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 |
|---|---|---|---|---|
| Acetaminophen | Analgesic, Miscellaneous | |||
| Albuterol nebulized solution | Beta2 Agonist | |||
| Anastrozole | Antineoplastic Agent, Aromatase Inhibitor | |||
| Aspirin | Antiplatelet Agent; Nonsteroidal Anti-Inflammatory Drug; Salicylate | |||
| Calcium | Electrolyte supplement | *Any formulation* | ||
| Corticosteroid (Topical) - Intermediate Potency | Topical Corticosteroids | *Any product* | Corticosteriods (Topical) - High Potency (Class I and II); Corticosteroid (Topical) - Low potency | |
| Corticosteroid (Topical) - Low Potency | Topical Corticosteroids | *Any product* | Corticosteriods (Topical) - High Potency (Class I and II); Corticosteroid (Topical) - Intermediate Potency | |
| Dextroamphetamine / Amphetamine (immediate release) | Central Nervous System Stimulant | Pediatric use only | Dextroamphetamine and amphetamine (long-acting) | |
| Dextroamphetamine / Amphetamine (long-acting) | Central Nervous System Stimulant | Pediatric use only | Dextroamphetamine and amphetamine (immediate release) | |
| Donepezil | Acetylcholinesterase Inhibitor (Central) | 5mg and 10mg strengths | ||
| Ethambutol | Antitubercular Agent | Isoniazid; Pyrazinamide; Rifampin; Rifapentine | ||
| Fluoxetine | Antidepressant, Selective Serotonin Reuptake Inhibitor | Sertraline | ||
| Glucagon | Antidote; Hypoglycemia | For outpatient use | ||
| H1 Antagonist (2nd generation), long-acting | Histamine H1 Antagonist, Second Generation | *Any product* | ||
| Corticosteroid, intranasal | Intranasal Corticosteroid | *Any product* | ||
| Isosorbide mononitrate | Antianginal Agent; Vasodilator | Nitroglycerin 0.4 Milligrams; Sublingual; Nitroglycerin patch | ||
| Laxative, bulk-forming | Bulk-forming Laxative | *Any product* | ||
| Laxative, stimulant | Stimulant Laxative | *Any product* | ||
| Letrozole | Antineoplastic Agent, Aromatase Inhibitor | |||
| Levothyroxine | Thyroid Agent | |||
| Metformin | Antidiabetic Agent; Biguanide | |||
| Methylphenidate (immediate release) | Central Nervous System Stimulant | Pediatric use only | Methylphenidate (long-acting) | |
| Methylphenidate (long-acting) | Central Nervous System Stimulant | Pediatric use only | Methylphenidate (immediate release) | |
| Mometasone (Asmanex®) | Corticosteroid, Inhalant | *Branded product* | ||
| Montelukast | Leukotriene Receptor Antagonist | |||
| Nitroglycerin 0.4 milligrams, sublingual | Antianginal Agent; Antidote, Extravasation; Vasodilator | Isosorbide mononitrate; Nitroglycerin patch | ||
| Nitroglycerin patch | Antianginal Agent; Antidote, Extravasation; Vasodilator | Isosorbide mononitrate; Nitroglycerin 0.4 milligrams; Sublingual | ||
| Oral contraceptive pill, monophasic: 20mcg EE (low) | Contraceptive | *Any product* | Monophasic: 30-35mcg EE (medium); Oral contraceptive pill | |
| Oral contraceptive pill, monophasic: 30-35mcg EE (medium) | Contraceptive | *Any product* | Monophasic: 20mcg EE (low) ; Oral contraceptive pill | |
| Oral contraceptive pill, progestin only | Contraceptive | *Any product* | Etonogestrel; Implant; Intrauterine Device; Levonorgestrel | |
| Oral contraceptive pill, triphasic | Contraceptive | *Any product* | Monophasics ; Oral Contraceptive Pill | |
| Prednisone | Corticosteroid, Systemic | |||
| Pyrazinamide | Antitubercular Agent | Ethambutol; Isoniazid; Rfapentine ; Rifampin | ||
| Rifampin | Antitubercular Agent | Ethambutol; Isoniazid; Pyrazinamide; Rifapentine | ||
| Salsalate | Salicylate | |||
| Sertraline | Antidepressant, Selective Serotonin Reuptake Inhibitor | Citalopram; Escitalopram; Fluoxetine; Paroxetine | ||
| Sulfasalazine | 5-Aminosalicylic Acid Derivative | Hydroxychloroquine; Leflunomide; Methotrexate | ||
| Tamoxifen | Antineoplastic Agent, Estrogen Receptor Antagonist; Selective Estrogen Receptor Modulator | |||
| Memantine | N-Methyl-D-Aspartate (NMDA) Receptor Antagonist | |||
| Fluconazole, oral | Antifungal Agent, Azole Derivative | |||
| Sildenafil | Phosphodiesterase-5 Enzyme Inhibitor | **Coming soon** | Tadalafil | |
| Tadalafil | Phosphodiesterase-5 Enzyme Inhibitor | **Coming soon** | Sildenafil | |
| Leuprolide | Antineoplastic Agent, Gonadotropin-Releasing Hormone Agonist | **Coming soon** | ||
| Famotidine | Histamine H2 Antagonist | **Coming soon** | ||
| Ciprofloxacin, oral | Antibiotic, Fluoroquinolone | **Coming soon** | ||
| Clotrimazole, topical | Antifungal Agent, Imidazole Derivative | **Coming soon** | ||
| Digoxin | Antiarrhythmic Agent, Miscellaneous; Cardiac Glycoside | Digoxin Use (2016) | ||
| 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 |
| Ezetimibe | Antilipemic Agent, 2-Azetidinone | 2018 ACC/AHA Cholesterol Guidelines (2019) | ||
| Lisinopril | Antihypertensive, Angiotensin-Converting Enzyme Inhibitor | ACEIs & ARBs in Heart Failure (2017) | ||
| Losartan | Antihypertensive, Angiotensin II Receptor Blocker | ACEIs & ARBs in Heart Failure (2017) | ||
| Tretinoin, topical | Topical Skin Product, Acne | Acne (2013) | *Any product* | |
| 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 | |
| Atomoxetine | Norepinephrine Reuptake Inhibitor, Selective | ADHD (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 | |
| Clonazepam | Benzodiazepine | Alcohol Withdrawal Syndrome (2015) | Lorazepam | |
| Lorazepam | Benzodiazepine | Alcohol Withdrawal Syndrome (2015) | Clonazepam | |
| Nortriptyline | Antidepressant, Tricyclic | Antidepressants in Pain Mgmt (2014) | Amitriptyline | |
| Amitriptyline | Antidepressant, Tricyclic | Antidepressants in Pain Mgmt (2014) | Nortriptyline | |
| Topiramate | Anticonvulsant, Miscellaneous | Antiepileptic Medications (2014) | Carbamazepine; Divalproex; Lamotrigine; Levetiracetam; Phenytoin | |
| Phenytoin | Anticonvulsant, Hydantoin | Antiepileptics (2014) | Carbamazepine; Divalproex; Lamotrigine; Levetiracetam; Topiramate | |
| Carbamazepine | Anticonvulsant, Miscellaneous | Antiepileptics (2014) | Divalproex; Lamotrigine; Levetiracetam; Phenytoin; Topiramate | |
| Levetiracetam | Anticonvulsant, Miscellaneous | Antiepileptics (2014) | Carbamazepine; Divalproex; Lamotrigine; Phenytoin; Topiramate | |
| Lamotrigine | Anticonvulsant, Miscellaneous | Antiepileptics (2014) | Carbamazepine; Divalproex; Levetiracetam; Phenytoin; Topiramate | |
| Oxybutynin, immediate-release | Antispasmodic Agent, Urinary | Antimuscarinics (2019) | Oxybutynin, extended-release | |
| Oxybutynin, extended-release | Antispasmodic Agent, Urinary | Antimuscarinics (2019) | Oxybutynin, Immediate-release | |
| Clopidogrel | Antiplatelet Agent | Antiplatelets (2015) | Aspirin | |
| Ethosuximide | Anticonvulsant, Succinimide | Anti-Seizure Drugs (2021) | Carbamazepine; Clonazepam; Divalproex; Gabapentin; Lamotrigine; Levetiracetam; Phenytoin; Topiramate | |
| Oxcarbazepine | Anticonvulsant, Miscellaneous | Anti-Seizure Drugs (2021) | Carbamazepine; Clonazepam; Divalproex; Gabapentin; Lamotrigine; Levetiracetam; Phenytoin; Topiramate | |
| Hydroxyzine | Histamine H1 Antagonist, First Generation | Anxiety Disorders (2021) | ||
| 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) | |
| Atenolol | Antihypertensive; Beta-Blocker, Beta1 Selective | Beta Blockers (2014) | Metoprolol; Propranolol | |
| Propranolol | Antihypertensive; Beta-Blocker, Non-Selective | Beta Blockers (2014) | Atenolol; Metoprolol | |
| Carvedilol, immediate-release | Antihypertensive; Beta-Blocker with Alpha-Blocking Activity | Beta-blockers in Heart Failure (2017) | Atenolol; Metoprolol; Propranolol | |
| Atypical antipsychotic | Antipsychotic, Atypical | Bipolar Disorders (2022) | *Any product* | Aripiprazole lauroxil; Haloperidol decanoate |
| Doxazosin | Alpha1 Blocker; Antihypertensive | Benign Prostatic Hypertrophy (2016) | Prazosin; Tamsulosin | |
| Finasteride | 5 Alpha-Reductase Inhibitor | Benign Prostatic Hypertrophy (2016) | ||
| Tamsulosin | Alpha1 Blocker | Benign Prostatic Hypertrophy (2016) | Doxazosin; Prazosin | |
| Diltiazem | Antihypertensive; Calcium Channel Blocker, Nondihydropyridine | Calcium Channel Blockers (2014) | Amlodipine | |
| Amlodipine | Antihypertensive; Calcium Channel Blocker, Dihydropyridine | Calcium Channel Blockers (2014) | Diltiazem | |
| Lactulose | Ammonium Detoxicant; Laxative, Osmotic | Cirrhosis & Complications (2015) | Polyethylene glycol | |
| Intrauterine device, copper | Contraceptive | Contraception (2016) | *Any product*; For use by a skilled and privileged provider | Intrauterine device, levonorgestrel |
| Intrauterine device, levonorgestrel | Contraceptive, Progestin | Contraception (2016) | *Any product*; For use by a skilled and privileged provider | Intrauterine device, copper |
| Levonorgestrel (Plan B One-Step®) | Contraceptive, Progestin | Contraception (2016) | *Branded product* | Ulipristal |
| Ethinyl estradiol / Etonogestrel vaginal ring | Contraceptive; Estrogen and Progestin Combination | Contraception (2016) | ||
| Ethinyl estradiol / Norelgestromin, transdermal | Contraceptive; Estrogen and Progestin Combination | Contraception (2016) | ||
| Etonogestrel, implant | Contraceptive; Progestin | Contraception (2016) | For use by a skilled and privileged provider | Oral contraceptive pill, progestin only |
| Ulipristal | Contraceptive; Progestin Receptor Modulator | Contraception (2016) | Levonorgestrel (Plan B One-Step®) | |
| Oral contraceptive pill, extended cycle | Contraceptive | Contraception (2016) | *Any product* | |
| Medroxyprogesterone acetate, injection | Contraceptive, Progestin (Injection/Depot) | Contraception (2016) | Medroxyprogesterone, oral; Oral contraceptive pill, progestin only | |
| Duloxetine | Antidepressant, Serotonin/Norepinephrine Reuptake Inhibitor/Antagonist | Diabetic Neuropathy (2018) | Bupropion; Venlafaxine | |
| Chlorthalidone | Antihypertensive; Thiazide-Related Diuretic | Diuretic Agents (2014) | Hydrochlorothiazide | |
| Hydrochlorothiazide | Antihypertensive; Thiazide Diuretic | Diuretics (2014) | Chlorthalidone | |
| Apixaban | Anticoagulant; Direct Oral Anticoagulant (DOAC); Factor Xa Inhibitor | Direct Oral Anticoagulants (2017) | Warfarin | |
| Warfarin | Anticoagulant; Vitamin K Antagonist | Direct Oral Anticoagulants (2017) | Apixaban; Low-molecular weight heparin | |
| Alogliptin | Antidiabetic Agent, Dipeptidyl Peptidase 4 (DPP-4) Inhibitor | DPP-IV Inhibitors (2019) | ||
| Epinephrine Injection Devices (both 0.15mg and 0.3mg) | Alpha-/Beta- Agonist | Epinephrine Injection Devices (2020 | Any device, auto-injector or pre-filled syringe | |
| Lithium | Antimanic Agent | ER Lithium & Divalproex (2012) | ||
| Divalproex | Anticonvulsant, Miscellaneous | ER Lithium & Divalproex (2012) | Carbamazepine; Lamotrigine; Levetiracetam; Phenytoin; Topiramate | |
| Gabapentin | Anticonvulsant, Miscellaneous; GABA Analog | Gabapentin & Pregabalin in Pain (2014) | ||
| 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 |
| Testosterone (**REMS Drug**) | Androgen | Gender-Affirming Medications (2022) | Any formulation; Certain formulations (i.e., undecoanate) have REMS requirements | |
| 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 | |
| Semaglutide -or- Liraglutide | 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 Delivery Devices (2021) | Any formulation | Glucagon |
| Allopurinol | Antigout Agent; Xanthine Oxidase Inhibitor | Gout (2016) | ||
| 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®) | |
| Torsemide -OR- Bumetanide | Antihypertensive | HFpEF (2022) | Bumetanide -OR- torsemide; Furosemide | |
| Bumetanide -OR- Torsemide | Antihypertensive | HFpEF (2022) | Furosemide; Torsemide -OR- Bumetanide | |
| Furosemide | Antihypertensive; Loop Diuretic | Heart Failure Overview (2017) | ||
| Metoprolol succinate | Antihypertensive; Beta-Blocker, Beta1 Selective | HFrEF (2022) | Atenolol; Carvedilol, immediate-release; Propranolol | |
| Sacubitril and Valsrtan | Angiotensin II Receptor Blocker; Neprilysin Inhibitor | HFrEF (2022) | ||
| Metoprolol tartrate | Antihypertensive; Beta-Blocker, Beta1 Selective | HFrEF (2022) | Atenolol; Carvedilol, immediate-release; Metoprolol succinate | |
| 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 |
| Pravastatin | Antilipemic Agent, HMG-CoA Reductase Inhibitor | Hyperlipidemia (2017) | Atorvastatin; Rosuvastatin; Simvastatin | |
| Rosuvastatin | Antilipemic Agent, HMG-CoA Reductase Inhibitor | Hyperlipidemia (2017) | Atorvastatin; Pravastatin; Simvastatin | |
| 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) | ||
| Insulin aspart (NovoLog®) | Insulin, Rapid-Acting | Insulins (2015) | *Branded product*; Pen Device | |
| Insulin aspart / Insulin aspart protamine (NovoLog® Mix 70/30) | Insulin, Combination (70/30 Mix) | Insulins (2015) | *Branded product*; Pen Device | |
| Insulin detemir (Levemir®) | Insulin, Long-Acting | Insulins (2015) | *Branded product*; Pen Device | Insulin glargine, any "interchangeable" product (Semglee® -OR- Lantus®) |
| Insulin NPH (NovoLIN® N) | Insulin, Intermediate-Acting | Insulins (2015) | *Branded product* | |
| Insulin NPH / Regular human insulin (NovoLIN® 70/30) | Insulin, Combination (70/30 Mix) | Insulins (2015) | *Branded product* | |
| Insulin Regular human (NovoLIN® R) | Insulin, Short-Acting | Insulins (2015) | *Branded product* | |
| 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®) |
| Umeclidinium/Vilanterol | Long-Acting Muscarinic Antagonist (LAMA) / Long-Acting Beta2 Agonist (LABA) | LAMAs (2019) | Tiotropium (Spiriva®) | |
| 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 |
| 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**) |
| Estradiol tablets | Estrogen Derivative | Menopausal Hormone Therapy (2016) | Estradiol for Injection; Estradiol, transdermal | |
| Spironolactone | Antihypertensive; Mineralocorticoid Receptor Antagonists; Potassium Sparing Diuretic | Mineralocorticoid Receptor Antagonist in HF (2017) | ||
| Varenicline | Partial Nicotine Agonist, Smoking Cessation Aid | Nicotine Dependence (2015) | Bupropion | |
| Nicotine replacement therapy (NRT), combination | Smoking Cessation Aid | Nicotine Dependence (2015) | Combination NRT (nicotine patches + any short-acting NRT product) | Bupropion; Varenicline |
| Bupropion | Antidepressant, Dopamine/Norepinephrine-Reuptake Inhibitor; Smoking Cessation Aid | Nicotine Dependence (2015) | Varenicline; Venlafaxine | |
| Leflunomide | Antirheumatic, Disease Modifying | Non-biologic DMARDs (2016) | Hydroxychloroquine; Methotrexate; Sulfasalazine | |
| Hydroxychloroquine | Antimalarial | Non-biologic DMARDs (2016) | Leflunomide; Methotrexate; Sulfasalazine | |
| Methotrexate | Antineoplastic Agent; Antirheumatic; Disease Modifying; Immunosuppresant Agent | Non-biologic DMARDs (2016) | Hydroxychloroquine; Leflunomide; Sulfasalazine | |
| Meloxicam | Nonsteroidal Anti-Inflammatory Drug | NSAIDs (2014) | Diclofenac; Ibuprofen; Indomethacin; Naproxen | |
| Naproxen | Nonsteroidal Anti-Inflammatory Drug | NSAIDs (2014) | Diclofenac; Ibuprofen; Indomethacin | |
| 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 |
| Cyanocobalamin (Vitamin B12), oral | Vitamin, Water Soluble | Hematologic Supplements (2016) | ||
| Isoniazid | Antitubercular Agent | Ethambutol; Pyrazinamide; Rifampin; Rifapentine | ||
| Iron, oral | Iron Salt | Hematologic Supplements (2016) | *Any oral formulation* | |
| Pyridoxine (Vitamin B6) | Vitamin, Water Soluble | Supplements in Obstetrics (2016) | ||
| Fluoride, oral | Nutritional Supplement | Supplements in Oral Health (2016) | *Any oral formulation* | |
| Folic Acid | Vitamin, Water Soluble | Supplements in Womens Health (2016) | Any product containing >400 mcg / daily dose | |
| 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 | Treatment of Opioid Overdose (2014) | ||
| Buprenorphine-Naloxone (**REMS drug**) | Analgesic, Opioid; Analgesic, Opioid Partial Agonist | Opioid Use Disorder (2018) | **See REMS here** | Naloxone |
| Naltrexone, extended-release for injection | Antidote; Opioid Antagonist | Opioid Use Disorder (2018) | ||
| Alendronate | Bisphosphonate Derivative | Osteoporosis (2016) | ||
| 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 | |
| Prazosin | Alpha1 Blocker; Antihypertensive | PTSD Indication (2012) | Doxazosin; Tamsulosin | |
| Prenatal Multivitamin | Vitamin | Pregnancy & Prenatal Care (2021) | Must contain >400 mcg of folic acid/dose | |
| Corticosteriods (Topical) - High Potency (Class I and II) | Topical Corticosteroids | Psoriasis (2018) | Corticosteroid (Topical) - Intermediate potency; Corticosteroid (Topical) - Low potency | |
| Vitamin D Analog, topical | Vitamin D Analog | Psoriasis (2018) | *Any product* | |
| Rifapentine | Antitubercular Agent | Rifapentine (2013) | Ethambutol; Isoniazid; Pyrazinamide; Rifampin | |
| Metronidazole, topical | Antibiotic, Topical | Rosacea (2022) | ||
| Sunscreen, Sun Protection Factor (SPF) 30 or greater | Ultraviolet light protectant, topical | Rosacea Treatment (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 |
| 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 | |
| Empagliflozin | Antidiabetic Agent, Sodium-Glucose Cotransporter 2 (SGLT2) Inhibitor | SGLT-2 Inhibitors (2019) | ||
| Venlafaxine | Antidepressant, Serotonin/Norepinephrine Reuptake Inhibitor/Antagonist | SNRIs (2012) | Bupropion; Duloxetine | |
| Mupirocin | Antibiotic, Topical | Skin & Soft Tissue Infections (2021) | ||
| Trimethoprim-Sulfamethoxazole | Antibiotic, Miscellaneous | Skin & Soft Tissue Infections (2021) | ||
| Tiotropium (Spiriva®) | Long-Acting Anticholinergic Agent | Inhaled Anticholinergics (2011) | *Branded product* | |
| Citalopram | Antidepressant, Selective Serotonin Reuptake Inhibitor | SSRIs (2019) | Escitalopram; Fluoxetine; Paroxetine; Sertraline | |
| Escitalopram | Antidepressant, Selective Serotonin Reuptake Inhibitor | SSRIs (2019) | Citalopram; Fluoxetine; Paroxetine; Sertraline | |
| Paroxetine | Antidepressant, Selective Serotonin Reuptake Inhibitor | SSRIs (2019) | Citalopram; Escitalopram; Fluoxetine; Sertraline | |
| Simvastatin | Antilipemic Agent, HMG-CoA Reductase Inhibitor | Dyslipidemia Guideline Review (2014) | Atorvastatin; Pravastatin; Rosuvastatin | |
| Atorvastatin | Antilipemic Agent, HMG-CoA Reductase Inhibitor | Dyslipidemia Guideline Review (2014) | Pravastatin; Rosuvastatin; Simvastatin | |
| 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 |
| Glipizide | Antidiabetic Agent; Sulfonylurea | Sulfonylureas (2015) | ||
| 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) |
| Serotonin 5-HT1 agonist (Triptan) | Antimigraine Agent; Serotonin 5-HT 1B/1D Receptor Agonist | Triptans (2016) | Any two (2) triptan medications are required, one must be sumatriptan | Sumatriptan |
| Sumatriptan | Antimigraine Agent; Serotonin 5-HT 1B/1D Receptor Agonist | Triptans (2016) | Any two (2) triptan medications are required, one must be sumatriptan | |
| 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 | |
| Vitamin D | Vitamin D Analog | Vitamin D (2010) | *Any product* | |
| Low-molecular weight heparin | Low-molecular Weight Heparin | VTE Prophylaxis (2011) | *Any product* | |
| Estrogen vaginal cream | Estrogen Derivative | NPTC Meeting Update (May 2018) | *Any product* | Estradiol tablets |
| Albuterol, metered dose inhaler (MDI) | Beta2 Agonist | NPTC Meeting Update (Nov 2017) | *Any product* |
