formulary: alphabetical listing*...2020/09/28 · cyanocobalamin tablet 500mcg vitamin b12...
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7 n:\lchc_pharm\formulary management\formulary of drugs book\2021 items to include\lean formulary book\7. formulary of drugs (alph) pp7,32.docx
FORMULARY: ALPHABETICAL LISTING* *Most current Formulary List of Drugs can be found:
1. DUH intranet [click on DRH (Duke Regional Hospital), Departments and Services, Pharmacy, then Lincoln Community Health Center Formulary] (https://lincolnchc.org/?page_id=6808)
2. LCHC website ((https://lincolnchc.org/?page_id=6808) 3. PADC website (http://www.projectaccessdurham.org/), 4. LCHC Intranet/ Pharmacy Department/ Formulary of Drugs. Use Ctrl-F to quickly search the listing for a specific item.
Patient Assistance Program Patients who meet specific eligibility requirements may receive formulary medications through
manufacturer-sponsored patient assistance programs (PAPs). Medications labeled as “PAP” are available to eligible patients through manufacturer-sponsored PAPs. These medications may not be readily available and may require up to an 8-week processing period.
HIV Patient Assistance Program EI Clinic may access medications through ADAP for qualified patients. For patients that do not
qualify for ADAP, HIV medications may be obtained from manufacturer programs. http://adap.directory/sites/default/files/uploads/formularies/HMAPProgramManual_01142019.pdf
Project Access Durham County Project Access Durham County (PADC) serves eligible low-income, uninsured Durham residents who have specialty medical care needs. PADC enrolls members based on referrals from a primary care provider at Lincoln Community Health Center (LCHC). PADC patients are eligible for LCHC formulary medications.
Safety in Lactation Lactation safety data from American Academy of Pediatrics (www.aap.org)
Medicaid Preferred Drug List http://www.ncdhhs.gov/dma/pharmacy/PDL.pdf
Medicaid Prior Authorizations https://www.nctracks.nc.gov/content/public/providers.html
Hazardous Drugs Hazardous Drugs (HD) identified by National Institute of Occupational Safety and Health as hazardous are labeled as “HD”. Use caution when handling. (https://www.cdc.gov/niosh/docs/2016-161/pdfs/2016-161.pdf?id=10.26616/NIOSHPUB2016161)
Beers List 2019 American Geriatrics Society Beers Criteria® Update Expert Panel. American Geriatrics Society 2019 Updated AGS Beers Criteria® for Potentially Inappropriate Medication Use in Older Adults. J Am Geriatr Soc. 2019 Jan 29. doi: 10.1111/jgs.15767.
8 n:\lchc_pharm\formulary management\formulary of drugs book\2021 items to include\lean formulary book\7. formulary of drugs (alph) pp7,32.docx
Medication Brand Name Therapeutic Category
Pharmacologic Category
Package Size Preg Cat Safety in Lactation
Crush/ Split
Beers List
Dose Adjust
K=Kidney L=Liver
Acetaminophen/Codeine Tablet 300mg/30mg
Tylenol With Codeine #3
ANALGESICS AND ANTIPYRETICS
Opioid
C - +
L
Acetaminophen Suspension 160mg/5mL
Tylenol Suspension
ANALGESICS AND ANTIPYRETICS
Miscellaneous 120 mL B +
L
Acetaminophen Tablet 325mg
Tylenol ANALGESICS AND ANTIPYRETICS
Miscellaneous #100 tabs B + + L
Acetazolamide ER 12hr Tablet 500mg
Diamox Sequels
CARDIOVASCULAR DRUGS
Carbonic Anhydrase Inhibitor
C - + K/L
Acyclovir Suspension 200mg/5mL
Zovirax ANTI-INFECTIVES Antiviral
B +
K/L
Adalimumab Injection 40mg (Patient Assistance Program)
Humira RHEUMATOLOGY Tumor Necrosis Factor Blocking Agent
90 day supply PAP
B - - ?
Albendazole Tablet 200mg
Albenza ANTI-INFECTIVES Antihelmintic
C ? + K
Albuterol MDI Proventil, Ventolin, ProAir
RESPIRATORY AGENTS
Bronchodilator, Beta2-Adrenergic Agonist
C ?
Albuterol Nebulizer Solution 0.083%
Proventil, Ventolin
RESPIRATORY AGENTS
Bronchodilator, Beta2-Adrenergic Agonist
#25 C ?
Alendronate Tablet 4mg Fosamax ENDOCRINE AND METABOLIC AGENTS
Biphosphonates, Osteoporosis
#4 tabs C - - K
Allopurinol Tablet 100mg, 300 mg
Zyloprim ENDOCRINE AND METABOLIC AGENTS
Gout, Xanthine Oxidase Inhibitors
C + + K
Amiodarone Tablet 200mg
Cordarone CARDIOVASCULAR DRUGS
Antiarrhythmic
D - + +
see p 69, 71
L
Amitriptyline Tablet 25mg, 50 mg
Elavil ANTIDEPRESSANT AGENTS
Tricyclic
D - + + see p 69
9 n:\lchc_pharm\formulary management\formulary of drugs book\2021 items to include\lean formulary book\7. formulary of drugs (alph) pp7,32.docx
Medication Brand Name Therapeutic Category
Pharmacologic Category
Package Size Preg Cat Safety in Lactation
Crush/ Split
Beers List
Dose Adjust
K=Kidney L=Liver
Amlodipine Tablet 5mg, 10mg
Norvasc CARDIOVASCULAR DRUGS
Calcium Channel Blocker
C ? + L
Amlodipine-benazepril Capsule 2.5-10mg, 5-20mg, 10-40mg
Lotrel CARDIOVASCULAR DRUGS
Calcium Channel Blocker- ACE-Inhibitor
D ? - L,K
Amoxicillin Capsule 500mg
Amoxil ANTI-INFECTIVES Penicillin
B + - K
Amoxicillin Suspension 400mg/5mL
Amoxil ANTI-INFECTIVES Penicillin
B +
K
Amoxicillin/Clavulanic Acid Suspension 600mg/42.9mg
Augmentin ES ANTI-INFECTIVES Penicillin B ? + K/L
Amoxicillin/Clavulanic Acid Tablet 875mg/125mg
Augmentin XR ANTI-INFECTIVES Penicillin
B ? + K/L
Apixaban Tablet 2.5mg, 5 mg (Patient Assistance Program)
Eliquis CARDIOVASCULAR Direct Oral Anticoagulant
90 day supply PAP
B - +
K
Aripiprazole Tablet 5mg, 15mg
Abilify ANTIPSYCHOTIC AGENTS
Second Generation (Atypical) Antipsychotic
C ? +
Artificial Tear Drops Artificial Tears
EYE, EAR, NOSE, AND THROAT
Lubricant 15 mL + +
Artificial Tear Ointment Duratears EYE, EAR, NOSE, AND THROAT
Lubricant 3.5 gm + +
Aspirin (enteric coated) Tablet 81mg, 325 mg
Ecotrin CARDIOVASCULAR DRUGS
Salicylate D ? -
K/L
10 n:\lchc_pharm\formulary management\formulary of drugs book\2021 items to include\lean formulary book\7. formulary of drugs (alph) pp7,32.docx
Medication Brand Name Therapeutic Category
Pharmacologic Category
Package Size Preg Cat Safety in Lactation
Crush/ Split
Beers List
Dose Adjust
K=Kidney L=Liver
Atenolol Tablet 50mg, 100mg
Tenormin CARDIOVASCULAR DRUGS
Beta Blocker
D - - K
Atorvastatin Tablet 10mg, 20mg, 40mg, 80mg
Lipitor CARDIOVASCULAR DRUGS
Antihyperlipidemic, HMG-CoA Reductase Inhibitor
X - + L
Atropine Ophth Solution 1%
Atropine EYE, EAR, NOSE, AND THROAT
Mydriatic 15 mL C +
Azithromycin Suspension 200mg/5mL
Zithromax ANTI-INFECTIVES Macrolide
B ?
K/L
Azithromycin Tablet 250mg
Zithromax ANTI-INFECTIVES Macrolide
B ? + K/L
Bacitracin Ointment 500 units/gm
SKIN AND MUCOUS MEMBRANE AGENTS
Antibiotic, Topical 15 gm B ?
Baclofen Tablet 10mg Lioresal SKELETAL MUSCLE RELAXANT
Skeletal Muscle Relaxant
C + + K
Benzonatate Capsule 100mg
Tessalon Perles
RESPIRATORY AGENTS
Antitussive #20 caps C ? -
Benzoyl Peroxide Gel 5%
Panoxyl SKIN AND MUCOUS MEMBRANE AGENTS
Acne 42.5 gm C ?
Bisacodyl Tablet 5mg Dulcolax GASTROINTESTINAL DRUGS
Laxative, Diphenylmethane
C ? - K
Bismuth Subsalicylate Tablet 262mg
Pepto-Bismol GASTROINTESTINAL DRUGS
Antidiarrheal #30 tabs D ? +
Bismuth/Metronidazole/ Tetracycline Capsule 140mg/125mg/125mg
Pylera ANTI-INFECTIVES/ GASTROINTESTINAL DRUGS
Antidiarrheal/ Miscellaneous/ Antibiotic, Tetracycline Derivative
#120 D ? - K/L
Brimonidine Ophth Drops 0.2%
Alphagan EYE, EAR, NOSE, AND THROAT
Antiglaucoma, Alpha2 Agonist
10 mL B ?
11 n:\lchc_pharm\formulary management\formulary of drugs book\2021 items to include\lean formulary book\7. formulary of drugs (alph) pp7,32.docx
Medication Brand Name Therapeutic Category
Pharmacologic Category
Package Size Preg Cat Safety in Lactation
Crush/ Split
Beers List
Dose Adjust
K=Kidney L=Liver
Budesonide/formoterol MDI 80mcg/4.5mcg, 160mcg/4.5mcg
Symbicort RESPIRATORY AGENTS
Beta2 Adrenergic Agonist/ Corticosteroid, Inhalant
C ?
Buprenorphine/Naloxone SL Tablet 2mg/ 0.5mg, 8mg/ 2mg
Zubsolv ANALGESICS AND ANTIPYRETICS
Opioid C ? + K/L
Bupropion ER Tablet 150mg, 300 mg
Wellbutrin XL ANTIDEPRESSANT AGENTS
Dopamine Reuptake Inhibitor
C - + K/L
Buspirone Tablet 15mg Buspar ANXIOLYTICS, SEDATIVES, HYPNOTICS
Antianxiety Agent
B - + K/L
Butalbital, Acetaminophen and Caffeine Tablet 50mg/325mg/40mg
Note: Fioricet changed strength April 2014 and no longer has a generic
MIGRAINE AGENTS Migraine Combinations
C - + +
see p 70 K/L
Calcitriol Capsule 0.5mcg Rocaltrol NEPHROLOGY Vitamin D Analog
C ? -
Calcium (elemental) Tablet 500mg
Calcium NUTRIENTS AND NUTRITIONAL AGENTS
Calcium Supplement #60 tabs + (? 1st trimester)
? + K
Calcium Acetate Capsule 667mg
PhosLo NEPHROLOGY Calcium, Phosphate Binder
C ? -
Capsaicin Cream 0.025% Capzasin ANALGESICS AND ANTIPYRETICS
Transient Receptor Potential Vanilloid 1 (TRPV1) Agonist
60 gm B +
Carbamazepine Tablet 200mg HD
Tegretol ANTICONVULSANT AGENTS
Miscellaneous
D + +
K/L
Carbamide Peroxide Otic Drops 6.5%
Debrox EYE, EAR, NOSE, AND THROAT
Cerumenolytic 15 mL ? ?
12 n:\lchc_pharm\formulary management\formulary of drugs book\2021 items to include\lean formulary book\7. formulary of drugs (alph) pp7,32.docx
Medication Brand Name Therapeutic Category
Pharmacologic Category
Package Size Preg Cat Safety in Lactation
Crush/ Split
Beers List
Dose Adjust
K=Kidney L=Liver
Carbidopa/Levodopa Tablet 25mg/100mg
Sinemet ANTIPARKINSON AGENTS
Dopamine Agonist
C - + K/L
Carvedilol Tablet 3.125mg, 12.5mg, 25mg
Coreg CARDIOVASCULAR DRUGS
Beta Blocker w/ alpha blocking activity
C ? + L
Cefdinir Suspension 250mg/5mL
Omnicef ANTI-INFECTIVES Cephalosporin, 3rd gen
B ?
K
Cefuroxime Tablet 250 mg Ceftin ANTI-INFECTIVES Cephalosporin, 2nd gen
Celecoxib Capsule 200mg Celebrex ANALGESICS AND ANTIPYRETICS
NSAID, COX-2 Inhibitor
C (D in 3rd trimester)
? -
K/L
Cephalexin Capsule 250mg
Keflex ANTI-INFECTIVES Cephalosporin
B ? - K
Cephalexin Suspension 250mg/5ml
Keflex ANTI-INFECTIVES Cephalosporin
B ?
K
Cetirizine Solution 1mg/mL
Zyrtec RESPIRATORY AGENTS
Antihistamine 120 mL B -
K
Cetirizine Tablet 10mg Zyrtec RESPIRATORY AGENTS
Antihistamine #30 tabs B - + K
Chlorhexidine Oral Rinse 0.12%
Peridex EYE, EAR, NOSE, AND THROAT
Anti-infective 480 mL B ?
Chlorthalidone Tablet 25mg
Thalitone CARDIOVASCULAR DRUGS
Diuretic, Thiazide B ? + K
Ciprofloxacin Ophth Solution 0.3%
Cipro ANTI-INFECTIVES Quinolone 5 mL bottle C (not likely
teratogen)
?
Ciprofloxacin Tablet 500mg
Cipro ANTI-INFECTIVES Quinolone
C (not likely
teratogen)
? + K/L
Clarithromycin Tablet 500mg
Biaxin ANTI-INFECTIVES Macrolide
C ? + K
13 n:\lchc_pharm\formulary management\formulary of drugs book\2021 items to include\lean formulary book\7. formulary of drugs (alph) pp7,32.docx
Medication Brand Name Therapeutic Category
Pharmacologic Category
Package Size Preg Cat Safety in Lactation
Crush/ Split
Beers List
Dose Adjust
K=Kidney L=Liver
Clindamycin Capsule 150mg
Cleocin ANTI-INFECTIVES Miscellaneous
B ? + K
Clindamycin Solution 75mg/5mL
Cleocin ANTI-INFECTIVES Miscellaneous 100 mL B ?
K
Clindamycin Topical Solution 1%
Cleocin-T ANTI-INFECTIVES Miscellaneous 60 mL B ?
Clobetasol Ointment 0.05%
Temovate SKIN AND MUCOUS MEMBRANE AGENTS
Corticosteroid 15 gm C ?
Clobetasol Topical Solution 0.05%
Temovate SKIN AND MUCOUS MEMBRANE AGENTS
Corticosteroid 50mL C ?
Clonidine Tablet 0.1mg, 0.2mg, 0.3mg
Catapres CARDIOVASCULAR DRUGS
Alpha2 Adrenergic Agonist
C ? + +
see p 68 K
Clopidogrel Tablet 75mg Plavix CARDIOVASCULAR DRUGS
Antiplatelet
B ? + L
Colchicine Tablet 0.6mg HD
Colcrys ENDOCRINE AND METABOLIC AGENTS
Gout
C ? +
K/L
Cyanocobalamin Tablet 500mcg
Vitamin B12 NUTRIENTS AND NUTRITIONAL AGENTS
Vitamin #130 tabs C + +
Cyclobenzaprine Tablet 5mg
Flexeril SKELETAL MUSCLE RELAXANT
Centrally Acting
B ? + + see p 71
L
Dextroamphetamine /Amphetamine Tablet 10mg
Adderall STIMULANT ADHD, Narcolepsy
C - + K
Diazepam Tablet 5mg Valium ANXIOLYTICS, SEDATIVES, HYPNOTICS
Benzodiazepine
D - + + see p 70,71
L
Dicyclomine Capsule 10mg
Bentyl GASTROINTESTINAL DRUGS
Anticholinergic
B - - + see p 68
Digoxin Tablet 0.125mg, 0.25mg
Lanoxin CARDIOVASCULAR DRUGS
Antiarrhythmic
C + + + see p 69
K
14 n:\lchc_pharm\formulary management\formulary of drugs book\2021 items to include\lean formulary book\7. formulary of drugs (alph) pp7,32.docx
Medication Brand Name Therapeutic Category
Pharmacologic Category
Package Size Preg Cat Safety in Lactation
Crush/ Split
Beers List
Dose Adjust
K=Kidney L=Liver
Diltiazem HCl XR Capsule 180mg, 240mg
Cardizem CD CARDIOVASCULAR DRUGS
Calcium Channel Blocker
C + -
Diphenhydramine Capsule 25mg, 50mg
Benadryl ANTIDOTE Antihistamine
B - - + see p 68
Diphenhydramine Elixer 12.5ml/5mL
Benadryl ANTIDOTE Antihistamine
B -
+ see p 68
Diphenoxylate/Atropine Sulf Tablet 2.5/0.025mg
Lomotil; Lonox
GASTROINTESTINAL DRUGS
Antidiarrheal
C - - K/L
Disulfiram Tablet 250mg Antabuse ANTIDOTE Aldehyde Dehydrogenase Inhibitor
C ? +
Divalproex Sodium Tablet 250mg HD
Depakote ANTICONVULSANT AGENTS
Miscellaneous
X ? - L
Docusate Sodium Capsule 100mg
Colace GASTROINTESTINAL DRUGS
Stool Softener #100 caps C ? - (taste)
Donepezil Tablet 10mg Aricept ALZHEIMER DISEASE Acetylcholinesterase Inhibitor (Central)
C ? +
Dorzolamide Ophth Drops 2%
Trusopt EYE, EAR, NOSE, AND THROAT
Antiglaucoma, Carbonic Anhydrase Inhibitor
10 mL C -
Doxazosin Tablet 2mg, 8mg
Cardura CARDIOVASCULAR DRUGS
Alpha1 Blocker
C ? + + see p 68, 71
L
Doxepin Capsule 25mg, 50mg
Sinequan ANTIDEPRESSANT AGENTS
Tricyclic
C - - + see p 69
Doxycycline Tablet 100mg Vibramycin ANTI-INFECTIVES Tetracycline
D ? +
15 n:\lchc_pharm\formulary management\formulary of drugs book\2021 items to include\lean formulary book\7. formulary of drugs (alph) pp7,32.docx
Medication Brand Name Therapeutic Category
Pharmacologic Category
Package Size Preg Cat Safety in Lactation
Crush/ Split
Beers List
Dose Adjust
K=Kidney L=Liver
Duloxetine Capsule 20mg, 30mg, 60mg
Cymbalta ANTIDEPRESSANT AGENTS
Serotonin/ Norepinephrine Reuptake Inhibitor
C ? - (Mix w/
apple-sauce, NOT choc-olate)
K/L
Electrolyte Solution Pedialyte/ Infalyte
ELECTROLYTE SUPPLEMENT
Treatment of Dehydration
1,000 mL ? ?
Eletriptan Tablet 40mg Relpax MIGRAINE AGENTS Serotonin 5-HT1 Receptor Agonist
#6 tabs C ? + L
Empagliflozin Tablet 10mg, 25mg
Jardiance ENDOCRINE AND METABOLIC AGENTS
Antidiabetic, SGLT-2 Inhibitor
C - + K
Enoxaparin SQ Injection 30mg, 40mg, 60mg, 80mg, 100mg, 120mg, 150mg (Patient Assistance Program)
Lovenox CARDIOVASCULAR DRUGS
Anticoagulant
B +
K
Epinephrine IM Injection 0.15mg/0.15mL, 0.3mg/0.3mL
EpiPen ANTIDOTE Alpha/Beta Adrenergic Agonist
2 Auto-Injectors
C -
Erythromycin Ophth Ointment 5mg/gm
Ilotycin EYE, EAR, NOSE, AND THROAT
Anti-infective 3.5 gm B +
Estradiol Tablet 2mg HD Estrace ENDOCRINE AND METABOLIC AGENTS
Estrogen Derivative X ? + +
see p 70 L
Estrogens, conjugated Cream 0.625mg/gm HD
Premarin SKIN AND MUCOUS MEMBRANE AGENTS
Estrogen 30 gm X -
+
see p 70 L
Estrogens, conjugated Tablet 0.625mg HD
Premarin ENDOCRINE AND METABOLIC AGENTS
Estrogen
X - + +
see p 70
Ezetimibe Tablet 10mg Zetia CARDIOVASCULAR DRUGS
Antihyperlipidemic, 2-Azetidinone
C ? + L
Famotidine Tablet 20mg, 40mg
Pepcid GASTROINTESTINAL DRUGS
Histamine H2 Antagonist
+ + + K
16 n:\lchc_pharm\formulary management\formulary of drugs book\2021 items to include\lean formulary book\7. formulary of drugs (alph) pp7,32.docx
Medication Brand Name Therapeutic Category
Pharmacologic Category
Package Size Preg Cat Safety in Lactation
Crush/ Split
Beers List
Dose Adjust
K=Kidney L=Liver
Famotidine Suspension 40mg/5mL
Pepcid GASTROINTESTINAL DRUGS
Histamine H2 Antagonist
+ + + K
Ferrous Sulfate Drops 75mg/mL (15mg/mL elemental)
ANTIANEMIA AGENTS
Iron Preparations 50mL + +
Ferrous Sulfate Elixer 220mg/5mL (44mg/5mL elemental)
ANTIANEMIA AGENTS
Iron Preparations 480mL + +
Ferrous Sulfate Tablet 325mg (65mg elemental)
ANTIANEMIA AGENTS
Iron Preparations #100 tabs + + +
Finasteride Tablet 5mg HD
Proscar ENDOCRINE AND METABOLIC AGENTS
Androgen Hormone Inhibitor, 5 Alpha-Reductase Inhibitor
#30 tabs X - - (HD)
L
Fluconazole Tablet 150mg HD
Diflucan ANTI-INFECTIVES Antifungal
C (single dose vag candida),
D all other indications
+ + K
Fluocinonide Cream 0.05%
Lidex SKIN AND MUCOUS MEMBRANE AGENTS
Corticosteroid 30 gm C -
Fluoxetine Capsule 20mg Prozac ANTIDEPRESSANT AGENTS
Selective Serotonin Reuptake Inhibitor
C (- in 3rd trimester)
- -
L
Fluticasone Propionate MDI 44mcg, 110mcg, 220mcg/puff
Flovent RESPIRATORY AGENTS
Corticosteroids, Inhalant
C ?
Fluticasone Propionate Nasal Spray 50mcg/spray
Flonase EYE, EAR, NOSE, AND THROAT
Corticosteroid 16 gm C ?
Fluticasone Propionate/ Salmeterol Diskus 100/50, 250/50, 500/50
Advair Diskus RESPIRATORY AGENTS
Beta2 Adrenergic Agonist/ Corticosteroid, Inhalant
C ?
17 n:\lchc_pharm\formulary management\formulary of drugs book\2021 items to include\lean formulary book\7. formulary of drugs (alph) pp7,32.docx
Medication Brand Name Therapeutic Category
Pharmacologic Category
Package Size Preg Cat Safety in Lactation
Crush/ Split
Beers List
Dose Adjust
K=Kidney L=Liver
Folic Acid Tablet 1mg
NUTRIENTS AND NUTRITIONAL AGENTS
Vitamin
A + +
Furosemide Tablet 40mg Lasix CARDIOVASCULAR DRUGS
Diuretic, Loop C ? + K/L
Gabapentin Capsule 100mg, 300mg
Neurontin ANALGESICS AND ANTIPYRETICS
Anticonvulsant, Neuropathic pain (unlabeled)
C ? - K
Gemfibrozil Tablet 600mg Lopid CARDIOVASCULAR DRUGS
Antihyperlipidemic, Fibric Acid
C ? + K
Glecaprevir-pibrentasvir Tablet 100-40mg (Patient Assistance Program)
Mavyret ANTI-INFECTIVES Antihepaciviral NS3/4A Protease Inhibitor; Antihepaciviral
NS5A Inhibitor
28 day supply PAP
C ? -/+ L
Glipizide ER Tablet 5mg, 10mg
Glucotrol XL ENDOCRINE AND METABOLIC AGENTS
Antidiabetic, Sulfonylurea
C ? - L
Glycerin Suppository 1 gm
Pedia-Lax Rectal
GASTROINTESTINAL DRUGS
Laxative, Osmotic
A + +
Glycerin Suppository 2 gm
Sani-Supp Adult Rectal
GASTROINTESTINAL DRUGS
Laxative, Osmotic
A + +
Griseofulvin Suspension 125mg/5mL
Grifulvin ANTI-INFECTIVES Antifungal
C ?
Guaifenesin Tablet 200mg
Humibid RESPIRATORY AGENTS
Expectorant #100 tabs C + +
Haloperidol Tablet 1mg, 2mg
Haldol ANTIPSYCHOTIC AGENTS
Typical, D2 Antagonist
C - +
Hydralazine Tablet 25mg, 50mg
Apresoline CARDIOVASCULAR DRUGS
Vasodilator
C + + K
18 n:\lchc_pharm\formulary management\formulary of drugs book\2021 items to include\lean formulary book\7. formulary of drugs (alph) pp7,32.docx
Medication Brand Name Therapeutic Category
Pharmacologic Category
Package Size Preg Cat Safety in Lactation
Crush/ Split
Beers List
Dose Adjust
K=Kidney L=Liver
Hydrochlorothiazide Tablet 25mg, 50mg
Hydrodiuril CARDIOVASCULAR DRUGS
Diuretic, Thiazide
B (D if used in
pregnancy-induced
HTN)
? + K
Hydrocodone- Acetaminophen Tablet 5mg-325mg
Norco ANALGESICS AND ANTIPYRETICS
Opioid
C ? + + see p 71
L
Hydrocortisone Cream 1%, 2.5 %
SKIN AND MUCOUS MEMBRANE AGENTS
Corticosteroid 30gm (1%) 20gm (2.5%)
C ?
Hydrocortisone Ointment 1%
SKIN AND MUCOUS MEMBRANE AGENTS
Corticosteroid 30 gm
Hydrocortisone Suppository 25mg
Anusol-HC SKIN AND MUCOUS MEMBRANE AGENTS
Corticosteroid #12 per box C ?
Hydroxychloroquine Tablet 200mg
Plaquenil ANTI-INFECTIVES Antimalarial
C + + K/L
Hydroxyzine HCL Syrup 10mg/5mL
Atarax ANXIOLYTICS, SEDATIVES, HYPNOTICS
Antihistamine
C -
+ see p 68
K/L
Hydroxyzine HCL Tablet 25mg, 50mg
Atarax ANXIOLYTICS, SEDATIVES, HYPNOTICS
Antihistamine
C - + + see p 68
K/L
Ibuprofen Suspension 100mg/5mL
Motrin ANALGESICS AND ANTIPYRETICS
NSAID 120 mL B (D in 3rd trimester)
+
+ see p 71
K
Ibuprofen Tablet 400mg
Motrin ANALGESICS AND ANTIPYRETICS
NSAID
B (D in 3rd trimester)
+ + (taste)
+ see p 71
K
Imipramine Tablet 10mg, 25mg
Tofranil ANTIDEPRESSANT AGENTS
Tricyclic
D - + + see p 69
Imiquimod Cream 5% Aldara SKIN AND MUCOUS MEMBRANE AGENTS
#12 single-use packets
C ?
19 n:\lchc_pharm\formulary management\formulary of drugs book\2021 items to include\lean formulary book\7. formulary of drugs (alph) pp7,32.docx
Medication Brand Name Therapeutic Category
Pharmacologic Category
Package Size Preg Cat Safety in Lactation
Crush/ Split
Beers List
Dose Adjust
K=Kidney L=Liver
Indomethacin Capsule 25mg, 50mg
Indocin ANALGESICS AND ANTIPYRETICS
NSAID
B (D in 3rd trimester)
+ - + see p 71
K
Insulin Aspart 100units/mL Rapid-Acting
NovoLog, NovoLog FlexPen
ENDOCRINE AND METABOLIC AGENTS
Antidiabetic, Insulin 10 mL vial, 3 mL pen
B/C +
Insulin Lispro 100units/mL Rapid-Acting
Humalog, Humalog KwikPen
ENDOCRINE AND METABOLIC AGENTS
Antidiabetic, Insulin Insured only, 10 mL vial, 3 mL pen
B/C +
Insulin Regular 100units/mL, Short-Acting
Novolin Regular
ENDOCRINE AND METABOLIC AGENTS
Antidiabetic, Insulin 10 mL vial B/C +
Insulin Aspart Protamine/ Insulin Aspart, Combination
NovoLog Mix 70/30, NovoLog Mix 70/30 FlexPen
ENDOCRINE AND METABOLIC AGENTS
Antidiabetic, Insulin 10 mL vial, 3 mL pen
B/C +
Insulin Lispro Protamine/ Insulin Lispro 100units/mL, Combination
Humalog Mix 75/25
ENDOCRINE AND METABOLIC AGENTS
Antidiabetic, Insulin Insured only, 10 mL vial
B/C +
Insulin NPH and Insulin Regular 100units/mL, Combination
Novolin 70/30, Humulin 70/30, Humulin 70/30 KwikPen
ENDOCRINE AND METABOLIC AGENTS
Antidiabetic, Insulin Humulin insured only, 10 mL vial, 3 mL pen
B/C +
Insulin NPH 100units/mL, Intermediate-Acting
Novolin N, Humulin N, Humulin N KwikPen
ENDOCRINE AND METABOLIC AGENTS
Antidiabetic, Insulin Humulin insured only, 10 mL vial, 3 mL pen
B/C +
20 n:\lchc_pharm\formulary management\formulary of drugs book\2021 items to include\lean formulary book\7. formulary of drugs (alph) pp7,32.docx
Medication Brand Name Therapeutic Category
Pharmacologic Category
Package Size Preg Cat Safety in Lactation
Crush/ Split
Beers List
Dose Adjust
K=Kidney L=Liver
Insulin Detemir 100units/mL, Long-Acting
Levemir, Levemir FlexTouch
ENDOCRINE AND METABOLIC AGENTS
Antidiabetic, Insulin 10 mL vial, 3 mL pen
B/C +
Insulin Glargine 100units/mL Long-Acting (Patient Assistance Program)
Lantus, Lantus SoloStar
ENDOCRINE AND METABOLIC AGENTS
Antidiabetic, Insulin 90 day supply PAP or insured only, 10 mL vial, 3 mL pen
B/C +
Insulin Glargine/ Lixisenatide 100units/33mcg/mL (Patient Assistance Program)
Soliqua ENDOCRINE AND METABOLIC AGENTS
Antidiabetic, Insulin and GLP-1 Agonist Combination
90 day supply PAP, 3 mL pen
B/C -
Insulin Glulisine 100units/mL Rapid-Acting (Patient Assistance Program)
Apidra, Apidra Solostar
ENDOCRINE AND METABOLIC AGENTS
Antidiabetic, Insulin 90 day supply PAP, 10 mL vial, 3 mL pen
B/C +
Ipratropium Bromide Nebulizer Solution 0.02%
Atrovent RESPIRATORY AGENTS
Bronchodilator, Anticholinergic
25 vials per box
B ?
Isosorbide Dinitrate Tablet 10mg, 20mg, 40mg
Isordil CARDIOVASCULAR DRUGS
Vasodilator
C ? +
Ivermectin Tablet 3 mg Stromectol ANTI-INFECTIVE Anthelmintic C ? +
Ketoconazole Shampoo 2%
Nizoral SKIN AND MUCOUS MEMBRANE AGENTS
Antifungal 120 mL C ?
Ketorolac Ophth Solution 0.5%
Acular EYE, EAR, NOSE, AND THROAT
Corticosteroid 5 mL C ?
Ketotifen Ophth Solution 0.025%
Zaditor EYE, EAR, NOSE, AND THROAT
Antihistamine, Mast Cell Stabilizer
5 mL C ?
Lactulose Syrup 10gm/15mL
Duphalac Syrup
GASTROINTESTINAL DRUGS
Constipation, Chronic
B ?
Lamotrigine Tablet 25mg, 100mg
Lamictal ANTICONVULSANT AGENTS
Miscellaneous
C - + L
21 n:\lchc_pharm\formulary management\formulary of drugs book\2021 items to include\lean formulary book\7. formulary of drugs (alph) pp7,32.docx
Medication Brand Name Therapeutic Category
Pharmacologic Category
Package Size Preg Cat Safety in Lactation
Crush/ Split
Beers List
Dose Adjust
K=Kidney L=Liver
Latanoprost Ophth Solution 0.005%
Xalatan EYE, EAR, NOSE, AND THROAT
Antiglaucoma, Prostaglandin Inhibitor
2.5 mL C ?
Ledaspasvir/sofosbuvir Tablet 90 mg/ 400mg (Patient Assistance Program)
Harvoni ANTI-INFECTIVES Antihepaciviral, NS5A Inhibitor; Antihepaciviral, NS5B RNA Polymerase Inhibitor
28 day supply PAP
B ? - (taste)
L
Leuprolide IM Injection 11.25mg, 22mg, 30mg HD (Patient Assistance Program)
Lupron ENDOCRINE AND METABOLIC AGENTS
Gonadotropin Releasing Hormone Agonist
90 day supply PAP
X -
Levetiracetam Tablet 250 mg, 500 mg, 750 mg
Keppra ANTICONVULSANT AGENTS
Miscellaneous C - + K
Levofloxacin Tablet 500mg
Levaquin ANTI-INFECTIVES Anti-Infective
C ? + K
Levonorgestrel Tablet 1.5mg HD
Plan B One-Step
ENDOCRINE AND METABOLIC AGENTS
Postcoital contraception
X + +
Levothyroxine Tablet 0.025mg, 0.1mg, 0.112mg, 0.125mg, 0.15mg, 0.175mg, 0.2mg
Levoxyl ENDOCRINE AND METABOLIC AGENTS
Thyroid A + +
Lidocaine (Viscous) Oral Solution 2%
Xylocaine EYE, EAR, NOSE, AND THROAT
Analgesic 100 mL B +
Liraglutide 18mg/3mL Pen Injector HD
Victoza ENDOCRINE AND METABOLIC AGENTS
Antidiabetic, GLP-1 Agonist
C -
Lisinopril Tablet 5mg, 10mg, 20mg, 40mg
Zestril CARDIOVASCULAR DRUGS
ACE-Inhibitor D ? + K
Lisinopril/HCTZ Tablet 20/12.5mg, 20/25mg
Zestoretic CARDIOVASCULAR DRUGS
ACE-Inhibitor/ Diuretic, Thiazide
D ? + K
22 n:\lchc_pharm\formulary management\formulary of drugs book\2021 items to include\lean formulary book\7. formulary of drugs (alph) pp7,32.docx
Medication Brand Name Therapeutic Category
Pharmacologic Category
Package Size Preg Cat Safety in Lactation
Crush/ Split
Beers List
Dose Adjust
K=Kidney L=Liver
Lithium Carbonate Capsule 300mg
Eskalith ANTIPSYCHOTIC AGENTS
Bipolar Disorder D - - K
Loperamide Tablet 2mg Imodium GASTROINTESTINAL DRUGS
Antidiarrheal #12 tabs C + +
Loratadine Tablet 10mg Claritin RESPIRATORY AGENTS
Antihistamine #30 tabs B + + K
Losartan Tablet 25mg, 50mg, 100mg
Cozaar CARDIOVASCULAR DRUGS
Angiotensin Receptor Blocker
D ? + L
Lubiprostone Capsule 24mcg (Patient Assistance Program)
Amitiza GASTROINTESTINAL DRUGS
Constipation, IBS 90 day supply PAP
C ? - L
Lurasidone Tablet 20mg, 40mg, 60mg, 80mg, 120mg (Patient Assistance Program)
Latuda ANTIPSYCHOTIC AGENTS
Atypical, mixed serotonin-dopamine antagonist
90 day supply PAP
B ? +
K/L
Magnesium Oxide Tablet 400mg (240mg elemental)
MagOx NUTRIENTS AND NUTRITIONAL AGENTS
Hypomagnesemia #120 A + + L
Magnesium/Aluminum/ Simethicone Solution 400mg/400mg/40mg per 5 mL
Maalox Max Strength
GASTROINTESTINAL DRUGS
Antacid 480 mL C ?
K
Meclizine Tablet 12.5mg Antivert ANTIEMETIC/ANTI-VERTIGO AGENTS
Anticholinergic, Antihistamine
B ? + +
see p 68
Medroxyprogesterone Acetate Tablet 10mg HD
Provera ENDOCRINE AND METABOLIC AGENTS
Contraceptive Hormone, Progestin
X + + L
Melatonin Tablet 3mg
ANXIOLYTICS, SEDATIVES, HYPNOTICS
Neurohormone, indole
#120 - -
Memantine ER tablet 7mg, 14mg, 21mg, 28mg (Patient Assistance Program)
Namenda XR ALZHEIMER DISEASE N-Methyl-D-Aspartate Receptor Antagonist
90 day supply PAP
B ? - K
23 n:\lchc_pharm\formulary management\formulary of drugs book\2021 items to include\lean formulary book\7. formulary of drugs (alph) pp7,32.docx
Medication Brand Name Therapeutic Category
Pharmacologic Category
Package Size Preg Cat Safety in Lactation
Crush/ Split
Beers List
Dose Adjust
K=Kidney L=Liver
Metformin Tablet 1000mg Glucophage ENDOCRINE AND METABOLIC AGENTS
Antidiabetic, Biguanide
B ? + K/L
Methimazole Tablet 10mg HD
Tapazole ENDOCRINE AND METABOLIC AGENTS
Thyroid
D + +
Methocarbamol Tablet 500mg
Robaxin SKELETAL MUSCLE RELAXANT
Centrally Acting
C ? + + see p 71
L
Methotrexate Tablet 2.5mg HD
Rheumatrex RHEUMATOLOGY Disease Modifying Antirheumatic Drug (DMARD)
X - + K/L
Methylphenidate HCl Tablet 5mg
Ritalin STIMULANT ADHD, Narcolepsy
C ? +
Methylprednisolone Tablet 4mg Dose Pack
Medrol ENDOCRINE AND METABOLIC AGENTS
Glucocorticoids #21 tabs C ? + K/L
Metoclopramide Tablet 10mg
Reglan GASTROINTESTINAL DRUGS
Prokinetic
B ? +
K
Metoprolol Succinate Tablet 25mg, 50mg, 100mg, 200mg
Toprol XL CARDIOVASCULAR DRUGS
Beta Blocker
C ? + L
Metronidazole Gel 0.75% (Topical)
Metrogel SKIN AND MUCOUS MEMBRANE AGENTS
Miscellaneous 45 gm B ?
Metronidazole Tablet 500mg
Flagyl ANTI-INFECTIVES Miscellaneous
B ? + K/L
Miconazole Cream 2% Micatin SKIN AND MUCOUS MEMBRANE AGENTS
Antifungal 30 gm + ?
Mirtazapine Tablet 30mg Remeron ANTIDEPRESSANT AGENTS
Alpha2 Antagonist
C ? +
K/L
Moisturizing Cream Eucerin SKIN AND MUCOUS MEMBRANE AGENTS
Moisturizing 120 gm + +
Montelukast Chewable Tablet 4mg, 5mg
Singulair RESPIRATORY AGENTS
Leukotriene Inhibitor
B ? + L
24 n:\lchc_pharm\formulary management\formulary of drugs book\2021 items to include\lean formulary book\7. formulary of drugs (alph) pp7,32.docx
Medication Brand Name Therapeutic Category
Pharmacologic Category
Package Size Preg Cat Safety in Lactation
Crush/ Split
Beers List
Dose Adjust
K=Kidney L=Liver
Montelukast Tablet 10mg Singulair RESPIRATORY AGENTS
Leukotriene Inhibitor
B ? + L
Multivitamin Drops with Iron
Poly-vi-sol NUTRIENTS AND NUTRITIONAL AGENTS
Vitamin 50 mL + +
Multivitamin Tablet, Adult
Centrum NUTRIENTS AND NUTRITIONAL AGENTS
Vitamin #100 tabs + + +
Multivitamin Tablet, Children
Flinstones NUTRIENTS AND NUTRITIONAL AGENTS
Vitamin #100 tabs + + +
Mupirocin Ointment 2% Bactroban SKIN AND MUCOUS MEMBRANE AGENTS
Antibiotic, Topical 22 gm B ?
Naloxone 4mg/ 0.1mL Nasal Spray
Narcan ANTIDOTE Opioid antagonist 2 devices C ?
Naltrexone Tablet 50mg ReVia
ANTIDOTE Opioid antagonist C ?
Naltrexone IM Injection 380 mg
Vivitrol ANTIDOTE Opioid antagonist C ?
Naphazoline/Pheniramine Ophth Solution 0.025%/0.3%
Vasocon-A EYE, EAR, NOSE, AND THROAT
Vasoconstrictor/ Antihistamine
15 mL C ?
Naproxen Sodium Tablet 500mg
Naprosyn ANALGESICS AND ANTIPYRETICS
NSAID
B (D in 3rd trimester)
+ + + see p 71
K
Nasal Aspirator
DEVICE
+ +
Nasal Irrigation Kit Neti Pot DEVICE
+ +
Neomycin/Polymyxin B /Hydrocortisone Otic Suspension
Cortisporin Otic
EYE, EAR, NOSE, AND THROAT
Anti-infective, Corticosteroid
Otic 10mL ? ?
Nicotine Gum 2mg, 4mg Nicorette Gum
SMOKING CESSATION
Nicotine Product 110 pieces C -
K/L
25 n:\lchc_pharm\formulary management\formulary of drugs book\2021 items to include\lean formulary book\7. formulary of drugs (alph) pp7,32.docx
Medication Brand Name Therapeutic Category
Pharmacologic Category
Package Size Preg Cat Safety in Lactation
Crush/ Split
Beers List
Dose Adjust
K=Kidney L=Liver
Nicotine Transdermal Patch 7mg/hr, 14mg/hr, 21mg/hr
Nicoderm CQ SMOKING CESSATION
Nicotine Product #14 patches D -
K/L
Nifedipine XL Tablet 30mg, 60mg, 90mg
Procardia XL CARDIOVASCULAR DRUGS
Calcium Channel Blocker
C - - L
Nitrofurantoin Capsule 100mg
Macrobid ANTI-INFECTIVES Urinary
B +?
+ see p 68
K/L
Nitroglycerin SL Tablet 0.4mg
Nitrostat CARDIOVASCULAR DRUGS
Vasodilator #25 tabs C ?
Nitroglycerin Transdermal Patch 0.2mg/hr, 0.4mg/hr, 0.6mg/hr
Transderm Nitro
CARDIOVASCULAR DRUGS
Vasodilator #30 patches C ? -
Norethindrone Tablet 0.35mg HD
Nor-Q-D ENDOCRINE AND METABOLIC AGENTS
Contraceptive Hormone, Progestin
#28 tabs X - (may start 6
wks after preg)
+
L
Norethindrone/ E. Estradiol (triphasic) Tablet 0.5-0.75-1mg/0.035mg HD
Ortho-Novum 7/7/7
ENDOCRINE AND METABOLIC AGENTS
Contraceptive Hormone, Combination
#28 tabs X/D - + + see p 70
L
Norgestrol / E. Estradiol Tablet 0.3mg/0.03mg HD
Lo-Ovral ENDOCRINE AND METABOLIC AGENTS
Contraceptive Hormone, Combination
#28 tabs X - + + see p 70
L
Nortriptyline Tablet 25mg Pamelor ANTIDEPRESSANT AGENTS
Tricyclic
D + + + see p 69
K/L
Nystatin Cream 100,000 units/gm
Mycostatin ANTI-INFECTIVES Antifungal 15 gm C ?
Nystatin Suspension 100,000 units/mL
Nilstat ANTI-INFECTIVES Antifungal 60 mL bottle C ?
26 n:\lchc_pharm\formulary management\formulary of drugs book\2021 items to include\lean formulary book\7. formulary of drugs (alph) pp7,32.docx
Medication Brand Name Therapeutic Category
Pharmacologic Category
Package Size Preg Cat Safety in Lactation
Crush/ Split
Beers List
Dose Adjust
K=Kidney L=Liver
Omega-3 Fatty Acids (180 EPA / 120 DHA)
Fish Oil NUTRIENTS AND NUTRITIONAL AGENTS
Vitamins #100 caps C ? - L
Omeprazole Capsule 20mg
Prilosec GASTROINTESTINAL DRUGS
Proton Pump Inhibitor
C ? -
L
Ondansetron Disintegrating Tablet 4mg
Zofran ODT ANTIEMETIC/ANTI-VERTIGO AGENTS
5-HT3 Receptor Antagonist
B ? + L
Oseltamivir Capsule 75mg Tamiflu ANTIVIRAL AGENT Neuraminidase Inhibitor
#10 tabs B + + K
Oseltamivir Suspension 6mg/ mL
Tamiflu ANTIVIRAL AGENT Neuraminidase Inhibitor
B + + K
Oxazepam Capsule 15mg Serax ANXIOLYTICS, SEDATIVES, HYPNOTICS
Benzodiazepine
D - - + see p 70,71
Oxybutynin Chloride Tablet 5mg
Ditropan GENITOURINARY AGENTS
Antispasmodic, Urinary
B ? +
K/L
Oxymetazoline Nasal Spray 0.05%
Afrin RESPIRATORY AGENTS
Decongestant (topical)
15 mL C ?
Pancreatic Enzymes Capsule Lipase/Protease/Amylase 6k/19k/30k, 12k/38k/60k, 24k/76k/120k (Patient Assistance Program)
Creon GASTROINTESTINAL DRUGS
Pancreatic Enzymes 90 day supply PAP
C ? - (can open and give w/ apple-
sauce or pudding)
K
Peak Flow Meter
DEVICE
+ +
Penicillin VK Suspension 250mg/5mL
Pen-Vee K ANTI-INFECTIVES Penicillin VK
B ?
K
Penicillin VK Tablet 500mg
Veetids ANTI-INFECTIVES Penicillin VK
B ? + K
Permethrin Cream 5% Elimite SKIN AND MUCOUS MEMBRANE AGENTS
Antiparasitic Agent, Scabicidal
60 gm B ?
27 n:\lchc_pharm\formulary management\formulary of drugs book\2021 items to include\lean formulary book\7. formulary of drugs (alph) pp7,32.docx
Medication Brand Name Therapeutic Category
Pharmacologic Category
Package Size Preg Cat Safety in Lactation
Crush/ Split
Beers List
Dose Adjust
K=Kidney L=Liver
Phenazopyridine Tablet 100mg
Pyridium GENITOURINARY AGENTS
Analgesic, Urinary
B ? + K
Phenobarbital Tablet 30mg
ANTICONVULSANT AGENTS
Barbiturate
D - + + see p 70
K/L
Phenytoin Sodium Chewable tablet 50g 100mg
Dilantin Infatabs
ANTICONVULSANT AGENTS
Hydantoin
D + + L
Pill Box
DEVICE
+ +
Pilocarpine Ophth Solution 4%
Pilocar EYE, EAR, NOSE, AND THROAT
Antiglaucoma, Cholinergic Agent
15 mL C ?
Pioglitazone Tablet 15mg, 30mg
Actos ENDOCRINE AND METABOLIC AGENTS
Antidiabetic, Thiazolidinedione
C ? +
L
Piperonyl Butoxide and Pyrethrum Extract Kit
Rid Shampoo SKIN AND MUCOUS MEMBRANE AGENTS
Antiparasitic Agent, Pediculocide
120 mL C ?
Polyethylene Glycol MiraLax GASTROINTESTINAL DRUGS
Laxative, Osmotic 238 gm C ?
Polyethylene Glycol with Electrolytes
GoLytely GASTROINTESTINAL DRUGS
Laxative, Osmotic (for Bowel Prep)
4,000 mL C ?
Polymyxin/Trimethoprim Ophth Solution 10,000 units-1mg/mL
Polytrim EYE, EAR, NOSE, AND THROAT
Anti-infective 10 mL C ?
Potassium Chloride Tablet 8mEq
Klor-Con ELECTROLYTE SUPPLEMENT
Treatment of Hypokalemia
C ? - K
Pravastatin 40mg Tablet Pravachol CARDIOVASCULAR DRUGS
Antihyperlipidemic, HMG-CoA Reductase Inhibitor
X - + K/L
Praziquantel Tablet 600mg
Biltricide ANTI-INFECTIVE Anthelmintic B - + L
Prazosin Capsule 1mg, 2mg, 5mg
Minipress CARDIOVASCULAR DRUGS
Alpha 1 Blocker, Antihypertensive
C ? - +
see p 68 L
28 n:\lchc_pharm\formulary management\formulary of drugs book\2021 items to include\lean formulary book\7. formulary of drugs (alph) pp7,32.docx
Medication Brand Name Therapeutic Category
Pharmacologic Category
Package Size Preg Cat Safety in Lactation
Crush/ Split
Beers List
Dose Adjust
K=Kidney L=Liver
Prednisolone Acetate Ophth Solution 1%
Pred Forte EYE, EAR, NOSE, AND THROAT
Corticosteroid 15 mL C ?
Prednisolone Syrup 15mg/mL
Prelone ENDOCRINE AND METABOLIC AGENTS
Glucocorticoids
C +
K/L
Prednisone Tablet 5mg, 20mg
Deltasone ENDOCRINE AND METABOLIC AGENTS
Glucocorticoids C + + K/L
Pregabalin Capsule 75mg, 150mg
Lyrica ANALGESICS AND ANTIPYRETICS
Anticonvulsant, Analgesic
C ? - K
Prenatal Vitamins Tablet Natalins RX NUTRIENTS AND NUTRITIONAL AGENTS
Vitamin #100 tabs + + +
Promethazine Suppository 25mg
Phenergan ANTIEMETIC/ANTI-VERTIGO AGENTS
Antidopaminergic, Phenothiazine
C -
+
see p 68 L
Promethazine Tablet 25mg
Phenergan ANTIEMETIC/ANTI-VERTIGO AGENTS
Antidopaminergic, Phenothiazine
C -
+
see p 68 L
Propranolol Tablet 10mg, 40mg
Inderal CARDIOVASCULAR DRUGS
Beta Blocker
C + + K/L
Pseudoephedrine Syrup 30mg/5mL
Sudafed RESPIRATORY AGENTS
Decongestant (Alpha/Beta Adrenergic Agonist)
C +
K
Pseudoephedrine Tablet 30mg, 60mg
Sudafed RESPIRATORY AGENTS
Decongestant (Alpha/Beta Adrenergic Agonist)
#24 tabs C + +
K
Psyllium Hydrophilic Powder
Metamucil GASTROINTESTINAL DRUGS
Laxative, Bulk 284 gm + ?
Quetiapine Tablet 25mg, 50mg, 100mg, 200mg, 300mg
Seroquel ANTIPSYCHOTIC AGENTS
Atypical, Serotonin/Dopamine Receptor Antagonist
C - +
K
29 n:\lchc_pharm\formulary management\formulary of drugs book\2021 items to include\lean formulary book\7. formulary of drugs (alph) pp7,32.docx
Medication Brand Name Therapeutic Category
Pharmacologic Category
Package Size Preg Cat Safety in Lactation
Crush/ Split
Beers List
Dose Adjust
K=Kidney L=Liver
Risperidone Tablet 0.5mg, 1mg, 2mg
Risperdal ANTIPSYCHOTIC AGENTS
Atypical, Serotonin/Dopamine Receptor Antagonist
C - +
K/L
Rivaroxaban Tablet 10 mg, 15mg, 20mg
Xarelto CARDIOVASCULAR Anticoagulant C - + + see p 69
K/L
Saline Nose Spray Saline Spray EYE, EAR, NOSE, AND THROAT
Irrigation 45 mL + +
Selenium Sulfide Lotion 2.5%
Selsun SKIN AND MUCOUS MEMBRANE AGENTS
Tinea Versicolor; Dandruff; Seborrheic Dermatitis
120 mL C ?
Sertraline Tablet 50mg, 100mg
Zoloft ANTIDEPRESSANT AGENTS
Selective Serotonin Reuptake Inhibitor
C (- in 3rd trimester)
+ +
L
Silver Sulfadiazine Cream 1%
Silvadene SKIN AND MUCOUS MEMBRANE AGENTS
Anti-infective 20 gm B -
Simethicone Drops 40mg/0.6mL
Mylicon GASTROINTESTINAL DRUGS
Antiflatulent 30 mL C but + ?
Sitagliptin Tablet 25mg, 50mg, 100mg
Januvia ENDOCRINE AND METABOLIC AGENTS
Anti-diabetic, Dipeptidyl Peptidase IV (DPP-IV) Inhib
B ? - K/L
Sodium Polystyrene Sulfonate Suspension 15gm/60mL
Kayexalate NEPHROLOGY Treatment of Hyperkalemia
60 mL per bottle
C ?
Sofosbuvir/ Velpatasvir Tablet 400 mg/ 100 mg (Patient Assistance Program)
HARVlusa ANTI-INFECTIVES Antihepaciviral, NS5A Inhibitor; Antihepaciviral, NS5B RNA Polymerase Inhibitor
28 day supply PAP
B ? - (taste)
Spacer Aerochamber DEVICE
+ +
Spacer, with mask Aerochamber, DEVICE
+ +
Spironolactone Tablet 25mg HD
Aldactone CARDIOVASCULAR DRUGS
Diuretic, Potassium Sparing
D + + K
30 n:\lchc_pharm\formulary management\formulary of drugs book\2021 items to include\lean formulary book\7. formulary of drugs (alph) pp7,32.docx
Medication Brand Name Therapeutic Category
Pharmacologic Category
Package Size Preg Cat Safety in Lactation
Crush/ Split
Beers List
Dose Adjust
K=Kidney L=Liver
Spironolactone/HCTZ Tablet 25mg/25mg HD
Aldactazide CARDIOVASCULAR DRUGS
Diuretic, Potassium Sparing / Thiazide
D + + K
Sulfamethoxazole/ Trimethoprim Suspension 200mg-40mg/5mL
Septra Suspension
ANTI-INFECTIVES Sulfonamide
C +
+ see p 71
Sulfamethoxazole/ Trimethoprim Tablet 800mg/160mg
Septra DS ANTI-INFECTIVES Sulfonamide
C +
+ see p 71
K/L
Sulfasalazine Tablet 500mg
Sulfazine, Azulfadine
ANTI-INFECTIVES Sulfonamide
D - + K/L
Sulfur/Salicylic Acid Shampoo 2%/2%
Sebulex SKIN AND MUCOUS MEMBRANE AGENTS
Dandruff 120 mL C -
Syringes 31G 5/16" 0.5mL, 1mL
Monoject DEVICE
+ +
Tablet Cutter
DEVICE
+ +
Tamoxifen Tablet 10mg HD
Nolvadex ANTINEOPLASTIC AGENTS
Anti-estrogen
D - -
Tamsulosin 0.4mg Capsule
Flomax
Alpha1 Blocker
B + -
Tenofovir/ Emtricitabine Tablet 200mg/ 300mg (Patient Assistance Program)
Truvada ANTI-INFECTIVES Antiviral 30 day supply PAP
B + + K
Terbinafine Cream 1% Lamisil AT ANTI-INFECTIVES Antifungal 15 gm B ?
Terbinafine Tablet 250mg Lamisil ANTI-INFECTIVES Antifungal
B - + K/L
Terconazole Vaginal Cream 0.8%
Terazol-3 SKIN AND MUCOUS MEMBRANE AGENTS
Antifungal 20 gm C -
Thiamine Tablet 100mg Various NUTRIENTS AND NUTRITIONAL AGENTS
Nutritional Supplement
#100 tabs A + +
31 n:\lchc_pharm\formulary management\formulary of drugs book\2021 items to include\lean formulary book\7. formulary of drugs (alph) pp7,32.docx
Medication Brand Name Therapeutic Category
Pharmacologic Category
Package Size Preg Cat Safety in Lactation
Crush/ Split
Beers List
Dose Adjust
K=Kidney L=Liver
Timolol Maleate Ophth Solution 0.5%
Timoptic EYE, EAR, NOSE, AND THROAT
Antiglaucoma, Beta-Adrenergic Blocker
5mL C +
Tiotropium Bromide Capsule for Inhalation 18mcg
Spiriva RESPIRATORY AGENTS
Bronchodilator, Anticholinergic
#30 caps C - -
Tolterodine Tartrate extended release tablet 4mg
Detrol LA GENITOURINARY AGENTS
Anticholinergic, Urinary
C - -
K/L
Topiramate Tablet 25mg, 100mg HD
Topamax ANTICONVULSANT AGENTS
Miscellaneous
D ? - (taste) K/L
Tramadol Tablet 50mg Ultram ANALGESICS AND ANTIPYRETICS
Opioid Analgesic
C - +
K/L
Trazodone Tablet 50mg Desyrel ANTIDEPRESSANT AGENTS
Serotonin Reuptake Inhibitor/Antagonist
C - +
K/L
Tretinoin Cream 0.05% HD
Retin-A SKIN AND MUCOUS MEMBRANE AGENTS
Acne 20 gm D -
Triamcinolone Acetonide Cream 0.1%
Aristocort; Kenalog
SKIN AND MUCOUS MEMBRANE AGENTS
Steroid 15 gm, 80 gm
C ?
Triamcinolone Acetonide Dental Paste 0.1%
Oralone SKIN AND MUCOUS MEMBRANE AGENTS
Steroid 5 gm C ?
Trihexphenidyl Tablet 2mg
Artane ANTIPARKINSON AGENTS
Anticholinergic
C - + + see p 68
K/L
Triprolidine/ Pseudoephedrine Tablet 2.5mg/60mg
Actifed RESPIRATORY AGENTS
Antihistamine and Decongestant (Alpha/Beta Adrenergic Agonist)
#24 tabs - (1st trimester),
C
? + + see p 68
Valacyclovir Tablet 1gm Valtrex ANTI-INFECTIVES Antiviral B + + K
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Medication Brand Name Therapeutic Category
Pharmacologic Category
Package Size Preg Cat Safety in Lactation
Crush/ Split
Beers List
Dose Adjust
K=Kidney L=Liver
Varenicline Tablet Starter Pack, Continuing Pack
Chantix SMOKING CESSATION
Partial Nicotine Agonist
C - + K
Verapamil SR Tablet 180mg, 240mg
Calan SR CARDIOVASCULAR DRUGS
Calcium Channel Blocker
C - + split/-
crush
K/L
Vitamin D3 Tablet 400 IU, 1000 IU
NUTRIENTS AND NUTRITIONAL AGENTS
Vitamin #100 tabs C Avoid high
doses
Vitamin D3 Capsule 50,000 IU
NUTRIENTS AND NUTRITIONAL AGENTS
Vitamin
C Avoid high
doses
-
Vitamin D3 Liquid 400 IU/mL
D-Vi-Sol NUTRIENTS AND NUTRITIONAL AGENTS
Vitamin 50 mL bottle C Avoid high
doses
Warfarin Tablet 5mg Coumadin CARDIOVASCULAR DRUGS
Anticoagulant
- (1st trimester),
C
Use caution
+ + see p 71
K/L
Zinc Oxide Ointment 20% Desitin SKIN AND MUCOUS MEMBRANE AGENTS
Protectant 30 gm + +
Updated: September 28, 2020
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