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 |
|---|---|---|---|---|
| Albuterol nebulized solution | Beta2 Agonist | |||
| Alendronate | Bisphosphonate Derivative | Osteoporosis (2016) | ||
| Allopurinol | Antigout Agent; Xanthine Oxidase Inhibitor | Gout (2016) | ||
| Amitriptyline | Antidepressant, Tricyclic | Antidepressants in Pain Mgmt (2014) | Nortriptyline | |
| Amlodipine | Antihypertensive; Calcium Channel Blocker, Dihydropyridine | Calcium Channel Blockers (2014) | Diltiazem | |
| Anastrozole | Antineoplastic Agent, Aromatase Inhibitor | |||
| Aspirin | Antiplatelet Agent; Nonsteroidal Anti-Inflammatory Drug; Salicylate | |||
| Atenolol | Antihypertensive; Beta-Blocker, Beta1 Selective | Beta Blockers (2014) | Metoprolol; Propranolol | |
| Atorvastatin | Antilipemic Agent, HMG-CoA Reductase Inhibitor | Dyslipidemia Guideline Review (2014) | Pravastatin; Rosuvastatin; Simvastatin | |
| Acetaminophen | Analgesic, Miscellaneous | |||
| Bupropion | Antidepressant, Dopamine/Norepinephrine-Reuptake Inhibitor; Smoking Cessation Aid | Nicotine Dependence (2015) | Varenicline; Venlafaxine | |
| Carbamazepine | Anticonvulsant, Miscellaneous | Antiepileptics (2014) | Divalproex; Lamotrigine; Levetiracetam; Phenytoin; Topiramate | |
| Carvedilol, immediate-release | Antihypertensive; Beta-Blocker with Alpha-Blocking Activity | Beta-blockers in Heart Failure (2017) | Atenolol; Metoprolol; Propranolol | |
| Chlorthalidone | Antihypertensive; Thiazide-Related Diuretic | Diuretic Agents (2014) | Hydrochlorothiazide | |
| Clonazepam | Benzodiazepine | Alcohol Withdrawal Syndrome (2015) | Lorazepam | |
| Clopidogrel | Antiplatelet Agent | Antiplatelets (2015) | Aspirin | |
| Cyanocobalamin (Vitamin B12), oral | Vitamin, Water Soluble | Hematologic Supplements (2016) | ||
| Digoxin | Antiarrhythmic Agent, Miscellaneous; Cardiac Glycoside | Digoxin Use (2016) | ||
| Diltiazem | Antihypertensive; Calcium Channel Blocker, Nondihydropyridine | Calcium Channel Blockers (2014) | Amlodipine | |
| Divalproex | Anticonvulsant, Miscellaneous | ER Lithium & Divalproex (2012) | Carbamazepine; Lamotrigine; Levetiracetam; Phenytoin; Topiramate | |
| Doxazosin | Alpha1 Blocker; Antihypertensive | Benign Prostatic Hypertrophy (2016) | Prazosin; Tamsulosin | |
| Estradiol tablets | Estrogen Derivative | Menopausal Hormone Therapy (2016) | Estradiol for Injection; Estradiol, transdermal | |
| Ethambutol | Antitubercular Agent | 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 (2016) | ||
| Fluoxetine | Antidepressant, Selective Serotonin Reuptake Inhibitor | Sertraline | ||
| Furosemide | Antihypertensive; Loop Diuretic | Heart Failure Overview (2017) | ||
| Gabapentin | Anticonvulsant, Miscellaneous; GABA Analog | Gabapentin & Pregabalin in Pain (2014) | ||
| Glipizide | Antidiabetic Agent; Sulfonylurea | Sulfonylureas (2015) | ||
| Hydrochlorothiazide | Antihypertensive; Thiazide Diuretic | Diuretics (2014) | 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 | Ethambutol; Pyrazinamide; Rifampin; Rifapentine | ||
| Isosorbide mononitrate | Antianginal Agent; Vasodilator | Nitroglycerin 0.4 Milligrams; Sublingual; Nitroglycerin patch | ||
| Lactulose | Ammonium Detoxicant; Laxative, Osmotic | Cirrhosis & Complications (2015) | Polyethylene glycol | |
| Lamotrigine | Anticonvulsant, Miscellaneous | Antiepileptics (2014) | Carbamazepine; Divalproex; Levetiracetam; Phenytoin; Topiramate | |
| Leflunomide | Antirheumatic, Disease Modifying | Non-biologic DMARDs (2016) | Hydroxychloroquine; Methotrexate; Sulfasalazine | |
| Letrozole | Antineoplastic Agent, Aromatase Inhibitor | |||
| Levetiracetam | Anticonvulsant, Miscellaneous | Antiepileptics (2014) | Carbamazepine; Divalproex; Lamotrigine; Phenytoin; Topiramate | |
| Levothyroxine | Thyroid Agent | |||
| Lisinopril | Antihypertensive, Angiotensin-Converting Enzyme Inhibitor | ACEIs & ARBs in Heart Failure (2017) | ||
| Lithium | Antimanic Agent | ER Lithium & Divalproex (2012) | ||
| Lorazepam | Benzodiazepine | Alcohol Withdrawal Syndrome (2015) | Clonazepam | |
| Losartan | Antihypertensive, Angiotensin II Receptor Blocker | ACEIs & ARBs in Heart Failure (2017) | ||
| Medroxyprogesterone acetate, injection | Contraceptive, Progestin (Injection/Depot) | Contraception (2016) | Medroxyprogesterone, oral; Oral contraceptive pill, progestin only | |
| Meloxicam | Nonsteroidal Anti-Inflammatory Drug | NSAIDs (2014) | Diclofenac; Ibuprofen; Indomethacin; Naproxen | |
| Metformin | Antidiabetic Agent; Biguanide | |||
| Methotrexate | Antineoplastic Agent; Antirheumatic; Disease Modifying; Immunosuppresant Agent | Non-biologic DMARDs (2016) | Hydroxychloroquine; Leflunomide; Sulfasalazine | |
| Metoprolol succinate | Antihypertensive; Beta-Blocker, Beta1 Selective | HFrEF (2022) | Atenolol; Carvedilol, immediate-release; Propranolol | |
| Montelukast | Leukotriene Receptor Antagonist | |||
| Naloxone | Antidote; Opioid Antagonist | Treatment of Opioid Overdose (2014) | ||
| Naltrexone, oral | Antidote; Opioid Antagonist | Alcohol Use Disorder (2022) | Naloxone | |
| Naproxen | Nonsteroidal Anti-Inflammatory Drug | NSAIDs (2014) | Diclofenac; Ibuprofen; Indomethacin | |
| 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 | ||
| Nortriptyline | Antidepressant, Tricyclic | Antidepressants in Pain Mgmt (2014) | Amitriptyline | |
| Oxybutynin, immediate-release | Antispasmodic Agent, Urinary | Antimuscarinics (2019) | Oxybutynin, extended-release | |
| Phenytoin | Anticonvulsant, Hydantoin | Antiepileptics (2014) | Carbamazepine; Divalproex; Lamotrigine; Levetiracetam; Topiramate | |
| Pioglitazone | Antidiabetic Agent, Thiazolidinedione | Thiazolidinediones (2017) | ||
| Pravastatin | Antilipemic Agent, HMG-CoA Reductase Inhibitor | Hyperlipidemia (2017) | Atorvastatin; Rosuvastatin; Simvastatin | |
| Prazosin | Alpha1 Blocker; Antihypertensive | PTSD Indication (2012) | Doxazosin; Tamsulosin | |
| Prednisone | Corticosteroid, Systemic | |||
| Propranolol | Antihypertensive; Beta-Blocker, Non-Selective | Beta Blockers (2014) | Atenolol; Metoprolol | |
| Rifampin | Antitubercular Agent | Ethambutol; Isoniazid; Pyrazinamide; Rifapentine | ||
| Rifapentine | Antitubercular Agent | Rifapentine (2013) | Ethambutol; Isoniazid; Pyrazinamide; Rifampin | |
| Rosuvastatin | Antilipemic Agent, HMG-CoA Reductase Inhibitor | Hyperlipidemia (2017) | Atorvastatin; Pravastatin; Simvastatin | |
| Salsalate | Salicylate | |||
| Pyrazinamide | Antitubercular Agent | Ethambutol; Isoniazid; Rfapentine ; Rifampin | ||
| Pyridoxine (Vitamin B6) | Vitamin, Water Soluble | Supplements in Obstetrics (2016) | ||
| Sertraline | Antidepressant, Selective Serotonin Reuptake Inhibitor | Citalopram; Escitalopram; Fluoxetine; Paroxetine | ||
| Simvastatin | Antilipemic Agent, HMG-CoA Reductase Inhibitor | Dyslipidemia Guideline Review (2014) | Atorvastatin; Pravastatin; Rosuvastatin | |
| Spironolactone | Antihypertensive; Mineralocorticoid Receptor Antagonists; Potassium Sparing Diuretic | Mineralocorticoid Receptor Antagonist in HF (2017) | ||
| Sulfasalazine | 5-Aminosalicylic Acid Derivative | Hydroxychloroquine; Leflunomide; Methotrexate | ||
| Tamoxifen | Antineoplastic Agent, Estrogen Receptor Antagonist; Selective Estrogen Receptor Modulator | |||
| Tamsulosin | Alpha1 Blocker | Benign Prostatic Hypertrophy (2016) | Doxazosin; Prazosin | |
| Topiramate | Anticonvulsant, Miscellaneous | Antiepileptic Medications (2014) | 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 (2015) | Bupropion | |
| Venlafaxine | Antidepressant, Serotonin/Norepinephrine Reuptake Inhibitor/Antagonist | SNRIs (2012) | 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 | Diabetic Neuropathy (2018) | Bupropion; Venlafaxine | |
| Corticosteriods (Topical) - High Potency (Class I and II) | Topical Corticosteroids | Psoriasis (2018) | Corticosteroid (Topical) - Intermediate potency; Corticosteroid (Topical) - Low potency | |
| 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 | |||
| 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 | |
| Loperamide | Antidiarrheal | Irritable Bowel Syndrome (2018) | ||
| Dicyclomine | Anticholinergic Agent | Irritable Bowel Syndrome (2018) | ||
| 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 | |
| Ezetimibe | Antilipemic Agent, 2-Azetidinone | 2018 ACC/AHA Cholesterol Guidelines (2019) | ||
| Empagliflozin | Antidiabetic Agent, Sodium-Glucose Cotransporter 2 (SGLT2) Inhibitor | SGLT-2 Inhibitors (2019) | ||
| Naltrexone, extended-release for injection | Antidote; Opioid Antagonist | Opioid Use Disorder (2018) | ||
| Oseltamivir | Antiviral Agent; Neuraminidase Inhibitor | Treatment of Influenza (2019) | ||
| 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) | |
| Atomoxetine | Norepinephrine Reuptake Inhibitor, Selective | ADHD (2020) | Dextroamphetamine / Amphetamine (immediate release); Dextroamphetamine / Amphetamine (long-acting); Methylphenidate (immediate release); Methylphenidate (long-acting) | |
| Methimazole | Antithyroid Agent; Thioamide | Hyperthyroidism (2021) | Propylthiouracil | |
| Propylthiouracil | Antithyroid Agent; Thioamide | Hyperthyroidism (2021) | Methimazole | |
| Ondansetron | Antiemetic; Selective 5-HT3 Receptor Antagonist | Antiemetic Agents (2021) | ||
| Ceftriaxone, injection | Antibiotic, Cephalosporin (Third Generation) | STIs - PART 1 (2021) | Cefdinir; Cefixime; 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 | |
| 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 | Anti-Seizure Drugs (2021) | Carbamazepine; Clonazepam; Divalproex; Gabapentin; Lamotrigine; Levetiracetam; Phenytoin; Topiramate | |
| 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 | HFpEF (2022) | Bumetanide -OR- torsemide; Furosemide | |
| Bumetanide -OR- Torsemide | Antihypertensive | HFpEF (2022) | Furosemide; Torsemide -OR- Bumetanide | |
| 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 | |
| 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 | **Coming soon** | ||
| Clotrimazole, topical | Antifungal Agent, Imidazole Derivative | **Coming soon** | ||
| 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** | ||
| 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 | |
| Phentermine and Topiramate ER (**REMS drug**) | Anticonvulsant, Miscellaneous; Central Nervous System Stimulant | Obesity Management (2022) | **For REMS criteria, see Formulary Brief** | |
| Diclofenac | Nonsteroidal Anti-Inflammatory Drug | NSAIDs (2014) | *Any formulation* | Ibuprofen; Indomethacin; Meloxicam; Naproxen |
| Calcium | Electrolyte supplement | *Any formulation* | ||
| Permethrin 1% | Antiparasitic Agent, Topical; Pediculocide; Scabicidal Agent | Sexually Transmitted Infections, Part III (2022) | *Any formulation* | Permethrin 5% cream |
| Fluoride, oral | Nutritional Supplement | Supplements in Oral Health (2016) | *Any oral formulation* | |
| Iron, oral | Iron Salt | Hematologic Supplements (2016) | *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 |
| H1 Antagonist (2nd generation), long-acting | Histamine H1 Antagonist, Second Generation | *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 | *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 | |
| Proton Pump Inhibitor | Proton Pump Inhibitor | GERD & PUD (2018) | *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 | Vitamin D Analog | Vitamin D (2010) | *Any product* | |
| Tretinoin, topical | Topical Skin Product, Acne | Acne (2013) | *Any product* | |
| Corticosteroid, intranasal | Intranasal Corticosteroid | *Any product* | ||
| Low-molecular weight heparin | Low-molecular Weight Heparin | VTE Prophylaxis (2011) | *Any product* | |
| Laxative, bulk-forming | Bulk-forming Laxative | *Any product* | ||
| Polyethylene glycol | Laxative, Osmotic | Irritable Bowel Syndrome (2018) | *Any product* | Lactulose |
| Laxative, stimulant | Stimulant Laxative | *Any product* | ||
| 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 | |
| Atypical antipsychotic | Antipsychotic, Atypical | Bipolar Disorders (2022) | *Any product* | Aripiprazole lauroxil; Haloperidol decanoate |
| Albuterol, metered dose inhaler (MDI) | Beta2 Agonist | NPTC Meeting Update (Nov 2017) | *Any product* | |
| 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 |
| 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* | |
| Levonorgestrel (Plan B One-Step®) | Contraceptive, Progestin | Contraception (2016) | *Branded product* | Ulipristal |
| Tiotropium (Spiriva®) | Long-Acting Anticholinergic Agent | Inhaled Anticholinergics (2011) | *Branded product* | |
| Mometasone (Asmanex®) | Corticosteroid, Inhalant | *Branded product* | ||
| 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®) |
| 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 | Opioid Use Disorder (2018) | **See REMS here** | 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** | 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**) |
| Testosterone (**REMS Drug**) | Androgen | Gender-Affirming Medications (2022) | Any formulation; Certain formulations (i.e., undecoanate) have REMS requirements | |
| Donepezil | Acetylcholinesterase Inhibitor (Central) | 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 | |
| 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®) |
| 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 Delivery Devices (2021) | Any formulation | Glucagon |
| Folic Acid | Vitamin, Water Soluble | Supplements in Womens Health (2016) | Any product containing >400 mcg / daily dose | |
| Sumatriptan | Antimigraine Agent; Serotonin 5-HT 1B/1D Receptor Agonist | Triptans (2016) | 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 | Triptans (2016) | Any two (2) triptan medications are required, one must be sumatriptan | Sumatriptan |
| Nicotine replacement therapy (NRT), combination | Smoking Cessation Aid | Nicotine Dependence (2015) | Combination NRT (nicotine patches + any short-acting NRT product) | Bupropion; Varenicline |
| 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 |
| 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 | 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 | Contraception (2016) | For use by a skilled and privileged provider | Oral contraceptive pill, progestin only |
| 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 | |
| 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) |
| 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) |
| 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 |
| 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) | |
| 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) | |
| 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 |
