Wake Brook Formulary ­ Brand
Category
CNS
Dermatological
Dermatological
Therapeutic Classification
Brand Name
Generic Name
Strength
Dosage Form
Antipsychotic
Cold Sore Agent
Emollient
Bronchodilator (sympathomimetic)
Inhaler spacer
Decongestant
Diuretics,K+ sparing
Hypnotic
Respiratory stimulant
Penicillin
Liniments
Antialcoholic agent
Abilify
Abreva
Absorbase/Hydrocerin
aripiprazole
docosanol moisturing cream
2mg, 5 mg, 10 mg, 15 mg
10%
tablet
cream
cream
Adrenalin
Aerochamber/Optihaler
Afrin
Aldactone
Ambien
Ammonia Inhalant
Amoxicillin Analgesic balm
Antabuse
epinephrine solution
spacer for inhaler
oxymetazoline HCL
spironolactone
zolpidem
ammonia Inhalant
amoxicillin
menthol/methyl salicylate
disulfiram
1:1000 (1 mg/1 ml)
0.05%
25 mg
5 mg
15%
500 mg
6 %/14%
250mg or 500 mg
injection
each
nasal spray
tablet
tablet
inhalant
capsule
cream
tablet
Antiseptic mouth cleanser
carbamide peroxide 10%
liquid
CNS
Mouth and throat product
Antiparkinson agent/anticholinergic
Artane
trihexylphenidyl
5 mg
tablet
Opthalmic
Hematologic Agent
CNS
CNS
Respiratory
Lubricant
Hematologic Agent
Antianxiety
Anticonvulsant
Anticholinergic
Artificial Tears/Hypotears
Aspirin
Ativan
Ativan
Atrovent HFA
81 mg
0.5 mg, 1 mg, 2 mg
0.5 mg, 1 mg, 2 mg
12.9 gm
solution
tablet
tablet
tablet
inhalant
Anti‐Infective
Otic
Dermatological
Penicillin
Analagesic/Anesthetic
Antibiotic
Augmentin
Aurodex Otic
Bacitracin
875 mg/125 mg
54 mg/ml, 14 mg/ml
500 units/gm
tablet
solution
ointment
Anti‐Infective
Sulfa combination
Antiparkinson agent/anticholinergic
Antiparkinson agent/anticholinergic
Antivertigo
Antihistamine
Antihistamine
Bactrim DS
lubricant, ophth
aspirin, chewable
lorazepam
lorazepam
ipratropium bromide
amoxicillin/clavulanate potassium
antipyrine/benzocaine
bacitracin zinc
sulfamethoxazole/trimethopri
m
800 mg/160 mg
tablet
Benadryl
diphenhydramine
25 mg
capsule/tablet
Benadryl
Benadryl
Benadryl
Benadryl
diphenhydramine
diphenhydramine
diphenhydramine
diphenhydramine liquid
50 mg/1 ml
25 mg
25 mg
12.5 mg/ 5 ml
injection
capsule/tablet
capsule/tablet
liquid
Respiratory
Miscellaneous
Cough/Cold agent
Renal Agent
CNS
Respiratory
Anti‐Infective
Dermatological
CNS
GI agent
CNS
CNS
CNS
Cough/Cold agent
Cough/Cold agent
Bold = Sample (may not be available)
1
5/7/2013
Wake Brook Formulary ­ Brand
Category
Therapeutic Classification
Brand Name
Generic Name
GI agent
Dermatological
Otic
Antispasmodic
Antibiotic
Antibacterial
Bentyl
Benzyl Peroxide
Borofax Ear Solution
dicyclomine
benzoyl peroxide
acetic acid
Respiratory
CNS
Dermatological
Cardiac agent
CNS
Dermatological
Dermatological
Cardiac agent
Nasal
Antianxiety
Anti‐itch
Calcium channel blocker
Antialcoholic agent
Cold Sore Agent
Lip Balm
Central alpha‐agonist
Cephalosporin, second generation
Antidepressant‐SSRI
Mouth and throat product
diabetic Urine Strips
Antihistamine
Fluroquinolones
Antihistamine
Lincosamide
Vaginal‐anti‐infective
Mouth and throat preparation
Miscellaneous
Antiparkinson agent/anticholinergic
Antiparkinson agent/anticholinergic
Stool Softener
Stool Softener
Breathe Right Nasal Strips
Buspar
Calamine
Calan SR
Campral
Carmex/Blistex
Carmex/Blistex
Catapress
nasal strips
buspirone
calamine/zinc oxide
verapamil ER
acamprosate menthol/camphor/phenol
menthol/camphor/phenol
clonidine Ceftin
Celexa
Cepastat
Chemstrips
Chlor‐Trimeton
Cipro
Claritin
Cleocin
Cleocin
Clove oil
Cocoa butter
Anti‐Infective
CNS
GI agent
Diagnostic
Cough/Cold agent
Anti‐Infective
Cough/Cold agent
Anti‐Infective
Vaginal
Dermatological
Dermatological
CNS
CNS
GI agent
GI agent
Endocrine/Metabolic gout agent
Otic
Hematologic Agent
Steroid/Antibiotic
Hematological Agent
Bold = Sample (may not be available)
Strength
Dosage Form
20 mg
10%
2%
tablet
cream
solution
5 mg, 10 mg
8 %/8 %
240 mg
333 mg
0.7 %/1.7 %/0.4 %
0.7 %/1.7 %/0.4 %
0.1 mg
topical
tablet
lotion
tablet
tablet
ointment
ointment
tablet
cefuroxime
citalopram
phenol oral anesthetic
urine strips
chlorpheniramine
ciprofloxacin
loratadine
clindamycin
clindamycin
clove oil
Cocoa butter
500 mg
10 mg, 20 mg
14.5 mg
tablet
tablet
lozenge
4 mg
500 mg
10 mg
150 mg
2%
1/8 oz
1 oz
tablet
tablet
tablet
capsule
vaginal cream
liquid
butter
Cogentin
benztropine mesylate 1 mg/1 ml
injection
Cogentin
colace
Colace
benztropine mesylate docusate sodium
docusate sodium syrup
1 mg
100 mg
20 mg/5 ml
tablet
capsule
syrup
Colchicine
colchicine
0.6 mg
hydrocortisone/neomycin/pol
Cortisporin Otic Suspension ymyxin
1%/5 mg/10,000 units
Coumadin/Jantoven
warfarin
1 mg, 5 mg
2
tablet
solution
tablet
5/7/2013
Wake Brook Formulary ­ Brand
Category
Therapeutic Classification
GI agent
CNS
Otic
Dermatological
Digestive Enzymes‐ not stocked, can order prn
Digestive Enzymes‐ not stocked, can order prn
Antidepressant­SNRI
Ear Wax Emulsifier
Mouth and throat preparation
CNS
Anticonvulsant
CNS
Dermatological
Anticonvulsant
Protectant
CNS
Antidepressant‐miscellaneous
Cough suppressant/Expectorant
Antifungal
Anticonvulsant
Angiotensin II receptor blocker (ARB)
Anticholinergic
Astringent
Antivertigo
Laxative
Laxative
Pregnancy test (urine)
Ear Plugs
Analgesics
Antidepressant‐SNRI
Antidepressant‐tricyclic
Scabicide
GI agent
Cough/Cold agent
Anti‐Infective
CNS
Cardiac agent
Renal Agent
Dermatological
CNS
GI agent
GI agent
Diagnostic
Otic
CNS
CNS
CNS
Dermatological
Nutritional Agent
Respiratory
CNS
Nutritional Supplement
Bronchodilator (sympathomimetic)
Antipsychotic
Bold = Sample (may not be available)
Brand Name
Generic Name
Creon 20‐n/a, can order prn
pancrelipase ‐ n/a, can order prn
pancrelipase ‐ n/a, can order Creon 5‐n/a, can order prn prn
Cymbalta
duloxetine HCL
Debrox
carbamide peroxide Dentemp Filling Mix
dental repair
divalproic acid DR (delayed Depakote
release)
divalproic acid ER (extended Depakote ER
release)
Desitin
zinc oxide
Strength
Dosage Form
20,000 units lipase
tablet
5,000 units lipase
30mg, 60 mg
7.5%
tablet
capsule
solution
mixture
250 mg, 500 mg
tablet
250 mg, 500 mg
10%
tablet
ointment
50 mg, 100 mg
tablet
Desyrel
trazodone
Diabetic Tussin
diflucan
Dilantin
dextromethorphan/guaifenesin 15mg/100mg per 5 ml
fluconazole
100 mg
phenytoin
100 mg
liquid
tablet
capsule
Diovan
Ditropan
Domeboro
Dramamine
Dulcolax
Dulcolax
E.P.T
Ear plugs
Ecotrin
Effexor XR
Elavil
Elimite
50 mg
10 mg
5 mg
tablet
tablet
powder
tablet
suppository
tablet
81 mg, 325 mg
37.5 mg, 75 mg 25 mg
5%
tablet
capsule
tablet
cream
Ensure High Protein
valsartan
oxybutynin
aluminum acetate
dimenhydrinate
bisacodyl
bisacodyl
Pregnancy test
ear plugs
aspirin, enteric coated
venlafaxine
amitriptyline
permethrin
nutritional supplement, high protein
8 oz
liquid
EpiPen
Eskalith epinephrine auto injector
lithium carbonate
0.3 mg
300 mg
injection
capsule
3
40 mg
5 mg
5/7/2013
Wake Brook Formulary ­ Brand
Category
Therapeutic Classification
Brand Name
CNS
Antipsychotic
CNS
Nutritional Agent
Dermatological
Anti‐Infective
Anti‐Infective
GI agent
CNS
Nutritional Agent
CNS
Anti‐Diabetic
Migraine Agent
Excedrin Migraine/Geneced
Trace element
Ferrous sulfate
Mouth and throat preparation Fixodent
Amebicide
Flagyl
STD State Free (for treatment of STD only)
Flagyl
Laxative (enema)
Fleet Enema
Muscle relaxant
Flexeril
Vitamin
Folate
Antipsychotic
Geodon
Glucose elevating agent
Glucagon Injection
Nutritional Agent
Anti‐Diabetic
Anti‐Diabetic
Anti‐Diabetic
Vaginal
CNS
Nutritional Supplement
biguanide
Sulfonylurea
Glucose elevating agent
Vaginal‐antifungal
Antipsychotic
CNS
CNS
Dermatological
Anti‐Diabetic
Antipsychotic
Antipsychotic
Anti‐dandruff
Insulin
Anti‐Diabetic
Dermatological
Dermatological
Renal Agent
Dermatological
Opthalmic
Cardiac agent
GI agent
Insulin
Corticosteroid
Corticosteroid
Diuretics, thiazide
Astringent
Antibiotic
Nitrate‐vasodilator
Antidiarrheal
Bold = Sample (may not be available)
Eskalith CR
Generic Name
Strength
Dosage Form
lithium carbonate ER
450 mg
tablet
ASA/APAP/Caffene
ferrous sulfate
dental adhesive
metronidazole
250 mg/ 250 mg/65 mg
325 mg
0.75 oz
500 mg
tablet
tablet
cream
tablet
500 mg
4.5 oz
10 mg
1 mg
20 mg, 40 mg, 60 mg, 80 mg
1 mg
tablet
enema
tablet
tablet
capsule
injection
Glucerna
Glucophage
Glucotrol XL
Glutose
Gyne‐Lotrimin
Haldol
metronidazole
phopha‐soda enema
cyclobenzaprine
folic Acid
ziprasidone
glucagon emergency kit
nutritional supplement, diabetic
metformin
glipizide extended release
glucose, instant
clotrimazole
haloperidol
8 oz
500 mg
5 mg
15 gm
1%
1 mg, 2 mg, 5 mg
liquid
tablet
tablet
oral gel
vaginal cream
tablet
Haldol
Haldol decanoate
Head & Shoulders
Humalog
haloperidol immediate release
haloperidol decanoate
pyrithione zinc
insulin lispro, rapid onset
5 mg/1 ml
100 mg/1 ml
1%
100 units/ml
injection
injection
shampoo
injection
Humulin 70/30
Hydorcortisone
Hydrocortisone
HydroDiuril
Hydrogen Peroxide
Ilosone ophth ointment
Imdur
Imodium
insulin‐70% isophane insulin, intermediate acting & 30% regular insulin, rapid acting
hydrocortisone
hydrocortisone acetate
hydrochlorothiazide
hydrogen peroxide
erythromycin ophth oint
isosorbide monohydrate ER loperamide
100 units/ml
1%, 2.5%
25 mg
25 mg
injection
cream
suppository
tablet
liquid
ointment
tablet
capsule
4
3%
0.5%/3.5 g
30 mg
2 mg
5/7/2013
Wake Brook Formulary ­ Brand
Category
Cardiac agent
CNS
CNS
Cardiac agent
Anti‐Infective
Dermatological
Dermatological
Dermatological
CNS
CNS
Nutritional Agent
Nutritional Agent
Dermatological
GI agent
CNS
Cardiac agent
Anti‐Diabetic
Renal Agent
CNS
Anti‐Infective
CNS
CNS
Cardiac agent
Anti‐Infective
GI agent
GI agent
Nutritional Agent
GI agent
Vaginal
Dermatological
GI agent
GI agent
Therapeutic Classification
Brand Name
Generic Name
Strength
Dosage Form
Beta blocker
Nonsteroidal Anti‐inflamatory drug
Antipsychotic
Potassium removing resin
Inderal
propranolol
20 mg
tablet
Indocin
Invega
Kayexalate
indomethacin
paliperidone
sodium polystrene sulfonate
25 mg
3 mg
15 gm/60 ml
capsule
tablet
suspension
Cephalosporin, first generation
Corticosteroid
Mouth and throat preparation
Emollient
Antianxiety
Anticonvulsant
Electrolyte
Electrolyte
Moisturizer
Stool Softener
Anticonvulsant
inotropic agent
Insulin
Diurectics, loop
Antipsychotic
Fluroquinolones
Antianxiety
Antipsychotic
Beta blocker
Nitrofurans ‐ 3/12‐ Not available
Laxative
Antacid
Mineral
Laxative (bulk producing)
Vaginal‐anti‐infective
Antifungal
Antacid
Laxative
Keflex
Kenalog
Kenalog acetonide dental
Keri Lotion
Klonopin
Klonopin
Klor‐Con 10
Klor‐Con‐20
Lac‐Hydrin
Lactulose
Lamictal
Lanoxin
Lantus
Lasix
Latuda
Levaquin
Librium
Lithobid
Lopressor
Macrobid‐ 3/12‐price incr, N/A
Magnesium Citrate
Mag‐Ox
Mag‐Ox
Metamucil
Metrogel
Micatin
Milk of Magnesia
Milk of Magnesia
cephalexin
triamcinolone
triamcinolone acetonide Keri Lotion
clonazepam
clonazepam
potassium chloride
potassium chloride
ammonium lactate lotion
lactulose solution
lamotrigine
digoxin
insulin glargine, long acting
furosemide
lurasidone
levofloxacin
chlordiazepoxide
lithium carbonate ER
metoprolol
nitrofurantoin 3/12‐price incr, N/A
magnesium citrate
magnesium oxide
magnesium oxide
psyllium
metronidazole
miconazole
magnesium hydroxide
magnesium hydroxide
500 mg
0.1%
0.1%
0.5 mg, 1 mg
0.5 mg, 1 mg
10 mEq
20 mEq
12%
10 gm/ 15 ml
25 mg,100 mg
0.125 mg
100 units/ml
20 mg, 40 mg
40mg, 80 mg
500 mg
25 mg
300 mg
25 mg , 50 mg
capsule
cream
oral paste
lotion
tablet
tablet
tablet
tablet
lotion
liquid
tablet
tablet
injection
tablet
tablet
tablet
capsule
tablet
tablet
100 mg (BID dosing)
1.745 gm/oz, 296 ml/bottle
400 mg
400 mg
3.4 gm
0.75%
2%
2400 mg/30 ml
2400 mg/30 ml
capsule
liquid
tablet
tablet
powder
vaginal cream
cream
liquid
liquid
Bold = Sample (may not be available)
5
5/7/2013
Wake Brook Formulary ­ Brand
Category
GI agent
GI agent
Therapeutic Classification
CNS
Antidotes
Cough/Cold agent
Respiratory
CNS
Laxative
Laxative
Nonsteroidal Anti‐inflamatory drug
Expectorant
Vitamin, Multiple
Corticosteroid/antifungal
Antiflatulent
Nonsteroidal Anti‐inflamatory drug
Narcotic antagonist
Mast cell stabilizer
mast cell stabilizer
Antipsychotic
Opthalmic
Antibiotic
Dermatological
CNS
CNS
CNS
Cardiac agent
Dermatological
Dermatological
Cardiac agent
GI agent
Cough/Cold agent
CNS
Cough/Cold agent
Nutritional Agent
Dermatological
GI agent
Diagnostic
GI agent
Nutritional Agent
GI agent
CNS
Anti‐Infective
Brand Name
Generic Name
Strength
Dosage Form
Mineral Oil
Miralax
mineral oil
polyethylene glycol soln
99.9%
3350
oil
powder
Motrin
Mucinex
Multiple Vitamin
Mycolog
Mylicon
ibuprofen
guaifenesin extended release
Vitamin, Multiple
nystatin/triamcinolone
simethicone
400mg, 600mg, 800mg
600 mg/120 mg
multiple
100,000 units/0.1 %
80 mg
tablet
tablet
tablet
cream
tablet
500 mg
0.4 mg/ml
5.2 mg/spray
5.2 mg/spray
2 mg, 5 mg
tablet
injection
nasal spray
nasal spray
tablet
1.75mg/10,000 units/0.025mg
solution
Antibiotic
Anticonvulsant
Smoking Deterrents
Smoking Deterrents
Nitrate‐vasodilator
Pediculicide
Antifungal
Calcium channel blocker
Mouth and throat product
Decongestant
Diabetic blood glucose testing strips
Mouth and throat product
naproxen
naloxone
cromolyn sodium
cromolyn sodium
thiothixene
neomycin/polymyxin/gramicid
Neosporin ophth solution in
triple antibiotic:bacitracin, Neosporin topical ointment neomycin, polymyxin
Neurontin
gabapentin
Nicorette
nicotine gum
Nicotine Transdermal
nicotine transdermal
Nitroglycerin SL
nitroglycerin Nix
permethrin
Nizoral
ketoconazole
Norvasc
amlodipine
Nystatin
nystatin
Ocean Nasal
saline nasal spray
400 units/3.5mg/5000 units
100 mg, 300 mg, 400 mg
2 mg
14 mg, 21 mg
0.4 mg
1%
2%
5mg, 10 mg
100, 000 units/ml
0.07%
ointment
capsule/tablet
lozenge
patch
tablet
lotion
cream
tablet
liquid
nasal spray
One Touch
Orajel
blood glucose strips
benzocaine
10%
topical
Mineral
Digestive Enzymes‐ not stocked, can order prn
Antidepressant‐SSRI
Penicillin
OsCal with D
Panokase‐n/a, can order prn
Paxil
Pen VK
calcium, elemental/ Vitamin D pancrelipase ‐ n/a, can order prn
paroxetine HCL
penicillin VK
500 mg/125 mg
tablet
8,000 units lipase
20 mg
500 mg
tablet
tablet
tablet
Bold = Sample (may not be available)
Naprosyn
Narcan
NasalCrom
NasalCrom
Navane
6
5/7/2013
Wake Brook Formulary ­ Brand
Category
GI agent
GI agent
CNS
CNS
CNS
CNS
CNS
Dermatological
Miscellaneous
Diagnostic
Therapeutic Classification
Antidiarrheal
Mouth and throat product
Antiemetic
Antiemetic
Antiemetic
Anticonvulsant
Sedative, barbiturate
Cleanser
Pill splitter
Tuberculin Skin test
Endocrine/Metabolic glucocorticoid
Dermatological
GI agent
CNS
Dermatological
CNS
CNS
CNS
Renal Agent
CNS
Antidotes
CNS
Brand Name
Pepto‐Bismol
Peridex
Phenergan
Phenergan
Phenergan
Phenobarbital
Phenobarbital
Phisoderm
pill splitter
PPD
Generic Name
bismuth subsalicylate
chlorhexidine gluconate
promethazine
promethazine
promethazine
phenobarbital
phenobarbital
Phisoderm
pill splitter
Tuberculin Purified Protein
Prednisone
prednisone
Preparation H/Formulation R
hemorrhoidal ointment
Prilosec
omeprazole delayed release
Pristiq
desvenlafaxine
Proctozone‐HC
hydrocortisone rectal cream
Prolixin
fluphenazine
Prolixin decanoate
fluphenazine decanoate
Prozac
fluoxetine
Pyridium
phenazopyridine
Remeron mirtazapine
ReVia
naltrexone
Risperdal
risperidone
Anti‐Infective
GI agent
CNS
Dermatological
Dermatological
Analgesics
Proton Pump Inhibitor
Antidepressant­SNRI
Corticosteroid
Antipsychotic
Antipsychotic
Antidepressant‐SSRI
Urinary analgesic
Antidepressant‐tetracyclic
Narcotic antagonist
Antipsychotic
STD State Free (for treatment of STD only)
Rocephin
Antacid
Rulox/Ala‐mag
Antipsychotic
Saphris
Anti‐dandruff (seborrheic)
Sebex
Anti‐psoriatic
Selenium sulfide
ceftriaxone
magaldrate/simethicone
asenapine
sulfur/salicylic acid
selenium sulfide
CNS
Dermatological
CNS
CNS
Antipsychotic
Burn Preparations
Antianxiety
Antidepressant‐tricyclic
quetiapine ER
silver sufadiazine
doxepin
doxepin
Bold = Sample (may not be available)
Seroquel XR
Silvadene
Sinequan
Sinequan
7
Strength
262 mg/15 ml
0.12%
25 mg/1 ml
25 mg
25 mg
30 mg
30 mg
Dosage Form
liquid
rinse
injection
suppository
tablet
tablet
tablet
cleanser
each
5 TU/0.1 ml
10 mg
tablet
2 oz.
20 mg
50 mg
2.50%
1 mg, 5 mg
25mg/1 ml
10 mg, 20 mg
200 mg
15 mg, 30 mg
50 mg
0.25 mg, 0.5 mg, 1 mg, 2 mg
ointment
capsule
tablet
cream
tablet
injection
capsule
tablet
tablet
tablet
tablet
250 mg
540 mg/40 mg per 5 ml
5mg, 10 mg
2%/2%
2.50%
50 mg, 150 mg, 200 mg, 300 mg, 400 mg
10 mg/gm
25 mg, 50 mg
25 mg, 50 mg
injection
liquid
SL tablet
shampoo
shampoo
tablet
cream
capsule
capsule
5/7/2013
Wake Brook Formulary ­ Brand
Category
Miscellaneous
Miscellaneous
Dermatological
CNS
CNS
Cough/Cold agent
Therapeutic Classification
Irrigation
Diluent
Anesthetic
Misc. psychotherapeutic, ADHD
Narcotic agonist
Decongestant
Endocrine/Metabolic Thyroid hormone
CNS
Anticonvulsant
Cardiac agent
Beta blocker
Preventative
CNS
CNS
CNS
CNS
Dermatological
CNS
Cardiac agent
Vaccine
Antiemetic
Antiemetic
Antipsychotic
Antipsychotic
Antifungal
Antidepressant‐tricyclic
Beta blocker
Dermatological
GI agent
Nutritional Agent
CNS
CNS
Diagnostic
CNS
CNS
CNS
CNS
Dermatological
Cardiac agent
Astringent
Antacid
Mineral
Analgesics
Analgesics
Diabetic lancets
Antianxiety
Antianxiety
Anticonvulsant
Anticonvulsant
Protectant
ACE inhibitor
Bronchodilator (sympathomimetic)
Respiratory
Bold = Sample (may not be available)
Brand Name
Generic Name
Strength
Sodium chloride Irrigation sodium chloride
Sterile water for injection Sterile water for injection
Sting Kill
benzocaine
20%
irrigation
injection
swab
Strattera
Subutex
Sudafed
atomoxetine
buprenorphine
pseudoephedrine
10 mg, 18 mg, 25mg, 40 mg
2 mg
30 mg
tablet
tablet
tablet
Synthroid
Tegretol
Tenormin
Tetanus and Diptheria Toxoids
Thorazine
Thorazine
Thorazine
Thorazine
Tinactin
Tofranil
Trandate
levothyroxine
carbamazepine
atenolol
50 mcg
200 mg
50 mg
tablet
tablet
tablet
tetanus & diptheria toxoids
chlorpromazine
chlorpromazine
chlorpromazine
chlorpromazine
tolnaftate
imipramine
labetalol
0.5 ml
25 mg/1 ml
25 mg
25mg/1 ml
25 mg
1%
25 mg, 50 mg
100 mg
injection
injection
tablet
injection
tablet
powder
tablet
tablet
Tuck's Hemorrhoidal pads
Tums
Tums
Tylenol
Tylenol
Unistik 2 Valium
Valium
Valium
Valium
Vaseline
Vasotec
witch hazel calcium carbonate
calcium carbonate
acetaminophen
acetaminophen
lancets
diazepam
diazepam
diazepam
diazepam
petrolatum, white
enalapril
50 %, 1 box
500 mg
500 mg
500 mg/5 ml
325 mg, 500 mg
pads
tablet
tablet
liquid
tablet
5 mg/1 ml
5 mg
5 mg/1 ml
5 mg
5 mg
injection
tablet
injection
tablet
ointment
tablet
Ventolin/Proventil
albuterol inhalation
90 mcg/actuation
inhalant
8
0.9%
Dosage Form
5/7/2013
Wake Brook Formulary ­ Brand
Category
Therapeutic Classification
Brand Name
Generic Name
Strength
Dosage Form
albuterol solution
0.083% nebulizer
inhalant
Anti‐Infective
Anti‐Infective
CNS
Opthalmic
Bronchodilator (sympathomimetic)
Ventolin/Proventil
STD State Free (for treatment of STD only)
Vibramycin
Tetracycline
Vibramycin
Analgesics
Vicodin
Vasoconstrictor
Visine
doxycycline
doxycycline
hydrocodone/APAP
tetrahydrozoline
100 mg
100 mg
5 mg/500 mg
0.05%
tablet
tablet
tablet
ophth soln
Opthalmic
CNS
Cough/Cold agent
Nutritional Agent
Nutritional Agent
Nutritional Agent
Nutritional Agent
Nutritional Agent
Vasoconstrictor/Antihistamine
Antianxiety
Antihistamine
Vitamin
Vitamin
Vitamin
Vitamin
Vitamin
Visine A Ophth Drops
Vistaril
Vistaril
vitamin B‐1
Vitamin B‐12
Vitamin B‐6
Vitamin C
Vitamin D
naphazoline/pheniramine
hydroxyzine pamoate
hydroxyzine pamoate
thiamine (B1)
cyanocobalamin pyridoxine (B6)
ascorbic acid cholecaliceferol
0.025%/0.3%
25 mg, 50 mg
25 mg, 50 mg
100 mg
1000 mcg
25 mg
500 mg
400 IU
ophth soln
capsule
capsule
tablet
tablet
tablet
tablet
tablet
CNS
Antidepressant‐miscellaneous
Wellbutrin
bupropion immediate release
75 mg, 100 mg
tablet
CNS
CNS
Antidepressant‐miscellaneous
Antianxiety
Wellbutrin SR
Xanax
bupropion sustained release
alprazolam
100 mg, 150 mg
0.5 mg. 1 mg
tablet
tablet
Dermatological
GI agent
Cardiac agent
Anti‐Infective
Mouth and throat preparation Xylocaine Viscuos
H2 Antagonist
Zantac
ACE inhibitor
Zestril/Prinivil
Macrolide Zithromax
STD State Free (for treatment of STD only)
Zithromax
Antidepressant
Zoloft
Antiviral
Zovirax
lidocaine oral, viscous
ranitidine
lisinopril
azithromycin
2%, 100 ml
150 mg
5 mg, 10 mg
250 mg
solution, topical
tablet
tablet
tablet
azithromycin
sertraline
acyclovir
500 mg
50 mg, 100 mg
400 mg
tablet
tablet
tablet
allopurinol
olanzapine
olanzapine, orally disintegrating
100 mg
5 mg
tablet
tablet
5 mg, 10mg, 15mg, 20mg
tablet
Respiratory
Anti‐Infective
CNS
Anti‐Infective
Endocrine/Metabolic gout agent
CNS
Antipsychotic
Zyloprim
Zyprexa
CNS
Zyprexa Zydis
Antipsychotic
Bold = Sample (may not be available)
9
5/7/2013