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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: 02/07/2024
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The following is a list of Medications currently in the queue. 233 record(s) found.
The following is a list of Medications currently in the queue. 233 record(s) found.
MedicationPharmacological CategoryFormulary BriefNotesSimilar Medications
Albuterol nebulized solution Beta2 Agonist Asthma & COPD Guidelines Review (2019)
Alendronate Bisphosphonate Derivative Osteoporosis (2016)
Allopurinol Antigout Agent; Xanthine Oxidase Inhibitor Gout (2016)
Amitriptyline Antidepressant, Tricyclic Bipolar Disorder (2022) Nortriptyline
Amlodipine Antihypertensive; Calcium Channel Blocker, Dihydropyridine Hypertension (2022) Diltiazem
Anastrozole Antineoplastic Agent, Aromatase Inhibitor NPTC Update Spring 2021
Aspirin Antiplatelet Agent; Nonsteroidal Anti-Inflammatory Drug; Salicylate Pregnancy & Prenatal Care (2021)
Atenolol Antihypertensive; Beta-Blocker, Beta1 Selective Hypertension (2022) Propranolol
Atorvastatin Antilipemic Agent, HMG-CoA Reductase Inhibitor Hyperlipidemia (2022) Pravastatin; Rosuvastatin; Simvastatin
Acetaminophen Analgesic, Miscellaneous Short-Acting Opioids (2014)
Etanercept Antirheumatic, Disease Modifying; Tumor Necrosis Factor (TNF) Blocking Agent TNF Inhibitors (2016) Adalimumab-bwwd (Hadlima™)
Bupropion Antidepressant, Dopamine/Norepinephrine-Reuptake Inhibitor; Smoking Cessation Aid Stimulant Use Disorder (2022) Varenicline; Venlafaxine
Carbamazepine Anticonvulsant, Miscellaneous Bipolar Disorder (2022) Divalproex; Lamotrigine; Levetiracetam; Phenytoin; Topiramate
Carvedilol, immediate-release Antihypertensive; Beta-Blocker with Alpha-Blocking Activity Heart Failure with Reduced Ejection Fraction (HFrEF) (2022) Atenolol; Propranolol
Chlorthalidone Antihypertensive; Thiazide-Related Diuretic Hypertension (2022) Hydrochlorothiazide
Clonazepam Benzodiazepine Antiseizure Drugs (2021) Lorazepam
Clopidogrel Antiplatelet Agent Antiplatelets (2015) Aspirin
Digoxin Antiarrhythmic Agent, Miscellaneous; Cardiac Glycoside Heart Failure with Reduced Ejection Fraction (HFrEF) (2022)
Diltiazem Antihypertensive; Calcium Channel Blocker, Nondihydropyridine Hypertension (2022) Amlodipine
Divalproex Anticonvulsant, Miscellaneous Bipolar Disorder (2022) Carbamazepine; Lamotrigine; Levetiracetam; Phenytoin; Topiramate
Cyanocobalamin (Vitamin B12), oral Vitamin, Water Soluble Hematologic Supplements (2016)
Doxazosin Alpha1 Blocker; Antihypertensive Benign Prostatic Hypertrophy (Nov 2022) Prazosin; Tamsulosin
Estradiol tablets Estrogen Derivative Gender-Affirming Medications (2022) Estradiol for Injection; Estradiol, transdermal
Adalimumab-bwwd (Hadlima™) Antirheumatic, Disease Modifying; Tumor Necrosis Factor (TNF) Blocking Agent **COMING SOON** Etanercept
Ethambutol Antitubercular Agent Treatment of Tuberculosis (2021) Isoniazid; Pyrazinamide; Rifampin; Rifapentine
Ethinyl estradiol / Etonogestrel vaginal ring Contraceptive; Estrogen and Progestin Combination Contraception (2016)
Ethinyl estradiol / Norelgestromin, transdermal Contraceptive; Estrogen and Progestin Combination Contraception (2016)
Finasteride 5 Alpha-Reductase Inhibitor Benign Prostatic Hypertrophy (Nov 2022)
Fluoxetine Antidepressant, Selective Serotonin Reuptake Inhibitor Bipolar Disorder (2022) Sertraline
Furosemide Antihypertensive Heart Failure with Preserved Ejection Fraction (HFpEF) (2022)
Gabapentin Anticonvulsant, Miscellaneous; GABA Analog Antiseizure Drugs (2021)
Glipizide Antidiabetic Agent; Sulfonylurea Diabetes Treatment Overview (2017)
Hydrochlorothiazide Antihypertensive; Thiazide Diuretic Hypertension (2022) Chlorthalidone
Hydroxychloroquine Antimalarial Non-biologic DMARDs (2016) Leflunomide; Methotrexate; Sulfasalazine
Ibuprofen Nonsteroidal Anti-Inflammatory Drug NSAIDs (2014) Diclofenac; Indomethacin; Meloxicam; Naproxen
Indomethacin Nonsteroidal Anti-Inflammatory Drug NSAIDs (2014) Diclofenac; Ibuprofen; Meloxicam; Naproxen
Isoniazid Antitubercular Agent Treatment of Tuberculosis (2021) Ethambutol; Pyrazinamide; Rifampin; Rifapentine
Isosorbide mononitrate Antianginal Agent; Vasodilator Anti-Anginal Treatment (2013) Nitroglycerin patch
Lactulose Ammonium Detoxicant; Laxative, Osmotic Hepatic Encephalopathy (2020) Polyethylene glycol
Lamotrigine Anticonvulsant, Miscellaneous Bipolar Disorder (2022) Carbamazepine; Divalproex; Levetiracetam; Phenytoin; Topiramate
Leflunomide Antirheumatic, Disease Modifying Non-biologic DMARDs (2016) Hydroxychloroquine; Methotrexate; Sulfasalazine
Letrozole Antineoplastic Agent, Aromatase Inhibitor NPTC Update Spring 2021
Levetiracetam Anticonvulsant, Miscellaneous Antiseizure Drugs (2021) Carbamazepine; Divalproex; Lamotrigine; Phenytoin; Topiramate
Levothyroxine Thyroid Agent Originally added 2004
Lisinopril Antihypertensive, Angiotensin-Converting Enzyme Inhibitor Hypertension (2022)
Lithium Antimanic Agent Bipolar Disorder (2022)
Lorazepam Benzodiazepine Alcohol Withdrawal Syndrome (2015) Clonazepam
Losartan Antihypertensive, Angiotensin II Receptor Blocker Hypertension (2022)
Meloxicam Nonsteroidal Anti-Inflammatory Drug NSAIDs (2014) Diclofenac; Ibuprofen; Indomethacin; Naproxen
Metformin Antidiabetic Agent; Biguanide Diabetes Treatment Overview (2017)
Methotrexate Antineoplastic Agent; Antirheumatic; Disease Modifying; Immunosuppresant Agent Non-biologic DMARDs (2016) Hydroxychloroquine; Leflunomide; Sulfasalazine
Metoprolol succinate Antihypertensive; Beta-Blocker, Beta1 Selective Heart Failure with Reduced Ejection Fraction (HFrEF) (2022) Atenolol; Carvedilol, immediate-release; Propranolol
Nitroglycerin 0.4 milligrams, sublingual Antianginal Agent; Antidote, Extravasation; Vasodilator Anti-Anginal Treatment (2013) Isosorbide mononitrate; Nitroglycerin patch
Nitroglycerin patch Antianginal Agent; Antidote, Extravasation; Vasodilator Anti-Anginal Treatment (2013) Isosorbide mononitrate
Nortriptyline Antidepressant, Tricyclic Bipolar Disorder (2022) Amitriptyline
Oxybutynin, immediate-release Antispasmodic Agent, Urinary Antimuscarinics (2019) Oxybutynin, extended-release
Phenytoin Anticonvulsant, Hydantoin Antiseizure Drugs (2021) Carbamazepine; Divalproex; Lamotrigine; Levetiracetam; Topiramate
Pioglitazone Antidiabetic Agent, Thiazolidinedione Thiazolidinediones (2017)
Pravastatin Antilipemic Agent, HMG-CoA Reductase Inhibitor Hyperlipidemia (2022) Atorvastatin; Rosuvastatin; Simvastatin
Prazosin Alpha1 Blocker; Antihypertensive Post Traumatic Stress Disorder (2021) Doxazosin; Tamsulosin
Prednisone Corticosteroid, Systemic Atopic Dermatitis (2020)
Propranolol Antihypertensive; Beta-Blocker, Non-Selective Migraine Prevention (2019) Atenolol
Montelukast Leukotriene Receptor Antagonist Asthma & COPD Guidelines Review (2019)
Naloxone Antidote; Opioid Antagonist Opioid Use Disorder (2018)
Naltrexone, oral Antidote; Opioid Antagonist Alcohol Use Disorder (2022) Naloxone
Naproxen Nonsteroidal Anti-Inflammatory Drug NSAIDs (2014) Diclofenac; Ibuprofen; Indomethacin
Rifampin Antitubercular Agent Treatment of Tuberculosis (2021) Ethambutol; Isoniazid; Pyrazinamide; Rifapentine
Rifapentine Antitubercular Agent Treatment of Tuberculosis (2021) Ethambutol; Isoniazid; Pyrazinamide; Rifampin
Rosuvastatin Antilipemic Agent, HMG-CoA Reductase Inhibitor Hyperlipidemia (2022) Atorvastatin; Pravastatin; Simvastatin
Salsalate Salicylate Added June 2008 (NSAIDs)
Pyrazinamide Antitubercular Agent Treatment of Tuberculosis (2021) Ethambutol; Isoniazid; Rifampin
Pyridoxine (Vitamin B6) Vitamin, Water Soluble Pregnancy & Prenatal Care (2021)
Sertraline Antidepressant, Selective Serotonin Reuptake Inhibitor Bipolar Disorder (2022) Citalopram; Escitalopram; Fluoxetine; Paroxetine
Simvastatin Antilipemic Agent, HMG-CoA Reductase Inhibitor Hyperlipidemia (2022) Atorvastatin; Pravastatin; Rosuvastatin
Spironolactone Antihypertensive; Mineralocorticoid Receptor Antagonists; Potassium Sparing Diuretic Heart Failure with Reduced Ejection Fraction (HFrEF) (2022)
Sulfasalazine 5-Aminosalicylic Acid Derivative Inflammatory Bowel Disease (2018) Hydroxychloroquine; Leflunomide; Methotrexate
Tamoxifen Antineoplastic Agent, Estrogen Receptor Antagonist; Selective Estrogen Receptor Modulator NPTC Update Spring 2021
Tamsulosin Alpha1 Blocker Benign Prostatic Hypertrophy (Nov 2022) Doxazosin; Prazosin
Topiramate Anticonvulsant, Miscellaneous Alcohol Use Disorder (2022) Carbamazepine; Divalproex; Lamotrigine; Levetiracetam; Phenytoin
Ulipristal Contraceptive; Progestin Receptor Modulator Contraception (2016) Levonorgestrel (Plan B One-Step®)
Varenicline Partial Nicotine Agonist, Smoking Cessation Aid Nicotine Dependence (2020) Bupropion
Venlafaxine Antidepressant, Serotonin/Norepinephrine Reuptake Inhibitor/Antagonist Bipolar Disorder (2022) Bupropion; Duloxetine
Warfarin Anticoagulant; Vitamin K Antagonist Direct Oral Anticoagulants (2017) Apixaban; Low-molecular weight heparin
Medroxyprogesterone, oral Contraceptive; Progestin Polycystic Ovarian Syndrome (2017) Medroxyprogesterone acetate, injection; Oral contraceptive pill, progestin only
Apixaban Anticoagulant; Direct Oral Anticoagulant (DOAC); Factor Xa Inhibitor Direct Oral Anticoagulants (2017) Warfarin
Duloxetine Antidepressant, Serotonin/Norepinephrine Reuptake Inhibitor/Antagonist Bipolar Disorder (2022) Bupropion; Venlafaxine
Corticosteroids (Topical) - High Potency (Class I and II) Topical Corticosteroids Alopecia Areata (2022) Corticosteroid (Topical) - Intermediate Potency; Corticosteroid (Topical) - Low Potency
Loperamide Antidiarrheal Irritable Bowel Syndrome (2018)
Dicyclomine Anticholinergic Agent Irritable Bowel Syndrome (2018)
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®)
Alogliptin Antidiabetic Agent, Dipeptidyl Peptidase 4 (DPP-4) Inhibitor DPP-IV Inhibitors (2019)
Oxybutynin, extended-release Antispasmodic Agent, Urinary Antimuscarinics (2019) Oxybutynin, Immediate-release
Umeclidinium/Vilanterol Long-Acting Muscarinic Antagonist (LAMA) / Long-Acting Beta2 Agonist (LABA) LAMAs (2019) Tiotropium (Spiriva®)
Fluticasone/Salmeterol Beta2 Agonist, Long-Acting; Corticosteroid, Inhalant LABAs (2019) Mometasone (Asmanex®)
Memantine N-Methyl-D-Aspartate (NMDA) Receptor Antagonist Alzheimer's disease (2019)
Carbidopa-Levodopa, immediate-release Anti-Parkinson Agent; Decarboxylase Inhibitor-Dopamine Precursor Parkinson's Disease (2019)
Bictegravir/Emtricitabine/Tenofovir alafenamide Antiretroviral, Integrase Inhibitor (Anti-HIV) HIV Treatment (2019) Dolutegravir/abacavir/lamivudine; Emtricitabine/tenofovir disoproxil fumarate; Raltegravir
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
Ezetimibe Antilipemic Agent, 2-Azetidinone Hyperlipidemia (2022)
Empagliflozin Antidiabetic Agent, Sodium-Glucose Cotransporter 2 (SGLT2) Inhibitor Heart Failure with Reduced Ejection Fraction (HFrEF) (2022)
Oseltamivir Antiviral Agent; Neuraminidase Inhibitor Treatment of Influenza (2019)
Naltrexone, extended-release for injection Antidote; Opioid Antagonist Opioid Use Disorder (2018)
Atomoxetine Norepinephrine Reuptake Inhibitor, Selective ADHD (Jan 2020) Dextroamphetamine / Amphetamine (immediate release); Dextroamphetamine / Amphetamine (long-acting); Methylphenidate (immediate release); Methylphenidate (long-acting)
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
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)
Methimazole Antithyroid Agent; Thioamide Hyperthyroidism (2021) Propylthiouracil
Propylthiouracil Antithyroid Agent; Thioamide Hyperthyroidism (2021) Methimazole
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
Hydroxyzine Histamine H1 Antagonist, First Generation Anxiety Disorders (2021)
Pramipexole Anti-Parkinson Agent, Dopamine Agonist Insomnia/Sleep Medications (2021)
Ethosuximide Anticonvulsant, Succinimide Anti-Seizure Drugs (2021) Carbamazepine; Clonazepam; Divalproex; Gabapentin; Lamotrigine; Levetiracetam; Phenytoin; Topiramate
Oxcarbazepine Anticonvulsant, Miscellaneous Bipolar Disorder (2022) Carbamazepine; Clonazepam; Divalproex; Gabapentin; Lamotrigine; Levetiracetam; Phenytoin; Topiramate
Ondansetron Antiemetic; Selective 5-HT3 Receptor Antagonist Antiemetic Agents (2021)
Ceftriaxone, injection Antibiotic, Cephalosporin (Third Generation) STIs - PART 1 (2021) Cefdinir; Cefixime; Cephalexin
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
Valacyclovir Antiviral Agent, Oral 2021 CDC Guidelines for Sexually Transmitted Infections (2021)
Mupirocin Antibiotic, Topical Skin & Soft Tissue Infections (2021)
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
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
Metronidazole, topical Antibiotic, Topical Rosacea (2022)
Sunscreen, Sun Protection Factor (SPF) 30 or greater Ultraviolet light protectant, topical Rosacea Treatment (2022)
Permethrin 5% cream Antiparasitic Agent, Topical; Pediculocide; Scabicidal Agent Sexually Transmitted Infections, Part III (2022) Permethrin 1%, any formulation
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)
Sildenafil Phosphodiesterase-5 Enzyme Inhibitor Erectile Dysfunction (Nov 2022) Tadalafil
Tadalafil Phosphodiesterase-5 Enzyme Inhibitor Erectile Dysfunction (Nov 2022) Sildenafil
Famotidine Histamine H2 Antagonist Fall 2022 NPTC Meeting Update
Azathioprine -OR- Mercaptopurine Immunosuppresant Agent Inflammatory Bowel Disease (2023) Methotrexate; Sulfasalazine
Mercaptopurine -OR- Azathioprine Immunosuppresant Agent Inflammatory Bowel Disease (2023) Methotrexate; Sumatriptan
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
Vancomycin, oral Glycopeptide Clostridioides Difficile (2023) Metronidazole, oral
Bismuth subsalicylate Antidiarrheal Helicobacter pylori Treatment (2023) Loperamide
Norgestrel 0.075mg OTC tablets (Opill®) Contraceptive, Progestin Norgestrel OTC - Opill (2023) Oral contraceptive pill, progestin only (prescription)
Nirmatrelvir and Ritonavir (Paxlovid®) Antiviral Agent; Cytochrome P-450 Inhibitor COVID-19 Update (2023)
Leuprolide Antineoplastic Agent, Gonadotropin-Releasing Hormone Agonist Treatment of Prostate Cancer (Nov 2022) **Any depot form**
Permethrin 1% Antiparasitic Agent, Topical; Pediculocide; Scabicidal Agent Sexually Transmitted Infections, Part III (2022) *Any formulation* Permethrin 5% cream
Diclofenac Nonsteroidal Anti-Inflammatory Drug NSAIDs (2014) *Any formulation* Ibuprofen; Indomethacin; Meloxicam; Naproxen
Calcium Electrolyte Supplement Osteoporosis (2016) *Any formulation*
Fluoride, oral Nutritional Supplement Supplements in Oral Health (2016) *Any oral formulation*
Iron, oral Iron Salt Pregnancy & Prenatal Care (2021) *Any oral formulation*
Estradiol, transdermal Estrogen Derivative Gender Affirming Therapies (2022) *Any patch* Estradiol for Injection; Estradiol tablets
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
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
Albuterol, metered dose inhaler (MDI) Beta2 Agonist Asthma & COPD Guidelines Review (2019) *Any product*
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
Atypical antipsychotic Antipsychotic, Atypical Bipolar Disorders (2022) *Any product* Aripiprazole lauroxil; Haloperidol decanoate
H1 Antagonist (2nd generation), long-acting Histamine H1 Antagonist, Second Generation Allergic Rhinitis (2018) *Any product*
Laxative, bulk-forming Bulk-forming Laxative Added July 2011 (Constipation) *Any product*
Polyethylene glycol Laxative, Osmotic Irritable Bowel Syndrome (2018) *Any product* Lactulose
Laxative, stimulant Stimulant Laxative Added July 2011 (Constipation) *Any product*
Corticosteroid, intranasal Intranasal Corticosteroid Allergic Rhinitis (2018) *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
Vitamin D Analog, topical Vitamin D Analog Psoriasis (2018) *Any product*
Vitamin D, Any Vitamin D Analog Vitamin D Analogues in CKD (2010) *Any product*
Tretinoin, topical Topical Skin Product, Acne Treatment of Acne vulgaris (2020) *Any product*
Proton Pump Inhibitor Proton Pump Inhibitor GERD & PUD (2018) *Any product*
Ophthalmic Prostaglandin Analog Ophthalmic Prostaglandin Analog Ophth Prostaglandin Analogs (2018) *Any product*
Oral contraceptive pill, extended cycle Contraceptive Contraception (2016) *Any product*
Oral contraceptive pill, monophasic: 20mcg EE (low) Contraceptive Contraception (2016) *Any product*
Oral contraceptive pill, monophasic: 30-35mcg EE (medium) Contraceptive Contraception (2016) *Any product*
Oral contraceptive pill, progestin only (prescription) Contraceptive, Progestin Norgestrel OTC - Opill (2023) *Any product*
Oral contraceptive pill, triphasic Contraceptive Contraception (2016) *Any product*
Intrauterine device, copper Contraceptive Long Acting Reversible Contraception (2021) *Any product*; For use by a skilled and privileged provider Intrauterine device, levonorgestrel
Intrauterine device, levonorgestrel Contraceptive, Progestin Long Acting Reversible Contraception (2021) *Any product*; For use by a skilled and privileged provider Intrauterine device, copper
Insulin glargine, Any Insulin, Long-Acting Long-Acting Insulins & Biosimilars (2021) *Biosimilars of insulin glargine are intended to be included for consideration
Mometasone (Asmanex®) Corticosteroid, Inhalant Asthma & COPD Guidelines Review (2019) *Branded product*
Levonorgestrel (Plan B One-Step®) Contraceptive, Progestin Contraception (2016) *Branded product* Ulipristal
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*
Tiotropium (Spiriva®) Long-Acting Anticholinergic Agent Long Acting Muscarinic Antagonists (2019) *Branded product*
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
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
Buprenorphine-Naloxone (**REMS drug**) Analgesic, Opioid; Analgesic, Opioid Partial Agonist MAT for OUD (2021) **See REMS here** Exit Disclaimer: You Are Leaving www.ihs.gov  Naloxone
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**)
Testosterone (**REMS Drug**) Androgen Male Hypogonadism (2022) Any formulation; Certain formulations (i.e., undecoanate) have REMS requirements Exit Disclaimer: You Are Leaving www.ihs.gov 
Donepezil Acetylcholinesterase Inhibitor (Central) Alzheimer's disease (2019) 5mg and 10mg strengths
Rifaximin Antibiotic, Rifamycin Hepatic Encephalopathy (2020) After failure of, or intolerance to, lactulose monotherapy as indicated for hepatic encephalopathy Lactulose
Vaccines, All ACIP-recommended Vaccines Vaccine (2011) All ACIP recommended vaccines for routine use in accordance with ACIP guidelines
Epinephrine Injection Devices (both 0.15mg and 0.3mg) Alpha-/Beta- Agonist Epinephrine Injection Devices (2020 Any device, auto-injector or pre-filled syringe
Glucose, oral Antidote Glucagon Products Review (2021) Any formulation Glucagon
Folic Acid Vitamin, Water Soluble Pregnancy & Prenatal Care (2021) Any product containing >400 mcg / daily dose
Sumatriptan Antimigraine Agent; Serotonin 5-HT 1B/1D Receptor Agonist Acute Migraine (2021) Any two (2) triptan medications are required, one must be sumatriptan
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
Medroxyprogesterone acetate, injection (IM and SC formulations) Contraceptive, Progestin (Injection/Depot) SC Depot Medroxyprogesterone (2023) Both SC and IM formulations should be made available Medroxyprogesterone, oral
Nicotine replacement therapy (NRT), combination Smoking Cessation Aid Nicotine Dependence (2020) Combination NRT (nicotine patches + any short-acting NRT product) Bupropion; Varenicline
Beta-3 agonist, Any Beta3 Agonist Urinary Incontinence (2023) Either mirabegron -or- vibegron Oxybutynin, extended-release; Oxybutynin, immediate-release
Estradiol for Injection Estrogen Derivative Gender Affirming Therapies (2022) Either valerate or cypionate product Estradiol tablets; Estradiol, transdermal
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
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
Long-acting monoclonal antibodies, All ACIP-recommended Immune Globulin; Monoclonal Antibody Prevention of RSV (2023) For example: nirsevimab (Beyfortus®)
Dolutegravir Antiretroviral, Integrase Inhibitor (Anti-HIV) HIV Updates (2020) For HIV treatment in pregnant patients Emtricitabine/tenofovir disoproxil fumarate; Raltegravir
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
Glucagon Antidote; Hypoglycemia Glucagon Products Review (2021) For outpatient use
Sevelamer carbonate Phosphate Binder Phosphate Binders (2018) For patients on dialysis who cannot use calcium-based phosphate binders due to hypercalcemia Calcium
Etonogestrel, implant Contraceptive; Progestin Long Acting Reversible Contraception (2021) For use by a skilled and privileged provider Oral contraceptive pill, progestin only
Semaglutide (Wegovy®) -OR- Tirzepatide (Zepbound™) Antidiabetic Agent, Glucagon-Like Peptide-1 (GLP-1) Receptor Agonist; Glucose-Dependent Insulinotropic Polypeptide (GIP)/Glucagon-Like Peptide (GLP-1) Receptor Agonist **COMING SOON** For weight management, with recommended local adoption of use criteria
Tirzepatide (Zepbound™) -OR- Semaglutide (Wegovy®) Antidiabetic Agent, Glucagon-Like Peptide-1 (GLP-1) Receptor Agonist; Glucose-Dependent Insulinotropic Polypeptide (GIP)/Glucagon-Like Peptide (GLP-1) Receptor Agonist **COMING SOON** For weight management, with recommended local adoption of use criteria
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
Prenatal Multivitamin Vitamin Pregnancy & Prenatal Care (2021) Must contain >400 mcg of folic acid/dose
Mesalamine, oral 5-Aminosalicylic Acid Derivative Inflammatory Bowel Disease (2023) Once-Daily Formulation Sulfasalazine
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
Penicillin V potassium Antibiotic, Penicillin Outpatient Abx Stewardship & URIs (2021) Pediatric and Adult oral formulations Amoxicillin; Amoxicillin and Clavulanate; Penicillin G benzathine
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
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)
Semaglutide (Ozempic®) Antidiabetic Agent, Glucagon-Like Peptide-1 (GLP-1) Receptor Agonist GLP-1 & GLP-1/GIP Receptor Agonists for DM2 and Obesity (2023) Subcutaneous formulation only