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: 04/12/2024
Search Medications Results
The following is a list of Medications currently in the queue. 233 record(s) found.
| Medication | Pharmacological Category | Formulary Brief | Notes | Similar Medications |
|---|---|---|---|---|
| Apixaban | Anticoagulant; Direct Oral Anticoagulant (DOAC); Factor Xa Inhibitor | Direct Oral Anticoagulants (2017) | Warfarin | |
| Bupropion | Antidepressant, Dopamine/Norepinephrine-Reuptake Inhibitor; Smoking Cessation Aid | Stimulant Use Disorder (2022) | Varenicline; Venlafaxine | |
| Levonorgestrel (Plan B One-Step®) | Contraceptive, Progestin | Contraception (2016) | *Branded product* | Ulipristal |
| 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 | NPTC Update (Jan 2024) | For weight management, with recommended local adoption of use criteria | Tirzepatide (Zepbound™) -OR- Semaglutide (Wegovy®) |
| Umeclidinium/Vilanterol | Long-Acting Muscarinic Antagonist (LAMA) / Long-Acting Beta2 Agonist (LABA) | LAMAs (2019) | Tiotropium (Spiriva®) | |
| Metronidazole, oral | Antibiotic, Miscellaneous | 2021 CDC Guidelines for Sexually Transmitted Infections (2021) | Tinidazole | |
| Sildenafil | Phosphodiesterase-5 Enzyme Inhibitor | Erectile Dysfunction (Nov 2022) | Tadalafil | |
| 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 |
| Mesalamine, oral | 5-Aminosalicylic Acid Derivative | Inflammatory Bowel Disease (2023) | Once-Daily Formulation | Sulfasalazine |
| Tadalafil | Phosphodiesterase-5 Enzyme Inhibitor | Erectile Dysfunction (Nov 2022) | Sildenafil | |
| Fluoxetine | Antidepressant, Selective Serotonin Reuptake Inhibitor | Bipolar Disorder (2022) | Sertraline | |
| 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 | NPTC Update (Jan 2024) | For weight management, with recommended local adoption of use criteria | Semaglutide (Wegovy®) -OR- Tirzepatide (Zepbound™) |
| 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 |
| Methimazole | Antithyroid Agent; Thioamide | Hyperthyroidism (2021) | Propylthiouracil | |
| Atenolol | Antihypertensive; Beta-Blocker, Beta1 Selective | Hypertension (2022) | Propranolol | |
| Doxazosin | Alpha1 Blocker; Antihypertensive | Benign Prostatic Hypertrophy (Nov 2022) | Prazosin; Tamsulosin | |
| Atorvastatin | Antilipemic Agent, HMG-CoA Reductase Inhibitor | Hyperlipidemia (2022) | Pravastatin; Rosuvastatin; Simvastatin | |
| Lactulose | Ammonium Detoxicant; Laxative, Osmotic | Hepatic Encephalopathy (2020) | Polyethylene glycol | |
| Permethrin 1% | Antiparasitic Agent, Topical; Pediculocide; Scabicidal Agent | Sexually Transmitted Infections, Part III (2022) | *Any formulation* | Permethrin 5% cream |
| Permethrin 5% cream | Antiparasitic Agent, Topical; Pediculocide; Scabicidal Agent | Sexually Transmitted Infections, Part III (2022) | Permethrin 1%, any formulation | |
| Oxybutynin, extended-release | Antispasmodic Agent, Urinary | Antimuscarinics (2019) | Oxybutynin, Immediate-release | |
| Beta-3 agonist, Any | Beta3 Agonist | Urinary Incontinence (2023) | Either mirabegron -or- vibegron | Oxybutynin, extended-release; Oxybutynin, immediate-release |
| Oxybutynin, immediate-release | Antispasmodic Agent, Urinary | Antimuscarinics (2019) | Oxybutynin, extended-release | |
| Norgestrel 0.075mg OTC tablets (Opill®) | Contraceptive, Progestin | Norgestrel OTC - Opill (2023) | Oral contraceptive pill, progestin only (prescription) | |
| Etonogestrel, implant | Contraceptive; Progestin | Long Acting Reversible Contraception (2021) | For use by a skilled and privileged provider | Oral contraceptive pill, progestin only |
| Amitriptyline | Antidepressant, Tricyclic | Bipolar Disorder (2022) | Nortriptyline | |
| Isosorbide mononitrate | Antianginal Agent; Vasodilator | Anti-Anginal Treatment (2013) | Nitroglycerin patch | |
| Naltrexone, oral | Antidote; Opioid Antagonist | Alcohol Use Disorder (2022) | Naloxone | |
| Buprenorphine-Naloxone (**REMS drug**) | Analgesic, Opioid; Analgesic, Opioid Partial Agonist | MAT for OUD (2021) | **See REMS here** | Naloxone |
| Fluticasone/Salmeterol | Beta2 Agonist, Long-Acting; Corticosteroid, Inhalant | LABAs (2019) | Mometasone (Asmanex®) | |
| Vancomycin, oral | Glycopeptide | Clostridioides Difficile (2023) | Metronidazole, oral | |
| Tinidazole | Antibiotic, Miscellaneous | 2021 CDC Guidelines for Sexually Transmitted Infections (2021) | Metronidazole | |
| 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) |
| Mercaptopurine -OR- Azathioprine | Immunosuppresant Agent | Inflammatory Bowel Disease (2023) | Methotrexate; Sumatriptan | |
| Azathioprine -OR- Mercaptopurine | Immunosuppresant Agent | Inflammatory Bowel Disease (2023) | Methotrexate; Sulfasalazine | |
| Propylthiouracil | Antithyroid Agent; Thioamide | Hyperthyroidism (2021) | Methimazole | |
| 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 |
| Medroxyprogesterone, oral | Contraceptive; Progestin | Polycystic Ovarian Syndrome (2017) | Medroxyprogesterone acetate, injection; Oral contraceptive pill, progestin only | |
| Clonazepam | Benzodiazepine | Antiseizure Drugs (2021) | Lorazepam | |
| Bismuth subsalicylate | Antidiarrheal | Helicobacter pylori Treatment (2023) | Loperamide | |
| Ulipristal | Contraceptive; Progestin Receptor Modulator | Contraception (2016) | Levonorgestrel (Plan B One-Step®) | |
| Hydroxychloroquine | Antimalarial | Non-biologic DMARDs (2016) | Leflunomide; Methotrexate; Sulfasalazine | |
| Glecaprevir/Pibrentasvir (Mavyret®) | Antihepaciviral | HCV Treatment (2018) | Ledipasvir/sofosbuvir (Harvoni®); Sofosbuvir/velpatasvir (Epclusa®) | |
| Polyethylene glycol | Laxative, Osmotic | Irritable Bowel Syndrome (2018) | *Any product* | Lactulose |
| Rifaximin | Antibiotic, Rifamycin | Hepatic Encephalopathy (2020) | After failure of, or intolerance to, lactulose monotherapy as indicated for hepatic encephalopathy | Lactulose |
| 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 | |
| Ethambutol | Antitubercular Agent | Treatment of Tuberculosis (2021) | Isoniazid; Pyrazinamide; Rifampin; Rifapentine | |
| 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 |
| Diclofenac | Nonsteroidal Anti-Inflammatory Drug | NSAIDs (2014) | *Any formulation* | Ibuprofen; Indomethacin; Meloxicam; Naproxen |
| Leflunomide | Antirheumatic, Disease Modifying | Non-biologic DMARDs (2016) | Hydroxychloroquine; Methotrexate; Sulfasalazine | |
| Methotrexate | Antineoplastic Agent; Antirheumatic; Disease Modifying; Immunosuppresant Agent | Non-biologic DMARDs (2016) | Hydroxychloroquine; Leflunomide; Sulfasalazine | |
| Sulfasalazine | 5-Aminosalicylic Acid Derivative | Inflammatory Bowel Disease (2018) | Hydroxychloroquine; Leflunomide; Methotrexate | |
| Chlorthalidone | Antihypertensive; Thiazide-Related Diuretic | Hypertension (2022) | Hydrochlorothiazide | |
| Aripiprazole lauroxil | Antipsychotic, Atypical (Second Generation) - Injectable | Long-Acting Injectable Antipsychotics (2020) | Injectable | Haloperidol decanoate |
| Glucose, oral | Antidote | Glucagon Products Review (2021) | Any formulation | Glucagon |
| 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®) | |
| Bumetanide -OR- Torsemide | Antihypertensive | Heart Failure with Preserved Ejection Fraction (HFpEF) (2022) | Furosemide; Torsemide -OR- Bumetanide | |
| Isoniazid | Antitubercular Agent | Treatment of Tuberculosis (2021) | Ethambutol; Pyrazinamide; Rifampin; Rifapentine | |
| Pyrazinamide | Antitubercular Agent | Treatment of Tuberculosis (2021) | Ethambutol; Isoniazid; Rifampin | |
| Rifampin | Antitubercular Agent | Treatment of Tuberculosis (2021) | Ethambutol; Isoniazid; Pyrazinamide; Rifapentine | |
| Rifapentine | Antitubercular Agent | Treatment of Tuberculosis (2021) | Ethambutol; Isoniazid; Pyrazinamide; Rifampin | |
| Adalimumab-bwwd (Hadlima™) | Antirheumatic, Disease Modifying; Tumor Necrosis Factor (TNF) Blocking Agent | NPTC Update (Jan 2024) | Etanercept | |
| Estradiol for Injection | Estrogen Derivative | Gender Affirming Therapies (2022) | Either valerate or cypionate product | Estradiol tablets; Estradiol, transdermal |
| Estrogen vaginal cream | Estrogen Derivative | NPTC Meeting Update (May 2018) | *Any product* | Estradiol tablets |
| Estradiol tablets | Estrogen Derivative | Gender-Affirming Medications (2022) | Estradiol for Injection; Estradiol, transdermal | |
| Estradiol, transdermal | Estrogen Derivative | Gender Affirming Therapies (2022) | *Any patch* | Estradiol for Injection; Estradiol tablets |
| Citalopram | Antidepressant, Selective Serotonin Reuptake Inhibitor | Bipolar Disorder (2022) | Escitalopram; Fluoxetine; Paroxetine; Sertraline | |
| Dolutegravir | Antiretroviral, Integrase Inhibitor (Anti-HIV) | HIV Updates (2020) | For HIV treatment in pregnant patients | Emtricitabine/tenofovir disoproxil fumarate; 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 |
| Prazosin | Alpha1 Blocker; Antihypertensive | Post Traumatic Stress Disorder (2021) | Doxazosin; Tamsulosin | |
| Tamsulosin | Alpha1 Blocker | Benign Prostatic Hypertrophy (Nov 2022) | Doxazosin; Prazosin | |
| Bictegravir/Emtricitabine/Tenofovir alafenamide | Antiretroviral, Integrase Inhibitor (Anti-HIV) | HIV Treatment (2019) | Dolutegravir/abacavir/lamivudine; Emtricitabine/tenofovir disoproxil fumarate; Raltegravir | |
| Carbamazepine | Anticonvulsant, Miscellaneous | Bipolar Disorder (2022) | Divalproex; Lamotrigine; Levetiracetam; Phenytoin; Topiramate | |
| Amlodipine | Antihypertensive; Calcium Channel Blocker, Dihydropyridine | Hypertension (2022) | Diltiazem | |
| Ibuprofen | Nonsteroidal Anti-Inflammatory Drug | NSAIDs (2014) | Diclofenac; Indomethacin; Meloxicam; Naproxen | |
| Indomethacin | Nonsteroidal Anti-Inflammatory Drug | NSAIDs (2014) | Diclofenac; Ibuprofen; Meloxicam; Naproxen | |
| Meloxicam | Nonsteroidal Anti-Inflammatory Drug | NSAIDs (2014) | Diclofenac; Ibuprofen; Indomethacin; Naproxen | |
| Naproxen | Nonsteroidal Anti-Inflammatory Drug | NSAIDs (2014) | Diclofenac; Ibuprofen; Indomethacin | |
| Atomoxetine | Norepinephrine Reuptake Inhibitor, Selective | ADHD (Jan 2020) | Dextroamphetamine / Amphetamine (immediate release); Dextroamphetamine / Amphetamine (long-acting); Methylphenidate (immediate release); Methylphenidate (long-acting) | |
| Corticosteroid (Topical) - Intermediate Potency | Topical Corticosteroids | Atopic Dermatitis (2020) | *Any product* | Corticosteroid (Topical) - Low Potency |
| Corticosteroids (Topical) - High Potency (Class I and II) | Topical Corticosteroids | Alopecia Areata (2022) | Corticosteroid (Topical) - Intermediate Potency; Corticosteroid (Topical) - Low Potency | |
| Corticosteroid (Topical) - Low Potency | Topical Corticosteroids | Atopic Dermatitis (2020) | *Any product* | Corticosteroid (Topical) - Intermediate Potency |
| 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) | |
| Lorazepam | Benzodiazepine | Alcohol Withdrawal Syndrome (2015) | Clonazepam | |
| 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 | |
| Sertraline | Antidepressant, Selective Serotonin Reuptake Inhibitor | Bipolar Disorder (2022) | Citalopram; Escitalopram; Fluoxetine; Paroxetine | |
| 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 |
| Hydrochlorothiazide | Antihypertensive; Thiazide Diuretic | Hypertension (2022) | Chlorthalidone | |
| Cefdinir | Antibiotic, Cephalosporin (Third Generation) | Outpatient Abx Stewardship & URIs (2021) | Pediatric and Adult oral formulations | Cefixime; Ceftriaxone Injection; 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 |
| Ceftriaxone, injection | Antibiotic, Cephalosporin (Third Generation) | STIs - PART 1 (2021) | Cefdinir; Cefixime; Cephalexin | |
| Cephalexin | Antibiotic, Cephalosporin (First Generation) | Outpatient Abx Stewardship & URIs (2021) | Pediatric and Adult oral formulations | Cefdinir; Cefixime; Ceftriaxone Injection |
| Divalproex | Anticonvulsant, Miscellaneous | Bipolar Disorder (2022) | Carbamazepine; Lamotrigine; Levetiracetam; Phenytoin; Topiramate | |
| Lamotrigine | Anticonvulsant, Miscellaneous | Bipolar Disorder (2022) | Carbamazepine; Divalproex; Levetiracetam; Phenytoin; Topiramate | |
| Levetiracetam | Anticonvulsant, Miscellaneous | Antiseizure Drugs (2021) | Carbamazepine; Divalproex; Lamotrigine; Phenytoin; Topiramate | |
| Phenytoin | Anticonvulsant, Hydantoin | Antiseizure Drugs (2021) | Carbamazepine; Divalproex; Lamotrigine; Levetiracetam; Topiramate | |
| Topiramate | Anticonvulsant, Miscellaneous | Alcohol Use Disorder (2022) | Carbamazepine; Divalproex; Lamotrigine; Levetiracetam; Phenytoin | |
| 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 | |
| Sevelamer carbonate | Phosphate Binder | Phosphate Binders (2018) | For patients on dialysis who cannot use calcium-based phosphate binders due to hypercalcemia | Calcium |
| Duloxetine | Antidepressant, Serotonin/Norepinephrine Reuptake Inhibitor/Antagonist | Bipolar Disorder (2022) | Bupropion; Venlafaxine | |
| Nicotine replacement therapy (NRT), combination | Smoking Cessation Aid | Nicotine Dependence (2020) | Combination NRT (nicotine patches + any short-acting NRT product) | Bupropion; Varenicline |
| Venlafaxine | Antidepressant, Serotonin/Norepinephrine Reuptake Inhibitor/Antagonist | Bipolar Disorder (2022) | Bupropion; Duloxetine | |
| Varenicline | Partial Nicotine Agonist, Smoking Cessation Aid | Nicotine Dependence (2020) | Bupropion | |
| 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**) |
| 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**) |
| Torsemide -OR- Bumetanide | Antihypertensive | Heart Failure with Preserved Ejection Fraction (HFpEF) (2022) | Bumetanide -OR- Torsemide; Furosemide | |
| 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 |
| 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 | |
| Pravastatin | Antilipemic Agent, HMG-CoA Reductase Inhibitor | Hyperlipidemia (2022) | Atorvastatin; Rosuvastatin; Simvastatin | |
| Rosuvastatin | Antilipemic Agent, HMG-CoA Reductase Inhibitor | Hyperlipidemia (2022) | Atorvastatin; Pravastatin; Simvastatin | |
| Simvastatin | Antilipemic Agent, HMG-CoA Reductase Inhibitor | Hyperlipidemia (2022) | Atorvastatin; Pravastatin; Rosuvastatin | |
| Carvedilol, immediate-release | Antihypertensive; Beta-Blocker with Alpha-Blocking Activity | Heart Failure with Reduced Ejection Fraction (HFrEF) (2022) | Atenolol; Propranolol | |
| Metoprolol succinate | Antihypertensive; Beta-Blocker, Beta1 Selective | Heart Failure with Reduced Ejection Fraction (HFrEF) (2022) | Atenolol; Carvedilol, immediate-release; Propranolol | |
| Metoprolol tartrate | Antihypertensive; Beta-Blocker, Beta1 Selective | Heart Failure with Reduced Ejection Fraction (HFrEF) (2022) | Atenolol; Carvedilol, immediate-release; Metoprolol succinate | |
| Propranolol | Antihypertensive; Beta-Blocker, Non-Selective | Migraine Prevention (2019) | Atenolol | |
| Clopidogrel | Antiplatelet Agent | Antiplatelets (2015) | Aspirin | |
| Ciprofloxacin, ophthalmic solution | Antibiotic, Ophthalmic Fluoroquinolone | Ocular Treatments (2022) | Artificial Tear substitute, ophthalmic (preservative free); 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 |
| 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 | |
| Polymyxin B/Trimethoprim, ophthalmic solution | Antibiotic, Ophthalmic | Ocular Treatments (2022) | Artificial Tear substitute, ophthalmic (preservative free); Ciprofloxacin, ophthalmic solution; Corticosteroid (Ophthalmic) - Low Potency | |
| Atypical antipsychotic | Antipsychotic, Atypical | Bipolar Disorders (2022) | *Any product* | Aripiprazole lauroxil; Haloperidol decanoate |
| Haloperidol decanoate | Antipsychotic, Typical (First Generation) - Injectable | Long-Acting Injectable Antipsychotics (2020) | Injectable | Aripiprazole lauroxil |
| Warfarin | Anticoagulant; Vitamin K Antagonist | Direct Oral Anticoagulants (2017) | Apixaban; Low-molecular weight heparin | |
| Amoxicillin and Clavulanate | Antibiotic, Penicillin | Outpatient Abx Stewardship & URIs (2021) | Pediatric and Adult oral formulations | Amoxicillin; Penicillin G benzathine; Penicllin V potassium |
| Penicillin G benzathine | Antibiotic, Penicillin | STIs - PART 1 (2021) | Amoxicillin; Amoxicillin and Clavulanate; Penicllin V potassium | |
| Penicillin V potassium | Antibiotic, Penicillin | Outpatient Abx Stewardship & URIs (2021) | Pediatric and Adult oral formulations | Amoxicillin; Amoxicillin and Clavulanate; Penicillin G benzathine |
| Amoxicillin | Antibiotic, Penicillin | Outpatient Abx Stewardship & URIs (2021) | Pediatric and Adult oral formulations | Amoxicillin and Clavulanate; Penicillin G benzathine; Penicllin V potassium |
| Diltiazem | Antihypertensive; Calcium Channel Blocker, Nondihydropyridine | Hypertension (2022) | Amlodipine | |
| Nortriptyline | Antidepressant, Tricyclic | Bipolar Disorder (2022) | Amitriptyline | |
| Etanercept | Antirheumatic, Disease Modifying; Tumor Necrosis Factor (TNF) Blocking Agent | TNF Inhibitors (2016) | Adalimumab-bwwd (Hadlima™) | |
| Albuterol, metered dose inhaler (MDI) | Beta2 Agonist | Asthma & COPD Guidelines Review (2019) | *Any product* | |
| Albuterol nebulized solution | Beta2 Agonist | Asthma & COPD Guidelines Review (2019) | ||
| Alendronate | Bisphosphonate Derivative | Osteoporosis (2016) | ||
| Allopurinol | Antigout Agent; Xanthine Oxidase Inhibitor | Gout (2016) | ||
| Anastrozole | Antineoplastic Agent, Aromatase Inhibitor | NPTC Update Spring 2021 | ||
| Aspirin | Antiplatelet Agent; Nonsteroidal Anti-Inflammatory Drug; Salicylate | Pregnancy & Prenatal Care (2021) | ||
| Calcium | Electrolyte Supplement | Osteoporosis (2016) | *Any formulation* | |
| Acetaminophen | Analgesic, Miscellaneous | Short-Acting Opioids (2014) | ||
| Donepezil | Acetylcholinesterase Inhibitor (Central) | Alzheimer's disease (2019) | 5mg and 10mg strengths | |
| Ethinyl estradiol / Etonogestrel vaginal ring | Contraceptive; Estrogen and Progestin Combination | Contraception (2016) | ||
| Ethinyl estradiol / Norelgestromin, transdermal | Contraceptive; Estrogen and Progestin Combination | Contraception (2016) | ||
| Digoxin | Antiarrhythmic Agent, Miscellaneous; Cardiac Glycoside | Heart Failure with Reduced Ejection Fraction (HFrEF) (2022) | ||
| Cyanocobalamin (Vitamin B12), oral | Vitamin, Water Soluble | Hematologic Supplements (2016) | ||
| 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 | |
| Laxative, bulk-forming | Bulk-forming Laxative | Added July 2011 (Constipation) | *Any product* | |
| Laxative, stimulant | Stimulant Laxative | Added July 2011 (Constipation) | *Any product* | |
| Iron, oral | Iron Salt | Pregnancy & Prenatal Care (2021) | *Any oral formulation* | |
| Losartan | Antihypertensive, Angiotensin II Receptor Blocker | Hypertension (2022) | ||
| Low-molecular weight heparin | Low-molecular Weight Heparin | VTE Prophylaxis (2011) | *Any product* | |
| Letrozole | Antineoplastic Agent, Aromatase Inhibitor | NPTC Update Spring 2021 | ||
| Levothyroxine | Thyroid Agent | Originally added 2004 | ||
| Lisinopril | Antihypertensive, Angiotensin-Converting Enzyme Inhibitor | Hypertension (2022) | ||
| Lithium | Antimanic Agent | Bipolar Disorder (2022) | ||
| Finasteride | 5 Alpha-Reductase Inhibitor | Benign Prostatic Hypertrophy (Nov 2022) | ||
| Fluoride, oral | Nutritional Supplement | Supplements in Oral Health (2016) | *Any oral formulation* | |
| Folic Acid | Vitamin, Water Soluble | Pregnancy & Prenatal Care (2021) | Any product containing >400 mcg / daily dose | |
| 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) | ||
| Glucagon | Antidote; Hypoglycemia | Glucagon Products Review (2021) | For outpatient use | |
| H1 Antagonist (2nd generation), long-acting | Histamine H1 Antagonist, Second Generation | Allergic Rhinitis (2018) | *Any 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 | |
| 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* | |
| Corticosteroid, intranasal | Intranasal Corticosteroid | Allergic Rhinitis (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* | |
| Mometasone (Asmanex®) | Corticosteroid, Inhalant | Asthma & COPD Guidelines Review (2019) | *Branded product* | |
| Montelukast | Leukotriene Receptor Antagonist | Asthma & COPD Guidelines Review (2019) | ||
| Naloxone | Antidote; Opioid Antagonist | Opioid Use Disorder (2018) | ||
| Metformin | Antidiabetic Agent; Biguanide | Diabetes Treatment Overview (2017) | ||
| Proton Pump Inhibitor | Proton Pump Inhibitor | GERD & PUD (2018) | *Any product* | |
| Prednisone | Corticosteroid, Systemic | Atopic Dermatitis (2020) | ||
| Pioglitazone | Antidiabetic Agent, Thiazolidinedione | Thiazolidinediones (2017) | ||
| Salsalate | Salicylate | Added June 2008 (NSAIDs) | ||
| Pyridoxine (Vitamin B6) | Vitamin, Water Soluble | Pregnancy & Prenatal Care (2021) | ||
| 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* | |
| Vaccines, All ACIP-recommended | Vaccines | Vaccine (2011) | All ACIP recommended vaccines for routine use in accordance with ACIP guidelines | |
| Spironolactone | Antihypertensive; Mineralocorticoid Receptor Antagonists; Potassium Sparing Diuretic | Heart Failure with Reduced Ejection Fraction (HFrEF) (2022) | ||
| Tiotropium (Spiriva®) | Long-Acting Anticholinergic Agent | Long Acting Muscarinic Antagonists (2019) | *Branded product* | |
| Sumatriptan | Antimigraine Agent; Serotonin 5-HT 1B/1D Receptor Agonist | Acute Migraine (2021) | Any two (2) triptan medications are required, one must be sumatriptan | |
| Tamoxifen | Antineoplastic Agent, Estrogen Receptor Antagonist; Selective Estrogen Receptor Modulator | NPTC Update Spring 2021 | ||
| Naltrexone, extended-release for injection | Antidote; Opioid Antagonist | Opioid Use Disorder (2018) | ||
| Alogliptin | Antidiabetic Agent, Dipeptidyl Peptidase 4 (DPP-4) Inhibitor | DPP-IV Inhibitors (2019) | ||
| Vitamin D Analog, topical | Vitamin D Analog | Psoriasis (2018) | *Any product* | |
| Loperamide | Antidiarrheal | Irritable Bowel Syndrome (2018) | ||
| Dicyclomine | Anticholinergic Agent | Irritable Bowel Syndrome (2018) | ||
| Hydroxyzine | Histamine H1 Antagonist, First Generation | Anxiety Disorders (2021) | ||
| Pramipexole | Anti-Parkinson Agent, Dopamine Agonist | Insomnia/Sleep Medications (2021) | ||
| Azithromycin | Antibiotic, Macrolide | STIs - PART 1 (2021) | ||
| Doxycycline | Antibiotic, Tetracycline | STIs - PART 1 (2021) | ||
| Ondansetron | Antiemetic; Selective 5-HT3 Receptor Antagonist | Antiemetic Agents (2021) | ||
| Prenatal Multivitamin | Vitamin | Pregnancy & Prenatal Care (2021) | Must contain >400 mcg of folic acid/dose | |
| Epinephrine Injection Devices (both 0.15mg and 0.3mg) | Alpha-/Beta- Agonist | Epinephrine Injection Devices (2020 | Any device, auto-injector or pre-filled syringe | |
| 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) | ||
| 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 | |
| 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) | ||
| Nitrofurantoin | Antibiotic, Miscellaneous | Urinary Tract Infections (2021) | ||
| Trimethoprim-Sulfamethoxazole | Antibiotic, Miscellaneous | Skin & Soft Tissue Infections (2021) | ||
| Clindamycin | Antibiotic, Lincosamide | Outpatient Abx Stewardship & URIs (2021) | Pediatric and Adult oral formulations | |
| Valacyclovir | Antiviral Agent, Oral | 2021 CDC Guidelines for Sexually Transmitted Infections (2021) | ||
| Insulin glargine, Any | Insulin, Long-Acting | Long-Acting Insulins & Biosimilars (2021) | *Biosimilars of insulin glargine are intended to be included for consideration | |
| Mupirocin | Antibiotic, Topical | Skin & Soft Tissue Infections (2021) | ||
| Testosterone (**REMS Drug**) | Androgen | Male Hypogonadism (2022) | Any formulation; Certain formulations (i.e., undecoanate) have REMS requirements | |
| Metronidazole, topical | Antibiotic, Topical | Rosacea (2022) | ||
| Sunscreen, Sun Protection Factor (SPF) 30 or greater | Ultraviolet light protectant, topical | Rosacea Treatment (2022) | ||
| Sacubitril and Valsrtan | Angiotensin II Receptor Blocker; Neprilysin Inhibitor | Heart Failure with Reduced Ejection Fraction (HFrEF) (2022) | ||
| 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) | ||
| Leuprolide | Antineoplastic Agent, Gonadotropin-Releasing Hormone Agonist | Treatment of Prostate Cancer (Nov 2022) | **Any depot form** | |
| Famotidine | Histamine H2 Antagonist | Fall 2022 NPTC Meeting Update | ||
| Nirmatrelvir and Ritonavir (Paxlovid®) | Antiviral Agent; Cytochrome P-450 Inhibitor | COVID-19 Update (2023) | ||
| Long-acting monoclonal antibodies, All ACIP-recommended | Immune Globulin; Monoclonal Antibody | Prevention of RSV (2023) | For example: nirsevimab (Beyfortus®) |
