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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)
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)
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 24, 2020                                                                         
CONFIDENTIAL FAX (202) 673-4365         

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