venofer) Injection, 100mg elemental Iron/5ml

Isentress – see Raltegravir

ISONIAZID (INH)

Syrup, 50 mg/5 ml Tablet, 100mg and 300 mg

ISOPROPYL ALCOHOL

Solution, 70%

ISOPROTERENOL (Isuprel)

Injection, 1:5000, 0.2 mg/ml

Isoptin - see Verapamil Isordil – see Isosorbide Dinitrate

ISOSORBIDE DINITRATE (Isordil) Tablet, 10 mg, 20 mg

ISOSORBIDE MONONITRATE (Imdur) Tablet, Extended Release 30mg, 60mg, 120mg

ISOTRETINOIN (Accutane, Amnesteem) Capsules, 10mg, 20mg, 40mg *Restricted to use by iPledge program registered providers & patients only

Isuprel – see Isoproterenol

IUD – see Intrauterine Device

Kayexalate – see Sodium Polystyrene Sulfonate Keflex – see Cephalexin Kefzol - see Cefazolin Kenalog – see Triamcinolone Keppra – see Levetiracetam

KETAMINE

Injection 10 mg/ml, 20ml vial *For IV use only * Schedule III Controlled Substance

KETOROLAC (Toradol, Acular) Injection, 30mg, 60 mg Solution, ophthalmic 0.5% *Restricted to Optometry consult, glaucoma patients.

Klonopin – see Clonazepam KY Jelly – see Lubricant, sterile surgical

LABETALOL (Normodyne) Injection, 5 mg/ml, 20 ml multi-dose vial

Lacri-Lube – see Lubricant Ocular

LACTULOSE (Chronulac, Cephulac) Syrup, 10 gm/15 ml

Lamisil - see Terbenafine

LAMIVUDINE / ZIDOVUDINE (Combivir) Tablet, 150 mg Lamivudine / 300 mg Zidovudine *Restricted to needle-stick HIV prophylaxis

LAMOTRIGINE (Lamictal) Tablet, 25mg, 100mg, 150mg, 200mg

LANCETS, BLOOD LETTING

LANOLIN, USP

Lanolin, hydrous, 30 gm Lansinoh, 100% ultrapure medical grade for breastfeeding, 56 gm

Lanoxin – see Digoxin Lansinoh - see Lanolin

LANSOPRAZOLE (Prevacid) Capsule, 15 mg, 30 mg *Restricted to H. Pylori treatment

Lasix – see Furosemide

LATANOPROST (Xalatan) Ophthalmic solution, 0.005% * Refrigerated

Lantus - see Insulin

LEUCOVORIN (Wellcovorin) Injection, 50 mg

LEUPROLIDE (Lupron) Depot Injection, 3.75 mg, 7.5 mg, 22.5 mg

Levaquin – see Levofloxacin Levemir – see Insulin Detemir

LEVETIRACETAM (Keppra) Tablets 250mg Tablets 500mg

Levodopa - see Carbidopa Levlen – see Ethinyl Estradiol/Levonorgestrel

LEVOFLOXACIN (Levaquin) Tablet, 500 mg Injection, 25 mg/ml - 20ml vial

LEVONORGESTREL (Mirena and Plan B) Intrauterine Device, 52 mg levonorgestrel, release rate of 20 mcg/day Tablet, 0.75 mg 1 tablet q 12 hours for emergency contraception

Levophed – see Norepinephrine Levothyroid – see Levothyroxine

LEVOTHYROXINE (Synthroid, Levothroid) Tablets, 25 mcg, 50 mcg, 75 mcg, 88 mcg, 100 mcg, 112 mcg, 125 mcg, 150 mcg

Lidex – see Fluocinonide

LIDOCAINE (Xylocaine, ELA-Max)

Injection, 100 mg/5 ml, prefilled syringe Infusion, 0.4% in 500 ml D5W - 2 gm Injection, 1%, 2% (local anesthetic use) - 20 ml vial Injection 1%, 2% with epinephrine 1:100,000 - 50 ml vial Powder - for preparation of LET solution (lidocaine, epinephrine, tetracaine) Solution, oral, viscous 2%, 100 ml.

Cream, topical, 4% (ELA-Max)

Lioresal – see Baclofen Lipitor – see Atorvastatin

LISINOPRIL (Zestril, Prinivil) Tablet, 5 mg, 10 mg, 20 mg, 40 mg

Lithane – see Lithium Carbonate

LITHIUM CARBONATE (Lithane, Eskalith) Capsule, 300 mg

LODOXAMIDE TROMETHAMINE (Alomide) Solution, ophthalmic 0.1%, 10 ml

LoEstrin/Microgestin – see Ethinyl Estradiol / Norethindrone

LOPERAMIDE – Imodium Capsule, 2 mg

Lopid - see Gemfibrozil Lopressor – see Metoprolol

LORATADINE (Claritin) Tablets, 10 mg Solution, oral, 5 mg/5 ml

LORAZEPAM (Ativan) Tablet, 1 mg Injection, 2 mg/ml vial * Refrigerated Schedule III Controlled Substance

Lotemax – see Loteprednol

LOTEPREDNOL ELABONATE (Lotemax) Ophthalmic suspension, 0.5%, 10ml Restricted to initiation by eye

Lotrimin – see Clotrimazole Lovenox - see Enoxaprin

LUBRICANT, OCULAR (Lacri-Lube, AKWA) Ointment, ophthalmic, 3.5 gm LUBRICANT, STERILE SURGICAL (KY Jelly, Surgilube) Lubricant, water-soluble jelly, 120 gm

Lupron - see Leuprolide M-M-R- see Measles, Mumps and Rubella Virus Vaccine, live Macrodantin – see Nitrofurantoin Magic Mouthwash - see Mouthwash Mag-Ox - see Magnesium Oxide

MAGNESIUM CITRATE SOLUTION (Citrate of Magnesia) Solution, 300 ml

MAGNESIUM HYDROXIDE (Milk of Magnesia, MOM) Suspension, oral 355 ml

MAGNESIUM OXIDE (Mag-Ox) Tablets, 420 mg

MAGNESIUM SULFATE

Injection, 50% (5 gm/10 ml) Injection, pre-mix, 4 gm/100ml water for IV infusion

MANNITOL

Injection, 25%, 12.5 gm/50ml Injection, pre-mix, 20% in 500 ml water for IV infusion

Marcaine – see Bupivacaine Maxzide – see Hydrochlorothiazide with Triamterene

MEASLES, MUMPS AND RUBELLA VIRUS VACCINE, LIVE (M-M-R)

Injection, 0.5ml single dose vial, with diluent

MEBENDAZOLE (Vermox) Tablet, chewable,100 mg

MECLIZINE (Antivert) Tablet, 25 mg

Medrol Dose-pack - see methylprednisolone

MEDROXYPROGESTERONE (Provera, Depo Provera, Prempro) Tablet, 2.5 mg, 10 mg Tablet, 2.5 mg with 0.625mg conjugated estrogens (Prempro) Injection, depot, suspension 150 mg/ml Note: Need annual patient consent when injection used for contraception.

Mefoxin – see Cefoxitin Megace - see Megestrol

MEGESTROL (Megace) Tablets, 40 mg Suspension, oral, 40 mg/ml

Menactra – see Meningococcal vaccine

MENINGOCOCCAL (Groups A,C,Y and W-135) polysaccharide Diphtheria Toxoid Conjugate vaccine (Menactra) * refrigerated

Mephyton – see Phytonadione

Metamucil - see Psyllium Hydrophilic Mucilloid

METFORMIN (Glucophage) Tablet, 500 mg, 850 mg, 1000 mg

METHADONE (Dolophine) Tablet, 10 mg

METHAZOLAMIDE (Neptazane) Tablet, 50 mg

Methergine – see Methylergonovine

METHIMAZOLE (Tapazole) Tablet, 5mg. 10mg

METHOCARBAMOL (Robaxin) Tablet, 500 mg Injection, 100 mg/ml

METHOTREXATE

Tablet, 2.5 mg Injection, 50 mg/2 ml METHYLDOPA (Aldomet) Tablet, 250 mg

METHYLENE BLUE

Injection 1%, 10 ml ampule

METHYLERGONOVINE (Methergine) Injection, 0.2 mg/ml * Refrigerated Tablet, 0.2 mg

METHYLPHENIDATE (Ritalin, Concerta) Tablet, 5 mg, 10 mg Tablet, sustained release, 20 mg Tablet, extended release, 18 mg (Concerta)

* Schedule II Controlled Substance

METHYLPREDNISOLONE (Medrol Dose-pack) Tablets, 4mg, 21 tablets per card Note: Methylpred 4mg = Prednisone 5mg Starting dose of medrol dose pack (24mg) is equal to 30mg prednisone

METHYLPREDNISOLONE (Solu-Medrol) Injection, 40 mg, 125 mg, 1000 mg (sodium succinate)

METHYLROSANILINE CHLORIDE (Gentian Violet)

Solution, topical, 1% *Flammable cabinet

METOCLOPRAMIDE (Reglan) Injection, 10 mg/2 ml ampules Tablet, 10 mg Solution, oral, 5 mg/5 ml

METOLAZONE (Zaroxolyn) Tablet, 2.5 mg, 5 mg

METOPROLOL (Lopressor) Injection, 1 mg/ml, 5 ml. Ampules Tablet, 25mg and 50 mg

METRONIDAZOLE (Flagyl, Metro-Gel) Tablet, 250 mg, 500 mg Injection, pre-mix 500 mg in 100ml for IV infusion Topical gel, 0.75% - 45gm tube Mi-Acid – see Aluminum and Magnesium Hydroxides

Microgestin – see Ethinyl Estradiol / Norethindrone Micronase – see Glyburide

MICONAZOLE (Desenex) Topical powder 2% - 43gm

MIDAZOLAM (Versed) Injection, 1 mg/ml - 5 ml vial

* Schedule IV Controlled Substance

Milk of Magnesia – Magnesium Hydroxide

MINERAL OIL, HEAVY

Liquid, 480 ml

MiraLax – see Polyethylene Glycol 3350 Mirena - see Levonorgestrel

MIRTAZAPINE (Remeron) Tablet, 15mg, 30mg *Restricted to initiation by Psychiatry only

MISOPROSTIL (Cytotec) Tablet, 200 mcg

* Restricted for use in post-partum bleeding when other agents have failed

M.O.M. – see Magnesium Hydroxide

MOMETASONE (Asmanex) Inhalation Aerosol (MDI) 110mcg, 220mcg per actuation

MOMETASONE/FORMOTEROL (Dulera) Inhalation MDI, 100mcg/5mcg, 200mcg/5mcg

MONTELUKAST (Singulair) Chewable tablet, 5mg children 6-14 y/o Tablet, 10 mg

Monsels Solution - see Ferric subsulfate

MORPHINE SULFATE

Injection, 2 mg/ml, 10 mg/ml Tablets, sustained release, 15 mg, 30 mg (MS Contin) Solution, oral, 10 mg/5ml

* Schedule II Controlled Substance

Motrin – see Ibuprofen

MOXIFLOXACIN HCl (Vigamox) Ophthalmic Solution, 0.5%, 3ml Restricted to eye

MOUTHWASH (Magic Mouthwash) 1 part Diphenhydramine elixir : 1 part Mylanta II (Maalox Plus) Note: 1 part Viscous Lidocaine may be added if the physician orders

MS Contin - see Morphine sulfate Mucomyst - see Acetylcysteine

MULTIVITAMIN B WITH C PLUS FOLATE (Berocca) Vitamin C 500 mg Folic acid 0.5 mg Thiamine (B1) 15 mg Niacin 100 mg Riboflavin (B2) 15 mg Cyanocobalamin 5 mcg Pyridoxine (B6) 4 mg Pantothenic Acid 18 mg

MULTIVITAMIN, CHILDREN with IRON (Flintstones)

* Restricted to children/pregnancy intolerant of standard forms of Iron Vitamin A 2500 IU Thiamine (B1) 1.05 mg Vitamin C 60 mg Riboflavin (B2) 1.2 mg Vitamin D 400 IU Niacin 13.5 mg Vitamin E 15 IU Pyridoxine (B6) 1.05 mg Iron 15 mg Cyanocobalamine 4.5 mcg Folic Acid 300 mcg

MULTIPLE VITAMIN INFUSION (MVI 12, MVI)

Injection, 10 ml. Vial (adult) * Refrigerated Contains:

Vitamin C 100 mg. Niacinamide (B3) 40 mg.

Vitamin A 3,300 I.U. vitamin E 10 mg.

Ergocalciferol 200 I.U. pantothenic acid (B5) 15 mg.

Thiamine (B1) 3 mg. Cyanocobalamine (B12) 5 mcg.

Riboflavin (B2) 3.6 mg. Biotin 60 mcg.

Pyridoxine (B6) 4 mg. Folate 0.4 mg.

MULTIVITAMINS AND MINERAL, PRENATAL

Contains:

Vitamin A 4000 IU niacinamide 20 mg Vitamin D 400 IU pyridoxine (B6) 10 mg Vitamin E 22 mg cyanocobalamin 12 mcg Vitamin C 120 mg calcium 200 mg Folic acid 1 mg Iron (ferrous fumarate) 27 mg Thiamine (B1) 1.84 mg zinc 25 mg Riboflavin (B2) 3 mg copper (cupric oxide) 2 mg

MULTIVITAMINS, PROPHYLACTIC

Contains:

Vitamin A 5000 IU riboflavin 1.7 mg Vitamin D 400 IU niacin 20 mg Vitamin E 30 IU pyridoxine 2 mg Vitamin C 60 mg cyanocobalamin 6 mcg Folic acid 0.4 mg calcium pantothenate (B5) 10 mg Thiamine (B1) 1.5 mg

MVI-12- see Multiple Vitamin Infusion

MUPIROCIN (Bactroban) Ointment, topical 22gm

* Restricted for treatment of impetigo in place of oral antibiotic

Myambutol– see Ethambutol Mycelex – see Clotrimazole

MYCOPHENOLATE (Cellcept) Capsules, 250 mg

Mycostatin – see Nystatin Mydfrin - see Phenylephrine Mydriacyl – see Tropicamide Mylicon – see Simethicone

NAFCILLIN (Unipen) Injection, 1 gm Injection, 1 gm, 2 gm ADD-Vantage

NALOXONE (Narcan) Injection, 1 mg/ml, prefilled syringe, ampule Injection, 0.4 mg/ml

NAPROSYN – see Naproxen

NAPROXEN (Naprosyn) Tablet, 250 mg, 500 mg

NAPROXEN SODIUM

Tablet, 220 mg

Narcan – see Naloxone Nasalcrom – see Cromolyn Natalins – see Multivitamin and Minerals, prenatal

NEOMYCIN-POLYMYXIN-HYDROCORTISONE (Cortisporin) Suspension, otic, 10 ml, each ml contains:

Neomycin sulfate 3.5 mg Polymyxin B sulfate 10,000 units Hydrocortisone 10 mg

NEOSTIGMINE (Prostigmin) Injection, 1:1000, 1 mg/ml

Neo-Synephrine – see Phenylephrine Neptazane – see Methazolamide Neurontin – see Gabapentin Nexplanon – see Etonorgestrel Implant

NicoDerm CQ – see Nicotine Transdermal

Nicotine Transdermal (NicoDerm CQ) 7mg/24hr patch, 14mg/24hr patch, 21mg/24hr patch

NIFEDIPINE (Adalat CC) Tablet, 30 mg, 60 mg, 90 mg

Nilstat – see Nystatin

NITROFURANTOIN (Furadantin, Macrodantin, Macrobid) Capsule, 50 mg, (macrocrystals) Suspension, oral, 25 mg/5 ml Capsule, 100mg (monohydrate/macrocrystal) Macrobid

NITROGLYCERIN

Tablet, sublingual, 400 mcg (0.4 mg, 1/150 grain) Infusion, pre-mix, 50 mg in 250 ml D5W (200 mcg/ml) Ointment, 2% (approximately 80 inches per 30 gm tube) Transdermal system, 0.1, 0.2, 0.4 mcg/hr patches

Nitropress - see Nitroprusside

NITROPRUSSIDE (Nitropress) Injection, 50 mg/2ml

Nix – see Permethrin Nolvadex - see Tamoxifen

Norcuron – see Vecuronium

NOREPINEPHRINE (Levophed) Injection, 1 mg/ml, 4 ml ampules

Norinyl 1/35 – see Ethinyl Estradiol / Norethindrone Normodyne – see Labetalol Norpramin – see Desipramine

NORETHINDRONE (Nor-QD) Tablet, 0.35 mg, 28 day pack *Progesterone only “minipill” for use in breastfeeding mothers

Nor-QD- see Norethindrone Norvasc - see Amlodipine NovoLog – see Insulin, Aspart NovoLog FlexPen – see Insulin, Aspart Nupercainal - see Dibucaine NuvaRing – see Ethinyl Estradiol / Ethonogestrel

NYSTATIN (Mycostatin, Nilstat) Suspension, oral, 100,000 units/ml, 60 ml

OCTREOTIDE (Sandostatin) Injection, 50 mcg/ml, 1ml ampule *Refrigerated

OLANZAPINE (Zyprexa) Tablet, 2.5 mg, 5 mg, 10 mg *Initiation restricted to psych or psych consult

OLOPATADINE (Patanol) Ophthalmic solution, 0.1%, 5ml Restricted to initiation by eye

OMEGA-3 FATTY ACIDS (Fish Oil) Capsule, 1 Gram EPA (Eicosapentaenoic Acid) 180mg DHA(Docosahexaenoic Acid) 120mg Other fatty acids 40mg

OMEPRAZOLE (Prilosec) Capsules, 20mg

Omnicef – see Cefdinir

OPHTHALMIC IRRIGATING SOLUTION

Solution, 120 ml

Optiray – see Ioversol Oretic – see Hydrochlorothiazide Orinase– see Tolbutamide Ortho Evra – see Ethinyl estradiol/norelgestromin Ortho-Novum– see Ethinyl Estradiol/Norethindrone Oxy-10 – see Benzoyl Peroxide

OXYBUTYNIN (Ditropan) Tablet, 5 mg

OXYCODONE (Oxy-Contin) Tablets, 5 mg Tablets, sustained release, 10 mg and 20mg

* Schedule II Controlled Substance

OXYCODONE WITH ACETAMINOPHEN (Percocet) Tablet, Oxycodone 5 mg with acetaminophen 325 mg *Schedule II Controlled Substance

Oxy-Contin - see Oxycodone

OXYMETAZOLINE (Afrin) Spray, nasal, 0.05% *Restricted to treatment of epitaxsis only OTC for other uses

OXYTOCIN (Pitocin) Injection, 10 units/ml *Refrigerated

Pacerone - see Amiodorone

PALIVIZUMAB (Synagis) Injection, 50 mg, 100 mg IgG *Refrigerated

PANCREALIPASE

Capsules, Lipase 8000 USP units Protease 30,000 USP units, Amylase 30,000 USP units

PAPAIN-UREA (Accuzyme, Ethezyme) Ointment, Debriding, 30 gm

PARA-AMINOBENZOIC ACID (Sunscreen) Lotion, 120 ml.

Patanol – see Olopatadine Pediapred - see Prednisolone Pediarix - see Diptheria, Tetanus, Acellular Pertussus, Polio Inactivated, Hepatitis B PedVaxHIB – see Haemophilus B Conjugate Vaccine

PENICILLIN G, BENZATHINE (Bicillin LA) Injection, 600,000 units tubex Injection, 1.2 Million units tubex

PENICILLIN G, POTASSIUM

Injection, 20,000,000 units/vial

Penicillin VK – see Penicillin V, Potassium

PENICILLIN V POTASSIUM (Penicillin VK, Pen VK) Solution, oral, 250 mg/5 ml Tablet, 250 mg (400,000 units), 500 mg

Percocet - see Oxycodone/acetaminophen Peridex– see Chlorhexidine Periogard – see Chlordexidine

PERMETHRIN – (Elimite, Nix) Cream, 5%, (Elimite), 60 gm Liquid (Crème rinse), 1% (Nix), 60 ml

PHENAZOPYRIDINE (Pyridium) Tablet, 100 mg

Phenergan – see Promethazine

PHENIRAMINE and NAPHAZOLINE (Visine A) Solution, ophthalmic, 15 ml Pheniramine 0.3% and Naphazoline 0.025%

PHENTOLAMINE (Regitine) Injection, 5 mg/vial

PHENYLEPHRINE (Neo-Synephrine) Solution, ophthalmic, 2.5 %, 10%

PHENYTOIN (Dilantin) Capsule, extended release, 30 mg, 100 mg Tablet, chewable, 50 mg Suspension, 125 mg/5 ml

Phoslo- see Calcium Acetate Phospho-Soda - see Sodium Phosphate

PHYSOSTIGMINE SALICYLATE (Antilirium) Injection, 1 mg/ml ampule

PHYTONDADIONE (Mephyton, Aqua-Mephyton, Vitamin K-1) Injection, 1 mg/0.5 ml (neonatal concentration) Injection, 10 mg/ml Tablet, 5 mg

PIPERACILLIN/TAZOBACTAM(Zosyn) Injection, 2.25 gm, 3.375 gm, 4.5 gm

PIOGLITAZONE (Actos) Tablet, 15 mg, 30 mg, 45 mg

PILOCARPINE

Solution, ophthalmic, 1%, 2%, 4%

PIROXICAM (Feldene) Capsule, 20 mg

Pitocin – see Oxytocin Pitressin – see Vasopressin Plan B- see Levonorgestrel Plaquenil – see Hydroxychloroquine Plavix – see Clopidogrel Bisulfate

PNEUMOCOCCAL VACCINE POLYVALENT (Pneumovax) Injection, adult, multi-dose vial

PNEUMOCOCCAL 7-VALENT CONJUGATE VACCINE (Prevnar) Injection, pediatric, 0.5 ml (Diptheria CRM197 Protein)

Pneumovax – see Pneumococcal Vaccine Polyvalent

POLIOVIRUS VACCINE

Injection, 10 ml multi-dose vial

POLYETHYLENE GLYCOL 3350 (MiraLax) Oral Powder, 30 doses per bottle, 17.9 oz bottle

POLYETHYLENE GLYCOL ELECTROLYTE LAVAGE SOLN (Colyte, Golytely) Contains, per gallon:

PEG 3350 240 gm NaCl 5.84 gm KCl 2.98 gm NaHCO3 6.742 gm Na2SO4 22.72 gm

Polysporin– see Bacitracin with Polymixin B Polytrim - see Trimethoprim and Polymixin

POLYVINYL CHLORIDE (Artificial Tears) Ophthalmic solution, 15 ml

Pontocaine – see Tetracaine

POTASSIUM CHLORIDE

Injection, pre-mix 10 mEq/100 ml for IV Infusion Injection, 2 mEq/ml, 20 ml Powder, for oral solution, 20 mEq per packet Tablet, Sustained Release, 10 mEq

* See Potassium Containing IV Solutions - Appendix XII

POTASSIUM HYDROXIDE

Aqueous Solution, 10% *Flammable cabinet

POTASSIUM PHOSPHATE

Injection, Phosphorus 3 mM/ml, Potassium 4.4 mEq/ml

POVIDONE-IODINE (Betadine) Solution, topical, 10%

PPD - see Tuberculin Purified Protein Derivative

PRALIDOXIME CHLORIDE (Protopam)

Injection, 1 gm/20 ml

Pred Forte – see Prednisolone

Pred Mild - see Prednisolone

PREDNISOLONE (Pred Forte, Pred Mild, Pediapred, Prelone) Suspension, ophthalmic, 0.125%, 1% (acetate) Liquid, oral, 15 mg/5 ml

PREDNISONE

Tablet, 1 mg, 5 mg, 10 mg, 20 mg

Prelone - see Prednisolone Premarin – see Estrogens, Conjugated Prempro - see Estrogens, Conjugated or Medroxyprogesterone Prenatal Vitamin – see Multivitamin and Mineral, Prenatal Prevacid – see Lansoprazole *restricted to H. Pylori treatment Prevnar - see Pneumococcal 7-valent conjugate Prilosec – see Omeprazole

PRIMIDONE (Mysoline) Tablet, 50 mg, 250 mg

Prinivil – see Lisinopril

PROBENECID (Benemid) Tablet, 500 mg

PROCAINAMIDE (Pronestyl) Injection, 100 mg/ml vial, 10 ml vial

PROCHLORPERAZINE (Compazine) Tablet, 5 mg Injection, 5 mg/ml Suppositories, 25 mg

Prograf- see Tacrolimus Prolixin – see Fluphenazine

PROMETHAZINE (Phenergan) Injection, 25 mg/ml Tablet, 25 mg Suppositories, 12.5 mg, 25 mg

Pronestyl – see Procainamide

PROPANTHELINE (Pro-Banthine) Tablet, 15 mg

PROPARACAINE

Solution, ophthalmic, 0.5% *Refrigerated

Propecia – see Finasteride Propine – see Dipivefrin

PROPRANOLOL (Inderal) Tablet, 10 mg, 20 mg, 40 mg, 80 mg Injection, 1 mg/ml

PROPYLTHIOURACIL (PTU)

Tablet, 50 mg Proscar – see Finasteride Prostigmin - see Neostigmine Prostin VR Pediatric – see Alprostadil

PROTAMINE

Injection, 50 mg/5 ml vial

Protopam – see Pralidoxime Chloride Proventil – see Albuterol Provera – see Medroxyprogesterone Prozac – see Fluoxetine

PSEUDOEPHEDRINE (Sudafed) Syrup, 30 mg/ 5 ml, 120 ml Tablet, 30 mg, 60 mg

PSYLLIUM HYDROPHILIC MUCILLOID (Metamucil, Reguloid) Powder, sugar-free, 13 ounce bottle

PTU – see Propylthiouracil

PYRAZINAMIDE

Tablet, 500 mg

Pyridium – see Phenazopyridine

PYRIDOXINE (Vitamin B-6) Injection, 100 mg/ml Tablet, 50 mg

QUETIAPINE (Seroquel) Tablet, 25mg, 100mg, 200mg *Restricted to initiation by Psychiatry only

RabAvert- see Rabies Vaccine

RABIES IMMUNE GLOBULIN (Human) Injection, 150 IU/ml - 2 ml vial *Refrigerated

RABIES VACCINE (RabAvert) Injection * Refrigerated Note: 5-dose series for past exposure

Racemic Epinephrine – see Epinephrine, Racemic

RALTEGRAVIR (Isentress) Tablet, 400mg *Restricted to use with Sexual Assault Nurse Examiner (SANE) program only.

RANITIDINE (Zantac) Tablet, 150 mg Solution, oral, 15 mg/ml Injection, 50 mg/2ml vials Injection, pre-mix, 50 mg/50ml NS for IV infusion

Rattlesnake Antivenin – see Antivenin (Crotalidae) Polyvalent

Regitine – see Phentolamine Reglan – see Metoclopramide Reguloid – see Psyllium Refresh Tears – see carboxymethylcellulose

REHYDRATION SALTS, ORAL (ORS)

Powder, world health organization formula Each packet contains:

Sodium Chloride 3.5 gm Potassium Chloride 1.5 gm Trisodium Citrate, dihydrate 2.9 gm Glucose Anhydrous 20 gm

Remeron – see Mirtazapine Remicade - see Infliximab Renagel- see Sevelamer Retin-A – see Tretinoin

Rho(D) IMMUNE GLOBULIN, HUMAN, SDF LYPHOLIZED (WinRho) Injection, 300 mcg (1500 IU)

RIFAMPIN

Capsule, 300 mg

Risperidal – see Risperidone

RISPERIDONE (Risperdal) Tablets, 1 mg, 2 mg, 4 mg Liquid, oral, 1 mg/ml

Ritalin - see Methylphenidate Robaxin – see Methocarbamol Robinul - see Glycopyrrolate Rocaltrol – see Calcitriol Rocephin – see Ceftriaxone Romazicon - see Flumazenil

SALICYLIC ACID IN FLEXIBLE COLLODION (DuoFilm) Solution, topical 17%, 15 ml

SALMETEROL (Serevent) Inhalation powder, diskus, 50 mcg/blister, 60 blisters

SALSALATE (Disalcid) Tablet, 750 mg

Sandostatin - see Octreotide Santyl – see Collagenase

Sea-Clens – see Sodium Chloride Wound Cleanser

SELEGILINE (Eldepryl) Capsules, 5 mg

SELENIUM SULFIDE (Selsun) Lotion, 2.5%, 120 ml

Selsun – see Selenium Sulfide Septra – see Cotrimoxazole Serevent - see Salmeterol

SERTRALINE (Zoloft) Tablet, 50 mg, 100 mg

SEVELAMER (Renagel) Tablet, 800 mg

Silvadene – see Silver Sulfadiazine Silvasorb – see Silver Antimicrobial Wound Gel

SILVER ANTIMICROBIAL WOUND GEL (Silvasorb) Gel, 44.4ml tube

SILVER NITRATE

Applicator sticks, Silver nitrate 75%, Potassium nitrate 25%

SILVER SULFADIAZINE (Silvadene) Cream, 1%, 20 gm, 400 gm

SIMETHICONE (Mylicon) Tablet, chewable, 80 mg

SIMVASTATIN (Zocor) Tablet, 20 mg, 40 mg

Sinemet – see Carbidopa-Levodopa Singulair- see Montelukast Snake Antivenin – see Antivenin Crotalidae Polyvalent

SODIUM BICARBONATE

Injection, 8.4% (1 mEq./ml.) 50 ml prefilled syringe, 50 ml vial Injection, 4% , 2.4 mEg/vial Injection, 4.2% (0.5 mEq/ml) 10 ml prefilled syringe Tablet, 650 mg

SODIUM CHLORIDE

Injection, 0.9%, 20 ml. (without preservative) Injection, 0.9%, 30 ml. (bacteriostatic) Solution, ophthalmic, 5% Ointment, ophthalmic, 5% Solution, irrigation, 0.9%, 1000 ml Solution, nasal, 0.4%, 15 ml drops, 50 ml spray Solution, sterile inhalation, 0.9%, 3 ml unit dose Solution, Hypertonic 3% premade

* See IV Fluid List - Appendix XIII

SODIUM CHLORIDE WOUND CLEANSER (Sea-Clens) Solution, 178ml Spray Bottle

Sodium Fluoride - see Fluoride Sodium

SODIUM METABISULFITE

Anhydrous, *Flammable cabinet

SODIUM PHOSPHATE AND BIPHOSPHATE (Fleets, Phospho-Soda) Solution, oral 45 ml Enema, disposable squeeze bottle, 133 ml adult, 66 ml pediatric

SODIUM POLYSTYRENE SULFONATE (Kayexalate) Suspension, 15 gm/60 ml in 23% sorbitol Note: Available as suspension for oral or rectal use (enemas)

Solu-Cortef – see Hydrocortisone Solu-Medrol – see Methylprednisolone Somophyllin – see Aminophylline Spectazole – see Econazole Nitrate

SPIRONOLACTONE (Aldactone) Tablet, 25 mg

STERILE WATER FOR INJECTION

Preservative Free, 20 ml Bacteriostatic , 30 ml

Strattera – see Atomoxetine Sublimaze – see Fentanyl

SUCCINYLCHOLINE (Anectine) Injection, 20 mg/ml * Refrigerated

SUCRALFATE (Carafate) Tablet, 1 gm

Sudafed – see Pseudoephedrine

SULFACETAMIDE WITH PREDNISOLONE (AK-Cide, Vasocidin) Suspension, ophthalmic, (sulfa 10%, prednisolone 0.23%) 10 ml

Sulfadiazine Silver – see Silver Sulfadiazine

SULFASALAZINE (Azulfidine) Tablet, 500 mg

SULINDAC (Clinoril) Tablets, 150 mg

SUMATRIPTAN SUCCINATE (Imitrex) Injection, 6 mg/0.5 ml Tablets, 25 mg, 50 mg - 9 tablets/box

Sunscreen – see Para-Aminobenzoic Acid Surgilube – see Lubricant, sterile surgical Symmetrel - see Amantadine Synagis - see Palivizumab Synthroid – see Levothyroxine

TACROLIMUS (Prograf) Capsules, 0.5 mg, 1 mg

TAMOXIFEN (Nolvadex) Tablet, 10 mg

TAMSULOSIN (Flomax) Capsule, 0.4mg

Tapazole – see Methimazole

Tar – see Coal Tar

Tdap (Boostrix) TETANUS, REDUCED DIPHTHERIA AND ACELLULAR PERTUSSIS (for adolescent use) * refrigerated Injection 0.5ml

Tegretol – see Carbamazepine Tegrin - see Coal Tar

TENECTEPLASE (TNKase) Injection, 50 mg

Tenormin - see Atenolol

TERAZOSIN (Hytrin) Capsule, 1 mg, 2 mg, 5 mg

TERBENAFINE (Lamisil) Tablet, 250 mg

* Restricted to diabetes patients or abnormal gait

TERBUTALINE (Brethine) Injection, 1 mg/ml Tablet, 2.5 mg, 5 mg

TEST STRIP, BLOOD GLUCOSE (Advantage) Strips, for blood testing, 50’s

TESTOSTERONE (Depo-Testosterone, Androgel) Injection Depot, 200 mg/ml (as Cypionate) Topical gel, 1%, 2.5 gm/unit dose, 5 gm/unit dose

* Schedule III Controlled Substance

TETANUS IMMUNE GLOBULIN, HUMAN

Injection, 250 units * refrigerated

TETANUS AND DIPHTHERIA TOXOIDS, ABSORBED (Td) Injection, Adult , 5 ml* refrigerated

TETRACAINE (Pontocaine) Solution, topical, 2%

TETRACYCLINE

Capsule, 250 mg.

Theo-Dur– see Theophylline

THEOPHYLLINE (Theo-Dur) Tablet, Sustained release, 200 mg

THIAMINE (Vitamin B1) Injection, 100 mg/ml Tablet, 100 mg

Thorazine – see Chlorpromazine

TIMOLOL MALEATE (Timoptic) Solution, ophthalmic, 0.5%, 10 ml

Timoptic – see Timolol TNKase - see Tenecteplase TobraDex – see Tobramycin/Dexamethasone

TOBRAMYCIN/DEXAMETHASONE (TobraDex) Ophthalmic ointment ,0.3%/0.1%, 3.5gm Ophthalmic Suspension, 0.3%/0.1%, 5ml Restricted to eye

TOCOPHERYL ACETATE (Vitamin E) Capsule, 400 IU

Tofranil – see Imipramine

TOLAZAMIDE (Tolinase) Tablet, 250 mg

TOLBUTAMIDE (Orinase) Tablet, 500 mg

Tolinase – Tolazamide Toradol – see Ketorolac

TRAMADOL (Ultram) Tablet, 50mg

TRAZODONE (Desyrel) Tablet, 50 mg

TRETINOIN (Retin-A) Cream, 0.05%, 20 gm

Triad - see Hydrophilic Wound Dressing

TRIAMCINOLONE (Aristocort, Azmacort,…