Acute Formulary
(Immediate Need Drug Pricing)

Allergy

Azelastine HCl 30ml 0.1% (137mcg) Nasal Spray
[Max Qty: 30ML] {ASTELIN}
Diphenhydramine 50mg Capsule [Max Qty: 60] {BENADRYL}
Fluticasone Propionate 16gm 50mcg/spray Nasal Spray
[Max Qty: 16GM] {FLONASE}

Anesthetics

Lidocaine Vicious HCl 100ml 20mg/ml Solution
[Max Qty: 100ML] {XYLOCAINE}

Antibiotics

Amoxicillin 250mg Capsule [Max Qty: 63] {AMOXIL}
Amoxicillin 500mg Capsule [Max Qty: 63] {AMOXIL}
Amoxicillin 875mg Tablet [Max Qty: 42] {AMOXIL}
Amoxicillin 250mg/5ml Suspension [Max Qty: 300ML] {AMOXIL}
Amoxicillin 400mg/5ml Suspension [Max Qty: 200ML] {AMOXIL}
Amoxicillin & K Clavulanate For Susp 600mg/42.9mg/5ml Suspension [Max Qty: 200ML] {AUGMENTIN}
Amoxicillin (Trihydrate) 500 Tablet [Max Qty: 63] {AMOXIL}
Amoxicillin/Potassium Clav 500/125mg Tablet [Max Qty: 63] {AUGMENTIN}
Amoxicillin/Potassium Clav 875/125mg Tablet [Max Qty: 42] {AUGMENTIN}
Amoxicillin/Potassium Clav 400/57mg/5ml Suspension
[Max Qty: 200ML] {AUGMENTIN}
Azithromycin 250mg (#6) Tablet [Max Qty: 1 Card] {ZITHROMAX}
Azithromycin 500mg (#3) Tablet [Max Qty: 1 Card] {ZITHROMAX}
Azithromycin 200mg/5ml (30ml) Suspension [Max Qty: 30ML] {ZITHROMAX}
Cefdinir 300mg Capsule [Max Qty: 42] {OMNICEF}
Cefdinir 250mg/5ml (100ml) Suspension [Max Qty: 200ML] {OMNICEF}
Cefuroxime Axetil Tab 500mg Tablet [Max Qty: 42] {CEFTIN}
Cephalexin 250mg Capsule [Max Qty: 84] {KEFLEX}
Cephalexin 500mg Capsule [Max Qty: 42] {KEFLEX}
Cephalexin 200ml 250mg/5ml Suspension [Max Qty: 400ML] {KEFLEX}
Ciprofloxacin HCl 250mg Tablet [Max Qty: 42] {CIPRO}
Ciprofloxacin HCl 500mg Tablet [Max Qty: 42] {CIPRO}
Clindamycin HCl 150mg Capsule [Max Qty: 84] {CLOECIN}
Clindamycin HCl 300mg Capsule [Max Qty: 42] {CLOECIN}
Doxycycline Hyclate 100mg Capsule [Max Qty: 63] {VIBRAMYCIN}
Doxycycline Hyclate 20mg Tablet [Max Qty: 42] {PERIOSTAT}
Levofloxacin 250mg Tablet [Max Qty: 20] {LEVAQUIN}
Levofloxacin 500mg Tablet [Max Qty: 20] {LEVAQUIN}
Nitrofurantoin monohydrate/macrocrystals 100mg Capsule [Max Qty: 42] {MACROBID}
Penicillin V Potassium 500mg Tablet [Max Qty: 60] {VEETIDS/VCILLINK}
Penicillin V Potassium 250mg/5ml Solution [Max Qty: 400ML] {VEETIDS }
Sulfamethoxazole/Trimethoprim 800mg/160mg Tablet
[Max Qty: 42] {BACTRIM DS}
Sulfamethoxazole/Trimethoprim 200mg-40mg/5ml Suspension
[Max Qty: 120ML] {BACTRIM PED SUSP}

Antibiotics (Ear)

Neomycin/Polymyxin/HC 10ml 3.5mg-10000 Unit-1%/ml Otic
Suspension [Max Qty: 10ML]
{CORTISPORITN OTIC SUSPENSION}
Neomycin/Polymyxin/HC 10ml 1% Otic Solution [Max Qty: 10ML]
{CORTISPORITN OTIC SOLUTION}

Antibiotics (Eye)

Ciprofloxacin HCl 5ml 0.3% Ophthalmic Solution
[Max Qty: 5ML] {CILOXAN}
Erythromycin 3.5gm 5mg/gm Ophthalmic Ointment
[Max Qty: 3.5GM] {EMYCIN}
Ofloxacin 5ml 0.3% Ophthalmic Solution
[Max Qty: 5ML] {OCUFLOX}
Polymyxin B Sulf/Trimethoprim 10ml 10,000u/0.1%/ml Drops
[Max Qty: 10ML] {POLYTRIM}
Tobramycin 5ml 0.3% Ophthalmic Drop [Max Qty: 5ML] {TOBREX}

Antibiotics (Topical)

Clindamycin Phosphate Soln 60ml 1% Solution [Max Qty: 60ML] {CLEOCIN}
Mupirocin 22gm 2% Ointment [Max Qty: 22GM] {BACTROBAN}

Antiburn (Topical)

Silver Sulfadiazine 50gm 1% Cream [Max Qty: 50GM] {SSD}

Antifungal/Anti-inflammatory (Topicals)

Clotrimazole/Betamethasone 15gm 1/0.05% Cream
[Max Qty: 15GM] {LOTRISONE}

Antifungals

Fluconazole 150mg Tablet [Max Qty: 1] {DIFLUCAN}
Metronidazole 500mg Tablet [Max Qty: 60] {FLAGYL}
Nystatin 60ml 100mu/ml Suspension [Max Qty: 60ML] {MYCOSTATIN}
Terbinafine 250mg Tablet [Max Qty: 21] {LAMISIL}

Antifungals (Topical)

Clotrimazole 45gm 1% Vaginal Cream [Max Qty: 45GM] {GYNELOTRIMIN }
Ketoconazole Shampoo 120ml 2% Shampoo [Max Qty: 120ML] {NIZORAL}
Metronidazole Vaginal Gel 70gm 0.75% Gel [Max Qty: 70GM] {METROGEL}
Nystatin Cream 30gm 100,000 units/gm Cream
[Max Qty: 30GM] {NYSTATIN}

Antigout

Allopurinol 100mg Tablet [Max Qty: 21] {XYLOPRIM}
Allopurinol 300mg Tablet [Max Qty: 21] {XYLOPRIM}

Antihistamines

Hydroxyzine HCl 25mg Tablet [Max Qty: 60] {ATARAX}

Anti-inflammatory (Eye)

Neomycin/Polymyxin/Dexamethasone 5ml 0.1% Ophthalmic Suspension [Max Qty: 5ML] {MAXITROL}
Prednisolone Acetate 5ml 1% Ophthalmic Suspension
[Max Qty: 5ML] {PRED FORTE}

Anti-inflammatory/NSAIDS

Diclofenac Potassium 50mg Tablet [Max Qty: 42] {CATAFLAM}
Diclofenac Sodium DR 50mg Tablet [Max Qty: 42] {VOLTAREN}
Diclofenac Sodium DR 75mg Tablet [Max Qty: 42] {VOLTAREN}
Ibuprofen 400mg Tablet [Max Qty: 60] {MOTRIN}
Ibuprofen 600mg Tablet [Max Qty: 60] {MOTRIN}
Ibuprofen 800mg Tablet [Max Qty: 60] {MOTRIN}
Indomethacin 25mg Capsule [Max Qty: 15] {INDOCIN}
Ketorolac Tromethamine 10mg Tablet [Max Qty: 15] {TORADOL}
Meloxicam 7.5mg Tablet [Max Qty: 21] {MOBIC}
Naproxen 375mg Tablet [Max Qty: 42] {NAPROSYN}
Naproxen 500mg Tablet [Max Qty: 42] {NAPROSYN}

Anti-inflammatory/Steroid (Oral)

Dexamethasone 4mg Tablet [Max Qty: 63] {DECADRON}
Fludrocortisone Acetate 0.1mg Tablet [Max Qty: 21] {FLORINEF}
Methylprednisolone Pack (1x21) 4mg Tablet [Max Qty: 21] {MEDROL DOSEPAK}
Prednisone 5mg Tablet [Max Qty: 30] {DELTASONE}
Prednisone 10mg Tablet [Max Qty: 30] {DELTASONE}
Prednisone 20mg Tablet [Max Qty: 30] {DELTASONE}
Prednisone 50mg Tablet [Max Qty: 42] {DELTASONE}

Anti-inflammatory/Steroid (Topical)

Betamethasone Valerate Oint 45gm .1% Ointment
[Max Qty: 45GM] {BETA-VAL}
Clobetasol 0.05% Cream [Max Qty: 15GM] {TEMOVATE}
Clobetasol Propionate 15gm 0.05% Ointment [Max Qty: 15GM] {CLOBEX}
Hydrocortisone Cream 30gm 2.5% Cream [Max Qty: 30GM] {HYTONE}
Mometasone Furoate 15gm 0.1% Cream [Max Qty: 15GM] {ELOCON}
Triamcinolone Acetonide 15gm 0.1% Cream [Max Qty: 15GM] {KENALOG}
Triamcinolone Acetonide 80gm 0.1% Ointment
[Max Qty: 80GM] {KENALOG}

Antinausea

Meclizine HCl 25mg Tablet [Max Qty: 63] {ANTIVERT}
Prochlorperazine Maleate 10mg Tablet [Max Qty: 21] {COMPAZINE}
Promethazine HCl 25mg Tablet [Max Qty: 84] {PHENERGAN}

Antivirals

Acyclovir 200mg Capsule [Max Qty: 50] {ZORIVAX}
Acyclovir 400mg Tablet [Max Qty: 30] {ZOVIRAX}
Acyclovir 800mg Tablet [Max Qty: 30] {ZOVIRAX}
Valacyclovir HCL 500mg Tablet [Max Qty: 42] {VALTREX}

Asthma/Bronchodilators

Albuterol Sulfate & Ipratropium Bromide (UD 30x3ml) 3mg/0.5mg
Inhalation Solution [Max Qty: 90ML] {DUONEB}
Albuterol Sulfate Soln Nebu 0.083% (2.5mg 3ml)
[Max Qty: 90ML] {VENTOLIN / PROVENTIL}
Montelukast Sodium 4mg ChewTab [Max Qty: 21] {SINGLAIR}
Montelukast Sodium 5mg Chew Tab [Max Qty: 21] {SINGULAIR}
Montelukast Sodium 10mg Tablet [Max Qty: 21] {SINGULAIR}
Prednisolone Sod Phosphate 15mg/5mL Oral Solution
[Max Qty: 120ML] {ORAPRED}

Cardiac/Hypertension

Nitroglycerin 0.4mg Disintegrating Bottle [Max Qty: 1 of 25] {NITROSTAT}

Cough and Cold

Benzonatate 100mg Capsule [Max Qty: 30] {TESSALON PERLES}
Benzonatate 200mg Capsule [Max Qty: 30] {TESSALON PERLES}
Promethazine/DM 6.25-15mg/5mL Syrup [Max Qty: 240ML] {PROMETH DM}
Pseudoephedrine/Brompheniramine/DM 10-3-2mg/5mL Syrup
[Max Qty: 240ML] {DALLERGY DM}

Gastrointestinal

Dicyclomine HCl 10mg Capsule [Max Qty: 60] {BENTYL}
Dicyclomine HCl 20mg Tablet [Max Qty: 63] {BENTYL}
Diphenox w/Atropine 2.5/.025mg Tablet [Max Qty: 30] {LOMOTIL}
Famotidine 20mg Tablet [Max Qty: 42] {PEPCID}
Pantoprazole Sodium EC 40mg Tablet [Max Qty: 21] {PROTONIX}
Polyethylene Glycol 3350 236gm NA Solution
[Max Qty: 4000ML] {GO-LYTELY}

Migraine

Butalbital/Acetaminophen/Caffeine 50/325/40mg Tablet
[Max Qty: 42] {FIORICET}
Naratriptan HCl 2.5mg Tablet [Max Qty: 9] {AMERGE}
Rizatriptan 5mg Tablet [Max Qty: 6] {MAXALT}
Rizatriptan 10mg Tablet [Max Qty: 6] {MAXALT}
Rizatriptan Benzoate ODT 10mg Tablet [Max Qty: 3]
{MAXALT MLT}
Sumatriptan Succinate 50mg Tablet [Max Qty: 9] {IMITREX}
Sumatriptan Succinate 100mg Tablet [Max Qty: 9] {IMITREX}

Muscle Relaxants

Cyclobenzaprine HCl 5mg Tablet [Max Qty: 30] {FLEXERIL}
Cycylobenzaprine HCl 10mg Tablet [Max Qty: 63] {FLEXERIL}
Methocarbamol 500mg Tablet [Max Qty: 60] {ROBAXIN}
Methocarbamol 750mg Tablet [Max Qty: 60] {ROBAXIN}
Tizanidine 2mg Tablet [Max Qty: 30] {ZANAFLEX}
Tizanidine 4mg Tablet [Max Qty: 42] {ZANAFLEX}

Oral Health

Chlorhexidine Gluconate 473ml 0.12% Oral Solution
[Max Qty: 473ML] {PERIDEX}
Sodium Fluoride 51gm 1.1% Gel [Max Qty: 51GM]
{PREVIDENT 5000}
Triamcinolone 5gm 0.1% Dental Paste [Max Qty: 5GM] {KENALOG IN ORABASE}

Pain Relievers

Acetaminophen/Tramadol HCl 325/37.5mg Tablet [Max Qty: 63] {ULTRACET}
Gabapentin 300mg Capsule [Max Qty: 60] {NEURONTIN}
Gabapentin 400mg Capsule [Max Qty: 60] {NEURONTIN}
Gabapentin 600mg Tablet [Max Qty: 60] {NEURONTIN}
Gabapentin 800mg Tablet [Max Qty: 60] {NEURONTIN}
Tramadol 50mg Tablet [Max Qty: 63] {TRAMADOL}