Illinois Formulary for the Drug Product Selection Program

Transcription

Illinois Formulary for the Drug Product Selection Program
Illinois Formulary
for the Drug Product
Selection Program
Twenty-first Edition
Issued June 30, 2003
Rod R. Blagojevich
Governor
www.idph.state.il.us
Eric E. Whitaker, M.D., M.P.H.
Director
ILLINOIS FORMULARY
FOR THE
DRUG PRODUCT SELECTION PROGRAM
Statutory Authority:
Illinois Public Acts 80-976, 82-237, 84-495, 85-451, 91-766, and 92-112
Illinois Food, Drugs and Cosmetic Act, [410 ILCS 620/2.22 and 620/3.14], (formerly Chapter 56 ½,
paragraphs 502.22 and 503.14, Illinois Revised Statutes), as amended.
Pharmacy Practice Act of 1987, [225 ILCS 85/25], (formerly Chapter 111, paragraphs 4123 and 4145,
Illinois Revised Statutes), as amended.
Public Act 80-976 took effect on October 1, 1977. The Drug Product Selection Program became
operative July 1, 1978. Public Act 82-237 was effective August 19, 1981. Public Act 84-495 took effect
September 17, 1985. Public Act 85-451 became effective on September 17, 1987. Portions of Public Act
91-766 took effect on June 9, 2000 and September 1, 2000. Public Act 92-112 became effective on July
20, 2001.
This Twenty-first Edition of the Illinois Formulary, issued June 30, 2003 replaces all previous editions and
supplements of the Illinois Formulary as follows:
First Edition . . . . . . . . . . . . . . . . . . . Effective July 1, 1978
Supplemental Update . . . . . . . . . Effective October 1, 1978
Supplemental Update . . . . . . Effective December 31, 1978
Supplemental Update . . . . . . . . . . . . Effective April 1, 1979
Second Edition . . . . . . . . . . . . . . . Effective August 1, 1979
Third Edition . . . . . . . . . . . . . Effective December 22, 1980
Supplemental Update . . . . . . . . . . . . . Effective July1, 1981
Supplemental Update . . . . . . . . . Effective October 1, 1981
Supplemental Update . . . . . . . . Effective February 1, 1982
Fourth Edition . . . . . . . . . . . . . . . . . . Effective July 1, 1982
Supplemental Update . . . . . . Effective September 15, 1982
Supplemental Update . . . . . . Effective December 15, 1982
Fifth Edition . . . . . . . . . . . . . . . . . . . Effective July 1, 1983
Supplemental Update . . . . . . . . . Effective October 1, 1983
Supplemental Update . . . . . . . . . Effective January 1, 1984
Supplemental Update . . . . . . . . . . Effective March 1, 1984
Sixth Edition . . . . . . . . . . . . . . . . . . . Effective July 1, 1984
Supplemental Update . . . . . . . Effective November 1, 1984
Supplemental Update . . . . . . . . . . . . Effective April 1, 1985
Supplemental Update . . . . . . . . . . . . Effective May 1, 1985
Seventh Edition . . . . . . . . . . . . . Effective January 1, 1986
Supplemental Update . . . . . . . . . . . . Effective May 1, 1986
Eighth Edition . . . . . . . . . . . . . Effective February 23, 1987
Supplemental Update . . . . . . . . . . . Effective May 15, 1987
Supplemental Update . . . . . . . . . Effective August 15, 1987
Supplemental Update . . . . . . . . . Effective January 1, 1988
Ninth Edition . . . . . . . . . . . . . . . . . . Effective April 15, 1988
Supplemental Update . . . . . . . . . . . Effective June 2, 1988
Supplemental Update . . . . . . . . . . Effective August 5, 1988
Supplemental Update . . . . . . . . . Effective October 7, 1988
Tenth Edition . . . . . . . . . . . . . Effective February 28, 1989
Supplemental Update . . . . . . . . . . Effective August 1, 1989
Supplemental Update . . . . . . . . Effective October 13, 1989
Supplemental Update . . . . . . . . Effective January 12, 1990
Twelfth Edition . . . . . . . . . . . . . . . Effective March 8, 1991
Supplemental Update . . . . . . . . . . . Effective July 19, 1991
Supplemental Update . . . . . . . . Effective October 25, 1991
Thirteenth Edition . . . . . . . . . . . . Effective March 14, 1992
Supplemental Update . . . . . . . . . . . Effective May 15, 1992
Supplemental Update . . . . . . . Effective November 9, 1992
Supplemental Update . . . . . . . . . Effective March 29, 1993
Supplemental Update . . . . . . . . . . . Effective July 26, 1993
Supplemental Update . . . . . . Effective December 20, 1993
Supplemental Update . . . . . . . . . . . Effective May 27, 1994
Fourteenth Edition . . . . . . . . Effective September 29, 1994
Supplemental Update . . . . . . Effective November 17, 1994
Supplemental Update . . . . . . . Effective February 23, 1995
Supplemental Update . . . . . . . . . . . Effective June 1, 1995
Supplemental Update . . . . . . . . . Effective August 31, 1995
Supplemental Update . . . . . . . Effective December 7, 1995
Supplemental Update . . . . . . . Effective February 29, 1996
Fifteenth Edition . . . . . . . . . . . . . . Effective June 15, 1996
Supplemental Update . . . . . . . . . Effective August 22, 1996
Supplemental Update . . . . . . Effective November 21, 1996
Supplemental Update . . . . . . . Effective February 27, 1997
Sixteenth Edition . . . . . . . . . . . . . . Effective May 29, 1997
Supplemental Update . . . . . . . . . Effective August 28, 1997
Supplemental Update . . . . . . Effective November 20, 1997
Supplemental Update . . . . . . . Effective February 26, 1998
Seventeenth Edition . . . . . . . . . . . . Effective May 28, 1998
Supplemental Update . . . . . . . . . Effective August 27, 1998
Supplemental Update . . . . . . Effective December 17, 1998
Supplemental Update . . . . . . . Effective February 25, 1999
Supplemental Update . . . . . . . . . . . Effective May 27, 1999
Supplemental Update . . . . . . . . . Effective August 26, 1999
Eighteenth Edition . . . . . . . . . . . . . Effective March 2, 2000
Supplemental Update . . . . . . . . . . . Effective June 1, 2000
Supplemental Update . . . . . . . . . Effective August 31, 2000
Nineteenth Edition . . . . . . . . . . . . . . Effective April 16, 2001
Supplemental Update . . . . . . . . . . . . Effective July 1, 2001
Supplemental Update . . . . . . . . . Effective October 1, 2001
Supplemental Update . . . . . . . . . Effective January 1, 2002
Twentieth Edition . . . . . . . . . . . . . . . . Effective April 5, 2002
Supplemental Update . . . . . . . . . . . . Issued October, 2002
Supplemental Update . . . . . . . . . . . . Issued January, 2003
Supplemental Update . . . . . . . . . . . . . . . Issued April, 2003
Updates posted monthly at http://www.idph.state.il.us/about/fdd/formulary.htm
ILLINOIS DEPARTMENT OF PUBLIC HEALTH
OFFICE OF HEALTH PROTECTION
DIVISION OF FOOD, DRUGS AND DAIRIES
525 WEST JEFFERSON STREET
SPRINGFIELD, IL 62761-0001
Printed by the Authority of the State of Illinois
ILLINOIS FORMULARY
for the
DRUG PRODUCT SELECTION PROGRAM
TECHNICAL ADVISORY COUNCIL AND DEPARTMENT STAFF
ROBERT W. BUCKMAN, PH.D.
Chicago, Illinois
DONALD R. GRONEWOLD, R.PH.
Washington, Illinois
ALFONSE T. MASI, M.D., DR.P.H.
Peoria, Illinois
JAMES T. O’DONNELL, PHARM. D., M.S.
Chicago, Illinois
THERESA MOFFETT WILLIS, R.PH., M.B.A.
Godfrey, Illinois
RONALD W. GOTTRICH, R.PH., M.S.
Manager,
Drugs and Medical Devices Programs
Division of Food, Drugs and Dairies
Office of Health Protection
Springfield, Illinois
ILLINOIS FORMULARY for the DRUG PRODUCT SELECTION PROGRAM
TABLE OF CONTENTS
GENERAL INSTRUCTIONS AND INFORMATION
I.
Application of the Illinois Formulary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i
II.
Prescription Requirements and Interpretation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i
Prescriptions Written Generically . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ii
Prescriptions from Out-of-State Prescribers . . . . . . . . . . . . . . . . . . . . . . . . . . . . ii
Prescriptions Mailed Out-of-State . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ii
III.
Pharmacy Records . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ii
IV.
Suggested Prescription Labeling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ii
V.
Penalties . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . iv
VI.
Relationship to the Public Aid Drug List . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . iv
VII.
Liability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . iv
VIII.
Criteria for Drug Product Inclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . iv
IX.
Criteria for Drug Product Exclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . v
X.
Pharmaceutical Equivalence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . v
XI.
Therapeutic Equivalence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vi
Excerpt from FDA Approved Drug Product List . . . . . . . . . . . . . . . . . . . . . . . . . vi
XII.
Formulary Format . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vii
Official Drug Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vii
Dosage Forms and Strengths . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vii
Application Holders, Manufacturers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vii
Abbreviations Used . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vii
XIII.
Interchange of Prescriptions for Nonlegend (OTC) Drug Products . . . . . . . . . . . . . . . . . . . . . . . vii
XIV.
Manufacturers’ Petitions for Product Inclusion; Review of Products . . . . . . . . . . . . . . . . . . . . . viii
XV.
FDA MedWatch Product Reporting Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . viii
XVI.
Program Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ix
XVII. Topical Ocular Pharmaceutical Agents for use by Certified Optometrists . . . . . . . . . . . . . . . . . . ix
Therapeutic Ocular Pharmaceutical Agents . . . . . . . . . . . . . . . . . . . . . . . . . . . . ix
“AUTHORIZED GENERIC” PHARMACEUTICAL PRODUCTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . x
SAMPLE PRESCRIPTION FORM
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xiii
PRESCRIPTION DISPENSING FLOW CHART . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xiv
USFDA MEDWATCH PRODUCT REPORT FORM (perforated, detachable, postage-paid) . . . . . . . . . xv
RULES AND REGULATIONS (77 Ill. Adm. Code 790) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Section 790.10 - Incorporated Materials . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Section 790.20 - Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Section 790.40 - Consideration of Drug Products for Inclusion in the Illinois Formulary . . . . . .
Section 790.60 - Additional Criteria . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Section 790.80 - Quality Listing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Section 790.100 - Generic Drug Entity Headings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Section 790.120 - Comments and Specific Administration . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Section 790.140 - Requests for Additional Copies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Section 790.160 - Prescription Use of Drug Products . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Section 790.180 - FDA Drug Product Approval and Recommendation . . . . . . . . . . . . . . . . . . .
Section 790.200 - Availability of Drug Products; Pharmaceutical Equivalence . . . . . . . . . . . . .
Section 790.220 - Single Source Drug Products Exclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Section 790.240 - Criteria for Exclusion of Drug Products . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Section 790.260 - Inclusion of Controlled Substances . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Section 790.280 - Equivalence of Products Requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Section 790.300 - Selection of Equivalent Drug Products . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Section 790.320 - Transfer of Prescription Records . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
xvii
xvii
xvii
xvii
xix
xix
xx
xx
xx
xx
xx
xxi
xxi
xxi
xxi
xxi
xxi
xxi
NON-INTERCHANGEABLE DRUG PRODUCTS (partial listing) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xxii
LIST OF PRODUCTS ADDED SINCE PUBLICATION OF THE TWENTIETH EDITION . . . . . . . . . . . . xxv
ALPHABETICAL LISTING OF APPROVED DRUG PRODUCTS FOR DRUG PRODUCT SELECTION
1
ALPHABETICAL INDEX . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 211
ILLINOIS FORMULARY
FOR THE
DRUG PRODUCT SELECTION PROGRAM
GENERAL INSTRUCTIONS AND INFORMATION
This section provides general information and answers questions concerning the operation of the drug
product selection program. For further information, please review the Section on Rules and Regulations
immediately preceding the alphabetical drug list, which covers some subjects in greater depth.
I.
Application of the Illinois Formulary:
The Drug Product Selection (DPS) Program applies whenever an outpatient or his/her representative
presents a prescription for a legend (prescription-requiring) drug to an outpatient pharmacy (community, clinic,
HMO or hospital) or when the outpatient pharmacy receives an oral or facsimile prescription order from the
prescriber to dispense a drug product to an outpatient. (Note that most home health care prescriptions are
considered outpatient prescriptions under Illinois law.) Drug Product Selection is the process by which a
pharmacist dispenses an approved, equivalent generic or brand name product of lesser cost than the
particular brand name product prescribed. Drug products selected for interchange must come from among
those generically equivalent products approved and listed in the current edition of the Illinois Formulary. Drug
Product Selection can only occur under the following circumstances:
A.
The prescriber has not blocked DPS either orally or by personally checking or marking beside
the “May Not Substitute” choice on a compliant prescription form, and;
B.
The drug entity and a pharmaceutically equivalent product are listed in the current Illinois
Formulary; and;
C.
The informed patient or his/her legal representative (parent, legal guardian, spouse) has
agreed to accept a generically equivalent product.
A flow chart depicting the process of drug product selection appears on page xiv.
II.
Prescription Requirements and Interpretation:
Since August 19, 1981, outpatient prescriptions written in Illinois have been required to comply with
Public Act 82-237 as follows:
On the prescription forms of prescribers, shall be placed a signature line and the
words “may substitute” and “may not substitute”. The prescriber, in his or her own
handwriting, shall place a mark beside either the “may substitute” or “may not substitute”
alternatives to guide the pharmacist in the dispensing of the prescription. A prescriber
placing a mark beside the “may substitute” alternative or failing in his or her own handwriting
to place a mark beside either alternative authorizes drug product selection in accordance with
this Act. Preprinted or rubber stamped marks, or other deviations from the above
prescription format shall not be permitted. The prescriber shall sign the form in his or her
own handwriting to authorize the issuance of the prescription.
Arrangement of the required wording on the prescription form is left to the prescriber’s perogative. A sample
prescription form is printed on page xiii.
If a prescriber’s dispensing instructions should create a problem of interpretation, the pharmacist
should contact the prescriber for clarification and document the instructions received from the prescriber.
When a drug entity is not included in the formulary, product selection cannot be practiced on brand
name prescriptions, even though the prescription may be marked “May Substitute.” This applies to
prescriptions for all types of reimbursement: private pay, Public Aid, HMO, and other third party prescriptions.
In such cases, the prescriber must be contacted and permission obtained to dispense anything other than the
brand originally prescribed. The pharmacist should them properly document his/her prescription records to
-i-
indicate that the prescriber was notified and that permission to dispense an alternate, non-formulary drug
product was received.
Prescriptions Written Generically - Requirements for prescriptions written using the generic
name of a drug product have not been changed. Any legally marketed product meeting the identity of the
prescribed drug may be professionally selected irrespective of the inclusion or exclusion of the entity in this
formulary.
Prescriptions from Out-of-State Prescribers - Prescriptions presented from out-of-state
prescribers should be filled in accordance with the intent of the Illinois statutes. The drug product would be
eligible for DPS consideration unless the prescriber indicated in a clear manner that interchange was not
desired.
Prescriptions Mailed Out-of-State - Prescriptions dispensed within the geographic boundary
of Illinois which are to be mailed out-of-state must be filled in compliance with the statutes and regulations of
Illinois concerning drug product selection.
III.
Pharmacy Records:
When DPS is not prohibited, the pharmacist should inform the patient of what alternate equivalent
drug product (brand name or generic) the pharmacy may have available and of the cost savings. If the
informed patient agrees to an interchange, the prescription may be filled with the alternate product of a lower
cost and the name of the product dispensed must be placed on the label.
In all cases of drug product selection, the identification of the product dispensed and its manufacturer,
if different than that prescribed, must be entered on the readily retrievable pharmacy record of the filled
prescription.
IV.
Suggested Prescription Labeling
Examples of suggested labeling of prescriptions for brand name and generic name drug products are
as follows:
A.
Brand name (e.g.: HYDRODIURIL 50MG) prescribed and dispensed.
acceptable labeling:
B.
Generic name (e.g.: HYDROCHLOROTHIAZIDE 50 MG) prescribed and the Merck
product is dispensed.
acceptable labeling:
3a)
HYDRODIURIL 50MG
or
HYDRODIURIL 50MG (Merck)
HYDROCHLOROTHIAZIDE 50MG
or
HYDROCHLOROTHIAZIDE 50MG (Merck)
or
HYDROCHLOROTHIAZIDE 50MG (HYDRODIURIL)
or
HYDRODIURIL 50MG
or
HYDRODIURIL 50MG (Merck)
Brand name (e.g.: HYDRODIURIL 50MG) prescribed and generically equivalent drug authorized
by physician and patient, generically equivalent drug (e.g.: ESIDRIX 50MG) dispensed.
-ii-
acceptable labeling:
non-acceptable labeling:
3b)
ESIDRIX 50MG
or
ESIDRIX 50MG (generic equivalent of HYDRODIURIL)
or
ESIDRIX 50MG (generic interchange of HYDRODIURIL)
or
ESIDRIX 50MG (generic for HYDRODIURIL)
or
ESIDRIX 50MG (gen. For HYDRODIURIL)
or
ESIDRIX 50MG (sub. For HYDRODIURIL)
HYDRODIURIL 50MG
or
HYDRODIURIL 50MG (generic)
or
HYDRODIURIL 50MG (ESIDRIX)
or
ESIDRIX 50MG (HYDRODIURIL)
or
ESIDRIX 50MG (same as HYDRODIURIL)
Brand name (e.g.: DARVON 65MG) prescribed, generically equivalent drug authorized by patient
physician, generic drug (e.g.: PROPOXYPHENE HCL 65MG by ESI/Lederle) dispensed.
Acceptable labeling:
`
PROPOXYPHENE HCL 65MG
or
PROPOXYPHENE HCL 65MG (ESI/Lederle)
or
PROPOXYPHENE HCL 65MG (generic equiv. of DARVON)
or
PROPOXYPHENE HCL 65MG (generic for DARVON)
or
PROPOXYPHENE HCL 65MG (gen. for DARVON)
or
PROPOXYPHENE HCL 65MG (sub. for DARVON)
or
PROPOXYPHENE HCL 65MG (generic interchange of DARVON)
or
ESI/Lederle PROPOXYPHENE HCL 65MG (gen. equiv. of DARVON)
or
ESI/Lederle PROPOXYPHENE HCL 65MG (generic interchange of
DARVON)
non-acceptable labeling:
DARVON 65MG
or
DARVON 65MG (generic)
or
DARVON 65MG (ESI/Lederle)
or
DARVON 65MG (PROPOXYPHENE HCL)
or
DARVON 65MG (Lederle PROPOXYPHENE HCL)
or
PROPOXYPHENE HCL 65MG (Same as DARVON)
NOTE: BRAND NAMES AND CORPORATE NAMES ARE USED FOR INFORMATIONAL
PURPOSES ONLY AND DO NOT IMPLY AN ENDORSEMENT BY THE STATE OF ILLINOIS.
-iii-
In all cases of drug product selection, the label must clearly indicate that a product other than that
prescribed has been dispensed. The examples provided above designated “acceptable” would not render
the product misbranded, nor would they infringe the trademark of the prescribed product.
V.
Penalties:
Sections 2 of Public Acts 80-976 and 82-237, dealing with prescription requirements, amend the
Pharmacy Practice Act of 1987. Penalties as provided in the Pharmacy Practice Act thus apply to applicable
portions of the Drug Product Selection Program. Failure to comply with Illinois laws and regulations
concerning drug product selection may result in consideration of pharmacists’ or pharmacies’ license
suspension or revocation actions by the State Board of Pharmacy.
VI.
Relationship to the Public Aid Drug List:
The Illinois Formulary is not to be confused with the Illinois Department of Public Aid (IDPA) List of
Reimbursable Drug Products, also known as the “Drug Manual” or the “Provider Bulletin.” The list of drug
products reimbursable by the Department of Public Aid Medicaid Drug Program contains many additional
products to those in the Illinois Formulary. When the drug entity is included in the Illinois Formulary, the
pharmacist must use the formulary when practicing drug product selection for prescriptions dispensed to
clients of the Department of Public Aid. However, when equivalent products are not in the Illinois Formulary
and the pharmacist wishes to dispense a lower cost product than the brand prescribed in order to meet Public
Aid’s maximum reimbursement (MAC) limits, the permission of the prescriber must be obtained to dispense
anything other than the product originally prescribed. As with prescriptions reimbursed from other sources,
the pharmacist must properly document that the prescriber has authorized the dispensing of a non-formulary
generic equivalent.
VII.
Liability:
Many experts have testified that pharmacist and physician liability is not increased by state drug
product selection programs in spite of claims of some major manufacturers. In support of this concept, most
liability insurance rates have not increased due strictly to DPS legislation. The legislation in Illinois specifically
states that pharmacists and physicians incur no increase in liability for permitting or practicing drug product
selection in accordance with applicable statutes and regulations. To date, no pharmacists or physicians are
known to have been involved in litigation pertaining to the good faith practice of DPS in Illinois.
VIII.
Criteria for Drug Product Inclusion:
Many factors concerning the product, its clinical history, the manufacturer, bioequivalence testing,
stability testing, etc., are taken into consideration by the program staff and Council in determining the listing
of products. In short, a conservative policy is followed in which positive data supporting equivalency is
required for listing rather than simply the lack of negative information. Some of the basic criteria which all
drugs must meet are as follows:
A.
Possess a federally approved New Drug Application (NDA), Abbreviated New Drug
Application (ANDA), paper NDA, or Antibiotic Form 5 or 6. (Exception possible via Section
790.60)
B.
Safety and Efficacy requirements met.
C.
Compendial and Good Manufacturing Practices (GMO) requirements met.
D.
Listed or approved for listing in the “Orange Book” and recommended by the FDA for DPS
use.
E.
Bioequivalency, bioavailability, and stability issues satisfied when known to be a problem or
potential problem. This includes meeting “proposed” bioequivalence standards.
Classified as prescription-only products.
F.
G.
Have pharmaceutically equivalent products available meeting all criteria from two or more
manufacturers or equivalent products available under different names from the same
manufacturer.
-iv-
IX.
Criteria for Drug Product Exclusion:
Basic categories for which products have been excluded are as follows:
A.
Marketed under “Grandfather” clauses (i.e., originally marketed before 1938) without an
approved application or lacking an approved application for any other reason. (Exception
possible via Section 790.60)
B.
Under review by the Drug Efficacy Study Implementation (DESI) program or under the
“EXEMPT” status of Judge William Bryants’ “Paragraph XIV” decision of October 11, 1972.
C.
Not cleared of bioequivalence, bioavailability, or stability issues.
D.
Not meeting pharmaceutical equivalence criteria.
E.
Available only under one marketing name by a single manufacturer.
F.
Enteric coated oral dosage forms subject to absorption difference.
G.
Suppositories for systemic absorption (vs. local effect).
H.
Injectable suspensions other than antibiotics.
I.
Aerosol or nebulizer products with inequivalent delivery systems.
J.
Products having drug standards issues.
K.
Nonlegend “OTC” products, diagnostic aids, nutritional supplements, and medical devices.
(See page vii for an explanation of drug product selection for OTC Prescriptions.)
Upon a majority vote of the assembled members of the Technical Advisory Council, criteria for product
inclusion or exclusion may be waived. Further information concerning criteria for drug inclusion can be found
in the Rules and Regulations section.
X.
Pharmaceutical Equivalence:
Products are not listed unless two or more pharmaceutically equivalent products are approved for
DPS use. Interchange can only take place between pharmaceutically equivalent products. The products must
contain the same active ingredients which vary in labeled dosage strength by no more than 1%, must be
identical in dosage form and route of administration, and must be formulated to meet the same or comparable
drug standards.
Thus, even though some products may contain the same strength of the same active ingredient, the
following pharmaceutical alternatives cannot be interchanged: tab/cap, chew tab/tab, solution/suspension,
ointment/cream, elixir/syrup, etc.
In some cases the strengths have not been listed (e.g., antibiotics and multiple strength injectables)
and the pharmacist must consider only products of equal strengths. Likewise, injectable oil solutions should
only be interchanged when the identical type of oil is used as a vehicle in both products.
Some individual products (especially creams, ointments, ophthalmic solutions) may be excluded if
they contain enough variance in their vehicle ingredients to cause a potential problem with therapeutic
equivalency.
XI.
Therapeutic Equivalence:
There have been varying opinions relative to the relationship between pharmaceutical and therapeutic
equivalence. Unless there is any research or clinical experience to cause reevaluation of the following
concept for a particular product, the policy of the federal Food and Drug Administration is accepted. Following
-v-
is a section entitled “General Policies Governing The List” which is reprinted from the preface to the FDA
publication, Approved Drug Products With Proposed Therapeutic Equivalence Evaluations, January, 1979:
“The fundamental policy governing this list is that the FDA considers
pharmaceutically equivalent drug products to be therapeutically equivalent providing they are
approved for both safety and effectiveness, are manufactured in accordance with Current
Good Manufacturing Practice Regulations, meet the same or equivalent standards, and, in
those instances where positive evidence of bioavailability is necessary, are shown to be
bioequivalent to an appropriate standard. The Agency believes this policy to be consistent
with the prevailing opinion of experts and with general experience in the marketplace through
the years.
“The Agency has considered, and rejected, the option of requiring in vivo
bioavailability studies for every product. Such a policy would result in the testing in humans
of a large number of products for which there is no evidence of a bioavailability problem, and
would thereby waste the nation’s clinical reason, the FDA has elected under its bioavailability
and bioequivalence regulations to confine in vivo testing of products for bioavailability to
those particular drugs for which such testing is scientifically and medically necessary. The
FDA has also considered, and rejected, the options of evaluating for therapeutic equivalence,
drugs legally marketed without approved applications and drugs still under review in the DESI
process. Although such products are required to be manufactured under the Current Good
Manufacturing Practice Regulations and to meet USP or other official specifications, the
effectiveness of the active ingredient or combination of ingredients in these products has not
been fully evaluated. The Agency is not proposing to evaluate the therapeutic equivalence
of products when the basic issue of their effectiveness is still in doubt.
“In considering the therapeutic equivalence of drugs with known or potential
bioavailability problems, the Agency has followed a policy of evaluating as therapeutic
equivalents only those products that have met current requirements (in vivo testing in
humans, in vitro dissolution rate requirement, or both, depending on the drug). When
bioavailability or bioequivalence requirements are newly established, there is a transition
period during which all manufacturers are permitted to submit information regarding their
products. For this reason some manufacturers whose products may not have yet met the
requirement are still legally marketed.
“The FDA emphasizes that the decision not to evaluate certain pharmaceutically
equivalent products as therapeutically equivalent does not necessarily imply that such
products are known to be inequivalent. In most cases, lack of necessary information
supporting therapeutic equivalence, not positive information of inequivalence, is the
underlying reason for the decision.”
This federal policy was further defined in the Third Edition of the FDA publication, Approved Prescription Drug
Products with Therapeutic Equivalence Evaluations, 4th Edition, 1983.
“Drug products considered to be therapeutic equivalents are pharmaceutical
equivalents and can be expected to have the same therapeutic effect when administered to
patients under the conditions specified in the labeling. The concept of therapeutic
equivalence, as used in developing the list, applies only to products containing the same
therapeutic agents used for the same disease (e.g., propoxyphene hydrochloride and
pentazocine hydrochloride for the treatment of pain). FDA evaluates as therapeutically
equivalent those drug products that meet the following general criteria: (1) They are in the
same dosage form, and (b) meet compendial or other applicable standards of identity,
strength, quality, and purity; (2) They are bioequivalent in that (a) they do not present a
known or potential bioinequivalence problem, or (b) if they do present such a known or
potential problem, they are shown to meet an appropriate bioequivalence standard; (3) They
are adequately labeled; (4) They are manufactured in compliance with Current Good
Manufacturing Practice regulations.
“FDA considers drug products to be therapeutically equivalent if they meet the criteria
outlined above, even though they may differ in certain other characteristics, e.g., color, flavor,
packaging, preservatives, expiration time and minor aspects of labeling. When such
-vi-
differences are important in the care of a particular patient, it is appropriate for the prescribing
physician to require that a particular brand be dispensed as a medical necessity. As long as
this consideration is met, however, FDA believes that products considered therapeutically
equivalent can be substituted with the full expectation that the substituted product will product
the same therapeutic effect as the prescribed product.”
XII.
Formulary Format:
Official Drug Name - Along the left hand margin of te drug list is found each drug entity
indicated b the official drug name or generic name in upper case letters, alphabetized and underlined. Under
the entity heading is first listed the products marketed under the generic name followed by the products
marketed by a brand name. Appropriate cross references have been included for multiple active ingredient
drug entities.
Dosage Forms and Strengths - In the center column are found the dosage forms and
dosage strengths which have been approved for drug product selection within that entity grouping. The
dosage form listed is the form as received by the pharmacist.
Application Holders, Manufacturers - The third column lists the approved federal
application holder which, usually, is also the manufacturer. In many cases, particularly for those corporations
listed in the generic section, there will be multiple distributors for each manufacturer, who market the product
under the generic name and/or various trade names. All such distributors and products are approved by
extension provided that the manufacturer is approved.
In order to use a product for drug product selection, pharmacists must be aware of the actual
manufacturer of the product either through label disclosure or information supplied by distributors. The names
of application holders who are known to be solely repackers have been enclosed in parentheses for the
information of the practitioner.
Abbreviations Used equivalent
gram
hydrochloride
International Units
microgram
milligram
milliliter
units
eq
gm
HCI
I.U.
mcg
mg
ml
U
In addition, simplified or abbreviated versions of company names have been used under the
manufacturing heading.
XIII.
Interchange of Prescriptions for Nonlegend (OTC) Drug Products:
Public Act 82-237 formally granted Illinois pharmacists the discretion to interchange prescriptions for
nonlegend drug product, provided that the same dosage form would be dispensed and there would be no
greater than a 1% variance in the labeled amounts of the products’ active ingredients. As with any instance
of generic interchange, the prescription record should be properly documented tot note the name and
manufacturer of the product dispensed.
XIV.
Manufacturers’ Petitions for Product Inclusion; Review of Products:
In accordance with the provisions of Public Act 92-112, manufacturers must submit their products for
consideration of inclusion in the Illinois Formulary. The Department no longer automatically reviews
products subject to a federal NDA or ANDA for listing in the Illinois Formulary. Information on new
generic products must be provided to the Department by the pharmaceutical company. Forms and
procedures for accurate preparation of the detailed information may be found at
http://www.idph.state.il.us/about/fdd/submission_form.pdf on the Department’s website. Such information is
then forwarded to the Technical Advisory Council for review and recommendations. From time to time, it is
necessary to request additional supportive information from manufacturers to complete the review of a
-vii-
particular product. These requests are handled on a case by case basis by Department staff.
The Technical Advisory Council’s determination of ‘issues’ related to the practice of medicine or the
practice of pharmacy’ temporarily halts a product’s entry into the Illinois Formulary pending a meeting of the
Council and, if necessary, a hearing before an Administrative Law Judge in accordance with P.A. 92-112.
Supplements and revisions to the Illinois Formulary are printed and distributed to Illinois’ pharmacies,
as well as other interested parties in accordance with the rules of the program. Subscriptions to the Illinois
Formulary are also available.
XV.
FDA MedWatch Medical Products Reporting Program:
The United State Food and Drug Administration coordinates a practitioner reporting system aimed
at improving product quality and voluntarily communicating health hazards and serious adverse events to
industry and government. The reporting program works simply and efficiently. Reporting can be done either
by stating the problem in writing, by calling the toll-free number 1-800-FDA-1088, by facsimile at
1-800-FDA-0178, by modem at 1-800-FDA-7737, or online at www.accessdata.fda.gov/scripts/medwatch/ via
the Internet.
Reports are acknowledged by the FDA. Copies of each report are forwarded to the manufacturer by
the FDA. The reporter may be contacted by the FDA , the manufacturer, or both for additional information
or with their respective evaluations of the observations.
Basically, anything considered to be a problem should be reported. Because the user is the best
person to judge what constitutes a product problem in a particular situation, and because the type of problem
will vary with the user, no attempt is made to limit or define what constitutes a product problem.
Drug problems include the entire spectrum of problems that might be noted when a drug product is
received, used, or dispensed. Examples of packaging and labeling complaints might be: carton does not
protect the inner container; container does not protect the product; wrong or deficient label; or inadequate
package insert information. Examples of evidence of poor pharmaceutical quality in the drug products
themselves might be: broken, crumbling or imperfectly manufactured dosage forms, foreign or particulate
matter present; drug solid does not reconstitute properly; off color or off taste; etc. Products having
questionable bioavailability and stability may also be reported. The program is not limited to prescription
drugs, so problems on both prescription and over-the-counter drug products can be reported. Regarding the
latter, many pharmacists have utilized the program to report problems experienced and discussed by
consumers.
Serious adverse events include outcomes involving a patient’s death, life threatening situations,
hospitalization (initial or prolonged), disability, congenital anomalies, or intervention efforts to prevent
permanent impairment or damage, resulting from the use or consumption of a medical product.
by FDA.
In addition, your suggestions for improvements indicated by reported problems are always welcome
All reports are computerized for trend analysis. The data base created from these reports can be
analyzed by product, manufacturer, or problem. This information is utilized by the FDA to identify any industrywide problems or trends, and to call attention to specific product problems.
For further information concerning the MedWatch Program, pharmacists and physicians may contact:
MedWatch Product Reporting Program, United States Food and Drug Administration, 5600 Fishers
Lane, Rockville, MD 20852-9787, Toll-free (800) FDA-1088, facsimile (800) FDA-0178, modem
(800) FDA-7737 or online at www.fda.gov/medwatch/safety.htm via the Internet. A sample postage-paid form
for use with this program appears on pages xv and xvi.
XVI.
to:
Program Information:
Requests for further information concerning the Drug Product Selection Program should be directed
-viii-
Manager, Drugs and Medical Devices Programs, Illinois Department of Public Health, Office of Health
Protection, Division of Food, Drugs and Dairies, 525 West Jefferson Street, Springfield, IL 62761-0001,
Telephone (217) 782-7532, facsimile (217) 782-0943, or via e-mail to rgottric@idph.state.il.us.
XVII.
Topical Ocular Pharmaceutical Agents for use by Certified Optometrists
Effective December 1, 1985, the Department of Professional Regulation has designated eight topical
ocular pharmaceutical agents which certified optometrists may use in their practices for examination
purposes. These agents are:
Proparacaine HCI (0.5%)
Benoxinate HCI (0.4%)
Tropicamide (0.5% and 1.0%)
Cyclopentolate HCI (0.5% and 1.0%)
Atropine Sulfate (ointment) (0.5%)
Homatropine (2.0% and 5.0%)
Pheylephrine HCI (2.5%)
Hydroxyamphetamine Hydrobromide (1.0%)
Public Act 89-0140 amended te Optometric Practice Act to allow certified optometrists to prescribe
”therapeutic ocular pharmaceutical agents” effective January 1, 1996. For purposes of the Act, “therapeutic
ocular pharmaceutical agents” means the following when used for diagnostic or therapeutic purposes:
Topical anti-infective agents
Topical anti-allergy agents
Topical anti-glaucoma agents
Topical anti-inflammatory agents
Topical anesthetic agents
Over-the-counter agents
Non-narcotic oral analgesic agents
Mydriatic reversing agents
To date, many optometrists have met necessary requirements and have been certified to use these
agents and may purchase or prescribe them from any Illinois licensed pharmacy. Such certified optometrists
have been issued certification numbers. Pharmacists wishing to confirm an optometrist’s number prior to
filling an order may call the Department of Professional Regulation’s Information Center at (217) 782-8556.
Pharmacists may also soon be able to verify the certification of optometrists for prescribing of topical ocular
pharmaceutical agents and therapeutic ocular pharmaceutical agents at the Internet website of the
Department of Professional Regulation, www.dpr.state.il.us, utilizing the link entitled “License Lookup.”
Additions to this list of approved topical ocular pharmaceutical agents and therapeutic ocular
pharmaceutical agents will be communicated to pharmacists in Illinois through future editions and
supplements of the Illinois Formulary.
-ix-
"AUTHORIZED GENERIC" PHARMACEUTICAL PRODUCTS
An ongoing trend in pharmaceutical marketing has proven to be very confusing to Illinois pharmacists,
physicians and consumers: Brand name drug manufacturers have introduced "authorized generic" versions
of their own branded products prior to or after the expiration date of the patents of their brand name products.
These brand name drug manufacturers are not obligated to submit Abbreviated New Drug Applications
(ANDAs) to the FDA in order to market these "authorized generics." These "authorized generic" products are
manufactured under the original FDA approved New Drug Application (NDA) which the manufacturer holds
for their innovator branded drug product. In these instances, pharmacists' use of the "authorized generic"
version is not an issue of drug product selection in that the "authorized generic" and the innovator product are,
in fact, one and the same entity (even though they may have different appearances). They have exactly the
same formulation; active ingredients and excipients are identical in composition and quantity (although,
obviously, imprint markings are different). Therefore, these "authorized generic" drug products may be
dispensed when the pharmacist receives a prescription for their innovator branded counterparts, as soon as
they are available, whether or not they appear in the current edition of the Illinois Formulary.
The pharmacist should follow the prescriber's intent when determining whether it is appropriate to dispense
an innovator's "authorized generic" product. If the prescription is marked "MAY NOT SUBSTITUTE," the
pharmacist should proceed to dispense the originally prescribed brand name (even though the innovator's
"authorized generic" is identical in formulation). Should the pharmacist desire to dispense the innovator's
"authorized generic" in place of the brand name drug product when the prescription has been marked "MAY
NOT SUBSTITUTE," the prescriber should be contacted to obtain a new prescription and the original,
undispensed written prescription should be destroyed. This ensures that the prescriber is made aware of the
unusual circumstance involving an identical formulation, with identical bioavailability and therapeutic
equivalency, from a product having a different appearance than that of the originally prescribed brand name
drug, particularly when the prescriber is later inspecting containers of medications dispensed to their patient.
The Illinois Formulary only lists actual drug manufacturers and FDA application holders. When a brand name
manufacturer creates a subsidiary or contracts with another labeler to market "authorized generic" versions
of their branded products under another name, the subsidiary and/or other labeler are considered distributors.
These "authorized generic" distributors are actually neither manufacturers, nor FDA application holders.
The following footnote appears in the Illinois Formulary to assist the pharmacist in identifying innovator
companies who market their own "generic" drug product under a previously FDA approved NDA:
*Products manufactured by this brand name manufacturer in this drug entity are available for
drug product selection under other brand and/or generic names.
In order for the pharmacist to correctly understand the true source of an "authorized generic" product, it is the
brand name pharmaceutical manufacturer's obligation to be candid in the identification of the product's
manufacturer. Many companies have notified pharmacists that they are the actual manufacturer of
"authorized generics" distributed by their own subsidiaries or other labelers. Promotional materials,
advertising and product labeling will often identify the "authorized generic" product's actual manufacturer.
Some "authorized generic" products are not clearly labeled, however. This omission of full disclosure creates
confusion for the pharmacist attempting to practice drug product selection in accordance with the Illinois
Formulary.
Pharmacists may feel free to use the "authorized generics" as soon as they are marketed, since the use of
these products does not constitute drug product selection. These products are one and the same as the
innovator. A list of "authorized generics" known to be marketed appears below and on the next pages.
"AUTHORIZED GENERICS"
Actigall
albuterol sulfate
Aldactazide
Aldactone
Aldomet
Aldoril
- Novartis’ “authorized generic” by Geneva
- Bausch & Lomb’s “authorized generic” by Automated Liquid/Warrick
- Searle/Pharmacia’s “authorized generic” by Greenstone
- Searle/Pharmacia’s “authorized generic” by Greenstone
- Merck's "authorized generic" by West Point
- Merck's "authorized generic" by West Point
-x-
"AUTHORIZED GENERICS"
Ansaid
Ativan
Atrovent
Avita
Betagan
Blocadren
Calan SR
Calcimar
Carafate
Cardizem
Cataflam
Catapres-TTS
Ceclor
Ceclor
Ceftin
Ceftin
Cipro
Cleocin T
Clinoril
Clomid
Condylox
Cordarone
Corgard
Cortisporin
Cytotec
Darvocet-N 100
Darvon
Darvon Compound 65
Daypro
DesOwen
DDAVP nasal spray
Diabeta
Diprolene AF
Ditropan
Diuril
Dolobid
Dyazide (old formula)
Dyazide (new formula)
Econopred Plus
Eldepryl
Fiorinal
Fiorinal with Codeine
Fioricet
Flexeril
Flumadine
Fulvicin
Glucophage XR
Grisactin
Grisactin Ultra
Halcion
Hydrodiuril
Indocin SR
Isopto Carpine
K-Dur
Keflex
Keflex
Klotrix
Imdur
Isoptin
Lac-Hydrin
Levsin SL
Levsinex
Lopid
- Pharmacia's "authorized generic" by Greenstone
- Wyeth’s “authorized generic” by ESI/Lederle
- Boehringer Ingelheim’s “authorized generic” by Roxane
- Bertek’s “authorized generic” by Alpharma
- Allergan's "authorized generic" by Schein/Pacific
- Merck's "authorized generic" by West Point
- Searle/Pharmacia's "authorized generic" by Zenith (BASF)
- Aventis’ "authorized generic" by Arcola
- Aventis’ “authorized generic” by Blue Ridge/Aventis
- Aventis’ "authorized generic" by Blue Ridge/Aventis
- Ciba/Novartis’ “authorized generic” by Geneva
- Boehringer Ingelheim’s “authorized generic” by Roxane
- Lilly's "authorized generic" by STC/Mylan
- Lilly’s “authorized generic” by Cura
- GlaxoSmithKline’s “authorized generic” by Cura
- GlaxoSmithKline’s “authorized generic” by Stada/Penn
- Bayer’s “authorized generic” by Bar
- Pharmacia's "authorized generic" by Greenstone
- Merck's "authorized generic" by West Point
- Aventis’ "authorized generic" by Blue Ridge/Aventis
- Oclassen/DPT’s “authorized generic” by Watson
- Novartis’ “authorized generic” by Geneva
- Bristol-Myers Squibb's “authorized generic” by Apothecon
- Monarch/King’s “authorized generic” by Falcon
- Pharmacia’s “authorized generic” by Greenstone
- Lilly's "authorized generic" by STC/Mylan
- Lilly's "authorized generic" by STC/Mylan
- Lilly's "authorized generic" by STC/Mylan
- Searle/Pharmacia’s “authorized generic” by Greenstone
- Galderma’s “authorized generic” by Glades
- Aventis’ “authorized generic” by Arcola
- Aventis’ "authorized generic" by Copley
- Schering’s “authorized generic” by Warrick
- Aventis’ “authorized generic” by Blue Ridge/Aventis
- Merck's "authorized generic" by West Point
- Merck's "authorized generic" by West Point
- GlaxoSmithKline’s "authorized generic" by Penn
- GlaxoSmithKline’s "authorized generic" by Penn
- Alcon’s “authorized generic” by Falcon
- Somerset’s “authorized generic” by Mylan
- Novartis’ “authorized generic” by Creighton
- Novartis’ “authorized generic” by Creighton
- Novartis’ “authorized generic” by Creighton
- Merck's "authorized generic" by West Point
- Forest’s “authorized generic” by Inwood
- Schering’s “authorized generic” by Warrick
- Bristol-Myers Squibb’s “authorized generic” by Par
- Wyeth’s “authorized generic” by ESI/Lederle
- Wyeth’s “authorized generic” by ESI/Lederle
- Pharmacia’s “authorized generic” by Greenstone
- Merck's "authorized generic" by West Point
- Merck's "authorized generic" by West Point
- Alcon’s “authorized generic” by Falcon
- Schering’s “authorized generic” by Warrick
- Lilly’s “authorized generic” by STC/Mylan
- Lilly’s “authorized generic” by Cura
- Bristol-Myers Squibb’s “authorized generic” by Apothecon
- Schering/Key’s “authorized generic” by Warrick
- Knoll/Abbott’s "authorized generic" by Sidmak (BASF)
- Bristol-Myers Squibb’s “authorized generic” by Apothecon
- Schwarz’ “authorized generic” by Kremers-Urban
- Schwarz’ “authorized generic” by Kremers-Urban
- Parke-Davis/Pfizer's "authorized generic" by Warner-Chilcott
- xi -
"AUTHORIZED GENERICS"
Lopressor
Lotrisone
Lozol
Maxitrol
Mellaril
Mestinon
Metaprel
Micro-K
Micronor
Micronase
Moduretic
Motrin
M.S. Contin
Nitro-Bid
Nolvadex
Nor-QD
Norflex
Norgesic
Norgesic Forte
Normodyne
Norpramin
Ogen
Oruvail
Pamelor
Parlodel
Paxil
Percocet
Percodan
Phenergan
Plaquenil
Procardia XL
Propine
Proventil
Provera
Quinidex
Reglan
Restoril
Silvadene
Sinemet
Symmetrel
Tagamet
Tambocor
Tenuate Dospan
Terazol
Tessalon
Tylenol with Codeine
Theo-Dur
Tiazac
Tylenol with codeine
Univasc
Ventolin Inhaler
Voltaren ophthalmic
Wellbutrin SR
Westcort
Xanax
Zaroxolyn
- Ciba-Geigy's "authorized generic" by Geneva
- Schering’s “authorized generic” by Warrick
- Aventis’ "authorized generic" by Arcola
- Alcon’s “authorized generic” by Falcon
- Novartis’ “authorized generic” by Creighton
- ICN/Southcoast’s “authorized generic” by Watson
- Boehringer's "authorized generic" inhaler by Roxane
- Robins’ “authorized generic” by ESI/Lederle
- Ortho-McNeil’s (OMJ’s) “authorized generic” by Watson (“Jolivette”)
- Pharmacia's "authorized generic" by Greenstone
- Merck's "authorized generic" by West Point
- Pharmacia’s “authorized generic” by Greenstone
- Purdue Frederick's "authorized generic" by AB Dick/Apotex
- Aventis’ “authorized generic” by Blue Ridge
- AstraZeneca's "authorized generic" by Barr
- Watson’s “authorized generic” by Watson
- 3M’s “authorized generic” by Mylan
- 3M’s “authorized generic” by Mylan
- 3M’s “authorized generic” by Mylan
- Schering’s “authorized generic” by Warrick
- Aventis’ “authorized generic” by Blue Ridge/Aventis
- Ortho/Johnson & Johnson’s “authorized generic” by NorAmCo
- Wyeth-Ayerst’s “authorized generic” by ESI/Lederle
- Novartis’ "authorized generic" by Creighton
- Novartis’ “authorized generic” by Geneva
- GlaxoSmithKline’s “authorized generic” by Par
- DuPont's "authorized generic" by Endo
- DuPont's "authorized generic" by Endo
- Wyeth’s authorized generic by ESI/Lederle
- Sanofi-Synthelabo’s “authorized generic” by Kanetta
- Pfizer’s “authorized generic” by Mylan
- Allergan's "authorized generic" by Schein
- Schering's "authorized generic" by Warrick
- Pharmacia’s “authorized generic” by Greenstone
- Robins’ “authorized generic” by ESI/Lederle
- Robins’ “authorized generic” by ESI/Lederle
- Novartis’ “authorized generic” by Creighton
- Aventis’ “authorized generic” by Blue Ridge/Aventis
- DuPont's "authorized generic" by Endo
- DuPont's "authorized generic" by Endo
- GlaxoSmithKline's "authorized generic" by Penn
- 3M’s “authorized generic” by Mylan
- Aventis’ "authorized generic" by Blue Ridge/Aventis
- Ortho-McNeil’s (OMJ’s) “authorized generic” by Watson
- Forest's "authorized generic" by Inwood
- Johnson & Johnson’s (OMJ’s) “authorized generic” by Purepac
- Schering's "authorized generic" by Warrick
- Biovail’s “authorized generic” by Inwood/Forest
- McNeil’s “authorized” generic by Purepac/OMJ
- Schwarz’ “authorized” generic by Kremers Urban
- GlaxoSmithKline’s “authorized generic” by Dey
- Ciba/Novartis’ “authorized generic” by Geneva
- GlaxoSmithKline’s “authorized generic” by Penn/Watson
- Bristol-Myers Squibb’s “authorized generic” by Apothecon
- Pharmacia's "authorized generic" by Greenstone
- Celltech’s “authorized generic” by Upstate
Additionally, Bausch & Lomb’s “authorized generics” by Sight
The Department of Public Health, Division of Food, Drugs and Dairies, will update this list periodically. If you
have any questions pertaining to drug product selection, please feel free to call (217) 782-7532.
-xii-
____________________
____________________
____________________
_________________________
_________________________
____________________
____________________
PATIENT NAME
____________________
AGE
ADDRESS
DATE
L
G
MAY SUBSTITUTE
G
MAY NOT SUBSTITUTE
, M.D.
MAY REFILL
TIMES
DEA
- xiii -
(DAW = DISPENSE AS WRITTEN)
Form Approved: OMB No. 0910-0291 Expires: 11/30/00
See OMB statement on reverse
For VOLUNTARY reporting
by health professionals of adverse
events and product problems
Page
C. Suspect medication(s)
3. Sex
□ female
□ male
4. Weight
lbs
death __________________
(mo/day/yr)
life-threatening
1. Name (give labeled strength & mfr/labeler, if known)
#1
or
kgs
B. Adverse event or product problem
1. □ Adverse event
and/or
□ Product problem (e.g., defects/malfunctions)
□
□
□
Triage unit
sequence #
____ of ____
A. Patient information
1. Patient identifier 2. Age at time
of event:
or
Date
of birth:
In confidence
2. Outcomes attributed to adverse event
(check all that apply)
FDA Use Only
□ disability
□ congenital anomaly
□ required intervention to prevent
#2
2. Dose, frequency & route used
3. Therapy dates (if unknown, give duration)
from/to (or best estimate)
#1
#1
#2
#2
5. Event abated after use
stopped or dose reduced
4. Diagnosis for use (indication)
#1
permanent impairment/damage
hospitalization – initial or prolonged
3. Date of
event
□ other:
___________________
4. Date of
this report
(mo/day/yr)
6. Lot # (if known)
7. Exp. date (if known)
#1
#1
(mo/day/yr)
5. Describe event or problem
#1
□ yes □ no □ doesn't
apply
#2
□ yes □ no □ doesn't
apply
#2
#2
#2
9. NDC # (for product problems only)
–
–
8. Event reappeared after
reintroduction
#1
□ yes □ no □ doesn't
apply
#2
□ yes □ no □ doesn't
apply
PLEASE TYPE OR USE BLACK INK
10. Concomitant medical products and therapy dates (exclude treatment of event)
D. Suspect medical device
1. Brand name
2. Type of device
4. Operator of device
3. Manufacturer name & address
□
□
□
health professional
lay user/patient
other:
________________
5. Expiration date
(mo/day/yr)
6.
model # ________________________________________
6. Relevant tests/laboratory data, including dates
catalog # _______________________________________
7. If implanted, give date
(mo/day/yr)
serial # _________________________________________
lot # ___________________________________________
8. If explanted, give date
(mo/day/yr)
other #
9. Device available for evaluation?
□
□
yes
no
□
(Do not send to FDA)
returned to manufacturer on __________________
(mo/day/yr)
10. Concomitant medical products and therapy dates (exclude treatment of event)
7. Other relevant history, including preexisting medical conditions (e.g., allergies,
race, pregnancy, smoking and alcohol use, hepatic/renal dysfunction, etc.)
E. Reporter (see confidentiality section on back)
1.
Name & address
2. Health professional? 3.
or FAX to:
Mail to: MEDWATCH
5600 Fishers Lane
1-800-FDA-0178
Rockville, MD 20852-9787
FDA Form 3500
□
5.
yes
□
phone #
Occupation
4. Also reported to
no
If you do NOT want your identity disclosed to
the manufacturer, place an “ X ” in this box.
□
□
□
□
manufacturer
user facility
distributor
Submission of a report does not constitute an admission that medical personnel or the product caused or contributed to the event.
ADVICE ABOUT VOLUNTARY REPORTING
Report experiences with:
• medications (drugs or biologics)
• medical devices (including in-vitro diagnostics)
• special nutritional products (dietary
supplements, medical foods, infant formulas)
• other products regulated by FDA
Report SERIOUS adverse events. An event
is serious when the patient outcome is:
• death
• life-threatening (real risk of dying)
• hospitalization (initial or prolonged)
• disability (significant, persistent or permanent)
• congenital anomaly
• required intervention to prevent permanent
impairment or damage
Report even if:
• you’re not certain the product caused the
event
• you don’t have all the details
Report product problems – quality, performance
or safety concerns such as:
• suspected contamination
• questionable stability
• defective components
• poor packaging or labeling
• therapeutic failures
The public reporting burden for this collection of information
has been estimated to average 30 minutes per response,
including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed,
and completing and reviewing the collection of information.
Send comments regarding this burden estimate or any other
aspect of this collection of information, including suggestions
for reducing this burden to:
FDA Form 3500-back
How to report:
• just fill in the sections that apply to your report
• use section C for all products except
medical devices
• attach additional blank pages if needed
• use a separate form for each patient
• report either to FDA or the manufacturer
(or both)
Important numbers:
• 1-800-FDA-0178 to FAX report
• 1-800-FDA-7737 to report by modem
• 1-800-FDA-1088 to report by phone or for
more information
• 1-800-822-7967 for a VAERS form
for vaccines
If your report involves a serious adverse event
with a device and it occurred in a facility outside a doctor’s office, that facility may be legally required to report to
FDA and/or the manufacturer. Please notify the person in
that facility who would handle such reporting.
Confidentiality: The patient’s identity is held in strict
confidence by FDA and protected to the fullest extent of
the law. The reporter’s identity, including the identity of a
self-reporter, may be shared with the manufacturer unless
requested otherwise. However, FDA will not disclose the
reporter’s identity in response to a request from the
public, pursuant to the Freedom of Information Act.
DHHS Reports Clearance Office
Paperwork Reduction Project (0910-0291)
Hubert H. Humphrey Building, Room 531-H
200 Independence Avenue, S.W.
Washington, DC 20201
“An agency may not conduct or sponsor,
and a person is not required to respond to,
a collection of information unless it displays
a currently valid OMB control number.”
Please DO NOT
RETURN this form
to this address.
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
Public Health Service • Food and Drug Administration
Please Use Address Provided Below – Just Fold In Thirds, Tape and Mail
Department of
Health and Human Services
Public Health Service
Food and Drug Administration
Rockville, MD 20857
Official Business
Penalty for Private Use $300
BUSINESS REPLY MAIL
FIRST CLASS MAIL PERMIT NO. 946 ROCKVILLE, MD
POSTAGE WILL BE PAID BY FOOD AND DRUG ADMINISTRATION
W
MED ATCH
The FDA Medical Products Reporting Program
Food and Drug Administration
5600 Fishers Lane
Rockville, MD 20852-9787
RULES AND REGULATIONS
ILLINOIS FORMULARY for the DRUG PRODUCT SELECTION PROGRAM
Section 790.10 Incorporated Materials
a)
The following materials are incorporated by reference in this Part and include no later amendments or
additions:
1)
2)
Section 314.1, Definitions for the Applications for FDA Approval to Market a New Drug, 21 CFR
314.3, April 1, 1999.
Section 320.1, Definitions for the Bioavailability and Bioequivalence Requirements,
21 CFR 320.1, April 1, 1999.
b)
Incorporations or references refer o the materials on the date specified and do not include later
amendments or additions.
c)
Copies of incorporated or referenced material are available for inspection and copying at the
Department of Public Health, Office of Health Protection, Division of Food, Drugs and Dairies, Drug
Product Selection Program, 525 West Jefferson Street, 2nd Floor, Springfield, Illinois 62761-0001.
Section 790.20 Introduction
a)
The Illinois Food, Drug and Cosmetic Act (Ill. Rev. Stat. 1987, Ch. 56 ½, par. 503.14) allows
interchange of different brands or nonbrands of the same generic drug entity for a drug product
prescribed by a specific trade name. Products selected for interchange must be pharmaceutically
equivalent to the prescribed product and must be listed in a positive drug product formulary known as
the Illinois Formulary which has been developed, maintained and issued by the Illinois Department of
Public Health (hereinafter referred to as the "Department"). The practice of selecting an equivalent
drug product from the Illinois Formulary to dispense instead of the trade name product prescribed is
known as Drug Product Selection (DPS).
b)
The initial issue of the Illinois Formulary for use in Drug Product Selection became effective on
July 1, 1978. Periodic updates to the Illinois Formulary will be distributed by the Department of Public
Health. Single copies of the Illinois Formulary shall be provided to all licensed pharmacies with Illinois
addresses. Upon request, single copies of the Illinois Formulary will be provided, at no charge, to
licensed prescribers, pharmacists practicing their profession in Illinois, to pharmacists seeking
reciprocation, students enrolled in a pharmacy curriculum at the University of Illinois at Chicago,
College of Pharmacy, the Chicago College of Pharmacy, St. Louis College of Pharmacy, students
enrolled out-of-state in a college of pharmacy who seek a pharmacist licensure in the State of Illinois,
or students enrolled in a pharmacy technician program.
c)
The Department shall make available to other interested parties a subscription to the Illinois Formulary
and its revisions at a fee of $50.00 per year. All subscription fees collected by the Department shall
be deposited into the Food and Drug Safety Fund.
Section 790.40 Consideration of Drug Products for Inclusion in the Illinois Formulary
a)
Drug products for inclusion in the Illinois Formulary shall be approved and recommended to the
Director of Public Health, by a Technical Advisory Council according to the notice and hearing
provisions of this Section. The Council is composed of 7 members, each of whom has extensive
experience in pharmaceutical affairs. Products for Council consideration shall be researched and
presented by Department staff following consideration of recommendations by the federal Food and
Drug Administration (FDA), of recognized drug reference sources, of published research, and of
qualified consultants.
- xvii -
b)
No product shall be considered for inclusion in the Illinois Formulary unless each individual dosage
form, dosage strength and manufacturer has been recommended for drug product selection use by
the FDA. Each product considered must be verified by the FDA as being marketed under currently
approved drug applications, as meeting required manufacturing standards and chemical identity
standards, and as being cleared of any issues involving the bioequivalence or bioavailability of the
product. Prior to being sanctioned for DPS use, the product must pass FDA criteria specific for DPS
approval which may be more stringent than that required for general marketing approval.
“Bioequivalence” and “bioavailability” have the meanings prescribed under 21 CFR 320.1, April 1, 1999.
c)
Generic Drug Products.
1)
Drug products previously approved by the Technical Advisory Council for generic interchange
may be substituted in the State of Illinois without further review subject to the conditions of
approval in the State before September 1, 2000 (the effective date of Public Act 91-766).
(Section 3.14 of the Illinois Food, Drug and Cosmetic Act [410 ILCS 620/3.14]). Drug products
requiring approval by the Council on or after September 1, 2000, for generic interchange are
subject to the notice and hearing provisions of this Section.
2)
If not subject to a hearing under subsection (c)(5) or if not specifically prohibited, then generic
drug products determined to be therapeutically equivalent by the FDA shall be available for
substitution in this State no sooner than 60 days after the submission of the prescribed
notification under subsection (d) to the Council. "Therapeutic equivalence" has the meaning
prescribed under the current edition or supplement of the FDA’s "Approved Drug Products with
Therapeutic Equivalence Evaluations".
3)
Manufacturers of the generic drug products shall submit to the Council the notification described
in subsection (d) at least 60 days before the scheduled substitution of the drug product. During
the 60-day notification period, the Council shall determine, based upon a preponderance of the
evidence, whether the generic drug product has issues related to the practice of medicine or the
practice of pharmacy.
4)
If the Council determines that the generic drug product does not have issues related to the
practice of medicine or pharmacy, then the Council shall issue its recommendation of approval
of the generic drug product to the Director. If included on the Drug Products Selection
Formulary by the Director under subsection (f), then the drug product may be substituted in the
State after the 60-day notification period, the date of the Director’s approval, or the date of the
product’s full approval for safety and efficacy by the FDA, whichever date is later.
5)
If the Council determines that the generic drug product has issues related to the practice of
medicine or pharmacy, then:
(A)
(B)
(C)
d)
a hearing on the drug product shall be held under subsection (e) at the Council’s next
regularly scheduled meeting;
the Council’s hearing determination shall be reviewed by the Director under subsection
(f); and
the drug product may not be substituted in the State unless included in the Drug
Products Selection Formulary by the Director.
The 60-day notification shall be submitted in writing to the Technical Advisory Council at the following
address:
Administrator, Drug Product Selection Program
Illinois Department of Public Health
Office of Health Protection
Division of Food, Drugs and Dairies
525 W. Jefferson Street
Springfield, Illinois 62761-0001
- xviii -
1)
The notification to the Council shall consist of 9 complete copies of all the following items:
(A)
(B)
(C)
2)
All testimony (plus one copy of the testimony that has individual identifying information
redacted) and data upon which comment or reference to may be made, whether
published or unpublished.
The drug product’s technical bioequivalence and therapeutic equivalence information,
including documentation of the required testing to support FDA product approval.
The information required in subsection (b).
The Department shall notify all other manufacturers of products within a specific generic entity
that a hearing will be held on the drug product. The notification may be posted on the
Department’s Internet Website at www.idph.state.il.us. These manufacturers shall provide 9
copies of all testimony (plus one copy of the testimony that has individual identifying information
redacted) and 9 copies of all data upon which comment or reference to may be made, whether
published or unpublished, in writing to the Department within 30 days before the regularly
scheduled meeting should they wish to be heard on the specific issue at the Council meeting.
Nine copies of all rebuttal comments from any concerned manufacturer shall be submitted in
writing to the Department within 14 days after the regularly scheduled meeting, should a
company wish to respond to its competitor's submission.
e)
The Director may designate an individual to conduct the hearing and make a recommendation to the
Council on a generic drug product that has issues related to the practice of medicine or pharmacy. The
Council shall make the final recommendation. Hearings shall be conducted according to the Rules of
Practice and Procedure in Administrative Hearings (77 Ill. Adm. Code 100) under Article 10 of the
Illinois Administrative Procedure Act [5 ILCS 100/Art. 10]. Determinations shall be accompanied by a
written detailed explanation of the decision’s basis. The Council shall make its recommendation of
approval or disapproval of the generic drug product to the Director within 20 business days after the
public hearing.
f)
After the Council’s recommendation for approval or disapproval of the drug product is submitted to the
Director, the Director may approve or prohibit the drug product’s inclusion in the Drug Products
Selection Formulary. Only if the Director decides that, based upon a preponderance of the evidence,
the generic drug is not bioequivalent, is not therapeutically equivalent, or could cause clinically
significant harm to the health or safety of patients, may the Director prohibit the drug product from
inclusion in the formulary. The Director’s decision to prohibit a drug product from inclusion in the
formulary shall be accompanied by a written detailed explanation of the decision’s basis. Decisions
under this subsection constitute a final administrative decision within the meaning of Section 22.2 of
the Illinois Food, Drug and Cosmetic Act [410 ILCS 620/22.2] and Section 3-101 of the Administrative
Review Law [735 ILCS 5/3-101] and are subject to judicial review under Article III of the Administrative
Review Law [735 ILCS 5/Art. III].
g)
Exclusive indications and unique product packaging, whether patented or unpatented, do not constitute
criteria for inclusion of a drug entity in the Illinois Formulary.
Section 790.60 Additional Criteria
Additional criteria may be adopted as needed by the Department upon the recommendation of the Technical Advisory
Council to further define the parameters for drug product inclusion. Individual exceptions to any criteria may be made
upon a majority vote of the assembled Council members and such exceptions must be noted in the Illinois Formulary.
Section 790.80 Quality Listing
a)
The Illinois Formulary is a quality listing of generically equivalent drug products approved for marketing
and is based upon the criteria as found in these Rules and Regulations. The listing is not affected by
costs or by current or pending litigation against a particular drug product. As an aid to users of the
formulary, an informational footnote will be placed with an entity listing whenever the
- xix -
Department receives substantive evidence of litigation involving the product(s). Products will be
deleted from the formulary listing whenever FDA regulatory processes or other legal action results in
a loss of the product's marketing approval or availability.
b)
The names of application holders who are known to be solely repackers will be enclosed in
parentheses for the information of the practitioner.
c)
Products discontinued from marketing or products which have their approval withdrawn for reasons
other than safety and efficacy, will be noted by the symbol "@" preceding the dosage form. This
symbol designates their non-marketed status and notifies practitioners that the specific manufacturer's
product may be in short supply. The "@" notation does not change the drug product selection status
of the drug entity. Products approved and listed for interchange may be used until their supply is
exhausted.
Section 790.100 Generic Drug Entity Headings
The formulary consists of generic drug entity headings in alphabetical order. Within the entity grouping is indicated
the individual product's marketed name, dosage form and dosage strength. The manufacturer listed is the firm holding
the FDA approved drug application for the product. Listed products remain approved for DPS use when distributed
under the label of another manufacturer.
Section 790.120 Comments and Specific Administration
Comments and specific information regarding drug products either listed or under consideration for formulary inclusion
will be accepted by the Department at any time for due consideration. Inquiries or comments should be directed to:
Administrator, Drug Product Selection Program
Illinois Department of Public Health
Office of Health Protection
Division of Food, Drugs and Dairies
525 West Jefferson Street
Springfield, Illinois 62761
Section 790.140 Requests for Additional Copies
Requests to receive additional copies of the formulary or for changes to the recipient mailing list should be sent to the
address in Section 790.120.
Section 790.160 Prescription Use of Drug Products
Drug products included shall be primarily for prescription use outside of the inpatient institutional setting. Excluded
are nonprescription drugs, diagnostic aids, nutritional supplements and medical devices.
Section 790.180 FDA Drug Product Approval and Recommendation
Drug products included shall have been approved and recommended for DPS use by the FDA and listed in a
publication of approved drug products distributed by the FDA for use in state programs. All products must have either
a New Drug Application (NDA), Abbreviated New Drug Application (ANDA), or Antibiotic Form 5 or 6 Application
approved by the FDA under the provisions of Sections 505 and 507 of the Federal Food, Drug and Cosmetic Act (21
U.S.C.A. 301 et seq.). All products have been certified by the FDA as safe and effective for their labeled use, meet
current compendial and Good Manufacturing Practices (GMP) requirements, and have met the applicable
bioavailability and bioequivalence criteria of the FDA.
- xx -
Section 790.200 Availability of Drug Products; Pharmaceutical Equivalence
Drug products included must be available from more than one approved manufacturing source unless otherwise noted.
Drug products listed must be pharmaceutically equivalent to at least one other drug product under the same entity
listing. Drug products are pharmaceutically equivalent if they contain the same active ingredients, are identical in
dosage form and route of administration, are formulated to meet the same or comparable standards and vary in
labeled dosage strength by no more than 1%.
Section 790.220 Single Source Drug Products Exclusion
Single source drug products which are available only under a single brand name label shall be excluded. Products
which have a single source manufacturer, but which may be distributed under multiple labels are listed with a warning
for pharmacists to ascertain that the product selected was produced by the approved manufacturer.
Section 790.240 Criteria for Exclusion of Drug Products
Drug products of the following dosage forms for which different brands are not necessarily pharmaceutically and
therapeutically equivalent shall be excluded:
a)
b)
c)
d)
Enteric coated tablets
Injectable suspensions, other than antibiotics
Suppositories containing active ingredients for which systemic absorption is necessary for therapeutic
activity
Different delivery systems for aerosol and nebulizer drugs
Section 790.260 Inclusion of Controlled Substances
Controlled substances listed in Schedule I of the Illinois Controlled Substances Act, (Ill. Rev. Stat., 1983, ch. 56 1-2,
par. 1100), shall be excluded. Products in Schedules II, III, IV and V are included provided they meet all other criteria
as set forth in subpart A of this Part.
Section 790.280 Equivalence of Products Requirements
All equivalent products selected by the pharmacist for interchange use must have the product's dosage form, the
dosage strength, and the manufacturer listed in the Illinois Formulary as revised. Drug products recommended by
the Technical Advisory Council for inclusion in a formulary revision must not be used for drug product selection until
the effective date of that revision.
Section 790.300 Selection of Equivalent Drug Products
Even though a prescribed brand name drug product is unlisted, pharmacists may select an equivalent drug product
to dispense under Section 790.280 as long as the corresponding generic drug entity with pharmaceutically equivalent
drug products are listed in the Illinois Formulary as revised.
Section 790.320 Transfer of Prescription Records
Pharmacists shall be required to designate the prescriber's original intent concerning drug product selection on every
prescription record transferred to another pharmacy, irrespective of the method of transfer. The receiving pharmacy
shall record the prescriber's drug product selection intent on the original prescription record of the transferred
prescription.
- xxi -
NON-INTERCHANGEABLE DRUG PRODUCTS
The following is an incomplete, partial listing of legend multiple-source drug products that are NOT listed in the current
edition of the Illinois Formulary for the Drug Product Selection Program. Illinois pharmacists may not interchange
prescriptions written for these brand-name drug products, even if the prescriber has checked the “MAY SUBSTITUTE” box
on the prescription form, without first obtaining a new prescription from the prescriber. This does not apply to “Authorized
Generics” (see page x of the 19th Edition of the Illinois Formulary) whereby a pharmaceutical labeler manufactures and
markets their own brand name product under a generic label.
Brand name
Generic name
ALL Prenatal vitamins with 1mg folic acid
ACT rinse
Aerolate-Jr, -Sr capsules
Anaspaz tablets
Antabuse tablets
Anthra-Derm ointment
Anusol-HC suppositories
Arlidin tablets
Aristocort tablets
Armour Thyroid
Aventyl capsules
Beclovent aerosol
Beconase, Beconase AQ aerosol
Bellergal-S tablets
Berocca tablets
Berocca Plus tablets
Bicillin-LA injection
Bicitra solution
Brethine tablets
Bricanyl tablets
Bontril 105 capsules
Bromfed capsules
Bronkodyl capsules
Butazolidin capsules
Chromagen capsules
Codimal-LA, Codimal-LA Half capsules
Col-Benemid tablets
Constant-T tablets
Cortef tablets
Cortone Acetate tablets
Cotazyme, Cotazyme-S capsules
Creon 10, 20 capsules
Creon, Creon 25 capsules
Cuprimine capsules
Cyclospasmol capsules
Cystospaz tablets, Cystospaz-M capsules
Dallergy caplets
Decadron-LA injection
Deconamine SR capsules
Delta-Cortef tablets
Depen tablets
Deponit patches
Diabeta tablets (not interchangeable with Micronase)
Dilatrate-SR capsules
Dilaudid tablets 2,3,4mg
Dilor tablets
Disalcid capsules, tablets
Diupres-250, -500 tablets
Donnatal tablets
Donnazyme tablets
Drithocreme
Dura-Vent/DA tablets
Duratuss GP tablets
Duratuss-G tablets
Eldoquin-Forte cream
Elixophyllin capsules
Elixophyllin SR capsules
Entex LA tablets
Entex PSE tablets
Entozyme tablets
Epifrin ophthalmic drops
Estraderm patch
Estratabs
Ethatabs
sodium fluoride
theophylline extended release
l-hyoscyamine
disulfiram
anthralin
hydrocortisone acetate
nylidrin
triamcinolone
desiccated thyroid
nortriptyline hydrochloride
beclomethasone dipropionate
beclomethasone dipropionate
belladonna alkaloids, ergotamine tartrate and phenobarbital
vitamins B with vitamin C
multivitamins
penicillin G benzathine
citrate and citric acid solutions
terbutaline sulfate
terbutaline sulfate
phendimetrazine tartrate
brompheniramine maleate with pseudoephedrine hydrochloride
theophylline immediate release
phenylbutazone
ascorbic acid, cyanocobalamin, ferrous fumarate, and intrinsic factor
chlorpheniramine maleate with pseudoephedrine hydrochloride
colchicine with probenecid
theophylline extended release
hydrocortisone
cortisone acetate
pancrelipase
amylase, lipase, and protease
amylase, lipase, pancreatin, and protease
penicillamine
cyclandelate
l-hyoscyamine
chlorpheniramine maleate, methscopolamine nitrate, and phenylephrine hydrochloride
dexamethasone acetate
chlorpheniramine maleate with pseudoephedrine hydrochloride
prednisolone
penicillamine
nitroglycerin
glyburide
isosorbide dinitrate
hydromorphone hydrochloride
dyphylline
salsalate
chlorothiazide with reserpine
belladonna alkaloids with phenobarbital
pancreatin
anthralin
chlorpheniramine maleate, methscopolamine nitrate, and phenylephrine hydrochloride
guaifenesin with pseudoephedrine hydrochloride
guaifenesin
hydroquinone
theophylline immediate release
theophylline extended release
guaifenesin with phenylpropanolamine hydrochloride
guaifenesin with pseudoephedrine hydrochloride
pancreatin
epinephrine hydrochloride
estradiol
esterified estrogens
papaverine hydrochloride
- xxii -
Brand name
Generic name
Etrafon tablets
Extendryl tablets, Extendryl S.R. capsules
Euthroid tablets
Fedahist Timecaps
Florone ointment, Florone, Florone E cream
Fluorigard rinse
Fluorinse
Fluoritabs
Gel-Kam
GenGraf capsules
Glaucon ophthalmic drops
Granulderm aerosol
Granulex aerosol
Guaifed, Guaifed-PD capsules
Guaifenex DX tablets
Guaifenex LA tablets
Guaifenex PSE
Habitrol patch
Halotestin tablets
Humibid L.A. tablets
Hydropres-25, 50 tablets
Infed injection
Isopto Carbachol ophthalmic solution
Isuprel inhaler
Karidium tablets, drops
Karigel, Karigel-N
Klotrix tablets
Kutrase capsules
Ku-Zyme HP capsules
Lasan cream, ointment
Levothroid tablets
Levsin tablets
Levsinex capsules
Librax capsules
Lipram capsules
Lufyllin tablets
Lufyllin-GG tablets, elixir
Luride Lozi-Tabs
Mandelamine tablets
Marax tablets
Maxiflor cream, ointment
Menest tablets
Mescolor tablets
Metahydrin tablets
Micronase tablets (not interchangeable with Diabeta)
Midrin capsules
MSIR tablets
Naldecon tablets
Naqua tablets
Nicoderm patches
Nicotrol patches
Nitro-Bid capsules, ointment
Nitrodisc patch
Nitrostat sublingual
Noctec capsules
Novafed A capsules
Oracit solution
Oramorph SR tablets
Oreton tablets
Pancrease capsules
PanMist LA tablets
Pavabid capsules
Pedameth capsules
Peritrate tablets
Permapen injection
Phenergan tablets (‘authorized generic’ only)
Point-Two rinse
Poly-Histine elixir
Poly-Vi-Flor tablets
Poly-Vi-Flor with Iron tablets
Polycitra, Polycitra-LC, Polycitra K solutions
Pramosone cream, lotion, ointment
Prevident gel
Probanthine tablets
ProctoCream-HC
Proctofoam-HC
amitriptyline hydrochloride with perphenazine
chlorpheniramine maleate, methscopolamine nitrate, and phenylephrine hydrochloride
liotrix
chlorpheniramine maleate with pseudoephedrine hydrochloride
diflorasone diacetate
sodium fluoride
sodium fluoride
sodium fluoride
stannous fluoride
cyclosporine
epinephrine hydrochloride
balsam peru, castor oil and trypsin
balsam peru, castor oil and trypsin
guaifenesin with pseudoephedrine hydrochloride
dextromethorphan hydrobromide with guaifenesin
guaifenesin
guaifenesin with pseudoephedrine hydrochloride
nicotine
fluoxymesterone
guaifenesin
hydrochlorothiazide with reserpine
iron dextran
carbachol
isoproterenol
sodium fluoride
sodium fluoride
potassium chloride
amylase, protease, lipase, cellulase, hyoscyamine sulfate, and phenyltoloxamine citrate
amylase, lipase, and protease
anthralin
levothyroxine sodium
l-hyoscyamine
l-hyoscyamine extended release
chlordiazepoxide hydrochloride with clidinium bromide
amylase, lipase, and protease
dyphylline
dyphylline with guaifenesin
sodium fluoride
methenamine mandelate
theophylline, hydroxyzine and ephedrine
diflorasone diacetate
esterified estrogens
chlorpheniramine maleate, methscopolamine nitrate with pseudoephedrine hydrochloride
trichlormethiazide
glyburide
acetaminophen, isometheptene mucate and dichloralphenazone
morphine sulfate immediate release
chlorpheniramine, phenylpropanolamine, phenyltoloxamine, and phenylephrine
trichlormethiazide
nicotine
nicotine
nitroglycerin
nitroglycerin
nitroglycerin
chloral hydrate
chlorpheniramine maleate with pseudoephedrine hydrochloride
citrate and citric acid solutions
morphine sulfate
methyltestosterone
pancreatin
guaifenesin with pseudoephedrine
papaverine hydrochloride
methionine
pentaerythritol tetranitrate
penicillin G benzathine
promethazine hydrochloride
sodium fluoride
pheniramine maleate, pyrilamine maleate and phenyltoloxamine citrate
multivitamins with fluoride
multivitamins with fluoride and iron
citrate and citric acid solutions
hydrocortisone with pramoxine
sodium fluoride
propantheline bromide
hydrocortisone acetate with pramoxine hydrochloride
hydrocortisone acetate with pramoxine hydrochloride
- xxiii -
Brand name
Generic name
Prostep patches
Proventil inhaler (not interchangeable with Ventolin inhaler)
Pseudovent PED capsules
Pyridium tablets
Quibron capsules
Quibron-T Dividose
Quibron-T/SR tablets
Quinaglute
Respbid tablets
RMS suppositories
Rondec, Rondec TR tablets
Roxanol SR tablets
Ru-Tuss tablets
Ru-Tuss DE tablets
Rynatan tablets
Salutensin, Salutensin-Demi tablets
Ser-Ap-Es tablets
Slo-Phyllin tablets
Slo-Phyllin Gyrocaps
Solaquin-Forte cream
Sustaire tablets
T-Phyl tablets
Theo-24 capsules
Theo-Sav tablets
Theobid Duracaps
Theoclear L.A. capsules
Theolair-SR tablets
Theospan-SR capsules
Theovent capsules
Thorazine tablets, Spansules
Thyrolar tablets
Tiazac capsules
Tigan capsules, suppositories
Tri-Vi-Flor tablets
Trilisate liquid, tablets
Trinsicon capsules
Tuss-Ornade Spansules
Ultrase capsules
Uni-Dur tablets
Uniphyl tablets
Urised tablets
Vancenase, Vancenase AQ aerosol
Vanceril aerosol
Vasodilan tablets
Ventolin inhaler (not interchangeable with Proventil inhaler)
Vi-Daylin/F tablets
Vi-Daylin/F + Iron tablets
Vioform-Hydrocortisone cream, ointment
Viokase tablets
Wellbutrin SR 150mg tablet
X-Trozine L.A.
Zephrex LA tablets
Zyban 150mg tablet
nicotine
albuterol
guaifenesin with pseudoephedrine hydrochloride
phenazopyridine hydrochloride
theophylline with guaifenesin
theophylline immediate release
theophylline extended release
quinidine gluconate
theophylline extended release
morphine sulfate
carbinoxamine maleate with pseudoephedrine hydrochloride
morphine sulfate extended release
belladonna alkaloids, chlorpheniramine, phenylephrine, and phenylpropanolamine
guaifenesin with pseudoephedrine hydrochloride
chlorpheniramine tannate, phenylephrine tannate, and pyrilamine tannate
hydroflumethiazide with reserpine
hydralazine, hydrochlorothiazide and reserpine
theophylline immediate release
theophylline extended release
hydroquinone
theophylline extended release
theophylline extended release
theophylline extended release
theophylline extended release
theophylline extended release
theophylline extended release
theophylline extended release
theophylline extended release
theophylline extended release
chlorpromazine hydrochloride
liotrix
diltiazem hydrochloride
trimethobenzamide hydrochloride
vitamins A, D and C with fluoride
choline salicylate and magnesium salicylate
ascorbic acid, cyanocobalamin, ferrous fumarate, folic acid, and intrinsic factor
caramiphen edisylate with phenylpropanolamine hydrochloride
pancrelipase
theophylline
theophylline extended release
methenamine, belladonna alkaloids, benzoic acid, phenylsalicylate and methylene blue
beclomethasone dipropionate
beclomethasone dipropionate
isoxsuprine hydrochloride
albuterol
multivitamins with fluoride
multivitamins with fluoride and iron
clioquinol with hydrocortisone
pancrelipase (amylase, lipase, and protease)
bupropion hydrochloride
phendimetrazine tartrate
guaifenesin with pseudoephedrine hydrochloride
bupropion hydrochloride
- xxiv -
APPROVED DRUG PRODUCTS FOR DRUG PRODUCT SELECTION
DRUG
ACEBUTOLOL HYDROCHLORIDE
Acebutolol Hydrochloride
Brand(s)
Sectral
ACETAMINOPHEN; BUTALBITAL
Acetaminophen; Butalbital
Brand(s)
Bancap
Bucet
Phrenilin Forte
Tencon
Triaprin
Butapap
Butapap
Phrenilin
Sedapap
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
capsule, oral eq 200,400mg base
capsule, oral eq 200,400mg base
capsule, oral eq 200,400mg base
Mylan
Par
Watson
capsule, oral eq 200,400mg base
ESP
@ tablet, oral 325mg;50mg
@ tablet, oral 325mg;50mg
Halsey
Watson
@ capsule, oral 325mg;50mg
capsule, oral 650mg;50mg
capsule, oral 650mg;50mg
capsule, oral 650mg;50mg
@ capsule, oral 325mg;50mg
tablet, oral 325mg;50mg
tablet, oral 650mg;50mg
tablet, oral 325mg;50mg
tablet, oral 650mg;50mg
Forest
Mallinckrodt
Amarin
Mallinckrodt
Dunhall
Mikart
Mikart
Amarin
Mayrand
ACETAMINOPHEN; BUTALBITAL; CAFFEINE
Acetaminophen; Butalbital;
capsule, oral 325mg;50mg;40mg
Caffeine
@ capsule, oral 325mg;50mg;40mg
capsule, oral 325mg;50mg;40mg
capsule, oral 500mg;50mg;40mg
tablet, oral 325mg;50mg;40mg
tablet, oral 500mg;50mg;40mg
@ tablet, oral 325mg;50mg;40mg
tablet, oral 325mg;50mg;40mg
tablet, oral 325mg;50mg;40mg
tablet, oral 500mg;50mg;40mg
tablet, oral 325mg;50mg;40mg
tablet, oral 500mg;50mg;40mg
Brand(s)
Anoquan
@ capsule, oral 325mg;50mg;40mg
Esgic Plus
capsule, oral 500mg;50mg;40mg
Femcet
@ capsule, oral 325mg;50mg;40mg
Medigesic Plus
@ capsule, oral 325mg;50mg;40mg
Triad
@ capsule, oral 325mg;50mg;40mg
Esgic
@ tablet, oral 325mg;50mg;40mg
Esgic Plus
tablet, oral 500mg;50mg;40mg
Fioricet
tablet, oral 325mg;50mg;40mg
Repan
tablet, oral 325mg;50mg;40mg
Gilbert
Mallinckrodt
Mikart
West-ward
Able
Able
Gilbert
Halsey
Mikart
Watson
West-ward
West-ward
Roberts and Hauck
Mikart
Mallinckrodt
US Chemical
Mallinckrodt
Forest
Mikart
Watson *
Mallinckrodt
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
ACETAMINOPHEN; BUTALBITAL; CAFFEINE; CODEINE PHOSPHATE
Acetaminophen; Butalbital;
capsule, oral 325mg;50mg;40mg;30mg West-ward
Caffeine; Codeine Phosphate
Brand(s)
Fioricet with Codeine
capsule, oral 325mg;50mg;40mg;30mg Watson
1
DRUG
DOSAGE FORM, STRENGTH
ACETAMINOPHEN; CAFFEINE; DIHYDROCODEINE BITARTRATE
Acetaminophen; Caffeine;
capsule, oral 356.4mg;30mg;16mg
Dihydrocodeine Bitartrate
Brand(s)
DHC Plus
@ capsule, oral 356.4mg;30mg;16mg
Synalgos-DC-A
@ capsule, oral 356.4mg;30mg;16mg
ACETAMINOPHEN; CODEINE PHOSPHATE
Acetaminophen;
@ capsule, oral 300mg;15,30,60mg
Codeine Phosphate
solution, oral 120mg/5ml; 12mg/5ml
solution, oral 120mg/5ml; 12mg/5ml
solution, oral 120mg/5ml; 12mg/5ml
solution, oral 120mg/5ml; 12mg/5ml
solution, oral 120mg/5ml; 12mg/5ml
solution, oral 120mg/5ml; 12mg/5ml
suspension, oral 120mg/5ml;12mg/5ml
tablet, oral 300mg; 30,60mg
@ tablet, oral 300mg;15,30,60mg
tablet, oral 300mg;15,30,60mg
@ tablet, oral 300mg;15,30,60mg
tablet, oral 300mg;15,30,60mg
@ tablet, oral 300mg;15,30,60mg
@ tablet, oral 325mg;30mg
tablet, oral 300mg;30,60mg
@ tablet, oral 300mg;15,30,60mg
@ tablet, oral 300mg;30mg
tablet, oral 300mg;30,60mg
@ tablet, oral 300mg;30,60mg
@ tablet, oral 325mg;15mg
@ tablet, oral 300mg;30mg
tablet, oral 300mg;15,30,60mg
tablet, oral 300mg;30mg
@ tablet, oral 300mg;60mg
tablet, oral 650mg;30mg
tablet, oral 300mg;15,30,60mg
tablet, oral 300mg;30mg
tablet, oral 300mg;30mg
@ tablet, oral 300mg;60mg
@ tablet, oral 300mg;15,60mg
tablet, oral 300mg;30mg
tablet, oral 300mg;15mg
@ tablet, oral 300mg;30,60mg
tablet, oral 300mg;15,30,60mg
@ tablet, oral 300mg;30,60mg
tablet, oral 300mg;15,30,60mg
@ tablet, oral 300mg;15,30,60mg
tablet, oral 300mg;15,30,60mg
@ tablet, oral 300mg;30,60mg
Brand(s)
Phenaphen No. 3 with Codeine
capsule, oral 325mg;30mg
Proval No. 3
@ capsule, oral 325mg;30mg
Tylenol with Codeine #3,#4
@ capsule, oral 300mg;30,60mg
Capital and Codeine
solution, oral 120mg/5ml; 12mg/5ml
Tylenol with Codeine
@ solution, oral 120mg/5ml; 12mg/5ml
Capital and Codeine
suspension, oral 120mg/5ml;12mg/5ml
Capital with Codeine
@ tablet, oral 325mg;30mg
Empracet with Codeine #3,#4
@ tablet, oral 300mg;30,60mg
Papa-Deine #3,#4
@ tablet, oral 300mg;30,60mg
Phenaphen-650 with Codeine
@ tablet, oral 650mg;30mg
Tylenol with Codeine No.s 2,3,4
tablet, oral 300mg;15,30,60mg
Tylenol with Codeine No.s 2,3,4 @ tablet, oral 325mg;15,30,60mg
APPLICATION HOLDER,
MANUFACTURER
Mikart
Purdue Frederick
Women First Healthcare
Teva
Clonmel
Hi-Tech
Mikart
Morton Grove
Pharmaceutical Assoc/Beach
Roxane
Amarin
Able
American Therapeutics
Andrx
Barr
Duramed/Barr
Eon
Everylife
Geneva
Halsey
ICN
IVAX
KV
KV
Lederle
Mallinckrodt
Mikart
Mikart
Mikart
Mutual
Pharmeral
Purepac
Purepac
Roxane
Roxane
Superpharm
Superpharm
Teva
USL
Vintage
Warner Chilcott
Watson
Whiteworth Towne Paulsen
Robins
Solvay
Ortho-McNeil
Alpharma
Ortho-McNeil
Alpharma
Carnrick
GlaxoSmithKline
(Vangard/MWM)
Robins
Ortho-McNeil *
Ortho-McNeil
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
2
DRUG
DOSAGE FORM, STRENGTH
ACETAMINOPHEN; HYDROCODONE BITARTRATE
Acetaminophen;
capsule, oral 500mg;5mg
Hydrocodone Bitartrate
capsule, oral 500mg;5mg
capsule, oral 500mg;5mg
solution, oral 500mg;7.5mg/15ml
solution, oral 500mg;7.5mg/15ml
solution, oral 500mg;7.5mg/15ml
tablet, oral 325mg;5,7.5,10mg
tablet, oral 500mg;5,7.5,10mg
tablet, oral 650mg;7.5,10mg
tablet, oral 750mg;7.5mg
tablet, oral 500mg;2.5,5,7.5,10mg
tablet, oral 650mg;7.5,10mg
tablet, oral 750mg;7.5mg
tablet, oral 400mg;5,7.5,10mg
tablet, oral 500mg;5,7.5mg
tablet, oral 650mg;7.5,10mg
tablet, oral 750mg;7.5mg
tablet, oral 500mg;5mg
tablet, oral 750mg;7.5mg
tablet, oral 500mg;5mg
tablet, oral 650mg;7.5,10mg
tablet, oral 750mg;7.5mg
tablet, oral 500mg;5mg
tablet, oral 325mg;5,7.5,10mg
tablet, oral 500mg;5,7.5,10mg
tablet, oral 650mg;10mg
tablet, oral 750mg;7.5mg
tablet, oral 500mg;2.5,5,7.5mg
tablet, oral 650mg;7.5,10mg
@ tablet, oral 500mg;5mg
@ tablet, oral 325mg;7.5,10mg
tablet, oral 500mg;10mg
tablet, oral 650mg;7.5mg
@ tablet, oral 500mg;5mg
tablet, oral 325mg;10mg
tablet, oral 500mg;2.5,5,7.5,10mg
tablet, oral 650mg;7.5,10mg
tablet, oral 660mg;10mg
tablet, oral 750mg;7.5mg
tablet, oral 325mg;10mg
tablet, oral 500mg;2.5,5,7.5,10mg
tablet, oral 650mg;7.5,10mg
tablet, oral 660mg;10mg
tablet, oral 750mg;7.5,10mg
Brand(s)
Allay
capsule, oral 500mg;5mg
Bancap HC
@ capsule, oral 500mg;5mg
Co-Gesic
@ capsule, oral 500mg;5mg
Hydrocet
capsule, oral 500mg;5mg
Lorcet-HD
capsule, oral 500mg;5mg
Anexsia
tablet, oral 500mg;5mg
Anexsia 7.5/650
tablet, oral 650mg;7.5mg
Anexsia 10/660
tablet, oral 660mg;10mg
Co-Gesic
tablet, oral 500mg;5mg
Duradyne DHC
@ tablet, oral 500mg;5mg
Hy-Phen
tablet, oral 500mg;5mg
Lortab
tablet, oral 500mg;5mg
Lortab
tablet, oral 500mg;10mg
Norcet
@ tablet, oral 500mg;5mg
Norco
tablet, oral 325mg;5,7.5,10mg
(continued on the next page)
3
APPLICATION HOLDER,
MANUFACTURER
Central
Mallinckrodt *
Mikart
KV
Mikart
Pharmaceutical Associates
Able
Able
Able
Able
Barr
Barr
Barr
Endo
Endo
Endo
Endo
Eon
Eon
Halsey
Halsey
Halsey
IVAX
Mallinckrodt
Mallinckrodt
Mallinckrodt
Mallinckrodt
Mikart
Mikart
Norton
UCB
UCB
UCB
USL
Vintage
Vintage
Vintage
Vintage
Vintage
Watson
Watson
Watson
Watson
Watson
IVAX
Forest
Central
Mallinckrodt *
Mallinckrodt *
Mallinckrodt *
Mallinckrodt *
Mallinckrodt *
Schwarz
Forest
Ascher
Mallinckrodt *
UCB
Abana
Watson
DRUG
DOSAGE FORM, STRENGTH
ACETAMINOPHEN; HYDROCODONE BITARTRATE (continued)
Tycolet
@ tablet, oral 500mg;5mg
Vicodin
tablet, oral 500mg;5mg
Vicodin ES
tablet, oral 750mg;7.5mg
Vicodin HP
tablet, oral 660mg;10mg
APPLICATION HOLDER,
MANUFACTURER
Ortho-McNeil
Abbott
Abbott
Abbott
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
ACETAMINOPHEN; OXYCODONE HYDROCHLORIDE
Acetaminophen;
capsule, oral 500mg;5mg
Oxycodone Hydrochloride
capsule, oral 500mg;5mg
capsule, oral 500mg;5mg
capsule, oral 500mg;5mg
capsule, oral 500mg;5mg
capsule, oral 500mg;5mg
capsule, oral 500mg;5mg
capsule, oral 500mg;5mg
tablet, oral 325mg;5mg
tablet, oral 325mg;5mg
tablet, oral 325mg;5mg
tablet, oral 325mg;2.5,5mg
tablet, oral 500mg;7.5mg
tablet, oral 325mg;5mg
tablet, oral 325mg;5mg
tablet, oral 500mg;7.5mg
tablet, oral 650mg;10mg
Brand(s)
Roxilox
capsule, oral 500mg;5mg
Tylox
capsule, oral 500mg;5mg
Oxycet
tablet, oral 325mg;5mg
Oxycodone 5/APAP 500
@ tablet, oral 500mg;5mg
Percocet
tablet, oral 325mg;5mg
Percocet
tablet, oral 500mg;7.5mg
Percocet
tablet, oral 650mg;10mg
Roxicet
tablet, oral 325mg;5mg
Roxicet 5/500
tablet, oral 500mg;5mg
Amide
Barr
Duramed/Barr
Endo
Halsey
Mallinckrodt
Vintage
Watson
Amide
Barr
Duramed/Barr
Endo
Endo
Vintage
Watson
Watson
Watson
Roxane
Ortho-McNeil *
Mallinckrodt
Bristol-Myers Squibb
Endo *
Endo *
Endo *
Roxane
Roxane
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
ACETAMINOPHEN; PENTAZOCINE HYDROCHLORIDE
Acetaminophen;
tablet, oral 650mg;eq 25mg base
Pentazocine Hydrochloride
tablet, oral 650mg;eq 25mg base
Brand(s)
Talacen
tablet, oral 650mg;eq 25mg base
ACETAMINOPHEN; PROPOXYPHENE HYDROCHLORIDE
Acetaminophen;
tablet, oral 650mg;65mg
Propoxyphene Hydrochloride
tablet, oral 650mg;65mg
tablet, oral 650mg;65mg
Brand(s)
Dolene AP-65
@ tablet, oral 650mg;65mg
Wygesic
tablet, oral 650mg;65mg
4
Amide
Watson
Sanofi Synthelabo
Geneva
Mylan
Watson
Lederle
Women First Healthcare
DRUG
DOSAGE FORM, STRENGTH
ACETAMINOPHEN; PROPOXYPHENE NAPSYLATE
Acetaminophen;
tablet, oral 650mg; 100mg
Propoxyphene Napsylate
@ tablet, oral 325mg;50mg
@ tablet, oral 650mg;100mg
@ tablet, oral 325mg;50mg
@ tablet, oral 650mg;100mg
tablet, oral 650mg;100mg
@ tablet, oral 325mg;50mg
tablet, oral 650mg;100mg
tablet, oral 650mg;100mg
tablet, oral 650mg;100mg
tablet, oral 650mg;100mg
tablet, oral 650mg;100mg
@ tablet, oral 650mg;100mg
tablet, oral 650mg;100mg
tablet, oral 650mg;100mg
Brand(s)
Darvocet-N 50
tablet, oral 325mg;50mg
Darvocet-N 100
tablet, oral 650mg;100mg
APPLICATION HOLDER,
MANUFACTURER
Able
Barr
Barr
Circa
Circa
Geneva
Halsey
Halsey
IVAX
Mallinckrodt
Mylan
Purepac
Superpharm
Teva
Vintage
AAI
AAI *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
ACETAZOLAMIDE
Acetazolamide
Brand(s)
Diamox
ACETAZOLAMIDE SODIUM
Acetazolamide Sodium
Brand(s)
Diamox
ACETIC ACID, GLACIAL
Acetic Acid, Glacial
Brand(s)
Acetasol
Orlex
VoSol
@ tablet, oral 250mg
@ tablet, oral 250mg
tablet, oral 250mg
tablet, oral 125,250mg
tablet, oral 125,250mg
@ tablet, oral 250mg
tablet, oral 250mg
tablet, oral 125,250mg
(Ascot)
Circa
Lannett
Mutual
Taro
(Vangard/MWM)
Watson
Lederle
injection eq 500mg base/vial
injection eq 500mg base/vial
@ injection eq 500mg base/vial
Abbott
Bedford
Quad
injection eq 500mg base/vial
Lederle
solution, irrigation-urethral, in plastic
container, 250mg/100ml (0.25%)
solution, irrigation-urethral, in plastic
container, 250mg/100ml (0.25%)
solution, irrigation-urethral, in plastic
container, 250mg/100ml (0.25%)
@ solution, otic 2%
solution, otic 2%
solution, otic 2%
KV
Morton Grove
Taro
solution, otic 2%
@ solution, otic 2%
solution, otic 2%
Alpharma
Procter and Gamble
Wallace
5
Abbott
Baxter
Braun
DRUG
DOSAGE FORM, STRENGTH
ACETIC ACID, GLACIAL; ALUMINUM ACETATE
Acetic Acid, Glacial;
solution, otic 2%;0.79%
Aluminum Acetate
Brand(s)
Borofair
@ solution, otic 2%;0.79%
Domeboro
solution, otic 2%;0.79%
ACETIC ACID, GLACIAL; HYDROCORTISONE
Acetic Acid, Glacial;
@ solution, otic 2%;1%
Hydrocortisone
@ solution, otic 2%;1%
solution, otic 2%;1%
solution, otic 2%;1%
Brand(s)
Acetasol HC
solution, otic 2%;1%
Orlex HC
@ solution, otic 2%;1%
VoSol HC
solution, otic 2%;1%
ACETOHEXAMIDE
Acetohexamide
Brand(s)
Dymelor
ACETYLCYSTEINE
Acetylcysteine
Brand(s)
Mucosil-10,20
Mucomyst
ACYCLOVIR
Acyclovir
(continued on the next page)
APPLICATION HOLDER,
MANUFACTURER
Bausch and Lomb
Pharmafair
Bayer
Bausch and Lomb
KV
Morton Grove
Taro
Alpharma
Procter and Gamble
Wallace
tablet, oral 250,500mg
@ tablet, oral 250,500mg
tablet, oral 250,500mg
Barr
USL
Watson
@ tablet, oral 250,500mg
Lilly
solution for inhalation 10,20%
solution for inhalation 10,20%
solution for inhalation 10,20%
solution for inhalation 10,20%
@ solution for inhalation 10,20%
solution for inhalation 10,20%
Abbott
Bedford
Faulding
Luitpold
Quad
Roxane
solution for inhalation 10,20%
solution for inhalation 10,20%
capsule, oral 200mg
capsule, oral 200mg
capsule, oral 200mg
capsule, oral 200mg
capsule, oral 200mg
capsule, oral 200mg
@ capsule, oral 200mg
capsule, oral 200mg
capsule, oral 200mg
capsule, oral 200mg
@ capsule, oral 200mg
capsule, oral 200mg
capsule, oral 200mg
capsule, oral 200mg
suspension, oral 200mg/5ml
tablet, oral 400,800mg
tablet, oral 400,800mg
tablet, oral 400,800mg
tablet, oral 400,800mg
tablet, oral 400,800mg
tablet, oral 400,800mg
6
Dey
Apothecon
AAIPharma
Apothecon
Copley
ESI Lederle
GenPharm
IVAX
Lek
Mylan
Purepac
Ranbaxy
Roxane
Stason
Teva
Watson
Alpharma
Apothecon
Carlsbad
Copley
ESI Lederle
GenPharm
IVAX
DRUG
ACYCLOVIR (continued)
Brand(s)
Zovirax
Zovirax
Zovirax
ACYCLOVIR SODIUM
Acyclovir Sodium
DOSAGE FORM, STRENGTH
@ tablet, oral 400,800mg
tablet, oral 400,800mg
tablet, oral 400,800mg
tablet, oral 400,800mg
tablet, oral 400,800mg
tablet, oral 400,800mg
ALBUTEROL
Albuterol
Brands
Proventil
Ventolin
Lek
Mylan
Neosan
Purepac
Ranbaxy
Teva
capsule, oral 200mg
suspension, oral 200mg/5ml
tablet, oral 400,800mg
GlaxoSmithKline
GlaxoSmithKline
GlaxoSmithKline
injection eq 25mg base/ml
injection eq 50mg base/ml
injection eq 500mg,1gm base/vial
injection eq 50mg base/ml
Faulding
Abbott
Abbott
American Pharmaceutical
Partners
American Pharmaceutical
Partners
Apothecon
Bedford
ESI Lederle
Gensia Sicor
Meridian
injection eq 500mg,1gm base/vial
Brand(s)
Zovirax
APPLICATION HOLDER,
MANUFACTURER
@ injection eq 500mg,1gm base/vial
injection eq 500mg,1gm base/vial
injection eq 500mg,1gm base/vial
injection eq 500mg,1gm base/vial
injection eq 50mg base/ml
injection eq 500mg,1gm base/vial
GlaxoSmithKline
aerosol, metered 0.09mg/inhalation
aerosol, metered 0.09mg/inhalation
aerosol, metered 0.09mg/inhalation
aerosol, metered 0.09mg/inhalation
Armstrong ***
GenPharm***
IVAX ***
Sidmak ***
aerosol, metered 0.09mg/inhalation
aerosol, metered 0.09mg/inhalation
Schering * **
GlaxoSmithKline *
**
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
** Proventil and Ventolin brands of albuterol metered dose inhalers are NOT INTERCHANGEABLE at this time.
Neither company has to date presented acceptable bioequivalence information comparing their brand of albuterol
metered dose inhaler to the other. Schering, via Warrick Pharmaceuticals, is manufacturing a generically labeled
albuterol metered dose inhaler using the Proventil federal new drug application (NDA) while GlaxoSmithKline
is doing the same, manufacturing an “authorized generic” for distribution under generic labeling by Dey
Laboratories, using the Ventolin NDA. Thus, Schering manufactured generically labeled albuterol metered dose
inhalers are NOT INTERCHANGEABLE with GlaxoSmithKline manufactured generically labeled albuterol
metered dose inhalers.
*** Albuterol metered dose inhalers manufactured by Armstrong (formerly Celltech or Medeva), GenPharm
(formerly Alpharma), Sidmak (formerly Medisol), and IVAX (formerly Norton Waterford) are, at this time, only
interchangeable with albuterol metered dose inhalers manufactured by GlaxoSmithKline.
ALBUTEROL SULFATE
Albuterol Sulfate
(continued on the next page)
solution for inhalation eq 0.083% base
solution for inhalation eq 0.083,
0.5% base
7
Alpharma
Bausch and Lomb*
DRUG
DOSAGE FORM, STRENGTH
ALBUTEROL SULFATE (continued)
@
@
@
@
@
@
@
Brand(s)
Proventil
Ventolin
Proventil
Ventolin
Volmax
VoSpire ER
Proventil
Ventolin
APPLICATION HOLDER,
MANUFACTURER
solution for inhalation eq 0.083,
0.5% base
solution for inhalation eq 0.083% base
solution for inhalation eq 0.083,
0.5% base
solution for inhalation eq 0.083% base
solution for inhalation eq 0.083% base
solution for inhalation eq 0.083,
0.5% base
solution for inhalation eq 0.5% base
solution for inhalation eq 0.083% base
solution for inhalation eq 0.083% base
syrup, oral eq 2mg base/5ml
syrup, oral eq 2mg base/5ml
syrup, oral eq 2mg base/5ml
syrup, oral eq 2mg base/5ml
syrup, oral eq 2mg base/5ml
syrup, oral eq 2mg base/5ml
tablet, oral eq 2,4mg base
tablet, oral eq 2,4mg base
tablet, oral eq 2,4mg base
tablet, oral eq 2,4mg base
tablet, oral eq 2,4mg base
tablet, oral eq 2,4mg base
tablet, oral eq 2,4mg base
tablet, oral eq 2,4mg base
tablet, oral eq 2,4mg base
tablet, oral eq 2,4mg base
tablet, oral eq 2,4mg base
solution for inhalation eq 0.083,
0.5% base
@ solution for inhalation eq 0.083,
0.5% base
syrup, oral eq 2mg base/5ml
@ syrup, oral eq 2mg base/5ml
tablet, extended release eq 4,8mg base
tablet, extended release eq 4,8mg base
tablet, oral eq 2,4mg base
@ tablet, oral eq 2,4mg base
Copley
Dey
Hi-Tech
IVAX
Morton Grove
Nephron
Novex
Roxane
Steripak
Alpharma
Clonmel
Hi-Tech
Teva
UDL
Watson
American Therapeutics
Celltech
Copley
Geneva
Lederle
Mutual
Mylan
Sidmak
Teva
Warner Chilcott
Watson
Schering *
GlaxoSmithKline
Schering *
GlaxoSmithKline
Muro
Sidmak
Schering *
GlaxoSmithKline
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
ALCOHOL; DEXTROSE
Alcohol; Dextrose
ALCOHOL; MORPHINE
Alcohol; Morphine
(continued on the next page)
injection 5ml/100ml (5%);
5gm/100ml (5%)
@ injection 5ml/100ml (5%);
5gm/100ml (5%)
injection 5ml/100ml (5%);
5gm/100ml (5%)
@ injection 5ml/100ml (5%);
5gm/100ml (5%)
solution, oral 45% v/v;2mg/5ml
solution, oral 45% v/v;2mg/5ml
8
Abbott
Baxter
Braun
Miles
Alpharma
Halsey
DRUG
DOSAGE FORM, STRENGTH
ALCOHOL; MORPHINE (continued)
Brand(s)
Paregoric Tincture
Paregoric Tincture
Paregoric Tincture
solution, oral 45% v/v;2mg/5ml
solution, oral 45% v/v;2mg/5ml
solution, oral 45% v/v;2mg/5ml
APPLICATION HOLDER,
MANUFACTURER
Cenci
Lilly
Morton Grove
* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as an
exception to the promulgated criteria for inclusion, pursuant to Rule 790.60.
ALFENTANIL HYDROCHLORIDE
Alfentanil Hydrochloride
Brand(s)
Alfenta
ALLOPURINOL
Allopurinol
Brand(s)
Lopurin
Zyloprim
ALPRAZOLAM
Alprazolam
Xanax
Brand(s)
injection eq 0.5mg base/ml
Abbott
injection eq 0.5mg base/ml
Akorn
@ tablet, oral 100,300mg
@ tablet, oral 100,300mg
tablet, oral 100,300mg
tablet, oral 100,300mg
tablet, oral 100,300mg
tablet, oral 100,300mg
@ tablet, oral 100,300mg
@ tablet, oral 100mg
tablet, oral 300mg
tablet, oral 100,300mg
Barr
Circa
Geneva
Mutual
Mylan
Par
Purepac
Superpharm
Superpharm
Watson
tablet, oral 100,300mg
tablet, oral 100,300mg
BASF
Prometheus
tablet, oral 0.25,0.5,1,2mg
tablet, oral 0.25,0.5,1,2mg
tablet, oral 0.25,0.5,1,2mg
tablet, oral 0.25,0.5,1,2mg
tablet, oral 0.25,0.5,1,2mg
tablet, oral 0.25,0.5,1,2mg
@ tablet, oral 0.25,0.5,1mg
tablet, oral 0.25,0.5,1,2mg
tablet, oral 0.25,0.5,1mg
Alphapharm
Geneva
IVAX
Lederle
Mylan
Purepac
Roxane
Teva
Watson
tablet, oral 0.25,0.5,1,2mg
Pharmacia & Upjohn *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
ALPROSTADIL
Alprostadil
Brand(s)
Caverject
Caverject
Edex
Prostin VR Pediatric
injection 0.5mg/ml
injection 0.5mg/ml
@ injection 0.005mg/vial
injection 0.01,0.02,0.04mg/vial
injection 0.005,0.01,0.02,0.04mg/vial
injection 0.5mg/ml
ALUMINUM ACETATE; ACETIC ACID, GLACIAL
See ACETIC ACID, GLACIAL; ALUMINUM ACETATE
9
Bedford
Gensia Sicor
Pharmacia & Upjohn
Pharmacia & Upjohn
Schwarz
Pharmacia & Upjohn
DRUG
AMANTADINE HYDROCHLORIDE
Amantadine Hydrochloride
Brand(s)
Symadine
Symmetrel
Symmetrel
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
@ capsule, oral 100mg
capsule, oral 100mg
capsule, oral 100mg
syrup, oral 50mg/5ml
syrup, oral 50mg/5ml
syrup, oral 50mg/5ml
syrup, oral 50mg/5ml
syrup, oral 50mg/5ml
syrup, oral 50mg/5ml
Circa
Geneva
USL
Alpharma
Copley
Hi-Tech
Mikart
Morton Grove
Pharmaceutical Associates
@ capsule, oral 100mg
@ capsule, oral 100mg
syrup, oral 50mg/5ml
Solvay
Bristol-Myers Squibb *
Endo *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
AMCINONIDE
Amcinonide
Brand(s)
Cyclocort
AMIKACIN SULFATE
Amikacin Sulfate
Brand(s)
Amikin
AMILORIDE HYDROCHLORIDE
Amiloride Hydrochloride
Brand(s)
Midamor
cream, topical 0.1%
Taro
cream, topical 0.1%
Fujisawa
injection eq 50,250mg base/ml
@ injection eq 50,250mg base/ml
injection eq 50,250mg base/ml
@ injection eq 50,250mg base/ml
injection eq 50,250mg base/ml
injection eq 50,250mg base/ml
Abbott
AstraZeneca
Bedford
Elkins-Sinn
Faulding
Gensia Sicor
injection eq 50,250mg base/ml
Apothecon
tablet, oral 5mg
Par
tablet, oral 5mg
Merck
AMILORIDE HYDROCHLORIDE; HYDROCHLOROTHIAZIDE
Amiloride Hydrochloride;
tablet, oral eq 5mg anhydrous;50mg
Hydrochlorothiazide
tablet, oral eq 5mg anhydrous;50mg
tablet, oral eq 5mg anhydrous;50mg
tablet, oral eq 5mg anhydrous;50mg
tablet, oral eq 5mg anhydrous;50mg
Brand(s)
Hydro-ride
tablet, oral eq 5mg anhydrous;50mg
Moduretic 5-50
tablet, oral eq 5mg anhydrous;50mg
Barr
Geneva
Mylan
Teva
Watson
Par
Merck *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
AMINOACETIC ACID
See GLYCINE
10
DRUG
AMINOCAPROIC ACID
Aminocaproic Acid
Brand(s)
Amicar
Amicar
AMINOHIPPURATE SODIUM
Aminohippurate Sodium
AMINOPHYLLINE
Aminophylline
DOSAGE FORM, STRENGTH
injection 250mg/ml
@ injection 250mg/ml
injection 250mg/ml
injection 250mg/ml
@ injection 250mg/ml
syrup, oral 1.25gm/5ml
injection 250mg/ml
syrup, oral 1.25gm/5ml
injection 25mg/ml
@ injection 25mg/ml
injection 25mg/ml
injection 25mg/ml
injection 25mg/ml
injection 25mg/ml
injection 25mg/ml
injection 25mg/ml
injection 25mg/ml
solution, oral 105mg/5ml
solution, oral 105mg/5ml
solution, oral 105mg/5ml
tablet, oral 100,200mg
tablet, oral 100,200mg
tablet, oral 100,200mg
tablet, oral 100,200mg
tablet, oral 100,200mg
tablet, oral 100,200mg
Abbott
American Pharmaceutical
Partners
Elkins-Sinn
Gensia Sicor
International Medication
King
Luitpold
Pharma Serve
Smith and Nephew
Alpharma
Morton Grove
Roxane
Duramed/Barr
Geneva
Impax
Roxane
(Vangard/MWM)
West-ward
injection 25mg/ml
solution, oral 105mg/5ml
solution, oral 105mg/5ml
tablet, oral 100,200mg
Searle
Fisons
Fisons
Searle
injection 50mg/ml
tablet, oral 200mg
tablet, oral 200mg
tablet, oral 200mg
tablet, oral 200mg
tablet, oral 200mg
tablet, oral 200mg
Apotex
Alphapharm
Barr
Copley
Eon
Taro
Teva
injection 50mg/ml
tablet, oral 200mg
tablet, oral 200mg
Wyeth
Wyeth
Upsher-Smith
@
@
@
@
Brand(s)
Cordarone
Cordarone
Pacerone
Xanodyne
Xanodyne
Merck
Quad
@
AMIODARONE HYDROCHLORIDE
Amiodarone Hydrochloride
Abbott
American Pharmaceutical
Partners
Elkins-Sinn
Luitpold
Quad
Mikart
injection 20%
@ injection 20%
@
Brand(s)
Aminophyllin
Somophyllin
Somophyllin-DF
Aminophyllin
APPLICATION HOLDER,
MANUFACTURER
@
@
@
@
AMITRIPTYLINE HYDROCHLORIDE
Amitriptyline Hydrochloride
@ injection 10mg/ml
(continued on the next page)
11
Steris
DRUG
DOSAGE FORM, STRENGTH
AMITRIPTYLINE HYDROCHLORIDE (continued)
@ tablet, oral 10,25,50,75,100mg
@ tablet, oral 10,25,50,75,100,150mg
@ tablet, oral 10,25,50,75,100,150mg
tablet, oral 10,25,50,75,100,150mg
@ tablet, oral 25mg
@ tablet, oral 10,25,50,75,100,150mg
tablet, oral 10,25,50,75,100,150mg
tablet, oral 10,25,50,75,100,150mg
@ tablet, oral 10,25,50,75,100,150mg
@ tablet, oral 10,25,50,75,100mg
@ tablet, oral 10,25,50,75,100mg
@ tablet, oral 150mg
tablet, oral 10,25,50,75,100,150mg
tablet, oral 10,25,50,75,100mg
tablet, oral 10,25,50,100mg
@ tablet, oral 75,150mg
@ tablet, oral 25mg
@ tablet, oral 10,50,75,100mg
tablet, oral 10,25,50,75,100,150mg
@ tablet, oral 10,25,50,75,100,150mg
@ tablet, oral 10,25,50mg
Brand(s)
Elavil
injection 10mg/ml
Amitid
@ tablet, oral 10,25,50,75,100mg
Amitril
@ tablet, oral 10,25,50,75,100,150mg
Elavil
tablet, oral 10,25,50,75,100,150mg
Endep
@ tablet, oral 10,25,50,75,100mg
Endep
@ tablet, oral 150mg
AMITRIPTYLINE HYDROCHLORIDE; CHLORDIAZEPOXIDE
Amitriptyline Hydrochloride;
@ tablet, oral eq 12.5mg base;5mg
Chlordiazepoxide
@ tablet, oral eq 25mg base;10mg
tablet, oral eq 12.5mg base;5mg
tablet, oral eq 25mg base;10mg
tablet, oral eq 12.5mg base;5mg
tablet, oral eq 25mg base;10mg
@ tablet, oral eq 12.5mg base;5mg
@ tablet, oral eq 25mg base;10mg
tablet, oral eq 12.5mg base;5mg
tablet, oral eq 25mg base;10mg
Brand(s)
Limbitrol
tablet, oral eq 12.5mg base;5mg
Limbitrol DS
tablet, oral eq 25mg base;10mg
AMITRIPTYLINE HYDROCHLORIDE; PERPHENAZINE
Amitriptyline Hydrochloride;
@ tablet, oral 10mg;2mg
Perphenazine
@ tablet, oral 25mg;2mg
@ tablet, oral 10mg;4mg
@ tablet, oral 25mg;4mg
@ tablet, oral 10mg;2mg
@ tablet, oral 25mg;2mg
@ tablet, oral 10mg;4mg
@ tablet, oral 25mg;4mg
@ tablet, oral 50mg;4mg
tablet, oral 10mg;2mg
tablet, oral 25mg;2mg
tablet, oral 10mg;4mg
tablet, oral 25mg;4mg
(continued on the next page)
12
APPLICATION HOLDER,
MANUFACTURER
American Therapeutics
Barr
Celltech
Geneva
Halsey
Lederle
Mutual
Mylan
Par
Purepac
Roxane
Roxane
Sidmak
Superpharm
Teva
Teva
USL
(Vangard/MWM)
Vintage
Watson
West-ward
AstraZeneca
Squibb
Warner Chilcott
AstraZeneca
Roche
Roche
Barr
Barr
Mylan
Mylan
Par
Par
USL
USL
Watson
Watson
ICN
ICN
Barr
Barr
Barr
Barr
Circa
Circa
Circa
Circa
Circa
Geneva
Geneva
Geneva
Geneva
DRUG
DOSAGE FORM, STRENGTH
AMITRIPTYLINE HYDROCHLORIDE; PERPHENAZINE (continued)
tablet, oral 50mg;4mg
@ tablet, oral 10mg;2mg
@ tablet, oral 25mg;2mg
@ tablet, oral 10mg;4mg
@ tablet, oral 25mg;4mg
@ tablet, oral 50mg;4mg
tablet, oral 10mg;2mg
tablet, oral 25mg;2mg
tablet, oral 10mg;4mg
tablet, oral 25mg;4mg
tablet, oral 50mg;4mg
@ tablet, oral 10mg;2mg
@ tablet, oral 25mg;2mg
@ tablet, oral 10mg;4mg
@ tablet, oral 25mg;4mg
@ tablet, oral 50mg;4mg
tablet, oral 10mg;2mg
tablet, oral 25mg;2mg
tablet, oral 10mg;4mg
tablet, oral 25mg;4mg
@ tablet, oral 50mg;4mg
Brand(s)
Triavil 2-10
@ tablet, oral 10mg;2mg
Triavil 2-25
@ tablet, oral 25mg;2mg
Triavil 4-10
@ tablet, oral 10mg;4mg
Triavil 4-25
@ tablet, oral 25mg;4mg
Triavil 4-50
@ tablet, oral 50mg;4mg
AMMONIUM LACTATE
Ammonium Lactate
Brand(s)
Lac-Hydrin
Lac-Hydrin
LAClotion
APPLICATION HOLDER,
MANUFACTURER
Geneva
IVAX
IVAX
IVAX
IVAX
IVAX
Mylan
Mylan
Mylan
Mylan
Mylan
Par
Par
Par
Par
Par
Watson
Watson
Watson
Watson
Watson
New River
New River
New River
New River
New River
cream, topical eq 12% base
Clay-Park
cream, topical eq 12% base
lotion, topical eq 12% base
lotion, topical eq 12% base
Westwood Squibb
Westwood Squibb *
Paddock
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
AMOXAPINE
Amoxapine
Brand(s)
Asendin
tablet, oral 25,50,100,150mg
tablet, oral 25,50,100,150mg
Geneva
Watson
@ tablet, oral 25,50,100,150mg
Lederle
AMOXICILLIN/AMOXICILLIN TRIHYDRATE
Amoxicillin/
@ capsule, oral 250,500mg
Amoxicillin Trihydrate
capsule, oral 250,500mg
capsule, oral 250,500mg
capsule, oral 250,500mg
@ capsule, oral 250,500mg
capsule, oral 250,500mg
capsule, oral 250,500mg
powder for suspension 125,250mg/5ml
powder for suspension 125,250mg/5ml
@ powder for suspension 125,250mg/5ml
powder for suspension 200,400mg/5ml
(continued on the next page)
13
Atral
Biochemie
Clonmel
Consolidated
Mylan
Ranbaxy
Teva
Clonmel
Consolidated
Mylan
Ranbaxy
DRUG
DOSAGE FORM, STRENGTH
AMOXICILLIN/AMOXICILLIN TRIHYDRATE (continued)
powder for suspension
125,200,250,400mg/5ml, 50mg/ml
@ tablet, chewable 125,250mg
tablet, chewable 125,250mg
tablet, chewable 125,200,250,400mg
tablet, chewable 125,250mg
tablet, oral 500,875mg
tablet, oral 500,875mg
Brand(s)
Amoxil
capsule, oral 250,500mg
Trimox
capsule, oral 250,500mg
Utimox
@ capsule, oral 250,500mg
Wymox
@ capsule, oral 250,500mg
Amoxil
powder for suspension
125,200,250,400mg/5ml, 50mg/ml
Larotid
@ powder for suspension 50mg/ml
Larotid
powder for suspension 125,250mg/5ml
Polymox
@ powder for suspension 125,250mg/5ml
Trimox
@ powder for suspension 50mg/ml
Trimox
powder for suspension 125,250mg/5ml
Utimox
@ powder for suspension 125,250mg/5ml
Wymox
powder for suspension 125,250mg/5ml
Amoxil
tablet, chewable 125,200,250,400mg
Amoxil
tablet, oral 500,875mg
AMOXICILLIN; CLAVULANATE POTASSIUM
Amoxicillin;
suspension, oral 200mg;
Potassium Clavulanate
eq 28.5mg base/5ml
suspension, oral 400mg;
eq 57mg base/5ml
suspension, oral 200mg;
eq 28.5mg base/5ml
suspension, oral 400mg;
eq 57mg base/5ml
tablet, chewable 200mg;
eq 28.5mg base
tablet, chewable 400mg;
eq 57mg base
tablet, oral 500mg;eq 125mg base
tablet, oral 875mg;eq 125mg base
tablet, oral 500mg;eq 125mg base
tablet, oral 875mg;eq 125mg base
tablet, oral 500mg;eq 125mg base
tablet, oral 875mg;eq 125mg base
tablet, oral 500mg;eq 125mg base
tablet, oral 875mg;eq 125mg base
Brand(s)
Augmentin 200
suspension, oral 200mg;
eq 28.5mg base/5ml
Augmentin 400
suspension, oral 400mg;
eq 57mg base/5ml
Augmentin 200
tablet, chewable 200mg;
eq 28.5mg base
Augmentin 400
tablet, chewable 400mg;
eq 57mg base
Augmentin 500
tablet, oral 500mg;eq 125mg base
Augmentin 875
tablet, oral 875mg;eq 125mg base
AMPHETAMINE
ASPARTAME;
AMPHETAMINE
SULFATE;
14
APPLICATION HOLDER,
MANUFACTURER
Teva
Apothecon
Clonmel
Ranbaxy
Teva
Ranbaxy
Teva
GlaxoSmithKline
Apothecon
Pfizer
Wyeth-Ayerst
GlaxoSmithKline
GlaxoSmithKline
GlaxoSmithKline
Apothecon
Apothecon
Apothecon
Pfizer
Wyeth-Ayerst
GlaxoSmithKline
GlaxoSmithKline
Geneva
Geneva
Lek
Lek
Geneva
Geneva
Geneva
Geneva
Lek
Lek
Ranbaxy
Ranbaxy
Teva
Teva
GlaxoSmithKline
GlaxoSmithKline
GlaxoSmithKline
GlaxoSmithKline
GlaxoSmithKline
GlaxoSmithKline
DEXTROAMPHETAMINE
SACCHARATE;
DRUG
DEXTROAMPHETAMINE SULFATE
Amphetamine Aspartame;
Amphetamine Sulfate;
Dextroamphetamine Saccharate;
Dextroamphetamine Sulfate
Brand(s)
Adderall 5
Adderall 10
Adderall 20
Adderall 30
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
tablet, oral 1.25mg;1.25mg;1.25mg;1.25mg Barr
tablet, oral 2.5mg;2.5mg;2.5mg;2.5mg Barr
tablet, oral 5mg;5mg;5mg;5mg
Barr
tablet, oral 7.5mg;7.5mg;7.5mg;7.5mg Barr
tablet, oral 1.25mg;1.25mg;1.25mg;1.25mg CorePharma
tablet, oral 2.5mg;2.5mg;2.5mg;2.5mg CorePharma
tablet, oral 5mg;5mg;5mg;5mg
CorePharma
tablet, oral 7.5mg;7.5mg;7.5mg;7.5mg CorePharma
tablet, oral 1.25mg;1.25mg;1.25mg;1.25mg Eon
tablet, oral 2.5mg;2.5mg;2.5mg;2.5mg Eon
tablet, oral 5mg;5mg;5mg;5mg
Eon
tablet, oral 7.5mg;7.5mg;7.5mg;7.5mg Eon
tablet, oral 1.25mg;1.25mg;1.25mg;1.25mg Watson
tablet, oral 2.5mg;2.5mg;2.5mg;2.5mg Watson
tablet, oral 5mg;5mg;5mg;5mg
Watson
tablet, oral 7.5mg;7.5mg;7.5mg;7.5mg Watson
tablet, oral 1.25mg;1.25mg;1.25mg;1.25mg Shire
tablet, oral 2.5mg;2.5mg;2.5mg;2.5mg Shire
tablet, oral 5mg;5mg;5mg;5mg
Shire
tablet, oral 7.5mg;7.5mg;7.5mg;7.5mg Shire
AMPHETAMINE SULFATE; AMPHETAMINE ASPARTAME; DEXTROAMPHETAMINE SACCHARATE;
DEXTROAMPHETAMINE SULFATE
See AMPHETAMINE ASPARTAME; AMPHETAMINE SULFATE; DEXTROAMPHETAMINE SACCHARATE;
DEXTROAMPHETAMINE SULFATE
AMPHOTERICIN B
Amphotericin B
Brand(s)
Fungizone
@ injection 50mg/vial
@ injection 50mg/vial
injection 50mg/vial
injection 50mg/vial
Abbott
American Pharmaceutical
Partners
Gensia Sicor
Pharma Tek
injection 50mg/vial
Apothecon
AMPICILLIN/AMPICILLIN TRIHYDRATE; PROBENECID
Brand(s)
Polycillin-PRB
@ powder for suspension
eq 3.5gm base/bottle;1gm/bottle
Probampacin
@ powder for suspension
eq 3.5gm base/bottle;1gm/bottle
AMPICILLIN/AMPICILLIN TRIHYDRATE
Ampicillin Trihydrate
@ capsule, oral eq 250,500mg base
capsule, oral eq 250,500mg base
capsule, oral eq 250,500mg base
@ capsule, oral eq 250,500mg base
@ capsule, oral eq 250,500mg base
@ capsule, oral eq 250,500mg base
@ capsule, oral eq 250,500mg base
@ capsule, oral eq 250mg base
capsule, oral eq 500mg base
capsule, oral eq 250,500mg base
(continued on the next page)
AMPICILLIN/AMPICILLIN TRIHYDRATE (continued)
15
Apothecon
Teva
Biochemie
Clonmel
Consolidated
Eon
IVAX
Lederle
Mylan
Purepac
Purepac
Teva
DRUG
Brand(s)
Amcill
Omnipen
Penbritin
Pfizerpen-A
Polycillin
Principen
Totacillin
Amcill
Omnipen
Penbritin
Pfizerpen-A
Polycillin
Principen
Totacillin
AMPICILLIN SODIUM
Ampicillin Sodium
Brand(s)
Omnipen-N
Penbritin-S
(continued on the next page)
AMPICILLIN SODIUM (continued)
Polycillin-N
DOSAGE FORM, STRENGTH
powder for suspension
eq 125,250mg base/5ml
powder for suspension
eq 125,250mg base/5ml
@ powder for suspension
eq 125,250mg base/5ml
powder for suspension
@ eq 125mg base/5ml
eq 250mg base/5ml
powder for suspension
eq 125,250mg base/5ml
APPLICATION HOLDER,
MANUFACTURER
Clonmel
Consolidated
Mylan
Purepac
Teva
@ capsule, oral eq 250,500mg base
capsule, oral eq 250,500mg base
@ capsule, oral eq 250,500mg base
@ capsule, oral eq 250,500mg base
@ capsule, oral eq 250,500mg base
capsule, oral eq 250,500mg base
capsule, oral eq 250,500mg base
@ powder for suspension
eq 125,250mg base/5ml
powder for suspension
eq 125,250mg base/5ml,
100mg/ml
@ powder for suspension
eq 125,250mg base/5ml,
100mg/ml
@ powder for suspension
eq 125,250mg base/5ml
@ powder for suspension
eq 125,250,500mg base/5ml,
100mg/ml
powder for suspension
eq 125,250mg base/5ml,
100mg/ml
@ powder for suspension
eq 125,250mg base/5ml
Pfizer
Wyeth-Ayerst
Wyeth-Ayerst
Pfizer
Bristol
Apothecon
GlaxoSmithKline
Pfizer
@ injection eq 125,250,500mg,
1,2gm base/vial
@ injection eq 125,250,500mg,
1,2,10gm base/vial
@ injection eq 125,250,500mg,
1,2,10gm base/vial
@ injection eq 125mg base/vial
injection eq 250,500mg,
1,2gm base/vial
@ injection eq 1,2gm base/vial
@ injection eq 500mg,1,2gm base/vial
injection eq 125,250,500mg,
1,2gm base/vial
@ injection eq 10gm base/vial
Consolidated
Wyeth-Ayerst
Wyeth-Ayerst
Pfizer
Apothecon
Apothecon
GlaxoSmithKline
Elkins-Sinn
Hanford
IBI
IBI
International Medication
Lilly
Marsam
Marsam
injection eq 125,250,500mg,
1,2gm base/vial
@ injection eq 125,250,500mg,
1,2gm base/vial
Wyeth-Ayerst
@ injection eq 125,250,500mg,
Bristol
16
Wyeth-Ayerst
DRUG
Principen
Totacillin-N
DOSAGE FORM, STRENGTH
1,2gm base/vial
injection eq 125,250,500mg,
1,2,10gm base/vial
injection eq 125,250,500mg,
1,2,10gm base/vial
APPLICATION HOLDER,
MANUFACTURER
Apothecon
GlaxoSmithKline
AMRINONE LACTATE
See INAMRINONE LACTATE
ANTAZOLINE PHOSPHATE; NAPHAZOLINE HYDROCHLORIDE
Antazoline Phosphate;
solution, ophthalmic 0.5%;0.05%
Naphazoline Hydrochloride
Brand(s)
Albalon A Liquifilm
solution, ophthalmic 0.5%;0.05%
Vasocon-A
solution, ophthalmic 0.5%;0.05%
Steris
Allergan
Novartis
* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as an
exception to the promulgated criteria for inclusion, pursuant to Rule 790.60.
ANTIPYRINE; BENZOCAINE
Antipyrine; Benzocaine
Brand(s)
A/B Otic Drops
Auralgan
Auroto Drops
Oto Ear Drops
solution, otic 54mg/ml(5.4%);
14mg/ml(1.4%)
solution, otic 54mg/ml(5.4%);
14mg/ml(1.4%)
solution, otic 54mg/ml(5.4%);
14mg/ml(1.4%)
solution, otic 54mg/ml(5.4%);
14mg/ml(1.4%)
solution, otic 54mg/ml(5.4%);
14mg/ml(1.4%)
solution, otic 54mg/ml(5.4%);
14mg/ml(1.4%)
solution, otic 54mg/ml(5.4%);
14mg/ml(1.4%)
Bausch and Lomb
Hi-Tech
Taro
Clay-Park
Wyeth-Ayerst
Alpharma
Vortech
* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as an
exception to the promulgated criteria for inclusion, pursuant to Rule 790.60.
ASCORBIC ACID; BIOTIN; CYANOCOBALAMIN; DEXPANTHENOL; ERGOCALCIFEROL; FOLIC ACID;
NIACINAMIDE; PYRIDOXINE HYDROCHLORIDE; RIBOFLAVIN PHOSPHATE SODIUM; THIAMINE
HYDROCHLORIDE; VITAMIN A; VITAMIN E
Brand(s)
M.V.C. 9+3
@ injection 10mg/ml;0.006mg/ml;
American Pharmaceutical
0.05mg/ml;1.5mg/ml;20IU/ml;
Partners
0.04mg/ml;4mg/ml;0.4mg/ml;
0.36mg/ml;0.3mg/ml;330IU/ml;
1IU/ml
MVC Plus
@ injection 10mg/ml;0.006mg/ml;
Steris
0.05mg/ml;1.5mg/ml;20IU/ml;
0.04mg/ml;4mg/ml;0.4mg/ml;
0.36mg/ml;0.3mg/ml;330IU/ml;
1IU/ml
(continued on the next page)
ASCORBIC ACID; BIOTIN; CYANOCOBALAMIN; DEXPANTHENOL; ERGOCALCIFEROL; FOLIC ACID;
NIACINAMIDE; PYRIDOXINE HYDROCHLORIDE; RIBOFLAVIN PHOSPHATE SODIUM; THIAMINE
17
DRUG
DOSAGE FORM, STRENGTH
HYDROCHLORIDE; VITAMIN A; VITAMIN E (continued)
M.V.I. - 12
injection 10mg/ml;0.006mg/ml;
0.05mg/ml;1.5mg/ml;20IU/ml;
0.04mg/ml;4mg/ml;0.4mg/ml;
0.36mg/ml;0.3mg/ml;330IU/ml;
1IU/ml
APPLICATION HOLDER,
MANUFACTURER
AAIPharma
ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; IRON; NICOTINIC ACID; PYRIDOXINE HYDROCHLORIDE;
RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D; VITAMIN E
Ascorbic Acid; Cyanocobalamin; drops, oral 35mg;2mcg;0.5mg;10mg;
Esquire
Fluoride; Iron; Nicotinic Acid;
8mg;0.4mg;0.6mg;0.5mg;
Pyridoxine Hydrochloride;
1500IU;400IU;5IU
Riboflavin; Thiamine Hydrochloride;
Vitamin A; Vitamin D; Vitamin E
Brand(s)
Poly-Vi-Flor with Iron
drops, oral 35mg;2mcg;0.5mg;10mg;
Mead Johnson/
8mg;0.4mg;0.6mg;0.5mg;
Bristol-Myers Squibb
1500IU;400IU;5IU
* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as an
exception to the promulgated criteria for inclusion, pursuant to Rule 790.60.
ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; NICOTINIC ACID; PYRIDOXINE HYDROCHLORIDE;
RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D; VITAMIN E
Ascorbic Acid;
drops, oral 35mg;2mcg;
Alpharma
Cyanocobalamin; Fluoride;
0.25mg;8mg;0.4mg;0.6mg;
Nicotinic Acid;
0.5mg;1500IU;400IU;5IU
Pyridoxine Hydrochloride;
drops, oral 35mg;2mcg;
Esquire
Riboflavin;
0.25mg;8mg;0.4mg;0.6mg;
Thiamine Hydrochloride;
0.5mg;1500IU;400IU;5IU
Vitamin A; Vitamin D; Vitamin E
drops, oral 35mg;2mcg;
Alpharma
0.5mg;8mg;0.4mg;0.6mg;
0.5mg;1500IU;400IU;5IU
drops, oral 35mg;2mcg;
Esquire
0.5mg;8mg;0.4mg;0.6mg;
0.5mg;1500IU;400IU;5IU
drops, oral 35mg;2mcg;
Hi-Tech
0.5mg;8mg;0.4mg;0.6mg;
0.5mg;1500IU;400IU;5IU
Brand(s)
Poly-Vi-Flor
drops, oral 35mg;2mcg;
Mead Johnson/
0.25mg;8mg;0.4mg;0.6mg;
Bristol-Myers Squibb
0.5mg;1500IU;44IU;5IU
Poly Vitamin Drops
drops, oral 35mg;2mcg;
Hi-Tech
with Fluoride 0.25mg
0.25mg;8mg;0.4mg;0.6mg;
0.5mg;1500IU;44IU;5IU
Poly-Vi-Flor
drops, oral 35mg;2mcg;
Mead Johnson/
0.5mg;8mg;0.4mg;0.6mg;
Bristol-Myers Squibb
0.5mg;1500IU;400IU;5IU
Poly Vitamin Drops
drops, oral 35mg;2mcg;
Hi-Tech
with Fluoride 0.5mg
0.5mg;8mg;0.4mg;0.6mg;
0.5mg;1500IU;400IU;5IU
* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as an
exception to the promulgated criteria for inclusion, pursuant to Rule 790.60.
ASCORBIC ACID; FLUORIDE; IRON; VITAMIN A; VITAMIN D
Ascorbic Acid; Fluoride;
drops, oral 35mg;0.25mg;
18
Abbott
DRUG
Iron; Vitamin A; Vitamin D
DOSAGE FORM, STRENGTH
10mg;1500IU;400IU
drops, oral 35mg;0.25mg;
10mg;1500IU;400IU
drops, oral 35mg;0.25mg;
10mg;1500IU;400IU
drops, oral 35mg;0.5mg;
10mg;1500IU;400IU
(continued on the next page)
ASCORBIC ACID; FLUORIDE; IRON; VITAMIN A; VITAMIN D (continued)
Brand(s)
Tri-Vi-Flor with Iron
drops, oral 35mg;0.25mg
10mg;1500IU;400IU
Tri-Vi-Flor with Iron
drops, oral 35mg;0.5mg;
10mg;1500IU;400IU
APPLICATION HOLDER,
MANUFACTURER
Alpharma
Morton Grove
Morton Grove
Mead Johnson/
Bristol-Myers Squibb
Mead Johnson/
Bristol-Myers Squibb
* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as an
exception to the promulgated criteria for inclusion, pursuant to Rule 790.60.
ASCORBIC ACID; FLUORIDE; VITAMIN A; VITAMIN D
Ascorbic Acid; Fluoride;
drops, oral 35mg;0.25mg;
Vitamin A; Vitamin D
1500IU;400IU
drops, oral 35mg;0.5mg;1500IU;400IU
drops, oral 35mg;0.25mg;
1500IU;400IU
drops, oral 35mg;0.5mg;1500IU;400IU
Brand(s)
Triple-Vita-Flor 0.25mg
drops, oral 35mg;0.25mg;
1500IU;400IU
Tri-Vi-Flor
drops, oral 35mg;0.25mg;
1500IU;400IU
TriVitamin Drops
drops, oral 35mg;0.25mg;
with Fluoride 0.25mg
1500IU;400IU
Triple-Vita-Flor 0.5mg
drops, oral 35mg;0.5mg;
1500IU;400IU
Tri-Vi-Flor
drops, oral 35mg;0.5mg;
1500IU;400IU
TriVitamin Drops
drops, oral 35mg;0.5mg;1500IU;400IU
with Fluoride 0.5mg
Abbott
Alpharma
Morton Grove
Morton Grove
Esquire
Mead Johnson/
Bristol-Myers Squibb
Hi-Tech
Esquire
Mead Johnson/
Bristol-Myers Squibb
Hi-Tech
* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as an
exception to the promulgated criteria for inclusion, pursuant to Rule 790.60.
ASPIRIN; BUTALBITAL; CAFFEINE
Aspirin; Butalbital; Caffeine
@ capsule, oral 325mg;50mg;40mg
@ tablet, oral 325mg;50mg;40mg
tablet, oral 325mg;50mg;40mg
tablet, oral 325mg;50mg;40mg
@ tablet, oral 325mg;50mg;40mg
@ tablet, oral 325mg;50mg;40mg
tablet, oral 325mg;50mg;40mg
Brand(s)
Fiorinal
capsule, oral 325mg;50mg;40mg
Lanorinal
capsule, oral 325mg;50mg;40mg
Butal Compound
tablet, oral 325mg;50mg;40mg
Butalbital Compound
@ tablet, oral 325mg;50mg;40mg
Fiorinal
tablet, oral 325mg;50mg;40mg
(continued on the next page)
ASPIRIN; BUTALBITAL; CAFFEINE (continued)
Lanorinal
@ tablet, oral 325mg;50mg;40mg
19
Watson
Halsey
Pharmeral
Purepac
Quantum
Watson
West-ward
Watson *
Lannett
Geneva
IVAX
Watson *
Lannett
DRUG
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
ASPIRIN; BUTALBITAL; CAFFEINE; CODEINE PHOSPHATE
Aspirin; Butalbital; Caffeine;
capsule, oral 325mg;50mg;40mg;30mg
Codeine Phosphate
capsule, oral 325mg;50mg;40mg;30mg
capsule, oral 325mg;50mg;40mg;30mg
Brands
Ascomp
capsule, oral 325mg;50mg;40mg;30mg
Fiorinal with Codeine #3
capsule, oral 325mg;50mg;40mg;30mg
Endo
Jerome Stevens
Watson
Anabolic
Watson *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
ASPIRIN; CAFFEINE; ORPHENADRINE CITRATE
Aspirin; Caffeine;
tablet, oral 385mg;30mg;25mg
Orphenadrine Citrate
tablet, oral 770mg;60mg;50mg
tablet, oral 385mg;30mg;25mg
tablet, oral 770mg;30mg;25mg
Brand(s)
Invagesic
tablet, oral 385mg;30mg;25mg
Invagesic Forte
tablet, oral 770mg;60mg;50mg
Norgesic
tablet, oral 385mg;30mg;25mg
Norgesic Forte
tablet, oral 770mg;60mg;50mg
Orphengesic
tablet, oral 385mg;30mg;25mg
Orphengesic
tablet, oral 385mg;30mg;25mg
ASPIRIN; CAFFEINE; PROPOXYPHENE HYDROCHLORIDE
(Propoxyphene Hydrochloride in Powder Form)
Aspirin; Caffeine;
@ capsule, oral 389mg;32.4mg;65mg
Propoxyphene Hydrochloride @ capsule, oral 389mg;32.4mg;65mg
capsule, oral 389mg;32.4mg;65mg
@ capsule, oral 389mg;32.4mg;65mg
Brand(s)
Compound 65
@ capsule, oral 389mg;32.4mg;65mg
Darvon Compound-65
capsule, oral 389mg;32.4mg;65mg
Propoxyphene Compound 65
@ capsule, oral 389mg;32.4mg;65mg
Eon
Eon
Jerome Stevens
Jerome Stevens
Geneva
Geneva
3M *
3M *
Par
Par
Eon
Geneva
Teva
Watson
Alra
AAI Pharma *
IVAX
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
ASPIRIN; CARISOPRODOL
Aspirin; Carisoprodol
Brand(s)
Soma Compound
tablet, oral 325mg;200mg
@ tablet, oral 325mg;200mg
tablet, oral 325mg;200mg
tablet, oral 325mg;200mg
tablet, oral 325mg;200mg
Amide
Circa
Eon
Par
Wallace
ASPIRIN; CARISOPRODOL; CODEINE PHOSPHATE
Aspirin; Carisoprodol;
tablet, oral 325mg;200mg;16mg
Codeine Phosphate
tablet, oral 325mg;200mg;16mg
Brand(s)
Soma Compound with Codeine
tablet, oral 325mg;200mg;16mg
Wallace
ASPIRIN; CODEINE PHOSPHATE
Aspirin; Codeine Phosphate
Barr
tablet, oral 325mg;15,30,60mg
20
Amide
Eon
DRUG
Brand(s)
Empirin #3
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
tablet, oral 325mg;15,30,60mg
tablet, oral 325mg;30mg
tablet, oral 325mg;30,60mg
Geneva
Halsey
IVAX
tablet, oral 325mg;15,30,60mg
GlaxoSmithKline
* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as an
exception to the promulgated criteria for inclusion, pursuant to Section 790.60.
ASPIRIN; MEPROBAMATE
Aspirin; Meprobamate
Brand(s)
Equagesic
Mepro-Aspirin
Micrainin
Q-Gesic
ASPIRIN; METHOCARBAMOL
Aspirin; Methocarbamol
Brand(s)
Robaxisal
@ tablet, oral 325mg;200mg
Par
tablet, oral 325mg;200mg
@ tablet, oral 325mg;200mg
tablet, oral 325mg;200mg
@ tablet, oral 325mg;200mg
Women First Healthcare
Eon
Wallace
Quantum
tablet, oral 325mg;400mg
tablet, oral 325mg;400mg
@ tablet, oral 325mg;400mg
tablet, oral 325mg;400mg
IVAX
Jerome Stevens
McNeil
Par
tablet, oral 325mg;400mg
Robins
ASPIRIN; OXYCODONE HYDROCHLORIDE: OXYCODONE TEREPHTHALATE
Aspirin;
@ tablet, oral 325mg;4.5mg;0.38mg
Barr
Oxycodone Hydrochloride;
tablet, oral 325mg;4.5mg;0.38mg
Halsey
Oxycodone Terephthalate
@ tablet, oral 325mg;2.25mg;0.19mg
Roxane
tablet, oral 325mg;4.5mg;0.38mg
Watson
Brand(s)
Percodan-Demi
tablet, oral 325mg;2.25mg;0.19mg
Endo
Codoxy
@ tablet, oral 325mg;4.5mg;0.38mg
Halsey
Percodan
tablet, oral 325mg;4.5mg;0.38mg
Endo *
Roxiprin
@ tablet, oral 325mg;4.5mg;0.38mg
Roxane
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
ATENOLOL
Atenolol
Brand(s)
Tenormin
@ tablet, oral 50,100mg
tablet, oral 50,100mg
tablet, oral 25,50,100mg
@ tablet, oral 25,50,100mg
tablet, oral 25,50,100mg
tablet, oral 25,50,100mg
tablet, oral 50,100mg
tablet, oral 25,50,100mg
tablet, oral 25,50,100mg
tablet, oral 50,100mg
tablet, oral 25,50,100mg
tablet, oral 50,100mg
tablet, oral 50,100mg
tablet, oral 25,50,100mg
ATENOLOL; CHLORTHALIDONE
21
Apothecon
Copley
Geneva
GenPharm
IPR
Lederle
Martec
Mutual
Mylan
SCS
Sidmak
Teva
Watson
AstraZeneca
DRUG
Atenolol; Chlorthalidone
Brand(s)
Tenoretic 50
Tenoretic 100
ATRACURIUM BESYLATE
Atracurium Besylate
Brand(s)
Atracurium Besylate
Preservative Free
Atracurium Besylate
Preservative Free
Atracurium Besylate
Preservative Free
Atracurium Besylate
Preservative Free
Atracurium Besylate
Preservative Free
Atracurium Besylate
Preservative Free
Tracrium
Tracrium Preservative Free
ATROPINE
Atropine
Brand(s)
Atropen
ATROPINE SULFATE
Atropine Sulfate
Brand(s)
Atropair
Atropine-1
Atropine Care
Atropisol
I-Tropine
Isopto Atropine
(continued on the next page)
ATROPINE SULFATE (continued)
Ocu-Tropine
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
tablet, oral 50mg;25mg
tablet, oral 100mg;25mg
tablet, oral 50mg;25mg
tablet, oral 100mg;25mg
tablet, oral 50mg;25mg
tablet, oral 100mg;25mg
tablet, oral 50mg;25mg
tablet, oral 100mg;25mg
tablet, oral 50mg;25mg
tablet, oral 100mg;25mg
tablet, oral 50mg;25mg
tablet, oral 100mg;25mg
IPR
IPR
Martec
Martec
Mutual
Mutual
Mylan
Mylan
Sidmak
Sidmak
Watson
Watson
tablet, oral 50mg;25mg
tablet, oral 100mg;25mg
AstraZeneca
AstraZeneca
injection 10mg/ml
injection 10mg/ml
injection 10mg/ml
injection 10mg/ml
injection 10mg/ml
injection 10mg/ml
injection 10mg/ml
Abbott
Baxter
Bedford
ESI Lederle
Faulding
Gensia Sicor
Marsam
injection 10mg/ml
Abbott
injection 10mg/ml
Baxter
injection 10mg/ml
Bedford
injection 10mg/ml
ESI Lederle
injection 10mg/ml
Faulding
injection 10mg/ml
Marsam
injection 10mg/ml
injection 10mg/ml
Abbott
Abbott
@ injection eq 2mg sulfate/0.7ml
Solvay
injection eq 2mg sulfate/0.7ml
Meridian
solution, ophthalmic 1%
solution, ophthalmic 1%
solution, ophthalmic 1%
solution, ophthalmic 1%
Allergan
Alpharma
Pharmafair
Steris
solution, ophthalmic 1%
solution, ophthalmic 1%
solution, ophthalmic 1%
solution, ophthalmic 0.5,1,2%
solution, ophthalmic 1%
solution, ophthalmic 0.5,1,2%
Balan
Optopics
Akorn
Iolab
Americal
Alcon
solution, ophthalmic 1%
Ocumed
22
DRUG
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as an
exception to the promulgated criteria for inclusion, pursuant to Rule 790.60.
ATROPINE SULFATE; DIPHENOXYLATE HYDROCHLORIDE
Atropine Sulfate;
liquid, oral 0.025mg/5ml;2.5mg/5ml
Diphenoxylate Hydrochloride
tablet, oral 0.025mg;2.5mg
@ tablet, oral 0.025mg;2.5mg
@ tablet, oral 0.025mg;2.5mg
tablet, oral 0.025mg;2.5mg
@ tablet, oral 0.025mg;2.5mg
@ tablet, oral 0.025mg;2.5mg
@ tablet, oral 0.025mg;2.5mg
tablet, oral 0.025mg;2.5mg
@ tablet, oral 0.025mg;2.5mg
tablet, oral 0.025mg;2.5mg
@ tablet, oral 0.025mg;2.5mg
tablet, oral 0.025mg;2.5mg
tablet, oral 0.025mg;2.5mg
@ tablet, oral 0.025mg;2.5mg
@ tablet, oral 0.025mg;2.5mg
@ tablet, oral 0.025mg;2.5mg
@ tablet, oral 0.025mg;2.5mg
@ tablet, oral 0.025mg;2.5mg
@ tablet, oral 0.025mg;2.5mg
@ tablet, oral 0.025mg;2.5mg
Brand(s)
Colonaid
@ liquid, oral 0.025mg/5ml;2.5mg/5ml
Lomanate
@ liquid, oral 0.025mg/5ml;2.5mg/5ml
Lomotil
liquid, oral 0.025mg/5ml;2.5mg/5ml
Colonaid
@ tablet, oral 0.025mg;2.5mg
Di-Atro
@ tablet, oral 0.025mg;2.5mg
Lofene
@ tablet, oral 0.025mg;2.5mg
Logen
@ tablet, oral 0.025mg;2.5mg
Lomotil
tablet, oral 0.025mg;2.5mg
Lonox
tablet, oral 0.025mg;2.5mg
Lo-Trol
@ tablet, oral 0.025mg;2.5mg
Low-Quel
@ tablet, oral 0.025mg;2.5mg
Roxane
Able
(Ascot)
Barr
Eon
Heather
ICN
Inwood/Forest
IVAX
KV
Lannett
Lederle
Mylan
Par
Pfizer
R and S Pharma
Private Formulations
Roxane
USL
Watson
West-ward
Wallace
Alpharma
Searle
Wallace
MD
Lannett
Superpharm
Searle
Geneva
(Vangard/MWM)
Halsey
ATROPINE SULFATE; HYOSCYAMINE; PHENOBARBITAL; SCOPOLAMINE HYDROBROMIDE
Atropine Sulfate; Hyoscyamine;
elixir, oral 0.0194mg/5ml;
Alpharma
Phenobarbital;
0.1037mg/5ml;16.2mg/5ml;
Scopolamine Hydrobromide
0.0065mg/5ml
elixir, oral 0.0194mg/5ml;
Cenci
0.1037mg/5ml;16.2mg/5ml;
0.0065mg/5ml
elixir, oral 0.0194mg/5ml;
Halsey
0.1037mg/5ml;16.2mg/5ml;
0.0065mg/5ml
elixir, oral 0.0194mg/5ml;
Life
0.1037mg/5ml;16.2mg/5ml;
0.0065mg/5ml
elixir, oral 0.0194mg/5ml;
Naska
0.1037mg/5ml;16.2mg/5ml;
0.0065mg/5ml
(continued on the next page)
ATROPINE SULFATE; HYOSCYAMINE; PHENOBARBITAL; SCOPOLAMINE HYDROBROMIDE (continued)
elixir, oral 0.0194mg/5ml;
Pharmaceutical Associates
23
DRUG
Brand(s)
Antispasmodic Elixir
Donnatal
DOSAGE FORM, STRENGTH
0.1037mg/5ml;16.2mg/5ml;
0.0065mg/5ml
elixir, oral 0.0194mg/5ml;
0.1037mg/5ml;16.2mg/5ml;
0.0065mg/5ml
elixir, oral 0.0194mg/5ml;
0.1037mg/5ml;16.2mg/5ml;
0.0065mg/5ml
elixir, oral 0.0194mg/5ml;
0.1037mg/5ml;16.2mg/5ml;
0.0065mg/5ml
APPLICATION HOLDER,
MANUFACTURER
Purepac
Morton Grove
Robins
* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as an
exception to the promulgated criteria for inclusion, pursuant to Rule 790.60.
ATROPINE SULFATE; MEPERIDINE HYDROCHLORIDE
Atropine Sulfate;
@ injection 0.4mg/ml;50mg/ml
Meperidine Hydrochloride
@ injection 0.4mg/ml;75mg/ml
@ injection 0.4mg/ml;100mg/ml
Brand(s)
Atropine & Demerol
injection 0.4mg/ml;50mg/ml
Atropine & Demerol
injection 0.4mg/ml;75mg/ml
Atropine & Demerol
injection 0.4mg/ml;100mg/ml
AZATHIOPRINE
Azathioprine
Brand(s)
Imuran
AZATHIOPRINE SODIUM
Azathioprine Sodium
Brand(s)
Imuran
AZELAIC ACID
Brand(s)
Azelex
Wyeth-Ayerst
Wyeth-Ayerst
Wyeth-Ayerst
Abbott
Abbott
Abbott
tablet, oral 50mg
tablet, oral 50mg
tablet, oral 50mg
Applied Analytical Industries
GenPharm
Roxane
tablet, oral 50mg
Prometheus
injection eq 100mg base/vial
@ injection eq 100mg base/vial
Bedford
Quad
injection eq 100mg base/vial
Promethius
cream, topical 20%
Allergan *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
BACITRACIN
Bacitracin
(continued on the next page)
BACITRACIN (continued)
@ injection 50,000U/vial
injection 10,000, 50,000U/vial
@ injection 10,000, 50,000U/vial
ointment, ophthalmic 500U/gm
@ ointment, ophthalmic 500U/gm
@ ointment, ophthalmic 500U/gm
@ ointment, ophthalmic 500U/gm
powder for compounding
24
Pfizer
Pharmacia & Upjohn
Quad
Altana
Lilly
Pharmaderm
Pharmafair
Apothekernes
DRUG
Brand(s)
Baciim
Baciguent
Baci-Rx
DOSAGE FORM, STRENGTH
5,000,000 U/bottle
@ powder for compounding
5,000,000 U/bottle
injection 50,000U/vial
@ ointment, ophthalmic 500U/gm
powder for compounding
5,000,000 U/bottle
APPLICATION HOLDER,
MANUFACTURER
Paddock
Pharma-Tek
Pharmacia & Upjohn
Pharma Tek
BACITRACIN; HYDROCORTISONE ACETATE; NEOMYCIN SULFATE; POLYMYXIN B SULFATE
Bacitracin;
@ ointment, ophthalmic 400U/gm;1%;
Altana
Hydrocortisone Acetate;
eq 3.5mg base/gm;10,000U/gm
Neomycin Sulfate;
ointment, ophthalmic 400U/gm;1%;
Pharmaderm
Polymyxin B Sulfate
eq 3.5mg base/gm;10,000U/gm
BACITRACIN ZINC; HYDROCORTISONE; NEOMYCIN SULFATE; POLYMYXIN B SULFATE
Bacitracin Zinc;
ointment, ophthalmic 400U/gm;1%;
Bausch and Lomb
Hydrocortisone;
eq 3.5mg base/gm;10,000U/gm
Neomycin Sulfate;
@ ointment, topical 400U/gm;1%;
Pharmafair
Polymyxin B Sulfate
eq 3.5mg base/gm;5,000U/gm
Brand(s)
Cortisporin
ointment, ophthalmic 400U/gm; 1%;
Monarch
eq 3.5mg base/gm;10,000U/gm
Ocutricin HC
@ ointment, ophthalmic 400U/gm; 1%;
Pharmafair
eq 3.5mg base/gm;10,000U/gm
Cortisporin
ointment, topical 400U/gm;1%;
Monarch
eq 3.5mg base/gm;5,000U/gm
BACITRACIN ZINC; NEOMYCIN SULFATE; POLYMYXIN B SULFATE
Bacitracin Zinc;
ointment, ophthalmic 400U/gm;
Neomycin Sulfate;
eq 3.5mg base/gm;10,000U/gm
Polymyxin B Sulfate
ointment, ophthalmic 400U/gm;
eq 3.5mg base/gm;10,000U/gm
Brand(s)
Neosporin
ointment, ophthalmic 400U/gm;
eq 3.5mg base/gm;10,000U/gm
Ocutricin
@ ointment, ophthalmic 400U/gm;
eq 3.5mg base/gm;10,000U/gm
BACITRACIN ZINC; POLYMYXIN B SULFATE
Bacitracin Zinc;
ointment, ophthalmic 500U/gm;
Polymyxin B Sulfate
10,000U/gm
ointment, ophthalmic 500U/gm;
10,000U/gm
Brand(s)
Ocumycin
@ ointment, ophthalmic 500U/gm;
10,000U/gm
Polysporin
ointment, ophthalmic 500U/gm;
10,000U/gm
BACLOFEN
Baclofen
(continued on the next page)
BACLOFEN (continued)
tablet, oral 10,20mg
@ tablet, oral 10,20mg
tablet, oral 10,20mg
25
Altana
Bausch and Lomb
Monarch
Pharmafair
Akorn
Bausch and Lomb
Pharmafair
Monarch
IVAX
Teva
USL
DRUG
Brand(s)
Lioresal
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
tablet, oral 10,20mg
Watson
@ tablet, oral 10,20mg
Novartis
BENZATHINE PENICILLIN G
See PENICILLIN G BENZATHINE
BENZOCAINE; ANTIPYRINE
See ANTIPYRINE; BENZOCAINE
BENZONATATE
Benzonatate
Brand(s)
Tessalon Perles
capsule, oral 100mg
Banner Pharmacaps
capsule, oral 100mg
Forest *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
BENZOYL PEROXIDE
Benzoyl Peroxide
Brand(s)
Persa-Gel
Zeroxin -5,-10
Benzac 5,10
5-Benzagel
10-Benzagel
Panoxyl 5,10
Ben Aqua 5,10
Benzac W 2.5,5,10
Desquam X 2.5,5,10
Panoxyl Aq 2.5,5,10
Persa-Gel W 5,10%
Benzac W Wash 5,10
Desquam X 5 Wash
gel, topical 5,10%
gel, topical 5,10%
gel, topical 5,10%
gel, aqueous base 5,10%
liquid 2.5,5,10%
Balan
Bioline
CMC
Pharmafair
Stiefel
gel, acetone base, topical 5,10%
gel, acetone base, topical 5,10%
gel, alcohol base, topical 5,10%
gel, alcohol base, topical 5%
gel, alcohol base, topical 10%
gel, alcohol base, topical 5,10%
gel, aqueous base, topical 5,10%
gel, aqueous base, topical 2.5,5,10%
gel, aqueous base, topical 2.5,5,10%
gel, aqueous base, topical 2.5,5,10%
gel, aqueous base, topical 5,10%
liquid, topical 5,10%
liquid, topical 5%
Ortho Derm
Syosset
Owen/Allercreme
Dermik
Dermik
Stiefel
Syosset
Owen/Allercreme
Westwood
Stiefel
Ortho Derm
Owen/Allercreme
Westwood
* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as an
exception to the promulgated criteria for inclusion, pursuant to Rule 790.60.
BENZTROPINE MESYLATE
Benztropine Mesylate
Brand(s)
Cogentin
tablet, oral 0.5,1,2mg
tablet, oral 1,2mg
tablet, oral 0.5,1,2mg
@ tablet, oral 0.5,1,2mg
tablet, oral 0.5,1,2mg
tablet, oral 0.5,1,2mg
CorePharma
Mutual
Par
Quantum
Sidmak
USL
@ tablet, oral 0.5,1,2mg
Merck
BEPRIDIL HYDROCHLORIDE
Brand(s)
26
DRUG
Bepadin
Vascor
Vascor
BETAMETHASONE DIPROPIONATE
Betamethasone Dipropionate
Brand(s)
Alphatrex
Diprosone
Alphatrex
Diprosone
Alphatrex
Diprosone
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
@ tablet, oral 200,300,400mg
tablet, oral 200,300mg
@ tablet, oral 400mg
Wallace
Ortho-McNeil
Ortho-McNeil
cream, topical eq 0.05% base
@ cream, topical eq 0.05% base
cream, topical eq 0.05% base
@ cream, topical eq 0.05% base
cream, topical eq 0.05% base
cream, topical eq 0.05% base
lotion, topical eq 0.05% base
lotion, topical eq 0.05% base
lotion, topical eq 0.05% base
lotion, topical eq 0.05% base
@ lotion, topical eq 0.05% base
lotion, topical eq 0.05% base
lotion, topical eq 0.05% base
ointment, topical eq 0.05% base
@ ointment, topical eq 0.05% base
ointment, topical eq 0.05% base
@ ointment, topical eq 0.05% base
ointment, topical eq 0.05% base
ointment, topical eq 0.05% base
Alpharma
Clay-Park
Fougera/Altana *
Pharmaderm
Taro
Teva
Alpharma
Clay-Park
Copley
Fougera/Altana *
Pharmaderm
Taro
Teva
Alpharma
Clay-Park
Fougera/Altana *
Pharmaderm
Taro
Teva
cream, topical eq 0.05% base
cream, topical eq 0.05% base
lotion, topical eq 0.05% base
lotion, topical eq 0.05% base
ointment, topical eq 0.05% base
@ ointment, topical eq 0.05% base
Savage/Altana
Schering
Savage/Altana
Schering
Savage/Altana
Schering
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
BETAMETHASONE DIPROPIONATE, AUGMENTED
Betamethasone Dipropionate,
ointment, topical eq 0.05% base
Augmented
ointment, topical eq 0.05% base
Brand(s)
Diprolene AF
ointment, topical eq 0.05% base
Alpharma
Altana
Schering *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
BETAMETHASONE DIPROPIONATE; CLOTRIMAZOLE
Betamethasone Dipropionate;
cream, topical eq 0.05% base; 1%
Clotrimazole
cream, topical eq 0.05% base; 1%
cream, topical eq 0.05% base; 1%
Brand(s)
Lotrisone
cream, topical eq 0.05% base; 1%
Alpharma
Altana
Taro
Schering *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
BETAMETHASONE SODIUM PHOSPHATE
Betamethasone Sodium Phosphate injection eq 3mg base/ml
27
Steris
DRUG
DOSAGE FORM, STRENGTH
Brand(s)
Celestone
BETAMETHASONE VALERATE
Betamethasone Valerate
Brand(s)
Beta-Val
Betaderm
Betatrex
Dermabet
Valisone
Valnac
Beta-Val
Betatrex
Valisone
Beta-Val
Betatrex
Valisone
injection eq 3mg base/ml
Clay-Park
Fougera/Altana
Pharmaderm
Pharmafair
Taro
Alpharma
Copley
Fougera/Altana
Pharmaderm
Pharmafair
Alpharma
Clay-Park
Fougera/Altana
Pharmaderm
Pharmafair
cream, topical eq 0.1% base
cream, topical eq 0.1% base
cream, topical eq 0.1% base
cream, topical eq 0.1% base
@ cream, topical eq 0.1% base
cream, topical eq 0.1% base
lotion, topical eq 0.1% base
lotion, topical eq 0.1% base
@ lotion, topical eq 0.1% base
ointment, topical eq 0.1% base
ointment, topical eq 0.1% base
@ ointment, topical eq 0.1% base
Teva
Roaco
Savage/Altana
Taro
Schering
Alpharma
Teva
Savage/Altana
Schering
Teva
Savage/Altana
Schering
Brand(s)
Betoptic
Kerlone
Brand(s)
Urecholine
Duvoid
Myotonachol
Urecholine
Schering
@ cream, topical eq 0.1% base
cream, topical eq 0.1% base
@ cream, topical eq 0.1% base
@ cream, topical eq 0.1% base
cream, topical eq 0.1% base
lotion, topical eq 0.1% base
lotion, topical eq 0.1% base
lotion, topical eq 0.1% base
@ lotion, topical eq 0.1% base
@ lotion, topical eq 0.1% base
ointment, topical eq 0.1% base
@ ointment, topical eq 0.1% base
ointment, topical eq 0.1% base
@ ointment, topical eq 0.1% base
@ ointment, topical eq 0.1% base
BETAXOLOL HYDROCHLORIDE
Betaxolol Hydrochloride
BETHANECHOL CHLORIDE
Bethanechol Chloride
APPLICATION HOLDER,
MANUFACTURER
@
@
@
@
@
@
@
solution, ophthalmic eq 0.5% base
solution, ophthalmic eq 0.5% base
tablet, oral 10,20mg
Akorn
Novex
Amide
solution, ophthalmic eq 0.5% base
tablet, oral 10,20mg
Alcon
Lorex
injection 5mg/ml
tablet, oral 10,25mg
tablet, oral 5,10,25,50mg
tablet, oral 5,10,25mg
tablet, oral 25mg
tablet, oral 5,10,25mg
tablet, oral 5,10,25,50mg
Quad
(Ascot)
Circa
Eon
IVAX
Lannett
Watson
@ injection 5mg/ml
@ tablet, oral 5,10,25,50mg
@ tablet, oral 5,10,25,50mg
tablet, oral 5,10,25,50mg
Sidmak
Wellspring
Glenwood
Odyssey
BIOTIN; ASCORBIC ACID; CYANOCOBALAMIN; DEXPANTHENOL; ERGOCALCIFEROL; FOLIC ACID;
NIACINAMIDE; PYRIDOXINE HYDROCHLORIDE; RIBOFLAVIN PHOSPHATE SODIUM; THIAMINE
28
DRUG
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
HYDROCHLORIDE; VITAMIN A; VITAMIN E
See ASCORBIC ACID; BIOTIN; CYANOCOBALAMIN; DEXPANTHENOL; ERGOCALCIFEROL; FOLIC
ACID; NIACINAMIDE; PYRIDOXINE HYDROCHLORIDE; RIBOFLAVIN PHOSPHATE SODIUM
HYDROCHLORIDE; VITAMIN A; VITAMIN E
BISOPROLOL FUMARATE
Bisoprolol Fumarate
Brand(s)
Zebeta
tablet, oral 5,10mg
tablet, oral 5,10mg
tablet, oral 5,10mg
Copley
Eon
Mutual
tablet, oral 5,10mg
Wyeth *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
BISOPROLOL FUMARATE; HYDROCHLOROTHIAZIDE
Bisoprolol Fumarate;
@ tablet, oral 2.5,5,10mg;6.25mg
Hydrochlorothiazide
tablet, oral 2.5,5,10mg;6.25mg
tablet, oral 2.5,5,10mg;6.25mg
tablet, oral 2.5,5,10mg;6.25mg
tablet, oral 2.5,5,10mg;6.25mg
tablet, oral 2.5,5,10mg;6.25mg
tablet, oral 2.5,5,10mg;6.25mg
tablet, oral 2.5,5,10mg;6.25mg
Brand(s)
Ziac
tablet, oral 2.5,5,10mg;6.25mg
Apothecon
Eon
Geneva
IVAX
Mylan
Purepac
Teva
Watson
Wyeth *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
BLEOMYCIN SULFATE
Bleomycin Sulfate
Brand(s)
Blenoxane
BRETYLIUM TOSYLATE
Bretylium Tosylate
Brand(s)
Bretylol
injection eq 15,30U base/vial
injection eq 15,30U base/vial
injection eq 15,30U base/vial
Faulding
Gensia-Sicor
Pharmacia & Upjohn
injection eq 15,30U base/vial
Bristol-Myers Squibb
injection 50mg/ml
@ injection 50mg/ml
@ injection 50mg/ml
injection 50mg/ml
injection 50mg/ml
injection 50mg/ml
@ injection 50mg/ml
Abbott
American Pharmaceutical
Partners
AstraZeneca
Elkins-Sinn
International Medication
Luitpold
Quad
@ injection 50mg/ml
Faulding
BRETYLIUM TOSYLATE; DEXTROSE
Bretylium Tosylate; Dextrose
injection 200mg/100ml;5gm/100ml
injection 400mg/100ml;5gm/100ml
@ injection 200mg/100ml;5gm/100ml
@ injection 400mg/100ml;5gm/100ml
(continued on the next page)
BRETYLIUM TOSYLATE; DEXTROSE (continued)
injection 200mg/100ml;5gm/100ml
29
Abbott
Abbott
Baxter
Baxter
Braun
DRUG
DOSAGE FORM, STRENGTH
injection 400mg/100ml;5gm/100ml
BROMOCRIPTINE MESYLATE
Bromocriptine Mesylate
Brand(s)
Parlodel
Parlodel
@ capsule, oral eq 5mg base
tablet, oral eq 2mg base
capsule, oral eq 5mg base
tablet, oral eq 2.5mg base
APPLICATION HOLDER,
MANUFACTURER
Braun
Lek
Lek
Novartis *
Novartis *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
BROMODIPHENHYDRAMINE HYDROCHLORIDE; CODEINE PHOSPHATE
Brand(s)
Ambenyl
syrup, oral 12.5mg/5ml;10mg/5ml
Bromanyl
@ syrup, oral 12.5mg/5ml;10mg/5ml
Mybanil
syrup, oral 12.5mg/5ml;10mg/5ml
BROMPHENIRAMINE MALEATE
Brompheniramine Maleate
Brand(s)
Dimetane-Ten
Dimetane
Veltane
Forest
Alpharma
Morton Grove
@ elixir, oral 2mg/5ml
elixir 2mg/5ml
@ elixir 2mg/5ml
@ elixir 2mg/5ml
injection 10mg/ml
@ tablet, oral 4mg
@ tablet, oral 4mg
@ tablet, oral 4mg
@ tablet, oral 4mg
@ tablet, oral 4mg
@ tablet, oral 4mg
tablet, oral 4mg
@ tablet, oral 4mg
tablet, oral 4mg
@ tablet, oral 4mg
tablet, oral 4mg
@ tablet, oral 4mg
Alpharma
KV
Pharmaceutical Associates
USL
Steris
Anabolic
Barr
Eon
Geneva
IVAX
Newtron
Nylos
Par
Phoenix
Pioneer
Private Formulations
Watson
@ injection 10mg/ml
@ tablet, oral 4mg
tablet, oral 4mg
Robins
Wyeth
Lannett
BROMPHENIRAMINE MALEATE; CODEINE PHOSPHATE; PHENYLPROPANOLAMINE HYDROCHLORIDE
Brand(s)
Bromanate DC
syrup, oral 2mg/5ml;10mg/5ml;
Alpharma
12.5mg/5ml
Dimetane-DC
@ syrup, oral 2mg/5ml;10mg/5ml;
Robins
12.5mg/5ml
Myphetane DC
syrup, oral 2mg/5ml;10mg/5ml;
Morton Grove
12.5mg/5ml
BROMPHENIRAMINE MALEATE; DEXTROMETHORPHAN HYDROBROMIDE; PSEUDOEPHEDRINE
30
DRUG
HYDROCHLORIDE
Brand(s)
Bromanate DM
Bromfed-DM
Dimetane-DX
Myphetane DX
DOSAGE FORM, STRENGTH
@ syrup, oral 2mg/5ml;10mg/5ml;
30mg/5ml
syrup, oral 2mg/5ml;10mg/5ml;
30mg/5ml
@ syrup, oral 2mg/5ml;10mg/5ml;
30mg/5ml
syrup, oral 2mg/5ml;10mg/5ml;
30mg/5ml
APPLICATION HOLDER,
MANUFACTURER
Alpharma
Muro
Robins
Morton Grove
BROMPHENIRAMINE MALEATE; PHENYLPROPANOLAMINE HYDROCHLORIDE
Brand(s)
Biphetapp
@ elixir, oral 4mg/5ml;25mg/5ml
Morton Grove
Bromanate
@ elixir, oral 4mg/5ml;25mg/5ml
Alpharma
BUMETANIDE
Bumetanide
Brand(s)
Bumex
Bumex
injection 0.25mg/ml
injection 0.25mg/ml
injection 0.25mg/ml
tablet, oral 0.5,1,2mg
tablet, oral 0.5,1,2mg
Abbott
Bedford
Gensia Sicor
Eon
IVAX
injection 0.25mg/ml
tablet, oral 0.5,1,2mg
Roche
Roche *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
BUPIVACAINE HYDROCHLORIDE
Bupivacaine Hydrochloride
Brand(s)
Marcaine HCl
Marcaine HCl Preservative Free
Sensorcaine
Marcaine
Sensorcaine
injection 0.25,0.5,0.75%
injection, spinal 0.75%
Abbott
Abbott
injection 0.25,0.5%
injection 0.25,0.5,0.75%
injection 0.25,0.5,0.75%
injection, spinal 0.75%
injection, spinal 0.75%
Abbott
Abbott
AstraZeneca
Abbott
AstraZeneca
BUPIVACAINE HYDROCHLORIDE; EPINEPHRINE BITARTRATE
Brand(s)
Marcaine HCl with Epinephrine
injection 0.25%;0.0091mg/ml
Marcaine HCl with Epinephrine
injection 0.5%;0.0091mg/ml
Marcaine HCl with Epinephrine
injection 0.25%;0.0091mg/ml
Preservative Free
Marcaine HCl with Epinephrine
injection 0.5%;0.0091mg/ml
Preservative Free
Marcaine HCl with Epinephrine
injection 0.75%;0.0091mg/ml
Preservative Free
Sensorcaine
injection 0.25%;0.0091mg/ml
Sensorcaine
injection 0.5%;0.0091mg/ml
Sensorcaine
injection 0.75%;0.0091mg/ml
31
Abbott
Abbott
Abbott
Abbott
Abbott
AstraZeneca
AstraZeneca
AstraZeneca
DRUG
DOSAGE FORM, STRENGTH
BUPRENORPHINE HYDROCHLORIDE
Buprenorphine Hydrochloride
injection eq 0.3mg base/ml
Brand(s)
Buprenex
injection eq 0.3mg base/ml
BUPROPION HYDROCHLORIDE
Bupropion Hydrochloride
Brand(s)
Wellbutrin
Wellbutrin SR
tablet, oral 75,100mg
@ tablet, oral 75,100mg
tablet, oral 75,100mg
tablet, oral 75,100mg
tablet, oral 75,100mg
tablet, oral 75,100mg
tablet, extended release 100,150mg
APPLICATION HOLDER,
MANUFACTURER
Abbott
Reckitt Benckiser
Eon
ESI Lederle
Geneva
Mylan
Teva
GlaxoSmithKline
GlaxoSmithKline *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
BUSPIRONE
Buspirone
Brand(s)
Buspar
Vanspar
tablet, oral 5,10,15mg
tablet, oral 5,10,15mg
tablet, oral 5,10,15mg
tablet, oral 5,10,15,30mg
tablet, oral 5,10,15mg
tablet, oral 5,10,15mg
tablet, oral 5,10,15mg
tablet, oral 5,10,15mg
tablet, oral 5,10,15mg
Geneva
IVAX
KV
Mylan
Par
Pharmex
Teva
TorPharm
Watson
tablet, oral 5,10,15,30mg
tablet, oral 7.5mg
Bristol-Myers Squibb
Par *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
BUTABARBITAL SODIUM
Butabarbital Sodium
Brand(s)
Butabarb
Butisol Sodium
Sarisol
Butisol Sodium
Sarisol No. 1, No. 2
@ elixir, oral 30mg/5ml
tablet, oral 30mg
@ tablet, oral 15,30mg
@ tablet, oral 15,30mg
@ tablet, oral 15,30mg
@ tablet, oral 15,30,100mg
tablet, oral 16.2,32.4mg
@ tablet, oral 16.2,32.4mg
@ tablet, oral 15,30mg
@ tablet, oral 15,30mg
@ tablet, oral 15,30mg
@ tablet, oral 15,30mg
Morton Grove
Bundy
Eon
Geneva
IVAX
Lannett
Marshall
Solvay
Teva
Watson
West-ward
Whiteworth Towne
@ elixir, oral 30mg/5ml
elixir, oral 30mg/5ml
@ elixir, oral 30mg/5ml
tablet, oral 15,30,100mg
@ tablet, oral 15,30mg
Alpharma
Wallace
Halsey
Wallace
Halsey
BUTALBITAL; ACETAMINOPHEN
See ACETAMINOPHEN; BUTALBITAL
32
DRUG
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
BUTALBITAL; ACETAMINOPHEN; CAFFEINE
See ACETAMINOPHEN; BUTALBITAL; CAFFEINE
BUTALBITAL; ASPIRIN; CAFFEINE
See ASPIRIN; BUTALBITAL; CAFFEINE
BUTORPHANOL TARTRATE
Butorphanol Tartrate
Brand(s)
Butorphanol Tartrate
Preservative-Free
Butorphanol Tartrate
Preservative-Free
Butorphanol Tartrate
Preservative-Free
Butorphanol Tartrate
Preservative-Free
Butorphanol Tartrate
Preservative-Free
Stadol
Stadol Preservative Free
Stadol NS
injection 1,2mg/ml
injection 1,2mg/ml
injection 1,2mg/ml
injection 1,2mg/ml
spray, metered, nasal 1mg/spray
spray, metered, nasal 1mg/spray
spray, metered, nasal 1mg/spray
Abbott
Apotex
Bedford
Faulding
Mylan
Novex
Roxane
injection 1,2mg/ml
Abbott
injection 1,2mg/ml
Apotex
injection 1,2mg/ml
Bedford
injection 1,2mg/ml
Faulding
injection 1,2mg/ml
Meridian
injection 1,2mg/ml
injection 1,2mg/ml
spray, metered, nasal 1mg/spray
Apothecon
Apothecon
Bristol-Myers Squibb
CAFFEINE; ACETAMINOPHEN; BUTALBITAL
See ACETAMINOPHEN; BUTALBITAL; CAFFEINE
CAFFEINE; ASPIRIN; BUTALBITAL
See ASPIRIN; BUTALBITAL; CAFFEINE
CAFFEINE; ASPIRIN; ORPHENADRINE CITRATE
See ASPIRIN: CAFFEINE: ORPHENADRINE CITRATE
CAFFEINE; ASPIRIN; PROPOXYPHENE HYDROCHLORIDE;
See ASPIRIN; CAFFEINE; PROPOXYPHENE HYDROCHLORIDE
CAFFEINE; ERGOTAMINE TARTRATE
Brand(s)
Cafergot
@ tablet, oral 100mg;1mg
Ercatab
tablet, oral 100mg;1mg
Wigraine
@ tablet, oral 100mg;1mg
Novartis
Geneva
Organon/Akzona
CALCITONIN, SALMON
Calcitonin-Salmon
@ injection 200IU/ml
AstraZeneca
Brand(s)
Calcimar
injection 200IU/ml
Aventis *
Miacalcin
injection 200IU/ml
Novartis
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
33
DRUG
CALCITRIOL
Calcitriol
Brand(s)
Rocaltrol
Rocaltrol
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
capsule, oral 0.25,0.5mcg
solution, oral 1mcg/ml
Teva
Roxane
capsule, oral 0.25,0.5mcg
solution, oral 1mcg/ml
Roche
Roche
CALCIUM CHLORIDE; DEXTROSE; GLUTATHIONE DISULFIDE; MAGNESIUM CHLORIDE; POTASSIUM
CHLORIDE; SODIUM BICARBONATE; SODIUM CHLORIDE; SODIUM PHOSPHATE
Brand(s)
BSS Plus
solution, irrigation 0.154mg/ml;
Alcon
0.92mg/ml;0.184mg/ml;
0.2mg/ml;0.38mg/ml;2.1mg/ml;
7.14mg/ml;0.42mg/ml
Endosol Extra
solution, irrigation 0.154mg/ml;
Akorn
0.92mg/ml;0.184mg/ml;
0.2mg/ml;0.38mg/ml;2.1mg/ml;
7.14mg/ml;0.42mg/ml
CALCIUM CHLORIDE; DEXTROSE; MAGNESIUM CHLORIDE; SODIUM CHLORIDE; SODIUM LACTATE
Solution; intraperitoneal; in plastic container
Brand(s)
Delflex with Dextrose 1.5%
solution 25.7mg/100ml;
Fresenius
(low magnesium)
1.5gm/100ml;5.08mg/100ml;
538mg/100ml;448mg/100ml
Delflex with Dextrose 2.5%
solution 25.7mg/100ml;
Fresenius
(low magnesium)
2.5gm/100ml;5.08mg/100ml;
538mg/100ml;448mg/100ml
Delflex with Dextrose 3.5%
solution 25.7mg/100ml;
Fresenius
(low magnesium)
3.5gm/100ml;5.08mg/100ml;
538mg/100ml;448mg/100ml
Delflex with Dextrose 4.25%
solution 25.7mg/100ml;
Fresenius
(low magnesium)
4.25gm/100ml;5.08mg/100ml;
538mg/100ml;448mg/100ml
Delflex with Dextrose 1.5%
solution, 18.4mg/100ml;
Fresenius
Low Magnesium
1.5gm/100ml; 5.08mg/100ml;
Low Calcium
538mg/100ml; 448mg/100ml
Delflex with Dextrose 2.5%
solution, 18.4mg/100ml;
Fresenius
Low Magnesium
2.5gm/100ml; 5.08mg/100ml;
Low Calcium
538mg/100ml; 448mg/100ml
Delflex with Dextrose 4.25%
solution, 18.4mg/100ml;
Fresenius
Low Magnesium
4.25gm/100ml; 5.08mg/100ml;
Low Calcium
538mg/100ml; 448mg/100ml
Delflex with Dextrose 1.5%
solution 25.7mg/100ml;
Fresenius
1.5gm/100ml;15.2mg/100ml;
567mg/100ml;392mg/100ml
Delflex with Dextrose 2.5%
solution 25.7mg/100ml;
Fresenius
2.5gm/100ml;15.2mg/100ml;
567mg/100ml;392mg/100ml
Delflex with Dextrose 3.5%
solution 25.7mg/100ml;
Fresenius
3.5gm/100ml;15.2mg/100ml;
567mg/100ml;392mg/100ml
Delflex with Dextrose 4.25%
solution 25.7mg/100ml;
Fresenius
4.25gm/100ml;15.2mg/100ml;
567mg/100ml;392mg/100ml
Dianeal PD-1
solution 25.7mg/100ml;
Baxter
with Dextrose 1.5%
1.5gm/100ml;15.2mg/100ml;
567mg/100ml;392mg/100ml
Dianeal PD-1
solution 25.7mg/100ml;
Baxter
with Dextrose 2.5%
2.5gm/100ml;15.2mg/100ml;
567mg/100ml;392mg/100ml
(continued on the next page)
CALCIUM CHLORIDE; DEXTROSE; MAGNESIUM CHLORIDE; SODIUM CHLORIDE; SODIUM LACTATE
34
DRUG
(continued)
Dianeal PD-1
with Dextrose 3.5%
Dianeal PD-1
with Dextrose 4.25%
Dianeal PD-2
with Dextrose 1.5%
Dianeal PD-2
with Dextrose 1.5%
Low Calcium
Dianeal PD-2
with Dextrose 2.5%
Dianeal PD-2
with Dextrose 3.5%
Dianeal PD-2
with Dextrose 4.25%
Dianeal 137
with Dextrose 1.5%
Dianeal 137
with Dextrose 2.5%
Dianeal 137
with Dextrose 4.25%
Dianeal Low Calcium
with Dextrose 1.5%
Dianeal Low Calcium
with Dextrose 2.5%
Dianeal Low Calcium
with Dextrose 3.5%
Dianeal Low Calcium
with Dextrose 4.25%
Inpersol-LC/LM
with Dextrose 1.5%
Inpersol-LC/LM
with Dextrose 2.5%
Inpersol-LC/LM
with Dextrose 3.5%
Inpersol-LC/LM
with Dextrose 4.25%
DOSAGE FORM, STRENGTH
solution 25.7mg/100ml;3.5gm/
100ml;15.2mg/100ml;
567mg/100ml;392mg/100ml
solution 25.7mg/100ml;
4.25gm/100ml;15.2mg/100ml;
567mg/100ml;392mg/100ml
solution 25.7mg/100ml;
1.5gm/100ml;5.08mg/100ml;
538mg/100ml;448mg/100ml
solution, 18.3mg/100ml;
1.5gm/100ml; 5.08mg/100ml;
538mg/100ml; 448mg/100ml
solution 25.7mg/100ml;
2.5gm/100ml;5.08mg/100ml;
538mg/100ml;448mg/100ml
solution 25.7mg/100ml;
3.5gm/100ml;5.08mg/100ml;
538mg/100ml;448mg/100ml
solution 25.7mg/100ml;
4.25gm/100ml;5.08mg/100ml;
538mg/100ml;448mg/100ml
solution 25.7mg/100ml;
1.5gm/100ml;15.2mg/100ml;
567mg/100ml;392mg/100ml
solution 25.7mg/100ml;
2.5gm/100ml;15.2mg/100ml;
567mg/100ml;392mg/100ml
solution 25.7mg/100ml;
4.25gm/100ml;15.2mg/100ml;
567mg/100ml;392mg/100ml
solution, 18.3mg/100ml;
1.5gm/100ml; 5.08mg/100ml;
538mg/100ml; 448mg/100ml
solution, 18.3mg/100ml;
2.5gm/100ml; 5.08mg/100ml;
538mg/100ml; 448mg/100ml
solution, 18.3mg/100ml;
3.5gm/100ml; 5.08mg/100ml;
538mg/100ml; 448mg/100ml
solution, 18.3mg/100ml;
4.25gm/100ml; 5.08mg/100ml;
538mg/100ml; 448mg/100ml
solution, 18.4mg/100ml;
1.5gm/100ml; 5.08mg/100ml;
538mg/100ml; 448mg/100ml
solution, 18.4mg/100ml;
2.5gm/100ml; 5.08mg/100ml;
538mg/100ml; 448mg/100ml
solution, 18.4mg/100ml;
3.5gm/100ml; 5.08mg/100ml;
538mg/100ml; 448mg/100ml
solution, 18.4mg/100ml;
4.25gm/100ml; 5.08mg/100ml;
538mg/100ml; 448mg/100ml
35
APPLICATION HOLDER,
MANUFACTURER
Baxter
Baxter
Baxter
Baxter
Baxter
Baxter
Baxter
Baxter
Baxter
Baxter
Baxter
Baxter
Baxter
Baxter
Fresenius
Fresenius
Fresenius
Fresenius
DRUG
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
CALCIUM CHLORIDE; DEXTROSE; POTASSIUM CHLORIDE; SODIUM CHLORIDE
Injection; in plastic container
Dextrose 5% in Ringer's
injection 33mg/100ml;5gm/100ml;
Abbott
30mg/100mg;860mg/100ml
Dextrose 5% in Ringer's
injection 33mg/100ml;5gm/100ml;
Baxter
30mg/100mg;860mg/100ml
Dextrose 5% in Ringer's
injection 33mg/100ml;5gm/100ml;
Braun
30mg/100mg;860mg/100ml
CALCIUM CHLORIDE; DEXTROSE; POTASSIUM CHLORIDE; SODIUM CHLORIDE; SODIUM LACTATE
Injection; in plastic container
Dextrose 5% in
injection 20mg/100ml;5gm/100ml;
Abbott
Lactated Ringer's
30mg/100ml;600mg/100ml;
310mg/100ml
Dextrose 5% in
injection 20mg/100ml;5gm/100ml;
Baxter
Lactated Ringer's
30mg/100ml;600mg/100ml;
310mg/100ml
Dextrose 5% in
injection 20mg/100ml;5gm/100ml;
Braun
Lactated Ringer's
30mg/100ml;600mg/100ml;
310mg/100ml
Dextrose 5% in
@ injection 20mg/100ml;5gm/100ml;
Miles
Lactated Ringer's
30mg/100ml;600mg/100ml;
310mg/100ml
Dextrose 5% in
@ injection 20mg/100ml;5gm/100ml;
Abbott
Lactated Ringer's
104mg/100ml;600mg/100ml;
with 10mEq KCl
310mg/100ml
Dextrose 5% in
injection 20mg/100ml;5gm/100ml;
Baxter
Lactated Ringer's
105mg/100ml;600mg/100ml;
with 10mEq KCl
310mg/100ml
Dextrose 5% in
injection 20mg/100ml;5gm/100ml;
Abbott
Lactated Ringer's
179mg/100ml;600mg/100ml;
with 20mEq KCl
310mg/ml
Dextrose 5% in
injection 20mg/100ml;5gm/100ml;
Baxter
Lactated Ringer's
179mg/100ml;600mg/100ml;
with 20mEq KCl
310mg/ml
Dextrose 5% in
@ injection 20mg/100ml;5gm/100ml;
Abbott
Lactated Ringer's
254mg/100ml;600mg/100ml;
with 30mEq KCl
310mg/100ml
Dextrose 5% in
injection 20mg/100ml;5gm/100ml;
Baxter
Lactated Ringer's
254mg/100ml;600mg/100ml;
with 30mEq KCl
310mg/100ml
Dextrose 5% in
injection 20mg/100ml;5gm/100ml;
Abbott
Lactated Ringer's
328mg/100ml;600mg/100ml;
with 40mEq KCl
310mg/100ml
Dextrose 5% in
injection 20mg/100ml;5gm/100ml;
Baxter
Lactated Ringer's
328mg/100ml;600mg/100ml;
with 40mEq KCl
310mg/100ml
CALCIUM CHLORIDE; MAGNESIUM CHLORIDE; POTASSIUM CHLORIDE; SODIUM CHLORIDE
Brand(s)
Cardioplegic in plastic container solution, perfusion, cardiac
Baxter
17.6mg/100ml; 325.3mg/100mg;
119.3mg/100ml; 643mg/100ml
Plegisol in plastic container
solution, perfusion, cardiac
Abbott
17.6mg/100ml; 325.3mg/100mg;
119.3mg/100ml; 643mg/100ml
36
DRUG
DOSAGE FORM, STRENGTH
CALCIUM CHLORIDE; POTASSIUM CHLORIDE; SODIUM CHLORIDE
Injection; in plastic container
Solution for irrigation; in plastic container
Ringer's
injection 33mg/100ml;30mg/100ml;
860mg/100ml
Ringer's
injection 33mg/100ml;30mg/100ml;
860mg/100ml
Ringer's
injection 33mg/100ml;30mg/100ml;
860mg/100ml
Ringer's
solution for irrigation 33mg/100ml;
30mg/100ml; 860mg/100ml
Ringer's
solution for irrigation 33mg/100ml;
30mg/100ml; 860mg/100ml
Ringer's
solution for irrigation 33mg/100ml;
30mg/100ml; 860mg/100ml
APPLICATION HOLDER,
MANUFACTURER
Abbott
Baxter
Braun
Abbott
Baxter
Braun
CALCIUM CHLORIDE; POTASSIUM CHLORIDE; SODIUM CHLORIDE; SODIUM LACTATE
Injection; in plastic container
Solution for irrigation; in plastic container
Lactated Ringer's
injection 20mg/100ml;30mg/100ml;
Abbott
600mg/100ml;310mg/100ml
Lactated Ringer's
injection 20mg/100ml;30mg/100ml;
Baxter
600mg/100ml;310mg/100ml
Lactated Ringer's
injection 20mg/100ml;30mg/100ml;
Braun
600mg/100ml;310mg/100ml
Lactated Ringer's
@ injection 20mg/100ml;30mg/100ml;
Miles
600mg/100ml;310mg/100ml
Lactated Ringer's
solution 20mg/100ml;30mg/100ml;
Abbott
600mg/100ml;310mg/100ml
Lactated Ringer's
solution 20mg/100ml;30mg/100ml;
Baxter
600mg/100ml;310mg/100ml
Lactated Ringer's
solution 20mg/100ml;30mg/100ml;
Braun
600mg/100ml;310mg/100ml
CALCIUM GLUBIONATE
Brand(s)
Calciquid
Neo-Calglucon
solution, oral 1.8gm/5ml
solution, oral 1.8gm/5ml
Econolab
Novartis
* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as an
exception to the promulgated criteria for inclusion, pursuant to Rule 790.60.
CALCIUM GLUCEPTATE
Calcium Gluceptate
CALCIUM GLUCONATE
Calcium Gluconate
(continued on the next page)
@ injection 0.09gm/5ml
(eq 90mg calcium)
@ injection 0.09gm/5ml
(eq 90mg calcium)
@ injection 0.09gm/5ml
(eq 90mg calcium)
injection 100mg/ml
injection 100mg/ml
injection 100mg/ml
37
Abbott
American Pharmaceutical
Partners
Lilly
AstraZeneca
American Pharmaceutical
Partners
Elkins-Sinn
DRUG
CALCIUM GLUCONATE (continued)
DOSAGE FORM, STRENGTH
injection 100mg/ml
injection 100mg/ml
APPLICATION HOLDER,
MANUFACTURER
Pharmacia & Upjohn
Warner Chilcott
* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as an
exception to the promulgated criteria for inclusion, pursuant to Section 790.60.
CAPTOPRIL
Captopril
Brand(s)
Capoten
tablet, oral 12.5,25,50,100mg
tablet, oral 12.5,25,50,100mg
tablet, oral 12.5,25,50,100mg
tablet, oral 12.5,25,50,100mg
tablet, oral 12.5,25,50,100mg
tablet, oral 12.5,25,50,100mg
tablet, oral 12.5,25,50,100mg
tablet, oral 12.5,25,50,100mg
tablet, oral 12.5,25,50,100mg
tablet, oral 12.5,25,50,100mg
tablet, oral 12.5,25,50,100mg
tablet, oral 12.5,25,50,100mg
tablet, oral 12.5,25,50,100mg
tablet, oral 12.5,25,50,100mg
tablet, oral 12.5,25,50,100mg
tablet, oral 12.5,25,50,100mg
tablet, oral 12.5,25,50,100mg
tablet, oral 12.5,25,50,100mg
Apothecon
Clonmel
Copley
Egis
Endo
Eon
Geneva
Hallmark
IVAX
Mylan
Par
Purepac
Stason
Teva
TorPharm
Watson
West-ward
Wockhardt
tablet, oral 12.5,25,50,100mg
Par
CAPTOPRIL; HYDROCHLOROTHIAZIDE
Captopril; Hydrochlorothiazide
tablet, oral 25mg;15mg, 25mg;25mg,
50mg;15mg, 50mg;25mg
tablet, oral 25mg;15mg, 25mg;25mg,
50mg;15mg, 50mg;25mg
tablet, oral 25mg;15mg, 25mg;25mg,
50mg;15mg, 50mg;25mg
tablet, oral 25mg;15mg, 25mg;25mg,
50mg;15mg, 50mg;25mg
@ tablet, oral 50mg;25mg
Brand(s)
Capozide
tablet, oral 25mg;15mg, 25mg;25mg,
50mg;15mg, 50mg;25mg
CARBACHOL
Carbachol
Brand(s)
Carbastat
Miostat
CARBAMAZEPINE
Carbamazepine
(continued on the next page)
@ solution, intraocular 0.01%
Endo
IVAX
Mylan
Teva
Watson
Apothecon
Pharmafair
solution, intraocular 0.01%
solution, intraocular 0.01%
Novartis
Alcon
suspension, oral 100mg/5ml
suspension, oral 100mg/5ml
tablet, chewable 100mg
tablet, chewable 100mg
tablet, chewable 100mg
tablet, oral 200mg
tablet, oral 200mg
Morton Grove
Taro
Caraco
Taro
Warner Chilcott
Apotex
Inwood/Forest
38
DRUG
CARBAMAZEPINE (continued)
Brand(s)
Tegretol
Epitol
Tegretol
Epitol
Tegretol
CARBENICILLIN, DISODIUM
Brand(s)
Geopen
Pyopen
DOSAGE FORM, STRENGTH
tablet, oral 200mg
tablet, oral 200mg
tablet, oral 200mg
@ tablet, oral 200mg
@ tablet, oral 200mg
suspension, oral 100mg/5ml
tablet, chewable 100mg
tablet, chewable 100mg
tablet, oral 200mg
tablet, oral 200mg
@ injection eq 1,2 5,10gm base/vial
@ injection eq 1,2,5,10gm base/vial
CARBIDOPA; LEVODOPA
Carbidopa; Levodopa
@
@
@
@
@
@
Brand(s)
Sinemet 10/100
Sinemet 25/100
Sinemet 25/250
Sinemet CR 25/100
Sinemet CR 50/200
APPLICATION HOLDER,
MANUFACTURER
Purepac
Sidmak
Taro
USL
Warner Chilcott
Novartis
Teva
Novartis
Teva
Novartis
Roerig-Pfizer
GlaxoSmithKline
tablet, oral 10mg;100mg
tablet, oral 25mg;100mg
tablet, oral 25mg;250mg
tablet, oral 10mg;100mg
tablet, oral 25mg;100mg
tablet, oral 25mg;250mg
tablet, oral 10mg;100mg
tablet, oral 25mg;100mg
tablet, oral 25mg;250mg
tablet, oral 10mg;100mg
tablet, oral 25mg;100mg
tablet, oral 25mg;250mg
tablet, oral 10mg;100mg
tablet, oral 25mg;100mg
tablet, oral 25mg;250mg
tablet, extended release 25mg;100mg
tablet, extended release 50mg;200mg
Geneva
Geneva
Geneva
Purepac
Purepac
Purepac
SCS
SCS
SCS
Teva
Teva
Teva
Watson
Watson
Watson
Mylan
Mylan
tablet, oral 10mg;100mg
tablet, oral 25mg;100mg
tablet, oral 25mg;250mg
tablet, extended release 25mg;200mg
tablet, extended release 50mg;200mg
Bristol-Myers Squibb *
Bristol-Myers Squibb *
Bristol-Myers Squibb *
Bristol-Myers Squibb *
Bristol-Myers Squibb *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
CARBINOXAMINE MALEATE; DEXTROMETHORPHAN HYDROBROMIDE; PSEUDOEPHEDRINE
HYDROCHLORIDE
Carbinoxamine Maleate;
syrup, oral 4mg/5ml;15mg/5ml;
Geneva
Dextromethorphan Hydrobromide; 60mg/5ml
Pseudoephedrine Hydrochloride syrup, oral 4mg/5ml;15mg/5ml;
Morton Grove
60mg/5ml
Brand(s)
Carbofed DM Drops
drops, oral 2mg/ml;4mg/ml;25mg/ml
Hi-Tech
Cardec DM Drops
drops, oral 2mg/ml;4mg/ml;25mg/ml
Alpharma
Chemdec DM Drops
drops, oral 2mg/ml;4mg/ml;25mg/ml
Norton
E-Dec DM Drops
drops, oral 2mg/ml;4mg/ml;25mg/ml
Esquire
Rondec DM Drops
drops, oral 2mg/ml;4mg/ml;25mg/ml
Ross/Abbott
(continued on the next page)
39
DRUG
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
CARBINOXAMINE MALEATE; DEXTROMETHORPHAN HYDROBROMIDE; PSEUDOEPHEDRINE
HYDROCHLORIDE (continued)
Carbofed DM Syrup
syrup, oral 4mg/5ml;15mg/5ml;
Hi-Tech
60mg/5ml
Cardec DM Syrup
syrup, oral 4mg/5ml;15mg/5ml;
Alpharma
60mg/5ml
Chemdec DM Syrup
syrup, oral 4mg/5ml;15mg/5ml;
Norton
60mg/5ml
E-Dec DM Syrup
syrup, oral 4mg/5ml;15mg/5ml;
Esquire
60mg/5ml
Maldec DM Syrup
syrup, oral 4mg/5ml;15mg/5ml;
Cenci
60mg/5ml
Rondec DM Syrup
syrup, oral 4mg/5ml;15mg/5ml;
Ross/Abbott
60mg/5ml
* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as an
exception to the promulgated criteria for inclusion, pursuant to Rule 790.60.
CARBINOXAMINE MALEATE; PSEUDOEPHEDRINE HYDROCHLORIDE
Carbinoxamine Maleate;
drops, oral 2mg/ml;25mg/ml
Pseudoephedrine Hydrochloride drops, oral 2mg/ml;25mg/ml
syrup, oral 4mg/5ml;60mg/5ml
Brand(s)
Rondec Drops
drops, oral 2mg/ml;25mg/ml
Chemdec Syrup
syrup, oral 4mg/5ml;60mg/5ml
Maldec
syrup, oral 4mg/5ml;60mg/5ml
Rondec Syrup
syrup, oral 4mg/5ml;60mg/5ml
Alpharma
Morton Grove
Alpharma
Ross
Norton
Cenci
Ross
* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as an
exception to the promulgated criteria for inclusion, pursuant to Rule 790.60.
CARISOPRODOL
Carisoprodol
Rela
Soma
Brand(s)
tablet, oral 350mg
tablet, oral 350mg
@ tablet, oral 350mg
tablet, oral 350mg
@ tablet, oral 350mg
tablet, oral 350mg
tablet, oral 350mg
@ tablet, oral 350mg
tablet, oral 350mg
tablet, oral 350mg
tablet, oral 350mg
Able
Amide
Circa
CorePharma
Eon
Geneva
Mutual
Pioneer
Vintage
Watson
West-ward
@ tablet, oral 350mg
tablet, oral 350mg
Schering
Wallace
CARISOPRODOL; ASPIRIN
See ASPIRIN; CARISOPRODOL
CARISOPRODOL; ASPIRIN; CODEINE PHOSPHATE
See ASPIRIN; CARISOPRODOL; CODEINE PHOSPHATE
40
DRUG
CARTEOLOL HYDROCHLORIDE
Carteolol Hydrochloride
Brand(s)
Ocupres
CEFACLOR
Cefaclor
Ceclor
Ceclor
Brand(s)
Ceclor CD
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
solution, ophthalmic 1%
solution, ophthalmic 1%
solution, ophthalmic 1%
Alcon
Bausch and Lomb
Novex
solution, ophthalmic 1%
Novartis
capsule, oral eq 250,500mg base
@ capsule, oral eq 250,500mg base
capsule, oral eq 250,500mg base
capsule, oral eq 250,500mg base
capsule, oral eq 250,500mg base
@ powder for suspension, oral eq 125,
187,250mg base/5ml
powder for suspension, oral eq
375mg base/5ml
@ powder for suspension, oral eq 125,
187,250,375mg base/5ml
powder for suspension, oral eq 125,
187,250,375mg base/5ml
powder for suspension, oral eq 125,
187,250,375mg base/5ml
tablet, extended release
eq 500mg base
tablet, extended release
eq 375,500mg base
capsule, oral eq 250,500mg base
powder for suspension, eq 125,187,
250,375mg base/5ml
tablet, extended release
eq 375,500mg base
IVAX
Lederle
Marsam
Ranbaxy
Teva
IVAX
IVAX
Lederle
Marsam
Ranbaxy
IVAX
Teva
Lilly *
Lilly *
Lilly
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
CEFADROXIL/CEFADROXIL HEMIHYDRATE
Cefadroxil/
capsule, oral eq 500mg base
Cefadroxil Hemihydrate
capsule, oral eq 500mg base
@ capsule, oral eq 500mg base
@ capsule, oral eq 500mg base
@ powder for suspension
eq 125,250,500mg base/5ml
@ powder for suspension
eq 125,250,500mg base/5ml
@ tablet, oral eq 1gm base
tablet, oral eq 1gm base
Brand(s)
Duricef
capsule, oral eq 500mg base
Ultracef
capsule, oral eq 500mg base
Duricef
powder for suspension
eq 125,250,500mg base/5ml
Duricef
tablet, oral eq 1gm base
Ultracef
@ tablet, oral eq 1gm base
Barr
IVAX
Purepac
Teva
Apothecon
Teva
IVAX
Ranbaxy
Warner Chilcott *
Apothecon
Warner Chilcott
Warner Chilcott
Apothecon
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
41
DRUG
CEFAZOLIN SODIUM
Cefazolin Sodium
DOSAGE FORM, STRENGTH
injection eq 500mg,1gm base/vial
@ injection eq 10,20gm base/vial
Ancef
Ancef
Kefzol
Brand(s)
Zolicef
CEFOTAXIME SODIUM
Cefotaxime Sodium
Brand(s)
Claforan
CEFOXITIN SODIUM
Cefoxitin Sodium
Brand(s)
Mefoxin
CEFPODOXIME PROXETIL
Cefpodoxime Proxetil
Banan
Brand(s)
Vantin
Banan
Vantin
CEFTAZIDIME
Brand(s)
Fortaz
Tazicef
Tazidime
@ injection eq 250,500mg,1,5,10gm
base/vial
@ injection eq 250,500mg,1,5,10,20gm
base/vial
injection eq 250,500mg,1,5,10,20gm
base/vial
@ injection eq 250,500mg,1gm
base/vial
injection eq 5,10gm base/vial
injection eq 500mg,1gm base/vial
@ injection eq 250mg base/vial
injection eq 500mg,1,5,10gm base/vial
injection eq 250,500mg,1,10,20gm
base/vial
injection eq 500mg,1,10gm base/vial
APPLICATION HOLDER,
MANUFACTURER
American Pharmaceutical
Partners
American Pharmaceutical
Partners
Bedford
Elkins-Sinn
Marsam
Teva
Teva
West-ward
GlaxoSmithKline
GlaxoSmithKline
Lilly
Apothecon
injection eq 500mg,
1,2,10,20gm base/vial
American Pharmaceutical
Partners
injection eq 500mg,
1,2,10,20gm base/vial
Aventis
injection eq 1,2,10gm base/vial
injection eq 1,2,10gm base/vial
American Pharmaceutical
Partners
ESI Lederle
injection eq 1,2,10gm base/vial
Merck
granules for suspension
eq 50,100mg base/5ml
Ranbaxy
@ granules for suspension
eq 50,100mg base/5ml
granules for suspension
eq 50,100mg base/5ml
@ tablet, oral eq 100,200mg base
tablet, oral eq 100,200mg base
injection 500mg,1,2,6gm/vial
injection 500mg,1,2,6gm/vial
injection 500mg,1,2gm/vial
CEFTAZIDIME (ARGININE FORMULATION)
Brand(s)
Ceptaz
injection 1,2,10gm/vial
Pentacef
@ injection 1,2,10gm/vial
42
Sankyo
Pharmacia & Upjohn
Sankyo
Pharmacia & Upjohn
GlaxoSmithKline
Abbott
Lilly
GlaxoSmithKline
GlaxoSmithKline
DRUG
DOSAGE FORM, STRENGTH
CEFTAZIDIME SODIUM
Ceftazidime Sodium
Fortaz
Brand(s)
Fortaz
injection, in plastic container
eq 10,20,40mg base/ml
@ injection, in plastic container
eq 10mg base/ml
injection, in plastic container
eq 20,40mg base/ml
CEFUROXIME AXETIL
Cefuroxime Axetil
Ceftin
Brand(s)
CEFUROXIME SODIUM
Cefuroxime Sodium
Zinacef
Zinacef
@
@
@
@
GlaxoSmithKline
tablet, oral eq 125,250,500mg base
GlaxoSmithKline
injection, IM/IV eq 7.5gm base/vial
American Pharmaceutical
Partners
Hanford
Marsam
Teva
American Pharmaceutical
Partners
Hanford
Marsam
Teva
injection, IM/IV eq 750mg base/vial
injection eq 1.5,7.5gm base/vial
@ injection, in plastic container
eq 750mg,1.5gm base/vial
injection, IM/IV eq 750mg base/vial
injection eq 1.5,7.5gm base/vial
@
GlaxoSmithKline
Apotex
Ranbaxy
injection eq 1.5,7.5gm base/vial
injection eq 1.5,7.5gm base/vial
injection eq 1.5,7.5gm base/vial
CEPHALEXIN
Cephalexin
Baxter
tablet, oral eq 250,500mg base
tablet, oral eq 125,250,500mg base
injection, IM/IV eq 7.5gm base/vial
injection, IM/IV eq 7.5gm base/vial
injection, IM/IV eq 7.5gm base/vial
injection eq 1.5,7.5gm base/vial
Brand(s)
Kefurox
Kefurox
Kefurox
APPLICATION HOLDER,
MANUFACTURER
capsule, oral eq 250,500mg base
capsule, oral eq 250,500mg base
capsule, oral eq 250,500mg base
capsule, oral eq 250,500mg base
capsule, oral eq 250,500mg base
capsule, oral eq 250,500mg base
capsule, oral eq 250mg base
capsule, oral eq 500mg base
capsule, oral eq 250,500mg base
capsule, oral eq 250,500mg base
powder for suspension
eq 125,250mg base/5ml
powder for suspension
eq 125mg base/5ml
powder for suspension
eq 250mg base/5ml
powder for suspension
eq 125,250mg base/5ml
powder for suspension
eq 125,250mg base/5ml
powder for suspension
eq 125,250mg base/5ml
(continued on the next page)
43
Lilly
Lilly
Lilly
GlaxoSmithKline
GlaxoSmithKline
Atral
Barr
IVAX
MJ
Purepac
Ranbaxy
Stevens
Stevens
Teva
Yoshitomi
Apothecon
Barr
Barr
Eon
Ranbaxy
Teva
DRUG
CEPHALEXIN (continued)
Brand(s)
Cefanex
Keflex
Keflex
Keflet
DOSAGE FORM, STRENGTH
@ tablet, oral eq 250,500mg base
@ tablet, oral eq 250,500mg base
tablet, oral eq 250,500mg base
capsule, oral eq 250,500mg base
capsule, oral eq 250,500mg base
powder for suspension
eq 125,250mg base/5ml
tablet, oral eq 250,500mg base
APPLICATION HOLDER,
MANUFACTURER
Barr
Eon
Teva
Apothecon
Lilly *
Ceph International *
Lilly
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
CEPHALOTHIN SODIUM
Cephalothin Sodium
Keflin
Seffin
Brand(s)
CEPHAPIRIN SODIUM
Cephapirin Sodium
Brand(s)
Cefadyl
@ injection eq 1,2gm base/vial
@ injection eq 1,2gm base/vial
injection eq 1,2,4gm base/vial
@ injection eq 1,2,4gm base/vial
Abbott
American Pharmaceutical
Partners
Bristol/Bristol-Myers
International Medication
@ injection eq 1,2,4gm base/vial
@ injection eq 1,2gm base/vial
Lilly
GlaxoSmithKline
@ injection eq 500mg,1,2,4,
American Pharmaceutical
20gm base/vial
Partners
@ injection eq 500mg,1,2,20gm base/vial Elkins-Sinn
injection eq 500mg,1,2,4gm base/vial
CEPHRADINE/CEPHRADINE DIHYDRATE
Cephradine/
@ capsule, oral 250,500mg
Cephradine Dihydrate
@ capsule, oral 250,500mg
@ capsule, oral 250,500mg
capsule, oral 250,500mg
@ powder for suspension 125,250mg/5ml
powder for suspension 125,250mg/5ml
Brand(s)
Anspor
capsule, oral 250,500mg
Velosef
capsule, oral 250,500mg
Anspor
powder for suspension 125,250mg/5ml
Velosef "125," "250"
powder for suspension 125,250mg/5ml
CHLORAL HYDRATE
Chloral Hydrate
Brand(s)
Noctec
syrup, oral 500mg/5ml
syrup, oral 500mg/5ml
syrup, oral 500mg/5ml
syrup, oral 500mg/5ml
@ syrup, oral 500mg/5ml
syrup, oral 500mg/5ml
syrup, oral 500mg/5ml
syrup, oral 500mg/5ml
Apothecon
Barr
Eon
IVAX
Teva
Barr
Teva
GlaxoSmithKline
Apothecon
GlaxoSmithKline
Apothecon
Alpharma
Cenci
Lederle
Morton Grove
Purepac
Roxane
Veratex
Squibb
* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as an
exception to the promulgated criteria for inclusion, pursuant to Rule 790.60.
44
DRUG
CHLORAMPHENICOL
Chloramphenicol
Brand(s)
Amphicol
Chloromycetin
Mychel
Chlorofair
Chloromycetin
Chloroptic S.O.P.
Econochlor
AK-Chlor
Chlorofair
Chloroptic
Econochlor
Ophthochlor
Optomycin
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
@ capsule, oral 250mg
ointment, ophthalmic 1%
@ solution, ophthalmic 0.5%
IVAX
Altana
Alcon
@ capsule, oral 100,250mg
@ capsule, oral 100,250mg
capsule, oral 250mg
@ ointment, ophthalmic 1%
ointment, ophthalmic 1%
ointment, ophthalmic 1%
@ ointment, ophthalmic 1%
@ solution, ophthalmic 0.5%
@ solution, ophthalmic 0.5%
solution, ophthalmic 0.5%
@ solution, ophthalmic 0.5%
@ solution, ophthalmic 0.5%
@ solution, ophthalmic 0.5%
Ferrante
Parkdale
Armenpharm
Pharmafair
Parkedale
Allergan
Alcon
Akorn
Pharmafair
Allergan
Alcon
Parkdale
Optopics
CHLORAMPHENICOL SODIUM SUCCINATE
Chloramphenicol
injection eq 1gm base/vial
Sodium Succinate
@ injection eq 1gm base/vial
injection eq 1gm base/vial
Brand(s)
Chloromycetin
injection eq 1gm base/vial
Mychel-S
@ injection eq 1gm base/vial
CHLORDIAZEPOXIDE HYDROCHLORIDE
Chlordiazepoxide
@ capsule, oral 5,10,25mg
Hydrochloride
capsule, oral 5,10,25mg
@ capsule, oral 5,10,25mg
@ capsule, oral 5,10,25mg
@ capsule, oral 5,10,25mg
@ capsule, oral 5,10,25mg
capsule, oral 10mg
@ capsule, oral 5,25mg
@ capsule, oral 5,10,25mg
@ capsule, oral 5,10,25mg
@ capsule, oral 10mg
@ capsule, oral 5,10,25mg
@ capsule, oral 5,10,25mg
@ capsule, oral 10,25mg
@ capsule, oral 5,10,25mg
@ capsule, oral 10,25mg
@ capsule, oral 5,10,25mg
@ capsule, oral 5,10,25mg
@ capsule, oral 5,25mg
capsule, oral 10mg
@ capsule, oral 5,10,25mg
capsule, oral 5,10,25mg
@ capsule, oral 5,10,25mg
Brand(s)
A-Poxide
@ capsule, oral 5,10,25mg
Chlordiazachel
@ capsule, oral 5,10,25mg
Librium
capsule, oral 5,10,25mg
Lygen
@ capsule, oral 5,10,25mg
45
American Pharmaceutical
Partners
Elkins Sinn
Gruppo Lepetit
Parkdale
Angus
(Ascot)
Barr
Eon
Ferrante
Geneva
Halsey
Impax
Impax
IVAX
Lederle
Mast
Mylan
Pfizer
Pioneer
Purepac
Roxane
Superpharm
Teva
USL
USL
(Vangard/MWM)
Watson
West-ward
Abbott
Rachelle
ICN
Alra
DRUG
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
CHLORDIAZEPOXIDE; AMITRIPTYLINE HYDROCHLORIDE
See AMITRIPTYLINE HYDROCHLORIDE; CHLORDIAZEPOXIDE
CHLORHEXIDINE GLUCONATE
Chlorhexidine Gluconate
Brand(s)
Peridex
PerioGard
solution, dental 0.12%
solution, dental 0.12%
solution, dental 0.12%
solution, dental 0.12%
Alpharma
Hi-Tech
Novex
Teva
solution, dental 0.12%
solution, dental 0.12%
Zila
Colgate
CHLOROPROCAINE HYDROCHLORIDE
Chloroprocaine Hydrochloride
injection 2,3%
injection 2,3%
Brand(s)
Nesacaine-MPF
injection 2,3%
CHLOROQUINE PHOSPHATE
Chloroquine Phosphate
Aralen
Brand(s)
CHLOROTHIAZIDE
Chlorothiazide
Diuril
Brand(s)
tablet, oral 250mg (eq 150mg base)
@ tablet, oral 250mg (eq 150mg base)
@ tablet, oral 250mg (eq 150mg base)
@ tablet, oral 250mg (eq 150mg base)
tablet, oral 250mg (eq 150mg base)
tablet, oral 500mg (eq 300mg base)
tablet, oral 250mg (eq 150mg base)
tablet, oral 500mg (eq 300mg base)
tablet, oral 500mg (eq 300mg base)
@
@
@
@
tablet, oral 250mg
tablet, oral 250,500mg
tablet, oral 250,500mg
tablet, oral 250,500mg
tablet, oral 250,500mg
@ tablet, oral 250,500mg
tablet, oral 250,500mg
tablet, oral 250,500mg
Abbott
Bedford
AstraZeneca
Impax
MD
Purepac
Teva
Watson
Watson
West-ward
West-ward
Sanofi Synthelabo
ABC
Circa
Eon
Lederle
Mylan
Watson
West-ward
Merck *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
CHLOROTHIAZIDE; METHYLDOPA
Chlorothiazide; Methyldopa
@
@
Brand(s)
Aldochlor-150
Aldochlor-250
CHLOROTRIANISENE
Chlorotrianisene
Brand(s)
TACE
tablet, oral 150mg;250mg
tablet, oral 250mg;250mg
Par
Par
tablet, oral 150mg;250mg
tablet, oral 250mg;250mg
Merck
Merck
@ capsule, oral 12mg
Banner Pharmacaps
@ capsule, oral 12mg
Aventis
46
DRUG
CHLORPHENIRAMINE MALEATE
Chlorpheniramine Maleate
DOSAGE FORM, STRENGTH
@
@
@
@
@
@
@
Brand(s)
Chlor-Trimeton
Pyridamal 100
Kloromin
@
@
injection 10mg/ml
injection 10mg/ml
injection 10,100mg/ml
tablet, oral 4mg
tablet, oral 4mg
tablet, oral 4mg
tablet, oral 4mg
tablet, oral 4mg
tablet, oral 4mg
tablet, oral 4mg
tablet, oral 4mg
tablet, oral 4mg
tablet, oral 4mg
tablet, oral 4mg
@ injection 10,100mg/ml
@ injection 100mg/ml
@ tablet, oral 4mg
APPLICATION HOLDER,
MANUFACTURER
Bel-Mar
Elkins-Sinn
Steris
Geneva
ICN
Impax
KV
Marshall
Pharmavite
Phoenix
Superpharm
Tablicaps
Watson
West-ward
Schering
Bel-Mar
Halsey
CHLORPHENIRAMINE MALEATE; CODEINE PHOSPHATE; PSEUDOEPHEDRINE HYDROCHLORIDE
Chlorpheniramine Maleate;
syrup, oral 2mg/5ml;10mg/5ml;
Morton Grove
Codeine Phosphate;
30mg/5ml
Pseudoephedrine Hydrochloride
Brand(s)
Dihistine DH Elixir
syrup, oral 2mg/5ml;10mg/5ml;
Alpharma
30mg/5ml
Novadyne DH Liquid
syrup, oral 2mg/5ml;10mg/5ml;
Norton
30mg/5ml
Novahistine DH Liquid
syrup, oral 2mg/5ml;10mg/5ml;
SmithKline Beecham
30mg/5ml
Phenylhistine DH
syrup, oral 2mg/5ml;10mg/5ml;
Cenci
30mg/5ml
Ryna C Liquid
syrup, oral 2mg/5ml;10mg/5ml;
Wallace
30mg/5ml
* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as an
exception to the promulgated criteria for inclusion, pursuant to Rule 790.60.
CHLORPHENIRAMINE MALEATE; PHENYLEPHRINE HYDROCHLORIDE; PHENYLPROPANOLAMINE
HYDROCHLORIDE; PHENYLTOLOXAMINE CITRATE
Chlorpheniramine Maleate;
@ drops, oral 0.5mg/ml;1.25mg/ml;
Alpharma
Phenylephrine Hydrochloride;
5mg/ml;2mg/ml
Phenylpropanolamine
@ syrup, oral 0.5mg/5ml;1.25mg/5ml;
Alpharma
Hydrochloride;
5mg/5ml;2mg/5ml
Phenyltoloxamine Citrate
@ syrup, oral 2.5mg/5ml;5mg/5ml;
Alpharma
20mg/5ml;7.5mg/5ml
@ syrup, oral 2.5mg/5ml;5mg/5ml;
Naska
20mg/5ml;7.5mg/5ml
Brand(s)
Naldecon Pediatric Drops
@ drops, oral 0.5mg/ml;1.25mg/ml;
Bristol/Bristol-Myers
5mg/ml;2mg/ml
Nalphen Pediatric Drops
@ drops, oral 0.5mg/ml;1.25mg/ml;
Hi-Tech
5mg/ml;2mg/ml
Sinucon Pediatric Drops
@ drops, oral 0.5mg/ml;1.25mg/ml;
Norton
5mg/ml;2mg/ml
Naldecon Pediatric Syrup
@ syrup, oral 0.5mg/5ml;1.25mg/5ml;
Bristol/Bristol-Myers
5mg/5ml;2mg/5ml
(continued on the next page)
47
DRUG
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
CHLORPHENIRAMINE MALEATE; PHENYLEPHRINE HYDROCHLORIDE; PHENYLPROPANOLAMINE
HYDROCHLORIDE; PHENYLTOLOXAMINE CITRATE (continued)
Naldecon Syrup
@ syrup, oral 2.5mg/5ml;5mg/5ml;
Bristol/Bristol-Myers
20mg/5ml;7.5mg/5ml
Nalphen Pediatric Syrup
@ syrup, oral 0.5mg/5ml;1.25mg/5ml;
Hi-Tech
5mg/5ml;2mg/5ml
Nalphen Syrup
@ syrup, oral 2.5mg/5ml;5mg/5ml;
Hi-Tech
20mg/5ml;7.5mg/5ml
Sinucon Pediatric Syrup
@ syrup, oral 0.5mg/5ml;1.25mg/5ml;
Norton
5mg/5ml;2mg/5ml
Sinucon Syrup
@ syrup, oral 2.5mg/5ml;5mg/5ml;
Norton
20mg/5ml;7.5mg/5ml
* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as an
exception to the promulgated criteria for inclusion, pursuant to Section 790.60.
CHLORPHENIRAMINE MALEATE; PHENYLPROPANOLAMINE HYDROCHLORIDE
Chlorpheniramine Maleate;
@ capsule, extended release 12mg;75mg Geneva
Phenylpropanolamine
@ capsule, extended release 12mg;75mg Watson
Hydrochloride
Brand(s)
Ornade
@ capsule, extended release 12mg;75mg GlaxoSmithKline
CHLORPHENIRAMINE TANNATE; PHENYLEPHRINE TANNATE; PYRILAMINE TANNATE
Chlorpheniramine Tannate;
suspension, oral 2mg/5ml;5mg/ml;
Ferndale
Phenylephrine Tannate;
12.5mg/5ml
Pyrilamine Tannate
Brand(s)
Histatan
suspension, oral 2mg/5ml;5mg/5ml;
Norton
12.5mg/5ml
R-Tannate
suspension, oral 2mg/5ml;5mg/5ml;
Copley
12.5mg/5ml
Rynatan Pediatric
suspension, oral 2mg/5ml;5mg/5ml;
Wallace
12.5mg/5ml
Triotann S
suspension, oral 2mg/5ml;5mg/5ml;
Duramed/Barr
12.5mg/5ml
* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as an
exception to the promulgated criteria for inclusion, pursuant to Section 790.60.
CHLORPROMAZINE HYDROCHLORIDE
Chlorpromazine Hydrochloride
concentrate, oral 100mg/ml
@ concentrate, oral 30,100mg/ml
concentrate, oral 30,100mg/ml
@ injection 25mg/ml
Brand(s)
Intensol
Sonazine
Thorazine
Thorazine
Sonazine
Thorazine
@
@
@
@
injection 25mg/ml
injection 25mg/ml
injection 25mg/ml
injection 25mg/ml
syrup, oral 10mg/5ml
Alpharma
Morton Grove
Pharmaceutical Associates
American Pharmaceutical
Partners
Elkins-Sinn
Marsam
Steris
Wyeth-Ayerst
Alpharma
concentrate, oral 30,100mg/ml
concentrate, oral 30,100mg/ml
concentrate, oral 30,100mg/ml
injection 25mg/ml
syrup, oral 10mg/5ml
syrup, oral 10mg/5ml
Roxane
Geneva
GlaxoSmithKline
GlaxoSmithKline
Geneva
GlaxoSmithKline
48
DRUG
CHLORPROPAMIDE
Chlorpropamide
DOSAGE FORM, STRENGTH
@
@
@
@
@
@
@
@
@
@
Brand(s)
Diabinese
Glucamide
CHLORTHALIDONE
Chlorthalidone
Barr
Circa
Duramed/Barr
Eon
Geneva
Halsey
IVAX
Lederle
Mylan
Par
Sidmak
Superpharm
Superpharm
Teva
USL
Watson
tablet, oral 100,250mg
@ tablet, oral 250mg
Pfizer
Teva
@
@
@
@
@
@
@
tablet, oral 25mg
tablet, oral 50mg
tablet, oral 25,50mg
tablet, oral 25,50mg
tablet, oral 25,50mg
tablet, oral 50mg
tablet, oral 25mg
tablet, oral 50mg
tablet, oral 25,50mg
tablet, oral 25,50mg
tablet, oral 25,50mg
tablet, oral 25,50mg
tablet, oral 25,50mg
tablet, oral 50mg
tablet, oral 25,50mg
tablet, oral 25,50mg
tablet, oral 25,50mg
tablet, oral 50mg
tablet, oral 25mg
tablet, oral 50mg
tablet, oral 25,50mg
tablet, oral 25,50mg
tablet, oral 25mg
tablet, oral 50mg
Abbott
Abbott
(Ascot)
Barr
Circa
Eon
Geneva
Geneva
IVAX
KV
Lederle
Mutual
Mylan
Pioneer
Purepac
Sidmak
Superpharm
Teva
USL
USL
(Vangard/MWM)
Warner Chilcott
Watson
Watson
tablet, oral 25,50mg
Aventis
@
@
@
@
@
@
@
@
@
Brand(s)
Hygroton
tablet, oral 100,250mg
tablet, oral 100,250mg
tablet, oral 100,250mg
tablet, oral 250mg
tablet, oral 100,250mg
tablet, oral 100,250mg
tablet, oral 100,250mg
tablet, oral 100,250mg
tablet, oral 100,250mg
tablet, oral 100,250mg
tablet, oral 100,250mg
tablet, oral 100mg
tablet, oral 250mg
tablet, oral 100mg
tablet, oral 100,250mg
tablet, oral 100,250mg
APPLICATION HOLDER,
MANUFACTURER
@
CHLORTHALIDONE; ATENOLOL
See ATENOLOL; CHLORTHALIDONE
CHLORTHALIDONE; CLONIDINE HYDROCHLORIDE
Chlorthalidone;
tablet, oral 15mg;0.1mg
Clonidine Hydrochloride
tablet, oral 15mg;0.2mg
tablet, oral 15mg;0.3mg
(continued on the next page)
49
Par
Par
Par
DRUG
DOSAGE FORM, STRENGTH
CHLORTHALIDONE; CLONIDINE HYDROCHLORIDE (continued)
Brand(s)
Clorpres
tablet, oral 15mg;0.1mg
Clorpres
tablet, oral 15mg;0.2mg
Clorpres
tablet, oral 15mg;0.3mg
Combipres
@ tablet, oral 15mg;0.1mg
Combipres
@ tablet, oral 15mg;0.2mg
Combipres
@ tablet, oral 15mg;0.3mg
CHLORZOXAZONE
Chlorzoxazone
Brand(s)
Paraflex
Parafon Forte DSC
Strifon Forte DSC
CHOLESTYRAMINE
Cholestyramine
Brand(s)
Cholestyramine Light
Cholestyramine Light
Cholestyramine Light
Cholestyramine Light
Locholest
Locholest
Locholest Light
Locholest Light
Prevalite
Prevalite
Questran
Questran
Questran Light
Questran Light
APPLICATION HOLDER,
MANUFACTURER
Mylan
Mylan
Mylan
Boehringer Ingelheim
Boehringer Ingelheim
Boehringer Ingelheim
tablet, oral 250,500mg
tablet, oral 500mg
tablet, oral 250,500mg
tablet, oral 500mg
tablet, oral 250,500mg
tablet, oral 250mg
@ tablet, oral 250,500mg
tablet, oral 500mg
@ tablet, oral 250mg
tablet, oral 500mg
Amide
Barr
Geneva
Mutual
Ohm
Par
Pioneer
Teva
Watson
Watson
@ tablet, oral 250mg
tablet, oral 500mg
tablet, oral 500mg
Ortho-McNeil
Ortho-McNeil
Ferndale
powder, oral eq 4gm resin/packet
powder, oral eq 4gm resin/scoopful
powder, oral eq 4gm resin/packet
powder, oral eq 4gm resin/scoopful
powder, oral eq 4gm resin/packet
powder, oral eq 4gm resin/scoopful
Copley
Copley
IVAX
IVAX
Teva
Teva
powder, oral eq 4gm resin/packet
powder, oral eq 4gm resin/scoopful
powder, oral eq 4gm resin/packet
powder, oral eq 4gm resin/scoopful
powder, oral eq 4gm resin/packet
powder, oral eq 4gm resin/scoopful
powder, oral eq 4gm resin/packet
powder, oral eq 4gm resin/scoopful
powder, oral eq 4gm resin/packet
powder, oral eq 4gm resin/scoopful
powder, oral eq 4gm resin/packet
powder, oral eq 4gm resin/scoopful
powder, oral eq 4gm resin/packet
powder, oral eq 4gm resin/scoopful
Copley
Copley
Teva
Teva
Eon
Eon
Eon
Eon
Upsher-Smith *
Upsher-Smith *
Bristol-Myers Squibb *
Bristol-Myers Squibb *
Bristol-Myers Squibb *
Bristol-Myers Squibb *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
CHROMIC CHLORIDE
Chromic Chloride
injection eq 0.004mg chromium/ml
@ injection eq 0.004mg chromium/ml
50
Abbott
American Pharmaceutical
Partners
DRUG
CIMETIDINE
Cimetidine
Brand(s)
Tagamet
DOSAGE FORM, STRENGTH
tablet, oral 300,400,800mg
tablet, oral 200,300,400,800mg
tablet, oral 200,300,400,800mg
tablet, oral 200,300,400,800mg
tablet, oral 200,300,400,800mg
tablet, oral 200,300,400,800mg
@ tablet, oral 300,400,800mg
tablet, oral 200,300,400,800mg
tablet, oral 200,300,400,800mg
tablet, oral 200,300,400,800mg
tablet, oral 200,300,400,800mg
tablet, oral 200,300,400,800mg
APPLICATION HOLDER,
MANUFACTURER
Clonmel
Endo
Geneva
IVAX
Lek
Mylan
Roxane
Sidmak
Teva
TorPharm
Watson
GlaxoSmithKline *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
CIMETIDINE HYDROCHLORIDE
Cimetidine Hydrochloride
Brand(s)
Tagamet
Tagamet
injection eq 300mg base/2ml
injection eq 300mg base/2ml
injection eq 300mg base/2ml
injection eq 300mg base/2ml
injection eq 300mg base/2ml
solution, oral eq 300mg base/5ml
solution, oral eq 300mg base/5ml
solution, oral eq 300mg base/5ml
solution, oral eq 300mg base/5ml
solution, oral eq 300mg base/5ml
solution, oral eq 300mg base/5ml
solution, oral eq 300mg base/5ml
solution, oral eq 300mg base/5ml
solution, oral eq 300mg base/5ml
solution, oral eq 300mg base/5ml
Abbott
Clonmel
Endo
Gensia Sicor
Luitpold
Alpharma
Copley
Duramed/Barr
Endo
Hi-Tech
Morton Grove
Novex
Pharmaceutical Associates
Roxane
Teva
injection eq 300mg base/2ml
solution, oral eq 300mg base/5ml
GlaxoSmithKline
GlaxoSmithKline
CIMETIDINE HYDROCHLORIDE; SODIUM CHLORIDE
Cimetidine Hydrochloride;
injection eq 600mg base/100ml;
Sodium Chloride
900mg/100ml
Brand(s)
Tagamet
injection eq 600mg base/100ml;
900mg/100ml
CINOXACIN
Cinoxacin
Brand(s)
Cinobac
Abbott
GlaxoSmithKline
@ capsule, oral 250,500mg
Teva
@ capsule, oral 250,500mg
Lilly
51
DRUG
CISPLATIN
Cisplatin
Brand(s)
Platinol-AQ
Platinol
DOSAGE FORM, STRENGTH
injection 1mg/ml
injection 1mg/ml
injection 1mg/ml
injection 1mg/ml
injection 10,50mg/vial
American Pharmaceutical
Partners
Bedford
Gensia-Sicor
Pharmachemie
Bedford
injection 1mg/ml
injection 10,50mg/vial
Bristol-Myers Squibb
Bristol-Myers Squibb
CITRIC ACID; MAGNESIUM OXIDE; SODIUM CARBONATE
Solution for irrigation; in plastic container
Brand(s)
Irrigating Solution G
solution for irrigation 3.24gm/100ml;
380mg/100ml;430mg/100ml
Urologic G
solution for irrigation 3.24gm/100ml;
380mg/100ml;430mg/100ml
CLADRIBINE
Cladribine
Brand(s)
Leustatin
CLEMASTINE FUMARATE
Clemastine Fumarate
Brand(s)
Tavist
Tavist 1
Tavist
APPLICATION HOLDER,
MANUFACTURER
Baxter
Abbott
injection 1mg/ml
Bedford
injection 1mg/ml
Ortho Biotech
syrup, oral eq 0.5mg base/5ml
syrup, oral eq 0.5mg base/5ml
syrup, oral eq 0.5mg base/5ml
syrup, oral eq 0.5mg base/5ml
syrup, oral eq 0.5mg base/5ml
syrup, oral eq 0.5mg base/5ml
tablet, oral eq 2.68mg base
@ tablet, oral eq 1.34mg base
tablet, oral eq 2.68mg base
Alpharma
Copley
Morton Grove
Novex
Silarx
Teva
Geneva
Teva
Teva
syrup, oral eq 0.5mg base/5ml
@ tablet, oral eq 1.34mg base
tablet, oral eq 2.68mg base
Novartis *
Novartis
Novartis
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
CLINDAMYCIN HYDROCHLORIDE
Clindamycin Hydrochloride
Brand(s)
Cleocin
capsule, oral eq 150,300mg base
capsule, oral eq 75,150mg base
@ capsule, oral eq 75mg base
capsule, oral eq 150,300mg base
capsule, oral eq 75,150,300mg base
Ranbaxy
Teva
Watson
Watson
Pharmacia & Upjohn *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
CLINDAMYCIN PHOSPHATE
Clindamycin Phosphate
(continued on the next page)
injection eq 150mg base/ml
@ injection eq 150mg base/ml
52
Abbott
American Pharmaceutical
Partners
DRUG
DOSAGE FORM, STRENGTH
CLINDAMYCIN PHOSPHATE (continued)
@ injection eq 150mg base/ml
@ injection eq 150mg base/ml
@ injection eq 150mg base/ml
@ injection eq 150mg base/ml
@ injection eq 150mg base/ml
injection eq 150mg base/ml
injection eq 150mg base/ml
@ injection eq 150mg base/ml
@ injection eq 150mg base/ml
@ injection eq 150mg base/ml
@ injection eq 150mg base/ml
gel, topical eq 1% base
lotion, topical eq 1% base
solution, topical eq 1% base
solution, topical eq 1% base
@ solution, topical eq 1% base
solution, topical eq 1% base
solution, topical eq 1% base
solution, topical eq 1% base
@ solution, topical eq 1% base
swab, topical eq 1% base
Brand(s)
Cleocin-T
gel, topical eq 1% base
Cleocin
injection eq 150mg base/ml
Cleocin-T
lotion, topical eq 1% base
Cleocin T
solution, topical eq 1% base
Clinda-Derm
solution, topical eq 1% base
Cleocin T
swab, topical eq 1% base
Clindets
swab, topical eq 1% base
APPLICATION HOLDER,
MANUFACTURER
AstraZeneca
Bedford
Bristol-Myers Squibb
Elkins-Sinn
Gensia Sicor
Lederle
Loch
Marsam
Quad
Solopak
Steris
Altana
Altana
Alpharma
Clay-Park
Copley
Fougera/Altana
Morton Grove
Stiefel
Teva
Clay-Park
Pharmacia & Upjohn *
Pharmacia & Upjohn
Pharmacia & Upjohn *
Pharmacia & Upjohn *
Paddock
Pharmacia & Upjohn *
Stiefel
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
CLINDAMYCIN PHOSPHATE; DEXTROSE
Clindamycin Phosphate;
injection eq 900mg base/100ml
Dextrose
in plastic container
@ injection eq 12mg base/ml
injection eq 900mg base/100ml
injection eq 6,12mg base/ml
Brand(s)
Cleocin Phosphate in Dextrose 5% injection eq 6,12,18mg base/ml
CLOBETASOL PROPIONATE
Clobetasol Propionate
(continued on the next page)
cream, (AB1) topical 0.05%
cream, (AB1) topical 0.05%
cream, (AB1) topical 0.05%
cream, (AB1) topical 0.05%
cream, (AB2) emollient topical 0.05%
cream, (AB2) emollient topical 0.05%
gel, topical 0.05%
gel, topical 0.05%
gel, topical 0.05%
ointment, topical 0.05%
ointment, topical 0.05%
ointment, topical 0.05%
ointment, topical 0.05%
ointment, topical 0.05%
53
American Pharmaceutical
Partners
American Pharmaceutical
Partners
Baxter
Baxter
Pharmacia & Upjohn
Alpharma
Copley
Fougera/Altana
Taro
Altana
Taro
Altana
Stiefel
Taro
Alpharma
Copley
Fougera/Altana
Stiefel
Taro
DRUG
DOSAGE FORM, STRENGTH
CLOBETASOL PROPIONATE (continued)
solution, topical 0.05%
solution, topical 0.05%
solution, topical 0.05%
solution, topical 0.05%
Brand(s)
Cormax
cream, (AB1) topical 0.05%
Temovate
cream, (AB1) topical 0.05%
Embeline E
cream, (AB2) emollient topical 0.05%
Temovate E
cream, (AB2) emollient topical 0.05%
Temovate
gel, topical 0.05%
Embeline
ointment, topical 0.05%
Temovate
ointment, topical 0.05%
Embeline
solution, topical 0.05%
Temovate
solution, topical 0.05%
APPLICATION HOLDER,
MANUFACTURER
Alpharma
Altana
Morton Grove
Taro
Healthpoint
GlaxoSmithKline
Healthpoint
GlaxoSmithKline
GlaxoSmithKline
Healthpoint
GlaxoSmithKline
DPT
GlaxoSmithKline
Products designated “AB1" may only be interchanged with other products designated as “AB1." Products
designated as “AB2" may only be interchanged with other products designated as “AB2.” Products designated
as “AB1" MAY NOT BE INTERCHANGED with products designated as “AB2.”
CLOFIBRATE
Clofibrate
Brand(s)
Atromid-S
CLOMIPHENE CITRATE
Clomiphene Citrate
Brand(s)
Clomid
Milophene
Serophene
capsule, oral 500mg
@ capsule, oral 500mg
capsule, oral 500mg
capsule, oral 500mg
@ capsule, oral 500mg
Banner Pharmacaps
Geneva
Teva
USL
Watson
capsule, oral 500mg
Wyeth-Ayerst
tablet, oral 50mg
Par
tablet, oral 50mg
tablet, oral 50mg
tablet, oral 50mg
Aventis
Milex
Serono *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
CLOMIPRAMINE HYDROCHLORIDE
Clomipramine Hydrochloride
@ capsule, oral 25,50,75mg
capsule, oral 25,50,75mg
capsule, oral 25,50,75mg
capsule, oral 25,50,75mg
capsule, oral 25,50,75mg
capsule, oral 25,50,75mg
Anafranil
CLONAZEPAM
Clonazepam
(continued on the next page)
capsule, oral 25,50,75mg
Circa
Geneva
Mylan
Taro
Teva
Watson
Brand(s)
Tyco
tablet, oral 0.5,1,2mg
tablet, oral 0.5,1,2mg
tablet, oral 0.5,1,2mg
tablet, oral 0.5,1,2mg
tablet, oral 0.5,1,2mg
tablet, oral 0.5,1,2mg
tablet, oral 0.5,1,2mg
Alphapharm
Caraco
Eon
Geneva
Mylan
Purepac
Teva
54
DRUG
DOSAGE FORM, STRENGTH
CLONAZEPAM (continued)
Brand(s)
Klonopin
CLONIDINE
Brand(s)
Catapres-TTS-1
Catapres-TTS-2
Catapres-TTS-3
APPLICATION HOLDER,
MANUFACTURER
tablet, oral 0.5,1,2mg
tablet, oral 0.5,1,2mg
TorPharm
Watson
tablet, oral 0.5,1,2mg
Roche
film, extended release, transdermal
0.1mg/24 hours
film, extended release, transdermal
0.2mg/24 hours
film, extended release, transdermal
0.3mg/24 hours
Boehringer Ingelheim *
Boehringer Ingelheim *
Boehringer Ingelheim *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
CLONIDINE HYDROCHLORIDE
Clonidine Hydrochloride
@
@
@
@
@
@
@
@
Brand(s)
Catapres
tablet, oral 0.1,0.2,0.3mg
tablet, oral 0.1,0.2,0.3mg
tablet, oral 0.1,0.2,0.3mg
tablet, oral 0.1,0.2,0.3mg
tablet, oral 0.1,0.2,0.3mg
tablet, oral 0.1mg
tablet, oral 0.1,0.2,0.3mg
tablet, oral 0.1,0.2,0.3mg
tablet, oral 0.1,0.2,0.3mg
tablet, oral 0.1,0.2,0.3mg
tablet, oral 0.1,0.2,0.3mg
tablet, oral 0.1,0.2,0.3mg
tablet, oral 0.1,0.2,0.3mg
tablet, oral 0.1,0.2,0.3mg
American Therapeutics
Barr
Circa
Duramed/Barr
Geneva
Halsey
Interpharm
Lederle
Mylan
Par
Purepac
Teva
Warner-Chilcott
Watson
tablet, oral 0.1,0.2,0.3mg
Boehringer Ingelheim
CLONIDINE HYDROCHLORIDE; CHLORTHALIDONE
See CHLORTHALIDONE; CLONIDINE HYDROCHLORIDE
CLORAZEPATE DIPOTASSIUM
Clorazepate Dipotassium
(continued on the next page)
@ capsule, oral 3.75,7.5,15mg
@ capsule, oral 3.75,7.5,15mg
capsule, oral 3.75,7.5,15mg
capsule, oral 3.75,7.5,15mg
capsule, oral 3.75,7.5,15mg
@ capsule, oral 3.75,7.5,15mg
@ capsule, oral 3.75,7.5,15mg
@ capsule, oral 3.75,7.5,15mg
@ capsule, oral 3.75,7.5,15mg
@ capsule, oral 3.75,7.5,15mg
@ capsule, oral 3.75,7.5,15mg
tablet, oral 3.75,7.5,15mg
@ tablet, oral 3.75,7.5,15mg
@ tablet, oral 3.75mg
tablet, oral 7.5,15mg
@ tablet, oral 3.75,7.5,15mg
tablet, oral 3.75,7.5,15mg
55
Able
American Therapeutics
Geneva
Lederle
Mylan
Purepac
Quantum
Searle
USL
Warner Chilcott
Watson
Able
American Therapeutics
Geneva
Geneva
Lederle
Mylan
DRUG
DOSAGE FORM, STRENGTH
CLORAZEPATE DIPOTASSIUM (continued)
@ tablet, oral 3.75,7.5,15mg
@ tablet, oral 3.75,7.5,15mg
tablet, oral 3.75,7.5,15mg
@ tablet, oral 3.75,7.5,15mg
tablet, oral 3.75,7.5,15mg
Brand(s)
Tranxene
@ capsule, oral 3.75,7.5,15mg
Gen-Xene
tablet, oral 3.75,7.5,15mg
Tranxene
tablet, oral 3.75,7.5,15mg
CLOTRIMAZOLE
Clotrimazole
Brand(s)
Lotrimin
Lotrimin
Mycelex
APPLICATION HOLDER,
MANUFACTURER
Purepac
Quantum
Taro
Warner Chilcott
Watson
Abbott
Alra
Ovation
cream, topical 1%
solution, topical 1%
solution, topical 1%
Taro
Taro
Teva
cream, topical 1%
solution, topical 1%
solution, topical 1%
Schering
Schering
Bayer
CLOTRIMAZOLE; BETAMETHASONE DIPROPIONATE
See BETAMETHASONE DIPROPIONATE; CLOTRIMAZOLE
CLOXACILLIN SODIUM MONOHYDRATE
Cloxacillin Sodium Monohydrate
capsule, oral eq 250,500mg base
powder for solution
eq 125mg base/5ml
Brand(s)
Cloxapen
capsule, oral eq 250,500mg base
Tegopen
@ capsule, oral eq 250,500mg base
Tegopen
@ powder for solution
eq 125mg base/5ml
CLOZAPINE
Clozapine
Brand(s)
Clozaril
Teva
Teva
GlaxoSmithKline
Apothecon
Apothecon
@ tablet, oral 25,100mg
tablet, oral 25,100mg
tablet, oral 25,100mg
Geneva
IVAX
Mylan
tablet, oral 25,100mg
Novartis
CODEINE PHOSPHATE; ACETAMINOPHEN
See ACETAMINOPHEN; CODEINE PHOSPHATE
CODEINE PHOSPHATE; ASPIRIN
See ASPIRIN; CODEINE PHOSPHATE
CODEINE PHOSPHATE; ASPIRIN; CARISOPRODOL
See ASPIRIN; CARISOPRODOL; CODEINE PHOSPHATE
CODEINE PHOSPHATE; BROMODIPHENHYDRAMINE HYDROCHLORIDE
See BROMODIPHENHYDRAMINE HYDROCHLORIDE; CODEINE PHOSPHATE
56
DRUG
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
CODEINE PHOSPHATE; BROMPHENIRAMINE MALEATE; PHENYLPROPANOLAMINE HYDROCHLORIDE
See BROMPHENIRAMINE MALEATE; CODEINE PHOSPHATE; PHENYLPROPANOLAMINE
HYDROCHLORIDE
CODEINE PHOSPHATE; CHLORPHENIRAMINE MALEATE; PSEUDOEPHEDRINE HYDROCHLORIDE
See CHLORPHENIRAMINE MALEATE; CODEINE PHOSPHATE; PSEUDOEPHEDRINE
HYDROCHLORIDE
CODEINE PHOSPHATE; GUAIFENESIN
Codeine Phosphate;
syrup, oral 10mg/5ml;100mg/5ml
Guaifenesin
syrup, oral 10mg/5ml;100mg/5ml
Brand(s)
Guiatuss AC
syrup, oral 10mg/5ml;100mg/5ml
Robitussin AC
syrup, oral 10mg/5ml;100mg/5ml
Cenci
Halsey
Alpharma
Robins
* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as an
exception to the promulgated criteria for inclusion, pursuant to Section 790.60.
CODEINE PHOSPHATE; GUAIFENESIN; PSEUDOEPHEDRINE HYDROCHLORIDE
Codeine Phosphate; Guaifenesin; syrup, oral 10mg/5ml;100mg/5ml;
Morton Grove
Pseudoephedrine Hydrochloride
30mg/5ml
Brand(s)
Codafed Expectorant
syrup, oral 10mg/5ml;100mg/5ml
Hauck
30mg/5ml
Guiatuss DAC
syrup, oral 10mg/5ml;100mg/5ml;
Alpharma
30mg/5ml
Novadyne Expectorant
syrup, oral 10mg/5ml;100mg/5ml
Norton
30mg/5ml
Novahistine Expectorant
syrup, oral 10mg/5ml;100mg/5ml;
Aventis
30mg/5ml
Phenylhistine Expectorant
syrup, oral 10mg/5ml;100mg/5ml;
Cenci
30mg/5ml
Robitussin DAC Syrup
syrup, oral 10mg/5ml;100mg/5ml;
Robins
30mg/5ml
* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as an
exception to the promulgated criteria for inclusion, pursuant to Rule 790.60.
CODEINE PHOSPHATE; IODINATED GLYCEROL
Codeine Phosphate;
@ liquid, oral 10mg/5ml;30mg/5ml
Iodinated Glycerol
@ liquid, oral 10mg/5ml;30mg/5ml
@ liquid, oral 10mg/5ml;30mg/5ml
Brand(s)
Iophen-C
@ liquid, oral 10mg/5ml;30mg/5ml
Iotuss-C
@ liquid, oral 10mg/5ml;30mg/5ml
Oridol C
@ liquid, oral 10mg/5ml;30mg/5ml
Tussi Organidin
@ liquid, oral 10mg/5ml;30mg/5ml
Tussi-R-Gen Expectorant
@ liquid, oral 10mg/5ml;30mg/5ml
Alpharma
Duramed/Barr
Halsey
Naska
Cenci
Norton
Wallace
Goldline
* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as an
exception to the promulgated criteria for inclusion, pursuant to Rule 790.60.
57
DRUG
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
CODEINE PHOSPHATE; PHENYLEPHRINE HYDROCHLORIDE; PROMETHAZINE HYDROCHLORIDE
Brand(s)
Phenergan VC with Codeine
syrup, oral 10mg/5ml;5mg/5ml;
Wyeth-Ayerst
6.25mg/5ml
Pherazine VC with Codeine
@ syrup, oral 10mg/5ml;5mg/5ml;
Halsey
6.25mg/5ml
Prometh VC with Codeine
syrup, oral 10mg/5ml;5mg/5ml;
Alpharma
6.25mg/5ml
Promethazine VC with Codeine @ syrup, oral 10mg/5ml;5mg/5ml;
Cenci
6.25mg/5ml
Promethazine VC with Codeine
syrup, oral 10mg/5ml;5mg/5ml;
Morton Grove
6.25mg/5ml
CODEINE PHOSPHATE; PROMETHAZINE HYDROCHLORIDE
Codeine Phosphate;
syrup, oral 10mg/5ml;6.25mg/5ml
Promethazine Hydrochloride
syrup, oral 10mg/5ml;6.25mg/5ml
Brand(s)
Phenergan with Codeine
syrup, oral 10mg/5ml;6.25mg/5ml
Pherazine with Codeine
@ syrup, oral 10mg/5ml;6.25mg/5ml
Prometh with Codeine
syrup, oral 10mg/5ml;6.25mg/5ml
Promethazine with Codeine
@ syrup, oral 10mg/5ml;6.25mg/5ml
Promethazine with Codeine
syrup, oral 10mg/5ml;6.25mg/5ml
Hi-Tech
Pharmaceutical Associates
Wyeth-Ayerst
Halsey
Alpharma
Cenci
Morton Grove
CODEINE PHOSPHATE; PSEUDOEPHEDRINE HYDROCHLORIDE; TRIPROLIDINE HYDROCHLORIDE
Codeine Phosphate;
@ syrup, oral 10mg/5ml;30mg/5ml;
Cenci
Pseudoephedrine Hydrochloride;
1.25mg/5ml
Triprolidine Hydrochloride
Brand(s)
Actifed with Codeine
@ syrup, oral 10mg/5ml;30mg/5ml;
GlaxoSmithKline
1.25mg/5ml
Pseudodine C
syrup, oral 10mg/5ml;30mg/5ml;
Morton Grove
1.25mg/5ml
Triacin-C
syrup, oral 10mg/5ml;30mg/5ml;
Alpharma
1.25mg/5ml
COLISTIMETHATE
Colistimethate
Brand(s)
Coly-Mycin M
CORTICOTROPIN
Corticotropin
Brand(s)
ACTH
Acthar
CROMOLYN SODIUM
Cromolyn Sodium
(continued on the next page)
CROMOLYN SODIUM (continued)
injection eq 150mg base/vial
Pharma-Tek
injection eq 150mg base/vial
Parkdale
@ injection 40U/vial
Steris
@ injection 25,40U/vial
@ injection 25,40U/vial
Parkdale
Aventis
solution for inhalation 10mg/ml
solution for inhalation 10mg/ml
solution for inhalation 10mg/ml
solution for inhalation 10mg/ml
solution for inhalation 10mg/ml
solution for inhalation 10mg/ml
solution for inhalation 10mg/ml
@ solution for inhalation 10mg/ml
solution for inhalation 10mg/ml
Alpharma
Bausch and Lomb
Dey
IVAX
Morton Grove
Novex
Roxane
Steripak
Warrick
58
DRUG
Brand(s)
Intal
Crolom
Cromoptic
Opticrom
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
solution, ophthalmic 4%
solution, ophthalmic 4%
solution, ophthalmic 4%
Akorn
Alcon *
Novex
solution for inhalation 10mg/ml
solution, ophthalmic 4%
solution, ophthalmic 4%
solution, ophthalmic 4%
Aventis *
Bausch and Lomb
King
Allergan
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
CROTAMITON
Brand(s)
Crotan
Eurax
CYANOCOBALAMIN
Cyanocobalamin
lotion, topical 10%
lotion, topical 10%
@ injection 1000mcg/ml
@ injection 30mcg/ml
injection 100mcg/ml
Brand(s)
Berubigen
Betalin 12
Cobavite
Redisol
Rubivite
Rubramin PC
Rubramin PC
Ruvite
Sytobex
Vi-Twel
Vibisone
@ injection 1000mcg/ml
@ injection 30,100,1000mcg/ml
injection 1000mcg/ml
@ injection 30mcg/ml
injection 1000mcg/ml
@ injection 1000mcg/ml
@ injection 1000mcg/ml
injection 100,1000mcg/ml
@ injection 1000mcg/ml
@ injection 100,1000mcg/ml
injection 100,1000mcg/ml
@ injection 1000mcg/ml
@ injection 30,100,1000mcg/ml
@ injection 100mcg/ml
injection 1000mcg/ml
@ injection 1000mcg/ml
@ injection 1000mcg/ml
@ injection 1000mcg/ml
injection 1000mcg/ml
Summers
Westwood Squibb
Akorn
American Pharmaceutical
Partners
American Pharmaceutical
Partners
Aventis
Dell
Elkins-Sinn
Luitpold
Luitpold
Medwick
Solopak
Wyeth-Ayerst
Pharmacia & Upjohn
Lilly
Steris
Merck
Bel-Mar
Bristol-Myers Squibb
Bristol-Myers Squibb
Savage/Altana
Warner Chilcott
Berlex
American Pharmaceutical
Partners
CYANOCOBALAMIN; ASCORBIC ACID; BIOTIN; DEXPANTHENOL; ERGOCALCIFEROL; FOLIC ACID;
NIACINAMIDE; PYRIDOXINE HYDROCHLORIDE; RIBOFLAVIN PHOSPHATE SODIUM; THIAMINE
HYDROCHLORIDE; VITAMIN A; VITAMIN E
See ASCORBIC ACID; BIOTIN; CYANOCOBALAMIN; DEXPANTHENOL; ERGOCALCIFEROL; FOLIC
ACID; NIACINAMIDE; PYRIDOXINE HYDROCHLORIDE; RIBOFLAVIN PHOSPHATE SODIUM
HYDROCHLORIDE; VITAMIN A; VITAMIN E
CYANOCOBALAMIN; ASCORBIC ACID; FLUORIDE; IRON; NICOTINIC ACID; PYRIDOXINE HYDROCHLORIDE;
RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D; VITAMIN E
See ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; IRON; NICOTINIC ACID; PYRIDOXINE
HYDROCHLORIDE; RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D;
VITAMIN E
59
DRUG
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
CYANOCOBALAMIN; ASCORBIC ACID; FLUORIDE; NICOTINIC ACID; PYRIDOXINE HYDROCHLORIDE;
RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D; VITAMIN E
See ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; NICOTINIC ACID; PYRIDOXINE
HYDROCHLORIDE; RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D;
VITAMIN E
CYCLACILLIN
Cyclacillin
Brand(s)
Cyclapen W
@ tablet, oral 250,500mg
Teva
@ tablet, oral 250,500mg
Wyeth-Ayerst
CYCLOBENZAPRINE HYDROCHLORIDE
Cyclobenzaprine Hydrochloride @ tablet, oral 10mg
tablet, oral 10mg
tablet, oral 10mg
tablet, oral 10mg
tablet, oral 10mg
tablet, oral 10mg
Brand(s)
Flexeril
tablet, oral 10mg
Barr
Geneva
Halsey
Mylan
Sidmak
Watson
McNeil Consumer *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
CYCLOPENTOLATE HYDROCHLORIDE
Cyclopentolate Hydrochloride
solution, ophthalmic 1%
@ solution, ophthalmic 1%
Brand(s)
AK-Pentolate
solution, ophthalmic 1,2%
Cyclogyl
solution, ophthalmic 0.5,1,2%
Pentolair
@ solution, ophthalmic 0.5,1%
Pentolair
solution, ophthalmic 1%
Alcon Universal
Sola Barnes Hind
Akorn
Alcon *
Pharmafair
Bausch and Lomb
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
CYCLOPHOSPHAMIDE
Cyclophosphamide
Brand(s)
Cytoxan
Lyophilized Cytoxan
Neosar
Cytoxan
CYCLOSPORINE
Brand(s)
Sandimmune
injection 100,200,500mg,1gm
tablet, oral 25,50mg
@ injection 100,200,500mg,1,2gm
injection 100,200,500mg,1,2gm
injection 100,200,500mg,1,2gm
tablet, oral 25,50mg
Baxter
Roxane
Bristol-Myers Squibb
Bristol-Myers Squibb
Pharmacia & Upjohn
Bristol-Myers Squibb
injection 50mg/ml
Bedford
injection 50mg/ml
Novartis
SEE NOTE ON NEXT PAGE PERTAINING TO INTERCHANGE OF CYCLOSPORINE PRESCRIPTIONS
60
DRUG
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
NOTE: Within 24 hours of any interchange of a patient’s cyclosporine prescription, whether from a brand
name manufacturer to a generic manufacturer, generic manufacturer to a brand name manufacturer, or
generic manufacturer to a different generic manufacturer, the pharmacist must notify the prescriber of
the interchange, identifying to the prescriber the name of the manufacturer of the cyclosporine product
dispensed to the patient.
CYPROHEPTADINE HYDROCHLORIDE
Cyproheptadine Hydrochloride
syrup, oral 2mg/5ml
@ syrup, oral 2mg/5ml
@ syrup, oral 2mg/5ml
@ syrup, oral 2mg/5ml
tablet, oral 4mg
@ tablet, oral 4mg
@ tablet, oral 4mg
@ tablet, oral 4mg
@ tablet, oral 4mg
@ tablet, oral 4mg
@ tablet, oral 4mg
@ tablet, oral 4mg
tablet, oral 4mg
@ tablet, oral 4mg
@ tablet, oral 4mg
@ tablet, oral 4mg
tablet, oral 4mg
@ tablet, oral 4mg
tablet, oral 4mg
@ tablet, oral 4mg
@ tablet, oral 4mg
Brand(s)
Periactin
syrup, oral 2mg/5ml
Periactin
@ tablet, oral 4mg
CYTARABINE
Cytarabine
Brand(s)
Cytosar-U
DACARBAZINE
Dacarbazine
Brand(s)
DTIC-Dome
DANAZOL
Danazol
Brand(s)
Danocrine
injection 100,500mg,1,2gm/vial
injection 2gm/vial
injection 100,500mg,1,2gm/vial
@ injection 100,500mg/vial
Alpharma
Halsey
Morton Grove
Naska
ABC
American Therapeutics
(Ascot)
Circa
Duramed/Barr
Eon
Geneva
Halsey
IVAX
KV
MD
Mylan
Par
Pioneer
Sidmak
Superpharm
Watson
Merck
Merck
Bedford
Faulding
Gensia Sicor
Quad
injection 100,500mg,1,2gm/vial
Pharmacia & Upjohn
injection 100,200mg/vial
American Pharmaceutical
Partners
Gensia Sicor
Quad
injection 200,500mg/vial
@ injection 100,200mg/vial
injection 100,200mg/vial
Bayer
capsule, oral 50,100,200mg
Barr
capsule, oral 50,100,200mg
Sanofi Synthelabo
61
DRUG
DAUNORUBICIN HYDROCHLORIDE
Daunorubicin Hydrochloride
Brand(s)
Cerubidine
Cerubidine
Cerubidine
DESIPRAMINE HYDROCHLORIDE
Desipramine Hydrochloride
Brand(s)
Norpramin
DESMOPRESSIN ACETATE
Desmopressin Acetate
DOSAGE FORM, STRENGTH
injection eq 5mg base/ml
injection eq 20mg base/vial
injection eq 5,20mg base/vial
APPLICATION HOLDER,
MANUFACTURER
Bedford
Bigmar
Gensia Sicor
injection eq 20mg base/vial
@ injection eq 20mg base/vial
@ injection eq 20mg base/vial
Bedford
Aventis
Wyeth-Ayerst
tablet, oral 10,25,50,75,100,150mg
tablet, oral 10,25,50,75,100,150mg
tablet, oral 25,50,75,100,150mg
@ tablet, oral 25,50,75,100mg
Eon
Geneva
Sidmak
USL
tablet, oral 10,25,50,75,100,150mg
Aventis
injection 0.004mg/ml
injection 0.004mg/ml
injection 0.004mg/ml
spray, metered, nasal 0.01mg/spray
Abbott
Bedford
Gensia Sicor
Bausch and Lomb
Brand(s)
Desmopressin Acetate
injection 0.004mg/ml
Preservative-Free
DDAVP
injection 0.004mg/ml
DDAVP
@ spray, metered, nasal 0.01mg/spray
DDAVP (needs no refrigeration)
spray, metered, nasal 0.01mg/spray
Bedford
Aventis *
Aventis *
Aventis *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
DESOGESTREL; ETHINYL ESTRADIOL
Brand(s)
Apri
tablet, oral 0.15mg;0.03mg
Desogen
tablet, oral 0.15mg;0.03mg
Ortho-Cept
tablet, oral 0.15mg;0.03mg
Kariva
tablet, oral 0.15mg;0.02mg and 0.1mg
Mircette
tablet, oral 0.15mg;0.02mg and 0.1mg
Duramed/Barr
Organon
Ortho-McNeil
Barr
Organon
Note: 21 day packs may not be interchanged with 28 day packs.
DESONIDE
Desonide
Brand(s)
DesOwen
Tridesilon
DesOwen
DesOwen
Tridesilon
cream, topical 0.05%
cream, topical 0.05%
ointment, topical 0.05%
Copley
Taro
Taro
cream, topical 0.05%
cream, topical 0.05%
lotion, topical 0.05%
ointment, topical 0.05%
ointment, topical 0.05%
Owen/Galderma
Clay Park
Owen/Galderma *
Owen/Galderma
Clay Park
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
62
DRUG
DESOXIMETASONE
Desoximetasone
Brand(s)
Topicort LP
Topicort
Topicort
Topicort
DEXAMETHASONE
Dexamethasone
Brand(s)
Decadron
Hexadrol
Mymethasone
Maxidex
Decadron
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
cream, topical 0.05,0.25%
gel, topical 0.05%
@ ointment, topical 0.25%
ointment, topical 0.25%
Taro
Taro
Altana
Taro
cream, topical 0.05%
cream, topical 0.25%
gel, topical 0.05%
ointment, topical 0.25%
Medicis
Medicis
Medicis
Medicis
elixir, oral 0.5mg/5ml
@ suspension, ophthalmic 0.1%
tablet, oral 0.5,0.75,1.5,4mg
Alpharma
Steris
Roxane
@ elixir, oral 0.5mg/5ml
elixir, oral 0.5mg/5ml
elixir, oral 0.5mg/5ml
suspension , ophthalmic 0.1%
tablet, oral 0.5,0.75,1.5,4mg
Merck
Organon/Akzona
Morton Grove
Alcon
Merck
DEXAMETHASONE; NEOMYCIN SULFATE; POLYMYXIN B SULFATE
Dexamethasone; Neomycin
ointment, ophthalmic 0.1%;
Sulfate; Polymyxin B Sulfate
eq 3.5mg base/gm;10,000U/gm
suspension , ophthalmic 0.1%;
eq 3.5mg base/ml;10,000u/ml
Brand(s)
Dexacidin
@ ointment, ophthalmic 0.1%;
eq 3.5mg base/gm;10,000U/gm
Dexasporin
ointment, ophthalmic 0.1%;
eq 3.5mg base/gm;10,000U/gm
Maxitrol
ointment, ophthalmic 0.1%;
eq 3.5mg base/gm;10,000U/gm
Dexacidin
suspension , ophthalmic 0.1%;
eq 3.5mg base/ml;10,000U/ml
Dexasporin
suspension , ophthalmic 0.1%;
eq 3.5mg base/ml;10,000U/ml
Maxitrol
suspension , ophthalmic 0.1%;
eq 3.5mg base/ml;10,000U/ml
Fougera/Altana
Alcon Universal
Novartis
Bausch and Lomb
Falcon *
Novartis
Bausch and Lomb
Falcon *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
DEXAMETHASONE; TOBRAMYCIN
Dexamethasone; Tobramycin
Brand(s)
Tobradex
solution, ophthalmic 0.1%; 0.3%
Bausch and Lomb
solution, ophthalmic 0.1%; 0.3%
Alcon
DEXAMETHASONE SODIUM PHOSPHATE
Dexamethasone Sodium
@ injection eq 4mg phosphate/ml
Phosphate
injection eq 4,10mg phosphate/ml
@ injection eq 4mg phosphate/ml
@ injection eq 4mg phosphate/ml
63
Akorn
American Pharmaceutical
Partners
Bel-Mar
Dell
DRUG
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
(continued on the next page)
DEXAMETHASONE SODIUM PHOSPHATE (continued)
injection eq 4,10mg phosphate/ml
@ injection eq 4mg phosphate/ml
injection eq 10mg phosphate/ml
@ injection eq 20mg phosphate/ml
injection eq 4mg phosphate/ml
@ injection eq 4,10,20,
24mg phosphate/ml
@ injection eq 4,10,24mg phosphate/ml
@ injection eq 4mg phosphate/ml
solution, ophthalmic-otic
eq 0.1% phosphate
solution, ophthalmic
eq 0.1% phosphate
@ solution, ophthalmic
eq 0.1% phosphate
Brand(s)
Dexacen-4
@ injection eq 4mg phosphate/ml
Decadron
@ injection eq 4,24mg phosphate/ml
Hexadrol
@ injection eq 4,10mg phosphate/ml
Hexadrol
@ injection eq 20mg phosphate/ml
Decadron
@ ointment, ophthalmic
eq 0.05% phosphate
Dexair
@ ointment, ophthalmic
eq 0.05% phosphate
Maxidex
@ ointment, ophthalmic
eq 0.05% phosphate
AK-Dex
@ solution, ophthalmic-otic
eq 0.1% phosphate
Decadron
solution, ophthalmic-otic
eq 0.1% phosphate
Dexair
@ solution, ophthalmic
eq 0.1% phosphate
DEXAMETHASONE SODIUM PHOSPHATE; NEOMYCIN SULFATE
Dexamethasone
@ solution, ophthalmic
Sodium Phosphate;
eq 0.1% phosphate;eq 3.5mg base/ml
Neomycin Sulfate
@ solution, ophthalmic
eq 0.1% phosphate;eq 3.5mg base/ml
Brand(s)
Neodecadron
solution, ophthalmic
eq 0.1% phosphate;eq 3.5mg base/ml
Neo-Dexair
@ solution, ophthalmic
eq 0.1% phosphate;eq 3.5mg base/ml
DEXCHLORPHENIRAMINE MALEATE
Dexchlorpheniramine Maleate
Brand(s)
Mylaramine
Polaramine
Polaramine
Elkins-Sinn
Gensia Sicor
Gensia Sicor
International Medication
Luitpold
Quad
Steris
Wyeth-Ayerst
Alcon Universal
Bausch and Lomb
Sola Barnes Hind
Central
Merck
Organon/Akzona
Organon/Akzona
Merck
Pharmafair
Alcon
Akorn
Merck
Pharmafair
Alcon Universal
Bausch and Lomb
Merck
Pharmafair
tablet, oral 2mg
Sidmak
syrup, oral 2mg/5ml
syrup, oral 2mg/5ml
tablet, oral 2mg
Morton Grove
Schering
Schering
DEXPANTHENOL; ASCORBIC ACID; BIOTIN; CYANOCOBALAMIN; ERGOCALCIFEROL; FOLIC ACID;
NIACINAMIDE; PYRIDOXINE HYDROCHLORIDE; RIBOFLAVIN PHOSPHATE SODIUM; THIAMINE
HYDROCHLORIDE; VITAMIN A; VITAMIN E
See ASCORBIC ACID; BIOTIN; CYANOCOBALAMIN; DEXPANTHENOL; ERGOCALCIFEROL; FOLIC
ACID; NIACINAMIDE; PYRIDOXINE HYDROCHLORIDE; RIBOFLAVIN PHOSPHATE SODIUM
HYDROCHLORIDE; VITAMIN A; VITAMIN E
64
DRUG
DOSAGE FORM, STRENGTH
DEXTROAMPHETAMINE SULFATE
Dextroamphetamine Sulfate
@
@
@
@
Brand(s)
Dexedrine Spansules
Dexampex
Dexedrine
Dextrostat
Ferndex
@
@
capsule, extended release 5,10,15mg
tablet, oral 5,10mg
tablet, oral 5mg
tablet, oral 5,10mg
tablet, oral 5,10mg
tablet, oral 10mg
tablet, oral 5,10mg
tablet, oral 5,10mg
tablet, oral 5mg
tablet, oral 5mg
capsule, extended release 5,10,15mg
@ tablet, oral 5,10mg
tablet, oral 5mg
tablet, oral 5,10mg
@ tablet, oral 5mg
APPLICATION HOLDER,
MANUFACTURER
Barr
Barr
Endo
Eon
Geneva
Halsey
Lannett
Mallinckrodt
Mast
Purepac
GlaxoSmithKline
Teva
GlaxoSmithKline
Shire Richwood
Ferndale
DEXTROAMPHETAMINE SACCHARATE; DEXTROAMPHETAMINE SULFATE; AMPHETAMINE ASPARTAME;
AMPHETAMINE SULFATE
See AMPHETAMINE ASPARTAME; AMPHETAMINE SULFATE; DEXTROAMPHETAMINE SACCHARATE;
DEXTROAMPHETAMINE SULFATE
DEXTROAMPHETAMINE SULFATE; DEXTROAMPHETAMINE SACCHARATE; AMPHETAMINE ASPARTAME;
AMPHETAMINE SULFATE
See AMPHETAMINE ASPARTAME; AMPHETAMINE SULFATE; DEXTROAMPHETAMINE SACCHARATE;
DEXTROAMPHETAMINE SULFATE
DEXTROMETHORPHAN HYDROBROMIDE; BROMPHENIRAMINE MALEATE;
PSEUDOEPHEDRINE HYDROCHLORIDE
See BROMPHENIRAMINE MALEATE; DEXTROMETHORPHAN HYDROBROMIDE;
PSEUDOEPHEDRINE HYDROCHLORIDE
DEXTROMETHORPHAN HYDROBROMIDE; CARBINOXAMINE MALEATE; PSEUDOEPHEDRINE
HYDROCHLORIDE
See CARBINOXAMINE MALEATE; DEXTROMETHORPHAN HYDROBROMIDE; PSEUDOEPHEDRINE
HYDROCHLORIDE
DEXTROMETHORPHAN HYDROBROMIDE; IODINATED GLYCEROL
Dextromethorphan
@ liquid, oral 10mg/5ml;30mg/5ml
Hydrobromide;
@ liquid, oral 10mg/5ml;20mg/5ml
Iodinated Glycerol
@ liquid, oral 10mg/5ml;30mg/5ml
@ liquid, oral 10mg/5ml;30mg/5ml
Brand(s)
Iogan DM
@ liquid, oral 10mg/5ml;30mg/5ml
Iophen DM
@ liquid, oral 10mg/5ml;30mg/5ml
Iotuss DM
@ liquid, oral 10mg/5ml;30mg/5ml
Sil-O-Tuss DM
@ liquid, oral 10mg/5ml;30mg/5ml
Tussi-Organidin DM
@ liquid, oral 10mg/5ml;30mg/5ml
Alpharma
Duramed/Barr
Halsey
LuChem
Hi-Tech
Naska
Cenci
Silarx
Wallace
* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as an
exception to the promulgated criteria for inclusion, pursuant to Section 790.60.
65
DRUG
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
DEXTROMETHORPHAN HYDROBROMIDE; PROMETHAZINE HYDROCHLORIDE
Dextromethorphan Hydrobromide; syrup, oral 15mg/5ml;6.25mg/5ml
Hi-Tech
Promethazine Hydrochloride
Brand(s)
Phenergan
syrup, oral 15mg/5ml;6.25mg/5ml
Wyeth-Ayerst
with Dextromethorphan
Pherazine DM
@ syrup, oral 15mg/5ml;6.25mg/5ml
Halsey
Prometh
syrup, oral 15mg/5ml;6.25mg/5ml
Alpharma
with Dextromethorphan
Promethazine
syrup, oral 15mg/5ml;6.25mg/5ml
Morton Grove
with Dextromethorphan
DEXTROSE
Dextrose
injection 5gm/100ml (5%),
10gm/100ml (10%),
20gm/100ml (20%),
30gm/100ml (30%),
40gm/100ml (40%),
50gm/100ml (50%),
60gm/100ml (60%),
70gm/100ml (70%)
injection 5gm/100ml (5%),
10gm/100ml (10%),
20gm/100ml (20%),
30gm/100ml (30%),
40gm/100ml (40%),
50gm/100ml (50%),
60gm/100ml (60%),
70gm/100ml (70%)
injection 5gm/100ml (5%),
10gm/100ml (10%),
@ 60gm/100ml (60%)
injection 5gm/100ml (5%)
@ injection 10gm/100ml (10%),
Abbott
Abbott
Abbott
Baxter
Braun
DHL
Miles
DEXTROSE; ALCOHOL
See ALCOHOL; DEXTROSE
DEXTROSE; BRETYLIUM TOSYLATE
See BRETYLIUM TOSYLATE; DEXTROSE
DEXTROSE; CALCIUM CHLORIDE; GLUTATHIONE DISULFIDE; MAGNESIUM CHLORIDE; POTASSIUM
CHLORIDE; SODIUM BICARBONATE; SODIUM CHLORIDE; SODIUM PHOSPHATE
See CALCIUM CHLORIDE; DEXTROSE; GLUTATHIONE DISULFIDE; MAGNESIUM CHLORIDE;
POTASSIUM CHLORIDE; SODIUM BICARBONATE; SODIUM CHLORIDE; SODIUM PHOSPHATE
DEXTROSE; CALCIUM CHLORIDE; MAGNESIUM CHLORIDE; SODIUM CHLORIDE; SODIUM LACTATE
See CALCIUM CHLORIDE; DEXTROSE; MAGNESIUM CHLORIDE; SODIUM CHLORIDE; SODIUM
LACTATE
DEXTROSE; CALCIUM CHLORIDE; POTASSIUM CHLORIDE; SODIUM CHLORIDE
See CALCIUM CHLORIDE; DEXTROSE; POTASSIUM CHLORIDE; SODIUM CHLORIDE
66
DRUG
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
DEXTROSE; CALCIUM CHLORIDE; POTASSIUM CHLORIDE; SODIUM CHLORIDE; SODIUM LACTATE
See CALCIUM CHLORIDE; DEXTROSE; POTASSIUM CHLORIDE; SODIUM CHLORIDE; SODIUM
LACTATE
DEXTROSE; CLINDAMYCIN PHOSPHATE
See CLINDAMYCIN PHOSPHATE; DEXTROSE
DEXTROSE; DOBUTAMINE HYDROCHLORIDE
Dextrose; Dobutamine
injection 5gm/100ml;
Hydrochloride
eq 50mg base/100ml
in plastic container
injection 5gm/100ml;
eq 100mg base/100ml
injection 5gm/100ml;
eq 200mg base/100ml
injection 5gm/100ml;
eq 400mg base/100ml
injection 5gm/100ml;
eq 50mg base/100ml
injection 5gm/100ml;
eq 100mg base/100ml
injection 5gm/100ml;
eq 200mg base/100ml
injection 5gm/100ml;
eq 400mg base/100ml
DEXTROSE; DOPAMINE HYDROCHLORIDE
Dextrose; Dopamine
injection 5gm/100ml;80mg/100ml
Hydrochloride
injection 5gm/100ml; 160mg/100ml
in plastic container
injection 5gm/100ml; 320mg/100ml
injection 5gm/100ml; 400mg/100ml
injection 5gm/100ml;80mg/100ml
injection 5gm/100ml; 160mg/100ml
injection 5gm/100ml; 320mg/100ml
injection 5gm/100ml;80mg/100ml
injection 5gm/100ml; 160mg/100ml
injection 5gm/100ml; 320mg/100ml
DEXTROSE; GENTAMICIN SULFATE
Dextrose;
Gentamicin Sulfate
injection 5gm/100ml; eq 60,70,
80,90,100mg base/100ml
injection 5gm/100ml; eq 40,60,70,
80,90,100,120mg base/100ml
injection 5gm/100ml; eq 40,60,70,
80,90,100,120mg base/100ml
@ injection 5gm/100ml;
eq 100mg/100ml
DEXTROSE; HEPARIN SODIUM
Dextrose; Heparin Sodium
in plastic container
(continued on the next page)
injection 5gm/100ml; 4,000U/100ml
injection 5gm/100ml; 5,000U/100ml
injection 5gm/100ml;10,000U/100ml
injection 5gm/100ml; 4,000U/100ml
injection 5gm/100ml; 5,000U/100ml
injection 5gm/100ml;10,000U/100ml
@ injection 5gm/100ml; 200U/100ml
@ injection 5gm/100ml; 1,000U/100ml
67
Abbott
Abbott
Abbott
Abbott
Baxter
Baxter
Baxter
Baxter
Abbott
Abbott
Abbott
Abbott
Baxter
Baxter
Baxter
Braun
Braun
Braun
Abbott
Baxter
Braun
International Medication
Abbott
Abbott
Abbott
Baxter
Baxter
Baxter
Braun
Braun
DRUG
DOSAGE FORM, STRENGTH
DEXTROSE; HEPARIN SODIUM (continued)
injection 5gm/100ml; 4,000U/100ml
injection 5gm/100ml; 5,000U/100ml
injection 5gm/100ml;10,000U/100ml
DEXTROSE; LIDOCAINE HYDROCHLORIDE
Dextrose; Lidocaine Hydrochloride injection 5gm/100ml;200mg/100ml
in plastic container
injection 5gm/100ml;400mg/100ml
injection 5gm/100ml;800mg/100ml
injection 7.5gm/100ml;5gm/100ml
injection 5gm/100ml;200mg/100ml
injection 5gm/100ml;400mg/100ml
injection 5gm/100ml;800mg/100ml
injection 5gm/100ml;200mg/100ml
injection 5gm/100ml;400mg/100ml
injection 5gm/100ml;800mg/100ml
Brand(s)
Xylocaine 5% with Glucose 7.5% @ injection 7.5gm/100ml;5gm/100ml
APPLICATION HOLDER,
MANUFACTURER
Braun
Braun
Braun
Abbott
Abbott
Abbott
Abbott
Baxter
Baxter
Baxter
Braun
Braun
Braun
AstraZeneca
DEXTROSE; MAGNESIUM CHLORIDE; POTASSIUM CHLORIDE; SODIUM ACETATE; SODIUM CHLORIDE;
SODIUM GLUCONATE
Injection; in plastic container
Brand(s)
Isolyte S with Dextrose 5%
injection 5gm/100ml;30mg/100ml;
Braun
37mg/100ml;370mg/100ml;
530mg/100ml;500mg/100ml
Plasma-Lyte 148 and Dextrose 5% injection 5gm/100ml;30mg/100ml;
Baxter
37mg/100ml;368mg/100ml;
526mg/100ml;502mg/100ml
DEXTROSE; MANNITOL
Dextrose; Mannitol
DEXTROSE; NITROGLYCERIN
Dextrose; Nitroglycerin
DEXTROSE; POTASSIUM CHLORIDE
Injection; in plastic container
Dextrose; Potassium Chloride
(continued on the next page)
injection 5gm/100ml;10gm/100ml
injection 5gm/100ml;15gm/100ml
injection 5gm/100ml;10gm/100ml
injection 5gm/100ml;15gm/100ml
Abbott
Abbott
Braun
Braun
injection 5gm/100ml;10mg/100ml
injection 5gm/100ml;20mg/100ml
injection 5gm/100ml;40mg/100ml
injection 5gm/100ml;10mg/100ml
injection 5gm/100ml;20mg/100ml
injection 5gm/100ml;40mg/100ml
Abbott
Abbott
Abbott
Baxter
Baxter
Baxter
injection 5gm/100ml (5%);
224mg/100ml (0.224%)
injection 5gm/100ml (5%);
75mg/100ml (0.075%)
5gm/100ml (5%);
150mg/100ml (0.15%)
5gm/100ml (5%);
224mg/100ml (0.224%)
5gm/100ml (5%);
300mg/100ml (0.3%)
Abbott
68
Baxter
Baxter
Baxter
Baxter
DRUG
DOSAGE FORM, STRENGTH
DEXTROSE; POTASSIUM CHLORIDE (continued)
injection 5gm/100ml (5%);
75mg/100ml (0.075%)
5gm/100ml (5%);
150mg/100ml (0.15%)
5gm/100ml (5%);
300mg/100ml (0.3%)
DEXTROSE; POTASSIUM CHLORIDE; SODIUM CHLORIDE
Injection; in plastic container
Dextrose;
injection 5gm/100ml (5%);
Potassium Chloride;
74.5mg/100ml (0.075%);
Sodium Chloride
450mg/100ml (0.45%)
injection 5gm/100ml (5%);
149mg/100ml (0.15%);
450mg/100ml (0.45%)
injection 5gm/100ml (5%);
224mg/100ml (0.224%);
450mg/100ml (0.45%)
injection 5gm/100ml (5%);
298mg/100ml (0.3%);
450mg/100ml (0.45%)
injection 5gm/100ml (5%);
74.5mg/100ml (0.075%);
900mg/100ml (0.9%)
injection 5gm/100ml (5%);
149mg/100ml (0.15%);
900mg/100ml (0.9%)
injection 5gm/100ml (5%);
224mg/100ml (0.224%);
900mg/100ml (0.9%)
injection 5gm/100ml (5%);
298mg/100ml (0.3%);
900mg/100ml (0.9%)
injection 5gm/100ml (5%);
75mg/100ml (0.075%);
200mg/100ml (0.2%)
injection 5gm/100ml (5%);
150mg/100ml (0.15%);
200mg/100ml (0.2%)
injection 5gm/100ml (5%);
224mg/100ml (0.224%);
200mg/100ml (0.2%)
injection 5gm/100ml (5%);
300mg/100ml (0.3%);
200mg/100ml (0.2%)
injection 5gm/100ml (5%);
75mg/100ml (0.075%);
330mg/100ml (0.33%)
injection 5gm/100ml (5%);
150mg/100ml (0.15%);
330mg/100ml (0.33%)
injection 5gm/100ml (5%);
224mg/100ml (0.224%);
330mg/100ml (0.33%)
injection 5gm/100ml (5%);
300mg/100ml (0.3%);
330mg/100ml (0.33%)
(continued on the next page)
69
APPLICATION HOLDER,
MANUFACTURER
Braun
Braun
Braun
Abbott
Abbott
Abbott
Abbott
Abbott
Abbott
Abbott
Abbott
Baxter
Baxter
Baxter
Baxter
Baxter
Baxter
Baxter
Baxter
DRUG
DOSAGE FORM, STRENGTH
DEXTROSE; POTASSIUM CHLORIDE; SODIUM CHLORIDE (continued)
injection 5gm/100ml (5%);
75mg/100ml (0.075%);
450mg/100ml (0.45%)
injection 5gm/100ml (5%);
150mg/100ml (0.15%);
450mg/100ml (0.45%)
injection 5gm/100ml (5%);
224mg/100ml (0.224%);
450mg/100ml (0.45%)
injection 5gm/100ml (5%);
300mg/100ml (0.3%);
450mg/100ml (0.45%)
injection 5gm/100ml (5%);
75mg/100ml (0.075%);
900mg/100ml (0.9%)
injection 5gm/100ml (5%);
150mg/100ml (0.15%);
900mg/100ml (0.9%)
injection 5gm/100ml (5%);
224mg/100ml (0.224%);
900mg/100ml (0.9%)
injection 5gm/100ml (5%);
300mg/100ml (0.3%);
900mg/100ml (0.9%)
injection 5gm/100ml (5%);
75mg/100ml (0.075%);
200mg/100ml (0.2%)
injection 5gm/100ml (5%);
150mg/100ml (0.15%);
200mg/100ml (0.2%)
injection 5gm/100ml (5%);
220mg/100ml (0.224%);
200mg/100ml (0.2%)
injection 5gm/100ml (5%);
300mg/100ml (0.3%);
200mg/100ml (0.2%)
injection 5gm/100ml (5%);
75mg/100ml (0.075%);
330mg/100ml (0.33%)
injection 5gm/100ml (5%);
150mg/100ml (0.15%);
330mg/100ml (0.33%)
injection 5gm/100ml (5%);
220mg/100ml (0.22%);
330mg/100ml (0.33%)
injection 5gm/100ml (5%);
300mg/100ml (0.3%);
330mg/100ml (0.33%)
injection 5gm/100ml (5%);
75mg/100ml (0.075%);
450mg/100ml (0.45%)
injection 5gm/100ml (5%);
150mg/100ml (0.15%);
450mg/100ml (0.45%)
injection 5gm/100ml (5%);
300mg/100ml (0.3%);
450mg/100ml (0.45%)
injection 5gm/100ml (5%);
75mg/100ml (0.075%);
900mg/100ml (0.9%)
(continued on the next page)
70
APPLICATION HOLDER,
MANUFACTURER
Baxter
Baxter
Baxter
Baxter
Baxter
Baxter
Baxter
Baxter
Braun
Braun
Braun
Braun
Braun
Braun
Braun
Braun
Braun
Braun
Braun
Braun
DRUG
DOSAGE FORM, STRENGTH
DEXTROSE; POTASSIUM CHLORIDE; SODIUM CHLORIDE (continued)
injection 5gm/100ml (5%);
150mg/100ml (0.15%);
900mg/100ml (0.9%)
injection 5gm/100ml (5%);
300mg/100ml (0.3%);
900mg/100ml (0.9%)
DEXTROSE; SODIUM CHLORIDE
Injection; in plastic container
Dextrose; Sodium Chloride
@
@
@
@
DEXTROSE; THEOPHYLLINE
Dextrose; Theophylline
injection 2.5gm/100ml (2.5%);
450mg/100ml (0.45%)
injection 5gm/100ml (5%);
300mg/100ml (0.3%)
injection 5gm/100ml (5%);
450mg/100ml (0.45%)
injection 5gm/100ml (5%);
900mg/100ml (0.9%
injection 2.5gm/100ml (2.5%);
450mg/100ml (0.45%)
injection 5gm/100ml (5%);
200mg/100ml (0.2%)
injection 5gm/100ml (5%);
330mg/100ml (0.33%)
injection 5gm/100ml (5%);
450mg/100ml (0.45%)
injection 5gm/100ml (5%);
900mg/100ml (0.9%)
injection 10gm/100ml (10%)
900mg/100ml (0.9%)
injection 2.5gm/100ml (2.5%);
450mg/100ml (0.45%)
injection 5gm/100ml (5%);
200mg/100ml (0.2%)
injection 5gm/100ml (5%);
330mg/100ml (0.33%)
injection 5gm/100ml (5%);
450mg/100ml (0.45%)
injection 5gm/100ml (5%);
900mg/100ml (0.9%)
injection 10gm/100ml (10%)
900mg/100ml (0.9%)
injection 5gm/100ml (5%);
200mg/100ml (0.2%)
injection 5gm/100ml (5%);
300mg/100ml (0.3%)
injection 5gm/100ml (5%);
450mg/100ml (0.45%)
injection 5gm/100ml (5%);
900mg/100ml (0.9%)
injection 5gm/100ml (5%);
40mg/100ml (0.04%)
injection 5gm/100ml (5%);
80mg/100ml (0.08%)
injection 5gm/100ml (5%);
160mg/100ml (0.16%)
(continued on the next page)
71
APPLICATION HOLDER,
MANUFACTURER
Braun
Braun
Abbott
Abbott
Abbott
Abbott
Baxter
Baxter
Baxter
Baxter
Baxter
Baxter
Braun
Braun
Braun
Braun
Braun
Braun
Miles
Miles
Miles
Miles
Abbott
Abbott
Abbott
DRUG
DOSAGE FORM, STRENGTH
DEXTROSE; THEOPHYLLINE (continued)
injection 5gm/100ml (5%);
200mg/100ml (0.2%)
injection 5gm/100ml (5%);
320mg/100ml (0.32%)
injection 5gm/100ml (5%);
400mg/100ml (0.4%)
injection 5gm/100ml (5%);
40mg/100ml (0.04%)
injection 5gm/100ml (5%);
80mg/100ml (0.08%)
injection 5gm/100ml (5%);
160mg/100ml (0.16%)
injection 5gm/100ml (5%);
200mg/100ml (0.2%)
injection 5gm/100ml (5%);
320mg/100ml (0.32%)
injection 5gm/100ml (5%);
400mg/100ml (0.4%)
injection 5gm/100ml (5%);
40mg/100ml (0.04%)
injection 5gm/100ml (5%);
80mg/100ml (0.08%)
injection 5gm/100ml (5%);
160mg/100ml (0.16%)
injection 5gm/100ml (5%);
200mg/100ml (0.2%)
injection 5gm/100ml (5%);
320mg/100ml (0.32%)
injection 5gm/100ml (5%);
400mg/100ml (0.4%)
DIAZEPAM
Diazepam
injection 5mg/ml
@ injection 5mg/ml
@
@
@
@
@
@
@
@
Brand(s)
Valium
Q-Pam
Valium
injection 5mg/ml
injection 5mg/ml
injection 5mg/ml
injection 5mg/ml
injection 5mg/ml
tablet, oral 2,5,10mg
tablet, oral 2,5,10mg
tablet, oral 2,5,10mg
tablet, oral 2,5,10mg
tablet, oral 2,5,10mg
tablet, oral 2,5,10mg
tablet, oral 2,5,10mg
tablet, oral 10mg
tablet, oral 2,5,10mg
tablet, oral 2,5,10mg
tablet, oral 2,5,10mg
tablet, oral 2,5,10mg
tablet, oral 2,5,10mg
tablet, oral 2,5,10mg
tablet, oral 2,5,10mg
@ injection 5mg/ml
@ tablet, oral 2,5,10mg
tablet, oral 2,5,10mg
72
APPLICATION HOLDER,
MANUFACTURER
Abbott
Abbott
Abbott
Baxter
Baxter
Baxter
Baxter
Baxter
Baxter
Braun
Braun
Braun
Braun
Braun
Braun
Abbott
American Pharmaceutical
Partners
Elkins-Sinn
Lederle
Marsam
Steris
Warner Chilcott
Barr
Duramed/Barr
Ferndale
Geneva
Halsey
IVAX
Lederle
Martec
Mylan
Par
Pioneer
Purepac
Roxane
Warner Chilcott
Watson
Roche
Quantum
Roche
DRUG
DIAZOXIDE
Diazoxide
Brand(s)
Hyperstat
DICLOFENAC POTASSIUM
Diclofenac Potassium
Brand(s)
Cataflam
DOSAGE FORM, STRENGTH
@ injection 15mg/ml
@ injection 15mg/ml
APPLICATION HOLDER,
MANUFACTURER
American Pharmaceutical
Partners
Quad
injection 15mg/ml
Schering
tablet, oral 50mg
tablet, oral 50mg
tablet, oral 50mg
tablet, oral 50mg
tablet, oral 50mg
Eon
Geneva
Mylan
Teva
Watson
tablet, oral 50mg
Novartis *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
DICLOFENAC SODIUM
Dicolfenac Sodium
Brand(s)
Voltaren
Voltaren
Voltaren-XR
@ solution, ophthalmic 0.1%
tablet, delayed release 15,50,75mg
tablet, delayed release 25,50,75mg
tablet, delayed release 25,50,75mg
tablet, delayed release 50,75mg
tablet, delayed release 50,75mg
tablet, delayed release 25,50,75mg
tablet, delayed release 50,75mg
tablet, delayed release 50,75mg
tablet, extended release 100mg
tablet, extended release 100mg
tablet, extended release 100ng
solution, ophthalmic 0.1%
tablet, delayed release 25,50,75mg
tablet, extended release 100mg
Falcon
Carlsbad
Copley
Geneva
Martec
Purepac
Roxane
Sidmak
Teva
Biovail
Mylan
Purepac
Novartis *
Novartis *
Novartis *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
DICLOXACILLIN SODIUM
Dicloxacillin Sodium
Brand(s)
Dycill
Dynapen
Pathocil
Dynapen
Pathocil
DICYCLOMINE HYDROCHLORIDE
Dicyclomine Hydrochloride
(continued on the next page)
capsule, oral eq 250,500mg base
Teva
@ capsule, oral eq 250,500mg base
capsule, oral eq 250,500mg base
capsule, oral eq 250,500mg base
powder for suspension
eq 62.5mg base/5ml
powder for suspension
eq 62.5mg base/5ml
GlaxoSmithKline
Apothecon
Wyeth-Ayerst
Apothecon
@ capsule, oral 10mg
@ capsule, oral 10mg
@ capsule, oral 10mg
capsule, oral 10mg
capsule, oral 10mg
Barr
Circa
Halsey
Lannett
Mylan
73
Wyeth-Ayerst
DRUG
DOSAGE FORM, STRENGTH
DICYCLOMINE HYDROCHLORIDE (continued)
@ capsule, oral 10mg
capsule, oral 10mg
capsule, oral 10mg
@ injection 10mg/ml
@ syrup, oral 10mg/5ml
@ tablet, oral 20mg
@ tablet, oral 20mg
tablet, oral 20mg
tablet, oral 20mg
@ tablet, oral 20mg
tablet, oral 20mg
tablet, oral 20mg
Brand(s)
Bentyl
capsule, oral 10mg
Bentyl
injection 10mg/ml
Bentyl Preservative-Free
injection 10mg/ml
Bentyl
syrup, oral 10mg/5ml
Bentyl
tablet, oral 20mg
DIENESTROL
Dienestrol
Brand(s)
DV
Estraguard
cream, vaginal 0.01%
@ cream, vaginal 0.01%
@ cream, vaginal 0.01%
DIETHYLPROPION HYDROCHLORIDE
Diethylpropion Hydrochloride
@
@
@
@
Brand(s)
Tenuate
Tepanil
@
DIETHYLSTILBESTROL
Diethylstilbestrol
Brand(s)
Stilbestrol
DIFLORASONE DIACETATE
Diflorasone Diacetate
Brand(s)
Psorcon
Psorcon
DIFLUNISAL
Diflunisal
(continued on the next page)
APPLICATION HOLDER,
MANUFACTURER
Pioneer
Watson
West-ward
Steris
Alpharma
Barr
Circa
Lannett
Mylan
Pioneer
Watson
West-ward
Aventis
Aventis
Aventis
Aventis
Aventis
Ortho-McNeil
Aventis
Solvay
tablet, oral 25mg
tablet, oral 25mg
tablet, oral 25mg
tablet, oral 25mg
tablet, oral 25mg
ABC
Celltech
Eon
Teva
Watson
tablet, oral 25mg
tablet, oral 25mg
Aventis
Riker/3M
@ suppository, vaginal 0.1,0.5mg
Lilly
@ suppository, vaginal 0.1,0.5mg
Squibb
cream (AB1), topical 0.05%
cream (AB1) , topical 0.05%
ointment, topical 0.05%
ointment, topical 0.05%
Altana
Taro
Altana
Taro
cream (AB1) , topical 0.05%
ointment, topical 0.05%
Dermik
Pharmacia & Upjohn
tablet, oral 500mg
@ tablet, oral 250,500mg
tablet, oral 250,500mg
tablet, oral 250,500mg
tablet, oral 250,500mg
74
Geneva
Purepac
Roxane
Teva
Watson
DRUG
DIFLUNISAL (continued)
Brand(s)
Dolobid
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
tablet, oral 250,500mg
Merck *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
DIGOXIN
Digoxin
Brand(s)
Lanoxin Pediatric
Lanoxin
Digitek
Lanoxin
elixir, oral 0.05mg/ml
elixir, oral 0.05mg/ml
elixir, oral 0.05mg/ml
injection 0.1,0.25mg/ml
@ injection 0.25mg/ml
injection 0.25mg/ml
injection 0.25mg/ml
tablet, oral 0.125,0.25mg
tablet, oral 0.125,0.25mg
Halsey
Pharmafair
Roxane
Abbott
American Pharmaceutical
Partners
Elkins-Sinn
Wyeth-Ayerst
Caraco
Jerome Stevens
elixir, oral 0.05mg/ml
injection 0.1,0.25mg/ml
tablet, oral 0.125,0.25mg
tablet, oral 0.125,0.25mg
GlaxoSmithKline
GlaxoSmithKline
Amide
GlaxoSmithKline
* The elixir form of this entity was reviewed by the Technical Advisory Council and admitted to the Illinois
Formulary as an exception to the promulgated criteria for inclusion, pursuant to Section 790.60.
DIHYDROCODONE BITARTRATE; ACETAMINOPHEN; CAFFEINE
See ACETAMINOPHEN; CAFFEINE; DIHYDROCODONE BITARTRATE
DIHYDROERGOTOXINE METHANESULFONATE
See ERGOLOID MESYLATES
DILTIAZEM HYDROCHLORIDE
Diltiazem Hydrochloride
(continued on the next page)
capsule (AB1), extended release
60,90,120mg
capsule (AB1), extended release
60,90,120mg
@ capsule (AB1), extended release
60,90,120mg
capsule (AB1), extended release
60,90,120mg
capsule (AB2), extended release
120,180,240mg
capsule (AB2), extended release
120,180,240mg
capsule (AB2), extended release
120,180,240mg
capsule (AB3), extended release
120,180,240,300mg
capsule (AB3), extended release
120,180,240,300mg
injection 5mg/ml
injection 5mg/ml
injection 5mg/ml
injection 5mg/ml
75
Biovail
Mylan
Prographarm
Teva
Andrx
Mylan
TorPharm
Biovail
Purepac
Abbott
Apotex
Bedford
Gensia Sicor
DRUG
DOSAGE FORM, STRENGTH
DILTIAZEM HYDROCHLORIDE (continued)
injection 5mg/ml
injection 5mg/ml
tablet, oral 30,60,90,120mg
tablet, oral 30,60,90,120mg
tablet, oral 30,60,90,120mg
tablet, oral 30,60,90,120mg
tablet, oral 30,60,90,120mg
tablet, oral 30,60,90,120mg
Brand(s)
Cardizem SR
capsule (AB1), extended release
60,90,120mg
Dilacor XR
capsule (AB2), extended release
120,180,240mg
Cardizem CD
capsule (AB3), extended release
120,180,240,300mg
Cartia XT
capsule (AB3), extended release
120,180,240,300mg
Taztia XT
capsule (AB4), extended release
120,180,240,300,360mg
Tiazac
capsule (AB4), extended release
120,180,240,300,360mg
Cardizem
injection 5mg/ml
Cardizem
injection 100mg/vial
Cardizem
tablet, oral 30,60,90,120mg
APPLICATION HOLDER,
MANUFACTURER
Meridian
Taylor
Apothecon
Copley
IVAX
Lederle
Mylan
Teva
Aventis
Watson *
Aventis
Andrx
Andrx
Biovail
Biovail
Aventis
Aventis *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
Products designated “AB1" may only be interchanged with other products designated as “AB1.” Products
designated as “AB2" may only be interchanged with other products designated as “AB2.” Products designated
as “AB3" may only be interchanged with other products designated as “AB3.” Products designated as “AB4"
may only be interchanged with other products designated as “AB4.” Products designated as “AB1" MAY NOT
BE INTERCHANGED with products designated as “AB2”, “AB3" or “AB4.” Products designated as “AB2" MAY
NOT BE INTERCHANGED with products designated as “AB1”, “AB3" or “AB4.” Products designated as “AB3"
MAY NOT BE INTERCHANGED with products designated as “AB1” “AB2"or “AB4.” Products designated as
“AB4" MAY NOT BE INTERCHANGED with products designated as “AB1” “AB2"or “AB3.”
DIMENHYDRINATE
Dimenhydrinate
@ injection 50mg/ml
injection 50mg/ml
injection 50mg/ml
DIPHENHYDRAMINE HYDROCHLORIDE
Diphenhydramine Hydrochloride @ capsule, oral 25,50mg
capsule, oral 25,50mg
@ capsule, oral 25,50mg
@ capsule, oral 25,50mg
@ capsule, oral 25,50mg
capsule, oral 25,50mg
capsule, oral 25mg
@ capsule, oral 50mg
@ capsule, oral 25,50mg
capsule, oral 25,50mg
@ capsule, oral 25,50mg
@ capsule, oral 25,50mg
@ capsule, oral 25,50mg
@ capsule, oral 25,50mg
capsule, oral 25,50mg
(continued on the next page)
76
Elkins-Sinn
Steris
Wyeth-Ayerst
Anabolic
Barr
Circa
Elkins-Sinn
Eon
Geneva
Halsey
Halsey
Heather
ICN
IVAX
Impax
Lannett
Lederle
LNK
DRUG
DOSAGE FORM, STRENGTH
DIPHENHYDRAMINE HYDROCHLORIDE (continued)
capsule, oral 25,50mg
capsule, oral 25,50mg
@ capsule, oral 25,50mg
@ capsule, oral 25,50mg
@ capsule, oral 25,50mg
capsule, oral 25,50mg
@ capsule, oral 25,50mg
@ capsule, oral 50mg
capsule, oral 25mg
@ capsule, oral 50mg
@ capsule, oral 25,50mg
@ capsule, oral 25,50mg
capsule, oral 25,50mg
@ capsule, oral 50mg
@ capsule, oral 25,50mg
@ elixir, oral 12.5mg/5ml
@ elixir, oral 12.5mg/5ml
elixir, oral 12.5mg/5ml
@ elixir, oral 12.5mg/5ml
elixir, oral 12.5mg/5ml
@ elixir, oral 12.5mg/5ml
@ elixir, oral 12.5mg/5ml
elixir, oral 12.5mg/5ml
@ elixir, oral 12.5mg/5ml
@ elixir, oral 12.5mg/5ml
elixir, oral 12.5mg/5ml
@ injection 10mg/ml
Brand(s)
Benadryl
Belix
Benadryl
Dibenil
Diphen
Hydramine
Benadryl
Benadryl
Benadryl Preservative-Free
Diphenhydramine Hydrochloride
Preservative-Free
Diphenhydramine Hydrochloride
Preservative-Free
Diphenhydramine Hydrochloride
Preservative-Free
Diphenhydramine Hydrochloride
Preservative-Free
APPLICATION HOLDER,
MANUFACTURER
@ injection 10mg/ml
injection 50mg/ml
injection 10,50mg/ml
injection 50mg/ml
MK
Mutual
Newtron
Perrigo
Pioneer
Private Formulations
Purepac
Roxane
Superpharm
Superpharm
Teva
(Vangard/MWM)
Watson
West-Ward
Whiteworth Towne
Bundy
KV
Lannett
Lederle
MK
Naska
Perrigo
Pharmaceutical Assoc/Beach
Private Formulations
Purepac
Roxane
American Pharmaceutical
Partners
Bel-Mar
Elkins-Sinn
Steris
Wyeth-Ayerst
@ capsule, oral 25,50mg
@ elixir, oral 12.5mg/5ml
elixir, oral 12.5mg/5ml
@ elixir, oral 12.5mg/5ml
@ elixir, oral 12.5mg/5ml
@ elixir, oral 12.5mg/5ml
@ injection 10mg/ml
injection 50mg/ml
injection 50mg/ml
injection 50mg/ml
Pfizer
Halsey
Pfizer
Cenci
USL
Alpharma
Pfizer
Pfizer
Pfizer
Abbott
injection 50mg/ml
injection 50mg/ml
American Pharmaceutical
Partners
International Medication
injection 50mg/ml
Steris
DIPHENOXYLATE HYDROCHLORIDE; ATROPINE SULFATE
See ATROPINE SULFATE; DIPHENOXYLATE HYDROCHLORIDE
DIPIVEFRIN HYDROCHLORIDE
Dipivefrin Hydrochloride
solution, ophthalmic 0.1%
solution, ophthalmic 0.1%
(continued on the next page)
77
Bausch and Lomb
Falcon *
DRUG
DOSAGE FORM, STRENGTH
DIPIVEFRIN HYDROCHLORIDE (continued)
Brand(s)
AKpro
solution, ophthalmic 0.1%
Propine
solution, ophthalmic 0.1%
APPLICATION HOLDER,
MANUFACTURER
Akorn
Allergan *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
DIPYRIDAMOLE
Dipyridamole
Brand(s)
Persantine
Persantine
DISOPYRAMIDE PHOSPHATE
Disopyramide Phosphate
Brand(s)
Norpace
Norpace CR
DOBUTAMINE HYDROCHLORIDE
Dobutamine Hydrochloride
Brand(s)
Dobutrex
injection 5mg/ml
injection 5mg/ml
injection 5mg/ml
injection 5mg/ml
injection 5mg/ml
injection 5mg/ml
tablet, oral 25,50,75mg
tablet, oral 25,50,75mg
tablet, oral 25,50,75mg
tablet, oral 25mg
@ tablet, oral 50,75mg
tablet, oral 50mg
injection 5mg/ml
tablet, oral 25,50,75mg
@ capsule, oral eq 100,150mg base
@ capsule, oral eq 100,150mg base
capsule, oral eq 100,150mg base
@ capsule, oral eq 100,150mg base
capsule, oral eq 100,150mg base
@ capsule, oral eq 100,150mg base
capsule, oral eq 100mg base
@ capsule, oral eq 150mg base
capsule, oral eq 100,150mg base
capsule, oral eq 100,150mg base
capsule, controlled release
eq 150mg base
Abbott
American Pharmaceutical
Partners
Apotex
Bedford
Elkins-Sinn
Gensia Sicor
Barr
Geneva
Lederle
Purepac
Purepac
Watson
Boehringer-Ingelheim
Boehringer-Ingelheim
Barr
Circa
Geneva
Interpharm
IVAX
Mylan
Superpharm
Superpharm
Teva
Watson
KV
capsule, oral eq 100,150mg base
capsule, controlled release
eq 100,150mg base
Searle
Searle
injection eq 12.5mg base/ml
injection eq 12.5mg base/ml
injection eq 12.5mg base/ml
injection eq 12.5mg base/ml
injection eq 12.5mg base/ml
injection eq 12.5mg base/ml
injection eq 12.5mg base/ml
injection eq 12.5mg base/ml
Abbott
AstraZeneca
Bedford
Elkins-Sinn
Gensia Sicor
Luitpold
Marsam
Steris
injection eq 12.5mg base/ml
Lilly
DOBUTAMINE HYDROCHLORIDE; DEXTROSE
See DEXTROSE; DOBUTAMINE HYDROCHLORIDE
78
DRUG
DOPAMINE HYDROCHLORIDE
Dopamine Hydrochloride
DOSAGE FORM, STRENGTH
injection 40,80mg/ml
@ injection 40,160mg/ml
injection 40,80,160mg/ml
injection 40,80mg/ml
injection 40,80mg/ml
injection 40mg/ml
injection 40,80,160mg/ml
@ injection 40,80mg/ml
@ injection 40,80mg/ml
Abbott
American Pharmaceutical
Partners
American Pharmaceutical
Partners
AstraZeneca
Elkins-Sinn
Gensia Sicor
International Medication
Luitpold
Smith and Nephew
Warner Chilcott
@ injection 40,80mg/ml
injection 40,80,160mg/ml
Pfizer
Faulding
injection 80mg/ml
Brand(s)
Dopastat
Intropin
APPLICATION HOLDER,
MANUFACTURER
DOPAMINE HYDROCHLORIDE; DEXTROSE
See DEXTROSE; DOPAMINE HYDROCHLORIDE
DOXAPRAM HYDROCHLORIDE
Doxapram Hydrochloride
Brand(s)
Dopram
DOXAZOSIN MESYLATE
Doxazosin Mesylate
Brand(s)
Cardura
DOXEPIN HYDROCHLORIDE
Doxepin Hydrochloride
(continued on the next page)
injection 20mg/ml
Steris
injection 20mg/ml
Robins
tablet, oral eq 1,2,4,8mg base
tablet, oral eq 1,2,4,8mg base
tablet, oral eq 1,2,4,8mg base
tablet, oral eq 1,2,4,8mg base
tablet, oral eq 1,2,4,8mg base
tablet, oral eq 1,2,4,8mg base
tablet, oral eq 1,2,4,8mg base
tablet, oral eq 1,2,4,8mg base
tablet, oral eq 1,2,4,8mg base
tablet, oral eq 1,2,4,8mg base
Eon
Geneva
GenPharm
IVAX
KV
Mylan
Purepac
Teva
TorPharm
Watson
tablet, oral eq 1,2,4,8mg base
Pfizer
@ capsule, oral eq 25,50,75,100mg base
capsule, oral eq 10,25,50,75,
100mg base
@ capsule, oral eq 10,25,50,75,100,
150mg base
capsule, oral eq 10,25,50,75,
100mg base
capsule, oral eq 10,25,50,75,100,
150mg base
@ capsule, oral eq 10,25,50,75,100,
150mg base
@ capsule, oral eq 10,25,50,75,100,
150mg base
capsule, oral eq 10,25,50,75,100,
150mg base
concentrate, oral eq 10mg base/ml
concentrate, oral eq 10mg base/ml
79
Barr
Geneva
Lederle
Mylan
Par
Purepac
Quantum
Watson
Copley
Morton Grove
DRUG
DOSAGE FORM, STRENGTH
DOXEPIN HYDROCHLORIDE (continued)
concentrate, oral eq 10mg base/ml
Brand(s)
Adapin
@ capsule, oral eq 10,25,50,75,100,
150mg base
Sinequan
capsule, oral eq 10,25,50,75,100,
150mg base
Sinequan
concentrate, oral eq 10mg base/ml
DOXORUBICIN HYDROCHLORIDE
Doxorubicin Hydrochloride
Brand(s)
Adriamycin PFS
Adriamycin RDF
Rubex
DOXYCYCLINE
Doxycycline
Brand(s)
Monodox
Doxychel
Vibramycin
DOXYCYCLINE HYCLATE
Doxycycline Hyclate
(continued on the next page)
injection 2mg/ml
APPLICATION HOLDER,
MANUFACTURER
Silarx
New River
Pfizer
Pfizer
injection 2mg/ml,200mg/100ml
injection 10,20,50mg/vial
injection 2mg/ml,200mg/100ml
injection 2mg/ml,200mg/100ml
injection 10,20,50mg/vial
American Pharmaceutical
Partners
Bedford
Bedford
Gensia Sicor
Pharmachemie
Pharmachemie
injection 2mg/ml,200mg/100ml
injection 10,20,50mg/vial
injection 10,50mg/vial
Pharmacia & Upjohn
Pharmacia & Upjohn
Bristol-Myers Squibb
capsule, oral eq 50,100mg base
capsule, oral eq 50,100mg base
capsule, oral eq 50,100mg base
capsule, oral eq 50,100mg base
Eon
Halsey
Par
Ranbaxy
capsule, oral eq 50,100mg base
@ powder for suspension
eq 25mg base/5ml
powder for suspension
eq 25mg base/5ml
OClassen
Rachelle
@ capsule, oral eq 50,100mg base
capsule, oral eq 50,100mg base
@ capsule, oral eq 50,100mg base
@ capsule, oral eq 50,100mg base
capsule, oral eq 50,100mg base
capsule, oral eq 50,100mg base
capsule, oral eq 50,100mg base
@ capsule, oral eq 50,100mg base
@ capsule, oral eq 50,100mg base
@ capsule, oral eq 50,100mg base
@ capsule, oral eq 50,100mg base
@ capsule, oral eq 50,100mg base
capsule, oral eq 50,100mg base
capsule, oral eq 50,100mg base
@ capsule, coated pellets eq 100mg base
@ injection eq 100,200mg base/vial
@ injection eq 100,200mg base/vial
@ injection eq 100,200mg base/vial
@ injection eq 100,200mg base/vial
@ tablet, oral eq 100mg base
@ tablet, oral eq 50mg base
tablet, oral eq 100mg base
@ tablet, oral eq 100mg base
Barr
Halsey
Heather
Interpharm
IVAX
Mutual
Mylan
Par
Private Formulations
Ranbaxy
Superpharm
Warner Chilcott
Watson
West-ward
Sidmak
Bedford
Elkins-Sinn
Lederle
Quad
Barr
Halsey
Halsey
Heather
80
Pfizer
DRUG
DOSAGE FORM, STRENGTH
DOXYCYCLINE HYCLATE (continued)
@ tablet, oral eq 100mg base
tablet, oral eq 100mg base
tablet, oral eq 100mg base
tablet, oral eq 100mg base
@ tablet, oral eq 100mg base
tablet, oral eq 100mg base
@ tablet, oral eq 100mg base
@ tablet, oral eq 50mg base
tablet, oral eq 100mg base
Brand(s)
Doxy-Lemmon
@ capsule, oral eq 50,100mg base
Doxychel Hyclate
@ capsule, oral eq 50,100mg base
Vibramycin
capsule, oral eq 50,100mg base
Doryx
capsule, coated pellets eq 100mg base
Doryx
capsule, coated pellets eq 100mg base
Doxy 100,200
injection eq 100,200mg base/vial
Doxychel Hyclate
Vibramycin
Doxy-Lemmon
Doxy-Tabs
Vibra-Tabs
@
@
@
@
DOXYLAMINE SUCCINATE
Doxylamine Succinate
Brand(s)
Decapryn
@ tablet, oral 25mg
Aventis
injection 2.5mg/ml
@ injection 2.5mg/ml
Abbott
American Pharmaceutical
Partners
AstraZeneca
Faulding
Luitpold
Quad
Smith and Nephew
Solopak
Steris
DROPERIDOL; FENTANYL CITRATE
Droperidol; Fentanyl Citrate
Brand(s)
Spectazole
Teva
Houba
Pfizer
Faulding
Warner-Chilcott
American Pharmaceutical
Partners
Rachelle
Pfizer
Teva
Houba
Pfizer
Par
Quantum
Brand(s)
Inapsine
ECONAZOLE NITRATE
Econazole nitrate
Interpharm
IVAX
Mutual
Mylan
Superpharm
Vintage
Warner Chilcott
Watson
Watson
@ tablet, oral 25mg
@ tablet, oral 25mg
DROPERIDOL
Droperidol
Brand(s)
Innovar
injection eq 100mg base/vial
injection eq 100,200mg base/vial
tablet, oral eq 100mg base
tablet, oral eq 50,100mg base
tablet, oral eq 100mg base
APPLICATION HOLDER,
MANUFACTURER
@ injection 2.5mg/ml
injection 2.5mg/ml
injection 2.5mg/ml
@ injection 2.5mg/ml
@ injection 2.5mg/ml
@ injection 2.5mg/ml
@ injection 2.5mg/ml
injection 2.5mg/ml
Akorn
injection 2.5mg/ml;eq 0.05mg base/ml
@ injection 2.5mg/ml;eq 0.05mg base/ml
Abbott
AstraZeneca
@ injection 2.5mg/ml;eq 0.05mg base/ml
Janssen
cream, topical 1%
cream, topical 1%
Altana
Taro
cream, topical 1%
Ortho-McNeil
81
DRUG
EDETATE DISODIUM
Edetate Disodium
Brand(s)
Endrate
EDROPHONIUM CHLORIDE
Edrophonium Chloride
Brand(s)
Edrophonium Chloride
Preservative-Free
Enlon
Reversol
Tensilon
Tensilon Preservative-Free
ENALAPRIL MALEATE
Enalapril Maleate
Brand(s)
Vasotec
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
injection 150mg/ml
injection 150mg/ml
Apotex
Steris
injection 150mg/ml
Abbott
injection 10mg/ml
@ injection 10mg/ml
Abbott
Steris
@ injection 10mg/ml
Steris
injection 10mg/ml
injection 10mg/ml
injection 10mg/ml
injection 10mg/ml
Baxter
Organon/Akzona
ICN
ICN
tablet, oral 2.5,5,10,20mg
tablet, oral 2.5,5,10,20mg
tablet, oral 2.5,5,10,20mg
tablet, oral 2.5,5,10,20mg
tablet, oral 2.5,5,10,20mg
tablet, oral 2.5,5,10,20mg
tablet, oral 2.5,5,10,20mg
tablet, oral 2.5,5,10,20mg
tablet, oral 2.5,5,10,20mg
tablet, oral 2.5,5,10,20mg
tablet, oral 2.5,5,10,20mg
tablet, oral 2.5,5,10,20mg
tablet, oral 2.5,5,10,20mg
Apothecon
Eon
Geneva
GenPharm
IVAX
KRKA
Lek
Mylan
Ranbaxy
Taro
Teva
Watson
Wockhardt Americas
tablet, oral 2.5,5,10,20mg
Biovail *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
ENALAPRIL MALEATE; HYDROCHLOROTHIAZIDE
Enalapril Maleate;
tablet, oral 5mg;12.5mg
Hydrochlorothiazide
tablet, oral 10mg; 25mg
tablet, oral 5mg;12.5mg
tablet, oral 10mg;25mg
tablet, oral 5mg;12.5mg
tablet, oral 10mg;25mg
tablet, oral 5mg;12.5mg
tablet, oral 10mg;25mg
tablet, oral 5mg;12.5mg
tablet, oral 10mg;25mg
tablet, oral 5mg;12.5mg
tablet, oral 10mg;25mg
Brand(s)
Vaseretic
tablet, oral 5mg;12.5mg
Vaseretic
tablet, oral 10mg;25mg
ENALIPRILAT
Enaliprilat
(continued on the next page)
injection 1.25mg/ml
injection 1.25mg/ml
82
Dr. Reddy
Dr. Reddy
Eon
Eon
IVAX
IVAX
Mylan
Mylan
Taro
Taro
Teva
Teva
Biovail
Biovail
Abbott
Bedford
DRUG
ENALIPRILAT (continued)
Brand(s)
Vasotec
ENFLURANE
Enflurane
Brand(s)
Ethrane
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
injection 1.25mg/ml
injection 1.25mg/ml
Faulding
Gensia-Sicor
injection 1.25mg/ml
Biovail
liquid, inhalation 99.9%
liquid, inhalation 99.9%
Abbott
Minrad
liquid, inhalation 99.9%
Baxter
EPHEDRINE; HYDROXYZINE HYDROCHLORIDE; THEOPHYLLINE
Ephedrine; Hydroxyzine
syrup, oral 6.25mg/5ml;2.5mg/5ml;
Hydrochloride; Theophylline
32.5mg/5ml
Brand(s)
Marax DF
syrup, oral 6.25mg/5ml;2.5mg/5ml;
32.5mg/5ml
Alpharma
Roerig/Pfizer
* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as an
exception to the promulgated criteria for inclusion, pursuant to Rule 790.60.
EPINEPHRINE BITARTRATE; BUPIVICAINE HYDROCHLORIDE
See BUPIVICAINE HYDROCHLORIDE; EPINEPHRINE BITARTRATE
EPINEPHRINE HYDROCHLORIDE
Epinephrine Hydrochloride
Brand(s)
Adrenalin Chloride
solution, ophthalmic 0.1%
Iolab
solution, ophthalmic 0.1%
Pfizer
* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as an
exception to the promulgated criteria for inclusion, pursuant to Rule 790.60.
EPINEPHRINE; LIDOCAINE HYDROCHLORIDE
Epinephrine; Lidocaine
injection 0.005mg/ml;0.5%
Hydrochloride
injection 0.005mg/ml;1%
injection 0.005mg/ml;1.5%
injection 0.005mg/ml;2%
injection 0.01mg/ml;1%
injection 0.01mg/ml;2%
@ injection 0.01mg/ml;1%
@ injection 0.01mg/ml;2%
injection 0.01mg/ml;1%
injection 0.01mg/ml;2%
injection 0.01mg/ml;2%
injection 0.02mg/ml;2%
injection 0.01mg/ml;1%
injection 0.01mg/ml;2%
injection 0.01mg/ml;1%
injection 0.02mg/ml;2%
@ injection 0.01mg/ml;1%
@ injection 0.01mg/ml;1%
@ injection 0.01mg/ml;2%
Brand(s)
Alphacaine Hydrochloride
@ injection 0.01mg/ml;2%
with Epinephrine
(continued on the next page)
83
Abbott
Abbott
Abbott
Abbott
Abbott
Abbott
Bel-Mar
Bel-Mar
Dell
Dell
Eastman Kodak
Eastman Kodak
Elkins-Sinn
Elkins-Sinn
Graham
Graham
International Medication
Steris
Steris
Carlisle
DRUG
DOSAGE FORM, STRENGTH
EPINEPHRINE; LIDOCAINE HYDROCHLORIDE (continued)
Alphacaine Hydrochloride
@ injection 0.02mg/ml;2%
with Epinephrine
Lidocaton
injection 0.01mg/ml;2%
Lidocaton
@ injection 0.02mg/ml;2%
Octocaine
injection 0.01mg/ml;2%
Octocaine
injection 0.02mg/ml;2%
Xylocaine with Epinephrine
injection 0.005mg/ml;0.5%
Xylocaine with Epinephrine
injection 0.005mg/ml;1%
Xylocaine with Epinephrine
injection 0.005mg/ml;1.5%
Xylocaine with Epinephrine
injection 0.005mg/ml;2%
Xylocaine with Epinephrine
injection 0.01mg/ml;1%
Xylocaine with Epinephrine
injection 0.01mg/ml;2%
Xylocaine with Epinephrine
@ injection 0.02mg/ml;2%
EPOETIN ALPHA
Brand(s)
Epogen
Procrit
injection, preservative free
2000, 3000, 4000, 10000U
injection, preservative free
2000, 3000, 4000, 10000U
APPLICATION HOLDER,
MANUFACTURER
Carlisle
Pharmaton
Pharmaton
Septodont
Septodont
AstraZeneca
AstraZeneca
AstraZeneca
AstraZeneca
AstraZeneca
AstraZeneca
AstraZeneca
Amgen
Ortho Biotech
* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as an
exception to the promulgated criteria for inclusion, pursuant to Rule 790.60.
ERGOCALCIFEROL (50,000 International Units = 1.25mg)
Vitamin D
capsule, oral 50,000IU
@ capsule, oral 50,000IU
@ capsule, oral 50,000IU
@ capsule, oral 50,000IU
@ capsule, oral 50,000IU
@ capsule, oral 50,000IU
Brand(s)
Deltalin
@ capsule, oral 50,000IU
Drisdol
capsule, oral 50,000IU
Banner Pharmacaps
Chase
Eon
Everylife
Impax
Lannett
Lilly
Sanofi Synthelabo
ERGOCALCIFEROL; ASCORBIC ACID; BIOTIN; CYANOCOBALAMIN; DEXPANTHENOL; FOLIC ACID;
NIACINAMIDE; PYRIDOXINE HYDROCHLORIDE; RIBOFLAVIN PHOSPHATE SODIUM; THIAMINE
HYDROCHLORIDE; VITAMIN A; VITAMIN E
See ASCORBIC ACID; BIOTIN; CYANOCOBALAMIN; DEXPANTHENOL; ERGOCALCIFEROL; FOLIC
ACID; NIACINAMIDE; PYRIDOXINE HYDROCHLORIDE; RIBOFLAVIN PHOSPHATE SODIUM
HYDROCHLORIDE; VITAMIN A; VITAMIN E
ERGOLOID MESYLATES (DIHYDROERGOTOXINE METHANESULFONATE)
Ergoloid Mesylates
@ tablet, oral 1.0mg
(Dihydroergotoxine
@ tablet, oral 1.0mg
Methanesulfonate)
tablet, oral 1.0mg
@ tablet, sublingual 0.5,1.0mg
@ tablet, sublingual 0.5,1.0mg
@ tablet, sublingual 0.5mg
tablet, sublingual 1.0mg
@ tablet, sublingual 0.5,1.0mg
@ tablet, sublingual 0.5,1.0mg
@ tablet, sublingual 0.5,1.0mg
Brand(s)
Gerimal
@ tablet, oral 1mg
Hydergine
tablet, oral 1.0mg
(continued on the next page)
84
Barr
Circa
Mutual
Barr
Circa
IVAX
IVAX
KV
Lederle
Superpharm
Watson
Novartis
DRUG
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
ERGOLOID MESYLATES (DIHYDROERGOTOXINE METHANESULFONATE) (continued)
Alkergot
@ tablet, sublingual 0.5,1.0mg
Eon
Circanol
@ tablet, sublingual 0.5,1.0mg
Riker/3-M
Deapril-ST
@ tablet, sublingual 1.0mg
Bristol-Myers Squibb
Gerimal
tablet, sublingual 0.5,1mg
Watson
H.E.A.
@ tablet, sublingual 0.5,1.0mg
(Vangard/MWM)
Hydergine
tablet, sublingual 0.5,1.0mg
Novartis
ERGOTAMINE TARTRATE
Brand(s)
Ergomar
Ergostat
Wigrettes
tablet, sublingual 2mg
@ tablet, sublingual 2mg
@ tablet, sublingual 2mg
Harvest
Pfizer
Organon/Akzona
ERGOTAMINE TARTRATE; CAFFEINE
See CAFFEINE; ERGOTAMINE TARTRATE
ERYTHROMYCIN
Erythromycin
@
@
@
@
@
Brand(s)
Eryc Sprinkles*
Eryc 125*
Eryc*
Eryc*
Emgel
Erygel
Ilotycin
A/T/S
C-Solve-2
Eryderm
Erymax
Erythra-Derm
Erythro-Statin
Sansac
Staticin
T-Stat
C-Solve-2
Erycette
T-Stat
cap, delayed release pellets 250mg
cap, delayed release pellets 250mg
gel, topical 2%
gel, topical 2%
ointment, ophthalmic 5mg/gm (0.5%)
ointment, ophthalmic 5mg/gm (0.5%)
ointment, ophthalmic 5mg/gm (0.5%)
ointment, ophthalmic 5mg/gm (0.5%)
ointment, ophthalmic 5mg/gm (0.5%)
solution, topical 1.5%
solution, topical 2%
solution, topical 2%
solution, topical 2%
solution, topical 2%
solution, topical 2%
solution, topical 2%
solution, topical 1.5,2%
solution, topical 2%
swab, topical 2%
@ cap, delayed release pellets 125mg
@ cap, delayed release pellets 125mg
cap, delayed release pellets 250mg
@ cap, delayed release pellets 250mg
gel, topical 2%
gel, topical 2%
ointment, ophthalmic 5mg/gm (0.5%)
solution, topical 2%
solution, topical 2%
solution, topical 2%
solution, topical 2%
solution, topical 2%
solution, topical 2%
solution, topical 2%
solution, topical 1.5%
solution, topical 2%
swab, topical 2%
swab, topical 2%
swab, topical 2%
(continued on the next page)
85
Abbott*
Barr*
Altana
Stiefel
Akorn
Bausch and Lomb
Fougera/Altana
Pharmaderm/Altana
Pharmafair
Alpharma
Alpharma
Altana
Bausch and Lomb
Clay-Park
Lilly
Morton Grove
Pharmafair
Stiefel
Stiefel
Faulding
Pfizer
Faulding
Warner-Chilcott
GlaxoSmithKline
Allergan Herbert
Lilly/Dista
Aventis
Bioglan
Abbott
Allergan Herbert
Paddock
Hi-Tech
Healthpoint
Westwood Squibb
Westwood Squibb
IVAX
J and J
Westwood Squibb
DRUG
ERYTHROMYCIN (continued)
E-Base*
E-Mycin*
Ery-tab *
Ilotycin*
R-P Mycin*
Robimycin*
DOSAGE FORM, STRENGTH
tablet, delayed release 333,500mg
tablet, delayed release 250,333mg
tablet, delayed release 250,333,500mg
@ tablet, delayed release 250mg
@ tablet, delayed release 250mg
@ tablet, delayed release 250mg
APPLICATION HOLDER,
MANUFACTURER
Barr
Abbott
Abbott
Dista
Solvay
Robins
* The admission of erythromycin delayed release enteric coated tablets and delayed release capsules containing
enteric coated pellets to the Illinois Formulary as an exception to the promulgated criteria was approved by a
majority vote of the Technical Advisory Council, pursuant to Rule 790.60.
ERYTHROMYCIN ESTOLATE
Erythromycin Estolate
Brand(s)
Ilosone
Ilosone
@
@
@
@
capsule, oral eq 125mg base
capsule, oral eq 250mg base
capsule, oral eq 250mg base
capsule, oral eq 250mg base
suspension, oral eq 125,
250mg base/5ml
@ suspension, oral eq 125,
250mg base/5ml
@ suspension, oral eq 250mg base/5ml
@ capsule, oral eq 125,250mg base
suspension, oral eq 125,
250mg base/5ml
ERYTHROMYCIN ETHYLSUCCINATE
Erythromycin Ethylsuccinate
@
@
@
@
@
@
E.E.S.
Brand(s)
Ery-Ped
Pediamycin
E.E.S. 200,400
E-Mycin-E
Pediamycin
Wyamycin - E
granular powder, oral
eq 200mg base/5ml
suspension, oral eq 200,
400mg base/5ml
suspension, oral eq 200,
400mg base/5ml
suspension, oral eq 200,
400mg base/5ml
suspension, oral eq 400mg base/5ml
suspension, oral eq 200,
400mg base/5ml
suspension, oral eq 200,
400mg base/5ml
tablet, oral eq 400mg base
tablet, oral eq 400mg base
granular powder, oral
eq 200mg base/5ml
granular powder, oral
eq 200mg base/5ml
@ granular powder, oral
eq 200mg base/5ml
suspension, oral eq 200,
400mg base/5ml
@ suspension, oral eq 200,
400mg base/5ml
suspension, oral eq 200,
400mg base/5ml
@ suspension, oral eq 200,
400mg base/5ml
(continued on the next page)
86
Barr
Barr
IVAX
Watson
Alpharma
Barr
Life
Lilly/Dista
Lilly/Dista
Barr
Alpharma
KV
Lilly/Dista
Naska
Pfizer
Pharmafair
Barr
Mylan
Abbott
Abbott
Ross/Abbott
Abbott
Pharmacia & Upjohn
Ross/Abbott
Wyeth-Ayerst
DRUG
DOSAGE FORM, STRENGTH
ERYTHROMYCIN ETHYLSUCCINATE (continued)
E.E.S.
tablet, chewable eq 200mg base
Ery-Ped
tablet, chewable eq 200mg base
Pediamycin
@ tablet, chewable eq 200mg base
E.E.S. 400
tablet, oral eq 400mg base
ERYTHROMYCIN ETHYLSUCCINATE; SULFISOXAZOLE ACETYL
Erythromycin Ethylsuccinate;
suspension, oral eq 200mg base/5ml;
Sulfisoxazole Acetyl
eq 600mg base/5ml
Brand(s)
Eryzole
suspension, oral eq 200mg base/5ml;
eq 600mg base/5ml
Pediazole
suspension, oral eq 200mg base/5ml;
eq 600mg base/5ml
ERYTHROMYCIN LACTOBIONATE
Erythromycin Lactobionate
@ injection eq 500mg,1gm base/vial
Brand(s)
Erythrocin
injection eq 500mg,1gm base/vial
injection eq 500mg,1gm base/vial
injection eq 500mg,1gm base/vial
@ injection eq 500mg,1gm base/vial
injection eq 500mg,1gm base/vial
APPLICATION HOLDER,
MANUFACTURER
Abbott
Abbott
Ross/Abbott
Abbott
Barr
Alra
Ross/Abbott
American Pharmaceutical
Partners
Elkins-Sinn
Gensia Sicor
Lederle
Quad
Abbott
ERYTHROMYCIN STEARATE (Bearing approved labeling which states that the tablets should be taken in the fasting
state or immediately before meals) **
Erythromycin Stearate
tablet, oral eq 250mg base
Barr
@ tablet, oral eq 500mg base
Barr
@ tablet, oral eq 250,500mg base
Lederle
tablet, oral eq 250,500mg base
Mylan
tablet, oral eq 250,500mg base
Watson
Brand(s)
Erythrocin Stearate
tablet, oral eq 250,500mg base
Abbott
Wyamycin-S
@ tablet, oral eq 250,500mg base
Wyeth-Ayerst
** Drug product selection should be made only from products bearing the same type of approved labeling within
an entity sub-heading.
ERYTHROMYCIN STEARATE (Bearing approved labeling which states that the tablets should be taken on an empty
stomach) **
Erythromycin Stearate
@ tablet, oral eq 250,500mg base
IVAX
@ tablet, oral eq 250mg base
Purepac
Brand(s)
Bristamycin
@ tablet, oral eq 250,500mg base
Bristol/Bristol-Myers
Erypar
@ tablet, oral eq 250,500mg base
Warner Chilcott
Ethril 250,500
@ tablet, oral eq 250,500mg base
Squibb
Pfizer-E
@ tablet, oral eq 250,500mg base
Pfizer
** Drug product selection should be made only from products bearing the same type of approved labeling within
an entity sub-heading.
ESTAZOLAM
Estazolam
(continued on the next page)
tablet, oral 1,2mg
tablet, oral 1,2mg
tablet, oral 1,2mg
87
IVAX
Teva
Watson
DRUG
ESTAZOLAM (continued)
Brand(s)
Prosom
ESTRADIOL
Estradiol
Brand(s)
Climara
Vivelle
Vivelle-Dot
Estrace
Gynodiol
Innofem
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
tablet, oral 1,2mg
Abbott
film (AB2), extended release,
transdermal 0.05,0.1mg/24 hours
tablet, oral 0.5,1,2mg
tablet, oral 0.5,1,2mg
tablet, oral 0.5,1,2mg
tablet, oral 0.5,1,2mg
tablet, oral 0.5,1,2mg
Mylan
film (AB2), extended release,
transdermal 0.05,0.1mg/24 hours
film (AB1), extended release,
transdermal 0.0375,0.05,0.075,
0.1mg/24 hours
film (AB1), extended release,
transdermal 0.0375,0.05,0.075,
0.1mg/24 hours
tablet, oral 0.5,1,2mg
tablet, oral 0.5,1,2mg
tablet, oral 0.5,1,2mg
Applied Analytical Industries
Barr
ESI Lederle
Mylan
Watson
Berlex
Novartis
Novartis
Bristol-Myers Squibb *
Duramed/Barr
Novo Nordisk
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
Products designated “AB1" may only be interchanged with other products designated as “AB1.” Products
designated as “AB2" may only be interchanged with other products designated as “AB2.” Products designated
as “AB1" MAY NOT BE INTERCHANGED with products designated as “AB2.” Products designated as “AB2"
MAY NOT BE INTERCHANGED with products designated as “AB1.”
ESTRADIOL CYPIONATE
Estradiol Cypionate
Brand(s)
Depo-Estradiol
@ injection 5mg/ml
injection 5mg/ml
injection 5mg/ml
ESTRADIOL CYPIONATE; TESTOSTERONE CYPIONATE
Estradiol Cypionate;
@ injection 2mg/ml;50mg/ml
Testosterone Cypionate
Brand(s)
Depo-Testadiol
injection 2mg/ml;50mg/ml
ESTRADIOL VALERATE
Estradiol Valerate
Brand(s)
Delestrogen
@ injection 10mg/ml
injection 20,40mg/ml
injection 10,20,40mg/ml
ESTRADIOL VALERATE; TESTOSTERONE ENANTHATE
Estradiol Valerate;
@ injection 4mg/ml;90mg/ml
Testosterone Enanthate
@ injection 8mg/ml;180mg/ml
(continued on the next page)
88
Quad
Steris
Pharmacia & Upjohn
Steris
Pharmacia & Upjohn
Steris
Steris
King
Steris
Steris
DRUG
DOSAGE FORM, STRENGTH
ESTRADIOL VALERATE; TESTOSTERONE ENANTHATE (continued)
Brand(s)
Deladumone
@ injection 4mg/ml;90mg/ml
Deladumone-OB
@ injection 8mg/ml;180mg/ml
Ditate-DS
@ injection 8mg/ml;180mg/ml
APPLICATION HOLDER,
MANUFACTURER
Bristol-Myers Squibb
Bristol-Myers Squibb
Savage
ESTROPIPATE (PIPERAZINE ESTRONE SULFATE)
Estropipate
tablet, oral 0.625,1.25,2.5mg
Barr
(Piperazine Estrone Sulfate)
(equivalent to 0.75,1.5,3mg estropipate)
tablet, oral 0.625,1.25,2.5,5mg
Duramed/Barr
(equivalent to 0.75,1.5,3,6mg estropipate)
tablet, oral 0.625,1.25,2.5,5mg
Mylan
(equivalent to 0.75,1.5,3,6mg estropipate)
tablet, oral 0.625,1.25,2.5,5mg
Watson
(equivalent to 0.75,1.5,3,6mg estropipate)
Brand(s)
Ogen
tablet, oral 0.625,1.25,2.5,5mg
Pharmacia & Upjohn
(equivalent to 0.75,1.5,3,6mg estropipate)
Ortho-Est
tablet, oral 0.625,1.25mg
Women First Healthcare*
(equivalent to 0.75,1.5mg estropipate)
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
ETHAMBUTOL HYDROCHLORIDE
Ethambutol Hydrochloride
Brands(s)
Myambutol
ETHCHLORVYNOL
Ethchlorvynol
Brand(s)
Placidyl
Placidyl
tablet, oral 400mg
tablet, oral 100,400mg
Barr
West-ward
tablet, oral 100mg,400mg
Lederle
@ capsule, oral 100mg
@ capsule, oral 200,500,750mg
Banner Pharmacaps
Banner Pharmacaps
@ capsule, oral 100mg
capsule, oral 200,500,750mg
Abbott
Abbott
ETHINYL ESTRADIOL; DESOGESTREL
See DESOGESTREL; ETHINYL ESTRADIOL
ETHINYL ESTRADIOL; ETHYNODIOL DIACETATE
Brand(s)
Demulen 1/35
tablet, oral 0.035mg;1mg
Demulen 1/50
tablet, oral 0.05mg;1mg
Zovia 1/35E
tablet, oral 0.035mg;1mg
Zovia 1/50E
tablet, oral 0.05mg;1mg
Searle
Searle
Watson
Watson
NOTE: 21 day packs may not be interchanged with 28 day packs.
ETHINYL ESTRADIOL; LEVONORGESTREL
Brand(s)
Alesse
tablet, (AB1) oral 0.02mg;0.1mg
Aviane
tablet, (AB1) oral 0.02mg;0.1mg
Lessina
tablet, (AB2) oral 0.02mg;0.1mg
Levlite
tablet, (AB2) oral 0.02mg;0.1mg
(continued on the next page)
89
Wyeth
Duramed/Barr
Barr
Berlex
DRUG
DOSAGE FORM, STRENGTH
ETHINYL ESTRADIOL; LEVONORGESTREL (continued)
Levora 0.15/30
tablet, oral 0.03mg;0.15mg
Nordette
tablet, oral 0.03mg;0.15mg
Portia
tablet, oral 0.03mg;0.15mg
Enpresse
tablet, oral, triphasic 0.03mg;0.05mg/
0.04mg;0.075mg/0.03mg;0.125mg
Triphasil
tablet, oral, triphasic 0.03mg;0.05mg/
0.04mg;0.075mg/0.03mg;0.125mg
Trivora
tablet, oral, triphasic 0.03mg;0.05mg/
0.04mg;0.075mg/0.03mg;0.125mg
APPLICATION HOLDER,
MANUFACTURER
Watson
Wyeth *
Barr
Duramed/Barr
Wyeth *
Watson
NOTE: 21 day packs may not be interchanged with 28 day packs.
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
Products designated “AB1" may only be interchanged with other products designated as “AB1.” Products
designated as “AB2" may only be interchanged with other products designated as “AB2.” Products designated
as “AB1" MAY NOT BE INTERCHANGED with products designated as “AB2.” Products designated as “AB2"
MAY NOT BE INTERCHANGED with products designated as “AB1.”
ETHINYL ESTRADIOL; NORETHINDRONE
Brand(s)
Brevicon
tablet, oral 0.035mg;0.5mg
Nortrel 0.5/35
tablet, oral 0.035mg;0.5mg
Genora 0.5/35
@ tablet, oral 0.035mg;0.5mg
Modicon
tablet, oral 0.035mg;0.5mg
Nelova
tablet, oral 0.035mg;0.5mg
Nortrel 1/35
tablet, oral 0.035mg;1mg
N.E.E. 1/35
@ tablet, oral 0.035mg;1mg
Necon 1/35
tablet, oral 0.035mg;1mg
Nelova
tablet, oral 0.035mg;1mg
Norcept-E 1/35
tablet, oral 0.035mg;1mg
Norethin 1/35E
tablet, oral 0.035mg;1mg
Norinyl 1+35
tablet, oral 0.035mg;1mg
Ortho-Novum 1/35
tablet, oral 0.035mg;1mg
Nelova 7/14
tablet, oral 0.035mg;0.5mg,
0.035mg; 1mg
Ortho Novum 7/14
tablet, oral 0.035mg;0.5mg,
0.035mg; 1mg
Gencept 10/11
tablet, oral 0.035mg;0.5mg,
0.035mg; 1mg
Nelova 10/11
tablet, oral 0.035mg;0.5mg,
0.035mg; 1mg
Ortho Novum 10/11
tablet, oral 0.035mg;0.5mg and 1mg
0.035mg; 1mg
Necon 7/7/7
tablet, oral 0.035mg; 0.5mg,
0.035mg; 0.75mg, 0.035mg; 1mg
Nortrel 7/7/7
tablet, oral 0.035mg; 0.5mg,
0.035mg; 0.75mg, 0.035mg; 1mg
Ortho-Novum 7/7/7
tablet, oral 0.035mg; 0.5mg,
0.035mg; 0.75mg, 0.035mg; 1mg
Watson
Barr
Roche
Ortho-McNeil
Watson
Barr
Lexis
Watson
Watson
Gynopharma
Watson
Watson
Ortho-McNeil
Watson
Ortho-McNeil
Barr
Watson
Ortho-McNeil
Ortho-McNeil *
Barr
Ortho-McNeil *
Note: 21 day packs may not be interchanged with 28 day packs.
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
90
DRUG
DOSAGE FORM, STRENGTH
ETHINYL ESTRADIOL; NORETHINDRONE ACETATE
Brand(s)
Junel 1/20
tablet, oral 0.02mg;1mg
Junel 1.5/30
tablet, oral 0.03mg;1.5mg
Loestrin 1/20
tablet, oral 0.02mg;1mg
Loestrin 1.5/30
tablet, oral 0.03mg;1.5mg
Loestrin FE 1/20
tablet, oral 0.02mg;1mg
Loestrin FE 1.5/30
tablet, oral 0.03mg;1.5mg
Microgestin FE 1/20
tablet, oral 0.02mg;1mg
Microgestin FE 1.5/30
tablet, oral 0.03mg;1.5mg
APPLICATION HOLDER,
MANUFACTURER
Barr
Barr
Galen
Galen
Galen
Galen
Watson
Watson
Note: 21 day packs may not be interchanged with 28 day packs.
ETHINYL ESTRADIOL: NORGESTIMATE
Brand(s)
MonoNessa
tablet, oral 0.035mg;0.25mg
Ortho-Cyclen
tablet, oral 0.035mg;0.25mg
Sprintec
tablet, oral 0.035mg;0.25mg
Ortho-Tri-Cyclen
tablet, oral 0.035mg; 0.18mg,
0.035mg; 0.215mg, 0.035mg; 0.25mg
Tri-Sprintec
tablet, oral 0.035mg; 0.18mg,
0.035mg; 0.215mg, 0.035mg; 0.25mg
TriNessa
tablet, oral 0.035mg; 0.18mg,
0.035mg; 0.215mg, 0.035mg; 0.25mg
Ortho-McNeil *
Ortho-McNeil *
Barr
Ortho-McNeil *
Barr
Ortho-McNeil *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
ETHINYL ESTRADIOL; NORGESTREL
Brand(s)
Cryselle
tablet, oral 0.03mg;0.3mg
Lo/Ovral
tablet, oral 0.03mg;0.3mg
Low-Ogestrel
tablet, oral 0.03mg;0.3mg
Ogestrel
tablet, oral 0.05mg;0.5mg
Ovral
tablet, oral 0.05mg;0.5mg
Note: 21 day packs may not be interchanged with 28 day packs.
ETHOSUXIMIDE
Ethosuximide
Brand(s)
Zarontin
Zarontin
Duramed/Barr
Wyeth
Watson
SCS
Wyeth
capsule, oral 250mg
syrup, oral 250mg/5ml
syrup, oral 250mg/5ml
Banner
Copley
Pharmaceutical Associates
capsule, oral 250mg
syrup, oral 250mg/5ml
Pfizer
Pfizer
ETHYNODIOL DIACETATE; ETHINYL ESTRADIOL
See ETHINYL ESTRADIOL; ETHYNODIOL DIACETATE
ETIDRONATE DISODIUM
Etidronate Disodium
Brand(s)
Didronel
tablet, oral 200,400mg
GenPharm
tablet, oral 200,400mg
Procter and Gamble
91
DRUG
ETODOLAC
Etodolac
Brand(s)
Lodine
Lodine
Lodine XL
DOSAGE FORM, STRENGTH
capsule, oral 200,300mg
capsule, oral 200,300mg
capsule, oral 200,300mg
capsule, oral 200,300mg
capsule, oral 200,300mg
capsule, oral 200,300mg
capsule, oral 300mg
capsule, oral 200,300mg
capsule, oral 200,300mg
capsule, oral 200,300mg
tablet, oral 400,500mg
@ tablet, oral 400mg
tablet, oral 400mg
tablet, oral 400,500mg
tablet, oral 400mg
tablet, oral 400,500mg
tablet, oral 400,500mg
tablet, oral 400,500mg
tablet, oral 400mg
tablet, oral 400,500mg
tablet, oral 400,500mg
tablet, oral 400,500mg
tablet, oral 400,500mg
tablet, oral 400,500mg
tablet, extended release 400,500mg
tablet, extended release
400,500,600mg
tablet, extended release
400,500,600mg
tablet, extended release 400mg
capsule, oral 200,300mg
tablet, oral 400,500mg
tablet, extended release
400,500,600mg
APPLICATION HOLDER,
MANUFACTURER
Endo
Geneva
GenPharm
IVAX
Taro
Mylan
Neosan
Teva
TorPharm
Watson
Apotex
Endeavor
Endo
Eon
Geneva
GenPharm
IVAX
Mylan
Neosan
Purepac
Ranbaxy
Taro
Teva
Watson
Andrx
Eon
Teva
Whitney/Point
Wyeth *
Wyeth *
Wyeth *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
ETOMIDATE
Etomidate
Brand(s)
Amidate
ETOPOSIDE
Etoposide
Brand(s)
VePesid
(continued on the next page)
injection 2mg/ml
Bedford
injection 2mg/ml
Abbott
capsule, oral 50mg
injection 20mg/ml
injection 20mg/ml
GenPharm
Abbott
American Pharmaceutical
Partners
Bedford
Gensia Sicor
Marsam
Pharmachemie
Pierre Fabre Medicament
Steris
Supergen
injection 20mg/ml
injection 20mg/ml
injection 20mg/ml
injection 20mg/ml
@ injection 20mg/ml
@ injection 20mg/ml
injection 20mg/ml
capsule, oral 50mg
92
Bristol-Myers Squibb
DRUG
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
ETOPOSIDE (continued)
Toposar
VePesid
injection 20mg/ml
injection 20mg/ml
Pharmacia & Upjohn
Bristol-Myers Squibb
FAMOTIDINE
Famotidine
injection, 10mg/ml (preserved)
American Pharmaceutical
Partners
Apotex
Apothecon
Bedford
ESI Lederle
Faulding
Apothecon
Carlsbad
Dr. Reddy
Eon
Geneva
GenPharm
IVAX
Mylan
Purepac
Teva
TorPharm
Watson
Brand(s)
Famotidine (preservative-free)
Famotidine (preservative-free)
Famotidine (preservative-free)
Famotidine (preservative-free)
Famotidine (preservative-free)
Famotidine (preservative-free)
Famotidine (preservative-free)
Pepcid (preserved)
Pepcid (preservative-free)
Pepcid
FENOFIBRATE
Fenofibrate
Tricor
Brand(s)
FENOPROFEN CALCIUM
Fenoprofen Calcium
(continued on the next page)
injection, 10mg/ml (preserved)
@ injection, 10mg/ml (preserved)
injection, 10mg/ml (preserved)
injection, 10mg/ml (preserved)
injection, 10mg.ml (preserved)
@ tablet, oral 20,40mg
tablet, oral 20,40mg
tablet, oral 20,40mg
tablet, oral 10,20mg
tablet, oral 20,40mg
tablet, oral 20,40mg
tablet, oral 20,40mg
tablet, oral 20,40mg
tablet, oral 20,40mg
tablet, oral 20,40mg
tablet, oral 20,40mg
tablet, oral 20,40mg
injection, 10mg/ml
injection, 10mg/ml
@ injection, 10mg/ml
injection, 10mg/ml
injection, 10mg/ml
injection, 10mg/ml
injection, 10mg/ml
injection, 10mg/ml
injection, 10mg/ml
tablet, oral 20,40mg
capsule, oral, micronized
67,134,200mg
American Pharmaceutical
Partners
Apotex
Apothecon
Bedford
Ben Venue
ESI Lederle
Faulding
Merck
Merck
Merck
Teva
@ capsule, oral, micronized
67,134,200mg
Abbott
@ capsule, oral eq 200,300mg base
capsule, oral eq 200,300mg base
@ capsule, oral eq 200,300mg base
capsule, oral eq 200,300mg base
@ capsule, oral eq 200,300mg base
@ capsule, oral eq 200,300mg base
@ capsule, oral eq 200,300mg base
@ tablet, oral eq 600mg base
tablet, oral eq 600mg base
@ tablet, oral eq 600mg base
tablet, oral eq 600mg base
tablet, oral eq 600mg base
tablet, oral eq 600mg base
tablet, oral eq 600mg base
American Therapeutics
Geneva
Halsey
Par
Quantum
Warner Chilcott
Watson
American Therapeutics
Geneva
Halsey
IVAX
Lederle
Mutual
Mylan
93
DRUG
DOSAGE FORM, STRENGTH
FENOPROFEN CALCIUM (continued)
Nalfon
Nalfon
Brand(s)
FENTANYL CITRATE
Fentanyl Citrate
APPLICATION HOLDER,
MANUFACTURER
tablet, oral eq 600mg base
tablet, oral eq 600mg base
@ tablet, oral eq 600mg base
@ tablet, oral eq 600mg base
tablet, oral eq 600mg base
Par
Purepac
Quantum
USL
Watson
capsule, oral eq 200,300mg base
@ tablet, oral eq 600mg base
Ranbaxy
Lilly/Dista
injection eq 0.05mg base/ml
@ injection eq 0.05mg base/ml
Abbott
Steris
Brand(s)
Fentanyl Citrate Preservative-Free
Fentanyl Citrate Preservative-Free
Fentanyl Citrate
@
Preservative-Free
Sublimaze Preservative-Free
injection eq 0.05mg base/ml
injection eq 0.05mg base/ml
injection eq 0.05mg base/ml
Abbott
Elkins-Sinn
Marsam
injection eq 0.05mg base/ml
Akorn
FENTANYL CITRATE; DROPERIDOL
See DROPERIDOL; FENTANYL CITRATE
FLECAINAIDE ACETATE
Flecainide Acetate
Brand(s)
Tambocor
tablet, oral 50,100,150mg
tablet, oral 50,100,150mg
tablet, oral 50,100,150mg
tablet, oral 50,100,150mg
Alphapharm
Barr
Geneva
Roxane
tablet, oral 50,100,150mg
3M *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
FLOXURIDINE
Floxuridine
FUDR
Brand(s)
FLUDROCORTISONE ACETATE
Fludrocortisone Acetate
Brand(s)
Florinef
FLUNISOLIDE
Flunisolide
Brand(s)
Nasalide
injection 500mg/vial
injection 500mg/vial
@ injection 500mg/vial
American Pharmaceutical
Partners
Bedford
Quad
injection 500mg/vial
Faulding
tablet, oral 0.1mg
tablet, oral 0.1mg
Barr
Impax
tablet, oral 0.1mg
King
spray, metered, nasal 0.025mg/spray
Bausch & Lomb
spray, metered, nasal 0.025mg/spray
IVAX
94
DRUG
FLUOCINOLONE ACETONIDE
Fluocinolone Acetonide
Brand(s)
Fluocet
Fluonid
Fluotrex
Synalar
Fluonid
Fluotrex
Synalar
Fluonid
Fluotrex
Synalar
FLUOCINONIDE
Fluocinonide
Brand(s)
Lidex
Lidex-E
Lidex
Lidex
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
@ cream, topical 0.01%
@ cream, topical 0.01,0.025%
cream, topical 0.01,0.025%
cream, topical 0.01,0.025%
@ cream, topical 0.01,0.025%
@ cream, topical 0.01,0.025%
cream, topical 0.01,0.025%
@ cream, topical 0.01,0.025%
ointment, topical 0.025%
ointment, topical 0.025%
@ ointment, topical 0.025%
@ ointment, topical 0.025%
ointment, topical 0.025%
@ ointment, topical 0.025%
solution, topical 0.01%
@ solution, topical 0.01%
solution, topical 0.01%
@ solution, topical 0.01%
@ solution, topical 0.01%
@ solution, topical 0.01%
solution, topical 0.01%
Alpharma
Clay-Park
Fougera/Altana
G&W
Pharmaderm/Altana
Pharmafair
Taro
USL
Fougera/Altana
G&W
Pharmaderm/Altana
Pharmafair
Taro
USL
Alpharma
Bausch and Lomb
Fougera/Altana
Morton Grove
Pharmaderm
Pharmafair
Taro
@ cream, topical 0.025%
@ cream, topical 0.025%
@ cream, topical 0.01,0.025%
cream, topical 0.01,0.025%
@ ointment, topical 0.025%
@ ointment, topical 0.025%
ointment, topical 0.025%
@ solution, topical 0.01%
@ solution, topical 0.01%
solution, topical 0.01%
Alpharma
Allergan Herbert
Altana/Savage
Medicis
Allergan Herbert
Altana/Savage
Medicis
Allergan Herbert
Altana/Savage
Medicis
cream, topical 0.05%
@ cream, topical 0.05%
cream, topical 0.05%
cream, topical 0.05%
cream, topical 0.05%
cream, topical 0.05%
cream, emulsified base 0.05%
cream, emulsified base 0.05%
gel, topical 0.05%
gel, topical 0.05%
gel, topical 0.05%
ointment, topical 0.05%
ointment, topical 0.05%
ointment, topical 0.05%
solution, topical 0.05%
solution, topical 0.05%
solution, topical 0.05%
solution, topical 0.05%
solution, topical 0.05%
Alpharma
Clay-Park
Draxis
Fougera/Altana
Taro
Teva
Alpharma
Teva
Fougera/Altana
Taro
Teva
Altana
Taro
Teva
Alpharma
Copley
Fougera/Altana
Taro
Teva
cream, topical 0.05%
cream, emulsified base 0.05%
gel, topical 0.05%
ointment, topical 0.05%
(continued on the next page)
95
Medicis *
Medicis *
Medicis *
Medicis *
DRUG
FLUOCINONIDE (continued)
Lidex
DOSAGE FORM, STRENGTH
solution, top 0.05%
APPLICATION HOLDER,
MANUFACTURER
Medicis *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
FLUORIDE; ASCORBIC ACID; CYANOCOBALAMIN; IRON; NICOTINIC ACID; PYRIDOXINE HYDROCHLORIDE;
RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D; VITAMIN E
See ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; IRON; NICOTINIC ACID; PYRIDOXINE
HYDROCHLORIDE; RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D;
VITAMIN E
FLUORIDE; ASCORBIC ACID; CYANOCOBALAMIN; NICOTINIC ACID; PYRIDOXINE HYDROCHLORIDE;
RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D; VITAMIN E
See ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; NICOTINIC ACID; PYRIDOXINE
HYDROCHLORIDE; RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D;
VITAMIN E
FLUORIDE; ASCORBIC ACID; IRON; VITAMIN A; VITAMIN D
See ASCORBIC ACID; FLUORIDE; IRON; VITAMIN A; VITAMIN D
FLUORIDE; ASCORBIC ACID; VITAMIN A; VITAMIN D
See ASCORBIC ACID; FLUORIDE; VITAMIN A; VITAMIN D
FLUOROMETHOLONE
Brand(s)
Fluor-Op
FML
suspension, ophthalmic 0.1%
suspension, ophthalmic 0.1%
Novartis *
Allergan *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
FLUOROURACIL
Fluorouracil
Brand(s)
Adrucil
FLUOXETINE HYDROCHLORIDE
Fluoxetine Hydrochloride
(continued on the next page)
@ injection 50mg/ml
injection 50mg/ml
injection 50mg/ml
injection 50mg/ml
injection 50mg/ml
injection 50mg/ml
@ injection 50mg/ml
@ injection 50mg/ml
@ injection 50mg/ml
injection 50mg/ml
ABIC
American Pharmaceutical
Partners
Bedford
Bigmar
Gensia-Sicor
ICN Puerto Rico
Marchar
Quad
Smith and Nephew
Steris
injection 50mg/ml
Pharmacia & Upjohn
capsule, oral eq 10,20mg base
capsule, oral eq 10,20mg base
capsule, oral eq 10,20mg base
capsule, oral eq 10,20,40mg base
capsule, oral eq 10,20mg base
Alphapharm
Barr
Carlsbad
Dr. Reddy
Eon
96
DRUG
DOSAGE FORM, STRENGTH
FLUOXETINE HYDROCHLORIDE (continued)
capsule, oral eq 10,20,40mg base
capsule, oral eq 10,20mg base
capsule, oral eq 10,20mg base
capsule, oral eq 10,20mg base
capsule, oral eq 10,20mg base
capsule, oral eq 10,20mg base
capsule, oral eq 10,20mg base
capsule, oral eq 10,20,40mg base
capsule, oral eq 10,20mg base
solution, oral eq 20mg base/5ml
solution, oral eq 20mg base/5ml
solution, oral eq 20mg base/5ml
solution, oral eq 20mg base/5ml
tablet, oral eq 10mg base
tablet, oral eq 10mg base
tablet, oral eq 10mg base
tablet, oral eq 10mg base
tablet, oral eq 10mg base
Brand(s)
Prozac
capsule, oral eq 10,20,40mg base
Prozac
solution, oral eq 20mg base/5ml
Prozac
tablet, oral eq 10mg base
Rapiflux
tablet, oral eq 20mg base
APPLICATION HOLDER,
MANUFACTURER
Geneva
IVAX
Mallinckrodt
Mutual
Mylan
Sidmak
Siegfried
Teva
Watson
Alpharma
Mallinckrodt
Novex
Teva
Alphapharm
Barr
Eon
IVAX
Teva
Lilly
Lilly
Lilly
Alphapharm *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
FLUPHENAZINE DECANOATE
Fluphenazine Decanoate
Brand(s)
Prolixin Decanoate
FLUPHENAZINE HYDROCHLORIDE
Fluphenazine Hydrochloride
Brand(s)
Permetil
Prolixin
Prolixin
Prolixin
Prolixin
injection 25mg/ml
injection 25mg/ml
injection 25mg/ml
injection 25mg/ml
injection 25mg/ml
@ injection 25mg/ml
American Pharmaceutical
Partners
Apotex
Bedford
Gensia Sicor
King
Quad
injection 25mg/ml
Bristol-Myers Squibb
concentrate, oral 5mg/ml
concentrate, oral 5mg/ml
elixir, oral 2.5mg/5ml
elixir, oral 2.5mg/5ml
injection 2.5mg/ml
Copley
Pharmaceutical Associates
Copley
Pharmaceutical Associates
American Pharmaceutical
Partners
Quad
Circa
Geneva
Mylan
Par
@ injection 2.5mg/ml
@ tablet, oral 1,2.5,5,10mg
tablet, oral 1,2.5,5,10mg
tablet, oral 1,2.5,5,10mg
tablet, oral 1,2.5,5,10mg
concentrate, oral 5mg/ml
concentrate, oral 5mg/ml
elixir, oral 2.5mg/5ml
injection 2.5mg/ml
tablet, oral 1,2.5,5,10mg
97
Schering
Apothecon
Apothecon
Apothecon
Apothecon
DRUG
FLURANDRENOLIDE
Flurandrenolide
Brand(s)
Cordran
FLURAZEPAM HYDROCHLORIDE
Flurazepam Hydrochloride
Brand(s)
Dalmane
FLURBIPROFEN
Flurbiprofen
Brand(s)
Ansaid
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
@ lotion, topical 0.05%
Alpharma
lotion, topical 0.05%
Oclassen
@ capsule, oral 15,30mg
capsule, oral 15,30mg
@ capsule, oral 15,30mg
capsule, oral 15,30mg
capsule, oral 15,30mg
@ capsule, oral 15,30mg
@ capsule, oral 15,30mg
@ capsule, oral 15,30mg
@ capsule, oral 15,30mg
capsule, oral 15,30mg
capsule, oral 15,30mg
capsule, oral 15,30mg
tablet, oral 50,100mg
tablet, oral 50,100mg
tablet, oral 50,100mg
tablet, oral 50,100mg
tablet, oral 50,100mg
tablet, oral 50,100mg
@ tablet, oral 50mg
tablet, oral 100mg
tablet, oral 50,100mg
Barr
Geneva
Halsey
Mylan
Par
Purepac
Superpharm
USL
Warner-Chilcott
Watson
West-ward
ICN
Caraco
Geneva
IVAX
Mylan
Sidmak
Teva
Warner Chilcott
Warner Chilcott
Pharmacia & Upjohn *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
FLURBIPROFEN SODIUM
Flurbiprofen Sodium
Brand(s)
Ocufen
solution, ophthalmic 0.03%
Aventis Behring
solution, ophthalmic 0.03%
Allergan *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
FLUTAMIDE
Flutamide
Brand(s)
Eulexin
FLUVOXAMINE MALEATE
Fluvoxamine Maleate
(continued on the next page)
capsule, oral 125mg
capsule, oral 125mg
capsule, oral 125mg
capsule, oral 125mg
Barr
Eon
IVAX
Teva
capsule, oral 125mg
Schering
tablet, oral 25,50,100mg
tablet, oral 25,50,100mg
tablet, oral 25,50,100mg
tablet, oral 25,50,100mg
Barr
Eon
Geneva
GenPharm
98
DRUG
DOSAGE FORM, STRENGTH
FLUVOXAMINE MALEATE (continued)
Luvox
Brand(s)
@ tablet, oral 25,50,100mg
FOLIC ACID
Folic Acid
injection 5mg/ml
@
@
@
@
@
@
@
@
@
@
@
@
@
@
@
@
Folvite
Folicet
Folvite
Brand(s)
tablet, oral 25,50,100mg
tablet, oral 25,50,100mg
tablet, oral 25,50,100mg
tablet, oral 25,50,100mg
tablet, oral 25,50,100mg
tablet, oral 25,50,100mg
tablet, oral 25,50,100mg
@
injection 5mg/ml
tablet, oral 1mg
tablet, oral 1mg
tablet, oral 1mg
tablet, oral 1mg
tablet, oral 1mg
tablet, oral 1mg
tablet, oral 1mg
tablet, oral 1mg
tablet, oral 1mg
tablet, oral 1mg
tablet, oral 1mg
tablet, oral 1mg
tablet, oral 1mg
tablet, oral 1mg
tablet, oral 1mg
tablet, oral 1mg
tablet, oral 1mg
tablet, oral 1mg
tablet, oral 1mg
tablet, oral 1mg
tablet, oral 1mg
tablet, oral 1mg
tablet, oral 1mg
tablet, oral 1mg
injection 5mg/ml
tablet, oral 1mg
@ tablet, oral 1mg
APPLICATION HOLDER,
MANUFACTURER
IVAX
Mylan
Purepac
Synthon
Teva
TorPharm
Watson
Solvay
American Pharmaceutical
Partners
Loch
Anabolic
Barr
Circa
Eon
Everylife
Halsey
ICN
Impax
IVAX
Lannett
Lilly
MK
Pharmeral
Pioneer
Private Formulations
Purepac
Tablicaps
(Unit Dose Labs)
USL
(Vangard/MWM)
Vintage
Watson
West-ward
Whiteworth Towne
Wyeth
Mission
Wyeth
FOLIC ACID; ASCORBIC ACID; BIOTIN; CYANOCOBALAMIN; DEXPANTHENOL; ERGOCALCIFEROL;
NIACINAMIDE; PYRIDOXINE HYDROCHLORIDE; RIBOFLAVIN PHOSPHATE SODIUM; THIAMINE
HYDROCHLORIDE; VITAMIN A; VITAMIN E
See ASCORBIC ACID; BIOTIN; CYANOCOBALAMIN; DEXPANTHENOL; ERGOCALCIFEROL; FOLIC
ACID; NIACINAMIDE; PYRIDOXINE HYDROCHLORIDE; RIBOFLAVIN PHOSPHATE SODIUM
HYDROCHLORIDE; VITAMIN A; VITAMIN E
FUROSEMIDE
Furosemide
(continued on the next page)
injection 10mg/ml
injection 10mg/ml
@ injection 10mg/ml
injection 10mg/ml
injection 10mg/ml
99
Abbott
American Pharmaceutical
Partners
AstraZeneca
Elkins-Sinn
International Medication
DRUG
DOSAGE FORM, STRENGTH
FUROSEMIDE (continued)
@
@
@
@
@
@
@
@
@
Lasix
Lasix
Lasix
Brand(s)
GEMFIBROZIL
Gemfibrozil
Lopid
Lopid
Brand(s)
APPLICATION HOLDER,
MANUFACTURER
injection 10mg/ml
injection 10mg/ml
injection 10mg/ml
injection 10mg/ml
injection 10mg/ml
injection 10mg/ml
injection 10mg/ml
injection 10mg/ml
solution, oral 10mg/ml
solution, oral 10mg/ml
tablet, oral 20,40,80mg
tablet, oral 40mg
tablet, oral 20,40,80mg
tablet, oral 20,40mg
tablet, oral 20,40mg
tablet, oral 20,40mg
tablet, oral 20,40,80mg
tablet, oral 20,40,80mg
tablet, oral 20,40,80mg
tablet, oral 20,40mg
tablet, oral 20,40,80mg
tablet, oral 20,40,80mg
Lederle
Luitpold
Marsam
Organon/Akzona
Smith and Nephew
Steris
Warner Chilcott
Wyeth-Ayerst
Morton Grove
Roxane
Barr
Eon
Geneva
International Medication
IVAX
Kalapharm
Lederle
Mylan
Roxane
Superpharm
Warner Chilcott
Watson
injection 10mg/ml
solution, oral 10mg/ml
tablet, oral 20,40,80mg
Aventis
Aventis
Aventis
@ capsule, oral 300mg
@ capsule, oral 300mg
tablet, oral 600mg
tablet, oral 600mg
tablet, oral 600mg
@ tablet, oral 600mg
tablet, oral 600mg
tablet, oral 600mg
tablet, oral 600mg
Mylan
Purepac
Geneva
Lederle
Mylan
Purepac
Teva
TorPharm
Watson
@ capsule, oral 300mg
tablet, oral 600mg
Pfizer
Pfizer *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
GENTAMICIN SULFATE
Gentamicin Sulfate
(continued on the next page)
@ cream, topical eq 0.1% base
@ cream, topical eq 0.1% base
cream, topical eq 0.1% base
cream, topical eq 0.1% base
@ cream, topical eq 0.1% base
cream, topical eq 0.1% base
injection eq 10,40mg base/ml
injection eq 10,40mg base/ml
injection eq 10,40mg base/ml
@ injection eq 10,40mg base/ml
@ injection eq 1,40mg base/ml
injection eq 40mg base/ml
100
Alpharma
Bausch and Lomb
Clay-Park
Fougera/Altana
Pharmaderm/Altana
Taro
Abbott
American Pharmaceutical
Partners
Elkins-Sinn
Gensia Sicor
International Medication
Kalapharm
DRUG
GENTAMICIN SULFATE (continued)
DOSAGE FORM, STRENGTH
injection eq 40mg base/ml
injection eq 10,40mg base/ml
injection eq 10,40mg base/ml
injection eq 10,40mg base/ml
ointment, topical eq 0.1% base
ointment, topical eq 0.1% base
ointment, topical eq 0.1% base
ointment, topical eq 0.1% base
@ ointment, topical eq 0.1% base
ointment, topical eq 0.1% base
ointment, ophthalmic eq 0.3% base
@ solution, ophthalmic eq 0.3% base
solution, ophthalmic eq 0.3% base
solution, ophthalmic eq 0.3% base
@ solution, ophthalmic eq 0.3% base
@
@
@
@
@
Brand(s)
Garamycin
Gentafair
Apogen
Bristagen
Garamycin
Garamycin
Gentafair
U-Gencin
Garamycin
Gentafair
Garamycin
Gentacidin
Gentafair
AK-Gentak
Garamycin
Genoptic
Gentacidin
Gentafair
@
@
@
@
@
@
@
@
@
@
@
cream, topical eq 0.1% base
cream, topical eq 0.1% base
injection eq 10,40mg base/ml
injection eq 40mg base/ml
injection eq 10mg base/ml
injection eq 1,40mg base/ml
injection eq 40mg base/ml
injection eq 10,40mg base/ml
ointment, topical eq 0.1% base
ointment, topical eq 0.1% base
ointment, ophthalmic eq 0.3% base
ointment, ophthalmic eq 0.3% base
ointment, ophthalmic eq 0.3% base
solution, ophthalmic eq 0.3% base
solution, ophthalmic eq 0.3% base
solution, ophthalmic eq 0.3% base
solution, ophthalmic eq 0.3% base
solution, ophthalmic eq 0.3% base
APPLICATION HOLDER,
MANUFACTURER
Pharmaceutical Specialties
Solopak
Steris
Wyeth-Ayerst
Alpharma
Bausch and Lomb
Clay-Park
Fougera/Altana
Pharmaderm/Altana
Taro
Akorn
Alcon Universal
Bausch and Lomb
Falcon *
Paco
Schering
Pharmafair
King
Bristol/Bristol-Myers
Schering
Schering
Pharmafair
Pharmacia & Upjohn
Schering
Pharmafair
Schering
Novartis
Pharmafair
Akorn
Schering
Allergan
Novartis
Pharmafair
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
GENTAMICIN SULFATE; DEXTROSE
See DEXTROSE; GENTAMICIN SULFATE
GENTAMICIN SULFATE; SODIUM CHLORIDE
Gentamicin Sulfate;
injection eq 60mg base/100ml;
Sodium Chloride
900mg/100ml
injection eq 70mg base/100ml;
900mg/100ml
injection eq 80mg base/100ml;
900mg/100ml
injection eq 90mg base/100ml;
900mg/100ml
injection eq 100mg base/100ml;
900mg/100ml
injection eq 1.2mg base/ml;9mg/ml
injection eq 1.4mg base/ml;9mg/ml
injection eq 1.6mg base/ml;9mg/ml
injection eq 1.8mg base/ml;9mg/ml
injection eq 2mg base/ml;9mg/ml
(continued on the next page)
101
Abbott
Abbott
Abbott
Abbott
Abbott
Abbott
Abbott
Abbott
Abbott
Abbott
DRUG
DOSAGE FORM, STRENGTH
GENTAMICIN SULFATE; SODIUM CHLORIDE (continued)
injection eq 40mg base/100ml;
900mg/100ml
injection eq 60mg base/100ml;
900mg/100ml
injection eq 80mg base/100ml;
900mg/100ml
injection eq 100mg base/100ml;
900mg/100ml
injection eq 120mg base/100ml;
900mg/100ml
injection eq 0.8mg base/ml;9mg/ml
injection eq 1.2mg base/ml;9mg/ml
injection eq 1.6mg base/ml;9mg/ml
injection eq 2mg base/ml;9mg/ml
injection eq 2.4mg base/ml;9mg/ml
injection eq 40mg base/100ml;
900mg/100ml
injection eq 60mg base/100ml;
900mg/100ml
injection eq 70mg base/100ml;
900mg/100ml
injection eq 80mg base/100ml;
900mg/100ml
injection eq 90mg base/100ml;
900mg/100ml
injection eq 100mg base/100ml;
900mg/100ml
injection eq 120mg base/100ml;
900mg/100ml
injection eq 0.8mg base/ml;9mg/ml
injection eq 1.2mg base/ml;9mg/ml
injection eq 1.4mg base/ml;9mg/ml
injection eq 1.6mg base/ml;9mg/ml
injection eq 1.8mg base/ml;9mg/ml
injection eq 2mg base/ml;9mg/ml
injection eq 2.4mg base/ml;9mg/ml
GLIPIZIDE
Glipizide
Brand(s)
Glucotrol
GLUCAGON HYDROCHLORIDE
Glucagon Hydrochloride
tablet, oral 5,10mg
@ tablet, oral 5,10mg
tablet, oral 5,10mg
tablet, oral 5,10mg
tablet, oral 5,10mg
tablet, oral 5,10mg
tablet, oral 5,10mg
tablet, oral 5,10mg
tablet, oral 5,10mg
tablet, oral 5,10mg
tablet, oral 5,10mg
tablet, oral 5,10mg
injection eq 1mg/vial
@ injection eq 10mg/vial
@ injection eq 1,10mg/vial
102
APPLICATION HOLDER,
MANUFACTURER
Baxter
Baxter
Baxter
Baxter
Baxter
Baxter
Baxter
Baxter
Baxter
Baxter
Braun
Braun
Braun
Braun
Braun
Braun
Braun
Braun
Braun
Braun
Braun
Braun
Braun
Braun
Alphapharm
Circa
Duramed/Barr
Endo
Geneva
IVAX
Mylan
Sidmak
Teva
TorPharm
Watson
Pfizer
Lilly
Lilly
Quad
DRUG
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
GLUTATHIONE DISULFIDE; CALCIUM CHLORIDE; DEXTROSE; MAGNESIUM CHLORIDE; POTASSIUM
CHLORIDE; SODIUM BICARBONATE; SODIUM CHLORIDE; SODIUM PHOSPHATE
See CALCIUM CHLORIDE; DEXTROSE; GLUTATHIONE DISULFIDE; MAGNESIUM CHLORIDE;
POTASSIUM CHLORIDE; SODIUM BICARBONATE; SODIUM CHLORIDE; SODIUM PHOSPHATE
GLUTETHIMIDE
Glutethimide
Brand(s)
Doriden
GLYBURIDE
Glyburide
Brand(s)
Diabeta
Micronase
@
@
@
@
@
tablet, oral 500mg
tablet, oral 500mg
tablet, oral 250,500mg
tablet, oral 250,500mg
tablet, oral 500mg
Eon
Geneva
Halsey
Lannett
Watson
@ tablet, oral 250,500mg
Aventis
tablet, oral 1.25,2.5,5mg
tablet, oral 1.25,2.5,5mg
CorePharma ***
Teva ***
tablet, oral 1.25,2.5,5mg
tablet, oral 1.25,2.5,5mg
Aventis * **
Pharmacia & Upjohn * **
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
** Diabeta and Micronase are NOT INTERCHANGEABLE at this time. Neither company has to date presented
acceptable bioequivalence information comparing their brand of glyburide to the other. Aventis, via Copley
(Teva), is manufacturing glyburide for other labelers using the Diabeta federal new drug application (NDA) while
Pharmacia & Upjohn is doing the same, via Greenstone, for at least one labeler using the Micronase NDA. Thus,
Aventis manufactured generically labeled glyburide products are NOT INTERCHANGEABLE at this time with
Pharmacia & Upjohn manufactured generically labeled glyburide products.
*** Note: Glyburide by CorePharma and Teva (formerly Novopharm) has only been determined, at this time,
to be equivalent to Micronase by Pharmacia & Upjohn. Pharmacists need to be particularly careful when
selecting a CorePharma or Teva product to verify the identity of the innovator product it is replacing.
GLYBURIDE, MICRONIZED
Glyburide, micronized
Brand(s)
Glynase
tablet, oral 1.5,3,6mg
tablet, oral 1.5,3,6mg
tablet, oral 1.5,3,4.5,6mg
tablet, oral 1.5,3mg
tablet, oral 1.5,3,6mg
tablet, oral 1.5,3,4.5,6mg
Amide
Aventis
Clonmel
Geneva
Mylan
Teva
tablet, oral 1.5,3,6mg
Pharmacia & Upjohn *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
Note: Prescribers and pharmacists should be aware of the differences in scoring mechanisms between different
manufacturers’ tablets and should take these differences into account when writing a prescription or practicing
drug product selection when the prescriber’s instructions to the patient call for the use of half tablets.
GLYCINE
Glycine
(Aminoacetic Acid)
solution for irrigation
solution 1.5gm/100ml (1.5%)
solution 1.5gm/100ml (1.5%)
solution 1.5gm/100ml (1.5%)
103
Abbott
Baxter
Braun
DRUG
GLYCOPYRROLATE
Glycopyrrolate
Brand(s)
Robinul
Robinul
Robinul Forte
DOSAGE FORM, STRENGTH
@ injection 0.2mg/ml
@ injection 0.2mg/ml
@ injection 0.2mg/ml
injection 0.2mg/ml
@ injection 0.2mg/ml
@ injection 0.2mg/ml
@ tablet, oral 1,2mg
@ tablet, oral 1,2mg
injection 0.2mg/ml
tablet, oral 1mg
tablet, oral 2mg
GONADOTROPIN CHORIONIC
Chorionic Gonadotropin
@
@
A.P.L.
Follutein
Pregnyl
Abbott
American Pharmaceutical
Partners
Gensia Sicor
Luitpold
Quad
Steris
Circa
Watson
Robins
First Horizon
First Horizon
injection 10,000IU/10ml
@
Brand(s)
APPLICATION HOLDER,
MANUFACTURER
@
American Pharmaceutical
Partners
injection 5,000, 15,000, 20,000IU/10ml American Pharmaceutical
Partners
injection 5,000, 10,000IU/10ml
Bel-Mar
injection 5,000, 10,000, 20,000IU/10ml Quad
injection 5,000, 10,000IU/10ml
Steris
injection 15,000, 20,000IU/10ml
Steris
injection 5,000, 10,000, 20,000IU/10ml Wyeth-Ayerst
@ injection 10,000IU/10ml
Squibb
injection 10,000IU/10ml
Organon/Akzona
GRAMICIDIN; NEOMYCIN SULFATE; POLYMYXIN B SULFATE
Gramicidin; Neomycin Sulfate;
solution, ophthalmic 0.025mg/ml;
Polymyxin B Sulfate
eq 1.75mg base/ml; 10,000U/ml
@ solution, ophthalmic 0.025mg/ml;
eq 1.75mg base/ml; 10,000U/ml
@ solution, ophthalmic 0.025mg/ml;
eq 1.75mg base/ml; 10,000U/ml
Brand(s)
Neo-Polycin
@ solution, ophthalmic 0.025mg/ml;
eq 1.75mg base/ml; 10,000U/ml
Neosporin
solution, ophthalmic 0.025mg/ml;
eq 1.75mg base/ml; 10,000U/ml
Ocutricin
@ solution, ophthalmic 0.025mg/ml;
eq 1.75mg base/ml; 10,000U/ml
GRISEOFULVIN MICROCRYSTALLINE
Brand(s)
Fulvicin-U/F
tablet, oral 250,500mg
Grifulvin V
tablet, oral 250,500mg
Grisactin
@ tablet, oral 500mg
Bausch and Lomb
Ipharm
Steris
Dow
Monarch
Pharmafair
Schering
J&J
Wyeth-Ayerst *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
GRISEOFULVIN ULTRAMICROCRYSTALLINE
Brand(s)
Fulvicin P/G
tablet, oral 125,165,250,330mg
Gris-PEG
tablet, oral 125,250mg
(continued on the next page)
104
Schering
Pedinol
DRUG
DOSAGE FORM, STRENGTH
GRISEOFULVIN ULTRAMICROCRYSTALLINE (continued)
Grisactin Ultra
@ tablet, oral 125,250mg
Grisactin Ultra
@ tablet, oral 165,330mg
Ultragris 165, 330
@ tablet, oral 165,330mg
APPLICATION HOLDER,
MANUFACTURER
Wyeth-Ayerst *
Wyeth-Ayerst *
Sidmak
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
GUAIFENESIN; CODEINE PHOSPHATE
See CODEINE PHOSPHATE; GUAIFENESIN
GUAIFENESIN; CODEINE PHOSPHATE; PSEUDOEPHEDRINE HYDROCHLORIDE
See CODEINE PHOSPHATE; GUAIFENESIN; PSEUDOEPHEDRINE HYDROCHLORIDE
GUAIFENESIN; HYDROCODONE BITARTRATE; PSEUDOEPHEDRINE HYDROCHLORIDE
Guaifenesin;
syrup, oral 200mg/5ml;5mg/5ml;
Morton Grove
Hydrocodone Bitartrate;
60mg/5ml
Pseudoephedrine Hydrochloride
Brand(s)
Detussin Expectorant
syrup, oral 200mg/5ml;5mg/5ml;
Alpharma
60mg/5ml
Hydrophed Expectorant
syrup, oral 200mg/5ml;5mg/5ml;
Norton
60mg/5ml
Hytussin Expectorant
syrup, oral 200mg/5ml;5mg/5ml;
Cenci
60mg/5ml
Tussend Expectorant
syrup, oral 200mg/5ml;5mg/5ml;
Aventis
60mg/5ml
* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as an
exception to the promulgated criteria for inclusion, pursuant to Rule 790.60.
GUAIFENESIN; PHENYLEPHRINE HYDROCHLORIDE; PHENYLPROPANOLAMINE HYDROCHLORIDE
Brand(s)
Entex
liquid 100mg/5ml;5mg/5ml;20mg/5ml
Procter and Gamble
Sil-Tex
liquid 100mg/5ml;5mg/5ml;20mg/5ml
Silarx
* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as an
exception to the promulgated criteria for inclusion, pursuant to Rule 790.60.
GUAIFENESIN; THEOPHYLLINE
Guaifenesin; Theophylline
Brand(s)
Quibron
liquid, oral 90mg/15ml;150mg/15ml
liquid, oral 90mg/15ml;150mg/15ml
liquid, oral 90mg/15ml;150mg/15ml
liquid, oral 90mg/15ml;150mg/15ml
liquid, oral 90mg/15ml;150mg/15ml
liquid, oral 90mg/15ml;150mg/15ml
Alpharma
Central
Forest
Geneva
Naska
Aventis
liquid, oral 90mg/15ml;150mg/15ml
Bristol-Myers
* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as an
exception to the promulgated criteria for inclusion, pursuant to Rule 790.60.
GUANABENZ ACETATE
Guanabenz Acetate
(continued on the next page)
tablet, oral eq 4,8mg base
tablet, oral eq 4,8mg base
105
Copley
Eon
DRUG
GUANABENZ ACETATE (continued)
Brand(s)
Wytensin
GUANETHIDINE MONOSULFATE
Guanethidine Monosulfate
Brand(s)
Ismelin
GUANFACINE HYDROCHLORIDE
Guanfacine Hydrochloride
Tenex
Brand(s)
HALOPERIDOL
Haloperidol
Haldol
Brand(s)
HALOPERIDOL DECANOATE
Haloperidol Decanoate
Brand(s)
Haldol Decanoate
HALOPERIDOL LACTATE
Haloperidol Lactate
(continued on the next page)
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
tablet, oral eq 4,8mg base
tablet, oral eq 4,8mg base
IVAX
Watson
tablet, oral eq 4,8mg base
Wyeth-Ayerst
@ tablet, oral eq 10,25mg sulfate
Circa
@ tablet, oral eq 10,25mg sulfate
Novartis
tablet, oral eq 1,2mg base
tablet, oral eq 1,2mg base
tablet, oral eq 1,2mg base
tablet, oral eq 1,2mg base
Amide
GenPharm
Mylan
Watson
tablet, oral eq 1,2mg base
ESP
@ tablet, oral 0.5,1,2,5,10,20mg
@ tablet, oral 0.5,1,2,5,10,20mg
@ tablet, oral 0.5,1,2,5,10,20mg
tablet, oral 0.5,1,2,5,10,20mg
@ tablet, oral 0.5,1,2,5,10,20mg
tablet, oral 0.5,1,2,5mg
tablet, oral 0.5,1,2,5,10mg
@ tablet, oral 20mg
@ tablet, oral 0.5,1,2,5,10,20mg
@ tablet, oral 0.5,1,2,5mg
@ tablet, oral 0.5,1,2,5,10,20mg
@ tablet, oral 0.5,1,2,5,10,20mg
tablet, oral 0.5,2,5mg
@ tablet, oral 1,10,20mg
Barr
Circa
Duramed/Barr
Geneva
Lederle
Mylan
Par
Par
Purepac
Quantum
Roxane
SCS
Watson
Watson
@ tablet, oral 0.5,1,2,5,10,20mg
Ortho-McNeil
injection eq 50,100mg base/ml
injection eq 50,100mg base/ml
injection eq 50,100mg base/ml
injection eq 50,100mg base/ml
injection eq 50,100mg base/ml
American Pharmaceutical
Partners
Apotex
Bedford
Gensia Sicor
King
injection eq 50,100mg base/ml
Ortho-McNeil
@ concentrate, oral eq 2mg base/ml
concentrate, oral eq 2mg base/ml
@ concentrate, oral eq 2mg base/ml
concentrate, oral eq 2mg base/ml
@ concentrate, oral eq 2mg base/ml
@ concentrate, oral eq 2mg base/ml
concentrate, oral eq 2mg base/ml
concentrate, oral eq 2mg base/ml
106
Alpharma
Copley
Morton Grove
Pharmaceutical Associates
Roxane
SCS
Silarx
Teva
DRUG
DOSAGE FORM, STRENGTH
HALOPERIDOL LACTATE (continued)
@
@
@
@
Haldol
Haldol
Brand(s)
HALOTHANE
Halothane
Brand(s)
Fluothane
HEPARIN SODIUM
Heparin Sodium
Brand(s)
Hep-Flush
Hep-Lock, Hep Lock U/P
Heparin Sodium
Preservative-Free
Lipo-Hepin
(continued on the next page)
injection eq 5mg base/ml
injection eq 5mg base/ml
injection eq 5mg base/ml
injection eq 5mg base/ml
injection eq 5mg base/ml
injection eq 5mg base/ml
APPLICATION HOLDER,
MANUFACTURER
American Pharmaceutical
Partners
Marsam
Quad
Smith and Nephew
SoloPak
Steris
@ concentrate, oral eq 2mg base/ml
injection eq 5mg base/ml
Ortho-McNeil
Ortho McNeil
liquid for inhalation 99.99%
@ liquid for inhalation 99.99%
liquid for inhalation 99.99%
Abbott
BH
Halocarbon
@ liquid for inhalation 99.99%
Wyeth-Ayerst
@ injection 1,000, 5,000, 10,000, 20,000,
40,000U/ml
injection 1,000, 5,000, 10,000,
20,000U/ml
injection 1,000U/ml
@ injection 1,000, 5,000, 10,000,
20,000U/ml
@ injection 1,000, 5,000, 10,000, 20,000,
40,000U/ml
injection 1,000, 5,000, 10,000U/ml
@ injection 10U/ml
@ injection 1,000, 20,000U/ml
injection 10,000U/ml
@ injection 10, 100, 1,000U/ml
injection 1,000U/ml
@ injection 20,000, 40,000U/ml
@ injection 10, 1,000, 5,000, 10,000,
20,000U/ml
@ injection 1,000, 5,000, 10,000,
20,000, 40,000U/ml
@ injection 1,000U/ml
@ injection 10, 100, 1,000U/ml
@ injection 10, 100, 1,000, 5,000
10,000U/ml
@ injection 10,000U/0.5ml
@ injection 100, 1,000, 5,000, 10,000,
20,000, 40,000U/ml
@ injection 5,000, 10,000U/ml
injection 1,000, 5,000, 10,000U/ml
@ injection 10, 100, 1,000, 2,500, 5,000,
10,000, 20,000U/ml
Akorn
injection 10, 100U/ml
American Pharmaceutical
Partners
Baxter
Chamberlin
Dell
Elkins-Sinn
International Medication
Lilly
Lilly
Luitpold
Marsam
Organon/Akzona
Pfizer
Pharmaceutical Specialties
Pharmaserv
Smith and Nephew
Solopak
Solopak
Steris
Sterling Winthrop
Pharmacia & Upjohn
Wyeth-Ayerst
American Pharmaceutical
Partners
injection 10, 100U/ml
Elkins-Sinn
injection 1,000U/ml
American Pharmaceutical
Partners
@ injection 1,000, 5,000, 10,000, 20,000, Riker/3-M
40,000U/ml
107
DRUG
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
HEPARIN SODIUM (continued)
Liquaemin Sodium
@ injection 100, 1,000, 5,000, 10,000,
Organon/Akzona
20,000, 40,000U/ml
Panheprin
injection 10, 100, 2,500, 5,000U/ml
Abbott
Panheprin
@ injection 1,000, 20,000, 40,000,
Abbott
10,000U/ml
NOTE: Check for equivalent strengths prior to drug product selection. Products with preservatives may
not be interchanged with preservative-free products.
HEPARIN SODIUM; DEXTROSE
See DEXTROSE; HEPARIN SODIUM
HEPARIN SODIUM; SODIUM CHLORIDE
Heparin Sodium;
injection 200U/100ml;900mg/100ml
Sodium Chloride
@ injection 1000U/100ml;900mg/100ml
injection 5000U/100ml;450mg/100ml
@ injection 5000U/100ml;900mg/100ml
injection 200U/100ml;900mg/100ml
injection 200U/100ml;900mg/100ml
@ injection 1000U/100ml;900mg/100ml
@ injection 5000U/100ml;450mg/100ml
@ injection 5000U/100ml;900mg/100ml
Abbott
Abbott
Abbott
Abbott
Baxter
Braun
Braun
Braun
Braun
HEXACHLOROPHENE
Brand(s)
Hexa-Germ
pHisoHex
Soy-Dome
Turgex
Dial
Germa-Medica "MG"
Septisoft
Septisol
Hexascrub
pHisoscrub
Huntington
Sanofi Synthelabo
Miles
Xttrium
Dial
Huntington
Calgon
Vestal
Prof Disposables
Sanofi Synthelabo
HOMATROPINE HYDROBROMIDE
Homatropine Methylbromide
Brand(s)
AK-Homatropine
I-Homatropine
Isopto Homatropine
@ emulsion, topical 3%
emulsion, topical 3%
@ emulsion, topical 3%
@ emulsion, topical 3%
@ solution, topical 0.25%
@ solution, topical 0.25%
@ solution, topical 0.25%
@ solution, topical 0.25%
@ sponge, topical 3%
@ sponge, topical 3%
solution, ophthalmic 2,5%
solution, ophthalmic 5%
solution, ophthalmic 5%
Iolab
Paco
Pharmafair
solution, ophthalmic 5%
solution, ophthalmic 5%
solution, ophthalmic 2,5%
Akorn
Americal
Alcon
* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as an
exception to the promulgated criteria for inclusion, pursuant to Rule 790.60.
HOMATROPINE METHYLBROMIDE; HYDROCODONE BITARTRATE
Homatropine Methylbromide;
tablet, oral 1.5mg/5mg
Hydrocodone Bitartrate
Brand(s)
Hycodan
syrup, oral 1.5mg/5ml;5mg/5ml
Hydrocodone Compound
syrup, oral 1.5mg/5ml;5mg/5ml
Hydropane
syrup, oral 1.5mg/5ml;5mg/5ml
Mycodone
syrup, oral 1.5mg/5ml;5mg/5ml
Hycodan
tablet, oral 1.5mg;5mg
Tussigon
tablet, oral 1.5mg;5mg
108
Amide
Endo
Alpharma
Halsey
Morton Grove
Endo
Jones
DRUG
DOSAGE FORM, STRENGTH
HYDRALAZINE HYDROCHLORIDE
Hydralazine Hydrochloride
injection 20mg/ml
@
@
@
@
@
@
@
@
@
@
@
@
@
@
Brand(s)
Apresoline
Apresoline
Dralzine
APPLICATION HOLDER,
MANUFACTURER
@
injection 20mg/ml
injection 20mg/ml
injection 20mg/ml
injection 20mg/ml
tablet, oral 10,25,50,100mg
tablet, oral 25,50mg
tablet, oral 25,50mg
tablet, oral 10,25,50,100mg
tablet, oral 25,50mg
tablet, oral 10,25,50mg
tablet, oral 10,25,50,100mg
tablet, oral 25mg
tablet, oral 50mg
tablet, oral 10,25,50,100mg
tablet, oral 25,50mg
tablet, oral 10,25,50mg
tablet, oral 10,25,50,100mg
tablet, oral 25,50mg
tablet, oral 10,25,50,100mg
tablet, oral 10,25,50,100mg
tablet, oral 10,25,50mg
tablet, oral 25,50mg
tablet, oral 25,50mg
tablet, oral 25,50mg
tablet, oral 25,50mg
@ injection 20mg/ml
tablet, oral 10,25,50,100mg
@ tablet, oral 25mg
HYDRALAZINE HYDROCHLORIDE; HYDROCHLOROTHIAZIDE
Hydralazine Hydrochloride;
@ capsule, oral 25mg;25mg, 50mg;50mg,
Hydrochlorothiazide
100mg;50mg
@ capsule, oral 25mg;25mg, 50mg;50mg
100mg;50mg
@ capsule, oral 25mg;25mg
capsule, oral 50mg;50mg
Brand(s)
Apresazide
capsule, oral 25mg;25mg, 50mg;50mg
Apresazide
@ capsule, oral 100mg;50mg
Hydra-Zide
capsule, oral 25mg;25mg, 50mg;50mg,
100mg;50mg
Hydral
@ capsule, oral 25mg;25mg, 50mg;50mg
Hydral
@ capsule, oral 100mg;50mg
HYDROCHLOROTHIAZIDE
Hydrochlorothiazide
(continued on the next page)
capsule, oral 12.5mg
@ solution, oral 50mg/5ml
solution, oral 50mg/5ml
tablet, oral 25,50mg
@ tablet, oral 25,50mg
@ tablet, oral 25,50,100mg
@ tablet, oral 25,50,100mg
@ tablet, oral 50mg
@ tablet, oral 25mg
tablet, oral 50mg
109
American Pharmaceutical
Partners
Gensia-Sicor
Luitpold
Smith and Nephew
Solopak
ABC
Amide
(Ascot)
Barr
Eon
Geneva
Halsey
Impax
Impax
IVAX
Lederle
Mutual
Par
Purepac
Quantum
Sidmak
Superpharm
USL
(Vangard/MWM)
Watson
West-ward
Novartis
Novartis
Teva
Circa
IVAX
Superpharm
Superpharm
Novartis
Novartis
Par
Solvay
Solvay
Mylan
Morton Grove
Roxane
ABC
(Ascot)
Barr
Circa
Elkins-Sinn
Eon
Eon
DRUG
DOSAGE FORM, STRENGTH
HYDROCHLOROTHIAZIDE (continued)
@
@
@
@
@
@
@
@
@
Brand(s)
Microzide
Esidrix
Hydro-D
HydroDIURIL
Oretic
Zide
@
@
@
@
@
@
@
@
@
@
tablet, oral 25,50mg
tablet, oral 25,50mg
tablet, oral 25,50,100mg
tablet, oral 50mg
tablet, oral 25,50mg
tablet, oral 25,50,100mg
tablet, oral 25,50mg
tablet, oral 100mg
tablet, oral 25,50mg
tablet, oral 25,50mg
tablet, oral 25,50mg
tablet, oral 25,50mg
tablet, oral 25,50mg
tablet, oral 25mg
tablet, oral 50mg
tablet, oral 25mg
tablet, oral 25,50,100mg
tablet, oral 25,50mg
tablet, oral 25,50mg
tablet, oral 25,50mg
tablet, oral 25,50mg
tablet, oral 25,50mg
tablet, oral 100mg
tablet, oral 25,50mg
tablet, oral 25,50,100mg
capsule, oral 12.5mg
tablet, oral 25,50,100mg
@ tablet, oral 25,50mg
@ tablet, oral 25,50,100mg
tablet, oral 25,50mg
@ tablet, oral 50mg
APPLICATION HOLDER,
MANUFACTURER
Geneva
Halsey
Impax
Heather
Inwood/Forest
IVAX
Lederle
Lederle
Mast
Mylan
Pharmeral
Private Formulations
Purepac
Roxane
Roxane
Solvay
Superpharm
Teva
USL
(Vangard/MWM)
Warner-Chilcott
Watson
Watson
West-ward
Whiteworth Towne
Watson
Novartis
Halsey
Merck *
Abbott
Solvay
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
HYDROCHLOROTHIAZIDE; AMILORIDE HYDROCHLORIDE
See AMILORIDE HYDROCHLORIDE; HYDROCHLOROTHIAZIDE
HYDROCHLOROTHIAZIDE; BISOPROLOL FUMARATE
See BISOPROLOL FUMARATE; HYDROCHLOROTHIAZIDE
HYDROCHLOROTHIAZIDE; CAPTOPRIL
See CAPTOPRIL; HYDROCHLOROTHIAZIDE
HYDROCHLOROTHIAZIDE; ENALAPRIL
See ENALAPRIL; HYDROCHLOROTHIAZIDE
HYDROCHLOROTHIAZIDE; HYDRALAZINE HYDROCHLORIDE
See HYDRALAZINE HYDROCHLORIDE; HYDROCHLOROTHIAZIDE
110
DRUG
DOSAGE FORM, STRENGTH
HYDROCHLOROTHIAZIDE; LABETALOL
Brand(s)
Normozide
@ tablet, oral 25mg;100mg
Normozide
@ tablet, oral 25mg;200mg
Normozide
@ tablet, oral 25mg;300mg
Normozide
@ tablet, oral 25mg;400mg
Trandate-HCT
@ tablet, oral 25mg;100mg
Trandate-HCT
@ tablet, oral 25mg;200mg
Trandate-HCT
@ tablet, oral 25mg;300mg
Trandate-HCT
@ tablet, oral 25mg;400mg
HYDROCHLOROTHIAZIDE; LISINOPRIL
Hydrochlorothiazide; Lisinopril
tablet, oral 12.5mg;10mg
tablet, oral 12.5mg;20mg
tablet, oral 25mg;20mg
tablet, oral 12.5mg;10mg
tablet, oral 12.5mg;20mg
tablet, oral 25mg;20mg
tablet, oral 12.5mg;10mg
tablet, oral 12.5mg;20mg
tablet, oral 25mg;20mg
tablet, oral 12.5mg;10mg
tablet, oral 12.5mg;20mg
tablet, oral 25mg;20mg
tablet, oral 12.5mg;10mg
tablet, oral 12.5mg;20mg
tablet, oral 25mg;20mg
tablet, oral 12.5mg;10mg
tablet, oral 12.5mg;20mg
tablet, oral 25mg;20mg
tablet, oral 12.5mg;10mg
tablet, oral 12.5mg;20mg
tablet, oral 25mg;20mg
tablet, oral 12.5mg;10mg
tablet, oral 12.5mg;20mg
tablet, oral 25mg;20mg
tablet, oral 12.5mg;10mg
tablet, oral 12.5mg;20mg
tablet, oral 25mg;20mg
Brand(s)
Prinzide 10-12.5
tablet, oral 12.5mg;10mg
Prinzide 20-12.5
tablet, oral 12.5mg;20mg
Prinzide 20-25
tablet, oral 25mg;20mg
Zestoretic 10-12.5
tablet, oral 12.5mg;10mg
Zestoretic 20-12.5
tablet, oral 12.5mg;20mg
Zestoretic 20-25
tablet, oral 25mg;20mg
APPLICATION HOLDER,
MANUFACTURER
Schering
Schering
Schering
Schering
GlaxoSmithKline
GlaxoSmithKline
GlaxoSmithKline
GlaxoSmithKline
Eon
Eon
Eon
Geneva
Geneva
Geneva
IVAX
IVAX
IVAX
Mylan
Mylan
Mylan
Purepac
Purepac
Purepac
Ranbaxy
Ranbaxy
Ranbaxy
Teva
Teva
Teva
Watson
Watson
Watson
West-ward
West-ward
West-ward
Merck *
Merck *
Merck *
AstraZeneca
AstraZeneca
AstraZeneca
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
HYDROCHLOROTHIAZIDE; METHYLDOPA
Hydrochlorothiazide;
@ tablet, oral 15mg;250mg
Methyldopa
@ tablet, oral 25mg;250mg
@ tablet, oral 30mg;500mg
@ tablet, oral 50mg;500mg
tablet, oral 15mg;250mg
tablet, oral 25mg;250mg
tablet, oral 30mg;500mg
tablet, oral 50mg;500mg
(continued on the next page)
111
Circa
Circa
Circa
Circa
Geneva
Geneva
Geneva
Geneva
DRUG
DOSAGE FORM, STRENGTH
HYDROCHLOROTHIAZIDE; METHYLDOPA (continued)
@ tablet, oral 15mg;250mg
@ tablet, oral 25mg;250mg
@ tablet, oral 30mg;500mg
@ tablet, oral 50mg;500mg
tablet, oral 15mg;250mg
tablet, oral 25mg;250mg
tablet, oral 30mg;500mg
tablet, oral 50mg;500mg
tablet, oral 15mg;250mg
tablet, oral 25mg;250mg
tablet, oral 15mg;250mg
tablet, oral 25mg;250mg
tablet, oral 30mg;500mg
tablet, oral 50mg;500mg
@ tablet, oral 15mg;250mg
@ tablet, oral 25mg;250mg
@ tablet, oral 30mg;500mg
@ tablet, oral 50mg;500mg
@ tablet, oral 15mg;250mg
@ tablet, oral 25mg;250mg
@ tablet, oral 30mg;500mg
@ tablet, oral 50mg;500mg
@ tablet, oral 15mg;250mg
@ tablet, oral 25mg;250mg
@ tablet, oral 30mg;500mg
@ tablet, oral 50mg;500mg
tablet, oral 15mg;250mg
tablet, oral 25mg;250mg
tablet, oral 30mg;500mg
tablet, oral 50mg;500mg
Brand(s)
Aldoril 15
tablet, oral 15mg;250mg
Aldoril 25
tablet, oral 25mg;250mg
Aldoril D30
tablet, oral 30mg;500mg
Aldoril D50
tablet, oral 50mg;500mg
APPLICATION HOLDER,
MANUFACTURER
IVAX
IVAX
IVAX
IVAX
Lederle
Lederle
Lederle
Lederle
Mylan
Mylan
Par
Par
Par
Par
Pfizer
Pfizer
Pfizer
Pfizer
Purepac
Purepac
Purepac
Purepac
Teva
Teva
Teva
Teva
Watson
Watson
Watson
Watson
Merck *
Merck *
Merck *
Merck *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
HYDROCHLOROTHIAZIDE; PROPRANOLOL HYDROCHLORIDE
Hydrochlorothiazide;
tablet, oral 25mg;40mg
Propranolol Hydrochloride
tablet, oral 25mg;80mg
@ tablet, oral 25mg;40mg
@ tablet, oral 25mg;80mg
tablet, oral 25mg;40mg
tablet, oral 25mg;80mg
@ tablet, oral 25mg;40mg
@ tablet, oral 25mg;80mg
tablet, oral 25mg;40mg
tablet, oral 25mg;80mg
tablet, oral 25mg;40mg
tablet, oral 25mg;80mg
tablet, oral 25mg;40mg
tablet, oral 25mg;80mg
@ tablet, oral 25mg;40mg
@ tablet, oral 25mg;80mg
tablet, oral 25mg;40mg
tablet, oral 25mg;80mg
Brand(s)
Inderide 40/25
tablet, oral 25mg;40mg
Inderide 80/25
tablet, oral 25mg;80mg
112
Barr
Barr
Duramed/Barr
Duramed/Barr
Geneva
Geneva
IVAX
IVAX
Mylan
Mylan
Purepac
Purepac
Sidmak
Sidmak
Warner Chilcott
Warner Chilcott
Watson
Watson
Wyeth
Wyeth
DRUG
DOSAGE FORM, STRENGTH
HYDROCHLOROTHIAZIDE; SPIRONOLACTONE
Hydrochlorothiazide;
@ tablet, oral 25mg;25mg
Spironolactone
@ tablet, oral 25mg;25mg
@ tablet, oral 25mg;25mg
tablet, oral 25mg;25mg
@ tablet, oral 25mg;25mg
@ tablet, oral 25mg;25mg
tablet, oral 25mg;25mg
tablet, oral 25mg;25mg
tablet, oral 25mg;25mg
@ tablet, oral 25mg;25mg
@ tablet, oral 25mg;25mg
@ tablet, oral 25mg;25mg
@ tablet, oral 25mg;25mg
@ tablet, oral 25mg;25mg
tablet, oral 25mg;25mg
Brand(s)
Aldactazide
tablet, oral 25mg;25mg
APPLICATION HOLDER,
MANUFACTURER
(Ascot)
Barr
Circa
Geneva
IVAX
Lederle
Mutual
Mylan
Pfizer
Purepac
Superpharm
Upsher-Smith
USL
(Vangard/MWM)
Watson
Searle *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
HYDROCHLOROTHIAZIDE; TRIAMTERENE
Hydrochlorothiazide; Triamterene
capsule, oral 25mg;37.5mg
capsule, oral 25mg;37.5mg
capsule, oral 25mg;37.5mg
capsule, oral 25mg;50mg
capsule, oral 25mg;50mg
capsule, oral 25mg;37.5mg
@ capsule, oral 25mg;37.5mg
@ tablet, oral 50mg;75mg
tablet, oral 25mg;37.5mg
tablet, oral 50mg;75mg
tablet, oral 25mg;37.5mg
tablet, oral 50mg;75mg
@ tablet, oral 50mg;75mg
tablet, oral 25mg;37.5mg
tablet, oral 50mg;75mg
tablet, oral 37.5mg;25mg
tablet, oral 50mg;75mg
Brand(s)
Dyazide
@ capsule, oral 25mg;50mg
Dyazide
capsule, oral 25mg;37.5mg
Maxzide-25
tablet, oral 25mg;37.5mg
Maxzide
tablet, oral 50mg;75mg
Barr
Duramed/Barr
Geneva
Geneva
IVAX
Mylan
Novartis
American Therapeutics
Barr
Barr
Geneva
Geneva
Quantum
Sidmak
Sidmak
Watson
Watson
GlaxoSmithKline *
GlaxoSmithKline *
Mylan *
Mylan *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
HYDROCODONE BITARTRATE; ACETAMINOPHEN
See ACETAMINOPHEN; HYDROCODONE BITARTRATE
HYDROCODONE BITARTRATE; GUAIFENESIN; PSEUDOEPHEDRINE HYDROCHLORIDE
See GUAIFENESIN; HYDROCODONE BITARTRATE; PSEUDOEPHEDRINE HYDROCHLORIDE
HYDROCODONE BITARTRATE; HOMATROPINE METHYLBROMIDE
See HOMATROPINE METHYLBROMIDE; HYDROCODONE BITARTRATE
113
DRUG
DOSAGE FORM, STRENGTH
HYDROCODONE BITARTRATE; IBUPROFEN
Hydrocodone Bitartrate;
tablet, oral 7.5mg;200mg
Ibuprofen
Brand(s)
Vicoprofen
tablet, oral 7.5mg;200mg
APPLICATION HOLDER,
MANUFACTURER
Teva
Abbot
HYDROCODONE BITARTRATE; PHENYLPROPANOLAMINE HYDROCHLORIDE
Hydrocodone Bitartrate;
syrup, oral 2.5mg/5ml;12.5mg/5ml
Halsey
Phenylpropanolamine
syrup, oral 5mg/5ml;12.5mg/5ml
Halsey
Hydrochloride
syrup, oral 5mg/5ml;25mg/5ml
Morton Grove
Brand(s)
Hycophen Pediatric Syrup
syrup, oral 2.5mg/5ml;12.5mg/5ml
Cenci
Hycomine Pediatric Syrup
syrup, oral 2.5mg/5ml;12.5mg/5ml
Endo
Codamine Syrup
syrup, oral 5mg/5ml;25mg/5ml
Alpharma
Hycophen Syrup
syrup, oral 5mg/5ml;25mg/5ml
Cenci
Hycomine Syrup
syrup, oral 5mg/5ml;25mg/5ml
Endo
Propachem Syrup
syrup, oral 5mg/5ml;25mg/5ml
Norton
* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as an
exception to the promulgated criteria for inclusion, pursuant to Rule 790.60.
HYDROCODONE BITARTRATE; PSEUDOEPHEDRINE HYDROCHLORIDE
Hydrocodone Bitartrate;
liquid, oral 5mg/5ml;60mg/5ml
Pseudoephedrine Hydrochloride liquid, oral 5mg/5ml;60mg/5ml
Brand(s)
Detussin
liquid, oral 5mg/5ml;60mg/5ml
Hydrophed
liquid, oral 5mg/5ml;60mg/5ml
Tussend
liquid, oral 5mg/5ml;60mg/5ml
Cenci
Morton Grove
Alpharma
Norton
Aventis
* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as an
exception to the promulgated criteria for inclusion, pursuant to Rule 790.60.
HYDROCORTISONE
Hydrocortisone
@
@
@
@
@
@
@
@
@
@
@
@
@
@
(continued on the next page)
@
cream, topical 1,2.5%
cream, topical 0.5,1%
cream, topical 1,2.5%
cream, topical 0.5,1%
cream, topical 2.5%
cream, topical 0.5%
cream, topical 1%
cream, topical 1,2.5%
cream, topical 1%
cream, topical 0.5,1%
cream, topical 1%
cream, topical 1%
cream, topical 2.5%
cream, topical 1%
cream, topical 1%
cream, topical 0.5%
cream, topical 1,2.5%
cream, topical 0.5,1,2.5%
cream, topical 1%
cream, topical 1,2.5%
cream, topical 1%
enema, rectal 100mg/60ml
lotion, topical 0.5,1%
lotion, topical 2.5%
lotion, topical 0.5,1%
114
Alpharma
Altana
Ambix/Organics
Clay-Park
Clay-Park
Everylife
Everylife
Fougera/Altana
G&W
Ingram
Naska
Pharmaderm/Altana
Pharmaderm/Altana
Pharmafair
Stiefel
Taro
Taro
Teva
Topiderm
USL
Whiteworth Towne
Copley
Alpharma
Altana
Clay-Park
DRUG
HYDROCORTISONE (continued)
Brand(s)
Ala-Cort
Anusol HC
Cort-Dome
Dermacort
Dermatol HC
Eldecort
Flexicort
H Cort
HC
HC #1
HC #4
HiCor
Hydrotex
Hymac
Hytone
Nogenic HC
Nutracort
Penecort
Proctocort
Synacort
Synacort
Colocort
Cortenema
Nutracort
Penecort
Acticort
Ala-Cort
Balneol-HC
Beta-HC
Cetacort
Cort-Dome
Delacort
Dermacort
Epicort
Glycort
H Cort
Hytone
Nutracort
Nutracort
Stie-Cort
Cortril
HC
(continued on the next page)
HYDROCORTISONE (continued)
DOSAGE FORM, STRENGTH
@ lotion, topical 0.5,1%
@ lotion, topical 1%
@ lotion, topical 1%
lotion, topical 2.5%
@ ointment, topical 0.5%
ointment, topical 1%
@ ointment, topical 1,2.5%
@ ointment, topical 0.5,1%
ointment, topical 2.5%
ointment, topical 2.5%
@ ointment, topical 1%
@ ointment, topical 1%
@ ointment, topical 0.5%
ointment, topical 1,2.5%
@ ointment, topical 1,2.5%
powder for compounding 100%
powder for compounding 100%
@
@
@
@
@
@
@
@
@
@
@
@
@
@
@
@
@
@
@
@
@
@
@
@
@
@
cream, topical 1%
cream, topical 2.5%
cream, topical 0.5,1%
cream, topical 1%
cream, topical 1%
cream, topical 1,2.5%
cream, topical 0.5,1,2.5%
cream, topical 0.5%
cream, topical 0.5,1%
cream, topical 0.5%
cream, topical 1%
cream, topical 2.5%
cream, topical 0.5%
cream, topical 1%
cream, topical 1,2.5%
cream, topical 1%
cream, topical 0.5,1%
cream, topical 1%
cream, topical 1%
cream, topical 0.5%
cream, topical 1,2.5%
enema, rectal 100mg/60ml
enema, rectal 100mg/60ml
gel, topical 1%
gel, topical 1%
lotion, topical 1%
lotion, topical 1%
lotion, topical 1%
lotion, topical 1%
lotion, topical 0.5,1%
lotion, topical 0.5,1%
lotion, topical 1%
lotion, topical 0.5,1%
lotion, topical 0.5%
lotion, topical 1.0%
lotion, topical 0.5%
lotion, topical 1,2.5%
lotion, topical 0.5%
lotion, topical 1,2.5%
lotion, topical 1,2.5%
ointment, topical 1,2.5%
ointment, topical 0.5,1%
115
APPLICATION HOLDER,
MANUFACTURER
Mericon
Naska
Taro
Taro
Altana
Altana
Ambix/Organics
Clay-Park
Clay-Park
Fougera/Altana
Naska
Pharmaderm/Altana
Taro
Taro
USL
Paddock
Pharma Tek
Del Ray
Parkdale
Bayer
Monarch
Taro
ICN
Westwood Squibb
Pharmaceutical Associates
C&M
Bayer
Bayer
C&M
Syosett
Alpharma
Dermik/Rorer
IVAX
Healthpoint
Allergan Herbert
Monarch
Medicis
Medicis
Paddock
Solvay
Owen/Galderma
Allergan Herbert
Baker Norton
Del Ray
Solvay
Beta Dermac
Healthpoint
Bayer
Mericon
Solvay
Bluline
Heran
Pharmaceutical Associates
Dermik/Rorer
Healthpoint
Healthpoint
Stiefel
Pfipharmecs/Pfizer
C&M
DRUG
Hydrocortisone in Absorbase
Hymac
Hytone
Penecort
Penecort
Texacort
H-Cort
DOSAGE FORM, STRENGTH
ointment, topical 1%
ointment, topical 1%
@ ointment, topical 1,2.5%
@ ointment, topical 2.5%
solution, topical 1%
solution, topical 1%
@ powder for compounding 100%
APPLICATION HOLDER,
MANUFACTURER
Carolina Medical
Alpharma
Dermik/Rorer
Allergan Herbert
Allergan Herbert
Sirius
Torch
HYDROCORTISONE; ACETIC ACID, GLACIAL
See ACETIC ACID, GLACIAL; HYDROCORTISONE
HYDROCORTISONE; BACITRACIN ZINC; NEOMYCIN SULFATE; POLYMYXIN B SULFATE
See BACITRACIN ZINC; HYDROCORTISONE; NEOMYCIN SULFATE; POLYMYXIN B SULFATE
HYDROCORTISONE; NEOMYCIN SULFATE; POLYMYXIN B SULFATE
Hydrocortisone;
solution, otic 1%; eq 3.5mg base/ml;
Neomycin Sulfate;
10,000U/ml
Polymyxin B Sulfate
@ suspension, ophthalmic 1%;
eq 3.5mg base/ml; 10,000U/ml
Brand(s)
Cortisporin
solution, otic 1%; eq 3.5mg base/ml;
10,000U/ml
Neo-Otosol-HC
@ solution, otic 1%; eq 3.5mg base/ml;
10,000U/ml
Oticair
@ solution, otic 1%; eq 3.5mg base/ml;
10,000U/ml
Otocort
@ solution, otic 1%; eq 3.5mg base/ml;
10,000U/ml
Cortisporin
suspension, ophthalmic 1%;
eq 3.5mg base/ml; 10,000U/ml
Ocutricin HC
@ suspension, ophthalmic 1%;
eq 3.5mg base/ml; 10,000U/ml
Cortisporin
@ suspension, otic 1%;
eq 3.5mg base/ml; 10,000U/ml
Oticair
suspension, otic 1%;
eq 3.5mg base/ml; 10,000U/ml
Otobione
@ suspension, otic 1%;
eq 3.5mg base/ml; 10,000U/ml
Otocort
@ suspension, otic 1%;
eq 3.5mg base/ml; 10,000U/ml
Pediotic Cortisporin
suspension, otic 1%;
eq 3.5mg base/ml; 10,000U/ml
Bausch and Lomb
Alcon Universal
Monarch *
Alcon
Pharmafair
Steris
Monarch *
Pharmafair
Monarch
Bausch and Lomb
Schering
Alcon Universal
Monarch
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
HYDROCORTISONE; POLYMYXIN B SULFATE
Brand(s)
Otobiotic
solution, otic 5mg/ml;
eq 10,000U base/ml
Pyocidin
@ solution, otic 5mg/ml;
eq 10,000U base/ml
HYDROCORTISONE; UREA
Brand(s)
Alphaderm
Calmurid HC
@ cream, topical 1%; 10%
@ cream, topical 1%; 10%
116
Schering
Forest
Bioglan
Pharmacia & Upjohn
DRUG
HYDROCORTISONE ACETATE
Hydrocortisone Acetate
Brand(s)
Hemsol-HC
Micort-HC
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
@ cream, topical 1%
@ cream, topical 1%
@ cream, topical 1%
Cenci
Pfizer
Purepac
cream, topical 1%
@ cream, topical 2.5%
Able
Ferndale
HYDROCORTISONE ACETATE; BACITRACIN; NEOMYCIN SULFATE; POLYMYXIN B SULFATE
See BACITRACIN; HYDROCORTISONE ACETATE; NEOMYCIN SULFATE; POLYMYXIN B SULFATE
HYDROCORTISONE ACETATE; NEOMYCIN SULFATE
Brand(s)
Cor-Oticin
@ suspension , ophthalmic 1.5%;
eq. 3.5mg base/ml
Neo-Cortef
@ suspension, ophthalmic 1.5%;
eq. 3.5mg base/ml
HYDROCORTISONE ACETATE; UREA
Brand(s)
Carmol HC
cream, topical 1%;10%
U-Cort
cream, topical 1%;10%
HYDROCORTISONE SODIUM PHOSPHATE
Hydrocortisone Sodium
@ injection eq 50mg base/ml
Phosphate
Brand(s)
Hydrocortone
@ injection eq 50mg base/ml
HYDROCORTISONE SODIUM SUCCINATE
Hydrocortisone Sodium
@ injection eq 100,250,500mg,
Succinate
1gm base/vial
@ injection eq 100,250,500mg,
1gm base/vial
injection eq 100mg base/vial
@ injection eq 100,250,500mg,
1gm base/vial
Brand(s)
A-Hydrocort
injection eq 100,250,500mg,
1gm base/vial
Solu-Cortef
injection eq 100,250,500mg,
1gm base/vial
HYDROCORTISONE VALERATE
Hydrocortisone Valerate
Brand(s)
Westcort
Westcort
Akorn
Pharmacia & Upjohn
Kenwood
Taro
Quad
Merck
American Pharmaceutical
Partners
Elkins-Sinn
International Medication
Steris
Abbott
Pharmacia & Upjohn
cream, topical 0.2%
cream, topical 0.2%
cream, topical 0.2%
ointment, topical 0.2%
Clay-Park
Copley
Taro
Taro
cream, topical 0.2%
ointment, topical 0.2%
Westwood Squibb *
Westwood Squibb *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
117
DRUG
HYDROFLUMETHIAZIDE
Hydroflumethiazide
Brand(s)
Diucardin
Saluron
DOSAGE FORM, STRENGTH
@ tablet, oral 50mg
tablet, oral 50mg
@ tablet, oral 50mg
tablet, oral 50mg
tablet, oral 50mg
HYDROMORPHONE HYDROCHLORIDE
Hydromorphone Hydrochloride
injection 1,2,4,10mg/ml
injection 2mg/ml
injection 2mg/ml
injection 2mg/ml
injection 2,10mg/ml
injection 1,2,4mg/ml
solution, oral 5mg/5ml
tablet, oral 8mg
Brand(s)
Dilaudid Hydrochloride
injection 1,2,4mg/ml
Dilaudid-HP
injection 10mg/ml
Dilaudid
solution, oral 5mg/5ml
Dilaudid
tablet, oral 8mg
APPLICATION HOLDER,
MANUFACTURER
Circa
Par
Watson
Wyeth-Ayerst
Shire
Abbott
AstraZeneca
Elkins-Sinn
Schein
Steris
Wyeth-Ayerst
Roxane
Roxane
Abbott
Abbott
Abbott
Abbott
* Strengths of injections other than 10mg/ml in this entity were reviewed by the Technical Advisory Council
and admitted to the Illinois Formulary as an exception to the promulgated criteria for inclusion, pursuant to
Rule 790.60.
HYDROXOCOBALAMIN
Hydroxocobalamin
Brand(s)
Alpha Redisol
Hydroxomin
@ injection 1000mcg/ml
injection 1000mcg/ml
@ injection 1000mcg/ml
@ injection 1000mcg/ml
HYDROXYCHLOROQUINE SULFATE
Hydroxychloroquine Sulfate
Brand(s)
Plaquenil
American Pharmaceutical
Partners
Steris
Merck
Bel-Mar
tablet, oral 200mg
tablet, oral 200mg
tablet, oral 200mg
tablet, oral 200mg
Copley
Geneva
Mylan
Watson
tablet, oral 200mg
Sanofi Synthelabo *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
HYDROXYPROGESTERONE CAPROATE
Hydroxyprogesterone Caproate @ injection 125mg/ml
@ injection 125,250mg/ml
Brand(s)
Delalutin
@ injection 125,250mg/ml
Dura-Lutin
@ injection 125,250mg/ml
118
Akorn
Quad
Squibb
Steris
DRUG
DOSAGE FORM, STRENGTH
HYDROXYUREA
Hydroxyurea
Brand(s)
Hydrea
HYDROXYZINE HYDROCHLORIDE
Hydroxyzine Hydrochloride
capsule, oral 250,500mg
capsule, oral 250,500mg
capsule, oral 500mg
capsule, oral 500mg
Barr
Duramed/Barr
Par
Roxane
capsule, oral 500mg
Bristol-Myers Squibb
injection 25,50mg/ml
@ injection 25,50mg/ml
injection 25,50mg/ml
@
@
@
@
@
@
@
@
@
@
@
@
@
@
@
@
@
Brand(s)
Orgatrax
Vistaril
Atarax
Atarax
APPLICATION HOLDER,
MANUFACTURER
injection 25,50mg/ml
injection 25,50mg/ml
injection 25,50mg/ml
injection 25mg/ml
injection 25,50mg/ml
injection 25mg/ml
injection 50mg/ml
injection 25,50mg/ml
syrup, oral 10mg/5ml
syrup, oral 10mg/5ml
syrup, oral 10mg/5ml
syrup, oral 10mg/5ml
tablet, oral 10,25,50mg
tablet, oral 10,25,50,100mg
tablet, oral 10,25,50mg
tablet, oral 10,25,50mg
tablet, oral 10,25,50mg
tablet, oral 10,25,50mg
tablet, oral 10,25,50,100mg
tablet, oral 10,25,50mg
tablet, oral 10,25,50mg
tablet, oral 10,25,50mg
tablet, oral 10,25,50mg
tablet, oral 10,25,50mg
tablet, oral 10,25,50mg
tablet, oral 10,25,50mg
tablet, oral 10,25,50mg
@ injection 25,50mg/ml
injection 25,50mg/ml
syrup, oral 10mg/5ml
tablet, oral 10,25,50,100mg
Abbott
Altana
American Pharmaceutical
Partners
Elkins-Sinn
Luitpold
Pharmafair
Smith and Nephew
Solopak
Steris
Steris
Wyeth-Ayerst
Alpharma
Hi-Tech
KV
Morton Grove
Amide
Barr
Eon
Geneva
Halsey
IVAX
KV
Mutual
Par
Purepac
Quantum
Sidmak
Superpharm
USL
Watson
Organon/Akzona
Roerig/Pfizer
Roerig/Pfizer
Roerig/Pfizer
HYDROXYZINE HYDROCHLORIDE; EPHEDRINE; THEOPHYLLINE
See EPHEDRINE; HYDROXYZINE HYDROCHLORIDE; THEOPHYLLINE
HYDROXYZINE PAMOATE
Hydroxyzine Pamoate
(continued on the next page)
capsule, oral eq 25,50,100mg HCl
@ capsule, oral eq 25,50,100mg HCl
@ capsule, oral eq 25,50,100mg HCl
capsule, oral eq 25,50mg HCl
capsule, oral eq 25mg HCl
@ capsule, oral eq 50,100mg HCl
capsule, oral eq 25,50mg HCl
@ capsule, oral eq 25,50,100mg HCl
119
Barr
Circa
Duramed/Barr
Eon
Geneva
Geneva
IVAX
Par
DRUG
DOSAGE FORM, STRENGTH
HYDROXYZINE PAMOATE (continued)
@ capsule, oral eq 25,50,100mg HCl
@ capsule, oral eq 25,50mg HCl
capsule, oral eq 25,50mg HCl
@ capsule, oral eq 100mg HCl
Brand(s)
Vistaril
capsule, oral eq 25,50,100mg HCl
APPLICATION HOLDER,
MANUFACTURER
Superpharm
(Vangard/MWM)
Watson
Watson
Pfizer
HYOSCYAMINE; ATROPINE SULFATE; PHENOBARBITAL; SCOPOLAMINE HYDROBROMIDE
See ATROPINE SULFATE; HYOSCYAMINE; PHENOBARBITAL; SCOPOLAMINE HYDROBROMIDE
IBUPROFEN
Ibuprofen
Brand(s)
Motrin
Ibu
Ibu-Tab
Ibu-Tab
Ibuprohm
Motrin
suspension, oral 100mg/5ml
@ tablet, oral 400,600,800mg
tablet, oral 300,400,600,800mg
@ tablet, oral 300,400,600,800mg
tablet, oral 400,600,800mg
tablet, oral 400,600,800mg
@ tablet, oral 400,600mg
@ tablet, oral 400,600mg
tablet, oral 300,400,600,800mg
tablet, oral 400,600,800mg
@ tablet, oral 300mg
tablet, oral 400,600,800mg
tablet, oral 300,400,600,800mg
@ tablet, oral 300,400,600,800mg
tablet, oral 400,600,800mg
@ tablet, oral 600mg
@ tablet, oral 400,600,800mg
tablet, oral 400mg
@ tablet, oral 300mg
tablet, oral 400,600,800mg
Alpharma
Barr
Geneva
Halsey
Interpharm
IVAX
Lederle
McNeil Consumer
Mutual
Mylan
Par
Par
Private Formulations
Purepac
Sidmak
Superpharm
Teva
Vintage
Watson
Watson
suspension, oral 100mg/5ml
tablet, oral 400,600,800mg
tablet, oral 400,600mg
@ tablet, oral 800mg
tablet, oral 400mg
tablet, oral 300,400,600,800mg
McNeil Consumer
BASF
Alra
Alra
Ohm
McNeil *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
IBUPROFEN; HYDROCODONE BITARTRATE
See HYDROCODONE BITARTRATE; IBUPROFEN
IDOXURIDINE
Brand(s)
Dendrid
Herplex Liquifilm
Stoxil
IMIPRAMINE HYDROCHLORIDE
Imipramine Hydrochloride
(continued on the next page)
solution, ophthalmic 0.1%
solution, ophthalmic 0.1%
@ solution, ophthalmic 0.1%
Alcon
Allergan
GlaxoSmithKline
@ tablet, oral 10,25,50mg
@ tablet, oral 10,25,50mg
tablet, oral 10,25,50mg
Circa
Eon
Geneva
120
DRUG
DOSAGE FORM, STRENGTH
IMIPRAMINE HYDROCHLORIDE (continued)
@ tablet, oral 10,25,50mg
tablet, oral 10,25,50mg
tablet, oral 10,25,50mg
tablet, oral 10mg
@ tablet, oral 25,50mg
tablet, oral 10,25,50mg
@ tablet, oral 25mg
@ tablet, oral 10,25,50mg
@ tablet, oral 10,25,50mg
@ tablet, oral 25,50mg
Brand(s)
Janimine
@ tablet, oral 10,25,50mg
Presamine
@ tablet, oral 10,25,50mg
Tofranil
tablet, oral 10,25,50mg
INAMRINONE LACTATE
Inamrinone Lactate
Inocor
Brand(s)
INDAPAMIDE
Indapamide
Lozol
Brand(s)
injection eq 5mg base/ml
injection eq 5mg base/ml
injection eq 5mg base/ml
APPLICATION HOLDER,
MANUFACTURER
Lederle
Mutual
Par
Roxane
Roxane
Teva
USL
(Vangard/MWM)
Watson
West-ward
Abbott
Aventis
Tyco
Abbott
Baxter
Bedford
@ injection eq 5mg base/ml
Sanofi Synthelabo
@ tablet, oral 2.5mg
tablet, oral 1.25,2.5mg
tablet, oral 1.25,2.5mg
tablet, oral 1.25,2.5mg
tablet, oral 1.25,2.5mg
tablet, oral 1.25,2.5mg
tablet, oral 1.25,2.5mg
tablet, oral 1.25,2.5mg
tablet, oral 1.25,2.5mg
Akorn
Alphapharm
Geneva
IVAX
Mylan
Purepac
Teva
Trigen
Watson
tablet, oral 1.25,2.5mg
Aventis *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
INDOMETHACIN
Indomethacin
@ capsule, oral 25,50mg
@ capsule, oral 25,50mg
@ capsule, oral 25,50mg
capsule, oral 25,50mg
@ capsule, oral 25,50mg
capsule, oral 25,50mg
capsule, oral 25,50mg
capsule, oral 25,50mg
capsule, oral 25,50mg
capsule, oral 25,50mg
@ capsule, oral 25,50mg
@ capsule, oral 25,50mg
@ capsule, oral 25,50mg
capsule, oral 25,50mg
@ capsule, oral 25,50mg
capsule, oral 25,50mg
@ capsule, oral 25,50mg
(continued on the next page)
121
Barr
Circa
Duramed/Barr
Geneva
Halsey
IVAX
Lederle
Mutual
Mylan
Par
Pfizer
Pioneer
Roxane
Sidmak
Superpharm
Teva
Watson
DRUG
INDOMETHACIN (continued)
Brand(s)
Indo-Lemmon
Indocin
Indocin-SR
Indocin
Indocin
DOSAGE FORM, STRENGTH
capsule, extended release 75mg
capsule, extended release 75mg
capsule, extended release 75mg
suppository, rectal 50mg
suspension, oral 25mg/5ml
capsule, oral 25,50mg
capsule, oral 25,50mg
@ capsule, extended release 75mg
suppository, rectal 50mg
suspension, oral 25mg/5ml
APPLICATION HOLDER,
MANUFACTURER
Able
Eon
Forest/Inwood
G&W
Roxane
Teva
Merck *
Eon
G&W
Merck
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
IODINATED GLYCEROL
Iodinated Glycerol
Brand(s)
Iogan Elixir
Iophen Elixir
Iotuss Elixir
Oridol Elixir
Organidin Elixir
Sil-O-Tuss Elixir
Iogan Solution
Iotuss Solution
Organidin Drops
Oridol Solution
@ liquid, oral 60mg/5ml
(30mg organically bound iodine)
@ liquid, oral 60mg/5ml
(30mg organically bound iodine)
@ liquid, oral 60mg/5ml
(30mg organically bound iodine)
@ solution, oral 50mg/ml
(25mg organically bound iodine)
@ liquid, oral 60mg/5ml
(30mg organically bound iodine)
@ liquid, oral 60mg/5ml
(30mg organically bound iodine)
@ liquid, oral 60mg/5ml
(30mg organically bound iodine)
@ liquid, oral 60mg/5ml
(30mg organically bound iodine)
@ liquid, oral 60mg/5ml
(30mg organically bound iodine)
@ liquid, oral 60mg/5ml
(30mg organically bound iodine)
@ solution, oral 50mg/ml
(25mg organically bound iodine)
@ solution, oral 50mg/ml
(25mg organically bound iodine)
@ solution, oral 50mg/ml
(25mg organically bound iodine)
@ solution, oral 50mg/ml
(25mg organically bound iodine)
Alpharma
Halsey
Morton Grove
Alpharma
Hi-Tech
Naska
Cenci
Norton
Wallace
Silarx
Hi-Tech
Cenci
Wallace
Norton
* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as an
exception to the promulgated criteria for inclusion, pursuant to Rule 790.60.
IODINATED GLYCEROL; CODEINE PHOSPHATE
See CODEINE PHOSPHATE; IODINATED GLYCEROL
IODINATED GLYCEROL; DEXTROMETHORPHAN HYDROBROMIDE
See DEXTROMETHORPHAN HYDROBROMIDE; IODINATED GLYCEROL
122
DRUG
IOPAMIDOL
Iopamidol
Brand(s)
Iopamidol-200
Iopamidol-250
Iopamidol-300
Iopamidol-370
Iopamidol-250
DOSAGE FORM, STRENGTH
injection 41,51,61,76%
@ injection 61,76%
injection 41%
injection 51%
injection 61%
injection 76%
injection 51%
Iopamidol-300
injection 61%
Iopamidol-370
injection 76%
Iopamidol-200
Iopamidol-250
Iopamidol-300
Iopamidol-370
Isovue-200
Isovue-250
Isovue-300
Isovue-370
injection 41%
injection 51%
injection 61%
injection 76%
injection 41%
injection 51%
injection 61%
injection 76%
IPRATROPIUM BROMIDE
Ipratropium Bromide
Brand(s)
Atrovent
Atrovent 0.03%
Atrovent 0.06%
solution for inhalation 0.02%
solution for inhalation 0.02%
solution for inhalation 0.02%
solution for inhalation 0.02%
solution for inhalation 0.02%
solution for inhalation 0.02%
solution for inhalation 0.02%
@ solution for inhalation 0.02%
spray, metered; nasal 0.021mg/spray
spray, metered; nasal 0.042mg/spray
solution for inhalation 0.02%
spray, metered; nasal 0.021mg/spray
spray, metered; nasal 0.042mg/spray
APPLICATION HOLDER,
MANUFACTURER
Elkins-Sinn
Faulding
Abbott
Abbott
Abbott
Abbott
American Pharmaceutical
Partners
American Pharmaceutical
Partners
American Pharmaceutical
Partners
Cook Imaging
Cook Imaging
Cook Imaging
Cook Imaging
Bracco
Bracco
Bracco
Bracco
Alpharma
Aslung
Dey
IVAX
Nephron
Novex
Roxane
Steripak
Novex
Novex
Boehringer Ingelheim *
Boehringer Ingelheim *
Boehringer Ingelheim *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
IRON; ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; NICOTINIC ACID; PYRIDOXINE
HYDROCHLORIDE; RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D; VITAMIN E
See ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; IRON; NICOTINIC ACID; PYRIDOXINE
HYDROCHLORIDE; RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D;
VITAMIN E
IRON; ASCORBIC ACID; FLUORIDE; VITAMIN A; VITAMIN D
See ASCORBIC ACID; FLUORIDE; IRON; VITAMIN A; VITAMIN D
ISOETHARINE HYDROCHLORIDE
Isoetharine Hydrochloride
@ solution for inhalation 1%
@ solution for inhalation 0.125,0.167,0.2,
0.25%
@ solution for inhalation 0.08,0.25%
(continued on the next page)
123
Alpharma
AstraZeneca
Baxter
DRUG
DOSAGE FORM, STRENGTH
ISOETHARINE HYDROCHLORIDE (continued)
@ solution for inhalation 0.08,0.1,0.17,
0.25,1%
@ solution for inhalation 0.08, 0.1,0.167,
0.2,0.25,1%
@ solution for inhalation 1%
@ solution for inhalation 0.1,0.125,0.167,
0.2,0.25%
solution for inhalation 1%
Brand(s)
Beta-2
solution for inhalation 1%
Bronkosol
@ solution for inhalation 0.25,1%
ISOFLURANE
Isoflurane
Brand(s)
Forane
ISONIAZID
Isoniazid
Brand(s)
Nydrazid
Rimifon
Laniazid
Rimifon
Hyzyd
Laniazid
Nydrazid
Stanozide
APPLICATION HOLDER,
MANUFACTURER
Dey
International Medication
Pfizer
Roxane
Roxane
Nephron
Sanofi Synthelabo
liquid for inhalation 99.9%
liquid for inhalation 99.9%
liquid for inhalation 99.9%
liquid for inhalation 99.9%
liquid for inhalation 99.9%
Abbott
Halocarbon
Marsam
Minrad
Rhodia
liquid for inhalation 99.9%
Baxter
@ injection 100mg/ml
syrup, oral 50mg/5ml
@ syrup, oral 50mg/5ml
@ tablet, oral 100mg
tablet, oral 100,300mg
@ tablet, oral 100,300mg
@ tablet, oral 300mg
@ tablet, oral 100mg
tablet, oral 300mg
tablet, oral 100,300mg
@ tablet, oral 50,100mg
tablet, oral 300mg
@ tablet, oral 100mg
@ tablet, oral 100,300mg
@ tablet, oral 100,300mg
@ tablet, oral 100mg
tablet, oral 100,300mg
@ tablet, oral 300mg
@ tablet, oral 50,100,300mg
@ tablet, oral 100mg
@ tablet, oral 100mg
@ tablet, oral 50,100mg
@ tablet, oral 50,100mg
@ tablet, oral 100mg
tablet, oral 100,300mg
tablet, oral 100,300mg
@ tablet, oral 100mg
Quad
Carolina Medical
Mikart
Anabolic
Barr
Circa
Dow
Duramed/Barr
Duramed/Barr
Eon
Halsey
Halsey
Impax
IVAX
Lilly
MK
Mikart
Novartis
Panray/Ormont
Perrigo
Pharmavite
Phoenix
Purepac
Watson
Watson
West-ward
Whiteworth Towne
injection 100mg/ml
injection 100mg/ml
syrup, oral 50mg/5ml
syrup, oral 50mg/5ml
tablet, oral 100,300mg
tablet, oral 50,100,300mg
@ tablet, oral 100mg
@ tablet, oral 100,300mg
Apothecon
Roche
Lannett
Roche
Wallace
Lannett
Squibb
Everylife
@
@
@
@
124
DRUG
DOSAGE FORM, STRENGTH
ISOPROTERENOL HYDROCHLORIDE
Isoproterenol Hydrochloride
@ injection 0.2mg/ml
Brand(s)
Isuprel
Aerolone
Isuprel
Vapo-ISO
ISOSORBIDE DINITRATE
Isosorbide Dinitrate
Brand(s)
Isordil
Sorbitrate
Sorbitrate
Isordil Tembid
Isordil
ISOSORBIDE MONONITRATE
Isosorbide Mononitrate
Brand(s)
ISMO
Monoket
Imdur
APPLICATION HOLDER,
MANUFACTURER
injection 0.2mg/ml
injection 0.2mg/ml
@ solution for inhalation 0.5%
@ solution for inhalation 0.25,0.5%
American Pharmaceutical
Partners
Elkins-Sinn
International Medication
Dey
Pfizer
injection 0.2mg/ml
@ solution for inhalation 0.25%
@ solution for inhalation 0.5%
@ solution for inhalation 0.5%
Abbott
Lilly
Sanofi Synthelabo
Fisons
@ tablet, oral 5,10,20,30mg
tablet, oral 5,10,20mg
tablet, oral 5,10,20,30mg
@ tablet, oral 5,10,20mg
tablet, oral 5,10mg
tablet, oral 5,10,20mg
tablet, extended release 40mg
@ tablet, sublingual 2.5,5,10mg
tablet, sublingual 2.5,5mg
tablet, sublingual 2.5,5mg
tablet, sublingual 2.5,5mg
Barr
Geneva
Par
Superpharm
Watson
West-ward
Inwood
Barr
Geneva
Watson
West-ward
tablet, oral 5,10,20,30,40mg
tablet, oral 20,40mg
@ tablet, oral 30mg
@ tablet, extended release 40mg
tablet, sublingual 2.5,5,10mg
Wyeth
AstraZeneca
AstraZeneca
Wyeth
Wyeth
tablet, oral 10,20mg
tablet, oral 20mg
tablet, oral 20mg
tablet, extended release 60mg
tablet, extended release 60mg
tablet, extended release 60mg
tablet, extended release 30,60,120mg
tablet, extended release 30,60,120mg
tablet, extended release 30,60,120mg
tablet, extended release 30,60mg
Purepac
Teva
West-ward
Brightstone
Dexcel
Elan
IVAX
Kremers-Urban
KV
Purepac
tablet, oral 10,20mg
tablet, oral 10,20mg
tablet, extended release 30,60,120mg
ESP
Schwarz *
Schering *
* Products manufactured by this brand name drug manufacturer in this drug entity are available for drug
product selection under other brand and/or generic names.
ISOTRETINOIN
Brand(s)
Accutane
Amnesteem
Claravis
Sotret
capsule, oral 10,20,40mg
capsule, oral 10,20,40mg
capsule, oral 10,20,40mg
capsule, oral 10,20,40mg
125
HLR
GenPharm
Barr
Ranbaxy
DRUG
KANAMYCIN SULFATE
Kanamycin Sulfate
DOSAGE FORM, STRENGTH
@ injection eq 75mg base/2ml
@
@
@
@
@
@
Brand(s)
Kantrex
Klebcil
KETAMINE HYDROCHLORIDE
Ketamine Hydrochloride
Brand(s)
Ketalar
KETOCONAZOLE
Ketoconazole
Brand(s)
Nizoral
Nizoral
KETOPROFEN
Ketoprofen
@
@
injection eq 500mg base/2ml,
1gm base/3ml
injection eq 75,500mg base/2ml,
1gm base/3ml
injection eq 500mg base/2ml,
1gm base/3ml
injection eq 75,500mg base/2ml,
1gm base/3ml
injection eq 75,500mg base/2ml,
1gm base/3ml
injection eq 75,500mg base/2ml,
1gm base/3ml
injection eq 75,500mg base/2ml,
1gm base/3ml
injection eq 1gm base/3ml
injection eq 1gm base/3ml
injection eq 75,500mg base/2ml,
1gm base/3ml
@ injection eq 75,500mg base/2ml,
1gm base/3ml
injection eq 50,100mg base/ml
injection eq 50,100mg base/ml
@ injection eq 10,50,100mg base/ml
injection eq 10,50,100mg base/ml
cream, topical 2%
cream, topical 2%
@ tablet, oral 200mg
tablet, oral 200mg
tablet, oral 200mg
tablet, oral 200mg
tablet, oral 200mg
tablet, oral 200mg
tablet, oral 200mg
tablet, oral 200mg
APPLICATION HOLDER,
MANUFACTURER
American Pharmaceutical
Partners
American Pharmaceutical
Partners
Elkins-Sinn
International Medication
Loch
Pharmafair
Quad
Solopak
Steris
Warner Chilcott
Apothecon
King
Abbott
Bedford
Quad
Parkedale
Taro
Teva
Aesgen
Mutual
Mylan
Neosan
Sidmak
Taro
Teva
TorPharm
cream, topical 2%
tablet, oral 200mg
Janssen
Janssen
capsule, extended release
100,150,200mg
capsule, extended release 200mg
capsule, extended release
100,150,200mg
capsule, oral 50,75mg
capsule, oral 25,50,75mg
capsule, oral 50,75mg
capsule, oral 25,50,75mg
Andrx
(continued on the next page)
126
Elan
Mylan
Geneva
Lederle
Mylan
Teva
DRUG
KETOPROFEN (continued)
Brand(s)
Orudis
Oruvail
KETOROLAC TROMETHAMINE
Ketorolac Tromethamine
Brand(s)
Ketorolac preservative-free
Toradol
Toradol
DOSAGE FORM, STRENGTH
capsule, oral 25,50,75mg
capsule, extended release
100,150,200mg
injection 15,30mg/ml
injection 30mg/ml
@ injection 15,30mg/ml
injection 15,30mg/ml
injection 15,30mg/ml
tablet, oral 10mg
@ tablet, oral 10mg
tablet, oral 10mg
tablet, oral 10mg
tablet, oral 10mg
injection 15,30mg/ml
injection 15,30mg
tablet, oral 10mg
APPLICATION HOLDER,
MANUFACTURER
Wyeth-Ayerst
Wyeth
Abbott
Apotex
Apothecon
Baxter
Bedford
Mylan
Roxane
Sidmak
Teva
Watson
Apotex
Roche
Roche *
* Products manufactured by this brand name drug manufacturer in this drug entity are available for drug
product selection under other brand and/or generic names.
LABETALOL HYDROCHLORIDE
Labetalol Hydrochloride
Brand(s)
Normodyne
Trandate
Normodyne
Trandate
injection 5mg/ml
injection 5mg/ml
@ injection 5mg/ml
injection 5mg/ml
injection 5mg/ml
injection 5mg/ml
tablet, oral 100,200,300mg
tablet, oral 100,200,300mg
tablet, oral 100,200,300mg
tablet, oral 100,200,300mg
tablet, oral 100,200,300mg
tablet, oral 100,200,300mg
injection 5mg/ml
injection 5mg/ml
tablet, oral 100,200,300mg
tablet, oral 100,200,300mg
Abbott
Apotex
Apothecon
Bedford
Faulding
Taylor
Apothecon
Eon
IVAX
Mutual
Teva
Watson
Schering
Prometheus
Schering *
Promethius
* Products manufactured by this brand name drug manufacturer in this drug entity are available for drug
product selection under other brand and/or generic names.
LABETALOL HYDROCHLORIDE; HYDROCHLOROTHIAZIDE
See HYDROCHLOROTHIAZIDE; LABETALOL HYDROCHLORIDE
LACTULOSE
Lactulose
(continued on the next page)
solution, oral 10gm/15ml
@ solution, oral 10gm/15ml
solution, oral 10gm/15ml
solution, oral 10gm/15ml
@ solution, oral 10gm/15ml
solution, oral 10gm/15ml
127
Hi-Tech
Inalco
Morton Grove
Novex
Paco
Pharmaceutical Associates
DRUG
LACTULOSE (continued)
Brand(s)
Chronulac
Constilac
Constulose
Duphalac
Evalose
Laxilose
Acilac
Cephulac
Cholac
Enulose
Generlac
Heptalac
Portalac
LEUCOVORIN CALCIUM
Leucovorin Calcium
Brand(s)
Leucovorin Calcium
Preservative-Free
Leucovorin Calcium
Preservative-Free
Leucovorin Calcium
Preservative-Free
Leucovorin Calcium
Preservative-Free
Leucovorin Calcium
Preservative-Free
Leucovorin Calcium
Preservative-Free
Leucovorin Calcium
Preservative-Free
Wellcovorin
Wellcovorin
Wellcovorin
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
solution, oral 10gm/15ml
@ solution, oral 10gm/15ml
solution, oral-rectal 10gm/15ml
@ solution, oral-rectal 10gm/15ml
@ solution, oral-rectal 10gm/15ml
Roxane
UDL
Hi-Tech
Paco
Roxane
solution, oral 10gm/15ml
solution, oral 10gm/15ml
solution, oral 10gm/15ml
@ solution, oral 10gm/15ml
solution, oral 10gm/15ml
solution, oral 10gm/15ml
solution, oral-rectal 10gm/15ml
@ solution, oral-rectal 10gm/15ml
solution, oral-rectal 10gm/15ml
solution, oral-rectal 10gm/15ml
solution, oral-rectal 10gm/15ml
solution, oral-rectal 10gm/15ml
@ solution, oral-rectal 10gm/15ml
Aventis
Alra
Alpharma
Solvay
Copley
Technilab
Technilab
Aventis
Alra
Alpharma
Morton Grove
Copley
Solvay
@
@
@
@
@
@
ABIC
Immunex
Quad
Abbott
ABIC
American Pharmaceutical
Partners
Bedford
Elkins-Sinn
Gensia Sicor
Pharmachemie
Quad
Xanodyne
Barr
Geneva
Par
Pharmachemie
Roxane
Xanodyne
injection eq 3mg base/ml
injection eq 3mg base/ml
injection eq 5mg base/ml
injection eq 100,250mg base/vial
injection eq 50mg base/vial
injection eq 50mg base/vial
injection eq 50,100mg base/vial
injection eq 50,100mg base/vial
injection eq 50,100,350mg base/vial
injection eq 50,100,350mg base/vial
@ injection eq 50,100mg base/vial
injection eq 50,100,350mg base/vial
tablet, oral eq 5,25mg base
tablet, oral eq 15mg base
tablet, oral eq 5,25mg base
tablet, oral eq 5,25mg base
tablet, oral eq 5,10,15,25mg base
tablet, oral eq 10,15mg base
injection eq 10mg base/ml
Abbott
injection eq 10mg base/ml
Bedford
injection eq 200,350mg base/vial
Bedford
@ injection eq 10mg base/ml
Bigmar
injection eq 200mg base/vial
Bigmar
injection eq 10mg base/ml
Gensia Sicor
@ injection eq 10mg base/ml
Luitpold
injection eq 5mg base/ml
@ injection eq 50,100mg base/vial
@ tablet, oral eq 5,25mg base
GlaxoSmithKline
GlaxoSmithKline
GlaxoSmithKline
LEUPROLIDE ACETATE
128
DRUG
Leuprolide Acetate
Brand(s)
Lupron
LEVOBUNOLOL HYDROCHLORIDE
Levobunolol Hydrochloride
Brand(s)
AKbeta
Betagan
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
injection 1mg/0.2ml
injection 1mg/0.2ml
Bedford
Gensia-Sicor
injection 1mg/0.2ml
TAP
solution, ophthalmic 0.25,0.5%
solution, ophthalmic 0.25,0.5%
solution, ophthalmic 0.25,0.5%
Bausch and Lomb
Falcon
Novex
solution, ophthalmic 0.25.0.5%
solution, ophthalmic 0.25,0.5%
Akorn
Allergan *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
LEVOCARNITINE
Levocarnitine
Brand(s)
Carnitor
injection 200mg/ml
Bedford
injection 200mg/5ml
Sigma Tau
LEVODOPA; CARBIDOPA
See CARBIDOPA; LEVODOPA
LEVONORDEFRIN; MEPIVICAINE HYDROCHLORIDE
Levonordefrin;
injection 0.05mg/ml;2%
Mepivicaine Hydrochloride
Brand(s)
Arestocaine Hydrochloride
@ injection 0.05mg/ml;2%
with Levonordefrin
Carbocaine Hydrochloride
injection 0.05mg/ml;2%
with Neo-Cobefrin
Isocaine Hydrochloride
injection 0.05mg/ml;2%
with Levonordefrin
Polocaine with Levonordefrin
injection 0.05mg/ml;2%
Scandonest L
injection 0.05mg/ml;2%
Graham
Solvay
Eastman Kodak
Novocol
Dentsply
Deproco
LEVONORGESTREL; ETHINYL ESTRADIOL
See ETHINYL ESTRADIOL; LEVONORGESTREL
LEVORPHANOL TARTRATE
Levorphanol Tartrate
Brand(s)
Levo-Dromoran
LEVOTHYROXINE SODIUM
Levothyroxine Sodium
Brand(s)
Unithroid
tablet, oral 2mg
Roxane
tablet, oral 2mg
ICN
tablet, oral 0.025, 0.05, 0.075, 0.088,
0.1, 0.112, 0.125, 0.15, 0.175,
0.2, 0.3mg
Mylan
tablet, oral 0.025, 0.05, 0.075, 0.088,
0.1, 0.112, 0.125, 0.15, 0.175,
0.2, 0.3mg
Jerome Stevens
129
DRUG
LIDOCAINE
Lidocaine
Brand(s)
Alphacaine
Xylocaine
LIDOCAINE HYDROCHLORIDE
Lidocaine Hydrochloride
Brand(s)
Alphacaine
Lidocaine Hydrochloride
Preservative-Free
Lidocaine Hydrochloride
Preservative-Free
Lidocaine Hydrochloride
Preservative-Free
Lidocaine Hydrochloride
Preservative-Free
Lidocaine Hydrochloride
Preservative-Free
Lidocaton
Lidopen
Xylocaine
Xylocaine Preservative-Free
Xylocaine Preservative-Free
Xylocaine
Xylocaine
Anestacon
Laryng-O-Jet
Laryngotracheal Anesthesia Kit
LTA II Kit
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
ointment, topical 5%
ointment, topical 5%
ointment, topical 5%
Fougera/Altana
Graham
Taro
ointment, topical 5%
ointment, topical 5%
Carlisle
AstraZeneca
injection 0.5,1,2,20%
@ injection 10%
@ injection 1,2%
@ injection 1.5,20%
@ injection 1,2%
@ injection 1,2%
@ injection 0.5,4%
injection 1,2%
injection 2%
injection 1,2%
@ injection 4%
injection 1,2%
@ injection 1,2%
@ injection 1,%
@ injection 1,2%
injection 1,2%
jelly, topical 2%
jelly, topical 2%
solution, oral (viscous) 2%
solution, oral (viscous) 2%
@ solution, oral (viscous) 2%
solution, oral (viscous) 2%
solution, oral (viscous) 2%
solution, topical 4%
@ solution, topical 4%
solution, topical 4%
Abbott
Abbott
Akorn
American Pharmaceutical
Partners
Bel Mar
Dell
Elkins-Sinn
Elkins-Sinn
Graham
International Medication
International Medication
Luitpold
Miles
Searle
Steris
Wyeth-Ayerst
Copley
International Medication
Alpharma
Hi-Tech
International Medication
Morton Grove
Roxane
Morton Grove
Paco
Roxane
@ injection 2%
injection 1,1.5,4%
Carlisle
Abbott
injection 1,2%
(in plastic container)
injection 1,2,4%
Abbott
injection 1,2%
American Pharmaceutical
Partners
Elkins-Sinn
injection 20%
International Medication
@ injection 2%
injection 10%
injection 0.5,1,1.5,2%
injection 1,4,10,20%
injection 2%
jelly, topical 2%
solution, oral (viscous) 2%
solution, topical 2%
solution, topical 4%
@ solution, topical 4%
solution, topical 4%
(continued on the next page)
LIDOCAINE HYDROCHLORIDE (continued)
130
Pharmaton
Meridian
AstraZeneca
AstraZeneca
Dentsply
AstraZeneca
AstraZeneca
Polymedica
International Medication
Kendall
Abbott
DRUG
Pediatric LTA Kit
Xylocaine 4% Preservative Free
DOSAGE FORM, STRENGTH
solution, topical 2%
solution, topical 4%
APPLICATION HOLDER,
MANUFACTURER
Abbott
AstraZeneca
* PRODUCTS LABELED FOR INTRACARDIAC USE MAY NOT BE INTERCHANGED.
LIDOCAINE HYDROCHLORIDE; DEXTROSE
See DEXTROSE; LIDOCAINE HYDROCHLORIDE
LIDOCAINE HYDROCHLORIDE; EPINEPHRINE
See EPINEPHRINE; LIDOCAINE HYDROCHLORIDE
LINCOMYCIN
Lincomycin
Brand(s)
Lincocin
@ injection eq 300 base mg/ml
@ injection eq 300 base mg/ml
injection eq 300 base mg/ml
LINDANE (GAMMA BENZENE HEXACHLORIDE)
Lindane
lotion, topical 1%
lotion, topical 1%
shampoo, topical 1%
shampoo, topical 1%
Brand(s)
Gamene
@ lotion, topical 1%
Kwell
@ lotion, topical 1%
Scabene
@ lotion, topical 1%
Gamene
@ shampoo, topical 1%
Kwell
@ shampoo, topical 1%
Scabene
@ shampoo, topical 1%
LIOTHYRONINE SODIUM
Liothyronine Sodium
Brand(s)
Cytomel
LISINOPRIL
Lisinopril
Prinivil
Zestril
Brand(s)
@ tablet, oral 0.025,0.05mg base
Quad
Steris
Pharmacia & Upjohn
Alpharma
Morton Grove
Alpharma
Morton Grove
Sola Barnes-Hind
Reed and Carnrick
Stiefel
Sola Barnes-Hind
Reed and Carnrick
Stiefel
Circa
tablet, oral 0.025,0.05mg base
Jones
tablet, oral 2.5,5,10,20,40mg
tablet, oral 2.5,5,10,20,40mg
tablet, oral 2.5,5,10,20,40mg
tablet, oral 2.5,5,10,20,40mg
tablet, oral 2.5,5,10,20,40mg
tablet, oral 2.5,5,10,20,40mg
tablet, oral 2.5,5,10,20,40mg
tablet, oral 2.5,5,10,20,40mg
tablet, oral 2.5,5,10,20,40mg
tablet, oral 2.5,5,10,20,40mg
tablet, oral 2.5,5,10,20,40mg
tablet, oral 2.5,5,10,20,40mg
Apotex
Eon
Geneva
IVAX
Lek
Mylan
Par
Purepac
Ranbaxy
Teva
Watson
West-ward
tablet, oral 2.5,5,10,20,40mg
tablet, oral 2.5,5,10,20,40mg
Merck *
AstraZeneca
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
131
DRUG
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
LISINOPRIL; HYDROCHLOROTHIAZIDE
See HYDROCHLOROTHIAZIDE; LISINOPRIL
LITHIUM CARBONATE
Lithium Carbonate
Brand(s)
Eskalith
Lithonate
Eskalith
Lithane
Lithotabs
Lithobid
capsule, oral 300mg
@ capsule, oral 300mg
capsule, oral 300mg
@ capsule, oral 300mg
capsule, oral 300mg
tablet, oral 300mg
tablet, oral 300mg
tablet, extended release 300mg
tablet, extended release 300mg
@
@
@
@
LITHIUM CITRATE
Lithium Citrate
Brand(s)
Lithonate
LOPERAMIDE HYDROCHLORIDE
Loperamide Hydrochloride
Brand(s)
Imodium
Able
Circa
Roxane
USL
West-ward
Roerig/Pfizer
Roxane
Able
Barr
capsule, oral 300mg
capsule, oral 300mg
tablet, oral 300mg
tablet, oral 300mg
tablet, oral 300mg
tablet, extended release 300mg
GlaxoSmithKline
Solvay
GlaxoSmithKline
Bayer
Solvay
Solvay
syrup, oral (eq 300mg carbonate/5ml)
syrup, oral (eq 300mg carbonate/5ml)
Morton Grove
Roxane
@ syrup, oral (eq 300mg carbonate/5ml)
Solvay
capsule, oral 2mg
capsule, oral 2mg
@ capsule, oral 2mg
capsule, oral 2mg
Geneva
Mylan
Roxane
Teva
LORAZEPAM
Lorazepam
@
@
@
@
@
@
@
capsule, oral 2mg
McNeil Consumer
injection 2,4mg/ml
injection 2mg/ml
injection 2,4mg/ml
injection 2,4mg/ml
injection 2,4mg/ml
injection 2,4mg/ml
injection 2mg/ml
tablet, oral 0.5,1,2mg
tablet, oral 0.5,1,2mg
tablet, oral 0.5,1,2mg
tablet, oral 0.5,1,2mg
tablet, oral 0.5,1,2mg
tablet, oral 0.5,1,2mg
tablet, oral 0.5,1,2mg
tablet, oral 0.5,1,2mg
tablet, oral 0.5,1,2mg
tablet, oral 0.5,1,2mg
tablet, oral 1,2mg
tablet, oral 1,2mg
tablet, oral 0.5,1,2mg
Abbott
Akorn
Clonmel
Elkins-Sinn
Marsam
Steris
Taylor
American Therapeutics
Barr
Geneva
Halsey
Mutual
Mylan
Par
Purepac
Ranbaxy
Superpharm
USL
Warner-Chilcott
Watson
(continued on the next page)
132
DRUG
LORAZEPAM (continued)
Brand(s)
Ativan
Ativan
Loraz
LOVASTATIN
Lovastatin
Brand(s)
Mevacor
LOXAPINE SUCCINATE
Loxapine Succinate
Brand(s)
Loxitane
DOSAGE FORM, STRENGTH
injection 2,4mg/ml
tablet, oral 0.5,1,2mg
@ tablet, oral 0.5,1,2mg
APPLICATION HOLDER,
MANUFACTURER
Wyeth-Ayerst
Wyeth-Ayerst
Quantum
tablet, oral 10,20,40mg
tablet, oral 10,20,40mg
tablet, oral 10,20,40mg
tablet, oral 10,20,40mg
tablet, oral 10,20,40mg
tablet, oral 10,20,40mg
tablet, oral 10,20,40mg
Carlsbad
Eon
Geneva
GenPharm
Mylan
Purepac
Teva
tablet, oral 10,20,40mg
Merck
capsule, oral eq 5,10,25,50mg base
Watson
capsule, oral eq 5,10,25,50mg base
Watson
MAGNESIUM CHLORIDE; CALCIUM CHLORIDE; DEXTROSE; GLUTATHIONE DISULFIDE; POTASSIUM
CHLORIDE; SODIUM BICARBONATE; SODIUM CHLORIDE; SODIUM PHOSPHATE
See CALCIUM CHLORIDE; DEXTROSE; GLUTATHIONE DISULFIDE; MAGNESIUM CHLORIDE;
POTASSIUM CHLORIDE; SODIUM BICARBONATE; SODIUM CHLORIDE; SODIUM PHOSPHATE
MAGNESIUM CHLORIDE; CALCIUM CHLORIDE; DEXTROSE; SODIUM CHLORIDE; SODIUM LACTATE
See CALCIUM CHLORIDE; DEXTROSE; MAGNESIUM CHLORIDE; SODIUM CHLORIDE; SODIUM
LACTATE
MAGNESIUM CHLORIDE; DEXTROSE; POTASSIUM CHLORIDE; SODIUM ACETATE;
SODIUM CHLORIDE; SODIUM GLUCONATE
See DEXTROSE; MAGNESIUM CHLORIDE; POTASSIUM CHLORIDE; SODIUM ACETATE; SODIUM
CHLORIDE; SODIUM GLUCONATE
MAGNESIUM CHLORIDE; CALCIUM CHLORIDE; DEXTROSE; GLUTATHIONE DISULFIDE; POTASSIUM
CHLORIDE; SODIUM BICARBONATE; SODIUM CHLORIDE; SODIUM PHOSPHATE
See CALCIUM CHLORIDE; DEXTROSE; GLUTATHIONE DISULFIDE; MAGNESIUM CHLORIDE;
POTASSIUM CHLORIDE; SODIUM BICARBONATE; SODIUM CHLORIDE; SODIUM PHOSPHATE
MAGNESIUM CHLORIDE; CALCIUM CHLORIDE; DEXTROSE; SODIUM CHLORIDE; SODIUM LACTATE
See CALCIUM CHLORIDE; DEXTROSE; MAGNESIUM CHLORIDE; SODIUM CHLORIDE; SODIUM
LACTATE
MAGNESIUM CHLORIDE; DEXTROSE; POTASSIUM CHLORIDE; SODIUM ACETATE;
SODIUM CHLORIDE; SODIUM GLUCONATE
See DEXTROSE; MAGNESIUM CHLORIDE; POTASSIUM CHLORIDE; SODIUM ACETATE; SODIUM
CHLORIDE; SODIUM GLUCONATE
133
DRUG
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
MAGNESIUM CHLORIDE; POTASSIUM CHLORIDE; SODIUM ACETATE; SODIUM CHLORIDE;
SODIUM GLUCONATE
Injection; in plastic container
Solution for irrigation; in plastic container
Brand(s)
Isolyte S
injection 30mg/100ml;37mg/100ml;
Braun
370mg/100ml;530mg/100ml;
500mg/100ml
Plasma-Lyte A
injection 30mg/100ml;37mg/100ml;
Baxter
368mg/100ml;526mg/100ml;
502mg/100ml
Plasma-Lyte 148
injection 30mg/100ml;37mg/100ml;
Baxter
368mg/100ml;526mg/100ml;
502mg/100ml
Physiolyte
solution, irrigation 30mg/100ml;
Braun
37mg/100ml;370mg/100ml;
530mg/100ml;500mg/100ml
Synovalyte
@ solution, irrigation 30mg/100ml;
Baxter
37mg/100ml;370mg/100ml;
530mg/100ml;500mg/100ml
MAGNESIUM CHLORIDE; CALCIUM CHLORIDE; POTASSIUM CHLORIDE; SODIUM CHLORIDE
See CALCIUM CHLORIDE; MAGNESIUM CHLORIDE; POTASSIUM CHLORIDE; SODIUM CHLORIDE
MAGNESIUM OXIDE; CITRIC ACID; SODIUM CARBONATE
See CITRIC ACID; MAGNESIUM OXIDE; SODIUM CARBONATE
MAGNESIUM SULFATE
Magnesium Sulfate
MANNITOL
Mannitol
Brand(s)
Osmitrol
@
@
@
@
@
injection 500mg/ml (50%)
injection 500mg/ml (50%)
Abbott
American Pharmaceutical
Partners
injection 5gm/100ml (5%),
10gm/100ml (10%),
15gm/100ml (15%),
20gm/100ml (20%),
25gm/100ml (25%)
injection 25gm/100ml (25%)
Abbott
injection 12.5gm/50ml (25%),
injection 5gm/100ml (5%),
10gm/100ml (10%),
15gm/100ml (15%),
20gm/100ml (20%),
injection 25gm/100ml (25%)
injection 25gm/100ml (25%)
injection 10gm/100ml (10%)
injection 15gm/100ml (15%)
injection 20gm/100ml (20%)
injection 25gm/100ml (25%)
injection 25gm/100ml (25%)
injection 5gm/100ml (5%),
10gm/100ml (10%),
15gm/100ml (15%),
20gm/100ml (20%)
134
American Pharmaceutical
Partners
AstraZeneca
Braun
International Medication
Luitpold
Miles
Miles
Miles
Merck
Steris
Baxter
DRUG
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
MANNITOL; DEXTROSE
See DEXTROSE; MANNITOL
MAPROTILINE HYDROCHLORIDE
Maprotiline Hydrochloride
Brand(s)
Ludiomil
@ tablet, oral 25,50,75mg
@ tablet, oral 25,50,75mg
tablet, oral 25,50,75mg
tablet, oral 25,50,75mg
MEBENDAZOLE
Mebendazole
Brand(s)
Vermox
MECLIZINE HYDROCHLORIDE
Meclizine Hydrochloride
Brand(s)
Antivert
Antivert
American Therapeutics
Circa
Mylan
Watson
tablet, oral 25,50,75mg
Novartis
tablet, chewable 100mg
Copley
tablet, chewable 100mg
McNeil Consumer
tablet, oral 12.5,25mg
@ tablet, oral 25mg
tablet, oral 12.5,25mg
@ tablet, oral 12.5mg
tablet, oral 12.5,25mg
tablet, oral 12.5,25mg
@ tablet, oral 12.5,25mg
tablet, oral 12.5,25,50mg
tablet, oral 12.5,25mg
@ tablet, oral 12.5,25mg
@ tablet, oral 12.5,25mg
@ tablet, oral 12.5,25mg
tablet, oral 12.5,25mg
@ tablet, oral 12.5mg
tablet, oral 25mg
@ tablet, chewable 25mg
@ tablet, chewable 25mg
tablet, chewable 25mg
tablet, oral 12.5,25,50mg
tablet, chewable 25mg
ABC
Anabolic
Bundy
Circa
Geneva
IVAX
KV
Par
Sidmak
Superpharm
(Unit Dose Labs)
(Vangard/MWM)
Vintage
Watson
Watson
Anabolic
IVAX
Sidmak
Roerig/Pfizer
Roerig/Pfizer
(All products are Rx, although some manufacturers also market an OTC version of the product)
MECLOFENAMATE SODIUM
Meclofenamate Sodium
Brand(s)
Meclomen
@
@
@
@
capsule, oral eq 50,100mg base
capsule, oral eq 50,100mg base
capsule, oral eq 50,100mg base
capsule, oral eq 50,100mg base
capsule, oral eq 50,100mg base
capsule, oral eq 50,100mg base
@ capsule, oral eq 50,100mg base
@ capsule, oral eq 50,100mg base
capsule, oral eq 50,100mg base
capsule, oral eq 50,100mg base
135
American Therapeutics
Barr
Circa
Eon
Geneva
Mylan
Par
USL
Watson
Pfizer
DRUG
DOSAGE FORM, STRENGTH
MEDROXYPROGESTERONE ACETATE
Medroxyprogesterone Acetate
tablet, oral 2.5,5,10mg
tablet, oral 2.5,5,10mg
Brand(s)
Cycrin
@ tablet, oral 2.5,5,10mg
Provera
tablet, oral 2.5,5,10mg
APPLICATION HOLDER,
MANUFACTURER
Barr
Duramed/Barr
ESI *
Pharmacia & Upjohn *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
MEFLOQUINE HYDROCHLORIDE
Mefloquine Hydrochloride
Brand(s)
Lariam
MEGESTROL ACETATE
Megestrol Acetate
Brand(s)
Megace
Megace
tablet, oral 250mg
Geneva
tablet, oral 250mg
Roche
suspension, oral 40mg/ml
suspension, oral 40mg/ml
suspension, oral 40mg/ml
tablet, oral 20,40mg
tablet, oral 20,40mg
tablet, oral 20,40mg
tablet, oral 40mg
@ tablet, oral 20,40mg
suspension, oral 40mg/ml
tablet, oral 20,40mg
Par
Roxane
Teva/Copley
Barr
Par
Roxane
Teva
USL
Bristol-Myers Squibb
Bristol-Myers Squibb
MENADIOL SODIUM PHOSPHATE
Brand(s)
Kappadione
Synkavite
@ injection 10mg/ml
@ injection 10mg/ml
Lilly
Roche
MENOTROPINS (FSH;LH)
Brand(s)
Humegon
Humegon
Pergonal
Pergonal
Repronex
Repronex
@ injection 75IU/vial;75IU/vial
@ injection 150IU/vial;150IU/vial
injection 75IU/vial;75IU/vial
injection 150IU/vial;150IU/vial
@ injection 75IU/vial;75IU/vial
@ injection 150IU/vial;150IU/vial
Organon
Organon
Serono
Serono
Ferring
Ferring
@ injection 25,50,75,100mg/ml
@ injection 25,50,75,100mg/ml
injection 25,50,75,100mg/ml
@ injection 50,75,100mg/ml
injection 50,100mg/ml
injection 25,50,75,100mg/ml
syrup, oral 50mg/5ml
tablet, oral 50,100mg
tablet, oral 50,100mg
tablet, oral 50,100mg
tablet, oral 50,100mg
tablet, oral 50,100mg
tablet, oral 50,100mg
Abbott
AstraZeneca
Elkins-Sinn
Pfizer
Steris
Wyeth-Ayerst
Roxane
Amide
Barr
Caraco
Duramed/Barr
Halsey
Mallinckrodt
MEPERIDINE HYDROCHLORIDE
Meperidine Hydrochloride
(continued on the next page)
136
DRUG
DOSAGE FORM, STRENGTH
MEPERIDINE HYDROCHLORIDE (continued)
tablet, oral 50,100mg
tablet, oral 50,100mg
tablet, oral 50mg
tablet, oral 50,100mg
Brand(s)
Demerol
injection 25,50,75,100mg/ml
Meperidine Hydrochloride
injection 10mg/ml
Preservative-Free
Meperidine Hydrochloride
injection 10mg/ml
Preservative-Free
Meperidine Hydrochloride
injection 10mg/ml
Preservative-Free
Meperidine Hydrochloride
injection 10mg/ml
Preservative-Free
Meperidine Hydrochloride
injection 10mg/ml
Preservative-Free
Meperidine Hydrochloride
injection 10mg/ml
Preservative-Free
Demerol
syrup, oral 50mg/5ml
Demerol
tablet, oral 50,100mg
APPLICATION HOLDER,
MANUFACTURER
Roxane
Watson
Wyeth-Ayerst
Vintage
Abbott
Abbott
AstraZeneca
Faulding
International Medications
Mallinckrodt
Steris
Sanofi Synthelabo
Sanofi Synthelabo
MEPERIDINE HYDROCHLORIDE; ATROPINE SULFATE
See ATROPINE SULFATE; MEPERIDINE HYDROCHLORIDE
MEPIVICAINE HYDROCHLORIDE
Mepivicaine Hydrochloride
Brand(s)
Arestocaine HCl
Carbocaine
Carbocaine
Isocaine HCl
Polocaine
Polocaine
Polocaine-MPF
Scandonest Plain
injection 3%
@ injection 1%
injection 1,2%
Graham
International Medication
Steris
@ injection 3%
injection 1,1.5,2%
injection 3%
injection 3%
injection 1,2%
injection 3%
injection 1,1.5,2%
injection 3%
Solvay
Sterling Winthrop
Eastman Kodak
Novocol
AstraZeneca
Dentsply
AstraZeneca
Deproco
MEPIVICAINE HYDROCHLORIDE; LEVONORDEFRIN
See LEVONORDEFRIN; MEPIVICAINE HYDROCHLORIDE
MEPROBAMATE
Meprobamate
(continued on the next page)
@ tablet, oral 200,400mg
tablet, oral 400mg
@ tablet, oral 200,600mg
@ tablet, oral 200,400mg
tablet, oral 200,400mg
@ tablet, oral 200,400mg
tablet, oral 400mg
@ tablet, oral 400mg
@ tablet, oral 400,600mg
@ tablet, oral 200,400mg
@ tablet, oral 200,400mg
@ tablet, oral 200,400,600mg
@ tablet, oral 200,400mg
@ tablet, oral 400mg
137
Anabolic
Barr
Barr
Elkins-Sinn
Eon
Everylife
Geneva
Halsey
Heather
ICN
Impax
IVAX
Lannett
Lederle
DRUG
MEPROBAMATE (continued)
Brand(s)
Amosene
Equanil
Mepriam
Miltown
Miltown
Neuramate
Tranmep
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
@ tablet, oral 400mg
@ tablet, oral 400mg
@ tablet, oral 200,400mg
tablet, oral 400mg
@ tablet, oral 200,400mg
@ tablet, oral 200,400mg
@ tablet, oral 400mg
@ tablet, oral 400mg
@ tablet, oral 400mg
@ tablet, oral 200,400mg
tablet, oral 600mg
tablet, oral 400mg
@ tablet, oral 200mg
tablet, oral 400mg
@ tablet, oral 200,400mg
@ tablet, oral 400mg
tablet, oral 200,400mg
@ tablet, oral 600mg
tablet, oral 200,400mg
@ tablet, oral 200,400mg
Lee
Mallard
MK
Mylan
Perrigo
Pfizer
Pharmavite
Pharmeral
Private Formulations
Purepac
Roxane
Scherer
Solvay
Tablicaps
USL
(Vangard/MWM)
Watson
Watson
West-ward
Whiteworth Towne
@ tablet, oral 400mg
tablet, oral 200,400mg
@ tablet, oral 400mg
tablet, oral 200,400mg
tablet, oral 600mg
@ tablet, oral 200,400mg
tablet, oral 400mg
Ferndale
Wyeth-Ayerst
Teva
Wallace
Medpointe
Halsey
Solvay
MEPROBAMATE; ASPIRIN
See ASPIRIN; MEPROBAMATE
MESNA
Mesna
Brand(s)
Mesnex
MESTRANOL; NORETHINDRONE
Brand(s)
Necon 1/50
Norethin 1/50M
Norinyl 1+50
Ortho-Novum 1/50
Norinyl 1+80
Ortho-Novum 1/80
injection 100mg/ml
American Pharmaceutical
Partners
injection 100mg/ml
Baxter
tablet, oral 0.05mg;1mg
Watson
tablet, oral 0.05mg;1mg
tablet, oral 0.05mg;1mg
tablet, oral 0.05mg;1mg
tablet, oral 0.05mg;1mg
@ tablet, oral 0.08mg;1mg
@ tablet, oral 0.08mg;1mg
Watson
Watson
Watson
Ortho-McNeil
Searle
Ortho-McNeil
Note: 21 day packs may not be interchanged with 28 day packs.
METAPROTERENOL SULFATE
Metaproterenol Sulfate
(continued on the next page)
@ solution for inhalation 0.4,0.6%
@ solution for inhalation 5%
solution for inhalation 0.4,0.6%
solution for inhalation 0.4,0.6%
@ syrup, oral 10mg/5ml
138
AstraZeneca
Morton Grove
Nephron
Novex
Copley
DRUG
DOSAGE FORM, STRENGTH
METAPROTERENOL SULFATE (continued)
@ syrup, oral 10mg/5ml
syrup, oral 10mg/5ml
syrup, oral 10mg/5ml
syrup, oral 10mg/ml
@ syrup, oral 10mg/5ml
@ tablet, oral 10,20mg
tablet, oral 10,20mg
tablet, oral 10,20mg
@ tablet, oral 10,20mg
tablet, oral 10,20mg
Brand(s)
Alupent
aerosol, metered 0.65mg/inhalation
Alupent
solution for inhalation 0.4,0.6%
Alupent
@ solution for inhalation 5%
Dey-Dose
@ solution for inhalation 5%
Dey-Lute
solution for inhalation 0.4,0.6%
Prometa
@ solution for inhalation 5%
Alupent
@ syrup, oral 10mg/5ml
Prometa
@ syrup, oral 10mg/5ml
Alupent
@ tablet, oral 10,20mg
APPLICATION HOLDER,
MANUFACTURER
JVL
Morton Grove
Novex
Silarx
Teva
American Therapeutics
Par
Teva
USL
Watson
Boehringer Ingelheim *
Boehringer Ingelheim *
Boehringer Ingelheim *
Dey
Dey
Muro
Boehringer Ingelheim *
Muro
Boehringer Ingelheim *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
METARAMINOL BITARTRATE
Metaraminol Bitartrate
Brand(s)
Aramine
METFORMIN HYDROCHLORIDE
Metformin Hydrochloride
Brand(s)
Glucophage
METHADONE HYDROCHLORIDE
Methadone Hydrochloride
(continued on the next page)
injection eq 10mg base/ml
@ injection eq 10mg base/ml
@ injection eq 10mg base/ml
American Pharmaceutical
Partners
Elkins-Sinn
Searle
injection eq 10mg base/ml
Merck
tablet, oral 500,850,1000mg
tablet, oral 500,850,1000mg
tablet, oral 500,850,1000mg
tablet, oral 500,850,1000mg
tablet, oral 500,850,1000mg
tablet, oral 500,850,1000mg
tablet, oral 500,850,1000mg
tablet, oral 500,850,1000mg
tablet, oral 500,850,1000mg
tablet, oral 500,850,1000mg
tablet, oral 500,850,1000mg
tablet, oral 500,850,1000mg
tablet, oral 500,850,1000mg
tablet, oral 500,850,1000mg
Alphapharm
Andrx
Barr
Caraco
Eon
Geneva
GenPharm
IVAX
Mutual
Mylan
Purepac
Teva
TorPharm
Watson
tablet, oral 500,850,1000mg
Bristol-Myers Squibb
concentrate, oral 10mg/ml
injection, preservative-free 1,1.5,4%
injection, preservative-free 1,2,4%
UDL
Abbott
American Pharmaceutical
Partners
Elkins-Sinn
Eon
injection, preservative-free 1,2%
tablet, oral 5,10mg
139
DRUG
DOSAGE FORM, STRENGTH
METHADONE HYDROCHLORIDE (continued)
tablet, oral 5,10mg
tablet, dispersable 40mg
tablet, dispersable 40mg
Brand(s)
Intensol
concentrate, oral 10mg/ml
Methadose
concentrate, oral 10mg/ml
Dolophine
tablet, oral 5,10mg
Methadose
tablet, oral 5,10mg
Methadose
tablet, dispersable 40mg
METHAMPHETAMINE HYDROCHLORIDE
Methamphetamine
@ tablet, oral 5,10mg
Hydrochloride
@ tablet, oral 5,10mg
@ tablet, oral 5mg
Brand(s)
Desoxyn
tablet, oral 5mg
Methampex
@ tablet, oral 10mg
METHAZOLAMIDE
Methazolamide
Brand(s)
Neptazane
METHENAMINE HIPPURATE
Methenamine Hippiraue
Brand(s)
Hiprex
Urex
METHIMAZOLE
Methimazole
Brand(s)
Tapazole
METHOCARBAMOL
Methocarbamol
(continued on the next page)
@ tablet, oral 25,50mg
tablet, oral 25,50mg
tablet, oral 25,50mg
tablet, oral 25,50mg
APPLICATION HOLDER,
MANUFACTURER
Roxane
Eon
Roxane
Roxane
Mallinckrodt
Roxane
Mallinckrodt
Mallinckrodt
Rexar
Shire Richwood
Teva
Ovation
Teva
Applied Analytical Industries
Copley
Geneva
Mikart
tablet, oral 25,50mg
Lederle
tablet, oral 1gm
CorePharma
tablet, oral 1gm
tablet, oral 1gm
Aventis
Riker/3-M
tablet, oral 5,10mg
tablet, oral 5,10mg
tablet, oral 5,10mg
Eon
GenPharm
Jones
tablet, oral 5,10mg
Lilly
@ injection 100mg/ml
injection 100mg/ml
tablet, oral 500,750mg
@ tablet, oral 500,750mg
@ tablet, oral 500,750mg
@ tablet, oral 500,750mg
@ tablet, oral 500,750mg
tablet, oral 500,750mg
tablet, oral 500,750mg
@ tablet, oral 500,750mg
tablet, oral 500,750mg
@ tablet, oral 500mg
@ tablet, oral 500,750mg
@ tablet, oral 500,750mg
tablet, oral 750mg
tablet, oral 500,750mg
140
Marsam
Steris
Able
American Therapeutics
(Ascot)
Barr
Circa
Eon
Geneva
Heather
Impax
Inwood/Forest
IVAX
KV
Lannett
Lederle
DRUG
METHOCARBAMOL (continued)
Brand(s)
Robaxin
Delaxin
Forbaxin
Robaxin
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
@ tablet, oral 500,750mg
tablet, oral 750mg
tablet, oral 500,750mg
@ tablet, oral 500,750mg
@ tablet, oral 500,750mg
@ tablet, oral 500,750mg
@ tablet, oral 500,750mg
@ tablet, oral 500,750mg
tablet, oral 500,750mg
tablet, oral 500mg
@ tablet, oral 500,750mg
tablet, oral 500,750mg
tablet, oral 500,750mg
Mylan
Nylos
Par
Pharmeral
Pioneer
Purepac
Roxane
Solvay
Superpharm
Tablicaps
Upsher-Smith
Watson
West-ward
injection 100mg/ml
@ tablet, oral 500mg
@ tablet, oral 750mg
tablet, oral 500,750mg
Robins
Ferndale
Schwarz
Schwarz
METHOCARBAMOL; ASPIRIN
See ASPIRIN; METHOCARBAMOL
METHOTREXATE SODIUM
Methotrexate Sodium
@ injection eq 2.5,25mg base/ml
@
@
@
@
Brand(s)
Abitrexate
Folex PFS
Methotrexate Preservative-Free
Mexate-AQ
Mexate-AQ Preserved
Abitrexate
Folex
Methotrexate Preservative-Free
Methotrexate Preservative-Free
Mexate
Rheumatrex
METHSCOPOLAMINE BROMIDE
Methscopolamine Bromide
Brand(s)
Pamine Bromide
American Pharmaceutical
Partners
injection eq 25mg base/ml
Bedford
injection eq 25mg base/ml
Bigmar
injection eq 25mg base/ml
Norbrook
injection eq 2.5,25mg base/ml
Lederle
injection eq 25mg base/ml
Pharmachemie
injection eq 25mg base/ml
Quad
injection eq 20,50,100mg base/vial
American Pharmaceutical
injection eq 20,50,100,250mg base/vial Quad
injection eq 20mg base/vial
Wyeth
injection eq 50,100mg base/vial
Wyeth
tablet, oral eq 2.5mg base
Barr
tablet, oral eq 2.5mg based
Duramed/Barr
tablet, oral eq 2.5mg base
Mylan
tablet, oral eq 2.5mg base
Roxane
@ injection eq 25mg base/ml
@ injection eq 25mg base/ml
injection eq 25mg base/ml
injection eq 25mg base/ml
@ injection eq 25mg base/ml
@ injection eq 50,100,250mg base/vial
injection eq 50,100,250mg base/vial
injection eq 1gm base/vial
injection eq 1gm base/vial
@ injection eq 20,50,100,250mg base/vial
tablet, oral eq 2.5mg base
ABIC
Pharmacia & Upjohn
Bigmar
Bristol-Myers Squibb
Bristol-Myers Squibb
ABIC
Pharmacia & Upjohn
Bigmar
Wyeth
Bristol-Myers Squibb
Clonmel
@ tablet, oral 2.5mg
Private Formulations
tablet, oral 2.5mg
141
Bradley
DRUG
METHYCLOTHIAZIDE
Methyclothiazide
Brand(s)
Aquatensen
Enduron
METHYLDOPA
Methyldopa
Brand(s)
Aldomet
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
@ tablet, oral 2.5,5mg
tablet, oral 2.5,5mg
tablet, oral 2.5mg
@ tablet, oral 5mg
@ tablet, oral 2.5mg
tablet, oral 5mg
@ tablet, oral 2.5,5mg
@ tablet, oral 5mg
@ tablet, oral 2.5mg
tablet, oral 5mg
Circa
Geneva
IVAX
IVAX
Mylan
Mylan
Par
USL
Watson
Watson
tablet, oral 5mg
tablet, oral 2.5,5mg
Wallace
Abbott
@ tablet, oral 125,250,500mg
@ tablet, oral 125,250,500mg
@ tablet, oral 250,500mg
tablet, oral 125,250,500mg
@ tablet, oral 125,250,500mg
tablet, oral 250,500mg
@ tablet, oral 125mg
tablet, oral 250,500mg
tablet, oral 250,500mg
tablet, oral 125,250,500mg
@ tablet, oral 125,250,500mg
@ tablet, oral 125,250,500mg
@ tablet, oral 125,250,500mg
tablet, oral 125,250,500mg
tablet, oral 250,500mg
@ tablet, oral 125,250,500mg
@ tablet, oral 125mg
@ tablet, oral 250,500mg
tablet, oral 125,250,500mg
Barr
Circa
Duramed/Barr
Geneva
Halsey
IVAX
Lederle
Lederle
Mylan
Par
Pfizer
Purepac
Roxane
Sidmak
Superpharm
Teva
Watson
Watson
Merck *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
METHYLDOPA; CHLOROTHIAZIDE
See CHLOROTHIAZIDE; METHYLDOPA
METHYLDOPA; HYDROCHLOROTHIAZIDE
See HYDROCHLOROTHIAZIDE; METHYLDOPA
METHYLDOPATE HYDROCHLORIDE
Methyldopate Hydrochloride
injection 50mg/ml
@ injection 50mg/ml
(continued on the next page)
injection 50mg/ml
@ injection 50mg/ml
injection 50mg/ml
injection 50mg/ml
@ injection 50mg/ml
@ injection 50mg/ml
@ injection 50mg/ml
142
Abbott
American Pharmaceutical
Partners
Elkins-Sinn
Faulding
Gensia Sicor
Luitpold
Marsam
Quad
Smith and Nephew
DRUG
DOSAGE FORM, STRENGTH
METHYLDOPATE HYDROCHLORIDE (continued)
Brand(s)
Aldomet
injection 50mg/ml
METHYLPHENIDATE HYDROCHLORIDE
Methylphenidate Hydrochloride
tablet, oral 5,10,20mg
tablet, oral 5,10,20mg
tablet, oral 5,10,20mg
tablet, extended release 20mg
tablet, extended release 20mg
tablet, extended release 20mg
Brand(s)
Methylin
tablet, oral 5,10,20mg
Ritalin
tablet, oral 5,10,20mg
Metadate ER
tablet, extended release 10,20mg
Methylin ER
tablet, extended release 10,20mg
Ritalin-SR
tablet, extended release 20mg
APPLICATION HOLDER,
MANUFACTURER
Merck
Celltech
Purepac
Watson
Able
Purepac
Watson
Mallinckrodt
Novartis *
Celltech
Mallinckrodt
Novartis *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
METHYLPREDNISOLONE
Methylprednisolone
Brand(s)
Medrol
tablet, oral 4mg
@ tablet, oral 4mg
tablet, oral 4mg
@ tablet, oral 4mg
tablet, oral 16,24,32mg
tablet, oral 4,8mg
tablet, oral 4mg
tablet, oral 4mg
@ tablet, oral 16mg
tablet, oral 4,8,16,24,32mg
Duramed/Barr
Eon
Geneva
Heather
Par
Trigen
Vintage
Watson
Watson
Pharmacia-Upjohn *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
METHYLPREDNISOLONE SODIUM SUCCINATE
Methylprednisolone
@ injection eq 40,125,500mg,
Sodium Succinate
1gm base/vial
@ injection eq 40,125,500mg,
1gm base/vial
injection eq 125mg base/vial
@ injection eq 500mg,1gm base/vial
@ injection eq 40,125,500mg,
1gm base/vial
@ injection eq 500mg,1gm base/vial
@ injection eq 40,125,500mg,
1gm base/vial
@ injection eq 40,125,500mg,
1gm base/vial
Brand(s)
A-Methapred
injection eq 40,125,500mg,
1gm base/vial
Solu-Medrol
injection eq 40,125,500mg,
1gm base/vial
143
American Pharmaceutical
Partners
Elkins-Sinn
Gensia Sicor
Gensia Sicor
International Medication
Organon/Akzona
Quad
Steris
Abbott
Upjohn
DRUG
METHYLTESTOSTERONE
Brand(s)
Android 10
Android 25
Metandren
METIPRANOLOL HYDROCHLORIDE
Metipranolol Hydrochloride
Brand(s)
OptiPranolol
DOSAGE FORM, STRENGTH
tablet, oral 10mg
tablet, oral 25mg
@ tablet, oral 10,25mg
APPLICATION HOLDER,
MANUFACTURER
ICN
ICN
Novartis
solution, ophthalmic 0.3%
Falcon
solution, ophthalmic 0.3%
Bausch and Lomb *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
METOCLOPRAMIDE HYDROCHLORIDE
Metoclopramide Hydrochloride
injection eq 5mg base/ml
@ injection eq 5mg base/ml
Brand(s)
Octamide PFS
Reglan
Reglan
Clopra
Maxolon
Reglan
@ injection eq 5mg base/ml
injection eq 5mg base/ml
injection eq 5mg base/ml
@ injection eq 5mg base/ml
@ injection eq 5mg base/ml
@ injection eq 5mg base/ml
solution, oral eq 5mg base/5ml
solution, oral eq 5mg base/5ml
@ solution, oral eq 5mg base/5ml
@ solution, oral eq 5mg base/5ml
solution, oral eq 5mg base/5ml
solution, oral eq 5mg base/5ml
solution, oral eq 5mg base/5ml
solution, oral eq 5mg base/5ml
solution, oral eq 5mg base/5ml
solution, oral eq 5mg base/5ml
@ tablet, oral eq 10mg base
@ tablet, oral eq 10mg base
tablet, oral eq 5,10mg base
@ tablet, oral eq 10mg base
@ tablet, oral eq 10mg base
tablet, oral eq 10mg base
@ tablet, oral eq 5,10mg base
@ tablet, oral eq 10mg base
tablet, oral eq 10mg base
@ tablet, oral eq 10mg base
tablet, oral eq 5,10mg base
@ tablet, oral eq 10mg base
tablet, oral eq 5,10mg base
@ tablet, oral eq 10mg base
tablet, oral eq 10mg base
Abbott
American Pharmaceutical
Partners
Bedford
Faulding
Gensia Sicor
Norbrook
Quad
Smith and Nephew
Alpharma
JVL
Morton Grove
Paco
Pharm Ventures
Pharmaceutical Associates
Roxane
Silarx
Teva
Vistapharm
Barr
Circa
Geneva
Halsey
Interpharm
Lederle
Mutual
Par
Purepac
Schering
Sidmak
Superpharm
Teva
USL
Watson
@ injection eq 5mg base/ml
injection eq 5mg base/ml
@ solution, oral eq 5mg base/5ml
@ tablet, oral eq 5,10mg base
@ tablet, oral eq 10mg base
tablet, oral eq 5,10mg base
Faulding
Robins
Robins
Quantum
King
Schwarz *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
144
DRUG
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
METOCURINE IODIDE
Metocurine Iodide
Brand(s)
Metubine Iodide
@ injection 2mg/ml
Quad
@ injection 2mg/ml
Lilly
METOLAZONE
Brand(s)
Diulo
Zaroxolyn
@ tablet, oral 2.5,5,10mg
tablet, oral 2.5,5,10mg
SCS
Celltech
injection 1mg/ml
injection 1mg/ml
tablet, oral 50,100mg
tablet, oral 50,100mg
tablet, oral 50,100mg
tablet, oral 50,100mg
tablet, oral 50,100mg
tablet, oral 50,100mg
tablet, oral 50,100mg
@ tablet, oral 50,100mg
tablet, oral 50,100mg
tablet, oral 50,100mg
Abbott
Steris
Apothecon
Caraco
Copley
Geneva
Mutual
Mylan
Par
Purepac
Teva
Watson
METOPROLOL TARTRATE
Metoprolol Tartrate
Brand(s)
Lopressor
Lopressor
injection 1mg/ml
tablet, oral 50,100mg
Novartis *
Novartis
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
METRONIDAZOLE
Metronidazole
injection 500mg/100ml
@ injection 500mg/100ml
injection 500mg/100ml
injection 500mg/100ml
injection 500mg/100ml
tablet, oral 250,500mg
tablet, oral 250,500mg
tablet, oral 250,500mg
@ tablet, oral 250,500mg
tablet, oral 250,500mg
tablet, oral 250mg
tablet, oral 250,500mg
tablet, oral 250,500mg
tablet, oral 250,500mg
@ tablet, oral 250,500mg
tablet, oral 250,500mg
tablet, extended release 750mg
Abbott
American Pharmaceutical
Partners
Elkins-Sinn
International Medication
Steris
Barr
Eon
Geneva
Halsey
IVAX
LNK
Mutual
Par
Sidmak
Superpharm
Watson
Able
injection 500mg/100ml
injection 500mg/100ml
injection 500mg/100ml
tablet, oral 250,500mg
tablet, oral 250,500mg
tablet, oral 250,500mg
@ tablet, oral 250,500mg
@ tablet, oral 250,500mg
tablet, extended release 750mg
Searle
Baxter
Braun
Searle
Laboratorios A.F.
Teva
Ortho-McNeil
Savage
Searle
@
@
@
@
Brand(s)
Flagyl I.V.
Flagyl I.V. RTU
Metro I.V.
Flagyl
Metromidol
Metryl
Protostat
Satric
Flagyl ER
145
DRUG
MEXILETINE HYDROCHLORIDE
Mexiletine Hydrochloride
Brand(s)
Mexetil
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
capsule, oral 150,200,250mg
capsule, oral 150,200,250mg
capsule, oral 150,200,250mg
Geneva
Teva
Watson
capsule, oral 150,200,250mg
Boehringer Ingelheim *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
MICONAZOLE NITRATE
Miconazole Nitrate
Brand(s)
Monistat 3
MIDAZOLAM HYDROCHLORIDE
Midazolam Hydrochloride
Brand(s)
Versed
Versed
MINOCYCLINE HYDROCHLORIDE
Minocycline Hydrochloride
Brand(s)
Minocin
Vectrin
Vectrin
MINOXIDIL
Minoxidil
Brand(s)
Loniten
Minodyl
suppository, vaginal 200mg
Alpharma
suppository, vaginal 200mg
Ortho-McNeil
injection eq 1,5mg base/ml
injection eq 1,5mg base/ml
injection eq 1,5gm base/ml
@ injection eq 1,5mg base/ml
@ injection eq 5mg base/ml
injection eq 1,5mg base/ml
injection eq 1,5mg base/ml
injection eq 1,5mg base/ml
injection eq 1,5mg base/ml
injection eq 1,5mg base/ml
injection eq 1,5mg base/ml
syrup, oral eq 2mg base/ml
syrup, oral eq 2mg base/ml
Abbott
American Pharmaceutical
Partners
Apotex
Apothecon
AstraZeneca
Baxter
Bedford
Ben Venue
ESI Lederle
Faulding
Taylor
Ranbaxy
Roxane
@ injection eq 1,5mg base/ml
@ syrup, oral eq 2mg base/ml
Roche
Roche
capsule, oral eq 50,100mg base
capsule, oral eq 50,75,100mg base
capsule, oral eq 50,100mg base
capsule, oral eq 50,75,100mg base
Impax
Ranbaxy
Teva
Watson
capsule, oral eq 50,75,100mg base
capsule, oral eq 50mg base
@ capsule, oral eq 75,100mg base
Wyeth
Medicis
Medicis
tablet, oral 2.5,10mg
tablet, oral 2.5,10mg
@ tablet, oral 2.5mg
tablet, oral 2.5,10mg
Mutual
Par
USL
Watson
tablet, oral 2.5,10mg
@ tablet, oral 2.5,10mg
Pharmacia & Upjohn
Quantum
146
DRUG
MIRTAZAPINE
Mirtazapine
Brand(s)
Remeron
MISOPROSTOL
Misoprostol
Brand(s)
Cytotec
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
tablet, oral 15,30,45mg
tablet, oral 15,30,45mg
tablet, oral 15,30,45mg
tablet, oral 15,30,45mg
tablet, oral 15,30,45mg
Andrx
Mylan
Purepac
Roxane
Teva
tablet, oral 15,30,45mg
Organon
tablet, oral 0.1,0.2mg
IVAX
tablet, oral 0.1,0.2mg
Searle *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
MITOMYCIN
Mitomycin
Brand(s)
Mutamycin
MOEXIPRIL HYDROCHLORIDE
Moexipril Hydrochloride
Brand(s)
Univasc
injection 5,20mg/vial
injection 5,20mg/vial
injection 20mg/vial
injection 5,20mg/vial
Bedford
ESI Lederle
Faulding
Supergen
injection 5,20mg/vial
Bristol-Myers
tablet, oral 7.5,15mg
Teva
tablet, oral 7.5,15mg
Schwarz *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
MOMETASONE FURORATE
Mometasone Furorate
Brand(s)
Elocon
MORPHINE SULFATE
Morphine Sulfate
Brand(s)
Astramorph PF
Duramorph PF
MSIR
Roxanol
MS/L
MS/L
MSIR
MSIR
(continued on the next page)
ointment, topical 0.1%
Clay-Park
ointment, topical 0.1%
Schering
injection 0.5,1mg/ml
injection 1mg/ml
injection 0.5,1mg/ml
solution, oral 10mg/5ml
solution, oral 20mg/5ml
tablet, extended release
15,30,60,100,200mg
tablet, extended release
15,30,60,100,200mg
tablet, extended release 15mg
tablet, extended release 100mg
Abbott
Mallinckrodt
Steris
Roxane *
Roxane *
AB Generics
injection 0.5,1mg/ml
injection 0.5,1mg/ml
solution, oral 20mg/ml
solution, oral 20mg/ml
solution, oral 10mg/5ml
solution, oral 20mg/5ml
solution, oral 10mg/5ml
solution, oral 20mg/5ml
Astra Zeneca
Elkins-Sinn
Purdue Frederick *
Roxane *
Liquipharm *
Liquipharm *
Purdue Frederick *
Purdue Frederick *
147
Endo
ESI Lederle
Watson
DRUG
DOSAGE FORM, STRENGTH
MORPHINE SULFATE (continued)
MS Contin
tablet, extended release
15,30,60,100,200mg
APPLICATION HOLDER,
MANUFACTURER
Purdue Frederick **
* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as an
exception to the promulgated criteria for inclusion, pursuant to Rule 790.60.
** Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
NABUMETONE
Nabumetone
Brand(s)
Relafen
NADOLOL
Nadolol
Brand(s)
Corgard
NAFCILLIN SODIUM
Nafcillin Sodium
Nafcil
Brand(s)
Nallpen
Unipen
NALBUPHINE HYDROCHLORIDE
Nalbuphine Hydrochloride
Brand(s)
Nubain
NALIDIXIC ACID
Nalidixic Acid
Brand(s)
NegGram
NALOXONE HYDROCHLORIDE
Naloxone Hydrochloride
(continued on the next page)
tablet, oral 750mg
tablet, oral 500,750mg
tablet, oral 500,750mg
@ tablet, oral 500,750mg
tablet, oral 500mg
Copley
Eon
Geneva
IVAX
Teva
tablet, oral 500,750mg
GlaxoSmithKline
tablet, oral 80,120,160mg
tablet, oral 20,40,80mg
tablet, oral 20,40,80,120,160mg
tablet, oral 20,40,80mg
Copley
Geneva
IVAX
Mylan
tablet, oral 20,40,80,120,160mg
Apothecon
@ injection eq 500mg,1,2,4,10gm
base/vial
Marsam
injection eq 500mg,1,2,4,10gm
base/vial
@ injection eq 500mg,1,2,10gm
base/vial
@ injection eq 500mg,1,2,4,10gm
base/vial
Apothecon
injection 10,20mg/ml
@ injection 10,20mg/ml
@ injection 10,20mg/ml
injection 10,20mg/ml
@ injection 10,20mg/ml
injection 10,20mg/ml
@ tablet, oral 250,500,1000mg
tablet, oral 250,500,1000mg
tablet, oral 250,500,1000mg
injection 0.02,0.4mg/ml
@ injection 0.02,0.4,1mg/ml
148
GlaxoSmithKline
Wyeth-Ayerst
Abbott
American Pharmaceutical
AstraZeneca
King
Quad
Endo
Barr
Watson
Sanofi Synthelabo
Abbott
American Pharmaceutical
Partners
DRUG
DOSAGE FORM, STRENGTH
NALOXONE HYDROCHLORIDE (continued)
@ injection 0.02,0.4,1mg/ml
injection 0.02,0.4,1mg/ml
injection 0.4,1mg/ml
@ injection 0.4mg/ml
@ injection 0.02,0.4,1mg/ml
@ injection 0.02,0.4mg/ml
@ injection 0.02,0.4mg/ml
Brand(s)
Narcan
@ injection 0.4mg/ml
@ injection 0.02,0.4mg/ml
injection 0.02,0.4,1mg/ml
NALOXONE HYDROCHLORIDE; PENTAZOCINE HYDROCHLORIDE
Naloxone Hydrochloride;
tablet, oral eq 0.5mg base;
Pentazocine Hydrochloride
eq 50mg base
tablet, oral eq 0.5mg base;
eq 50mg base
tablet, oral eq 0.5mg base;
eq 50mg base
Brand(s)
Talwin NX
tablet, oral eq 0.5mg base;
eq 50mg base
NALTREXONE HYDROCHLORIDE
Naltrexone Hydrochloride
Revia
Brand(s)
NANDROLONE DECANOATE
Nandrolone Decanoate
Brand(s)
Deca-Durabolin
APPLICATION HOLDER,
MANUFACTURER
AstraZeneca
Elkins-Sinn
International Medication
Marsam
Quad
Smith and Nephew
Solopak
Steris
Wyeth-Ayerst
Endo
Amide
Ranbaxy
Watson
Sanofi Synthelabo
tablet, oral 50mg
tablet, oral 50mg
tablet, oral 50mg
Amide
Barr
Eon
tablet, oral 50mg
Barr
@ injection 100mg/ml
@ injection 100,200mg/ml
@ injection 50,100,200mg/ml
injection 50,100,200mg/ml
injection 50,100,200mg/ml
NANDROLONE PHENPROPIONATE
Nandrolone Phenpropionate
@ injection 25,50mg/ml
@ injection 25,50mg/ml
Brand(s)
Durabolin
@ injection 25,50mg/ml
NAPHAZOLINE HYDROCHLORIDE
Brand(s)
AK-Con
solution, ophthalmic 0.1%
Albalon
solution, ophthalmic 0.1%
Nafazair
solution, ophthalmic 0.1%
Naphcon Forte
@ solution, ophthalmic 0.1%
Opcon
@ solution, ophthalmic 0.1%
Vasocon
solution, ophthalmic 0.1%
149
Akorn
American Pharmaceutical
Partners
Quad
Steris
Organon/Akzona
Quad
Steris
Organon/Akzona
Taylor
Allergan
Bausch and Lomb
Alcon
Bausch and Lomb
Novartis
DRUG
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
NAPHAZOLINE HYDROCHLORIDE; ANTAZOLINE PHOSPHATE
See ANTAZOLINE PHOSPHATE; NAPHAZOLINE HYDROCHLORIDE
NAPHAZOLINE HYDROCHLORIDE; PHENIRAMINE MALEATE
Brand(s)
AK-Con-A
solution, ophthalmic 0.025%;0.3%
Muro's Opcon A
solution, ophthalmic 0.025%;0.3%
Naphcon A
solution, ophthalmic 0.025%;0.3%
Naphoptic-A
solution, ophthalmic 0.025%;0.3%
Akorn *
Bausch and Lomb *
Alcon *
Optopics *
* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as an
exception to the promulgated criteria for inclusion, pursuant to Rule 790.60.
NAPROXEN
Naproxen
Brand(s)
Naprosyn
EC-Naprosyn
Naprosyn
suspension, oral 125mg/5ml
tablet, delayed release 375,500mg
tablet, delayed release 375,500mg
tablet, delayed release 375,500mg
tablet, delayed release 375,500mg
tablet, oral 250,375,500mg
tablet, oral 250,375,500mg
tablet, oral 250,375,500mg
@ tablet, oral 250,375,500mg
tablet, oral 250,375,500mg
tablet, oral 250,375,500mg
tablet, oral 250,375,500mg
tablet, oral 250,375,500mg
tablet, oral 250,375,500mg
tablet, oral 250,375,500mg
tablet, oral 250,375,500mg
tablet, oral 250,375,500mg
tablet, oral 250,375,500mg
suspension, oral 125mg/5ml
tablet, delayed release 375,500mg
tablet, oral 250,375,500mg
Roxane
Geneva
Purepac
Sidmak
Teva
Clonmel
Copley
Geneva
Hamilton
Interpharm
IVAX
Lederle
Mylan
Purepac
Roxane
Sidmak
Teva
Watson
Syntex
Syntex *
Syntex
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
NAPROXEN SODIUM
Naproxen Sodium
Brand(s)
Anaprox
Anaprox DS
Naprelan
tablet, oral eq 500mg base
tablet, oral eq 250,500mg base
tablet, oral eq 250,500mg base
@ tablet, oral eq 250,500mg base
tablet, oral eq 250,500mg base
tablet, oral eq 250,500mg base
@ tablet, oral eq 250,500mg base
tablet, oral eq 250,500mg base
tablet, oral eq 250,500mg base
tablet, oral eq 250,500mg base
tablet, oral eq 250,500mg base
tablet, extended release
eq 375,500mg base
tablet, oral eq 250mg base
tablet, oral eq 500mg base
tablet, extended release
eq 375,500mg base
150
Al-Hikma
Copley
Geneva
Hamilton
IVAX
Mylan
Purepac
Roxane
Sidmak
Teva
Watson
Andrx
Syntex
Syntex
Élan
DRUG
NEOMYCIN SULFATE
Neomycin Sulfate
Brand(s)
Neo-Rx
Mycifradin
Neobiotic
DOSAGE FORM, STRENGTH
@
@
@
@
@
@
@
@
@
APPLICATION HOLDER,
MANUFACTURER
injection eq 350mg base/vial
injection eq 350mg base/vial
powder for compounding 100%
powder for compounding 100%
tablet, oral eq 350mg base
tablet, oral eq 350mg base
tablet, oral eq 350mg base
tablet, oral eq 350mg base
tablet, oral eq 350mg base
tablet, oral eq 350mg base
powder for compounding 100%
@ tablet, oral eq 350mg base
@ tablet, oral eq 350mg base
Pfizer
Squibb
Elkins-Sinn
Paddock
Eon
Lannett
Lilly
Roxane
Squibb
Teva
Pharm Tek
Pharmacia & Upjohn
Pfizer
NEOMYCIN SULFATE; BACITRACIN; HYDROCORTISONE ACETATE; POLYMYXIN B SULFATE
See BACITRACIN; HYDROCORTISONE ACETATE; NEOMYCIN SULFATE; POLYMYXIN B SULFATE
NEOMYCIN SULFATE; BACITRACIN ZINC; HYDROCORTISONE; POLYMYXIN B SULFATE
See BACITRACIN ZINC; HYDROCORTISONE; NEOMYCIN SULFATE; POLYMYXIN B SULFATE
NEOMYCIN SULFATE; BACITRACIN ZINC; POLYMYXIN B SULFATE
See BACITRACIN ZINC; NEOMYCIN SULFATE; POLYMYXIN B SULFATE
NEOMYCIN SULFATE; DEXAMETHASONE; POLYMYXIN B SULFATE
See DEXAMETHASONE; NEOMYCIN SULFATE; POLYMYXIN B SULFATE
NEOMYCIN SULFATE; DEXAMETHASONE SODIUM PHOSPHATE
See DEXAMETHASONE SODIUM PHOSPHATE; NEOMYCIN SULFATE
NEOMYCIN SULFATE; GRAMICIDIN; POLYMYXIN B SULFATE
See GRAMICIDIN; NEOMYCIN SULFATE; POLYMYXIN B SULFATE
NEOMYCIN SULFATE; HYDROCORTISONE; POLYMYXIN B SULFATE
See HYDROCORTISONE; NEOMYCIN SULFATE; POLYMYXIN B SULFATE
NEOMYCIN SULFATE; HYDROCORTISONE ACETATE
See HYDROCORTISONE ACETATE; NEOMYCIN SULFATE
NEOMYCIN SULFATE; POLYMYXIN B SULFATE
Neomycin Sulfate;
@ solution eq 40mg base/ml;200,000U/ml Steris
Polymyxin B Sulfate
Brand(s)
Neosporin G.U. Irrigant
solution eq 40mg base/ml;200,000U/ml Monarch
NIACIN (NICOTINIC ACID)
Niacin
(continued on the next page)
@
@
@
@
@
tablet, oral 500mg
tablet, oral 500mg
tablet, oral 500mg
tablet, oral 500mg
tablet, oral 500mg
151
Circa
Everylife
Geneva
Halsey
Impax
DRUG
DOSAGE FORM, STRENGTH
NIACIN (NICOTINIC ACID) (continued)
@ tablet, oral 500mg
tablet, oral 500mg
@ tablet, oral 500mg
tablet, oral 500mg
@ tablet, oral 500mg
@ tablet, oral 500mg
tablet, oral 500mg
Brand(s)
Niacor
tablet, oral 500mg
Nicolar
tablet, oral 500mg
APPLICATION HOLDER,
MANUFACTURER
IVAX
MK
Purepac
Tablicaps
Watson
West-ward
Wockhardt
Upsher-Smith
Aventis
NOTE: Dosage strengths less than 500mg are OTC.
NIACINAMIDE; ASCORBIC ACID; BIOTIN; CYANOCOBALAMIN; DEXPANTHENOL; ERGOCALCIFEROL;
FOLIC ACID; PYRIDOXINE HYDROCHLORIDE; RIBOFLAVIN PHOSPHATE SODIUM; THIAMINE
HYDROCHLORIDE; VITAMIN A; VITAMIN E
See ASCORBIC ACID; BIOTIN; CYANOCOBALAMIN; DEXPANTHENOL; ERGOCALCIFEROL; FOLIC
ACID; NIACINAMIDE; PYRIDOXINE HYDROCHLORIDE; RIBOFLAVIN PHOSPHATE SODIUM
HYDROCHLORIDE; VITAMIN A; VITAMIN E
NICARDIPINE HYDROCHLORIDE
Nicardipine Hydrochloride
Brand(s)
Cardene
NICOTINE
Nicotine
Brand(s)
Nicotrol
capsule, oral 20,30mg
capsule, oral 20,30mg
capsule, oral 20,30mg
capsule, oral 20,30mg
capsule, oral 20,30mg
GenPharm
IVAX
Mylan
Teva
Watson
capsule, oral 20,30mg
Roche
film, extended release, transdermal
7,14,21mg/24 hours
Sano
film, extended release, transdermal
7,14,21mg/24 hours
Novartis
NICOTINIC ACID; ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; IRON; PYRIDOXINE
HYDROCHLORIDE; RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D; VITAMIN E
See ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; IRON; NICOTINIC ACID; PYRIDOXINE
HYDROCHLORIDE; RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D;
VITAMIN E
NICOTINIC ACID; ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; PYRIDOXINE HYDROCHLORIDE;
RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D; VITAMIN E
See ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; NICOTINIC ACID; PYRIDOXINE
HYDROCHLORIDE; RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D;
VITAMIN E
NIFEDIPINE
Nifedipine
(continued on the next page)
@ capsule, oral 10,20mg
capsule, oral 10mg
capsule, oral 10,20mg
capsule, oral 10,20mg
capsule, oral 10mg
152
Chase
Flemington
Purepac
Scherer
Teva
DRUG
NIFEDIPINE (continued)
Brand(s)
Adalat
Procardia
Adalat CC
DOSAGE FORM, STRENGTH
(AB1) tablet, extended release
30,60,90mg
(AB1) tablet, extended release 30mg
@ (AB2) tablet, extended release 30mg
capsule, oral 10,20mg
capsule, oral 10,20mg
(AB1) tablet, extended release
30,60,90mg
(AB2) tablet, extended release
30,60mg
(AB2) tablet, extended release
30,60,90mg
Nifedical XL
Procardia XL
APPLICATION HOLDER,
MANUFACTURER
Biovail
Elan
Mylan
Bayer
Pfizer
Bayer
Biovail
Pfizer *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
Products designated “AB1" may only be interchanged with other products designated as “AB1.” Products
designated as “AB2" may only be interchanged with other products designated as “AB2.” Products designated
as “AB1" MAY NOT BE INTERCHANGED with products designated as “AB2.” Products designated as “AB2"
MAY NOT BE INTERCHANGED with products designated as “AB1.”
NITROFURANTOIN
Nitrofurantoin
Brand(s)
Furadantin
Furalan
@
@
@
@
@
@
@
tablet, oral 50,100mg
tablet, oral 50,100mg
tablet, oral 50,100mg
tablet, oral 50,100mg
tablet, oral 50mg
tablet, oral 100mg
tablet, oral 100mg
@ tablet, oral 50,100mg
@ tablet, oral 50,100mg
NITROFURANTOIN, MACROCRYSTALLINE
Nitrofurantoin, Macrocrystalline @ capsule, oral 50,100mg
capsule, oral 50,100mg
capsule, oral 50,100mg
capsule, oral 50,100mg
capsule, oral 25,50,100mg
Brand(s)
Macrodantin
capsule, oral 25,50,100mg
Circa
Elkins-Sinn
Eon
IVAX
Watson
Watson
Whiteworth Towne
Procter and Gamble
Lannett
Circa
Geneva
IVAX
Mylan
Watson
Procter and Gamble
Note: Nitrofurantoin macrocrystalline extended release capsules are not interchangeable with nitrofurantoin
macrocrystalline capsules.
NITROFURAZONE
Nitrofurazone
Brand(s)
Actin-H
Furacin
@ ointment, topical 0.2%
@ ointment, topical 0.2%
@ ointment, topical 0.2%
ointment, topical 0.2%
ointment, topical 0.2%
@ solution, topical 0.2%
solution, topical 0.2%
Ambix/Organics
Clay-Park
Lannett
Taro
Wendt
Clay-Park
Wendt
@ ointment, topical 0.2%
@ ointment, topical 0.2%
Sherwood
Shire
153
DRUG
DOSAGE FORM, STRENGTH
NITROGLYCERIN
Nitroglycerin
Brand(s)
Nitro-Bid
Nitro-Bid
Nitrol
Nitro I.V.
Nitrostat
Tridil
Minitran
Nitro-DUR
Transderm-Nitro
film (AB1), extended release
transdermal 0.1,0.2,0.4,0.6mg/hour
film (AB2), extended release
transdermal 0.2,0.4,0.6mg/hour
film (AB2), extended release
transdermal 0.2,0.4,0.6mg/hour
injection 5mg/ml
@ injection 5mg/ml
@ injection 5mg/ml
injection 5mg/ml
@ injection 5,10mg/ml
@ injection 5mg/ml
@
@
@
@
injection 5mg/ml
injection 10mg/ml
injection 0.8mg/ml
injection 5mg/ml
injection 0.8,5,10mg/ml
injection 5mg/ml
film (AB1), extended release
transdermal 0.1,0.2,0.4,0.6mg/hour
film (AB1), extended release
transdermal 0.1,0.2,0.4,0.6mg/hour
film (AB2), extended release
transdermal 0.2,0.4,0.6mg/hour
APPLICATION HOLDER,
MANUFACTURER
Mylan
Hercon
Mylan
Abbott
American Pharmaceutical
Partners
International Medication
Luitpold
Quad
Smith and Nephew
Aventis
Aventis
Aventis
Pohl Boskamp
Pfizer
Faulding
3M
Schering/Key
Novartis
Products designated “AB1" may only be interchanged with other products designated as “AB1.” Products
designated “AB2" may only be interchanged with other products designated as “AB2.” Products designated
as “AB1" MAY NOT BE INTERCHANGED with products designated as “AB2.”
NIZATIDINE
Nizatitine
Axid
Brand(s)
capsule, oral 150,300mg
capsule, oral 150,300mg
capsule, oral 150,300mg
capsule, oral 150,300mg
capsule, oral 150,300mg
capsule, oral 150,300mg
capsule, oral 150,300mg
Eon
GenPharm
IVAX
Mylan
Teva
TorPharm
Watson
capsule, oral 150,300mg
Reliant
NORGESTIMATE; ETHINYL ESTRADIOL
See ETHINYL ESTRADIOL; NORGESTIMATE
NORGESTREL; ETHINYL ESTRADIOL
See ETHINYL ESTRADIOL; NORGESTREL
NORETHINDRONE
Brand(s)
Camila
Errin
Micronor
Nor-QD
tablet (AB1), oral 0.35mg
tablet (AB2), oral 0.35mg
tablet (AB2), oral 0.35mg
tablet (AB1), oral 0.35mg
Barr
Barr
Ortho McNeil *
Watson *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
154
DRUG
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
NORETHINDRONE; ETHINYL ESTRADIOL
See ETHINYL ESTRADIOL; NORETHINDRONE
NORETHINDRONE; MESTRANOL
See MESTRANOL; NORETHINDRONE
NORETHINDRONE ACETATE
Norethindrone Acetate
Brand(s)
Aygestin
Norlutate
tablet, oral 5mg
tablet, oral 5mg
@ tablet, oral 5mg
NORTRIPTYLINE HYDROCHLORIDE
Nortriptyline Hydrochloride
Brand(s)
Pamelor
Aventyl HCl
Pamelor
Barr
Wyeth
Pfizer
capsule, oral eq 10,25,50,75mg base
capsule, oral eq 10,25,50,75mg base
capsule, oral eq 10,25,50,75mg base
capsule, oral eq 10,25,50,75mg base
capsule, oral eq 10,25,50,75mg base
solution, oral eq 10mg base/ml
Geneva
Mylan
Taro
Teva
Watson
Pharmaceutical Associates
capsule, oral eq 10,25,50,75mg base
solution, oral eq 10mg base/5ml
solution, oral eq 10mg base/5ml
Tyco *
Ranbaxy
Tyco
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
NYSTATIN
Nystatin
@
@
@
@
@
@
@
@
@
@
@
(continued on the next page)
cream, topical 100,000U/gm
cream, topical 100,000U/gm
cream, topical 100,000U/gm
cream, topical 100,000U/gm
cream, topical 100,000U/gm
ointment, topical 100,000U/gm
ointment, topical 100,000U/gm
ointment, topical 100,000U/gm
powder, oral 100%
suspension, oral 100,000U/ml
suspension, oral 100,000U/ml
suspension, oral 100,000U/ml
suspension, oral 100,000U/ml
suspension, oral 100,000U/ml
suspension, oral 100,000U/ml
suspension, oral 100,000U/ml
suspension, oral 100,000U/ml
suspension, oral 100,000U/ml
suspension, oral 100,000U/ml
tablet, oral 500,000U
tablet, oral 500,000U
tablet, oral 500,000U
tablet, oral 500,000U
tablet, oral 500,000U
tablet, oral 500,000U
tablet, oral 500,000U
tablet, vaginal 100,000U
tablet, vaginal 100,000U
tablet, vaginal 100,000U
155
Alpharma
Altana
Clay-Park
Taro
Teva
Alpharma
Altana
Clay-Park
Paddock
Alpharma
Bausch and Lomb
Fougera/Altana
Morton Grove
Pharmaderm/Altana
Pharmafair
Roxane
Taro
Teva
UDL
Eon
Mutual
Par
Quantum
Teva
USL
Watson
Eon
Fougera/Altana
Odyssey
DRUG
NYSTATIN (continued)
Brand(s)
Candex
Mycostatin
Mykinac
Nilstat
Mycostatin
Mykinac
Nilstat
Barstatin 100
Nilstat
Mycostatin
Nystop
Mycostatin
Nilstat
Nystex
Mycostatin
Nilstat
Korostatin
Mycostatin
Nilstat
DOSAGE FORM, STRENGTH
tablet, vaginal 100,000U
@ tablet, vaginal 100,000U
@ tablet, vaginal 100,000U
@ tablet, vaginal 100,000U
Pharmaderm/Altana
Quantum
Teva
Watson
@ cream, topical 100,000U/gm
cream, topical 100,000U/gm
@ cream, topical 100,000U/gm
@ cream, topical 100,000U/gm
@ ointment, topical 100,000U/gm
@ ointment, topical 100,000U/gm
@ ointment, topical 100,000U/gm
@ powder, oral 100%
powder, oral 100%
powder, topical 100,000U/gm
powder, topical 100,000U/gm
suspension, oral 100,000U/ml
suspension, oral 100,000U/ml
suspension, oral 100,000U/ml
tablet, oral 500,000U
@ tablet, oral 500,000U
@ tablet, vaginal 100,000U
@ tablet, vaginal 100,000U
@ tablet, vaginal 100,000U
Bayer
Westwood Squibb
Alpharma
Lederle
Westwood Squibb
Alpharma
Lederle
Barlan
Lederle
Westwood Squibb
Paddock
Apothecon
Lederle
Savage/Altana
Apothecon
Lederle
Holland-Rantos
Squibb
Lederle
NYSTATIN; TRIAMCINOLONE ACETONIDE
Nystatin;
@ cream, topical 100,000U/gm;0.1%
Triamcinolone Acetonide
@ cream, topical 100,000U/gm;0.1%
cream, topical 100,000U/gm;0.1%
@ cream, topical 100,000U/gm;0.1%
@ cream, topical 100,000U/gm;0.1%
cream, topical 100,000U/gm;0.1%
@ ointment, topical 100,000U/gm;0.1%
ointment, topical 100,000U/gm;0.1%
@ ointment, topical 100,000U/gm;0.1%
@ ointment, topical 100,000U/gm;0.1%
ointment, topical 100,000U/gm;0.1%
Brand(s)
Dermacomb
@ cream, topical 100,000U/gm;0.1%
Myco-Triacet II
cream, topical 100,000U/gm;0.1%
Mycolog-II
cream, topical 100,000U/gm;0.1%
Mykacet
cream, topical 100,000U/gm;0.1%
Mytrex F
cream, topical 100,000U/gm;0.1%
Myco-Triacet II
@ ointment, topical 100,000U/gm;0.1%
Mycolog-II
ointment, topical 100,000U/gm;0.1%
Mykacet
ointment, topical 100,000U/gm;0.1%
Mytrex F
ointment, topical 100,000U/gm;0.1%
OMEPRAZOLE
Omeprazole
Brand(s)
Prilosec
APPLICATION HOLDER,
MANUFACTURER
Alpharma
Clay-Park
Fougera/Altana
Pharmaderm/Altana
Pharmafair
Taro
Clay-Park
Fougera/Altana
Pharmaderm/Altana
Pharmafair
Taro
Taro
Teva
Apothecon
Alpharma
Savage/Altana
Teva
Apothecon
Alpharma
Savage/Altana
capsule, delayed release 10,20,40mg
capsule, delayed release 10,20mg
capsule, delayed release 10,20mg
Andrx
Kremers Urban
Lek
capsule, delayed release 10,20,40mg
AstraZeneca
156
DRUG
ORPHENADRINE CITRATE
Orphenadrine Citrate
Brand(s)
Norflex
Norflex
DOSAGE FORM, STRENGTH
injection 30mg/ml
@ tablet, extended release 100mg
@ tablet, extended release 100mg
tablet, extended release 100mg
tablet, extended release 100mg
tablet, extended release 100mg
tablet, extended release 100mg
injection 30mg/ml
tablet, extended release 100mg
APPLICATION HOLDER,
MANUFACTURER
Steris
(Ascot)
Circa
Eon
Geneva
Impax
Kiel
Riker/3-M
Riker/3-M *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
ORPHENADRINE CITRATE; ASPIRIN; CAFFEINE
See ASPIRIN; CAFFEINE; ORPHENADRINE CITRATE
OXACILLIN SODIUM
Oxacillin Sodium
Brand(s)
Bactocill
Prostaphlin
Bactocill
Bactocill
Prostaphlin
Prostaphlin
Bactocill
Prostaphlin
OXAPROZIN
Oxaprozin
Brand(s)
Daypro
capsule, oral eq 250,500mg base
@ injection eq 250,500mg,1,2,4,
10gm base/vial
@ injection eq 250,500mg,
1,2gm base/vial
injection eq 250,500mg,1,2,4,
10gm base/vial
powder for solution
eq 250mg base/5ml
Teva
Elkins-Sinn
capsule, oral eq 250,500mg base
@ capsule, oral eq 250,500mg base
@ injection eq 500mg,4,10gm base/vial
@ injection eq 1,2gm base/vial
injection eq 250,500mg,1,2,
10gm base/vial
@ injection eq 4gm base/vial
powder for solution
eq 250mg base/5ml
powder for solution
eq 250mg base/5ml
GlaxoSmithKline
Apothecon
GlaxoSmithKline
GlaxoSmithKline
Apothecon
IBI
Marsam
Teva
Apothecon
SmithKline Beecham
Apothecon
tablet, oral 600mg
tablet, oral 600mg
tablet, oral 600mg
tablet, oral 600mg
tablet, oral 600mg
tablet, oral 600mg
tablet, oral 600mg
tablet, oral 600mg
tablet, oral 600mg
tablet, oral 600mg
Caraco
Dr. Reddy’s
Eon
Geneva
GenPharm
IVAX
Mylan
Purepac
Teva
Watson
tablet, oral 600mg
Searle *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
157
DRUG
OXAZEPAM
Oxazepam
Brand(s)
Serax
Zaxopam
Serax
OXTRIPHYLLINE
Oxtriphylline
Brand(s)
Choledyl
Choledyl
Choledyl
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
@ capsule, oral 10,15,30mg
@ capsule, oral 10,15,30mg
capsule, oral 10,15,30mg
capsule, oral 10,15,30mg
@ capsule, oral 10,15,30mg
capsule, oral 10,15,30mg
capsule, oral 10,15,30mg
@ tablet, oral 15mg
@ tablet, oral 15mg
@ tablet, oral 15mg
American Therapeutics
Barr
Geneva
IVAX
Mylan
Purepac
Watson
Barr
Pfizer
Watson
capsule, oral 10,15,30mg
@ capsule, oral 10,15,30mg
tablet, oral 15mg
Faulding
Quantum
Faulding
@ solution, oral 100mg/5ml
@ syrup, oral 50mg/5ml
@ tablet, delayed release 100,200mg
Morton Grove
Morton Grove
Circa *
@ solution, oral 100mg/5ml
@ syrup, oral 50mg/5ml
@ tablet, delayed release 100,200mg
Pfizer
Pfizer
Pfizer *
* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as an
exception to the promulgated criteria for inclusion, pursuant to Rule 790.60.
OXYBUTYNIN CHLORIDE
Oxybutynin Chloride
Brand(s)
Ditropan
Ditropan
syrup, oral 5mg/5ml
syrup, oral 5mg/5ml
syrup, oral 5mg/5ml
syrup, oral 5mg/5ml
syrup, oral 5mg/5ml
@ tablet, oral 5mg
@ tablet, oral 5mg
tablet, oral 5mg
tablet, oral 5mg
tablet, oral 5mg
syrup, oral 5mg/5ml
tablet, oral 5mg
Mikart
Morton Grove
Novex
Pharmaceutical Associates
Silarx
Circa
Quantum
Sidmak
USL
Vintage
Alza
Alza
OXYCODONE HYDROCHLORIDE; ACETAMINOPHEN
See ACETAMINOPHEN; OXYCODONE HYDROCHLORIDE
OXYCODONE HYDROCHLORIDE; ASPIRIN; OXYCODONE TEREPHTHALATE
See ASPIRIN; OXYCODONE HYDROCHLORIDE; OXYCODONE TEREPHTHALATE
OXYCODONE TEREPHTHALATE; ASPIRIN; OXYCODONE HYDROCHLORIDE
See ASPIRIN; OXYCODONE HYDROCHLORIDE; OXYCODONE TEREPHTHALATE
158
DRUG
DOSAGE FORM, STRENGTH
OXYTETRACYCLINE HYDROCHLORIDE
Oxytetracycline Hydrochloride
@ capsule, oral eq 250mg base
@ capsule, oral eq 250mg base
@ capsule, oral eq 250mg base
@ capsule, oral eq 250mg base
Brand(s)
Oxy-Kesso-Tetra
@ capsule, oral eq 250mg base
Terramycin
capsule, oral eq 250mg base
OXYTOCIN
Oxytocin
Brand(s)
Pitocin
Syntocinon
PACLITAXEL
Paclitaxel
Taxol
Brand(s)
PANCURONIUM BROMIDE
Pancuronium Bromide
Brand(s)
Pavulon
PAROMOMYCIN SULFATE
Paromomycin Sulfate
Brand(s)
Humatin
PEMOLINE
Pemoline
Cylert
Cylert
Brand(s)
PENICILLIN G POTASSIUM
Penicillin G Potassium
(continued on the next page)
injection 10 USP U/ml
@ injection 10 USP U/ml
APPLICATION HOLDER,
MANUFACTURER
Impax
Proter
Purepac
West-ward
Ferrante
Pfizer
American Pharmaceutical
Partners
Wyeth-Ayerst
injection 10 USP U/ml
injection 10 USP U/ml
Parkdale
Novartis
injection 6mg/ml
injection 6mg/ml
injection 6mg/ml
Baker Norton
IVAX
Mylan
injection 6mg/ml
Bristol-Myers Squibb
injection 1,2mg/ml
@ injection 1,2mg/ml
injection 1,2mg/ml
injection 1,2mg/ml
@ injection 1,2mg/ml
Abbott
AstraZeneca
Elkins-Sinn
Gensia Sicor
Quad
injection 1,2mg/ml
Organon/Akzona
capsule, oral eq 250mg base
Caraco
capsule, oral eq 250mg base
Parkdale
tablet, chewable 37.5mg
tablet, chewable 37.5mg
tablet, oral 18.75,37.5,75mg
tablet, oral 18.75,37.5,75mg
tablet, oral 18.75,37.5,75mg
tablet, oral 18.75,37.5,75mg
tablet, oral 18.75,37.5,75mg
Amide
Copley
Amide
Copley
Geneva
Vintage
Watson
tablet, chewable 37.5mg
tablet, oral 18.75,37.5,75mg
Abbott
Abbott
@ injection 1,000,000, 5,000,000,
10,000,000, 20,000,000U/vial
@ injection 500,000, 1,000,000,
5,000,000, 10,000,000U/vial
159
Apothecon
Consolidated
DRUG
DOSAGE FORM, STRENGTH
PENICILLIN G POTASSIUM (continued)
@
@
@
@
@
@
@
@
@
Brand(s)
Pfizerpen
Pentids 200
Pentids 400
Pfizerpen-G
Pentids 200
Pentids 250
Pentids 400
Pentids 800
Pfizerpen-G
PENICILLIN G PROCAINE
Penicillin G Procaine
Brand(s)
Duracillin A.S.
Pfizerpen-AS
Wycillin
@
@
@
@
@
@
@
@
injection 1,000,000, 5,000,000,
20,000,000U/vial
powder for suspension 200,000U/5ml
powder for suspension 400,000U/5ml
powder for suspension 400,000U/5ml
tablet, oral 200,000U
tablet, oral 250,000U
tablet, oral 400,000U
tablet, oral 800,000U
tablet, oral 200,000, 250,000, 400,000,
800,000U
Geneva
Lilly/Dista
Marsam
Mylan
Purepac
Teva
IVAX
Lilly/Dista
Mylan
Purepac
Teva
Wyeth-Ayerst
Pfizer
Apothecon
Apothecon
Pfizer
Apothecon
Apothecon
Apothecon
Apothecon
Pfizer
@ injection 300,000U/ml
Consolidated
@ injection 300,000U/ml
@ injection 300,000, 600,000U/ml
injection 300,000, 600,000U/ml
Lilly
Pfizer
King
PENICILLIN V POTASSIUM
Penicillin V Potassium
@
@
(continued on the next page)
injection 1,000,000, 5,000,000,
20,000,000U/vial
injection 500,000, 1,000,000,
5,000,000, 20,000,000U/vial
injection 1,000,000, 5,000,000,
10,000,000, 20,000,000U/vial
powder for suspension 200,000,
250,000, 400,000U/5ml
powder for suspension 250,000,
400,000U/5ml
powder for suspension 200,000,
250,000, 400,000U/5ml
tablet, oral 400,000U
tablet, oral 250,000U
tablet, oral 200,000, 250,000, 400,000,
500,000, 800,000U
tablet, oral 200,000, 250,000,
400,000U
tablet, oral 200,000, 250,000, 400,000,
500,000U
tablet, oral 200,000, 250,000,
400,000U
APPLICATION HOLDER,
MANUFACTURER
@
@
powder for solution eq 125,
250mg base/5ml
powder for solution eq 125,
250mg base/5ml
powder for solution eq 125,
250mg base/5ml
powder for solution eq 125,
250mg base/5ml
powder for solution eq 125,
250mg base/5ml
tablet, oral eq 250,500mg base
tablet, oral eq 250,500mg base
tablet, oral eq 250,500mg base
tablet, oral eq 125,250,500mg base
tablet, oral eq 250,500mg base
160
Clonmel
Consolidated
Mylan
Purepac
Teva
Biochemie
Clonmel
Consolidated
IVAX
Mylan
DRUG
DOSAGE FORM, STRENGTH
PENICILLIN V POTASSIUM (continued)
@ tablet, oral eq 125,250,500mg base
tablet, oral eq 250,500mg base
Brand(s)
Beepen-VK
powder for solution eq 125,
250mg base/5ml
Betapen-VK
@ powder for solution eq 125,
250mg base/5ml
Ledercillin VK
powder for solution eq 125,
250mg base/5ml
Pen-Vee K
@ powder for solution eq 125,
250mg base/5ml
Penapar-VK
@ powder for solution eq 125,
250mg base/5ml
Pfizerpen-VK
@ powder for solution eq 125,
250mg base/5ml
V-Cillin K
@ powder for solution eq 125,
250mg base/5ml
Veetids 125
powder for solution
eq 125mg base/5ml
Veetids 250
powder for solution
eq 250mg base/5ml
Beepen-VK
tablet, oral eq 250,500mg base
Betapen-VK
tablet, oral eq 250,500mg base
Ledercillin VK
tablet, oral eq 250,500mg base
Pen-Vee K
@ tablet, oral eq 125mg base
Pen-Vee K
tablet, oral eq 250,500mg base
Penapar-VK
@ tablet, oral eq 250,500mg base
Pfizerpen-VK
@ tablet, oral eq 250,500mg base
Uticillin VK
tablet, oral eq 250mg base
Uticillin VK
@ tablet, oral eq 500mg base
V-Cillin K
@ tablet, oral eq 125,250,500mg base
Veetids 250
tablet, oral eq 250mg base
Veetids 500
tablet, oral eq 500mg base
PENTAMIDINE ISETHIONATE
Pentamidine Isethionate
Brand(s)
Pentacarinat
Pentam 300
injection 300mg/vial
injection 300mg/vial
injection 300mg/vial
@ injection 300mg/vial
injection 300mg/vial
APPLICATION HOLDER,
MANUFACTURER
Purepac
Teva
GlaxoSmithKline
Apothecon
Lederle
Wyeth-Ayerst
Pfizer
Pfizer
Lilly
Apothecon
Apothecon
GlaxoSmithKline
Bristol
Lederle
Wyeth-Ayerst
Wyeth-Ayerst
Pfizer
Pfizer
Pharmacia & Upjohn
Pharmacia & Upjohn
Lilly
Apothecon
Apothecon
Abbott
Elkins-Sinn
Steris
Armour
American Pharmaceutical
Partners
PENTAZOCINE HYDROCHLORIDE; ACETAMINOPHEN
See NALOXONE HYDROCHLORIDE; ACETAMINOPHEN
PENTAZOCINE HYDROCHLORIDE; NALOXONE HYDROCHLORIDE
See NALOXONE HYDROCHLORIDE; PENTAZOCINE HYDROCHLORIDE
PENTOBARBITAL SODIUM
Pentobarbital Sodium
(continued on the next page)
@
@
@
@
@
capsule, oral 100mg
capsule, oral 100mg
capsule, oral 100mg
capsule, oral 100mg
capsule, oral 100mg
capsule, oral 100mg
161
Anabolic
Elkins-Sinn
Eon
Everylife
Halsey
ICN
DRUG
DOSAGE FORM, STRENGTH
PENTOBARBITAL SODIUM (continued)
@
@
@
@
@
@
@
@
@
Brand(s)
Nembutal Sodium
Nembutal Sodium
Nembutal Sodium
PENTOXIFYLLINE
Pentoxifylline
Brand(s)
Trental
APPLICATION HOLDER,
MANUFACTURER
capsule, oral 50,100mg
capsule, oral 50,100mg
capsule, oral 100mg
capsule, oral 100mg
capsule, oral 100mg
capsule, oral 100mg
capsule, oral 100mg
capsule, oral 100mg
injection 50mg/ml
injection 50mg/ml
@ tablet, oral 100mg
@ tablet, oral 100mg
IVAX
Lannett
Perrigo
Pfizer
Purepac
Watson
Whiteworth Towne
Wyeth-Ayerst
Elkins-Sinn
Wyeth-Ayerst
Anabolic
Eon
@ capsule, oral 50mg
capsule, oral 100mg
injection 50mg/ml
Abbott
Abbott
Abbott
tablet, extended release 400mg
tablet, extended release 400mg
tablet, extended release 400mg
tablet, extended release 400mg
tablet, extended release 400mg
tablet, extended release 400mg
tablet, extended release 400mg
tablet, extended release 400mg
tablet, extended release 400mg
tablet, extended release 400mg
Biovail
ESI-Lederle
Impax
Mylan
Purepac
Sidmak
Teva
TorPharm
Watson
Upsher-Smith
tablet, extended release 400mg
Aventis *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
PERGOLIDE MESYLATE
Pergolide Mesylate
Brand(s)
Permax
PERMETHRIN
Permethrin
Brand(s)
Elimite
PERPHENAZINE
Perphenazine
Brand(s)
Trilafon
tablet, oral eq 0.05,0.25,1mg base
Teva
tablet, oral eq 0.05,0.25,1mg base
Lilly
cream, topical 5%
Alpharma
cream, topical 5%
Allergan
tablet, oral 2,4,8,16mg
tablet, oral 2,4,8,16mg
tablet, oral 2,4,8,16mg
Geneva
IVAX
Vintage
tablet, oral 2,4,8,16mg
Schering *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
PERPHENAZINE; AMITRIPTYLINE HYDROCHLORIDE
See AMITRIPTYLINE HYDROCHLORIDE; PERPHENAZINE
162
DRUG
PHENDIMETRAZINE TARTRATE
Phendimetrazine Tartrate
Brand(s)
Phenazine
SPRX-3
Statobex
X-Trozine
Adphen
Alphazine
Bontril PDM
Cam-Metrazine
Di-Metrex
Melfiat
Metra
Obezine
Phenazine
Phenazine-35
Plegine
Statobex
Statobex-G
X-Trozine
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
capsule, oral 35mg
@ tablet, oral 35mg
@ tablet, oral 35mg
tablet, oral 35mg
@ tablet, oral 35mg
@ tablet, oral 35mg
@ tablet, oral 35mg
@ tablet, oral 35mg
@ tablet, oral 35mg
@ tablet, oral 35mg
tablet, oral 35mg
@ tablet, oral 35mg
@ tablet, oral 35mg
@ tablet, oral 35mg
Eon
Anabolic
Barr
Eon
Ferndale
Geneva
Inwood/Forest
IVAX
KV
Manufacturing Chemists
Mikart
Private Formulations
Solvay
Watson
@ capsule, oral 35mg
@ capsule, oral 35mg
@ capsule, oral 35mg
capsule, oral 35mg
@ tablet, oral 35mg
@ tablet, oral 35mg
tablet, oral 35mg
tablet, oral 35mg
@ tablet, oral 35mg
@ tablet, oral 35mg
@ tablet, oral 35mg
@ tablet, oral 35mg
@ tablet, oral 35mg
@ tablet, oral 35mg
@ tablet, oral 35mg
@ tablet, oral 35mg
@ tablet, oral 35mg
tablet, oral 35mg
Mast
Solvay
Teva
Shire Richwood
Ferndale
Eon
Amarin
ABC
Private Formulations
Numark
Forest
USL
Mast
ABC
Wyeth-Ayerst
Teva
Teva
Shire Richwood
PHENIRAMINE MALEATE; NAPHAZOLINE HYDROCHLORIDE
See NAPHAZOLINE HYDROCHLORIDE; PHENIRAMINE MALEATE
PHENOBARBITAL
Phenobarbital
elixir, oral 20mg/5ml
elixir, oral 20mg/5ml
elixir, oral 20mg/5ml
elixir, oral 20mg/5ml
elixir, oral 20mg/5ml
Alpharma *
Cenci *
Halsey *
Lilly *
Naska *
* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as an
exception to the promulgated criteria for inclusion, pursuant to Rule 790.60.
PHENOBARBITAL; ATROPINE SULFATE; HYOSCYAMINE; SCOPALAMINE HYDROBROMIDE
See ATROPINE SULFATE; HYOSCYAMINE; PHENOBARBITAL; SCOPALAMINE HYDROBROMIDE
PHENTERMINE HYDROCHLORIDE
Phentermine Hydrochloride
(continued on the next page)
capsule, oral 15,30,37.5mg
capsule, oral 15mg
capsule, oral 30,37.5mg
@ capsule, oral 30mg
capsule, oral 15,30mg
163
ABC
Able
Amide
Duramed/Barr
Eon
DRUG
DOSAGE FORM, STRENGTH
PHENTERMINE HYDROCHLORIDE (continued)
@ capsule, oral 30mg
capsule, oral 30mg
@ capsule, oral 30mg
@ capsule, oral 30mg
capsule, oral 30mg
@ capsule, oral 30mg
tablet, oral 8,37.5mg
tablet, oral 37.5mg
@ tablet, oral 8mg
@ tablet, oral 8mg
tablet, oral 37.5mg
tablet, oral 8,37.5mg
@ tablet, oral 8mg
Brand(s)
Adipex P
capsule, oral 37.5mg
Dapex-37.5
@ capsule, oral 37.5mg
Fastin
@ capsule, oral 30mg
Obestin-30
@ capsule, oral 30mg
Oby-Trim
@ capsule, oral 30mg
Ona-Mast
capsule, oral 30mg
Adipex P
tablet, oral 37.5mg
Ona-Mast
tablet, oral 8mg
Tora
@ tablet, oral 8mg
PHENTERMINE RESIN COMPLEX
Phentermine Resin Complex
Brand(s)
Ionamin-30
@ capsule, slow release 30mg
PHENTOLAMINE MESYLATE
Phentolamine Mesylate
Brand(s)
Regitine
PHENYLEPHRINE HYDROCHLORIDE
Phenylephrine Hydrochloride
Brand(s)
AK-Dilate
I-Phrine
Mydfrin
Neo-Synephrine
Phenoptic
APPLICATION HOLDER,
MANUFACTURER
IVAX
King
Lannett
Teva
USL
Watson
ABC
Amide
Eon
IVAX
Purepac
USL
Watson
Teva
Eon
GlaxoSmithKline
Ferndale
Shire Richwood
Mast
Teva
Mast
Solvay
Quantum
capsule, slow release 30mg
Celltech
injection 5mg/ml
Bedford
injection 5mg/ml
Novartis
solution, ophthalmic 2.5%
solution, ophthalmic 10%
Paco *
Iolab *
solution, ophthalmic 2.5,10%
solution, ophthalmic 2.5,10%
solution, ophthalmic 2.5%
solution, ophthalmic 2.5,10%
solution, ophthalmic 2.5%
Akorn *
International Pharm *
Alcon *
Sterling Winthrop *
Optopics *
* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as an
exception to the promulgated criteria for inclusion, pursuant to Rule 790.60.
PHENYLEPHRINE HYDROCHLORIDE; CHLORPHENIRAMINE MALEATE; PHENYLPROPANOLAMINE
HYDROCHLORIDE; PHENYLTOLOXAMINE CITRATE
See CHLORPHENIRAMINE MALEATE; PHENYLEPHRINE HYDROCHLORIDE;
PHENYLPROPANOLAMINE HYDROCHLORIDE; PHENYLTOLOXAMINE CITRATE
PHENYLEPHRINE TANNATE; CHLORPHENIRAMINE TANNATE; PYRILAMINE TANNATE
See CHLORPHENIRAMINE TANNATE; PHENYLEPHRINE TANNATE; PYRILAMINE TANNATE
164
DRUG
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
PHENYLEPHRINE HYDROCHLORIDE; CODEINE PHOSPHATE; PROMETHAZINE HYDROCHLORIDE
See CODEINE PHOSPHATE; PHENYLEPHRINE HYDROCHLORIDE; PROMETHAZINE
HYDROCHLORIDE
PHENYLEPHRINE HYDROCHLORIDE; GUAIFENESIN; PHENYLPROPANOLAMINE HYDROCHLORIDE
See GUAIFENESIN; PHENYLEPHRINE HYDROCHLORIDE; PHENYLPROPANOLAMINE
HYDROCHLORIDE
PHENYLEPHRINE HYDROCHLORIDE; PROMETHAZINE HYDROCHLORIDE
Phenylephrine Hydrochloride;
@ syrup, oral 5mg/5ml;6.25mg/5ml
Promethazine Hydrochloride
syrup, oral 5mg/5ml;6.25mg/5ml
Brand(s)
Phenergan VC
@ syrup, oral 5mg/5ml;6.25mg/5ml
Pherazine VC
@ syrup, oral 5mg/5ml;6.25mg/5ml
Prometh VC Plain
syrup, oral 5mg/5ml;6.25mg/5ml
Cenci
Morton Grove
Wyeth-Ayerst
Halsey
Alpharma
PHENYLPROPANOLAMINE HYDROCHLORIDE; BROMPHENIRAMINE MALEATE
See BROMPHENIRAMINE MALEATE; PHENYLPROPANOLAMINE HYDROCHLORIDE
PHENYLPROPANOLAMINE HYDROCHLORIDE; BROMPHENIRAMINE MALEATE; CODEINE PHOSPHATE
See BROMPHENIRAMINE MALEATE; CODEINE PHOSPHATE; PHENYLPROPANOLAMINE
HYDROCHLORIDE
PHENYLPROPANOLAMINE HYDROCHLORIDE; CHLORPHENIRAMINE MALEATE
See CHLORPHENIRAMINE MALEATE; PHENYLPROPANOLAMINE HYDROCHLORIDE
PHENYLPROPANOLAMINE HYDROCHLORIDE; CHLORPHENIRAMINE MALEATE; PHENYLEPHRINE
HYDROCHLORIDE; PHENYLTOLOXAMINE CITRATE
See CHLORPHENIRAMINE MALEATE; PHENYLEPHRINE HYDROCHLORIDE;
PHENYLPROPANOLAMINE HYDROCHLORIDE; PHENYLTOLOXAMINE CITRATE
PHENYLPROPANOLAMINE HYDROCHLORIDE; GUAIFENESIN; PHENYLEPHRINE HYDROCHLORIDE
See GUAIFENESIN; PHENYLEPHRINE HYDROCHLORIDE; PHENYLPROPANOLAMINE
HYDROCHLORIDE
PHENYLPROPANOLAMINE HYDROCHLORIDE; HYDROCODONE BITARTRATE
See HYDROCODONE BITARTRATE; PHENYLPROPANOLAMINE HYDROCHLORIDE
PHENYLTOLOXAMINE CITRATE; CHLORPHENIRAMINE MALEATE; PHENYLEPHRINE HYDROCHLORIDE;
PHENYLPROPANOLAMINE HYDROCHLORIDE
See CHLORPHENIRAMINE MALEATE; PHENYLEPHRINE HYDROCHLORIDE;
PHENYLPROPANOLAMINE HYDROCHLORIDE; PHENYLTOLOXAMINE CITRATE
PHENYTOIN
Phenytoin
Brand(s)
Dilantin-125
suspension, oral 125mg/5ml
suspension, oral 125mg/5ml
suspension, oral 125mg/5ml
Alpharma
Morton Grove
Vistapharm
suspension, oral 125mg/5ml
Pfizer
165
DRUG
PHENYTOIN SODIUM
Phenytoin Sodium
Brand(s)
Dilantin
PILOCARPINE HYDROCHLORIDE
Pilocarpine Hydrochloride
Brand(s)
Adsorbocarpine
AKarpine
Isopto Carpine
Pilocar
DOSAGE FORM, STRENGTH
@ injection 50mg/ml
@ injection 50mg/ml
@
@
@
@
@
injection 50mg/ml
injection 50mg/ml
injection 50mg/ml
injection 50mg/ml
injection 50mg/ml
injection 50mg/ml
@ injection 50mg/ml
APPLICATION HOLDER,
MANUFACTURER
Abbott
American Pharmaceutical
Partners
Elkins-Sinn
Marsam
Smith and Nephew
Solopak
Steris
Warner Chilcott
Pfizer
solution, ophthalmic 0.5,1,2,3,4,6%
solution, ophthalmic 1,2,4,6%
solution, ophthalmic 0.5,1,2,4,6%
solution, ophthalmic 1,2,3,4%
Optopics *
Paco *
Pharmafair *
Steris *
solution, ophthalmic 1,2,4,8%
solution, ophthalmic 1,2,3,4%
solution, ophthalmic 0.5,1,2,3,4,6,8,
10%
solution, ophthalmic 0.5,1,2,4,6%
Alcon *
Akorn *
Alcon * **
Iolab *
* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as an
exception to the promulgated criteria for inclusion, pursuant to Rule 790.60.
** Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
PINDOLOL
Pindolol
Brand(s)
Visken
PIPERAZINE CITRATE
Piperazine Citrate
Brand(s)
Antepar
Bryrel
Multifuge
Vermidol
PIROXICAM
Piroxicam
(continued on the next page)
tablet, oral 5,10mg
tablet, oral 5,10mg
tablet, oral 5,10mg
tablet, oral 5,10mg
tablet, oral 5,10mg
tablet, oral 5,10mg
@ tablet, oral 5,10mg
tablet, oral 5,10mg
tablet, oral 5,10mg
tablet, oral 5,10mg
Geneva
GenPharm
IVAX
Martec
Mutual
Mylan
Purepac
Teva
Watson
Novartis
@ syrup, oral eq 500mg base/5ml
@ syrup, oral eq 500mg base/5ml
syrup, oral eq 500mg base/5ml
Alpharma
Lannett
Luitpold
@ syrup, oral eq 500mg base/5ml
@ syrup, oral eq 500mg base/5ml
syrup, oral eq 500mg base/5ml
@ syrup, oral eq 500mg base/5ml
GlaxoSmithKline
Sanofi Synthelabo
Bluline
Solvay
capsule, oral 10,20mg
capsule, oral 10,20mg
166
Copley
Egis
DRUG
PIROXICAM (continued)
Brand(s)
Feldene
PODOFILOX
Podofilox
Brand(s)
Condylox
DOSAGE FORM, STRENGTH
capsule, oral 10,20mg
capsule, oral 10,20mg
capsule, oral 10,20mg
capsule, oral 10,20mg
capsule, oral 10,20mg
@ capsule, oral 10,20mg
capsule, oral 10,20mg
capsule, oral 10,20mg
capsule, oral 10,20mg
APPLICATION HOLDER,
MANUFACTURER
GenPharm
IVAX
Mepha
Mutual
Mylan
Roxane
SCS
Teva
Watson
capsule, oral 10,20mg
Pfizer
solution, topical 0.5%
Paddock
solution, topical 0.5%
Paddock
POLYETHYLENE GLYCOL 3350; POTASSIUM CHLORIDE; SODIUM BICARBONATE; SODIUM
CHLORIDE; SODIUM SULFATE, ANHYDROUS
Brand(s)
Co-Lav
powder for reconstitution, oral
Copley
240gm/bottle;2.98gm/bottle;
6.72gm/bottle;5.84gm/bottle;
22.72gm/bottle
Colovage
powder for reconstitution, oral
Dynapharm
227.1gm/packet;2.82gm/packet;
6.36gm/packet;5.53gm/packet;
21.5gm/packet
Colyte
powder for reconstitution, oral
Schwarz *
227.1gm/bottle;2.82gm/bottle;
6.36gm/bottle;5.53gm/bottle;
21.5gm/bottle
Colyte
powder for reconstitution, oral
Schwarz *
240gm/bottle;2.98gm/bottle;
6.72gm/bottle;5.84gm/bottle;
22.72gm/bottle
Colyte-Flavored
powder for reconstitution, oral
Schwarz *
227.1gm/bottle;2.82gm/bottle;
6.36gm/botlet;5.53gm/bottle;
21.5gm/bottle
Colyte-Flavored
powder for reconstitution, oral
Schwarz *
240gm/bottle;2.98gm/bottle;
6.72gm/bottle;5.84gm/bottle;
22.72gm/bottle
E-Z-EM Prep Lyte
powder for reconstitution, oral
E Z EM
236gm/bottle;2.97gm/bottle;
6.74gm/bottle;5.86gm/bottle;
22.74gm/bottle
Glycoprep
powder for reconstitution, oral
Goldline
236gm/bottle;2.97gm/bottle;
6.74gm/bottle;5.86gm/bottle;
22.74gm/bottle
Go-Evac
powder for reconstitution, oral
Copley
236gm/bottle;2.97gm/bottle;
6.74gm/bottle;5.86gm/bottle;
22.74gm/bottle
(continued on the next page)
167
DRUG
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
POLYETHYLENE GLYCOL 3350; POTASSIUM CHLORIDE; SODIUM BICARBONATE; SODIUM
CHLORIDE; SODIUM SULFATE, ANHYDROUS (continued)
Golytely
powder for reconstitution, oral
Braintree
236gm/bottle;2.97gm/bottle;
6.74gm/bottle;5.86gm/bottle;
22.74gm/bottle
Golytely
powder for reconstitution, oral
Braintree
227.1gm/packet;2.82gm/packet;
6.36gm/packet;5.53gm/packet;
21.5gm/packet
PEG-Lyte
@ powder for reconstitution, oral
Invamed
236gm/bottle;2.97gm/bottle;
6.74gm/bottle;5.86gm/bottle;
22.74gm/bottle
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
POLYMYXIN B SULFATE
Polymyxin B Sulfate
Brand(s)
Aerosporin
Poly-Rx
injection eq 500,000 U base/vial
injection eq 500,000 U base/vial
@ powder for compounding
100,000,000U/bottle
Bedford
Pharma Tek
Paddock
@ injection eq 500,000 U base/vial
powder for compounding
100,000,000U/bottle
GlaxoSmithKline
Pharma Tek
POLYMYXIN B SULFATE; BACITRACIN; HYDROCORTISONE ACETATE; NEOMYCIN SULFATE
See BACITRACIN; HYDROCORTISONE ACETATE; NEOMYCIN SULFATE; POLYMYXIN B SULFATE
POLYMYXIN B SULFATE; BACITRACIN ZINC
See BACITRACIN ZINC; POLYMYXIN B SULFATE
POLYMYXIN B SULFATE; BACITRACIN ZINC; HYDROCORTISONE; NEOMYCIN SULFATE
See BACITRACIN ZINC; HYDROCORTISONE; NEOMYCIN SULFATE; POLYMYXIN B SULFATE
POLYMYXIN B SULFATE; BACITRACIN ZINC; NEOMYCIN SULFATE
See BACITRACIN ZINC; NEOMYCIN SULFATE: POLYMYXIN B SULFATE
POLYMYXIN B SULFATE; DEXAMETHASONE; NEOMYCIN SULFATE
See DEXAMETHASONE; NEOMYCIN SULFATE; POLYMYXIN B SULFATE
POLYMYXIN B SULFATE; GRAMICIDIN; NEOMYCIN SULFATE
See GRAMICIDIN; NEOMYCIN SULFATE; POLYMYXIN B SULFATE
POLYMYXIN B SULFATE; HYDROCORTISONE
See HYDROCORTISONE; POLYMYXIN B SULFATE
POLYMYXIN B SULFATE; HYDROCORTISONE; NEOMYCIN SULFATE
See HYDROCORTISONE; NEOMYCIN SULFATE; POLYMYXIN B SULFATE
168
DRUG
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
POLYMYXIN B SULFATE; NEOMYCIN SULFATE
See NEOMYCIN SULFATE; POLYMYXIN B SULFATE
POLYMYXIN B SULFATE; TRIMETHOPRIM SULFATE
Polymyxin B Sulfate;
solution, ophthalmic 10,000U/ml;
Trimethoprim Sulfate
eq 1mg base/ml
solution, ophthalmic 10,000U/ml;
eq 1mg base/ml
solution, ophthalmic 10,000U/ml;
eq 1mg base/ml
Brand(s)
Polytrim
solution, ophthalmic 10,000U/ml
eq 1mg base/ml
Falcon *
Bausch and Lomb
Taylor
Allergan *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
POTASSIUM BICARBONATE
Potassium Bicarbonate
Brand(s)
Effer-K
K + Care ET
Klor-Con EF
K-Lyte
tablet, effervescent 25mEq
tablet, effervescent 25mEq
Bajamar *
Copley *
tablet, effervescent 25mEq
tablet, effervescent 25mEq
tablet, effervescent 25mEq
tablet, effervescent 25mEq
Nomax *
Alra *
CFH *
Mead Johnson/Bristol-Myers *
* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as an
exception to the promulgated criteria for inclusion, pursuant to Rule 790.60.
POTASSIUM CHLORIDE
Potassium Chloride
capsule, extended release
10mEq (750mg)
capsule, extended release
8mEq (600mg),10mEq (750mg)
@ injection 1mEq/ml
injection 2mEq/ml
@ injection 2mEq/ml
injection 2,3mEq/ml
@
@
@
@
@
@
@
@
@
injection 2mEq/ml
injection 2mEq/ml
injection 2mEq/ml
injection 2mEq/ml
injection 2mEq/ml
injection 2mEq/ml
injection 1,2,3mEq/ml
injection 4mEq/ml
injection 2mEq/ml
injection 1,2,3,4mEq/ml
injection 2,3mEq/ml
injection, in plastic container
14.9mg/ml (10mEq)
745mg/100ml (10mEq)
29.8mg/ml (20mEq)
1.49gm/100ml (20mEq)
2.24gm/100ml (30mEq)
2.98gm/100ml (40mEq)
(continued on the next page)
169
KV
Teva
Abbott
Abbott
Akorn
American Pharmaceutical
Partners
Baxter
Braun
Elkins-Sinn
International Medication
Lilly
Luitpold
Miles
Miles
Pharma Serve
Searle
Steris
Abbott
DRUG
POTASSIUM CHLORIDE (continued)
(sugar-free)
(sugar-free)
(sugar free)
(sugar free)
(sugar-free)
(sugar-free)
(sugar-free)
(sugar-free)
Brand(s)
K Lease
Micro-K
Micro-K 10
Gen-K
K + Care
K-Lor
Kato
Kay Ciel
Klor-Con
Cena-K
(sugar-free)
EM-K-10%
(sugar-free)
DOSAGE FORM, STRENGTH
injection, in plastic container 2mEq/ml
injection, in plastic container
14.9mg/ml (10mEq)
746mg/100ml (10mEq)
1.49gm/100ml (20mEq)
29.8mg/ml (20mEq)
2.24gm/100ml (30mEq)
2.98gm/100ml (40mEq)
powder, oral 20mEq/packet
powder, oral 20mEq/packet
solution, oral 1500mg/15ml
(20mEq/15ml,10%)
solution, oral 1500mg/15ml
(20mEq/15ml,10%)
solution, oral 3000mg/15ml
(40mEq/15ml,20%)
solution, oral 1500mg/15ml
(20mEq/15ml,10%)
solution, oral 1500mg/15ml
(20mEq/15ml,10%)
solution, oral 1500mg/15ml
(20mEq/15ml,10%)
solution, oral 3000mg/15ml
(40mEq/15ml,20%)
solution, oral 1500mg/15ml
(20mEq/15ml,10%)
solution, oral 3000mg/15ml
(40mEq/15ml,20%)
solution, oral 1500mg/15ml
(20mEq/15ml,10%)
solution, oral 1500mg/15ml
(20mEq/15ml,10%)
solution, oral 3000mg/15ml
(40mEq/15ml,20%)
tablet, extended release
10mEq (750mg),
20mEq (1500mg)
tablet, extended release
8mEq (600mg)
tablet, extended release
20mEq (1500mg)
@ capsule, extended release
8,10mEq (600,750mg)
capsule, extended release
8mEq (600mg)
capsule, extended release
10mEq (750mg)
powder, oral 20mEq/packet
powder, oral 20mEq/packet
powder, oral 20mEq/packet
powder, oral 20mEq/packet
powder, oral 20mEq/packet
powder, oral 20mEq/packet
solution, oral 1500mg/15ml
(20mEq/15ml,10%)
solution, oral 1500mg/15ml
(20mEq/15ml,10%)
(continued on the next page)
170
APPLICATION HOLDER,
MANUFACTURER
American Pharmaceutical
Partners
Baxter
Bajamar *
Copley *
Alpharma *
Alpharma *
Alpharma *
Halsey *
Morton Grove *
Morton Grove *
Morton Grove *
Naska *
Naska *
Norton *
Norton *
Norton *
Andrx
Copley
KV
Savage
KV
KV
Howard Food/USA American *
Alra *
Abbott *
ICN *
Forest *
Upsher-Smith *
Century *
Econo Med *
DRUG
POTASSIUM CHLORIDE (continued)
Kaochlor 10%
Kaochlor SF
Kay Ciel
(sugar-free)
Klor-10%
(sugar-free)
Klorvess 10%
Potsalan
(sugar-free)
Kaon-Cl 20%
(sugar-free)
Klor Con 20%
K+8
Klor-Con
Slow K
K-Dur
Klor-Con M10
K-Dur
Klor-Con M20
DOSAGE FORM, STRENGTH
solution, oral 1500mg/15ml
(20mEq/15ml,10%)
solution, oral 1500mg/15ml
(20mEq/15ml,10%)
solution, oral 1500mg/15ml
(20mEq/15ml,10%)
solution, oral 1500mg/15ml
(20mEq/15ml,10%)
solution, oral 1500mg/15ml
(20mEq/15ml,10%)
solution, oral 1500mg/15ml
(20mEq/15ml,10%)
solution, oral 3000mg/15ml
(40mEq/15ml,20%)
solution, oral 3000mg/15ml
(40mEq/15ml,20%)
tablet, extended release
8mEq (600mg)
tablet, extended release
8mEq (600mg)
tablet, extended release
8mEq (600mg)
tablet, extended release
10mEq (750mg)
tablet, extended release
10mEq (750mg)
tablet, extended release
20mEq (1500mg)
tablet, extended release
20mEq (1500mg)
APPLICATION HOLDER,
MANUFACTURER
Pharmacia & Upjohn *
Pharmacia & Upjohn *
Forest/Inwood *
Upsher-Smith *
Novartis *
Pharmacia & Upjohn *
Pharmacia & Upjohn *
Upsher-Smith *
Alra
Upsher-Smith
Novartis
Schering/Key **
Upsher-Smith
Schering/Key **
Upsher-Smith
Products containing sugar shall not be interchanged with sugar-free products without verification of the
diabetic status of the patient.
* Some oral potassium chloride solutions, powders for solutions and extended release capsules were reviewed
by the Technical Advisory Council and admitted to the Illinois Formulary as an exception to the promulgated
criteria for inclusion, pursuant to Section 790.60.
** Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
POTASSIUM CHLORIDE; CALCIUM CHLORIDE; DEXTROSE; GLUTATHIONE DISULFIDE; MAGNESIUM
CHLORIDE; SODIUM BICARBONATE; SODIUM CHLORIDE; SODIUM PHOSPHATE
See CALCIUM CHLORIDE; DEXTROSE; GLUTATHIONE DISULFIDE; MAGNESIUM CHLORIDE;
POTASSIUM CHLORIDE; SODIUM BICARBONATE; SODIUM CHLORIDE; SODIUM PHOSPHATE
POTASSIUM CHLORIDE; CALCIUM CHLORIDE; DEXTROSE; SODIUM CHLORIDE
See CALCIUM CHLORIDE; DEXTROSE; POTASSIUM CHLORIDE; SODIUM CHLORIDE
POTASSIUM CHLORIDE; CALCIUM CHLORIDE; DEXTROSE; SODIUM CHLORIDE; SODIUM LACTATE
See CALCIUM CHLORIDE; DEXTROSE; POTASSIUM CHLORIDE; SODIUM CHLORIDE; SODIUM
LACTATE
POTASSIUM CHLORIDE; CALCIUM CHLORIDE; MAGNESIUM CHLORIDE; SODIUM CHLORIDE
See CALCIUM CHLORIDE; MAGNESIUM CHLORIDE; POTASSIUM CHLORIDE; SODIUM CHLORIDE
171
DRUG
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
POTASSIUM CHLORIDE; CALCIUM CHLORIDE; SODIUM CHLORIDE
See CALCIUM CHLORIDE; POTASSIUM CHLORIDE; SODIUM CHLORIDE
POTASSIUM CHLORIDE; CALCIUM CHLORIDE; SODIUM CHLORIDE; SODIUM LACTATE
See CALCIUM CHLORIDE; POTASSIUM CHLORIDE; SODIUM CHLORIDE; SODIUM LACTATE
POTASSIUM CHLORIDE; DEXTROSE
See DEXTROSE; POTASSIUM CHLORIDE
POTASSIUM CHLORIDE; DEXTROSE; MAGNESIUM CHLORIDE; SODIUM ACETATE; SODIUM CHLORIDE;
SODIUM GLUCONATE
See DEXTROSE; MAGNESIUM CHLORIDE; POTASSIUM CHLORIDE; SODIUM ACETATE; SODIUM
CHLORIDE; SODIUM GLUCONATE
POTASSIUM CHLORIDE; DEXTROSE; SODIUM CHLORIDE
See DEXTROSE; POTASSIUM CHLORIDE; SODIUM CHLORIDE
POTASSIUM CHLORIDE; MAGNESIUM CHLORIDE; SODIUM ACETATE; SODIUM CHLORIDE;
SODIUM GLUCONATE
See MAGNESIUM CHLORIDE; POTASSIUM CHLORIDE; SODIUM ACETATE; SODIUM CHLORIDE;
SODIUM GLUCONATE
POTASSIUM CHLORIDE; SODIUM CHLORIDE
Potassium Chloride;
injection 149mg/100ml (0.149%);
Sodium Chloride
900mg/100ml (0.9%)
injection 298mg/100ml (0.298%);
900mg/100ml (0.9%)
@ injection 75mg/100ml(0.075%);
900mg/100ml(0.9%)
injection 150mg/100ml(0.15%);
900mg/100ml(0.9%)
injection 300mg/100ml(0.3%);
900mg/100ml(0.9%)
@ injection 75mg/100ml(0.075%);
900mg/100ml(0.9%)
injection 150mg/100ml(0.15%);
900mg/100ml(0.9%)
injection 300mg/100ml(0.3%);
900mg/100ml(0.9%)
POTASSIUM GLUCONATE
Potassium Gluconate
elixir, oral 4.68gm/15ml
(20mEq/15ml,10%)
elixir, oral 4.68gm/15ml
(20mEq/15ml,10%)
elixir, oral 4.68gm/15ml
(20mEq/15ml,10%)
elixir, oral 4.68gm/15ml
(20mEq/15ml,10%)
elixir, oral 4.68gm/15ml
(20mEq/15ml,10%)
elixir, oral 4.68gm/15ml
(20mEq/15ml,10%)
(continued on the next page)
172
Abbott
Abbott
Baxter
Baxter
Baxter
Braun
Braun
Braun
Alpharma *
Naska *
Morton Grove *
Newton *
Pharmaceutical Associates *
SteriMed *
DRUG
DOSAGE FORM, STRENGTH
POTASSIUM GLUCONATE (continued)
Brand(s)
Kaon 10%
elixir, oral 4.68gm/15ml
(20mEq/15ml,10%)
APPLICATION HOLDER,
MANUFACTURER
Pharmacia & Upjohn *
* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as an
exception to the promulgated criteria for inclusion, pursuant to Rule 790.60.
PRALIDOXIME CHLORIDE
Pralidoxime Chloride
Brand(s)
Protopam
@ injection 1gm/vial
injection 1gm/vial
Quad
Wyeth-Ayerst
PRAMOXINE HYDROCHLORIDE; HYDROCORTISONE ACETATE
See HYDROCORTISONE ACETATE; PRAMOXINE HYDROCHLORIDE
PRAZOSIN HYDROCHLORIDE
Prazosin Hydrochloride
Brand(s)
Minipress
PREDNISOLONE
Prednisolone
Brand(s)
Pre-Pred
Prelone
PREDNISOLONE ACETATE
Brand(s)
Econopred Plus
Pred Forte
@ capsule, oral eq 1,2,5mg base
capsule, oral eq 1,2,5mg base
capsule, oral eq 1,2,5mg base
capsule, oral eq 1,2,5mg base
capsule, oral eq 1,2,5mg base
@ capsule, oral eq 1,2,5mg base
capsule, oral eq 1,2,5mg base
American Therapeutics
Geneva
IVAX
Lederle
Mylan
Purepac
Watson
capsule, oral eq 1,2,5mg base
Pfizer
syrup, oral 15mg/5ml
syrup, oral 15mg/5ml
syrup, oral 5mg/5ml, 15mg/5ml
syrup, oral 15mg/5ml
Copley
Halsey
KV
UDL
syrup, oral 15mg/5ml
syrup, oral 5mg/5ml, 15mg/5ml
WE
Muro
suspension, ophthalmic 1%
suspension, ophthalmic 1%
Falcon *
Allergan *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
PREDNISOLONE ACETATE; SULFACETAMIDE SODIUM
Brand(s)
Metimyd
@ ointment, ophthalmic 0.5%;10%
Predsulfair
@ ointment, ophthalmic 0.5%;10%
Vasocidin
ointment, ophthalmic 0.5%;10%
Blephamide
suspension, ophthalmic 0.2%;10%
Metimyd
@ suspension, ophthalmic 0.5%;10%
Predamide
@ suspension, ophthalmic 0.5%;10%
Predsulfair
@ suspension, ophthalmic 0.5%;10%
Predsulfair II
@ suspension, ophthalmic 0.2%;10%
Sulphrin
@ suspension, ophthalmic 0.5%;10%
173
Schering
Pharmafair
Novartis
Allergan
Schering
Akorn
Pharmafair
Pharmafair
Bausch and Lomb
DRUG
DOSAGE FORM, STRENGTH
PREDNISOLONE SODIUM PHOSPHATE
Prednisolone Sodium
@ injection eq 20mg phosphate/ml
Phosphate
@ solution, ophthalmic 0.125,1%
(eq 0.11%, 0.9% phosphate)
solution, ophthalmic 0.125,1%
(eq 0.11%, 0.9% phosphate)
@ solution, ophthalmic 0.125,1%
(eq 0.11%, 0.9% phosphate)
solution, oral eq 5mg base/5ml
Brand(s)
Hydeltrasol
@ injection eq 20mg phosphate/ml
AK-Pred
@ solution, ophthalmic 0.125,1%
(eq 0.11%, 0.9% phosphate)
Inflamase Mild
solution, ophthalmic 0.125%
(eq 0.11% phosphate)
Inflamase Forte
solution, ophthalmic 1%
(eq 0.9% phosphate)
Predair
@ solution, ophthalmic 0.125%
(eq 0.11% phosphate)
Predair Forte
@ solution, ophthalmic 1%
(eq 0.9% phosphate)
Pediapred
solution, oral eq 5mg base/5ml
PREDNISOLONE SODIUM PHOSPHATE; SULFACETAMIDE SODIUM
Prednisolone Sodium Phosphate; solution, ophthalmic eq 0.23%
Sulfacetamide Sodium
phosphate; 10%
solution, ophthalmic eq 0.23%
phosphate; 10%
Brand(s)
Sulster
@ solution, ophthalmic eq 0.23%
phosphate; 10%
Vasocidin
solution, ophthalmic eq 0.23%
phosphate; 10%
PREDNISONE
Prednisone
Brand(s)
Deltasone
Meticorten
Orasone
Prednicen-N
APPLICATION HOLDER,
MANUFACTURER
Steris
Alcon Universal
Bausch and Lomb
Sola Barnes-Hind
Morton Grove
Merck
Akorn
Novartis
Novartis
Pharmafair
Pharmafair
Celltech
Alcon
Bausch and Lomb
Akorn
Novartis
@ solution, oral 5mg/5ml
solution, oral 5mg/5ml
@ tablet, oral 5,10,20,50mg
@ tablet, oral 5,10,20mg
@ tablet, oral 50mg
tablet, oral 10,20,50mg
@ tablet, oral 5,10mg
@ tablet, oral 5,10,20,50mg
@ tablet, oral 5mg
@ tablet, oral 5,10,20mg
tablet, oral 5,10,20mg
tablet, oral 5mg
@ tablet, oral 20mg
@ tablet, oral 5,10,20mg
tablet, oral 1,2.5,5,10,20,50mg
@ tablet, oral 25mg
@ tablet, oral 5,10,20mg
tablet, oral 5,10,20,50mg
tablet, oral 5,10,20,50mg
@ tablet, oral 10mg
Morton Grove
Roxane
Barr
Duramed/Barr
Geneva
Geneva
Halsey
Heather
Impax
Interpharm
Mutual
Private Formulations
Private Formulations
Purepac
Roxane
Roxane
Superpharm
Watson
West-Ward
Whiteworth Towne
tablet, oral 2.5,5,10,20,50mg
@ tablet, oral 1mg
@ tablet, oral 1,5,10,20,50mg
@ tablet, oral 5mg
Pharmacia & Upjohn
Schering
Solvay
Schwarz
174
DRUG
PRIMIDONE
Primidone
Brand(s)
Mysoline
PROBENECID
Probenecid
Brand(s)
Benemid
Probalan
DOSAGE FORM, STRENGTH
@ tablet, oral 250mg
tablet, oral 50,250mg
tablet, oral 250mg
tablet, oral 50,250mg
APPLICATION HOLDER,
MANUFACTURER
Circa
Lannett
Watson
Xcel
tablet, oral 500mg
@ tablet, oral 500mg
tablet, oral 500mg
tablet, oral 500mg
IVAX
Lederle
Mylan
Watson
@ tablet, oral 500mg
tablet, oral 500mg
Merck
Lannett
PROBENECID; AMPICILLIN
See AMPICILLIN; PROBENECID
PROCAINAMIDE HYDROCHLORIDE
Procainamide Hydrochloride
@ capsule, oral 250,375,500mg
@ capsule, oral 250,500mg
capsule, oral 250,375,500mg
capsule, oral 250,375,500mg
capsule, oral 250,500mg
@ capsule, oral 250,375,500mg
@ capsule, oral 250,500mg
@ capsule, oral 250,500mg
capsule, oral 250,375,500mg
injection 100,500mg/ml
@ injection 100,500mg/ml
@
@
@
@
@
@
@
@
Brand(s)
Procan
Procapan
Pronestyl
Pronestyl
Procan-SR
Procan-SR
Rhythmin
Rhythmin
injection 100,500mg/ml
injection 100,500mg/ml
injection 100,500mg/ml
injection 100,500mg/ml
injection 100,500mg/ml
injection 500mg/ml
injection 100,500mg/ml
injection 100,500mg/ml
tablet, extended release
250,500,750,1000mg
tablet, extended release
500,750,1000mg
tablet, extended release 500mg
tablet, extended release
250,500,750mg
tablet, extended release
250,500,750mg
@ capsule, oral 250,375,500mg
@ capsule, oral 250mg
capsule, oral 250,375,500mg
injection 100,500mg/ml
@ tablet, controlled release 250mg
@ tablet, controlled release
500,750,1000mg
@ tablet, controlled release 250mg
tablet, controlled release 500mg
175
(Ascot)
Circa
Geneva
IVAX
Lannett
Lederle
Roxane
(Vangard/MWM)
Watson
Abbott
American Pharmaceutical
Partners
Elkins-Sinn
International Medication
Pharmafair
Quad
Smith and Nephew
Solopak
Steris
Warner Chilcott
Circa
Copley
Forest/Inwood
Geneva
Watson
Pfizer
Panray/Ormont
Apothecon
Apothecon
Pfizer
Parkdale
Sidmak
Sidmak
DRUG
PROCAINE HYDROCHLORIDE
Procaine Hydrochloride
Brand(s)
Novocain
DOSAGE FORM, STRENGTH
injection 1,2%
@ injection 1,2%
injection 1,2%
@ injection 1,2%
@ injection 1,2%
injection 1,2%
injection 1,2%
PROCAINE HYDROCHLORIDE; TETRACYCLINE HYDROCHLORIDE
Brand(s)
Achromycin
@ injection 40mg/vial;100mg/vial
@ injection 40mg/vial;250mg/vial
Tetracyn
@ injection 40mg/vial;100mg/vial
@ injection 40mg/vial;250mg/vial
PROCHLORPERAZINE
Prochlorperazine
Brand(s)
Compazine
Compro
Brand(s)
Compazine
American Pharmaceutical
Partners
Bel-Mar
Elkins-Sinn
Miles
Searle
Steris
Abbott
Lederle
Lederle
Pfizer
Pfizer
suppository, rectal 2.5,5,25mg
suppository, rectal 25mg
Able
G&W
suppository, rectal 2.5,5,25mg
suppository, rectal 25mg
GlaxoSmithKline
Paddock
PROCHLORPERAZINE EDISYLATE
Prochlorperazine Edisylate
@ concentrate, oral eq 10mg base/ml
@ concentrate, oral eq 10mg base/ml
injection eq 5mg base/ml
injection eq 5mg base/ml
@ injection eq 5mg base/ml
@ injection eq 5mg base/ml
@ injection eq 5mg base/ml
injection eq 5mg base/ml
@ injection eq 5mg base/ml
@ syrup, oral eq 5mg base/5ml
@ syrup, oral eq 5mg base/5ml
Brand(s)
Compazine
@ concentrate, oral eq 10mg base/ml
Compazine
injection eq 5mg base/ml
Compazine
syrup, oral eq 5mg base/5ml
PROCHLORPERAZINE MALEATE
Prochlorperazine Maleate
APPLICATION HOLDER,
MANUFACTURER
@ tablet, oral eq 5,10,25mg base
tablet, oral eq 5,10mg base
tablet, oral eq 5,10mg base
tablet, oral eq 5,10,25mg base
tablet, oral eq 5,10mg base
tablet, oral eq 5,10mg base
tablet, oral eq 5,10mg base
tablet, oral eq 5,10,25mg base
176
Alpharma
Morton Grove
Abbott
Elkins-Sinn
Marsam
Quad
Smith and Nephew
Steris
Wyeth-Ayerst
Alpharma
Morton Grove
GlaxoSmithKline
GlaxoSmithKline
GlaxoSmithKline
Circa
Copley
Duramed/Barr
Geneva
IVAX
Mylan
Trigen
GlaxoSmithKline
DRUG
PROGESTERONE
Progesterone
PROMAZINE HYDROCHLORIDE
Promazine Hydrochloride
Brand(s)
Sparine
PROMETHAZINE HYDROCHLORIDE
Promethazine Hydrochloride
Brand(s)
Phenergan
Phenergan
Zipan-25,50
Phenergan
Mymethazine Fortis
Phenergan
Phenergan Fortis
Prometh
Prometh Fortis
Phenergan
DOSAGE FORM, STRENGTH
injection 50mg/ml
APPLICATION HOLDER,
MANUFACTURER
@ injection 50mg/ml
injection 50mg/ml
American Pharmaceutical
Partners
Lilly
Schein
@ injection 25,50mg/ml
Steris
@ injection 25,50mg/ml
Wyeth-Ayerst
injection 25,50mg/ml
@ injection 25,50mg/ml
injection 25,50mg/ml
@ injection 25,50mg/ml
injection 25,50mg/ml
suppository, rectal 12.5,25,50mg
suppository, rectal 25,50mg
@ syrup, oral 6.25mg/5ml
syrup, oral 6.25mg/5ml
@ syrup, oral 6.25mg/5ml,25mg/5ml
syrup, oral 6.25mg/5ml
@ syrup, oral 6.25mg/5ml
syrup, oral 6.25mg/5ml
Abbott
Akorn
Elkins-Sinn
Marsam
Steris
Able
G&W
Cenci
Hi-Tech
KV
Morton Grove
Pharmaceutical Associates
Whiteworth Towne
injection 25mg/ml
@ injection 50mg/ml
@ injection 25,50mg/ml
suppository, rectal 12.5,25,50mg
@ syrup, oral 25mg/5ml
syrup, oral 6.25mg/5ml
@ syrup, oral 25mg/5ml
syrup, oral 6.25mg/5ml
@ syrup, oral 25mg/5ml
tablet, oral 12.5,25mg
Wyeth
Wyeth
Altana
Wyeth
USL
Wyeth
Wyeth
Alpharma
Alpharma
Wyeth *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
PROMETHAZINE HYDROCHLORIDE; CODEINE PHOSPHATE
See CODEINE PHOSPHATE; PROMETHAZINE HYDROCHLORIDE
PROMETHAZINE HYDROCHLORIDE; CODEINE PHOSPHATE; PHENYLEPHRINE HYDROCHLORIDE
See CODEINE PHOSPHATE; PHENYLEPHRINE HYDROCHLORIDE; PROMETHAZINE
HYDROCHLORIDE
PROMETHAZINE HYDROCHLORIDE; DEXTROMETHORPHAN HYDROBROMIDE
See DEXTROMETHORPHAN HYDROBROMIDE; PROMETHAZINE HYDROCHLORIDE
PROMETHAZINE HYDROCHLORIDE; PHENYLEPHRINE HYDROCHLORIDE
See PHENYLEPHRINE HYDROCHLORIDE; PROMETHAZINE HYDROCHLORIDE
177
DRUG
DOSAGE FORM, STRENGTH
PROPAFENONE HYDROCHLORIDE
Propafenone Hydrochloride
Brand(s)
Rythmol
PROPARACAINE HYDROCHLORIDE
Proparacaine Hydrochloride
Brand(s)
Alcaine
Kainair
Ophthaine
Ophthetic
Paracaine
APPLICATION HOLDER,
MANUFACTURER
tablet, oral 150,225,300mg
tablet, oral 150,225,300mg
tablet, oral 150,225mg
KV
Mutual
Watson
tablet, oral 150,225,300mg
Abbott
solution, ophthalmic 0.5%
@ solution, ophthalmic 0.5%
solution, ophthalmic 0.5%
Bausch and Lomb
Sola Barnes-Hind
Taylor
solution, ophthalmic 0.5%
@ solution, ophthalmic 0.5%
solution, ophthalmic 0.5%
solution, ophthalmic 0.5%
solution, ophthalmic 0.5%
Alcon
Pharmafair
Apothecon
Allergan
Optopics
PROPOFOL
Propofol
Brand(s)
Diprivan
injection 10mg/ml
Gensia Sicor
injection 10mg/ml
AstraZeneca
Note: Gensia Sicor’s propofol injection utilizes sodium metabisulfite as a preservative while Astra Zeneca’s
Diprivan brand of propofol injection utilizes disodium edetate as a preservative. Patients’ allergy status
should be reviewed prior to the interchange of any propofol injection products.
PROPOXYPHENE HYDROCHLORIDE
Propoxyphene Hydrochloride
@
@
@
@
@
@
@
@
@
@
@
@
Brand(s)
Darvon
Darvon
Dolene
Kesso-Gesic
Prophene
capsule, oral 65mg
capsule, oral 65mg
capsule, oral 32,65mg
capsule, oral 65mg
capsule, oral 65mg
capsule, oral 32mg
capsule, oral 65mg
capsule, oral 65mg
capsule, oral 32mg
capsule, oral 65mg
capsule, oral 32,65mg
capsule, oral 65mg
capsule, oral 32,65mg
capsule, oral 65mg
capsule, oral 65mg
capsule, oral 65mg
capsule, oral 65mg
capsule, oral 65mg
capsule, oral 32mg
capsule, oral 65mg
capsule, oral 65mg
capsule, oral 65mg
@ capsule, oral 65mg
Anabolic
Barr
Eon
Geneva
ICN
IVAX
IVAX
Impax
Mylan
Mylan
Private Formulations
Purepac
Roxane
Teva
Warner Chilcott
Watson
West-ward
Whiteworth Towne
AAI
AAI *
Lederle
MK
Halsey
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
PROPOXYPHENE HYDROCHLORIDE; ACETAMINOPHEN
See ACETAMINOPHEN; PROPOXYPHENE HYDROCHLORIDE
178
DRUG
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
PROPOXYPHENE HYDROCHLORIDE; ASPIRIN; CAFFEINE
See ASPIRIN; CAFFEINE; PROPOXYPHENE HYDROCHLORIDE
PROPOXYPHENE HYDROCHLORIDE COMPOUND
PROPOXYPHENE HYDROCHLORIDE; ASPIRIN; CAFFEINE
See ASPIRIN; CAFFEINE; PROPOXYPHENE HYDROCHLORIDE
PROPOXYPHENE NAPSYLATE; ACETAMINOPHEN
See ACETAMINOPHEN; PROPOXYPHENE NAPSYLATE
PROPRANOLOL HYDROCHLORIDE
Propranolol Hydrochloride
@ capsule, extended release
60,80,120,160mg
injection 1mg/ml
@ injection 1mg/ml
@ injection 1mg/ml
@ solution, oral 20mg/5ml
@ solution, oral 40mg/5ml
solution, oral 20mg/5ml
solution, oral 40mg/5ml
@ tablet, oral 10,20,40,60,80mg
@ tablet, oral 10,20,40,60,80mg
@ tablet, oral 10,20,40,60,80,90mg
tablet, oral 10,20,40,60,80mg
@ tablet, oral 90mg
@ tablet, oral 10,20,40,80mg
@ tablet, oral 10,20,40,60,80mg
@ tablet, oral 10,20,40,60,80,90mg
tablet, oral 10,20,40,80mg
@ tablet, oral 60mg
tablet, oral 10,20,40,60,80,90mg
@ tablet, oral 10,20,40,60,80mg
@ tablet, oral 10,20,40,60,80,90mg
@ tablet, oral 10,20,40,60,80mg
tablet, oral 10,20,40,60,80,90mg
@ tablet, oral 10,20,40,80mg
@ tablet, oral 10,20mg
tablet, oral 40mg
@ tablet, oral 10,20,40,60,80mg
tablet, oral 10,20,40,60,80,90mg
Brand(s)
Inderal LA
capsule, extended release
60,80,120,160mg
Inderal
injection 1mg/ml
Inderal
tablet, oral 10,20,40,60,80mg
Inderal
@ tablet, oral 90mg
Inwood
Bedford
Smith and Nephew
Solopak
Morton Grove
Morton Grove
Roxane
Roxane
Barr
Circa
Duramed/Barr
Geneva
Geneva
Interpharm
IVAX
Lederle
Mylan
Mylan
Par
Purepac
Roxane
Schering
Sidmak
Superpharm
Teva
Teva
Warner Chilcott
Watson
Wyeth
Wyeth
Wyeth
Wyeth
PROPRANOLOL HYDROCHLORIDE; HYDROCHLOROTHIAZIDE
See HYDROCHLOROTHIAZIDE; PROPRANOLOL HYDROCHLORIDE
PROTAMINE SULFATE
Protamine Sulfate
injection 10mg/ml
injection 10mg/ml
injection 10mg/ml
@ injection 10mg/ml,50mg/vial
@ injection 50mg/vial
179
American Pharmaceutical
Partners
Elkins-Sinn
Lilly
Quad
Upjohn
DRUG
PROTIRELIN
Brand(s)
Thyrel TRH
Thypinone
DOSAGE FORM, STRENGTH
injection 0.5mg/ml
@ injection 0.5mg/ml
PROTRIPTYLINE HYDROCHLORIDE
Protriptyline Hydrochloride
@ tablet, oral 5,10mg
Brand(s)
Vivactil
tablet, oral 5,10mg
APPLICATION HOLDER,
MANUFACTURER
Ferring
Abbott
Sidmak
Odyssey
PSEUDOEPHEDRINE HYDROCHLORIDE; BROMPHENIRAMINE MALEATE;
DEXTROMETHORPHAN HYDROBROMIDE
See BROMPHENIRAMINE MALEATE; DEXTROMETHORPHAN HYDROBROMIDE;
PSEUDOEPHEDRINE HYDROCHLORIDE
PSEUDOEPHEDRINE HYDROCHLORIDE; CARBINOXAMINE MALEATE
See CARBINOXAMINE MALEATE; PSEUDOEPHEDRINE HYDROCHLORIDE
PSEUDOEPHEDRINE HYDROCHLORIDE; CARBINOXAMINE MALEATE; DEXTROMETHORPHAN
HYDROBROMIDE
See CARBINOXAMINE MALEATE; DEXTROMETHORPHAN HYDROBROMIDE;
PSEUDOEPHEDRINE HYDROCHLORIDE
PSEUDOEPHEDRINE HYDROCHLORIDE; CHLORPHENIRAMINE MALEATE; CODEINE PHOSPHATE
See CHLORPHENIRAMINE MALEATE; CODEINE PHOSPHATE; PSEUDOEPHEDRINE
HYDROCHLORIDE
PSEUDOEPHEDRINE HYDROCHLORIDE; CODEINE PHOSPHATE; GUAIFENESIN
See CODEINE PHOSPHATE; GUAIFENESIN; PSEUDOEPHEDRINE HYDROCHLORIDE
PSEUDOEPHEDRINE HYDROCHLORIDE; CODEINE PHOSPHATE; TRIPROLIDINE HYDROCHLORIDE
See CODEINE PHOSPHATE; PSEUDOEPHEDRINE HYDROCHLORIDE;
TRIPROLIDINE HYDROCHLORIDE
PSEUDOEPHEDRINE HYDROCHLORIDE; GUAIFENESIN; HYDROCODONE BITARTRATE
See GUAIFENESIN; HYDROCODONE BITARTRATE; PSEUDOEPHEDRINE HYDROCHLORIDE
PSEUDOEPHEDRINE HYDROCHLORIDE; HYDROCODONE BITARTRATE
See HYDROCODONE BITARTRATE; PSEUDOEPHEDRINE HYDROCHLORIDE
PSEUDOEPHEDRINE HYDROCHLORIDE; TRIPROLIDINE HYDROCHLORIDE
Pseudoephedrine
@ tablet, oral 60mg;2.5mg
Hydrochloride;
tablet, oral 60mg;2.5mg
Triprolidine Hydrochloride
@ tablet, oral 60mg;2.5mg
tablet, oral 60mg;2.5mg
@ tablet, oral 60mg;2.5mg
Brand(s)
Actahist
@ syrup, oral 30mg/5ml;1.25mg/5ml
Histafed
@ syrup, oral 30mg/5ml;1.25mg/5ml
Myfed
@ syrup, oral 30mg/5ml;1.25mg/5ml
(continued on the next page)
180
Circa
Eon
IVAX
Superpharm
West-ward
Cenci
Cenci
USL
DRUG
DOSAGE FORM, STRENGTH
PSEUDOEPHEDRINE HYDROCHLORIDE; TRIPROLIDINE HYDROCHLORIDE
Trilitron
@ syrup, oral 30mg/5ml;1.25mg/5ml
Allerfed
@ tablet, oral 60mg;2.5mg
Corphed
tablet, oral 60mg;2.5mg
Trilitron
tablet, oral 60mg;2.5mg
Triphed
@ tablet, oral 60mg;2.5mg
PYRAZINAMIDE
Pyrazinamide
PYRIDOSTIGMINE BROMIDE
Pyridostigmine Bromide
Brand(s)
Mestinon
Regonol
Mestinon
APPLICATION HOLDER,
MANUFACTURER
(continued)
Newtron
Private Formulations
Geneva
Newtron
Teva
tablet, oral 500mg
tablet, oral 500mg
Clonmel
Mikart
tablet, oral 60mg
CorePharma
injection 5mg/ml
injection 5mg/ml
tablet, oral 60mg
ICN
Organon/Akzona
ICN *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
PYRIDOXINE HYDROCHLORIDE
Pyridoxine Hydrochloride
@ injection 100mg/ml
injection 100mg/ml
@
@
@
@
Brand(s)
Hexa-Betalin
PYRILAMINE MALEATE
Pyrilamine Maleate
injection 100mg/ml
injection 100mg/ml
injection 100mg/ml
injection 100mg/ml
injection 100mg/ml
Akorn
American Pharmaceutical
Partners
Bel-Mar
Dell
Elkins-Sinn
Luitpold
Steris
@ injection 100mg/ml
Lilly
tablet, oral 25mg
@ tablet, oral 25mg
Impax
Watson
PYRILAMINE TANNATE; CHLORPHENIRAMINE TANNATE; PHENYLEPHRINE TANNATE
See CHLORPHENIRAMINE TANNATE; PHENYLEPHRINE TANNATE; PYRILAMINE TANNATE
PYRIDOXINE HYDROCHLORIDE; ASCORBIC ACID; BIOTIN; CYANOCOBALAMIN; DEXPANTHENOL;
ERGOCALCIFEROL; FOLIC ACID; NIACINAMIDE; RIBOFLAVIN PHOSPHATE SODIUM; THIAMINE
HYDROCHLORIDE; VITAMIN A; VITAMIN E
See ASCORBIC ACID; BIOTIN; CYANOCOBALAMIN; DEXPANTHENOL; ERGOCALCIFEROL; FOLIC
ACID; NIACINAMIDE; PYRIDOXINE HYDROCHLORIDE; RIBOFLAVIN PHOSPHATE SODIUM;
THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN E
PYRIDOXINE HYDROCHLORIDE; ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; IRON; NICOTINIC
ACID; RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D; VITAMIN E
See ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; IRON; NICOTINIC ACID; PYRIDOXINE
HYDROCHLORIDE; RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D;
VITAMIN E
181
DRUG
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
PYRIDOXINE HYDROCHLORIDE; ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; NICOTINIC ACID;
RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D; VITAMIN E
See ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; NICOTINIC ACID; PYRIDOXINE
HYDROCHLORIDE; RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D;
VITAMIN E
QUINIDINE SULFATE
Quinidine Sulfate
Brand(s)
Cin-Quin
Cin-Quin
Quinora
Quinidex
@ capsule, oral 200mg
@ tablet, oral 200mg
@ tablet, oral 200mg
tablet, oral 200,300mg
@ tablet, oral 200mg
tablet, oral 200,300mg
@ tablet, oral 200mg
@ tablet, oral 200mg
@ tablet, oral 200mg
@ tablet, oral 200mg
@ tablet, oral 200mg
@ tablet, oral 200mg
tablet, oral 200mg
tablet, oral 200mg
@ tablet, oral 200mg
tablet, oral 100,200mg
@ tablet, oral 300mg
@ tablet, oral 200mg
@ tablet, oral 200mg
tablet, oral 200mg
@ tablet, oral 200mg
tablet, oral 200,300mg
@ tablet, oral 200mg
tablet, oral 200mg
@ tablet, oral 200mg
@ tablet, oral 200mg
@ tablet, oral 200mg
@ tablet, oral 200mg
@ tablet, oral 100mg
tablet, oral 200,300mg
@ tablet, oral 200mg
@ tablet, oral 200mg
tablet, extended release 300mg
Lilly
Barr
Elkins-Sinn
Eon
Everylife
Geneva
Halsey
ICN
Impax
IVAX
King
KV
Lannett
Lederle
Lilly
Mutual
Mutual
Perrigo
Pharmavite
Private Formulations
Purepac
Roxane
Scherer
Superpharm
USL
(Vangard/MWM)
Vintage
Warner Chilcott
Watson
Watson
West-ward
Whiteworth Towne
Copley
@ capsule, oral 200mg
@ tablet, oral 100,200,300mg
@ tablet, oral 200,300mg
tablet, extended release 300mg
Solvay
Solvay
Schering
Wyeth *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
RANITIDINE HYDROCHLORIDE
Ranitidine Hydrochloride
(continued on the next page)
capsule, oral eq 150,300mg base
capsule, oral eq 150,300mg base
capsule, oral eq 150,300mg base
capsule, oral eq 150,300mg base
@ tablet, oral eq 150,300mg base
tablet, oral eq 150,300mg base
tablet, oral eq 150,300mg base
tablet, oral eq 150,300mg base
tablet, oral eq 150,300mg base
182
Dr. Reddy
Geneva
GenPharm
Teva
Boehringer Ingelheim
Geneva
GenPharm
IVAX
Mylan
DRUG
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
RANITIDINE HYDROCHLORIDE (continued)
tablet, oral eq 150,300mg base
tablet, oral eq 150,300mg base
tablet, oral eq 150,300mg base
tablet, oral eq 150,300mg base
tablet, oral eq 150,300mg base
tablet, oral eq 150,300mg base
Brand(s)
Zantac
@ capsule, oral eq 150mg base
Zantac
@ capsule, oral eq 300mg base
Zantac
tablet, oral eq 150,300mg base
GlaxoSmithKline
GlaxoSmithKline
GlaxoSmithKline
RESERPINE
Brand(s)
Sandril
Serpasil
Lilly
Novartis
@ injection 2.5mg/ml
@ injection 2.5mg/ml
Par
Ranbaxy
Teva
TorPharm
Watson
Wockhardt
RIBOFLAVIN PHOSPHATE SODIUM; ASCORBIC ACID; BIOTIN; CYANOCOBALAMIN; DEXPANTHENOL;
ERGOCALCIFEROL; FOLIC ACID; NIACINAMIDE; PYRIDOXINE HYDROCHLORIDE; THIAMINE
HYDROCHLORIDE; VITAMIN A; VITAMIN E
See ASCORBIC ACID; BIOTIN; CYANOCOBALAMIN; DEXPANTHENOL; ERGOCALCIFEROL; FOLIC
ACID; NIACINAMIDE; PYRIDOXINE HYDROCHLORIDE; RIBOFLAVIN PHOSPHATE SODIUM;
THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN E
RIBOFLAVIN; ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; IRON; NICOTINIC ACID; PYRIDOXINE
HYDROCHLORIDE; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D; VITAMIN E
See ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; IRON; NICOTINIC ACID; PYRIDOXINE
HYDROCHLORIDE; RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D;
VITAMIN E
RIBOFLAVIN; ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; NICOTINIC ACID; PYRIDOXINE
HYDROCHLORIDE; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D; VITAMIN E
See ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; NICOTINIC ACID; PYRIDOXINE
HYDROCHLORIDE; RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D;
VITAMIN E
RIFAMPIN
Rifampin
Brand(s)
Rifadin
Rimactane
Rifadin
RIMANTIDINE HYDROCHLORIDE
Rimantidine Hydrochloride
Brand(s)
Flumadine
capsule, oral 150,300mg
injection 600mg/vial
Eon
Bedford
capsule, oral 150,300mg
capsule, oral 300mg
injection 600mg/vial
Aventis
Geneva
Aventis
tablet, oral 100mg
tablet, oral 100mg
Amide
CorePharma
tablet, oral 100mg
Forest *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
183
DRUG
RITODRINE HYDROCHLORIDE
Ritodrine Hydrochloride
Brand(s)
Yutopar
DOSAGE FORM, STRENGTH
injection 10,15mg/ml
@ injection 10,15mg/ml
APPLICATION HOLDER,
MANUFACTURER
@ injection 10,15mg/ml
Abbott
American Pharmaceutical
Partners
Quad
@ injection 10,15mg/ml
AstraZeneca
SCOPALAMINE HYDROBROMIDE; ATROPINE SULFATE; HYOSCYAMINE; PHENOBARBITAL
See ATROPINE SULFATE; HYOSCYAMINE; PHENOBARBITAL; SCOPALAMINE HYDROBROMIDE
SECOBARBITAL SODIUM
Secobarbital Sodium
Brand(s)
Seconal
Seconal
SELEGILINE HYDROCHLORIDE
Selegiline Hydrochloride
Brand(s)
Eldepryl
Eldepryl
@ capsule, oral 100mg
@ capsule, oral 100mg
@ capsule, oral 100mg
capsule, oral 100mg
@ capsule, oral 100mg
@ capsule, oral 100mg
@ capsule, oral 100mg
@ capsule, oral 100mg
@ capsule, oral 50,100mg
@ capsule, oral 100mg
@ capsule, oral 100mg
@ capsule, oral 100mg
@ capsule, oral 100mg
capsule, oral 100mg
@ capsule, oral 100mg
@ capsule, oral 100mg
injection 50mg/ml
Anabolic
Barr
Eon
Everylife
Halsey
ICN
IVAX
KV
Lannett
Perrigo
Pfizer
Purepac
Watson
West-ward
Whiteworth Towne
Wyeth-Ayerst
Wyeth-Ayerst
capsule, oral 50,100mg
@ injection 50mg/ml
Ranbaxy
Lilly
capsule, oral 5mg
@ capsule, oral 5mg
capsule, oral 5mg
tablet, oral 5mg
tablet, oral 5mg
tablet, oral 5mg
tablet, oral 5mg
tablet, oral 5mg
tablet, oral 5mg
tablet, oral 5mg
tablet, oral 5mg
Clonmel
Norton
TorPharm
Alphapharm
Apotex
Clonmel
Endo
IVAX
Siegfried
Stason
Teva
capsule, oral 5mg
tablet, oral 5mg
Somerset *
Somerset *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
SELENIUM SULFIDE
Selenium Sulfide
lotion/shampoo, topical 2.5%
lotion/shampoo, topical 2.5%
@ lotion/shampoo, topical 2.5%
(continued on the next page)
184
Alpharma
Clay-Park
IVAX
DRUG
SELENIUM SULFIDE (continued)
Brand(s)
Exsel
Selsun
SILVER SULFADIAZINE
Brand(s)
Silvadene
SSD
Thermazine
DOSAGE FORM, STRENGTH
lotion/shampoo, topical 2.5%
@ lotion/shampoo, topical 2.5%
APPLICATION HOLDER,
MANUFACTURER
Morton Grove
Taro
lotion/shampoo, topical 2.5%
lotion/shampoo, topical 2.5%
Allergan Herbert
Chattem
cream, topical 1%
cream, topical 1%
cream, topical 1%
King
BASF
Kendall
SODIUM ACETATE; DEXTROSE; MAGNESIUM CHLORIDE; POTASSIUM CHLORIDE; SODIUM CHLORIDE;
SODIUM GLUCONATE
See DEXTROSE; MAGNESIUM CHLORIDE; POTASSIUM CHLORIDE; SODIUM ACETATE;
SODIUM CHLORIDE; SODIUM GLUCONATE
SODIUM ACETATE; MAGNESIUM CHLORIDE; POTASSIUM CHLORIDE; SODIUM CHLORIDE;
SODIUM GLUCONATE
See MAGNESIUM CHLORIDE; POTASSIUM CHLORIDE; SODIUM ACETATE;
SODIUM CHLORIDE; SODIUM GLUCONATE
SODIUM AMINOSALICYLATE
Sodium Aminosalicylate
Brand(s)
P.A.S. Sodium
Parasal Sodium
Sodium P.A.S.
Teebacin
@ powder, oral 100%
Hexcel
@ powder, oral 4gm/packet
@ tablet, oral 500mg
tablet, oral 500mg
@ tablet, oral 500mg
Century
Panray
Lannett
Consolidated Midland
SODIUM BICARBONATE; CALCIUM CHLORIDE; DEXTROSE; GLUTATHIONE DISULFIDE; MAGNESIUM
CHLORIDE; POTASSIUM CHLORIDE; SODIUM CHLORIDE; SODIUM PHOSPHATE
See CALCIUM CHLORIDE; DEXTROSE; GLUTATHIONE DISULFIDE; MAGNESIUM CHLORIDE;
POTASSIUM CHLORIDE; SODIUM BICARBONATE; SODIUM CHLORIDE; SODIUM PHOSPHATE
SODIUM CARBONATE; CITRIC ACID; MAGNESIUM OXIDE
See CITRIC ACID; MAGNESIUM OXIDE; SODIUM CARBONATE
SODIUM CHLORIDE
Injection; in plastic container
Solution for irrigation; in plastic container
Sodium Chloride
bacteriostatic injection 9mg/ml
bacteriostatic injection 9mg/ml
injection 9mg/ml (0.9%),
450mg/100ml (0.45%),
900mg/100ml (0.9%)
injection 9mg/ml (0.9%)
(continued on the next page)
injection 9mg/ml (0.9%),
450mg/100ml (0.45%),
900mg/100ml (0.9%),
3gm/100ml (3%)
185
Abbott
American Pharmaceutical
Partners
Abbott
American Pharmaceutical
Partners
Baxter
DRUG
SODIUM CHLORIDE (continued)
DOSAGE FORM, STRENGTH
injection 450mg/100ml (0.45%),
900mg/100ml (0.9%),
3gm/100ml (3%)
@ injection 450mg/100ml (0.45%),
@ 900mg/100ml (0.9%)
solution 450mg/100ml (0.45%),
900mg/100ml (0.9%)
solution 450mg/100ml (0.45%),
900mg/100ml (0.9%)
solution 900mg/100ml (0.9%)
@ solution 900mg/100ml (0.9%)
APPLICATION HOLDER,
MANUFACTURER
Braun
Miles
Abbott
Baxter
Braun
Miles
SODIUM CHLORIDE; CALCIUM CHLORIDE; DEXTROSE; GLUTATHIONE DISULFIDE; MAGNESIUM
CHLORIDE; POTASSIUM CHLORIDE; SODIUM BICARBONATE; SODIUM PHOSPHATE
See CALCIUM CHLORIDE; DEXTROSE; GLUTATHIONE DISULFIDE; MAGNESIUM CHLORIDE;
POTASSIUM CHLORIDE; SODIUM BICARBONATE; SODIUM CHLORIDE; SODIUM PHOSPHATE
SODIUM CHLORIDE; CALCIUM CHLORIDE; DEXTROSE; MAGNESIUM CHLORIDE; SODIUM LACTATE
See CALCIUM CHLORIDE; DEXTROSE; MAGNESIUM CHLORIDE; SODIUM CHLORIDE; SODIUM
LACTATE
SODIUM CHLORIDE; CALCIUM CHLORIDE; DEXTROSE; POTASSIUM CHLORIDE
See CALCIUM CHLORIDE; DEXTROSE; POTASSIUM CHLORIDE; SODIUM CHLORIDE
SODIUM CHLORIDE; CALCIUM CHLORIDE; DEXTROSE; POTASSIUM CHLORIDE; SODIUM LACTATE
See CALCIUM CHLORIDE; DEXTROSE; POTASSIUM CHLORIDE; SODIUM CHLORIDE; SODIUM
LACTATE
SODIUM CHLORIDE; CALCIUM CHLORIDE; MAGNESIUM CHLORIDE; POTASSIUM CHLORIDE
See CALCIUM CHLORIDE; MAGNESIUM CHLORIDE; POTASSIUM CHLORIDE; SODIUM CHLORIDE
SODIUM CHLORIDE; CALCIUM CHLORIDE; POTASSIUM CHLORIDE
See CALCIUM CHLORIDE; POTASSIUM CHLORIDE; SODIUM CHLORIDE
SODIUM CHLORIDE; CALCIUM CHLORIDE; POTASSIUM CHLORIDE; SODIUM LACTATE
See CALCIUM CHLORIDE; POTASSIUM CHLORIDE; SODIUM CHLORIDE; SODIUM LACTATE
SODIUM CHLORIDE; CIMETIDINE HYDROCHLORIDE
See CIMETIDINE HYDROCHLORIDE; SODIUM CHLORIDE
SODIUM CHLORIDE; DEXTROSE
See DEXTROSE; SODIUM CHLORIDE
SODIUM CHLORIDE; DEXTROSE; MAGNESIUM CHLORIDE; POTASSIUM CHLORIDE; SODIUM ACETATE;
SODIUM GLUCONATE
See DEXTROSE; MAGNESIUM CHLORIDE; POTASSIUM CHLORIDE; SODIUM ACETATE; SODIUM
CHLORIDE; SODIUM GLUCONATE
186
DRUG
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
SODIUM CHLORIDE; DEXTROSE; POTASSIUM CHLORIDE
See DEXTROSE; POTASSIUM CHLORIDE; SODIUM CHLORIDE
SODIUM CHLORIDE; GENTAMICIN SULFATE
See GENTAMICIN SULFATE; SODIUM CHLORIDE
SODIUM CHLORIDE; HEPARIN SODIUM
See HEPARIN SODIUM; SODIUM CHLORIDE
SODIUM CHLORIDE; MAGNESIUM CHLORIDE; POTASSIUM CHLORIDE; SODIUM ACETATE;
SODIUM GLUCONATE
See MAGNESIUM CHLORIDE; POTASSIUM CHLORIDE; SODIUM ACETATE; SODIUM CHLORIDE;
SODIUM GLUCONATE
SODIUM CHLORIDE; POTASSIUM CHLORIDE
See POTASSIUM CHLORIDE; SODIUM CHLORIDE
SODIUM GLUCONATE; DEXTROSE; MAGNESIUM CHLORIDE; POTASSIUM CHLORIDE; SODIUM
CHLORIDE; SODIUM ACETATE
See DEXTROSE; MAGNESIUM CHLORIDE; POTASSIUM CHLORIDE; SODIUM ACETATE; SODIUM
CHLORIDE; SODIUM GLUCONATE
SODIUM GLUCONATE; MAGNESIUM CHLORIDE; POTASSIUM CHLORIDE; SODIUM ACETATE;
SODIUM CHLORIDE
See MAGNESIUM CHLORIDE; POTASSIUM CHLORIDE; SODIUM ACETATE; SODIUM CHLORIDE;
SODIUM GLUCONATE
SODIUM LACTATE
Injection; in plastic container
Sodium Lactate
injection 1.87gm/100ml (0.167 molar)
injection 1.87gm/100ml (0.167 molar)
injection 1.87gm/100ml (0.167 molar)
Abbott
Baxter
Braun
SODIUM LACTATE; CALCIUM CHLORIDE; DEXTROSE; MAGNESIUM CHLORIDE; SODIUM CHLORIDE
See CALCIUM CHLORIDE; DEXTROSE; MAGNESIUM CHLORIDE; SODIUM CHLORIDE; SODIUM
LACTATE
SODIUM LACTATE; CALCIUM CHLORIDE; POTASSIUM CHLORIDE; SODIUM CHLORIDE
See CALCIUM CHLORIDE; POTASSIUM CHLORIDE; SODIUM CHLORIDE; SODIUM LACTATE
SODIUM NITROPRUSSIDE
Sodium Nitroprusside
Brand(s)
Nipride
Nitropress
Nitropress
@ injection 50mg/vial
injection 50mg/vial
injection 25mg/ml
@ injection 50mg/vial
injection 25mg/ml
injection 50mg/vial
187
American Pharmaceutical
Partners
Elkins-Sinn
Gensia Sicor
Roche
Abbott
Abbott
DRUG
DOSAGE FORM, STRENGTH
SODIUM POLYSTYRENE SULFONATE
Sodium Polystyrene Sulfonate
powder, oral-rectal
454gm/bottle
@ powder, oral-rectal
453.6gm bottle
@ suspension, oral-rectal
15gm/60ml
suspension, oral-rectal
15gm/60ml
Brand(s)
Kayexalate
powder, oral-rectal
453.6gm bottle
Kionex
powder, oral-rectal
454gm/bottle
SPS
suspension, oral-rectal
15gm/60ml
APPLICATION HOLDER,
MANUFACTURER
Carolina Medical
Morton Grove
Morton Grove
Roxane
Sanofi Synthelabo
Paddock
Carolina Medical
SODIUM PHOSPHATE; CALCIUM CHLORIDE; DEXTROSE; GLUTATHIONE DISULFIDE; MAGNESIUM
CHLORIDE; POTASSIUM CHLORIDE; SODIUM BICARBONATE; SODIUM CHLORIDE
See CALCIUM CHLORIDE; DEXTROSE; GLUTATHIONE DISULFIDE; MAGNESIUM CHLORIDE;
POTASSIUM CHLORIDE; SODIUM BICARBONATE; SODIUM CHLORIDE; SODIUM PHOSPHATE
SOTALOL HYDROCHLORIDE
Sotalol Hydrochloride
Brand(s)
Betapace
Sorine
SOYBEAN OIL
Brand(s)
Intralipid 10%
Intralipid 20%
Intralipid 30%
Liposyn III 10%
Liposyn III 20%
Liposyn III 30%
Nutrilipid 10%
Nutrilipid 20%
Soyacal 10%
Soyacal 20%
Travamulsion 10%
Travamulsion 20%
SPIRONOLACTONE
Spironolactone
(continued on the next page)
tablet, oral 80,120,160,240mg
tablet, oral 80,120,160,240mg
tablet, oral 80,120,160,240mg
tablet, oral 80,120,160,240mg
tablet, oral 80,120,160,240mg
tablet, oral 80,120,160,240mg
tablet, oral 80,120,160,240mg
tablet, oral 80,120,160,240mg
Apotex
Eon
GenPharm
Impax
Mutual
Mylan
Teva
Watson
tablet, oral 80,120,160,240mg
tablet, oral 80,120,160,240mg
Berlex
Upsher-Smith
injection 10%
injection 20%
injection 30%
injection 10%
injection 20%
injection 30%
injection 10%
injection 20%
injection 10%
injection 20%
@ injection 10%
@ injection 20%
Fresenius Kabi
Fresenius Kabi
Fresenius Kabi
Abbott
Abbott
Abbott
Braun
Braun
Alpha Therapeutic
Alpha Therapeutic
Baxter
Baxter
@ tablet, oral 25mg
@ tablet, oral 25mg
tablet, oral 25mg
tablet, oral 25mg
@ tablet, oral 25mg
@ tablet, oral 25mg
(Ascot)
Circa
Geneva
Halsey
IVAX
Lederle
188
DRUG
DOSAGE FORM, STRENGTH
SPIRONOLACTONE (continued)
@
Brand(s)
Aldactone
@
@
@
@
APPLICATION HOLDER,
MANUFACTURER
tablet, oral 25,50,100mg
tablet, oral 25,50,100mg
tablet, oral 25mg
tablet, oral 50,100mg
tablet, oral 25mg
tablet, oral 25mg
tablet, oral 25mg
tablet, oral 25mg
tablet, oral 25mg
Mutual
Mylan
Purepac
Purepac
Superpharm
Upsher-Smith
(Vangard/MWM)
Warner Chilcott
Watson
tablet, oral 25,50,100mg
Searle *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
SPIRONOLACTONE; HYDROCHLOROTHIAZIDE
See HYDROCHLOROTHIAZIDE; SPIRONOLACTONE
STREPTOMYCIN SULFATE
Streptomycin Sulfate
SUCCINYLCHOLINE CHLORIDE
Succinylcholine Chloride
Brand(s)
Anectine
Quelicin
Quelicin Preservative Free
Sucostrin
SUCRALFATE
Sucralfate
Brand(s)
Carafate
SUFENTANIL CITRATE
Sufentanil Citrate
Brand(s)
Sufenta
@ injection eq 1,5gm base/vial
@ injection eq 1,5gm base/vial
injection eq 1gm base/vial
injection 20mg/ml
injection 20mg/ml
injection 20mg/ml
injection 20mg/ml
@ injection 20mg/ml
Lilly
Pfizer
Pharma-Tek
Organon
GlaxoSmithKline
Abbott
Abbott
Apothecon
tablet, oral 1gm
tablet, oral 1gm
Ratiopharm/Martec
Teva
tablet, oral 1gm
Blue Ridge/Aventis
injection eq 0.05mg base/ml
injection eq 0.05mg base/ml
@ injection eq 0.05mg base/ml
injection eq 0.05mg base/ml
SULFABENZAMIDE; SULFACETAMIDE; SULFATHIAZOLE
Sulfabenzamide;
@ tablet, vaginal 184mg; 143.75mg;
Sulfacetamide; Sulfathiazole
172.5mg
(Triple Sulfa)
@ tablet, vaginal 184mg; 143.75mg;
172.5mg
Brand(s)
Gyne-Sulf
cream, vaginal 3.7%; 2.86%; 3.42%
Sultrin
cream, vaginal 3.7%; 2.86%; 3.42%
Triple Sulfa
cream, vaginal 3.7%; 2.86%; 3.42%
Triple Sulfa
cream, vaginal 3.7%; 2.86%; 3.42%
(continued on the next page)
189
Abbott
Elkins-Sinn
Steris
Akorn
Fougera/Altana
Pharmaderm/Altana
G&W
Ortho-McNeil
Alpharma
Clay-Park
DRUG
DOSAGE FORM, STRENGTH
SULFABENZAMIDE; SULFACETAMIDE; SULFATHIAZOLE (continued)
Triple Sulfa
@ cream, vaginal 3.7%; 2.86%; 3.42%
Trysul
cream, vaginal 3.7%; 2.86%; 3.42%
Vagilia
@ cream, vaginal 3.7%; 2.86%; 3.42%
Sultrin
@ tablet, vaginal 184mg; 143.75mg;
172.5mg
SULFACETAMIDE SODIUM
Sulfacetamide Sodium
Brand(s)
Bleph-10
Cetamide
Sodium Sulamyd
Sulfair-10
AK-Sulf
AK-Sulf
Bleph-10
Bleph-30
Isopto Cetamide
Ocusulf-10
Ocusulf-30
Sodium Sulamyd
Sulf-10
Sulf-15
Sulfacel-15
Sulfair-10
Sulfair-15
Sulfair Forte
Sulten-10
APPLICATION HOLDER,
MANUFACTURER
Fougera/Altana
Savage/Altana
Teva
Ortho-McNeil
ointment, ophthalmic 10%
solution, ophthalmic 10%
solution, ophthalmic 10%
@ solution, ophthalmic 10,30%
solution, ophthalmic 30%
Altana
Alcon Universal
Bausch and Lomb
Sola Barnes-Hind
Steris
@ ointment, ophthalmic 10%
ointment, ophthalmic 10%
@ ointment, ophthalmic 10%
@ ointment, ophthalmic 10%
solution, ophthalmic 10,30%
@ solution, ophthalmic 15%
solution, ophthalmic 10%
solution, ophthalmic 10%
solution, ophthalmic 15%
solution, ophthalmic 10%
@ solution, ophthalmic 30%
@ solution, ophthalmic 10,30%
solution, ophthalmic 10%
solution, ophthalmic 15%
solution, ophthalmic 15%
@ solution, ophthalmic 10%
@ solution, ophthalmic 15%
@ solution, ophthalmic 30%
@ solution, ophthalmic 10%
Allergan
Alcon
Schering
Pharmafair
Akorn
Akorn
Allergan
Allergan
Alcon
Miza
Miza
Schering
Novartis
Novartis
Optopics
Pharmafair
Pharmafair
Pharmafair
Bausch and Lomb
SULFACETAMIDE SODIUM: PREDNISOLONE ACETATE
See PREDNISOLONE ACETATE; SULFACETAMIDE SODIUM
SULFACETAMIDE SODIUM; PREDNISOLONE SODIUM PHOSPHATE
See PREDNISOLONE SODIUM PHOSPHATE; SULFACETAMIDE
SULFADIAZINE
Sulfadiazine
@
@
@
@
@
tablet, oral 500mg
tablet, oral 500mg
tablet, oral 500mg
tablet, oral 500mg
tablet, oral 500mg
tablet, oral 500mg
Eon
Everylife
Impax
Lannett
Lederle
Lilly
SULFADIAZINE; SULFAMETHAZINE; SULFAMERAZINE
See TRISULFAPYRIMIDINE
SULFAMETHIZOLE
Brand(s)
Proklar
Thiosulfil
@ tablet, oral 500mg
@ tablet, oral 500mg
190
Forest
Wyeth-Ayerst
DRUG
SULFAMETHOXAZOLE
Sulfamethoxazole
Brand(s)
Gantanol
Gantanol DS
Urobak
DOSAGE FORM, STRENGTH
@
@
@
@
@
tablet, oral 500mg
tablet, oral 500mg
tablet, oral 500mg,1gm
tablet, oral 500mg
tablet, oral 500mg
@ tablet, oral 500mg
@ tablet, oral 1gm
@ tablet, oral 500mg
APPLICATION HOLDER,
MANUFACTURER
(Ascot)
Barr
Circa
Geneva
Heather
Roche
Roche
Shionogi
SULFAMETHOXAZOLE; TRIMETHOPRIM
Sulfamethoxazole; Trimethoprim
injection 80mg/ml;16mg/ml
@ injection 80mg/ml;16mg/ml
Brand(s)
Bactrim
Septra
Sulfamethoprim
Bactrim
Bactrim Pediatric
Cotrim Pediatric
Septra
Septra Grape
SMZ-TMP
SMZ-TMP Pediatric
Sulfatrim
Sulfatrim Pediatric
Sulmeprim
Sulmeprim Pediatric
(continued on the next page)
Abbott
American Pharmaceutical
Partners
@ injection 80mg/ml;16mg/ml
Bedford
injection 80mg/ml;16mg/ml
Elkins-Sinn
injection 80mg/ml;16mg/ml
Gensia Sicor
@ injection 80mg/ml;16mg/ml
Quad
@ injection 80mg/ml;16mg/ml
Steris
suspension, oral 200mg/5ml;40mg/5ml Hi-Tech
@ suspension, oral 200mg/5ml;40mg/5ml Naska
@ tablet, oral 400mg;80mg
Barr
@ tablet, oral 800mg;160mg
Barr
@ tablet, oral 400mg;80mg
Eon
tablet, oral 800mg;160mg
Eon
tablet, oral 400mg;80mg
Geneva
tablet, oral 800mg;160mg
Geneva
@ tablet, oral 400mg;80mg
Heather
@ tablet, oral 800mg;160mg
Heather
@ tablet, oral 400mg;80mg
Interpharm
@ tablet, oral 800mg;160mg
Interpharm
@ tablet, oral 400mg;80mg
Martec
@ tablet, oral 800mg;160mg
Martec
tablet, oral 400mg;80mg
Mutual
tablet, oral 800mg;160mg
Mutual
tablet, oral 400mg;80mg
Plantex
@ tablet, oral 400mg;80mg
Roxane
@ tablet, oral 800mg;160mg
Roxane
tablet, oral 400mg;80mg
Sidmak
tablet, oral 800mg;160mg
Sidmak
tablet, oral 800mg;160mg
Teva
@ tablet, oral 400mg;80mg
USL
@ tablet, oral 800mg;160mg
USL
tablet, oral 400mg;80mg
Watson
tablet, oral 800mg;160mg
Watson
@
@
@
@
@
injection 80mg/ml;16mg/ml
injection 80mg/ml;16mg/ml
injection 80mg/ml;16mg/ml
suspension, oral 200mg/5ml;40mg/5ml
suspension, oral 200mg/5ml;40mg/5ml
suspension, oral 200mg/5ml;40mg/5ml
suspension, oral 200mg/5ml;40mg/5ml
suspension, oral 200mg/5ml;40mg/5ml
suspension, oral 200mg/5ml;40mg/5ml
suspension, oral 200mg/5ml;40mg/5ml
suspension, oral 200mg/5ml;40mg/5ml
suspension, oral 200mg/5ml;40mg/5ml
suspension, oral 200mg/5ml;40mg/5ml
suspension, oral 200mg/5ml;40mg/5ml
191
Women First Healthcare
Monarch
Quad
Women First Healthcare
Women First Healthcare
Teva
Monarch
Monarch
Teva
Teva
Alpharma
Alpharma
USL
USL
DRUG
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
SULFAMETHOXAZOLE; TRIMETHOPRIM (continued)
Bactrim
tablet, oral 400mg;80mg
Bactrim DS
tablet, oral 800mg;160mg
Cotrim
tablet, oral 400mg;80mg
Cotrim D.S.
tablet, oral 800mg;160mg
Septra
tablet, oral 400mg;80mg
Septra DS
tablet, oral 800mg;160mg
SMZ-TMP
tablet, oral 400mg;80mg
SMZ-TMP
tablet, oral 800mg;160mg
Sulfamethoprim
tablet, oral 400mg;80mg
Sulfamethoprim-DS
tablet, oral 800mg;160mg
Sulfatrim SS
@ tablet, oral 400mg;80mg
Sulfatrim DS
@ tablet, oral 800mg;160mg
Uroplus SS
@ tablet, oral 400mg;80mg
Uroplus DS
@ tablet, oral 800mg;160mg
Women First Healthcare
Women First Healthcare
Teva
Teva
Monarch
Monarch
Teva
Teva
Par
Par
Superpharm
Superpharm
Shionogi
Shionogi
SULFANILAMIDE
Brand(s)
AVC
Vagitrol
Novavax
Teva
SULFASALAZINE
Sulfasalazine
Brand(s)
Azulfidine
S.A.S.-500
cream, vaginal 15%
cream, vaginal 15%
@ tablet, oral 500mg
@ tablet, oral 500mg
@ tablet, oral 500mg
tablet, oral 500mg
@ tablet, oral 500mg
tablet, oral 500mg
Circa
Eon
Lederle
Mutual
Superpharm
Watson
tablet, oral 500mg
@ tablet, oral 500mg
Pharmacia & Upjohn
Solvay
SULFATHIAZOLE; SULFACETAMIDE; SULFABENZAMIDE; UREA
See SULFACETAMIDE; SULFABENZAMIDE; SULFATHIAZOLE; UREA
SULFINPYRAZONE
Sulfinpyrazone
Brand(s)
Anturane
Anturane
SULFISOXAZOLE
Sulfisoxazole
(continued on the next page)
capsule, oral 200mg
capsule, oral 200mg
capsule, oral 200mg
@ capsule, oral 200mg
tablet, oral 100mg
@ tablet, oral 100mg
tablet, oral 100mg
@ tablet, oral 100mg
capsule, oral 200mg
tablet, oral 100mg
@
@
@
@
tablet, oral 500mg
tablet, oral 500mg
tablet, oral 500mg
tablet, oral 500mg
tablet, oral 500mg
@ tablet, oral 500mg
@ tablet, oral 500mg
192
Barr
IVAX
Par
(Vangard/MWM)
Barr
IVAX
Par
Watson
Novartis
Novartis
Barr
Eon
Geneva
Heather
ICN
Impax
IVAX
DRUG
SULFISOXAZOLE (continued)
Brand(s)
Gantrisin
Sosol
Sulfalar
Sulsoxin
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
@
@
@
@
tablet, oral 500mg
tablet, oral 500mg
tablet, oral 500mg
tablet, oral 500mg
tablet, oral 500mg
@ tablet, oral 500mg
@ tablet, oral 500mg
Lannett
Lederle
Pharmeral
Purepac
Roxane
Watson
West-ward
@ tablet, oral 500mg
tablet, oral 500mg
@ tablet, oral 500mg
@ tablet, oral 500mg
Roche
MK
Pfizer
Solvay
SULFISOXAZOLE ACETYL; ERYTHROMYCIN ETHYLSUCCINATE
See ERYTHROMYCIN ETHYLSUCCINATE; SULFISOXAZOLE
SULINDAC
Sulindac
Brand(s)
Clinoril
tablet, oral 150,200mg
tablet, oral 150,200mg
tablet, oral 150,200mg
tablet, oral 150,200mg
tablet, oral 150,200mg
tablet, oral 150,200mg
tablet, oral 150,200mg
Geneva
Lederle
Mutual
Mylan
Teva
Warner Chilcott
Watson
tablet, oral 150,200mg
Merck *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
TAMOXIFEN CITRATE
Tamoxifen Citrate
Brand(s)
Nolvadex
tablet, oral eq 10,20mg base
tablet, oral eq 10,20mg base
tablet, oral eq 10,20mg base
tablet, oral eq 10,20mg base
tablet, oral eq 10mg base
tablet, oral eq 10,20mg base
tablet, oral eq 10,20mg base
Andrx
Barr
IVAX
Mylan
Pharmachemie
Roxane
Teva
tablet, oral eq 10,20mg base
AstraZeneca *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
TEMAZEPAM
Temazepam
@ capsule, oral 15,30mg
@ capsule, oral 15,30mg
@ capsule, oral 15,30mg
capsule, oral 15,30mg
capsule, oral 15,30mg
capsule, oral 15,30mg
capsule, oral 15,30mg
@ capsule, oral 15,30mg
capsule, oral 15,30mg
(continued on the next page)
193
Barr
Circa
Duramed/Barr
Geneva
Mylan
Par
Purepac
USL
Watson
DRUG
DOSAGE FORM, STRENGTH
TEMAZEPAM (continued)
Brand(s)
Temaz
Restoril
@ capsule, oral 15,30mg
capsule, oral 7.5,15,30mg
APPLICATION HOLDER,
MANUFACTURER
Quantum
Tyco *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
TERAZOSIN HYDROCHLORIDE
Terazosin Hydrochloride
Hytrin
Hytrin
Brand(s)
capsule, oral eq 1,2,5,10mg base
capsule, oral eq 1,2,5,10mg base
capsule, oral eq 1,2,5,10mg base
capsule, oral eq 1,2,5,10mg base
capsule, oral eq 1,2,5,10mg base
tablet, oral eq 1,2,5,10mg base
tablet, oral eq 1,2,5,10mg base
tablet, oral eq 1,2,5,10mg base
Geneva
IVAX
Mylan
Ranbaxy
TorPharm
Geneva
IVAX
Teva
tablet, oral eq 1,2,5,10mg base
capsule, oral eq 1,2,5,10mg base
Abbott *
Abbott *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
TERBUTALINE SULFATE
Terbutaline Sulfate
Brand(s)
Brethine
Bricanyl
Brethine
TERCONAZOLE
Brand(s)
Terazol 3
Terazol 7
tablet, oral 2.5,5mg
injection 1mg/ml
@ injection 1mg/ml
tablet, oral 2.5,5mg
cream, vaginal 0.8%
cream, vaginal 0.4%
Impax
AAIPharma
Aventis
AAIPharma
Ortho-McNeil *
Ortho-McNeil *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
TESTOSTERONE CYPIONATE
Testosterone Cypionate
Brand(s)
Depo-Testosterone
@ injection 100,200mg/ml
injection 100,200mg/ml
injection 100,200mg/ml
Quad
Steris
Pharmacia & Upjohn
TESTOSTERONE CYPIONATE; ESTRADIOL CYPIONATE
See ESTRADIOL CYPIONATE; TESTOSTERONE CYPIONATE
TESTOSTERONE ENANTHATE
Testosterone Enanthate
Brand(s)
Delatestryl
@ injection 100,200mg/ml
@ injection 100mg/ml
injection 200mg/ml
Quad
Steris
Steris
injection 200mg/ml
BTG
194
DRUG
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
TESTOSTERONE ENANTHATE; ESTRADIOL VALERATE
See ESTRADIOL VALERATE; TESTOSTERONE ENANTHATE
TESTOSTERONE PROPIONATE
Testosterone Propionate
TETRACAINE HYDROCHLORIDE
Tetracaine Hydrochloride
Brand(s)
Pontocaine
@
@
@
@
injection 25,50,100mg/ml
injection 25mg/ml
injection 50mg/ml
injection 100mg/ml
injection 25,50,100mg/ml
Bel-Mar
Elkins-Sinn
Lilly
Quad
Steris
solution, ophthalmic 0.5%
Optopics *
solution, ophthalmic 0.5%
Sterling Winthrop *
* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as an
exception to the promulgated criteria for inclusion, pursuant to Rule 790.60.
TETRACYCLINE HYDROCHLORIDE
Tetracycline Hydrochloride
@ capsule, oral 250,500mg
capsule, oral 250,500mg
capsule, oral 250,500mg
@ capsule, oral 250mg
@ capsule, oral 250mg
@ capsule, oral 250mg
capsule, oral 250,500mg
@ capsule, oral 250,500mg
@ capsule, oral 250,500mg
capsule, oral 250,500mg
capsule, oral 250,500mg
capsule, oral 250mg
capsule, oral 250,500mg
@ capsule, oral 250,500mg
@ capsule, oral 250,500mg
capsule, oral 500mg
@ capsule, oral 250,500mg
@ capsule, oral 250,500mg
@ capsule, oral 250,500mg
@ capsule, oral 250,500mg
@ capsule, oral 250,500mg
@ suspension, oral 125mg/5ml
@ suspension, oral 125mg/5ml
@ suspension, oral 125mg/5ml
Brand(s)
Achromycin V
capsule, oral 250,500mg
Bristacycline
capsule, oral 250,500mg
Cyclopar
@ capsule, oral 250,500mg
Panmycin
@ capsule, oral 250mg
Retet
@ capsule, oral 250,500mg
Robitet
@ capsule, oral 250,500mg
Sumycin
capsule, oral 250,500mg
Tetrachel
@ capsule, oral 250,500mg
Tetracyn
@ capsule, oral 250,500mg
Achromycin
@ injection 250mg/vial
Achromycin
@ injection 500mg/vial
Tetracyn
@ injection 250,500mg/vial
Achromycin V
@ suspension, oral 125mg/5ml
Biocycline
@ suspension, oral 125mg/5ml
(continued on the next page)
195
Abbott
Atral
Barr
Elkins-Sinn
Eon
Ferrante
Halsey
Heather
ICN
Impax
IVAX
Mast
Mylan
Private Formulations
Purepac
Roxane
Superpharm
Warner Chilcott
Watson
West-ward
Wyeth-Ayerst
Ferrante
Proter
Purepac
Lederle
Bristol
Warner Chilcott
Pharmacia & Upjohn
Solvay
Wyeth-Ayerst
Apothecon
Angus
Pfipharmecs/Pfizer
Lederle
Lederle
Pfizer
Lederle
Alpharma
DRUG
TETRACYCLINE HYDROCHLORIDE
Sumycin
Tetracyn
Tetramed
Panmycin
Sumycin
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
(continued)
suspension, oral 125mg/5ml
@ suspension, oral 125mg/5ml
@ suspension, oral 125mg/5ml
@ tablet, oral 500mg
tablet, oral 500mg
Apothecon
Pfipharmecs/Pfizer
IVAX
Upjohn
Apothecon
TETRACYCLINE HYDROCHLORIDE; PROCAINE HYDROCHLORIDE
See PROCAINE HYDROCHLORIDE; TETRACYCLINE HYDROCHLORIDE
THEOPHYLLINE
Theophylline
@
@
@
@
@
Brand(s)
Slo-BID
Elixomin
Elixophyllin
Lanophyllin
Theolixir
Theolair
Accurbron
Aquaphyllin
Slo-Phyllin-80
Theoclear-80
Theocron
Theo-Dur
@
@
@
@
@
capsule, extended release
100,125,200,300mg
elixir, oral 80mg/15ml
elixir, oral 80mg/15ml
elixir, oral 80mg/15ml
elixir, oral 80mg/15ml
elixir, oral 80mg/15ml
elixir, oral 80mg/15ml
elixir, oral 80mg/15ml
solution, oral 80mg/15ml
syrup, oral 80mg/15ml
syrup, oral 150mg/15ml
tablet, extended release
100,200,300,450mg
capsule, extended release
100,125,200,300mg
elixir, oral 80mg/15ml
elixir, oral 80mg/15ml
elixir, oral 80mg/15ml
elixir, oral 80mg/15ml
solution, oral 80mg/15ml
syrup, oral 150mg/15ml
syrup, oral 80mg/15ml
syrup, oral 80mg/15ml
syrup, oral 80mg/15ml
tablet, extended release
100,200,300,450mg
tablet, extended release
100,200,300,450mg
Inwood/Forest
Alpharma
Halsey
Morton Grove
Perrigo
Pharmaceutical Associates
Roxane
Taro
Roxane
Alpharma
Alpharma
Sidmak
Aventis *
Cenci
Forest
Lannett
Panray/Ormont
Riker/3M
Aventis
Ferndale
Aventis
Central
Forest/Inwood
Schering *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
THEOPHYLLINE; DEXTROSE
See DEXTROSE; THEOPHYLLINE
THEOPHYLLINE; EPHEDRINE; HYDROXYZINE HYDROCHLORIDE
See EPHEDRINE; HYDROXYZINE HYDROCHLORIDE; THEOPHYLLINE
THEOPHYLLINE; GUAIFENESIN
See GUAIFENESIN; THEOPHYLLINE
196
DRUG
THIAMINE HYDROCHLORIDE
Thiamine Hydrochloride
Brand(s)
Betalin S
DOSAGE FORM, STRENGTH
injection 100mg/ml
@ injection 100mg/ml
injection 100mg/ml
APPLICATION HOLDER,
MANUFACTURER
@ injection 100,200mg/ml
@ injection 100mg/ml
injection 100mg/ml
@ injection 100mg/ml
@ injection 100mg/ml
injection 100,200mg/ml
injection 100mg/ml
Abbott
Akorn
American Pharmaceutical
Partners
Bel-Mar
Dell
Elkins-Sinn
Luitpold
Pfizer
Steris
Wyeth-Ayerst
@ injection 100mg/ml
Lilly
THIAMINE HYDROCHLORIDE; ASCORBIC ACID; BIOTIN; CYANOCOBALAMIN; DEXPANTHENOL;
ERGOCALCIFEROL; FOLIC ACID; NIACINAMIDE; PYRIDOXINE HYDROCHLORIDE; RIBOFLAVIN
PHOSPHATE SODIUM; VITAMIN A; VITAMIN E
See ASCORBIC ACID; BIOTIN; CYANOCOBALAMIN; DEXPANTHENOL; ERGOCALCIFEROL; FOLIC
ACID; NIACINAMIDE; PYRIDOXINE HYDROCHLORIDE; RIBOFLAVIN PHOSPHATE SODIUM;
THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN E
THIAMINE HYDROCHLORIDE; ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; IRON; NICOTINIC ACID;
PYRIDOXINE HYDROCHLORIDE; RIBOFLAVIN; VITAMIN A; VITAMIN D; VITAMIN E
See ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; IRON; NICOTINIC ACID; PYRIDOXINE
HYDROCHLORIDE; RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D;
VITAMIN E
THIAMINE HYDROCHLORIDE; ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; NICOTINIC ACID;
PYRIDOXINE HYDROCHLORIDE; RIBOFLAVIN; VITAMIN A; VITAMIN D; VITAMIN E
See ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; NICOTINIC ACID; PYRIDOXINE
HYDROCHLORIDE; RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D;
VITAMIN E
THIORIDAZINE HYDROCHLORIDE
Thioridazine Hydrochloride
(continued on the next page)
@ concentrate, oral 30mg/ml
concentrate, oral 100mg/ml
concentrate, oral 30,100mg/ml
@ concentrate, oral 30,100mg/ml
concentrate, oral 30,100mg/ml
@ concentrate, oral 30,100mg/ml
concentrate, oral 30,100mg/ml
@ tablet, oral 10,15,25,100,150,200mg
@ tablet, oral 10,15,25,50,100,
150,200mg
tablet, oral 10,15,25,50,100,
150,200mg
tablet, oral 50mg
tablet, oral 10,15,25mg
@ tablet, oral 50,100mg
tablet, oral 10,25,50,100mg
tablet, oral 10,25,50,100mg
@ tablet, oral 10,15,25,50,100,
150,200mg
@ tablet, oral 10,25,50,100mg
@ tablet, oral 10,25,50mg
@ tablet, oral 10mg
197
Alpharma
Alpharma
Copley
Geneva
Hi-Tech
Morton Grove
Pharmaceutical Associates
Barr
Circa
Geneva
Halsey
IVAX
IVAX
Mutual
Mylan
Par
Roxane
Superpharm
Teva
DRUG
DOSAGE FORM, STRENGTH
THIORIDAZINE HYDROCHLORIDE (continued)
tablet, oral 100mg
tablet, oral 10,15,25,50,100,
150,200mg
@ tablet, oral 10,15,25,50mg
Brand(s)
Intensol
concentrate, oral 30,100mg/ml
Mellaril
@ concentrate, oral 30,100mg/ml
Mellaril
@ tablet, oral 10,15,25,50,100,
150,200mg
APPLICATION HOLDER,
MANUFACTURER
Teva
Watson
West-ward
Roxane
Novartis
Novartis *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
THIOTEPA
Thiotepa
Brand(s)
Thioplex
THIOTHIXENE
Thiothixene
Brand(s)
Navane
THIOTHIXENE HYDROCHLORIDE
Thiothixene Hydrochloride
Brand(s)
Intensol
Navane
TICLOPIDINE HYDROCHLORIDE
Ticlopidine Hydrochloride
Ticlid
Brand(s)
TIMOLOL MALEATE
Timolol Maleate
(continued on the next page)
injection 15mg/vial
Bedford
injection 15mg/vial
Immunex
@ capsule, oral 1,2,5,10,20mg
capsule, oral 1,2,5,10mg
capsule, oral 1,2,5,10mg
capsule, oral 1,2,5,10mg
capsule, oral 1,2,5,10,20mg
American Therapeutics
Geneva
Mylan
Watson
Roerig/Pfizer
@ concentrate, oral eq 5mg base/ml
concentrate, oral eq 5mg base/ml
@ concentrate, oral eq 5mg base/ml
@ concentrate, oral eq 5mg base/ml
Alpharma
Copley
Paco
Teva
@ concentrate, oral eq 5mg base/ml
concentrate, oral eq 5mg base/ml
Roxane
Roerig/Pfizer
tablet, oral 250mg
tablet, oral 250mg
tablet, oral 250mg
tablet, oral 250mg
tablet, oral 250mg
tablet, oral 250mg
tablet, oral 250mg
tablet, oral 250mg
tablet, oral 250mg
Caraco
Eon
Geneva
GenPharm
Mylan
Purepac
Teva
TorPharm
Watson
tablet, oral 250mg
Roche
solution, ophthalmic
eq 0.25,0.5% base
solution, ophthalmic
eq 0.25,0.5% base
@ solution, ophthalmic
eq 0.25,0.5% base
Akorn
198
Bausch and Lomb
Falcon *
DRUG
DOSAGE FORM, STRENGTH
TIMOLOL MALEATE (continued)
@
@
@
@
Brand(s)
Timoptic
Timoptic-XE
Blocadren
solution, ophthalmic
eq 0.25,0.5% base
solution, ophthalmic
eq 0.25,0.5% base
solution, ophthalmic
eq 0.25,0.5% base
solution, gel forming drops, ophthalmic
eq 0.25,0.5% base
tablet, oral 5,10,20mg
tablet, oral 5,10,20mg
tablet, oral 5,10,20mg
tablet, oral 5,10,20mg
tablet, oral 5,10,20mg
tablet, oral 5,10,20mg
tablet, oral 5,10,20mg
APPLICATION HOLDER,
MANUFACTURER
Fougera/Altana
Novex
Pacific
Falcon *
Circa
Geneva
Mylan
Quantum
Teva
USL
Watson
solution, ophthalmic
Merck
eq 0.25,0.5% base
solution, gel forming drops, ophthalmic Merck
eq 0.25,0.5% base
tablet, oral 5,10,20mg
Merck *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
TIZANIDINE HYDROCHLORIDE
Tizanidine Hydrochloride
Brand(s)
Zanaflex
TOBRAMYCIN
Tobramycin
Brand(s)
AKtob
Tobrex
tablet, oral eq 2,4mg base
tablet, oral eq 2,4mg base
tablet, oral eq 2,4mg base
tablet, oral eq 2,4mg base
tablet, oral eq 2,4mg base
tablet, oral eq 2,4mg base
tablet, oral eq 2,4mg base
Barr
CorePharma
Dr. Reddy
Eon
Mylan
Purepac
Teva
tablet, oral eq 2,4mg base
Élan
@ solution, ophthalmic 0.3%
solution, ophthalmic 0.3%
solution, ophthalmic 0.3%
@ solution, ophthalmic 0.3%
solution, ophthalmic 0.3%
solution, ophthalmic 0.3%
Alcon Universal
Bausch and Lomb
Novex
Steris
Akorn
Falcon *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
TOBRAMYCIN; DEXAMETHASONE
See DEXAMETHASONE; TOBRAMYCIN
TOBRAMYCIN SULFATE
Tobramycin Sulfate
(continued on the next page)
injection eq 10,40mg base/ml
injection eq 10,40mg base/ml
@ injection eq 10,40mg base/ml
@ injection eq 10,40mg base/ml
199
Abbott
Apothecon
AstraZeneca
Elkins-Sinn
DRUG
TOBRAMYCIN SULFATE (continued)
Brand(s)
Nebcin
TOLAZAMIDE
Tolazamide
Brand(s)
Tolinase
TOLBUTAMIDE
Tolbutamide
DOSAGE FORM, STRENGTH
injection eq 40mg base/ml
@ injection eq 10mg base/ml
injection eq 40mg base/ml
injection eq 10,40mg base/ml
injection eq 10,40mg base/ml
@ tablet, oral 100,250,500mg
@ tablet, oral 100,250,500mg
@ tablet, oral 100,250,500mg
tablet, oral 100,250,500mg
@ tablet, oral 250,500mg
tablet, oral 100,250,500mg
tablet, oral 100,250,500mg
tablet, oral 250,500mg
tablet, oral 100,250,500mg
@ tablet, oral 250,500mg
@ tablet, oral 250,500mg
tablet, oral 100,250,500mg
@
@
@
@
@
@
@
@
Brand(s)
Orinase
TOLMETIN SODIUM
Tolmetin Sodium
APPLICATION HOLDER,
MANUFACTURER
Gensia Sicor
Lederle
Lederle
Marsam
Dista/Lilly
Barr
Circa
Duramed/Barr
Geneva
Interpharm
IVAX
Mutual
Mylan
Par
Superpharm
USL
Watson
tablet, oral 100,250,500mg
Pharmacia & Upjohn
tablet, oral 500mg
tablet, oral 500mg
tablet, oral 250,500mg
tablet, oral 500mg
tablet, oral 500mg
tablet, oral 500mg
tablet, oral 500mg
tablet, oral 500mg
tablet, oral 500mg
tablet, oral 500mg
tablet, oral 500mg
tablet, oral 500mg
tablet, oral 500mg
(Ascot)
Barr
Circa
Eon
Geneva
IVAX
Lederle
Mylan
Pfizer
Purepac
Superpharm
(Vangard/MWM)
Watson
@ tablet, oral 250,500mg
Pharmacia & Upjohn
@ capsule, oral eq 400mg base
capsule, oral eq 400mg base
capsule, oral eq 400mg base
capsule, oral eq 400mg base
capsule, oral eq 400mg base
capsule, oral eq 400mg base
tablet, oral eq 200,600mg base
tablet, oral eq 600mg base
tablet, oral eq 200mg base
tablet, oral eq 600mg base
tablet, oral eq 600mg base
@ tablet, oral eq 600mg base
Geneva
IVAX
Mutual
Mylan
Purepac
Teva
Geneva
IVAX
Mutual
Mylan
Purepac
Teva
(continued on the next page)
200
DRUG
DOSAGE FORM, STRENGTH
TOLMETIN SODIUM (continued)
Brand(s)
Tolectin D.S.
Tolectin
Tolectin 600
capsule, oral eq 400mg base
tablet, oral eq 200mg base
tablet, oral eq 600mg base
APPLICATION HOLDER,
MANUFACTURER
Ortho-McNeil *
Ortho-McNeil *
Ortho-McNeil *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
TORSEMIDE
Torsemide
Brand(s)
Demadex
TRAMADOL
Tramadol
Ultram
Brand(s)
TRAZODONE HYDROCHLORIDE
Trazodone Hydrochloride
Brand(s)
Desyrel
Trialodine
tablet, oral 5,10,20,100mg
tablet, oral 5,10,20,100mg
Par
Teva
tablet, oral 5,10,20,100mg
Roche
tablet, oral 50mg
tablet, oral 50mg
tablet, oral 50mg
tablet, oral 50mg
tablet, oral 50mg
tablet, oral 50mg
tablet, oral 50mg
tablet, oral 50mg
tablet, oral 50mg
tablet, oral 50mg
tablet, oral 50mg
tablet, oral 50mg
Alphapharm
Caraco
CorePharma
Eon
IVAX
Mallinckrodt
Mutual
Mylan
Purepac
Sidmak
Teva
Watson
tablet, oral 50mg
Ortho-McNeil
@ tablet, oral 50,100mg
tablet, oral 50,100,150,300mg
@ tablet, oral 50,100mg
tablet, oral 50,100mg
tablet, oral 50,100,150mg
tablet, oral 50,100mg
tablet, oral 50,100mg
@ tablet, oral 100mg
tablet, oral 50,100,150mg
tablet, oral 50,100,150mg
@ tablet, oral 50,100mg
tablet, oral 50,100mg
American Therapeutics
Barr
Circa
Geneva
Mutual
Mylan
Purepac
Quantum
Sidmak *
Teva
USL
Watson
tablet, oral 50,100,150,300mg
@ tablet, oral 50mg
Apothecon **
Quantum
*Some manufacturers’ 150mg tablet cannot be broken into three 50mg segments. Prescribers and
pharmacists should be aware of this difference and take it into account when writing a prescription or
practicing drug product selection.
** Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
201
DRUG
DOSAGE FORM, STRENGTH
TRETINOIN
Tretinoin
Brand(s)
Retin-A
Avita
Retin-A
Retin-A
APPLICATION HOLDER,
MANUFACTURER
cream, topical 0.025,0.5,1%
gel, topical 0.025%
solution, topical 0.05%
solution, topical 0.05%
Spear
Spear
Copley
Morton Grove
cream, topical 0.025,0.5,1%
cream, topical 0.025%
gel, topical 0.025%
solution, topical 0.05%
Johnson & Johnson
Bertek *
Johnson & Johnson
Johnson & Johnson
** Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
TRIAMCINOLONE ACETONIDE
Triamcinolone Acetonide
@
@
@
@
@
@
@
@
@
Brand(s)
Aristocort
Flutex
Kenac
Kenalog
Triacet
Triacort
Triatex
Triderm
Trymex
Trymex
Aristocort A
Kenalog-H
Kenalog
Aristocort
Aristocort
Flutex
Kenac
Kenalog
Kenalog
Trymex
Aristocort A
Aristocort A
Kenalog in Orabase
Oracort
Oralone
cream, topical 0.025,0.1,0.5%
cream, topical 0.025%
cream, topical 0.025,0.1,0.5%
cream, topical 0.025,0.1%
cream, topical 0.025,0.1,0.5%
cream, topical 0.025,0.1,0.5%
cream, topical 0.025,0.1,0.5%
cream, topical 0.025,0.1,0.5%
cream, topical 0.025,0.1,0.5%
lotion, topical 0.025,0.1%
lotion, topical 0.025,0.1%
lotion, topical 0.1%
ointment, topical 0.5%
ointment, topical 0.025,0.1,0.5%
ointment, topical 0.025,0.1,0.5%
ointment, topical 0.025,0.1%
ointment, topical 0.025,0.1,0.5%
ointment, topical 0.025,0.1%
ointment, topical 0.025,0.1,0.5%
cream, topical 0.025,0.1,0.5%
@ cream, topical 0.025,0.1,0.5%
@ cream, topical 0.025,0.1%
cream, topical 0.025,0.1,0.5%
cream, topical 0.025,0.1,0.5%
@ cream, topical 0.1%
@ cream, topical 0.025,0.1,0.5%
cream, topical 0.1%
cream, topical 0.025,0.1%
@ cream, topical 0.5%
cream, hydrophilic 0.025,0.1,0.5%
@ cream, hydrophilic 0.1%
lotion, topical 0.025,0.1%
ointment, topical 0.1%
@ ointment, topical 0.5%
@ ointment, topical 0.025,0.1,0.5%
ointment, topical 0.1%
ointment, topical 0.025,0.1%
@ ointment, topical 0.5%
ointment, topical 0.025,0.1%
ointment, hydrophilic 0.1%
@ ointment, hydrophilic 0.5%
paste, dental 0.1%
paste, dental 0.1%
paste, dental 0.1%
202
Altana
Ambix
Clay-Park
G and W
Morton Grove
Pharmaderm/Altana
Pharmafair
Taro
Topiderm
Alpharma
Morton Grove
Taro
Alpharma
Altana
Clay-Park
G&W
Morton Grove
Pharmaderm/Altana
Taro
Fujisawa
IVAX
Alpharma
Apothecon
Teva
Solvay
IVAX
Del-Ray
Altana/Savage
Altana/Savage
Fujisawa
Apothecon
Apothecon
Fujisawa
Fujisawa
IVAX
Alpharma
Apothecon
Apothecon
Savage/Altana
Fujisawa
Fujisawa
Apothecon
Taro
Taro
DRUG
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
TRIAMCINOLONE ACETONIDE; NEOMYCIN SULFATE
See NEOMYCIN SULFATE; TRIAMCINOLONE ACETONIDE
TRIAMCINOLONE ACETONIDE; NYSTATIN
See NYSTATIN; TRIAMCINOLONE ACETONIDE
TRIAMTERENE; HYDROCHLOROTHIAZIDE
See HYDROCHLOROTHIAZIDE; TRIAMTERENE
TRIAZOLAM
Triazolam
Brand(s)
Halcion
tablet, oral 0.125,0.25mg
tablet, oral 0.125,0.25mg
tablet, oral 0.125,0.25mg
Alphapharm
Roxane
Watson
tablet, oral 0.125,0.25mg
Pharmacia & Upjohn *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
TRIFLUOPERAZINE HYDROCHLORIDE
Trifluoperazine Hydrochloride
@ concentrate, oral eq 10mg base/ml
@ injection eq 2mg base/ml
@ tablet, oral eq 1,2,5,10mg base
@ tablet, oral eq 1,2,5,10mg base
tablet, oral eq 1,2,5,10mg base
@ tablet, oral eq 1,2,5,10mg base
tablet, oral eq 1,2,5,10mg base
Brand(s)
Stelazine
concentrate, oral eq 10mg base/ml
TFP
@ concentrate, oral eq 10mg base/ml
Stelazine
injection eq 2mg base/ml
Stelazine
tablet, oral eq 1,2,5,10mg base
TFP
tablet, oral eq 1,2,5,10mg base
TRIFLURIDINE
Trifluridine
Brand(s)
Viroptic
Morton Grove
Quad
Circa
Duramed/Barr
Geneva
IVAX
Mylan
GlaxoSmithKline
Geneva
GlaxoSmithKline
GlaxoSmithKline Beecham
Geneva
solution, ophthalmic 1%
Alcon
solution, ophthalmic 1%
Monarch
TRIHEXYPHENIDYL HYDROCHLORIDE
Trihexyphenidyl Hydrochloride
elixir, oral 2mg/5ml
elixir, oral 2mg/5ml
elixir, oral 2mg/5ml
@ tablet, oral 2,5mg
tablet, oral 5mg
@ tablet, oral 2mg
tablet, oral 2,5mg
tablet, oral 2,5mg
tablet, oral 2,5mg
Brand(s)
Artane
elixir, oral 2mg/5ml
Artane
tablet, oral 2,5mg
Tremin
@ tablet, oral 2,5mg
Mikart
Pharm Ventures
Pharmaceutical Associates
Circa
Nylos
(Vangard/MWM)
Vintage
Watson
West-ward
Lederle *
Lederle
Schering
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
203
DRUG
DOSAGE FORM, STRENGTH
TRIMEPRAZINE TARTRATE
Trimeprazine Tartrate
Brand(s)
Temaril
@ syrup, oral 2.5mg/5ml
@ syrup, oral 2.5mg/5ml
Alpharma
Morton Grove
@ syrup, oral 2.5mg/5ml
Allergan Herbert
TRIMETHOBENZAMIDE HYDROCHLORIDE
Trimethobenzamide Hydrochloride injection 100mg/ml
@ injection 100mg/ml
@ injection 100mg/ml
@ injection 100mg/ml
Brand(s)
Tigan
injection 100mg/ml
TRIMETHOPRIM
Trimethoprim
Brand(s)
Proloprim
Trimpex
APPLICATION HOLDER,
MANUFACTURER
Abbott
Smith and Nephew
Solopak
Steris
King
@ tablet, oral 100,200mg
tablet, oral 100,200mg
tablet, oral 100mg
Barr
Teva
Watson
tablet, oral 100,200mg
@ tablet, oral 100,200mg
Monarch
Roche
TRIMETHOPRIM; SULFAMETHOXAZOLE
See SULFAMETHOXAZOLE; TRIMETHOPRIM
TRIMETHOPRIM SULFATE; POLYMYXIN B SULFATE
See POLYMYXIN B SULFATE; TRIMETHOPRIM SULFATE
TRIPELENNAMINE HYDROCHLORIDE
Tripelennamine Hydrochloride
@
@
@
@
@
PBZ
Brand(s)
TRIPROLIDINE HYDROCHLORIDE
Triprolidine Hydrochloride
Actidil
Myidyl
Actidil
Brand(s)
tablet, oral 50mg
tablet, oral 50mg
tablet, oral 50mg
tablet, oral 50mg
tablet, oral 50mg
tablet, oral 50mg
@ tablet, oral 50mg
tablet, oral 50mg
tablet, oral 50mg
Anabolic
Barr
Circa
Heather
Impax
Lannett
Pfizer
Nylos
Watson
tablet, oral 50mg
Novartis
syrup, oral 1.25mg/5ml
syrup, oral 1.25mg/5ml
syrup, oral 1.25mg/5ml
tablet, oral 2.5mg
tablet, oral 2.5mg
Alpharma
Halsey
Pharmaceutical Associates
Eon
Watson
@
@
@
@
@
@ syrup, oral 1.25mg/5ml
@ syrup, oral 1.25mg/5ml
@ tablet, oral 2.5mg
GlaxoSmithKline
USL
GlaxoSmithKline
TRIPROLIDINE HYDROCHLORIDE; CODEINE PHOSPHATE; PSEUDOEPHEDRINE HYDROCHLORIDE
See CODEINE PHOSPHATE; PSEUDOEPHEDRINE HYDROCHLORIDE; TRIPROLIDINE
HYDROCHLORIDE
204
DRUG
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
TRIPROLIDINE HYDROCHLORIDE; PSEUDOEPHEDRINE HYDROCHLORIDE
See PSEUDOEPHEDRINE HYDROCHLORIDE; TRIPROLIDINE HYDROCHLORIDE
TRISULFAPYRIMIDINE (SULFADIAZINE, SULFAMETHAZINE AND SULFAMERAZINE)
Brand(s)
Lantrisul
@ suspension, oral 167mg/5ml;
Lannett
167mg/5ml;167mg/5ml (501mg/5ml)
Neotrizine
@ suspension, oral 167mg/5ml;
Lilly
167mg/5ml;167mg/5ml (501mg/5ml)
Sulfaloid
@ suspension, oral 167mg/5ml;
Forest
167mg/5ml;167mg/5ml (501mg/5ml)
Sulfose
@ suspension, oral 167mg/5ml;
Wyeth-Ayerst
167mg/5ml;167mg/5ml (501mg/5ml)
Terfonyl
@ suspension, oral 167mg/5ml;
Squibb
167mg/5ml;167mg/5ml (501mg/5ml)
Triple Sulfa
@ suspension, oral 167mg/5ml;
Alpharma
167mg/5ml;167mg/5ml (501mg/5ml)
Triple Sulfas
@ suspension, oral 167mg/5ml;
Lederle
167mg/5ml;167mg/5ml (501mg/5ml)
Neotrizine
@ tablet, oral 167mg;167mg;167mg
Lilly
(501mg)
Sulfa-Triple #2
@ tablet, oral 167mg;167mg;167mg
Impax
(501mg)
Sulfaloid
@ tablet, oral 167mg;167mg;167mg
Forest
(501mg)
Sulfose
@ tablet, oral 167mg;167mg;167mg
Wyeth-Ayerst
(501mg)
Terfonyl
@ tablet, oral 167mg;167mg;167mg
Squibb
(501mg)
Triple Sulfa
@ tablet, oral 167mg;167mg;167mg
Purepac
(501mg)
Triple Sulfas
@ tablet, oral 167mg;167mg;167mg
Lederle
(501mg)
Triple Sulfoid
tablet, oral 167mg;167mg;167mg
Pal Pak
(501mg)
TROPICAMIDE
Tropicamide
Brand(s)
Mydriacil
Mydriafair
Tropicacyl
TUBOCURARINE CHLORIDE
Tubocurarine Chloride
@ solution, ophthalmic 0.5%
solution, ophthalmic 1%
solution, ophthalmic 0.5,1%
solution, ophthalmic 0.5,1%
Alcon Universal
Alcon Universal
Bausch and Lomb
Miza
solution, ophthalmic 0.5,1%
@ solution, ophthalmic 0.5,1%
solution, ophthalmic 0.5,1%
Alcon
Pharmafair
Akorn
injection 3mg/ml
injection 3mg/ml
@ injection 3mg/ml
Abbott
Bristol-Myers Squibb
Lilly
UREA; HYDROCORTISONE
See HYDROCORTISONE; UREA
UREA; HYDROCORTISONE ACETATE
See HYDROCORTISONE ACETATE; UREA
205
DRUG
URSODIOL
Ursodiol
Brand(s)
Actigall
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
capsule, oral 300mg
capsule, oral 300mg
Amide
Copley
capsule, oral 300mg
Watson *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
VALPROIC ACID
Valproic Acid
Brand(s)
Depakene
Depakene
Myproic Acid
VANCOMYCIN HYDROCHLORIDE
Vancomycin Hydrochloride
Brand(s)
Lyphocin
Vancocin
Vancoled
Vancor
Vancocin
Vancoled
VECURONIUM BROMIDE
Vecuronium Bromide
Brand(s)
Norcuron
VERAPAMIL HYDROCHLORIDE
Verapamil Hydrochloride
(continued on the next page)
capsule, oral 250mg
@ capsule, oral 250mg
capsule, oral 250mg
capsule, oral 250mg
syrup, oral 250mg/5ml
syrup, oral 250mg/5ml
syrup, oral 250mg/5ml
syrup, oral 250mg/5ml
capsule, oral 250mg
syrup, oral 250mg/5ml
syrup, oral 250mg/5ml
injection eq 500mg,1,5gm base/vial
@ injection eq 500mg,1gm base/vial
@ injection eq 500mg,1gm base/vial
Banner Pharmacaps
Par
Scherer
USL
Copley
Hi-Tech
Pharmaceutical Associates
UDL
Abbott
Abbott
Morton Grove
Abbott
Elkins-Sinn
Quad
injection eq 500mg,1,5,10gm base/vial American Pharmaceutical
Partners
injection eq 500mg,1,10gm base/vial
Lilly
injection eq 500mg,1,5,10gm base/vial Lederle
@ injection eq 500mg,1gm base/vial
Pharmacia & Upjohn
powder for reconstitution, oral
Lilly
eq 250mg base/5ml
eq 500mg base/6ml
powder for reconstitution, oral
Lederle
eq 250mg base/5ml
@ eq 500mg base/6ml
injection 10,20mg/vial
injection 10,20mg/vial
injection 10,20mg/vial
injection 10,20mg/vial
injection 10,20mg/vial
Abbott
Bedford
ESI/Lederle
Gensia Sicor
Steris
injection 10,20mg/vial
Organon
capsule, extended release
120,180,240mg
injection 2.5mg/ml
@ injection 2.5mg/ml
injection 2.5mg/ml
injection 2.5mg/ml
206
Mylan
Abbott
American Pharmaceutical
Partners
Bedford
International Medication
DRUG
DOSAGE FORM, STRENGTH
VERAPAMIL HYDROCHLORIDE (continued)
injection 2.5mg/ml
@ injection 2.5mg/ml
@ injection 2.5mg/ml
@ injection 2.5mg/ml
@ injection 2.5mg/ml
@ tablet, oral 80,120mg
tablet, oral 40,80,120mg
tablet, oral 80,120mg
tablet, oral 80,120mg
tablet, oral 80,120mg
tablet, oral 80,120mg
tablet, oral 40,80,120mg
@ tablet, oral 80,120mg
tablet, oral 40,80,120mg
@ tablet, extended release 120,240mg
tablet, extended release
120,180,240mg
tablet, extended release
120,180,240mg
tablet, extended release 240mg
Brand(s)
Verelan
capsule, extended release
120,180,240mg
Calan
@ injection 2.5mg/ml
Isoptin
injection 2.5mg/ml
Calan
tablet, oral 40,80,120mg
Isoptin
tablet, oral 40,80,120mg
Isoptin SR
tablet, extended release
120,180,240mg
APPLICATION HOLDER,
MANUFACTURER
Luitpold
Marsam
Quad
Smith and Nephew
Solopak
Barr
Geneva
Lederle
Mutual
Mylan
Purepac
Sidmak
Warner Chilcott
Watson
Barr
IVAX
Mylan
Sidmak
Elan *
Searle
Abbott
Searle
Abbott
Abbott *
* Products manufactured by this brand name manufacturer in this drug entity are available for drug product
selection under other brand and/or generic names.
VINBLASTINE SULFATE
Vinblastine Sulfate
injection 1mg/ml
injection 10mg/vial
injection 10mg/vial
@ injection 10mg/vial
American Pharmaceutical
Partners
Quad
American Pharmaceutical
Partners
Bedford
Faulding
Quad
@ injection 10mg/vial
Lilly
@ injection 1mg/ml
@ injection 1mg/ml
@ injection 1mg/ml
injection 1,2,5mg/vial
@ injection 1,2,5mg/vial
ABIC
American Pharmaceutical
Partners
Quad
Faulding
Quad
injection 1mg/ml
@ injection 1,5mg/vial
injection 1mg/ml
@ injection 5mg/vial
Lilly
Lilly
Pharmacia & Upjohn
Bristol-Myers Squibb
@ injection 1mg/ml
@ injection 10mg/vial
Brand(s)
Velban
VINCRISTINE SULFATE
Vincristine Sulfate
Brand(s)
Oncovin
Oncovin
Vincasar PFS
Vincrex
(continued on the next page)
207
DRUG
DOSAGE FORM, STRENGTH
VINCRISTINE SULFATE (continued)
Vincristine Sulfate
Preservative-Free
Vincristine Sulfate
Preservative-Free
VITAMIN A (50,000 USP Units = 15mg)
Vitamin A
@
@
@
@
Brand(s)
Aquasol A
APPLICATION HOLDER,
MANUFACTURER
injection 1mg/ml
Faulding
injection 1mg/ml
Gensia Sicor
capsule, oral 50,000 USP Units
capsule, oral 50,000 USP Units
capsule, oral 50,000 USP Units
capsule, oral 50,000 USP Units
capsule, oral 50,000 USP Units
Banner Pharmacaps
Chase
Everylife
Impax
West-ward
@ capsule, oral 50,000 USP Units
AstraZeneca
VITAMIN A; ASCORBIC ACID; BIOTIN; CYANOCOBALAMIN; DEXPANTHENOL; ERGOCALCIFEROL; FOLIC
ACID; NIACINAMIDE; PYRIDOXINE HYDROCHLORIDE; RIBOFLAVIN PHOSPHATE SODIUM; THIAMINE
HYDROCHLORIDE; VITAMIN E
See ASCORBIC ACID; BIOTIN; CYANOCOBALAMIN; DEXPANTHENOL; ERGOCALCIFEROL; FOLIC
ACID; NIACINAMIDE; PYRIDOXINE HYDROCHLORIDE; RIBOFLAVIN PHOSPHATE SODIUM;
THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN E
VITAMIN A; ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; IRON; NICOTINIC ACID; PYRIDOXINE
HYDROCHLORIDE; RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN D; VITAMIN E
See ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; IRON; NICOTINIC ACID; PYRIDOXINE
HYDROCHLORIDE; RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D;
VITAMIN E
VITAMIN A; ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; NICOTINIC ACID; PYRIDOXINE
HYDROCHLORIDE; RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN D; VITAMIN E
See ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; NICOTINIC ACID; PYRIDOXINE
HYDROCHLORIDE; RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D;
VITAMIN E
VITAMIN A; ASCORBIC ACID; FLUORIDE; IRON; VITAMIN D
See ASCORBIC ACID; FLUORIDE; IRON; VITAMIN A; VITAMIN D
VITAMIN A; ASCORBIC ACID; FLUORIDE; VITAMIN D
See ASCORBIC ACID; FLUORIDE; VITAMIN A; VITAMIN D
VITAMIN A PALMITATE (50,000 Units base = 15mg)
Vitamin A Palmitate
capsule, oral 50,000 Units base
@ capsule, oral 50,000 Units base
@ capsule, oral 50,000 Units base
@ capsule, oral 50,000 Units base
@ capsule, oral 50,000 Units base
@ capsule, oral 50,000 Units base
@ capsule, oral 50,000 Units base
capsule, oral 50,000 Units base
@ capsule, oral 50,000 Units base
@ capsule, oral 50,000 Units base
@ capsule, oral 50,000 Units base
@ capsule, oral 50,000 Units base
@ injection 50,000 Units base/ml
(continued on the next page)
208
Arcum
Banner Pharmacaps
Chase
Elkins-Sinn
Everylife
Impax
IVAX
MK
Squibb
Teva
West-ward
Wharton
Bel-Mar
DRUG
DOSAGE FORM, STRENGTH
VITAMIN A PALMITATE (50,000 Units base = 15mg) (continued)
Brand(s)
Afaxin
@ capsule, oral 50,000 Units base
Alphalin
@ capsule, oral 50,000 Units base
Del-Vi-A
@ capsule, oral 50,000 Units base
Vi-Dom-A
@ capsule, oral 50,000 Units base
Aquasol A
@ injection 50,000 Units base/ml
APPLICATION HOLDER,
MANUFACTURER
Sterling Winthrop
Lilly
Del-Ray
Bayer
AstraZeneca
VITAMIN D; ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; IRON; NICOTINIC ACID; PYRIDOXINE
HYDROCHLORIDE; RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN E
See ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; IRON; NICOTINIC ACID; PYRIDOXINE
HYDROCHLORIDE; RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D;
VITAMIN E
VITAMIN D; ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; NICOTINIC ACID; PYRIDOXINE
HYDROCHLORIDE; RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN E
See ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; NICOTINIC ACID; PYRIDOXINE
HYDROCHLORIDE; RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D;
VITAMIN E
VITAMIN D; ASCORBIC ACID; FLUORIDE; IRON; VITAMIN A
See ASCORBIC ACID; FLUORIDE; IRON; VITAMIN A; VITAMIN D
VITAMIN D; ASCORBIC ACID; FLUORIDE; VITAMIN A
See ASCORBIC ACID; FLUORIDE; VITAMIN A; VITAMIN D
VITAMIN E; ASCORBIC ACID; BIOTIN; CYANOCOBALAMIN; DEXPANTHENOL; ERGOCALCIFEROL; FOLIC
ACID; NIACINAMIDE; PYRIDOXINE HYDROCHLORIDE; RIBOFLAVIN PHOSPHATE SODIUM; THIAMINE
HYDROCHLORIDE; VITAMIN A
See ASCORBIC ACID; BIOTIN; CYANOCOBALAMIN; DEXPANTHENOL; ERGOCALCIFEROL; FOLIC
ACID; NIACINAMIDE; PYRIDOXINE HYDROCHLORIDE; RIBOFLAVIN PHOSPHATE SODIUM;
THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN E
VITAMIN E; ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; IRON; NICOTINIC ACID; PYRIDOXINE
HYDROCHLORIDE; RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D
See ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; IRON; NICOTINIC ACID; PYRIDOXINE
HYDROCHLORIDE; RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D;
VITAMIN E
VITAMIN E; ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; NICOTINIC ACID; PYRIDOXINE
HYDROCHLORIDE; RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D
See ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; NICOTINIC ACID; PYRIDOXINE
HYDROCHLORIDE; RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D;
VITAMIN E
209
DRUG
WARFARIN SODIUM
Warfarin Sodium
Brand(s)
Coumadin
DOSAGE FORM, STRENGTH
APPLICATION HOLDER,
MANUFACTURER
tablet, oral 1,2,2.5,3,4,5,6,7.5,10mg
tablet, oral 1,2,2.5,3,4,5,6,7.5,10mg
tablet, oral 1,2,2.5,4,5,7.5,10mg
Barr
Geneva
Taro
tablet, oral 1,2,2.5,3,4,5,6,7.5,10mg
Bristol-Myers Squibb
NOTE: Within 24 hours of any interchange of a patient’s warfarin sodium prescription, whether from a
brand name manufacturer to a generic manufacturer, generic manufacturer to a brand name manufacturer,
or generic manufacturer to a different generic manufacturer, the pharmacist must notify the prescriber of
the interchange, identifying to the prescriber the name of the manufacturer of the warfarin sodium tablets
dispensed to the patient.
WATER FOR INJECTION, STERILE
Sterile water in plastic container
Water
injection 100%
injection 100%
injection 100%
injection 100%
Abbott
American Pharmaceutical
Partners
Baxter
Braun
WATER FOR IRRIGATION, STERILE
Sterile water in plastic container
Water
liquid 100%
liquid 100%
liquid 100%
@ liquid 100%
Abbott
Baxter
Braun
Miles
XYLOSE
Xylose
@ powder, oral 25gm/bottle
Lyne
@ powder, oral 25gm/bottle
Savage
Brand(s)
Xylo-Pfan
210
ILLINOIS FORMULARY
TWENTY-FIRST EDITION
DRUG PRODUCT SELECTION PROGRAM
ALPHABETICAL INDEX
NOTE: Not all dosage forms and/or strengths of the drug products listed in this index may actually appear in the text. Always
refer to the drug's specific page in the text to be sure that an approved, generically and pharmaceutically equivalent product is
being dispensed.
Page
Page
A.P.L.
104
A/T/S
85
A-Hydrocort
117
A-Methapred
143
A-Poxide
45
A/B Otic Drops
17
Abitrexate
141
Accurbron
196
Accutane
128
ACEBUTOLOL HYDROCHLORIDE
1
ACETAMINOPHEN; BUTALBITAL
1
ACETAMINOPHEN; BUTALBITAL; CAFFEINE
1
ACETAMINOPHEN: BUTALBITAL: CAFFEINE;
1
CODEINE PHOSPHATE
ACETAMINOPHEN; CAFFEINE;
2
DIHYDROCODEINE BITARTRATE
ACETAMINOPHEN; CODEINE PHOSPHATE
2
ACETAMINOPHEN; HYDROCODONE
3,4
BITARTRATE
ACETAMINOPHEN; OXYCODONE
4
HYDROCHLORIDE
ACETAMINOPHEN; PENTAZOCINE
4
HYDROCHLORIDE
ACETAMINOPHEN; PROPOXYPHENE
4
HYDROCHLORIDE
ACETAMINOPHEN; PROPOXYPHENE
5
NAPSYLATE
Acetasol
5
Acetasol HC
6
ACETAZOLAMIDE
5
ACETAZOLAMIDE SODIUM
5
ACETIC ACID, GLACIAL
5
ACETIC ACID, GLACIAL; ALUMINUM ACETATE
6
ACETIC ACID, GLACIAL; HYDROCORTISONE
6
ACETOHEXAMIDE
6
ACETYLCYSTEINE
6
Achromycin
176,195
Achromycin V
195
Acilac
128
Actahist
180
Actigall
206
ACTH
Acthar
Acticort
Actidil
Actifed w/Codeine
Actin-H
ACYCLOVIR
ACYCLOVIR SODIUM
Adalat
Adalat CC
Adapin
Adderall 5
Adderall 10
Adderall 15
Adderall 20
Adipex-P
Adphen
Adrenalin Chloride
Adriamycin PFS
Adriamycin RDF
Adrucil
Adsorbocarpine
Aerolone
Aerosporin
Afaxin
AK-Chlor
AK-Con
AK-Con A
AK-Dex
AK-Dilate
AK-Gentak
AK-Homatropine
AK-Pentolate
AK-Pred
AK-Sulf
AKbeta
AKarpine
AKpro
AKtob
Ala-Cort
Albalon
211
58
58
115
204
58
153
6,7
7
153
153
80
15
15
15
15
164
163
83
80
80
96
166
125
168
209
45
149
150
64
164
101
108
60
174
190
129
166
78
199
115
149
Page
Albalon A
ALBUTEROL
ALBUTEROL SULFATE
Alcaine
ALCOHOL; DEXTROSE
ALCOHOL; MORPHINE
Aldactazide
Aldactone
Aldochlor 150
Aldochlor 250
Aldomet
Aldoril 15
Aldoril 25
Aldoril D30
Aldoril D50
Alesse
Alfenta
ALFENTANIL HYDROCHLORIDE
Alkergot
Allay
Allerfed
ALLOPURINOL
Alpha Redisol
Alphacaine
Alphacaine HCl w/Epinephrine
Alphaderm
Alphalin
Alphatrex
Alphazine
ALPRAZOLAM
ALPROSTADIL
Alupent
AMANTADINE HYDROCHLORIDE
Ambenyl
Amcill
AMCINONIDE
Amicar
Amidate
AMIKACIN SULFATE
Amikin
AMILORIDE HYDROCHLORIDE
AMILORIDE HYDROCHLORIDE;
HYDROCHLOROTHIAZIDE
AMINOACETIC ACID
AMINOCAPROIC ACID
AMINOHIPPURATE SODIUM
Aminophyllin
AMINOPHYLLINE
AMIODARONE HYDROCHLORIDE
Amitid
Amitril
AMITRIPTYLINE HYDROCHLORIDE
Page
17
7
7,8
178
8
8,9
113
189
46
46
142,143
112
112
112
112
89
9
9
85
3
181
9
118
130
83,84
116
209
27
163
9
9
139
10
30
16
10
11
92
10
10
10
10
AMITRIPTYLINE HYDROCHLORIDE;
12
CHLORDIAZEPOXIDE
AMITRIPTYLINE HYDROCHLORIDE;
12,13
PERPHENAZINE
AMMONIUM LACTATE
13
Amnesteem
125
Amosene
138
AMOXAPINE
13
AMOXICILLIN/AMOXICILLIN TRIHYDRATE
13,14
AMOXICILLIN; CLAVULANATE POTASSIUM
14
Amoxil
14
AMPHETAMINE ASPARTAME; AMPHETAMINE
15
SULFATE; DEXTROAMPHETAMINE SACCHARATE;
DEXTROAMPHETAMINE SULFATE
Amphicol
45
AMPHOTERICIN B
15
AMPICILLIN/AMPICILLIN TRIHYDRATE;
15
PROBENECID
AMPICILLIN SODIUM
16,17
AMPICILLIN TRIHYDRATE
15,16
AMRINONE LACTATE
see INAMRINONE LACTATE
Anafranil
54
Anaprox
150
Anaprox DS
150
Ancef
42
Android 10
144
Android 25
144
Anectine
189
Anestacon
130
Anexsia
3
Anexsia 7.5/650
3
Anexsia 10/660
3
Anoquan
1
Ansaid
98
ANTAZOLINE PHOSPHATE;
17
NAPHAZOLINE HYDROCHLORIDE
ANTIPYRINE; BENZOCAINE
17
Anspor
44
Antepar
166
Antispasmodic Elixir
24
Antivert
135
Anturane
192
Anusol HC
115
Apogen
101
Apresazide
109
Apresoline
109
Apri
62
Aquaphyllin
196
Aquasol A
208,209
Aquatensen
142
Aralen
46
Aramine
139
103
11
11
11
11
11
12
12
11,12
212
Page
Page
Arestocaine HCl
136
Arestocaine HCl w/Levonordefrin
129
Aristocort
202
Aristocort A
202
Artane
203
Ascomp
20
ASCORBIC ACID; BIOTIN;
17,18
CYANOCOBALAMIN; DEXPANTHENOL;
ERGOCALCIFEROL; FOLIC ACID; NIACINAMIDE;
PYRIDOXINE HYDROCHLORIDE; RIBOFLAVIN
PHOSPHATE SODIUM; THIAMINE
HYDROCHLORIDE; VITAMIN A; VITAMIN E
ASCORBIC ACID; CYANOCOBALAMIN;
18
FLUORIDE; IRON; NICOTINIC ACID
PYRIDOXINE HYDROCHLORIDE;
RIBOFLAVIN; THIAMINE HYDROCHLORIDE;
VITAMIN A; VITAMIN D; VITAMIN E
ASCORBIC ACID; CYANOCOBALAMIN;
18
FLUORIDE; NICOTINIC ACID;
PYRIDOXINE HYDROCHLORIDE;
RIBOFLAVIN; THIAMINE HYDROCHLORIDE;
VITAMIN A; VITAMIN D; VITAMIN E
ASCORBIC ACID; FLUORIDE; IRON;
18,19
VITAMIN A; VITAMIN D
ASCORBIC ACID; FLUORIDE;
19
VITAMIN A; VITAMIN D
Asendin
13
ASPIRIN; BUTALBITAL; CAFFEINE;
19,20
ASPIRIN; BUTALBITAL; CAFFEINE;
20
CODEINE PHOSPHATE
ASPIRIN; CAFFEINE; ORPHENADRINE CITRATE
20
ASPIRIN; CAFFEINE;
20
PROPOXYPHENE HYDROCHLORIDE
ASPIRIN; CARISOPRODOL
20
ASPIRIN; CARISOPRODOL;
20
CODEINE PHOSPHATE
ASPIRIN; CODEINE PHOSPHATE
21
ASPIRIN; MEPROBAMATE
21
ASPIRIN; METHOCARBAMOL
21
ASPIRIN; OXYCODONE HYDROCHLORIDE;
21
OXYCODONE TEREPHTHALATE
Astramorph PF
147
Atarax
119
ATENOLOL
21
ATENOLOL; CHLORTHALIDONE
22
Ativan
133
ATRACURIUM BESYLATE
22
Atracurium Besylate Preservative-Free
22
Atromid-S
54
Atropair
22
Atropen
22
ATROPINE
22
Atropine Care
22
ATROPINE SULFATE
22,23
Atropine and Demerol
24
ATROPINE SULFATE; DIPHENOXYLATE
23
HYDROCHLORIDE
ATROPINE SULFATE; HYOSCYAMINE;
23,24
PHENOBARBITAL; SCOPOLAMINE
HYDROBROMIDE
ATROPINE SULFATE; MEPERIDINE
24
HYDROCHLORIDE
Atropine-1
22
Atropisol
22
Atrovent
123
Augmentin 200
14
Augmentin 400
14
Augmentin 500
14
Augmentin 875
14
Auralgan
17
Auroto Drops
17
AVC
192
Aventyl HCl
155
Aviane
89
Avita
202
Axid
154
Aygestin
155
AZATHIOPRINE
24
AZATHIOPRINE SODIUM
24
AZELAIC ACID
24
Azelex
24
Azulfidine
192
Baci-Rx
25
Baciguent
25
Baciim
25
BACITRACIN
24,25
BACITRACIN; HYDROCORTISONE ACETATE;
25
NEOMYCIN SULFATE; POLYMYXIN B SULFATE
BACITRACIN ZINC; HYDROCORTISONE;
25
NEOMYCIN SULFATE; POLYMYXIN B SULFATE
BACITRACIN ZINC; NEOMYCIN SULFATE;
25
POLYMYXIN B SULFATE
BACITRACIN ZINC; POLYMYXIN B SULFATE
25
BACLOFEN
25,26
Bactocill
157
Bactrim
191,192
Bactrim DS
192
Bactrim Pediatric
191
Balneol-HC
115
Banan
42
Bancap
1
Bancap HC
3
Barstatin 100
156
Beepen-VK
161
213
Page
Belix
Ben Aqua 5
Ben Aqua 10
Benadryl
Benadryl Preservative-Free
Benemid
Bentyl
Bentyl Preservative-Free
Benzac 5
Benzac 10
Benzac W 2.5
Benzac W 5
Benzac W 10
Benzac W Wash 5
Benzac W Wash 10
BENZONATATE
BENZOYL PEROXIDE
BENZTROPINE MESYLATE
Bepadin
BEPRIDIL HYDROCHLORIDE
Berubigen
Beta-2
Beta-HC
Beta-Val
Betaderm
Betagan
Betalin-S
Betalin 12
BETAMETHASONE DIPROPIONATE
BETAMETHASONE DIPROPIONATE,
AUGMENTED
BETAMETHASONE DIPROPIONATE;
CLOTRIMAZOLE
BETAMETHASONE SODIUM PHOSPHATE
BETAMETHASONE VALERATE
Betapace
Betapen-VK
Betatrex
BETAXOLOL HYDROCHLORIDE
BETHANECHOL CHLORIDE
Betoptic
Biocycline
Biphetap
BISOPROLOL FUMARATE
BISOPROLOL FUMARATE;
HYDROCHLOROTHIAZIDE
Blenoxane
BLEOMYCIN SULFATE
Bleph-10
Bleph-30
Blephamide
Blocadren
Page
77
26
26
77
77
175
74
74
26
26
26
26
26
26
26
26
26
26
27
27
59
124
115
28
28
129
197
59
27
27
Bontril PDM
163
Borofair
6
Brethine
194
BRETYLIUM TOSYLATE
29
BRETYLIUM TOSYLATE; DEXTROSE
29,30
Bretylol
29
Brevicon
90
Bricanyl
194
Bristacycline
195
Bristagen
101
Bristamycin
87
Bromanate
31
Bromanate DC
30
Bromanate DM
31
Bromanyl
30
Bromfed-DM
31
BROMOCRIPTINE MESYLATE
30
BROMODIPHENHYDRAMINE
30
HYDROCHLORIDE; CODEINE PHOSPHATE
BROMPHENIRAMINE MALEATE
30
BROMPHENIRAMINE MALEATE; CODEINE
30
PHOSPHATE; PHENYLPROPANOLAMINE
HYDROCHLORIDE
BROMPHENIRAMINE MALEATE;
31
DEXTROMETHORPHAN HYDROBROMIDE;
PSEUDOEPHEDRINE HYDROCHLORIDE
BROMPHENIRAMINE MALEATE;
31
PHENYLPROPANOLAMINE HYDROCHLORIDE
Bronkosol
124
Bryrel
166
BSS Plus
34
Bucet
1
BUMETANIDE
31
Bumex
31
BUPIVACAINE HYDROCHLORIDE
31
BUPIVACAINE HYDROCHLORIDE;
31
EPINEPHRINE BITARTRATE
BUPRENORPHINE HYDROCHLORIDE
32
Buprenex
32
BUPROPION HYDROCHLORIDE
32
Buspar
32
BUSPIRONE
32
Butabarb
32
BUTABARBITAL SODIUM
32
Butal Compound
19
Butalbital Compound
19
Butapap
1
Butisol Sodium
32
BUTORPHANOL TARTRATE
33
Butorphanol Tartrate Preservative-Free
33
C-Solve 2
85
Cafergot
33
27
28
28
188
161
28
28
28
28
195
31
29
29
29
29
190
190
173
199
214
Page
Page
CAFFEINE; ERGOTAMINE TARTRATE
33
Calan
207
Calcimar
33
Calciquid
37
CALCITONIN, SALMON
33
CALCITRIOL
34
CALCIUM CHLORIDE; DEXTROSE;
34
GLUTATHIONE DISULFIDE;
MAGNESIUM CHLORIDE; POTASSIUM
CHLORIDE; SODIUM BICARBONATE;
SODIUM CHLORIDE; SODIUM PHOSPHATE
CALCIUM CHLORIDE; DEXTROSE;
34,35
MAGNESIUM CHLORIDE; SODIUM
CHLORIDE; SODIUM LACTATE
CALCIUM CHLORIDE; DEXTROSE;
36
POTASSIUM CHLORIDE; SODIUM CHLORIDE
CALCIUM CHLORIDE; DEXTROSE;
36
POTASSIUM CHLORIDE; SODIUM
CHLORIDE; SODIUM LACTATE
CALCIUM CHLORIDE; MAGNESIUM CHLORIDE;
36
POTASSIUM CHLORIDE; SODIUM CHLORIDE
CALCIUM CHLORIDE; POTASSIUM
37
CHLORIDE; SODIUM CHLORIDE
CALCIUM CHLORIDE; POTASSIUM
37
CHLORIDE; SODIUM CHLORIDE;
SODIUM LACTATE
CALCIUM GLUBIONATE
37
CALCIUM GLUCEPTATE
37
CALCIUM GLUCONATE
37
Calmurid HC
116
Cam-Metrazine
163
Camila
154
Candex
156
Capital with Codeine
2
Capoten
38
Capozide
38
CAPTOPRIL
39
CAPTOPRIL; HYDROCHLOROTHIAZIDE
38
Carafate
189
CARBACHOL
38
Carbastat
38
CARBAMAZEPINE
38,39
CARBENICILLIN DISODIUM
38
CARBIDOPA; LEVODOPA
39
CARBINOXAMINE MALEATE;
39,40
DEXTROMETHORPHAN HYDROBROMIDE;
PSEUDOEPHEDRINE HYDROCHLORIDE
CARBINOXAMINE MALEATE;
40
PSEUDOEPHEDRINE HYDROCHLORIDE
Carbocaine
136
Carbocaine Hydrochloride w/Neocobefrin
129
Carbofed DM Drops
39
Carbofed DM Syrup
Cardec DM Drops
Cardec DM Syrup
Cardene
Cardioplegic
Cardizem
Cardizem CD
Cardizem SR
Cardura
CARISOPRODOL
Carmol HC
Carnitor
CARTEOLOL HYDROCHLORIDE
Cartia XT
Cataflam
Catapres
Catapres-TTS
Caverject
Ceclor
Ceclor CD
CEFACLOR
CEFADROXIL/CEFADROXIL HEMIHYDRATE
Cefadyl
Cefanex
CEFAZOLIN SODIUM
CEFOTAXIME SODIUM
CEFOXITIN SODIUM
CEFPODOXIME PROXETIL
CEFTAZIDIME
CEFTAZIDIME(ARGININE FORMULATION)
CEFTAZIDIME SODIUM
Ceftin
CEFUROXIME AXETIL
CEFUROXIME SODIUM
Celestone
Cena K
CEPHALEXIN
CEPHALOTHIN SODIUM
CEPHAPIRIN SODIUM
CEPHRADINE/CEPHRADINE DIHYDRATE
Cephulac
Ceptaz
Cerubidine
Cetacort
Cetamide
Chemdec DM Drops
Chemdec DM Syrup
Chemdec
Chlor-Trimeton
CHLORAL HYDRATE
CHLORAMPHENICOL
CHLORAMPHENICOL SODIUM SUCCINATE
215
40
39
40
152
36
76
76
76
79
40
117
129
41
76
73
55
55
9
41
41
41
41
44
44
42
42
42
42
42
42
43
43
43
43
28
170
43,44
44
44
44
128
42
62
115
190
39
40
40
47
44
45
45
Page
Page
Chlordiazachel
45
CHLORDIAZEPOXIDE HYDROCHLORIDE
45
Chlorofair
45
CHLORHEXIDINE GLUCONATE
46
Chloromycetin
45
CHLOROPROCAINE HYDROCHLORIDE
46
Chloroptic
45
Chloroptic S.O.P.
45
CHLOROQUINE PHOSPHATE
46
CHLOROTHIAZIDE
46
CHLOROTHIAZIDE; METHYLDOPA
46
CHLOROTRIANISENE
46
CHLORPHENIRAMINE MALEATE
47
CHLORPHENIRAMINE MALEATE;
47
CODEINE PHOSPHATE; PSEUDOEPHEDRINE
HYDROCHLORIDE
CHLORPHENIRAMINE MALEATE;
47,48
PHENYLEPHRINE HYDROCHLORIDE;
PHENYLPROPANOLAMINE HYDROCHLORIDE;
PHENYLTOLOXAMINE CITRATE
CHLORPHENIRAMINE MALEATE;
48
PHENYLPROPANOLAMINE HYDROCHLORIDE
CHLORPHENIRAMINE TANNATE;
48
PHENYLEPHRINE TANNATE;
PYRILAMINE TANNATE
CHLORPROMAZINE HYDROCHLORIDE
48
CHLORPROPAMIDE
49
CHLORTHALIDONE
49
CHLORTHALIDONE; CLONIDINE
49,50
HYDROCHLORIDE
CHLORZOXAZONE
50
Cholac
128
Choledyl
158
CHOLESTYRAMINE
50
Cholestyramine Light
50
CHORIONIC GONADOTROPIN
104
CHROMIC CHLORIDE
50
Chronulac
128
CIMETIDINE
51
CIMETIDINE HYDROCHLORIDE
51
CIMETIDINE HYDROCHLORIDE;
51
SODIUM CHLORIDE
Cinobac
51
CINOXACIN
51
Cin-Quin
182
Circanol
85
CISPLATIN
52
CITRIC ACID; MAGNESIUM OXIDE;
52
SODIUM CARBONATE
Claforan
42
Claravis
125
Cleocin
52,53
Cleocin Phosphate in Dextrose 5%
Cleocin T
CLADRIBINE
CLEMASTINE FUMARATE
Climara
Clinda-Derm
CLINDAMYCIN HYDROCHLORIDE
CLINDAMYCIN PHOSPHATE
CLINDAMYCIN PHOSPHATE; DEXTROSE
Clindets
Clinoril
CLOBETASOL PROPIONATE
CLOFIBRATE
Clomid
CLOMIPHENE CITRATE
CLOMIPRAMINE HYDROCHLORIDE
CLONAZEPAM
CLONIDINE
CLONIDINE HYDROCHLORIDE
Clopra
CLORAZEPATE DIPOTASSIUM
Clorpres
CLOTRIMAZOLE
CLOXACILLIN SODIUM MONOHYDRATE
Cloxapen
CLOZAPINE
Clozaril
Cobavite
Codafed
Codamine
CODEINE PHOSPHATE; GUAIFENESIN
CODEINE PHOSPHATE; GUAIFENESIN;
PSEUDOEPHEDRINE HYDROCHLORIDE
CODEINE PHOSPHATE;
IODINATED GLYCEROL
CODEINE PHOSPHATE; PHENYLEPHRINE
HYDROCHLORIDE; PROMETHAZINE
HYDROCHLORIDE
CODEINE PHOSPHATE; PROMETHAZINE
HYDROCHLORIDE
CODEINE PHOSPHATE;
PSEUDOEPHEDRINE HYDROCHLORIDE;
TRIPROLIDINE HYDROCHLORIDE
Codoxy
Cogentin
Co-Gesic
Co-Lav
COLISTIMETHATE
Colocort
Colovage
Colonaid
Coly-Mycin M
216
53
53
52
52
88
53
52
52,53
53
53
193
53,54
54
54
54
54
54,55
55
55
144
55,56
50
56
56
56
56
56
59
57
114
57
57
57
58
58
58
21
26
3
167
58
115
167
23
58
Page
Colyte
Colyte-Flavored
Combipres
Compazine
Compound 65
Compro
Condylox
Constilac
Constulose
Cor-Oticin
Cordarone
Cordran
Corgard
Cormax
Corphed
Cort-Dome
Cortenema
CORTICOTROPIN
Cortisporin ophthalmic ointment
Cortisporin ophthalmic suspension
Cortisporin otic solution
Cortisporin otic suspension
Cortisporin topical ointment
Cortril
Cotrim
Cotrim DS
Cotrim Pediatric
Coumadin
Crolom
CROMOLYN SODIUM
Cromoptic
CROTAMITON
Crotan
Cryselle
CYANOCOBALAMIN
CYCLACILLIN
Cyclapen W
CYCLOBENZAPRINE HYDROCHLORIDE
Cyclocort
Cyclogyl
Cyclopar
CYCLOPENTOLATE HYDROCHLORIDE
CYCLOPHOSPHAMIDE
CYCLOSPORINE
Cycrin
Cylert
CYPROHEPTADINE HYDROCHLORIDE
CYTARABINE
Cytomel
Cytosar-U
Cytotec
Cytoxan
Page
167
167
50
176
20
176
167
128
128
117
11
97
148
54
181
115
115
58
25
116
116
116
25
115
192
192
191
210
59
58,59
59
59
59
91
59
60
60
60
10
60
195
60
60
60
136
159
61
61
131
61
147
60
DACARBAZINE
Dalmane
DANAZOL
Danocrine
Dapex-37.5
Darvocet-N 50
Darvocet-N 100
Darvon
Darvon Compound-65
DAUNORUBICIN HYDROCHLORIDE
Daypro
DDAVP
Deapril-ST
Decadron
Deca-Durabolin
Decapryn
Delacort
Delalutin
Deladumone
Deladumone-OB
Delatestryl
Delaxin
Delestrogen
Delflex w/Dextrose
Delflex w/Dextrose low magnesium
Delflex w/Dextrose low magnesium / low calcium
Deltalin
Deltasone
Del-Vi-A
Demadex
Demerol
Demulen 1/35
Demulen 1/50
Dendrid
Depakene
Depo-Estradiol
Depo-Testadiol
Depo-Testosterone
Dermabet
Dermacomb
Dermacort
Dermatol HC
DESIPRAMINE HYDROCHLORIDE
DESMOPRESSIN ACETATE
Desmopressin Acetate Preservative-Free
Desogen
DESOGESTREL; ETHINYL ESTRADIOL
DESONIDE
DesOwen
DESOXIMETASONE
Desoxyn
Desquam X 2.5
217
61
98
61
61
164
5
5
178
20
62
157
62
85
63,64
149
81
115
118
89
89
194
141
88
34
34
34
84
174
209
201
136
89
89
120
206
88
88
194
28
156
115
115
62
62
62
62
62
62
62
63
140
26
Page
Page
Desquam X 5
26
Desquam X 10
26
Desquam X 5 Wash
26
Desyrel
201
Detussin Expectorant
105
Detussin Liquid
114
Dexacen-4
64
Dexacidin
63
Dexair
64
DEXAMETHASONE
63
DEXAMETHASONE; NEOMYCIN SULFATE;
63
POLYMYXIN B SULFATE
DEXAMETHASONE; TOBRAMYCIN
63
DEXAMETHASONE SODIUM PHOSPHATE
63,64
DEXAMETHASONE SODIUM PHOSPHATE;
64
NEOMYCIN SULFATE
Dexampex
65
Dexasporin
63
DEXCHLORPHENIRAMINE MALEATE
64
Dexedrine
65
DEXTROAMPHETAMINE SULFATE
65
DEXTROMETHORPHAN HYDROBROMIDE;
65
IODINATED GLYCEROL
DEXTROMETHORPHAN HYDROBROMIDE;
66
PROMETHAZINE HYDROCHLORIDE
DEXTROSE
66
Dextrose 5% in Lactated Ringers
36
Dextrose 5% in Lactated Ringers
36
with Potassium Chloride 10,20,30,40mEq
Dextrose 5% in Ringers
36
DEXTROSE; DOBUTAMINE HYDROCHLORIDE
67
DEXTROSE; DOPAMINE HYDROCHLORIDE
67
DEXTROSE; GENTAMICIN SULFATE
67
DEXTROSE; HEPARIN SODIUM
67,68
DEXTROSE; LIDOCAINE HYDROCHLORIDE
68
DEXTROSE; MAGNESIUM CHLORIDE;
68
POTASSIUM CHLORIDE; SODIUM
ACETATE; SODIUM CHLORIDE;
SODIUM GLUCONATE
DEXTROSE; MANNITOL
68
DEXTROSE; NITROGLYCERIN
68
DEXTROSE; POTASSIUM CHLORIDE
68,69
DEXTROSE; POTASSIUM
69,70,71
CHLORIDE; SODIUM CHLORIDE
DEXTROSE; SODIUM CHLORIDE
71
DEXTROSE; THEOPHYLLINE
71,72
Dextrostat
65
Dey-Dose
139
Dey-Lute
139
DHC Plus
2
Di-Atro
23
Di-Metrex
163
Diabeta
Diabinese
Dial
Diamox
Dianeal 137 w/Dextrose
Dianeal Low Calcium w/Dextrose
Dianeal PD-1 w/Dextrose
Dianeal PD-2 w/Dextrose
Dianeal PD-2 w/Dextrose, Low Calcium
DIAZEPAM
DIAZOXIDE
Dibenil
DICLOFENAC POTASSIUM
DICLOFENAC SODIUM
DICLOXACILLIN SODIUM
DICYCLOMINE HYDROCHLORIDE
Didronel
DIENESTROL
DIETHYLPROPION HYDROCHLORIDE
DIETHYLSTILBESTROL
DIFLORASONE DIACETATE
DIFLUNISAL
Digitek
DIGOXIN
Dihistine DH
DIHYDROERGOTOXINE METHANESULFONATE
Dilacor XR
Dilantin Injection
Dilantin 125 Suspension
Dilaudid
Dilaudid HP
Dilaudid Hydrochloride
DILTIAZEM HYDROCHLORIDE
DIMENHYDRINATE
Dimetane
Dimetane-DC
Dimetane-DX
Dimetane-Ten
Diphen
DIPHENHYDRAMINE HYDROCHLORIDE
Diphenhydramine Hydrochloride Preservative-Free
DIPIVEFRIN HYDROCHLORIDE
Diprivan
Diprolene AF
Diprosone
DIPYRIDAMOLE
DISOPYRAMIDE PHOSPHATE
Ditate-DS
Ditropan
Diucardin
Diulo
Diuril
218
103
49
108
5
35
35
34,35
34,35
35
72
73
77
73
73
73
73,74
91
74
74
74
74
74,75
75
75
47
84,85
76
166
165
118
118
118
75,76
76
30
30
31
30
77
76,77
77
77,78
178
27
27
78
78
89
158
118
145
46
Page
DOBUTAMINE HYDROCHLORIDE
Dobutrex
Dolene
Dolene AP-65
Dolobid
Dolophine
Domeboro
Donnatal
DOPAMINE HYDROCHLORIDE
Dopastat
Dopram
Doriden
Doryx
DOXAPRAM HYDROCHLORIDE
DOXAZOSIN MESYLATE
DOXEPIN HYDROCHLORIDE
DOXORUBICIN HYDROCHLORIDE
Doxy 100
Doxy 200
Doxy-Lemmon
Doxy-Tabs
Doxychel
Doxychel Hyclate
DOXYCYCLINE
DOXYCYCLINE HYCLATE
DOXYLAMINE SUCCINATE
Dralzine
Drisdol
DROPERIDOL
DROPERIDOL; FENTANYL CITRATE
DTIC-Dome
Duphalac
Dura-Lutin
Durabolin
Duracillin A.S.
Duradyne DHC
Duramorph PF
Duricef
Duvoid
DV Vaginal Cream
Dyazide
Dycill
Dymelor
Dynapen
E-Base
E-Z-EM Prep Lyte
EC-Naprosyn
ECONAZOLE NITRATE
Econochlor
Econopred Plus
E-Dec DM Drops
E-Dec DM Syrup
Page
78
78
178
4
75
140
6
24
79
79
79
103
81
79
79
79,80
80
81
81
81
81
80
81
80
80,81
81
109
84
81
81
61
128
118
149
160
3
147
41
28
74
113
73
6
73
86
167
150
81
45
173
39
40
EDETATE DISODIUM
82
Edex
9
EDROPHONIUM CHLORIDE
82
Edrophonium Chloride Preservative-Free
82
E.E.S.
86,87
E.E.S. 200
86
E.E.S. 400
86,87
Effer-K
169
Elavil
12
Eldecort
115
Eldepryl
184
Elimite
162
Elixomin
196
Elixophyllin
196
Elocon
147
EM-K-10%
170
Embeline
54
Embelene E
54
Emgel
85
Empirin #3
21
Empracet with Codeine #3,4
2
E-Mycin
86
E-Mycin-E
86
ENALAPRIL MALEATE
82
ENALAPRIL MALEATE; HYDROCHLOROTHIAZIDE 82
ENALIPRILAT
82,83
Endep
12
Endosol Extra
34
Endrate
82
Enduron
142
ENFLURANE
83
Enlon
82
Enpresse
90
Entex
105
Enulose
128
EPHEDRINE; HYDROXYZINE
83
HYDROCHLORIDE; THEOPHYLLINE
Epicort
115
EPINEPHRINE HYDROCHLORIDE
83
EPINEPHRINE; LIDOCAINE HYDROCHLORIDE 83,84
Epitol
39
EPOETIN ALPHA
84
Epogen
84
Equagesic
21
Equanil
138
Ercatab
33
ERGOCALCIFEROL
84
ERGOLOID MESYLATES
84,85
Ergomar
85
Ergostat
85
ERGOTAMINE TARTRATE
85
Ery-Ped
86,87
219
Page
Ery-Tab
Eryc
Eryc 125
Eryc Sprinkles
Erycette
Eryderm
Erygel
Erymax
Erypar
Erythra-Derm
Erythro-Statin
Erythrocin
Erythrocin Stearate
ERYTHROMYCIN
ERYTHROMYCIN ESTOLATE
ERYTHROMYCIN ETHYLSUCCINATE
ERYTHROMYCIN ETHYLSUCCINATE;
SULFISOXAZOLE ACETYL
ERYTHROMYCIN LACTOBIONATE
ERYTHROMYCIN STEARATE
Eryzole
Esgic
Esgic Plus
Esidrix
Eskalith
ESTAZOLAM
Estrace
ESTRADIOL
ESTRADIOL CYPIONATE
ESTRADIOL CYPIONATE; TESTOSTERONE
CYPIONATE
ESTRADIOL VALERATE
ESTRADIOL VALERATE; TESTOSTERONE
ENANTHATE
Estraguard
ESTROPIPATE
ETHAMBUTOL HYDROCHLORIDE
ETHCHLORVYNOL
ETHINYL ESTRADIOL; ETHYNODIOL
DIACETATE
ETHINYL ESTRADIOL; LEVONORGESTREL
ETHINYL ESTRADIOL; NORETHINDRONE
ETHINYL ESTRADIOL: NORETHINDRONE
ACETATE
ETHINYL ESTRADIOL; NORGESTIMATE
ETHINYL ESTRADIOL; NORGESTREL
ETHOSUXIMIDE
Ethrane
Ethril 250
Ethril 500
ETIDRONATE DISODIUM
ETODOLAC
Page
86
85
85
85
85
85
85
85
87
85
85
87
87
85,86
86
86,87
87
ETOMIDATE
ETOPOSIDE
Eulexin
Eurax
Evalose
Exsel
FAMOTIDINE
Famotidine Preservative-Free
Fastin
Feldene
Femcet
FENOFIBRATE
FENOPROFEN CALCIUM
FENTANYL CITRATE
Fentanyl Citrate Preservative-Free
Ferndex
Fioricet
Fioricet with Codeine
Fiorinal
Fiorinal with Codeine #3
Flagyl
Flagyl I.V.
Flagyl I.V. RTU
FLECAINIDE ACETATE
Flexeril
Flexicort
Florinef
FLOXURIDINE
FLUDROCORTISONE ACETATE
Flumadine
FLUNISOLIDE
Fluocet
FLUOCINOLONE ACETONIDE
FLUOCINONIDE
Fluonid
FLUOROMETHALONE
Fluor-Op
FLUOROURACIL
Fluothane
Fluotrex
FLUOXETINE HYDROCHLORIDE
FLUPHENAZINE DECANOATE
FLUPHENAZINE HYDROCHLORIDE
FLURANDRENOLIDE
FLURAZEPAM HYDROCHLORIDE
FLURBIPROFEN
FLURBIPROFEN SODIUM
FLUTAMIDE
Flutex
FLUVOXAMINE MALEATE
FML
Folex
87
87
87
1
1
110
132
87,88
88
88
88
88
88
88,89
74
89
89
89
89
89,90
90
91
91
91
91
83
87
87
91
92
220
92
92,93
98
59
128
185
93
93
164
167
1
93
93,94
94
94
65
1
1
19
20
145
145
145
94
60
115
94
94
94
183
94
95
95
95,96
95
96
96
96
107
95
96,97
97
97
97
98
98
98
98
202
98,99
96
141
Page
Page
Folex PFS
141
FOLIC ACID
99
Folicet
99
Follutein
104
Folvite
99
Forane
124
Forbaxin
141
Fortaz
42,43
FSH; LH
136
FUDR
94
Fulvicin P/G
104
Fulvicin U/F
104
Fungizone
14
Furacin
153
Furadantin
153
Furalan
153
FUROSEMIDE
99,100
GAMMA BENZENE HEXACHLORIDE
131
Gamene
131
Gantanol
191
Gantanol DS
191
Gantrisin
193
Garamycin
101
GEMFIBROZIL
100
Gencept 0.5/35
90
Gencept 1/35
90
Gencept 10/11
90
Generlac
128
Genoptic
101
Genora 0.5/35
90
Gentacidin
101
Gentafair
101
GENTAMICIN SULFATE
100,101
GENTAMICIN SULFATE; SODIUM CHLORIDE 101,102
Gen-K
170
Gen-Xene
56
Geopen
39
Gerimal
84,85
Germa-Medica "MG"
108
GLIPIZIDE
102
GLUCAGON HYDROCHLORIDE
102
Glucamide
49
Glucophage
139
GLUTETHIMIDE
103
Glucotrol
102
GLYBURIDE
103
GLYBURIDE, MICRONIZED
103
GLYCINE
103
Glycoprep
167
GLYCOPYRROLATE
104
Glycort
115
Glynase
103
Go-Evac
167
Golytely
168
GONADOTROPIN CHORIONIC
104
GRAMICIDIN; NEOMYCIN SULFATE;
104
POLYMYXIN B SULFATE
Grifulvin V
104
Grisactin
105
Grisactin Ultra
105
GRISEOFULVIN MICROCRYSTALLINE
104
GRISEOFULVIN ULTRAMICROCRYSTALLINE 104,105
Gris-PEG
104
GUAIFENESIN; HYDROCODONE
105
BITARTRATE; PSEUDOEPHEDRINE
HYDROCHLORIDE
GUAIFENESIN; PHENYLEPHRINE
105
HYDROCHLORIDE; PHENYLPROPANOLAMINE
HYDROCHLORIDE
GUAIFENESIN; THEOPHYLLINE
105
GUANABENZ ACETATE
105,106
GUANETHIDINE MONOSULFATE
106
GUANFACINE HYDROCHLORIDE
106
Guiatuss AC
57
Guiatus DAC
57
Gyne-Sulf
189
Gynodiol
88
Halcion
203
Haldol
106,107
Haldol Decanoate
106
HALOPERIDOL
106
HALOPERIDOL DECANOATE
106
HALOPERIDOL LACTATE
107
HALOTHANE
107
HC
115
HC #1
115
HC #4
115
H Cort
115,116
H.E.A.
85
Hemsol-HC
117
HEPARIN SODIUM
107,108
Heparin Sodium Preservative-Free
107
HEPARIN SODIUM; SODIUM CHLORIDE
108
Hep Flush
107
Hep-Lock, Hep Lock PF
107
Hep-Lock, Hep Lock U/P
107
Heptalac
128
Herplex Liquifilm
120
Hexa-Betalin
181
HEXACHLOROPHENE
108
Hexadrol
63,64
Hexa-Germ
108
Hexascrub
108
HiCor
115
221
Page
Page
Hiprex
140
Histafed
180
Histatan
48
HOMATROPINE HYDROBROMIDE
108
HOMATROPINE METHYLBROMIDE;
108
HYDROCODONE BITARTRATE
Humatin
159
Humegon
136
Hycodan
108
Hycomine
114
Hycophen
114
Hydeltrasol
174
Hydergine
84,85
Hydral
109
HYDRALAZINE HYDROCHLORIDE
109
HYDRALAZINE HYDROCHLORIDE;
109
HYDROCHLOROTHIAZIDE
Hydramine
77
Hydra-Zide
109
Hydrea
119
Hydrocet
3
HYDROCHLOROTHIAZIDE
109,110
HYDROCHLOROTHIAZIDE; LABETALOL
111
HYDROCHLOROTHIAZIDE; LISINOPRIL
111
HYDROCHLOROTHIAZIDE; METHYLDOPA
111,112
HYDROCHLOROTHIAZIDE;
112
PROPRANOLOL HYDROCHLORIDE
HYDROCHLOROTHIAZIDE;
113
SPIRONOLACTONE
HYDROCHLOROTHIAZIDE; TRIAMTERENE
113
HYDROCODONE BITARTRATE
114
IBUPROFEN
HYDROCODONE BITARTRATE;
114
PHENYLPROPANOLAMINE HYDROCHLORIDE
HYDROCODONE BITARTRATE;
114
PSEUDOEPHEDRINE HYDROCHLORIDE
Hydrocodone Compound
108
HYDROCORTISONE
114,115,116
Hydrocortisone in Adsorbase
116
HYDROCORTISONE;
116
NEOMYCIN SULFATE;
POLYMYXIN B SULFATE
HYDROCORTISONE; POLYMYXIN B SULFATE
116
HYDROCORTISONE; UREA
116
HYDROCORTISONE ACETATE
117
HYDROCORTISONE ACETATE; NEOMYCIN
117
SULFATE
HYDROCORTISONE ACETATE; UREA
117
HYDROCORTISONE SODIUM PHOSPHATE
117
HYDROCORTISONE SODIUM SUCCINATE
117
HYDROCORTISONE VALERATE
117
Hydrocortone
117
Hydro-D
HydroDIURIL
HYDROFLUMETHIAZIDE
HYDROMORPHONE HYDROCHLORIDE
Hydropane
Hydrophed
Hydrophed Expectorant
Hydro-ride
Hydrotex
HYDROXOCOBALAMIN
Hydroxomin
HYDROXYCHLOROQUINE SULFATE
HYDROXYPROGESTERONE CAPROATE
HYDROXYUREA
HYDROXYZINE HYDROCHLORIDE
HYDROXYZINE PAMOATE
Hygroton
Hymac
Hyperstat
Hy-Phen
Hytone
Hytrin
Hytussin
Hyzyd
I-Homatropine
I-Phrine
I-Tropine
Ibu
IBUPROFEN
Ibuprohm
Ibu-Tab
IDOXURIDINE
Ilosone
Ilotycin
Imdur
IMIPRAMINE HYDROCHLORIDE
Imodium
Imuran
INAMRINONE LACTATE
Inapsine
INDAPAMIDE
Inderal
Inderal LA
Inderide 40/25
Inderide 80/25
Indocin
Indocin-SR
Indo-Lemmon
INDOMETHACIN
Inflamase Mild
Inflamase Forte
Innofem
222
110
110
118
118
108
114
105
10
115
118
118
118
118
119
119
119,120
49
115,116
73
3
115,116
194
105
124
108
164
22
120
120
120
120
120
86
85,86
125
120,121
132
24
121
81
121
179
179
112
112
122
122
122
121,122
174
174
88
Page
Innovar
Inocor
Inpersol-LC/LM with Dextrose
Intal
Intensol Chlorpromazine
Intensol Methadone
Intensol Thioridazine
Intensol Thiothixene
Intralipid 10%
Intralipid 20%
Intralipid 30%
Intropin
Invagesic
Invagesic Forte
IODINATED GLYCEROL
Iogan
Iogan DM
Ionamin-30
IOPAMIDOL
Iopamidol-200
Iopamidol-250
Iopamidol-300
Iopamidol-370
Iophen C
Iophen DM
Iophen Elixir
Iotuss-C
Iotuss-DM
Iotuss Elixir, Solution
Iotuss Solution
IPRATROPIUM BROMIDE
Irrigating Solution G
Ismelin
ISMO
Isocaine HCl
Isocaine HCl w/Levonordefrin
ISOETHARINE HYDROCHLORIDE
ISOFLURANE
Isolyte S
Isolyte S w/Dextrose 5%
ISONIAZID
ISOPROTERENOL HYDROCHLORIDE
Isoptin
Isoptin SR
Isopto Atropine
Isopto Carpine
Isopto Cetamide
Isopto Homatropine
Isordil
Isordil Tembid
ISOSORBIDE DINITRATE
ISOSORBIDE MONONITRATE
Page
81
121
35
59
48
140
198
198
188
188
188
79
20
20
122
122
65
164
123
123
123
123
123
57
65
122
57
65
122
122
123
52
106
125
136
129
123,124
124
134
69
124
125
207
207
22
166
190
108
125
125
125
125
ISOTRETINOIN
Isovue-200
Isovue-250
Isovue-300
Isovue-370
Isuprel
Janimine
Junel 1/20
Junel 1.5/30
K+8
K + Care
K + Care ET
K-Dur
Kainair
KANAMYCIN SULFATE
Kantrex
Kaochlor 10%
Kaochlor SF
Kaon 10%
Kaon Cl 20%
Kappadione
Kato
Kay Ciel
Kayexalate
Keflet
Keflex
Keflin
Kefurox
Kefzol
Kenac
Kenalog
Kenalog-H
Kenalog in Orabase
Kerlone
Kesso-Gesic
Ketalar
KETAMINE HYDROCHLORIDE
KETOCONAZOLE
KETOPROFEN
KETOROLAC TROMETHAMINE
Ketorolac Tromethamine Preservative-Free
Kionex
K-Lease
K-Lor
K-Lyte
Klebcil
Klonopin
Klor-10%
Klor-Con
Klor-Con 20%
Klor-Con EF
Klor-Con M10
223
125
123
123
123
123
125
121
91
91
171
170
169
171
178
126
126
171
171
173
171
136
170
170,171
188
44
44
44
43
42
202
202
202
202
28
178
126
126
126
126,127
127
127
188
170
170
169
126
55
171
170,171
171
169
171
Page
Klor-Con M20
Kloromin
Klorvess
Korostatin
Kwell
LABETALOL HYDROCHLORIDE
Lac-Hydrin
LAClotion
Lactated Ringer's
LACTULOSE
Laniazid
Lanophyllin
Lanorinal
Lanoxin
Lantrisul
Lariam
Larotid
Laryng-O-Jet
Laryngotracheal Anesthesia Kit
Lasix
Laxilose
Ledercillin-VK
Lessina
LEUCOVORIN CALCIUM
Leucovorin Calcium Preservative-Free
LEUPROLIDE ACETATE
Leustatin
Levlite
Levo-Dromoran
LEVOBUNOLOL HYDROCHLORIDE
LEVOCARNITINE
LEVONORDEFRIN; MEPIVICAINE
HYDROCHLORIDE
Levora 0.15/30
LEVORPHANOL TARTRATE
LEVOTHYROXINE SODIUM
Librium
Lidex
Lidex-E
LIDOCAINE
LIDOCAINE HYDROCHLORIDE
Lidocaine Hydrochloride Preservative-Free
Lidocaton
Lidopen
Limbitrol
Limbitrol DS
Lincocin
LINCOMYCIN
LINDANE
Lioresal
LIOTHYRONINE SODIUM
Lipo-Hepin
Page
171
47
171
156
131
127
13
13
37
127,128
124
196
20
75
205
136
14
130
130
100
128
161
89
128
128
129
52
89
129
129
129
129
Liposyn III 10%
Liposyn III 20%
Liposyn III 30%
Liquaemin Sodium
LISINOPRIL
Lithane
LITHIUM CARBONATE
LITHIUM CITRATE
Lithonate
Lithotabs
Lo/Ovral
Lo-Trol
Locholest
Locholest Light
Lodine
Lodine XL
Loestrin 1/20
Loestrin 1.5/30
Loestrin FE 1/20
Loestrin FE 1.5/30
Lofene
Logen
Lomanate
Lomotil
Loniten
Lonox
LOPERAMIDE HYDROCHLORIDE
Lopid
Lopressor
Lopurin
Loraz
LORAZEPAM
Lorcet-HD
Lortab
Lotrimin
Lotrisone
LOVASTATIN
Low-Ogestrel
Low-Quel
LOXAPINE SUCCINATE
Loxitane
Lozol
LTA II Kit
Ludiomil
Lupron
Luvox
Lygen
Lyophilized Cytoxan
Lyphocin
Macrodantin
90
129
129
45
95,96
95
130
130,131
130
84,130
130
12
12
131
131
131
26
131
107
224
188
188
188
108
131
132
132
132
132
132
91
23
50
50
92
92
91
91
91
91
23
23
23
23
146
23
132
100
145
9
133
132,133
3
3
56
27
133
91
23
133
133
121
130
135
129
99
45
60
206
153
Page
Page
MAGNESIUM CHLORIDE; POTASSIUM
134
CHLORIDE; SODIUM ACETATE;
SODIUM CHLORIDE; SODIUM GLUCONATE
MAGNESIUM SULFATE
134
Maldec
40
Maldec DM Syrup
40
MANNITOL
134
MAPROTILINE HYDROCHLORIDE
135
Marax DF
83
Marcaine Hydrochloride
31
Marcaine Hydrochloride with Epinephrine
31
Marcaine Hydrochloride Preservative-Free
31
Marcaine HCl with Epinephrine Preservative-Free
31
Maxidex
63,64
Maxitrol
63
Maxolon
144
Maxzide
113
Maxzide-25
113
MEBENDAZOLE
135
MECLIZINE HYDROCHLORIDE
135
MECLOFENAMATE SODIUM
135
Meclomen
135
Medigesic Plus
1
Medrol
143
MEDROXYPROGESTERONE ACETATE
136
MEFLOQUINE HYDROCHLORIDE
136
Mefoxin
42
MEGESTROL ACETATE
136
Megace
136
Melfiat
163
Mellaril
198
MENADIOL SODIUM PHOSPHATE
136
MENOTROPINS
136
MEPERIDINE HYDROCHLORIDE
136,137
Meperidine Hydrochloride Preservative-Free
137
MEPIVICAINE HYDROCHLORIDE
137
Mepriam
138
Mepro-Aspirin
21
MEPROBAMATE
137,138
MESNA
138
Mesnex
138
Mestinon
181
MESTRANOL; NORETHINDRONE
138
Metadate ER
143
Metandren
144
METAPROTERENOL SULFATE
138,139
METARAMINOL BITARTRATE
139
METFORMIN HYDROCHLORIDE
139
METHADONE HYDROCHLORIDE
139,140
Methadose
140
Methampex
140
METHAMPHETAMINE HYDROCHLORIDE
140
METHAZOLAMIDE
METHENAMINE HIPPURATE
METHIMAZOLE
METHOCARBAMOL
METHOTREXATE SODIUM
Methotrexate Sodium Preservative-Free
METHSCOPOLAMINE BROMIDE
METHYCLOTHIAZIDE
METHYLDOPA
METHYLDOPATE HYDROCHLORIDE
Methylin
Methylin ER
METHYLPHENIDATE HYDROCHLORIDE
METHYLPREDNISOLONE
METHYLPREDNISOLONE
SODIUM SUCCINATE
METHYLTESTOSTERONE
Meticorten
Metimyd
METIPRANOLOL HYDROCHLORIDE
METOCLOPRAMIDE HYDROCHLORIDE
METOCURINE IODIDE
METOLAZONE
METOPROLOL TARTRATE
Metra
Metro I.V.
Metromidol
METRONIDAZOLE
Metryl
Metubine Iodide
Mevacor
Mexate
Mexate-AQ
Mexate-AQ Preserved
Mexetil
MEXILETINE HYDROCHLORIDE
Miacalcin
MICONAZOLE NITRATE
Micort HC
Micrainin
Micro-K
Micro-K 10
Microgestin FE 1/20
Microgestin FE 1.5/30
Micronase
Micronor
Microzide
Midamor
MIDAZOLAM
Milophene
Miltown
Minipress
225
140
140
140
140,141
141
141
141
142
142
142,143
143
143
143
143
143
144
174
173
144
144
145
145
145
163
145
145
145
145
145
133
141
141
141
146
146
33
146
117
21
170
170
91
91
103
154
110
10
146
54
138
173
Page
Minitran
Minocin
MINOCYCLINE HYDROCHLORIDE
Minodyl
MINOXIDIL
Miostat
Mircette
MIRTAZAPINE
MISOPROSTOL
MITOMYCIN
Modicon
Moduretic
MOEXIPRIL HYDROCHLORIDE
MOMETASONE FURORATE
Monistat 3
Monodox
Monoket
Mononessa
MORPHINE SULFATE
Motrin
MS Contin
MS/L
MSIR
Mucomyst
Mucosil 10
Mucosil 20
Multifuge
Muro's Opcon A
Mutamycin
M.V.C. 9+3
M.V.C. Plus
M.V.I. - 12
Myambutol
Mybanil
Mycelex
Mychel
Mychel-S
Mycifradin
Mycodone
Mycolog-II
Mycostatin
Myco-Triacet II
Mydfrin
Mydriacil
Mydriafair
Myfed
Myidil
Mykacet
Mykinac
Mylaramine
Mymethasone
Mymethazine Fortis
Page
154
146
146
146
146
38
62
147
147
147
90
10
147
147
146
80
125
91
147,148
120
148
147
147
6
6
6
166
150
147
17
17
18
89
30
56
45
45
151
108
156
156
156
164
205
205
180
204
156
156
64
63
177
Myotonachol
Myphetane DC
Myphetane DX
Myproic Acid
Mysoline
Mytrex F
N.E.E. 1/35
NABUMETONE
NADOLOL
Nafazair
Nafcil
NAFCILLIN SODIUM
NALBUPHINE HYDROCHLORIDE
Naldecon Pediatric Drops
Naldecon Pediatric Syrup
Naldecon Syrup
Nalfon
NALIDIXIC ACID
Nallpen
NALOXONE HYDROCHLORIDE
NALOXONE HYDROCHLORIDE;
PENTAZOCINE HYDROCHLORIDE
Nalphen
Nalphen Pediatric Drops
Nalphen Pediatric Syrup
NALTREXONE HYDROCHLORIDE
NANDROLONE DECANOATE
NANDROLONE PHENPROPIONATE
NAPHAZOLINE HYDROCHLORIDE
NAPHAZOLINE HYDROCHLORIDE;
PHENIRAMINE MALEATE
Naphcon A
Naphcon Forte
Naphoptic A
Naprelan
Naprosyn
NAPROXEN
NAPROXEN SODIUM
Narcan
Nasalide
Navane
Nebcin
Necon 1/35
Necon 1/50
Necon 777
NegGram
Nelova
Nelova 7/14
Nelova 10/11
Nembutal Sodium
Neo-Calglucon
Neo-Cortef
226
28
30
31
206
175
156
90
148
148
149
148
148
148
47
47
48
94
148
148
148,149
149
48
47
48
149
149
149
149
150
150
149
150
150
150
150
150
149
94
198
200
90
138
90
148
90
90
90
162
37
117
Page
Neo-Dexair
Neo-Otosol-HC
Neo-Polycin
Neo-Rx
Neo-Synephrine
Neobiotic
Neodecadron
NEOMYCIN SULFATE
NEOMYCIN SULFATE; POLYMYXIN B
SULFATE
Neosar
Neosporin G.U. Irrigant
Neosporin Ophthalmic Ointment
Neosporin Ophthalmic Solution
Neotrizine
Neptazane
Nesacaine-MPF
Neuramate
NIACIN
Niacor
NICARDIPINE HYDROCHLORIDE
Nicolar
NICOTINE
NICOTINIC ACID
Nicotrol
Nifedical XL
NIFEDIPINE
Nilstat
Nipride
Nitro-Bid
Nitro-DUR
NITROFURANTOIN
NITROFURANTOIN MACROCRYSTALLINE
NITROFURAZONE
NITROGLYCERIN
Nitro I.V.
Nitrol
Nitropress
Nitrostat Injection
NIZATIDINE
Nizoral
Noctec
Nogenic HC
Nolvadex
Nor-QD
Norcept E 1/35
Norcet
Norco
Norcuron
Nordette
Norethin 1/35E
Norethin 1/50M
Page
64
116
104
151
164
151
64
151
151
NORETHINDRONE
NORETHINDRONE ACETATE
Norflex
Norgesic
Norgesic Forte
Norinyl 1+35
Norinyl 1+50
Norinyl 1+80
Norlutate
Normodyne
Normozide
Norpace
Norpace CR
Norpramin
Nortrel 0.5/35
Nortrel 1/35
Nortrel 777
NORTRIPTYLINE HYDROCHLORIDE
Novadyne DH Liquid
Novadyne Expectorant
Novahistine DH Liquid
Novahistine Expectorant
Novocain
Nubain
Nutracort
Nutrilipid 10%
Nutrilipid 20%
Nydrazid
NYSTATIN
NYSTATIN; TRIAMCINOLONE ACETONIDE
Nystex
Nystop
Obezine
Obestin-30
Oby-Trim
Octamide PFS
Octocaine
Ocufen
Ocumycin
Ocupres
Ocusulf-10
Ocusulf-30
Ocutricin
Ocutricin HC
Ocu-Tropine
Ogen
Ogestrel
OMEPRAZOLE
Omnipen
Omnipen-N
Ona-Mast
Oncovin
60
151
25
104
205
140
46
138
151,152
152
152
152
152
151,152
152
153
152,153
156
187
154
154
153
153
153
154
154
154
187
154
154
126
44
115
193
154
90
3
3
206
90
90
138
227
154
155
157
20
20
90
138
138
155
127
111
78
78
62
90
90
90
155
47
57
47
57
176
148
115
188
188
124
155,156
156
156
156
163
164
164
144
84
98
25
41
190
190
25,104
25,116
23
89
91
156
16
16
164
207
Page
Opcon
Opcon-A
Ophthaine
Ophthetic
Ophthochlor
Opticrom
Optipranolol
Optomycin
Oracort
Oralone
Orasone
Oretic
Organidin Drops
Organidin Elixir
Orgatrax
Oridol C
Oridol Elixir
Oridol Solution
Orinase
Orlex
Orlex HC
Ornade
ORPHENADRINE CITRATE
Orphengesic
Ortho-Cept
Ortho-Cyclen
Ortho-Est
Ortho-Novum 1/35
Ortho-Novum 1/50
Ortho-Novum 1/80
Ortho-Novum 7/14
Ortho-Novum 10/11
Ortho-Novum 777
Ortho-Tri-Cyclen
Orudis
Oruvail
Osmitrol
Oticair
Oto Ear Drops
Otobione
Otobiotic
Otocort
Ovral
OXACILLIN SODIUM
OXAPROZIN
OXAZEPAM
OXTRIPHYLLINE
Oxy-Kesso-Tetra
OXYBUTYNIN CHLORIDE
Oxycet
Oxycodone 5/APAP 500
OXYTETRACYCLINE HYDROCHLORIDE
Page
149
150
178
178
45
59
144
45
202
202
174
110
122
122
119
57
122
122
200
5
6
48
157
20
62
91
89
90
138
138
90
90
90
91
127
127
134
116
17
116
116
116
91
157
157
158
158
159
158
4
4
159
OXYTOCIN
P.A.S. Sodium
Pacerone
PACLITAXEL
Pamelor
Pamine
PANCURONIUM BROMIDE
Panheprin
Panmycin
Panoxyl 5
Panoxyl 10
Panoxyl Aq 2.5
Panoxyl Aq 5
Panoxyl Aq 10
Papa-Deine #3
Papa-Deine #4
Paracaine
Paraflex
Parafon Forte DSC
Parasal Sodium
Paregoric Tincture
Parlodel
PAROMOMYCIN SULFATE
Pathocil
Pavulon
PBZ
Pediamycin
Pediapred
Pediatric LTA Kit
Pediazole
Pediotic Cortisporin
PEG-Lyte
PEMOLINE
Pen-Vee K
Penapar-VK
Penbritin
Penbritin-S
Penecort
PENICILLIN G POTASSIUM
PENICILLIN G PROCAINE
PENICILLIN V POTASSIUM
Pentacarinat
Pentam 300
Pentacef
PENTAMIDINE ISETHIONATE
Pentids 200
Pentids 250
Pentids 400
Pentids 800
PENTOBARBITAL SODIUM
Pentolair
PENTOXIFYLLINE
228
159
185
11
159
155
141
159
108
195,196
26
26
26
26
26
2
2
178
50
50
185
9
30
159
73
159
204
87
174
131
87
116
168
159
161
161
16
16
115,116
159,160
160
160,161
161
161
42
161
160
160
160
160
161,162
60
162
Page
Pepcid
Percocet
Percodan
Percodan-Demi
PERGOLOID MESYLATE
Pergonal
Periactin
Peridex
PerioGard
Permax
PERMETHRIN
Permetil
PERPHENAZINE
Persa-Gel
Persa-Gel W 5%
Persa-Gel W 10%
Persantine
Pfizer-E
Pfizerpen
Pfizerpen-A
Pfizerpen-AS
Pfizerpen-G
Pfizerpen-VK
Phenaphen No. 3 w/Codeine
Phenaphen-650 w/Codeine
Phenazine
Phenazine-35
PHENDIMETRAZINE TARTRATE
Phenergan Fortis
Phenergan Injection
Phenergan Suppository
Phenergan Syrup
Phenergan Tablet
Phenergan w/Codeine
Phenergan VC
Phenergan VC w/Codeine
Phenergan w/Dextromethorphan
PHENOBARBITAL
Phenoptic
PHENTERMINE HYDROCHLORIDE
PHENTERMINE RESIN COMPLEX
PHENTOLAMINE MESYLATE
PHENYLEPHRINE HYDROCHLORIDE
PHENYLEPHRINE HYDROCHLORIDE;
PROMETHAZINE HYDROCHLORIDE
Phenylhistine DH
Phenylhistine Expectorant
PHENYTOIN SODIUM INJECTION
PHENYTOIN SUSPENSION
Pherazine w/Codeine
Pherazine DM
Pherazine VC
Page
93
4
21
21
162
136
61
46
46
162
162
97
162
26
26
26
78
87
160
16
160
160
161
2
2
163
163
163
177
177
177
177
177
58
165
58
66
163
164
163,164
164
164
164
165
Pherazine VC w/Codeine
58
pHisoHex
108
pHisoscrub
108
Phrenilin
1
Phrenilin Forte
1
Physiolyte
134
Pilocar
166
PILOCARPINE HYDROCHLORIDE
166
PINDOLOL
166
PIPERAZINE CITRATE
166
PIPERAZINE ESTRONE CITRATE
89
PIROXICAM
166,167
Pitocin
159
Placidyl
89
Plaquenil
118
Plasma-Lyte 148
134
Plasma-Lyte 148 w/Dextrose 5%
69
Plasma-Lyte A
134
Platinol
52
Platinol-AQ
52
Plegine
163
Plegisol
36
PODOFILOX
167
Polaramine
64
Polocaine
137
Polocaine w/ Levonordefrin
129
Polocaine-MPF
137
Poly-Rx
168
Poly-Vi-Flor
18
Poly-Vi-Flor with Iron
18
Poly Vitamin Drops with Fluoride 0.25mg
18
Poly Vitamin Drops with Fluoride 0.5mg
18
Polycillin
16
Polycillin-N
16
Polycillin-PRB
15
POLYETHYLENE GLYCOL 3350;
167,168
POTASSIUM CHLORIDE; SODIUM
BICARBONATE; SODIUM CHLORIDE;
SODIUM SULFATE, ANHYDROUS
Polymox
14
POLYMYXIN B SULFATE
168
POLYMYXIN B SULFATE;
169
TRIMETHOPRIM SULFATE
Polysporin
25
Polytrim
169
Pontocaine
195
Portalac
128
Portia
90
POTASSIUM BICARBONATE
169
POTASSIUM CHLORIDE
169,170,171
POTASSIUM CHLORIDE; SODIUM CHLORIDE
172
POTASSIUM GLUCONATE
172,173
47
57
165
165
58
66
165
229
Page
Potsalan
PRALIDOXIME CHLORIDE
PRAZOSIN HYDROCHLORIDE
Pre-Pred
Pred Forte
Predair
Predair Forte
Predamide
Prednicen-N
PREDNISOLONE
PREDNISOLONE ACETATE
PREDNISOLONE ACETATE;
SULFACETAMIDE SODIUM
PREDNISOLONE SODIUM PHOSPHATE
PREDNISOLONE SODIUM PHOSPHATE;
SULFACETAMIDE SODIUM
PREDNISONE
Predsulfair
Predsulfair II
Pregnyl
Prelone
Presamine
Prevalite
Prilosec
PRIMIDONE
Principen
Prinivil
Prinzide 10 - 12.5
Prinzide 20 - 12.5
Prinzide 20 - 25
Probalan
Probampacin
PROBENECID
PROCAINAMIDE HYDROCHLORIDE
PROCAINE HYDROCHLORIDE
PROCAINE HYDROCHLORIDE;
TETRACYCLINE HYDROCHLORIDE
Procan
Procan-SR
Procapan
Procardia
Procardia XL
PROCHLORPERAZINE
PROCHLORPERAZINE EDISYLATE
PROCHLORPERAZINE MALEATE
Procrit
Proctocort
PROGESTERONE
Proklar
Prolixin
Prolixin Decanoate
Proloprim
Page
171
173
173
173
173
174
174
173
174
173
173
173
PROMAZINE HYDROCHLORIDE
Prometa
Prometh
Prometh Fortis
Prometh w/Codeine
Prometh VC Plain
Prometh VC w/Codeine
Prometh w/Dextromethorphan
Promethazine w/Dextromethorphan
PROMETHAZINE HYDROCHLORIDE
Promethazine with Codeine
Promethazine with Dextromethorphan
Promethazine VC
Promethazine VC w/Codeine
Pronestyl
Propachem
PROPAPHENONE HYDROCHLORIDE
PROPARACAINE HYDROCHLORIDE
Prophene
Propine
PROPOFOL
Propoxyphene Compound 65
PROPOXYPHENE HYDROCHLORIDE
PROPRANOLOL HYDROCHLORIDE
Prosom
Prostaphlin
Prostin VR Pediatric
PROTAMINE SULFATE
PROTIRELIN
Protopam
Protostat
PROTRIPTYLINE HYDROCHLORIDE
Proval No. 3
Proventil
Provera
Prozac
Pseudodine C
PSEUDOEPHEDRINE HYDROCHLORIDE;
TRIPROLIDINE HYDROCHLORIDE
Psorcon
Pyocidin
Pyopen
PYRAZINAMIDE
Pyribenzamine
Pyridamal 100
PYRIDOSTIGMINE BROMIDE
PYRIDOXINE HYDROCHLORIDE
PYRILAMINE MALEATE
Q-Gesic
Q-Pam
Quelicin
Quelicin Preservative-Free
174
174
174
173
173
104
173
121
50
156
175
16
131
111
111
111
175
15
175
175
176
176
175
175
175
153
153
176
176
176
84
115
177
190
97
97
204
230
177
139
177
177
58
165
58
66
66
177
58
66
165
58
175
114
178
178
178
78
178
20
178
179
88
157
9
179
180
173
145
180
2
7,8
136
97
58
180,181
74
116
39
181
204
47
181
181
181
21
72
189
189
Page
Questran
Questran Light
Quibron
Quinidex
QUINIDINE SULFATE
Quinora
R-P Mycin
R-Tannate
RANITIDINE HYDROCHLORIDE
Rapiflux
Redisol
Regitine
Reglan
Regonol
Rela
Relafen
Repan
Repronex
RESERPINE
Restoril
Retet
Retin-A
Reversol
Revia
Rheumatrex
Rhythmin
Rifadin
RIFAMPIN
Rimactane
RIMANTIDINE HYDROCHLORIDE
Rimifon
Ringer's
Ritalin
Ritalin-SR
RITODRINE HYDROCHLORIDE
Robaxin
Robaxisal
Robimycin
Robinul
Robinul Forte
Robitet
Robitussin AC
Robitussin DAC
Rocaltrol
Rondec Drops
Rondec Syrup
Rondec DM Drops
Rondec DM Syrup
Roxanol
Roxicet
Roxicet 5/500
Roxilox
Page
50
50
105
182
182
182
86
48
183
97
59
164
144
181
40
148
1
136
183
194
195
202
82
149
141
175
183
183
183
183
124
37
143
143
184
141
21
86
104
104
195
57
57
34
40
40
39
40
147
4
4
4
Roxiprin
Rubex
Rubivite
Rubramin PC
Rufen
Ruvite
Ryna C Liquid
Rynatan Pediatric
Rythmol
S.A.S.-500
Saluron
Sandimmune Injection
Sandril
Sansac
Sarisol
Sarisol #1
Sarisol #2
Satric
Scabene
Scandonest L
Scandonest Plain
SECOBARBITAL SODIUM
Seconal
Sectral
Sedapap
Seffin
SELEGILINE HYDROCHLORIDE
SELENIUM SULFIDE
Selsun
Sensorcaine
Septisoft
Septisol
Septra
Septra DS
Septra Grape
Serax
Serophene
Serpasil
Sil-O-Tuss DM
Sil-O-Tuss Elixir
Sil-Tex
Silvadene
SILVER SULFADIAZINE
Sinemet 10/100
Sinemet 25/100
Sinemet 25/250
Sinemet CR 25/100
Sinemet CR 50/200
Sinequan
Sinucon Pediatric Drops
Sinucon Pediatric Syrup
Sinucon Syrup
231
21
80
59
59
119
59
47
48
178
192
118
60
183
85
32
32
32
145
131
129
137
184
184
1
1
44
184
184,185
185
31
108
108
191,192
192
191
158
54
183
65
122
105
185
185
39
39
39
39
39
80
47
48
48
Page
Slo-Bid
Slo-Phyllin-80
Slow K
SMZ-TMP
SMZ-TMP Pediatric
SODIUM AMINOSALICYLATE
SODIUM CHLORIDE
SODIUM LACTATE
SODIUM NITROPRUSSIDE
SODIUM POLYSTYRENE SULFONATE
SODIUM SULFACETAMIDE
Sodium P.A.S.
Sodium Sulamyd
SOLTALOL HYDROCHLORIDE
Solu-Cortef
Solu-Medrol
Soma
Soma Compound
Soma Compound with Codeine
Somophyllin
Somophyllin-DF
Sonazine
Sorbitrate
Sorine
Sosol
Sotret
Soy-Dome
Soyacal 10%
Soyacal 20%
SOYBEAN OIL
Sparine
Spectazole
SPIRONOLACTONE
Sprintec
SPRX-3
SPS
SSD
Stadol
Stadol NS
Stadol Preservative-Free
Stanozide
Staticin
Statobex
Statobex-G
Stelazine
Stie-Cort
Stilbestrol
Stoxil
STREPTOMYCIN SULFATE
Strifon Forte DSC
Sublimaze Preservative-Free
SUCCINYLCHOLINE CHLORIDE
Page
196
196
171
191,192
191
185
185,186
186
186
188
190
185
190
188
117
143
40
20
20
11
11
48
125
188
193
125
108
188
188
188
177
81
188,189
91
163
188
185
33
33
33
124
85
163
163
203
115
74
120
189
50
94
189
Sucostrin
SUCRALFATE
Sufenta
SUFENTANIL CITRATE
Sulf-10
Sulf-15
Sulfa-Triple #2
SULFABENZAMIDE; SULFACETAMIDE;
SULFATHIAZOLE
Sulfacel-15
SULFACETAMIDE SODIUM
SULFADIAZINE
SULFADIAZINE; SULFAMETHAZINE;
SULFAMERAZINE
Sulfair-10
Sulfair-15
Sulfair Forte
Sulfalar
Sulfaloid
SULFAMETHIZOLE
Sulfamethoprim
Sulfamethoprim-DS
SULFAMETHOXAZOLE
SULFAMETHOXAZOLE; TRIMETHOPRIM
SULFANILAMIDE
SULFASALAZINE
Sulfatrim
Sulfatrim DS
Sulfatrim Pediatric
Sulfatrim SS
SULFINPYRAZONE
SULFISOXAZOLE
Sulfose
SULINDAC
Sulmeprim
Sulmeprim Pediatric
Sulphrin
Sulsoxin
Sulster
Sulten-10
Sultrin
Sumycin
Symadine
Symmetrel
Synacort
Synalar
Synalgos-DC-A
Synkavite
Synovalyte
Syntocinon
Sytobex
T-Stat
232
189
189
189
189
190
190
205
189,190
190
190
190
205
190
190
190
193
205
190
191,192
192
191
191,192
192
192
191
192
191
192
192
192,193
205
193
191
191
173
193
174
190
189,190
195,196
10
10
115
95
2
136
134
159
59
85
Page
Tace
Tagamet
Talacen
Talwin NX
Tambocor
TAMOXIFEN CITRATE
Tapazole
Taxol
Tavist
Tavist-1
Tazicef
Tazidime
Taztia XT
Teebacin
Tegopen
Tegretol
Temaril
Temaz
TEMAZEPAM
Temovate
Temovate E
Tencon
Tenex
Tenoretic 50
Tenoretic 100
Tenormin
Tensilon
Tensilon Preservative-Free
Tenuate
Tepanil
Terazol 3
Terazol 7
TERAZOSIN
TERBUTALINE SULFATE
TERCONAZOLE
Terfonyl
Terramycin
Tessalon Perles
TESTOSTERONE CYPIONATE
TESTOSTERONE ENANTHATE
TESTOSTERONE PROPIONATE
TETRACAINE HYDROCHLORIDE
Tetrachel
TETRACYCLINE HYDROCHLORIDE
Tetracyn
Tetramed
Texacort
TFP
Theo-Dur
Theoclear-80
Theocron
Theolair
Page
46
51
4
149
94
193
140
159
52
52
42
42
76
185
56
39
204
194
193,194
54
54
1
106
22
22
21
82
82
74
74
194
194
194
194
194
205
159
26
194
194
195
195
195
195,196
176,195,196
196
116
203
196
196
196
196
Theolixir
THEOPHYLLINE
Thermazine
THIAMINE HYDROCHLORIDE
Thioplex
THIORIDAZINE HYDROCHLORIDE
Thiosulfil
THIOTEPA
THIOTHIXENE
THIOTHIXENE HYDROCHLORIDE
Thorazine
Thypinone
Thyrel TRH
Tiazac
Ticlid
TICLOPIDINE HYDROCHLORIDE
Tigan Injection
TIMOLOL MALEATE
Timoptic
Timoptic XE
TIZANIDINE HYDROCHLORIDE
Tobradex
TOBRAMYCIN
TOBRAMYCIN SULFATE
Tobrex
Tofranil
TOLAZAMIDE
TOLBUTAMIDE
Tolectin
Tolectin 600
Tolectin D.S.
Tolinase
TOLMETIN SODIUM
Topicort
Topicort LP
Toposar
Tora
Toradol
TORSEMIDE
Totacillin
Totacillin-N
Tracrium
Tracrium Preservative-Free
TRAMADOL
Trandate
Trandate-HCT
Tranmep
Transderm-Nitro
Tranxene
Travamulsion 10%
Travamulsion 20%
TRAZODONE HYDROCHLORIDE
233
196
196
185
197
198
197,198
190
198
198
198
48
180
180
76
198
198
204
198,199
199
199
199
63
199
199,200
199
121
200
200
201
201
201
200
200,201
63
63
93
164
127
201
16
16
22
22
201
127
111
138
154
56
188
188
201
Page
Page
Tremin
203
Trental
162
TRETINOIN
202
Tri-Sprintec
91
Tri-Vi-Flor
19
Tri-Vi-Flor w/ Iron
19
Tri-Vitamin Drops w/Fluoride
19
Triacet
202
Triacin-C
58
Triacort
202
Triad
1
Trialodine
201
TRIAMCINOLONE ACETONIDE
202
Triaprin
1
Triatex
202
Triavil 2-10
13
Triavil 2-25
13
Triavil 4-10
13
Triavil 4-25
13
Triavil 4-50
13
TRIAZOLAM
203
Tricor
93
Triderm
202
Tridesilon
62
Tridil
154
TRIFLUOPERAZINE HYDROCHLORIDE
203
TRIFLURIDINE
203
TRIHEXYPHENIDYL HYDROCHLORIDE
203
Trilafon
162
Trilitron
181
TRIMEPRAZINE TARTRATE
204
TRIMETHOBENZAMIDE HYDROCHLORIDE
204
TRIMETHOPRIM
204
Trimox
14
Trimpex
204
Trinessa
91
Triotann S
48
TRIPELENNAMINE HYDROCHLORIDE
204
Triphasil
90
Triphed
181
Triple Sulfa
189,190,205
Triple Sulfas
205
Triple Sulfoid
205
Triple-Vita-Flor 0.25mg
19
Triple-Vita-Flor 0.5mg
19
TRIPROLIDINE HYDROCHLORIDE
204
TRISULFAPYRIMIDINE
205
Tri Vitamin Drops w/Fluoride 0.25mg
19
Tri Vitamin Drops w/ Fluoride 0.5mg
19
Trivora
90
Tropicacyl
205
TROPICAMIDE
205
Trymex
Trysul
TUBOCURARINE CHLORIDE
Turgex
Tussend
Tussend Expectorant
Tussi Organidin
Tussi-Organidin DM
Tussi-R-Gen Expectorant
Tussigon
Tycolet
Tylenol with Codeine
Tylox
U-Cort
U-Gencin
Ultracef
Ultragris 165
Ultragris 330
Ultram
Unipen
Unithroid
Univasc
Urecholine
Urex
Urobak
Urologic G
Uroplus SS
Uroplus DS
URSODIOL
Uticillin-VK
Utimox
Vagilia
Vagitrol
Valisone
Valium
Valnac
VALPROIC ACID
VANCOMYCIN HYDROCHLORIDE
Vancocin
Vancoled
Vancor
Vanspar
Vantin
Vaseretic
Vascor
Vapo-ISO
Vasocidin
Vasocon
Vasocon A
Vasotec
V-Cillin K
Vectrin
234
202
190
205
108
114
105
57
65
57
108
4
2
4
117
101
41
105
105
201
148
129
147
28
140
191
52
192
192
206
161
14
190
192
28
72
28
206
206
206
206
206
32
42
82
27
125
173,174
149
17
82,83
161
146
Page
VECURONIUM BROMIDE
Veetids 125
Veetids 250
Veetids 500
Velban
Velosef
Velosef 125
Velosef 250
Veltane
Ventolin
VePesid
VERAPAMIL HYDROCHLORIDE
Verelan
Vermidol
Vermox
Versed
Vi-Dom-A
Vi-Twel
Vibisone
Vibra-Tabs
Vibramycin
Vicodin
Vicodin ES
Vicodin HP
Vicoprofen
VINBLASTINE SULFATE
Vincasar PFS
Vincrex
VINCRISTINE SULFATE
Vincristine Sulfate Preservative-Free
Viroptic
Visken
Vistaril
VITAMIN A
VITAMIN A PALMITATE
VITAMIN D
Vivactil
Vivelle
Vivelle-Dot
Voltaren
Voltaren-XR
Volmax
VoSol
VoSol HC
VoSpire ER
WARFARIN SODIUM
WATER FOR INJECTION
WATER FOR IRRIGATION
Wellbutrin
Wellbutrin-SR
Wellcovorin
Westcort
Page
206
161
161
161
207
44
44
44
30
7,8
92
206,207
207
166
135
146
209
59
59
81
80,81
4
4
4
114
207
207
207
207,208
208
203
166
119,120
208
208,209
84
180
88
88
73
73
8
5
6
8
210
210
210
32
32
128
117
Wigraine
Wigrettes
Wyamycin-E
Wyamycin-S
Wycillin
Wygesic
Wymox
Wytensin
X-Trozine
Xanax
Xylocaine
Xylocaine Preservative-Free
Xylocaine with Epinephrine
Xylocaine with Glucose
Xylocaine 4% Preservative-Free
Xylo-Pfan
XYLOSE
Yutopar
Zanaflex
Zantac
Zarontin
Zaroxolyn
Zaxopam
Zebeta
Zeroxin-5, -10
Zestoretic 10 - 12.5
Zestoretic 20 - 12.5
Zestoretic 20 - 25
Zestril
Ziac
Zide
Zinacef
Zipan-25
Zipan-50
Zolicef
Zovia 1/35E
Zovia 1/50E
Zovirax
Zyloprim
5-Benzagel
10-Benzagel
235
33
85
86
87
160
4
14
106
163
9
130
130
84
69
131
210
210
184
199
183
91
144
158
29
26
111
111
111
131
29
110
43
177
177
42
89
89
7
9
26
26
Illinois Department of Public Health
Office of Health Protection
Division of Food, Drugs and Dairies
525 W. Jefferson St.
Springfield, IL 62761-0001
Printed by Authority of the State of Illinois
P.O. 523246 4.3M 6/03
PAID
Springfield, IL
Permit No. 101
PRSRT STD
U.S. POSTAGE