Ryan White Part B Formulary

Ryan White Part B Formulary

GENERIC NAME BRAND NAME*

Must use generic when available

INDICATION or USE**

Must be HIV related

alprazolam Xanax anti-anxiety
diazepam Valium anti-anxiety
lorazepam Ativan anti-anxiety
triazolam Halcion anti-anxiety
amoxicillin Amoxil anti-bacterial
amoxicillin/clavulanic acid Augmentin anti-bacterial
cefuroxime Ceftin anti-bacterial
cephalexin Keflex anti-bacterial
ciprofloxacin Cipro anti-bacterial
dicloxacillin anti-bacterial
doxycycline Vibramycin anti-bacterial
moxifloxacin Avelox anti-bacterial
mupirocin Bactroban anti-bacterial
nitrofurantoin Macrobid anti-bacterial
penicillin anti-bacterial
warfarin Coumadin anti-coagulant
betamethasone/clotrimazole Lotrisone anti-infective
clotrimazole Lotrimin, Mycelex anti-infective
clotrimazole troches Mycelex Troches anti-infective
ketoconazole Nizoral anti-infective
metronidazole Flagyl anti-infective
nystatin Mycostatin Susp. anti-infective
valacyclovir Valtrex anti-viral
oseltamivir Tamiflu anti-viral
zanamivir Relenza anti-viral
amlodipine Norvasc cardiac
atenolol Tenormin cardiac
clonidine Catapres cardiac
diltiazem Cardizem cardiac
doxazosin Cardura cardiac
enalapril Vasotec cardiac
fosinopril Monopril cardiac
irbesartan Avapro cardiac
labetolol Trandate cardiac
lisinopril Zestril cardiac
losartan Cozaar cardiac
metoprolol Lopressor cardiac
potassium cardiac
propranolol Inderal cardiac
verapamil Covera, Calan cardiac
fluocinonide Lidex dermatologic
imiquimod Aldara Cream dermatologic
bacitracin/neomycin/polymyxin B Neosporin dermatologic
triamcinolone:Eucerin (compound) dermatologic
diphenoxylate/atropine Lomotil, Lonox diarrhea
  loperamide Imodium diarrhea
furosemide Lasix diuretic
hydrochlorothiazide diuretic
spironolactone Aldactone diuretic
levothyroxine Synthroid hormone
prednisone Deltasone hormone
testosterone Androderm, Androdgel, Oxandrin hormone
acetaminophen/codeine Tylenol 3 pain
butalbital/acetaminophen/caffeine Fioricet pain
celecoxib Celebrex pain
fentanyl Duragesic pain
hydrocodone Hycodan, Lortab, Vicodin pain
hydromorphone Dilaudid pain
methadone Dolophine pain
morphine sulphate MS Contin pain
naproxen sodium Naprosyn, Alleve pain
oxycodone Roxicodone, OxyContin pain
propoxyphene Darvon, Darvocet pain
tramadol Ultram pain
albuterol Ventolin, Accuneb, Duoneb, Proventil respiratory
beclomethasone QVAR respiratory
guaifenesin/codeine respiratory
salmeterol Serevent respiratory
carbamazepine Tegretol seizures
clonazepam Klonopin seizures
divalproex sodium Depakote seizures
phenytoin Dilantin seizures
temazepam Restoril sleep
zolpidem Ambien sleep
dronabinol Marinol wasting
meningococcal conjugate   vaccine