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Hoosier School Benefit Trust Health and Wellness Center Prescription Hoosier School Benefit Trust Health and Wellness Center Prescription Medication Formulary Brand Name Generic Name Strength ZOVIRAX ACYCLOVIR 800MG VENTOLIN HFA ALBUTEROL SULFATE 90 MCG HFA NORVASC AMLODIPINE BESYLATE 5MG AMOXICILLIN AMOXICILLIN 250MG/5ML SUSP ML AMOXICILLIN AMOXICILLIN 250MG AMOXICILLIN AMOXICILLIN 400MG/5ML SUSP ML AMOXICILLIN AMOXICILLIN 500MG CAP AMOXICILLIN AMOXICILLIN 875MG TAB AUGMENTIN AMOXICILLIN/POTASSIUM CLAV 400-57MG/5 SUSP ML AUGMENTIN AMOXICILLIN/POTASSIUM CLAV 500-125MG TAB AUGMENTIN AMOXICILLIN/POTASSIUM CLAV 875-125MG TAB TENORMIN ATENOLOL 50MG TAB LIPITOR ATORVASTATIN CALCIUM 10MG TAB LIPITOR ATORVASTATIN CALCIUM 20MG TAB LIPITOR ATORVASTATIN CALCIUM 40MG TAB ZITHROMAX AZITHROMYCIN 200MG/5ML SUSP ML ZITHROMAX AZITHROMYCIN 250MG TAB TESSALON BENZONATATE 200MG CAP BETAMETHASONE DIPROPIONATE BETAMETHASONE DIPROPIONATE CREAM OMNICEF CEFDINIR 125MG/5ML SUSP ML OMNICEF CEFDINIR 300MG CAP KEFLEX CEPHALEXIN 500MG CAP CIPRO CIPROFLOXACIN HCL 500MG TAB CELEXA CITALOPRAM HYDROBROMIDE 20MG TAB CELEXA CITALOPRAM HYDROBROMIDE 40MG TAB LOTRIMIN CLOTRIMAZOLE 1% CREAM LOTRISONE CLOTRIMAZOLE-BETAMETHASONE CREAM FLEXERIL CYCLOBENZAPRINE HCL 10MG TAB VOLTAREN DICLOFENAC SODIUM 50MG TAB VIBRAMYCIN DOXYCYCLINE HYCLATE 100MG CAP ROMYCIN ERYTHROMYCIN BASE 5MG/G EYE OINT LEXAPRO ESCITALOPRAM OXALATE 20MG TAB TRICOR FENOFIBRATE NANOCRYSTALLIZED 145MG TAB DIFLUCAN FLUCONAZOLE 150MG TAB 1.1.17 Hoosier School Benefit Trust Health and Wellness Center Prescription Medication Formulary Brand Name Generic Name Strength LIDEX FLUOCINONIDE CREAM PROZAC FLUOXETINE HCL 10MG CAP PROZAC FLUOXETINE HCL 20MG CAP FLONASE FLUTICASONE PROPIONATE 50MCG SPR NEURONTIN GABAPENTIN 300MG CAP GLUCOTROL GLIPIZIDE 10MG TAB HYDROCHLOROTHIAZIDE HYDROCHLOROTHIAZIDE 25MG TAB MOTRIN IBUPROFEN 600MG TAB NIZORAL KETOCONAZOLE 2% CREAM SYNTHROID LEVOTHYROXINE SODIUM 100MCG TAB SYNTHROID LEVOTHYROXINE SODIUM 112MCG TAB SYNTHROID LEVOTHYROXINE SODIUM 125MCG TAB SYNTHROID LEVOTHYROXINE SODIUM 200MCG TAB SYNTHROID LEVOTHYROXINE SODIUM 25MCG TAB SYNTHROID LEVOTHYROXINE SODIUM 50MCG TAB SYNTHROID LEVOTHYROXINE SODIUM 75MCG TAB SYNTHROID LEVOTHYROXINE SODIUM 88MCG TAB ZESTRIL LISINOPRIL 5MG TAB ZESTRIL LISINOPRIL 20MG TAB ZESTRIL LISINOPRIL 10MG TAB ZESTORETIC LISINOPRIL/HYDROCHLOROTHIAZIDE 10-12.5MG TAB ZESTORETIC LISINOPRIL/HYDROCHLOROTHIAZIDE 20-12.5MG TAB ZESTORETIC LISINOPRIL/HYDROCHLOROTHIAZIDE 20-25MG TAB COZAAR LOSARTAN POTASSIUM 25MG TAB MOBIC MELOXICAM 15MG TAB GLUCOPHAGE XR METFORMIN ER 500MG TAB GLUCOPHAGE METFORMIN HCL 1000MG TAB GLUCOPHAGE METFORMIN HCL 500MG TAB MEDROL METHYLPREDNISOLONE 4MG TAB TOPROL XL METOPROLOL SUCCINATE 50MG TAB TOPROL XL METOPROLOL SUCCINATE 100MG TAB TOPROL XL METOPROLOL SUCCINATE 25MG TAB FLAGYL METRONIDAZOLE 500MG TAB SINGULAIR MONTELUKAST SODIUM 10MG TAB BACTROBAN MUPIROCIN 2% OINT DEXASPORIN NEO/POLYMX B/DEXAMETH EYE DROPS MACROBID NITROFURANTOIN MONOHYD/M-CRYST 100MG CAP PRILOSEC OMEPRAZOLE 20MG CAP 1.1.17 Hoosier School Benefit Trust Health and Wellness Center Prescription Medication Formulary Brand Name Generic Name Strength ZOFRAN ONDANSETRON HCL 4MG TAB PROTONIX PANTOPRAZOLE SODIUM 40MG TAB PAXIL PAROXETINE HCL 20MG TAB AZO STANDARD PHENAZOPYRIDINE HCL 97.5MG TAB PREDNISONE PREDNISONE 10MG TAB PREDNISONE PREDNISONE 20MG TAB PREDNISONE DOSEPAK PREDNISONE DOSEPAK 10MG TAB PREDNISONE DOSEPAK PREDNISONE DOSEPAK 5MG TAB PHENERGAN PROMETHAZINE HCL 25MG TAB ZOLOFT SERTRALINE HCL 100MG TAB ZOLOFT SERTRALINE HCL 50MG TAB SILVADENE SILVER SULFADIAZINE CREAM ZOCOR SIMVASTATIN 10MG TAB ZOCOR SIMVASTATIN 20MG TAB ZOCOR SIMVASTATIN 40MG TAB BACTRIM DS SULFAMETHOXAZOLE/TRIMETHOPRIM 800-160MG TAB IMITREX SUMATRIPTAN SUCCINATE 100MG TAB IMITREX SUMATRIPTAN SUCCINATE 50MG TAB TOBREX TOBRAMYCIN 0.3 % EYE DROP TRIDERM TRIAMCINOLONE ACETONIDE 0.1% CREAM MAXZIDE-25 MG TRIAMTERENE/HYDROCHLOROTHIAZID 37.5-25MG TAB 1.1.17 .
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