formulary
- Pharmacy Bridge Formulary
Pharmacy Bridge Formulary
Only medications on this formulary will be covered.
Category
Analgesics
Analgesics
Analgesics
Analgesics
Anti-coagulant
Anticonvulsant
Anticonvulsant
Anticonvulsant
Anticonvulsant
Anticonvulsant
Antidepressant
Antidepressant
Antidepressant
Antidepressant
Antidepressant
anti-Gout
anti-Gout
Anti-HTN
Anti-HTN
Anti-HTN
Anti-HTN
Anti-HTN
Anti-HTN
Anti-HTN
Anti-HTN
Anti-HTN
Anti-HTN
Anti-HTN
Anti-HTN
Anti-HTN
Anti-HTN
Anti-HTN
Anti-HTN
antihyperlipidemic
antihyperlipidemic
antihyperlipidemic
Antimicrobials
Antimicrobials
Antimicrobials
Antimicrobials
Antimicrobials
Antimicrobials
Antimicrobials
Antimicrobials
Antimicrobials
Antimicrobials
Antimicrobials
Antimicrobials
Antimicrobials
Antimicrobials
Antimicrobials
Antimicrobials
Antimicrobials
Antimicrobials
Antimicrobials
Anti-psychotic
Bone Disease
Cardiac
Cardiac
Cardiac
Cardiac
cough/cold/allergy
cough/cold/allergy
cough/cold/allergy
cough/cold/allergy
cough/cold/allergy
cough/cold/allergy
cough/cold/allergy
Dermatological
Dermatological
Dermatological
Dermatological
Dermatological
Dermatological
Dermatological
Dermatological
Dermatological
Dermatological
Dermatological
Dermatological
Dermatological
Dermatological
Diabetes
Diabetes
Diabetes
Diabetes
Diabetes
Diabetes
Diabetes
Diabetes
Diabetes
Diabetes
Diabetes
Diabetes
Diuretic
Glaucoma
Glaucoma
Glaucoma
Glaucoma
Glaucoma
GU/GI
GU/GI
GU/GI
GU/GI
GU/GI
GU/GI
GU/GI
GU/GI
GU/GI
GU/GI
GU/GI
GU/GI
GU/GI
GU/GI
Migraine
Muscle Relaxants
NSAID
Ophthalmic
Ophthalmic
Otic
Otic
Respiratory
Respiratory
Respiratory
Respiratory
Supplements
Supplements
Supplements
Supplements
SystemicCorticosteroids
SystemicCorticosteroids
Thyroid
Thyroid
Women Health
Women Health
Brand Name
ACETAMINOPHEN
ASPIRIN
IBUPROFEN
INDOMETHACIN
COUMADIN
CARBAMAZEPINE
CLONAZEPAM
PHENOBARBITAL
DILANTIN
DEPAKENE
AMITRIPTYLINCE HCL
CELEXA
FLUOXETINE HCL
PAROXETINE HCL
SERTRALINE HCL
DESYREL
ALLOPURINOL
COLCHICINE
ATENOLOL
CAPOTEN
CHLORTHALIDONE
CATAPRES
CARDIZEM
ENALAPRIL MALEATE
FUROSEMIDE
HCTZ
INDAPAMIDE
LISINOPRIL
LISINOPRIL-HCTZ
METOPROLOL TARTRATE
PROPRANOLOL HCL W/HCTZ
HYTERIN
TRIAMTERENE-HCTZ
VERAPAMIL HCL
GEMFIBROZIL
LOVASTATIN
ACYCLOVIR
AUGMENTIN
AMOXIL
AZITHROMYCIN
CEPHALEXIN
CIPRO
BIAXIN
CLEOCIN HCL
CLEOCIN PALMITATE
DICLOXACILLIN SODIUM
DOXYCYCLINE HYCLATE
ERYTHROMYCIN
DIFLUCAN
MEBENDAZOLE
FLAGYL
PENICILLIN V POTASSIUM
BACTRIM
LAMISIL
SUMYCIN
COMPAZINE
ALENDRONATE SODIUM
DIGOXIN
ISOSORBIDE DINITRATE
ISOSORBIDE MONONITRATE
NITROGLYCERIN
FLUNISOLIDE
FLONASE
GUAIFENESIN
BRONTEX
HYDROXYZINE HCL
ALLERGY RELIEF
DECONGESTANT NOSE DROPS
BETAMETHASONE DIPROPIONATE
BETAMETHASONE VALERATE
FLUOCINONIDE
HYDROCORTISONE
HYDROCORTISONE ACETATE
MICONAZOLE
BACTROBAN
CORTISPORIN
NYSTATIN
NYSTATIN-TRIAMCINOLONE
ACTICIN
SELENIUM SULFIDE
ARGLAES
ACCU-CHEK ACTIVE
DEX4 GLUCOSE
GLIPIZIDE
DIABETA
HUMULIN 70-30
NOVOLOG
HUMALOG
HUMULIN R
NOVOLOG MIX 70-30
GLUCOPHAGE
GLUCOPHAGE XR
HUMULIN N
ALDACTONE
BETAXOLOL HCL
CARTEOLOL HCL
BETAGAN
PILOCARPINE HCL
TIMOLOL MALEATE
ACID REDUCER
BENTYL
FAMOTIDINE
CYSTOSPAZ
HYOSCYAMINE SULFATE
MECLIZINE HCL
METOCLOPRAMIDE HCL
MACRODANTIN
MACROBID
OMEPRAZOLE
GAVILYTE-G
PHENAZOPYRIDINE HCL
PROMETHAZINE HCL
RANITIDINE HCL
IMITRIEX
CYCLOBENZAPRINE HCL
AMIGESIC
GARAMYCIN
BLEPH-10
ANTIBIOTIC EAR
FLOXIN
ALBUTEROL SULFATE
ALBUTEROL SULFATE HFA
FLOVENT HFA
IPRATROPIUM BROMIDE
TRIAMCINOLONE ACETONIDE
K-DUR
FOLIC ACID
PRENATAL LOW IRON
PRENATAL FORMULA
DEXAMETHASONE
PREDNISONE
LEVOTHROID
THYROID
3-DAY VAGINAL CREAM
ESTRACE
Generic Name
ACETAMINOPHEN
ASPIRIN
IBUPOFEN
INDOMETHACIN
WARFARIN SODIUM
CARBAMAZEPINE
CLONAZEPAM
PHENOBARBITAL
PHENYTOIN
VALPORIC ACID
AMITRIPTYLINE HCL
CITALOPRAM HYDROBROMIDE
FLUOXETINE HCL
PAROXETINE HCL
SERTRALINE HCL
TRAZODONE HCL
ALLOPURINOL
COLCHICINE
ATENOLOL
CAPTOPRIL
CHLORTHALIDONE
CLONIDINE HCL
DILTIAZEM HCL
ENALAPRIL MALEATE
FUROSEMIDE
HYDROCHLORORTHIAZIDE
INDAPAMIDE
LINSINOPRIL
LISINOPRIL/HYDROCHLOROTHIAZIDE
METOPROLOL TARTRATE
PROPRANOLOL/HYDROCHLOROTHIAZID
TERAZOSIN HCL
VERAPAMIL HCL
GEMFIBROZIL
LOVASTATIN
SIMVASTATIN
ACYCLOVIR
AMOX TR/POTASSIUM CLAVULANATE
AMOXICILLIN TRIHYDRATE
AZITHROMYCIN
CEPHALEXIN MONOHYDRATE
CIPROFLOXACIN HCL
CLARITHROMYCIN
CLINDAMYCIN HCL
CLINDAMYCIN PALMITATE HCL
DICLOXACILLIN SODIUM
DOXYCYCLINE HYCLATE
ERYTHROMYCIN BASE
FLUCONAZOLE
MEBENDAZOLE
METRONIDAZOLE
PENICILLIN V POTASSIUM
SULFAMETHOXAZOLE/TRIMETHOPRIM
TERBINAFINE HCL
TETRACYCLINE HCL
PROCHLORPERAZINE MALEATE
ALENDRONATE SODIUM
DIGOXIN
ISOSORBIDE DINITRATE
ISOSORBIDE MONONITRATE
NITROGLYCERIN
FLUNISOLIDE
FLUTICASONE PROPIONATE
GUAIFENESIN
GUAIFENESIN/CODEINE PHOS
HYDROXYZINE HCL
LORATADINE
PHENYLEPHRINE HCL
BACITRACIN ZINC
BETAMETHASONE DIPROPIONATE
BETAMETHASONE VALERATE
FLUOCINONIDE
HYDROCORTISONE
HYDROCORTISONE ACETATE
MICONAZOLE NITRATE
MUPIROCIN
NEOMYCIN/BACITRA/POLYMYXIN/HC
NYSTATIN
NSTATIN/TRIAMCIN
PERMETHRIN
SELENIUM SULFIDE
SILVER/SODIUM ALGINATE
BLOOD SUGAR DIAGNOSTIC
DEXTROSE
GLIPIZIDE
GLYBURIDE
HUM INSULIN NPH/REG INSULIN HM
INSULIN ASPART
INSULIN LISPRO
INSULIN REGULAR, HUMAN
INSULIN ASP PRT/INSULIN ASPART
METFORMIN HCL
METFORMIN HCL
NPH, HUMAN INSULIN ISOPHANE
SPIRONOLACTONE
BETAXOLOL HCL
CARTEOLOL HCL
LEVOBUNOLOL HCL
PILOCARPINE HCL
TIMOLOL MALEATE
CIMETIDINE
DICYCLOMINE HCL
FAMOTIDINE
HYOSCYAMINE
HYOSCYAMINE SULFATE
MECLIZINE HCL
METOCLOPRAMIDE HCL
NITROFURANTOIN/NITROFURAN MAC
OMEPRAZOLE
PEG 3350/NA SULG, BICARB, CL/KCL
PHENAZOPYRIDINE HCL
PROMETHAZINE HCL
RANITIDINE HCL
SUMATRIPTAN SUCCINATE
CYCLOBENZAPRINE HCL
SALSALATE
GENTAMICIN SULFATE
SULFACETAMIDE SODIUM
NEOMY SULF/POLYMYX B SULF/HC
OFLOXACIN
ALBUTEROL SULFATE
ALBUTERIL SULFATE
FLUTICASONE PROPIONATE
IPRATROPIUM BROMIDE
TRIAMCINOLONE ACETONIDE
POTASSIUM CHLORIDE
FOLIC ACID
PNV W/ CA, NO. 74/IRON/FA
PRENATAL VIT/FE FUMARATE/FA
DEXAMETHASONE
PREDNISONE
LEVOTHYROXINE SODIUM
THYROID
CLOTRIMAZOLE
ESTRADIOL
