3-7-24 COHM FORMULARY-CURRENT - CrossOver Formulary.xlsx

	A	C	F	H	J
1	CrossOver Formulary
2
3		DONATED: AMERICARES, DIRECT RELIEF, RXP OR PATIENT DONATIONS	denotes currently in stock, will be removed once stock is deplenished	To Be Cost Effective, Please Use RxP Medications FIRST
4			denotes currently out of stock until further notice of replenishment
5	5/20/24
6	Amiyah Newsome
7	Bottle Size	Allergies & Asthma & COPD	Strength	Source (RxP=Donated Cardinal=Purchased)
8	1	Albuterol HFA	90mcg	RXP
9	30	Albuterol Solution	2.5mg/3ml, 0.63 mg/3ml	PATIENT DONATION	EXP: 5/2025
10	60 Blisters	Anoro Ellipta	62.5mcg/25mcg	RxP
11	30 Blisters	Arnuity Ellipta	100mcg	RxP
12	60 doses	Asmanex Twisthaler	220 mcg	Patient donation
13	30ml	Azelastine HCL nasal spray	137mcg	PATIENT DONATION	EXP: 5/2025
14	60	Breo	100mcg/25mcg, 200mcg/25 mcg	RxP
15	120 doses	Breztri Aerosphere (budesonide/glycopyrrolate/formoterol fumarate))	160mcg/9mcg/4.8mcg	Patient Donation
16	30	Budesonide	0.5mg/2ml	PATIENT DONATION	EXP: 5/2024 5 BOXES
17	bulk	Cetirizine HCL	10mg	Cardinal
18	60 doses	Flovent Diskus	100mcg,250mcg	RxP
19	12 g,120 doses	Flovent HFA	44mcg,110mcg,220mcg	RxP
20	60 doses	Fluticasone Propionate and Salmeterol Inhalation Powder	55mcg/14mcg	Direct Relief
21	60 doses	Fluticasone Propionate and Salmeterol Inhalation Powder	100/mcg/50mcg	Direct Relief
22	60 doses	Fluticasone Propionate and Salmeterol Inhalation Powder (AIRDUO DIGIHALER)	113mcg/14mcg	Direct Relief
23	30 doses	Incruse Ellipta	62.5 mcg	RxP
24	1000	Montelukast	10mg	RxP
25	100	Predisone	5mg, 10mg, 20mg	Direct Relief
26	30 doses	Spiriva Respimat	1.25 mcg, 2.5mcg	Patient Donation
27	30 doses	Stiolto Respimat	2.5-2.5 mcg/act	Patient donation
28	120 doses	Symbicort	160/4.5 mcg	Patient donation	5 boxes
29	30	Trelegy	100mcg/ 62.5mg, 200/62.5/25mcg	RXP, Patient donation
30	30	Yupelri (revefenacin)	175mcg/3mL	Patient Donation
31
32	Bottle Size	Antibiotics	Strength
33	500	Amoxicillin	500mg	Cardinal
34	30	Azithromycin	250mg,500mg	Direct Rellief
35	500	Bactrim DS (sulfamethoxazole/trimethoprim)	800-160mg	Cardinal
36	100	Doxycycline Monohydrate Cap	100mg	Cardinal
37	12	Fluconazole	150mg	Cardinal
38	bulk	Metronidazole	500mg	Cardinal
39	100	Nitrofurantoin Macrocrystals	50mg, 100mg	Cardinal
40
41	Bottle Size	Anticoagulants	Strength
42	bulk	ENOXAPARIN syringe	60 MG/0.6 ML	Patient Donation
43	bulk	ENOXAPARIN syringe	40 MG/0.4 ML	Patient Donation
44	bulk	ENOXAPARIN syringe	100 MG/ML	Patient Donation
45	bulk	ENOXAPARIN syringe	80 MG/0.8 ML	Patient Donation
46	1 pkg -10 pens .3mL/pen	Lovenox	30mg/0.3ml	Direct Relief Replenishment
47	1 pkg -10 pens .4mL/pen	Lovenox	40mg/0.4ml	Direct Relief Replenishment
48	1 pkg -10 pens .6mL/pen	Lovenox	60mg/0.6ml	Direct Relief Replenishment
49	1 pkg -10 pens .8mL/pen	Lovenox	80mg/0.8ml	Direct Relief Replenishment
50	1 pkg -10 pens 1.0mL/pen	Lovenox	100mg/1.0ml	Direct Relief Replenishment
51	30,60,90	Xarelto (Rivaroxaban)	2.5mg,10mg, 15mg, 20mg	Direct Relief Replenishment
52	bulk	Warfarin	1mg, 2mg, 3mg	Cardinal
53
54	Bottle Size	Antiretroviral	Strength
55	60	Intelence	100mg,200mg	Direct Relief Replenishment
56	60	Prezista	600mg	Direct Relief Replenishment
57	30	Symtuza		Direct Relief Replenishment
58
59	Bottle Size	Antivirals	Strength
60	10,60ml	Tamiflu	75mg	direct relief	EXP: 6/2025
61
62	Bottle Size	Arthritis/Pain	Strength
63	bulk	Allopurinol	100mg	Cardinal
64	30	Arava (Leflunomide)	20mg	Direct Relief Replenishment
65	60	Arthrotec	75mg/200mcg	RxP	TEMPORARILY OOS
66	bulk	Celecoxib	200mg	Direct Relief
67	500	Cyclobenzaprine	10mg	RxP
68	30 ml	Dexamethasone Intensol	1mg/ml	Patient Donation
69	30	Diclofenac Epolamine Patches 1.3%		Patient Donation
70	500	Meloxicam	7.5mg, 15mg	RxP
71	500	Naproxen	500mg	RxP
72	100	Predisone	5mg, 10mg, 20mg	Direct Relief
73
74	Bottle Size	Birth Control	Strength
75	28	Desogestrel and ethinyl estradiol	0.15 mg/0.02 mg	Direct relief
76	28	Mili	0.25-0.035 mg	cardinal
77	28	Sprintec	0.250mg/0.035mg	cardinal
78	28	Tri- Estarylla	0.18mg/0.035mg, 0.215/0.035	cardinal
79			& 0.25mg/0.035mg
80
81	Bottle Size	Bladder & Prostate	Strength
82	30	Arava (Leflunomide)	20mg	Direct Relief Replenishment
83	90	Detrol la	4mg	Direct Relief
84	30	Myrbetriq ER	50mg	Patient Donation	exp 01/2026
85	bulk	Tamsulosin	0.4mg	Cardinal
86
87
88	Bottle Size	Cholestrol Lowering Agents	Strength
89	1000	Atorvastatin	10mg, 20mg,40mg	RxP
90	90	Fenofibrate	145mg	RxP
91	90	Pravastatin Sodium	20mg	Patient Donation
92	90	Rosuvastatin	10mg,20mg	RxP
93
94	Bottle Size	Creams & Ointments & Lotions	Strength
95	454G	Triamcinolone Acetonide Cream 0.025%		Patient Donation
96
97	Bottle Size	Diabetes	Strength
98	30	Alogliptin	12.5mg	Patient Donation
99	bulk	Glimepiride	1mg, 4mg	Cardinal
100	bulk	Glipizide	5mg, 10mg	RxP