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National Core Formulary

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

  • It establishes the "floor" for the pharmacy benefit.
  • Except in closed classes, facilities are expected to add other drugs to the local formulary as needed.
Last Updated: 11/10/2022
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The following is a list of Medications currently in the queue. 225 record(s) found.
The following is a list of Medications currently in the queue. 225 record(s) found.
MedicationPharmacological CategoryFormulary BriefNotesSimilar Medications
Acetaminophen Analgesic, Miscellaneous
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 Exit Disclaimer: You Are Leaving www.ihs.gov 
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** Exit Disclaimer: You Are Leaving www.ihs.gov  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** Exit Disclaimer: You Are Leaving www.ihs.gov  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** Exit Disclaimer: You Are Leaving www.ihs.gov  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*