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National Core Formulary

The IHS National Core Formulary represents the basic standard of care drugs which must be carried by all federal facilities to generally promote the parity, portability, quality, safety, convenience, and cost-effectiveness of the pharmacy benefit.

  • It establishes the "floor" for the pharmacy benefit.
  • Except in closed classes, facilities are expected to add other drugs to the local formulary as needed.
Last Updated: 11/10/2022
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The following is a list of Medications currently in the queue. 225 record(s) found.
The following is a list of Medications currently in the queue. 225 record(s) found.
MedicationPharmacological CategoryFormulary BriefNotesSimilar Medications
Acetaminophen Analgesic, Miscellaneous Short-Acting Opioids (2014)
Adalimumab -OR- Etanercept (can choose either product) Antirheumatic, Disease Modifying; Tumor Necrosis Factor (TNF) Blocking Agent TNF Inhibitors (2016) ONLY In consultation with a rheumatologist Etanercept -OR- Adalimumab (can choose either product)
Albuterol nebulized solution Beta2 Agonist Asthma & COPD Guidelines Review (2019)
Albuterol, metered dose inhaler (MDI) Beta2 Agonist Asthma & COPD Guidelines Review (2019) *Any product*
Alendronate Bisphosphonate Derivative Osteoporosis (2016)
Allopurinol Antigout Agent; Xanthine Oxidase Inhibitor Gout (2016)
Alogliptin Antidiabetic Agent, Dipeptidyl Peptidase 4 (DPP-4) Inhibitor DPP-IV Inhibitors (2019)
Amitriptyline Antidepressant, Tricyclic Bipolar Disorder (2022) Nortriptyline
Amlodipine Antihypertensive; Calcium Channel Blocker, Dihydropyridine Hypertension (2022) Diltiazem
Amoxicillin Antibiotic, Penicillin Outpatient Abx Stewardship & URIs (2021) Pediatric and Adult oral formulations Amoxicillin and Clavulanate; Penicillin G benzathine; Penicllin V potassium
Amoxicillin and Clavulanate Antibiotic, Penicillin Outpatient Abx Stewardship & URIs (2021) Pediatric and Adult oral formulations Amoxicillin; Penicillin G benzathine; Penicllin V potassium
Anastrozole Antineoplastic Agent, Aromatase Inhibitor NPTC Update Spring 2021
Apixaban Anticoagulant; Direct Oral Anticoagulant (DOAC); Factor Xa Inhibitor Direct Oral Anticoagulants (2017) Warfarin
Aripiprazole lauroxil Antipsychotic, Atypical (Second Generation) - Injectable Long-Acting Injectable Antipsychotics (2020) Injectable Haloperidol decanoate
Artificial Tear substitute, ophthalmic (preservative free) Ophthalmic Agent, Miscellaneous Ocular Treatments (2022) *Any Preservative-Free product* Ciprofloxacin, Ophthalmic Solution; Corticosteroid (Ophthalmic) - Low Potency; Polymyxin B/trimethoprim, Ophthalmic Solution
Aspirin Antiplatelet Agent; Nonsteroidal Anti-Inflammatory Drug; Salicylate Pregnancy & Prenatal Care (2021)
Atenolol Antihypertensive; Beta-Blocker, Beta1 Selective Hypertension (2022) Propranolol
Atomoxetine Norepinephrine Reuptake Inhibitor, Selective ADHD (Jan 2020) Dextroamphetamine / Amphetamine (immediate release); Dextroamphetamine / Amphetamine (long-acting); Methylphenidate (immediate release); Methylphenidate (long-acting)
Atorvastatin Antilipemic Agent, HMG-CoA Reductase Inhibitor Hyperlipidemia (2022) Pravastatin; Rosuvastatin; Simvastatin
Atypical antipsychotic Antipsychotic, Atypical Bipolar Disorders (2022) *Any product* Aripiprazole lauroxil; Haloperidol decanoate
Azithromycin Antibiotic, Macrolide STIs - PART 1 (2021)
Benzoyl Peroxide Topical Skin Product, Acne Acne Treatment (2020) Benzoyl Peroxide AND Clindamycin, topical combination
Benzoyl Peroxide AND Clindamycin, topical combination Topical Skin Product, Acne; Topical Skin Product, Acne (Lincosamide Antibiotic) Acne Treatment (2020) Benzoyl Peroxide
Bictegravir/Emtricitabine/Tenofovir alafenamide Antiretroviral, Integrase Inhibitor (Anti-HIV) HIV Treatment (2019) Dolutegravir/abacavir/lamivudine; Emtricitabine/tenofovir disoproxil fumarate; Raltegravir
Bumetanide -OR- Torsemide Antihypertensive Heart Failure with Preserved Ejection Fraction (HFpEF) (2022) Furosemide; Torsemide -OR- Bumetanide
Buprenorphine, long-acting (**REMS drug**) Analgesic, Opioid; Analgesic, Opioid Partial Agonist MAT for OUD (2021) Any formulation; Restricted to treatment of Opioid Use Disorder; **See REMS here** Exit Disclaimer: You Are Leaving www.ihs.gov  Buprenorphine, short-acting (**REMS drug**); Buprenorphine-Naloxone (**REMS drug**)
Buprenorphine, short-acting (**REMS drug**) Analgesic, Opioid; Analgesic, Opioid Partial Agonist MAT for OUD (2021) Any formulation; Restricted to treatment of Opioid Use Disorder; **See REMS here** Exit Disclaimer: You Are Leaving www.ihs.gov  Buprenorphine, long-acting (**REMS drug**); Buprenorphine-Naloxone (**REMS drug**)
Buprenorphine-Naloxone (**REMS drug**) Analgesic, Opioid; Analgesic, Opioid Partial Agonist MAT for OUD (2021) **See REMS here** Exit Disclaimer: You Are Leaving www.ihs.gov  Naloxone
Bupropion Antidepressant, Dopamine/Norepinephrine-Reuptake Inhibitor; Smoking Cessation Aid Stimulant Use Disorder (2022) Varenicline; Venlafaxine
Calcium Electrolyte Supplement Osteoporosis (2016) *Any formulation*
Carbamazepine Anticonvulsant, Miscellaneous Bipolar Disorder (2022) Divalproex; Lamotrigine; Levetiracetam; Phenytoin; Topiramate
Carbidopa-Levodopa, immediate-release Anti-Parkinson Agent; Decarboxylase Inhibitor-Dopamine Precursor Parkinson's Disease (2019)
Carvedilol, immediate-release Antihypertensive; Beta-Blocker with Alpha-Blocking Activity Heart Failure with Reduced Ejection Fraction (HFrEF) (2022) Atenolol; Propranolol
Cefdinir Antibiotic, Cephalosporin (Third Generation) Outpatient Abx Stewardship & URIs (2021) Pediatric and Adult oral formulations Cefixime; Ceftriaxone Injection; Cephalexin
Cefixime Antibiotic, Cephalosporin (Third Generation) STIs - PART 1 (2021) For outpatient treatment of gonorrhea for Expedited Partner Therapy or when injection therapy is not possible Cefdinir; Ceftriaxone Injection; Cephalexin
Ceftriaxone, injection Antibiotic, Cephalosporin (Third Generation) STIs - PART 1 (2021) Cefdinir; Cefixime; Cephalexin
Cephalexin Antibiotic, Cephalosporin (First Generation) Outpatient Abx Stewardship & URIs (2021) Pediatric and Adult oral formulations Cefdinir; Cefixime; Ceftriaxone Injection
Chlorthalidone Antihypertensive; Thiazide-Related Diuretic Hypertension (2022) Hydrochlorothiazide
Ciprofloxacin, ophthalmic solution Antibiotic, Ophthalmic Fluoroquinolone Ocular Treatments (2022) Artificial Tear substitute, ophthalmic (preservative free); Corticosteroid (Ophthalmic) - Low Potency; Polymyxin B/trimethoprim, Ophthalmic Solution
Ciprofloxacin, oral Antibiotic, Fluoroquinolone Male Genitourinary Infections (Nov 2022)
Citalopram Antidepressant, Selective Serotonin Reuptake Inhibitor Bipolar Disorder (2022) Escitalopram; Fluoxetine; Paroxetine; Sertraline
Clindamycin Antibiotic, Lincosamide Outpatient Abx Stewardship & URIs (2021) Pediatric and Adult oral formulations
Clonazepam Benzodiazepine Antiseizure Drugs (2021) Lorazepam
Clopidogrel Antiplatelet Agent Antiplatelets (2015) Aspirin
Clotrimazole, topical Antifungal Agent, Imidazole Derivative Male Genitourinary Infections (Nov 2022)
Corticosteroid (Ophthalmic) - Low Potency Corticosteroid, Ophthalmic Ocular Treatments (2022) *Any product - see Form Brief for suggested products Artificial Tear substitute, Ophthalmic (Preservative Free); Ciprofloxacin, Ophthalmic Solution; Polymyxin B/trimethoprim, Ophthalmic Solution; Prednisolone, Ophthalmic Suspension
Corticosteroid (Topical) - Intermediate Potency Topical Corticosteroids Atopic Dermatitis (2020) *Any product* Corticosteroid (Topical) - Low Potency
Corticosteroid (Topical) - Low Potency Topical Corticosteroids Atopic Dermatitis (2020) *Any product* Corticosteroid (Topical) - Intermediate Potency
Corticosteroid, intranasal Intranasal Corticosteroid Allergic Rhinitis (2018) *Any product*
Corticosteroids (Topical) - High Potency (Class I and II) Topical Corticosteroids Alopecia Areata (2022) Corticosteroid (Topical) - Intermediate Potency; Corticosteroid (Topical) - Low Potency
Cyanocobalamin (Vitamin B12), oral Vitamin, Water Soluble Hematologic Supplements (2016)
Dextroamphetamine / Amphetamine (immediate release) Central Nervous System Stimulant ADHD (Jan 2020) Pediatric use only
Dextroamphetamine / Amphetamine (long-acting) Central Nervous System Stimulant ADHD (Jan 2020) Pediatric use only
Diclofenac Nonsteroidal Anti-Inflammatory Drug NSAIDs (2014) *Any formulation* Ibuprofen; Indomethacin; Meloxicam; Naproxen
Dicyclomine Anticholinergic Agent Irritable Bowel Syndrome (2018)
Digoxin Antiarrhythmic Agent, Miscellaneous; Cardiac Glycoside Heart Failure with Reduced Ejection Fraction (HFrEF) (2022)
Diltiazem Antihypertensive; Calcium Channel Blocker, Nondihydropyridine Hypertension (2022) Amlodipine
Divalproex Anticonvulsant, Miscellaneous Bipolar Disorder (2022) Carbamazepine; Lamotrigine; Levetiracetam; Phenytoin; Topiramate
Dolutegravir Antiretroviral, Integrase Inhibitor (Anti-HIV) HIV Updates (2020) For HIV treatment in pregnant patients Emtricitabine/tenofovir disoproxil fumarate; Raltegravir
Dolutegravir/Abacavir/Lamivudine Antiretroviral, Integrase Inhibitor (Anti-HIV) HIV Treatment (2019) *Note: HLA B5701 testing required prior to initiation Bictegravir/Emtricitabine/Tenofovir alafenamide; Dolutegravir; Emtricitabine/tenofovir disoproxil fumarate; Raltegravir
Donepezil Acetylcholinesterase Inhibitor (Central) Alzheimer's disease (2019) 5mg and 10mg strengths
Doxazosin Alpha1 Blocker; Antihypertensive Benign Prostatic Hypertrophy (Nov 2022) Prazosin; Tamsulosin
Doxycycline Antibiotic, Tetracycline STIs - PART 1 (2021)
Duloxetine Antidepressant, Serotonin/Norepinephrine Reuptake Inhibitor/Antagonist Bipolar Disorder (2022) Bupropion; Venlafaxine
Empagliflozin Antidiabetic Agent, Sodium-Glucose Cotransporter 2 (SGLT2) Inhibitor Heart Failure with Reduced Ejection Fraction (HFrEF) (2022)
Emtricitabine/Tenofovir disoproxil fumarate Antiretroviral, Reverse Transcriptase Inhibitor, Nucleoside (Anti-HIV); Antiretroviral, Reverse Transcriptase Inhibitor, Nucleotide (Anti-HIV) HIV Pre-Exposure Prophylaxis (PrEP) (2018) For (1) Pre-Exposure HIV Prophylaxis, (2) Post-Exposure HIV Prophylaxis (with raltegravir) or (3) HIV Treatment (with raltegravir) in patients with contraindications for 1st line anti-HIV agents Raltegravir
Epinephrine Injection Devices (both 0.15mg and 0.3mg) Alpha-/Beta- Agonist Epinephrine Injection Devices (2020 Any device, auto-injector or pre-filled syringe
Escitalopram Antidepressant, Selective Serotonin Reuptake Inhibitor Bipolar Disorder (2022) Citalopram; Fluoxetine; Paroxetine; Sertraline
Estradiol for Injection Estrogen Derivative Gender Affirming Therapies (2022) Either valerate or cypionate product Estradiol tablets; Estradiol, transdermal
Estradiol tablets Estrogen Derivative Gender-Affirming Medications (2022) Estradiol for Injection; Estradiol, transdermal
Estradiol, transdermal Estrogen Derivative Gender Affirming Therapies (2022) *Any patch* Estradiol for Injection; Estradiol tablets
Estrogen vaginal cream Estrogen Derivative NPTC Meeting Update (May 2018) *Any product* Estradiol tablets
Etanercept -OR- Adalimumab (can choose either product) Antirheumatic, Disease Modifying; Tumor Necrosis Factor (TNF) Blocking Agent TNF Inhibitors (2016) ONLY In consultation with a rheumatologist Adalimumab -OR- Etanercept (can choose either product)
Ethambutol Antitubercular Agent Treatment of Tuberculosis (2021) Isoniazid; Pyrazinamide; Rifampin; Rifapentine
Ethinyl estradiol / Etonogestrel vaginal ring Contraceptive; Estrogen and Progestin Combination Contraception (2016)
Ethinyl estradiol / Norelgestromin, transdermal Contraceptive; Estrogen and Progestin Combination Contraception (2016)
Ethosuximide Anticonvulsant, Succinimide Anti-Seizure Drugs (2021) Carbamazepine; Clonazepam; Divalproex; Gabapentin; Lamotrigine; Levetiracetam; Phenytoin; Topiramate
Etonogestrel, implant Contraceptive; Progestin Long Acting Reversible Contraception (2021) For use by a skilled and privileged provider Oral contraceptive pill, progestin only
Ezetimibe Antilipemic Agent, 2-Azetidinone Hyperlipidemia (2022)
Famotidine Histamine H2 Antagonist Fall 2022 NPTC Meeting Update
Finasteride 5 Alpha-Reductase Inhibitor Benign Prostatic Hypertrophy (Nov 2022)
Fluconazole, oral Antifungal Agent, Azole Derivative Male Genitourinary Infections (Nov 2022)
Fluoride, oral Nutritional Supplement Supplements in Oral Health (2016) *Any oral formulation*
Fluoxetine Antidepressant, Selective Serotonin Reuptake Inhibitor Bipolar Disorder (2022) Sertraline
Fluticasone/Salmeterol Beta2 Agonist, Long-Acting; Corticosteroid, Inhalant LABAs (2019) Mometasone (Asmanex®)
Folic Acid Vitamin, Water Soluble Pregnancy & Prenatal Care (2021) Any product containing >400 mcg / daily dose
Furosemide Antihypertensive Heart Failure with Preserved Ejection Fraction (HFpEF) (2022)
Gabapentin Anticonvulsant, Miscellaneous; GABA Analog Antiseizure Drugs (2021)
Glecaprevir/Pibrentasvir (Mavyret®) Antihepaciviral HCV Treatment (2018) Ledipasvir/sofosbuvir (Harvoni®); Sofosbuvir/velpatasvir (Epclusa®)
Glipizide Antidiabetic Agent; Sulfonylurea Diabetes Treatment Overview (2017)
Glucagon Antidote; Hypoglycemia Glucagon Products Review (2021) For outpatient use
Glucose, oral Antidote Glucagon Products Review (2021) Any formulation Glucagon
H1 Antagonist (2nd generation), long-acting Histamine H1 Antagonist, Second Generation Allergic Rhinitis (2018) *Any product*
Haloperidol decanoate Antipsychotic, Typical (First Generation) - Injectable Long-Acting Injectable Antipsychotics (2020) Injectable Aripiprazole lauroxil
Hydrochlorothiazide Antihypertensive; Thiazide Diuretic Hypertension (2022) Chlorthalidone
Hydroxychloroquine Antimalarial Non-biologic DMARDs (2016) Leflunomide; Methotrexate; Sulfasalazine
Hydroxyzine Histamine H1 Antagonist, First Generation Anxiety Disorders (2021)
Ibuprofen Nonsteroidal Anti-Inflammatory Drug NSAIDs (2014) Diclofenac; Indomethacin; Meloxicam; Naproxen
Indomethacin Nonsteroidal Anti-Inflammatory Drug NSAIDs (2014) Diclofenac; Ibuprofen; Meloxicam; Naproxen
Insulin aspart (NovoLog®) Insulin, Rapid-Acting Diabetes Treatment Overview (2017) *Branded product*; Pen Device
Insulin aspart / Insulin aspart protamine (NovoLog® Mix 70/30) Insulin, Combination (70/30 Mix) Diabetes Treatment Overview (2017) *Branded product*; Pen Device
Insulin detemir (Levemir®) Insulin, Long-Acting Long-acting Insulins & Biosimilars (2021) *Branded product*; Pen Device
Insulin glargine, any Insulin, Long-Acting Long-Acting Insulins & Biosimilars (2021) An interchangeable biosimilar product is a biosimilar that meets additional requirements outlined by the law that allows for the FDA to approve biosimilar and interchangeable biosimilar medications. Insulin detemir (Levemir®)
Insulin NPH (NovoLIN® N) Insulin, Intermediate-Acting Diabetes Treatment Overview (2017) *Branded product*
Insulin NPH / Regular human insulin (NovoLIN® 70/30) Insulin, Combination (70/30 Mix) Diabetes Treatment Overview (2017) *Branded product*
Insulin Regular human (NovoLIN® R) Insulin, Short-Acting Diabetes Treatment Overview (2017) *Branded product*
Intrauterine device, copper Contraceptive Long Acting Reversible Contraception (2021) *Any product*; For use by a skilled and privileged provider Intrauterine device, levonorgestrel
Intrauterine device, levonorgestrel Contraceptive, Progestin Long Acting Reversible Contraception (2021) *Any product*; For use by a skilled and privileged provider Intrauterine device, copper
Iron, oral Iron Salt Pregnancy & Prenatal Care (2021) *Any oral formulation*
Isoniazid Antitubercular Agent Treatment of Tuberculosis (2021) Ethambutol; Pyrazinamide; Rifampin; Rifapentine
Isosorbide mononitrate Antianginal Agent; Vasodilator Anti-Anginal Treatment (2013) Nitroglycerin patch
Lactulose Ammonium Detoxicant; Laxative, Osmotic Hepatic Encephalopathy (2020) Polyethylene glycol
Lamotrigine Anticonvulsant, Miscellaneous Bipolar Disorder (2022) Carbamazepine; Divalproex; Levetiracetam; Phenytoin; Topiramate
Laxative, bulk-forming Bulk-forming Laxative Added July 2011 (Constipation) *Any product*
Laxative, stimulant Stimulant Laxative Added July 2011 (Constipation) *Any product*
Ledipasvir/Sofosbuvir (Harvoni®) Antihepaciviral HCV Treatment (2018) Glecaprevir/Pibrentasvir (Mavyret®); Sofosbuvir/velpatasvir (Epclusa®)
Leflunomide Antirheumatic, Disease Modifying Non-biologic DMARDs (2016) Hydroxychloroquine; Methotrexate; Sulfasalazine
Letrozole Antineoplastic Agent, Aromatase Inhibitor NPTC Update Spring 2021
Leuprolide Antineoplastic Agent, Gonadotropin-Releasing Hormone Agonist Treatment of Prostate Cancer (Nov 2022) **Any depot form**
Levetiracetam Anticonvulsant, Miscellaneous Antiseizure Drugs (2021) Carbamazepine; Divalproex; Lamotrigine; Phenytoin; Topiramate
Levonorgestrel (Plan B One-Step®) Contraceptive, Progestin Contraception (2016) *Branded product* Ulipristal
Levothyroxine Thyroid Agent Originally added 2004
Liraglutide -or- Semaglutide Antidiabetic Agent, Glucagon-Like Peptide-1 (GLP-1) Receptor Agonist GLP-1 Receptor Agonists (2019) Select either of these subcutaneous agents, no preference given
Lisinopril Antihypertensive, Angiotensin-Converting Enzyme Inhibitor Hypertension (2022)
Lithium Antimanic Agent Bipolar Disorder (2022)
Loperamide Antidiarrheal Irritable Bowel Syndrome (2018)
Lorazepam Benzodiazepine Alcohol Withdrawal Syndrome (2015) Clonazepam
Losartan Antihypertensive, Angiotensin II Receptor Blocker Hypertension (2022)
Low-molecular weight heparin Low-molecular Weight Heparin VTE Prophylaxis (2011) *Any product*
Medroxyprogesterone acetate, injection Contraceptive, Progestin (Injection/Depot) Contraception (2016) Medroxyprogesterone, oral; Oral contraceptive pill, progestin only
Medroxyprogesterone, oral Contraceptive; Progestin Polycystic Ovarian Syndrome (2017) Medroxyprogesterone acetate, injection; Oral contraceptive pill, progestin only
Meloxicam Nonsteroidal Anti-Inflammatory Drug NSAIDs (2014) Diclofenac; Ibuprofen; Indomethacin; Naproxen
Memantine N-Methyl-D-Aspartate (NMDA) Receptor Antagonist Alzheimer's disease (2019)
Metformin Antidiabetic Agent; Biguanide Diabetes Treatment Overview (2017)
Methimazole Antithyroid Agent; Thioamide Hyperthyroidism (2021) Propylthiouracil
Methotrexate Antineoplastic Agent; Antirheumatic; Disease Modifying; Immunosuppresant Agent Non-biologic DMARDs (2016) Hydroxychloroquine; Leflunomide; Sulfasalazine
Methylphenidate (immediate release) Central Nervous System Stimulant ADHD (Jan 2020) Pediatric use only Methylphenidate (long-acting)
Methylphenidate (long-acting) Central Nervous System Stimulant ADHD (Jan 2020) Pediatric use only Methylphenidate (immediate release)
Metoprolol succinate Antihypertensive; Beta-Blocker, Beta1 Selective Heart Failure with Reduced Ejection Fraction (HFrEF) (2022) Atenolol; Carvedilol, immediate-release; Propranolol
Metoprolol tartrate Antihypertensive; Beta-Blocker, Beta1 Selective Heart Failure with Reduced Ejection Fraction (HFrEF) (2022) Atenolol; Carvedilol, immediate-release; Metoprolol succinate
Metronidazole, oral Antibiotic, Miscellaneous 2021 CDC Guidelines for Sexually Transmitted Infections (2021) Tinidazole
Metronidazole, topical Antibiotic, Topical Rosacea (2022)
Moisturizers (both cream- AND petroleum-based) Skin and Mucous Membrane Agent, Miscellaneous; Topical Skin Product Atopic Dermatitis (2020) Corticosteriods (Topical) - High potency (Class I and II); Corticosteroid (Topical) - Intermediate potency; Corticosteroid (Topical) - Low potency; Tacrolimus
Mometasone (Asmanex®) Corticosteroid, Inhalant Asthma & COPD Guidelines Review (2019) *Branded product*
Montelukast Leukotriene Receptor Antagonist Asthma & COPD Guidelines Review (2019)
Mupirocin Antibiotic, Topical Skin & Soft Tissue Infections (2021)
Naloxone Antidote; Opioid Antagonist Opioid Use Disorder (2018)
Naltrexone, extended-release for injection Antidote; Opioid Antagonist Opioid Use Disorder (2018)
Naltrexone, oral Antidote; Opioid Antagonist Alcohol Use Disorder (2022) Naloxone
Naproxen Nonsteroidal Anti-Inflammatory Drug NSAIDs (2014) Diclofenac; Ibuprofen; Indomethacin
Nicotine replacement therapy (NRT), combination Smoking Cessation Aid Nicotine Dependence (2020) Combination NRT (nicotine patches + any short-acting NRT product) Bupropion; Varenicline
Nitrofurantoin Antibiotic, Miscellaneous Urinary Tract Infections (2021)
Nitroglycerin 0.4 milligrams, sublingual Antianginal Agent; Antidote, Extravasation; Vasodilator Anti-Anginal Treatment (2013) Isosorbide mononitrate; Nitroglycerin patch
Nitroglycerin patch Antianginal Agent; Antidote, Extravasation; Vasodilator Anti-Anginal Treatment (2013) Isosorbide mononitrate
Nortriptyline Antidepressant, Tricyclic Bipolar Disorder (2022) Amitriptyline
Ondansetron Antiemetic; Selective 5-HT3 Receptor Antagonist Antiemetic Agents (2021)
Ophthalmic Prostaglandin Analog Ophthalmic Prostaglandin Analog Ophth Prostaglandin Analogs (2018) *Any product*
Oral contraceptive pill, extended cycle Contraceptive Contraception (2016) *Any product*
Oral contraceptive pill, monophasic: 20mcg EE (low) Contraceptive Contraception (2016) *Any product*
Oral contraceptive pill, monophasic: 30-35mcg EE (medium) Contraceptive Contraception (2016) *Any product*
Oral contraceptive pill, progestin only Contraceptive Contraception (2016) *Any product*
Oral contraceptive pill, triphasic Contraceptive Contraception (2016) *Any product*
Oseltamivir Antiviral Agent; Neuraminidase Inhibitor Treatment of Influenza (2019)
Oxcarbazepine Anticonvulsant, Miscellaneous Bipolar Disorder (2022) Carbamazepine; Clonazepam; Divalproex; Gabapentin; Lamotrigine; Levetiracetam; Phenytoin; Topiramate
Oxybutynin, extended-release Antispasmodic Agent, Urinary Antimuscarinics (2019) Oxybutynin, Immediate-release
Oxybutynin, immediate-release Antispasmodic Agent, Urinary Antimuscarinics (2019) Oxybutynin, extended-release
Paroxetine Antidepressant, Selective Serotonin Reuptake Inhibitor Bipolar Disorder (2022) Citalopram; Escitalopram; Fluoxetine; Sertraline
Penicillin G benzathine Antibiotic, Penicillin STIs - PART 1 (2021) Amoxicillin; Amoxicillin and Clavulanate; Penicllin V potassium
Penicllin V potassium Antibiotic, Penicillin Outpatient Abx Stewardship & URIs (2021) Pediatric and Adult oral formulations Amoxicillin; Amoxicillin and Clavulanate; Penicillin G benzathine
Permethrin 1% Antiparasitic Agent, Topical; Pediculocide; Scabicidal Agent Sexually Transmitted Infections, Part III (2022) *Any formulation* Permethrin 5% cream
Permethrin 5% cream Antiparasitic Agent, Topical; Pediculocide; Scabicidal Agent Sexually Transmitted Infections, Part III (2022) Permethrin 1%, any formulation
Phentermine and Topiramate ER (**REMS drug**) Anticonvulsant, Miscellaneous; Central Nervous System Stimulant Obesity Management (2022) **For REMS criteria, see Formulary Brief**
Phenytoin Anticonvulsant, Hydantoin Antiseizure Drugs (2021) Carbamazepine; Divalproex; Lamotrigine; Levetiracetam; Topiramate
Pioglitazone Antidiabetic Agent, Thiazolidinedione Thiazolidinediones (2017)
Polyethylene glycol Laxative, Osmotic Irritable Bowel Syndrome (2018) *Any product* Lactulose
Polymyxin B/Trimethoprim, ophthalmic solution Antibiotic, Ophthalmic Ocular Treatments (2022) Artificial Tear substitute, ophthalmic (preservative free); Ciprofloxacin, ophthalmic solution; Corticosteroid (Ophthalmic) - Low Potency
Pramipexole Anti-Parkinson Agent, Dopamine Agonist Insomnia/Sleep Medications (2021)
Pravastatin Antilipemic Agent, HMG-CoA Reductase Inhibitor Hyperlipidemia (2022) Atorvastatin; Rosuvastatin; Simvastatin
Prazosin Alpha1 Blocker; Antihypertensive Post Traumatic Stress Disorder (2021) Doxazosin; Tamsulosin
Prednisolone acetate, ophthalmic suspension Corticosteroid, Ophthalmic Ocular Treatments (2022) Artificial Tear substitute, ophthalmic (preservative free); Ciprofloxacin, ophthalmic solution; Corticosteroid (Ophthalmic) - Low Potency; Polymyxin B/Trimethoprim, ophthalmic solution
Prednisone Corticosteroid, Systemic Atopic Dermatitis (2020)
Prenatal Multivitamin Vitamin Pregnancy & Prenatal Care (2021) Must contain >400 mcg of folic acid/dose
Propranolol Antihypertensive; Beta-Blocker, Non-Selective Migraine Prevention (2019) Atenolol
Propylthiouracil Antithyroid Agent; Thioamide Hyperthyroidism (2021) Methimazole
Proton Pump Inhibitor Proton Pump Inhibitor GERD & PUD (2018) *Any product*
Pyrazinamide Antitubercular Agent Treatment of Tuberculosis (2021) Ethambutol; Isoniazid; Rifampin
Pyridoxine (Vitamin B6) Vitamin, Water Soluble Pregnancy & Prenatal Care (2021)
Raltegravir Antiretroviral, Integrase Inhibitor (Anti-HIV) HIV Treatment (2019) For (1) HIV Post-Exposure Prophylaxis (with emtricitabine/ tenofovir DF) or (2) HIV Treatment (with emtricitabine/tenofovir DF) in patients with contraindications for 1st line anti-HIV agents Emtricitabine/tenofovir disoproxil fumarate
Rifampin Antitubercular Agent Treatment of Tuberculosis (2021) Ethambutol; Isoniazid; Pyrazinamide; Rifapentine
Rifapentine Antitubercular Agent Treatment of Tuberculosis (2021) Ethambutol; Isoniazid; Pyrazinamide; Rifampin
Rifaximin Antibiotic, Rifamycin Hepatic Encephalopathy (2020) After failure of, or intolerance to, lactulose monotherapy as indicated for hepatic encephalopathy Lactulose
Rosuvastatin Antilipemic Agent, HMG-CoA Reductase Inhibitor Hyperlipidemia (2022) Atorvastatin; Pravastatin; Simvastatin
Sacubitril and Valsrtan Angiotensin II Receptor Blocker; Neprilysin Inhibitor Heart Failure with Reduced Ejection Fraction (HFrEF) (2022)
Salsalate Salicylate Added June 2008 (NSAIDs)
Semaglutide -or- Liraglutide Antidiabetic Agent, Glucagon-Like Peptide-1 (GLP-1) Receptor Agonist Long-term Pharmacotherapy for the Patient with Overweight or Obesity (2022) Select either of these subcutaneous agents, no preference given
Serotonin 5-HT1 agonist (Triptan) Antimigraine Agent; Serotonin 5-HT 1B/1D Receptor Agonist Acute Migraine (2021) Any two (2) triptan medications are required, one must be sumatriptan Sumatriptan
Sertraline Antidepressant, Selective Serotonin Reuptake Inhibitor Bipolar Disorder (2022) Citalopram; Escitalopram; Fluoxetine; Paroxetine
Sevelamer carbonate Phosphate Binder Phosphate Binders (2018) For patients on dialysis who cannot use calcium-based phosphate binders due to hypercalcemia Calcium
Sildenafil Phosphodiesterase-5 Enzyme Inhibitor Erectile Dysfunction (Nov 2022) Tadalafil
Simvastatin Antilipemic Agent, HMG-CoA Reductase Inhibitor Hyperlipidemia (2022) Atorvastatin; Pravastatin; Rosuvastatin
Sofosbuvir/Velpatasvir (Epclusa®) Antihepaciviral HCV Treatment (2018) Glecaprevir/Pibrentasvir (Mavyret®); Ledipasvir/Sofosbuvir (Harvoni®)
Spironolactone Antihypertensive; Mineralocorticoid Receptor Antagonists; Potassium Sparing Diuretic Heart Failure with Reduced Ejection Fraction (HFrEF) (2022)
Sulfasalazine 5-Aminosalicylic Acid Derivative Inflammatory Bowel Disease (2018) Hydroxychloroquine; Leflunomide; Methotrexate
Sumatriptan Antimigraine Agent; Serotonin 5-HT 1B/1D Receptor Agonist Acute Migraine (2021) Any two (2) triptan medications are required, one must be sumatriptan
Sunscreen, Sun Protection Factor (SPF) 30 or greater Ultraviolet light protectant, topical Rosacea Treatment (2022)
Tacrolimus, topical Calcineurin Inhibitor; Immunosuppressant Agent; Topical Skin Product Atopic Dermatitis (2020) Corticosteriods (Topical) - High Potency (Class I and II); Corticosteroid (Topical) - Intermediate Potency; Corticosteroid (Topical) - Low Potency; Moisturizers (both cream- AND petroleum-based)
Tadalafil Phosphodiesterase-5 Enzyme Inhibitor Erectile Dysfunction (Nov 2022) Sildenafil
Tamoxifen Antineoplastic Agent, Estrogen Receptor Antagonist; Selective Estrogen Receptor Modulator NPTC Update Spring 2021
Tamsulosin Alpha1 Blocker Benign Prostatic Hypertrophy (Nov 2022) Doxazosin; Prazosin
Testosterone (**REMS Drug**) Androgen Male Hypogonadism (2022) Any formulation; Certain formulations (i.e., undecoanate) have REMS requirements Exit Disclaimer: You Are Leaving www.ihs.gov 
Tinidazole Antibiotic, Miscellaneous 2021 CDC Guidelines for Sexually Transmitted Infections (2021) Metronidazole
Tiotropium (Spiriva®) Long-Acting Anticholinergic Agent Long Acting Muscarinic Antagonists (2019) *Branded product*
Topiramate Anticonvulsant, Miscellaneous Alcohol Use Disorder (2022) Carbamazepine; Divalproex; Lamotrigine; Levetiracetam; Phenytoin
Torsemide -OR- Bumetanide Antihypertensive Heart Failure with Preserved Ejection Fraction (HFpEF) (2022) Bumetanide -OR- Torsemide; Furosemide
Tretinoin, topical Topical Skin Product, Acne Treatment of Acne vulgaris (2020) *Any product*
Trimethoprim-Sulfamethoxazole Antibiotic, Miscellaneous Skin & Soft Tissue Infections (2021)
Ulipristal Contraceptive; Progestin Receptor Modulator Contraception (2016) Levonorgestrel (Plan B One-Step®)
Umeclidinium/Vilanterol Long-Acting Muscarinic Antagonist (LAMA) / Long-Acting Beta2 Agonist (LABA) LAMAs (2019) Tiotropium (Spiriva®)
Vaccines, All ACIP-recommended Vaccines Vaccine (2011) All ACIP recommended vaccines for routine use in accordance with ACIP guidelines
Valacyclovir Antiviral Agent, Oral 2021 CDC Guidelines for Sexually Transmitted Infections (2021)
Varenicline Partial Nicotine Agonist, Smoking Cessation Aid Nicotine Dependence (2020) Bupropion
Venlafaxine Antidepressant, Serotonin/Norepinephrine Reuptake Inhibitor/Antagonist Bipolar Disorder (2022) Bupropion; Duloxetine
Vitamin D Vitamin D Analog Pregnancy & Prenatal Care (2021) *Any product*
Vitamin D Analog, topical Vitamin D Analog Psoriasis (2018) *Any product*
Warfarin Anticoagulant; Vitamin K Antagonist Direct Oral Anticoagulants (2017) Apixaban; Low-molecular weight heparin