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Pharmacy Instructions & Formulary
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Pharmacy Instructions & Formulary
This is the home page for all things pharmacy in EHHOP. This includes information on routine prescribing, EHHOP's formulary, as well as information about supplies and storage in clinic.
Quick Links
Below are a few quick links that are helpful while managing patients in and between clinic.
Medication Management on Epic
DOH enrollment instructions
Dispensary of Hope (DOH) information
Prescribing Urgent and In-Clinic Medications
Refill Instructions for Patients
Storage, Locker Codes, and Diabetes Supplies
PDAP Medications
PPI Prescribing Guide
Reimbursements
Using the Formulary
The formulary can be used to search for medications that are 'on-formulary', which means they are offered by the Mount Sinai pharmacy.
If a medication is marked 'Do Not Prescribe - Apply for PDAP', that means it is a specialty medication that we obtain for free through the use of PDAP (Patient Drug Assistance Programs) from pharmaceutical companies. To request a PDAP medication, please follow the instructions on this form.
If a medication is not on formulary and can't be obtained through PDAP, please see if there is a similar medication on formulary that can be prescribed.
If a medication is not on formulary, can't be obtained by PDAP, and can't be replaced, we can sometimes try to obtain it through purchasing with cash at a local pharmacy; however, please always check-in with the pharmacy team prior to pursuing this option.
If a medication is marked 'Available In-Clinic - See TS', it can be prescribed in clinic for urgent, single treatments.
If a medication is marked 'Available via DOH - Flexible/Primary', this should be the preferred medication since it is free of charge. If it is marked 'Primary', order it normally and the patient can pick it up normally. If this is their first time receiving medications via DOH, tell the patient not to go to the pharmacy until Tuesday. If it is marked 'Flexible', please order normally through Epic and email james.blum@icahn.mssm.edu that it is being prescribed. The medication will arrive in 7-10 days so make sure the patient knows it won't be ready immediately.
Please make sure patients do not pick up medications on Mondays before 12:00 p.m. so the pharmacy can be sure the medications are ready.
If you have any questions/difficulties please contact the pharmacy chair, Sharon Barazani.
- Formulary
-
GENERAL
- Calcium Acetate (Phoslo)
$0.42 (667 mg)
GENERAL
- Sodium Bicarbonate
$0.01 (650 mg)
GENERAL
- Methylprednisolone
4mg, 16mg
GENERAL Available via DOH - Flexible
- Colchicine
300mg, 0.6
GENERAL Available via DOH - Flexible
- Naltrexone
$0.79 (50mg tab)
GENERAL
-
ANALGESICS
- Acetaminophen
$0.01 (325mg)
ANALGESICS
- Aspirin
325mg
ANALGESICS Available In Clinic - See TS Available via DOH - Flexible
- Ibuprofen
$0.07 (400mg), $0.04 (600mg)
ANALGESICS
- Celecoxib
100mg, 200mg
ANALGESICS Available via DOH - Primary Oral NSAID
- Naproxen
$0.07 (500mg), $0.04 (250mg)
ANALGESICS
- Diclofenac
50mg tablet, 3% topical gel
ANALGESICS NSAID Available via DOH - Primary
- Lidocaine
5% Topical Ointment
ANALGESICS Available via DOH - Flexible Local Anesthetic
- Lidocaine
5% Transdermal Patch
ANALGESICS Available via DOH - Flexible Local Anesthetic
- Codeine/Acetaminophen (Tylenol 3)
$0.04 (30mg/300mg)
ANALGESICS
- Oxycodone/Acetaminophen (Percocet)
$0.08 (5mg/325mg)
ANALGESICS
- Morphine Extended Release
$0.21 (15mg), $0.54 (30mg)
ANALGESICS
- Morphine SR
$0.42 (30mg), $2.42 (60mg)
ANALGESICS
- Hydromorphone
$0.09 (2mg), $0.11 (4mg)
ANALGESICS
- Oxycodone
$0.10 (5mg)
ANALGESICS
- Gabapentin (Neurontin)
$0.58 (600mg), $0.05 (300mg), $0.06 (400mg), $0.03 (100mg)
ANALGESICS
- Amitriptyline
25mg, 50mg, 75mg
ANALGESICS Available via DOH - Primary
- Pregabalin (Lyrica)
$3.16 (75mg, 100mg), $2.88 (25mg, 50mg)
ANALGESICS Do Not Prescribe - Apply for PDAP
- Duloxetine
20mg, 30mg, 60mg
ANALGESICS Available via DOH - Primary
- Fentanyl Patches
$2.88 (25mg, 50mg), $3.16 (75mg, 100mg)
ANALGESICS Do Not Prescribe - Apply for PDAP
- Liquid Morphine (Roxanol)
$3.16 (75mg, 100mg), $2.88 (25mg, 50mg)
ANALGESICS Do Not Prescribe
-
VITAMINS
- Calcium Carbonate
$0.01 (648mg), $0.02 (1250mg)
VITAMINS
- Cyanocobalamin Tablets and Injections (B12)
10000mcg/10mL
VITAMINS Available via DOH - Flexible
- Folate
$0.01 (1mg)
VITAMINS
- Iron Sulfate (Ferrous sulfate)
$0.01 (325mg)
VITAMINS
- Ferrous Gluconate 325mg
$0.01 (325mg)
VITAMINS
- Multivitamin
$0.01
VITAMINS
- Multigen Caplet
VITAMINS Available via DOH - Flexible Multivitamin
- Prena1
VITAMINS Available via DOH - Flexible Multivitamin
- Multivitamin High Potency
$0.03
VITAMINS
- Potassium Chloride
8mEq
VITAMINS Available via DOH - Primary Electrolyte Replacement
- Pyridoxine B6
$0.01 (50mg)
VITAMINS
- Thiamine B1
$0.01 (50mg)
VITAMINS
- Vitamin D
$0.01 (400IU)
VITAMINS
- Aqueous Vitamin D
4000u/mL
VITAMINS Available via DOH - Flexible
- Vitamin D2 Ergocalciferol
$0.12 (50000IU)
VITAMINS
- Vitamin D3 Cholecalciferol
$0.01 ()
VITAMINS
- Folbee Plus
VITAMINS Available via DOH - Primary
- Folbic (Folic Acid-B6-B12)
2mg-2.5mg-25mg
VITAMINS Available via DOH - Primary
- VitaPearl Prenatal Multivitamin
VITAMINS Available via DOH - Primary
-
ANTIFUNGALS
- Clotrimazole Topical Cream
$0.91 (15g)
ANTIFUNGALS Topical
- Bacitracin Ointment 0.5%
$3.21 (1oz)
ANTIFUNGALS Topical
- Econazole Nit Cream 1%
$4.28 (15g)
ANTIFUNGALS Topical
- Erythromycin Ophthalmic Ointment 0.5%
$6.39 (3.5 g)
ANTIFUNGALS Topical
- Ketoconazole Cream 2%
$30.04 (30g)
ANTIFUNGALS Topical
- Econazole Nitrate (Spectrazole)
$4.79 ()
ANTIFUNGALS Do Not Prescribe Topical
- Metrogel
ANTIFUNGALS Do Not Prescribe Topical
- Clindamycin
1% Solution, 150mg
ANTIFUNGALS Check with TS Topical
- Patanol
$36 (5mL)
ANTIFUNGALS Do Not Prescribe - Apply for PDAP Eye Drops
-
ANTIMICROBIALS
- Penicillin V
$0.07 (250mg)
ANTIMICROBIALS Oral antibiotics / antifungals / antivirals / anti-mycobacterium
- Amoxicillin
$0.06 (500mg)
ANTIMICROBIALS Oral antibiotics / antifungals / antivirals / anti-mycobacterium
- Doxycycline
100mg
ANTIMICROBIALS Available via DOH - Primary Tetracycline
- Doxycycline Hyclate
50mg
ANTIMICROBIALS Available via DOH - Flexible Tetracycline
- Amoxicillin / Clavulanate
600-42.9mg (Pediatric - DOH)
ANTIMICROBIALS Available via DOH - Flexible Oral antibiotics / antifungals / antivirals / anti-mycobacterium
- Cephalexin
$0.10 (500mg), $0.07 (250mg)
ANTIMICROBIALS Oral antibiotics / antifungals / antivirals / anti-mycobacterium
- Ceftriaxone
$0.71 ()
ANTIMICROBIALS Oral antibiotics/ Injectable antibiotics
- Ciprofloxacin
$0.28 (750mg), $0.19 (500mg), $0.11 (250mg)
ANTIMICROBIALS Oral antibiotics / antifungals / antivirals / anti-mycobacterium
- Levaquin (Levofloxacin)
250mg
ANTIMICROBIALS Oral antibiotics / antifungals / antivirals / anti-mycobacterium
- Erythromycin
$2.68 (250mg)
ANTIMICROBIALS Oral antibiotics / antifungals / antivirals / anti-mycobacterium
- Azithromycin
$0.64 (250mg)
ANTIMICROBIALS Oral antibiotics / antifungals / antivirals / anti-mycobacterium
- Fluconazole
50mg
ANTIMICROBIALS Available In Clinic - See TS Available via DOH - Primary Oral antibiotics / antifungals / antivirals / anti-mycobacterium
- Itraconazole
$0.53 (100mg), $0.06 (50mg), $0.20 (200mg), $0.37 (150mg)
ANTIMICROBIALS Oral antibiotics / antifungals / antivirals / anti-mycobacterium
- Ketoconazole
$0.16 (200mg)
ANTIMICROBIALS Oral antibiotics / antifungals / antivirals / anti-mycobacterium
- Metronidazole
$0.03 (250mg)
ANTIMICROBIALS Oral antibiotics / antifungals / antivirals / anti-mycobacterium
- Miconazole 2% Vaginal Cream
$6.85 (1 tube)
ANTIMICROBIALS Oral antibiotics / antifungals / antivirals / anti-mycobacterium
- Nitrofurantoin (Macrobid)
50mg, 100mg
ANTIMICROBIALS Available In Clinic - See TS Available via DOH - Flexible Oral antibiotics
- Isoniazid
$0.14 (300mg)
ANTIMICROBIALS Oral antibiotics / antifungals / antivirals / anti-mycobacterium
- Rifampin
$0.54 (400mg)
ANTIMICROBIALS Oral antibiotics / antifungals / antivirals / anti-mycobacterium
- RIPE Therapy
$0.54 (400mg)
ANTIMICROBIALS Check First With TS Oral antibiotics / antifungals / antivirals / anti-mycobacterium
- Terbinafine
$0.9 (250mg)
ANTIMICROBIALS Oral antibiotics / antifungals / antivirals / anti-mycobacterium
- TMP/SMX (Bactrim)
80/400mg
ANTIMICROBIALS Available In Clinic - See TS Available via DOH - Flexible Oral antibiotics / antifungals / antivirals / anti-mycobacterium
- Valacyclovir (Valtrex)
500mg, 1000mg
ANTIMICROBIALS Available via DOH - Primary Oral antibiotics / antifungals / antivirals / anti-mycobacterium
- Famciclovir
$1.76 (500mg)
ANTIMICROBIALS Oral antibiotics / antifungals / antivirals / anti-mycobacterium
- Acyclovir
5% Topical Ointment
ANTIMICROBIALS Available via DOH - Flexible Oral antibiotics / antifungals / antivirals / anti-mycobacterium
- PeP/PrEP
$0.00 (0)
ANTIMICROBIALS Do Not Prescribe - Apply for PDAP or Jack Martin Clinic Oral antibiotics / antifungals / antivirals / anti-mycobacterium
- Ganciclovir
$0.05 (200mg)
ANTIMICROBIALS Restricted Use - Check With TS Oral antibiotics / antifungals / antivirals / anti-mycobacterium
- Oseltamivir
30mg, 75mg
ANTIMICROBIALS Available via DOH - Flexible Antiviral
- Moxifloxacin
400mg
ANTIMICROBIALS Quinolone
- Vancomycin
250mg Powder for Injection
ANTIMICROBIALS Available via DOH - Flexible Antiviral
-
ANTIHYPERTENSIVES/CARDIOVASCULAR
- Lisinopril
$0.03 (5mg), $0.04 (10mg), $0.06 (20mg), $0.11 (40mg)
ANTIHYPERTENSIVES/CARDIOVASCULAR Available In Clinic - See TS ACE inhibitors
- Enalapril
$0.02 (20mg)
ANTIHYPERTENSIVES/CARDIOVASCULAR ACE inhibitors
- Losartan (Cozaar)
$0.07 (100mg), $0.04 (50mg), $0.05 (25mg)
ANTIHYPERTENSIVES/CARDIOVASCULAR ARBs
- Valsartan
$0.81 (80mg)
ANTIHYPERTENSIVES/CARDIOVASCULAR ARBs
- Hydralazine
25mg
ANTIHYPERTENSIVES/CARDIOVASCULAR Available via DOH - Primary Available In Clinic - See TS
- Furosemide (Lasix)
20mg, 40mg, 80mg
ANTIHYPERTENSIVES/CARDIOVASCULAR Available via DOH - Primary Diuretics
- Chlorthalidone
25mg
ANTIHYPERTENSIVES/CARDIOVASCULAR Available via DOH - Primary Diuretics
- Hydrochlorothiazide
12.5mg
ANTIHYPERTENSIVES/CARDIOVASCULAR Available via DOH - Flexible Diuretics
- Metolazone
2.5mg, 5mg
ANTIHYPERTENSIVES/CARDIOVASCULAR Available via DOH - Primary Diuretics
- Spironolactone
50mg, 100mg
ANTIHYPERTENSIVES/CARDIOVASCULAR Available via DOH - Primary
- Acetazolamide
$1.96 (250mg)
ANTIHYPERTENSIVES/CARDIOVASCULAR Diuretics
- Propranolol
10mg, 20mg, 40mg
ANTIHYPERTENSIVES/CARDIOVASCULAR Available via DOH - Primary Beta-blockers
- Atenolol
25mg, 50mg, 100mg
ANTIHYPERTENSIVES/CARDIOVASCULAR Available via DOH - Primary Beta-blockers
- Carvedilol
3.125mg, 6.25mg, 12.5mg, 25mg
ANTIHYPERTENSIVES/CARDIOVASCULAR Available via DOH - Primary Beta-blockers
- Metoprolol Succinate
25mg
ANTIHYPERTENSIVES/CARDIOVASCULAR Available via DOH - Primary Beta-blockers
- Metoprolol Tartrate
25mg, 50mg, 100mg
ANTIHYPERTENSIVES/CARDIOVASCULAR Available via DOH - Primary Beta Blockers
- Labetalol
100mg
ANTIHYPERTENSIVES/CARDIOVASCULAR Available In Clinic - See TS Available via DOH - Primary Beta Blockers
- Nifedipine (ER)
30mg, 60mg, 90mg
ANTIHYPERTENSIVES/CARDIOVASCULAR Available via DOH - Primary Calcium Channel Blockers
- Amlodipine
5mg
ANTIHYPERTENSIVES/CARDIOVASCULAR Available In Clinic - See TS Calcium Channel Blockers
- Amlodipine Besylate
2.5mg
ANTIHYPERTENSIVES/CARDIOVASCULAR Available via DOH - Primary Antihypertensive
- Diltiazem
120mg
ANTIHYPERTENSIVES/CARDIOVASCULAR Available via DOH - Primary Calcium Channel Blockers
- Verapamil
$0.56 (120mg), $0.05 (80mg)
ANTIHYPERTENSIVES/CARDIOVASCULAR Calcium Channel Blockers
- Verapamil (SR)
$0.16 (240mg), $0.56 (120mg), $0.17 (180mg)
ANTIHYPERTENSIVES/CARDIOVASCULAR Calcium Channel Blockers
- Nitroglycerin
0.4mg/hr Transdermal Patch
ANTIHYPERTENSIVES/CARDIOVASCULAR Available via DOH - Primary Nitrate
- Isosorbide Mononitrate
$0.12 (60mg), $0.18 (30mg)
ANTIHYPERTENSIVES/CARDIOVASCULAR Nitrate
- Digoxin
$0.26 (0.25mg), $0.26 (0.125mg)
ANTIHYPERTENSIVES/CARDIOVASCULAR
- Terazosin
$0.04 (1mg), $0.12 (5mg)
ANTIHYPERTENSIVES/CARDIOVASCULAR
- Clonidine
0.1mg, 0.2mg, 0.3mg
ANTIHYPERTENSIVES/CARDIOVASCULAR Available In Clinic - See TS Available via DOH - Primary
- Olmesartan
20mg
ANTIHYPERTENSIVES/CARDIOVASCULAR Antihypertensive
- Prazosin
1 mg, 5mg
ANTIHYPERTENSIVES/CARDIOVASCULAR Available via DOH - Primary Antihypertensive
- Captopril
12.5mg, 25mg
ANTIHYPERTENSIVES/CARDIOVASCULAR Available via DOH - Primary Antihypertensive
- Digitek
0.125mg, 0.25mg
ANTIHYPERTENSIVES/CARDIOVASCULAR Available via DOH - Primary Antiarrhythmic
- Digoxin
0.125mg, 0.25mg
ANTIHYPERTENSIVES/CARDIOVASCULAR Available via DOH - Primary Antiarrhythmic
- Triamterene
37.5-25mg, 75-50mg
ANTIHYPERTENSIVES/CARDIOVASCULAR Available via DOH - Primary
- Benazepril
10mg, 20mg
ANTIHYPERTENSIVES/CARDIOVASCULAR Available via DOH - Flexible
- Felodipine
10mg
ANTIHYPERTENSIVES/CARDIOVASCULAR Available via DOH - Flexible
-
ANTIHYPERLIPIDEMICS
- Simvastatin (Zocor)
10mg, 20mg, 40mg
ANTIHYPERLIPIDEMICS Available via DOH - Primary Statins
- Rosuvastatin (Crestor)
$0.06 (5 mg), $0.23 (10mg)
ANTIHYPERLIPIDEMICS Statins
- Pravastatin (Pravachol)
40mg
ANTIHYPERLIPIDEMICS Available via DOH - Primary Statins
- Atorvastatin (Lipitor)
10mg, 20mg, 40mg
ANTIHYPERLIPIDEMICS Available via DOH - Primary Statins
- Ezetimibe/Simvastatin
10/10mg, 10/20mg, 10/40mg
ANTIHYPERLIPIDEMICS Available via DOH - Primary Antihyperlipidemic
- Ezetimibe
1mg, 10mg
ANTIHYPERLIPIDEMICS Available via DOH - Primary Antihyperlipidemic
- Red yeast rice
$0.16 (80mg), $0.07 (10mg), $0.18 (20mg), $0.07 (40mg)
ANTIHYPERLIPIDEMICS Statins
- Niacin (Vit B6)
$0.2 (500mg)
ANTIHYPERLIPIDEMICS Statins
- Gemfibrozil (Lopid)
$0.15 (600mg)
ANTIHYPERLIPIDEMICS Statins
- Fenofibrate (Tricor, Triglide)
145mg, 54mg
ANTIHYPERLIPIDEMICS Available via DOH - Primary Antihyperlipidemic
- Colesevelam
625mg
ANTIHYPERLIPIDEMICS Available via DOH - Primary Antihyperlipidemic
-
ANTICOAGULANTS
- Aspirin
325mg
ANTICOAGULANTS Available via DOH - Primary
- Warfrin(Coumadin)
$0.04 (2mg, 2.5mg, 3mg, 4mg, 5mg), $0.03 (1mg), $0.05 (5mg, 7.5mg, 10mg)
ANTICOAGULANTS
- Clopidogrel
300mg
ANTICOAGULANTS Available via DOH - Flexible
- Apixaban (Eliquis)
$6.24 (2.5/5mg)
ANTICOAGULANTS Do Not Prescribe - Apply for PDAP
- Dabigatran (Pradaxa)
$5.75 (110mg)
ANTICOAGULANTS
- Dabigatran (Pradaxa)
$4.49 (75/150mg)
ANTICOAGULANTS<br>
- Rivaroxaban (Xarelto)
$11.62 (10/15/20mg)
ANTICOAGULANTS
-
DIABETES
- Metformin
500mg, 850mg, 1000mg
DIABETES Available via DOH - Primary Orals
- Glimepiride
4mg
DIABETES Preferred Sulfonylurea Orals
- Glipizide (ER)
5mg, 10mg
DIABETES Available via DOH - Flexible Orals
- Glucometer Lancets
DIABETES Available in clinic
- Glucometer Test Strips
DIABETES Available in clinic
- Glucometers
DIABETES Available in clinic
- Insulin NPH (Novolin)
$128.16 (10 mL)
DIABETES Do Not Prescribe - See TS for Management
- Insulin Lantus (Basaglar)
DIABETES Do Not Prescribe - Apply for PDAP
- Insulin syringes
DIABETES Available in clinic
- Rosiglitazone (Avandia)
DIABETES Do Not Prescribe
- Januvia
DIABETES Do Not Prescribe - Apply for PDAP
- Dulaglutide (Trulicity)
DIABETES Do Not Prescribe - Apply for PDAP Consider as Substitute for Liraglutide (Victoza)
-
GI DRUGS
- Tums (Calcium Carbonate)
$0.91 (4mg)
GI DRUGS Review PPI Guidelines Above
- Maalox (Calcium Carbonate)
$0.91 (4mg)
GI DRUGS Review PPI Guidelines Above
- Omeprazole
10mg, 20mg
GI DRUGS Review PPI Guidelines Above Available via DOH - Primary
- Esomeprazole (Nexium)
20mg, 40mg
GI DRUGS Do Not Prescribe - Review PPI Guidelines Above Available via DOH - Primary
- Famotidine (Pepcid)
20mg
GI DRUGS Available via DOH - Primary Antiulcer
- Ranitidine (Zantac)
$0.05 (150mg)
GI DRUGS Preferred H2RA
- Pantoprazole (Protonix)
40mg
GI DRUGS Preferred PPI - Review PPI Guidelines Above Available via DOH - Primary
- Lansoprazole
15mg
GI DRUGS Available via DOH - Flexible Antiulcer
- Misoprostol
$0.35 (100mg), $0.45 (50mg)
GI DRUGS Mucosal protection
- Docusate sodium (Colace)
$0.02 (100mg)
GI DRUGS Laxatives and stool softeners
- Dicyclomine
20mg
GI DRUGS Available via DOH - Primary Anticholinergic
- Senna
$0.01 (8.6mg)
GI DRUGS Laxatives and stool softeners
- Bisacodyl (Dulcolax)
$0.01 (5mg), $0.12 (10mg)
GI DRUGS Laxatives and stool softeners
- Miralax (polyethylene glycol)
$0.01 (5mg), $0.12 (10mg)
GI DRUGS Laxatives and stool softeners
- MoviPrep (polyethylene glycol in 2L, colonoscopy prep)
$0.12 (10mg), $0.01 (5mg)
GI DRUGS Laxatives and stool softeners
- Erythromycin
$2.68 (250mg)
GI DRUGS Pro-motility
- Meclizine
12.5mg, 25mg
GI DRUGS Available via DOH - Flexible Antiemetic
- Ondansetron (Zofran)
4mg, 8 mg
GI DRUGS Available In Clinic - See TS Available via DOH - Primary Antiemetic
- Metoclopramide
5mg, 10mg
GI DRUGS Available via DOH - Primary Anti-emetic
- Simethicone
$0.01 (80mg)
GI DRUGS Other
- Loperamide
2mg
GI DRUGS Available via DOH - Flexible Antidiarrheal
- Prochlorperazine
5mg, 10mg
GI DRUGS Available via DOH - Primary Antiemetic
- Sucralfate
1g
GI DRUGS Available via DOH - Primary Antiulcer
-
PSYCHOTROPICS
- Fluoxetine (Prozac)
10mg, 20mg
PSYCHOTROPICS Available via DOH - Primary Antidepressants/SSRIs
- Citalopram (Celexa)
10mg, 20mg, 40mg
PSYCHOTROPICS Available via DOH - Primary Antidepressants/SSRIs
- Escitalopram
5mg, 20mg
PSYCHOTROPICS Available via DOH - Flexible Antidepressants/SSRIs
- Mirtazapine
15mg, 30mg, 45mg
PSYCHOTROPICS Available via DOH - Primary Antidepressants/SSRIs
- Paroxetine (Paxil)
20mg, 40mg
PSYCHOTROPICS Available via DOH - Primary Antidepressants/SSRIs
- Sertraline (Zoloft)
$0.05 (25 mg), $0.04 (50 mg), $0.05 (100 mg)
PSYCHOTROPICS Antidepressants/SSRIs
- Buproprion (Wellbutrin)
75mg
PSYCHOTROPICS Available via DOH - Primary Antidepressants/SNRIs
- Nortryptiline
$0.11 (25mg), $0.07 (10mg)
PSYCHOTROPICS Tricyclic Antidepressants
- Amitriptyline
$0.22 (25mg), $0.02 (10mg), $0.47 (50mg)
PSYCHOTROPICS
- Lithium
300mg
PSYCHOTROPICS Available via DOH - Primary Antipsychotics
- Haloperidol (Haldol)
$0.40-$0.59 (0.5mg, 1mg, 2mg, 5mg, 10mg)
PSYCHOTROPICS Antipsychotics: Typical
- Haloperidol Decanoate
100mg/mL
PSYCHOTROPICS Available via DOH - Flexible
- Risperidone (Risperadol)
2mg, 3mg
PSYCHOTROPICS Available via DOH - Flexible Antipsychotics: Atypicals
- Chlorpromazine
50mg, 100 mg, 200 mg
PSYCHOTROPICS Available via DOH - Primary Antipsychotic
- Fluphenazine
10mg
PSYCHOTROPICS Available via DOH - Primary Antipsychotic
- Quetiapine (Seroquel)
50mg
PSYCHOTROPICS Available via DOH - Flexible Antipsychotics: Atypicals
- Aripiprazole (Abilify)
2mg, 5mg, 10mg, 15mg, 20mg, 30mg
PSYCHOTROPICS Available via DOH - Flexible Antipsychotics: Atypicals
- Olanzapine
2.5mg, 5mg, 10mg, 15mg, 20mg
PSYCHOTROPICS Available via DOH - Flexible Antipsychotics: Atypicals
- Alprazolam (Xanax)
$0.03 (0.25mg, 0.5mg, 1mg)
PSYCHOTROPICS Benzodiazepenes
- Lorazepam (Ativan)
$0.03 (1mg), $0.02 (0.5mg), $0.05 (2mg)
PSYCHOTROPICS Benzodiazepenes
- Clonazepam (Klonopin)
$0.01 (0.5mg), $0.03 (1mg), $0.04 (2mg)
PSYCHOTROPICS Benzodiazepenes
- Cyclobenzaprine (Flexeril)
5mg, 7.5mg, 10mg
PSYCHOTROPICS Available via DOH - Flexible Muscle relaxant
- Zolpidem (Ambien)
$0.04 (10mg), $0.02 (5mg)
PSYCHOTROPICS Anti-insomnia/non-BZD
- Trazodone
50mg
PSYCHOTROPICS Available via DOH - Primary Anti-insomnia/non-BZD
- Buspirone
5mg, 10mg, 15mg, 30mg, 75mg
PSYCHOTROPICS Available via DOH - Primary Anxiolytic
- Topamax (Topiramate)
$0.03 (25mg), $0.05 (100mg)
PSYCHOTROPICS Anticonvulsants
- Valproate/Valproic Acid (Depakote)
$0.07-$0.13 (125mg, 250mg, 500mg)
PSYCHOTROPICS Anticonvulsants
- Lamotrigine (Lamictal)
25mg, 100mg, 150mg, 200mg
PSYCHOTROPICS Available via DOH - Flexible Anticonvulsants
- Carbamazepine
$0.67 (200mg)
PSYCHOTROPICS Anti-convulsants
- Divalproex
250mg, 500mg
PSYCHOTROPICS Available via DOH - Primary Anticonvulsant
- Gabapentin (Neurontin)
$0.15 (600mg), $0.06 (400mg), $0.04 (300mg), $0.02 (100mg)
PSYCHOTROPICS Anticonvulsants
- Pregabalin (Lyrica)
$3.16 (75mg, 100mg), $2.88 (25mg, 50mg)
PSYCHOTROPICS Do Not Prescribe - Apply for PDAP Anticonvulsants
- Pramipexole
0.25mg
PSYCHOTROPICS Antiparkinsonian
- Rizatriptan
10mg
PSYCHOTROPICS Available via DOH - Primary Anti-Migraine
- Ropinirole
0.5mg, 1mg, 2mg
PSYCHOTROPICS Available via DOH - Primary Antiparksonian
- Venlafaxine
37.5mg, 75 mg
PSYCHOTROPICS Available via DOH - Primary Antidepressant
- Zolmitriptan
2.5mg, 5mg
PSYCHOTROPICS Available via DOH - Flexible Anti-Migraine
- Clomipramine
50mg
PSYCHOTROPICS Available via DOH - Flexible Antidepressant
- Doxepin
10mg, 25mg, 50mg, 100mg
PSYCHOTROPICS Available via DOH - Primary Antidepressant
- Paliperidone
3mg, 6mg
PSYCHOTROPICS Available via DOH - Primary Atypical Antipsychotic
- Phenytoin
100mg
PSYCHOTROPICS Available via DOH - Primary Anticonvulsant
- Sumatriptan
25mg, 50mg
PSYCHOTROPICS Available via DOH - Primary Anti-Migraine
- Sumatriptan Injection
6mg/0.5mL
PSYCHOTROPICS Available via DOH - Primary Anti-Migraine
- Tizanidine
2mg, 4mg
PSYCHOTROPICS Available via DOH - Primary
- Levetiracetam
100mg/ml solution, 500mg
PSYCHOTROPICS Available via DOH - Flexible
- Perphenazine
2mg
PSYCHOTROPICS Available via DOH - Flexible
-
ASTHMA/COPD
- Prednisone
5mg, 10mg
ASTHMA/COPD Available In Clinic - See TS Available via DOH - Flexible Systemic corticosteroids
- Albuterol HFA Inhaler
0.08% 3mL
ASTHMA/COPD Available In Clinic - See TS Available via DOH - Flexible Bronchodilators
- Levalbuterol
0.63mg/3mL
ASTHMA/COPD Available via DOH - Primary SABA
- Fluticasone Inhaler (Flovent)
ASTHMA/COPD Do Not Prescribe - Apply for PDAP Inhaled corticosteroids
- Montelukast (Singulair)
4mg, 10mg
ASTHMA/COPD Available via DOH - Flexible
- Fluticasone/Salmeterol (Advair)
0.02%
ASTHMA/COPD Do Not Prescribe - Apply for PDAP ICS/LABA
- Ipratroprium Bromide(Atrovent)
0.02%
ASTHMA/COPD Available via DOH - Primary ICS/LABA
- Budesonide/Formeterol (Symbicort)
ASTHMA/COPD Do Not Prescribe - Apply for PDAP ICS/LABA
- Asthma Medication Spacer
ASTHMA/COPD Do Not Prescribe - Available in Clinic Other
-
ALLERGIES
- Diphenhydramine (Benadryl)
$0.02 (50mg), $0.02 (25mg)
ALLERGIES First generation anti-histamine
- Loratadine (Claritin)
10mg
ALLERGIES Available via DOH - Primary Second generation anti-histamine
- Cetirizine (Zyrtec)
10mg
ALLERGIES Available via DOH - Primary Second generation anti-histamine
- Isotonic Saline Spray 0.65% 45mL
$0.59 ()
ALLERGIES Sprays
- Beclomethasone Nasal (Beconase AQ)
$0.59 ()
ALLERGIES Do Not Prescribe - Apply for PDAP Sprays
- Fluticasone Nasal Spray (Flonase)
$3.55 ()
ALLERGIES Sprays
- Hydroxyzine
$0.09 (25mg), $0.12 (10mg), $0.15 (50mg)
ALLERGIES Sprays
- Epipen
ALLERGIES Check First with TS Available In Clinic - See TS $150 (Dual Pack)
-
DERMATOLOGY
- Minocycline
75mg
DERMATOLOGY Available via DOH - Primary
- Hydrocortisone 1% Cream
$1.21 (30g)
DERMATOLOGY Mild potency
- Hydrocortisone 2.5% Cream
DERMATOLOGY Available via DOH - Flexible Mild potency
- Hydrocortisone 0.5% Ointment
$2.76 (30g)
DERMATOLOGY Mild potency
- Hydrocortisone 1% Ointment
$0.76 (30g)
DERMATOLOGY Mild potency
- Triamcinolone Acetonide (TAC)
0.1% Topical Cream
DERMATOLOGY Check First with TS Available via DOH - Flexible Moderate potency
- Mometasone Furoate 0.1% cream 45gm
$7.25 ()
DERMATOLOGY Moderate potency
- Betamethasone 0.1%
$2.74 (15g)
DERMATOLOGY Moderate potency
- Clobetasol Cream
0.05%
DERMATOLOGY Available via DOH - Primary High potency
- Fluocinonide (Lidex)
0.05% Topical Gel
DERMATOLOGY Check First with TS Available via DOH - Flexible Topical
- BenzaClin Gel
$380 ()
DERMATOLOGY Do Not Prescribe
- Dovonex
$204
DERMATOLOGY Do Not Prescribe Topical
- Metrogel
$89
DERMATOLOGY Do Not Prescribe Topical
-
MALE GU
- Terazosin
$0.07 (1mg, 2mg, 5mg)
MALE GU BPH
- Finasteride
$0.06 (5mg)
MALE GU BPH
- Tamsulosin (Flomax)
0.4 mg
MALE GU Available via DOH - Flexible BPH
- Doxazosin
1mg, 2mg, 4mg
MALE GU Available via DOH - Primary BPH
- Sildenafil (Viagra)
$0.23 (5mg)
MALE GU Not Available - Consider Cialis
- Tadalafil (Cialis)
20mg
MALE GU Do Not Prescribe - Apply for PDAP
- Caverject (Alprostadil)
$0.23 (5mg)
MALE GU Do Not Prescribe - Apply for PDAP
-
IMMUNE/METABOLIC/ENDOCRINE
- Prednisone
$0.10 (1mg), $0.02 (5mg), $0.12 (10mg), $0.04 (20mg), $0.16 (50mg)
IMMUNE/METABOLIC/ENDOCRINE Immune Modulators
- Methotrexate
2.5mg
IMMUNE/METABOLIC/ENDOCRINE Available via DOH - Primary Immune Modulators
- Hydroxychloroquine (Plaquenil)
$0.11 (200mg)
IMMUNE/METABOLIC/ENDOCRINE Immune Modulators
- Azathioprine
$0.12 (50mg)
IMMUNE/METABOLIC/ENDOCRINE Immune Modulators
- Sulfasalazine
$0.17 (500mg)
IMMUNE/METABOLIC/ENDOCRINE Immune Modulators
- Levothyroxine
25mcg, 50mcg, 75mcg, 88mcg, 100mcg, 112mcg, 125mcg, 137mcg, 150mcg, 175mcg, 200mcg
IMMUNE/METABOLIC/ENDOCRINE Available via DOH - Primary Hypothyroid
- Methimazole
$0.18 (10mg)
IMMUNE/METABOLIC/ENDOCRINE Hyperthyroid
- Propylthiouracil
$0.35 (50mg)
IMMUNE/METABOLIC/ENDOCRINE Hyperthyroid
- Alendronate (Flosamax)
35mg
IMMUNE/METABOLIC/ENDOCRINE Available via DOH - Flexible
- Risedronate
150mg
IMMUNE/METABOLIC/ENDOCRINE Available via DOH - Primary Bone Resorption Inhibitor
- Allopurinol
100mg, 300mg
IMMUNE/METABOLIC/ENDOCRINE Available via DOH - Primary Antigout
- Ursodiol
300mg
IMMUNE/METABOLIC/ENDOCRINE Available via DOH - Primary Bile Acid
-
SMOKING CESSATION
- Nicotine Patches
$0.60 (70mg)
SMOKING CESSATION Call 1-866-NY-QUITS
- Buproprion (Wellbutrin)
75mg
SMOKING CESSATION Available via DOH - Primary Antidepressants/SNRIs
- Topiramate
25mg, 100mg
SMOKING CESSATION Available via DOH - Flexible
-
VACCINES: All Vaccines in IMA cabinet.
- Hepatitis A
$0.03 (25mg)
VACCINES: All Vaccines in IMA cabinet.
- Hepatitis B
$0.03 (25mg)
VACCINES: All Vaccines in IMA cabinet.
- Pneumovax
$0.03 (25mg)
VACCINES: All Vaccines in IMA cabinet.
- Tetanus toxoid
$0.03 (25mg)
VACCINES: All Vaccines in IMA cabinet.
- Diptheria and Tetanus
$0.03 (25mg)
VACCINES: All Vaccines in IMA cabinet.
- Diptheria, Pertussis and Tetanus
$0.03 (25mg)
VACCINES: All Vaccines in IMA cabinet.
- MMR
$0.03 (25mg)
VACCINES: All Vaccines in IMA cabinet.
- Polio
$0.03 (25mg)
VACCINES: All Vaccines in IMA cabinet.
- Meningococcal
$0.03 (25mg)
VACCINES: All Vaccines in IMA cabinet.
- Zoster Vax
VACCINES: All Vaccines in IMA cabinet. Do Not Prescribe or Administer
- Gardasil
$0.03 (25mg)
VACCINES: All Vaccines in IMA cabinet. Not Available in WHC
- Meningococcal
$0.03 (25mg)
VACCINES: All Vaccines in IMA cabinet.
- Gardasil (HPV)
$0.03 (25mg)
VACCINES: All Vaccines in IMA cabinet.
-
CONTRACEPTION/FEMALE GU
- Ethinyl estradiolĀ w/ Norgestimate (Ortho-Tricyclen)
$10.08 (28-day pack)
CONTRACEPTION/FEMALE GU Preferred
- Ethinyl estradiolĀ w/ Norethidrone (Ortho-Novum) 1/35
$16.52 (28-day pack)
CONTRACEPTION/FEMALE GU
- Ethinyl estradiol w/ Desogestrel (Ortho-cept)
$17.64 (28-day pack)
CONTRACEPTION/FEMALE GU
- Ethinyl estradiol w/ Levonorgestrel triphasic (Tri-phasil)
$17.64 (28-day pack)
CONTRACEPTION/FEMALE GU
- Ethinyl estradiol w/ Levonorgestrel (Alesse)
$19.04 (28-day pack)
CONTRACEPTION/FEMALE GU
- Norelgestromin/ethinyl estradiol (Ortho-evra, Xulane)
$99 (Box of 3 patches)
CONTRACEPTION/FEMALE GU Do Not Prescribe - Apply for PDAP
- Copper IUD
$0 (1 device)
CONTRACEPTION/FEMALE GU Available Free at WHC
- Liletta Hormonal IUD
$0 (1 device)
CONTRACEPTION/FEMALE GU Available Free at WHC
- Nexplanon Progestin Implant
$0 (1 device)
CONTRACEPTION/FEMALE GU Available Free at WHC
- Medroxyprogesterone IM injection (Depo Provera)
$0 (dose)
CONTRACEPTION/FEMALE GU Available Free at WHC
- Levonorgestrel (Plan B)
CONTRACEPTION/FEMALE GU
- Estradiol Vaginal Cream
0.01%
CONTRACEPTION/FEMALE GU Available via DOH - Primary Estrogen
- Estradiol
0.5mg, 1mg
CONTRACEPTION/FEMALE GU Available via DOH - Primary Estrogen
-
ESTROGEN THERAPY
- Medroxyprogesterone 2.5mg tab
$0.04 (1 tab)
ESTROGEN THERAPY
- Condoms
$0.23 (5mg)
ESTROGEN THERAPY
- Conjugated Estrogens Vaginal Cream
$45 ()
ESTROGEN THERAPY Do Not Prescribe - Apply for PDAP
-
OPHTHALMOLOGY: 1 mL ~ 20 drops
- Visine (Artificial) Tears
$5.16 (0.5oz)
OPHTHALMOLOGY: 1 mL ~ 20 drops lubricant
- Artificial Tear (Night-time) Gel
$1.90
OPHTHALMOLOGY: 1 mL ~ 20 drops lubricant
- Latanoprost 0.005%
$6 (2.5mL)
OPHTHALMOLOGY: 1 mL ~ 20 drops Preferred pressure-lowering
- Timolol maleate 0.5%
$3.22 (5mL)
OPHTHALMOLOGY: 1 mL ~ 20 drops pressure-lowering
- Dorzolamide 2%
$8 (10mL)
OPHTHALMOLOGY: 1 mL ~ 20 drops pressure-lowering
- Acetazolamide (Diamox) - oral
$1.88 (250mg)
OPHTHALMOLOGY: 1 mL ~ 20 drops pressure-lowering
- Prednisolone acetate 1% (Predforte)
$33 (5mL)
OPHTHALMOLOGY: 1 mL ~ 20 drops steroid
- Diclofenac 0.1%
$3 (2.5mL)
OPHTHALMOLOGY: 1 mL ~ 20 drops NSAID
- Gentamicin
$4 (5mL)
OPHTHALMOLOGY: 1 mL ~ 20 drops antibiotic
- Polytrim Ophthalmic Solution (Trimethoprim/Polymyxin B)
$5 (10mL)
OPHTHALMOLOGY: 1 mL ~ 20 drops antibiotic
- Neomycin-polymyxin B-gramicidin (Neosporin)
$42 (10mL)
OPHTHALMOLOGY: 1 mL ~ 20 drops Do Not Prescribe Without TS Approval antibiotic
- Neomycin-polymyxin B-dexamethasone (Maxitrol)
$13 (5mL)
OPHTHALMOLOGY: 1 mL ~ 20 drops antibiotic+steroid
- Erythromycin Ophthalmic Ointment
$5.90 (1g)
OPHTHALMOLOGY: 1 mL ~ 20 drops topical antibiotic
- Acyclovir - oral
$7 (100 200mg tablets)
OPHTHALMOLOGY: 1 mL ~ 20 drops antiviral
- Atropine sulfate 1%
$25 (15mL)
OPHTHALMOLOGY: 1 mL ~ 20 drops cycloplegic+mydriatic
- Olopatadine 0.1%
OPHTHALMOLOGY: 1 mL ~ 20 drops Available via DOH - Primary