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Outpatient Pharmacy $11 medication list

Drug Name Quantity Drug Name Quantity

Antibiotic Fungal Infections Amoxicillin 125mg/5ml suspension ...... 100 ml Nystatin/Triamcinolone cream...... 15 gm Amoxicillin 125mg/5ml suspension ...... 150 ml Nystatin/Triamcinolone cream...... 30 gm Amoxicillin 250mg/5ml suspension ...... 100 ml Nystatin/Triamcinolone ointment ...... 15 gm Amoxicillin 250mg/5ml suspension ...... 150 ml Nystatin/Triamcinolone ointment ...... 30 gm Amoxicillin 400mg/5ml suspension ...... 50 ml Nystatin cream ...... 15 gm Amoxicillin 400mg/5ml suspension ...... 100 ml Nystatin cream ...... 30 gm Amoxicillin 250mg capsules ...... 30 Nystatin ointment ...... 15 gm Amoxicillin 500mg capsules ...... 30 Nystatin ointment ...... 30 gm Amoxil 50mg/ml drops ...... 30 ml Cephalexin 250mg capsules...... 28 Gastrointestinal Cephalexin 500mg capsules...... 30 Metoclopramide 10mg tablets ...... 60 Ciprofloxacin 250mg tablets...... 28 Metoclopramide 5mg/5ml syrup ...... 60 ml Ciprofloxacin 500mg tablets...... 28 5mg tablets ...... 60 Clindamycin HCl 150mg capsules ...... 56 Prochlorperazine 10mg tablets ...... 30 Clindamycin HCl 300mg capsules ...... 56 Ranitidine 150mg tablets ...... 60 Doxycycline 50mg capsules ...... 30 Ranitidine 300mg tablets ...... 30 Doxycycline 100mg capsules ...... 20 Metronidazole 250mg tablets...... 28 Glaucoma/Eye Care Metronidazole 500mg tablets...... 28 Bacitracin ophthalmic ointment...... 4 gm SMZ-TMP 400mg-80mg tablets...... 28 ophthalmic solution 0 25%...... 15 ml SMZ-TMP DS 800mg-160mg tablets ...... 20 Levobunolol ophthalmic solution 0 .5% ...... 15 ml SMZ-TMP 200mg-40mg/5ml suspension ...... 120 ml ophthalmic solution 0 .25% ...... 15 ml Timolol ophthalmic solution 0 .5% ...... 15 ml Arthritis/Pain Tobramycin ophthalmic solution 0 .3% ...... 5 ml Allopurinol 100mg tablets ...... 30 Allopurinol 300mg tablets ...... 30 Heart/BP Health Indomethacin 25mg capsules ...... 60 25mg tablets ...... 30 Atenolol 50mg tablets ...... 30 Asthma Atenolol 100mg tablets ...... 30 Albuterol 2mg tablets ...... 90 3 .125mg tablets ...... 60 Albuterol 4mg tablets ...... 60 Carvedilol 6 .25mg tablets ...... 60 Albuterol 2mg/5ml syrup ...... 120 ml Carvedilol 12 .5mg tablets ...... 60 Albuterol 0 .5% neb solution ...... 20 ml Carvedilol 25mg tablets ...... 60 Albuterol 0 .083% neb solution...... 75 ml Digoxin 125mcg tablets...... 30 Digoxin 250mcg tablets ...... 30 Cholesterol Diltiazem 30mg tablets ...... 120 Simvastatin 10mg tablets ...... 30 Diltiazem 60mg tablets ...... 90 Simvastatin 20mg tablets ...... 30 Diltiazem 90mg tablets ...... 60 Simvastatin 40mg tablets ...... 30 Furosemide 20mg tablets ...... 30 Simvastatin 80mg tablets ...... 30 Furosemide 40mg tablets ...... 30 Furosemide 80mg tablets ...... 30 Cold/Flu/Allergy Hydrochlorothiazide 12 .5mg tablets ...... 30 Benzonatate 100mg capsules ...... 14 Hydrochlorothiazide 25mg tablets ...... 30 DM syrup ...... 120 ml Hydrochlorothiazide 50mg tablets ...... 30 Isosorbide dinitrate 5mg tablets ...... 90 Diabetes Isosorbide dinitrate 10mg tablets ...... 90 Glyburide 2 .5mg tablets ...... 30 Isosorbide dinitrate 20mg tablets ...... 90 Glyburide 5mg tablets ...... 30 Isosorbide mononitrate ER 30mg tablets ...... 30 Metformin 500mg tablets ...... 60 Isosorbide mononitrate ER 60mg tablets ...... 30 Metformin 850mg tablets ...... 60 Isosorbide mononitrate ER 120mg tablets ...... 30 Metformin 1000mg tablets ...... 60 Lisinopril 2 .5mg tablets ...... 30 Metformin ER 500mg tablets ...... 60 Lisinopril 5mg tablets ...... 30 Lisinopril 10mg tablets ...... 30

continued on next page Outpatient Pharmacy $11 medication list

Drug Name Quantity Drug Name Quantity

Heart/BP Health (continued) Skin Conditions Lisinopril 20mg tablets ...... 30 Silver Sulfadiazine 1% cream ...... 50 gm tartrate 25mg tablets ...... 60 Triamcinolone 0 .025% cream ...... 15 gm Metoprolol tartrate 50mg tablets ...... 60 Triamcinolone 0 .025% cream ...... 80 gm Metoprolol tartrate 100mg tablets ...... 60 Triamcinolone 0 .1% cream ...... 15 gm Nitroquick sublingual 0 .4mg tablets ...... 100 Triamcinolone 0 .1% cream ...... 80 gm Spironolactone 25mg tablets ...... 30 Triamcinolone 0 .1% ointment ...... 15 gm Terazosin 1mg capsules ...... 30 Triamcinolone 0 .1% ointment ...... 80 gm Terazosin 2mg capsules ...... 30 Triamcinolone 0 .5% cream ...... 15 gm Terazosin 5mg capsules ...... 30 Terazosin 10mg capsules ...... 30 Thyroid Condition Warfarin 1mg tablets ...... 30 Levothyroxine 25mcg tablets ...... 30 Warfarin 2mg tablets ...... 30 Levothyroxine 50mcg tablets ...... 30 Warfarin 2 .5mg tablets ...... 30 Levothyroxine 75mcg tablets ...... 30 Warfarin 3mg tablets ...... 30 Levothyroxine 88mcg tablets ...... 30 Warfarin 4mg tablets ...... 30 Levothyroxine 100mcg tablets ...... 30 Warfarin 5mg tablets ...... 30 Levothyroxine 112mcg tablets ...... 30 Warfarin 6mg tablets...... 30 Levothyroxine 125mcg tablets ...... 30 Warfarin 7 .5mg tablets ...... 30 Levothyroxine 137mcg tablets ...... 30 Warfarin 10mg tablets ...... 30 Levothyroxine 150mcg tablets ...... 30 Levothyroxine 175mcg tablets ...... 30 Mental Health Levothyroxine 200mcg tablets ...... 30 10mg tablets ...... 30 Amitriptyline 25mg tablets ...... 30 Viruses Amitriptyline 50mg tablets ...... 30 Acyclovir 200mg capsules...... 30 Amitriptyline 75mg tablets ...... 30 Amitriptyline 100mg tablets ...... 30 Vitamins/Nutritional Amitriptyline 150mg tablets ...... 30 Potassium Chloride Extended Release 10meq tablets ...... 30 Carbamazepine 200mg tablets...... 60 Multi-Vitamin with Fluoride 0 .25mg chewable tablets ...... 30 Citalopram 20mg tablets ...... 30 Multi-Vitamin with Fluoride 0 .5mg chewable tablets ...... 30 Fluoxetine 10mg capsules...... 30 Multi-Vitamin with Fluoride 1mg chewable tablets ...... 30 Fluoxetine 20mg capsules...... 30 Natalcare Plus tablets ...... 30 Fluoxetine 40mg capsules...... 30 0 .5mg tablets ...... 30 Women’s Health Haloperidol 1mg tablets ...... 30 Alendronate 35mg tablets ...... 4 Haloperidol 2mg tablets ...... 30 Alendronate 70mg tablets ...... 4 Haloperidol 5mg tablets ...... 30 Estradiol 0 .5mg tablets ...... 30 Lithium carbonate 300mg capsules ...... 90 Estradiol 1mg tablets ...... 30 Paroxetine 20mg tablets ...... 30 Estradiol 2mg tablets ...... 30 Sertraline 25mg tablets ...... 60 Estropipate 0 .75mg tablets ...... 30 Thiothixene 2mg tablets...... 30 Estropipate 1 .5mg tablets ...... 30 50mg tablets ...... 30 Medroxyprogesterone 2 .5mg tablets ...... 30 Trazodone 100mg tablets ...... 30 Medroxyprogesterone 5mg tablets ...... 30 Trazodone 150mg tablets ...... 30 Medroxyprogesterone 10mg tablets ...... 10 5mg tablets ...... 30 Tamoxifen citrate 10mg tablets ...... 60 Tamoxifen citrate 20mg tablets ...... 30 Misc . Conditions Acetazolamide 250mg tablets ...... 60 To be eligible for the Generic Drug Program, you must not have any prescription Dexamethasone 4mg tablets ...... 40 drug insurance or benefits through: private insurance, employer-sponsored Methazolamide 50mg tablets ...... 60 insurance, HMOs, Medicaid, Medicare prescription coverage (Part B and Part Methylprednisolone 4mg Dosepak tablets ...... 21 D), State Pharmacy Assistance Programs (SPAP, SCHIP, PACE, etc .) or veterans assistance . You also must reside in the United States and have a treating physician Prednisone 2 .5mg tablets ...... 30 licensed in the United States . The program is offered to all patients regardless of age Prednisone 5mg tablets ...... 30 or income . Discounts offered through the Generic Drug Program are not insurance Prednisone 10mg tablets ...... 30 and are not intended to substitute for insurance . Prednisone 20mg tablets ...... 30 This prescription medication list is subject to change without notice . Prednisolone Sodium Phosphate 15mg/5ml solution ...... 120 ml 10-2010 [14]