FORMULARY: ALPHABETICAL LISTING*...DRUGS Beta Blocker D - - K Atorvastatin Tablet 10mg, 20mg, 40mg, 80mg LAB Lipitor CARDIOVASCULAR DRUGS Antihyperlipidemic, HMG-CoA Reductase Inhibitor

6

n:\lchc_pharm\formulary management\formulary of drugs book\2020\7. formulary of drugs (alph) pp6,31.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/), then click on the Lincoln Pharmacy formulary. 4. LCHC Intranet/ Pharmacy Department/ Formulary of Drugs. Use Ctrl-F to quickly search the listing for a specific item.

Pfizer Institutional Patient Assistance Program Pfizer drugs are available to uninsured patients who are at or below 400% of the

federal poverty level. Only a dispensing fee is charged. NOTE: These medications are labeled as “IPAP”.

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://epi.publichealth.nc.gov/cd/hiv/docs/ADAPProgrammanual.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.

Lab Monitoring Some formulary drugs require laboratory monitoring and are labeled as “LAB” (See Section VII.4. Drugs Requiring Lab Monitoring pg 86)

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 Drugs 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.

https://lincolnchc.org/?page_id=6808

https://lincolnchc.org/?page_id=6808

http://epi.publichealth.nc.gov/cd/hiv/docs/ADAPProgrammanual.pdf

http://www.aap.org/

http://www.ncdhhs.gov/dma/pharmacy/PDL.pdf

https://www.nctracks.nc.gov/content/public/providers.html

https://www.cdc.gov/niosh/docs/2016-161/pdfs/2016-161.pdf?id=10.26616/NIOSHPUB2016161

https://www.cdc.gov/niosh/docs/2016-161/pdfs/2016-161.pdf?id=10.26616/NIOSHPUB2016161

7


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 Tab 300mg/30mg

Tylenol With Codeine #3

ANALGESICS AND ANTIPYRETICS

Opioid

C - + +

L

Acetaminophen Suspension 160mg/5mL

Tylenol Susp ANALGESICS AND ANTIPYRETICS

Miscellaneous 120 mL B +

L

Acetaminophen Tablet 325mg

Tylenol ANALGESICS AND ANTIPYRETICS

Miscellaneous #100 tabs B + + L

Acetazolamide Tablet 500mg ER 12hr

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, LAB

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 LAB

Cordarone CARDIOVASCULAR DRUGS

Antiarrhythmic

D - + +

L

Amitriptyline Tablet 25mg, 50 mg

Elavil ANTIDEPRESSANT AGENTS

Tricyclic

D - + +

8





Crush/ Split

Beers List

Dose Adjust

K=Kidney L=Liver

Amlodipine Tablets 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 250mg

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 Tablets 875mg/125mg

Augmentin XR ANTI-INFECTIVES Penicillin

B ? + K/L

Apixaban Tablets 2.5mg, 5 mg (Patient Assistance Program)

Eliquis CARDIOVASCULAR Direct Oral Anticoagulant

90 day supply PAP

B - + +

K

Aripiprazole Tablets 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 Tablet 81mg, 325 mg (enteric coated)

Ecotrin CARDIOVASCULAR DRUGS

Salicylate D ? - +

K/L

9





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 LAB

Lipitor CARDIOVASCULAR DRUGS

Antihyperlipidemic, HMG-CoA Reductase Inhibitor

X - + L

Atropine Ophth Soln 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 0.2% ophth drops

Alphagan EYE, EAR, NOSE, AND THROAT

Antiglaucoma, Alpha2 Agonist

10 mL B ?

10





Crush/ Split

Beers List

Dose Adjust

K=Kidney L=Liver

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 - + +

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 per bottle

+ (? 1st trimester)

? + K

Calcium Acetate Capsule 667mg

PhosLo NEPHROLOGY Calcium, Phosphate Binder

C ? -

Capsaicin 0.025% Cream Capzasin ANALGESICS AND ANTIPYRETICS

Transient Receptor Potential Vanilloid 1 (TRPV1) Agonist

60 gm B +

Carbamazepine Tablet 200mg LAB, HD

Tegretol ANTICONVULSANT AGENTS

Miscellaneous

D + + +

K/L

Carbamide Peroxide Otic Drops 6.5%

Debrox EYE, EAR, NOSE, AND THROAT

Cerumenolytic 15 mL ? ?

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

11





Crush/ Split

Beers List

Dose Adjust

K=Kidney L=Liver

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 IPAP

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 tablets B - + K

Chlorhexidine Oral Rinse 0.12%

Peridex EYE, EAR, NOSE, AND THROAT

Anti-infective 480 mL B ?

Chlorthalidone Tablet Thalitone CARDIOVASCULAR DRUGS

Diuretic, Thiazide B ? + K

Ciprofloxacin Ophth Soln 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

Clindamycin Capsule 150mg

Cleocin ANTI-INFECTIVES Miscellaneous

B ? + K

Clindamycin Solution 75mg/5mL

Cleocin ANTI-INFECTIVES Miscellaneous 100 mL B ?

K

12





Crush/ Split

Beers List

Dose Adjust

K=Kidney L=Liver

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 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 ? + +

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 Tablets 500mcg

Vitamin B12 NUTRIENTS AND NUTRITIONAL AGENTS

Vitamin #130 tabs C + +

Cyclobenzaprine Tablets 5mg

Flexeril SKELETAL MUSCLE RELAXANT

Centrally Acting

B ? + +

L

Dextroamphetamine /Amphetamine Tabs 10mg

Adderall STIMULANT ADHD, Narcolepsy

C - + K

Diazepam Tablets 5mg Valium ANXIOLYTICS, SEDATIVES, HYPNOTICS

Benzodiazepine

D - + +

L

Dicyclomine Capsules 10mg

Bentyl GASTROINTESTINAL DRUGS

Anticholinergic

B - - +

Digoxin Tablets 0.125mg, 0.25mg LAB

Lanoxin CARDIOVASCULAR DRUGS

Antiarrhythmic

C + + +

K

Diltiazem HCl XR 180mg, 240mg Capsule

Cardizem CD CARDIOVASCULAR DRUGS


C + - +

Diphenhydramine Capsule 25mg, 50mg

Benadryl ANTIDOTE Antihistamine

B - - +

13





Crush/ Split

Beers List

Dose Adjust

K=Kidney L=Liver

Diphenhydramine Elixer 12.5ml/5mL

Benadryl ANTIDOTE Antihistamine

B -

+

Diphenoxylate/Atropine Sulf Tablets 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 LAB, 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 2% Trusopt EYE, EAR, NOSE, AND THROAT

Antiglaucoma, Carbonic Anhydrase Inhibitor

10 mL C -

Doxazosin Tablet 2mg, 8mg

Cardura CARDIOVASCULAR DRUGS

Alpha1 Blocker

C ? + +

L

Doxepin Capsule 25mg, 50mg

Sinequan ANTIDEPRESSANT AGENTS

Tricyclic

C - - +

Doxycycline Tablet 100mg Vibramycin ANTI-INFECTIVES Tetracycline

D ? +

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 ? ?

14





Crush/ Split

Beers List

Dose Adjust

K=Kidney L=Liver

Eletriptan Tablet 40mg Relpax MIGRAINE AGENTS Serotonin 5-HT1 Receptor Agonist

6 tabs per box

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, LAB

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 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 ? + + L

Estrogens, conjugated Cream 0.625mg/gm HD

Premarin SKIN AND MUCOUS MEMBRANE AGENTS

Estrogen 30 gm X -

+ L

Estrogens, conjugated Tablet 0.625mg HD

Premarin ENDOCRINE AND METABOLIC AGENTS

Estrogen

X - + +

Ezetimibe tablet 10mg Zetia CARDIOVASCULAR DRUGS

Antihyperlipidemic, 2-Azetidinone

C ? + L

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 + + +

15





Crush/ Split

Beers List

Dose Adjust

K=Kidney L=Liver

Finasteride Tablet 5mg HD

Proscar ENDOCRINE AND METABOLIC AGENTS

Androgen Hormone Inhibitor, 5 Alpha-Reductase Inhibitor

X - -

(HD) L

Fluconazole Tablet 150mg 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 ?

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

16





Crush/ Split

Beers List

Dose Adjust

K=Kidney L=Liver

Glecaprevir-pibrentasvir Tablet 100-40mg Patient Assistance Program

Mavyret ANTI-INFECTIVES Antihepaciviral NS3/4A Protease Inhibitor; Antihepaciviral NS5A Inhibitor

C ? -/+ L

Glipizide ER Tablet 5mg, 10mg

Glucotrol XL ENDOCRINE AND METABOLIC AGENTS

Antidiabetic, Sulfonylurea

C ? - L

Glycerin 1 gm suppository Pedia-Lax Rectal


Laxative, Osmotic

A + +

Glycerin 1 gm suppository Sani-Supp Adult Rectal


Laxative, Osmotic

A + +

Griseofulvin Susp 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

Hydrochlorothiazide Tablet 25mg, 50mg

Hydrodiuril CARDIOVASCULAR DRUGS

Diuretic, Thiazide

B (D if used in

pregnancy-induced

HTN)

? + K

Hydrocodone and Acetaminophen Tab 5mg/325mg

Norco ANALGESICS AND ANTIPYRETICS

Opioid

C ? + +

L

Hydrocortisone Cream 1%, 2.5 %


Corticosteroid 30gm (1%) 20gm (2.5%)

C ?

17





Crush/ Split

Beers List

Dose Adjust

K=Kidney L=Liver

Hydrocortisone Ointment 1%


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 -

+

K/L

Hydroxyzine HCL Tablet 25mg, 50mg

Atarax ANXIOLYTICS, SEDATIVES, HYPNOTICS

Antihistamine

C - + +

K/L

Ibuprofen Suspension 100mg/5mL

Motrin ANALGESICS AND ANTIPYRETICS

NSAID

B (D in 3rd trimester)

+

+

K

Ibuprofen Tablet 400mg Motrin ANALGESICS AND ANTIPYRETICS

NSAID


+ + (taste)

+

K

Imipramine Tablet 10mg, 25mg

Tofranil ANTIDEPRESSANT AGENTS

Tricyclic

D - + +

Imiquimod Cream 5% Aldara SKIN AND MUCOUS MEMBRANE AGENTS

#12 single-use packets

C ?

Indomethacin Capsule 25mg, 50mg

Indocin ANALGESICS AND ANTIPYRETICS

NSAID


+ - +

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


Antidiabetic, Insulin Insured only, 10 mL vial, 3 mL pen

B/C +

+

Insulin Regular 100units/mL, Short-Acting

Novolin Regular


Antidiabetic, Insulin

B/C +

+

18





Crush/ Split

Beers List

Dose Adjust

K=Kidney L=Liver

Insulin Aspart Protamine/ Insulin Aspart, Combination

NovoLog Mix 70/30, NovoLog Mix 70/30 FlexPen



B/C +

Insulin Lispro Protamine/ Insulin Lispro 100units/mL, Combination

Humalog Mix 75/25


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


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


Antidiabetic, Insulin Humulin insured only, 10 mL vial, 3 mL pen

B/C +

Insulin Detemir 100units/mL, Long-Acting

Levemir, Levemir FlexTouch



B/C +

Insulin Glargine 100units/mL Patient Assistance Program, Long-Acting

Lantus, Lantus SoloStar


Antidiabetic, Insulin 90 day supply PAP or insured only, 10 mL vial, 3 mL pen

B/C +

Insulin glargine and 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 -

19





Crush/ Split

Beers List

Dose Adjust

K=Kidney L=Liver

Insulin Glulisine 100units/mL Patient Assistance Program, Rapid-Acting

Apidra, Apidra Solostar


Antidiabetic, Insulin 90 day supply PAP, 10 mL vial, 3 mL pen

B/C +

+

Ipratropium Bromide Nebulizer Soln 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 2% Shampoo

Nizoral SKIN AND MUCOUS MEMBRANE AGENTS

Antifungal 120 mL C ?

Ketorolac 0.5% Ophth Soln

Acular EYE, EAR, NOSE, AND THROAT

Corticosteroid 5 mL C ?

Ketotifen 0.025% Ophth Soln

Zaditor EYE, EAR, NOSE, AND THROAT

Antihistamine, Mast Cell Stabilizer

5 mL C ?

Lactulose Syrup 10gm/15mL

Duphalac Syrup


Constipation, Chronic

B ?

Lamotrigine Tablet 25mg, 100mg

Lamictal ANTICONVULSANT AGENTS

Miscellaneous

C - + L

Latanoprost Ophth Sol 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 Patient Assistance Program, LAB, HD

Lupron ENDOCRINE AND METABOLIC AGENTS

Gonadotropin Releasing Hormone Agonist

90 day supply PAP

X -

20





Crush/ Split

Beers List

Dose Adjust

K=Kidney L=Liver

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 Plan B One-Step


Postcoital contraception

X + +

Levothyroxine 0.025mg, 0.1mg, 0.112mg, 0.125mg, 0.15mg, 0.175mg, 0.2mg Tablet LAB

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 Patient Assistance Program

Victoza ENDOCRINE AND METABOLIC AGENTS

Antidiabetic, GLP-1 Agonist

#4 month supply PAP

C -

Lisinopril Tablet 5mg, 10mg, 20mg, 40mg LAB

Zestril CARDIOVASCULAR DRUGS

ACE-Inhibitor D ? + K

Lisinopril/HCTZ Tablet 20/12.5mg, 20/25mg LAB

Zestoretic CARDIOVASCULAR DRUGS

ACE-Inhibitor/ Diuretic, Thiazide

D ? + K

Lithium Carbonate Capsule 300mg LAB

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

21





Crush/ Split

Beers List

Dose Adjust

K=Kidney L=Liver

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 Suspension

Maalox Max Strength


Antacid 480 mL C ?

K

Meclizine Tablet 12.5mg Antivert ANTIEMETIC/ANTI-VERTIGO AGENTS

Anticholinergic, Antihistamine

B ? + +

Medroxyprogesterone Acetate Tablet 10mgHD

Provera ENDOCRINE AND METABOLIC AGENTS

Contraceptive Hormone, Progestin

X + + L

Melatonin Tablet 3mg

ANXIOLYTICS, SEDATIVES, HYPNOTICS

Neurohormone, indole

#120 - -

Memantine extended release tablet 7mg, 14mg, 21mg, 28mg Patient Assistance Program

Namenda XR ALZHEIMER DISEASE N-Methyl-D-Aspartate Receptor Antagonist

90 day supply PAP

B ? - K

Metformin Tablet 1000mg LAB

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 ? + +

L

22





Crush/ Split

Beers List

Dose Adjust

K=Kidney L=Liver

Methotrexate Tablet 2.5mg LAB, 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 tablets 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

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 + + +

23





Crush/ Split

Beers List

Dose Adjust

K=Kidney L=Liver

Multivitamin tablet, Children

Flinstones NUTRIENTS AND NUTRITIONAL AGENTS

Vitamin #100 tabs + + +

Mupirocin 2% Ointment 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 Tablets 50mg ReVia

ANTIDOTE Opioid antagonist C ?

Naltrexone IM Injection 380 mg

Vivitrol ANTIDOTE Opioid antagonist C ?

Naphazoline/Pheniramine Ophth Soln 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


+ + +

K

Nasal Aspirator

DEVICE

+ +

Nasal Irrigation Kit Neti Pot DEVICE

+ +

Neomycin/Polymyxin B /Hydrocortisone Otic Susp

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

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


C - - L

Nitrofurantoin Capsule 100mg

Macrobid ANTI-INFECTIVES Urinary

B +?

+

K/L

Nitroglycerin SL Tablet 0.4mg

Nitrostat CARDIOVASCULAR DRUGS

Vasodilator #100 tabs C ?

24





Crush/ Split

Beers List

Dose Adjust

K=Kidney L=Liver

Nitroglycerin Transdermal Patch 0.2mg/hr, 0.4mg/hr, 0.6mg/hr

Transderm Nitro

CARDIOVASCULAR DRUGS

Vasodilator #30 patches C ? -

Norethindrone Tablet 0.35mgHD

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/0.035mgHD

Ortho-Novum 7/7/7


Contraceptive Hormone, Combination

#28 tabs X/D - + +

L

Norgestrol / E. Estradiol Tablet 0.3mg/0.03mg HD

Lo-Ovral ENDOCRINE AND METABOLIC AGENTS

Contraceptive Hormone, Combination

#28 tabs X - + +

L

Nortriptyline Tablet 25mg Pamelor ANTIDEPRESSANT AGENTS

Tricyclic

D + + +

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 ?

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

B + + K

25





Crush/ Split

Beers List

Dose Adjust

K=Kidney L=Liver

Oseltamivir Suspension 6mg/ mL

Tamiflu ANTIVIRAL AGENT Neuraminidase Inhibitor

B + + K

Oxazepam Capsule 15mg Serax ANXIOLYTICS, SEDATIVES, HYPNOTICS

Benzodiazepine

D - - +

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 ?

Phenazopyridine Tablet 100mg

Pyridium GENITOURINARY AGENTS

Analgesic, Urinary

B ? + K

Phenobarbital Tablet 30mg

ANTICONVULSANT AGENTS

Barbiturate

D - + +

K/L

Phenytoin Sodium Chewable tablet 50g 100mg LAB

Dilantin Infatabs

ANTICONVULSANT AGENTS

Hydantoin

D + + L

Pill Box

DEVICE

+ +

Pilocarpine Ophth Soln 4%

Pilocar EYE, EAR, NOSE, AND THROAT

Antiglaucoma, Cholinergic Agent

15 mL C ?

26





Crush/ Split

Beers List

Dose Adjust

K=Kidney L=Liver

Pioglitazone Tablet 15mg, 30mg LAB

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 255 gm C ?

Polyethylene Glycol with Electrolytes

GoLytely GASTROINTESTINAL DRUGS

Laxative, Osmotic (for Bowel Prep)

4,000 mL C ?

Polymyxin/Trimethoprim Ophth Soln 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 Pravachol CARDIOVASCULAR DRUGS

Antihyperlipidemic, HMG-CoA Reductase Inhibitor

X - + K/L

Praziquantel Tablet 600 mg

Biltricide ANTI-INFECTIVE Anthelmintic B - + L

Prazosin Capsule 1mg, 2mg, 5mg

Minipress CARDIOVASCULAR DRUGS

Alpha 1 Blocker, Antihypertensive

C ? - +

L

Prednisolone Acetate Ophth Soln 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 IPAP

Lyrica ANALGESICS AND ANTIPYRETICS

Anticonvulsant, Analgesic

C ? - K

Prenatal Vitamins Natalins RX NUTRIENTS AND NUTRITIONAL AGENTS

Vitamin #100 tablets + + +

27





Crush/ Split

Beers List

Dose Adjust

K=Kidney L=Liver

Promethazine Suppository 25mg

Phenergan ANTIEMETIC/ANTI-VERTIGO AGENTS

Antidopaminergic, Phenothiazine

C -

+

L

Promethazine Tablet 25mg

Phenergan ANTIEMETIC/ANTI-VERTIGO AGENTS

Antidopaminergic, Phenothiazine

C -

+

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 25mg50mg, 100mg, 200mg, 300mg LAB

Seroquel ANTIPSYCHOTIC AGENTS

Atypical, Serotonin/Dopamine Receptor Antagonist

C - + +

K

Ranitidine Syrup 15mg/mL

Zantac GASTROINTESTINAL DRUGS

Histamine H2 Antagonist

B ?

+

K/L

Ranitidine Tablet 150mg, 300mg

Zantac GASTROINTESTINAL DRUGS

Histamine H2 Antagonist

B ? + +

K/L

Risperidone Tablet 0.5mg, 1mg, 2mg LAB

Risperdal ANTIPSYCHOTIC AGENTS

Atypical, Serotonin/Dopamine Receptor Antagonist

C - + +

K/L

Rivaroxaban Tablet 10 mg, 15mg, 20mg

Xarelto CARDIOVASCULAR Anticoagulant C - + +

K/L

Saline Nose Spray Saline Spray EYE, EAR, NOSE, AND THROAT

Irrigation 45 mL + +

28





Crush/ Split

Beers List

Dose Adjust

K=Kidney L=Liver

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 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 Susp 15gm/60mL

Kayexalate NEPHROLOGY Treatment of Hyperkalemia

60 mL per bottle

C ?

Sofosbuvir/ velpatasvir Tablet 400 mg/ 100 mg Patient Assistance Program

Epclusa 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

Aldactone CARDIOVASCULAR DRUGS

Diuretic, Potassium Sparing

D + + K

Spironolactone/HCTZ Tablet 25mg/25mg

Aldactazide CARDIOVASCULAR DRUGS

Diuretic, Potassium Sparing / Thiazide

D + + K

Sulfamethoxazole/ Trimethoprim Suspension 200mg-40mg/5mL

Septra Suspension

ANTI-INFECTIVES Sulfonamide

C +

+

29





Crush/ Split

Beers List

Dose Adjust

K=Kidney L=Liver

Sulfamethoxazole/ Trimethoprim Tablet 800mg/160mg

Septra DS ANTI-INFECTIVES Sulfonamide

C +

+

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 LAB, 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 B + + K

Terbinafine Cream 1% LAB

Lamisil AT ANTI-INFECTIVES Antifungal 15 gm B ?

Terbinafine Tablet 250mg LAB

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 + +

Timolol Maleate Ophth Soln 0.5%

Timoptic EYE, EAR, NOSE, AND THROAT

Antiglaucoma, Beta-Adrenergic Blocker

5mL C +

Tiotropium Bromide Cap for inhalation 18mcg

Spiriva RESPIRATORY AGENTS

Bronchodilator, Anticholinergic

30 capsules C - -

30





Crush/ Split

Beers List

Dose Adjust

K=Kidney L=Liver

Tolterodine Tartrate extended release tablet 4mg IPAP

Detrol LA GENITOURINARY AGENTS

Anticholinergic, Urinary

C - - +

K/L

Topiramate Tablet 25mg, 100mg LAB, 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 45 gm D -

Triamcinolone Acetonide Cream 0.1%

Aristocort; Kenalog


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 - + +

K/L

Triprolidine/ Pseudoephedrine Tablet 2.5mg/60mg

Actifed RESPIRATORY AGENTS

Antihistamine and Decongestant (Alpha/Beta Adrenergic Agonist)

#24 tabs - (1st trimester),

C

? + +

Valacyclovir Tablet 1gm Valtrex ANTI-INFECTIVES Antiviral B + + K

Varenicline Tablet Starter Pack, Continuing Pack IPAP

Chantix SMOKING CESSATION

Partial Nicotine Agonist

C - + K

Verapamil SR Tablet 180mg, 240mg

Calan SR CARDIOVASCULAR DRUGS


C - + split/-

crush +

K/L

31





Crush/ Split

Beers List

Dose Adjust

K=Kidney L=Liver

Vitamin D3 Tablet 400 IU, 1000 IU


Vitamin #100 tabs C Avoid high

doses

Vitamin D3 Capsule 50,000 IU


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 LAB Coumadin CARDIOVASCULAR DRUGS

Anticoagulant

- (1st trimester),

C

Use caution

+ +

K/L

Zinc Oxide Ointment 20% Desitin SKIN AND MUCOUS MEMBRANE AGENTS

Protectant 30 gm + +

Updated: February 27, 2020

Documents

FORMULARY: ALPHABETICAL LISTING*...DRUGS Beta Blocker D - - K Atorvastatin Tablet 10mg, 20mg, 40mg, 80mg LAB Lipitor CARDIOVASCULAR DRUGS Antihyperlipidemic, HMG-CoA Reductase Inhibitor