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: 03/10/2023
Search Medications Results
The following is a list of Medications currently in the queue. 230 record(s) found.
| Medication | Pharmacological Category | Formulary Brief | Notes | Similar Medications |
|---|---|---|---|---|
| Cyanocobalamin (Vitamin B12), oral | Vitamin, Water Soluble | Hematologic Supplements (2016) | ||
| Folic Acid | Vitamin, Water Soluble | Pregnancy & Prenatal Care (2021) | Any product containing >400 mcg / daily dose | |
| Pyridoxine (Vitamin B6) | Vitamin, Water Soluble | Pregnancy & Prenatal Care (2021) | ||
| Vitamin D | Vitamin D Analog | Pregnancy & Prenatal Care (2021) | *Any product* | |
| Vitamin D Analog, topical | Vitamin D Analog | Psoriasis (2018) | *Any product* | |
| Prenatal Multivitamin | Vitamin | Pregnancy & Prenatal Care (2021) | Must contain >400 mcg of folic acid/dose | |
| Vaccines, All ACIP-recommended | Vaccines | Vaccine (2011) | All ACIP recommended vaccines for routine use in accordance with ACIP guidelines | |
| Sunscreen, Sun Protection Factor (SPF) 30 or greater | Ultraviolet light protectant, topical | Rosacea Treatment (2022) | ||
| Benzoyl Peroxide AND Clindamycin, topical combination | Topical Skin Product, Acne; Topical Skin Product, Acne (Lincosamide Antibiotic) | Acne Treatment (2020) | Benzoyl Peroxide | |
| Benzoyl Peroxide | Topical Skin Product, Acne | Acne Treatment (2020) | Benzoyl Peroxide AND Clindamycin, topical combination | |
| Tretinoin, topical | Topical Skin Product, Acne | Treatment of Acne vulgaris (2020) | *Any product* | |
| Corticosteroids (Topical) - High Potency (Class I and II) | Topical Corticosteroids | Alopecia Areata (2022) | Corticosteroid (Topical) - Intermediate Potency; Corticosteroid (Topical) - Low Potency | |
| 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 |
| Levothyroxine | Thyroid Agent | Originally added 2004 | ||
| Laxative, stimulant | Stimulant Laxative | Added July 2011 (Constipation) | *Any product* | |
| Nicotine replacement therapy (NRT), combination | Smoking Cessation Aid | Nicotine Dependence (2020) | Combination NRT (nicotine patches + any short-acting NRT product) | Bupropion; Varenicline |
| 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 | |
| Salsalate | Salicylate | Added June 2008 (NSAIDs) | ||
| Proton Pump Inhibitor | Proton Pump Inhibitor | GERD & PUD (2018) | *Any product* | |
| Sildenafil | Phosphodiesterase-5 Enzyme Inhibitor | Erectile Dysfunction (Nov 2022) | Tadalafil | |
| Tadalafil | Phosphodiesterase-5 Enzyme Inhibitor | Erectile Dysfunction (Nov 2022) | Sildenafil | |
| Sevelamer carbonate | Phosphate Binder | Phosphate Binders (2018) | For patients on dialysis who cannot use calcium-based phosphate binders due to hypercalcemia | Calcium |
| Varenicline | Partial Nicotine Agonist, Smoking Cessation Aid | Nicotine Dependence (2020) | Bupropion | |
| Ophthalmic Prostaglandin Analog | Ophthalmic Prostaglandin Analog | Ophth Prostaglandin Analogs (2018) | *Any product* | |
| 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 |
| Fluoride, oral | Nutritional Supplement | Supplements in Oral Health (2016) | *Any oral formulation* | |
| Atomoxetine | Norepinephrine Reuptake Inhibitor, Selective | ADHD (Jan 2020) | Dextroamphetamine / Amphetamine (immediate release); Dextroamphetamine / Amphetamine (long-acting); Methylphenidate (immediate release); Methylphenidate (long-acting) | |
| Ibuprofen | Nonsteroidal Anti-Inflammatory Drug | NSAIDs (2014) | Diclofenac; Indomethacin; Meloxicam; Naproxen | |
| Indomethacin | Nonsteroidal Anti-Inflammatory Drug | NSAIDs (2014) | Diclofenac; Ibuprofen; Meloxicam; Naproxen | |
| Diclofenac | Nonsteroidal Anti-Inflammatory Drug | NSAIDs (2014) | *Any formulation* | Ibuprofen; Indomethacin; Meloxicam; Naproxen |
| Naproxen | Nonsteroidal Anti-Inflammatory Drug | NSAIDs (2014) | Diclofenac; Ibuprofen; Indomethacin | |
| Meloxicam | Nonsteroidal Anti-Inflammatory Drug | NSAIDs (2014) | Diclofenac; Ibuprofen; Indomethacin; Naproxen | |
| Memantine | N-Methyl-D-Aspartate (NMDA) Receptor Antagonist | Alzheimer's disease (2019) | ||
| Low-molecular weight heparin | Low-molecular Weight Heparin | VTE Prophylaxis (2011) | *Any product* | |
| Umeclidinium/Vilanterol | Long-Acting Muscarinic Antagonist (LAMA) / Long-Acting Beta2 Agonist (LABA) | LAMAs (2019) | Tiotropium (Spiriva®) | |
| Tiotropium (Spiriva®) | Long-Acting Anticholinergic Agent | Long Acting Muscarinic Antagonists (2019) | *Branded product* | |
| Montelukast | Leukotriene Receptor Antagonist | Asthma & COPD Guidelines Review (2019) | ||
| Polyethylene glycol | Laxative, Osmotic | Irritable Bowel Syndrome (2018) | *Any product* | Lactulose |
| Iron, oral | Iron Salt | Pregnancy & Prenatal Care (2021) | *Any oral formulation* | |
| Corticosteroid, intranasal | Intranasal Corticosteroid | Allergic Rhinitis (2018) | *Any product* | |
| Insulin Regular human (NovoLIN® R) | Insulin, Short-Acting | Diabetes Treatment Overview (2017) | *Branded product* | |
| Insulin aspart (NovoLog®) | Insulin, Rapid-Acting | 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 aspart / Insulin aspart protamine (NovoLog® Mix 70/30) | Insulin, Combination (70/30 Mix) | Diabetes Treatment Overview (2017) | *Branded product*; Pen Device | |
| Azathioprine -OR- Mercaptopurine | Immunosuppresant Agent | Inflammatory Bowel Disease (2023) | Methotrexate; Sulfasalazine | |
| Mercaptopurine -OR- Azathioprine | Immunosuppresant Agent | Inflammatory Bowel Disease (2023) | Methotrexate; Sumatriptan | |
| Famotidine | Histamine H2 Antagonist | Fall 2022 NPTC Meeting Update | ||
| H1 Antagonist (2nd generation), long-acting | Histamine H1 Antagonist, Second Generation | Allergic Rhinitis (2018) | *Any product* | |
| Hydroxyzine | Histamine H1 Antagonist, First Generation | Anxiety Disorders (2021) | ||
| Vancomycin, oral | Glycopeptide | Clostridioides Difficile (2023) | Metronidazole, oral | |
| Estradiol, transdermal | Estrogen Derivative | Gender Affirming Therapies (2022) | *Any patch* | Estradiol for Injection; Estradiol tablets |
| Estradiol for Injection | Estrogen Derivative | Gender Affirming Therapies (2022) | Either valerate or cypionate product | Estradiol tablets; Estradiol, transdermal |
| Estrogen vaginal cream | Estrogen Derivative | NPTC Meeting Update (May 2018) | *Any product* | Estradiol tablets |
| Estradiol tablets | Estrogen Derivative | Gender-Affirming Medications (2022) | Estradiol for Injection; Estradiol, transdermal | |
| Calcium | Electrolyte Supplement | Osteoporosis (2016) | *Any formulation* | |
| Prednisone | Corticosteroid, Systemic | Atopic Dermatitis (2020) | ||
| 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 |
| 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 | |
| Mometasone (Asmanex®) | Corticosteroid, Inhalant | Asthma & COPD Guidelines Review (2019) | *Branded product* | |
| Ulipristal | Contraceptive; Progestin Receptor Modulator | Contraception (2016) | Levonorgestrel (Plan B One-Step®) | |
| Medroxyprogesterone, oral | Contraceptive; Progestin | Polycystic Ovarian Syndrome (2017) | Medroxyprogesterone acetate, injection; Oral contraceptive pill, progestin only | |
| Etonogestrel, implant | Contraceptive; Progestin | Long Acting Reversible Contraception (2021) | For use by a skilled and privileged provider | Oral contraceptive pill, progestin only |
| Ethinyl estradiol / Etonogestrel vaginal ring | Contraceptive; Estrogen and Progestin Combination | Contraception (2016) | ||
| Ethinyl estradiol / Norelgestromin, transdermal | Contraceptive; Estrogen and Progestin Combination | Contraception (2016) | ||
| Medroxyprogesterone acetate, injection | Contraceptive, Progestin (Injection/Depot) | Contraception (2016) | Medroxyprogesterone, oral; Oral contraceptive pill, progestin only | |
| Levonorgestrel (Plan B One-Step®) | Contraceptive, Progestin | Contraception (2016) | *Branded product* | Ulipristal |
| Intrauterine device, levonorgestrel | Contraceptive, Progestin | Long Acting Reversible Contraception (2021) | *Any product*; For use by a skilled and privileged provider | Intrauterine device, copper |
| Intrauterine device, copper | Contraceptive | Long Acting Reversible Contraception (2021) | *Any product*; For use by a skilled and privileged provider | Intrauterine device, levonorgestrel |
| 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* | |
| 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) |
| 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 | |
| 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) | |
| Laxative, bulk-forming | Bulk-forming Laxative | Added July 2011 (Constipation) | *Any product* | |
| Alendronate | Bisphosphonate Derivative | Osteoporosis (2016) | ||
| Fluticasone/Salmeterol | Beta2 Agonist, Long-Acting; Corticosteroid, Inhalant | LABAs (2019) | Mometasone (Asmanex®) | |
| Albuterol, metered dose inhaler (MDI) | Beta2 Agonist | Asthma & COPD Guidelines Review (2019) | *Any product* | |
| Albuterol nebulized solution | Beta2 Agonist | Asthma & COPD Guidelines Review (2019) | ||
| Clonazepam | Benzodiazepine | Antiseizure Drugs (2021) | Lorazepam | |
| Lorazepam | Benzodiazepine | Alcohol Withdrawal Syndrome (2015) | Clonazepam | |
| Oseltamivir | Antiviral Agent; Neuraminidase Inhibitor | Treatment of Influenza (2019) | ||
| Valacyclovir | Antiviral Agent, Oral | 2021 CDC Guidelines for Sexually Transmitted Infections (2021) | ||
| Pyrazinamide | Antitubercular Agent | Treatment of Tuberculosis (2021) | Ethambutol; Isoniazid; Rifampin | |
| Rifampin | Antitubercular Agent | Treatment of Tuberculosis (2021) | Ethambutol; Isoniazid; Pyrazinamide; Rifapentine | |
| Rifapentine | Antitubercular Agent | Treatment of Tuberculosis (2021) | Ethambutol; Isoniazid; Pyrazinamide; Rifampin | |
| Ethambutol | Antitubercular Agent | Treatment of Tuberculosis (2021) | Isoniazid; Pyrazinamide; Rifampin; Rifapentine | |
| Isoniazid | Antitubercular Agent | Treatment of Tuberculosis (2021) | Ethambutol; Pyrazinamide; Rifampin; Rifapentine | |
| Methimazole | Antithyroid Agent; Thioamide | Hyperthyroidism (2021) | Propylthiouracil | |
| Propylthiouracil | Antithyroid Agent; Thioamide | Hyperthyroidism (2021) | Methimazole | |
| Oxybutynin, extended-release | Antispasmodic Agent, Urinary | Antimuscarinics (2019) | Oxybutynin, Immediate-release | |
| Oxybutynin, immediate-release | Antispasmodic Agent, Urinary | Antimuscarinics (2019) | Oxybutynin, extended-release | |
| Etanercept -OR- Adalimumab (can choose either product) | Antirheumatic, Disease Modifying; Tumor Necrosis Factor (TNF) Blocking Agent | Inflammatory Bowel Disease (2023) | Adalimumab -OR- Etanercept (can choose either product) | |
| Adalimumab -OR- Etanercept (can choose either product) | Antirheumatic, Disease Modifying; Tumor Necrosis Factor (TNF) Blocking Agent | Inflammatory Bowel Disease (2023) | Etanercept -OR- Adalimumab (can choose either product) | |
| Leflunomide | Antirheumatic, Disease Modifying | Non-biologic DMARDs (2016) | Hydroxychloroquine; Methotrexate; Sulfasalazine | |
| 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 |
| 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 |
| Dolutegravir | Antiretroviral, Integrase Inhibitor (Anti-HIV) | HIV Updates (2020) | For HIV treatment in pregnant patients | Emtricitabine/tenofovir disoproxil fumarate; Raltegravir |
| Bictegravir/Emtricitabine/Tenofovir alafenamide | Antiretroviral, Integrase Inhibitor (Anti-HIV) | HIV Treatment (2019) | Dolutegravir/abacavir/lamivudine; 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 |
| Haloperidol decanoate | Antipsychotic, Typical (First Generation) - Injectable | Long-Acting Injectable Antipsychotics (2020) | Injectable | Aripiprazole lauroxil |
| Aripiprazole lauroxil | Antipsychotic, Atypical (Second Generation) - Injectable | Long-Acting Injectable Antipsychotics (2020) | Injectable | Haloperidol decanoate |
| Atypical antipsychotic | Antipsychotic, Atypical | Bipolar Disorders (2022) | *Any product* | Aripiprazole lauroxil; Haloperidol decanoate |
| Aspirin | Antiplatelet Agent; Nonsteroidal Anti-Inflammatory Drug; Salicylate | Pregnancy & Prenatal Care (2021) | ||
| Clopidogrel | Antiplatelet Agent | Antiplatelets (2015) | Aspirin | |
| Carbidopa-Levodopa, immediate-release | Anti-Parkinson Agent; Decarboxylase Inhibitor-Dopamine Precursor | Parkinson's Disease (2019) | ||
| Pramipexole | Anti-Parkinson Agent, Dopamine Agonist | Insomnia/Sleep Medications (2021) | ||
| Permethrin 5% cream | Antiparasitic Agent, Topical; Pediculocide; Scabicidal Agent | Sexually Transmitted Infections, Part III (2022) | Permethrin 1%, any formulation | |
| Permethrin 1% | Antiparasitic Agent, Topical; Pediculocide; Scabicidal Agent | Sexually Transmitted Infections, Part III (2022) | *Any formulation* | Permethrin 5% cream |
| Methotrexate | Antineoplastic Agent; Antirheumatic; Disease Modifying; Immunosuppresant Agent | Non-biologic DMARDs (2016) | Hydroxychloroquine; Leflunomide; Sulfasalazine | |
| Leuprolide | Antineoplastic Agent, Gonadotropin-Releasing Hormone Agonist | Treatment of Prostate Cancer (Nov 2022) | **Any depot form** | |
| Tamoxifen | Antineoplastic Agent, Estrogen Receptor Antagonist; Selective Estrogen Receptor Modulator | NPTC Update Spring 2021 | ||
| Anastrozole | Antineoplastic Agent, Aromatase Inhibitor | NPTC Update Spring 2021 | ||
| Letrozole | Antineoplastic Agent, Aromatase Inhibitor | NPTC Update Spring 2021 | ||
| 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 |
| Sumatriptan | Antimigraine Agent; Serotonin 5-HT 1B/1D Receptor Agonist | Acute Migraine (2021) | Any two (2) triptan medications are required, one must be sumatriptan | |
| Lithium | Antimanic Agent | Bipolar Disorder (2022) | ||
| Hydroxychloroquine | Antimalarial | Non-biologic DMARDs (2016) | Leflunomide; Methotrexate; Sulfasalazine | |
| Atorvastatin | Antilipemic Agent, HMG-CoA Reductase Inhibitor | Hyperlipidemia (2022) | Pravastatin; Rosuvastatin; Simvastatin | |
| Pravastatin | Antilipemic Agent, HMG-CoA Reductase Inhibitor | Hyperlipidemia (2022) | Atorvastatin; Rosuvastatin; Simvastatin | |
| Simvastatin | Antilipemic Agent, HMG-CoA Reductase Inhibitor | Hyperlipidemia (2022) | Atorvastatin; Pravastatin; Rosuvastatin | |
| Rosuvastatin | Antilipemic Agent, HMG-CoA Reductase Inhibitor | Hyperlipidemia (2022) | Atorvastatin; Pravastatin; Simvastatin | |
| Ezetimibe | Antilipemic Agent, 2-Azetidinone | Hyperlipidemia (2022) | ||
| Chlorthalidone | Antihypertensive; Thiazide-Related Diuretic | Hypertension (2022) | Hydrochlorothiazide | |
| Hydrochlorothiazide | Antihypertensive; Thiazide Diuretic | Hypertension (2022) | Chlorthalidone | |
| Spironolactone | Antihypertensive; Mineralocorticoid Receptor Antagonists; Potassium Sparing Diuretic | Heart Failure with Reduced Ejection Fraction (HFrEF) (2022) | ||
| Diltiazem | Antihypertensive; Calcium Channel Blocker, Nondihydropyridine | Hypertension (2022) | Amlodipine | |
| Amlodipine | Antihypertensive; Calcium Channel Blocker, Dihydropyridine | Hypertension (2022) | Diltiazem | |
| Propranolol | Antihypertensive; Beta-Blocker, Non-Selective | Migraine Prevention (2019) | Atenolol | |
| Metoprolol succinate | Antihypertensive; Beta-Blocker, Beta1 Selective | Heart Failure with Reduced Ejection Fraction (HFrEF) (2022) | Atenolol; Carvedilol, immediate-release; Propranolol | |
| Atenolol | Antihypertensive; Beta-Blocker, Beta1 Selective | Hypertension (2022) | Propranolol | |
| Metoprolol tartrate | Antihypertensive; Beta-Blocker, Beta1 Selective | Heart Failure with Reduced Ejection Fraction (HFrEF) (2022) | Atenolol; Carvedilol, immediate-release; Metoprolol succinate | |
| Carvedilol, immediate-release | Antihypertensive; Beta-Blocker with Alpha-Blocking Activity | Heart Failure with Reduced Ejection Fraction (HFrEF) (2022) | Atenolol; Propranolol | |
| Lisinopril | Antihypertensive, Angiotensin-Converting Enzyme Inhibitor | Hypertension (2022) | ||
| Losartan | Antihypertensive, Angiotensin II Receptor Blocker | Hypertension (2022) | ||
| Furosemide | Antihypertensive | Heart Failure with Preserved Ejection Fraction (HFpEF) (2022) | ||
| Torsemide -OR- Bumetanide | Antihypertensive | Heart Failure with Preserved Ejection Fraction (HFpEF) (2022) | Bumetanide -OR- Torsemide; Furosemide | |
| Bumetanide -OR- Torsemide | Antihypertensive | Heart Failure with Preserved Ejection Fraction (HFpEF) (2022) | Furosemide; Torsemide -OR- Bumetanide | |
| Glecaprevir/Pibrentasvir (Mavyret®) | Antihepaciviral | HCV Treatment (2018) | Ledipasvir/sofosbuvir (Harvoni®); Sofosbuvir/velpatasvir (Epclusa®) | |
| Ledipasvir/Sofosbuvir (Harvoni®) | Antihepaciviral | HCV Treatment (2018) | Glecaprevir/Pibrentasvir (Mavyret®); Sofosbuvir/velpatasvir (Epclusa®) | |
| Sofosbuvir/Velpatasvir (Epclusa®) | Antihepaciviral | HCV Treatment (2018) | Glecaprevir/Pibrentasvir (Mavyret®); Ledipasvir/Sofosbuvir (Harvoni®) | |
| Allopurinol | Antigout Agent; Xanthine Oxidase Inhibitor | Gout (2016) | ||
| Clotrimazole, topical | Antifungal Agent, Imidazole Derivative | Male Genitourinary Infections (Nov 2022) | ||
| Fluconazole, oral | Antifungal Agent, Azole Derivative | Male Genitourinary Infections (Nov 2022) | ||
| Ondansetron | Antiemetic; Selective 5-HT3 Receptor Antagonist | Antiemetic Agents (2021) | ||
| Naltrexone, extended-release for injection | Antidote; Opioid Antagonist | Opioid Use Disorder (2018) | ||
| Naloxone | Antidote; Opioid Antagonist | Opioid Use Disorder (2018) | ||
| Naltrexone, oral | Antidote; Opioid Antagonist | Alcohol Use Disorder (2022) | Naloxone | |
| Glucagon | Antidote; Hypoglycemia | Glucagon Products Review (2021) | For outpatient use | |
| Glucose, oral | Antidote | Glucagon Products Review (2021) | Any formulation | Glucagon |
| Bismuth subsalicylate | Antidiarrheal | Helicobacter pylori Treatment (2023) | Loperamide | |
| Loperamide | Antidiarrheal | Irritable Bowel Syndrome (2018) | ||
| Glipizide | Antidiabetic Agent; Sulfonylurea | Diabetes Treatment Overview (2017) | ||
| Metformin | Antidiabetic Agent; Biguanide | Diabetes Treatment Overview (2017) | ||
| Pioglitazone | Antidiabetic Agent, Thiazolidinedione | Thiazolidinediones (2017) | ||
| Empagliflozin | Antidiabetic Agent, Sodium-Glucose Cotransporter 2 (SGLT2) Inhibitor | Heart Failure with Reduced Ejection Fraction (HFrEF) (2022) | ||
| 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 | |
| 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 | |
| Alogliptin | Antidiabetic Agent, Dipeptidyl Peptidase 4 (DPP-4) Inhibitor | DPP-IV Inhibitors (2019) | ||
| Nortriptyline | Antidepressant, Tricyclic | Bipolar Disorder (2022) | Amitriptyline | |
| Amitriptyline | Antidepressant, Tricyclic | Bipolar Disorder (2022) | Nortriptyline | |
| Duloxetine | Antidepressant, Serotonin/Norepinephrine Reuptake Inhibitor/Antagonist | Bipolar Disorder (2022) | Bupropion; Venlafaxine | |
| Venlafaxine | Antidepressant, Serotonin/Norepinephrine Reuptake Inhibitor/Antagonist | Bipolar Disorder (2022) | Bupropion; Duloxetine | |
| Sertraline | Antidepressant, Selective Serotonin Reuptake Inhibitor | Bipolar Disorder (2022) | Citalopram; Escitalopram; Fluoxetine; Paroxetine | |
| Fluoxetine | Antidepressant, Selective Serotonin Reuptake Inhibitor | Bipolar Disorder (2022) | Sertraline | |
| Citalopram | Antidepressant, Selective Serotonin Reuptake Inhibitor | Bipolar Disorder (2022) | Escitalopram; Fluoxetine; Paroxetine; Sertraline | |
| Escitalopram | Antidepressant, Selective Serotonin Reuptake Inhibitor | Bipolar Disorder (2022) | Citalopram; Fluoxetine; Paroxetine; Sertraline | |
| Paroxetine | Antidepressant, Selective Serotonin Reuptake Inhibitor | Bipolar Disorder (2022) | Citalopram; Escitalopram; Fluoxetine; Sertraline | |
| Bupropion | Antidepressant, Dopamine/Norepinephrine-Reuptake Inhibitor; Smoking Cessation Aid | Stimulant Use Disorder (2022) | Varenicline; Venlafaxine | |
| Ethosuximide | Anticonvulsant, Succinimide | Anti-Seizure Drugs (2021) | Carbamazepine; Clonazepam; Divalproex; Gabapentin; Lamotrigine; Levetiracetam; Phenytoin; Topiramate | |
| Gabapentin | Anticonvulsant, Miscellaneous; GABA Analog | Antiseizure Drugs (2021) | ||
| Phentermine and Topiramate ER (**REMS drug**) | Anticonvulsant, Miscellaneous; Central Nervous System Stimulant | Obesity Management (2022) | **For REMS criteria, see Formulary Brief** | |
| Oxcarbazepine | Anticonvulsant, Miscellaneous | Bipolar Disorder (2022) | Carbamazepine; Clonazepam; Divalproex; Gabapentin; Lamotrigine; Levetiracetam; Phenytoin; Topiramate | |
| Levetiracetam | Anticonvulsant, Miscellaneous | Antiseizure Drugs (2021) | Carbamazepine; Divalproex; Lamotrigine; Phenytoin; Topiramate | |
| Lamotrigine | Anticonvulsant, Miscellaneous | Bipolar Disorder (2022) | Carbamazepine; Divalproex; Levetiracetam; Phenytoin; Topiramate | |
| Carbamazepine | Anticonvulsant, Miscellaneous | Bipolar Disorder (2022) | Divalproex; Lamotrigine; Levetiracetam; Phenytoin; Topiramate | |
| Divalproex | Anticonvulsant, Miscellaneous | Bipolar Disorder (2022) | Carbamazepine; Lamotrigine; Levetiracetam; Phenytoin; Topiramate | |
| Topiramate | Anticonvulsant, Miscellaneous | Alcohol Use Disorder (2022) | Carbamazepine; Divalproex; Lamotrigine; Levetiracetam; Phenytoin | |
| Phenytoin | Anticonvulsant, Hydantoin | Antiseizure Drugs (2021) | Carbamazepine; Divalproex; Lamotrigine; Levetiracetam; Topiramate | |
| Warfarin | Anticoagulant; Vitamin K Antagonist | Direct Oral Anticoagulants (2017) | Apixaban; Low-molecular weight heparin | |
| Apixaban | Anticoagulant; Direct Oral Anticoagulant (DOAC); Factor Xa Inhibitor | Direct Oral Anticoagulants (2017) | Warfarin | |
| Dicyclomine | Anticholinergic Agent | Irritable Bowel Syndrome (2018) | ||
| Mupirocin | Antibiotic, Topical | Skin & Soft Tissue Infections (2021) | ||
| Metronidazole, topical | Antibiotic, Topical | Rosacea (2022) | ||
| Doxycycline | Antibiotic, Tetracycline | STIs - PART 1 (2021) | ||
| Rifaximin | Antibiotic, Rifamycin | Hepatic Encephalopathy (2020) | After failure of, or intolerance to, lactulose monotherapy as indicated for hepatic encephalopathy | Lactulose |
| Penicillin G benzathine | Antibiotic, Penicillin | STIs - PART 1 (2021) | Amoxicillin; Amoxicillin and Clavulanate; Penicllin V potassium | |
| 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 |
| Penicillin V potassium | Antibiotic, Penicillin | Outpatient Abx Stewardship & URIs (2021) | Pediatric and Adult oral formulations | Amoxicillin; Amoxicillin and Clavulanate; Penicillin G benzathine |
| Ciprofloxacin, ophthalmic solution | Antibiotic, Ophthalmic Fluoroquinolone | Ocular Treatments (2022) | Artificial Tear substitute, ophthalmic (preservative free); Corticosteroid (Ophthalmic) - Low Potency; Polymyxin B/trimethoprim, Ophthalmic Solution | |
| Polymyxin B/Trimethoprim, ophthalmic solution | Antibiotic, Ophthalmic | Ocular Treatments (2022) | Artificial Tear substitute, ophthalmic (preservative free); Ciprofloxacin, ophthalmic solution; Corticosteroid (Ophthalmic) - Low Potency | |
| Nitrofurantoin | Antibiotic, Miscellaneous | Urinary Tract Infections (2021) | ||
| Trimethoprim-Sulfamethoxazole | Antibiotic, Miscellaneous | Skin & Soft Tissue Infections (2021) | ||
| Metronidazole, oral | Antibiotic, Miscellaneous | 2021 CDC Guidelines for Sexually Transmitted Infections (2021) | Tinidazole | |
| Tinidazole | Antibiotic, Miscellaneous | 2021 CDC Guidelines for Sexually Transmitted Infections (2021) | Metronidazole | |
| Azithromycin | Antibiotic, Macrolide | STIs - PART 1 (2021) | ||
| Clindamycin | Antibiotic, Lincosamide | Outpatient Abx Stewardship & URIs (2021) | Pediatric and Adult oral formulations | |
| Ciprofloxacin, oral | Antibiotic, Fluoroquinolone | Male Genitourinary Infections (Nov 2022) | ||
| Ceftriaxone, injection | Antibiotic, Cephalosporin (Third Generation) | STIs - PART 1 (2021) | Cefdinir; Cefixime; 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 |
| Cefdinir | Antibiotic, Cephalosporin (Third Generation) | Outpatient Abx Stewardship & URIs (2021) | Pediatric and Adult oral formulations | Cefixime; Ceftriaxone Injection; Cephalexin |
| Cephalexin | Antibiotic, Cephalosporin (First Generation) | Outpatient Abx Stewardship & URIs (2021) | Pediatric and Adult oral formulations | Cefdinir; Cefixime; Ceftriaxone Injection |
| Digoxin | Antiarrhythmic Agent, Miscellaneous; Cardiac Glycoside | Heart Failure with Reduced Ejection Fraction (HFrEF) (2022) | ||
| Isosorbide mononitrate | Antianginal Agent; Vasodilator | Anti-Anginal Treatment (2013) | Nitroglycerin patch | |
| 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 | |
| Sacubitril and Valsrtan | Angiotensin II Receptor Blocker; Neprilysin Inhibitor | Heart Failure with Reduced Ejection Fraction (HFrEF) (2022) | ||
| Testosterone (**REMS Drug**) | Androgen | Male Hypogonadism (2022) | Any formulation; Certain formulations (i.e., undecoanate) have REMS requirements | |
| 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** | 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** | Naloxone |
| 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** | Buprenorphine, short-acting (**REMS drug**); Buprenorphine-Naloxone (**REMS drug**) |
| Acetaminophen | Analgesic, Miscellaneous | Short-Acting Opioids (2014) | ||
| Lactulose | Ammonium Detoxicant; Laxative, Osmotic | Hepatic Encephalopathy (2020) | Polyethylene glycol | |
| Doxazosin | Alpha1 Blocker; Antihypertensive | Benign Prostatic Hypertrophy (Nov 2022) | Prazosin; Tamsulosin | |
| Prazosin | Alpha1 Blocker; Antihypertensive | Post Traumatic Stress Disorder (2021) | Doxazosin; Tamsulosin | |
| Tamsulosin | Alpha1 Blocker | Benign Prostatic Hypertrophy (Nov 2022) | Doxazosin; Prazosin | |
| Epinephrine Injection Devices (both 0.15mg and 0.3mg) | Alpha-/Beta- Agonist | Epinephrine Injection Devices (2020 | Any device, auto-injector or pre-filled syringe | |
| Donepezil | Acetylcholinesterase Inhibitor (Central) | Alzheimer's disease (2019) | 5mg and 10mg strengths | |
| Sulfasalazine | 5-Aminosalicylic Acid Derivative | Inflammatory Bowel Disease (2018) | Hydroxychloroquine; Leflunomide; Methotrexate | |
| Mesalamine, oral | 5-Aminosalicylic Acid Derivative | Inflammatory Bowel Disease (2023) | Once-Daily Formulation | Sulfasalazine |
| Finasteride | 5 Alpha-Reductase Inhibitor | Benign Prostatic Hypertrophy (Nov 2022) |
