Illinois Formularyfor the Drug ProductSelection Program

Twentieth EditionEffective April 5, 2002

George H. RyanGovernor

John R. Lumpkin, M.D., M.P.H.Directorwww.idph.state.il.us

ILLINOIS FORMULARYFOR THE

DRUG PRODUCT SELECTION PROGRAM

Statutory Authority:Illinois Public Acts 80-976, 82-237, 84-495, 85-451, 91-766, and 92-112

Illinois Food, Drugs and Cosmetic Act, [410 ILCS 620/2.22 and 620/3.14], (formerly Chapter 56 ½,paragraphs 502.22 and 503.14, Illinois Revised Statutes), as amended.

Pharmacy Practice Act of 1987, [225 ILCS 85/25], (formerly Chapter 111, paragraphs 4123 and 4145,Illinois Revised Statutes), as amended.

Public Act 80-976 took effect on October 1, 1977. The Drug Product Selection Program becameoperative July 1, 1978. Public Act 82-237 was effective August 19, 1981. Public Act 84-495 took effectSeptember 17, 1985. Public Act 85-451 became effective on September 17, 1987. Portions of PublicAct 91-766 took effect on June 9, 2000 and September 1, 2000. Public Act 92-112 became effective onJuly 20, 2001.

This Twentieth Edition of the Illinois Formulary, effective April 5, 2002 replaces all previous editions andsupplements of the Illinois Formulary as follows:

First Edition . . . . . . . . . . . . . . . . . . . Effective July 1, 1978Supplemental Update . . . . . . . . . Effective October 1, 1978Supplemental Update . . . . . . Effective December 31, 1978Supplemental Update . . . . . . . . . . . . Effective April 1, 1979Second Edition . . . . . . . . . . . . . . . Effective August 1, 1979Third Edition . . . . . . . . . . . . . Effective December 22, 1980Supplemental Update . . . . . . . . . . . . . Effective July1, 1981Supplemental Update . . . . . . . . . Effective October 1, 1981Supplemental Update . . . . . . . . Effective February 1, 1982Fourth Edition . . . . . . . . . . . . . . . . . . Effective July 1, 1982Supplemental Update . . . . . . Effective September 15, 1982Supplemental Update . . . . . . Effective December 15, 1982Fifth Edition . . . . . . . . . . . . . . . . . . . Effective July 1, 1983Supplemental Update . . . . . . . . . Effective October 1, 1983Supplemental Update . . . . . . . . . Effective January 1, 1984Supplemental Update . . . . . . . . . . Effective March 1, 1984Sixth Edition . . . . . . . . . . . . . . . . . . . Effective July 1, 1984Supplemental Update . . . . . . . Effective November 1, 1984Supplemental Update . . . . . . . . . . . . Effective April 1, 1985Supplemental Update . . . . . . . . . . . . Effective May 1, 1985Seventh Edition . . . . . . . . . . . . . Effective January 1, 1986Supplemental Update . . . . . . . . . . . . Effective May 1, 1986Eighth Edition . . . . . . . . . . . . . Effective February 23, 1987Supplemental Update . . . . . . . . . . . Effective May 15, 1987Supplemental Update . . . . . . . . . Effective August 15, 1987Supplemental Update . . . . . . . . . Effective January 1, 1988Ninth Edition . . . . . . . . . . . . . . . . . . Effective April 15, 1988Supplemental Update . . . . . . . . . . . Effective June 2, 1988Supplemental Update . . . . . . . . . . Effective August 5, 1988Supplemental Update . . . . . . . . . Effective October 7, 1988Tenth Edition . . . . . . . . . . . . . Effective February 28, 1989Supplemental Update . . . . . . . . . . Effective August 1, 1989Supplemental Update . . . . . . . . Effective October 13, 1989Supplemental Update . . . . . . . . Effective January 12, 1990Twelfth Edition . . . . . . . . . . . . . . . Effective March 8, 1991Supplemental Update . . . . . . . . . . . Effective July 19, 1991Supplemental Update . . . . . . . . Effective October 25, 1991

Thirteenth Edition . . . . . . . . . . . . Effective March 14, 1992Supplemental Update . . . . . . . . . . . Effective May 15, 1992Supplemental Update . . . . . . . Effective November 9, 1992Supplemental Update . . . . . . . . . Effective March 29, 1993Supplemental Update . . . . . . . . . . . Effective July 26, 1993Supplemental Update . . . . . . Effective December 20, 1993Supplemental Update . . . . . . . . . . . Effective May 27, 1994Fourteenth Edition . . . . . . . . Effective September 29, 1994Supplemental Update . . . . . . Effective November 17, 1994Supplemental Update . . . . . . . Effective February 23, 1995Supplemental Update . . . . . . . . . . . Effective June 1, 1995Supplemental Update . . . . . . . . . Effective August 31, 1995Supplemental Update . . . . . . . Effective December 7, 1995Supplemental Update . . . . . . . Effective February 29, 1996Fifteenth Edition . . . . . . . . . . . . . . Effective June 15, 1996Supplemental Update . . . . . . . . . Effective August 22, 1996Supplemental Update . . . . . . Effective November 21, 1996Supplemental Update . . . . . . . Effective February 27, 1997Sixteenth Edition . . . . . . . . . . . . . . Effective May 29, 1997Supplemental Update . . . . . . . . . Effective August 28, 1997Supplemental Update . . . . . . Effective November 20, 1997Supplemental Update . . . . . . . Effective February 26, 1998Seventeenth Edition . . . . . . . . . . . . Effective May 28, 1998Supplemental Update . . . . . . . . . Effective August 27, 1998Supplemental Update . . . . . . Effective December 17, 1998Supplemental Update . . . . . . . Effective February 25, 1999Supplemental Update . . . . . . . . . . . Effective May 27, 1999Supplemental Update . . . . . . . . . Effective August 26, 1999Eighteenth Edition . . . . . . . . . . . . . Effective March 2, 2000Supplemental Update . . . . . . . . . . . Effective June 1, 2000Supplemental Update . . . . . . . . . Effective August 31, 2000Nineteenth Edition . . . . . . . . . . . . . . Effective April 16, 2001Supplemental Update . . . . . . . . . . . . Effective July 1, 2001Supplemental Update . . . . . . . . . Effective October 1, 2001Supplemental Update . . . . . . . . . Effective January 1, 2002

Updates posted monthly at http://www.idph.state.il.us/about/fdd/formulary.htm

ILLINOIS DEPARTMENT OF PUBLIC HEALTHOFFICE OF HEALTH PROTECTION

DIVISION OF FOOD, DRUGS AND DAIRIES525 WEST JEFFERSON STREET

SPRINGFIELD, IL 62761-0001

Printed by the Authority of the State of Illinois

ILLINOIS FORMULARYfor the

DRUG PRODUCT SELECTION PROGRAMTECHNICAL ADVISORY COUNCIL AND DEPARTMENT STAFF

ROBERT W. BUCKMAN, PH.D.Chicago, Illinois

DONALD R. GRONEWOLD, R.PH.Washington, Illinois

ALFONSE T. MASI, M.D., DR.P.H.Peoria, Illinois

JAMES T. O’DONNELL, PHARM. D., M.S.Chicago, Illinois

THERESA MOFFETT WILLIS, R.PH., M.B.A.Godfrey, Illinois

RONALD W. GOTTRICH, R.PH., M.S.Manager,Drugs and Medical Devices ProgramsDivision of Food, Drugs and DairiesOffice of Health ProtectionSpringfield, Illinois

ILLINOIS FORMULARY for the DRUG PRODUCT SELECTION PROGRAM

TABLE OF CONTENTS

GENERAL INSTRUCTIONS AND INFORMATIONI. Application of the Illinois Formulary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . iII. Prescription Requirements and Interpretation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i

Prescriptions Written Generically . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . iiPrescriptions from Out-of-State Prescribers . . . . . . . . . . . . . . . . . . . . . . . . . . . iiPrescriptions Mailed Out-of-State . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ii

III. Pharmacy Records . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . iiIV. Suggested Prescription Labeling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . iiV. Penalties . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ivVI. Relationship to the Public Aid Drug List . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ivVII. Liability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ivVIII. Criteria for Drug Product Inclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ivIX. Criteria for Drug Product Exclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vX. Pharmaceutical Equivalence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vXI. Therapeutic Equivalence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vi

Excerpt from FDA Approved Drug Product List . . . . . . . . . . . . . . . . . . . . . . . . viXII. Formulary Format . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vii

Official Drug Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . viiDosage Forms and Strengths . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . viiApplication Holders, Manufacturers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . viiAbbreviations Used . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vii

XIII. Interchange of Prescriptions for Nonlegend (OTC) Drug Products . . . . . . . . . . . . . . . . . . . . . . viiXIV. Manufacturers’ Petitions for Product Inclusion; Review of Products . . . . . . . . . . . . . . . . . . . . viiiXV. FDA MedWatch Product Reporting Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . viiiXVI. Program Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ixXVII. Topical Ocular Pharmaceutical Agents for use by Certified Optometrists . . . . . . . . . . . . . . . . . ix

Therapeutic Ocular Pharmaceutical Agents . . . . . . . . . . . . . . . . . . . . . . . . . . . ix

“AUTHORIZED GENERIC” PHARMACEUTICAL PRODUCTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . x

SAMPLE PRESCRIPTION FORM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xiii

PRESCRIPTION DISPENSING FLOW CHART . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xiv

USFDA MEDWATCH PRODUCT REPORT FORM (perforated, detachable, postage-paid) . . . . . . . . xv

RULES AND REGULATIONS (77 Ill. Adm. Code 790) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xviiSection 790.10 - Incorporated Materials . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xviiSection 790.20 - Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xviiSection 790.40 - Consideration of Drug Products for Inclusion in the Illinois Formulary . . . . . xviiSection 790.60 - Additional Criteria . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xixSection 790.80 - Quality Listing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xixSection 790.100 - Generic Drug Entity Headings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xxSection 790.120 - Comments and Specific Administration . . . . . . . . . . . . . . . . . . . . . . . . . . . . xxSection 790.140 - Requests for Additional Copies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xxSection 790.160 - Prescription Use of Drug Products . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xxSection 790.180 - FDA Drug Product Approval and Recommendation . . . . . . . . . . . . . . . . . . xxSection 790.200 - Availability of Drug Products; Pharmaceutical Equivalence . . . . . . . . . . . . xxiSection 790.220 - Single Source Drug Products Exclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . xxiSection 790.240 - Criteria for Exclusion of Drug Products . . . . . . . . . . . . . . . . . . . . . . . . . . . . xxiSection 790.260 - Inclusion of Controlled Substances . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xxiSection 790.280 - Equivalence of Products Requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . xxiSection 790.300 - Selection of Equivalent Drug Products . . . . . . . . . . . . . . . . . . . . . . . . . . . . xxiSection 790.320 - Transfer of Prescription Records . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xxi

NON-INTERCHANGEABLE DRUG PRODUCTS (partial listing) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xxii

LIST OF PRODUCTS ADDED SINCE PUBLICATION OF THE NINETEENTH EDITION . . . . . . . . . xxv

ALPHABETICAL LISTING OF APPROVED DRUG PRODUCTS FOR DRUG PRODUCT SELECTION 1

ALPHABETICAL INDEX . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 209

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ILLINOIS FORMULARYFOR THE

DRUG PRODUCT SELECTION PROGRAM

GENERAL INSTRUCTIONS AND INFORMATION

This section provides general information and answers questions concerning the operation of thedrug product selection program. For further information, please review the Section on Rules and Regulationsimmediately preceding the alphabetical drug list, which covers some subjects in greater depth.

I. Application of the Illinois Formulary:

The Drug Product Selection (DPS) Program applies whenever an outpatient or his/herrepresentative presents a prescription for a legend (prescription-requiring) drug to an outpatient pharmacy(community, clinic, HMO or hospital) or when the outpatient pharmacy receives an oral or facsimileprescription order from the prescriber to dispense a drug product to an outpatient. (Note that most homehealth care prescriptions are considered outpatient prescriptions under Illinois law.) Drug Product Selectionis the process by which a pharmacist dispenses an approved, equivalent generic or brand name productof lesser cost than the particular brand name product prescribed. Drug products selected for interchangemust come from among those generically equivalent products approved and listed in the current edition ofthe Illinois Formulary. Drug Product Selection can only occur under the following circumstances:

A. The prescriber has not blocked DPS either orally or by personally checking or markingbeside the “May Not Substitute” choice on a compliant prescription form, and;

B. The drug entity and a pharmaceutically equivalent product are listed in the current IllinoisFormulary; and;

C. The informed patient or his/her legal representative (parent, legal guardian, spouse) hasagreed to accept a generically equivalent product.

A flow chart depicting the process of drug product selection appears on page xiv.

II. Prescription Requirements and Interpretation:

Since August 19, 1981, outpatient prescriptions written in Illinois have been required to comply withPublic Act 82-237 as follows:

On the prescription forms of prescribers, shall be placed a signature line and thewords “may substitute” and “may not substitute”. The prescriber, in his or her ownhandwriting, shall place a mark beside either the “may substitute” or “may not substitute”alternatives to guide the pharmacist in the dispensing of the prescription. A prescriberplacing a mark beside the “may substitute” alternative or failing in his or her own handwritingto place a mark beside either alternative authorizes drug product selection in accordancewith this Act. Preprinted or rubber stamped marks, or other deviations from the aboveprescription format shall not be permitted. The prescriber shall sign the form in his or herown handwriting to authorize the issuance of the prescription.

Arrangement of the required wording on the prescription form is left to the prescriber’s perogative. A sampleprescription form is printed on page xiii.

If a prescriber’s dispensing instructions should create a problem of interpretation, the pharmacistshould contact the prescriber for clarification and document the instructions received from the prescriber.

When a drug entity is not included in the formulary, product selection cannot be practiced on brandname prescriptions, even though the prescription may be marked “May Substitute.” This applies toprescriptions for all types of reimbursement: private pay, Public Aid, HMO, and other third partyprescriptions. In such cases, the prescriber must be contacted and permission obtained to dispense

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anything other than the brand originally prescribed. The pharmacist should them properly document his/herprescription records to indicate that the prescriber was notified and that permission to dispense an alternate,non-formulary drug product was received.

Prescriptions Written Generically - Requirements for prescriptions written using thegeneric name of a drug product have not been changed. Any legally marketed product meeting the identityof the prescribed drug may be professionally selected irrespective of the inclusion or exclusion of the entityin this formulary.

Prescriptions from Out-of-State Prescribers - Prescriptions presented from out-of-stateprescribers should be filled in accordance with the intent of the Illinois statutes. The drug product would beeligible for DPS consideration unless the prescriber indicated in a clear manner that interchange was notdesired.

Prescriptions Mailed Out-of-State - Prescriptions dispensed within the geographicboundary of Illinois which are to be mailed out-of-state must be filled in compliance with the statutes andregulations of Illinois concerning drug product selection.

III. Pharmacy Records:

When DPS is not prohibited, the pharmacist should inform the patient of what alternate equivalentdrug product (brand name or generic) the pharmacy may have available and of the cost savings. If theinformed patient agrees to an interchange, the prescription may be filled with the alternate product of a lowercost and the name of the product dispensed must be placed on the label.

In all cases of drug product selection, the identification of the product dispensed and itsmanufacturer, if different than that prescribed, must be entered on the readily retrievable pharmacy recordof the filled prescription.

IV. Suggested Prescription Labeling

Examples of suggested labeling of prescriptions for brand name and generic name drug productsare as follows:

A. Brand name (e.g.: HYDRODIURIL 50MG) prescribed and dispensed.

acceptable labeling: HYDRODIURIL 50MGor

HYDRODIURIL 50MG (Merck)

B. Generic name (e.g.: HYDROCHLOROTHIAZIDE 50 MG) prescribed and the Merck product is dispensed.

acceptable labeling: HYDROCHLOROTHIAZIDE 50MGor

HYDROCHLOROTHIAZIDE 50MG (Merck)or

HYDROCHLOROTHIAZIDE 50MG (HYDRODIURIL)or

HYDRODIURIL 50MGor

HYDRODIURIL 50MG (Merck)

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3a) Brand name (e.g.: HYDRODIURIL 50MG) prescribed and generically equivalent drug authorizedby physician and patient, generically equivalent drug (e.g.: ESIDRIX 50MG) dispensed.

acceptable labeling: ESIDRIX 50MGor

ESIDRIX 50MG (generic equivalent of HYDRODIURIL)or

ESIDRIX 50MG (generic interchange of HYDRODIURIL)or

ESIDRIX 50MG (generic for HYDRODIURIL)or

ESIDRIX 50MG (gen. For HYDRODIURIL)or

ESIDRIX 50MG (sub. For HYDRODIURIL)

non-acceptable labeling: HYDRODIURIL 50MGor

HYDRODIURIL 50MG (generic)or

HYDRODIURIL 50MG (ESIDRIX)or

ESIDRIX 50MG (HYDRODIURIL)or

ESIDRIX 50MG (same as HYDRODIURIL)

3b) Brand name (e.g.: DARVON 65MG) prescribed, generically equivalent drug authorized by patientphysician, generic drug (e.g.: PROPOXYPHENE HCL 65MG by ESI/Lederle) dispensed.

Acceptable labeling: PROPOXYPHENE HCL 65MGor

PROPOXYPHENE HCL 65MG (ESI/Lederle)or

` PROPOXYPHENE HCL 65MG (generic equiv. of DARVON)or

PROPOXYPHENE HCL 65MG (generic for DARVON)or

PROPOXYPHENE HCL 65MG (gen. for DARVON)or

PROPOXYPHENE HCL 65MG (sub. for DARVON)or

PROPOXYPHENE HCL 65MG (generic interchange of DARVON)or

ESI/Lederle PROPOXYPHENE HCL 65MG (gen. equiv. of DARVON)or

ESI/Lederle PROPOXYPHENE HCL 65MG (generic interchange of DARVON)

non-acceptable labeling: DARVON 65MGor

DARVON 65MG (generic) orDARVON 65MG (ESI/Lederle)

orDARVON 65MG (PROPOXYPHENE HCL)

orDARVON 65MG (Lederle PROPOXYPHENE HCL)

orPROPOXYPHENE HCL 65MG (Same as DARVON)

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NOTE: BRAND NAMES AND CORPORATE NAMES ARE USED FOR INFORMATIONALPURPOSES ONLY AND DO NOT IMPLY AN ENDORSEMENT BY THE STATE OF ILLINOIS.

In all cases of drug product selection, the label must clearly indicate that a product other than thatprescribed has been dispensed. The examples provided above designated “acceptable” would not renderthe product misbranded, nor would they infringe the trademark of the prescribed product.

V. Penalties:

Sections 2 of Public Acts 80-976 and 82-237, dealing with prescription requirements, amend thePharmacy Practice Act of 1987. Penalties as provided in the Pharmacy Practice Act thus apply to applicableportions of the Drug Product Selection Program. Failure to comply with Illinois laws and regulationsconcerning drug product selection may result in consideration of pharmacists’ or pharmacies’ licensesuspension or revocation actions by the State Board of Pharmacy.

VI. Relationship to the Public Aid Drug List:

The Illinois Formulary is not to be confused with the Illinois Department of Public Aid (IDPA) List ofReimbursable Drug Products, also known as the “Drug Manual” or the “Provider Bulletin.” The list of drugproducts reimbursable by the Department of Public Aid Medicaid Drug Program contains many additionalproducts to those in the Illinois Formulary. When the drug entity is included in the Illinois Formulary, thepharmacist must use the formulary when practicing drug product selection for prescriptions dispensed toclients of the Department of Public Aid. However, when equivalent products are not in the Illinois Formularyand the pharmacist wishes to dispense a lower cost product than the brand prescribed in order to meetPublic Aid’s maximum reimbursement (MAC) limits, the permission of the prescriber must be obtained todispense anything other than the product originally prescribed. As with prescriptions reimbursed from othersources, the pharmacist must properly document that the prescriber has authorized the dispensing of a non-formulary generic equivalent.

VII. Liability:

Many experts have testified that pharmacist and physician liability is not increased by state drugproduct selection programs in spite of claims of some major manufacturers. In support of this concept, mostliability insurance rates have not increased due strictly to DPS legislation. The legislation in Illinoisspecifically states that pharmacists and physicians incur no increase in liability for permitting or practicingdrug product selection in accordance with applicable statutes and regulations. To date, no pharmacists orphysicians are known to have been involved in litigation pertaining to the good faith practice of DPS inIllinois.

VIII. Criteria for Drug Product Inclusion:

Many factors concerning the product, its clinical history, the manufacturer, bioequivalence testing,stability testing, etc., are taken into consideration by the program staff and Council in determining the listingof products. In short, a conservative policy is followed in which positive data supporting equivalency isrequired for listing rather than simply the lack of negative information. Some of the basic criteria which alldrugs must meet are as follows:

A. Possess a federally approved New Drug Application (NDA), Abbreviated New DrugApplication (ANDA), paper NDA, or Antibiotic Form 5 or 6. (Exception possible via Section790.60)

B. Safety and Efficacy requirements met.

C. Compendial and Good Manufacturing Practices (GMO) requirements met.

D. Listed or approved for listing in the “Orange Book” and recommended by the FDA for DPSuse.

E. Bioequivalency, bioavailability, and stability issues satisfied when known to be a problemor potential problem. This includes meeting “proposed” bioequivalence standards.

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F. Classified as prescription-only products.

G. Have pharmaceutically equivalent products available meeting all criteria from two or moremanufacturers or equivalent products available under different names from the samemanufacturer.

IX. Criteria for Drug Product Exclusion:

Basic categories for which products have been excluded are as follows:

A. Marketed under “Grandfather” clauses (i.e., originally marketed before 1938) without anapproved application or lacking an approved application for any other reason. (Exceptionpossible via Section 790.60)

B. Under review by the Drug Efficacy Study Implementation (DESI) program or under the“EXEMPT” status of Judge William Bryants’ “Paragraph XIV” decision of October 11, 1972.

C. Not cleared of bioequivalence, bioavailability, or stability issues.

D. Not meeting pharmaceutical equivalence criteria.

E. Available only under one marketing name by a single manufacturer.

F. Enteric coated oral dosage forms subject to absorption difference.

G. Suppositories for systemic absorption (vs. local effect).

H. Injectable suspensions other than antibiotics.

I. Aerosol or nebulizer products with inequivalent delivery systems.

J. Products having drug standards issues.

K. Nonlegend “OTC” products, diagnostic aids, nutritional supplements, and medical devices.(See page vii for an explanation of drug product selection for OTC Prescriptions.)

Upon a majority vote of the assembled members of the Technical Advisory Council, criteria forproduct inclusion or exclusion may be waived. Further information concerning criteria for drug inclusion canbe found in the Rules and Regulations section.

X. Pharmaceutical Equivalence:

Products are not listed unless two or more pharmaceutically equivalent products are approved forDPS use. Interchange can only take place between pharmaceutically equivalent products. The productsmust contain the same active ingredients which vary in labeled dosage strength by no more than 1%, mustbe identical in dosage form and route of administration, and must be formulated to meet the same orcomparable drug standards.

Thus, even though some products may contain the same strength of the same active ingredient, thefollowing pharmaceutical alternatives cannot be interchanged: tab/cap, chew tab/tab, solution/suspension,ointment/cream, elixir/syrup, etc.

In some cases the strengths have not been listed (e.g., antibiotics and multiple strength injectables)and the pharmacist must consider only products of equal strengths. Likewise, injectable oil solutions shouldonly be interchanged when the identical type of oil is used as a vehicle in both products.

Some individual products (especially creams, ointments, ophthalmic solutions) may be excluded ifthey contain enough variance in their vehicle ingredients to cause a potential problem with therapeuticequivalency.

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XI. Therapeutic Equivalence:

There have been varying opinions relative to the relationship between pharmaceutical andtherapeutic equivalence. Unless there is any research or clinical experience to cause reevaluation of thefollowing concept for a particular product, the policy of the federal Food and Drug Administration is accepted.Following is a section entitled “General Policies Governing The List” which is reprinted from the preface tothe FDA publication, Approved Drug Products With Proposed Therapeutic Equivalence Evaluations,January, 1979:

“The fundamental policy governing this list is that the FDA considerspharmaceutically equivalent drug products to be therapeutically equivalent providing theyare approved for both safety and effectiveness, are manufactured in accordance withCurrent Good Manufacturing Practice Regulations, meet the same or equivalent standards,and, in those instances where positive evidence of bioavailability is necessary, are shownto be bioequivalent to an appropriate standard. The Agency believes this policy to beconsistent with the prevailing opinion of experts and with general experience in themarketplace through the years.

“The Agency has considered, and rejected, the option of requiring in vivobioavailability studies for every product. Such a policy would result in the testing in humansof a large number of products for which there is no evidence of a bioavailability problem,and would thereby waste the nation’s clinical reason, the FDA has elected under itsbioavailability and bioequivalence regulations to confine in vivo testing of products forbioavailability to those particular drugs for which such testing is scientifically and medicallynecessary. The FDA has also considered, and rejected, the options of evaluating fortherapeutic equivalence, drugs legally marketed without approved applications and drugsstill under review in the DESI process. Although such products are required to bemanufactured under the Current Good Manufacturing Practice Regulations and to meetUSP or other official specifications, the effectiveness of the active ingredient or combinationof ingredients in these products has not been fully evaluated. The Agency is not proposingto evaluate the therapeutic equivalence of products when the basic issue of theireffectiveness is still in doubt.

“In considering the therapeutic equivalence of drugs with known or potentialbioavailability problems, the Agency has followed a policy of evaluating as therapeuticequivalents only those products that have met current requirements (in vivo testing inhumans, in vitro dissolution rate requirement, or both, depending on the drug). Whenbioavailability or bioequivalence requirements are newly established, there is a transitionperiod during which all manufacturers are permitted to submit information regarding theirproducts. For this reason some manufacturers whose products may not have yet met therequirement are still legally marketed.

“The FDA emphasizes that the decision not to evaluate certain pharmaceuticallyequivalent products as therapeutically equivalent does not necessarily imply that suchproducts are known to be inequivalent. In most cases, lack of necessary informationsupporting therapeutic equivalence, not positive information of inequivalence, is theunderlying reason for the decision.”

This federal policy was further defined in the Third Edition of the FDA publication, Approved PrescriptionDrug Products with Therapeutic Equivalence Evaluations, 4th Edition, 1983.

“Drug products considered to be therapeutic equivalents are pharmaceuticalequivalents and can be expected to have the same therapeutic effect when administeredto patients under the conditions specified in the labeling. The concept of therapeuticequivalence, as used in developing the list, applies only to products containing the sametherapeutic agents used for the same disease (e.g., propoxyphene hydrochloride andpentazocine hydrochloride for the treatment of pain). FDA evaluates as therapeuticallyequivalent those drug products that meet the following general criteria: (1) They are in thesame dosage form, and (b) meet compendial or other applicable standards of identity,

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strength, quality, and purity; (2) They are bioequivalent in that (a) they do not present aknown or potential bioinequivalence problem, or (b) if they do present such a known orpotential problem, they are shown to meet an appropriate bioequivalence standard; (3)They are adequately labeled; (4) They are manufactured in compliance with Current GoodManufacturing Practice regulations.

“FDA considers drug products to be therapeutically equivalent if they meet thecriteria outlined above, even though they may differ in certain other characteristics, e.g.,color, flavor, packaging, preservatives, expiration time and minor aspects of labeling. Whensuch differences are important in the care of a particular patient, it is appropriate for theprescribing physician to require that a particular brand be dispensed as a medical necessity.As long as this consideration is met, however, FDA believes that products consideredtherapeutically equivalent can be substituted with the full expectation that the substitutedproduct will product the same therapeutic effect as the prescribed product.”

XII. Formulary Format:

Official Drug Name - Along the left hand margin of te drug list is found each drug entityindicated b the official drug name or generic name in upper case letters, alphabetized and underlined.Under the entity heading is first listed the products marketed under the generic name followed by theproducts marketed by a brand name. Appropriate cross references have been included for multiple activeingredient drug entities.

Dosage Forms and Strengths - In the center column are found the dosage forms anddosage strengths which have been approved for drug product selection within that entity grouping. Thedosage form listed is the form as received by the pharmacist.

Application Holders, Manufacturers - The third column lists the approved federalapplication holder which, usually, is also the manufacturer. In many cases, particularly for thosecorporations listed in the generic section, there will be multiple distributors for each manufacturer, whomarket the product under the generic name and/or various trade names. All such distributors and productsare approved by extension provided that the manufacturer is approved.

In order to use a product for drug product selection, pharmacists must be aware of the actualmanufacturer of the product either through label disclosure or information supplied by distributors. Thenames of application holders who are known to be solely repackers have been enclosed in parentheses forthe information of the practitioner.

Abbreviations Used -equivalent eqgram gmhydrochloride HCIInternational Units I.U.microgram mcgmilligram mgmilliliter mlunits U

In addition, simplified or abbreviated versions of company names have been used under themanufacturing heading.

XIII. Interchange of Prescriptions for Nonlegend (OTC) Drug Products:

Public Act 82-237 formally granted Illinois pharmacists the discretion to interchange prescriptionsfor nonlegend drug product, provided that the same dosage form would be dispensed and there would beno greater than a 1% variance in the labeled amounts of the products’ active ingredients. As with anyinstance of generic interchange, the prescription record should be properly documented tot note the nameand manufacturer of the product dispensed.

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XIV. Manufacturers’ Petitions for Product Inclusion; Review of Products:

In accordance with the provisions of Public Act 92-112, manufacturers must submit their productsfor consideration of inclusion in the Illinois Formulary. The Department no longer automatically reviewsproducts subject to a federal NDA or ANDA for listing in the Illinois Formulary. Information on newgeneric products must be provided to the Department by the pharmaceutical company. Forms andprocedures for accurate preparation of the detailed information may be found athttp://www.idph.state.il.us/about/fdd/submission_form.pdf on the Department’s website. Such informationis then forwarded to the Technical Advisory Council for review and recommendations. From time to time,it is necessary to request additional supportive information from manufacturers to complete the review ofa particular product. These requests are handled on a case by case basis by Department staff.

The Technical Advisory Council’s determination of ‘issues’ related to the practice of medicine or thepractice of pharmacy’ temporarily halts a product’s entry into the Illinois Formulary pending a meeting of theCouncil and, if necessary, a hearing before an Administrative Law Judge in accordance with P.A. 92-112.

Supplements and revisions to the Illinois Formulary are printed and distributed to Illinois’pharmacies, as well as other interested parties in accordance with the rules of the program. Subscriptionsto the Illinois Formulary are also available.

XV. FDA MedWatch Medical Products Reporting Program:

The United State Food and Drug Administration coordinates a practitioner reporting system aimedat improving product quality and voluntarily communicating health hazards and serious adverse events toindustry and government. The reporting program works simply and efficiently. Reporting can be done eitherby stating the problem in writing, by calling the toll-free number 1-800-FDA-1088, by facsimile at1-800-FDA-0178, by modem at 1-800-FDA-7737, or online at www.accessdata.fda.gov/scripts/medwatch/via the Internet.

Reports are acknowledged by the FDA. Copies of each report are forwarded to the manufacturerby the FDA. The reporter may be contacted by the FDA , the manufacturer, or both for additional informationor with their respective evaluations of the observations.

Basically, anything considered to be a problem should be reported. Because the user is the bestperson to judge what constitutes a product problem in a particular situation, and because the type of problemwill vary with the user, no attempt is made to limit or define what constitutes a product problem.

Drug problems include the entire spectrum of problems that might be noted when a drug productis received, used, or dispensed. Examples of packaging and labeling complaints might be: carton does notprotect the inner container; container does not protect the product; wrong or deficient label; or inadequatepackage insert information. Examples of evidence of poor pharmaceutical quality in the drug productsthemselves might be: broken, crumbling or imperfectly manufactured dosage forms, foreign or particulatematter present; drug solid does not reconstitute properly; off color or off taste; etc. Products havingquestionable bioavailability and stability may also be reported. The program is not limited to prescriptiondrugs, so problems on both prescription and over-the-counter drug products can be reported. Regardingthe latter, many pharmacists have utilized the program to report problems experienced and discussed byconsumers.

Serious adverse events include outcomes involving a patient’s death, life threatening situations,hospitalization (initial or prolonged), disability, congenital anomalies, or intervention efforts to preventpermanent impairment or damage, resulting from the use or consumption of a medical product.

In addition, your suggestions for improvements indicated by reported problems are always welcomeby FDA.

All reports are computerized for trend analysis. The data base created from these reports can beanalyzed by product, manufacturer, or problem. This information is utilized by the FDA to identify anyindustry-wide problems or trends, and to call attention to specific product problems.

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For further information concerning the MedWatch Program, pharmacists and physicians maycontact:

MedWatch Product Reporting Program, United States Food and Drug Administration, 5600 FishersLane, Rockville, MD 20852-9787, Toll-free (800) FDA-1088, facsimile (800) FDA-0178, modem(800) FDA-7737 or online at www.fda.gov/medwatch/safety.htm via the Internet. A sample postage-paidform for use with this program appears on pages xv and xvi.

XVI. Program Information:

Requests for further information concerning the Drug Product Selection Program should be directedto:

Manager, Drugs and Medical Devices Programs, Illinois Department of Public Health, Office ofHealth Protection, Division of Food, Drugs and Dairies, 525 West Jefferson Street, Springfield, IL62761-0001, Telephone (217) 782-7532, facsimile (217) 782-0943, or via e-mail to rgottric@idph.state.il.us.

XVII. Topical Ocular Pharmaceutical Agents for use by Certified Optometrists

Effective December 1, 1985, the Department of Professional Regulation has designated eight topicalocular pharmaceutical agents which certified optometrists may use in their practices for examinationpurposes. These agents are:

Proparacaine HCI (0.5%)Benoxinate HCI (0.4%)Tropicamide (0.5% and 1.0%)Cyclopentolate HCI (0.5% and 1.0%)Atropine Sulfate (ointment) (0.5%)Homatropine (2.0% and 5.0%)Pheylephrine HCI (2.5%)Hydroxyamphetamine Hydrobromide (1.0%)

Public Act 89-0140 amended te Optometric Practice Act to allow certified optometrists to prescribe”therapeutic ocular pharmaceutical agents” effective January 1, 1996. For purposes of the Act, “therapeuticocular pharmaceutical agents” means the following when used for diagnostic or therapeutic purposes:

Topical anti-infective agentsTopical anti-allergy agentsTopical anti-glaucoma agentsTopical anti-inflammatory agentsTopical anesthetic agentsOver-the-counter agentsNon-narcotic oral analgesic agentsMydriatic reversing agents

To date, many optometrists have met necessary requirements and have been certified to use theseagents and may purchase or prescribe them from any Illinois licensed pharmacy. Such certified optometristshave been issued certification numbers. Pharmacists wishing to confirm an optometrist’s number prior tofilling an order may call the Department of Professional Regulation’s Information Center at (217) 782-8556.Pharmacists may also soon be able to verify the certification of optometrists for prescribing of topical ocularpharmaceutical agents and therapeutic ocular pharmaceutical agents at the Internet website of theDepartment of Professional Regulation, www.dpr.state.il.us, utilizing the link entitled “License Lookup.”

Additions to this list of approved topical ocular pharmaceutical agents and therapeutic ocularpharmaceutical agents will be communicated to pharmacists in Illinois through future editions andsupplements of the Illinois Formulary.

"AUTHORIZED GENERIC" PHARMACEUTICAL PRODUCTS

An ongoing trend in pharmaceutical marketing has proven to be very confusing to Illinois pharmacists,physicians and consumers: Brand name drug manufacturers have introduced "authorized generic" versionsof their own branded products prior to or after the expiration date of the patents of their brand nameproducts. These brand name drug manufacturers are not obligated to submit Abbreviated New DrugApplications (ANDAs) to the FDA in order to market these "authorized generics." These "authorized generic"products are manufactured under the original FDA approved New Drug Application (NDA) which themanufacturer holds for their innovator branded drug product. In these instances, pharmacists' use of the"authorized generic" version is not an issue of drug product selection in that the "authorized generic" andthe innovator product are, in fact, one and the same entity (even though they may have differentappearances). They have exactly the same formulation; active ingredients and excipients are identical incomposition and quantity (although, obviously, imprint markings are different). Therefore, these "authorizedgeneric" drug products may be dispensed when the pharmacist receives a prescription for their innovatorbranded counterparts, as soon as they are available, whether or not they appear in the current edition of theIllinois Formulary.

The pharmacist should follow the prescriber's intent when determining whether it is appropriate to dispensean innovator's "authorized generic" product. If the prescription is marked "MAY NOT SUBSTITUTE," thepharmacist should proceed to dispense the originally prescribed brand name (even though the innovator's"authorized generic" is identical in formulation). Should the pharmacist desire to dispense the innovator's"authorized generic" in place of the brand name drug product when the prescription has been marked "MAYNOT SUBSTITUTE," the prescriber should be contacted to obtain a new prescription and the original,undispensed written prescription should be destroyed. This ensures that the prescriber is made aware ofthe unusual circumstance involving an identical formulation, with identical bioavailability and therapeuticequivalency, from a product having a different appearance than that of the originally prescribed brand namedrug, particularly when the prescriber is later inspecting containers of medications dispensed to their patient.

The Illinois Formulary only lists actual drug manufacturers and FDA application holders. When a brandname manufacturer creates a subsidiary or contracts with another labeler to market "authorized generic"versions of their branded products under another name, the subsidiary and/or other labeler are considereddistributors. These "authorized generic" distributors are actually neither manufacturers, nor FDA applicationholders.

The following footnote appears in the Illinois Formulary to assist the pharmacist in identifying innovatorcompanies who market their own "generic" drug product under a previously FDA approved NDA:

*Products manufactured by this brand name manufacturer in this drug entity are availablefor drug product selection under other brand and/or generic names.

In order for the pharmacist to correctly understand the true source of an "authorized generic" product, it isthe brand name pharmaceutical manufacturer's obligation to be candid in the identification of the product'smanufacturer. Many companies have notified pharmacists that they are the actual manufacturer of"authorized generics" distributed by their own subsidiaries or other labelers. Promotional materials,advertising and product labeling will often identify the "authorized generic" product's actual manufacturer.Some "authorized generic" products are not clearly labeled, however. This omission of full disclosurecreates confusion for the pharmacist attempting to practice drug product selection in accordance with theIllinois Formulary.

Pharmacists may feel free to use the "authorized generics" as soon as they are marketed, since the use ofthese products does not constitute drug product selection. These products are one and the same as theinnovator. A list of "authorized generics" known to be marketed appears on the next page.

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"AUTHORIZED GENERICS"

Actigall - Novartis’ “authorized generic” by GenevaAldactone - Searle/Pharmacia’s “authorized generic” by GreenstoneAldomet - Merck's "authorized generic" by West PointAldoril - Merck's "authorized generic" by West PointAnsaid - Pharmacia's "authorized generic" by GreenstoneAtivan - Wyeth-Ayerst’s “authorized generic” by ESI/LederleAtrovent - Boehringer Ingelheim’s “authorized generic” by RoxaneBetagan - Allergan's "authorized generic" by Schein/PacificBlocadren - Merck's "authorized generic" by West PointCalan SR - Searle/Pharmacia's "authorized generic" by Zenith (BASF)Calcimar - Aventis’ "authorized generic" by ArcolaCarafate - Aventis’ “authorized generic” by Blue Ridge/AventisCardizem - Aventis’ "authorized generic" by Blue Ridge/AventisCataflam - Ciba/Novartis’ “authorized generic” by GenevaCeclor - Lilly's "authorized generic" by STC/MylanCleocin T - Pharmacia's "authorized generic" by Greenstone Clinoril - Merck's "authorized generic" by West PointClomid - Aventis’ "authorized generic" by Blue Ridge/AventisCordarone - Novartis’ “authorized generic” by GenevaCorgard - Bristol-Myers Squibb's “authorized generic” by ApotheconCortisporin - Monarch/King’s “authorized generic” by FalconDarvocet-N 100 - Lilly's "authorized generic" by STC/MylanDarvon - Lilly's "authorized generic" by STC/MylanDarvon Compound 65 - Lilly's "authorized generic" by STC/MylanDaypro - Searle/Pharmacia’s “authorized generic” by GreenstoneDDAVP nasal spray - Aventis’ “authorized generic” by ArcolaDiabeta - Aventis’ "authorized generic" by CopleyDiprolene AF - Schering’s “authorized generic” by WarrickDitropan - Aventis’ “authorized generic” by Blue Ridge/AventisDiuril - Merck's "authorized generic" by West PointDolobid - Merck's "authorized generic" by West PointDyazide (old formula) - GlaxoSmithKline’s "authorized generic" by PennDyazide (new formula) - GlaxoSmithKline’s "authorized generic" by PennEconopred Plus - Alcon’s “authorized generic” by FalconFiorinal - Novartis’ “authorized generic” by CreightonFiorinal with Codeine - Novartis’ “authorized generic” by CreightonFioricet - Novartis’ “authorized generic” by CreightonFlexeril - Merck's "authorized generic" by West Point

Flumadine - Forest’s “authorized generic” by InwoodFulvicin - Schering’s “authorized generic” by WarrickGrisactin - Wyeth Ayerst’s “authorized generic” by ESI/LederleGrisactin Ultra - Wyeth Ayerst’s “authorized generic” by ESI/LederleHalcion - Pharmacia’s “authorized generic” by GreenstoneHydrodiuril - Merck's "authorized generic" by West PointIndocin SR - Merck's "authorized generic" by West PointIsopto Carpine - Alcon’s “authorized generic” by FalconK-Dur - Schering’s “authorized generic” by WarrickKeflex - Lilly’s “authorized generic” by STC/MylanKlotrix - Bristol-Myers Squibb’s “authorized generic” by ApotheconImdur - Schering/Key’s “authorized generic” by WarrickIsoptin - Knoll/Abbott’s "authorized generic" by Sidmak (BASF)Lac-Hydrin - Bristol-Myers Squibb’s “authorized generic” by ApotheconLevsin SL - Schwarz’ “authorized generic” by Kremers-UrbanLevsinex - Schwarz’ “authorized generic” by Kremers-UrbanLopid - Parke-Davis/Pfizer's "authorized generic" by Warner-ChilcottLopressor - Ciba-Geigy's "authorized generic" by GenevaLotrisone - Schering’s “authorized generic” by WarrickLozol - Aventis’ "authorized generic" by Arcola

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"AUTHORIZED GENERICS"

Maxitrol - Alcon’s “authorized generic” by FalconMellaril - Novartis’ “authorized generic” by CreightonMetaprel - Boehringer's "authorized generic" inhaler by RoxaneMicro-K - Robins’ “authorized generic” by ESI/LederleMicronase - Pharmacia's "authorized generic" by GreenstoneModuretic - Merck's "authorized generic" by West PointMotrin - Pharmacia’s “authorized generic” by GreenstoneM.S. Contin - Purdue Frederick's "authorized generic" by AB Dick/ApotexNitro-Bid - Aventis’ “authorized generic” by Blue RidgeNolvadex - AstraZeneca's "authorized generic" by BarrNorflex - 3M’s “authorized generic” by MylanNorgesic - 3M’s “authorized generic” by MylanNorgesic Forte - 3M’s “authorized generic” by MylanNormodyne - Schering’s “authorized generic” by WarrickNorpramin - Aventis’ “authorized generic” by Blue Ridge/AventisOgen - Ortho/Johnson & Johnson’s “authorized generic” by NorAmCoOruvail - Wyeth-Ayerst’s “authorized generic” by ESI/LederlePamelor - Novartis’ "authorized generic" by CreightonParlodel - Novartis’ “authorized generic” by GenevaPercocet - DuPont's "authorized generic" by EndoPercodan - DuPont's "authorized generic" by EndoPhenergan - Wyeth-Ayerst’s authorized generic by ESI/LederlePlaquenil - Sanofi-Synthelabo’s “authorized generic” by KanettaProcardia XL - Pfizer’s “authorized generic” by MylanPropine - Allergan's "authorized generic" by ScheinProventil - Schering's "authorized generic" by WarrickProvera - Pharmacia’s “authorized generic” by GreenstoneQuinidex - Robins’ “authorized generic” by ESI/LederleReglan - Robins’ “authorized generic” by ESI/LederleRestoril - Novartis’ “authorized generic” by CreightonSilvadene - Aventis’ “authorized generic” by Blue Ridge/AventisSinemet - DuPont's "authorized generic" by EndoSymmetrel - DuPont's "authorized generic" by EndoTagamet - GlaxoSmithKline's "authorized generic" by PennTambocor - 3M’s “authorized generic” by MylanTenuate Dospan - Aventis’ "authorized generic" by Blue Ridge/AventisTessalon - Forest's "authorized generic" by InwoodTylenol with Codeine - Johnson & Johnson’s (OMJ’s) “authorized generic” by PurepacTheo-Dur - Schering's "authorized generic" by WarrickTylenol with codeine - McNeil’s “authorized” generic by Purepac/OMJVentolin Inhaler - GlaxoSmithKline’s “authorized generic” by DeyVoltaren ophthalmic - Ciba/Novartis’ “authorized generic” by GenevaWestcort - Bristol-Myers Squibb’s “authorized generic” by ApotheconXanax - Pharmacia's "authorized generic" by Greenstone

Additionally, Bausch & Lomb’s “authorized generics” by Sight

The Department of Public Health, Division of Food, Drugs and Dairies, will update this list periodically. Ifyou have any questions pertaining to drug product selection, please feel free to call (217) 782-7532.

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____________________ ____________________ ____________________

__________________________________________________

____________________ ____________________ ____________________

PATIENT NAME AGE

ADDRESS

DATE

L

G MAY SUBSTITUTE

G MAY NOT SUBSTITUTE

, M.D.

MAY REFILL TIMES DEA

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(DAW = DISPENSE AS WRITTEN)

2. Outcomes attributed to adverse event(check all that apply)

death __________________

life-threatening

hospitalization - initial or prolonged

3. Sex

female

male

4. Weight

lbsor

A. Patient information

1. Adverse event and/or Product problem (e.g., defects/malfunctions)

7. Other relevant history, including preexisting medical conditions (e.g., allergies,race, pregnancy, smoking and alcohol use, hepatic/renal dysfunction, etc.)

6. Relevant tests/laboratory data, including dates

5. Describe event or problem

1. Patient identifier

Mail to: FAX to: 5600 Fishers Lane 1-800-FDA-0178Rockville, MD 20852-9787

Triage unitsequence #

FDA Use Only

Form Approved: OMB No. 0910-0291 Expires: 04/30/03See OMB statement on reverse

3. Date ofevent

4. Date of this report

2. Health professional?

yes no

4. Also reported to

manufacturer

user facility

distributor

4. Operator of device

5. Expiration date

7. If implanted, give date

8. If explanted, give date

1. Name (give labeled strength & mfr/labeler, if known)

1. Name & address

1. Brand name

2. Type of device

3. Manufacturer name & address

model # ________________________________________

catalog # _______________________________________

serial # _________________________________________

lot # ___________________________________________

other #

9. Device available for evaluation? (Do not send to FDA)

2. Dose, frequency & route used 3. Therapy dates (if unknown, give duration)

5. Event abated after usestopped or dose reduced

yes no doesn'tapply

yes no returned to manufacturer on __________________

health professional

lay user/patient

other:

________________

5. If you do NOT want your identity disclosed tothe manufacturer, place an " X " in this box.

E. Reporter (see confidentiality section on back)

8. Event reappeared afterreintroduction

6. Lot # (if known)

9. NDC # (for product problems only)- -

D. Suspect medical device

C. Suspect medication(s)

from/to (or best estimate)

disability

congenital anomaly

required intervention to preventpermanent impairment/damage

other: ___________________

FDA Form 3500 Submission of a report does not constitute an admission that medical personnel or the product caused or contributed to the event.

#1

#2

#1

#2

#1

#2

4. Diagnosis for use (indication)

#1

#2

In confidence kgs

6.

3. Occupation

10. Concomitant medical products and therapy dates (exclude treatment of event)

10. Concomitant medical products and therapy dates (exclude treatment of event)

B. Adverse event or product problem

7. Exp. date (if known)

#1

#2

#1

#2

For VOLUNTARY reporting ofadverse events and product problems

(mo/day/yr)

#1

#2 yes no doesn'tapply

yes no doesn'tapply#1

#2 yes no doesn'tapply

(mo/day/yr)

(mo/day/yr)

(mo/day/yr)

(mo/day/yr)

Page ____ of ____

2. Age at timeof event:

Dateof birth:

or

(mo/day/yr)

(mo/day/yr)

R U

SE B

LA

CK

IN

KP

LE

ASE

TY

PE

OR

phone #

MEDWATCH

U.S. Department of Health and Human Services

The FDA Safety Information and Adverse Event Reporting Program

MEDWATCH

Report adverse experiences with:• medications (drugs or biologics)• medical devices (including in-vitro diagnostics)•

•

special nutritional products (dietarysupplements, medical foods, infant formulas)cosmetics

• medication errors

Report SERIOUS adverse events. An eventis serious when the patient outcome is:

• death• life-threatening (real risk of dying)• hospitalization (initial or prolonged)• disability (significant, persistent or permanent)• congenital anomaly• required intervention to prevent permanent

impairment or damage

Report even if:• you’re not certain the product caused the

event• you don’t have all the details

Report product problems – quality, performanceor safety concerns such as:

• suspected contamination• questionable stability• defective components• poor packaging or labeling• therapeutic failures

How to report:• just fill in the sections that apply to your report• use section C for all products except

medical devices• attach additional blank pages if needed• use a separate form for each patient• report either to FDA or the manufacturer

(or both)

Important numbers:• 1-800-FDA-0178 to FAX report• 1-800-FDA-1088 to report by phone or for

more information• 1-800-822-7967 for a VAERS form for vaccines

If your report involves a serious adverse eventwith a device and it occurred in a facility outside a doc-tor’s office, that facility may be legally required to report toFDA and/or the manufacturer. Please notify the person inthat facility who would handle such reporting.

The public reporting burden for this collection of informationhas been estimated to average 30 minutes per response,including the time for reviewing instructions, searching exist-ing data sources, gathering and maintaining the data needed,and completing and reviewing the collection of information.Send comments regarding this burden estimate or any otheraspect of this collection of information, including suggestionsfor reducing this burden to:

Please DO NOTRETURN this formto this address.

BUSINESS REPLY MAILFIRST CLASS MAIL PERMIT NO. 946 ROCKVILLE, MD

The FDA Safety Information and Adverse Event Reporting ProgramFood and Drug Administration5600 Fishers LaneRockville, MD 20852-9787

Please Use Address Provided Below – Just Fold In Thirds, Tape and Mail

ADVICE ABOUT VOLUNTARY REPORTING

Department ofHealth and Human ServicesPublic Health ServiceFood and Drug AdministrationRockville, MD 20857

Official BusinessPenalty for Private Use $300

FDA Form 3500-back

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICESPublic Health Service • Food and Drug Administration

DHHS Reports Clearance OfficePaperwork Reduction Project (0910-0291)Hubert H. Humphrey Building, Room 531-H200 Independence Avenue, S.W.Washington, DC 20201

“An agency may not conduct or sponsor,and a person is not required to respond to,a collection of information unless it displaysa currently valid OMB control number.”

MEDWATCH

Confidentiality: The patient’s identity is held in strict confidence by FDA and protected to the fullest extent of the law. FDA will not disclose the reporter’s identity in response to a request from the public, pursuant to the Freedom of Information Act. The reporter’s identity, including the identity of a self-reporter, may be shared with the manufacturer unless requested otherwise.

To Report via the Internet: https://www.accessdata.fda.gov/scripts/medwatch/

RULES AND REGULATIONSILLINOIS FORMULARY for the DRUG PRODUCT SELECTION PROGRAM

(current through December 8, 2000)

Section 790.10 Incorporated Materials

a) The following materials are incorporated by reference in this Part and include no later amendmentsor additions:

1) Section 314.1, Definitions for the Applications for FDA Approval to Market a New Drug,21 CFR 314.3, April 1, 1999.

2) Section 320.1, Definitions for the Bioavailability and Bioequivalence Requirements,21 CFR 320.1, April 1, 1999.

b) Incorporations or references refer o the materials on the date specified and do not include lateramendments or additions.

c) Copies of incorporated or referenced material are available for inspection and copying at theDepartment of Public Health, Office of Health Protection, Division of Food, Drugs and Dairies, DrugProduct Selection Program, 525 West Jefferson Street, 2nd Floor, Springfield, Illinois 62761-0001.

Section 790.20 Introduction

a) The Illinois Food, Drug and Cosmetic Act (Ill. Rev. Stat. 1987, Ch. 56 ½, par. 503.14) allowsinterchange of different brands or nonbrands of the same generic drug entity for a drug productprescribed by a specific trade name. Products selected for interchange must be pharmaceuticallyequivalent to the prescribed product and must be listed in a positive drug product formulary knownas the Illinois Formulary which has been developed, maintained and issued by the Illinois Departmentof Public Health (hereinafter referred to as the "Department"). The practice of selecting an equivalentdrug product from the Illinois Formulary to dispense instead of the trade name product prescribed isknown as Drug Product Selection (DPS).

b) The initial issue of the Illinois Formulary for use in Drug Product Selection became effective onJuly 1, 1978. Periodic updates to the Illinois Formulary will be distributed by the Department of PublicHealth. Single copies of the Illinois Formulary shall be provided to all licensed pharmacies withIllinois addresses. Upon request, single copies of the Illinois Formulary will be provided, at nocharge, to licensed prescribers, pharmacists practicing their profession in Illinois, to pharmacistsseeking reciprocation, students enrolled in a pharmacy curriculum at the University of Illinois atChicago, College of Pharmacy, the Chicago College of Pharmacy, St. Louis College of Pharmacy,students enrolled out-of-state in a college of pharmacy who seek a pharmacist licensure in the Stateof Illinois, or students enrolled in a pharmacy technician program.

c) The Department shall make available to other interested parties a subscription to the IllinoisFormulary and its revisions at a fee of $50.00 per year. All subscription fees collected by theDepartment shall be deposited into the Food and Drug Safety Fund.

Section 790.40 Consideration of Drug Products for Inclusion in the Illinois Formulary

a) Drug products for inclusion in the Illinois Formulary shall be approved and recommended to theDirector of Public Health, by a Technical Advisory Council according to the notice and hearingprovisions of this Section. The Council is composed of 7 members, each of whom has extensiveexperience in pharmaceutical affairs. Products for Council consideration shall be researched andpresented by Department staff following consideration of recommendations by the federal Food andDrug Administration (FDA), of recognized drug reference sources, of published research, and ofqualified consultants.

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b) No product shall be considered for inclusion in the Illinois Formulary unless each individual dosageform, dosage strength and manufacturer has been recommended for drug product selection use bythe FDA. Each product considered must be verified by the FDA as being marketed under currentlyapproved drug applications, as meeting required manufacturing standards and chemical identitystandards, and as being cleared of any issues involving the bioequivalence or bioavailability of theproduct. Prior to being sanctioned for DPS use, the product must pass FDA criteria specific for DPSapproval which may be more stringent than that required for general marketing approval.“Bioequivalence” and “bioavailability” have the meanings prescribed under 21 CFR 320.1,April 1, 1999.

c) Generic Drug Products.

1) Drug products previously approved by the Technical Advisory Council for generic interchangemay be substituted in the State of Illinois without further review subject to the conditions ofapproval in the State before September 1, 2000 (the effective date of Public Act 91-766).(Section 3.14 of the Illinois Food, Drug and Cosmetic Act [410 ILCS 620/3.14]). Drug productsrequiring approval by the Council on or after September 1, 2000, for generic interchange aresubject to the notice and hearing provisions of this Section.

2) If not subject to a hearing under subsection (c)(5) or if not specifically prohibited, then genericdrug products determined to be therapeutically equivalent by the FDA shall be available forsubstitution in this State no sooner than 60 days after the submission of the prescribednotification under subsection (d) to the Council. "Therapeutic equivalence" has the meaningprescribed under the current edition or supplement of the FDA’s "Approved Drug Products withTherapeutic Equivalence Evaluations".

3) Manufacturers of the generic drug products shall submit to the Council the notificationdescribed in subsection (d) at least 60 days before the scheduled substitution of the drugproduct. During the 60-day notification period, the Council shall determine, based upon apreponderance of the evidence, whether the generic drug product has issues related to thepractice of medicine or the practice of pharmacy.

4) If the Council determines that the generic drug product does not have issues related to thepractice of medicine or pharmacy, then the Council shall issue its recommendation of approvalof the generic drug product to the Director. If included on the Drug Products SelectionFormulary by the Director under subsection (f), then the drug product may be substituted inthe State after the 60-day notification period, the date of the Director’s approval, or the dateof the product’s full approval for safety and efficacy by the FDA, whichever date is later.

5) If the Council determines that the generic drug product has issues related to the practice ofmedicine or pharmacy, then:

(A) a hearing on the drug product shall be held under subsection (e) at the Council’s nextregularly scheduled meeting;

(B) the Council’s hearing determination shall be reviewed by the Director under subsection(f); and

(C) the drug product may not be substituted in the State unless included in the DrugProducts Selection Formulary by the Director.

d) The 60-day notification shall be submitted in writing to the Technical Advisory Council at the followingaddress:

Administrator, Drug Product Selection ProgramIllinois Department of Public HealthOffice of Health ProtectionDivision of Food, Drugs and Dairies525 W. Jefferson Street Springfield, Illinois 62761-0001

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1) The notification to the Council shall consist of 9 complete copies of all the following items:

(A) All testimony (plus one copy of the testimony that has individual identifying informationredacted) and data upon which comment or reference to may be made, whetherpublished or unpublished.

(B) The drug product’s technical bioequivalence and therapeutic equivalence information,including documentation of the required testing to support FDA product approval.

(C) The information required in subsection (b).

2) The Department shall notify all other manufacturers of products within a specific generic entitythat a hearing will be held on the drug product. The notification may be posted on theDepartment’s Internet Website at www.idph.state.il.us. These manufacturers shall provide 9copies of all testimony (plus one copy of the testimony that has individual identifyinginformation redacted) and 9 copies of all data upon which comment or reference to may bemade, whether published or unpublished, in writing to the Department within 30 days beforethe regularly scheduled meeting should they wish to be heard on the specific issue at theCouncil meeting. Nine copies of all rebuttal comments from any concerned manufacturer shallbe submitted in writing to the Department within 14 days after the regularly scheduled meeting,should a company wish to respond to its competitor's submission.

e) The Director may designate an individual to conduct the hearing and make a recommendation to theCouncil on a generic drug product that has issues related to the practice of medicine or pharmacy.The Council shall make the final recommendation. Hearings shall be conducted according to theRules of Practice and Procedure in Administrative Hearings (77 Ill. Adm. Code 100) under Article 10of the Illinois Administrative Procedure Act [5 ILCS 100/Art. 10]. Determinations shall beaccompanied by a written detailed explanation of the decision’s basis. The Council shall make itsrecommendation of approval or disapproval of the generic drug product to the Director within 20business days after the public hearing.

f) After the Council’s recommendation for approval or disapproval of the drug product is submitted tothe Director, the Director may approve or prohibit the drug product’s inclusion in the Drug ProductsSelection Formulary. Only if the Director decides that, based upon a preponderance of the evidence,the generic drug is not bioequivalent, is not therapeutically equivalent, or could cause clinicallysignificant harm to the health or safety of patients, may the Director prohibit the drug product frominclusion in the formulary. The Director’s decision to prohibit a drug product from inclusion in theformulary shall be accompanied by a written detailed explanation of the decision’s basis. Decisionsunder this subsection constitute a final administrative decision within the meaning of Section 22.2 ofthe Illinois Food, Drug and Cosmetic Act [410 ILCS 620/22.2] and Section 3-101 of the AdministrativeReview Law [735 ILCS 5/3-101] and are subject to judicial review under Article III of theAdministrative Review Law [735 ILCS 5/Art. III].

g) Exclusive indications and unique product packaging, whether patented or unpatented, do notconstitute criteria for inclusion of a drug entity in the Illinois Formulary.

Section 790.60 Additional Criteria

Additional criteria may be adopted as needed by the Department upon the recommendation of the TechnicalAdvisory Council to further define the parameters for drug product inclusion. Individual exceptions to any criteriamay be made upon a majority vote of the assembled Council members and such exceptions must be noted in theIllinois Formulary.

Section 790.80 Quality Listing

a) The Illinois Formulary is a quality listing of generically equivalent drug products approved formarketing and is based upon the criteria as found in these Rules and Regulations. The listing is notaffected by costs or by current or pending litigation against a particular drug product. As an aid tousers of the formulary, an informational footnote will be placed with an entity listing whenever the

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Department receives substantive evidence of litigation involving the product(s). Products will bedeleted from the formulary listing whenever FDA regulatory processes or other legal action resultsin a loss of the product's marketing approval or availability.

b) The names of application holders who are known to be solely repackers will be enclosed inparentheses for the information of the practitioner.

c) Products discontinued from marketing or products which have their approval withdrawn for reasonsother than safety and efficacy, will be noted by the symbol "@" preceding the dosage form. Thissymbol designates their non-marketed status and notifies practitioners that the specificmanufacturer's product may be in short supply. The "@" notation does not change the drug productselection status of the drug entity. Products approved and listed for interchange may be used untiltheir supply is exhausted.

Section 790.100 Generic Drug Entity Headings

The formulary consists of generic drug entity headings in alphabetical order. Within the entity grouping is indicatedthe individual product's marketed name, dosage form and dosage strength. The manufacturer listed is the firmholding the FDA approved drug application for the product. Listed products remain approved for DPS use whendistributed under the label of another manufacturer.

Section 790.120 Comments and Specific Administration

Comments and specific information regarding drug products either listed or under consideration for formularyinclusion will be accepted by the Department at any time for due consideration. Inquiries or comments should bedirected to:

Administrator, Drug Product Selection ProgramIllinois Department of Public HealthOffice of Health ProtectionDivision of Food, Drugs and Dairies525 West Jefferson StreetSpringfield, Illinois 62761

Section 790.140 Requests for Additional Copies

Requests to receive additional copies of the formulary or for changes to the recipient mailing list should be sent tothe address in Section 790.120.

Section 790.160 Prescription Use of Drug Products

Drug products included shall be primarily for prescription use outside of the inpatient institutional setting. Excludedare nonprescription drugs, diagnostic aids, nutritional supplements and medical devices.

Section 790.180 FDA Drug Product Approval and Recommendation

Drug products included shall have been approved and recommended for DPS use by the FDA and listed in apublication of approved drug products distributed by the FDA for use in state programs. All products must haveeither a New Drug Application (NDA), Abbreviated New Drug Application (ANDA), or Antibiotic Form 5 or 6Application approved by the FDA under the provisions of Sections 505 and 507 of the Federal Food, Drug andCosmetic Act (21 U.S.C.A. 301 et seq.). All products have been certified by the FDA as safe and effective for theirlabeled use, meet current compendial and Good Manufacturing Practices (GMP) requirements, and have met theapplicable bioavailability and bioequivalence criteria of the FDA.

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Section 790.200 Availability of Drug Products; Pharmaceutical Equivalence

Drug products included must be available from more than one approved manufacturing source unless otherwisenoted. Drug products listed must be pharmaceutically equivalent to at least one other drug product under the sameentity listing. Drug products are pharmaceutically equivalent if they contain the same active ingredients, are identicalin dosage form and route of administration, are formulated to meet the same or comparable standards and vary inlabeled dosage strength by no more than 1%.

Section 790.220 Single Source Drug Products Exclusion

Single source drug products which are available only under a single brand name label shall be excluded. Productswhich have a single source manufacturer, but which may be distributed under multiple labels are listed with awarning for pharmacists to ascertain that the product selected was produced by the approved manufacturer.

Section 790.240 Criteria for Exclusion of Drug Products

Drug products of the following dosage forms for which different brands are not necessarily pharmaceutically andtherapeutically equivalent shall be excluded:

a) Enteric coated tabletsb) Injectable suspensions, other than antibioticsc) Suppositories containing active ingredients for which systemic absorption is necessary for therapeutic

activityd) Different delivery systems for aerosol and nebulizer drugs

Section 790.260 Inclusion of Controlled Substances

Controlled substances listed in Schedule I of the Illinois Controlled Substances Act, (Ill. Rev. Stat., 1983, ch. 56 1-2,par. 1100), shall be excluded. Products in Schedules II, III, IV and V are included provided they meet all other criteriaas set forth in subpart A of this Part.

Section 790.280 Equivalence of Products Requirements

All equivalent products selected by the pharmacist for interchange use must have the product's dosage form, thedosage strength, and the manufacturer listed in the Illinois Formulary as revised. Drug products recommended bythe Technical Advisory Council for inclusion in a formulary revision must not be used for drug product selection untilthe effective date of that revision.

Section 790.300 Selection of Equivalent Drug Products

Even though a prescribed brand name drug product is unlisted, pharmacists may select an equivalent drug productto dispense under Section 790.280 as long as the corresponding generic drug entity with pharmaceutically equivalentdrug products are listed in the Illinois Formulary as revised.

Section 790.320 Transfer of Prescription Records

Pharmacists shall be required to designate the prescriber's original intent concerning drug product selection on everyprescription record transferred to another pharmacy, irrespective of the method of transfer. The receiving pharmacyshall record the prescriber's drug product selection intent on the original prescription record of the transferredprescription.

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NON-INTERCHANGEABLE DRUG PRODUCTS

The following is an incomplete, partial listing of legend multiple-source drug products that are NOT listed in the currentedition of the Illinois Formulary for the Drug Product Selection Program. Illinois pharmacists may not interchangeprescriptions written for these brand-name drug products, even if the prescriber has checked the “MAY SUBSTITUTE”box on the prescription form, without first obtaining a new prescription from the prescriber. This does not apply to“Authorized Generics” (see page x of the 19th Edition of the Illinois Formulary) whereby a pharmaceutical labelermanufactures and markets their own brand name product under a generic label.

Brand name Generic name

ALL Prenatal vitamins with 1mg folic acidACT rinse sodium fluorideAerolate-Jr, -Sr capsules theophylline extended releaseAnaspaz tablets l-hyoscyamineAntabuse tablets disulfiramAnthra-Derm ointment anthralinAnusol-HC suppositories hydrocortisone acetateArlidin tablets nylidrinAristocort tablets triamcinoloneArmour Thyroid desiccated thyroidAventyl capsules nortriptyline hydrochlorideBeclovent aerosol beclomethasone dipropionateBeconase, Beconase AQ aerosol beclomethasone dipropionateBellergal-S tablets belladonna alkaloids, ergotamine tartrate and phenobarbitalBerocca tablets vitamins B with vitamin CBerocca Plus tablets multivitaminsBicillin-LA injection penicillin G benzathineBicitra solution citrate and citric acid solutionsBrethine tablets terbutaline sulfateBricanyl tablets terbutaline sulfateBontril 105 capsules phendimetrazine tartrateBromfed capsules brompheniramine maleate with pseudoephedrine hydrochlorideBronkodyl capsules theophylline immediate releaseButazolidin capsules phenylbutazoneChromagen capsules ascorbic acid, cyanocobalamin, ferrous fumarate, and intrinsic factorCodimal-LA, Codimal-LA Half capsules chlorpheniramine maleate with pseudoephedrine hydrochlorideCol-Benemid tablets colchicine with probenecidConstant-T tablets theophylline extended releaseCortef tablets hydrocortisoneCortone Acetate tablets cortisone acetateCotazyme, Cotazyme-S capsules pancrelipaseCreon 10, 20 capsules amylase, lipase, and proteaseCreon, Creon 25 capsules amylase, lipase, pancreatin, and proteaseCuprimine capsules penicillamineCyclospasmol capsules cyclandelateCystospaz tablets, Cystospaz-M capsules l-hyoscyamineDallergy caplets chlorpheniramine maleate, methscopolamine nitrate, and phenylephrine hydrochlorideDecadron-LA injection dexamethasone acetateDeconamine SR capsules chlorpheniramine maleate with pseudoephedrine hydrochlorideDelta-Cortef tablets prednisoloneDepen tablets penicillamineDeponit patches nitroglycerinDiabeta tablets (not interchangeable with Micronase) glyburideDilatrate-SR capsules isosorbide dinitrateDilaudid tablets 2,3,4mg hydromorphone hydrochlorideDilor tablets dyphyllineDisalcid capsules, tablets salsalateDiupres-250, -500 tablets chlorothiazide with reserpineDonnatal tablets belladonna alkaloids with phenobarbitalDonnazyme tablets pancreatinDrithocreme anthralinDura-Vent/DA tablets chlorpheniramine maleate, methscopolamine nitrate, and phenylephrine hydrochlorideDuratuss GP tablets guaifenesin with pseudoephedrine hydrochlorideDuratuss-G tablets guaifenesin Eldoquin-Forte cream hydroquinoneElixophyllin capsules theophylline immediate releaseElixophyllin SR capsules theophylline extended releaseEntex LA tablets guaifenesin with phenylpropanolamine hydrochlorideEntex PSE tablets guaifenesin with pseudoephedrine hydrochlorideEntozyme tablets pancreatinEpifrin ophthalmic drops epinephrine hydrochlorideEstraderm patch estradiolEstratabs esterified estrogensEthatabs papaverine hydrochloride

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Brand name Generic name

Etrafon tablets amitriptyline hydrochloride with perphenazineExtendryl tablets, Extendryl S.R. capsules chlorpheniramine maleate, methscopolamine nitrate, and phenylephrine hydrochlorideEuthroid tablets liotrixFedahist Timecaps chlorpheniramine maleate with pseudoephedrine hydrochlorideFlorone ointment, Florone, Florone E cream diflorasone diacetateFluorigard rinse sodium fluorideFluorinse sodium fluorideFluoritabs sodium fluorideGel-Kam stannous fluorideGenGraf capsules cyclosporineGlaucon ophthalmic drops epinephrine hydrochlorideGranulderm aerosol balsam peru, castor oil and trypsinGranulex aerosol balsam peru, castor oil and trypsinGuaifed, Guaifed-PD capsules guaifenesin with pseudoephedrine hydrochlorideGuaifenex DX tablets dextromethorphan hydrobromide with guaifenesinGuaifenex LA tablets guaifenesinGuaifenex PSE guaifenesin with pseudoephedrine hydrochlorideHabitrol patch nicotineHalotestin tablets fluoxymesteroneHumibid L.A. tablets guaifenesinHydropres-25, 50 tablets hydrochlorothiazide with reserpineInfed injection iron dextranIsopto Carbachol ophthalmic solution carbacholIsuprel inhaler isoproterenolKaridium tablets, drops sodium fluorideKarigel, Karigel-N sodium fluorideKlotrix tablets potassium chlorideKutrase capsules amylase, protease, lipase, cellulase, hyoscyamine sulfate, and phenyltoloxamine citrateKu-Zyme HP capsules amylase, lipase, and proteaseLasan cream, ointment anthralinLevothroid tablets levothyroxine sodiumLevsin tablets l-hyoscyamineLevsinex capsules l-hyoscyamine extended releaseLibrax capsules chlordiazepoxide hydrochloride with clidinium bromideLipram capsules amylase, lipase, and proteaseLufyllin tablets dyphyllineLufyllin-GG tablets, elixir dyphylline with guaifenesinLuride Lozi-Tabs sodium fluorideMandelamine tablets methenamine mandelateMarax tablets theophylline, hydroxyzine and ephedrineMaxiflor cream, ointment diflorasone diacetateMenest tablets esterified estrogensMescolor tablets chlorpheniramine maleate, methscopolamine nitrate with pseudoephedrine hydrochlorideMetahydrin tablets trichlormethiazideMicronase tablets (not interchangeable with Diabeta) glyburideMidrin capsules acetaminophen, isometheptene mucate and dichloralphenazoneMSIR tablets morphine sulfate immediate releaseNaldecon tablets chlorpheniramine, phenylpropanolamine, phenyltoloxamine, and phenylephrineNaqua tablets trichlormethiazideNicoderm patches nicotineNicotrol patches nicotineNitro-Bid capsules, ointment nitroglycerinNitrodisc patch nitroglycerinNitrostat sublingual nitroglycerinNoctec capsules chloral hydrateNovafed A capsules chlorpheniramine maleate with pseudoephedrine hydrochloride Oracit solution citrate and citric acid solutionsOramorph SR tablets morphine sulfateOreton tablets methyltestosteronePancrease capsules pancreatinPanMist LA tablets guaifenesin with pseudoephedrinePavabid capsules papaverine hydrochloridePedameth capsules methioninePeritrate tablets pentaerythritol tetranitratePermapen injection penicillin G benzathinePhenergan tablets (‘authorized generic’ only) promethazine hydrochloridePhenergan suppositories promethazine hydrochloridePoint-Two rinse sodium fluoridePoly-Histine elixir pheniramine maleate, pyrilamine maleate and phenyltoloxamine citratePoly-Vi-Flor tablets multivitamins with fluoridePoly-Vi-Flor with Iron tablets multivitamins with fluoride and ironPolycitra, Polycitra-LC, Polycitra K solutions citrate and citric acid solutionsPramosone cream, lotion, ointment hydrocortisone with pramoxinePrevident gel sodium fluorideProbanthine tablets propantheline bromideProctoCream-HC hydrocortisone acetate with pramoxine hydrochlorideProctofoam-HC hydrocortisone acetate with pramoxine hydrochloride

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Brand name Generic name

Prostep patches nicotineProventil inhaler (not interchangeable with Ventolin inhaler) albuterolPseudovent PED capsules guaifenesin with pseudoephedrine hydrochloridePyridium tablets phenazopyridine hydrochlorideQuibron capsules theophylline with guaifenesinQuibron-T Dividose theophylline immediate releaseQuibron-T/SR tablets theophylline extended releaseQuinaglute quinidine gluconateRespbid tablets theophylline extended releaseRMS suppositories morphine sulfateRondec, Rondec TR tablets carbinoxamine maleate with pseudoephedrine hydrochlorideRoxanol SR tablets morphine sulfate extended releaseRu-Tuss tablets belladonna alkaloids, chlorpheniramine, phenylephrine, and phenylpropanolamineRu-Tuss DE tablets guaifenesin with pseudoephedrine hydrochlorideRynatan tablets chlorpheniramine tannate, phenylephrine tannate, and pyrilamine tannateSalutensin, Salutensin-Demi tablets hydroflumethiazide with reserpineSer-Ap-Es tablets hydralazine, hydrochlorothiazide and reserpineSlo-Phyllin tablets theophylline immediate releaseSlo-Phyllin Gyrocaps theophylline extended releaseSolaquin-Forte cream hydroquinoneSustaire tablets theophylline extended releaseT-Phyl tablets theophylline extended releaseTheo-24 capsules theophylline extended releaseTheo-Sav tablets theophylline extended releaseTheobid Duracaps theophylline extended releaseTheoclear L.A. capsules theophylline extended releaseTheolair-SR tablets theophylline extended releaseTheospan-SR capsules theophylline extended releaseTheovent capsules theophylline extended releaseThorazine tablets, Spansules chlorpromazine hydrochlorideThyrolar tablets liotrixTiazac capsules diltiazem hydrochlorideTigan capsules, suppositories trimethobenzamide hydrochlorideTri-Vi-Flor tablets vitamins A, D and C with fluorideTrilisate liquid, tablets choline salicylate and magnesium salicylateTrinsicon capsules ascorbic acid, cyanocobalamin, ferrous fumarate, folic acid, and intrinsic factorTuss-Ornade Spansules caramiphen edisylate with phenylpropanolamine hydrochlorideUltrase capsules pancrelipaseUni-Dur tablets theophyllineUniphyl tablets theophylline extended releaseUrised tablets methenamine, belladonna alkaloids, benzoic acid, phenylsalicylate and methylene blueVancenase, Vancenase AQ aerosol beclomethasone dipropionateVanceril aerosol beclomethasone dipropionateVasodilan tablets isoxsuprine hydrochlorideVentolin inhaler (not interchangeable with Proventil inhaler) albuterolVi-Daylin/F tablets multivitamins with fluorideVi-Daylin/F + Iron tablets multivitamins with fluoride and ironVioform-Hydrocortisone cream, ointment clioquinol with hydrocortisoneViokase tablets pancrelipase (amylase, lipase, and protease)Wellbutrin SR 150mg tablet bupropion hydrochlorideX-Trozine L.A. phendimetrazine tartrateZephrex LA tablets guaifenesin with pseudoephedrine hydrochlorideZyban 150mg tablet bupropion hydrochloride

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A REMINDER: Pharmacists may neither solicit nor receive “blanket” authorizations fromphysicians to practice drug product selection on prescriptions issued for brand name products.

APPROVED DRUG PRODUCTS FOR DRUG PRODUCT SELECTIONFourth CUMULATIVE Supplement to the Nineteenth Edition of the Illinois Formulary

(A compilation of all changes made to the 19th Edition up to the April 5, 2002 issuance of the 20th Edition)(First Supplement issued July 1, 2001; Second Supplement issued October 1, 2001; Third Supplement issued January 1, 2002)

KKKK PHARMACISTS CAN NOW CHECK THE STATUS OF UPDATES TO THE ILLINOIS FORMULARY ONLINE AT: http://www.idph.state.il.us/about/fdd/formulary.htm

PAGE DRUG NAME APPLICATION HOLDER,(19th Ed.) (EFFECTIVE DATE OF ACTION / SUPPLEMENT) DOSAGE FORM, STRENGTH MANUFACTURER

p. 1 ACETAMINOPHEN; BUTALBITAL; CAFFEINEAdded: (08-12-01 [second supplement]) tablet, oral 325mg;50mg;40mg AbleAdded: (08-12-01 [second supplement]) tablet, oral 500mg;50mg;40mg Able

p. 2 ACETAMINOPHEN; CODEINE PHOSPHATEAdded: (10-02-01 [third supplement]) tablet, oral 300mg; 15,30,60mg Mallinckrodt

p. 4 ACETAMINOPHEN; PROPOXYPHENE NAPSYLATEAdded: (08-18-01 [second supplement]) tablet, oral 650mg;100mg AbleAdded: (11-13-01 [third supplement]) tablet, oral 650mg;100mg Mallinckrodt

p. 7 ALBUTEROL SULFATEAdded: (05-13-01 [first supplement]) solution for inhalation eq 0.083% base Roxane

p. 11 AMIODARONE HYDROCHLORIDEAdded: (06-11-01[first supplement]) tablet, oral 200mg Taro

p. 14 AMPHETAMINE ASPARTAME; AMPHETAMINE SULFATE; DEXTROAMPHETAMINE SACCHARATE;DEXTROAMPHETAMINE SULFATE (New Entity to the Illinois Formulary at the Fourth Supplement)Added: (02-11-02 [fourth supplement]) tablet, oral 2.5mg;2.5mg;2.5mg;2.5mg BarrAdded: (02-11-02 [fourth supplement]) tablet, oral 1.25mg;1.25mg;1.25mg;1.25mg BarrAdded: (02-11-02 [fourth supplement]) tablet, oral 5mg;5mg;5mg;5mg BarrAdded: (02-11-02 [fourth supplement]) tablet, oral 7.5mg;7.5mg;7.5mg;7.5mg BarrAdded: Adderall 5 (02-11-02 [fourth supplement]) tablet, oral 1.25mg;1.25mg;1.25mg;1.25mg ShireAdded: Adderall 10 (02-11-02 [fourth supplement]) tablet, oral 2.5mg;2.5mg;2.5mg;2.5mg ShireAdded: Adderall 20 (02-11-02 [fourth supplement]) tablet, oral 5mg;5mg;5mg;5mg ShireAdded: Adderall 30 (02-11-02 [fourth supplement]) tablet, oral 7.5mg;7.5mg;7.5mg;7.5mg Shire

p. 23 AZELAIC ACID (New Entity to the Illinois Formulary at the Third Supplement)Added: Azelex (12-01-01 [third supplement]) cream, topical 20% Allergan *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug product selection under otherbrand and/or generic names.

p. 26 BETAMETHASONE DIPROPIONATE; CLOTRIMAZOLE (New Entity to the Illinois Formulary at the Second Supplement)Added: (08-20-01 [second supplement]) cream, topical 0.05%;1% AltanaAdded: (07-30-01 [second supplement]) cream, topical 0.05%;1% TaroAdded: Lotrisone (07-30-01 [second supplement]) cream, topical 0.05%; 1% Schering *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug product selection under otherbrand and/or generic names.

p. 27 BISOPROLOL FUMARATEAdded: (06-26-01 [first supplement]) tablet, oral 5,10mg Copley/Teva

p. 28 BISOPROLOL FUMARATE; HYDROCHLOROTHIAZIDEAdded: (05-15-01 [first supplement]) tablet, oral 2.5mg;6.25mg WatsonAdded: (05-15-01 [first supplement]) tablet, oral 5mg; 6.25mg WatsonAdded: (05-15-01 [first supplement]) tablet, oral 10mg;6.25mg Watson

p. 30 BUSPIRONEAdded: (03-01-02 [fourth supplement]) tablet, oral 5,10,15mg IVAXAdded: (02-27-02 [fourth supplement]) tablet, oral 5,10,15mg KVAdded: (09-08-01 [second supplement]) tablet, oral 30mg MylanAdded: (02-28-02 [fourth supplement]) tablet, oral 5,10,15mg ParAdded: (02-28-02 [fourth supplement]) tablet, oral 5,10,15mg TevaAdded: (04-05-02 [fourth supplement]) tablet, oral 5,10,15mg TorPharmAdded: (05-14-01 [first supplement]) tablet, oral 5,10mg WatsonAdded: (03-13-02 [fourth supplement]) tablet, oral 15mg Watson

(continued on the next page)- xxv -

PAGE DRUG NAME APPLICATION HOLDER,(19th Ed.) (EFFECTIVE DATE OF ACTION / SUPPLEMENT) DOSAGE FORM, STRENGTH MANUFACTURER

p. 30 BUSPIRONE (continued)Added: Buspar (09-08-01 [second supplement]) tablet, oral 30mg Bristol-Myers SquibbAdded: Vanspar (06-12-01 [first supplement]) tablet, oral 7.5mg Par *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug product selection under otherbrand and/or generic names.

p. 31 BUTORPHANOL TARTRATEAdded: (10-23-01 [third supplement]) injection 1,2mg/ml Apotex/NovexAdded: (10-13-01 [third supplement]) spray, metered, nasal 1mg/ml Lederle/MylanAdded: (03-12-02 [fourth supplement]) spray, metered, nasal 1mg/ml RoxaneAdded: Stadol NS (08-08-01 [second supplement]) spray, metered, nasal 1mg/ml Bristol-Myers Squibb

p. 32 CALCITRIOL (New Entity to the Illinois Formulary at the Third Supplement)Added: (10-12-01 [third supplement]) capsule, oral 0.25,0.5mcg TevaAdded: Rocaltrol (10-12-01 [third supplement]) capsule, oral 0.25,0.5mcg Roche

p. 37 CARBAMAZEPINEAdded: (11-10-01 [third supplement]) tablet, chewable 100mg CaracoAdded: (02-27-02 [fourth supplement]) tablet, oral 200mg Apotex

p. 39 CARISOPRODOLAdded: (08-12-01 [second supplement]) tablet, oral 350mg Able

p. 39 CARTEOLOL HYDROCHLORIDEAdded: (02-06-02 [fourth supplement]) solution, ophthalmic 1% Novex

p. 42 CEPHALEXINAdded: (12-10-01 [third supplement]) oral suspension 125,250mg/5ml Ranbaxy

p. 51 CLINDAMYCIN PHOSPHATEAdded: (04-03-02 [fourth supplement]) lotion, topical eq 1% base AltanaAdded: Cleocin-T (04-03-02 [fourth supplement]) lotion, topical eq 1% base Pharmacia

p. 53 CLONAZEPAMAdded: (10-17-01 [third supplement]) tablet, oral 0.5,1,2mg Caraco

p. 63 DEXTROAMPHETAMINE SULFATEAdded: (04-01-02 [fourth supplement]) capsule, extended release 5,10,15mg BarrAdded: Dexedrine (04-01-02 [fourth supplement]) capsule, extended release 5,10,15mg GlaxoSmithKline

p. 71 DICLOFENAC POTASSIUMAdded: (08-11-01 [second supplement]) tablet, oral 50mg Eon

p. 71 DICLOFENAC SODIUMAdded: (12-13-01 [third supplement]) tablet, extended release 100mg MylanAdded: (01-07-02 [fourth supplement]) tablet, extended release 100mg Purepac

p. 80 ENALAPRIL MALEATEAdded: (08-22-00 [19th edition]) tablet, oral 20mg ApotheconAdded: (08-22-00 [19th edition]) tablet, oral 20mg ChelseaAdded: (08-22-00 [19th edition]) tablet, oral 20mg EonAdded: (08-22-00 [19th edition]) tablet, oral 20mg ESI LederleAdded: (08-22-00 [19th edition]) tablet, oral 20mg GenevaAdded: (08-22-00 [19th edition]) tablet, oral 20mg GenPharmAdded: (08-22-00 [19th edition]) tablet, oral 20mg KRKAAdded: (08-22-00 [19th edition]) tablet, oral 20mg LekAdded: (08-22-00 [19th edition]) tablet, oral 20mg MylanAdded: (08-22-00 [19th edition]) tablet, oral 20mg RanbaxyAdded: (09-26-01 [second supplement]) tablet, oral 2.5,5,10,20mg TaroAdded: (08-22-00 [19th edition]) tablet, oral 20mg TevaAdded: (08-22-00 [19th edition]) tablet, oral 20mg Wockhardt AmericasAdded: (08-22-00 [19th edition]) tablet, oral 20mg Zenith GoldlineAdded: Vasotec (08-22-00 [19th edition]) tablet, oral 20mg Merck

p. 80 ENALAPRIL MALEATE; HYDROCHLOROTHIAZIDE (New Entity to the Illinois Formulary at the Second Supplement)Added: (02-10-02 [fourth supplement]) tablet, oral 5mg;12.5mg, 10mg;25mg EonAdded: (04-03-02 [fourth supplement]) tablet, oral 5mg;12.5mg, 10mg;25mg Dr. ReddyAdded: (09-18-01 [second supplement]) tablet, oral 5mg;12.5mg, 10mg;25mg MylanAdded: (09-18-01 [second supplement]) tablet, oral 5mg;12.5mg, 10mg;25mg TaroAdded: (09-18-01 [second supplement]) tablet, oral 5mg;12.5mg, 10mg;25mg TevaAdded: Vaseretic tablet, oral 5mg;12.5mg, 10mg;25mg Merck (09-18-01 [second supplement])

p. 86 ETHAMBUTOLAdded: (01-29-02 [fourth supplement]) tablet, oral 400mg Barr

- xxvi -

PAGE DRUG NAME APPLICATION HOLDER,(19th Ed.) (EFFECTIVE DATE OF ACTION / SUPPLEMENT) DOSAGE FORM, STRENGTH MANUFACTURER

p. 87 ETHINYL ESTRADIOL; LEVONORGESTRELAdded: Alesse (09-01-01 [second supplement]) tablet, oral 0.02mg;0.1mg Wyeth-AyerstAdded: Aviane (09-01-01 [second supplement]) tablet, oral 0.02mg;0.1mg DuramedAdded: Enpresse (02-21-02 [second supplement]) tablet, oral, triphasic 0.03mg;0.05mg/ Duramed/Barr

0.04mg;0.075mg/0.03mg;0.125mg

p. 87 ETHINYL ESTRADIOL; NORETHINDRONEAdded: Loestrin FE 1/20 tablet, oral 0.02mg; 1mg Parke-Davis (05-23-01 [first supplement])Added: Loestrin FE 1.5/30 tablet, oral 0.03mg; 1.5mg Parke-Davis (05-23-01 [first supplement])Added: Microgestin FE 1/20 tablet, oral 0.02mg; 1mg Watson (05-23-01 [first supplement])Added: Microgestin FE 1.5/30 tablet, oral 0.03mg; 1.5mg Watson (05-23-01 [first supplement])

p. 88 ETHINYL ESTRADIOL; NORGESTRELAdded: Cryselle (02-20-02 [fourth supplement]) tablet, oral 0.03mg;0.3mg Duramed/Barr

p. 88 ETODOLACAdded: (11-30-01 [third supplement]) tablet, extended release 400,500mg Andrx

p. 89 ETOPOSIDEAdded: (09-19-01 [second supplement]) capsule, oral 50mg GenPharmAdded: Vepesid (09-19-01 second supplement]) capsule, oral 50mg Bristol

p. 89 FAMOTIDINEAdded: (09-25-01 [second supplement]) tablet, oral 20,40mg Apotex/TorPharmAdded: (04-14-01 [19th edition]) tablet, oral 20,40mg EonAdded: (09-05-01 [second supplement]) tablet, oral 20,40mg Carlsbad

p. 90 FLECAINIDE ACETATE (New Entity to the Illinois Formulary at the Second supplement)Added: (07-31-01 [second supplement]) tablet, oral 50,100,150mg AlphapharmAdded: Tambocor (07-31-01[second supplement]) tablet, oral 50,100,150mg 3M *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug product selection under otherbrand and/or generic names.

p. 90 FLOXURIDINEAdded: (10-06-01 [third supplement]) injection 500mg/vial American Pharmaceutical

Partners

p. 92 FLUOXETINE HYDROCHLORIDE (New Entity to the Illinois Formulary at the Second Supplement)Added: (01-29-02 [fourth supplement]) capsule, oral eq 10,20mg base AlphapharmAdded: (01-30-02 [fourth supplement]) capsule, oral eq 10mg base BarrAdded: (08-02-01 [second supplement]) capsule, oral eq 20mg base BarrAdded: (01-29-02 [fourth supplement]) capsule, oral eq 10,20mg base ChelseaAdded: (01-29-02 [second supplement]) capsule, oral eq 10,20mg base Dr. Reddy’sAdded: (08-02-01 [second supplement]) capsule, oral eq 40mg base Dr. Reddy’sAdded: (01-29-02 [fourth supplement]) capsule, oral eq 10,20mg base EonAdded: (03-31-02 [fourth supplement]) capsule, oral eq 10,20mg base Ganes/SiegfriedAdded: (08-27-01 [second supplement]) capsule, oral eq 10mg base GenevaAdded: (01-29-02 [fourth supplement]) capsule, oral eq 20mg base GenevaAdded: (03-13-02 [fourth supplement]) capsule, oral eq 40mg base GenevaAdded: (01-31-02 [fourth supplement]) capsule, oral eq 10,20mg base IVAXAdded: (01-29-02 [fourth supplement]) capsule, oral eq 10,20mg base MallinckrodtAdded: (01-30-02 [fourth supplement]) capsule, oral eq 10,20mg base MylanAdded: (01-29-02 [fourth supplement]) capsule, oral eq 10,20,40mg base TevaAdded: (01-29-02 [fourth supplement]) capsule, oral eq 10,20mg base WatsonAdded: (01-29-02 [fourth supplement]) solution, oral eq 20mg base/5ml MallinckrodtAdded: (02-07-02 [fourth supplement]) solution, oral eq 20mg base/5ml NovexAdded: (08-02-01 [second supplement]) solution, oral eq 20mg base/5ml TevaAdded: (08-02-01 [second supplement]) tablet, oral eq 10mg base Alphapharm/ParAdded: (01-29-02 [fourth supplement]) tablet, oral eq 10mg base EonAdded: (02-28-02 [fourth supplement]) tablet, oral eq 10mg base IVAXAdded: (01-29-02 [fourth supplement]) tablet, oral eq 10mg base TevaAdded: Prozac (08-27-01) [second supplement]) capsule, oral eq 10mg base LillyAdded: Prozac (08-02-01) [second supplement]) capsule, oral eq 20,40mg base LillyAdded: Prozac (08-02-01) [second supplement]) solution, oral eq 20 base/5ml LillyAdded: Prozac (08-02-01) [second supplement]) tablet, oral eq 10mg base LillyAdded: Rapiflux (08-02-01) [second supplement]) tablet, oral eq 20mg base Alphapharm *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug product selection under otherbrand and/or generic names.

- xxvii -

PAGE DRUG NAME APPLICATION HOLDER,(19th Ed.) (EFFECTIVE DATE OF ACTION / SUPPLEMENT) DOSAGE FORM, STRENGTH MANUFACTURER

p. 92 FLUPHENAZINE DECANOATEAdded: (08-17-01 [second supplement]) injection 25mg/ml Apotex

p. 93 FLUTAMIDE (New Entity to the Illinois Formulary at the Second Supplement)Added: (09-18-01 [second supplement]) capsule, oral 125mg BarrAdded: (10-06-01 [third supplement]) capsule, oral 125mg EonAdded: (09-18-01 [second supplement]) capsule, oral 125mg TevaAdded: (09-19-01 [second supplement]) capsule, oral 125mg Zenith-GoldlineAdded: Eulexin (09-18-01 [second supplement]) capsule, oral 125mg Schering

p. 94 FLUVOXAMINE MALEATEAdded: (07-09-01 [second supplement]) tablet, oral 25,50,100mg Anapharm/SynthonAdded: (10-15-01 [third supplement]) tablet, oral 25,50,100mg GenPharm

p. 97 GLIPIZIDEAdded: (06-13-01 [first supplement]) tablet, oral 5,10mg TorPharm

p. 116 INDOMETHACINAdded: (02-06-02 [fourth supplement]) capsule, extended release 75mg Able

p. 118 IPRATROPIUM BROMIDEAdded: (05-22-01 [first supplement]) solution for inhalation 0.2% Novex

p. 121 KETOCONAZOLEAdded: (01-10-02 [fourth supplement]) tablet, oral 200mg TorPharm

p. 121 KETOPROFENAdded: (02-20-02 [fourth supplement]) capsule, extended release 100,150,200mg Mylan

p. 121 KETOROLAC TROMETHAMINEAdded: (07-24-01 [second supplement]) injection 15,30mg/ml Apotex/NovexAdded: Ketorolac Tromethamine preservative-free injection 15,30mg/ml Apotex/Novex (06-29-01 [second supplement])

p. 122 LACTULOSEAdded: (02-21-01 [fourth supplement]) solution, oral 10gm/15ml Novex

p. 123 LEUCOVORIN CALCIUMAdded: Leucovorin injection preservative-free injection eq 10mg base/ml Luitpold (09-25-01 [second supplement])

p. 124 LEVOCARNITINE (New Entity to the Illinois Formulary at the Third Supplement)Added: (10-10-01 [third supplement]) injection 200mg/ml BedfordAdded: Carnitor (10-10-01 [third supplement]) injection 200mg/ml Sigma Tau

p. 126 LITHIUM CARBONATEAdded: (09-27-01 [second supplement]) capsule, oral 300mg Able

p. 127 LORAZEPAMAdded: (12-09-01 [third supplement]) tablet, oral 0.5,1,2mg Ranbaxy

p. 127 LOVASTATIN (New Entity to the Illinois Formulary at the Third Supplement)Added: (12-17-01 [third supplement]) tablet, oral 10,20,40mg EonAdded: (12-17-01 [third supplement]) tablet, oral 10,20,40mg GenevaAdded: (12-17-01 [third supplement]) tablet, oral 10,20,40mg GenPharmAdded: (12-17-01 [third supplement]) tablet, oral 10,20,40mg MylanAdded: (12-17-01 [third supplement]) tablet, oral 10,20,40mg PurepacAdded: (12-17-01 [third supplement]) tablet, oral 10,20,40mg TevaAdded: Mevacor (12-17-01 [third supplement]) tablet, oral 10,20,40mg Merck

p. 130 MEFLOQUINE HYDROCHLORIDE (New Entity to the Illinois Formulary at the Fourth Supplement)Added: (02-20-02 [fourth supplement]) tablet, oral 250mg GenevaAdded: Lariam (02-20-02 [fourth supplement]) tablet, oral 250mg Roche

p. 130 MEGESTROL ACETATEAdded: (08-02-01 [second supplement]) suspension, oral 40mg/ml ParAdded: (03-31-02 [fourth supplement]) suspension, oral 40mg/ml RoxaneAdded: Megace (08-02-01 [second supplement]) suspension, oral 40mg/ml Bristol-Myers Squibb

p. 132 MESNA (New Entity to the Illinois Formulary at the Third Supplement)Added: (10-06-01 [third supplement]) injection 100mg/ml American Pharmaceutical

PartnersAdded: Mesnex (10-06-01 [third supplement]) injection 100mg/ml Asta

p. 132 METAPROTERENOL SULFATEAdded: (05-22-01 [first supplement]) solution for inhalation 0.4, 0.6% Novex

- xxviii -

PAGE DRUG NAME APPLICATION HOLDER,(19th Ed.) (EFFECTIVE DATE OF ACTION / SUPPLEMENT) DOSAGE FORM, STRENGTH MANUFACTURER

p. 133 METFORMIN HYDROCHLORIDE (New Entity to the Illinois Formulary at the Fourth Supplement)Added: (01-29-02 [fourth supplement]) tablet, oral 500,850,1000mg AlphapharmAdded: (01-25-02 [fourth supplement]) tablet, oral 500,850,1000mg AndrxAdded: (01-25-02 [fourth supplement]) tablet, oral 500,850,1000mg BarrAdded: (01-25-02 [fourth supplement]) tablet, oral 500,850,1000mg EonAdded: (01-25-02 [fourth supplement]) tablet, oral 500,850,1000mg GenevaAdded: (01-25-02 [fourth supplement]) tablet, oral 500,850,1000mg GenPharmAdded: (01-24-02 [fourth supplement]) tablet, oral 500,850,1000mg IVAXAdded: (01-24-02 [fourth supplement]) tablet, oral 500,850,1000mg MylanAdded: (01-24-02 [fourth supplement]) tablet, oral 500,850,1000mg PurepacAdded: (01-25-02 [fourth supplement]) tablet, oral 500,850,1000mg Teva

p. 133 METFORMIN HYDROCHLORIDE (continued)Added: (01-24-02 [fourth supplement]) tablet, oral 500,850,1000mg WatsonAdded: Glucophage (01-24-02 [fourth supplement]) tablet, oral 500,850,1000mg Bristol-Myers Squibb

p. 134 METHIMAZOLE (New Entity to the Illinois Formulary at the First Supplement)Added: (08-03-01 [second supplement]) tablet, oral 5,10mg EonAdded: (04-10-01 [first supplement]) tablet, oral 5,10mg GenPharmAdded: (02-10-02 [fourth supplement]) tablet, oral 5,10mg JonesAdded: Tapazole (04-10-01 [first supplement]) tablet, oral 5,10mg Lilly

p. 136 METHYLPHENIDATE HYDROCHLORIDEAdded: (08-18-01 [second supplement]) tablet, oral 5,10,20mg AbleAdded: (02-05-02 [fourth supplement]) tablet, oral 5,10,20mg PurepacAdded: (08-18-01 [second supplement]) tablet, extended release 20mg AbleAdded: (05-14-01 [first supplement]) tablet, extended release 20mg Danbury/WatsonAdded: (12-21-01 [third supplement]) tablet, extended release 20mg Purepac

p. 137 METIPRANOLOL HYDROCHLORIDEAdded: (10-10-01 [third supplement]) solution, ophthalmic 0.3% Alcon

p. 139 MINOCYCLINE HYDROCHLORIDEAdded: Minocin (06-04-01 [first supplement]) capsule, oral eq 75mg base ESI Lederle / Wyeth-Ayerst

p. 140 MORPHINE SULFATEAdded: (05-15-01 [first supplement]) tablet, extended release 100mg Watson

p. 141 NABUMETONEAdded: (02-25-02 [fourth supplement]) tablet, oral 500,750mg Geneva

p. 143 NAPROXENAdded: (03-20-02 [fourth supplement]) tablet, oral 250,375,500mg Interpharm

p. 143 NAPROXEN SODIUMAdded: (07–05-01[second supplement]) tablet, extended release eq 375,500mg base AndrxAdded: Naprelan (07-05-01 [second supplement]) tablet, extended release eq 375,500mg base Élan

p. 147 NORETHINDRONE ACETATEAdded: (05-25-01 [first supplement]) tablet, oral 5mg Barr

p. 149 OMEPRAZOLE (New Entity to the Illinois Formulary at the Third Supplement)Added: (11-16-01 [third supplement]) capsule, delayed release, oral 10,20,40mg AndrxAdded: Prilosec (11-16-01 [third supplement]) capsule, delayed release, oral 10,20,40mg AstraZeneca

p. 149 ORPHENADRINE CITRATEAdded: (10-15-01 [third supplement]) tablet, extended release 100mg Impax

p. 150 OXAPROZINAdded: (11-18-01 [third supplement]) tablet, oral 600mg Dr. Reddy’sAdded: (08-17-01 [second supplement]) tablet, oral 600mg MylanAdded: (05-15-01 [first supplement]) tablet, oral 600mg Watson

p. 151 PACLITAXELAdded: (07-23-01 [second supplement]) injection 6mg/ml MylanAdded: (08-20-01 [second supplement]) injection 6mg/ml Zenith Goldline/SP

p. 152 PEMOLINEAdded: (06-13-01 [first supplement]) tablet, oral 18.75mg Watson

p. 156 PHENTERMINE HYDROCHLORIDEAdded: (08-30-01 [second supplement]) capsule, oral 30mg AbleAdded: (08-30-01 [second supplement]) tablet, oral 37.5mg Able

p. 158 PHENYTOINAdded: (05-08-01 [first supplement]) suspension, oral 125mg/5ml UDL

- xxix -

PAGE DRUG NAME APPLICATION HOLDER,(19th Ed.) (EFFECTIVE DATE OF ACTION / SUPPLEMENT) DOSAGE FORM, STRENGTH MANUFACTURER

p. 165 PREDNISOLONEAdded: (01-08-02 [fourth supplement]) syrup, oral 5mg/5ml KVAdded: Prelone (01-08-02 [fourth supplement]) syrup, oral 5mg/5ml Muro

p. 167 PRIMIDONEAdded: (09-02-01 [second supplement]) tablet, oral 50mg LannettAdded: Mysoline (09-02-01 [second supplement]) tablet, oral 50mg Xcel

p. 168 PROCHLORPERAZINEAdded: (08-18-01 [second supplement]) suppository, rectal 2.5,5,25mg AbleAdded: Compazine (08-18-01 [second supp.]) suppository, rectal 2.5,5mg SmithKline Beecham

p. 169 PROGESTERONEAdded: (10-06-01 [third supplement]) injection 50mg/ml American Pharmaceutical

Partnersp. 170 PROPAPHENONE HYDROCHLORIDE (New Entity to the Illinois Formulary at the First Supplement)

Added: (03-10-02 [fourth supplement]) tablet, oral 150,225mg MutualAdded: (05-16-01 [first supplement]) tablet, oral 150,225mg WatsonAdded: Rhythmol (05-16-01 [first supplement]) tablet, oral 150,225mg Abbott

p. 174 QUINIDINE GLUCONATEDeleted: (07-01-01 [first supplement]) ALL LISTINGS

p. 176 RIMANTIDINE HYDROCHLORIDE (New Entity to the Illinois Formulary at the Third Supplement)Added: (11-02-01 [third supplement]) tablet, oral 100mg CorePharmaAdded: Flumadine (11-02-01 [third supplement]) tablet, oral 100mg Forest

p. 181 SOLTALOL HYDROCHLORIDEAdded: (10-15-01 [third supplement]) tablet, oral 80,120,160,240mg ImpaxAdded: (03-17-02 [third supplement]) tablet, oral 80,120,160,240mg MutualAdded: Sorine (07-14-01 [second supplement]) tablet, oral 80,120,160,240mg Upsher-Smith

p. 181 SPIRONOLACTONEAdded: (08-20-01 [second supplement]) tablet, oral 50,100mg Mylan

p. 187 TERBUTALINE SULFATEAdded: (10-15-01 [third supplement]) tablet, oral 2.5,5mg ImpaxAdded: Brethine (10-15-01 [third supplement]) tablet, oral 2.5,5mg Novartis

p. 190 THIOTEPAAdded: (10-10-01 [third supplement]) injection 15mg/vial Bedford

p. 195 TRIFLURIDINEAdded: (08-04-01 [second supplement]) solution, ophthalmic 1% Alcon

L Changed all Camall to ABC (first supplement)

L Changed all Chelsea to Watson (fourth supplement)

L Changed all Ciba Vision to Novartis (third supplement)

L Changed all DuPont to Bristol-Myers Squibb (fourth supplement)

L Changed all Knoll to Abbott (second supplement)

L Changed all Lotus to New River (fourth supplement)

L Changed all Medeva to Celltech (first supplement)

L Changed all Novopharm to Teva (first supplement)

L Changed all Ohmeda to Baxter (third supplement)

L Changed all Roberts to Shire (second supplement)

L Changed all Rosemont to USL (fourth supplement)

L Changed all Zenith Goldline to IVAX (fourth supplement)

- xxx -

1

APPROVED DRUG PRODUCTS FOR DRUG PRODUCT SELECTION

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

ACEBUTOLOL HYDROCHLORIDEAcebutolol Hydrochloride capsule, oral eq 200,400mg base Mylan

capsule, oral eq 200,400mg base Parcapsule, oral eq 200,400mg base Watson

Brand(s)Sectral capsule, oral eq 200,400mg base Wyeth-Ayerst

ACETAMINOPHEN; BUTALBITALAcetaminophen; Butalbital @ tablet, oral 325mg;50mg Danbury

@ tablet, oral 325mg;50mg HalseyBrand(s)

Bancap @ capsule, oral 325mg;50mg ForestBucet capsule, oral 650mg;50mg MallinckrodtPhrenilin Forte capsule, oral 650mg;50mg AmarinTencon capsule, oral 650mg;50mg MallinckrodtTriaprin @ capsule, oral 325mg;50mg DunhallButapap tablet, oral 325mg;50mg MikartButapap tablet, oral 650mg;50mg MikartPhrenilin tablet, oral 325mg;50mg AmarinSedapap tablet, oral 650mg;50mg Mayrand

ACETAMINOPHEN; BUTALBITAL; CAFFEINEAcetaminophen; Butalbital; capsule, oral 325mg;50mg;40mg Gilbert Caffeine @ capsule, oral 325mg;50mg;40mg Mallinckrodt

capsule, oral 325mg;50mg;40mg Mikartcapsule, oral 500mg;50mg;40mg West-wardtablet, oral 325mg;50mg;40mg Abletablet, oral 500mg;50mg;40mg Able

@ tablet, oral 325mg;50mg;40mg Gilberttablet, oral 325mg;50mg;40mg Halseytablet, oral 325mg;50mg;40mg Mikarttablet, oral 500mg;50mg;40mg Watsontablet, oral 325mg;50mg;40mg West-wardtablet, oral 500mg;50mg;40mg West-ward

Brand(s)Anoquan @ capsule, oral 325mg;50mg;40mg Roberts and HauckEsgic Plus capsule, oral 500mg;50mg;40mg MikartFemcet @ capsule, oral 325mg;50mg;40mg MallinckrodtMedigesic Plus @ capsule, oral 325mg;50mg;40mg US ChemicalTriad @ capsule, oral 325mg;50mg;40mg MallinckrodtEsgic @ tablet, oral 325mg;50mg;40mg ForestEsgic Plus tablet, oral 500mg;50mg;40mg MikartFioricet tablet, oral 325mg;50mg;40mg Novartis *Repan tablet, oral 325mg;50mg;40mg Mallinckrodt

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

ACETAMINOPHEN; CAFFEINE; DIHYDROCODEINE BITARTRATEAcetaminophen; Caffeine; capsule, oral 356.4mg;30mg;16mg Mikart Dihydrocodeine Bitartrate

Brand(s)DHC Plus @ capsule, oral 356.4mg;30mg;16mg Purdue FrederickSynalgos-DC-A @ capsule, oral 356.4mg;30mg;16mg Women First Healthcare

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

2

ACETAMINOPHEN; CODEINE PHOSPHATEAcetaminophen; @ capsule, oral 300mg;15,30,60mg Teva Codeine Phosphate solution, oral 120mg/5ml; 12mg/5ml Hi-Tech

solution, oral 120mg/5ml; 12mg/5ml Mikartsolution, oral 120mg/5ml; 12mg/5ml Morton Grovesolution, oral 120mg/5ml; 12mg/5ml Movasolution, oral 120mg/5ml; 12mg/5ml Pharmaceutical Assoc/Beachsolution, oral 120mg/5ml; 12mg/5ml Roxanesuspension, oral 120mg/5ml;12mg/5ml Amarin

@ tablet, oral 300mg;15,30,60mg American Therapeutics@ tablet, oral 300mg;15,30,60mg Barr

tablet, oral 300mg;15,30,60mg Duramed@ tablet, oral 300mg;15,30,60mg Eon@ tablet, oral 325mg;30mg Everylife

tablet, oral 300mg;30,60mg Geneva@ tablet, oral 300mg;15,30,60mg Halsey@ tablet, oral 300mg;30mg ICN

tablet, oral 300mg;30,60mg IVAX@ tablet, oral 300mg;30,60mg KV@ tablet, oral 325mg;15mg KV@ tablet, oral 300mg;30mg Lederle

tablet, oral 300mg;15,30,60mg Mallinckrodttablet, oral 300mg;30mg Mikart

@ tablet, oral 300mg;60mg Mikarttablet, oral 650mg;30mg Mikarttablet, oral 300mg;15,30,60mg Mutualtablet, oral 300mg;30mg Pharmeraltablet, oral 300mg;30,60mg Purepac

@ tablet, oral 300mg;15,60mg Roxanetablet, oral 300mg;30mg Roxanetablet, oral 300mg;15,30,60mg Roycetablet, oral 300mg;15mg Superpharm

@ tablet, oral 300mg;30,60mg Superpharmtablet, oral 300mg;15,30,60mg Teva

@ tablet, oral 300mg;30,60mg USLtablet, oral 300mg;15,30,60mg Vintage

@ tablet, oral 300mg;15,30,60mg Warner Chilcott@ tablet, oral 300mg;15,30,60mg Watson@ tablet, oral 300mg;30,60mg Whiteworth Towne Paulsen

Brand(s)Phenaphen No. 3 with Codeine capsule, oral 325mg;30mg RobinsProval No. 3 @ capsule, oral 325mg;30mg SolvayTylenol with Codeine #3,#4 @ capsule, oral 300mg;30,60mg RW JohnsonCapital and Codeine solution, oral 120mg/5ml; 12mg/5ml AlpharmaTylenol with Codeine solution, oral 120mg/5ml; 12mg/5ml RW JohnsonCapital and Codeine suspension, oral 120mg/5ml;12mg/5ml AlpharmaCapital with Codeine @ tablet, oral 325mg;30mg CarnrickEmpracet with Codeine #3,#4 @ tablet, oral 300mg;30,60mg Glaxo WellcomePapa-Deine #3,#4 @ tablet, oral 300mg;30,60mg (Vangard/MWM)Phenaphen-650 with Codeine @ tablet, oral 650mg;30mg RobinsTylenol with Codeine No.s 2,3,4 tablet, oral 300mg;15,30,60mg RW Johnson *Tylenol with Codeine No.s 2,3,4 @ tablet, oral 325mg;15,30,60mg RW Johnson

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

ACETAMINOPHEN; HYDROCODONE BITARTRATEAcetaminophen; capsule, oral 500mg;5mg Central Hydrocodone Bitartrate capsule, oral 500mg;5mg Mallinckrodt *

capsule, oral 500mg;5mg Mikart(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

3

ACETAMINOPHEN; HYDROCODONE BITARTRATE (continued)solution, oral 500mg;7.5mg/15ml Mikartsolution, oral 500mg;7.5mg/15ml Pharmaceutical Associatestablet, oral 500mg;2.5,5,7.5,10mg Barrtablet, oral 650mg;7.5,10mg Barrtablet, oral 750mg;7.5mg Barrtablet, oral 400mg;5,7.5,10mg Endotablet, oral 500mg;5,7.5mg Endotablet, oral 650mg;7.5,10mg Endotablet, oral 750mg;7.5mg Endotablet, oral 500mg;5mg Eontablet, oral 750mg;7.5mg Eontablet, oral 500mg;5mg Halseytablet, oral 650mg;7.5,10mg Halseytablet, oral 750mg;7.5mg Halseytablet, oral 325mg;5,7.5,10mg Mallinckrodttablet, oral 500mg;5,7.5,10mg Mallinckrodttablet, oral 650mg;10mg Mallinckrodttablet, oral 750mg;7.5mg Mallinckrodttablet, oral 500mg;2.5,5,7.5mg Mikarttablet, oral 650mg;7.5,10mg Mikarttablet, oral 500mg;5mg Nortontablet, oral 500mg;10mg Peachtreetablet, oral 500mg;2.5,5,7.5mg Roycetablet, oral 650mg;7.5,10mg Roycetablet, oral 750mg;7.5mg Roycetablet, oral 325mg;7.5,10mg UCBtablet, oral 650mg;7.5mg UCB

@ tablet, oral 500mg;5mg USLtablet, oral 325mg;10mg Vintagetablet, oral 500mg;2.5,5,7.5,10mg Vintagetablet, oral 650mg;7.5,10mg Vintagetablet, oral 660mg;10mg Vintagetablet, oral 750mg;7.5mg Vintage

@ tablet, oral 325mg;7.5mg Watsontablet, oral 325mg;10mg Watsontablet, oral 500mg;2.5,5,7.5,10mg Watsontablet, oral 650mg;7.5,10mg Watsontablet, oral 660mg;10mg Watsontablet, oral 750mg;7.5mg Watson

Brand(s)Allay capsule, oral 500mg;5mg IVAXBancap HC @ capsule, oral 500mg;5mg ForestCo-Gesic @ capsule, oral 500mg;5mg CentralHydrocet capsule, oral 500mg;5mg Mallinckrodt *Lorcet-HD capsule, oral 500mg;5mg Mallinckrodt *Anexsia tablet, oral 500mg;5mg Mallinckrodt *Anexsia 7.5/650 tablet, oral 650mg;7.5mg Mallinckrodt *Anexsia 10/660 tablet, oral 660mg;10mg Mallinckrodt *Co-Gesic tablet, oral 500mg;5mg CentralDuradyne DHC @ tablet, oral 500mg;5mg ForestHy-Phen tablet, oral 500mg;5mg AscherLortab tablet, oral 325mg;5mg WatsonLortab tablet, oral 500mg;5mg Mallinckrodt *Lortab tablet, oral 500mg;10mg UCBNorcet @ tablet, oral 500mg;5mg AbanaNorco tablet, oral 325mg;10mg WatsonTycolet @ tablet, oral 500mg;5mg RW Johnson

(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

4

ACETAMINOPHEN; HYDROCODONE BITARTRATE (continued)Vicodin tablet, oral 500mg;5mg AbbottVicodin ES tablet, oral 750mg;7.5mg AbbottVicodin HP tablet, oral 660mg;10mg Abbott

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

ACETAMINOPHEN; OXYCODONE HYDROCHLORIDEAcetaminophen; capsule, oral 500mg;5mg Amide Oxycodone Hydrochloride capsule, oral 500mg;5mg Barr

capsule, oral 500mg;5mg Duramedcapsule, oral 500mg;5mg Endocapsule, oral 500mg;5mg Halseycapsule, oral 500mg;5mg Mallinckrodtcapsule, oral 500mg;5mg Roycecapsule, oral 500mg;5mg Vintagetablet, oral 325mg;5mg Amidetablet, oral 325mg;5mg Barrtablet, oral 325mg;5mg Duramedtablet, oral 325mg;2.5,5mg Endotablet, oral 500mg;7.5mg Endotablet, oral 325mg;5mg Roycetablet, oral 325mg;5mg Vintagetablet, oral 500mg;7.5mg Watsontablet, oral 650mg;10mg Watson

Brand(s)Roxilox capsule, oral 500mg;5mg RoxaneTylox capsule, oral 500mg;5mg RW Johnson *Oxycet tablet, oral 325mg;5mg MallinckrodtOxycodone 5/APAP 500 @ tablet, oral 500mg;5mg Bristol-Myers SquibbPercocet tablet, oral 325mg;5mg Endo *Percocet tablet, oral 500mg;7.5mg Endo *Percocet tablet, oral 650mg;10mg Endo *Roxicet tablet, oral 325mg;5mg RoxaneRoxicet 5/500 tablet, oral 500mg;5mg Roxane

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

ACETAMINOPHEN; PENTAZOCINE HYDROCHLORIDEAcetaminophen; tablet, oral 650mg;eq 25mg base Watson Pentazocine Hydrochloride

Brand(s)Talacen tablet, oral 650mg;eq 25mg base Sanofi Synthelabo

ACETAMINOPHEN; PROPOXYPHENE HYDROCHLORIDEAcetaminophen; tablet, oral 650mg;65mg Geneva Propoxyphene Hydrochloride tablet, oral 650mg;65mg Mylan

tablet, oral 650mg;65mg RoyceBrand(s)

Dolene AP-65 @ tablet, oral 650mg;65mg LederleWygesic tablet, oral 650mg;65mg Women First Healthcare

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

5

ACETAMINOPHEN; PROPOXYPHENE NAPSYLATEAcetaminophen; tablet, oral 650mg; 100mg Able Propoxyphene Napsylate tablet, oral 325mg;50mg Barr

tablet, oral 650mg;100mg Barr@ tablet, oral 325mg;50mg Circa@ tablet, oral 650mg;100mg Circa

tablet, oral 650mg;100mg Geneva@ tablet, oral 325mg;50mg Halsey

tablet, oral 650mg;100mg Halseytablet, oral 650mg;100mg IVAXtablet, oral 650mg;100mg Mallinckrodttablet, oral 650mg;100mg Mylantablet, oral 650mg;100mg Purepac

@ tablet, oral 650mg;100mg Superpharmtablet, oral 650mg;100mg Tevatablet, oral 650mg;100mg Vintage

Brand(s)Darvocet-N 50 tablet, oral 325mg;50mg LillyDarvocet-N 100 tablet, oral 650mg;100mg Lilly *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

ACETAZOLAMIDEAcetazolamide @ tablet, oral 250mg (Ascot)

@ tablet, oral 250mg Circatablet, oral 250mg Danburytablet, oral 250mg Lannetttablet, oral 125,250mg Mutualtablet, oral 125,250mg Taro

@ tablet, oral 250mg (Vangard/MWM)Brand(s)

Diamox tablet, oral 125,250mg Storz

ACETAZOLAMIDE SODIUMAcetazolamide Sodium injection eq 500mg/vial Abbott

injection eq 500mg/vial Bedford@ injection eq 500mg/vial Quad

Brand(s)Diamox injection eq 500mg/vial Storz

ACETIC ACID, GLACIALAcetic Acid, Glacial solution, irrigation-urethral, in plastic Abbott

container, 250mg/100ml (0.25%)solution, irrigation-urethral, in plastic Baxter container, 250mg/100ml (0.25%)solution, irrigation-urethral, in plastic Braun container, 250mg/100ml (0.25%)

@ solution, otic 2% KVsolution, otic 2% Morton Grovesolution, otic 2% Thames

Brand(s)Acetasol solution, otic 2% AlpharmaOrlex @ solution, otic 2% Procter and GambleVoSol solution, otic 2% Wallace

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

6

ACETIC ACID, GLACIAL; ALUMINUM ACETATEAcetic Acid, Glacial; @ solution, otic 2%;0.79% Bausch and Lomb Aluminum Acetate

Brand(s)Borofair @ solution, otic 2%;0.79% PharmafairDomeboro solution, otic 2%;0.79% Bayer

ACETIC ACID, GLACIAL; HYDROCORTISONEAcetic Acid, Glacial; solution, otic 2%;1% Bausch and Lomb Hydrocortisone @ solution, otic 2%;1% KV

solution, otic 2%;1% Morton Grovesolution, otic 2%;1% Thames

Brand(s)Acetasol HC solution, otic 2%;1% AlpharmaOrlex HC @ solution, otic 2%;1% Procter and GambleVoSol HC solution, otic 2%;1% Wallace

ACETOHEXAMIDEAcetohexamide tablet, oral 250,500mg Barr

tablet, oral 250,500mg Danbury@ tablet, oral 250,500mg USL

Brand(s)Dymelor @ tablet, oral 250,500mg Lilly

ACETYLCYSTEINEAcetylcysteine solution for inhalation 10,20% Abbott

solution for inhalation 10,20% Bedfordsolution for inhalation 10,20% Fauldingsolution for inhalation 10,20% Luitpold

@ solution for inhalation 10,20% Quadsolution for inhalation 10,20% Roxane

Brand(s)Mucosil-10,20 solution for inhalation 10,20% DeyMucomyst solution for inhalation 10,20% Apothecon

ACYCLOVIRAcyclovir capsule, oral 200mg Aesgen

capsule, oral 200mg Apotheconcapsule, oral 200mg Copleycapsule, oral 200mg ESI Lederlecapsule, oral 200mg Genpharmcapsule, oral 200mg IVAXcapsule, oral 200mg Lekcapsule, oral 200mg Mylancapsule, oral 200mg Purepaccapsule, oral 200mg Ranbaxy

@ capsule, oral 200mg Roxanecapsule, oral 200mg Stasoncapsule, oral 200mg Tevacapsule, oral 200mg Watsonsuspension, oral 200mg/5ml Alpharmatablet, oral 400,800mg Aesgentablet, oral 400,800mg Apothecontablet, oral 400,800mg Carlsbadtablet, oral 400,800mg Copleytablet, oral 400,800mg ESI Lederle

(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

7

ACYCLOVIR (continued)tablet, oral 400,800mg GenPharmtablet, oral 400,800mg IVAXtablet, oral 400,800mg Lektablet, oral 400,800mg Mylantablet, oral 400,800mg Purepactablet, oral 400,800mg Ranbaxytablet, oral 400,800mg Teva

Brand(s)Zovirax capsule, oral 200mg Glaxo WellcomeZovirax suspension, oral 200mg/5ml Glaxo WellcomeZovirax tablet, oral 400,800mg Glaxo Wellcome

ACYCLOVIR SODIUMAcyclovir Sodium injection eq 25mg base/ml Faulding

injection eq 50mg base/ml Abbottinjection eq 500mg,1gm base/vial Abbottinjection eq 50mg base/ml American Pharmaceutical

Partnersinjection eq 500mg,1gm base/vial American Pharmaceutical

Partners@ injection eq 500mg,1gm base/vial Apothecon

injection eq 500mg,1gm base/vial Bedfordinjection eq 500mg,1gm base/vial ESI Lederleinjection eq 500mg,1gm base/vial Gensia Sicorinjection eq 50mg base/ml Meridian

Brand(s)Zovirax injection eq 500mg,1gm base/vial Glaxo Wellcome

ALBUTEROLAlbuterol aerosol, metered 0.09mg/inhalation Armstrong ***

aerosol, metered 0.09mg/inhalation GenPharm***aerosol, metered 0.09mg/inhalation IVAX ***aerosol, metered 0.09mg/inhalation Sidmak ***

BrandsProventil aerosol, metered 0.09mg/inhalation Schering * **Ventolin aerosol, metered 0.09mg/inhalation GlaxoSmithKline * **

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

** Proventil and Ventolin brands of albuterol metered dose inhalers are NOT INTERCHANGEABLE at this time.Neither company has to date presented acceptable bioequivalence information comparing their brand ofalbuterol metered dose inhaler to the other. Schering, via Warrick Pharmaceuticals, is manufacturing agenerically labeled albuterol metered dose inhaler using the Proventil federal new drug application (NDA) whileGlaxoSmithKline is doing the same, manufacturing an “authorized generic” for distribution under genericlabeling by Dey Laboratories, using the Ventolin NDA. Thus, Schering manufactured generically labeledalbuterol metered dose inhalers are NOT INTERCHANGEABLE with GlaxoSmithKline manufactured genericallylabeled albuterol metered dose inhalers.

*** Albuterol metered dose inhalers manufactured by Armstrong (formerly Celltech or Medeva), GenPharm(formerly Alpharma), Sidmak (formerly Medisol), and IVAX (formerly Norton Waterford) are, at this time, onlyinterchangeable with albuterol metered dose inhalers manufactured by GlaxoSmithKline.

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

8

ALBUTEROL SULFATEAlbuterol Sulfate solution for inhalation eq 0.083% base Alpharma

solution for inhalation eq 0.083% base Bausch and Lomb 0.5% basesolution for inhalation eq 0.083, Copley 0.5% basesolution for inhalation eq 0.083% base Deysolution for inhalation eq 0.083, Hi-Tech 0.5% basesolution for inhalation eq 0.083% base Morton Grovesolution for inhalation eq 0.083% base Nephronsolution for inhalation eq 0.083% base Roxanesolution for inhalation eq 0.083% base Steripaksyrup, oral eq 2mg base/5ml Alpharmasyrup, oral eq 2mg base/5ml Hi-Tech

@ syrup, oral eq 2mg base/5ml Movasyrup, oral eq 2mg base/5ml Tevasyrup, oral eq 2mg base/5ml UDL

@ syrup, oral eq 2mg base/5ml Watson@ tablet, oral eq 2,4mg base American Therapeutics@ tablet, oral eq 2,4mg base Celltech@ tablet, oral eq 2,4mg base Copley

tablet, oral eq 2,4mg base Danburytablet, oral eq 2,4mg base Genevatablet, oral eq 2,4mg base Lederletablet, oral eq 2,4mg base Mutualtablet, oral eq 2,4mg base Mylantablet, oral eq 2,4mg base Sidmaktablet, oral eq 2,4mg base Teva

@ tablet, oral eq 2,4mg base Warner Chilcotttablet, oral eq 2,4mg base Watson

Brand(s)Proventil solution for inhalation eq 0.083, Schering *

0.5% baseVentolin solution for inhalation eq 0.083, Glaxo Wellcome

0.5% baseProventil syrup, oral eq 2mg base/5ml Schering *Ventolin @ syrup, oral eq 2mg base/5ml Glaxo WellcomeProventil tablet, oral eq 2,4mg base Schering *Ventolin @ tablet, oral eq 2,4mg base Glaxo Wellcome

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

ALCOHOL; DEXTROSEAlcohol; Dextrose injection 5ml/100ml (5%); Abbott

5gm/100ml (5%)@ injection 5ml/100ml (5%); Baxter

5gm/100ml (5%)injection 5ml/100ml (5%); Braun 5gm/100ml (5%)

@ injection 5ml/100ml (5%); Miles 5gm/100ml (5%)

ALCOHOL; MORPHINEAlcohol; Morphine solution, oral 45% v/v;2mg/5ml Alpharma

solution, oral 45% v/v;2mg/5ml Halsey

(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

9

ALCOHOL; MORPHINE (continued)Brand(s)

Paregoric Tincture solution, oral 45% v/v;2mg/5ml CenciParegoric Tincture solution, oral 45% v/v;2mg/5ml LillyParegoric Tincture solution, oral 45% v/v;2mg/5ml Morton Grove

* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as anexception to the promulgated criteria for inclusion, pursuant to Rule 790.60.

ALFENTANIL HYDROCHLORIDEAlfentanil Hydrochloride injection eq 0.5mg base/ml Abbott

Brand(s)Alfenta injection eq 0.5mg base/ml Akorn

ALLOPURINOLAllopurinol @ tablet, oral 100,300mg Barr

@ tablet, oral 100,300mg Circatablet, oral 100,300mg Danburytablet, oral 100,300mg Genevatablet, oral 100,300mg Mutualtablet, oral 100,300mg Mylantablet, oral 100,300mg Par

@ tablet, oral 100,300mg Purepac@ tablet, oral 100mg Superpharm

tablet, oral 300mg Superpharm@ tablet, oral 100,300mg Watson

Brand(s)Lopurin tablet, oral 100,300mg BASFZyloprim tablet, oral 100,300mg Prometheus

ALPRAZOLAMAlprazolam tablet, oral 0.25,0.5,1,2mg Alphapharm

tablet, oral 0.25,0.5,1,2mg Genevatablet, oral 0.25,0.5,1,2mg IVAXtablet, oral 0.25,0.5,1,2mg Lederletablet, oral 0.25,0.5,1,2mg Mylantablet, oral 0.25,0.5,1,2mg Purepac

@ tablet, oral 0.25,0.5,1mg Roxanetablet, oral 0.25,0.5,1mg Roycetablet, oral 0.25,0.5,1,2mg Tevatablet, oral 0.25,0.5,1mg Watson

Brand(s)Xanax tablet, oral 0.25,0.5,1,2mg Pharmacia & Upjohn *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

ALPROSTADILAlprostadil injection 0.5mg/ml Bedford

injection 0.5mg/ml Gensia SicorBrand(s)

Caverject @ injection 0.005mg/vial Pharmacia & UpjohnCaverject injection 0.01,0.02,0.04mg/vial Pharmacia & UpjohnEdex injection 0.005,0.01,0.02,0.04mg/vial SchwarzProstin VR Pediatric injection 0.5mg/ml Pharmacia & Upjohn

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

10

ALUMINUM ACETATE; ACETIC ACID, GLACIALSee ACETIC ACID, GLACIAL; ALUMINUM ACETATE

AMANTADINE HYDROCHLORIDEAmantadine Hydrochloride @ capsule, oral 100mg Circa

capsule, oral 100mg Genevacapsule, oral 100mg USLsyrup, oral 50mg/5ml Alpharmasyrup, oral 50mg/5ml Copleysyrup, oral 50mg/5ml Hi-Techsyrup, oral 50mg/5ml Mikartsyrup, oral 50mg/5ml Morton Grovesyrup, oral 50mg/5ml Pharmaceutical Associates

Brand(s)Symadine @ capsule, oral 100mg SolvaySymmetrel capsule, oral 100mg Bristol-Myers Squibb *Symmetrel syrup, oral 50mg/5ml Endo *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

AMIKACIN SULFATEAmikacin Sulfate injection eq 50,250mg base/ml Abbott

@ injection eq 50,250mg base/ml Astra Zenecainjection eq 50,250mg base/ml Bedford

@ injection eq 50,250mg base/ml Elkins-Sinninjection eq 50,250mg base/ml Fauldinginjection eq 50,250mg base/ml Gensia Sicor

Brand(s)Amikin injection eq 50,250mg base/ml Apothecon

AMILORIDE HYDROCHLORIDEAmiloride Hydrochloride tablet, oral 5mg Par

Brand(s)Midamor tablet, oral 5mg Merck Sharp and Dohme

AMILORIDE HYDROCHLORIDE; HYDROCHLOROTHIAZIDEAmiloride Hydrochloride; tablet, oral eq 5mg anhydrous;50mg Barr Hydrochlorothiazide tablet, oral eq 5mg anhydrous;50mg Geneva

tablet, oral eq 5mg anhydrous;50mg Mylantablet, oral eq 5mg anhydrous;50mg Roycetablet, oral eq 5mg anhydrous;50mg Teva

Brand(s)Hydro-ride tablet, oral eq 5mg anhydrous;50mg ParModuretic tablet, oral eq 5mg anhydrous;50mg Merck Sharp and Dohme *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

AMINOACETIC ACIDSee GLYCINE

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

11

AMINOCAPROIC ACIDAminocaproic Acid injection 250mg/ml Abbott

@ injection 250mg/ml American Pharmaceutical Partners

injection 250mg/ml Elkins-Sinninjection 250mg/ml Luitpold

@ injection 250mg/ml Quadsyrup, oral 1.25gm/5ml Mikart

Brand(s)Amicar injection 250mg/ml ImmunexAmicar syrup, oral 1.25gm/5ml Immunex

AMINOHIPPURATE SODIUMAminohippurate Sodium injection 20% Merck Sharp and Dohme

@ injection 20% Quad

AMINOPHYLLINEAminophylline injection 25mg/ml Abbott

@ injection 25mg/ml American Pharmaceutical Partners

injection 25mg/ml Elkins-Sinninjection 25mg/ml Gensia Sicorinjection 25mg/ml International Medication

@ injection 25mg/ml Kinginjection 25mg/ml Luitpoldinjection 25mg/ml Pharma Serve

@ injection 25mg/ml Smith and Nephewsolution, oral 105mg/5ml Alpharma

@ solution, oral 105mg/5ml Morton Grovesolution, oral 105mg/5ml Roxane

@ tablet, oral 100,200mg Duramedtablet, oral 100,200mg Geneva

@ tablet, oral 100,200mg Impaxtablet, oral 100,200mg Roxane

@ tablet, oral 100,200mg (Vangard/MWM)tablet, oral 100,200mg West-ward

Brand(s)Aminophyllin @ injection 25mg/ml SearleSomophyllin @ solution, oral 105mg/5ml FisonsSomophyllin-DF @ solution, oral 105mg/5ml FisonsAminophyllin tablet, oral 100,200mg Searle

AMIODARONE HYDROCHLORIDEAmiodarone Hydrochloride tablet, oral 200mg Alphapharm

tablet, oral 200mg Barrtablet, oral 200mg Copleytablet, oral 200mg Eontablet, oral 200mg Tarotablet, oral 200mg Teva

Brand(s)Cordarone tablet, oral 200mg Wyeth-AyerstPacerone tablet, oral 200mg Upsher-Smith

AMITRIPTYLINE HYDROCHLORIDEAmitriptyline Hydrochloride @ injection 10mg/ml Steris

(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

12

AMITRIPTYLINE HYDROCHLORIDE (continued)@ tablet, oral 10,25,50,75,100mg American Therapeutics@ tablet, oral 10,25,50,75,100,150mg Barr@ tablet, oral 10,25,50,75,100,150mg Celltech@ tablet, oral 10,25,50,75,100,150mg Danbury

tablet, oral 10,25,50,75,100,150mg Geneva@ tablet, oral 25mg Halsey@ tablet, oral 10,25,50,75,100,150mg Lederle

tablet, oral 10,25,50,75,100,150mg Mutualtablet, oral 10,25,50,75,100,150mg Mylan

@ tablet, oral 10,25,50,75,100,150mg Par@ tablet, oral 10,25,50,75,100mg Purepac@ tablet, oral 10,25,50,75,100mg Roxane@ tablet, oral 150mg Roxane

tablet, oral 10,25,50,75,100,150mg Sidmaktablet, oral 10,25,50,75,100mg Superpharmtablet, oral 10,25,50,100mg Teva

@ tablet, oral 75,150mg Teva@ tablet, oral 25mg USL@ tablet, oral 10,50,75,100mg (Vangard/MWM)

tablet, oral 10,25,50,75,100,150mg Vintage@ tablet, oral 10,25,50,75,100,150mg Watson@ tablet, oral 10,25,50mg West-ward

Brand(s)Elavil injection 10mg/ml ZenecaAmitid @ tablet, oral 10,25,50,75,100mg SquibbAmitril @ tablet, oral 10,25,50,75,100,150mg Warner ChilcottElavil tablet, oral 10,25,50,75,100,150mg ZenecaEndep @ tablet, oral 10,25,50,75,100mg RocheEndep @ tablet, oral 150mg Roche

AMITRIPTYLINE HYDROCHLORIDE; CHLORDIAZEPOXIDEAmitriptyline Hydrochloride; @ tablet, oral eq 12.5mg base;5mg Barr Chlordiazepoxide @ tablet, oral eq 25mg base;10mg Barr

tablet, oral eq 12.5mg base;5mg Danburytablet, oral eq 25mg base;10mg Danburytablet, oral eq 12.5mg base;5mg Mylantablet, oral eq 25mg base;10mg Mylantablet, oral eq 12.5mg base;5mg Partablet, oral eq 25mg base;10mg Par

@ tablet, oral eq 12.5mg base;5mg USL@ tablet, oral eq 25mg base;10mg USL

Brand(s)Limbitrol tablet, oral eq 12.5mg base;5mg ICNLimbitrol DS tablet, oral eq 25mg base;10mg ICN

AMITRIPTYLINE HYDROCHLORIDE; PERPHENAZINEAmitriptyline Hydrochloride; @ tablet, oral 10mg;2mg Barr Perphenazine @ tablet, oral 25mg;2mg Barr

@ tablet, oral 10mg;4mg Barr@ tablet, oral 25mg;4mg Barr@ tablet, oral 10mg;2mg Circa@ tablet, oral 25mg;2mg Circa@ tablet, oral 10mg;4mg Circa@ tablet, oral 25mg;4mg Circa@ tablet, oral 50mg;4mg Circa

(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

13

AMITRIPTYLINE HYDROCHLORIDE; PERPHENAZINE (continued)@ tablet, oral 10mg;2mg Danbury@ tablet, oral 25mg;2mg Danbury@ tablet, oral 10mg;4mg Danbury@ tablet, oral 25mg;4mg Danbury@ tablet, oral 50mg;4mg Danbury

tablet, oral 10mg;2mg Genevatablet, oral 25mg;2mg Genevatablet, oral 10mg;4mg Genevatablet, oral 25mg;4mg Genevatablet, oral 50mg;4mg Geneva

@ tablet, oral 10mg;2mg IVAX@ tablet, oral 25mg;2mg IVAX@ tablet, oral 10mg;4mg IVAX@ tablet, oral 25mg;4mg IVAX@ tablet, oral 50mg;4mg IVAX@ tablet, oral 10mg;2mg Mylan@ tablet, oral 25mg;2mg Mylan@ tablet, oral 10mg;4mg Mylan@ tablet, oral 25mg;4mg Mylan@ tablet, oral 50mg;4mg Mylan@ tablet, oral 10mg;2mg Par@ tablet, oral 25mg;2mg Par@ tablet, oral 10mg;4mg Par@ tablet, oral 25mg;4mg Par@ tablet, oral 50mg;4mg Par

tablet, oral 10mg;2mg Roycetablet, oral 25mg;2mg Roycetablet, oral 10mg;4mg Roycetablet, oral 25mg;4mg Royce

@ tablet, oral 50mg;4mg WatsonBrand(s)

Triavil 2-10 @ tablet, oral 10mg;2mg New RiverTriavil 2-25 @ tablet, oral 25mg;2mg New RiverTriavil 4-10 @ tablet, oral 10mg;4mg New RiverTriavil 4-25 @ tablet, oral 25mg;4mg New RiverTriavil 4-50 @ tablet, oral 50mg;4mg New River

AMMONIUM LACTATEBrand(s)

Lac-Hydrin lotion, topical 12% Bristol-Myers Squibb *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

AMOXAPINEAmoxapine tablet, oral 25,50,100,150mg Danbury

tablet, oral 25,50,100,150mg Genevatablet, oral 25,50,100,150mg Watson

Brand(s)Asendin @ tablet, oral 25,50,100,150mg Lederle

AMOXICILLIN/AMOXICILLIN TRIHYDRATEAmoxicillin/ @ capsule, oral 250,500mg Atral Amoxicillin Trihydrate capsule, oral 250,500mg Biochemie

capsule, oral 250,500mg Clonmelcapsule, oral 250,500mg Consolidated

(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

14

AMOXICILLIN/AMOXICILLIN TRIHYDRATE (continued)@ capsule, oral 250,500mg Mylan

capsule, oral 250,500mg Ranbaxycapsule, oral 250,500mg Tevapowder for suspension 125,250mg/5ml Clonmelpowder for suspension 125,250mg/5ml Consolidated

@ powder for suspension 125,250mg/5ml Mylanpowder for suspension Teva 125,250mg/5ml, 50mg/mltablet, chewable 125,250mg Apothecontablet, chewable 125,250mg Clonmeltablet, chewable 125,200,250,400mg Ranbaxytablet, chewable 125,250mg Tevatablet, oral 500,875mg Ranbaxytablet, oral 500,875mg Teva

Brand(s)Amoxil capsule, oral 250,500mg SmithKline BeechamTrimox capsule, oral 250,500mg ApotheconUtimox @ capsule, oral 250,500mg Parke-DavisWymox @ capsule, oral 250,500mg Wyeth-AyerstAmoxil powder for suspension SmithKline Beecham

125,250mg/5ml, 50mg/mlLarotid @ powder for suspension 50mg/ml SmithKline BeechamLarotid powder for suspension 125,250mg/5ml SmithKline BeechamPolymox @ powder for suspension 125,250mg/5ml ApotheconTrimox @ powder for suspension 50mg/ml ApotheconTrimox powder for suspension 125,250mg/5ml ApotheconUtimox @ powder for suspension 125,250mg/5ml Parke-DavisWymox powder for suspension 125,250mg/5ml Wyeth-AyerstAmoxil tablet, chewable 125,200,250,400mg SmithKline BeechamAmoxil tablet, oral 500,875mg SmithKline Beecham

AMPHETAMINE ASPARTAME; AMPHETAMINE SULFATE; DEXTROAMPHETAMINE SACCHARATE;DEXTROAMPHETAMINE SULFATE

Amphetamine Aspartame; tablet, oral 2.5mg;2.5mg;2.5mg;2.5mg BarrAmphetamine Sulfate; tablet, oral 1.25mg;1.25mg;1.25mg;1.25mg BarrDextroamphetamine Saccharate; tablet, oral 5mg;5mg;5mg;5mg BarrDextroamphetamine Sulfate tablet, oral 7.5mg;7.5mg;7.5mg;7.5mg Barr

Brand(s)Adderall 5 tablet, oral 1.25mg;1.25mg;1.25mg;1.25mg ShireAdderall 10 tablet, oral 2.5mg;2.5mg;2.5mg;2.5mg ShireAdderall 20 tablet, oral 5mg;5mg;5mg;5mg ShireAdderall 30 tablet, oral 7.5mg;7.5mg;7.5mg;7.5mg Shire

AMPHETAMINE SULFATE; AMPHETAMINE ASPARTAME; DEXTROAMPHETAMINE SACCHARATE;DEXTROAMPHETAMINE SULFATE

See AMPHETAMINE ASPARTAME; AMPHETAMINE SULFATE; DEXTROAMPHETAMINESACCHARATE; DEXTROAMPHETAMINE SULFATE

AMPHOTERICIN BAmphotericin B @ injection 50mg/vial Abbott

@ injection 50mg/vial American Pharmaceutical Partners

injection 50mg/vial Gensia Sicorinjection 50mg/vial Pharma Tek

Brand(s)Fungizone injection 50mg/vial Apothecon

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

15

AMPICILLIN/AMPICILLIN TRIHYDRATE; PROBENECIDBrand(s)

Polycillin-PRB @ powder for suspension Apothecon eq 3.5gm base/bottle;1gm/bottle

Probampacin @ powder for suspension Teva eq 3.5gm base/bottle;1gm/bottle

AMPICILLIN SODIUMAmpicillin Sodium @ injection eq 125,250,500mg, Consolidated

1,2gm base/vial@ injection eq 125,250,500mg, Elkins-Sinn

1,2,10gm base/vial@ injection eq 125,250,500mg, Hanford

1,2,10gm base/vial@ injection eq 125mg base/vial IBI

injection eq 250,500mg, IBI 1,2gm base/vial

@ injection eq 1,2gm base/vial International Medication@ injection eq 500mg,1,2gm base/vial Lilly

injection eq 125,250,500mg, Marsam 1,2gm base/vial

@ injection eq 10gm base/vial MarsamBrand(s)

Omnipen-N injection eq 125,250,500mg, Wyeth-Ayerst 1,2gm base/vial

Penbritin-S @ injection eq 125,250,500mg, Wyeth-Ayerst 1,2gm base/vial

Polycillin-N @ injection eq 125,250,500mg, Bristol 1,2gm base/vial

Principen injection eq 125,250,500mg, Apothecon 1,2,10gm base/vial

Totacillin-N injection eq 125,250,500mg, SmithKline Beecham 1,10gm base/vial

Totacillin-N @ injection eq 2gm base/vial SmithKline Beecham

AMPICILLIN/AMPICILLIN TRIHYDRATEAmpicillin Trihydrate @ capsule, oral eq 250,500mg base Biochemie

capsule, oral eq 250,500mg base Clonmelcapsule, oral eq 250,500mg base Consolidated

@ capsule, oral eq 250,500mg base Eon@ capsule, oral eq 250,500mg base IVAX@ capsule, oral eq 250,500mg base Lederle@ capsule, oral eq 250,500mg base Mylan@ capsule, oral eq 250mg base Purepac

capsule, oral eq 500mg base Purepaccapsule, oral eq 250,500mg base Tevapowder for suspension Clonmel eq 125,250mg base/5mlpowder for suspension Consolidated eq 125,250mg base/5ml

@ powder for suspension Mylan eq 125,250mg base/5mlpowder for suspension Purepac

@ eq 125mg base/5ml eq 250mg base/5mlpowder for suspension Teva eq 125,250mg base/5ml

(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

16

AMPICILLIN/AMPICILLIN TRIHYDRATE (continued)Brand(s)

Amcill @ capsule, oral eq 250,500mg base Parke-DavisOmnipen capsule, oral eq 250,500mg base Wyeth-AyerstPenbritin @ capsule, oral eq 250,500mg base Wyeth-AyerstPfizerpen-A @ capsule, oral eq 250,500mg base PfizerPolycillin @ capsule, oral eq 250,500mg base BristolPrincipen capsule, oral eq 250,500mg base ApotheconTotacillin capsule, oral eq 250,500mg base SmithKline BeechamAmcill @ powder for suspension Parke-Davis

eq 125,250mg base/5mlOmnipen powder for suspension Wyeth-Ayerst

eq 125,250mg base/5ml, 100mg/ml

Penbritin @ powder for suspension Wyeth-Ayerst eq 125,250mg base/5ml, 100mg/ml

Pfizerpen-A @ powder for suspension Pfizer eq 125,250mg base/5ml

Polycillin @ powder for suspension Apothecon eq 125,250,500mg base/5ml, 100mg/ml

Principen powder for suspension Apothecon eq 125,250mg base/5ml, 100mg/ml

Totacillin @ powder for suspension SmithKline Beecham eq 125,250mg base/5ml

AMRINONE LACTATESee INAMRINONE LACTATE

ANTAZOLINE PHOSPHATE; NAPHAZOLINE HYDROCHLORIDEAntazoline Phosphate; solution, ophthalmic 0.5%;0.05% Steris Naphazoline Hydrochloride

Brand(s)Albalon A Liquifilm solution, ophthalmic 0.5%;0.05% AllerganVasocon-A solution, ophthalmic 0.5%;0.05% Novartis

* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as anexception to the promulgated criteria for inclusion, pursuant to Rule 790.60.

ANTIPYRINE; BENZOCAINEAntipyrine; Benzocaine solution, otic 54mg/ml(5.4%); Bausch and Lomb

14mg/ml(1.4%)solution, otic 54mg/ml(5.4%); Hi-Tech 14mg/ml(1.4%)solution, otic 54mg/ml(5.4%); Thames 14mg/ml(1.4%)

Brand(s)A/B Otic Drops solution, otic 54mg/ml(5.4%); Clay-Park

14mg/ml(1.4%)Auralgan solution, otic 54mg/ml(5.4%); Wyeth-Ayerst

14mg/ml(1.4%)

(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

17

ANTIPYRINE; BENZOCAINE (continued)Auroto Drops solution, otic 54mg/ml(5.4%); Alpharma

14mg/ml(1.4%)Oto Ear Drops solution, otic 54mg/ml(5.4%); Vortech

14mg/ml(1.4%)

* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as anexception to the promulgated criteria for inclusion, pursuant to Rule 790.60.

ASCORBIC ACID; BIOTIN; CYANOCOBALAMIN; DEXPANTHENOL; ERGOCALCIFEROL; FOLIC ACID;NIACINAMIDE; PYRIDOXINE HYDROCHLORIDE; RIBOFLAVIN PHOSPHATE SODIUM; THIAMINEHYDROCHLORIDE; VITAMIN A; VITAMIN E

Brand(s)M.V.C. 9+3 @ injection 10mg/ml;0.006mg/ml; American Pharmaceutical

0.05mg/ml;1.5mg/ml;20IU/ml; Partners 0.04mg/ml;4mg/ml;0.4mg/ml; 0.36mg/ml;0.3mg/ml;330IU/ml; 1IU/ml

MVC Plus injection 10mg/ml;0.006mg/ml; Steris 0.05mg/ml;1.5mg/ml;20IU/ml; 0.04mg/ml;4mg/ml;0.4mg/ml; 0.36mg/ml;0.3mg/ml;330IU/ml; 1IU/ml

M.V.I. - 12 injection 10mg/ml;0.006mg/ml; Neosan 0.05mg/ml;1.5mg/ml;20IU/ml; 0.04mg/ml;4mg/ml;0.4mg/ml; 0.36mg/ml;0.3mg/ml;330IU/ml; 1IU/ml

ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; IRON; NICOTINIC ACID; PYRIDOXINE HYDROCHLORIDE;RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D; VITAMIN E

Ascorbic Acid; Cyanocobalamin; drops, oral 35mg;2mcg;0.5mg;10mg; Esquire Fluoride; Iron; Nicotinic Acid; 8mg;0.4mg;0.6mg;0.5mg; Pyridoxine Hydrochloride; 1500IU;400IU;5IU Riboflavin; Thiamine Hydrochloride; Vitamin A; Vitamin D; Vitamin E

Brand(s)Poly-Vi-Flor with Iron drops, oral 35mg;2mcg;0.5mg;10mg; Mead Johnson/

8mg;0.4mg;0.6mg;0.5mg; Bristol-Myers Squibb 1500IU;400IU;5IU

* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as anexception to the promulgated criteria for inclusion, pursuant to Rule 790.60.

ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; NICOTINIC ACID; PYRIDOXINE HYDROCHLORIDE;RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D; VITAMIN E

Ascorbic Acid; drops, oral 35mg;2mcg; Alpharma Cyanocobalamin; Fluoride; 0.25mg;8mg;0.4mg;0.6mg; Nicotinic Acid; 0.5mg;1500IU;400IU;5IU Pyridoxine Hydrochloride; drops, oral 35mg;2mcg; Esquire Riboflavin; 0.25mg;8mg;0.4mg;0.6mg; Thiamine Hydrochloride; 0.5mg;1500IU;400IU;5IU Vitamin A; Vitamin D; Vitamin E drops, oral 35mg;2mcg; Alpharma

0.5mg;8mg;0.4mg;0.6mg; 0.5mg;1500IU;400IU;5IU

(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

18

ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; NICOTINIC ACID; PYRIDOXINE HYDROCHLORIDE;RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D; VITAMIN E (continued)

drops, oral 35mg;2mcg; Esquire 0.5mg;8mg;0.4mg;0.6mg; 0.5mg;1500IU;400IU;5IUdrops, oral 35mg;2mcg; Hi-Tech 0.5mg;8mg;0.4mg;0.6mg; 0.5mg;1500IU;400IU;5IU

Brand(s)Poly-Vi-Flor drops, oral 35mg;2mcg; Mead Johnson/

0.25mg;8mg;0.4mg;0.6mg; Bristol-Myers Squibb 0.5mg;1500IU;44IU;5IU

Poly Vitamin Drops drops, oral 35mg;2mcg; Hi-Tech with Fluoride 0.25mg 0.25mg;8mg;0.4mg;0.6mg;

0.5mg;1500IU;44IU;5IUPoly-Vi-Flor drops, oral 35mg;2mcg; Mead Johnson/

0.5mg;8mg;0.4mg;0.6mg; Bristol-Myers Squibb 0.5mg;1500IU;400IU;5IU

Poly Vitamin Drops drops, oral 35mg;2mcg; Hi-Tech with Fluoride 0.5mg 0.5mg;8mg;0.4mg;0.6mg;

0.5mg;1500IU;400IU;5IU

* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as anexception to the promulgated criteria for inclusion, pursuant to Rule 790.60.

ASCORBIC ACID; FLUORIDE; IRON; VITAMIN A; VITAMIN DAscorbic Acid; Fluoride; drops, oral 35mg;0.25mg; Abbott Iron; Vitamin A; Vitamin D 10mg;1500IU;400IU

drops, oral 35mg;0.25mg; Alpharma 10mg;1500IU;400IUdrops, oral 35mg;0.25mg; Morton Grove 10mg;1500IU;400IUdrops, oral 35mg;0.5mg; Morton Grove 10mg;1500IU;400IU

Brand(s)Tri-Vi-Flor with Iron drops, oral 35mg;0.25mg Mead Johnson/

10mg;1500IU;400IU Bristol-Myers SquibbTri-Vi-Flor with Iron drops, oral 35mg;0.5mg; Mead Johnson/

10mg;1500IU;400IU Bristol-Myers Squibb

* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as anexception to the promulgated criteria for inclusion, pursuant to Rule 790.60.

ASCORBIC ACID; FLUORIDE; VITAMIN A; VITAMIN DAscorbic Acid; Fluoride; drops, oral 35mg;0.25mg; Abbott Vitamin A; Vitamin D 1500IU;400IU

drops, oral 35mg;0.5mg;1500IU;400IU Alpharmadrops, oral 35mg;0.25mg; Morton Grove 1500IU;400IUdrops, oral 35mg;0.5mg;1500IU;400IU Morton Grove

Brand(s)Triple-Vita-Flor 0.25mg drops, oral 35mg;0.25mg; Esquire

1500IU;400IUTri-Vi-Flor drops, oral 35mg;0.25mg; Mead Johnson/

1500IU;400IU Bristol-Myers SquibbTriVitamin Drops drops, oral 35mg;0.25mg; Hi-Tech with Fluoride 0.25mg 1500IU;400IU

(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

19

ASCORBIC ACID; FLUORIDE; VITAMIN A; VITAMIN D (continued)Triple-Vita-Flor 0.5mg drops, oral 35mg;0.5mg; Esquire

1500IU;400IUTri-Vi-Flor drops, oral 35mg;0.5mg; Mead Johnson/

1500IU;400IU Bristol-Myers SquibbTriVitamin Drops drops, oral 35mg;0.5mg;1500IU;400IU Hi-Tech with Fluoride 0.5mg

* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as anexception to the promulgated criteria for inclusion, pursuant to Rule 790.60.

ASPIRIN; BUTALBITAL; CAFFEINEAspirin; Butalbital; Caffeine @ capsule, oral 325mg;50mg;40mg Watson

@ tablet, oral 325mg;50mg;40mg Halseytablet, oral 325mg;50mg;40mg Pharmeraltablet, oral 325mg;50mg;40mg Purepac

@ tablet, oral 325mg;50mg;40mg Quantum@ tablet, oral 325mg;50mg;40mg Watson

tablet, oral 325mg;50mg;40mg West-wardBrand(s)

Fiorinal capsule, oral 325mg;50mg;40mg Novartis *Lanorinal capsule, oral 325mg;50mg;40mg LannettButal Compound tablet, oral 325mg;50mg;40mg GenevaButalbital Compound @ tablet, oral 325mg;50mg;40mg IVAXFiorinal tablet, oral 325mg;50mg;40mg Novartis *Lanorinal @ tablet, oral 325mg;50mg;40mg Lannett

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

ASPIRIN; BUTALBITAL; CAFFEINE; CODEINE PHOSPHATEAspirin; Butalbital; Caffeine; capsule, oral 325mg;50mg;40mg;30mg Endo Codeine Phosphate capsule, oral 325mg;50mg;40mg;30mg Jerome Stevens

capsule, oral 325mg;50mg;40mg;30mg WatsonBrands

Fiorinal with Codeine #3 capsule, oral 325mg;50mg;40mg;30mg Novartis *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

ASPIRIN; CAFFEINE; ORPHENADRINE CITRATEAspirin; Caffeine; tablet, oral 385mg;30mg;25mg Eon Orphenadrine Citrate tablet, oral 770mg;60mg;50mg Eon

tablet, oral 385mg;30mg;25mg Jerome Stevenstablet, oral 770mg;30mg;25mg Jerome Stevens

Brand(s)Invagesic tablet, oral 385mg;30mg;25mg GenevaInvagesic Forte tablet, oral 770mg;60mg;50mg GenevaNorgesic tablet, oral 385mg;30mg;25mg 3M *Norgesic Forte tablet, oral 770mg;60mg;50mg 3M *Orphengesic tablet, oral 385mg;30mg;25mg ParOrphengesic tablet, oral 385mg;30mg;25mg Par

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

20

ASPIRIN; CAFFEINE; PROPOXYPHENE HYDROCHLORIDE(Propoxyphene Hydrochloride in Powder Form)

Aspirin; Caffeine; @ capsule, oral 389mg;32.4mg;65mg Eon Propoxyphene Hydrochloride @ capsule, oral 389mg;32.4mg;65mg Geneva

capsule, oral 389mg;32.4mg;65mg Teva@ capsule, oral 389mg;32.4mg;65mg Watson

Brand(s)Compound 65 @ capsule, oral 389mg;32.4mg;65mg AlraDarvon Compound-65 capsule, oral 389mg;32.4mg;65mg Lilly *Propoxyphene Compound 65 @ capsule, oral 389mg;32.4mg;65mg IVAX

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

ASPIRIN; CARISOPRODOLAspirin; Carisoprodol tablet, oral 325mg;200mg Amide

@ tablet, oral 325mg;200mg Circatablet, oral 325mg;200mg Eontablet, oral 325mg;200mg Par

Brand(s)Soma Compound tablet, oral 325mg;200mg Wallace

ASPIRIN; CARISOPRODOL; CODEINE PHOSPHATEAspirin; Carisoprodol; tablet, oral 325mg;200mg;16mg Amide Codeine Phosphate tablet, oral 325mg;200mg;16mg Eon

Brand(s)Soma Compound with Codeine tablet, oral 325mg;200mg;16mg Wallace

ASPIRIN; CODEINE PHOSPHATEAspirin; Codeine Phosphate tablet, oral 325mg;15,30,60mg Barr

tablet, oral 325mg;15,30,60mg Genevatablet, oral 325mg;30mg Halseytablet, oral 325mg;30,60mg IVAX

Brand(s)Empirin #3 tablet, oral 325mg;15,30,60mg Glaxo Wellcome

* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as anexception to the promulgated criteria for inclusion, pursuant to Section 790.60.

ASPIRIN; MEPROBAMATEAspirin; Meprobamate @ tablet, oral 325mg;200mg Par

Brand(s)Equagesic tablet, oral 325mg;200mg Women First HealthcareMepro-Aspirin @ tablet, oral 325mg;200mg EonMicrainin tablet, oral 325mg;200mg WallaceQ-Gesic @ tablet, oral 325mg;200mg Quantum

ASPIRIN; METHOCARBAMOLAspirin; Methocarbamol tablet, oral 325mg;400mg IVAX

@ tablet, oral 325mg;400mg McNeiltablet, oral 325mg;400mg Partablet, oral 325mg;400mg Stevens

Brand(s)Robaxisal tablet, oral 325mg;400mg Robins

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

21

ASPIRIN; OXYCODONE HYDROCHLORIDE: OXYCODONE TEREPHTHALATEAspirin; Oxycodone Hydrochloride; tablet, oral 325mg;4.5mg;0.38mg Barr Oxycodone Terephthalate tablet, oral 325mg;4.5mg;0.38mg Halsey

@ tablet, oral 325mg;2.25mg;0.19mg Roxanetablet, oral 325mg;4.5mg;0.38mg Watson

Brand(s)Percodan-Demi tablet, oral 325mg;2.25mg;0.19mg EndoCodoxy @ tablet, oral 325mg;4.5mg;0.38mg HalseyPercodan tablet, oral 325mg;4.5mg;0.38mg Endo *Roxiprin @ tablet, oral 325mg;4.5mg;0.38mg Roxane

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

ATENOLOLAtenolol @ tablet, oral 50,100mg Apothecon

tablet, oral 50,100mg Copleytablet, oral 50,100mg Danburytablet, oral 25,50,100mg Geneva

@ tablet, oral 25,50,100mg Genpharmtablet, oral 25,50,100mg IPRtablet, oral 25,50,100mg Lederletablet, oral 50,100mg Martectablet, oral 25,50,100mg Mutualtablet, oral 25,50,100mg Mylantablet, oral 50,100mg SCStablet, oral 25,50,100mg Sidmaktablet, oral 50,100mg Teva

Brand(s)Tenormin tablet, oral 25,50,100mg Zeneca

ATENOLOL; CHLORTHALIDONEAtenolol; Chlorthalidone tablet, oral 50mg;25mg Danbury

tablet, oral 100mg;25mg Danburytablet, oral 50mg;25mg IPRtablet, oral 100mg;25mg IPRtablet, oral 50mg;25mg Martectablet, oral 100mg;25mg Martectablet, oral 50mg;25mg Mutualtablet, oral 100mg;25mg Mutualtablet, oral 50mg;25mg Mylantablet, oral 100mg;25mg Mylantablet, oral 50mg;25mg Sidmaktablet, oral 100mg;25mg Sidmak

Brand(s)Tenoretic 50 tablet, oral 50mg;25mg ZenecaTenoretic 100 tablet, oral 100mg;25mg Zeneca

ATRACURIUM BESYLATEAtracurium Besylate injection 10mg/ml Abbott

injection 10mg/ml Baxterinjection 10mg/ml Bedfordinjection 10mg/ml ESI Lederleinjection 10mg/ml Fauldinginjection 10mg/ml Gensia Sicorinjection 10mg/ml Marsam

(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

22

ATRACURIUM BESYLATE (continued)Brand(s)

Atracurium Besylate injection 10mg/ml Abbott Preservative FreeAtracurium Besylate injection 10mg/ml Baxter Preservative FreeAtracurium Besylate injection 10mg/ml Bedford Preservative FreeAtracurium Besylate injection 10mg/ml ESI Lederle Preservative FreeAtracurium Besylate injection 10mg/ml Faulding Preservative FreeAtracurium Besylate injection 10mg/ml Marsam Preservative FreeTracrium injection 10mg/ml AbbottTracrium Preservative Free injection 10mg/ml Abbott

ATROPINEAtropine @ injection eq 2mg sulfate/0.7ml Solvay

Brand(s)Atropen injection eq 2mg sulfate/0.7ml Meridian

ATROPINE SULFATEAtropine Sulfate solution, ophthalmic 1% Allergan

solution, ophthalmic 1% Alpharmasolution, ophthalmic 1% Pharmafairsolution, ophthalmic 1% Steris

Brand(s)Atropair solution, ophthalmic 1% BalanAtropine-1 solution, ophthalmic 1% OptopicsAtropine Care solution, ophthalmic 1% AkornAtropisol solution, ophthalmic 0.5,1,2% IolabI-Tropine solution, ophthalmic 1% AmericalIsopto Atropine solution, ophthalmic 0.5,1,2% AlconOcu-Tropine solution, ophthalmic 1% Ocumed

* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as anexception to the promulgated criteria for inclusion, pursuant to Rule 790.60.

ATROPINE SULFATE; DIPHENOXYLATE HYDROCHLORIDEAtropine Sulfate; liquid, oral 0.025mg/5ml;2.5mg/5ml Roxane Diphenoxylate Hydrochloride tablet, oral 0.025mg;2.5mg Able

@ tablet, oral 0.025mg;2.5mg (Ascot)@ tablet, oral 0.025mg;2.5mg Barr

tablet, oral 0.025mg;2.5mg Eon@ tablet, oral 0.025mg;2.5mg Heather@ tablet, oral 0.025mg;2.5mg ICN@ tablet, oral 0.025mg;2.5mg Inwood/Forest

tablet, oral 0.025mg;2.5mg IVAX@ tablet, oral 0.025mg;2.5mg KV

tablet, oral 0.025mg;2.5mg Lannett@ tablet, oral 0.025mg;2.5mg Lederle

tablet, oral 0.025mg;2.5mg Mylantablet, oral 0.025mg;2.5mg Par

@ tablet, oral 0.025mg;2.5mg Parke-Davis@ tablet, oral 0.025mg;2.5mg R and S Pharma@ tablet, oral 0.025mg;2.5mg Private Formulations

(continued)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

23

ATROPINE SULFATE; DIPHENOXYLATE HYDROCHLORIDE@ tablet, oral 0.025mg;2.5mg Roxane@ tablet, oral 0.025mg;2.5mg USL@ tablet, oral 0.025mg;2.5mg Watson@ tablet, oral 0.025mg;2.5mg West-ward

Brand(s)Colonaid @ liquid, oral 0.025mg/5ml;2.5mg/5ml WallaceLomanate @ liquid, oral 0.025mg/5ml;2.5mg/5ml AlpharmaLomotil liquid, oral 0.025mg/5ml;2.5mg/5ml SearleColonaid @ tablet, oral 0.025mg;2.5mg WallaceDi-Atro @ tablet, oral 0.025mg;2.5mg MDLofene @ tablet, oral 0.025mg;2.5mg LannettLogen @ tablet, oral 0.025mg;2.5mg SuperpharmLomotil tablet, oral 0.025mg;2.5mg SearleLonox tablet, oral 0.025mg;2.5mg GenevaLo-Trol @ tablet, oral 0.025mg;2.5mg (Vangard/MWM)Low-Quel @ tablet, oral 0.025mg;2.5mg Halsey

ATROPINE SULFATE; HYOSCYAMINE; PHENOBARBITAL; SCOPOLAMINE HYDROBROMIDEAtropine Sulfate; Hyoscyamine; elixir, oral 0.0194mg/5ml; Alpharma Phenobarbital; 0.1037mg/5ml;16.2mg/5ml; Scopolamine Hydrobromide 0.0065mg/5ml

elixir, oral 0.0194mg/5ml; Cenci 0.1037mg/5ml;16.2mg/5ml; 0.0065mg/5mlelixir, oral 0.0194mg/5ml; Halsey 0.1037mg/5ml;16.2mg/5ml; 0.0065mg/5mlelixir, oral 0.0194mg/5ml; Life 0.1037mg/5ml;16.2mg/5ml; 0.0065mg/5mlelixir, oral 0.0194mg/5ml; Naska 0.1037mg/5ml;16.2mg/5ml; 0.0065mg/5mlelixir, oral 0.0194mg/5ml; Pharmaceutical Associates 0.1037mg/5ml;16.2mg/5ml; 0.0065mg/5mlelixir, oral 0.0194mg/5ml; Purepac 0.1037mg/5ml;16.2mg/5ml; 0.0065mg/5ml

Brand(s)Antispasmodic Elixir elixir, oral 0.0194mg/5ml; Morton Grove

0.1037mg/5ml;16.2mg/5ml; 0.0065mg/5ml

Donnatal elixir, oral 0.0194mg/5ml; Robins 0.1037mg/5ml;16.2mg/5ml; 0.0065mg/5ml

* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as anexception to the promulgated criteria for inclusion, pursuant to Rule 790.60.

ATROPINE SULFATE; MEPERIDINE HYDROCHLORIDEAtropine Sulfate; @ injection 0.4mg/ml;50mg/ml Wyeth-Ayerst Meperidine Hydrochloride @ injection 0.4mg/ml;75mg/ml Wyeth-Ayerst

@ injection 0.4mg/ml;100mg/ml Wyeth-AyerstBrand(s)

Atropine & Demerol injection 0.4mg/ml;50mg/ml AbbottAtropine & Demerol injection 0.4mg/ml;75mg/ml AbbottAtropine & Demerol injection 0.4mg/ml;100mg/ml Abbott

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

24

AZATHIOPRINEAzathioprine tablet, oral 50mg Applied Analytical Industries

tablet, oral 50mg GenPharmtablet, oral 50mg Roxane

Brand(s)Imuran tablet, oral 50mg Prometheus

AZATHIOPRINE SODIUMAzathioprine Sodium injection eq 100mg base/vial Bedford

@ injection eq 100mg base/vial QuadBrand(s)

Imuran injection eq 100mg base/vial Glaxo Wellcome

AZELAIC ACIDBrand(s)

Azelex cream, topical 20% Allergan *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

BACITRACINBacitracin @ injection 50,000U/vial Pfizer

injection 10,000, 50,000U/vial Pharmacia & Upjohn@ injection 10,000, 50,000U/vial Quad

ointment, ophthalmic 500U/gm Altana@ ointment, ophthalmic 500U/gm Lilly@ ointment, ophthalmic 500U/gm Pharmaderm@ ointment, ophthalmic 500U/gm Pharmafair

powder for compounding Apothekernes 5,000,000 U/bottle

@ powder for compounding Paddock 5,000,000 U/bottle

Brand(s)Baciim injection 50,000U/vial Pharma-TekBaciguent @ ointment, ophthalmic 500U/gm Pharmacia & UpjohnBaci-Rx powder for compounding Pharma Tek

5,000,000 U/bottle

BACITRACIN; HYDROCORTISONE ACETATE; NEOMYCIN SULFATE; POLYMYXIN B SULFATEBacitracin; ointment, ophthalmic 400U/gm;1%; Altana Hydrocortisone Acetate; eq 3.5mg base/gm;10,000U/gm Neomycin Sulfate; ointment, ophthalmic 400U/gm;1%; Pharmaderm Polymyxin B Sulfate eq 3.5mg base/gm;10,000U/gm

BACITRACIN ZINC; HYDROCORTISONE; NEOMYCIN SULFATE; POLYMYXIN B SULFATEBacitracin Zinc; ointment, ophthalmic 400U/gm;1%; Bausch and Lomb Hydrocortisone; eq 3.5mg base/gm;10,000U/gm Neomycin Sulfate; @ ointment, topical 400U/gm;1%; Pharmafair Polymyxin B Sulfate eq 3.5mg base/gm;5,000U/gm

Brand(s)Cortisporin ointment, ophthalmic 400U/gm; 1%; Glaxo Wellcome

eq 3.5mg base/gm;10,000U/gmOcutricin HC @ ointment, ophthalmic 400U/gm; 1%; Pharmafair

eq 3.5mg base/gm;10,000U/gmCortisporin ointment, topical 400U/gm;1%; Monarch

eq 3.5mg base/gm;5,000U/gm

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

25

BACITRACIN ZINC; NEOMYCIN SULFATE; POLYMYXIN B SULFATEBacitracin Zinc; ointment, ophthalmic 400U/gm; Altana Neomycin Sulfate; eq 3.5mg base/gm;10,000U/gm Polymyxin B Sulfate ointment, ophthalmic 400U/gm; Bausch and Lomb

eq 3.5mg base/gm;10,000U/gmBrand(s)

Neosporin ointment, ophthalmic 400U/gm; Monarch eq 3.5mg base/gm;10,000U/gm

Ocutricin @ ointment, ophthalmic 400U/gm; Pharmafair eq 3.5mg base/gm;10,000U/gm

BACITRACIN ZINC; POLYMYXIN B SULFATEBacitracin Zinc; ointment, ophthalmic 500U/gm; Akorn Polymyxin B Sulfate 10,000U/gm

ointment, ophthalmic 500U/gm; Bausch and Lomb 10,000U/gm

Brand(s)Ocumycin @ ointment, ophthalmic 500U/gm; Pharmafair

10,000U/gmPolysporin ointment, ophthalmic 500U/gm; Monarch

10,000U/gm

BACLOFENBaclofen tablet, oral 10,20mg Danbury

tablet, oral 10,20mg IVAXtablet, oral 10,20mg Roycetablet, oral 10,20mg Tevatablet, oral 10,20mg USLtablet, oral 10,20mg WatsonBrand(s)

Lioresal tablet, oral 10,20mg Novartis

BENZATHINE PENICILLIN GSee PENICILLIN G BENZATHINE

BENZOCAINE; ANTIPYRINESee ANTIPYRINE; BENZOCAINE

BENZONATATEBenzonatate capsule, oral 100mg Banner Pharmacaps

Brand(s)Tessalon Perles capsule, oral 100mg Forest *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

BENZOYL PEROXIDEBenzoyl Peroxide gel, topical 5,10% Balan

gel, topical 5,10% Biolinegel, topical 5,10% CMCgel, aqueous base 5,10% Pharmafairliquid 2.5,5,10% Stiefel

(continued on the next page)BENZOYL PEROXIDE (continued)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

26

Brand(s)Persa-Gel gel, acetone base, topical 5,10% Ortho DermZeroxin -5,-10 gel, acetone base, topical 5,10% SyossetBenzac 5,10 gel, alcohol base, topical 5,10% Owen/Allercreme5-Benzagel gel, alcohol base, topical 5% Dermik10-Benzagel gel, alcohol base, topical 10% DermikPanoxyl 5,10 gel, alcohol base, topical 5,10% StiefelBen Aqua 5,10 gel, aqueous base, topical 5,10% SyossetBenzac W 2.5,5,10 gel, aqueous base, topical 2.5,5,10% Owen/AllercremeDesquam X 2.5,5,10 gel, aqueous base, topical 2.5,5,10% WestwoodPanoxyl Aq 2.5,5,10 gel, aqueous base, topical 2.5,5,10% StiefelPersa-Gel W 5,10% gel, aqueous base, topical 5,10% Ortho DermBenzac W Wash 5,10 liquid, topical 5,10% Owen/AllercremeDesquam X 5 Wash liquid, topical 5% Westwood

* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as anexception to the promulgated criteria for inclusion, pursuant to Rule 790.60.

BENZTROPINE MESYLATEBenztropine Mesylate tablet, oral 0.5,1,2mg Geneva

tablet, oral 1,2mg Mutualtablet, oral 0.5,1,2mg Par

@ tablet, oral 0.5,1,2mg Quantumtablet, oral 0.5,1,2mg Sidmaktablet, oral 0.5,1,2mg USL

Brand(s)Cogentin tablet, oral 0.5,1,2mg Merck Sharp and Dohme

BEPRIDIL HYDROCHLORIDEBrand(s)

Bepadin @ tablet, oral 200,300,400mg WallaceVascor tablet, oral 200,300mg RW JohnsonVascor @ tablet, oral 400mg RW Johnson

BETAMETHASONE DIPROPIONATEBetamethasone Dipropionate @ cream, topical eq 0.05% base Clay-Park

cream, topical eq 0.05% base Fougera/Altana *cream, topical eq 0.05% base NMC

@ cream, topical eq 0.05% base Pharmadermcream, topical eq 0.05% base Tarocream, topical eq 0.05% base Tevacream, topical eq 0.05% base Thameslotion, topical eq 0.05% base Alpharmalotion, topical eq 0.05% base Clay-Parklotion, topical eq 0.05% base Copleylotion, topical eq 0.05% base Fougera/Altana *

@ lotion, topical eq 0.05% base Pharmadermlotion, topical eq 0.05% base Tarolotion, topical eq 0.05% base Tevalotion, topical eq 0.05% base Thames

@ ointment, topical eq 0.05% base Clay-Parkointment, topical eq 0.05% base Fougera/Altana *ointment, topical eq 0.05% base NMC

@ ointment, topical eq 0.05% base Pharmadermointment, topical eq 0.05% base Taroointment, topical eq 0.05% base Teva

(continued on the next page)BETAMETHASONE DIPROPIONATE (continued)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

27

Brand(s)Alphatrex cream, topical eq 0.05% base Savage/AltanaDiprosone cream, topical eq 0.05% base ScheringAlphatrex lotion, topical eq 0.05% base Savage/AltanaDiprosone lotion, topical eq 0.05% base ScheringAlphatrex ointment, topical eq 0.05% base Savage/AltanaDiprosone ointment, topical eq 0.05% base Schering

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

BETAMETHASONE DIPROPIONATE, AUGMENTEDBetamethasone Dipropionate, ointment, topical eq 0.05% base Altana Augmented ointment, topical eq 0.05% base NMC

Brand(s)Diprolene AF ointment, topical eq 0.05% base Schering *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

BETAMETHASONE DIPROPIONATE; CLOTRIMAZOLEBetamethasone Dipropionate; cream, topical eq 0.05% base;1% Altana Clotrimazole cream, topical eq 0.05% base;1% Taro

Brand(s)Lotrisone cream, topical eq 0.05% base; 1% Schering *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

BETAMETHASONE SODIUM PHOSPHATEBetamethasone Sodium Phosphate injection eq 3mg base/ml Steris

Brand(s)Celestone injection eq 3mg base/ml Schering

BETAMETHASONE VALERATEBetamethasone Valerate @ cream, topical eq 0.1% base Clay-Park

cream, topical eq 0.1% base Fougera/Altana@ cream, topical eq 0.1% base Pharmaderm@ cream, topical eq 0.1% base Pharmafair

cream, topical eq 0.1% base Thameslotion, topical eq 0.1% base Alpharmalotion, topical eq 0.1% base Copleylotion, topical eq 0.1% base Fougera/Altana

@ lotion, topical eq 0.1% base Pharmaderm@ lotion, topical eq 0.1% base Pharmafair@ ointment, topical eq 0.1% base Clay-Park

ointment, topical eq 0.1% base Fougera/Altanaointment, topical eq 0.1% base NMC

@ ointment, topical eq 0.1% base Pharmaderm@ ointment, topical eq 0.1% base Pharmafair

Brand(s)Beta-Val cream, topical eq 0.1% base TevaBetaderm cream, topical eq 0.1% base RoacoBetatrex cream, topical eq 0.1% base Savage/AltanaDermabet cream, topical eq 0.1% base Taro

(continued on the next page)BETAMETHASONE VALERATE (continued)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

28

Valisone @ cream, topical eq 0.1% base ScheringValnac cream, topical eq 0.1% base NMCBeta-Val lotion, topical eq 0.1% base TevaBetatrex lotion, topical eq 0.1% base Savage/AltanaValisone @ lotion, topical eq 0.1% base ScheringBeta-Val ointment, topical eq 0.1% base TevaBetatrex ointment, topical eq 0.1% base Savage/AltanaValisone @ ointment, topical eq 0.1% base Schering

BETAXOLOL HYDROCHLORIDEBetaxolol Hydrochloride solution, ophthalmic eq 0.5% base Akorn

solution, ophthalmic eq 0.5% base Novextablet, oral 10,20mg Amide

Brand(s)Betoptic solution, ophthalmic eq 0.5% base AlconKerlone tablet, oral 10,20mg Lorex

BETHANECHOL CHLORIDEBethanechol Chloride @ injection 5mg/ml Quad

@ tablet, oral 10,25mg (Ascot)@ tablet, oral 5,10,25,50mg Circa@ tablet, oral 5,10,25,50mg Danbury@ tablet, oral 5,10,25mg Eon@ tablet, oral 25mg IVAX@ tablet, oral 5,10,25mg Lannett

tablet, oral 5,10,25,50mg Odyssey@ tablet, oral 5,10,25mg Watson

Brand(s)Urecholine @ injection 5mg/ml SidmakDuvoid @ tablet, oral 5,10,25,50mg WellspringMyotonachol @ tablet, oral 5,10,25,50mg GlenwoodUrecholine @ tablet, oral 5,10,25,50mg Sidmak

BIOTIN; ASCORBIC ACID; CYANOCOBALAMIN; DEXPANTHENOL; ERGOCALCIFEROL; FOLIC ACID;NIACINAMIDE; PYRIDOXINE HYDROCHLORIDE; RIBOFLAVIN PHOSPHATE SODIUM; THIAMINEHYDROCHLORIDE; VITAMIN A; VITAMIN E

See ASCORBIC ACID; BIOTIN; CYANOCOBALAMIN; DEXPANTHENOL; ERGOCALCIFEROL; FOLICACID; NIACINAMIDE; PYRIDOXINE HYDROCHLORIDE; RIBOFLAVIN PHOSPHATE SODIUMHYDROCHLORIDE; VITAMIN A; VITAMIN E

BISOPROLOL FUMARATEBisoprolol Fumarate tablet, oral 5,10mg Copley

tablet, oral 5,10mg Eontablet, oral 5,10mg Mylan

Brand(s)Zebeta tablet, oral 5,10mg ESI Lederle *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

BISOPROLOL FUMARATE; HYDROCHLOROTHIAZIDEBisoprolol Fumarate; @ tablet, oral 2.5,5,10mg;6.25mg Apothecon

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

29

Hydrochlorothiazide tablet, oral 2.5,5,10mg;6.25mg Eontablet, oral 2.5,5,10mg;6.25mg Genevatablet, oral 2.5,5,10mg;6.25mg IVAXtablet, oral 2.5,5,10mg;6.25mg Mylantablet, oral 2.5,5,10mg;6.25mg Purepactablet, oral 2.5,5,10mg;6.25mg Tevatablet, oral 2.5,5,10mg;6.25mg Watson

Brand(s)Ziac tablet, oral 2.5,5,10mg;6.25mg ESI Lederle *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

BLEOMYCIN SULFATEBleomycin Sulfate injection eq 15,30U base/vial Faulding

injection eq 15,30U base/vial Gensia-Sicorinjection eq 15,30U base/vial Pharmacia & Upjohn

Brand(s)Blenoxane injection eq 15,30U base/vial Bristol-Myers Squibb

BRETYLIUM TOSYLATEBretylium Tosylate injection 50mg/ml Abbott

@ injection 50mg/ml American Pharmaceutical Partners

@ injection 50mg/ml AstraZenecainjection 50mg/ml Elkins-Sinninjection 50mg/ml International Medicationinjection 50mg/ml Luitpold

@ injection 50mg/ml QuadBrand(s)

Bretylol @ injection 50mg/ml Faulding

BRETYLIUM TOSYLATE; DEXTROSEBretylium Tosylate; Dextrose injection 200mg/100ml;5gm/100ml Abbott

injection 400mg/100ml;5gm/100ml Abbott@ injection 200mg/100ml;5gm/100ml Baxter@ injection 400mg/100ml;5gm/100ml Baxter

injection 200mg/100ml;5gm/100ml Brauninjection 400mg/100ml;5gm/100ml Braun

BROMOCRIPTINE MESYLATEBromocriptine Mesylate capsule, oral eq 5mg base Lek

tablet, oral eq 2mg base LekBrand(s)

Parlodel capsule, oral eq 5mg base Novartis *Parlodel tablet, oral eq 2.5mg base Novartis *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

BROMODIPHENHYDRAMINE HYDROCHLORIDE; CODEINE PHOSPHATEBrand(s)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

30

Ambenyl syrup, oral 12.5mg/5ml;10mg/5ml ForestBromanyl syrup, oral 12.5mg/5ml;10mg/5ml AlpharmaMybanil syrup, oral 12.5mg/5ml;10mg/5ml Morton Grove

BROMPHENIRAMINE MALEATEBrompheniramine Maleate @ elixir, oral 2mg/5ml Alpharma

elixir 2mg/5ml KV@ elixir 2mg/5ml Pharmaceutical Associates@ elixir 2mg/5ml USL

injection 10mg/ml Steris@ tablet, oral 4mg Anabolic@ tablet, oral 4mg Barr@ tablet, oral 4mg Danbury@ tablet, oral 4mg Eon@ tablet, oral 4mg Geneva@ tablet, oral 4mg IVAX@ tablet, oral 4mg Newtron

tablet, oral 4mg Nylos@ tablet, oral 4mg Par

tablet, oral 4mg Phoenix@ tablet, oral 4mg Pioneer

tablet, oral 4mg Private Formulations@ tablet, oral 4mg Watson

Brand(s)Dimetane-Ten @ injection 10mg/ml RobinsDimetane @ tablet, oral 4mg Whitehall RobinsVeltane tablet, oral 4mg Lannett

BROMPHENIRAMINE MALEATE; CODEINE PHOSPHATE; PHENYLPROPANOLAMINE HYDROCHLORIDEBrand(s)

Bromanate DC syrup, oral 2mg/5ml;10mg/5ml; Alpharma 12.5mg/5ml

Dimetane-DC @ syrup, oral 2mg/5ml;10mg/5ml; Robins 12.5mg/5ml

Myphetane DC syrup, oral 2mg/5ml;10mg/5ml; Morton Grove 12.5mg/5ml

BROMPHENIRAMINE MALEATE; DEXTROMETHORPHAN HYDROBROMIDE; PSEUDOEPHEDRINEHYDROCHLORIDE

Brand(s)Bromanate DM syrup, oral 2mg/5ml;10mg/5ml; Alpharma

30mg/5mlBromfed-DM syrup, oral 2mg/5ml;10mg/5ml; Muro

30mg/5mlDimetane-DX syrup, oral 2mg/5ml;10mg/5ml; Robins

30mg/5mlMyphetane DX syrup, oral 2mg/5ml;10mg/5ml; Morton Grove

30mg/5ml

BROMPHENIRAMINE MALEATE; PHENYLPROPANOLAMINE HYDROCHLORIDEBrand(s)

Biphetapp @ elixir, oral 4mg/5ml;25mg/5ml Morton GroveBromanate @ elixir, oral 4mg/5ml;25mg/5ml Alpharma

BUMETANIDEBumetanide injection 0.25mg/ml Abbott

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

31

injection 0.25mg/ml Bedfordinjection 0.25mg/ml Gensia Sicortablet, oral 0.5,1,2mg Eontablet, oral 0.5,1,2mg IVAX

Brand(s)Bumex injection 0.25mg/ml RocheBumex tablet, oral 0.5,1,2mg Roche *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

BUPIVACAINE HYDROCHLORIDEBupivacaine Hydrochloride injection 0.25,0.5,0.75% Abbott

injection, spinal 0.75% AbbottBrand(s)

Marcaine HCl injection 0.25,0.5% Sanofi SynthelaboMarcaine HCl Preservative Free injection 0.25,0.5,0.75% Sanofi SynthelaboSensorcaine injection 0.25,0.5,0.75% Astra ZenecaMarcaine injection, spinal 0.75% Sterling WinthropSensorcaine injection, spinal 0.75% Astra Zeneca

BUPIVACAINE HYDROCHLORIDE; EPINEPHRINE BITARTRATEBrand(s)

Marcaine HCl with Epinephrine injection 0.25%;0.0091mg/ml Sanofi SynthelaboMarcaine HCl with Epinephrine injection 0.5%;0.0091mg/ml Sanofi SynthelaboMarcaine HCl with Epinephrine injection 0.25%;0.0091mg/ml Sanofi Synthelabo Preservative FreeMarcaine HCl with Epinephrine injection 0.5%;0.0091mg/ml Sanofi Synthelabo Preservative FreeMarcaine HCl with Epinephrine injection 0.75%;0.0091mg/ml Sanofi Synthelabo Preservative FreeSensorcaine injection 0.25%;0.0091mg/ml Astra ZenecaSensorcaine injection 0.5%;0.0091mg/ml Astra ZenecaSensorcaine injection 0.75%;0.0091mg/ml Astra Zeneca

BUPRENORPHINE HYDROCHLORIDEBuprenorphine Hydrochloride injection eq 0.3mg base/ml Abbott

Brand(s)Buprenex injection eq 0.3mg base/ml Reckitt Benckiser

BUPROPION HYDROCHLORIDEBupropion Hydrochloride tablet, oral 75,100mg Eon

tablet, oral 75,100mg ESI Lederletablet, oral 75,100mg Invamedtablet, oral 75,100mg Mylantablet, oral 75,100mg Teva

Brand(s)Wellbutrin tablet, oral 75,100mg Glaxo Wellcome

BUSPIRONEBuspirone tablet, oral 5,10,15mg Geneva

tablet, oral 5,10,15mg IVAXtablet, oral 5,10,15mg KV

(continued on the next page)BUSPIRONE (continued)

tablet, oral 5,10,15,30mg Mylan

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

32

tablet, oral 5,10,15mg Partablet, oral 5,10,15mg Tevatablet, oral 5,10,15mg Watsontablet, oral 5,10,15mg TorPharm

Brand(s)Buspar tablet, oral 5,10,15,30mg Bristol-Myers SquibbVanspar tablet, oral 7.5mg Par *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

BUTABARBITAL SODIUMButabarbital Sodium @ elixir, oral 30mg/5ml Morton Grove

tablet, oral 30mg Bundy@ tablet, oral 15,30mg Eon@ tablet, oral 15,30mg Geneva@ tablet, oral 15,30mg IVAX@ tablet, oral 15,30,100mg Lannett

tablet, oral 16.2,32.4mg Marshall@ tablet, oral 16.2,32.4mg Solvay@ tablet, oral 15,30mg Teva@ tablet, oral 15,30mg Watson@ tablet, oral 15,30mg West-ward@ tablet, oral 15,30mg Whiteworth Towne

Brand(s)Butabarb @ elixir, oral 30mg/5ml AlpharmaButisol Sodium elixir, oral 30mg/5ml WallaceSarisol @ elixir, oral 30mg/5ml HalseyButisol Sodium tablet, oral 15,30,100mg WallaceSarisol No. 1, No. 2 @ tablet, oral 15,30mg Halsey

BUTALBITAL; ACETAMINOPHENSee ACETAMINOPHEN; BUTALBITAL

BUTALBITAL; ACETAMINOPHEN; CAFFEINESee ACETAMINOPHEN; BUTALBITAL; CAFFEINE

BUTALBITAL; ASPIRIN; CAFFEINESee ASPIRIN; BUTALBITAL; CAFFEINE

BUTORPHANOL TARTRATEButorphanol Tartrate injection 1,2mg/ml Abbott

injection 1,2mg/ml Apotexinjection 1,2mg/ml Bedfordinjection 1,2mg/ml Fauldingspray, metered, nasal 1mg/spray Lederle/Mylanspray, metered, nasal 1mg/spray Roxane

Brand(s)Butorphanol Tartrate injection 1,2mg/ml Apotex Preservative-FreeButorphanol Tartrate injection 1,2mg/ml Bedford Preservative-Free

(continued on the next page)BUTORPHANOL TARTRATE (continued)

Butorphanol Tartrate injection 1,2mg/ml Meridian

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

33

Preservative-FreeStadol injection 1,2mg/ml ApotheconStadol Preservative Free injection 1,2mg/ml ApotheconStadol NS spray, metered, nasal 1mg/spray Bristol-Myers Squibb

CAFFEINE; ACETAMINOPHEN; BUTALBITALSee ACETAMINOPHEN; BUTALBITAL; CAFFEINE

CAFFEINE; ASPIRIN; BUTALBITALSee ASPIRIN; BUTALBITAL; CAFFEINE

CAFFEINE; ASPIRIN; ORPHENADRINE CITRATESee ASPIRIN: CAFFEINE: ORPHENADRINE CITRATE

CAFFEINE; ASPIRIN; PROPOXYPHENE HYDROCHLORIDE; See ASPIRIN; CAFFEINE; PROPOXYPHENE HYDROCHLORIDE

CAFFEINE; ERGOTAMINE TARTRATEBrand(s)

Cafergot @ tablet, oral 100mg;1mg NovartisErcatab tablet, oral 100mg;1mg GenevaWigraine tablet, oral 100mg;1mg Organon/Akzona

CALCITONIN, SALMONCalcitonin-Salmon @ injection 200IU/ml Astra Zeneca

Brand(s)Calcimar injection 200IU/ml Aventis *

Miacalcin injection 200IU/ml Novartis

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

CALCITRIOLCalcitriol capsule, oral 0.25,0.5mcg Teva

Brand(s)Rocaltrol capsule, oral 0.25,0.5mcg Roche

CALCIUM CHLORIDE; DEXTROSE; GLUTATHIONE DISULFIDE; MAGNESIUM CHLORIDE; POTASSIUMCHLORIDE; SODIUM BICARBONATE; SODIUM CHLORIDE; SODIUM PHOSPHATE

Brand(s)BSS Plus solution, irrigation 0.154mg/ml; Alcon

0.92mg/ml;0.184mg/ml; 0.2mg/ml;0.38mg/ml;2.1mg/ml; 7.14mg/ml;0.42mg/ml

Endosol Extra solution, irrigation 0.154mg/ml; Akorn 0.92mg/ml;0.184mg/ml; 0.2mg/ml;0.38mg/ml;2.1mg/ml; 7.14mg/ml;0.42mg/ml

CALCIUM CHLORIDE; DEXTROSE; MAGNESIUM CHLORIDE; SODIUM CHLORIDE; SODIUM LACTATESolution; intraperitoneal; in plastic container

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

34

Brand(s)Delflex with Dextrose 1.5% solution 25.7mg/100ml; Fresenius (low magnesium) 1.5gm/100ml;5.08mg/100ml;

538mg/100ml;448mg/100mlDelflex with Dextrose 2.5% solution 25.7mg/100ml; Fresenius (low magnesium) 2.5gm/100ml;5.08mg/100ml;

538mg/100ml;448mg/100mlDelflex with Dextrose 3.5% solution 25.7mg/100ml; Fresenius (low magnesium) 3.5gm/100ml;5.08mg/100ml;

538mg/100ml;448mg/100mlDelflex with Dextrose 4.25% solution 25.7mg/100ml; Fresenius (low magnesium) 4.25gm/100ml;5.08mg/100ml;

538mg/100ml;448mg/100mlDelflex with Dextrose 1.5% solution, 18.4mg/100ml; Fresenius Low Magnesium 1.5gm/100ml; 5.08mg/100ml; Low Calcium 538mg/100ml; 448mg/100mlDelflex with Dextrose 2.5% solution, 18.4mg/100ml; Fresenius Low Magnesium 2.5gm/100ml; 5.08mg/100ml; Low Calcium 538mg/100ml; 448mg/100mlDelflex with Dextrose 4.25% solution, 18.4mg/100ml; Fresenius Low Magnesium 4.25gm/100ml; 5.08mg/100ml; Low Calcium 538mg/100ml; 448mg/100mlDelflex with Dextrose 1.5% solution 25.7mg/100ml; Fresenius

1.5gm/100ml;15.2mg/100ml; 567mg/100ml;392mg/100ml

Delflex with Dextrose 2.5% solution 25.7mg/100ml; Fresenius 2.5gm/100ml;15.2mg/100ml; 567mg/100ml;392mg/100ml

Delflex with Dextrose 3.5% solution 25.7mg/100ml; Fresenius 3.5gm/100ml;15.2mg/100ml; 567mg/100ml;392mg/100ml

Delflex with Dextrose 4.25% solution 25.7mg/100ml; Fresenius 4.25gm/100ml;15.2mg/100ml; 567mg/100ml;392mg/100ml

Dianeal PD-1 solution 25.7mg/100ml; Baxter with Dextrose 1.5% 1.5gm/100ml;15.2mg/100ml;

567mg/100ml;392mg/100mlDianeal PD-1 solution 25.7mg/100ml; Baxter with Dextrose 2.5% 2.5gm/100ml;15.2mg/100ml;

567mg/100ml;392mg/100mlDianeal PD-1 solution 25.7mg/100ml;3.5gm/ Baxter with Dextrose 3.5% 100ml;15.2mg/100ml;

567mg/100ml;392mg/100mlDianeal PD-1 solution 25.7mg/100ml; Baxter with Dextrose 4.25% 4.25gm/100ml;15.2mg/100ml;

567mg/100ml;392mg/100mlDianeal PD-2 solution 25.7mg/100ml; Baxter with Dextrose 1.5% 1.5gm/100ml;5.08mg/100ml;

538mg/100ml;448mg/100mlDianeal PD-2 solution, 18.3mg/100ml; Baxter with Dextrose 1.5% 1.5gm/100ml; 5.08mg/100ml; Low Calcium 538mg/100ml; 448mg/100mlDianeal PD-2 solution 25.7mg/100ml; Baxter with Dextrose 2.5% 2.5gm/100ml;5.08mg/100ml;

538mg/100ml;448mg/100mlDianeal PD-2 solution 25.7mg/100ml; Baxter with Dextrose 3.5% 3.5gm/100ml;5.08mg/100ml;

538mg/100ml;448mg/100ml(continued on the next page)CALCIUM CHLORIDE; DEXTROSE; MAGNESIUM CHLORIDE; SODIUM CHLORIDE; SODIUM LACTATE(continued)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

35

Dianeal PD-2 solution 25.7mg/100ml; Baxter with Dextrose 4.25% 4.25gm/100ml;5.08mg/100ml;

538mg/100ml;448mg/100mlDianeal 137 solution 25.7mg/100ml; Baxter with Dextrose 1.5% 1.5gm/100ml;15.2mg/100ml;

567mg/100ml;392mg/100mlDianeal 137 solution 25.7mg/100ml; Baxter with Dextrose 2.5% 2.5gm/100ml;15.2mg/100ml;

567mg/100ml;392mg/100mlDianeal 137 solution 25.7mg/100ml; Baxter with Dextrose 4.25% 4.25gm/100ml;15.2mg/100ml;

567mg/100ml;392mg/100mlDianeal Low Calcium solution, 18.3mg/100ml; Baxter with Dextrose 1.5% 1.5gm/100ml; 5.08mg/100ml;

538mg/100ml; 448mg/100mlDianeal Low Calcium solution, 18.3mg/100ml; Baxter with Dextrose 2.5% 2.5gm/100ml; 5.08mg/100ml;

538mg/100ml; 448mg/100mlDianeal Low Calcium solution, 18.3mg/100ml; Baxter with Dextrose 3.5% 3.5gm/100ml; 5.08mg/100ml;

538mg/100ml; 448mg/100mlDianeal Low Calcium solution, 18.3mg/100ml; Baxter with Dextrose 4.25% 4.25gm/100ml; 5.08mg/100ml;

538mg/100ml; 448mg/100mlInpersol-LC/LM solution, 18.4mg/100ml; Fresenius with Dextrose 1.5% 1.5gm/100ml; 5.08mg/100ml;

538mg/100ml; 448mg/100mlInpersol-LC/LM solution, 18.4mg/100ml; Fresenius with Dextrose 2.5% 2.5gm/100ml; 5.08mg/100ml;

538mg/100ml; 448mg/100mlInpersol-LC/LM solution, 18.4mg/100ml; Fresenius with Dextrose 3.5% 3.5gm/100ml; 5.08mg/100ml;

538mg/100ml; 448mg/100mlInpersol-LC/LM solution, 18.4mg/100ml; Fresenius with Dextrose 4.25% 4.25gm/100ml; 5.08mg/100ml;

538mg/100ml; 448mg/100ml

CALCIUM CHLORIDE; DEXTROSE; POTASSIUM CHLORIDE; SODIUM CHLORIDEInjection; in plastic container

Dextrose 5% in Ringer's injection 33mg/100ml;5gm/100ml; Abbott 30mg/100mg;860mg/100ml

Dextrose 5% in Ringer's injection 33mg/100ml;5gm/100ml; Baxter 30mg/100mg;860mg/100ml

Dextrose 5% in Ringer's injection 33mg/100ml;5gm/100ml; Braun 30mg/100mg;860mg/100ml

CALCIUM CHLORIDE; DEXTROSE; POTASSIUM CHLORIDE; SODIUM CHLORIDE; SODIUM LACTATEInjection; in plastic container

Dextrose 5% in injection 20mg/100ml;5gm/100ml; Abbott Lactated Ringer's 30mg/100ml;600mg/100ml;

310mg/100mlDextrose 5% in injection 20mg/100ml;5gm/100ml; Baxter Lactated Ringer's 30mg/100ml;600mg/100ml;

310mg/100ml

(continued on the next page)CALCIUM CHLORIDE; DEXTROSE; POTASSIUM CHLORIDE; SODIUM CHLORIDE; SODIUM LACTATE(continued)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

36

Dextrose 5% in injection 20mg/100ml;5gm/100ml; Braun Lactated Ringer's 30mg/100ml;600mg/100ml;

310mg/100mlDextrose 5% in @ injection 20mg/100ml;5gm/100ml; Miles Lactated Ringer's 30mg/100ml;600mg/100ml;

310mg/100mlDextrose 5% in @ injection 20mg/100ml;5gm/100ml; Abbott Lactated Ringer's 104mg/100ml;600mg/100ml; with 10mEq KCl 310mg/100mlDextrose 5% in injection 20mg/100ml;5gm/100ml; Baxter Lactated Ringer's 105mg/100ml;600mg/100ml; with 10mEq KCl 310mg/100mlDextrose 5% in injection 20mg/100ml;5gm/100ml; Abbott Lactated Ringer's 179mg/100ml;600mg/100ml; with 20mEq KCl 310mg/mlDextrose 5% in injection 20mg/100ml;5gm/100ml; Baxter Lactated Ringer's 179mg/100ml;600mg/100ml; with 20mEq KCl 310mg/mlDextrose 5% in @ injection 20mg/100ml;5gm/100ml; Abbott Lactated Ringer's 254mg/100ml;600mg/100ml; with 30mEq KCl 310mg/100mlDextrose 5% in injection 20mg/100ml;5gm/100ml; Baxter Lactated Ringer's 254mg/100ml;600mg/100ml; with 30mEq KCl 310mg/100mlDextrose 5% in injection 20mg/100ml;5gm/100ml; Abbott Lactated Ringer's 328mg/100ml;600mg/100ml; with 40mEq KCl 310mg/100mlDextrose 5% in injection 20mg/100ml;5gm/100ml; Baxter Lactated Ringer's 328mg/100ml;600mg/100ml; with 40mEq KCl 310mg/100ml

CALCIUM CHLORIDE; MAGNESIUM CHLORIDE; POTASSIUM CHLORIDE; SODIUM CHLORIDEBrand(s)

Cardioplegic in plastic container solution, perfusion, cardiac Baxter 17.6mg/100ml; 325.3mg/100mg; 119.3mg/100ml; 643mg/100ml

Plegisol in plastic container solution, perfusion, cardiac Abbott 17.6mg/100ml; 325.3mg/100mg; 119.3mg/100ml; 643mg/100ml

CALCIUM CHLORIDE; POTASSIUM CHLORIDE; SODIUM CHLORIDEInjection; in plastic containerSolution for irrigation; in plastic container

Ringer's injection 33mg/100ml;30mg/100ml; Abbott 860mg/100ml

Ringer's injection 33mg/100ml;30mg/100ml; Baxter 860mg/100ml

Ringer's injection 33mg/100ml;30mg/100ml; Braun 860mg/100ml

Ringer's solution for irrigation 33mg/100ml; Abbott 30mg/100ml; 860mg/100ml

Ringer's solution for irrigation 33mg/100ml; Baxter 30mg/100ml; 860mg/100ml

Ringer's solution for irrigation 33mg/100ml; Braun 30mg/100ml; 860mg/100ml

CALCIUM CHLORIDE; POTASSIUM CHLORIDE; SODIUM CHLORIDE; SODIUM LACTATEInjection; in plastic container

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

37

Solution for irrigation; in plastic containerLactated Ringer's injection 20mg/100ml;30mg/100ml; Abbott

600mg/100ml;310mg/100mlLactated Ringer's injection 20mg/100ml;30mg/100ml; Baxter

600mg/100ml;310mg/100mlLactated Ringer's injection 20mg/100ml;30mg/100ml; Braun

600mg/100ml;310mg/100mlLactated Ringer's @ injection 20mg/100ml;30mg/100ml; Miles

600mg/100ml;310mg/100mlLactated Ringer's solution 20mg/100ml;30mg/100ml; Abbott

600mg/100ml;310mg/100mlLactated Ringer's solution 20mg/100ml;30mg/100ml; Baxter

600mg/100ml;310mg/100mlLactated Ringer's solution 20mg/100ml;30mg/100ml; Braun

600mg/100ml;310mg/100ml

CALCIUM GLUBIONATEBrand(s)

Calciquid solution, oral 1.8gm/5ml EconolabNeo-Calglucon solution, oral 1.8gm/5ml Novartis

* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as anexception to the promulgated criteria for inclusion, pursuant to Rule 790.60.

CALCIUM GLUCEPTATECalcium Gluceptate @ injection 0.09gm/5ml Abbott

(eq 90mg calcium)@ injection 0.09gm/5ml American Pharmaceutical

(eq 90mg calcium) Partners@ injection 0.09gm/5ml Lilly

(eq 90mg calcium)

CALCIUM GLUCONATECalcium Gluconate injection 100mg/ml Astra Zeneca

injection 100mg/ml American Pharmaceutical Partners

injection 100mg/ml Elkins-Sinninjection 100mg/ml Pharmacia & Upjohninjection 100mg/ml Warner Chilcott

* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as anexception to the promulgated criteria for inclusion, pursuant to Section 790.60.

CAPTOPRILCaptopril tablet, oral 12.5,25,50,100mg Apothecon

tablet, oral 12.5,25,50,100mg Copleytablet, oral 12.5,25,50,100mg Danburytablet, oral 12.5,25,50,100mg Egistablet, oral 12.5,25,50,100mg Endotablet, oral 12.5,25,50,100mg Eontablet, oral 12.5,25,50,100mg Genevatablet, oral 12.5,25,50,100mg Hallmarktablet, oral 12.5,25,50,100mg IVAXtablet, oral 12.5,25,50,100mg Mova

(continued on the next page)CAPTOPRIL (continued)

tablet, oral 12.5,25,50,100mg Mylan

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

38

tablet, oral 12.5,25,50,100mg Partablet, oral 12.5,25,50,100mg Purepactablet, oral 12.5,25,50,100mg Roycetablet, oral 12.5,25,50,100mg Stasontablet, oral 12.5,25,50,100mg Tevatablet, oral 12.5,25,50,100mg TorPharmtablet, oral 12.5,25,50,100mg Watsontablet, oral 12.5,25,50,100mg West-wardtablet, oral 12.5,25,50,100mg Wockhardt

Brand(s)Capoten tablet, oral 12.5,25,50,100mg Bristol-Myers Squibb

CAPTOPRIL; HYDROCHLOROTHIAZIDECaptopril; Hydrochlorothiazide @ tablet, oral 50mg;25mg Danbury

tablet, oral 25mg;15mg, 25mg;25mg, Endo 50mg;15mg, 50mg;25mgtablet, oral 25mg;15mg, 25mg;25mg, IVAX 50mg;15mg, 50mg;25mgtablet, oral 25mg;15mg, 25mg;25mg, Mylan 50mg;15mg, 50mg;25mgtablet, oral 25mg;15mg, 25mg;25mg, Teva 50mg;15mg, 50mg;25mg

Brand(s)Capozide tablet, oral 25mg;15mg, 25mg;25mg, Bristol-Myers Squibb

50mg;15mg, 50mg;25mg

CARBACHOLCarbachol @ solution, intraocular 0.01% Pharmafair

Brand(s)Carbastat solution, intraocular 0.01% NovartisMiostat solution, intraocular 0.01% Alcon

CARBAMAZEPINECarbamazepine suspension, oral 100mg/5ml Taro

tablet, chewable 100mg Caracotablet, chewable 100mg Tarotablet, chewable 100mg Warner Chilcotttablet, oral 200mg Apotextablet, oral 200mg Inwood/Foresttablet, oral 200mg Purepactablet, oral 200mg Sidmaktablet, oral 200mg Taro

@ tablet, oral 200mg USL@ tablet, oral 200mg Warner Chilcott

Brand(s)Tegretol suspension, oral 100mg/5ml NovartisEpitol tablet, chewable 100mg TevaTegretol tablet, chewable 100mg NovartisEpitol tablet, oral 200mg TevaTegretol tablet, oral 200mg Novartis

CARBENICILLIN, DISODIUMBrand(s)

Geopen @ injection eq 1,2 5,10gm base/vial Roerig-PfizerPyopen @ injection eq 1,2,5,10gm base/vial SmithKline Beecham

CARBIDOPA; LEVODOPACarbidopa; Levodopa tablet, oral 10mg;100mg Geneva

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

39

tablet, oral 25mg;100mg Genevatablet, oral 25mg;250mg Genevatablet, oral 10mg;100mg Purepactablet, oral 25mg;100mg Purepactablet, oral 25mg;250mg Purepac

@ tablet, oral 10mg;100mg SCS@ tablet, oral 25mg;100mg SCS@ tablet, oral 25mg;250mg SCS

tablet, oral 10mg;100mg Tevatablet, oral 25mg;100mg Tevatablet, oral 25mg;250mg Teva

@ tablet, oral 10mg;100mg Watson@ tablet, oral 25mg;100mg Watson@ tablet, oral 25mg;250mg Watson

tablet, extended release 25mg;100mg Mylantablet, extended release 50mg;200mg Mylan

Brand(s)Sinemet 10/100 tablet, oral 10mg;100mg Bristol-Myers Squibb *Sinemet 25/100 tablet, oral 25mg;100mg Bristol-Myers Squibb *Sinemet 25/250 tablet, oral 25mg;250mg Bristol-Myers Squibb *Sinemet CR 25/100 tablet, extended release 25mg;200mg Bristol-Myers Squibb *Sinemet CR 50/200 tablet, extended release 50mg;200mg Bristol-Myers Squibb *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

CARBINOXAMINE MALEATE; DEXTROMETHORPHAN HYDROBROMIDE; PSEUDOEPHEDRINEHYDROCHLORIDE

Carbinoxamine Maleate; syrup, oral 4mg/5ml;15mg/5ml; Geneva Dextromethorphan Hydrobromide; 60mg/5ml Pseudoephedrine Hydrochloride syrup, oral 4mg/5ml;15mg/5ml; Morton Grove

60mg/5mlBrand(s)

Carbofed DM Drops drops, oral 2mg/ml;4mg/ml;25mg/ml Hi-TechCardec DM Drops drops, oral 2mg/ml;4mg/ml;25mg/ml AlpharmaChemdec DM Drops drops, oral 2mg/ml;4mg/ml;25mg/ml NortonE-Dec DM Drops drops, oral 2mg/ml;4mg/ml;25mg/ml EsquireRondec DM Drops drops, oral 2mg/ml;4mg/ml;25mg/ml Ross/AbbottCarbofed DM Syrup syrup, oral 4mg/5ml;15mg/5ml; Hi-Tech

60mg/5mlCardec DM Syrup syrup, oral 4mg/5ml;15mg/5ml; Alpharma

60mg/5mlChemdec DM Syrup syrup, oral 4mg/5ml;15mg/5ml; Norton

60mg/5mlE-Dec DM Syrup syrup, oral 4mg/5ml;15mg/5ml; Esquire

60mg/5mlMaldec DM Syrup syrup, oral 4mg/5ml;15mg/5ml; Cenci

60mg/5mlRondec DM Syrup syrup, oral 4mg/5ml;15mg/5ml; Ross/Abbott

60mg/5ml

* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as anexception to the promulgated criteria for inclusion, pursuant to Rule 790.60.

CARBINOXAMINE MALEATE; PSEUDOEPHEDRINE HYDROCHLORIDECarbinoxamine Maleate; drops, oral 2mg/ml;25mg/ml Alpharma

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

40

Pseudoephedrine Hydrochloride drops, oral 2mg/ml;25mg/ml Morton Grovesyrup, oral 4mg/5ml;60mg/5ml Alpharma

Brand(s)Rondec Drops drops, oral 2mg/ml;25mg/ml RossChemdec Syrup syrup, oral 4mg/5ml;60mg/5ml NortonMaldec syrup, oral 4mg/5ml;60mg/5ml CenciRondec Syrup syrup, oral 4mg/5ml;60mg/5ml Ross

* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as anexception to the promulgated criteria for inclusion, pursuant to Rule 790.60.

CARISOPRODOLCarisoprodol tablet, oral 350mg Able

tablet, oral 350mg Amide@ tablet, oral 350mg Circa

tablet, oral 350mg CorePharmatablet, oral 350mg Danbury

@ tablet, oral 350mg Eontablet, oral 350mg Genevatablet, oral 350mg Mutual

@ tablet, oral 350mg Pioneertablet, oral 350mg Roycetablet, oral 350mg Vintagetablet, oral 350mg Watsontablet, oral 350mg West-ward

Brand(s)Rela @ tablet, oral 350mg ScheringSoma tablet, oral 350mg Wallace

CARISOPRODOL; ASPIRINSee ASPIRIN; CARISOPRODOL

CARISOPRODOL; ASPIRIN; CODEINE PHOSPHATESee ASPIRIN; CARISOPRODOL; CODEINE PHOSPHATE

CARTEOLOL HYDROCHLORIDECarteolol Hydrochloride solution, ophthalmic 1% Alcon

solution, ophthalmic 1% Bausch and Lombsolution, ophthalmic 1% Novex

Brand(s)Ocupres solution, ophthalmic 1% Novartis

CEFACLORCefaclor capsule, oral eq 250,500mg base IVAX

@ capsule, oral eq 250,500mg base Lederlecapsule, oral eq 250,500mg base Marsamcapsule, oral eq 250,500mg base Ranbaxycapsule, oral eq 250,500mg base Teva

@ powder for suspension, oral eq 125, IVAX 187,250mg base/5mlpowder for suspension, oral eq IVAX 375mg base/5ml

(continued on the next page)CEFACLOR (continued)

@ powder for suspension, oral eq 125, Lederle

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

41

187,250,375mg base/5mlpowder for suspension, oral eq 125, Marsam 187,250,375mg base/5mlpowder for suspension, oral eq 125, Ranbaxy 187,250,375mg base/5mltablet, extended release IVAX eq 500mg base

Brand(s)Ceclor capsule, oral eq 250,500mg base Lilly *Ceclor powder for suspension, eq 125,187, Lilly *

250,375mg base/5mlCeclor CD tablet, extended release Lilly

eq 500mg base

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

CEFADROXIL/CEFADROXIL HEMIHYDRATECefadroxil/ capsule, oral eq 500mg base Barr Cefadroxil Hemihydrate capsule, oral eq 500mg base IVAX

@ capsule, oral eq 500mg base Purepac@ capsule, oral eq 500mg base Teva@ powder for suspension Apothecon

eq 125,250,500mg base/5ml@ powder for suspension Teva

eq 125,250,500mg base/5ml@ tablet, oral eq 1gm base IVAX

tablet, oral eq 1gm base RanbaxyBrand(s)

Duricef capsule, oral eq 500mg base Bristol-Myers Squibb *Ultracef capsule, oral eq 500mg base ApotheconDuricef powder for suspension Bristol-Myers Squibb

eq 125,250,500mg base/5mlDuricef tablet, oral eq 1gm base Bristol-Myers SquibbUltracef @ tablet, oral eq 1gm base Apothecon

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

CEFAZOLIN SODIUMCefazolin Sodium injection eq 500mg,1gm base/vial American Pharmaceutical

Partners@ injection eq 10,20gm base/vial American Pharmaceutical

Partners@ injection eq 250,500mg,1,5,10gm Bedford

base/vial@ injection eq 250,500mg,1,5,10,20gm Elkins-Sinn

base/vialinjection eq 500mg,1,10gm base/vial Hanfordinjection eq 250,500mg,1,5,10,20gm Marsam base/vial

@ injection eq 250,500mg,1gm Teva base/vialinjection eq 5,10gm base/vial Teva

(continued on the next page)CEFAZOLIN SODIUM (continued)

Brand(s)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

42

Ancef @ injection eq 250mg base/vial SmithKline BeechamAncef injection eq 500mg,1,5,10gm base/vial SmithKline BeechamKefzol injection eq 250,500mg,1,10,20gm Lilly

base/vialZolicef injection eq 500mg,1,10gm base/vial Apothecon

CEFOTAXIME SODIUMCefotaxime Sodium injection eq 500mg, American Pharmaceutical

1,2,10,20gm base/vial PartnersBrand(s)

Claforan injection eq 500mg, Aventis 1,2,10,20gm base/vial

CEFOXITIN SODIUMCefoxitin Sodium injection eq 1,2,10gm base/vial American Pharmaceutical

Partnersinjection eq 1,2,10gm base/vial ESI Lederle

Brand(s)Mefoxin injection eq 1,2,10gm base/vial Merck

CEFPODOXIME PROXETILBrand(s)

Banan @ granules for suspension Sankyo eq 50,100mg base/5ml

Vantin granules for suspension Pharmacia & Upjohn eq 50,100mg base/5ml

Banan @ tablet, oral eq 100,200mg base SankyoVantin tablet, oral eq 100,200mg base Pharmacia & Upjohn

CEFTAZIDIMEBrand(s)

Fortaz injection 500mg,1,2,6gm/vial Glaxo WellcomeTazicef injection 500mg,1,2,6gm/vial AbbottTazidime injection 500mg,1,2gm/vial Lilly

CEFTAZIDIME (ARGININE FORMULATION)Brand(s)

Ceptaz injection 1,2,10gm/vial Glaxo WellcomePentacef @ injection 1,2,10gm/vial SmithKline Beecham

CEFTAZIDIME SODIUMCeftazidime Sodium injection, in plastic container Baxter

eq 10,20,40mg base/mlBrand(s)

Fortaz @ injection, in plastic container Glaxo Wellcome eq 10mg base/ml

Fortaz injection, in plastic container Glaxo Wellcome eq 20,40mg base/ml

CEFUROXIME SODIUMCefuroxime Sodium injection, IM/IV eq 7.5gm base/vial American Pharmaceutical

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

43

Partnersinjection, IM/IV eq 7.5gm base/vial Hanfordinjection, IM/IV eq 7.5gm base/vial Marsaminjection, IM/IV eq 7.5gm base/vial Tevainjection eq 1.5,7.5gm base/vial Hanfordinjection eq 1.5,7.5gm base/vial Marsaminjection eq 1.5,7.5gm base/vial Teva

Brand(s)Kefurox injection, IM/IV eq 750mg base/vial LillyKefurox injection eq 1.5,7.5gm base/vial LillyKefurox @ injection, in plastic container Lilly

eq 750mg,1.5gm base/vialZinacef injection, IM/IV eq 750mg base/vial Glaxo WellcomeZinacef injection eq 1.5,7.5gm base/vial Glaxo Wellcome

CEPHALEXINCephalexin capsule, oral eq 250,500mg base Atral

capsule, oral eq 250,500mg base Barrcapsule, oral eq 250,500mg base IVAXcapsule, oral eq 250,500mg base MJ

@ capsule, oral eq 250,500mg base Purepaccapsule, oral eq 250,500mg base Ranbaxycapsule, oral eq 250mg base Stevens

@ capsule, oral eq 500mg base Stevenscapsule, oral eq 250,500mg base Teva

@ capsule, oral eq 250,500mg base Yoshitomipowder for suspension Apothecon eq 125,250mg base/5ml

@ powder for suspension Barr eq 125mg base/5mlpowder for suspension Barr eq 250mg base/5ml

@ powder for suspension Eon eq 125,250mg base/5mlpowder for suspension Ranbaxy eq 125,250mg base/5mlpowder for suspension Teva eq 125,250mg base/5ml

@ tablet, oral eq 250,500mg base Barr@ tablet, oral eq 250,500mg base Eon

tablet, oral eq 250,500mg base TevaBrand(s)

Cefanex capsule, oral eq 250,500mg base ApotheconKeflex capsule, oral eq 250,500mg base Lilly *Keflex powder for suspension Ceph Intl *

eq 125,250mg base/5mlKeflet tablet, oral eq 250,500mg base Lilly

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

CEPHALOTHIN SODIUMCephalothin Sodium @ injection eq 1,2gm base/vial Abbott

@ injection eq 1,2gm base/vial American Pharmaceutical Partners

injection eq 1,2,4gm base/vial Bristol/Bristol-Myers(continued on the next page)CEPHALOTHIN SODIUM (continued)

@ injection eq 1,2,4gm base/vial International Medication

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

44

Brand(s)Keflin injection eq 1,2,4gm base/vial LillySeffin @ injection eq 1,2gm base/vial Glaxo Wellcome

CEPHAPIRIN SODIUMCephapirin Sodium @ injection eq 500mg,1,2,4, American Pharmaceutical

20gm base/vial Partners@ injection eq 500mg,1,2,20gm base/vial Elkins-Sinn

Brand(s)Cefadyl injection eq 500mg,1,2,4gm base/vial Apothecon

CEPHRADINE/CEPHRADINE DIHYDRATECephradine/ @ capsule, oral 250,500mg Barr Cephradine Dihydrate @ capsule, oral 250,500mg Eon

@ capsule, oral 250,500mg IVAXcapsule, oral 250,500mg Teva

@ powder for suspension 125,250mg/5ml Barrpowder for suspension 125,250mg/5ml Teva

Brand(s)Anspor capsule, oral 250,500mg SmithKline BeechamVelosef capsule, oral 250,500mg ApotheconAnspor powder for suspension 125,250mg/5ml SmithKline BeechamVelosef "125," "250" powder for suspension 125,250mg/5ml Apothecon

CHLORAL HYDRATEChloral Hydrate syrup, oral 500mg/5ml Alpharma

syrup, oral 500mg/5ml Cencisyrup, oral 500mg/5ml Lederlesyrup, oral 500mg/5ml Morton Grove

@ syrup, oral 500mg/5ml Purepacsyrup, oral 500mg/5ml Roxanesyrup, oral 500mg/5ml Veratex

Brand(s)Noctec syrup, oral 500mg/5ml Squibb

* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as anexception to the promulgated criteria for inclusion, pursuant to Rule 790.60.

CHLORAMPHENICOLChloramphenicol @ capsule, oral 250mg IVAX

ointment, ophthalmic 1% Altana@ solution, ophthalmic 0.5% Alcon

Brand(s)Amphicol @ capsule, oral 100,250mg FerranteChloromycetin @ capsule, oral 100,250mg ParkdaleMychel capsule, oral 250mg ArmenpharmChlorofair @ ointment, ophthalmic 1% PharmafairChloromycetin ointment, ophthalmic 1% ParkedaleChloroptic S.O.P. ointment, ophthalmic 1% AllerganEconochlor @ ointment, ophthalmic 1% AlconAK-Chlor @ solution, ophthalmic 0.5% AkornChlorofair @ solution, ophthalmic 0.5% PharmafairChloroptic solution, ophthalmic 0.5% AllerganEconochlor @ solution, ophthalmic 0.5% Alcon

(continued on the next page)CHLORAMPHENICOL (continued)

Ophthochlor @ solution, ophthalmic 0.5% Parkdale

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

45

Optomycin @ solution, ophthalmic 0.5% Optopics

CHLORAMPHENICOL SODIUM SUCCINATEChloramphenicol injection eq 1gm base/vial American Pharmaceutical Sodium Succinate @ injection eq 1gm base/vial Elkins Sinn

injection eq 1gm base/vial Gruppo LepetitBrand(s)

Chloromycetin injection eq 1gm base/vial Parke-DavisMychel-S @ injection eq 1gm base/vial Angus

CHLORDIAZEPOXIDE HYDROCHLORIDEChlordiazepoxide @ capsule, oral 5,10,25mg (Ascot) Hydrochloride capsule, oral 5,10,25mg Barr

@ capsule, oral 5,10,25mg Eon@ capsule, oral 5,10,25mg Ferrante

capsule, oral 10mg Geneva@ capsule, oral 5,25mg Geneva@ capsule, oral 5,10,25mg Halsey

capsule, oral 10mg Impax@ capsule, oral 5,25mg Impax@ capsule, oral 5,10,25mg IVAX@ capsule, oral 5,10,25mg Lederle@ capsule, oral 10mg Mast@ capsule, oral 5,10,25mg Mylan@ capsule, oral 5,10,25mg Parke-Davis@ capsule, oral 10,25mg Pioneer@ capsule, oral 5,10,25mg Purepac@ capsule, oral 10,25mg Roxane@ capsule, oral 5,10,25mg Superpharm@ capsule, oral 5,10,25mg Teva@ capsule, oral 5,25mg USL

capsule, oral 10mg USL@ capsule, oral 5,10,25mg (Vangard/MWM)

capsule, oral 5,10,25mg Watson@ capsule, oral 5,10,25mg West-ward

Brand(s)A-Poxide @ capsule, oral 5,10,25mg AbbottChlordiazachel @ capsule, oral 5,10,25mg RachelleLibrium capsule, oral 5,10,25mg ICNLygen @ capsule, oral 5,10,25mg Alra

CHLORDIAZEPOXIDE; AMITRIPTYLINE HYDROCHLORIDESee AMITRIPTYLINE HYDROCHLORIDE; CHLORDIAZEPOXIDE

CHLORHEXIDINE GLUCONATEChlorhexidine Gluconate solution, dental 0.12% Alpharma

solution, dental 0.12% Hi-Techsolution, dental 0.12% Novexsolution, dental 0.12% Teva

Brand(s)Peridex solution, dental 0.12% ZilaPerioGard solution, dental 0.12% Colgate-Palmolive

CHLOROPROCAINE HYDROCHLORIDEChloroprocaine Hydrochloride injection 2,3% Abbott

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

46

injection 2,3% BedfordBrand(s)

Nesacaine-MPF injection 2,3% Astra Zeneca

CHLOROQUINE PHOSPHATEChloroquine Phosphate tablet, oral 250mg (eq 150mg base) Danbury

tablet, oral 500mg (eq 300mg base) Danburytablet, oral 250mg (eq 150mg base) Impax

@ tablet, oral 250mg (eq 150mg base) MD@ tablet, oral 250mg (eq 150mg base) Purepac@ tablet, oral 250mg (eq 150mg base) Teva

tablet, oral 250mg (eq 150mg base) West-wardtablet, oral 500mg (eq 300mg base) West-ward

Brand(s)Aralen tablet, oral 500mg (eq 300mg base) Sanofi Synthelabo

CHLOROTHIAZIDEChlorothiazide @ tablet, oral 250mg ABC

@ tablet, oral 250,500mg Circa@ tablet, oral 250mg Danbury@ tablet, oral 250,500mg Eon@ tablet, oral 250,500mg Lederle

tablet, oral 250,500mg Mylan@ tablet, oral 250,500mg Watson

tablet, oral 250,500mg West-wardBrand(s)

Diuril tablet, oral 250,500mg Merck Sharp and Dohme *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

CHLOROTHIAZIDE; METHYLDOPAChlorothiazide; Methyldopa @ tablet, oral 150mg;250mg Par

@ tablet, oral 250mg;250mg ParBrand(s)

Aldochlor-150 tablet, oral 150mg;250mg Merck Sharp and DohmeAldochlor-250 tablet, oral 250mg;250mg Merck Sharp and Dohme

CHLOROTRIANISENEChlorotrianisene @ capsule, oral 12mg Banner Pharmacaps

Brand(s)TACE capsule, oral 12mg Aventis

CHLORPHENIRAMINE MALEATEChlorpheniramine Maleate @ injection 10mg/ml Bel-Mar

@ injection 10mg/ml Elkins-Sinn@ injection 10,100mg/ml Steris@ tablet, oral 4mg Danbury@ tablet, oral 4mg Geneva

tablet, oral 4mg ICN@ tablet, oral 4mg Impax@ tablet, oral 4mg KV

tablet, oral 4mg Marshall(continued on the next page)CHLORPHENIRAMINE MALEATE (continued)

@ tablet, oral 4mg Pharmavite

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

47

tablet, oral 4mg Phoenixtablet, oral 4mg Superpharmtablet, oral 4mg Tablicaps

@ tablet, oral 4mg West-wardBrand(s)

Chlor-Trimeton @ injection 10,100mg/ml ScheringPyridamal 100 @ injection 100mg/ml Bel-MarKloromin @ tablet, oral 4mg Halsey

CHLORPHENIRAMINE MALEATE; CODEINE PHOSPHATE; PSEUDOEPHEDRINE HYDROCHLORIDEChlorpheniramine Maleate; syrup, oral 2mg/5ml;10mg/5ml; Morton Grove Codeine Phosphate; 30mg/5ml Pseudoephedrine Hydrochloride

Brand(s)Dihistine DH Elixir syrup, oral 2mg/5ml;10mg/5ml; Alpharma

30mg/5mlNovadyne DH Liquid syrup, oral 2mg/5ml;10mg/5ml; Norton

30mg/5mlNovahistine DH Liquid syrup, oral 2mg/5ml;10mg/5ml; SmithKline Beecham

30mg/5mlPhenylhistine DH syrup, oral 2mg/5ml;10mg/5ml; Cenci

30mg/5mlRyna C Liquid syrup, oral 2mg/5ml;10mg/5ml; Wallace

30mg/5ml

* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as anexception to the promulgated criteria for inclusion, pursuant to Rule 790.60.

CHLORPHENIRAMINE MALEATE; PHENYLEPHRINE HYDROCHLORIDE; PHENYLPROPANOLAMINEHYDROCHLORIDE; PHENYLTOLOXAMINE CITRATE

Chlorpheniramine Maleate; drops, oral 0.5mg/ml;1.25mg/ml; Alpharma Phenylephrine Hydrochloride; 5mg/ml;2mg/ml Phenylpropanolamine syrup, oral 0.5mg/5ml;1.25mg/5ml; Alpharma Hydrochloride; 5mg/5ml;2mg/5ml Phenyltoloxamine Citrate syrup, oral 2.5mg/5ml;5mg/5ml; Alpharma 20mg/5ml;7.5mg/5ml syrup, oral 2.5mg/5ml;5mg/5ml; Naska

20mg/5ml;7.5mg/5mlBrand(s)

Naldecon Pediatric Drops drops, oral 0.5mg/ml;1.25mg/ml; Bristol/Bristol-Myers 5mg/ml;2mg/ml

Nalphen Pediatric Drops drops, oral 0.5mg/ml;1.25mg/ml; Hi-Tech 5mg/ml;2mg/ml

Sinucon Pediatric Drops drops, oral 0.5mg/ml;1.25mg/ml; Norton 5mg/ml;2mg/ml

Naldecon Pediatric Syrup syrup, oral 0.5mg/5ml;1.25mg/5ml; Bristol/Bristol-Myers 5mg/5ml;2mg/5ml

Naldecon Syrup syrup, oral 2.5mg/5ml;5mg/5ml; Bristol/Bristol-Myers 20mg/5ml;7.5mg/5ml

Nalphen Pediatric Syrup syrup, oral 0.5mg/5ml;1.25mg/5ml; Hi-Tech 5mg/5ml;2mg/5ml

Nalphen Syrup syrup, oral 2.5mg/5ml;5mg/5ml; Hi-Tech 20mg/5ml;7.5mg/5ml

Sinucon Pediatric Syrup syrup, oral 0.5mg/5ml;1.25mg/5ml; Norton 5mg/5ml;2mg/5ml

(continued on the next page)CHLORPHENIRAMINE MALEATE; PHENYLEPHRINE HYDROCHLORIDE; PHENYLPROPANOLAMINEHYDROCHLORIDE; PHENYLTOLOXAMINE CITRATE

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

48

Sinucon Syrup syrup, oral 2.5mg/5ml;5mg/5ml; Norton 20mg/5ml;7.5mg/5ml

* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as anexception to the promulgated criteria for inclusion, pursuant to Section 790.60.

CHLORPHENIRAMINE MALEATE; PHENYLPROPANOLAMINE HYDROCHLORIDEChlorpheniramine Maleate; capsule, extended release 12mg;75mg Geneva Phenylpropanolamine @ capsule, extended release 12mg;75mg Watson Hydrochloride

Brand(s)Ornade capsule, extended release 12mg;75mg SmithKline Beecham

CHLORPHENIRAMINE TANNATE; PHENYLEPHRINE TANNATE; PYRILAMINE TANNATEChlorpheniramine Tannate; suspension, oral 2mg/5ml;5mg/ml; Ferndale Phenylephrine Tannate; 12.5mg/5ml Pyrilamine Tannate

Brand(s)Histatan suspension, oral 2mg/5ml;5mg/5ml; Norton

12.5mg/5mlR-Tannate suspension, oral 2mg/5ml;5mg/5ml; Copley

12.5mg/5mlRynatan Pediatric suspension, oral 2mg/5ml;5mg/5ml; Wallace

12.5mg/5mlTriotann S suspension, oral 2mg/5ml;5mg/5ml; Duramed

12.5mg/5ml

* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as anexception to the promulgated criteria for inclusion, pursuant to Section 790.60.

CHLORPROMAZINE HYDROCHLORIDEChlorpromazine Hydrochloride concentrate, oral 100mg/ml Alpharma

@ concentrate, oral 30,100mg/ml Morton Groveconcentrate, oral 30,100mg/ml Pharmaceutical Associates

@ injection 25mg/ml American Pharmaceutical Partners

injection 25mg/ml Elkins-Sinninjection 25mg/ml Marsam

@ injection 25mg/ml Steris@ injection 25mg/ml Wyeth-Ayerst@ syrup, oral 10mg/5ml Alpharma

Brand(s)Intensol concentrate, oral 30,100mg/ml RoxaneSonazine concentrate, oral 30,100mg/ml GenevaThorazine concentrate, oral 30,100mg/ml SmithKline BeechamThorazine injection 25mg/ml SmithKline BeechamSonazine syrup, oral 10mg/5ml GenevaThorazine syrup, oral 10mg/5ml SmithKline Beecham

CHLORPROPAMIDEChlorpropamide @ tablet, oral 100,250mg Barr

@ tablet, oral 100,250mg Circatablet, oral 100,250mg Danbury

@ tablet, oral 100,250mg Duramed(continued on the next page)CHLORPROPAMIDE (continued)

@ tablet, oral 250mg Eon

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

49

tablet, oral 100,250mg Geneva@ tablet, oral 100,250mg Halsey@ tablet, oral 100,250mg IVAX

tablet, oral 100,250mg Lederletablet, oral 100,250mg Mylantablet, oral 100,250mg Partablet, oral 100,250mg Sidmaktablet, oral 100mg Superpharm

@ tablet, oral 250mg Superpharm@ tablet, oral 100mg Teva@ tablet, oral 100,250mg USL@ tablet, oral 100,250mg Watson

Brand(s)Diabinese tablet, oral 100,250mg PfizerGlucamide @ tablet, oral 250mg Teva

CHLORTHALIDONEChlorthalidone @ tablet, oral 25mg Abbott

@ tablet, oral 50mg Abbott@ tablet, oral 25,50mg (Ascot)@ tablet, oral 25,50mg Barr@ tablet, oral 25,50mg Circa@ tablet, oral 25,50mg Danbury@ tablet, oral 50mg Eon@ tablet, oral 25mg Geneva

tablet, oral 50mg Genevatablet, oral 25,50mg IVAX

@ tablet, oral 25,50mg KV@ tablet, oral 25,50mg Lederle

tablet, oral 25,50mg Mutualtablet, oral 25,50mg Mylan

@ tablet, oral 50mg Pioneer@ tablet, oral 25,50mg Purepac

tablet, oral 25,50mg Sidmak@ tablet, oral 25,50mg Superpharm@ tablet, oral 50mg Teva

tablet, oral 25mg USL@ tablet, oral 50mg USL@ tablet, oral 25,50mg (Vangard/MWM)@ tablet, oral 25,50mg Warner Chilcott

tablet, oral 25mg Watson@ tablet, oral 50mg Watson

Brand(s)Hygroton tablet, oral 25,50mg Aventis

CHLORTHALIDONE; ATENOLOLSee ATENOLOL; CHLORTHALIDONE

CHLORTHALIDONE; CLONIDINE HYDROCHLORIDEChlorthalidone; tablet, oral 15mg;0.1mg Mylan Clonidine Hydrochloride tablet, oral 15mg;0.2mg Mylan

tablet, oral 15mg;0.3mg Mylantablet, oral 15mg;0.1mg Partablet, oral 15mg;0.2mg Partablet, oral 15mg;0.3mg Par

(continued on the next page)CHLORTHALIDONE; CLONIDINE HYDROCHLORIDE (continued)

Brand(s)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

50

Combipres tablet, oral 15mg;0.1mg Boehringer IngelheimCombipres tablet, oral 15mg;0.2mg Boehringer IngelheimCombipres tablet, oral 15mg;0.3mg Boehringer Ingelheim

CHLORZOXAZONEChlorzoxazone tablet, oral 250,500mg Amide

tablet, oral 500mg Barr@ tablet, oral 250,500mg Danbury

tablet, oral 250,500mg Genevatablet, oral 500mg Mutualtablet, oral 250,500mg Ohmtablet, oral 250mg Par

@ tablet, oral 250,500mg Pioneertablet, oral 500mg Roycetablet, oral 500mg Teva

@ tablet, oral 250mg Watsontablet, oral 500mg Watson

Brand(s)Paraflex @ tablet, oral 250mg JohnsonParafon Forte DSC tablet, oral 500mg McNeilStrifon Forte DSC tablet, oral 500mg Ferndale

CHOLESTYRAMINECholestyramine powder, oral eq 4gm resin/packet Copley

powder, oral eq 4gm resin/scoopful Copleypowder, oral eq 4gm resin/packet IVAXpowder, oral eq 4gm resin/scoopful IVAXpowder, oral eq 4gm resin/packet Tevapowder, oral eq 4gm resin/scoopful Teva

Brand(s)Cholestyramine Light powder, oral eq 4gm resin/packet CopleyCholestyramine Light powder, oral eq 4gm resin/scoopful CopleyCholestyramine Light powder, oral eq 4gm resin/packet TevaCholestyramine Light powder, oral eq 4gm resin/scoopful TevaLocholest powder, oral eq 4gm resin/packet EonLocholest powder, oral eq 4gm resin/scoopful EonLocholest Light powder, oral eq 4gm resin/packet EonLocholest Light powder, oral eq 4gm resin/scoopful EonPrevalite powder, oral eq 4gm resin/packet Upsher-Smith *Prevalite powder, oral eq 4gm resin/scoopful Upsher-Smith *Questran powder, oral eq 4gm resin/packet Bristol-Myers Squibb *Questran powder, oral eq 4gm resin/scoopful Bristol-Myers Squibb *Questran Light powder, oral eq 4gm resin/packet Bristol-Myers Squibb *Questran Light powder, oral eq 4gm resin/scoopful Bristol-Myers Squibb *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

CHROMIC CHLORIDEChromic Chloride injection eq 0.004mg chromium/ml Abbott

@ injection eq 0.004mg chromium/ml American Pharmaceutical Partners

CIMETIDINECimetidine tablet, oral 200,300,400,800mg Danbury

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

51

tablet, oral 200,300,400,800mg Endotablet, oral 200,300,400,800mg Genevatablet, oral 200,300,400,800mg IVAXtablet, oral 200,300,400,800mg Lektablet, oral 300,400,800mg Movatablet, oral 200,300,400,800mg Mylan

@ tablet, oral 300,400,800mg Roxanetablet, oral 200,300,400,800mg Sidmaktablet, oral 200,300,400,800mg Tevatablet, oral 200,300,400,800mg TorPharm

Brand(s)Tagamet tablet, oral 200,300,400,800mg SmithKline Beecham *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

CIMETIDINE HYDROCHLORIDECimetidine Hydrochloride injection eq 300mg base/2ml Abbott

injection eq 300mg base/2ml Endoinjection eq 300mg base/2ml Gensia Sicorinjection eq 300mg base/2ml Luitpoldinjection eq 300mg base/2ml Movasolution, oral eq 300mg base/5ml Alpharmasolution, oral eq 300mg base/5ml Copleysolution, oral eq 300mg base/5ml Duramedsolution, oral eq 300mg base/5ml Endosolution, oral eq 300mg base/5ml Hi-Techsolution, oral eq 300mg base/5ml Morton Grovesolution, oral eq 300mg base/5ml Novexsolution, oral eq 300mg base/5ml Pharmaceutical Associatessolution, oral eq 300mg base/5ml Roxanesolution, oral eq 300mg base/5ml Teva

Brand(s)Tagamet injection eq 300mg base/2ml SmithKline BeechamTagamet solution, oral eq 300mg base/5ml SmithKline Beecham

CIMETIDINE HYDROCHLORIDE; SODIUM CHLORIDECimetidine Hydrochloride; injection eq 600mg base/ml; Abbott Sodium Chloride 900mg/100ml

Brand(s)Tagamet injection eq 600mg base/ml; SmithKline Beecham

900mg/100ml

CINOXACINCinoxacin @ capsule, oral 250,500mg Teva

Brand(s)Cinobac capsule, oral 250,500mg Lilly

CISPLATINCisplatin injection 1mg/ml American Pharmaceutical

Partnersinjection 1mg/ml Bedfordinjection 1mg/ml Gensia-Sicorinjection 1mg/ml Pharmachemie

(continued on the next page)CISPLATIN

injection 10,50mg/vial Bedford

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

52

Brand(s)Platinol-AQ injection 1mg/ml Bristol-Myers SquibbPlatinol injection 10,50mg/vial Bristol-Myers Squibb

CITRIC ACID; MAGNESIUM OXIDE; SODIUM CARBONATESolution for irrigation; in plastic container

Brand(s)Irrigating Solution G solution for irrigation 3.24gm/100ml; Baxter

380mg/100ml;430mg/100mlUrologic G solution for irrigation 3.24gm/100ml; Abbott

380mg/100ml;430mg/100ml

CLADRIBINECladribine injection 1mg/ml Bedford

Brand(s)Leustatin injection 1mg/ml RW Johnson

CLEMASTINE FUMARATEClemastine Fumarate syrup, oral eq 0.5mg base/5ml Alpharma

syrup, oral eq 0.5mg base/5ml Copleysyrup, oral eq 0.5mg base/5ml Morton Grovesyrup, oral eq 0.5mg base/5ml Novexsyrup, oral eq 0.5mg base/5ml Silarxsyrup, oral eq 0.5mg base/5ml Tevatablet, oral eq 2.68mg base Geneva

@ tablet, oral eq 1.34mg base Tevatablet, oral eq 2.68mg base Teva

Brand(s)Tavist syrup, oral eq 0.5mg base/5ml Novartis *Tavist 1 @ tablet, oral eq 1.34mg base NovartisTavist tablet, oral eq 2.68mg base Novartis

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

CLINDAMYCIN HYDROCHLORIDEClindamycin Hydrochloride @ capsule, oral eq 75mg base Danbury

capsule, oral eq 150mg base Danburycapsule, oral eq 150,300mg base Ranbaxycapsule, oral eq 75,150mg base Teva

Brand(s)Cleocin capsule, oral eq 75,150,300mg base Pharmacia & Upjohn *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

CLINDAMYCIN PHOSPHATEClindamycin Phosphate injection eq 150mg base/ml Abbott

@ injection eq 150mg base/ml American Pharmaceutical Partners

@ injection eq 150mg base/ml Astra Zenecainjection eq 150mg base/ml Bedford

@ injection eq 150mg base/ml Bristol-Myers Squibb(continued on the next page)CLINDAMYCIN PHOSPHATE (continued)

@ injection eq 150mg base/ml Elkins-Sinn

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

53

@ injection eq 150mg base/ml Gensia Sicorinjection eq 150mg base/ml Lederleinjection eq 150mg base/ml Lochinjection eq 150mg base/ml Marsam

@ injection eq 150mg base/ml Quad@ injection eq 150mg base/ml Solopak@ injection eq 150mg base/ml Steris

gel, topical eq 1% base Altanalotion, topical eq 1% base Altanasolution, topical eq 1% base Alpharmasolution, topical eq 1% base Clay-Park

@ solution, topical eq 1% base Copleysolution, topical eq 1% base Fougera/Altanasolution, topical eq 1% base Morton Grovesolution, topical eq 1% base Stiefel

@ solution, topical eq 1% base Tevaswab, topical eq 1% base Clay-Park

Brand(s)Cleocin-T gel, topical eq 1% base Pharmacia & Upjohn *Cleocin injection eq 150mg base/ml Pharmacia & UpjohnCleocin-T lotion, topical eq 1% base Pharmacia & UpjohnCleocin T solution, topical eq 1% base Pharmacia & Upjohn *Clinda-Derm solution, topical eq 1% base PaddockCleocin T swab, topical eq 1% base Pharmacia & UpjohnClindets swab, topical eq 1% base Stiefel

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

CLINDAMYCIN PHOSPHATE; DEXTROSEClindamycin Phosphate; injection eq 900mg base/100ml American Pharmaceutical Dextrose Partners in plastic container @ injection eq 12mg base/ml American Pharmaceutical

Partnersinjection eq 900mg base/100ml Baxterinjection eq 6,12mg base/ml Baxter

Brand(s)Cleocin Phosphate in Dextrose 5% injection eq 6,12,18mg base/ml Pharmacia & Upjohn

CLOBETASOL PROPIONATEClobetasol Propionate cream, (AB1) topical 0.05% Altana

cream, (AB1) topical 0.05% Copleycream, (AB1) topical 0.05% Fougera/Altanacream, (AB1) topical 0.05% Tarocream, (AB2) emollient topical 0.05% Altanacream, (AB2) emollient topical 0.05% Tarogel, topical 0.05% Altanagel, topical 0.05% Stiefelgel, topical 0.05% Taroointment, topical 0.05% Copleyointment, topical 0.05% Fougera/Altanaointment, topical 0.05% NMCointment, topical 0.05% Stiefelointment, topical 0.05% Tarosolution, topical 0.05% Altanasolution, topical 0.05% Morton Grove

(continued on the next page)CLOBETASOL PROPIONATE (continued)

solution, topical 0.05% NMC

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

54

solution, topical 0.05% Tarosolution, topical 0.05% Thames

Brand(s)Cormax cream, (AB1) topical 0.05% HealthpointTemovate cream, (AB1) topical 0.05% Glaxo WellcomeEmbeline E cream, (AB2) emollient topical 0.05% HealthpointTemovate E cream, (AB2) emollient topical 0.05% Glaxo WellcomeTemovate gel, topical 0.05% Glaxo WellcomeEmbeline ointment, topical 0.05% HealthpointTemovate ointment, topical 0.05% Glaxo WellcomeEmbeline solution, topical 0.05% DPTTemovate solution, topical 0.05% Glaxo Wellcome

Products designated “AB1" may only be interchanged with other products designated as “AB1." Productsdesignated as “AB2" may only be interchanged with other products designated as “AB2.” Productsdesignated as “AB1" MAY NOT BE INTERCHANGED with products designated as “AB2.”

CLOFIBRATEClofibrate capsule, oral 500mg Banner Pharmacaps

@ capsule, oral 500mg Genevacapsule, oral 500mg Tevacapsule, oral 500mg USL

@ capsule, oral 500mg WatsonBrand(s)

Atromid-S capsule, oral 500mg Wyeth-Ayerst

CLOMIPHENE CITRATEClomiphene Citrate tablet, oral 50mg Par

Brand(s)Clomid tablet, oral 50mg AventisMilophene tablet, oral 50mg MilexSerophene tablet, oral 50mg Serono *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

CLOMIPRAMINE HYDROCHLORIDEClomipramine Hydrochloride capsule, oral 25,50,75mg Circa

capsule, oral 25,50,75mg Genevacapsule, oral 25,50,75mg Mylancapsule, oral 25,50,75mg Tarocapsule, oral 25,50,75mg Tevacapsule, oral 25,50,75mg Watson

Brand(s)Anafranil capsule, oral 25,50,75mg Tyco

CLONAZEPAMClonazepam tablet, oral 0.5,1,2mg Alphapharm

tablet, oral 0.5,1,2mg Caracotablet, oral 0.5,1,2mg Eontablet, oral 0.5,1,2mg Genevatablet, oral 0.5,1,2mg Mylan

(continued on the next page)CLONAZEPAM (continued)

tablet, oral 0.5,1,2mg Purepactablet, oral 0.5,1,2mg Teva

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

55

tablet, oral 0.5,1,2mg TorPharmtablet, oral 0.5,1,2mg Watson

Brand(s)Klonopin tablet, oral 0.5,1,2mg Roche

CLONIDINE HYDROCHLORIDEClonidine Hydrochloride @ tablet, oral 0.1,0.2,0.3mg American Therapeutics

tablet, oral 0.1mg Barr@ tablet, oral 0.2,0.3mg Barr@ tablet, oral 0.1,0.2,0.3mg Circa

tablet, oral 0.1,0.2,0.3mg Danbury@ tablet, oral 0.1,0.2,0.3mg Duramed

tablet, oral 0.1,0.2,0.3mg Geneva@ tablet, oral 0.1,0.2,0.3mg Interpharm

tablet, oral 0.1,0.2,0.3mg Lederletablet, oral 0.1,0.2,0.3mg Mylan

@ tablet, oral 0.1,0.2,0.3mg Partablet, oral 0.1,0.2,0.3mg Purepac

@ tablet, oral 0.1,0.2,0.3mg Teva@ tablet, oral 0.1,0.2,0.3mg Warner-Chilcott

Brand(s)Catapres tablet, oral 0.1,0.2,0.3mg Boehringer Ingelheim

CLONIDINE HYDROCHLORIDE; CHLORTHALIDONESee CHLORTHALIDONE; CLONIDINE HYDROCHLORIDE

CLORAZEPATE DIPOTASSIUMClorazepate Dipotassium @ capsule, oral 3.75,7.5,15mg Able

@ capsule, oral 3.75,7.5,15mg American Therapeuticscapsule, oral 3.75,7.5,15mg Genevacapsule, oral 3.75,7.5,15mg Lederlecapsule, oral 3.75,7.5,15mg Mylan

@ capsule, oral 3.75,7.5,15mg Purepac@ capsule, oral 3.75,7.5,15mg Quantum@ capsule, oral 3.75,7.5,15mg Searle@ capsule, oral 3.75,7.5,15mg USL@ capsule, oral 3.75,7.5,15mg Warner Chilcott@ capsule, oral 3.75,7.5,15mg Watson

tablet, oral 3.75,7.5,15mg Able@ tablet, oral 3.75,7.5,15mg American Therapeutics@ tablet, oral 3.75mg Geneva

tablet, oral 7.5,15mg Geneva@ tablet, oral 3.75,7.5,15mg Lederle

tablet, oral 3.75,7.5,15mg Mylan@ tablet, oral 3.75,7.5,15mg Purepac@ tablet, oral 3.75,7.5,15mg Quantum

tablet, oral 3.75,7.5,15mg Taro@ tablet, oral 3.75,7.5,15mg Warner Chilcott

Brand(s)Tranxene @ capsule, oral 3.75,7.5,15mg AbbottGen-Xene tablet, oral 3.75,7.5,15mg AlraTranxene tablet, oral 3.75,7.5,15mg Abbott

CLOTRIMAZOLEClotrimazole cream, topical 1% Taro

solution, topical 1% Taro

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

56

solution, topical 1% TevaBrand(s)

Lotrimin cream, topical 1% ScheringLotrimin solution, topical 1% ScheringMycelex solution, topical 1% Miles

CLOTRIMAZOLE; BETAMETHASONE DIPROPIONATESee BETAMETHASONE DIPROPIONATE; CLOTRIMAZOLE

CLOXACILLIN SODIUM MONOHYDRATECloxacillin Sodium Monohydrate capsule, oral eq 250,500mg base Teva

powder for solution Teva eq 125mg base/5ml

Brand(s)Cloxapen capsule, oral eq 250,500mg base SmithKline BeechamTegopen @ capsule, oral eq 250,500mg base ApotheconTegopen @ powder for solution Apothecon

eq 125mg base/5ml

CLOZAPINEClozapine @ tablet, oral 25,100mg Geneva

tablet, oral 25,100mg IVAXtablet, oral 25,100mg Mylan

Brand(s)Clozaril tablet, oral 25,100mg Novartis

CODEINE PHOSPHATE; ACETAMINOPHENSee ACETAMINOPHEN; CODEINE PHOSPHATE

CODEINE PHOSPHATE; ASPIRINSee ASPIRIN; CODEINE PHOSPHATE

CODEINE PHOSPHATE; ASPIRIN; CARISOPRODOLSee ASPIRIN; CARISOPRODOL; CODEINE PHOSPHATE

CODEINE PHOSPHATE; BROMODIPHENHYDRAMINE HYDROCHLORIDESee BROMODIPHENHYDRAMINE HYDROCHLORIDE; CODEINE PHOSPHATE

CODEINE PHOSPHATE; BROMPHENIRAMINE MALEATE; PHENYLPROPANOLAMINE HYDROCHLORIDESee BROMPHENIRAMINE MALEATE; CODEINE PHOSPHATE; PHENYLPROPANOLAMINE

HYDROCHLORIDE

CODEINE PHOSPHATE; CHLORPHENIRAMINE MALEATE; PSEUDOEPHEDRINE HYDROCHLORIDESee CHLORPHENIRAMINE MALEATE; CODEINE PHOSPHATE; PSEUDOEPHEDRINE

HYDROCHLORIDE

CODEINE PHOSPHATE; GUAIFENESINCodeine Phosphate; syrup, oral 10mg/5ml;100mg/5ml Cenci Guaifenesin syrup, oral 10mg/5ml;100mg/5ml Halsey

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

57

Brand(s)Guiatuss AC syrup, oral 10mg/5ml;100mg/5ml AlpharmaRobitussin AC syrup, oral 10mg/5ml;100mg/5ml Robins

* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as anexception to the promulgated criteria for inclusion, pursuant to Section 790.60.

CODEINE PHOSPHATE; GUAIFENESIN; PSEUDOEPHEDRINE HYDROCHLORIDECodeine Phosphate; Guaifenesin; syrup, oral 10mg/5ml;100mg/5ml; Morton Grove Pseudoephedrine Hydrochloride 30mg/5ml

Brand(s)Codafed Expectorant syrup, oral 10mg/5ml;100mg/5ml Hauck

30mg/5mlGuiatuss DAC syrup, oral 10mg/5ml;100mg/5ml; Alpharma

30mg/5mlNovadyne Expectorant syrup, oral 10mg/5ml;100mg/5ml Norton

30mg/5mlNovahistine Expectorant syrup, oral 10mg/5ml;100mg/5ml; Aventis

30mg/5mlPhenylhistine Expectorant syrup, oral 10mg/5ml;100mg/5ml; Cenci

30mg/5mlRobitussin DAC Syrup syrup, oral 10mg/5ml;100mg/5ml; Robins

30mg/5ml

* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as anexception to the promulgated criteria for inclusion, pursuant to Rule 790.60.

CODEINE PHOSPHATE; IODINATED GLYCEROLCodeine Phosphate; @ liquid, oral 10mg/5ml;30mg/5ml Alpharma Iodinated Glycerol @ liquid, oral 10mg/5ml;30mg/5ml Duramed

@ liquid, oral 10mg/5ml;30mg/5ml HalseyBrand(s)

Iophen-C @ liquid, oral 10mg/5ml;30mg/5ml NaskaIotuss-C @ liquid, oral 10mg/5ml;30mg/5ml CenciOridol C @ liquid, oral 10mg/5ml;30mg/5ml NortonTussi Organidin @ liquid, oral 10mg/5ml;30mg/5ml WallaceTussi-R-Gen Expectorant @ liquid, oral 10mg/5ml;30mg/5ml Goldline

* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as anexception to the promulgated criteria for inclusion, pursuant to Rule 790.60.

CODEINE PHOSPHATE; PHENYLEPHRINE HYDROCHLORIDE; PROMETHAZINE HYDROCHLORIDEBrand(s)

Phenergan VC with Codeine syrup, oral 10mg/5ml;5mg/5ml; Wyeth-Ayerst 6.25mg/5ml

Pherazine VC with Codeine @ syrup, oral 10mg/5ml;5mg/5ml; Halsey 6.25mg/5ml

Prometh VC with Codeine syrup, oral 10mg/5ml;5mg/5ml; Alpharma 6.25mg/5ml

Promethazine VC with Codeine @ syrup, oral 10mg/5ml;5mg/5ml; Cenci 6.25mg/5ml

Promethazine VC with Codeine syrup, oral 10mg/5ml;5mg/5ml; Morton Grove 6.25mg/5ml

CODEINE PHOSPHATE; PROMETHAZINE HYDROCHLORIDECodeine Phosphate; syrup, oral 10mg/5ml;6.25mg/5ml Hi-Tech

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

58

Promethazine Hydrochloride syrup, oral 10mg/5ml;6.25mg/5ml Pharmaceutical AssociatesBrand(s)

Phenergan with Codeine syrup, oral 10mg/5ml;6.25mg/5ml Wyeth-AyerstPherazine with Codeine @ syrup, oral 10mg/5ml;6.25mg/5ml HalseyPrometh with Codeine syrup, oral 10mg/5ml;6.25mg/5ml AlpharmaPromethazine with Codeine @ syrup, oral 10mg/5ml;6.25mg/5ml CenciPromethazine with Codeine syrup, oral 10mg/5ml;6.25mg/5ml Morton Grove

CODEINE PHOSPHATE; PSEUDOEPHEDRINE HYDROCHLORIDE; TRIPROLIDINE HYDROCHLORIDECodeine Phosphate; @ syrup, oral 10mg/5ml;30mg/5ml; Cenci Pseudoephedrine Hydrochloride; 1.25mg/5ml Triprolidine Hydrochloride

Brand(s)Actifed with Codeine @ syrup, oral 10mg/5ml;30mg/5ml; Glaxo Wellcome

1.25mg/5mlPseudodine C syrup, oral 10mg/5ml;30mg/5ml; Morton Grove

1.25mg/5mlTriacin-C syrup, oral 10mg/5ml;30mg/5ml; Alpharma

1.25mg/5ml

COLISTIMETHATEColistimethate injection eq 150mg base/vial Pharma-Tel

Brand(s)Coly-Mycin M injection eq 150mg base/vial Parkdale

CORTICOTROPINCorticotropin @ injection 40U/vial Steris

Brand(s)ACTH @ injection 25,40U/vial ParkdaleActhar @ injection 25,40U/vial Aventis

CROMOLYN SODIUMCromolyn Sodium solution for inhalation 10mg/ml Alpharma

solution for inhalation 10mg/ml Bausch and Lombsolution for inhalation 10mg/ml Deysolution for inhalation 10mg/ml Morton Grovesolution for inhalation 10mg/ml Roxanesolution for inhalation 10mg/ml Steripaksolution for inhalation 10mg/ml Warricksolution, ophthalmic 4% Akornsolution, ophthalmic 4% Alcon *solution, ophthalmic 4% Novex

Brand(s)Intal solution for inhalation 10mg/ml Aventis *Crolom solution, ophthalmic 4% Bausch and LombCromoptic solution, ophthalmic 4% KingOpticrom solution, ophthalmic 4% Allergan

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

CROTAMITONBrand(s)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

59

Crotan lotion, topical 10% SummersEurax lotion, topical 10% Westwood Squibb

CYANOCOBALAMINCyanocobalamin @ injection 1000mcg/ml Akorn

@ injection 30mcg/ml American Pharmaceutical Partners

injection 100mcg/ml American Pharmaceutical Partners

@ injection 1000mcg/ml Aventis@ injection 30,100,1000mcg/ml Dell

injection 1000mcg/ml Elkins-Sinn@ injection 30mcg/ml Luitpold

injection 1000mcg/ml Luitpoldinjection 1000mcg/ml Medwick

@ injection 1000mcg/ml SolopakBrand(s)

Berubigen @ injection 1000mcg/ml Pharmacia & UpjohnBetalin 12 @ injection 100,1000mcg/ml LillyCobavite injection 100,1000mcg/ml SterisRedisol @ injection 1000mcg/ml Merck Sharp DohmeRubivite @ injection 30,100,1000mcg/ml Bel-MarRubramin PC @ injection 100mcg/ml SquibbRubramin PC injection 1000mcg/ml SquibbRuvite @ injection 1000mcg/ml Savage/AltanaSytobex @ injection 1000mcg/ml Warner ChilcottVi-Twel @ injection 1000mcg/ml BerlexVibisone injection 1000mcg/ml American Pharmaceutical

Partners

CYANOCOBALAMIN; ASCORBIC ACID; BIOTIN; DEXPANTHENOL; ERGOCALCIFEROL; FOLIC ACID;NIACINAMIDE; PYRIDOXINE HYDROCHLORIDE; RIBOFLAVIN PHOSPHATE SODIUM; THIAMINEHYDROCHLORIDE; VITAMIN A; VITAMIN E

See ASCORBIC ACID; BIOTIN; CYANOCOBALAMIN; DEXPANTHENOL; ERGOCALCIFEROL; FOLICACID; NIACINAMIDE; PYRIDOXINE HYDROCHLORIDE; RIBOFLAVIN PHOSPHATE SODIUMHYDROCHLORIDE; VITAMIN A; VITAMIN E

CYANOCOBALAMIN; ASCORBIC ACID; FLUORIDE; IRON; NICOTINIC ACID; PYRIDOXINE HYDROCHLORIDE;RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D; VITAMIN E

See ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; IRON; NICOTINIC ACID; PYRIDOXINEHYDROCHLORIDE; RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D;VITAMIN E

CYANOCOBALAMIN; ASCORBIC ACID; FLUORIDE; NICOTINIC ACID; PYRIDOXINE HYDROCHLORIDE;RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D; VITAMIN E

See ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; NICOTINIC ACID; PYRIDOXINEHYDROCHLORIDE; RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D;VITAMIN E

CYCLACILLINCyclacillin @ tablet, oral 250,500mg Teva

Brand(s)Cyclapen W @ tablet, oral 250,500mg Wyeth-Ayerst

CYCLOBENZAPRINE HYDROCHLORIDE

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

60

Cyclobenzaprine Hydrochloride tablet, oral 10mg Barrtablet, oral 10mg Danburytablet, oral 10mg Genevatablet, oral 10mg Mylantablet, oral 10mg Roycetablet, oral 10mg Sidmaktablet, oral 10mg Watson

Brand(s)Flexeril tablet, oral 10mg Merck Sharp and Dohme *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

CYCLOPENTOLATE HYDROCHLORIDECyclopentolate Hydrochloride solution, ophthalmic 1% Alcon Universal

@ solution, ophthalmic 1% Sola Barnes HindBrand(s)

AK-Pentolate solution, ophthalmic 1,2% AkornCyclogyl solution, ophthalmic 0.5,1,2% AlconPentolair @ solution, ophthalmic 0.5,1% PharmafairPentolair solution, ophthalmic 1% Bausch and Lomb

CYCLOPHOSPHAMIDECyclophosphamide injection 100,200,500mg,1gm Asta

tablet, oral 25,50mg RoxaneBrand(s)

Cytoxan @ injection 100,200,500mg,1,2gm Bristol-Myers SquibbLyophilized Cytoxan injection 100,200,500mg,1,2gm Bristol-Myers SquibbNeosar injection 100,200,500mg,1,2gm Pharmacia & UpjohnCytoxan tablet, oral 25,50mg Bristol-Myers Squibb

CYCLOSPORINEinjection 50mg/ml Bedford

Brand(s)Sandimmune injection 50mg/ml Novartis

CYPROHEPTADINE HYDROCHLORIDECyproheptadine Hydrochloride syrup, oral 2mg/5ml Alpharma

@ syrup, oral 2mg/5ml Halsey@ syrup, oral 2mg/5ml Morton Grove@ syrup, oral 2mg/5ml Naska

tablet, oral 4mg ABC@ tablet, oral 4mg American Therapeutics@ tablet, oral 4mg (Ascot)@ tablet, oral 4mg Circa

(continued on the next page)CYPROHEPTADINE HYDROCHLORIDE (continued)

NOTE: Within 24 hours of any interchange of a patient’s cyclosporine prescription, whether from abrand name manufacturer to a generic manufacturer, generic manufacturer to a brand namemanufacturer, or generic manufacturer to a different generic manufacturer, the pharmacist must notifythe prescriber of the interchange, identifying to the prescriber the name of the manufacturer of thecyclosporine product dispensed to the patient.

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

61

@ tablet, oral 4mg Danbury@ tablet, oral 4mg Duramed@ tablet, oral 4mg Eon@ tablet, oral 4mg Geneva@ tablet, oral 4mg Halsey

tablet, oral 4mg IVAX@ tablet, oral 4mg KV

tablet, oral 4mg MD@ tablet, oral 4mg Mylan

tablet, oral 4mg Par@ tablet, oral 4mg Pioneer

tablet, oral 4mg Sidmak@ tablet, oral 4mg Superpharm@ tablet, oral 4mg Watson

Brand(s)Periactin syrup, oral 2mg/5ml Merck Sharp and DohmePeriactin tablet, oral 4mg Merck Sharp and Dohme

CYTARABINECytarabine injection 100,500mg,1,2gm/vial Bedford

injection 2gm/vial Fauldinginjection 100,500mg,1,2gm/vial Gensia Sicor

@ injection 100,500mg/vial QuadBrand(s)

Cytosar-U injection 100,500mg,1,2gm/vial Pharmacia & Upjohn

DACARBAZINEDacarbazine injection 100,200mg/vial American Pharmaceutical

Partnersinjection 200,500mg/vial Gensia Sicor

@ injection 100,200mg/vial QuadBrand(s)

DTIC-Dome injection 100,200mg/vial Bayer

DANAZOLDanazol capsule, oral 50,100,200mg Barr

Brand(s)Danocrine capsule, oral 50,100,200mg Sanofi Synthelabo

DAUNORUBICIN HYDROCHLORIDEDaunorubicin Hydrochloride injection eq 5mg base/ml Bedford

injection eq 20mg base/vial Bigmarinjection eq 5,20mg base/vial Gensia Sicor

Brand(s)Cerubidine injection eq 20mg base/vial BedfordCerubidine @ injection eq 20mg base/vial AventisCerubidine @ injection eq 20mg base/vial Wyeth-Ayerst

DESIPRAMINE HYDROCHLORIDEDesipramine Hydrochloride tablet, oral 10,25,50,75,100,150mg Eon

tablet, oral 10,25,50,75,100,150mg Genevatablet, oral 25,50,75,100,150mg Sidmak

@ tablet, oral 25,50,75,100mg USLBrand(s)

Norpramin tablet, oral 10,25,50,75,100,150mg Aventis

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

62

DESMOPRESSIN ACETATEDesmopressin Acetate injection 0.004mg/ml Abbott

injection 0.004mg/ml Bedfordinjection 0.004mg/ml Gensia Sicorspray, metered, nasal 0.01mg/spray Bausch and Lomb

Brand(s)Desmopressin Acetate injection 0.004mg/ml Bedford Preservative-FreeDDAVP injection 0.004mg/ml Aventis *DDAVP spray, metered, nasal 0.01mg/spray Aventis *DDAVP (needs no refrigeration) spray, metered, nasal 0.01mg/spray Aventis *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

DESOGESTREL; ETHINYL ESTRADIOLBrand(s)

Apri tablet, oral 0.15mg;0.03mg DuramedDesogen tablet, oral 0.15mg;0.03mg OrganonOrtho-Cept tablet, oral 0.15mg;0.03mg RW Johnson

Note: 21 day packs may not be interchanged with 28 day packs.

DESONIDEDesonide cream, topical 0.05% Copley

cream, topical 0.05% Taroointment, topical 0.05% Taro

Brand(s)Desowen cream, topical 0.05% Owen/GaldermaTridesilon cream, topical 0.05% Clay ParkDesowen ointment, topical 0.05% Owen/GaldermaTridesilon ointment, topical 0.05% Clay Park

DESOXIMETASONEDesoximetasone cream, topical 0.05,0.25% Taro

gel, topical 0.05% Taroointment, topical 0.25% Altana

Brand(s)Topicort LP cream, topical 0.05% MedicisTopicort cream, topical 0.25% MedicisTopicort gel, topical 0.05% MedicisTopicort @ ointment, topical 0.25% Medicis

DEXAMETHASONEDexamethasone elixir, oral 0.5mg/5ml Alpharma

@ suspension, ophthalmic 0.1% Steristablet, oral 0.5,0.75,1.5,4mg Roxane

Brand(s)Decadron elixir, oral 0.5mg/5ml Merck Sharp and DohmeHexadrol elixir, oral 0.5mg/5ml Organon/AkzonaMymethasone elixir, oral 0.5mg/5ml Morton GroveMaxidex suspension , ophthalmic 0.1% AlconDecadron tablet, oral 0.5,0.75,1.5,4mg Merck Sharp and Dohme

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

63

DEXAMETHASONE; NEOMYCIN SULFATE; POLYMYXIN B SULFATEDexamethasone; Neomycin ointment, ophthalmic 0.1%; Fougera/Altana Sulfate; Polymyxin B Sulfate eq 3.5mg base/gm;10,000U/gm

suspension , ophthalmic 0.1%; Alcon Universal eq 3.5mg base/ml;10,000u/ml

Brand(s)Dexacidin @ ointment, ophthalmic 0.1%; Novartis

eq 3.5mg base/gm;10,000U/gmDexasporin ointment, ophthalmic 0.1%; Bausch and Lomb

eq 3.5mg base/gm;10,000U/gmMaxitrol ointment, ophthalmic 0.1%; Falcon *

eq 3.5mg base/gm;10,000U/gmDexacidin suspension , ophthalmic 0.1%; Novartis

eq 3.5mg base/ml;10,000U/mlDexasporin suspension , ophthalmic 0.1%; Bausch and Lomb

eq 3.5mg base/ml;10,000U/mlMaxitrol suspension , ophthalmic 0.1%; Falcon *

eq 3.5mg base/ml;10,000U/ml

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

DEXAMETHASONE; TOBRAMYCINDexamethasone; Tobramycin solution, ophthalmic 0.1%; 0.3% Bausch and Lomb

Brand(s)Tobradex solution, ophthalmic 0.1%; 0.3% Alcon

DEXAMETHASONE SODIUM PHOSPHATEDexamethasone Sodium @ injection eq 4mg phosphate/ml Akorn Phosphate @ injection eq 4mg phosphate/ml American Pharmaceutical

Partnersinjection eq 10mg phosphate/ml American Pharmaceutical

Partners@ injection eq 4mg phosphate/ml Bel-Mar@ injection eq 4mg phosphate/ml Dell

injection eq 4,10mg phosphate/ml Elkins-Sinn@ injection eq 4mg phosphate/ml Gensia Sicor

injection eq 10mg phosphate/ml Gensia Sicor@ injection eq 20mg phosphate/ml International Medication

injection eq 4mg phosphate/ml Luitpold@ injection eq 4,10,20, Quad

24mg phosphate/mlinjection eq 4,10mg phosphate/ml Steris

@ injection eq 24mg phosphate/ml Steris@ injection eq 4mg phosphate/ml Wyeth-Ayerst

solution, ophthalmic-otic Alcon Universal eq 0.1% phosphatesolution, ophthalmic Bausch and Lomb eq 0.1% phosphate

@ solution, ophthalmic Sola Barnes Hind eq 0.1% phosphate

Brand(s)Dexacen-4 @ injection eq 4mg phosphate/ml CentralDecadron injection eq 4,24mg phosphate/ml Merck Sharp and DohmeHexadrol injection eq 4,10mg phosphate/ml Organon/AkzonaHexadrol @ injection eq 20mg phosphate/ml Organon/AkzonaDecadron @ ointment, ophthalmic Merck Sharp and Dohme

eq 0.05% phosphate(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

64

DEXAMETHASONE SODIUM PHOSPHATE (continued)Dexair @ ointment, ophthalmic Pharmafair

eq 0.05% phosphateMaxidex ointment, ophthalmic Alcon

eq 0.05% phosphateAK-Dex @ solution, ophthalmic-otic Akorn

eq 0.1% phosphateDecadron solution, ophthalmic-otic Merck Sharp and Dohme

eq 0.1% phosphateDexair @ solution, ophthalmic Pharmafair

eq 0.1% phosphate

DEXAMETHASONE SODIUM PHOSPHATE; NEOMYCIN SULFATEDexamethasone @ solution, ophthalmic Alcon Universal Sodium Phosphate; eq 0.1% phosphate;eq 3.5mg base/ml Neomycin Sulfate @ solution, ophthalmic Bausch and Lomb

eq 0.1% phosphate;eq 3.5mg base/mlBrand(s)

Neodecadron solution, ophthalmic Merck Sharp and Dohme eq 0.1% phosphate;eq 3.5mg base/ml

Neo-Dexair @ solution, ophthalmic Pharmafair eq 0.1% phosphate;eq 3.5mg base/ml

DEXCHLORPHENIRAMINE MALEATEDexchlorpheniramine Maleate tablet, oral 2mg Sidmak

Brand(s)Mylaramine syrup, oral 2mg/5ml Morton GrovePolaramine syrup, oral 2mg/5ml ScheringPolaramine tablet, oral 2mg Schering

DEXPANTHENOL; ASCORBIC ACID; BIOTIN; CYANOCOBALAMIN; ERGOCALCIFEROL; FOLIC ACID;NIACINAMIDE; PYRIDOXINE HYDROCHLORIDE; RIBOFLAVIN PHOSPHATE SODIUM; THIAMINEHYDROCHLORIDE; VITAMIN A; VITAMIN E

See ASCORBIC ACID; BIOTIN; CYANOCOBALAMIN; DEXPANTHENOL; ERGOCALCIFEROL; FOLICACID; NIACINAMIDE; PYRIDOXINE HYDROCHLORIDE; RIBOFLAVIN PHOSPHATE SODIUMHYDROCHLORIDE; VITAMIN A; VITAMIN E

DEXTROAMPHETAMINE SULFATEDextroamphetamine Sulfate capsule, extended release 5,10,15mg Barr

tablet, oral 5,10mg Barrtablet, oral 5mg Endo

@ tablet, oral 5,10mg Eon@ tablet, oral 5,10mg Geneva@ tablet, oral 10mg Halsey@ tablet, oral 5,10mg Lannett@ tablet, oral 5mg Mast@ tablet, oral 5mg Purepac

Brand(s)Dexedrine Spansules capsule, extended release 5,10,15mg GlaxoSmithKlineDexampex @ tablet, oral 5,10mg TevaDexedrine tablet, oral 5mg GlaxoSmithKlineDextrostat tablet, oral 5,10mg Shire RichwoodFerndex @ tablet, oral 5mg Ferndale

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

65

DEXTROAMPHETAMINE SACCHARATE; DEXTROAMPHETAMINE SULFATE; AMPHETAMINE ASPARTAME;AMPHETAMINE SULFATE

See AMPHETAMINE ASPARTAME; AMPHETAMINE SULFATE; DEXTROAMPHETAMINESACCHARATE; DEXTROAMPHETAMINE SULFATE

DEXTROAMPHETAMINE SULFATE; DEXTROAMPHETAMINE SACCHARATE; AMPHETAMINE ASPARTAME;AMPHETAMINE SULFATE

See AMPHETAMINE ASPARTAME; AMPHETAMINE SULFATE; DEXTROAMPHETAMINESACCHARATE; DEXTROAMPHETAMINE SULFATE

DEXTROMETHORPHAN HYDROBROMIDE; BROMPHENIRAMINE MALEATE;PSEUDOEPHEDRINE HYDROCHLORIDE

See BROMPHENIRAMINE MALEATE; DEXTROMETHORPHAN HYDROBROMIDE; PSEUDOEPHEDRINE HYDROCHLORIDE

DEXTROMETHORPHAN HYDROBROMIDE; CARBINOXAMINE MALEATE; PSEUDOEPHEDRINEHYDROCHLORIDE

See CARBINOXAMINE MALEATE; DEXTROMETHORPHAN HYDROBROMIDE; PSEUDOEPHEDRINEHYDROCHLORIDE

DEXTROMETHORPHAN HYDROBROMIDE; IODINATED GLYCEROLDextromethorphan @ liquid, oral 10mg/5ml;30mg/5ml Alpharma Hydrobromide; @ liquid, oral 10mg/5ml;20mg/5ml Duramed Iodinated Glycerol @ liquid, oral 10mg/5ml;30mg/5ml Halsey

@ liquid, oral 10mg/5ml;30mg/5ml LuChemBrand(s)

Iogan DM @ liquid, oral 10mg/5ml;30mg/5ml Hi-TechIophen DM @ liquid, oral 10mg/5ml;30mg/5ml NaskaIotuss DM @ liquid, oral 10mg/5ml;30mg/5ml CenciSil-O-Tuss DM @ liquid, oral 10mg/5ml;30mg/5ml SilarxTussi-Organidin DM @ liquid, oral 10mg/5ml;30mg/5ml Wallace

* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as anexception to the promulgated criteria for inclusion, pursuant to Section 790.60.

DEXTROMETHORPHAN HYDROBROMIDE; PROMETHAZINE HYDROCHLORIDEDextromethorphan Hydrobromide; syrup, oral 15mg/5ml;6.25mg/5ml Hi-Tech Promethazine Hydrochloride

Brand(s)Phenergan syrup, oral 15mg/5ml;6.25mg/5ml Wyeth-Ayerst with DextromethorphanPherazine DM @ syrup, oral 15mg/5ml;6.25mg/5ml HalseyPrometh syrup, oral 15mg/5ml;6.25mg/5ml Alpharma with DextromethorphanPromethazine syrup, oral 15mg/5ml;6.25mg/5ml Morton Grove with Dextromethorphan

DEXTROSEDextrose injection 5gm/100ml (5%), Abbott

10gm/100ml (10%), 20gm/100ml (20%), 30gm/100ml (30%), Abbott 40gm/100ml (40%),

(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

66

DEXTROSE (continued) 50gm/100ml (50%), Abbott 60gm/100ml (60%), 70gm/100ml (70%)injection 5gm/100ml (5%), Baxter 10gm/100ml (10%), 20gm/100ml (20%), 30gm/100ml (30%), 40gm/100ml (40%), 50gm/100ml (50%), 60gm/100ml (60%), 70gm/100ml (70%)injection 5gm/100ml (5%), Braun 10gm/100ml (10%),

@ 60gm/100ml (60%)injection 10gm/100ml (10%) DHL

@ injection 10gm/100ml (10%), Miles

DEXTROSE; ALCOHOLSee ALCOHOL; DEXTROSE

DEXTROSE; BRETYLIUM TOSYLATESee BRETYLIUM TOSYLATE; DEXTROSE

DEXTROSE; CALCIUM CHLORIDE; GLUTATHIONE DISULFIDE; MAGNESIUM CHLORIDE; POTASSIUMCHLORIDE; SODIUM BICARBONATE; SODIUM CHLORIDE; SODIUM PHOSPHATE

See CALCIUM CHLORIDE; DEXTROSE; GLUTATHIONE DISULFIDE; MAGNESIUM CHLORIDE;POTASSIUM CHLORIDE; SODIUM BICARBONATE; SODIUM CHLORIDE; SODIUM PHOSPHATE

DEXTROSE; CALCIUM CHLORIDE; MAGNESIUM CHLORIDE; SODIUM CHLORIDE; SODIUM LACTATESee CALCIUM CHLORIDE; DEXTROSE; MAGNESIUM CHLORIDE; SODIUM CHLORIDE; SODIUM

LACTATE

DEXTROSE; CALCIUM CHLORIDE; POTASSIUM CHLORIDE; SODIUM CHLORIDESee CALCIUM CHLORIDE; DEXTROSE; POTASSIUM CHLORIDE; SODIUM CHLORIDE

DEXTROSE; CALCIUM CHLORIDE; POTASSIUM CHLORIDE; SODIUM CHLORIDE; SODIUM LACTATESee CALCIUM CHLORIDE; DEXTROSE; POTASSIUM CHLORIDE; SODIUM CHLORIDE; SODIUM

LACTATE

DEXTROSE; CLINDAMYCIN PHOSPHATESee CLINDAMYCIN PHOSPHATE; DEXTROSE

DEXTROSE; DOBUTAMINE HYDROCHLORIDEDextrose; Dobutamine injection 5gm/100ml; Abbott Hydrochloride eq 50mg base/100ml in plastic container injection 5gm/100ml; Abbott

eq 100mg base/100mlinjection 5gm/100ml; Abbott eq 200mg base/100ml

(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

67

DEXTROSE; DOBUTAMINE HYDROCHLORIDE (continued)injection 5gm/100ml; Abbott eq 400mg base/100mlinjection 5gm/100ml; Baxter eq 50mg base/100mlinjection 5gm/100ml; Baxter eq 100mg base/100mlinjection 5gm/100ml; Baxter eq 200mg base/100mlinjection 5gm/100ml; Baxter eq 400mg base/100ml

DEXTROSE; DOPAMINE HYDROCHLORIDEDextrose; Dopamine injection 5gm/100ml;80mg/100ml Abbott Hydrochloride injection 5gm/100ml; 160mg/100ml Abbott in plastic container injection 5gm/100ml; 320mg/100ml Abbott

injection 5gm/100ml; 400mg/100ml Abbottinjection 5gm/100ml;80mg/100ml Baxterinjection 5gm/100ml; 160mg/100ml Baxterinjection 5gm/100ml; 320mg/100ml Baxterinjection 5gm/100ml;80mg/100ml Brauninjection 5gm/100ml; 160mg/100ml Brauninjection 5gm/100ml; 320mg/100ml Braun

DEXTROSE; GENTAMICIN SULFATEDextrose; injection 5gm/100ml; eq 60,70, Abbott Gentamicin Sulfate 80,90,100mg base/100ml

injection 5gm/100ml; eq 60,70, Baxter 80,90,100mg base/100mlinjection 5gm/100ml; eq 60,70, Braun 80,90,100mg base/100ml

@ injection 5gm/100ml; International Medication eq 100mg/100ml

DEXTROSE; HEPARIN SODIUMDextrose; Heparin Sodium injection 5gm/100ml; 4,000U/100ml Abbott in plastic container injection 5gm/100ml; 5,000U/100ml Abbott

injection 5gm/100ml;10,000U/100ml Abbottinjection 5gm/100ml; 4,000U/100ml Baxterinjection 5gm/100ml; 5,000U/100ml Baxterinjection 5gm/100ml;10,000U/100ml Baxter

@ injection 5gm/100ml; 200U/100ml Braun@ injection 5gm/100ml; 1,000U/100ml Braun

injection 5gm/100ml; 4,000U/100ml Brauninjection 5gm/100ml; 5,000U/100ml Brauninjection 5gm/100ml;10,000U/100ml Braun

DEXTROSE; LIDOCAINE HYDROCHLORIDEDextrose; Lidocaine Hydrochloride injection 5gm/100ml;200mg/100ml Abbott in plastic container injection 5gm/100ml;400mg/100ml Abbott

injection 5gm/100ml;800mg/100ml Abbottinjection 7.5gm/100ml;5gm/100ml Abbottinjection 5gm/100ml;200mg/100ml Baxterinjection 5gm/100ml;400mg/100ml Baxterinjection 5gm/100ml;800mg/100ml Baxter

(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

68

DEXTROSE; LIDOCAINE HYDROCHLORIDE (continued)injection 5gm/100ml;200mg/100ml Brauninjection 5gm/100ml;400mg/100ml Brauninjection 5gm/100ml;800mg/100ml Braun

Brand(s)Xylocaine 5% with Glucose 7.5% injection 7.5gm/100ml;5gm/100ml Astra Zeneca

DEXTROSE; MAGNESIUM CHLORIDE; POTASSIUM CHLORIDE; SODIUM ACETATE; SODIUM CHLORIDE;SODIUM GLUCONATEInjection; in plastic container

Brand(s)Isolyte S with Dextrose 5% injection 5gm/100ml;30mg/100ml; Braun

37mg/100ml;370mg/100ml; 530mg/100ml;500mg/100ml

Plasma-Lyte 148 and Dextrose 5% injection 5gm/100ml;30mg/100ml; Baxter 37mg/100ml;368mg/100ml;

526mg/100ml;502mg/100ml

DEXTROSE; MANNITOLDextrose; Mannitol injection 5gm/100ml;10gm/100ml Abbott

injection 5gm/100ml;10gm/100ml Braun

DEXTROSE; NITROGLYCERINDextrose; Nitroglycerin injection 5gm/100ml;10mg/100ml Abbott

injection 5gm/100ml;20mg/100ml Abbottinjection 5gm/100ml;40mg/100ml Abbottinjection 5gm/100ml;10mg/100ml Baxterinjection 5gm/100ml;20mg/100ml Baxterinjection 5gm/100ml;40mg/100ml Baxter

DEXTROSE; POTASSIUM CHLORIDEInjection; in plastic container

Dextrose; Potassium Chloride injection 5gm/100ml (5%); Abbott 224mg/100ml (0.224%)injection 5gm/100ml (5%); Baxter 75mg/100ml (0.075%) 5gm/100ml (5%); Baxter 150mg/100ml (0.15%) 5gm/100ml (5%); Baxter 224mg/100ml (0.224%) 5gm/100ml (5%); Baxter 300mg/100ml (0.3%)injection 5gm/100ml (5%); Braun 75mg/100ml (0.075%) 5gm/100ml (5%); Braun 150mg/100ml (0.15%) 5gm/100ml (5%); Braun 300mg/100ml (0.3%)

DEXTROSE; POTASSIUM CHLORIDE; SODIUM CHLORIDEInjection; in plastic container

Dextrose; injection 5gm/100ml (5%); Abbott Potassium Chloride; 74.5mg/100ml (0.075%); Sodium Chloride 450mg/100ml (0.45%)

(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

69

DEXTROSE; POTASSIUM CHLORIDE; SODIUM CHLORIDE (continued)injection 5gm/100ml (5%); Abbott 149mg/100ml (0.15%); 450mg/100ml (0.45%)injection 5gm/100ml (5%); Abbott 224mg/100ml (0.224%); 450mg/100ml (0.45%)injection 5gm/100ml (5%); Abbott 298mg/100ml (0.3%); 450mg/100ml (0.45%)injection 5gm/100ml (5%); Abbott 74.5mg/100ml (0.075%); 900mg/100ml (0.9%)injection 5gm/100ml (5%); Abbott 149mg/100ml (0.15%); 900mg/100ml (0.9%)injection 5gm/100ml (5%); Abbott 224mg/100ml (0.224%); 900mg/100ml (0.9%)injection 5gm/100ml (5%); Abbott 298mg/100ml (0.3%); 900mg/100ml (0.9%)injection 5gm/100ml (5%); Baxter 75mg/100ml (0.075%); 200mg/100ml (0.2%)injection 5gm/100ml (5%); Baxter 150mg/100ml (0.15%); 200mg/100ml (0.2%)injection 5gm/100ml (5%); Baxter 224mg/100ml (0.224%); 200mg/100ml (0.2%)injection 5gm/100ml (5%); Baxter 300mg/100ml (0.3%); 200mg/100ml (0.2%)injection 5gm/100ml (5%); Baxter 75mg/100ml (0.075%); 330mg/100ml (0.33%)injection 5gm/100ml (5%); Baxter 150mg/100ml (0.15%); 330mg/100ml (0.33%)injection 5gm/100ml (5%); Baxter 224mg/100ml (0.224%); 330mg/100ml (0.33%)injection 5gm/100ml (5%); Baxter 300mg/100ml (0.3%); 330mg/100ml (0.33%)injection 5gm/100ml (5%); Baxter 75mg/100ml (0.075%); 450mg/100ml (0.45%)injection 5gm/100ml (5%); Baxter 150mg/100ml (0.15%); 450mg/100ml (0.45%)injection 5gm/100ml (5%); Baxter 224mg/100ml (0.224%); 450mg/100ml (0.45%)injection 5gm/100ml (5%); Baxter 300mg/100ml (0.3%); 450mg/100ml (0.45%)

(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

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DEXTROSE; POTASSIUM CHLORIDE; SODIUM CHLORIDE (continued)injection 5gm/100ml (5%); Baxter 75mg/100ml (0.075%); 900mg/100ml (0.9%)injection 5gm/100ml (5%); Baxter 150mg/100ml (0.15%); 900mg/100ml (0.9%)injection 5gm/100ml (5%); Baxter 224mg/100ml (0.224%); 900mg/100ml (0.9%)injection 5gm/100ml (5%); Baxter 300mg/100ml (0.3%); 900mg/100ml (0.9%)injection 5gm/100ml (5%); Braun 75mg/100ml (0.075%); 200mg/100ml (0.2%)injection 5gm/100ml (5%); Braun 150mg/100ml (0.15%); 200mg/100ml (0.2%)injection 5gm/100ml (5%); Braun 220mg/100ml (0.224%); 200mg/100ml (0.2%)injection 5gm/100ml (5%); Braun 300mg/100ml (0.3%); 200mg/100ml (0.2%)injection 5gm/100ml (5%); Braun 75mg/100ml (0.075%); 330mg/100ml (0.33%)injection 5gm/100ml (5%); Braun 150mg/100ml (0.15%); 330mg/100ml (0.33%)injection 5gm/100ml (5%); Braun 220mg/100ml (0.22%); 330mg/100ml (0.33%)injection 5gm/100ml (5%); Braun 300mg/100ml (0.3%); 330mg/100ml (0.33%)injection 5gm/100ml (5%); Braun 75mg/100ml (0.075%); 450mg/100ml (0.45%)injection 5gm/100ml (5%); Braun 150mg/100ml (0.15%); 450mg/100ml (0.45%)injection 5gm/100ml (5%); Braun 300mg/100ml (0.3%); 450mg/100ml (0.45%)injection 5gm/100ml (5%); Braun75mg/100ml (0.075%); 900mg/100ml (0.9%)injection 5gm/100ml (5%); Braun 150mg/100ml (0.15%); 900mg/100ml (0.9%)injection 5gm/100ml (5%); Braun 300mg/100ml (0.3%); 900mg/100ml (0.9%)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

71

DEXTROSE; SODIUM CHLORIDEInjection; in plastic container

Dextrose; Sodium Chloride injection 2.5gm/100ml (2.5%); Abbott 450mg/100ml (0.45%)injection 5gm/100ml (5%); Abbott 300mg/100ml (0.3%)injection 5gm/100ml (5%); Abbott 450mg/100ml (0.45%)injection 5gm/100ml (5%); Abbott 900mg/100ml (0.9%injection 2.5gm/100ml (2.5%); Baxter 450mg/100ml (0.45%)injection 5gm/100ml (5%); Baxter 200mg/100ml (0.2%)injection 5gm/100ml (5%); Baxter 330mg/100ml (0.33%)injection 5gm/100ml (5%); Baxter 450mg/100ml (0.45%)injection 5gm/100ml (5%); Baxter 900mg/100ml (0.9%)injection 10gm/100ml (10%) Baxter 900mg/100ml (0.9%)injection 2.5gm/100ml (2.5%); Braun 450mg/100ml (0.45%)injection 5gm/100ml (5%); Braun 200mg/100ml (0.2%)injection 5gm/100ml (5%); Braun 330mg/100ml (0.33%)injection 5gm/100ml (5%); Braun 450mg/100ml (0.45%)injection 5gm/100ml (5%); Braun 900mg/100ml (0.9%)injection 10gm/100ml (10%) Braun 900mg/100ml (0.9%)

@ injection 5gm/100ml (5%); Miles 200mg/100ml (0.2%)

@ injection 5gm/100ml (5%); Miles 300mg/100ml (0.3%)

@ injection 5gm/100ml (5%); Miles 450mg/100ml (0.45%)

@ injection 5gm/100ml (5%); Miles 900mg/100ml (0.9%)

DEXTROSE; THEOPHYLLINEDextrose; Theophylline injection 5gm/100ml (5%); Abbott

40mg/100ml (0.04%)injection 5gm/100ml (5%); Abbott 80mg/100ml (0.08%)injection 5gm/100ml (5%); Abbott 160mg/100ml (0.16%)injection 5gm/100ml (5%); Abbott 200mg/100ml (0.2%)injection 5gm/100ml (5%); Abbott 320mg/100ml (0.32%)injection 5gm/100ml (5%); Abbott 400mg/100ml (0.4%)injection 5gm/100ml (5%); Baxter 40mg/100ml (0.04%)

(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

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DEXTROSE; THEOPHYLLINE (continued)injection 5gm/100ml (5%); Baxter 80mg/100ml (0.08%)injection 5gm/100ml (5%); Baxter 160mg/100ml (0.16%)injection 5gm/100ml (5%); Baxter 200mg/100ml (0.2%)injection 5gm/100ml (5%); Baxter 320mg/100ml (0.32%)injection 5gm/100ml (5%); Baxter 400mg/100ml (0.4%)injection 5gm/100ml (5%); Braun 40mg/100ml (0.04%)injection 5gm/100ml (5%); Braun 80mg/100ml (0.08%)injection 5gm/100ml (5%); Braun 160mg/100ml (0.16%)injection 5gm/100ml (5%); Braun 200mg/100ml (0.2%)injection 5gm/100ml (5%); Braun 320mg/100ml (0.32%)injection 5gm/100ml (5%); Braun 400mg/100ml (0.4%)

DIAZEPAMDiazepam injection 5mg/ml Abbott

@ injection 5mg/ml American Pharmaceutical Partners

injection 5mg/ml Elkins-Sinninjection 5mg/ml Lederleinjection 5mg/ml Marsaminjection 5mg/ml Steris

@ injection 5mg/ml Warner Chilcotttablet, oral 2,5,10mg Barrtablet, oral 2,5,10mg Danbury

@ tablet, oral 2,5,10mg Duramed@ tablet, oral 2,5,10mg Ferndale

tablet, oral 2,5,10mg Geneva@ tablet, oral 2,5,10mg Halsey@ tablet, oral 2,5,10mg IVAX

tablet, oral 2,5,10mg Lederle@ tablet, oral 10mg Martec

tablet, oral 2,5,10mg Mylantablet, oral 2,5,10mg Par

@ tablet, oral 2,5,10mg Pioneertablet, oral 2,5,10mg Purepac

@ tablet, oral 2,5,10mg Roxane@ tablet, oral 2,5,10mg Warner Chilcott@ tablet, oral 2,5,10mg Watson

Brand(s)Valium injection 5mg/ml RocheQ-Pam @ tablet, oral 2,5,10mg QuantumValium tablet, oral 2,5,10mg Roche

DIAZOXIDEDiazoxide @ injection 15mg/ml American Pharmaceutical

Partners@ injection 15mg/ml Quad

(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

73

DIAZOXIDE (continued)Brand(s)

Hyperstat injection 15mg/ml Schering

DICLOFENAC POTASSIUMDiclofenac Potassium tablet, oral 50mg Eon

tablet, oral 50mg Genevatablet, oral 50mg Mylantablet, oral 50mg Tevatablet, oral 50mg Watson

Brand(s)Cataflam tablet, oral 50mg Novartis *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

DICLOFENAC SODIUMDicolfenac Sodium @ solution, ophthalmic 0.1% Falcon

tablet, delayed release 15,50,75mg Carlsbadtablet, delayed release 25,50,75mg Copleytablet, delayed release 25,50,75mg Genevatablet, delayed release 50,75mg Martectablet, delayed release 50,75mg Purepactablet, delayed release 25,50,75mg Roxanetablet, delayed release 50,75mg Sidmaktablet, delayed release 50,75mg Tevatablet, extended release 100mg Biovailtablet, extended release 100mg Mylantablet, extended release 100ng Purepac

Brand(s)Voltaren solution, ophthalmic 0.1% Novartis *Voltaren tablet, delayed release 25,50,75mg Novartis *Voltaren-XR tablet, extended release 100mg Novartis *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

DICLOXACILLIN SODIUMDicloxacillin Sodium capsule, oral eq 250,500mg base Teva

Brand(s)Dycill @ capsule, oral eq 250,500mg base SmithKline BeechamDynapen capsule, oral eq 250,500mg base ApotheconPathocil capsule, oral eq 250,500mg base Wyeth-AyerstDynapen powder for suspension Apothecon

eq 62.5mg base/5mlPathocil powder for suspension Wyeth-Ayerst

eq 62.5mg base/5ml

DICYCLOMINE HYDROCHLORIDEDicyclomine Hydrochloride capsule, oral 10mg Barr

@ capsule, oral 10mg Circa@ capsule, oral 10mg Halsey

capsule, oral 10mg Lannettcapsule, oral 10mg Mylan

@ capsule, oral 10mg Pioneercapsule, oral 10mg Watson

(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

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DICYCLOMINE HYDROCHLORIDE (continued)capsule, oral 10mg West-ward

@ injection 10mg/ml Steris@ syrup, oral 10mg/5ml Alpharma@ tablet, oral 20mg Barr@ tablet, oral 20mg Circa

tablet, oral 20mg Lannetttablet, oral 20mg Mylan

@ tablet, oral 20mg Pioneertablet, oral 20mg Watsontablet, oral 20mg West-ward

Brand(s)Bentyl capsule, oral 10mg AventisBentyl injection 10mg/ml AventisBentyl Preservative-Free injection 10mg/ml AventisBentyl syrup, oral 10mg/5ml AventisBentyl tablet, oral 20mg Aventis

DIENESTROLDienestrol cream, vaginal 0.01% RW Johnson

Brand(s)DV @ cream, vaginal 0.01% AventisEstraguard @ cream, vaginal 0.01% Solvay

DIETHYLPROPION HYDROCHLORIDEDiethylpropion Hydrochloride tablet, oral 25mg ABC

@ tablet, oral 25mg Celltech@ tablet, oral 25mg Eon@ tablet, oral 25mg Teva@ tablet, oral 25mg Watson

Brand(s)Tenuate tablet, oral 25mg AventisTepanil @ tablet, oral 25mg Riker/3M

DIETHYLSTILBESTROLDiethylstilbestrol @ suppository, vaginal 0.1,0.5mg Lilly

Brand(s)Stilbestrol @ suppository, vaginal 0.1,0.5mg Squibb

DIFLORASONE DIACETATEDiflorasone Diacetate cream, topical 0.05% Altana

cream, topical 0.05% Taroointment, topical 0.05% Altanaointment, topical 0.05% Taro

Brand(s)Psorcon cream, topical 0.05% DermikPsorcon ointment, topical 0.05% Pharmacia & Upjohn

DIFLUNISALDiflunisal tablet, oral 250,500mg Danbury

tablet, oral 500mg Geneva@ tablet, oral 250,500mg Purepac

tablet, oral 250,500mg Roxanetablet, oral 250,500mg Teva

(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

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DIFLUNISAL (continued)Brand(s)

Dolobid tablet, oral 250,500mg Merck Sharp and Dohme *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

DIGOXINDigoxin elixir, oral 0.05mg/ml Halsey

elixir, oral 0.05mg/ml Pharmafairelixir, oral 0.05mg/ml Roxaneinjection 0.1,0.25mg/ml Abbott

@ injection 0.25mg/ml American Pharmaceutical Partners

injection 0.25mg/ml Elkins-Sinninjection 0.25mg/ml Wyeth-Ayerst

Brand(s)Lanoxin Pediatric elixir, oral 0.05mg/ml Glaxo WellcomeLanoxin injection 0.1,0.25mg/ml Glaxo WellcomeDigitek tablet, oral 0.125,0.25mg AmideLanoxin tablet, oral 0.125,0.25mg Glaxo Wellcome

* The elixir form of this entity was reviewed by the Technical Advisory Council and admitted to the IllinoisFormulary as an exception to the promulgated criteria for inclusion, pursuant to Section 790.60.

DIHYDROCODONE BITARTRATE; ACETAMINOPHEN; CAFFEINESee ACETAMINOPHEN; CAFFEINE; DIHYDROCODONE BITARTRATE

DIHYDROERGOTOXINE METHANESULFONATESee ERGOLOID MESYLATES

DILTIAZEM HYDROCHLORIDEDiltiazem Hydrochloride capsule (AB1), extended release Biovail

60,90,120mgcapsule (AB1), extended release Mylan 60,90,120mgcapsule (AB1), extended release Prographarm 60,90,120mgcapsule (AB1), extended release Teva 60,90,120mgcapsule (AB2), extended release Andrx 120,180,240mgcapsule (AB2), extended release Mylan 120,180,240mgcapsule (AB2), extended release TorPharm 120,180,240mgcapsule (AB3), extended release Biovail 120,180,240,300mgcapsule (AB3), extended release Purepac 120,180,240,300mginjection 5mg/ml Abbottinjection 5mg/ml Apotexinjection 5mg/ml Bedfordinjection 5mg/ml Gensia Sicorinjection 5mg/ml Meridian

(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

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DILTIAZEM HYDROCHLORIDE (continued)injection 5mg/ml Taylortablet, oral 30,60,90,120mg Apothecontablet, oral 30,60,90,120mg Copleytablet, oral 30,60,90,120mg IVAXtablet, oral 30,60,90,120mg Lederletablet, oral 30,60,90,120mg Mylantablet, oral 30,60,90,120mg Teva

Brand(s)Cardizem SR capsule (AB1), extended release Aventis

60,90,120mgDilacor XR capsule (AB2), extended release Aventis *

120,180,240mgCardizem CD capsule (AB3), extended release Carderm

120,180,240,300mgCartia XT capsule (AB3), extended release Andrx

120,180,240,300mgCardizem injection 5mg/ml,100mg/vial AventisCardizem tablet, oral 30,60,90,120mg Aventis *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

Products designated “AB1" may only be interchanged with other products designated as “AB1.” Productsdesignated as “AB2" may only be interchanged with other products designated as “AB2.” Products designatedas “AB3" may only be interchanged with other products designated as “AB3.” Products designated as “AB1"MAY NOT BE INTERCHANGED with products designated as “AB2” or “AB3.” Products designated as “AB2"MAY NOT BE INTERCHANGED with products designated as “AB1” or “AB3.” Products designated as “AB3"MAY NOT BE INTERCHANGED with products designated as “AB1” or “AB2.”

DIMENHYDRINATEDimenhydrinate @ injection 50mg/ml Elkins-Sinn

injection 50mg/ml Sterisinjection 50mg/ml Wyeth-Ayerst

DIPHENHYDRAMINE HYDROCHLORIDEDiphenhydramine Hydrochloride @ capsule, oral 25,50mg Anabolic

capsule, oral 25,50mg Barr@ capsule, oral 25,50mg Circa

capsule, oral 25,50mg Danbury@ capsule, oral 25,50mg Elkins-Sinn@ capsule, oral 25,50mg Eon

capsule, oral 25,50mg Geneva@ capsule, oral 50mg Halsey@ capsule, oral 25,50mg Heather

capsule, oral 25,50mg ICN@ capsule, oral 25,50mg IVAX@ capsule, oral 25,50mg Impax@ capsule, oral 25,50mg Lannett@ capsule, oral 25,50mg Lederle

capsule, oral 25,50mg LNKcapsule, oral 25,50mg MKcapsule, oral 25,50mg Mutual

@ capsule, oral 25,50mg Newtron@ capsule, oral 25,50mg Perrigo@ capsule, oral 25,50mg Pioneer

capsule, oral 25,50mg Private Formulations@ capsule, oral 25,50mg Purepac

(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

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DIPHENHYDRAMINE HYDROCHLORIDE (continued)@ capsule, oral 50mg Roxane

capsule, oral 25mg Superpharm@ capsule, oral 50mg Superpharm@ capsule, oral 25,50mg Teva@ capsule, oral 25,50mg (Vangard/MWM)@ capsule, oral 25,50mg Watson@ capsule, oral 50mg West-Ward@ capsule, oral 25,50mg Whiteworth Towne@ elixir, oral 12.5mg/5ml Bundy@ elixir, oral 12.5mg/5ml KV

elixir, oral 12.5mg/5ml Lannett@ elixir, oral 12.5mg/5ml Lederle

elixir, oral 12.5mg/5ml MK@ elixir, oral 12.5mg/5ml Naska@ elixir, oral 12.5mg/5ml Perrigo

elixir, oral 12.5mg/5ml Pharmaceutical Assoc/Beach@ elixir, oral 12.5mg/5ml Private Formulations

elixir, oral 12.5mg/5ml Purepacelixir, oral 12.5mg/5ml Roxane

@ injection 10mg/ml American Pharmaceutical Partners

@ injection 10mg/ml Bel-Marinjection 50mg/ml Elkins-Sinninjection 10,50mg/ml Sterisinjection 50mg/ml Wyeth-Ayerst

Brand(s)Benadryl capsule, oral 25,50mg Parke-DavisBelix @ elixir, oral 12.5mg/5ml HalseyBenadryl elixir, oral 12.5mg/5ml Parke-DavisDibenil @ elixir, oral 12.5mg/5ml CenciDiphen @ elixir, oral 12.5mg/5ml USLHydramine @ elixir, oral 12.5mg/5ml AlpharmaBenadryl @ injection 10mg/ml Parke-DavisBenadryl Preservative-Free injection 50mg/ml Parke-DavisDiphenhydramine Hydrochloride injection 50mg/ml Abbott Preservative-FreeDiphenhydramine Hydrochloride @ injection 50mg/ml American Pharmaceutical Preservative-Free PartnersDiphenhydramine Hydrochloride injection 50mg/ml International Medication Preservative-FreeDiphenhydramine Hydrochloride injection 50mg/ml Steris Preservative-Free

DIPHENOXYLATE HYDROCHLORIDE; ATROPINE SULFATESee ATROPINE SULFATE; DIPHENOXYLATE HYDROCHLORIDE

DIPIVEFRIN HYDROCHLORIDEDipivefrin Hydrochloride solution, ophthalmic 0.1% Bausch and Lomb

solution, ophthalmic 0.1% Falcon *Brand(s)

AKpro solution, ophthalmic 0.1% AkornPropine solution, ophthalmic 0.1% Allergan *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

78

DIPYRIDAMOLEDipyridamole injection 5mg/ml Abbott

injection 5mg/ml American Pharmaceutical Partners

injection 5mg/ml Bedfordinjection 5mg/ml Elkins-Sinninjection 5mg/ml Gensia Sicortablet, oral 25,50,75mg Barrtablet, oral 25,50,75mg Genevatablet, oral 25,50,75mg Lederle

@ tablet, oral 25,50,75mg Purepactablet, oral 50mg Watson

Brand(s)Persantine injection 5mg/ml Boehringer-IngelheimPersantine tablet, oral 25,50,75mg Boehringer-Ingelheim

DISOPYRAMIDE PHOSPHATEDisopyramide Phosphate @ capsule, oral eq 100,150mg base Barr

@ capsule, oral eq 100,150mg base Circacapsule, oral eq 100,150mg base Danburycapsule, oral eq 100,150mg base Geneva

@ capsule, oral eq 100,150mg base Interpharmcapsule, oral eq 100,150mg base IVAX

@ capsule, oral eq 100,150mg base Mylancapsule, oral eq 100mg base Superpharm

@ capsule, oral eq 150mg base Superpharmcapsule, oral eq 100,150mg base Tevacapsule, controlled release KV eq 150mg base

Brand(s)Norpace capsule, oral eq 100,150mg base SearleNorpace CR capsule, controlled release Searle

eq 100,150mg base

DOBUTAMINE HYDROCHLORIDEDobutamine Hydrochloride injection eq 12.5mg base/ml Abbott

injection eq 12.5mg base/ml Astra Zenecainjection eq 12.5mg base/ml Bedfordinjection eq 12.5mg base/ml Elkins-Sinninjection eq 12.5mg base/ml Gensia Sicorinjection eq 12.5mg base/ml Luitpoldinjection eq 12.5mg base/ml Marsaminjection eq 12.5mg base/ml Steris

Brand(s)Dobutrex injection eq 12.5mg base/ml Lilly

DOBUTAMINE HYDROCHLORIDE; DEXTROSESee DEXTROSE; DOBUTAMINE HYDROCHLORIDE

DOPAMINE HYDROCHLORIDEDopamine Hydrochloride injection 40,80mg/ml Abbott

@ injection 40,160mg/ml American Pharmaceutical Partners

injection 80mg/ml American Pharmaceutical Partners

injection 40,80,160mg/ml Astra Zeneca(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

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DOPAMINE HYDROCHLORIDE (continued)injection 40,80mg/ml Elkins-Sinninjection 40,80mg/ml Gensia Sicorinjection 40mg/ml International Medicationinjection 40,80,160mg/ml Luitpoldinjection 40mg/ml Sanofi Synthelabo

@ injection 40,80mg/ml Smith and Nephew@ injection 40,80mg/ml Warner Chilcott

Brand(s)Dopastat @ injection 40,80mg/ml Parke-DavisIntropin injection 40,80,160mg/ml Faulding

DOPAMINE HYDROCHLORIDE; DEXTROSESee DEXTROSE; DOPAMINE HYDROCHLORIDE

DOXAPRAM HYDROCHLORIDEDoxapram Hydrochloride injection 20mg/ml Steris

Brand(s)Dopram injection 20mg/ml Robins

DOXAZOSIN MESYLATEDoxazosin Mesylate tablet, oral eq 1,2,4,8mg base Eon

tablet, oral eq 1,2,4,8mg base ESI Lederletablet, oral eq 1,2,4,8mg base Genevatablet, oral eq 1,2,4,8mg base GenPharmtablet, oral eq 1,2,4,8mg base IVAXtablet, oral eq 1,2,4,8mg base KVtablet, oral eq 1,2,4,8mg base Mylantablet, oral eq 1,2,4,8mg base Purepactablet, oral eq 1,2,4,8mg base Tevatablet, oral eq 1,2,4,8mg base TorPharmtablet, oral eq 1,2,4,8mg base Watson

Brand(s)Cardura tablet, oral eq 1,2,4,8mg base Pfizer

DOXEPIN HYDROCHLORIDEDoxepin Hydrochloride @ capsule, oral eq 25,50,75,100mg base Barr

capsule, oral eq 10,25,50,75, Danbury 100mg basecapsule, oral eq 10,25,50,75, Geneva 100mg basecapsule, oral eq 10,25,50,75,100, Lederle 150mg basecapsule, oral eq 10,25,50,75, Mylan 100mg basecapsule, oral eq 10,25,50,75,100, Par 150mg base

@ capsule, oral eq 10,25,50,75,100, Purepac 150mg base

@ capsule, oral eq 10,25,50,75,100, Quantum 150mg basecapsule, oral eq 10,25,50mg base Royce

@ capsule, oral eq 10,25,50,75,100, Watson 150mg base

(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

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DOXEPIN HYDROCHLORIDE (continued)concentrate, oral eq 10mg base/ml Copleyconcentrate, oral eq 10mg base/ml Morton Groveconcentrate, oral eq 10mg base/ml Silarx

Brand(s)Adapin @ capsule, oral eq 10,25,50,75,100, New River

150mg baseSinequan capsule, oral eq 10,25,50,75,100, Pfizer

150mg baseSinequan concentrate, oral eq 10mg base/ml Pfizer

DOXORUBICIN HYDROCHLORIDEDoxorubicin Hydrochloride injection 2mg/ml American Pharmaceutical

Partnersinjection 2mg/ml,200mg/100ml Bedfordinjection 10,20,50mg/vial Bedfordinjection 2mg/ml,200mg/100ml Gensia Sicorinjection 2mg/ml,200mg/100ml Pharmachemieinjection 10,20,50mg/vial Pharmachemie

Brand(s)Adriamycin PFS injection 2mg/ml,200mg/100ml Pharmacia & UpjohnAdriamycin RDF injection 10,20,50mg/vial Pharmacia & UpjohnRubex injection 10,50mg/vial Bristol-Myers Squibb

DOXYCYCLINEDoxycycline capsule, oral eq 50,100mg base Eon

capsule, oral eq 50,100mg base Halseycapsule, oral eq 50,100mg base Parcapsule, oral eq 50,100mg base Ranbaxy

Brand(s)Monodox capsule, oral eq 50,100mg base OClassenDoxychel @ powder for suspension Rachelle

eq 25mg base/5mlVibramycin powder for suspension Pfizer

eq 25mg base/5ml

DOXYCYCLINE HYCLATEDoxycycline Hyclate capsule, oral eq 50,100mg base Barr

capsule, oral eq 50,100mg base Danburycapsule, oral eq 50,100mg base Halsey

@ capsule, oral eq 50,100mg base Heather@ capsule, oral eq 50,100mg base Interpharm

capsule, oral eq 50,100mg base IVAXcapsule, oral eq 50,100mg base Mutualcapsule, oral eq 50,100mg base Mylan

@ capsule, oral eq 50,100mg base Par@ capsule, oral eq 50,100mg base Private Formulations@ capsule, oral eq 50,100mg base Ranbaxy@ capsule, oral eq 50,100mg base Superpharm@ capsule, oral eq 50,100mg base Warner Chilcott

capsule, oral eq 50,100mg base West-ward@ capsule, coated pellets eq 100mg base Sidmak@ capsule, oral eq 50,100mg base Watson@ injection eq 100,200mg base/vial Bedford@ injection eq 100,200mg base/vial Elkins-Sinn@ injection eq 100,200mg base/vial Lederle

(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

81

DOXYCYCLINE HYCLATE (continued)@ injection eq 100,200mg base/vial Quad

tablet, oral eq 100mg base Barrtablet, oral eq 100mg base Danbury

@ tablet, oral eq 50mg base Halseytablet, oral eq 100mg base Halsey

@ tablet, oral eq 100mg base Heather@ tablet, oral eq 100mg base Interpharm

tablet, oral eq 100mg base IVAXtablet, oral eq 100mg base Mutualtablet, oral eq 100mg base Mylan

@ tablet, oral eq 100mg base Superpharmtablet, oral eq 100mg base Vintage

@ tablet, oral eq 100mg base Warner Chilcott@ tablet, oral eq 50,100mg base Watson

Brand(s)Doxy-Lemmon @ capsule, oral eq 50,100mg base TevaDoxychel Hyclate capsule, oral eq 50,100mg base HoubaVibramycin capsule, oral eq 50,100mg base PfizerDoryx capsule, coated pellets eq 100mg base FauldingDoryx capsule, coated pellets eq 100mg base Warner-ChilcottDoxy 100,200 injection eq 100,200mg base/vial American Pharmaceutical

PartnersDoxychel Hyclate @ injection eq 100mg base/vial RachelleVibramycin injection eq 100,200mg base/vial PfizerDoxy-Lemmon @ tablet, oral eq 100mg base TevaDoxy-Tabs @ tablet, oral eq 50,100mg base HoubaVibra-Tabs tablet, oral eq 100mg base Pfizer

DOXYLAMINE SUCCINATEDoxylamine Succinate @ tablet, oral 25mg Par

@ tablet, oral 25mg QuantumBrand(s)

Decapryn @ tablet, oral 25mg Aventis

DROPERIDOLDroperidol injection 2.5mg/ml Abbott

@ injection 2.5mg/ml American Pharmaceutical Partners

@ injection 2.5mg/ml Astra Zenecainjection 2.5mg/ml Fauldinginjection 2.5mg/ml Luitpold

@ injection 2.5mg/ml Quad@ injection 2.5mg/ml Smith and Nephew@ injection 2.5mg/ml Solopak@ injection 2.5mg/ml Steris

Brand(s)Inapsine injection 2.5mg/ml Akorn

DROPERIDOL; FENTANYL CITRATEDroperidol; Fentanyl Citrate injection 2.5mg/ml;eq 0.05mg base/ml Abbott

injection 2.5mg/ml;eq 0.05mg base/ml Astra ZenecaBrand(s)

Innovar @ injection 2.5mg/ml;eq 0.05mg base/ml Janssen

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

82

EDETATE DISODIUMEdetate Disodium injection 150mg/ml Steris

Brand(s)Endrate injection 150mg/ml Abbott

EDROPHONIUM CHLORIDEEdrophonium Chloride injection 10mg/ml Abbott

@ injection 10mg/ml SterisBrand(s)

Edrophonium Chloride @ injection 10mg/ml Steris Preservative-FreeEnlon injection 10mg/ml BaxterReversol injection 10mg/ml Organon/AkzonaTensilon injection 10mg/ml ICNTensilon Preservative-Free injection 10mg/ml ICN

ENALAPRIL MALEATEEnalapril Maleate tablet, oral 2.5,5,10,20mg Apothecon

tablet, oral 2.5,5,10,20mg Eontablet, oral 2.5,5,10,20mg Genevatablet, oral 2.5,5,10,20mg GenPharmtablet, oral 2.5,5,10,20mg IVAXtablet, oral 2.5,5,10,20mg KRKA/Danburytablet, oral 2.5,5,10,20mg Lektablet, oral 2.5,5,10,20mg Mylantablet, oral 2.5,5,10,20mg Ranbaxytablet, oral 2.5,5,10,20mg Tarotablet, oral 2.5,5,10,20mg Tevatablet, oral 2.5,5,10,20mg Watsontablet, oral 2.5,5,10,20mg Wockhardt Americas

Brand(s)Vasotec tablet, oral 2.5,5,10,20mg Merck *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

ENALAPRIL MALEATE; HYDROCHLOROTHIAZIDEEnalapril Maleate; tablet, oral 5mg;12.5mg Eon Hydrochlorothiazide tablet, oral 10mg; 25mg Eon

tablet, oral 5mg;12.5mg Dr. Reddytablet, oral 10mg;25mg Dr. Reddytablet, oral 5mg;12.5mg Mylantablet, oral 10mg;25mg Mylantablet, oral 5mg;12.5mg Tarotablet, oral 10mg;25mg Tarotablet, oral 5mg;12.5mg Tevatablet, oral 10mg;25mg Teva

Brand(s)Vaseretic tablet, oral 5mg;12.5mg MerckVaseretic tablet, oral 10mg;25mg Merck

ENALIPRILATEnaliprilat injection 1.25mg/ml Abbott

injection 1.25mg/ml Bedfordinjection 1.25mg/ml Fauldinginjection 1.25mg/ml Gensia-Sicor

(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

83

ENALIPRILAT (continued)Brand(s)

Vasotec injection 1.25mg/ml Merck

ENFLURANEEnflurane liquid, inhalation 99.9% Abbott

liquid, inhalation 99.9% MinradBrand(s)

Ethrane liquid, inhalation 99.9% Baxter

EPHEDRINE; HYDROXYZINE HYDROCHLORIDE; THEOPHYLLINEEphedrine; Hydroxyzine syrup, oral 6.25mg/5ml;2.5mg/5ml; Alpharma Hydrochloride; Theophylline 32.5mg/5ml

Brand(s)Marax DF syrup, oral 6.25mg/5ml;2.5mg/5ml; Roerig/Pfizer

32.5mg/5ml

* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as anexception to the promulgated criteria for inclusion, pursuant to Rule 790.60.

EPINEPHRINE BITARTRATE; BUPIVICAINE HYDROCHLORIDESee BUPIVICAINE HYDROCHLORIDE; EPINEPHRINE BITARTRATE

EPINEPHRINE HYDROCHLORIDEEpinephrine Hydrochloride solution, ophthalmic 0.1% Iolab

Brand(s)Adrenalin Chloride solution, ophthalmic 0.1% Parke-Davis

* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as anexception to the promulgated criteria for inclusion, pursuant to Rule 790.60.

EPINEPHRINE; LIDOCAINE HYDROCHLORIDEEpinephrine; Lidocaine injection 0.005mg/ml;0.5% Abbott Hydrochloride injection 0.005mg/ml;1% Abbott

injection 0.005mg/ml;1.5% Abbottinjection 0.005mg/ml;2% Abbottinjection 0.01mg/ml;1% Abbottinjection 0.01mg/ml;2% Abbott

@ injection 0.01mg/ml;1% Bel-Mar@ injection 0.01mg/ml;2% Bel-Mar

injection 0.01mg/ml;1% Dellinjection 0.01mg/ml;2% Dellinjection 0.01mg/ml;2% Eastman Kodakinjection 0.02mg/ml;2% Eastman Kodakinjection 0.01mg/ml;1% Elkins-Sinninjection 0.01mg/ml;2% Elkins-Sinninjection 0.01mg/ml;1% Grahaminjection 0.02mg/ml;2% Graham

@ injection 0.01mg/ml;1% International Medication@ injection 0.01mg/ml;1% Steris@ injection 0.01mg/ml;2% Steris

(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

84

EPINEPHRINE; LIDOCAINE HYDROCHLORIDE (continued)Brand(s)

Alphacaine Hydrochloride @ injection 0.01mg/ml;2% Carlisle with EpinephrineAlphacaine Hydrochloride @ injection 0.02mg/ml;2% Carlisle with EpinephrineLidocaton injection 0.01mg/ml;2% PharmatonLidocaton @ injection 0.02mg/ml;2% PharmatonOctocaine injection 0.01mg/ml;2% NovocolOctocaine injection 0.02mg/ml;2% NovocolXylocaine with Epinephrine injection 0.005mg/ml;0.5% Astra ZenecaXylocaine with Epinephrine injection 0.005mg/ml;1% Astra ZenecaXylocaine with Epinephrine injection 0.005mg/ml;1.5% Astra ZenecaXylocaine with Epinephrine injection 0.005mg/ml;2% Astra ZenecaXylocaine with Epinephrine injection 0.01mg/ml;1% Astra ZenecaXylocaine with Epinephrine injection 0.01mg/ml;2% Astra ZenecaXylocaine with Epinephrine @ injection 0.02mg/ml;2% Astra Zeneca

EPOETIN ALPHABrand(s)

Epogen injection, preservative free Amgen2000, 3000, 4000, 10000U

Procrit injection, preservative free Ortho Biotech2000, 3000, 4000, 10000U

* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as anexception to the promulgated criteria for inclusion, pursuant to Rule 790.60.

ERGOCALCIFEROL (50,000 International Units = 1.25mg)Vitamin D capsule, oral 50,000IU Banner Pharmacaps

@ capsule, oral 50,000IU Chase@ capsule, oral 50,000IU Eon@ capsule, oral 50,000IU Everylife@ capsule, oral 50,000IU Impax@ capsule, oral 50,000IU Lannett

capsule, oral eq 10,25,50,75,100, Par 150mg base

Brand(s)Deltalin @ capsule, oral 50,000IU LillyDrisdol capsule, oral 50,000IU Sanofi Synthelabo

ERGOCALCIFEROL; ASCORBIC ACID; BIOTIN; CYANOCOBALAMIN; DEXPANTHENOL; FOLIC ACID;NIACINAMIDE; PYRIDOXINE HYDROCHLORIDE; RIBOFLAVIN PHOSPHATE SODIUM; THIAMINEHYDROCHLORIDE; VITAMIN A; VITAMIN E

See ASCORBIC ACID; BIOTIN; CYANOCOBALAMIN; DEXPANTHENOL; ERGOCALCIFEROL; FOLICACID; NIACINAMIDE; PYRIDOXINE HYDROCHLORIDE; RIBOFLAVIN PHOSPHATE SODIUMHYDROCHLORIDE; VITAMIN A; VITAMIN E

ERGOLOID MESYLATES (DIHYDROERGOTOXINE METHANESULFONATE)Ergoloid Mesylates @ tablet, oral 1.0mg Barr (Dihydroergotoxine @ tablet, oral 1.0mg Circa Methanesulfonate) @ tablet, oral 1.0mg Danbury

tablet, oral 1.0mg Mutual@ tablet, sublingual 0.5,1.0mg Barr@ tablet, sublingual 0.5,1.0mg Circa

tablet, sublingual 0.5mg Danbury(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

85

ERGOLOID MESYLATES (DIHYDROERGOTOXINE METHANESULFONATE) (continued)@ tablet, sublingual 1.0mg Danbury@ tablet, sublingual 0.5mg IVAX

tablet, sublingual 1.0mg IVAX@ tablet, sublingual 0.5,1.0mg KV@ tablet, sublingual 0.5,1.0mg Lederle@ tablet, sublingual 0.5,1.0mg Superpharm

Brand(s)Gerimal @ tablet, oral 1mg WatsonHydergine tablet, oral 1.0mg NovartisAlkergot @ tablet, sublingual 0.5,1.0mg EonCircanol @ tablet, sublingual 0.5,1.0mg Riker/3-MDeapril-ST @ tablet, sublingual 1.0mg Bristol-Myers SquibbGerimal tablet, sublingual 0.5,1mg WatsonH.E.A. @ tablet, sublingual 0.5,1.0mg (Vangard/MWM)Hydergine tablet, sublingual 0.5,1.0mg Novartis

ERGOTAMINE TARTRATEBrand(s)

Ergomar tablet, sublingual 2mg New RiverErgostat @ tablet, sublingual 2mg Parke-DavisWigrettes @ tablet, sublingual 2mg Organon/Akzona

ERGOTAMINE TARTRATE; CAFFEINESee CAFFEINE; ERGOTAMINE TARTRATE

ERYTHROMYCINErythromycin cap, delayed release pellets 250mg Abbott*

cap, delayed release pellets 250mg Barr*gel, topical 2% Altanagel, topical 2% Stiefelointment, ophthalmic 5mg/gm (0.5%) Akornointment, ophthalmic 5mg/gm (0.5%) Bausch and Lombointment, ophthalmic 5mg/gm (0.5%) Fougera/Altana

@ ointment, ophthalmic 5mg/gm (0.5%) Pharmaderm/Altana@ ointment, ophthalmic 5mg/gm (0.5%) Pharmafair@ solution, topical 1.5% Alpharma

solution, topical 2% Alpharmasolution, topical 2% Altanasolution, topical 2% Bausch and Lombsolution, topical 2% Clay-Park

@ solution, topical 2% Lillysolution, topical 2% Morton Grove

@ solution, topical 1.5,2% Pharmafairsolution, topical 2% Stiefelswab, topical 2% Stiefel

Brand(s)Eryc Sprinkles* @ cap, delayed release pellets 125mg FauldingEryc 125* @ cap, delayed release pellets 125mg Parke-DavisEryc* cap, delayed release pellets 250mg FauldingEryc* @ cap, delayed release pellets 250mg Warner-ChilcottEmgel gel, topical 2% GlaxoErygel gel, topical 2% Allergan HerbertIlotycin ointment, ophthalmic 5mg/gm (0.5%) Lilly/DistaA/T/S solution, topical 2% AventisC-Solve-2 solution, topical 2% BioglanEryderm solution, topical 2% Abbott

(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

86

ERYTHROMYCIN (continued)Erymax solution, topical 2% Allergan HerbertErythra-Derm solution, topical 2% PaddockErythro-Statin solution, topical 2% Hi-TechSansac solution, topical 2% HealthpointStaticin solution, topical 1.5% Westwood SquibbT-Stat solution, topical 2% Westwood SquibbC-Solve-2 swab, topical 2% IVAXErycette swab, topical 2% J and JT-Stat swab, topical 2% Westwood SquibbE-Base* tablet, delayed release 333,500mg BarrE-Mycin* tablet, delayed release 250,333mg AbbottEry-tab * tablet, delayed release 250,333,500mg AbbottIlotycin* @ tablet, delayed release 250mg DistaR-P Mycin* @ tablet, delayed release 250mg SolvayRobimycin* @ tablet, delayed release 250mg Robins

* The admission of erythromycin delayed release enteric coated tablets and delayed release capsulescontaining enteric coated pellets to the Illinois Formulary as an exception to the promulgated criteria wasapproved by a majority vote of the Technical Advisory Council, pursuant to Rule 790.60.

ERYTHROMYCIN ESTOLATEErythromycin Estolate @ capsule, oral eq 125mg base Barr

capsule, oral eq 250mg base Barr@ capsule, oral eq 250mg base Danbury@ capsule, oral eq 250mg base IVAX

suspension, oral eq 125, Alpharma 250mg base/5ml

@ suspension, oral eq 125, Barr 250mg base/5ml

@ suspension, oral eq 250mg base/5ml LifeBrand(s)

Ilosone @ capsule, oral eq 125,250mg base Lilly/DistaIlosone suspension, oral eq 125, Lilly/Dista

250mg base/5ml

ERYTHROMYCIN ETHYLSUCCINATEErythromycin Ethylsuccinate granular powder, oral Barr

eq 200mg base/5mlsuspension, oral eq 200, Alpharma 400mg base/5ml

@ suspension, oral eq 200, KV 400mg base/5ml

@ suspension, oral eq 200, Lilly/Dista 400mg base/5ml

@ suspension, oral eq 400mg base/5ml Naska@ suspension, oral eq 200, Parke-Davis

400mg base/5ml@ suspension, oral eq 200, Pharmafair

400mg base/5ml@ tablet, oral eq 400mg base Barr

tablet, oral eq 400mg base MylanBrand(s)

E.E.S. granular powder, oral Abbott eq 200mg base/5ml

Ery-Ped granular powder, oral Abbott eq 200mg base/5ml

(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

87

ERYTHROMYCIN ETHYLSUCCINATE (continued)Pediamycin @ granular powder, oral Ross/Abbott

eq 200mg base/5mlE.E.S. 200,400 suspension, oral eq 200, Abbott

400mg base/5mlE-Mycin-E @ suspension, oral eq 200, Pharmacia & Upjohn

400mg base/5mlPediamycin suspension, oral eq 200, Ross/Abbott

400mg base/5mlWyamycin - E @ suspension, oral eq 200, Wyeth-Ayerst

400mg base/5mlE.E.S. tablet, chewable eq 200mg base AbbottEry-Ped tablet, chewable eq 200mg base AbbottPediamycin @ tablet, chewable eq 200mg base Ross/AbbottE.E.S. 400 tablet, oral eq 400mg base Abbott

ERYTHROMYCIN ETHYLSUCCINATE; SULFISOXAZOLE ACETYLErythromycin Ethylsuccinate; suspension, oral eq 200mg base/5ml; Barr Sulfisoxazole Acetyl eq 600mg base/5ml

Brand(s)Eryzole suspension, oral eq 200mg base/5ml; Alra

eq 600mg base/5mlPediazole suspension, oral eq 200mg base/5ml; Ross/Abbott

eq 600mg base/5ml

ERYTHROMYCIN LACTOBIONATEErythromycin Lactobionate @ injection eq 500mg,1gm base/vial American Pharmaceutical

Partnersinjection eq 500mg,1gm base/vial Elkins-Sinninjection eq 500mg,1gm base/vial Gensia Sicorinjection eq 500mg,1gm base/vial Lederle

@ injection eq 500mg,1gm base/vial QuadBrand(s)

Erythrocin injection eq 500mg,1gm base/vial Abbott

ERYTHROMYCIN STEARATE (Bearing approved labeling which states that the tablets should be taken in thefasting state or immediately before meals) **

Erythromycin Stearate tablet, oral eq 250mg base Barr@ tablet, oral eq 500mg base Barr@ tablet, oral eq 250,500mg base Lederle

tablet, oral eq 250,500mg base Mylantablet, oral eq 250,500mg base Watson

Brand(s)Erythrocin Stearate tablet, oral eq 250,500mg base AbbottWyamycin-S @ tablet, oral eq 250,500mg base Wyeth-Ayerst

** Drug product selection should be made only from products bearing the same type of approved labelingwithin an entity sub-heading.

ERYTHROMYCIN STEARATE (Bearing approved labeling which states that the tablets should be taken on anempty stomach) **

Erythromycin Stearate @ tablet, oral eq 250,500mg base IVAX@ tablet, oral eq 250mg base Purepac

Brand(s)Bristamycin @ tablet, oral eq 250,500mg base Bristol/Bristol-MyersErypar @ tablet, oral eq 250,500mg base Warner ChilcottEthril 250,500 @ tablet, oral eq 250,500mg base Squibb

(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

88

ERYTHROMYCIN STEARATE (Bearing approved labeling which states that the tablets should be taken on anempty stomach) ** (continued)

Pfizer-E @ tablet, oral eq 250,500mg base Pfizer

** Drug product selection should be made only from products bearing the same type of approved labelingwithin an entity sub-heading.

ESTAZOLAMEstazolam tablet, oral 1,2mg IVAX

tablet, oral 1,2mg Roycetablet, oral 1,2mg Teva

Brand(s)Prosom tablet, oral 1,2mg Abbott

ESTRADIOLEstradiol film, extended release, transdermal Mylan

0.05,0.1mg/24 hourstablet, oral 0.5,1,2mg Applied Analytical Industriestablet, oral 0.5,1,2mg Barrtablet, oral 0.5,1,2mg Duramedtablet, oral 0.5,1,2mg ESI Lederletablet, oral 0.5,1,2mg Mylantablet, oral 0.5,1,2mg Watson

Brand(s)Climara film, extended release, transdermal Berlex

0.05,0.1mg/24 hoursVivelle film, extended release, transdermal Novartis

0.0375,0.05,0.075,0.1mg 24 hoursVivelle-Dot film, extended release, transdermal Novartis

0.0375,0.05,0.075,0.1mg/24 hoursEstrace tablet, oral 0.5,1,2mg Bristol-Myers Squibb *Innofem tablet, oral 0.5,1,2mg Novo Nordisk

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

ESTRADIOL CYPIONATEEstradiol Cypionate @ injection 5mg/ml Quad

injection 5mg/ml SterisBrand(s)

Depo-Estradiol injection 5mg/ml Pharmacia & Upjohn

ESTRADIOL CYPIONATE; TESTOSTERONE CYPIONATEEstradiol Cypionate; injection 2mg/ml;50mg/ml Steris Testosterone Cypionate

Brand(s)Depo-Testadiol injection 2mg/ml;50mg/ml Pharmacia & Upjohn

ESTRADIOL VALERATEEstradiol Valerate @ injection 10mg/ml Steris

injection 20,40mg/ml SterisBrand(s)

Delestrogen injection 10,20,40mg/ml King

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

89

ESTRADIOL VALERATE; TESTOSTERONE ENANTHATEEstradiol Valerate; injection 4mg/ml;90mg/ml Steris Testosterone Enanthate @ injection 8mg/ml;180mg/ml Steris

Brand(s)Deladumone @ injection 4mg/ml;90mg/ml Bristol-Myers SquibbDeladumone-OB @ injection 8mg/ml;180mg/ml Bristol-Myers SquibbDitate-DS injection 8mg/ml;180mg/ml Savage

ESTROPIPATE (PIPERAZINE ESTRONE SULFATE)Estropipate tablet, oral 0.625,1.25,2.5mg Barr (Piperazine Estrone Sulfate) (equivalent to 0.75,1.5,3mg estropipate)

tablet, oral 0.625,1.25,2.5,5mg Duramed(equivalent to 0.75,1.5,3,6mg estropipate)tablet, oral 0.625,1.25,2.5,5mg Mylan(equivalent to 0.75,1.5,3,6mg estropipate)tablet, oral 0.625,1.25,2.5,5mg Watson(equivalent to 0.75,1.5,3,6mg estropipate)

Brand(s)Ogen tablet, oral 0.625,1.25,2.5,5mg Pharmacia & Upjohn

(equivalent to 0.75,1.5,3,6mg estropipate)Ortho-Est tablet, oral 0.625,1.25mg Women First Healthcare*

(equivalent to 0.75,1.5mg estropipate)

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

ETHAMBUTOL HYDROCHLORIDEEthambutol Hydrochloride tablet, oral 400mg Barr

tablet, oral 100,400mg West-wardBrands(s)

Myambutol tablet, oral 100mg,400mg Lederle

ETHCHLORVYNOLEthchlorvynol capsule, oral 100mg Banner Pharmacaps

@ capsule, oral 200,500,750mg Banner PharmacapsBrand(s)

Placidyl @ capsule, oral 100mg AbbottPlacidyl capsule, oral 200,500,750mg Abbott

ETHINYL ESTRADIOL; DESOGESTRELSee DESOGESTREL; ETHINYL ESTRADIOL

ETHINYL ESTRADIOL; ETHYNODIOL DIACETATEBrand(s)

Demulen 1/35 tablet, oral 0.035mg;1mg SearleDemulen 1/50 tablet, oral 0.05mg;1mg SearleZovia 1/35E tablet, oral 0.035mg;1mg WatsonZovia 1/50E tablet, oral 0.05mg;1mg Watson

NOTE: 21 day packs may not be interchanged with 28 day packs.

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

90

ETHINYL ESTRADIOL; LEVONORGESTRELBrand(s)

Alesse tablet, oral 0.02mg;0.1mg Wyeth-AyerstAviane tablet, oral 0.02mg;0.1mg DuramedLevora 0.15/30 tablet, oral 0.03mg;0.15mg WatsonNordette tablet, oral 0.03mg;0.15mg Wyeth-Ayerst *Enpresse tablet, oral, triphasic 0.03mg;0.05mg/ Duramed/Barr

0.04mg;0.075mg/0.03mg;0.125mgTriphasil tablet, oral, triphasic 0.03mg;0.05mg/ Wyeth-Ayerst *

0.04mg;0.075mg/0.03mg;0.125mgTrivora tablet, oral, triphasic 0.03mg;0.05mg/ Watson

0.04mg;0.075mg/0.03mg;0.125mg

NOTE: 21 day packs may not be interchanged with 28 day packs.

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

ETHINYL ESTRADIOL; NORETHINDRONEBrand(s)

Brevicon tablet, oral 0.035mg;0.5mg WatsonNortrel 0.5/35 tablet, oral 0.035mg;0.5mg BarrGenora 0.5/35 tablet, oral 0.035mg;0.5mg SyntexModicon tablet, oral 0.035mg;0.5mg Ortho/RW JohnsonNelova tablet, oral 0.035mg;0.5mg WatsonNortrel 1/35 tablet, oral 0.035mg;1mg BarrN.E.E. 1/35 @ tablet, oral 0.035mg;1mg LexisNecon 1/35 tablet, oral 0.035mg;1mg WatsonNelova tablet, oral 0.035mg;1mg WatsonNorcept-E 1/35 tablet, oral 0.035mg;1mg GynopharmaNorethin 1/35E tablet, oral 0.035mg;1mg WatsonNorinyl 1+35 tablet, oral 0.035mg;1mg WatsonOrtho-Novum 1/35 tablet, oral 0.035mg;1mg Ortho/RW JohnsonNelova 7/14 tablet, oral 0.035mg;0.5mg and 1mg WatsonOrtho Novum 7/14 tablet, oral 0.035mg;0.5mg and 1mg Ortho/RW JohnsonGencept 10/11 tablet, oral 0.035mg;0.5mg and 1mg BarrNelova 10/11 tablet, oral 0.035mg;0.5mg and 1mg WatsonOrtho Novum 10/11 tablet, oral 0.035mg;0.5mg and 1mg Ortho/RW Johnson

Note: 21 day packs may not be interchanged with 28 day packs.

ETHINYL ESTRADIOL; NORETHINDRONE ACETATEBrand(s)

Loestrin FE 1/20 tablet, oral 0.02mg;1mg Parke-DavisLoestrin FE 1.5/30 tablet, oral 0.03mg;1.5mg Parke-DavisMicrogestin FE 1/20 tablet, oral 0.02mg;1mg WatsonMicrogestin FE 1.5/30 tablet, oral 0.03mg;1.5mg Watson

Note: 21 day packs may not be interchanged with 28 day packs.

ETHINYL ESTRADIOL; NORGESTRELBrand(s)

Cryselle tablet, oral 0.03mg;0.3mg Duramed/BarrLo/Ovral tablet, oral 0.03mg;0.3mg Wyeth-AyerstLow-Ogestrel tablet, oral 0.03mg;0.3mg WatsonOgestrel tablet, oral 0.05mg;0.5mg SCSOvral tablet, oral 0.05mg;0.5mg Wyeth-AyerstNote: 21 day packs may not be interchanged with 28 day packs.

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

91

ETHOSUXIMIDEEthosuximide syrup, oral 250mg/5ml Copley

syrup, oral 250mg/5ml Pharmaceutical AssociatesBrand(s)

Zarontin syrup, oral 250mg/5ml Parke-Davis

ETHYNODIOL DIACETATE; ETHINYL ESTRADIOLSee ETHINYL ESTRADIOL; ETHYNODIOL DIACETATE

ETODOLACEtodolac capsule, oral 300mg Aesgen

capsule, oral 200,300mg Endocapsule, oral 200,300mg Genevacapsule, oral 200,300mg GenPharmcapsule, oral 200,300mg IVAXcapsule, oral 200,300mg Mylancapsule, oral 200,300mg Roycecapsule, oral 200,300mg Tarocapsule, oral 200,300mg Tevacapsule, oral 200,300mg TorPharmcapsule, oral 200,300mg Watsontablet, oral 400mg Aesgentablet, oral 400mg Endeavortablet, oral 400mg Endotablet, oral 400,500mg Eontablet, oral 400mg Genevatablet, oral 400,500mg GenPharmtablet, oral 400,500mg IVAXtablet, oral 400,500mg Mylantablet, oral 400,500mg Purepactablet, oral 400,500mg Ranbaxytablet, oral 400mg Roycetablet, oral 400,500mg Tarotablet, oral 400,500mg Tevatablet, oral 400mg Watsontablet, extended release 400,500mg Andrxtablet, extended release Teva 400,500,600mgtablet, extended release 400mg Whitney/Point

Brand(s)Lodine capsule, oral 200,300mg Wyeth-Ayerst *Lodine tablet, oral 400,500mg Wyeth-Ayerst *Lodine XL tablet, extended release Wyeth-Ayerst *

400,500,600mg

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

ETOMIDATEEtomidate injection 2mg/ml Bedford

Brand(s)Amidate injection 2mg/ml Abbott

ETOPOSIDEEtoposide capsule, oral 50mg GenPharm

injection 20mg/ml Abbott(continued on the next page)

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92

ETOPOSIDE (continued)injection 20mg/ml American Pharmaceutical

Partnersinjection 20mg/ml Bedfordinjection 20mg/ml Gensia Sicorinjection 20mg/ml Marsaminjection 20mg/ml Pharmachemieinjection 20mg/ml Pierre Fabre Medicament

@ injection 20mg/ml Sterisinjection 20mg/ml Supergen

Brand(s)VePesid capsule, oral 50mg Bristol-Myers SquibbToposar injection 20mg/ml Pharmacia & UpjohnVePesid injection 20mg/ml Bristol-Myers Squibb

FAMOTIDINEFamotidine injection, 10mg/ml American Pharmaceutical

Partners@ injection, 10mg/ml Apothecon

injection, 10mg/ml Bedfordinjection, 10mg/ml Ben Venueinjection, 10mg/ml ESI Lederleinjection, 10mg.ml Fauldingtablet, oral 20,40mg Apothecontablet, oral 20,40mg Carlsbadtablet, oral 20,40mg Danburytablet, oral 10,20mg Eontablet, oral 20,40mg Genevatablet, oral 20,40mg GenPharmtablet, oral 20,40mg IVAXtablet, oral 20,40mg Mylantablet, oral 20,40mg Purepactablet, oral 20,40mg Reddy-Cheminortablet, oral 20,40mg Tevatablet, oral 20,40mg TorPharm

Brand(s)Famotidine (preservative-free) injection, 10mg/ml American Pharmaceutical

PartnersFamotidine (preservative-free) @ injection, 10mg/ml ApotheconFamotidine (preservative-free) injection, 10mg/ml BedfordFamotidine (preservative-free) injection, 10mg/ml Ben VenueFamotidine (preservative-free) injection, 10mg/ml ESI LederleFamotidine (preservative-free) injection, 10mg/ml FauldingPepcid injection, 10mg/ml MerckPepcid (preservative-free) injection, 10mg/ml MerckPepcid tablet, oral 20,40mg Merck

FENOPROFEN CALCIUMFenoprofen Calcium @ capsule, oral eq 200,300mg base American Therapeutics

@ capsule, oral eq 200,300mg base Danburycapsule, oral eq 200,300mg base Geneva

@ capsule, oral eq 200,300mg base Halseycapsule, oral eq 200,300mg base Par

@ capsule, oral eq 200,300mg base Quantum@ capsule, oral eq 200,300mg base Warner Chilcott@ capsule, oral eq 200,300mg base Watson@ tablet, oral eq 600mg base American Therapeutics

tablet, oral eq 600mg base Danbury(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

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FENOPROFEN CALCIUM (continued)tablet, oral eq 600mg base Geneva

@ tablet, oral eq 600mg base Halseytablet, oral eq 600mg base IVAXtablet, oral eq 600mg base Lederletablet, oral eq 600mg base Mutualtablet, oral eq 600mg base Mylantablet, oral eq 600mg base Partablet, oral eq 600mg base Purepac

@ tablet, oral eq 600mg base Quantum@ tablet, oral eq 600mg base USL

tablet, oral eq 600mg base WatsonBrand(s)

Nalfon capsule, oral eq 200,300mg base Lilly/DistaNalfon tablet, oral eq 600mg base Lilly/Dista

FENTANYL CITRATEFentanyl Citrate @ injection eq 0.05mg base/ml Steris

Brand(s)Fentanyl Citrate Preservative-Free injection eq 0.05mg base/ml AbbottFentanyl Citrate Preservative-Free injection eq 0.05mg base/ml Elkins-SinnFentanyl Citrate @ injection eq 0.05mg base/ml Marsam Preservative-FreeSublimaze Preservative-Free injection eq 0.05mg base/ml Akorn

FENTANYL CITRATE; DROPERIDOLSee DROPERIDOL; FENTANYL CITRATE

FLECAINAIDE ACETATEFlecainide Acetate tablet, oral 50,100,150mg Alphapharm

Brand(s)Tambocor tablet, oral 50,100,150mg 3M *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

FLOXURIDINEFloxuridine injection 500mg/vial American Pharmaceutical

Partnersinjection 500mg/vial Bedford

@ injection 500mg/vial QuadBrand(s)

FUDR injection 500mg/vial Roche

FLUOCINOLONE ACETONIDEFluocinolone Acetonide @ cream, topical 0.01% Alpharma

@ cream, topical 0.01,0.025% Clay-Parkcream, topical 0.01,0.025% Fougera/Altanacream, topical 0.01,0.025% G & W

@ cream, topical 0.01,0.025% Pharmaderm/Altana@ cream, topical 0.01,0.025% Pharmafair

cream, topical 0.01,0.025% Tarocream, topical 0.01,0.025% Thames

@ cream, topical 0.01,0.025% USL

(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

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FLUOCINOLONE ACETONIDE (continued)ointment, topical 0.025% Fougera/Altanaointment, topical 0.025% G & W

@ ointment, topical 0.025% Pharmaderm/Altana@ ointment, topical 0.025% Pharmafair

ointment, topical 0.025% Taro@ ointment, topical 0.025% USL

solution, topical 0.01% Alpharma@ solution, topical 0.01% Bausch and Lomb

solution, topical 0.01% Fougera/Altana@ solution, topical 0.01% Morton Grove@ solution, topical 0.01% Pharmaderm@ solution, topical 0.01% Pharmafair

solution, topical 0.01% ThamesBrand(s)

Fluocet cream, topical 0.025% AlpharmaFluonid @ cream, topical 0.025% Allergan HerbertFluotrex @ cream, topical 0.01,0.025% Altana/SavageSynalar cream, topical 0.01,0.025% MedicisFluonid @ ointment, topical 0.025% Allergan HerbertFluotrex @ ointment, topical 0.025% Altana/SavageSynalar ointment, topical 0.025% MedicisFluonid solution, topical 0.01% Allergan HerbertFluotrex @ solution, topical 0.01% Altana/SavageSynalar solution, topical 0.01% Medicis

FLUOCINONIDEFluocinonide @ cream, topical 0.05% Clay-Park

cream, topical 0.05% Draxiscream, topical 0.05% Fougera/Altanacream, topical 0.05% NMCcream, topical 0.05% Tarocream, topical 0.05% Tevacream, topical 0.05% Thamescream, emulsified base 0.05% NMCgel, topical 0.05% Fougera/Altanagel, topical 0.05% Tarogel, topical 0.05% Tevaointment, topical 0.05% Altanaointment, topical 0.05% Taroointment, topical 0.05% Tevasolution, topical 0.05% Alpharmasolution, topical 0.05% Copleysolution, topical 0.05% Fougera/Altanasolution, topical 0.05% Tarosolution, topical 0.05% Tevasolution, topical 0.05% Thames

Brand(s)Lidex cream, topical 0.05% Medicis *Lidex-E cream, emulsified base 0.05% Medicis *Lidex gel, topical 0.05% Medicis *Lidex ointment, topical 0.05% Medicis *Lidex solution, top 0.05% Medicis *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

95

FLUORIDE; ASCORBIC ACID; CYANOCOBALAMIN; IRON; NICOTINIC ACID; PYRIDOXINE HYDROCHLORIDE;RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D; VITAMIN E

See ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; IRON; NICOTINIC ACID; PYRIDOXINEHYDROCHLORIDE; RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D;VITAMIN E

FLUORIDE; ASCORBIC ACID; CYANOCOBALAMIN; NICOTINIC ACID; PYRIDOXINE HYDROCHLORIDE;RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D; VITAMIN E

See ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; NICOTINIC ACID; PYRIDOXINEHYDROCHLORIDE; RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D;VITAMIN E

FLUORIDE; ASCORBIC ACID; IRON; VITAMIN A; VITAMIN DSee ASCORBIC ACID; FLUORIDE; IRON; VITAMIN A; VITAMIN D

FLUORIDE; ASCORBIC ACID; VITAMIN A; VITAMIN DSee ASCORBIC ACID; FLUORIDE; VITAMIN A; VITAMIN D

FLUOROMETHOLONEBrand(s)

Fluor-Op suspension, ophthalmic 0.1% Novartis *FML suspension, ophthalmic 0.1% Allergan *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

FLUOROURACILFluorouracil @ injection 50mg/ml ABIC

injection 50mg/ml American Pharmaceutical Partners

injection 50mg/ml Bedfordinjection 50mg/ml Bigmarinjection 50mg/ml Gensia-Sicorinjection 50mg/ml ICN Puerto Rico

@ injection 50mg/ml Marchar@ injection 50mg/ml Quad@ injection 50mg/ml Smith and Nephew

injection 50mg/ml SterisBrand(s)

Adrucil injection 50mg/ml Pharmacia & Upjohn

FLUOXETINE HYDROCHLORIDEFluoxetine Hydrochloride capsule, oral eq 10,20mg base Alphapharm

capsule, oral eq 10,20mg base Barrcapsule, oral eq 10,20,40mg base Dr. Reddycapsule, oral eq 10,20mg base Eoncapsule, oral eq 10,20,40mg base Genevacapsule, oral eq 10,20mg base IVAXcapsule, oral eq 10,20mg base Mallinckrodtcapsule, oral eq 10,20mg base Mylancapsule, oral eq 10,20mg base Siegfriedcapsule, oral eq 10,20,40mg base Tevacapsule, oral eq 10,20mg base Watson

(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

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FLUOXETINE HYDROCHLORIDE (continued)solution, oral eq 20mg base/5ml Mallinckrodtsolution, oral eq 20mg base/5ml Novexsolution, oral eq 20mg base/5ml Tevatablet, oral eq 10mg base Alphapharmtablet, oral eq 10mg base Eontablet, oral eq 10mg base IVAXtablet, oral eq 10mg base Teva

Brand(s)Prozac capsule, oral eq 10,20,40mg base LillyProzac solution, oral eq 20mg base/5ml LillyProzac tablet, oral eq 10mg base LillyRapiflux tablet, oral eq 20mg base Alphapharm *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

FLUPHENAZINE DECANOATEFluphenazine Decanoate injection 25mg/ml American Pharmaceutical

Partnersinjection 25mg/ml Apotexinjection 25mg/ml Bedfordinjection 25mg/ml Gensia Sicorinjection 25mg/ml King

@ injection 25mg/ml QuadBrand(s)

Prolixin Decanoate injection 25mg/ml Apothecon

FLUPHENAZINE HYDROCHLORIDEFluphenazine Hydrochloride concentrate, oral 5mg/ml Copley

concentrate, oral 5mg/ml Pharmaceutical Associateselixir, oral 2.5mg/5ml Copleyelixir, oral 2.5mg/5ml Pharmaceutical Associatesinjection 2.5mg/ml American Pharmaceutical

Partners@ injection 2.5mg/ml Quad@ tablet, oral 1,2.5,5,10mg Circa

tablet, oral 1,2.5,5,10mg Genevatablet, oral 1,2.5,5,10mg Mylantablet, oral 1,2.5,5,10mg Par

Brand(s)Permetil concentrate, oral 5mg/ml ScheringProlixin concentrate, oral 5mg/ml ApotheconProlixin elixir, oral 2.5mg/5ml ApotheconProlixin injection 2.5mg/ml ApotheconProlixin tablet, oral 1,2.5,5,10mg Apothecon

FLURANDRENOLIDEFlurandrenolide @ lotion, topical 0.05% Alpharma

Brand(s)Cordran lotion, topical 0.05% Oclassen

FLURAZEPAM HYDROCHLORIDEFlurazepam Hydrochloride @ capsule, oral 15,30mg Barr

capsule, oral 15,30mg Danburycapsule, oral 15,30mg Geneva

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APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

97

FLURAZEPAM HYDROCHLORIDE (continued)@ capsule, oral 15,30mg Halsey

capsule, oral 15,30mg Mylancapsule, oral 15,30mg Par

@ capsule, oral 15,30mg Purepac@ capsule, oral 15,30mg Superpharm@ capsule, oral 15,30mg USL@ capsule, oral 15,30mg Warner-Chilcott@ capsule, oral 15mg Watson

capsule, oral 30mg Watsoncapsule, oral 15,30mg West-ward

Brand(s)Dalmane capsule, oral 15,30mg ICN Puerto Rico

FLURBIPROFENFlurbiprofen tablet, oral 50,100mg Geneva

tablet, oral 50,100mg IVAXtablet, oral 50,100mg Mylantablet, oral 50,100mg Sidmaktablet, oral 50,100mg Tevatablet, oral 50,100mg Warner Chilcott

Brand(s)Ansaid tablet, oral 50,100mg Pharmacia & Upjohn *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

FLURBIPROFEN SODIUMFlurbiprofen Sodium solution, ophthalmic 0.03% Bausch and Lomb

Brand(s)Ocufen solution, ophthalmic 0.03% Allergan *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

FLUTAMIDEFlutamide capsule, oral 125mg Barr

capsule, oral 125mg Eoncapsule, oral 125mg IVAXcapsule, oral 125mg Teva

Brand(s)Eulexin capsule, oral 125mg Schering

FLUVOXAMINE MALEATEFluvoxamine Maleate tablet, oral 25,50,100mg Barr

tablet, oral 25,50,100mg Eontablet, oral 25,50,100mg Genevatablet, oral 25,50,100mg GenPharmtablet, oral 25,50,100mg IVAXtablet, oral 25,50,100mg Mylantablet, oral 25,50,100mg Purepactablet, oral 25,50,100mg Synthontablet, oral 25,50,100mg TorPharmtablet, oral 25,50,100mg Watson

Brand(s)Luvox tablet, oral 25,50,100mg Solvay

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

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FOLIC ACIDFolic Acid injection 5mg/ml American Pharmaceutical

Partnersinjection 5mg/ml Loch

@ tablet, oral 1mg Anabolic@ tablet, oral 1mg Barr@ tablet, oral 1mg Circa

tablet, oral 1mg Danbury@ tablet, oral 1mg Eon@ tablet, oral 1mg Everylife@ tablet, oral 1mg Halsey

tablet, oral 1mg ICN@ tablet, oral 1mg Impax

tablet, oral 1mg IVAX@ tablet, oral 1mg Lannett@ tablet, oral 1mg Lilly

tablet, oral 1mg MK@ tablet, oral 1mg Pharmeral@ tablet, oral 1mg Pioneer

tablet, oral 1mg Private Formulations@ tablet, oral 1mg Purepac

tablet, oral 1mg Tablicaps@ tablet, oral 1mg (Unit Dose Labs)@ tablet, oral 1mg USL@ tablet, oral 1mg (Vangard/MWM)@ tablet, oral 1mg Vintage@ tablet, oral 1mg Watson

tablet, oral 1mg West-ward @ tablet, oral 1mg Whiteworth TowneBrand(s)

Folvite injection 5mg/ml LederleFolicet tablet, oral 1mg MissionFolvite @ tablet, oral 1mg Lederle

FOLIC ACID; ASCORBIC ACID; BIOTIN; CYANOCOBALAMIN; DEXPANTHENOL; ERGOCALCIFEROL;NIACINAMIDE; PYRIDOXINE HYDROCHLORIDE; RIBOFLAVIN PHOSPHATE SODIUM; THIAMINEHYDROCHLORIDE; VITAMIN A; VITAMIN E

See ASCORBIC ACID; BIOTIN; CYANOCOBALAMIN; DEXPANTHENOL; ERGOCALCIFEROL; FOLICACID; NIACINAMIDE; PYRIDOXINE HYDROCHLORIDE; RIBOFLAVIN PHOSPHATE SODIUMHYDROCHLORIDE; VITAMIN A; VITAMIN E

FUROSEMIDEFurosemide injection 10mg/ml Abbott

injection 10mg/ml American Pharmaceutical Partners

@ injection 10mg/ml Astra Zenecainjection 10mg/ml Elkins-Sinninjection 10mg/ml International Medicationinjection 10mg/ml Lederleinjection 10mg/ml Luitpoldinjection 10mg/ml Marsam

@ injection 10mg/ml Organon/Akzonainjection 10mg/ml Sanofi Synthelabo

@ injection 10mg/ml Smith and Nephew@ injection 10mg/ml Steris@ injection 10mg/ml Warner Chilcott@ injection 10mg/ml Wyeth-Ayerst

(continued on the next page)

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FUROSEMIDE (continued)solution, oral 10mg/ml Morton Grovesolution, oral 10mg/ml Roxane

@ tablet, oral 20,40,80mg Barr

tablet, oral 20,40,80mg Danbury@ tablet, oral 40mg Eon

tablet, oral 20,40,80mg Genevatablet, oral 20,40mg International Medicationtablet, oral 20,40mg IVAXtablet, oral 20,40mg Kalapharmtablet, oral 20,40,80mg Lederletablet, oral 20,40,80mg Mylantablet, oral 20,40,80mg Roxane

@ tablet, oral 20,40mg Superpharm@ tablet, oral 20,40,80mg Warner Chilcott

tablet, oral 20,40,80mg WatsonBrand(s)

Lasix injection 10mg/ml AventisLasix solution, oral 10mg/ml AventisLasix tablet, oral 20,40,80mg Aventis

GEMFIBROZILGemfibrozil @ capsule, oral 300mg Mylan

@ capsule, oral 300mg Purepactablet, oral 600mg Genevatablet, oral 600mg Lederletablet, oral 600mg Mylan

@ tablet, oral 600mg Purepactablet, oral 600mg Tevatablet, oral 600mg TorPharmtablet, oral 600mg Watson

Brand(s)Lopid @ capsule, oral 300mg Parke-DavisLopid tablet, oral 600mg Parke-Davis *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

GENTAMICIN SULFATEGentamicin Sulfate @ cream, topical eq 0.1% base Alpharma

@ cream, topical eq 0.1% base Bausch and Lombcream, topical eq 0.1% base Clay-Parkcream, topical eq 0.1% base Fougera/Altana

@ cream, topical eq 0.1% base Pharmaderm/Altanacream, topical eq 0.1% base Thamesinjection eq 10,40mg base/ml Abbottinjection eq 10,40mg base/ml American Pharmaceutical

Partnersinjection eq 10,40mg base/ml Elkins-Sinninjection eq 10mg base/ml Gensia Sicor

@ injection eq 40mg base/ml Gensia Sicor@ injection eq 1,40mg base/ml International Medication

injection eq 40mg base/ml Kalapharminjection eq 40mg base/ml Pharmaceutical Specialties

@ injection eq 10,40mg base/ml Solopak@ injection eq 10,40mg base/ml Steris@ injection eq 10,40mg base/ml Wyeth-Ayerst

(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

100

GENTAMICIN SULFATE (continued)@ ointment, topical eq 0.1% base Alpharma@ ointment, topical eq 0.1% base Bausch and Lomb

ointment, topical eq 0.1% base Clay-Parkointment, topical eq 0.1% base Fougera/Altana

@ ointment, topical eq 0.1% base Pharmaderm/Altanaointment, topical eq 0.1% base Thamesointment, ophthalmic eq 0.3% base Akorn

@ solution, ophthalmic eq 0.3% base Alcon Universalsolution, ophthalmic eq 0.3% base Bausch and Lombsolution, ophthalmic eq 0.3% base Falcon *

@ solution, ophthalmic eq 0.3% base PacoBrand(s)

Garamycin cream, topical eq 0.1% base ScheringGentafair @ cream, topical eq 0.1% base PharmafairApogen @ injection eq 10,40mg base/ml KingBristagen @ injection eq 40mg base/ml Bristol/Bristol-MyersGaramycin @ injection eq 10mg base/ml ScheringGaramycin injection eq 1,40mg base/ml ScheringGentafair @ injection eq 40mg base/ml PharmafairU-Gencin @ injection eq 10,40mg base/ml Pharmacia & UpjohnGaramycin ointment, topical eq 0.1% base ScheringGentafair @ ointment, topical eq 0.1% base PharmafairGaramycin ointment, ophthalmic eq 0.3% base ScheringGentacidin @ ointment, ophthalmic eq 0.3% base NovartisGentafair @ ointment, ophthalmic eq 0.3% base PharmafairAK-Gentak solution, ophthalmic eq 0.3% base AkornGaramycin solution, ophthalmic eq 0.3% base ScheringGenoptic solution, ophthalmic eq 0.3% base AllerganGentacidin solution, ophthalmic eq 0.3% base NovartisGentafair @ solution, ophthalmic eq 0.3% base Pharmafair

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

GENTAMICIN SULFATE; DEXTROSESee DEXTROSE; GENTAMICIN SULFATE

GENTAMICIN SULFATE; SODIUM CHLORIDEGentamicin Sulfate; injection eq 60mg base/100ml; Abbott Sodium Chloride 900mg/100ml

injection eq 70mg base/100ml; Abbott 900mg/100mlinjection eq 80mg base/100ml; Abbott 900mg/100mlinjection eq 90mg base/100ml; Abbott 900mg/100mlinjection eq 100mg base/100ml; Abbott 900mg/100mlinjection eq 1.2mg base/ml;9mg/ml Abbottinjection eq 1.4mg base/ml;9mg/ml Abbottinjection eq 1.6mg base/ml;9mg/ml Abbottinjection eq 1.8mg base/ml;9mg/ml Abbottinjection eq 2mg base/ml;9mg/ml Abbottinjection eq 40mg base/100ml; Baxter 900mg/100mlinjection eq 60mg base/100ml; Baxter 900mg/100ml

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APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

101

GENTAMICIN SULFATE; SODIUM CHLORIDE (continued)injection eq 80mg base/100ml; Baxter 900mg/100mlinjection eq 100mg base/100ml; Baxter 900mg/100mlinjection eq 120mg base/100ml; Baxter 900mg/100mlinjection eq 0.8mg base/ml;9mg/ml Baxterinjection eq 1.2mg base/ml;9mg/ml Baxter

injection eq 1.6mg base/ml;9mg/ml Baxterinjection eq 2mg base/ml;9mg/ml Baxterinjection eq 2.4mg base/ml;9mg/ml Baxterinjection eq 40mg base/100ml; Braun 900mg/100mlinjection eq 60mg base/100ml; Braun 900mg/100mlinjection eq 70mg base/100ml; Braun 900mg/100mlinjection eq 80mg base/100ml; Braun 900mg/100mlinjection eq 90mg base/100ml; Braun 900mg/100mlinjection eq 100mg base/100ml; Braun 900mg/100mlinjection eq 120mg base/100ml; Braun 900mg/100mlinjection eq 0.8mg base/ml;9mg/ml Brauninjection eq 1.2mg base/ml;9mg/ml Brauninjection eq 1.4mg base/ml;9mg/ml Brauninjection eq 1.6mg base/ml;9mg/ml Brauninjection eq 1.8mg base/ml;9mg/ml Brauninjection eq 2mg base/ml;9mg/ml Brauninjection eq 2.4mg base/ml;9mg/ml Braun

GLIPIZIDEGlipizide tablet, oral 5,10mg Alphapharm

tablet, oral 5,10mg Circatablet, oral 5,10mg Duramedtablet, oral 5,10mg Endotablet, oral 5,10mg Genevatablet, oral 5,10mg IVAXtablet, oral 5,10mg Mylantablet, oral 5,10mg Sidmaktablet, oral 5,10mg Tevatablet, oral 5,10mg TorPharmtablet, oral 5,10mg Watson

Brand(s)Glucotrol tablet, oral 5,10mg Pfizer

GLUCAGON HYDROCHLORIDEGlucagon Hydrochloride injection eq 1mg base/vial Lilly

@ injection eq 10mg base/vial Lilly@ injection eq 1,10mg base/vial Quad

GLUTATHIONE DISULFIDE; CALCIUM CHLORIDE; DEXTROSE; MAGNESIUM CHLORIDE; POTASSIUMCHLORIDE; SODIUM BICARBONATE; SODIUM CHLORIDE; SODIUM PHOSPHATE

See CALCIUM CHLORIDE; DEXTROSE; GLUTATHIONE DISULFIDE; MAGNESIUM CHLORIDE;POTASSIUM CHLORIDE; SODIUM BICARBONATE; SODIUM CHLORIDE; SODIUM PHOSPHATE

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

102

GLUTETHIMIDEGlutethimide tablet, oral 500mg Danbury

@ tablet, oral 500mg Eontablet, oral 500mg Geneva

@ tablet, oral 250,500mg Halsey@ tablet, oral 250,500mg Lannett@ tablet, oral 500mg Watson

Brand(s)Doriden @ tablet, oral 250,500mg Aventis

GLYBURIDEGlyburide tablet, oral 1.25,2.5,5mg Teva ***

Brand(s)Diabeta tablet, oral 1.25,2.5,5mg Aventis * **Micronase tablet, oral 1.25,2.5,5mg Pharmacia & Upjohn * **

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

** Diabeta and Micronase are NOT INTERCHANGEABLE at this time. Neither company has to date presentedacceptable bioequivalence information comparing their brand of glyburide to the other. Aventis, via Copley(Teva), is manufacturing glyburide for other labelers using the Diabeta federal new drug application (NDA) whilePharmacia & Upjohn is doing the same, via Greenstone, for at least one labeler using the Micronase NDA.Thus, Aventis manufactured generically labeled glyburide products are NOT INTERCHANGEABLE at this timewith Pharmacia & Upjohn manufactured generically labeled glyburide products.

*** Note: Glyburide by Teva (formerly Novopharm) has only been determined, at this time, to be equivalentto Micronase by Pharmacia & Upjohn. Pharmacists need to be particularly careful when selecting a Tevaproduct to verify the identity of the innovator product it is replacing.

GLYBURIDE, MICRONIZEDGlyburide, micronized tablet, oral 1.5,3,6mg Mylan

Brand(s)Glynase tablet, oral 1.5,3,6mg Pharmacia & Upjohn *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

Note: Prescribers and pharmacists should be aware of the differences in scoring mechanisms betweendifferent manufacturers’ tablets and should take these differences into account when writing a prescription orpracticing drug product selection when the prescriber’s instructions to the patient call for the use of half tablets.

GLYCINEGlycine solution 1.5gm/100ml (1.5%) Abbott (Aminoacetic Acid) solution 1.5gm/100ml (1.5%) Baxter solution for irrigation solution 1.5gm/100ml (1.5%) Braun

GLYCOPYRROLATEGlycopyrrolate @ injection 0.2mg/ml Abbott

@ injection 0.2mg/ml American Pharmaceutical Partners

@ injection 0.2mg/ml Gensia Sicorinjection 0.2mg/ml Luitpold

@ injection 0.2mg/ml Quad@ injection 0.2mg/ml Steris@ tablet, oral 1,2mg Circa

(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

103

GLYCOPYRROLATE (continued)@ tablet, oral 1,2mg Danbury@ tablet, oral 1mg Watson

Brand(s)Robinul injection 0.2mg/ml RobinsRobinul tablet, oral 1mg First HorizonRobinul Forte tablet, oral 2mg First Horizon

GONADOTROPIN CHORIONICChorionic Gonadotropin injection 10,000IU/10ml American Pharmaceutical

Partners@ injection 5,000, 15,000, 20,000IU/10ml American Pharmaceutical

Partners@ injection 5,000, 10,000IU/10ml Bel-Mar@ injection 5,000, 10,000, 20,000IU/10ml Quad

injection 5,000, 10,000IU/10ml Steris@ injection 15,000, 20,000IU/10ml Steris

Brand(s)A.P.L. injection 5,000, 10,000, 20,000IU/10ml Wyeth-AyerstFollutein @ injection 10,000IU/10ml SquibbPregnyl injection 10,000IU/10ml Organon/Akzona

GRAMICIDIN; NEOMYCIN SULFATE; POLYMYXIN B SULFATEGramicidin; Neomycin Sulfate; solution, ophthalmic 0.025mg/ml; Bausch and Lomb Polymyxin B Sulfate eq 1.75mg base/ml; 10,000U/ml

@ solution, ophthalmic 0.025mg/ml; Ipharm eq 1.75mg base/ml; 10,000U/ml

@ solution, ophthalmic 0.025mg/ml; Steris eq 1.75mg base/ml; 10,000U/ml

Brand(s)Neo-Polycin @ solution, ophthalmic 0.025mg/ml; Dow

eq 1.75mg base/ml; 10,000U/mlNeosporin solution, ophthalmic 0.025mg/ml; Monarch

eq 1.75mg base/ml; 10,000U/mlOcutricin @ solution, ophthalmic 0.025mg/ml; Pharmafair

eq 1.75mg base/ml; 10,000U/ml

GRISEOFULVIN MICROCRYSTALLINEBrand(s)

Fulvicin-U/F tablet, oral 250,500mg ScheringGrifulvin V tablet, oral 250,500mg J & JGrisactin tablet, oral 500mg Wyeth-Ayerst *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

GRISEOFULVIN ULTRAMICROCRYSTALLINEBrand(s)

Fulvicin P/G tablet, oral 125,165,250,330mg ScheringGris-PEG tablet, oral 125,250mg PedinolGrisactin Ultra @ tablet, oral 125,250mg Wyeth-Ayerst *Grisactin Ultra tablet, oral 165,330mg Wyeth-Ayerst *Ultragris 165, 330 @ tablet, oral 165,330mg Sidmak

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

104

GUAIFENESIN; CODEINE PHOSPHATESee CODEINE PHOSPHATE; GUAIFENESIN

GUAIFENESIN; CODEINE PHOSPHATE; PSEUDOEPHEDRINE HYDROCHLORIDESee CODEINE PHOSPHATE; GUAIFENESIN; PSEUDOEPHEDRINE HYDROCHLORIDE

GUAIFENESIN; HYDROCODONE BITARTRATE; PSEUDOEPHEDRINE HYDROCHLORIDEGuaifenesin; syrup, oral 200mg/5ml;5mg/5ml; Morton Grove Hydrocodone Bitartrate; 60mg/5ml Pseudoephedrine Hydrochloride

Brand(s)Detussin Expectorant syrup, oral 200mg/5ml;5mg/5ml; Alpharma

60mg/5mlHydrophed Expectorant syrup, oral 200mg/5ml;5mg/5ml; Norton

60mg/5mlHytussin Expectorant syrup, oral 200mg/5ml;5mg/5ml; Cenci

60mg/5mlTussend Expectorant syrup, oral 200mg/5ml;5mg/5ml; Aventis

60mg/5ml

* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as anexception to the promulgated criteria for inclusion, pursuant to Rule 790.60.

GUAIFENESIN; PHENYLEPHRINE HYDROCHLORIDE; PHENYLPROPANOLAMINE HYDROCHLORIDEBrand(s)

Entex liquid 100mg/5ml;5mg/5ml;20mg/5ml Procter and GambleSil-Tex liquid 100mg/5ml;5mg/5ml;20mg/5ml Silarx

* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as anexception to the promulgated criteria for inclusion, pursuant to Rule 790.60.

GUAIFENESIN; THEOPHYLLINEGuaifenesin; Theophylline liquid, oral 90mg/15ml;150mg/15ml Alpharma

liquid, oral 90mg/15ml;150mg/15ml Centralliquid, oral 90mg/15ml;150mg/15ml Forestliquid, oral 90mg/15ml;150mg/15ml Genevaliquid, oral 90mg/15ml;150mg/15ml Naskaliquid, oral 90mg/15ml;150mg/15ml Aventis

Brand(s)Quibron liquid, oral 90mg/15ml;150mg/15ml Bristol-Myers

* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as anexception to the promulgated criteria for inclusion, pursuant to Rule 790.60.

GUANABENZ ACETATEGuanabenz Acetate tablet, oral eq 4,8mg base Copley

tablet, oral eq 4,8mg base Eontablet, oral eq 4,8mg base IVAXtablet, oral eq 4,8mg base Watson

Brand(s)Wytensin tablet, oral eq 4,8mg base Wyeth-Ayerst

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

105

GUANETHIDINE MONOSULFATEGuanethidine Monosulfate @ tablet, oral eq 10,25mg sulfate Circa

Brand(s)Ismelin tablet, oral eq 10,25mg sulfate Novartis

GUANFACINE HYDROCHLORIDEGuanfacine Hydrochloride tablet, oral eq 1,2mg base Amide

tablet, oral eq 1,2mg base GenPharmtablet, oral eq 1,2mg base Mylantablet, oral eq 1,2mg base Roycetablet, oral eq 1,2mg base Watson

Brand(s)Tenex tablet, oral eq 1,2mg base Robins

HALOPERIDOLHaloperidol @ tablet, oral 0.5,1,2,5,10,20mg Barr

@ tablet, oral 0.5,1,1,2,5,10,20mg Circatablet, oral 0.5,2,5mg Danbury

@ tablet, oral 10,20mg Danbury@ tablet, oral 0.5,1,2,5,10,20mg Duramed

tablet, oral 0.5,1,2,5,10,20mg Geneva@ tablet, oral 0.5,1,2,5,10,20mg Lederle

tablet, oral 0.5,1,2,5mg Mylantablet, oral 0.5,1,2,5,10mg Par

@ tablet, oral 20mg Par@ tablet, oral 0.5,1,2,5,20mg Purepac

tablet, oral 10mg Purepac@ tablet, oral 0.5,1,2,5mg Quantum@ tablet, oral 0.5,1,2,5,10,20mg Roxane@ tablet, oral 0.5,1,2,5,10,20mg Royce@ tablet, oral 0.5,1,2,5,10,20mg SCS

Brand(s)Haldol tablet, oral 0.5,1,2,5,10,20mg Ortho McNeil

HALOPERIDOL DECANOATEHaloperidol Decanoate injection eq 50,100mg base/ml American Pharmaceutical

Partnersinjection eq 50,100mg base/ml Apotexinjection eq 50,100mg base/ml Bedfordinjection eq 50,100mg base/ml Gensia Sicorinjection eq 50,100mg base/ml King

Brand(s)Haldol Decanoate injection eq 50,100mg base/ml Ortho McNeil

HALOPERIDOL LACTATEHaloperidol Lactate concentrate, oral eq 2mg base/ml Alpharma

concentrate, oral eq 2mg base/ml Copley@ concentrate, oral eq 2mg base/ml Morton Grove

concentrate, oral eq 2mg base/ml Pharmaceutical Associates@ concentrate, oral eq 2mg base/ml Roxane@ concentrate, oral eq 2mg base/ml SCS

concentrate, oral eq 2mg base/ml Silarxconcentrate, oral eq 2mg base/ml Tevainjection eq 5mg base/ml American Pharmaceutical

Partnersinjection eq 5mg base/ml Marsam

(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

106

HALOPERIDOL LACTATE (continued)@ injection eq 5mg base/ml Quad@ injection eq 5mg base/ml Smith and Nephew@ injection eq 5mg base/ml SoloPak@ injection eq 5mg base/ml Steris

Brand(s)Haldol concentrate, oral eq 2mg base/ml Ortho McNeilHaldol injection eq 5mg base/ml Ortho McNeil

HALOTHANEHalothane liquid for inhalation 99.99% Abbott

@ liquid for inhalation 99.99% BHliquid for inhalation 99.99% Halocarbon

Brand(s)Fluothane liquid for inhalation 99.99% Wyeth-Ayerst

HEPARIN SODIUMHeparin Sodium @ injection 1,000, 5,000, 10,000, 20,000, Akorn

40,000U/mlinjection 1,000, 5,000, 10,000, American Pharmaceutical 20,000U/ml Partnersinjection 1,000U/ml Baxter

@ injection 1,000, 5,000, 10,000, Chamberlin 20,000U/mlinjection 1,000, 5,000, 10,000, 20,000, Dell 40,000U/mlinjection 1,000, 5,000, 10,000U/ml Elkins-Sinn

@ injection 10U/ml International Medication@ injection 1,000, 20,000U/ml Lilly

injection 10,000U/ml Lilly@ injection 10, 100, 1,000U/ml Luitpold

injection 1,000U/ml Marsam@ injection 20,000, 40,000U/ml Organon/Akzona@ injection 10, 1,000, 5,000, 10,000, Parke-Davis

20,000U/ml@ injection 1,000, 5,000, 10,000, Pharmaceutical Specialties

20,000, 40,000U/ml@ injection 1,000U/ml Pharmaserv@ injection 10, 100, 1,000U/ml Smith and Nephew@ injection 10, 100, 1,000, 5,000 Solopak

10,000U/ml@ injection 10,000U/0.5ml Solopak@ injection 100, 1,000, 5,000, 10,000, Steris 20,000, 40,000U/ml

injection 5,000, 10,000U/ml Sterling Winthropinjection 1,000, 5,000, 10,000U/ml Pharmacia & Upjohninjection 10, 100, 1,000, 2,500, 5,000, Wyeth-Ayerst 10,000, 20,000U/ml

Brand(s)Hep-Flush injection 10, 100U/ml American Pharmaceutical

PartnersHep-Lock, Hep Lock U/P injection 10, 100U/ml Elkins-SinnHeparin Sodium injection 1,000U/ml American Pharmaceutical Preservative-Free PartnersLipo-Hepin @ injection 1,000, 5,000, 10,000, 20,000, Riker/3-M

40,000U/mlLiquaemin Sodium @ injection 100, 1,000, 5,000, 10,000, Organon/Akzona

20,000, 40,000U/ml(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

107

HEPARIN SODIUM (continued)Panheprin injection 10, 100, 2,500, 5,000U/ml AbbottPanheprin @ injection 1,000, 20,000, 40,000, Abbott

10,000U/mlNOTE: Check for equivalent strengths prior to drug product selection. Products with preservatives maynot be interchanged with preservative-free products.

HEPARIN SODIUM; DEXTROSESee DEXTROSE; HEPARIN SODIUM

HEPARIN SODIUM; SODIUM CHLORIDEHeparin Sodium; injection 200U/100ml;900mg/100ml Abbott Sodium Chloride @ injection 1000U/100ml;900mg/100ml Abbott

injection 5000U/100ml;450mg/100ml Abbott@ injection 5000U/100ml;900mg/100ml Abbott

injection 200U/100ml;900mg/100ml Baxterinjection 200U/100ml;900mg/100ml Braun

@ injection 1000U/100ml;900mg/100ml Braun@ injection 5000U/100ml;450mg/100ml Braun@ injection 5000U/100ml;900mg/100ml Braun

HEXACHLOROPHENEBrand(s)

Hexa-Germ @ emulsion, topical 3% HuntingtonpHisoHex emulsion, topical 3% Sanofi SynthelaboSoy-Dome @ emulsion, topical 3% MilesTurgex @ emulsion, topical 3% XttriumDial @ solution, topical 0.25% DialGerma-Medica "MG" @ solution, topical 0.25% HuntingtonSeptisoft @ solution, topical 0.25% CalgonSeptisol @ solution, topical 0.25% VestalHexascrub @ sponge, topical 3% Prof DisposablespHisoscrub @ sponge, topical 3% Sanofi Synthelabo

HOMATROPINE HYDROBROMIDEHomatropine Methylbromide solution, ophthalmic 2,5% Iolab

solution, ophthalmic 5% Pacosolution, ophthalmic 5% Pharmafair

Brand(s)AK-Homatropine solution, ophthalmic 5% AkornI-Homatropine solution, ophthalmic 5% AmericalIsopto Homatropine solution, ophthalmic 2,5% Alcon

* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as anexception to the promulgated criteria for inclusion, pursuant to Rule 790.60.

HOMATROPINE METHYLBROMIDE; HYDROCODONE BITARTRATEHomatropine Methylbromide; tablet, oral 1.5mg/5mg Amide Hydrocodone Bitartrate

Brand(s)Hycodan syrup, oral 1.5mg/5ml;5mg/5ml EndoHydrocodone Compound syrup, oral 1.5mg/5ml;5mg/5ml AlpharmaHydropane syrup, oral 1.5mg/5ml;5mg/5ml HalseyMycodone syrup, oral 1.5mg/5ml;5mg/5ml Morton GroveHycodan tablet, oral 1.5mg;5mg EndoTussigon tablet, oral 1.5mg;5mg Daniels

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

108

HYDRALAZINE HYDROCHLORIDEHydralazine Hydrochloride injection 20mg/ml American Pharmaceutical

Partnersinjection 20mg/ml Gensia-Sicorinjection 20mg/ml Luitpold

@ injection 20mg/ml Smith and Nephew@ injection 20mg/ml Solopak

tablet, oral 10,25,50,100mg ABC@ tablet, oral 25,50mg Amide@ tablet, oral 25,50mg (Ascot)@ tablet, oral 10,25,50,100mg Barr

tablet, oral 25,50mg Danbury@ tablet, oral 25,50mg Eon

tablet, oral 10,25,50mg Geneva@ tablet, oral 10,25,50,100mg Halsey@ tablet, oral 25mg Impax

tablet, oral 50mg Impax@ tablet, oral 10,25,50,100mg IVAX

tablet, oral 25,50mg Lederletablet, oral 10,25,50mg Mutualtablet, oral 10,25,50,100mg Par

@ tablet, oral 25mg Purepac@ tablet, oral 50mg Purepac@ tablet, oral 10,25,50,100mg Quantum

tablet, oral 10,25,50,100mg Sidmak@ tablet, oral 10,25,50mg Superpharm@ tablet, oral 25,50mg USL@ tablet, oral 25,50mg (Vangard/MWM)@ tablet, oral 25,50mg Watson@ tablet, oral 25,50mg West-ward

Brand(s)Apresoline @ injection 20mg/ml NovartisApresoline tablet, oral 10,25,50,100mg NovartisDralzine @ tablet, oral 25mg Teva

HYDRALAZINE HYDROCHLORIDE; HYDROCHLOROTHIAZIDEHydralazine Hydrochloride; @ capsule, oral 25mg;25mg, 50mg;50mg, Circa Hydrochlorothiazide 100mg;50mg

@ capsule, oral 25mg;25mg, 50mg;50mg IVAX 100mg;50mg

@ capsule, oral 25mg;25mg Superpharmcapsule, oral 50mg;50mg Superpharm

Brand(s)Apresazide capsule, oral 25mg;25mg, 50mg;50mg NovartisApresazide @ capsule, oral 100mg;50mg NovartisHydra-Zide capsule, oral 25mg;25mg, 50mg;50mg, Par

100mg;50mgHydral @ capsule, oral 25mg;25mg, 50mg;50mg SolvayHydral @ capsule, oral 100mg;50mg Solvay

HYDROCHLOROTHIAZIDEHydrochlorothiazide capsule, oral 12.5mg Mylan

@ solution, oral 50mg/5ml Morton Grovesolution, oral 50mg/5ml Roxanetablet, oral 25,50mg ABC

@ tablet, oral 25,50mg (Ascot)tablet, oral 25,50mg Barr

@ tablet, oral 100mg Barr(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

109

HYDROCHLOROTHIAZIDE (continued)@ tablet, oral 25,50,100mg Circa

tablet, oral 25,100mg Danbury@ tablet, oral 50mg Danbury@ tablet, oral 50mg Elkins-Sinn@ tablet, oral 25mg Eon

tablet, oral 50mg Eontablet, oral 25,50mg Geneva

@ tablet, oral 25,50mg Halsey@ tablet, oral 25,50,100mg Impax@ tablet, oral 50mg Heather@ tablet, oral 25,50mg Inwood/Forest

tablet, oral 25,50,100mg IVAXtablet, oral 25,50,100mg Lederle

@ tablet, oral 25,50mg Mast@ tablet, oral 25,50mg Mylan@ tablet, oral 25,50mg Pharmeral

tablet, oral 25,50mg Private Formulationstablet, oral 25,50mg Purepac

@ tablet, oral 25mg Roxanetablet, oral 50mg Roxane

@ tablet, oral 25mg Solvay@ tablet, oral 25,50,100mg Superpharm@ tablet, oral 25,50mg Teva@ tablet, oral 25,50mg USL@ tablet, oral 25,50mg (Vangard/MWM)@ tablet, oral 25,50mg Warner-Chilcott@ tablet, oral 25,50,100mg Watson@ tablet, oral 25,50mg West-ward@ tablet, oral 25,50,100mg Whiteworth Towne

Brand(s)Microzide capsule, oral 12.5mg WatsonEsidrix tablet, oral 25,50,100mg NovartisHydro-D @ tablet, oral 25,50mg HalseyHydroDIURIL tablet, oral 25,50,100mg Merck Sharp and Dohme *Oretic tablet, oral 25,50mg AbbottZide @ tablet, oral 50mg Solvay

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

HYDROCHLOROTHIAZIDE; AMILORIDE HYDROCHLORIDESee AMILORIDE HYDROCHLORIDE; HYDROCHLOROTHIAZIDE

HYDROCHLOROTHIAZIDE; BISOPROLOL FUMARATESee BISOPROLOL FUMARATE; HYDROCHLOROTHIAZIDE

HYDROCHLOROTHIAZIDE; CAPTOPRILSee CAPTOPRIL; HYDROCHLOROTHIAZIDE

HYDROCHLOROTHIAZIDE; ENALAPRILSee ENALAPRIL; HYDROCHLOROTHIAZIDE

HYDROCHLOROTHIAZIDE; HYDRALAZINE HYDROCHLORIDESee HYDRALAZINE HYDROCHLORIDE; HYDROCHLOROTHIAZIDE

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

110

HYDROCHLOROTHIAZIDE; LABETALOLBrand(s)

Normozide @ tablet, oral 25mg;100mg ScheringNormozide @ tablet, oral 25mg;200mg ScheringNormozide @ tablet, oral 25mg;300mg ScheringNormozide @ tablet, oral 25mg;400mg ScheringTrandate-HCT @ tablet, oral 25mg;100mg Glaxo WellcomeTrandate-HCT @ tablet, oral 25mg;200mg Glaxo WellcomeTrandate-HCT @ tablet, oral 25mg;300mg Glaxo WellcomeTrandate-HCT @ tablet, oral 25mg;400mg Glaxo Wellcome

HYDROCHLOROTHIAZIDE; LISINOPRILBrand(s)

Prinzide 10-12.5 tablet, oral 12.5mg;10mg Merck Sharp and Dohme *Prinzide 20-12.5 tablet, oral 12.5mg;20mg Merck Sharp and Dohme *Prinzide 20-25 tablet, oral 25mg;20mg Merck Sharp and Dohme *Zestoretic 10-12.5 tablet, oral 12.5mg;10mg ZenecaZestoretic 20-12.5 tablet, oral 12.5mg;20mg ZenecaZestoretic 20-25 tablet, oral 25mg;20mg Zeneca

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

HYDROCHLOROTHIAZIDE; METHYLDOPAHydrochlorothiazide; @ tablet, oral 15mg;250mg Circa Methyldopa @ tablet, oral 25mg;250mg Circa

@ tablet, oral 30mg;500mg Circa@ tablet, oral 50mg;500mg Circa

tablet, oral 15mg;250mg Danburytablet, oral 25mg;250mg Danburytablet, oral 30mg;500mg Danburytablet, oral 50mg;500mg Danburytablet, oral 15mg;250mg Genevatablet, oral 25mg;250mg Genevatablet, oral 30mg;500mg Genevatablet, oral 50mg;500mg Genevatablet, oral 15mg;250mg Invamedtablet, oral 25mg;250mg Invamed

@ tablet, oral 15mg;250mg IVAX@ tablet, oral 25mg;250mg IVAX@ tablet, oral 30mg;500mg IVAX@ tablet, oral 50mg;500mg IVAX

tablet, oral 15mg;250mg Lederletablet, oral 25mg;250mg Lederletablet, oral 30mg;500mg Lederletablet, oral 50mg;500mg Lederletablet, oral 15mg;250mg Mylantablet, oral 25mg;250mg Mylantablet, oral 15mg;250mg Partablet, oral 25mg;250mg Partablet, oral 30mg;500mg Partablet, oral 50mg;500mg Par

@ tablet, oral 15mg;250mg Parke-Davis@ tablet, oral 25mg;250mg Parke-Davis@ tablet, oral 30mg;500mg Parke-Davis@ tablet, oral 50mg;500mg Parke-Davis

(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

111

HYDROCHLOROTHIAZIDE; METHYLDOPA (continued)@ tablet, oral 15mg;250mg Purepac@ tablet, oral 25mg;250mg Purepac@ tablet, oral 30mg;500mg Purepac@ tablet, oral 50mg;500mg Purepac@ tablet, oral 15mg;250mg Teva@ tablet, oral 25mg;250mg Teva@ tablet, oral 30mg;500mg Teva@ tablet, oral 50mg;500mg Teva@ tablet, oral 15mg;250mg Watson@ tablet, oral 25mg;250mg Watson@ tablet, oral 30mg;500mg Watson@ tablet, oral 50mg;500mg Watson

Brand(s)Aldoril 15 tablet, oral 15mg;250mg Merck Sharp and Dohme *Aldoril 25 tablet, oral 25mg;250mg Merck Sharp and Dohme *Aldoril D30 tablet, oral 30mg;500mg Merck Sharp and Dohme *Aldoril D50 tablet, oral 50mg;500mg Merck Sharp and Dohme *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

HYDROCHLOROTHIAZIDE; PROPRANOLOL HYDROCHLORIDEHydrochlorothiazide; tablet, oral 25mg;40mg Barr Propranolol Hydrochloride tablet, oral 25mg;80mg Barr

@ tablet, oral 25mg;40mg Danbury@ tablet, oral 25mg;80mg Danbury@ tablet, oral 25mg;40mg Duramed@ tablet, oral 25mg;80mg Duramed

tablet, oral 25mg;40mg Genevatablet, oral 25mg;80mg Geneva

@ tablet, oral 25mg;40mg IVAX@ tablet, oral 25mg;80mg IVAX

tablet, oral 25mg;40mg Mylantablet, oral 25mg;80mg Mylantablet, oral 25mg;40mg Purepactablet, oral 25mg;80mg Purepactablet, oral 25mg;40mg Sidmaktablet, oral 25mg;80mg Sidmak

@ tablet, oral 25mg;40mg Warner Chilcott@ tablet, oral 25mg;80mg Warner Chilcott

tablet, oral 25mg;40mg Watsontablet, oral 25mg;80mg Watson

Brand(s)Inderide 40/25 tablet, oral 25mg;40mg Wyeth-AyerstInderide 80/25 tablet, oral 25mg;80mg Wyeth-Ayerst

HYDROCHLOROTHIAZIDE; SPIRONOLACTONEHydrochlorothiazide; @ tablet, oral 25mg;25mg (Ascot) Spironolactone tablet, oral 25mg;25mg Barr

@ tablet, oral 25mg;25mg Circatablet, oral 25mg;25mg Danburytablet, oral 25mg;25mg Geneva

@ tablet, oral 25mg;25mg IVAX@ tablet, oral 25mg;25mg Lederle

tablet, oral 25mg;25mg Mutualtablet, oral 25mg;25mg Mylantablet, oral 25mg;25mg Parke-Davis

(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

112

HYDROCHLOROTHIAZIDE; SPIRONOLACTONE (continued)@ tablet, oral 25mg;25mg Purepac@ tablet, oral 25mg;25mg Superpharm@ tablet, oral 25mg;25mg Upsher-Smith@ tablet, oral 25mg;25mg USL@ tablet, oral 25mg;25mg (Vangard/MWM)@ tablet, oral 25mg;25mg Watson

Brand(s)Aldactazide tablet, oral 25mg;25mg Searle

HYDROCHLOROTHIAZIDE; TRIAMTERENEHydrochlorothiazide; Triamterene capsule, oral 25mg;37.5mg Barr

capsule, oral 25mg;37.5mg Duramedcapsule, oral 25mg;37.5mg Genevacapsule, oral 25mg;50mg IVAXcapsule, oral 25mg;37.5mg Mylancapsule, oral 25mg;37.5mg Novartiscapsule, oral 25mg;50mg Genevacapsule, oral 25mg;37.5mg Novartis

@ tablet, oral 50mg;75mg American Therapeuticstablet, oral 25mg;37.5mg Barrtablet, oral 50mg;75mg Barrtablet, oral 50mg;75mg Danburytablet, oral 25mg;37.5mg Genevatablet, oral 50mg;75mg Geneva

@ tablet, oral 50mg;75mg Quantumtablet, oral 25mg;37.5mg Sidmaktablet, oral 50mg;75mg Sidmaktablet, oral 37.5mg;25mg Watsontablet, oral 50mg;75mg Watson

Brand(s)Dyazide @ capsule, oral 25mg;50mg SmithKline Beecham *Dyazide capsule, oral 25mg;37.5mg SmithKline Beecham *Maxzide-25 tablet, oral 25mg;37.5mg Mylan *Maxzide tablet, oral 50mg;75mg Mylan *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

HYDROCODONE BITARTRATE; ACETAMINOPHENSee ACETAMINOPHEN; HYDROCODONE BITARTRATE

HYDROCODONE BITARTRATE; GUAIFENESIN; PSEUDOEPHEDRINE HYDROCHLORIDESee GUAIFENESIN; HYDROCODONE BITARTRATE; PSEUDOEPHEDRINE HYDROCHLORIDE

HYDROCODONE BITARTRATE; HOMATROPINE METHYLBROMIDESee HOMATROPINE METHYLBROMIDE; HYDROCODONE BITARTRATE

HYDROCODONE BITARTRATE; PHENYLPROPANOLAMINE HYDROCHLORIDEHydrocodone Bitartrate; syrup, oral 2.5mg/5ml;12.5mg/5ml Halsey Phenylpropanolamine syrup, oral 5mg/5ml;12.5mg/5ml Halsey Hydrochloride syrup, oral 5mg/5ml;25mg/5ml Morton Grove

(continued on the next page)HYDROCODONE BITARTRATE; PHENYLPROPANOLAMINE HYDROCHLORIDE (continued)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

113

Brand(s)Hycophen Pediatric Syrup syrup, oral 2.5mg/5ml;12.5mg/5ml CenciHycomine Pediatric Syrup syrup, oral 2.5mg/5ml;12.5mg/5ml EndoCodamine Syrup syrup, oral 5mg/5ml;25mg/5ml AlpharmaHycophen Syrup syrup, oral 5mg/5ml;25mg/5ml CenciHycomine Syrup syrup, oral 5mg/5ml;25mg/5ml EndoPropachem Syrup syrup, oral 5mg/5ml;25mg/5ml Norton

* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as anexception to the promulgated criteria for inclusion, pursuant to Rule 790.60.

HYDROCODONE BITARTRATE; PSEUDOEPHEDRINE HYDROCHLORIDEHydrocodone Bitartrate; liquid, oral 5mg/5ml;60mg/5ml Cenci Pseudoephedrine Hydrochloride liquid, oral 5mg/5ml;60mg/5ml Morton Grove

Brand(s)Detussin liquid, oral 5mg/5ml;60mg/5ml AlpharmaHydrophed liquid, oral 5mg/5ml;60mg/5ml NortonTussend liquid, oral 5mg/5ml;60mg/5ml Aventis

* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as anexception to the promulgated criteria for inclusion, pursuant to Rule 790.60.

HYDROCORTISONEHydrocortisone cream, topical 2.5% Alpharma

cream, topical 0.5,1% Altana@ cream, topical 1,2.5% Ambix/Organics@ cream, topical 0.5,1% Clay-Park

cream, topical 2.5% Clay-Park@ cream, topical 0.5% Everylife

cream, topical 1% Everylifecream, topical 1,2.5% Fougera/Altana

@ cream, topical 1% G & Wcream, topical 0.5,1% Ingramcream, topical 1% NMC

@ cream, topical 1% Naska@ cream, topical 1% Pharmaderm/Altana

cream, topical 2.5% Pharmaderm/Altana@ cream, topical 1% Pharmafair@ cream, topical 1% Stiefel@ cream, topical 0.5,1,2.5% Teva@ cream, topical 0.5% Thames

cream, topical 1,2.5% Thames@ cream, topical 1% Topiderm@ cream, topical 1,2.5% USL@ cream, topical 1% Whiteworth Towne

enema, rectal 100mg/60ml Copley@ lotion, topical 0.5,1% Alpharma

lotion, topical 2.5% Altana@ lotion, topical 0.5,1% Clay-Park@ lotion, topical 0.5,1% Mericon@ lotion, topical 1% Naska@ lotion, topical 1% Thames

lotion, topical 2.5% Thames@ ointment, topical 0.5% Altana

ointment, topical 1% Altana@ ointment, topical 1,2.5% Ambix/Organics@ ointment, topical 0.5,1% Clay-Park

(continued on the next page)HYDROCORTISONE (continued)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

114

ointment, topical 2.5% Clay-Parkointment, topical 2.5% Fougera/Altana

@ ointment, topical 1% Naska@ ointment, topical 1% Pharmaderm/Altana@ ointment, topical 0.5% Thames

ointment, topical 1,2.5% Thames@ ointment, topical 1,2.5% USL

powder for compounding 100% Paddockpowder for compounding 100% Pharma Tek

Brand(s)Ala-Cort cream, topical 1% Del RayAnusol HC cream, topical 2.5% ParkdaleCort-Dome @ cream, topical 0.5,1% BayerDermacort cream, topical 1% MonarchDermatol HC cream, topical 1% ThamesEldecort @ cream, topical 1,2.5% ICNFlexicort @ cream, topical 0.5,1,2.5% Westwood SquibbH Cort @ cream, topical 0.5% Pharmaceutical AssociatesHC @ cream, topical 0.5,1% C & MHC #1 @ cream, topical 0.5% BayerHC #4 @ cream, topical 1% BayerHiCor cream, topical 2.5% C & MHydrotex cream, topical 0.5% SyosettHymac cream, topical 1% NMCHytone cream, topical 1,2.5% Dermik/RorerNogenic HC @ cream, topical 1% IVAXNutracort @ cream, topical 0.5,1% HealthpointPenecort cream, topical 1% Allergan HerbertProctocort @ cream, topical 1% MonarchSynacort @ cream, topical 0.5% MedicisSynacort cream, topical 1,2.5% MedicisColocort enema, rectal 100mg/60ml PaddockCortenema enema, rectal 100mg/60ml SolvayNutracort @ gel, topical 1% Owen/GaldermaPenecort gel, topical 1% Allergan HerbertActicort @ lotion, topical 1% Baker NortonAla-Cort lotion, topical 1% Del RayBalneol-HC @ lotion, topical 1% SolvayBeta-HC @ lotion, topical 1% Beta DermacCetacort lotion, topical 0.5,1% Owen/GaldermaCort-Dome @ lotion, topical 0.5,1% BayerDelacort lotion, topical 1% MericonDermacort @ lotion, topical 0.5,1% SolvayEpicort lotion, topical 0.5% BlulineGlycort @ lotion, topical 1.0% HeranH Cort @ lotion, topical 0.5% Pharmaceutical AssociatesHytone lotion, topical 1,2.5% Dermik/RorerNutracort @ lotion, topical 0.5% HealthpointNutracort lotion, topical 1,2/5% HealthpointStie-Cort lotion, topical 1,2.5% StiefelCortril ointment, topical 1,2.5% Pfipharmecs/PfizerHC @ ointment, topical 0.5,1% C & MHydrocortisone in Absorbase ointment, topical 1% Carolina MedicalHymac ointment, topical 1% NMCHytone @ ointment, topical 1,2.5% Dermik/RorerPenecort @ ointment, topical 2.5% Allergan HerbertPenecort solution, topical 1% Allergan HerbertTexacort solution, topical 1% SiriusH-Cort @ powder for compounding 100% Torch

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

115

HYDROCORTISONE; ACETIC ACID, GLACIALSee ACETIC ACID, GLACIAL; HYDROCORTISONE

HYDROCORTISONE; BACITRACIN ZINC; NEOMYCIN SULFATE; POLYMYXIN B SULFATESee BACITRACIN ZINC; HYDROCORTISONE; NEOMYCIN SULFATE; POLYMYXIN B SULFATE

HYDROCORTISONE; NEOMYCIN SULFATE; POLYMYXIN B SULFATEHydrocortisone; solution, otic 1%; eq 3.5mg base/ml; Bausch and Lomb Neomycin Sulfate; 10,000U/ml Polymyxin B Sulfate @ suspension, ophthalmic 1%; Alcon Universal

eq 3.5mg base/ml; 10,000U/mlBrand(s)

Cortisporin solution, otic 1%; eq 3.5mg base/ml; Monarch * 10,000U/ml

Neo-Otosol-HC @ solution, otic 1%; eq 3.5mg base/ml; Alcon 10,000U/ml

Oticair @ solution, otic 1%; eq 3.5mg base/ml; Pharmafair 10,000U/ml

Otocort @ solution, otic 1%; eq 3.5mg base/ml; Steris 10,000U/ml

Cortisporin suspension, ophthalmic 1%; Monarch * eq 3.5mg base/ml; 10,000U/ml

Ocutricin HC @ suspension, ophthalmic 1%; Pharmafair eq 3.5mg base/ml; 10,000U/ml

Cortisporin @ suspension, otic 1%; Monarch eq 3.5mg base/ml; 10,000U/ml

Oticair suspension, otic 1%; Bausch and Lomb eq 3.5mg base/ml; 10,000U/ml

Otobione @ suspension, otic 1%; Schering eq 3.5mg base/ml; 10,000U/ml

Otocort @ suspension, otic 1%; Alcon Universal eq 3.5mg base/ml; 10,000U/ml

Pediotic Cortisporin suspension, otic 1%; Monarch eq 3.5mg base/ml; 10,000U/ml

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

HYDROCORTISONE; POLYMYXIN B SULFATEBrand(s)

Otobiotic solution, otic 5mg/ml; Schering eq 10,000U base/ml

Pyocidin @ solution, otic 5mg/ml; Forest eq 10,000U base/ml

HYDROCORTISONE; UREABrand(s)

Alphaderm @ cream, topical 1%; 10% BioglanCalmurid HC @ cream, topical 1%; 10% Pharmacia & Upjohn

HYDROCORTISONE ACETATEHydrocortisone Acetate @ cream, topical 1% Cenci

@ cream, topical 1% Parke Davis@ cream, topical 1% Purepac

(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

116

HYDROCORTISONE ACETATE (continued)Brand(s)

Hemsol-HC cream, topical 1% AbleMicort-HC @ cream, topical 2.5% Ferndale

HYDROCORTISONE ACETATE; BACITRACIN; NEOMYCIN SULFATE; POLYMYXIN B SULFATESee BACITRACIN; HYDROCORTISONE ACETATE; NEOMYCIN SULFATE; POLYMYXIN B SULFATE

HYDROCORTISONE ACETATE; NEOMYCIN SULFATEBrand(s)

Cor-Oticin @ suspension , ophthalmic 1.5%; Akorn eq. 3.5mg base/ml

Neo-Cortef @ suspension, ophthalmic 1.5%; Pharmacia & Upjohn eq. 3.5mg base/ml

HYDROCORTISONE ACETATE; UREABrand(s)

Carmol HC cream, topical 1%;10% KenwoodU-Cort cream, topical 1%;10% Thames

HYDROCORTISONE SODIUM PHOSPHATEHydrocortisone Sodium @ injection eq 50mg base/ml Quad Phosphate

Brand(s)Hydrocortone injection eq 50mg base/ml Merck Sharp and Dohme

HYDROCORTISONE SODIUM SUCCINATEHydrocortisone Sodium @ injection eq 100,250,500mg, American Pharmaceutical Succinate 1gm base/vial Partners

@ injection eq 100,250,500mg, Elkins-Sinn 1gm base/vialinjection eq 100mg base/vial International Medication

@ injection eq 100,250,500mg, Steris 1gm base/vial

Brand(s)A-Hydrocort injection eq 100,250,500mg, Abbott

1gm base/vialSolu-Cortef injection eq 100,250,500mg, Pharmacia & Upjohn

1gm base/vial

HYDROCORTISONE VALERATEHydrocortisone Valerate cream, topical 0.2% Clay-Park

cream, topical 0.2% Copleycream, topical 0.2% Taroointment, topical 0.2% Taro

Brand(s)Westcort cream, topical 0.2% Westwood Squibb *Westcort ointment, topical 0.2% Westwood Squibb *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

117

HYDROFLUMETHIAZIDEHydroflumethiazide @ tablet, oral 50mg Circa

tablet, oral 50mg Par@ tablet, oral 50mg Watson

Brand(s)Diucardin tablet, oral 50mg Wyeth-AyerstSaluron tablet, oral 50mg Shire

HYDROMORPHONE HYDROCHLORIDEHydromorphone Hydrochloride injection 1,2,4,10mg/ml Abbott

injection 2mg/ml Astra Zenecainjection 2mg/ml Elkins-Sinninjection 2mg/ml Scheininjection 2,10mg/ml Sterisinjection 1,2,4mg/ml Wyeth-Ayerstsolution, oral 5mg/5ml Roxanetablet, oral 8mg Roxane

Brand(s)Dilaudid Hydrochloride injection 1,2,4mg/ml AbbottDilaudid-HP injection 10mg/ml AbbottDilaudid solution, oral 5mg/5ml AbbottDilaudid tablet, oral 8mg Abbott

* Strengths of injections other than 10mg/ml in this entity were reviewed by the Technical Advisory Counciland admitted to the Illinois Formulary as an exception to the promulgated criteria for inclusion, pursuant toRule 790.60.

HYDROXOCOBALAMINHydroxocobalamin @ injection 1000mcg/ml American Pharmaceutical

Partnersinjection 1000mcg/ml Steris

Brand(s)Alpha Redisol @ injection 1000mcg/ml Merck Sharp and DohmeHydroxomin @ injection 1000mcg/ml Bel-Mar

HYDROXYCHLOROQUINE SULFATEHydroxychloroquine Sulfate tablet, oral 200mg Copley

tablet, oral 200mg Genevatablet, oral 200mg Mylantablet, oral 200mg Royce

Brand(s)Plaquenil tablet, oral 200mg Sanofi *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

HYDROXYPROGESTERONE CAPROATEHydroxyprogesterone Caproate @ injection 125mg/ml Akorn

@ injection 125,250mg/ml QuadBrand(s)

Delalutin @ injection 125,250mg/ml SquibbDura-Lutin @ injection 125mg/ml SterisDura-Lutin injection 250mg/ml Steris

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

118

HYDROXYUREAHydroxyurea capsule, oral 500mg Barr

capsule, oral 500mg Duramedcapsule, oral 500mg Parcapsule, oral 500mg Roxane

Brand(s)Hydrea capsule, oral 500mg Bristol-Myers Squibb

HYDROXYZINE HYDROCHLORIDEHydroxyzine Hydrochloride injection 25,50mg/ml Abbott

@ injection 25,50mg/ml Altanainjection 25,50mg/ml American Pharmaceutical

Partnersinjection 25,50mg/ml Elkins-Sinninjection 25,50mg/ml Luitpold

@ injection 25,50mg/ml Pharmafair@ injection 25mg/ml Smith and Nephew@ injection 25,50mg/ml Solopak@ injection 25mg/ml Steris

injection 50mg/ml Steris@ injection 25,50mg/ml Wyeth-Ayerst

syrup, oral 10mg/5ml Alpharmasyrup, oral 10mg/5ml Hi-Tech

@ syrup, oral 10mg/5ml KVsyrup, oral 10mg/5ml Morton Grove

@ tablet, oral 10,25,50mg Amide@ tablet, oral 10,25,50,100mg Barr

tablet, oral 10,25,50mg Danbury@ tablet, oral 10,25,50mg Eon

tablet, oral 10,25,50mg Geneva@ tablet, oral 10,25,50mg Halsey@ tablet, oral 10,25,50mg IVAX@ tablet, oral 10,25,50,100mg KV

tablet, oral 10,25,50mg Mutual@ tablet, oral 10,25,50mg Par@ tablet, oral 10,25,50mg Purepac@ tablet, oral 10,25,50mg Quantum

tablet, oral 10,25,50mg Roycetablet, oral 10,25,50mg Sidmak

@ tablet, oral 10,25,50mg Superpharm@ tablet, oral 10,25,50mg USL@ tablet, oral 10,25,50mg Watson

Brand(s)Orgatrax @ injection 25,50mg/ml Organon/AkzonaVistaril injection 25,50mg/ml Roerig/PfizerAtarax syrup, oral 10mg/5ml Roerig/PfizerAtarax tablet, oral 10,25,50,100mg Roerig/Pfizer

HYDROXYZINE HYDROCHLORIDE; EPHEDRINE; THEOPHYLLINESee EPHEDRINE; HYDROXYZINE HYDROCHLORIDE; THEOPHYLLINE

HYDROXYZINE PAMOATEHydroxyzine Pamoate capsule, oral eq 25,50,100mg HCl Barr

@ capsule, oral eq 25,50,100mg HCl Circacapsule, oral eq 25,50,100mg HCl Danbury

@ capsule, oral eq 25,50,100mg HCl Duramedcapsule, oral eq 25,50mg HCl Eon

(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

119

HYDROXYZINE PAMOATE (continued)capsule, oral eq 25mg HCl Geneva

@ capsule, oral eq 50,100mg HCl Genevacapsule, oral eq 25,50mg HCl IVAX

@ capsule, oral eq 25,50,100mg HCl Par@ capsule, oral eq 25,50,100mg HCl Superpharm@ capsule, oral eq 25,50mg HCl (Vangard/MWM)

capsule, oral eq 25,50mg HCl Watson@ capsule, oral eq 100mg HCl Watson

Brand(s)Vistaril capsule, oral eq 25,50,100mg HCl Pfizer

HYOSCYAMINE; ATROPINE SULFATE; PHENOBARBITAL; SCOPALAMINE HYDROBROMIDESee ATROPINE SULFATE; HYOSCYAMINE; PHENOBARBITAL; SCOPALAMINE HYDROBROMIDE

IBUPROFENIbuprofen suspension, oral 100mg/5ml Alpharma

@ tablet, oral 400,600,800mg Barrtablet, oral 400,600,800mg Danburytablet, oral 300,400,600,800mg Geneva

@ tablet, oral 300,400,600,800mg Halseytablet, oral 400,600,800mg Interpharmtablet, oral 400,600,800mg Invamedtablet, oral 400,600,800mg IVAX

@ tablet, oral 400,600mg Lederle@ tablet, oral 400,600mg McNeil Consumer

tablet, oral 300,400,600,800mg Mutualtablet, oral 400,600,800mg Mylan

@ tablet, oral 300mg Partablet, oral 400,600,800mg Partablet, oral 300,400,600,800mg Private Formulations

@ tablet, oral 300,400,600,800mg Purepactablet, oral 400,600,800mg Sidmak

@ tablet, oral 600mg Superpharm@ tablet, oral 400,600,800mg Teva

tablet, oral 400mg Vintage@ tablet, oral 300,400,600,800mg Watson

Brand(s)Motrin suspension, oral 100mg/5ml McNeil ConsumerIbu tablet, oral 400,600,800mg BASFIbu-Tab tablet, oral 400,600mg AlraIbu-Tab @ tablet, oral 800mg AlraIbuprohm tablet, oral 400mg OhmMotrin tablet, oral 300,400,600,800mg McNeil *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

IDOXURIDINEBrand(s)

Dendrid solution, ophthalmic 0.1% AlconHerplex Liquifilm solution, ophthalmic 0.1% AllerganStoxil @ solution, ophthalmic 0.1% SmithKline Beecham

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

120

IMIPRAMINE HYDROCHLORIDEImipramine Hydrochloride @ tablet, oral 10,25,50mg Circa

@ tablet, oral 10,25,50mg Eontablet, oral 10,25,50mg Geneva

@ tablet, oral 10,25,50mg Lederletablet, oral 10,25,50mg Mutualtablet, oral 10,25,50mg Partablet, oral 10,25,50mg Roxanetablet, oral 10,25,50mg Teva

@ tablet, oral 25mg USL@ tablet, oral 10,25,50mg (Vangard/MWM)@ tablet, oral 10,25,50mg Watson@ tablet, oral 25,50mg West-ward

Brand(s)Janimine @ tablet, oral 10,25,50mg AbbottPresamine @ tablet, oral 10,25,50mg AventisTofranil tablet, oral 10,25,50mg Tyco

INAMRINONE LACTATEInamrinone Lactate injection eq 5mg base/ml Abbott

injection eq 5mg base/ml Baxterinjection eq 5mg base/ml Bedford

Brand(s)Inocor injection eq 5mg base/ml Sanofi Synthelabo

INDAPAMIDEIndapamide tablet, oral 2.5mg Akorn

tablet, oral 1.25,2.5mg Alphapharmtablet, oral 1.25,2.5mg Genevatablet, oral 1.25,2.5mg IVAXtablet, oral 1.25,2.5mg Mylantablet, oral 1.25,2.5mg Purepactablet, oral 1.25,2.5mg Tevatablet, oral 1.25,2.5mg Trigentablet, oral 1.25,2.5mg Watson

Brand(s)Lozol tablet, oral 1.25,2.5mg Aventis *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

INDOMETHACINIndomethacin @ capsule, oral 25,50mg Barr

@ capsule, oral 25,50mg Circa@ capsule, oral 25,50mg Danbury@ capsule, oral 25,50mg Duramed

capsule, oral 25,50mg Geneva@ capsule, oral 25,50mg Halsey

capsule, oral 25,50mg IVAXcapsule, oral 25,50mg Lederlecapsule, oral 25,50mg Mutualcapsule, oral 25,50mg Mylancapsule, oral 25,50mg Par

@ capsule, oral 25,50mg Parke-Davis@ capsule, oral 25,50mg Pioneer@ capsule, oral 25,50mg Roxane

capsule, oral 25,50mg Sidmak(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

121

INDOMETHACIN (continued)@ capsule, oral 25,50mg Superpharm

capsule, oral 25,50mg Teva@ capsule, oral 25,50mg Watson

capsule, extended release 75mg Able capsule, extended release 75mg Eoncapsule, extended release 75mg Forest/Inwoodsuppository, rectal 50mg G & Wsuspension, oral 25mg/5ml Roxane

Brand(s)Indo-Lemmon capsule, oral 25,50mg TevaIndocin capsule, oral 25,50mg Merck Sharp and Dohme *Indocin-SR @ capsule, extended release 75mg Merck Sharp and Dohme *Indocin suppository, rectal 50mg G & WIndocin suspension, oral 25mg/5ml Merck Sharp and Dohme

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

IODINATED GLYCEROLIodinated Glycerol @ liquid, oral 60mg/5ml Alpharma

(30mg organically bound iodine)@ liquid, oral 60mg/5ml Halsey

(30mg organically bound iodine)@ liquid, oral 60mg/5ml Morton Grove

(30mg organically bound iodine)@ solution, oral 50mg/ml Alpharma

(25mg organically bound iodine)Brand(s)

Iogan Elixir @ liquid, oral 60mg/5ml Hi-Tech (30mg organically bound iodine)

Iophen Elixir @ liquid, oral 60mg/5ml Naska (30mg organically bound iodine)

Iotuss Elixir @ liquid, oral 60mg/5ml Cenci (30mg organically bound iodine)

Oridol Elixir @ liquid, oral 60mg/5ml Norton (30mg organically bound iodine)

Organidin Elixir @ liquid, oral 60mg/5ml Wallace (30mg organically bound iodine)

Sil-O-Tuss Elixir @ liquid, oral 60mg/5ml Silarx (30mg organically bound iodine)

Iogan Solution @ solution, oral 50mg/ml Hi-Tech (25mg organically bound iodine)

Iotuss Solution @ solution, oral 50mg/ml Cenci (25mg organically bound iodine)

Organidin Drops @ solution, oral 50mg/ml Wallace (25mg organically bound iodine)

Oridol Solution @ solution, oral 50mg/ml Norton (25mg organically bound iodine)

* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as anexception to the promulgated criteria for inclusion, pursuant to Rule 790.60.

IODINATED GLYCEROL; CODEINE PHOSPHATESee CODEINE PHOSPHATE; IODINATED GLYCEROL

IODINATED GLYCEROL; DEXTROMETHORPHAN HYDROBROMIDESee DEXTROMETHORPHAN HYDROBROMIDE; IODINATED GLYCEROL

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

122

IOPAMIDOLIopamidol injection 41,51,61,76% Elkins-Sinn

injection 61,76% FauldingBrand(s)

Iopamidol-200 injection 41% AbbottIopamidol-250 injection 51% AbbottIopamidol-300 injection 61% AbbottIopamidol-370 injection 76% AbbottIopamidol-250 injection 51% American Pharmaceutical

PartnersIopamidol-300 injection 61% American Pharmaceutical

PartnersIopamidol-370 injection 76% American Pharmaceutical

PartnersIopamidol-200 injection 41% Cook ImagingIopamidol-250 injection 51% Cook ImagingIopamidol-300 injection 61% Cook ImagingIopamidol-370 injection 76% Cook ImagingIsovue-200 injection 41% BraccoIsovue-250 injection 51% BraccoIsovue-300 injection 61% BraccoIsovue-370 injection 76% Bracco

IPRATROPIUM BROMIDEIpratropium Bromide solution for inhalation 0.2% Alpharma

solution for inhalation 0.2% Aslungsolution for inhalation 0.2% Deysolution for inhalation 0.2% Novexsolution for inhalation 0.2% Steripak

Brand(s)Atrovent solution for inhalation 0.2% Boehringer Ingelheim *Atrovent 0.03% spray, metered; nasal 0.021mg/spray Boehringer Ingelheim *Atrovent 0.06% spray, metered; nasal 0.042mg/spray Boehringer Ingelheim *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

IRON; ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; NICOTINIC ACID; PYRIDOXINEHYDROCHLORIDE; RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D; VITAMIN E

See ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; IRON; NICOTINIC ACID; PYRIDOXINEHYDROCHLORIDE; RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D;VITAMIN E

IRON; ASCORBIC ACID; FLUORIDE; VITAMIN A; VITAMIN DSee ASCORBIC ACID; FLUORIDE; IRON; VITAMIN A; VITAMIN D

ISOETHARINE HYDROCHLORIDEIsoetharine Hydrochloride @ solution for inhalation 1% Alpharma

@ solution for inhalation 0.125,0.167,0.2, Astra Zeneca 0.25%

@ solution for inhalation 0.08,0.25% Baxter@ solution for inhalation 0.08,0.1,0.17, Dey

0.25%solution for inhalation 1% Dey

@ solution for inhalation 0.08, 0.1,0.167, International Medication 0.2,0.25,1%

(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

123

ISOETHARINE HYDROCHLORIDE (continued)@ solution for inhalation 1% Parke-Davis@ solution for inhalation 0.1,0.125,0.167, Roxane

0.2,0.25%solution for inhalation 1% Roxane

Brand(s)Beta-2 solution for inhalation 1% NephronBronkosol @ solution for inhalation 0.25,1% Sanofi Synthelabo

ISOFLURANEIsoflurane liquid for inhalation 99.9% Abbott

liquid for inhalation 99.9% Halocarbonliquid for inhalation 99.9% Minradliquid for inhalation 99.9% Marsamliquid for inhalation 99.9% Rhodia

Brand(s)Forane liquid for inhalation 99.9% Baxter

ISONIAZIDIsoniazid @ injection 100mg/ml Quad

syrup, oral 50mg/5ml Carolina Medical@ syrup, oral 50mg/5ml Mikart@ tablet, oral 100mg Anabolic

tablet, oral 100,300mg Barr@ tablet, oral 100,300mg Circa@ tablet, oral 50,100mg Danbury

tablet, oral 300mg Danbury@ tablet, oral 300mg Dow@ tablet, oral 100mg Duramed

tablet, oral 300mg Duramedtablet, oral 100,300mg Eon

@ tablet, oral 50,100mg Halseytablet, oral 300mg Halsey

@ tablet, oral 100mg Impax@ tablet, oral 100,300mg IVAX@ tablet, oral 100,300mg Lilly@ tablet, oral 100mg MK

tablet, oral 100,300mg Mikart@ tablet, oral 300mg Novartis@ tablet, oral 50,100,300mg Panray/Ormont@ tablet, oral 100mg Perrigo@ tablet, oral 100mg Pharmavite@ tablet, oral 50,100mg Phoenix@ tablet, oral 50,100mg Purepac@ tablet, oral 100,300mg Watson

tablet, oral 100,300mg West-ward@ tablet, oral 100mg Whiteworth Towne

Brand(s)Nydrazid injection 100mg/ml ApotheconRimifon @ injection 100mg/ml RocheLaniazid @ syrup, oral 50mg/5ml LannettRimifon @ syrup, oral 50mg/5ml RocheHyzyd @ tablet, oral 100,300mg WallaceLaniazid tablet, oral 50,100,300mg LannettNydrazid @ tablet, oral 100mg SquibbStanozide @ tablet, oral 100,300mg Everylife

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

124

ISOPROTERENOL HYDROCHLORIDEIsoproterenol Hydrochloride @ injection 0.2mg/ml American Pharmaceutical

Partnersinjection 0.2mg/ml Elkins-Sinninjection 0.2mg/ml International Medication

@ solution for inhalation 0.5% Dey@ solution for inhalation 0.25,0.5% Parke-Davis

Brand(s)Isuprel injection 0.2mg/ml AbbottAerolone @ solution for inhalation 0.25% LillyIsuprel @ solution for inhalation 0.5% Sanofi SynthelaboVapo-ISO @ solution for inhalation 0.5% Fisons

ISOSORBIDE DINITRATEIsosorbide Dinitrate @ tablet, oral 5,10,20,30mg Barr

tablet, oral 5,10mg Danburytablet, oral 5,10,20mg Genevatablet, oral 5,10,20,30mg Par

@ tablet, oral 5,10,20mg Superpharmtablet, oral 5,10,20mg West-wardtablet, extended release 40mg Inwood

@ tablet, sublingual 2.5,5,10mg Barrtablet, sublingual 2.5,5mg Danburytablet, sublingual 2.5,5mg Genevatablet, sublingual 2.5,5mg West-ward

Brand(s)Isordil tablet, oral 5,10,20,30,40mg Wyeth-AyerstSorbitrate tablet, oral 20,40mg ZenecaSorbitrate @ tablet, oral 30mg ZenecaIsordil Tembid @ tablet, extended release 40mg Wyeth-AyerstIsordil tablet, sublingual 2.5,5,10mg Wyeth-Ayerst

ISOSORBIDE MONONITRATEIsosorbide Mononitrate tablet, oral 10,20mg Purepac

tablet, oral 20mg Tevatablet, oral 20mg West-wardtablet, extended release 60mg Brightstonetablet, extended release 60mg Dexceltablet, extended release 60mg Elantablet, extended release 30,60,120mg IVAXtablet, extended release 30,120mg Kremers-Urbantablet, extended release 30,60,120mg KVtablet, extended release 30,60mg Purepac

Brand(s)ISMO tablet, oral 10,20mg RobinsMonoket tablet, oral 10,20mg Schwarz *Imdur tablet, extended release 30,60,120mg Schering *

* Products manufactured by this brand name drug manufacturer in this drug entity are available for drugproduct selection under other brand and/or generic names.

KANAMYCIN SULFATEKanamycin Sulfate @ injection eq 75,500mg base/2ml, American Pharmaceutical

1gm base/3ml Partners@ injection eq 75,500mg base/2ml, Elkins-Sinn 1gm base/3ml

(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

125

KANAMYCIN SULFATE (continued)@ injection eq 500mg base/2ml, International Medication 1gm base/3ml@ injection eq 75,500mg base/2ml, Loch

1gm base/3ml@ injection eq 75,500mg base/2ml, Pharmafair

1gm base/3ml@ injection eq 75,500mg base/2ml, Quad

1gm base/3ml@ injection eq 75,500mg base/2ml, Solopak

1gm base/3ml@ injection eq 1gm base/3ml Steris@ injection eq 1gm base/3ml Warner Chilcott

Brand(s)Kantrex injection eq 75,500mg base/2ml, Apothecon

1gm base/3mlKlebcil @ injection eq 75,500mg base/2ml, King

1gm base/3ml

KETAMINE HYDROCHLORIDEKetamine Hydrochloride injection eq 50,100mg base/ml Abbott

injection eq 50,100mg base/ml Bedford@ injection eq 10,50,100mg base/ml Quad

Brand(s)Ketalar injection eq 10,50,100mg base/ml Parkedale

KETOCONAZOLEKetoconazole cream, topical 2% Teva

tablet, oral 200mg Aesgentablet, oral 200mg Applied Analytical Industriestablet, oral 200mg Mutualtablet, oral 200mg Mylantablet, oral 200mg Sidmaktablet, oral 200mg Tarotablet, oral 200mg Tevatablet, oral 200mg TorPharm

Brand(s)Nizoral cream, topical 2% JanssenNizoral tablet, oral 200mg Janssen

KETOPROFENKetoprofen capsule, extended release Andrx

100,150,200mgcapsule, extended release 200mg Elancapsule, extended release Mylan 100,150,200mgcapsule, oral 50,75mg Genevacapsule, oral 25,50,75mg Lederlecapsule, oral 50,75mg Mylancapsule, oral 25,50,75mg Teva

Brand(s)Orudis capsule, oral 25,50,75mg Wyeth-AyerstOruvail capsule, extended release Wyeth-Ayerst

100,150,200mg

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

126

KETOROLAC TROMETHAMINEKetorolac Tromethamine injection 15,30mg/ml Abbott

injection 30mg/ml Apotex@ injection 15,30mg/ml Apothecon

injection 15,30mg/ml Baxterinjection 15,30mg/ml Bedfordtablet, oral 10mg Mylan

@ tablet, oral 10mg Roxanetablet, oral 10mg Sidmaktablet, oral 10mg Tevatablet, oral 10mg Watson

Brand(s)Ketorolac preservative-free injection 15,30mg/ml ApotexToradol injection 15,30mg SyntexToradol tablet, oral 10mg Syntex *

* Products manufactured by this brand name drug manufacturer in this drug entity are available for drugproduct selection under other brand and/or generic names.

LABETALOL HYDROCHLORIDELabetalol Hydrochloride injection 5mg/ml Abbott

@ injection 5mg/ml Apotheconinjection 5mg/ml Bedfordinjection 5mg/ml Fauldinginjection 5mg/ml Taylortablet, oral 100,200,300mg Apothecontablet, oral 100,200,300mg Eontablet, oral 100,200,300mg IVAXtablet, oral 100,200,300mg Mutualtablet, oral 100,200,300mg Tevatablet, oral 100,200,300mg Watson

Brand(s)Normodyne injection 5mg/ml ScheringTrandate injection 5mg/ml PrometheusNormodyne tablet, oral 100,200,300mg Schering *Trandate tablet, oral 100,200,300mg Faro

* Products manufactured by this brand name drug manufacturer in this drug entity are available for drugproduct selection under other brand and/or generic names.

LABETALOL HYDROCHLORIDE; HYDROCHLOROTHIAZIDESee HYDROCHLOROTHIAZIDE; LABETALOL HYDROCHLORIDE

LACTULOSELactulose solution, oral 10gm/15ml Hi-Tech

solution, oral 10gm/15ml Inalcosolution, oral 10gm/15ml Morton Grovesolution, oral 10gm/15ml Novex

@ solution, oral 10gm/15ml Pacosolution, oral 10gm/15ml Pharmaceutical Associatessolution, oral 10gm/15ml Roxanesolution, oral 10gm/15ml UDLsolution, oral-rectal 10gm/15ml Hi-Tech

@ solution, oral-rectal 10gm/15ml Pacosolution, oral-rectal 10gm/15ml Roxane

(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

127

LACTULOSE (continued)Brand(s)

Chronulac solution, oral 10gm/15ml AventisConstilac solution, oral 10gm/15ml AlraConstulose solution, oral 10gm/15ml AlpharmaDuphalac @ solution, oral 10gm/15ml SolvayEvalose solution, oral 10gm/15ml CopleyLaxilose solution, oral 10gm/15ml TechnilabAcilac solution, oral-rectal 10gm/15ml TechnilabCephulac solution, oral-rectal 10gm/15ml AventisCholac solution, oral-rectal 10gm/15ml AlraEnulose solution, oral-rectal 10gm/15ml AlpharmaGenerlac solution, oral-rectal 10gm/15ml Morton GroveHeptalac solution, oral-rectal 10gm/15ml CopleyPortalac @ solution, oral-rectal 10gm/15ml Solvay

LEUCOVORIN CALCIUMLeucovorin Calcium @ injection eq 3mg base/ml ABIC

@ injection eq 3mg base/ml Immunex@ injection eq 5mg base/ml Quad

injection eq 100,250mg base/vial Abbott@ injection eq 50mg base/vial ABIC@ injection eq 50mg base/vial American Pharmaceutical

Partnersinjection eq 50,100mg base/vial Bedfordinjection eq 50,100mg base/vial Elkins-Sinninjection eq 50,100,350mg base/vial Gensia Sicorinjection eq 50,100,350mg base/vial Immunexinjection eq 50,100,350mg base/vial Pharmachemie

@ injection eq 50,100mg base/vial Quadtablet, oral eq 5,25mg base Barrtablet, oral eq 15mg base Genevatablet, oral eq 10,15mg base Immunextablet, oral eq 15mg base Invamedtablet, oral eq 5,25mg base Partablet, oral eq 5,25mg base Pharmachemietablet, oral eq 5,10,15,25mg base Roxane

Brand(s)Leucovorin Calcium injection eq 10mg base/ml Abbott Preservative-FreeLeucovorin Calcium injection eq 10mg base/ml Bedford Preservative-FreeLeucovorin Calcium injection eq 200,350mg base/vial Bedford Preservative-FreeLeucovorin Calcium injection eq 10mg base/ml Bigmar Preservative-FreeLeucovorin Calcium injection eq 200mg base/vial Bigmar Preservative-FreeLeucovorin Calcium injection eq 10mg base/ml Gensia Sicor Preservative-FreeLeucovorin Calcium injection eq 10mg base/ml Luitpold Preservative-FreeWellcovorin injection eq 5mg base/ml Glaxo WellcomeWellcovorin @ injection eq 50,100mg base/vial Glaxo WellcomeWellcovorin @ tablet, oral eq 5,25mg base Glaxo Wellcome

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

128

LEUPROLIDE ACETATELeuprolide Acetate injection 1mg/0.2ml Bedford

injection 1mg/0.2ml Gensia-SicorBrand(s)

Lupron injection 1mg/0.2ml TAP

LEVOBUNOLOL HYDROCHLORIDELevobunolol Hydrochloride solution, ophthalmic 0.25,0.5% Alcon

solution, ophthalmic 0.25,0.5% Bausch and Lombsolution, ophthalmic 0.25,0.5% Novex

Brand(s)AKbeta solution, ophthalmic 0.25.0.5% AkornBetagan solution, ophthalmic 0.25,0.5% Allergan *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

LEVOCARNITINELevocarnitine injection 200mg/ml Bedford

Brand(s)Carnitor injection 200mg/5ml Sigma Tau

LEVODOPA; CARBIDOPASee CARBIDOPA; LEVODOPA

LEVONORDEFRIN; MEPIVICAINE HYDROCHLORIDELevonordefrin; injection 0.05mg/ml;2% Graham Mepivicaine Hydrochloride

Brand(s)Arestocaine Hydrochloride @ injection 0.05mg/ml;2% Solvay with LevonordefrinCarbocaine Hydrochloride injection 0.05mg/ml;2% Eastman Kodak with Neo-CobefrinIsocaine Hydrochloride injection 0.05mg/ml;2% Novocol with LevonordefrinPolocaine with Levonordefrin injection 0.05mg/ml;2% DentsplyScandonest L injection 0.05mg/ml;2% Deproco

LEVONORGESTREL; ETHINYL ESTRADIOLSee ETHINYL ESTRADIOL; LEVONORGESTREL

LEVORPHANOL TARTRATELevorphanol Tartrate tablet, oral 2mg Roxane

Brand(s)Levo-Dromoran tablet, oral 2mg ICN

LIDOCAINELidocaine ointment, topical 5% Fougera/Altana

ointment, topical 5% Grahamointment, topical 5% Thames

Brand(s)Alphacaine ointment, topical 5% CarlisleXylocaine ointment, topical 5% Astra Zeneca

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

129

LIDOCAINE HYDROCHLORIDELidocaine Hydrochloride injection 0.5,1,2,20% Abbott

@ injection 10% Abbott@ injection 1,2% Akorn@ injection 1.5,20% American Pharmaceutical

Partners@ injection 1,2% Bel Mar@ injection 1,2% Dell@ injection 0.5,4% Elkins-Sinn

injection 1,2% Elkins-Sinninjection 2% Grahaminjection 1,2% International Medication

@ injection 4% International Medicationinjection 1,2% Luitpold

@ injection 1,2% Miles@ injection 1,% Searle@ injection 1,2% Steris

injection 1,2% Wyeth-Ayerstjelly, topical 2% Copleyjelly, topical 2% International Medicationsolution, oral (viscous) 2% Alpharmasolution, oral (viscous) 2% Hi-Tech

@ solution, oral (viscous) 2% International Medicationsolution, oral (viscous) 2% Morton Grovesolution, oral (viscous) 2% Roxanesolution, topical 4% Morton Grove

@ solution, topical 4% Pacosolution, topical 4% Roxane

Brand(s)Alphacaine @ injection 2% CarlisleLidocaine Hydrochloride injection 1,1.5,4% Abbott Preservative-FreeLidocaine Hydrochloride injection 1,2% Abbott Preservative-Free (in plastic container)Lidocaine Hydrochloride injection 1,2,4% American Pharmaceutical Preservative-Free PartnersLidocaine Hydrochloride injection 1,2% Elkins-Sinn Preservative-FreeLidocaine Hydrochloride injection 20% International Medication Preservative-FreeLidocaton @ injection 2% PharmatonLidopen injection 10% MeridianXylocaine injection 0.5,1,1.5,2% Astra ZenecaXylocaine Preservative-Free injection 2,4,10,20% Astra ZenecaXylocaine jelly, topical 2% Astra ZenecaXylocaine solution, oral (viscous) 2% Astra ZenecaAnestacon solution, topical 2% PolymedicaLaryng-O-Jet solution, topical 4% International MedicationLaryngotracheal Anesthesia Kit @ solution, topical 4% KendallLTA II Kit solution, topical 4% AbbottPediatric LTA Kit solution, topical 2% AbbottXylocaine 4% solution, topical 4% Astra Zeneca

* PRODUCTS LABELED FOR INTRACARDIAC USE MAY NOT BE INTERCHANGED.

LIDOCAINE HYDROCHLORIDE; DEXTROSESee DEXTROSE; LIDOCAINE HYDROCHLORIDE

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

130

LIDOCAINE HYDROCHLORIDE; EPINEPHRINESee EPINEPHRINE; LIDOCAINE HYDROCHLORIDE

LINCOMYCINLincomycin @ injection eq 300 base mg/ml Quad

@ injection eq 300 base mg/ml SterisBrand(s)

Lincocin injection eq 300 base mg/ml Pharmacia & Upjohn

LINDANE (GAMMA BENZENE HEXACHLORIDE)Lindane lotion, topical 1% Alpharma

lotion, topical 1% Morton Groveshampoo, topical 1% Alpharmashampoo, topical 1% Morton Grove

Brand(s)Gamene @ lotion, topical 1% Sola Barnes-HindKwell @ lotion, topical 1% Reed and CarnrickScabene @ lotion, topical 1% StiefelGamene @ shampoo, topical 1% Sola Barnes-HindKwell @ shampoo, topical 1% Reed and CarnrickScabene @ shampoo, topical 1% Stiefel

LIOTHYRONINE SODIUMLiothyronine Sodium @ tablet, oral 0.025,0.05mg base Circa

Brand(s)Cytomel tablet, oral 0.025,0.05mg base SmithKline Beecham

LISINOPRILBrand(s)

Prinivil tablet, oral 2.5,5,10,20,40mg Merck Sharp and Dohme *Zestril tablet, oral 2.5,5,10,20,40mg Zeneca

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

LISINOPRIL; HYDROCHLOROTHIAZIDESee HYDROCHLOROTHIAZIDE; LISINOPRIL

LITHIUM CARBONATELithium Carbonate capsule, oral 300mg Able

@ capsule, oral 300mg Circacapsule, oral 300mg Roxane

@ capsule, oral 300mg USLtablet, oral 300mg Roerig/Pfizertablet, oral 300mg Roxane

Brand(s)Eskalith capsule, oral 300mg SmithKline BeechamLithonate @ capsule, oral 300mg SolvayEskalith @ tablet, oral 300mg SmithKline BeechamLithane @ tablet, oral 300mg BayerLithotabs @ tablet, oral 300mg Solvay

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

131

LITHIUM CITRATELithium Citrate syrup, oral (eq 300mg carbonate/5ml) Morton Grove

syrup, oral (eq 300mg carbonate/5ml) RoxaneBrand(s)

Lithonate @ syrup, oral (eq 300mg carbonate/5ml) Solvay

LOPERAMIDE HYDROCHLORIDELoperamide Hydrochloride capsule, oral 2mg Geneva

capsule, oral 2mg Mylan@ capsule, oral 2mg Roxane

capsule, oral 2mg TevaBrand(s)

Imodium capsule, oral 2mg McNeil Consumer

LORAZEPAMLorazepam injection 2,4mg/ml Abbott

injection 2mg/ml Akorninjection 2,4mg/ml Elkins-Sinninjection 2,4mg/ml Marsaminjection 2,4mg/ml Movainjection 2,4mg/ml Sterisinjection 2mg/ml Taylor

@ tablet, oral 0.5,1,2mg American Therapeutics@ tablet, oral 0.5,1,2mg Barr

tablet, oral 0.5,1,2mg Danburytablet, oral 0.5,1,2mg Geneva

@ tablet, oral 0.5,1,2mg Halseytablet, oral 0.5,1,2mg Mutualtablet, oral 0.5,1,2mg Mylan

@ tablet, oral 0.5,1,2mg Partablet, oral 0.5,1,2mg Purepactablet, oral 0.5,1,2mg Ranbaxytablet, oral 0.5,1,2mg Royce

@ tablet, oral 0.5,1,2mg Superpharm@ tablet, oral 1,2mg USL@ tablet, oral 1,2mg Warner-Chilcott

tablet, oral 0.5,1,2mg WatsonBrand(s)

Ativan injection 2,4mg/ml Wyeth-AyerstAtivan tablet, oral 0.5,1,2mg Wyeth-AyerstLoraz @ tablet, oral 0.5,1,2mg Quantum

LOVASTATINLovastatin tablet, oral 10,20,40mg Eon

tablet, oral 10,20,40mg Genevatablet, oral 10,20,40mg GenPharmtablet, oral 10,20,40mg Mylantablet, oral 10,20,40mg Purepactablet, oral 10,20,40mg Teva

Brand(s)Mevacor tablet, oral 10,20,40mg Merck

LOXAPINE SUCCINATELoxapine Succinate capsule, oral eq 5,10,25,50mg base Watson

Brand(s)Loxitane capsule, oral eq 5,10,25,50mg base Watson

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

132

MAGNESIUM CHLORIDE; CALCIUM CHLORIDE; DEXTROSE; GLUTATHIONE DISULFIDE; POTASSIUMCHLORIDE; SODIUM BICARBONATE; SODIUM CHLORIDE; SODIUM PHOSPHATE

See CALCIUM CHLORIDE; DEXTROSE; GLUTATHIONE DISULFIDE; MAGNESIUM CHLORIDE;POTASSIUM CHLORIDE; SODIUM BICARBONATE; SODIUM CHLORIDE; SODIUMPHOSPHATE

MAGNESIUM CHLORIDE; CALCIUM CHLORIDE; DEXTROSE; SODIUM CHLORIDE; SODIUM LACTATESee CALCIUM CHLORIDE; DEXTROSE; MAGNESIUM CHLORIDE; SODIUM CHLORIDE; SODIUM

LACTATE

MAGNESIUM CHLORIDE; DEXTROSE; POTASSIUM CHLORIDE; SODIUM ACETATE;SODIUM CHLORIDE; SODIUM GLUCONATE

See DEXTROSE; MAGNESIUM CHLORIDE; POTASSIUM CHLORIDE; SODIUM ACETATE; SODIUMCHLORIDE; SODIUM GLUCONATE

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

132

MAGNESIUM CHLORIDE; CALCIUM CHLORIDE; DEXTROSE; GLUTATHIONE DISULFIDE; POTASSIUMCHLORIDE; SODIUM BICARBONATE; SODIUM CHLORIDE; SODIUM PHOSPHATE

See CALCIUM CHLORIDE; DEXTROSE; GLUTATHIONE DISULFIDE; MAGNESIUM CHLORIDE;POTASSIUM CHLORIDE; SODIUM BICARBONATE; SODIUM CHLORIDE; SODIUMPHOSPHATE

MAGNESIUM CHLORIDE; CALCIUM CHLORIDE; DEXTROSE; SODIUM CHLORIDE; SODIUM LACTATESee CALCIUM CHLORIDE; DEXTROSE; MAGNESIUM CHLORIDE; SODIUM CHLORIDE; SODIUM

LACTATE

MAGNESIUM CHLORIDE; DEXTROSE; POTASSIUM CHLORIDE; SODIUM ACETATE;SODIUM CHLORIDE; SODIUM GLUCONATE

See DEXTROSE; MAGNESIUM CHLORIDE; POTASSIUM CHLORIDE; SODIUM ACETATE; SODIUMCHLORIDE; SODIUM GLUCONATE

MAGNESIUM CHLORIDE; POTASSIUM CHLORIDE; SODIUM ACETATE; SODIUM CHLORIDE;SODIUM GLUCONATEInjection; in plastic containerSolution for irrigation; in plastic container

Brand(s)Isolyte S injection 30mg/100ml;37mg/100ml; Braun

370mg/100ml;530mg/100ml; 500mg/100ml

Plasma-Lyte A injection 30mg/100ml;37mg/100ml; Baxter 368mg/100ml;526mg/100ml; 502mg/100ml

Plasma-Lyte 148 injection 30mg/100ml;37mg/100ml; Baxter 368mg/100ml;526mg/100ml; 502mg/100ml

Physiolyte solution, irrigation 30mg/100ml; Braun 37mg/100ml;370mg/100ml; 530mg/100ml;500mg/100ml

Synovalyte @ solution, irrigation 30mg/100ml; Baxter 37mg/100ml;370mg/100ml; 530mg/100ml;500mg/100ml

MAGNESIUM CHLORIDE; CALCIUM CHLORIDE; POTASSIUM CHLORIDE; SODIUM CHLORIDESee CALCIUM CHLORIDE; MAGNESIUM CHLORIDE; POTASSIUM CHLORIDE; SODIUM CHLORIDE

MAGNESIUM OXIDE; CITRIC ACID; SODIUM CARBONATESee CITRIC ACID; MAGNESIUM OXIDE; SODIUM CARBONATE

MAGNESIUM SULFATEMagnesium Sulfate injection 500mg/ml (50%) Abbott

injection 500mg/ml (50%) American Pharmaceutical Partners

MANNITOLMannitol injection 5gm/100ml (5%), Abbott

10gm/100ml (10%), 15gm/100ml (15%), 20gm/100ml (20%), 25gm/100ml (25%)

(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

133

MANNITOL (continued)injection 25gm/100ml (25%) American Pharmaceutical

Partnersinjection 12.5gm/50ml (25%), Astra Zenecainjection 5gm/100ml (5%), Braun 10gm/100ml (10%), 15gm/100ml (15%), 20gm/100ml (20%),injection 25gm/100ml (25%) International Medicationinjection 25gm/100ml (25%) Luitpold

@ injection 10gm/100ml (10%) Miles@ injection 15gm/100ml (15%) Miles@ injection 20gm/100ml (20%) Miles@ injection 25gm/100ml (25%) Merck Sharp and Dohme@ injection 25gm/100ml (25%) Steris

Brand(s)Osmitrol injection 5gm/100ml (5%), Baxter

10gm/100ml (10%), 15gm/100ml (15%), 20gm/100ml (20%)

MANNITOL; DEXTROSESee DEXTROSE; MANNITOL

MAPROTILINE HYDROCHLORIDEMaprotiline Hydrochloride @ tablet, oral 25,50,75mg American Therapeutics

@ tablet, oral 25,50,75mg Circatablet, oral 25,50,75mg Mylantablet, oral 25,50,75mg Watson

Brand(s)Ludiomil tablet, oral 25,50,75mg Novartis

MEBENDAZOLEMebendazole tablet, chewable 100mg Copley

Brand(s)Vermox tablet, chewable 100mg McNeil Consumer

MECLIZINE HYDROCHLORIDEMeclizine Hydrochloride tablet, oral 12.5,25mg ABC

@ tablet, oral 25mg Anabolictablet, oral 12.5,25mg Bundy

@ tablet, oral 12.5mg Circatablet, oral 12.5,25mg Geneva

@ tablet, oral 12.5,25mg IVAX@ tablet, oral 12.5,25mg KV

tablet, oral 12.5,25,50mg Partablet, oral 12.5,25mg Sidmak

@ tablet, oral 12.5,25mg Superpharm@ tablet, oral 12.5,25mg (Unit Dose Labs)@ tablet, oral 12.5,25mg (Vangard/MWM)

tablet, oral 12.5,25mg Vintage@ tablet, oral 12.5mg Watson

tablet, oral 25mg Watson@ tablet, chewable 25mg Anabolic@ tablet, chewable 25mg IVAX

tablet, chewable 25mg Sidmak(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

134

MECLIZINE HYDROCHLORIDEBrand(s)

Antivert tablet, oral 12.5,25,50mg Roerig/PfizerAntivert tablet, chewable 25mg Roerig/Pfizer

(All products are Rx, although some manufacturers also market an OTC version of the product)

MECLOFENAMATE SODIUMMeclofenamate Sodium @ capsule, oral eq 50,100mg base American Therapeutics

@ capsule, oral eq 50,100mg base Barr@ capsule, oral eq 50,100mg base Circa

capsule, oral eq 50,100mg base Danbury@ capsule, oral eq 50,100mg base Eon

capsule, oral eq 50,100mg base Genevacapsule, oral eq 50,100mg base Mylan

@ capsule, oral eq 50,100mg base Par@ capsule, oral eq 50,100mg base USL@ capsule, oral eq 50,100mg base Watson

Brand(s)Meclomen capsule, oral eq 50,100mg base Parke-Davis

MEDROXYPROGESTERONE ACETATEMedroxyprogesterone Acetate tablet, oral 2.5,5,10mg Barr

tablet, oral 2.5,5,10mg DuramedBrand(s)

Cycrin @ tablet, oral 2.5,5,10mg ESI *Provera tablet, oral 2.5,5,10mg Pharmacia & Upjohn *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

MEFLOQUINE HYDROCHLORIDEMefloquine Hydrochloride tablet, oral 250mg Geneva

Brand(s)Lariam tablet, oral 250mg Roche

MEGESTROL ACETATEMegestrol Acetate suspension, oral 40mg/ml Par

suspension, oral 40mg/ml Roxanetablet, oral 20,40mg Barrtablet, oral 20,40mg Partablet, oral 20,40mg Roxanetablet, oral 40mg Teva

@ tablet, oral 20,40mg USLBrand(s)

Megace suspension, oral 40mg/ml Bristol-Myers SquibbMegace tablet, oral 20,40mg Bristol-Myers Squibb

MENADIOL SODIUM PHOSPHATEBrand(s)

Kappadione @ injection 10mg/ml LillySynkavite @ injection 10mg/ml Roche

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

135

MENOTROPINS (FSH;LH)Brand(s)

Humegon @ injection 75IU/vial;75IU/vial OrganonHumegon @ injection 150IU/vial;150IU/vial OrganonPergonal injection 75IU/vial;75IU/vial SeronoPergonal injection 150IU/vial;150IU/vial SeronoRepronex @ injection 75IU/vial;75IU/vial FerringRepronex @ injection 150IU/vial;150IU/vial Ferring

MEPERIDINE HYDROCHLORIDEMeperidine Hydrochloride @ injection 25,50,75,100mg/ml Abbott

@ injection 25,50,75,100mg/ml Astra Zenecainjection 25,50,75,100mg/ml Elkins-Sinn

@ injection 50,75,100mg/ml Parke-Davisinjection 50,100mg/ml Sterisinjection 25,50,75,100mg/ml Wyeth-Ayerstsyrup, oral 50mg/5ml Roxanetablet, oral 50,100mg Amidetablet, oral 50,100mg Barrtablet, oral 50,100mg Duramedtablet, oral 50,100mg Halseytablet, oral 50,100mg Mallinckrodttablet, oral 50,100mg Roxanetablet, oral 50,100mg Roycetablet, oral 50mg Wyeth-Ayersttablet, oral 50,100mg Vintage

Brand(s)Demerol injection 25,50,75,100mg/ml Sanofi SynthelaboMeperidine Hydrochloride injection 10mg/ml Abbott Preservative-FreeMeperidine Hydrochloride injection 10mg/ml Astra Zeneca Preservative-FreeMeperidine Hydrochloride injection 10mg/ml Faulding Preservative-FreeMeperidine Hydrochloride injection 10mg/ml International Medications Preservative-FreeMeperidine Hydrochloride injection 10mg/ml Mallinckrodt Preservative-FreeMeperidine Hydrochloride injection 10mg/ml Steris Preservative-FreeDemerol syrup, oral 50mg/5ml Sanofi SynthelaboDemerol tablet, oral 50,100mg Sanofi Synthelabo

MEPERIDINE HYDROCHLORIDE; ATROPINE SULFATESee ATROPINE SULFATE; MEPERIDINE HYDROCHLORIDE

MEPIVICAINE HYDROCHLORIDEMepivicaine Hydrochloride injection 3% Graham

@ injection 1% International Medicationinjection 1,2% Steris

Brand(s)Arestocaine HCl @ injection 3% SolvayCarbocaine injection 1,1.5,2% Sterling WinthropCarbocaine injection 3% Eastman KodakIsocaine HCl injection 3% NovocolPolocaine injection 1,2% Astra ZenecaPolocaine injection 3% Dentsply

(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

136

MEPIVICAINE HYDROCHLORIDE (continued)Polocaine-MPF injection 1,1.5,2% Astra ZenecaScandonest Plain injection 3% Deproco

MEPIVICAINE HYDROCHLORIDE; LEVONORDEFRINSee LEVONORDEFRIN; MEPIVICAINE HYDROCHLORIDE

MEPROBAMATEMeprobamate @ tablet, oral 200,400mg Anabolic

tablet, oral 400mg Barr@ tablet, oral 200,600mg Barr

tablet, oral 200,400mg Watson@ tablet, oral 600mg Watson

tablet, oral 200,400mg Danbury@ tablet, oral 600mg Danbury@ tablet, oral 200,400mg Elkins-Sinn

tablet, oral 200,400mg Eon@ tablet, oral 200,400mg Everylife

tablet, oral 400mg Geneva@ tablet, oral 400mg Halsey@ tablet, oral 400,600mg Heather@ tablet, oral 200,400mg ICN@ tablet, oral 200,400mg Impax@ tablet, oral 200,400,600mg IVAX@ tablet, oral 200,400mg Lannett@ tablet, oral 400mg Lederle@ tablet, oral 400mg Lee@ tablet, oral 400mg Mallard@ tablet, oral 200,400mg MK

tablet, oral 400mg Mylan@ tablet, oral 200,400mg Parke-Davis@ tablet, oral 200,400mg Perrigo@ tablet, oral 400mg Pharmavite@ tablet, oral 400mg Pharmeral@ tablet, oral 400mg Private Formulations@ tablet, oral 200,400mg Purepac

tablet, oral 600mg Roxanetablet, oral 400mg Scherer

@ tablet, oral 200mg Solvaytablet, oral 400mg Tablicaps

@ tablet, oral 200,400mg USL@ tablet, oral 400mg (Vangard/MWM)

tablet, oral 200,400mg West-ward@ tablet, oral 200,400mg Whiteworth Towne

Brand(s)Amosene @ tablet, oral 400mg FerndaleEquanil tablet, oral 200,400mg Wyeth-AyerstMepriam @ tablet, oral 400mg TevaMiltown tablet, oral 200,400,600mg WallaceNeuramate @ tablet, oral 200,400mg HalseyTranmep tablet, oral 400mg Solvay

MEPROBAMATE; ASPIRINSee ASPIRIN; MEPROBAMATE

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

137

MESNAMesna injection 100mg/ml American Pharmaceutical

PartnersBrand(s)

Mesnex injection 100mg/ml Asta

MESTRANOL; NORETHINDRONEtablet, oral 0.05mg;1mg Watson

Brand(s)Necon 1/50 tablet, oral 0.05mg;1mg WatsonNorethin 1/50M tablet, oral 0.05mg;1mg WatsonNorinyl 1+50 tablet, oral 0.05mg;1mg WatsonOrtho-Novum 1/50 tablet, oral 0.05mg;1mg RW JohnsonNorinyl 1+80 @ tablet, oral 0.08mg;1mg SearleOrtho-Novum 1/80 @ tablet, oral 0.08mg;1mg RW Johnson

Note: 21 day packs may not be interchanged with 28 day packs.

METAPROTERENOL SULFATEMetaproterenol Sulfate @ solution for inhalation 0.4,0.6% AstraZeneca

@ solution for inhalation 5% Morton Grovesolution for inhalation 0.4,0.6% Nephronsolution for inhalation 0.4,0.6% Novex

@ syrup, oral 10mg/5ml Copleysyrup, oral 10mg/5ml JVLsyrup, oral 10mg/5ml Morton Grovesyrup, oral 10mg/5ml Novexsyrup, oral 10mg/ml Silarx

@ syrup, oral 10mg/5ml Teva@ tablet, oral 10,20mg American Therapeutics

tablet, oral 10,20mg Danburytablet, oral 10,20mg Partablet, oral 10,20mg Teva

@ tablet, oral 10,20mg USLBrand(s)

Alupent aerosol, metered 0.65mg/inhalation Boehringer Ingelheim *Alupent solution for inhalation 0.4,0.6,5% Boehringer Ingelheim *Dey-Dose @ solution for inhalation 5% DeyDey-Lute solution for inhalation 0.4,0.6% DeyPrometa @ solution for inhalation 5% MuroAlupent @ syrup, oral 10mg/5ml Boehringer Ingelheim *Prometa @ syrup, oral 10mg/5ml MuroAlupent tablet, oral 10,20mg Boehringer Ingelheim *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

METARAMINOL BITARTRATEMetaraminol Bitartrate injection eq 10mg base/ml American Pharmaceutical

Partners@ injection eq 10mg base/ml Elkins-Sinn@ injection eq 10mg base/ml Searle

Brand(s)Aramine injection eq 10mg base/ml Merck Sharp and Dohme

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

138

METFORMIN HYDROCHLORIDEMetformin Hydrochloride tablet, oral 500,850,1000mg Alphapharm

tablet, oral 500,850,1000mg Andrxtablet, oral 500,850,1000mg Barrtablet, oral 500,850,1000mg Eontablet, oral 500,850,1000mg Genevatablet, oral 500,850,1000mg GenPharmtablet, oral 500,850,1000mg IVAXtablet, oral 500,850,1000mg Mylantablet, oral 500,850,1000mg Purepactablet, oral 500,850,1000mg Tevatablet, oral 500,850,1000mg Watson

Brand(s)Glucophage tablet, oral 500,850,1000mg Bristol-Myers Squibb

METHADONE HYDROCHLORIDEMethadone Hydrochloride concentrate, oral 10mg/ml UDL

injection, preservative-free 1,1.5,4% Abbottinjection, preservative-free 1,2,4% American Pharmaceutical

Partnersinjection, preservative-free 1,2% Elkins-Sinntablet, oral 5,10mg Eontablet, oral 5,10mg Roxanetablet, dispersable 40mg Eontablet, dispersable 40mg Roxane

Brand(s)Intensol concentrate, oral 10mg/ml RoxaneMethadose concentrate, oral 10mg/ml MallinckrodtDolophine tablet, oral 5,10mg LillyMethadose tablet, oral 5,10mg MallinckrodtMethadose tablet, dispersable 40mg Mallinckrodt

METHAMPHETAMINE HYDROCHLORIDEMethamphetamine @ tablet, oral 5,10mg Rexar

tablet, oral 5,10mg Shire Richwood Hydrochloride @ tablet, oral 5mg Teva

Brand(s)Desoxyn tablet, oral 5mg AbbottMethampex @ tablet, oral 10mg Teva

METHAZOLAMIDEMethazolamide @ tablet, oral 25,50mg Applied Analytical Industries

tablet, oral 25,50mg Copleytablet, oral 25,50mg Genevatablet, oral 25,50mg Invamedtablet, oral 25,50mg Mikart

Brand(s)Neptazane tablet, oral 25,50mg Storz

METHENAMINE HIPPURATEBrand(s)

Hiprex tablet, oral 1gm AventisUrex tablet, oral 1gm Riker/3-M

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

139

METHIMAZOLEMethimazole tablet, oral 5,10mg Eon

tablet, oral 5,10mg GenPharmtablet, oral 5,10mg Jones

Brand(s)Tapazole tablet, oral 5,10mg Lilly

METHOCARBAMOLMethocarbamol injection 100mg/ml Marsam

injection 100mg/ml Steris@ tablet, oral 500,750mg American Therapeutics@ tablet, oral 500,750mg (Ascot)@ tablet, oral 500,750mg Barr@ tablet, oral 500,750mg Circa

tablet, oral 500,750mg Danburytablet, oral 500,750mg Eontablet, oral 500,750mg Geneva

@ tablet, oral 500,750mg Heathertablet, oral 500,750mg Impax

@ tablet, oral 500mg Inwood/Forest@ tablet, oral 500,750mg IVAX@ tablet, oral 500,750mg KV

tablet, oral 750mg Lannetttablet, oral 500,750mg Lederle

@ tablet, oral 500,750mg Mylantablet, oral 750mg Nylostablet, oral 500,750mg Par

@ tablet, oral 500,750mg Pharmeral@ tablet, oral 500,750mg Pioneer@ tablet, oral 500,750mg Purepac@ tablet, oral 500,750mg Roxane@ tablet, oral 500,750mg Solvay

tablet, oral 500,750mg Superpharmtablet, oral 500mg Tablicaps

@ tablet, oral 500,750mg Upsher-Smithtablet, oral 500,750mg Watsontablet, oral 500,750mg West-ward

Brand(s)Robaxin injection 100mg/ml SchwarzDelaxin @ tablet, oral 500mg FerndaleForbaxin @ tablet, oral 750mg Schwarz Robaxin tablet, oral 500,750mg Robins

METHOCARBAMOL; ASPIRINSee ASPIRIN; METHOCARBAMOL

METHOTREXATE SODIUMMethotrexate Sodium @ injection eq 2.5,25mg base/ml American Pharmaceutical

Partnersinjection eq 25mg base/ml Bedfordinjection eq 25mg base/ml Bigmarinjection eq 25mg base/ml Norbrookinjection eq 2.5,25mg base/ml Lederleinjection eq 25mg base/ml Pharmachemie

@ injection eq 25mg base/ml Quad@ injection eq 20,50,100mg base/vial American Pharmaceutical

Partners(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

140

METHOTREXATE SODIUM (continued)injection eq 20,50,100mg base/vial Lederle

@ injection eq 20,50,100,250mg base/vial Quadtablet, oral eq 2.5mg base Barrtablet, oral eq 2.5mg based Duramedtablet, oral eq 2.5mg base Mylantablet, oral eq 2.5mg base Roxane

Brand(s)Abitrexate @ injection eq 25mg base/ml ABICFolex PFS @ injection eq 25mg base/ml Pharmacia & UpjohnMethotrexate Preservative-Free injection eq 25mg base/ml BigmarMexate-AQ injection eq 25mg base/ml Bristol-Myers SquibbMexate-AQ Preserved @ injection eq 25mg base/ml Bristol-Myers SquibbAbitrexate @ injection eq 50,100,250mg base/vial ABICFolex injection eq 50,100,250mg base/vial Pharmacia & UpjohnMethotrexate Preservative-Free injection eq 1gm base/vial BigmarMethotrexate Preservative-Free injection eq 1gm base/vial LederleMexate @ injection eq 20,50,100,250mg base/vial Bristol-Myers SquibbRheumatrex tablet, oral eq 2.5mg base Lederle

METHSCOPOLAMINE BROMIDEMethscopolamine Bromide @ tablet, oral 2.5mg Private Formulations

Brand(s)Pamine Bromide tablet, oral 2.5mg Bradley

METHYCLOTHIAZIDEMethyclothiazide @ tablet, oral 2.5,5mg Circa

tablet, oral 2.5,5mg Geneva@ tablet, oral 2.5,5mg IVAX@ tablet, oral 2.5mg Mylan

tablet, oral 5mg Mylan@ tablet, oral 2.5,5mg Par@ tablet, oral 5mg USL@ tablet, oral 2.5mg Watson

tablet, oral 5mg WatsonBrand(s)

Aquatensen tablet, oral 5mg WallaceEnduron tablet, oral 2.5,5mg Abbott

METHYLDOPAMethyldopa @ tablet, oral 125,250,500mg Barr

@ tablet, oral 125,250,500mg Circatablet, oral 250,500mg Danbury

@ tablet, oral 250,500mg Duramedtablet, oral 125,250,500mg Geneva

@ tablet, oral 125,250,500mg Halseytablet, oral 250,500mg IVAX

@ tablet, oral 125mg Lederletablet, oral 250,500mg Lederletablet, oral 250,500mg Mylantablet, oral 125,250,500mg Par

@ tablet, oral 125,250,500mg Parke-Davis@ tablet, oral 125,250,500mg Purepac@ tablet, oral 125,250,500mg Roxane

tablet, oral 125,250,500mg Sidmaktablet, oral 250,500mg Superpharm

(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

141

METHYLDOPA@ tablet, oral 125,250,500mg Teva@ tablet, oral 125,250,500mg Watson

Brand(s)Aldomet tablet, oral 125,250,500mg Merck Sharp and Dohme *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

METHYLDOPA; CHLOROTHIAZIDESee CHLOROTHIAZIDE; METHYLDOPA

METHYLDOPA; HYDROCHLOROTHIAZIDESee HYDROCHLOROTHIAZIDE; METHYLDOPA

METHYLDOPATE HYDROCHLORIDEMethyldopate Hydrochloride injection 50mg/ml Abbott

@ injection 50mg/ml American Pharmaceutical Partners

injection 50mg/ml Elkins-Sinninjection 50mg/ml Fauldinginjection 50mg/ml Gensia Sicorinjection 50mg/ml Luitpold

@ injection 50mg/ml Marsam@ injection 50mg/ml Quad@ injection 50mg/ml Smith and Nephew

Brand(s)Aldomet injection 50mg/ml Merck Sharp and Dohme

METHYLPHENIDATE HYDROCHLORIDEMethylphenidate Hydrochloride tablet, oral 5,10,20mg Danbury

tablet, oral 5,10,20mg MDtablet, oral 5,10,20mg Purepactablet, extended release 20mg Abletablet, extended release 20mg Danburytablet, extended release 20mg Purepac

Brand(s)Methylin tablet, oral 5,10,20mg MallinckrodtRitalin tablet, oral 5,10,20mg Novartis *Metadate ER tablet, extended release 10,20mg CelltechMethylin ER tablet, extended release 10,20mg MallinckrodtRitalin-SR tablet, extended release 20mg Novartis *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

METHYLPREDNISOLONEMethylprednisolone tablet, oral 4mg Duramed

@ tablet, oral 4mg Eontablet, oral 4mg Geneva

@ tablet, oral 4mg Heathertablet, oral 16,24,32mg Partablet, oral 4,8mg Trigentablet, oral 4mg Vintage

(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

142

METHYLPREDNISOLONE (continued)tablet, oral 4mg Watson

@ tablet, oral 16mg WatsonBrand(s)

Medrol tablet, oral 4,8,16,24,32mg Upjohn *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

METHYLPREDNISOLONE SODIUM SUCCINATEMethylprednisolone @ injection eq 40,125,500mg, American Pharmaceutical Sodium Succinate 1gm base/vial Partners

@ injection eq 40,125,500mg, Elkins-Sinn 1gm base/vialinjection eq 125mg base/vial Gensia Sicor

@ injection eq 500mg,1gm base/vial Gensia Sicor@ injection eq 40,125,500mg, International Medication

1gm base/vial@ injection eq 500mg,1gm base/vial Organon/Akzona@ injection eq 40,125,500mg, Quad

1gm base/vial@ injection eq 40,125,500mg, Steris

1gm base/vialBrand(s)

A-Methapred injection eq 40,125,500mg, Abbott 1gm base/vial

Solu-Medrol injection eq 40,125,500mg, Upjohn 1gm base/vial

METHYLTESTOSTERONEBrand(s)

Android 10 tablet, oral 10mg ICNAndroid 25 tablet, oral 25mg ICNMetandren @ tablet, oral 10,25mg Novartis

METIPRANOLOL HYDROCHLORIDEMetipranolol Hydrochloride solution, ophthalmic 0.3% Alcon

Brand(s)OptiPranolol solution, ophthalmic 0.3% Bausch and Lomb *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

METOCLOPRAMIDE HYDROCHLORIDEMetoclopramide Hydrochloride injection eq 5mg base/ml Abbott

@ injection eq 5mg base/ml American Pharmaceutical Partners

injection eq 5mg base/ml Bedfordinjection eq 5mg base/ml Fauldinginjection eq 5mg base/ml Gensia Sicor

@ injection eq 5mg base/ml Norbrook@ injection eq 5mg base/ml Quad@ injection eq 5mg base/ml Smith and Nephew

solution, oral eq 5mg base/5ml Alpharmasolution, oral eq 5mg base/5ml JVL

@ solution, oral eq 5mg base/5ml Morton Grove(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

143

METOCLOPRAMIDE HYDROCHLORIDE (continued)@ solution, oral eq 5mg base/5ml Paco

solution, oral eq 5mg base/5ml Pharm Venturessolution, oral eq 5mg base/5ml Pharmaceutical Associatessolution, oral eq 5mg base/5ml Roxanesolution, oral eq 5mg base/5ml Silarxsolution, oral eq 5mg base/5ml Tevasolution, oral eq 5mg base/5ml UDL

@ tablet, oral eq 10mg base Barr@ tablet, oral eq 10mg base Circa

tablet, oral eq 10mg base Danburytablet, oral eq 5,10mg base Geneva

@ tablet, oral eq 10mg base Halsey@ tablet, oral eq 10mg base Interpharm

tablet, oral eq 10mg base Lederle@ tablet, oral eq 5,10mg base Mutual@ tablet, oral eq 10mg base Par

tablet, oral eq 10mg base Purepac@ tablet, oral eq 10mg base Schering

tablet, oral eq 5,10mg base Sidmak@ tablet, oral eq 10mg base Superpharm

tablet, oral eq 5,10mg base Teva@ tablet, oral eq 10mg base USL@ tablet, oral eq 10mg base Watson

Brand(s)Octamide PFS injection eq 5mg base/ml FauldingReglan injection eq 5mg base/ml RobinsReglan solution, oral eq 5mg base/5ml RobinsClopra @ tablet, oral eq 5,10mg base QuantumMaxolon @ tablet, oral eq 10mg base KingReglan tablet, oral eq 5,10mg base Schwarz *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

METOCURINE IODIDEMetocurine Iodide @ injection 2mg/ml Quad

Brand(s)Metubine Iodide injection 2mg/ml Lilly

METOLAZONEBrand(s)

Diulo @ tablet, oral 2.5,5,10mg SCSZaroxolyn tablet, oral 2.5,5,10mg Celltech

METOPROLOL TARTRATEMetoprolol Tartrate injection 1mg/ml Abbott

injection 1mg/ml Steristablet, oral 50,100mg Apothecontablet, oral 50,100mg Caracotablet, oral 50,100mg Copleytablet, oral 50,100mg Genevatablet, oral 50,100mg Mutualtablet, oral 50,100mg Mylantablet, oral 50,100mg Par

@ tablet, oral 50,100mg Purepac

(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

144

METOPROLOL TARTRATE (continued)tablet, oral 50,100mg Tevatablet, oral 50,100mg Watson

Brand(s)Lopressor injection 1mg/ml Novartis *Lopressor tablet, oral 50,100mg Novartis

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

METRONIDAZOLEMetronidazole injection 500mg/100ml Abbott

@ injection 500mg/100ml American Pharmaceutical Partners

@ injection 500mg/100ml Elkins-Sinn@ injection 500mg/100ml International Medication@ injection 500mg/100ml Steris@ tablet, oral 250,500mg Barr

tablet, oral 250,500mg Danburytablet, oral 250,500mg Eontablet, oral 250,500mg Geneva

@ tablet, oral 250,500mg Halseytablet, oral 250,500mg IVAXtablet, oral 250mg LNKtablet, oral 250,500mg Mutualtablet, oral 250,500mg Partablet, oral 250,500mg Sidmak

@ tablet, oral 250,500mg Superpharm@ tablet, oral 250,500mg Watson

Brand(s)Flagyl I.V. injection 500mg/100ml SCSFlagyl I.V. RTU injection 500mg/100ml BaxterMetro I.V. injection 500mg/100ml BraunFlagyl tablet, oral 250,500mg SearleMetromidol tablet, oral 250,500mg Laboratorios A.F.Metryl tablet, oral 250,500mg TevaProtostat @ tablet, oral 250,500mg RW JohnsonSatric @ tablet, oral 250,500mg Savage

MEXILETINE HYDROCHLORIDEMexiletine Hydrochloride capsule, oral 150,200,250mg Danbury

capsule, oral 150,200,250mg Genevacapsule, oral 150,200,250mg Tevacapsule, oral 150,200,250mg Watson

Brand(s)Mexetil capsule, oral 150,200,250mg Boehringer Ingelheim *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

MICONAZOLE NITRATEMiconazole Nitrate suppository, vaginal 200mg Alpharma

Brand(s)Monistat 3 suppository, vaginal 200mg RW Johnson

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

145

MIDAZOLAM HYDROCHLORIDEMidazolam Hydrochloride injection eq 1,5mg base/ml Abbott

injection eq 1,5mg base/ml American Pharmaceutical Partners

injection eq 1,5gm base/ml Apotex@ injection eq 1,5mg base/ml Apothecon@ injection eq 5mg base/ml AstraZeneca

injection eq 1,5mg base/ml Baxterinjection eq 1,5mg base/ml Bedfordinjection eq 1,5mg base/ml Ben Venueinjection eq 1,5mg base/ml ESI Lederleinjection eq 1,5mg base/ml Fauldinginjection eq 1,5mg base/ml Taylor

Brand(s)Versed injection eq 1,5mg base/ml Roche

MINOCYCLINE HYDROCHLORIDEMinocycline Hydrochloride capsule, oral eq 50,75,100mg base Danbury

capsule, oral eq 50,100mg base Impaxcapsule, oral eq 50,75,100mg base Ranbaxycapsule, oral eq 50,100mg base Teva

Brand(s)Minocin capsule, oral eq 50,75,100mg base LederleVectrin capsule, oral eq 50mg base MedicisVectrin @ capsule, oral eq 75,100mg base Medicis

MINOXIDILMinoxidil tablet, oral 2.5,10mg Danbury

tablet, oral 2.5,10mg Mutualtablet, oral 2.5,10mg Par

@ tablet, oral 2.5,10mg Royce@ tablet, oral 2.5mg USL

Brand(s)Loniten tablet, oral 2.5,10mg Pharmacia & UpjohnMinodyl @ tablet, oral 2.5,10mg Quantum

MITOMYCINMitomycin injection 5,20mg/vial Bedford

injection 20mg/vial Fauldinginjection 5,20mg/vial ESI Lederleinjection 5,20mg/vial Supergen

Brand(s)Mutamycin injection 5,20mg/vial Bristol-Myers

MORPHINE; ALCOHOLSee ALCOHOL; MORPHINE

MORPHINE SULFATEMorphine Sulfate injection 0.5,1mg/ml Abbott

injection 1mg/ml Mallinckrodtinjection 0.5,1mg/ml Sterissolution, oral 10mg/5ml Roxane *solution, oral 20mg/5ml Roxane *

(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

146

MORPHINE SULFATE (continued)tablet, extended release AB Generics 15,30,60,100,200mgtablet, extended release Endo 15,30,60,100,200mgtablet, extended release 15mg ESI Lederletablet, extended release 100mg Watson

Brand(s)Astramorph PF injection 0.5,1mg/ml Astra ZenecaDuramorph PF injection 0.5,1mg/ml Elkins-SinnMSIR solution, oral 20mg/ml Purdue Frederick *Roxanol solution, oral 20mg/ml Roxane *MS/L solution, oral 10mg/5ml Liquipharm *MS/L solution, oral 20mg/5ml Liquipharm *MSIR solution, oral 10mg/5ml Purdue Frederick *MSIR solution, oral 20mg/5ml Purdue Frederick *MS Contin tablet, extended release Purdue Frederick **

15,30,60,100,200mg

* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as anexception to the promulgated criteria for inclusion, pursuant to Rule 790.60.

** Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

NABUMETONENabumetone tablet, oral 750mg Copley

tablet, oral 500,750mg Genevatablet, oral 500mg Teva

Brand(s)Relafen tablet, oral 500,750mg SmithKline Beecham

NADOLOLNadolol tablet, oral 80,120,160mg Copley

tablet, oral 20,40,80mg Genevatablet, oral 20,40,80,120,160mg IVAXtablet, oral 20,40,80mg Mylan

Brand(s)Corgard tablet, oral 20,40,80,120,160mg Apothecon

NAFCILLIN SODIUMNafcillin Sodium @ injection eq 500mg,1,2,4,10gm Marsam

base/vialBrand(s)

Nafcil injection eq 500mg,1,2,4,10gm Apothecon base/vial

Nallpen @ injection eq 500mg,1,2,10gm SmithKline Beecham base/vial

Unipen @ injection eq 500mg,1,2,4,10gm Wyeth-Ayerst base/vial

NALBUPHINE HYDROCHLORIDENalbuphine Hydrochloride injection 10,20mg/ml Abbott

@ injection 10,20mg/ml American Pharmaceutical Partners

(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

147

NALBUPHINE HYDROCHLORIDE (continued)@ injection 10,20mg/ml Astra Zeneca

injection 10,20mg/ml King@ injection 10,20mg/ml Quad

Brand(s)Nubain injection 10,20mg/ml Endo

NALIDIXIC ACIDNalidixic Acid @ tablet, oral 250,500,1000mg Barr

tablet, oral 250,500,1000mg DanburyBrand(s)

NegGram tablet, oral 250,500,1000mg Sanofi Synthelabo

NALOXONE HYDROCHLORIDENaloxone Hydrochloride injection 0.02,0.4mg/ml Abbott

@ injection 0.02,0.4,1mg/ml American Pharmaceutical Partners

@ injection 0.02,0.4,1mg/ml Astra Zenecainjection 0.02,0.4,1mg/ml Elkins-Sinninjection 0.4,1mg/ml International Medication

@ injection 0.4mg/ml Marsam@ injection 0.02,0.4,1mg/ml Quad@ injection 0.02,0.4mg/ml Smith and Nephew@ injection 0.02,0.4mg/ml Solopak@ injection 0.4mg/ml Steris@ injection 0.02,0.4mg/ml Wyeth-Ayerst

Brand(s)Narcan injection 0.02,0.4,1mg/ml Endo

NALOXONE HYDROCHLORIDE; PENTAZOCINE HYDROCHLORIDENaloxone Hydrochloride; tablet, oral eq 0.5mg base; Ranbaxy Pentazocine Hydrochloride eq 50mg base

tablet, oral eq 0.5mg base; Royce eq 50mg base

Brand(s)Talwin NX tablet, oral eq 0.5mg base; Sanofi Synthelabo

eq 50mg base

NALTREXONE HYDROCHLORIDENaltrexone Hydrochloride tablet, oral 50mg Amide

tablet, oral 50mg Barrtablet, oral 50mg Eon

Brand(s)Revia tablet, oral 50mg Bristol-Myers Squibb

NANDROLONE DECANOATENandrolone Decanoate @ injection 100mg/ml Akorn

@ injection 100,200mg/ml American Pharmaceutical Partners

@ injection 50,100,200mg/ml Quadinjection 50,100,200mg/ml Steris

Brand(s)Deca-Durabolin injection 50,100,200mg/ml Organon/Akzona

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

148

NANDROLONE PHENPROPIONATENandrolone Phenpropionate @ injection 25,50mg/ml Quad

@ injection 25,50mg/ml SterisBrand(s)

Durabolin @ injection 25,50mg/ml Organon/Akzona

NAPHAZOLINE HYDROCHLORIDEBrand(s)

AK-Con solution, ophthalmic 0.1% TaylorAlbalon solution, ophthalmic 0.1% AllerganNafazair solution, ophthalmic 0.1% Bausch and LombNaphcon Forte @ solution, ophthalmic 0.1% AlconOpcon @ solution, ophthalmic 0.1% Bausch and LombVasocon solution, ophthalmic 0.1% Novartis

NAPHAZOLINE HYDROCHLORIDE; ANTAZOLINE PHOSPHATESee ANTAZOLINE PHOSPHATE; NAPHAZOLINE HYDROCHLORIDE

NAPHAZOLINE HYDROCHLORIDE; PHENIRAMINE MALEATEBrand(s)

AK-Con-A solution, ophthalmic 0.025%;0.3% Akorn *Muro's Opcon A solution, ophthalmic 0.025%;0.3% Bausch and Lomb *Naphcon A solution, ophthalmic 0.025%;0.3% Alcon *Naphoptic-A solution, ophthalmic 0.025%;0.3% Optopics *

* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as anexception to the promulgated criteria for inclusion, pursuant to Rule 790.60.

NAPROXENNaproxen suspension, oral 125mg/5ml Roxane

tablet, delayed release 375,500mg Genevatablet, delayed release 375,500mg Purepactablet, delayed release 375,500mg Sidmaktablet, delayed release 375,500mg Tevatablet, oral 250,375,500mg Copleytablet, oral 250,375,500mg Danburytablet, oral 250,375,500mg Geneva

@ tablet, oral 250,375,500mg Hamiltontablet, oral 250,375,500mg Interpharmtablet, oral 250,375,500mg IVAXtablet, oral 250,375,500mg Lederletablet, oral 250,375,500mg Movatablet, oral 250,375,500mg Mylantablet, oral 250,375,500mg Purepactablet, oral 250,375,500mg Roxanetablet, oral 250,375,500mg Sidmaktablet, oral 250,375,500mg Tevatablet, oral 250,375,500mg Watson

Brand(s)Naprosyn suspension, oral 125mg/5ml SyntexEC-Naprosyn tablet, delayed release 375,500mg Syntex *Naprosyn tablet, oral 250,375,500mg Syntex

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

149

NAPROXEN SODIUMNaproxen Sodium tablet, oral eq 500mg base Al-Hikma

tablet, oral eq 250,500mg base Copleytablet, oral eq 250,500mg base Danburytablet, oral eq 250,500mg base Geneva

@ tablet, oral eq 250,500mg base Hamiltontablet, oral eq 250,500mg base IVAXtablet, oral eq 250,500mg base Mylan

@ tablet, oral eq 250,500mg base Purepactablet, oral eq 250,500mg base Roxanetablet, oral eq 250,500mg base Sidmaktablet, oral eq 250,500mg base Tevatablet, oral eq 250,500mg base Watson

Brand(s)Anaprox tablet, oral eq 250mg base SyntexAnaprox DS tablet, oral eq 500mg base Syntex

NEOMYCIN SULFATENeomycin Sulfate @ injection eq 350mg base/vial Pfizer

@ injection eq 350mg base/vial Squibb@ powder for compounding 100% Elkins-Sinn@ powder for compounding 100% Paddock@ tablet, oral eq 350mg base Eon@ tablet, oral eq 350mg base Lannett@ tablet, oral eq 350mg base Lilly@ tablet, oral eq 350mg base Roxane@ tablet, oral eq 350mg base Squibb

tablet, oral eq 350mg base TevaBrand(s)

Neo-Rx powder for compounding 100% Pharm TekMycifradin @ tablet, oral eq 350mg base Pharmacia & UpjohnNeobiotic @ tablet, oral eq 350mg base Pfizer

NEOMYCIN SULFATE; BACITRACIN; HYDROCORTISONE ACETATE; POLYMYXIN B SULFATESee BACITRACIN; HYDROCORTISONE ACETATE; NEOMYCIN SULFATE; POLYMYXIN B SULFATE

NEOMYCIN SULFATE; BACITRACIN ZINC; HYDROCORTISONE; POLYMYXIN B SULFATESee BACITRACIN ZINC; HYDROCORTISONE; NEOMYCIN SULFATE; POLYMYXIN B SULFATE

NEOMYCIN SULFATE; BACITRACIN ZINC; POLYMYXIN B SULFATESee BACITRACIN ZINC; NEOMYCIN SULFATE; POLYMYXIN B SULFATE

NEOMYCIN SULFATE; DEXAMETHASONE; POLYMYXIN B SULFATESee DEXAMETHASONE; NEOMYCIN SULFATE; POLYMYXIN B SULFATE

NEOMYCIN SULFATE; DEXAMETHASONE SODIUM PHOSPHATESee DEXAMETHASONE SODIUM PHOSPHATE; NEOMYCIN SULFATE

NEOMYCIN SULFATE; GRAMICIDIN; POLYMYXIN B SULFATESee GRAMICIDIN; NEOMYCIN SULFATE; POLYMYXIN B SULFATE

NEOMYCIN SULFATE; HYDROCORTISONE; POLYMYXIN B SULFATESee HYDROCORTISONE; NEOMYCIN SULFATE; POLYMYXIN B SULFATE

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

150

NEOMYCIN SULFATE; HYDROCORTISONE ACETATESee HYDROCORTISONE ACETATE; NEOMYCIN SULFATE

NEOMYCIN SULFATE; POLYMYXIN B SULFATENeomycin Sulfate; @ solution eq 40mg base/ml;200,000U/ml Steris Polymyxin B Sulfate

Brand(s)Neosporin G.U. Irrigant solution eq 40mg base/ml;200,000U/ml Monarch

NIACIN (NICOTINIC ACID)Niacin @ tablet, oral 500mg Circa

@ tablet, oral 500mg Danbury@ tablet, oral 500mg Everylife@ tablet, oral 500mg Geneva@ tablet, oral 500mg Halsey@ tablet, oral 500mg Impax@ tablet, oral 500mg IVAX

tablet, oral 500mg MK@ tablet, oral 500mg Purepac

tablet, oral 500mg Tablicaps@ tablet, oral 500mg Watson@ tablet, oral 500mg West-ward

tablet, oral 500mg WockhardtBrand(s)

Niacor tablet, oral 500mg Upsher-SmithNicolar tablet, oral 500mg Aventis

NOTE: Dosage strengths less than 500mg are OTC.

NIACINAMIDE; ASCORBIC ACID; BIOTIN; CYANOCOBALAMIN; DEXPANTHENOL; ERGOCALCIFEROL;FOLIC ACID; PYRIDOXINE HYDROCHLORIDE; RIBOFLAVIN PHOSPHATE SODIUM; THIAMINEHYDROCHLORIDE; VITAMIN A; VITAMIN E

See ASCORBIC ACID; BIOTIN; CYANOCOBALAMIN; DEXPANTHENOL; ERGOCALCIFEROL;FOLIC ACID; NIACINAMIDE; PYRIDOXINE HYDROCHLORIDE; RIBOFLAVIN PHOSPHATESODIUM HYDROCHLORIDE; VITAMIN A; VITAMIN E

NICARDIPINE HYDROCHLORIDENicardipine Hydrochloride capsule, oral 20,30mg GenPharm

capsule, oral 20,30mg IVAXcapsule, oral 20,30mg Mylancapsule, oral 20,30mg Tevacapsule, oral 20,30mg Watson

Brand(s)Cardene capsule, oral 20,30mg Roche

NICOTINENicotine film, extended release, transdermal Sano

7,14,21mg/24 hoursBrand(s)

Nicotrol film, extended release, transdermal Novartis 7,14,21mg/24 hours

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

151

NICOTINIC ACID; ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; IRON; PYRIDOXINEHYDROCHLORIDE; RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D; VITAMIN E

See ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; IRON; NICOTINIC ACID; PYRIDOXINEHYDROCHLORIDE; RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D;VITAMIN E

NICOTINIC ACID; ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; PYRIDOXINE HYDROCHLORIDE;RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D; VITAMIN E

See ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; NICOTINIC ACID; PYRIDOXINEHYDROCHLORIDE; RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D;VITAMIN E

NIFEDIPINENifedipine @ capsule, oral 10,20mg Chase

capsule, oral 10mg Flemingtoncapsule, oral 10,20mg Purepaccapsule, oral 10,20mg Scherercapsule, oral 10mg Teva(AB1) tablet, extended release Biovail 30,60mg(AB1) tablet, extended release 30mg Elan

@ (AB2) tablet, extended release 30mg MylanBrand(s)

Adalat capsule, oral 10,20mg BayerProcardia capsule, oral 10,20mg PfizerAdalat CC (AB1) tablet, extended release Bayer

30,60mgNifedical XL (AB2) tablet, extended release Biovail

30,60mgProcardia XL (AB2) tablet, extended release Pfizer *

30,60,90mg

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

Products designated “AB1" may only be interchanged with other products designated as “AB1.” Productsdesignated as “AB2" may only be interchanged with other products designated as “AB2.” Productsdesignated as “AB1" MAY NOT BE INTERCHANGED with products designated as “AB2.” Productsdesignated as “AB2" MAY NOT BE INTERCHANGED with products designated as “AB1.”

NITROFURANTOINNitrofurantoin tablet, oral 50mg Circa

@ tablet, oral 100mg Circa@ tablet, oral 50,100mg Elkins-Sinn@ tablet, oral 50,100mg Eon@ tablet, oral 50,100mg IVAX@ tablet, oral 50,100mg Watson

tablet, oral 100mg Whiteworth TowneBrand(s)

Furadantin tablet, oral 50,100mg Procter and GambleFuralan @ tablet, oral 50,100mg Lannett

NITROFURANTOIN, MACROCRYSTALLINENitrofurantoin, Macrocrystalline @ capsule, oral 50,100mg Circa

capsule, oral 25,50,100mg Danburycapsule, oral 50,100mg Geneva

(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

152

NITROFURANTOIN, MACROCRYSTALLINE (continued)capsule, oral 50,100mg IVAXcapsule, oral 50,100mg Mylan

Brand(s)Macrodantin capsule, oral 25,50,100mg Procter and Gamble

Note: Nitrofurantoin macrocrystalline extended release capsules are not interchangeable withnitrofurantoin macrocrystalline capsules.

NITROFURAZONENitrofurazone @ ointment, topical 0.2% Ambix/Organics

@ ointment, topical 0.2% Clay-Park@ ointment, topical 0.2% Lannett

ointment, topical 0.2% Thamesointment, topical 0.2% Wendt

@ solution, topical 0.2% Clay-Parksolution, topical 0.2% Wendt

Brand(s)Actin-H @ ointment, topical 0.2% SherwoodFuracin ointment, topical 0.2% Shire

NITROGLYCERINNitroglycerin film (AB1), extended release Mylan

transdermal 0.1,0.2,0.4,0.6mg/hourfilm (AB2), extended release Hercon transdermal 0.2,0.4,0.6mg/hourfilm (AB2), extended release Mylan transdermal 0.2,0.4,0.6mg/hourinjection 5mg/ml Abbott

@ injection 5mg/ml American Pharmaceutical Partners

@ injection 5mg/ml International Medicationinjection 5mg/ml Luitpold

@ injection 5,10mg/ml Quad@ injection 5mg/ml Smith and Nephew

Brand(s)Nitro-Bid injection 5mg/ml AventisNitro-Bid @ injection 10mg/ml AventisNitrol @ injection 0.8mg/ml AventisNitro I.V. @ injection 5mg/ml Pohl BoskampNitrostat @ injection 0.8,5,10mg/ml Parke-DavisTridil injection 5mg/ml FauldingMinitran film (AB1), extended release 3M

transdermal 0.1,0.2,0.4,0.6mg/hourNitro-DUR film (AB1), extended release Schering/Key

transdermal 0.1,0.2,0.4,0.6mg/hourTransderm-Nitro film (AB2), extended release Novartis

transdermal 0.2,0.4,0.6mg/hour

Products designated “AB1" may only be interchanged with other products designated as “AB1.” Productsdesignated “AB2" may only be interchanged with other products designated as “AB2.” Productsdesignated as “AB1" MAY NOT BE INTERCHANGED with products designated as “AB2.”

NITROGLYCERIN; DEXTROSESee DEXTROSE; NITROGLYCERIN

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

153

NORGESTREL; ETHINYL ESTRADIOLSee ETHINYL ESTRADIOL; NORGESTREL

NORETHINDRONE; ETHINYL ESTRADIOLSee ETHINYL ESTRADIOL; NORETHINDRONE

NORETHINDRONE; MESTRANOLSee MESTRANOL; NORETHINDRONE

NORETHINDRONE ACETATENorethindrone Acetate tablet, oral 5mg Barr

Brand(s)Aygestin tablet, oral 5mg Wyeth-AyerstNorlutate @ tablet, oral 5mg Parke-Davis

NORTRIPTYLINE HYDROCHLORIDENortriptyline Hydrochloride capsule, oral eq 10,25,50,75mg base Danbury

capsule, oral eq 10,25,50,75mg base Genevacapsule, oral eq 10,25,50,75mg base Mylancapsule, oral eq 10,25,50,75mg base Tarocapsule, oral eq 10,25,50,75mg base Tevasolution, oral eq 10mg base/ml Pharmaceutical Associates

Brand(s)Pamelor capsule, oral eq 10,25,50,75mg base Tyco *Aventyl HCl solution, oral eq 10mg base/5ml LillyPamelor solution, oral eq 10mg base/5ml Tyco

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

NYSTATINNystatin cream, topical 100,000U/gm Alpharma

cream, topical 100,000U/gm Altanacream, topical 100,000U/gm Clay-Parkcream, topical 100,000U/gm Taro

@ cream, topical 100,000U/gm Tevacream, topical 100,000U/gm Thamesointment, topical 100,000U/gm Alpharmaointment, topical 100,000U/gm Altanaointment, topical 100,000U/gm Clay-Parkpowder, oral 100% Paddocksuspension, oral 100,000U/ml Alpharmasuspension, oral 100,000U/ml Bausch and Lombsuspension, oral 100,000U/ml Fougera/Altanasuspension, oral 100,000U/ml Morton Grove

@ suspension, oral 100,000U/ml Pharmaderm/Altana@ suspension, oral 100,000U/ml Pharmafair@ suspension, oral 100,000U/ml Roxane@ suspension, oral 100,000U/ml Teva@ suspension, oral 100,000U/ml Thames

suspension, oral 100,000U/ml UDL@ tablet, oral 500,000U Eon

tablet, oral 500,000U Mutualtablet, oral 500,000U Par

@ tablet, oral 500,000U Quantum(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

154

NYSTATIN (continued)tablet, oral 500,000U Teva

@ tablet, oral 500,000U USL@ tablet, oral 500,000U Watson@ tablet, vaginal 100,000U Eon

tablet, vaginal 100,000U Fougera/Altanatablet, vaginal 100,000U Odysseytablet, vaginal 100,000U Pharmaderm/Altana

@ tablet, vaginal 100,000U Quantum@ tablet, vaginal 100,000U Teva@ tablet, vaginal 100,000U Watson

Brand(s)Candex @ cream, topical 100,000U/gm BayerMycostatin cream, topical 100,000U/gm SquibbMykinac @ cream, topical 100,000U/gm AlpharmaNilstat @ cream, topical 100,000U/gm LederleMycostatin @ ointment, topical 100,000U/gm Westwood SquibbMykinac @ ointment, topical 100,000U/gm AlpharmaNilstat @ ointment, topical 100,000U/gm LederleBarstatin 100 @ powder, oral 100% BarlanNilstat powder, oral 100% LederleMycostatin powder, topical 100,000U/gm Westwood SquibbNystop powder, topical 100,000U/gm PaddockMycostatin suspension, oral 100,000U/ml ApotheconNilstat suspension, oral 100,000U/ml LederleNystex suspension, oral 100,000U/ml Savage/AltanaMycostatin tablet, oral 500,000U ApotheconNilstat tablet, oral 500,000U LederleKorostatin @ tablet, vaginal 100,000U Holland-RantosMycostatin tablet, vaginal 100,000U SquibbNilstat tablet, vaginal 100,000U Lederle

NYSTATIN; TRIAMCINOLONE ACETONIDENystatin; @ cream, topical 100,000U/gm;0.1% Alpharma Triamcinolone Acetonide @ cream, topical 100,000U/gm;0.1% Clay-Park

cream, topical 100,000U/gm;0.1% Fougera/Altana@ cream, topical 100,000U/gm;0.1% Pharmaderm/Altana@ cream, topical 100,000U/gm;0.1% Pharmafair

cream, topical 100,000U/gm;0.1% Thames@ ointment, topical 100,000U/gm;0.1% Clay-Park

ointment, topical 100,000U/gm;0.1% Fougera/Altana@ ointment, topical 100,000U/gm;0.1% Pharmaderm/Altana@ ointment, topical 100,000U/gm;0.1% Pharmafair

ointment, topical 100,000U/gm;0.1% TaroBrand(s)

Dermacomb Cream cream, topical 100,000U/gm;0.1% TaroMyco-Triacet II cream, topical 100,000U/gm;0.1% TevaMycolog-II cream, topical 100,000U/gm;0.1% ApotheconMykacet cream, topical 100,000U/gm;0.1% NMCMytrex F cream, topical 100,000U/gm;0.1% Savage/AltanaMyco-Triacet II @ ointment, topical 100,000U/gm;0.1% TevaMycolog-II ointment, topical 100,000U/gm;0.1% ApotheconMykacet ointment, topical 100,000U/gm;0.1% NMCMytrex F ointment, topical 100,000U/gm;0.1% Savage/Altana

OMEPRAZOLEOmeprazole capsule, delayed release 10,20,40mg Andrx

Brand(s)Prilosec capsule, delayed release 10,20,40mg AstraZeneca

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

155

ORPHENADRINE CITRATEOrphenadrine Citrate injection 30mg/ml Steris

@ tablet, extended release 100mg (Ascot)@ tablet, extended release 100mg Circa

tablet, extended release 100mg Eontablet, extended release 100mg Genevatablet, extended release 100mg Impaxtablet, extended release 100mg Kiel

Brand(s)Norflex injection 30mg/ml Riker/3-MNorflex tablet, extended release 100mg Riker/3-M *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

ORPHENADRINE CITRATE; ASPIRIN; CAFFEINESee ASPIRIN; CAFFEINE; ORPHENADRINE CITRATE

OXACILLIN SODIUMOxacillin Sodium capsule, oral eq 250,500mg base Teva

@ injection eq 250,500mg,1,2,4, Elkins-Sinn 10gm base/vial

@ injection eq 250,500mg, IBI 1,2gm base/vialinjection eq 250,500mg,1,2,4, Marsam 10gm base/vialpowder for solution Teva eq 250mg base/5ml

Brand(s)Bactocill capsule, oral eq 250,500mg base SmithKline BeechamProstaphlin @ capsule, oral eq 250,500mg base ApotheconBactocill @ injection eq 500mg,4,10gm base/vial SmithKline BeechamBactocill @ injection eq 1,2gm base/vial SmithKline Beecham

Prostaphlin injection eq 250,500mg,1,2, Apothecon 10gm base/vial

Prostaphlin @ injection eq 4gm base/vial ApotheconBactocill powder for solution SmithKline Beecham

eq 250mg base/5mlProstaphlin powder for solution Apothecon

eq 250mg base/5ml

OXAPROZINOxaprozin tablet, oral 600mg Dr. Reddy’s

tablet, oral 600mg Eontablet, oral 600mg Genevatablet, oral 600mg GenPharmtablet, oral 600mg IVAXtablet, oral 600mg Mylantablet, oral 600mg Purepactablet, oral 600mg Watson

Brand(s)Daypro tablet, oral 600mg Searle *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

156

OXAZEPAMOxazepam @ capsule, oral 10,15,30mg American Therapeutics

@ capsule, oral 10,15,30mg Barrcapsule, oral 10,15,30mg Danburycapsule, oral 10,15,30mg Genevacapsule, oral 10,15,30mg IVAX

@ capsule, oral 10,15,30mg Mylancapsule, oral 10,15,30mg Purepac

@ tablet, oral 15mg Barr@ tablet, oral 15mg Danbury@ tablet, oral 15mg Parke-Davis

Brand(s)Serax capsule, oral 10,15,30mg FauldingZaxopam @ capsule, oral 10,15,30mg QuantumSerax tablet, oral 15mg Faulding

OXTRIPHYLLINEOxtriphylline @ solution, oral 100mg/5ml Morton Grove

@ syrup, oral 50mg/5ml Morton Grove@ tablet, delayed release 100,200mg Circa *

Brand(s)Choledyl @ solution, oral 100mg/5ml Parke-DavisCholedyl @ syrup, oral 50mg/5ml Parke-DavisCholedyl @ tablet, delayed release 100,200mg Parke-Davis *

* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as anexception to the promulgated criteria for inclusion, pursuant to Rule 790.60.

OXYBUTYNIN CHLORIDEOxybutynin Chloride syrup, oral 5mg/5ml Mikart

syrup, oral 5mg/5ml Morton Grovesyrup, oral 5mg/5ml Novexsyrup, oral 5mg/5ml Pharmaceutical Associatessyrup, oral 5mg/5ml Silarx

@ tablet, oral 5mg Circa@ tablet, oral 5mg Quantum

tablet, oral 5mg Sidmaktablet, oral 5mg USLtablet, oral 5mg Vintage

Brand(s)Ditropan syrup, oral 5mg/5ml AlzaDitropan tablet, oral 5mg Alza

OXYCODONE HYDROCHLORIDE; ACETAMINOPHENSee ACETAMINOPHEN; OXYCODONE HYDROCHLORIDE

OXYCODONE HYDROCHLORIDE; ASPIRIN; OXYCODONE TEREPHTHALATESee ASPIRIN; OXYCODONE HYDROCHLORIDE; OXYCODONE TEREPHTHALATE

OXYCODONE TEREPHTHALATE; ASPIRIN; OXYCODONE HYDROCHLORIDESee ASPIRIN; OXYCODONE HYDROCHLORIDE; OXYCODONE TEREPHTHALATE

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

157

OXYTETRACYCLINE HYDROCHLORIDEOxytetracycline Hydrochloride @ capsule, oral eq 250mg base Impax

@ capsule, oral eq 250mg base Proter@ capsule, oral eq 250mg base Purepac@ capsule, oral eq 250mg base West-ward

Brand(s)Oxy-Kesso-Tetra @ capsule, oral eq 250mg base FerranteTerramycin capsule, oral eq 250mg base Pfizer

OXYTOCINOxytocin injection 10 USP U/ml American Pharmaceutical

Partners@ injection 10 USP U/ml Wyeth-Ayerst

Brand(s)Pitocin injection 10 USP U/ml ParkdaleSyntocinon injection 10 USP U/ml Novartis

PACLITAXELPaclitaxel injection 6mg/ml Baker Norton

injection 6mg/ml IVAXinjection 6mg/ml Mylan

Brand(s)Taxol injection 6mg/ml Bristol-Myers Squibb

PANCURONIUM BROMIDEPancuronium Bromide injection 1,2mg/ml Abbott

@ injection 1,2mg/ml Astra Zenecainjection 1,2mg/ml Elkins-Sinninjection 1,2mg/ml Gensia Sicor

@ injection 1,2mg/ml QuadBrand(s)

Pavulon injection 1,2mg/ml Organon/Akzona

PAROMOMYCIN SULFATEParomomycin Sulfate capsule, oral eq 250mg base Caraco

Brand(s)Humatin capsule, oral eq 250mg base Parkdale

PEMOLINEPemoline tablet, chewable 37.5mg Amide

tablet, chewable 37.5mg Copleytablet, oral 18.75,37.5,75mg Amidetablet, oral 18.75,37.5,75mg Copleytablet, oral 18.75,37.5,75mg Genevatablet, oral 18.75,37.5,75mg Vintagetablet, oral 18.75,37.5,75mg Watson

Brand(s)Cylert tablet, chewable 37.5mg AbbottCylert tablet, oral 18.75,37.5,75mg Abbott

PENICILLIN G POTASSIUMPenicillin G Potassium @ injection 1,000,000, 5,000,000, Apothecon

10,000,000, 20,000,000U/vial

(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

158

PENICILLIN G POTASSIUM (continued)@ injection 500,000, 1,000,000, Consolidated

5,000,000, 10,000,000U/vial@ injection 500,000, 1,000,000, Lilly/Dista

5,000,000, 20,000,000U/vialinjection 1,000,000, 5,000,000, Marsam 10,000,000, 20,000,000U/vial

@ injection 1,000,000, 5,000,000U/vial Parke-Davis@ powder for suspension 200,000, Mylan

250,000, 400,000U/5ml@ powder for suspension 250,000, Purepac

400,000U/5ml@ powder for suspension 200,000, Teva

250,000, 400,000U/5ml@ tablet, oral 400,000U IVAX@ tablet, oral 250,000U Lilly/Dista@ tablet, oral 200,000, 250,000, 400,000, Mylan

500,000, 800,000U@ tablet, oral 200,000, 250,000, Purepac

400,000U@ tablet, oral 200,000, 250,000, 400,000, Teva

500,000Utablet, oral 200,000, 250,000, Wyeth-Ayerst 400,000U

Brand(s)Pfizerpen injection 1,000,000, 5,000,000, Pfizer

20,000,000U/vialPentids 200 @ powder for suspension 200,000U/5ml ApotheconPentids 400 @ powder for suspension 400,000U/5ml ApotheconPfizerpen-G @ powder for suspension 400,000U/5ml PfizerPentids 200 @ tablet, oral 200,000U ApotheconPentids 250 @ tablet, oral 250,000U ApotheconPentids 400 @ tablet, oral 400,000U ApotheconPentids 800 @ tablet, oral 800,000U ApotheconPfizerpen-G @ tablet, oral 200,000, 250,000, 400,000, Pfizer

800,000U

PENICILLIN G PROCAINEPenicillin G Procaine @ injection 300,000U/ml Consolidated

@ injection 300,000U/ml Parke-DavisBrand(s)

Duracillin A.S. @ injection 300,000U/ml LillyPfizerpen-AS @ injection 300,000, 600,000U/ml PfizerWycillin injection 300,000, 600,000U/ml King

PENICILLIN V POTASSIUMPenicillin V Potassium powder for solution eq 125, Clonmel

250mg base/5mlpowder for solution eq 125, Consolidated 250mg base/5ml

@ powder for solution eq 125, Mylan 250mg base/5ml

@ powder for solution eq 125, Purepac 250mg base/5mlpowder for solution eq 125, Teva 250mg base/5mltablet, oral eq 250,500mg base Biochemietablet, oral eq 250,500mg base Clonmel

(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

159

PENICILLIN V POTASSIUM (continued)tablet, oral eq 250,500mg base Consolidated

@ tablet, oral eq 125,250,500mg base IVAX@ tablet, oral eq 250,500mg base Mylan@ tablet, oral eq 125,250,500mg base Purepac

tablet, oral eq 250,500mg base TevaBrand(s)

Beepen-VK powder for solution eq 125, SmithKline Beecham 250mg base/5ml

Betapen-VK @ powder for solution eq 125, Apothecon 250mg base/5ml

Ledercillin VK powder for solution eq 125, Lederle 250mg base/5ml

Pen-Vee K powder for solution eq 125, Wyeth-Ayerst 250mg base/5ml

Penapar-VK @ powder for solution eq 125, Parke-Davis 250mg base/5ml

Pfizerpen-VK @ powder for solution eq 125, Pfizer 250mg base/5ml

V-Cillin K @ powder for solution eq 125, Lilly 250mg base/5ml

Veetids 125 powder for solution Apothecon eq 125mg base/5ml

Veetids 250 powder for solution Apothecon eq 250mg base/5ml

Beepen-VK tablet, oral eq 250,500mg base SmithKline BeechamBetapen-VK tablet, oral eq 250,500mg base BristolLedercillin VK tablet, oral eq 250,500mg base LederlePen-Vee K @ tablet, oral eq 125mg base Wyeth-AyerstPen-Vee K tablet, oral eq 250,500mg base Wyeth-AyerstPenapar-VK @ tablet, oral eq 250,500mg base Parke-DavisPfizerpen-VK @ tablet, oral eq 250,500mg base PfizerUticillin VK tablet, oral eq 250mg base Pharmacia & UpjohnUticillin VK @ tablet, oral eq 500mg base Pharmacia & UpjohnV-Cillin K @ tablet, oral eq 125,250,500mg base LillyVeetids 250 tablet, oral eq 250mg base ApotheconVeetids 500 tablet, oral eq 500mg base Apothecon

PENTAMIDINE ISETHIONATEPentamidine Isethionate injection 300mg/vial Abbott

injection 300mg/vial Elkins-Sinninjection 300mg/vial Steris

Brand(s)Pentacarinat @ injection 300mg/vial ArmourPentam 300 injection 300mg/vial American Pharmaceutical

Partners

PENTAZOCINE HYDROCHLORIDE; ACETAMINOPHENSee NALOXONE HYDROCHLORIDE; ACETAMINOPHEN

PENTAZOCINE HYDROCHLORIDE; NALOXONE HYDROCHLORIDESee NALOXONE HYDROCHLORIDE; PENTAZOCINE HYDROCHLORIDE

PENTOBARBITAL SODIUMPentobarbital Sodium @ capsule, oral 100mg Anabolic

@ capsule, oral 100mg Elkins-Sinn(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

160

PENTOBARBITAL SODIUM (continued)@ capsule, oral 100mg Eon@ capsule, oral 100mg Everylife@ capsule, oral 100mg Halsey

capsule, oral 100mg ICN@ capsule, oral 50,100mg IVAX@ capsule, oral 50,100mg Lannett@ capsule, oral 100mg Parke-Davis@ capsule, oral 100mg Perrigo@ capsule, oral 100mg Purepac@ capsule, oral 100mg Watson@ capsule, oral 100mg Whiteworth Towne@ capsule, oral 100mg Wyeth-Ayerst@ injection 50mg/ml Elkins-Sinn

injection 50mg/ml Wyeth-Ayerst@ tablet, oral 100mg Anabolic@ tablet, oral 100mg Eon

Brand(s)Nembutal Sodium @ capsule, oral 50mg AbbottNembutal Sodium capsule, oral 100mg AbbottNembutal Sodium injection 50mg/ml Abbott

PENTOXIFYLLINEPentoxifylline tablet, extended release 400mg Biovail

tablet, extended release 400mg ESI-Lederletablet, extended release 400mg Impaxtablet, extended release 400mg Mylantablet, extended release 400mg Purepactablet, extended release 400mg Sidmaktablet, extended release 400mg Tevatablet, extended release 400mg TorPharmtablet, extended release 400mg Watsontablet, extended release 400mg Upsher-Smith

Brand(s)Trental tablet, extended release 400mg Aventis *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

PERMETHRINPermethrin cream, topical 5% Alpharma

Brand(s)Elimite cream, topical 5% Glaxo Wellcome

PERPHENAZINEPerphenazine tablet, oral 2,4,8,16mg Geneva

tablet, oral 2,4,8,16mg IVAXtablet, oral 2,4,8,16mg Vintage

Brand(s)Trilafon tablet, oral 2,4,8,16mg Schering *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

PERPHENAZINE; AMITRIPTYLINE HYDROCHLORIDESee AMITRIPTYLINE HYDROCHLORIDE; PERPHENAZINE

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

161

PHENDIMETRAZINE TARTRATEPhendimetrazine Tartrate capsule, oral 35mg Eon

@ tablet, oral 35mg Anabolic@ tablet, oral 35mg Barr

tablet, oral 35mg Eon@ tablet, oral 35mg Ferndale@ tablet, oral 35mg Geneva@ tablet, oral 35mg Inwood/Forest@ tablet, oral 35mg IVAX@ tablet, oral 35mg KV@ tablet, oral 35mg Manufacturing Chemists@ tablet, oral 35mg Mikart@ tablet, oral 35mg Private Formulations@ tablet, oral 35mg Solvay@ tablet, oral 35mg Watson

Brand(s)Phenazine @ capsule, oral 35mg MastSPRX-3 @ capsule, oral 35mg SolvayStatobex @ capsule, oral 35mg TevaX-Trozine capsule, oral 35mg Shire RichwoodAdphen @ tablet, oral 35mg FerndaleAlphazine @ tablet, oral 35mg EonBontril PDM tablet, oral 35mg AmarinCam-Metrazine tablet, oral 35mg ABCDi-Metrex @ tablet, oral 35mg Private FormulationsMelfiat @ tablet, oral 35mg NumarkMetra @ tablet, oral 35mg ForestObezine @ tablet, oral 35mg USLPhenazine @ tablet, oral 35mg MastPhenazine-35 @ tablet, oral 35mg ABCPlegine @ tablet, oral 35mg Wyeth-AyerstStatobex @ tablet, oral 35mg TevaStatobex-G @ tablet, oral 35mg TevaX-Trozine tablet, oral 35mg Shire Richwood

PHENIRAMINE MALEATE; NAPHAZOLINE HYDROCHLORIDESee NAPHAZOLINE HYDROCHLORIDE; PHENIRAMINE MALEATE

PHENOBARBITAL Phenobarbital elixir, oral 20mg/5ml Alpharma *

elixir, oral 20mg/5ml Cenci *elixir, oral 20mg/5ml Halsey *elixir, oral 20mg/5ml Lilly *elixir, oral 20mg/5ml Naska *

* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as anexception to the promulgated criteria for inclusion, pursuant to Rule 790.60.

PHENOBARBITAL; ATROPINE SULFATE; HYOSCYAMINE; SCOPALAMINE HYDROBROMIDESee ATROPINE SULFATE; HYOSCYAMINE; PHENOBARBITAL; SCOPALAMINE HYDROBROMIDE

PHENTERMINE HYDROCHLORIDEPhentermine Hydrochloride capsule, oral 15,30,37.5mg ABC

capsule, oral 30,37.5mg Amide@ capsule, oral 30mg Duramed

capsule, oral 15,30mg Eon(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

162

PHENTERMINE HYDROCHLORIDE (continued)@ capsule, oral 30mg IVAX

capsule, oral 30mg King@ capsule, oral 30mg Lannett@ capsule, oral 30mg Teva

capsule, oral 30mg USL@ capsule, oral 30mg Watson

tablet, oral 8,37.5mg ABCtablet, oral 37.5mg Amide

@ tablet, oral 8mg Eon@ tablet, oral 8mg IVAX

tablet, oral 37.5mg Purepactablet, oral 8,37.5mg USL

@ tablet, oral 8mg WatsonBrand(s)

Adipex P capsule, oral 37.5mg TevaDapex-37.5 @ capsule, oral 37.5mg EonFastin @ capsule, oral 30mg SmithKline BeechamObestin-30 @ capsule, oral 30mg FerndaleOby-Trim @ capsule, oral 30mg Shire RichwoodOna-Mast capsule, oral 30mg MastAdipex P tablet, oral 37.5mg TevaOna-Mast tablet, oral 8mg MastTora @ tablet, oral 8mg Solvay

PHENTERMINE RESIN COMPLEXPhentermine Resin Complex @ capsule, slow release 30mg Quantum

Brand(s)Ionamin-30 capsule, slow release 30mg Fisons

PHENTOLAMINE MESYLATEPhentolamine Mesylate injection 5mg/ml Bedford

Brand(s)Regitine injection 5mg/ml Novartis

PHENYLEPHRINE HYDROCHLORIDEPhenylephrine Hydrochloride solution, ophthalmic 2.5% Paco *

solution, ophthalmic 10% Iolab *Brand(s)

AK-Dilate solution, ophthalmic 2.5,10% Akorn *I-Phrine solution, ophthalmic 2.5,10% International Pharm *Mydfrin solution, ophthalmic 2.5% Alcon *Neo-Synephrine solution, ophthalmic 2.5,10% Sterling Winthrop *Phenoptic solution, ophthalmic 2.5% Optopics *

* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as anexception to the promulgated criteria for inclusion, pursuant to Rule 790.60.

PHENYLEPHRINE HYDROCHLORIDE; CHLORPHENIRAMINE MALEATE; PHENYLPROPANOLAMINEHYDROCHLORIDE; PHENYLTOLOXAMINE CITRATE

See CHLORPHENIRAMINE MALEATE; PHENYLEPHRINE HYDROCHLORIDE;PHENYLPROPANOLAMINE HYDROCHLORIDE; PHENYLTOLOXAMINE CITRATE

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

163

PHENYLEPHRINE TANNATE; CHLORPHENIRAMINE TANNATE; PYRILAMINE TANNATESee CHLORPHENIRAMINE TANNATE; PHENYLEPHRINE TANNATE; PYRILAMINE TANNATE

PHENYLEPHRINE HYDROCHLORIDE; CODEINE PHOSPHATE; PROMETHAZINE HYDROCHLORIDESee CODEINE PHOSPHATE; PHENYLEPHRINE HYDROCHLORIDE; PROMETHAZINE

HYDROCHLORIDE

PHENYLEPHRINE HYDROCHLORIDE; GUAIFENESIN; PHENYLPROPANOLAMINE HYDROCHLORIDESee GUAIFENESIN; PHENYLEPHRINE HYDROCHLORIDE; PHENYLPROPANOLAMINE

HYDROCHLORIDE

PHENYLEPHRINE HYDROCHLORIDE; PROMETHAZINE HYDROCHLORIDEPhenylephrine Hydrochloride; @ syrup, oral 5mg/5ml;6.25mg/5ml Cenci Promethazine Hydrochloride syrup, oral 5mg/5ml;6.25mg/5ml Morton Grove

Brand(s)Phenergan VC syrup, oral 5mg/5ml;6.25mg/5ml Wyeth-AyerstPherazine VC @ syrup, oral 5mg/5ml;6.25mg/5ml HalseyPrometh VC Plain syrup, oral 5mg/5ml;6.25mg/5ml Alpharma

PHENYLPROPANOLAMINE HYDROCHLORIDE; BROMPHENIRAMINE MALEATESee BROMPHENIRAMINE MALEATE; PHENYLPROPANOLAMINE HYDROCHLORIDE

PHENYLPROPANOLAMINE HYDROCHLORIDE; BROMPHENIRAMINE MALEATE; CODEINE PHOSPHATESee BROMPHENIRAMINE MALEATE; CODEINE PHOSPHATE; PHENYLPROPANOLAMINE

HYDROCHLORIDE

PHENYLPROPANOLAMINE HYDROCHLORIDE; CHLORPHENIRAMINE MALEATESee CHLORPHENIRAMINE MALEATE; PHENYLPROPANOLAMINE HYDROCHLORIDE

PHENYLPROPANOLAMINE HYDROCHLORIDE; CHLORPHENIRAMINE MALEATE; PHENYLEPHRINEHYDROCHLORIDE; PHENYLTOLOXAMINE CITRATE

See CHLORPHENIRAMINE MALEATE; PHENYLEPHRINE HYDROCHLORIDE;PHENYLPROPANOLAMINE HYDROCHLORIDE; PHENYLTOLOXAMINE CITRATE

PHENYLPROPANOLAMINE HYDROCHLORIDE; GUAIFENESIN; PHENYLEPHRINE HYDROCHLORIDESee GUAIFENESIN; PHENYLEPHRINE HYDROCHLORIDE; PHENYLPROPANOLAMINE

HYDROCHLORIDE

PHENYLPROPANOLAMINE HYDROCHLORIDE; HYDROCODONE BITARTRATESee HYDROCODONE BITARTRATE; PHENYLPROPANOLAMINE HYDROCHLORIDE

PHENYLTOLOXAMINE CITRATE; CHLORPHENIRAMINE MALEATE; PHENYLEPHRINEHYDROCHLORIDE; PHENYLPROPANOLAMINE HYDROCHLORIDE

See CHLORPHENIRAMINE MALEATE; PHENYLEPHRINE HYDROCHLORIDE;PHENYLPROPANOLAMINE HYDROCHLORIDE; PHENYLTOLOXAMINE CITRATE

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

164

PHENYTOINPhenytoin suspension, oral 125mg/5ml Alpharma

suspension, oral 125mg/5ml UDLBrand(s)

Dilantin-125 suspension, oral 125mg/5ml Parke-Davis

PHENYTOIN SODIUMPhenytoin Sodium injection 50mg/ml Abbott

@ injection 50mg/ml American Pharmaceutical Partners

injection 50mg/ml Elkins-Sinn@ injection 50mg/ml Marsam@ injection 50mg/ml Smith and Nephew@ injection 50mg/ml Solopak@ injection 50mg/ml Steris@ injection 50mg/ml Warner Chilcott

Brand(s)Dilantin injection 50mg/ml Parke-Davis

PILOCARPINE HYDROCHLORIDEPilocarpine Hydrochloride solution, ophthalmic 0.5,1,2,3,4,6% Optopics *

solution, ophthalmic 1,2,4,6% Paco *solution, ophthalmic 0.5,1,2,4,6% Pharmafair *solution, ophthalmic 1,2,3,4% Steris *

Brand(s)Adsorbocarpine solution, ophthalmic 1,2,4,8% Alcon *AKarpine solution, ophthalmic 1,2,3,4% Akorn *Isopto Carpine solution, ophthalmic 0.5,1,2,3,4,6,8, Alcon * **

10%Pilocar solution, ophthalmic 0.5,1,2,4,6% Iolab *

* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as anexception to the promulgated criteria for inclusion, pursuant to Rule 790.60.

** Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

PINDOLOLPindolol tablet, oral 5,10mg Geneva

tablet, oral 5,10mg GenPharmtablet, oral 5,10mg IVAXtablet, oral 5,10mg Martectablet, oral 5,10mg Mutualtablet, oral 5,10mg Mylantablet, oral 5,10mg Purepactablet, oral 5,10mg Roycetablet, oral 5,10mg Teva

Brand(s)Visken tablet, oral 5,10mg Novartis

PIPERAZINE CITRATEPiperazine Citrate @ syrup, oral eq 500mg base/5ml Alpharma

@ syrup, oral eq 500mg base/5ml Lannettsyrup, oral eq 500mg base/5ml Luitpold

(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

165

PIPERAZINE CITRATE (continued on the next page)Brand(s)

Antepar @ syrup, oral eq 500mg base/5ml Glaxo WellcomeBryrel @ syrup, oral eq 500mg base/5ml Sanofi SynthelaboMultifuge syrup, oral eq 500mg base/5ml BlulineVermidol @ syrup, oral eq 500mg base/5ml Solvay

PIROXICAMPiroxicam capsule, oral 10,20mg Copley

capsule, oral 10,20mg Danburycapsule, oral 10,20mg Egiscapsule, oral 10,20mg GenPharmcapsule, oral 10,20mg IVAXcapsule, oral 10,20mg Mephacapsule, oral 10,20mg Mutualcapsule, oral 10,20mg Mylan

@ capsule, oral 10,20mg Roxanecapsule, oral 10,20mg Roycecapsule, oral 10,20mg SCScapsule, oral 10,20mg Teva

Brand(s)Feldene capsule, oral 10,20mg Pfizer

POLYETHYLENE GLYCOL 3350; POTASSIUM CHLORIDE; SODIUM BICARBONATE; SODIUMCHLORIDE; SODIUM SULFATE, ANHYDROUS

Brand(s)Co-Lav powder for reconstitution, oral Copley

240gm/bottle;2.98gm/bottle; 6.72gm/bottle;5.84gm/bottle; 22.72gm/bottle

Colovage powder for reconstitution, oral Dynapharm 227.1gm/packet;2.82gm/packet; 6.36gm/packet;5.53gm/packet; 21.5gm/packet

Colyte powder for reconstitution, oral Schwarz * 227.1gm/bottle;2.82gm/bottle; 6.36gm/bottle;5.53gm/bottle; 21.5gm/bottle

Colyte powder for reconstitution, oral Schwarz * 240gm/bottle;2.98gm/bottle; 6.72gm/bottle;5.84gm/bottle; 22.72gm/bottle

Colyte-Flavored powder for reconstitution, oral Schwarz * 227.1gm/bottle;2.82gm/bottle; 6.36gm/botlet;5.53gm/bottle; 21.5gm/bottle

Colyte-Flavored powder for reconstitution, oral Schwarz * 240gm/bottle;2.98gm/bottle; 6.72gm/bottle;5.84gm/bottle; 22.72gm/bottle

E-Z-EM Prep Lyte powder for reconstitution, oral E Z EM 236gm/bottle;2.97gm/bottle; 6.74gm/bottle;5.86gm/bottle; 22.74gm/bottle

Glycoprep powder for reconstitution, oral Goldline 236gm/bottle;2.97gm/bottle; 6.74gm/bottle;5.86gm/bottle; 22.74gm/bottle

(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

166

POLYETHYLENE GLYCOL 3350; POTASSIUM CHLORIDE; SODIUM BICARBONATE; SODIUMCHLORIDE; SODIUM SULFATE, ANHYDROUS (continued)

Go-Evac powder for reconstitution, oral Copley 236gm/bottle;2.97gm/bottle; 6.74gm/bottle;5.86gm/bottle; 22.74gm/bottle

Golytely powder for reconstitution, oral Braintree 236gm/bottle;2.97gm/bottle; 6.74gm/bottle;5.86gm/bottle; 22.74gm/bottle

Golytely powder for reconstitution, oral Braintree 227.1gm/packet;2.82gm/packet; 6.36gm/packet;5.53gm/packet; 21.5gm/packet

PEG-Lyte powder for reconstitution, oral Invamed 236gm/bottle;2.97gm/bottle; 6.74gm/bottle;5.86gm/bottle; 22.74gm/bottle

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

POLYMYXIN B SULFATEPolymyxin B Sulfate injection eq 500,000 U base/vial Bedford

injection eq 500,000 U base/vial Pharma Tek@ powder for compounding Paddock

100,000,000U/bottleBrand(s)

Aerosporin injection eq 500,000 U base/vial Glaxo WellcomePoly-Rx powder for compounding Pharma Tek

100,000,000U/bottle

POLYMYXIN B SULFATE; BACITRACIN; HYDROCORTISONE ACETATE; NEOMYCIN SULFATESee BACITRACIN; HYDROCORTISONE ACETATE; NEOMYCIN SULFATE; POLYMYXIN B SULFATE

POLYMYXIN B SULFATE; BACITRACIN ZINCSee BACITRACIN ZINC; POLYMYXIN B SULFATE

POLYMYXIN B SULFATE; BACITRACIN ZINC; HYDROCORTISONE; NEOMYCIN SULFATESee BACITRACIN ZINC; HYDROCORTISONE; NEOMYCIN SULFATE; POLYMYXIN B SULFATE

POLYMYXIN B SULFATE; BACITRACIN ZINC; NEOMYCIN SULFATESee BACITRACIN ZINC; NEOMYCIN SULFATE: POLYMYXIN B SULFATE

POLYMYXIN B SULFATE; DEXAMETHASONE; NEOMYCIN SULFATESee DEXAMETHASONE; NEOMYCIN SULFATE; POLYMYXIN B SULFATE

POLYMYXIN B SULFATE; GRAMICIDIN; NEOMYCIN SULFATESee GRAMICIDIN; NEOMYCIN SULFATE; POLYMYXIN B SULFATE

POLYMYXIN B SULFATE; HYDROCORTISONESee HYDROCORTISONE; POLYMYXIN B SULFATE

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

167

POLYMYXIN B SULFATE; HYDROCORTISONE; NEOMYCIN SULFATESee HYDROCORTISONE; NEOMYCIN SULFATE; POLYMYXIN B SULFATE

POLYMYXIN B SULFATE; NEOMYCIN SULFATESee NEOMYCIN SULFATE; POLYMYXIN B SULFATE

POLYMYXIN B SULFATE; TRIMETHOPRIM SULFATEPolymyxin B Sulfate; solution, ophthalmic 10,000U/ml; Falcon * Trimethoprim Sulfate eq 1mg base/ml

solution, ophthalmic 10,000U/ml; Bausch and Lomb eq 1mg base/mlsolution, ophthalmic 10,000U/ml; Taylor eq 1mg base/ml

Brand(s)Polytrim solution, ophthalmic 10,000U/ml Allergan *

eq 1mg base/ml

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

POTASSIUM BICARBONATEPotassium Bicarbonate tablet, effervescent 25mEq Bajamar *

tablet, effervescent 25mEq Copley *Brand(s)

Effer-K tablet, effervescent 25mEq Nomax *K + Care ET tablet, effervescent 25mEq Alra *Klor-Con EF tablet, effervescent 25mEq CFH *K-Lyte tablet, effervescent 25mEq Mead Johnson/Bristol-Myers *

* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as anexception to the promulgated criteria for inclusion, pursuant to Rule 790.60.

POTASSIUM CHLORIDEPotassium Chloride capsule, extended release KV

10mEq (750mg)capsule, extended release Teva 8mEq (600mg),10mEq (750mg)

@ injection 1mEq/ml Abbottinjection 2mEq/ml Abbott

@ injection 2mEq/ml Akorninjection 2,3mEq/ml American Pharmaceutical

Partnersinjection 2mEq/ml Baxterinjection 2mEq/ml Braun

@ injection 2mEq/ml Elkins-Sinninjection 2mEq/ml International Medication

@ injection 2mEq/ml Lillyinjection 2mEq/ml Luitpold

@ injection 1,2,3mEq/ml Milesinjection 4mEq/ml Milesinjection 2mEq/ml Pharma Serve

@ injection 1,2,3,4mEq/ml Searle@ injection 2,3mEq/ml Steris

(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

168

POTASSIUM CHLORIDE (continued)@ injection, in plastic container Abbott@ 14.9mg/ml (10mEq)@ 745mg/100ml (10mEq)

29.8mg/ml (20mEq)@ 1.49gm/100ml (20mEq)

2.24gm/100ml (30mEq) 2.98gm/100ml (40mEq)injection, in plastic container 2mEq/ml American Pharmaceutical

Partnersinjection, in plastic container Baxter 14.9mg/ml (10mEq) 746mg/100ml (10mEq) 1.49gm/100ml (20mEq) 29.8mg/ml (20mEq) 2.24gm/100ml (30mEq) 2.98gm/100ml (40mEq)powder, oral 20mEq/packet Bajamar *powder, oral 20mEq/packet Copley *solution, oral 1500mg/15ml Alpharma * (20mEq/15ml,10%)

(sugar-free) solution, oral 1500mg/15ml Alpharma * (20mEq/15ml,10%)

(sugar-free) solution, oral 3000mg/15ml Alpharma * (40mEq/15ml,20%)solution, oral 1500mg/15ml Halsey * (20mEq/15ml,10%)solution, oral 1500mg/15ml Morton Grove * (20mEq/15ml,10%)

(sugar free) solution, oral 1500mg/15ml Morton Grove * (20mEq/15ml,10%)

(sugar free) solution, oral 3000mg/15ml Morton Grove * (40mEq/15ml,20%)

(sugar-free) solution, oral 1500mg/15ml Naska * (20mEq/15ml,10%)

(sugar-free) solution, oral 3000mg/15ml Naska * (40mEq/15ml,20%)solution, oral 1500mg/15ml Norton * (20mEq/15ml,10%)

(sugar-free) solution, oral 1500mg/15ml Norton * (20mEq/15ml,10%)

(sugar-free) solution, oral 3000mg/15ml Norton * (40mEq/15ml,20%)tablet, extended release Copley 8mEq (600mg)

Brand(s)K Lease @ capsule, extended release Savage

8,10mEq (600,750mg)Micro-K capsule, extended release KV

8mEq (600mg)Micro-K 10 capsule, extended release KV

10mEq (750mg)Gen-K powder, oral 20mEq/packet Howard Food/USA American *K + Care powder, oral 20mEq/packet Alra *K-Lor powder, oral 20mEq/packet Abbott *Kato powder, oral 20mEq/packet ICN *Kay Ciel powder, oral 20mEq/packet Forest *Klor-Con powder, oral 20mEq/packet Upsher-Smith *Cena-K solution, oral 1500mg/15ml Century * (sugar-free) (20mEq/15ml,10%)

(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

169

POTASSIUM CHLORIDE (continued)EM-K-10% solution, oral 1500mg/15ml Econo Med * (sugar-free) (20mEq/15ml,10%)Kaochlor 10% solution, oral 1500mg/15ml Pharmacia & Upjohn *

(20mEq/15ml,10%)Kaochlor SF solution, oral 1500mg/15ml Pharmacia & Upjohn *

(20mEq/15ml,10%)Kay Ciel solution, oral 1500mg/15ml Forest/Inwood * (sugar-free) (20mEq/15ml,10%)Klor-10% solution, oral 1500mg/15ml Upsher-Smith * (sugar-free) (20mEq/15ml,10%)Klorvess 10% solution, oral 1500mg/15ml Novartis *

(20mEq/15ml,10%)Potsalan solution, oral 1500mg/15ml Pharmacia & Upjohn * (sugar-free) (20mEq/15ml,10%)Kaon-Cl 20% solution, oral 3000mg/15ml Pharmacia & Upjohn * (sugar-free) (40mEq/15ml,20%)Klor Con 20% solution, oral 3000mg/15ml Upsher-Smith *

(40mEq/15ml,20%)K + 8 tablet, extended release Alra

8mEq (600mg)Klor-Con tablet, extended release Upsher-Smith

8mEq (600mg)Slow K tablet, extended release Novartis

8mEq (600mg)K-Dur tablet, extended release Schering/Key **

10mEq (750mg)Klor-Con M10 tablet, extended release Upsher-Smith

10mEq (750mg)K-Dur tablet, extended release Schering/Key **

20mEq (1500mg)Klor-Con M20 tablet, extended release Upsher-Smith

20mEq (1500mg)

Products containing sugar shall not be interchanged with sugar-free products without verification of thediabetic status of the patient.

* Some oral potassium chloride solutions, powders for solutions and extended release capsules were reviewedby the Technical Advisory Council and admitted to the Illinois Formulary as an exception to the promulgatedcriteria for inclusion, pursuant to Section 790.60.

** Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

POTASSIUM CHLORIDE; CALCIUM CHLORIDE; DEXTROSE; GLUTATHIONE DISULFIDE; MAGNESIUMCHLORIDE; SODIUM BICARBONATE; SODIUM CHLORIDE; SODIUM PHOSPHATE

See CALCIUM CHLORIDE; DEXTROSE; GLUTATHIONE DISULFIDE; MAGNESIUM CHLORIDE;POTASSIUM CHLORIDE; SODIUM BICARBONATE; SODIUM CHLORIDE; SODIUMPHOSPHATE

POTASSIUM CHLORIDE; CALCIUM CHLORIDE; DEXTROSE; SODIUM CHLORIDESee CALCIUM CHLORIDE; DEXTROSE; POTASSIUM CHLORIDE; SODIUM CHLORIDE

POTASSIUM CHLORIDE; CALCIUM CHLORIDE; DEXTROSE; SODIUM CHLORIDE; SODIUM LACTATESee CALCIUM CHLORIDE; DEXTROSE; POTASSIUM CHLORIDE; SODIUM CHLORIDE; SODIUM

LACTATE

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

170

POTASSIUM CHLORIDE; CALCIUM CHLORIDE; MAGNESIUM CHLORIDE; SODIUM CHLORIDESee CALCIUM CHLORIDE; MAGNESIUM CHLORIDE; POTASSIUM CHLORIDE; SODIUM CHLORIDE

POTASSIUM CHLORIDE; CALCIUM CHLORIDE; SODIUM CHLORIDESee CALCIUM CHLORIDE; POTASSIUM CHLORIDE; SODIUM CHLORIDE

POTASSIUM CHLORIDE; CALCIUM CHLORIDE; SODIUM CHLORIDE; SODIUM LACTATESee CALCIUM CHLORIDE; POTASSIUM CHLORIDE; SODIUM CHLORIDE; SODIUM LACTATE

POTASSIUM CHLORIDE; DEXTROSESee DEXTROSE; POTASSIUM CHLORIDE

POTASSIUM CHLORIDE; DEXTROSE; MAGNESIUM CHLORIDE; SODIUM ACETATE; SODIUM CHLORIDE;SODIUM GLUCONATE

See DEXTROSE; MAGNESIUM CHLORIDE; POTASSIUM CHLORIDE; SODIUM ACETATE; SODIUMCHLORIDE; SODIUM GLUCONATE

POTASSIUM CHLORIDE; DEXTROSE; SODIUM CHLORIDESee DEXTROSE; POTASSIUM CHLORIDE; SODIUM CHLORIDE

POTASSIUM CHLORIDE; MAGNESIUM CHLORIDE; SODIUM ACETATE; SODIUM CHLORIDE;SODIUM GLUCONATE

See MAGNESIUM CHLORIDE; POTASSIUM CHLORIDE; SODIUM ACETATE; SODIUM CHLORIDE;SODIUM GLUCONATE

POTASSIUM CHLORIDE; SODIUM CHLORIDEPotassium Chloride; injection 149mg/100ml (0.149%); Abbott Sodium Chloride 900mg/100ml (0.9%)

injection 298mg/100ml (0.298%); Abbott 900mg/100ml (0.9%)

@ injection 75mg/100ml(0.075%); Baxter 900mg/100ml(0.9%)injection 150mg/100ml(0.15%); Baxter 900mg/100ml(0.9%)injection 300mg/100ml(0.3%); Baxter 900mg/100ml(0.9%)

@ injection 75mg/100ml(0.075%); Braun 900mg/100ml(0.9%)injection 150mg/100ml(0.15%); Braun 900mg/100ml(0.9%)injection 300mg/100ml(0.3%); Braun 900mg/100ml(0.9%)

POTASSIUM GLUCONATEPotassium Gluconate elixir, oral 4.68gm/15ml Alpharma *

(20mEq/15ml,10%)elixir, oral 4.68gm/15ml Naska * (20mEq/15ml,10%)elixir, oral 4.68gm/15ml Morton Grove * (20mEq/15ml,10%)

(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

171

POTASSIUM GLUCONATE (continued)elixir, oral 4.68gm/15ml Newton * (20mEq/15ml,10%)elixir, oral 4.68gm/15ml Pharmaceutical Associates * (20mEq/15ml,10%)elixir, oral 4.68gm/15ml SteriMed * (20mEq/15ml,10%)

Brand(s)Kaon 10% elixir, oral 4.68gm/15ml Pharmacia & Upjohn *

(20mEq/15ml,10%)

* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as anexception to the promulgated criteria for inclusion, pursuant to Rule 790.60.

PRALIDOXIME CHLORIDEPralidoxime Chloride @ injection 1gm/vial Quad

Brand(s)Protopam injection 1gm/vial Wyeth-Ayerst

PRAMOXINE HYDROCHLORIDE; HYDROCORTISONE ACETATESee HYDROCORTISONE ACETATE; PRAMOXINE HYDROCHLORIDE

PRAZOSIN HYDROCHLORIDEPrazosin Hydrochloride @ capsule, oral eq 1,2,5mg base American Therapeutics

capsule, oral eq 1,2,5mg base Danburycapsule, oral eq 1,2,5mg base Genevacapsule, oral eq 1,2,5mg base IVAXcapsule, oral eq 1,2,5mg base Lederlecapsule, oral eq 1,2,5mg base Mylan

@ capsule, oral eq 1,2,5mg base PurepacBrand(s) base

Minipress capsule, oral eq 1,2,5mg base Pfizer

PREDNISOLONEPrednisolone syrup, oral 15mg/5ml Copley

syrup, oral 15mg/5ml Halseysyrup, oral 5mg/5ml KVsyrup, oral 15mg/5ml UDL

Brand(s)Pre-Pred syrup, oral 15mg/5ml WEPrelone syrup, oral 5mg/5ml, 15mg/5ml Muro

PREDNISOLONE ACETATEBrand(s)

Econopred Plus suspension, ophthalmic 1% Falcon *Pred Forte suspension, ophthalmic 1% Allergan *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

PREDNISOLONE ACETATE; SULFACETAMIDE SODIUMBrand(s)

Metimyd ointment, ophthalmic 0.5%;10% ScheringPredsulfair @ ointment, ophthalmic 0.5%;10% Pharmafair

(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

172

PREDNISOLONE ACETATE; SULFACETAMIDE SODIUM (continued)Vasocidin ointment, ophthalmic 0.5%;10% NovartisBlephamide suspension, ophthalmic 0.2%;10% AllerganMetimyd suspension, ophthalmic 0.5%;10% ScheringPredamide @ suspension, ophthalmic 0.5%;10% AkornPredsulfair @ suspension, ophthalmic 0.5%;10% PharmafairPredsulfair II @ suspension, ophthalmic 0.2%;10% PharmafairSulphrin @ suspension, ophthalmic 0.5%;10% Bausch and Lomb

PREDNISOLONE SODIUM PHOSPHATEPrednisolone Sodium @ injection eq 20mg phosphate/ml Steris Phosphate @ solution, ophthalmic 0.125,1% Alcon Universal

(eq 0.11%, 0.9% phosphate)solution, ophthalmic 0.125,1% Bausch and Lomb (eq 0.11%, 0.9% phosphate)

@ solution, ophthalmic 0.125,1% Sola Barnes-Hind (eq 0.11%, 0.9% phosphate)

Brand(s)Hydeltrasol @ injection eq 20mg phosphate/ml Merck Sharp and DohmeAK-Pred @ solution, ophthalmic 0.125,1% Akorn

(eq 0.11%, 0.9% phosphate)Inflamase Mild solution, ophthalmic 0.125% Novartis

(eq 0.11% phosphate)Inflamase Forte solution, ophthalmic 1% Novartis

(eq 0.9% phosphate)Predair @ solution, ophthalmic 0.125% Pharmafair

(eq 0.11% phosphate)Predair Forte @ solution, ophthalmic 1% Pharmafair

(eq 0.9% phosphate)

PREDNISOLONE SODIUM PHOSPHATE; SULFACETAMIDE SODIUMPrednisolone Sodium Phosphate; solution, ophthalmic eq 0.23% Alcon Universal Sulfacetamide Sodium phosphate; 10%

solution, ophthalmic eq 0.23% Bausch and Lomb phosphate; 10%

Brand(s)Sulster @ solution, ophthalmic eq 0.23% Akorn

phosphate; 10%Vasocidin solution, ophthalmic eq 0.23% Novartis

phosphate; 10%

PREDNISONEPrednisone @ solution, oral 5mg/5ml Morton Grove

solution, oral 5mg/5ml Roxane@ tablet, oral 5,20,50mg Barr

tablet, oral 10mg Barrtablet, oral 5,10,20mg Danbury

@ tablet, oral 5,10,20mg Duramed@ tablet, oral 50mg Geneva

tablet, oral 10,20,50mg Geneva@ tablet, oral 5,10mg Halsey@ tablet, oral 5,10,20,50mg Heather@ tablet, oral 5mg Impax@ tablet, oral 5,10,20mg Interpharm

tablet, oral 5,10,20mg Mutualtablet, oral 5mg Private Formulations

@ tablet, oral 20mg Private Formulations(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

173

PREDNISONE (continued)@ tablet, oral 5,10,20mg Purepac

tablet, oral 1,2.5,5,10,20,50mg Roxane@ tablet, oral 25mg Roxane@ tablet, oral 5,10,20mg Superpharm@ tablet, oral 50mg Watson

tablet, oral 10,20,50mg Watsontablet, oral 5,10,20,50mg West-Ward

@ tablet, oral 10mg Whiteworth TowneBrand(s)

Deltasone tablet, oral 2.5,5,10,20,50mg Pharmacia & UpjohnMeticorten @ tablet, oral 1mg ScheringOrasone tablet, oral 1,5,10,20mg SolvayOrasone @ tablet, oral 50mg SolvayPrednicen-N @ tablet, oral 5mg Schwarz

PRIMIDONEPrimidone @ tablet, oral 250mg Circa

tablet, oral 250mg Danburytablet, oral 50,250mg Lannett

Brand(s)Mysoline tablet, oral 50,250mg Xcel

PROBENECIDProbenecid tablet, oral 500mg Danbury

tablet, oral 500mg IVAX@ tablet, oral 500mg Lederle

tablet, oral 500mg Mylan@ tablet, oral 500mg Watson

Brand(s)Benemid @ tablet, oral 500mg MerckProbalan tablet, oral 500mg Lannett

PROBENECID; AMPICILLINSee AMPICILLIN; PROBENECID

PROCAINAMIDE HYDROCHLORIDEProcainamide Hydrochloride @ capsule, oral 250,375,500mg (Ascot)

@ capsule, oral 250,500mg Circacapsule, oral 250,375,500mg Danburycapsule, oral 250,375,500mg Genevacapsule, oral 250,375,500mg IVAXcapsule, oral 250,500mg Lannett

@ capsule, oral 250,375,500mg Lederle@ capsule, oral 250,500mg Roxane@ capsule, oral 250,500mg (Vangard/MWM)@ capsule, oral 250,375,500mg Watson

injection 100,500mg/ml Abbott@ injection 100,500mg/ml American Pharmaceutical

Partnersinjection 100,500mg/ml Elkins-Sinninjection 100,500mg/ml International Medication

@ injection 100,500mg/ml Pharmafair@ injection 100,500mg/ml Quad@ injection 100,500mg/ml Smith and Nephew@ injection 500mg/ml Solopak

(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

174

PROCAINAMIDE HYDROCHLORIDE (continued)@ injection 100,500mg/ml Steris@ injection 100,500mg/ml Warner Chilcott@ tablet, extended release Circa

250,500,750,1000mgtablet, extended release Copley 500,750,1000mgtablet, extended release Danbury 250,500,750mg

@ tablet, extended release 500mg Forest/Inwoodtablet, extended release Geneva 250,500,750mgtablet, extended release 500mg Invamed

Brand(s)Procan @ capsule, oral 250,375,500mg Parke-DavisProcapan @ capsule, oral 250mg Panray/OrmontPronestyl capsule, oral 250,375,500mg ApotheconPronestyl injection 100,500mg/ml ApotheconProcan-SR @ tablet, controlled release 250mg Parke-DavisProcan-SR @ tablet, controlled release Parkdale

500,750,1000mgRhythmin @ tablet, controlled release 250mg SidmakRhythmin tablet, controlled release 500mg Sidmak

PROCAINE HYDROCHLORIDEProcaine Hydrochloride injection 1,2% American Pharmaceutical

Partners@ injection 1,2% Bel-Mar

injection 1,2% Elkins-Sinn@ injection 1,2% Miles@ injection 1,2% Searle

injection 1,2% SterisBrand(s)

Novocain injection 1,2% Abbott

PROCAINE HYDROCHLORIDE; TETRACYCLINE HYDROCHLORIDEBrand(s)

Achromycin @ injection 40mg/vial;100mg/vial Lederle@ injection 40mg/vial;250mg/vial Lederle

Tetracyn @ injection 40mg/vial;100mg/vial Pfizerinjection 40mg/vial;250mg/vial Pfizer

PROCHLORPERAZINEProchlorperazine suppository, rectal 2.5,5,25mg Able

suppository, rectal 25mg G&WBrand(s)

Compazine suppository, rectal 2.5,5,25mg SmithKline BeechamCompro suppository, rectal 25mg Paddock

PROCHLORPERAZINE EDISYLATEProchlorperazine Edisylate @ concentrate, oral eq 10mg base/ml Alpharma

@ concentrate, oral eq 10mg base/ml Morton Groveinjection eq 5mg base/ml Abbottinjection eq 5mg base/ml Elkins-Sinninjection eq 5mg base/ml Marsam

@ injection eq 5mg base/ml Quad(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

175

PROCHLORPERAZINE EDISYLATE (continued)@ injection eq 5mg base/ml Smith and Nephew

injection eq 5mg base/ml Steris@ injection eq 5mg base/ml Wyeth-Ayerst@ syrup, oral eq 5mg base/5ml Alpharma@ syrup, oral eq 5mg base/5ml Morton Grove

Brand(s)Compazine @ concentrate, oral eq 10mg base/ml SmithKline BeechamCompazine injection eq 5mg base/ml SmithKline BeechamCompazine syrup, oral eq 5mg base/5ml SmithKline Beecham

PROCHLORPERAZINE MALEATEProchlorperazine Maleate @ tablet, oral eq 5,10,25mg base Circa

tablet, oral eq 5,10mg base Copleytablet, oral eq 5,10mg base Duramedtablet, oral eq 5,10,25mg base Genevatablet, oral eq 5,10mg base IVAXtablet, oral eq 5,10mg base Mylantablet, oral eq 5,10mg base Trigen

Brand(s)Compazine tablet, oral eq 5,10,25mg base SmithKline Beecham

PROGESTERONEProgesterone injection 50mg/ml American Pharmaceutical

Partners@ injection 50mg/ml Lilly

injection 50mg/ml Schein

PROMAZINE HYDROCHLORIDEPromazine Hydrochloride @ injection 25,50mg/ml Steris

Brand(s)Sparine @ injection 25mg/ml Wyeth-AyerstSparine injection 50mg/ml Wyeth-Ayerst

PROMETHAZINE HYDROCHLORIDEPromethazine Hydrochloride injection 25,50mg/ml Abbott

@ injection 25,50mg/ml Akorn injection 25,50mg/ml Elkins-Sinn

injection 25,50mg/ml Marsaminjection 25,50mg/ml Steris

@ syrup, oral 6.25mg/5ml Cencisyrup, oral 6.25mg/5ml Hi-Tech

@ syrup, oral 6.25mg/5ml,25mg/5ml KVsyrup, oral 6.25mg/5ml Morton Grove

@ syrup, oral 6.25mg/5ml Pharmaceutical Associatessyrup, oral 6.25mg/5ml Whiteworth Towne

Brand(s)Phenergan injection 25,50mg/ml Wyeth-AyerstZipan-25,50 @ injection 25,50mg/ml AltanaMymethazine Fortis @ syrup, oral 25mg/5ml USLPhenergan syrup, oral 6.25mg/5ml Wyeth-AyerstPhenergan Fortis syrup, oral 25mg/5ml Wyeth-AyerstPrometh syrup, oral 6.25mg/5ml AlpharmaPrometh Fortis @ syrup, oral 25mg/5ml AlpharmaPhenergan tablet, oral 12.5,25mg Wyeth-Ayerst ** Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

176

PROMETHAZINE HYDROCHLORIDE; CODEINE PHOSPHATESee CODEINE PHOSPHATE; PROMETHAZINE HYDROCHLORIDE

PROMETHAZINE HYDROCHLORIDE; CODEINE PHOSPHATE; PHENYLEPHRINE HYDROCHLORIDESee CODEINE PHOSPHATE; PHENYLEPHRINE HYDROCHLORIDE; PROMETHAZINE

HYDROCHLORIDE

PROMETHAZINE HYDROCHLORIDE; DEXTROMETHORPHAN HYDROBROMIDESee DEXTROMETHORPHAN HYDROBROMIDE; PROMETHAZINE HYDROCHLORIDE

PROMETHAZINE HYDROCHLORIDE; PHENYLEPHRINE HYDROCHLORIDESee PHENYLEPHRINE HYDROCHLORIDE; PROMETHAZINE HYDROCHLORIDE

PROPAPHENONE HYDROCHLORIDEPropaphenone Hydrochloride tablet, oral 150,225,300mg Mutual

tablet, oral 150,225mg WatsonBrand(s)

Rhythmol tablet, oral 150,225,300mg Abbott

PROPARACAINE HYDROCHLORIDEProparacaine Hydrochloride solution, ophthalmic 0.5% Bausch and Lomb

@ solution, ophthalmic 0.5% Sola Barnes-Hindsolution, ophthalmic 0.5% Taylor

Brand(s)Alcaine solution, ophthalmic 0.5% AlconKainair @ solution, ophthalmic 0.5% PharmafairOphthaine solution, ophthalmic 0.5% ApotheconOphthetic solution, ophthalmic 0.5% AllerganParacaine solution, ophthalmic 0.5% Optopics

PROPOFOLPropofol injection 10mg/ml Gensia Sicor

Brand(s)Diprivan injection 10mg/ml Astra Zeneca

Note: Gensia Sicor’s propofol injection utilizes sodium metabisulfite as a preservative while Astra Zeneca’sDiprivan brand of propofol injection utilizes disodium edetate as a preservative. Patients’ allergy statusshould be reviewed prior to the interchange of any propofol injection products.

PROPOXYPHENE HYDROCHLORIDEPropoxyphene Hydrochloride @ capsule, oral 65mg Anabolic

@ capsule, oral 65mg Barr@ capsule, oral 65mg Danbury@ capsule, oral 32,65mg Eon@ capsule, oral 65mg Geneva

capsule, oral 65mg ICN@ capsule, oral 32mg IVAX

capsule, oral 65mg IVAX@ capsule, oral 65mg Impax

capsule, oral 32mg Mylan@ capsule, oral 65mg Mylan@ capsule, oral 32,65mg Private Formulations

capsule, oral 65mg Purepac(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

177

PROPOXYPHENE HYDROCHLORIDE (continued)@ capsule, oral 32,65mg Roxane

capsule, oral 65mg Teva@ capsule, oral 65mg Warner Chilcott@ capsule, oral 65mg Watson

capsule, oral 65mg West-Wardcapsule, oral 65mg Whiteworth Towne

Brand(s)Darvon capsule, oral 32mg LillyDarvon capsule, oral 65mg Lilly *Dolene capsule, oral 65mg LederleKesso-Gesic capsule, oral 65mg MKProphene @ capsule, oral 65mg Halsey

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

PROPOXYPHENE HYDROCHLORIDE; ACETAMINOPHENSee ACETAMINOPHEN; PROPOXYPHENE HYDROCHLORIDE

PROPOXYPHENE HYDROCHLORIDE; ASPIRIN; CAFFEINESee ASPIRIN; CAFFEINE; PROPOXYPHENE HYDROCHLORIDE

PROPOXYPHENE HYDROCHLORIDE COMPOUNDPROPOXYPHENE HYDROCHLORIDE; ASPIRIN; CAFFEINE

See ASPIRIN; CAFFEINE; PROPOXYPHENE HYDROCHLORIDE

PROPOXYPHENE NAPSYLATE; ACETAMINOPHENSee ACETAMINOPHEN; PROPOXYPHENE NAPSYLATE

PROPRANOLOL HYDROCHLORIDEPropranolol Hydrochloride @ capsule, extended release Inwood

60,80,120,160mginjection 1mg/ml Bedford

@ injection 1mg/ml Smith and Nephew@ injection 1mg/ml Solopak@ solution, oral 20mg/5ml Morton Grove@ solution, oral 40mg/5ml Morton Grove

solution, oral 20mg/5ml Roxanesolution, oral 40mg/5ml Roxane

@ tablet, oral 10,20,40,60,80mg Barr@ tablet, oral 10,20,40,60,80mg Circa

tablet, oral 10,20,40,80mg Danbury@ tablet, oral 60,90mg Danbury@ tablet, oral 10,20,40,60,80,90mg Duramed

tablet, oral 10,20,40,60,80mg Geneva@ tablet, oral 10,20,40,80mg Interpharm

tablet, oral 10,20,40,60,80,90mg Invamed@ tablet, oral 10,20,40,60,80mg IVAX@ tablet, oral 10,20mg Lederle

tablet, oral 40,60,80,90mg Lederletablet, oral 10,20,40,80mg Mylan

@ tablet, oral 60mg Mylantablet, oral 10,20,40,60,80,90mg Partablet, oral 10,20,40,60,80mg Purepac

(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

178

PROPRANOLOL HYDROCHLORIDE (continued)@ tablet, oral 10,20,40,60,80,90mg Roxane@ tablet, oral 10,20,40,60,80mg Schering

tablet, oral 10,20,40,60,80,90mg Sidmak@ tablet, oral 10,20,40,80mg Superpharm@ tablet, oral 10,20mg Teva

tablet, oral 40mg Teva@ tablet, oral 10,20,40,60,80mg Warner Chilcott@ tablet, oral 20mg Watson

tablet, oral 10,40,60,80,90mg WatsonBrand(s)

Inderal LA capsule, extended release Wyeth-Ayerst 60,80,120,160mg

Inderal injection 1mg/ml Wyeth-AyerstInderal tablet, oral 10,20,40,60,80mg Wyeth-AyerstInderal @ tablet, oral 90mg Wyeth-Ayerst

PROPRANOLOL HYDROCHLORIDE; HYDROCHLOROTHIAZIDESee HYDROCHLOROTHIAZIDE; PROPRANOLOL HYDROCHLORIDE

PROTAMINE SULFATEProtamine Sulfate injection 10mg/ml American Pharmaceutical

Partnersinjection 10mg/ml Elkins-Sinninjection 10mg/ml Lilly

@ injection 10mg/ml,50mg/vial Quad@ injection 50mg/vial Upjohn

PROTIRELINBrand(s)

Thyrel TRH injection 0.5mg/ml FerringThypinone @ injection 0.5mg/ml Abbott

PROTRIPTYLINE HYDROCHLORIDEProtriptyline Hydrochloride @ tablet, oral 5,10mg Sidmak

Brand(s)Vivactil tablet, oral 5,10mg Odyssey

PSEUDOEPHEDRINE HYDROCHLORIDE; BROMPHENIRAMINE MALEATE;DEXTROMETHORPHAN HYDROBROMIDE

See BROMPHENIRAMINE MALEATE; DEXTROMETHORPHAN HYDROBROMIDE;PSEUDOEPHEDRINE HYDROCHLORIDE

PSEUDOEPHEDRINE HYDROCHLORIDE; CARBINOXAMINE MALEATESee CARBINOXAMINE MALEATE; PSEUDOEPHEDRINE HYDROCHLORIDE

PSEUDOEPHEDRINE HYDROCHLORIDE; CARBINOXAMINE MALEATE; DEXTROMETHORPHANHYDROBROMIDE

See CARBINOXAMINE MALEATE; DEXTROMETHORPHAN HYDROBROMIDE;PSEUDOEPHEDRINE HYDROCHLORIDE

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

179

PSEUDOEPHEDRINE HYDROCHLORIDE; CHLORPHENIRAMINE MALEATE; CODEINE PHOSPHATESee CHLORPHENIRAMINE MALEATE; CODEINE PHOSPHATE; PSEUDOEPHEDRINE

HYDROCHLORIDE

PSEUDOEPHEDRINE HYDROCHLORIDE; CODEINE PHOSPHATE; GUAIFENESINSee CODEINE PHOSPHATE; GUAIFENESIN; PSEUDOEPHEDRINE HYDROCHLORIDE

PSEUDOEPHEDRINE HYDROCHLORIDE; CODEINE PHOSPHATE; TRIPROLIDINE HYDROCHLORIDESee CODEINE PHOSPHATE; PSEUDOEPHEDRINE HYDROCHLORIDE;

TRIPROLIDINE HYDROCHLORIDE

PSEUDOEPHEDRINE HYDROCHLORIDE; GUAIFENESIN; HYDROCODONE BITARTRATESee GUAIFENESIN; HYDROCODONE BITARTRATE; PSEUDOEPHEDRINE HYDROCHLORIDE

PSEUDOEPHEDRINE HYDROCHLORIDE; HYDROCODONE BITARTRATESee HYDROCODONE BITARTRATE; PSEUDOEPHEDRINE HYDROCHLORIDE

PSEUDOEPHEDRINE HYDROCHLORIDE; TRIPROLIDINE HYDROCHLORIDEPseudoephedrine @ tablet, oral 60mg;2.5mg Circa Hydrochloride; tablet, oral 60mg;2.5mg Eon Triprolidine Hydrochloride @ tablet, oral 60mg;2.5mg IVAX

tablet, oral 60mg;2.5mg Superpharm@ tablet, oral 60mg;2.5mg West-ward

Brand(s)Actahist @ syrup, oral 30mg/5ml;1.25mg/5ml CenciHistafed @ syrup, oral 30mg/5ml;1.25mg/5ml CenciMyfed @ syrup, oral 30mg/5ml;1.25mg/5ml USLTrilitron @ syrup, oral 30mg/5ml;1.25mg/5ml NewtronAllerfed @ tablet, oral 60mg;2.5mg Private FormulationsCorphed tablet, oral 60mg;2.5mg GenevaTrilitron tablet, oral 60mg;2.5mg NewtronTriphed @ tablet, oral 60mg;2.5mg Teva

PYRAZINAMIDEPyrazinamide tablet, oral 500mg Lederle

tablet, oral 500mg Mikart

PYRIDOSTIGMINE BROMIDEBrand(s)

Mestinon injection 5mg/ml ICNRegonol injection 5mg/ml Organon/Akzona

PYRIDOXINE HYDROCHLORIDEPyridoxine Hydrochloride @ injection 100mg/ml Akorn

injection 100mg/ml American Pharmaceutical Partners

@ injection 100mg/ml Bel-Mar@ injection 100mg/ml Dell@ injection 100mg/ml Elkins-Sinn@ injection 100mg/ml Luitpold

injection 100mg/ml SterisBrand(s)

Hexa-Betalin @ injection 100mg/ml Lilly

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

180

PYRILAMINE MALEATEPyrilamine Maleate tablet, oral 25mg Impax

@ tablet, oral 25mg Watson

PYRILAMINE TANNATE; CHLORPHENIRAMINE TANNATE; PHENYLEPHRINE TANNATESee CHLORPHENIRAMINE TANNATE; PHENYLEPHRINE TANNATE; PYRILAMINE TANNATE

PYRIDOXINE HYDROCHLORIDE; ASCORBIC ACID; BIOTIN; CYANOCOBALAMIN; DEXPANTHENOL;ERGOCALCIFEROL; FOLIC ACID; NIACINAMIDE; RIBOFLAVIN PHOSPHATE SODIUM; THIAMINEHYDROCHLORIDE; VITAMIN A; VITAMIN E

See ASCORBIC ACID; BIOTIN; CYANOCOBALAMIN; DEXPANTHENOL; ERGOCALCIFEROL;FOLIC ACID; NIACINAMIDE; PYRIDOXINE HYDROCHLORIDE; RIBOFLAVIN PHOSPHATESODIUM; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN E

PYRIDOXINE HYDROCHLORIDE; ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; IRON; NICOTINICACID; RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D; VITAMIN E

See ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; IRON; NICOTINIC ACID; PYRIDOXINEHYDROCHLORIDE; RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D;VITAMIN E

PYRIDOXINE HYDROCHLORIDE; ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; NICOTINIC ACID;RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D; VITAMIN E

See ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; NICOTINIC ACID; PYRIDOXINEHYDROCHLORIDE; RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D;VITAMIN E

QUINIDINE SULFATEQuinidine Sulfate @ capsule, oral 200mg Lilly

@ tablet, oral 200mg Barr@ tablet, oral 100mg Danbury

tablet, oral 200,300mg Danbury@ tablet, oral 200mg Elkins-Sinn

tablet, oral 200,300mg Eon@ tablet, oral 200mg Everylife

tablet, oral 200,300mg Geneva@ tablet, oral 200mg Halsey@ tablet, oral 200mg ICN@ tablet, oral 200mg Impax@ tablet, oral 200mg IVAX

tablet, oral 200mg King@ tablet, oral 200mg KV

tablet, oral 200mg Lannetttablet, oral 200mg Lederle

@ tablet, oral 200mg Lillytablet, oral 100,200mg Mutual

@ tablet, oral 300mg Mutual@ tablet, oral 200mg Perrigo@ tablet, oral 200mg Pharmavite

tablet, oral 200mg Private Formulationstablet, oral 200mg Purepactablet, oral 200,300mg Roxane

@ tablet, oral 200mg Scherertablet, oral 200mg Superpharm

@ tablet, oral 200mg USL@ tablet, oral 200mg (Vangard/MWM)

(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

181

QUINIDINE SULFATE (continued)@ tablet, oral 200mg Vintage@ tablet, oral 200mg Warner Chilcott

tablet, oral 200mg Watson@ tablet, oral 200mg West-Ward@ tablet, oral 200mg Whiteworth Towne

tablet, extended release 300mg CopleyBrand(s)

Cin-Quin @ capsule, oral 200mg SolvayCin-Quin @ tablet, oral 100,200,300mg SolvayQuinora @ tablet, oral 200,300mg ScheringQuinidex tablet, extended release 300mg Robins *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

RANITIDINE HYDROCHLORIDERanitidine Hydrochloride capsule, oral eq 150,300mg base Geneva

capsule, oral eq 150,300mg base GenPharmcapsule, oral eq 150,300mg base Reddy-Cheminorcapsule, oral eq 150,300mg base Tevatablet, oral eq 150,300mg base Boehringer Ingelheimtablet, oral eq 150,300mg base Genevatablet, oral eq 150,300mg base GenPharmtablet, oral eq 150,300mg base IVAXtablet, oral eq 150,300mg base Mylantablet, oral eq 150,300mg base Partablet, oral eq 150,300mg base Ranbaxytablet, oral eq 150,300mg base Tevatablet, oral eq 150,300mg base TorPharmtablet, oral eq 150,300mg base Watsontablet, oral eq 150,300mg base Wockhardt

Brand(s)Zantac @ capsule, oral eq 150mg base Glaxo WellcomeZantac capsule, oral eq 300mg base Glaxo WellcomeZantac tablet, oral eq 150,300mg base Glaxo Wellcome

RESERPINEBrand(s)

Sandril @ injection 2.5mg/ml LillySerpasil @ injection 2.5mg/ml Novartis

RIBOFLAVIN PHOSPHATE SODIUM; ASCORBIC ACID; BIOTIN; CYANOCOBALAMIN; DEXPANTHENOL;ERGOCALCIFEROL; FOLIC ACID; NIACINAMIDE; PYRIDOXINE HYDROCHLORIDE; THIAMINEHYDROCHLORIDE; VITAMIN A; VITAMIN E

See ASCORBIC ACID; BIOTIN; CYANOCOBALAMIN; DEXPANTHENOL; ERGOCALCIFEROL;FOLIC ACID; NIACINAMIDE; PYRIDOXINE HYDROCHLORIDE; RIBOFLAVIN PHOSPHATESODIUM; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN E

RIBOFLAVIN; ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; IRON; NICOTINIC ACID; PYRIDOXINEHYDROCHLORIDE; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D; VITAMIN E

See ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; IRON; NICOTINIC ACID; PYRIDOXINEHYDROCHLORIDE; RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D;VITAMIN E

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

182

RIBOFLAVIN; ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; NICOTINIC ACID; PYRIDOXINEHYDROCHLORIDE; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D; VITAMIN E

See ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; NICOTINIC ACID; PYRIDOXINEHYDROCHLORIDE; RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D;VITAMIN E

RIFAMPINRifampin capsule, oral 150,300mg Eon

injection 600mg/vial BedfordBrand(s)

Rifadin capsule, oral 150,300mg AventisRimactane capsule, oral 300mg GenevaRifadin injection 600mg/vial Aventis

RIMANTIDINE HYDROCHLORIDERimantidine Hydrochloride tablet, oral 100mg CorePharma

Brand(s)Flumadine tablet, oral 100mg Forest *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

RITODRINE HYDROCHLORIDERitodrine Hydrochloride injection 10,15mg/ml Abbott

@ injection 10,15mg/ml American Pharmaceutical Partners

@ injection 10,15mg/ml QuadBrand(s)

Yutopar @ injection 10,15mg/ml Astra Zeneca

SCOPALAMINE HYDROBROMIDE; ATROPINE SULFATE; HYOSCYAMINE; PHENOBARBITALSee ATROPINE SULFATE; HYOSCYAMINE; PHENOBARBITAL; SCOPALAMINE HYDROBROMIDE

SECOBARBITAL SODIUMSecobarbital Sodium @ capsule, oral 100mg Anabolic

@ capsule, oral 100mg Barr@ capsule, oral 100mg Eon

capsule, oral 100mg Everylife@ capsule, oral 100mg Halsey@ capsule, oral 100mg ICN@ capsule, oral 100mg IVAX@ capsule, oral 100mg KV@ capsule, oral 50,100mg Lannett@ capsule, oral 100mg Parke-Davis@ capsule, oral 100mg Perrigo@ capsule, oral 100mg Purepac@ capsule, oral 100mg Watson

capsule, oral 100mg West-Ward@ capsule, oral 100mg Whiteworth Towne@ capsule, oral 100mg Wyeth-Ayerst

injection 50mg/ml Wyeth-AyerstBrand(s)

Seconal capsule, oral 50,100mg LillySeconal @ injection 50mg/ml Lilly

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

183

SELEGILINE HYDROCHLORIDESelegiline Hydrochloride capsule, oral 5mg ESI/Lederle

capsule, oral 5mg Nortoncapsule, oral 5mg TorPharmtablet, oral 5mg Alphapharmtablet, oral 5mg Apotextablet, oral 5mg Apothecontablet, oral 5mg Endotablet, oral 5mg ESI/Lederletablet, oral 5mg IVAXtablet, oral 5mg Stasontablet, oral 5mg Teva

Brand(s)Eldepryl capsule, oral 5mg SomersetEldepryl tablet, oral 5mg Somerset

SELENIUM SULFIDESelenium Sulfide lotion/shampoo, topical 2.5% Alpharma

lotion/shampoo, topical 2.5% Clay-Park@ lotion/shampoo, topical 2.5% IVAX

lotion/shampoo, topical 2.5% Morton Grove@ lotion/shampoo, topical 2.5% Thames

Brand(s)Exsel lotion/shampoo, topical 2.5% Allergan HerbertSelsun lotion/shampoo, topical 2.5% Abbott

SILVER SULFADIAZINEBrand(s)

Silvadene cream, topical 1% AventisSSD cream, topical 1% AbbottThermazine cream, topical 1% Kendall

SODIUM ACETATE; DEXTROSE; MAGNESIUM CHLORIDE; POTASSIUM CHLORIDE; SODIUM CHLORIDE;SODIUM GLUCONATE

See DEXTROSE; MAGNESIUM CHLORIDE; POTASSIUM CHLORIDE; SODIUM ACETATE;SODIUM CHLORIDE; SODIUM GLUCONATE

SODIUM ACETATE; MAGNESIUM CHLORIDE; POTASSIUM CHLORIDE; SODIUM CHLORIDE;SODIUM GLUCONATE

See MAGNESIUM CHLORIDE; POTASSIUM CHLORIDE; SODIUM ACETATE;SODIUM CHLORIDE; SODIUM GLUCONATE

SODIUM AMINOSALICYLATESodium Aminosalicylate @ powder, oral 100% Hexcel

Brand(s)P.A.S. Sodium @ powder, oral 4gm/packet CenturyParasal Sodium @ tablet, oral 500mg PanraySodium P.A.S. tablet, oral 500mg LannettTeebacin @ tablet, oral 500mg Consolidated Midland

SODIUM BICARBONATE; CALCIUM CHLORIDE; DEXTROSE; GLUTATHIONE DISULFIDE; MAGNESIUMCHLORIDE; POTASSIUM CHLORIDE; SODIUM CHLORIDE; SODIUM PHOSPHATE

See CALCIUM CHLORIDE; DEXTROSE; GLUTATHIONE DISULFIDE; MAGNESIUM CHLORIDE;POTASSIUM CHLORIDE; SODIUM BICARBONATE; SODIUM CHLORIDE; SODIUMPHOSPHATE

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

184

SODIUM CARBONATE; CITRIC ACID; MAGNESIUM OXIDESee CITRIC ACID; MAGNESIUM OXIDE; SODIUM CARBONATE

SODIUM CHLORIDEInjection; in plastic containerSolution for irrigation; in plastic container

Sodium Chloride bacteriostatic injection 9mg/ml Abbottbacteriostatic injection 9mg/ml American Pharmaceutical

Partnersinjection 9mg/ml (0.9%), Abbott 450mg/100ml (0.45%), 900mg/100ml (0.9%)injection 9mg/ml (0.9%) American Pharmaceutical

Partnersinjection 9mg/ml (0.9%), Baxter 450mg/100ml (0.45%), 900mg/100ml (0.9%), 3gm/100ml (3%)injection 450mg/100ml (0.45%), Braun 900mg/100ml (0.9%), 3gm/100ml (3%)

@ injection 450mg/100ml (0.45%), Miles@ 900mg/100ml (0.9%)

solution 450mg/100ml (0.45%), Abbott 900mg/100ml (0.9%)solution 450mg/100ml (0.45%), Baxter 900mg/100ml (0.9%)solution 900mg/100ml (0.9%) Braun

@ solution 900mg/100ml (0.9%) Miles

SODIUM CHLORIDE; CALCIUM CHLORIDE; DEXTROSE; GLUTATHIONE DISULFIDE; MAGNESIUMCHLORIDE; POTASSIUM CHLORIDE; SODIUM BICARBONATE; SODIUM PHOSPHATE

See CALCIUM CHLORIDE; DEXTROSE; GLUTATHIONE DISULFIDE; MAGNESIUM CHLORIDE;POTASSIUM CHLORIDE; SODIUM BICARBONATE; SODIUM CHLORIDE; SODIUMPHOSPHATE

SODIUM CHLORIDE; CALCIUM CHLORIDE; DEXTROSE; MAGNESIUM CHLORIDE; SODIUM LACTATESee CALCIUM CHLORIDE; DEXTROSE; MAGNESIUM CHLORIDE; SODIUM CHLORIDE; SODIUM

LACTATE

SODIUM CHLORIDE; CALCIUM CHLORIDE; DEXTROSE; POTASSIUM CHLORIDESee CALCIUM CHLORIDE; DEXTROSE; POTASSIUM CHLORIDE; SODIUM CHLORIDE

SODIUM CHLORIDE; CALCIUM CHLORIDE; DEXTROSE; POTASSIUM CHLORIDE; SODIUM LACTATESee CALCIUM CHLORIDE; DEXTROSE; POTASSIUM CHLORIDE; SODIUM CHLORIDE; SODIUM

LACTATE

SODIUM CHLORIDE; CALCIUM CHLORIDE; MAGNESIUM CHLORIDE; POTASSIUM CHLORIDESee CALCIUM CHLORIDE; MAGNESIUM CHLORIDE; POTASSIUM CHLORIDE; SODIUM CHLORIDE

SODIUM CHLORIDE; CALCIUM CHLORIDE; POTASSIUM CHLORIDESee CALCIUM CHLORIDE; POTASSIUM CHLORIDE; SODIUM CHLORIDE

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

185

SODIUM CHLORIDE; CALCIUM CHLORIDE; POTASSIUM CHLORIDE; SODIUM LACTATESee CALCIUM CHLORIDE; POTASSIUM CHLORIDE; SODIUM CHLORIDE; SODIUM LACTATE

SODIUM CHLORIDE; CIMETIDINE HYDROCHLORIDESee CIMETIDINE HYDROCHLORIDE; SODIUM CHLORIDE

SODIUM CHLORIDE; DEXTROSESee DEXTROSE; SODIUM CHLORIDE

SODIUM CHLORIDE; DEXTROSE; MAGNESIUM CHLORIDE; POTASSIUM CHLORIDE; SODIUM ACETATE;SODIUM GLUCONATE

See DEXTROSE; MAGNESIUM CHLORIDE; POTASSIUM CHLORIDE; SODIUM ACETATE; SODIUMCHLORIDE; SODIUM GLUCONATE

SODIUM CHLORIDE; DEXTROSE; POTASSIUM CHLORIDESee DEXTROSE; POTASSIUM CHLORIDE; SODIUM CHLORIDE

SODIUM CHLORIDE; GENTAMICIN SULFATESee GENTAMICIN SULFATE; SODIUM CHLORIDE

SODIUM CHLORIDE; HEPARIN SODIUMSee HEPARIN SODIUM; SODIUM CHLORIDE

SODIUM CHLORIDE; MAGNESIUM CHLORIDE; POTASSIUM CHLORIDE; SODIUM ACETATE;SODIUM GLUCONATE

See MAGNESIUM CHLORIDE; POTASSIUM CHLORIDE; SODIUM ACETATE; SODIUM CHLORIDE;SODIUM GLUCONATE

SODIUM CHLORIDE; POTASSIUM CHLORIDESee POTASSIUM CHLORIDE; SODIUM CHLORIDE

SODIUM GLUCONATE; DEXTROSE; MAGNESIUM CHLORIDE; POTASSIUM CHLORIDE; SODIUMCHLORIDE; SODIUM ACETATE

See DEXTROSE; MAGNESIUM CHLORIDE; POTASSIUM CHLORIDE; SODIUM ACETATE; SODIUMCHLORIDE; SODIUM GLUCONATE

SODIUM GLUCONATE; MAGNESIUM CHLORIDE; POTASSIUM CHLORIDE; SODIUM ACETATE;SODIUM CHLORIDE

See MAGNESIUM CHLORIDE; POTASSIUM CHLORIDE; SODIUM ACETATE; SODIUM CHLORIDE;SODIUM GLUCONATE

SODIUM LACTATEInjection; in plastic container

Sodium Lactate injection 1.87gm/100ml (0.167 molar) Abbottinjection 1.87gm/100ml (0.167 molar) Baxterinjection 1.87gm/100ml (0.167 molar) Braun

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

186

SODIUM LACTATE; CALCIUM CHLORIDE; DEXTROSE; MAGNESIUM CHLORIDE; SODIUM CHLORIDESee CALCIUM CHLORIDE; DEXTROSE; MAGNESIUM CHLORIDE; SODIUM CHLORIDE; SODIUM

LACTATE

SODIUM LACTATE; CALCIUM CHLORIDE; POTASSIUM CHLORIDE; SODIUM CHLORIDESee CALCIUM CHLORIDE; POTASSIUM CHLORIDE; SODIUM CHLORIDE; SODIUM LACTATE

SODIUM NITROPRUSSIDESodium Nitroprusside @ injection 50mg/vial American Pharmaceutical

Partnersinjection 50mg/vial Elkins-Sinninjection 25mg/ml Gensia Sicor

Brand(s)Nipride @ injection 50mg/vial RocheNitropress injection 25mg/ml AbbottNitropress injection 50mg/vial Abbott

SODIUM POLYSTYRENE SULFONATESodium Polystyrene Sulfonate powder, oral-rectal Carolina Medical

454gm/bottle@ powder, oral-rectal Morton Grove

453.6gm bottlepowder, oral-rectal Paddock 454gm/bottlesuspension, oral-rectal Carolina Medical 15gm/60ml

@ suspension, oral-rectal Morton Grove 15gm/60mlsuspension, oral-rectal Roxane 15gm/60ml

Brand(s)Kayexalate powder, oral-rectal Sanofi Synthelabo

453.6gm bottle

SODIUM PHOSPHATE; CALCIUM CHLORIDE; DEXTROSE; GLUTATHIONE DISULFIDE; MAGNESIUMCHLORIDE; POTASSIUM CHLORIDE; SODIUM BICARBONATE; SODIUM CHLORIDE

See CALCIUM CHLORIDE; DEXTROSE; GLUTATHIONE DISULFIDE; MAGNESIUM CHLORIDE;POTASSIUM CHLORIDE; SODIUM BICARBONATE; SODIUM CHLORIDE; SODIUMPHOSPHATE

SOLTALOL HYDROCHLORIDESoltalol Hydrochloride tablet, oral 80,120,160,240mg Eon

tablet, oral 80,120,160,240mg GenPharmtablet, oral 80,120,160,240mg Impaxtablet, oral 80,120,160,240mg Mutualtablet, oral 80,120,160,240mg Mylantablet, oral 80,120,160,240mg Tevatablet, oral 80,120,160,240mg Watson

Brand(s)Betapace tablet, oral 80,120,160,240mg BerlexSorine tablet, oral 80,120,160,240mg Upsher-Smith

NOTE: The above products are NOT interchangeable with prescriptions written for Betapace AF tabletsfrom Berlex Laboratories.

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

187

SOYBEAN OILBrand(s)

Intralipid 10% injection 10% Fresenius Kabi Intralipid 20% injection 20% Fresenius KabiIntralipid 30% injection 30% Fresenius KabiLiposyn III 10% injection 10% AbbottLiposyn III 20% injection 20% AbbottLiposyn III 30% injection 30% AbbottNutrilipid 10% injection 10% BraunNutrilipid 20% injection 20% BraunSoyacal 10% injection 10% Alpha TherapeuticSoyacal 20% injection 20% Alpha TherapeuticTravamulsion 10% @ injection 10% BaxterTravamulsion 20% @ injection 20% Baxter

SPIRONOLACTONESpironolactone @ tablet, oral 25mg (Ascot)

tablet, oral 25mg Barr@ tablet, oral 25mg Circa

tablet, oral 25mg Geneva@ tablet, oral 25mg IVAX@ tablet, oral 25mg Lederle

tablet, oral 25,50,100mg Mutualtablet, oral 25,50,100mg Mylan

@ tablet, oral 25mg Purepactablet, oral 50,100mg Purepactablet, oral 25mg Superpharm

@ tablet, oral 25mg Upsher-Smith@ tablet, oral 25mg (Vangard/MWM)@ tablet, oral 25mg Warner Chilcott@ tablet, oral 25mg Watson

Brand(s)Aldactone tablet, oral 25,50,100mg Searle *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

SPIRONOLACTONE; HYDROCHLOROTHIAZIDESee HYDROCHLOROTHIAZIDE; SPIRONOLACTONE

STREPTOMYCIN SULFATEStreptomycin Sulfate @ injection eq 1,5gm base/vial Lilly

@ injection eq 1,5gm base/vial Pfizerinjection eq 1gm base/vial Pharma-Tex

SUCCINYLCHOLINE CHLORIDESuccinylcholine Chloride injection 20mg/ml Organon

Brand(s)Anectine injection 20mg/ml Glaxo WellcomeQuelicin injection 20mg/ml AbbottQuelicin Preservative Free injection 20mg/ml AbbottSucostrin injection 20mg/ml Apothecon

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

188

SUCRALFATESucralfate tablet, oral 1gm Ratiopharm/Martec

tablet, oral 1gm TevaBrand(s)

Carafate tablet, oral 1gm Blue Ridge/Aventis

SUFENTANIL CITRATESufentanil Citrate injection eq 0.05mg base/ml Abbott

injection eq 0.05mg base/ml Elkins-Sinn@ injection eq 0.05mg base/ml Steris

Brand(s)Sufenta injection eq 0.05mg base/ml Akorn

SULFABENZAMIDE; SULFACETAMIDE; SULFATHIAZOLESulfabenzamide; @ tablet, vaginal 184mg; 143.75mg; Fougera/Altana Sulfacetamide; Sulfathiazole 172.5mg (Triple Sulfa) @ tablet, vaginal 184mg; 143.75mg; Pharmaderm/Altana

172.5mgBrand(s)

Gyne-Sulf cream, vaginal 3.7%; 2.86%; 3.42% G & WSultrin cream, vaginal 3.7%; 2.86%; 3.42% RW JohnsonTriple Sulfa cream, vaginal 3.7%; 2.86%; 3.42% AlpharmaTriple Sulfa cream, vaginal 3.7%; 2.86%; 3.42% Clay-ParkTriple Sulfa @ cream, vaginal 3.7%; 2.86%; 3.42% Fougera/AltanaTrysul cream, vaginal 3.7%; 2.86%; 3.42% Savage/AltanaVagilia @ cream, vaginal 3.7%; 2.86%; 3.42% TevaSultrin tablet, vaginal 184mg; 143.75mg; RW Johnson

172.5mg

SULFACETAMIDE SODIUMSulfacetamide Sodium ointment, ophthalmic 10% Altana

solution, ophthalmic 10% Alcon Universalsolution, ophthalmic 10% Bausch and Lomb

@ solution, ophthalmic 10,30% Sola Barnes-Hindsolution, ophthalmic 30% Steris

Brand(s)Bleph-10 @ ointment, ophthalmic 10% AllerganCetamide ointment, ophthalmic 10% AlconSodium Sulamyd @ ointment, ophthalmic 10% ScheringSulfair-10 @ ointment, ophthalmic 10% PharmafairAK-Sulf solution, ophthalmic 10,30% AkornAK-Sulf @ solution, ophthalmic 15% AkornBleph-10 solution, ophthalmic 10% AllerganBleph-30 solution, ophthalmic 10% AllerganIsopto Cetamide solution, ophthalmic 15% AlconOcusulf-10 solution, ophthalmic 10% MizaOcusulf-30 @ solution, ophthalmic 30% MizaSodium Sulamyd @ solution, ophthalmic 10,30% ScheringSulf-10 @ solution, ophthalmic 10% NovartisSulf-15 solution, ophthalmic 15% NovartisSulfacel-15 solution, ophthalmic 15% OptopicsSulfair-10 @ solution, ophthalmic 10% PharmafairSulfair-15 @ solution, ophthalmic 15% PharmafairSulfair Forte @ solution, ophthalmic 30% PharmafairSulten-10 @ solution, ophthalmic 10% Bausch and Lomb

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

189

SULFACETAMIDE SODIUM: PREDNISOLONE ACETATESee PREDNISOLONE ACETATE; SULFACETAMIDE SODIUM

SULFACETAMIDE SODIUM; PREDNISOLONE SODIUM PHOSPHATESee PREDNISOLONE SODIUM PHOSPHATE; SULFACETAMIDE

SULFADIAZINESulfadiazine tablet, oral 500mg Eon

@ tablet, oral 500mg Everylife@ tablet, oral 500mg Impax@ tablet, oral 500mg Lannett@ tablet, oral 500mg Lederle@ tablet, oral 500mg Lilly

SULFADIAZINE; SULFAMETHAZINE; SULFAMERAZINESee TRISULFAPYRIMIDINE

SULFAMETHIZOLEBrand(s)

Proklar @ tablet, oral 500mg ForestThiosulfil tablet, oral 500mg Wyeth-Ayerst

SULFAMETHOXAZOLESulfamethoxazole @ tablet, oral 500mg (Ascot)

@ tablet, oral 500mg Barr@ tablet, oral 500mg,1gm Circa@ tablet, oral 500mg Geneva@ tablet, oral 500mg Heather

Brand(s)Gantanol tablet, oral 500mg RocheGantanol DS @ tablet, oral 1gm RocheUrobak @ tablet, oral 500mg Shionogi

SULFAMETHOXAZOLE; TRIMETHOPRIMSulfamethoxazole; Trimethoprim injection 80mg/ml;16mg/ml Abbott

@ injection 80mg/ml;16mg/ml American Pharmaceutical Partners

@ injection 80mg/ml;16mg/ml Bedfordinjection 80mg/ml;16mg/ml Elkins-Sinninjection 80mg/ml;16mg/ml Gensia Sicor

@ injection 80mg/ml;16mg/ml Quad@ injection 80mg/ml;16mg/ml Steris

suspension, oral 200mg/5ml;40mg/5ml Hi-Tech@ suspension, oral 200mg/5ml;40mg/5ml Naska@ tablet, oral 400mg;80mg Barr@ tablet, oral 800mg;160mg Barr

tablet, oral 400mg;80mg Danburytablet, oral 800mg;160mg Danbury

@ tablet, oral 400mg;80mg Eontablet, oral 800mg;160mg Eontablet, oral 400mg;80mg Genevatablet, oral 800mg;160mg Geneva

@ tablet, oral 400mg;80mg Heather@ tablet, oral 800mg;160mg Heather

(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

190

SULFAMETHOXAZOLE; TRIMETHOPRIM (continued)@ tablet, oral 400mg;80mg Interpharm@ tablet, oral 800mg;160mg Interpharm@ tablet, oral 400mg;80mg Martec@ tablet, oral 800mg;160mg Martec

tablet, oral 400mg;80mg Mutualtablet, oral 800mg;160mg Mutualtablet, oral 400mg;80mg Plantex

@ tablet, oral 400mg;80mg Roxanetablet, oral 800mg;160mg Roxanetablet, oral 400mg;80mg Sidmaktablet, oral 800mg;160mg Sidmaktablet, oral 800mg;160mg Teva

@ tablet, oral 400mg;80mg USL@ tablet, oral 800mg;160mg USL@ tablet, oral 400mg;80mg Watson@ tablet, oral 800mg;160mg Watson

Brand(s)Bactrim injection 80mg/ml;16mg/ml Women First HealthcareSeptra injection 80mg/ml;16mg/ml Glaxo WellcomeSulfamethoprim @ injection 80mg/ml;16mg/ml QuadBactrim suspension, oral 200mg/5ml;40mg/5ml Women First HealthcareBactrim Pediatric suspension, oral 200mg/5ml;40mg/5ml Women First HealthcareCotrim Pediatric suspension, oral 200mg/5ml;40mg/5ml TevaSeptra suspension, oral 200mg/5ml;40mg/5ml Glaxo WellcomeSeptra Grape suspension, oral 200mg/5ml;40mg/5ml Glaxo WellcomeSMZ-TMP suspension, oral 200mg/5ml;40mg/5ml TevaSMZ-TMP Pediatric suspension, oral 200mg/5ml;40mg/5ml TevaSulfatrim suspension, oral 200mg/5ml;40mg/5ml AlpharmaSulfatrim Pediatric suspension, oral 200mg/5ml;40mg/5ml AlpharmaSulmeprim @ suspension, oral 200mg/5ml;40mg/5ml USLSulmeprim Pediatric @ suspension, oral 200mg/5ml;40mg/5ml USLBactrim tablet, oral 400mg;80mg Women First HealthcareBactrim DS tablet, oral 800mg;160mg Women First HealthcareCotrim tablet, oral 400mg;80mg TevaCotrim D.S. tablet, oral 800mg;160mg TevaSeptra tablet, oral 400mg;80mg Glaxo WellcomeSeptra DS tablet, oral 800mg;160mg Glaxo WellcomeSMZ-TMP tablet, oral 400mg;80mg TevaSMZ-TMP tablet, oral 800mg;160mg TevaSulfamethoprim tablet, oral 400mg;80mg ParSulfamethoprim-DS tablet, oral 800mg;160mg ParSulfatrim SS @ tablet, oral 400mg;80mg SuperpharmSulfatrim DS @ tablet, oral 800mg;160mg SuperpharmUroplus SS @ tablet, oral 400mg;80mg ShionogiUroplus DS @ tablet, oral 800mg;160mg Shionogi

SULFANILAMIDEBrand(s)

AVC cream, vaginal 15% NovavaxVagitrol cream, vaginal 15% Teva

SULFASALAZINESulfasalazine @ tablet, oral 500mg Circa

tablet, oral 500mg Danbury@ tablet, oral 500mg Eon@ tablet, oral 500mg Lederle

tablet, oral 500mg Mutual(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

191

SULFASALAZINE (continued)@ tablet, oral 500mg Superpharm

tablet, oral 500mg WatsonBrand(s)

Azulfidine tablet, oral 500mg Pharmacia & UpjohnS.A.S.-500 @ tablet, oral 500mg Solvay

SULFATHIAZOLE; SULFACETAMIDE; SULFABENZAMIDE; UREASee SULFACETAMIDE; SULFABENZAMIDE; SULFATHIAZOLE; UREA

SULFINPYRAZONESulfinpyrazone capsule, oral 200mg Barr

@ capsule, oral 200mg IVAXcapsule, oral 200mg Par

@ capsule, oral 200mg (Vangard/MWM)tablet, oral 100mg Barr

@ tablet, oral 100mg Danbury@ tablet, oral 100mg IVAX

tablet, oral 100mg ParBrand(s)

Anturane capsule, oral 200mg NovartisAnturane tablet, oral 100mg Novartis

SULFISOXAZOLESulfisoxazole @ tablet, oral 500mg Barr

@ tablet, oral 500mg Eon@ tablet, oral 500mg Geneva@ tablet, oral 500mg Heather

tablet, oral 500mg ICN@ tablet, oral 500mg Impax@ tablet, oral 500mg IVAX@ tablet, oral 500mg Lannett@ tablet, oral 500mg Lederle@ tablet, oral 500mg Pharmeral@ tablet, oral 500mg Purepac

tablet, oral 500mg Roxane@ tablet, oral 500mg Watson@ tablet, oral 500mg West-Ward

Brand(s)Gantrisin @ tablet, oral 500mg RocheSosol tablet, oral 500mg MKSulfalar @ tablet, oral 500mg Parke-DavisSulsoxin @ tablet, oral 500mg Solvay

SULFISOXAZOLE ACETYL; ERYTHROMYCIN ETHYLSUCCINATESee ERYTHROMYCIN ETHYLSUCCINATE; SULFISOXAZOLE

SULINDACSulindac tablet, oral 150,200mg Danbury

tablet, oral 150,200mg Genevatablet, oral 150,200mg Lederletablet, oral 150,200mg Mutualtablet, oral 150,200mg Mylantablet, oral 150,200mg Tevatablet, oral 150,200mg Warner Chilcott

(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

192

SULINDAC (continued)Brand(s)

Clinoril tablet, oral 150,200mg Merck Sharp and Dohme *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

TAMOXIFEN CITRATETamoxifen Citrate @ tablet, oral eq 10mg base Mylan

@ tablet, oral eq 10mg base PharmachemieBrand(s)

Nolvadex tablet, oral eq 10mg base Zeneca *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

TEMAZEPAMTemazepam @ capsule, oral 15,30mg Barr

@ capsule, oral 15,30mg Circacapsule, oral 15,30mg Danbury

@ capsule, oral 15,30mg Duramedcapsule, oral 15,30mg Genevacapsule, oral 15,30mg Mylancapsule, oral 15,30mg Parcapsule, oral 15,30mg Purepac

@ capsule, oral 15,30mg USLBrand(s)

Temaz @ capsule, oral 15,30mg QuantumRestoril capsule, oral 7.5,15,30mg Tyco *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

TERAZOSIN HYDROCHLORIDETerazosin Hydrochloride capsule, oral eq 1,2,5,10mg base Geneva

capsule, oral eq 1,2.5,10mg base Invamedcapsule, oral eq 1,2,5,10mg base IVAXcapsule, oral eq 1,2,5,10mg base Mylancapsule, oral eq 1,2,5,10mg base TorPharmtablet, oral eq 1,2,5,10mg base Genevatablet, oral eq 1,2,5,10mg base Invamedtablet, oral eq 1,2,5,10mg base IVAXtablet, oral eq 1,2,5,10mg base Teva

Brand(s)Hytrin @ tablet, oral eq 1,2,5,10mg base Abbott *Hytrin capsule, oral eq 1,2,5,10mg base Abbott *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

TERBUTALINE SULFATETerbutaline Sulfate tablet, oral 2.5,5mg Impax

Brand(s)Brethine injection 1mg/ml NovartisBricanyl @ injection 1mg/ml AventisBrethine tablet, oral 2.5,5mg Novartis

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

193

TESTOSTERONE CYPIONATETestosterone Cypionate @ injection 100,200mg/ml Quad

injection 100,200mg/ml SterisBrand(s)

Depo-Testosterone injection 100,200mg/ml Pharmacia & Upjohn

TESTOSTERONE CYPIONATE; ESTRADIOL CYPIONATESee ESTRADIOL CYPIONATE; TESTOSTERONE CYPIONATE

TESTOSTERONE ENANTHATETestosterone Enanthate @ injection 100,200mg/ml Quad

@ injection 100mg/ml Sterisinjection 200mg/ml Steris

Brand(s)Delatestryl injection 200mg/ml BTG

TESTOSTERONE ENANTHATE; ESTRADIOL VALERATESee ESTRADIOL VALERATE; TESTOSTERONE ENANTHATE

TESTOSTERONE PROPIONATETestosterone Propionate @ injection 25,50,100mg/ml Bel-Mar

@ injection 25mg/ml Elkins-Sinn@ injection 50mg/ml Lilly@ injection 100mg/ml Quad

injection 25,50,100mg/ml Steris

TETRACAINE HYDROCHLORIDETetracaine Hydrochloride solution, ophthalmic 0.5% Optopics *

Brand(s)Pontocaine solution, ophthalmic 0.5% Sterling Winthrop *

* This entity was reviewed by the Technical Advisory Council and admitted to the Illinois Formulary as anexception to the promulgated criteria for inclusion, pursuant to Rule 790.60.

TETRACYCLINE HYDROCHLORIDETetracycline Hydrochloride @ capsule, oral 250,500mg Abbott

capsule, oral 250,500mg Atralcapsule, oral 250,500mg Barr

@ capsule, oral 250,500mg Danbury@ capsule, oral 250mg Elkins-Sinn

capsule, oral 250mg Eon@ capsule, oral 250mg Ferrante

capsule, oral 250,500mg Halsey@ capsule, oral 250,500mg Heather@ capsule, oral 250,500mg ICN

capsule, oral 250,500mg Impaxcapsule, oral 250,500mg IVAXcapsule, oral 250mg Mastcapsule, oral 250,500mg Mylan

@ capsule, oral 250,500mg Private Formulations@ capsule, oral 250,500mg Purepac

capsule, oral 500mg Roxane@ capsule, oral 250,500mg Superpharm@ capsule, oral 250,500mg Warner Chilcott

(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

194

TETRACYCLINE HYDROCHLORIDE (continued)@ capsule, oral 250,500mg Watson@ capsule, oral 250,500mg West-ward@ capsule, oral 250,500mg Wyeth-Ayerst@ suspension, oral 125mg/5ml Ferrante@ suspension, oral 125mg/5ml Proter@ suspension, oral 125mg/5ml Purepac

Brand(s)Achromycin V capsule, oral 250,500mg LederleBristacycline capsule, oral 250,500mg BristolCyclopar @ capsule, oral 250,500mg Warner ChilcottPanmycin @ capsule, oral 250mg Pharmacia & UpjohnRetet @ capsule, oral 250,500mg SolvayRobitet @ capsule, oral 250,500mg Wyeth-AyerstSumycin capsule, oral 250,500mg ApotheconTetrachel @ capsule, oral 250,500mg AngusTetracyn @ capsule, oral 250,500mg Pfipharmecs/PfizerAchromycin injection 250,500mg/vial LederleTetracyn @ injection 250,500mg/vial PfizerAchromycin V suspension, oral 125mg/5ml LederleBiocycline @ suspension, oral 125mg/5ml AlpharmaSumycin suspension, oral 125mg/5ml ApotheconTetracyn @ suspension, oral 125mg/5ml Pfipharmecs/PfizerTetramed @ suspension, oral 125mg/5ml IVAXPanmycin @ tablet, oral 500mg UpjohnSumycin tablet, oral 500mg Apothecon

TETRACYCLINE HYDROCHLORIDE; PROCAINE HYDROCHLORIDESee PROCAINE HYDROCHLORIDE; TETRACYCLINE HYDROCHLORIDE

THEOPHYLLINETheophylline capsule, extended release Inwood/Forest

100,125,200,300mgelixir, oral 80mg/15ml Alpharma

@ elixir, oral 80mg/15ml Halseyelixir, oral 80mg/15ml Morton Grove

@ elixir, oral 80mg/15ml Perrigoelixir, oral 80mg/15ml Pharmaceutical Associates

@ elixir, oral 80mg/15ml Roxaneelixir, oral 80mg/15ml Thamessolution, oral 80mg/15ml Roxane

@ syrup, oral 80mg/15ml Alpharma@ syrup, oral 150mg/15ml Alpharma

tablet, extended release Sidmak 100,200,300,450mg

Brand(s)Slo-BID capsule, extended release Aventis *

100,125,200,300mgElixomin @ elixir, oral 80mg/15ml CenciElixophyllin elixir, oral 80mg/15ml ForestLanophyllin @ elixir, oral 80mg/15ml LannettTheolixir @ elixir, oral 80mg/15ml Panray/OrmontTheolair solution, oral 80mg/15ml Riker/3MAccurbron @ syrup, oral 150mg/15ml AventisAquaphyllin @ syrup, oral 80mg/15ml FerndaleSlo-Phyllin-80 syrup, oral 80mg/15ml AventisTheoclear-80 syrup, oral 80mg/15ml Central

(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

195

THEOPHYLLINE (continued)Theocron tablet, extended release Forest/Inwood

100,200,300,450mgTheo-Dur tablet, extended release Schering *

100,200,300,450mg

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

THEOPHYLLINE; DEXTROSESee DEXTROSE; THEOPHYLLINE

THEOPHYLLINE; EPHEDRINE; HYDROXYZINE HYDROCHLORIDESee EPHEDRINE; HYDROXYZINE HYDROCHLORIDE; THEOPHYLLINE

THEOPHYLLINE; GUAIFENESINSee GUAIFENESIN; THEOPHYLLINE

THIAMINE HYDROCHLORIDEThiamine Hydrochloride injection 100mg/ml Abbott

@ injection 100mg/ml Akorninjection 100mg/ml American Pharmaceutical

Partners@ injection 100,200mg/ml Bel-Mar@ injection 100mg/ml Dell

injection 100mg/ml Elkins-Sinn@ injection 100mg/ml Luitpold@ injection 100mg/ml Parke-Davis

injection 100,200mg/ml Sterisinjection 100mg/ml Wyeth-Ayerst

Brand(s)Betalin S @ injection 100mg/ml Lilly

THIAMINE HYDROCHLORIDE; ASCORBIC ACID; BIOTIN; CYANOCOBALAMIN; DEXPANTHENOL;ERGOCALCIFEROL; FOLIC ACID; NIACINAMIDE; PYRIDOXINE HYDROCHLORIDE; RIBOFLAVINPHOSPHATE SODIUM; VITAMIN A; VITAMIN E

See ASCORBIC ACID; BIOTIN; CYANOCOBALAMIN; DEXPANTHENOL; ERGOCALCIFEROL;FOLIC ACID; NIACINAMIDE; PYRIDOXINE HYDROCHLORIDE; RIBOFLAVIN PHOSPHATESODIUM; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN E

THIAMINE HYDROCHLORIDE; ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; IRON; NICOTINICACID; PYRIDOXINE HYDROCHLORIDE; RIBOFLAVIN; VITAMIN A; VITAMIN D; VITAMIN E

See ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; IRON; NICOTINIC ACID; PYRIDOXINEHYDROCHLORIDE; RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D;VITAMIN E

THIAMINE HYDROCHLORIDE; ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; NICOTINIC ACID;PYRIDOXINE HYDROCHLORIDE; RIBOFLAVIN; VITAMIN A; VITAMIN D; VITAMIN E

See ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; NICOTINIC ACID; PYRIDOXINEHYDROCHLORIDE; RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D;VITAMIN E

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

196

THIORIDAZINE HYDROCHLORIDEThioridazine Hydrochloride @ concentrate, oral 30mg/ml Alpharma

concentrate, oral 100mg/ml Alpharmaconcentrate, oral 30,100mg/ml Copley

@ concentrate, oral 30,100mg/ml Genevaconcentrate, oral 30,100mg/ml Hi-Tech

@ concentrate, oral 30,100mg/ml Morton Groveconcentrate, oral 30,100mg/ml Pharmaceutical Associates

@ tablet, oral 10,15,25,100,150,200mg Barrtablet, oral 50mg Barr

@ tablet, oral 10,15,25,50,100, Circa 150,200mgtablet, oral 10,15,25,50,100, Danbury 150,200mgtablet, oral 10,15,25,50,100, Geneva 150,200mgtablet, oral 10,15,25mg IVAX

@ tablet, oral 50,100mg IVAXtablet, oral 10,25,50,100mg Mutualtablet, oral 10,25,50,100mg Mylan

@ tablet, oral 10,15,25,50,100, Par 150,200mg

@ tablet, oral 10,25,50,100mg Roxane@ tablet, oral 10,25,50mg Superpharm@ tablet, oral 10mg Teva

tablet, oral 100mg Tevatablet, oral 25,50,100mg Watson

@ tablet, oral 10,15mg Watson@ tablet, oral 10,15,25,50mg West-Ward

Brand(s)Intensol concentrate, oral 30,100mg/ml RoxaneMellaril concentrate, oral 30,100mg/ml NovartisMellaril tablet, oral 10,15,25,50,100, Novartis *

150,200mg

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

THIOTEPAThiotepa injection 15mg/vial Bedford

injection 15mg/vial ImmunexBrand(s)

Thioplex injection 15mg/vial Immunex

THIOTHIXENEThiothixene @ capsule, oral 1,2,5,10,20mg American Therapeutics

capsule, oral 1,2,5,10mg Danburycapsule, oral 1,2,5,10mg Genevacapsule, oral 1,2,5,10mg Mylan

@ capsule, oral 2,5,10mg WatsonBrand(s)

Navane capsule, oral 1,2,5,10,20mg Roerig/Pfizer

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

197

THIOTHIXENE HYDROCHLORIDEThiothixene Hydrochloride @ concentrate, oral eq 5mg base/ml Alpharma

concentrate, oral eq 5mg base/ml Copley@ concentrate, oral eq 5mg base/ml Paco@ concentrate, oral eq 5mg base/ml Teva

Brand(s)Intensol concentrate, oral eq 5mg base/ml RoxaneNavane concentrate, oral eq 5mg base/ml Roerig/Pfizer

TICLOPIDINE HYDROCHLORIDETiclopidine Hydrochloride tablet, oral 250mg Danbury

tablet, oral 250mg Eontablet, oral 250mg Genevatablet, oral 250mg GenPharmtablet, oral 250mg Mylantablet, oral 250mg Purepactablet, oral 250mg Tevatablet, oral 250mg TorPharm

Brand(s)Ticlid tablet, oral 250mg Roche

TIMOLOL MALEATETimolol Maleate solution, ophthalmic Akorn

eq 0.25,0.5% basesolution, ophthalmic Bausch and Lomb eq 0.25,0.5% basesolution, ophthalmic Falcon * eq 0.25,0.5% basesolution, ophthalmic Fougera/Altana eq 0.25,0.5% basesolution, ophthalmic Novex eq 0.25,0.5% basesolution, ophthalmic Pacific eq 0.25,0.5% basesolution, gel forming drops, ophthalmic Falcon * eq 0.25,0.5% base

@ tablet, oral 5,10,20mg Circatablet, oral 5,10,20mg Danburytablet, oral 5,10,20mg Genevatablet, oral 5,10,20mg Mylan

@ tablet, oral 5,10,20mg Quantum@ tablet, oral 5,10,20mg Teva@ tablet, oral 5,10,20mg USL

Brand(s)Timoptic solution, ophthalmic Merck

eq 0.25,0.5% baseTimoptic-XE solution, gel forming drops, ophthalmic Merck

eq 0.25,0.5% baseBlocadren tablet, oral 5,10,20mg Merck *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

TOBRAMYCINTobramycin @ solution, ophthalmic 0.3% Alcon Universal

solution, ophthalmic 0.3% Bausch and Lombsolution, ophthalmic 0.3% Steris

(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

198

TOBRAMYCIN (continued)Brand(s)

AKtob solution, ophthalmic 0.3% AkornTobrex solution, ophthalmic 0.3% Falcon *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

TOBRAMYCIN; DEXAMETHASONESee DEXAMETHASONE; TOBRAMYCIN

TOBRAMYCIN SULFATETobramycin Sulfate injection eq 10,40mg base/ml Abbott

injection eq 10,40mg base/ml Apothecon@ injection eq 10mg base/ml Astra Zeneca

injection eq 40mg base/ml Astra Zeneca@ injection eq 10,40mg base/ml Elkins-Sinn

injection eq 40mg base/ml Gensia Sicor@ injection eq 10mg base/ml Lederle

injection eq 40mg base/ml Lederleinjection eq 10,40mg base/ml Marsam

Brand(s)Nebcin injection eq 10,40mg base/ml Dista/Lilly

TOLAZAMIDETolazamide @ tablet, oral 100,250,500mg Barr

@ tablet, oral 100,250,500mg Circatablet, oral 100,250,500mg Danbury

@ tablet, oral 100,250,500mg Duramedtablet, oral 100,250,500mg Geneva

@ tablet, oral 250,500mg Interpharmtablet, oral 100,250,500mg IVAXtablet, oral 100,250,500mg Mutualtablet, oral 250,500mg Mylantablet, oral 100,250,500mg Par

@ tablet, oral 250,500mg Superpharm@ tablet, oral 250,500mg USL

Brand(s)Tolinase tablet, oral 100,250,500mg Pharmacia & Upjohn

TOLBUTAMIDETolbutamide @ tablet, oral 500mg (Ascot)

@ tablet, oral 500mg Barr@ tablet, oral 250,500mg Circa

tablet, oral 500mg Danbury@ tablet, oral 500mg Eon

tablet, oral 500mg Genevatablet, oral 500mg IVAXtablet, oral 500mg Lederletablet, oral 500mg Mylan

@ tablet, oral 500mg Parke-Davis@ tablet, oral 500mg Purepac@ tablet, oral 500mg Superpharm@ tablet, oral 500mg (Vangard/MWM)

tablet, oral 500mg WatsonBrand(s)

Orinase @ tablet, oral 250,500mg Pharmacia & Upjohn

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

199

TOLMETIN SODIUMTolmetin Sodium @ capsule, oral eq 400mg base Geneva

capsule, oral eq 400mg base IVAXcapsule, oral eq 400mg base Mutualcapsule, oral eq 400mg base Mylancapsule, oral eq 400mg base Purepaccapsule, oral eq 400mg base Tevatablet, oral eq 200,600mg base Genevatablet, oral eq 600mg base IVAXtablet, oral eq 200mg base Mutualtablet, oral eq 600mg base Mylantablet, oral eq 600mg base Purepac

@ tablet, oral eq 600mg base TevaBrand(s)

Tolectin D.S. capsule, oral eq 400mg base RW Johnson *Tolectin tablet, oral eq 200mg base RW Johnson *Tolectin 600 tablet, oral eq 600mg base RW Johnson *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

TRAZODONE HYDROCHLORIDETrazodone Hydrochloride @ tablet, oral 50,100mg American Therapeutics

tablet, oral 50,100,150,300mg Barr@ tablet, oral 50,100mg Circa

tablet, oral 50,100mg Danburytablet, oral 50,100mg Genevatablet, oral 50,100,150mg Mutualtablet, oral 50,100mg Mylantablet, oral 50,100mg Purepac

@ tablet, oral 100mg Quantumtablet, oral 50,100,150mg Sidmak *tablet, oral 50,100,150mg Teva

@ tablet, oral 50,100mg USLBrand(s)

Desyrel tablet, oral 50,100,150,300mg Apothecon **Trialodine @ tablet, oral 50mg Quantum

*Some manufacturers’ 150mg tablet cannot be broken into three 50mg segments. Prescribers andpharmacists should be aware of this difference and take it into account when writing a prescription orpracticing drug product selection.

** Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

TRETINOINTretinoin cream, topical 0.025,0.5,1% Spear

gel, topical 0.025% Spearsolution, topical 0.05% Copleysolution, topical 0.05% Morton Grove

Brand(s)Retin-A cream, topical 0.025,0.5,1% Johnson & JohnsonAvita cream, topical 0.025% BertekRetin-A gel, topical 0.025% Johnson & JohnsonRetin-A solution, topical 0.05% Johnson & Johnson

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

200

TRIAMCINOLONE ACETONIDETriamcinolone Acetonide cream, topical 0.025,0.1,0.5% Altana

cream, topical 0.025% Ambixcream, topical 0.025,0.1,0.5% Clay-Parkcream, topical 0.025,0.1% G and W

@ cream, topical 0.025,0.1,0.5% Morton Grove@ cream, topical 0.025,0.1,0.5% Pharmaderm/Altana@ cream, topical 0.025,0.1,0.5% Pharmafair@ cream, topical 0.025% Taro

cream, topical 0.1% Tarocream, topical 0.025,0.1,0.5% Thames

@ cream, topical 0.025,0.1,0.5% Topiderm@ lotion, topical 0.025,0.1% Alpharma

lotion, topical 0.025,0.1% Morton Grovelotion, topical 0.1% Thames

@ ointment, topical 0.5% Alpharmaointment, topical 0.025,0.1,0.5% Altanaointment, topical 0.025,0.1,0.5% Clay-Park

@ ointment, topical 0.025,0.1% G & W@ ointment, topical 0.025,0.1,0.5% Morton Grove@ ointment, topical 0.025,0.1% Pharmaderm/Altana

ointment, topical 0.025,0.1% Taroointment, topical 0.1% Thames

Brand(s)Aristocort cream, topical 0.025,0.1,0.5% FujisawaFlutex @ cream, topical 0.025,0.1,0.5% IVAXKenac @ cream, topical 0.025,0.1% AlpharmaKenalog cream, topical 0.025,0.1,0.5% ApotheconTriacet cream, topical 0.025,0.1,0.5% TevaTriacort @ cream, topical 0.1% SolvayTriatex @ cream, topical 0.025,0.1,0.5% IVAXTriderm cream, topical 0.1% Del-RayTrymex cream, topical 0.025,0.1% Altana/SavageTrymex @ cream, topical 0.5% Altana/SavageAristocort A cream, hydrophilic 0.025,0.1,0.5% FujisawaKenalog-H @ cream, hydrophilic 0.1% ApotheconKenalog lotion, topical 0.025,0.1% ApotheconAristocort ointment, topical 0.1% FujisawaAristocort @ ointment, topical 0.5% FujisawaFlutex @ ointment, topical 0.025,0.1,0.5% IVAXKenac ointment, topical 0.1% NMCKenalog ointment, topical 0.025,0.1% ApotheconKenalog @ ointment, topical 0.5% ApotheconTrymex ointment, topical 0.025,0.1% Savage/AltanaAristocort A ointment, hydrophilic 0.1% FujisawaAristocort A @ ointment, hydrophilic 0.5% FujisawaKenalog in Orabase paste, dental 0.1% ApotheconOracort paste, dental 0.1% TaroOralone paste, dental 0.1% Thames

TRIAMCINOLONE ACETONIDE; NEOMYCIN SULFATESee NEOMYCIN SULFATE; TRIAMCINOLONE ACETONIDE

TRIAMCINOLONE ACETONIDE; NYSTATINSee NYSTATIN; TRIAMCINOLONE ACETONIDE

TRIAMTERENE; HYDROCHLOROTHIAZIDESee HYDROCHLOROTHIAZIDE; TRIAMTERENE

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

201

TRIAZOLAMTriazolam tablet, oral 0.125,0.25mg Alphapharm

tablet, oral 0.125,0.25mg Roxanetablet, oral 0.125,0.25mg Watson

Brand(s)Halcion tablet, oral 0.125,0.25mg Pharmacia & Upjohn *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

TRIFLUOPERAZINE HYDROCHLORIDETrifluoperazine Hydrochloride @ concentrate, oral eq 10mg base/ml Morton Grove

@ injection eq 2mg base/ml Quad@ tablet, oral eq 1,2,5,10mg base Circa@ tablet, oral eq 1,2,5,10mg base Duramed

tablet, oral eq 1,2,5,10mg base Geneva@ tablet, oral eq 1,2,5,10mg base IVAX

tablet, oral eq 1,2,5,10mg base MylanBrand(s)

Stelazine concentrate, oral eq 10mg base/ml SmithKline BeechamTFP @ concentrate, oral eq 10mg base/ml GenevaStelazine injection eq 2mg base/ml SmithKline BeechamStelazine tablet, oral eq 1,2,5,10mg base SmithKline BeechamTFP tablet, oral eq 1,2,5,10mg base Geneva

TRIFLURIDINETrifluridine solution, ophthalmic 1% Alcon

Brand(s)Viroptic solution, ophthalmic 1% Monarch

TRIHEXYPHENIDYL HYDROCHLORIDETrihexyphenidyl Hydrochloride elixir, oral 2mg/5ml Mikart

elixir, oral 2mg/5ml Pharm Ventureselixir, oral 2mg/5ml Pharmaceutical Associatestablet, oral 2,5mg Circatablet, oral 2,5mg Danburytablet, oral 5mg Nylos

@ tablet, oral 2mg (Vangard/MWM)tablet, oral 2,5mg Vintagetablet, oral 2,5mg West-ward

Brand(s)Artane elixir, oral 2mg/5ml Lederle *Artane tablet, oral 2,5mg LederleTremin @ tablet, oral 2,5mg Schering

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

TRIMEPRAZINE TARTRATETrimeprazine Tartrate @ syrup, oral 2.5mg/5ml Alpharma

@ syrup, oral 2.5mg/5ml Morton GroveBrand(s)

Temaril @ syrup, oral 2.5mg/5ml Allergan Herbert

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

202

TRIMETHOBENZAMIDE HYDROCHLORIDETrimethobenzamide Hydrochloride injection 100mg/ml Abbott

@ injection 100mg/ml Smith and Nephew@ injection 100mg/ml Solopak

injection 100mg/ml SterisBrand(s)

Tigan injection 100mg/ml King

TRIMETHOPRIMTrimethoprim @ tablet, oral 100,200mg Barr

tablet, oral 100mg Danburytablet, oral 100,200mg Teva

Brand(s)Proloprim tablet, oral 100,200mg MonarchTrimpex tablet, oral 100mg RocheTrimpex @ tablet, oral 200mg Roche

TRIMETHOPRIM; SULFAMETHOXAZOLESee SULFAMETHOXAZOLE; TRIMETHOPRIM

TRIMETHOPRIM SULFATE; POLYMYXIN B SULFATESee POLYMYXIN B SULFATE; TRIMETHOPRIM SULFATE

TRIPELENNAMINE HYDROCHLORIDETripelennamine Hydrochloride @ tablet, oral 50mg Anabolic

@ tablet, oral 50mg Barr@ tablet, oral 50mg Circa

tablet, oral 50mg Danbury@ tablet, oral 50mg Heather@ tablet, oral 50mg Impax

tablet, oral 50mg Lannett@ tablet, oral 50mg Parke-Davis

tablet, oral 50mg Nylos@ tablet, oral 50mg Watson

Brand(s)PBZ tablet, oral 50mg Novartis

TRIPROLIDINE HYDROCHLORIDETriprolidine Hydrochloride @ syrup, oral 1.25mg/5ml Alpharma

@ syrup, oral 1.25mg/5ml Halsey@ syrup, oral 1.25mg/5ml Pharmaceutical Associates@ tablet, oral 2.5mg Danbury@ tablet, oral 2.5mg Eon

Brand(s)Actidil @ syrup, oral 1.25mg/5ml Glaxo WellcomeMyidyl @ syrup, oral 1.25mg/5ml USLActidil @ tablet, oral 2.5mg Glaxo Wellcome

TRIPROLIDINE HYDROCHLORIDE; CODEINE PHOSPHATE; PSEUDOEPHEDRINE HYDROCHLORIDESee CODEINE PHOSPHATE; PSEUDOEPHEDRINE HYDROCHLORIDE; TRIPROLIDINE

HYDROCHLORIDE

TRIPROLIDINE HYDROCHLORIDE; PSEUDOEPHEDRINE HYDROCHLORIDESee PSEUDOEPHEDRINE HYDROCHLORIDE; TRIPROLIDINE HYDROCHLORIDE

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

203

TRISULFAPYRIMIDINE (SULFADIAZINE, SULFAMETHAZINE AND SULFAMERAZINE)Brand(s)

Lantrisul @ suspension, oral 167mg/5ml; Lannett 167mg/5ml;167mg/5ml (501mg/5ml)

Neotrizine @ suspension, oral 167mg/5ml; Lilly 167mg/5ml;167mg/5ml (501mg/5ml)

Sulfaloid @ suspension, oral 167mg/5ml; Forest 167mg/5ml;167mg/5ml (501mg/5ml)

Sulfose @ suspension, oral 167mg/5ml; Wyeth-Ayerst 167mg/5ml;167mg/5ml (501mg/5ml)

Terfonyl @ suspension, oral 167mg/5ml; Squibb 167mg/5ml;167mg/5ml (501mg/5ml)

Triple Sulfa @ suspension, oral 167mg/5ml; Alpharma 167mg/5ml;167mg/5ml (501mg/5ml)

Triple Sulfas @ suspension, oral 167mg/5ml; Lederle 167mg/5ml;167mg/5ml (501mg/5ml)

Neotrizine @ tablet, oral 167mg;167mg;167mg Lilly (501mg)

Sulfa-Triple #2 @ tablet, oral 167mg;167mg;167mg Impax (501mg)

Sulfaloid @ tablet, oral 167mg;167mg;167mg Forest (501mg)

Sulfose @ tablet, oral 167mg;167mg;167mg Wyeth-Ayerst (501mg)

Terfonyl @ tablet, oral 167mg;167mg;167mg Squibb (501mg)

Triple Sulfa @ tablet, oral 167mg;167mg;167mg Purepac (501mg)

Triple Sulfas @ tablet, oral 167mg;167mg;167mg Lederle (501mg)

Triple Sulfoid tablet, oral 167mg;167mg;167mg Pal Pak (501mg)

TROPICAMIDETropicamide @ solution, ophthalmic 0.5% Alcon Universal

solution, ophthalmic 1% Alcon Universalsolution, ophthalmic 0.5,1% Bausch and Lombsolution, ophthalmic 0.5,1% Miza

Brand(s)Mydriacil solution, ophthalmic 0.5,1% AlconMydriafair @ solution, ophthalmic 0.5,1% PharmafairTropicacyl solution, ophthalmic 0.5,1% Akorn

TUBOCURARINE CHLORIDETubocurarine Chloride injection 3mg/ml Abbott

injection 3mg/ml Bristol-Myers Squibbinjection 3mg/ml Lilly

UREA; HYDROCORTISONESee HYDROCORTISONE; UREA

UREA; HYDROCORTISONE ACETATESee HYDROCORTISONE ACETATE; UREA

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

204

URSODIOLUrsodiol capsule, oral 300mg Amide

capsule, oral 300mg CopleyBrand(s)

Actigall capsule, oral 300mg Novartis *

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

VALPROIC ACIDValproic Acid capsule, oral 250mg Banner Pharmacaps

@ capsule, oral 250mg Parcapsule, oral 250mg Scherercapsule, oral 250mg USLsyrup, oral 250mg/5ml Copleysyrup, oral 250mg/5ml Hi-Techsyrup, oral 250mg/5ml Pharmaceutical Associatessyrup, oral 250mg/5ml UDL

Brand(s)Depakene capsule, oral 250mg AbbottDepakene syrup, oral 250mg/5ml AbbottMyproic Acid syrup, oral 250mg/5ml Morton Grove

VANCOMYCIN HYDROCHLORIDEVancomycin Hydrochloride injection eq 500mg,1,5gm base/vial Abbott

@ injection eq 500mg,1gm base/vial Elkins-Sinn@ injection eq 500mg,1gm base/vial Quad

Brand(s)Lyphocin injection eq 500mg,1,5,10gm base/vial American Pharmaceutical

PartnersVancocin injection eq 500mg,1,10gm base/vial LillyVancoled injection eq 500mg,1,5,10gm base/vial LederleVancor @ injection eq 500mg,1gm base/vial Pharmacia & UpjohnVancocin powder for reconstitution, oral Lilly

eq 250mg base/5ml eq 500mg base/6ml

Vancoled powder for reconstitution, oral Lederle eq 250mg base/5ml

@ eq 500mg base/6ml

VECURONIUM BROMIDEVecuronium Bromide injection 10,20mg/vial Abbott

injection 10,20mg/vial Bedfordinjection 10,20mg/vial ESI/Lederleinjection 10,20mg/vial Gensia Sicorinjection 10,20mg/vial Steris

Brand(s)Norcuron injection 10,20mg/vial Organon

VERAPAMIL HYDROCHLORIDEVerapamil Hydrochloride capsule, extended release Mylan

120,180,240mginjection 2.5mg/ml Abbott

@ injection 2.5mg/ml American Pharmaceutical Partners

injection 2.5mg/ml Bedford(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

205

VERAPAMIL HYDROCHLORIDE (continued)injection 2.5mg/ml International Medicationinjection 2.5mg/ml Luitpoldinjection 2.5mg/ml Marsam

@ injection 2.5mg/ml Quad@ injection 2.5mg/ml Smith and Nephew@ injection 2.5mg/ml Solopak@ tablet, oral 80,120mg Barr

tablet, oral 80,120mg Danburytablet, oral 40,80,120mg Genevatablet, oral 80,120mg Lederletablet, oral 80,120mg Mutualtablet, oral 80,120mg Mylantablet, oral 80,120mg Purepactablet, oral 40,80,120mg Sidmak

@ tablet, oral 80,120mg Warner Chilcotttablet, oral 40,80,120mg Watson

@ tablet, extended release 120,240mg Barrtablet, extended release IVAX 120,180,240mgtablet, extended release Mylan 120,180,240mgtablet, extended release 240mg Sidmak

Brand(s)Verelan capsule, extended release Elan *

120,180,240mgCalan @ injection 2.5mg/ml SearleIsoptin injection 2.5mg/ml AbbottCalan tablet, oral 40,80,120mg SearleIsoptin tablet, oral 40,80,120mg AbbottIsoptin SR tablet, extended release Abbott *

120,180,240mg

* Products manufactured by this brand name manufacturer in this drug entity are available for drug productselection under other brand and/or generic names.

VINBLASTINE SULFATEVinblastine Sulfate injection 1mg/ml American Pharmaceutical

Partners@ injection 1mg/ml Quad@ injection 10mg/vial American Pharmaceutical

Partnersinjection 10mg/vial Bedfordinjection 10mg/vial Faulding

@ injection 10mg/vial QuadBrand(s)

Velban @ injection 10mg/vial Lilly

VINCRISTINE SULFATEVincristine Sulfate @ injection 1mg/ml ABIC

@ injection 1mg/ml American Pharmaceutical Partners

@ injection 1mg/ml Faulding@ injection 1mg/ml Quad

injection 1,2,5mg/vial Faulding@ injection 1,2,5mg/vial Quad

(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

206

VINCRISTINE SULFATE (continued)Brand(s)

Oncovin injection 1mg/ml LillyOncovin @ injection 1,5mg/vial LillyVincasar PFS injection 1mg/ml Pharmacia & UpjohnVincrex @ injection 5mg/vial Bristol-Myers SquibbVincristine Sulfate injection 1mg/ml Gensia Sicor Preservative-Free

VITAMIN A (50,000 USP Units = 15mg)Vitamin A @ capsule, oral 50,000 USP Units Banner Pharmacaps

@ capsule, oral 50,000 USP Units Chase@ capsule, oral 50,000 USP Units Everylife@ capsule, oral 50,000 USP Units Impax

capsule, oral 50,000 USP Units West-WardBrand(s)

Aquasol A @ capsule, oral 50,000 USP Units Astra Zeneca

VITAMIN A; ASCORBIC ACID; BIOTIN; CYANOCOBALAMIN; DEXPANTHENOL; ERGOCALCIFEROL;FOLIC ACID; NIACINAMIDE; PYRIDOXINE HYDROCHLORIDE; RIBOFLAVIN PHOSPHATE SODIUM;THIAMINE HYDROCHLORIDE; VITAMIN E

See ASCORBIC ACID; BIOTIN; CYANOCOBALAMIN; DEXPANTHENOL; ERGOCALCIFEROL;FOLIC ACID; NIACINAMIDE; PYRIDOXINE HYDROCHLORIDE; RIBOFLAVIN PHOSPHATESODIUM; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN E

VITAMIN A; ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; IRON; NICOTINIC ACID; PYRIDOXINEHYDROCHLORIDE; RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN D; VITAMIN E

See ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; IRON; NICOTINIC ACID; PYRIDOXINEHYDROCHLORIDE; RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D;VITAMIN E

VITAMIN A; ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; NICOTINIC ACID; PYRIDOXINEHYDROCHLORIDE; RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN D; VITAMIN E

See ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; NICOTINIC ACID; PYRIDOXINEHYDROCHLORIDE; RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D;VITAMIN E

VITAMIN A; ASCORBIC ACID; FLUORIDE; IRON; VITAMIN DSee ASCORBIC ACID; FLUORIDE; IRON; VITAMIN A; VITAMIN D

VITAMIN A; ASCORBIC ACID; FLUORIDE; VITAMIN DSee ASCORBIC ACID; FLUORIDE; VITAMIN A; VITAMIN D

VITAMIN A PALMITATE (50,000 Units base = 15mg)Vitamin A Palmitate capsule, oral 50,000 Units base Arcum

@ capsule, oral 50,000 Units base Banner Pharmacaps@ capsule, oral 50,000 Units base Chase@ capsule, oral 50,000 Units base Elkins-Sinn@ capsule, oral 50,000 Units base Everylife@ capsule, oral 50,000 Units base Impax@ capsule, oral 50,000 Units base IVAX

capsule, oral 50,000 Units base MK(continued on the next page)

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

207

VITAMIN A PALMITATE (50,000 Units base = 15mg) (continued)@ capsule, oral 50,000 Units base Squibb@ capsule, oral 50,000 Units base Teva@ capsule, oral 50,000 Units base West-ward@ capsule, oral 50,000 Units base Wharton@ injection 50,000 Units base/ml Bel-Mar

Brand(s)Afaxin @ capsule, oral 50,000 Units base Sterling WinthropAlphalin @ capsule, oral 50,000 Units base LillyDel-Vi-A @ capsule, oral 50,000 Units base Del-RayVi-Dom-A @ capsule, oral 50,000 Units base BayerAquasol A injection 50,000 Units base/ml Astra Zeneca

VITAMIN D; ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; IRON; NICOTINIC ACID; PYRIDOXINEHYDROCHLORIDE; RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN E

See ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; IRON; NICOTINIC ACID; PYRIDOXINEHYDROCHLORIDE; RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D;VITAMIN E

VITAMIN D; ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; NICOTINIC ACID; PYRIDOXINEHYDROCHLORIDE; RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN E

See ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; NICOTINIC ACID; PYRIDOXINEHYDROCHLORIDE; RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D;VITAMIN E

VITAMIN D; ASCORBIC ACID; FLUORIDE; IRON; VITAMIN ASee ASCORBIC ACID; FLUORIDE; IRON; VITAMIN A; VITAMIN D

VITAMIN D; ASCORBIC ACID; FLUORIDE; VITAMIN ASee ASCORBIC ACID; FLUORIDE; VITAMIN A; VITAMIN D

VITAMIN E; ASCORBIC ACID; BIOTIN; CYANOCOBALAMIN; DEXPANTHENOL; ERGOCALCIFEROL;FOLIC ACID; NIACINAMIDE; PYRIDOXINE HYDROCHLORIDE; RIBOFLAVIN PHOSPHATE SODIUM;THIAMINE HYDROCHLORIDE; VITAMIN A

See ASCORBIC ACID; BIOTIN; CYANOCOBALAMIN; DEXPANTHENOL; ERGOCALCIFEROL;FOLIC ACID; NIACINAMIDE; PYRIDOXINE HYDROCHLORIDE; RIBOFLAVIN PHOSPHATESODIUM; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN E

VITAMIN E; ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; IRON; NICOTINIC ACID; PYRIDOXINEHYDROCHLORIDE; RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D

See ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; IRON; NICOTINIC ACID; PYRIDOXINEHYDROCHLORIDE; RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D;VITAMIN E

VITAMIN E; ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; NICOTINIC ACID; PYRIDOXINEHYDROCHLORIDE; RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D

See ASCORBIC ACID; CYANOCOBALAMIN; FLUORIDE; NICOTINIC ACID; PYRIDOXINEHYDROCHLORIDE; RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D;VITAMIN E

APPLICATION HOLDER,DRUG DOSAGE FORM, STRENGTH MANUFACTURER

208

WARFARIN SODIUMWarfarin Sodium tablet, oral 1,2,2.5,3,4,5,6,7.5,10mg Barr

tablet, oral 1,2,2.5,3,4,5,6,7.5,10mg Genevatablet, oral 1,2,2.5,4,5,7.5,10mg Taro

Brand(s)Coumadin tablet, oral 1,2,2.5,3,4,5,6,7.5,10mg Bristol-Myers Squibb

NOTE: Within 24 hours of any interchange of a patient’s warfarin sodium prescription, whether from abrand name manufacturer to a generic manufacturer, generic manufacturer to a brand name manufacturer,or generic manufacturer to a different generic manufacturer, the pharmacist must notify the prescriber ofthe interchange, identifying to the prescriber the name of the manufacturer of the warfarin sodium tabletsdispensed to the patient.

WATER FOR INJECTION, STERILESterile water in plastic container

Water injection 100% Abbottinjection 100% American Pharmaceutical

Partnersinjection 100% Baxterinjection 100% Braun

WATER FOR IRRIGATION, STERILESterile water in plastic container

Water liquid 100% Abbottliquid 100% Baxterliquid 100% Braun

@ liquid 100% Miles

XYLOSEXylose powder, oral 25gm/bottle Lyne

Brand(s)Xylo-Pfan @ powder, oral 25gm/bottle Savage

209

ILLINOIS FORMULARYTWENTIETH EDITION

DRUG PRODUCT SELECTION PROGRAMALPHABETICAL INDEX

NOTE: Not all dosage forms and/or strengths of the drug products listed in this index may actually appear in the text. Alwaysrefer to the drug's specific page in the text to be sure that an approved, generically and pharmaceutically equivalent product isbeing dispensed.

Page

A.P.L. 103A/T/S 85A-Hydrocort 116A-Methapred 142A-Poxide 45A/B Otic Drops 16Abitrexate 140Accurbron 194ACEBUTOLOL HYDROCHLORIDE 1ACETAMINOPHEN; BUTALBITAL 1ACETAMINOPHEN; BUTALBITAL; CAFFEINE 1ACETAMINOPHEN; CAFFEINE; 1 DIHYDROCODEINE BITARTRATEACETAMINOPHEN; CODEINE PHOSPHATE 2ACETAMINOPHEN; HYDROCODONE 2,3,4 BITARTRATEACETAMINOPHEN; OXYCODONE 4 HYDROCHLORIDEACETAMINOPHEN; PENTAZOCINE 4 HYDROCHLORIDEACETAMINOPHEN; PROPOXYPHENE 4 HYDROCHLORIDEACETAMINOPHEN; PROPOXYPHENE 5 NAPSYLATEAcetasol 5Acetasol HC 6ACETAZOLAMIDE 5ACETAZOLAMIDE SODIUM 5ACETIC ACID, GLACIAL 5ACETIC ACID, GLACIAL; ALUMINUM ACETATE 6ACETIC ACID, GLACIAL; HYDROCORTISONE 6ACETOHEXAMIDE 6ACETYLCYSTEINE 6Achromycin 174,194Achromycin V 194Acilac 127Actahist 179Actigall 204

Page

ACTH 58Acthar 58Acticort 114Actidil 202Actifed w/Codeine 58Actin-H 152ACYCLOVIR 6,7ACYCLOVIR SODIUM 7Adalat 151Adalat CC 151Adapin 80Adderall 14Adipex-P 162Adphen 161Adrenalin Chloride 83Adriamycin PFS 80Adriamycin RDF 80Adrucil 95Adsorbocarpine 164Aerolone 124Aerosporin 166Afaxin 207AK-Chlor 44AK-Con 148AK-Con A 148AK-Dex 64AK-Dilate 162AK-Gentak 100AK-Homatropine 106AK-Pentolate 60AK-Pred 172AK-Sulf 188AKbeta 128AKarpine 164AKpro 77AKtob 198Ala-Cort 114Albalon 148

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210

Albalon A 16ALBUTEROL 7ALBUTEROL SULFATE 7,8Alcaine 176ALCOHOL; DEXTROSE 8ALCOHOL; MORPHINE 8,9Aldactazide 112Aldactone 187Aldochlor 150 46Aldochlor 250 46Aldomet 141Aldoril 15 111Aldoril 25 111Aldoril D30 111Aldoril D50 111Alesse 90Alfenta 9ALFENTANIL HYDROCHLORIDE 9Alkergot 85Allay 3Allerfed 179ALLOPURINOL 9Alpha Redisol 117Alphacaine 128,129Alphacaine HCl w/Epinephrine 84Alphaderm 115Alphalin 207Alphatrex 27Alphazine 161ALPRAZOLAM 9ALPROSTADIL 9Alupent 137AMANTADINE HYDROCHLORIDE 10Ambenyl 30Amcill 16Amicar 11Amidate 91AMIKACIN SULFATE 10Amikin 10AMILORIDE HYDROCHLORIDE 10AMILORIDE HYDROCHLORIDE; 10 HYDROCHLOROTHIAZIDEAMINOACETIC ACID 102AMINOCAPROIC ACID 11AMINOHIPPURATE SODIUM 11Aminophyllin 11AMINOPHYLLINE 11AMIODARONE HYDROCHLORIDE 11Amitid 12Amitril 12AMITRIPTYLINE HYDROCHLORIDE 11,12

AMITRIPTYLINE HYDROCHLORIDE; 12 CHLORDIAZEPOXIDEAMITRIPTYLINE HYDROCHLORIDE; 12,13 PERPHENAZINEAMMONIUM LACTATE 13Amosene 136AMOXAPINE 13AMOXICILLIN/AMOXICILLIN TRIHYDRATE 13,14Amoxil 14AMPHETAMINE ASPARTAME; AMPHETAMINE 14 SULFATE; DEXTROAMPHETAMINE SACCHARATE; DEXTROAMPHETAMINE SULFATEAmphicol 44AMPHOTERICIN B 14AMPICILLIN/AMPICILLIN TRIHYDRATE; 15 PROBENECIDAMPICILLIN SODIUM 15AMPICILLIN TRIHYDRATE 15,16AMRINONE LACTATE see INAMRINONE LACTATEAnafranil 54Anaprox 149Anaprox DS 149Ancef 42Android 10 142Android 25 142Anectine 187Anestacon 129Anexsia 3Anexsia 7.5/650 3Anexsia 10/660 3Anoquan 1Ansaid 96ANTAZOLINE PHOSPHATE; 16 NAPHAZOLINE HYDROCHLORIDEANTIPYRINE; BENZOCAINE 16,17Anspor 44Antepar 165Antispasmodic Elixir 23Antivert 134Anturane 191Anusol HC 114Apogen 100Apresazide 108Apresoline 108Apri 62Aquaphyllin 194Aquasol A 206,207Aquatensen 140Aralen 46Aramine 137Arestocaine HCl 135

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211

Arestocaine HCl w/Levonordefrin 128Aristocort 200Aristocort A 200Artane 201ASCORBIC ACID; BIOTIN; 17 CYANOCOBALAMIN; DEXPANTHENOL; ERGOCALCIFEROL; FOLIC ACID; NIACINAMIDE; PYRIDOXINE HYDROCHLORIDE; RIBOFLAVIN PHOSPHATE SODIUM; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN EASCORBIC ACID; CYANOCOBALAMIN; 17 FLUORIDE; IRON; NICOTINIC ACID PYRIDOXINE HYDROCHLORIDE; RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D; VITAMIN E ASCORBIC ACID; CYANOCOBALAMIN; 17,18 FLUORIDE; NICOTINIC ACID; PYRIDOXINE HYDROCHLORIDE; RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN D; VITAMIN EASCORBIC ACID; FLUORIDE; IRON; 18 VITAMIN A; VITAMIN DASCORBIC ACID; FLUORIDE; 18 VITAMIN A; VITAMIN DAsendin 13ASPIRIN; BUTALBITAL; CAFFEINE; 19ASPIRIN; BUTALBITAL; CAFFEINE; 19 CODEINE PHOSPHATEASPIRIN; CAFFEINE; ORPHENADRINE CITRATE 19ASPIRIN; CAFFEINE; 20 PROPOXYPHENE HYDROCHLORIDEASPIRIN; CARISOPRODOL 20ASPIRIN; CARISOPRODOL; 20 CODEINE PHOSPHATEASPIRIN; CODEINE PHOSPHATE 20ASPIRIN; MEPROBAMATE 20ASPIRIN; METHOCARBAMOL 20ASPIRIN; OXYCODONE HYDROCHLORIDE; 21 OXYCODONE TEREPHTHALATEAstramorph PF 146Atarax 118ATENOLOL 21ATENOLOL; CHLORTHALIDONE 21Ativan 131ATRACURIUM BESYLATE 21,22Atracurium Besylate Preservative-Free 22Atromid-S 54Atropair 22Atropen 22ATROPINE 22Atropine Care 22

ATROPINE SULFATE 22Atropine and Demerol 23ATROPINE SULFATE; DIPHENOXYLATE 22,23 HYDROCHLORIDEATROPINE SULFATE; HYOSCYAMINE; 23 PHENOBARBITAL; SCOPOLAMINE HYDROBROMIDEATROPINE SULFATE; MEPERIDINE 23 HYDROCHLORIDEAtropine-1 22Atropisol 22Atrovent 122Auralgan 16Auroto Drops 17AVC 190Aventyl HCl 153Aviane 90Avita 199Aygestin 153AZATHIOPRINE 24AZATHIOPRINE SODIUM 24AZELAIC ACID 24Azelex 24Azulfidine 191Baci-Rx 24Baciguent 24Baciim 24BACITRACIN 24BACITRACIN; HYDROCORTISONE ACETATE; 24 NEOMYCIN SULFATE; POLYMYXIN B SULFATEBACITRACIN ZINC; HYDROCORTISONE; 24 NEOMYCIN SULFATE; POLYMYXIN B SULFATEBACITRACIN ZINC; NEOMYCIN SULFATE; 25 POLYMYXIN B SULFATEBACITRACIN ZINC; POLYMYXIN B SULFATE 25BACLOFEN 25Bactocill 155Bactrim 190Bactrim DS 190Bactrim Pediatric 190Balneol-HC 114Banan 42Bancap 1Bancap HC 3Barstatin 100 154Beepen-VK 159Belix 77Ben Aqua 5 26Ben Aqua 10 26Benadryl 77Benadryl Preservative-Free 77

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Benemid 173Bentyl 74Bentyl Preservative-Free 74Benzac 5 26Benzac 10 26Benzac W 2.5 26Benzac W 5 26Benzac W 10 26Benzac W Wash 5 26Benzac W Wash 10 26BENZONATATE 25BENZOYL PEROXIDE 25,26BENZTROPINE MESYLATE 26Bepadin 26BEPRIDIL HYDROCHLORIDE 26Berubigen 59Beta-2 123Beta-HC 114Beta-Val 27,28Betaderm 27Betagan 128Betalin-S 195Betalin 12 59BETAMETHASONE DIPROPIONATE 26,27BETAMETHASONE DIPROPIONATE, 27 AUGMENTEDBETAMETHASONE DIPROPIONATE; 27 CLOTRIMAZOLEBETAMETHASONE SODIUM PHOSPHATE 27BETAMETHASONE VALERATE 27,28Betapace 186Betapen-VK 159Betatrex 27,28BETAXOLOL HYDROCHLORIDE 28BETHANECHOL CHLORIDE 28Betoptic 28Biocycline 194Biphetap 30BISOPROLOL FUMARATE 28BISOPROLOL FUMARATE; 29 HYDROCHLOROTHIAZIDEBlenoxane 29BLEOMYCIN SULFATE 29Bleph-10 188Bleph-30 188Blephamide 172Blocadren 197Bontril PDM 161Borofair 6Brethine 192BRETYLIUM TOSYLATE 29

BRETYLIUM TOSYLATE; DEXTROSE 29Bretylol 29Brevicon 90Bricanyl 192Bristacycline 194Bristagen 100Bristamycin 87Bromanate 30Bromanate DC 30Bromanate DM 30Bromanyl 30Bromfed-DM 30BROMOCRIPTINE MESYLATE 29BROMODIPHENHYDRAMINE 30 HYDROCHLORIDE; CODEINE PHOSPHATEBROMPHENIRAMINE MALEATE 30BROMPHENIRAMINE MALEATE; CODEINE 30 PHOSPHATE; PHENYLPROPANOLAMINE HYDROCHLORIDEBROMPHENIRAMINE MALEATE; 30 DEXTROMETHORPHAN HYDROBROMIDE; PSEUDOEPHEDRINE HYDROCHLORIDEBROMPHENIRAMINE MALEATE; 30 PHENYLPROPANOLAMINE HYDROCHLORIDEBronkosol 123Bryrel 165BSS Plus 33Bucet 1BUMETANIDE 31Bumex 31BUPIVACAINE HYDROCHLORIDE 31BUPIVACAINE HYDROCHLORIDE; 31 EPINEPHRINE BITARTRATEBUPRENORPHINE HYDROCHLORIDE 31Buprenex 31BUPROPION HYDROCHLORIDE 31Buspar 32BUSPIRONE 31,32Butabarb 32BUTABARBITAL SODIUM 32Butal Compound 19Butalbital Compound 19Butapap 1Butisol Sodium 32BUTORPHANOL TARTRATE 32,33Butorphanol Tartrate Preservative-Free 32,33C-Solve 2 85,86Cafergot 33CAFFEINE; ERGOTAMINE TARTRATE 33Calan 205Calcimar 33

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Calciquid 37CALCITONIN, SALMON 33CALCITRIOL 33CALCIUM CHLORIDE; DEXTROSE; 33 GLUTATHIONE DISULFIDE; MAGNESIUM CHLORIDE; POTASSIUM CHLORIDE; SODIUM BICARBONATE; SODIUM CHLORIDE; SODIUM PHOSPHATECALCIUM CHLORIDE; DEXTROSE; 34,35 MAGNESIUM CHLORIDE; SODIUM CHLORIDE; SODIUM LACTATECALCIUM CHLORIDE; DEXTROSE; 35 POTASSIUM CHLORIDE; SODIUM CHLORIDECALCIUM CHLORIDE; DEXTROSE; 35,36 POTASSIUM CHLORIDE; SODIUM CHLORIDE; SODIUM LACTATECALCIUM CHLORIDE; MAGNESIUM CHLORIDE; 36 POTASSIUM CHLORIDE; SODIUM CHLORIDECALCIUM CHLORIDE; POTASSIUM 37 CHLORIDE; SODIUM CHLORIDECALCIUM CHLORIDE; POTASSIUM 37 CHLORIDE; SODIUM CHLORIDE; SODIUM LACTATECALCIUM GLUBIONATE 37CALCIUM GLUCEPTATE 37CALCIUM GLUCONATE 37Calmurid HC 115Cam-Metrazine 161Candex 154Capital with Codeine 2Capoten 38Capozide 38CAPTOPRIL 38,39CAPTOPRIL; HYDROCHLOROTHIAZIDE 38Carafate 188CARBACHOL 38Carbastat 38CARBAMAZEPINE 38CARBENICILLIN DISODIUM 38CARBIDOPA; LEVODOPA 39CARBINOXAMINE MALEATE; 39 DEXTROMETHORPHAN HYDROBROMIDE; PSEUDOEPHEDRINE HYDROCHLORIDECARBINOXAMINE MALEATE; 40 PSEUDOEPHEDRINE HYDROCHLORIDECarbocaine 135Carbocaine Hydrochloride w/Neocobefrin 128Carbofed DM 39Cardec DM 39Cardene 150Cardioplegic 36

Cardizem 76Cardizem CD 76Cardizem SR 76Cardura 79CARISOPRODOL 40Carmol HC 116Carnitor 128CARTEOLOL HYDROCHLORIDE 40Cartia XT 76Cataflam 73Catapres 55Caverject 9Ceclor 41Ceclor CD 41CEFACLOR 40,41CEFADROXIL/CEFADROXIL HEMIHYDRATE 41Cefadyl 44Cefanex 43CEFAZOLIN SODIUM 41,42CEFOTAXIME SODIUM 42CEFOXITIN SODIUM 42CEFPODOXIME PROXETIL 42CEFTAZIDIME 42CEFTAZIDIME(ARGININE FORMULATION) 42CEFTAZIDIME SODIUM 42CEFUROXIME SODIUM 43Celestone 27Cena K 168CEPHALEXIN 43CEPHALOTHIN SODIUM 43,44CEPHAPIRIN SODIUM 44CEPHRADINE/CEPHRADINE DIHYDRATE 44Cephulac 127Ceptaz 42Cerubidine 61Cetacort 114Cetamide 188Chemdec DM 39Chemdec 40Chlor-Trimeton 47CHLORAL HYDRATE 44CHLORAMPHENICOL 44,45CHLORAMPHENICOL SODIUM SUCCINATE 45Chlordiazachel 45CHLORDIAZEPOXIDE HYDROCHLORIDE 45Chlorofair 44CHLORHEXIDINE GLUCONATE 45Chloromycetin 44,45CHLOROPROCAINE HYDROCHLORIDE 46Chloroptic 44Chloroptic S.O.P. 44

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CHLOROQUINE PHOSPHATE 46CHLOROTHIAZIDE 46CHLOROTHIAZIDE; METHYLDOPA 46CHLOROTRIANISENE 46CHLORPHENIRAMINE MALEATE 46,47CHLORPHENIRAMINE MALEATE; 47 CODEINE PHOSPHATE; PSEUDOEPHEDRINE HYDROCHLORIDECHLORPHENIRAMINE MALEATE; 47,48 PHENYLEPHRINE HYDROCHLORIDE; PHENYLPROPANOLAMINE HYDROCHLORIDE; PHENYLTOLOXAMINE CITRATECHLORPHENIRAMINE MALEATE; 48 PHENYLPROPANOLAMINE HYDROCHLORIDECHLORPHENIRAMINE TANNATE; 48 PHENYLEPHRINE TANNATE; PYRILAMINE TANNATECHLORPROMAZINE HYDROCHLORIDE 48CHLORPROPAMIDE 48,49CHLORTHALIDONE 49CHLORTHALIDONE; CLONIDINE 49,50 HYDROCHLORIDECHLORZOXAZONE 50Cholac 127Choledyl 156CHOLESTYRAMINE 50Cholestyramine Light 50CHORIONIC GONADOTROPIN 103CHROMIC CHLORIDE 50Chronulac 127CIMETIDINE 51CIMETIDINE HYDROCHLORIDE 51CIMETIDINE HYDROCHLORIDE; 51 SODIUM CHLORIDECinobac 51CINOXACIN 51Cin-Quin 181Circanol 85CISPLATIN 51,52CITRIC ACID; MAGNESIUM OXIDE; 52 SODIUM CARBONATEClaforan 42Cleocin 52,53Cleocin Phosphate in Dextrose 5% 53Cleocin T 53CLADRIBINE 52CLEMASTINE FUMARATE 52Climara 88Clinda-Derm 53CLINDAMYCIN HYDROCHLORIDE 52CLINDAMYCIN PHOSPHATE 52,53

CLINDAMYCIN PHOSPHATE; DEXTROSE 53Clindets 53Clinoril 192CLOBETASOL PROPIONATE 53,54CLOFIBRATE 54Clomid 54CLOMIPHENE CITRATE 54CLOMIPRAMINE HYDROCHLORIDE 54CLONAZEPAM 54,55CLONIDINE HYDROCHLORIDE 55Clopra 143CLORAZEPATE DIPOTASSIUM 55CLOTRIMAZOLE 56CLOXACILLIN SODIUM MONOHYDRATE 56Cloxapen 56CLOZAPINE 56Clozaril 56Cobavite 59Codafed 57Codamine 113CODEINE PHOSPHATE; GUAIFENESIN 57CODEINE PHOSPHATE; GUAIFENESIN; 57 PSEUDOEPHEDRINE HYDROCHLORIDECODEINE PHOSPHATE; 57 IODINATED GLYCEROLCODEINE PHOSPHATE; PHENYLEPHRINE 57 HYDROCHLORIDE; PROMETHAZINE HYDROCHLORIDECODEINE PHOSPHATE; PROMETHAZINE 58 HYDROCHLORIDECODEINE PHOSPHATE; 58 PSEUDOEPHEDRINE HYDROCHLORIDE; TRIPROLIDINE HYDROCHLORIDECodoxy 21Cogentin 26Co-Gesic 3Co-Lav 165COLISTIMETHATE 58Colocort 114Colovage 165Colonaid 23Coly-Mycin M 58Colyte 165Colyte-Flavored 165Combipres 50Compazine 174,175Compound 65 20Compro 174Constilac 127Constulose 127Cor-Oticin 116

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Cordarone 11Cordran 96Corgard 146Cormax 54Corphed 179Cort-Dome 114Cortenema 114CORTICOTROPIN 58Cortisporin ophthalmic ointment 24Cortisporin ophthalmic suspension 115Cortisporin otic solution 115Cortisporin topical ointment 24Cortril 114Cotrim 190Cotrim DS 190Cotrim Pediatric 190Coumadin 208Crolom 58CROMOLYN SODIUM 58Cromoptic 58CROTAMITON 59Crotan 59Cryselle 90CYANOCOBALAMIN 59CYCLACILLIN 59Cyclapen W 59CYCLOBENZAPRINE HYDROCHLORIDE 60Cyclogyl 60Cyclopar 194CYCLOPENTOLATE HYDROCHLORIDE 60CYCLOPHOSPHAMIDE 60CYCLOSPORINE 60Cycrin 134Cylert 157CYPROHEPTADINE HYDROCHLORIDE 60,61CYTARABINE 61Cytomel 130Cytosar-U 61Cytoxan 60DACARBAZINE 61Dalmane 97DANAZOL 61Danocrine 61Dapex-37.5 162Darvocet-N 50 5Darvocet-N 100 5Darvon 177Darvon Compound-65 20DAUNORUBICIN HYDROCHLORIDE 61Daypro 155DDAVP 62

Deapril-ST 85Decadron 62,63Deca-Durabolin 147Decapryn 81Delacort 114Delalutin 117Deladumone 89Deladumone-OB 89Delatestryl 193Delaxin 139Delestrogen 88Delflex w/Dextrose 34Delflex w/Dextrose low magnesium 34Delflex w/Dextrose low magnesium / low calcium 34Deltalin 84Deltasone 173Del-Vi-A 207Demerol 135Demulen 1/35 89Demulen 1/50 89Dendrid 119Depakene 204Depo-Estradiol 88Depo-Testadiol 88Depo-Testosterone 193Dermabet 27Dermacomb 154Dermacort 114Dermatol HC 114DESIPRAMINE HYDROCHLORIDE 61DESMOPRESSIN ACETATE 62Desmopressin Acetate Preservative-Free 62Desogen 62DESOGESTREL; ETHINYL ESTRADIOL 62DESONIDE 62Desowen 62DESOXIMETASONE 62Desoxyn 138Desquam X 2.5 26Desquam X 5 26Desquam X 10 26Desquam X 5 Wash 26Desyrel 199Detussin Expectorant 104Detussin Liquid 113Dexacen-4 63Dexacidin 63Dexair 64DEXAMETHASONE 62DEXAMETHASONE; NEOMYCIN SULFATE; 63 POLYMYXIN B SULFATE

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DEXAMETHASONE; TOBRAMYCIN 63DEXAMETHASONE SODIUM PHOSPHATE 63,64DEXAMETHASONE SODIUM PHOSPHATE; 64 NEOMYCIN SULFATEDexampex 64Dexasporin 63DEXCHLORPHENIRAMINE MALEATE 64Dexedrine 64DEXTROAMPHETAMINE SULFATE 64DEXTROMETHORPHAN HYDROBROMIDE; 65 IODINATED GLYCEROLDEXTROMETHORPHAN HYDROBROMIDE; 65 PROMETHAZINE HYDROCHLORIDEDEXTROSE 65,66Dextrose 5% in Lactated Ringers 35,36Dextrose 5% in Lactated Ringers 36 with Potassium Chloride 10,20,30,40mEqDextrose 5% in Ringers 35DEXTROSE; DOBUTAMINE HYDROCHLORIDE 66,67DEXTROSE; DOPAMINE HYDROCHLORIDE 67DEXTROSE; GENTAMICIN SULFATE 67DEXTROSE; HEPARIN SODIUM 67DEXTROSE; LIDOCAINE HYDROCHLORIDE 67,68DEXTROSE; MAGNESIUM CHLORIDE; 68 POTASSIUM CHLORIDE; SODIUM ACETATE; SODIUM CHLORIDE; SODIUM GLUCONATEDEXTROSE; MANNITOL 68DEXTROSE; NITROGLYCERIN 68DEXTROSE; POTASSIUM CHLORIDE 68DEXTROSE; POTASSIUM 68,69,70 CHLORIDE; SODIUM CHLORIDEDEXTROSE; SODIUM CHLORIDE 69DEXTROSE; THEOPHYLLINE 71,72Dextrostat 64Dey-Dose 137Dey-Lute 137DHC Plus 1Di-Atro 23Di-Metrex 161Diabeta 102Diabinese 49Dial 106Diamox 5Dianeal 137 w/Dextrose 35Dianeal Low Calcium w/Dextrose 35Dianeal PD-1 w/Dextrose 34Dianeal PD-2 w/Dextrose 34,35Dianeal PD-2 w/Dextrose, Low Calcium 34DIAZEPAM 72DIAZOXIDE 72,73

Dibenil 77DICLOFENAC POTASSIUM 73DICLOFENAC SODIUM 73DICLOXACILLIN SODIUM 73DICYCLOMINE HYDROCHLORIDE 73,74DIENESTROL 74DIETHYLPROPION HYDROCHLORIDE 74DIETHYLSTILBESTROL 74DIFLORASONE DIACETATE 74DIFLUNISAL 74,75Digitek 75DIGOXIN 75Dihistine DH 47DIHYDROERGOTOXINE METHANESULFONATE 84Dilacor XR 76Dilantin Injection 164Dilantin 125 Suspension 164Dilaudid 117Dilaudid HP 117Dilaudid Hydrochloride 117DILTIAZEM HYDROCHLORIDE 75,76DIMENHYDRINATE 76Dimetane 30Dimetane-DC 30Dimetane-DX 30Dimetane-Ten 30Diphen 77DIPHENHYDRAMINE HYDROCHLORIDE 76,77Diphenhydramine Hydrochloride Preservative-Free 77DIPIVEFRIN HYDROCHLORIDE 77Diprivan 176Diprolene AF 27Diprosone 27DIPYRIDAMOLE 78DISOPYRAMIDE PHOSPHATE 78Ditate-DS 89Ditropan 156Diucardin 117Diulo 143Diuril 46DOBUTAMINE HYDROCHLORIDE 78Dobutrex 78Dolene 177Dolene AP-65 4Dolobid 75Dolophine 138Domeboro 6Donnatal 23DOPAMINE HYDROCHLORIDE 79Dopastat 79Dopram 79

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Doriden 102Doryx 81DOXAPRAM HYDROCHLORIDE 79DOXAZOSIN MESYLATE 79DOXEPIN HYDROCHLORIDE 79,80DOXORUBICIN HYDROCHLORIDE 80Doxy 100 81Doxy 200 81Doxy-Lemmon 81Doxy-Tabs 81Doxychel 80Doxychel Hyclate 81DOXYCYCLINE 80DOXYCYCLINE HYCLATE 80,81DOXYLAMINE SUCCINATE 81Dralzine 108Drisdol 84DROPERIDOL 81DROPERIDOL; FENTANYL CITRATE 81DTIC-Dome 61Duphalac 127Dura-Lutin 114Durabolin 148Duracillin A.S. 158Duradyne DHC 3Duramorph PF 146Duricef 41Duvoid 28DV Vaginal Cream 74Dyazide 112Dycill 73Dymelor 6Dynapen 73E-Base 86E-Z-EM Prep Lyte 165EC-Naprosyn 148Econochlor 44Econopred Plus 171E-Dec DM 39EDETATE DISODIUM 82Edex 9EDROPHONIUM CHLORIDE 82Edrophonium Chloride Preservative-Free 82E.E.S. 86,87E.E.S. 200 87E.E.S. 400 87Effer-K 167Elavil 12Eldecort 114Eldepryl 183Elimite 160

Elixomin 194Elixophyllin 194EM-K-10% 169Embeline 54Embelene E 54Emgel 85Empirin #3 20Empracet with Codeine #3,4 2E-Mycin 86E-Mycin-E 87ENALAPRIL MALEATE 82ENALAPRIL MALEATE; HYDROCHLOROTHIAZIDE 82ENALIPRILAT 82,83Endep 12Endosol Extra 33Endrate 82Enduron 140ENFLURANE 83Enlon 82Enpresse 90Entex 104Enulose 127EPHEDRINE; HYDROXYZINE 83 HYDROCHLORIDE; THEOPHYLLINEEpicort 114EPINEPHRINE HYDROCHLORIDE 83EPINEPHRINE; LIDOCAINE HYDROCHLORIDE 83,84Epitol 38EPOETIN ALPHA 84Epogen 84Equagesic 20Equanil 136Ercatab 33ERGOCALCIFEROL 84ERGOLOID MESYLATES 84,85Ergomar 85Ergostat 85ERGOTAMINE TARTRATE 85Ery-Ped 86,87Ery-Tab 86Eryc 85Eryc 125 85Eryc Sprinkles 85Erycette 86Eryderm 85Erygel 85Erymax 86Erypar 87Erythra-Derm 86Erythro-Statin 86Erythrocin 87

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Erythrocin Stearate 87ERYTHROMYCIN 85,86ERYTHROMYCIN ESTOLATE 86ERYTHROMYCIN ETHYLSUCCINATE 86,87ERYTHROMYCIN ETHYLSUCCINATE; 87 SULFISOXAZOLE ACETYLERYTHROMYCIN LACTOBIONATE 87ERYTHROMYCIN STEARATE 87,88Eryzole 87Esgic 1Esgic Plus 1Esidrix 109Eskalith 130ESTAZOLAM 88Estrace 88ESTRADIOL 88ESTRADIOL CYPIONATE 88ESTRADIOL CYPIONATE; TESTOSTERONE 88 CYPIONATEESTRADIOL VALERATE 88ESTRADIOL VALERATE; TESTOSTERONE 89 ENANTHATEEstraguard 74ESTROPIPATE 89ETHAMBUTOL HYDROCHLORIDE 89ETHCHLORVYNOL 89ETHINYL ESTRADIOL; ETHYNODIOL 89 DIACETATEETHINYL ESTRADIOL; LEVONORGESTREL 90ETHINYL ESTRADIOL; NORETHINDRONE 90ETHINYL ESTRADIOL: NORETHINDRONE 90 ACETATEETHINYL ESTRADIOL; NORGESTREL 90ETHOSUXIMIDE 91Ethrane 83Ethril 250 87Ethril 500 87ETODOLAC 91ETOMIDATE 91ETOPOSIDE 91,92Eulexin 97Eurax 59Evalose 127Exsel 183FAMOTIDINE 92Famotidine Preservative-Free 92Fastin 162Feldene 165Femcet 1FENOPROFEN CALCIUM 92,93FENTANYL CITRATE 93

Fentanyl Citrate Preservative-Free 93Ferndex 64Fioricet 1Fiorinal 19Fiorinal with Codeine #3 19Flagyl 144Flagyl I.V. 144Flagyl I.V. RTU 144FLECAINIDE ACETATE 93Flexeril 60Flexicort 114FLOXURIDINE 93Flumadine 182Fluocet 94FLUOCINOLONE ACETONIDE 93,94FLUOCINONIDE 94Fluonid 94FLUOROMETHALONE 95Fluor-Op 95FLUOROURACIL 95Fluothane 106Fluotrex 94FLUOXETINE HYDROCHLORIDE 95,96FLUPHENAZINE DECANOATE 96FLUPHENAZINE HYDROCHLORIDE 96FLURANDRENOLIDE 96FLURAZEPAM HYDROCHLORIDE 96,97FLURBIPROFEN 97FLURBIPROFEN SODIUM 97FLUTAMIDE 97Flutex 200FLUVOXAMINE MALEATE 97FML 95Folex 140Folex PFS 140FOLIC ACID 98Folicet 98Follutein 103Folvite 98Forane 123Forbaxin 139Fortaz 42FSH; LH 130FUDR 93Fulvicin P/G 103Fulvicin U/F 103Fungizone 14Furacin 152Furadantin 151Furalan 151FUROSEMIDE 98,99

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GAMMA BENZENE HEXACHLORIDE 130Gamene 130Gantanol 189Gantanol DS 189Gantrisin 191Garamycin 100GEMFIBROZIL 99Gencept 0.5/35 90Gencept 1/35 90Gencept 10/11 90Generlac 127Genoptic 100Genora 0.5/35 90Gentacidin 100Gentafair 100GENTAMICIN SULFATE 99,100GENTAMICIN SULFATE; SODIUM CHLORIDE 100,101Gen-K 168Gen-Xene 55Geopen 38Gerimal 85Germa-Medica "MG" 106GLIPIZIDE 101GLUCAGON HYDROCHLORIDE 101Glucamide 49Glucophage 138GLUTETHIMIDE 102Glucotrol 101GLYBURIDE 102GLYBURIDE, MICRONIZED 102GLYCINE 102Glycoprep 165GLYCOPYRROLATE 102,103Glycort 114Glynase 102Go-Evac 166Golytely 166GONADOTROPIN CHORIONIC 103GRAMICIDIN; NEOMYCIN SULFATE; 103 POLYMYXIN B SULFATEGrifulvin V 103Grisactin 103Grisactin Ultra 103GRISEOFULVIN MICROCRYSTALLINE 103GRISEOFULVIN ULTRAMICROCRYSTALLINE 103Gris-PEG 103GUAIFENESIN; HYDROCODONE 104 BITARTRATE; PSEUDOEPHEDRINE HYDROCHLORIDE

GUAIFENESIN; PHENYLEPHRINE 104 HYDROCHLORIDE; PHENYLPROPANOLAMINE HYDROCHLORIDEGUAIFENESIN; THEOPHYLLINE 104GUANABENZ ACETATE 104GUANETHIDINE MONOSULFATE 105GUANFACINE HYDROCHLORIDE 105Guiatuss AC 57Guiatus DAC 57Gyne-Sulf 188Halcion 201Haldol 105,106Haldol Decanoate 105HALOPERIDOL 105HALOPERIDOL DECANOATE 105HALOPERIDOL LACTATE 105,106HALOTHANE 106HC 114HC #1 114HC #4 114H Cort 114H.E.A. 85Hemsol-HC 116HEPARIN SODIUM 106,107Heparin Sodium Preservative-Free 106HEPARIN SODIUM; SODIUM CHLORIDE 107Hep Flush 106Hep-Lock, Hep Lock PF 106Hep-Lock, Hep Lock U/P 106Heptalac 127Herplex Liquifilm 119Hexa-Betalin 179HEXACHLOROPHENE 107Hexadrol 62,63Hexa-Germ 107Hexascrub 107HiCor 114Hiprex 138Histafed 179Histatan 48HOMATROPINE HYDROBROMIDE 107HOMATROPINE METHYLBROMIDE; 107 HYDROCODONE BITARTRATEHumatin 157Humegon 135Hycodan 107Hycomine 113Hycophen 113Hydeltrasol 172Hydergine 85Hydral 108

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HYDRALAZINE HYDROCHLORIDE 108HYDRALAZINE HYDROCHLORIDE; 108 HYDROCHLOROTHIAZIDEHydramine 77Hydra-Zide 108Hydrea 118Hydrocet 3HYDROCHLOROTHIAZIDE 108,109HYDROCHLOROTHIAZIDE; LABETALOL 110HYDROCHLOROTHIAZIDE; LISINOPRIL 110HYDROCHLOROTHIAZIDE; METHYLDOPA 110,111HYDROCHLOROTHIAZIDE; 111 PROPRANOLOL HYDROCHLORIDEHYDROCHLOROTHIAZIDE; 111,112 SPIRONOLACTONEHYDROCHLOROTHIAZIDE; TRIAMTERENE 112HYDROCODONE BITARTRATE; 112,113 PHENYLPROPANOLAMINE HYDROCHLORIDEHYDROCODONE BITARTRATE; 113 PSEUDOEPHEDRINE HYDROCHLORIDEHydrocodone Compound 107HYDROCORTISONE 113,114Hydrocortisone in Adsorbase 114HYDROCORTISONE; 115 NEOMYCIN SULFATE; POLYMYXIN B SULFATEHYDROCORTISONE; POLYMYXIN B SULFATE 115HYDROCORTISONE; UREA 115HYDROCORTISONE ACETATE 115,116HYDROCORTISONE ACETATE; NEOMYCIN 116 SULFATEHYDROCORTISONE ACETATE; UREA 116HYDROCORTISONE SODIUM PHOSPHATE 116HYDROCORTISONE SODIUM SUCCINATE 116HYDROCORTISONE VALERATE 116Hydrocortone 116Hydro-D 109HydroDIURIL 109HYDROFLUMETHIAZIDE 117HYDROMORPHONE HYDROCHLORIDE 117Hydropane 107Hydrophed 113Hydrophed Expectorant 104Hydro-ride 10Hydrotex 114HYDROXOCOBALAMIN 117Hydroxomin 117HYDROXYCHLOROQUINE SULFATE 117HYDROXYPROGESTERONE CAPROATE 117HYDROXYUREA 118HYDROXYZINE HYDROCHLORIDE 118

HYDROXYZINE PAMOATE 118,119Hygroton 49Hymac 114Hyperstat 73Hy-Phen 3Hytone 114Hytrin 192Hytussin 104Hyzyd 123Ibu 119IBUPROFEN 119Ibuprohm 119Ibu-Tab 119IDOXURIDINE 119I-Homatropine 107I-Phrine 162I-Tropine 22Ilosone 86Ilotycin 85,86Imdur 124IMIPRAMINE HYDROCHLORIDE 120Imodium 131Imuran 24INAMRINONE LACTATE 120Inapsine 81INDAPAMIDE 120Inderal 178Inderal LA 178Inderide 40/25 111Inderide 80/25 111Indocin 121Indocin-SR 121Indo-Lemmon 121INDOMETHACIN 120,121Inflamase Mild 172Inflamase Forte 172Innofem 88Innovar 81Inocor 120Inpersol-LC/LM with Dextrose 35Intal 58Intensol Chlorpromazine 48Intensol Methadone 138Intensol Thioridazine 196Intensol Thiothixene 197Intralipid 10% 187Intralipid 20% 187Intralipid 30% 187Intropin 79Invagesic 19Invagesic Forte 19

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IODINATED GLYCEROL 121Iogan 121Iogan DM 65Ionamin-30 162IOPAMIDOL 122Iopamidol-200 122Iopamidol-250 122Iopamidol-300 122Iopamidol-370 122Iophen C 57Iophen DM 65Iophen Elixir 121Iotuss-C 57Iotuss-DM 65Iotuss Elixir, Solution 121Iotuss Solution 121IPRATROPIUM BROMIDE 122Irrigating Solution G 52Ismelin 105ISMO 124Isocaine HCl 135Isocaine HCl w/Levonordefrin 128ISOETHARINE HYDROCHLORIDE 122,123ISOFLURANE 123Isolyte S 132Isolyte S w/Dextrose 5% 68ISONIAZID 123ISOPROTERENOL HYDROCHLORIDE 124Isoptin 205Isoptin SR 205Isopto Atropine 22Isopto Carpine 164Isopto Cetamide 188Isopto Homatropine 107Isordil 124Isordil Tembid 124ISOSORBIDE DINITRATE 124ISOSORBIDE MONONITRATE 124Isovue-200 122Isovue-250 122Isovue-300 122Isovue-370 122Isuprel 124Janimine 120K + 8 169K + Care 168K + Care ET 167K-Dur 169Kainair 176KANAMYCIN SULFATE 124,125Kantrex 125

Kaochlor 10% 169Kaochlor SF 169Kaon 10% 171Kaon Cl 20% 169Kappadione 134Kato 168Kay Ciel 168,169Kayexalate 186Keflet 43Keflex 43Keflin 44Kefurox 43Kefzol 42Kenac 200Kenalog 200Kenalog-H 200Kenalog in Orabase 200Kerlone 28Kesso-Gesic 177Ketalar 125KETAMINE HYDROCHLORIDE 125KETOCONAZOLE 125KETOPROFEN 125KETOROLAC TROMETHAMINE 126Ketorolac Tromethamine Preservative-Free 126K-Lease 168K-Lor 168K-Lyte 167Klebcil 125Klonopin 55Klor-10% 169Klor-Con 167,168,169Klor-Con 20% 169Klor-Con EF 167Klor-Con M10 169Klor-Con M20 169Kloromin 47Klorvess 169Korostatin 154Kwell 130LABETALOL HYDROCHLORIDE 126Lac-Hydrin 13Lactated Ringer's 37LACTULOSE 126,127Laniazid 123Lanophyllin 194Lanorinal 19Lanoxin 75Lantrisul 203Lariam 134Larotid 14

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Laryng-O-Jet 129Laryngotracheal Anesthesia Kit 129Lasix 99Laxilose 127Ledercillin-VK 159LEUCOVORIN CALCIUM 127Leucovorin Calcium Preservative-Free 127LEUPROLIDE ACETATE 128Leustatin 52Levo-Dromoran 128LEVOBUNOLOL HYDROCHLORIDE 128LEVOCARNITINE 128LEVONORDEFRIN; MEPIVICAINE 128 HYDROCHLORIDELevora 0.15/30 90LEVORPHANOL TARTRATE 128Librium 45Lidex 94Lidex-E 94LIDOCAINE 128LIDOCAINE HYDROCHLORIDE 129Lidocaine Hydrochloride Preservative-Free 129Lidocaton 84,129Lidopen 129Limbitrol 12Limbitrol DS 12Lincocin 130LINCOMYCIN 130LINDANE 130Lioresal 25LIOTHYRONINE SODIUM 130Lipo-Hepin 106Liposyn III 10% 187Liposyn III 20% 187Liposyn III 30% 187Liquaemin Sodium 106LISINOPRIL 130Lithane 130LITHIUM CARBONATE 130LITHIUM CITRATE 131Lithonate 130,131Lithotabs 130Lo/Ovral 90Lo-Trol 23Locholest 50Locholest Light 50Lodine 91Lodine XL 91Loestrin FE 1/20 90Loestrin FE 1.5/30 90Lofene 23

Logen 23Lomanate 23Lomotil 23Loniten 145Lonox 23LOPERAMIDE HYDROCHLORIDE 131Lopid 99Lopressor 144Lopurin 9Loraz 131LORAZEPAM 131Lorcet-HD 3Lortab 3Lotrimin 56Lotrisone 27LOVASTATIN 131Low-Ogestrel 90Low-Quel 23LOXAPINE SUCCINATE 131Loxitane 131Lozol 120LTA II Kit 129Ludiomil 133Lupron 128Luvox 97Lygen 45Lyophilized Cytoxan 60Lyphocin 204Macrodantin 152MAGNESIUM CHLORIDE; POTASSIUM 132 CHLORIDE; SODIUM ACETATE; SODIUM CHLORIDE; SODIUM GLUCONATEMAGNESIUM SULFATE 132Maldec 40Maldec DM Syrup 39MANNITOL 132MAPROTILINE HYDROCHLORIDE 133Marax DF 83Marcaine Hydrochloride 31Marcaine Hydrochloride with Epinephrine 31Marcaine Hydrochloride Preservative-Free 31Marcaine HCl with Epinephrine Preservative-Free 31Maxidex 62,64Maxitrol 63Maxolon 143Maxzide 112Maxzide-25 112MEBENDAZOLE 133MECLIZINE HYDROCHLORIDE 133,134MECLOFENAMATE SODIUM 134Meclomen 134

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Medigesic Plus 1Medrol 142MEDROXYPROGESTERONE ACETATE 134MEFLOQUINE HYDROCHLORIDE 134Mefoxin 42MEGESTROL ACETATE 134Megace 134Melfiat 161Mellaril 196MENADIOL SODIUM PHOSPHATE 134MENOTROPINS 135MEPERIDINE HYDROCHLORIDE 135Meperidine Hydrochloride Preservative-Free 135MEPIVICAINE HYDROCHLORIDE 135,136Mepriam 136Mepro-Aspirin 20MEPROBAMATE 136MESNA 137Mesnex 137Mestinon 179MESTRANOL; NORETHINDRONE 137Metadate ER 141Metandren 142METAPROTERENOL SULFATE 137METARAMINOL BITARTRATE 137METFORMIN HYDROCHLORIDE 138METHADONE HYDROCHLORIDE 138Methadose 138Methampex 138METHAMPHETAMINE HYDROCHLORIDE 138METHAZOLAMIDE 138METHENAMINE HIPPURATE 138METHIMAZOLE 139METHOCARBAMOL 139METHOTREXATE SODIUM 139,140Methotrexate Sodium Preservative-Free 140METHSCOPOLAMINE BROMIDE 140METHYCLOTHIAZIDE 140METHYLDOPA 140,141METHYLDOPATE HYDROCHLORIDE 141Methylin 141Methylin ER 141METHYLPHENIDATE HYDROCHLORIDE 141METHYLPREDNISOLONE 141,142METHYLPREDNISOLONE 142 SODIUM SUCCINATEMETHYLTESTOSTERONE 142Meticorten 173Metimyd 171,172METIPRANOLOL HYDROCHLORIDE 142METOCLOPRAMIDE HYDROCHLORIDE 142,143

METOCURINE IODIDE 143METOLAZONE 143METOPROLOL TARTRATE 143,144Metra 161Metro I.V. 144Metromidol 144METRONIDAZOLE 144Metryl 144Metubine Iodide 143Mevacor 131Mexate 140Mexate-AQ 140Mexate-AQ Preserved 140Mexetil 144MEXILETINE HYDROCHLORIDE 144Miacalcin 33MICONAZOLE NITRATE 144Micort HC 116Micrainin 20Micro-K 168Micro-K 10 168Microgestin FE 1/20 90Microgestin FE 1.5/30 90Micronase 102Microzide 109Midamor 10MIDAZOLAM 145Milophene 54Miltown 136Minipress 171Minitran 152Minocin 145MINOCYCLINE HYDROCHLORIDE 145Minodyl 145MINOXIDIL 145Miostat 38MITOMYCIN 145Modicon 90Moduretic 10Monistat 3 144Monodox 80Monoket 124MORPHINE SULFATE 145,146Motrin 119MS Contin 146MS/L 146MSIR 146Mucomyst 6Mucosil 10 6Mucosil 20 6Multifuge 165

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Muro's Opcon A 148Mutamycin 145M.V.C. 9+3 17M.V.C. Plus 17M.V.I. - 12 17Myambutol 89Mybanil 30Mycelex 56Mychel 44Mychel-S 45Mycifradin 149Mycodone 107Mycolog-II 154Mycostatin 154Myco-Triacet II 154Mydfrin 162Mydriacil 203Mydriafair 203Myfed 179Myidil 202Mykacet 154Mykinac 154Mylaramine 64Mymethasone 62Mymethazine Fortis 175Myotonachol 28Myphetane DC 30Myphetane DX 30Myproic Acid 204Mysoline 173Mytrex F 154N.E.E. 1/35 90NABUMETONE 146NADOLOL 146Nafazair 148Nafcil 146NAFCILLIN SODIUM 146NALBUPHINE HYDROCHLORIDE 146,147Naldecon Pediatric Drops 47Naldecon Pediatric Syrup 47Naldecon Syrup 47Nalfon 93NALIDIXIC ACID 147Nallpen 146NALOXONE HYDROCHLORIDE 147NALOXONE HYDROCHLORIDE; 147 PENTAZOCINE HYDROCHLORIDENalphen 47Nalphen Pediatric Drops 47Nalphen Pediatric Syrup 47NALTREXONE HYDROCHLORIDE 147

NANDROLONE DECANOATE 147NANDROLONE PHENPROPIONATE 148NAPHAZOLINE HYDROCHLORIDE 148NAPHAZOLINE HYDROCHLORIDE; 148 PHENIRAMINE MALEATE Naphcon A 148Naphcon Forte 148Naphoptic A 148Naprelan 148Naprosyn 148NAPROXEN 148NAPROXEN SODIUM 149Narcan 147Navane 196,197Nebcin 198Necon 1/35 90Necon 1/50 137NegGram 147Nelova 90Nelova 7/14 90Nelova 10/11 90Nembutal Sodium 160Neo-Calglucon 37Neo-Cortef 116Neo-Dexair 64Neo-Otosol-HC 115Neo-Polycin 103Neo-Rx 149Neo-Synephrine 162Neobiotic 149Neodecadron 64NEOMYCIN SULFATE 149NEOMYCIN SULFATE; POLYMYXIN B 150 SULFATENeosar 60Neosporin G.U. Irrigant 150Neosporin Ophthalmic Ointment 25Neosporin Ophthalmic Solution 103Neotrizine 203Neptazane 138Nesacaine-MPF 46Neuramate 136NIACIN 150Niacor 150NICARDIPINE HYDROCHLORIDE 150Nicolar 150NICOTINE 150NICOTINIC ACID 150Nicotrol 150Nifedical XL 151NIFEDIPINE 151

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Nilstat 154Nipride 186Nitro-Bid 152Nitro-DUR 152NITROFURANTOIN 151NITROFURANTOIN MACROCRYSTALLINE 151,152NITROFURAZONE 152NITROGLYCERIN 152Nitro I.V. 152Nitrol 152Nitropress 186Nitrostat Injection 152Nizoral 125Noctec 44Nogenic HC 114Nolvadex 192Norcept E 1/35 90Norcet 3Norco 3Norcuron 204Nordette 90Norethin 1/35E 90Norethin 1/50M 137NORETHINDRONE ACETATE 153Norflex 155Norgesic 19Norgesic Forte 19Norinyl 1+35 90Norinyl 1+50 137Norinyl 1+80 137Norlutate 153Normodyne 126Normozide 110Norpace 78Norpace CR 78Norpramin 61Nortrel 0.5/35 90Nortrel 1/35 90NORTRIPTYLINE HYDROCHLORIDE 153Novadyne DH Liquid 47Novadyne Expectorant 57Novahistine DH Liquid 47Novahistine Expectorant 57Novocain 174Nubain 147Nutracort 114Nutrilipid 10% 187Nutrilipid 20% 187Nydrazid 123NYSTATIN 153,154NYSTATIN; TRIAMCINOLONE ACETONIDE 154

Nystex 154Nystop 154Obezine 161Obestin-30 162Oby-Trim 162Octamide PFS 143Octocaine 84Ocufen 97Ocumycin 25Ocupres 40Ocusulf-10 188Ocusulf-30 188Ocutricin 25,103Ocutricin HC 25,115Ocu-Tropine 22Ogen 89Ogestrel 90OMEPRAZOLE 154Omnipen 16Omnipen-N 15Ona-Mast 162Oncovin 206Opcon 148Opcon-A 148Ophthaine 176Ophthetic 176Ophthochlor 45Opticrom 58Optipranolol 142Optomycin 45Oracort 200Oralone 200Orasone 173Oretic 109Organidin Drops 121Organidin Elixir 121Orgatrax 118Oridol C 57Oridol Elixir 121Oridol Solution 121Orinase 198Orlex 5Orlex HC 6Ornade 48ORPHENADRINE CITRATE 155Orphengesic 19Ortho-Cept 62Ortho-Est 89Ortho-Novum 1/35 90 Ortho-Novum 1/50 137Ortho-Novum 1/80 137

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Ortho-Novum 7/14 90Ortho-Novum 10/11 90Orudis 125Oruvail 125Osmitrol 133Oticair 115Oto Ear Drops 17Otobione 115Otobiotic 115Otocort 115Ovral 90OXACILLIN SODIUM 155OXAPROZIN 155OXAZEPAM 156OXTRIPHYLLINE 156Oxy-Kesso-Tetra 157OXYBUTYNIN CHLORIDE 156Oxycet 4Oxycodone 5/APAP 500 4OXYTETRACYCLINE HYDROCHLORIDE 157OXYTOCIN 157P.A.S. Sodium 183Pacerone 11PACLITAXEL 157Pamelor 153Pamine 140PANCURONIUM BROMIDE 157Panheprin 107Panmycin 194Panoxyl 5 26Panoxyl 10 26Panoxyl Aq 2.5 26Panoxyl Aq 5 26Panoxyl Aq 10 26Papa-Deine #3 2Papa-Deine #4 2Paracaine 176Paraflex 50Parafon Forte DSC 50Parasal Sodium 183Paregoric Tincture 9Parlodel 29PAROMOMYCIN SULFATE 157Pathocil 73Pavulon 157PBZ 202Pediamycin 87Pediatric LTA Kit 129Pediazole 87Pediotic Cortisporin 115PEG-Lyte 166

PEMOLINE 157Pen-Vee K 159Penapar-VK 159Penbritin 16Penbritin-S 15Penecort 114PENICILLIN G POTASSIUM 157,158PENICILLIN G PROCAINE 158PENICILLIN V POTASSIUM 158,159Pentacarinat 159Pentam 300 159Pentacef 42PENTAMIDINE ISETHIONATE 159Pentids 200 158Pentids 250 158Pentids 400 158Pentids 800 158PENTOBARBITAL SODIUM 159,160Pentolair 60PENTOXIFYLLINE 160Pepcid 92Percocet 4Percodan 21Percodan-Demi 21Pergonal 135Periactin 61Peridex 45PerioGard 45PERMETHRIN 160Permetil 96PERPHENAZINE 160Persa-Gel 26Persa-Gel W 5% 26Persa-Gel W 10% 26Persantine 78Pfizer-E 88Pfizerpen 158Pfizerpen-A 16Pfizerpen-AS 158Pfizerpen-G 158Pfizerpen-VK 159Phenaphen No. 3 w/Codeine 2Phenaphen-650 w/Codeine 2Phenazine 161Phenazine-35 161PHENDIMETRAZINE TARTRATE 161Phenergan Fortis 175Phenergan Injection 175Phenergan Syrup 175Phenergan Tablet 175Phenergan w/Codeine 58

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Phenergan VC 163Phenergan VC w/Codeine 57Phenergan w/Dextromethorphan 65PHENOBARBITAL 161Phenoptic 162PHENTERMINE HYDROCHLORIDE 161,162PHENTERMINE RESIN COMPLEX 162PHENTOLAMINE MESYLATE 162PHENYLEPHRINE HYDROCHLORIDE 162PHENYLEPHRINE HYDROCHLORIDE; 163 PROMETHAZINE HYDROCHLORIDEPhenylhistine DH 47Phenylhistine Expectorant 57PHENYTOIN SODIUM INJECTION 164PHENYTOIN SUSPENSION 164Pherazine w/Codeine 58Pherazine DM 65Pherazine VC 163Pherazine VC w/Codeine 57pHisoHex 107pHisoscrub 107Phrenilin 1Phrenilin Forte 1Physiolyte 132Pilocar 164PILOCARPINE HYDROCHLORIDE 164PINDOLOL 164PIPERAZINE CITRATE 164,165PIPERAZINE ESTRONE CITRATE 89PIROXICAM 165Pitocin 157Placidyl 89Plaquenil 117Plasma-Lyte 148 132Plasma-Lyte 148 w/Dextrose 5% 68Plasma-Lyte A 132Platinol 52Platinol-AQ 52Plegine 161Plegisol 36Polaramine 64Polocaine 135Polocaine w/ Levonordefrin 128Polocaine-MPF 136Poly-Rx 166Poly-Vi-Flor 18Poly-Vi-Flor with Iron 17Poly Vitamin Drops with Fluoride 0.25mg 18Poly Vitamin Drops with Fluoride 0.5mg 18Polycillin 16Polycillin-N 15

Polycillin-PRB 15POLYETHYLENE GLYCOL 3350; 165,166 POTASSIUM CHLORIDE; SODIUM BICARBONATE; SODIUM CHLORIDE; SODIUM SULFATE, ANHYDROUSPolymox 14POLYMYXIN B SULFATE 166POLYMYXIN B SULFATE; 167 TRIMETHOPRIM SULFATEPolysporin 25Polytrim 167Pontocaine 193Portalac 127POTASSIUM BICARBONATE 167POTASSIUM CHLORIDE 167,168,169POTASSIUM CHLORIDE; SODIUM CHLORIDE 170POTASSIUM GLUCONATE 170,171Potsalan 169PRALIDOXIME CHLORIDE 171PRAZOSIN HYDROCHLORIDE 171Pre-Pred 171Pred Forte 171Predair 172Predair Forte 172Predamide 172Prednicen-N 173PREDNISOLONE 171PREDNISOLONE ACETATE 171PREDNISOLONE ACETATE; 171 SULFACETAMIDE SODIUMPREDNISOLONE SODIUM PHOSPHATE 172PREDNISOLONE SODIUM PHOSPHATE; 172 SULFACETAMIDE SODIUMPREDNISONE 172,173Predsulfair 171,172Predsulfair II 172Pregnyl 103Prelone 171Presamine 120Prevalite 50Prilosec 154PRIMIDONE 173Principen 15,16Prinivil 130Prinzide 10 - 12.5 110Prinzide 20 - 12.5 110Prinzide 20 - 25 110Probalan 173Probampacin 15PROBENECID 173PROCAINAMIDE HYDROCHLORIDE 173,174

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PROCAINE HYDROCHLORIDE 174PROCAINE HYDROCHLORIDE; 174 TETRACYCLINE HYDROCHLORIDEProcan 174Procan-SR 174Procapan 174Procardia 151Procardia XL 151PROCHLORPERAZINE 174PROCHLORPERAZINE EDISYLATE 174,175PROCHLORPERAZINE MALEATE 175Procrit 84Proctocort 114PROGESTERONE 175Proklar 189Prolixin 96Prolixin Decanoate 96Proloprim 202PROMAZINE HYDROCHLORIDE 175Prometa 137Prometh 175Prometh Fortis 175Prometh w/Codeine 58Prometh VC Plain 163Prometh VC w/Codeine 57Prometh w/Dextromethorphan 65Promethazine w/Dextromethorphan 65PROMETHAZINE HYDROCHLORIDE 175Promethazine with Codeine 58Promethazine with Dextromethorphan 65Promethazine VC 163Promethazine VC w/Codeine 56Pronestyl 174Propachem 113PROPAPHENONE HYDROCHLORIDE 176PROPARACAINE HYDROCHLORIDE 176Prophene 177Propine 77PROPOFOL 176Propoxyphene Compound 65 20PROPOXYPHENE HYDROCHLORIDE 176,177PROPRANOLOL HYDROCHLORIDE 177,178Prosom 88Prostaphlin 155Prostin VR Pediatric 9PROTAMINE SULFATE 178PROTIRELIN 178Protopam 171Protostat 144PROTRIPTYLINE HYDROCHLORIDE 178Proval No. 3 2

Proventil 7,8Provera 134Prozac 96Pseudodine C 58PSEUDOEPHEDRINE HYDROCHLORIDE; 179 TRIPROLIDINE HYDROCHLORIDEPsorcon 74Pyocidin 115Pyopen 38PYRAZINAMIDE 179Pyribenzamine 202Pyridamal 100 47PYRIDOSTIGMINE BROMIDE 179PYRIDOXINE HYDROCHLORIDE 179PYRILAMINE MALEATE 180Q-Gesic 20Q-Pam 72Quelicin 187Quelicin Preservative-Free 187Questran 50Questran Light 50Quibron 104Quinidex 181QUINIDINE SULFATE 180,181Quinora 181R-P Mycin 86R-Tannate 48RANITIDINE HYDROCHLORIDE 181Rapiflux 96Redisol 59Regitine 162Reglan 143Regonol 179Rela 40Relafen 146Repan 1Repronex 135RESERPINE 181Restoril 192Retet 194Retin-A 199Reversol 82Revia 147Rheumatrex 140Rhythmin 174Rifadin 182RIFAMPIN 182Rimactane 182RIMANTIDINE HYDROCHLORIDE 182Rimifon 123Ringer's 36

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Ritalin 141Ritalin-SR 141RITODRINE HYDROCHLORIDE 182Robaxin 139Robaxisal 20Robimycin 86Robinul 103Robinul Forte 103Robitet 194Robitussin AC 57Robitussin DAC 57Rocaltrol 33Rondec Drops 40Rondec Syrup 40Rondec DM Drops 39Rondec DM Syrup 39Roxanol 146Roxicet 4Roxicet 5/500 4Roxilox 4Roxiprin 21Rubex 80Rubivite 59Rubramin PC 59Rufen 119Ruvite 59Ryna C Liquid 47Rynatan Pediatric 48Rythmol 176S.A.S.-500 191Saluron 117Sandimmune Injection 60Sandril 181Sansac 86Sarisol 32Sarisol #1 32Sarisol #2 32Satric 144Scabene 130Scandonest L 128Scandonest Plain 136SECOBARBITAL SODIUM 182Seconal 182Sectral 1Sedapap 1Seffin 44SELEGILINE HYDROCHLORIDE 183SELENIUM SULFIDE 183Selsun 183Sensorcaine 31Septisoft 107

Septisol 107Septra 190Septra DS 190Septra Grape 190Serax 156Serophene 54Serpasil 181Sil-O-Tuss DM 65Sil-O-Tuss Elixir 121Sil-Tex 104Silvadene 183SILVER SULFADIAZINE 183Sinemet 10/100 39Sinemet 25/100 39Sinemet 25/250 39Sinemet CR 25/100 39Sinemet CR 50/200 39Sinequan 80Sinucon Pediatric Drops 47Sinucon Pediatric Syrup 47Sinucon Syrup 48Slo-Bid 194Slo-Phyllin-80 194Slow K 169SMZ-TMP 190SMZ-TMP Pediatric 190SODIUM AMINOSALICYLATE 183SODIUM CHLORIDE 184SODIUM LACTATE 185SODIUM NITROPRUSSIDE 186SODIUM POLYSTYRENE SULFONATE 186SODIUM SULFACETAMIDE 188Sodium P.A.S. 183Sodium Sulamyd 188SOLTALOL HYDROCHLORIDE 186Solu-Cortef 116Solu-Medrol 142Soma 40Soma Compound 20Soma Compound with Codeine 20Somophyllin 11Somophyllin-DF 11Sonazine 48Sorbitrate 124Sorine 186Sosol 191Soy-Dome 107Soyacal 10% 187Soyacal 20% 187SOYBEAN OIL 187Sparine 175

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SPIRONOLACTONE 187SPRX-3 161SSD 183Stadol 33Stadol NS 33Stadol Preservative-Free 33Stanozide 123Staticin 86Statobex 161Statobex-G 161Stelazine 201Stie-Cort 114Stilbestrol 74Stoxil 119STREPTOMYCIN SULFATE 187Strifon Forte DSC 50Sublimaze Preservative-Free 93SUCCINYLCHOLINE CHLORIDE 187Sucostrin 187SUCRALFATE 188Sufenta 188SUFENTANIL CITRATE 188Sulf-10 188Sulf-15 188Sulfa-Triple #2 203SULFABENZAMIDE; SULFACETAMIDE; 188 SULFATHIAZOLESulfacel-15 188SULFACETAMIDE SODIUM 188SULFADIAZINE 189SULFADIAZINE; SULFAMETHAZINE; 203 SULFAMERAZINESulfair-10 188Sulfair-15 188Sulfair Forte 188Sulfalar 191Sulfaloid 203SULFAMETHIZOLE 189Sulfamethoprim 190Sulfamethoprim-DS 190SULFAMETHOXAZOLE 189SULFAMETHOXAZOLE; TRIMETHOPRIM 189,190SULFANILAMIDE 190SULFASALAZINE 190,191Sulfatrim 190Sulfatrim DS 190Sulfatrim Pediatric 190Sulfatrim SS 190SULFINPYRAZONE 191SULFISOXAZOLE 191Sulfose 203

SULINDAC 191,192Sulmeprim 190Sulmeprim Pediatric 190Sulphrin 172Sulsoxin 191Sulster 172Sulten-10 188Sultrin 188Sumycin 194Symadine 10Symmetrel 10Synacort 114Synalar 94Synalgos-DC-A 1Synkavite 134Synovalyte 132Syntocinon 157Sytobex 59T-Stat 86Tace 46Tagamet 51Talacen 4Talwin NX 147Tambocor 93TAMOXIFEN CITRATE 192Tapazole 139Taxol 157Tavist 52Tavist-1 52Tazicef 42Tazidime 42Teebacin 183Tegopen 56Tegretol 38Temaril 201Temaz 192TEMAZEPAM 192Temovate 54Temovate E 54Tencon 1Tenex 105Tenoretic 50 21Tenoretic 100 21Tenormin 21Tensilon 82Tensilon Preservative-Free 82Tenuate 74Tepanil 74TERAZOSIN 192TERBUTALINE SULFATE 192Terfonyl 203

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Terramycin 157Tessalon Perles 25TESTOSTERONE CYPIONATE 193TESTOSTERONE ENANTHATE 193TESTOSTERONE PROPIONATE 193TETRACAINE HYDROCHLORIDE 193Tetrachel 193TETRACYCLINE HYDROCHLORIDE 193,194Tetracyn 174,194Tetramed 194Texacort 114TFP 201Theo-Dur 195Theoclear-80 194Theocron 195Theolair 194Theolixir 194THEOPHYLLINE 194,195Thermazine 183THIAMINE HYDROCHLORIDE 195Thioplex 196THIORIDAZINE HYDROCHLORIDE 196Thiosulfil 189THIOTEPA 196THIOTHIXENE 196THIOTHIXENE HYDROCHLORIDE 197Thorazine 48Thypinone 178Thyrel TRH 178Ticlid 197TICLOPIDINE HYDROCHLORIDE 197Tigan Injection 202TIMOLOL MALEATE 197Timoptic 197Timoptic XE 197Tobradex 63TOBRAMYCIN 197,198TOBRAMYCIN SULFATE 198Tobrex 198Tofranil 120TOLAZAMIDE 198TOLBUTAMIDE 198Tolectin 199Tolectin 600 199Tolectin D.S. 199Tolinase 198TOLMETIN SODIUM 199Topicort 62Toposar 92Tora 162Toradol 126

Totacillin 16Totacillin-N 15Tracrium 22Tracrium Preservative-Free 22Trandate 126Trandate-HCT 110Tranmep 136Transderm-Nitro 152Tranxene 55Travamulsion 10% 187Travamulsion 20% 187TRAZODONE HYDROCHLORIDE 199Tremin 201Trental 160TRETINOIN 199Tri-Vi-Flor 18,19Tri-Vi-Flor w/ Iron 18Tri-Vitamin Drops w/Fluoride 18,19Triacet 200Triacin-C 58Triacort 200Triad 1Trialodine 199TRIAMCINOLONE ACETONIDE 200Triaprin 1Triatex 200Triavil 2-10 13Triavil 2-25 13Triavil 4-10 13Triavil 4-25 13Triavil 4-50 13TRIAZOLAM 201Triderm 200Tridesilon 62Tridil 152TRIFLUOPERAZINE HYDROCHLORIDE 201TRIFLURIDINE 201TRIHEXYPHENIDYL HYDROCHLORIDE 201Trilafon 160Trilitron 179TRIMEPRAZINE TARTRATE 201TRIMETHOBENZAMIDE HYDROCHLORIDE 202TRIMETHOPRIM 202Trimox 14Trimpex 202Triotann S 48TRIPELENNAMINE HYDROCHLORIDE 202Triphasil 90Triphed 179Triple Sulfa 188,203Triple Sulfas 203

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Triple Sulfoid 203Triple-Vita-Flor 0.25mg 18Triple-Vita-Flor 0.5mg 19TRIPROLIDINE HYDROCHLORIDE 202TRISULFAPYRIMIDINE 203Tri Vitamin Drops w/Fluoride 0.25mg 18Tri Vitamin Drops w/ Fluoride 0.5mg 19 Trivora 90Tropicacyl 203TROPICAMIDE 203Trymex 200Trysul 188TUBOCURARINE CHLORIDE 203Turgex 107Tussend 113Tussend Expectorant 104Tussi Organidin 57Tussi-Organidin DM 65Tussi-R-Gen Expectorant 57Tussigon 107Tycolet 3Tylenol with Codeine 2Tylox 4U-Cort 116U-Gencin 100Ultracef 41Ultragris 165 103Ultragris 330 103Unipen 146Urecholine 28Urex 138Urobak 189Urologic G 52Uroplus SS 190Uroplus DS 190URSODIOL 204Uticillin-VK 159Utimox 14Vagilia 188Vagitrol 190Valisone 28Valium 72Valnac 28VALPROIC ACID 204VANCOMYCIN HYDROCHLORIDE 204Vancocin 204Vancoled 204Vancor 204Vanspar 32Vantin 42Vaseretic 82

Vascor 26Vapo-ISO 124Vasocidin 172Vasocon 148Vasocon A 16Vasotec 82,83V-Cillin K 159Vectrin 145VECURONIUM BROMIDE 204Veetids 125 159Veetids 250 159Veetids 500 159Velban 205Velosef 44Velosef 125 44Velosef 250 44Veltane 30Ventolin 7,8VePesid 92VERAPAMIL HYDROCHLORIDE 204,205Verelan 205Vermidol 165Vermox 133Versed 145Vi-Dom-A 207Vi-Twel 59Vibisone 59Vibra-Tabs 81Vibramycin 80,81Vicodin 4Vicodin ES 4Vicodin HP 4VINBLASTINE SULFATE 205Vincasar PFS 206Vincrex 206VINCRISTINE SULFATE 205,206Vincristine Sulfate Preservative-Free 206Viroptic 201Visken 164Vistaril 118,119VITAMIN A 206VITAMIN A PALMITATE 206,207VITAMIN D 82Vivactil 178Vivelle 88Vivelle-Dot 88Voltaren 73Voltaren-XR 73VoSol 5VoSol HC 6WARFARIN SODIUM 208

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WATER FOR INJECTION 208WATER FOR IRRIGATION 208Wellbutrin 31Wellcovorin 127Westcort 116Wigraine 32Wigrettes 85Wyamycin-E 87Wyamycin-S 87Wycillin 158Wygesic 4Wymox 14Wytensin 104X-Trozine 161Xanax 9Xylocaine 128,129Xylocaine Preservative-Free 129Xylocaine with Epinephrine 84Xylocaine with Glucose 68Xylo-Pfan 208XYLOSE 208Yutopar 182Zantac 181Zarontin 91Zaroxolyn 143Zaxopam 156Zebeta 28Zeroxin-5, -10 25Zestoretic 10 - 12.5 110Zestoretic 20 - 12.5 110Zestoretic 20 - 25 110Zestril 130Ziac 29Zide 109Zinacef 43Zipan-25 175Zipan-50 175Zolicef 42Zovia 1/35E 89Zovia 1/50E 89Zovirax 7Zyloprim 95-Benzagel 2610-Benzagel 26

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