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

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)
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)

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)

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) 

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) 

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)
Rifapentine (Prifitin)
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, chew tab)
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 Redihaler)
Tiotropium (Spiriva Handihaler) 
Fluticasone (Flovent)
Roflumilast (Daliresp)#
Severent (Salmeterol)

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

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)
Pyridoxine 50mg 
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: July 21, 2020    
CONFIDENTIAL FAX (202) 673-4365
 

 

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