Maxwell AFB Outpatient Formulary

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Alphabetical Listing by Name

This do cument is cu rrent as of The availability of formulary items is subject to change

February 3, 2016

AcetaminophenOutpatient Dosage FormsCaplet, oral:Mapap® Extra Strength: 500 mg [scored]

Elixir, oral:Mapap® Children's: 160 mg/5 mL (118 mL) [ethanol free; contains benzoicacid, propylene glycol, sodium benzoate; cherry flavor]

Solution, oral [drops]:Q-Pap Infant's: 80 mg/0.8 mL (15 mL) [ethanol free; contains propylene glycol;fruit flavor]

Suppository, rectal: 120 mg (12s)Acephen™: 650 mg (12s)

Tablet, oral:Mapap®: 325 mg

Acetaminophen and CodeineOutpatient Dosage FormsSolution, oral [C-V]: Acetaminophen 120 mg and codeine phosphate 12 mg per5 mL (473 mL) [BCF]

Tablet, oral [C-III]: Acetaminophen 300 mg and codeine phosphate 30 mg [BCF]

AcetaZOLAMIDEOutpatient Dosage FormsCapsule, sustained release, oral:Diamox® Sequels®: 500 mg

Tablet, oral: 250 mg

Acetic Acid (Otic)Outpatient Dosage FormsSolution, otic [drops]: 2% (60 mL)

Acyclovir (Systemic)Outpatient Dosage FormsCapsule, oral: 200 mg [BCF]Suspension, oral: 200 mg/5 mL (473 mL) [BCF]Tablet, oral: 800 mg [BCF]

Acyclovir (Topical)Outpatient Dosage FormsOintment, topical:Zovirax®: 5% (30 g)

AdapaleneOutpatient Dosage FormsCream, External:Generic: 0.1% (45 g)

Gel, External:Generic: 0.1% (45 g)

AlbiglutideOutpatient Dosage FormsPen-injector, Subcutaneous [preservative free]:Tanzeum: 30 mg (1 ea); 50 mg (1 ea) [contains polysorbate 80]

AlbuterolOutpatient Dosage FormsAerosol, for oral inhalation:ProAir® HFA: 90 mcg/inhalation (8.5 g) [chlorofluorocarbon free; 200 meteredactuations] [BCF]

Solution, for nebulization: 0.5% [100 mg/20 mL] (1s)Solution, for nebulization [preservative free]: 0.083% [2.5 mg/3 mL] (25s) [BCF]Syrup, oral: 2 mg/5 mL (473 mL)

AlendronateOutpatient Dosage FormsTablet, oral: 10 mg [BCF], 35 mg [BCF], 70 mg [BCF]

AlfuzosinOutpatient Dosage FormsTablet, extended release, oral, as hydrochloride:Uroxatral®: 10 mg [BCF]

AllopurinolOutpatient Dosage FormsTablet, oral: 100 mg [BCF], 300 mg [BCF]

ALPRAZolamOutpatient Dosage FormsTablet, oral: 0.25 mg, 0.5 mg, 1 mg, 2 mg

Aluminum Chloride HexahydrateOutpatient Dosage FormsSolution, topical:Drysol™: 20% (37.5 mL) [contains ethanol 93%]

Aluminum Hydroxide, Magnesium Hydroxide, and SimethiconeOutpatient Dosage FormsSuspension, oral:Mi-Acid: Aluminum hydroxide 200 mg, magnesium hydroxide 200 mg, andsimethicone 20 mg per 5 mL (360 mL)

AmantadineOutpatient Dosage FormsCapsule, oral, as hydrochloride: 100 mg [BCF]

AmiodaroneOutpatient Dosage FormsTablet, oral, as hydrochloride: 200 mg [BCF]

AmitriptylineOutpatient Dosage FormsTablet, oral, as hydrochloride: 10 mg [BCF], 25 mg [BCF]

AmLODIPineOutpatient Dosage FormsTablet, oral: 2.5 mg [BCF], 5 mg [BCF], 10 mg [BCF]

Amlodipine and BenazeprilOutpatient Dosage FormsCapsule, oral:Lotrel®: 5/10: Amlodipine 5 mg and benazepril hydrochloride 10 mg [BCF]Lotrel®: 5/20: Amlodipine 5 mg and benazepril hydrochloride 20 mg [BCF]Lotrel®: 5/40: Amlodipine 5 mg and benazepril hydrochloride 40 mg [BCF]Lotrel®: 10/20: Amlodipine 10 mg and benazepril hydrochloride 20 mg [BCF]Lotrel®: 10/40: Amlodipine 10 mg and benazepril hydrochloride 40 mg [BCF]

AmoxicillinOutpatient Dosage FormsCapsule, oral: 250 mg [BCF], 500 mg [BCF]Powder for suspension, oral: 125 mg/5 mL (150 mL); 250 mg/5 mL (150 mL)[BCF]; 400 mg/5 mL (100 mL) [BCF]

Tablet, oral: 875 mgTablet, chewable, oral: 250 mg

Amoxicillin and ClavulanateOutpatient Dosage FormsPowder for suspension, oral:200: Amoxicillin 200 mg and clavulanate potassium 28.5 mg per 5 mL (100mL) [BCF]

400: Amoxicillin 400 mg and clavulanate potassium 57 mg per 5 mL (100mL) [BCF]

600: Amoxicillin 600 mg and clavulanate potassium 42.9 mg per 5 mL (75mL) [BCF]

Tablet, oral:250: Amoxicillin 250 mg and clavulanate potassium 125 mg [BCF]500: Amoxicillin 500 mg and clavulanate potassium 125 mg [BCF]875: Amoxicillin 875 mg and clavulanate potassium 125 mg [BCF]

Antipyrine and BenzocaineOutpatient Dosage FormsSolution, otic [drops]: Antipyrine 5.4% and benzocaine 1.4% (10 mL) [BCF]Aurodex™: Antipyrine 5.4% and benzocaine 1.4% (10 mL) [BCF]

ApixabanOutpatient Dosage FormsTablet, Oral:Eliquis: 2.5 mg, 5 mg

ARIPiprazoleOutpatient Dosage FormsTablet, oral:Abilify®: 2 mg, 5 mg, 10 mg, 15 mg, 20 mg

Artificial TearsOutpatient Dosage FormsOintment, ophthalmic [drops, preservative free]: (3.5 g)Solution, ophthalmic [drops]: (15 mL)

AspirinOutpatient Dosage FormsTablet, chewable, oral: 81 mgTablet, enteric coated, oral: 81 mg, 325 mg

Aspirin and DipyridamoleOutpatient Dosage FormsCapsule, variable release, oral:Aggrenox®: Aspirin 25 mg [immediate release] and dipyridamole 200 mg[extended release]

AtenololOutpatient Dosage FormsTablet, oral: 25 mg [BCF], 50 mg [BCF]

AtoMOXetineOutpatient Dosage FormsCapsule, oral:Strattera®: 10 mg, 18 mg, 25 mg, 40 mg, 60 mg

AtorvaSTATinOutpatient Dosage FormsTablet, oral: 10 mg [BCF], 20 mg [BCF], 40 mg [BCF], 80 mg [BCF]

ACETAMINOPHEN

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Atovaquone and ProguanilOutpatient Dosage FormsTablet, oral: Atovaquone 250 mg and proguanil hydrochloride 100 mg

AzaTHIOprineOutpatient Dosage FormsTablet, oral: 50 mg

Azelaic AcidOutpatient Dosage FormsGel, topical:Finacea: 15% (50 g) [contains benzoic acid, disodium edta, polysorbate 80,propylene glycol]

Azelastine (Nasal)Outpatient Dosage FormsSolution, intranasal, as hydrochloride [spray]:Astelin®: 0.1% [137 mcg/spray] (30 mL) [contains benzalkonium chloride; 200metered sprays]

Azithromycin (Systemic)Outpatient Dosage FormsPowder for suspension, oral, as dihydrate [strength expressed as base]:100 mg/5 mL (15 mL) [BCF]; 200 mg/5 mL (22.5 mL)Zithromax®: 100 mg/5 mL (15 mL) [contains sodium 3.7 mg/5 mL; cherry-crème de vanilla-banana flavor] [BCF]

Zithromax®: 200 mg/5 mL (15 mL, 22.5 mL, 30 mL) [contains sodium 7.4 mg/5mL; cherry-crème de vanilla-banana flavor]

Tablet, oral, as monohydrate [strength expressed as base]: 250 mg [BCF]

Bacitracin, Neomycin, and Polymyxin B (Ophthalmic)Outpatient Dosage FormsOintment, ophthalmic: Bacitracin 400 units, neomycin 3.5 mg, and polymyxin B10,000 units per g (3.5 g) [BCF]

Bacitracin, Neomycin, Polymyxin B, and Hydrocortisone(Ophthalmic)Outpatient Dosage FormsOintment, ophthalmic: Bacitracin 400 units, neomycin 3.5 mg, polymyxin B10,000 units, and hydrocortisone 10 mg per g (3.5 g)

Bacitracin (Ophthalmic)Outpatient Dosage FormsOintment, Ophthalmic:Generic: 500 units/g (3.5 g)

Bacitracin (Topical)Outpatient Dosage FormsOintment, External, as zinc [strength expressed as base]:Generic: 500 units/g (30 g)

BaclofenOutpatient Dosage FormsTablet, oral: 10 mg

BenzonatateOutpatient Dosage FormsCapsule, softgel, oral: 100 mg

Benzoyl PeroxideOutpatient Dosage FormsGel, topical: 5% (60 g); 10% (42.5 g)Acne Medication 10: 10% (42.5 g) [contains edetate disodium]

Liquid, topical [wash]: 5% (148 g)Liquid, topical [wash/water based]:Desquam-X® 5: 5% (140 g)

BenztropineOutpatient Dosage FormsTablet, oral, as mesylate: 2 mg [BCF]

Betamethasone and ClotrimazoleOutpatient Dosage FormsCream, topical: Betamethasone dipropionate 0.05% (base) and clotrimazole 1%(15 g, 45 g)

Betamethasone (Systemic)Outpatient Dosage FormsInjection, suspension:Celestone® Soluspan®: Betamethasone sodium phosphate 3 mg and beta-methasone acetate 3 mg per 1 mL (5 mL) [contains benzalkonium chloride,edetate disodium; total of 6 mg/mL]

Betamethasone (Topical)Outpatient Dosage FormsCream, topical, as valerate [strength expressed as base]: 0.1% (15 g, 45 g)Lotion, topical, as dipropionate [strength expressed as base]: 0.05% (60 mL)Ointment, topical, as valerate [strength expressed as base]: 0.1% (45 g)

BimatoprostOutpatient Dosage FormsSolution, ophthalmic [drops]:Lumigan®: 0.03% (5 mL) [contains benzalkonium chloride]

BisacodylOutpatient Dosage FormsSuppository, rectal:Bisac-Evac™: 10 mg (50s)

Tablet, enteric coated, oral:Dacodyl™: 5 mg

Bismuth SubsalicylateOutpatient Dosage FormsTablet, chewable, oral, as subsalicylate:Peptic Relief: 262 mg

Brimonidine and TimololOutpatient Dosage FormsSolution, ophthalmic [drops]:Combigan®: Brimonidine tartrate 0.2% and timolol 0.5% (10 mL) [containsbenzalkonium chloride]

Brimonidine (Ophthalmic)Outpatient Dosage FormsSolution, ophthalmic, as tartrate [drops]:Alphagan® P: 0.15% (10 mL) [contains Purite®] [BCF]

BromocriptineOutpatient Dosage FormsTablet, oral: 2.5 mg

Brompheniramine, Pseudoephedrine, and DextromethorphanOutpatient Dosage FormsSyrup, oral:Bromfed® DM: Brompheniramine maleate 2 mg, pseudoephedrine hydrochlor-ide 30 mg, and dextromethorphan hydrobromide 10 mg per 5 mL (473 mL)[contains ethanol 0.95%, propylene glycol, sodium benzoate; butterscotchflavor]

Budesonide (Oral Inhalation)Outpatient Dosage FormsSuspension, for nebulization:Pulmicort Respules®: 0.25 mg/2 mL (30s); 0.5 mg/2 mL (30s)

BuPROPionOutpatient Dosage FormsTablet, extended release, oral, as hydrochloride: 100 mg [generic for WellbutrinSR®] [BCF], 150 mg [generic for Wellbutrin SR® [BCF], 150 mg [generic forWellbutrin XL®] [BCF], 300 mg [generic for Wellbutrin XL®] [BCF]

BusPIRoneOutpatient Dosage FormsTablet, oral, as hydrochloride: 10 mg [BCF], 15 mg [BCF]

Butalbital, Acetaminophen, and CaffeineOutpatient Dosage FormsTablet, oral: Butalbital 50 mg, acetaminophen 325 mg, and caffeine 40 mg[BCF]

Butalbital, Aspirin, and CaffeineOutpatient Dosage FormsTablet, oral: Butalbital 50 mg, aspirin 325 mg, and caffeine 40 mg

CalcitriolOutpatient Dosage FormsCapsule, softgel, oral: 0.5 mcg

CandesartanOutpatient Dosage FormsTablet, oral, as cilexetil:Atacand®: 4 mg, 8 mg, 16 mg, 32 mg [scored]

Candesartan and HydrochlorothiazideOutpatient Dosage FormsTablet, oral:Atacand HCT®: 16/12.5: Candesartan cilexetil 16 mg and hydrochlorothiazide12.5 mg, 32/12.5: Candesartan cilexetil 32 mg and hydrochlorothiazide12.5 mg [scored]

CaptoprilOutpatient Dosage FormsTablet, oral: 25 mg [BCF], 50 mg [BCF]

CarBAMazepineOutpatient Dosage FormsTablet, oral: 200 mg [BCF]Tablet, chewable, oral: 100 mg [BCF]Tablet, extended release, oral: 200 mg

CARBAMAZEPINE

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Carbamide PeroxideOutpatient Dosage FormsSolution, otic [drops]: 6.5% (15 mL)

Carbidopa and LevodopaOutpatient Dosage FormsTablet, oral: 25/100: Carbidopa 25 mg and levodopa 100 mg [BCF]

CarboxymethylcelluloseOutpatient Dosage FormsSolution, ophthalmic, as sodium:Refresh Tears: 0.5% (15 mL)

Solution, ophthalmic, as sodium [preservative free]:Refresh Plus: 0.5% (0.4 mL)

CarvedilolOutpatient Dosage FormsCapsule, extended release, oral, as phosphate:Coreg CR®: 10 mg, 20 mg, 40 mg, 80 mg

Tablet, oral: 3.125 mg [BCF], 6.25 mg [BCF], 25 mg [BCF]

CefdinirOutpatient Dosage FormsCapsule, oral: 300 mgPowder for suspension, oral: 125 mg/5 mL (100 mL); 250 mg/5 mL (100 mL)

CefprozilOutpatient Dosage FormsPowder for suspension, oral: 250 mg/5 mL (50 mL, 100 mL)Tablet, oral: 250 mg, 500 mg

CefuroximeOutpatient Dosage FormsTablet, oral, as axetil [strength expressed as base]: 250 mg

CelecoxibOutpatient Dosage FormsCapsule, oral:CeleBREX®: 100 mg, 200 mg

CephalexinOutpatient Dosage FormsCapsule, oral: 250 mg [BCF], 500 mg [BCF]Powder for suspension, oral: 125 mg/5 mL (100 mL); 250 mg/5 mL (100mL) [BCF]

CetirizineOutpatient Dosage FormsSyrup, oral, as hydrochloride: 5 mg/5 mL (118 mL)Tablet, oral, as hydrochloride: 10 mg

ChlorambucilOutpatient Dosage FormsTablet, oral:Leukeran®: 2 mg

ChlordiazePOXIDEOutpatient Dosage FormsCapsule, oral, as hydrochloride: 25 mg

Chlorhexidine GluconateOutpatient Dosage FormsLiquid, oral [rinse]:PerioGard®: 0.12% (480 mL) [contains ethanol 11.6%; mint flavor] [BCF]

ChloroquineOutpatient Dosage FormsTablet, oral, as phosphate: 500 mg [equivalent to chloroquine base 300 mg]

ChlorpheniramineOutpatient Dosage FormsSyrup, oral, as maleate:Aller-chlor®: 2 mg/5 mL (118 mL) [contains ethanol 5%, menthol, propyleneglycol; cherry flavor]

Tablet, oral, as maleate:Aller-chlor®: 4 mg [scored]

ChlorthalidoneOutpatient Dosage FormsTablet, oral: 25 mg [BCF]

CholecalciferolOutpatient Dosage FormsLiquid, Oral:Generic: 400 units/mL

CiclopiroxOutpatient Dosage FormsSolution, topical [nail lacquer]: 8% (6.6 mL)

Ciprofloxacin (Ophthalmic)Outpatient Dosage FormsSolution, ophthalmic, as hydrochloride [drops]: 3.5 mg/mL (5 mL) [equivalent tociprofloxacin base 0.3%]

Ciprofloxacin (Systemic)Outpatient Dosage FormsTablet, oral, as hydrochloride [strength expressed as base]: 250 mg [BCF],500 mg [BCF]

CitalopramOutpatient Dosage FormsTablet, oral: 10 mg [BCF], 20 mg [BCF], 40 mg [BCF]

ClarithromycinOutpatient Dosage FormsTablet, oral: 500 mgBiaxin®: 500 mg

Tablet, extended release, oral: 500 mgBiaxin® XL: 500 mg

Clidinium and ChlordiazepoxideOutpatient Dosage FormsCapsule, oral: Clidinium bromide 2.5 mg and chlordiazepoxide hydrochloride5 mg

Clindamycin and Benzoyl PeroxideOutpatient Dosage FormsGel, topical:BenzaClin®: Clindamycin 1% and benzoyl peroxide 5% (50 g)Duac®: Clindamycin phosphate 1.2% and benzoyl peroxide 5% (45 g)

Clindamycin (Systemic)Outpatient Dosage FormsCapsule, oral, as hydrochloride [strength expressed as base]: 150 mg [BCF]

Clindamycin (Topical)Outpatient Dosage FormsCream, vaginal, as phosphate [strength expressed as base]: 2% (40 g) [BCF]Lotion, topical, as phosphate [strength expressed as base]: 1% (60 mL)Solution, topical, as phosphate [strength expressed as base]: 1% (60 mL) [BCF]

ClobetasolOutpatient Dosage FormsCream, topical, as propionate: 0.05% (15 g, 30 g, 60 g)Ointment, topical, as propionate: 0.05% (30 g, 60 g)

ClonazePAMOutpatient Dosage FormsTablet, oral: 0.5 mg [BCF], 1 mg, 2 mg

CloNIDineOutpatient Dosage FormsTablet, oral, as hydrochloride: 0.1 mg [BCF], 0.2 mg [BCF]

ClopidogrelOutpatient Dosage FormsTablet, oral: 75 mg [BCF]

Clotrimazole (Oral)Outpatient Dosage FormsTroche, oral: 10 mg

Clotrimazole (Topical)Outpatient Dosage FormsCream, topical: 1% (15 g, 30 g)Cream, vaginal: 1% (45 g)

CodeineOutpatient Dosage FormsTablet, oral, as sulfate: 30 mg

ColchicineOutpatient Dosage FormsTablet, oral:Colcrys®: 0.6 mg [scored]

ColestipolOutpatient Dosage FormsTablet, oral, as hydrochloride [micronized]:Colestid®: 1 g

CortisoneOutpatient Dosage FormsTablet, oral, as acetate: 25 mg

CyanocobalaminOutpatient Dosage FormsInjection, solution: 1000 mcg/mL (1 mL)

CARBAMIDE PEROXIDE

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CyclobenzaprineOutpatient Dosage FormsCapsule, extended release, oral, as hydrochloride:Amrix®: 15 mg, 30 mg

Tablet, oral, as hydrochloride: 10 mg [BCF]

CyclophosphamideOutpatient Dosage FormsTablet, oral: 50 mg

CycloSPORINE (Ophthalmic)Outpatient Dosage FormsEmulsion, ophthalmic [drops, preservative free]:Restasis®: 0.05% (0.4 mL) [contains castor oil]

CyproheptadineOutpatient Dosage FormsTablet, oral, as hydrochloride: 4 mg [BCF]

Dabigatran EtexilateOutpatient Dosage FormsCapsule, oral:Pradaxa®: 75 mg, 150 mg

Dapsone (Systemic)Outpatient Dosage FormsTablet, oral: 25 mg

DesmopressinOutpatient Dosage FormsSolution, intranasal, as acetate [spray]:DDAVP®: 0.1 mg/mL (5 mL) [contains benzalkonium chloride; delivers 10 mcg/spray]

DesonideOutpatient Dosage FormsCream, topical: 0.05% (60 g)

DesoximetasoneOutpatient Dosage FormsCream, topical: 0.05% (60 g)Ointment, topical: 0.05% (60 g)

Dexamethasone (Systemic)Outpatient Dosage FormsSolution, oral: 0.5 mg/5 mL (500 mL)Tablet, oral: 4 mg

DexmethylphenidateOutpatient Dosage FormsTablet, oral, as hydrochloride: 10 mg

DextroamphetamineOutpatient Dosage FormsCapsule, extended release, oral, as sulfate: 5 mg, 10 mgTablet, oral, as sulfate: 5 mg

Dextroamphetamine and AmphetamineOutpatient Dosage FormsCapsule, extended release, oral:5 mg [dextroamphetamine sulfate 1.25 mg, dextroamphetamine saccharate1.25 mg, amphetamine aspartate monohydrate 1.25 mg, amphetamine sul-fate 1.25 mg (equivalent to amphetamine base 3.1 mg)] [BCF]

10 mg [dextroamphetamine sulfate 2.5 mg, dextroamphetamine saccharate2.5 mg, amphetamine aspartate monohydrate 2.5 mg, amphetamine sulfate2.5 mg (equivalent to amphetamine base 6.3 mg)] [BCF]

15 mg [dextroamphetamine sulfate 3.75 mg, dextroamphetamine saccharate3.75 mg, amphetamine aspartate monohydrate 3.75 mg, amphetamine sul-fate 3.75 mg (equivalent to amphetamine base 9.4 mg)] [BCF]

20 mg [dextroamphetamine sulfate 5 mg, dextroamphetamine saccharate5 mg, amphetamine aspartate monohydrate 5 mg, amphetamine sulfate5 mg (equivalent to amphetamine base 12.5 mg)] [BCF]

25 mg [dextroamphetamine sulfate 6.25 mg, dextroamphetamine saccharate6.25 mg, amphetamine aspartate monohydrate 6.25 mg, amphetamine sul-fate 6.25 mg (equivalent to amphetamine base 15.6 mg)] [BCF]

30 mg [dextroamphetamine sulfate 7.5 mg, dextroamphetamine saccharate7.5 mg, amphetamine aspartate monohydrate 7.5 mg, amphetamine sulfate7.5 mg (equivalent to amphetamine base 18.8 mg)] [BCF]

Tablet, oral:5 mg [dextroamphetamine sulfate 1.25 mg, dextroamphetamine saccharate1.25 mg, amphetamine aspartate 1.25 mg, amphetamine sulfate 1.25 mg(equivalent to amphetamine base 3.13 mg)]

10 mg [dextroamphetamine sulfate 2.5 mg, dextroamphetamine saccharate2.5 mg, amphetamine aspartate 2.5 mg, amphetamine sulfate 2.5 mg (equiv-alent to amphetamine base 6.3 mg)]

20 mg [dextroamphetamine sulfate 5 mg, dextroamphetamine saccharate5 mg, amphetamine aspartate 5 mg, amphetamine sulfate 5 mg (equivalentto amphetamine base 12.6 mg)]

30 mg [dextroamphetamine sulfate 7.5 mg, dextroamphetamine saccharate7.5 mg, amphetamine aspartate 7.5 mg, amphetamine sulfate 7.5 mg (equiv-alent to amphetamine base 18.8 mg)]

Diabetic SuppliesOutpatient Dosage FormsGlucose meter:FreeStyle Lite Meter: 1 ea [BCF]

Lancet [ultra thin]: 100sTest Strips:FreeStyle Lite Test Strips: 50/box [BCF]Precision Xtra Blood Glucose In Vitro Strips: 50/box [BCF], 100/box [BCF]TRUEtest test strips: 50/box

DiazepamOutpatient Dosage FormsTablet, oral: 5 mg [BCF]

Diclofenac (Systemic)Outpatient Dosage FormsTablet, delayed release, enteric coated, oral, as sodium: 50 mg, 75 mg

Diclofenac (Topical)Outpatient Dosage FormsGel, topical, as sodium:Voltaren® Gel: 1% (100 g) [contains isopropyl alcohol]

DicloxacillinOutpatient Dosage FormsCapsule, oral: 250 mg [BCF]

DicyclomineOutpatient Dosage FormsTablet, oral, as hydrochloride: 20 mg [BCF]

DigoxinOutpatient Dosage FormsSolution, oral: 50 mcg/mL (60 mL)Tablet, oral:Lanoxin®: 125 mcg [BCF], 250 mcg [BCF] [scored]

DihydroergotamineOutpatient Dosage FormsInjection, solution, as mesylate: 1 mg/mL (1 mL)

DiltiazemOutpatient Dosage FormsCapsule, extended release, oral, as hydrochloride [once-daily dosing]: 120 mg[BCF], 180 mg [BCF], 240 mg [BCF], 360 mg [BCF]

Tablet, oral, as hydrochloride: 60 mg

DiphenhydrAMINE (Systemic)Outpatient Dosage FormsCapsule, oral, as hydrochloride: 25 mgSolution, oral, as hydrochloride:Q-dryl: 12.5 mg/5 mL (120 mL) [ethanol free; contains sodium 5 mg/5 mL,sodium benzoate; cherry flavor]

Diphenoxylate and AtropineOutpatient Dosage FormsTablet, oral: 2.5/0.025: Diphenoxylate hydrochloride 2.5 mg and atropine sulfate0.025 mg

DipyridamoleOutpatient Dosage FormsTablet, oral: 25 mg, 75 mg

DisopyramideOutpatient Dosage FormsCapsule, oral: 100 mg, 150 mg

DocusateOutpatient Dosage FormsCapsule, softgel, oral, as sodium: 100 mgDok™: 100 mg

Syrup, oral, as sodium: 20 mg/5 mL (473 mL)

DonepezilOutpatient Dosage FormsTablet, oral, as hydrochloride: 5 mg, 10 mg

DorzolamideOutpatient Dosage FormsSolution, ophthalmic [drops]: 2% (10 mL)

Dorzolamide and TimololOutpatient Dosage FormsSolution, ophthalmic [drops]: Dorzolamide hydrochloride 2% [strength expressedas base] and timolol maleate 0.5% [strength expressed as base] (10 mL)

DORZOLAMIDE AND TIMOLOL

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DoxazosinOutpatient Dosage FormsTablet, oral: 2 mg, 4 mg, 8 mg

Doxepin (Systemic)Outpatient Dosage FormsCapsule, oral: 25 mg [BCF]

DoxycyclineOutpatient Dosage FormsCapsule, oral, as hyclate [strength expressed as base]: 100 mg [BCF]

EmollientsOutpatient Dosage FormsCream, topical: (113 g)Vanicream: (453 g)

Ointment, topical:Aquaphor: 3.5 oz

EnoxaparinOutpatient Dosage FormsInjection, solution, as sodium [preservative free]:Lovenox®: 40 mg/0.4 mL (0.4 mL) [BCF]; 60 mg/0.6 mL (0.6 mL) [BCF];80 mg/0.8 mL (0.8 mL) [BCF]; 100 mg/mL (1 mL) [BCF] [prefilled syringe]

EPINEPHrine (Systemic)Outpatient Dosage FormsInjection, solution:EpiPen 2-Pak®: 0.3 mg/0.3 mL (2 mL) [contains sodium metabisulfite; 1:1000solution; delivers 0.3 mg per injection]

EpiPen Jr 2-Pak®: 0.15 mg/0.3 mL (2 mL) [contains sodium metabisulfite;1:2000 solution; delivers 0.15 mg per injection]

ErgocalciferolOutpatient Dosage FormsCapsule, oral: 50,000 units [1.25 mg]

Erythromycin and SulfisoxazoleOutpatient Dosage FormsPowder for suspension, oral:E.S.P.®: Erythromycin ethylsuccinate 200 mg and sulfisoxazole acetyl 600 mgper 5 mL (200 mL) [cheri-beri flavor]

Erythromycin (Ophthalmic)Outpatient Dosage FormsOintment, Ophthalmic:Generic: 5 mg/g (3.5 g) [BCF]

Erythromycin (Systemic)Outpatient Dosage FormsTablet, delayed release, enteric coated, oral, as base:Ery-Tab®: 250 mg [contains sodium 8.3 mg (0.4 mEq)/tablet] [BCF]

EscitalopramOutpatient Dosage FormsTablet, oral: 5 mg, 10 mg, 20 mg

EsomeprazoleOutpatient Dosage FormsCapsule, delayed release, oral, as magnesium [strength expressed as base]:NexIUM®: 20 mg [BCF], 40 mg [BCF]

Estradiol (Systemic)Outpatient Dosage FormsInjection, oil, as valerate:Delestrogen®: 20 mg/mL (5 mL); 40 mg/mL (5 mL) [contains benzyl alcohol,benzyl benzoate, castor oil]

Patch, transdermal [once-weekly patch]:Climara®: 0.025 mg/24 hours (4s) [6.5 cm2, total estradiol 2.04 mg] [BCF]Climara®: 0.0375 mg/24 hours (4s) [9.375 cm2, total estradiol 2.85 mg] [BCF]Climara®: 0.05 mg/24 hours (4s) [12.5 cm2, total estradiol 3.8 mg] [BCF]Climara®: 0.1 mg/24 hours (4s) [25 cm2, total estradiol 7.6 mg] [BCF]

Tablet, oral: 1 mg

Estradiol (Topical)Outpatient Dosage FormsCream, vaginal:Estrace: 0.1 mg/g (42.5 g)

Estrogens (Conjugated/Equine) and MedroxyprogesteroneOutpatient Dosage FormsTablet, oral:Prempro®: 0.45/1.5: Conjugated estrogens 0.45 mg and medroxyprogester-one acetate 1.5 mg [BCF]

Prempro®: 0.625/2.5: Conjugated estrogens 0.625 mg and medroxyprogester-one acetate 2.5 mg [BCF]

Prempro®: 0.625/5: Conjugated estrogens 0.625 mg and medroxyprogester-one acetate 5 mg [BCF]

Estrogens (Conjugated/Equine, Systemic)Outpatient Dosage FormsTablet, oral:Premarin®: 0.3 mg [BCF], 0.45 mg [BCF], 0.625 mg [BCF], 0.9 mg,1.25 mg [BCF]

Estrogens (Conjugated/Equine, Topical)Outpatient Dosage FormsCream, vaginal:Premarin®: 0.625 mg/g (30 g) [BCF]

Estrogens (Esterified) and MethyltestosteroneOutpatient Dosage FormsTablet, oral: Esterified estrogens 0.625 mg and methyltestosterone 1.25 mg,Esterified estrogens 1.25 mg and methyltestosterone 2.5 mg

EszopicloneOutpatient Dosage FormsTablet, Oral:Generic: 1 mg, 2 mg, 3 mg

EthambutolOutpatient Dosage FormsTablet, oral, as hydrochloride: 400 mg [BCF]

Ethinyl Estradiol and DesogestrelOutpatient Dosage FormsTablet, oral [low dose formulation]:Azurette™:Day 1-21: Ethinyl estradiol 0.02 mg and desogestrel 0.15 mg [21 whitetablets]

Day 22-23: 2 inactive green tabletsDay 24-28: Ethinyl estradiol 0.01 mg [5 blue tablets] (28s)

Tablet, oral [monophasic formulation]:Reclipsen®: Ethinyl estradiol 0.03 mg and desogestrel 0.15 mg [21 whitetablets and 7 green inactive tablets] (28s)

Ethinyl Estradiol and DrospirenoneOutpatient Dosage FormsTablet, oral:Yasmin®: Ethinyl estradiol 0.03 mg and drospirenone 3 mg [21 yellow activetablets and 7 white inactive tablets] (28s) [BCF]

Yaz®: Ethinyl estradiol 0.02 mg and drospirenone 3 mg [24 light pink activetablets and 4 white inactive tablets] (28s) [BCF]

Ethinyl Estradiol and Ethynodiol DiacetateOutpatient Dosage FormsTablet, oral:Zovia® 1/35: Ethinyl estradiol 0.035 mg and ethynodiol diacetate 1 mg [21 lightpink tablets and 7 white inactive tablets]

Ethinyl Estradiol and EtonogestrelOutpatient Dosage FormsRing, vaginal:NuvaRing®: Ethinyl estradiol 0.015 mg/day and etonogestrel 0.12 mg/day (3s)[3-week duration]

Ethinyl Estradiol and LevonorgestrelOutpatient Dosage FormsTablet, oral [extended cycle regimen]:Jolessa™: Ethinyl estradiol 0.03 mg and levonorgestrel 0.15 mg (91s) [84 pinktablets and 7 white inactive tablets] [BCF]

Tablet, oral [low dose formulation]:Lutera®: Ethinyl estradiol 0.02 mg and levonorgestrel 0.1 mg (28s) [21 whitetablets and 7 peach inactive tablets] [BCF]

Tablet, oral [monophasic formulation]:Levora®: Ethinyl estradiol 0.03 mg and levonorgestrel 0.15 mg (28s) [21 whitetablets and 7 peach inactive tablets] [BCF]

Tablet, oral [triphasic formulation]:Trivora®:Day 1-6: Ethinyl estradiol 0.03 mg and levonorgestrel 0.05 mg [6 blue tablets]Day 7-11: Ethinyl estradiol 0.04 mg and levonorgestrel 0.075 mg [5 whitetablets]

Day 12-21: Ethinyl estradiol 0.03 mg and levonorgestrel 0.125 mg [10 pinktablets]

Day 22-28: 7 peach inactive tablets (28s)

Ethinyl Estradiol and NorelgestrominOutpatient Dosage FormsPatch, transdermal:Ortho Evra®: Ethinyl estradiol 0.75 mg and norelgestromin 6 mg [releasesethinyl estradiol 20 mcg and norelgestromin 150 mcg per day] (3s)

Ethinyl Estradiol and NorethindroneOutpatient Dosage FormsTablet, oral:femhrt® 1/5: Ethinyl estradiol 0.005 mg and norethindrone acetate 1 mg [whitetablets] (28s)

DOXAZOSIN

6

Tablet, oral [monophasic formulation]:Microgestin® Fe 1/20: Ethinyl estradiol 0.02 mg and norethindrone acetate1 mg [21 white tablets] and ferrous fumarate 75 mg [7 brown tablets] (28s)

Microgestin® Fe 1.5/30: Ethinyl estradiol 0.03 mg and norethindrone acetate1.5 mg [21 green tablets] and ferrous fumarate 75 mg [7 brown tablets] (28s)

Norinyl® 1+35: Ethinyl estradiol 0.035 mg and norethindrone 1 mg (28s) [21yellow-green tablets and 7 orange inactive tablets] [BCF]

Tablet, oral [triphasic formulation]:Necon® 7/7/7:Day 1-7: Ethinyl estradiol 0.035 mg and norethindrone 0.5 mg [7 whitetablets]

Day 8-14: Ethinyl estradiol 0.035 mg and norethindrone 0.75 mg [7 lightpeach tablets]

Day 15-21: Ethinyl estradiol 0.035 mg and norethindrone 1 mg [7 peachtablets]

Day 22-28: 7 green inactive tablets (28s)

Ethinyl Estradiol and NorgestimateOutpatient Dosage FormsTablet, oral [monophasic formulation]:MonoNessa®: Ethinyl estradiol 0.035 mg and norgestimate 0.25 mg [21 bluetablets and 7 green inactive tablets] [BCF]

Ortho-Cyclen®: Ethinyl estradiol 0.035 mg and norgestimate 0.25 mg [21 bluetablets and 7 dark green inactive tablets] (28s)

Tablet, oral [triphasic formulation]:Ortho Tri-Cyclen®:Day 1-7: Ethinyl estradiol 0.035 mg and norgestimate 0.18 mg [7 whitetablets]

Day 8-14: Ethinyl estradiol 0.035 mg and norgestimate 0.215 mg [7 light bluetablets]

Day 15-21: Ethinyl estradiol 0.035 mg and norgestimate 0.25 mg [7 bluetablets]

Day 22-28: 7 dark green inactive tablets (28s)Ortho Tri-Cyclen® Lo [BCF]:Day 1-7: Ethinyl estradiol 0.025 mg and norgestimate 0.18 mg [7 whitetablets]

Day 8-14: Ethinyl estradiol 0.025 mg and norgestimate 0.215 mg [7 light bluetablets]

Day 15-21: Ethinyl estradiol 0.025 mg and norgestimate 0.25 mg [7 dark bluetablets]

Day 22-28: 7 dark green inactive tabletsTriNessa® [BCF]:Day 1-7: Ethinyl estradiol 0.035 mg and norgestimate 0.18 mg [7 whitetablets]

Day 8-14: Ethinyl estradiol 0.035 mg and norgestimate 0.215 mg [7 light bluetablets]

Day 15-21: Ethinyl estradiol 0.035 mg and norgestimate 0.25 mg [7 bluetablets]

Day 22-28: 7 green inactive tablets

Ethinyl Estradiol and NorgestrelOutpatient Dosage FormsTablet, oral [monophasic formulation]:Low-Ogestrel®: Ethinyl estradiol 0.03 mg and norgestrel 0.3 mg [21 whitetablets and 7 peach inactive tablets] (28s)

EthosuximideOutpatient Dosage FormsSolution, oral: 250 mg/5 mL (473 mL)

EtodolacOutpatient Dosage FormsTablet, oral: 400 mg

EtonogestrelOutpatient Dosage FormsImplant, Subcutaneous:Implanon: 68 mg (1 ea)

ExenatideOutpatient Dosage FormsInjection, microspheres for suspension, extended release:Bydureon™: 2 mg [contains polylactide-co-glycolide, sucrose 0.8 mg/vial;supplied with diluent]

EzetimibeOutpatient Dosage FormsTablet, oral:Zetia®: 10 mg

FelodipineOutpatient Dosage FormsTablet, extended release, oral: 2.5 mg, 5 mg, 10 mg

Fenofibrate and DerivativesOutpatient Dosage FormsCapsule, oral [micronized]: 67 mg, 134 mg, 200 mgTablet, oral: 54 mg, 160 mgTablet, oral:TriCor®: 48 mg [BCF], 145 mg [BCF] [contains soybean lecithin]

Ferrous SulfateOutpatient Dosage FormsLiquid, oral [drops]:Fer-iron: 75 mg/mL (50 mL) [contains ethanol 0.2%, sodium bisulfite; lemonflavor; elemental iron 15 mg/mL]

Tablet, oral: 325 mg [elemental iron 65 mg]

FexofenadineOutpatient Dosage FormsTablet, oral, as hydrochloride: 180 mg

Fexofenadine and PseudoephedrineOutpatient Dosage FormsTablet, extended release, oral:Allegra-D® 12 Hour: Fexofenadine hydrochloride 60 mg [immediate release]and pseudoephedrine hydrochloride 120 mg [extended release]

FinasterideOutpatient Dosage FormsTablet, oral: 5 mg [BCF]

FlecainideOutpatient Dosage FormsTablet, oral, as acetate: 100 mg

FluconazoleOutpatient Dosage FormsPowder for suspension, oral: 10 mg/mL (35 mL); 40 mg/mL (35 mL)Tablet, oral: 100 mg, 200 mgDiflucan®: 150 mg [BCF]

FludrocortisoneOutpatient Dosage FormsTablet, oral, as acetate: 0.1 mg

Fluocinolone (Topical)Outpatient Dosage FormsOil, topical, as acetonide [scalp oil]:Derma-Smoothe/FS®: 0.01% (120 mL) [contains isopropyl alcohol, peanut oil]

Solution, topical, as acetonide: 0.01% (60 mL)

FluocinonideOutpatient Dosage FormsCream, topical: 0.05% (15 g, 60 g) [BCF]Gel, topical: 0.05% (30 g)Ointment, topical: 0.05% (30 g) [BCF]

FluorideOutpatient Dosage FormsCream, oral, as sodium [toothpaste]:PreviDent® 5000 Plus®: 1.1% (51 g) [contains sodium benzoate; spearmintflavor; equivalent to fluoride 2.5 mg/dose]

Gel, topical, as sodium:PreviDent®: 1.1% (56 g) [very berry flavor; equivalent to fluoride 2 mg/dose]

FluorometholoneOutpatient Dosage FormsSuspension, ophthalmic, as base [drops]: 0.1% (5 mL)

Fluorouracil (Topical)Outpatient Dosage FormsCream, topical:Efudex®: 5% (40 g)

FLUoxetineOutpatient Dosage FormsCapsule, oral: 10 mg [BCF], 20 mg [BCF]Tablet, oral: 10 mg [BCF]

FlutamideOutpatient Dosage FormsCapsule, oral: 125 mg

Fluticasone and SalmeterolOutpatient Dosage FormsAerosol, for Oral Inhalation:Advair HFA: 45/21: Fluticasone propionate 45 mcg and salmeterol 21 mcg perinhalation (12 g) [chlorofluorocarbon free; 120 metered actuations] [BCF]

Advair HFA: 115/21: Fluticasone propionate 115 mcg and salmeterol 21 mcgper inhalation (12 g) [chlorofluorocarbon free; 120 metered actuations] [BCF]

Advair HFA: 230/21: Fluticasone propionate 230 mcg and salmeterol 21 mcgper inhalation (12 g) [chlorofluorocarbon free; 120 metered actuations] [BCF]

Powder, for Oral Inhalation:Advair Diskus: 100/50: Fluticasone propionate 100 mcg and salmeterol 50 mcg(60 ea) [contains lactose] [BCF]

Advair Diskus: 250/50: Fluticasone propionate 250 mcg and salmeterol 50 mcg(60 ea) [contains lactose] [BCF]

Advair Diskus: 500/50: Fluticasone propionate 500 mcg and salmeterol 50 mcg(60 ea) [contains lactose] [BCF]

FLUTICASONE AND SALMETEROL

7

Fluticasone (Nasal)Outpatient Dosage FormsSuspension, intranasal, as propionate [spray]: 50 mcg/inhalation (16 g) [BCF]

Fluticasone (Oral Inhalation)Outpatient Dosage FormsAerosol, for oral inhalation, as propionate:Flovent® HFA: 44 mcg/inhalation (10.6 g) [chlorofluorocarbon free; 120metered actuations] [BCF]

Flovent® HFA: 110 mcg/inhalation (12 g) [chlorofluorocarbon free; 120metered actuations] [BCF]

Flovent® HFA: 220 mcg/inhalation (12 g) [chlorofluorocarbon free; 120metered actuations] [BCF]

Folic AcidOutpatient Dosage FormsTablet, oral: 1 mg [BCF]

FosinoprilOutpatient Dosage FormsTablet, oral, as sodium: 10 mg, 20 mg, 40 mg

FurosemideOutpatient Dosage FormsSolution, oral: 10 mg/mL (120 mL) [BCF]Tablet, oral: 20 mg [BCF], 40 mg [BCF]

GabapentinOutpatient Dosage FormsCapsule, oral: 100 mg [BCF], 300 mg [BCF], 400 mg [BCF]Tablet, oral: 600 mg [BCF], 800 mg [BCF]

GemfibrozilOutpatient Dosage FormsTablet, oral: 600 mg [BCF]

Gentamicin (Ophthalmic)Outpatient Dosage FormsOintment, ophthalmic:Gentak®: 0.3% (3.5 g) [BCF]

GlipiZIDEOutpatient Dosage FormsTablet, oral: 5 mg [BCF], 10 mg [BCF]Tablet, extended release, oral: 5 mg, 10 mg

GlucagonOutpatient Dosage FormsInjection, powder for reconstitution:Glucagon Emergency Kit: 1 mg [contains glycerin (in diluent), lactose 49 mg;equivalent to 1 unit]

GlyBURIDEOutpatient Dosage FormsTablet, oral: 1.25 mg [BCF], 5 mg [BCF]Tablet, oral [micronized]: 1.5 mg [BCF], 3 mg [BCF], 6 mg [BCF]

Glyburide and MetforminOutpatient Dosage FormsTablet, oral: 5/500: Glyburide 5 mg and metformin hydrochloride 500 mg

GlycopyrrolateOutpatient Dosage FormsTablet, oral: 1 mg

GriseofulvinOutpatient Dosage FormsSuspension, oral [microsize]: 125 mg/5 mL (118 mL) [BCF]Tablet, oral [ultramicrosize]:Gris-PEG®: 250 mg [BCF] [scored]

GuaiFENesinOutpatient Dosage FormsLiquid, oral:Q-Tussin: 100 mg/5 mL (118 mL) [ethanol free; contains sodium 2 mg/5 mL,sodium benzoate; cherry flavor]

Tablet, extended release, oral:Mucinex®: 600 mg

Guaifenesin and CodeineOutpatient Dosage FormsSyrup, oral: Guaifenesin 100 mg and codeine phosphate 10 mg per 5 mL (473mL)

Guaifenesin and DextromethorphanOutpatient Dosage FormsSyrup, oral: Guaifenesin 100 mg and dextromethorphan hydrobromide 10 mgper 5 mL (118 mL)

Q-Tussin DM: 100/10: guaifenesin 100 mg and dextromethorphan hydrobro-mide 10 mg per 5 mL (118 mL) [ethanol free; contains sodium benzoate;cherry flavor]

Guaifenesin and PseudoephedrineOutpatient Dosage FormsTablet, extended release, oral:Mucinex® D: Guaifenesin 600 mg and pseudoephedrine hydrochloride 60 mg

GuanFACINEOutpatient Dosage FormsTablet, oral: 1 mg

HaloperidolOutpatient Dosage FormsTablet, oral: 2 mg, 5 mg

HydrALAZINEOutpatient Dosage FormsTablet, oral, as hydrochloride: 25 mg [BCF], 50 mg [BCF]

HydrochlorothiazideOutpatient Dosage FormsCapsule, oral: 12.5 mg [BCF]Tablet, oral: 25 mg [BCF], 50 mg [BCF]

Hydrochlorothiazide and TriamtereneOutpatient Dosage FormsTablet, oral: Hydrochlorothiazide 25 mg and triamterene 37.5 mg [BCF]

Hydrocodone and AcetaminophenOutpatient Dosage FormsElixir, oral: Hydrocodone bitartrate 7.5 mg and acetaminophen 500 mg per 15mL (473 mL)

Tablet, oral:Hydrocodone bitartrate 5 mg and acetaminophen 325 mgHydrocodone bitartrate 5 mg and acetaminophen 500 mgHydrocodone bitartrate 7.5 mg and acetaminophen 325 mgHydrocodone bitartrate 7.5 mg and acetaminophen 500 mgHydrocodone bitartrate 7.5 mg and acetaminophen 650 mgHydrocodone bitartrate 10 mg and acetaminophen 325 mgHydrocodone bitartrate 10 mg and acetaminophen 500 mg

Hydrocodone and HomatropineOutpatient Dosage FormsSyrup, oral:Hydromet: Hydrocodone bitartrate 5 mg and homatropine methylbromide1.5 mg per 5 mL (480 mL) [cherry flavor]

Hydrocortisone (Systemic)Outpatient Dosage FormsTablet, oral, as base: 20 mg

Hydrocortisone (Topical)Outpatient Dosage FormsCream, topical, as base: 1% (30 g)Proctozone-HC 2.5%™: 2.5% (30 g) [BCF]

Ointment, topical, as base: 1% (30 g)Suppository, rectal, as acetate:Anucort-HC®: 25 mg (12s) [BCF]

HYDROmorphoneOutpatient Dosage FormsTablet, oral, as hydrochloride: 2 mg, 4 mg

HydroquinoneOutpatient Dosage FormsCream, topical:Melquin HP®: 4% (28.4 g) [contains sodium metabisulfite]

HydroxychloroquineOutpatient Dosage FormsTablet, oral, as sulfate: 200 mg [equivalent to 155 mg base]

Hydroxypropyl MethylcelluloseOutpatient Dosage FormsGel, ophthalmic [preservative free]:GenTeal®: 0.3% (3.5 g)

Solution, ophthalmic [drops, preservative free]:GenTeal®: 0.3% (15 mL)

HydroxyureaOutpatient Dosage FormsCapsule, oral:Hydrea®: 500 mg

HydrOXYzineOutpatient Dosage FormsCapsule, oral, as pamoate: 25 mgSyrup, oral, as hydrochloride: 10 mg/5 mL (473 mL) [BCF]Tablet, oral, as hydrochloride: 10 mg [BCF], 25 mg [BCF]

FLUTICASONE (NASAL)

8

HyoscyamineOutpatient Dosage FormsElixir, oral, as sulfate: 0.125 mg/5 mL (473 mL)

Hyoscyamine, Atropine, Scopolamine, and PhenobarbitalOutpatient Dosage FormsElixir, oral:Donnatal®: Hyoscyamine sulfate 0.1037 mg, atropine sulfate 0.0194 mg,scopolamine hydrobromide 0.0065 mg, and phenobarbital 16.2 mg per 5mL (118 mL) [contains ethanol <23.8%; grape flavor]

Tablet, oral:Donnatal®: Hyoscyamine sulfate 0.1037 mg, atropine sulfate 0.0194 mg,scopolamine hydrobromide 0.0065 mg, and phenobarbital 16.2 mg

IbandronateOutpatient Dosage FormsTablet, oral:Boniva®: 150 mg [once-monthly formulation]

IbuprofenOutpatient Dosage FormsSuspension, oral: 100 mg/5 mL (120 mL)Tablet, oral: 400 mg [BCF], 600 mg [BCF], 800 mg [BCF]

ImipramineOutpatient Dosage FormsTablet, oral, as hydrochloride: 10 mg [BCF], 25 mg [BCF]

ImiquimodOutpatient Dosage FormsCream, topical: 5% (24s) [0.25 g/packet]

IndapamideOutpatient Dosage FormsTablet, oral: 2.5 mg

IndomethacinOutpatient Dosage FormsCapsule, oral: 25 mg [BCF], 50 mg [BCF]

Inhalation DevicesOutpatient Dosage FormsHolding chamber:OptiChamber® Advantage

Mask [pediatric]: Small, mediumOptiChamber® [adult]: Large

Insulin AspartOutpatient Dosage FormsInjection, solution:NovoLOG® FlexPen®: 100 units/mL (3 mL) [BCF]NovoLOG® Penfill®: 100 units/mL (3 mL) [cartridge] [BCF]

Insulin Aspart Protamine and Insulin AspartOutpatient Dosage FormsInjection, suspension:NovoLOG® Mix 70/30 FlexPen®: 100 units/mL: Insulin aspart protaminesuspension 70% [intermediate acting] and insulin aspart solution 30%[rapid-acting] (3 mL) [BCF]

Insulin DetemirOutpatient Dosage FormsInjection, solution:Levemir®: 100 units/mL (10 mL)Levemir® FlexPen®: 100 units/mL (3 mL)

Insulin GlargineOutpatient Dosage FormsInjection, solution:Lantus®: 100 units/mL (10 mL) [vial] [BCF]Lantus® Solostar®: 100 units/mL (3 mL) [prefilled pen] [BCF]

Insulin NPHOutpatient Dosage FormsInjection, suspension:NovoLIN® N: 100 units/mL (10 mL) [vial] [BCF]

Insulin NPH and Insulin RegularOutpatient Dosage FormsInjection, suspension:NovoLIN® 70/30: Insulin NPH suspension 70% [intermediate acting] andinsulin regular solution 30% [short acting]: 100 units/mL (10 mL) [vial] [BCF]

Insulin RegularOutpatient Dosage FormsInjection, solution:NovoLIN® R: 100 units/mL (10 mL) [BCF]

Ipratropium and AlbuterolOutpatient Dosage FormsAerosol, for oral inhalation:Combivent®: Ipratropium bromide 18 mcg and albuterol (base) 90 mcg perinhalation (14.7 g) [contains chlorofluorocarbon, soya lecithin; 200 meteredactuations] [BCF]

Ipratropium (Nasal)Outpatient Dosage FormsSolution, intranasal, as bromide [spray]: 0.03% (30 mL); 0.06% (15 mL)

Ipratropium (Oral Inhalation)Outpatient Dosage FormsAerosol, for oral inhalation, as bromide:Atrovent® HFA: 17 mcg/actuation (12.9 g) [chlorofluorocarbon free; 200metered actuations] [BCF]

Solution, for nebulization, as bromide [preservative free]: 0.02% [500 mcg/2.5mL] (30s)

IsoniazidOutpatient Dosage FormsSolution, oral: 50 mg/5 mL (473 mL)Tablet, oral: 100 mg [BCF], 300 mg [BCF]

Isosorbide DinitrateOutpatient Dosage FormsTablet, oral: 10 mg [BCF]Tablet, extended release, oral: 40 mg [BCF]

Isosorbide MononitrateOutpatient Dosage FormsTablet, extended release, oral: 30 mg [BCF], 60 mg [BCF]

Ketoconazole (Systemic)Outpatient Dosage FormsTablet, oral: 200 mg

Ketoconazole (Topical)Outpatient Dosage FormsCream, topical: 2% (15 g, 30 g)Shampoo, topical: 2% (120 mL)Nizoral®: 2% (120 mL)

Ketorolac (Systemic)Outpatient Dosage FormsInjection, solution, as tromethamine: 30 mg/mL (1 mL, 2 mL)Tablet, oral, as tromethamine: 10 mg

Ketotifen (Ophthalmic)Outpatient Dosage FormsSolution, ophthalmic [drops]: 0.025% (5 mL)

LabetalolOutpatient Dosage FormsTablet, oral, as hydrochloride: 200 mg

Lactic Acid and Ammonium HydroxideOutpatient Dosage FormsLotion, topical: Lactic acid 12% with ammonium hydroxide (225 g)

LactuloseOutpatient Dosage FormsSolution, oral/rectal:Generlac: 10 g/15 mL (473 mL) [BCF]

LamoTRIgineOutpatient Dosage FormsTablet, oral: 25 mg, 100 mg, 150 mg, 200 mg

LatanoprostOutpatient Dosage FormsSolution, ophthalmic [drops]: 0.005% (2.5 mL) [BCF]Xalatan®: 0.005% (2.5 mL) [contains benzalkonium chloride] [BCF]

Leucovorin CalciumOutpatient Dosage FormsTablet, oral [strength expressed as base]: 5 mg

LeuprolideOutpatient Dosage FormsInjection, powder for reconstitution, as acetate [depot formulation, preservativefree]:Lupron Depot®: 3.75 mg (monthly), 7.5 mg (monthly), 11.25 mg (3 month),22.5 mg (3 month) [contains polylactide-co-glycolide, polysorbate 80]

LevalbuterolOutpatient Dosage FormsSolution, for nebulization, as hydrochloride [strength expressed as base, pres-ervative free]:Xopenex®: 0.31 mg/3 mL (24s); 0.63 mg/3 mL (24s)

LEVALBUTEROL

9

LevETIRAcetamOutpatient Dosage FormsSolution, oral: 100 mg/mL (473 mL)Tablet, oral: 250 mg, 500 mg

LevobunololOutpatient Dosage FormsSolution, ophthalmic, as hydrochloride [drops]: 0.5% (10 mL)

Levofloxacin (Systemic)Outpatient Dosage FormsTablet, oral:Levaquin®: 500 mg [BCF], 750 mg [BCF]

Levonorgestrel (IUD)Outpatient Dosage FormsIntrauterine Device:Mirena: 20 mcg/24 hr

Levonorgestrel (Systemic)Outpatient Dosage FormsTablet, Oral:Plan B: 0.75 mg [BCF]Plan B One-Step: 1.5 mg

LevothyroxineOutpatient Dosage FormsCapsule, oral, as sodium:Tirosint: 13 mcg, 25 mcg, 50 mcg, 75 mcg, 88 mcg, 100 mcg, 112 mcg, 125mcg, 137 mcg, 150 mcg

Tablet, oral, as sodium:Synthroid: 25 mcg [BCF], 50 mcg [BCF], 75 mcg [BCF], 88 mcg [BCF], 100mcg [BCF], 112 mcg [BCF], 125 mcg [BCF], 137 mcg [BCF], 150 mcg[BCF], 175 mcg [BCF], 200 mcg [BCF]

Lidocaine (Topical)Outpatient Dosage FormsJelly, topical, as hydrochloride: 2% (30 mL)Ointment, topical: 5% (35.4 g)Solution, topical, as hydrochloride: 4% [40 mg/mL] (50 mL)Solution, viscous, oral topical, as hydrochloride: 2% [20 mg/mL] (100 mL)

LisinoprilOutpatient Dosage FormsTablet, oral: 5 mg [BCF], 10 mg [BCF], 20 mg [BCF], 40 mg [BCF]

Lisinopril and HydrochlorothiazideOutpatient Dosage FormsTablet, oral:10/12.5: Lisinopril 10 mg and hydrochlorothiazide 12.5 mg [BCF]20/12.5: Lisinopril 20 mg and hydrochlorothiazide 12.5 mg [BCF]20/25: Lisinopril 20 mg and hydrochlorothiazide 25 mg [BCF]

LithiumOutpatient Dosage FormsCapsule, oral, as carbonate: 300 mg [BCF]

LoperamideOutpatient Dosage FormsCapsule, oral, as hydrochloride: 2 mg [BCF]

LoratadineOutpatient Dosage FormsSyrup, oral: 5 mg/5 mL (120 mL)Tablet, oral: 10 mg

LORazepamOutpatient Dosage FormsTablet, oral: 0.5 mg, 1 mg, 2 mg

LosartanOutpatient Dosage FormsTablet, oral, as potassium: 25 mg [BCF], 50 mg [BCF], 100 mg [BCF]

Losartan and HydrochlorothiazideOutpatient Dosage FormsTablet, oral:50/12.5: Losartan potassium 50 mg and hydrochlorothiazide 12.5 mg [BCF]100/12.5: Losartan potassium 100 mg and hydrochlorothiazide 12.5 mg [BCF]100/25: Losartan potassium 100 mg and hydrochlorothiazide 25 mg [BCF]

LoteprednolOutpatient Dosage FormsOintment, Ophthalmic, as etabonate:Lotemax: 0.5% (3.5 g)

Suspension, Ophthalmic, as etabonate:Lotemax: 0.5% (5 mL)

LubiprostoneOutpatient Dosage FormsCapsule, softgel, oral:Amitiza®: 24 mcg

Magnesium CitrateOutpatient Dosage FormsSolution, oral: 290 mg/5 mL (296 mL)

Magnesium OxideOutpatient Dosage FormsTablet, oral: 400 mg [equivalent to elemental magnesium 240 mg]

MeclizineOutpatient Dosage FormsCaplet, oral, as hydrochloride: 12.5 mgTablet, oral, as hydrochloride: 25 mg

MedroxyPROGESTERoneOutpatient Dosage FormsInjection, suspension, as acetate: 150 mg/mL (1 mL)Depo-Provera® Contraceptive: 150 mg/mL (1 mL) [contains polysorbate 80]

Tablet, oral, as acetate: 5 mg [BCF], 10 mg [BCF]

MefloquineOutpatient Dosage FormsTablet, oral, as hydrochloride: 250 mg [equivalent to mefloquine base 228 mg]

MegestrolOutpatient Dosage FormsSuspension, oral, as acetate: 40 mg/mL (473 mL)Tablet, oral, as acetate: 40 mg

MeloxicamOutpatient Dosage FormsTablet, oral: 7.5 mg [BCF], 15 mg [BCF]

MelphalanOutpatient Dosage FormsTablet, oral:Alkeran®: 2 mg

MeperidineOutpatient Dosage FormsTablet, oral, as hydrochloride: 50 mg

MercaptopurineOutpatient Dosage FormsTablet, oral: 50 mg

MesalamineOutpatient Dosage FormsCapsule extended release 24 hour, oral:Apriso: 0.375 g [contains aspartame]

Suspension, rectal: 4 g/60 mL (7 ea)Tablet delayed release, oral:Asacol: 400 mgLialda: 1.2 g [BCF]

MetFORMINOutpatient Dosage FormsTablet, oral, as hydrochloride: 500 mg [BCF], 850 mg [BCF], 1000 mg [BCF]

MethadoneOutpatient Dosage FormsTablet, oral, as hydrochloride: 5 mg, 10 mg

MethimazoleOutpatient Dosage FormsTablet, oral: 5 mg

MethocarbamolOutpatient Dosage FormsTablet, oral: 500 mg [BCF], 750 mg

MethotrexateOutpatient Dosage FormsInjection, solution: 25 mg/mL (2 mL)Tablet, oral: 2.5 mg [BCF]

MethyldopaOutpatient Dosage FormsTablet, oral: 250 mg

MethylphenidateOutpatient Dosage FormsCapsule, extended release, oral, as hydrochloride [bi-modal release]:Ritalin LA®: 10 mg [5 mg immediate release, 5 mg extended release] [BCF]Ritalin LA®: 20 mg [10 mg immediate release, 10 mg extended release] [BCF]Ritalin LA®: 30 mg [15 mg immediate release, 15 mg extended release] [BCF]

Tablet, oral, as hydrochloride: 5 mg [BCF], 10 mg [BCF], 20 mg [BCF]

LEVETIRACETAM

10

Tablet, extended release, oral, as hydrochloride [bi-modal release]:Concerta®: 18 mg [4 mg immediate release, 14 mg extended release] [BCF]Concerta®: 27 mg [6 mg immediate release, 21 mg extended release] [BCF]Concerta®: 36 mg [8 mg immediate release, 28 mg extended release] [BCF]Concerta®: 54 mg [12 mg immediate release, 42 mg extended release] [BCF]

Tablet, sustained release, oral, as hydrochloride: 20 mg

MethylPREDNISoloneOutpatient Dosage FormsTablet, oral:Medrol®: 4 mg [scored]

Tablet, oral [dose-pack]:Medrol® Dosepak™: 4 mg [scored; 21s]

MetoclopramideOutpatient Dosage FormsSolution, oral: 5 mg/5 mL (473 mL) [BCF]Tablet, oral: 10 mg [BCF]

MetolazoneOutpatient Dosage FormsTablet, oral: 2.5 mg, 5 mg

MetoprololOutpatient Dosage FormsTablet, oral, as tartrate: 25 mg [BCF], 50 mg [BCF], 100 mg [BCF]Tablet, extended release, oral, as succinate [expressed as mg equivalent totartrate]: 25 mg [BCF], 50 mg [BCF], 100 mg [BCF], 200 mg [BCF]

MetroNIDAZOLE (Systemic)Outpatient Dosage FormsTablet, oral: 250 mg [BCF], 500 mg [BCF]

MetroNIDAZOLE (Topical)Outpatient Dosage FormsGel, topical:MetroGel®: 1% (60 g)

Gel, vaginal:Vandazole®: 0.75% (70 g) [BCF]

Miconazole (Topical)Outpatient Dosage FormsCream, topical, as nitrate: 2% (30 g)Cream, vaginal, as nitrate: 2% (45 g)

MinocyclineOutpatient Dosage FormsCapsule, oral: 50 mg, 100 mg

Minoxidil (Systemic)Outpatient Dosage FormsTablet, oral: 2.5 mg, 10 mg

MirtazapineOutpatient Dosage FormsTablet, oral: 15 mg, 30 mg

Mometasone (Nasal)Outpatient Dosage FormsSuspension, intranasal, as furoate [spray]:Nasonex®: 50 mcg/spray (17 g) [contains benzalkonium chloride; delivers 120sprays]

MontelukastOutpatient Dosage FormsGranules, oral:Singulair®: 4 mg/packet (30s) [BCF]

Tablet, oral: 10 mg [BCF]Tablet, chewable, oral: 4 mg [BCF], 5 mg [BCF]

Morphine (Systemic)Outpatient Dosage FormsTablet, oral, as sulfate: 15 mgTablet, extended release, oral, as sulfate: 15 mg [BCF], 30 mg [BCF], 60 mg[BCF], 100 mg [BCF]

Moxifloxacin (Ophthalmic)Outpatient Dosage FormsSolution, ophthalmic [drops]:Vigamox®: 0.5% (3 mL)

MupirocinOutpatient Dosage FormsCream, topical, as calcium [strength expressed as base]:Bactroban Cream®: 2% (15 g) [contains benzyl alcohol]

Ointment, topical: 2% (22 g) [BCF]

MycophenolateOutpatient Dosage FormsCapsule, oral, as mofetil:CellCept®: 250 mg

NabumetoneOutpatient Dosage FormsTablet, oral: 500 mg

Naphazoline and PheniramineOutpatient Dosage FormsSolution, ophthalmic:Naphcon-A®: Naphazoline hydrochloride 0.025% and pheniramine maleate0.3% (5 mL) [contains benzalkonium chloride; 2 bottles/box], (15 mL) [con-tains benzalkonium chloride]

NaproxenOutpatient Dosage FormsTablet, oral: 250 mg [BCF], 500 mg [BCF]Tablet, oral, as sodium: 275 mg [equivalent to naproxen base 250 mg], 550 mg[equivalent to naproxen base 500 mg]

NeomycinOutpatient Dosage FormsTablet, oral, as sulfate: 500 mg

Neomycin, Polymyxin B, and DexamethasoneOutpatient Dosage FormsOintment, ophthalmic: Neomycin 3.5 mg, polymyxin B sulfate 10,000 units, anddexamethasone 0.1% per g (3.5 g)

Neomycin, Polymyxin B, and GramicidinOutpatient Dosage FormsSolution, ophthalmic [drops]: Neomycin 1.75 mg, polymyxin B 10,000 units, andgramicidin 0.025 mg per 1 mL (10 mL) [BCF]

Neomycin, Polymyxin B, and Hydrocortisone (Otic)Outpatient Dosage FormsSuspension, otic: Neomycin 3.5 mg, polymyxin B 10,000 units, and hydro-cortisone 10 mg per 1 mL (10 mL) [BCF]

NiacinOutpatient Dosage FormsTablet, extended release, oral:Niaspan®: 500 mg [BCF], 750 mg [BCF], 1000 mg [BCF]

NicotineOutpatient Dosage FormsGum, chewing, oral, as polacrilex: 2 mg (110s) [BCF]; 4 mg (110s) [BCF]Patch 24 Hour, transdermal: 7 mg/24 hr (7 ea) [BCF]; 14 mg/24 hr (7 ea) [BCF];21 mg/24 hr (7 ea) [BCF]

NIFEdipineOutpatient Dosage FormsCapsule, softgel, oral:Procardia®: 10 mg

Tablet, extended release, oral: 30 mg [BCF], 60 mg [BCF], 90 mg [BCF]

NitrofurantoinOutpatient Dosage FormsCapsule, oral [macrocrystal]: 50 mg [BCF]Capsule, oral [macrocrystal/monohydrate]: 100 mg [BCF]Suspension, oral:Furadantin®: 25 mg/5 mL (230 mL)

NitroglycerinOutpatient Dosage FormsPatch, transdermal: 0.2 mg/hour (30s) [BCF]; 0.4 mg/hour (30s) [BCF]; 0.6 mg/hour (30s) [BCF]

Solution, translingual [spray]:Nitrolingual®: 0.4 mg/spray (12 g) [contains ethanol 20%; 200 meteredsprays] [BCF]

Tablet, sublingual:Nitrostat®: 0.3 mg, 0.4 mg [BCF]

NorethindroneOutpatient Dosage FormsTablet, oral:Nor-QD®: 0.35 mg [BCF]

Tablet, oral, as acetate: 5 mg

NortriptylineOutpatient Dosage FormsCapsule, oral: 10 mg [BCF], 25 mg [BCF]

Nystatin and TriamcinoloneOutpatient Dosage FormsCream, topical: Nystatin 100,000 units and triamcinolone acetonide 0.1% (30 g)

Nystatin (Oral)Outpatient Dosage FormsSuspension, oral: 100,000 units/mL (473 mL) [BCF]Tablet, oral: 500,000 units

NYSTATIN (ORAL)

11

Nystatin (Topical)Outpatient Dosage FormsCream, topical: 100,000 units/g (15 g) [BCF]Ointment, topical: 100,000 units/g (30 g) [BCF]Powder, topical:Nystop®: 100,000 units/g (15 g) [contains talc]

Ofloxacin (Otic)Outpatient Dosage FormsSolution, otic [drops]: 0.3% (5 mL)

Olopatadine (Ophthalmic)Outpatient Dosage FormsSolution, ophthalmic [drops]:Pataday™: 0.2% (2.5 mL) [contains benzalkonium chloride]Patanol®: 0.1% (5 mL) [contains benzalkonium chloride] [BCF]Pazeo: 0.7% (2.5 mL) [contains benzalkonium chloride]

Omega-3 Fatty AcidsOutpatient Dosage FormsCapsule, liquid gel, oral:Lovaza®: 1 g [contains DHA ~375 mg/capsule, EPA ~465 mg/capsule, soy-bean oil]

OmeprazoleOutpatient Dosage FormsCapsule, delayed release, oral: 20 mg [BCF], 40 mg

OndansetronOutpatient Dosage FormsTablet, oral: 4 mg, 8 mgTablet, orally disintegrating: 4 mg

Ophthalmic Irrigant MixtureOutpatient Dosage FormsSolution, ophthalmic: 118 mL

OseltamivirOutpatient Dosage FormsCapsule, oral, as phosphate:Tamiflu®: 75 mg

Powder for suspension, oral:Tamiflu®: 6 mg/mL (60 mL) [contains sodium benzoate; tutti frutti flavor]

OXcarbazepineOutpatient Dosage FormsTablet, oral: 150 mg

OxybutyninOutpatient Dosage FormsTablet, oral, as chloride: 5 mgTablet, extended release, oral, as chloride: 5 mg [BCF], 10 mg [BCF]

Oxycodone and AcetaminophenOutpatient Dosage FormsCapsule, oral: 5/500: Oxycodone hydrochloride 5 mg and acetaminophen500 mg

Tablet, oral: 5/325: Oxycodone hydrochloride 5 mg and acetaminophen325 mg [BCF]

Oxymetazoline (Nasal)Outpatient Dosage FormsSolution, intranasal, as hydrochloride [spray]: 0.05% (15 mL)

PancrelipaseOutpatient Dosage FormsCapsule, delayed release, enteric coated microspheres, oral [porcine derived]:Creon: Lipase 6000 USP units, protease 19,000 USP units, and amylase30,000 USP units [BCF]

Creon: Lipase 12,000 USP units, protease 38,000 USP units, and amylase60,000 USP units [BCF]

Creon: Lipase 24,000 USP units, protease 76,000 USP units, and amylase120,000 USP units [BCF]

Creon: Lipase 36,000 USP units, protease 114,000 USP units, and amylase180,000 USP units [BCF]

Pancreaze: Lipase 16,800 units, protease 40,000 units, and amylase 70,000units

PantoprazoleOutpatient Dosage FormsTablet, delayed release, oral: 40 mg

PARoxetineOutpatient Dosage FormsTablet, oral, as hydrochloride [strength expressed as base]: 10 mg, 20 mg,30 mg, 40 mg

PenicillAMINEOutpatient Dosage FormsCapsule, oral:Cuprimine®: 250 mg

Penicillin V PotassiumOutpatient Dosage FormsTablet, oral: 250 mg [BCF], 500 mg [BCF]

PentoxifyllineOutpatient Dosage FormsTablet, extended release, oral: 400 mg

PermethrinOutpatient Dosage FormsCream, topical: 5% (60 g) [BCF]Lotion, topical: 1% (60 mL)

PhenazopyridineOutpatient Dosage FormsTablet, oral, as hydrochloride: 100 mg [BCF]

PHENobarbitalOutpatient Dosage FormsTablet, oral: 16.2 mg, 32.4 mg

Phenylephrine (Ophthalmic)Outpatient Dosage FormsSolution, ophthalmic, as hydrochloride [drops]: 2.5% (15 mL)

PhenytoinOutpatient Dosage FormsCapsule, extended release, oral, as sodium: 100 mg [BCF]Tablet, chewable, oral:Dilantin®: 50 mg [scored] [BCF]

Pilocarpine (Ophthalmic)Outpatient Dosage FormsSolution, ophthalmic, as hydrochloride [drops]: 1% (15 mL) [BCF]

PimecrolimusOutpatient Dosage FormsCream, topical:Elidel®: 1% (30 g) [BCF] [contains benzyl alcohol]

PindololOutpatient Dosage FormsTablet, oral: 5 mg

PioglitazoneOutpatient Dosage FormsTablet, oral:Actos®: 15 mg, 30 mg, 45 mg

Pioglitazone and MetforminOutpatient Dosage FormsTablet, oral:Actoplus Met®: 15/500: Pioglitazone 15 mg and metformin hydrochloride500 mg, 15/850: Pioglitazone 15 mg and metformin hydrochloride 850 mg

PiroxicamOutpatient Dosage FormsCapsule, oral: 20 mg

PodofiloxOutpatient Dosage FormsSolution, topical: 0.5% (3.5 mL)

Polyethylene Glycol 3350Outpatient Dosage FormsPowder for solution, oral: 17 g/dose (527 g); 17 g/packet (30s)

Polyethylene Glycol-Electrolyte SolutionOutpatient Dosage FormsSolution reconstituted, oral:MoviPrep: Pouch A: PEG 3350 100g, sodium sulfate 7.5 g, sodium chloride2.69 g, potassium chloride 1.02 g; Pouch B: Ascorbic acid 4.7 g, sodiumascorbate 5.9 g (1000 mL) [contains phenylalanine 131 mg/treatment; lemonflavor; packaged with 2 of Pouch A and 2 of Pouch B in carton and adisposable reconstitution container]

Generic: PEG 3350 240 g, sodium sulfate 22.72 g, sodium bicarbonate 6.72 g,sodium chloride 5.84 g, and potassium chloride 2.98 g (4000 mL)

NYSTATIN (TOPICAL)

12

Potassium ChlorideOutpatient Dosage FormsSolution, oral: 20 mEq/15 mL (480 mL) [BCF]Tablet, extended release, microencapsulated, oral:Klor-Con® M20: 20 mEq [scored; 1500 mg] [BCF]

Tablet, extended release, wax matrix, oral:Klor-Con® 8: 8 mEq [600 mg]Klor-Con® 10: 10 mEq [750 mg] [BCF]

Potassium CitrateOutpatient Dosage FormsTablet, extended release, oral: 1080 mg

PramipexoleOutpatient Dosage FormsTablet, oral, as dihydrochloride monohydrate:Mirapex®: 0.125 mgMirapex®: 0.25 mg, 0.5 mg, 1 mg, 1.5 mg [scored]

Pramoxine and HydrocortisoneOutpatient Dosage FormsAerosol, foam, rectal:Proctofoam® HC: Pramoxine hydrochloride 1% and hydrocortisone acetate1% (10 g)

PravastatinOutpatient Dosage FormsTablet, oral, as sodium: 10 mg [BCF], 20 mg [BCF], 40 mg [BCF], 80 mg [BCF]

PrazosinOutpatient Dosage FormsCapsule, oral: 1 mg, 2 mg, 5 mg

PrednisoLONE (Ophthalmic)Outpatient Dosage FormsSuspension, ophthalmic, as acetate [drops]: 1% (5 mL) [BCF]

PrednisoLONE (Systemic)Outpatient Dosage FormsSolution, oral, as base: 15 mg/5 mL (480 mL)

PredniSONEOutpatient Dosage FormsTablet, oral: 1 mg [BCF], 2.5 mg, 5 mg [BCF], 10 mg [BCF], 20 mg [BCF],50 mg

PrimaquineOutpatient Dosage FormsTablet, oral, as phosphate: 26.3 mg [15 mg base]

PrimidoneOutpatient Dosage FormsTablet, oral: 50 mg, 250 mg

ProbenecidOutpatient Dosage FormsTablet, Oral:Generic: 500 mg [BCF]

ProchlorperazineOutpatient Dosage FormsSuppository, rectal: 25 mg (12s)Tablet, oral, as maleate [strength expressed as base]: 5 mg

PromethazineOutpatient Dosage FormsSuppository, rectal, as hydrochloride: 25 mg (12s) [BCF]Promethegan™: 12.5 mg (12s) [BCF]

Syrup, oral, as hydrochloride: 6.25 mg/5 mL (473 mL) [BCF]Tablet, oral, as hydrochloride: 25 mg [BCF]

PropanthelineOutpatient Dosage FormsTablet, oral, as bromide: 15 mg

ProparacaineOutpatient Dosage FormsSolution, ophthalmic, as hydrochloride [drops]: 0.5% (15 mL)

PropranololOutpatient Dosage FormsCapsule, extended release, oral, as hydrochloride: 60 mg, 80 mg, 120 mgTablet, oral, as hydrochloride: 10 mg, 20 mg, 40 mg

PropylthiouracilOutpatient Dosage FormsTablet, oral: 50 mg [BCF]

PseudoephedrineOutpatient Dosage FormsLiquid, oral, as hydrochloride:Children's Nasal Decongestant: 30 mg/5 mL (118 mL) [contains sodiumbenzoate; raspberry flavor]

Tablet, oral, as hydrochloride: 30 mgSudoGest: 30 mg

Pyrantel PamoateOutpatient Dosage FormsSuspension, oral, as pamoate:Pin-X®: 144 mg/mL (60 mL) [sugar free; contains sodium benzoate; caramelflavor; equivalent to pyrantel base 50 mg/mL]

PyrazinamideOutpatient Dosage FormsTablet, oral: 500 mg [BCF]

PyridostigmineOutpatient Dosage FormsTablet, oral, as bromide: 60 mgTablet, sustained release, oral, as bromide:Mestinon® Timespan®: 180 mg [scored]

PyridoxineOutpatient Dosage FormsTablet, oral, as hydrochloride: 50 mg

QUEtiapineOutpatient Dosage FormsTablet, oral:SEROquel®: 25 mg [BCF], 100 mg [BCF], 200 mg [BCF]

Tablet, extended release, oral:SEROquel XR®: 200 mg [BCF], 300 mg [BCF], 400 mg [BCF]

RaloxifeneOutpatient Dosage FormsTablet, oral, as hydrochloride:Evista®: 60 mg [BCF]

RamiprilOutpatient Dosage FormsCapsule, oral: 2.5 mg [BCF], 5 mg [BCF], 10 mg [BCF]

RanitidineOutpatient Dosage FormsSyrup, oral: 15 mg/mL (473 mL) [BCF]Tablet, oral: 150 mg [BCF]

RifampinOutpatient Dosage FormsCapsule, oral: 300 mg [BCF]

RisperiDONEOutpatient Dosage FormsSolution, oral: 1 mg/mL (30 mL) [BCF]Tablet, oral: 0.25 mg [BCF], 0.5 mg [BCF], 1 mg [BCF], 2 mg [BCF],4 mg [BCF]

RivaroxabanOutpatient Dosage FormsTablet, Oral:Xarelto: 15 mg, 20 mg

RizatriptanOutpatient Dosage FormsTablet, oral:Maxalt®: 5 mg [BCF], 10 mg [BCF]

Tablet, orally disintegrating:Maxalt-MLT®: 5 mg [contains phenylalanine 1.05 mg/tablet; peppermint fla-vor] [BCF]

Maxalt-MLT®: 10 mg [contains phenylalanine 2.1 mg/tablet; peppermint fla-vor] [BCF]

ROPINIRoleOutpatient Dosage FormsTablet, oral:Generic: 0.25 mg

RosuvastatinOutpatient Dosage FormsTablet, oral:Crestor®: 5 mg, 10 mg, 20 mg, 40 mg

Salicylic AcidOutpatient Dosage FormsLiquid, topical:DuoFilm®: 17% (9.8 mL) [contains ethanol]

SALICYLIC ACID

13

SalmeterolOutpatient Dosage FormsPowder, for oral inhalation:Serevent® Diskus®: 50 mcg (60s) [contains lactose] [BCF]

SalsalateOutpatient Dosage FormsTablet, oral: 500 mg [BCF], 750 mg [BCF]

Selenium SulfideOutpatient Dosage FormsLotion, topical: 2.5% (120 mL) [BCF]

SertralineOutpatient Dosage FormsTablet, oral: 25 mg [BCF], 50 mg [BCF], 100 mg [BCF]

SildenafilOutpatient Dosage FormsTablet, oral:Viagra®: 25 mg [BCF], 50 mg [BCF], 100 mg [BCF]

Silver SulfadiazineOutpatient Dosage FormsCream, topical: 1% (85 g) [BCF]Silvadene®: 1% (50 g) [BCF]

SimethiconeOutpatient Dosage FormsSuspension, oral [drops]: 40 mg/0.6 mL (30 mL)Tablet, chewable, oral:Mi-Acid Gas Relief: 80 mg

SimvastatinOutpatient Dosage FormsTablet, oral: 5 mg [BCF], 10 mg [BCF], 20 mg [BCF], 40 mg [BCF], 80 mg

SitaGLIPtinOutpatient Dosage FormsTablet, oral:Januvia®: 25 mg [BCF], 50 mg [BCF], 100 mg [BCF]

Sitagliptin and MetforminOutpatient Dosage FormsTablet, oral:Janumet® 50/500: Sitagliptin 50 mg and metformin hydrochloride500 mg [BCF]

Janumet® 50/1000: Sitagliptin 50 mg and metformin hydrochloride1000 mg [BCF]

Tablet, extended release, oral:Janumet® XR: 50/500: Sitagliptin 50 mg and metformin hydrochloride 500 mgJanumet® XR: 50/1000: Sitagliptin 50 mg and metformin hydrochloride1000 mg

Sodium ChlorideOutpatient Dosage FormsOintment, ophthalmic: 5% (3.5 g)Solution, intranasal [spray]:Deep Sea: 0.65% (44 mL) [contains benzalkonium chloride, benzyl alcohol]

Solution, ophthalmic [drops]: 5% (15 mL)

Sodium Citrate and Citric AcidOutpatient Dosage FormsSolution, oral: Sodium citrate 500 mg and citric acid 334 mg per 5 mL (473 mL)[equivalent to bicarbonate 1 mEq/mL]

Sodium PhosphatesOutpatient Dosage FormsSolution, rectal [enema]: Monobasic sodium phosphate 19 g and dibasic sodiumphosphate 7 g per 118 mL delivered dose (133 mL)

SorbitolOutpatient Dosage FormsSolution, oral: 70% (480 mL)

SotalolOutpatient Dosage FormsTablet, oral, as hydrochloride: 80 mg

SpironolactoneOutpatient Dosage FormsTablet, oral: 25 mg [BCF]

SucralfateOutpatient Dosage FormsSuspension, oral:Carafate®: 1 g/10 mL (420 mL)

Tablet, oral: 1 g

Sulfacetamide (Ophthalmic)Outpatient Dosage FormsSolution, ophthalmic, as sodium [drops]: 10% (15 mL) [BCF]

Sulfamethoxazole and TrimethoprimOutpatient Dosage FormsSuspension, oral: Sulfamethoxazole 200 mg and trimethoprim 40 mg per 5 mL(473 mL) [BCF]

Tablet, oral: Sulfamethoxazole 400 mg and trimethoprim 80 mg [BCF]Tablet, double strength, oral: Sulamethoxazole 800 mg and trimethoprim160 mg [BCF]

SulfaSALAzineOutpatient Dosage FormsTablet, delayed release, enteric coated, oral:Sulfazine EC: 500 mg

SulindacOutpatient Dosage FormsTablet, oral: 200 mg

SUMAtriptanOutpatient Dosage FormsInjection, solution, as succinate [strength expressed as base]: 6 mg/0.5 mL (0.5mL) [BCF]

Tablet, oral, as succinate [strength expressed as base]: 25 mg [BCF], 50 mg[BCF], 100 mg [BCF]

Sumatriptan and NaproxenOutpatient Dosage FormsTablet, oral:Treximet® 85/500: Sumatriptan 85 mg and naproxen sodium 500 mg [containssodium 61.2 mg/tablet (~2.7 mEq/tablet)]

SyringeOutpatient Dosage FormsSyringe/needle:UltiCare Tuberculin Safety Syringe: 25 gauge x 1" (1 mL) [100/box]

TamoxifenOutpatient Dosage FormsTablet, oral: 10 mg [BCF]

TamsulosinOutpatient Dosage FormsCapsule, oral, as hydrochloride: 0.4 mg [BCF]

TelmisartanOutpatient Dosage FormsTablet, Oral:Generic: 20 mg, 40 mg, 80 mg

Telmisartan and HydrochlorothiazideOutpatient Dosage FormsTablet, oral:Micardis HCT: 40/12.5: Telmisartan 40 mg and hydrochlorothiazide 12.5 mgMicardis HCT: 80/12.5: Telmisartan 80 mg and hydrochlorothiazide 12.5 mgMicardis HCT: 80/25: Telmisartan 80 mg and hydrochlorothiazide 25 mg

TemazepamOutpatient Dosage FormsCapsule, oral: 15 mg [BCF], 30 mg [BCF]

TerazosinOutpatient Dosage FormsCapsule, oral: 1 mg [BCF], 2 mg [BCF], 5 mg [BCF], 10 mg [BCF]

Terbinafine (Systemic)Outpatient Dosage FormsTablet, oral: 250 mg

TestosteroneOutpatient Dosage FormsGel, topical:Fortesta™: 10 mg/actuation (60 g) [contains ethanol; 0.5 g gel/actuation; 120metered actuations] [BCF]

Testim®: 1% [5 g gel/tube] (30s) [contains ethanol 74%; may be chemicallysynthesized from soy]

Injection, oil, as cypionate: 200 mg/mL (10 mL)Depo®-Testosterone: 200 mg/mL (1 mL) [contains benzyl alcohol, benzylbenzoate, cottonseed oil]

Injection, oil, as enanthate: 200 mg/mL (5 mL)Patch, transdermal:Androderm®: 2 mg/24 hours (60s); 4 mg/24 hours (30s) [contains ethanol,metal]

TetracyclineOutpatient Dosage FormsCapsule, oral, as hydrochloride: 250 mg [BCF]

SALMETEROL

14

TheophyllineOutpatient Dosage FormsTablet, extended release, oral: 200 mg [BCF]

ThioridazineOutpatient Dosage FormsTablet, oral, as hydrochloride: 25 mg

Timolol (Ophthalmic)Outpatient Dosage FormsGel forming solution, ophthalmic, as maleate [strength expressed as base,drops]:Timolol GFS: 0.25% (5 mL) [BCF]; 0.5% (5 mL) [BCF]

Solution, ophthalmic, as maleate [strength expressed as base, drops]: 0.25% (5mL) [BCF]; 0.5% (15 mL) [BCF]

TiotropiumOutpatient Dosage FormsPowder, for oral inhalation:Spiriva® HandiHaler®: 18 mcg/capsule (30s) [contains lactose] [BCF]

TiZANidineOutpatient Dosage FormsTablet, Oral:Generic: 2 mg, 4 mg

Tobramycin and DexamethasoneOutpatient Dosage FormsOintment, ophthalmic:TobraDex®: Tobramycin 0.3% and dexamethasone 0.1% (3.5 g) [containschlorobutanol]

Suspension, ophthalmic [drops]: Tobramycin 0.3% and dexamethasone 0.1%(5 mL)

Tobramycin (Ophthalmic)Outpatient Dosage FormsOintment, ophthalmic:Tobrex®: 0.3% (3.5 g) [contains chlorobutanol]

Solution, ophthalmic [drops]: 0.3% (5 mL)

TolterodineOutpatient Dosage FormsCapsule, extended release, oral, as tartrate:Detrol® LA: 2 mg [BCF], 4 mg [BCF]

TopiramateOutpatient Dosage FormsTablet, oral: 25 mg, 50 mg, 100 mg

TraMADolOutpatient Dosage FormsTablet, oral, as hydrochloride: 50 mg [BCF]

TraZODoneOutpatient Dosage FormsTablet, oral, as hydrochloride: 50 mg [BCF]

Tretinoin (Topical)Outpatient Dosage FormsCream, topical: 0.025% (20 g) [BCF]; 0.05% (20 g) [BCF]; 0.1% (20 g)Gel, topical: 0.01% (15 g); 0.025% (15 g)

Triamcinolone (Topical)Outpatient Dosage FormsAerosol, spray, topical, as acetonide:Kenalog®: 0.2 mg/2-second spray (63 g, 100 g) [contains dehydrated etha-nol 10.3%]

Cream, topical, as acetonide: 0.1% (15 g, 30 g, 80 g, 454 g) [BCF]Ointment, topical, as acetonide: 0.1% (15 g, 80 g, 454 g)Paste, oral topical, as acetonide: 0.1% (5 g)

TriazolamOutpatient Dosage FormsTablet, oral: 0.25 mg

TrifluridineOutpatient Dosage FormsSolution, ophthalmic [drops]: 1% (7.5 mL)

TrihexyphenidylOutpatient Dosage FormsTablet, oral, as hydrochloride: 2 mg [BCF]

Trimethoprim and Polymyxin BOutpatient Dosage FormsSolution, ophthalmic [drops]: Trimethoprim 1 mg and polymyxin B sulfate 10,000units per 1 mL (10 mL) [BCF]

Triprolidine and PseudoephedrineOutpatient Dosage FormsTablet, oral:Aprodine: Triprolidine hydrochloride 2.5 mg and pseudoephedrine hydrochlor-ide 60 mg [scored]

TropicamideOutpatient Dosage FormsSolution, ophthalmic [drops]: 0.5% (15 mL); 1% (15 mL)

ValACYclovirOutpatient Dosage FormsTablet, oral: 500 mg, 1 g

Valproic Acid and DerivativesOutpatient Dosage FormsCapsule, sprinkle, oral [strength expressed as valproic acid]:Depakote® Sprinkle: 125 mg [BCF] [strength expressed as valproic acid]

Tablet, delayed release, oral [strength expressed as valproic acid]: 125 mg[BCF], 250 mg [BCF]

Tablet, extended release, oral [strength expressed as valproic acid]: 250 mg[BCF], 500 mg [BCF]

ValsartanOutpatient Dosage FormsTablet, oral:Diovan®: 40 mg [scored] [BCF], 80 mg [BCF], 160 mg [BCF], 320 mg [BCF]

Valsartan and HydrochlorothiazideOutpatient Dosage FormsTablet, oral:Diovan HCT®: 80 mg/12.5 mg: Valsartan 80 mg and hydrochlorothiazide12.5 mg [BCF]

Diovan HCT®: 160 mg/12.5 mg: Valsartan 160 mg and hydrochlorothiazide12.5 mg [BCF]

Diovan HCT®: 160 mg/25 mg: Valsartan 160 mg and hydrochlorothiazide25 mg [BCF]

Diovan HCT®: 320 mg/12.5 mg: Valsartan 320 mg and hydrochlorothiazide12.5 mg [BCF]

Diovan HCT®: 320 mg/25 mg: Valsartan 320 mg and hydrochlorothiazide25 mg [BCF]

VareniclineOutpatient Dosage FormsTablet, oral:Chantix: 1 mgChantix Starting Month Pak: 0.5 mg x 11 & 1 mg x 42

VenlafaxineOutpatient Dosage FormsCapsule, extended release, oral:Effexor XR®: 37.5 mg [BCF], 75 mg [BCF], 150 mg [BCF]

Tablet, oral: 37.5 mg [BCF]

VerapamilOutpatient Dosage FormsTablet, oral, as hydrochloride: 80 mg, 120 mgTablet, extended release, oral, as hydrochloride: 120 mg [BCF], 180 mg [BCF],240 mg [BCF]

Vitamins (Multiple/Pediatric)Outpatient Dosage FormsContent varies depending on product used.Solution, oral [drops]: 35 mg/mL (50 mL)Solution, oral [with iron, drops]: 10 mg/mL (50 mL)

Vitamins (Multiple/Prenatal)Outpatient Dosage FormsContent varies depending on product used.Capsule, oral:Prenate DHA: 28-0.6-0.4-300 mg (30s)

Tablet, oral: (100s)

WarfarinOutpatient Dosage FormsTablet, oral, as sodium: 1 mg [BCF], 2 mg [BCF], 2.5 mg [BCF], 3 mg [BCF],4 mg [BCF], 5 mg [BCF], 7.5 mg [BCF], 10 mg [BCF]

ZaleplonOutpatient Dosage FormsCapsule, oral: 5 mg, 10 mg

ZiprasidoneOutpatient Dosage FormsCapsule, oral, as hydrochloride:Geodon®: 20 mg, 40 mg, 60 mg, 80 mg

ZIPRASIDONE

15

ZOLMitriptanOutpatient Dosage FormsTablet, oral:Zomig®: 2.5 mg [scored]Zomig®: 5 mg

Tablet, orally disintegrating, oral:Zomig-ZMT®: 2.5 mg [contains phenylalanine 2.81 mg/tablet; orange flavor]Zomig-ZMT®: 5 mg [contains phenylalanine 5.62 mg/tablet; orange flavor]

ZolpidemOutpatient Dosage FormsTablet, oral, as tartrate:Generic: 5 mg [BCF], 10 mg [BCF]

Tablet Extended Release, Oral, as tartrate:Generic: 6.25 mg, 12.5 mg

ZOLMITRIPTAN

16

Therapeutic Category Index

17

Acetylcholinesterase InhibitorPyridostigmine .......................................................................................... 13

Acetylcholinesterase Inhibitor (Central)Donepezil .................................................................................................... 5

Acne ProductsAdapalene ...................................................................................................2Benzoyl Peroxide ........................................................................................3Clindamycin and Benzoyl Peroxide ........................................................... 4Salicylic Acid .............................................................................................13Tretinoin (Topical) ..................................................................................... 15

Adrenergic Agonist AgentOxymetazoline (Nasal) ............................................................................. 12

Alkalinizing Agent, OralPotassium Citrate ..................................................................................... 13Sodium Citrate and Citric Acid .................................................................14

Alkylamine DerivativeBrompheniramine, Pseudoephedrine, and Dextromethorphan .................3Chlorpheniramine ........................................................................................4Naphazoline and Pheniramine ................................................................. 11Triprolidine and Pseudoephedrine ........................................................... 15

Alpha1 AgonistNaphazoline and Pheniramine ................................................................. 11

Alpha1 BlockerAlfuzosin ......................................................................................................2Doxazosin ................................................................................................... 6Prazosin .................................................................................................... 13Tamsulosin ................................................................................................ 14Terazosin ...................................................................................................14

Alpha2-Adrenergic AgonistCloNIDine ....................................................................................................4GuanFACINE .............................................................................................. 8Methyldopa ................................................................................................10TiZANidine ................................................................................................ 15

Alpha2 Agonist, OphthalmicBrimonidine and Timolol .............................................................................3Brimonidine (Ophthalmic) ........................................................................... 3

Alpha-Adrenergic AgonistPhenylephrine (Ophthalmic) .....................................................................12

Alpha/Beta AgonistBrompheniramine, Pseudoephedrine, and Dextromethorphan .................3EPINEPHrine (Systemic) ............................................................................6Fexofenadine and Pseudoephedrine ......................................................... 7Guaifenesin and Pseudoephedrine ............................................................8Pseudoephedrine ......................................................................................13Triprolidine and Pseudoephedrine ........................................................... 15

5 Alpha-Reductase InhibitorFinasteride .................................................................................................. 7

AmebicideMetroNIDAZOLE (Systemic) .....................................................................11

Aminoquinoline (Antimalarial)Chloroquine .................................................................................................4Hydroxychloroquine .................................................................................... 8Primaquine ................................................................................................13

5-Aminosalicylic Acid DerivativeMesalamine ...............................................................................................10SulfaSALAzine ..........................................................................................14

Ammonium DetoxicantLactulose .....................................................................................................9Neomycin .................................................................................................. 11

Analgesic Combination (Opioid)Acetaminophen and Codeine .....................................................................2Hydrocodone and Acetaminophen .............................................................8Oxycodone and Acetaminophen ..............................................................12

Analgesic, NonopioidAcetaminophen ........................................................................................... 2Aspirin ......................................................................................................... 2Celecoxib .................................................................................................... 4Diclofenac (Systemic) .................................................................................5Etodolac ...................................................................................................... 7Ibuprofen ..................................................................................................... 9Indomethacin ...............................................................................................9Ketorolac (Systemic) ...................................................................................9Meloxicam .................................................................................................10Nabumetone ..............................................................................................11Naproxen ...................................................................................................11

Piroxicam .................................................................................................. 12Sulindac .................................................................................................... 14Sumatriptan and Naproxen ...................................................................... 14

Analgesic, OpioidAcetaminophen and Codeine .....................................................................2Codeine .......................................................................................................4Hydrocodone and Acetaminophen .............................................................8HYDROmorphone .......................................................................................8Meperidine ................................................................................................ 10Methadone ................................................................................................ 10Morphine (Systemic) ................................................................................. 11Oxycodone and Acetaminophen ..............................................................12TraMADol .................................................................................................. 15

Analgesic, TopicalLidocaine (Topical) ....................................................................................10

Analgesic, UrinaryPhenazopyridine ....................................................................................... 12

AndrogenTestosterone ............................................................................................. 14

Anesthetic/CorticosteroidPramoxine and Hydrocortisone ................................................................13

Angiotensin II Receptor BlockerCandesartan ................................................................................................3Candesartan and Hydrochlorothiazide .......................................................3Losartan .................................................................................................... 10Losartan and Hydrochlorothiazide ........................................................... 10Telmisartan ................................................................................................14Telmisartan and Hydrochlorothiazide .......................................................14Valsartan ................................................................................................... 15Valsartan and Hydrochlorothiazide .......................................................... 15

Angiotensin-Converting Enzyme (ACE) InhibitorAmlodipine and Benazepril ........................................................................ 2Captopril ......................................................................................................3Fosinopril .....................................................................................................8Lisinopril .................................................................................................... 10Lisinopril and Hydrochlorothiazide ........................................................... 10Ramipril ..................................................................................................... 13

AntacidAluminum Hydroxide, Magnesium Hydroxide, and Simethicone ..............2

AnthelminticPyrantel Pamoate ..................................................................................... 13

Antianginal AgentAmLODIPine ............................................................................................... 2Amlodipine and Benazepril ........................................................................ 2Atenolol ....................................................................................................... 2Diltiazem ..................................................................................................... 5Isosorbide Dinitrate .....................................................................................9Isosorbide Mononitrate ............................................................................... 9Metoprolol ..................................................................................................11NIFEdipine .................................................................................................11Nitroglycerin .............................................................................................. 11Propranolol ................................................................................................13Verapamil .................................................................................................. 15

Antianxiety Agent, MiscellaneousBusPIRone ..................................................................................................3

Antiarrhythmic Agent, Class IaDisopyramide .............................................................................................. 5

Antiarrhythmic Agent, Class IcFlecainide ....................................................................................................7

Antiarrhythmic Agent, Class IIPropranolol ................................................................................................13Sotalol ....................................................................................................... 14

Antiarrhythmic Agent, Class IIIAmiodarone .................................................................................................2Sotalol ....................................................................................................... 14

Antiarrhythmic Agent, Class IVDiltiazem ..................................................................................................... 5Verapamil .................................................................................................. 15

Antiarrhythmic Agent, MiscellaneousDigoxin ........................................................................................................ 5

Antibiotic, AminoglycosideGentamicin (Ophthalmic) ............................................................................8Neomycin .................................................................................................. 11Tobramycin (Ophthalmic) ..........................................................................15

ACETYLCHOLINESTERASE INHIBITOR

18

Antibiotic, Cephalosporin (First Generation)Cephalexin .................................................................................................. 4

Antibiotic, Cephalosporin (Second Generation)Cefprozil ...................................................................................................... 4Cefuroxime ..................................................................................................4

Antibiotic, Cephalosporin (Third Generation)Cefdinir ........................................................................................................ 4

Antibiotic/Corticosteroid, OphthalmicNeomycin, Polymyxin B, and Dexamethasone ....................................... 11Tobramycin and Dexamethasone ............................................................ 15

Antibiotic/Corticosteroid, OticNeomycin, Polymyxin B, and Hydrocortisone (Otic) ............................... 11

Antibiotic, FluoroquinoloneCiprofloxacin (Ophthalmic) ......................................................................... 4Ciprofloxacin (Systemic) .............................................................................4Levofloxacin (Systemic) ............................................................................10Moxifloxacin (Ophthalmic) ........................................................................ 11Ofloxacin (Otic) ......................................................................................... 12

Antibiotic, LincosamideClindamycin (Systemic) .............................................................................. 4Clindamycin (Topical) ................................................................................. 4

Antibiotic, MacrolideAzithromycin (Systemic) ............................................................................. 3Clarithromycin ............................................................................................. 4Erythromycin and Sulfisoxazole .................................................................6Erythromycin (Ophthalmic) ......................................................................... 6Erythromycin (Systemic) .............................................................................6

Antibiotic, Macrolide CombinationErythromycin and Sulfisoxazole .................................................................6

Antibiotic, MiscellaneousDapsone (Systemic) ................................................................................... 5MetroNIDAZOLE (Systemic) .....................................................................11Nitrofurantoin .............................................................................................11Rifampin .................................................................................................... 13Sulfamethoxazole and Trimethoprim ....................................................... 14

Antibiotic, OphthalmicBacitracin, Neomycin, and Polymyxin B (Ophthalmic) ..............................3Bacitracin, Neomycin, Polymyxin B, and Hydrocortisone (Ophthalmic) ...3Bacitracin (Ophthalmic) .............................................................................. 3Ciprofloxacin (Ophthalmic) ......................................................................... 4Erythromycin (Ophthalmic) ......................................................................... 6Gentamicin (Ophthalmic) ............................................................................8Moxifloxacin (Ophthalmic) ........................................................................ 11Neomycin, Polymyxin B, and Gramicidin .................................................11Sulfacetamide (Ophthalmic) ..................................................................... 14Tobramycin (Ophthalmic) ..........................................................................15Trimethoprim and Polymyxin B ................................................................ 15

Antibiotic, Oral RinseChlorhexidine Gluconate ............................................................................ 4

Antibiotic, OticNeomycin, Polymyxin B, and Hydrocortisone (Otic) ............................... 11Ofloxacin (Otic) ......................................................................................... 12

Antibiotic, PenicillinAmoxicillin ................................................................................................... 2Amoxicillin and Clavulanate ....................................................................... 2Dicloxacillin ................................................................................................. 5Penicillin V Potassium ..............................................................................12

Antibiotic, Respiratory FluoroquinoloneLevofloxacin (Systemic) ............................................................................10

Antibiotic, Sulfonamide DerivativeErythromycin and Sulfisoxazole .................................................................6Sulfamethoxazole and Trimethoprim ....................................................... 14

Antibiotic, Tetracycline DerivativeDoxycycline .................................................................................................6Minocycline ................................................................................................11Tetracycline ............................................................................................... 14

Antibiotic, TopicalBacitracin (Topical) ..................................................................................... 3Chlorhexidine Gluconate ............................................................................ 4MetroNIDAZOLE (Topical) ........................................................................ 11Mupirocin ...................................................................................................11Neomycin .................................................................................................. 11Silver Sulfadiazine .................................................................................... 14

Anticholinergic AgentBenztropine .................................................................................................3

Dicyclomine .................................................................................................5Glycopyrrolate .............................................................................................8Hyoscyamine .............................................................................................. 9Hyoscyamine, Atropine, Scopolamine, and Phenobarbital ....................... 9Ipratropium and Albuterol ........................................................................... 9Ipratropium (Nasal) ..................................................................................... 9Ipratropium (Oral Inhalation) ...................................................................... 9Propantheline ............................................................................................13Tiotropium ................................................................................................. 15Tolterodine .................................................................................................15Trihexyphenidyl .........................................................................................15

Anticholinergic Agent, Long-ActingTiotropium ................................................................................................. 15

AnticoagulantApixaban ..................................................................................................... 2Dabigatran Etexilate ................................................................................... 5Enoxaparin ..................................................................................................6Rivaroxaban ..............................................................................................13Warfarin .....................................................................................................15

Anticoagulant, Direct Thrombin InhibitorDabigatran Etexilate ................................................................................... 5

Anticoagulant, Factor Xa InhibitorApixaban ..................................................................................................... 2Rivaroxaban ..............................................................................................13

Anticoagulant, Low Molecular Weight HeparinEnoxaparin ..................................................................................................6

Anticoagulant, Vitamin K AntagonistWarfarin .....................................................................................................15

Anticonvulsant, BarbituratePHENobarbital .......................................................................................... 12

Anticonvulsant, HydantoinPhenytoin .................................................................................................. 12

Anticonvulsant, MiscellaneousAcetaZOLAMIDE ........................................................................................ 2CarBAMazepine ..........................................................................................3Gabapentin ..................................................................................................8LamoTRIgine ...............................................................................................9LevETIRAcetam ........................................................................................10OXcarbazepine ......................................................................................... 12Primidone .................................................................................................. 13Topiramate ................................................................................................ 15Valproic Acid and Derivatives .................................................................. 15

Anticonvulsant, SuccinimideEthosuximide .............................................................................................. 7

Antidepressant, Alpha-2 AntagonistMirtazapine ................................................................................................11

Antidepressant, Dopamine/Norepinephrine-Reuptake InhibitorBuPROPion .................................................................................................3

Antidepressant, Selective Serotonin Reuptake InhibitorCitalopram ...................................................................................................4Escitalopram ............................................................................................... 6FLUoxetine ..................................................................................................7PARoxetine ............................................................................................... 12Sertraline ...................................................................................................14

Antidepressant, Serotonin/Norepinephrine Reuptake InhibitorVenlafaxine ............................................................................................... 15

Antidepressant, Serotonin Reuptake Inhibitor/AntagonistTraZODone ............................................................................................... 15

Antidepressant, Tricyclic (Secondary Amine)Nortriptyline ............................................................................................... 11

Antidepressant, Tricyclic (Tertiary Amine)Amitriptyline .................................................................................................2Doxepin (Systemic) .....................................................................................6Imipramine .................................................................................................. 9

Antidiabetic Agent, BiguanideGlyburide and Metformin ............................................................................ 8MetFORMIN ..............................................................................................10Pioglitazone and Metformin ......................................................................12Sitagliptin and Metformin ..........................................................................14

Antidiabetic Agent, Dipeptidyl Peptidase IV (DPP-IV) InhibitorSitaGLIPtin ................................................................................................14Sitagliptin and Metformin ..........................................................................14

Antidiabetic Agent, Dopamine AgonistBromocriptine ..............................................................................................3

ANTIDIABETIC AGENT, DOPAMINE AGONIST

19

Antidiabetic Agent, Glucagon-Like Peptide-1 (GLP-1) ReceptorAgonist

Albiglutide ....................................................................................................2Exenatide .................................................................................................... 7

Antidiabetic Agent, SulfonylureaGlipiZIDE .....................................................................................................8GlyBURIDE ................................................................................................. 8Glyburide and Metformin ............................................................................ 8

Antidiabetic Agent, ThiazolidinedionePioglitazone .............................................................................................. 12Pioglitazone and Metformin ......................................................................12

AntidiarrhealBismuth Subsalicylate ................................................................................ 3Diphenoxylate and Atropine ....................................................................... 5Loperamide ............................................................................................... 10

AntidoteGlucagon .....................................................................................................8Leucovorin Calcium .................................................................................... 9

Antidote, ExtravasationNitroglycerin .............................................................................................. 11

Antidote, HypoglycemiaGlucagon .....................................................................................................8

AntiemeticDexamethasone (Systemic) ....................................................................... 5HydrOXYzine .............................................................................................. 8Meclizine ................................................................................................... 10Metoclopramide .........................................................................................11Ondansetron ............................................................................................. 12Prochlorperazine .......................................................................................13Promethazine ............................................................................................13

AntiflatulentAluminum Hydroxide, Magnesium Hydroxide, and Simethicone ..............2Simethicone .............................................................................................. 14

Antifungal Agent, Imidazole DerivativeClotrimazole (Oral) ......................................................................................4Clotrimazole (Topical) ................................................................................. 4Ketoconazole (Systemic) ............................................................................9Ketoconazole (Topical) ............................................................................... 9Miconazole (Topical) ................................................................................. 11

Antifungal Agent, OralFluconazole .................................................................................................7Griseofulvin ................................................................................................. 8Ketoconazole (Systemic) ............................................................................9Terbinafine (Systemic) .............................................................................. 14

Antifungal Agent, Oral NonabsorbedClotrimazole (Oral) ......................................................................................4Nystatin (Oral) ........................................................................................... 11

Antifungal Agent, ParenteralFluconazole .................................................................................................7

Antifungal Agent, TopicalBetamethasone and Clotrimazole ..............................................................3Ciclopirox .................................................................................................... 4Clotrimazole (Topical) ................................................................................. 4Ketoconazole (Topical) ............................................................................... 9Miconazole (Topical) ................................................................................. 11Nystatin and Triamcinolone ...................................................................... 11Nystatin (Topical) ...................................................................................... 12

Antifungal Agent, VaginalClotrimazole (Topical) ................................................................................. 4Miconazole (Topical) ................................................................................. 11

Antigout AgentAllopurinol ................................................................................................... 2Colchicine ....................................................................................................4

Antihemophilic AgentDesmopressin ............................................................................................. 5

Antihemorrhoidal AgentHydrocortisone (Topical) .............................................................................8

AntihypertensiveAmLODIPine ............................................................................................... 2Amlodipine and Benazepril ........................................................................ 2Atenolol ....................................................................................................... 2Candesartan ................................................................................................3Candesartan and Hydrochlorothiazide .......................................................3Captopril ......................................................................................................3Carvedilol .................................................................................................... 4

Chlorthalidone .............................................................................................4CloNIDine ....................................................................................................4Diltiazem ..................................................................................................... 5Doxazosin ................................................................................................... 6Felodipine ....................................................................................................7Fosinopril .....................................................................................................8Furosemide ................................................................................................. 8GuanFACINE .............................................................................................. 8HydrALAZINE ............................................................................................. 8Hydrochlorothiazide .................................................................................... 8Hydrochlorothiazide and Triamterene ........................................................ 8Indapamide ................................................................................................. 9Labetalol ......................................................................................................9Lisinopril .................................................................................................... 10Lisinopril and Hydrochlorothiazide ........................................................... 10Losartan .................................................................................................... 10Losartan and Hydrochlorothiazide ........................................................... 10Methyldopa ................................................................................................10Metoprolol ..................................................................................................11Minoxidil (Systemic) .................................................................................. 11NIFEdipine .................................................................................................11Pindolol ..................................................................................................... 12Prazosin .................................................................................................... 13Propranolol ................................................................................................13Ramipril ..................................................................................................... 13Spironolactone .......................................................................................... 14Telmisartan ................................................................................................14Telmisartan and Hydrochlorothiazide .......................................................14Terazosin ...................................................................................................14Valsartan ................................................................................................... 15Valsartan and Hydrochlorothiazide .......................................................... 15Verapamil .................................................................................................. 15

Anti-inflammatory AgentDexamethasone (Systemic) ....................................................................... 5

Anti-inflammatory, Locally AppliedCarbamide Peroxide ...................................................................................4

Antilipemic Agent, 2-AzetidinoneEzetimibe .................................................................................................... 7

Antilipemic Agent, Bile Acid SequestrantColestipol .................................................................................................... 4

Antilipemic Agent, Fibric AcidFenofibrate and Derivatives ....................................................................... 7Gemfibrozil .................................................................................................. 8

Antilipemic Agent, HMG-CoA Reductase InhibitorAtorvaSTATin .............................................................................................. 2Pravastatin ................................................................................................ 13Rosuvastatin ............................................................................................. 13Simvastatin ................................................................................................14

Antilipemic Agent, MiscellaneousNiacin .........................................................................................................11

Antilipemic Agent, Omega-3 Fatty AcidsOmega-3 Fatty Acids ................................................................................12

Antimalarial AgentAtovaquone and Proguanil .........................................................................3Chloroquine .................................................................................................4Hydroxychloroquine .................................................................................... 8Mefloquine .................................................................................................10Primaquine ................................................................................................13

Antimanic AgentLithium .......................................................................................................10RisperiDONE ............................................................................................ 13Valproic Acid and Derivatives .................................................................. 15

Antimigraine AgentDihydroergotamine ......................................................................................5Rizatriptan ................................................................................................. 13SUMAtriptan ..............................................................................................14Sumatriptan and Naproxen ...................................................................... 14ZOLMitriptan ............................................................................................. 16

Antineoplastic Agent, Alkylating AgentChlorambucil ............................................................................................... 4Cyclophosphamide ..................................................................................... 5Melphalan ..................................................................................................10

Antineoplastic Agent, Alkylating Agent (Nitrogen Mustard)Chlorambucil ............................................................................................... 4Cyclophosphamide ..................................................................................... 5Melphalan ..................................................................................................10

Antineoplastic Agent, AntiandrogenFlutamide .................................................................................................... 7

ANTIDIABETIC AGENT, GLUCAGON-LIKE PEPTIDE-1 (GLP-1) RECEPTOR AGONIST

20

Antineoplastic Agent, AntimetaboliteFluorouracil (Topical) .................................................................................. 7Mercaptopurine ......................................................................................... 10

Antineoplastic Agent, Antimetabolite (Antifolate)Methotrexate ............................................................................................. 10

Antineoplastic Agent, Antimetabolite (Purine Analog)Mercaptopurine ......................................................................................... 10

Antineoplastic Agent, Antimetabolite (Pyrimidine Analog)Fluorouracil (Topical) .................................................................................. 7

Antineoplastic Agent, Estrogen Receptor AntagonistTamoxifen ..................................................................................................14

Antineoplastic Agent, Gonadotropin-Releasing Hormone AgonistLeuprolide ................................................................................................... 9

Antineoplastic Agent, HormoneMegestrol .................................................................................................. 10

Antineoplastic Agent, MiscellaneousHydroxyurea ................................................................................................8

Antiparasitic Agent, TopicalPermethrin .................................................................................................12

Anti-Parkinson's Agent, AnticholinergicBenztropine .................................................................................................3Trihexyphenidyl .........................................................................................15

Anti-Parkinson's Agent, Decarboxylase InhibitorCarbidopa and Levodopa ...........................................................................4

Anti-Parkinson's Agent, Dopamine AgonistAmantadine .................................................................................................2Bromocriptine ..............................................................................................3Pramipexole .............................................................................................. 13ROPINIRole .............................................................................................. 13

Anti-Parkinson's Agent, Dopamine PrecursorCarbidopa and Levodopa ...........................................................................4

Antiplatelet AgentAspirin ......................................................................................................... 2Aspirin and Dipyridamole ........................................................................... 2Clopidogrel .................................................................................................. 4Dipyridamole ............................................................................................... 5

Antiplatelet Agent, ThienopyridineClopidogrel .................................................................................................. 4

Antiprotozoal, NitroimidazoleMetroNIDAZOLE (Systemic) .....................................................................11

Antirheumatic, Disease ModifyingMethotrexate ............................................................................................. 10

Antirheumatic MiscellaneousCyclophosphamide ..................................................................................... 5

Antispasmodic Agent, GastrointestinalClidinium and Chlordiazepoxide .................................................................4Hyoscyamine, Atropine, Scopolamine, and Phenobarbital ....................... 9

Antispasmodic Agent, UrinaryOxybutynin ................................................................................................ 12

Antithyroid AgentMethimazole ..............................................................................................10Propylthiouracil ......................................................................................... 13

Antitubercular AgentEthambutol .................................................................................................. 6Isoniazid ...................................................................................................... 9Pyrazinamide ............................................................................................ 13Rifampin .................................................................................................... 13

AntitussiveBenzonatate ................................................................................................3Brompheniramine, Pseudoephedrine, and Dextromethorphan .................3Codeine .......................................................................................................4Guaifenesin and Codeine ...........................................................................8Guaifenesin and Dextromethorphan .......................................................... 8Hydrocodone and Homatropine ................................................................. 8

Antiviral AgentAcyclovir (Systemic) ................................................................................... 2Amantadine .................................................................................................2Oseltamivir ................................................................................................ 12ValACYclovir ............................................................................................. 15

Antiviral Agent, AdamantaneAmantadine .................................................................................................2

Antiviral Agent, OphthalmicTrifluridine ..................................................................................................15

Antiviral Agent, OralValACYclovir ............................................................................................. 15

Antiviral Agent, TopicalAcyclovir (Topical) .......................................................................................2

Appetite StimulantMegestrol .................................................................................................. 10

BarbiturateButalbital, Acetaminophen, and Caffeine ...................................................3Butalbital, Aspirin, and Caffeine .................................................................3PHENobarbital .......................................................................................... 12Primidone .................................................................................................. 13

BenzodiazepineALPRAZolam .............................................................................................. 2ChlordiazePOXIDE ..................................................................................... 4Clidinium and Chlordiazepoxide .................................................................4ClonazePAM ............................................................................................... 4Diazepam .................................................................................................... 5LORazepam ..............................................................................................10Temazepam .............................................................................................. 14Triazolam ...................................................................................................15

Beta2-Adrenergic AgonistIpratropium and Albuterol ........................................................................... 9

Beta2-Adrenergic Agonist, Long-ActingFluticasone and Salmeterol ........................................................................7Salmeterol ................................................................................................. 14

Beta2 AgonistAlbuterol ...................................................................................................... 2Fluticasone and Salmeterol ........................................................................7Levalbuterol .................................................................................................9Salmeterol ................................................................................................. 14

Beta-Adrenergic Blocker, NonselectiveDorzolamide and Timolol ............................................................................5Levobunolol ...............................................................................................10Propranolol ................................................................................................13Sotalol ....................................................................................................... 14

Beta-Blocker, Beta-1 SelectiveAtenolol ....................................................................................................... 2Metoprolol ..................................................................................................11

Beta-Blocker, NonselectiveBrimonidine and Timolol .............................................................................3Timolol (Ophthalmic) .................................................................................15

Beta-Blocker With Alpha-Blocking ActivityCarvedilol .................................................................................................... 4Labetalol ......................................................................................................9

Beta-Blocker With Intrinsic Sympathomimetic ActivityPindolol ..................................................................................................... 12

Bisphosphonate DerivativeAlendronate .................................................................................................2Ibandronate ................................................................................................. 9

Blood Viscosity Reducer AgentPentoxifylline .............................................................................................12

Calcineurin InhibitorCycloSPORINE (Ophthalmic) .....................................................................5Pimecrolimus ............................................................................................ 12

Calcium Channel BlockerAmLODIPine ............................................................................................... 2Amlodipine and Benazepril ........................................................................ 2Diltiazem ..................................................................................................... 5Felodipine ....................................................................................................7NIFEdipine .................................................................................................11Verapamil .................................................................................................. 15

Calcium Channel Blocker, DihydropyridineAmLODIPine ............................................................................................... 2Amlodipine and Benazepril ........................................................................ 2Felodipine ....................................................................................................7NIFEdipine .................................................................................................11

Calcium Channel Blocker, NondihydropyridineDiltiazem ..................................................................................................... 5Verapamil .................................................................................................. 15

Carbonic Anhydrase InhibitorAcetaZOLAMIDE ........................................................................................ 2

CARBONIC ANHYDRASE INHIBITOR

21

Carbonic Anhydrase Inhibitor (Ophthalmic)Dorzolamide ................................................................................................5Dorzolamide and Timolol ............................................................................5

Cardiac GlycosideDigoxin ........................................................................................................ 5

CatharticSodium Phosphates ................................................................................. 14

Central Nervous System StimulantDexmethylphenidate ................................................................................... 5Dextroamphetamine ....................................................................................5Dextroamphetamine and Amphetamine .................................................... 5Methylphenidate ........................................................................................10

Chelating AgentPenicillAMINE ........................................................................................... 12

Chemotherapy Modulating AgentLeucovorin Calcium .................................................................................... 9

Chloride Channel ActivatorLubiprostone ............................................................................................. 10

ContraceptiveEthinyl Estradiol and Desogestrel ..............................................................6Ethinyl Estradiol and Drospirenone ........................................................... 6Ethinyl Estradiol and Ethynodiol Diacetate ................................................6Ethinyl Estradiol and Etonogestrel .............................................................6Ethinyl Estradiol and Levonorgestrel ......................................................... 6Ethinyl Estradiol and Norelgestromin .........................................................6Ethinyl Estradiol and Norethindrone .......................................................... 6Ethinyl Estradiol and Norgestimate ............................................................7Ethinyl Estradiol and Norgestrel .................................................................7Etonogestrel ................................................................................................7Levonorgestrel (IUD) ................................................................................ 10Levonorgestrel (Systemic) ........................................................................10MedroxyPROGESTERone ....................................................................... 10Norethindrone ............................................................................................11

Corticosteroid, Inhalant (Oral)Budesonide (Oral Inhalation) ......................................................................3Fluticasone and Salmeterol ........................................................................7Fluticasone (Oral Inhalation) ...................................................................... 8

Corticosteroid, NasalFluticasone (Nasal) .....................................................................................8Mometasone (Nasal) .................................................................................11

Corticosteroid, OphthalmicBacitracin, Neomycin, Polymyxin B, and Hydrocortisone (Ophthalmic) ...3Fluorometholone ......................................................................................... 7Loteprednol ............................................................................................... 10PrednisoLONE (Ophthalmic) ....................................................................13

Corticosteroid, OticNeomycin, Polymyxin B, and Hydrocortisone (Otic) ............................... 11

Corticosteroid, RectalHydrocortisone (Topical) .............................................................................8

Corticosteroid, SystemicBetamethasone (Systemic) ........................................................................ 3Cortisone .....................................................................................................4Dexamethasone (Systemic) ....................................................................... 5Fludrocortisone ........................................................................................... 7Hydrocortisone (Systemic) ......................................................................... 8MethylPREDNISolone ...............................................................................11PrednisoLONE (Systemic) ....................................................................... 13PredniSONE ............................................................................................. 13

Corticosteroid, TopicalBetamethasone and Clotrimazole ..............................................................3Betamethasone (Topical) ............................................................................3Clobetasol ................................................................................................... 4Desonide ..................................................................................................... 5Desoximetasone ......................................................................................... 5Fluocinolone (Topical) .................................................................................7Fluocinonide ................................................................................................7Hydrocortisone (Topical) .............................................................................8Nystatin and Triamcinolone ...................................................................... 11Triamcinolone (Topical) .............................................................................15

Cough PreparationGuaifenesin and Codeine ...........................................................................8Guaifenesin and Dextromethorphan .......................................................... 8

DecongestantBrompheniramine, Pseudoephedrine, and Dextromethorphan .................3Fexofenadine and Pseudoephedrine ......................................................... 7Oxymetazoline (Nasal) ............................................................................. 12

Pseudoephedrine ......................................................................................13Triprolidine and Pseudoephedrine ........................................................... 15

Depigmenting AgentHydroquinone ..............................................................................................8

DeviceSyringe ...................................................................................................... 14

Diagnostic AgentGlucagon .....................................................................................................8

Diagnostic Agent, OphthalmicHydroxypropyl Methylcellulose ...................................................................8

Diuretic, Carbonic Anhydrase InhibitorAcetaZOLAMIDE ........................................................................................ 2

Diuretic, LoopFurosemide ................................................................................................. 8

Diuretic, Potassium-SparingHydrochlorothiazide and Triamterene ........................................................ 8Spironolactone .......................................................................................... 14

Diuretic, ThiazideCandesartan and Hydrochlorothiazide .......................................................3Hydrochlorothiazide .................................................................................... 8Hydrochlorothiazide and Triamterene ........................................................ 8Lisinopril and Hydrochlorothiazide ........................................................... 10Losartan and Hydrochlorothiazide ........................................................... 10Telmisartan and Hydrochlorothiazide .......................................................14Valsartan and Hydrochlorothiazide .......................................................... 15

Diuretic, Thiazide-RelatedChlorthalidone .............................................................................................4Indapamide ................................................................................................. 9Metolazone ................................................................................................11

Electrolyte Supplement, OralMagnesium Oxide .....................................................................................10Potassium Chloride .................................................................................. 13

Electrolyte Supplement, ParenteralPotassium Chloride .................................................................................. 13Sodium Chloride ....................................................................................... 14Sodium Phosphates ................................................................................. 14

EnzymePancrelipase ............................................................................................. 12

Ergot DerivativeBromocriptine ..............................................................................................3Dihydroergotamine ......................................................................................5

Estrogen and Androgen CombinationEstrogens (Esterified) and Methyltestosterone ..........................................6

Estrogen and Progestin CombinationEstrogens (Conjugated/Equine) and Medroxyprogesterone ..................... 6Ethinyl Estradiol and Desogestrel ..............................................................6Ethinyl Estradiol and Drospirenone ........................................................... 6Ethinyl Estradiol and Ethynodiol Diacetate ................................................6Ethinyl Estradiol and Etonogestrel .............................................................6Ethinyl Estradiol and Levonorgestrel ......................................................... 6Ethinyl Estradiol and Norelgestromin .........................................................6Ethinyl Estradiol and Norethindrone .......................................................... 6Ethinyl Estradiol and Norgestimate ............................................................7Ethinyl Estradiol and Norgestrel .................................................................7

Estrogen DerivativeEstradiol (Systemic) ....................................................................................6Estradiol (Topical) ....................................................................................... 6Estrogens (Conjugated/Equine, Systemic) ................................................ 6Estrogens (Conjugated/Equine, Topical) ....................................................6

Ethanolamine DerivativeDiphenhydrAMINE (Systemic) ....................................................................5

ExpectorantGuaiFENesin ...............................................................................................8Guaifenesin and Codeine ...........................................................................8Guaifenesin and Dextromethorphan .......................................................... 8Guaifenesin and Pseudoephedrine ............................................................8

First Generation (Typical) AntipsychoticHaloperidol .................................................................................................. 8Prochlorperazine .......................................................................................13Thioridazine ...............................................................................................15

GABA AnalogGabapentin ..................................................................................................8

CARBONIC ANHYDRASE INHIBITOR (OPHTHALMIC)

22

Gastrointestinal Agent, MiscellaneousLubiprostone ............................................................................................. 10Sucralfate .................................................................................................. 14

Gastrointestinal Agent, ProkineticMetoclopramide .........................................................................................11

Genitourinary IrrigantSodium Chloride ....................................................................................... 14Sorbitol ...................................................................................................... 14

Gonadotropin Releasing Hormone AgonistLeuprolide ................................................................................................... 9

Hemostatic AgentAluminum Chloride Hexahydrate ............................................................... 2Desmopressin ............................................................................................. 5

Histamine H1 AntagonistAzelastine (Nasal) .......................................................................................3Brompheniramine, Pseudoephedrine, and Dextromethorphan .................3Cetirizine ..................................................................................................... 4Chlorpheniramine ........................................................................................4Cyproheptadine ...........................................................................................5DiphenhydrAMINE (Systemic) ....................................................................5Fexofenadine .............................................................................................. 7Fexofenadine and Pseudoephedrine ......................................................... 7HydrOXYzine .............................................................................................. 8Ketotifen (Ophthalmic) ................................................................................9Loratadine ................................................................................................. 10Meclizine ................................................................................................... 10Naphazoline and Pheniramine ................................................................. 11Olopatadine (Ophthalmic) .........................................................................12Promethazine ............................................................................................13Triprolidine and Pseudoephedrine ........................................................... 15

Histamine H1 Antagonist, First GenerationBrompheniramine, Pseudoephedrine, and Dextromethorphan .................3Chlorpheniramine ........................................................................................4Cyproheptadine ...........................................................................................5DiphenhydrAMINE (Systemic) ....................................................................5HydrOXYzine .............................................................................................. 8Meclizine ................................................................................................... 10Naphazoline and Pheniramine ................................................................. 11Promethazine ............................................................................................13Triprolidine and Pseudoephedrine ........................................................... 15

Histamine H1 Antagonist, Second GenerationAzelastine (Nasal) .......................................................................................3Cetirizine ..................................................................................................... 4Fexofenadine .............................................................................................. 7Fexofenadine and Pseudoephedrine ......................................................... 7Ketotifen (Ophthalmic) ................................................................................9Loratadine ................................................................................................. 10Olopatadine (Ophthalmic) .........................................................................12

Histamine H2 AntagonistRanitidine .................................................................................................. 13

Histone Deacetylase InhibitorValproic Acid and Derivatives .................................................................. 15

Hormone, Posterior PituitaryDesmopressin ............................................................................................. 5

Hypnotic, MiscellaneousEszopiclone .................................................................................................6Zaleplon .................................................................................................... 15Zolpidem ................................................................................................... 16

Imidazoline DerivativeNaphazoline and Pheniramine ................................................................. 11Oxymetazoline (Nasal) ............................................................................. 12

Immunosuppressant AgentAzaTHIOprine ............................................................................................. 3Cyclophosphamide ..................................................................................... 5CycloSPORINE (Ophthalmic) .....................................................................5Mercaptopurine ......................................................................................... 10Methotrexate ............................................................................................. 10Mycophenolate ..........................................................................................11Pimecrolimus ............................................................................................ 12

Inhalation, MiscellaneousInhalation Devices ...................................................................................... 9

Insulin, CombinationInsulin Aspart Protamine and Insulin Aspart ............................................. 9Insulin NPH and Insulin Regular ................................................................9

Insulin, Intermediate-ActingInsulin NPH .................................................................................................9

Insulin, Long-ActingInsulin Detemir ............................................................................................ 9Insulin Glargine ...........................................................................................9

Insulin, Rapid-ActingInsulin Aspart .............................................................................................. 9

Insulin, Short-ActingInsulin Regular ............................................................................................ 9

Iron SaltFerrous Sulfate ........................................................................................... 7

IrrigantSodium Chloride ....................................................................................... 14

Keratolytic AgentPodofilox ................................................................................................... 12Salicylic Acid .............................................................................................13

Laxative, Bowel EvacuantSodium Phosphates ................................................................................. 14

Laxative, OsmoticLactulose .....................................................................................................9Polyethylene Glycol 3350 .........................................................................12Polyethylene Glycol-Electrolyte Solution ................................................. 12Sorbitol ...................................................................................................... 14

Laxative, SalineMagnesium Citrate ....................................................................................10

Laxative, StimulantBisacodyl .....................................................................................................3

Leukotriene-Receptor AntagonistMontelukast ............................................................................................... 11

Local AnestheticLidocaine (Topical) ....................................................................................10

Local Anesthetic, OphthalmicProparacaine .............................................................................................13

Lubricant, OcularHydroxypropyl Methylcellulose ...................................................................8Sodium Chloride ....................................................................................... 14

Magnesium SaltMagnesium Citrate ....................................................................................10Magnesium Oxide .....................................................................................10

Mast Cell StabilizerKetotifen (Ophthalmic) ................................................................................9

Mineralocorticoid (Aldosterone) Receptor AntagonistsSpironolactone .......................................................................................... 14

Miscellaneous ProductDiabetic Supplies ........................................................................................5

Neuraminidase InhibitorOseltamivir ................................................................................................ 12

Nonsteroidal Anti-inflammatory Drug (NSAID)Diclofenac (Systemic) .................................................................................5Diclofenac (Topical) .................................................................................... 5

Nonsteroidal Anti-inflammatory Drug (NSAID), COX-2 SelectiveCelecoxib .................................................................................................... 4

Nonsteroidal Anti-inflammatory Drug (NSAID), OralAspirin ......................................................................................................... 2Diclofenac (Systemic) .................................................................................5Etodolac ...................................................................................................... 7Ibuprofen ..................................................................................................... 9Indomethacin ...............................................................................................9Ketorolac (Systemic) ...................................................................................9Meloxicam .................................................................................................10Nabumetone ..............................................................................................11Naproxen ...................................................................................................11Piroxicam .................................................................................................. 12Sulindac .................................................................................................... 14Sumatriptan and Naproxen ...................................................................... 14

Nonsteroidal Anti-inflammatory Drug (NSAID), ParenteralIbuprofen ..................................................................................................... 9Indomethacin ...............................................................................................9Ketorolac (Systemic) ...................................................................................9

Nonsteroidal Anti-inflammatory Drug (NSAID), TopicalDiclofenac (Topical) .................................................................................... 5

Norepinephrine Reuptake Inhibitor, SelectiveAtoMOXetine ...............................................................................................2

NOREPINEPHRINE REUPTAKE INHIBITOR, SELECTIVE

23

Nutritional SupplementFluoride ....................................................................................................... 7

Ophthalmic Agent, AntiglaucomaAcetaZOLAMIDE ........................................................................................ 2Bimatoprost ................................................................................................. 3Brimonidine and Timolol .............................................................................3Brimonidine (Ophthalmic) ........................................................................... 3Dorzolamide ................................................................................................5Dorzolamide and Timolol ............................................................................5Latanoprost ................................................................................................. 9Levobunolol ...............................................................................................10Phenylephrine (Ophthalmic) .....................................................................12Pilocarpine (Ophthalmic) .......................................................................... 12Timolol (Ophthalmic) .................................................................................15

Ophthalmic Agent, MioticPilocarpine (Ophthalmic) .......................................................................... 12

Ophthalmic Agent, MiscellaneousArtificial Tears ..............................................................................................2Carboxymethylcellulose ..............................................................................4Ophthalmic Irrigant Mixture ...................................................................... 12

Ophthalmic Agent, MydriaticPhenylephrine (Ophthalmic) .....................................................................12Tropicamide .............................................................................................. 15

Ophthalmic Agent, VasoconstrictorNaphazoline and Pheniramine ................................................................. 11

Otic Agent, AnalgesicAntipyrine and Benzocaine ........................................................................ 2

Otic Agent, Anti-infectiveAcetic Acid (Otic) ........................................................................................ 2

Otic Agent, CerumenolyticAntipyrine and Benzocaine ........................................................................ 2Carbamide Peroxide ...................................................................................4

Partial Nicotine AgonistVarenicline .................................................................................................15

PediculocidePermethrin .................................................................................................12

Phenothiazine DerivativePromethazine ............................................................................................13

Phosphodiesterase-5 Enzyme InhibitorSildenafil ....................................................................................................14

Phosphodiesterase Enzyme Inhibitor, NonselectiveTheophylline ..............................................................................................15

Piperazine DerivativeCetirizine ..................................................................................................... 4HydrOXYzine .............................................................................................. 8Meclizine ................................................................................................... 10

Piperidine DerivativeCyproheptadine ...........................................................................................5Fexofenadine .............................................................................................. 7Fexofenadine and Pseudoephedrine ......................................................... 7Ketotifen (Ophthalmic) ................................................................................9Loratadine ................................................................................................. 10Olopatadine (Ophthalmic) .........................................................................12

ProgestinEtonogestrel ................................................................................................7Levonorgestrel (IUD) ................................................................................ 10Levonorgestrel (Systemic) ........................................................................10MedroxyPROGESTERone ....................................................................... 10Megestrol .................................................................................................. 10Norethindrone ............................................................................................11

Prostaglandin, OphthalmicBimatoprost ................................................................................................. 3Latanoprost ................................................................................................. 9

Proton Pump InhibitorEsomeprazole ............................................................................................. 6Omeprazole ...............................................................................................12Pantoprazole .............................................................................................12

Rescue Agent (Chemotherapy)Leucovorin Calcium .................................................................................... 9

Retinoic Acid DerivativeTretinoin (Topical) ..................................................................................... 15

SalicylateAspirin ......................................................................................................... 2Salsalate ................................................................................................... 14

Scabicidal AgentPermethrin .................................................................................................12

Second Generation (Atypical) AntipsychoticARIPiprazole ............................................................................................... 2QUEtiapine ................................................................................................13RisperiDONE ............................................................................................ 13Ziprasidone ............................................................................................... 15

Selective 5-HT3 Receptor AntagonistOndansetron ............................................................................................. 12

Selective Estrogen Receptor Modulator (SERM)Raloxifene ................................................................................................. 13Tamoxifen ..................................................................................................14

Serotonin 5-HT1B, 1D Receptor AgonistRizatriptan ................................................................................................. 13SUMAtriptan ..............................................................................................14Sumatriptan and Naproxen ...................................................................... 14ZOLMitriptan ............................................................................................. 16

Skeletal Muscle RelaxantBaclofen ...................................................................................................... 3Cyclobenzaprine ......................................................................................... 5Methocarbamol ......................................................................................... 10

Skin and Mucous Membrane AgentImiquimod ....................................................................................................9

Skin and Mucous Membrane Agent, MiscellaneousEmollients ....................................................................................................6

Smoking Cessation AidBuPROPion .................................................................................................3Nicotine ..................................................................................................... 11Varenicline .................................................................................................15

Sodium SaltSodium Chloride ....................................................................................... 14

Stool SoftenerDocusate ..................................................................................................... 5

Substituted BenzimidazoleEsomeprazole ............................................................................................. 6Omeprazole ...............................................................................................12Pantoprazole .............................................................................................12

ThioamideMethimazole ..............................................................................................10Propylthiouracil ......................................................................................... 13

Thyroid ProductLevothyroxine ............................................................................................10

Topical Skin ProductAluminum Chloride Hexahydrate ............................................................... 2Benzoyl Peroxide ........................................................................................3Clindamycin and Benzoyl Peroxide ........................................................... 4Emollients ....................................................................................................6Fluorouracil (Topical) .................................................................................. 7Imiquimod ....................................................................................................9Lactic Acid and Ammonium Hydroxide ......................................................9Pimecrolimus ............................................................................................ 12Podofilox ................................................................................................... 12Selenium Sulfide .......................................................................................14

Topical Skin Product, AcneAdapalene ...................................................................................................2Azelaic Acid ................................................................................................ 3Benzoyl Peroxide ........................................................................................3Clindamycin and Benzoyl Peroxide ........................................................... 4Clindamycin (Topical) ................................................................................. 4Salicylic Acid .............................................................................................13Tretinoin (Topical) ..................................................................................... 15

Uricosuric AgentProbenecid ................................................................................................13

VasodilatorDipyridamole ............................................................................................... 5HydrALAZINE ............................................................................................. 8Isosorbide Dinitrate .....................................................................................9Isosorbide Mononitrate ............................................................................... 9Nitroglycerin .............................................................................................. 11

Vasodilator, Direct-ActingMinoxidil (Systemic) .................................................................................. 11

NUTRITIONAL SUPPLEMENT

24

Vasopressin Analog, Synthetic

Desmopressin ............................................................................................. 5

Vitamin

Vitamins (Multiple/Pediatric) ..................................................................... 15

Vitamins (Multiple/Prenatal) ......................................................................15

Vitamin D Analog

Calcitriol ...................................................................................................... 3

Cholecalciferol ............................................................................................ 4

Ergocalciferol .............................................................................................. 6

Vitamin, Water Soluble

Cyanocobalamin ......................................................................................... 4

Folic Acid .................................................................................................... 8

Leucovorin Calcium .................................................................................... 9

Niacin .........................................................................................................11

Pyridoxine ................................................................................................. 13

Xanthine Oxidase Inhibitor

Allopurinol ................................................................................................... 2

XANTHINE OXIDASE INHIBITOR

25