Approved Formulary
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Restricted Medications
Please review each of these drugs carefully.| abacavir |
|
| abatacept |
|
| acetaminophen-traMADol |
|
| acetylcysteine |
|
| aclidinium |
|
| aclidinium-formoterol |
|
| adalimumab |
|
| adenosine |
|
| albuterol |
|
| albuterol-budesonide |
|
| albuterol-ipratropium |
|
| aldesleukin |
|
| alemtuzumab |
|
| alendronate |
|
| alfuzosin |
|
| alogliptin |
|
| alogliptin-metFORMIN |
|
| alogliptin-pioglitazone |
|
| alteplase |
|
| amcinonide topical |
|
| aminocaproic acid |
|
| amiodarone |
|
| anagrelide |
|
| andexanet alfa |
|
| antipyrine-benzocaine otic |
|
| aprepitant |
|
| arformoterol |
|
| argatroban |
|
| armodafinil |
|
| arsenic trioxide |
|
| asparaginase Escherichia coli |
|
| aspirin-butalbital-caffeine |
|
| atropine |
|
| azaCITIDine |
|
| azilsartan |
|
| beclomethasone |
|
| beclomethasone nasal |
|
| belimumab |
|
| benazepril |
|
| bendamustine |
|
| benzocaine-butamben-tetracaine |
|
| betamethasone topical |
|
| bevacizumab |
|
| bivalirudin |
|
| bleomycin |
|
| bortezomib |
|
| brimonidine-timolol ophthalmic |
|
| budesonide nasal |
|
| budesonide-formoterol |
|
| budesonide-formoterol-glycopyrrolate |
|
| bumetanide |
|
| bupivacaine |
|
| bupivacaine-fentaNYL |
|
| buprenorphine |
|
| buprenorphine-naloxone |
|
| cabazitaxel |
|
| caffeine-ergotamine |
|
| calcitonin |
|
| calcium carbonate-magnesium chloride |
|
| calcium gluconate |
|
| canagliflozin |
|
| candesartan |
|
| CARBOplatin |
|
| carboxymethylcellulose |
|
| carfilzomib |
|
| carmustine |
|
| caspofungin |
|
| cefaclor |
|
| cefadroxil |
|
| cefixime |
|
| cefotaxime |
|
| cefoTEtan |
|
| cefpodoxime |
|
| ceftaroline |
|
| cefTAZidime-avibactam |
|
| ceftibuten |
|
| ceftolozane-tazobactam |
|
| cetirizine |
|
| cetirizine-pseudoePHEDrine |
|
| cetuximab |
|
| chlorpheniramine |
|
| choline magnesium trisalicylate |
|
| ciclesonide |
|
| ciclesonide nasal |
|
| ciclopirox topical |
|
| cimetidine |
|
| ciprofloxacin otic |
|
| ciprofloxacin-dexamethasone otic |
|
| ciprofloxacin-hydrocortisone otic |
|
| CISatracurium |
|
| CISplatin |
|
| citalopram |
|
| clioquinol topical |
|
| clioquinol-hydrocortisone topical |
|
| clocortolone topical |
|
| cloxacillin |
|
| cocaine topical |
|
| conjugated estrogens topical |
|
| crotamiton topical |
|
| cycloSPORINE ophthalmic |
|
| cytarabine |
|
| dacarbazine |
|
| DACTINomycin |
|
| dapsone |
|
| DAPTOmycin |
|
| darifenacin |
|
| decitabine |
|
| demo |
|
| denosumab |
|
| desloratadine |
|
| desoximetasone topical |
|
| dexlansoprazole |
|
| dexmedetomidine |
|
| diazePAM |
|
| diclofenac |
|
| diflorasone topical |
|
| digoxin |
|
| digoxin immune FAB |
|
| diltiaZEM |
|
| DOBUTamine |
|
| DOCEtaxel |
|
| dofetilide |
|
| dolasetron |
|
| donepezil-memantine |
|
| DOPamine |
|
| doripenem |
|
| DOXOrubicin |
|
| DOXOrubicin liposomal |
|
| droperidol |
|
| econazole topical |
|
| empagliflozin-linagliptin |
|
| EPINEPHrine |
|
| epiRUBicin |
|
| eprosartan |
|
| eriBULin |
|
| ertapenem |
|
| ertugliflozin |
|
| ertugliflozin-metFORMIN |
|
| ertugliflozin-SITagliptin |
|
| esmolol |
|
| estazolam |
|
| eszopiclone |
|
| etodolac |
|
| etoposide |
|
| ezetimibe-simvastatin |
|
| famciclovir |
|
| fenoldopam |
|
| fenoprofen |
|
| fenoterol-ipratropium |
|
| fentaNYL |
|
| ferric carboxymaltose |
|
| ferrous fumarate |
|
| ferrous gluconate |
|
| ferumoxytol |
|
| fexofenadine |
|
| fexofenadine-pseudoePHEDrine |
|
| fidaxomicin |
|
| filgrastim |
|
| flavoxATE |
|
| floxuridine |
|
| fludarabine |
|
| flunisolide |
|
| flunisolide nasal |
|
| fluocinolone topical |
|
| fluorouracil |
|
| fluPHENAZine |
|
| flurandrenolide topical |
|
| flurazepam |
|
| flurbiprofen |
|
| fluticasone topical |
|
| fluticasone-salmeterol |
|
| fluticasone-umeclidinium-vilanterol |
|
| fluticasone-vilanterol |
|
| fluvastatin |
|
| formoterol-glycopyrrolate |
|
| formoterol-mometasone |
|
| fosfomycin |
|
| fosinopril |
|
| frovatriptan |
|
| gemcitabine |
|
| glycopyrrolate-indacaterol |
|
| halcinonide topical |
|
| halobetasol topical |
|
| haloperidol |
|
| heparin |
|
| herbal supplements |
|
| hydrocortisone-pramoxine topical |
|
| HYDROmorphone |
|
| ibandronate |
|
| ibutilide |
|
| ifosfamide |
|
| immune globulin intravenous and subcutaneous |
|
| indacaterol |
|
| inFLIXimab |
|
| insulin aspart |
|
| insulin aspart-insulin aspart protamine |
|
| insulin degludec |
|
| insulin glargine |
|
| insulin glulisine |
|
| insulin human in Normal Saline |
|
| insulin regular |
|
| interferon alfa-2b |
|
| ipilimumab |
|
| ipratropium |
|
| irbesartan |
|
| irinotecan |
|
| iron dextran |
|
| iron polysaccharide |
|
| iron sucrose |
|
| isoproterenol |
|
| ixabepilone |
|
| ketamine |
|
| ketoconazole topical |
|
| ketoprofen |
|
| labetalol |
|
| lansoprazole |
|
| leuprolide |
|
| levalbuterol |
|
| levocetirizine |
|
| lidocaine |
|
| linagliptin-metFORMIN |
|
| lindane topical |
|
| lodoxamide ophthalmic |
|
| LORazepam |
|
| lovastatin |
|
| lurasidone |
|
| magnesium gluconate |
|
| magnesium sulfate |
|
| meclofenamate |
|
| mefenamic acid |
|
| menthol-methyl salicylate topical |
|
| meperidine |
|
| metFORMIN-SAXagliptin |
|
| metFORMIN-SITagliptin |
|
| methadone |
|
| methenamine-sodium acid phosphate |
|
| methenamine-sodium biphosphate |
|
| methicillin |
|
| methylcellulose |
|
| metoprolol |
|
| micafungin |
|
| midazolam |
|
| milrinone |
|
| mitoMYcin |
|
| mitoXANTRONE |
|
| moexipril |
|
| mometasone |
|
| mometasone nasal |
|
| mometasone topical |
|
| morphine |
|
| moxifloxacin |
|
| nabumetone |
|
| naftifine topical |
|
| naphazoline-pheniramine ophthalmic |
|
| naratriptan |
|
| neomycin topical |
|
| neostigmine |
|
| neutraceuticals |
|
| niCARdipine |
|
| nitroglycerin |
|
| nitroprusside |
|
| nizatidine |
|
| norEPINEPHrine |
|
| nystatin topical |
|
| ofloxacin ophthalmic |
|
| olmesartan |
|
| olodaterol |
|
| olodaterol-tiotropium |
|
| olopatadine ophthalmic |
|
| olsalazine |
|
| omeprazole |
|
| omeprazole-sodium bicarbonate |
|
| oxacillin |
|
| OXALIplatin |
|
| oxaprozin |
|
| oxazepam |
|
| oxiconazole topical |
|
| oxitropium |
|
| oxyMORphone |
|
| PACLitaxel |
|
| PACLitaxel protein-bound |
|
| pamidronate |
|
| PEMEtrexed |
|
| penciclovir topical |
|
| pentosan polysulfate sodium |
|
| pentostatin |
|
| pertuzumab |
|
| phenylephrine |
|
| phenytoin IV |
|
| piroxicam |
|
| pitavastatin |
|
| polyethylene glycol-propylene glycol |
|
| polyvinyl alcohol |
|
| potassium chloride |
|
| potassium phosphate |
|
| pramoxine topical |
|
| pramoxine-zinc oxide topical |
|
| pravastatin |
|
| procainamide |
|
| propofol |
|
| propranolol |
|
| protamine |
|
| quazepam |
|
| quinapril |
|
| RABEprazole |
|
| ramelteon |
|
| ramipril |
|
| ramucirumab |
|
| reslizumab |
|
| revefenacin |
|
| riMANTAdine |
|
| risedronate |
|
| riTUXimab |
|
| rocuronium |
|
| saccharomyces boulardii lyo |
|
| salmeterol |
|
| sarilumab |
|
| SAXagliptin |
|
| sertaconazole topical |
|
| simvastatin |
|
| SITagliptin |
|
| sodium chloride IV solution (Hypertonic) |
|
| sodium phosphate |
|
| streptozocin |
|
| succinylcholine |
|
| sulconazole topical |
|
| sulindac |
|
| tedizolid |
|
| telavancin |
|
| telmisartan |
|
| tenecteplase |
|
| terbinafine topical |
|
| terconazole topical |
|
| tetrahydrozoline ophthalmic |
|
| thiopental |
|
| thiothixene |
|
| tiaGABine |
|
| ticarcillin-clavulanate |
|
| tigecycline |
|
| tiotropium |
|
| tirofiban |
|
| tocilizumab |
|
| tolmetin |
|
| tolnaftate topical |
|
| topotecan |
|
| trastuzumab |
|
| triamcinolone nasal |
|
| triazolam |
|
| triethanolamine otic |
|
| umeclidinium |
|
| umeclidinium-vilanterol |
|
| ustekinumab |
|
| vasopressin |
|
| vecuronium |
|
| vedolizumab |
|
| verapamil |
|
| vinBLAStine |
|
| vinCRIStine |
|
| vinORELBine |
|
| zaleplon |
|
| ziv-aflibercept |
|
| zoledronic acid |
|
| ZOLMitriptan |
|