Genericformulary.xls

Project Access Generic Formulary
I) BLOOD MODIFIERS
A) ANTICOAGULANTS
ORAL
warfarin
B) PLATELET AGGREGATION INHIBITORS
dipyridamole
C) MISCELLANEOUS
pentoxifylline ext-rel
II) CARDIOVASCULAR AGENTS
A) ACE INHIBITORS
Enalapril
captopril
lisinopril
lisinopril/hydrochlorothiazide
captopril/hydrochlorothiazide
moexipril
enalapril/hydrochlorothiazide
benazepril/hydrochlorothiazide
benazepril
fosinopril
B) ALPHA BLOCKERS
doxazosin
prazosin
terazosin
C) ANGIOTENSIN II RECEPTOR BLOCKERS
No Generics
D) ANTIARRHYTHMICS AND CARDIAC GLYCOSIDES
digoxin
quinidine sulfate
mexiletine
quinidine gluconate ext-rel
disopyramide ext-rel
amiodarone
propafenone
disopyramide
procainamide ext-rel (6 hr)
flecainide
E) BETA BLOCKERS
BETA AND ALPHA BLOCKERS
labetalol
E) BETA BLOCKERS cont…
CARDIOSELECTIVE
atenolol
metoprolol
atenolol/chlorthalidone
bisoprolol/hydrochlorothiazide
bisoprolol
NONCARDIOSELECTIVE
pindolol
propranolol
F) CALCIUM CHANNEL BLOCKERS
DIHYDROPYRIDINES
nifedipine ext-rel
nifedipine ext-rel
NONDIHYDROPYRIDINES
verapamil
verapamil ext-rel
diltiazem
diltiazem ext-rel
diltiazem ext-rel
diltiazem ext-rel
G) DIURETICS
hydrochlorothiazide
chlorthalidone
amiloride/hydrochlorothiazide
indapamide
furosemide
triamterene/HCTZ
bumetanide
triamterene/HCTZ
amiloride
spironolactone
spironolactone/HCTZ
metolazone
H) LIPID LOWERING AGENTS
gemfibrozil
lovastatin
cholestyramine
I) NITRATES
isosorbide dinitrate oral
isosorbide mononitrate extrel
nitroglycerin sublingual
isosorbide dinitrate ext-rel tabs
nitroglycerin transdermal
I) NITRATES CONT….
nitroglycerin transdermal
J) MISCELLANEOUS
hydralazine
clonidine
guanfacine
methyldopa
midodrine
IV) CENTRAL NERVOUS SYSTEM
A) ALZHEIMER’S DISEASE
No generics
B) ANALGESICS
NSAIDS
ibuprofen
naproxen
naproxen sodium
ketorolac
etodolac
diflunisal
OPIOIDS
oxycodone/acetaminophen 5/325 only
propoxyphenenap/acetaminophen
hydrocodone/acetaminophen 7.5/750
hydrocodone/acetaminophen tabs
codeine/acetaminophen
hydrocodone/acetaminophen
propoxyphene hcl
oxycodone/aspirin
oxycodone
oxycodone
hydromorphone
morphine
morphine ext-rel
meperidine
morphine supp
MISCELLANEOUS
butalbital/acetaminophen/caffeine
butalbital/aspirin/caffeine
C) MIGRAINE
ABORTIVE THERAPY
ibuprofen
acetaminophen/dichloralphenazone/isometheptene
naproxen sodium
dihydroergotamine inj
PROPHYLACTIC THERAPY
propranolol
verapamil
amitriptyline
D) MULTIPLE SCLEROSIS
No Generics
E) MYASTHENIA GRAVIS
pyridostigmine
F) PARKINSON’S DISEASE
diphenhydramine
benztropine
trihexyphenidyl
selegiline tabs
amantadine, except tabs
carbidopa/levodopa
bromocriptine
carbidopa/levodopa ext-rel
pergolide
G) SEIZURES
phenobarbital
clonazepam tabs
carbamazepine
phenytoin sodium extended
primidone
ethosuximide
valproic acid
V) DERMATOLOGY
A) ACNE VULGARIS
ORAL
tetracycline
doxycycline hyclate
minocycline
isotretinoin
TOPICAL
erythromycin soln
clindamycin soln
# benzoyl peroxide
erythromycin gel 2%
sulfacetamide/sulfur
clindamycin gel
clindamycin lotion
A) ACNE VULGARI TOPICAL cont…
tretinoin
tretinoin
erythromycin/benzoyl peroxide
B) BACTERIAL INFECTIONS
Gentamicin
silver sulfadiazine
mupirocin
C) CORTICOSTEROIDS
Products are grouped based upon relative potency. Cost comparison is based on 15 g
package size.
LOW
hydrocortisone lotion 1%
hydrocortisone crm 2.5%
desonide oint 0.05%
MEDIUM
triamcinolone acetonide crm/lotion 0.025%
triamcinolone acetonide crm/oint/lotion 0.1%
betamethascrm/oint/lotion 0.1%
fluocinolone acetonide crm/oint 0.025%/soln 0.01%
hydrocortisone valerate crm/oint 0.2%
mometasone furoate oint 0.1%
HIGH
fluocinonide crm/oint/gel 0.05%
triamcinolone acetonide crm 0.5%
betamethasone dipropionate crm/oint/lotion 0.05%
desoximetasone crm/oint 0.25%/gel 0.05%
diflorasone diacetate crm 0.05%
VERY HIGH
clobetasol propionate crm/oint 0.05%
betamethasone dipropionate augmented oint 0.05%
diflorasone diacetate oint 0.05%
betamethasone dipropionate augmented gel 0.05%
betamethasone dipropionate augmented crm 0.05%
D) DEPIGMENTING AND REPIGMENTING AGENTS
hydroquinone
hydroquinone/sunscreens
E) FUNGAL INFECTIONS
nystatin/triamcinolone
nystatin
clotrimazole
ketoconazole
econazole
F) PSORIASIS
methotrexate, 2.5 mg only
G) ROSACEA
sulfacetamide/sulfur
H) SCABIES AND PEDICULOSIS
lindane
permethrin 5%
I) VIRAL INFECTIONS
No Generic Topicals
J) MISCELLANEOUS
hydrocortisone crm
selenium sulfide shampoo 2.5%
ketoconazole shampoo 2%
ammonium lactate 12%
lidocaine/prilocaine
VI) EAR, NOSE, & THROAT
A) EAR
benzocaine/antipyrine
acetic acid
B) NOSE
ANTIHISTAMINES
First Generation
promethazine
diphenhydramine
clemastine 2.68 mg
cyproheptadine
hydroxyzine hcl
Second Generation
No Generics
ANTIHISTAMINE/DECONGESTANT COMBINATIONS
First Generation
chlorpheniramine/pseudoephedrine ext-rel 8 mg/120 mg
brompheniramine/pseudoephedrine ext-rel 6 mg/60 mg
brompheniramine/pseudoephedrine ext-rel 12 mg/120 mg
brompheniramine/pseudoephedrine 4 mg/45 mg per 5 mL
carbinoxamine/pseudoephedrine 1 mg/15 mg per mL
Second Generation
No Generics
STEROIDS
No Generics
MISCELLANEOUS
ipratropium spray
C) THROAT AND MOUTH
chlorhexidine gluconate
lidocaine viscous
triamcinolone paste
VII) ENDOCRINOLOGY
A) ADRENAL CORTICOSTEROIDS
prednisone
dexamethasone
prednisolone syrup
fludrocortisone
hydrocortisone
methylprednisolone
prednisolone sodium phosphate
B) DIABETES MELLITUS
INSULINS
OTC insulin human
insulin aspart protamine 70%/insulin aspart 30% OTC insulin isophane human 70%/regular 30% OTC insulin isophane human 50%/regular 50% OTC insulin isophane human 70%/regular 30% insulin glargine LANTUSinsulin aspart NOVOLOGinsulin lispro HUMALOGinsulin lisp 75%/insulin lispro 25% MONITORING-STRIPS AND KITS/DIABETIC SUPPLIES
ORAL AGENTS
glipizide
glyburide
glyburide
glyburide, micronized
metformin
glipizide ext-rel
metformin ext-rel
C) THYROID DISEASE
propylthiouracil
levothyroxine
levothyroxine
levothyroxine
methimazole
D) MISCELLANEOUS
desmopressin nasal
bromocriptine
leuprolide acetate
VIII) GASTROINTESTINAL
A) DIARRHEA
loperamide
diphenoxylate/atropine
B) EMESIS
meclizine
metoclopramide
promethazine
prochlorperazine
trimethobenzamide
C) GASTROESOPHAGEAL REFLUX DISEASE (GERD)/HEARTBURN
ranitidine
cimetidine
nizatidine
famotidine
metoclopramide
omeprazole delayed-rel
D) GASTROINTESTINAL SPASM
atropine/hyoscyamine/scopolamine/Phenobarbital
hyoscyamine sulfate
dicyclomine
hyoscyamine sulfate ext-rel
hyoscyamine sulfate ext-rel
E) INFLAMMATORY BOWEL DISEASE
sulfasalazine
sulfasalazine delayed-rel
hydrocortisone enema
F) PANCREATIC ENZYMES
pancrelipase
pancrelipase delayed-rel
pancrelipase delayed-rel
pancrelipase delayed-rel
pancrelipase delayed-rel
G) ULCERS
cimetidine
ranitidine
famotidine
nizatidine
sucralfate
omeprazole delayed-rel
H) MISCELLANEOUS
lactulose
peg 3350/electrolytes
peg 3350/sodium bicarbonate/NaCL/KCl
lactulose
ursodiol
misoprostol
IX) INFECTIOUS DISEASES
A) ANTIBACTERIALS
CEPHALOSPORINS
First Generation
cephalexin
Second Generation
cefaclor
cefuroxime axetil
MACROLIDES
erythromycin stearate
erythromycin delayed-rel
erythromycin ethylsuccinate
erythromycin/sulfisoxazole
PENICILLINS
* amoxicillin
penicillin VK
ampicillin
dicloxacillin
amoxicillin/clavulanate
SULFONAMIDES
sulfamethoxazole/trimethoprim
TETRACYCLINES
doxycycline hyclate
tetracycline
minocycline
B) ANTIFUNGALS
nystatin
ketoconazole
C) ANTIVIRALS
FOR CYTOMEGALOVIRUS
ganciclovir
FOR HEPATITIS C
ribavirin
FOR HERPES
acyclovir
FOR INFLUENZA
amantadine, except tabs
D) MISCELLANEOUS
isoniazid
metronidazole tabs
hydroxychloroquine
mebendazole
trimethoprim tabs
chloroquine phosphate
nitrofurantoin macrocrystals
clindamycin
mefloquine
pyrazinamide
rifampin
ethambutol
X) MUSCULOSKELETAL
A) ARTHRITIS
DISEASE-MODIFYING ANTI-RHEUMATIC DRUGS
sulfasalazine delayed-rel
sulfasalazine
hydroxychloroquine
methotrexate, 2.5 mg only
azathioprine
NSAIDS AND OTHER ANALGESICS
Piroxicam
indomethacin
ibuprofen
naproxen
salsalate
sulindac
oxaprozin
naproxen sodium
etodolac
diclofenac sodium delayed-rel
indomethacin ext-rel
nabumetone
diflunisal
B) GOUT
indomethacin
allopurinol
naproxen
colchicine
sulindac
probenecid
C) SKELETAL MUSCLE RELAXANTS
MUSCLE SPASM
chlorzoxazone
cyclobenzaprine
carisoprodol
methocarbamol
SPASTICITY
diazepam
baclofen
tizanidine
XI) OB-GYN
A) CONTRACEPTIVES
MONOPHASIC
20 mcg estrogen norethindronecetate/EE/iron 1/20
levonorgestrel/EE 0.1/20
norethindrone acetate/EE 1/20
30 mcg estrogen norethindrone acetate/EE/iron 1.5/30
norgestrel/EE 0.3/30
levonorgestrel/EE 0.15/30
norethindrone acetate/EE 1.5/30
† desogestrel/EE 0.15/30
35 mcg estrogen ethynodiol diacetate/EE 1/35
norethindrone/EE 1/35
norethindrone/EE 0.5/35
† norgestimate/EE 0.25/35
† norethindrone/EE 1/35
† norethindrone/EE 0.5/35
50 mcg estrogen ethynodiol diacetate/EE 1/50
norethindrone/ME 1/50
† norethindrone/ME 1/50
BIPHASIC
† desogestrel/EE
† norethindrone/EE
TRIPHASIC
levonorgestrel/EE
desogestrel/EE
norgestimate/EE
norethindrone/EE
PROGESTIN
norethindrone
† norethindrone
B) ENDOMETRIOSIS
danazol
C) HORMONE THERAPY/MENOPAUSE
ESTROGENS
Oral
estropipate
estradiol
estrogens, esterified/methyltestosterone
Transdermal
estradiol
PROGESTINS
medroxyprogesterone acetate
norethindrone acetate
D) VAGINAL INFECTIONS
ORAL
metronidazole tabs
XII) OPHTHALMIC
A) ALLERGY
cromolyn sodium
B) ANTI-INFLAMMATORIES
Cost is generally based upon solution/suspension formulations. Ointments are also
available for many of the products, and they should be considered on the formulary.
neomycin/polymyxin B/dexamethasMAXITROL
fluorometholone
prednisolone acetate 1%
prednisolone phosphate 1%
sulfacetamide/prednisolone phosphate 10%/0.25%
dexamethasone sodium phosphate
neomycin/polymyxin B/hydrocortisone
C) INFECTIONS
Cost is generally based upon solution formulations. Ointments are also available for
many of the products and they should be considered on the formulary.
BACTERIAL
Bacitracin
erythromycin
gentamicin
sulfacetamide 10%
tobramycin
polymyxin B/trimethoprim
polymyxin B/bacitracin
neomycin/polymyxin B/gramicidin
VIRAL
trifluridine
D) GLAUCOMA
ORAL
Acetazolamide
methazolamide
TOPICAL
dipivefrin
pilocarpine
timolol maleate
levobunolol
timolol maleate gel
metipranolol
carteolol
brimonidine 0.2%
E) MISCELLANEOUS
atropine
XIII) PSYCHIATRIC
A) ANXIETY
diazepam
alprazolam
chlordiazepoxide
buspirone
lorazepam
oxazepam
paroxetine hcl
hydroxyzine hcl
B) ATTENTION DEFICIT HYPERACTIVITY DISORDER
dextroamphetamine
methylphenidate
methylphenidate ext-rel
methylphenidate ext-rel
dextroamphetamine ext-rel
C) BIPOLAR DISORDER
lithium carbonate
lithium carbonate ext-rel caps
lithium carbonate ext-rel tabs
D) DEPRESSION
amitriptyline
fluoxetine
trazodone
nortriptyline
desipramine
imipramine hcl
† mirtazapine
paroxetine hcl
bupropion
nefazodone
† bupropion ext-rel
E) INSOMNIA
temazepam
triazolam
chloral hydrate
F) NARCOLEPSY
methylphenidate
dextroamphetamine
methylphenidate ext-rel
methylphenidate ext-rel
dextroamphetamine ext-rel
G) OBSESSIVE COMPULSIVE DISORDER
fluoxetine
clomipramine
paroxetine hcl
fluvoxamine
H) PANIC DISORDER
fluoxetine
alprazolam
clonazepam tabs
paroxetine hcl
I) PSYCHOSES
haloperidol
fluphenazine
thiothixene
trifluoperazine
thioridazine
chlorpromazine
perphenazine
clozapine
XIV) RESPIRATORY DRUGS
A) ASTHMA/COPD
INHALERS
Beta Agonists
albuterol
INHALATIONS FOR NEBULIZATION
albuterol soln
cromolyn soln
ipratropium soln
ORAL AGENTS
Beta Agonists
albuterol
terbutaline
Theophylline
theophylline ext-rel tabs
theophylline ext-rel caps (12 hr)
theophylline liquid
B) ANTITUSSIVES AND EXPECTORANTS
guaifenesin/pseudoephedrine ext-rel
dextromethorphan/carbinoxamine/pseudoephedrine drops
codeine/guaifenesin
hydrocodone/homatropine
codeine/promethazine
codeine/chlorpheniramine/pseudoephedrine
hydrocodone/chlorpheniramine/phenylephrine
benzonatate
dextromethorphan/brompheniramine/pseudoephedrine
codeine/promethazine/phenylephrine
codeine/guaifenesin/pseudoephedrine
dextromethorphan/brompheniramine/pseudoephedrine syrup
dextromethorphan/carbinoxamine/pseudoephedrine drops
dextromethorphan/promethazine
XV) SUPPLEMENTS
A) POTASSIUM
potassium chloride liquid
potassium chloride ext-rel tabs 8 mEq
potassium chloride ext-rel caps 10 mEq
potassium chloride ext-rel tabs 10 mEq
potassium chloride ext-rel tabs 10 mEq
potassium chloride ext-rel tabs 20 mEq
B) VITAMINS AND MINERALS
fluoride tabs
multivitamins/fluoride/±iron drops/tabs
vitamins ADC/fluoride/±iron drops
folic acid
fluoride drops
prenatal vitamins w/folic acid
ergocalciferol (D2)
calcitriol (1,25-D3)
XVI) UROLOGICAL
A) ERECTILE DYSFUNCTION
No Generics
B) SYMPTOMATIC BENIGN PROSTATIC HYPERTROPHY
doxazosin
terazosin
C) MISCELLANEOUS
phenazopyridine
oxybutynin
bethanechol

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