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.

Therapeutic Interchange

Please review each of these drugs carefully.
abacavir-dolutegravir-lamiVUDine
abacavir-lamiVUDine
abacavir-lamiVUDine-zidovudine
acetaminophen-HYDROcodone
acetaminophen-oxyCODONE
acetic acid-aluminum acetate otic
aclidinium
acyclovir
acyclovir-hydrocortisone topical
aflibercept ophthalmic
alatrofloxacin
albuterol
albuterol-budesonide
albuterol-ipratropium
alcaftadine ophthalmic
alclometasone topical
alfuzosin
aliskiren-amLODIPine
aliskiren-amLODIPine-hydroCHLOROthiazide
aliskiren-hydroCHLOROthiazide
almotriptan
alogliptin-metFORMIN
alogliptin-pioglitazone
ALPRAZolam
aluminum hydroxide
aluminum hydroxide-magnesium hydroxide
amitriptyline-perphenazine
amLODIPine-atorvaSTATin
amlodipine-celecoxib
amLODIPine-hydroCHLOROthiazide-valsartan
amLODIPine-olmesartan
amLODIPine-valsartan
amoxicillin
amoxicillin-clarithromycin-lansoprazole
amoxicillin-clarithromycin-omeprazole
amoxicillin-clavulanate
amphetamine
amphetamine sulfate
  • Adzenys XR-ODT --> no automatic interchange in pediatrics, use home supply or contact physician.
amphotericin B
amphotericin B cholesteryl sulfate
amphotericin B lipid complex
ampicillin
anidulafungin
antihemophilic factor-von Willebrand factor
ARIPiprazole
aspirin
aspirin-omeprazole
aspirin-pravastatin
atazanavir-cobicistat
atropine/hyoscyamine/PB/scopolamine
azelastine nasal
azelastine ophthalmic
azelastine-fluticasone nasal
azilsartan
azilsartan-chlorTHALidone
aZITHromycin
bacitracin-polymyxin B topical
baloxavir marboxil
balsalazide
balsam Peru-castor oil topical
balsam Peru/castor oil/trypsin topical
beclomethasone
beclomethasone nasal
benazepril
benazepril-hydroCHLOROthiazide
bendroflumethiazide
bendroflumethiazide-nadolol
Benzhydrocodone-acetaminophen
benzocaine topical
benzocaine-menthol topical
benzyl alcohol topical
bepotastine ophthalmic
beractant
besifloxacin ophthalmic
betamethasone topical
betamethasone-calcipotriene topical
betaxolol
betrixaban
bimatoprost ophthalmic
bismuth subsalicylate
bismuth subsalicylate-metroNIDAZOLE-tetracycline
bisoprolol
bisoprolol-hydroCHLOROthiazide
boric acid otic
brexpiprazole
brimonidine ophthalmic
brimonidine-timolol ophthalmic
bromfenac ophthalmic
bromocriptine
budesonide
budesonide nasal
budesonide/glycopyrrolate/formoterol
bumetanide
buprenorphine
buprenorphine-nalOXone
buPROPion
butorphanol
calcifediol
calcitonin
calcitriol topical
calcium acetate
calcium carbonate
calcium carbonate-sodium fluoride
calcium citrate
calcium gluconate
calcium lactate
calcium-vitamin D
calfactant
canagliflozin-metFORMIN
candesartan
capsaicin topical
captopril-hydroCHLOROthiazide
carBAMazepine
carbamide peroxide otic
carbidopa-levodopa
carbonyl iron
carteolol
carvedilol
caspofungin
cefaclor
cefditoren
cefixime
cefoperazone
cefotaxime
cefoTEtan
cefprozil
ceftibuten
celecoxib-tramadol
cephalexin
cephradine
cetirizine ophthalmic
cetirizine-pseudoephedrine
chlophedianol-pseudoephedrine
chlordiazePOXIDE-amitriptyline
chlorothiazide
chlorpheniramine
chlorpheniramine-HYDROcodone-PSE
chlorproMAZINE
chlorTHALidone
chlorTHALidone-cloNIDine
chlorzoxazone
ciclesonide
ciclesonide nasal
ciclopirox topical
ciprofloxacin
ciprofloxacin-hydrocortisone otic
clocortolone topical
clorazepate
clotrimazole topical
cloxacillin
coal tar topical
cobicistat-darunavir
cobicistat-elvitegravir-emtricitabine-tenofovir disoproxil fumarate
codeine polistirex-chlorpheniramine polistirex
colistin-HC-neomycin-thonzonium otic
conjugated estrogens
cortisone
cromolyn ophthalmic
dalbavancin
dalteparin
dapagliflozin-metFORMIN
dapagliflozin-sAXagliptin
dapagliflozin-sAXagliptin-metFORMIN
darbepoetin alfa
darifenacin
dasiglucagon
desloratadine
desloratadine-pseudoephedrine
desoximetasone topical
dexlansoprazole
dextromethorphan-Bupropion ER
dezocine
dibucaine topical
diclofenac
diclofenac ophthalmic
diclofenac-miSOPROStol
diflorasone topical
diflunisal
difluprednate ophthalmic
docusate
docusate-senna
dolasetron
dolutegravir-lamivudine
dolutegravir-rilpivirine
donepezil
doravirine-lamiVUDine-tenofovir disoproxil fumarate
doripenem
doxazosin
doxepin
doxercalciferol
DOXYcycline
DOXYcycline-salicylic acid topical
doxylamine-pyridoxine
dutasteride-tamsulosin
econazole topical
edoxaban
efavirenz-emtricitabine-tenofovir disoproxil fumarate
efavirenz-lamiVUDine-tenofovir disoproxil fumarate
Eflapegrastim
eletriptan
elvitegravir
emedastine ophthalmic
empagliflozin-linaGLIPtin
empagliflozin-metFORMIN
emtricitabine-rilpivirine-tenofovir alafenamide
emtricitabine-rilpivirine-tenofovir disoproxil fumarate
emtricitabine-tenofovir alafenamide
emtricitabine-tenofovir disoproxil fumarate
enoxacin
epinastine ophthalmic
eplerenone
eprosartan
eprosartan-hydroCHLOROthiazide
ergocalciferol
ertugliflozin-metFORMIN
ertugliflozin-SITagliptin
erythromycin topical
eslicarbazepine
esomeprazole
estazolam
estradiol-levonorgestrel
estropipate
eszopiclone
ethyl chloride topical
etidronate
etodolac
ezetimibe-atorvaSTATin
factor IX complex  
famotidine-ibuprofen
felodipine
fenofibrate
fenofibric acid
fenoprofen
ferric citrate
ferric derisomaltose
ferrous fumarate
ferrous fumarate-iron polysaccharide
fesoterodine
fexofenadine
fexofenadine-pseudoephedrine
filgrastim  
flunisolide
flunisolide nasal
fluocinonide topical
FLUoxetine-OLANZapine
flurandrenolide topical
flurazepam
flurbiprofen
fluticasone
fluticasone nasal
fluticasone topical
fluticasone-salmeterol
fluticasone-umeclidinium-vilanterol
fluticasone-vilanterol
fluvastatin
formoterol
  • For PEDS call physician for alternative therapy.
formoterol-mometasone
fosinopril
fosinopril-hydroCHLOROthiazide
fosnetupitant-palonosetron
frovatriptan
gatifloxacin
gatifloxacin ophthalmic
gemifloxacin
gentamicin topical
glimepiride
glimepiride-pioglitazone
glipiZIDE-metFORMIN
glyBURIDE
glyBURIDE-metFORMIN
glycerin otic
glycopyrrolate
glycopyrrolate-formoterol
granisetron
grepafloxacin
guaiFENesin
halazepam
halcinonide topical
halobetasol topical
haloprogin topical
heme iron polypeptide-iron polysaccharide
hepatitis B vaccine
hydrALAZINE-isosorbide dinitrate
hydroCHLOROthiazide-methyldopa
hydroCHLOROthiazide-metoprolol
hydroCHLOROthiazide-propranolol
HYDROcodone
HYDROcodone-guaiFENesin
HYDROcodone-ibuprofen
HYDROcodone-pseudoephedrine
hydrocortisone-lidocaine topical
hydrocortisone-polymyxin B otic
hydrocortisone-salicylic acid-sulfur topical
hydroflumethiazide
hylan G-F 20
hyoscyamine-methenamine
icosapent  
iloperidone
imipenem-cilastatin
imipramine
indacaterol
  • For PEDS call physician for alternative therapy.
indacaterol-glycopyrrolate
insulin aspart
insulin aspart-insulin aspart protamine
insulin degludec
insulin glulisine
insulin inhaled
insulin lispro
ipratropium
irbesartan-hydroCHLOROthiazide
isosorbide dinitrate
isosorbide mononitrate
isradipine
ivermectin topical
ketoprofen
lamiVUDine-tenofovir disoproxil fumarate
lamiVUDine-zidovudine
lanolin-mineral oil topical
lanreotide
lansoprazole
levalbuterol
levocabastine ophthalmic
levocetirizine
levoFLOXacin ophthalmic
LEVOleucovorin
levothyroxine
lidocaine topical
lidocaine-prilocaine topical
lidocaine-tetracaine topical
linaGLIPtin-metFORMIN
lisdexamfetamine
lodoxamide ophthalmic
lomefloxacin
LORazepam
loteprednol-tobramycin ophthalmic
lovastatin
lovastatin-niacin
lucinactant
luliconazole topical
m-cresyl acetate otic
mafenide topical
Magic Mouthwash with Nystatin
magnesium amino acids chelate
magnesium chloride
magnesium lactate
malathion topical
meclofenamate
mefenamic acid
melphalan
memantine-donepezil
meperidine-promethazine
metFORMIN-pioglitazone
metFORMIN-repaglinide
metFORMIN-SITagliptin
methenamine combination
  • UTA on long-term backorder as of May 2017.
methenamine mandelate-sodium acid phosphate
methenamine-sodium biphosphate
methenamine-sodium salicylate
methyclothiazide
miconazole
miconazole topical
miconazole-zinc oxide topical
miglitol
modafinil
moexipril
moexipril-hydroCHLOROthiazide
mometasone nasal
mometasone topical
montelukast
morphine-naltrexone
moxifloxacin
nabilone
nadolol
nafcillin
naftifine topical
naldemedine
nalOXone
nalOXone-oxyCODONE
naproxen-esomeprazole
naproxen-SUMAtriptan
nebivolol-valsartan
nepafenac ophthalmic
niacin
niacin-simvastatin
niacinamide
niCARdipine
nicotine
NIFEdipine
nisoldipine
nizatidine
norfloxacin
nystatin topical
octreotide
ofloxacin
ofloxacin ophthalmic
OLANZapine-samidorphan
olmesartan
olmesartan-amLODIPine-hydroCHLOROthiazide
olmesartan-hydroCHLOROthiazide
olodaterol
  • For PEDS call physician for alternative therapy.
olopatadine nasal
olsalazine
omega-3 polyunsaturated fatty acids
omeprazole
omeprazole-amoxicillin-rifabutin
omeprazole-sodium bicarbonate
opicapone
opium tincture
orlistat  
oxacillin
oxaprozin
oxazepam
oxiconazole topical
oxybutynin
oxyCODONE-ibuprofen
oxyCODONE-naltrexone
oxyMORphone
oxytetracycline
palonosetron
pegaptanib ophthalmic
pemirolast ophthalmic
penbutolol
penicillin G sodium
  • Interchange to penicillin G potassium on a 1:1 dosage ratio.
pentazocine
perindopril
perindopril-amLODIPine
phenol topical
phenoxybenzamine
piperonyl butoxide-pyrethrins topical
pirbuterol
pitavastatin
plecanatide
polycarbophil
polythiazide
povidone-tetrahydrozoline ophthalmic
prednicarbate topical
progesterone
progesterone topical
prothrombin complex  
pyrithione zinc topical
quazepam
quinapril
quinapril-hydroCHLOROthiazide
RABEprazole
raltegravir
ramelteon
ranibizumab
raNITIdine
revefenacin
RHo (D) immune globulin
risedronate
rizatriptan
rolapitant
rosuvastatin
rosuvastatin-ezetimibe
safinamide
salicylic acid-urea topical
salmeterol
  • For PEDS call physician for alternative therapy.
sAXagliptin-metFORMIN
selenium sulfide topical
serdexmethylphenidate/ dexmethylphenidate
sertaconazole topical
silodosin
simvastatin
SITagliptin-simvastatin
sodium ferric gluconate complex
sodium hyaluronate topical
sodium picosulfate-magnesium oxide-citric acid
solifenacin
Sotagliflozin
sotalol
sparfloxacin
spironolactone-hydroCHLOROthiazide
steven-Test  
sucroferric oxyhydroxide
sulconazole topical
sulfacetamide sodium topical
suvorexant
tafluprost ophthalmic
tedizolid
telmisartan
telmisartan-amLODIPine
telmisartan-hydroCHLOROthiazide
ticlopidine
timolol
tinzaparin
tiotropium
  • Spiriva Respimat --> interchange does not apply to pediatrics, contact physician for possible alternatives.
tiotropium-olodaterol
tolmetin
tolnaftate topical
torsemide
trandolapril-verapamil
trastuzumab
travoprost ophthalmic
triamcinolone nasal
trichlormethiazide
trimipramine
trospium
trovafloxacin
umeclidinium
umeclidinium-vilanterol
unoprostone ophthalmic
urea topical
vonoprazan
vonoprazan-amoxicillin
vonoprazan-amoxicillin-clarithromycin
zafirlukast
zaleplon
zileuton
zoledronic acid
ZOLMitriptan






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