Microsoft word - 3 formulary.doc

SOUTHWESTERN BEHAVIORAL HEALTHCARE, INC. FORMULARY
Adderall (mixed Amphetamine salts)
Adderal XR
Atomoxetine (Strattera)
Catapres (Clonidine)
Clonidine (Catapres)
Clonidine ER (Kapvay)
Clonidine patches
Concerta
Daytrana (Methamphetamine) patch
Dexoxyn (Methamphetamine)
Dexedrine (Dextroamphetamine)
Dexmethylphenidate HCI (Focalin)
Dextroamphetamine (Dexedrine)
Focalin (Dexmethylphenidate HCI)
Guanfacine (Tenex)
Guanfacine (Intuniv) extended release
Intuniv (Guanfacine) extended release
Kapvay (Clonidine ER)
Metadate CD
Metadate ER
Methamphetamine (Desoxyn)
Methylin (Methylphenidate)
Methylphenidate (Ritalin, Methylin,
Metadate, Concerta, Ritalin LA)
Methylphenidate ER
Ritalin LA
Strattera (Atomoxetine)
Tenex (Guanfacine)
Amitriptyline (Elavil)
Amoxapine (Asendin)
Anafranil (Clomipramine)
Asendin (Amoxapine)
Buproprion (Wellbutrin)
Buproprion SR (Wellbutrin SR)
Buproprion XL (Wellbutrin XL)
Celexa (Citalopram)
Citalopram (Celexa)
Clomipramine (Anafranil)
Cymbalta (Duloxetine)
Desipramine (Norpramin)
Desvenlafaxine (Pristiq)
Desyrel (Trazadone)
Doxepin (Sinequan, Adapin)
Duloxetine (Cymbalta)
Effexor & Effexor XR (Venlafaxine)
Effexor ER(Venlafaxine)
Elavil (Amitriptyline)
EMSAM (Selegiline Transdermal) patch
Escitalopram (Lexapro)
Fluoxetine (Prozac)
Fluvoxamine Maleate (Luvox)
Imipramine (Tofranil)
Lexapro (Escitalopram)
Ludiomil (Maprotiline)
Luvox (Fluvoxamine Maleate)
Luvox CR (Fluvoxamine Maleate)
Maprotiline (Ludiomil)
Mirtazapine (Remeron) & Sol Tab
Nardil (Phenelzine)
DRUG NAMES
Nefazodone
Norpramin (Desipramine)
Nortriptyline (Pamelor)
Oleptro (Trazadone extended release)
Pamelor (Nortriptyline)
Parnate (Tranylcypromine)
Paronxetine (Paxil)
Paxil (Paroxetine)
Phenelzine (Nardil)
Pristiq (Desvanlafaxine)
Protriptyline (Vivactil)
Prozac (Fluoxetine)
Prozac weekley
Remeron (Mirtazapine)
Selegiline Transdermal (EMSAM) patch
Sertaline (Zoloft)
Sinequan (Doxepin)
Surmontil (Trimipramine)
Tofranil (Imipramine)
Tranylcypromine (Parnate)
Trazadone (Desyrel)
Trazadone extended release (Oleptro)
Trimipramine (Surmontil)
Venlafaxine (Effexor & XR)
Venlafaxine ER (Effexor)
Vivactil (Protriptyline)
Wellbutrin (Buproprion)
Wellbutrin SR (Buproprion SR)
Wellbutrin XL (Buproprion XB)
Zoloft (Sertraline)
Amantadine (Symmetrel)
Artane (Trihexyphenidyl)
Benadryl (Diphenhydramine)
Benztropine (Cogentin)
Cogentin (Benztropine)
Comtan (Entacapone)
Diphenhydramine (Benadryl)
Entacapone (Comtan)
Symmetrel (Amantadine)
Trihexyphenidyl (Artane)
Fluphenzine Decanoate (Prolixin D)
Geodon IM (Ziprasidone IM)
Haldol Decanoate (Haloperidol)
Haloperidol (Haldol Decanoate)
Invega Sustena
Olanzapine IM (Zyprexa IM)
Risperdal Consta (Risperidone Long Acting)
Risperidone Long Acting (Risperdal Consta)
Ziprasidone IM (Geodon IM)
Zyprexa IM (Olanzapine IM)
DRUG NAMES
Abilify (Aripiprazole)
Abilify Solution (Oral)
Aripiprazole (Abilify)
Asenapine (Saphris)
20 Sublingual-do not eat or drink
for 10 minutes
Chlorpromazine (Thorazine)
Clozapine (Clozaril) *
1000 * PLEASE REFER TO CLOZARIL POLICY
Clozaril (Clozapine) *
1000 * PLEASE REFER TO CLOZARIL POLICY
Fanapt (Iloperidone)
Fluphenazine (Prolixin)
Geodon (Ziprasadone)
Haldol (Haloperidol)
Iloperidone (Fanapt)
Invega (Paliperidone)
Latuda (Lurasidone)
Loxitane (Loxapine)
Loxapine (Loxitane)
Lurasidone (Latuda)
Mellaril (Thioridazine)
Mesoridzazine (Serentil)
Moban (Molindone)
Molindone (Moban)
Navane (Thiothixine)
Olanzapine (Zyprexa)
Orap (Pimozide)
Paliperidone (Invega)
Perphenazine (Trilafon)
Pimozide (Orap)
Prolixin (Fluphenazine)
Quetiapine Fumarate (Seroquel)
Risperdal (Risperidone)
Risperidone (Risperdal)
Saphris (Asenapine)
20 Sublingual-do not eat or drink
for 10 minutes
Serentil (Mesoridzazine)
DRUG NAMES
Seroquel (Quetiapine Fumarate)
Seroquel XR
Stelazine (Trifluoperazine)
Thioridazine (Mellaril)
Thiothixine (Navane)
Thorazine (Chlorpromazine)
Trilafon (Perphenazine)
Trifluoperazine (Stelazine)
Ziprasadone (Geodon)
Zyprexa (Olanzapine)
Alprazolam (Xanax)
Alprazolam XR (Xanax XR)
Atarax (Hydroxyzine)
Ativan (Lorazepam)
Buspar (Buspirone)
Busiprone (Buspar)
Centrax (Prazepam)
Chlordiazepoxide (Librium)
Clonazepam (Klonopin)
Clorazepate (Tranxene)
Diazepam (Valium)
Halazepam (Paxipam)
Hydroxyzine (Atarax, Vistaril)
Klonopin (Clonazepam)
Librium (Chlordiazepoxide)
Lorazepam (Ativan)
Oxazepam (Serax)
Paxipam (Halazapam)
Prazepam (Centrax)
Serax (Oxazepam)
Tranxene (Clorazepate)
Valium (Diazepam)
Vistaril (Hydroxyzine)
Xanax (Alprazolam)
Xanax XR (Alprazolam XR)
CLINICAL
MONITOR LEVELS
DRUG NAMES
AND SPECIAL
(MG/DAY)
INSTRUCTIONS
Ambien (Zolpidem Tartrate)
Chloral Hydrate
Dalmane (Flurazepam)
Doral (Quazepam)
Estazolam (Prosom)
Eszopiclone (Lunesta)
Flurazepam (Dalmane)
Halcion (Triazolam)
Lunesta (Eszopiclone)
Prosom (Estazolam)
Quazepam (Doral)
Restoril (Temazepam)
Rozerem (Ramelteon)
Ramelteon (Rozerem)
Sonata (Zaleplon)
Temazepam (Restoril)
Triazolam (Halcion)
Zaleplon (Sonata)
Zolpidem Tartrate (Ambien)
Carbamazepine (Tegretol)
Carbatrol (Carbamazepine)
Depakote – Depakene (Valproate)
Keppra (Levetiracetam)
Lamictal (Lamotrigine)
Lamictal ODT
Lamotrigine (Lamictal)
Levetiracetam (Keppra)
Neurontin
Olanzapine/Prozac (Symbyax)
Oxycarbazepine (Trileptal)
Prozac/Olanzapine (Symbyax)
Symbyax (Olanzapine/Prozac)
Do not exceed 60 Confirm not Cymbalta or Tegretol (Carbamazepine)
Topamax (Topiramate)
Topiramate (Topamax)
Trileptal (Oxycarbazepine)
Valproate (Depakote – Depakene)
Zonegran (Zonisamide)
Zonisamide (Zonegran)
Acamprosate Calcium (Campral)
Antabuse (Disulfiram)
Aricept (Donepezil HCI)
Armodafinil (Nuvigil)
Atrovent nasal (Ipratropium)
Baclofen
Campral (Acamprosate Calcium)
Carbamazepine (Carbatrol, Tegretol)
Carbatrol (Carbamazepine)
Catapres (Clonidine)
Chantix (Varenicline) smoking cessation
Clonidine (Catapres)
Cyproheptadine (Periactin)
DDAVP (tablets & spray)
Depakote – Depakene (Valproic Acid)
Dilantin (Phenytoin)
Disulfiram (Antabuse)
Docusate Calcium (Surfak)
Donepezil HCI (Aricept)
Exelon (Rivastigmine)
Galantamine (Reminyl)
Inderal (propranolol)
Inversine (Mecamylamine HCL)
Ipratropium (Atrovent nasal)
Levothyroixin (Synthroid)
300 mcg Take in a.m., on empty stomach
Lyrica (Pregabalin)
Mecamylamine HCL (Inversine)
Memantine (Namenda)
Minipress (Prazosin)
Modafinil (Provigil)
Naltrexone HCI (Revia)
Namenda (Memantine)
Nicotine (Transdermal)
Nicrorette Gum
Nuvigil (Armodafinil)
Periactin (Cyproheptadine)
Phenytoin (Dilantin)
Prazosin (Minipress)
Propranolol (Inderal)
Provigil (Modafinil)
Reminyl (Galantamine)
Requip (Ropinirole)
Revia (Naltrexone HCI)
Rivastigmine (Exelon)
Ropinirole (Requip)
Sildenafil Citrate (Viagra)
Surfak (Docusate Calcium)
Synthroid (Levothyroixin)
300 mcg Take in a.m., on empty stomach
Tegretol (Carbamazepine)
Valproic Acid (Depakote – Depakene)
Varenicline (Chantix) smoking cessation
Viagra (Sildenafil Citrate)
Voltarin
Yohimbine
___________________________________________ _______________________ Willard Whitehead III, M.D. Date Medical Director

Source: http://www.southwestern.org/rc/wp-content/uploads/Patient-Services-Manual-Formulary.pdf