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Alphabetical Listing by Therapeutic Category Dod UNIFORM DoD UNIFORM OUTPATIENTFORMULARY Alphabetical Listing by Therapeutic Category This document is current as of July 14, 2021 The availability of formulary items is subject to change. 1 ABORTIFACIENT Abortifacient Dextromethorphan and Chlorpheniramine .............................................35 Carboprost Tromethamine ..................................................................... 23 Hydrocodone and Chlorpheniramine ..................................................... 60 Dinoprostone .......................................................................................... 37 Ibuprofen, Phenylephrine, and Chlorpheniramine ................................. 62 MiFEPRIStone ........................................................................................81 Ibuprofen, Pseudoephedrine, and Chlorpheniramine ............................ 62 Naphazoline and Pheniramine ...............................................................83 Acetylcholinesterase Inhibitor Triprolidine ............................................................................................ 116 Echothiophate Iodide ............................................................................. 40 Triprolidine and Pseudoephedrine ....................................................... 117 Edrophonium .......................................................................................... 40 Edrophonium and Atropine .................................................................... 41 Allergen-Specific Immunotherapy Neostigmine ............................................................................................84 Grass Pollen Allergen Extract (5 Grass Extract) ................................... 56 Physostigmine ........................................................................................ 93 Grass Pollen Allergen Extract (Timothy Grass) .....................................56 Pyridostigmine ......................................................................................100 Ragweed Pollen Allergen Extract ........................................................ 100 Acetylcholinesterase Inhibitor (Central) Alpha1 Agonist Donepezil ................................................................................................39 Midodrine ................................................................................................81 Galantamine ........................................................................................... 54 Naphazoline and Pheniramine ...............................................................83 Rivastigmine .........................................................................................103 Naphazoline (Ophthalmic) ......................................................................83 Acne Products Alpha1 Blocker Adapalene ................................................................................................ 5 Alfuzosin ...................................................................................................6 Benzoyl Peroxide ................................................................................... 15 Doxazosin ...............................................................................................39 Benzoyl Peroxide and Hydrocortisone ...................................................16 Phenoxybenzamine ................................................................................93 Clindamycin and Benzoyl Peroxide ....................................................... 28 Phentolamine ..........................................................................................93 Erythromycin and Benzoyl Peroxide ......................................................43 Prazosin ..................................................................................................97 Erythromycin (Topical) ............................................................................44 Tamsulosin ............................................................................................110 ISOtretinoin (Systemic) .......................................................................... 67 Terazosin .............................................................................................. 112 Salicylic Acid ........................................................................................ 103 Sulfacetamide (Topical) ........................................................................109 Alpha2-Adrenergic Agonist Sulfur and Sulfacetamide .....................................................................109 CloNIDine ............................................................................................... 29 Tazarotene ............................................................................................110 Clonidine and Chlorthalidone .................................................................29 Tretinoin (Topical) ................................................................................. 115 DexmedeTOMIDine ................................................................................34 GuanFACINE ..........................................................................................58 Activated Prothrombin Complex Concentrate (aPCC) Methyldopa .............................................................................................79 Anti-inhibitor Coagulant Complex (Human) ........................................... 10 Methyldopa and Hydrochlorothiazide .....................................................79 Activin Receptor Ligand Trap TiZANidine ............................................................................................ 114 Luspatercept ...........................................................................................74 Alpha2 Agonist, Ophthalmic Adhesiolytic Apraclonidine ..........................................................................................10 Icodextrin ................................................................................................62 Brimonidine (Ophthalmic) .......................................................................18 Brinzolamide and Brimonidine ............................................................... 18 Adrenergic Agonist Agent DOBUTamine ......................................................................................... 39 Alpha-Adrenergic Agonist DOPamine ..............................................................................................39 Acetaminophen, Diphenhydramine, and Phenylephrine ..........................3 Epinephrine (Racemic) and Aluminum Potassium Sulfate ....................43 Acetaminophen, Guaifenesin, and Phenylephrine ...................................4 Oxymetazoline (Nasal) ...........................................................................89 Brompheniramine and Phenylephrine ....................................................18 Propylhexedrine ..................................................................................... 99 Brompheniramine, Dextromethorphan, and Phenylephrine ...................18 Tetrahydrozoline (Nasal) .......................................................................112 Chlorpheniramine and Phenylephrine ....................................................26 Tetrahydrozoline (Ophthalmic) ..............................................................112 Chlorpheniramine, Phenylephrine, and Dextromethorphan ...................26 Dexbrompheniramine and Phenylephrine ..............................................34 Adrenergic Agonist Agent, Ophthalmic Diphenhydramine and Phenylephrine ....................................................37 Hydroxyamphetamine and Tropicamide ................................................ 61 Ibuprofen, Phenylephrine, and Chlorpheniramine ................................. 62 Phenylephrine and Ketorolac .................................................................93 Phenylephrine and Pramoxine ...............................................................93 Adrenocorticotropin Stimulating Hormone Phenylephrine and Pyrilamine ............................................................... 93 Phenylephrine and Thonzylamine ..........................................................93 Corticotropin ........................................................................................... 31 Phenylephrine (Nasal) ............................................................................93 Cosyntropin ............................................................................................ 31 Phenylephrine (Ophthalmic) ...................................................................93 Aldehyde Dehydrogenase Inhibitor Phenylephrine (Systemic) ...................................................................... 93 Disulfiram ................................................................................................38 Phenylephrine (Topical) ..........................................................................93 Promethazine and Phenylephrine ..........................................................98 Alkalinizing Agent Promethazine, Phenylephrine, and Codeine ......................................... 98 Citric Acid, Sodium Citrate, and Potassium Citrate ...............................27 Sodium Bicarbonate .............................................................................106 Alpha/Beta Agonist Acetaminophen and Pseudoephedrine ....................................................3 Alkalinizing Agent, Oral Acrivastine and Pseudoephedrine ..........................................................
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