| GENERIC NAME | BRAND NAME | |
| ACETAMINOPHEN | TYLENOL # 3 TAB (Limited to 20, post-op only) | |
| ACETAZOLAMIDE | DIAMOX 250 MG TAB | |
| ACETAZOLAMIDE | DIAMOX 500 MG SEQUELS | |
| ACYCLOVIR | ZOVIRAX 200 MG CAP | |
| ACYCLOVIR | ZOVIRAX 800 MG CAP | |
| ALBUTEROL (30 days of brand name may be dispensed, ONE TIME if generic is not available) | PROVENTIL INHALER (17 GM) | |
| ALLOPURINOL | ZYLOPRIM 100 MG TAB | |
| ALLOPURINOL | ZYLOPRIM 300 MG TAB | |
| AMITRIPTYLENE | ELAVIL | |
| ATENOLOL | TENORIMIN 100 MG TAB | |
| ATENOLOL | TENORIMIN 50 MG TAB | |
| BENZTROPINE MESYLATE | COGENTIN 0.6 MG TAB | |
| BENZTROPINE MESYLATE | COGENTIN 1 MG TAB | |
| BENZTROPINE MESYLATE | COGENTIN 2 MG TAB | |
| CAPTOPRIL | CAPOTEN 100 MG TAB | |
| CAPTOPRIL | CAPOTEN 12.5 MG TAB | |
| CAPTOPRIL | CAPOTEN 25 MG TAB | |
| CAPTOPRIL | CAPOTEN 50 MG TAB | |
| CARBAMAZEPINE | TEGRETOL 200 MG TAB | |
| CHLORTHALIDONE | HYGROTON 25 MG TAB | |
| CHLORTHALIDONE | HYGROTON 50 MG TAB | |
| CLONIDINE | CATAPRES 0.1 MG TAB | |
| CLONIDINE | CATAPRES 0.2 MG TAB | |
| CLONIDINE | CATAPRES 0.3 MG TAB | |
| COLCHICINE | COLCHICINE 0.6 MG TAB | |
| CONJUGATED ESTROGEN | PREMARIN 0.3 MG TAB | |
| CONJUGATED ESTROGEN | PREMARIN 0.625 MG TAB | |
| CONJUGATED ESTROGEN | PREMARIN 1.25 MG TAB | |
| CONJUGATED ESTROGEN | PREMARIN 2.5 MG TAB | |
| DESIPRAMINE | NORPRAMIN | |
| DIGOXIN | LANOXIN 0.125MG TAB | |
| DIGOXIN | LANOXIN 0.25 MG TAB | |
| DIGOXIN PED. ELIXIR | LANOXIN 0.05 MG/ML PEDIATRIC ELIXIR | |
| DILTIAZEM | CARDIZEM 30 MG TAB | |
| DILTIAZEM | CARDIZEM 60 MG TAB | |
| DILTIAZEM CD | CARDIZEM CD 180 MG CAP | |
| DILTIAZEM CD | CARDIZEM CD 240 MG CAP | |
| DILTIAZEM CD | CARDIZEM CD 300 MG CAP | |
| DIPIVEFRIN HCL 0PHTH SOLN | PROPINE 0.1 % OPHTH SOLN (MD must write letter) | |
| DIPYRIDAMOLE | PERSANTINE 25 MG TAB | |
| DIPYRIDAMOLE | PERSANTINE 50 MG TAB | |
| DOXEPIN | SINEQUAN | |
| DOXYCYCLINE | VIBRAMYCIN 100 MG CAP | |
| DOXYCYCLINE | VIBRAMYCIN 50 MG CAP | |
| ERGOTAMINE TARTRATE/CAFFEINE | CAFERGOT TAB | |
| FLUOXETINE | PROZAC 10MG | |
| FLUOXETINE | PROZAC 20MG | |
| FOLIC ACID | FOLIC ACID 1 MG TAB | |
| FUROSEMIDE | LASIX 20 MG TAB | |
| FUROSEMIDE | LASIX 40 MG TAB | |
| GEMFIBROZIL | LOPID 600 MG TAB | |
| GENTAMICIN | GENTAMICIN OPHTH DROPS | |
| GLIPIZIDE | GLUCOTROL 10 MG TAB | |
| GLIPIZIDE | GLUCOTROL 5 MG TAB | |
| GLYBURIDE | MICRONASE 1.25 MG TAB | |
| GLYBURIDE | MICRONASE 2.5 MG TAB | |
| GLYBURIDE | MICRONASE 5 MG TAB | |
| GRISEOFULVIN V | GRIFULVIN V 250 MG TAB | |
| HYDRALAZINE | APRESOLINE 10 MG TAB | |
| HYDRALAZINE | APRESOLINE 25 MG TAB | |
| HYDRALAZINE | APRESOLINE 50 MG TAB | |
| HYDROCHLOROTHIAZIDE | HCTZ 25 MG TAB | |
| HYDROCHLOROTHIAZIDE | HCTZ 50 MG TAB | |
| HYDROCODONE/APAP | VICODIN 5/500 MG TAB (Limited to 20, no refills, post-op only) | |
| INDOMETHACIN | INDOCIN 25 MG CAP | |
| INDOMETHACIN | INDOCIN 50 MG CAP | |
| INSULIN HUMAN 70/30 | NOVOLIN 70/30 INS 100 U/CC (10 CC) | |
| INSULIN HUMAN N | NOVOLIN N INS 100 U/CC (10 CC) | |
| INSULIN HUMAN R | NOVOLIN R INS 100 U/CC (10 CC) | |
| INSULIN HUMAN U | NOVOLIN U INS 1OO U/CC (10 CC) | |
| ISRADIPINE | DYNACIRC 2.5 MG CAP | |
| ISRADIPINE | DYNACIRC 5 MG CAP | |
| KETOCONAZOLE | NIZORAL 200 MG TAB | |
| LABETALOL HCL | NORMODYNE 100 MG TAB | |
| LABETALOL HCL | NORMODYNE 200 MG TAB | |
| LEVODOPA/CARBIDOPA | SINEMET 10/100 MG TAB | |
| LEVODOPA/CARBIDOPA | SINEMET 25/100 MG TAB | |
| LEVODOPA/CARBIDOPA | SINEMET 25/250 MG TAB | |
| LEVOTHYROXINE SODIUM | LEVOTHROID 100 MCG TAB | |
| LEVOTHYROXINE SODIUM | LEVOTHROID 150 MCG TAB | |
| LEVOTHYROXINE SODIUM | LEVOTHROID 200 MCG TAB | |
| LEVOTHYROXINE SODIUM | LEVOTHROID 25 MCG TAB | |
| LEVOTHYROXINE SODIUM | LEVOTHROID 300 MCG TAB | |
| LEVOTHYROXINE SODIUM | LEVOTHROID 50 MCG TAB | |
| LISINOPRIL | PRINIVIL 10 MG TAB | |
| LISINOPRIL | PRINIVIL 20 MG TAB | |
| LISINOPRIL | PRINIVIL 40 MG TAB | |
| LISINOPRIL | PRINIVIL 5 MG TAB | |
| LITHIUM CARBONATE | LITHOBID 300 MG CAP | |
| MEDROXYPROGESTERONE ACETATE | PROVERA 10 MG TAB | |
| METHYLDOPA | ALDOMET 250 MG TAB | |
| METHYLDOPA | ALDOMET 500 MG TAB | |
| METHYLERGONOVINE MALEATE | METHERGINE 0.2 MG TAB | |
| METOCLOPRAMIDE HCL | REGLAN 10 MG TAB | |
| METOPROLOL TARTRATE | LOPRESSOR 100 MG TAB | |
| METOPROLOL TARTRATE | LOPRESSOR 50 MG TAB | |
| MINOXIDIL | LONITEN 10 MG TAB | |
| MINOXIDIL | LONITEN 2.5 MG TAB | |
| NADOLOL | CORGARD 120 MG TAB | |
| NADOLOL | CORGARD 160 MG TAB | |
| NADOLOL | CORGARD 40 MG TAB | |
| NADOLOL | CORGARD 80 MG TAB | |
| NIFEDIPINE | PROCARDIA 10 MG CAP | |
| NITROFURANTOIN MACROCRYSTALS | MACRODANTIN 50 MG CAP | |
| NITROGLYCERIN | NITROGLYCERIN 0.15 MG TAB | |
| NITROGLYCERIN | NITROGLYCERIN 0.3 MG TAB | |
| NITROGLYCERIN | NITROGLYCERIN 0.4 MG TAB | |
| NITROGLYCERIN | NITROGLYCERIN 0.6 MG TAB | |
| NITROGLYCERIN OINTMENT | NITROL OINT (30 GM) | |
| NITROGLYCERIN OINTMENT | NITROL OINT (60 GM) | |
| NYSTATIN | NYSTATIN 500 MU TAB | |
| NYSTATIN SUSP. | NYSTATIN 100 MU SUSP | |
| PANCRELIPASE | VIOKASE 5 GR. | |
| PHENOBARBITAL | PHENOBARBITAL 100 MG TAB | |
| PHENOBARBITAL | PHENOBARBITAL 15 MG TAB | |
| PHENOBARBITAL | PHENOBARBITAL 30 MG TAB | |
| PHENOBARBITAL | PHENOBARBITAL 60 MG TAB | |
| PHENOBARBITAL | PHENOBARBITAL 90 MG TAB | |
| PHENOBARBITAL ELIXIR | PHENOBARBIAL 20 MG/5 ML ELIXIR | |
| PHENYTOIN | DILANTIN 100 MG CAP | |
| PHENYTOIN INFATAB | DILANTIN 50 MG INFATABS | |
| PHENYTOIN PED. SUSP | DILANTIN 30 MG/5 ML PEDIATRIC SUSP | |
| PHENYTOIN SUSP | DILANTIN 125 MG/5 ML SUSP | |
| PIRBUTERROL | MAXAIR INHALER (LIMIT 2/MONTH) | |
| POTASSIUM CHLORIDE | MICRO K 8 MEQ TAB | |
| POTASSIUM CHLORIDE | POTASSIUM CHL 10 % SOLN | |
| POTASSIUM CHLORIDE | POTASSIUM CHL 20 % SOLN | |
| PRAZOSIN HCL | MINIPRESS 1 MG CAP | |
| PRAZOSIN HCL | MINIPRESS 2 MG CAP | |
| PRAZOSIN HCL | MINIPRESS 5 MG CAP | |
| PREDNISOLONE ACETATE | PRED FORTE 1 % OPHTH SOLN | |
| PREDNISONE | PREDNISONE 10 MG TAB | |
| PREDNISONE | PREDNISONE 20 MG TAB | |
| PREDNISONE | PREDNISONE 5 MG TAB | |
| PROBENECID | BENEMID 0.5 GM TAB | |
| PROPANTHELINE BROMIDE | PROBANTHINE 15 MG TAB | |
| PROPOXYPHENE NAPSYLATE/APAP | DARVOCET N-100 MG TAB (20 tab max. post-op) | |
| PROPRANOLOL | INDERAL 10 MG TAB | |
| PROPRANOLOL | INDERAL 20 MG TAB | |
| PROPRANOLOL | INDERAL 40 MG TAB | |
| PROPRANOLOL | INDERAL 80 MG TAB | |
| QUINDINE GLUCONATE | QUINIDINE GLUCONATE 324 MG TAB | |
| QUINDINE SULFATE | QUINIDINE SULFATE 200 MG TAB | |
| QUINIDINE SULFATE ER | QUINIDEX ER 300 MG TAB | |
| SPIRONOLACTONE | ALDACTONE 25 MG TAB | |
| SUCRALFATE | CARAFATE 1 GM TAB | |
| THEOPHYLLINE SA | THEO-DUR 100 MG TAB | |
| THEOPHYLLINE SA | THEO-DUR 200 MG TAB | |
| THEOPHYLLINE SA | THEO-DUR 300 MG TAB | |
| TOLAZAMIDE | TOLINASE 100 MG TAB | |
| TOLAZAMIDE | TOLINASE 250 MG TAB | |
| TRAZADONE | DESYREL 100 MG TAB | |
| TRAZADONE | DESYREL 50 MG TAB | |
| TRIAMTERENE/HCTZ | MAXZIDE 75/50 MG TAB | |
| VALPROIC ACID | DEPAKOTE 250MG | |
| VERAPAMIL | CALAN 120 MG TAB | |
| VERAPAMIL | CALAN 80 MG TAB | |
| VERAPAMIL SR | CALAN SR 180 MG TAB | |
| VERAPAMIL SR | CALAN SR 240 MG TAB | |
| WAFARIN SODIUM | COUMADIN 10 MG TAB | |
| WAFARIN SODIUM | COUMADIN 2 MG TAB | |
| WAFARIN SODIUM | COUMADIN 2.5 MG TAB | |
| WAFARIN SODIUM | COUMADIN 5 MG TAB | |
| WAFARIN SODIUM | COUMADIN 7.5 MG TAB | |