URGENT CARE VIA RETAIL FORMULARY
ANTIBIOTIC
- AMOXICILLIN, 250 MG CAP, Max Qty: 60 (Amoxil)
- AMOXICILLIN, 500 MG CAP, Max Qty: 30 (Amoxil)
- AMOXICILLIN, 875 MG TAB, Max Qty: 28 (Amoxil)
- AMOXICILLIN, 250 MG/5ML SUSP, Max Qty: 200 (Amoxil)
- AMOXICILLIN, 400 MG/5ML SUSP, Max Qty: 200 (Amoxil)
- AMOXICILLIN/CLAVULANIC ACID, 500-125 MG TAB, Max Qty: 28 (Augmentin)
- AMOXICILLIN/CLAVULANIC ACID, 875-125 MG TAB, Max Qty: 28 (Augmentin)
- AMOXICILLIN/CLAVULANIC ACID, 400-57 MG/5ML SUSP, Max Qty: 200 (Augmentin)
- AMOXICILLIN/CLAVULANIC ACID, 600-42.9 MG/5ML SUSP, Max Qty: 200 (Augmentin)
- AZITHROMYCIN, 250 MG TAB, Max Qty: 6 (Zithromax)
- AZITHROMYCIN, 500 MG TAB, Max Qty: 3 (Zithromax)
- AZITHROMYCIN, 100 MG/5ML SUSP, Max Qty: 15 (Zithromax)
- AZITHROMYCIN, 200 MG/5ML SUSP, Max Qty: 30 (Zithromax)
- CEFDINIR, 300 MG CAP, Max Qty: 14 (Omnicef)
- CEPHALEXIN, 250 MG CAP, Max Qty: 56 (Keflex)
- CEPHALEXIN, 500 MG CAP, Max Qty: 28 (Keflex)
- CEPHALEXIN, 250 MG/5ML SUSP, Max Qty: 200 (Keflex)
- CIPROFLOXACIN, 250 MG TAB, Max Qty: 28 (Cipro)
- CIPROFLOXACIN, 500 MG TAB, Max Qty: 28 (Cipro)
- CLINDAMYCIN, 150 MG CAP, Max Qty: 28 (Cleocin)
- CLINDAMYCIN, 300 MG CAP, Max Qty: 28 (Cleocin)
- DOXYCYCLINE HYCLATE, 100 MG TAB, Max Qty: 28 (Vibramycin)
- LEVOFLOXACIN, 250 MG TAB, Max Qty: 21 (Levaquin)
- LEVOFLOXACIN 500 MG TAB, Max Qty: 21 (Levaquin)
- METRONIDAZOLE 500 MG TAB, Max Qty: 28 (Flagyl)
- NITROFURANTOIN 100 MG CAP, Max Qty: 28 (Macrobid)
- PENICILLIN VK 500 MG TAB, Max Qty: 28 (Veetids)
- PENICILLIN VK 250 MG/5ML SUSP, Max Qty: 200 (Veetids)
- SMZ/TMP DS 800-160 MG TAB, Max Qty: 28 (Bactrim)
- SMZ/TMP 200-40 MG/5ML SUSP, Max Qty: 120 (Bactrim)
ANTIBIOTIC TOPICAL
- ERYTHROMYCIN 0.5% OPTH OINT, Max Qty: 3.5 (Ilotycin)
- MUPIROCIN 2% OINT, Max Qty: 22 (Bactroban)
- NEO/POLY/HC OTIC SOLN, Max Qty: 10 (Cortisporin)
- POLYMYXIN B/TRIMETH OPTH SOLN, Max Qty: 10 (Polytrim)
- SILVER SULFADIAZINE 1% CREAM, Max Qty: 50 (Silvadene)
- TOBRAMYCIN 0.3% OPTH SOLN, Max Qty: 5 (Tobrex)
ANTIFUNGAL
- FLUCONAZOLE 150 MG TAB, Max Qty: 1 (Diflucan)
- NYSTATIN 100,000 USP CREAM, Max Qty: 30 (Mycostatin)
- NYSTATIN 100,000 USP OINT, Max Qty: 30 (Mycostatin)
ANTIHISTAMINE
-
HYDROXYZINE 25 MG TAB, Max Qty: 30 (Atarax)
CADIOVASULAR
-
NITROGLYCERIN 0.4 MG SL TAB, Max Qty: 25 (Nitrostat)
CORTICOSTEROID
- METHYLPREDNISOLONE 4 MG PACK, Max Qty: 21 (Medrol Dosepak)
- PREDNISONE 10 MG TAB, Max Qty: 20 (Deltasone)
- PREDNISONE 20 MG TAB, Max Qty: 20 (Deltasone)
- PREDNISOLONE 15 MG/5ML SOLN, Max Qty: 120 (Orapred)
CORTICOSTEROID TOPICAL
- HYDROCORTISONE 2.5% CREAM, Max Qty: 30 (Hytone)
- PREDNISOLONE 1% OPTH SUSP, Max Qty: 5 (Pred Forte)
- TRIAMCINOLONE 0.1% CREAM, Max Qty: 30 (Kenalog)
- TRIAMCINOLONE 0.1% OINT, Max Qty: 30 (Kenalog)
COUGH SUPPRESSANT
- BENZONATATE 100 MG CAP, Max Qty: 20 (Tessalon Perles)
- BENZONATATE 200 MG CAP, Max Qty: 20 (Tessalon Perles)
GASTROINTESTINAL
- DICYCLOMINE 20 MG TAB, Max Qty: 60 (Bentyl)
- DIPHENOX-ATROPINE 2.5-0.025 MG TAB, Max Qty: 30 (Lomotil)
- PANTOPRAZOLE 40 MG TAB, Max Qty: 21 (Protonix)
- PROMETHAZINE 25 MG TAB, Max Qty: 30 (Phenergan)
GOUT
- ALLOPURINOL 100 MG TAB, Max Qty: 21 (Zyloprim)
- ALLOPURINOL 300 MG TAB, Max Qty: 21 (Zyloprim)
MIGRAINE
- SUMATRIPTAN 50 MG TAB, Max Qty: 9 (Imitrex)
- SUMATRIPTAN 100 MG TAB, Max Qty: 9 (Imitrex)
MUSCLE RELAXANT
-
CYCLOBENZAPRINE 10 MG TAB, Max Qty: 30 (Flexeril)
PAIN MANAGEMENT
- IBUPROFEN 800 MG TAB, Max Qty: 60 (Motrin)
- NAPROXEN 500 MG TAB, Max Qty: 30 (Naprosyn)
- TRAMADOL 50 MG TAB, Max Qty: 30 (Ultram)