doh

DC Health
 

DC Agency Top Menu

Help us get everyone in our community pre-registered for a vaccination appointment.
Go to vaccinate.dc.gov or call 1-855-363-0333 to pre-register and then help us spread the word. #DCHOPE
Read Mayor Bowser’s Presentation on DC’s COVID-19 Situational Update: April 19

-A +A
Bookmark and Share

Drugs Available through DC ADAP (Formulary)

The following drugs are available through the District of Columbia AIDS Drug Assistance Program.
Click Here for print version.


HIV/AIDS DRUGS
ANTI-RETROVIRALS:
BOOSTING AGENTS

  • Cobicistat (Tybost)
  • Ritonavir (Norvir)

CD4 DIRECTED POST-ATTACHMENT 
HIV-1 INHIBITOR

  • Ibalizumab-uiyk (Trogarzo)# 

FUSION INHIBITORS

  • Enfuvirtide (Fuzeon)
  • Maraviroc (Selzentry)

INTEGRASE INHIBITORS

  • Raltegravir (Isentress)
  • Dolutegravir (Tivicay)
  • Elvitegravir (Vitekta)
  • Cabotegravir (Vocabria) 

NUCLEOTIDE REVERSE
TRANSCRIPTASE INHIBITORS (NRTI)

  • Abacavir (Ziagen)
  • Abacavir/Lamivudine (Epzicom)
  • Abacavir/Lamivudine/Zidovudine (Trizivir)
  • Didanosine (Videx)
  • Emtricitabine (Emtriva)
  • Emtricitabine/Tenofovir disoproxil fumarate (Truvada)
  • Emtricitabine/Tenofovir alafenamide (Descovy)
  • Lamivudine (Epivir)
  • Lamivudine/ Tenofovir disoproxil fumarate (Cimduo/Temixys )#
  • Lamivudine/Zidovudine (Combivir)
  • Stavudine (Zerit)
  • Tenofovir disoproxil fumarate (Viread)
  • Zidovudine (Retrovir, AZT)

NON-NUCLEOSIDE REVERSE 
TRANSCRIPTASE INHIBITORS (NNRTI)

  • Delavirdine (Rescriptor)
  • Rilpivirine HCl (Edurant)
  • Efavirenz (Sustiva)
  • Etravirine (Intelence)
  • Nevirapine (Viramune, Viramune XR)
  • Doravirine (Pifeltro)

HIV-1 INTEGRASE STRAND TRANSFER INHIBITOR/ NRTI COMBINATION 

  • Bictegravir/Emtricitabine/Tenofovir alafenamide fumarate (Biktarvy)
  • Dolutegravir/Abacavir/Lamivudine (Triumeq)
  • Dolutegravir/Lamivudine (Dovato)
  • Dolutegravir/Rilpivirine (Juluca)
  • Elvitegravir/ Cobicistat/ Emtricitabine/ Tenofovir disoproxil fumarate (Stribild)
  • Elvitegravir/Cobicistat/Emtricitabine/ Tenofovir alafenamide fumarate (TAF) (Genvoya)
  • Cabotegravir/Rilpivirine Inj. (Cabenuva)

HIV/AIDS DRUGS
ANTI-RETROVIRALS:

NNRTI/NRTI COMBINATION

  • Efavirenz/Emtricitabine/Tenofovir disoproxil fumarate (Atripla)
  • Emtricitabine/Rilpivirine/Tenofovir disoproxil fumarate (Complera)
  • Emtricitabine/Rilpivirine/Tenofovir alafenamide (Odefsey)
  • Efavurenz 400 mg /Lamivudine/ Tenofovir disoproxil fumarate (Symfi Lo)++
  • Efavurenz 600 mg/Lamivudine/ Tenofovir disoproxil fumarate  (Symfi )++
  • Doravirine/Lamivudine/Tenofovir disoproxil fumarate (Delstrigo)

PROTEASE INHIBITORS (PI)

  • Atazanavir (Reyataz)
  • Darunavir (Prezista)
  • Fosamprenavir (Lexiva)
  • Indinavir (Crixivan)
  • Lopinavir/Ritonavir (Kaletra)
  • Nelfinavir (Viracept)
  • Ritonavir (Norvir)
  • Saquinavir (Invirase)#
  • Tipranavir (Aptivus)

CYP3A INHIBITOR/PROTEASE INHIBITOR

  • Darunavir/Cobicistat  (Prezcobix)
  • Atazanavir/Cobicistat (Evotaz) 

PROTEASE INHIBITOR/CYP3A INHIBITOR/NRTI

  • Darunavir/Cobicistat/Emtricitabine/TAF (Symtuza) 

ANALGESICS

  • Acetaminophen with codeine (Tylenol w/Codeine) CIII**
  • Fentanyl Patch (Duragesic Patch) CII**
  • Ibuprofen (600mg - 800mg Motrin)
  • Morphine Sulfate (MS Contin) CII**
  • Tramadol (Ultram) CIV**
  • Oxycodone/Acetaminophen 5mg/325mg
  • ASA/Butalbital/caffeine/codeine (Fiorinal w/codeine) 

ANTI-DEPRESSANTS

  • Amitriptyline HCL (Elavil)
  • Bupropion (Wellbutrin SR)
  • Citalopram (Celexa)
  • Escitalopram (Lexapro)
  • Duloxetine (Cymbalta)
  • Fluoxetine (Prozac)
  • Mirtazapine
  • Paroxetine
  • Sertraline (Zoloft)
  • Trazodone
  • Venlafaxine ER
  • ANTI-DIARRHEAL
  • Diphenoxylate/Atropine (Lonox, Lomotil) CV**
  • Crofelemer (Mytesi)

ANTI-EMETICS

  • Ondansetron Injection 
  • Ondansetron Oral Solution
  • Ondansetron (tab, ODT)
  • Prochlorperazine (tab, injection)
  • Prochlorperazine (suppository)
  • Meclizine (tab, chew tab)
  • Metoclopramide (solution, tab) 

ANTI-INFECTIVE

  • Amoxicillin Clavulanate (Augmentin)
  • Azithromycin (Zithromax)
  • Ciprofloxacin (Cipro) 
  • Clarithromycin (Biaxin, Biaxin XL) 
  • Clindamycin HCL (Cleocin)
  • Doxycycline Hyclate (Vibramycin)
  • Ethambutol (Myambutol)
  • Isoniazid (INH)
  • Levofloxacin (Levaquin)
  • Linezolid (Zyvox)
  • Metronidazole tablets (Flagyl)
  • Metronidazole vaginal gel
  • Pyrazinamide (Pyrazinamide)
  • Pyrimethamine (Daraprim)#
  • Rifabutin (Mycobutin)
  • Rifampin (Rifadin)
  • Rifapentine (Prifitin)
  • Sulfadiazine

Community AcquiredBacterial Pneumonia (Oral) 

  • Ampxicillin tablet,capsule,suspension,chewtablet
  • Cefpodoxine
  • Moxifloxacin

Mycobacterium Tuberculosis

  • 1st line 
    Rifapentine (Priftin) tablet
  • 2nd line
    Bedaquilline (Sirturo) tablet
  • Pretomanid tablet
  • Cycloserine (Seromycin) capsule
  • Ethionamide (Trecalor) tablet
  • Para-aminosalicylic acid (Pacer) 
  • Streptomycin solution

ANTI-FUNGALS

  • Clotrimazole (Mycelex, Lotrimin - Rx only)
  • Fluconazole (Diflucan)
  • Itraconazole (Sporanox)
  • Ketoconazole (Nizoral – Rx only)
  • Voriconazole (Vfend)

ANTI-VIRALS

  • Acyclovir (Zovirax) [oral and topical]
  • Cidofovir (Vistide)
  • Valacyclovir (Valtrex)
  • Valganciclovir (Valcyte)
  • Oseltamivir (Tamiflu)
  • Ganciclovir (Zirgan) [ophthalmic)

PCP PROPHYLAXIS

  • Aerosolized Pentamidine (Nebupent)
  • Atovaquone Suspension (Mepron)
  • Dapsone
  • Sulfamethoxazole-Trimethoprim (Bactrim)

ANTI-HYPERTENSIVES 

PRIMARY AGENTS:

ACE INHIBITORS (ACEI)

  • Benazepril (Lotensin)
  • Lisinopril (Prinivil, Zestril, Qbrelis)

ANGIOTENSIN II RECEPTOR BLOCKERS (ARB)

  • Losartan (Cozaar)
  • Valsartan (Diovan)

CALCIUM CHANNEL BLOCKERS

  • Amlodipine (Norvasc)
  • Diltiazem XR

PRIMARY COMBINATION PRODUCTS

  • Lisinopril/HCTZ (Zestoretic)
  • Losartan/HCTZ (Hyzaar)
  • Valsartan/HCTZ (Diovan HCT)
  • Amlodipine/Benazepril (Lotrel)

SECONDARY AGENTS:

ALDOSTERONE ANTAGONISTS

  • Spironolactone (Aldactone, Carospir)

ALPHA-1 BLOCKERS

  • Doxazosin (Cardura)
  • Doxazosin (Cardura XL)

BETA-BLOCKERS

  • Labetalol (Trandate)
  • Metoprolol tartrate (Lopressor)
  • Metoprolol succinate (Toprol XL)
  • Propranolol

CENTRALLY ACTING AGENTS

  • Clonidine tablet 
  • Clonidine patches (Catapres TTS)
  • COMBINED ALPHA AND BETA-BLOCKERS
  • Carvedilol (Coreg)
  • Carvedilol (Coreg CR)

LOOP DIURETICS

  • Furosemide (Lasix)

DIRECT VASODILATORS

  • Hydralazine (Apresoline)

SECONDARY COMBINATION PRODUCTS

  • Triamterene/HCTZ (Dyazide, Maxide)
  • Hydralazine /Isosorbide (Bidil)

HEPATITIS B TREATMENT

  • Adefovir (Hepsera)
  • Entecavir (Baraclude)
  • Lamivudine (Epivir HBV)
  • Peginterferon alfa-2a (Pegasys)
  • Peginterferon alfa-2b (Peg-Intron)
  • Tenofovir alafenamide (Vemlidy)

HEPATITIS C

  • Daclatasvir (Daklinza) #
  • Elbasvir and grazoprevir (Zepatier) #
  • Glecaprevir /pibretasvir (Mavyret) #
  • Ledipasvir and Sofosbuvir (Harvoni) #
  • Ombitasvir/Paritaprevir/Ritonavir/    
  • Dasabuvir (Viekira Pak, Viekira XR) #
  • Peginterferon alfa-2a (Pegasys)
  • Peginterferon alfa-2b (Peg-Intron)
  • Ribavirin (Rebetol, Copegus)
  • Sofosbuvir (Sovaldi) #
  • Tenofovir alafenamide (Vemlidy)

HYPOGLYCEMICS

  • Canagliflozin (Invokana)
  • Empagliflozin (Jardiance)
  • Glipizide (Glucotrol, Glucotrol XL)
  • Metformin (Glucophage, Glucophage XL)
  • Metformin and Pioglitazone (ActoPlus Met)
  • Metformin and Glipizide (Metaglip)
  • Nateglinide (Starlix)
  • Sitagliptin (Januvia)
  • Sitagliptin/Metformin (Janumet)

LIPID LOWERING AGENT

  • Atorvastatin (Lipitor)#
  • Ezetimibe (Zetia)
  • Fenofibrate (Tricor)
  • Pravastatin (Pravachol)#

COPD

  • Albuterol Inhaler (ProAir) 
  • Beclomethasone (Qvar) Redihaler
  • Fluticasone Inhaler (Flovent) 
  • Roflumilast (Daliresp) tablet#
  • Severent (Salmeterol)
  • Tiotropium (Spiriva) Handihaler
  • Tiotropium (Respimat)

COPD COMBINATIONS

  • Albuterol/Ipratropium (Combivent Respimat)
  • Tiotropium/Olodaterol (Stiolto Respimat)
  • Budesonide/Formoterol (Symbicort)

NEBULIZERS

  • Albuterol nebulizer Solution 
  • Albuterol/Ipratropium (DuoNeb) nebulizer solution 

ANTI-PARKINSON’S AGENT

  • Benztropine (Cogentin)

ANTI-PSYCHOTICS

  • Aripiprazole (Abilify)
  • Haloperidol (Haldol)
  • Olanazapine (Zyprexa)
  • Quetiapine (Seroquel)
  • Risperidone (Risperdal)
  • Ziprasidone (Geodon)
  • KAPOSI’S SARCOMA TREATMENTS
  • Interferon Alpha-2b (Intron A)
  • Doxorubicin (Doxil)
  • Generic Doxorubicin (Lipodox)

OPIOID ADDICTION TREATMENT

  • Buprenorphine (Subutex) CIII**#
  • Buprenorphine/Naloxone (Suboxone) CIII**#

OPIOID ANTAGONIST

  • Naloxone (Evzio) 2mg Auto-injector
  • Naloxone (Narcan) 4mg Nasal spray

OSTEOPOROSIS

  • Alendronate 70mg plus Vitamin D 
  • Calcitonin-salmon Nasal spray
  • Raloxifene (Evista)

SMOKING CESSATION

  • Nicotine Gum
  • Nicotine mini lozenges
  • Nicotine transdermal patch
  • Varenicline (Chantix)

TOPICAL STEROIDS

  • Hydrocortisone 2.5% [cream, lotion, ointment]
  • Hydrocortisone valerate 0.2% [cream]

TOPICAL ANESTHETICS

  • Lidocaine Patch (Lidoderm)

TRANSGENDER HORMONES

  • Estradiol valerate injection 10mg/ml
  • Estradiol tablets 
  • Leuprolide acetate injection 3.75mg, 11.25mg
  • Spironolactone tablet 50mg, 100 mg
  • Finasteride tablet 5 mg
  • Testosterone cypionate injection, CIII**
  • Testosterone, topical 1%, (Androgel) CIII** (generic only)
  • Testosterone pump, topical 1.62%, (Androgel) CIII**
  • Conjugated estrogen tablet 0.3 mg, 0.45 mg, 0.625 mg, 0.9 mg, 1.25 mg

WEIGHT LOSS/WASTING

  • Dronabinol (Marinol/Syndros) CIII** #
  • Megestrol (Megace, Megace ES)
  • Oxandrolone (Oxandrin) CIII **
  • Somatropin (Serostim) #

MISCELLANEOUS

  • Berocca Plus vitamins (Rx Only)
  • V-C Forte vitamin (Rx only)
  • Pyridoxine 50mg 
  • Epoetin Alfa  (Procrit, Epogen)#
  • Gabapentin (Neurontin)

UPDATED April 20, 2021     


 CONFIDENTIAL FAX (202) 673-4365    

** DENOTES CONTROLLED SUBSTANCES
#  DENOTES PRIOR AUTHORIZATION 
++ DENOTES DOSAGE STRENGTH CAUTION  

CONTROLLED SUBSTANCES ARE AVAILABLE AT ANY CONTRACTED NETWORK PHARMACY

Delivery Available – inquire with individual pharmacy
 

Contact Phone: 
(202) 671-4815
Contact TTY: 
711