Anti-Infectives

NAME

STRENGTH

AVG. RX INGREDIENT COST

ABSORBABLE SULFONAMIDES

sulfamethoxazole/trimethoprim

n/a

$4.14/20

AZULFIDINE (sulfasalazine)

n/a

$14.03/100

ANTI-FUNGAL AGENTS

ketoconazole

n/a

$82.94/30

nystatin

n/a

$47.17/100

griseofulvin ultramicrosize

330 mg

$24.7/30

LAMISIL (terbinafine hcl)

250 mg

$260.52/30

DIFLUCAN (fluconazole)

100 mg

$80.90/10

SPORANOX (itraconazole)

n/a

$244.79/30

ANTIVIRALS, GENERAL

Acyclovir

200 mg

$11/30

VALTREX (valacyclovlr hcl)

500 mg

$162.49/42

CEPHALOSPORINS

Cefadroxil monohydrate

500 mg

$40.00/20

Cephalexin

500 mg

$8.60/40

OMNICEF (cetdinir)

n/a

$42.82/10

CEDAX (ceftibuten dihydrate)

n/a

$82.42/10

Cefaclor

250 mg

$27.87/40

CEFTIN (cefuroxime axetil)

250 mg

$99.68/20

MACROLIDES

Erythromycin base

250 mg

$7.56/40

Erychromycin ethylsuccinate

400

$9.36/40

Erythromycin stearate

n/a

n/a

Erythromycin w/sulfisoxazole

200 mg

$11/200cc

Erythromycin estolate

n/a

n/a

BIAXIN XL (clarithromycin)

500 mg

$64.23/14

BIAXIN (clarithromycin)

500 mg

$82.85/20

ZITHROMAX (azithromycin)

250 mg

$43.09/6

NITROFURAN DERIVATIVES AND URINARY ANTI-INFECTIVES

MACROBID (nitrofurantoin/nitrofuran mac)

100 mg

$39.56/20

Nitrofurantoin macrocrystal

100 mg

$14.85/20

PENICILLINS

Amoxicillin

500 mg

$3.81/30

Ampicillin trihydrate

500 mg

$4.46/40

Cloxacillin sodium

250 mg

$15.78/40

Dicloxacillin sodium

250 mg

$16.81/40

Oxacillin sodium

n/a

n/a

AUGMENTIN

500 mg

$82.08/20

QUINOLONES

NOROXIN (norfloxacin)

400 mg

$81.05/20

CIPRO (ciprofloxacin) 500 mg $93.43/20
FLOXIN (ofloxacin) 400 mg $108.89/20
LEVAQUIN (levofloxacin) 500 mg $88.75/10

TETRACYCLINES

doxycycline hyclate 100 mg $88.75/10
DYNACIN (minocycline) 100 mg $10.50/20
doxycycline monohydrate n/a n/a
tetracycline 500 mg $2.60/40
Minocycline 100 mg $23/30

Autonomic and CNS

 

NAME

STRENGTH

AVG. RX INGREDIENT COST

ANALGESICS, NARCOTICS

codeine phosphate 30 mg $21.00/30
codeine phosphate/apap (Gen Tylenol #3) 30 mg/300 $10.80/30
codeine phosphate/aspirin 30 mg/325 $5.10/30
codeine sulfate 30 mg $13.20/30
hydrocodone bitartrate/apap 5 mg/500 $3.30/30
hydrocodone bitartrate/aspirin n/a n/a
LORTAB (hydrocodone bitartrate/apap) 5 mg/100 $22.20/30
meperidine hcl 50 mg n/a
methadone hcl 10 mg $4.50/30
MSCONTIN (morphine sulfate) 30 mg $56.70/30
MSIR (morphine sulfate) 15 mg $6.60/30
OXYCONTIN (oxycodone hcl) 20 mg

$74.10/30

OXYIR (oxycodone hcl) 5 mg $11.10/30
propoxyphene hcl/acetaminophen 100 mg $5.70/30
propoxyphene napsylate/apap 100 mg $7.50/30
ULTRAM (tramadol hcl) 50 mg $25.57/30
DURAGESIC (fentanyl) 50 mg $106/5

ANTI-ANXIETY AGENTS

chlordiazepoxide hcl 10 mg

$3.00/30

diazepam 5 mg $.96/30
lorazepam 1 mg $17.10/30
alprazolam 0.5 mg $2.10/30
clorazepate dipotassium 3.75 mg $25.20/30
Buspirone 10 mg $40/30

ANTI-EMETICS AGENTS

meclizine hcl 25 mg $1.20/30
prochlorperazine maleate 10 mg $17.40/30
promethazine hcl 25 mg $90/30
ZOFRAN (ondansetron) 4 mg $52.08/3

ANTI-PHYCHOTICS AGENTS, NON-PHENOTHIAZINES

haloperidol 1 mg $3.00/100
RISPERDAL (risperidone) 0.5 mg $90/30

ANTI-PSYCHOTICS AGENTS, PHENOTHIAZINES

chlorpromazine hcl 25 mg $4/30
fluphenazine hcl (Prolixin) 1 mg $7/30
thioridazine hcl 50 mg $18/30

ANTICONVULSANTS

carbamazepine 100 mg $15/100
DILANTIN (phenytoin sodium extended) 100 mg $28/100
clonazepam 1 mg $10/30
valproic acid 250 mg $32/100
primidone 250 mg $36/100
NEURONTIN (gabapentin) 300 mg $72/60
Depakote 250 mg $93/100

ANTIDEPRESSANTS

amitriptyline hcl 25 mg $3/100
trazodone hcl 50 mg $6/100
desipramine hcl 50 mg $8/100
nortriptyline hcl 25 mg $16/100
doxepin hcl 25 mg $18/100
imipramine hcl 25 mg $18/100
clomipramine hcl 25 mg $38/100
SARAFEM (fluoxetine hcl) 10 mg $81/28
WELLBUTRIN SR (bupropion hcl) 150 mg $101/60
bupropion hcl 100 mg $96/100
EFFEXOR (venlafaxine hcl) 50 mg $146/100
CELEXA (citalopram hydrobromide) 20 mg $69/30
ZOLOFT (sertraline hcl) 50 mg $73/30
EFFEXOR XR (venlafaxine hcl) 75 mg $81/30
PAXIL (paroxetine hcl) 20 mg $82/30
PROZAC (fluoxetine hcl) 20 mg $89/30
Fluoxetine 20 mg $49/30
Fluvoxamine maleate 50 mg $99/30

ANTIMIGRAINE PREPARATIONS

MIDRIN n/a $15/30
isomethaptene/apap/dichiphen n/a $9/30
ZOMIG (zoimitrlptan) 2.5 mg $95/6
IMITREX (sumatriptan) 50 mg $148/9

ANTIPARKINSONISM AGENTS, OTHER

carbidOPA/LEVADOPA 10mg /100 $39/100
amantadine hcl 200 mg $22/50
mirapex 0.125 mg $52/63
REQUIP (ropinirole) .25mg $37/30

CHOLINESTERASE INHIBITORS

EXELON (rivastigmine tartrate) 1.5 mg $139/60
ARICEPT (donepezil hcl) 5 mg $142/30

NSAIDS/ANTI-INFLAMMATORY AGENTS

Diclofenac 50 mg $29/60
Vioxx 12.5 mg $79/30
Ibuprofen 600 mg $2.22/30
Indomethacin 25 mg $1.32/30
Ketoprofen n/a n/a
Naproxen 500 mg $4.89/30
mobic (meloxicam) 7.5 mg $64.35/30
Sulindac 200 mg

$10.50/30

CELEBREX (celecoxib) 100 mg $47/30
oxaprozin 600 mg $44/30
RELAFEN (nabumetone) 500 mg $87/60
Etodolac 400 mg $10.35/30
Piroxicam 20 mg $4.47/30

SEDATIVE-HYPNOTICS, NON-BARBITURATE

Diphenhydramine hcl 50 mg n/a
Flurazepam hcl 15 mg $210/30
Temazepam 15 mg $390/30
Triazolam 0.125 mg $12.00/30
SONATA (zaleplon) 5 mg $61/30
AMBIEN (zolpidem tartrate) 5 mg $62/30

SKELETAL MUSCLE RELAXANTS

Robaxisal n/a n/a
Orphenadrine/aspirin/caffeine 100 mg $330/30
Baclofen 10 mg $.27/30
Carisoprodol 350 mg $11.22/30
Chlorzoxazone 500 mg $18/30
orphenadrine citrate n/a n/a

Cardiovascular

 

NAME

STRENGTH

AVG. RX INGREDIENT COST

ALPHA/BETA ADRENERGIC BLOCKIGN AGENTS

labetalol hcl

200 mg $20/30

ANTIARRHYTHMICS

disopyramide phosphate 100 mg $22/90
quinidine gluconate 200 mg $12/90
lidocaine hcl n/a n/a
propafenone hcl 150 mg $85/60
amiodarone hcl 200 mg $69/60

BETA-ADRENERGIC BLOCKING AGENTS

atenolol 50 mg $5/30
metoprolol 50 mg $7/60
nadolol 40 mg $35/60
propranolol hcl 40 mg $7/100
TOPROL XL (metoprolol succinate) 50 mg $22/30
LEVATOL (penbutolol sulfate) 20 mg $46/30
sotalol 80 mg $45/30

CALCIUM CHANNEL BLOCKING AGENTS

verapamil hacl 240 mg

$9.00/30

nifedipine 10 mg $16.00/30
SULAR (nisoldipine) 10 mg $35/30
diltiazem hcl 180 mg $32/30
TIAZAC (diltiazem hcl) 180 mg $40/30
NORVASC (amlodipine) 5 mg $39/30
COVERA-HS (verapamil hcl) 180 mg $46/30
ADALAT CC (nifedipine) 60 mg $75/30

DIGITALIS GLYCOSIDES

digoxin 0.125 mg $5.10/30

HYPOTENSIVES, ANGIOTENSIN CONVERTING ENZYME BLOCKERS

captopril 25 mg $5.40/30
enalapril maleate 5 mg $1.50/30
MONOPRIL (fosinopril sodium) 10 mg $33/30
ACCUPRIL (quinapril hcl) 10 mg $34/30
LOTENSIN (benazepril hcl) 10 mg $29/30
ZESTRIL (lisinopril) 10 mg $32/30

HYPOTENSIVES, ANGIOTENSIN II RECEPTOR ANTAGONIST

ATACAND (candesartan cilexetil) 16 mg $43/30
AVALIDE (irvesartan/hctz) 150/12.5 mg $56/30
AVAPRO (irbesartan) 150 mg $46/30
DIOVAN (valsartan) 80 mg $42/30

HYPOTENSIVES, MISCELLANEOUS

propranolol hcl w/hctz

40/25 mg

$2.40/30
atenolol w/chlorthalidone 50/25 mg $5/30
bisoprolol fumarate/hctz 5/6.25 mg $15/30

HYPOTENSIVES, SYMPATHOLYTIC

clonidine hcl 0.1 mg $3/30
guanfacine hcl 1 mg $16/30

HYPOTENSIVES, VASODILATORS

doxazosin mesylate 2 mg $18/30
prazosin hcl 2 mg $6/30
terazosin hcl 2 mg $15/30

LIPOTROPICS

gemfibrozil 600 mg $49/60
TRICOR (fenofibrate, micronized) 54 mg $25/30
LIPITOR (atorvastatin) 10 mg $69/30
PRAVACHOL (pravastatin) 20 mg $80/30
ZOCOR 30 mg $132/30

LOOP DIURETICS

furosemide 40 mg n/a
bumetanide 2 mg n/a
DEMADEX (torsemide) 20 mg $26/30

POTASSIUM SPARING DIURETICS IN COMBINATION

triamterene w/hctz 25 mg $7/30
spironolactone w/hctz 25 mg $10/30

THIAZIDE AND RELATED DIURETICS

hydrochlorothiazide 25 mg n/a
indapamide 2.5 mg n/a
ZAROXOLYN (metolazone) 2.5 mg $30/30

VASODILATORS, CORONARY

isosorbide dinitrate 5 mg n/a
nitroglycerin Nitrostat .4 mg $9/100
NITROLINGUAL (nitroglycerin) n/a $36/ea
NITRO-DUR (nitroglycerin) Gen 0.1 mg $52/30
isosorbide mononitrate 30 mg $25/60
IMDUR (isosorbide mononitrate) 30 mg $100/60

Glucocorticoids

NAME

STRENGTH

AVG. RX INGREDIENT COST

GLUCOCORTICOIDS

dexamethasone .075 mg n/a
cortisone acetate 10 mg n/a
hydrocortisone 10 mg n/a
prednisone 5 mg n/a
PEDIAPRED (prednisolone sod phosphate) 6.7 mg $28/4 oz
VANCERIL (beciomethasone dipropionate) n/a $47/ea
FLOVENT (fluticasone propionate) n/a $119/ea
PULMICORT (budesonida) n/a $160/ea

Oral Hypoglycemic Agents

NAME

STRENGTH

AVG. RX INGREDIENT COST

ORAL HYPOGLYCEMIC AGENTS NON-SULFONVLUREA TYPE

GLUCOPHAGE XR (metformin hcl) 500 mg $20/30
GLUCOPHAGE (metformin hcl) 500 mg $47/60

ORAL HYPOGLYCEMIC AGENTS, SULFONYLUREA TYPE

glipizide

5 mg $10/100
glyburide micronized 3 mg $32/100
GLUCOTROL XL (glipizide) 5 mg $11/30
GLUCOVANCE (glyburide/metformin hcl) 2.5 mg/500 $27/30
glyburide 5 mg $26/100

ORAL HYPOGLYCEMIC, INSULIN-RESPONSE ENHANCER (N-S)

AVANDIA (rosiglitazone maleate) 2 mg $58/30
ACTOS (pioglitazone hcl) 15 mg $97/30

THYROID AGENTS

thyroid (Armour) 1 gr $4/30
LEVOTHROID (levothyroxine sodium) 0.1 $8/30
LEVOXYL (levothyroxine sodium) 0.1 $8/30
SYNTHROID (levothyroxine sodium) 0.1 $12/30

Gastrointestinal

NAME

STRENGTH

AVG. RX INGREDIENT COST

ANTI-ULCER PREPARATIONS

NEXIUM (esomeprazole mag trihydrate) 20 mg $124/30
PRILOSEC (omeprazole) 20 mg $135/30
PROTONIX 40 mg $101/30
PREVACID (lensoprazole) 30 mg $132/30

ANTI-ULCER H.PYLORI AGENTS

HELIDAC n/a $147/ea
Prevpac tetracy hcl/bis ss/metronid n/a $281/ea

ANTIDIARRHEALS

loperamide hcl 2 mg $4.50/30
diphenoxylate.atropine 2.5 mg $11/30

BELLADONNA ALKALOIDS

Levsin (Hyosyamine) 0.125 mg $4/30
Belladonna ALK PB 16.2 mg $18/30

BILE SALT SEQUESTRANTS

cholestyramine light n/a $40/pk
cholestyramine n/a $44/pk
COLESTID (colestipol hcl) 1 gm $59/120
WELCHOL (colesevelam hcl) n/a $142/180

HISTAMINE H2 INHIBITORS

cimetidine 300 mg

$12/100

famotidine 20 mg

$12/60

ranitidine hcl 150 mg $10/30
AXID (nizatidine) 150 mg $79/30

INFLAMMATORY BOWEL AGENTS

ASACOL (mesalamine) 200 mg $94/100

Nutritional Products and Electrolytes

NAME

STRENGTH

AVG. RX INGREDIENT COST

POTASSIUM REPLACEMENT

potassium chloride 10 mg $3-30

K-DUR (potassium chloride)

10 mg $10/30

Obstetrical and Gynecological

NAME

STRENGTH

AVG. RX INGREDIENT COST

ESTROGEN/ANDROGEN COMBINATION AGENTS

ESTRATEST H.S. (methyltestosterone/estrogen) n/a $41/30
ESTRATEST methyltestosterone/estrogen) n/a $51/30

ESTROGENIC AGENTS

estradiol

1 mg $7/30
ORTHO-PREFEST (estradiol/norgestimate) n/a

$31/ea

ACTIVELLA (estradiol/noreth ac) n/a

$27/ea

ALORA (estradlol) n/a

$32/ea

ESTRADERM (estradlol) n/a

$30/ea

VIVELLE-DOT (estradiol) n/a

$29/ea

VIVELLE (estradlol)

n/a $29/ea
PREMPHASE (estrogen,con/m-progest acet) n/a $32/ea
PREMPRO (estrogen,con/m-progest acet) n/a $34/ea
COMBIPATCH (estradiol/noreth ac) n/a $35/ea
PREMARIN (estrogens,conjugated) 0.625 mg $24/30

PROGESTATIONAL AGENTS

medroxyprogesterone acet 10 mg $6.6/30
PROMETRIUM (progesterone, micronized) 100 mg $25/30

VAGINAL ANTI-FUNGALS

clotrimazole n/a $9/tube

nystatin tab

500 mg $64/100
nystatin vag tab

$26/15

TERAZOL 7 (terconazole) n/a $35/ea
TERAZOL 3 (terconazole) n/a $35/ea

VAGINAL ESTROGEN PREPARATIONS

VAGIFEM (estradiol) n/a $22/8
PREMARIN (estrogens, conjugated) 0.625 mg $24/30

Respiratory

NAME

STRENGTH

AVG. RX INGREDIENT COST

ANTIHISTAMINES

clemastine fumarate n/a n/a
cyproheptadine hcl n/a n/a
diphenhydramine hcl n/a n/a
hydroxyzine hcl n/a n/a

ANTIHISTAMINES, NON-SEDATING

ZYRTEC (cetirizine hcl) 10 mg $60/30
CLARITIN (loratadine) 10 mg $90/30

BETA-ADRENERGIC AGENTS, RESPIRATORY

PROVENTIL HFA (albuterol sulfate) n/a $34/ea
COMBIVENT (albuterol sulfate/ipratroplum) n/a $49/ea
PROVENTIL (albuterol) n/a $34/ea
SEREVENT (salmeterol xinafoate) n/a $76/ea
Alupent inhaler n/a $30/ea
xopenex inhalation solution 0.63 mg/3 ml $52/24
Albuterol inhaler n/a $8/ea

BETA-ADRENERGICS AND GLUCOCORTICOIDS COMBINATION

ADVAIR DISKUS (salmet xinaft/flutic propin) 250 mg/50 $135/ea

Urological

NAME

STRENGTH

AVG. RX INGREDIENT COST

BENGN PROSTATIC HYPERTROPHY/MICTURITION AGENTS

FLOMAX (tamsulosin hcl) 0.4 mg $56/30
PROSCAR 5 mg $80/30

URINARY TRACT ANTISPASMODIC AGENTS

oxybutynin chloride 5 mg $17/100
DETROL LA (tolterodine tartrate) 2 mg $85/30
DETROL (tolterodine tartrate) 2 mg $97/60
DITROPAN XL (oxybutynin chloride) 5 mg $80/30

Miscellaneous

NAME

STRENGTH

AVG. RX INGREDIENT COST

BONE RESORPTION SUPPRESSIVE AGENTS

ACTONEL (risedronate sodium) 5 mg $69/30
EVISTA (raloxlfene hcl) 60 mg $73/30
FOSAMAX (alendronate sodium) 10 mg $70/30
MIACALCIN (calcitonin, salmon, synthetic) n/a $66/ea

CNS STIMULANTS

Methylphenidate 10 mg $6/30
Concerta 36 mg $74/30
Adderall 20 mg $45/30

 

*This is not a comprehensive list; however, it does include most frequently used drugs in Dalton-Whitfield County.

 

  


Pharmaceutical Reference Guide

Developed by the Health Care Delivery System Improvement Team*
Updated July 22, 2002

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