For Website COMPLETE FORMULARY LISTED ALPHABETICALLY
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ABCD
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UNC-CH CAMPUS HEALTH SERVICES FORMULARY
Updated 04/26/2017
Note: OTC items stocked in OTC Pharmacy are NOT listed. Brand Names for information only-
NOT all brand names listed below are stocked, generics are used when possible
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Generic Drug NameDEA CSFormulary Dosage Forms Brand Names
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Acetaminophen and CodeineIII •Tablet: Acetaminophen 300 mg and codeine phosphate 30 mgTylenol® With Codeine #3
4
Acetaminophen and HydrocodoneII •Tablet: Hydrocodone bitartrate 5 mg and acetaminophen 325 mgLortab®; Norco®, Vicodin®
5
Acetaminophen and OxycodoneII •Tablet: Acetaminophen 325 mg and oxycodone hydrochloride 5 mg; acetaminophen 325 mg and oxycodone hydrochloride 10 mg Percocet® 5/325; Roxicet® 5/325; Percocet® 10/325; Roxicet® 10/325
6
Acetazolamide •Tablet, immediate release: 250 mg
•Capsule, 12-hour release: 500 mg
Diamox®, Diamox® Sequels
7
Acetic acid-hydrocortisone •Otic solution: (10 mL) [contains benzethonium chloride]Acetasol® HC Otic, VoSol® HC Otic [DSC]
8
Acyclovir •Tablet: 400 mg Zovirax®
9
Adapalene •Cream, topical: 0.1% (45 g)
•Gel, topical: 0.1%, 0.3% (45 g) [alcohol free]
Differin®
10
Albendazole •Tablet: 200mg Albenza®
11
Albuterol •Aerosol, for oral inhalation: 90 mcg/metered inhalation (18 g) [200 metered inhalations; chlorofluorocarbon free]
•Solution for nebulization: 0.083% (3 mL)
Ventolin® HFA
ProAir® HFA
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Alcohol (Isopropyl) •Swabs: 70% (200/box)
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Alendronate •Tablet: 70 mgFosamax®
14
Allopurinol •Tablet: 100 mg, 300 mgZyloprim®
15
Almotriptan •Tablet: 12.5 mg Axert®
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AlprazolamIV •Tablet: 0.25 mg, 0.5 mg, 1 mgXanax®
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Aluminum Chloride Hexahydrate •Solution, topical: 20% in SD alcohol 40 (30 mL) Drysol™
18
Amitriptyline Hydrochloride •Tablet: 10 mg, 25 mg, 75 mg Elavil® [DSC]
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Amlodipine •Tablet: 5mg, 10mgNorvasc®
20
Amlodipine/Benazapril •Tablet: 10 mg - 20 mg (amlodipine 10 mg, benazapril 20 mg)Lotrel®
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Amoxicillin •Capsule: 500 mg
•Tablet: 875 mg
•Powder for oral suspension: 250 mg/5 mL (150 mL)
•Powder for oral suspension: 400 mg/5 mL
Amoxil®
22
Amoxicillin and Clavulanic Acid •Tablet: 500: Amoxicillin trihydrate 500 mg & clavulanic acid 125 mg
•Tablet: 875: Amoxicillin trihydrate 875 mg & clavulanic acid 125 mg
•Tablet, extended release: Amoxicillin 1000 mg and clavulanic acid 62.5 mg
•Powder for oral suspension: 250-62.5 mg/5 mL, 400-57 mg/5 mL
Augmentin XR™; Augmentin®
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Ampicillin •Capsule: 500 mg
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Ampicillin Sodium and Sulbactam Sodium •Infusion [ADD-Vantage® vial]: 3 g [ampicillin sodium 2 g and sulbactam sodium 1 g] Unasyn®
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Aripiprazole •Tablet: 2 mg, 5 mg, 10 mg, 15 mgAbilify®
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Armodafinil •Tablet: 250 mgNuvigil®
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Atenolol •Tablet: 25 mg, 50 mg Tenormin®
28
Atomoxetine •Capsule: 10 mg, 25 mg, 40 mg, 60 mg, 80 mg, 100 mg Strattera™
29
Atorvastatin •Tablet: 10 mg, 20 mg, 40 mg Lipitor®
30
Atovaquone and Proguanil •Tablet: Atovaquone 250 mg and proguanil hydrochloride 100 mg Malarone™
31
Atropine Sulfate •Injection: 0.1 mg/mL (10 mL syringe)
32
Azathioprine •Tablet: 50 mgImuran®
33
Azelaic Acid •Cream: 20% (30 g)
•Gel: 15% (30 g)
Azelex®; Finacea®+D41; Finevin®
34
Azelastine•Spray, intranasal solution, 0.1%: 1 mg/mL [137 mcg/spray] (30 mL) [contains benzalkonium chloride]
•Spray, intranasal solution, 0.15%: 1.5 mg/mL (30 mL) [contains benzalkonium chloride]
Astelin®
Astepro®
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Azithromycin •Tablet, as dihydrate: 250 mg, 500 mg
•Tablet Tri-Pack [unit-dose pack]: 500 mg (3s)
•Tablet Z-Pack [unit-dose pack]: 250 mg (6s)
•Suspension: 100 mg/5 mL, 200 mg/5 mL
Zithromax®, Z-pack®
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Baclofen •Tablet: 10 mg
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Balsalazide •Capsule: 750 mg Colazal®
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Beclomethasone dipropionate •Spray, aerosol, oral inhalation (QVAR 80®): 80 mcg/actuation (8.7 g = 120 actuations)
•Spray, aerosol, oral inhalation (QVAR 40®): 40 mcg/actuation (8.7 g = 120 actuations)
QVAR 80®
39
Benzonatate •Capsule: 100 mg, 200 mg Tessalon® Perles
40
Bicalutamide •Tablet: 50 mgCasodex®
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Bisoprolol Fumarate •Tablet: 5 mgZebeta®
42
Blood Glucose Monitor •Kit (contents vary with brand): OneTouch® Ultra-2®, OneTouch® Verio IQ, OneTouch® Verio Sync, Contour® Next USB: in stock. Precision Xtra™ and ACCU-CHEK® Aviva meter-Ordered on as needed basisOne Touch Ultra-2®; OneTouch® Verio IQ, OneTouch® Verio Sync, Contour® Next USB, Precision Xtra™, ACCU-CHEK® Aviva meter
43
Brimonidine Tartrate •Ophthalmic solution, 0.15%, 10 mLAlphagan P®
44
Brinzolamide •Ophthalmic suspension, 1%, 10 mLAzopt®
45
Budesonide •Powder for oral inhalation: 180 mcg/inhalation (225 mg) [delivers approx.160 mcg/inhalation; 120 metered doses]
•Powder for oral inhalation: 90 mcg/inhalation (60 metered doses)
•Suspension, nasal [spray]: 32 mcg/inhalation (5 mL) [60 metered doses]
Pulmicort Flexhaler®;
Rhinocort® Allergy (OTC ONLY)
46
Budesonide and Formoterol HFA •Aerosol, oral inhalation: 80/4.5 mcg per inhalation 10.2 g (120 inhalations), 160/4.5 mcg per inhalation 10.2 g (120 inhalations)Symbicort HFA®
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Betamethasone •Injection, as sodium phosphate and acetate: 3 mg/mL (5 mL)Celestone Soluspan®
48
Bupivacaine Hydrochloride •Injection: 0.5% [5 mg/mL] (10 mL) Marcaine®
49
Bupropion Hydrochloride •Tablet, immediate release: 75 mg, 100 mg
•Tablet, extended release: (24 hour): 150 mg, 300 mg
•Tablet, sustained release (12 hour): 100 mg, 150 mg, 200 mg
Wellbutrin SR®; Wellbutrin XL™; Wellbutrin®; Zyban®
50
BusPIRone •Tablet, as hydrochloride:10 mg, 15 mg, 30 mg BuSpar®
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Cabergoline •Tablet: 0.5 mgDostinex®
52
Calcipotriene •Cream: 0.005% (60 g)
•Solution (scalp): 0.005% (60 mL)
Dovonex
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Carbarmazepine •Tablet, extended release, 200 mgTegretol® XL
54
Carvedilol •Tablet, immediate release: 3.125 mg, 6.25 mg, 12.5 mgCoreg®
55
Cefadroxil •Capsule, as monohydrate: 500 mg Duricef®
56
Cefdinir •Capsule: 300 mgOmnicef®
57
Cefpodoxime •Tablet [film coated]: 200 mg Vantin®
58
Ceftriaxone Sodium •Infusion, as sodium [ADD-Vantage® vial]: 1 g
•Powder for injection: 250 mg, 1 g
Rocephin®
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Cefuroxime •Tablet, as axetil: 250 mg, 500 mg Ceftin®
60
Celecoxib •Capsule: 200 mg Celebrex®
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Cervical Cap •Device 22mm; 26mm; 30mm (Ordered as needed on an individual basis)FemCap®
62
Cephalexin Monohydrate •Capsule: 250 mg, 500 mg Keflex®
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Cetirizine •Tablet: 10 mg
•Syrup: 1 mg/1 mL, 120 mL bottle
Zyrtec®
64
Charcoal •Liquid, activated, with sorbitol: 50 g (240 mL)
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Chlorhexidine Gluconate •Rinse, oral (mint flavor): 0.12% with alcohol 11.6% (480 mL) Peridex®; PerioGard®
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Chloroquine •Tablet, as phosphate: 500 mg [300 mg base] Aralen®
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Chlorthalidone •Tablet: 25 mg Thalitone® [DSC]
68
Cholecalciferol (vitamin D3) •Capsule: 50,000 international units (IU)Decara™
69
Cholera, Attenuated Live Oral Vaccine •Suspension for oral administration supplied as a packet of the buffer component and a packet of the active component (lyophilized V. cholerae CVD 103-HgR). After preparation, a single dose of VAXCHORA is 100 mL.Vaxchora®
70
Cholestyramine •Powder: 4 g packetsQuestran®
71
Ciclopirox •Solution, topical (nail lacquer): 8% (6.6 mL)
•Shampoo: 1% (120 mL)
Penlac®, Loprox®
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Ciprofloxacin and Dexamethasone •Suspension, sterile, otic: Ciprofloxacin hydrochloride 0.3% and dexamethasone 0.1% (7.5 mL) Ciprodex®
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Ciprofloxacin Hydrochloride •Solution, ophthalmic: 0.3% (5 mL)
•Tablet: 250 mg, 500 mg
Ciloxan®; Cipro®
74
Citalopram •Tablet, as hydrobromide: 10 mg, 20 mg, 40 mg Celexa®
75
Clarithromycin •Capsule: 250 mg, 500 mgBiaxin®
76
Clindamycin •Capsule, as hydrochloride: 150 mg, 300 mg
•Cream, vaginal: 2% (40 g tube with 7 applicators)
•Gel, topical, as phosphate: 1% [10 mg/g] (30 g)
•Lotion, topical, as phosphate: 1% [10 mg/mL] (60 mL)
•Solution, topical, as phosphate: 1% [10 mg/mL] (60 mL)
Cleocin T®; Cleocin®; Clindagel®
77
Clobetasol Dipropionate •Cream: 0.05% (15 g)
•Ointment, topical: 0.05% (30 g)
•Solution, topical: 0.05% (50 ml)
Temovate®
78
Clobetasol Propionate •Foam, emollient: 0.05% (15 g)Olux-E®
79
Clomiphene •Tablet: 50 mgClomid®
80
ClonazepamIV •Tablet: 0.5 mg, 1 mgKlonopin®
81
Clonidine •Tablet: 0.1 mg Catapres®
82
Clopidogrel •Tablet: 75 mgPlavix®
83
Clotrimazole •Troche: 10 mg
84
Colchicine •Tablet: 0.6 mgColcrys®
85
Colesevelam •Tablet: 625 mgWelchol®
86
Co-Trimoxazole •Tablet, double strength: trimethoprim 160 mg and sulfamethoxazole 800 mg Bactrim™ DS; Septra® DS
87
Cyanocobalamin •Injection: 1000 mcg/mL (1 mL)
88
Cyclobenzaprine Hydrochloride •Tablet: 5 mg, 10 mg Flexeril®
89
Cyclosporine •Ophthalmic emulsion: 0.05% (0.4 mL single use vials)Restasis®
90
Cyproheptadine •Tablet: 4 mg
91
Dapsone •Gel, topical: 5% (30 g) Aczone®
92
Desipramine •Tablet: 10 mg, 50 mgNorpramin®
93
Desloratadine •Tablet: 5 mgClarinex®
94
Desonide •Cream, topical: 0.05% (15 g, 60 g)
•Lotion, topical: 0.05% (118 mL)
•Ointment, topical: 0.05% (15 g, 60 g)
DesOwen®
95
Desoximetasone •Cream, topical: 0.25% (15 g, 60 g)Topicort®
96
Desvenlafaxine •Tablet: 25 mg, 50 mg, 100 mg Pristiq®
97
Dexamethasone •Sodium phosphate: Gel, ultrasound: 4% (250 g), extemporaneously prepared by pharmacy for use in phonophoresis
•Injection: 4 mg/mL (5 mL); 10 mg/ml (1 mL)
•Tablet: 0.5 mg, 1 mg, 4 mg
Decadron®
98
DexmethylphenidateII •Tablet (immediate release): 5 mg, 10 mg
•Capsule (extended release): 5 mg, 10 mg, 15 mg, 20 mg, 40 mg
Focalin®, Focalin® XR
99
Dextroamphetamine and Amphetamine (mixed salts)II •Tablet (immediate release): 5 mg, 10 mg, 15 mg, 20 mg, 30 mg
•Capsule (Extended Release): 5 mg, 10 mg, 15 mg, 20 mg, 25 mg, 30 mg
Adderall®, Adderall XR®
100
Dextroamphetamine SulfateII •Tablet (immediate release): 5 mg, 10 mg
•Capsule (extended release): 10 mg, 15 mg
Dexedrine®; Dextrostat®
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