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Drugs Available through DC ADAP (Formulary)

The following drugs are available through the District of Columbia AIDS Drug Assistance Program.
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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)

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)
•    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)

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) 

ANALGESICS NSAIDS
•    Celecoxib (Celebrex) (except solution)
•    Diclofenac potassium 
•    Meloxicam (Mobic)
•    Naproxen IR 
•    Diclofenac Gel 3%

ANTIBIOTICS
•    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)
•    Sulfadiazine

ANTI-DEPRESSANTS
•    Amitriptyline HCL (Elavil)
•    Bupropion (Wellbutrin SR)
•    Citalopram (Escitalopram)
•    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, chewtab)
•    Metoclopramide (solution, tab) 

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

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)

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)
•    Valacyclovir (Valtrex)
•    Valganciclovir (Valcyte)
•    Oseltamivir (Tamiflu)
•    Ganciclovir (Zirgan) [ophthalmic]

COPD
•    Albuterol Inhaler (ProAir HFA)
•    Beclomethasone (Qvar ReadyHaler)
•    Fluticasone (Flovent)
•    Roflumist (Daliresp)
•    Severent (Salmeterol)
•    Tiotropium/Olodaterol (Stiolto Respimat)

COPD COMBINATIONS
•    Albuterol/Ipratropium (Combivent Inhaler)
•    Budesonide/Formoterol (Symbicort 120)
•    Tiotropium (Spiriva Handihaler)

NEBULIZERS
•    Albuterol Nebulizer Solution (ProAir HFA)
•    Ipratropium Nebulizer Solution (ProAir HFA)

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)
•    Dapagliflozin (Farxiga)
•    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)

KAPOSI’S SARCOMA TREATMENTS
•    Interferon Alpha-2b  (Intron A)
•    Doxorubicin (Doxil)
•    Generic Doxorubicin (Lipodox)

LIPID LOWERING AGENT
•    Atorvastatin (Lipitor)
•    Ezetimibe (Zetia)
•    Fenofibrate (Tricor)
•    Pravastatin (Pravachol)

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)

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)
•    Epoetin Alfa  (Procrit, Epogen)#
•    Gabapentin (Neurontin)
 

** 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: February 3, 2021
CONFIDENTIAL FAX (202) 673-4365
 

 

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