NMCSD AND NHCP OUTPATIENT FORMULARY Alphabetical Listing by Therapeutic Category This document is current as of July 16, 2020. The availability of formulary items is subject to change. 1 ACETYLCHOLINESTERASE INHIBITOR Acetylcholinesterase Inhibitor Analgesic, Nonopioid Neostigmine .................................................................................................. Acetaminophen ............................................................................................. Pyridostigmine ............................................................................................... Aspirin ........................................................................................................... Butalbital, Acetaminophen, and Caffeine ..................................................... Acetylcholinesterase Inhibitor (Central) Celecoxib ...................................................................................................... Donepezil ...................................................................................................... Diclofenac (Systemic) ................................................................................... Acne Products Ibuprofen ....................................................................................................... Adapalene ..................................................................................................... Indomethacin ................................................................................................. Benzoyl Peroxide .......................................................................................... Ketorolac (Systemic) ..................................................................................... Clindamycin and Benzoyl Peroxide .............................................................. Meloxicam ..................................................................................................... Erythromycin (Topical) .................................................................................. Nabumetone .................................................................................................. ISOtretinoin (Systemic) ................................................................................. Naproxen ....................................................................................................... Salicylic Acid ................................................................................................. Piroxicam (Systemic) .................................................................................... Sulfur and Sulfacetamide .............................................................................. Sulindac ........................................................................................................ Tazarotene .................................................................................................... Analgesic, Opioid Tretinoin (Topical) ......................................................................................... Acetaminophen and Codeine ....................................................................... Adrenergic Agonist Agent Belladonna and Opium ................................................................................. Oxymetazoline (Nasal) .................................................................................. Butorphanol ................................................................................................... Codeine ......................................................................................................... Aldehyde Dehydrogenase Inhibitor FentaNYL ...................................................................................................... Disulfiram ...................................................................................................... Hydrocodone and Acetaminophen ............................................................... Alkalinizing Agent Hydrocodone and Chlorpheniramine ............................................................ Sodium Bicarbonate ...................................................................................... HYDROmorphone ......................................................................................... Methadone .................................................................................................... Alkalinizing Agent, Oral Morphine (Systemic) ..................................................................................... Potassium Citrate .......................................................................................... OxyCODONE ................................................................................................ Sodium Citrate and Citric Acid ..................................................................... Oxycodone and Acetaminophen ................................................................... Promethazine and Codeine .......................................................................... Alkylamine Derivative Tapentadol .................................................................................................... Chlorpheniramine .......................................................................................... TraMADol ...................................................................................................... Hydrocodone and Chlorpheniramine ............................................................ Naphazoline and Pheniramine ...................................................................... Analgesic, Opioid Partial Agonist Butorphanol ................................................................................................... Alpha1 Agonist Naphazoline and Pheniramine ...................................................................... Analgesic, Topical Naphazoline (Ophthalmic) ............................................................................ Benzocaine ................................................................................................... Capsaicin ...................................................................................................... Alpha1 Blocker Lidocaine (Topical) ........................................................................................ Alfuzosin ........................................................................................................ Methyl Salicylate and Menthol ...................................................................... Doxazosin ..................................................................................................... Prazosin ........................................................................................................ Analgesic, Urinary Tamsulosin .................................................................................................... Pentosan Polysulfate Sodium ....................................................................... Terazosin ....................................................................................................... Phenazopyridine ........................................................................................... Alpha2-Adrenergic Agonist Androgen CloNIDine ...................................................................................................... Testosterone .................................................................................................. GuanFACINE ................................................................................................ Methyldopa .................................................................................................... Anesthetic/Corticosteroid TiZANidine .................................................................................................... Pramoxine and Hydrocortisone .................................................................... Angiotensin II Receptor Blocker Alpha2 Agonist, Ophthalmic Apraclonidine ................................................................................................ Amlodipine and Valsartan ............................................................................. Brimonidine and Timolol ............................................................................... Amlodipine, Valsartan, and Hydrochlorothiazide .......................................... Brimonidine (Ophthalmic) ............................................................................. Azilsartan and Chlorthalidone ....................................................................... Brinzolamide and Brimonidine ...................................................................... Candesartan .................................................................................................. Irbesartan ...................................................................................................... Alpha-Adrenergic Agonist Losartan ........................................................................................................ Phenylephrine (Nasal) .................................................................................. Losartan and Hydrochlorothiazide ................................................................ Phenylephrine (Ophthalmic) ......................................................................... Telmisartan .................................................................................................... Phenylephrine (Topical) ...............................................................................