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Introduction to the AIDS Drug Assistance ProgramEvery year we get latest information for every state. We don’t know of any other print publication that does this. Here’s the information we provide for each state, using Alabama, the first state on the list, as an example. Underneath the state’s name, you’ll see the phone number for their ADAP program. We urge you to call the number for your state to confirm their latest information. We do our very best to make this list accurate, but sometimes we make mistakes. Sometimes the states make mistakes, too, and changes may have been made since press time. Below the phone number is the maximum qualifying income for a single person to receive assistance from ADAP. In Alabama this year it is $49,960 - that’s the most you can make and still get your drugs through the Alabama ADAP. In Texas, Idaho and a few other states, it is only $24,980. But in California it is $62,450 - more than two-and-a-half times as much as Texas! Lastly, we give you each state’s “formulary,” a list of the drugs that state’s ADAP program covers. As you can see, this also varies dramatically! Alabama covers only a few of the basics. You can see at a glance that Arizona covers more than three times as many. Some states have an “open formulary,” which means that the state covers most FDA-approved drugs for the treatment of HIV and the side-effects of HIV medication. *See below for individual state links. Alabama,
Alaska,
Arizona,
Arkansas,
California,
Colorado,
Connecticut,
Delaware,
District of Columbia,
Florida, 866-574-9964 (ADAP) Aptivus; Atripla; Biktarvy; Cimduo; Combivir; Complera; Crixivan; Delstrigo; Descovy; Edurant; Emtriva; Epivir; Epzicom; Evotaz; Fuzeon (prior authorization required); Genvoya; Intelence; Invirase; Isentress; Isentress HD; Lexiva; Juluca; Kaletra; Norvir; Odefsey; Pifeltro; Prezcobix; Prezista; Rescriptor; Retrovir; Reyataz; Selzentry; Stribild; Sustiva, Symfi, Symfi Lo, Tivicay, Triumeq, Trizivir, Truvada; Tybost; Videx, Videx EC, Viracept; Viramune; Viramune EC; Viread; Vitekta; Zerit; Ziagen. 800-478-AIDS (ADAP) Atripla; Cimduo; Complera; Descovy; Genvoya; Intelence; Isentress; Isentress HD; Juluca; Norvir; Odefsey; Prezcobix; Prezista; Reyataz; Stribild; Symfi; Symfi Lo; Tivicay; Triumeq; Truvada; Viread. 602-364-3263 (ADAP) Aptivus; Atripla; Biktarvy; Cimduo; Combivir; Complera; Crixivan; Delstrigo; Descovy; Dovato; Edurant; Efavirenz; Emtriva; Epivir; Epzicom; Evotaz; Fuzeon; Genvoya; Intelence; Invirase; Isentress; Isentress HD; Juluca; Kaletra; Lexiva; Norvir; Odesfey; Prezcobix; Prezista; Rescriptor; Reyataz; Selzentry; Stribild; Symfi; Symfi Lo; Tivicay; Trizivir; Truvada; Tybost; Vemlidy; Videx; Viracept; Viramune; Viread; Zerit. 501-661-2408 (ADAP) Aptivus; Atripla; Combivir; Complera; Crixivan; Descovy; Edurant; Emtriva; Epivir; Epzicom; Evotaz; Fuzeon prior approval required; Genvoya; Isentress; Isentress HD; Intelence; Invirase; Kaletra; Lexiva; Norvir; Odefsey; Prezcobix; Prezista; Retrovir; Reyataz; Selzentry prior approval required; Sustiva; Tivicay; Triumeq; Trizivir; Truvada; Viracept; Viramune; Videx EC; Viread; Zerit; Ziagen. 844-421-7050 (ADAP) Aptivus; Atripla; Biktarvy; Cimduo; Combivir; Complera; Crixivan; Delstrigo prior approval required; Descovy; Dovato; Emtriva; Epivir; Epzicom; Evotaz; Fuzeon Prior approval required; Genvoya; Juluca; Kaletra; Lexiva; Isentress; Intelence; Invirase; Norvir; Odefsey; Pifeltro prior approval required; Prezcobix; Prezista; Rescriptor; Retrovir; Reyataz; Selzentry; Stribild; Sustiva; Symfi; Symtuza; Tivicay; Triumeq; Trizivir; Trograzo prior approval required; Truvada; Tybost; Vemlidy (prior approval required); Viracept; Viramune; Videx; Videx EC; Viread; Zerit; Ziagen. 303-692-2716 (ADAP) Abacavir; abacavir/lamivudine; abacavir/lamivudine/zidovudine; acamprosate calcium; acyclovir; adefovir; amoxicillin; amphotericin injection; aripiprazole; atazanavir; atazanavir/cobicistat; atenolol; atorvastatin; atovaquone; aviane and generics; azithromycin; bictegravir/emtricitabine/tenofovir alafenamide; boceprevir; buproprion; chlorhexidine rinse; cidofovir; citalopram; clarithromycin; clindamycin; clotrimazole; cobicistat; contraceptives; daclatasvir; dapsone; darbepoetin alfa; darunavir; darunavir/cobicistat; delavirdine; didanosine; diphenoxylate/atropine; divalproex sodium; dolutegravir; dolutegravir/lamivudine/abacavir; dolutegravir/rilpivirine; efavirenz; efavirenz/emtricitabine/tenofovir DF; elbasvir/grazoprevir; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; enfuvirtide; entecavir; epoetin alfa/erythropoietin; etravirine; esomeprazole; ethambutol; famciclovir; fenofibrate; filgrastim; fluconazole; fosamprenavir; foscarnet; gabapentin; ganciclovir; gemfibrozil; glucometer; glucose strips; glyburide; hydrochlorothiazide; ibalizumab-uiyk; indinavir; insulin; itraconazole; lamivudine; lamivudine/zidovudine; lancets; leucovorin; levetiracetam; lisinopril; lisinopril/hctz; loperamide; lopinavir/ritonavir; losartan; maraviroc; metformin; metformin/glyburide; metoprolol; metronidazole; mirtazpine; necon 1/35 and generics; nelfinavir; nevirapine; nitazoxanide; nystatin suspension; olanzapine; ombitasvir/paritaprevir/ritonavir; pegfilgrastim; peginterferon alfa-2a; peginterferon alfa-2b; penicillin; pentamidine/aerosol; pyrimethamine; quetiapine; raltegravir; ranitidine; ribavirin; rifabutin; rilipivirine; risperidone; ritonavir; rosuvastatin; saquinavir; sertraline; sofosbuvir; sofosbuvir/velpatasvir; stavudine; sulfadiazine; telaprevir; telbivudine; tenofovir; tesamorelin; testosterone; tipranavir; TMP/SMX; vaginal ring; valacyclovir; valganciclovir; varenicline; venlafaxine; voriconazole; zidovudine; ziprasidone. 800-233-2503 (ADAP) Abacavir; abacavir/lamivudine; abacavir/dolutegravir/lamivudine abacavir/lamivudine/zidovudine; acetaminophen with codeine; acyclovir; albuterol; alclometasone dipropionate; alendronate; alendronate sodium/cholecalciferol; alprazolam; amitriptyline HCL; amlodipine; amoxicillin; amoxicillin/clavulanate pot.; amphotericin B; ampicillin; amprenavir; aripiprazole; atazanavir; atazanavir/cobicistat; atenolol; atorvastatin; atovaquone; azelastine HCL; azithromycin; benztropine mesylate; betamethasone; bictegravir/emtricitabine/tenofovir alafenamide; budesonide; bupropion HCL; buspirone; calcium supplements; carbamazepine; cefditoren pivoxil; ceftriaxone; cefuroxime; celecoxib; cephalexin; chlorhexidine gluconate; cholestyramine; cidofovir; ciprofloxacin; citalopram; clarithromycin; clindamycin; clindamycin gel; clobetasol propionate; clofibrate; clonazepam; clopidigrel; clotrimazole; cobicistat; colesevelam HCL; comvax; dapsone; darunavir; darunavir/cobicistat; delavirdine; desloratadine; dexamethasone; diazepam; dicloxacillin; didanosine; digoxin; diltiazem HCL; diphenoxylate HCL; divalproex sodium; dolutegravir; dolutegravir/lamivudine/abacavir; dolutegravir/rilpivirine; doxycycline hyclate; dronabinol; duloxetine; efavirenz; efavirenz/emtricitabine/tenofovir DF; elvitegravir; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; enalapril maleate; enfuvirtide; engerix-B; entecavir; erythropoietin; escitalopram oxalate; esomeprazole; ethambutol; etravirine; exenatide; ezetimibe; famciclovir; famotidine; fenofibrate; fenofibric acid; fentanyl transdermal system; ferrous sulfate; filgrastim; flucinonide; fluconazole; fluoxetine HCL; flunisolide; fluticasone propionate; fosamprenavir; foscarnet; furosemide; gabapentin; ganciclovir; gatifloxacin; gemfibrozil; gentamicin; glipizide; glyburide; guaifenesin/codeine PH; guaifenesin/DM HBr; guaifenesin/pseudoephedrine; granisetron; havrix; hydrochlorothiazide; hydrocortisone topical; hydroxyurea; hydroxyzine HCL; ibuprofen; imiquimod; indinavir; insulin NPH; insulin Regular; ipratropium bromide; isosorbide dinitrate; isosorbide mononitrate; itraconazole; ketoconazole; ketoconazole 2%; ketoprofen; labetalol HCL; lactic acid; lactulose; lamivudine; lamivudine/zidovudine; lamotrigine; lansoprazole; leucovorin; levocarnitine/oral; levofloxacin; levothyroxine sodium; lisinopril; lithium; loperamide HCL; lopinavir/ritonavir; lorazepam; maraviroc; megestrol acetate; meningococcal vaccines; metformin HCL; metronidazole; metronidazole cream; metroprolol succinate; minocycline HCL; minoxidil; mirtazapine; mometasone furaote monohydrate; mupirocin ointment.; nandrolone decanoate; naproxen; nelfinavir; neomycin sulfate; nevirapine; nitrofurantoin monohydrate; nitroglycerin; nortriptyline HCL; nystatin; ofloxacin; olanzapine; omega-3 acid ethyl esthers; ondansetron; oseltamivir; oxandrolone; oxycodone with APAP 5/325; oxycodone with APAP SLN; oxycodone HCL – CR; oxymetholone; pantoprazole sodium; paromomycin; paroxetine; peg-interferon alfa-2a; peg-interferon alfa-2b; penicillin G benzathine; penicillin V potassium; pentamidine; pioglitazone HCL; pneumococcal vaccine; pravastatin; prednisone; pimecrolimus; primaquine; prochlorperazine; pyrimethamine; quetiapine fumarate; rabeprazole sodium; raltegravir; ranitidine HCL; recombivax HB; ribavirin; rifabutin; rifampin; rilpivirine; risperidone; ritonavir; rosiglitazone maleate; rosuvastatin; salmeterol; salmeterol xinafoate; saquinavir; sertraline; somatropin; spironolactone; stavudine; strovite/forte/plusd/advance/one; sulfadiazine; temazepam; tenofovir; terbinafine; terconazole; testosterone; testosterone cypionate; testosterone gel; tipranavir; TMP/SMX; tramadol HCL; trazadone; triamcinolone acetonide; trimethoprim; twinrix; valacyclovir; valganciclovir; valsartan; valsartan and HCT; vancomycin; vaqta; venlafaxine; verapamil; vitamin D supplements; voriconazole; zalcitabine; zanamivir; zidovudine; zolpidem tartrate; zoster vaccine - recombinant, adjuvanted. 302-744-1050 (ADAP) Abacavir; abacavir/lamivudine; abacavir/lamivudine/zidovudine; acarbose; acetaminophen/oxy-
codone; acyclovir; adult diapers; albuterol inhaler; albuterol/ipratropium; alendronate; alprazolam; amikacin sulfate; amitriptyline; amlodipine; amlodipine/atorvastatin; amoxapine; amoxicillin; amoxicillin/potassium clavulanate; ampicillin; amprenavir; apresonline; aripiprazole; asenapine; aspirin; atazanavir; atazanavir/cobicistat; atenolol; atorvastatin; atovaquone; azelastine; azithromycin; beclomethasone; benztropine; bictegravir/emtricitabine/tenofovir alafenamide; brompheniramine; budesonide; bupropion; buspirone; carafate; carbamazepine; carvedilol; catheters; cefixime; cefuroxime; cephalexin; cetirizine; chlordiazepoxide; chlorpromazine; cholestyramine; cidofovir; ciprofloxacin; citalopram; clarithromycin; clemastine; clindamycin; clomipramine; clonazepam; clonidine; clorazepate; clotrimazole troches; clotrimazole vaginal; codeine with pain relievers; colesevelam; cyproheptadine; dapsone; darunavir; darunavir/cobicistat; delavirdine; desipramine; desloratadine; desvenlafaxine; dexamethasone; dexlansoprazole; dexchlorpheniramine; dexlansoprazole; diabetic supplies; diazepam; diclofenac; dicloxacillin; didanosine; digoxin; diltiazem; diphenhydramine; diphenoxylate/atropine; disposable syringes; docusate-sennoside; dolutegravir; doxycycline; duloxetine; econazole nitrate 1% cream; efavirenz; efavirenz/emtricitabine/tenofovir DF; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; enalapril; enfuvirtide; epoetin alpha; erythromycin base/succinate/stearate; escitalopram; esomeprazole; estazolam; ethambutol; ethosuximide; etodolac; etravirine; ezetimibe; ezetimibe/simvastatin; famciclovir; famotidine; felodipine; fenofibrate; fenofibrate micronized; fenoprofen; fentanyl transdermal system; ferrous sulfate; fexofenadine; filgrastim; florinef acetate; fluconazole; flunisolide; fluocinonide; fluoxetine; flurazepam; flurbiprofen; fluticasone; fluticasone/salmeterol; fluvoxamine; fomivirsen; fosamprenavir; foscarnet; fosinopril; furosemide; gabapentin; ganciclovir; gatifloxacin; gemfibrozil; glimepiride; glipizide; glyburide; haloperidol; hemorrhoidal creams & suppository; hepatitis A vaccine; hepatitis B vaccine; hepatitis A/B vaccine; human papillomavirus quadrivalent; hydrochlorothiazide; hydrocodone and derivatives; hydrocodone/IBU; hydrocortisone; hydromorphone and derivatives; hydroxyzine; ibandronate; ibuprofen; imipenem/cilastatin; imipramine; imiquimod; indinavir; influenza/vaccine/seasonal; insulins; inteferon alfa-2b; interferon alfa-2b + ribavirin; ipratropium; isoniazid (INH); isoproterenol; isradipine; itraconazole; ketoconazole; ketoconazole cream; ketoprofen; ketorolac; labetalol; lamivudine; lamivudine/zidovudine; lamotrigine; lancets; lansoprazole; leucovorin; levetiracetam; levofloxacin; levothyroxine; linezolid; lisinopril; lithium carbonate; loperamide; lopinavir/ritonavir; loratadine; lorazepam; losartan; lovastatin; lurasidone; maprotiline; maraviroc; meclofenamate; meloxicam; meperidine; metaproterenol inhaler; metformin; metformin/repaglinide/rosiglitazone/sitagliptin; methylprednisone; metolazone; metoprolol; metronidazole; miconazole cream; minocycline HCL; minoxidil; mirtazapine; montelukast; morphine sulfate; moxifloxacin; mycostatin; nabumetone; nandrolone; naproxen; nefazodone; nelfinavir; neomycin sulfate; nevirapine; niacin; nifedipine; nitrofurantoin; nizatidine; nortriptyline; nystatin cream; ofloxacin; olanzapine; olmesartan; omega-3-acid ethyl esters; omeprazole; ondansetron; oxandrolone; oxaprozin; oxazepam; oxycodone/ APAP; paliperidone; pancrease enzymes; pantoprazole; paromomycin; paroxetine; pegylated interferon; penicillin G benzathine; penicillin V potassium; pentamidine; pentobarbital; phenytoin; pioglitazone; piroxicam; pneumococcal 23; pravastatin; prednisone; pregabalin; pneumococcal 13 - valent conjugate vaccine; primaquine phosphate; probenecid; prochlorperazine; promethazine; propranolol; protriptyline; pyrazinemide; pyridoxine; pyrimethamine; quetiapine; quiniapril; rabeprazole; raltegravir; ramipril; ranitidine; repaglinide; ribavirin; rifabutin; rifampin; rilpivirine; risedronate; risperidone; ritonavir; rosiglitazone; rosuvastatin; salmeterol; saquinavir; sertraline; simvastatin; sinequan; sitagliptin; somatropin; spironolactone; stavudine; sulfadiazine; sulindac; td; tdap; telmisartan/HCTZ; temazepam; tenofovir; terbutaline; terconazole; testosterone; tiagabine; tipranavir; tolmentin; tramadol; TMP/SMX; trazadone; triamcinolone; triamcinolone 0.1% dental paste; triamterene; trifluoperazine; trimipramine; valacyclovir; valganciclovir; valproate; valsartan; venlafaxine; verapamil; vilazodone; voriconazole; warfarin; zidovudine; ziprasidone; zolpidem. DISTRICT OF COLUMBIA 202-671-4815 (ADAP) Abacavir; abacavir/lamivudine; abacavir/lamivudine/dolutegravir; abacavir/lamivudine/zidovudine; acetamenaphine/codeine; acyclovir; adefovir; aerosolized pentamidine; alpha interferon; amitriptyline; amoxicillin/clavulante; aripiprazole; atazanavr; atazanavir/cobicistat; atorvastatin; atovaquone suspension; azithromycin; benztropine; berocca plus vitamins; boceprevir; buprenorphine; buprenorphine/naloxone; bupropion; cidofovir; ciprofloxacin; clarithromycin; clindamycin; clotrimazole; cobicistat; dapsone; darunavir; darunavir/cobicistat; delavirdine; didanosine; diphenoxylate/atropine; dolutegravir; dolutegravir/lamivudine/abacavir; doxorubicin; doxycycline; dronabinol; duloxetine; efavirenz; efavirenz/emtricitabine/tenofovir DF; elvitegravir; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; enfurvirtide; entecavir; erythropoietin alpha; ethambutol; etravirine; ezetimibe; fenofibrate; fentanyl patch; fluconazole; fluoxetine; fosamprenavir; gabapentin; ganciclovir; glipizide; haloperidol; hydrocortisone 2.5%; hydrocortisone valerate 0.2%; ibuprofen; indinavir; isoniazid; itraconazole; ketoconazole; lamivudine; lamivudine/zidovudine; levofloxacin; lidocaine patch; linezolid; lopinavir/ritonavir; maraviroc; megestrol; metformin; metformin/glipizide; metformin/pioglitazone; morphine sulfate; nelfinavir; nevirapine; olanazapine; oseltamivir; oxandrolone; peginterferon alfa 2a; peginterferon alfa-2b; pravastatin; pyrazinamide; pyrimethamine; quetiapine; raltegravir; ribavirin; rifabutin; rifampin; rilpivirine; risperidone; ritonavir; saquinavir; sertraline; somatropin; stavudine; sulfadiazine; telaprevir; tenofovir; testosterone; tipranavir; TMP/SMX; valacyclovir; valganciclovir; voriconazole; zidovudine; ziprasidone. 850-245-4422 (ADAP) Abacavir; abacavir/lamivudine; abacavir/lamivudine/dolutegravir; abacavir/lamivudine/zidovudine; amantadine; amitriptyline; acyclovir; adefovir; aripiprazole; atazanavir; atazanavir/cobicistat; atorvastatin; atovaquone; azithromycin; bupropion; clarithromycin; clotrimazole; cobicistat; daclatasvir; darunavir; darunavir/cobicistat; dapsone; delavirdine; didanosine; diphenoxylate; divalproex sodium; dolutegravir; dolutegravir/lamivudine/abacavir; dronabinol; duloxetine; efavirenz/emtricitabine/tenofovir DF; elbasvir/grazoprevir; elvitegravir; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricita-bine; emtricitabine/tenofovir alafenamide; 404-463-0416 (ADAP) Abacavir; abacavir/lamivudine; abacavir/lamivudine/dolutegravir; abacavir/lamivudine/zidovudine; acyclovir; amprenavir; atazanavir; atazanavir/cobicistat; atovaquone; azithromycin; clarithromycin; clindamycin; clotrimazole; cobicistat; dapsone; darunavir; darunavir/cobicistat; delavirdine; didanosine; dolutegravir; efavirenz; efavirenz/emtricitabine/tenofovir DF; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; enfuvirtide; epoetin alpha; ethambutol; etravirine; famciclovir; fluconazole; flucytosine; fosamprenavir; gabapentin; ganciclovir; hydroxyurea; indinavir; isoniazid; itraconazole; ketoconazole; lamivudine; lamivudine/zidovudine; leucovorin; loperamide; lopinavir/ritonavir; maraviroc; nelfinavir; nevirapine; nystatin; prednisone; primaquine; prochlorperazine; pyrazinamide; pyrimethamine; raltegravir; rifabutin; rifampin; rilpivirine; ritonavir; saquinavir; stavudine; sulfadiazine; tenofovir; tipranavir; TMP/SMX; trimethoprim; valacyclovir; valganciclovir; zidovudine. 808-733-9360 (ADAP) Abacavir; abacavir/lamivudine; abacavir/lamivudine/dolutegravir; abacavir/lamivudine/zidovudine; acamprosate; acyclovir; albuterol; alendronate; aliretinoin gel; amitriptyline; amlodipine; amphotericin B; amphotericin B liposomal; aripiprazole; atazanavir; atazanavir/cobicistat; atorvastatin; atovaquone; azithromycin; boceprevir; buprenorphine; buprenorphine/naloxone; bupropion; cephalexin; cidofovir; ciprofloxacin; citalopram; clarithromycin; clindamycin; clonidine; clopidogrel; clotrimazole; cobicistat; crofelemer; cyanocobalamin; daclatasvir; dapsone; darunavir; darunavir/cobicistat; daunorubicin; delavirdine; dicloxacillin; didanosine; diphenox-ylate/atropine; disulfiram; divalproex sodium; dolutegravir; doxycycline; dutasteride; efavirenz; efavirenz/emtricitabine/tenofovir DF; elbasvir/grazoprevir; elvitegravir; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; enfuvirtide; entecavir; epinephrine autoinjector; epoetin alpha; erythromycin; estradiol- oral, sublingual, transdermal; estradiol cypionate for IM injection; estradiol valerate for IM injection; ethambutol; etravirine; famciclovir; finasteride- 1 MG, 5 MG; fenofibrate; filgrastim; finasteride; fluconazole; flucytosine; fluorouracil; fluoxetine; fosamprenavir; foscarnet; furosemide; gabapentin; ganciclovir; gemfibrozil; glecaprevir/pibrentasvir; glyburide; hepatitis A&B vaccines; hexachlorophene 3%; hydrochlorothiazide; hydrocortisone 1% cream; hydroxyurea; imiquimod; indinavir; isoniazid; isosorbide mononitrate; itraconazole; ketoconazole; lamivudine; lamivudine/zidovudine; ledipasvir/sofosbuvir; leucovorin; levabuterol; levetiracetam; lisinopril; lisinopril/hydrochlorothiazide; loperamide; lopinavir/ritonavir; losartan; maraviroc; medroxyprogesterone acetate, oral; megestrol acetate; metformin; metronidazole; mirtazapine; naloxone; naltrexone; naproxen; nelfinavir; nevirapine; niacin extended-release tablets; norfloxacin; olanzapine; olmesartan; olmesartan/hydrochlorothiazide; ombitasvir/paritaprevir/ritonavir; omeprazole; ondansetron; oseltamivir; quetiapine; paclitaxel; pancrelipase; pantoprazole; paromomycin; paroxetine; peginterferon alpha 2a; peginterferon alfa-2b; pentamidine-aerosolized; pioglitazone; pitavastatin; pneumococcal PSV; posaconazole; pravastatin; prednisone; pregabalin; primaquine; probenecid; prochlorperazine; progesterone, micronized; pyrazinamide; pyrimethamine; raltegravir; ribavirin; rifabutin; rifampin; rilpivirine; risedronate; risperidone; ritonavir; rosiglitazone; rosuvastatin; saquinavir; sertraline; simeprevir; sinecatechins ointment 15%; sofosbuvir; sofosbuvir/velpatasvir/voxilaprevir; spironolactone; stavudine; sulfadiazine; tamsulosin; telaprevir; telbivudine; tenofovir; terazosin; terbinafine; testosterone cypionate; testosterone gel; tetracycline; tipranavir; TMP/SMX; valacyclovir; valganciclovir; vancomycin; varenicline; venlafaxine; viekira pak; warfarin; zanamivir; zidovudine; ziprasidone. 208-334-5612 (ADAP) Abacavir; abacavir/lamivudine; abacavir/lamivudine/zidovudine; acyclovir; atazanavir; atazanavir/cobicistat; azithromycin; bictegravir/emtricitabine/ tenofovir alafenamide fumarate; clarithromycin; crofelemer; dapsone; darunavir; darunavir/cobicistat; didanosine; dolutegravir; dolutegravir/lamivudine/abacavir; dolutegravir/rilpivirine; efavirenz; efavirenz/emtricitabine/tenofovir DF; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; enfuvirtide; etravirine; fosamprenavir; indinavir; lamivudine; lamivudine/zidovudine; lopinavir/ritonavir; maraviroc; nelfinavir; nevirapine XR; raltegravir; rilpivirine; ritonavir; stavudine; sulfamethoxazole/trimethoprim; tenofovir; tipranavir; valacyclovir; zidovudine. 800-825-3518 (ADAP) Abacavir; abacavir/lamivudine; abacavir/lamivudine/zidovudine; acyclovir; amoxicillin; amphotericin B (I.V. only); amprenavir (solution only); atazanavir; atovaquone; azithromycin; cefixime; cephalexin; chlorhexidine gluconate; cidofovir plus probenecid intravenous; ciprofloxacin; clarithromycin; clindamycin HCL; clindamycin phosphate; clindamycin palmitate/ leucovorin calcium; clotrimazole; cobicistat; daclatasvir; dapsone; darunavir; darunavir/cobicistat; dasabuvir/ ombitasvir/paritaprevir/ritonavir; delavirdine; dicloxacillin sodium; didanosine; diphenoxylate/atropine; dolutegravir; dolutegravir/lamivudine/abacavir; doxycycline hyclate; efavirenz; efavirenz/emtricitabine/tenofovir DF; elbasvir/grazoprevir; elvitegravir; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; enfuvirtide; entecavir; ethambutol; etravirine; famciclovir; fenofibrate; fluconazole; fosamprenavir; gabapentin; ibalizumab-uiyk; imiquimod cream; imodium; indinavir; isoniazid; isoniazid/pyrazinamide/rifampin; itraconazole; lamivudine; lamivudine/zidovudine; ledipasvir/sofosbuvir; levofloxacin; lomotil; loperamide; lopinavir/ritonavir; maraviroc; metronidazole; miconazole; nelfinavir; nevirapine; nystatin; ombitasvir/paritaprevir/ritonavir; paromomycin sulfate; penicillin VK; pentamidine isethionate; pravastatin; primaquine phosphate; pyrazinamide; pyridoxine hcl; pyrimethamine; raltegravir; ribavirin; rifabutin; rifampin; rilpivirine; ritonavir; saquinavir; sofosbuvir; sofosbuvir/velpatasvir; stavudine; sulfadiazine; sulfamethoxazole; tenofovir; tesamorelin; testosterone cypionate; testosterone enanthate I.M. only); tipranavir; TMP/SMX; trimethoprim; valacyclovir; valgancyclovir; zidovudine. 866-588-4948 (ADAP) Abacavir; abacavir/lamivudine; abacavir/lamivudine/zidovudine; acamprosate; acetaminophen/hydrocodone; acetaminophen/codeine; acetaminophen/oxycodone; acyclovir; albuterol; alendronate; alprazolam; amitriptyline; amlodipine; amoxicillin; amoxicillin/clavulanate acid; aripiprazole; atazanavir; atazanavir/cobicistat; atorvastatin; atovaquone; azithromycin; betamethasone; bictegravir/emtricitabine; tenofovir alafenamide; buprenorphine+naloxone; beclomethasone; budesonide/formoterol; bupropion; buspirone; carbamezapine; carvedilol; cefixime; ceftriaxone; cephalexin; cetirizine; chlorhexidine-gluconate; ciprofloxacin; citalopram; clarithromycin; clonazepam; clonidine; clopidogrel; clotrimazole; cobicistat; cyclobenzaprine; dapsone; darunavir; darunavir/cobicistat; delavirdine; desipramine; diabetes supplies; didanosine; diphenhydramine; diphenoxylate atropine; disulfiram; dolutegravir; dolutegravir/lamivudine/abacavir; dolutegravir/rilpivirine; doxepin; doxycycline; dronabinol; duloxetine; efavirenz; efavirenz/emtricitabine/tenofovir DF; elvitegravir; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; enfuvirtide; entecavir; esomeprazole; estradiol; estrogen conjugated; ethambutol; ethinyl estradiol/norgestimate; etravirine; famotidine; fenofibrate; finasteride; fluconazole; flucytosine; fluocinonide; fluoxetine; fluticasone NS; fosamprenavir; gabapentin; gemfibrozil; hydrochlorothiazide; hydroxyzine; ibuprofen; imiquimod; indinavir; insulins; ipratropium/albuterol; isoniazid; isosorbide dinitrate; isosorbide mononitrate; itraconazole; ketoconazole; lamivudine; lamivudine/zidovudine; lamotrigine; leucovorin; levetiracetam; levofloxacin; lisinopril; lithium; loperamide; lopinavir/ritonavir; loratadine; lorazepam; losartan; maraviroc; mary’s magic mouthwash; medroxyprogesterone; metformin; metoprolol; methadone; metronidazole; mirtazapine; morphine sulfate; naltrexone; naproxen; nelfinavir; nevirapine; nicotine patches; nitroglycerine; norethindrone acetate /ethinyl estradiol; nystatin; olanzapine; omega-3-acid ethyl esters; omeprazole; ondansetron; oxycodone; pantoprazole; paroxetine; penicillin G benzathine; pentamidine; phenobarbital; phenytoin; polysaccharide iron complex; pravastatin; prednisone; pregabalin; prochlorperazine; promethazine; pyridoxine; pyrimethamine; quetiapine; raltegravir; ranitidine; ribavirin; rifabutin; rifampin; rilpivirine; risiperidone; ritonavir; ropinirole; saquinavir; sertraline; sitagliptin; spironolactone; stavudine; sulfadiazine; sumatriptan; tamsulosin; temazepam; tenofovir; terbinafine; testosterone; tiotropium; tipranavir; TMP/SMX; tramadol; trazadone; triamcinolone NS; valacyclovir; valganciclovir oral; valproate; varenicline; venlaxafine; voriconazole; warfarin; zidovudine; ziprasidone; zolpidem. Clients apply to ADAP through their case manager so someone wanting ADAP assistance must first engage in case management through one of the ten Ryan White agencies in Iowa. (ADAP) Iowa has an open formulary with an exclusion list. The ADAP covers all meds unless they fall into a catagory on the exclusion list. Iowa ADAP Formulary Exclusion List- - Abortifacients – misoprostol, etc. 785-296-6174 (ADAP) This formulary currently includes all FDA-approved medications for the treatment of HIV infection, including other medications that are utilized for prevention and treatment of secondary infections. 866-510-0005 (ADAP) Abacavir; abacavir/lamivudine; abacavir/lamivudine/zidovudine; acyclovir; amoxicillin; amprenavir; atazanavir; atovaquone; azithromycin; bictegravir/emtricitabine/tenofovir alafenamide; cephalexin; ciprofloxacin; clarithromycin; clotrimazole; cobicistat; dapsone; darunavir; delavirdine; didanosine; dolutegravir; dolutegravir/lamivudine/abacavir; dolutegravir/rilpivirine; doxycycline; efavirenz; efavirenz/emtricitabine/tenofovir DF; elvitegravir; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; emtricitabine/tenofovir alafenamide; emtri-citabine/tenofovir DF; enfuvirtide; ethambutol; etravirine; fluconazole; fosamprenavir; hepatitis A vaccine; hepatitis B vaccine; hepatitis A/B vaccine; imiquimod; immodium; indinavir; isoniazid; itraconazole; ketoconazole; lamivudine; lamivudine/zidovudine; leucovorin; lopinavir/ritonavir; maraviroc; megestrol; nelfinavir; nevirapine; nystatin; paramomycin; prenatal vitamins; primaquine; promethazine HCL; pyrimethamine; raltegravir; rifabutin; rifampin; rilpivirine; rimactane; ritonavir; saquinavir; stavudine; sulfadiazine; tenofovir; testosterone; tipranavir; TMP/SMX; trimethoprim; valganciclovir; vitamin D; zidovudine. 504-568-7474 (ADAP) Abacavir; abacavir/lamivudine; abacavir/lamivudine/zidovudine; acyclovir; amphotericin B; atazanavir; atazanavir/cobicistat; atovaquone; azithromycin; bictegravir/emtricitabine/tenofovir alafenamide; cidofovir; clarithromycin; clindamycin; cobicistat; dapsone; darunavir; darunavir/cobicistat; delavirdine; didanosine; dolutegravir; dolutegravir/lamivudine/abacavir; dolutegravir/rilpivirine; efavirenz; efavirenz/emtricitabine/tenofovir DF; elvitegravir; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; enfuvirtide; ethambutol; etravirine; famciclovir; fluconazole; flucytosine; fosamprenavir; foscarnet; ganciclovir; ibalizumab-uiyk; indinavir; isoniazid; itraconazole; lamivudine; leucovorin; lopinavir/ritonavir; maraviroc; nelfinavir; nevirapine; pentamidine; prednisone; probenecid; pyrazinamide; pyridoxine; pyrimethamine; raltegravir; ribavirin; rifabutin; rifampin; rilpivirine; ritonavir; saquinavir; stavudine; sulfadiazine; tenofovir; tenofovir/emtricitabine; tipranavir; trimethoprim/sulfamethoxazole; valacyclovir; valganciclovir; zidovudine; zidovudine/lamivudine. 207-287-3498 (ADAP) Abacavir; abacavir/lamivudine; abacavir/lamivudine/zidovudine; acarbose; acyclovir; adefovir dipivoxil; albendazole; amantadine HCL; amikacin; amphotericin B; amprenavir; atazanavir; atovaquone; azithromycin; benzocaine; benzo caine-benzethonium; benzo-caine-ephedrine; benzocaine-phenylephrine; benz-pyril-phenyleph-bismuth subgallate-zinc oxide; butoconazole nitrate; calamine-zinc oxide; camphor-phenol-tannic acid-zinc oxide; caspofungin acetate; cefotaxime sodium; cidofovir; ciprofloxacin; clarithromycin; clindamycin; clotrimazole; cocoa butter-shark liver oil; dapsone; darunavir; delavirdine; dibucaine; didanosine; diperodon HCl; diperodon-pyrilamine-phenylephrine; dolutegravir; doxycycline; dronabinol; econazole; efavirenz; efavirenz/emtricitabine/tenofovir DF; elbasvir/grazoprevir; elvitegravir; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; enfuvirtide; ephedrine & belladonna; erythromycin; ethambutol; etravirine; famciclovir; fluconazole; flucytosine; fosamprenavir; gabapentin; ganciclovir; gatifloxacin; hamamelis water-glycerin; hepatitis A vaccine; hepatitis b vaccine; hydrocortisone; indinavir; influenza virus; isoniazid; itraconazole; ketoconazole; lamivudine; lamivudine/zidovudine; leucovorin; levofloxacin; lopinavir/ritonavir; maraviroc; measles/mumps & rubella vaccine; methylprednisone; miconazole; minocycline; naftifine; nandrolone decanoate; nandrolone phenpropionate; nelfinavir; nevirapine; nystatin; oseltamivir; oxiconazole; pentamidine; pneumococcal vac polyvalent; prednisone; primaquine; pyrazinamide; pyridoxine; pyrimethamine; raltegravir; rifabutin; rifampin; rifapentine; rilpivirine; rimantadine; ritonavir; saquinavir; sertaconazole; sulconazole; stavudine; sulfadiazine; sulfamethoxazole; tetracycline; tenofovir; testosterone; testosterone cypionate; tioconazole; tipranavir; TMP/SMX; trifluridine; valacyclovir; valganciclovir; varicella-zoster immune globulin; voriconazole; zalcitabine; zidovudine. List of drugs for HIV-related side-effects is extensive. Please call for complete listing or visit the following link for the complete list: www.maine.gov/dhhs/mecdc/infectious-disease/hiv-std/documents/ADAP_Quarterly_Formulary_Report_1818.pdf. 410-767-6535 (ADAP) Abacavir; abacavir/lamivudine; abacavir/lamivudine/zidovudine; acyclovir; adefovir dipivoxil; albuterol; amantadine; amikacin sulfate; amitriptyline HCL; amlodipine; amoxicillin; amoxicillin/clavulanate potassium; amphotericin-B; atazanavir; atazanavir/cobicistat; atenolol; atorvastatin; atovaquone/proguanil; azathioprine; azithromycin; beclomethasone; belatacept; bictegravir/emtricitabine/tenofovir alafenamide; budesonide; budesonide/formoterol fumarate; buprenorphine sublingual; buprenorphine/naloxone sublingual; bupropion; captopril; carbamazapine; cefpodoxime proxetil; ceftriaxone sodium; cephalexin; chlorothiazide; cidofovir; ciprofloxacin; citalopram; clarithromycin; clindamycin; clonidine; clotrimazole; clotrimazole-betamethasone; cobicistat; crofelemer; cyclosporine; cyclosporine modified; daclatasvir; dapsone; darunavir; darunavir/cobicistat; dasabuvir/ombitasvir/paritaprevir-RTV; daunorubicin citrate liposome; delavirdine; didanosine; diltiazem; diphenoxylate/atropine; divalproex sodium; dolutegravir; dolutegravir/lamivudine/abacavir; dolutegravir/rilpivirine; doxazosin; doxycycline; duloxetine; efavirenz; efavirenz/emtricitabine/tenofovir DF; elbasvir-grazoprevir; elvitegravir; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; enalapril; enfuvirtide; entecavir; epoetin alpha; ergocalciferol; erythromycin; escitalopram oxalate; estradiol cypionate; estradiol transdermal; estradiol valerate; ethambutol; ethinyl estradiol-ethynodiol; ethinyl estradiol-norgestimate; etravirine; everolimus; famciclovir; fenofibrate micronized; fenofibric acid; filgrastim; finasteride; fluconazole; flucytosine; flutamide; fluoxetine; fluphenazine; fluticasone/salmeterol; formoterol; fosamprenavir; foscarnet; furosemide; gabapentin; ganciclovir; gemfibrozil; glimepiride; glipizide; glycopyrrolate formeterol fumurate; haloperidol; hepatitis A vaccine; hepatitis B vaccine; hepatitis A/B vaccine; human papillomavirus 9-valent/recomb; hydralazine; hydrochlorothiazide; hydroxizine; hydroxyzine pamoate; imiquimod; indacaterol maleate; indapamide; indinavir; influenza vaccine; insulin detemir; insulin glargine; insulin lispro; insulin NPH; insulin-regular; interferon alpha-2A; interferon alpha 2b; ipratropium/albuterol sulfate; ipratropium bromide; isavuconazonium sulfate; isoniazid; isoniazid-rifampin; itraconazole; ketoconazole; lamivudine; lamivudine/zidovudine; lamotrigine; lancets; lansoprazole; leucovorin; ledipasvir-sofosbuvir; levetiracetam; levofloxacin; levonorgestrel 0.75 mg; lisinopril; lithium carbonate; loperamide; lopinavir/ritonavir; losartan; losartan-hctz; maraviroc; medroxyprogesterone; mefloquine HCl; megestrol acetate; mening vac a,c,y,w-135 dip/pf; metformin HCL; metoclopramide; metoprolol; metronidazole; miconazole; mirtazapine; moxifloxacin HCL; mycophenolate mofetil; mycophenolate sodium; naloxone injection; naloxone nasal spray; nandrolone decanoate; nelfinavir; nevirapine; nifedipine; nitazoxinide; norethindrone; nortriptyline; nystatin; octreotide; ofosbuvir; olanzapine; olanzapine/fluoxetine; olodaterol; ombitasvir-paritaprevir-RTV; omega-3 acid ethyl esters; ondansetron HCL; oseltamivir phosphate; oxandrolone; oxymetholone; paromomycin; paroxetine; peginterferon alfa 2a; peginterferon alfa 2b; penicillin G benzathine; pentamidine; perphenazine; pneumococcal 23 vaccine; pneumococcal conjugate 13-valent; polymyxin B-trimethoprim sulfate; posaconazole; pravastatin; prednisone; primaquine phosphate; prochlorperazine; promethazine HCL; propanolol; pyrazinamide; pyrimethamine; quetiapine; raltegravir; ranitidine; ribavirin; rifabutin; rifampin; rilpivirine; rimantadine HCL; risperidone; ritonavir; rosuvastatin; salmeterol xinafoate; saquinavir; sertraline; 800-228-2714 (ADAP) MA has an “open formulary” and cover all FDA approved drugs for HIV and related conditions (including HCV). There is a short list of exclusions to the formulary that can be found on the website. 888-826-6565 (ADAP) Abacavir; abacavir/lamivudine; abacavir/lamivudine/zidovudine; acamprosate; acyclovir; acetaminophen/caffeine/butabital; acetaminophen/caffeine/butabital/codeine; albuterol; aldesleukin; alendronate; alprazolam; amitriptyline; amitriptyline; amlodipine; amoxicillin; amoxicillin/clarithromycin/lansoprazole; amoxicllin/clavulanic acid; amphotericin B; amprenavir; aripiprazole; asa/caffeine/butabital; asa/caffeine/butabital/codeine; atazanavir; atazanavir/cobicistat; atenolol; atenolol/chlorthalidone; atorvastatin; atovaquone; azithromycin; baclofen; beclomethasone; benazepril; bictegravir/emtricitabine/tenofovir alafenamide; buprenorphine; buprenorphine/naloxone; buspirone; codeine; codeine/acetaminophen; celecoxib; cephalexin; cetirizine; cetirizine/p-ephedrine; cholestyramine; chlorpromazine; cidofovir; cilostazol; ciprofloxacin; ciprofloxacin/dexamethasone; ciprofloxacin/hc; citalopram; clarithromycin; clindamycin; clopidogrel; clonazepam; clonidine; clotrimazole; clotrimazole/betamethasone; cobicistat; conjugated estrogens tablet/vaginal cream; cyclobenzaprine; dapsone; darunavir; darunavir/cobicistat; delavirdine; dental products; desonide; diabetes supplies; diazepam; diclofenac; diclofenac/misoprostol; dicyclomine; didanosine; diltiazem; diphenhydramine; diphenoxylate/atropine; divalproex sodium; dolutegravir; dolutegravir/lamivudine/abacavir; dolutegravir/rilpivirine; doxepin; doxycycline; dronabinol; duloxetine; efavirenz; efavirenz/emtricitabine/tenofovir DF; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; enalapril; enalapril/hctz; enfuvirtide; entecavir; epinephrine; epoetin alfa; erythromycin; escitalopram; ethambutol; etravirine; famciclovir; famotidine; felodipine; fenofibrate; fentanyl; filgrastim; fluconazole; fluoxetine; fosamprenavir; foscarnet; furosemide; gabapentin; ganciclovir; gemfibrozil; glipizide; glyburide; glyburide/metformin; haloperidol; hctz/triamterene; hepatitis A vaccine; hepatitis B vaccine; hydrochlorothiazide; hydrocodone/acetaminophen; hydrocortisone 2.5% cream; hydromorphone; hydroxyurea; ibuprofen; imiquimod; indinavir; influenza vaccine; insulins; interferon alfa 2b; ipratropium; isoniazid; itraconazole; ketoconazole; lactulose; lamivudine; lamivudine/zidovudine; lansoprazole; leucovorin; levofloxicin; levetiracetam; levothyroxine; lisinopril; lisinopril/hctz; loperamide; lopinavir/ritonavir; loratadine; lorazepam; losartan; losartan/hctz; maraviroc; megestrol; meperidine; mesalamine, 5-ASA; metformin; methadone; methyltestosterone; metoclopramide; metoprolol; metronidazole; minoxidil; mirtazapine; montelukast; morphine; opium tincture; nabumetone; nelfinavir; nevirapine; niacin; nicotine patch/nasal spray/gum; nifedipine XL, ER; nitroglycerin sublingual tab/spray/cap; nizatidine; nystatin; pancrelipase; potassium chloride; ofloxacin; olanzapine; omeprazole; oseltamivir; oxandrolone; oxybutynin; oxycodone; oxycodone/acetaminophen; paromomycin; peginterferon alfa-2a; peginterferon alfa-2b; penicillin; penicillin inj; pentamidine; phenytoin; pioglitazone; pneumonococcal vaccine; podofilox; pravastatin; primaquine; prednisone; prochlorperazine; promethazine; propranolol; pyrazinamide; pyridoxine; pyrimethamine; quinapril; raltegravir; ramipril; ranitidine; ribavirin; rifabutin; rifampin; rilpivirine; riman-tadine; risperidone; ritonavir; rosiglitazone; rosigli- 651-431-2414 (ADAP) Abacavir; abacavir/lamivudine; abacavir/lamivudine/zidovudine; acyclovir; adefovir dipivoxil; albendazole; amitriptyline; amoxapine; amoxicillin; amoxicillin/clavulanic acid; amprenavir; androderm; androgel; aripiprazole; atazanavir; atazanavir/cobicistat; atorvastatin; atova- quone; azithromycin; bacitracin; bacitracin/polymyxin; boceprevir; buconazole; bupropion; carbamazepine; cefpodoxime; cephadroxil; cephalexin; chlorhexidine gluconate; ciprofloxacin; citalopram; cholestyramine; clarithromycin; clindamycin; clindamycin 1% gel; clotrimazole; cobicistat; dapsone; darafenacin; darunavir; darunavir/cobicistat; delavirdine; desipramine; desmopressin acetate; dicloxacillin; didanosine; diphenoxylate/atropine; divalproex sodium; dolutegravir; dolutegravir/lamivudine/abacavir; doxepin; doxycycline; duloxetine; econazole; econazole; efavirenz; efavirenz/emtricitabine/tenofovir DF; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; enfurvitide; entecavir; epoetin alfa; escitalopram; ethambutol; etravirine; famciclovir; famotidine; fenofibrate; filgrastim; fluconazole; flucytosine; fluoxetine; fluvastatin; fluvoxamine; foscarnet; fosamprenavir; gemfibrozil; gentamicin; imipramine; imiquimod; indinavir; isocarboxazid; isoniazid/vitamin B6; itraconazole; ketoconazole; lamivudine; lamivudine/zidovudine; lansoprazole; leucovorin; levofloxacin; loperamide; lopinavir/ritonavir; lovastatin; maprotiline HCL; maraviroc; megestrol; metoclopramide; metronidazole; miconazole; minocycline; mirtazapine; moxifloxacin; multi vitamins; mupirocin 2% ointment; nelfinavir; nevirapine; niacin; nitrofurantoin; nortriptyline; nystatin; omeprazole; ondansetron; oseltamivir; oxybutynin; pantoprazole; paromomycin; paroxetine; peginterferon alfa-2B; pegylated interferon; penciclovir; penicillin; pentamidine; podofilox; pravastatin; prenatal vitamins; primaquine; prochlorperazine; pyrazinamide; pyrimethamine; quetiapine; raltegravir; ranitidine; ribavirin; rifabutin; rifampin; rilpivirine; ritonavir; rosuvastatin; saquinavir; sertraline; silver sulfadiazine; simeprevir; simvastatin; sofosbuvir; somatropin; stavudine; sulfadiazine; telaprevir; tenofovir; terconazole; tesamorelin; tetracycline; tipranavir; TMP/SMX; trazadone; trimipramine maleate; trospium; valacyclovir; valganciclovir; venlafaxine; voriconazole; warfarin; zanamivir; zidovudne; zolpidem. 888-343-7373 (ADAP) Abacavir; abacavir/lamivudine; abacavir/lamivudine/zidovudine; acyclovir; amoxicillin; amitriptyline HCL; atazanavir; atorvastatin; azithromycin; bictegravir/emtricitabine/tenofovir alafenamide; chlorihexidine gluconate; citalopram; clarithromycin; clindamycin; crofelemer; dapsone; darunavir; didanosine; dolutegravir; dolutegravir/lamivudine/abacavir; dolutegravir/rilpivirine; efavirenz; efavirenz/emtricitabine/tenofovir DF; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; enfuvirtide; ethambutol; etravirine; fluconazole; fosamprenavir; gabapentin; ibalizumab-uiyk; indinavir; isoniazid; itraconazole; lamivudine; lamivudine/zidovudine; leucovorin; lopinavir/ritonavir; maraviroc; metronidazole; nelfinavir; nevirapine; niacin; oxandrolone; peginterferon alfa 2a; pentamidine; pyrazinamide; pyrimethamine; raltegravir; ribavirin; rifabutin; rifampin; rilpivirine; ritonavir; saquinavir; sertraline; stavudine; sulfadiazine; tenofovir; tesamorelin; tipranavir; TMP/SMX; valacyclovir; valganciclovir; zidovudine. 573-751-6439 (ADAP) Abacavir; abacavir/lamivudine; abacavir/lamivudine/zidovudine; acetaminophen; acyclovir; adefovir; albendazole; albuterol; alprazolam; amitriptyline; amlodipine; amoxicillin with or without clavulanate; amprenavir; aspirin; aripiprazole; atazanavir; atazanavir/cobicistat; atorvastatin; atovaquone; azithromycin; bictegravir/emtricitabine/tenofovir alafenamide; bupropion; busesonide and formaterol; buspirone; carbamazepine; carvidilol; cephalexin; chlordiazepoxide; chlorhexidine; cidofovir; ciprofloxacin; citalopram; clarithromycin; clindamycin; clonazepam; clotrimazole; crofelemer; dapsone; darunavir; darunavir/cobicistat; delavirdine; diabetic supplies; diazepam; didanosine; divalprox; dolutegravir; dolutegravir/lamivudine/abacavir; dolutegravir/rilpivirine; doxepin; doxycycline; duloxetine; efavirenz; efavirenz/emtricitabine/tenofovir DF; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; enfuvirtide; entecavir; erythromycin; escitalopram; esomeprazole; eszopiclone; ethambutol; etravirine; famciclovir; fenofibrate; fluconazole; flucytosine; fluoxetine; fluticasone; fluticasone and salmeterol; fluvoxamine; folinic acid; fosamprenavir; gabapentin; ganciclovir; glipizide; glyburide; hepatitits A vaccine; hepatitis B vaccine; hydrochlorothiazide; hydrocodone; ibuprofen; imipramine; imiquimod; indinavir; insulin; isoniazid; itraconazole; lamivudine; lamivudine/zidovudine; lamotrigine; levetiracetam; levofloxacin; levothyroxine; lisinopril; lithium; lopinavir/ritonavir; lorazepam; maraviroc; metformin; methylphenidate; metoprolol; metronidazole; miconazole; mirtazapine; moxifloxican; nefazodone; nelfinavir; nevirapine; nortriptyline; nystatin; olanzapine; omeprazole; oseltamivir; oxycodone combinations; paliperidone; paroxetine; penicillin; pentamidine; phenytoin; pioglitazone; podophyllum; pravastatin; prednisone; pregabalin; prenatal vitamins; primaquine; primidone; prixidone; pyrazinamide; quetiapine; raltegravir; ramelteon; ramipril; ranitidine; resperidone; rosuvastatin; rifabutin; rifampin; rilpivirine; ritonavir; saquinavir; sertraline; sodium fluoride; stavudine; sucralfate; telbivudine; temazepam; tenofovir; tetracycline; tiotropium; tipranavir; TMP/SMX; trazadone; trifluridine; valacyclovir; valganciclovir; valproic acid; venlafaxine; voriconazole; zalcitabine; zanamivir; zidovudine; ziprasidone; zolpidem. 406-444-4744 (ADAP) Abacavir; abacavir/dolutegravir/lamivudine; abacavir/lamivudine; abacavir/lamivudine/zidovudine; acyclovir; aldera cream; amantadine; amitriptyline; amoxicillin; amphotericin B; aripiprazole; atazanavir; atazanavir/cobicistat; atorvastatin; atovaquone; azithromycin; bictegravir/emtricitabine/tenofovir alafenamide; bupropion; buspirone; carbamazepine; caspofungin; chlorpromazine; ciprofloxacin; citalopram; clarithromycin; clindamycin; clomipramine; clotrimazole tablets; clozapine; cobicistat; crofelemer; dapsone; darunavir; darunavir/cobicistat; delavirdine; didanosine; diphenoxylate/atropine; dolutegravir; dolutegravir/lamivudine/abacavir; dolutegravir/rilpivirine; doxepin; duloxetine; efavirenz; efavirenz/emtricitabine/tenofovir DF; elvitegravir; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; enfuvirtide; erythropoietin alfa; escitalopram oxalate; ethambutol; etravirine; ezetimibe; fenofibrate; fenofibric acid; filgrastim; fluconazole; fluoxetine; fluphenazine; folinic acid; fosamprenavir; foscarnet; gabapentin; gemfibrozil; haloperidol; hydroxyzine; ibalizumab-uiyk; imipramine; indinavir; isoniazid; itraconazole; ketoconazole; lamivudine; lamivudine/zidovudine; lamotrigine; lithium; loperamide; lopinavir/ritonavir; maraviroc; megestrol acetate; mirtazapine; nelfinavir; nevirapine; nortriptyline; nystatin; olanzapine; omega-3-acid ethyl esters; ondansetron; oseltamivir; oxcarbazepine; paroxetine; pentamidine; perphenazine; pravastatin; pregabalin; pyrazinamide; pyrimethamine; quetiapine; raltegravir; rifabutin; rifampin; rilpivirine; risperidone; ritonavir; rosuvastatin; saquinavir; sertraline; sodium divalproex; sertraline; sodium divalproex; stavudine; sulfadiazine; tenofovir; testosterone; thioridazine; thiothixene; tiagabine; tipranavir; TMP/SMX; topiramate; trazadone; trifluoperazine; valacyclovir; valgancyclovir; valproic acid; varenicline; venlafaxine; vilazodone; voriconazole; zanamivir; zidovudine; ziprasidone. 402-471-2101 (ADAP) The Nebraska Ryan White AIDS Drug Assistance Program (ADAP) now enjoys an open formulary for both Copay and Standard (non- insured) ADAP Members. This is subject to change based on funding levels and ADAP does not cover the following: - Prescription Pain Control Medications 775-684-4247 (ADAP) Abacavir; abacavir/lamivudine; abacavir/lamivudine/zidovudine; acyclovir; amitriptyline; amlodipine; amoxicillin/clavulanate; atazanavir; atenolol; atorvastatin calcium; atovaquone; azithromycin; cefpodoxime; ciprofloxacin; clarithromycin; clindamycin; clotrimazole; dapsone; darunavir; darunavir/cobicistat; darbopoeiten; delavirdine; didanosine; diphenoxylate/atropine; diprolene ointment and cream; divalproex sodium; dolutegravir; dolutegravir/lamivudine/ abacavir; dolutegravir/rilprivirine; doxycycline; dronabinol; efavirenz; efavirenz/emtricitabine/tenofovir DF; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emticitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; enfuvirtide; erythropoetin; ethambutol; etravirine; fenofibrate; fluconazole; fosamprenavir; gabapentin; GCSF; gemfibrozil; glyburide; hydrochlorothiazide; ibuprofen; indinavir; itraconazole; lamivudine; lamivudine/zidovudine; leucovorin; levofloxacin; lisinopril; loperamide; lopinavir/ritonavir; losartan; lovaza; maraviroc; megestrol; metformin; moxifloxacin; naprosyn; nelfinavir; nevirapine; niaspan; nitazoxanide; nystatin; ondansetron-only after compazine; pancreatic enzymes; paromomycin; phenytoin; pioglitazone; posaconazole; primaquine; prochlorperazine; pyrimethamine; raltegravir; rifabutin; rilpivirine; ritonavir; saquinavir; scopalamine patch; stavudine; sulfadiazine; tenofovir; testosterone; tipranavir; TMP/SMX; trazadone; triamcinolone ointment and cream; valganciclovir; zidovudine. 603-271-4502 (ADAP) The NH Care Program formulary covers all FDA approved antiretroviral and opportunistic infection-related medications with some exclusions. The NH CARE Program follows the Medicaid Preferred Drug List (PDL) and has a list of excluded items. The following exclusions apply, but are not limited to: - Therapeutic Class Name 877-613-4533 (ADAP) The program covers a wide range of FDA-approved medications for treating individuals with HIV and AIDS. Your doctor or clinic will tell you which of the approved drugs are appropriate for you. 505-476-3628 (ADAP) New Mexico’s AIDS Drug Assistance Program (ADAP) strives to ensure that persons living with HIV (PLWH) across the state have access to life-saving HIV-related medications. While the emphasis is on HIV anti-retroviral therapy (ART) drugs, other FDA-approved medications are covered as well. Effective July 1, 2018, the New Mexico ADAP no longer has a specific list of medications that are included in a standardized “formulary”. Instead, the state will use an Enhanced Formulary model. Under this model, any FDA-approved medications could be considered for coverage depending on the patient’s needs, prescriber’s recommendations, and specific health insurance coverage. See link for more information: www.nmhealth.org/publication/view/general/4529/ 800-542-2437 (ADAP) Abacavir; abacavir/lamivudine; abacavir/lamivudine/zidovudine; acarbose; acebutolol; acetohexamide; albuterol; albuterol-ipratropium; alclometasone; acetylcholine; acrivastine/pseudoephedrine; acyclovir; adefovir; albendazole; alitretinoin; alprazolam; amcinonide; amiloride; amitriptyline; amlexanox; amlodipine; amoxicillin; amoxicillin-clavulanate; ampicillin; apraclonidine; amprenavir; aminosalicyclic acid; amphotericin B; amylase-lipase-protease; aripiprazole; atazanavir; atazanavir/cobicistat; atropine-diphenoxylate; azithromycin; aztreonam; atenolol; atorvastatin; atovaquone; atropine; azatadine; bacitracin; beclomethasone; benazepril; bendroflumethiazide; benztropine; betamethasone; betaxolol; bictegravir/emtricitabine/tenofovir alafenamide; bisoprolol; bitolterol; bleomycin; brimonidine; brinzolamide; brompheniramine w/wo combinations; budesonide; bumetanide; buprenorphine; bupropion; buspirone; butabarbital; candesartan; capreomycin; captopril; carbachol; carbamazepine; carbinoxamine; carteolol; carvedilol; caspofungin; cefaclor; cefadroxil; cefazolin; cefixime; cefoxitin; cefpodoxime; cefprozil; ceftazidime; ceftriaxone; cefuroxime; cephalexin; cephradine; chloral hydrate; chloramphenicol; chlordiazepoxide w/wo clidinium; chlorhexidine gluconate; chlorothiazide; chlorpheniramine w/wo/ combinations; chlorpropamide; chlorthalidone; chlorpromazine; cholestyramine; cidofovir; cimetidine; ciprofloxacin; citalopram; clarithromycin; clemastine; clindamycin; clobetasol; clocortolone; clomipramine; clonazepam; clonidine; clopidogrel; clorazepate; clotrimazole; cloxacillin; clozapine; cobicistat; colestipol; cromolyn; cyclopentolate; cyclopentolate-phenylephrine; cyclophosphamide; cycloserine; cyproheptadine; cytarabine; dapsone; darunavir; darunavir/cobicistat; desonide; desoximetasone; daunorubicin liposomal; delavirdine; desipramine; dexamethasone; dexbrompheniramine/pseudoephedrine; dexchlorpheniramine; dextroamphetamine; diabetes supplies; diazepam; dicloxacillin; didanosine; diflorasone; digoxin; diltiazem; diphenhydramine; dipivefrin; divalproex sodium; dolasetron; dolutegravir; dolutegravir/abacavir/lamivudine; dolutegravir/rilpivirine; dorzolamide; dorzolamide w/timolol; dorzolamide; doxazosin; doxepin; doxorubicin; doxycycline; dronabinol; duloxetine; dyphylline; econazole; ecothiopate; efavirenz; efavirenz/emtricitabine/tenofovir DF; elvitegravir/cobicistat/emtricitabine/tenfovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; enalapril; enfuvirtide; enoxaparin; entecavir; epoetin alfa; erythromycin; escitalopram; esomeprazole; estrogen; estrogens-progestins; ethambutol; ethionamide; etoposide; etravirine; ezetimibe; felbamate; felodipine; fenofibrate; filgrastim; fluconazole; flucytosine; flunisolide; fluocinolone; fluoride; fluoxetine; fluphenazine; flurandrenolide; flurazepam; fluticasone; fluvastatin; fluvoxamine; flavoxate; formivirsen; formoterol; fosamprenavir; foscarnet; fosfomycin; fosinopril; furazolidone; furosemide; gabapentin; ganciclovir; gatifloxacin; gemfibrozil; gentamicin; glimepiride; glipizide; glyburide; granisetron; griseofulvin; guanabenz; guanadrel; guanfacine; halazepam; halcinonide; halobetasol; haloperidol; hepatitis A & B vaccines; HPV vaccine; homatropine; hydralazine; hydrochlorothiazide; hydrocortisone w/wo/ combinations; hydroflumethiazide; hydroxyurea; hydroxyzine; ibalizumab-uiyk ibuprofen; imipenem-cilastatin; imipramine; imiquimod; immune globulin Rho; indapamide; indinavir; insulin; interferon alfa; intravenous immune globulin (18 and under); ipratropium; irbesartan; isoniazid; isosorbide; isoxsuprine; isradipine; itraconazole; ivermectin; kanamycin; ketoconazole; ketoprofen; labetalol; lamivudine; lamivudine/zidovudine; lamotrigine; lansoprazole; latanoprost; leucovorin; levetiracetam; levobunolol; levofloxacin; lisinopril; lithium; lomustine; loperamide; lopinavir/ritonavir; loracarbef; lorazepam; losartan; loteprednol; loxapine; maraviroc; magnesium sulfate; medrysone; megestrol; meningococcal vaccine; mesoridazine; metaproterenol; metoclopramide; metformin; methotrexate; methyclothiazide; methyldopa; methylphenidate; metipranol; metolazone; metoprolol; metronidazole; miconazole; miglitol; minocycline; minoxidil; mirtazapine; misoprostol; moexipril; molindone; mometasone; montelukast; moricizine; moxifloxacin; mupirocin; nadolol; naphazoline w/wo combinations; naproxen; nefazodone; nelfinavir; neomycin w/wo/combinations; nevirapine; niacin; nicardipine; nicotine inhaler; nicotine nasal spray; nifedipine; nisoldipine; nitrofurantoin; nitroglycerin; nortriptyline; nystatin; ofloxacin; olanzapine; omega 3 fatty acids; omeprazole; ondansetron; opium; oprelvekin; oseltamivir; oxazepam; oxcarbazepine; oxtriphylline; oxybutynin; paclitaxel; pancrelipase; pantoprazole; papaverine; paromomycin; paroxetine; peginterferon; pemoline; penbutolol; penciclovir; penicillin; pentamidine; pentobarbital; perphenazine; phenir/ppa/phenylt./pyrilamine; phenylephrine-promethazine; phenylprop-pyril-pheniramine; phenyltolox-APAP; phenyltolox/pyril/pheniramine; phenytoin; metipranol; pindolol; pioglitazone; pirbuterol; podofilox; polythiazide; pravastatin; prazosin; prednicarbate; prednisolone; prednisone; pregabalin; primaquine; primidone; probenecid; procainamide; procarbazine; prochlorperazine; progestins; promethazine; propranolol; pyrazinamide; pyrimethamine; quetiapine; quinapril; rabeprazole; raltegravir; ramipril; ranitidine; repaglinide; ribavirin; rifabutin; rifampin w/wo combinations; rifapentine; rilpivirine; rimantadine; rimexolone; risperidone; ritonavir; rosiglitazone; rosuvastatin; salmeterol; saquinavir; sargramostim; secobarbital; sertraline; sotalol; sparfloxacin; spectinomycin; spironolactone; stavudine; streptomycin; sucralfate; sulfadiazine; sulfadoxine/pyrimethamine; sulfasalazine; telmisartan; temazepam; tenofovir; terazosin; terbinafine; terbutaline; terconazole; testosterone; tetracycline; thalidomide; theophylline; tiagabine; ticarcillin-clavulanate; thiethylperazine; thioridazine; thiothixene; timolol; tiotropium; tipranavir; TMP/SMX; tobramycin; tocainide; tolazamide; tolbutamide; tolterodine; topiramate; torsemide; tramadol; trandolapril; trazadone; triamcinolone; triamterene; triazolam; trichlormethiazide; trifluoperazine; trimethobenzamide; trimethoprim; trimipramine; triple sulfa; triprolidine; tropicamide w/wo hydroxyamphetamine; valacyclovir; valganciclovir; valproic acid; valsartan; vancomycin; varenicline; venlafaxine; verapamil; vinblastine; vincristine; voriconazole; warfarin; zafirlukast; zanamivir; zidovudine; zileuton; ziprasidone; zolpidem. 877-466-2232 (ADAP) Abacavir; abacavir/lamivudine; abacavir/lamivudine/zidovudine; acyclovir; adefovir; amikacin; amitriptyline; amlodipine; amoxicillin; amphotericin B; amprenavir; atazanavir; atazanavir/cobicistat; atenolol; atorvastatin; atovaquone; azithromycin; benazepril; bupropion; carbamazepine; cephalexin; cidofovir; ciprofloxacin; citaolpram; clarithromycin; clindamycin; clonidine; clotrimazole; cobicistat; crofelemer; dapsone; darunavir; darunavir/cobicistat; delavirdine; didanosine; diphenoxylate/atropine; divalproex; dolutegravir; dolutegravir/lamivudine/abacavir; doxepin; doxycycline; dronabinol; efavirenz; efavirenz/emtricitabine/tenofovir DF; elvitegravir; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; enalapril; enfuvirtide; entecavir; erythropoetin; escitalopram; ethambutol; etravirine; ezetimibe; famciclovir; fenofibrate; fenofibric acid; filgrastim; fluconazole; flucytosine; fluoxetine; fosamprenavir; foscarnet; gabapentin; ganciclovir; gemfibrozil; hydrocholorithiazide; hydroxyurea; imiquimod; indinavir; interferon alfacon-1; interferon alfa-2a; isoniazid; itraconazole; ketoconazole; lamivudine; lamivudine/zidovudine; lansoprazole; leucovorin; levetiracetam; levofloxacin; lisinopril HCTZ; loperamide; lopinavir/ritonavir; lovastatin; maraviroc; megestrol; metformin; metoclopramide; metoprolol; metronidazole; minocycline; mirtazapine; moxifloxacin; nelfinavir; nevirapine; nortriptyline; nystatin; omeprazole; ondansetron; oseltamivir; pancrelipase; paromomycin; paroxetine; peginterferon alfa 2a; peginterferon alfa 2b; penicillin G benzathine; penicillin VK; pentamidine; phenobarbital; phenytoin; pravastatin; prednisone; pregabalin; primaquine; probenecid; prochloroperazine; promethazine; pyrazinamide; pyrimethamine; raltegravir; ribavirin; rifabutin; rifampin; rilpivirine; ritonavir; rosuvastatin; saquinavir; sertraline; stavudine; tenofovir; testosterone; tipranavir; TMP/SMX; trazadone; valacyclovir; valganciclovir; varenicline; venlafaxine; verapamil; zidovudine. 701-328-2378 (ADAP) 23-valent pnemococcal; abacavir; abacavir/lamivudine; acetaminophen/codeine; acyclovir; albendazole; albuterol inhaler; amantadine HCL; amitriptyline; amoxicillin; amphotericin; atazanavir; atazanavir/cobicistat; atorvastatin; atovaquone; azithromycin; bictegravir/emtricitabine/tenofovir alafenamide; bupropion; calcium acetate; chlor-hexidine; cidofovir; ciprofloxacin; clindamycin; clotrimazole; cobicistat; crofelemer; dapsone; darunavir; darunavir/cobicistat; dolutegravir; dolutegravir/lamivudine/abacavir; dolutegravir/rilpivirine; diphenoxylate w/atropine; doxazosin; dronabinol; efavirenz; efavirenz/emtricitabine/tenofovir DF; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/tenofovir DF; emtricitabine/tenofovir DF; erythromycin; erythropoietin; ethambutol; etravirine; famciclovir; fenofibrate; filgrastim; fluconazole; fludrocortisone; fluoxetine; fosamprenavir; foscarnet sodium; gaba-pentin; ganciclovir; haemophilus influenzae B; haloperidol; hepatitis A vaccine; hepatitis B vaccine series; hepatitis A/B vaccine; influenza; itraconazole; lamivudine; lamivudine/zidovudine; leucovorin; lisinopril; loperamide; lopinavir/ritonavir; lorazepam; maraviroc; megestrol; meningococcal; morphine; nelfinavir; nevirapine; nystatin; olanzapine; ondansetron; oseltamivir; pantoprazole; paromomycin; pentamidine; pneumococcal vaccine; pravastatin; prednisone; prochlorperazine; pyrimethamine; quadrivalent human papillomavirus; raltegravir; ranitidine; rifabutin; rilpivirine; ritonavir; saquinavir; sertraline; sulfadiazine; tdap; tenofovir; tetanus/ diphtheria/pertussis; TMP/SMX; trazadone; valganciclovir; venlafaxine; vitamin; zidovudine. 866-777-4775 (ADAP) 405-271-4636 (ADAP) Abacavir; abacavir/lamivudine; abacavir/lamivudine/zidovudine; acyclovir; atazanavir; atazanavir/cobicistat; azithromycin; cobicistat; darunavir; darunavir/cobicistat; delavirdine; didanosine; dolutegravir; dolutegravir/lamivudine/abacavir; dronabinol; efavirenz/emtricitabine/tenofovir DF; elvitegravir; elvitegravir/cobicistat/emtricitabine/tenfovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; enfuvirtide; etravirine; fluconazole; fosamprenavir; indinavir; itraconazole; lamivudine; lamivudine/zidovudine; lopinavir/ritonavir; maraviroc; nelfinavir; nevirapine; oxandrolone; raltegravir; rifampin; rilpivirine; ritonavir; saquinavir; stavudine; tenofovir; TMP/SMX; valganciclovir; zidovudine. Other formulary drugs include antibiotics, antihypertensives, diuretics, antidepressants, lipid control, anti-nausea, anti-anxiolytic, anti-psychotic, anti-epileptic and opportunistic infection medications. 971-673-0144 (ADAP) Abacavir; abacavir/lamivudine; abacavir/lamivudine/zidovudine; acarbose; acebutolol; acyclovir; adefovir dipivoxil; aerosolized pentamidine; alprazolam; amikacin; amitriptyline; amlodipine; amoxicillin; amoxicillin/potassium clavulanate; ampicillin; atenolol; atazanavir; atazanavir/cobicistat; atovaquone; azithromycin; bictegravir/emtricitabine/tenofovir alafenamide; benazepril; buprenorphine; bupropion; buspirone; captopril; capreomycin; carvedilol; cefpodoxime; ceftriaxone; cephalexin; chlordiazepoxide; cidofovir; ciprofloxacin; citalopram; clarithromycin; clindamycin; clonazepam; clotrimazole; clotrimazole/betamethasone; cobicistat; cyancobalamin; dapsone; darunavir; darunavir/cobicistat; delavirdine; diabetic supplies; diazepam; dicloxacillin; didanosine; diltiazem; diphtheria/tetanus; dolutegravir; dolutegravir/lamivudine/abacavir; dolutegravir/rilpivirine; doxazosin; doxycycline; efavirenz; efavirenz/emtricitabine/tenofovir DF; elvitegravir; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; enalapril; enfuvirtide; entecavir; epoetin-alpha; erythromycin; ethambutol; ethionamide; etravirine; felodipine; fentanyl; filgrastim; fluconazole; fluoxetine; flurazepam; folic acid; fomivirsen; fosamprenavir; foscarnet; furosemide; ganciclovir; glimepiride; glipizide; glyburide; haloperidol; hemophilus influenza Type B vaccine; hepatitis A/B vaccine; hepatitis A/hepatitis B vaccine; hepatitis B Immune Globulin; human papillomavirus/HPV; hydralazine; hydrocholorthiazide; hydrocodone/APAP; hydrocodone/ibuprofen; hydroxyzine HCL, pamoate; indinavir; interferon alfa-2a; inteferon alfa-2b; interferon alfacon 1; interferon alfa-N3; isoniazid; itraconazole; ketoconazole; lamivudine; lamivudine/zidovudine; leucovorin; levofloxacin; lisinopril; lopinavir/ritonavir; lorazepam; losartan; maraviroc; metformin; metformin/repaglinide; metformin/rosiglitazone; metformin/sitagliptin; methadone; metoprolol; miconazole; mirtazapine; morphine sulfate; moxifloxacin; naproxen; nelfinavir; nevirapine; nifedipine; nystatin; ofloxacin; olanzapine; oseltamivir; oxycodone; oxycodone/APAP; oxycodone/ASA; naproxen; oxazepam; para-aminosalicylic acid; paroxetine; pegylated interferons; penicillin; perphenazine; pioglitazone; pneumococcal vaccine; propranolol; pyrazinamide; pyridoxine; pyrimethamine; quetiapine; quinapril; raltegravir; repaglinide; ribavirin; ribavirin/interferon alfa 2B; rifabutin; rifampin; rifampin/isoniazid; rifapentine; rilpivirine; risperidone; ritonavir; rosiglitazone; saquinavir; sertraline; sitagliptin; spironolactone; stavudine; streptomycin; sulfadiazine; sulfa/pyrimethamine; telbivudine; temazepam; tenofovir; terconazole; tetracycline; thiothixene; tipranavir; trazadone; trimethoprim; TMP/SMX; valacyclovir; valganciclovir; vancomycin oral; varenicline; venlafaxine; verapamil; zanamivir; zidovudine; ziprasidone. 800-922-9384 (ADAP) Abacavir; abacavir/lamivudine; abacavir/lamivudine/zidovudine; acyclovir/valacyclovir; amikacin; amphotericin B; atazanavir; atazanavir/cobicistat; atovaquone; azithromycin; bictegravir/emtricitabine/tenofovir alafenamide; bleomycin; capreomycin; cidofovir injection; ciprofloxacin; cobicistat; clarithromycin; clindamycin; clofazimine; clotrimazole; dapsone; darunavir; darunavir/cobicistat; crofelemer; delavirdine; dexamethasone; didanosine; dolutegravir; dolutegravir/lamivudine/abacavir; dolutegravir/rilpivirine; doxorubicin; dronabinol; efavirenz; efavirenz/emtricitabine/tenofovir DF; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; enfuvirtide; ethambutol; ethionamide; etravirine; famciclovir; fluconazole; flucytosine; fosamprenavir; foscarnet; ganciclovir; ibalizumab-uiyk; indinavir; isoniazid; itraconazole; ketoconazole; lamivudine; lamivudine/zidovudine; leucovorin; lopinavir/ritonavir; lovaza; maraviroc; megestrol; nelfinavir; nevirapine; nevirapine XR; nystatin; ofloxacin; paromomycin sulfate; pentamidine; prednisone; primaquine phosphate; pyrazinamide; pyrimethamine; rifabutin; rifampin; rilpivirine; ritonavir; saquinavir; stavudine; sulfadiazine; sulfadoxine/pyrimethamine; tenofovir; terconazole; tipranavir; TMP/SMX; trimetrexate; valganciclovir; vinblastine; vincristine; zidovudine. List of drugs for HIV-related side-effects is extensive. Please call for complete listing or visit the following link: www.health.pa.gov/topics/Documents/Programs/HIV/SPBP%20Covered%20Drug%20List%20(Effective%2007-01-18).pdf 401-462-3294 (ADAP) Abacavir; abacavir/lamivudine; abacavir/lamivudine/zidovudine; acyclovir; amitriptyline; amprenavir; atazanavir; atovaquone; azithromycin; ciprofloxacin; citalopram; clarithromycin; clonazepam; dapsone; darunavir; delavirdine; didanosine; dolutegravir; dolutegravir/lamivudine/abacavir; dolutegravir/rilpivirine; atazanavir/cobicistat; efavirenz; efavirenz/emtricitabine/tenofovir DF; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; enfuvirtide; ethambutol; etravirine; fentanyl; fluconazole; fluoxetine; fosamprenavir; gabapentin; ganciclovir/oral; hydroxyurea; indinavir; interferon Alfa 2b; isonaizid; itraconazole; lamivudine; lamivudine/zidovudine; leucovorin; lopinavir/ritonavir; lorazepam; maraviroc; morphine sulfate; nelfinavir; nevirapine; olanzapine; oseltamivir; oxycodone; paroxetine; pentamidine; peginterferon alfa 2a; peginterferon alfa 2b; primaquine; pyrimethamine; raltegravir; ribavirin; rifabutin; risperidone; ritonavir; saquinavir; sertraline; stavudine; sulfadiazine; sulfamethoxazole/trimethoprim; tenofovir; tipranavir; trazodone; valacyclovir; valganciclovir; zanamivir; zidovudine. 800-856-9954 (ADAP) Abacavir; abacavir/lamivudine; abacavir/lamivudine/zidovudine; acyclovir; amitriptyline; amoxicillin; amoxicillin-clavulanate, oral; atazanavir; atazanavir/cobicistat; atovaquone; azithromycin; bictegravir/emtricitabine/tenofovir alafenamide; bupropion; ciprofloxacin, oral; citalopram; clarithromycin; clindamycin; clotrimazole; clotrimazole/betamethasone cream; cobicistat; dapsone; darunavir; darunavir/cobicistat; delavirdine; didanosine; dolutegravir; dolutegravir/lamivudine/abacavir; dolutegravir/rilpivirine; doxycycline; duloxetine; efavirenz; efavirenz/emtricitabine/tenofovir DF; elvitegravir; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; enfuvirtide; escitalopram; ethambutol; etravirine; famciclovir; fluconazole; fluoxetine; fosamprenavir; gabapentin; indinavir; itraconazole; ketoconazole tablets, cream; lamivudine; lamivudine/zidovudine; leucovorin; levofloxacin; lopinavir/ritonavir; maraviroc; metronidazole, oral; mirtazapine; moxifloxacin, oral; nelfinavir; nevirapine; nystatin; nystatin/triamcinolone, cream, ointment; ondansetron; oseltamivir; paroxetine; peginterferon-alfa 2a; peginterferon-alfa 2b; pravastatin; prednisone, oral; promethazine; pyrimethamine; raltegravir; ribavirin, oral; rifabutin; rilpivirine; ritonavir; rosuvastatin; saquinavir; sertraline; simvastatin; stavudine; sulfadiazine; tesamorelin; tenofovir; tipranavir; TMP/SMX; trazadone; valacyclovir; valganciclovir; venlafaxine; voriconazole; zanamivir; zidovudine. 605-773-3737 (ADAP) 23-valent; abacavir; abacavir/lamivudine; abacavir/lamivudine/zidovudine; acetaminophen w/codeine; acyclovir; amitriptyline; amprenavir; atazanavir; atovaquone; azithromycin; ciprofloxacin; clarithromycin; clofazamine; clotrimazole; dapsone; darunavir; delavirdine; didanosine; divalproex sodium; dolutegravir; dolutegravir/lamivudine/abacavir; efavirenz; efavirenz/emtricitabine/tenofovir DF; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; enfuvirtide; ethambutol; etravirine; famciclovir; fentanyl; fluconazole; fosamprenavir; gabapentin; indinavir; influenza; hepatitis A vaccine; hepatitis B vaccine; hepatitis A/B vaccine; interferon alfa-2b; itraconazole; lamivudine; lamivudine/zidovudine; leucovorin; levofloxacin; lopinavir/ritonavir; maraviroc; megestrol; morphine w/wo sulphate; nelfinavir; nevirapine; paromomycin sulfate; peg-interferon alfa 2-a; peg-interferon alfa 2-b; pentamidine; phenytoin; pregabalin; prochlorperazine; pyrimethamine; raltegravir; ribavirin/interferon alfa-2b; ribavirin; rifabutin; rilpivirine; ritonavir; saquinavir; stavudine; tenofovir; tipranavir; TMP/SMX; triamcinolone acetoinide cream; valacyclovir; zalcitabine; zidovudine. 615-741-7500 (ADAP) Abacavir; abacavir/lamivudine; abacavir/lamivudine/zidovudine; atazanavir; atazanavir/cobicistat; atovaquone; azithromycin; bictegravir/emtricitabine/tenofovir alafenamide; bupropion; ceftriaxone; clarithromycin; clindamycin; cosyntropin; dapsone; darunavir; darunavir/cobicistat; didanosine; dolutegravir; dolutegravir/lamivudine/abacavir; dolutegravir/rilpivirine; efavirenz; efavirenz/emtricitabine/tenofovir DF; elbasvir/grazoprevir; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; enfuvirtide; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; ethambutol; etravirine; fluconazole; foscarnet; fosamprenavir; gabapentin; ganciclovir; gemfibrozil; indinavir; itraconazole; lamivudine; lamivudine/zidovudine; ledipasvir/sofosbuvir; leucovorin; lopinavir/ritonavir; maraviroc; nelfinavir; nevirapine; novolin 70/30; nystatin; quine; ombitasvir/paritaprevir/ritonavir; pioglitazone; pyrimethamine; raltegravir; rifabutin; rilpivirine; ritonavir; saquinavir; sertraline; stavudine; sulfadiazine; tenofovir; tipranavir; TMP/SMX; valacyclovir; valganciclovir; vancomycin; venlafaxine; zidovudine. 800-255-1090 (ADAP) Abacavir; abacavir/lamivudine; abacavir/lamivudine/zidovudine; acyclovir; atazanavir; atazanavir/cobicistat; atovaquone; azithromycin; bictegravir/emtricitabine/tenofovir alafenamide; clarithromycin; clindamycin; clotrimaz troche; cobicistat; crofelemer; dapsone; darunavir; darunavir/cobicistat; delavirdine; didanosine; dolutegravir; dolutegravir/lamivudine/abacavir; dolutegravir/rilpivirine efavirenz; efavirenz/emtricitabine/tenofovir DF; elvitegravir; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; enfuvirtide; ethambutol; etravirine; famciclovir; fluconazole; fosamprenavir; gynazole; indinavir; isoniazid; itraconazole; lamivudine; lamivudine/zidovudine; lopinavir/ritonavir; maraviroc; megestrol acetate; mystatin; nelfinavir; nevirapine; pentamidine; prednisone; primaquine phosphate; raltegravir; rifabutin; rifampin; rilpivirine; ritonavir; saquinavir; stavudine; sulfadiazine; tenofovir; terconazole; tipranavir; TMP/SMX; valacyclovir; valganciclovir; voriconazole; zidovudine. 801-538-6197 (ADAP) Abacavir; abacavir/lamivudine; abacavir/lamivudine/zidovudine; acyclovir; atazanavir; atazanavir/cobicistat; atovaquone; azithromycin; bictegravir/emtricitabine/tenofofvir alafenamide; clarithromycin; clindamycin; cobicistat; crofelemer; dapsone; darunavir; darunavir/cobicistat; delavirdine; didanosine; dolutegravir; dolutegravir/rilpivirine; dolutegravir/lamivudine/abacavir; efavirenz; efavirenz/tenofovir/emtricitabine; elvitegravir; elvitegravir/cobicistat/emtricitabine/tenofovir; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; emtricitabine; emtricitabine/rilpivirine/tenofovir; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/tenofovir; emtricitabine/tenofovir alafenamide; enfuvirtide; ethambutol; etravirine; fluconazole; fosamprenavir; ibalizumab-uiyk; indinavir; itraconazole; lamivudine; lamivudine/zidovudine; leucovorin; linezolid; lopinavir/ritonavir; maraviroc; nelfinavir; nevirapine; nystatin; pentamidine inhaled; pyrimethamine; raltegravir; rifabutin; rilpivirine; ritonavir; saquinavir; stavudine; sulfadiazine; tenofovir; tipranavir; TMP/SMX; valacyclovir; valgancyclovir; zidovudine; zoster vaccine - recombinant, adjuvanted. 802-951-4005 (ADAP) Abacavir; abacavir/lamivudine/zidovudine; acyclovir; albuterol (inhaled); amitriptyline; amphoteracin B; amprenavir; atazanavir; atazanavir/cobicistat; atorvastatin; atovaquone; azithromycin; bictegravir/emtricitabine/tenofovir alafenamide; buproprion; cidofovir; ciprofloxacin; citalopram; clarithromycin; clindamycin; clotrimazole; dapsone; darunavir; darunavir/cobicistat; delavirdine; didanosine; dideoxycytidine; dolutegravir; dolutegravir/abacavir/lamivudine; dolutegravir/rilpivirine; doxorubicin (liposomal); efavirenz; efavirenz/emtricitabine/tenofovir DF; elivitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; enfuvirtide; escitalopram; ethambutol; etravirine; ezetimibe; famciclovir; fenofibrate; fentanyl; fluconazole; fluoxetine; fluvastatin; fosamprenavir; foscarnet;gabapentin; GCSF; gemfibrozil; hydroxyurea; ibuprofen; indinavir; itraconazole; ketoconazole; lamivudine; lamivudine/abaca-vir; lamivudine/zidovudine; leucovorin; levoalbuterol; loperamide; lopinavir/ritonavir; lovastatin; maraviroc; megestrol acetate; morphine sulfate; nefazodone; nelfinavir; nevirapine; niacin; nystatin; oseltamivir; paroxetine; pentamidine; polycarbophil; prednisone; primaquine; pravastatin; psyllium; pyrimethamine; raltegravir; rifabutin; rilpivirine; ritinovir; saquinavir; sertraline; simvastatin; stavudine; sulfadiazine; tenofovir; tipranavir; trazadone; trimethoprim; trimethoprim/sulfamethoxazole; valacyclovir; valganciclovir; venlafaxine; zanamivir; zidovudine. 855-362-0658 (ADAP) Abacavir; abacavir/lamivudine; abacavir/lamivudine/zidovudine; acyclovir; aerosolized pentamidine; alendronate sodium; amikacin; amitriptyline; atazanavir; atazanavir/cobicistat; atorvastatin; atovaquone; azithromycin; bictegravir/emtricitabine/tenofovir alafenamide; bupropion; buspirone; capreomycin; chlorpromazine; cidofovir; citalopram; clarithromycin; clindamycin; cycloserine; daclatasvir; dapsone; darunavir; darunavir/cobicistat; delavirdine; didanosine; dolutegravir; dolutegravir/lamivudine/abacavir; dolutegravir/rilpivirine; doxepin; duloxetine; efavirenz; efavirenz/emtricitabine/tenofovir DF; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; enfuvirtide; epoetin alpha; escitalopram; esomeprazole; ethambutol; ethionamide; etravirine; ezetimibe; famciclovir; famotidine; fenofibrate; fluconazole; fluoxetine; fosamprenavir; foscarnet; gabapentin; ganciclvir IV; glipizide; gemfibrozil; glipizide/metformin; glyburide; glyburide/metformin; haloperidol; hepatitis A; hepatitis B; hepatitis A/B; hydroxyzine; indinavir; influenza; insulininjectable; isoniazid; itraconazole; lamivudine; lamivudine/zidovudine; lansoprazole; ledipasvir/sofosbuvir; leucovorin; levofloxacin; lithium; lopinavir/ritonavir; mara- viroc; megestrol; metformin; meningococcal conjugate vaccine; mirtazapine; nelfinavir; nevirapine; niacin; nortriptyline; olanzapine; omeprazole; pantoprazole; para-aminosalicylic acid; paroxetine; pioglitazone hydrochloride; pneumococcal conjugate; pneumococcal vaccine polyvalent; pravastatin; prednisone; primaquine; prochlorperazine; promethazine; pyrazinamide; pyridoxine; pyrimethamine; raltegravir; ranitidine; rifabutin; rifampin; rilpivirine; risperidone; ritonavir; rosiglitazone; rosuvastatin; saquinavir; sertraline; sofosbuvir; stavudine; sulfadiazine; tenofovir; tenofovir alafenamide; tetanus/diphtheria; tetanus/diphtheria/pertussis; tipranavir; TMP/SMX; trazadone; trimethoprim; valganciclovir; valproic acid/divalproex sodium; venlafaxine; viekira pak; voriconazole; zidovudine; ziprasidone; zoster vaccine - recombinant, adjuvanted. 877-376-9316 (ADAP) Abacavir; abacavir/lamivudine; abacavir/lamivudine/zidovudine; acamprostate; acyclovir; adefovir; albendazole; amoxicillin; amoxicillin/potassium clavulante; ampicillin; amprenavir; atazanavir; atazanavir/cobicistat; atovaquone; azrithromycin; bictegravir/emtricitabine/tenofovir alafenamide; boceprevir; buprenorphine/naloxone; carbamazepine; cefpodoxime; ceftriaxone; cephalexin; chlorhexidine gluconate; cidofovir; cimetidine; ciprofloxacin; clarithromycin; clindamycin; clofazimine; clonidine; clotrimazole; clotrimazole/betamethasone; clozapine; cobicistat; crofelemer; daclatasvir; dapsone; darunavir; darunavir/cobicistat; delavirdine; dicloxacillin; dicyclomine; didanosine; diphenoxylate/atropine; diphtheria & tetanus toxoids; diphtheria & tetanus toxoids & pertussis vaccine; disulfuram; divalproex sodium; dolutegravir; dolutegravir/lamivudine/abacavir; dolutegravir/rilpivirine; doxycycline; dronabinol; efavirenz; efavirenz/emtricitabine/tenofovir DF; elbasvir/grazoprevir; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; enfuvirtide; entecavir; epoetin-alpha; erythromycin; esomeprazole; estrogen; ethambutol; etravirine; famotidine; filgrastim; fluconazole; fomivirsen; fosamprenavir; foscarnet; gabapentin; ganciclovir; hemophilus influenza type B vaccine; hepatitis A vaccine; hepatitis B vac-cine; hepatitis A/B vaccine; hepatitis B immune globulin; hormone replacement therapy/gender transitioning meds; hydroxyurea; hyoscyamine; imiquimod cream; immune globulin IM; influenza virus vaccine, split or whole virus; indinavir; interferon alfa-2a; inteferon alfa-2b; isoniazid; itraconazole; ketoconazole; lamivudine; lamivudine/zidovudine; lamotrigine; lansoprazole; leucovorin; levofloxacin; lindane; lithium; loperamide; lopinavir/ritonavir; maraviroc; mediset fills; medroxyprogesterone; megestrol acetate; methylprednisolone; metoclopramide; metronidazole; miconazole; moxifloxacin; mupirocin; naltrexone; naloxone; nandrolone; nelfinavir; nevirapine; nizatidine; nystatin; ofloxacin; olanzapine; ombitasvir/paritaprevir/ritonavir; omeprazole; ondansetron HCL; opium tincture; oseltamivir; oxandrolone; oxcarbazepine; pantoprazole; paromomycin; pegylated interferons; penicillin; peridex; permethrin; phenazopyridine; pneumococcal vaccine; podofilox; pill splitter; prednisolone 1% soln; prednisone; primaquine; prochlorperazine; promethazine; pyrazinamide; pyrimethamine; quetiapine; rabeprazole; raltegravir; ranitidine; ribavirin; rifabutin; rifampin; rilpivirine; risperidone; ritonavir; saquinavir; selenium sulfide; sofosbuvir/velpatasvir; stavudine; sulfadiazine; sulfa/pyrimethamine; telaprevir; tenofovir; terconazole; testosterone products; tetracycline; tipranavir; topiramate; TMP/SMX; trifluridine; trimethoprim; valacyclovir; valganciclovir; valproic acid; vancomycin oral; VZIG; varicella zoster immune globulin; zalcitabine; 304-232-6822 (ADAP) 800-991-5532 (ADAP) Abacavir; abacavir/lamivudine; abacavir/lamivudine/zidovudine; acyclovir; amitriptyline; amphotericin B; atazanavir; atazanavir/cobicistat; atorvastatin; atovaquone; azithromycin; bictegravir/emtricitabine/tenofovir alafenamide; cidofovir; clarithromycin; clindamycin; cobicistat; dapsone; darunavir; darunavir/cobicistat; delavirdine; didanosine; diphenoxylate; dolutegravir; dolutegravir/lamivudine/abacavir; dolutegravir/rilpivirine; efavirenz; efavirenz/emtricitabine/tenofovir DF; elvitegravir; elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide; elvitegravir/cobicistat/emtricitabine/tenofovir DF; emtricitabine; emtricitabine/rilpivirine/tenofovir alafenamide; emtricitabine/rilpivirine/tenofovir DF; emtricitabine/tenofovir alafenamide; emtricitabine/tenofovir DF; enfuvirtide; ethambutol; etravirine; famciclovir; fenofibrate; fluconazole; fosamprenavir; foscarnet; gabapentin; ganciclovir; gemfibrozil; indinavir; interferon alpha-2b; itraconazole; ketoconazole; lamivudine; lamivudine/zidovudine; leucovorin; loperamide; lopinavir/ritonavir; maraviroc; nelfinavir; nevirapine; niacin; oseltamivir; pegylated interferon alfa-2a; pegylated interferon alfa-2b; pentamidine; pravastatin; prochlorperazine; pyrimethamine; raltegravir; ribavirin; rifabutin; rilpivirine; ritonavir; saquinavir; stavudine; sulfadiazine; tenofovir; tipranavir; TMP/SMX; valacyclovir; valganciclovir; zanamivir; zidovudine. 307-777-5856 (ADAP) Wyoming has an open formulary. Copyright 2018, Positive Health Publications, Inc. This magazine is intended to enhance your relationship with your doctor - not replace it! Medical treatments and products should always be discussed with a licensed physician who has experience treating HIV and AIDS!
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