Formulary 2007
The Stark Prescription Assistance Network, Inc. will purchase short term emergency medications for residents of
Stark County, Ohio. Individuals must have a current prescription, meet the income guidelines and may not have
prescription insurance. Please see the formulary below.
If you do not have a Physician, please view the Clinics Link or the Need a Doctor Link.
| Generic Name | Brand Name | Notes |
| ANTI-INFECTIVES (Antibiotics/Antifungals/Antivirals) | ||
| Anti-Infectives, Oral | ||
| amoxicillin | Amoxil | |
| amoxicillin/clavulanic acid | Augmentin | Augmentin ES not covered |
| azithromycin | Zithromax, Z-Pak | |
| cefaclor | Ceclor | |
| cefuroxime | Ceftin | |
| cephalexin | Keflex | |
| ciprofloxacin | Cipro | |
| doxycycline | Vibra-Tabs, Vibramycin | |
| mebendazole | Vermox | |
| metronidazole | Flagyl | |
| penicillin VK | Pen-Vee K, Veetids | |
| trimethoprim & sulfamethoxazole | Bactrim DS | |
| CARDIOVASCULAR (Blood Pressure/Heart/Cholesterol) | ||
| ACE Inhibitors | ||
| benazepril | Lotensin | |
| captopril | Capoten | |
| enalapril | Vasotec | |
| lisinopril | Prinivil, Zestril | |
| Beta Blockers | ||
| nadolol | Corgard | |
| propranolol | Inderal | (Inderal LA not covered) |
| metoprolol | Lopressor | |
| labetalol | Normodyne, Trandate | |
| acebutolol | Sectral | |
| atenolol | Tenormin | |
| bisoprolol | Zebeta | |
| carvedilol | Coreg | Use should be reserved for CHF |
| Generic Name | Brand Name | Notes |
| Anticoagulants | ||
| clopidogrel | Plavix | |
| dipyridamole | Persantine | |
| heparin | heparin | |
| pentoxifylline | Trental | |
| ticlopidine | Ticlid | |
| warfarin | Coumadin | |
| Calcium Channel Blockers | ||
| amlodipine | Norvasc | |
| diltiazem | Cardizem, Cardizem SR, Dilacor XR, Diltia XT | Cardizem CD not covered |
| nifedipine ER | Procardia XL | nifedipine immediate-release capsules not covered |
| verapamil | Calan, Calan SR | |
| Cholesterol-Lowering | ||
| cholestyramine | Questran, Questran Light | |
| gemfibrozil | Lopid | |
| lovastatin | Mevacor | |
| nicotinic acid | Niacin (tablets and SR capsules) | Niaspan not covered |
| Diuretics | ||
| bumetanide | Bumex | |
| chlorthalidone | Hygroton | |
| furosemide | Lasix | |
| hydrochlorothiazide | HydroDIURIL | |
| hydrochlorothiazide & triamterene | Maxzide | |
| indapamide | Lozol | |
| metolazone | Zaroxolyn | |
| spironolactone | Aldactone | |
| Generic Name | Brand Name | Notes |
| Heart Rhythm | ||
| acebutolol | Sectral | |
| amiodarone | Cordarone | |
| digoxin | Lanoxin | |
| disopyramide | Norpace, Norpace CR | |
| mexiletine | Mexitil | |
| procainamide | Procan SR, Pronestyl | |
| propaferone | Rythmol | |
| propranolol | Inderal | Inderal LA not covered |
| quinidine | Quinaglute Dura-Tabs | |
| sotalol | Betapace | |
| Nitrates | ||
| isosorbide dinitrate | Isordil, Isordil Tembids | |
| isosorbide mononitrate | ISMO, Imdur, Monoket | |
| nitroglycerin | Nitro-Dur (patch) | |
| nitroglycerin | Nitrostat (Sublingual tablets) | |
| ENDOCRINE (Diabetes/Hormones) | ||
| Corticosteroids, Oral | ||
| dexamethasone | Decadron | |
| methylprednisolone | Medrol | |
| prednisolone | Pediapred, Prelone | |
| prednisone | Deltasone | |
| Diabetes | ||
| glargine insulin | Lantus | |
| glipizide | Glucotrol | |
| glucagon | glucagon | |
| glyburide | Micronase, Glynase Prestab | |
| human insulin R, L, N, 70/30 | Novolin, Humulin | |
| human insulin U | Humulin U | |
| insulin aspart | Novolog | |
| insulin aspart/NPH | Novolog 70/30 | |
| metformin | Glucophage | |
| pioglitazone | Actos | |
| insulin lispro | Humalog | |
| Generic Name | Brand Name | Notes |
| Thyroid | ||
| levothyroxine | levothyroxine | |
| EYE & EAR | ||
| Anti-Infective and Combination Eye Agents | ||
| bacitracin | bacitracin | |
| sodium sulfacetamide | Bleph-10 | |
| bacitracin/neomycin/polymyxin B/hydrocortisone | Cortisporin | |
| gentamicin | Garamycin | |
| erythromycin | Ilotycin | |
| neomycin/polymixin B/dexamethasone | Maxitrol | |
| bacitracin/neomycin/polymixin B | Neosporin | ointment |
| neomycin/polymixin B gramicidin | Neosporin | solution |
| ofloxacin | Ocuflox | |
| bacitracin & polymyxin B | Polysporin | |
| sodium sulfacetamide | Sodium Sulamyd | |
| tobramycin | Tobrex | solution |
| sodium sulfacetamide & prednisolone | Vasocidin | solution |
| Anti-Inflammatory Eye Agents | ||
| dexamethasone sodium phosphate | Decadron | solution only |
| fluorometholone | FML | 0.1% suspension and ointment |
| prednisolone sodium phosphate | Inflamase Forte | |
| flurbiprofen | Ocufen | |
| prednisolone acetate | Pred Forte | |
| Glaucoma | ||
| betaxolol | Betopic | |
| levobunolol | Betagan | |
| metipranolol | OptiPranolol | |
| timolol maleate | Timoptic | |
| Generic Name | Brand Name | Notes |
| Ear Agents | ||
| antipyrine & benzocaine | Auralgan | |
| neomycin/polymixin B/hydrocortisone | Cortisporin Otic | |
| acetic acid/proplyene glycol | Vosol | |
| acetic acid/propylene glycol diacetate/hydrocortisone | Vosol HC | |
| GASTROINTESTINAL | ||
| Anti-Nausea | ||
| metoclopramide | Reglan | |
| prochlorperazine | Compazine | |
| promethazine | Phenergan | |
| trimethobenzamide | Tigan | |
| Cathartics and Laxatives | ||
| lactulose | Chronulac | |
| polyethylene glycol | MiraLax | |
| Heartburn and Ulcer Drugs | ||
| cimetidine | Tagamet | |
| famotidine | Pepcid | |
| omeprazole | Prilosec | |
| ranitidine | Zantac | |
| sucralfate | Carafate | |
| Pancreatic Enzymes | ||
| amylase/lipase/protease | Creon | |
| amylase/lipase/protease | Ultrase | |
| amylase/lipase/protease | Ultrase MT | |
| amylase/lipase/protease | Viokase | |
| Mental Health | ||
| Anticonvulsants | ||
| carbamazepine | Tegretol | Tegretol XR not covered |
| gabapentin | Neurontin | |
| phenobarbital | phenobarbital | |
| phenytoin | Dilantin | |
| valproic acid | Depakene | |
| Antidepressants | ||
| amitriptyline | Elavil | |
| amoxapine | Asendin | |
| bupropion | Wellbutrin, Wellbutrin SR | |
| clomipramine | Anafranil | |
| desipramine | Norpramin | |
| doxepin | Sinequan | |
| fluoxetine | Prozac | |
| fluvoxamine | Luvox | |
| imipramine | Tofranil | Tofranil PM not covered |
| maprotiline | Ludiomil | |
| mirtazapine | Remeron | |
| nortriptyline | Aventyl, Pamelor | |
| paroxetine | Paxil | Paxil CR not covered |
| trazodone | Desyrel | |
| Generic Name | Brand Name | Notes |
| PAIN | ||
| Nonsteroidal Anti-inflammatory Drugs (NSAIDs) | ||
| choline magnesium trisalicylate | Trilisate | |
| diclofenac sodium | Voltaren | Voltaren XR and Cataflam not covered |
| diflunisal | Dolobid | |
| etodolac | Lodine | Lodine XL not covered |
| flurbiprofen | Ansaid | |
| ibuprofen | Motrin | |
| indomethacin | Indocin, Indocin SR | |
| ketoprofen | Orudis | |
| nabumetone | Relafen | |
| naproxen | Naprosyn | Naprosyn EC not covered |
| naproxen sodium | Anaprox | |
| oxaprozin | Daypro | |
| salsalate | Disalcid | |
| sulindac | Clinoril | |
| tolmetin | Tolectin | |
| RESPIRATORY | ||
| Asthma/Pulmonary Disease | ||
| albuterol | Proventil, Ventolin | |
| cromolyn sodium | Intal solution | |
| fluticasone | Flovent | |
| ipratropium | Atrovent inhaler | |
| ipratropium | Atrovent inhalation solution | |
| salmeterol | Serevent | |