As of April 5, 2023 the following drugs are available through the District of Columbia AIDS Drug Assistance Program.
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HIV/AIDS DRUGS:
ANTI-RETROVIRAL:
BOOSTING AGENTS
- Cobicistat (Tybost)
- Ritonavir (Norvir)
CD4 DIRECTED POST-ATTACHMENT
HIV-1 INHIBITOR
- Ibalizumab-uiyk (Trogarzo)#
FUSION INHIBITORS
- Enfuvirtide (Fuzeon)
- Maraviroc (Selzentry)
INTEGRASE INHIBITORS
- Dolutegravir (Tivicay)
- Elvitegravir (Vitekta)
- Raltegravir (Isentress)
- 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)
- Doravirine (Pifeltro)
- Efavirenz (Sustiva)
- Etravirine (Intelence)
- Nevirapine (Viramune, Viramune XR)\
- Rilpivirine HCl (Edurant)
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)
NNRTI/NRTI COMBINATION
- Doravirine/Lamivudine/Tenofovir disoproxil fumarate (Delstrigo)
- Efavirenz/Emtricitabine/Tenofovir disoproxil fumarate (Atripla)
- Efavurenz 400 mg /Lamivudine/ Tenofovir disoproxil fumarate (Symfi Lo)++
- Efavurenz 600 mg/Lamivudine/ Tenofovir disoproxil fumarate (Symfi )++
- Emtricitabine/Rilpivirine/Tenofovir alafenamide (Odefsey)
- Emtricitabine/Rilpivirine/Tenofovir disoproxil fumarate (Complera)
HIV/AIDS DRUGS:
ANTI-RETROVIRALS
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)
INTERGRASE INHIBITOR/NNRTI COMBINATION
LONG ACTING INJECTABLE
- Cabotegravir/Rilpivirine (Cabenuva)
ANALGESICS
- Acetaminophen with codeine (Tylenol w/Codeine) CIII**
- ASA/Butalbital/caffeine/codeine (Fiorinal w/codeine)
- Fentanyl Patch (Duragesic Patch) CII**
- Ibuprofen (600mg - 800mg Motrin)
- Morphine Sulfate (MS Contin) CII**
- Oxycodone/Acetaminophen 5mg/325mg
- Tramadol (Ultram) CIV**
ANTI-DEPRESSANTS
- Amitriptyline HCL (Elavil)
- Bupropion (Wellbutrin SR)
- Citalopram (Celexa)
- Duloxetine (Cymbalta)
- Escitalopram (Lexapro)
- Fluoxetine (Prozac)
- Mirtazapine (Remeron)
- Paroxetine (Paxil)
- Sertraline (Zoloft)
- Trazodone
- Venlafaxine ER (Effexor ER)
ANTI-DIARRHEAL
- Crofelemer (Mytesi)
- Diphenoxylate/Atropine (Lonox, Lomotil) CV**
ANTI-EMETICS
- Meclizine (tab, chew tab)
- Metoclopramide (solution, tab)
- Ondansetron Injection
- Ondansetron Oral Solution
- Ondansetron (tab, ODT)
- Prochlorperazine (tab, injection)
- Prochlorperazine (suppository)
ANTI-FUNGALS
- Clotrimazole (Mycelex, Lotrimin - Rx only)
- Fluconazole (Diflucan)
- Itraconazole (Sporanox)
- Ketoconazole (Nizoral – Rx only)
- Voriconazole (Vfend)
Vuvolvaginitis Candidasis
- Ibrexfungerp (Brexafemme) 150mg tablet
- Butoconazole (Gynazole-1) vaginal 2% cream
- Terconazole 0.4% vaginal cream
- Terconazole 0.8% vaginal cream
ANTI-HISTAMINES (only oral products)
- Cetirizine (Zytrec)
- Hydroxyzine HCl
- Hydroxyzine Pamoate
- Loratadine (Claritin)
- Promethazine DM
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
- Amlodipine/Benazepril (Lotrel)
- Lisinopril/HCTZ (Zestoretic)
- Losartan/HCTZ (Hyzaar)
- Valsartan/HCTZ (Diovan HCT)
SECONDARY AGENTS:
ALDOSTERONE ANTAGONISTS
- Spironolactone (Aldactone, Carospir)
ALPHA-1 BLOCKERS
- Doxazosin (Cardura)
- Doxazosin (Cardura XL)
BETA-BLOCKERS
- Labetalol (Trandate)
- Metoprolol succinate (Toprol XL)
- Metoprolol tartrate (Lopressor)
- Propranolol
CENTRALLY ACTING AGENTS
- Clonidine patches (Catapres TTS)
- Clonidine tablet
COMBINED ALPHA AND BETA-BLOCKERS
- Carvedilol (Coreg)
- Carvedilol (Coreg CR)
LOOP DIURETICS
- Furosemide (Lasix)
DIRECT VASODILATORS
- Hydralazine (Apresoline)
SECONDARY COMBINATION PRODUCTS
- Hydralazine /Isosorbide (Bidil)
- Triamterene/HCTZ (Dyazide, Maxide)
ANTIMICROBIALS
- 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 Acquired Bacterial Pneumonia (Oral)
- Amoxicillin (Oral products)
- Cefpodoxine
- Moxifloxacin
Mycobacterium Tuberculosis
1st line
- Rifapentine (Priftin)
2nd line
- Bedaquilline (Sirturo)
- Pretomanid
- Cycloserine (Seromycin)
- Ethionamide (Trecalor)
- Para-aminosalicylic acid (Pacer)
- Streptomycin solution
ANTI-PARKINSON’S AGENT
- Benztropine (Cogentin)
ANTI-PSYCHOTICS
- Aripiprazole (Abilify)
- Haloperidol (Haldol)
- Olanazapine (Zyprexa)
- Quetiapine (Seroquel)
- Risperidone (Risperdal)
- Ziprasidone (Geodon)
ANTI-VIRALS
- Acyclovir (Zovirax) [oral and topical]
- Cidofovir (Vistide)
- Ganciclovir (Zirgan) [ophthalmic]
- Oseltamivir (Tamiflu)
- Valacyclovir (Valtrex)
- Valganciclovir (Valcyte)
CHRONIC OBSRUCTIVE
PULMONARY DISEASE (COPD)
- Albuterol Inhaler (ProAir)
- Beclomethasone (Qvar) Redihaler
- Fluticasone Inhaler (Flovent)
- Roflumilast (Daliresp) tablet#
- Salmeterol (Severent)
- Tiotropium (Spiriva) Handihaler
- Tiotropium (Respimat)
COPD COMBINATIONS
- Albuterol/Ipratropium (Combivent Respimat)
- Budesonide/Formoterol (Symbicort)
- Tiotropium/Olodaterol (Stiolto Respimat)
NEBULIZERS
- Albuterol nebulizer Solution
- Albuterol/Ipratropium (DuoNeb) nebulizer Solution
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)
HISTAMINE TYPE-2 RECEPTOR ANTAGONIST (H2RA)
- Famotidine 40 mg (Pepcid) tab, oral suspensión
- Lansoprazole/Amoxicillin/Clarithomycin (Prevpac)
- Omeprazole 40 mg DR cap (Prilosec)
- Pantoprazole 20mg, 40 mg DR tab, 40mg oral susp. (qty. limits apply)
HYPOGLYCEMICS
- Canagliflozin (Invokana)
- Dapagliflozin (Farxiga)
- Empagliflozin (Jardiance)
- Glipizide (Glucotrol, Glucotrol XL)
- Metformin (Glucophage, Glucophage XL)
- Metformin and Pioglitazone (ActoPlus Met)
- Metformin and Glipizide (Metaglip)
- Nateglinide (Starlix)
- Semaglutide (Ozempic, Rybelsus)
- Sitagliptin (Januvia)
- Sitagliptin/Metformin (Janumet)
KAPOSI’S SARCOMA TREATMENTS
- Doxorubicin (Doxil)
- Generic Doxorubicin (Lipodox)
- Interferon Alpha-2b (Intron A)
LIPID LOWERING AGENTS #
- Atorvastatin (Lipitor)
- Ezetimibe (Zetia)
- Fenofibrate (Tricor)
- Pravastatin (Pravachol)
OMEGA-3 FATTY ACIDS
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)
PCP PROPHYLAXIS
- Aerosolized Pentamidine (Nebupent)
- Atovaquone Suspension (Mepron)
- Dapsone
- Sulfamethoxazole-Trimethoprim (Bactrim)
SMOKING CESSATION
- Par-Varenicline
- Apo-Varenicline
TOPICAL STEROIDS
- Hydrocortisone 2.5% [cream, lotion, ointment]
- Hydrocortisone valerate 0.2% [cream]
TOPICAL ANESTHETICS
- Lidocaine Patch (Lidoderm)
TRANSGENDER HORMONES
- Conjugated estrogen tablet 0.3 mg, 0.45 mg,
- 0.625 mg, 0.9 mg, 1.25 mg
- Estradiol valerate injection 10mg/ml
- Estradiol tablets
- Finasteride tablet 5 mg
- Leuprolide acetate injection 3.75mg, 11.25mg
- Spironolactone tablet 50mg, 100 mg
- Testosterone cypionate injection, CIII**
- Testosterone, topical 1%, (Androgel) CIII** (generic only)
- Testosterone pump, topical 1.62%, (Androgel)
- CIII**
WEIGHT LOSS/WASTING
- Dronabinol (Marinol/Syndros) CIII** #
- Megestrol (Megace, Megace ES)
- Oxandrolone (Oxandrin) CIII **
- Somatropin (Serostim) #
MISCELLANEOUS
- Berocca Plus vitamins (Rx Only)
- Epoetin Alfa (Procrit, Epogen)#
- Pyridoxine 50mg
- Gabapentin (Neurontin)
- V-C Forte vitamin (Rx only)
** 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
UPDATED April 5, 2023
CONFIDENTIAL FAX (202) 673-4365