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Huntsville Hospital

Approved Hospital Formulary

Suggestions or Corrections? Above and Beyond Nominations Formulary Request

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Medications not yet evaluated by P&T are considered NON-FORMULARY . . . . . Always check 2 unique patient identifiers - NAME and DATE OF BIRTH - at every step! . . . . . Please be sure to document all clinical activities daily.

Huntsville Hospital

Approved Hospital Formulary

Suggestions or Corrections? Above and Beyond Nominations Formulary Request

Formulary, Not Routinely Stocked

Please review each of these drugs carefully.

abarelix	Plenaxis
acetic acid otic	Acetasol --> 2%
acitretin
aclidinium	Tudorza Pressair
adefovir
albuterol	Proventil 2 mg tablet; Vospire ER 4 mg ER tablet
alefacept
alfuzosin
allopurinol	Aloprim
alogliptin	6.25 mg, 25 mg
alosetron	Lotronex: 0.5 mg tablet, 1 mg tablet
aluminum hydroxide-magnesium hydroxide-simethicone
amifostine
aminolevulinic acid	1500 mg (Must order by 1400 to receive by following day)
amoxicillin-clavulanate	Augmentin XR --> 1000 mg-62.5 mg
amphetamine-dextroamphetamine	Adderall --> 12.5 mg, 30 mg Adderall XR --> 10 mg, 15 mg, 25 mg, 30 mg
ampicillin	250 mg capsules, oral supsension
anagrelide	Agrylin --> 0.5 mg capsule, 1 mg capsule
anakinra	100 mg/0.67 mL prefilled syringe
antithrombin recombinant
APAP/dichloralphenazone/isometheptene	January 2017
aprepitant	Emend --> 80 mg capsule, 125 mg capsule
arginine	Deprecated: preg_match(): Passing null to parameter #2 ($subject) of type string is deprecated in /var/www/formweb/system/views/site/listingview.php on line 46
ARIPiprazole	Abilify --> 1 mg/ mL oral solution
artesunate	110 mg
asparaginase Erwinia chrysanthemi
asparaginase Erwinia chrysanthemi, recombinant
atazanavir	Reyataz --> 200 mg capsule
atoMOXetine	10 mg capsule
atropine ophthalmic	1% ointment
aZITHromycin ophthalmic	1% ophthalmic 2.5 mL bottle
bacitracin ophthalmic	500 units/g
bacitracin/HC/neomycin/polymyxin B ophthalmic	bacitracin/HC/neomycin/polymyxin B ophthalmic as a generic is FNRS.
becaplermin topical	Regranex --> 0.01% gel
beclomethasone nasal	beclomethasone (BECONASE AQ) 42 mcg 25 g bottle
belladonna-opium	Deprecated: preg_match(): Passing null to parameter #2 ($subject) of type string is deprecated in /var/www/formweb/system/views/site/listingview.php on line 46
benazepril	Lotensin
benazepril-hydroCHLOROthiazide	Lotensin HCT
betaxolol ophthalmic	Betoptic S --> 0.25%
bethanechol	Urecholine, Duvoid --> 5 mg tablet, 50 mg tablet
bictegravir-emtricitabine-tenofovir alafenamide
brivaracetam	10 mg, 75 mg, 100 mg, Oral Solution
budesonide nasal	Rhinocort Aqua
busulfan	Myleran --> 2 mg tablet
cadexomer iodine topical
calcipotriene topical	Dovonex --> 0.005% topical cream 60 g tube
calcitriol	Rocaltrol --> 1 mcg/mL 1 mL vial
candesartan
candesartan-hydroCHLOROthiazide
capecitabine	150 mg
captopril	25 mg
carbidopa-levodopa-entacapone	18.75-75-200 mg tablet; 31.25-125-200 mg tablet; 25-100-200 mg tablet
cariprazine	4.5 mg, 6 mg
carteolol ophthalmic	1% ophthalmic 5 mL
caspofungin	Cancidas --> 50 mg, 70 mg
cenobamate
certolizumab	Cimzia --> 200 mg subcutaneous
charcoal-sorbitol
chlorambucil	Leukeran --> 2 mg tablet
chlorproMAZINE	Thorazine --> 100 tablet
chlorproPAMIDE	Diabinese --> 250 mg tablet
ciprofloxacin	Cipro --> 750 mg tablet
clarithromycin	250 mg tablet, 125 mg/5 mL oral susp., 250 mg/5 mL oral susp.
clindamycin topical	Cleocin --> 2% cream
cloBAZam	Onfi --> 20 mg tablet
coal tar topical	DHS Tar, DHS Targel
conjugated estrogens-medroxyPROGESTERone	0.3-1.5 mg tablet; 0.625-5 mg tablet
copanlisib
cyclophosphamide	Cytoxan --> 25 mg tablet
dalbavancin	Dalvance --> 500 mg
dalteparin	Fragmin --> 10,000 units/mL
danazol	Danocrine --> 50 mg, 200 mg capsule
dantrolene	50 mg capsule
daratumumab	Darzalex --> 100 mg/5 mL, 400 mg/20 mL
darbepoetin alfa	25 mcg/mL
daunorubicin liposomal-cytarabine liposomal	Vyxeos --> 44 mg-100 mg
desipramine	Norpramin --> 25 mg tablet
desvenlafaxine	Pristiq 100 mg
dexlansoprazole	Dexilant --> 30 mg DRC
dexmethylphenidate	Focalin --> 2.5 mg, 10 mg Focalin XR --> 25 mg, 30 mg, 35 mg, 40 mg
dextroamphetamine	ProCentra, LiquADD --> 5 mg/5 mL oral solution
diosmiplex	630 mg tablet
dipyridamole	50 mg tablet; 75 mg tablet
disopyramide	100 mg capsule
disulfiram
divalproex sodium	125 mg DR-tab
dolutegravir	Tivicay PD
doravirine	Pifeltor --> 100 mg tablet
doxapram
doxepin topical	Prudoxin, Zonalon --> 5% cream
doxercalciferol	Hectorol --> 0.5 mcg capsule, 2.5 mcg capsule
edetate calcium disodium
edoxaban	Savaysa --> 15 mg tablet, 30 mg tablet, 60 mg tablet
eletriptan	Relpax --> 40 mg tablet
elotuzumab
elvitegravir-cobicistat-emtricitabine-tenofovir alafenamide
emicizumab	Hemlibra--> 30 mg/mL, 60 mg/0.4 mL, 105 mg/0.7 mL, 150 mg/mL
ergotamine	2 mg SL tab
ertugliflozin	5 mg tablet, 15 mg tablet
erythromycin	EES-400 mg Tab
eslicarbazepine	Aptiom --> 400 mg tablet, 600 mg tablet
esomeprazole	Nexium IV
estradiol-norethindrone	Activella 0.5 mg-0.1 mg
etoposide	VePesid --> 50 mg capsule
exenatide	Byetta - 5 mcg/0.02 mL prefilled 1.2 mL pen and 10 mcg/0.04 mL prefilled 2.4 mL pen
ezetimibe-simvastatin	10 mg - 10 mg
felbamate	Felbatol --> Suspension, 400 mg tablet
felodipine	Plendil --> 5 mg ER tablet
ferric citrate
fibrinogen	Fibryga
fluocinonide topical	Lidex --> 0.05% Topical gel 15 g tube
fluorometholone ophthalmic	FML Forte --> 0.25%
fluPHENAZine	Prolixin --> 2.5 mg/mL solution injectable
flurbiprofen ophthalmic	Ocufen --> 0.03%
flutamide	Eulexin --> 125 mg capsule
fluticasone-salmeterol	100 mcg - 50 mcg Diskus
fluvastatin	Lescol XL --> 80 mg ER tablet
fosamprenavir	Lexiva --> 700 mg tablet
foscarnet	Foscavir
glyBURIDE	Glynase PresTab --> micronized 1.5 mg, micronized 3 mg, micronized 6 mg
gramicidin/neomycin/polymyxin B ophthalmic	10 mL bottle
griseofulvin	Gris-PEG --> ultramicrocrystalline 125 mg tablet griseofulvin --> 500 mg tablet Grifulvin V --> 125 mg/5 mL suspension oral
guanFACINE	Intuniv --> 3 mg, 4 mg
haloperidol	Haldol --> 20 mg tablet
hydrocortisone	Cortifoam --> 10% foam
hydroxyurea	DROXIA 200 mg
hydrOXYzine	Vistaril 100 mg
ibandronate	Boniva --> 3 mg intravenous
iloperidone	Fanapt --> 4 mg tablet, 6 mg tablet
imipramine	10 mg tablet
imiquimod topical	Aldara --> 5% cream
indigo carmine	8 mg/mL
indomethacin	Indocin SR -->75 mg ER Capsule
inotuzumab ozogamicin
interferon alfa-2a
interferon alfa-2b
interferon beta-1a	Rebif --> 44 mcg/0.5 mL Avonex --> 30 mcg
ipratropium	Atrovent HFA
irbesartan-hydroCHLOROthiazide	All strengths
ketoconazole	200 mg tablet
lasmiditan	100 mg
latanoprost-netarsudil ophthalmic
leucovorin	25 mg tablet
levomilnacipran	20 mg extended release capsule
levothyroxine	Ermeza
lisdexamfetamine	Vyvanse --> 30 mg, 40 mg, 60 mg, 70 mg
lisinopril	Qbrelis
lopinavir-ritonavir	20-80 mg/mL oral solution
lovastatin	Mevacor --> 20 mg tablet
maprotiline	50 mg tablet, 75 mg tablet
maraviroc	Selzentry
mefenamic acid	250 mg
mefloquine
melphalan	Alkeran --> 2 mg tablet
mercaptopurine	Purixan -> 20 mg/mL
mesalamine	sfRowasa
methotrexate	Xatmep -> 2.5 mg/mL
methylphenidate	Daytrana --> 10 mg, 15 mg, 20 mg, 30 mg
methylphenidate_old	Daytrana --> 10 mg, 15 mg, 20 mg, 30 mg
methylPREDNISolone	DEPO-MEDROL 40 mg/mL 5 mL vial
metoclopramide	Metozolv ODT
mexiletine	250 mg capsule
midostaurin	Rydapt --> 25 mg capsule
milnacipran	12.5 mg tablet
mivacurium
moxetumomab pasudotox-tdfk	Lumoxiti --> 1 mg
mupirocin topical	Bactroban (cream)
nadolol	Corgard --> 40 mg tablet, 80 mg tablet
naratriptan	1 mg tablet
nateglinide	120 mg
nelfinavir	Viracept --> 250 mg tablet, 625 mg tablet
netarsudil ophthalmic	Rhopressa --> 0.02%
nevirapine	Viramune --> 200 mg tablet
niacin	Niacin ER capsules--> 250 mg, 500 mg
niacinamide	niacinamide --> 100 mg
niCARdipine	30 mg capsule
nitazoxanide	Oral tablet
obiltoxaximab	Anthim --> 600 mg/6 mL
ofatumumab	Arzerra
omeprazole	10 mg capsule
oxaprozin	600 mg
oxybutynin	Gelnique --> 10% gel
palivizumab	50 mg, 100 mg
pancuronium	pancuronium
panitumumab	Vectibix --> 20 mg/mL solution
penciclovir topical	1% topical cream 5 g tube
penicillAMINE	Cuprimine: 250 mg capsule
penicillin g procaine
pentamidine	Pentam 300 --> 300 mg vial
perflutren
phenelzine	Nardil --> 15 mg tablet
pimavanserin	10 mg
pimozide	2 mg tablet
pindolol	10 mg
piroxicam	Feldene --> 20 mg capsule
plecanatide	Trulance --> 3 mg tablet
posaconazole	Noxafil IV --> 18 mg/mL
pramoxine topical	Proctofoam --> 1%
progesterone	Endometrin --> 100 mg
progesterone topical	Endometrin --> 100 mg
promethazine	50 mg rectal suppoistory
pyrimethamine	25 mg
quiNIDine	QUINAGLUTE DURA --> 324 mg extended release tablet
RABEprazole
ramelteon	Rozerem --> 8mg
remifentanil
rifapentine	Priftin --> 150 mg
rimabotulinumtoxinB
risperiDONE	Uzedy 125 mg
riTUXimab-hyaluronidase
rOPINIRole	Requip XL --> 8 mg ER tablet
rufinamide	Banzel --> 400 mg tablet
salsalate	500 mg tablet, 750 mg tablet
saquinavir	Invirase
sargramostim	Leukine --> 250 mcg vial
selegiline	Emsam
selenium sulfide topical	1% topical shampoo 11oz bottle
simvastatin	Zocor --> 5 mg tablet, 80 mg tablet
sirolimus	1 mg, 2 mg, 1 mg/mL
sodium biphosphate-sodium phosphate	OsmoPrep, Fleet Phosphasoda (adult)
sodium chondroitin-hyaluronate ophthalmic	DisCoVisc
sodium hyaluronate	Euflexxa
sodium hypochlorite topical	0.5% (Full Strength)
stavudine	Zerit --> 20 mg tablet, 40 mg tablet
sucroferric oxyhydroxide
sulfADIAZINE	sulfADIAZINE --> 500 mg
sulindac	150 mg
telbivudine
telmisartan	20 mg, 80 mg
temozolomide	Temodar: 5 mg capsule, 140 mg capsule, 180 mg capsule, 250 mg capsule
tenofovir alafenamide	Vemlidy --> 25 mg
terconazole topical	Terazole 3--> 80 mg suppository Terazole 3--> 0.8% vaginal cream
testosterone	Androderm 4 mg/24 hrs Patch
tetracycline	250 mg capsule, 500 mg capsule
theophylline	Theo-24 --> 400 mg capsule
thioridazine	Mellaril --> 25 mg tablet, 100 mg tablet
thiothixene	Navane --> 1 mg capsule, 2 mg capsule
tiaGABine	Gabitril --> 12 mg tablet, 16 mg tablet
timolol
tipranavir
trabectedin	Yondelis --> 1 mg
trandolapril	2 mg
triamcinolone nasal	Nasacort --> 55 mcg/inh
triamterene	Dyrenium: 100 mg capsule
trifluoperazine	5 mg tablet
trimethoBENZamide	100 mg/mL injectable
triptorelin
ubrogepant	100 mg
uridine triacetate	10 grams - available from manufacturer within approximately 24 hrs.
valsartan	320 mg
vibegron	Deprecated: preg_match(): Passing null to parameter #2 ($subject) of type string is deprecated in /var/www/formweb/system/views/site/listingview.php on line 46
vitamin E topical	28,000 units per 30 mL bottle
vorapaxar	2.08 mg
voriconazole	suspension
zafirlukast	Accolate --> 10 mg, 20 mg
zanamivir	5 mg/blister inhaler
zonisamide	Zonisade -> 20 mg/mL

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