Page 422 - 2021 IDMT Digital
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Attachment 3
                               IDMT DRUG FORMULARY


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          EENT DRUGS
           Generic Name                     Trade Name
           %HQ]RFDLQH                       &HSDFROŠ
           %HQ]RQDWDWH                      7HVVDORQ 3HUOHVŠ
           &HWLUL]LQH                       =\UWHFŠ
           'LPHQK\GULQDWH                   'UDPDPLQHŠ
           'LSKHQK\GUDPLQH                  %HQDGU\OŠ
           )H[RIHQDGLQH                     $OOHJUDŠ
           *XDLIHQHVLQ                      0XFLQH[Š  5RELWXVVLQŠ
           *XDLIHQHVLQ 'H[WURPHWKRUSKDQ     5RELWXVVLQ '0Š
           *XDLIHQHVLQ 3VHXGRHSKHGULQH      0XFLQH[ 'Š
           +\GUR[\]LQH K\GURFKORULGH        $WDUD[Š
           /RUDWDGLQH                       &ODULWLQŠ
           3VHXGRHSKHGULQH                  6XGDIHGŠ
          *May prescribe combination drugs of any of the above medication

          OTIC and NASAL PREPARATIONS
           Generic Name                     Trade Name

           $FHWLF $FLG 6ROXWLRQ             %XUURZ¶V RWLFŠ
           $QWLS\UHQH DQG %HQ]RFDLQH        $XUDOJDQŠ
           $]HODVWLQH                       $VWHOLQŠ
           &KORUKH[LGLQH JOXFRQDWH          3HULGH[Š
           &LSURIOR[DFLQ RWLF ³03´          &HWUD[DOŠ
           )OXWLFDVRQH                      )ORQDVHŠ
           0RPHWDVRQH                       1DVRQH[Š
           2[\PHWD]ROLQH                    $IULQŠ
           3RO\P\[LQ % 1HRP\FLQ +\GURFRUWLVRQH RWLF   &RUWLVSRULQŠ
           VXVSHQVLRQ ³03´













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