Updated Formulary: 16June2005

UPDATED FORMULARY: 16JUNE2005

Naval Health Clinic Patuxent River Pharmacy Department
Outpatient Formulary

Phone (301) 342-1453/1454
The following is a list of medications currently carried at the NavalHealthClinicPatuxentRiver Pharmacy in Maryland. This list is designed to assist civilian practitioners in the community when prescribing medications for eligible military beneficiaries. Only generic equivalent products are available at Navy facilities for many of the brand name products on the market today. The listing of the brand name does not imply that the brand name is stocked.
RESTRICTIONS ARE INCLUDED:
ALL MEDICATIONS ARE LISTED BY GENERIC NAME.
-Telephone prescriptions and Fax prescriptions are not permitted.
-All substitutions are generic, not therapeutic.
- Include complete written directions on prescriptions (“as directed” is not acceptable)
-Refills are honored up to a maximum of one year and all other controlled substances (CIII-CV) up to a 30-day supply with no more than 5 refills.
- Prescriptions must be renewed after 12 months.
-All narcotic (C II) medications are limited to 30 doses or 30 days with written diagnosis and no refills. The prescription must be received by the pharmacy within 7 days of being written.
-Attention Deficit Hyperactive Disorder medications may be prescribed for 90 days.
-Prescribe each item on a separate prescription paper.
Prescribe amounts in cursive, i.e. ten; not 10.
-To request refills go online to or call 1-800-377-1723. Refills requested before 3 pm will be ready in 4 business days. Refills requested after 3 pm will be ready in 4 business days from the following day.
-Prescriptions must be picked up within 7 days or they are returned to stock.
-Patients have option to fill prescriptions at Tricare Mail Order Pharmacy ( or at a civilian pharmacies (CVS, Target, or Giants) and use Tricare Benefits (Co-pay = $3/generic to $9/brand).
ACETAMINOPHEN
80MG CHEWABLE TAB
ACETAMINOPHEN
325MG TAB
ACETAMINOPHEN
80MG/0.8ML DROPS,
160MG/5ML ELIX
ACETAMINOPHEN
120, 325, 650MG SUPP
ACETIC ACID 2% OTIC SOL

ACTIFED TAB/ SYRUP

ACYCLOVIR 200 CAP
ACYCLOVIR 400MG TAB
ACYCLOVIR 800MG TAB
ACYCLOVIR 5% OINT
ADDERALL 5, 10, 20MG
ADDERALL XR 10, 20, 30MG
ADVAIR 100, 250, 500MG INH

ALBUTEROL INH SOLN 0.5%

ALBUTEROL ORAL MDI
ALBUTEROL 2MG/5ML SYRUP
ALBUTEROL NEBULIZER
ALENDRONATE 5, 10, 35, 75MG
ALLOPURINOL 100, 300MG TAB
ALPRAZOLAM 0.25, 0.5MG TAB
ALUMINUM SULFATE
(BLUBORO TABS)
AMANTIDINE 100MG CAP
AMCINONIDE CREAM, OINT
AMIODARONE 200MG TAB
AMITRIPTYLINE 10, 25, 50MG
AMLODIPINE 2.5, 5, 10MG TAB
AMPICILLIN 250, 500MG
DILTIAZEM 30, 60MG TAB
DILTIAZEM SR
180, 240, 300, 360MG CAP
DIPHENHYDRAMINE 25MG CAP
DIPHENHYDRAMINE
12.5MG/5ML ELIX
DIPYRIDAMOLE 25, 50MG TAB
DISULFIRAM 250MG TAB
DIVALPROEX 125, 250, 500MG
DIVALPROEX ER 250, 500MG
DIVALPROEX SPRNK 125MG
DOCUSATE SODIUM
100MG CAP (COLACE)
50MG/5ML SOL
DONEPEZIL 5, 10MG TAB
DONNATAL TAB ELIX
DORZOLAMIDE OPTH SOL

DOXEPIN 10, 25, 50MG CAP

DOXYCYCLINE 50, 100MG TAB
DURAGESIC PATCH
25, 50, 75, 100MG
ENOXAPARIN (LOVENOX) INJ
ENTEX PSE TAB
ERYTHROMYCIN 250MG TAB
ERYTHROMYCN ETHYLSUC
200MG/5ML SUSP
ERYTHROMYCIN
OPHTH OINT,
2% TOPICAL SOLN
ESTRADIOL TRANSDERMAL
ESTROGEN CONJUGATED
0.3, 0.625, 0.9, 1.25MG TAB
ESTROGEN CONJUGATED
0.625MG/GM VAG OINT
ETHAMBUTOL 100, 400MG TAB
EUCERIN CREAM 114, 454GM
EUCERIN LOTION
FERROUS SULF 325MG TAB
FERROUS SULF 220MG/ML SOLN
FIORICET TAB
FIORINAL TAB
FLEET ENEMA PED, ADULT
FLUCONAZOLE
100, 150, 200MG TAB
FLUCONAZOLE 10MG/ML
40MG/ML SUSPENSION
FLUOCINONIDE 0.05% CRM
FLUOXETINE
10MG TAB, 20MG CAP
FLUTICASONE (FLONASE)
16GM NASAL SPRAY
FLUTICASONE (FLOVENT)
44, 110, 220MG ORAL INH
FOLIC ACID 1MG TAB
FUROSEMIDE 40MG TAB
GABAPENTIN 100, 300,
400MG CAP, 600, 800MG TAB
GATIFLOXACIN 200, 400MG TAB
GAVISCON CHEW TAB
GEMFIBROZIL 600MG TAB
GENTAMICIN 0.3%
OPHTH SOLN, OINT
GLIMEPIRIDE 1, 2, 4MG TAB
GLIPIZIDE 5, 10MG TAB
GLIPIZIDE XL 2.5, 5, 10MG TAB
GLUCAGON EMERGENCY KIT
GLYBURIDE 1.5, 2.5, 3, 5MG TAB
GLYCERIN SUPPOSITORY
ADULT, INFANT
GLYCOPYRROLATE 1MG TAB
GOSERELIN 3.6, 10.8MG IMPLAN
GRISEOFULVIN 125, 250MG TAB
GRISEOFULVIN 125MG/5ML
GUAIFENESIN DM TAB
GUAIFENESIN LA 600MG TAB
HALOPERIDOL 1, 2, 5MG TAB
HEMORRHOIDAL HC 25MG SUP
HOMATROPINE 2% OPTH SOL
HUMULIN ULTRALENTE
HYDRALAZINE 10, 25, 50MG
HYDROCHLOROTHIAZIDE
25MG, 50MG TAB
HYDROCORTISONE 1%,2.5%CR
HYDROCORTISONE VAL 0.02% CRM
HYDROXYCHLOROQUINE
200MG / AMONIUM LACTATE LOTION
AMOXICILLIN 250, 500MG CAP
AMOXICILLIN CHEWABLES
250MG, 400MG
AMOXICILLIN 875MG TAB
AMOXICILLIN 125MG/5ML SUSP
AMOXICILLIN 250MG/5ML SUSP
ANTIPYRINE/BENZOCAINE
OTIC SOLN (AURALGAN)
ANTAZOLINE PHOSPHATE
(VASOCON-A) EYE DROPS
AQUAPHOR OINT
ARTIFICIAL TEARS EYE DROPS
ASCORBIC ACID 500MG TAB
ASPIRIN CHEWABLE 81MG TAB

ASPIRIN 325MG TAB

ASPIRIN 81, 325MG EC TAB
ATROPINE 1% OPTH SOLN
ATENOLOL 25, 50, 100MG TAB
ATOMOXETINE 18, 40MG CAP
AUGMENTIN 250, 500, 875MG AUGMENTIN CHEWABLE
200, 400MG TAB
AUGMENTIN 125MG/5ML SUSP
AUGMENTIN 250MG/5ML SUSP
AUGMENTIN 400MG/5ML SUSP
AUGMENTIN ES 600MG/5ML
AVANDAMET TABLET
AZITHROMYCIN
100MG/5ML SUSP
200MG/5ML SUSP
AZITHROMYCIN 1GM PACK
AZITHROMYCIN 250MG TAB
BACITRACIN TOP OINT
HYDROXYZINE HCL
10, 25, 50MG TAB
HYDOXYZINE PAMOATE TAB
HYDROXYZINE HCL
10MG/5ML SYR
IBUPROFEN 200MG CHEW TAB,
400, 600, 800MG TAB
100MG/5ML SUSP
IMIPRAMINE 25, 50MG TAB
INDOMETHACIN 25MG CAP
IPECAC SYRUP, USP
IPRATROPIUM BROMIDE
INH SOLN NEB, ORAL MDI
ISONIAZID 300MG TAB
ISOPTO HYOSCINE
0.25% OPHT SOLUTION
ISOSORBIDE DINITRATE
10, 20, 40MG TAB
ISOSORBIDE MONONITRATE
KAOPECTATE TYPE SUSP
KETOCONAZOLE
2% CREAM, SHAMPOO
LACRILUBE TYPE OPHTH
OINT, SOL (HYPOTEARS)
LACTULOSE 10GM/15ML SYR
LANTUS INJ
LATANOPROST 0.005%
OPHT SOL (XALATAN)
LEVOBUNOLOL 0.5% OPHT SOL
LEVOTHYROXINE SODIUM
0.025, 0.05, 0.075, 0.088, 0.1,
0.112, 0.137, 0.125, 0.15, 0.175
0.2MG TAB
LIDOCAINE 2% JELLY
LIDOCAINE 2% VISCOUS
LINDANE 1% SHAMPOO
LISINOPRIL 2.5, 10, 20, 30, 40MG
LITHIUM CARB 300MG TAB
LO-ESTRIN 1/20, (21 DAY)
LO-ESTRIN-FE 1/20
LO-ESTRIN FE 1.5/30
LO-OVRAL
LOMOTIL TABS
LOPERAMIDE 2MG CAP
LORATIDINE 10MG TABS
LORAZEPAM 0.5, 1MG TABS
LOSARTAN 25, 50, 100MG TAB
MAGNESIUM CITRATE SOLN
MAGNESIUM OXIDE 400MG TAB
MAXZIDE 75/50, 37.5/25 TAB
MEBENDAZOLE 100MG CHEW
TAB
MECLIZINE 25MG TAB
MEDISENSE LANCETS
MEDROXYPROGESTERONE
2.5, 5, 10MG TAB
MEGESTROL 40MG TAB
MELOXICAM 7.5, 15MG TAB
MEPERIDINE 50MG TAB
MESALAMINE 400MG TABS
METAPROTERENOL
ORAL MDI
METAPROTERENOL
20MG TAB
METFORMIN 500, 850MG TAB
METHOCARBAMOL
500MG TAB
MERCATOPURINE 50MG TAB
METHYLERGONOVINE 0.2MG TAB
METHYLPREDNISOLONE
4MG TAB AND
MEDROL DOSE PACK
METHYLPHENIDATE
5, 10, 20MG TAB
METOCLOPRAMIDE
10MG TAB
METOLAZONE 2.5, 5MG TAB
METOPROLOL 50, 100MG TAB
METRONIDAZOLE 250MG TAB
METRONIDAZOLE 0.75% TOP
METRONIDAZOLE VAG GEL
MICONAZOLE 2% CRM
MICARDIS/HCTZ 40/12.5, 80/12.5MG
MIDRIN TYPE CAP MILK OF MAGNESIA SUSP / BACITRACIN OPTH OINT
BACLOFEN 10, 20MG TAB
BELLERGAL-S
BEN-GAY METHOL/METHYL
OINTMENT
BENZONATATE 100MG PERLES
BENZOYL PEROX 5%, 10% GEL
BENZOYL PEROX 5%, 10% WASH
BENTROPINE (CONGENTIN)
BETAMETHASONE VAL. 1%
BETAXOLOL 0.5% OPTH SOL
BETAXOLOL 0.25%(BETOPTIC S)
BETHANECHOL 10, 25MG TAB
BISACODYL 5MG TAB, 10MG SUPP
BISMUTH SUBSALICYLATE
262 MG TAB, LIQUID
BLEPHAMIDE 10% OPHTH
OINTMENT
BRIMONIDINE
(ALPHAGAN) OPTH
BROMOCRIPTINE 2.5, 5MG TAB
BUDESONIDE INH
BUPROPIO REG 75, 100MG TAB
BUPROPION SR 100, 150, 200MG
BUSPIRONE 5, 10, 15MG TAB
CAFERGOT TAB
CALAMINE LOTION
CALCIUM 500MG PLAIN
CAPTOPRIL 25MG TAB
CARBAMAZEPINE
100, 200MG TAB
CARDEC SYRUP
MINERAL OIL USP
MOMETASONE NASAL SPRAY
50MCG (NASONEX)
MONTELUKAST 4, 5 (CHEW),
10MG CHEW TAB
MOXIFLOXACIN 0.5% OPTH SOL
MS CONTIN 15, 30, 60MG TAB
MULTIVITAMIN
(ONEDAILY) TAB, CHEW
MULTIVITAMIN W/FLUORIDE
0.25, 0.5, 1MG TAB
MULTIVITAMIN W/IRON
AND FLUORIDE 0.5MG TAB
MUPIROCIN 2% OINT
MYCOLOG II CREAM, OINT
NAPROSYN 250, 275, 375,
500, 550MG TABS
NECON 1/35
NIACIN 50, 250, 500MG TAB
NIASPAN 500, 750, 1000MG TAB
NICOTINE PATCH
7, 14, 21MG TRANSDERMAL
NIFEDIPINE 10MG CAP
NIFEDIPINE (ADALAT CC)
30, 60, 90MG TAB
NITROFURANTOIN
(MACROBID) 50, 100MG CAP-
.025MG/5ML SUSP
NITROGLYCERIN SUBLINGUAL
0.3, 0.4, 0.6MG TAB
NITROGLYCERIN PATCH
0.1, 0.2, 0.3, 0.4, 0.6, 0.8MG
NITROGLYCERIN SPRAY
NORETHINDRONE 0.35MG
NORINYL 1/35-1/50 TAB
NORTRIPTYLINE 10, 25MG CAP
NOVOLIN NPH
NOVOLIN REGULAR
NOVOLIN 70/30
NOVOLOG INJECTION
NYSTATIN ORAL SUSP, CREAM
OLOPATADINE OPHT SOL
0.1% (PATANOL)
OMEPRAZOLE 20, 40MG CAP
ORTHO-EVRA PATCH
ORTHO-NOVUM 7/7/7 TAB
OS-CAL 500MG TAB
OS-CAL VIT-D 500MG TAB
OXIFLOXACIN OTIC SOL
OXYBUTYNIN 5MG TAB
OXYCODONE 5MG TAB
OXYCODONE/APAP
5/325MG TAB (PERCOCET)
OXYCONTIN SR
10, 20, 40, 80MG TAB
OXYMETAZOLINE
0.05% NASAL SPRAY
PAROXETINE
10, 20, 30, 40MG TAB
PENICILLIN V 250/5ML SUSP
PENICILLIN VK 250, 500MG TAB
PERMETHIN 5% CREAM
PETROLATUM JELLY
PHENAZOPYRIDINE 100MG TAB PHENOBARBITAL 15, 30MG TAB PHENYLEPHRINE HCL 2.5%
NASAL SOLN
PHENYTOIN 50MG TAB, 100MG CAP
PILOCARPINE 1, 2% OPHTH SOLN
PIMECROLIMUS (ELIDEL) CRM
PIROXICAM 20MG CAP
POLYSPORIN OPHTH OINT
POLYTRIM OPTH SOLUTION
POTASSIUM CL 20 mEq TAB
PRAZOSIN 1, 2MG CAP
PRECISION EXTRA
BLOOD GLUCOSE MONITOR
BLOOD GLUCOSE STRIP
PREDNISONE 5, 10, 20, 50MG TB
PREDNISOLONE OPHTH SUSP
1% (PRED FORTE)
PREDNISOLONE
15MG/5ML SYR REG
15MG/5ML SYR
PREMPRO 0.3MG/1.5MG, 06.25/5 / CARBIDOPA/LEVODOPA 10-100
CARBIDOPA/LEVODOPA 25/100
CARBIDOPA/LEVODOPA 25/250
CARISOPRODOL 350MG TAB
CARTEOLOL 1% OPTH SOL
CEFUROXIME 125MG/5ML SUSP
CEFUROXIME 250MG/5ML SUSP
CELEBREX 100, 200MG CAP
CEPACOL LOZG REG
CEPACOL LOZG XTRA
CEPHALEXIN 250, 500MG CAP
CEPHALEXIN 250MG/5ML SUSP
CETIRIZINE 5, 10MG TAB, 1MG-ML SYRUP
CETAPHIL CLEANSER
CHLORHEXIDINE
GLUCONATE 0.12% ORAL
CHLOROQUINE 500MG TAB
CHLORPHENIRAMINE
4MG TAB, 2MG/5ML SYRUP
CHLORPROMAZINE 25MG TAB
CHLORTHALIDONE
CHOLINE MAG. TRI. 750MG
CIMETIDINE 300, 400MG TAB,
300MG/5ML SYRUP
CIPROFLOXACIN 250, 500,
750MG TAB
CIPROFLOXACIN OPHT SOL
CITALOPRAM 20, 40MG TAB
CLINDAMYCIN 150MG CAP
CLINDAMYCIN 1% TOP SOLN
CLINDAMYCIN 75MG/5ML SUSP
CLINDAMYCIN 2% VAG CRM
CLONAZEPAM 0.5MG TAB
PRENATAL VITAMINS TAB
PRIMIDONE 50MG TAB
PRIMAQUINE 26.3MG TAB
PROBENECID 500MG TAB
PROCHLORPERAZINE
5, 10MG TAB, 25MG SUPP
PROCTOFOAM 1%
PROMETHAZINE 25MG TAB
PROMETHAZINE 12.5, 25MG
SUPPOSITORY
PROPRANOLOL
10, 40, 60, 80MG TABS
PROPRANOLOL LA
60, 80, 120, 160MG CAPSULE
PROPYLTHIOURACIL 50MG TABS
PSEUDOEPHEDRINE
30, 60MG TABS,
30MG/5ML SYR
PSYLLIUM MUCILLOID WITH
DEXTROSE 3.4GM
POWDER
PULMICORT MDI,
0.25, 0.5 NEBULIZER
PYRAZINAMIDE 500MG TAB
PYRIDOXINE 50MG TAB
QUETIAPINE TAB
QUINIDINE SULFATE
200MG TAB
QUINIDINE
GLUCONATE 324MG TAB
QUININE SULFATE
260MG TAB
325MG CAP
RABEPERAZOLE
(ACIPHEX) 20MG TAB
RALOXIFENE TAB
RANITIDINE 150MG
TABS, 15MG/ML,SYR
RISPERDAL
0.5, 1, 2, 3, 4MG TAB
RIFAMPIN 300MG CAP
ROBITUSSIN 100MG/5ML SYR
ROBITUSSIN DM
ROBITUSSIN WITH
CODEINE
ROSIBLITAZONE 2, 4, 8MG TAB
SALICYLIC ACID
SALMETEROL INH
ORAL DISKUS
SALSALATE 500MG TAB
SCOPOLAMINE 1.5MG PATCH
SELENIUM SULFIDE
2.5% SHAMPOO
SENNOSIDES TAB
8.6MG (SENOKOT)
SEPTRA DS/BACTRIM
TAB, SUSPENSION
SERTRALINE
25, 50, 100MG TABS
SHARPS CONTAINER SILVADENE 1% CRM
SIMETHICONE 80MG CHEW / DROPS
SIMVASTATIN
5, 10, 20, 40MG TAB
SOD CHLORIDE NASAL 0.65%
SPRAY
SODIUM FLORIDE
0.25, 0.5, 1MG TAB
DENTAL GEL
1.1% 60GM TUBE
0.25MG DROPS
SOD SULFACET 10%
OPHTH SOLN, OINT.
SPIRONOLACTONE
25MG TAB
SUCRALFATE 1GM TAB
SULFASALAZINE EC
500MG TAB
SULINDAC 200MG TAB
SUMATRIPTAN
25, 50, 100MG TAB
SUMATRIPTAN STAT DOSE
AUTOINJECTOR
SUBCUTANIOUS / CLONIDINE 0.1, 0.2, 0.3MG TAB
CLOPIDOGREL 75MG TAB
CLORAZEPATE 3.75MG TAB
CLOTRIMAZOLE 1% CRM,
TOPICAL, SOLN, VAG. CRM
COLCHICINE 0.6MG TAB
COLESTIPOL 1G TAB
COLESTIPOL SUSP
COLYTE (FLAVORED)
COMBIVENT INH
CONCERTA 18, 27, 36, 54MG TAB
CORTISPORIN OTIC SUSP
CROMOLYN ORAL MDI
CYCLOBENZAPRINE 10MG TAB
CYPROHEPTADINE 4MG TAB
DACRIOSE IRRIG. SOLUTION
DARVOCET 100MG/650MG TAB
DEBROX OTIC DROPS
DECONAMINE SR CAP
DEMULEN 1/35
DESMOPRESSIN
NSL SPRAY (DDAVP)
DEXAMETHASONE
0.5, 1, 4MG TAB
DIAZEPAM 5MG TAB
DIBUCAINE 1% OINT
DICLOFENAC 50, 75MG TAB
DICLOXACILLIN 250MG CAP
DICLOXACILLIN 62.5MG/5ML
DICYCLOMINE
10MG CAP, 20MG TAB
DIGOXIN 0.125, 0.250MG TAB
DIGOXIN 50MCG/1ML ELIX
TAMOXIFEN 10, 20MG TAB
TELMISARTAN 20, 40, 80MG TAB
TEMAZEPAM
15, 30MG CAPS
TERAZOSIN
1, 2, 5, 10MG CAP
TERBUTALINE
2.5, 5MG TAB
TETRACYCLINE 250MG CAP
TETRACAINE 0.5% OPH SOLN
THEO-DUR 300MG TAB
THIAMINE 50MG TAB
TIMOPTIC 0.25, 0.50% OPHTH
TOBRAMYCIN 0.3%
OPH OINT
TOCOPHEROL (VIT E)
400UI CAP
TOLTERODINE LA 2, 4MG CAP
TRAMADOL 50MG TAB
TRAZODONE 50MG TAB
TRETINOIN 0.05MG CRM
TRETINOIN 0.025% GEL
TRIAMCINOLONE ORAL MDI
TRIAMCINOLONE/
NYSTATIN CRM
TRIAMCINOLONE
0.1% CRM,
DENTAL PATSE
TRIAZOLAM
0.25, 0.5 MG TAB
TRIHEXYPHENIDYL 2, 5MG TAB
TRI-LEVLEN 28 TAB
TRIMETHOBENZAMIDE 200mg
SUPP
TUCKS PADS
TYLENOL III TABS
TYLENOL III ELIXIR
VALACYCLOVIR
500, 1000MG TAB
VASCON-A OPHTH
SOLN
VENLAFAXINE
25, 35, 50, 75MG TAB
VENLAFAXINE XR
35, 75, 150MG CAP
VERAPAMIL 80MG, 180MG SR,
240MG SR TAB
VICODIN 5/500MG TAB
VITAMIN C 500MG TAB
VITAMINS, MULTIPLE (DAILY) TAB,
CHEW
VIDAYLIN MULTIVITAMIN DROPS
VITAMINS PRENATAL TABS
VITAMIN A & D OINT
WARFARIN 1, 2, 2.5, 3,
4, 5, 6, 7.5, 10MG TAB
ZINC OXIDE OINT
ZOLMITRIPTAN 2.5, 5MG TABS
ZOLPIDEM
5, 10MG TAB