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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: 08/18/2021
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The following is a list of Medications currently in the queue. 191 record(s) found.
The following is a list of Medications currently in the queue. 191 record(s) found.
MedicationPharmacological CategoryFormulary BriefNotesSimilar 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
Chlorthalidone Antihypertensive; Thiazide-Related Diuretic Diuretic Agents (2014) Hydrochlorothiazide
Clonazepam Benzodiazepine Alcohol Withdrawal Syndrome (2015) Lorazepam
Clopidogrel Antiplatelet Agent Antiplatelets (2015) Aspirin
Carbamazepine Anticonvulsant, Miscellaneous Antiepileptics (2014) Divalproex; Lamotrigine; Levetiracetam; Phenytoin; Topiramate
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
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)
Estradiol tablets Estrogen Derivative Menopausal Hormone Therapy (2016)
Finasteride 5 Alpha-Reductase Inhibitor Benign Prostatic Hypertrophy (2016)
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
Fluoxetine Antidepressant, Selective Serotonin Reuptake Inhibitor Sertraline
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
Montelukast Leukotriene Receptor Antagonist
Naloxone Antidote; Opioid Antagonist Treatment of Opioid Overdose (2014)
Naltrexone, oral Antidote; Opioid Antagonist Alcohol Use Disorders (2015) 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
Metoprolol Antihypertensive; Beta-Blocker, Beta1 Selective Beta-blockers in Heart Failure (2017) Atenolol; Propranolol
Pyrazinamide Antitubercular Agent Ethambutol; Isoniazid; Rfapentine ; Rifampin
Pyridoxine (Vitamin B6) Vitamin, Water Soluble Supplements in Obstetrics (2016)
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
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
Sertraline Antidepressant, Selective Serotonin Reuptake Inhibitor Citalopram; Escitalopram; Fluoxetine; Paroxetine
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®)
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
Varenicline Partial Nicotine Agonist, Smoking Cessation Aid Nicotine Dependence (2015) Bupropion
Venlafaxine Antidepressant, Serotonin/Norepinephrine Reuptake Inhibitor/Antagonist SNRIs (2012) Bupropion; Duloxetine
Loperamide Antidiarrheal Irritable Bowel Syndrome (2018)
Dicyclomine Anticholinergic Agent Irritable Bowel Syndrome (2018)
Phentermine Central Nervous System Stimulant Obesity Treatment (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
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 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)
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 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
Azithromycin Antibiotic, Macrolide STIs - PART 1 (2021)
Doxycycline Antibiotic, Tetracycline STIs - PART 1 (2021)
Penicillin G benzathine Antibiotic, Penicillin STIs - PART 1 (2021)
Hydroxyzine Histamine H1 Antagonist, First Generation **COMING SOON**
Pramipexole Anti-Parkinson Agent, Dopamine Agonist **COMING SOON**
Ethosuximide Anticonvulsant, Succinimide **COMING SOON** Carbamazepine; Clonazepam; Divalproex; Gabapentin; Lamotrigine; Levetiracetam; Phenytoin; Topiramate
Oxcarbazepine Anticonvulsant, Miscellaneous **COMING SOON** Carbamazepine; Clonazepam; Divalproex; Gabapentin; Lamotrigine; Levetiracetam; Phenytoin; Topiramate
Ondansetron Antiemetic; Selective 5-HT3 Receptor Antagonist Antiemetic Agents (2021)
Ceftriaxone Injection Antibiotic, Cephalosporin STIs - PART 1 (2021) Cefixime
Diclofenac Nonsteroidal Anti-Inflammatory Drug NSAIDs (2014) *Any formulation* Ibuprofen; Indomethacin; Meloxicam; Naproxen
Calcium Electrolyte supplement *Any formulation*
Iron, oral Iron Salt Hematologic Supplements (2016) *Any oral formulation*
Fluoride, oral Nutritional Supplement Supplements in Oral Health (2016) *Any oral formulation*
H1 Antagonist (2nd generation), long-acting Histamine H1 Antagonist, Second Generation *Any product*
Corticosteroid, intranasal Intranasal Corticosteroid *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*
Low-molecular weight heparin Low-molecular Weight Heparin VTE Prophylaxis (2011) *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 Atypical Antipsychotic Agents (2015) *Any product* Aripiprazole lauroxil; Haloperidol decanoate
Albuterol, metered dose inhaler (MDI) Beta2 Agonist NPTC Meeting Update (Nov 2017) *Any product*
Phosphodiesterase 5 (PDE5) Inhibitor Phosphodiesterase-5 Enzyme Inhibitor Phosphodiesterase 5 Inhibitors (2018) *Any product*
Estrogen vaginal cream Estrogen Derivative NPTC Meeting Update (May 2018) *Any product* Estradiol tablets
Vitamin D Vitamin D Analog Vitamin D (2010) *Any product*
Vitamin D Analog (Topical) Vitamin D Analog Psoriasis (2018) *Any product*
Tretinoin, topical Topical Skin Product, Acne Acne (2013) *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 *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
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
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*
Mometasone (Asmanex®) Corticosteroid, Inhalant *Branded product*
Tiotropium (Spiriva®) Long-Acting Anticholinergic Agent Inhaled Anticholinergics (2011) *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 (Lantus®)
Carvedilol Antihypertensive; Beta-Blocker with Alpha-Blocking Activity Beta-blockers in Heart Failure (2017) *Immediate-release only Atenolol; Metoprolol; Propranolol
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** Exit Disclaimer: You Are Leaving www.ihs.gov  Naloxone
Buprenorphine, short-acting (**REMS drug**) Analgesic, Opioid; Analgesic, Opioid Partial Agonist **COMING SOON** 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 **COMING SOON** 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**)
Naltrexone, extended-release for injection (**REMS drug**) Antidote; Opioid Antagonist Opioid Use Disorder (2018) **See REMS here** Exit Disclaimer: You Are Leaving www.ihs.gov 
Ranitidine* Histamine H2 Antagonist GERD & PUD (2018) *(April 1, 2020) The Food and Drug Administration has recommended that all formulations of ranitidine be taken off the market due to contaminates of N-Nitrosodimethylamine (NDMA), a carcinogen, in ranitidine products. Exit Disclaimer: You Are Leaving www.ihs.gov  Proton Pump Inhibitor
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
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
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 STIs - PART 1 (2021) For outpatient treatment of gonorrhea for Expedited Partner Therapy or when injection therapy is not possible Ceftriaxone Injection
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
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)
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)
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
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