Commercial Drug Formulary

Transcription

Commercial Drug Formulary
COMMERCIAL FORMULARY
Effective October 2016
Provided by EnvisionRx
Introduction
The Total Health Care (THC) Commercial Formulary was developed to serve as a guide for physicians,
pharmacists, health care professionals and members in the selection of cost-effective drug therapy. Total
Health Care recognizes that drug therapy is an integral part of effective health management.
Total Health Care continually reviews new and existing medications to ensure the Formulary remains
responsive to the needs of our members and health professionals. Criteria used to evaluate drug selection for
the formulary includes, but is not limited to: safety, efficacy and cost-effectiveness data, as well as comparison
of relevant benefits of similar prescription or over-the counter (OTC) agents while minimizing potential
duplications.
Notice
The information contained in this formulary is provided by THC, solely for the convenience of medical
providers and members. THC does not warrant or assure accuracy of this information, nor is it intended to be
comprehensive in nature.
This formulary is not intended to be a substitute for the knowledge, expertise, skill or judgment of the medical
provider in their choice of prescription drugs. Total Health Care assumes no responsibility for the actions or
omissions of any medical provider based upon reliance, in whole or in part, on the information contained
herein. The medical provider should consult the drug manufacturer’s product literature or standard references
for more detailed information.
How to Read the Formulary
Drug Name
All formulary drugs are listed either by their generic names (in lowercase) or by their brand names (in
uppercase). Drugs are grouped together by their therapeutic drug category. Specific drug listings may be
accessed by using the index, using the covered generic name or the covered brand name of the drug. The
brand names listed are for reference use only, and do not denote coverage, unless specifically noted. Any drug
not found in this Formulary listing shall be considered a non-formulary drug.
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Co-Pay Structure
Generic Drug
Generic Co-Pay Applies
Brand Drug
Brand Co-Pay Applies
Requirements/Limits
This field includes potential limitations to the formulary drug. It also may contain additional information
about the coverage of the drug such as applicable quantity limits (QL). For certain agents within the
Commercial Formulary, a recommended prescribing guideline may apply.
Prescribing Guidelines
Prescribing guidelines may apply to select drugs on the THC formulary. Prescribing guidelines may vary by
benefit design but may include:
Prior Authorization
Required (PA)
Drug requires prior authorization through a specific physician request
process.
Over the Counter Drugs
(OTC)
Drug coverage is available for drugs that are available OTC with an
authorized prescription from your provider.
Specialty Drugs (SP)
Drug requires processing through THC’s contracted specialty pharmacy,
Diplomat Specialty Pharmacy.
Quantity Limit (QL)
Drug coverage may be limited to specific quantities per prescription and/or
time period.
Age Limit (AL)
Drug coverage may depend on patient age.
Gender Restriction (GR)
Drug coverage may depend on patient gender.
Step Therapy Required
(ST)
Drug coverage requires that an alternative or trial of another drug be used
before the medication is covered.
Custom (C)
Drug coverage has unique restrictions.
Benefit Coverage and Limitations
This formulary does not define benefit coverage and limitations. Members may have specific benefit
inclusions, exclusions, copayments, or a lack of coverage, which are not reflected in the Total Health Care
Commercial Formulary. Members should contact Total Health Care at 1-800-826-2862 if they have
questions regarding their coverage. Please note that the formulary process is evolutionary and changes can
occur throughout the year.
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Prior Authorization (PA)
Drugs indicated with a “PA” require Prior Authorization for coverage. A prescriber may complete a Prior
Authorization form that can be found on the Total Health Care website at www.THCmi.com. You may also
request a form by calling Total Health Care at 1-844-222-5584. Completed prior authorization forms should
be faxed to 1-866-414-3453. Prior Authorization review of prescribing guidelines will be evaluated utilizing
the established drug review criteria approved by Total Health Care. If the request does not meet the approved
criteria, the request will not be approved and alternative therapy may be recommended along with the proper
course of alternative action. The requesting provider will be provided written notification of Total Health
Care review decisions. THC’s website has a contact link where members can contact THC’s Pharmacy
Department to ask for an exception request.
Non-Formulary Agents
A Drug not located on the Total Health Care Commercial Formulary, or any updates published by Total
Health Care, shall be considered a non-formulary drug. Requests for coverage of non-formulary agents may
be requested by the health professional depending on specific coverage parameters. Review for nonformulary drug requests will require a Prior Authorization request with documentation of medical necessity.
Generally, the following basic medical necessity guidelines are used in conducting a review:



The patient has failed an appropriate trial of formulary or preferred agents.
The use of preferred or formulary agent is contraindicated in the patient.
The formulary drug or preferred agents are not suited for the present patient care need, and the drug
selected is required for patient safety.
If the request does not meet the established guidelines request, it will not be approved and alternative therapy
may be recommended along with the proper course of alternative action.
Common Drug Exclusions
The member’s plan design may exclude certain drug classes. Prior authorization is generally not available for
drugs that are specifically excluded by benefit design. Common excluded coverages may include, but are not
limited to:







OTC medications or their equivalents unless otherwise specified in the Formulary listing.
Drug products used for cosmetic purposes.
Drug products for erectile dysfunction.
Drug products for infertility treatment.
Drug products for weight loss.
Experimental drug products or any drug product used in an experimental manner.
Foreign drugs or drugs not approved by the United States Food & Drug Administration (FDA).
Mandated Generic Substitution
Total Health Care advocates the use of cost-effective generic drugs where FDA-approved generic equivalent
drugs are available. Generic products are listed in the Formulary and noted in lowercase lettering wherever
an FDA-approved generic drug product is available. If a member or physician requests a brand-name product
in lieu of an approved generic, the member, based upon their coverage, will typically be required to pay the
difference in cost between the brand and the generic drug.
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Total Health Care Pharmacy and Therapeutics (P&T) Committee
Total Health Care’s Pharmacy & Therapeutics Committee meets quarterly to review and recommend
medications for formulary consideration. The Committee considers clinical information on drugs that are new
to the market and drugs that are typically included in an outpatient pharmacy benefit. This assures that the
formulary remains responsive to patient and physician needs. The Committee is composed of physicians,
pharmacists, and health care professionals. The Committee also uses reference materials from our Pharmacy
Benefits Manager's Pharmacy and Therapeutics Advisory Panel.
Product Selection Criteria
The primary goal of the THC Pharmacy & Therapeutics Committee is to maintain and update the formulary
based upon an objective analysis of the safety, efficacy, approved indications, adverse effects,
contraindications, patient administration/compliance considerations and cost effectiveness of available drugs.
When a drug is considered for formulary inclusion, it will be reviewed relative to similar drugs including
those currently in the THC Commercial Formulary. Physicians may request a copy of THC’s drug criteria by
calling the Pharmacy Department at 1-800-826-2862.
Diabetic Testing Supplies
Total Health Care works with J&B Medical Supply to provide diabetic testing supplies to our members.
Covered diabetic testing supplies include Glucocard Vital glucometer, Glucocard Expression glucometer, and
SD Biosensor GlucoNavii glucometer, Glucocard Vital test strips, Glucocard Expression test strips, SD
Biosensor GlucoNavii test strips, lancets, insulin syringes, alcohol swabs and ketone strips. These supplies are
to be filled through J&B Medical Supply. If you have any questions about our diabetic supply program,
please contact J&B Medical Supply at 1-844-236-7933.
Specialty Bio-Pharmaceutical Pharmacy Program
Total Health Care works with Diplomat Specialty Pharmacy to provide Specialty Bio-Pharmaceutical
Pharmacy products to our members. These medications are to be filled exclusively through Diplomat
Specialty Pharmacy.
A Specialty Drug Prior Authorization Request form must be completed and faxed to EnvisionRx at 1-866414-3453 with supporting documentation and the prescription. A prescriber may obtain a Specialty Drug
Prior Authorization Request form found on the Total Health Care website at www.THCmi.com.
Once the order is received, EnvisionRx obtains authorization from Total Health Care. If the specialty prior
authorization is approved, Total Health Care notifies Diplomat Specialty Pharmacy. Then, the Diplomat
Specialty Pharmacy staff ships the medication directly to the physician's office or the patient’s home. All
packages are individually marked for each patient and refrigerated items are shipped in insulated containers.
Where appropriate, each shipment includes needles, syringes and alcohol swabs. If you have any questions
about our Specialty Bio-Pharmaceutical Pharmacy program, please contact EnvisionRx at 1-844-222-5584 or
Diplomat Specialty Pharmacy at 1-877-977-9118.
Contact Information
The Total Health Care Commercial Formulary is designed to assist physicians, members and other health care
professionals in the selection of cost-effective agents. Total Health Care encourages your input and feedback
on how we can assist in improving this document and the formulary management process. You may contact
THC at 1-800-826-2862.
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Medication Limitations
Quantity Limitations
Quantity Limitations are on medications throughout the formulary and are indicated with a "QL" notation.
These are medications that have a daily dose restriction, quantity/days’ supply limitation, and/or a limitation
on the duration of therapy.
Age Limitations
Age Limitations are on medications throughout the formulary and are indicated with an "AL" notation.
Coverage for a medication is indicated by the age limitation. This could be a minimum age, maximum age,
and/or the combination of a minimum and maximum age edit.
Gender Restrictions
Gender restrictions are indicated with a “GR” on the formulary and require the member to be a specific
gender for coverage.
Step Therapy Criteria
Step Therapy medications are indicated with a “ST” on the formulary and require that an alternative, first line
medication be tried and failed before the requested medication can be covered. The online claims adjudication
system will automatically allow for the requested medication to be filled based on electronic claims history
indicating that the first line medication was filled.
Step Therapy Criteria
Therapy Class
First Line
Second Line
Third Line
Step Therapy Criteria
Attention
Deficit/Hyperactivity
amphetamine
immediaterelease
amphetamine
extendedrelease
VYVANSE
Antimigraine
sumatriptan,
rizatriptan
naratriptan
Second Line: Prior use
of amphetamine
immediate-release for 60
days within the last 90
days.
Third Line: Prior use of
amphetamine extendedrelease for 60 days
within the last 90 days.
Prior use of sumatriptan
AND rizatriptan in the
last 90 days.
Antipsychotic
Agents
risperidone,
quetiapine
immediaterelease,
olanzapine
alendronate
ziprasidone
Second Line: Prior use
of one step 1 agent
within the last 90 days.
risedronate
Prior use of alendronate
within the last 90 days.
Osteoporosis
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Urinary
Antispasmodics
oxybutynin,
oxybutynin er,
oxybutynin
syrup,
OXYTROL
OTC
tolterodine,
tolterodine er,
trospium
darifenacin
er,
trospium er,
VESICARE
Second Line: Prior use
of OXYTROL OTC,
oxybutynin, oxybutynin
er, or oxybutynin syrup
in the last 90 days.
Third Line: Prior use of
tolterodine, tolterodine
er, or trospium in the last
90 days.
*Formulary Disclaimer: Coverage for some drugs may be limited to specific dosage forms and/or strengths.
The benefit design determines what is covered and the applicable co-payment. The medications listed on this
formulary are subject to change pursuant to the formulary management activities of EnvisionRx. The presence
of a medication on this formulary list does not guarantee coverage.
vi
lowercase italics = Generic drugs
UPPERCASE BOLD = Brand name drugs
Drug
*Adhd/Anti-Narcolepsy/Anti-Obesity/A
norexiants*
Status
T1 = Covered
Status
Notes
AL = Age Limit
GR-F = Female Only
GR-M = Male Only
PA = Prior Authorization
QL = Quantity Limit
ST = Step Therapy
Notes
amphetamine-dextroamphet er oral capsule
extended release 24 hour 10 mg, 15 mg, 20 mg,
25 mg, 30 mg, 5 mg
T1
ST; QL (30 EA per 30 days); AL
(Min 6 Years and Max 17 Years)
amphetamine-dextroamphetamine oral tablet 10
mg, 12.5 mg, 15 mg, 20 mg, 30 mg, 5 mg, 7.5 mg
T1
AL (Min 6 Years and Max 17
Years)
dexmethylphenidate hcl oral tablet 10 mg, 2.5 mg,
5 mg
T1
AL (Min 6 Years and Max 17
Years)
dextroamphetamine sulfate er oral capsule
extended release 24 hour 10 mg, 15 mg, 5 mg
T1
AL (Min 6 Years and Max 17
Years)
dextroamphetamine sulfate oral tablet 10 mg, 5
mg
T1
AL (Min 6 Years and Max 17
Years)
METADATE ER ORAL TABLET
EXTENDEDRELEASE* 20 MG
T1
QL (90 EA per 30 days); AL (Min
6 Years and Max 17 Years)
methylphenidate hcl er (cd) oral capsule extended
release* 10 mg, 20 mg, 30 mg, 40 mg, 50 mg, 60
mg
T1
QL (30 EA per 30 days); AL (Min
6 Years and Max 17 Years)
methylphenidate hcl er oral tablet
extendedrelease* 10 mg
T1
QL (30 EA per 30 days); AL (Min
6 Years and Max 17 Years)
methylphenidate hcl er oral tablet
extendedrelease* 20 mg
T1
QL (90 EA per 30 days); AL (Min
6 Years and Max 17 Years)
methylphenidate hcl oral tablet 10 mg
T1
QL (180 EA per 30 days); AL
(Min 6 Years and Max 17 Years)
methylphenidate hcl oral tablet 20 mg, 5 mg
T1
QL (90 EA per 30 days); AL (Min
6 Years and Max 17 Years)
1
Drug
VYVANSE ORAL CAPSULE 10 MG, 20 MG,
30 MG, 40 MG, 50 MG, 60 MG, 70 MG
Status
T1
Notes
ST; QL (30 EA per 30 days); AL
(Min 6 Years and Max 17 Years)
*Aminoglycosides*
neomycin sulfate oral tablet 500 mg
T1
*Analgesics - Anti-Inflammatory*
diclofenac potassium oral tablet 50 mg
T1
diclofenac sodium er oral tablet extended release
24 hr* 100 mg
T1
diclofenac sodium oral tablet delayed release 25
mg, 50 mg, 75 mg
T1
ENBREL SUBCUTANEOUS* 25 MG/0.5ML,
50 MG/ML
T1
PA
ENBREL SUBCUTANEOUS* SOLUTION
RECONSTITUTED 25 MG
T1
PA
ENBREL SURECLICK SUBCUTANEOUS*
50 MG/ML
T1
PA
fenoprofen calcium oral tablet 600 mg
T1
flurbiprofen oral tablet 100 mg, 50 mg
T1
HUMIRA PEDIATRIC CROHNS START
SUBCUTANEOUS* 40 MG/0.8ML
T1
PA
HUMIRA PEN SUBCUTANEOUS* 40
MG/0.8ML
T1
PA
HUMIRA PEN-CROHNS STARTER
SUBCUTANEOUS* 40 MG/0.8ML
T1
PA
HUMIRA PEN-PSORIASIS STARTER
SUBCUTANEOUS* 40 MG/0.8ML
T1
PA
HUMIRA SUBCUTANEOUS* 10 MG/0.2ML,
20 MG/0.4ML, 40 MG/0.8ML
T1
PA
ibuprofen oral capsule 200 mg
T1
ibuprofen oral suspension 100 mg/5ml
T1
ibuprofen oral tablet 200 mg, 400 mg, 600 mg,
800 mg
T1
indomethacin oral capsule 25 mg, 50 mg
T1
ketoprofen oral capsule 50 mg
T1
QL (360 EA per 30 days)
ketoprofen oral capsule 75 mg
T1
QL (120 EA per 30 days)
ketorolac tromethamine oral tablet 10 mg
T1
QL (20 EA per 5 days)
leflunomide oral tablet 10 mg, 20 mg
T1
meclofenamate sodium oral capsule 50 mg
T1
meloxicam oral tablet 15 mg, 7.5 mg
T1
nabumetone oral tablet 500 mg
T1
QL (120 EA per 30 days)
nabumetone oral tablet 750 mg
T1
QL (60 EA per 30 days)
2
Drug
Status
naproxen dr oral tablet delayed release 375 mg
T1
naproxen oral tablet 250 mg, 375 mg, 500 mg
T1
naproxen sodium oral capsule 220 mg
T1
naproxen sodium oral tablet 220 mg
T1
naproxen sodium powder
T1
oxaprozin oral tablet 600 mg
T1
piroxicam oral capsule 10 mg, 20 mg
T1
sulindac oral tablet 150 mg, 200 mg
T1
Notes
*Analgesics - Nonnarcotic*
ACEPHEN SUPPOSITORY 325 MG
T1
acetaminophen er oral tablet extendedrelease*
650 mg
T1
acetaminophen oral capsule 500 mg
T1
acetaminophen oral elixir 160 mg/5ml
T1
acetaminophen oral suspension 160 mg/5ml
T1
acetaminophen oral tablet 325 mg, 500 mg
T1
acetaminophen suppository 120 mg
T1
adult aspirin low strength oral tablet dispersible
81 mg
T1
apap oral tablet chewable 80 mg
T1
aspirin adult low strength oral tablet delayed
release 81 mg
T1
QL (60 EA per 30 days); AL (Min
40 Years and Max 79 Years)
aspirin low dose oral tablet chewable 81 mg
T1
QL (60 EA per 30 days); AL (Min
40 Years and Max 79 Years)
aspirin oral tablet 325 mg
T1
QL (30 EA per 30 days); AL (Min
40 Years and Max 79 Years)
aspirin oral tablet 81 mg
T1
QL (60 EA per 30 days); AL (Min
40 Years and Max 79 Years)
aspirin oral tablet delayed release 325 mg
T1
QL (30 EA per 30 days); AL (Min
40 Years and Max 79 Years)
aspirin suppository 300 mg, 600 mg
T1
aspirtab maximum strength oral tablet 500 mg
T1
buffasal oral tablet 324 mg
T1
QL (30 EA per 30 days); AL (Min
40 Years and Max 79 Years)
buffered aspirin oral tablet 325 mg
T1
QL (30 EA per 30 days); AL (Min
40 Years and Max 79 Years)
butalbital-acetaminophen oral tablet 50-325 mg
T1
butalbital-apap-caffeine oral tablet 50-325-40 mg
T1
butalbital-aspirin-caffeine oral capsule
50-325-40 mg
T1
QL (30 EA per 30 days); AL (Min
40 Years and Max 79 Years)
3
Drug
Status
choline-mag trisalicylate oral liquid† 500 mg/5ml
T1
diflunisal oral tablet 500 mg
T1
infants pain relief oral suspension 80 mg/0.8ml
T1
migraine relief oral tablet 250-250-65 mg
T1
q-pap infants oral solution 80 mg/0.8ml
T1
q-pap oral liquid† 160 mg/5ml
T1
salsalate oral tablet 500 mg, 750 mg
T1
Notes
*Analgesics - Opioid*
acetaminophen-codeine #2 oral tablet 300-15 mg
T1
QL (390 EA per 30 days)
acetaminophen-codeine #3 oral tablet 300-30 mg
T1
QL (390 EA per 30 days)
acetaminophen-codeine #4 oral tablet 300-60 mg
T1
QL (390 EA per 30 days)
acetaminophen-codeine oral solution 120-12
mg/5ml
T1
butalbital-apap-caff-cod oral capsule
50-325-40-30 mg
T1
butalbital-asa-caff-codeine oral capsule
50-325-40-30 mg
T1
codeine sulfate oral tablet 30 mg, 60 mg
T1
fentanyl transdermal patch 72 hr 100 mcg/hr, 25
mcg/hr, 50 mcg/hr, 75 mcg/hr
T1
QL (10 EA per 30 days)
fentanyl transdermal patch 72 hr 12 mcg/hr
T1
PA; QL (10 EA per 30 days)
hydrocodone-acetaminophen oral solution 10-325
mg/15ml, 7.5-325 mg/15ml
T1
QL (900 ML per 90 days)
hydrocodone-acetaminophen oral tablet 10-325
mg, 7.5-325 mg
T1
QL (180 EA per 30 days)
hydrocodone-acetaminophen oral tablet 5-325 mg
T1
QL (360 EA per 30 days)
hydromorphone hcl oral tablet 2 mg, 4 mg, 8 mg
T1
QL (240 EA per 30 days)
meperidine hcl oral tablet 100 mg, 50 mg
T1
methadone hcl oral concentrate 10 mg/ml
T1
methadone hcl oral solution 10 mg/5ml, 5 mg/5ml
T1
methadone hcl oral tablet 10 mg
T1
methadone hcl oral tablet 5 mg
T1
methadone hcl oral tablet soluble 40 mg
T1
morphine sulfate (concentrate) oral solution 100
mg/5ml
T1
morphine sulfate er oral tablet extendedrelease*
100 mg, 15 mg, 30 mg, 60 mg
T1
morphine sulfate oral solution 10 mg/5ml, 20
mg/5ml
T1
morphine sulfate oral tablet 15 mg, 30 mg
T1
4
QL (240 EA per 30 days)
QL (90 EA per 30 days)
QL (180 EA per 30 days)
Drug
Status
Notes
oxycodone hcl oral concentrate 100 mg/5ml
T1
oxycodone hcl oral solution 5 mg/5ml
T1
oxycodone hcl oral tablet 15 mg, 30 mg, 5 mg
T1
QL (180 EA per 30 days)
oxycodone-acetaminophen oral tablet 10-325 mg,
7.5-325 mg
T1
QL (180 EA per 30 days)
oxycodone-acetaminophen oral tablet 5-325 mg
T1
QL (360 EA per 30 days)
oxycodone-aspirin oral tablet 4.8355-325 mg
T1
tramadol hcl oral tablet 50 mg
T1
QL (240 EA per 30 days)
T1
PA
*Androgens-Anabolic*
testosterone cypionate intramuscular* solution
100 mg/ml, 200 mg/ml
*Anorectal Agents*
hemorrhoidal cream 1-0.25-14.4-15 %
T1
hemorrhoidal suppository 51 %
T1
hydrocortisone acetate suppository 25 mg, 30 mg
T1
hydrocortisone enema 100 mg/60ml
T1
PROCTOCORT CREAM 1 %
T1
PROCTOZONE-HC CREAM 2.5 %
T1
QL (28 EA per 14 days)
QL (120 GM per 30 days)
*Antacids*
ALKA-SELTZER HEARTBURN ORAL
TABLET EFFERVESCENT 1940-1000 MG
T1
ALMACONE ORAL TABLET CHEWABLE
200-200-25 MG
T1
antacid & antigas oral suspension 200-200-20
mg/5ml, 400-400-40 mg/5ml
T1
antacid extra strength oral tablet chewable
675-135 mg
T1
antacid multi-symptom oral tablet chewable
675-135-60 mg
T1
antacid oral tablet chewable 1177 mg, 350-150
mg, 420 mg, 550-110 mg
T1
calcium antacid ultra oral tablet chewable 1000
mg
T1
calcium carbonate antacid oral tablet 648 mg
T1
calcium carbonate antacid oral tablet chewable
500 mg, 750 mg
T1
CHILDRENS SOOTHE ORAL TABLET
CHEWABLE 400 MG
T1
CITROCARBONATE ORAL GRANULES
EFFERVESCENT 0.78-1.82 GM/DOSE
T1
5
Drug
Status
cvs antacid & anti-gas oral tablet chewable
1000-60 mg
T1
cvs antacid supreme oral suspension 400-135
mg/5ml
T1
DEWEES CARMINATIVE ORAL LIQUID†
6-250
T1
E-Z-GAS II ORAL PACKET 2.21-1.53-0.04
GM
T1
GAVISCON EXTRA RELIEF FORMULA
ORAL SUSPENSION 508-475 MG/10ML
T1
GAVISCON ORAL TABLET CHEWABLE
80-14.2 MG
T1
gnp foaming antacid oral suspension 95-358
mg/15ml
T1
gnp foaming antacid oral tablet chewable 80-20
mg
T1
heartburn antacid ex st oral tablet chewable
160-105 mg
T1
mag-al oral liquid† 200-200 mg/5ml
T1
magnesium oxide oral capsule 400 mg
T1
magnesium oxide oral tablet 250 mg, 400 mg, 420
mg
T1
magnesium oxide powder
T1
MI-ACID ORAL TABLET CHEWABLE
700-300 MG
T1
sodium bicarbonate oral powder
T1
sodium bicarbonate oral tablet 325 mg, 650 mg
T1
URO-MAG ORAL CAPSULE 140 MG
T1
*Anthelmintics*
PIN-X ORAL SUSPENSION 50 MG/ML
T1
PIN-X ORAL TABLET CHEWABLE 720.5
MG
T1
reeses pinworm medicine oral suspension 144
mg/ml
T1
*Antianginal Agents*
isosorbide dinitrate er oral tablet
extendedrelease* 40 mg
T1
isosorbide dinitrate oral tablet 10 mg, 20 mg, 30
mg, 5 mg
T1
isosorbide mononitrate er oral tablet extended
release 24 hr* 120 mg, 30 mg, 60 mg
T1
isosorbide mononitrate oral tablet 20 mg
T1
6
Notes
Drug
Status
NITRO-BID TRANSDERMAL OINTMENT 2
%
T1
nitroglycerin er oral capsule extended release*
2.5 mg, 6.5 mg, 9 mg
T1
nitroglycerin transdermal patch 24 hr 0.1 mg/hr,
0.2 mg/hr, 0.4 mg/hr, 0.6 mg/hr
T1
NITROSTAT SUBLINGUAL TABLET
SUBLINGUAL 0.3 MG, 0.4 MG, 0.6 MG
T1
Notes
*Antianxiety Agents*
alprazolam oral tablet 0.25 mg, 0.5 mg, 1 mg, 2
mg
T1
buspirone hcl oral tablet 10 mg, 15 mg, 30 mg, 5
mg, 7.5 mg
T1
chlordiazepoxide hcl oral capsule 10 mg, 25 mg,
5 mg
T1
clorazepate dipotassium oral tablet 15 mg, 3.75
mg, 7.5 mg
T1
diazepam injection solution 5 mg/ml
T1
diazepam oral solution 1 mg/ml
T1
AL (Max 64 Years)
diazepam oral tablet 10 mg, 2 mg, 5 mg
T1
AL (Max 64 Years)
hydroxyzine hcl oral syrup 10 mg/5ml
T1
hydroxyzine hcl oral tablet 10 mg, 25 mg, 50 mg
T1
hydroxyzine pamoate oral capsule 100 mg, 25
mg, 50 mg
T1
lorazepam oral tablet 0.5 mg, 1 mg, 2 mg
T1
oxazepam oral capsule 10 mg, 15 mg, 30 mg
T1
AL (Max 64 Years)
*Antiarrhythmics*
amiodarone hcl oral tablet 200 mg
T1
disopyramide phosphate oral capsule 100 mg,
150 mg
T1
flecainide acetate oral tablet 100 mg, 150 mg, 50
mg
T1
NORPACE CR ORAL CAPSULE
EXTENDED RELEASE 12 HOUR 100 MG
T1
QL (60 EA per 30 days)
NORPACE CR ORAL CAPSULE
EXTENDED RELEASE 12 HOUR 150 MG
T1
QL (120 EA per 30 days)
propafenone hcl oral tablet 150 mg, 225 mg, 300
mg
T1
quinidine gluconate er oral tablet
extendedrelease* 324 mg
T1
quinidine sulfate oral tablet 200 mg, 300 mg
T1
7
Drug
*Antiasthmatic And Bronchodilator
Agents*
Status
Notes
ADVAIR DISKUS INHALATION AEROSOL
POWDER, BREATH ACTIVATED 100-50
MCG/DOSE
T1
QL (60 EA per 30 days); AL (Max
11 Years)
AEROSPAN INHALATION AEROSOL,
SOLUTION 80 MCG/ACT
T1
QL (8.9 GM per 30 days)
albuterol sulfate inhalation nebulization solution
(2.5 mg/3ml) 0.083%, (5 mg/ml) 0.5%
T1
albuterol sulfate oral syrup 2 mg/5ml
T1
ANORO ELLIPTA INHALATION
AEROSOL POWDER, BREATH
ACTIVATED 62.5-25 MCG/INH
T1
PA; QL (60 EA per 30 days)
ATROVENT HFA INHALATION
AEROSOL, SOLUTION 17 MCG/ACT
T1
QL (12.9 GM per 30 days)
BREO ELLIPTA INHALATION AEROSOL
POWDER, BREATH ACTIVATED 100-25
MCG/INH, 200-25 MCG/INH
T1
QL (60 EA per 30 days)
budesonide inhalation suspension 0.25 mg/2ml,
0.5 mg/2ml
T1
AL (Max 6 Years)
DULERA INHALATION AEROSOL† 100-5
MCG/ACT, 200-5 MCG/ACT
T1
QL (13 GM per 30 days)
FLOVENT DISKUS INHALATION
AEROSOL POWDER, BREATH
ACTIVATED 100 MCG/BLIST, 50
MCG/BLIST
T1
QL (60 EA per 30 days); AL (Min
4 Years and Max 11 Years)
FLOVENT HFA INHALATION AEROSOL†
44 MCG/ACT
T1
QL (10.6 GM per 30 days); AL
(Min 4 Years and Max 11 Years)
FORADIL AEROLIZER INHALATION
CAPSULE 12 MCG
T1
QL (60 EA per 30 days)
INCRUSE ELLIPTA INHALATION
AEROSOL POWDER, BREATH
ACTIVATED 62.5 MCG/INH
T1
QL (30 EA per 30 days)
ipratropium bromide inhalation solution 0.02 %
T1
LUFYLLIN ORAL TABLET 200 MG, 400
MG
T1
metaproterenol sulfate oral syrup 10 mg/5ml
T1
metaproterenol sulfate oral tablet 10 mg, 20 mg
T1
montelukast sodium oral tablet 10 mg
T1
montelukast sodium oral tablet chewable 4 mg, 5
mg
T1
SEREVENT DISKUS INHALATION
AEROSOL POWDER, BREATH
ACTIVATED 50 MCG/DOSE
T1
8
QL (120 EA per 30 days)
Drug
Status
Notes
STRIVERDI RESPIMAT INHALATION
AEROSOL, SOLUTION 2.5 MCG/ACT
T1
QL (4 GM per 30 days)
SYMBICORT INHALATION AEROSOL†
160-4.5 MCG/ACT, 80-4.5 MCG/ACT
T1
QL (10.2 GM per 30 days)
terbutaline sulfate oral tablet 2.5 mg, 5 mg
T1
THEO-24 ORAL CAPSULE EXTENDED
RELEASE 24 HOUR 100 MG, 200 MG, 300
MG
T1
theophylline er oral tablet extended release 12
hr* 100 mg, 200 mg, 300 mg, 450 mg
T1
theophylline oral solution 80 mg/15ml
T1
TUDORZA PRESSAIR INHALATION
AEROSOL POWDER, BREATH
ACTIVATED 400 MCG/ACT
T1
QL (1 EA per 30 days)
VENTOLIN HFA INHALATION AEROSOL,
SOLUTION 108 (90 BASE) MCG/ACT
T1
QL (18 GM per 25 days)
enoxaparin sodium injection solution 300 mg/3ml
T1
PA
enoxaparin sodium subcutaneous* solution 100
mg/ml, 120 mg/0.8ml, 150 mg/ml, 30 mg/0.3ml,
40 mg/0.4ml, 60 mg/0.6ml, 80 mg/0.8ml
T1
PA
heparin sodium (porcine) injection solution 1000
unit/ml, 10000 unit/ml, 20000 unit/ml, 5000
unit/ml
T1
heparin sodium (porcine) pf injection solution
5000 unit/0.5ml
T1
JANTOVEN ORAL TABLET 1 MG, 10 MG, 2
MG, 2.5 MG, 3 MG, 4 MG, 5 MG, 6 MG, 7.5
MG
T1
warfarin sodium oral tablet 1 mg, 10 mg, 2 mg,
2.5 mg, 3 mg, 4 mg, 5 mg, 6 mg, 7.5 mg
T1
XARELTO ORAL TABLET 10 MG
T1
*Anticoagulants*
PA; QL (35 EA per 35 days)
*Anticonvulsants*
carbamazepine er oral capsule extended release
12 hour 300 mg
T1
carbamazepine er oral tablet extended release 12
hr* 200 mg, 400 mg
T1
carbamazepine oral suspension 100 mg/5ml
T1
carbamazepine oral tablet 200 mg
T1
carbamazepine oral tablet chewable 100 mg
T1
clonazepam oral tablet 0.5 mg, 1 mg, 2 mg
T1
diazepam gel 2.5 mg
T1
QL (2 EA per 30 days)
9
Drug
Status
Notes
DILANTIN ORAL CAPSULE 100 MG
T1
divalproex sodium er oral tablet extended release
24 hr* 250 mg, 500 mg
T1
divalproex sodium oral 125 mg
T1
divalproex sodium oral tablet delayed release 125
mg, 250 mg, 500 mg
T1
EPITOL ORAL TABLET 200 MG
T1
ethosuximide oral capsule 250 mg
T1
ethosuximide oral solution 250 mg/5ml
T1
fosphenytoin sodium injection solution 100 mg
pe/2ml, 500 mg pe/10ml
T1
gabapentin oral capsule 100 mg, 300 mg, 400 mg
T1
gabapentin oral solution 250 mg/5ml
T1
gabapentin oral tablet 600 mg, 800 mg
T1
lamotrigine oral tablet 100 mg, 150 mg, 200 mg
T1
lamotrigine oral tablet 25 mg
T1
lamotrigine oral tablet chewable 25 mg, 5 mg
T1
levetiracetam oral solution 100 mg/ml
T1
levetiracetam oral tablet 1000 mg
T1
QL (90 EA per 30 days)
levetiracetam oral tablet 250 mg
T1
QL (360 EA per 30 days)
levetiracetam oral tablet 500 mg
T1
QL (180 EA per 30 days)
levetiracetam oral tablet 750 mg
T1
QL (120 EA per 30 days)
oxcarbazepine oral tablet 150 mg, 300 mg, 600
mg
T1
phenytoin oral suspension 125 mg/5ml
T1
phenytoin oral tablet chewable 50 mg
T1
phenytoin sodium extended oral capsule 100 mg
T1
primidone oral tablet 250 mg, 50 mg
T1
topiramate oral capsule sprinkle 15 mg, 25 mg
T1
topiramate oral tablet 100 mg, 200 mg, 25 mg, 50
mg
T1
valproic acid oral capsule 250 mg
T1
valproic acid oral solution 250 mg/5ml
T1
zonisamide oral capsule 100 mg
T1
QL (180 EA per 30 days)
zonisamide oral capsule 25 mg, 50 mg
T1
QL (30 EA per 30 days)
amitriptyline hcl oral tablet 10 mg, 100 mg, 150
mg, 25 mg, 50 mg, 75 mg
T1
AL (Max 64 Years)
amoxapine oral tablet 100 mg, 150 mg, 25 mg, 50
mg
T1
AL (Max 64 Years)
QL (3 EA per 1 day)
QL (750 ML per 30 days)
*Antidepressants*
10
Drug
Status
Notes
bupropion hcl er (sr) oral tablet extended release
12 hr* 100 mg, 150 mg, 200 mg
T1
bupropion hcl er (xl) oral tablet extended release
24 hr* 150 mg, 300 mg
T1
bupropion hcl oral tablet 100 mg, 75 mg
T1
citalopram hydrobromide oral tablet 10 mg, 20
mg, 40 mg
T1
doxepin hcl oral capsule 10 mg, 100 mg, 150 mg,
25 mg, 50 mg, 75 mg
T1
AL (Max 64 Years)
doxepin hcl oral concentrate 10 mg/ml
T1
AL (Max 64 Years)
duloxetine hcl oral capsule delayed release
particles 20 mg
T1
QL (60 EA per 30 days)
duloxetine hcl oral capsule delayed release
particles 30 mg, 60 mg
T1
QL (30 EA per 30 days)
escitalopram oxalate oral tablet 10 mg, 5 mg
T1
QL (45 EA per 30 days)
escitalopram oxalate oral tablet 20 mg
T1
QL (30 EA per 30 days)
fluoxetine hcl oral capsule 10 mg, 20 mg, 40 mg
T1
fluoxetine hcl oral solution 20 mg/5ml
T1
fluvoxamine maleate oral tablet 100 mg, 25 mg,
50 mg
T1
imipramine hcl oral tablet 10 mg, 25 mg, 50 mg
T1
mirtazapine oral tablet 15 mg, 30 mg, 45 mg
T1
nortriptyline hcl oral capsule 10 mg, 25 mg, 50
mg, 75 mg
T1
nortriptyline hcl oral solution 10 mg/5ml
T1
paroxetine hcl oral tablet 10 mg, 20 mg, 30 mg,
40 mg
T1
phenelzine sulfate oral tablet 15 mg
T1
sertraline hcl oral tablet 100 mg, 25 mg, 50 mg
T1
tranylcypromine sulfate oral tablet 10 mg
T1
trazodone hcl oral tablet 100 mg, 150 mg, 50 mg
T1
venlafaxine hcl er oral capsule extended release
24 hour 150 mg, 37.5 mg, 75 mg
T1
venlafaxine hcl oral tablet 100 mg, 25 mg, 37.5
mg, 50 mg, 75 mg
T1
AL (Max 64 Years)
PA
*Antidiabetics*
acarbose oral tablet 100 mg, 25 mg, 50 mg
T1
alogliptin benzoate oral tablet 12.5 mg, 25 mg,
6.25 mg
T1
QL (30 EA per 30 days)
alogliptin-metformin hcl oral tablet 12.5-1000
mg, 12.5-500 mg
T1
QL (30 EA per 30 days)
11
Drug
Status
Notes
alogliptin-pioglitazone oral tablet 12.5-15 mg,
12.5-30 mg, 12.5-45 mg, 25-15 mg, 25-30 mg,
25-45 mg
T1
APIDRA INJECTION SOLUTION 100
UNIT/ML
T1
APIDRA SOLOSTAR SUBCUTANEOUS*
100 UNIT/ML
T1
chlorpropamide oral tablet 100 mg, 250 mg
T1
glimepiride oral tablet 1 mg, 2 mg, 4 mg
T1
glipizide oral tablet 10 mg, 5 mg
T1
glipizide xl oral tablet extended release 24 hr* 10
mg, 2.5 mg, 5 mg
T1
QL (60 EA per 30 days)
GLUCAGON EMERGENCY INJECTION
KIT 1 MG
T1
QL (2 EA per 365 days)
glyburide micronized oral tablet 1.5 mg, 3 mg, 6
mg
T1
glyburide oral tablet 1.25 mg, 2.5 mg, 5 mg
T1
glyburide-metformin oral tablet 1.25-250 mg,
2.5-500 mg, 5-500 mg
T1
INVOKANA ORAL TABLET 100 MG, 300
MG
T1
PA; QL (30 EA per 30 days)
JANUMET ORAL TABLET 50-1000 MG,
50-500 MG
T1
QL (60 EA per 30 days)
JANUMET XR ORAL TABLET EXTENDED
RELEASE 24 HR* 100-1000 MG, 50-1000
MG, 50-500 MG
T1
QL (30 EA per 30 days)
JANUVIA ORAL TABLET 100 MG, 25 MG,
50 MG
T1
QL (30 EA per 30 days)
LANTUS SOLOSTAR SUBCUTANEOUS*
100 UNIT/ML
T1
LANTUS SUBCUTANEOUS* SOLUTION
100 UNIT/ML
T1
metformin hcl er oral tablet extended release 24
hr* 500 mg, 750 mg
T1
metformin hcl oral tablet 1000 mg, 500 mg, 850
mg
T1
nateglinide oral tablet 120 mg, 60 mg
T1
NOVOLIN 70/30 RELION
SUBCUTANEOUS* SUSPENSION (70-30)
100 UNIT/ML
T1
NOVOLIN 70/30 SUBCUTANEOUS*
SUSPENSION (70-30) 100 UNIT/ML
T1
12
QL (30 EA per 30 days)
QL (90 EA per 30 days)
Drug
Status
Notes
NOVOLIN N RELION SUBCUTANEOUS*
SUSPENSION 100 UNIT/ML
T1
NOVOLIN N SUBCUTANEOUS*
SUSPENSION 100 UNIT/ML
T1
NOVOLIN R INJECTION SOLUTION 100
UNIT/ML
T1
NOVOLIN R RELION INJECTION
SOLUTION 100 UNIT/ML
T1
NOVOLOG MIX 70/30 SUBCUTANEOUS*
SUSPENSION (70-30) 100 UNIT/ML
T1
pioglitazone hcl oral tablet 15 mg, 30 mg, 45 mg
T1
QL (30 EA per 30 days)
pioglitazone hcl-metformin hcl oral tablet 15-500
mg, 15-850 mg
T1
QL (60 EA per 30 days)
TANZEUM SUBCUTANEOUS* 30 MG, 50
MG
T1
PA
TOUJEO SOLOSTAR SUBCUTANEOUS*
300 UNIT/ML
T1
*Antidiarrheals*
acidophilus/citrus pectin oral tablet
T1
acidophilus/pectin oral capsule
T1
bismuth oral tablet chewable 262 mg
T1
CULTURELLE DIGESTIVE HEALTH
ORAL CAPSULE
T1
CULTURELLE DIGESTIVE HEALTH
ORAL TABLET CHEWABLE
T1
diphenoxylate-atropine oral liquid† 2.5-0.025
mg/5ml
T1
diphenoxylate-atropine oral tablet 2.5-0.025 mg
T1
IMODIUM A-D ORAL TABLET
CHEWABLE 2 MG
T1
loperamide hcl oral capsule 2 mg
T1
loperamide hcl oral liquid† 1 mg/5ml
T1
loperamide hcl oral suspension 1 mg/7.5ml
T1
loperamide hcl oral tablet 2 mg
T1
pink bismuth maximum strength oral suspension
525 mg/15ml
T1
pink bismuth oral suspension 262 mg/15ml
T1
ra pink bismuth oral tablet 262 mg
T1
ra probiotic digestive care oral capsule
T1
13
Drug
*Antidotes*
Status
Notes
naloxone hcl injection solution 0.4 mg/ml, 1
mg/ml
T1
QL (2 ML per 90 days)
naltrexone hcl oral tablet 50 mg
T1
QL (40 EA per 30 days)
*Antiemetics*
dimenhydrinate injection solution 50 mg/ml
T1
dimenhydrinate oral tablet 50 mg
T1
DRAMAMINE ORAL TABLET CHEWABLE
50 MG
T1
dronabinol oral capsule 10 mg, 2.5 mg, 5 mg
T1
meclizine hcl oral tablet 12.5 mg, 25 mg
T1
meclizine hcl oral tablet chewable 25 mg
T1
meclizine hcl powder
T1
ondansetron hcl oral solution 4 mg/5ml
T1
ondansetron hcl oral tablet 4 mg, 8 mg
T1
ondansetron oral tablet dispersible 4 mg, 8 mg
T1
trimethobenzamide hcl oral capsule 300 mg
T1
PA
QL (50 ML per 30 days)
*Antifungals*
fluconazole oral suspension reconstituted 10
mg/ml, 40 mg/ml
T1
fluconazole oral tablet 100 mg, 200 mg, 50 mg
T1
fluconazole oral tablet 150 mg
T1
griseofulvin microsize oral suspension 125
mg/5ml
T1
griseofulvin microsize oral tablet 500 mg
T1
griseofulvin ultramicrosize oral tablet 125 mg,
250 mg
T1
ketoconazole oral tablet 200 mg
T1
nystatin oral powder
T1
nystatin oral tablet 500000 unit
T1
terbinafine hcl oral tablet 250 mg
T1
QL (4 EA per 30 days)
*Antihistamines*
aler-dryl oral tablet 50 mg
T1
aller-chlor oral syrup 2 mg/5ml
T1
cetirizine hcl oral syrup 5 mg/5ml
T1
cetirizine hcl oral tablet 10 mg, 5 mg
T1
chlorpheniramine maleate er oral tablet
extendedrelease* 12 mg
T1
chlorpheniramine maleate oral tablet 4 mg
T1
14
PA
Drug
Status
Notes
chlorpheniramine maleate powder
T1
clemastine fumarate oral syrup 0.67 mg/5ml
T1
clemastine fumarate oral tablet 1.34 mg, 2.68 mg
T1
cvs allergy childrens oral tablet chewable 12.5
mg
T1
cyproheptadine hcl oral syrup 2 mg/5ml
T1
cyproheptadine hcl oral tablet 4 mg
T1
dexchlorpheniramine maleate oral syrup 2
mg/5ml
T1
diphenhist oral liquid† 12.5 mg/5ml
T1
PA
diphenhydramine hcl oral capsule 25 mg, 50 mg
T1
PA
diphenhydramine hcl oral elixir 12.5 mg/5ml
T1
PA
diphenhydramine hcl oral tablet 25 mg
T1
PA
ED CHLORPED ORAL LIQUID† 2 MG/ML
T1
fexofenadine hcl childrens oral suspension 30
mg/5ml
T1
fexofenadine hcl oral tablet 180 mg
T1
levocetirizine dihydrochloride oral tablet 5 mg
T1
loratadine allergy relief oral tablet dispersible 10
mg
T1
loratadine childrens oral solution 5 mg/5ml
T1
loratadine oral tablet 10 mg
T1
promethazine hcl oral solution 6.25 mg/5ml
T1
promethazine hcl oral tablet 12.5 mg, 25 mg, 50
mg
T1
promethazine hcl suppository 12.5 mg, 25 mg, 50
mg
T1
QL (28 EA per 14 days)
ra allergy relief childrens oral tablet dispersible
12.5 mg
T1
PA
silphen cough oral syrup 12.5 mg/5ml
T1
PA
TRIAMINIC COUGH/RUNNY NOSE ORAL
STRIP 12.5 MG
T1
PA
QL (30 EA per 30 days)
*Antihyperlipidemics*
atorvastatin calcium oral tablet 10 mg, 20 mg, 40
mg, 80 mg
T1
cholestyramine light oral powder 4 gm/dose
T1
cholestyramine oral powder 4 gm/dose
T1
colestipol hcl oral granules 5 gm
T1
colestipol hcl oral tablet 1 gm
T1
QL (30 EA per 30 days)
15
Drug
Status
fenofibrate micronized oral capsule 134 mg, 200
mg, 67 mg
T1
fenofibrate oral tablet 160 mg, 54 mg
T1
gemfibrozil oral tablet 600 mg
T1
lovastatin oral tablet 10 mg, 20 mg, 40 mg
T1
NIACOR ORAL TABLET 500 MG
T1
pravastatin sodium oral tablet 10 mg, 20 mg, 40
mg, 80 mg
T1
simvastatin oral tablet 10 mg, 20 mg, 40 mg, 5 mg
T1
Notes
QL (30 EA per 30 days)
QL (30 EA per 30 days)
*Antihypertensives*
amlodipine besy-benazepril hcl oral capsule
10-20 mg, 10-40 mg, 2.5-10 mg, 5-10 mg, 5-20
mg, 5-40 mg
T1
atenolol-chlorthalidone oral tablet 100-25 mg,
50-25 mg
T1
AZOR ORAL TABLET 10-20 MG, 10-40 MG,
5-20 MG, 5-40 MG
T1
benazepril hcl oral tablet 10 mg, 20 mg, 40 mg, 5
mg
T1
benazepril-hydrochlorothiazide oral tablet
10-12.5 mg, 20-12.5 mg, 20-25 mg, 5-6.25 mg
T1
bisoprolol-hydrochlorothiazide oral tablet
10-6.25 mg, 2.5-6.25 mg, 5-6.25 mg
T1
captopril oral tablet 100 mg
T1
captopril oral tablet 12.5 mg, 25 mg, 50 mg
T1
captopril-hydrochlorothiazide oral tablet 25-15
mg, 25-25 mg, 50-15 mg, 50-25 mg
T1
clonidine hcl oral tablet 0.1 mg, 0.2 mg, 0.3 mg
T1
doxazosin mesylate oral tablet 1 mg, 2 mg, 4 mg,
8 mg
T1
enalapril maleate oral tablet 10 mg, 2.5 mg, 20
mg, 5 mg
T1
enalapril-hydrochlorothiazide oral tablet 10-25
mg, 5-12.5 mg
T1
fosinopril sodium oral tablet 10 mg, 20 mg, 40 mg
T1
guanfacine hcl oral tablet 1 mg, 2 mg
T1
hydralazine hcl oral tablet 10 mg, 100 mg, 25 mg,
50 mg
T1
irbesartan oral tablet 150 mg, 300 mg, 75 mg
T1
QL (30 EA per 30 days)
irbesartan-hydrochlorothiazide oral tablet
150-12.5 mg, 300-12.5 mg
T1
QL (30 EA per 30 days)
16
PA; QL (30 EA per 30 days)
QL (90 EA per 30 days)
Drug
Status
Notes
lisinopril oral tablet 10 mg, 2.5 mg, 20 mg, 30
mg, 40 mg, 5 mg
T1
lisinopril-hydrochlorothiazide oral tablet 10-12.5
mg, 20-12.5 mg, 20-25 mg
T1
losartan potassium oral tablet 100 mg, 25 mg, 50
mg
T1
QL (30 EA per 30 days)
losartan potassium-hctz oral tablet 100-12.5 mg,
100-25 mg, 50-12.5 mg
T1
QL (30 EA per 30 days)
methyldopa oral tablet 250 mg, 500 mg
T1
metoprolol-hydrochlorothiazide oral tablet
100-25 mg, 100-50 mg, 50-25 mg
T1
minoxidil oral tablet 10 mg, 2.5 mg
T1
moexipril hcl oral tablet 15 mg, 7.5 mg
T1
prazosin hcl oral capsule 1 mg, 2 mg, 5 mg
T1
propranolol-hctz oral tablet 40-25 mg, 80-25 mg
T1
quinapril hcl oral tablet 10 mg, 20 mg, 40 mg, 5
mg
T1
quinapril-hydrochlorothiazide oral tablet 10-12.5
mg, 20-12.5 mg, 20-25 mg
T1
ramipril oral capsule 1.25 mg, 10 mg, 2.5 mg, 5
mg
T1
terazosin hcl oral capsule 1 mg, 10 mg, 2 mg, 5
mg
T1
trandolapril oral tablet 1 mg, 2 mg, 4 mg
T1
QL (60 EA per 30 days)
QL (30 EA per 30 days)
*Anti-Infective Agents - Misc.*
atovaquone oral suspension 750 mg/5ml
T1
QL (210 ML per 18 days)
clindamycin hcl oral capsule 150 mg, 300 mg, 75
mg
T1
clindamycin palmitate hcl oral solution
reconstituted 75 mg/5ml
T1
dapsone oral tablet 100 mg, 25 mg
T1
DORIBAX INTRAVENOUS* SOLUTION
RECONSTITUTED 250 MG, 500 MG
T1
FIRST-VANCOMYCIN 25 ORAL
SOLUTION 25 MG/ML
T1
QL (300 ML per 15 days)
FIRST-VANCOMYCIN 50 ORAL
SOLUTION 50 MG/ML
T1
QL (150 ML per 15 days)
metronidazole oral tablet 250 mg, 500 mg
T1
PRIMSOL ORAL SOLUTION 50 MG/5ML
T1
sulfamethoxazole-trimethoprim oral suspension
200-40 mg/5ml
T1
QL (600 ML per 30 days)
17
Drug
Status
sulfamethoxazole-trimethoprim oral tablet 400-80
mg, 800-160 mg
T1
trimethoprim oral tablet 100 mg
T1
vancomycin hcl intravenous* solution
reconstituted 10 gm, 1000 mg, 500 mg, 5000 mg,
750 mg
T1
Notes
QL (60 EA per 30 days)
*Antimalarials*
chloroquine phosphate oral tablet 250 mg
T1
PA
DARAPRIM ORAL TABLET 25 MG
T1
PA
hydroxychloroquine sulfate oral tablet 200 mg
T1
mefloquine hcl oral tablet 250 mg
T1
QL (5 EA per 30 days)
primaquine phosphate oral tablet 26.3 mg
T1
QL (14 EA per 30 days)
quinine sulfate oral capsule 324 mg
T1
*Antimycobacterial Agents*
ethambutol hcl oral tablet 100 mg, 400 mg
T1
isoniazid oral syrup 50 mg/5ml
T1
isoniazid oral tablet 100 mg, 300 mg
T1
pyrazinamide oral tablet 500 mg
T1
rifampin oral capsule 150 mg, 300 mg
T1
RIFATER ORAL TABLET 50-120-300 MG
T1
TRECATOR ORAL TABLET 250 MG
T1
*Antineoplastics And Adjunctive
Therapies*
anastrozole oral tablet 1 mg
T1
bicalutamide oral tablet 50 mg
T1
capecitabine oral tablet 150 mg, 500 mg
T1
cyclophosphamide oral capsule 25 mg, 50 mg
T1
ELIGARD SUBCUTANEOUS* KIT 22.5 MG,
30 MG, 45 MG, 7.5 MG
T1
flutamide oral capsule 125 mg
T1
PA
HEXALEN ORAL CAPSULE 50 MG
T1
PA
hydroxyurea oral capsule 500 mg
T1
imatinib mesylate oral tablet 100 mg, 400 mg
T1
PA
INTRON A INJECTION SOLUTION
10000000 UNIT/ML, 6000000 UNIT/ML
T1
PA
INTRON A INJECTION SOLUTION
RECONSTITUTED 10000000 UNIT,
18000000 UNIT, 50000000 UNIT
T1
PA
letrozole oral tablet 2.5 mg
T1
QL (30 EA per 30 days)
18
GR-F
PA
Drug
Status
Notes
leucovorin calcium oral tablet 15 mg, 25 mg, 5
mg
T1
LEUKERAN ORAL TABLET 2 MG
T1
lomustine oral capsule 10 mg, 100 mg, 40 mg
T1
PA
LUPRON DEPOT INTRAMUSCULAR* KIT
11.25 MG, 22.5 MG, 3.75 MG, 30 MG, 7.5 MG
T1
PA
MATULANE ORAL CAPSULE 50 MG
T1
PA
megestrol acetate oral suspension 40 mg/ml, 400
mg/10ml
T1
megestrol acetate oral tablet 20 mg, 40 mg
T1
mercaptopurine oral tablet 50 mg
T1
methotrexate oral tablet 2.5 mg
T1
MYLERAN ORAL TABLET 2 MG
T1
TABLOID ORAL TABLET 40 MG
T1
tamoxifen citrate oral tablet 10 mg, 20 mg
T1
GR-F; AL (Min 35 Years)
tretinoin oral capsule 10 mg
T1
PA
*Antiparkinson Agents*
amantadine hcl oral capsule 100 mg
T1
amantadine hcl oral syrup 50 mg/5ml
T1
benztropine mesylate oral tablet 0.5 mg, 1 mg, 2
mg
T1
bromocriptine mesylate oral capsule 5 mg
T1
bromocriptine mesylate oral tablet 2.5 mg
T1
carbidopa oral tablet 25 mg
T1
carbidopa-levodopa er oral tablet
extendedrelease* 25-100 mg, 50-200 mg
T1
carbidopa-levodopa oral tablet 10-100 mg,
25-100 mg, 25-250 mg
T1
entacapone oral tablet 200 mg
T1
pramipexole dihydrochloride oral tablet 0.125
mg, 0.25 mg, 0.5 mg, 1 mg, 1.5 mg
T1
ropinirole hcl oral tablet 0.25 mg, 0.5 mg, 1 mg, 2
mg, 3 mg, 4 mg, 5 mg
T1
selegiline hcl oral capsule 5 mg
T1
trihexyphenidyl hcl oral elixir 0.4 mg/ml
T1
trihexyphenidyl hcl oral tablet 2 mg, 5 mg
T1
*Antipsychotics/Antimanic Agents*
clozapine oral tablet 100 mg, 200 mg, 25 mg, 50
mg
T1
fluphenazine hcl injection solution 2.5 mg/ml
T1
19
Drug
Status
fluphenazine hcl oral concentrate 5 mg/ml
T1
fluphenazine hcl oral elixir 2.5 mg/5ml
T1
fluphenazine hcl oral tablet 1 mg, 10 mg, 2.5 mg,
5 mg
T1
haloperidol decanoate intramuscular* solution
100 mg/ml
T1
haloperidol oral tablet 0.5 mg, 1 mg, 10 mg, 2
mg, 20 mg, 5 mg
T1
lithium carbonate er oral tablet extendedrelease*
300 mg, 450 mg
T1
lithium carbonate oral capsule 150 mg, 300 mg,
600 mg
T1
lithium carbonate oral tablet 300 mg
T1
loxapine succinate oral capsule 10 mg, 25 mg, 5
mg, 50 mg
T1
olanzapine oral tablet 10 mg, 15 mg, 2.5 mg, 20
mg, 5 mg, 7.5 mg
T1
perphenazine oral tablet 16 mg, 2 mg, 4 mg, 8 mg
T1
prochlorperazine maleate oral tablet 10 mg, 5 mg
T1
prochlorperazine suppository 25 mg
T1
quetiapine fumarate oral tablet 100 mg, 200 mg,
25 mg, 300 mg, 400 mg, 50 mg
T1
risperidone oral tablet 0.25 mg, 0.5 mg, 1 mg, 2
mg, 3 mg, 4 mg
T1
thiothixene oral capsule 1 mg, 10 mg, 2 mg, 5 mg
T1
trifluoperazine hcl oral tablet 1 mg, 10 mg, 2 mg,
5 mg
T1
ziprasidone hcl oral capsule 20 mg, 40 mg, 60
mg, 80 mg
T1
Notes
QL (60 EA per 30 days)
ST
*Antiseptics & Disinfectants*
povidone-iodine external pad 10 %
T1
povidone-iodine external solution 10 %
T1
*Antivirals*
abacavir sulfate oral tablet 300 mg
T1
QL (60 EA per 30 days)
abacavir-lamivudine-zidovudine oral tablet
300-150-300 mg
T1
QL (60 EA per 30 days)
acyclovir oral capsule 200 mg
T1
acyclovir oral suspension 200 mg/5ml
T1
acyclovir oral tablet 400 mg, 800 mg
T1
APTIVUS ORAL CAPSULE 250 MG
T1
QL (120 EA per 30 days)
APTIVUS ORAL SOLUTION 100 MG/ML
T1
QL (300 ML per 30 days)
20
AL (Max 12 Years)
Drug
Status
Notes
ATRIPLA ORAL TABLET 600-200-300 MG
T1
QL (30 EA per 30 days)
COMPLERA ORAL TABLET 200-25-300
MG
T1
QL (30 EA per 30 days)
CRIXIVAN ORAL CAPSULE 200 MG
T1
QL (360 EA per 30 days)
CRIXIVAN ORAL CAPSULE 400 MG
T1
QL (180 EA per 30 days)
didanosine oral capsule delayed release 125 mg,
200 mg
T1
QL (60 EA per 30 days)
didanosine oral capsule delayed release 250 mg,
400 mg
T1
QL (30 EA per 30 days)
EDURANT ORAL TABLET 25 MG
T1
QL (30 EA per 30 days)
EMTRIVA ORAL CAPSULE 200 MG
T1
QL (30 EA per 30 days)
EMTRIVA ORAL SOLUTION 10 MG/ML
T1
QL (600 ML per 30 days)
EPIVIR HBV ORAL SOLUTION 5 MG/ML
T1
QL (1800 ML per 30 days)
EPZICOM ORAL TABLET 600-300 MG
T1
QL (30 EA per 30 days)
INTELENCE ORAL TABLET 100 MG
T1
QL (120 EA per 30 days)
INTELENCE ORAL TABLET 200 MG
T1
QL (60 EA per 30 days)
INTELENCE ORAL TABLET 25 MG
T1
INVIRASE ORAL CAPSULE 200 MG
T1
QL (300 EA per 30 days)
INVIRASE ORAL TABLET 500 MG
T1
QL (120 EA per 30 days)
ISENTRESS ORAL TABLET 400 MG
T1
QL (60 EA per 30 days)
ISENTRESS ORAL TABLET CHEWABLE
100 MG, 25 MG
T1
KALETRA ORAL SOLUTION 400-100
MG/5ML
T1
QL (450 ML per 30 days)
KALETRA ORAL TABLET 100-25 MG
T1
QL (360 EA per 30 days)
KALETRA ORAL TABLET 200-50 MG
T1
QL (180 EA per 30 days)
lamivudine oral solution 10 mg/ml
T1
QL (900 ML per 30 days)
lamivudine oral tablet 100 mg
T1
lamivudine oral tablet 150 mg
T1
QL (60 EA per 30 days)
lamivudine oral tablet 300 mg
T1
QL (30 EA per 30 days)
lamivudine-zidovudine oral tablet 150-300 mg
T1
QL (60 EA per 30 days)
LEXIVA ORAL SUSPENSION 50 MG/ML
T1
QL (360 ML per 60 days)
LEXIVA ORAL TABLET 700 MG
T1
QL (120 EA per 30 days)
nevirapine er oral tablet extended release 24 hr*
400 mg
T1
QL (30 EA per 30 days)
nevirapine oral suspension 50 mg/5ml
T1
QL (1200 ML per 30 days)
nevirapine oral tablet 200 mg
T1
QL (60 EA per 30 days)
NORVIR ORAL CAPSULE 100 MG
T1
QL (360 EA per 30 days)
NORVIR ORAL SOLUTION 80 MG/ML
T1
QL (450 ML per 30 days)
NORVIR ORAL TABLET 100 MG
T1
QL (360 EA per 30 days)
21
Drug
Status
Notes
PEG-INTRON REDIPEN PAK 4
SUBCUTANEOUS* KIT 120 MCG/0.5ML,
150 MCG/0.5ML, 50 MCG/0.5ML, 80
MCG/0.5ML
T1
PA
PEG-INTRON REDIPEN SUBCUTANEOUS*
KIT 120 MCG/0.5ML, 150 MCG/0.5ML, 50
MCG/0.5ML, 80 MCG/0.5ML
T1
PA
PEGINTRON SUBCUTANEOUS* KIT 120
MCG/0.5ML, 150 MCG/0.5ML, 50
MCG/0.5ML, 80 MCG/0.5ML
T1
PA
PEG-INTRON SUBCUTANEOUS* KIT 120
MCG/0.5ML, 150 MCG/0.5ML, 50
MCG/0.5ML, 80 MCG/0.5ML
T1
PA
PREZISTA ORAL TABLET 150 MG
T1
QL (240 EA per 30 days)
PREZISTA ORAL TABLET 600 MG
T1
QL (60 EA per 30 days)
PREZISTA ORAL TABLET 75 MG
T1
QL (480 EA per 30 days)
PREZISTA ORAL TABLET 800 MG
T1
QL (30 EA per 30 days)
RELENZA DISKHALER INHALATION
AEROSOL POWDER, BREATH
ACTIVATED 5 MG/BLISTER
T1
QL (20 EA per 5 days)
RESCRIPTOR ORAL TABLET 100 MG
T1
QL (360 EA per 30 days)
RESCRIPTOR ORAL TABLET 200 MG
T1
REYATAZ ORAL CAPSULE 150 MG, 200
MG
T1
QL (60 EA per 30 days)
REYATAZ ORAL CAPSULE 300 MG
T1
QL (30 EA per 30 days)
RIBASPHERE ORAL CAPSULE 200 MG
T1
PA
ribavirin oral capsule 200 mg
T1
PA
rimantadine hcl oral tablet 100 mg
T1
SELZENTRY ORAL TABLET 150 MG, 300
MG
T1
stavudine oral capsule 15 mg, 20 mg, 30 mg, 40
mg
T1
QL (60 EA per 30 days)
stavudine oral solution reconstituted 1 mg/ml
T1
QL (1200 ML per 30 days)
STRIBILD ORAL TABLET 150-150-200-300
MG
T1
QL (30 EA per 30 days)
SUSTIVA ORAL CAPSULE 200 MG
T1
QL (90 EA per 30 days)
SUSTIVA ORAL CAPSULE 50 MG
T1
QL (360 EA per 30 days)
SUSTIVA ORAL TABLET 600 MG
T1
QL (30 EA per 30 days)
TAMIFLU ORAL CAPSULE 30 MG, 45 MG,
75 MG
T1
QL (10 EA per 5 days)
TAMIFLU ORAL SUSPENSION
RECONSTITUTED 6 MG/ML
T1
AL (Max 12 Years)
22
Drug
Status
Notes
TIVICAY ORAL TABLET 50 MG
T1
QL (30 EA per 30 days)
TRIUMEQ ORAL TABLET 600-50-300 MG
T1
QL (30 EA per 30 days)
TRUVADA ORAL TABLET 100-150 MG,
133-200 MG, 167-250 MG, 200-300 MG
T1
QL (30 EA per 30 days)
valacyclovir hcl oral tablet 1 gm, 500 mg
T1
VIDEX ORAL SOLUTION
RECONSTITUTED 2 GM, 4 GM
T1
QL (603 ML per 30 days)
VIRACEPT ORAL TABLET 250 MG
T1
QL (300 EA per 30 days)
VIRACEPT ORAL TABLET 625 MG
T1
QL (120 EA per 30 days)
VIRAMUNE ORAL SUSPENSION 50
MG/5ML
T1
QL (1200 ML per 30 days)
VIREAD ORAL TABLET 150 MG, 200 MG,
250 MG, 300 MG
T1
QL (30 EA per 30 days)
ZIAGEN ORAL SOLUTION 20 MG/ML
T1
QL (900 ML per 30 days)
zidovudine oral capsule 100 mg
T1
QL (180 EA per 30 days)
zidovudine oral syrup 50 mg/5ml
T1
QL (1800 ML per 30 days)
zidovudine oral tablet 300 mg
T1
QL (60 EA per 30 days)
*Assorted Classes*
ARGYLE STERILE WATER IRRIGATION
SOLUTION
T1
azathioprine oral tablet 50 mg
T1
CELLCEPT ORAL SUSPENSION
RECONSTITUTED 200 MG/ML
T1
cyclosporine modified oral capsule 100 mg, 25
mg, 50 mg
T1
cyclosporine modified oral solution 100 mg/ml
T1
cyclosporine oral capsule 100 mg, 25 mg
T1
GENGRAF ORAL CAPSULE 100 MG, 25
MG
T1
GENGRAF ORAL SOLUTION 100 MG/ML
T1
KIONEX ORAL POWDER
T1
mycophenolate mofetil oral capsule 250 mg
T1
mycophenolate mofetil oral suspension
reconstituted 200 mg/ml
T1
mycophenolate mofetil oral tablet 500 mg
T1
sodium polystyrene sulfonate oral powder
T1
sterile water for irrigation irrigation solution
T1
tacrolimus oral capsule 0.5 mg, 1 mg, 5 mg
T1
PA
*Beta Blockers*
acebutolol hcl oral capsule 200 mg, 400 mg
T1
23
Drug
Status
atenolol oral tablet 100 mg, 25 mg, 50 mg
T1
bisoprolol fumarate oral tablet 10 mg, 5 mg
T1
BYSTOLIC ORAL TABLET 10 MG, 2.5 MG,
20 MG, 5 MG
T1
carvedilol oral tablet 12.5 mg, 25 mg, 3.125 mg,
6.25 mg
T1
labetalol hcl oral tablet 100 mg, 200 mg, 300 mg
T1
metoprolol succinate er oral tablet extended
release 24 hr* 100 mg, 200 mg, 25 mg, 50 mg
T1
metoprolol tartrate oral tablet 100 mg, 25 mg, 50
mg
T1
nadolol oral tablet 20 mg, 40 mg, 80 mg
T1
pindolol oral tablet 10 mg, 5 mg
T1
propranolol hcl er oral capsule extended release
24 hour 120 mg, 160 mg, 60 mg, 80 mg
T1
propranolol hcl oral solution 20 mg/5ml, 40
mg/5ml
T1
propranolol hcl oral tablet 10 mg, 20 mg, 40 mg,
60 mg, 80 mg
T1
sotalol hcl (af) oral tablet 120 mg, 160 mg, 80 mg
T1
sotalol hcl oral tablet 120 mg, 160 mg, 240 mg,
80 mg
T1
timolol maleate oral tablet 10 mg, 20 mg, 5 mg
T1
Notes
*Calcium Channel Blockers*
amlodipine besylate oral tablet 10 mg, 2.5 mg, 5
mg
T1
QL (30 EA per 30 days)
CARTIA XT ORAL CAPSULE EXTENDED
RELEASE 24 HOUR 120 MG, 180 MG, 240
MG, 300 MG
T1
QL (30 EA per 30 days)
diltiazem cd oral capsule extended release 24
hour 120 mg, 180 mg
T1
QL (30 EA per 30 days)
diltiazem hcl er beads oral capsule extended
release 24 hour 420 mg
T1
QL (30 EA per 30 days)
diltiazem hcl er coated beads oral capsule
extended release 24 hour 300 mg
T1
QL (30 EA per 30 days)
diltiazem hcl er oral capsule extended release 12
hour 120 mg, 60 mg, 90 mg
T1
QL (60 EA per 30 days)
diltiazem hcl er oral capsule extended release 24
hour 120 mg, 180 mg, 240 mg
T1
QL (30 EA per 30 days)
diltiazem hcl oral tablet 120 mg, 30 mg, 60 mg,
90 mg
T1
24
Drug
Status
Notes
dilt-xr oral capsule extended release 24 hour 120
mg, 180 mg, 240 mg
T1
QL (30 EA per 30 days)
felodipine er oral tablet extended release 24 hr*
10 mg, 2.5 mg, 5 mg
T1
QL (30 EA per 30 days)
nicardipine hcl oral capsule 20 mg, 30 mg
T1
nifedipine er oral tablet extended release 24 hr*
30 mg, 60 mg, 90 mg
T1
QL (30 EA per 30 days)
nifedipine er osmotic release oral tablet extended
release 24 hr* 30 mg, 60 mg, 90 mg
T1
QL (30 EA per 30 days)
nifedipine oral capsule 10 mg, 20 mg
T1
nimodipine oral capsule 30 mg
T1
PA
TAZTIA XT ORAL CAPSULE EXTENDED
RELEASE 24 HOUR 120 MG, 180 MG, 240
MG, 300 MG, 360 MG
T1
QL (30 EA per 30 days)
verapamil hcl er oral capsule extended release 24
hour 100 mg, 120 mg, 180 mg, 200 mg, 240 mg,
300 mg, 360 mg
T1
QL (30 EA per 30 days)
verapamil hcl er oral tablet extendedrelease* 120
mg, 180 mg, 240 mg
T1
QL (30 EA per 30 days)
verapamil hcl oral tablet 120 mg, 40 mg, 80 mg
T1
*Cardiotonics*
digoxin oral tablet 125 mcg, 250 mcg
T1
*Cephalosporins*
cefaclor oral capsule 250 mg, 500 mg
T1
cefaclor oral suspension reconstituted 125
mg/5ml, 250 mg/5ml, 375 mg/5ml
T1
AL (Max 11 Years)
cefadroxil oral capsule 500 mg
T1
QL (40 EA per 10 days)
cefadroxil oral suspension reconstituted 250
mg/5ml, 500 mg/5ml
T1
cefadroxil oral tablet 1 gm
T1
cefdinir oral capsule 300 mg
T1
cefdinir oral suspension reconstituted 125
mg/5ml, 250 mg/5ml
T1
cefpodoxime proxetil oral suspension
reconstituted 100 mg/5ml, 50 mg/5ml
T1
cefpodoxime proxetil oral tablet 100 mg, 200 mg
T1
cefprozil oral suspension reconstituted 125
mg/5ml, 250 mg/5ml
T1
cefprozil oral tablet 250 mg, 500 mg
T1
CEFTIN ORAL SUSPENSION
RECONSTITUTED 125 MG/5ML, 250
MG/5ML
T1
QL (20 EA per 10 days)
AL (Max 11 Years)
AL (Max 11 Years)
25
Drug
Status
Notes
ceftriaxone sodium injection solution
reconstituted 1 gm, 500 mg
T1
QL (10 EA per 30 days)
ceftriaxone sodium injection solution
reconstituted 250 mg
T1
QL (180 EA per 30 days)
ceftriaxone sodium intravenous* solution
reconstituted 1 gm
T1
cefuroxime axetil oral suspension reconstituted
125 mg/5ml
T1
cefuroxime axetil oral tablet 250 mg, 500 mg
T1
cephalexin oral capsule 250 mg, 500 mg
T1
cephalexin oral suspension reconstituted 125
mg/5ml, 250 mg/5ml
T1
*Chemicals*
acetone solution
T1
ACTIPHYTE OF LEMONGRASS LIQUID†
T1
ammonium lactate solution 70 %
T1
benzyl benzoate liquid†
T1
camphor spirit spirit
T1
chlorhexidine gluconate solution
T1
chloroform solution
T1
cottonseed oil oil
T1
CRYOSERV SOLUTION
T1
dimethyl sulfoxide solution , 100 %
T1
ether solution
T1
ethyl alcohol (rubbing) solution 70 %
T1
ethyl alcohol external solution 95 %
T1
ethyl alcohol solution 95 %
T1
eugenol solution
T1
glycerin liquid†
T1
glycerin solution
T1
glycerine liquid†
T1
glycerol formal liquid†
T1
glycine soya extract solution
T1
glycine soya protein solution
T1
gnp alcohol denatured solution
T1
gnp peppermint spirit spirit
T1
gnp sodium silicate solution
T1
guaiacol solution
T1
hydroxyprogesterone caproate powder
T1
26
AL (Max 11 Years)
Drug
Status
isopropyl alcohol solution , 50 %, 70 %, 91 %
T1
isopropyl palmitate liquid†
T1
methanol solution , 99 %
T1
methyl alcohol solution
T1
peppermint spirit spirit
T1
pine tar liquid†
T1
polysorbate 20 solution
T1
polysorbate 40 solution
T1
polysorbate 60 liquid†
T1
polysorbate 80 oral liquid†
T1
PRETZ SOLUTION 10 %
T1
ra ethyl alcohol solution 70 %
T1
sm camphor spirit spirit
T1
sodium bicarbonate powder
T1
sodium silicate solution 40 %
T1
turpentine liquid†
T1
undecylenic acid liquid†
T1
Notes
*Contraceptives*
desogestrel-ethinyl estradiol oral tablet 0.15-30
mg-mcg
T1
GR-F; QL (28 EA per 21 days)
KELNOR 1/35 ORAL TABLET 1-35
MG-MCG
T1
GR-F; QL (28 EA per 21 days)
levonorgest-eth estrad 91-day oral tablet
0.15-0.03 mg
T1
GR-F; QL (91 EA per 91 days)
levonorgestrel oral tablet 0.75 mg, 1.5 mg
T1
GR-F; QL (2 EA per 30 days)
levonorgestrel-ethinyl estrad oral tablet 0.1-20
mg-mcg, 0.15-30 mg-mcg
T1
GR-F; QL (28 EA per 21 days)
LOW-OGESTREL ORAL TABLET 0.3-30
MG-MCG
T1
GR-F; QL (28 EA per 21 days)
medroxyprogesterone acetate intramuscular*
suspension 150 mg/ml
T1
GR-F; QL (1 ML per 90 days)
MICROGESTIN 1.5/30 ORAL TABLET
1.5-30 MG-MCG
T1
GR-F; QL (21 EA per 21 days)
MICROGESTIN FE 1.5/30 ORAL TABLET
1.5-30 MG-MCG
T1
GR-F; QL (28 EA per 21 days)
NECON 0.5/35 (28) ORAL TABLET 0.5-35
MG-MCG
T1
GR-F; QL (28 EA per 21 days)
NECON 1/35 (28) ORAL TABLET 1-35
MG-MCG
T1
GR-F; QL (28 EA per 21 days)
NECON 1/50 (28) ORAL TABLET 1-50
MG-MCG
T1
GR-F; QL (28 EA per 21 days)
27
Drug
Status
Notes
NECON 10/11 (28) ORAL TABLET 35 MCG
T1
GR-F; QL (28 EA per 21 days)
NECON 7/7/7 ORAL TABLET 0.5/0.75/1-35
MG-MCG
T1
GR-F; QL (28 EA per 21 days)
norethin ace-eth estrad-fe oral tablet 1-20
mg-mcg, 1-20 mg-mcg(24)
T1
GR-F; QL (28 EA per 21 days)
norethindrone acet-ethinyl est oral tablet 1-20
mg-mcg
T1
GR-F; QL (21 EA per 21 days)
norethindrone oral tablet 0.35 mg
T1
GR-F; QL (28 EA per 21 days)
norgestimate-eth estradiol oral tablet 0.25-35
mg-mcg
T1
GR-F; QL (28 EA per 21 days)
TRINESSA (28) ORAL TABLET
0.18/0.215/0.25 MG-35 MCG
T1
GR-F; QL (28 EA per 21 days)
TRIVORA (28) ORAL TABLET
T1
GR-F; QL (28 EA per 21 days)
VELIVET ORAL TABLET 0.1/0.125/0.15
-0.025 MG
T1
GR-F; QL (28 EA per 21 days)
ZOVIA 1/50E (28) ORAL TABLET 1-50
MG-MCG
T1
GR-F; QL (28 EA per 21 days)
*Corticosteroids*
cortisone acetate oral tablet 25 mg
T1
DEXAMETHASONE INTENSOL ORAL
CONCENTRATE 1 MG/ML
T1
dexamethasone oral elixir 0.5 mg/5ml
T1
dexamethasone oral solution 0.5 mg/5ml
T1
dexamethasone oral tablet 0.5 mg, 0.75 mg, 1 mg,
1.5 mg, 2 mg, 4 mg, 6 mg
T1
DEXPAK 10 DAY ORAL 1.5 MG (35)
T1
DEXPAK 13 DAY ORAL 1.5 MG (51)
T1
DEXPAK 6 DAY ORAL 1.5 MG (21)
T1
fludrocortisone acetate oral tablet 0.1 mg
T1
hydrocortisone oral tablet 10 mg, 20 mg, 5 mg
T1
methylprednisolone oral 4 mg
T1
methylprednisolone oral tablet 16 mg, 32 mg, 4
mg, 8 mg
T1
prednisolone oral solution 15 mg/5ml
T1
prednisolone sodium phosphate oral solution 15
mg/5ml, 6.7 (5 base) mg/5ml
T1
prednisone oral 10 mg (21), 10 mg (48), 5 mg
(21), 5 mg (48)
T1
prednisone oral solution 5 mg/5ml
T1
prednisone oral tablet 1 mg, 10 mg, 2.5 mg, 20
mg, 5 mg, 50 mg
T1
28
Drug
*Cough/Cold/Allergy*
Status
ACETADRYL ORAL TABLET 25-500 MG
T1
ACETA-GESIC ORAL TABLET 12.5-325
MG
T1
acetylcysteine inhalation solution 10 %, 20 %
T1
ADVIL ALLERGY & CONGESTION ORAL
TABLET 4-10-200 MG
T1
ADVIL ALLERGY SINUS ORAL TABLET
2-30-200 MG
T1
ADVIL COLD & SINUS LIQUI-GELS ORAL
CAPSULE 30-200 MG
T1
ALA-HIST PE ORAL TABLET 2-10 MG
T1
ALKA-SELTZER PLS ALLERGY & CGH
ORAL CAPSULE 5-6.25-10-325 MG
T1
ALKA-SELTZER PLUS COLD & COUGH
ORAL CAPSULE 5-2-10-325 MG
T1
ALKA-SELTZER PLUS COLD & COUGH
ORAL TABLET EFFERVESCENT
7.8-2-10-325 MG
T1
ALKA-SELTZER PLUS COLD & FLU
ORAL TABLET EFFERVESCENT
5-2-10-250 MG
T1
ALKA-SELTZER PLUS DAY/NIGHT ORAL
T1
ALKA-SELTZER PLUS NIGHT COLD
ORAL TABLET EFFERVESCENT
7.8-6.25-10-500 MG
T1
ALKA-SELTZER PLUS SINUS ORAL
TABLET EFFERVESCENT 7.8-325 MG
T1
all day pain relf sinus/cold d oral tablet extended
release 12 hr* 120-220 mg
T1
aller-time oral tablet 2.5-60 mg
T1
ambi 12.5cpd/100gfn/30pse oral liquid†
30-12.5-100 mg/5ml
T1
ambi 12.5cpd/1dcpm/30pse oral liquid† 30-1-12.5
mg/5ml
T1
ap-hist dm oral liquid† 7.5-4-15 mg/5ml
T1
benzonatate oral capsule 100 mg, 200 mg
T1
biobron sf oral syrup 10-15-350 mg/5ml
T1
biodesp dm oral syrup 5-15-100 mg/5ml
T1
biogtuss oral liquid† 10-15-300 mg/5ml
T1
bionatuss dxp oral liquid† 10-2-20 mg/5ml
T1
bionel oral liquid† 30-15-200 mg/5ml
T1
Notes
29
Drug
Status
bionel pediatric oral liquid† 15-5-50 mg/5ml
T1
biospec dmx oral liquid† 15-25 mg/5ml
T1
bpm-dm-phen oral syrup 5-2-10 mg/5ml
T1
bronchial asthma relief oral tablet 12.5-200 mg
T1
BRONCOTRON PED DROPS ORAL
LIQUID† 2.5-5-100 MG/ML
T1
BRONCOTRON PED ORAL LIQUID†
10-15-350 MG/5ML
T1
BRONCOTRON-S ORAL LIQUID† 20-400
MG/5ML
T1
BRONKAID ORAL TABLET 25-400 MG
T1
bronkids oral liquid† 1.5-0.6-2.75 mg/ml, 10-4-10
mg/5ml
T1
brotapp dm oral liquid† 15-1-5 mg/5ml
T1
capcof oral syrup 5-2-10 mg/5ml
T1
capmist dm oral tablet 60-15-400 mg
T1
capron dm oral liquid† 7.5-7.5 mg/5ml
T1
CARBAPHEN CH ORAL SUSPENSION
10-4-24 MG/5ML
T1
CARBAPHEN PED CH ORAL SUSPENSION
2.5-1.25-8 MG/ML
T1
CCP CAFFEINE FREE ORAL TABLET
325-200-10 MG
T1
CERTUSS-D ORAL TABLET 60-25-400 MG
T1
cetirizine-pseudoephedrine er oral tablet
extended release 12 hr* 5-120 mg
T1
cheratussin ac oral syrup 100-10 mg/5ml
T1
cheratussin dac oral solution 30-10-100 mg/5ml
T1
chest congestion daytime oral tablet 325-200 mg
T1
chest congestion relief pe oral tablet 10-400 mg
T1
chest congestion/pain & sinus oral tablet
10-650-400 mg
T1
childrens cough oral liquid† 5-100 mg/5ml
T1
childrens cough/runny nose oral suspension
5-160-1 mg/5ml
T1
childrens plus cold & allergy oral suspension
12.5-2.5-160 mg/5ml
T1
childrens plus cold oral suspension 1-2.5-160
mg/5ml
T1
childrens plus flu oral suspension 2.5-1-5-160
mg/5ml
T1
30
Notes
Drug
Status
chlo tuss ex oral liquid† 12.5-100 mg/5ml
T1
CHLO TUSS ORAL LIQUID† 30-1-12.5
MG/5ML
T1
chlophed oral liquid† 5-12.5-100 mg/5ml
T1
codituss dm oral syrup 5-8.33-10 mg/5ml
T1
cold & cough childrens oral elixir 2.5-1-5 mg/5ml
T1
cold & cough day/night child oral 2.5-5
&2.5-6.25 mg/5ml
T1
cold & cough daytime oral liquid† 1000-30
mg/30ml
T1
cold & flu nighttime/daytime oral (liquid)
T1
cold & flu relief nighttime d oral liquid†
60-12.5-30-1000 mg/30ml
T1
cold & flu severe daytime oral tablet
5-10-200-325 mg
T1
cold control pe cold/flu med oral tablet 25-10-650
mg
T1
cold head congestion daytime oral tablet
10-5-325 mg
T1
cold head congestion nighttime oral tablet
5-2-10-325 mg
T1
cold multi-symptom day/night oral 5-2-10-325 mg
T1
cold multi-symptom warm night oral liquid†
5-6.25-10-325 mg/15ml
T1
cold relief plus oral tablet effervescent 2-7.8-325
mg
T1
cold/flu relief day/night oral
T1
cold/flu relief nighttime oral liquid† 15-6.25-325
mg/15ml
T1
cold/flu relief oral liquid† 10-5-325 mg/15ml
T1
complete sinus relief oral tablet 2-10-500 mg
T1
CONEX COLD/ALLERGY ORAL
SOLUTION 1-30 MG/5ML
T1
CONEX COLD/ALLERGY ORAL TABLET
2-60 MG
T1
CONTAC COLD+FLU MAX ST ORAL
TABLET 2-5-500 MG
T1
CORICIDIN HBP CONGESTION/COUGH
ORAL CAPSULE 10-200 MG
T1
CORICIDIN HBP DAY/NIGHT COLD
ORAL 10-20 &15-200-2 MG
T1
Notes
31
Drug
Status
CORICIDIN NIGHTTIME COLD-COUGH
ORAL LIQUID† 12.5-325 MG/15ML
T1
cough & cold oral tablet 4-30 mg
T1
cough & sore throat nighttime oral liquid†
30-12.5-1000 mg/30ml
T1
cough daytime/nighttime oral 6.25-15 & 15
mg/15ml
T1
cvs cough & sore throat child oral liquid† 160-5
mg/5ml
T1
cvs non-drying sinus pe oral tablet 5-200 mg
T1
DALLERGY ORAL LIQUID† 1-2.5 MG/ML
T1
DALLERGY ORAL TABLET 1-5 MG
T1
day time pe cold/flu relief oral capsule 10-5-325
mg
T1
daytime cold & cough childrens oral solution
2.5-5 mg/5ml
T1
DAYTIME COLD MEDICINE ORAL
LIQUID† 325-15 MG/15ML
T1
DELSYM CGH/CLD NIGHTTIME CHILD
ORAL LIQUID† 12.5-5-325 MG/10ML
T1
DELTUSS DMX ORAL LIQUID† 30-1-15
MG/5ML
T1
DELTUSS DP ORAL LIQUID† 1-30 MG/5ML
T1
DESGEN DM ORAL SYRUP 5-15-100
MG/5ML
T1
DESGEN PEDIATRIC ORAL LIQUID†
2.5-5-50 MG/ML
T1
despec dm oral syrup 5-10-100 mg/5ml
T1
despec-dm oral tablet 40-30-400 mg
T1
dextromethorphan-guaifenesin oral solution
10-100 mg/5ml
T1
DIABETIC TUSSIN COLD & FLU ORAL
LIQUID† 10-12.5-325 MG/5ML
T1
DIABETIC TUSSIN NIGHT COLD/FLU
ORAL LIQUID† 10-12.5-325 MG/5ML
T1
DIMETAPP LONG ACT COUGH/COLD
ORAL SYRUP 1-7.5 MG/5ML
T1
DOLOGEN ORAL TABLET 2-650 MG
T1
dometuss-da/children oral liquid† 1-2.5 mg/5ml
T1
dometuss-dmx oral liquid† 10-30-200 mg/5ml
T1
DURAVENT PE ORAL TABLET 10-395 MG
T1
ed bron gp oral liquid† 5-100 mg/5ml
T1
32
Notes
Drug
Status
ED CHLORPED D ORAL LIQUID† 2-5
MG/ML
T1
ed-a-hist dm oral liquid† 10-4-15 mg/5ml
T1
endacof-c oral liquid† 2-10 mg/5ml
T1
ENDACOF-DM ORAL LIQUID† 2.5-1-5
MG/5ML
T1
ENDACON ORAL SYRUP 10-20-100
MG/5ML
T1
ENTEX LQ ORAL LIQUID† 10-100 MG/5ML
T1
ENTEX T ORAL TABLET 60-375 MG
T1
entre-cough oral liquid† 30-15-175 mg/5ml
T1
eq allergy/sinus headache oral tablet 12.5-30-500
mg
T1
eq childrens cold oral liquid† 1-15-160 mg/5ml
T1
eq cold plus oral capsule 2-30-325 mg
T1
eq cold relief complete oral tablet 30-2-15-325
mg
T1
eq cold/cough plus oral capsule 30-2-10-325 mg
T1
eq daytime cold/flu relief oral capsule 30-325-15
mg
T1
eq daytime cold/flu relief oral liquid† 30-325-15
mg/15ml
T1
eq flu & severe cold & cough oral packet
25-10-650 mg
T1
eq flu relief oral tablet 30-500-15 mg
T1
eq flu/severe cold/congestion oral packet
60-4-30-1000 mg
T1
eq night time cold & cough oral liquid† 6.25-2.5
mg/5ml
T1
eq nite time cold/flu relief oral capsule
30-6.25-15-325 mg
T1
eq nitetime cold/flu ms relief oral capsule
15-6.25-325 mg
T1
eq non-drying sinus oral capsule 30-200 mg
T1
eq sinus congestion & pain oral tablet 5-325-200
mg
T1
eq triacting cold/allergy oral syrup 1-15 mg/5ml
T1
FENESIN DM IR ORAL TABLET 15-400 MG
T1
flu & sore throat oral packet 20-10-650 mg
T1
flu/severe cold & cough day oral packet
20-10-650 mg
T1
gnp night time sinus oral capsule 6.25-5-325 mg
T1
Notes
33
Drug
Status
G-P-TUSS DXP ORAL LIQUID† 10-2-20
MG/5ML
T1
G-TRON PEDIATRIC DROPS ORAL
LIQUID† 2.5-5-100 MG/ML
T1
guaifenesin dm oral tablet 400-20 mg
T1
guaifenesin er oral tablet extended release 12 hr*
1200 mg, 600 mg
T1
guaifenesin oral solution 100 mg/5ml
T1
guaifenesin oral tablet 200 mg, 400 mg
T1
guaifenesin powder
T1
guaifenesin-dm oral syrup 100-10 mg/5ml
T1
G-ZYNCOF ORAL SYRUP 20-400 MG/5ML
T1
HERBAL EXPEC ORAL LIQUID† 150
MG/15ML
T1
HISTEX-DM ORAL SYRUP 10-2.5-20
MG/5ML
T1
HISTEX-PE ORAL SYRUP 2.5-10 MG/5ML
T1
hist-pse oral liquid† 0.938-10 mg/ml
T1
hydrocod polst-cpm polst er oral 10-8 mg/5ml
T1
hydrocodone-homatropine oral syrup 5-1.5
mg/5ml
T1
hydrocodone-homatropine oral tablet 5-1.5 mg
T1
ibu-profen cold/sinus oral tablet 30-200 mg
T1
intense cough reliever oral liquid† 20-300
mg/5ml, 30-200 mg/5ml
T1
liquituss gg oral liquid† 200 mg/5ml
T1
LITTLE REMEDIES FOR COLDS ORAL
LIQUID† 2.5-1.25-80 MG/ML
T1
LODRANE D ORAL CAPSULE 4-60 MG
T1
LOHIST-D ORAL LIQUID† 2-30 MG/5ML
T1
loratadine-d 12hr oral tablet extended release 12
hr* 5-120 mg
T1
loratadine-d 24hr oral tablet extended release 24
hr* 10-240 mg
T1
LORTUSS DM ORAL LIQUID† 30-6.25-15
MG/5ML
T1
LORTUSS LQ ORAL LIQUID† 6.25-30
MG/5ML
T1
MAR-COF BP ORAL LIQUID† 30-2-7.5
MG/5ML
T1
m-end dmx oral liquid† 20-0.667-10 mg/5ml
T1
34
Notes
Drug
Status
m-end max d oral liquid† 20-0.667-6 mg/5ml
T1
M-END PE ORAL LIQUID† 3.33-1.33-6.33
MG/5ML
T1
MUCINEX CHILD MS DAY-NIGHT CLD
ORAL
T1
MUCINEX COUGH FOR KIDS ORAL
PACKET 5-100 MG
T1
MUCINEX FAST-MAX CONGEST COUGH
ORAL TABLET 5-10-200 MG
T1
MUCINEX FAST-MAX DAY/NIGHT ORAL
T1
MUCINEX FOR KIDS ORAL PACKET 100
MG
T1
MUCINEX SINUS-MAX DAY/NIGHT ORAL
Notes
T1
mucus d oral tablet extended release 12 hr*
120-1200 mg
T1
mucus relief cold flu throat oral liquid†
5-10-200-325 mg/10ml
T1
mucus relief cold/sinus max st oral liquid†
10-650-400 mg/20ml
T1
mucus relief d oral tablet 40-400 mg
T1
mucus relief severe congst/cgh oral liquid†
10-20-400 mg/20ml
T1
mucus-dm max oral tablet extended release 12
hr* 60-1200 mg
T1
mucus-dm oral tablet extended release 12 hr*
30-600 mg
T1
nasal mist inhalation aerosol, solution 0.9 %
T1
NASOPEN ORAL LIQUID† 9.375-30
MG/5ML
T1
NASOPEN PE ORAL LIQUID† 50-10
MG/15ML
T1
NEOTUSS PLUS ORAL LIQUID† 7.5-4-30
MG/5ML
T1
NEOTUSS-D ORAL LIQUID† 7.5-30-200
MG/5ML
T1
nighttime cough oral liquid† 6.25-15 mg/15ml
T1
nite-time cold/flu relief oral liquid†
5-6.25-15-500 mg/15ml
T1
NIVANEX DMX ORAL TABLET 10-15-380
MG
T1
nohist-lq oral liquid† 4-10 mg/5ml
T1
35
Drug
Status
non-pseudo cold relief oral tablet 5-15-200-325
mg
T1
NOREL AD ORAL TABLET 4-10-325 MG
T1
PANATUSS PED DROPS ORAL LIQUID†
15-0.5-6.25 MG/ML
T1
PANATUSS PED ORAL LIQUID† 60-2-25
MG/5ML
T1
PECGEN DMX ORAL LIQUID† 15-125
MG/5ML
T1
PEDIACARE CHILD ALLERGY/COLD
ORAL LIQUID† 12.5-5 MG/5ML
T1
pediatric cough/cold oral liquid† 15-1-5 mg/5ml
T1
phenylhistine dh oral liquid† 30-2-10 mg/5ml
T1
POLY HIST FORTE ORAL TABLET 7.5-10
MG
T1
poly-hist dm oral liquid† 5-25-10 mg/5ml
T1
poly-hist pd oral liquid† 6.25-6.25 mg/ml
T1
poly-tussin ac oral liquid† 10-4-10 mg/5ml
T1
poly-tussin d oral liquid† 10-30-9.375 mg/5ml
T1
poly-tussin oral liquid† 10-9.375 mg/5ml
T1
POLY-VENT DM ORAL TABLET 60-20-380
MG
T1
POLY-VENT IR ORAL TABLET 60-380 MG
T1
pres gen pediatric oral liquid† 2.5-5-75 mg/5ml
T1
pro-chlo oral liquid† 5-12.5-12.5 mg/5ml
T1
PRO-CLEAR AC ORAL SYRUP 9-8.33
MG/5ML
T1
promethazine vc plain oral syrup 6.25-5 mg/5ml
T1
promethazine vc/codeine oral syrup 6.25-5-10
mg/5ml
T1
promethazine-codeine oral syrup 6.25-10 mg/5ml
T1
promethazine-dm oral syrup 6.25-15 mg/5ml
T1
PRO-RED AC ORAL SYRUP 5-1-9 MG/5ML
T1
pseudoeph-bromphen-dm oral syrup 30-2-10
mg/5ml
T1
pseudoephedrine-guaifenesin er oral tablet
extended release 12 hr* 60-600 mg
T1
pyrilamine-phenylephrine oral suspension 5-16
mg/5ml
T1
pyrilamine-phenylephrine oral tablet 25-10 mg
T1
qc cold relief oral tablet 12.5-500 mg
T1
36
Notes
Drug
Status
qc cold relief plus oral tablet effervescent 2-5-250
mg
T1
qc flu relief therapy night oral liquid† 12.5-5-325
mg/15ml
T1
Q-TAPP ORAL ELIXIR 1-15 MG/5ML
T1
ra allergy multi-symptom night oral tablet
25-5-325 mg
T1
ra allergy multi-symptom oral tablet 2-5-325 mg
T1
ra allergy plus sinus oral tablet 25-10 mg
T1
ra childrens cold & allergy oral elixir 1-2.5
mg/5ml
T1
ra cold & flu oral tablet 2-325 mg
T1
ra cold/cough sinus relief pe oral tablet
5-10-100-325 mg
T1
ra flu maximum strength oral tablet 15-500-2 mg
T1
ra severe cold/sinus relief pe oral tablet
12.5-5-325 mg
T1
ra sinus congst/pain day/night oral 2-5-325 &
5-325 mg
T1
ra suphedrine day/night combo oral
T1
ra suphedrine pe oral tablet 4-10 mg, 5-325 mg
T1
refenesen plus oral tablet 60-400 mg
T1
relcof c oral solution 100-6.3 mg/5ml
T1
RESCON DM ORAL SYRUP 30-2-10
MG/5ML
T1
RESPAIRE-30 ORAL CAPSULE 30-150 MG
T1
ROBITUSSIN CHILD COUGH/COLD CF
ORAL LIQUID† 2.5-5-50 MG/5ML
T1
ROBITUSSIN CHILD COUGH/COLD LA
ORAL LIQUID† 1-7.5 MG/5ML
T1
ROBITUSSIN DAY/NIGHT VALUE PAK
ORAL
T1
ROBITUSSIN NIGHTTIME COUGH DM
ORAL LIQUID† 12.5-30 MG/10ML
T1
ROBITUSSIN PEAK COLD MULTI-SYM
ORAL LIQUID† 6.25-2.5-160 MG/5ML
T1
ROBITUSSIN PK COLD DAY/NGHT DM
ORAL
T1
ROBITUSSIN PK COLD DAY/NGHT MS
ORAL
T1
ru-hist d oral tablet 4-10 mg
T1
rymed oral tablet 2-10 mg
T1
Notes
37
Drug
Status
SAFE TUSSIN PM ORAL LIQUID† 3.125-7.5
MG/5ML
T1
sb daytime sinus oral capsule 5-325 mg
T1
sb severe cold congestion oral tablet
30-15-200-325 mg
T1
SCOT-TUSSIN DM ORAL LIQUID† 2-15
MG/5ML
T1
SCOT-TUSSIN SENIOR ORAL LIQUID†
15-200 MG/5ML
T1
SINADRIN PE COMPLETE SINUS REL
ORAL TABLET 2-10-650 MG
T1
sinus daytime/nighttime oral
T1
sinus maximum strength oral tablet 30-500 mg
T1
sm cough/runny nose childrens oral liquid† 1-5
mg/5ml
T1
sm ibuprofren cold childrens oral suspension
15-100 mg/5ml
T1
sm pain reliever sinus pe oral tablet 5-500 mg
T1
sm tussin cf oral liquid† 30-10-100 mg/5ml
T1
sodium chloride inhalation nebulization solution
0.9 %
T1
stahist ad oral liquid† 25-60 mg/5ml
T1
stahist ad oral tablet 25-60 mg
T1
SUDAFED PE DAY & NIGHT ORAL 25-10 &
10 MG
T1
SUDOGEST SINUS/ALLERGY ORAL
TABLET 4-60 MG
T1
super strength sinadrin oral tablet 4-10-650 mg
T1
supress a pediatric oral liquid† 5-1-10 mg/ml
T1
supress dm pediatric oral liquid† 5-50 mg/ml
T1
SUPRESS-PE PEDIATRIC ORAL LIQUID†
2.5-50 MG/ML
T1
terpin hydrate powder
T1
tg 10peh/380gfn oral tablet 10-380 mg
T1
tgq 15dm/5peh/2cpm oral syrup 15-5-2 mg/5ml
T1
tgq 30pse/150gfn/15dm oral syrup 30-150-15
mg/5ml
T1
theracaps cough/cold reliever oral tablet
30-2-15-500 mg
T1
THERAFLU MAX-D COLD & FLU ORAL
PACKET 60-30-400-1000 MG
T1
38
Notes
Drug
Status
THERAFLU SEVERE COLD & COUGH
ORAL PACKET
T1
THERAFLU SEVERE COLD DAYTIME
ORAL TABLET 15-5-325 MG
T1
TREXBROM ORAL LIQUID† 10-4-25
MG/5ML
T1
triactin chest congestion oral solution 50 mg/5ml
T1
TRIAMINIC CHEST/NASAL CONGEST
ORAL SYRUP 2.5-50 MG/5ML
T1
TRIAMINIC COLD/ALLERGY CHILD
ORAL SYRUP 1-2.5 MG/5ML
T1
TRIAMINIC COLD/COUGH DAY TIME
ORAL SOLUTION 2.5-5 MG/5ML
T1
TRIAMINIC COUGH & SORE THROAT
ORAL SYRUP 160-5 MG/5ML
T1
TRIAMINIC COUGH/SORE THROAT
ORAL TABLET CHEWABLE 160-5 MG
T1
TRIAMINIC NIGHT TIME COLD/CGH
ORAL SYRUP 6.25-2.5 MG/5ML
T1
TRISPEC DMX ORAL LIQUID† 10-187
MG/5ML
T1
trymine cg oral liquid† 225-7.5 mg/5ml
T1
TUSICOF ORAL LIQUID† 10-20-400
MG/5ML
T1
TUSICOF ORAL TABLET 10-20-400 MG
T1
TUSNEL C ORAL SYRUP 30-10-100
MG/5ML
T1
TUSNEL ORAL CAPSULE 2-15-200 MG
T1
TUSNEL ORAL LIQUID† 30-15-200
MG/5ML
T1
TUSNEL PEDIATRIC ORAL LIQUID†
15-5-50 MG/5ML
T1
tussafex ex oral liquid† 10-30-200 mg/5ml
T1
tussafex-a oral liquid† 6-2-15 mg/5ml
T1
tussin cf cough & cold oral liquid† 5-10-100
mg/5ml
T1
tussin cf max multi-symptom oral liquid†
5-10-200 mg/5ml
T1
tussin chest congestion oral syrup 100 mg/5ml
T1
tussin cold/congestion oral capsule 30-10-200 mg
T1
tussin cough oral syrup 15 mg/5ml
T1
tussin dm max oral liquid† 10-200 mg/5ml
T1
Notes
39
Drug
Status
tussi-pres b oral liquid† 10-4-20 mg/5ml
T1
TUSSLIN ORAL LIQUID† 10-28-388
MG/5ML
T1
TUSSLIN PEDIATRIC ORAL LIQUID†
2.5-7.5-88 MG/ML
T1
TYLENOL CHILDRENS COLD/STUFFY
ORAL SUSPENSION 2.5-160 MG/5ML
T1
TYLENOL CHILDRENS PLUS CLD/CGH
ORAL SUSPENSION 5-2.5-160 MG/5ML
T1
VANACOF APE ORAL LIQUID† 10-50-25
MG/15ML
T1
VANACOF DM ORAL LIQUID† 10-18-200
MG/15ML
T1
VANACOF G ORAL LIQUID† 25-200
MG/5ML
T1
VANACOF GPE ORAL LIQUID† 10-25-200
MG/15ML
T1
VANACOF-8 ORAL LIQUID† 25-50
MG/15ML
T1
VANATAB DX ORAL TABLET 30-12.5-200
MG
T1
vaporizing steam inhalation liquid† 6.2 %
T1
VAZOBID-PD ORAL SUSPENSION 6-10
MG/5ML
T1
VICKS DAYQUIL MUCUS CONTROL DM
ORAL LIQUID† 10-200 MG/15ML
T1
VICKS DAYQUIL SEVERE COLD/FLU
ORAL LIQUID† 5-10-200-325 MG/15ML
T1
VICKS NATURE FUSION COLD & FLU
ORAL LIQUID† 30-7.5-650 MG/30ML
T1
VICKS NATURE FUSION CONGEST ORAL
LIQUID† 20-200 MG/30ML
T1
VICKS NYQUIL CHILDRENS CLD/CGH
ORAL LIQUID† 2-15 MG/15ML
T1
VICKS NYQUIL COLD & FLU NIGHT
ORAL LIQUID† 30-650-4 MG/30ML
T1
virdec dm oral liquid† 3.5-1-3 mg/ml
T1
virdec oral liquid† 1-3.5 mg/ml
T1
WAL-FLU COLD & SORE THROAT ORAL
PACKET 20-10-325 MG
T1
WAL-FLU SEVERE COLD DAYTIME
ORAL PACKET 10-650 MG
T1
40
Notes
Drug
Status
ZODRYL AC 25 ORAL SUSPENSION
0.333-1 MG/ML
T1
ZODRYL AC 30 ORAL SUSPENSION
0.286-1 MG/ML
T1
ZODRYL AC 35 ORAL SUSPENSION 0.25-1
MG/ML
T1
ZODRYL AC 40 ORAL SUSPENSION
0.222-1 MG/ML
T1
ZODRYL DAC 25 ORAL SUSPENSION
5-0.333-1 MG/ML
T1
ZODRYL DAC 30 ORAL SUSPENSION
4.286-0.286-1 MG/ML
T1
ZODRYL DAC 35 ORAL SUSPENSION
3.75-0.25-1 MG/ML
T1
ZODRYL DAC 40 ORAL SUSPENSION
3.333-0.222-1 MG/ML
T1
ZODRYL DEC 25 ORAL SUSPENSION
5-1-20 MG/ML
T1
ZODRYL DEC 30 ORAL SUSPENSION
4.286-1-20 MG/ML
T1
ZODRYL DEC 35 ORAL SUSPENSION
3.75-1-20 MG/ML
T1
ZODRYL DEC 40 ORAL SUSPENSION
3.333-1-20 MG/ML
T1
Z-TUSS AC ORAL LIQUID† 2-9 MG/5ML
T1
ZYNCOF ORAL SYRUP 20-400 MG/5ML
T1
Notes
*Dermatologicals*
ABREVA EXTERNAL CREAM 10 %
T1
acne medication 10 external lotion 10 %
T1
acne medication 5 external lotion 5 %
T1
ADULT ACNOMEL EXTERNAL CREAM
2-8 %
T1
alclometasone dipropionate external cream 0.05
%
T1
alclometasone dipropionate external ointment
0.05 %
T1
ammonium lactate external cream 12 %
T1
ammonium lactate external lotion 12 %
T1
bacitracin external ointment 500 unit/gm
T1
bacitracin zinc external ointment 500 unit/gm
T1
bacitracin-neomycin-polymyxin external ointment
400-5-5000
T1
41
Drug
Status
Notes
benzoyl peroxide cleanser external lotion 6 %
T1
benzoyl peroxide external gel 10 %, 2.5 %, 5 %
T1
benzoyl peroxide wash external liquid† 10 %, 5 %
T1
benzoyl peroxide-erythromycin external gel 5-3 %
T1
QL (46.6 GM per 30 days)
betamethasone dipropionate aug external cream
0.05 %
T1
QL (100 GM per 30 days)
betamethasone dipropionate external cream 0.05
%
T1
QL (90 GM per 30 days)
betamethasone dipropionate external lotion 0.05
%
T1
betamethasone dipropionate external ointment
0.05 %
T1
QL (90 GM per 30 days)
betamethasone valerate external cream 0.1 %
T1
QL (90 GM per 30 days)
betamethasone valerate external lotion 0.1 %
T1
QL (120 ML per 30 days)
betamethasone valerate external ointment 0.1 %
T1
QL (90 GM per 30 days)
bp cleansing external lotion 4 %
T1
bp cleansing wash external emulsion 10-4 %
T1
BRASIVOL EXTERNAL PASTE
T1
CALAGESIC EXTERNAL LOTION 1-8 %
T1
capsaicin external cream 0.025 %, 0.1 %
T1
CAPZASIN EXTERNAL LIQUID† 0.15 %
T1
ciclopirox external solution 8 %
T1
CLINDAMAX EXTERNAL LOTION 1 %
T1
clindamycin phosphate external lotion 1 %
T1
clindamycin phosphate external solution 1 %
T1
clindamycin phosphate external swab 1 %
T1
clobetasol propionate external solution 0.05 %
T1
clotrimazole external cream 1 %
T1
clotrimazole external solution 1 %
T1
clotrimazole-betamethasone external cream
1-0.05 %
T1
QL (90 GM per 30 days)
clotrimazole-betamethasone external lotion
1-0.05 %
T1
QL (60 ML per 30 days)
cvs cortisone cooling relief external gel 1 %
T1
QL (60 GM per 30 days)
cvs targeted acne spot external cream 2.5 %
T1
desonide external ointment 0.05 %
T1
econazole nitrate external cream 1 %
T1
effaclar duo external solution 5.5 %
T1
eql lice solution combination kit 0.5-0.33-4 %
T1
erythromycin external gel 2 %
T1
42
QL (6.6 ML per 30 days)
QL (100 ML per 30 days)
QL (120 GM per 30 days)
Drug
Status
Notes
erythromycin external solution 2 %
T1
first aid antibiotic external ointment 4 %
T1
fluocinolone acetonide body external oil 0.01 %
T1
QL (120 ML per 30 days)
fluocinolone acetonide external cream 0.01 %,
0.025 %
T1
QL (120 GM per 30 days)
fluocinolone acetonide external ointment 0.025 %
T1
QL (120 GM per 30 days)
fluocinolone acetonide scalp external oil 0.01 %
T1
QL (120 ML per 30 days)
fluocinonide external cream 0.05 %
T1
QL (120 GM per 30 days)
fluocinonide external gel 0.05 %
T1
QL (120 GM per 30 days)
fluocinonide external ointment 0.05 %
T1
QL (120 GM per 30 days)
fluocinonide external solution 0.05 %
T1
QL (120 ML per 30 days)
fluocinonide-e external cream 0.05 %
T1
QL (120 GM per 30 days)
fluorouracil external cream 5 %
T1
fluorouracil external solution 2 %, 5 %
T1
fluticasone propionate external cream 0.05 %
T1
fluticasone propionate external ointment 0.005 %
T1
FUNGOID TINCTURE EXTERNAL
SOLUTION 2 %
T1
gentamicin sulfate external cream 0.1 %
T1
gentamicin sulfate external ointment 0.1 %
T1
glycerin external liquid†
T1
halobetasol propionate external cream 0.05 %
T1
halobetasol propionate external ointment 0.05 %
T1
HC DERMAPAX EXTERNAL LIQUID†
0.5-0.5 %
T1
hydrocortisone external cream 0.5 %
T1
QL (60 GM per 30 days)
hydrocortisone external cream 2.5 %
T1
QL (90 GM per 30 days)
hydrocortisone external lotion 1 %
T1
QL (240 GM per 30 days)
hydrocortisone external lotion 2.5 %
T1
QL (120 ML per 30 days)
hydrocortisone external ointment 0.5 %, 1 %
T1
QL (60 GM per 30 days)
hydrocortisone external ointment 2.5 %
T1
QL (90 GM per 30 days)
hydrocortisone max st external cream 1 %
T1
QL (120 GM per 30 days)
hydrocortisone valerate external cream 0.2 %
T1
hydrocortisone valerate external ointment 0.2 %
T1
QL (120 GM per 30 days)
hydrocortisone-aloe external cream 0.5 %, 1 %
T1
QL (90 GM per 30 days)
isopropyl alcohol wipes external 70 %
T1
ketoconazole external cream 2 %
T1
ketoconazole external shampoo 2 %
T1
QL (120 GM per 30 days)
QL (100 GM per 30 days)
43
Drug
Status
LAC-HYDRIN FIVE EXTERNAL LOTION 5
%
T1
lactic acid e external cream 10-3500 %-unt/30gm
T1
lactic acid external lotion 10 %
T1
lice killing maximum strength external shampoo
0.33-4 %
T1
lice solution combination kit 0.33-4-0.5 %
T1
lice treatment external liquid† 0.33-4 %, 1 %
T1
LICIDE TREATMENT COMBINATION KIT
Notes
T1
lidocaine external cream 4 %
T1
QL (90 GM per 30 days)
lidocaine hcl external cream 3 %
T1
QL (85 GM per 30 days)
lidocaine hcl external gel 2 %
T1
lidocaine hcl external solution 4 %
T1
lidocaine-prilocaine external cream 2.5-2.5 %
T1
lindane external lotion 1 %
T1
lindane external shampoo 1 %
T1
LIQUIMAT EXTERNAL LOTION 5 %
T1
LOTRIMIN AF EXTERNAL AEROSOL† 2
%
T1
malathion external lotion 0.5 %
T1
medi-first hydrocortisone external cream 1 %
T1
metronidazole external cream 0.75 %
T1
metronidazole external gel 0.75 %
T1
metronidazole external lotion 0.75 %
T1
miconazole nitrate external aerosol, powder 2 %
T1
miconazole nitrate external cream 2 %
T1
miconazorb af external powder 2 %
T1
mometasone furoate external cream 0.1 %
T1
QL (60 GM per 30 days)
mometasone furoate external ointment 0.1 %
T1
QL (60 GM per 30 days)
mometasone furoate external solution 0.1 %
T1
QL (60 ML per 30 days)
mupirocin external ointment 2 %
T1
NEOSPORIN ESSENTIALS TRIAL PK
EXTERNAL KIT 1 & 1 %
T1
NEUTROGENA CLEAR PORE EXTERNAL
LIQUID† 3.5 %
T1
nystatin external cream 100000 unit/gm
T1
nystatin external ointment 100000 unit/gm
T1
nystatin external powder 100000 unit/gm
T1
44
QL (30 GM per 30 days)
QL (60 EA per 30 days)
Drug
Status
Notes
nystatin-triamcinolone external cream
100000-0.1 unit/gm-%
T1
nystatin-triamcinolone external ointment
100000-0.1 unit/gm-%
T1
OC8 EXTERNAL GEL 7 %
T1
permethrin external cream 5 %
T1
permethrin external lotion 1 %
T1
podofilox external solution 0.5 %
T1
prednicarbate external ointment 0.1 %
T1
ra acne maximum external pad 2 %
T1
ra acne treatment external cream 10 %
T1
ra first aid anti-itch spray external solution 1 %
T1
ra lice bedding aerosol† 0.5 %
T1
ra lice egg remover external gel
T1
ra wart remover external pad 40 %
T1
REZAMID EXTERNAL LOTION 2-5 %
T1
RID ESSENTIAL LICE ELIMINATION
EXTERNAL KIT 0.33-4 %
T1
SANTYL EXTERNAL OINTMENT 250
UNIT/GM
T1
SCHOOLTIME SHAMPOO EXTERNAL
SHAMPOO
T1
sebex external shampoo 2-2 %
T1
selenium sulfide external lotion 2.5 %
T1
silver sulfadiazine external cream 1 %
T1
STEP 2 EXTERNAL SOLUTION 8 %
T1
sulfacetamide sodium (acne) external lotion 10 %
T1
sulfacetamide sodium-sulfur external emulsion
10-5 %
T1
sulfacetamide sodium-sulfur external liquid†
9-4.5 %
T1
terbinafine hcl external cream 1 %
T1
tretinoin external cream 0.025 %
T1
QL (45 GM per 30 days); AL
(Max 29 Years)
tretinoin external cream 0.05 %, 0.1 %
T1
AL (Max 29 Years)
triamcinolone acetonide external cream 0.025 %,
0.1 %
T1
QL (160 GM per 30 days)
triamcinolone acetonide external cream 0.5 %
T1
QL (60 GM per 30 days)
triamcinolone acetonide external lotion 0.025 %,
0.1 %
T1
QL (120 ML per 30 days)
QL (120 GM per 30 days)
QL (60 GM per 30 days)
QL (90 GM per 30 days)
QL (60 GM per 30 days)
45
Drug
Status
Notes
triamcinolone acetonide external ointment 0.025
%, 0.1 %
T1
QL (160 GM per 30 days)
triamcinolone acetonide external ointment 0.5 %
T1
QL (60 GM per 30 days)
triple paste af external ointment 2 %
T1
trixaicin hp external cream 0.075 %
T1
urea external cream 40 %
T1
VASOLEX EXTERNAL OINTMENT
T1
QL (60 GM per 30 days)
*Diagnostic Products*
GLUCOCARD EXPRESSION TEST IN
VITRO STRIP
T1
GLUCOCARD VITAL TEST IN VITRO
STRIP
T1
KETOSTIX IN VITRO STRIP
T1
PRECISION XTRA KETONE IN VITRO
STRIP
T1
*Dietary Products/Dietary Management
Products*
complete protein/vitamin shake oral powder
T1
*Digestive Aids*
CREON ORAL CAPSULE DELAYED
RELEASE PARTICLES 12000 UNIT, 24000
UNIT, 3000-9500 UNIT, 36000 UNIT, 6000
UNIT
T1
PANCREAZE ORAL CAPSULE DELAYED
RELEASE PARTICLES 10500 UNIT, 16800
UNIT, 21000 UNIT, 4200 UNIT
T1
pancrelipase (lip-prot-amyl) oral capsule delayed
release particles 5000 unit
T1
PERTZYE ORAL CAPSULE DELAYED
RELEASE PARTICLES 16000 UNIT, 8000
UNIT
T1
ULTRESA ORAL CAPSULE DELAYED
RELEASE PARTICLES 13800 UNIT, 20700
UNIT, 23000 UNIT
T1
VIOKACE ORAL TABLET 10440 UNIT,
20880 UNIT
T1
ZENPEP ORAL CAPSULE DELAYED
RELEASE PARTICLES 10000 UNIT, 15000
UNIT, 20000 UNIT, 25000 UNIT, 3000-10000
UNIT, 5000 UNIT
T1
*Direct-Acting P2y12 Inhibitors***
BRILINTA ORAL TABLET 60 MG, 90 MG
46
T1
QL (60 EA per 30 days)
Drug
*Diuretics*
Status
acetazolamide er oral capsule extended release
12 hour 500 mg
T1
acetazolamide oral tablet 125 mg, 250 mg
T1
amiloride hcl oral tablet 5 mg
T1
amiloride-hydrochlorothiazide oral tablet 5-50
mg
T1
bumetanide oral tablet 0.5 mg, 1 mg, 2 mg
T1
chlorothiazide oral tablet 250 mg, 500 mg
T1
chlorthalidone oral tablet 25 mg, 50 mg
T1
DIURIL ORAL SUSPENSION 250 MG/5ML
T1
furosemide injection solution 10 mg/ml
T1
furosemide oral solution 10 mg/ml
T1
furosemide oral tablet 20 mg, 40 mg, 80 mg
T1
hydrochlorothiazide oral capsule 12.5 mg
T1
hydrochlorothiazide oral tablet 25 mg, 50 mg
T1
indapamide oral tablet 1.25 mg, 2.5 mg
T1
methazolamide oral tablet 25 mg, 50 mg
T1
methyclothiazide oral tablet 5 mg
T1
metolazone oral tablet 10 mg, 2.5 mg, 5 mg
T1
spironolactone oral tablet 100 mg, 25 mg, 50 mg
T1
spironolactone-hctz oral tablet 25-25 mg
T1
torsemide oral tablet 10 mg, 100 mg, 20 mg, 5 mg
T1
triamterene-hctz oral capsule 37.5-25 mg
T1
triamterene-hctz oral tablet 37.5-25 mg, 75-50 mg
T1
Notes
QL (600 ML per 30 days); AL
(Max 12 Years)
*Endocrine And Metabolic Agents Misc.*
alendronate sodium oral tablet 10 mg, 35 mg, 40
mg, 5 mg, 70 mg
T1
calcitonin (salmon) nasal solution 200 unit/act
T1
calcitriol oral capsule 0.25 mcg, 0.5 mcg
T1
desmopressin ace spray refrig nasal solution 0.01
%
T1
desmopressin acetate oral tablet 0.1 mg, 0.2 mg
T1
desmopressin acetate spray nasal solution 0.01 %
T1
ibandronate sodium oral tablet 150 mg
T1
QL (1 EA per 28 days)
LUPRON DEPOT-PED INTRAMUSCULAR*
KIT 11.25 MG, 15 MG, 7.5 MG
T1
PA
47
Drug
Status
Notes
risedronate sodium oral tablet 150 mg, 30 mg, 35
mg, 5 mg
T1
SENSIPAR ORAL TABLET 30 MG, 60 MG,
90 MG
T1
PA
COVARYX HS ORAL TABLET 0.625-1.25
MG
T1
GR-F; QL (21 EA per 28 days)
COVARYX ORAL TABLET 1.25-2.5 MG
T1
GR-F; QL (21 EA per 28 days)
est estrogens-methyltest ds oral tablet 1.25-2.5
mg
T1
GR-F; QL (21 EA per 28 days)
est estrogens-methyltest hs oral tablet 0.625-1.25
mg
T1
GR-F; QL (21 EA per 28 days)
est estrogens-methyltest oral tablet 1.25-2.5 mg
T1
GR-F; QL (21 EA per 28 days)
estradiol oral tablet 0.5 mg, 1 mg, 2 mg
T1
GR-F
estradiol transdermal patch biweekly 0.025
mg/24hr, 0.0375 mg/24hr, 0.05 mg/24hr, 0.075
mg/24hr, 0.1 mg/24hr
T1
GR-F; QL (8 EA per 28 days)
estradiol transdermal patch weekly 0.025
mg/24hr, 0.0375 mg/24hr, 0.05 mg/24hr, 0.06
mg/24hr, 0.075 mg/24hr, 0.1 mg/24hr
T1
GR-F; QL (4 EA per 28 days)
estradiol-norethindrone acet oral tablet 0.5-0.1
mg, 1-0.5 mg
T1
GR-F; QL (28 EA per 28 days)
estropipate oral tablet 0.75 mg, 1.5 mg, 3 mg
T1
GR-F; QL (21 EA per 28 days)
JINTELI ORAL TABLET 1-5 MG-MCG
T1
GR-F; QL (21 EA per 28 days)
MENEST ORAL TABLET 0.3 MG, 0.625 MG,
1.25 MG, 2.5 MG
T1
GR-F
norethindrone-eth estradiol oral tablet 0.5-2.5
mg-mcg
T1
GR-F; QL (28 EA per 28 days)
PREMARIN ORAL TABLET 0.3 MG, 0.45
MG, 0.625 MG, 0.9 MG, 1.25 MG
T1
GR-F; QL (30 EA per 30 days)
PREMPHASE ORAL TABLET 0.625-5 MG
T1
GR-F; QL (30 EA per 30 days)
PREMPRO ORAL TABLET 0.3-1.5 MG,
0.45-1.5 MG, 0.625-2.5 MG, 0.625-5 MG
T1
GR-F; QL (30 EA per 30 days)
*Estrogens*
*Fluoroquinolones*
ciprofloxacin hcl oral tablet 250 mg, 500 mg, 750
mg
T1
levofloxacin oral tablet 250 mg, 500 mg, 750 mg
T1
ofloxacin oral tablet 400 mg
T1
*Gastrointestinal Agents - Misc.*
APRISO ORAL CAPSULE EXTENDED
RELEASE 24 HOUR 0.375 GM
T1
balsalazide disodium oral capsule 750 mg
T1
48
QL (120 EA per 30 days)
Drug
Status
Notes
BICARSIM FORTE ORAL TABLET 125 MG
T1
BICARSIM ORAL TABLET 80 MG
T1
calcium acetate (phos binder) oral capsule 667
mg
T1
calcium acetate (phos binder) oral tablet 667 mg
T1
cvs gas relief drops ex st oral liquid† 40 mg/0.6ml
T1
DELZICOL ORAL CAPSULE DELAYED
RELEASE 400 MG
T1
GAS-X EXTRA STRENGTH ORAL STRIP
62.5 MG
T1
lactulose encephalopathy oral solution 10
gm/15ml
T1
mesalamine enema 4 gm
T1
metoclopramide hcl oral solution 10 mg/10ml, 5
mg/5ml
T1
metoclopramide hcl oral tablet 10 mg, 5 mg
T1
RENAGEL ORAL TABLET 400 MG, 800 MG
T1
PA
SFROWASA ENEMA 4 GM/60ML
T1
QL (240 ML per 30 days)
simethicone oral capsule 125 mg, 180 mg
T1
simethicone oral suspension 20 mg/0.3ml
T1
simethicone oral tablet chewable 125 mg, 80 mg
T1
sulfasalazine oral tablet 500 mg
T1
sulfasalazine oral tablet delayed release 500 mg
T1
ursodiol oral capsule 300 mg
T1
ursodiol oral tablet 250 mg, 500 mg
T1
QL (180 EA per 30 days)
QL (240 ML per 30 days)
*Genitourinary Agents - Miscellaneous*
alfuzosin hcl er oral tablet extended release 24
hr* 10 mg
T1
citric acid-sodium citrate oral solution 334-500
mg/5ml
T1
cytra k crystals oral packet 3300-1002 mg
T1
cytra-2 oral solution 500-334 mg/5ml
T1
CYTRA-3 ORAL SYRUP 550-500-334
MG/5ML
T1
cytra-k oral solution 1100-334 mg/5ml
T1
finasteride oral tablet 5 mg
T1
K-PHOS NO 2 ORAL TABLET 305-700 MG
T1
ORACIT ORAL SOLUTION 490-640
MG/5ML
T1
49
Drug
Status
phenazopyridine hcl oral tablet 100 mg, 200 mg,
95 mg
T1
potassium citrate-citric acid oral packet
3300-1002 mg
T1
potassium citrate-citric acid oral solution
1100-334 mg/5ml
T1
sodium chloride irrigation solution 0.9 %
T1
tamsulosin hcl oral capsule 0.4 mg
T1
Notes
*Gout Agents*
allopurinol oral tablet 100 mg, 300 mg
T1
colchicine oral tablet 0.6 mg
T1
colchicine-probenecid oral tablet 0.5-500 mg
T1
probenecid oral tablet 500 mg
T1
QL (20 EA per 30 days)
*Hematological Agents - Misc.*
anagrelide hcl oral capsule 0.5 mg, 1 mg
T1
BRILINTA ORAL TABLET 60 MG, 90 MG
T1
cilostazol oral tablet 100 mg, 50 mg
T1
clopidogrel bisulfate oral tablet 300 mg
T1
clopidogrel bisulfate oral tablet 75 mg
T1
dipyridamole oral tablet 25 mg, 50 mg, 75 mg
T1
EFFIENT ORAL TABLET 10 MG, 5 MG
T1
PA
pentoxifylline er oral tablet extendedrelease* 400
mg
T1
QL (90 EA per 30 days)
ticlopidine hcl oral tablet 250 mg
T1
QL (60 EA per 30 days)
QL (30 EA per 30 days)
*Hematopoietic Agents*
cyanocobalamin injection solution 1000 mcg/ml
T1
ELITE IRON ORAL TABLET 15 MG
T1
EPOGEN INJECTION SOLUTION 10000
UNIT/ML, 2000 UNIT/ML, 20000 UNIT/ML,
3000 UNIT/ML, 4000 UNIT/ML
T1
ferretts ips oral solution 40 mg/15ml
T1
ferretts oral tablet 325 (106 fe) mg
T1
FERRIMIN 150 ORAL TABLET 150 MG
T1
ferrous fumarate oral tablet 29 mg, 324 (106 fe)
mg
T1
ferrous gluconate oral tablet 225 (27 fe) mg, 240
(27 fe) mg, 324 (37.5 fe) mg, 325 (36 fe) mg
T1
ferrous sulfate granules
T1
ferrous sulfate oral elixir 220 (44 fe) mg/5ml
T1
AL (Max 12 Years)
ferrous sulfate oral solution 75 (15 fe) mg/ml
T1
AL (Max 12 Years)
50
PA
Drug
Status
ferrous sulfate oral syrup 300 (60 fe) mg/5ml
T1
ferrous sulfate oral tablet 27 mg, 325 (65 fe) mg
T1
ferrous sulfate oral tablet delayed release 325 (65
fe) mg
T1
folic acid oral tablet 1 mg
T1
folic acid oral tablet 400 mcg, 800 mcg
T1
HEMATOGEN FORTE ORAL CAPSULE
460-60-0.01-1 MG
T1
high potency iron oral capsule 86 (27 fe) mg
T1
high potency iron oral tablet 134 mg
T1
hm iron oral tablet 200 (65 fe) mg
T1
iron (ferrous gluconate) oral tablet 256 (28 fe)
mg
T1
iron complex oral capsule
T1
IRON UP ORAL LIQUID† 15 MG/0.5ML
T1
MYKIDZ IRON 10 ORAL SUSPENSION 15
MG/1.5ML
T1
NOVAFERRUM PEDIATRIC DROPS ORAL
LIQUID† 15 MG/ML
T1
PERFECT IRON ORAL TABLET 25 MG
T1
poly-iron 150 forte oral capsule 150-25-1
mg-mcg-mg
T1
PROCRIT INJECTION SOLUTION 10000
UNIT/ML, 2000 UNIT/ML, 20000 UNIT/ML,
3000 UNIT/ML, 4000 UNIT/ML, 40000
UNIT/ML
T1
PROFERRIN ES ORAL TABLET 12 MG
T1
slow iron oral tablet extendedrelease* 160 (50 fe)
mg
T1
slow release iron oral tablet extendedrelease* 45
mg, 47.5 mg
T1
sm slow release iron oral tablet extendedrelease*
142 (45 fe) mg
T1
SPATONE PUR-ABSORB IRON ORAL
LIQUID† 5 MG/20ML
T1
tl icon oral capsule
T1
vitamin b-12 oral tablet 1000 mcg
T1
ZARXIO INJECTION 300 MCG/0.5ML, 480
MCG/0.8ML
T1
Notes
AL (Max 12 Years)
GR-F; QL (30 EA per 30 days);
AL (Min 14 Years and Max 50
Years)
PA
AL (Max 12 Years)
PA
51
Drug
*Hypnotics*
Status
Notes
diphenhydramine hcl (sleep) oral tablet 50 mg
T1
diphenhydramine-apap (sleep) oral tablet 25-500
mg
T1
estazolam oral tablet 1 mg, 2 mg
T1
flurazepam hcl oral capsule 15 mg, 30 mg
T1
ibuprofen pm oral tablet 200-38 mg
T1
phenobarbital oral solution 20 mg/5ml
T1
phenobarbital oral tablet 100 mg, 15 mg, 16.2
mg, 30 mg, 32.4 mg, 60 mg, 64.8 mg, 97.2 mg
T1
ra sleep aid (diphenhydramine) oral tablet 25 mg
T1
PA
ra sleep aid oral capsule 50 mg
T1
PA
ra sleep aid oral liquid† 50 mg/30ml
T1
PA
ra sleep-aid nighttime oral capsule 25 mg
T1
PA
temazepam oral capsule 15 mg, 30 mg
T1
QL (30 EA per 30 days); AL (Max
64 Years)
triazolam oral tablet 0.125 mg, 0.25 mg
T1
AL (Max 64 Years)
wal-som oral tablet dispersible 25 mg
T1
PA
zaleplon oral capsule 10 mg, 5 mg
T1
zolpidem tartrate oral tablet 10 mg, 5 mg
T1
*Laxatives*
AGORAL MAXIMUM STRENGTH ORAL
LIQUID† 25 MG/15ML
T1
bisacodyl ec oral tablet delayed release 5 mg
T1
bisacodyl suppository 10 mg
T1
CORRECTOL HERBAL TEA ORAL 30 MG
T1
cvs mini enema kids enema 100 mg/5ml
T1
cvs natural fiber supplement oral packet 58.6 %
T1
diocto oral syrup 60 mg/15ml
T1
docusate calcium oral capsule 240 mg
T1
docusate sodium oral capsule 100 mg, 250 mg
T1
docusate sodium oral liquid† 50 mg/5ml
T1
docusate sodium oral tablet 100 mg
T1
DOCUSOL MINI ENEMA 283 MG
T1
DOCUSOL PLUS MINI-ENEMA ENEMA
20-283 MG
T1
EQUALACTIN ORAL TABLET
CHEWABLE 625 MG
T1
EVAC-U-GEN ORAL TABLET CHEWABLE
10 MG
T1
52
PA
QL (30 EA per 30 days)
Drug
Status
Notes
fiber laxative oral capsule 0.52 gm
T1
fiber laxative oral tablet 625 mg
T1
fiber therapy oral powder 58.6 %
T1
FLEET BISACODYL ENEMA 10 MG/30ML
T1
GAVILYTE-C ORAL SOLUTION
RECONSTITUTED 240 GM
T1
QL (4000 ML per 365 days); AL
(Min 50 Years and Max 75 Years)
GAVILYTE-G ORAL SOLUTION
RECONSTITUTED 236 GM
T1
QL (4000 ML per 365 days); AL
(Min 50 Years and Max 75 Years)
geri-mucil oral powder 68 %
T1
glycerin (adult) suppository 2.1 gm
T1
glycerin (infants & children) suppository 1 gm,
1.2 gm
T1
glycerin adult suppository 2 gm
T1
GOLYTELY ORAL SOLUTION
RECONSTITUTED 227.1 GM
T1
HYDROCIL ORAL PACKET 95 %
T1
KONSYL ORAL PACKET 100 %, 28.3 %,
60.3 %
T1
KONSYL ORAL POWDER 60.3 %, 71.67 %
T1
KONSYL-D ORAL POWDER 52.3 %
T1
lactulose oral solution 10 gm/15ml
T1
laxative pills oral tablet 15 mg
T1
magnesium citrate oral solution 1.745 gm/30ml
T1
METAMUCIL ORAL WAFER
T1
METAMUCIL SMOOTH TEXTURE ORAL
PACKET 28 %
T1
natural fiber laxative oral powder 28.3 %, 48.57
%
T1
natural fiber therapy oral powder 30.9 %
T1
natural psyllium seed oral powder 100 %
T1
natural senna laxative oral tablet 64.8-324 mg
T1
PEDIA-LAX ORAL LIQUID† 50 MG/15ML
T1
PEDIA-LAX SUPPOSITORY 2.8 GM
T1
peg 3350 oral packet
T1
peg 3350/electrolytes oral solution reconstituted
240 gm
T1
polyethylene glycol 3350 oral powder
T1
qc natural vegetable oral powder 95 %
T1
ra col-rite oral capsule 50 mg
T1
ra glycerin child suppository 80.7 %
T1
QL (1 EA per 365 days)
QL (4000 ML per 365 days); AL
(Min 50 Years and Max 75 Years)
53
Drug
Status
ra laxative extra strength oral tablet 17.2 mg
T1
ra laxative oral tablet chewable 15 mg
T1
senna laxative oral tablet 25 mg
T1
senna leaves oral leaves
T1
senna oral capsule 8.6 mg
T1
senna oral syrup 176 mg/5ml, 8.8 mg/5ml
T1
senna oral tablet 8.6 mg
T1
senna-docusate sodium oral tablet 8.6-50 mg
T1
SOLUBLE FIBER THERAPY ORAL
POWDER
T1
TRILYTE ORAL SOLUTION
RECONSTITUTED 420 GM
T1
Notes
QL (4000 ML per 365 days); AL
(Min 50 Years and Max 75 Years)
*Local Anesthetics-Parenteral*
lidocaine hcl (pf) injection solution 4 %
T1
*Macrolides*
azithromycin oral suspension reconstituted 100
mg/5ml, 200 mg/5ml
T1
azithromycin oral tablet 250 mg
T1
azithromycin oral tablet 500 mg, 600 mg
T1
clarithromycin oral suspension reconstituted 125
mg/5ml, 250 mg/5ml
T1
clarithromycin oral tablet 250 mg, 500 mg
T1
QL (12 EA per 30 days)
*Medical Devices*
1st tier unifine pentips 29g x 12mm , 31g x 5 mm ,
31g x 6 mm , 31g x 8 mm , 32g x 4 mm
T1
QL (200 EA per 30 days)
1st tier unifine pentips plus 29g x 12mm , 31g x 5
mm , 31g x 6 mm , 31g x 8 mm , 32g x 4 mm
T1
QL (200 EA per 30 days)
ACCU-CHEK TENDER 1 INFUSION KIT
T1
QL (200 EA per 30 days)
administration set
T1
QL (200 EA per 30 days)
ADVOCATE INSULIN PEN NEEDLES 31G
X 5 MM , 31G X 8 MM
T1
QL (200 EA per 30 days)
ADVOCATE INSULIN SYRINGE 29G X 1/2"
0.3 ML, 29G X 1/2" 0.5 ML, 29G X 1/2" 1 ML,
30G X 5/16" 0.3 ML, 30G X 5/16" 0.5 ML, 30G
X 5/16" 1 ML, 31G X 5/16" 0.3 ML, 31G X
5/16" 0.5 ML, 31G X 5/16" 1 ML
T1
QL (200 EA per 30 days)
air eliminating tpn iv set
T1
QL (200 EA per 30 days)
anesthesia extension tubing
T1
QL (200 EA per 30 days)
anti-stick insulin syringe 29g x 1/2" 1 ml
T1
QL (200 EA per 30 days)
ARGYLE EXTENSION TUBE 20"
T1
QL (200 EA per 30 days)
54
Drug
Status
Notes
ASSURE DOSE CONTROL IN VITRO
SOLUTION NORMAL
T1
ASSURE ID INSULIN SAFETY SYR 29G X
1/2" 0.5 ML, 29G X 1/2" 1 ML
T1
QL (200 EA per 30 days)
aurora pen needles 29g x 12mm , 31g x 6 mm ,
31g x 8 mm
T1
QL (200 EA per 30 days)
aurora unifine pentips 31g x 5 mm , 32g x 4 mm
T1
QL (200 EA per 30 days)
AUTOJECT 2
T1
QL (200 EA per 30 days)
autopen device
T1
QL (200 EA per 30 days)
BD ANGIOCATH AUTOGUARD
T1
QL (200 EA per 30 days)
BD AUTOSHIELD 29G X 12MM , 29G X
5MM , 29G X 8MM
T1
QL (200 EA per 30 days)
BD AUTOSHIELD DUO 30G X 5 MM
T1
QL (200 EA per 30 days)
BD ECLIPSE SYRINGE 25G X 5/8" 1 ML
T1
QL (200 EA per 30 days)
BD FIRST MIDCATH 18G/4FRX20CM
T1
QL (200 EA per 30 days)
BD FIRST MIDCATH 18G/4FRX20CM KIT
T1
QL (200 EA per 30 days)
BD FIRST MIDCATH 20G/3FRX20CM
T1
QL (200 EA per 30 days)
BD FIRST MIDCATH 20G/3FRX20CM KIT
T1
QL (200 EA per 30 days)
BD FIRST PICC 16G/5FRX65CM
T1
QL (200 EA per 30 days)
BD FIRST PICC 16G/5FRX65CM KIT
T1
QL (200 EA per 30 days)
BD FIRST PICC 18G/4FRX65CM
T1
QL (200 EA per 30 days)
BD FIRST PICC 18G/4FRX65CM KIT
T1
QL (200 EA per 30 days)
BD FIRST PICC 20G/3FRX65CM
T1
QL (200 EA per 30 days)
BD FIRST PICC 20G/3FRX65CM KIT
T1
QL (200 EA per 30 days)
BD FIRST PICC 22G/2.8FRX50CM
T1
QL (200 EA per 30 days)
BD FIRST PICC 26G/1.9FRX50CM
T1
QL (200 EA per 30 days)
BD FIRST PICC 26G/1.9FRX50CM KIT
T1
QL (200 EA per 30 days)
BD INSULIN SYR ULTRAFINE II 31G X
5/16" 0.5 ML, 31G X 5/16" 1 ML
T1
QL (200 EA per 30 days)
BD INSULIN SYRINGE 25G X 1" 1 ML, 25G
X 5/8" 1 ML, 26G X 1/2" 1 ML, 27G X 1/2" 1
ML, 28G X 1/2" 1 ML, 29G X 1/2" 0.5 ML,
29G X 1/2" 1 ML, 30G X 1/2" 0.5 ML, 31G X
5/16" 0.3 ML, U-100 1 ML
T1
QL (200 EA per 30 days)
BD INSULIN SYRINGE HALF-UNIT 31G X
5/16" 0.3 ML
T1
QL (200 EA per 30 days)
BD INSULIN SYRINGE MICROFINE 27G X
5/8" 1 ML, 28G X 1/2" 0.3 ML, 28G X 1/2" 0.5
ML, 28G X 1/2" 1 ML
T1
QL (200 EA per 30 days)
BD INSULIN SYRINGE U-40 25G X 5/8" 1
ML
T1
QL (200 EA per 30 days)
55
Drug
Status
Notes
BD INSULIN SYRINGE ULTRAFINE 29G X
1/2" 0.3 ML, 29G X 1/2" 0.5 ML, 29G X 1/2" 1
ML, 30G X 1/2" 0.3 ML, 30G X 1/2" 0.5 ML,
30G X 1/2" 1 ML, 31G X 15/64" 0.3 ML, 31G
X 15/64" 0.5 ML, 31G X 15/64" 1 ML, 31G X
5/16" 0.3 ML, 31G X 5/16" 0.5 ML, 31G X
5/16" 1 ML
T1
QL (200 EA per 30 days)
BD INTEGRA INSULIN SYRINGE 29G X
1/2" 1 ML
T1
QL (200 EA per 30 days)
BD INTEGRA SYRINGE 25G X 1" 1 ML,
25G X 5/8" 1 ML
T1
QL (200 EA per 30 days)
BD L-CATH 16G/5FR KIT
T1
QL (200 EA per 30 days)
BD L-CATH 16G/5FRX60CM
T1
QL (200 EA per 30 days)
BD L-CATH 18G/3.5FR KIT
T1
QL (200 EA per 30 days)
BD L-CATH 18G/3.5FRX60CM
T1
QL (200 EA per 30 days)
BD L-CATH 20G/2.6FR KIT
T1
QL (200 EA per 30 days)
BD L-CATH 20G/2.6FRX60CM
T1
QL (200 EA per 30 days)
BD L-CATH 20G/3FR KIT
T1
QL (200 EA per 30 days)
BD L-CATH 20G/3FRX60CM
T1
QL (200 EA per 30 days)
BD L-CATH 28G/1.2FRX25CM KIT
T1
QL (200 EA per 30 days)
BD L-CATH MIDLINE 18G/3.5FRX20
T1
QL (200 EA per 30 days)
BD L-CATH MIDLINE 18G/3.5FRX20 KIT
T1
QL (200 EA per 30 days)
BD L-CATH MIDLINE 20G/3FRX20CM
T1
QL (200 EA per 30 days)
BD LUER-LOK SYRINGE 20G X 1" 1 ML,
25G X 5/8" 1 ML
T1
QL (200 EA per 30 days)
BD NEXIVA 18GX1.25"
T1
QL (200 EA per 30 days)
BD NEXIVA 18GX1.75"
T1
QL (200 EA per 30 days)
BD NEXIVA 20GX1"
T1
QL (200 EA per 30 days)
BD NEXIVA 20GX1.25"
T1
QL (200 EA per 30 days)
BD NEXIVA 20GX1.75"
T1
QL (200 EA per 30 days)
BD NEXIVA 22GX1"
T1
QL (200 EA per 30 days)
BD NEXIVA 24GX0.56"
T1
QL (200 EA per 30 days)
BD NEXIVA 24GX0.75"
T1
QL (200 EA per 30 days)
BD PEN NEEDLE MINI U/F 31G X 5 MM
T1
QL (200 EA per 30 days)
BD PEN NEEDLE NANO U/F 32G X 4 MM
T1
QL (200 EA per 30 days)
BD PEN NEEDLE SHORT U/F 31G X 8 MM
T1
QL (200 EA per 30 days)
BD PEN NEEDLE ULTRAFINE 29G X
12.7MM
T1
QL (200 EA per 30 days)
BD SAFETYGLIDE INSULIN SYRINGE 30G
X 5/16" 0.5 ML
T1
QL (200 EA per 30 days)
56
Drug
Status
Notes
BD SAFETY-LOK INSULIN SYRINGE 29G
X 1/2" 1 ML
T1
QL (200 EA per 30 days)
BD SAFETY-LOK SET
T1
QL (200 EA per 30 days)
BD SAFETY-LOK VACUTAINER SET
T1
QL (200 EA per 30 days)
BD SAF-T E-Z SET
T1
QL (200 EA per 30 days)
BD SAF-T-INTIMA 18G X 1" KIT
T1
QL (200 EA per 30 days)
BD SAF-T-INTIMA 20GX1"
T1
QL (200 EA per 30 days)
BD SAF-T-INTIMA 22G X 0.75" KIT
T1
QL (200 EA per 30 days)
BD SAF-T-INTIMA 22GX3/4"
T1
QL (200 EA per 30 days)
BD SAF-T-INTIMA 24G X 0.75" KIT
T1
QL (200 EA per 30 days)
BD SAF-T-INTIMA 24GX3/4"
T1
QL (200 EA per 30 days)
BD SYRINGE/NEEDLE 25G X 5/8" 1 ML
T1
QL (200 EA per 30 days)
BD SYRINGE/NEEDLE SLIP TIP 26G X 5/8"
1 ML
T1
QL (200 EA per 30 days)
BD VACUTAINER SET
T1
QL (200 EA per 30 days)
CAREFINE PEN NEEDLES 29G X 12MM ,
30G X 8 MM , 31G X 6 MM , 31G X 8 MM ,
32G X 4 MM , 32G X 5 MM , 32G X 6 MM
T1
QL (200 EA per 30 days)
careone insulin syringe 30g x 1/2" 0.3 ml, 30g x
1/2" 0.5 ml, 30g x 1/2" 1 ml, 31g x 5/16" 0.3 ml,
31g x 5/16" 0.5 ml, 31g x 5/16" 1 ml
T1
QL (200 EA per 30 days)
careone unifine pentips 29g x 12mm , 31g x 5 mm
, 31g x 6 mm , 31g x 8 mm , 32g x 4 mm
T1
QL (200 EA per 30 days)
careone unifine pentips plus 29g x 12mm , 31g x 5
mm , 31g x 6 mm , 31g x 8 mm , 32g x 4 mm
T1
QL (200 EA per 30 days)
clickfine pen needles 31g x 6 mm , 31g x 8 mm ,
32g x 4 mm
T1
QL (200 EA per 30 days)
COMFORT EZ INSULIN SYRINGE 28G X
1/2" 0.5 ML, 28G X 1/2" 1 ML, 29G X 1/2" 0.3
ML, 29G X 1/2" 0.5 ML, 29G X 1/2" 1 ML,
30G X 1/2" 0.3 ML, 30G X 1/2" 0.5 ML, 30G X
1/2" 1 ML, 30G X 5/16" 0.3 ML, 30G X 5/16"
0.5 ML, 30G X 5/16" 1 ML, 31G X 5/16" 0.3
ML, 31G X 5/16" 0.5 ML, 31G X 5/16" 1 ML
T1
QL (200 EA per 30 days)
COMFORT EZ PEN NEEDLES 31G X 5 MM
, 31G X 6 MM , 31G X 8 MM , 32G X 4 MM
T1
QL (200 EA per 30 days)
cool mist humidifier
T1
CORNWALL METAL PIPETTING
T1
CURITY ALCOHOL PREPS PAD 70 %
T1
denture adhesive cream
T1
drug mart unifine pentips 29g x 12mm , 31g x 5
mm , 31g x 6 mm , 31g x 8 mm , 32g x 4 mm
T1
QL (200 EA per 30 days)
QL (200 EA per 30 days)
57
Drug
Status
Notes
drug mart unifine pentips plus 32g x 4 mm
T1
QL (200 EA per 30 days)
duane reade unifine pentips 29g x 12mm , 31g x 6
mm , 31g x 8 mm
T1
QL (200 EA per 30 days)
EASIVENT
T1
QL (2 EA per 365 days)
EASIVENT MASK LARGE
T1
QL (2 EA per 365 days)
EASIVENT MASK MEDIUM
T1
QL (2 EA per 365 days)
EASIVENT MASK SMALL
T1
QL (2 EA per 365 days)
easy comfort insulin syringe 30g x 1/2" 0.5 ml,
30g x 1/2" 1 ml, 30g x 5/16" 0.3 ml, 30g x 5/16"
0.5 ml, 30g x 5/16" 1 ml
T1
QL (200 EA per 30 days)
easy comfort pen needles 31g x 5 mm , 31g x 8
mm , 32g x 4 mm
T1
QL (200 EA per 30 days)
EASY TOUCH FLURINGE 25G X 1" 1 ML,
25G X 5/8" 1 ML
T1
QL (200 EA per 30 days)
EASY TOUCH INSULIN SAFETY SYR 29G
X 1/2" 0.5 ML, 29G X 1/2" 1 ML, 30G X 1/2"
1 ML, 30G X 5/16" 0.5 ML
T1
QL (200 EA per 30 days)
EASY TOUCH INSULIN SYRINGE 27G X
1/2" 0.5 ML, 27G X 1/2" 1 ML, 28G X 1/2" 0.5
ML, 28G X 1/2" 1 ML, 29G X 1/2" 0.5 ML,
29G X 1/2" 1 ML, 30G X 1/2" 0.3 ML, 30G X
1/2" 0.5 ML, 30G X 1/2" 1 ML, 30G X 5/16"
0.3 ML, 30G X 5/16" 0.5 ML, 30G X 5/16" 1
ML, 31G X 5/16" 0.3 ML, 31G X 5/16" 0.5
ML, 31G X 5/16" 1 ML
T1
QL (200 EA per 30 days)
EASY TOUCH PEN NEEDLES 29G X 12MM
, 31G X 5 MM , 31G X 6 MM , 31G X 8 MM ,
32G X 4 MM , 32G X 5 MM , 32G X 6 MM
T1
QL (200 EA per 30 days)
EASY TOUCH SAFETY SYRINGE 25G X 1"
1 ML, 25G X 5/8" 1 ML
T1
QL (200 EA per 30 days)
eql insulin syringe 29g x 1/2" 0.3 ml, 29g x 1/2"
0.5 ml, 29g x 1/2" 1 ml, 30g x 5/16" 0.3 ml, 30g x
5/16" 0.5 ml, 30g x 5/16" 1 ml, 31g x 5/16" 0.3
ml, 31g x 5/16" 0.5 ml, 31g x 5/16" 1 ml
T1
QL (200 EA per 30 days)
eql short pen needle 31g x 8 mm
T1
QL (200 EA per 30 days)
eql ultra comfort insulin syr 31g x 5/16" 0.3 ml
T1
QL (200 EA per 30 days)
eql ultra short pen needle 31g x 6 mm
T1
QL (200 EA per 30 days)
EXCEL COMFORT POINT PEN NEEDLE
29G X 12MM , 31G X 6 MM , 31G X 8 MM
T1
QL (200 EA per 30 days)
EXEL COMFORT POINT INSULIN SYR
28G X 1/2" 0.5 ML, 28G X 1/2" 1 ML, 29G X
1/2" 0.3 ML, 29G X 1/2" 0.5 ML, 29G X 1/2" 1
ML, 30G X 5/16" 0.3 ML, 30G X 5/16" 0.5
ML, 30G X 5/16" 1 ML
T1
QL (200 EA per 30 days)
58
Drug
Status
Notes
FIFTY50 PEN NEEDLES 31G X 5 MM , 31G
X 8 MM
T1
QL (200 EA per 30 days)
FIFTY50 SUPERIOR COMFORT SYR 31G X
5/16" 0.3 ML, 31G X 5/16" 0.5 ML, 31G X
5/16" 1 ML
T1
QL (200 EA per 30 days)
fluid administration set
T1
QL (200 EA per 30 days)
freds pharmacy unifine pentip+ 31g x 5 mm , 31g
x 8 mm
T1
QL (200 EA per 30 days)
freds pharmacy unifine pentips 32g x 4 mm
T1
QL (200 EA per 30 days)
FREESTYLE CONTROL SOLUTION IN
VITRO LIQUID†
T1
FREESTYLE PRECISION INS SYR 30G X
5/16" 0.5 ML, 30G X 5/16" 1 ML, 31G X 5/16"
0.5 ML, 31G X 5/16" 1 ML
T1
gauze sponge pad 4"x4"
T1
global ease inject pen needles 29g x 12mm , 31g x
5 mm , 31g x 8 mm , 32g x 4 mm
T1
QL (200 EA per 30 days)
global inject ease insulin syr 28g x 1/2" 0.5 ml,
28g x 1/2" 1 ml, 29g x 1/2" 0.3 ml, 29g x 1/2" 0.5
ml, 29g x 1/2" 1 ml, 30g x 1/2" 0.3 ml, 30g x 1/2"
0.5 ml, 30g x 1/2" 1 ml, 30g x 5/16" 0.3 ml, 30g x
5/16" 0.5 ml, 30g x 5/16" 1 ml, 31g x 5/16" 0.3
ml, 31g x 5/16" 0.5 ml, 31g x 5/16" 1 ml
T1
QL (200 EA per 30 days)
GLUCOCARD EXPRESSION CONTROL IN
VITRO SOLUTION
T1
GLUCOPRO INSULIN SYRINGE 30G X 1/2"
0.3 ML, 30G X 1/2" 0.5 ML, 30G X 1/2" 1 ML,
30G X 5/16" 0.3 ML, 30G X 5/16" 0.5 ML, 30G
X 5/16" 1 ML, 31G X 5/16" 0.3 ML, 31G X
5/16" 0.5 ML, 31G X 5/16" 1 ML
T1
QL (200 EA per 30 days)
gnp clickfine pen needles 31g x 6 mm , 31g x 8
mm
T1
QL (200 EA per 30 days)
gnp insulin syringe 28g x 1/2" 0.5 ml, 28g x 1/2"
1 ml, 29g x 1/2" 0.3 ml, 29g x 1/2" 0.5 ml, 29g x
1/2" 1 ml, 30g x 5/16" 0.3 ml, 30g x 5/16" 0.5 ml,
30g x 5/16" 1 ml, 31g x 5/16" 0.3 ml, 31g x 5/16"
0.5 ml, 31g x 5/16" 1 ml
T1
QL (200 EA per 30 days)
gnp ultra com insulin syringe 28g x 1/2" 0.5 ml,
28g x 1/2" 1 ml, 29g x 1/2" 0.3 ml, 29g x 1/2" 0.5
ml, 29g x 1/2" 1 ml, 30g x 5/16" 0.3 ml, 30g x
5/16" 0.5 ml, 30g x 5/16" 1 ml, 31g x 5/16" 0.3
ml, 31g x 5/16" 0.5 ml, 31g x 5/16" 1 ml
T1
QL (200 EA per 30 days)
H 468L TUBING
T1
QL (200 EA per 30 days)
healthwise mini pen needles 31g x 6 mm
T1
QL (200 EA per 30 days)
healthwise pen needles 29g x 12mm
T1
QL (200 EA per 30 days)
QL (200 EA per 30 days)
59
Drug
Status
Notes
healthwise short pen needles 31g x 8 mm
T1
QL (200 EA per 30 days)
healthwise unifine pentips 32g x 4 mm
T1
QL (200 EA per 30 days)
healthy accents unifine pentip 29g x 12mm , 31g x
5 mm , 31g x 6 mm , 31g x 8 mm , 32g x 4 mm
T1
QL (200 EA per 30 days)
h-e-b incontrol pen needles 29g x 12mm , 31g x 5
mm , 31g x 6 mm , 31g x 8 mm , 32g x 4 mm
T1
QL (200 EA per 30 days)
HUBER INFUSION SET
T1
QL (200 EA per 30 days)
HUMAPEN LUXURA HD DEVICE
T1
QL (200 EA per 30 days)
HUMATROPEN FOR 12MG DEVICE
T1
QL (200 EA per 30 days)
HUMATROPEN FOR 24MG DEVICE
T1
QL (200 EA per 30 days)
HUMATROPEN FOR 6MG DEVICE
T1
QL (200 EA per 30 days)
infusion set
T1
QL (200 EA per 30 days)
infusion set 23" comfort
T1
QL (200 EA per 30 days)
inject-ease
T1
QL (200 EA per 30 days)
INJECT-EASE AUTOMATIC INJECTOR
T1
QL (200 EA per 30 days)
INSUFLON 25G X 0.71"
T1
QL (200 EA per 30 days)
insulin syringe 28g x 1/2" 0.5 ml, 28g x 1/2" 1 ml,
29g x 1" 0.3 ml, 30g x 1/2" 0.5 ml, 30g x 5/16" 1
ml
T1
QL (200 EA per 30 days)
insulin syringe 29g x 1/2" 0.3 ml, 29g x 1/2" 0.5
ml, 29g x 1/2" 1 ml, 30g x 5/16" 0.5 ml, 31g x
5/16" 0.3 ml, 31g x 5/16" 0.5 ml, 31g x 5/16" 1 ml
T1
insulin syringe/needle 27g x 1/2" 0.5 ml, 28g x
1/2" 0.5 ml, 28g x 1/2" 1 ml
T1
QL (200 EA per 30 days)
insupen pen needles 32g x 4 mm
T1
QL (200 EA per 30 days)
INSUPEN SENSITIVE 32G X 6 MM , 32G X 8
MM
T1
QL (200 EA per 30 days)
INSUPEN ULTRAFIN 29G X 12MM , 30G X
8 MM , 31G X 6 MM , 31G X 8 MM
T1
QL (200 EA per 30 days)
INSYTE AUTOGUARD 14GX1.75"
T1
QL (200 EA per 30 days)
INSYTE AUTOGUARD 18GX1.16"
T1
QL (200 EA per 30 days)
INSYTE AUTOGUARD 20GX1"
T1
QL (200 EA per 30 days)
INSYTE AUTOGUARD 20GX1.16"
T1
QL (200 EA per 30 days)
INSYTE AUTOGUARD 22GX1"
T1
QL (200 EA per 30 days)
INSYTE AUTOGUARD 24GX3/4"
T1
QL (200 EA per 30 days)
INTERLINK INJECT SITE/LUER LOC
T1
QL (200 EA per 30 days)
KANGAROO BURETTE SET
T1
QL (200 EA per 30 days)
kinray insulin syringe 29g x 1/2" 0.5 ml, 31g x
5/16" 0.3 ml, 31g x 5/16" 0.5 ml, 31g x 5/16" 1 ml
T1
QL (200 EA per 30 days)
kmart valu insulin syringe 29g u-100 0.5 ml,
u-100 1 ml
T1
QL (200 EA per 30 days)
60
Drug
Status
Notes
kmart valu insulin syringe 30g u-100 0.3 ml,
u-100 0.5 ml, u-100 1 ml
T1
QL (200 EA per 30 days)
kroger insulin syringe 29g x 1/2" 0.3 ml, 29g x
1/2" 0.5 ml, 29g x 1/2" 1 ml, 30g x 5/16" 0.3 ml,
30g x 5/16" 0.5 ml, 30g x 5/16" 1 ml, 31g x 5/16"
0.3 ml, 31g x 5/16" 0.5 ml, 31g x 5/16" 1 ml
T1
QL (200 EA per 30 days)
kroger pen needles 29g x 12mm , 31g x 6 mm ,
31g x 8 mm
T1
QL (200 EA per 30 days)
L606 TUBING
T1
QL (200 EA per 30 days)
L609 TUBING
T1
QL (200 EA per 30 days)
leader insulin syringe 28g x 1/2" 0.5 ml, 28g x
1/2" 1 ml, 29g x 1/2" 0.3 ml, 29g x 1/2" 0.5 ml,
29g x 1/2" 1 ml, 30g x 5/16" 0.3 ml, 30g x 5/16"
0.5 ml, 30g x 5/16" 1 ml, 31g x 5/16" 0.3 ml, 31g
x 5/16" 0.5 ml, 31g x 5/16" 1 ml
T1
QL (200 EA per 30 days)
LEADER UNIFINE PENTIPS 31G X 5 MM ,
32G X 4 MM
T1
QL (200 EA per 30 days)
LEADER UNIFINE PENTIPS PLUS 31G X 5
MM , 31G X 8 MM , 32G X 4 MM
T1
QL (200 EA per 30 days)
LITE TOUCH PEN NEEDLES 31G X 5 MM
T1
QL (200 EA per 30 days)
LITETOUCH INSULIN SYRINGE 28G X
1/2" 0.5 ML, 28G X 1/2" 1 ML, 29G X 1/2" 0.3
ML, 29G X 1/2" 0.5 ML, 29G X 1/2" 1 ML,
30G X 5/16" 0.3 ML, 30G X 5/16" 0.5 ML, 30G
X 5/16" 1 ML, 31G X 5/16" 0.3 ML, 31G X
5/16" 0.5 ML, 31G X 5/16" 1 ML
T1
QL (200 EA per 30 days)
LITETOUCH PEN NEEDLES 29G X 12.7MM
, 31G X 6 MM , 31G X 8 MM
T1
QL (200 EA per 30 days)
live better pen needles 29g x 12mm , 31g x 6 mm ,
31g x 8 mm
T1
QL (200 EA per 30 days)
longs insulin syringe 31g x 5/16" 0.5 ml
T1
QL (200 EA per 30 days)
LTXF PRIM CNV PIN MICRODRIP
T1
QL (200 EA per 30 days)
LTXF PRIM IV SET/CNVT PIN
T1
QL (200 EA per 30 days)
LTXF SECONDARY/CNV PIN/32INC
T1
QL (200 EA per 30 days)
MAGELLAN INSULIN SAFETY SYR 29G X
1/2" 0.3 ML, 29G X 1/2" 0.5 ML, 29G X 1/2" 1
ML, 30G X 5/16" 0.3 ML, 30G X 5/16" 0.5
ML, 30G X 5/16" 1 ML
T1
QL (200 EA per 30 days)
medic insulin syringe 30g x 5/16" 0.3 ml, 30g x
5/16" 0.5 ml
T1
QL (200 EA per 30 days)
medicine shoppe pen needles 29g x 12mm , 31g x
6 mm , 31g x 8 mm
T1
QL (200 EA per 30 days)
MEDSAVER SYRINGE 25G X 5/8" 1 ML
T1
QL (200 EA per 30 days)
61
Drug
Status
Notes
meijer pen needles 29g x 12mm , 31g x 6 mm ,
31g x 8 mm
T1
QL (200 EA per 30 days)
MONOJECT INSULIN SYRINGE 25G X 5/8"
1 ML, 27G X 1/2" 1 ML, 28G X 1/2" 0.5 ML,
28G X 1/2" 1 ML, 29G X 1/2" 0.3 ML, 29G X
1/2" 0.5 ML, 29G X 1/2" 1 ML, 30G X 5/16"
0.3 ML, 30G X 5/16" 0.5 ML, 30G X 5/16" 1
ML, 31G X 5/16" 1 ML, U-100 1 ML
T1
QL (200 EA per 30 days)
MONOJECT LIFESHIELD SYRINGE 18G X
1" 1 ML
T1
QL (200 EA per 30 days)
MONOJECT MAGELLAN SYRINGE 23G X
1" 1 ML, 25G X 1" 1 ML, 25G X 5/8" 1 ML
T1
QL (200 EA per 30 days)
MONOJECT ULTRA COMFORT SYRINGE
28G X 1/2" 0.5 ML, 28G X 1/2" 1 ML, 29G X
1/2" 0.3 ML, 29G X 1/2" 0.5 ML, 29G X 1/2" 1
ML, 30G X 5/16" 0.3 ML, 30G X 5/16" 0.5
ML, 31G X 5/16" 0.3 ML, 31G X 5/16" 0.5 ML
T1
QL (200 EA per 30 days)
MOORE MONO INSULIN SYRINGE 28G X
1/2" 0.5 ML, 28G X 1/2" 1 ML, 29G X 1/2" 0.5
ML, 29G X 1/2" 1 ML
T1
QL (200 EA per 30 days)
ms insulin syringe 31g x 5/16" 0.3 ml, 31g x 5/16"
0.5 ml, 31g x 5/16" 1 ml
T1
QL (200 EA per 30 days)
NERIA 29G INFUSION SET 10MM
T1
QL (200 EA per 30 days)
NERIA 29G INFUSION SET 6MM
T1
QL (200 EA per 30 days)
NERIA 29G INFUSION SET 8MM
T1
QL (200 EA per 30 days)
NERIA MULTI 27G 2X10MM
T1
QL (200 EA per 30 days)
NERIA MULTI 27G 3X10MM
T1
QL (200 EA per 30 days)
NERIA MULTI 27G 4X12MM
T1
QL (200 EA per 30 days)
NERIA SOFT 25G INFUSION 13MM
T1
QL (200 EA per 30 days)
NERIA SOFT 25G INFUSION 17MM
T1
QL (200 EA per 30 days)
NORDIPEN 5 INJECTION DEVICE
T1
QL (200 EA per 30 days)
NORDIPEN DELIVERY SYSTEM
T1
QL (200 EA per 30 days)
NOVOFINE 30G X 8 MM , 32G X 6 MM
T1
QL (200 EA per 30 days)
NOVOFINE AUTOCOVER 30G X 8 MM
T1
QL (200 EA per 30 days)
NOVOFINE PLUS 32G X 4 MM
T1
QL (200 EA per 30 days)
NOVOPEN ECHO DEVICE
T1
QL (200 EA per 30 days)
NOVOTWIST 30G X 8 MM , 32G X 5 MM
T1
QL (200 EA per 30 days)
OMNIFLEX DIAPHRAGM VAGINAL
DIAPHRAGM
T1
GR-F; QL (1 EA per 365 days)
OMNITROPE PEN 10 INJ DEVICE
T1
QL (200 EA per 30 days)
OMNITROPE PEN 5 INJ DEVICE
T1
QL (200 EA per 30 days)
62
Drug
Status
Notes
ONETOUCH ULTRA CONTROL IN VITRO
SOLUTION
T1
ORTHO DIAPHRAGM ALL-FLEX
VAGINAL DIAPHRAGM 65 MM, 70 MM, 75
MM, 80 MM
T1
GR-F; QL (1 EA per 365 days)
ORTHO DIAPHRAGM COIL VAGINAL
KIT 100 MM, 105 MM, 50 MM
T1
GR-F; QL (1 EA per 365 days)
ORTHO DIAPHRAGM FLAT VAGINAL
KIT 55 MM, 60 MM, 65 MM, 70 MM, 75 MM,
80 MM, 85 MM, 90 MM, 95 MM
T1
GR-F; QL (1 EA per 365 days)
pc unifine pentips 29g x 12mm , 31g x 5 mm , 31g
x 6 mm , 31g x 8 mm
T1
QL (200 EA per 30 days)
pen needles 1/2" 29g x 12mm
T1
QL (200 EA per 30 days)
pen needles 29g x 12mm , 31g x 6 mm
T1
QL (200 EA per 30 days)
pen needles 3/16" 31g x 5 mm
T1
QL (200 EA per 30 days)
pen needles 5/16" 30g x 8 mm , 31g x 8 mm
T1
QL (200 EA per 30 days)
plastic adapter , 1 ml
T1
QL (200 EA per 30 days)
PRECISION SUREDOSE PLUS SYR 29G X
1/2" 0.3 ML, 29G X 1/2" 1 ML
T1
QL (200 EA per 30 days)
PRECISION SURE-DOSE SYRINGE 28G X
1/2" 0.5 ML, 28G X 1/2" 1 ML, 29G X 1/2" 0.5
ML, 30G X 3/8" 0.5 ML
T1
QL (200 EA per 30 days)
preferred plus insulin syringe 28g x 1/2" 0.5 ml,
28g x 1/2" 1 ml, 29g x 1/2" 0.3 ml, 29g x 1/2" 0.5
ml, 29g x 1/2" 1 ml, 30g x 5/16" 0.3 ml, 30g x
5/16" 0.5 ml, 30g x 5/16" 1 ml
T1
QL (200 EA per 30 days)
preferred plus unifine pentips 29g x 12mm , 31g x
5 mm , 31g x 6 mm , 31g x 8 mm , 32g x 4 mm
T1
QL (200 EA per 30 days)
PRODIGY INSULIN SYRINGE 28G X 1/2" 1
ML, 31G X 5/16" 0.3 ML, 31G X 5/16" 0.5 ML
T1
QL (200 EA per 30 days)
px extra short pen needles 31g x 6 mm
T1
QL (200 EA per 30 days)
px insulin syringe 30g x 1/2" 0.3 ml, 30g x 1/2"
0.5 ml, 30g x 1/2" 1 ml, 31g x 5/16" 0.3 ml, 31g x
5/16" 0.5 ml, 31g x 5/16" 1 ml
T1
QL (200 EA per 30 days)
px mini pen needles 31g x 5 mm
T1
QL (200 EA per 30 days)
px pen needle 29g x 12mm , 31g x 8 mm
T1
QL (200 EA per 30 days)
qc pen needles 29g x 12mm , 31g x 6 mm , 31g x 8
mm
T1
QL (200 EA per 30 days)
qc unifine pentips 32g x 4 mm
T1
QL (200 EA per 30 days)
ra insulin syringe 29g x 1/2" 0.5 ml, 29g x 1/2" 1
ml, 30g x 5/16" 0.5 ml, 30g x 5/16" 1 ml
T1
QL (200 EA per 30 days)
ra pen needles 31g x 5 mm , 31g x 8 mm
T1
QL (200 EA per 30 days)
63
Drug
Status
Notes
RELI-ON INSULIN SYRINGE 29G 0.3 ML,
29G 0.5 ML, 29G X 1/2" 1 ML
T1
QL (200 EA per 30 days)
RELION INSULIN SYRINGE 29G X 1/2" 0.3
ML, 29G X 1/2" 0.5 ML, 29G X 1/2" 1 ML,
30G X 5/16" 0.3 ML, 30G X 5/16" 0.5 ML, 30G
X 5/16" 1 ML
T1
QL (200 EA per 30 days)
RELION INSULIN SYRINGE 31G X 5/16"
0.3 ML, 31G X 5/16" 0.5 ML, 31G X 5/16" 1
ML
T1
RELION MINI PEN NEEDLES 31G X 6 MM
T1
QL (200 EA per 30 days)
RELION PEN NEEDLES 29G X 12MM , 31G
X 8 MM , 32G X 4 MM
T1
QL (200 EA per 30 days)
RELION SHORT PEN NEEDLES 31G X 8
MM
T1
QL (200 EA per 30 days)
SAFELET IV CATHETER
T1
QL (200 EA per 30 days)
SAFESNAP INSULIN SYRINGE 28G X 1/2"
1 ML, 29G X 1/2" 0.5 ML, 29G X 1/2" 1 ML,
30G X 5/16" 0.3 ML, 30G X 5/16" 0.5 ML
T1
QL (200 EA per 30 days)
SAFETY-GLIDE SYRINGE 29G X 1/2" 0.3
ML
T1
QL (200 EA per 30 days)
sb insulin syringe 29g x 1/2" 0.5 ml, 29g x 1/2" 1
ml, 30g x 5/16" 0.5 ml, 30g x 5/16" 1 ml, 31g x
5/16" 1 ml
T1
QL (200 EA per 30 days)
scalp vein set
T1
QL (200 EA per 30 days)
schnucks insulin syringe 29g x 1/2" 0.5 ml, 30g x
5/16" 0.5 ml
T1
QL (200 EA per 30 days)
SHOPKO UNIFINE PENTIPS 29G X 12MM ,
31G X 5 MM , 31G X 8 MM , 32G X 4 MM
T1
QL (200 EA per 30 days)
sm insulin syringe 31g x 5/16" 1 ml
T1
QL (200 EA per 30 days)
solution administration set
T1
QL (200 EA per 30 days)
solution transfer device
T1
QL (200 EA per 30 days)
sure comfort insulin syringe 28g x 1/2" 0.5 ml,
28g x 1/2" 1 ml, 29g x 1/2" 0.3 ml, 29g x 1/2" 0.5
ml, 29g x 1/2" 1 ml, 30g x 1/2" 0.3 ml, 30g x 1/2"
0.5 ml, 30g x 1/2" 1 ml, 30g x 5/16" 0.5 ml, 30g x
5/16" 1 ml, 31g x 5/16" 0.3 ml, 31g x 5/16" 0.5
ml, 31g x 5/16" 1 ml
T1
QL (200 EA per 30 days)
sure comfort pen needles 30g x 8 mm , 31g x 5
mm , 31g x 8 mm , 32g x 4 mm
T1
QL (200 EA per 30 days)
SURE-FINE PEN NEEDLES 29G X 12.7MM ,
31G X 5 MM , 31G X 8 MM
T1
QL (200 EA per 30 days)
64
Drug
Status
Notes
SURE-JECT INSULIN SYRINGE 28G X 1/2"
0.5 ML, 28G X 1/2" 1 ML, 29G X 1/2" 0.3 ML,
29G X 1/2" 0.5 ML, 29G X 1/2" 1 ML, 30G X
5/16" 0.3 ML, 30G X 5/16" 0.5 ML, 30G X
5/16" 1 ML, 31G X 5/16" 0.3 ML, 31G X 5/16"
0.5 ML, 31G X 5/16" 1 ML
T1
QL (200 EA per 30 days)
SURE-T INFUSION SET 18"
T1
QL (200 EA per 30 days)
SURE-T INFUSION SET 23"
T1
QL (200 EA per 30 days)
SURE-T INFUSION SET 32"
T1
QL (200 EA per 30 days)
surgical dressing pad 5"x9"
T1
syringe luer slip 25g x 5/8" 1 ml, 26g x 3/8" 1 ml
T1
QL (200 EA per 30 days)
TERUMO INSULIN SYRINGE 27G X 1/2"
0.5 ML, 27G X 1/2" 1 ML, 28G X 1/2" 0.5 ML,
28G X 1/2" 1 ML, 29G X 1/2" 0.3 ML, 29G X
1/2" 0.5 ML, 29G X 1/2" 1 ML, 30G X 3/8" 0.5
ML, 30G X 3/8" 1 ML
T1
QL (200 EA per 30 days)
TERUMO SURGUARD INSULIN SYR 28G X
1/2" 0.5 ML, 28G X 1/2" 1 ML, 29G X 1/2" 0.3
ML, 29G X 1/2" 0.5 ML, 29G X 1/2" 1 ML
T1
QL (200 EA per 30 days)
TERUMO SURGUARD2 SYRINGE 25G X
5/8" 1 ML, 26G X 3/8" 1 ML
T1
QL (200 EA per 30 days)
THINPRO INSULIN SYRINGE 28G X 1/2"
0.5 ML, 28G X 1/2" 1 ML, 29G X 1/2" 0.3 ML,
29G X 1/2" 0.5 ML, 29G X 1/2" 1 ML, 30G X
3/8" 0.5 ML, 30G X 3/8" 1 ML, 31G X 3/8" 0.3
ML, 31G X 3/8" 0.5 ML, 31G X 3/8" 1 ML
T1
QL (200 EA per 30 days)
todays health mini pen needles 31g x 6 mm
T1
QL (200 EA per 30 days)
todays health pen needles 29g x 12mm
T1
QL (200 EA per 30 days)
todays health short pen needle 31g x 8 mm
T1
QL (200 EA per 30 days)
topcare clickfine pen needles 31g x 6 mm , 31g x
8 mm
T1
QL (200 EA per 30 days)
topcare ultra comfort ins syr 29g x 1/2" 0.3 ml,
29g x 1/2" 0.5 ml, 29g x 1/2" 1 ml, 30g x 5/16"
0.3 ml, 30g x 5/16" 0.5 ml, 30g x 5/16" 1 ml, 31g
x 5/16" 0.3 ml, 31g x 5/16" 0.5 ml, 31g x 5/16" 1
ml
T1
QL (200 EA per 30 days)
TRUEPLUS INSULIN SYRINGE 28G X 1/2"
0.5 ML, 28G X 1/2" 1 ML, 29G X 1/2" 0.3 ML,
29G X 1/2" 0.5 ML, 29G X 1/2" 1 ML, 30G X
5/16" 0.3 ML, 30G X 5/16" 0.5 ML, 30G X
5/16" 1 ML, 31G X 5/16" 0.3 ML, 31G X 5/16"
0.5 ML, 31G X 5/16" 1 ML
T1
QL (200 EA per 30 days)
ULTICARE INSULIN SAFETY SYR 29G X
1/2" 0.5 ML, 29G X 1/2" 1 ML
T1
QL (200 EA per 30 days)
65
Drug
Status
Notes
ULTICARE INSULIN SYRINGE 28G X 1/2"
0.5 ML, 28G X 1/2" 1 ML, 29G X 1/2" 0.3 ML,
29G X 1/2" 0.5 ML, 29G X 1/2" 1 ML, 30G X
1/2" 0.3 ML, 30G X 1/2" 0.5 ML, 30G X 1/2" 1
ML, 30G X 5/16" 0.3 ML, 30G X 5/16" 0.5
ML, 30G X 5/16" 1 ML, 31G X 5/16" 0.3 ML,
31G X 5/16" 0.5 ML, 31G X 5/16" 1 ML
T1
QL (200 EA per 30 days)
ULTICARE MICRO PEN NEEDLES 32G X 4
MM
T1
QL (200 EA per 30 days)
ULTICARE MINI PEN NEEDLES 31G X 6
MM
T1
QL (200 EA per 30 days)
ULTICARE PEN NEEDLES 29G X 12.7MM ,
29G X 12MM
T1
QL (200 EA per 30 days)
ULTICARE SHORT PEN NEEDLES 31G X 8
MM
T1
QL (200 EA per 30 days)
ULTICARE SYRINGE 22G X 1-1/2" 1 ML
T1
QL (200 EA per 30 days)
ULTILET INSULIN SYRINGE SHORT 30G
X 5/16" 0.3 ML, 30G X 5/16" 1 ML
T1
ULTILET INSULIN SYRINGE SHORT 30G
X 5/16" 0.5 ML, 31G X 5/16" 0.3 ML, 31G X
5/16" 0.5 ML, 31G X 5/16" 1 ML
T1
QL (200 EA per 30 days)
ULTILET PEN NEEDLE 31G X 8 MM
T1
QL (200 EA per 30 days)
ultra comfort insulin syringe 30g x 5/16" 0.3 ml
T1
QL (200 EA per 30 days)
ultra-comfort insulin syringe 28g x 1/2" 0.5 ml,
28g x 1/2" 1 ml, 29g x 1/2" 0.3 ml, 29g x 1/2" 0.5
ml, 29g x 1/2" 1 ml, 30g x 5/16" 0.3 ml, 30g x
5/16" 0.5 ml, 30g x 5/16" 1 ml, 31g x 5/16" 0.3
ml, 31g x 5/16" 0.5 ml, 31g x 5/16" 1 ml
T1
QL (200 EA per 30 days)
ULTRA-THIN II INS SYR SHORT 31G X
5/16" 1 ML
T1
QL (200 EA per 30 days)
UNIFINE PENTIPS 29G X 12MM , 31G X 5
MM , 31G X 6 MM , 31G X 8 MM , 32G X 4
MM
T1
QL (200 EA per 30 days)
unifine pentips plus 29g x 12mm , 31g x 5 mm ,
31g x 6 mm , 31g x 8 mm , 32g x 4 mm
T1
QL (200 EA per 30 days)
VACUTAINER TUBING
T1
QL (200 EA per 30 days)
value health insulin syringe 29g x 1/2" 0.5 ml,
29g x 1/2" 1 ml
T1
QL (200 EA per 30 days)
valumark pen needles 29g x 12mm , 31g x 6 mm ,
31g x 8 mm
T1
QL (200 EA per 30 days)
VANISHPOINT 18GX1-1/4" FEP
T1
QL (200 EA per 30 days)
VANISHPOINT 18GX1-1/4" PUR
T1
QL (200 EA per 30 days)
VANISHPOINT 20GX1-1/4" FEP
T1
QL (200 EA per 30 days)
VANISHPOINT 20GX1-1/4" PUR
T1
QL (200 EA per 30 days)
66
Drug
Status
Notes
VANISHPOINT 22GX1" FEP
T1
QL (200 EA per 30 days)
VANISHPOINT 22GX1" PUR
T1
QL (200 EA per 30 days)
VANISHPOINT 24GX3/4" FEP
T1
QL (200 EA per 30 days)
VANISHPOINT 24GX3/4" PUR
T1
QL (200 EA per 30 days)
VANISHPOINT INSULIN SYRINGE 29G X
1/2" 1 ML, 30G X 1/2" 0.5 ML
T1
QL (200 EA per 30 days)
VANISHPOINT SYRINGE 25G X 1" 1 ML
T1
QL (200 EA per 30 days)
VIDA MIA UNIFINE PENTIPS 29G X 12MM
, 31G X 6 MM , 31G X 8 MM , 32G X 4 MM
T1
QL (200 EA per 30 days)
vp insulin syringe 29g x 1/2" 0.3 ml
T1
QL (200 EA per 30 days)
V-R MONO INSULIN SYRINGE 28G X 1/2"
0.5 ML, 28G X 1/2" 1 ML, 29G X 1/2" 0.3 ML,
29G X 1/2" 0.5 ML, 29G X 1/2" 1 ML
T1
QL (200 EA per 30 days)
warm mist vaporizer
T1
wegmans unifine pentips plus 31g x 5 mm , 31g x
6 mm , 31g x 8 mm , 32g x 4 mm
T1
QL (200 EA per 30 days)
WIDE-SEAL DIAPHRAGM 60 VAGINAL
DIAPHRAGM 2 %
T1
GR-F; QL (1 EA per 365 days)
WIDE-SEAL DIAPHRAGM 65 VAGINAL
DIAPHRAGM 2 %
T1
GR-F; QL (1 EA per 365 days)
WIDE-SEAL DIAPHRAGM 70 VAGINAL
DIAPHRAGM 2 %
T1
GR-F; QL (1 EA per 365 days)
WIDE-SEAL DIAPHRAGM 75 VAGINAL
DIAPHRAGM 2 %
T1
GR-F; QL (1 EA per 365 days)
WIDE-SEAL DIAPHRAGM 80 VAGINAL
DIAPHRAGM 2 %
T1
GR-F; QL (1 EA per 365 days)
WIDE-SEAL DIAPHRAGM 85 VAGINAL
DIAPHRAGM 2 %
T1
GR-F; QL (1 EA per 365 days)
WIDE-SEAL DIAPHRAGM 90 VAGINAL
DIAPHRAGM 2 %
T1
GR-F; QL (1 EA per 365 days)
WIDE-SEAL DIAPHRAGM 95 VAGINAL
DIAPHRAGM 2 %
T1
GR-F; QL (1 EA per 365 days)
naratriptan hcl oral tablet 1 mg, 2.5 mg
T1
ST; QL (9 EA per 30 days)
rizatriptan benzoate oral tablet 10 mg, 5 mg
T1
QL (9 EA per 30 days)
rizatriptan benzoate oral tablet dispersible 10 mg,
5 mg
T1
QL (9 EA per 30 days)
sumatriptan succinate oral tablet 100 mg, 25 mg,
50 mg
T1
*Migraine Products*
*Minerals & Electrolytes*
cal/mag oral tablet 200-100 mg
T1
67
Drug
Status
CALCET CREAMY BITES ORAL TABLET
CHEWABLE 500-400 MG-UNIT
T1
calcium + d3 oral tablet 600-200 mg-unit
T1
calcium 500 + d oral tablet 500-125 mg-unit
T1
calcium 500/d oral tablet 500-200 mg-unit
T1
calcium 500+d high potency oral tablet 500-400
mg-unit
T1
calcium 500+d oral tablet 500-200 mg-unit,
500-400 mg-unit
T1
calcium 600+d oral tablet 600-200 mg-unit,
600-400 mg-unit
T1
calcium 600+d3 oral tablet 600-400 mg-unit,
600-800 mg-unit
T1
calcium carbonate oral suspension 1250 (500 ca)
mg/5ml
T1
calcium carbonate oral tablet 1250 (500 ca) mg
T1
calcium carbonate-vitamin d oral capsule
600-200 mg-unit
T1
calcium citrate + d oral tablet 315-200 mg-unit
T1
calcium citrate + d3 oral tablet 250-200 mg-unit
T1
calcium citrate malate-vit d oral tablet 250-100
mg-unit
T1
calcium citrate oral granules 760 mg/3.5gm
T1
calcium citrate oral tablet 200 mg, 950 mg
T1
calcium citrate-vitamin d oral tablet 250-50
mg-unit
T1
calcium citrate-vitamin d3 oral liquid† 1000-400
T1
calcium oral tablet chewable 500-100 mg-unit,
600-400 mg-unit
T1
calcium plus vitamin d oral capsule 300-100
mg-unit
T1
calcium/vitamin d3 gummies oral tablet chewable
200-200 mg-unit
T1
calcium-carb 600 + d oral tablet 600-125 mg-unit
T1
calcium-magnesium oral tablet 250-125 mg,
750-465 mg
T1
calcium-vitamin d oral tablet 500-125 mg-unit,
600-200 mg-unit
T1
calcium-vitamin d3 oral capsule 600-400 mg-unit
T1
CAL-MAG CHELA-MAX ORAL CAPSULE
70-83 MG
T1
68
Notes
Drug
Status
CAL-QUICK ORAL LIQUID† 500-400
MG-UNT/5ML
T1
chelated magnesium oral tablet 100 mg
T1
cvs oyster shell calcium+vit d oral tablet 500-125
mg-unit
T1
effervescent pot chloride oral tablet effervescent
25 meq
T1
eql calcium/vitamin d oral capsule 600-100
mg-unit
T1
eql vitamin d-3 high potency oral tablet 115-2000
mg-unit
T1
gnp calcium 500 +d3 oral tablet 500-600 mg-unit
T1
K-PHOS ORAL TABLET 500 MG
T1
mag-delay oral tablet extendedrelease* 535 (64
mg) mg
T1
MAGINEX DS ORAL PACKET 1230 MG
T1
MAGINEX ORAL TABLET DELAYED
RELEASE 615 MG
T1
magnesium carbonate powder
T1
magnesium chloride crystals
T1
magnesium chloride powder
T1
magnesium citrate oral tablet 100 mg
T1
magnesium gluconate oral tablet 30 mg, 500 (27
mg) mg, 550 mg
T1
magnesium oral capsule 300 mg
T1
magnesium oral tablet 200 mg, 250 mg, 30 mg,
400 mg
T1
magnesium oxide -mg supplement oral tablet 250
mg
T1
magnesium oxide oral powder
T1
magnesium oxide oral tablet 400 (240 mg) mg,
400 (241.3 mg) mg
T1
magnesium sulfate injection solution 50 %
T1
magnesium sulfate intravenous* solution 2
gm/50ml, 20 gm/500ml, 4 gm/100ml, 4 gm/50ml,
40 gm/1000ml
T1
MAGONATE ORAL LIQUID† 1000 (54 MG)
MG/5ML
T1
MAG-TAB SR ORAL TABLET
EXTENDEDRELEASE* 84 MG (7MEQ)
T1
ORAZINC ORAL TABLET 110 MG
T1
Notes
69
Drug
Status
Notes
OSTEO-PORETICAL ORAL TABLET
600-1000 MG-UNIT
T1
oyster shell calcium/d oral tablet 250-125
mg-unit, 250-250 mg-unit
T1
parva-cal oral tablet 250-100 mg-unit, 500-200
mg-unit
T1
PEDIALYTE ORAL SOLUTION
T1
PHOSPHA 250 NEUTRAL ORAL TABLET
155-852-130 MG
T1
potassium bicarbonate oral tablet effervescent 25
meq
T1
potassium chloride crys er oral tablet
extendedrelease* 10 meq, 20 meq
T1
potassium chloride er oral capsule extended
release* 10 meq, 8 meq
T1
potassium chloride er oral tablet
extendedrelease* 10 meq, 8 meq
T1
potassium chloride oral packet 20 meq
T1
potassium chloride oral solution 20 meq/15ml
(10%)
T1
ra calcium-boron oral tablet 500-1.5 mg
T1
sodium chloride flush intravenous* solution 0.9
%
T1
sodium chloride injection solution 0.9 %
T1
sodium chloride intravenous* solution 0.9 %
T1
sodium chloride oral tablet 1 gm
T1
sodium fluoride oral solution 1.1 (0.5 f) mg/ml
T1
QL (30 ML per 30 days); AL (Max
10 Years)
sodium fluoride oral tablet chewable 1.1 (0.5 f)
mg, 2.2 (1 f) mg
T1
QL (30 EA per 30 days); AL (Max
10 Years)
UPCAL D ORAL PACKET 500-500
MG-UNIT
T1
UPCAL D ORAL POWDER 500-500
MG-UNT/5GM
T1
VITALINE BUFFERED ZINC-220 ORAL
TABLET EXTENDEDRELEASE* 220 (50
ZN) MG
T1
ZINC 15 ORAL TABLET 66 MG
T1
zinc sulfate granules
T1
zinc sulfate intravenous* solution 1 mg/ml, 5
mg/ml
T1
70
Drug
*Mouth/Throat/Dental Agents*
Status
BENZ-O-STHETIC MOUTH/THROAT
SOLUTION 20 %
T1
BENZ-O-STHETIC MOUTH/THROAT
SWAB 20 %
T1
chlorhexidine gluconate mouth/throat solution
0.12 %
T1
clotrimazole mouth/throat lozenge 10 mg
T1
GEL-TIN DENTAL GEL 0.4 %
T1
lidocaine hcl mouth/throat solution 4 %
T1
lidocaine viscous mouth/throat solution 2 %
T1
nystatin mouth/throat suspension 100000 unit/ml
T1
ORA-FILM MOUTH/THROAT STRIP 6 %
T1
oral analgesic max st mouth/throat gel 20 %
T1
oral analgesic max st mouth/throat liquid† 20 %
T1
oral anesthetic mouth/throat paste 20 %
T1
PERIOMED MOUTH/THROAT
CONCENTRATE 0.63 %
T1
pilocarpine hcl oral tablet 5 mg
T1
ra baby care oral pain relief mouth/throat gel 7.5
%
T1
sf 5000 plus dental cream 1.1 %
T1
triamcinolone acetonide mouth/throat paste 0.1 %
T1
Notes
*Multivitamins*
adult gummy oral tablet chewable
T1
ATABEX EC ORAL TABLET DELAYED
RELEASE 29-1 MG
T1
GR-F
ATABEX ORAL TABLET CHEWABLE
18-0.8 MG
T1
GR-F
b-complex balanced oral tablet
T1
b-complex/vitamin c oral tablet
T1
biovol oral syrup
T1
BRAINSTRONG PRENATAL ORAL 33-0.8
& 350 MG
T1
GR-F
CENTRUM SPECIALIST PRENATAL
ORAL 27-0.8 & 200 MG
T1
GR-F
T1
AL (Max 9 Years)
childrens gummies oral tablet chewable
T1
AL (Max 9 Years)
childrens multivitamin oral tablet chewable 60
mg
T1
AL (Max 9 Years)
child chewable vitamins/iron oral tablet chewable
71
Drug
Status
Notes
CLINICAL NUTRIENTS PRENATAL ORAL
TABLET 7.5-0.2 MG
T1
GR-F
COMPLETE FORMULATION PEDIATRIC
ORAL SOLUTION 45 MG/0.5ML
T1
AL (Max 9 Years)
complete natal dha oral 29-1-200 & 250 mg
T1
GR-F
complete prenatal/dha oral 30-0.975 & 300 mg
T1
GR-F
cvs prenatal gummy oral tablet chewable
0.4-113.5 mg
T1
GR-F
daily multiple vitamins/min oral tablet
T1
DAILY PAK MAXIMUM MULTIVITAMIN
ORAL
T1
daily vitamin plus oral capsule
T1
daily-vitamin oral tablet
T1
DIALYVITE SUPREME D ORAL TABLET 3
MG
T1
ELDERTONIC ORAL ELIXIR
T1
eql gummies childrens oral tablet chewable 30
mg
T1
AL (Max 9 Years)
FOLGARD OS ORAL TABLET 500-1.1 MG
T1
GR-F; QL (30 EA per 30 days);
AL (Min 14 Years and Max 50
Years)
HEALTHY MAMA BE WELL ROUNDED
ORAL 28-0.8 & 450 MG
T1
GR-F
HONEY BEARS W/IRON-ZINC ORAL
TABLET CHEWABLE 30-200-3
T1
AL (Max 9 Years)
kpn prenatal oral tablet 0.1 mg
T1
GR-F
MEGA MULTIVITAMIN ORAL POWDER
T1
multi-delyn oral liquid†
T1
multivitamins oral tablet chewable
T1
multivitamins pediatric oral solution
T1
AL (Max 9 Years)
MYNATAL ORAL CAPSULE
T1
GR-F
mynatal plus oral tablet
T1
GR-F
mynate 90 plus oral tablet extendedrelease*
T1
GR-F
NANOVM T/F ORAL LIQUID†
T1
AL (Max 9 Years)
NATALVIT ORAL TABLET
T1
GR-F
OBSTETRIX DHA ORAL 29-1 & 387 MG
T1
GR-F
OBSTETRIX EC ORAL TABLET 29-1 MG
T1
GR-F
O-CAL PRENATAL ORAL TABLET
T1
GR-F
ONE-A-DAY WOMENS PRENATAL ORAL
28-0.8 & 223 MG
T1
GR-F
pa prenatal formula oral tablet 9-0.5 mg
T1
GR-F
72
AL (Max 9 Years)
Drug
Status
Notes
PERRY PRENATAL ORAL CAPSULE
13.5-0.4 MG
T1
GR-F
poly vitamin oral tablet chewable
T1
AL (Max 9 Years)
polyvitamin oral solution 35 mg/ml
T1
AL (Max 9 Years)
polyvitamin/iron oral solution 10 mg/ml
T1
AL (Max 9 Years)
PR NATAL 400 ORAL 29-1-200 & 400 MG
T1
GR-F
PR NATAL 430 ORAL 29-1-200 & 430 MG
T1
GR-F
PRENATA ORAL TABLET CHEWABLE
29-1 MG
T1
GR-F
prenatabs fa oral tablet
T1
GR-F
prenatal 19 oral tablet 29-1 mg
T1
GR-F
prenatal 19 oral tablet chewable 29-1 mg
T1
GR-F
prenatal complete oral tablet 14-0.4 mg
T1
GR-F
prenatal formula a-free oral tablet 9-0.267 mg
T1
GR-F
prenatal formula oral capsule 28-0.8-235 mg
T1
GR-F
prenatal multi +dha oral capsule 27-0.8-228 mg
T1
GR-F
PRENATAL MULTIVITAMIN + DHA ORAL
28-0.8 & 200 MG
T1
GR-F
prenatal oral tablet 27-0.8 mg, 28-0.8 mg,
6.75-0.2 mg
T1
GR-F
prenatal plus iron oral tablet 29-1 mg
T1
GR-F
prenatal plus oral tablet 27-1 mg
T1
GR-F
prenatal vitamins oral tablet 0.8 mg
T1
GR-F
prenatal/omega-3/fa/iron oral capsule 28-0.8-530
mg
T1
GR-F
prenatal+dha oral 28-0.975 & 200 mg
T1
GR-F
PRENATAL-U ORAL CAPSULE 106.5-1 MG
T1
GR-F
profe forte oral capsule 155-1 mg
T1
GR-F
purefe ob plus oral capsule 162-115.2-1 mg
T1
GR-F
T1
AL (Max 9 Years)
ra one daily oral 28-0.8 & 440 mg
T1
GR-F
RENAL ORAL CAPSULE 1 MG
T1
stress formula/iron oral tablet
T1
stress formula/zinc oral tablet
T1
STUART ONE ORAL CAPSULE 27-0.8-200
MG
T1
super b complex/vitamin c oral tablet
T1
SUPERVITE EC ORAL TABLET DELAYED
RELEASE 1 MG
T1
qc childrens vitamins/extra c oral tablet chewable
GR-F
73
Drug
Status
Notes
SYNATEK ORAL CAPSULE 1.25 MG
T1
TARON-BC ORAL 20-1 & 25 (2) MG
T1
GR-F
THERANATAL COMPLETE ORAL 27-1 &
300 MG
T1
GR-F
therapeutic liquid oral solution
T1
trinatal rx 1 oral tablet 60-1 mg
T1
GR-F
tri-vit/fluoride oral solution 0.25 mg/ml
T1
AL (Max 9 Years)
tri-vitamin/fluoride oral solution 0.5 mg/ml
T1
AL (Max 9 Years)
ultra-mega oral tablet extendedrelease*
T1
VINATE II ORAL TABLET 29-1 MG
T1
GR-F
VINATE M ORAL TABLET 27-1 MG
T1
GR-F
virt-vite gt oral tablet 90-1 mg
T1
GR-F
vitamin c-electrolytes oral packet
T1
*Musculoskeletal Therapy Agents*
baclofen oral tablet 10 mg, 20 mg
T1
chlorzoxazone oral tablet 500 mg
T1
cyclobenzaprine hcl oral tablet 10 mg, 5 mg
T1
methocarbamol oral tablet 500 mg, 750 mg
T1
tizanidine hcl oral tablet 2 mg, 4 mg
T1
QL (90 EA per 30 days)
*Nasal Agents - Systemic And Topical*
anefrin spray nasal solution 0.05 %
T1
childrens silfedrine oral liquid† 15 mg/5ml
T1
cromolyn sodium nasal aerosol, solution 5.2
mg/act
T1
flunisolide nasal solution 25 mcg/act (0.025%)
T1
QL (50 ML per 30 days)
fluticasone propionate nasal suspension 50
mcg/act
T1
QL (16 GM per 30 days)
ipratropium bromide nasal solution 0.03 %
T1
QL (30 ML per 30 days)
ipratropium bromide nasal solution 0.06 %
T1
QL (15 ML per 30 days)
NASACORT ALLERGY 24HR NASAL
AEROSOL† 55 MCG/ACT
T1
nasal decongestant oral liquid† 30 mg/5ml
T1
nasal decongestant oral syrup 30 mg/5ml
T1
NEXAFED ORAL 30 MG
T1
pseudoephedrine hcl er oral tablet extended
release 12 hr* 120 mg
T1
pseudoephedrine hcl oral tablet 30 mg, 60 mg
T1
RHINOCORT ALLERGY NASAL
SUSPENSION 32 MCG/ACT
T1
74
Drug
saline nasal spray nasal solution 0.65 %
Status
T1
Notes
QL (90 ML per 30 days)
*Ophthalmic Agents*
advanced lubricant ophthalmic solution 0.05-1 %
T1
artificial tears ophthalmic ointment 83-15 %
T1
artificial tears ophthalmic solution 0.1-0.3 %,
0.2-0.2-1 %, 0.4 %, 1-0.3 %, 5-6 mg/ml
T1
atropine sulfate ophthalmic ointment 1 %
T1
atropine sulfate ophthalmic solution 1 %
T1
azelastine hcl ophthalmic solution 0.05 %
T1
bacitracin ophthalmic ointment 500 unit/gm
T1
bacitracin-polymyxin b ophthalmic ointment
500-10000 unit/gm
T1
bacitra-neomycin-polymyxin-hc ophthalmic
ointment 1 %
T1
betaxolol hcl ophthalmic solution 0.5 %
T1
bimatoprost ophthalmic solution 0.03 %
T1
BLEPHAMIDE S.O.P. OPHTHALMIC
OINTMENT 10-0.2 %
T1
BLINK TEARS OPHTHALMIC GEL 0.25 %
T1
BLINK TEARS OPHTHALMIC SOLUTION
0.25 %
T1
brimonidine tartrate ophthalmic solution 0.2 %
T1
carteolol hcl ophthalmic solution 1 %
T1
ciprofloxacin hcl ophthalmic solution 0.3 %
T1
cromolyn sodium ophthalmic solution 4 %
T1
cvs lubricant drops ophthalmic gel 0.25-0.3 %, 1
%
T1
cyclopentolate hcl ophthalmic solution 1 %
T1
dexamethasone sodium phosphate ophthalmic
solution 0.1 %
T1
diclofenac sodium ophthalmic solution 0.1 %
T1
dorzolamide hcl ophthalmic solution 2 %
T1
dorzolamide hcl-timolol mal ophthalmic solution
22.3-6.8 mg/ml
T1
epinastine hcl ophthalmic solution 0.05 %
T1
EQ GENTLE LUBRICANT OPHTHALMIC
SOLUTION 0.3 %
T1
eq lubricating eye drops ophthalmic solution
0.5-0.9 %
T1
erythromycin ophthalmic ointment 5 mg/gm
T1
ST; QL (5 ML per 30 days)
75
Drug
Status
Notes
eye allergy relief ophthalmic solution 0.025-0.3
%, 0.027-0.315 %
T1
eye drops allergy relief ophthalmic solution
0.05-0.25 %
T1
eye drops ophthalmic solution 0.012-0.2 %
T1
eye lubricant ophthalmic ointment
T1
FLAREX OPHTHALMIC SUSPENSION 0.1
%
T1
fluorometholone ophthalmic suspension 0.1 %
T1
flurbiprofen sodium ophthalmic solution 0.03 %
T1
FML OPHTHALMIC OINTMENT 0.1 %
T1
gentamicin sulfate ophthalmic ointment 0.3 %
T1
gentamicin sulfate ophthalmic solution 0.3 %
T1
GONIOTAIRE OPHTHALMIC SOLUTION
2.5 %
T1
homatropine hbr ophthalmic solution 5 %
T1
ISOPTO TEARS OPHTHALMIC
SOLUTION 0.5 %
T1
ketorolac tromethamine ophthalmic solution 0.4
%
T1
ketorolac tromethamine ophthalmic solution 0.5
%
T1
QL (5 ML per 18 days)
ketotifen fumarate ophthalmic solution 0.025 %
T1
QL (5 ML per 30 days)
latanoprost ophthalmic solution 0.005 %
T1
QL (5 ML per 30 days)
levobunolol hcl ophthalmic solution 0.5 %
T1
QL (5 ML per 18 days)
lubricant eye drops ophthalmic solution 0.4-0.3
%, 0.5 %, 0.6 %
T1
metipranolol ophthalmic solution 0.3 %
T1
multi-purpose solution solution
T1
naphazoline hcl ophthalmic solution 0.1 %
T1
neomycin-bacitracin zn-polymyx ophthalmic
ointment 5-400-10000
T1
neomycin-polymyxin-dexameth ophthalmic
ointment 3.5-10000-0.1
T1
neomycin-polymyxin-dexameth ophthalmic
suspension 3.5-10000-0.1
T1
neomycin-polymyxin-gramicidin ophthalmic
solution 1.75-10000-.025
T1
neomycin-polymyxin-hc ophthalmic suspension
3.5-10000-1
T1
NEO-POLYCIN HC OPHTHALMIC
OINTMENT 1 %
T1
76
Drug
Status
Notes
ofloxacin ophthalmic solution 0.3 %
T1
polymyxin b-trimethoprim ophthalmic solution
10000-0.1 unit/ml-%
T1
prednisolone acetate ophthalmic suspension 1 %
T1
prednisolone sodium phosphate ophthalmic
solution 1 %
T1
proparacaine hcl ophthalmic solution 0.5 %
T1
ra sterile eye drops ophthalmic solution 0.03-0.5
%
T1
redness relief max strength ophthalmic solution
0.03-0.5 %
T1
REDNESS RELIEF OPHTHALMIC
SOLUTION 0.012-0.25 %
T1
redness reliever eye drops ophthalmic solution
0.05 %
T1
REFRESH OPTIVE ADVANCED
OPHTHALMIC SOLUTION 0.5-1-0.5 %
T1
RETAINE MGD OPHTHALMIC
EMULSION 0.5-0.5 %
T1
sm redness relief ophthalmic solution 0.012-0.2 %
T1
sodium chloride (hypertonic) ophthalmic ointment
5%
T1
sodium chloride (hypertonic) ophthalmic solution
5%
T1
STERILE LUBRICANT OPHTHALMIC
LIQUID† 0.7 %
T1
sulfacetamide sodium ophthalmic solution 10 %
T1
sulfacetamide-prednisolone ophthalmic solution
10-0.23 %
T1
SYSTANE OVERNIGHT THERAPY
OPHTHALMIC GEL 0.3 %
T1
timolol maleate ophthalmic solution 0.25 %, 0.5
%
T1
tobramycin ophthalmic solution 0.3 %
T1
tobramycin-dexamethasone ophthalmic
suspension 0.3-0.1 %
T1
QL (5 ML per 10 days)
travoprost ophthalmic solution 0.004 %
T1
ST; QL (5 ML per 30 days)
trifluridine ophthalmic solution 1 %
T1
tropicamide ophthalmic solution 0.5 %, 1 %
T1
*Otic Agents*
acetic acid otic solution 2 %
T1
acetic acid-aluminum acetate otic solution 2 %
T1
77
Drug
Status
antipyrine-benzocaine otic solution 5.4-1.4 %
T1
ciprofloxacin hcl otic solution 0.2 %
T1
ear drops otic solution 6.5 %
T1
ear wax cleansing otic kit 6.5 %
T1
hydrocortisone-acetic acid otic solution 1-2 %
T1
neomycin-polymyxin-hc otic solution 1 %
T1
neomycin-polymyxin-hc otic suspension
3.5-10000-1
T1
ofloxacin otic solution 0.3 %
T1
Notes
*Oxytocics*
methylergonovine maleate oral tablet 0.2 mg
T1
QL (28 EA per 365 days)
*Passive Immunizing Agents*
RHOGAM ULTRA-FILTERED PLUS
INTRAMUSCULAR* 1500 UNIT
T1
SYNAGIS INTRAMUSCULAR* SOLUTION
100 MG/ML, 50 MG/0.5ML
T1
PA
*Penicillins*
amoxicillin oral capsule 250 mg, 500 mg
T1
amoxicillin oral suspension reconstituted 125
mg/5ml, 200 mg/5ml, 250 mg/5ml, 400 mg/5ml
T1
amoxicillin oral tablet 875 mg
T1
amoxicillin oral tablet chewable 125 mg, 250 mg
T1
amoxicillin-pot clavulanate oral suspension
reconstituted 200-28.5 mg/5ml, 400-57 mg/5ml,
600-42.9 mg/5ml
T1
amoxicillin-pot clavulanate oral tablet 250-125
mg
T1
QL (42 EA per 14 days)
amoxicillin-pot clavulanate oral tablet 500-125
mg, 875-125 mg
T1
QL (28 EA per 14 days)
amoxicillin-pot clavulanate oral tablet chewable
200-28.5 mg, 400-57 mg
T1
AL (Max 11 Years)
ampicillin oral capsule 250 mg, 500 mg
T1
ampicillin oral suspension reconstituted 125
mg/5ml, 250 mg/5ml
T1
BICILLIN C-R 900/300 INTRAMUSCULAR*
SUSPENSION 900000-300000 UNIT/2ML
T1
QL (4 ML per 28 days)
BICILLIN C-R INTRAMUSCULAR*
SUSPENSION 1200000 UNIT/2ML
T1
QL (4 ML per 28 days)
dicloxacillin sodium oral capsule 250 mg, 500 mg
T1
penicillin v potassium oral solution reconstituted
125 mg/5ml, 250 mg/5ml
T1
78
Drug
penicillin v potassium oral tablet 250 mg, 500 mg
Status
Notes
T1
*Pharmaceutical Adjuvants*
benzyl alcohol liquid†
T1
cherry concentrate oral syrup
T1
cherry oral syrup
T1
FLAVOR BLEND ORAL SUSPENSION
T1
flavor plus oral liquid†
T1
flavor sweet oral syrup
T1
flavor sweet-sf oral liquid†
T1
grape syrup oral syrup
T1
ORA-BLEND ORAL SUSPENSION
T1
ORA-BLEND SF ORAL SUSPENSION
T1
ORAL MIX ORAL LIQUID†
T1
ORAL MIX SF ORAL LIQUID†
T1
oral suspend oral liquid†
T1
oral syrup oral liquid†
T1
oral syrup sf oral liquid†
T1
ORA-PLUS ORAL LIQUID†
T1
ORA-SWEET ORAL SYRUP
T1
ORA-SWEET SF ORAL SYRUP
T1
PCCA SWEET-SF ORAL SYRUP
T1
PCCA SYRUP VEHICLE ORAL SYRUP
T1
PCCA-PLUS ORAL SUSPENSION
T1
polyethylene glycol 3350 powder
T1
SYRPALTA (RED) ORAL SYRUP
T1
syrpalta oral syrup
T1
SYRSPEND SF ORAL LIQUID†
T1
VERSAFREE ORAL SYRUP
T1
VERSAPLUS ORAL SYRUP
T1
*Potassium Removing Agents***
KIONEX ORAL POWDER
T1
sodium polystyrene sulfonate oral powder
T1
*Prenatal Mv & Minerals W/
Fa-Omega Fatty Acids W/O Iron***
cvs prenatal gummy oral tablet chewable
0.4-113.5 mg
T1
GR-F
79
Drug
*Progestins*
Status
Notes
medroxyprogesterone acetate oral tablet 10 mg,
2.5 mg, 5 mg
T1
GR-F; QL (30 EA per 30 days)
norethindrone acetate oral tablet 5 mg
T1
GR-F; QL (60 EA per 30 days)
AVONEX INTRAMUSCULAR* KIT 30 MCG
T1
PA
BETASERON SUBCUTANEOUS* KIT 0.3
MG
T1
PA
bupropion hcl er (smoking det) oral tablet
extended release 12 hr* 150 mg
T1
QL (180 EA per 365 days)
CHANTIX CONTINUING MONTH PAK
ORAL TABLET 1 MG
T1
QL (60 EA per 30 days)
CHANTIX ORAL TABLET 0.5 MG, 1 MG
T1
QL (60 EA per 30 days)
CHANTIX STARTING MONTH PAK ORAL
TABLET 0.5 MG X 11 & 1 MG X 42
T1
QL (60 EA per 30 days)
disulfiram oral tablet 250 mg, 500 mg
T1
donepezil hcl oral tablet 10 mg, 5 mg
T1
EXTAVIA SUBCUTANEOUS* KIT 0.3 MG
T1
galantamine hydrobromide oral tablet 12 mg, 4
mg, 8 mg
T1
GLATOPA SUBCUTANEOUS* 20 MG/ML
T1
PA
nicotine mini mouth/throat lozenge 2 mg
T1
QL (270 EA per 30 days)
nicotine polacrilex mouth/throat gum 2 mg, 4 mg
T1
QL (270 EA per 30 days)
nicotine polacrilex mouth/throat lozenge 4 mg
T1
QL (270 EA per 30 days)
nicotine transdermal kit 21-14-7 mg/24hr
T1
nicotine transdermal patch 24 hr 14 mg/24hr, 21
mg/24hr, 7 mg/24hr
T1
NICOTROL INHALATION INHALER 10
MG
T1
NICOTROL NS NASAL SOLUTION 10
MG/ML
T1
*Psychotherapeutic And Neurological
Agents - Misc.*
PA
*Respiratory Agents - Misc.*
PULMOZYME INHALATION SOLUTION 1
MG/ML
T1
*Serotonin Modulators***
trazodone hcl oral tablet 100 mg, 150 mg, 300
mg, 50 mg
T1
*Sulfonamides*
sulfadiazine oral tablet 500 mg
80
T1
PA
Drug
*Tetracyclines*
Status
doxycycline hyclate oral capsule 100 mg, 50 mg
T1
doxycycline hyclate oral tablet 100 mg
T1
doxycycline monohydrate oral suspension
reconstituted 25 mg/5ml
T1
minocycline hcl oral capsule 100 mg, 50 mg, 75
mg
T1
VIBRAMYCIN ORAL SYRUP 50 MG/5ML
T1
Notes
*Thyroid Agents*
ARMOUR THYROID ORAL TABLET 120
MG, 15 MG, 180 MG, 240 MG, 30 MG, 300
MG, 60 MG
T1
levothyroxine sodium oral tablet 100 mcg, 112
mcg, 125 mcg, 137 mcg, 150 mcg, 175 mcg, 200
mcg, 25 mcg, 300 mcg, 50 mcg, 75 mcg, 88 mcg
T1
LEVOXYL ORAL TABLET 100 MCG, 112
MCG, 125 MCG, 137 MCG, 150 MCG, 175
MCG, 200 MCG, 25 MCG, 50 MCG, 75 MCG,
88 MCG
T1
methimazole oral tablet 10 mg, 5 mg
T1
NATURE-THROID ORAL TABLET 130 MG,
146.25 MG, 16.25 MG, 162.5 MG, 195 MG, 260
MG, 32.5 MG, 325 MG, 48.75 MG, 65 MG,
97.5 MG
T1
np thyroid oral tablet 30 mg, 90 mg
T1
propylthiouracil oral tablet 50 mg
T1
SYNTHROID ORAL TABLET 100 MCG, 112
MCG, 125 MCG, 137 MCG, 150 MCG, 175
MCG, 200 MCG, 25 MCG, 300 MCG, 50
MCG, 75 MCG, 88 MCG
T1
UNITHROID ORAL TABLET 100 MCG, 112
MCG, 125 MCG, 137 MCG, 150 MCG, 175
MCG, 200 MCG, 25 MCG, 300 MCG, 50
MCG, 75 MCG, 88 MCG
T1
WESTHROID ORAL TABLET 130 MG, 195
MG, 32.5 MG, 65 MG, 97.5 MG
T1
WP THYROID ORAL TABLET 113.75 MG,
130 MG, 32.5 MG, 48.75 MG, 65 MG, 81.25
MG, 97.5 MG
T1
*Ulcer Drugs*
cimetidine hcl oral solution 300 mg/5ml
T1
cimetidine oral tablet 200 mg, 300 mg, 400 mg,
800 mg
T1
81
Drug
Status
Notes
dicyclomine hcl oral capsule 10 mg
T1
dicyclomine hcl oral solution 10 mg/5ml
T1
dicyclomine hcl oral tablet 20 mg
T1
famotidine intravenous* solution 20 mg/2ml, 200
mg/20ml, 40 mg/4ml, 500 mg/50ml
T1
famotidine oral suspension reconstituted 40
mg/5ml
T1
famotidine oral tablet 10 mg, 20 mg, 40 mg
T1
famotidine premixed intravenous* solution 20-0.9
mg/50ml-%
T1
FIRST-LANSOPRAZOLE ORAL
SUSPENSION 3 MG/ML
T1
QL (150 ML per 30 days)
FIRST-OMEPRAZOLE ORAL
SUSPENSION 2 MG/ML
T1
QL (150 ML per 30 days)
glycopyrrolate oral tablet 1 mg, 2 mg
T1
hyoscyamine sulfate er oral tablet extended
release 12 hr* 0.375 mg
T1
hyoscyamine sulfate oral elixir 0.125 mg/5ml
T1
hyoscyamine sulfate oral solution 0.125 mg/ml
T1
hyoscyamine sulfate oral tablet 0.125 mg
T1
hyoscyamine sulfate oral tablet dispersible 0.125
mg
T1
hyoscyamine sulfate sublingual tablet sublingual
0.125 mg
T1
lansoprazole oral capsule delayed release 15 mg
T1
QL (60 EA per 30 days)
lansoprazole oral capsule delayed release 30 mg
T1
QL (30 EA per 30 days)
misoprostol oral tablet 100 mcg, 200 mcg
T1
NEXIUM 24HR ORAL CAPSULE DELAYED
RELEASE 20 MG
T1
QL (60 EA per 30 days)
omeprazole oral capsule delayed release 10 mg
T1
QL (30 EA per 30 days)
omeprazole oral capsule delayed release 20 mg
T1
QL (60 EA per 30 days)
omeprazole oral capsule delayed release 40 mg
T1
omeprazole oral tablet delayed release 20 mg
T1
QL (60 EA per 30 days)
omeprazole-sodium bicarbonate oral capsule
20-1100 mg
T1
QL (60 EA per 30 days)
pantoprazole sodium oral tablet delayed release
20 mg
T1
QL (30 EA per 30 days)
pantoprazole sodium oral tablet delayed release
40 mg
T1
QL (60 EA per 30 days)
PEPCID AC MAXIMUM STRENGTH ORAL
TABLET CHEWABLE 20 MG
T1
82
Drug
Status
PRILOSEC OTC ORAL TABLET DELAYED
RELEASE 20 MG
T1
propantheline bromide oral tablet 15 mg
T1
ranitidine hcl oral syrup 15 mg/ml
T1
ranitidine hcl oral tablet 150 mg, 300 mg, 75 mg
T1
sucralfate oral tablet 1 gm
T1
Notes
QL (60 EA per 30 days)
*Urinary Anti-Infectives*
methenamine hippurate oral tablet 1 gm
T1
methenamine mandelate oral tablet 0.5 gm, 1 gm
T1
nitrofurantoin macrocrystal oral capsule 100 mg,
50 mg
T1
nitrofurantoin macrocrystal oral capsule 25 mg
T1
nitrofurantoin monohyd macro oral capsule 100
mg
T1
QL (60 EA per 30 days)
nitrofurantoin oral suspension 25 mg/5ml
T1
AL (Max 12 Years)
QL (60 EA per 30 days)
*Urinary Antispasmodics*
bethanechol chloride oral tablet 10 mg, 25 mg, 5
mg, 50 mg
T1
darifenacin hydrobromide er oral tablet extended
release 24 hr* 15 mg, 7.5 mg
T1
ENABLEX ORAL TABLET EXTENDED
RELEASE 24 HR* 15 MG, 7.5 MG
T1
oxybutynin chloride er oral tablet extended
release 24 hr* 10 mg, 15 mg, 5 mg
T1
oxybutynin chloride oral syrup 5 mg/5ml
T1
oxybutynin chloride oral tablet 5 mg
T1
OXYTROL FOR WOMEN TRANSDERMAL
PATCH BIWEEKLY 3.9 MG/24HR
T1
OXYTROL TRANSDERMAL PATCH
BIWEEKLY 3.9 MG/24HR
T1
tolterodine tartrate er oral capsule extended
release 24 hour 2 mg, 4 mg
T1
ST
tolterodine tartrate oral tablet 1 mg, 2 mg
T1
ST
tolterodine tartrate oral tablet 2 mg
T1
TOVIAZ ORAL TABLET EXTENDED
RELEASE 24 HR* 4 MG, 8 MG
T1
ST
trospium chloride er oral capsule extended
release 24 hour 60 mg
T1
ST
trospium chloride oral tablet 20 mg
T1
ST
VESICARE ORAL TABLET 10 MG, 5 MG
T1
ST
ST
83
Drug
*Vaccines*
Status
Notes
AFLURIA INTRAMUSCULAR*
SUSPENSION
T1
QL (0.5 ML per 365 days); AL
(Min 9 Years)
AFLURIA PRESERVATIVE FREE
INTRAMUSCULAR* 0.5 ML
T1
QL (0.5 ML per 365 days); AL
(Min 9 Years)
FLUARIX QUADRIVALENT
INTRAMUSCULAR* 0.5 ML
T1
QL (0.5 ML per 365 days); AL
(Min 3 Years)
FLUCELVAX INTRAMUSCULAR* 0.5 ML
T1
QL (0.5 ML per 365 days)
FLULAVAL QUADRIVALENT
INTRAMUSCULAR* 0.5 ML
T1
QL (0.5 ML per 365 days); AL
(Min 9 Years)
FLULAVAL QUADRIVALENT
INTRAMUSCULAR* SUSPENSION
T1
QL (0.5 ML per 365 days); AL
(Min 6 Months)
FLUVIRIN INTRAMUSCULAR*
SUSPENSION
T1
QL (0.5 ML per 365 days); AL
(Min 4 Years)
FLUVIRIN PRESERVATIVE FREE
INTRAMUSCULAR* 0.5 ML
T1
QL (0.5 ML per 365 days); AL
(Min 4 Years)
FLUZONE QUADRIVALENT
INTRAMUSCULAR* 0.25 ML
T1
QL (0.25 ML per 365 days); AL
(Min 6 Months and Max 35
Months)
FLUZONE QUADRIVALENT
INTRAMUSCULAR* 0.5 ML
T1
QL (0.5 ML per 365 days); AL
(Min 3 Years)
FLUZONE QUADRIVALENT
INTRAMUSCULAR* SUSPENSION
T1
QL (0.5 ML per 365 days); AL
(Min 6 Months)
FLUZONE QUADRIVALENT
INTRAMUSCULAR* SUSPENSION 0.5 ML
T1
QL (0.5 ML per 365 days); AL
(Min 3 Years)
ZOSTAVAX SUBCUTANEOUS* SOLUTION
RECONSTITUTED 19400 UNT/0.65ML
T1
AL (Min 60 Years)
CLEOCIN VAGINAL SUPPOSITORY 100
MG
T1
GR-F
clindamycin phosphate vaginal cream 2 %
T1
GR-F
clotrimazole 3 vaginal cream 2 %
T1
GR-F
clotrimazole-7 vaginal cream 1 %
T1
GR-F
ESTRACE VAGINAL CREAM 0.1 MG/GM
T1
GR-F
FIRST-PROGESTERONE VGS 100
VAGINAL SUPPOSITORY 100 MG
T1
FIRST-PROGESTERONE VGS 200
VAGINAL SUPPOSITORY 200 MG
T1
FIRST-PROGESTERONE VGS 25 VAGINAL
SUPPOSITORY 25 MG
T1
FIRST-PROGESTERONE VGS 400
VAGINAL SUPPOSITORY 400 MG
T1
*Vaginal Products*
84
Drug
Status
Notes
FIRST-PROGESTERONE VGS 50 VAGINAL
SUPPOSITORY 50 MG
T1
GYNAZOLE-1 VAGINAL CREAM 2 %
T1
GR-F
metronidazole vaginal gel 0.75 %
T1
GR-F
miconazole 3 combo pack vaginal kit 200 & 2
mg-% (9gm)
T1
GR-F
miconazole 3 vaginal suppository 200 mg
T1
GR-F
miconazole 7 vaginal cream 2 %
T1
GR-F
miconazole 7 vaginal suppository 100 mg
T1
GR-F
OPERAND POVIDONE-IODINE VAGINAL
SOLUTION 10 %
T1
terconazole vaginal cream 0.4 %, 0.8 %
T1
GR-F
terconazole vaginal suppository 80 mg
T1
GR-F
ADRENACLICK INJECTION 0.3 MG/0.3ML
T1
QL (2 EA per 30 days)
epinephrine injection 0.3 mg/0.3ml
T1
QL (2 EA per 30 days)
EPIPEN 2-PAK INJECTION 0.3 MG/0.3ML
T1
QL (2 EA per 30 days)
EPIPEN JR 2-PAK INJECTION 0.15
MG/0.3ML
T1
QL (2 EA per 30 days)
midodrine hcl oral tablet 10 mg, 2.5 mg, 5 mg
T1
QL (90 EA per 30 days)
*Vasopressors*
*Vitamins*
ACEROLA C 500 ORAL WAFER 500 MG
T1
ascorbic acid injection solution 500 mg/ml
T1
b1 natural oral tablet 250 mg
T1
benfotiamine oral capsule 150 mg
T1
biotin 5000 oral capsule 5 mg
T1
biotin oral capsule 2500 mcg
T1
biotin oral tablet 10 mg, 1000 mcg, 300 mcg, 5
mg, 7500 mcg, 800 mcg
T1
B-NATAL MOUTH/THROAT LOLLIPOP 25
MG
T1
B-NATAL MOUTH/THROAT LOZENGE 25
MG
T1
BPROTECTED VITAMIN C ORAL
LIQUID† 500 MG/5ML
T1
buffered vitamin c oral capsule 1000 mg
T1
calcium pantothenate oral tablet 100 mg
T1
cvs biotin oral capsule 10 mg
T1
cvs vitamin c oral tablet chewable 1000 mg
T1
d 1000 oral tablet 1000 unit
T1
85
Drug
Status
Notes
d 5000 oral tablet 5000 unit
T1
fruit c oral tablet chewable 100 mg
T1
LEXINAL ORAL TABLET 2.5 MG
T1
M2 POTASSIUM ORAL CAPSULE 60 MG
T1
niacin er oral capsule extended release* 250 mg,
500 mg
T1
niacin er oral tablet extendedrelease* 1000 mg,
250 mg, 500 mg, 750 mg
T1
niacin oral tablet 100 mg, 250 mg, 50 mg, 500 mg
T1
niacinamide oral tablet 100 mg, 500 mg
T1
niacinamide oral tablet extendedrelease* 500 mg
T1
paba oral tablet 100 mg
T1
POTABA ORAL CAPSULE 500 MG
T1
riboflavin oral capsule 100 mg, 50 mg
T1
riboflavin oral tablet 400 mg
T1
sodium ascorbate granules
T1
vitamin b-1 oral tablet 100 mg, 50 mg
T1
vitamin b-2 oral tablet 25 mg, 50 mg
T1
vitamin b-6 er oral tablet extendedrelease* 200
mg
T1
vitamin b-6 oral tablet 100 mg, 25 mg, 250 mg,
50 mg, 500 mg
T1
vitamin b6 oral tablet 200 mg
T1
vitamin c (calcium ascorbate) oral solution
reconstituted
T1
vitamin c drops mouth/throat lozenge 60 mg
T1
vitamin c er oral capsule extended release* 500
mg
T1
vitamin c er oral tablet extendedrelease* 1500
mg, 500 mg
T1
vitamin c oral syrup 500 mg/5ml
T1
vitamin c oral tablet 100 mg, 1000 mg, 250 mg,
500 mg
T1
vitamin c oral tablet chewable 250 mg, 500 mg
T1
vitamin c-rose hips er oral tablet
extendedrelease* 1000 mg
T1
vitamin d (cholecalciferol) oral capsule 400 unit
T1
AL (Min 65 Years)
vitamin d (ergocalciferol) oral capsule 50000 unit
T1
QL (4 EA per 28 days)
vitamin d3 oral tablet 400 unit
T1
QL (60 EA per 30 days); AL (Min
65 Years)
vitamin e oral capsule 400 unit
T1
86
Drug
vitamin k (phytonadione) oral tablet 100 mcg
Status
Notes
T1
87
88
Index
Index
Index
Index
1st tier unifine pentips .............................. 54
1st tier unifine pentips plus ............... 54
abacavir sulfate ................................................... 20
abacavir-lamivudine-zidovudine
....................................................................................................... 20
ABREVA ..................................................................... 41
acarbose ......................................................................... 11
ACCU-CHEK TENDER 1
INFUSION ............................................................... 54
acebutolol hcl ......................................................... 23
ACEPHEN ................................................................... 3
ACEROLA C 500 ......................................... 85
ACETADRYL .................................................... 29
ACETA-GESIC ............................................... 29
acetaminophen ......................................................... 3
acetaminophen er ................................................. 3
acetaminophen-codeine .............................. 4
acetaminophen-codeine #2 .................... 4
acetaminophen-codeine #3 .................... 4
acetaminophen-codeine #4 .................... 4
acetazolamide ........................................................ 47
acetazolamide er ............................................... 47
acetic acid ................................................................... 77
acetic acid-aluminum acetate ........ 77
acetone ............................................................................. 26
acetylcysteine ......................................................... 29
acidophilus/citrus pectin ....................... 13
acidophilus/pectin ........................................... 13
acne medication 10 ........................................ 41
acne medication 5 ............................................ 41
ACTIPHYTE OF
LEMONGRASS ............................................. 26
acyclovir ......................................................................... 20
administration set ............................................ 54
ADRENACLICK .......................................... 85
ADULT ACNOMEL ............................... 41
adult aspirin low strength ....................... 3
adult gummy ............................................................. 71
ADVAIR DISKUS ........................................... 8
advanced lubricant ........................................ 75
ADVIL ALLERGY &
CONGESTION ................................................ 29
ADVIL ALLERGY SINUS ......... 29
ADVIL COLD & SINUS
LIQUI-GELS ....................................................... 29
ADVOCATE INSULIN PEN
NEEDLES ................................................................. 54
ADVOCATE INSULIN
SYRINGE .................................................................. 54
AEROSPAN .............................................................. 8
AFLURIA .................................................................. 84
AFLURIA PRESERVATIVE
FREE ................................................................................. 84
AGORAL MAXIMUM
STRENGTH .......................................................... 52
air eliminating tpn iv set ........................ 54
ALA-HIST PE ................................................... 29
albuterol sulfate ...................................................... 8
alclometasone dipropionate ............. 41
alendronate sodium ....................................... 47
aler-dryl .......................................................................... 14
alfuzosin hcl er ..................................................... 49
ALKA-SELTZER
HEARTBURN ....................................................... 5
ALKA-SELTZER PLS
ALLERGY & CGH .................................. 29
ALKA-SELTZER PLUS COLD
& COUGH ............................................................... 29
ALKA-SELTZER PLUS COLD
& FLU .............................................................................. 29
ALKA-SELTZER PLUS
DAY/NIGHT ........................................................ 29
ALKA-SELTZER PLUS
NIGHT COLD .................................................. 29
ALKA-SELTZER PLUS SINUS
....................................................................................................... 29
all day pain relf sinus/cold d .......... 29
aller-chlor .................................................................... 14
aller-time ....................................................................... 29
allopurinol .................................................................. 50
ALMACONE ........................................................... 5
alogliptin benzoate ......................................... 11
alogliptin-metformin hcl ........................ 11
alogliptin-pioglitazone ............................. 12
alprazolam ...................................................................... 7
amantadine hcl ..................................................... 19
ambi 12.5cpd/100gfn/30pse ............. 29
ambi 12.5cpd/1dcpm/30pse .............. 29
amiloride hcl ........................................................... 47
amiloride-hydrochlorothiazide .... 47
amiodarone hcl ........................................................ 7
amitriptyline hcl ................................................. 10
amlodipine besy-benazepril hcl
....................................................................................................... 16
amlodipine besylate ...................................... 24
ammonium lactate ............................... 26, 41
amoxapine ................................................................... 10
amoxicillin .................................................................. 78
amoxicillin-pot clavulanate .............. 78
amphetamine-dextroamphet er ........ 1
amphetamine-dextroamphetamine
........................................................................................................... 1
ampicillin ...................................................................... 78
anagrelide hcl ........................................................ 50
anastrozole ................................................................. 18
anefrin spray ........................................................... 74
anesthesia extension tubing .............. 54
ANORO ELLIPTA ....................................... 8
antacid .................................................................................. 5
antacid & antigas ................................................ 5
antacid extra strength .................................... 5
antacid multi-symptom ................................. 5
antipyrine-benzocaine ............................... 78
anti-stick insulin syringe ....................... 54
apap .......................................................................................... 3
ap-hist dm .................................................................... 29
APIDRA ....................................................................... 12
APIDRA SOLOSTAR .......................... 12
APRISO ........................................................................ 48
APTIVUS ................................................................... 20
ARGYLE EXTENSION TUBE
20" .......................................................................................... 54
ARGYLE STERILE WATER
....................................................................................................... 23
ARMOUR THYROID ......................... 81
artificial tears ........................................................ 75
ascorbic acid ........................................................... 85
aspirin .................................................................................... 3
aspirin adult low strength ....................... 3
aspirin low dose ..................................................... 3
aspirtab maximum strength .................. 3
ASSURE DOSE CONTROL .... 55
ASSURE ID INSULIN SAFETY
SYR ...................................................................................... 55
ATABEX ..................................................................... 71
ATABEX EC ........................................................ 71
atenolol ............................................................................ 24
atenolol-chlorthalidone .......................... 16
atorvastatin calcium .................................... 15
atovaquone ................................................................. 17
ATRIPLA .................................................................. 21
atropine sulfate .................................................... 75
ATROVENT HFA .......................................... 8
aurora pen needles ......................................... 55
aurora unifine pentips ............................... 55
AUTOJECT 2 ..................................................... 55
autopen ............................................................................. 55
AVONEX .................................................................... 80
azathioprine .............................................................. 23
azelastine hcl ........................................................... 75
azithromycin ............................................................. 54
AZOR ............................................................................... 16
b1 natural ..................................................................... 85
bacitracin ......................................................... 41, 75
bacitracin zinc ....................................................... 41
bacitracin-neomycin-polymyxin
....................................................................................................... 41
bacitracin-polymyxin b ............................ 75
bacitra-neomycin-polymyxin-hc
....................................................................................................... 75
baclofen ........................................................................... 74
89
Index
Index
Index
balsalazide disodium .................................. 48
b-complex balanced ...................................... 71
b-complex/vitamin c ..................................... 71
BD ANGIOCATH
AUTOGUARD .................................................. 55
BD AUTOSHIELD .................................... 55
BD AUTOSHIELD DUO ................ 55
BD ECLIPSE SYRINGE ................ 55
BD FIRST MIDCATH
18G/4FRX20CM ............................................ 55
BD FIRST MIDCATH
20G/3FRX20CM ............................................ 55
BD FIRST PICC
16G/5FRX65CM ............................................ 55
BD FIRST PICC
18G/4FRX65CM ............................................ 55
BD FIRST PICC
20G/3FRX65CM ............................................ 55
BD FIRST PICC
22G/2.8FRX50CM ...................................... 55
BD FIRST PICC
26G/1.9FRX50CM ...................................... 55
BD INSULIN SYR ULTRAFINE
II ................................................................................................ 55
BD INSULIN SYRINGE ................. 55
BD INSULIN SYRINGE
HALF-UNIT ......................................................... 55
BD INSULIN SYRINGE
MICROFINE ....................................................... 55
BD INSULIN SYRINGE U-40
....................................................................................................... 55
BD INSULIN SYRINGE
ULTRAFINE ....................................................... 56
BD INTEGRA INSULIN
SYRINGE .................................................................. 56
BD INTEGRA SYRINGE ............. 56
BD L-CATH 16G/5FR ......................... 56
BD L-CATH 16G/5FRX60CM
....................................................................................................... 56
BD L-CATH 18G/3.5FR ................... 56
BD L-CATH 18G/3.5FRX60CM
....................................................................................................... 56
BD L-CATH 20G/2.6FR ................... 56
BD L-CATH 20G/2.6FRX60CM
....................................................................................................... 56
BD L-CATH 20G/3FR ......................... 56
BD L-CATH 20G/3FRX60CM
....................................................................................................... 56
BD L-CATH 28G/1.2FRX25CM
....................................................................................................... 56
BD L-CATH MIDLINE
18G/3.5FRX20 ................................................... 56
BD L-CATH MIDLINE
20G/3FRX20CM ............................................ 56
BD LUER-LOK SYRINGE ........ 56
BD NEXIVA 18GX1.25" ................. 56
BD NEXIVA 18GX1.75" ................. 56
BD NEXIVA 20GX1" ........................... 56
BD NEXIVA 20GX1.25" ................. 56
BD NEXIVA 20GX1.75" ................. 56
BD NEXIVA 22GX1" ........................... 56
BD NEXIVA 24GX0.56" ................. 56
BD NEXIVA 24GX0.75" ................. 56
BD PEN NEEDLE MINI U/F
....................................................................................................... 56
BD PEN NEEDLE NANO U/F
....................................................................................................... 56
BD PEN NEEDLE SHORT U/F
....................................................................................................... 56
BD PEN NEEDLE ULTRAFINE
....................................................................................................... 56
BD SAFETYGLIDE INSULIN
SYRINGE .................................................................. 56
BD SAFETY-LOK INSULIN
SYRINGE .................................................................. 57
BD SAFETY-LOK SET .................... 57
BD SAFETY-LOK
VACUTAINER SET ............................... 57
BD SAF-T E-Z SET .................................. 57
BD SAF-T-INTIMA 18G X 1"
....................................................................................................... 57
BD SAF-T-INTIMA 20GX1"
....................................................................................................... 57
BD SAF-T-INTIMA 22G X
0.75" .................................................................................... 57
BD SAF-T-INTIMA 22GX3/4"
....................................................................................................... 57
BD SAF-T-INTIMA 24G X
0.75" .................................................................................... 57
BD SAF-T-INTIMA 24GX3/4"
....................................................................................................... 57
BD SYRINGE/NEEDLE .................. 57
BD SYRINGE/NEEDLE SLIP
TIP ......................................................................................... 57
BD VACUTAINER SET .................. 57
benazepril hcl ......................................................... 16
benazepril-hydrochlorothiazide
....................................................................................................... 16
benfotiamine ............................................................. 85
benzonatate ................................................................ 29
BENZ-O-STHETIC ................................. 71
benzoyl peroxide ................................................ 42
benzoyl peroxide cleanser ................... 42
benzoyl peroxide wash ............................. 42
benzoyl peroxide-erythromycin ... 42
benztropine mesylate ................................... 19
benzyl alcohol ........................................................ 79
benzyl benzoate ................................................... 26
betamethasone dipropionate ........... 42
betamethasone dipropionate aug
....................................................................................................... 42
betamethasone valerate .......................... 42
BETASERON ..................................................... 80
betaxolol hcl ............................................................. 75
bethanechol chloride ................................... 83
bicalutamide ............................................................. 18
BICARSIM ............................................................. 49
BICARSIM FORTE ................................ 49
BICILLIN C-R ................................................. 78
BICILLIN C-R 900/300 ..................... 78
bimatoprost ................................................................ 75
biobron sf ...................................................................... 29
biodesp dm .................................................................. 29
biogtuss ............................................................................ 29
bionatuss dxp .......................................................... 29
bionel .................................................................................. 29
bionel pediatric ................................................... 30
biospec dmx ............................................................... 30
biotin .................................................................................... 85
biotin 5000 .................................................................. 85
biovol .................................................................................. 71
bisacodyl ........................................................................ 52
bisacodyl ec ............................................................... 52
bismuth ............................................................................. 13
bisoprolol fumarate ...................................... 24
bisoprolol-hydrochlorothiazide
....................................................................................................... 16
BLEPHAMIDE S.O.P. ........................ 75
BLINK TEARS ................................................ 75
B-NATAL .................................................................. 85
bp cleansing .............................................................. 42
bp cleansing wash ........................................... 42
bpm-dm-phen .......................................................... 30
BPROTECTED VITAMIN C
....................................................................................................... 85
BRAINSTRONG PRENATAL
....................................................................................................... 71
BRASIVOL ............................................................ 42
BREO ELLIPTA .............................................. 8
BRILINTA ................................................... 46, 50
brimonidine tartrate ..................................... 75
bromocriptine mesylate ........................... 19
bronchial asthma relief ........................... 30
BRONCOTRON PED .......................... 30
BRONCOTRON PED DROPS
....................................................................................................... 30
BRONCOTRON-S ..................................... 30
BRONKAID .......................................................... 30
bronkids .......................................................................... 30
brotapp dm ................................................................. 30
budesonide ...................................................................... 8
buffasal ................................................................................ 3
buffered aspirin ....................................................... 3
buffered vitamin c ............................................ 85
90
Index
Index
Index
bumetanide ................................................................. 47
bupropion hcl ......................................................... 11
bupropion hcl er (smoking det) ... 80
bupropion hcl er (sr) ................................... 11
bupropion hcl er (xl) ................................... 11
buspirone hcl ............................................................... 7
butalbital-acetaminophen ........................ 3
butalbital-apap-caff-cod ............................ 4
butalbital-apap-caffeine ............................. 3
butalbital-asa-caff-codeine ................... 4
butalbital-aspirin-caffeine ...................... 3
BYSTOLIC ............................................................. 24
cal/mag ............................................................................. 67
CALAGESIC ....................................................... 42
CALCET CREAMY BITES ..... 68
calcitonin (salmon) ........................................ 47
calcitriol ......................................................................... 47
calcium ............................................................................. 68
calcium + d3 ............................................................ 68
calcium 500 + d .................................................. 68
calcium 500/d ......................................................... 68
calcium 500+d ...................................................... 68
calcium 500+d high potency .......... 68
calcium 600+d ...................................................... 68
calcium 600+d3 .................................................. 68
calcium acetate (phos binder) ....... 49
calcium antacid ultra ..................................... 5
calcium carbonate ........................................... 68
calcium carbonate antacid ..................... 5
calcium carbonate-vitamin d .......... 68
calcium citrate ...................................................... 68
calcium citrate + d ......................................... 68
calcium citrate + d3 ..................................... 68
calcium citrate malate-vit d .............. 68
calcium citrate-vitamin d ..................... 68
calcium citrate-vitamin d3 ................. 68
calcium pantothenate ................................. 85
calcium plus vitamin d .............................. 68
calcium/vitamin d3 gummies .......... 68
calcium-carb 600 + d ................................ 68
calcium-magnesium ...................................... 68
calcium-vitamin d ............................................ 68
calcium-vitamin d3 ........................................ 68
CAL-MAG CHELA-MAX ........... 68
CAL-QUICK ........................................................ 69
camphor spirit ....................................................... 26
capcof ................................................................................. 30
capecitabine ............................................................. 18
capmist dm .................................................................. 30
capron dm .................................................................... 30
capsaicin ........................................................................ 42
captopril ......................................................................... 16
captopril-hydrochlorothiazide ..... 16
CAPZASIN ............................................................. 42
carbamazepine ......................................................... 9
carbamazepine er ................................................. 9
CARBAPHEN CH ...................................... 30
CARBAPHEN PED CH .................... 30
carbidopa ..................................................................... 19
carbidopa-levodopa ..................................... 19
carbidopa-levodopa er ............................. 19
CAREFINE PEN NEEDLES ... 57
careone insulin syringe ........................... 57
careone unifine pentips ........................... 57
careone unifine pentips plus ............ 57
carteolol hcl .............................................................. 75
CARTIA XT .......................................................... 24
carvedilol ...................................................................... 24
CCP CAFFEINE FREE .................... 30
cefaclor ............................................................................ 25
cefadroxil ...................................................................... 25
cefdinir ............................................................................. 25
cefpodoxime proxetil ................................... 25
cefprozil .......................................................................... 25
CEFTIN ........................................................................ 25
ceftriaxone sodium ......................................... 26
cefuroxime axetil ............................................... 26
CELLCEPT ........................................................... 23
CENTRUM SPECIALIST
PRENATAL .......................................................... 71
cephalexin .................................................................... 26
CERTUSS-D ......................................................... 30
cetirizine hcl ............................................................. 14
cetirizine-pseudoephedrine er ....... 30
CHANTIX ................................................................. 80
CHANTIX CONTINUING
MONTH PAK .................................................... 80
CHANTIX STARTING
MONTH PAK .................................................... 80
chelated magnesium ..................................... 69
cheratussin ac ........................................................ 30
cheratussin dac .................................................... 30
cherry ................................................................................. 79
cherry concentrate .......................................... 79
chest congestion daytime ...................... 30
chest congestion relief pe ..................... 30
chest congestion/pain & sinus ...... 30
child chewable vitamins/iron ......... 71
childrens cough ................................................... 30
childrens cough/runny nose ............. 30
childrens gummies .......................................... 71
childrens multivitamin .............................. 71
childrens plus cold ......................................... 30
childrens plus cold & allergy ......... 30
childrens plus flu ............................................... 30
childrens silfedrine ........................................ 74
CHILDRENS SOOTHE ....................... 5
CHLO TUSS ......................................................... 31
chlo tuss ex ................................................................. 31
chlophed ......................................................................... 31
chlordiazepoxide hcl ....................................... 7
chlorhexidine gluconate ............. 26, 71
chloroform .................................................................. 26
chloroquine phosphate ............................. 18
chlorothiazide ........................................................ 47
chlorpheniramine maleate ...... 14, 15
chlorpheniramine maleate er ......... 14
chlorpropamide ................................................... 12
chlorthalidone ....................................................... 47
chlorzoxazone ........................................................ 74
cholestyramine ..................................................... 15
cholestyramine light ..................................... 15
choline-mag trisalicylate .......................... 4
ciclopirox ...................................................................... 42
cilostazol ........................................................................ 50
cimetidine ..................................................................... 81
cimetidine hcl ......................................................... 81
ciprofloxacin hcl ........................ 48, 75, 78
citalopram hydrobromide .................... 11
citric acid-sodium citrate ..................... 49
CITROCARBONATE ............................. 5
clarithromycin ....................................................... 54
clemastine fumarate ..................................... 15
CLEOCIN ................................................................. 84
clickfine pen needles .................................... 57
CLINDAMAX .................................................... 42
clindamycin hcl ................................................... 17
clindamycin palmitate hcl ................... 17
clindamycin phosphate ................ 42, 84
CLINICAL NUTRIENTS
PRENATAL .......................................................... 72
clobetasol propionate ................................ 42
clonazepam .................................................................... 9
clonidine hcl ............................................................. 16
clopidogrel bisulfate .................................... 50
clorazepate dipotassium ............................ 7
clotrimazole .................................................. 42, 71
clotrimazole 3 ........................................................ 84
clotrimazole-7 ........................................................ 84
clotrimazole-betamethasone ............ 42
clozapine ........................................................................ 19
codeine sulfate .......................................................... 4
codituss dm ................................................................ 31
colchicine ..................................................................... 50
colchicine-probenecid ............................... 50
cold & cough childrens ........................... 31
cold & cough day/night child ......... 31
cold & cough daytime ............................... 31
cold & flu nighttime/daytime .......... 31
cold & flu relief nighttime d ............. 31
cold & flu severe daytime .................... 31
cold control pe cold/flu med ............ 31
cold head congestion daytime ....... 31
cold head congestion nighttime
....................................................................................................... 31
91
Index
Index
Index
cold multi-symptom day/night ....... 31
cold multi-symptom warm night
....................................................................................................... 31
cold relief plus ...................................................... 31
cold/flu relief ........................................................... 31
cold/flu relief day/night ........................... 31
cold/flu relief nighttime ........................... 31
colestipol hcl ........................................................... 15
COMFORT EZ INSULIN
SYRINGE .................................................................. 57
COMFORT EZ PEN NEEDLES
....................................................................................................... 57
COMPLERA ........................................................ 21
COMPLETE FORMULATION
PEDIATRIC ......................................................... 72
complete natal dha ......................................... 72
complete prenatal/dha .............................. 72
complete protein/vitamin shake
....................................................................................................... 46
complete sinus relief .................................... 31
CONEX COLD/ALLERGY ...... 31
CONTAC COLD+FLU MAX ST
....................................................................................................... 31
cool mist humidifier ...................................... 57
CORICIDIN HBP
CONGESTION/COUGH ................ 31
CORICIDIN HBP DAY/NIGHT
COLD ............................................................................... 31
CORICIDIN NIGHTTIME
COLD-COUGH .............................................. 32
CORNWALL METAL
PIPETTING .......................................................... 57
CORRECTOL HERBAL TEA
....................................................................................................... 52
cortisone acetate ............................................... 28
cottonseed oil .......................................................... 26
cough & cold ........................................................... 32
cough & sore throat nighttime ..... 32
cough daytime/nighttime ....................... 32
COVARYX ............................................................. 48
COVARYX HS ................................................. 48
CREON ......................................................................... 46
CRIXIVAN ............................................................. 21
cromolyn sodium ................................... 74, 75
CRYOSERV ......................................................... 26
CULTURELLE DIGESTIVE
HEALTH .................................................................... 13
CURITY ALCOHOL PREPS
....................................................................................................... 57
cvs allergy childrens .................................... 15
cvs antacid & anti-gas .................................. 6
cvs antacid supreme ......................................... 6
cvs biotin ....................................................................... 85
cvs cortisone cooling relief ............... 42
cvs cough & sore throat child ....... 32
cvs gas relief drops ex st ....................... 49
cvs lubricant drops ......................................... 75
cvs mini enema kids ...................................... 52
cvs natural fiber supplement ........... 52
cvs non-drying sinus pe ........................... 32
cvs oyster shell calcium+vit d ....... 69
cvs prenatal gummy .......................... 72, 79
cvs targeted acne spot ............................... 42
cvs vitamin c ............................................................. 85
cyanocobalamin ................................................. 50
cyclobenzaprine hcl ...................................... 74
cyclopentolate hcl ............................................ 75
cyclophosphamide ........................................... 18
cyclosporine ............................................................. 23
cyclosporine modified ............................... 23
cyproheptadine hcl ......................................... 15
cytra k crystals ..................................................... 49
cytra-2 ............................................................................... 49
CYTRA-3 ................................................................... 49
cytra-k ................................................................................ 49
d 1000 ................................................................................ 85
d 5000 ................................................................................ 86
daily multiple vitamins/min ............... 72
DAILY PAK MAXIMUM
MULTIVITAMIN ....................................... 72
daily vitamin plus ............................................. 72
daily-vitamin ............................................................ 72
DALLERGY ......................................................... 32
dapsone ............................................................................ 17
DARAPRIM .......................................................... 18
darifenacin hydrobromide er ......... 83
day time pe cold/flu relief .................... 32
daytime cold & cough childrens
....................................................................................................... 32
DAYTIME COLD MEDICINE
....................................................................................................... 32
DELSYM CGH/CLD
NIGHTTIME CHILD .......................... 32
DELTUSS DMX ............................................. 32
DELTUSS DP ..................................................... 32
DELZICOL ............................................................ 49
denture adhesive ................................................ 57
DESGEN DM ...................................................... 32
DESGEN PEDIATRIC ...................... 32
desmopressin ace spray refrig ...... 47
desmopressin acetate .................................. 47
desmopressin acetate spray .............. 47
desogestrel-ethinyl estradiol ........... 27
desonide .......................................................................... 42
despec dm ..................................................................... 32
despec-dm .................................................................... 32
DEWEES CARMINATIVE ........... 6
dexamethasone ..................................................... 28
DEXAMETHASONE
INTENSOL ............................................................. 28
dexamethasone sodium phosphate
....................................................................................................... 75
dexchlorpheniramine maleate ....... 15
dexmethylphenidate hcl ............................... 1
DEXPAK 10 DAY ....................................... 28
DEXPAK 13 DAY ....................................... 28
DEXPAK 6 DAY ........................................... 28
dextroamphetamine sulfate ................... 1
dextroamphetamine sulfate er ........... 1
dextromethorphan-guaifenesin .... 32
DIABETIC TUSSIN COLD &
FLU ...................................................................................... 32
DIABETIC TUSSIN NIGHT
COLD/FLU ............................................................. 32
DIALYVITE SUPREME D ........ 72
diazepam .................................................................... 7, 9
diclofenac potassium ....................................... 2
diclofenac sodium .................................... 2, 75
diclofenac sodium er ....................................... 2
dicloxacillin sodium ..................................... 78
dicyclomine hcl .................................................... 82
didanosine ................................................................... 21
diflunisal ............................................................................ 4
digoxin .............................................................................. 25
DILANTIN .............................................................. 10
diltiazem cd ............................................................... 24
diltiazem hcl ............................................................. 24
diltiazem hcl er ..................................................... 24
diltiazem hcl er beads ................................ 24
diltiazem hcl er coated beads ......... 24
dilt-xr .................................................................................. 25
dimenhydrinate .................................................... 14
DIMETAPP LONG ACT
COUGH/COLD ............................................... 32
dimethyl sulfoxide ............................................ 26
diocto .................................................................................. 52
diphenhist ..................................................................... 15
diphenhydramine hcl ................................... 15
diphenhydramine hcl (sleep) ........... 52
diphenhydramine-apap (sleep) .... 52
diphenoxylate-atropine ............................ 13
dipyridamole ............................................................ 50
disopyramide phosphate ............................ 7
disulfiram ..................................................................... 80
DIURIL ......................................................................... 47
divalproex sodium ........................................... 10
divalproex sodium er .................................. 10
docusate calcium ............................................... 52
docusate sodium ................................................. 52
DOCUSOL MINI ......................................... 52
DOCUSOL PLUS
MINI-ENEMA .................................................. 52
DOLOGEN ............................................................. 32
dometuss-da/children ................................. 32
dometuss-dmx ......................................................... 32
92
Index
Index
Index
donepezil hcl ............................................................ 80
DORIBAX ................................................................. 17
dorzolamide hcl ................................................... 75
dorzolamide hcl-timolol mal ........... 75
doxazosin mesylate ........................................ 16
doxepin hcl ................................................................. 11
doxycycline hyclate ....................................... 81
doxycycline monohydrate .................... 81
DRAMAMINE .................................................. 14
dronabinol ................................................................... 14
drug mart unifine pentips ..................... 57
drug mart unifine pentips plus ..... 58
duane reade unifine pentips ............. 58
DULERA ......................................................................... 8
duloxetine hcl ......................................................... 11
DURAVENT PE ............................................. 32
ear drops ....................................................................... 78
ear wax cleansing ............................................ 78
EASIVENT ............................................................. 58
EASIVENT MASK LARGE ..... 58
EASIVENT MASK MEDIUM
....................................................................................................... 58
EASIVENT MASK SMALL ..... 58
easy comfort insulin syringe ............ 58
easy comfort pen needles ...................... 58
EASY TOUCH FLURINGE ..... 58
EASY TOUCH INSULIN
SAFETY SYR ..................................................... 58
EASY TOUCH INSULIN
SYRINGE .................................................................. 58
EASY TOUCH PEN NEEDLES
....................................................................................................... 58
EASY TOUCH SAFETY
SYRINGE .................................................................. 58
econazole nitrate ............................................... 42
ed bron gp .................................................................... 32
ED CHLORPED ............................................ 15
ED CHLORPED D .................................... 33
ed-a-hist dm .............................................................. 33
EDURANT ............................................................... 21
effaclar duo ............................................................... 42
effervescent pot chloride ....................... 69
EFFIENT .................................................................... 50
ELDERTONIC ................................................ 72
ELIGARD ................................................................. 18
ELITE IRON ....................................................... 50
EMTRIVA ................................................................ 21
ENABLEX ................................................................ 83
enalapril maleate .............................................. 16
enalapril-hydrochlorothiazide ..... 16
ENBREL ......................................................................... 2
ENBREL SURECLICK ........................ 2
endacof-c ....................................................................... 33
ENDACOF-DM ............................................... 33
ENDACON .............................................................. 33
enoxaparin sodium ............................................. 9
entacapone ................................................................. 19
ENTEX LQ ............................................................. 33
ENTEX T ................................................................... 33
entre-cough ................................................................ 33
epinastine hcl .......................................................... 75
epinephrine ................................................................ 85
EPIPEN 2-PAK ............................................... 85
EPIPEN JR 2-PAK .................................... 85
EPITOL ........................................................................ 10
EPIVIR HBV ....................................................... 21
EPOGEN .................................................................... 50
EPZICOM ................................................................ 21
eq allergy/sinus headache ................... 33
eq childrens cold ............................................... 33
eq cold plus ................................................................ 33
eq cold relief complete ............................. 33
eq cold/cough plus .......................................... 33
eq daytime cold/flu relief ...................... 33
eq flu & severe cold & cough ........ 33
eq flu relief ................................................................. 33
eq flu/severe cold/congestion ......... 33
EQ GENTLE LUBRICANT ..... 75
eq lubricating eye drops ........................ 75
eq night time cold & cough ............... 33
eq nite time cold/flu relief .................... 33
eq nitetime cold/flu ms relief ........... 33
eq non-drying sinus ....................................... 33
eq sinus congestion & pain ............... 33
eq triacting cold/allergy ......................... 33
eql calcium/vitamin d ................................. 69
eql gummies childrens .............................. 72
eql insulin syringe ........................................... 58
eql lice solution ................................................... 42
eql short pen needle ...................................... 58
eql ultra comfort insulin syr ............ 58
eql ultra short pen needle .................... 58
eql vitamin d-3 high potency ........... 69
EQUALACTIN ................................................ 52
erythromycin .................................... 42, 43, 75
escitalopram oxalate ................................... 11
est estrogens-methyltest .......................... 48
est estrogens-methyltest ds ................. 48
est estrogens-methyltest hs ................. 48
estazolam ...................................................................... 52
ESTRACE ................................................................ 84
estradiol .......................................................................... 48
estradiol-norethindrone acet .......... 48
estropipate .................................................................. 48
ethambutol hcl ....................................................... 18
ether ...................................................................................... 26
ethosuximide ............................................................ 10
ethyl alcohol ............................................................. 26
ethyl alcohol (rubbing) ............................ 26
eugenol ............................................................................. 26
EVAC-U-GEN ................................................... 52
EXCEL COMFORT POINT
PEN NEEDLE ................................................... 58
EXEL COMFORT POINT
INSULIN SYR ................................................... 58
EXTAVIA ................................................................. 80
eye allergy relief ................................................ 76
eye drops ....................................................................... 76
eye drops allergy relief ............................ 76
eye lubricant ............................................................ 76
E-Z-GAS II .................................................................. 6
famotidine .................................................................... 82
famotidine premixed .................................... 82
felodipine er .............................................................. 25
FENESIN DM IR ......................................... 33
fenofibrate ................................................................... 16
fenofibrate micronized .............................. 16
fenoprofen calcium ............................................ 2
fentanyl ................................................................................. 4
ferretts ............................................................................... 50
ferretts ips .................................................................... 50
FERRIMIN 150 ............................................... 50
ferrous fumarate ................................................ 50
ferrous gluconate .............................................. 50
ferrous sulfate ............................................ 50, 51
fexofenadine hcl .................................................. 15
fexofenadine hcl childrens .................. 15
fiber laxative ............................................................ 53
fiber therapy ............................................................. 53
FIFTY50 PEN NEEDLES ............. 59
FIFTY50 SUPERIOR
COMFORT SYR ........................................... 59
finasteride .................................................................... 49
first aid antibiotic ............................................ 43
FIRST-LANSOPRAZOLE .......... 82
FIRST-OMEPRAZOLE .................. 82
FIRST-PROGESTERONE VGS
100 .......................................................................................... 84
FIRST-PROGESTERONE VGS
200 .......................................................................................... 84
FIRST-PROGESTERONE VGS
25 .............................................................................................. 84
FIRST-PROGESTERONE VGS
400 .......................................................................................... 84
FIRST-PROGESTERONE VGS
50 .............................................................................................. 85
FIRST-VANCOMYCIN 25 ......... 17
FIRST-VANCOMYCIN 50 ......... 17
FLAREX ..................................................................... 76
FLAVOR BLEND ....................................... 79
flavor plus .................................................................... 79
flavor sweet ............................................................... 79
flavor sweet-sf ....................................................... 79
flecainide acetate .................................................. 7
FLEET BISACODYL .......................... 53
93
Index
Index
Index
FLOVENT DISKUS .................................... 8
FLOVENT HFA ................................................. 8
flu & sore throat ................................................ 33
flu/severe cold & cough day ............ 33
FLUARIX QUADRIVALENT
....................................................................................................... 84
FLUCELVAX ..................................................... 84
fluconazole ................................................................. 14
fludrocortisone acetate ............................ 28
fluid administration set ............................ 59
FLULAVAL QUADRIVALENT
....................................................................................................... 84
flunisolide .................................................................... 74
fluocinolone acetonide ............................. 43
fluocinolone acetonide body ............ 43
fluocinolone acetonide scalp .......... 43
fluocinonide .............................................................. 43
fluocinonide-e ........................................................ 43
fluorometholone ................................................. 76
fluorouracil ................................................................ 43
fluoxetine hcl ........................................................... 11
fluphenazine hcl ...................................... 19, 20
flurazepam hcl ....................................................... 52
flurbiprofen .................................................................... 2
flurbiprofen sodium ...................................... 76
flutamide ........................................................................ 18
fluticasone propionate .................. 43, 74
FLUVIRIN ............................................................... 84
FLUVIRIN PRESERVATIVE
FREE ................................................................................. 84
fluvoxamine maleate .................................... 11
FLUZONE QUADRIVALENT
....................................................................................................... 84
FML ..................................................................................... 76
FOLGARD OS .................................................. 72
folic acid ........................................................................ 51
FORADIL AEROLIZER ................... 8
fosinopril sodium .............................................. 16
fosphenytoin sodium .................................... 10
freds pharmacy unifine pentip+
....................................................................................................... 59
freds pharmacy unifine pentips ... 59
FREESTYLE CONTROL
SOLUTION ............................................................ 59
FREESTYLE PRECISION INS
SYR ...................................................................................... 59
fruit c ................................................................................... 86
FUNGOID TINCTURE .................... 43
furosemide ................................................................... 47
gabapentin .................................................................. 10
galantamine hydrobromide ............... 80
GAS-X EXTRA STRENGTH
....................................................................................................... 49
gauze sponge ........................................................... 59
GAVILYTE-C ................................................... 53
GAVILYTE-G ................................................... 53
GAVISCON ............................................................... 6
GAVISCON EXTRA RELIEF
FORMULA ................................................................. 6
GEL-TIN .................................................................... 71
gemfibrozil .................................................................. 16
GENGRAF .............................................................. 23
gentamicin sulfate ............................... 43, 76
geri-mucil ..................................................................... 53
GLATOPA ............................................................... 80
glimepiride ................................................................. 12
glipizide ........................................................................... 12
glipizide xl ................................................................... 12
global ease inject pen needles ...... 59
global inject ease insulin syr .......... 59
GLUCAGON EMERGENCY
....................................................................................................... 12
GLUCOCARD EXPRESSION
CONTROL .............................................................. 59
GLUCOCARD EXPRESSION
TEST .................................................................................. 46
GLUCOCARD VITAL TEST
....................................................................................................... 46
GLUCOPRO INSULIN
SYRINGE .................................................................. 59
glyburide ........................................................................ 12
glyburide micronized .................................. 12
glyburide-metformin .................................... 12
glycerin ................................................................ 26, 43
glycerin (adult) .................................................... 53
glycerin (infants & children) .......... 53
glycerin adult .......................................................... 53
glycerine ......................................................................... 26
glycerol formal ..................................................... 26
glycine soya extract ...................................... 26
glycine soya protein ..................................... 26
glycopyrrolate ....................................................... 82
gnp alcohol denatured .............................. 26
gnp calcium 500 +d3 .................................. 69
gnp clickfine pen needles ...................... 59
gnp foaming antacid ........................................ 6
gnp insulin syringe ......................................... 59
gnp night time sinus ...................................... 33
gnp peppermint spirit ................................. 26
gnp sodium silicate ........................................ 26
gnp ultra com insulin syringe ........ 59
GOLYTELY ......................................................... 53
GONIOTAIRE ................................................. 76
G-P-TUSS DXP ............................................... 34
grape syrup ................................................................ 79
griseofulvin microsize ............................... 14
griseofulvin ultramicrosize ................ 14
G-TRON PEDIATRIC DROPS
....................................................................................................... 34
guaiacol .......................................................................... 26
guaifenesin ................................................................. 34
guaifenesin dm ...................................................... 34
guaifenesin er ......................................................... 34
guaifenesin-dm ..................................................... 34
guanfacine hcl ....................................................... 16
GYNAZOLE-1 .................................................. 85
G-ZYNCOF ............................................................ 34
H 468L TUBING ........................................... 59
halobetasol propionate ............................ 43
haloperidol ................................................................. 20
haloperidol decanoate .............................. 20
HC DERMAPAX .......................................... 43
healthwise mini pen needles ............ 59
healthwise pen needles ............................. 59
healthwise short pen needles .......... 60
healthwise unifine pentips ................... 60
healthy accents unifine pentip ....... 60
HEALTHY MAMA BE WELL
ROUNDED .............................................................. 72
heartburn antacid ex st ................................ 6
h-e-b incontrol pen needles ............... 60
HEMATOGEN FORTE ................... 51
hemorrhoidal .............................................................. 5
heparin sodium (porcine) ......................... 9
heparin sodium (porcine) pf ................ 9
HERBAL EXPEC ....................................... 34
HEXALEN ............................................................... 18
high potency iron .............................................. 51
HISTEX-DM ........................................................ 34
HISTEX-PE ........................................................... 34
hist-pse ............................................................................. 34
hm iron ............................................................................. 51
homatropine hbr ................................................ 76
HONEY BEARS
W/IRON-ZINC ................................................. 72
HUBER INFUSION SET ................ 60
HUMAPEN LUXURA HD ........... 60
HUMATROPEN FOR 12MG
....................................................................................................... 60
HUMATROPEN FOR 24MG
....................................................................................................... 60
HUMATROPEN FOR 6MG ..... 60
HUMIRA ........................................................................ 2
HUMIRA PEDIATRIC
CROHNS START ........................................... 2
HUMIRA PEN ...................................................... 2
HUMIRA PEN-CROHNS
STARTER .................................................................... 2
HUMIRA PEN-PSORIASIS
STARTER .................................................................... 2
hydralazine hcl ..................................................... 16
hydrochlorothiazide ..................................... 47
HYDROCIL .......................................................... 53
hydrocod polst-cpm polst er ............ 34
hydrocodone-acetaminophen ............. 4
94
Index
Index
Index
hydrocodone-homatropine ................. 34
hydrocortisone .................................. 5, 28, 43
hydrocortisone acetate ................................. 5
hydrocortisone max st ............................... 43
hydrocortisone valerate .......................... 43
hydrocortisone-acetic acid ................ 78
hydrocortisone-aloe ..................................... 43
hydromorphone hcl ........................................... 4
hydroxychloroquine sulfate ............... 18
hydroxyprogesterone caproate .... 26
hydroxyurea .............................................................. 18
hydroxyzine hcl ........................................................ 7
hydroxyzine pamoate ...................................... 7
hyoscyamine sulfate ...................................... 82
hyoscyamine sulfate er ............................. 82
ibandronate sodium ...................................... 47
ibuprofen ........................................................................... 2
ibu-profen cold/sinus .................................. 34
ibuprofen pm ........................................................... 52
imatinib mesylate .............................................. 18
imipramine hcl ...................................................... 11
IMODIUM A-D ............................................... 13
INCRUSE ELLIPTA ................................. 8
indapamide ................................................................. 47
indomethacin ............................................................... 2
infants pain relief ................................................. 4
infusion set .................................................................. 60
infusion set 23" comfort ......................... 60
inject-ease .................................................................... 60
INJECT-EASE AUTOMATIC
INJECTOR ............................................................. 60
INSUFLON ............................................................. 60
insulin syringe ....................................................... 60
insulin syringe/needle ................................ 60
insupen pen needles ...................................... 60
INSUPEN SENSITIVE ...................... 60
INSUPEN ULTRAFIN ....................... 60
INSYTE AUTOGUARD
14GX1.75" ................................................................ 60
INSYTE AUTOGUARD
18GX1.16" ................................................................ 60
INSYTE AUTOGUARD
20GX1" .......................................................................... 60
INSYTE AUTOGUARD
20GX1.16" ................................................................ 60
INSYTE AUTOGUARD
22GX1" .......................................................................... 60
INSYTE AUTOGUARD
24GX3/4" .................................................................... 60
INTELENCE ....................................................... 21
intense cough reliever ............................... 34
INTERLINK INJECT
SITE/LUER LOC ........................................ 60
INTRON A ............................................................... 18
INVIRASE ............................................................... 21
INVOKANA .......................................................... 12
ipratropium bromide ........................... 8, 74
irbesartan ..................................................................... 16
irbesartan-hydrochlorothiazide
....................................................................................................... 16
iron (ferrous gluconate) ......................... 51
iron complex ............................................................ 51
IRON UP ..................................................................... 51
ISENTRESS .......................................................... 21
isoniazid ......................................................................... 18
isopropyl alcohol .............................................. 27
isopropyl alcohol wipes .......................... 43
isopropyl palmitate ........................................ 27
ISOPTO TEARS ........................................... 76
isosorbide dinitrate ........................................... 6
isosorbide dinitrate er ................................... 6
isosorbide mononitrate ................................ 6
isosorbide mononitrate er ....................... 6
JANTOVEN .............................................................. 9
JANUMET ............................................................... 12
JANUMET XR ................................................. 12
JANUVIA .................................................................. 12
JINTELI ...................................................................... 48
KALETRA ............................................................... 21
KANGAROO BURETTE SET
....................................................................................................... 60
KELNOR 1/35 ................................................... 27
ketoconazole ................................................. 14, 43
ketoprofen ........................................................................ 2
ketorolac tromethamine .................. 2, 76
KETOSTIX ............................................................ 46
ketotifen fumarate ............................................ 76
kinray insulin syringe ................................. 60
KIONEX .......................................................... 23, 79
kmart valu insulin syringe 29g ..... 60
kmart valu insulin syringe 30g ..... 61
KONSYL .................................................................... 53
KONSYL-D ............................................................ 53
K-PHOS ........................................................................ 69
K-PHOS NO 2 .................................................... 49
kpn prenatal .............................................................. 72
kroger insulin syringe ................................ 61
kroger pen needles ......................................... 61
L606 TUBING ................................................... 61
L609 TUBING ................................................... 61
labetalol hcl .............................................................. 24
LAC-HYDRIN FIVE ............................. 44
lactic acid ..................................................................... 44
lactic acid e ............................................................... 44
lactulose ......................................................................... 53
lactulose encephalopathy ..................... 49
lamivudine ................................................................... 21
lamivudine-zidovudine ............................. 21
lamotrigine ................................................................. 10
lansoprazole ............................................................. 82
LANTUS ...................................................................... 12
LANTUS SOLOSTAR ........................ 12
latanoprost ................................................................. 76
laxative pills ............................................................. 53
leader insulin syringe ................................. 61
LEADER UNIFINE PENTIPS
....................................................................................................... 61
LEADER UNIFINE PENTIPS
PLUS .................................................................................. 61
leflunomide ..................................................................... 2
letrozole .......................................................................... 18
leucovorin calcium ......................................... 19
LEUKERAN ......................................................... 19
levetiracetam ........................................................... 10
levobunolol hcl ..................................................... 76
levocetirizine dihydrochloride ...... 15
levofloxacin ............................................................... 48
levonorgest-eth estrad 91-day ...... 27
levonorgestrel ........................................................ 27
levonorgestrel-ethinyl estrad .......... 27
levothyroxine sodium .................................. 81
LEVOXYL ............................................................... 81
LEXINAL .................................................................. 86
LEXIVA ....................................................................... 21
lice killing maximum strength ....... 44
lice solution ............................................................... 44
lice treatment .......................................................... 44
LICIDE TREATMENT .................... 44
lidocaine ......................................................................... 44
lidocaine hcl ................................................. 44, 71
lidocaine hcl (pf) ............................................... 54
lidocaine viscous ............................................... 71
lidocaine-prilocaine ..................................... 44
lindane .............................................................................. 44
LIQUIMAT ............................................................ 44
liquituss gg ................................................................. 34
lisinopril ......................................................................... 17
lisinopril-hydrochlorothiazide ..... 17
LITE TOUCH PEN NEEDLES
....................................................................................................... 61
LITETOUCH INSULIN
SYRINGE .................................................................. 61
LITETOUCH PEN NEEDLES
....................................................................................................... 61
lithium carbonate ............................................. 20
lithium carbonate er ..................................... 20
LITTLE REMEDIES FOR
COLDS ........................................................................... 34
live better pen needles ............................... 61
LODRANE D ....................................................... 34
LOHIST-D ............................................................... 34
lomustine ....................................................................... 19
longs insulin syringe .................................... 61
loperamide hcl ...................................................... 13
loratadine ..................................................................... 15
95
Index
Index
Index
loratadine allergy relief ......................... 15
loratadine childrens ..................................... 15
loratadine-d 12hr ............................................. 34
loratadine-d 24hr ............................................. 34
lorazepam ......................................................................... 7
LORTUSS DM .................................................. 34
LORTUSS LQ ................................................... 34
losartan potassium ......................................... 17
losartan potassium-hctz .......................... 17
LOTRIMIN AF ............................................... 44
lovastatin ....................................................................... 16
LOW-OGESTREL .................................... 27
loxapine succinate ........................................... 20
LTXF PRIM CNV PIN
MICRODRIP ...................................................... 61
LTXF PRIM IV SET/CNVT PIN
....................................................................................................... 61
LTXF SECONDARY/CNV
PIN/32INC ................................................................ 61
lubricant eye drops ........................................ 76
LUFYLLIN ................................................................. 8
LUPRON DEPOT ....................................... 19
LUPRON DEPOT-PED .................... 47
M2 POTASSIUM ......................................... 86
mag-al .................................................................................... 6
mag-delay ..................................................................... 69
MAGELLAN INSULIN
SAFETY SYR ..................................................... 61
MAGINEX ............................................................... 69
MAGINEX DS ................................................... 69
magnesium .................................................................. 69
magnesium carbonate ............................... 69
magnesium chloride ..................................... 69
magnesium citrate ............................... 53, 69
magnesium gluconate ................................ 69
magnesium oxide ....................................... 6, 69
magnesium oxide -mg supplement
....................................................................................................... 69
magnesium sulfate ........................................... 69
MAGONATE ...................................................... 69
MAG-TAB SR ................................................... 69
malathion ...................................................................... 44
MAR-COF BP ................................................... 34
MATULANE ........................................................ 19
meclizine hcl ............................................................ 14
meclofenamate sodium ................................. 2
medic insulin syringe .................................. 61
medicine shoppe pen needles ......... 61
medi-first hydrocortisone ..................... 44
medroxyprogesterone acetate
........................................................................................... 27, 80
MEDSAVER SYRINGE .................. 61
mefloquine hcl ....................................................... 18
MEGA MULTIVITAMIN ............ 72
megestrol acetate .............................................. 19
meijer pen needles .......................................... 62
meloxicam ........................................................................ 2
m-end dmx ................................................................... 34
m-end max d ............................................................. 35
M-END PE ............................................................... 35
MENEST .................................................................... 48
meperidine hcl ........................................................... 4
mercaptopurine ................................................... 19
mesalamine ................................................................ 49
METADATE ER ............................................... 1
METAMUCIL ................................................... 53
METAMUCIL SMOOTH
TEXTURE ................................................................ 53
metaproterenol sulfate .................................. 8
metformin hcl .......................................................... 12
metformin hcl er ................................................. 12
methadone hcl ........................................................... 4
methanol ......................................................................... 27
methazolamide ...................................................... 47
methenamine hippurate ........................... 83
methenamine mandelate ........................ 83
methimazole .............................................................. 81
methocarbamol .................................................... 74
methotrexate ............................................................. 19
methyclothiazide ................................................ 47
methyl alcohol ....................................................... 27
methyldopa ................................................................. 17
methylergonovine maleate .................. 78
methylphenidate hcl .......................................... 1
methylphenidate hcl er ................................. 1
methylphenidate hcl er (cd) .................. 1
methylprednisolone ....................................... 28
metipranolol ............................................................. 76
metoclopramide hcl ....................................... 49
metolazone .................................................................. 47
metoprolol succinate er .......................... 24
metoprolol tartrate ......................................... 24
metoprolol-hydrochlorothiazide
....................................................................................................... 17
metronidazole ................................. 17, 44, 85
MI-ACID ......................................................................... 6
miconazole 3 ............................................................ 85
miconazole 3 combo pack ................... 85
miconazole 7 ............................................................ 85
miconazole nitrate ........................................... 44
miconazorb af ........................................................ 44
MICROGESTIN 1.5/30 ..................... 27
MICROGESTIN FE 1.5/30 ......... 27
midodrine hcl .......................................................... 85
migraine relief ........................................................... 4
minocycline hcl .................................................... 81
minoxidil ........................................................................ 17
mirtazapine ................................................................ 11
misoprostol ................................................................ 82
moexipril hcl ............................................................ 17
mometasone furoate ..................................... 44
MONOJECT INSULIN
SYRINGE .................................................................. 62
MONOJECT LIFESHIELD
SYRINGE .................................................................. 62
MONOJECT MAGELLAN
SYRINGE .................................................................. 62
MONOJECT ULTRA
COMFORT SYRINGE ...................... 62
montelukast sodium ........................................... 8
MOORE MONO INSULIN
SYRINGE .................................................................. 62
morphine sulfate .................................................... 4
morphine sulfate (concentrate) ....... 4
morphine sulfate er ............................................ 4
ms insulin syringe ............................................ 62
MUCINEX CHILD MS
DAY-NIGHT CLD ..................................... 35
MUCINEX COUGH FOR KIDS
....................................................................................................... 35
MUCINEX FAST-MAX
CONGEST COUGH ............................... 35
MUCINEX FAST-MAX
DAY/NIGHT ........................................................ 35
MUCINEX FOR KIDS ....................... 35
MUCINEX SINUS-MAX
DAY/NIGHT ........................................................ 35
mucus d ............................................................................ 35
mucus relief cold flu throat ............... 35
mucus relief cold/sinus max st ...... 35
mucus relief d ......................................................... 35
mucus relief severe congst/cgh .... 35
mucus-dm ..................................................................... 35
mucus-dm max ...................................................... 35
multi-delyn .................................................................. 72
multi-purpose solution .............................. 76
multivitamins ........................................................... 72
multivitamins pediatric ............................ 72
mupirocin ..................................................................... 44
mycophenolate mofetil .............................. 23
MYKIDZ IRON 10 .................................... 51
MYLERAN ............................................................. 19
MYNATAL ............................................................. 72
mynatal plus ............................................................. 72
mynate 90 plus ...................................................... 72
nabumetone ................................................................... 2
nadolol .............................................................................. 24
naloxone hcl ............................................................. 14
naltrexone hcl ........................................................ 14
NANOVM T/F ................................................... 72
naphazoline hcl ................................................... 76
naproxen ............................................................................ 3
naproxen dr ................................................................... 3
naproxen sodium ................................................... 3
naratriptan hcl ...................................................... 67
96
Index
Index
Index
NASACORT ALLERGY 24HR
....................................................................................................... 74
nasal decongestant ......................................... 74
nasal mist ...................................................................... 35
NASOPEN ................................................................ 35
NASOPEN PE .................................................... 35
NATALVIT ............................................................ 72
nateglinide .................................................................. 12
natural fiber laxative .................................. 53
natural fiber therapy ................................... 53
natural psyllium seed ................................. 53
natural senna laxative ............................... 53
NATURE-THROID ................................. 81
NECON 0.5/35 (28) .................................... 27
NECON 1/35 (28) .......................................... 27
NECON 1/50 (28) .......................................... 27
NECON 10/11 (28) ...................................... 28
NECON 7/7/7 ....................................................... 28
neomycin sulfate .................................................... 2
neomycin-bacitracin zn-polymyx
....................................................................................................... 76
neomycin-polymyxin-dexameth ... 76
neomycin-polymyxin-gramicidin
....................................................................................................... 76
neomycin-polymyxin-hc .............. 76, 78
NEO-POLYCIN HC ............................... 76
NEOSPORIN ESSENTIALS
TRIAL PK ................................................................ 44
NEOTUSS PLUS .......................................... 35
NEOTUSS-D ........................................................ 35
NERIA 29G INFUSION SET
10MM ............................................................................... 62
NERIA 29G INFUSION SET
6MM ................................................................................... 62
NERIA 29G INFUSION SET
8MM ................................................................................... 62
NERIA MULTI 27G 2X10MM
....................................................................................................... 62
NERIA MULTI 27G 3X10MM
....................................................................................................... 62
NERIA MULTI 27G 4X12MM
....................................................................................................... 62
NERIA SOFT 25G INFUSION
13MM ............................................................................... 62
NERIA SOFT 25G INFUSION
17MM ............................................................................... 62
NEUTROGENA CLEAR PORE
....................................................................................................... 44
nevirapine .................................................................... 21
nevirapine er ........................................................... 21
NEXAFED ................................................................ 74
NEXIUM 24HR ............................................... 82
niacin .................................................................................. 86
niacin er .......................................................................... 86
niacinamide ............................................................... 86
NIACOR ...................................................................... 16
nicardipine hcl ...................................................... 25
nicotine ............................................................................. 80
nicotine mini ............................................................ 80
nicotine polacrilex .......................................... 80
NICOTROL ........................................................... 80
NICOTROL NS .............................................. 80
nifedipine ...................................................................... 25
nifedipine er .............................................................. 25
nifedipine er osmotic release .......... 25
nighttime cough ................................................... 35
nimodipine .................................................................. 25
nite-time cold/flu relief ............................. 35
NITRO-BID ............................................................... 7
nitrofurantoin ......................................................... 83
nitrofurantoin macrocrystal ............. 83
nitrofurantoin monohyd macro ... 83
nitroglycerin ................................................................. 7
nitroglycerin er ........................................................ 7
NITROSTAT ........................................................... 7
NIVANEX DMX ............................................ 35
nohist-lq .......................................................................... 35
non-pseudo cold relief .............................. 36
NORDIPEN 5 INJECTION
DEVICE ....................................................................... 62
NORDIPEN DELIVERY
SYSTEM ..................................................................... 62
NOREL AD ............................................................ 36
norethin ace-eth estrad-fe ................... 28
norethindrone ......................................................... 28
norethindrone acetate ............................... 80
norethindrone acet-ethinyl est ...... 28
norethindrone-eth estradiol .............. 48
norgestimate-eth estradiol .................. 28
NORPACE CR ..................................................... 7
nortriptyline hcl .................................................. 11
NORVIR ...................................................................... 21
NOVAFERRUM PEDIATRIC
DROPS ........................................................................... 51
NOVOFINE ........................................................... 62
NOVOFINE AUTOCOVER ..... 62
NOVOFINE PLUS ..................................... 62
NOVOLIN 70/30 ............................................ 12
NOVOLIN 70/30 RELION .......... 12
NOVOLIN N ........................................................ 13
NOVOLIN N RELION ....................... 13
NOVOLIN R ........................................................ 13
NOVOLIN R RELION ....................... 13
NOVOLOG MIX 70/30 ...................... 13
NOVOPEN ECHO ..................................... 62
NOVOTWIST .................................................... 62
np thyroid ..................................................................... 81
nystatin ..................................................... 14, 44, 71
nystatin-triamcinolone ............................. 45
OBSTETRIX DHA .................................... 72
OBSTETRIX EC .......................................... 72
OC8 ...................................................................................... 45
O-CAL PRENATAL ............................... 72
ofloxacin ................................................. 48, 77, 78
olanzapine ................................................................... 20
omeprazole ................................................................. 82
omeprazole-sodium bicarbonate
....................................................................................................... 82
OMNIFLEX DIAPHRAGM ..... 62
OMNITROPE PEN 10 INJ
DEVICE ....................................................................... 62
OMNITROPE PEN 5 INJ
DEVICE ....................................................................... 62
ondansetron .............................................................. 14
ondansetron hcl ................................................... 14
ONE-A-DAY WOMENS
PRENATAL .......................................................... 72
ONETOUCH ULTRA
CONTROL .............................................................. 63
OPERAND
POVIDONE-IODINE ........................... 85
ORA-BLEND ...................................................... 79
ORA-BLEND SF ........................................... 79
ORACIT ...................................................................... 49
ORA-FILM ............................................................. 71
oral analgesic max st .................................. 71
oral anesthetic ....................................................... 71
ORAL MIX ............................................................. 79
ORAL MIX SF ................................................. 79
oral suspend ............................................................. 79
oral syrup ..................................................................... 79
oral syrup sf .............................................................. 79
ORA-PLUS ............................................................. 79
ORA-SWEET ..................................................... 79
ORA-SWEET SF .......................................... 79
ORAZINC ................................................................. 69
ORTHO DIAPHRAGM
ALL-FLEX .............................................................. 63
ORTHO DIAPHRAGM COIL
....................................................................................................... 63
ORTHO DIAPHRAGM FLAT
....................................................................................................... 63
OSTEO-PORETICAL ........................ 70
oxaprozin .......................................................................... 3
oxazepam .......................................................................... 7
oxcarbazepine ........................................................ 10
oxybutynin chloride ....................................... 83
oxybutynin chloride er .............................. 83
oxycodone hcl ............................................................ 5
oxycodone-acetaminophen ..................... 5
oxycodone-aspirin ............................................... 5
OXYTROL .............................................................. 83
OXYTROL FOR WOMEN ........ 83
oyster shell calcium/d ................................ 70
pa prenatal formula ...................................... 72
97
Index
Index
Index
paba ...................................................................................... 86
PANATUSS PED .......................................... 36
PANATUSS PED DROPS ............. 36
PANCREAZE ..................................................... 46
pancrelipase (lip-prot-amyl) ........... 46
pantoprazole sodium ................................... 82
paroxetine hcl ........................................................ 11
parva-cal ....................................................................... 70
pc unifine pentips ............................................. 63
PCCA SWEET-SF ...................................... 79
PCCA SYRUP VEHICLE ............. 79
PCCA-PLUS ......................................................... 79
PECGEN DMX ................................................ 36
PEDIACARE CHILD
ALLERGY/COLD ..................................... 36
PEDIA-LAX .......................................................... 53
PEDIALYTE ........................................................ 70
pediatric cough/cold .................................... 36
peg 3350 ......................................................................... 53
peg 3350/electrolytes .................................. 53
PEGINTRON ...................................................... 22
PEG-INTRON ................................................... 22
PEG-INTRON REDIPEN ............. 22
PEG-INTRON REDIPEN PAK
4 .................................................................................................. 22
pen needles ................................................................. 63
pen needles 1/2" ................................................. 63
pen needles 3/16" ............................................. 63
pen needles 5/16" ............................................. 63
penicillin v potassium .................... 78, 79
pentoxifylline er .................................................. 50
PEPCID AC MAXIMUM
STRENGTH .......................................................... 82
peppermint spirit ............................................... 27
PERFECT IRON .......................................... 51
PERIOMED .......................................................... 71
permethrin ................................................................... 45
perphenazine ........................................................... 20
PERRY PRENATAL ............................. 73
PERTZYE ................................................................ 46
phenazopyridine hcl ..................................... 50
phenelzine sulfate ............................................. 11
phenobarbital ......................................................... 52
phenylhistine dh .................................................. 36
phenytoin ....................................................................... 10
phenytoin sodium extended ............... 10
PHOSPHA 250 NEUTRAL ........ 70
pilocarpine hcl ...................................................... 71
pindolol ............................................................................ 24
pine tar ............................................................................. 27
pink bismuth ............................................................. 13
pink bismuth maximum strength
....................................................................................................... 13
PIN-X .................................................................................... 6
pioglitazone hcl ................................................... 13
pioglitazone hcl-metformin hcl .... 13
piroxicam .......................................................................... 3
plastic adapter ...................................................... 63
podofilox ........................................................................ 45
POLY HIST FORTE ............................. 36
poly vitamin ............................................................... 73
polyethylene glycol 3350 .......... 53, 79
poly-hist dm ............................................................... 36
poly-hist pd ................................................................ 36
poly-iron 150 forte ......................................... 51
polymyxin b-trimethoprim ................... 77
polysorbate 20 ....................................................... 27
polysorbate 40 ....................................................... 27
polysorbate 60 ....................................................... 27
polysorbate 80 ....................................................... 27
poly-tussin ................................................................... 36
poly-tussin ac .......................................................... 36
poly-tussin d ............................................................. 36
POLY-VENT DM ........................................ 36
POLY-VENT IR ............................................ 36
polyvitamin ................................................................. 73
polyvitamin/iron ................................................. 73
POTABA ..................................................................... 86
potassium bicarbonate ............................. 70
potassium chloride ......................................... 70
potassium chloride crys er ................. 70
potassium chloride er ................................. 70
potassium citrate-citric acid ............ 50
povidone-iodine .................................................. 20
PR NATAL 400 ................................................ 73
PR NATAL 430 ................................................ 73
pramipexole dihydrochloride ......... 19
pravastatin sodium ......................................... 16
prazosin hcl ............................................................... 17
PRECISION SUREDOSE PLUS
SYR ...................................................................................... 63
PRECISION SURE-DOSE
SYRINGE .................................................................. 63
PRECISION XTRA KETONE
....................................................................................................... 46
prednicarbate ......................................................... 45
prednisolone ............................................................. 28
prednisolone acetate ................................... 77
prednisolone sodium phosphate
........................................................................................... 28, 77
prednisone ................................................................... 28
preferred plus insulin syringe ....... 63
preferred plus unifine pentips ....... 63
PREMARIN .......................................................... 48
PREMPHASE .................................................... 48
PREMPRO .............................................................. 48
PRENATA ................................................................ 73
prenatabs fa .............................................................. 73
prenatal ........................................................................... 73
prenatal 19 ................................................................. 73
prenatal complete ............................................ 73
prenatal formula ................................................ 73
prenatal formula a-free ........................... 73
prenatal multi +dha ..................................... 73
PRENATAL MULTIVITAMIN
+ DHA .............................................................................. 73
prenatal plus ............................................................ 73
prenatal plus iron ............................................ 73
prenatal vitamins .............................................. 73
prenatal/omega-3/fa/iron ..................... 73
prenatal+dha .......................................................... 73
PRENATAL-U .................................................. 73
pres gen pediatric ............................................ 36
PRETZ ............................................................................ 27
PREZISTA .............................................................. 22
PRILOSEC OTC .......................................... 83
primaquine phosphate ............................... 18
primidone ..................................................................... 10
PRIMSOL ................................................................. 17
probenecid .................................................................. 50
pro-chlo ........................................................................... 36
prochlorperazine ............................................... 20
prochlorperazine maleate ................... 20
PRO-CLEAR AC ......................................... 36
PROCRIT ................................................................. 51
PROCTOCORT ................................................. 5
PROCTOZONE-HC ................................... 5
PRODIGY INSULIN SYRINGE
....................................................................................................... 63
profe forte .................................................................... 73
PROFERRIN ES ........................................... 51
promethazine hcl ............................................... 15
promethazine vc plain ............................... 36
promethazine vc/codeine ....................... 36
promethazine-codeine ............................... 36
promethazine-dm .............................................. 36
propafenone hcl ...................................................... 7
propantheline bromide ............................. 83
proparacaine hcl ............................................... 77
propranolol hcl .................................................... 24
propranolol hcl er ........................................... 24
propranolol-hctz ................................................ 17
propylthiouracil .................................................. 81
PRO-RED AC .................................................... 36
pseudoeph-bromphen-dm ..................... 36
pseudoephedrine hcl .................................... 74
pseudoephedrine hcl er ........................... 74
pseudoephedrine-guaifenesin er
....................................................................................................... 36
PULMOZYME ................................................. 80
purefe ob plus ......................................................... 73
px extra short pen needles .................. 63
px insulin syringe ............................................. 63
px mini pen needles ....................................... 63
px pen needle .......................................................... 63
98
Index
Index
Index
pyrazinamide ........................................................... 18
pyrilamine-phenylephrine ................... 36
qc childrens vitamins/extra c .......... 73
qc cold relief ............................................................ 36
qc cold relief plus ............................................. 37
qc flu relief therapy night ..................... 37
qc natural vegetable ..................................... 53
qc pen needles ....................................................... 63
qc unifine pentips ............................................. 63
q-pap ........................................................................................ 4
q-pap infants ................................................................ 4
Q-TAPP ......................................................................... 37
quetiapine fumarate ...................................... 20
quinapril hcl ............................................................. 17
quinapril-hydrochlorothiazide ..... 17
quinidine gluconate er .................................. 7
quinidine sulfate ..................................................... 7
quinine sulfate ....................................................... 18
ra acne maximum ............................................. 45
ra acne treatment ............................................. 45
ra allergy multi-symptom ..................... 37
ra allergy multi-symptom night ... 37
ra allergy plus sinus ..................................... 37
ra allergy relief childrens .................... 15
ra baby care oral pain relief ........... 71
ra calcium-boron .............................................. 70
ra childrens cold & allergy ............... 37
ra cold & flu ............................................................. 37
ra cold/cough sinus relief pe ........... 37
ra col-rite ...................................................................... 53
ra ethyl alcohol .................................................... 27
ra first aid anti-itch spray ................... 45
ra flu maximum strength ....................... 37
ra glycerin child ................................................. 53
ra insulin syringe .............................................. 63
ra laxative .................................................................... 54
ra laxative extra strength ..................... 54
ra lice bedding ...................................................... 45
ra lice egg remover ....................................... 45
ra one daily ................................................................ 73
ra pen needles ........................................................ 63
ra pink bismuth .................................................... 13
ra probiotic digestive care ................. 13
ra severe cold/sinus relief pe .......... 37
ra sinus congst/pain day/night ..... 37
ra sleep aid ................................................................. 52
ra sleep aid (diphenhydramine)
....................................................................................................... 52
ra sleep-aid nighttime ................................ 52
ra sterile eye drops ........................................ 77
ra suphedrine day/night combo
....................................................................................................... 37
ra suphedrine pe ................................................ 37
ra wart remover .................................................. 45
ramipril ............................................................................ 17
ranitidine hcl ........................................................... 83
REDNESS RELIEF .................................. 77
redness relief max strength ............... 77
redness reliever eye drops .................. 77
reeses pinworm medicine ......................... 6
refenesen plus ........................................................ 37
REFRESH OPTIVE
ADVANCED ......................................................... 77
relcof c .............................................................................. 37
RELENZA DISKHALER .............. 22
RELION INSULIN SYRINGE
....................................................................................................... 64
RELI-ON INSULIN SYRINGE
....................................................................................................... 64
RELION MINI PEN NEEDLES
....................................................................................................... 64
RELION PEN NEEDLES ............. 64
RELION SHORT PEN
NEEDLES ................................................................. 64
RENAGEL ............................................................... 49
RENAL .......................................................................... 73
RESCON DM ...................................................... 37
RESCRIPTOR .................................................. 22
RESPAIRE-30 ................................................... 37
RETAINE MGD ............................................ 77
REYATAZ ............................................................... 22
REZAMID ................................................................ 45
RHINOCORT ALLERGY .......... 74
RHOGAM ULTRA-FILTERED
PLUS .................................................................................. 78
RIBASPHERE .................................................. 22
ribavirin .......................................................................... 22
riboflavin ....................................................................... 86
RID ESSENTIAL LICE
ELIMINATION .............................................. 45
rifampin ........................................................................... 18
RIFATER .................................................................. 18
rimantadine hcl ................................................... 22
risedronate sodium ........................................ 48
risperidone ................................................................. 20
rizatriptan benzoate ...................................... 67
ROBITUSSIN CHILD
COUGH/COLD CF .................................. 37
ROBITUSSIN CHILD
COUGH/COLD LA .................................. 37
ROBITUSSIN DAY/NIGHT
VALUE PAK ....................................................... 37
ROBITUSSIN NIGHTTIME
COUGH DM ......................................................... 37
ROBITUSSIN PEAK COLD
MULTI-SYM ....................................................... 37
ROBITUSSIN PK COLD
DAY/NGHT DM ............................................ 37
ROBITUSSIN PK COLD
DAY/NGHT MS ............................................. 37
ropinirole hcl .......................................................... 19
ru-hist d ........................................................................... 37
rymed .................................................................................. 37
SAFE TUSSIN PM .................................... 38
SAFELET IV CATHETER ........ 64
SAFESNAP INSULIN
SYRINGE .................................................................. 64
SAFETY-GLIDE SYRINGE .... 64
saline nasal spray ............................................ 75
salsalate .............................................................................. 4
SANTYL ...................................................................... 45
sb daytime sinus ................................................. 38
sb insulin syringe .............................................. 64
sb severe cold congestion .................... 38
scalp vein set ........................................................... 64
schnucks insulin syringe ........................ 64
SCHOOLTIME SHAMPOO ... 45
SCOT-TUSSIN DM .................................. 38
SCOT-TUSSIN SENIOR ................ 38
sebex ..................................................................................... 45
selegiline hcl ............................................................ 19
selenium sulfide ................................................... 45
SELZENTRY ...................................................... 22
senna .................................................................................... 54
senna laxative ........................................................ 54
senna leaves .............................................................. 54
senna-docusate sodium ........................... 54
SENSIPAR ............................................................... 48
SEREVENT DISKUS ............................... 8
sertraline hcl ........................................................... 11
sf 5000 plus ................................................................ 71
SFROWASA ......................................................... 49
SHOPKO UNIFINE PENTIPS
....................................................................................................... 64
silphen cough .......................................................... 15
silver sulfadiazine ............................................ 45
simethicone ................................................................ 49
simvastatin .................................................................. 16
SINADRIN PE COMPLETE
SINUS REL ............................................................ 38
sinus daytime/nighttime .......................... 38
sinus maximum strength ......................... 38
slow iron ........................................................................ 51
slow release iron ............................................... 51
sm camphor spirit ............................................ 27
sm cough/runny nose childrens ... 38
sm ibuprofren cold childrens .......... 38
sm insulin syringe ............................................ 64
sm pain reliever sinus pe ...................... 38
sm redness relief ................................................ 77
sm slow release iron .................................... 51
sm tussin cf ................................................................. 38
sodium ascorbate .............................................. 86
sodium bicarbonate ............................... 6, 27
sodium chloride ........................... 38, 50, 70
99
Index
Index
Index
sodium chloride (hypertonic) ......... 77
sodium chloride flush ................................. 70
sodium fluoride .................................................... 70
sodium polystyrene sulfonate
........................................................................................... 23, 79
sodium silicate ...................................................... 27
SOLUBLE FIBER THERAPY
....................................................................................................... 54
solution administration set ................ 64
solution transfer device ........................... 64
sotalol hcl ..................................................................... 24
sotalol hcl (af) ....................................................... 24
SPATONE PUR-ABSORB
IRON ................................................................................. 51
spironolactone ...................................................... 47
spironolactone-hctz ....................................... 47
stahist ad ....................................................................... 38
stavudine ........................................................................ 22
STEP 2 ............................................................................ 45
STERILE LUBRICANT .................. 77
sterile water for irrigation .................. 23
stress formula/iron ......................................... 73
stress formula/zinc .......................................... 73
STRIBILD ................................................................ 22
STRIVERDI RESPIMAT .................. 9
STUART ONE .................................................. 73
sucralfate ...................................................................... 83
SUDAFED PE DAY & NIGHT
....................................................................................................... 38
SUDOGEST SINUS/ALLERGY
....................................................................................................... 38
sulfacetamide sodium ................................. 77
sulfacetamide sodium (acne) .......... 45
sulfacetamide sodium-sulfur ........... 45
sulfacetamide-prednisolone ............. 77
sulfadiazine ................................................................ 80
sulfamethoxazole-trimethoprim
........................................................................................... 17, 18
sulfasalazine ............................................................ 49
sulindac ............................................................................... 3
sumatriptan succinate ............................... 67
super b complex/vitamin c .................. 73
super strength sinadrin ............................ 38
SUPERVITE EC ........................................... 73
supress a pediatric ......................................... 38
supress dm pediatric .................................... 38
SUPRESS-PE PEDIATRIC ....... 38
sure comfort insulin syringe ............ 64
sure comfort pen needles ...................... 64
SURE-FINE PEN NEEDLES
....................................................................................................... 64
SURE-JECT INSULIN
SYRINGE .................................................................. 65
SURE-T INFUSION SET 18"
....................................................................................................... 65
SURE-T INFUSION SET 23"
thiothixene ................................................................... 20
ticlopidine hcl ........................................................ 50
timolol maleate ........................................ 24, 77
TIVICAY .................................................................... 23
tizanidine hcl ........................................................... 74
tl icon .................................................................................. 51
tobramycin .................................................................. 77
tobramycin-dexamethasone .............. 77
todays health mini pen needles .... 65
todays health pen needles .................... 65
todays health short pen needle ..... 65
tolterodine tartrate ......................................... 83
tolterodine tartrate er ................................ 83
topcare clickfine pen needles ......... 65
topcare ultra comfort ins syr .......... 65
topiramate ................................................................... 10
torsemide ....................................................................... 47
TOUJEO SOLOSTAR ........................ 13
TOVIAZ ....................................................................... 83
tramadol hcl ................................................................. 5
trandolapril ............................................................... 17
tranylcypromine sulfate .......................... 11
travoprost ..................................................................... 77
trazodone hcl ............................................... 11, 80
TRECATOR ......................................................... 18
tretinoin ............................................................... 19, 45
TREXBROM ....................................................... 39
triactin chest congestion ........................ 39
triamcinolone acetonide
............................................................................... 45, 46, 71
TRIAMINIC CHEST/NASAL
CONGEST ............................................................... 39
TRIAMINIC COLD/ALLERGY
CHILD ............................................................................ 39
TRIAMINIC COLD/COUGH
DAY TIME .............................................................. 39
TRIAMINIC COUGH & SORE
THROAT .................................................................... 39
TRIAMINIC COUGH/RUNNY
NOSE ................................................................................ 15
TRIAMINIC COUGH/SORE
THROAT .................................................................... 39
TRIAMINIC NIGHT TIME
COLD/CGH ........................................................... 39
triamterene-hctz ................................................. 47
triazolam ........................................................................ 52
trifluoperazine hcl ........................................... 20
trifluridine ................................................................... 77
trihexyphenidyl hcl ......................................... 19
TRILYTE .................................................................. 54
trimethobenzamide hcl ............................. 14
trimethoprim ............................................................ 18
trinatal rx 1 ................................................................ 74
TRINESSA (28) ............................................... 28
triple paste af .......................................................... 46
100
.......................................................................................................
65
SURE-T INFUSION SET 32"
65
surgical dressing ............................................... 65
SUSTIVA .................................................................... 22
SYMBICORT ......................................................... 9
SYNAGIS ................................................................... 78
SYNATEK ................................................................ 74
SYNTHROID ...................................................... 81
syringe luer slip .................................................. 65
syrpalta ............................................................................ 79
SYRPALTA (RED) ................................... 79
SYRSPEND SF ................................................. 79
SYSTANE OVERNIGHT
THERAPY ............................................................... 77
TABLOID ................................................................. 19
tacrolimus .................................................................... 23
TAMIFLU ................................................................. 22
tamoxifen citrate ................................................ 19
tamsulosin hcl ........................................................ 50
TANZEUM ............................................................. 13
TARON-BC ............................................................ 74
TAZTIA XT .......................................................... 25
temazepam .................................................................. 52
terazosin hcl ............................................................. 17
terbinafine hcl ........................................... 14, 45
terbutaline sulfate ................................................ 9
terconazole ................................................................. 85
terpin hydrate ......................................................... 38
TERUMO INSULIN SYRINGE
....................................................................................................... 65
TERUMO SURGUARD
INSULIN SYR ................................................... 65
TERUMO SURGUARD2
SYRINGE .................................................................. 65
testosterone cypionate ................................... 5
tg 10peh/380gfn .................................................. 38
tgq 15dm/5peh/2cpm ................................... 38
tgq 30pse/150gfn/15dm ........................... 38
THEO-24 ........................................................................ 9
theophylline ................................................................... 9
theophylline er .......................................................... 9
theracaps cough/cold reliever ...... 38
THERAFLU MAX-D COLD &
FLU ...................................................................................... 38
THERAFLU SEVERE COLD &
COUGH ........................................................................ 39
THERAFLU SEVERE COLD
DAYTIME ................................................................ 39
THERANATAL COMPLETE
....................................................................................................... 74
therapeutic liquid ............................................. 74
THINPRO INSULIN SYRINGE
....................................................................................................... 65
.......................................................................................................
Index
Index
Index
TRISPEC DMX ............................................... 39
TRIUMEQ ............................................................... 23
tri-vit/fluoride ........................................................ 74
tri-vitamin/fluoride ........................................ 74
TRIVORA (28) ................................................. 28
trixaicin hp ................................................................. 46
tropicamide ................................................................ 77
trospium chloride ............................................. 83
trospium chloride er ..................................... 83
TRUEPLUS INSULIN
SYRINGE .................................................................. 65
TRUVADA .............................................................. 23
trymine cg .................................................................... 39
TUDORZA PRESSAIR ......................... 9
turpentine ..................................................................... 27
TUSICOF ................................................................... 39
TUSNEL ...................................................................... 39
TUSNEL C .............................................................. 39
TUSNEL PEDIATRIC ....................... 39
tussafex ex ................................................................... 39
tussafex-a ...................................................................... 39
tussin cf cough & cold .............................. 39
tussin cf max multi-symptom ........... 39
tussin chest congestion ............................. 39
tussin cold/congestion ............................... 39
tussin cough .............................................................. 39
tussin dm max ......................................................... 39
tussi-pres b ................................................................. 40
TUSSLIN .................................................................... 40
TUSSLIN PEDIATRIC ..................... 40
TYLENOL CHILDRENS
COLD/STUFFY .............................................. 40
TYLENOL CHILDRENS PLUS
CLD/CGH ................................................................. 40
ULTICARE INSULIN SAFETY
SYR ...................................................................................... 65
ULTICARE INSULIN
SYRINGE .................................................................. 66
ULTICARE MICRO PEN
NEEDLES ................................................................. 66
ULTICARE MINI PEN
NEEDLES ................................................................. 66
ULTICARE PEN NEEDLES ... 66
ULTICARE SHORT PEN
NEEDLES ................................................................. 66
ULTICARE SYRINGE ...................... 66
ULTILET INSULIN SYRINGE
SHORT .......................................................................... 66
ULTILET PEN NEEDLE .............. 66
ultra comfort insulin syringe .......... 66
ultra-comfort insulin syringe .......... 66
ultra-mega ................................................................... 74
ULTRA-THIN II INS SYR
SHORT .......................................................................... 66
ULTRESA ................................................................ 46
undecylenic acid ................................................ 27
UNIFINE PENTIPS ................................. 66
unifine pentips plus ........................................ 66
UNITHROID ....................................................... 81
UPCAL D ................................................................... 70
urea ........................................................................................ 46
URO-MAG .................................................................. 6
ursodiol ............................................................................ 49
VACUTAINER TUBING ............... 66
valacyclovir hcl ................................................... 23
valproic acid ............................................................ 10
value health insulin syringe .............. 66
valumark pen needles ................................. 66
VANACOF APE ............................................ 40
VANACOF DM ............................................... 40
VANACOF G ...................................................... 40
VANACOF GPE ............................................ 40
VANACOF-8 ........................................................ 40
VANATAB DX ................................................. 40
vancomycin hcl .................................................... 18
VANISHPOINT 18GX1-1/4"
FEP ....................................................................................... 66
VANISHPOINT 18GX1-1/4"
PUR ...................................................................................... 66
VANISHPOINT 20GX1-1/4"
FEP ....................................................................................... 66
VANISHPOINT 20GX1-1/4"
PUR ...................................................................................... 66
VANISHPOINT 22GX1" FEP
....................................................................................................... 67
VANISHPOINT 22GX1" PUR
....................................................................................................... 67
VANISHPOINT 24GX3/4" FEP
....................................................................................................... 67
VANISHPOINT 24GX3/4" PUR
....................................................................................................... 67
VANISHPOINT INSULIN
SYRINGE .................................................................. 67
VANISHPOINT SYRINGE ....... 67
vaporizing steam ............................................... 40
VASOLEX ................................................................ 46
VAZOBID-PD .................................................... 40
VELIVET .................................................................. 28
venlafaxine hcl ...................................................... 11
venlafaxine hcl er ............................................. 11
VENTOLIN HFA ............................................. 9
verapamil hcl .......................................................... 25
verapamil hcl er ................................................. 25
VERSAFREE ...................................................... 79
VERSAPLUS ....................................................... 79
VESICARE ............................................................. 83
VIBRAMYCIN ................................................. 81
VICKS DAYQUIL MUCUS
CONTROL DM ............................................... 40
VICKS DAYQUIL SEVERE
COLD/FLU ............................................................. 40
VICKS NATURE FUSION
COLD & FLU ..................................................... 40
VICKS NATURE FUSION
CONGEST ............................................................... 40
VICKS NYQUIL CHILDRENS
CLD/CGH ................................................................. 40
VICKS NYQUIL COLD & FLU
NIGHT ............................................................................ 40
VIDA MIA UNIFINE PENTIPS
....................................................................................................... 67
VIDEX ............................................................................. 23
VINATE II ............................................................... 74
VINATE M .............................................................. 74
VIOKACE ................................................................ 46
VIRACEPT ............................................................. 23
VIRAMUNE ......................................................... 23
virdec .................................................................................. 40
virdec dm ....................................................................... 40
VIREAD ....................................................................... 23
virt-vite gt ..................................................................... 74
VITALINE BUFFERED
ZINC-220 .................................................................... 70
vitamin b-1 .................................................................. 86
vitamin b-12 .............................................................. 51
vitamin b-2 .................................................................. 86
vitamin b6 .................................................................... 86
vitamin b-6 .................................................................. 86
vitamin b-6 er ......................................................... 86
vitamin c ......................................................................... 86
vitamin c (calcium ascorbate) ....... 86
vitamin c drops ..................................................... 86
vitamin c er ................................................................ 86
vitamin c-electrolytes ................................. 74
vitamin c-rose hips er ................................ 86
vitamin d (cholecalciferol) ................. 86
vitamin d (ergocalciferol) .................... 86
vitamin d3 .................................................................... 86
vitamin e ......................................................................... 86
vitamin k (phytonadione) ...................... 87
vp insulin syringe ............................................. 67
V-R MONO INSULIN
SYRINGE .................................................................. 67
VYVANSE .................................................................... 2
WAL-FLU COLD & SORE
THROAT .................................................................... 40
WAL-FLU SEVERE COLD
DAYTIME ................................................................ 40
wal-som ........................................................................... 52
warfarin sodium ..................................................... 9
warm mist vaporizer .................................... 67
wegmans unifine pentips plus ........ 67
WESTHROID .................................................... 81
101
Index
WIDE-SEAL DIAPHRAGM 60
....................................................................................................... 67
WIDE-SEAL DIAPHRAGM 65
....................................................................................................... 67
WIDE-SEAL DIAPHRAGM 70
....................................................................................................... 67
WIDE-SEAL DIAPHRAGM 75
....................................................................................................... 67
WIDE-SEAL DIAPHRAGM 80
....................................................................................................... 67
WIDE-SEAL DIAPHRAGM 85
....................................................................................................... 67
WIDE-SEAL DIAPHRAGM 90
....................................................................................................... 67
WIDE-SEAL DIAPHRAGM 95
....................................................................................................... 67
WP THYROID ................................................. 81
XARELTO ................................................................... 9
zaleplon ........................................................................... 52
ZARXIO ...................................................................... 51
ZENPEP ....................................................................... 46
ZIAGEN ....................................................................... 23
zidovudine .................................................................... 23
ZINC 15 ........................................................................ 70
zinc sulfate .................................................................. 70
ziprasidone hcl ..................................................... 20
ZODRYL AC 25 ............................................. 41
ZODRYL AC 30 ............................................. 41
ZODRYL AC 35 ............................................. 41
ZODRYL AC 40 ............................................. 41
ZODRYL DAC 25 ....................................... 41
ZODRYL DAC 30 ....................................... 41
ZODRYL DAC 35 ....................................... 41
ZODRYL DAC 40 ....................................... 41
ZODRYL DEC 25 ....................................... 41
ZODRYL DEC 30 ....................................... 41
ZODRYL DEC 35 ....................................... 41
ZODRYL DEC 40 ....................................... 41
zolpidem tartrate ............................................... 52
zonisamide .................................................................. 10
ZOSTAVAX .......................................................... 84
ZOVIA 1/50E (28) ....................................... 28
Z-TUSS AC ............................................................. 41
ZYNCOF ..................................................................... 41
102

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