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MERCER COUNTY
MH/MR DRUG FORMULARY
EFFECTIVE JULY 1, 2011
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All forms of a drug listed on this formulary will be covered with the exception of injectables.
Generic drugs must be substituted, if available. In order for a brand name to be dispensed, the prescriber must hand-write "brand necessary" or "brand medically necessary."
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ABILIFY |
ARIPIPRAZOLE |
ADAPIN, SINEQUAN |
DOXEPIN |
ADDERALL |
AMPHETAMINE & DEXTROAMPHETAMINE MIXTURE |
ADDERALL XR |
AMPHETAMINE & DEXTROAMPHETAMINE MIXTURE |
AKINETON |
BIPERIDEN |
AMBIEN |
ZOLPIDEM TARTRATE |
ANAFRANIL |
CLOMIPRAMINE |
ARTANE |
TRIHEXYPHENIDYL |
ASENDIN |
AMOXAPINE |
ATARAX |
HYDROXYZINE HYDROCHLORIDE |
ATIVAN |
LORAZEPAM |
BENADRYL |
DIPHENHYDRAMINE |
BUSPAR |
BUSPIRONE |
CAMPRAL |
ACAMPROSATE |
CELEXA |
CITALOPRAM HYDROROMIDE |
COGENTIN |
BENZTROPINE |
CONCERTA |
METHYLPHENIDATE HYDROCHLORIDE |
CYLERT, ORAP |
PEMOLINE |
CYLERT |
PEMOLINE |
CYMBALTA |
DULOXETINE HCI |
DAYTRANA (Patch) |
METHYLPHENIDATE |
DEPAKOTE |
DIVALPROEX |
DEPAKOTE ER |
DIVALPROEX |
DESYREL |
TRAZODONE |
DEXEDRINE |
DEXTRO AMPHETAMINE |
EFFEXOR |
VENLAFAXINE HYDROCHLORIDE |
EFFEXOR XR |
VENLAFAXINE HYDROCHLORIDE |
ELAVIL, ENDEP |
AMITRIPTYLINE |
FOCALIN XR |
DEXMETHYPHENIDATE |
GABITRIL |
TIAGABINE HCL |
GEODON |
ZIPRASIDONE |
HALDOL |
HALOPERIDOL |
HALDOL DECANOATE |
HALOPERIDOL DECANOATE |
INDERAL |
PROPRANOLOL |
INVEGA |
PALIPERIDONE |
KLONOPIN |
CLONAZEPAM |
KLONOPIN WAFERS |
CLONAZEPAM |
LAMICTAL |
LAMOTRIGINE |
LEXAPRO |
ESCITALOPRAM OXALATE |
LIBRIUM |
CHLORDIAZEPOXIDE |
LIMBITROL |
CHLORDIAZEPOXIDE W/AMITRIPTYLINE |
LITHOBID, ESKALITH |
LITHIUM CARBONATE |
LOXITANE |
LOXAPINE |
LUDIOMIL |
MAPROTILINE |
LUNESTA |
ESZOPICIONE |
LUVOX |
FLUVOXAMINE MALEATE |
LUVOX CR |
FLUVOXAMINE |
MELLARIL |
THIORIDAZINE |
METADATE ER |
METHYLPHENIDATE HYDROCHLORIDE |
METHYLIN ER |
METHYLPHENIDATE HYDROCHLORIDE |
MOBAN |
MOLINDONE |
MYSOLINE |
PRIMIDONE |
NARDIL |
PHENELZINE |
NAVANE |
THIOTHIXENE |
NEURONTIN |
GABAPENTIN |
NORPRAMIN, PERTOFRANE |
DESIPRAMINE |
ORAP |
PIMOZIDE |
PAMELOR, AVENTYL |
NORTRIPTYLINE |
PARLODEL |
BROMOCRIPTINE |
PARNATE |
TRANYLCYPROMINE |
PAXIL |
PAROXETINE HYDROCHLORIDE |
PAXIL CR |
PAROXETINE |
PEXEVA |
PAROXETINE |
PROLIXIN, PERMITIL |
FLUPHENAZINE |
PROLIXIN DECANOATE |
FLUPHENAZINE DECANOATE |
PROVIGIL |
MODAFINIL |
PROZAC |
FLUOXETINE |
PROZAC WEEKLY |
FLUOXETINE |
REMERON |
MIRTAZAPINE |
REMERON SOL TAB |
MIRTAZAPINE |
RESTORIL |
TEMAZEPAM |
RISPERDAL |
RISPERIDONE |
RISPERDAL M TAB |
RISPERIDONE |
RITALIN |
METHYLPHENIDATE |
SERAX |
OXAZEPAM |
SERZONE |
NEFAZODONE HYDROCHLORIDE |
SEROQUEL |
QUETIAPINE |
SONATA |
ZALEPLON |
STELAZINE |
TRIFLUOPERAZINE |
STRATTERA |
ATOMOXETINE HCL |
SURMONTIL |
TRIMIPRAMINE MALEATE |
SYMMETREL |
AMANTADINE |
TEGRETOL |
CARBAMAZEPINE |
TEGRETOL XR |
CARBAMAZEPINE |
THORAZINE |
CHLORPROMAZINE HYDROCHLORIDE |
TOFRANIL |
IMIPRAMINE |
TOPAMAX |
TOPIRAMATE |
TRANXENE |
CLORAZEPATE DIPOTASSIUM |
TRIAVIL, ETRAFON |
AMITRIPTYLINE/PERPHENAZINE |
TRILAFON |
PERPHENAZINE |
TRILEPTAL |
OXCARBAZEPINE |
VALIUM |
DIAZEPAM |
VISTARIL |
HYDROXYZINE PAMOATE |
VIVACTIL |
PROTRIPTYLINE |
WELLBUTRIN |
BUPROPION HYDROCHLORIDE |
WELLBUTRIN SR |
BUPROPION HYDROCHLORIDE |
WELLBUTRIN XL |
BUPROPION HYDROCHLORIDE |
XANAX |
ALPRAZOLAM |
XANAX XR |
ALPRAZOLAM XR |
ZOLOFT |
SERTRALINE HC1 |
ZYPREXA |
OLANZAPINE |

Effective 7/1/11
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