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
Search Medications Results
The following is a list of Medications currently in the queue. 225 record(s) found.
| Medication | Pharmacological Category | Formulary Brief | Notes | Similar Medications |
|---|---|---|---|---|
| Ondansetron | Antiemetic; Selective 5-HT3 Receptor Antagonist | Antiemetic Agents (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 | |
| Valacyclovir | Antiviral Agent, Oral | 2021 CDC Guidelines for Sexually Transmitted Infections (2021) | ||
| 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 |
| 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 |
| Clindamycin | Antibiotic, Lincosamide | Outpatient Abx Stewardship & URIs (2021) | Pediatric and Adult oral formulations | |
| Penicllin V potassium | Antibiotic, Penicillin | Outpatient Abx Stewardship & URIs (2021) | Pediatric and Adult oral formulations | Amoxicillin; Amoxicillin and Clavulanate; Penicillin G benzathine |
| 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 | |
| Tretinoin, topical | Topical Skin Product, Acne | Treatment of Acne vulgaris (2020) | *Any product* | |
| 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 | |
| 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 | |
| Atomoxetine | Norepinephrine Reuptake Inhibitor, Selective | ADHD (Jan 2020) | Dextroamphetamine / Amphetamine (immediate release); Dextroamphetamine / Amphetamine (long-acting); Methylphenidate (immediate release); Methylphenidate (long-acting) | |
| Naltrexone, oral | Antidote; Opioid Antagonist | Alcohol Use Disorder (2022) | Naloxone | |
| Topiramate | Anticonvulsant, Miscellaneous | Alcohol Use Disorder (2022) | Carbamazepine; Divalproex; Lamotrigine; Levetiracetam; Phenytoin | |
| H1 Antagonist (2nd generation), long-acting | Histamine H1 Antagonist, Second Generation | Allergic Rhinitis (2018) | *Any product* | |
| 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 | |
| Lorazepam | Benzodiazepine | Alcohol Withdrawal Syndrome (2015) | Clonazepam | |
| Donepezil | Acetylcholinesterase Inhibitor (Central) | Alzheimer's disease (2019) | 5mg and 10mg strengths | |
| Memantine | N-Methyl-D-Aspartate (NMDA) Receptor Antagonist | Alzheimer's disease (2019) | ||
| Oxybutynin, extended-release | Antispasmodic Agent, Urinary | Antimuscarinics (2019) | Oxybutynin, Immediate-release | |
| Oxybutynin, immediate-release | Antispasmodic Agent, Urinary | Antimuscarinics (2019) | Oxybutynin, extended-release | |
| Clopidogrel | Antiplatelet Agent | Antiplatelets (2015) | Aspirin | |
| Clonazepam | Benzodiazepine | Antiseizure Drugs (2021) | Lorazepam | |
| Levetiracetam | Anticonvulsant, Miscellaneous | Antiseizure Drugs (2021) | Carbamazepine; Divalproex; Lamotrigine; Phenytoin; Topiramate | |
| Gabapentin | Anticonvulsant, Miscellaneous; GABA Analog | Antiseizure Drugs (2021) | ||
| Phenytoin | Anticonvulsant, Hydantoin | Antiseizure Drugs (2021) | Carbamazepine; Divalproex; Lamotrigine; Levetiracetam; Topiramate | |
| Ethosuximide | Anticonvulsant, Succinimide | Anti-Seizure Drugs (2021) | Carbamazepine; Clonazepam; Divalproex; Gabapentin; Lamotrigine; Levetiracetam; Phenytoin; Topiramate | |
| Hydroxyzine | Histamine H1 Antagonist, First Generation | Anxiety Disorders (2021) | ||
| Mometasone (Asmanex®) | Corticosteroid, Inhalant | Asthma & COPD Guidelines Review (2019) | *Branded product* | |
| Montelukast | Leukotriene Receptor Antagonist | Asthma & COPD Guidelines Review (2019) | ||
| Albuterol, metered dose inhaler (MDI) | Beta2 Agonist | Asthma & COPD Guidelines Review (2019) | *Any product* | |
| Albuterol nebulized solution | Beta2 Agonist | Asthma & COPD Guidelines Review (2019) | ||
| 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 |
| Prednisone | Corticosteroid, Systemic | Atopic Dermatitis (2020) | ||
| 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 | |
| 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) | |
| 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 | |
| Oxcarbazepine | Anticonvulsant, Miscellaneous | Bipolar Disorder (2022) | Carbamazepine; Clonazepam; Divalproex; Gabapentin; Lamotrigine; Levetiracetam; Phenytoin; Topiramate | |
| Nortriptyline | Antidepressant, Tricyclic | Bipolar Disorder (2022) | Amitriptyline | |
| Lithium | Antimanic Agent | Bipolar Disorder (2022) | ||
| 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 | |
| Amitriptyline | Antidepressant, Tricyclic | Bipolar Disorder (2022) | Nortriptyline | |
| Carbamazepine | Anticonvulsant, Miscellaneous | Bipolar Disorder (2022) | Divalproex; Lamotrigine; Levetiracetam; Phenytoin; Topiramate | |
| Fluoxetine | Antidepressant, Selective Serotonin Reuptake Inhibitor | Bipolar Disorder (2022) | Sertraline | |
| Divalproex | Anticonvulsant, Miscellaneous | Bipolar Disorder (2022) | Carbamazepine; Lamotrigine; Levetiracetam; Phenytoin; Topiramate | |
| Lamotrigine | Anticonvulsant, Miscellaneous | Bipolar Disorder (2022) | Carbamazepine; Divalproex; Levetiracetam; Phenytoin; Topiramate | |
| Atypical antipsychotic | Antipsychotic, Atypical | Bipolar Disorders (2022) | *Any product* | Aripiprazole lauroxil; Haloperidol decanoate |
| Doxazosin | Alpha1 Blocker; Antihypertensive | Benign Prostatic Hypertrophy (Nov 2022) | Prazosin; Tamsulosin | |
| Finasteride | 5 Alpha-Reductase Inhibitor | Benign Prostatic Hypertrophy (Nov 2022) | ||
| Tamsulosin | Alpha1 Blocker | Benign Prostatic Hypertrophy (Nov 2022) | Doxazosin; Prazosin | |
| Ulipristal | Contraceptive; Progestin Receptor Modulator | Contraception (2016) | Levonorgestrel (Plan B One-Step®) | |
| Medroxyprogesterone acetate, injection | Contraceptive, Progestin (Injection/Depot) | Contraception (2016) | Medroxyprogesterone, oral; Oral contraceptive pill, progestin only | |
| 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* | |
| Ethinyl estradiol / Etonogestrel vaginal ring | Contraceptive; Estrogen and Progestin Combination | Contraception (2016) | ||
| Ethinyl estradiol / Norelgestromin, transdermal | Contraceptive; Estrogen and Progestin Combination | Contraception (2016) | ||
| Levonorgestrel (Plan B One-Step®) | Contraceptive, Progestin | Contraception (2016) | *Branded product* | Ulipristal |
| Sulfasalazine | 5-Aminosalicylic Acid Derivative | Inflammatory Bowel Disease (2018) | Hydroxychloroquine; Leflunomide; Methotrexate | |
| Metformin | Antidiabetic Agent; Biguanide | Diabetes Treatment Overview (2017) | ||
| 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* | |
| Glipizide | Antidiabetic Agent; Sulfonylurea | Diabetes Treatment Overview (2017) | ||
| 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 | |
| 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 | |
| Alogliptin | Antidiabetic Agent, Dipeptidyl Peptidase 4 (DPP-4) Inhibitor | DPP-IV Inhibitors (2019) | ||
| Varenicline | Partial Nicotine Agonist, Smoking Cessation Aid | Nicotine Dependence (2020) | Bupropion | |
| Nicotine replacement therapy (NRT), combination | Smoking Cessation Aid | Nicotine Dependence (2020) | Combination NRT (nicotine patches + any short-acting NRT product) | Bupropion; Varenicline |
| Epinephrine Injection Devices (both 0.15mg and 0.3mg) | Alpha-/Beta- Agonist | Epinephrine Injection Devices (2020 | Any device, auto-injector or pre-filled syringe | |
| 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 |
| Estradiol tablets | Estrogen Derivative | Gender-Affirming Medications (2022) | Estradiol for Injection; Estradiol, transdermal | |
| Ciprofloxacin, ophthalmic solution | Antibiotic, Ophthalmic Fluoroquinolone | Ocular Treatments (2022) | Artificial Tear substitute, ophthalmic (preservative free); Corticosteroid (Ophthalmic) - Low Potency; Polymyxin B/trimethoprim, Ophthalmic Solution | |
| Proton Pump Inhibitor | Proton Pump Inhibitor | GERD & PUD (2018) | *Any product* | |
| 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 | |
| Glucose, oral | Antidote | Glucagon Products Review (2021) | Any formulation | Glucagon |
| Glucagon | Antidote; Hypoglycemia | Glucagon Products Review (2021) | For outpatient use | |
| Allopurinol | Antigout Agent; Xanthine Oxidase Inhibitor | Gout (2016) | ||
| Ciprofloxacin, oral | Antibiotic, Fluoroquinolone | Male Genitourinary Infections (Nov 2022) | ||
| Clotrimazole, topical | Antifungal Agent, Imidazole Derivative | Male Genitourinary Infections (Nov 2022) | ||
| Fluconazole, oral | Antifungal Agent, Azole Derivative | Male Genitourinary Infections (Nov 2022) | ||
| 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®) | |
| 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 | |
| Sacubitril and Valsrtan | Angiotensin II Receptor Blocker; Neprilysin Inhibitor | Heart Failure with Reduced Ejection Fraction (HFrEF) (2022) | ||
| Metoprolol tartrate | Antihypertensive; Beta-Blocker, Beta1 Selective | Heart Failure with Reduced Ejection Fraction (HFrEF) (2022) | Atenolol; Carvedilol, immediate-release; Metoprolol succinate | |
| Empagliflozin | Antidiabetic Agent, Sodium-Glucose Cotransporter 2 (SGLT2) Inhibitor | Heart Failure with Reduced Ejection Fraction (HFrEF) (2022) | ||
| Carvedilol, immediate-release | Antihypertensive; Beta-Blocker with Alpha-Blocking Activity | Heart Failure with Reduced Ejection Fraction (HFrEF) (2022) | Atenolol; Propranolol | |
| Digoxin | Antiarrhythmic Agent, Miscellaneous; Cardiac Glycoside | Heart Failure with Reduced Ejection Fraction (HFrEF) (2022) | ||
| Spironolactone | Antihypertensive; Mineralocorticoid Receptor Antagonists; Potassium Sparing Diuretic | Heart Failure with Reduced Ejection Fraction (HFrEF) (2022) | ||
| Metoprolol succinate | Antihypertensive; Beta-Blocker, Beta1 Selective | Heart Failure with Reduced Ejection Fraction (HFrEF) (2022) | Atenolol; Carvedilol, immediate-release; Propranolol | |
| Lactulose | Ammonium Detoxicant; Laxative, Osmotic | Hepatic Encephalopathy (2020) | Polyethylene glycol | |
| Rifaximin | Antibiotic, Rifamycin | Hepatic Encephalopathy (2020) | After failure of, or intolerance to, lactulose monotherapy as indicated for hepatic encephalopathy | Lactulose |
| Dolutegravir | Antiretroviral, Integrase Inhibitor (Anti-HIV) | HIV Updates (2020) | For HIV treatment in pregnant patients | Emtricitabine/tenofovir disoproxil fumarate; Raltegravir |
| 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 |
| 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 |
| Ezetimibe | Antilipemic Agent, 2-Azetidinone | Hyperlipidemia (2022) | ||
| Rosuvastatin | Antilipemic Agent, HMG-CoA Reductase Inhibitor | Hyperlipidemia (2022) | Atorvastatin; Pravastatin; 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 | |
| Atorvastatin | Antilipemic Agent, HMG-CoA Reductase Inhibitor | Hyperlipidemia (2022) | Pravastatin; Rosuvastatin; Simvastatin | |
| Atenolol | Antihypertensive; Beta-Blocker, Beta1 Selective | Hypertension (2022) | Propranolol | |
| Chlorthalidone | Antihypertensive; Thiazide-Related Diuretic | Hypertension (2022) | Hydrochlorothiazide | |
| Amlodipine | Antihypertensive; Calcium Channel Blocker, Dihydropyridine | Hypertension (2022) | Diltiazem | |
| Diltiazem | Antihypertensive; Calcium Channel Blocker, Nondihydropyridine | Hypertension (2022) | Amlodipine | |
| Lisinopril | Antihypertensive, Angiotensin-Converting Enzyme Inhibitor | Hypertension (2022) | ||
| Losartan | Antihypertensive, Angiotensin II Receptor Blocker | Hypertension (2022) | ||
| Hydrochlorothiazide | Antihypertensive; Thiazide Diuretic | Hypertension (2022) | Chlorthalidone | |
| Methimazole | Antithyroid Agent; Thioamide | Hyperthyroidism (2021) | Propylthiouracil | |
| Propylthiouracil | Antithyroid Agent; Thioamide | Hyperthyroidism (2021) | Methimazole | |
| Oseltamivir | Antiviral Agent; Neuraminidase Inhibitor | Treatment of Influenza (2019) | ||
| Pramipexole | Anti-Parkinson Agent, Dopamine Agonist | Insomnia/Sleep Medications (2021) | ||
| Polyethylene glycol | Laxative, Osmotic | Irritable Bowel Syndrome (2018) | *Any product* | Lactulose |
| Loperamide | Antidiarrheal | Irritable Bowel Syndrome (2018) | ||
| Dicyclomine | Anticholinergic Agent | Irritable Bowel Syndrome (2018) | ||
| Fluticasone/Salmeterol | Beta2 Agonist, Long-Acting; Corticosteroid, Inhalant | LABAs (2019) | Mometasone (Asmanex®) | |
| 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 detemir (Levemir®) | Insulin, Long-Acting | Long-acting Insulins & Biosimilars (2021) | *Branded product*; Pen Device | |
| 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* | |
| Aripiprazole lauroxil | Antipsychotic, Atypical (Second Generation) - Injectable | Long-Acting Injectable Antipsychotics (2020) | Injectable | Haloperidol decanoate |
| Haloperidol decanoate | Antipsychotic, Typical (First Generation) - Injectable | Long-Acting Injectable Antipsychotics (2020) | Injectable | Aripiprazole lauroxil |
| 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 |
| Etonogestrel, implant | Contraceptive; Progestin | Long Acting Reversible Contraception (2021) | For use by a skilled and privileged provider | Oral contraceptive pill, progestin only |
| 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, 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**) |
| Buprenorphine-Naloxone (**REMS drug**) | Analgesic, Opioid; Analgesic, Opioid Partial Agonist | MAT for OUD (2021) | **See REMS here** | Naloxone |
| Propranolol | Antihypertensive; Beta-Blocker, Non-Selective | Migraine Prevention (2019) | Atenolol | |
| Methotrexate | Antineoplastic Agent; Antirheumatic; Disease Modifying; Immunosuppresant Agent | Non-biologic DMARDs (2016) | Hydroxychloroquine; Leflunomide; Sulfasalazine | |
| Hydroxychloroquine | Antimalarial | Non-biologic DMARDs (2016) | Leflunomide; Methotrexate; Sulfasalazine | |
| Leflunomide | Antirheumatic, Disease Modifying | Non-biologic DMARDs (2016) | Hydroxychloroquine; Methotrexate; Sulfasalazine | |
| 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 |
| Meloxicam | Nonsteroidal Anti-Inflammatory Drug | NSAIDs (2014) | Diclofenac; Ibuprofen; Indomethacin; Naproxen | |
| Naproxen | Nonsteroidal Anti-Inflammatory Drug | NSAIDs (2014) | Diclofenac; Ibuprofen; Indomethacin | |
| Cyanocobalamin (Vitamin B12), oral | Vitamin, Water Soluble | Hematologic Supplements (2016) | ||
| Isoniazid | Antitubercular Agent | Treatment of Tuberculosis (2021) | Ethambutol; Pyrazinamide; Rifampin; Rifapentine | |
| Fluoride, oral | Nutritional Supplement | Supplements in Oral Health (2016) | *Any oral formulation* | |
| 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 | |
| Phentermine and Topiramate ER (**REMS drug**) | Anticonvulsant, Miscellaneous; Central Nervous System Stimulant | Obesity Management (2022) | **For REMS criteria, see Formulary Brief** | |
| Polymyxin B/Trimethoprim, ophthalmic solution | Antibiotic, Ophthalmic | Ocular Treatments (2022) | Artificial Tear substitute, ophthalmic (preservative free); Ciprofloxacin, ophthalmic solution; Corticosteroid (Ophthalmic) - Low Potency | |
| 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 | |
| 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 |
| Ophthalmic Prostaglandin Analog | Ophthalmic Prostaglandin Analog | Ophth Prostaglandin Analogs (2018) | *Any product* | |
| Naloxone | Antidote; Opioid Antagonist | Opioid Use Disorder (2018) | ||
| Naltrexone, extended-release for injection | Antidote; Opioid Antagonist | Opioid Use Disorder (2018) | ||
| Alendronate | Bisphosphonate Derivative | Osteoporosis (2016) | ||
| Calcium | Electrolyte Supplement | Osteoporosis (2016) | *Any formulation* | |
| Carbidopa-Levodopa, immediate-release | Anti-Parkinson Agent; Decarboxylase Inhibitor-Dopamine Precursor | Parkinson's Disease (2019) | ||
| Sevelamer carbonate | Phosphate Binder | Phosphate Binders (2018) | For patients on dialysis who cannot use calcium-based phosphate binders due to hypercalcemia | Calcium |
| Medroxyprogesterone, oral | Contraceptive; Progestin | Polycystic Ovarian Syndrome (2017) | Medroxyprogesterone acetate, injection; Oral contraceptive pill, progestin only | |
| Vitamin D | Vitamin D Analog | Pregnancy & Prenatal Care (2021) | *Any product* | |
| Pyridoxine (Vitamin B6) | Vitamin, Water Soluble | Pregnancy & Prenatal Care (2021) | ||
| Aspirin | Antiplatelet Agent; Nonsteroidal Anti-Inflammatory Drug; Salicylate | Pregnancy & Prenatal Care (2021) | ||
| Folic Acid | Vitamin, Water Soluble | Pregnancy & Prenatal Care (2021) | Any product containing >400 mcg / daily dose | |
| Iron, oral | Iron Salt | Pregnancy & Prenatal Care (2021) | *Any oral formulation* | |
| Prenatal Multivitamin | Vitamin | Pregnancy & Prenatal Care (2021) | Must contain >400 mcg of folic acid/dose | |
| Leuprolide | Antineoplastic Agent, Gonadotropin-Releasing Hormone Agonist | Treatment of Prostate Cancer (Nov 2022) | **Any depot form** | |
| Vitamin D Analog, topical | Vitamin D Analog | Psoriasis (2018) | *Any product* | |
| Prazosin | Alpha1 Blocker; Antihypertensive | Post Traumatic Stress Disorder (2021) | Doxazosin; Tamsulosin | |
| Metronidazole, topical | Antibiotic, Topical | Rosacea (2022) | ||
| Sunscreen, Sun Protection Factor (SPF) 30 or greater | Ultraviolet light protectant, topical | Rosacea Treatment (2022) | ||
| Acetaminophen | Analgesic, Miscellaneous | Short-Acting Opioids (2014) | ||
| 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 |
| Azithromycin | Antibiotic, Macrolide | STIs - PART 1 (2021) | ||
| Doxycycline | Antibiotic, Tetracycline | STIs - PART 1 (2021) | ||
| Penicillin G benzathine | Antibiotic, Penicillin | STIs - PART 1 (2021) | Amoxicillin; Amoxicillin and Clavulanate; Penicllin V potassium | |
| Mupirocin | Antibiotic, Topical | Skin & Soft Tissue Infections (2021) | ||
| Trimethoprim-Sulfamethoxazole | Antibiotic, Miscellaneous | Skin & Soft Tissue Infections (2021) | ||
| Bupropion | Antidepressant, Dopamine/Norepinephrine-Reuptake Inhibitor; Smoking Cessation Aid | Stimulant Use Disorder (2022) | Varenicline; Venlafaxine | |
| 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 |
| Pioglitazone | Antidiabetic Agent, Thiazolidinedione | Thiazolidinediones (2017) | ||
| 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) |
| 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 | |
| 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 | |
| Nitrofurantoin | Antibiotic, Miscellaneous | Urinary Tract Infections (2021) | ||
| Vaccines, All ACIP-recommended | Vaccines | Vaccine (2011) | All ACIP recommended vaccines for routine use in accordance with ACIP guidelines | |
| Low-molecular weight heparin | Low-molecular Weight Heparin | VTE Prophylaxis (2011) | *Any product* | |
| Sildenafil | Phosphodiesterase-5 Enzyme Inhibitor | Erectile Dysfunction (Nov 2022) | Tadalafil | |
| Tadalafil | Phosphodiesterase-5 Enzyme Inhibitor | Erectile Dysfunction (Nov 2022) | Sildenafil | |
| Letrozole | Antineoplastic Agent, Aromatase Inhibitor | NPTC Update Spring 2021 | ||
| Anastrozole | Antineoplastic Agent, Aromatase Inhibitor | NPTC Update Spring 2021 | ||
| Tamoxifen | Antineoplastic Agent, Estrogen Receptor Antagonist; Selective Estrogen Receptor Modulator | NPTC Update Spring 2021 | ||
| Estrogen vaginal cream | Estrogen Derivative | NPTC Meeting Update (May 2018) | *Any product* | Estradiol tablets |
| Famotidine | Histamine H2 Antagonist | Fall 2022 NPTC Meeting Update | ||
| Laxative, stimulant | Stimulant Laxative | Added July 2011 (Constipation) | *Any product* | |
| Laxative, bulk-forming | Bulk-forming Laxative | Added July 2011 (Constipation) | *Any product* | |
| Salsalate | Salicylate | Added June 2008 (NSAIDs) | ||
| 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 | |
| Isosorbide mononitrate | Antianginal Agent; Vasodilator | Anti-Anginal Treatment (2013) | Nitroglycerin patch | |
| Levothyroxine | Thyroid Agent | Originally added 2004 |
