5-Alpha Reductase Inhibitors
Non-Formulary Order
Formulary Equivalent Order
Dutasteride capsule
Finasteride tablet
0.5 mg once daily
5 mg once daily
Dutasteride/tamsulosin combination products
Equivalent dose of finasteride + tamsulosin
Alpha1 Blockers
Alfuzosin tablet, ER
Tamsulosin capsule
10 mg once daily
0.4 mg once daily
Doxazosin tablet
Terazosin capsule
1 mg once daily
2 mg once daily
4 mg once daily
8 mg once daily
Doxazosin tablet, ER
Silodosin capsule
Tamsulosin/dutasteride combination products
Equivalent dose of tamsulosin + finasteride
Angiotensin II Receptor Blockers
Azilsartan tablet
Valsartan tablet
20 mg daily
160 mg daily
40 mg daily
320 mg daily
80 mg daily
Azilsartan/chlorthalidone combination products
Equivalent dose of valsartan + chlorthalidone
Candesartan tablet
4 mg daily
8 mg daily
16 mg daily
32 mg daily
Candesartan/hydrochlorothiazide combination products
Equivalent dose of valsartan + hydrochlorothiazide
Eprosartan tablet
400 mg daily
600 mg daily
800 mg daily
Irbesartan tablet
75 mg daily
150 mg daily
300 mg daily
Irbesartan/hydrochlorothiazide combination products
Losartan/hydrochlorothiazide combination products
Equivalent dose of losartan + hydrochlorothiazide
Olmesartan tablet
5 mg daily
10 mg daily
Olmesartan/amlodipine combination products
Equivalent dose of valsartan + amlodipine
Olmesartan/hydrochlorothiazide combination products
Olmesartan/amlodipine/hydrochlorothiazide combination products
Equivalent dose of valsartan + amlodipine + hydrochlorothiazide
Telmisartan tablet
Telmisartan/amlodipine combination products
Telmisartan/hydrochlorothiazide combination products
Valsartan/amlodipine combination products
Valsartan/hydrochlorothiazide
Valsartan/amlodipine/hydrochlorothiazide combination products
Angiotensin Converting Enzyme Inhibitors
Amlodipine/benazepril combination products
Equivalent dose of amlodipine + lisinopril
Benazepril tablet
Lisinopril tablet
20 mg once daily
40 mg once daily
Fosinopril tablet
Hydrochlorothiazide/lisinopril combination products
Equivalent dose of hydrochlorothiazide + lisinopril
Moexipril tablet
3.75 mg daily
7.5 mg once daily
15 mg once daily
30 mg daily
Perindopril tablet
Quinapril tablet
5 mg twice daily
10 mg twice daily
20 mg twice daily
Ramipril Tablet
1.25 mg once daily
2.5 mg once daily
80 mg once daily
Trandolapril tablet
Antiretrovirals
Raltegravir tablet (Isentress HD)
Raltegravir tablet (Isentress)
1200 mg once daily
400 mg twice daily
Barbiturates
Phenobarbital tablet
15 mg twice daily
16.2 mg twice daily
15 mg three times daily
16.2 mg three times daily
30 mg twice daily
32.4 mg twice daily
30 mg three times daily
32.4 mg three times daily
60 mg twice daily
64.8 mg twice daily
60 mg three times daily
64.8 mg three times daily
100 mg twice daily
97.2 mg twice daily
100 mg three times daily
97.2 mg three times daily
Benzodiazepines
Alprazolam tablet, ER
Alprazolam tablet, IR
0.125 mg four times daily
0.25 mg four times daily
0.5 mg four times daily
3 mg once daily
1 mg three times daily
1 mg four times daily
6 mg once daily
2 mg three times daily
Chlordiazepoxide/amitriptyline combination products
Equivalent dose of chlordiazepoxide + amitriptyline
Diazepam rectal kit
Midazolam solution, intranasal
0.2 to 0.5 mg/kg once per rectum PRN
0.2 mg/kg once intranasal PRN
Beta-Blockers
Acebutolol capsule
Metoprolol tartrate tablet
25 mg twice daily
200 mg twice daily
50 mg twice daily
Atenolol/chlorthalidone combination products
Equivalent dose of atenolol + chlorthalidone
Betaxolol tablet
Metoprolol succinate tablet
50 mg once daily
100 mg once daily
200 mg once daily
Bisoprolol tablet
Bisoprolol/hydrochlorothiazide combination products
Equivalent dose of metoprolol succinate + hydrochlorothiazide
Carvedilol capsule, CR
Carvedilol tablet, IR
3.125 mg twice daily
6.25 mg twice daily
12.5 mg twice daily
Metoprolol tartrate/hydrochlorothiazide combination products
Equivalent dose of metoprolol tartrate + hydrochlorothiazide
Metoprolol succinate/hydrochlorothiazide combination products
Nadolol tablet
Propranolol tablet
40 mg twice daily
80 mg twice daily
160 mg twice daily
Nebivolol tablet
Pindolol tablet
5 mg three times daily
40 mg three times daily
10 mg three times daily
80 mg three times daily
20 mg three times daily
160 mg three times daily
Propranolol ER capsule
60 mg daily
120 mg daily
240 mg daily
120 mg twice daily
Timolol tablet
Beta-Blockers, Ophthalmic
Betaxolol 0.25% ophthalmic solution
Timolol maleate 0.25% ophthalmic solution
1 drop twice daily
2 drops twice daily
Betaxolol 0.5% ophthalmic solution, suspension
Timolol maleate 0.5% ophthalmic solution
Carteolol 1% ophthalmic solution
Levobunolol 0.25% ophthalmic solution
1 drop once daily
2 drops once daily
Levobunolol 0.5% ophthalmic solution
Metipranolol 0.3% ophthalmic solution
Timolol hemihydrate 0.25% ophthalmic solution
Timolol hemihydrate 0.5% ophthalmic solution
Timolol maleate 0.25% ophthalmic gel-forming solution
Timolol maleate 0.5% ophthalmic gel-forming solution
Timolol-brimonidine ophthalmic solution 0.5%-0.2% combination product
Equivalent dose of timolol + brimonidine ophthalmic solution
Biguanides
Metformin tablet, ER
Metformin tablet, IR
500 mg once daily
250 mg twice daily
1000 mg once daily
500 mg twice daily
2000 mg once daily
1000 mg twice daily
Bile Acid Sequestrants
Cholestyramine powder with aspartame
Cholestyramine powder
4 g once daily
4 g twice daily
Colestipol packet, granules
5 g once daily
5 g twice daily
Colesevelam packet
3.75 g once daily
Colesevelam tablet
Colestipol tablet
1.875 g twice daily
2 g twice daily
Calcium Carbonate Products
Calcium carbonate tablet/capsule
Calcium carbonate tablet
500 mg elemental calcium (1,250 mg calcium carbonate)
600 mg elemental calcium (1,500 mg calcium carbonate)
Calcium-Cholecalciferol (Vitamin D) Combination Products
Calcium carbonate/cholecalciferol tablet, capsule
Calcium carbonate tablet + cholecalciferol tablet
200 mg (elemental calcium)/250 IU cholecalciferol
300 mg (elemental calcium) + 200 IU cholecalciferol
250 mg (elemental calcium)/125 IU cholecalciferol
250 mg (elemental calcium)/200 IU cholecalciferol
500 mg (elemental calcium)/125 IU cholecalciferol
600 mg (elemental calcium) + 200 IU cholecalciferol
500 mg (elemental calcium)/200 IU cholecalciferol
500 mg (elemental calcium)/250 IU cholecalciferol
500 mg (elemental calcium)/400 IU cholecalciferol
600 mg (elemental calcium) + 400 IU cholecalciferol
600 mg (elemental calcium)/200 IU cholecalciferol
600 mg (elemental calcium)/400 IU cholecalciferol
600 mg (elemental calcium)/800 IU cholecalciferol
600 mg (elemental calcium) + 800 IU cholecalciferol
600 mg (elemental calcium)/1,000 IU cholecalciferol
Calcium Channel Blockers
Amlodipine/lisinopril combination products
Amlodipine/losartan combination products
Equivalent dose of amlodipine + losartan
Amlodipine/losartan/hydrochlorothiazide combination products
Equivalent dose of amlodipine + losartan + hydrochlorothiazide
Amlodipine/valsartan combination products
Equivalent dose of amlodipine + valsartan
Diltiazem ER (12h twice daily) capsule
Diltiazem ER (24 hr once daily) capsule
120 mg once daily
90 mg twice daily
180 mg once daily
240 mg once daily
Felodipine tablet
Amlodipine tablet
2.5 mg twice daily
Isradipine capsule, IR
Nicardipine capsule, IR
2.5 mg daily
Nifedipine (Adalat CC) tablet, ER
Nifedipine (Procardia) tablet, ER
30 mg once daily
60 mg once daily
90 mg once daily
Nisoldipine (geomatrix) tablet, ER
8.5 mg daily
17 mg daily
25.5 mg daily
34 mg daily
Nisoldipine (original formulation) tablet, ER
Carbonic Anhydrase Inhibitors, Ophthalmic
Brinzolamide 1% ophthalmic solution
Dorzolamide 2% ophthalmic solution
1 drop three times daily
CorticoSteroids, Intranasal
Beclomethasone nasal inhaler
Fluticasone nasal inhaler
1 spray in each nostril once daily
2 sprays in each nostril once daily
1 spray in each nostril twice daily
2 sprays in each nostril twice daily
Budesonide nasal inhaler
Ciclesonide nasal inhaler
Flunisolide nasal inhaler
2 sprays in each nostril three times daily
Mometasone nasal inhaler
Triamcinolone nasal inhaler
Corticosteroids, Inhaled
ADULT - Formulary Equivalent Order
PEDIATRIC - Formulary Equivalent Order
Beclomethasone (QVAR Redihaler) 40 mcg/dose
Fluticasone (Arnuity Ellipta) 100 mcg/dose Inhaler
Fluticasone (Flovent HFA) 44 mcg/actuation
Beclomethasone (QVAR Redihaler) 80 mcg/dose
Fluticasone (Flovent HFA) 110 mcg/actuation
1 or 2 inhalations twice daily
1 inhalation daily
Budesonide (Pulmicort Flexhaler) 90 mcg/dose Inhaler
2 inhalations twice daily
Budesonide (Pulmicort Flexhaler) 180 mcg/dose Inhaler
1 inhalation twice daily
Fluticasone (Arnuity Ellipta) 200 mcg/dose Inhaler
Ciclesonide (Alvesco) 80 mcg/dose Inhaler
Ciclesonide (Alvesco) 160 mcg/dose Inhaler
Fluticasone (Flovent HFA) 220 mcg/actuation
Fluticasone (Flovent HFA) 44 mcg/dose Inhaler
Not applicable
Fluticasone (Flovent HFA) 110 mcg/dose Inhaler
Fluticasone (Flovent HFA) 220 mcg/dose Inhaler
Fluticasone (Flovent Diskus) 50 mcg/dose Inhaler
Fluticasone (Flovent Diskus) 100 mcg/dose Inhaler
Fluticasone (Flovent Diskus) 250 mcg/dose Inhaler
Mometasone (Asmanex HFA) 100 mcg/dose Inhaler
Mometasone (Asmanex HFA) 200 mcg/dose Inhaler
Mometasone (Asmanex Twisthaler) 110 mcg/dose Inhaler
2 inhalations once or twice daily
Mometasone (Asmanex Twisthaler) 220 mcg/dose Inhaler
1 inhalation once or twice daily
Fluticasone (Arnuity Ellipta)100 mcg/dose Inhaler
2 inhalations once daily
Corticosteroids & Long-Acting Beta Agonist Combinations, Inhaled
Budesonide/Formoterol (Symbicort) 80-4.5 mcg/dose Inhaler
Fluticasone/Vilanterol (Breo Ellipta) 100-25 mcg/dose Inhaler
Budesonide/Formoterol (Symbicort) 160-4.5 mcg/dose Inhaler
Fluticasone/Vilanterol (Breo Ellipta) 200-25 mcg/dose Inhaler
Fluticasone/Salmeterol (Advair Diskus) 100-50 mcg/dose Inhaler
Fluticasone/Salmeterol (Advair Diskus) 250-50 mcg/dose Inhaler
Fluticasone/Salmeterol (Advair Diskus) 500-50 mcg/dose Inhaler
Fluticasone/Salmeterol (Advair HFA) 45-21 mcg/dose Inhaler
Fluticasone/Salmeterol (Advair HFA) 115-21 mcg/dose Inhaler
Fluticasone/Salmeterol (Advair HFA) 230-21 mcg/dose Inhaler
Fluticasone/Salmeterol (AirDuo RespiClick) 55-14 mcg/dose Inhaler
Fluticasone/Salmeterol (AirDuo RespiClick) 113-14 mcg/dose Inhaler
Fluticasone/Salmeterol (AirDuo RespiClick) 232-14 mcg/dose Inhaler
Mometasone/Formoterol (Dulera) 100-5 mcg/dose Inhaler
Mometasone/Formoterol (Dulera) 200-5 mcg/dose Inhaler
Fluticasone/Umeclidinium/Vilanterol (Trelegy) 100-62.5-25 mcg/dose Inhaler
Umeclidinium (Incruse Ellipta) 62.5 mcg/dose Inhaler
Fibric Acid Derivatives
Fenofibrate (Fenoglide) tablet
Fenofibrate, nanocrystalized (Tricor) tablet
48 mg once daily
145 mg once daily
Fenofibrate (Lipofen) capsule
150 mg once daily
Fenofibrate, micronized (Anatara) capsule
43 mg once daily
130 mg once daily
Fenofibrate, micronized (Lofibra) tablet, capsule
54 mg once daily
67 mg once daily
134 mg once daily
160 mg once daily
Fenofibrate, nanocrystalized (Triglide) tablet
Fenofibric Acid (Fibricor) tablet
35 mg once daily
105 mg once daily
GABA Analogs
Gabapentin IR tablet
Gabapentin IR capsule
300 mg three times a day
600 mg three times a day
Gabapentin ER tablet (Gralise)
1800 mg daily
Gabapentin enacarbil ER tablet (Gralise)
200 mg three times a day
600 mg twice daily
400 mg three times a day
Histamine1 Antagonists, Oral
Desloratadine tablet, ODT tablet, or capsule
Loratadine tablet
Desloratadine oral syrup
Loratadine oral suspension
Diphenhydramine tablet
Diphenhydramine capsule
25 mg once daily
25 mg every 4 hours
50 mg every 4 hours
25 mg every 6 hours
50 mg every 6 hours
Doxylamine-pyridoxine (vitamin B6) tablet
Doxylamine tablet + pyridoxine (vitamin B6) tablet
10-10 mg once daily
12.5 mg + 25 mg once daily
10-10 mg twice daily
12.5 mg + 25 mg twice daily
20-20 mg once daily
25 mg + 25 mg once daily
20-20 mg twice daily
25 mg + 25 mg twice daily
Fexofenadine tablet, ODT
Fexofenadine oral suspension
Fexofenadine/pseudoephedrine combination products
Equivalent dose of loratadine + pseudoephedrine
Hydroxyzine capsule
Hydroxyzine tablet
25 mg four times daily
50 mg four times daily
100 mg four times daily
Levocetirizine tablet
Loratadine/pseudoephedrine combination products
Histamine1 Receptor Antagonists, Miscellaneous
Alcaftadine ophthalmic solution 0.25%
Ketotifen ophthalmic solution 0.025%
Bepotastine ophthalmic solution 1.5%
Emedastine ophthalmic solution 0.05%
1 drop 4 times daily
Epinastine ophthalmic solution 0.05%
Olopatadine ophthalmic solution 0.1%
Olopatadine ophthalmic solution 0.2%
Olopatadine ophthalmic solution 0.7%
Histamine2 Receptor Antagonists
Cimetidine tablet
Famotidine tablet
300 mg twice daily
800 mg once daily
Nizatidine tablet
150 mg twice daily
300 mg once daily
Ranitidine tablet
75 mg twice daily
Oral Iron Products
Ferrous gluconate tablet
Ferrous sulfate tablet
324 mg once daily
162.5 mg once daily
Ferrous fumarate tablet
Polysaccharide iron complex
Carbonyl iron tablet
45 mg once daily
325 mg once daily
Long-Acting Beta2-Adrenergic Agonists, Inhaled
Formoterol nebule
Arformoterol nebule
20 mcg twice daily
15 mcg twice daily
Indacaterol inhaler
75 mcg once daily
Olodaterol inhaler
5 mcg once daily
Salmeterol inhaler
50 mcg twice daily
Long-Acting Anticholinergic Agents, Inhaled
Tiotropium (Spiriva HandiHaler) Inhaler
Umeclidinium (Incruse Ellipta) Inhaler
1 capsule for inhalation (18 mcg) once daily
1 inhalation (62.5 mcg) once daily
Long-Acting Antimuscarinics, Inhaled
Aclidinium (Tudorza Pressair) Inhaler
1 inhalation (400 mcg) twice daily
1 inhalation (62.5 mcg) daily
Glycopyrrolate (Seebri Neohaler) Inhaler
1 inhalation (15.6 mcg) twice daily
Glycopyrrolate (Lonhala Magnair) Nebulizer
1 inhalation (25 mcg) twice daily
Glycopyrrolate-formoterol (Bevespi) Inhaler
Umeclidinium-vilanterol (Anoro Ellipta) Inhaler
2 inhalations (9-4.8 mcg/inhalation) twice daily
1 inhalation (62.5-25 mcg) daily
Glycopyrrolate-indacaterol (Utibron Neohaler) Inhaler
1 inhalations (15.6-27.5 mcg) twice daily
Revefenacin (Yupelri) Nebulizer
1 inhalation (175 mcg) once daily
1 capsule (18 mcg*) for inhalation daily
Tiotropium (Spiriva Respimat) Inhaler
2 inhalations (5 mcg) daily (COPD)
Tiotropium-olodaterol (Stiolto Respimat) Inhaler
2 inhalations (2.5-2.5 mcg/actuation) daily
Leukotriene Receptor Antagonists
Zafirlukast tablet
Montelukast tablet
Nitroglycerin Products
Sublingual nitroglycerin powder
Sublingual nitroglycerin tablet
0.4 mg PRN
0.3 mg PRN
0.6 mg PRN
Nonsteroidal Anti-Inflammatory Drugs
Diclofenac tablet, DR
Meloxicam tablet
7.5 mg twice daily
Diclofenac tablet, ER
100 mg daily
15 mg daily
Indomethacin capsule, ER
Indomethacin capsule, IR
75 mg once daily
25 mg three times daily
50 mg three times daily
Ketorolac tablet
Ibuprofen tablet
10 mg three times a day
10 mg four times a day
400 mg four times a day
20 mg once
800 mg once
Nabumetone tablet
Naproxen tablet, IR
500 mg daily
1,000 mg daily
2,000 mg daily
Naproxen sodium tablet
220 mg twice daily
275 mg twice daily
550 mg twice daily
Piroxicam capsule
Phosphate Binders
Sevelamer HCl (Renagel) tablet
Sevelamer carbonate (Renvela) tablet
400 mg three times daily
800 mg three times daily
1,200 mg three times daily
1,600 mg three times daily
2,400 mg three times daily
3,200 mg three times daily
Prostaglandins, Ophthalmic
Bimatoprost 0.01% ophthalmic drops
Latanoprost 0.005% ophthalmic drops
One drop each evening into affected eye(s)
Bimatoprost 0.03% ophthalmic drops
Tafluprost 0.0015% ophthalmic drops
Travoprost 0.004% ophthalmic drops
Proton Pump Inhibitors
Dexlansoprazole capsule
Pantoprazole tablet
Esomeprazole capsule, tablet
Lansoprazole capsule, ODT
Omeprazole capsule, or tablet
Omeprazole/sodium bicarbonate capsule
Rabeprazole capsule, or tablet, EC
Selective Serotonin Reuptake Inhibitors
Fluoxetine ER tablet
Fluoxetine IR capsule
90 mg weekly
Paroxetine ER tablet
Paroxetine IR tablet
12.5 mg daily
25 mg daily
37.5 mg daily
Nefazodone tablet
Trazodone tablet
150 mg once daily at bedtime
225 mg once daily at bedtime
400 mg once daily at bedtime
Short-Acting Bronchodilators
Levalbuterol inhaler (Xopenex HFA) 45 mcg/actuation
Albuterol inhaler (Ventolin HFA) 90 mcg/actuation
2 inhalations every 4 hours
2 inhalations every 6 hours
Ipratropium-albuterol inhaler (Combivent)
Albuterol-ipratropium nebule (DuoNeb)
20-100 mcg/actuation
2.5-0.5 mg/3 mL
1 inhalation every 6 hours
1 nebule every 6 hours
Ipratropium inhaler (Atrovent HFA) 17 mcg/actuation
Ipratropium nebule (Atrovent) 0.5 mg/2.5 mL
Skeletal Muscle Relaxants
Carisoprodol tablet
Methocarbamol tablet
250 mg three times a day
500 mg three times a day
250 mg four times a day
500 mg four times a day
350 mg three times a day
1,000 mg three times a day
350 mg four times a day
1,000 mg four times a day
Chlorzoxazone tablet
250 mg three times daily
250 mg four times daily
500 mg three times daily
500 mg four times daily
Cyclobenzaprine tablet, ER
Cyclobenzaprine tablet, IR
5 mg three times a day
Metaxalone tablet
800 mg three times a day
800 mg four times a day
Tizanidine capsule
Tizanidine tablet
2 mg three times a day
4 mg three times a day
Sleep Aids
Eszopiclone tablet
Zolpidem tablet
1 mg at night
5 mg at night
2 mg at night
3 mg at night
10 mg at night
Zolpidem tablet, ER
6.25 mg at night
12.5 mg at night
Zaleplon capsule
20 mg at night
Serotonin-Norepinephrine Reuptake Inhibitors
Desvenlafaxine tablet, ER
Venlafaxine capsule, ER
37.5 mg once daily
Venlafaxine tablet, ER
Statins
Fluvastatin capsule
Pravastatin tablet
20 mg nightly
10 mg nightly
40 mg nightly
Fluvastatin tablet, ER
80 mg nightly
Lovastatin tablet
Lovastatin tablet, ER
60 mg nightly
Pitavastatin calcium tablet
1 mg nightly
2 mg nightly
4 mg nightly
Pitavastatin magnesium tablet
Rosuvastatin tablet
Atorvastatin tablet
5 mg nightly
Simvastatin tablet
*Pravastatin may be used in place of atorvastatin for patients with intolerance to atorvastatin
Sulfonylureas
Glimepiride tablet
Glipizide tablet, IR
1 mg once daily with food
2.5 mg once daily with food
2 mg once daily with food
5 mg once daily with food
4 mg once daily with food
10 mg once daily with food
8 mg once daily with food
10 mg twice daily with food
Glipizide tablet, ER
20 mg once daily with food
Thiazides
Indapamide tablet
Chlorthalidone tablet
1.25 mg daily
50 mg daily
Triptans
Almotriptan tablet
Sumatriptan tablet
6.25 mg once
50 mg once
12.5 mg once
100 mg once
25 mg once
Eletriptan tablet
40 mg once
80 mg once
Frovatriptan tablet
2.5 mg once
75 mg once
5 mg once
7.5 mg once
Naratriptan tablet
1 mg once
Zolmitriptan tablet
1.25 mg once
10 mg once
Urinary Antispasmodics
Darifenacin ER tablet
Oxybutynin IR tablet
Fesoterodine ER tablet
Flavoxate tablet
200 mg three times daily
5 mg four times daily
Oxybutynin ER tablet
20-30 mg once daily
Oxybutynin transdermal patch
3.9 mg/24 hours
Tolterodine tablet
1 mg twice daily
2 mg twice daily
Tolterodine ER capsule
Trospium tablet
Trospium ER capsule
Vitamin B Products
Vitamin B complex tablet (Renavite)
Vitamin B complex tablet (Balance B-50)
1 tablet once daily
1 tablet twice daily
Vitamin B complex capsule (Nephrocaps)
1 capsule once daily
1 capsule twice daily
Vitamin B complex tablet (Nephro-vite)
Vitamin B complex tablet (Z-bec B)
Vitamin B complex tablet (Hematinic)
Vitamin B complex (Total B with C)
Vitamin B complex tablet (Nephron FA)
Vitamin D Products
Cholecalciferol capsule
Cholecalciferol tablet
400 IU once daily
1000 IU once daily
5000 IU once daily
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5-Alpha Reductase Inhibitors
Non-Formulary Order
Formulary Equivalent Order
Dutasteride capsule
Finasteride tablet
0.5 mg once daily
5 mg once daily
Dutasteride/tamsulosin combination products
Equivalent dose of finasteride + tamsulosin
Alpha1 Blockers
Non-Formulary Order
Formulary Equivalent Order
Alfuzosin tablet, ER
Tamsulosin capsule
10 mg once daily
0.4 mg once daily
Doxazosin tablet
Terazosin capsule
1 mg once daily
1 mg once daily
2 mg once daily
2 mg once daily
4 mg once daily
5 mg once daily
8 mg once daily
10 mg once daily
Doxazosin tablet, ER
Terazosin capsule
4 mg once daily
5 mg once daily
8 mg once daily
10 mg once daily
Silodosin capsule
Tamsulosin capsule
4 mg once daily
0.4 mg once daily
8 mg once daily
0.4 mg once daily
Tamsulosin/dutasteride combination products
Equivalent dose of tamsulosin + finasteride
Angiotensin II Receptor Blockers
Non-Formulary Order
Formulary Equivalent Order
Azilsartan tablet
Valsartan tablet
20 mg daily
160 mg daily
40 mg daily
320 mg daily
80 mg daily
320 mg daily
Azilsartan/chlorthalidone combination products
Equivalent dose of valsartan + chlorthalidone
Candesartan tablet
Valsartan tablet
4 mg daily
40 mg daily
8 mg daily
80 mg daily
16 mg daily
160 mg daily
32 mg daily
320 mg daily
Candesartan/hydrochlorothiazide combination products
Equivalent dose of valsartan + hydrochlorothiazide
Eprosartan tablet
Valsartan tablet
400 mg daily
40 mg daily
600 mg daily
80 mg daily
800 mg daily
160 mg daily
Irbesartan tablet
Valsartan tablet
75 mg daily
40 mg daily
150 mg daily
80 mg daily
300 mg daily
160 mg daily
Irbesartan/hydrochlorothiazide combination products
Equivalent dose of valsartan + hydrochlorothiazide
Losartan/hydrochlorothiazide combination products
Equivalent dose of losartan + hydrochlorothiazide
Olmesartan tablet
Valsartan tablet
5 mg daily
20 mg daily
10 mg daily
40 mg daily
20 mg daily
80 mg daily
40 mg daily
160 mg daily
Olmesartan/amlodipine combination products
Equivalent dose of valsartan + amlodipine
Olmesartan/hydrochlorothiazide combination products
Equivalent dose of valsartan + hydrochlorothiazide
Olmesartan/amlodipine/hydrochlorothiazide combination products
Equivalent dose of valsartan + amlodipine + hydrochlorothiazide
Telmisartan tablet
Valsartan tablet
20 mg daily
40 mg daily
40 mg daily
80 mg daily
80 mg daily
160 mg daily
Telmisartan/amlodipine combination products
Equivalent dose of valsartan + amlodipine
Telmisartan/hydrochlorothiazide combination products
Equivalent dose of valsartan + hydrochlorothiazide
Valsartan/amlodipine combination products
Equivalent dose of valsartan + amlodipine
Valsartan/hydrochlorothiazide
Equivalent dose of valsartan + hydrochlorothiazide
Valsartan/amlodipine/hydrochlorothiazide combination products
Equivalent dose of valsartan + amlodipine + hydrochlorothiazide
Angiotensin Converting Enzyme Inhibitors
Non-Formulary Order
Formulary Equivalent Order
Amlodipine/benazepril combination products
Equivalent dose of amlodipine + lisinopril
Benazepril tablet
Lisinopril tablet
5 mg once daily
5 mg once daily
10 mg once daily
10 mg once daily
20 mg once daily
20 mg once daily
40 mg once daily
40 mg once daily
Fosinopril tablet
Lisinopril tablet
10 mg once daily
10 mg once daily
20 mg once daily
20 mg once daily
40 mg once daily
40 mg once daily
Hydrochlorothiazide/lisinopril combination products
Equivalent dose of hydrochlorothiazide + lisinopril
Moexipril tablet
Lisinopril tablet
3.75 mg daily
5 mg daily
7.5 mg once daily
10 mg once daily
15 mg once daily
20 mg once daily
30 mg daily
40 mg once daily
Perindopril tablet
Lisinopril tablet
2 mg once daily
5 mg once daily
4 mg once daily
10 mg once daily
8 mg once daily
20 mg once daily
Quinapril tablet
Lisinopril tablet
5 mg once daily
5 mg once daily
5 mg twice daily
10 mg once daily
10 mg once daily
10 mg once daily
10 mg twice daily
20 mg once daily
20 mg once daily
20 mg once daily
20 mg twice daily
40 mg once daily
40 mg once daily
40 mg once daily
Ramipril Tablet
Lisinopril tablet
1.25 mg once daily
5 mg once daily
2.5 mg once daily
10 mg once daily
5 mg once daily
20 mg once daily
10 mg once daily
40 mg once daily
20 mg once daily
80 mg once daily
Trandolapril tablet
Lisinopril tablet
1 mg once daily
10 mg once daily
2 mg once daily
20 mg once daily
4 mg once daily
40 mg once daily
Antiretrovirals
Non-Formulary Order
Formulary Equivalent Order
Raltegravir tablet (Isentress HD)
Raltegravir tablet (Isentress)
1200 mg once daily
400 mg twice daily
Barbiturates
Non-Formulary Order
Formulary Equivalent Order
Phenobarbital tablet
Phenobarbital tablet
15 mg twice daily
16.2 mg twice daily
15 mg three times daily
16.2 mg three times daily
30 mg twice daily
32.4 mg twice daily
30 mg three times daily
32.4 mg three times daily
60 mg twice daily
64.8 mg twice daily
60 mg three times daily
64.8 mg three times daily
100 mg twice daily
97.2 mg twice daily
100 mg three times daily
97.2 mg three times daily
Benzodiazepines
Non-Formulary Order
Formulary Equivalent Order
Alprazolam tablet, ER
Alprazolam tablet, IR
0.5 mg once daily
0.125 mg four times daily
1 mg once daily
0.25 mg four times daily
2 mg once daily
0.5 mg four times daily
3 mg once daily
1 mg three times daily
4 mg once daily
1 mg four times daily
6 mg once daily
2 mg three times daily
Chlordiazepoxide/amitriptyline combination products
Equivalent dose of chlordiazepoxide + amitriptyline
Diazepam rectal kit
Midazolam solution, intranasal
0.2 to 0.5 mg/kg once per rectum PRN
0.2 mg/kg once intranasal PRN
Beta-Blockers
Non-Formulary Order
Formulary Equivalent Order
Acebutolol capsule
Metoprolol tartrate tablet
100 mg twice daily
25 mg twice daily
200 mg twice daily
50 mg twice daily
Atenolol/chlorthalidone combination products
Equivalent dose of atenolol + chlorthalidone
Betaxolol tablet
Metoprolol succinate tablet
5 mg once daily
50 mg once daily
10 mg once daily
100 mg once daily
20 mg once daily
200 mg once daily
Bisoprolol tablet
Metoprolol succinate tablet
2.5 mg once daily
50 mg once daily
5 mg once daily
100 mg once daily
10 mg once daily
200 mg once daily
Bisoprolol/hydrochlorothiazide combination products
Equivalent dose of metoprolol succinate + hydrochlorothiazide
Carvedilol capsule, CR
Carvedilol tablet, IR
10 mg once daily
3.125 mg twice daily
20 mg once daily
6.25 mg twice daily
40 mg once daily
12.5 mg twice daily
80 mg once daily
25 mg twice daily
Metoprolol tartrate/hydrochlorothiazide combination products
Equivalent dose of metoprolol tartrate + hydrochlorothiazide
Metoprolol succinate/hydrochlorothiazide combination products
Equivalent dose of metoprolol succinate + hydrochlorothiazide
Nadolol tablet
Propranolol tablet
20 mg daily
20 mg twice daily
40 mg daily
40 mg twice daily
80 mg daily
80 mg twice daily
160 mg daily
160 mg twice daily
Nebivolol tablet
Carvedilol tablet, IR
5 mg once daily
6.25 mg twice daily
10 mg once daily
12.5 mg twice daily
20 mg once daily
25 mg twice daily
40 mg once daily
25 mg twice daily
Pindolol tablet
Propranolol tablet
5 mg twice daily
40 mg twice daily
5 mg three times daily
40 mg three times daily
10 mg twice daily
80 mg twice daily
10 mg three times daily
80 mg three times daily
20 mg twice daily
160 mg twice daily
20 mg three times daily
160 mg three times daily
Propranolol ER capsule
Propranolol tablet
60 mg daily
30 mg twice daily
80 mg daily
40 mg twice daily
120 mg daily
60 mg twice daily
160 mg daily
80 mg twice daily
240 mg daily
120 mg twice daily
Timolol tablet
Propranolol tablet
10 mg twice daily
40 mg twice daily
20 mg twice daily
80 mg twice daily
30 mg twice daily
120 mg twice daily
Beta-Blockers, Ophthalmic
Non-Formulary Order
Formulary Equivalent Order
Betaxolol 0.25% ophthalmic solution
Timolol maleate 0.25% ophthalmic solution
1 drop twice daily
1 drop twice daily
2 drops twice daily
1 drop twice daily
Betaxolol 0.5% ophthalmic solution, suspension
Timolol maleate 0.5% ophthalmic solution
1 drop twice daily
1 drop twice daily
Carteolol 1% ophthalmic solution
Timolol maleate 0.5% ophthalmic solution
1 drop twice daily
1 drop twice daily
Levobunolol 0.25% ophthalmic solution
Timolol maleate 0.25% ophthalmic solution
1 drop once daily
1 drop twice daily
2 drops once daily
1 drop twice daily
Levobunolol 0.5% ophthalmic solution
Timolol maleate 0.5% ophthalmic solution
1 drop once daily
1 drop twice daily
2 drops once daily
1 drop twice daily
Metipranolol 0.3% ophthalmic solution
Timolol maleate 0.5% ophthalmic solution
1 drop twice daily
1 drop twice daily
Timolol hemihydrate 0.25% ophthalmic solution
Timolol maleate 0.25% ophthalmic solution
1 drop twice daily
1 drop twice daily
Timolol hemihydrate 0.5% ophthalmic solution
Timolol maleate 0.5% ophthalmic solution
1 drop twice daily
1 drop twice daily
Timolol maleate 0.25% ophthalmic gel-forming solution
Timolol maleate 0.25% ophthalmic solution
1 drop once daily
1 drop twice daily
Timolol maleate 0.5% ophthalmic gel-forming solution
Timolol maleate 0.5% ophthalmic solution
1 drop once daily
1 drop twice daily
Timolol-brimonidine ophthalmic solution 0.5%-0.2% combination product
Equivalent dose of timolol + brimonidine ophthalmic solution
Biguanides
Non-Formulary Order
Formulary Equivalent Order
Metformin tablet, ER
Metformin tablet, IR
500 mg once daily
250 mg twice daily
1000 mg once daily
500 mg twice daily
2000 mg once daily
1000 mg twice daily
Bile Acid Sequestrants
Non-Formulary Order
Formulary Equivalent Order
Cholestyramine powder with aspartame
Cholestyramine powder
4 g once daily
4 g once daily
4 g twice daily
4 g twice daily
Colestipol packet, granules
Cholestyramine powder
5 g once daily
4 g once daily
5 g twice daily
4 g twice daily
Colesevelam packet
Cholestyramine powder
3.75 g once daily
4 g once daily
Colesevelam tablet
Colestipol tablet
1.875 g twice daily
2 g twice daily
3.75 g once daily
2 g twice daily
Calcium Carbonate Products
Non-Formulary Order
Formulary Equivalent Order
Calcium carbonate tablet/capsule
Calcium carbonate tablet
500 mg elemental calcium (1,250 mg calcium carbonate)
600 mg elemental calcium (1,500 mg calcium carbonate)
Calcium-Cholecalciferol (Vitamin D) Combination Products
Non-Formulary Order
Formulary Equivalent Order
Calcium carbonate/cholecalciferol tablet, capsule
Calcium carbonate tablet + cholecalciferol tablet
200 mg (elemental calcium)/250 IU cholecalciferol
300 mg (elemental calcium) + 200 IU cholecalciferol
250 mg (elemental calcium)/125 IU cholecalciferol
300 mg (elemental calcium) + 200 IU cholecalciferol
250 mg (elemental calcium)/200 IU cholecalciferol
300 mg (elemental calcium) + 200 IU cholecalciferol
500 mg (elemental calcium)/125 IU cholecalciferol
600 mg (elemental calcium) + 200 IU cholecalciferol
500 mg (elemental calcium)/200 IU cholecalciferol
600 mg (elemental calcium) + 200 IU cholecalciferol
500 mg (elemental calcium)/250 IU cholecalciferol
600 mg (elemental calcium) + 200 IU cholecalciferol
500 mg (elemental calcium)/400 IU cholecalciferol
600 mg (elemental calcium) + 400 IU cholecalciferol
600 mg (elemental calcium)/200 IU cholecalciferol
600 mg (elemental calcium) + 200 IU cholecalciferol
600 mg (elemental calcium)/400 IU cholecalciferol
600 mg (elemental calcium) + 400 IU cholecalciferol
600 mg (elemental calcium)/800 IU cholecalciferol
600 mg (elemental calcium) + 800 IU cholecalciferol
600 mg (elemental calcium)/1,000 IU cholecalciferol
600 mg (elemental calcium) + 800 IU cholecalciferol
Calcium Channel Blockers
Non-Formulary Order
Formulary Equivalent Order
Amlodipine/benazepril combination products
Equivalent dose of amlodipine + lisinopril
Amlodipine/lisinopril combination products
Equivalent dose of amlodipine + lisinopril
Amlodipine/losartan combination products
Equivalent dose of amlodipine + losartan
Amlodipine/losartan/hydrochlorothiazide combination products
Equivalent dose of amlodipine + losartan + hydrochlorothiazide
Amlodipine/valsartan combination products
Equivalent dose of amlodipine + valsartan
Diltiazem ER (12h twice daily) capsule
Diltiazem ER (24 hr once daily) capsule
60 mg twice daily
120 mg once daily
90 mg twice daily
180 mg once daily
120 mg twice daily
240 mg once daily
Felodipine tablet
Amlodipine tablet
2.5 mg twice daily
2.5 mg twice daily
5 mg twice daily
5 mg twice daily
10 mg daily
10 mg daily
20 mg daily
10 mg daily
Isradipine capsule, IR
Amlodipine tablet
2.5 mg twice daily
5 mg daily
5 mg twice daily
10 mg daily
10 mg twice daily
10 mg daily
Nicardipine capsule, IR
Amlodipine tablet
20 mg three times daily
2.5 mg daily
30 mg three times daily
5 mg daily
40 mg three times daily
10 mg daily
Nifedipine (Adalat CC) tablet, ER
Nifedipine (Procardia) tablet, ER
30 mg once daily
30 mg once daily
60 mg once daily
60 mg once daily
90 mg once daily
90 mg once daily
120 mg once daily
120 mg once daily
Nisoldipine (geomatrix) tablet, ER
Amlodipine tablet
8.5 mg daily
2.5 mg daily
17 mg daily
5 mg daily
25.5 mg daily
10 mg daily
34 mg daily
10 mg daily
Nisoldipine (original formulation) tablet, ER
Amlodipine tablet
10 mg daily
2.5 mg daily
20 mg daily
5 mg daily
30 mg daily
10 mg daily
40 mg daily
10 mg daily
Carbonic Anhydrase Inhibitors, Ophthalmic
Non-Formulary Order
Formulary Equivalent Order
Brinzolamide 1% ophthalmic solution
Dorzolamide 2% ophthalmic solution
1 drop three times daily
1 drop three times daily
CorticoSteroids, Intranasal
Non-Formulary Order
Formulary Equivalent Order
Beclomethasone nasal inhaler
Fluticasone nasal inhaler
1 spray in each nostril once daily
2 sprays in each nostril once daily
2 sprays in each nostril once daily
2 sprays in each nostril once daily
1 spray in each nostril twice daily
2 sprays in each nostril once daily
2 sprays in each nostril twice daily
2 sprays in each nostril once daily
Budesonide nasal inhaler
Fluticasone nasal inhaler
1 spray in each nostril once daily
2 sprays in each nostril once daily
2 sprays in each nostril once daily
2 sprays in each nostril once daily
Ciclesonide nasal inhaler
Fluticasone nasal inhaler
1 spray in each nostril once daily
2 sprays in each nostril once daily
2 sprays in each nostril once daily
2 sprays in each nostril once daily
Flunisolide nasal inhaler
Fluticasone nasal inhaler
2 sprays in each nostril twice daily
2 sprays in each nostril once daily
2 sprays in each nostril three times daily
2 sprays in each nostril once daily
Mometasone nasal inhaler
Fluticasone nasal inhaler
2 sprays in each nostril once daily
2 sprays in each nostril once daily
2 sprays in each nostril twice daily
2 sprays in each nostril once daily
Triamcinolone nasal inhaler
Fluticasone nasal inhaler
1 spray in each nostril once daily
2 sprays in each nostril once daily
2 sprays in each nostril once daily
2 sprays in each nostril once daily
Corticosteroids, Inhaled
Non-Formulary Order
ADULT - Formulary Equivalent Order
PEDIATRIC - Formulary Equivalent Order
Beclomethasone (QVAR Redihaler) 40 mcg/dose
Fluticasone (Arnuity Ellipta) 100 mcg/dose Inhaler
Fluticasone (Flovent HFA) 44 mcg/actuation
Beclomethasone (QVAR Redihaler) 80 mcg/dose
Fluticasone (Arnuity Ellipta) 100 mcg/dose Inhaler
Fluticasone (Flovent HFA) 110 mcg/actuation
1 or 2 inhalations twice daily
1 inhalation daily
1 or 2 inhalations twice daily
Budesonide (Pulmicort Flexhaler) 90 mcg/dose Inhaler
Fluticasone (Arnuity Ellipta) 100 mcg/dose Inhaler
Fluticasone (Flovent HFA) 44 mcg/actuation
2 inhalations twice daily
1 inhalation daily
1 or 2 inhalations twice daily
Budesonide (Pulmicort Flexhaler) 180 mcg/dose Inhaler
Fluticasone (Arnuity Ellipta) 100 mcg/dose Inhaler
Fluticasone (Flovent HFA) 44 mcg/actuation
1 inhalation twice daily
1 inhalation daily
1 or 2 inhalations twice daily
Budesonide (Pulmicort Flexhaler) 180 mcg/dose Inhaler
Fluticasone (Arnuity Ellipta) 200 mcg/dose Inhaler
Fluticasone (Flovent HFA) 110 mcg/actuation
2 inhalations twice daily
1 inhalation daily
1 or 2 inhalations twice daily
Ciclesonide (Alvesco) 80 mcg/dose Inhaler
Fluticasone (Arnuity Ellipta) 100 mcg/dose Inhaler
Fluticasone (Flovent HFA) 110 mcg/actuation
1 or 2 inhalations twice daily
1 inhalation daily
1 or 2 inhalations twice daily
Ciclesonide (Alvesco) 160 mcg/dose Inhaler
Fluticasone (Arnuity Ellipta) 100 mcg/dose Inhaler
Fluticasone (Flovent HFA) 110 mcg/actuation
1 inhalation twice daily
1 inhalation daily
1 or 2 inhalations twice daily
Ciclesonide (Alvesco) 160 mcg/dose Inhaler
Fluticasone (Arnuity Ellipta) 200 mcg/dose Inhaler
Fluticasone (Flovent HFA) 220 mcg/actuation
2 inhalations twice daily
1 inhalation daily
1 or 2 inhalations twice daily
Fluticasone (Flovent HFA) 44 mcg/dose Inhaler
Fluticasone (Arnuity Ellipta) 100 mcg/dose Inhaler
Not applicable
1 or 2 inhalations twice daily
1 inhalation daily
Fluticasone (Flovent HFA) 110 mcg/dose Inhaler
Fluticasone (Arnuity Ellipta) 100 mcg/dose Inhaler
Not applicable
1 inhalation twice daily
1 inhalation daily
Fluticasone (Flovent HFA) 110 mcg/dose Inhaler
Fluticasone (Arnuity Ellipta) 200 mcg/dose Inhaler
Not applicable
2 inhalations twice daily
1 inhalation daily
Fluticasone (Flovent HFA) 220 mcg/dose Inhaler
Fluticasone (Arnuity Ellipta) 200 mcg/dose Inhaler
Not applicable
1 or 2 inhalations twice daily
1 inhalation daily
Fluticasone (Flovent Diskus) 50 mcg/dose Inhaler
Fluticasone (Arnuity Ellipta) 100 mcg/dose Inhaler
Fluticasone (Flovent HFA) 44 mcg/actuation
1 or 2 inhalations twice daily
1 inhalation daily
1 or 2 inhalations twice daily
Fluticasone (Flovent Diskus) 100 mcg/dose Inhaler
Fluticasone (Arnuity Ellipta) 100 mcg/dose Inhaler
Fluticasone (Flovent HFA) 44 mcg/actuation
1 inhalation twice daily
1 inhalation daily
1 or 2 inhalations twice daily
Fluticasone (Flovent Diskus) 100 mcg/dose Inhaler
Fluticasone (Arnuity Ellipta) 200 mcg/dose Inhaler
Fluticasone (Flovent HFA) 110 mcg/actuation
2 inhalations twice daily
1 inhalation daily
1 or 2 inhalations twice daily
Fluticasone (Flovent Diskus) 250 mcg/dose Inhaler
Fluticasone (Arnuity Ellipta) 200 mcg/dose Inhaler
Fluticasone (Flovent HFA) 220 mcg/actuation
1 or 2 inhalations twice daily
1 inhalation daily
1 or 2 inhalations twice daily
Mometasone (Asmanex HFA) 100 mcg/dose Inhaler
Fluticasone (Arnuity Ellipta) 100 mcg/dose Inhaler
Fluticasone (Flovent HFA) 110 mcg/actuation
1 or 2 inhalations twice daily
1 inhalation daily
1 or 2 inhalations twice daily
Mometasone (Asmanex HFA) 200 mcg/dose Inhaler
Fluticasone (Arnuity Ellipta) 200 mcg/dose Inhaler
Fluticasone (Flovent HFA) 220 mcg/actuation
2 inhalations twice daily
1 inhalation daily
1 or 2 inhalations twice daily
Mometasone (Asmanex Twisthaler) 110 mcg/dose Inhaler
Fluticasone (Arnuity Ellipta) 100 mcg/dose Inhaler
Fluticasone (Flovent HFA) 110 mcg/actuation
2 inhalations once or twice daily
1 inhalation daily
1 or 2 inhalations twice daily
Mometasone (Asmanex Twisthaler) 220 mcg/dose Inhaler
Fluticasone (Arnuity Ellipta) 100 mcg/dose Inhaler
Fluticasone (Flovent HFA) 110 mcg/actuation
1 inhalation once or twice daily
1 inhalation daily
1 or 2 inhalations twice daily
Mometasone (Asmanex Twisthaler) 220 mcg/dose Inhaler
Fluticasone (Arnuity Ellipta)100 mcg/dose Inhaler
Fluticasone (Flovent HFA) 110 mcg/actuation
2 inhalations once daily
1 inhalation daily
1 or 2 inhalations twice daily
Mometasone (Asmanex Twisthaler) 220 mcg/dose Inhaler
Fluticasone (Arnuity Ellipta) 200 mcg/dose Inhaler
Fluticasone (Flovent HFA) 220 mcg/actuation
2 inhalations twice daily
1 inhalation daily
2 inhalations twice daily
Corticosteroids & Long-Acting Beta Agonist Combinations, Inhaled
Non-Formulary Order
ADULT - Formulary Equivalent Order
PEDIATRIC - Formulary Equivalent Order
Budesonide/Formoterol (Symbicort) 80-4.5 mcg/dose Inhaler
Fluticasone/Vilanterol (Breo Ellipta) 100-25 mcg/dose Inhaler
Not applicable
2 inhalations twice daily
1 inhalation daily
Budesonide/Formoterol (Symbicort) 160-4.5 mcg/dose Inhaler
Fluticasone/Vilanterol (Breo Ellipta) 200-25 mcg/dose Inhaler
2 inhalations twice daily
1 inhalation daily
Fluticasone/Salmeterol (Advair Diskus) 100-50 mcg/dose Inhaler
Fluticasone/Vilanterol (Breo Ellipta) 100-25 mcg/dose Inhaler
1 inhalation twice daily
1 inhalation daily
Fluticasone/Salmeterol (Advair Diskus) 250-50 mcg/dose Inhaler
Fluticasone/Vilanterol (Breo Ellipta) 100-25 mcg/dose Inhaler
Budesonide/Formoterol (Symbicort) 80-4.5 mcg/dose Inhaler
1 inhalation twice daily
Fluticasone/Salmeterol (Advair Diskus) 500-50 mcg/dose Inhaler
Fluticasone/Vilanterol (Breo Ellipta) 200-25 mcg/dose Inhaler
1 inhalation twice daily
1 inhalation daily
2 inhalations twice daily
Fluticasone/Salmeterol (Advair HFA) 45-21 mcg/dose Inhaler
Budesonide/Formoterol (Symbicort) 80-4.5 mcg/dose Inhaler
2 inhalations twice daily
1 inhalation daily
2 inhalations twice daily
Fluticasone/Salmeterol (Advair HFA) 115-21 mcg/dose Inhaler
Fluticasone/Vilanterol (Breo Ellipta) 100-25 mcg/dose Inhaler
Budesonide/Formoterol (Symbicort) 80-4.5 mcg/dose Inhaler
2 inhalations twice daily
1 inhalation daily
2 inhalations twice daily
Fluticasone/Salmeterol (Advair HFA) 230-21 mcg/dose Inhaler
Fluticasone/Vilanterol (Breo Ellipta) 200-25 mcg/dose Inhaler
2 inhalations twice daily
1 inhalation daily
2 inhalations twice daily
Fluticasone/Salmeterol (AirDuo RespiClick) 55-14 mcg/dose Inhaler
Budesonide/Formoterol (Symbicort) 80-4.5 mcg/dose Inhaler
1 inhalation twice daily
1 inhalation daily
2 inhalations twice daily
Fluticasone/Salmeterol (AirDuo RespiClick) 113-14 mcg/dose Inhaler
Fluticasone/Vilanterol (Breo Ellipta) 100-25 mcg/dose Inhaler
Budesonide/Formoterol (Symbicort) 80-4.5 mcg/dose Inhaler
1 inhalation twice daily
1 inhalation daily
2 inhalations twice daily
Fluticasone/Salmeterol (AirDuo RespiClick) 232-14 mcg/dose Inhaler
Fluticasone/Vilanterol (Breo Ellipta) 200-25 mcg/dose Inhaler
Budesonide/Formoterol (Symbicort) 160-4.5 mcg/dose Inhaler
1 inhalation twice daily
1 inhalation daily
2 inhalations twice daily
Mometasone/Formoterol (Dulera) 100-5 mcg/dose Inhaler
Fluticasone/Vilanterol (Breo Ellipta) 100-25 mcg/dose Inhaler
Budesonide/Formoterol (Symbicort) 80-4.5 mcg/dose Inhaler
2 inhalations twice daily
1 inhalation daily
2 inhalations twice daily
Mometasone/Formoterol (Dulera) 200-5 mcg/dose Inhaler
Fluticasone/Vilanterol (Breo Ellipta) 200-25 mcg/dose Inhaler
Budesonide/Formoterol (Symbicort) 160-4.5 mcg/dose Inhaler
2 inhalations twice daily
1 inhalation daily
2 inhalations twice daily
Fluticasone/Umeclidinium/Vilanterol (Trelegy) 100-62.5-25 mcg/dose Inhaler
Fluticasone/Vilanterol (Breo Ellipta) 100-25 mcg/dose Inhaler
Not applicable
1 inhalation daily
Umeclidinium (Incruse Ellipta) 62.5 mcg/dose Inhaler
Fibric Acid Derivatives
Non-Formulary Order
Formulary Equivalent Order
Fenofibrate (Fenoglide) tablet
Fenofibrate, nanocrystalized (Tricor) tablet
40 mg once daily
48 mg once daily
120 mg once daily
145 mg once daily
Fenofibrate (Lipofen) capsule
Fenofibrate, nanocrystalized (Tricor) tablet
50 mg once daily
48 mg once daily
150 mg once daily
145 mg once daily
Fenofibrate, micronized (Anatara) capsule
Fenofibrate, nanocrystalized (Tricor) tablet
30 mg once daily
48 mg once daily
43 mg once daily
48 mg once daily
90 mg once daily
145 mg once daily
130 mg once daily
145 mg once daily
Fenofibrate, micronized (Lofibra) tablet, capsule
Fenofibrate, nanocrystalized (Tricor) tablet
54 mg once daily
48 mg once daily
67 mg once daily
48 mg once daily
134 mg once daily
145 mg once daily
160 mg once daily
145 mg once daily
200 mg once daily
145 mg once daily
Fenofibrate, nanocrystalized (Triglide) tablet
Fenofibrate, nanocrystalized (Tricor) tablet
160 mg once daily
145 mg once daily
Fenofibric Acid (Fibricor) tablet
Fenofibrate, nanocrystalized (Tricor) tablet
35 mg once daily
48 mg once daily
105 mg once daily
145 mg once daily
GABA Analogs
Non-Formulary Order
Formulary Equivalent Order
Gabapentin IR tablet
Gabapentin IR capsule
300 mg daily
300 mg daily
300 mg three times a day
300 mg three times a day
600 mg daily
600 mg daily
600 mg three times a day
600 mg three times a day
Gabapentin ER tablet (Gralise)
Gabapentin IR capsule
1800 mg daily
600 mg three times a day
Gabapentin enacarbil ER tablet (Gralise)
Gabapentin IR capsule
600 mg daily
200 mg three times a day
600 mg twice daily
400 mg three times a day
Histamine1 Antagonists, Oral
Non-Formulary Order
Formulary Equivalent Order
Desloratadine tablet, ODT tablet, or capsule
Loratadine tablet
2.5 mg once daily
5 mg once daily
5 mg once daily
10 mg once daily
Desloratadine oral syrup
Loratadine oral suspension
2.5 mg once daily
5 mg once daily
5 mg once daily
10 mg once daily
Diphenhydramine tablet
Diphenhydramine capsule
25 mg once daily
25 mg once daily
50 mg once daily
50 mg once daily
25 mg every 4 hours
25 mg every 4 hours
50 mg every 4 hours
50 mg every 4 hours
25 mg every 6 hours
25 mg every 6 hours
50 mg every 6 hours
50 mg every 6 hours
Doxylamine-pyridoxine (vitamin B6) tablet
Doxylamine tablet + pyridoxine (vitamin B6) tablet
10-10 mg once daily
12.5 mg + 25 mg once daily
10-10 mg twice daily
12.5 mg + 25 mg twice daily
20-20 mg once daily
25 mg + 25 mg once daily
20-20 mg twice daily
25 mg + 25 mg twice daily
Fexofenadine tablet, ODT
Loratadine tablet
60 mg twice daily
10 mg once daily
180 mg once daily
10 mg once daily
Fexofenadine oral suspension
Loratadine oral suspension
60 mg twice daily
10 mg once daily
Fexofenadine/pseudoephedrine combination products
Equivalent dose of loratadine + pseudoephedrine
Hydroxyzine capsule
Hydroxyzine tablet
25 mg four times daily
25 mg four times daily
50 mg four times daily
50 mg four times daily
100 mg four times daily
100 mg four times daily
Levocetirizine tablet
Loratadine tablet
5 mg once daily
10 mg once daily
Loratadine/pseudoephedrine combination products
Equivalent dose of loratadine + pseudoephedrine
Histamine1 Receptor Antagonists, Miscellaneous
Non-Formulary Order
Formulary Equivalent Order
Alcaftadine ophthalmic solution 0.25%
Ketotifen ophthalmic solution 0.025%
1 drop once daily
1 drop twice daily
Bepotastine ophthalmic solution 1.5%
Ketotifen ophthalmic solution 0.025%
1 drop twice daily
1 drop twice daily
Emedastine ophthalmic solution 0.05%
Ketotifen ophthalmic solution 0.025%
1 drop 4 times daily
1 drop twice daily
Epinastine ophthalmic solution 0.05%
Ketotifen ophthalmic solution 0.025%
1 drop twice daily
1 drop twice daily
Olopatadine ophthalmic solution 0.1%
Ketotifen ophthalmic solution 0.025%
1 drop twice daily
1 drop twice daily
Olopatadine ophthalmic solution 0.2%
Ketotifen ophthalmic solution 0.025%
1 drop once daily
1 drop twice daily
Olopatadine ophthalmic solution 0.7%
Ketotifen ophthalmic solution 0.025%
1 drop once daily
1 drop twice daily
Histamine2 Receptor Antagonists
Non-Formulary Order
Formulary Equivalent Order
Cimetidine tablet
Famotidine tablet
300 mg twice daily
20 mg twice daily
400 mg twice daily
20 mg twice daily
800 mg once daily
40 mg once daily
Nizatidine tablet
Famotidine tablet
150 mg once daily
20 mg once daily
150 mg twice daily
20 mg twice daily
300 mg once daily
40 mg once daily
Ranitidine tablet
75 mg twice daily
10 mg twice daily
150 mg twice daily
20 mg twice daily
300 mg once daily
40 mg once daily
Oral Iron Products
Non-Formulary Order
Formulary Equivalent Order
Ferrous gluconate tablet
Ferrous sulfate tablet
324 mg once daily
162.5 mg once daily
Ferrous fumarate tablet
Polysaccharide iron complex
324 mg once daily
150 mg once daily
Carbonyl iron tablet
Ferrous sulfate tablet
45 mg once daily
325 mg once daily
Long-Acting Beta2-Adrenergic Agonists, Inhaled
Non-Formulary Order
Formulary Equivalent Order
Formoterol nebule
Arformoterol nebule
20 mcg twice daily
15 mcg twice daily
Indacaterol inhaler
Arformoterol nebule
75 mcg once daily
15 mcg twice daily
Olodaterol inhaler
Arformoterol nebule
5 mcg once daily
15 mcg twice daily
Salmeterol inhaler
Arformoterol nebule
50 mcg twice daily
15 mcg twice daily
Long-Acting Anticholinergic Agents, Inhaled
Non-Formulary Order
Formulary Equivalent Order
Tiotropium (Spiriva HandiHaler) Inhaler
Umeclidinium (Incruse Ellipta) Inhaler
1 capsule for inhalation (18 mcg) once daily
1 inhalation (62.5 mcg) once daily
Long-Acting Antimuscarinics, Inhaled
Non-Formulary Order
Formulary Equivalent Order
Aclidinium (Tudorza Pressair) Inhaler
Umeclidinium (Incruse Ellipta) Inhaler
1 inhalation (400 mcg) twice daily
1 inhalation (62.5 mcg) daily
Glycopyrrolate (Seebri Neohaler) Inhaler
Umeclidinium (Incruse Ellipta) Inhaler
1 inhalation (15.6 mcg) twice daily
1 inhalation (62.5 mcg) daily
Glycopyrrolate (Lonhala Magnair) Nebulizer
Umeclidinium (Incruse Ellipta) Inhaler
1 inhalation (25 mcg) twice daily
1 inhalation (62.5 mcg) daily
Glycopyrrolate-formoterol (Bevespi) Inhaler
Umeclidinium-vilanterol (Anoro Ellipta) Inhaler
2 inhalations (9-4.8 mcg/inhalation) twice daily
1 inhalation (62.5-25 mcg) daily
Glycopyrrolate-indacaterol (Utibron Neohaler) Inhaler
Umeclidinium-vilanterol (Anoro Ellipta) Inhaler
1 inhalations (15.6-27.5 mcg) twice daily
1 inhalation (62.5-25 mcg) daily
Revefenacin (Yupelri) Nebulizer
Umeclidinium (Incruse Ellipta) Inhaler
1 inhalation (175 mcg) once daily
1 inhalation (62.5 mcg) daily
Tiotropium (Spiriva HandiHaler) Inhaler
Umeclidinium (Incruse Ellipta) Inhaler
1 capsule (18 mcg*) for inhalation daily
1 inhalation (62.5 mcg) daily
Tiotropium (Spiriva Respimat) Inhaler
Umeclidinium (Incruse Ellipta) Inhaler
2 inhalations (5 mcg) daily (COPD)
1 inhalation (62.5 mcg) daily
Tiotropium-olodaterol (Stiolto Respimat) Inhaler
Umeclidinium-vilanterol (Anoro Ellipta) Inhaler
2 inhalations (2.5-2.5 mcg/actuation) daily
1 inhalation (62.5-25 mcg) daily
Leukotriene Receptor Antagonists
Non-Formulary Order
Formulary Equivalent Order
Zafirlukast tablet
Montelukast tablet
20 mg twice daily
10 mg daily
Nitroglycerin Products
Non-Formulary Order
Formulary Equivalent Order
Sublingual nitroglycerin powder
Sublingual nitroglycerin tablet
0.4 mg PRN
0.4 mg PRN
Sublingual nitroglycerin tablet
Sublingual nitroglycerin tablet
0.3 mg PRN
0.4 mg PRN
0.6 mg PRN
0.4 mg PRN
Nonsteroidal Anti-Inflammatory Drugs
Non-Formulary Order
Formulary Equivalent Order
Diclofenac tablet, DR
Meloxicam tablet
25 mg twice daily
7.5 mg once daily
50 mg twice daily
7.5 mg twice daily
75 mg twice daily
7.5 mg twice daily
Diclofenac tablet, ER
Meloxicam tablet
100 mg daily
15 mg daily
Indomethacin capsule, ER
Indomethacin capsule, IR
75 mg once daily
25 mg three times daily
75 mg twice daily
50 mg three times daily
Ketorolac tablet
Ibuprofen tablet
10 mg three times a day
400 mg three times a day
10 mg four times a day
400 mg four times a day
20 mg once
800 mg once
Nabumetone tablet
Naproxen tablet, IR
500 mg daily
250 mg twice daily
1,000 mg daily
500 mg twice daily
2,000 mg daily
500 mg twice daily
Naproxen sodium tablet
Naproxen tablet, IR
220 mg twice daily
250 mg twice daily
275 mg twice daily
250 mg twice daily
550 mg twice daily
500 mg twice daily
Piroxicam capsule
Meloxicam tablet
10 mg once daily
7.5 mg once daily
20 mg once daily
15 mg once daily
Phosphate Binders
Non-Formulary Order
Formulary Equivalent Order
Sevelamer HCl (Renagel) tablet
Sevelamer carbonate (Renvela) tablet
400 mg three times daily
400 mg three times daily
800 mg three times daily
800 mg three times daily
1,200 mg three times daily
1,200 mg three times daily
1,600 mg three times daily
1,600 mg three times daily
2,400 mg three times daily
2,400 mg three times daily
3,200 mg three times daily
3,200 mg three times daily
Prostaglandins, Ophthalmic
Non-Formulary Order
Formulary Equivalent Order
Bimatoprost 0.01% ophthalmic drops
Latanoprost 0.005% ophthalmic drops
One drop each evening into affected eye(s)
One drop each evening into affected eye(s)
Bimatoprost 0.03% ophthalmic drops
Latanoprost 0.005% ophthalmic drops
One drop each evening into affected eye(s)
One drop each evening into affected eye(s)
Tafluprost 0.0015% ophthalmic drops
Latanoprost 0.005% ophthalmic drops
One drop each evening into affected eye(s)
One drop each evening into affected eye(s)
Travoprost 0.004% ophthalmic drops
Latanoprost 0.005% ophthalmic drops
One drop each evening into affected eye(s)
One drop each evening into affected eye(s)
Proton Pump Inhibitors
Non-Formulary Order
Formulary Equivalent Order
Dexlansoprazole capsule
Pantoprazole tablet
30 mg daily
20 mg daily
60 mg daily
40 mg daily
Esomeprazole capsule, tablet
Pantoprazole tablet
20 mg daily
20 mg daily
40 mg daily
40 mg daily
Lansoprazole capsule, ODT
Pantoprazole tablet
15 mg daily
20 mg daily
30 mg daily
40 mg daily
Omeprazole capsule, or tablet
Pantoprazole tablet
20 mg daily
20 mg daily
40 mg daily
40 mg daily
Omeprazole/sodium bicarbonate capsule
Pantoprazole tablet
20 mg daily
40 mg daily
40 mg daily
40 mg twice daily
Rabeprazole capsule, or tablet, EC
Pantoprazole tablet
10 mg daily
20 mg daily
20 mg daily
40 mg daily
Selective Serotonin Reuptake Inhibitors
Non-Formulary Order
Formulary Equivalent Order
Fluoxetine ER tablet
Fluoxetine IR capsule
90 mg weekly
20 mg daily
Paroxetine ER tablet
Paroxetine IR tablet
12.5 mg daily
10 mg daily
25 mg daily
20 mg daily
37.5 mg daily
30 mg daily
Nefazodone tablet
Trazodone tablet
100 mg twice daily
150 mg once daily at bedtime
150 mg twice daily
225 mg once daily at bedtime
300 mg twice daily
400 mg once daily at bedtime
Short-Acting Bronchodilators
Non-Formulary Order
Formulary Equivalent Order
Levalbuterol inhaler (Xopenex HFA) 45 mcg/actuation
Albuterol inhaler (Ventolin HFA) 90 mcg/actuation
2 inhalations every 4 hours
2 inhalations every 4 hours
2 inhalations every 6 hours
2 inhalations every 6 hours
Ipratropium-albuterol inhaler (Combivent)
Albuterol-ipratropium nebule (DuoNeb)
20-100 mcg/actuation
2.5-0.5 mg/3 mL
1 inhalation every 6 hours
1 nebule every 6 hours
Ipratropium inhaler (Atrovent HFA) 17 mcg/actuation
Ipratropium nebule (Atrovent) 0.5 mg/2.5 mL
2 inhalations every 6 hours
1 nebule every 6 hours
Skeletal Muscle Relaxants
Non-Formulary Order
Formulary Equivalent Order
Carisoprodol tablet
Methocarbamol tablet
250 mg three times a day
500 mg three times a day
250 mg four times a day
500 mg four times a day
350 mg three times a day
1,000 mg three times a day
350 mg four times a day
1,000 mg four times a day
Chlorzoxazone tablet
Methocarbamol tablet
250 mg three times daily
500 mg three times a day
250 mg four times daily
500 mg four times a day
500 mg three times daily
1,000 mg three times a day
500 mg four times daily
1,000 mg four times a day
Cyclobenzaprine tablet, ER
Cyclobenzaprine tablet, IR
15 mg once daily
5 mg three times a day
30 mg once daily
10 mg three times a day
Metaxalone tablet
Methocarbamol tablet
800 mg three times a day
1,000 mg three times a day
800 mg four times a day
1,000 mg four times a day
Tizanidine capsule
Tizanidine tablet
2 mg three times a day
2 mg three times a day
4 mg three times a day
4 mg three times a day
Sleep Aids
Non-Formulary Order
Formulary Equivalent Order
Eszopiclone tablet
Zolpidem tablet
1 mg at night
5 mg at night
2 mg at night
5 mg at night
3 mg at night
10 mg at night
Zolpidem tablet, ER
Zolpidem tablet
6.25 mg at night
5 mg at night
12.5 mg at night
10 mg at night
Zaleplon capsule
Zolpidem tablet
5 mg at night
5 mg at night
10 mg at night
5 mg at night
20 mg at night
10 mg at night
Serotonin-Norepinephrine Reuptake Inhibitors
Non-Formulary Order
Formulary Equivalent Order
Desvenlafaxine tablet, ER
Venlafaxine capsule, ER
25 mg once daily
37.5 mg once daily
50 mg once daily
75 mg once daily
100 mg once daily
150 mg once daily
200 mg once daily
150 mg once daily
Venlafaxine tablet, ER
Venlafaxine capsule, ER
37.5 mg once daily
37.5 mg once daily
75 mg once daily
75 mg once daily
150 mg once daily
150 mg once daily
Statins
Non-Formulary Order
Formulary Equivalent Order
Fluvastatin capsule
Pravastatin tablet
20 mg nightly
10 mg nightly
40 mg nightly
20 mg nightly
40 mg twice daily
40 mg nightly
Fluvastatin tablet, ER
Pravastatin tablet
80 mg nightly
40 mg nightly
Lovastatin tablet
Pravastatin tablet
10 mg nightly
10 mg nightly
20 mg nightly
20 mg nightly
40 mg nightly
40 mg nightly
80 mg nightly
80 mg nightly
Lovastatin tablet, ER
Pravastatin tablet
20 mg nightly
20 mg nightly
40 mg nightly
40 mg nightly
60 mg nightly
40 mg nightly
Pitavastatin calcium tablet
Pravastatin tablet
1 mg nightly
20 mg nightly
2 mg nightly
40 mg nightly
4 mg nightly
80 mg nightly
Pitavastatin magnesium tablet
Pravastatin tablet
1 mg nightly
20 mg nightly
2 mg nightly
40 mg nightly
4 mg nightly
80 mg nightly
Rosuvastatin tablet
Atorvastatin tablet
5 mg nightly
10 mg nightly
10 mg nightly
20 mg nightly
20 mg nightly
40 mg nightly
40 mg nightly
80 mg nightly
Simvastatin tablet
Pravastatin tablet
5 mg nightly
10 mg nightly
10 mg nightly
20 mg nightly
20 mg nightly
40 mg nightly
40 mg nightly
80 mg nightly
*Pravastatin may be used in place of atorvastatin for patients with intolerance to atorvastatin
Sulfonylureas
Non-Formulary Order
Formulary Equivalent Order
Glimepiride tablet
Glipizide tablet, IR
1 mg once daily with food
2.5 mg once daily with food
2 mg once daily with food
5 mg once daily with food
4 mg once daily with food
10 mg once daily with food
8 mg once daily with food
10 mg twice daily with food
Glipizide tablet, ER
Glipizide tablet, IR
2.5 mg once daily with food
2.5 mg once daily with food
5 mg once daily with food
5 mg once daily with food
10 mg once daily with food
10 mg once daily with food
20 mg once daily with food
10 mg twice daily with food
Thiazides
Non-Formulary Order
Formulary Equivalent Order
Indapamide tablet
Chlorthalidone tablet
1.25 mg daily
12.5 mg daily
2.5 mg daily
25 mg daily
5 mg daily
50 mg daily
10 mg daily
100 mg daily
Triptans
Non-Formulary Order
Formulary Equivalent Order
Almotriptan tablet
Sumatriptan tablet
6.25 mg once
50 mg once
12.5 mg once
100 mg once
25 mg once
100 mg once
Eletriptan tablet
Sumatriptan tablet
20 mg once
50 mg once
40 mg once
100 mg once
80 mg once
100 mg once
Frovatriptan tablet
Sumatriptan tablet
2.5 mg once
75 mg once
5 mg once
100 mg once
7.5 mg once
100 mg once
Naratriptan tablet
Sumatriptan tablet
1 mg once
50 mg once
2.5 mg once
100 mg once
5 mg once
100 mg once
Zolmitriptan tablet
Sumatriptan tablet
1.25 mg once
25 mg once
2.5 mg once
50 mg once
10 mg once
100 mg once
Urinary Antispasmodics
Non-Formulary Order
Formulary Equivalent Order
Darifenacin ER tablet
Oxybutynin IR tablet
7.5 mg once daily
5 mg twice daily
15 mg once daily
5 mg three times daily
Fesoterodine ER tablet
Oxybutynin IR tablet
4 mg once daily
5 mg twice daily
8 mg once daily
5 mg three times daily
Flavoxate tablet
Oxybutynin IR tablet
100 mg twice daily
5 mg twice daily
200 mg twice daily
5 mg three times daily
100 mg three times daily
5 mg three times daily
200 mg three times daily
5 mg four times daily
Oxybutynin ER tablet
Oxybutynin IR tablet
5 mg once daily
2.5 mg twice daily
10 mg once daily
5 mg twice daily
15 mg once daily
5 mg three times daily
20-30 mg once daily
5 mg four times daily
Oxybutynin transdermal patch
Oxybutynin IR tablet
3.9 mg/24 hours
5 mg twice daily
Tolterodine tablet
Oxybutynin IR tablet
1 mg twice daily
2.5 mg twice daily
2 mg twice daily
5 mg twice daily
Tolterodine ER capsule
Oxybutynin IR tablet
2 mg once daily
2.5 mg twice daily
4 mg once daily
5 mg twice daily
Trospium tablet
Oxybutynin IR tablet
20 mg twice daily
5 mg twice daily
Trospium ER capsule
Oxybutynin IR tablet
60 mg once daily
5 mg twice daily
Vitamin B Products
Non-Formulary Order
Formulary Equivalent Order
Vitamin B complex tablet (Renavite)
Vitamin B complex tablet (Balance B-50)
1 tablet once daily
1 tablet once daily
1 tablet twice daily
1 tablet twice daily
Vitamin B complex capsule (Nephrocaps)
Vitamin B complex tablet (Balance B-50)
1 capsule once daily
1 tablet once daily
1 capsule twice daily
1 tablet twice daily
Vitamin B complex tablet (Nephro-vite)
Vitamin B complex tablet (Balance B-50)
1 tablet once daily
1 tablet once daily
1 tablet twice daily
1 tablet twice daily
Vitamin B complex tablet (Z-bec B)
Vitamin B complex tablet (Balance B-50)
1 tablet once daily
1 tablet once daily
1 tablet twice daily
1 tablet twice daily
Vitamin B complex tablet (Hematinic)
Vitamin B complex tablet (Balance B-50)
1 tablet once daily
1 tablet once daily
1 tablet twice daily
1 tablet twice daily
Vitamin B complex (Total B with C)
Vitamin B complex tablet (Balance B-50)
1 tablet once daily
1 tablet once daily
1 tablet twice daily
1 tablet twice daily
Vitamin B complex tablet (Nephron FA)
Vitamin B complex tablet (Balance B-50)
1 tablet once daily
1 tablet once daily
1 tablet twice daily
1 tablet twice daily
Vitamin D Products
Non-Formulary Order
Formulary Equivalent Order
Cholecalciferol capsule
Cholecalciferol tablet
400 IU once daily
400 IU once daily
1000 IU once daily
1000 IU once daily
5000 IU once daily
5000 IU once daily