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ADAP and Medicare: ADAP Formulary
AIDS Drug Assistance Program (ADAP) Formulary (Office of HIV / AIDS)
Nucleoside / Nucleotide Revers Transcriptase Inhibitors
Medication |
Strength / Package Size |
ABACAVIR (ZIAGEN) |
300 MG TABLETS |
ABACAVIR (ZIAGEN) |
ORAL SOLUTION (20mg/mL) |
ATRIPLA (EFAVIRENZ/EMTRICITABINE/ TENOFOVIR DISOPROXIL FUMARATE) |
600 MG/200 MG/300 MG TABLETS |
COMBIVIR (LAMIVUDINE/ZIDOVUDINE) |
150 MG/300 MG TABLETS |
DIDANOSINE EC (VIDEX, ddI) |
200 MG, 250 MG, 400 MG CAPSULES |
EMTRICITABINE (EMTRIVA) |
200 MG CAPSULES |
EPZICOM (LAMIVUDINE/ABACAVIR) |
300 MG/600 MG TABLETS |
LAMIVUDINE (EPIVIR, 3TC) |
150 MG, 300 MG TABLETS |
LAMIVUDINE (EPIVIR, 3TC) |
ORAL SOLUTION (10mg/mL) |
STAVUDINE (ZERIT, d4T) |
40 MG, 30 MG, 20 MG, 15 MG CAPSULES |
STAVUDINE (ZERIT, d4T) |
POWDER FOR ORAL SOLUTION (1mg/mL) |
TENOFOVIR (VIREAD) |
300 MG TABLETS |
TRIZIVIR (ABACAVIR/LAMIVUDINE/ ZIDOVUDINE) |
300 MG/150 MG/300 MG |
TRUVADA (TENOFOVIR/EMTRICITABINE) |
300 MG/200 MG TABLETS |
ZALCITABINE (HIVID, ddC) |
0.750 MG TABLETS |
ZIDOVUDINE (RETROVIR, AZT) |
100 MG CAPSULES, 300 MG TABLETS |
ZIDOVUDINE (RETROVIR, AZT) |
SYRUP (10mg/mL) |
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Protease Inhibitors
Medication |
Strength / Package Size |
ATAZANAVIR (REYATAZ) |
100 MG, 150 MG, 200 MG CAPSULES AND 300 MG CAPLET |
DARUNAVIR (PREZISTA) |
300 MG TABLETS |
FOSAMPRENAVIR CALCIUM (LEXIVA) |
700 MG TABLETS |
INDINAVIR (CRIXIVAN) |
400 MG , 200 MG CAPSULES |
LOPINAVIR/RITONAVIR (KALETRA) |
200 MG/50 MG TABLETS |
LOPINAVIR/RITONAVIR (KALETRA) |
ORAL SOLUTION (80mg/20mg per mL) |
NELFINAVIR (VIRACEPT) |
250 MG, 625 MG TABLETS |
NELFINAVIR (VIRACEPT) |
PEDIATRIC POWDER (50 mg/g) |
RITONAVIR (NORVIR) |
100 MG CAPSULES |
RITONAVIR (NORVIR) |
ORAL SOLUTION (80mg/mL) |
SAQUINAVIR (INVIRASE) |
200 MG CAPSULES, 500 MG TABLETS |
**TIPRANAVIR (APTIVUS) |
250 MG CAPSULES |
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Non-Nucleoside Reverse Transcriptase Inhibitors
Medication |
Strength / Package Size |
DELAVIRDINE (RESCRIPTOR) |
200 MG TABLETS |
EFAVIRENZ (SUSTIVA) |
600 MG TABLETS, 200 MG CAPSULES |
NEVIRAPINE (VIRAMUNE) |
200 MG TABLETS |
NEVIRAPINE (VIRAMUNE) |
ORAL SUSPENSION (50mg/5mL) |
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HIV Entry / Fusion Inhibitors
Medication |
Strength / Package Size |
*ENFUVIRTIDE (FUZEON) |
90 MG/mL VIALS |
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Allergy / Cough / Cold
Medication |
Strength / Package Size |
DIPHENHYDRAMINE |
50 MG |
FLUTICASONE |
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HYDROXYZINE |
25 MG, 50 MG |
LORATIDINE |
10 MG |
PROMETHAZINE/CODEINE |
6.25 MG/10 MG/mL |
PSEUDOEPHEDRINE |
30 MG |
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Last updated on January 6, 2009
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