Medication to be held 48 Banaflex /skeletal muscle relaxer Clozaril/antischizophenia HOURS BEFORE AND 24 HOURS Bancap/contains caffei Cogentin/antidyskinectic/ant AFTER MYELOGRAM Banzel/seizure adjunct iemetic/antipsychotic Updated December 2016 BC powder/ contains caffeine Compazine/phenothiazine Belviq/appetite suppressant Concerta/CNS stimulant Abilify / antipsychotic Bevespi contains formoterol Contrave/antidepressant Acetophenazine/ antipsychotic Benzphetamine/appetite Cyclizine/ antiemetic Adderall/amphetamine and suppressant antivertigo agent dextroamphetamine Bismuth subcitrate potassium/ Cyclobenzaprine/muscle Adipex-P/stimulant/ anorectic mineral relaxer Adsuva/antidepressant Bonine/meclicine Cylert/ADHD agent Adphen/ /antidepressant Bontril/appetite suppressant Cymbalta/antidepressant/tri appetite suppressant Bontril PDM/appetite suppressant cyclic Adipost/ appetite suppressants, Bortezomib/antineoplastics Sympathomimetic (Systemic Brintxelli / antidepressant Adrafinil/cognitive enhancer Bucladin-S softab/antiemetic Dapex/appetite suppressant Alatrofloxacin/ antibacterial antivertigo Dayquil/contains caffeine Aliskiren Bucet/contains caffeine Darvon 65/contain caffeine Hemifumarate/antihypertensive Buclizine/antiemetic/antivertigo Daytrana/CNS stimulant direct renal inhibitor / Budeption/antidepressant Desipramine/tricyclic/antide Alsuma/s Buphenamine/appetite suppressant pressant Amaphen/ barbituate Buproban/antidepressantr Desoxyn/amphetamine Amitriptyline/ tricyclic BupropionBuffets/caffeine Desvenlafaxine succinate/ antidepressant Butalbital with Caffeine/caffeine antidepressant Amoxapine/antidepressants, Butace/contains caffeine Desyrel/antidepressant/antin tricyclic euragic Amphetamine/ stimulant Dexedrin/appetite Amrix/ muscle relaxer Cafatine/contains caffeine suppressant Anafranil/ antidepressants, Cafcit /contains caffeine Dexedrine/appetite tricyclic Cafergot/Contains caffeine suppressant Anergan 50/ phenothiazine- Cafetrate/ caffeine Dexmethyl derivative Caffeine I.V. or Phenidate/ADHD Agent Anoquan/ analgesic/ barbituate Caffeine Tablets or medicines Dextroamphetamine/appet Anoxine AM/ phentermine containing caffeine ite suppressant Antiflex/muscle relaxer Carbex/antiparkinson adjunct Dextrostat/amphetermine Antivert/ antiemetic/ antivertigo Cariprazine/antipsychotic DHC plus/contains caffeine Antizol/ antifreeze antidote Carisoprodol/muscle relaxer Didrex/appetite suppressant Antrizine/ antihistamine Cefepime/cephlosporin Diethylpropion/appetite Aplenzinantidepressant Celexa/SSRI suppressant Apo-Amitriptyline/Amitriptyline Cerebyx/anticonvulsant Dihydrocodonecaffeine / tricyclic antidepressant Certolizumab/ antibody for Dital/ appetite suppressant Arcet/contains caffeine Crohn’s Dizac/benzodiazepine Aricept / dementia symptoms Chlordiazepoxide/Amitriptyline/ Dizmiss/antiemetic/antiverti treatment adjunct tricycle /antidepressant go agent Aripiprazole/ antipsychotic Chlorpromazine/phenothiazine Dolmar/contains caffeine Aristada/ antipsyschotic inj. Chlorprothixene/antipsychotic/t Donepezil/Alzheiner adjunct Armodafinil/cognitive enhancer hioxanthenes Dopram/CNS depressant Artane/antidyskinectic/ Chlorzoxazone/muscle relaxer Doribax/gram(-) antibiotic antiemetic/antipsychotic Cidofovir/antiviral Doripenem/antibiotic Asenapine/ antipsychotic Cimzia/antibody for crohn’s Dothiepin/antidepressant Asendin/ tricyclic antidepressants Citalopram/antidepressant/tricyclic Doxapram/CNS depressant Atomoxetine/ selective Clomipramine/tricyclic/antidepress Doxepin/tricyclic/ Atarax phenothiazine ant antidepressant norepinephrine reuptake inhibitor Clorazepate/CNS depressant Dramamine/antiemetic/ Aventyl /tricyclic antidepressant Clorazpine/antipsychotic antivertigo Clozapine/antipschotic Droperidol/antinausea
Page 1 of 4 PE14008 Addendum Droperidol with Fentanyl Furazolidoneantibacterial/ Meni- /antinausea antiprotozoan D/antiemetic/antivertigo Duloxetine/antidepressant Furoxone(same as furazolidone) Mepergan/contains Dyrexan/appetite suppressant Gelprin/contains caffeine phenothiazine Gen-Xene/antianxiety Mircera/protein for anemia Geodon/antipsychotic Meridia/appetite suppressant Effexor/antidepressant/anti Goody powder/ contains caffeine Meropenem/antibacterial anxiety agent Guanfacine/ADHD adjunct Merrem/antibacterial Elavil/tricyclic/ antidepressant Haldol/antidyskinectic/ Mesoridazine/ahenothiazine Endep/tricyclic/antidepressant antiemetic/antipsychotic Metadate CD/CNS stimulant Eldepryl/antiparkansonian adjunct Haloperidol(same as Haldol) Metaxalone/muscle relaxer Endolor/contains caffeine Hydroxyzine phenothiazine Methamphetamine/amphert /contains caffeine Iloperidone /antipsychotic amine Entacapone/antiparkansonian Imipramine/tricyclix/antidepressant Methotrimeprazine/antipsy adjunct Inapsine/antinauseous chotic Ercaf/contains caffeine Innovarantiemetic Methoxy Polyethy glycol- Escitalopramantidepressant Intuniv/ADHD adjunct epooetin beta Esgic/contains caffeine Invega/antipsycotic Methylin/CNS stimlant EsgicPlus/contains caffeine Ionamin/phenertermine MethylphenidateCNS Ethopropazineantidyskinectic Iproniazid/MAO antidepressant stimulant /antiparkinson adjunct Isocarboxazid/MAO antidepressant Methylphenidate extended Etrafon/tricyclic antidepressant Kapvay/ADHD adjunct releaseCNS Stimulant Etrafon 25/50/ tricyclic/ Lacosamide/seizure Milnacipran/Antidepressant antidepressant adjunct/anticonvulsant MioRel/muscle relaxer Etrafon A/tricyclic/antidepressant Largactil/phenothiazine Mirtazapine/antidepressant Extrafon Forte/ tricyclic/ Largon/antidepressant Moban/antischzophrenia antidepressant Latuda/antipsydhotic agent Excedrin/contains caffeine Levomilnnacipran antidepressant Modafinil/cognitive enhancer Exelon/dementia adjunct Levoprome/antipsychotic Modecate/phenothiazine Ezol/contains caffeine Levothyroxine Sodium Moditen/phenothiazine Fanapt/antipsychotic\ Levoxyl Molindone/antischzophrenia Fanapta/antipsychotic Lexapro/antidepressant agent Fastin/phenothiazine Levate/antidepressant Mus-Lax/muscle relaxer Femcet/contains caffeine Limbitrol/antianxiety/antipsychotic Myolin/muscle relaxer Fentanyl/ Droperidol Liquadd/CNS stimulant Myotrol/muscle relaxer Combination/ antiemetic Lisdexamfetamine Dimesylate/ Ferndex/amphetamine Amphetamine Fetzima antidepressant Lorzone muscle relaxer Namenda Fioricet/contains caffeine Loxapine/antipsychotic Nardil/ antidpressant Florinal/contains caffeine Loxipac/antidepressant Navane/thiothixene Flexeril/muscle relaxer Loxitane antianxiety/antidepressant schizophrenia agent Flexoject/muscle relaxer Ludiomil/antidepressant Nefazodone/antidepressant Fluoxetine/tricyclic antidepressant Lurasidone/antipsychotic Nilotinib Hydrochloride Flupenthixol/thioxanthene Luvox/SSRI Monohydrate/ Fluphenazineantipsychotic/ Maprotiline/tricyclic/antidepressant chemotherapy antischizophrenia Marezine/antiemetic/antivertigo No Doz/contains caffeine adjunct/phenothiazine Marplan/ADHDadjunct Norflexmuscle relaxer Fluvoxamine/antidepressant Maxipime/cephalosporin Norfraniltricyclic/antidepress Focalin/CNS depressant Mazanor/appetite suppressant ant (FocalinXR) Mazindol/appetite suppressant Norgesic / muscle relaxer Fomepizole/antifreeze poisoning Meclizine/antiemetic/antivertigo Norgesic Forte/analgesic antidote Medigesic/contains caffeine /muscle relaxer Forfivo XL/antidepressant Melfiat/appetite suppressant Norpramintricyclic/antidepre Formoterol Mellaril/tricyclic/antidepressant ssant Fumaarate/Inhalant Menantine/anti alzheimers Nortriptylinetricyclic t agent/dementia adjunct /antidepressant
Page 2 of 4 PE14008 Addendum Novoperidol/antidepressant Pimozide/appetite suppressant Sedapac/contains caffeine Nuvigil/ cognitive enhancer Plegine/appetite suppressan Selegiline/antidyskinectic Nyquil Prelu-2appetite Suppressant Serentil/phenothiazine Pristiq/antidepressant Serqouel/antipsychotic Procentra/CNS stimlant Sertraline/antidepressant Obe-Nix 30 Obenix/appetite Prochlorperazine/phenothiazine Serzone/antidepressant suppressant Profluphenazine/antidepressant Shogan/phenothiazine Obephen/phenermine Prolixin/phenothiazine Sibutramine/appetite Obermine/phenermine Promazine/phenothiazine suppressant Obestin/phenermine Promethazinephenothiazine Silenor/(doxepin)tricyclic Olanzapine antischizophrenia Promethazine and Sinequan/tricyclic agent Combinationssame as above antidepressant Oleptro/antidepressant Propiomazinetricyclic Amitriptyline/antipsycholic Ondansetronantinauseous antidepressant SK-Pramine/appetite Onzetra Xsail/ sumatriptan nasal Propoxyphene Cpd-65 Caffeine suppressant powder Prothiadentricyclic antidepressant Skelaxin/muscle relaxer Orap/ /antipsychotic Protriptyline/tricyclic Soma/muscle relaxer Orflo/muscle relaxer antidepressant Soneta Ormazine/phenothiazine Provigil/cognitive enhancer Spancap/appetite Orphenadrine/muscle relaxer Prozac/antipsychoticantiobsessive suppressant Orphenate/muscle relaxer Prozine-50/neuroleptic Sparfloxacin/antibacterial Oxilapine/antidepressant Pylera/ antibody for crohn’s Sparine/antipsychotic Oxydess II/appetite suppressant Stelazine/phenothiazine Strattera/ADHD adjunct Quetiapine/antipsychotic Sumavel/SSRI Paliperidone/antipsychotic QuillivantantXR/ADHD adjunct Sunitdinib malate Pamelor/tricyclic/ antidepressant Qsymia/Phentermine HCL Supac/contains caffeine Paraflex Suprenza/appetite skeletal muscle relaxer suppressant Parafon Forte/skeletal muscle Racemic amphetamine Surmontil/tricyclic relaxer sulfateamphetermine antidepressant Parmine/appetite suppressant Rapiflux tricyclic antidepressant Sutent Parnate/antidepressant Recharge/contains caffeine SynalgosDC/contains Paroxetine/ Antipanic/ Remeron/antidepressant caffeine Antianxiety./antiobsession agent Remular/skeletal muscle relaxer Symbicort(formoterol) inh Parsido/lAntidyskentixs Repan/contains caffeine Symbyax/Fluoxetine Paxil/Antidepressant Rexaphen/appetite suppressant Synthroid Pegasys/protein for hepatitis C Rexigen/appetite suppressant Pegintron/Rebetol combo Rexulti(brexpiprazole)Antipsychotic pack/protein Ribavirin Taractan/Thiothixene Peginterferon Alfa-2b/protein Risperdal/antipsychotic antipsychotic Pemoline/CNS Stimulant Risperidone/antipsycotic Tasigna/ chemotherapy Perforomist/ inhalant Ritalin/CNS stimulant Tekturna/ Peridol/antidepressant Ritalin XR/CNSStimulant Antihypertensive/direct renal Permitil/Phenothiazine Rivastigmine tartrate/dementia inhibitor Perphenazine/antipsychotic adjunct Tencet/caffeine Pevexa(Paroxetine) Rufinamide/ anticonvulsant Tencon/caffeine Phenazinephenothiazine Ru-Vert-M/.antiemetic/ antivertigo Tenex/ADHD adjunct Phencen/phenothiazine Tenuate/appetite Phendimetrazine/appetite suppressant suppressant Sumatriptan/SSRI Tenuate Dospan/appetite Phenelzine/MAO depressant Sancuso/antiemetic suppressant Phenerganphenothiazine Sanorex/appetite suppressant Thiethylperazine/phenothia Phentermine/appetite Saphris/antipsychotic zine suppressant Sarafem/antidepressant/antibulemic Thioridazine/phenothiazine Phentrol/phenothiazine Savella/Antipsychotic Thiothixene/antipsychotic
Page 3 of 4 PE14008 Addendum Thorazine/phenothiazine Zaleplon/sedative/ hypnotic Tindal/antipsychotic Zanaflex/antispasmotic Tirosint/ levothyroxine Zenzedi/CNS stimulant Tizanidine/CNS muscle relaxer Ziprasidone/antipsychotic Tofranil/tricyclic antidepressant Zofran/antiemetic Torecan/antiemetic Zoloft//antidepressant Tramadol/analgesic opioid Zomaril/antipsychotic Tranxene/antianxiety Zonalon/antipruritic Tranyclcypromine/ Zonagran antidepressantMAO Zonisamide Trazodone/antidepressant/ Zyban/antidepressant antineuralgia Zyprexa/antipsychotic Triad/contains caffeine Triapin/contains caffeine Other: Triavil/antipsychotic Trifluoperazine/phenothiazine Triflupromazine/phenothiazine Trilafon/phenothiazine Trimipramine/phenothiazine Trovan/antibacterial Trovan IV/antibacterial Trovofloxacin/antibacterial Two-Dyne/contains caffeine
Ultiva/opiod Ultram/analgesic Ultracet/analgesic
Vanquish/contains caffeine V-gan/ phenothiazine Velcade/antineoplastic Venlafaxine/antidepressant Verapamil-IV Only Vesacloz/antipsychotic Vesprin/phenothiazine Viibryd/Antidepressant Vilazodoneserotonergic antidepressant Vimpat/ antiepileptic Vistaril/phenothiazine Vistide/antiviral Vivactil/tricyclic depressant Vivarin/contains caffeine Vortioxetine /antidepressant Vraylar/antipsychotic Vyvanse/ amphetamine
Wellbutrin/antidepressant Wigraine/contains caffeine
Page 4 of 4 PE14008 Addendum