SAIF Formulary: Extended
We listed common brand names as a convenience. If generics are available, the prescription will be filled with the generic option. Not all strengths and formulations of drugs on this list are on the formulary.
| Generic | Common Brand |
|---|---|
| Acetaminophen | Tylenol |
| Alprazolam | Niravam, Xanax |
| Amitripryline HCL | Elavil |
| Amox TR/Potassium Clavulanate | Augmentin, INC ES 600, XR |
| Amoxapine | Asendin |
| Amoxicillin Trihydrate | Amoxil, Trimox |
| Ampicillin Trihydrate | Principen |
| Aspirin | Bayer |
| Azithromycin | Zithromax, Zmax |
| Baclofen | Lioresal |
| Bupropion HCL | Wellbutrin, INC SR & XL |
| Bupropion HCL, SR | Budeprion SR |
| Buspirone HCL | Buspar |
| Carbamazepine | Carbatrol |
| Carisoprodol | Soma |
| Cefadroxil Hydrate | Duricef |
| Celecoxib | Celebrex |
| Cephalexin Monohydrate | Keflex |
| Chlorzoxazone | Parafon Forte DSC |
| Ciprofloxacin | Cipro |
| Ciprofloxacin HCL | Ciloxan |
| Citalopram Hydrobromide | Celexa |
| Clarithromycin | Ciaxin, INC. XL |
| Clomipramine HCL | Anafranil |
| Clonazepam | Klonopin |
| Clorazepate Dipotassium | Tranxene SD |
| Codeine Phos/Acetaminophen | Tylenol w/Codeine No. 3 |
| Codeine Sulf | Codeine Sulfate |
| Cyclobenzaprine HCL | Flexeril |
| Dalteparin Sodium, Porcine | Fragmin |
| Demeclocycline HCL | Declomycin |
| Desipramine HCL | Norpramin |
| Diazepam | Valium |
| Diclofenac Potassium | Cataflam |
| Dicloxacillin Sodium | Diclox |
| Diflunisal | Dolobid |
| Diphenhydramine HCL | Benadryl |
| Divalproex Sodium | Depakote |
| Doxephin HCL | Sinequan |
| Doxycycline Calcium | Vibramycin |
| Doxycycline Hyclate | Doryx |
| Doxycycline Monohydrate | Adoxa, Adoxa Pak |
| Duloxetine HCL | Cymbalta |
| Enoxaparin Sodium | Lovenox |
| Erythromycin Base | E-mycin, Eryc, Ery-Tab, Romycin |
| Erythromycin Ethylsuccinate | E.E.S. |
| Erythromycin Lactobionate | Erythrocin Lactobionate |
| Erythromycin Stearate | Erythromycin Stearate |
| Escitalopram Oxalate | Lexapro |
| Estazolam | Prosom |
| Eszopiclone | Lunesta |
| Ethosximide | Zarontin |
| Etodolac | Lodine |
| Felbamate | Felbatol |
| Fenoprofen Calcium | Nalfon |
| Fluoxetine HCL | Prozac |
| Flurazepam HCL | Dalmane |
| Flurbiprofen | Ansaid |
| Fluvoxamine Maleate | Luvox |
| Gabapentin | Neurontin |
| Gentamicin Sulfate | Garamycin |
|
Hydrocodone Bit/Acetaminophen |
Anexsia, Hydrocet Lorcet, Lortab, Norco Vicodin |
| Hydromorphone HCL | Dilaudid |
| Hydroxyzine HCL | Atarax |
| Hydroxyzine Pamoate | Vistaril |
| Ibuprofen | Advil |
| Imipramine HCL | Tofranil |
| Imipramine Pamoate | Tofranil-PM |
| Indomethacin | Indocin, Incl SR |
| Ketoprofen | Actron, Orudis, Oruvail |
| Ketorolac Tromethamine | Toradol |
| Lamotrigine | Lamictal |
| Levetiracetam | Keppra |
| Levofloxacin | Levaquin |
| Levorphanol Tartrate | Levo-Dromoran |
| Lidocaine | Lidoderm |
| Lorazepam | Ativan |
| Meclofenamate Sodium | Meclofenamate Sodium |
| Meloxicam | Mobic |
| Metaxalone | Skelaxin |
| Methadone HCL | Dolophine, Methadose |
| Methocarbamol | Robaxin |
| Methylprednisolone | Medrol |
| Minocycline HCL | Dynacin, Minocin, Myrac |
| Mirtazapine | Remeron |
| Morphine Sulfate | Oramorph, Roxanol, MSIR |
| Morphine Sulfate ER | Avinza, Kadian, MS Contin |
| Moxifloxacin HCL | Avelox, Vigamox |
| Nabumetone | Relafen |
| Naproxen | Naprosyn |
| Naproxen Sodium | Aleve |
| Nitrofurantoin | Furadantin |
| Nitrofurantoin Macrocrystal | Macrodantin |
| Norfloxacin | Noroxin |
| Nortriptyline HCL | Pamelor |
| Ofloxacin | Floxin, Ocuflox |
| Orphenadrine Citrate | Norflex |
| Orphenadrine/Aspirin/Caffeine | Norgesic Forte |
| Oxaprozin | Daypro |
| Oxazepam | Serax |
| Oxcarbazepine | Trileptal |
| Oxycodone HCL | Oxyfast, Oxyir, Endocet, Percocet Roxicet, Tylox |
| Oxycodone HCL ER | Oxycontin |
| Oxycodone HCL/Aspirin | Percodan |
| Oxymorphone HCL | Opana, Incl ER |
| Paroxetine HCL | Paxil |
| Penicillin V Potassium | Veetids |
| Phenytoin | Dilantin |
| Phenytoin Sodium Extended | Phenytek |
| Piroxicam | Feldene |
| Prednisone | Prednisone |
| Pregabalin | Lyrica |
| Primidone | Mysoline |
| Propoxyphene HCL | Darvon, Incl -N |
| Protriptyline HCL | Vivactil |
| Quazepam | Doral |
| Salsalate | Amigesic |
| Sertraline HCL | Zoloft |
| Silver Sulfadiazine | Silvadene |
| Silver Sulfadiazine | SSD |
| Silver Sulfadiazine | Thermazene |
| Sulfamethoxazole/Trimethoprim | Bactrim, Septra, SMZ-TMP, Sulfatrim, Sultrex |
| Sulindac | Clinoril |
| Temazepam | Restoril |
| Tetracycline HCL | Sumycin |
| Tiagabine HCL | Gabitril |
| Tizanidine HCL | Zanaflex |
| Tobramycin Sulfate | Tobrex |
| Topiramate | Topamax |
| Tramadol HCL | Ultram, Incl ER |
| Tramadol HCL/Acetaminophen | Ultracet |
| Trazodone HCL | Desyrel |
| Triazolam | Halcion |
| Trimipramine Maleate | Surmontil |
| Vancomycin HCL | Vancocin |
| Venlafaxine HCL | Effexor, Incl XR |
| Warfarin Sodium | Coumadin |
| Zaleplon | Sonata |
| Zolpidem Tartrate | Ambien |
| Zonisamide | Zonegran |