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VCMC-SPH Drug Formulary

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VCMC-SPH Drug Formulary Ventura County Medical Center-Santa Paula Hospital Drug Formulary Generic Brand Route Form Dose Special Notes Added to Formulary Abacavir Ziagen oral tab 300 mg BBW Abatacept Orencia IV soln 250 mg in NS 500mL Children's Tylenol oral liq 80 mg/0.8 mL Infants Tylenol Concentrated Drops oral liq 80 mg/0.8 mL oral liq 80 mg/0.8 mL, 160 mg/5 mL, 650 Acetaminophen mg/25 mL Tylenol rectal supp 120 mg, 325 mg, 650 mg oral tab 325 mg oral tab 325 mg-10 mg, 325 mg-5 mg, 300 mg- 7/1/2013 Vicodin 5 mg Acetaminophen-HYDROcodone oral tab 325 mg-10 mg, 325 mg-5 mg, 300 mg- Norco 10 mg Acetaminophen-oxyCODONE Percocet 5/325 oral tab 325 mg-5 mg inj powder 500 mg Diamox acetaZOLAMIDE oral tab 250 mg Diamox Sequels oral cap-XR 500 mg Acetic acid topical acetic acid irrigation irrigation soln 0.25% Acetylchloine opth Miochol intraocular powder 1% Acetadote IV soln 20% Acetylcysteine Mucomyst-10 inhalation soln 10% Mucomyst-20 inhalation soln 20% IV powder 500 mg Acyclovir Zovirax oral susp 200 mg/5 mL Adenosine Adenocard, Adenoscan IV soln 3 mg/mL Ado-trastuzumab emtansine Kadcyla® IV soln 100 mg, 160 mg 8/29/2013 Aerochamber N/A inhalation device n/a Aerochamber w/mask Large N/A inhalation device n/a Aerochamber w/mask small N/A inhalation device n/a Aluminum hydroxide/Magnesium oral susp 200 mg-200 mg-20 mg/5 mL Maalox Antacid Antigas Regular Strength hydroxide/simethicone Albendazole Albenza oral tab 200 mg Albumin human Albumar-5 IV soln 5%, 25% Albuterol Proventil oral syrup 2 mg/5 mL inhalation aerosol with adapter CFC free 90 mcg/inh Proventil HFA Albuterol inhalation soln 0.5%, 1.25mg/3 mL (0.042%), 2.5 N/A mg/3 mL (0.083%) Aldesleukin Proleukin IV powder 22000000 intl units BBW Alemtuxumab Campath 5/24/2012 IV powder 500 mg Allopurinol Zyloprim oral tab 100 mg, 300 mg ALPRAZolam Xanax oral tab 0.25 mg, 0.5 mg BBW Alprostadil Prostin VR inj soln 0.5 mg/mL Aluminum chloride hexahydrate topical Drysol top soln 20% Aluminum hydroxide Alternagel oral susp 320 mg/5 mL Aluminum sulfate-calcium acetate topical Domeboro top powder - Amantadine Symmetrel oral cap 100 mg aMILoride Midamor oral tab 5 mg BBW Aminocaproic acid Amicar IV soln 250 mg/mL Aminophylline Phyllocontin IV soln 25 mg/mL Cordarone oral tab 200 mg BBW Amiodarone Cordarone IV IV soln 50 mg/mL Amitriptyline Elavil oral tab 10 mg, 25 mg, 50 mg, 75 mg BBW AmLODIPine Norvasc oral tab 5 mg, 10 mg Ventura County Medical Center-Santa Paula Hospital Drug Formulary Generic Brand Route Form Dose Special Notes Added to Formulary Ammonia inhalant N/A inhalation amp - oral cap 250 mg, 500 mg Amoxicillin Amoxil oral powder 125 mg/5 mL, 250 mg/5 mL oral powder 200 mg-28.5 mg/5 mL, 400 mg-57 mg/5 mL Amoxicillin-clavulanate Augmentin oral tab 250 mg-125 mg, 875 mg-125 mg, 10/4/2017 1000 mg-62.5 mg Amphetamine-dextroamphetamine Adderall oral tab 5 mg Ampicillin inj powder 1 g, 2 g, 125 mg, 250 mg, 500 mg Ampicillin Principen oral cap 1 g, 2 g, 125 mg, 250 mg, 500 mg Ampicillin-sulbactam Unasyn inj powder 1 g-0.5 g, 2 g-1 g Amyl nitrite/Na nitrite/Na thiosulfate Cyanide Antidote Kit inj kit 0.3 mL-30 mg-25 mg Anagrelide Agrylin oral cap 0.5 mg Anastrazole Arimidex oral tab 1 mg Antazoline-naphazoline ophth Naphcon-A opthalmic soln 0.5%-0.05% IV powder recombinant albumin-free Antihemophilic factor Advate rAHF-PFM IV powder recombinant Antihemophilic factor-von Willebrand Factor Humate-P, Wilate IV powder 1 IU - 1 IU Antipyrine-benzocaine otic Aurodex otic soln 54 mg-14 mg/mL Antivenin (crotalidae) polyvalent Crotalidae inj soln APAP/dichloralphenazone/isometheptene Midrin oral cap 325 mg-100 mg-65 mg Apixaban Eliquis oral tab 2.5 mg, 5 mg BBW Argatroban argatroban IV soln 100 mg/mL ARIPiprazole Abilify oral tab 5 mg, 10 mg, 15 mg, 30 mg BBW ARIPiprazole for extended release inj Abilify Maintena IM susp 300 mg, 400 mg BBW Arsenic trioxide Trisenox IV soln 1 mg/mL inj soln 500 mg/mL Ascorbic acid Vitamin C oral tab 500 mg rectal supp 300 mg Aspirin oral tab-chew 81 mg, 325 mg oral tab-EC 81 mg, 325 mg Aspirin-dipyridamole Aggrenox oral cap-XR 25 mg-200 mg Atazanavir Reyataz oral cap 200 mg, 300 mg Atenolol Tenormin oral tab 25 mg, 50 mg, 100 mg BBW Atomoxetine Strattera oral tab 10 mg, 25 mg, 40 mg BBW 6/23/2015 Atorvastatin Lipitor oral tab 10 mg, 20 mg, 40 mg, 80 mg Atovaquone Mepron oral susp 750 mg/5 mL Atropine Atropine inj soln 0.1 mg/mL, 0.4 mg/mL, 1 mg/mL Atropine opth Atropine opthalmic oint 1% oral liq 0.025 mg-2.5 mg/5 mL Atropine-diphenoxylate Lomotil oral tab 0.025 mg-2.5 mg Azacitidine Vidaza subQ Azathioprine Imuran oral tab 50 mg BBW IV powder 500 mg Azithromycin Zithromax oral powder 200 mg/5 mL oral tab 250 mg Bacitracin BacIM IM powder 50000 units BBW Bacitracin opthalmic Ak-Tracin opthalmic oint 500 units/g Bacitracin topical Baciguent top oint 500 units/g Bacitracin/HC/neomycin/polymyxin B opth Cortisporin Opthalmic opthalmic oint 400 units-10 mg-3.5 mg-10000 units/g Bacitracin/neomycin/polymyxin B opth Cortisporin Opthalmic Suspension opthalmic oint 400 units-3.5 mg-10000 units/g Bacitracin-polymyxin B opth Polysporin Ophthalmic opthalmic oint 500 units-10000 units/g Bacitracin-polymyxin B topical Polysporin top oint 500 units-10000 units/g Ventura County Medical Center-Santa Paula Hospital Drug Formulary Generic Brand Route Form Dose Special Notes Added to Formulary Baclofen Lioresal oral tab 10 mg BBW Belimumab Benlysta Rx: Add TB Screen to Order - Belladonna-opium Belladonna-opium rectal supp 16.2 mg-60 mg Benazepril Lotensin oral tab 5 mg, 10 mg, 20 mg BBW Benzocaine topical Dermoplast top spray - mucous aerosol 14%-2%-2% Benzocaine/butamben/tetracaine topical Cetacain membrane Benzoin topical Tincture of benzoin top tincture - Benzonatate Tessalon Perles oral capsules 100 mg 6/1/2016 Benzoyl peroxide topical various top gel 5% inj soln 1 mg/mL Benztropine Cogentin oral tab 0.5 mg, 1 mg, 2 mg Beractant Survanta Intrathecal intrathecal susp 25 mg/mL Betamethasone Celestone Soluspan inj susp 6 mg/mL top oint, cream dipropionate 0.05%, dipropionate, Betamethasone topical Diprolene augmented 0.05% Betaxolol Betoptic S opthalmic susp 0.25% subQ soln 5 mg/mL Bethanechol Urecholine oral tab 25 mg Bevacizumab Avastin IV soln 25 mg/mL Bicalutamide Casodex oral tab 50 mg rectal supp 10 mg Bisacodyl Dulcolax oral tab-EC 5 mg oral susp 262 mg/5 mL Bismuth subsalicylate Pepto Bismol oral tab-chew 262 mg Black widow spider Antivenin inj powder 6000 units Bleomycin Blenoxane inj powder 15 units BBW Botulinum toxin type A Botox inj powder 100 units Brentuximab vedotin Adcetris Rx: Add TB Screen to Order 9/22/2011 Brimonidine opth Alphagan P opthalmic soln 0.15% Bromocriptine Parlodel oral tab 2.5 mg Entocort EC oral cap-XR 3 mg Budesonide Pulmicort inhalation susp 0.5 mg/2 mL Pulmicort Respules inhalation susp 0.5 mg/2 mL 160 mcg-4.5 mcg/actuation, 80 mcg- 2/26/2009 Budesonide/Formoterol Symbicort inhalation liq 4.5 mcg/actuation inj soln 0.25 mg/mL BBW Bumetanide Bumex oral tab 1 mg BBW Bupivacaine Sensorcaine inj soln 0.25%, 0.5% 0.25%-1:200,000, 0.5%-1:200,000, Bupivacaine-EPINEPHrine Sensorcaine with Epinephrine inj soln 0.75%-1:200,000 Bupivacaine-fentaNYL N/A inj soln 0.1%-2mcg/mL Buprenorphine Subutex oral film 2 mg BBW 10/4/2017 Buprenorphine-Naloxone Suboxone oral tab 2 mg-0.5 mg 1/9/2019 Wellbutrin oral tab 75 mg, 100 mg BBW BuPROPion oral tab-XR 100 mg/12 hours, 150 mg/12 hours BBW Wellbutrin XL BusPIRone BuSpar oral tab 5 mg Busulfan Myleran oral tab 2 mg Butorphanol Stadol inj soln 1 mg/mL, 2 mg/mL BBW oral liq citrate 20 mg/mL Caffeine Cafcit IV soln citrate 20 mg/mL Calamine topical Calamine top lotion - oral cap 0.25 mcg Calcitriol Rocaltrol Ventura County Medical Center-Santa Paula Hospital Drug Formulary Generic Brand Route Form Dose Special Notes Added to Formulary Calcitriol Rocaltrol oral liq 1 mcg/mL Calcium acetate PhosLo oral tab 667 mg Tums oral tab-chew 500 mg Calcium carbonate oral susp 1250 mg/5 mL 9/12/2018 Calcium chloride various inj soln 100 mg/mL Calcium glubionate Calcium glubionate oral syrup 1.8 g/5 mL Calcium gluconate Calcium gluconate inj soln 100 mg/mL Calcium-vitamin D Oscal-D oral tab 500 mg-200 intl units Candida albicans extract Candida Skin Test intradermal soln Capecitabine Xeloda oral tab 500 mg BBW Capreomycin Capastate Sulfate IM powder 1 g Capsaicin topical Capzasin top cream 0.025%, 0.75% Captopril Capoten oral tab 12.5 mg, 25 mg BBW Carbachol opth Isopto Carbachol opthalmic soln 3.00% oral susp 100 mg/5 mL BBW CarBAMazepine Tegretol oral tab 200 mg BBW oral tab-chew 100 mg BBW Carbamide peroxide otic Carbamoxide otic soln 6.50% oral tab 10 mg-100 mg, 25 mg-100 mg, 25 mg- Carbidopa-levodopa Sinemet 250 mg CARBOplatin Paraplatin IV powder 50 mg BBW Carboprost Hemabate inj soln 250 mcg/mL BBW Carfilzomib Kyprolis inj powder 30 mg, 60 mg Carmustine BiCNU IV powder 100 mg Carvedilol Coreg oral tab 3.125 mg, 6.25 mg, 12.5 mg, 25 mg Carvedilol Phosphate Coreg CR oral 7/26/2007 inj powder 1 g, 500 mg CeFAZolin Ancef IV soln 1 g/50 mL Cefepime Maxipime inj powder 1 g, 2 g inj powder 1 g, 2 g CefOXitin Mefoxin IV soln 1 g/50 mL, 2 g/50 mL Cefpodoxime proxetil Vantin oral tab 200 mg 1/9/2019 CefTAZidime Fortaz, Tazicef inj powder 1 g, 2 g CefTRIAXone Rocephin inj powder 1 g, 2 g, 250 mg, 500 mg Ceftin inj powder 1.5 g, 750 mg Ceftin oral powder 250 mg/5 mL Cefuroxime Ceftin, Zinacef oral tab 250 mg Kefurox inj powder 1.5 g Celecoxib CeleBREX oral cap 100 mg BBW oral cap 250 mg, 500 mg Cephalexin Keflex oral powder 125 mg/5 mL, 250 mg/5 mL Aquachloral Supprettes rectal supp 325 mg Chloral hydrate Somnote oral syrup 500 mg/5 mL Chlorambucil
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