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mini formulary 6 28 oct 94

By Chad Ferguson,2014-05-07 15:41
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mini formulary 6 28 oct 94

Whiteman AFB Pharmacy Updated Quarterly (Jan * Apr * July * Oct) Nov 09

    The Outpatient Quick Reference Formulary is an abbreviated thCeftin (cefuroxime) 250mg tab compilation of all medications stocked in the 509 Medical Cefzil (cefprozil) 250mg/5ml susp Group’s Pharmacy. However, many agents are available only Cipro (ciprofloxacin) 250mg, 500mg, 750mg tab in the generic formulation. Cleocin (clindamycin) 150mg cap,75mg/5ml soln Doxycycline 100mg tab NOTE TO CIVILIAN DOCTORS: The medications stocked in Duracef (cefadroxil) 250mg/5ml susp the pharmacy are determined by the Medical Staff of Whiteman Dynapen (dicloxacillin) 250mg cap Air Force Base. The medications used are based on their scope E.E.S. (erythromycin ethylsuccinate) 200mg/5ml ssp,400mg tab of practice. In addition, the pharmacy is required to carry E-Mycin (erythromycin base) 250mg tab medications listed on the ―BASIC CORE FORMULARY‖. The Flagyl (metronidazole) 250mg tab ―BASIC CORE FORMULARY‖ is a list of medications Gantrisin (sulfisoxazole) 500mg/5ml susp (determined by the DoD Pharmacoeconomic Center) that should Keflex (cephalexin) 250mg, 500mg cap, 250mg/5ml susp be stocked at every military medical treatment facility. Levaquin (levafloxacin) 250mg, 500mg tab MacroBid (nitrofurantoin macrocrystals) 100mg THE PHARMACY DOES NOT ACCEPT CALL IN or FAXED Minocin (minocycline) 50mg, 100mg cap PRESCRIPTIONS. ELECTRONICALLY SIGNED SCRIPTS Neomycin 500mg tab ARE NOT ACCEPTABLE UNLESS THEY ARE PRINTED Omnicef (cefdinir) 125mg/5ml, 250mg/5ml susp ON TAMPER-RESISTANT PAPER OR INITIALED BY THE Penicillin VK 250mg, 500mg tab, 250mg/5ml susp PROVIDER. Tetracycline 250mg cap Vibramycin (doxycycline) 100mg cap NOTE TO PATIENTS: Please ensure that your provider fills out Zithromax (azithromycin) 250mg tab, 1gm susp your prescription completely and legibly. Zithromax (azithromycin) 100mg/5ml, 200mg/5ml susp To include the following information: Z-Pack (azithromycin) 250mg tab (6 TAB PACK) 1. Patient Name Zithromax TRIPAK 500mg tab (3 TAB PACK) 2. Date ANTICOAGULANTS 3. Drug Name, Strength and Quantity Aspirin (acetylsalicylic acid) enteric coated 81mg tab 4. Directions (―use as directed‖ is not considered directions). Coumadin (warfarin sodium) 1mg, 2mg, 2.5mg, 3mg, 4mg, 5mg, 6mg tab 5. Signature Lovenox (enoxaprin) 100mg/ml, 80mg/0.8ml inj Persantine (dipyridamole) 25mg, 75mg tab PHONE-IN REFILL SERVICE: All prescription refills are filled Plavix (clopidogrel bisulfate) 75mg tab via a 24 hour phone-in refill service. Refills will be ready the next Trental (pentoxyphylline) 400mg tab duty day after 10:00. Phone-in refill service is (660) 687-2137 or ANTICONVULSANTS (800) 334-2958. Depakote (divalproex sodium) 250mg, 500mg tab Depakote ER (divalproex sodium) 250mg, 500mg tab HOURS OF OPERATION: Whiteman Pharmacy is OPEN: Dilantin (phenytoin) 100mg cap, 50mg chew tab Monday Friday from 07:30 to 16:30. CLOSED: The second Mysoline (primidone) 50mg, 250mg tab Wednesday of each month at 12:00 for training. Phenobarbital - see Schedule III-V Controlled Substances Tegretol (carbamazepine) 100mg, 200mg tab RECENT FORMULARY ADDITIONS Topamax (topiramate) 25mg, 50mg, 100mg, 200mg tab We’ve added a few new strengths of medications we have: ANTI-DEPRESSANTS / ANTIPSYCHOTICS Tenormin (Atenolol) 25mg Buspar (buspirone) 10mg tab Lasix (Furosemide) 20 mg Celexa (citalopram) 20mg, 40mg tab

    Cogentin (benztropine) 2mg tab Desyrel (trazadone) 50mg tab RECENT DELETIONS FROM THE FORMULARY Effexor XR (venflexine) 37.5mg, 75mg, 150mg cap No medications were deleted from the formulary Elavil (amitriptyline) 10mg, 25mg, 50mg tab

    Eskalith (lithium) 300mg cap, 450mg CR tab this quarter.

    Geodon (ziprasidone) 20mg, 40mg, 60mg, 80mg cap Haldol (haloperidol) 1mg tab FIND THE FORMULARY ONLINE AT: Nardil (phenelzine) 15mg tab www.whiteman.af.mi/units/509mdg/index.asp Pamelor (nortriptyline) 10mg, 25mg cap

     Paxil (paroxetine) 20mg, 40mg tab

    Prozac (fluoxetine) 10mg, 20mg cap ANTHELMINTICS Risperdal (respiridone) 0.5mg, 1mg, 2mg, 4mg tab Vermox (mebendazole) 100mg chew tab Risperdal (respiridone) 1mg/1ml soln ANTI-ARRHYTHMICS Seroquel (quetiapine) 25mg, 100mg, 300mg tab Lanoxin (digoxin) 0.125mg, 0.25mg tab, 50mcg/ml elix Seroquel XR (quetiapine) 200mg, 300mg, 400mg Sinequan (doxepin) 25mg cap ANTIBIOTICS (Oral) Strattera (atomoxetine) 18mg, 25mg, 40mg, 60mg cap Amoxicillin 250mg, 500mg cap, 875mg tab Thorazine (chlorpromazine) 25mg tab Amoxicillin 250mg/5ml susp, 400mg/5ml susp Tofranil (imipramine) 10mg, 25mg tab Augmentin (amox/clavulan) 250mg, 500mg, 875mg tab Wellbutrin SR (bupropion) 100mg, 150mg tab Augmentin (amox/clavulan) 400mg/5ml susp Wellbutrin (bupropion) 100mg tab Augmentin (amox/clavulan) ES 600 susp Zoloft (sertraline) 50mg, 100mg tab Bactrim DS (160mg trimethoprim/800mg sulfmeth) tab, susp

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Whiteman AFB Pharmacy Updated Quarterly (Jan * Apr * July * Oct) Nov 09

Zyprexa (olanzapine) 5mg, 10mg tab Coreg CR (carvedilol) 10mg, 20mg, 40mg, 80mg cap Cozaar (losartan) 25mg, 50mg, 100mg tab HCTZ (hydrochlorthiazide) 25mg, 50mg tab ANTI-FUNGAL Hygroton (chlorthalidone) 50mg tab Diflucan (fluconazole) 100mg, 150mg, 200mg tab, 40mg/ml susp Hytrin (terazosin) 1mg, 2mg, 5mg, 10mg cap Gris-Peg (ultramicrosize griseofulvin) 125mg tab Hyzaar (losartan/HCTZ) 50/12.5mg, 100/25mg tab Grifulvin-V (griseofulvin) 125mg/5ml susp Imdur (isorbide mononitrate) 60mg tab Lamisil (terbinafile) 250mg tab Inderal (propranolol) 10mg,20mg,40mg tab Nizoral (ketoconazole) 200mg tab Inderal LA (propranolol) 60mg,80mg cap Nystatin 100,000 units/ml susp, 500,000 unit tab Isordil (Isosorbide dinitrate) 10mg, 40mg ER tab Lanoxin (digoxin) 0.125mg, 0.25mg tab, 50mcg/ml elixir ANTI-HYPERLIPIDEMIC (High Cholesterol) Lasix (furosemide) 20 mg, 40mg tab, 10mg/ml soln Colestid (colestipol) 1gm tab Lopressor (metaprolol) 50mg,100mg tab (amlodipine/benazepril) 2.5/10mg, 5/10mg, 5/20mg, 5/40mg, 10/20mg Lipitor (atorvastatin) 10mg, 20mg, 40mg, 80mg LotrelMaxzide (triamterene/HCTZ) tab 75/50mg, 37.5/25mg Lopid (gemfibrizol) 600mg tab Micardis (telmisartan) 40mg, 80mg tab Niacin (immediate release niacin) 500mg tab Micardis HCT (telmisartan/HCTZ) 40mg/12.5mg, 80mg/12.5mg Niaspan (niacin) ER 500mg, 1000mg Minipress (prazosin) 1mg, 2mg, 5mg cap Pravachol (pravastatin) 10mg, 20mg, 40mg, 80mg tab Monopril (fosinopril) 10mg, 20mg, 40mg tab Triglide (fenofibrate) 40mg, 50mg, 120mg, 160mg Nitrostat (nitroglycerin) 0.4mg tab SL Vytorin (ezetimbe/simvastatin) 10/20, 10/40, 10/80 tab Nitrolingual Spray (nitroglycerin) Oral spray Zetia (ezetimibe) 10mg tab Nitro-Dur Patch (nitroglycerin) 0.1mg, 0.2mg and 0.4mg Patch Zocor (simvastatin) 5mg, 10mg, 20mg, 40mg, 80mg tab Norvasc (Amlodipine) 5mg, 10mg tab ANTI-INFLAMMATORY/ANTI-ARTHRITIS/ANALGESIC Plendil (felodipine) 2.5mg, 5mg, 10mg tab Aspirin enteric coated 81mg tab Prinzide (lisinopril/hydrochlorthiazide) 10/12.5, 20/12.5, 20/25mg tab Azulfidine (sulfasalazine) 500mg tab Procardia (nifedipine) 10mg cap Celebrex (celecoxib) 100mg, 200mg Tenormin (atenolol) 25mg, 50mg tab Disalcid (salsalate) 500mg tab Tiazac (diltiazem) 120mg, 180mg, 240mg,300mg,360mg extended caps Feldene (piroxicam) 20mg cap Toprol XL (metoprolol) 25mg, 50mg, 100mg tab Indocin (indomethacin) 25mg cap Trental (pentoxyphylline) 400mg tab Mobic (meloxicam) 15mg tab Zaroxolyn (metolazone) 5mg, 10mg tab Motrin (ibuprofen) 400mg, 800mg tab,100mg/5ml susp Zestril (lisinopril) 5mg, 10mg, 20mg, 30mg, 40mg tab Naprosyn (naproxen) 250mg, 500mg tab CHEMOTHERAPY Neurontin (gabapentin) 100mg, 300mg, 400mg, 600mg Imuran (azathioprine) 50mg tab Tolectin DS (tolmentin) 400mg cap Methotrexate 2.5mg tab Tylenol (acetaminophen) 325mg tabs, 160mg/5ml liq, 80mg/0.8ml Nolvaldex (tamoxifen) 10mg tab Ultram (tramadol) 50mg tab CONTRACEPTIVES ANTI-MALARIAL Alesse (ethynylestradiol 20mcg/levonorgestrel 0.1mg) tab 28 day Aralen (chloroquine) 500mg tab Demulin 1/35 (ethynodiol diacetate/ethinyl estradiol) tab 28 day Lariam (mefloquine) 250mg tab Depo-Provera (medroxyprogesterone) 150mg/ml inj Plaquenil (hydroxychloroquine) 200mg tab Implanon (etonogestrel) 68mg implant Primaquine (primaquine phosphate) 26.3mg tab Levlen 28 (levonorgestrel/ethinyl estradiol) tab 28 day ANTI-TUBERCULOSIS Loestrin FE 1.5/30 (norethidrone/ethinyl estradiol) tab 28 day Isoniazid 100mg,300mg tab Loestrin FE 1/20 (norethidrone/ethinyl estradiol) tab 28 day Myambutol (ethambutol) 400mg tab LoOvral (norgestrel/ethinyl estradiol) tab 28 day Rifampin 300mg cap Nor-QD (norethindrone 0.35mg) tab 28 day Pyrazinamide 500mg tab Norinyl 1/35 (norethindrone 1mg/ethinyl estradiol 0.035mg) tab 28 day NuvaRing (etonogestrel 0.12mg/ethinyl estradiol 0.015mg) vaginal ANTI-VIRAL Ortho-Cept 28 (desogestrel/ethinyl estradiol) tab 28 day Symmetrel (amantadine) 100mg cap Ortho-Cyclen 28 (norgestimate/ethinyl estradiol) tab 28 day Valtrex (valcyclovir) 500mg, 1gm tablet Ortho-Evra (norelgestromin/ethinyl estradiol) transdermal patch Zovirax (acyclovir) 200mg cap, 800mg tab Ortho-Novum 777 (norethidrone/ethinyl estradiol) tab 28 day CARDIAC (High Blood Pressure, CHF, etc) Ortho-Tri-Cyclen (norgestimate/ethinyl estradiol) tab 28 day Aldomet (methyldopa) 250mg tab Ortho-Tri-Cyclen Lo (norgestimate/ethinyl estradiol) tab 28 day Adalat CC (nifedipine) 30mg, 60mg, 90mg tab Tri-levlen/Tri-phasil (levonogestrel/ethinyl estradiol) tab 28 day Aldactazide (spironalactone 25mg /hydrochlorthiazide25mg) tab Yasmin (drospirenone) tab 28 day Aldactone (spironalactone) 25mg tab YAZ (drospirenone/ethinyl estradiol) tab 28 day Apresoline (hydralazine) 25mg tab COUGH, ANTIHISTAMINE, DECONGESTANT, Calan (verapamil) 80mg, 120mg tab EXPECTORANT Calan SR (verapamil) 180mg, 240mg Allegra-D (fexofenadine60mg/pseudoephedrine 120mg) tab Capoten (captopril) 25mg, 50mg tab Atarax (hydroxyzine HCL) 10mg, 25mg tab Cardiazem (diltiazem) 60mg tab Atarax (hydroxyzine HCL) 10mg/5ml syrup Catapres (clonidine) 0.1mg, 0.2mg tab Benadryl (diphenhydramine) 25mg cap, 12.5mg/5ml elixir Cordarone (amiodarone) 200mg tab Claritin (loratadine) 10mg tab, 5mg/5ml syrup Coreg (carvedilol) 3.125mg, 6.25mg, 25mg tab

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Whiteman AFB Pharmacy Updated Quarterly (Jan * Apr * July * Oct) Nov 09

CTM (chlorpheniramine) 4mg tab Zofran (ondansetron) 4mg tab Dimetapp (brompheniramine 1mg/pseudoephedrine 15mg) soln Mucinex (guafenisin) 600mg tab GOUT Periactin (cyproheptadine) 4mg tab Benemid (probenecid) 500mg tab Robitussin (guaifenesin) liq 100mg/5ml Colchicine 0.6mg tab Robitussin DM (guaif/dextromethorphan) liq Zyloprim (allopurinol) 100mg and 300mg tab Sudafed (pseudoephedrine) 30mg tab, 30mg/5ml liquid Tessalon (benzonatate) 100mg cap Xylocaine (lidocaine) 2% viscous soln Zyrtec (cetirizine) 10mg tab, 1mg/ml syrup HORMONES Climara (estradiol) 0.025mg, 0.05mg, 0.1mg transdermal patch DIABETIC MEDICATIONS AND SUPPLIES Cytomel (liothyronine) 25mcg tab Actos (pioglitazone) 15mg, 30mg, 45mg tab Depo Testosterone (cypionate) 200mg/1ml injection Amaryl (glimepiride) 1mg, 2mg, 4mg tab Estratest HS (esterified e 0.625mg/methyltestosterone 1.25mg) Avandia (rosiglitazone) 2mg, 4mg, 8mg tab FemHRT (1mg norethindrone/5mcg ethinyl estradiol) tab Avandamet (rosiglitazone/metformin) 2/500mg, 4/500mg tab Premarin (estrogens) 0.3mg,0.45mg, 0.625mg, 0.9mg, 1.25mg Glucagon 1mg inj kit Premarin (conj estrogens) vag cream Glucophage (metformin) 500mg , 850mg, 1000mg tab PremPro (conj estrogens/ medroxyprogesterone) 0.3/1.5mg tab Glucotrol (glipizide) 5mg tab PremPro (conj estrogens/ medroxyprogesterone) 0.45/1.5mg tab Glucovance (glyburide/metformin)1.25/250mg,2.5/500mg, PremPro (conj estrogens/ medroxyprogesterone) 0.625/2.5mg 5/500mg tab PremPro (conj estrogens/ medroxyprogesterone) 0.625/5mg tab Glynase (glyburide) 3mg tab Propylthiouracil 50mg tab Janumet (sitagliptin/metformin) 50/500mg, 50/1000mg tab Provera (medroxyprogesterone) 2.5mg, 5mg, 10mg tab Januvia (sitagliptin) 25mg, 50mg, 100mg tab Synthroid (levothyroxine) 25mcg, 50mcg, 75mcg, 88mcg tab Lantus (insulin glargine) Synthroid (levothyroxine) 100mcg,112mcg, 125mcg, 150 mcg, 175mcg Levemir (insulin detemir) Flex Pen Thyroid 60mg tab Micronase (glyburide) 2.5mg, 5mg tab NovoFine 30 (Needles) for Flex-pen INHALERS / INHALANT SOLUTIONS Novolin (human insulin) R, NPH, 70/30 inj Advair (fluticasone/salmeterol) 100/50, 250/50 & 500/50 Oral Inhaler Novolog (insulin aspart) inj Advair HFA (fluticasone/salmeterol) 45/21,115/21, 230/21 Novolog (insulin aspart) Flex Pen AeroChamber (small, medium, large) Device Novolog (insulin aspart) Mix 70/30 Flex Pen Afrin (oxymetazoline 0.05%) nasal spray Precision Xtra Blood Glucose Monitor & Test Strips Asmanex (mometasone furoate) 110 mcg, 220 mcg Oral Twisthaler Lancets Atrovent (ipatropium bromide) 14gm oral inhaler---200 puffs Syringes & Needles 0.5ml, 1.0ml Atrovent (ipatropium bromide) 0.5mg/2ml solution for nebulizer GASTROINTESTINAL (Stomach Medicines) Combivent ( ipratropium/albuterol) oral Inhaler200 puffs Amitiza (lubiprostone) 8mcg, 24mcg cap DDAVP Nasal Solution (desmopressin acetate) 50 doses Asacol (mesalamine) 400mg tab Duoneb (albuterol/ipratropium) 2.5-0.5mg/3 ml neb soln Bellergal-S (belladona/phenobarb 40mg/ergotamine) tab Flonase (fluticasone) nasal Inhaler---120 puffs Bentyl (dicyclomine) 20mg tab Flovent (fluticasone) 44mcg, 110mcg, 220mcg oral Inhaler Bisacodyl 5mg tab Flovent (fluticasone) 50mcg, 100mcg, 250mcg diskus Chronulac (lactulose) 10gm/15ml oral soln Inspirease Device and Bags Colace (docusate sodium) 100mg cap, 50mg/5ml liq Intal (cromolyn sodium) neb soln 2ml amp and Oral Inhaler Co-Lyte (polyethylene glycol) soln Nasonex (mometasone) nasal spray Compazine (prochlorperazine) 5mg tab Normal saline (noraml saline 0.9%) soln for oral nebulizer Dipentum (osalazine) 250mg cap Ocean (saline) 0.65% nasal spray Donnatal (atopine/scopalamine/phenobarb) tab Pulmicort (budesonide) 0.25mg/2ml, 0.5mg/2ml amp 30 Fleet Prep kit #3Proventil (albuterol sulfate) 17gm oral inhaler---200 puffs (phospho soda 1.5fl oz/4 biscodyl 5mg tab/1 fleet enema) Proventil (albuterol sulfate) neb soln PREMIXED 0.083% HalfLytely Bowel Prep Kit (4 biscodyl 5mg tab/2 liter bottle of HalfLytely) Proventil (albuterol sulfate) neb soln 0.05% 20ml bottle Imodium (loperamide) 2mg cap Rhinall (phenylephrine) 0.25% nasal drops Levsin (hyoscyamine) 0.125mg tab Serevent Diskus (salmeteral xinafoate) Inahlation Powder---60 Librax (chlordiazepoxide 5mg/clidinium 2.5mg) cap Spiriva (tiotropium bromide) 18 mcg Inhalation Powder Magnesium Citrate Saline Laxative (10 oz bottle) Symbicort (budesonide/formoterol) 80/4.5, 160/4.5mcg-120puffs Miralax (polyethylene glycol) powder Xopenex (levalbuterol) 0.63mg/3 ml neb soln Mylicon (simethecone) 80mg chewable tab Xopenex HFA (levalbuterol) oral inhaler200 puffs Nexium (esomeprazole) 40mg Pancrease (lipase, protease, amylase) MT 16 cap MIGRAINE Pepto-Bismol (bismuth salicylate) chewable tab Fioricet (50mg butalbital/40mg caffeine/325 Acetaminophen) tab Phenergan (promethazine)25mg tab Imitrex (sumatriptan) 50mg, 100mg tabs Phenergan (promethazine) 6.25mg/5ml syrup Imitrex (sumatriptan) 6mg Autoinjector PrevPAC (lansoprazole/amoxicillin/clarithromycin) tab Imitrex (sumatriptan) 20mg nasal spray Prilosec (omperazole) 20mg cap Maxalt MLT (rizatriptan) 5mg,10mg tabs (max 12 tabs/month) Reglan (metoclopramide) 10mg tab, 5mg/5ml liq Midrin (325mg APAP/100mg dichloralphenazone/65mg Tagamet (cimetadine) 400mg tab isometheptene) Caps**Midrin is considered a narc and is limited Thorazine (chlorpromazine) 25mg tab to a 30 day supply & 5 Refills Zantac (ranitidine) 150mg tab, 15mg/5ml liq

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Whiteman AFB Pharmacy Updated Quarterly (Jan * Apr * July * Oct) Nov 09

    Treximet (sumatriptan/naproxen) 85mg/500mg tab Debrox (carbamide peroxide) 6.5% soln Topamax (topiramate) 25mg, 50mg, 100mg, 200mg tabs Vosol HC (acetic acid/hydrocortisone) soln Zomig (zolmitriptan) 2.5mg, 5mg tabs PARKINSONS MEDICATION Zomig (zolmitriptan) ZMT 2.5mg, 5mg tabs Artane (trihexyphenidyl) 2mg tab Parlodel (bromocriptine) 2.5mg tab Sinemet (carbidopa/levodopa) 25-100mg tab Sinemet CR (carbidopa/ levodopa) 25-100mg, 50-200mg tab MUSCLE RELAXANTS Flexeril (cyclobenzaprine) 10mg tab RECTALS and VAGINALS Lioresal (baclofen) 10mg tab Anusol HC (hydrocortisone) 2.5% cream Parafon Forte (chlorzoxazone) 500mg tab Anusol HC (hydrocortisone) 25mg supp Robaxin (methacarbamol) 500mg tab Cleocin (clindamycin) 2% vag cream Skelaxin (metaxalone) 800mg Dulcolax (bisacodyl) 10mg supp Fleet Enema (sodium phosphate) ready-to-use OPHTHALMICS (Eye Drops and Eye Ointments) Metrogel (metronidazole) 0.75% vag gel Alphagan P (brimonidine) oph 0.15% sol Mycelex (clotrimazole) 1% vag cream Artificial Tears (polyvinyl alcohol) 1.4% soln Phenergan (promethazine) 25mg supp Betagan (levobunolol) 0.5% soln Premarin (cong estrogen) vag cream Betoptic S (betaxolol) 0.25% soln Terazol-7 (terconazole) 0.4% vag cream Blephamide (sulfacetamide 10%/prednisolone 0.2%) susp Tigan (trimethobenzamide) 200mg supp Ciloxin (ciprofloxacin) 0.3% soln Tylenol (acetaminophen) 120mg, 325mg, 650mg supp Cortisporin (neomycin/bacitracin/polymyxin b/HC) oint Cosopt (2%dorzolamide / .5% timolol) soln Cyclogyl (cyclopentolate) 1% soln RESPIRATORY Decadron (dexamethasone) 0.1% soln Brethine (terbutaline) 5mg tab Erythromycin oph oint (generic) - 3.5gm Proventil (albuterol) 2mg/5ml syrup Flarex (fluorometholone acetate) 0.1% susp Singulair (montelukast) 4mg, 5mg, 10mg Tab FML (fluoromethalone) 0.1% susp Singulair (montelukast) 4mg granules Gentamicin oph oint and soln Theo-Dur (theophylline) 200mg, 300mg tab Genteal (hypromellose) 0.3% gel, soln Isopto atropine (atropine) 1% soln SCHEDULE II CONTROLLED SUBSTANCES Isopto Homatropine (homatropine hydrobromide) 2% soln (30 day supply/No Refills) (**90 day for ADHD diagnosis) Isopto Hyoscine (scopolamine) 0.25% Adderall XR 10mg, 15mg, 20mg, 25mg, 30mg cap ** Lacrilube (min oil, petrolatum) oint Adderall (amphetamines) 10mg, 20mg tab ** Mydriacyl (tropicamide) 1% soln Codeine 30mg tab Muro 128 (sodium chloride) 5% soln, oint Concerta (methylphenidate) 18mg, 27mg, 36mg, 54mg tab ** Neosporin (neomycin) oph sol and oint Dexedrine Spansules (dextroamphetamine) 10mg cap ** Patanol (olopatadine) 0.1% soln Dexedrine (dextroamphetamine) 5mg tab ** Pilocarpine (generic) 1%,2%, 4% soln MS Contin (morphine sulfate) 15mg, 30mg, 60mg tab Pilopine (pilocarpine) 4% HS gel MSIR (morphine) 30mg tab Polysporin (polymixin/bacitracin) oint Percocet (5mg oxycodone / 325mg APAP) tab Polytrim (TMP / polymixin-b) sol Ritalin (methylphenidate) 5mg,10mg, 20mg SR tab ** Pred Forte (prednisolone acetate) 1% susp SCHEDULE III-V CONTROLLED SUBSTANCES Refresh celluvisc (carboxymethylcellulose)1% soln (30 day supply/max 5 refills) Sulamyd (sulfacetamide) 10% soln Ambien (zolpidem) 5mg, 10mg Timoptic (timolol) 0.25%, 0.5% soln Ativan (lorazepam) 0.5mg, 1mg tab Timoptic XE (timolol) 0.25%, 0.5% gel Darvocet-N (propxyphene nap 100mg/APAP 650mg) tab TobraDex (tobramycin/dexamethasone) susp Depo Testosterone (cypionate) 200mg/1ml injection Trusopt (dorzolamde) 2% soln Fiorinal (butalbital/asa/caffeine) tab Vigamox (moxifloxacin) 0.5% soln Halcion (triazolam) 0.25mg tab Visin-A (pheniramine/naphazoline) soln Klonopin (clonazepam) 0.5mg, 1mg tab Voltaren (diclofenac) 0.1% soln Librium (chlordiazepoxide) 10mg cap Xalatan (latanoprost) oph 0.005% soln Lomotil (diphenoxylate/atropine) 2.5/.025mg tab Zaditor (ketotifen) 0.025% soln Lortab (hydrocodone/APAP 7.5/500mg) tab Midrin (325mg APAP/100mg dichloralphenazone/65mg isometheptene) cap OSTEOPOROSIS Phenobarbital 30mg tab, 20mg/5ml liq Actonel (risedronate) 35mg tab Restoril (temazepam) 15mg cap Boniva (ibandronate) 150mg tab Robitussin AC (guaifenesin/codeine) 100-10mg/5ml liq Evista (raloxifene) 60mg tab Tylenol #3 (apap 300mg/codeine phos 30mg) tab Fosamax (alendronate) 5mg, 10mg , 35mg, 70mg tab Tylenol #3 (apap 120mg/codeine 12mg/5ml) elixir Fosamax Plus D (alendronate/vitamin D) 70mg/2800 IU tab Xanax (alprazolam) 0.5mg, 1mg tab Fosamax Plus D (alendronate/vitamin D) 70mg/5600 IU tab Valium (diazepam) 5mg tab Vicodin (hydrocodone/APAP 5mg/500mg) tab OTICS (Ear Medications) Auralgan (generic) drops SMOKING CESSATION PRODUCTS CiproDex (ciprofloxacin 0.3%/ dexamethasone 0.1%) susp Chantix (varenicline) Starting Pack-28 days Cortisporin (neomycin/hydrocortisone/polymixin b) susp Chantix (varenicline) Maintenance Pack-28 days

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Whiteman AFB Pharmacy Updated Quarterly (Jan * Apr * July * Oct) Nov 09

    Commit (nicotine polacrilex) Lozenge 2mg 4mg Ferrous Sulfate 15mg/0.6ml drops Nicotrol NASAL Inhaler (see NOTE below) Ferrous Sulfate 325mg tab Nicotrol ORAL Inhaler (see NOTE below) Fluoride (sodium fluoride) 0.25mg/drop liq Nicorette 2mg/4mg Gum (see NOTE below) Folic Acid 1mg tab Nicotine Patches 7mg, 14mg, 21mg patch (see NOTE below) Optisource tab (post bariatric surgery formula)

     Oyster Shell (calcium/vitamin D) 500mg/200 IU tab NOTE: (Recommend patient enroll in American Lung Prenatal Vitamin tab Association or Health And Wellness Center class. To enroll Prevident 5000 (1.1 % sodium flouride) paste please call 660-687-3438 or 660-687-7662) Prevident 5000 Sensitive (sod. fluoride/potassium nitrate) paste

    Potassium Chloride 8mEq, 10mEq, 20mEq tab, 20mEq/15ml liq Vitamin B-6 (pyridoxine) 50mg tab STEROIDS Vitamin B-12 (cyanocobalmin) 1000mcg/ml inj Cortef (hydrocortisone) 5mg, 10mg, 20mg tab Vi-Daylin-F or TRI-VI-FLOR (vitamin ADC with F) drops Decadron (dexamethasone) 0.5mg, 4mg tab Xylitol Dental Gum Dexamethasone Intensol 1mg/ml soln Florinef (fludrocortisone Acetate)0.5mg tab Medrol DosePak (methylprednisolone) 4mg tab MISCELLANEOUS Orapred (prednisolone) 15mg/5ml syrup Aricept (donepezil) 5mg, 10mg tab Orapred (prednisolone) 15mg ODT tab Antivert (mecliziine) 25mg tab Prednisone 1mg, 5mg, 10mg, 20mg tab Clomid (clomiphene) 50mg tab Prelone (prednisone) 15mg/5ml liq Diamox (acetazolamide) 250mg tab TOPICALS Epi-Pen (epinephrine) auto-injector 0.15mg Jr, 0.3mg Adult (corticosteroid potency-Very High, High, Medium,Low) Hyalgan (sodium hyaluronate) 20mg/2 ml Injection Bacitracin oint - 15gm Levitra (vardenafil) 5mg, 10mg, 20mg tab Bactroban (mupirocin) 2% ointment Lupron (leuprolide Acetate) Depot 3.75mg, 7.5mg Injection Benzoyl peroxide 10% gel Peridex (chlorhexidine gluc) liq Cleocin (clindamycin) 1% Soln Requip (ropinirole) 0.25mg, 0.5mg, 1mg, 2 mg, 3mg, 4mg, 5mg Condylox (podofilox) 0.5% soln Twinject (epinephrine) Auto-injector 0.15, 0.3 one and two-pack Differin (adapalene) 0.1% gel

    Drysol (aluminum) 20% soln

    Efudex (fluorouracil) 5% cream

    Elidel (pimecrolimus) 1% cream

    Elimite (permethrin) 5% cream

    ErythaDerm (erythromycin) 2% soln

    Hydrocortisone 1% cream and ointment (LOW)

    Hydrocortisone 2.5% cream (LOW)

    Kenalog (triamcinolone) 0.1% dental paste

    Lac-Hydrin (ammonium lactate) 12% lotion

    Lidex (fluocinonide) 0.05% cream, oint (HIGH)

    Lidocaine 2% jelly topical, 5% oint topical

    Lidoderm (lidocaine) 5% patches

    Metrogel (metronidazole) 0.1% gel

    Mycelex (clotrimazole) 1% cream, 1% soln

    Mycolog (nystatin/triamcinolone) cream

    Nitro-Dur (nitroglycerin) 0.1, 0.2, 0.4mg/hr Patch

    Nizoral (ketoconazole) 2% cream

    Nizoral (ketoconazole) shampoo

    Nystatin cream

    Retin-A (tretinoin) 0.025% gel & cream, 0.05% cream

    Sebutone (coal tar) shampoo

    Selsun Rx (selenium sulfide) 2.5% shampoo

    Silvadene (silver sulfadiazine) 1% cream

    Synalar (fluocinolone) 0.01% soln (LOW)

    Temovate (clobetasol) 0.05% oint, 0.05% cream (VERY HIGH)

    Triamcinolone 0.5% cream, 0.1% cream, 0.1% oint (MEDIUM)

    Wescort (hydrocortisone valerate) 0.2% cream (MEDIUM)

    Zovirax (acyclovir) 5% oint

    URINARY

    Detrol LA (tolterodine) 2mg, 4mg cap

    Ditropan XL (oxybutynin ER) 5mg, 10mg, 15mg tab

    Proscar (finasteride) 5mg

    Pyridium (phenazopyridine) 100mg tab

    Uroxatral (alfuzosin) 10mg tab VITAMINS/MINERALS/SUPPLEMENTS

     5

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