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 ..........................................................