|
Class |
Generic Name |
Brand Name |
Restriction |
|
DE350 |
A & D OINT (OTC) |
VITAMIN A AND D |
Open Formulary
|
|
AM800 |
ABACAVIR 300MG TAB |
ZIAGEN |
Restricted to HIV prescribers
|
|
AM800 |
ABACAVIR 300MG/LAMIVUDINE 150MG/ZIDOVUDINE 300MG COMB TAB |
TRIZIVIR |
Restricted to HIV prescribers
|
|
AM800 |
ABACAVIR ORAL SOLN |
ZIAGEN |
HIV
|
|
AM800 |
ABACAVIR/LAMIVUDINE ORAL |
EPZICOM |
HIV - ID
|
|
BL117 |
ABCIXIMAB INJ 2MG/ML 5ML |
REOPRO |
Restrictions per local facility
|
|
HS502 |
ACARBOSE ORAL TAB |
PRECOSE |
Open Formulary
|
|
CN101 |
ACETAMINOPHEN 300MG/CODEINE 30MG TAB |
TYLENOL #3 |
Open Formulary
|
|
CN103 |
ACETAMINOPHEN 325MG TAB |
TYLENOL |
Open Formulary
|
|
CN103 |
ACETAMINOPHEN 325MG/BUTALBITAL 50MG/CAFFEINE 40MG ORAL |
FIORICET |
Open Formulary
|
|
CN103 |
ACETAMINOPHEN ELIXIR 160MG/5ML |
TYLENOL |
Open Formulary
|
|
CN103 |
ACETAMINOPHEN SUPP 650MG |
TYLENOL |
Open Formulary
|
|
CV703 |
ACETAZOLAMIDE 250MG REGULAR RELEASE TAB |
DIAMOX |
Open Formulary
|
|
CV703 |
ACETAZOLAMIDE INJ 500MG |
DIAMOX |
Acetazolamide SA
|
|
IR100 |
ACETIC ACID IRRIGATION SOLN |
N/A |
Open Formulary
|
|
OT109 |
ACETIC ACID OTIC SOLN |
VOSOL |
Open Formulary
|
|
OT109 |
ACETIC ACID/ALUMINUM ACETATE OTIC SOLN |
DOMEBORO OTIC SOLN |
Open Formulary
|
|
OT250 |
ACETIC ACID/HC/ OTIC SOLN |
VOSUL HC |
Open Formulary
|
|
OP102 |
ACETYLCHOLINE CL OPH SOLN |
MIOCHOL |
Open Formulary
|
|
RE400 |
ACETYLCYSTEINE INHL SOLN |
MUCOMYST |
Open Formulary
|
|
AD000 |
ACETYLCYSTEINE INJ 1GM/5ML |
ACETADOSE |
Acetylcysteine IV
|
|
RE400 |
ACETYLCYSTEINE INJ 20% 30ML |
MUCOMYST |
Restrictions per local facility
|
|
DE810 |
ACITRETIN ORAL |
SORIATANE |
Acitretin
|
|
DE103 |
ACYCLOVIR 5% TOP OINT |
ZOVIRAX |
Restricted to Dermatology or local equivalent
|
|
AM800 |
ACYCLOVIR NA INJ |
ZOVIRAX |
Restrictions per local facility
|
|
AM800 |
ACYCLOVIR ORAL |
ZOVIRAX |
Open Formulary
|
|
AM800 |
ADEFOVIR DIPIVOXIL ORAL |
HEPSERA |
GI and ID
|
|
CV300 |
ADENOSINE INJ |
ADENOCARD |
Restricted to Cardiology Service or local equivalent
|
|
XA603 |
ADHESIVE AEROSOL |
N/A |
Open Formulary
|
|
XA603 |
ADHESIVE CEMENT |
N/A |
Open Formulary
|
|
XA699 |
ADHESIVE REMOVER |
N/A |
Open Formulary
|
|
XA900 |
ADHESIVE REMOVER PAD (OTC) |
N/A |
Open Formulary
|
|
XA900 |
ADHESIVE REMOVER SPRAY (OTC) |
N/A |
Open Formulary
|
|
AP200 |
ALBENDAZOLE ORAL |
ALBENZA |
Open Formulary
|
|
BL500 |
ALBUMIN INJ 25% 50ML |
ALBUMINAR |
Restrictions per local facility
|
|
RE102 |
ALBUTEROL INHALATION SOLUTION |
PROVENTIL |
Neb solutions
|
|
RE109 |
ALBUTEROL 90MCG/IPRATROPIUM 18MCG 200DOSE ORAL INHL |
COMBIVENT |
Open Formulary
|
|
RE102 |
ALBUTEROL CFC-F 90MCG 200DOSE ORAL INHALER |
PROVENTIL |
Open Formulary
|
|
RE103 |
ALBUTEROL SULFATE 2MG, 4MG TAB |
PROVENTIL |
Open Formulary
|
|
RE109 |
ALBUTEROL/IPRATROPIUM INHL, SOLN |
N/A |
Oral solution inh
|
|
DE101 |
ALCOHOL ISOPROPYL 70% (OTC) |
N/A |
Open Formulary
|
|
XA105 |
ALCOHOL PREP PAD |
N/A |
Open Formulary
|
|
TN900 |
ALCOHOL, ABSOLUTE INJ |
N/A |
Restrictions per local facility
|
|
DE900 |
ALCOHOL, ISOPROPYL 70% 473ML |
N/A |
Ward
|
|
PH000 |
ALCOHOL,DENATURED 473ML |
N/A |
Open Formulary
|
|
PH000 |
ALCOHOL,DENATURED 95% 5GAL. |
N/A |
Open Formulary
|
|
TN101 |
ALCOHOL/DEXTROSE INJ |
N/A |
Open Formulary
|
|
IM700 |
ALDESLEUKIN INJ |
PROLEUKIN |
Restrictions per local facility
|
|
HS900 |
ALENDRONATE ORAL 10MG, 40MG, 70MG |
FOSAMAX |
Open Formulary
|
|
CN101 |
ALFENTANIL INJ 0.5MG/ML 10ML |
ALFENTA |
Restrictions per local facility
|
|
GA199 |
ALGINIC ACID/NA BICARB/CA STEARATE/MAG TRI CHEW ORAL |
GAVISCON; = ALOH 80/MG TRISIL 20MG CHEW TAB |
Open Formulary
|
|
IM900 |
ALLERGENIC EXTRACT (VARIOUS) |
N/A |
Open Formulary
|
|
MS400 |
ALLOPURINOL 100MG TAB |
ZYLOPRIM |
Open Formulary
|
|
MS400 |
ALLOPURINOL 300MG TAB |
ZYLOPRIM |
Open Formulary
|
|
GA199 |
ALOH/MGOH/SIMTH XTRA STRENGTH |
MAALOX |
Open Formulary
|
|
CN302 |
ALPRAZOLAM ORAL |
XANAX |
Restricted to Psychiatry/Mental Health or local equivalent
|
|
HS875 |
ALPROSTADIL URETHRAL SUPP (MUSE) |
MUSE |
Alprostadil
|
|
HS875 |
ALPROSTADIL INJ (CAVERJECT DRY POWDER VIALS) |
CAVERJECT |
Alprostadil
|
|
BL115 |
ALTEPLASE, RECOMBINANT INJ (TPA) |
ACTIVASE |
Restrictions per local facility
|
|
DE450 |
ALUMINUM CHLORIDE HEXAHYDRATE |
DRYSOL |
Open Formulary
|
|
GA101 |
ALUMINUM HYDROXIDE GEL 320MG/5ML |
AMPHOGEL |
Open Formulary
|
|
DE900 |
ALUMINUM SULF/CALCIUM ACE POWDER PACKETS |
DOMEBORO SOLUTION |
Open Formulary
|
|
AM800 |
AMANTADINE HCL 100MG CAP |
SYMMETREL |
Open Formulary
|
|
AM800 |
AMANTADINE SYRUP 50MG/5ML 473M |
SYMMETREL |
Open Formulary
|
|
AM300 |
AMIKACIN SULFATE INJ |
AMIKIN |
Restrictions per local facility
|
|
TN501 |
AMINO ACID INJ 8.5% 500ML |
AMINOSYN |
Restrictions per local facility
|
|
TN501 |
AMINO ACIDS/DEXTROSE INJ |
N/A |
Restrictions per local facility
|
|
BL116 |
AMINOCAPROIC ACID 500MG TAB |
AMICAR |
Open Formulary
|
|
BL116 |
AMINOCAPROIC ACID INJ 250MG/ML |
AMICAR |
Open Formulary
|
|
RE104 |
AMINOPHYLLINE INJ 25MG/ML 10ML |
TRUPHYLINE |
Restrictions per local facility
|
|
CV300 |
AMIODARONE INJ |
CORDARONE |
Restricted to Cardiology Service or local equivalent
|
|
CV300 |
AMIODARONE ORAL TAB |
CORDARONE |
Restricted to Cardiology Service or local equivalent
|
|
CN601 |
AMITRIPTYLINE HCL 10MG, 25MG, 50MG TAB |
ELAVIL |
Open Formulary
|
|
CV200 |
AMLODIPINE ORAL TAB |
NORVASC |
DHP CCB
|
|
RE900 |
AMMONIA AROMATIC INHALANT 0.33 |
N/A |
Open Formulary
|
|
TN499 |
AMMONIUM CHLORIDE INJ |
|
Open Formulary
|
|
DE350 |
AMMONIUM LACTATE 12% LOTION |
LAC HYDRIN |
Open Formulary
|
|
DE350 |
AMMONIUM LACTATE CREAM |
LAC HYDRIN |
Open Formulary
|
|
AM111 |
AMOXICILLIN 250MG CAP |
AMOXIL |
Open Formulary
|
|
AM111 |
AMOXICILLIN ORAL SUSP 250MG/5ML |
AMOXIL |
Open Formulary
|
|
AM111 |
AMOXICILLIN/CLAVULANATE K ORAL |
AUGMENTIN |
Restricted to ID Service or local equivalent
|
|
AM700 |
AMPHOTERICIN B INJ 50MG/VIAL |
FUNGIZONE |
Open Formulary
|
|
AM700 |
AMPHOTERICIN B LIPID COMPLEX INJ |
ALBECET |
Amphotericin B lipid
|
|
AM111 |
AMPICILLIN INJ 1GM/VIAL |
OMNIPEN |
Open Formulary
|
|
AM111 |
AMPICILLIN INJ 2GM/VIAL |
OMNIPEN |
Open Formulary
|
|
AM111 |
AMPICILLIN NA/SULBACTAM NA INJ |
UNASYN |
Restrictions per local facility
|
|
CV250 |
AMYL NITRITE INHL |
N/A |
Open Formulary
|
|
BL400 |
ANAGRELIDE HCL ORAL CAPSULE |
AGRYLIN |
Anagrelide
|
|
AN900 |
ANASTRAZOLE ORAL TAB |
ARIMIDEX |
Anastrozole
|
|
DE820 |
ANTHRALIN 0.1% TOP CREAM |
ANTHRADERM |
Open Formulary
|
|
DE820 |
ANTHRALIN 0.5% TOP CREAM |
ANTHRADERM |
Open Formulary
|
|
DE820 |
ANTHRALIN 1% TOP CREAM |
ANTHRADERM |
Open Formulary
|
|
IM900 |
ANTI-THYMOCYTE GLOBULIN INJ |
ATGAM |
Restrictions per local facility
|
|
BL500 |
ANTIHEMOPHILIC FACTOR,HUMAN INJ |
HEMOFIL |
Restrictions per local facility
|
|
OT400 |
ANTIPYRINE/BENZOCAINE/GLYCERIN OTIC SOLN |
AURALGAN |
Open Formulary
|
|
IM300 |
ANTIVENIN,CROTALIDAE POLYVALENT INJ |
CROFAB |
Open Formulary
|
|
CN500 |
APOMORPHINE ORAL |
N/A |
Neurology
|
|
XA900 |
APPLIANCE CLEANSING SUPPLIES |
N/A |
Open Formulary
|
|
OP900 |
APRACLONIDINE HCL OPH SOLN |
IODIPINE |
Restricted to Ophthalmology or eye clinic
|
|
GA605 |
APREPITANT CAP,ORAL |
EMEND |
Aprepitant
|
|
XA204 |
AQUACEL RIBBON |
AQUACEL |
Open Formulary
|
|
CN709 |
ARIPIPRAZOLE INJ |
ABILIFY |
Atypical antipsychotic inj
|
|
CN709 |
ARIPIPRAZOLE ORAL TAB |
ABILIFY |
Atypical Antipsychotics
|
|
OR500 |
ARTIFICIAL SALIVA (OTC) |
SALIVA SUBSTITUTE |
Open Formulary
|
|
OP500 |
ARTIFICIAL TEARS - METHYLCELLULOSE/DEXTRAN-70 |
BION TEARS, AKWA TEARS, ISOPTO TEARS |
Open Formulary
|
|
OP500 |
ARTIFICIAL TEARS - POLYVINYL ALCOHOL (PF) (OTC) |
TERGEN, REFRESH |
Open Formulary
|
|
CN103 |
ASA/BUTALBITAL/CAFN ORAL |
FIORINAL |
Open Formulary
|
|
VT400 |
ASCORBIC ACID 500MG TAB |
VITAMIN C |
Open Formulary
|
|
VT400 |
ASCORBIC ACID INJ 500MG/2ML |
VITAMIN C |
Open Formulary
|
|
AN900 |
ASPARAGINASE INJ |
ELSPAR |
Restrictions per local facility
|
|
BL117 |
ASPIRIN + DIPYRIDAMOLE SA ORAL |
AGGRENOX |
Aggrenox
|
|
CN103 |
ASPIRIN 325MG EC TAB |
ECOTRIN |
Open Formulary
|
|
CN103 |
ASPIRIN 325MG TAB |
APSIRIN |
Open Formulary
|
|
CN103 |
ASPIRIN 81MG CHEW TAB |
BABY ASPIRIN |
Open Formulary
|
|
CN103 |
ASPIRIN 81MG EC TAB |
N/A |
Open Formulary
|
|
CN103 |
ASPIRIN BUFFERED ORAL (OTC) |
BUFFERIN |
Open Formulary
|
|
CN103 |
ASPIRIN SUPPOSITORY |
N/A |
Open Formulary
|
|
AM800 |
ATAZANAVIR SO4 ORAL |
REYATAZ |
Atazanavir
|
|
CV100 |
ATENOLOL 50MG, 100MG TAB |
TENORMIN |
Open Formulary
|
|
CV100 |
ATENOLOL INJ |
TENORMIN |
Restrictions per local facility
|
|
CV400 |
ATENOLOL/CHLORTHALIDONE ORAL TAB |
TENORETIC |
Open Formulary
|
|
AP109 |
ATOVAQUONE ORAL |
MEPRON |
Restricted to ID Service or local equivalent
|
|
MS300 |
ATRACURIUM INJ |
N/A |
Restrictions per local facility
|
|
AU350 |
ATROPINE INJ 0.1MG/ML 10ML SYR |
N/A |
Open Formulary
|
|
AU350 |
ATROPINE INJ 0.4MG/ML 1ML INJ, 20ML MDV |
N/A |
Open Formulary
|
|
OP600 |
ATROPINE OPHTH 1% SOLN 15ML |
ISOPTO ATROPINE |
Open Formulary
|
|
OP600 |
ATROPINE SULFATE OPH OINT |
OCU-TROPINE |
Open Formulary
|
|
XA305 |
ATTENDS BRIEFS, LARGE 96/CASE |
ATTENDS |
Open Formulary
|
|
XA305 |
ATTENDS BRIEFS, MEDIUM 96/CASE |
ATTENDS |
Open Formulary
|
|
MS160 |
AURANOFIN ORAL |
RIDAURA |
Open Formulary
|
|
MS160 |
AUROTHIOGLUCOSE SUSP INJ |
SOLGANOL |
Restrictions per local facility
|
|
AN300 |
AZACITIDINE INJ |
VIDAZA |
Azacitidine
|
|
IM600 |
AZATHIOPRINE INJ |
IMURAN |
Open Formulary
|
|
IM600 |
AZATHIOPRINE 50MG TAB |
IMURAN |
Open Formulary
|
|
AM200 |
AZITHROMYCIN INJ |
ZITHROMAX |
Restrictions per local facility
|
|
AM200 |
AZITHROMYCIN ORAL |
ZITHROMAX |
Restrictions per local facility
|
|
AM119 |
AZTREONAM INJ |
AZACTAM |
Restrictions per local facility
|
|
OP210 |
BACITRACIN OPH OINT |
AK-TRACIN |
Open Formulary
|
|
DE109 |
BACITRACIN 500/POLYMYXIN 10000U/GM OINT (OTC) |
POLYSPORIN |
Open Formulary
|
|
DE109 |
BACITRACIN 500/POLYMYXIN 10000U/GM PWD (OTC) |
POLYSPORIN |
Open Formulary
|
|
AM900 |
BACITRACIN INJ 50,000 UNITS |
AK-TRACIN |
Restrictions per local facility
|
|
DE101 |
BACITRACIN TOP OINT 30GM |
AK-TRACIN |
Open Formulary
|
|
OP350 |
BACITRACIN/HC /NEO/POLYMYX OPH OINT |
CORTISPORIN |
Open Formulary
|
|
OP219 |
BACITRACIN/NEOMYCIN/POLYMYXIN OPH OINT |
NEOSPORIN |
Open Formulary
|
|
OP219 |
BACITRACIN/POLYMYXIN OPH OINT |
POLYSPORIN |
Open Formulary
|
|
MS200 |
BACLOFEN 10MG TAB |
LIORESAL |
Open Formulary
|
|
MS200 |
BACLOFEN INJ |
LIORESAL |
Baclofen intrathecal
|
|
XA501 |
BAG BEDSIDE URINARYBAG |
N/A |
Open Formulary
|
|
XA799 |
BAG FEEDING W/TUBE |
N/A |
Open Formulary
|
|
XA607 |
BAG IRRIGATOR W/CONE |
N/A |
Open Formulary
|
|
XA508 |
BAG LEG DISPOSABLE |
N/A |
Open Formulary
|
|
XA508 |
BAG LEG DISPOSABLE, FLIP-FLOW |
N/A |
Open Formulary
|
|
XA508 |
BAG LEG REUSABLE |
N/A |
Open Formulary
|
|
XA508 |
BAG LEG REUSABLE W/ VALVE |
N/A |
Open Formulary
|
|
XA508 |
BAG,LEG (OTC) |
N/A |
Open Formulary
|
|
XA701 |
BAG,TUBE FEEDING (OTC) |
N/A |
Open Formulary
|
|
XA701 |
BAG,TUBE FEEDING GRAVITY (OTC) |
N/A |
Open Formulary
|
|
OP500 |
BALANCED SALT SOLUTION 18ML |
IRRIGATING EYE SOLN, OPH |
Open Formulary
|
|
OP500 |
BALANCED SALT SOLUTION/GLUTATHIONE 500ML |
IRRIGATING EYE SOLN, OPH |
Open Formulary
|
|
GA900 |
BALSALAZIDE ORAL CAPSULE |
COLAZA |
Balsalazide
|
|
DE900 |
BALSAM PERU/CASTOR OIL/TRYPSIN AEROSOL |
GRANULEX |
Open Formulary
|
|
XA104 |
BAND-AID (OTC) |
BAND-AID |
Open Formulary
|
|
XA108 |
BANDAGE ELASTIC ADHESIVE |
N/A |
Open Formulary
|
|
XA109 |
BANDAGE TUBULAR ELASTIC (OTC) |
N/A |
Open Formulary
|
|
XA108 |
BANDAGE,ACE 3 INCH |
ACE |
Open Formulary
|
|
XA104 |
BANDAGE,ADHESIVE (1IN X 3IN) (PLASTIC, FABRIC) |
N/A |
Open Formulary
|
|
XA102 |
BANDAGE,ADHESIVE FLEXIBLE FABRIC 2IN X 3-1/2IN |
BAND-AID 2IN |
Open Formulary
|
|
XA604 |
BARRIER OSTOMY TWO-PIECE FLANGE SIZE 1 1/2 - 4 |
N/A |
Open Formulary
|
|
XA604 |
BARRIER,HOLLIHESIVE H#7701 (OTC) |
N/A |
Open Formulary
|
|
XA602 |
BARRIER,OSTOMY H#3702 (OTC) |
N/A |
Open Formulary
|
|
XA602 |
BARRIER,OSTOMY H#3703 (OTC) |
N/A |
Open Formulary
|
|
XA602 |
BARRIER,OSTOMY H#3704 (OTC) |
N/A |
Open Formulary
|
|
XA602 |
BARRIER,OSTOMY H#3706 (OTC) |
N/A |
Open Formulary
|
|
XA602 |
BARRIER,OSTOMY H#3707 (OTC) |
N/A |
Open Formulary
|
|
IM600 |
BASILIXIMAB INJ |
SIMULECT |
Transplant service
|
|
DE350 |
BATH OIL (OTC) |
N/A |
Open Formulary
|
|
IM100 |
BCG VACCINE INJ 50MG/ML 2ML |
THERACYS |
Open Formulary
|
|
AN900 |
BCG,TICE VACCINE |
TICE |
Restrictions per local facility
|
|
XA900 |
BEDPAN,DISPOSABLE (OTC) |
N/A |
Open Formulary
|
|
CN101 |
BELLADONNA/OPIUM 60MG SUPP |
B&O |
Open Formulary
|
|
XA605 |
BELT,OSTOMY (OTC) |
N/A |
Open Formulary
|
|
CV800 |
BENAZEPRIL ORAL |
LOTENSIN |
Open Formulary
|
|
OP900 |
BENOXINATE HCL/FLUORESCEIN NA OPH SOLN |
FLURESS |
Restricted to Ophthalmology or eye clinic
|
|
OP900 |
BENZALKONIUM CHLORIDE/TYLOXAPOL OPH SOLN (OTC) |
ENUCLENE |
Open Formulary
|
|
NT300 |
BENZOCAINE DENTAL GEL (OTC) |
ANBESOL |
Open Formulary
|
|
NT300 |
BENZOCAINE /CETYLPYRIDINIUM CL LOZENGE (OTC) |
CEPACOL |
Open Formulary
|
|
DE900 |
BENZOIN COMPOUND 30%/ISOPROPYL ALCOHOL 44.8% SPRAY |
N/A |
Open Formulary
|
|
XA604 |
BENZOIN TINCTURE TOPICAL |
N/A |
Open Formulary
|
|
RE302 |
BENZONATATE 100MG CAP |
TESSALON |
Benzonate
|
|
DE752 |
BENZOYL PEROXIDE 10% LOTION (OTC) |
BENZAC |
Open Formulary
|
|
DE752 |
BENZOYL PEROXIDE 10% TOP GEL |
BENZAC |
Open Formulary
|
|
DE752 |
BENZOYL PEROXIDE 5% LOTION (OTC) |
BENZAC |
Open Formulary
|
|
DE752 |
BENZOYL PEROXIDE 5% TOP GEL |
BENZAC |
Open Formulary
|
|
DE752 |
BENZOYL PEROXIDE 5%/ERYTHROMYCIN 3% TOP GEL |
BENZAMYCIN |
Open Formulary
|
|
AU350 |
BENZTROPINE INJ 1MG/ML 2ML |
COGENTIN |
Open Formulary
|
|
AU350 |
BENZTROPINE MESYLATE 0.5MG, 1MG, 2MG TAB |
COGENTIN |
Open Formulary
|
|
DE200 |
BETAMETHASONE DIPROPIONATE TOPICAL CREAM |
DIPROSONE |
Open Formulary
|
|
DE200 |
BETAMETHASONE DIPROPIONATE TOPICAL OINTMENT |
DIPROSONE |
Open Formulary
|
|
DE200 |
BETAMETHASONE VALERATE 0.1% OINTMENT |
VALISONE |
Open Formulary
|
|
DE200 |
BETAMETHASONE VALERATE TOPICAL CREAM |
VALISONE |
Open Formulary
|
|
DE200 |
BETAMETHASONE VALERATE TOPICAL LOTION |
VALISONE |
Open Formulary
|
|
OP101 |
BETAXOLOL HCL 0.25% OPH SUSP |
BETOPTIC |
Betaxolol ophth
|
|
AU300 |
BETHANECHOL CHLORIDE 5MG, 10MG, 20MG TAB |
URECHOLINE |
Open Formulary
|
|
AU300 |
BETHANECHOL INJ 5MG/ML 1ML |
URECHOLINE |
Open Formulary
|
|
AN900 |
BICALUTAMIDE 50MG TAB |
CASODEX |
Open Formulary
|
|
RS300 |
BISACODYL 10MG ENEMA |
DULCOLAX |
Open Formulary
|
|
RS300 |
BISACODYL 10MG RTL SUPP (OTC) |
DULCOLAX |
Open Formulary
|
|
GA204 |
BISACODYL 5MG EC TAB |
DULCOLAX |
Open Formulary
|
|
GA209 |
BISACODYL/PHOSPHO SODA KIT (TAB/SUPP/LIQUID) |
N/A |
Open Formulary
|
|
GA208 |
BISMUTH SUBSALICYLATE ORAL |
PEPTO-BISMOL |
Open Formulary
|
|
CV100 |
BISOPROLOL ORAL TAB |
N/A |
Metoprolol XL and bisoprolol
|
|
BL110 |
BIVALIRUDIN INJ |
ANGIOMAX |
Restrictions per local facility
|
|
AN200 |
BLEOMYCIN SO4 INJ |
BLENOXANE |
Restrictions per local facility
|
|
DX900 |
BLOOD GLUCOSE MONITORING DEVICES AND STRIPS |
N/A |
Blood glucose test strips
|
|
DX900 |
BLOOD GLUCOSE MONITORING SOLUTIONS |
N/A |
Open Formulary
|
|
XA502 |
BOTTLES/OTHER BEDSIDE URINARY COLLECTION DEVICES |
N/A |
Open Formulary
|
|
IM300 |
BOTULISM ANTITOXIN INJ |
N/A |
Restrictions per local facility
|
|
XA900 |
BOWEL MANAGEMENT TOOL |
N/A |
Open Formulary
|
|
XA305 |
BRIEF/PANT INCONTINENCE MALE |
N/A |
Open Formulary
|
|
OP900 |
BRIMONIDINE TARTRATE OPH SOLN |
ALPHAGAN |
Restricted to Ophthalmology or eye clinic
|
|
AU900 |
BROMOCRIPTINE MESYLATE 2.5MG TAB |
PARLODEL |
Open Formulary
|
|
CV702 |
BUMETANIDE INJ |
BUMEX |
Restrictions per local facility
|
|
CV702 |
BUMETANIDE ORAL |
BUMEX |
Open Formulary
|
|
CN204 |
BUPIVACAINE /EPINEPHRINE INJ |
SENSORCAINE |
Open Formulary
|
|
CN204 |
BUPIVACAINE INJ |
SENSORCAINE |
Open Formulary
|
|
CN204 |
BUPIVACAINE/DEXTROSE INJECTION |
N/A |
Open Formulary
|
|
CN101 |
BUPRENORPHINE SUBLINGUAL TAB |
SUBUTEX |
Buprenorphine
|
|
CN101 |
BUPRENORPHINE/NALOXONE |
SUBOXONE |
Buprenorphine
|
|
CN609 |
BUPROPION 100MG, 150MG SA TAB |
WELLBUTRIN, ZYBAN |
Bupropion SR
|
|
CN609 |
BUPROPION 75MG, 100MG TAB |
WELLBUTRIN |
Open Formulary
|
|
CN309 |
BUSPIRONE HCL ORAL |
BUSPAR |
Open Formulary
|
|
AN100 |
BUSULFAN ORAL AND INJ |
MYLERAN |
Open Formulary
|
|
CN101 |
BUTORPHANOL TARTRATE INJ |
STADOL |
Open Formulary
|
|
CN105 |
CAFFEINE/ERGOTAMINE ORAL |
CAFFERGOT |
Open Formulary
|
|
CN105 |
CAFFEINE/ERGOTAMINE RTL SUPP |
CAFFERGOT |
Open Formulary
|
|
CN809 |
CAFFEINE/SODIUM BENZOATE INJ |
N/A |
Electroconvulsive therapy
|
|
DE900 |
CALAMINE LOTION (OTC) |
CALAMINE |
Open Formulary
|
|
DE820 |
CALCIPOTRIENE TOPICAL CREAM |
DOVONEX |
Dermatology
|
|
HS900 |
CALCITONIN INJ |
MIACALCIN |
Open Formulary
|
|
HS900 |
CALCITONIN SOLN |
MIACALCIN |
Open Formulary
|
|
VT502 |
CALCITRIOL INJ |
CALCIJEX |
Restrictions per local facility
|
|
VT502 |
CALCITRIOL 0.25MCG CAP |
ROCALTROL |
Open Formulary
|
|
TN420 |
CALCIUM ACETATE ORAL CAPSULE |
PHOSLO |
Open Formulary
|
|
TN420 |
CALCIUM CARBONATE (OTC) TAB |
N/A |
Open Formulary
|
|
TN420 |
CALCIUM CARBONATE 420MG CHEW TAB |
TUMS |
Open Formulary
|
|
TN420 |
CALCIUM CHLORIDE INJ |
CALCIUM CHLORIDE |
Open Formulary
|
|
TN420 |
CALCIUM GLUCONATE INJ 10% 10ML |
CALCIUM GLUCONATE |
Open Formulary
|
|
VT802 |
CALCIUM/VITAMIN D (OTC) |
OSCAL |
Open Formulary
|
|
DE900 |
CAMPHOR 0.5%/MENTHOL 0.5% LOTION |
MENTHOLATUM |
Open Formulary
|
|
DX300 |
CANDIDA 1:100 SKIN TEST |
CANDIDA |
Open Formulary
|
|
AM500 |
CAPREOMYCIN INJ |
CAPASTAT |
Open Formulary
|
|
DE650 |
CAPSAICIN 0.025% CREAM (OTC) |
ZOSTRIX |
Open Formulary
|
|
DE650 |
CAPSAICIN 0.075% CREAM (OTC) |
ZOSTRIX |
Open Formulary
|
|
CV800 |
CAPTOPRIL 12.5MG, 25MG, 50MG, 100MG TAB |
CAPOTEN |
Open Formulary
|
|
DE400 |
CARA-KLENZ SKIN & WOUND CLEANSER (OTC) |
CARA-KLENZ |
Open Formulary
|
|
OP102 |
CARBACHOL OPH SOLN |
MIOSTAT |
Open Formulary
|
|
CN400 |
CARBAMAZEPINE 200MG TAB |
TEGRETOL |
Open Formulary
|
|
CN400 |
CARBAMAZEPINE TAB, CHEWABLE |
TEGRETOL |
Oral solution
|
|
OT300 |
CARBAMIDE PEROXIDE OTIC SOLN (OTC) |
DEBROX |
Open Formulary
|
|
CN500 |
CARBIDOPA 10MG/LEVODOPA 100MG TAB |
SINEMET |
Open Formulary
|
|
CN500 |
CARBIDOPA 25MG/LEVODOPA 100MG TAB |
SINEMET |
Open Formulary
|
|
CN500 |
CARBIDOPA 25MG/LEVODOPA 250MG TAB |
SINEMET |
Open Formulary
|
|
CN500 |
CARBIDOPA 50MG/LEVODOPA 200MG SA TAB |
SINEMET CR |
Restricted to Neurology Service or local equivalent
|
|
AN900 |
CARBOPLATIN INJ |
PARAPLATIN |
Restrictions per local facility
|
|
TN100 |
CARDIOPLEGIA SOLUTION 1000ML |
N/A |
Open Formulary
|
|
TN100 |
CARDIOPLEGIA SOLUTION,ENHANCED |
N/A |
Open Formulary
|
|
AN100 |
CARMUSTINE INJ |
BICNU |
Restrictions per local facility
|
|
DE900 |
CARRINGTON DRESSING GEL TOP SPRAY (OTC) |
CARRINGTON |
Open Formulary
|
|
DE900 |
CARRINGTON TOP GEL (OTC) |
CARRINGTON |
Open Formulary
|
|
CV100 |
CARVEDILOL RR ORAL TAB |
COREG |
Open Formulary
|
|
DE102 |
CASTELLANI TOP PAINT (OTC) |
N/A |
Open Formulary
|
|
GA204 |
CASTOR OIL 60ML |
N/A |
Open Formulary
|
|
XA513 |
CATHETER EXTERNAL W/ADHESIVE LATEX |
N/A |
Open Formulary
|
|
XA513 |
CATHETER EXTERNAL W/ADHESIVE NON-LATEX |
N/A |
Open Formulary
|
|
XA509 |
CATHETER STRAIGHT BALLOON 30CC |
N/A |
Open Formulary
|
|
XA509 |
CATHETER STRAIGHT BALLOON 5CC |
N/A |
Open Formulary
|
|
XA512 |
CATHETER STRAIGHT RUBBER |
N/A |
Open Formulary
|
|
XA512 |
CATHETER STRAIGHT SILICONE |
N/A |
Open Formulary
|
|
XA900 |
CATHETER SUCTION 14FR |
N/A |
Open Formulary
|
|
XA510 |
CATHETER,COUDE-TIP |
N/A |
Open Formulary
|
|
XA513 |
CATHETER,EXTERNAL URINARY |
N/A |
Open Formulary
|
|
XA512 |
CATHETER,RED RUBBER |
N/A |
Open Formulary
|
|
XA599 |
CATHETERIZATION TRAY W/CATHETER |
N/A |
Open Formulary
|
|
XA599 |
CATHETERIZATION TRAY W/O CATHETER |
N/A |
Open Formulary
|
|
AM116 |
CEFACLOR ORAL |
CECLOR |
Restricted to ID Service or local equivalent
|
|
AM115 |
CEFAZOLIN INJ 1GM |
ANCEF |
Open Formulary
|
|
AM115 |
CEFAZOLIN INJ 10GM |
ANCEF |
Open Formulary
|
|
AM117 |
CEFEPIME INJ |
MAXIPIME |
Restrictions per local facility
|
|
AM117 |
CEFIXIME ORAL |
SUPRAX |
Open Formulary
|
|
AM117 |
CEFOTAXIME INJ |
CLAFORAN |
Restrictions per local facility
|
|
AM116 |
CEFOTETAN INJ |
CEFOTAN |
Restrictions per local facility
|
|
AM116 |
CEFOXITIN NA INJ |
MEFOXIN |
Restrictions per local facility
|
|
AM116 |
CEFPODOXIME PROXETIL ORAL |
VANTIN |
Restricted to ID Service or local equivalent
|
|
AM117 |
CEFTAZIDIME INJ |
FORTAZ |
Restrictions per local facility
|
|
AM117 |
CEFTIZOXIME |
CEFIZOX |
Restrictions per local facility
|
|
AM117 |
CEFTRIAXONE NA INJ |
ROCEPHIN |
Restrictions per local facility
|
|
AM116 |
CEFUROXIME AXETIL ORAL |
CEFTIN |
Restricted to ID Service or local equivalent
|
|
AM115 |
CEPHALEXIN ORAL |
KEFLEX |
Open Formulary
|
|
AH500 |
CETIRIZINE ORAL |
ZYRTEC |
Open Formulary
|
|
OR500 |
CETYLPYRIDINIUM 0.05% MOUTHWASH (OTC) |
CEPACOL |
Open Formulary
|
|
NT900 |
CETYLPYRIDINIUM CL 0.07% LOZENGE |
CEPACOL |
Open Formulary
|
|
AD900 |
CHARCOAL ACTIVATED IN SORBITOL LIQUID (OTC) |
CHARCOAL |
Open Formulary
|
|
AD900 |
CHARCOAL ACTIVATED LIQUID (OTC) |
CHARCOAL |
Open Formulary
|
|
XA100 |
CHEMO SPILL KIT |
N/A |
Open Formulary
|
|
CN309 |
CHLORAL HYDRATE 500MG CAP |
NOCTEC |
Chloral hydrate
|
|
CN309 |
CHLORAL HYDRATE SYRUP |
N/A |
Chloral hydrate
|
|
AN100 |
CHLORAMBUCIL ORAL |
LEUKARAN |
Restricted to Oncology Service or local equivalent
|
|
AM150 |
CHLORAMPHENICOL INJ |
CHLOROMYCETIN |
Restrictions per local facility
|
|
OP210 |
CHLORAMPHENICOL OPH SOLN |
CHLOROPTIC |
Open Formulary
|
|
CN302 |
CHLORDIAZEPOXIDE 10MG, 25MG CAP |
LIBRIUM |
Open Formulary
|
|
OR400 |
CHLORHEXIDINE GLUCONATE 0.12% ALCOHOL-FREE MOUTH RINSE |
N/A |
Open Formulary
|
|
OR500 |
CHLORHEXIDINE GLUCONATE ORAL RINSE |
PERIDEX |
Open Formulary
|
|
DE101 |
CHLORHEXIDINE GLUCONATE SURGICAL SCRUB (OTC) |
HIBICLENS |
Open Formulary
|
|
DE101 |
CHLORHEXIDINE GLUCONATE TOP LIQUID (OTC) |
HIBICLENS |
Open Formulary
|
|
DE900 |
CHLOROPHYLL/PAPAIN/UREA OINT |
PANAFIL, ZIOX |
Restricted to Dermatology or local equivalent
|
|
AH400 |
CHLORPHENIRAMINE MALEATE 4MG TAB |
CHLOR-TRIMETON |
Open Formulary
|
|
AH400 |
CHLORPHENIRAMINE MALEATE SA TAB (OTC) |
CHLOR-TRIMETON |
Open Formulary
|
|
CN204 |
CHLORPROCAINE HCL INJ |
NESACAINE |
Open Formulary
|
|
CN701 |
CHLORPROMAZINE 10MG TAB |
THORAZINE |
Open Formulary
|
|
CN701 |
CHLORPROMAZINE HCL 25, 50, 100, 200MG TAB |
THORAZINE |
Open Formulary
|
|
CN701 |
CHLORPROMAZINE INJ 25MG/ML 2ML |
THORAZINE |
Open Formulary
|
|
CN701 |
CHLORPROMAZINE ORAL CONC 30MG/ML |
THORAZINE |
Open Formulary
|
|
CN701 |
CHLORPROMAZINE ORAL CONC 100MG/ML |
THORAZINE |
Open Formulary
|
|
CN701 |
CHLORPROMAZINE SYRUP 10MG/5ML |
THORAZINE |
Open Formulary
|
|
CV701 |
CHLORTHALIDONE ORAL |
HYGROTON |
Open Formulary
|
|
CV350 |
CHOLESTYRAMINE 4GM/9GM ORAL PWD |
QUESTRAN |
Cholestyramine & Colestipol
|
|
OP900 |
CHONDROITIN / HYALURONATE OPHTHALMIC INJECTION |
N/A |
Open Formulary
|
|
TN499 |
CHROMIUM INJ |
N/A |
Restrictions per local facility
|
|
AM800 |
CIDOFOVIR INJ |
VISTIDE |
Restricted to HIV prescribers
|
|
AM119 |
CILASTATIN NA/IMIPENEM INJ |
PRIMAXIN |
Restrictions per local facility
|
|
GA301 |
CIMETIDINE 300MG,400MG TAB |
TAGAMET |
Open Formulary
|
|
GA301 |
CIMETIDINE ELIXIR 300MG/5ML |
TAGAMET |
Open Formulary
|
|
GA301 |
CIMETIDINE HCL INJ |
TAGAMET |
Open Formulary
|
|
OP210 |
CIPROFLOXACIN HCL OPH SOLN |
CIPRO |
Restricted to Ophthalmology or eye clinic
|
|
AM900 |
CIPROFLOXACIN HCL REGULAR RELEASE ORAL TAB |
CIPRO |
Open Formulary
|
|
AM900 |
CIPROFLOXACIN INJ |
CIPRO |
Restrictions per local facility
|
|
MS300 |
CISATRACURIUM BESYLATE INJ |
NIMBEX |
Restrictions per local facility
|
|
AN900 |
CISPLATIN INJ |
PLATINOL |
Restrictions per local facility
|
|
CN609 |
CITALOPRAM ORAL |
CELEXA |
SSRI
|
|
IR100 |
CITRIC ACID/GLUCONO-DELTA/LACTONE/MAGNESIUM CARBON |
N/A |
Open Formulary
|
|
TN478 |
CITRIC ACID/K CITRATE/NA CITRATE SYRUP |
POLYCITRA |
Open Formulary
|
|
IR100 |
CITRIC ACID/MAGNESIUM OXIDE/SODIUM CARBONATE SOLN |
SOLU G UROLOGICAL IRRIGATING SOLN |
Open Formulary
|
|
TN478 |
CITRIC ACID/NA CITRATE ORAL SOLN |
BICITRA |
Open Formulary
|
|
TN478 |
CITRIC ACID/POTASSIUM CITRATE ORAL POWDER |
CYTRA-K, POLYCITRA-K |
Open Formulary
|
|
TN478 |
CITRIC ACID/POTASSIUM CITRATE ORAL SOLUTION |
N/A |
Open Formulary
|
|
AN300 |
CLADRIBINE INJ |
LEUSTATIN |
Restrictions per local facility
|
|
XA599 |
CLAMP CUNNINGHAM REGULAR |
CUNNINGHAM |
Open Formulary
|
|
XA699 |
CLAMP,BAG (OTC) |
N/A |
Open Formulary
|
|
XA599 |
CLAMP,CUNNINGHAM (OTC) |
CUNNINGHAM |
Open Formulary
|
|
AM200 |
CLARITHROMYCIN ORAL |
BIAXIN |
Restricted to ID Service or local equivalent
|
|
CV805 |
CLASS REVIEW: ANGIOTENSIN II INHIBITORS |
N/A |
Open Formulary
|
|
NT200 |
CLASS REVIEW: ANTI-INFLAMMATORIES,NASAL |
N/A |
Restrictions per local facility
|
|
RE109 |
CLASS REVIEW: ANTIASTHMA,OTHER-INCLUDING LEUKOTRIE |
N/A |
Restrictions per local facility
|
|
RE103 |
CLASS REVIEW: BRONCHODILATORS,SYMPATHOMIMETIC,ORAL |
N/A |
Restrictions per local facility
|
|
HS900 |
CLASS REVIEW: HORMONES/MODIFIERS/OTHER |
N/A |
Open Formulary
|
|
DX102 |
CLASS REVIEW: IONIC CONTRAST MEDIA |
N/A |
Open Formulary
|
|
DX101 |
CLASS REVIEW: NON-IONIC CONTRAST MEDIA |
N/A |
Open Formulary
|
|
AM350 |
CLINDAMYCIN HCL 150MG, 300MG CAP |
CLEOCIN |
Open Formulary
|
|
AM350 |
CLINDAMYCIN ORAL SUSP 75MG/5ML |
CLEOCIN |
Open Formulary
|
|
GU300 |
CLINDAMYCIN PHOSPHATE VAG CREAM |
CLEOCIN |
Open Formulary
|
|
AM350 |
CLINDAMYCIN PHOSPHATE INJ |
CLEOCIN |
Open Formulary
|
|
DE752 |
CLINDAMYCIN TOPICAL SOLN 1% 60ML |
CLEOCIN |
Open Formulary
|
|
DE200 |
CLOBETASOL PROP CREAM |
TEMOVATE |
Open Formulary
|
|
DE200 |
CLOBETASOL PROPIONATE 0.05% OINT |
TEMOVATE |
Open Formulary
|
|
DE200 |
CLOBETASOL PROPIONATE 0.05% TOP SOLN |
TEMOVATE |
Open Formulary
|
|
HS400 |
CLOMIPHENE CITRATE 50MG TAB |
CLOMID |
Women's health
|
|
CN601 |
CLOMIPRAMINE ORAL |
ANAFRANIL |
Open Formulary
|
|
CN400 |
CLONAZEPAM ORAL |
KLONOPIN |
Open Formulary
|
|
CV490 |
CLONIDINE PATCH |
CATAPRES |
Clonidine patch
|
|
CV490 |
CLONIDINE HCL 0.1MG, 0.2MG TAB |
CATAPRESS |
Open Formulary
|
|
CN103 |
CLONIDINE PF INJ |
DURACLON |
Clonidine intrathecal
|
|
BL117 |
CLOPIDOGREL ORAL |
PLAVIX |
Clopidogrel
|
|
DE102 |
CLOTRIMAZOLE 1% TOP SOLN |
MYCELEX |
Open Formulary
|
|
NT900 |
CLOTRIMAZOLE 10MG TROCHE |
MYCELEX |
Open Formulary
|
|
DE102 |
CLOTRIMAZOLE CREAM 1% 30GM |
MYCELEX |
Open Formulary
|
|
GU300 |
CLOTRIMAZOLE VAG CREAM (OTC) |
MYCELEX |
Open Formulary
|
|
CN709 |
CLOZAPINE ORAL |
CLOZARIL |
Atypical Antipsychotics
|
|
DE820 |
COAL TAR 0.5/%SAL AC 2%/SULFUR 2% SHAMPOO (OTC) |
SEBULEX |
Open Formulary
|
|
DE820 |
COAL TAR 10%/SALICYLIC ACID 4% SHAMPOO (OTC) |
N/A |
Open Formulary
|
|
DE820 |
COAL TAR 2% OINT (OTC) |
N/A |
Open Formulary
|
|
DE820 |
COAL TAR 2.5% TOP SOLN (OTC) |
BALNETAR |
Open Formulary
|
|
DE820 |
COAL TAR 5%/SALICYCLIC ACID 2%/SULFUR 2% SHAMPOO ( |
SEBUTONE |
Open Formulary
|
|
DE820 |
COAL TAR 8.75% SHAMPOO (OTC) |
N/A |
Open Formulary
|
|
DE820 |
COAL TAR SHAMPOO 1% 180ML (OTC) |
POLYTAR |
Open Formulary
|
|
NT300 |
COCAINE 4% TOPICAL SOLN 4ML |
N/A |
Open Formulary
|
|
DX300 |
COCCIDIOIDIN INJ 1:100 1ML |
N/A |
Open Formulary
|
|
CN101 |
CODEINE SULFATE 30MG TAB |
CODEINE |
Open Formulary
|
|
RE301 |
CODEINE/GUAIFENESIN SYRUP |
ROBITUSSIN AC |
Codeine/guaifenesin syrup
|
|
MS400 |
COLCHICINE 0.6MG TAB |
COLCHICINE |
Open Formulary
|
|
CV350 |
COLESTIPOL GRANULES |
COLESTID |
Cholestyramine & Colestipol
|
|
CV350 |
COLESTIPOL ORAL PWD 500GM |
COLESTID |
Cholestyramine & Colestipol
|
|
CV350 |
COLESTIPOL ORAL TAB |
COLESTID |
Cholestyramine & Colestipol
|
|
DE900 |
COLLAGENASE TOP OINT |
SANTYL |
Restricted to Dermatology or local equivalent
|
|
XA602 |
COLLAR,TAN,SUR-FIT FLEX C#0225-21 (OTC) |
N/A |
Open Formulary
|
|
XA602 |
COLLAR,TAN,SUR-FIT FLEX C#0225-22 (OTC) |
N/A |
Open Formulary
|
|
XA602 |
COLLAR,TAN,SUR-FIT FLEX C#0225-23 (OTC) |
N/A |
Open Formulary
|
|
XA604 |
COMPOUND BENZOIN TINCTURE,TOP (OTC) |
N/A |
Open Formulary
|
|
XA900 |
CONDOM FEMALE |
N/A |
Open Formulary
|
|
XA900 |
CONDOM LATEX LUBRICATED |
N/A |
Open Formulary
|
|
XA900 |
CONDOM LATEX PLAIN |
N/A |
Open Formulary
|
|
HS900 |
CONJUGATED ESTROGENS 0.3MG/1.5MG MEDROXYPROGESTERONE |
PREMPRO 0.3 MG/ 1.5MG |
Open Formulary
|
|
HS900 |
CONJUGATED ESTROGENS 0.45MG/1.5MG MEDROXYPROGESTERONE |
PREMPRO |
Open Formulary
|
|
HS900 |
CONJUGATED ESTROGENS 0.625MG/2.5MG MEDROXYPROGEST |
PREMPRO |
Open Formulary
|
|
HS900 |
CONJUGATED ESTROGENS 0.625MG/5MG MEDROXYPROGESTERO |
PREMPRO |
Open Formulary
|
|
HS900 |
CONJUGATED ESTROGENS/PROGESTERONE TAB |
PREMPHASE |
Women's health
|
|
XA602 |
CONVEX INSERT ID 1 - 1 3/8 |
N/A |
Open Formulary
|
|
XA602 |
CONVEX INSERT,SUR-FIT C#1850-12 (OTC) |
N/A |
Open Formulary
|
|
XA602 |
CONVEX INSERT,SUR-FIT C#1850-15 (OTC) |
N/A |
Open Formulary
|
|
XA602 |
CONVEX INSERT,SUR-FIT C#1850-16 (OTC) |
N/A |
Open Formulary
|
|
XA602 |
CONVEX INSERT,SUR-FIT C#1850-17 (OTC) |
N/A |
Open Formulary
|
|
XA602 |
CONVEX INSERT,SUR-FIT C#1850-20 (OTC) |
N/A |
Open Formulary
|
|
TN499 |
COPPER INJ |
N/A |
Restrictions per local facility
|
|
HS701 |
CORTICOTROPIN INJ |
ACTHAR |
Open Formulary
|
|
DX900 |
COSYNTROPIN INJ |
CORTROSYN |
Open Formulary
|
|
XA900 |
COTTON BALLS EA. |
N/A |
Open Formulary
|
|
XA900 |
COTTON-TIP APPLICATOR NONSTERILE (OTC) |
N/A |
Open Formulary
|
|
XA900 |
COTTON-TIP APPLICATOR STERILE (OTC) |
N/A |
Open Formulary
|
|
RE109 |
CROMOLYN SODIUM AEROSOL, ORAL |
N/A |
Open Formulary
|
|
OP900 |
CROMOLYN SODIUM OPH SOLN |
INTAL |
Open Formulary
|
|
IM900 |
CROMOLYN SODIUM ORAL |
INTAL |
Open Formulary
|
|
RE109 |
CROMOLYN SODIUM SOLN, INHL |
N/A |
Oral solution inh
|
|
NT900 |
CROMOLYN SODIUM SOLN, NASAL |
N/A |
Open Formulary
|
|
DE900 |
CURAFIL WOUND DRESSING TOPICAL GEL |
CURAFIL |
Open Formulary
|
|
AD200 |
CYANIDE ANTIDOTE PACKAGE INJ |
CYANIDE |
Open Formulary
|
|
VT101 |
CYANOCOBALAMIN 1000MCG TAB |
REDISOL |
Open Formulary
|
|
VT101 |
CYANOCOBALAMIN 1000MCG/ML INJ |
REDISOL |
Open Formulary
|
|
MS200 |
CYCLOBENZAPRINE ORAL |
FLEXERIL |
Open Formulary
|
|
OP600 |
CYCLOPENTOLATE HCL OPH SOLN |
CYCLOGYL |
Open Formulary
|
|
OP600 |
CYCLOPENTOLATE/PHENYLEPHRINE 1%/2.5% OPH |
CYCLOMYDRIL |
Open Formulary
|
|
AN100 |
CYCLOPHOSPHAMIDE INJ |
CYTOXAN |
Restrictions per local facility
|
|
AN100 |
CYCLOPHOSPHAMIDE ORAL |
CYTOXAN |
Open Formulary
|
|
AM500 |
CYCLOSERINE ORAL |
SEROMYCIN |
Open Formulary
|
|
IM600 |
CYCLOSPORINE 25MG CAP (GENGRAF BRAND IS PREFERRED) |
GENGRAF |
Transplant service
|
|
IM600 |
CYCLOSPORINE 100MG CAP (GENGRAF BRAND IS PREFERRED) |
GENGRAF |
Transplant service
|
|
IM600 |
CYCLOSPORINE INJ |
SANDIMMUNE |
Restrictions per local facility
|
|
IM600 |
CYCLOSPORINE ORAL SOLN 100MG/ML |
SANDIMMUNE |
Transplant service
|
|
AH700 |
CYPROHEPTADINE HCL 4MG TAB |
PERIACTIN |
Open Formulary
|
|
AN300 |
CYTARABINE INJ |
CYTOSAR U |
Restrictions per local facility
|
|
IM500 |
CYTOMEGALOVIRUS IMMUNE GLOBULIN HUMAN |
CYTOGAM |
Open Formulary
|
|
AN900 |
DACARBAZINE INJ |
DTIC |
Restrictions per local facility
|
|
IM600 |
DACLIZUMAB INJ |
ZENAPAX |
Transplant service
|
|
AN200 |
DACTINOMYCIN INJ |
COSMEGEN |
Restrictions per local facility
|
|
AM900 |
DALFOPRISTIN / QUINUPRISTIN INJ (SYNERCID) |
SYNERCID |
Quinupristin/dalfopristin
|
|
BL110 |
DALTEPARIN INJ |
FRAGMIN |
LMWH's
|
|
HS100 |
DANAZOL ORAL |
DANOCRINE |
Open Formulary
|
|
MS200 |
DANTROLENE INJ 20MG |
DANTRIUM |
Restrictions per local facility
|
|
MS200 |
DANTROLENE NA 100MG CAP |
DANTRIUM |
Restricted to Neurology Service or local equivalent
|
|
MS200 |
DANTROLENE NA 25MG CAP |
DANTRIUM |
Restricted to Neurology Service or local equivalent
|
|
AM900 |
DAPSONE 100MG TAB |
AVLOSULFON |
Open Formulary
|
|
AM900 |
DAPSONE 25MG TAB |
AVLOSULFON |
Open Formulary
|
|
AM900 |
DAPTOMYCIN INJECTION |
CUBICIN |
ID or Transplant
|
|
BL400 |
DARBEPOETIN INJ |
ARANESP |
Epoetin/Darbepoetin
|
|
AM800 |
DARUNAVIR ORAL TAB |
PREZISTA |
Darunavir
|
|
AN200 |
DAUNORUBICIN INJ |
CERUBIDINE |
Restrictions per local facility
|
|
AD300 |
DEFEROXAMINE MESYLATE INJ |
DESFERAL |
Open Formulary
|
|
AM800 |
DELAVIRDINE ORAL |
RESCRIPTOR |
Restricted to HIV prescribers
|
|
AM250 |
DEMECLOCYCLINE HCL ORAL |
DECLOMYCIN |
Open Formulary
|
|
CN203 |
DESFLURANE INHALATION |
SUPRANE |
Restrictions per local facility
|
|
CN601 |
DESIPRAMINE HCL ORALTAB |
NORPRAMIN |
Open Formulary
|
|
HS702 |
DESMOPRESSIN ACETATE INJ |
DDAVP |
Open Formulary
|
|
HS702 |
DESMOPRESSIN INTRANASAL PUMP |
DDAVP |
Open Formulary
|
|
HS200 |
DESOGESTREL 0.15/ETHINYL ESTRADIOL 30 TAB |
RECLIPSEN |
Open Formulary
|
|
DE200 |
DESONIDE 0.05% TOPICAL CREAM |
DESOWEN |
Restricted to Dermatology or local equivalent
|
|
HS051 |
DEXAMETHASONE 0.5MG, 0.75MG, 1.5MG TAB |
DECADRON |
Open Formulary
|
|
HS051 |
DEXAMETHASONE 2MG, 4MG TAB |
DECADRON |
Open Formulary
|
|
HS051 |
DEXAMETHASONE ELIXIR 0.5MG/5ML |
DECADRON |
Open Formulary
|
|
HS051 |
DEXAMETHASONE INJ 4MG/ML 1ML |
DECADRON |
Open Formulary
|
|
OP350 |
DEXAMETHASONE NA PHOS/NEOMYCIN/ OPH SOLN |
NEODECADRON |
Open Formulary
|
|
OP300 |
DEXAMETHASONE NA PHOSPHATE OPH SOLN |
MAXIDEX |
Open Formulary
|
|
OP300 |
DEXAMETHASONE OPHTH OINT 0.05% |
MAXIDEX |
Open Formulary
|
|
OP350 |
DEXAMETHASONE/NEO/POLYMX OPH OINT |
MAXITROL |
Open Formulary
|
|
OP350 |
DEXAMETHASONE/TOBRAMYCIN OPH OINT |
TOBRADEX |
Open Formulary
|
|
OP350 |
DEXAMETHASONE/TOBRAMYCIN OPH SUSP |
TOBRADEX |
Open Formulary
|
|
CN309 |
DEXMEDETOMIDINE INJ |
PRECEDEX |
Dexmedetomidine
|
|
AN700 |
DEXRAZOXANE INJ |
ZINECARD |
Dexrazoxane
|
|
BL800 |
DEXTRAN 40 INJ |
GENTRAN |
Open Formulary
|
|
BL800 |
DEXTRAN 70 INJ |
N/A |
Open Formulary
|
|
BL800 |
DEXTRAN 75 INJ |
N/A |
Open Formulary
|
|
BL800 |
DEXTRAN HM (DEXTRAN 70/DEXTROSE 10% WATER) |
N/A |
Open Formulary
|
|
AD900 |
DEXTRAN-1 INJ 150MG/ML 20ML |
PROMIT |
Open Formulary
|
|
CN801 |
DEXTROAMPHETAMINE REGULAR RELEASE ORAL CAP & TAB |
DEXEDRINE |
Dextroamphetamine
|
|
CN801 |
DEXTROAMPHETAMINE SA CAP |
N/A |
Dextroamphetamine
|
|
RE302 |
DEXTROMETHORPHAN/GUAIFENESIN (SF) LIQUID (OTC) |
ROBITUSSIN DM |
Open Formulary
|
|
TN102 |
DEXTROSE 5%/0.2% NACL INJ 100 |
N/A |
Open Formulary
|
|
TN102 |
DEXTROSE 5%/0.2% NACL/20MEQ KCL |
N/A |
Open Formulary
|
|
TN102 |
DEXTROSE 5%/0.2% NACL/30MEQ KCL |
N/A |
Open Formulary
|
|
TN102 |
DEXTROSE 5%/0.2% NACL/40MEQ KCL |
N/A |
Open Formulary
|
|
TN102 |
DEXTROSE 5%/0.33% NACL/20MEQ KCL |
N/A |
Open Formulary
|
|
TN102 |
DEXTROSE 5%/0.45% NACL INJ 500ML |
N/A |
Open Formulary
|
|
TN102 |
DEXTROSE 5%/0.45% NACL INJ 1000ML |
N/A |
Open Formulary
|
|
TN102 |
DEXTROSE 5%/0.45% NACL/20MEQ KCL |
N/A |
Open Formulary
|
|
TN102 |
DEXTROSE 5%/0.45% NACL/30MEQ KCL |
N/A |
Open Formulary
|
|
TN102 |
DEXTROSE 5%/0.45% NACL/40MEQ KCL |
N/A |
Open Formulary
|
|
TN102 |
DEXTROSE 5%/0.9% NACL INJ 100ML |
N/A |
Open Formulary
|
|
TN102 |
DEXTROSE 5%/0.9% NACL/20MEQ KCL |
N/A |
Open Formulary
|
|
TN102 |
DEXTROSE 5%/LACTATED RINGERS |
N/A |
Open Formulary
|
|
TN102 |
DEXTROSE 5%/WATER/20MEQ KCL |
N/A |
Open Formulary
|
|
TN102 |
DEXTROSE 5%/WATER/40MEQ KCL |
N/A |
Open Formulary
|
|
TN102 |
DEXTROSE 10%/0.45% NACL INJ 1000ML |
N/A |
Open Formulary
|
|
PH000 |
DEXTROSE 25%INJ |
N/A |
Open Formulary
|
|
HS503 |
DEXTROSE 50%/WATER INJ 50ML |
N/A |
Open Formulary
|
|
TN101 |
DEXTROSE INJ (5,10,20, 50, 70%) |
N/A |
Open Formulary
|
|
HS503 |
DEXTROSE SQUEEZE TUBE (OTC) |
N/A |
Open Formulary
|
|
TN102 |
DEXTROSE/ISOLYTE INJ |
N/A |
Open Formulary
|
|
IR200 |
DEXTROSE/PERITONEAL DIALYSIS SOLN |
N/A |
Open Formulary
|
|
XA305 |
DIAPER W/ELASTIC STRAPS |
N/A |
Open Formulary
|
|
XA900 |
DIAPHRAGM KIT (OTC) 65MM,70MM,75MM,80MM |
N/A |
Open Formulary
|
|
DX900 |
DIASTIX (GLUCOSE) TEST STRIP (OTC) |
DIASTIX |
Open Formulary
|
|
CN302 |
DIAZEPAM 5MG TAB |
VALIUM |
Open Formulary
|
|
CN302 |
DIAZEPAM 5MG/ML INJ 2ML |
VALIUM |
Open Formulary
|
|
DE700 |
DIBUCAINE 1% OINT (OTC) |
NUPERCAINAL |
Open Formulary
|
|
OP300 |
DICLOFENAC NA OPH SOLN |
VOLTAREN |
Open Formulary
|
|
MS120 |
DICLOFENAC ORAL TAB, EC |
VOLTAREN |
Open Formulary
|
|
AM112 |
DICLOXACILLIN NA 250MG CAP |
DYNAPEN |
Open Formulary
|
|
AU350 |
DICYCLOMINE HCL 10MG, 20MG CAP, TAB |
BENTYL |
Open Formulary
|
|
AU350 |
DICYCLOMINE HCL INJ |
BENTYL |
Open Formulary
|
|
AU350 |
DICYCLOMINE HCL SYRUP |
BENTYL |
Oral solution
|
|
AM800 |
DIDANOSINE ORAL - RR and EC |
VIDEX |
Restricted to ID Service or local equivalent
|
|
CV050 |
DIGOXIN (LANOXIN) 0.125MG, 0.25MG TAB |
LANOXIN |
Open Formulary
|
|
CV050 |
DIGOXIN ELIXIR 0.05MG/ML 60ML |
LANOXIN |
Open Formulary
|
|
AD900 |
DIGOXIN IMMUNE FAB (OVINE) INJ |
DIGIBIND |
Open Formulary
|
|
CV050 |
DIGOXIN INJ 0.5MG/2ML |
LANOXIN |
Open Formulary
|
|
CN105 |
DIHYDROERGOTAMINE MESYLATE INJ |
DHE |
Open Formulary
|
|
VT503 |
DIHYDROTACHYSTEROL ORAL |
DHT |
Open Formulary
|
|
CV200 |
DILTIAZEM (TIAZAC) 120, 180, 240, 300MG SA CAP |
TIAZAC |
Open Formulary
|
|
CV200 |
DILTIAZEM HCL INJ |
CARDIZEM |
Open Formulary
|
|
CV200 |
DILTIAZEM HCL IR ORAL TAB |
CARDIZEM |
Diltiazem IR
|
|
AD300 |
DIMERCAPROL INJ |
BAL IN OIL |
Open Formulary
|
|
GU900 |
DIMETHYLSULFOXIDE URH SOLN |
DMSO |
Open Formulary
|
|
AH200 |
DIPHENHYDRAMINE HCL 25MG, 50MG CAP |
BENADRYL |
Open Formulary
|
|
AH200 |
DIPHENHYDRAMINE INJ 50MG/ML |
BENADRYL |
Open Formulary
|
|
AH200 |
DIPHENHYDRAMINE SYRUP 2.5MG/ML |
BENADRYL |
Open Formulary
|
|
GA208 |
DIPHENOXYLATE/ATROPINE LIQUID |
LOMOTIL |
Open Formulary
|
|
GA208 |
DIPHENOXYLATE/ATROPINE TAB |
LOMOTIL |
Open Formulary
|
|
IM105 |
DIPHTHERIA, TETANUS, PERTUSSIS VACCINE |
ADACEL, "TDAP" |
Tdap
|
|
IM105 |
DIPHTHERIA/TETANUS TOXOID INJ |
N/A |
Open Formulary
|
|
OP103 |
DIPIVEFRIN HCL 0.1% OPH SOLN |
PROPINE |
Open Formulary
|
|
BL117 |
DIPYRIDAMOLE 25MG ORAL |
PERSANTINE |
Open Formulary
|
|
DX900 |
DIPYRIDAMOLE INJ |
PERSANTINE |
Open Formulary
|
|
XA305 |
DISPOSABLE DIAPER |
N/A |
Open Formulary
|
|
XA301 |
DISPOSABLE UNDERPAD |
N/A |
Underpads
|
|
AD100 |
DISULFIRAM (ANTABUSE) 250MG TAB |
ANTABUSE |
Open Formulary
|
|
AD100 |
DISULFIRAM (ANTABUSE) 500MG TAB |
ANTABUSE |
Open Formulary
|
|
CN400 |
DIVALPROEX 24 HR (ER) SA TAB |
DEPAKOTE ER (EXTENDED RELEASE) |
Divalproex SA
|
|
RE302 |
DM 10/GUAIFENESN 100MG/5ML (ALCOHOL FREE) (OTC) |
ROBITUSSIN DM |
Open Formulary
|
|
AU100 |
DOBUTAMINE INJ 250MG |
DOBUTREX |
Open Formulary
|
|
AN900 |
DOCETAXEL INJ |
TAXOTERE |
Hematology - Oncology
|
|
RS300 |
DOCUSATE (OTC) ENEMA, RECTAL |
ENEMEEZ |
Open Formulary
|
|
GA205 |
DOCUSATE LIQUID 60MG/15ML 473M |
COLACE |
Open Formulary
|
|
GA205 |
DOCUSATE SODIUM 250MG CAP |
DOS |
Open Formulary
|
|
GA204 |
DOCUSATE/SENNOSIDES ORAL TAB |
N/A |
Open Formulary
|
|
CN900 |
DONEPEZIL ORAL |
ARICEPT |
Alzheimers
|
|
AU100 |
DOPAMINE INJ 400MG/5ML INJ |
INTROPIN |
Open Formulary
|
|
AU100 |
DOPAMINE INJ 800MG/D5W 500ML PRE-MIXDEXTROSE 5%/L |
INTROPIN |
Open Formulary
|
|
OP109 |
DORZOLAMIDE HCL OPH SOLN |
TRUSOPT |
Dorzolamide/brinzolamide
|
|
OP105 |
DORZOLAMIDE/TIMOLOL OPHTH SOLN |
COSOPT |
Dorzolamide/timolol
|
|
RE900 |
DOXAPRAM HCL INJ |
DOPRAM |
Restrictions per local facility
|
|
CV150 |
DOXAZOSIN ORAL |
CARDURA |
Open Formulary
|
|
CN601 |
DOXEPIN HCL 10MG, 25MG, 50MG CAP |
SINEQUAN |
Open Formulary
|
|
CN601 |
DOXEPIN ORAL LIQUID |
N/A |
Open Formulary
|
|
AN200 |
DOXORUBICIN INJ |
ADRIAMYCIN |
Restrictions per local facility
|
|
AM250 |
DOXYCYCLINE CAP/TAB |
VIBRAMYCIN |
Open Formulary
|
|
AM250 |
DOXYCYCLINE INJ 100MG |
VIBRAMYCIN |
Restrictions per local facility
|
|
XA199 |
DRESSING ALGINATE |
N/A |
Open Formulary
|
|
XA199 |
DRESSING HYDROCOLLOID |
N/A |
Open Formulary
|
|
XA199 |
DRESSING HYDROGEL |
N/A |
Open Formulary
|
|
XA103 |
DRESSING NON-ADHESIVE OIL/EMULSION |
N/A |
Open Formulary
|
|
XA900 |
DRESSING TRAY FOR CENTRAL LINE (OTC) |
N/A |
Open Formulary
|
|
XA199 |
DRESSING TRAYS |
N/A |
Open Formulary
|
|
XA103 |
DRESSING, ALLEVYN (OTC) |
ALLEVYN |
Open Formulary
|
|
XA199 |
DRESSING, PROFORE 4-LAYER |
PROFORE DRESSING |
Open Formulary
|
|
XA199 |
DRESSING,CLEARSITE (OTC) |
CLEARSITE |
Open Formulary
|
|
XA199 |
DRESSING,DUODERM (OTC) |
DUODERM |
Open Formulary
|
|
XA199 |
DRESSING,PROFORE-LF 4-LAYER SN#66020626 |
N/A |
Open Formulary
|
|
XA199 |
DRESSING,RESTORE (OTC) |
RESTORE |
Open Formulary
|
|
XA199 |
DRESSING,SORBSAN (OTC) |
SORSBAN |
Open Formulary
|
|
XA599 |
DRIP COLLECTOR CONVEEN #5410 (OTC) |
CONVEEN |
Open Formulary
|
|
CN205 |
DROPERIDOL INJ 2.5MG/ML 2ML |
INAPSINE |
Restrictions per local facility
|
|
XA604 |
DUODERM HYDROGEL (OTC) |
DUODERM |
Open Formulary
|
|
OP102 |
ECHOTHIOPHATE IODIDE 0.125% OP |
PHOSPHOLINE IODIDE |
Open Formulary
|
|
OP102 |
ECHOTHIOPHATE IODIDE 0.25% OP |
PHOSPHOLINE IODIDE |
Open Formulary
|
|
AD300 |
EDETATE CALCIUM DISODIUM INJ |
CALCIUM DISODIUM VERSENATE |
Open Formulary
|
|
AU300 |
EDROPHONIUM INJ 10MG/ML 15ML |
TENSILON |
Restrictions per local facility
|
|
AM800 |
EFAVIRENZ 200MG CAP |
SUSTIVA |
Restricted to HIV prescribers
|
|
AM800 |
EFAVIRENZ/EMTRICITABINE/TENOFOVIR TAB |
ATRIPLA |
HIV
|
|
XA108 |
ELASTOPLAST (OTC) |
ELASTOPLAST |
Open Formulary
|
|
XA900 |
EMPTY FLEXIBLE CONTAINER (OTC) |
N/A |
Open Formulary
|
|
AM800 |
EMTRICITABINE ORAL |
EMTRIVA |
HIV - ID
|
|
AM800 |
EMTRICITABINE/TENOFOVIR ORAL |
TRUVADA |
HIV - ID
|
|
CV800 |
ENALAPRIL ORAL TAB |
VASOTEC |
Open Formulary
|
|
CV800 |
ENALAPRILAT INJ |
VASOTEC |
Restrictions per local facility
|
|
XA900 |
ENEMA BAG (OTC) |
N/A |
Open Formulary
|
|
CN201 |
ENFLURANE INHALATION |
ETHRANE |
Open Formulary
|
|
AM800 |
ENFUVIRTIDE INJ |
FUZEON |
Restricted to HIV prescribers
|
|
BL110 |
ENOXAPARIN INJ |
LOVENOX |
LMWH's
|
|
CN500 |
ENTACAPONE ORAL |
COMTAN |
Entacapone
|
|
AM800 |
ENTECAVIR ORAL TABLET AND ORAL SOLUTION |
BARACLUDE |
Entecavir
|
|
AU100 |
EPHEDRINE INJ |
EFEDRON |
Open Formulary
|
|
AU100 |
EPINEPHRINE 0.3MG/0.3ML INJ EPI-PEN |
EPIPEN |
Open Formulary
|
|
AU100 |
EPINEPHRINE INJ 0.1MG/ML 1ML, 10ML |
ADRENALIN |
Open Formulary
|
|
AU100 |
EPINEPHRINE INJ 1MG/ML 1ML TUBEX, 30ML INJ |
ADRENALIN |
Open Formulary
|
|
BL400 |
EPOETIN ALFA,RECOMBINANT INJ |
PROCRIT, EPOGEN |
Epoetin/Darbepoetin
|
|
BL110 |
EPTIFIBATIDE INJ |
INTEGRELIN |
Restricted to Cardiology Service or local equivalent
|
|
CN900 |
ERGOLOID MESYLATES ORAL RR TAB |
HYDERGINE |
Open Formulary
|
|
GU600 |
ERGONOVINE MALEATE INJ |
ERGOTRATE |
Restrictions per local facility
|
|
AM119 |
ERTAPENEM INJ |
INVANZ |
ID
|
|
OP210 |
ERYTHROMYCIN 0.5% OPH OINT |
ILOTYCIN |
Open Formulary
|
|
DE752 |
ERYTHROMYCIN 2% TOP GEL |
EMGEL |
Open Formulary
|
|
DE752 |
ERYTHROMYCIN 2% TOP SOLN |
ERYTHRA DERM |
Open Formulary
|
|
AM200 |
ERYTHROMYCIN 250MG EC TAB |
E-MYCIN |
Open Formulary
|
|
AM200 |
ERYTHROMYCIN ETHYLSUCC SUSP 20 |
EES |
Open Formulary
|
|
AM200 |
ERYTHROMYCIN LACTOBIONATE INJ |
ERYTHROCIN |
Restrictions per local facility
|
|
CV100 |
ESMOLOL HCL INJ |
BREVIBLOC |
Open Formulary
|
|
HS300 |
ESTRADIOL PATCH |
CLIMARA |
Estradiol patches
|
|
HS300 |
ESTRADIOL 0.5MG TAB |
ESTRACE |
Open Formulary
|
|
HS300 |
ESTRADIOL 1MG TAB |
ESTRACE |
Open Formulary
|
|
HS300 |
ESTRADIOL 2MG TAB |
ESTRACE |
Open Formulary
|
|
HS300 |
ESTRADIOL INJ |
ESTRACE |
Open Formulary
|
|
AN900 |
ESTRAMUSTINE ORAL |
EMCYT |
Restricted to Oncology Service or local equivalent
|
|
HS300 |
ESTROGENS CONJUGATED 0.3MG TAB |
PREMARIN |
Open Formulary
|
|
HS300 |
ESTROGENS CONJUGATED 0.625MG TAB |
PREMARIN |
Open Formulary
|
|
HS300 |
ESTROGENS CONJUGATED 1.25MG TAB |
PREMARIN |
Open Formulary
|
|
HS300 |
ESTROGENS CONJUGATED INJ |
PREMARIN |
Restrictions per local facility
|
|
GU500 |
ESTROGENS CONJUGATED VAG CREAM |
PREMARIN |
Open Formulary
|
|
CV702 |
ETHACRYNATE NA INJ |
EDECRIN |
Restrictions per local facility
|
|
CV702 |
ETHACRYNIC ACID ORAL |
EDACRIN |
Open Formulary
|
|
AM500 |
ETHAMBUTOL 100MG, 400MG TAB |
MYAMBUTAL |
Open Formulary
|
|
CV600 |
ETHANOLAMINE OLEATE INJ |
ETHAMOLIN |
Restrictions per local facility
|
|
HS200 |
ETHINYL ESTRADIOL 0.12MG/ETONOGESTREL 0.15MG VAG RING |
NUVARING |
Women's health
|
|
HS900 |
ETHINYL ESTRADIOL 1MG /NORETHINDRONE AC 5MCG ORAL TAB |
FEMHRT 1/5 |
Open Formulary
|
|
HS200 |
ETHINYL ESTRADIOL 20MCG ORAL |
N/A |
Open Formulary
|
|
HS200 |
ETHINYL ESTRADIOL 20MCG/LEVONORGESTREL 0.1MG, 28 |
EQU-LUTERA |
Open Formulary
|
|
HS200 |
ETHINYL ESTRADIOL 30MCG/LEVONORGESTREL 0.15MG, 28 (MONO) |
EQV-LEVLEN |
Open Formulary
|
|
HS200 |
ETHINYL ESTRADIOL 30MCG/LEVONORGESTREL, 28 (TRI) |
TRI-LEVLEN |
Open Formulary
|
|
HS200 |
ETHINYL ESTRADIOL 35 MCG/NORGESTIMATE 25 MCG TABLETS, 28, MONO |
MONONESSA (EQUIV) |
Open Formulary
|
|
HS200 |
ETHINYL ESTRADIOL 35MCG/NORETHINDRONE 1MG TAB, 21 |
ORTHO-NOVUM 1/35 |
Open Formulary
|
|
HS200 |
ETHINYL ESTRADIOL 35MCG/NORETHINDRONE 1MG TAB, 28 |
ORTHO-NOVUM 1/35 |
Open Formulary
|
|
HS200 |
ETHINYL ESTRADIOL 35MCG/NORETHINDRONE TAB |
EQU-NECON 7/7/7 |
Open Formulary
|
|
HS200 |
ETHINYL ESTRADIOL/NORGESTIMATE TRIPHASIC ORAL CONTRACEPTIVE |
TRINESSA, ORTHO TRI-CYCLEN |
Open Formulary
|
|
AM500 |
ETHIONAMIDE ORAL |
TRECATOR-SC |
Open Formulary
|
|
DE700 |
ETHYL CHLORIDE 100% TOP AEROSOL |
N/A |
Open Formulary
|
|
HS900 |
ETIDRONATE DISODIUM 200MG TAB |
DIDRONEL |
Alendronate
|
|
HS900 |
ETIDRONATE INJ |
DIDRONEL |
Restrictions per local facility
|
|
CN104 |
ETODOLAC 200MG IR CAP |
LODINE |
Open Formulary
|
|
CN203 |
ETOMIDATE INHALATION |
AMIDATE |
Restrictions per local facility
|
|
AN900 |
ETOPOSIDE INJ |
VEPESID |
Restrictions per local facility
|
|
AN900 |
ETOPOSIDE ORAL |
VEPESID |
Restricted to Oncology Service or local equivalent
|
|
AM800 |
ETRAVIRINE ORAL TAB |
INTELENCE |
Etravirine
|
|
XA900 |
EVACUATED CONTAINER (OTC) |
N/A |
Open Formulary
|
|
XA101 |
EYE PAD STERILE (OTC) |
N/A |
Open Formulary
|
|
OP500 |
EYE RINSE SOLN (OTC) |
N/A |
Open Formulary
|
|
XA900 |
FACE PLATE |
N/A |
Open Formulary
|
|
BL500 |
FACTOR IX COMPLEX, HUMAN |
ALPHANINE |
Factor IX
|
|
AM800 |
FAMCICLOVIR ORAL |
FAMVIR |
Famciclovir
|
|
GA301 |
FAMOTIDINE INJ |
PEPCID |
Open Formulary
|
|
TN300 |
FAT EMULSION INJ 10% 500ML |
N/A |
Open Formulary
|
|
TN300 |
FAT EMULSION INJ 20% 500ML |
N/A |
Open Formulary
|
|
XA900 |
FECAL INCONTINENCE COLLECTOR (OTC) |
N/A |
Open Formulary
|
|
XA703 |
FEEDING TUBE (OTC) |
N/A |
Open Formulary
|
|
CN400 |
FELBAMATE ORAL |
FELBATOL |
Restricted to Neurology Service or local equivalent
|
|
CV200 |
FELODIPINE 2.5MG, 5MG, 10MG SA TAB |
PLENDIL |
DHP CCB
|
|
AU100 |
FENOLDOPAM MESYLATE INJ |
CORLOPAM |
Fenoldopam
|
|
CN101 |
FENTANYL INJ 0.05MG/ML 2ML, 5ML |
SUBLIMAZE |
Open Formulary
|
|
CN101 |
FENTANYL PATCH |
DURAGESIC |
Fentanyl patch
|
|
TN410O |
FERRIC NA GLUCONATE COMPLEX 12.5MG/ML INJ |
FERRLECIT |
Open Formulary
|
|
TN410O |
FERROUS GLUCONATE ORAL |
FERGON |
Iron products
|
|
TN410O |
FERROUS SULFATE 325MG TAB |
FEOSOL |
Open Formulary
|
|
TN410O |
FERROUS SULFATE ELIXIR 220MG/5ML |
FEOSOL |
Open Formulary
|
|
BL400 |
FILGRASTIM 300MCG/ML INJ |
NEUPOGEN |
CSF's
|
|
XA859 |
FILTER NEEDLE (OTC) |
N/A |
Open Formulary
|
|
HS900 |
FINASTERIDE 5MG TAB |
PROSCAR |
Finasteride
|
|
XA900 |
FINGER COT (OTC) |
N/A |
Open Formulary
|
|
AM700 |
FLUCONAZOLE INJ |
DIFLUCAN |
Open Formulary
|
|
AM700 |
FLUCONAZOLE ORAL |
DIFLUCAN |
Open Formulary
|
|
AM700 |
FLUCYTOSINE ORAL |
ANCOBON |
Restricted to ID Service or local equivalent
|
|
AN300 |
FLUDARABINE INJ |
FLUDARA |
Restrictions per local facility
|
|
HS052 |
FLUDROCORTISONE ACETATE 0.1MG |
FLORINEF |
Open Formulary
|
|
AD900 |
FLUMAZENIL INJ |
ROMAZICON |
Open Formulary
|
|
NT200 |
FLUNISOLIDE 25MCG 200D NASAL INHL |
NASALIDE |
Open Formulary
|
|
RE101 |
FLUNISOLIDE ORAL INHALER |
AEROBID |
Oral steroid inhalers
|
|
DE200 |
FLUOCINOLONE ACETONIDE 0.01% TOP SOLN |
SYNALAR |
Open Formulary
|
|
DE200 |
FLUOCINONIDE 0.05% CREAM |
LIDEX |
Open Formulary
|
|
DE200 |
FLUOCINONIDE 0.05% OINT |
LIDEX |
Open Formulary
|
|
OP900 |
FLUORESCEIN NA /PROPARACAINE OPH SOLN |
FLUORACAINE |
Open Formulary
|
|
OP900 |
FLUORESCEIN NA INJ |
FLUORESCITE |
Open Formulary
|
|
OP900 |
FLUORESCEIN OPHTH STRIP |
FLUOR-I-STRIP |
Open Formulary
|
|
DE700 |
FLUORI-METHANE TOP SPRAY 120ML |
FLUORI-METHANE |
Open Formulary
|
|
OP300 |
FLUOROMETHOLONE OPH SUSP |
FML |
Open Formulary
|
|
DE600 |
FLUOROURACIL 2% TOP SOLN |
EFUDEX |
Open Formulary
|
|
DE600 |
FLUOROURACIL 5% CREAM |
EFUDEX |
Open Formulary
|
|
DE600 |
FLUOROURACIL 5% TOP SOLN |
EFUDEX |
Open Formulary
|
|
AN300 |
FLUOROURACIL INJ |
ADRUCIL |
Restrictions per local facility
|
|
CN609 |
FLUOXETINE ORAL |
PROZAC |
Open Formulary
|
|
HS100 |
FLUOXYMESTERONE ORAL |
HALOTESTIN |
Restricted to Endocrinology or local equivalent
|
|
CN701 |
FLUPHENAZINE DECANOATE INJ 25M |
PROLIXIN |
Restrictions per local facility
|
|
CN701 |
FLUPHENAZINE HCL 1MG, 2.5MG, 5MG TAB |
PROLIXIN |
Open Formulary
|
|
CN701 |
FLUPHENAZINE HCL ELIXIR 2.5MG/5ML |
PROLIXIN |
Open Formulary
|
|
CN701 |
FLUPHENAZINE HCL ORAL CONC 5MG/ML |
PROLIXIN |
Open Formulary
|
|
DE200 |
FLURANDRENOLIDE 4MCG/SQCM TAPE |
CORDRAN |
Open Formulary
|
|
OP900 |
FLURBIPROFEN NA OPH SOLN |
OCUFEN |
Open Formulary
|
|
AN900 |
FLUTAMIDE ORAL CAP |
N/A |
Open Formulary
|
|
VT102 |
FOLIC ACID 1MG TAB |
FOLVITE |
Open Formulary
|
|
VT102 |
FOLIC ACID INJ 5MG/ML 10ML |
FOLVITE |
Open Formulary
|
|
AD900 |
FOMEPIZOLE INJ |
ANTIZOL |
Open Formulary
|
|
BL110 |
FONDAPARINUX INJ |
ARIXTRA |
FONDAPARINUX
|
|
RE102 |
FORMOTEROL CAP FOR INHALATION |
FORADIL |
Formoterol/Salmeterol
|
|
AM800 |
FOSAMPRENAVIR ORAL TAB |
LEXIVA |
HIV
|
|
OP900 |
FOSCARNET NA INJ |
FOSCAVIR |
Restricted to ID Service or local equivalent
|
|
CV800 |
FOSINOPRIL 10MG, 20MG TAB |
MONOPRIL |
Fosinopril
|
|
CN400 |
FOSPHENYTOIN NA INJ |
CEREBYX |
Restrictions per local facility
|
|
CV702 |
FUROSEMIDE 20MG, 40MG, 80MG TAB |
LASIX |
Open Formulary
|
|
CV702 |
FUROSEMIDE INJ 10MG/ML 2ML |
LASIX |
Open Formulary
|
|
CN400 |
GABAPENTIN ORAL CAPSULE |
NEURONTIN |
Open Formulary
|
|
DX900 |
GADOBENATE DIMEGLUMINE INJ |
MULTIHANCE |
Gadobenate / Gadoteridol
|
|
DX102 |
GADOPENTETATE DTPA INJ |
MAGNEVIST |
Open Formulary
|
|
DX900 |
GADOTERIDOL INJ |
PROHANCE |
Gadobenate / Gadoteridol
|
|
CN900 |
GALANTAMINE HYDROBROMIDE ORAL (SA CAPS AND RR TABS) |
RAZADYNE (REMINYL=OLD NAME) |
Alzheimers
|
|
AM800 |
GANCICLOVIR INJ |
CYTOVENE |
Restrictions per local facility
|
|
OP230 |
GANCICLOVIR OPH IMPLANT |
VITRASERT |
Ganciclovir implant
|
|
XA109 |
GAUZE ELASTIC STERILE |
N/A |
Open Formulary
|
|
XA103 |
GAUZE ADAPTIC (OTC) |
N/A |
Open Formulary
|
|
XA101 |
GAUZE DRESSING 2X2IN STERILE # |
N/A |
Open Formulary
|
|
XA101 |
GAUZE DRESSING 4X4IN STERILE # |
N/A |
Open Formulary
|
|
XA109 |
GAUZE ELASTIC NONSTERILE |
N/A |
Open Formulary
|
|
XA103 |
GAUZE NON-ADHESIVE PETROLATUM |
N/A |
Open Formulary
|
|
XA111 |
GAUZE PACKING PLAIN |
N/A |
Open Formulary
|
|
XA101 |
GAUZE PAD 2IN X 2IN STERILE |
N/A |
Open Formulary
|
|
XA101 |
GAUZE PAD 4IN X 4IN STERILE |
N/A |
Open Formulary
|
|
XA102 |
GAUZE PAD NONSTERILE |
N/A |
Open Formulary
|
|
XA102 |
GAUZE PAD NONSTERILE(OTC) |
N/A |
Open Formulary
|
|
XA101 |
GAUZE PAD STERILE |
N/A |
Open Formulary
|
|
XA109 |
GAUZE,ELASTIC (OTC) |
N/A |
Open Formulary
|
|
XA106 |
GAUZE,FINE MESH STERILE (OTC) |
N/A |
Open Formulary
|
|
XA103 |
GAUZE,PETROLATUM (OTC) |
N/A |
Open Formulary
|
|
BL116 |
GELATIN FILM, ABSORBABLE 100X125 |
N/A |
Open Formulary
|
|
OP900 |
GELATIN,ABSORBABLE |
N/A |
Open Formulary
|
|
AN900 |
GEMCITABINE INJ |
GEMZAR |
Restrictions per local facility
|
|
CV350 |
GEMFIBROZIL 600MG TAB |
LOPID |
Open Formulary
|
|
AM300 |
GENTAMICIN INJ 40MG/ML 2ML INJ, 20ML MDV |
GARAMYCIN |
Restrictions per local facility
|
|
OP210 |
GENTAMICIN OPHTHALMIC SOLN |
GARAMYCIN |
Open Formulary
|
|
OP210 |
GENTAMICIN SO4 OPH OINT |
GARAMYCIN |
Open Formulary
|
|
DE101 |
GENTAMICIN SULFATE CREAM |
GARAMYCIN |
Open Formulary
|
|
OP350 |
GENTAMICIN/PREDNISOLONE OPH SUSP |
PRED-G |
Open Formulary
|
|
DE109 |
GENTIAN VIOLET 1% TOP SOLN (OTC) |
N/A |
Open Formulary
|
|
DE109 |
GENTIAN VIOLET 2% TOP SOLN (OTC) |
N/A |
Open Formulary
|
|
IM900 |
GLATIRAMER ACETATE INJ |
COPAXONE |
Multiple Sclerosis
|
|
HS502 |
GLIPIZIDE 10MG TAB |
GLUCOTROL |
Open Formulary
|
|
HS502 |
GLIPIZIDE 5MG TAB |
GLUCOTROL |
Open Formulary
|
|
IM500 |
GLOBULIN,IMMUNE INJ |
N/A |
Open Formulary
|
|
XA900 |
GLOVE LATEX NONSTERILE (OTC) |
N/A |
Open Formulary
|
|
XA900 |
GLOVE LATEX STERILE (OTC) |
N/A |
Open Formulary
|
|
XA900 |
GLOVE VINYL LARGE NONSTERILE (OTC) |
N/A |
Open Formulary
|
|
XA900 |
GLOVE VINYL MEDIUM NONSTERILE (OTC) |
N/A |
Open Formulary
|
|
HS503 |
GLUCAGON 1MG/VI INJ |
N/A |
Open Formulary
|
|
HS503 |
GLUCOSE CHEW TAB (OTC) |
N/A |
Open Formulary
|
|
DX900 |
GLUCOSE KETONE TEST STRIP |
KETODIASTIX |
Open Formulary
|
|
DX900 |
GLUCOSE TOLERANCE TEST BEVERAGE 10OZ |
N/A |
Open Formulary
|
|
HS502 |
GLYBURIDE 2.5MG TAB |
DIABETA |
Open Formulary
|
|
HS502 |
GLYBURIDE 5MG TAB |
DIABETA |
Open Formulary
|
|
RS300 |
GLYCERIN SUPP |
N/A |
Open Formulary
|
|
IR100 |
GLYCINE IRRIGATION SOLN |
AMINOACETIC ACID IRRIGATION SOLN |
Open Formulary
|
|
DE900 |
GLYCOLIC ACID 12% LOTION (OTC) |
N/A |
Open Formulary
|
|
AU350 |
GLYCOPYRROLATE INJ 0.2MG/ML 1M |
ROBINUL |
Open Formulary
|
|
MS160 |
GOLD NA THIOMALATE INJ |
MYOCHRYSINE |
Restricted to Rheumatology
|
|
AN500 |
GOSERELIN ACETATE IMPLANT SYRINGE |
ZOLADEX |
Oncology and Urology
|
|
OP219 |
GRAMICIDIN/NEOMYCIN/POLYMYXIN OPH SOLN |
NEOSPORIN |
Open Formulary
|
|
RE302 |
GUAIFENESIN 100MG/5ML SYRUP |
ROBITUSSIN |
Open Formulary
|
|
RE302 |
GUAIFENESIN ORAL |
HUMIBID |
Open Formulary
|
|
XA112 |
GUAZE PACKING, MEDICATED (OTC) |
N/A |
Open Formulary
|
|
IM100 |
HAEMOPHILUS B CONJUGATE VACCINE |
ACTHIB |
Open Formulary
|
|
CN709 |
HALOPERIDOL 0.5, 1, 2, 5, 10, 20MG TAB |
HALDOL |
Open Formulary
|
|
CN709 |
HALOPERIDOL DECANOATE INJ |
HALDOL |
Open Formulary
|
|
CN709 |
HALOPERIDOL INJ 5MG/ML 1ML |
HALDOL |
Open Formulary
|
|
CN709 |
HALOPERIDOL ORAL CONC 2MG/ML |
HALDOL |
Open Formulary
|
|
CN201 |
HALOTHANE 125ML |
FLUOTHANE |
Open Formulary
|
|
DE900 |
HAMAMELIS WATER 50% TOP PAD (OTC) |
TUCKS |
Open Formulary
|
|
OT250 |
HC 1%/NEOMYCIN 3.5MG/POLYMYXIN OTIC |
CORTISPORIN |
Open Formulary
|
|
CV704 |
HCTZ 50/TRIAMTERENE 75MG TAB |
MAXZIDE |
Open Formulary
|
|
DX900 |
HEMA-CHEK OCCULT BLOOD SLIDE TEST (OTC) |
HEMA-CHEK |
Open Formulary
|
|
DX900 |
HEMATEST TAB (NOT FOR ORAL USE) (OTC) |
HEMATEST |
Open Formulary
|
|
RS201 |
HEMORRHOIDAL RTL OINT (OTC) |
PREPARATION H |
Open Formulary
|
|
RS201 |
HEMORRHOIDAL RTL SUPP |
PREPARATION H |
Open Formulary
|
VISN 20 WebRx Formulary By Generic Name Updated May 1, 2009