Andersen AFB Pharmacy Formulary

							Andersen AFB Pharmacy Formulary Medication Listing (P & T Approved as of 17 April 2008)

Team Andersen: “One Team -- No Seams” Dear Pharmacy Patron, The enclosed formulary (drug) list has been developed to assist you and your provider (a licensed Doctor/Physician, Physician Assistant, or Nurse Practitioner) when using the Andersen AFB Pharmacy. The formulary lists those medications stocked by the Andersen pharmacy. Additionally, some important pharmacy policies are described below. Please share this reference with your provider when prescriptions are written. Use of this reference will minimize inconvenience to you and to your provider, and it will help us in our efforts to provide you with a convenient, efficient pharmacy service. We appreciate your help. U.S. Drug Control laws, the Department of Defense (DoD), and the United States Air Force (USAF) regulate the service we provide. The Andersen AFB Pharmacy and Therapeutics (P&T) Committee establishes policy that further defines our service. This may result in formulary medication list changes. Additionally, while we are not specifically bound by state pharmacy practice regulations, we do try to maintain our practice in conformity with them. Some unique and important regulations and policies are listed below for your reference: USAF pharmacies are permitted to fill prescriptions written by civilian providers for drugs that are routinely stocked. The formulary defines the list of routinely stocked drugs, which are selected and periodically reviewed by the P&T Committee. We are not authorized to purchase non-stocked drugs to fill prescriptions from civilian providers. Generic equivalent drugs are used to the maximum extent possible. USAF regulations authorize pharmacy personnel to automatically substitute generic equivalent drugs, when brand name drugs are prescribed by military providers. For prescriptions written by civilian providers we will substitute, in accordance with applicable state law. Ask your provider to allow us the opportunity to dispense a generic equivalent product, whenever possible. The pharmacy cannot fill prescriptions marked “do not substitute” or “dispense as written” when the continuing availability of the brand name product cannot be guaranteed. As with drugs that are not routinely stocked, we are not permitted to purchase brand name drugs to fill prescriptions when a generic equivalent product is stocked. Please also note that injectable/diagnostic/antidote/etc. medications listed are for clinic use only. FOR THE PRESCRIBER: Dear Provider, Please remember to include your DEA number on all prescriptions for controlled drugs as well as your signature. If your name and phone number are not pre-printed on the prescription form, please include these also. Prescriptions must be written legibly in ink, or typewritten, and must be hand signed in ink. Prescriptions with stamped or facsimile signatures cannot be filled. Additionally, we ask that prescriptions for controlled substances be written separately from non-controlled substances, and that prescriptions for Schedule II drugs be written separate from those in Schedule III, IV, or V. Preferably write only one item per prescription. Due to the limited number of pharmacists assigned, and high prescription volume, we are unable to accept prescriptions by phone or facsimile transmission. Hours of Operations: Monday - Friday 0800 – 1700 (Closed: Weekends, training days and holidays) Pharmacy Telephone Numbers: Automated call-in refill number: (671) 344-9620 Andersen Main Pharmacy: (671) 366-5271 US Naval Hospital Guam Main Pharmacy: (671) 344-9265

Please feel free to contact one of our members at the numbers listed above if we can be of assistance. Sincerely, Scott E. Olech, R.Ph. SCOTT E. OLECH, Major, USAF, BSC Diagnostics and Therapeutics Flight Commander

Andersen AFB Formulary List Updated Version 17 April 2008 Accu-Chek® Soft Touch Lancets 200’s Acetaminophen (Tylenol®) 100mg/ml drops 15ml Acetaminophen (Tylenol®) 160mg/5ml elixir 120ml Acetaminophen (Tylenol®) 325mg tablets Acetaminophen (Tylenol®)120mg suppositories Acetylcysteine (Mucomust® - APAP OD) Activated Charcoal Suspension Acyclovir (Zovirax®) 200mg capsules Acyclovir (Zovirax®) 200mg/5ml Oral Suspension Acyclovir (Zovirax®) 800mg tablets Adapalene (Differin) 0.1% gel Adderall XR (Amphetamine extended release) tablets Adderall® (Amphetamine salts) 10mg tablets (CII) Adderall® (Amphetamine salts) 20mg tablets (CII) Adenosine 6mg/2ml injection 2ml vial Advair® (Fluticasone/salmeterol) Oral Inhaler 100/50 Advair® (Fluticasone/salmeterol) Oral Inhaler 250/50 Advair® (Fluticasone/salmeterol) Oral Inhaler 500/50 Aerochamber Albuterol (Proventil®) 0.5% Inhalation Solution Albuterol (Proventil®) 2.5mg/3ml pre-mix Albuterol (Proventil®) Oral Inhaler Alcohol pads #200 per box Alendronate (Fosamax®) 10mg tablets Alendronate (Fosamax®) 70mg tablets (Once a Week) Alendronate (Fosamax®) 70mg tablets plus D (Once a Week) Alfuzosin (Uroxatral) 10mg Allopurinol (Zyloprim®) 100mg tablets Allopurinol (Zyloprim®) 300mg tablets Alprazolam (Xanax®) 0.5mg tablets (CIV) Aluminum Acetate (Domeboro®) Eff. tablets Aluminum Chloride Hexahydrate (Drysol®) Antiseptic Solution 37.5ml (For in-Clinic Use Only) Amantadine (Symmetrel®) 100mg capsules Aminophylline 25mg/ml inj 10ml bristoject Amiodarone 200 mg tablets Amiodarone 50mg/ml Injection 1ml vial Amitriptyline (Elavil®) 100mg tablets Amitriptyline (Elavil®) 25mg tablets Amitryptiline (Elavil) 10mg tablets Amlodipine (Norvasc) 10mg tablets Ammonium lactate (Lac-Hydrin®) 12% lotion 225gm Amoxicillin (Amoxil®) 250mg capsules Amoxicillin (Amoxil®) 250mg/5ml Suspension 150ml Amoxicillin (Amoxil®) 500mg capsules Amoxicillin 400/ 5 ml suspension 200ml Amoxicillin 400mg chewable tablets Antivenin Polyvalent (Crotalidae® - Pit viper bites) Aquaphor ointment Aricept 5mg and 10mg tablets Artificial tears 1.4% Aspirin (Enteric Coated) 325mg tablets Aspirin Lo-dose 81mg tablets Atenolol (Tenormin®) 100mg tablets Atenolol (Tenormin®) 50mg tablets Atropine 0.1mg/ml injection 10ml bristoject (Organophosphate/carbamate insecticides, & Muscarine) Augmentin ES 600mg suspension Augmentin® (Amox/K Clavulanate) 875 mg tablets Augmentin® 400mg/5ml Suspension 100ml bottle Auralgan® Otic solution Avandamet 1/500 mg tablets Azithromycin (Zithromax®) 200mg/5ml 15ml & 30ml Azithromycin (Zithromax®) 250mg tablets Bacitracin Ointment 15gram Bactrim® DS (Trimethazole/Sulf) tablets Benzoil peroxide 5% gel Benzonatate (Tessalon®) 100mg perles Benztropine 1 mg tablets Betamethasone Valerate (Valisone®) 0.1% cr 45gr Bisacodyl (Dulcolax®) 5mg tablets Bisacodyl 10mg Suppositories Bretylium Tosylate 50mg/ml inj 10ml bristoject Brimonidine (Alphagan-P®) Ophth Soln Bupivacaine (Marcaine®) 0.25% inj 50ml vial Bupropion 100mg tablets Bupropion 75mg tablets Buproprion (Wellbutrin®) 150mg SR tablets Buproprion (Zyban) 150mg (Smoking Program Only) Buspirone (Buspar®) 10mg tablets Cafergot® (Ergotamine/Caffeine) tablets Calcium Chloride 10% injection 10ml bristoject Calcium Gluconate Injection Calcium w/ vitamin D 600mg/ 200IU Captopril (Capoten®) 25mg tablets Carbamazepine (Tegretol®) 100mg chewable tablets Carbamazepine (Tegretol®) 200mg tablets Carvedilol (Coreg®) 6.25mg and 25mg tablets Cefpodoxime (Vantin®) 100mg/5ml 100ml bottle Ceftriaxone (Rocephin®) 1gm vial Ceftriaxone (Rocephin®) 250mg vial Celluvisc® Ophth Solution Cephalexin (Keflex®) 250mg and 500mg capsules Cephalexin (Keflex®) 250mg/5ml Suspension 200ml Cetirizine (Zyrtec®) 10mg tablet Cetirizine (Zyrtec®) 5mg/5ml liquid Cetaphil® lotion clenaser 473ml Chlorhexidine Gluconate 0.12% oral rinse (Peridex®) Chlorpheniramine (CTM) 2mg/5ml syrup 120ml bottle Chlorpheniramine (CTM) 4mg tablets Chlorthalidone 50 mg tablets Cimetidine (Tagamet®) 300mg/5ml syrup Cimetidine (Tagamet®) 400mg tablets Ciprofloxacin (Ciloxan®) Ophth Sol 0.3% Ciprofloxacin (Cipro) 500mg tablets Citalopram (Celexa®) 20mg tablets Clarithromycin (Biaxin) 500mg Clindamycin (Cleocin®) 150mg capsules Clindamycin (Cleocin®) Injection 600mg/4ml Clindamycin (Cleocin-T® ) 1% Gel 30gm Clindamycin (Cleocin-T® ) Solution 60ml Clindamycin Vaginal Cream Clobetasol (Temovate®) .05% Cream Clonazepam (Klonopin®) 0.5mg tablets (CIV) Clonazepam (Klonopin®) 1mg tablets (CIV) Clonidine (Catapres®) 0.1mg tablets Clopidogrel (Plavix®) 75mg tablet Clotrimazole (Lotrimin®) 1% Cream 30gm tube Clotrimazole (Mycelex®) 1% Solution 10ml bottle Clotrimazole (Mycelex-7®) 1% Vaginal Cream 45gm

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Coal Tar Shampoo Colchicine 0.6mg tablets Colestipol (Colestid®) 1gram tablets Colestipol (Colestid®) 5gram packets Combivent® (Ipratropium/albuterol sulfate) Inhaler Cortisporin® otic suspension Cromolyn Sodium (Intal®) 14.2gm Oral Inhaler Cromolyn Sodium (Intal®) Inhalation Solution Cyanocobalamin 1mg/ml (Vit B12) inj 10ml vial Cyclobenzaprine (Flexeril®)10mg tablets Cylclopentolate (Cyclogyl®) 1% Ophth Sol Cyproheptadine (Periactin®) 4mg tablets Dacriose® Ophth Sol (Eye Wash) Darvocet® (Propoxy/APAP) N-100 tablets (CIV) Debrox® ear drops Deconamine® (CTM/Sudafed) SR capsules Deferoxamine (Desferal® - Iron poisonings) Desogen (desogestrel/ethinyl estradiol) Dexamethasone (Decadron®) 4mg/ml 5ml vial Dexamethasone .5mg/5ml Elixir Dextroamphetamine (Dexedrine) 10mg tabs (flight crew only) Dextrose 50% injection 50ml bristoject Diazepam (Valium®) 5mg tablets (CIV) Dicloxacillin (Dynapen®) 250mg capsules Dicyclomine (Bentyl®) 20mg tablets Digoxin (Lanoxin®) 0.25mg tablets Digoxin 250mg/ml injection 2ml ampule Dihydroergotamine (DHE) 1mg/ml ampule Dihydroergotamine (Migranal®) Nasal Spray (in-house use only) Diltiazem (Cardizem®) 60mg tablets Diltiazem (Tiazac®) 180mg XR caplets Diltiazem (Tiazac®) 240mg XR caplets Dimercaprol (Bal in oil – Arsenic, lead, mercury, gold, trivalent antimony, methyl br, methyl iodide poison) Diphenhydramine (Benadryl®) 12.5mg/ml 120ml Diphenhydramine (Benadryl®) 25mg capsules Diphenhydramine 50mg/ml injection syringe Divalproex Sodium (Depakote®) 250mg tablets Divalproex Sodium (Depakote®) ER 500mg tablets Docusate Sodium (Colace®) 100mg capsules Docusate Sodium (Colace®) 20mg/5ml syrup Domeboro® Otic solution Donepezil 10 mg tablets Donnatol® Elixir 120ml bottle Dopamine 40mg/ml injection 5ml vial Doxepin (Sinequan®) 25mg capsules Doxycycline (Vibramycin®) 100mg capsules Doxycycline (Vibramycin®) 100mg tablets D-penicillamine (Cuprimine® - Arsenic, lead, poison) E.E.S.® granules 200mg/5ml Suspension 200ml bottle Elidel cream Elocon (Mometasone furoate) Cream EMLA cream Epinephrine 1:10,000 injection 10ml bristoject Epinephrine 1:1000 Inj Anaphylaxis Kit (Ana-Kit®) Epinephrine 1:1000 injection 1ml tubex Epinephrine Auto-Injector 0.15mg (Epi-Pen Jr.®) Epinephrine Auto-Injector 0.3mg (Epi-Pen®) Erythromycin (E-Mycin®) 250mg tablets Erythromycin (Ilotycin®) 0.5% Ophth Ointment

Erythromycin (T-Stat®) Solution 2% 60ml bottle Esomeprazole (Nexium®) 20mg caps Esomeprazole (Nexium®) 40mg caps Estradiol (Climara®) 0.1mg transdermal patches Estratest® HS (Half Strength) tablets Estratest® tablets Estrogen, conjugated (Premarin®) 0.625mg tablets Estrogen, conjugated (Premarin®) 1.25mg tablets Estropipate (Ogen®) Vaginal Cream 42.5gm tube Ethambutol (Myambutol®) 100mg tablets Ethambutol (Myambutol®) 400mg tablets Ethanol (Ethylene glycol or methanol poison) Eucerin® cream 120gm jars Eucerin® cream 454 gm jars Ezetimibe (Zetia®) 10mg tabs Fenofibrate (Triglide®) 160mg tablets Fentanyl (Sublimaze®) Inj (CII) for Clinic use Ferrous Sulfate 325mg tablets Ferrous Sulfate Drops 15mg/0.6ml 50ml bottle Finasteride (Proscar) 5mg tablets Fioricet®(APAP 325mg/butalbital 50mg/Caffeine 40mg) tablets Fleet® Enema 133ml bottle Fluconazole (Diflucan) 200mg tablets (with positive nail culture) Fluconazole (Diflucan®) 150mg tablets Flumazenil 0.1mg/ml 10ml vial (Romazicon® -Benzodiazepine OD) Fluocinonide (Lidex®) cream 0.05% 15gm tubes Fluorescein Sod Ophth Strips Fluoride 1mg tablets Fluorometholone (FML®) Ophth Ointment Fluorometholone (FML®) Ophth Susp Fluoxetine (Prozac®) 20mg capsules Fluress® Ophth Sol Fluticasone (Flonase®) Nasal Spray Fluticasone (Flovent®) 44mcg Oral Inhaler Fluticasone (Flovent®) 110mcg Oral Inhaler Fluticasone (Flovent®) 220mcg Oral Inhaler Folic Acid 1mg tablets Furazolidone (Furoxone®) 50mg/15ml liquid Furosemide (Lasix®) 10mg/ml inj 10ml vial Furosemide (Lasix®) 10mg/ml inj 2ml vial Furosemide (Lasix®) 40mg tablets Gabapentin (Neurontin) 100mg capsules Gabapentin (Neurontin) 300mg capsules Gatifloxacin (Tequin) 200mg tablets Gatifloxacin (Tequin) 400mg tablets Gemfibrozil (Lopid®) 600mg tablets Gentamicin Ophth Ointment Gentamicin Ophth Solution Glipizide Extended Release (Glucotrol® XL) 10mg Glipizide Immediate Release (Glucotrol®) 10mg tab Glipizide Immediate Release (Glucotrol®) 5mg tablets Glucagon® (Propranolol OD) Glucovance® (Glyburide/Metformin Comb) 5/500 tab Glyburide (Micronase®) 5mg tablets Glyburide Micronized (Glynase®) 6mg tablets Glycerine suppositories (Child size) Griseofulvin 125/5ml suspension Griseofulvin 125mg tablets Guaifenesin (Humibid® LA) 600mg tablets

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Haloperidol (Haldol®) 2mg tablets Haloperidol (Haldol®) 5mg tablets Haloperidol (Haldol®) 5mg/ml ampule Heparin Sodium Drip 40u/ml in 500ml D5W bag Homatropine® Ophth Solution Hydralazine (Apresoline®) 20mg/ml vial Hydralazine (Apresoline®) 25mg tablets Hydrochlorothiazide (Oretic®) 25mg tablets Hydrocodone/APAP (Vicodin®) 5/500 tablets Hydrocortisone (Solu-Cortef®) 100mg injection 2ml Hydrocortisone 2.5% cream Hydrocortisone Acetate 2.5% Cr (ProctoCream-HC®) Hydrocortisone Acetate Suppositories 25mg Hydrocortisone cream 1% 30gm tubes Hydrocortisone Valerate (Westcort®) 0.2% cr 15gm Hydroquinone (Solaquine) 4% gel Hydroxycholoroquine 200mg tablets Hydroxyzine (Atarax®) 10mg/5ml syrup Hydroxyzine HCl(Atarax®) 10mg tablets Hydroxyzine HCl(Atarax®) 25mg tablets Hyoscyamine Sulfate (Levsin®) Elixir 0.125mg/ml Ibuprofen (Motrin®) 400mg tablets Ibuprofen (Motrin®) 800mg tablets Ibuprofen (Motrin®) pediatric 100mg/5ml susp 120ml Imipramine (Tofranil®) 10mg tablets Imipramine (Tofranil®) 25mg tablets Imiquimod (Aldara®) topical Indomethacin (Indocin®) 25mg capsules Insulin Human 70/30 (Novolin®) Injection 10ml Insulin Human NPH (Novolin®) Injection 10ml Insulin Human Regular (Novolin®) Injection 10ml Insuline Glargine (Lantus®)Injection 10ml Insulin Syringes (Lo Dose) 1/2ml 100’s Insulin Syringes (Regular) 1ml 100’s Ipecac Syrup 30ml bottle Ipratropium Bromide (Atrovent®) 0.02% Inhalation Ipratropium Bromide (Atrovent®) 0.06% Nasal Spray Ipratropium Bromide (Atrovent®) Oral Inhaler Isoniazid (INH) 300mg tablets Isoniazid (INH) 50mg/5ml Syrup Isoproterenol (Isuprel®) 0.2mg/ml 5ml amupule Isosorbide Dinitrate (Isordil®) 10mg tablets Isosorbide Mononitrate (Imdur®) 30mg tablets Ivermectin (Stromectol®) 3mg tablets Ketoconazole (Nizoral) shampoo Ketoconazole (Nizoral®) 2% cream 15gm tube Ketoconazole (Nizoral®) 200mg tablets Ketorolac (Toradol®) 30mg/ml inj 1ml tubex Ketorolac trimethamine (Acular®) Ophth Soln Lacrilube® Ophth Ointment Lactulose 10mg/15ml Syrup Lantus (Insulin glargine) 100iu/ml (Contains m-cresol) Latanoprost (Xalatan) Levlite (EE 20mcg; .1mg levonorgestrel) tabs Levonorgestrel (Mirena) IUD Levothyroxine (Synthroid) 0.075mg tablets Levothyroxine (Synthroid) 0.2mg tablets Levothyroxine (Synthroid®) 0.025mg tablets Levothyroxine (Synthroid®) 0.05mg tablets Levothyroxine (Synthroid®) 0.088mg tablets

Levothyroxine (Synthroid®) 0.112mg tablets Levothyroxine (Synthroid®) 0.175mg tablets Levothyroxine (Synthroid®) 0.1mg tablets Lidocaine 1% injection 50ml vial Lidocaine 1% w/ Epi. injection 20ml MDV Lidocaine 2% w/ Epi (Xylocaine®) 50ml MDV Lidocaine HCL 10mg/ml injection – 5ml Lidocaine Viscous 2% Liothyroninre (T-3) (Cytomel®) 25mcg tablets Lisinopril (Zestril) 30mg tablets Lisinopril (Zestril®) 10mg tablets Lisinopril (Zestril®) 20mg tablets Lisinopril (Zestril®) 40mg tablets Lisinopril (Zestril®) 5mg tablets Lithium Carbonate 300mg capsules Lo/Ovral® tablets 28’s (30mcg eth estr/0.3mg norgest) Lodoxamide (Alomide®) 1% Ophth Solution Loestrin FE 1/20 tablets (Noreth 1mg/ eth est 20 mic) Loestrin® FE 1.5/30 (30mcg ethinyl est/1.5mg noreth) Loperamide (Imodium®) 2mg capsules Loratadine (Claritin) 10 mg tablets Loratadine (Claritin) syrup Losartan (Cozaar) 25mg tablets Losartan (Cozaar®) 50mg tablets Lotrel® (Amlodipine/Benazepril) 2.5/10 capsules Lotrel® (Amlodipine/Benazepril) 5/10 capsules Lotrel® (Amlodipine/Benazepril) 10/20 capsules Maalox® Extra Strength Suspension 120ml bottle Magnesium Sulfate 50% injection-10ml syringe Magnessium Citrate oral solution Mannitol 25% injection 50ml vial Maxzide® (75mg Triamterene/50mg HCTZ)tablets Mebendazole (Vermox®) 100mg tablets Meclizine (Antivert®) 25mg tablets Medroxyprogesterone (Depo-Provera®) 150mg inj Medroxyprogesterone (Provera®) 10mg tablets Medroxyprogesterone (Provera®) 2.5mg tablets Mefloquine (Lariam®) 250mg tablets Meloxicam (Mobic) 7.5mg tablets Meloxicam (Mobic) 15mg tablets Meselamine (Asacol) 400mg tablets Metamucil® Metformin (Glucophage) 850mg tablets Metformin (Glucophage®) 1000mg tablets Metformin (Glucophage®) 500mg tablets Methocarbamol (Robaxin®) 500mg tablets Methotrexate 2.5mg tablets Methylene Blue (Methemoglobin inducer, ie, cyanosis) Methylphenidate (Ritalin®) 10mg tablets (CII) Methylphenidate (Ritalin®) 5mg tablets (CII) Methylphenidate ER (Concerta®) 18mg tablets (CII) Methylphenidate ER (Concerta®) 27mg tablets (CII) Methylphenidate ER (Concerta®) 36mg tablets (CII) Methylphenidate ER (Concerta®) 54mg tablets (CII) Methylphenidate SR (Ritalin® SR) 20mg tablets (CII) Methylprednisolone (Depo-Medrol®) 40 mg/ml 1ml Methylprednisolone (Solu-Medrol®) 125mg inj 2ml Metoclopramide (Reglan) syrup Metoclopramide (Reglan®) 10mg tablets Metoclopramine 5mg/ml 2ml vial

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Metoprolol (Lopressor®) 100mg tablets Metoprolol (Lopressor®) 1mg/ml inj 5ml ampule Metoprolol (Lopressor®) 50mg tablets Metoprolol (Toprol XL®) 50mg extended release tablets Metronidazole (Flagyl®) 250mg tablets Metronidazole (Metrogel) 0.75% topical Metronidazole (MetroGel®) 0.75% vaginal gel 70gm Micardis HCT® (telmisartan/hctz) 40/12.5 mg tablets Micardis HCT® (telmisartan/hctz) 80/12.5 mg tablets Micardis HCT® (telmisartan/hctz) 80/25 mg tablets Miconazole (Monistat®) 2% vaginal cream 45gm pg Midrin® Capsules (CIV) Mineral Oil Minocycline (Minocin®) 100mg capsules Minoxidil (Loniten®) tablets 10mg Minoxidil (Loniten®) tablets 2.5mg Modafinil (Provigil) 200mg (Aerospace only) Mometasone (Elocon) cream Mometasone (Nasonex®) Nasal Inhaler Montelukast (Singulair®) 10mg tablets Montelukast (Singulair®) 5mg chewable tablets Montelukast (Singulair®) 4mg chewable tablets Morphine 15mg/ml Injection 1ml Tubex (CII) Morphine Sulfate Elixir 20mg/ml (CII) Morphine Sulfate IR 15mg tablet (CII) Morphine Sulfate SR 15mg tablet (CII) Morphine Sulfate SR 100mg tablet (CII) Moxifloxicin (Vigamox®) Opth Soln Mucinex D (600mg guafenesin/60mg PSE) ER tabs Mupirocin (Bactroban®) 2% ointment 15gm tube Mycolog® II (Nystatin/Triamcinolone) cream 15gm Nalbuphine (Nubain®) 10mg/ml injection 10ml vial Naloxone 1mg/ml inj 2ml ampule (Narcan® - Opiate) Naproxen (Naprosyn®) 500mg tablets Nedocromil Sodium (Tilade®) Oral Inhaler Nefazodone (Serzone®) 200mg tablets Neosporin® Ophth Solution Niacin Immediate Release 500mg tablets Nicoderm® CQ 14mg patch(Smoking Program Only) Nicoderm® CQ 21mg patch(Smoking Program Only) Nicoderm® CQ 7mg patch(Smoking Program Only) Nifedipine (Adalat® CC) 30mg XR tablets Nifedipine (Adalat® CC) 60mg XR tablets Nifedipine (Adalat® CC) 90mg XR tablets Nitrofurantoin (Furadantin®) 25mg/5ml Suspension Nitrofurantoin (Macrobid®) 100mg capsules Nitrofurantoin 50mg Capsules Nitroglycerin (Nitro-Bid®) I.V. 5mg/ml inj 10ml Nitroglycerin (Nitrol®) 2% oint. 60gm tube (in-house use only) Nitroglycerin (Nitrostat®) 0.4mg SL tablets Nitroglycerin 0.4 mg transdermal patches Nitroglycerin Drip 200mcg/ml 250ml bottle Nitroglycerine (Nitrolingual®) Sublingual Spray Norepinephrine Bitartrate 1mg/ml – 4ml ampule Nordette (EE 30mcg; .15mg levonorgestrel) tabs Nor-QD® tablets 28’s (0.35mg norethindrone) Nortriptyline (Pamelor®) 25mg capsules Novolog insulin Nuvaring Contraception Nystatin (Mycostatin®) 1% cream 15gm tube

Nystatin (Mycostatin®) 1% ointment 15gm tube Nystatin (Mycostatin®) topical powder 15gm Nystatin (Mycostatin®) 100,000u/ml Suspension 60ml Olopatadine (Patanol®) Opth Drops Omeprazole (Prilosec®) 10mg capsules Omeprazole (Prilosec®) 20mg capsules Ortho Tri-cyclen® tablets 28’s (ethinylestradiol/norgestimate) Ortho Tri-cyclen® LO tablets 28’s (ethinylestradiol/norgestimate) Ortho-Cept® tablets 28’s (30mcg eth est/0.15mg deso) Ortho-Cyclen® 28’s (35mcg eth est/0.25mg norgest) Ortho-Novum 1/50 tablets 28’s (Noreth/mestranol) Ortho-Novum® 1/35 28’s (35mcg eth est /1mg nor) Ortho-Novum® 7/7/7 tablets 28’s (eth estr/norethin) Oxybutynin (Ditropan®) 5mg tablets Paroxetine (Paxil®) 20mg tablets Pediazole suspension Penicillin (Pen-VK®) 250mg tablets Penicillin (Pen-VK®) 500mg tablets Penicillin VK 250mg/5ml Suspension 200ml bottle Percocet® (Oxycodone/APAP) 5/325 tablets (CII) Permethrin (Elimite®) 5% Cream 60gm tube Permethrin (Nix®) Rinse 60ml bottle Phenazopyridine (Pyridium®) 100mg tablets Phenobarbital 30mg tablets (CIV) Phenylephrine 2.5% Opth soln 15 ml Phenylephrine (Neo-Synephrine®) 1% inj 1ml ampul Phenytoin (Dilantin) 50mg tablets Phenytoin (Dilantin®) 100mg Kapseals Phenytoin (Dilantin®) 50mg/ml inj 5ml vial Physostigmine 1mg/ml inj 2ml ampule (Antilirium® Phytonadione 10mg/ml ampule (Aquamephyton® - Coumarin derivatives, indandione derivatives OD) Pilocarpine 1% Ophth Solution Pilocarpine 2% Ophth Solution Pilocarpine 4% Ophth Solution Pimecrolimus 1% (Elidel) cream 30 gm Pioglitazone (Actos) 15mg tablets Pioglitazone (Actos) 30mg tablets Plan B tablets Podofilox (Condylox) 0.5% solution Polyethylene Glycol 3350 (Miralax®) powder Polysporin® Ophth Ointment Polytrim® Ophth Drops Poly Vi-Sol® Drops Pontocaine HCL 2% Pontocaine HCL 2% solution Potassium Chloride (Slow-K®) 8 mEq tablets Pralidoxime 1gm vial (Protopam® - Organophosphate, insecticides, tacrine OD) Pravastatin (Pravachol®) 20mg tablets Prazosin (Minipress®) 1mg capsules Prazosin (Minipress®) 5mg capsules Precision® Xtra Blood Glucose Monitor Precision® Xtra strips 100’s Pred-Forte® 1% Ophth Suspension Prednisolone (Prelone®) 15mg/5ml syrup Prednisone (Deltasone®) 20mg tablets Prednisone (Deltasone®) 5mg tablets Prempro® (Conjugated estrogen and medroprogesterone) 0.625/2.5

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Prempro® (Conjugated estrogen and medroprogesterone) 0.625/5 Prenatal Vitamin with folic acid & mineral tablets Prevident 5000 Plus Dental Paste Primaquine 26.3mg tablets Primidone (Mysoline®) 250mg tablets Probenecid (Benemid®) 500mg tablets Procainamide (Pronestyl®) 100mg/ml 10ml vial Procainamide (Pronestyl®) 250mg capsules Prochloperazine (Compazine®) 5mg/ml inj 2ml vial Promethazine (Phenergan®) 12.5mg suppositories Promethazine (Phenergan®) 25mg suppositories Promethazine (Phenergan®) 25mg tablets Promethazine (Phenergan®) 25mg/ml inj 1ml ampule Promethazine (Phenergan®) 6.25mg/5ml syrup Proparacaine Ophth Solution (Ophth Clinic Use Only) Propranolol (Inderal®) 10mg tablets Propranolol (Inderal®) 120mg LA capsules Propranolol (Inderal®) 40mg tablets Propranolol (Inderal®) 80mg LA capsules Propylthiouracil (PTU) 50mg tablets Protamine Sulfate (Heparin OD) Pseudoephedrine (Sudafed®) 30mg tablets Pseudoephrine (Sudafed®) 30mg/5ml syrup 120ml Pseuephedrine/Guiaifenesin--Extended Release tablets Pulmicort Respules (Budesonide micro) 0.25mg/2ml Pyrazinamide (PZA) 500mg tablets Pyridoxine (Vit B6 – Isoniazid monomethyl) Pyridoxine (Vitamin B6) 50mg tablets Quetiapine 25 mg tablets Raloxifene (Evista®) 60mg tablet Ranitidine (Zantac®) 150mg tablets Ranitidine (Zantac®) 15mg/ml syrup Refresh® Plus Ophth Sol 0.5% Risperidone (Risperdal®) .5mg tablets Risperidone (Risperdal®) 2mg tablets Risperidone (Risperdal®) 4mg tablets Rifampin (Rifadin®) 300mg capsules Robecoxib (Vioxx) 12.5mg tablets Robecoxib (Vioxx) 25mg tablets Robecoxib (Vioxx) 50mg tablets Robitussin® AC *Equiv syrup 120ml bottle (CVI) Robitussin® DM *Equiv syrup 120ml bottle Rosiglitazone Maleate (Avandia®) 4mg tablets Salicilyc acid 40% (Mediplast) Salicylic Acid (Duofilm®) solution 15ml bottle Salicylic Acid/coal tar (Sebutone) shampoo Salmeterol (Serevent®) diskus inhalation powder Salsalate 750mg tablets Selenium Sulfide (Selsun®) 2.5% lotion 120ml bottle Septra® Pediatric Suspension Sertraline (Zoloft®) 100mg tablets Silver Sulfadiazine (Silvadene®) 1% cream 454gm jar Simethicone (Mylicon®) 40mg/0.6ml drops 30ml Simethicone (Mylicon®) 80mg tablets Simvastatin (Zocor®) 5mg tablets Simvastatin (Zocor®) 10mg tablets Simvastatin (Zocor®) 20mg tablets Simvastatin (Zocor®) 40mg tablets Simvastatin (Zocor®) 80mg tablets Sinemet® (Carbidopa/Levodopa) 25/250mg tablets

Sinemet® (Carbidopa/Levodopa) 10/100mg tablets Sinemet® (Carbidopa/Levodopa) 25/100mg tablets Sodium Bicarbonate 4.2% inj 10ml bristoject Sodium Bicarbonate 8.4% 50ml vials Sodium Chloride (Adsorbonac®) Ophth Sol 5% Sodium Chloride (Muro® 128) Ophth Ointment 5% Sodium Chloride 0.65% Nasal Solution Sodium Chloride 0.9% inj 5ml ampule Sodium Chloride Inhalant Solution 0.9% for nebulizer Sodium Fluoride (Pediaflor®) solution 50ml bottle Spacer, Inhaler (Inspirease®) Spironolactone (Aldactone®) 25mg tablets Sterile Water for injection 10ml vial Succimer (Chemet® - Lead, arsenic, mercury poison) Sulfacetamide (Sulamyd®) 10% Ophth Solution Sulfacetamine opthalmic ointment Sulfasalazine (Azulfidine®) 500mg tablets Sulindac (Clinoril®) 150mg tablets Sumatriptan (Imitrex®) 50mg tablets Sumatriptan Succinate (Imitrex®) 6mg/0.5mg Inj Tamoxifen (Nolvadex®) 10mg tablets Telmisartan (Micardis®) 40mg tablets Telmisartan (Micardis®) 80mg tablets Temazepam (Restoril®) 15mg and 30mg capsules (CIV) Terazosin (Hytrin®) 1mg capsules Terazosin (Hytrin®) 5mg capsules Terbinafine (Lamisil) 250mg tablets Terbutaline (Brethine®) 1mg/ml inj 1ml ampule Terconazole (Terazol-3®) Vaginal suppository Tetracycline (Achromycin®) 250mg capsules Tetracycline 500mg capsules Theophylline (Theo-Dur®) 200mg tablets Theophylline (Theo-Dur®) 300mg tablets Theophylline Oral Liquid Thiamine 100mg/ml injection 1ml ampule Timolol 0.25% Ophth Solution Timolol 0.5% Ophth Solution Timolol 0.5% Long acting (gel forming) solution Tobradex (Tobramycin and dexamethasone Tobramycin (Tobrex®) Ophth Ointment Tobramycin (Tobrex®) Ophth Soln Tolterodine LA 4 mg capsules Tramadol (Ultram) 50mg tabs Trazodone (Desyrel®) 50mg tablets Tretinoin (Retin-A®) 0.025% Cream 20gm tube Tretinoin (Retin-A®) 0.05% Cream 20gm tube Triamcinolone (Aristocort®) 0.1% cream 15gm tube Triamcinolone (Aristocort®) 0.1% oint 80gm tube Triamcinolone (Azmacort®) Oral Inhaler Triamcinolone (Kenalog®) 40mg/ml inj 10ml vial Triamcinolone Dental Paste 3.5gm Triaminic® oral infant drops 15ml bottle Trifluridine (Viroptic) ophth Solution Trihexylphenidyl 2 mg tablets Tri-Levlen®/Triphasil® 28’s (eth estr/levonorgestrel) Triple paste ointment Tropicamide (Mydriacyl®) 1% Ophth Sol Tylenol® #3 (APAP/Codeine) * Equivalent Elixir Tylenol® #3 (APAP/Codeine) *Equiv tablets (CIII) Valacyclovir (Valtrex®) 500mg Tablet

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Vasacon-A® Ophth Solution VoSol HC Opth drops (acetic acid and HC) Vasopressin 20u/ml 1ml Vial Venlafaxine (Effexor) XR 150mg tablets Venlafaxine (Effexor®) 37.5mg tablets Venlafaxine (Effexor®) XR 75mg tablets Verapamil (Calan® SR) 240mg tablets Verapamil (Calan®) 2.5mg/ml inj 2ml ampule Verapamil 80mg IR tablets Vitamin C 500mg (restricted to optometry use) Vytorin® (Ezetimibe/Simvistatin) 10/10, 10/20, 10/40, 10/80mg tb Warfarin Sodium (Coumadin®) 1mg tablets Warfarin Sodium (Coumadin®) 2mg tablets Warfarin Sodium (Coumadin®) 5mg tablets Yasmin (EE 30mcg; 3mg drospirenone) tabs Yaz (EE 20mcg; 3 drospirenone) tabs Zolmitriptan (Zomig) 2.5 mg tablets Zolmitriptan (Zomig) 5mg tablets Zolpidem (Ambien)10mg(CIV) (max 15 tabs no refill)

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