Medications are listed below by generic and brand name. They are grouped by indication or use. The indication or use must be HIV-related.
Ryan White Part B Formulary (rev. 08/07/19)
GENERIC NAME | AVAILABLE BRAND NAME*
Must use generic when available |
CLASS OR TYPE OF DRUG**
Must be HIV related or for conditions that affect health outcomes related to HIV management |
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 hydrochloride | Catapres | cardiac, opioid use disorder treatment |
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 |
* RWHAP B funds will pay for brand name formulations only if a generic formulation is not available. Brand names listed on the formulary are for reference only. ** Use of medications must be HIV-related, but is not restricted to the indication/use cited on the formulary. Alternatively, the medication must treat a co-morbid condition or disorder that affects HIV management or an individual’s health outcomes such as HIV viral load suppression. The information provided is only a resource and does not provide clinical advice or information.
GENERIC NAME | AVAILABLE BRAND NAME*
Must use generic when available |
CLASS OR TYPE OF DRUG**
Must be HIV related or for conditions that affect health outcomes related to HIV management |
fluocinonide | Lidex | dermatologic |
imiquimod | Aldara Cream | dermatologic |
bacitracin/neomycin/polymyxin B | Neosporin | dermatologic |
triamcinolone: Eucerin (compond) | 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 |
buprenorphine/naloxone | Suboxone (sublingual film), Zubsolv (sublingual tablet), Bunavail (buccal film) | opioid use disorder treatment |
buprenorphine (monoproduct) | Sublocade (injection), buprenorphine tablets | opioid use disorder treatment♦ |
lofexidine | Lucemyra | opioid use disorder treatment |
methadone | Dolophine, Methadose | opioid use disorder treatment‡ |
naltrexone | Vivitrol (tablet and injection) | opioid use disorder treatment, alcohol use disorder treatment |
acetaminophen/codeine | Tylenol 3 | pain |
butalbital/acetaminophen/caffeine | Fioricet | pain |
celecoxib | Celebrex | pain |
fentanyl | Duragesic | pain |
gabapentin | Neurontin | pain (neuropathic) |
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 |
* RWHAP B funds will pay for brand name formulations only if a generic formulation is not available. Brand names listed on the formulary are for reference only. ** Use of medications must be HIV-related, but is not restricted to the indication/use cited on the formulary. Alternatively, the medication must treat a co-morbid condition or disorder that affects HIV management or an individual’s health outcomes such as HIV viral load suppression. The information provided is only a resource and does not provide clinical advice or information. ♦The Drug Addiction and Treatment Act of 2000 limits office-based use of buprenorphine-containing products to prescribers who have met the qualifications to receive a waiver. These prescribers will have a special DEA number starting with the letter “X”. ‡ By law, methadone can only be dispensed through an opioid treatment program (OTP) certified by the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA).
GENERIC NAME | AVAILABLE BRAND NAME*
Must use generic when available |
CLASS OR TYPE OF DRUG**
Must be HIV related or for conditions that affect health outcomes related to HIV management |
carbamazepine | Tegretol | seizures |
clonazepam | Klonopin | seizures |
divalproex sodium | Depakote | seizures |
gabapentin | Neurontin | seizures |
phenytoin | Dilantin | seizures |
temazepam | Restoril | sleep |
zolpidem | Ambien | sleep |
dronabinol | Marinol | wasting |
meningococcal conjugate | vaccine |
* RWHAP B funds will pay for brand name formulations only if a generic formulation is not available. Brand names listed on the formulary are for reference only. ** Use of medications must be HIV-related, but is not restricted to the indication/use cited on the formulary. Alternatively, the medication must treat a co-morbid condition or disorder that affects HIV management or an individual’s health outcomes such as HIV viral load suppression. The information provided is only a resource and does not provide clinical advice or information.
Last Updated: November 14, 2022.