As of May 17, 2021, 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)#
• Fostemsavir (Rukobia)
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 Acquired Bacterial 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
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, package 1%, (Androgel) CIII** (generic only)
• Testosterone pump, package 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)
** DENOTES CONTROLLED SUBSTANCES
CONTROLLED SUBSTANCES ARE AVAILABLE AT ANY CONTRACTED NETWORK PHARMACY
# DENOTES PRIOR AUTHORIZATION
++ DENOTES DOSAGE STRENGTH CAUTION
## Must enroll patient in manufacturer’s program