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Product Name Strength Image (not to scale) Pack Size NDC # RLD / Brand Name TE Rating Therapeutic Category
Formoterol Fumarate Inhalation Solution

20mcg/2mL

30 UD Vials
60 UD Vials

70748-261-30
70748-261-60

Perforomist®

AN

Long-acting beta agonists (LABAs)/ Bronchodilator

Diclofenac Sodium Topical Solution

2%

112g

68180-537-01

Pennsaid® 2%

AB

Topical nonsteroidal anti-inflammatory drug (NSAID)

Rufinamide Tablets USP

200mg
400mg

120

68180-803-16
68180-804-16

Banzel®

AB

Anticonvulsants

Pentazocine and Naloxone Tablets USP

50mg/0.5mg

100

43386-680-01

Talwin® NX

AB

Adjunct to Anesthesia Opioid Analgesic

Lurasidone Hydrochloride Tablets

20mg
40mg
60mg
80mg
120mg

30

68180-672-06
68180-673-06
68180-674-06
68180-670-06
68180-671-06

Latuda®

AB

Atypical antipsychotics

Darunavir Tablets

600mg
800mg

30
60

68180-345-07
68180-346-06

Prezista®

AB

Antiretrovirals

Thiamine Hydrochloride Injection USP

200mg/2ml (100mg/ml)

25ml

70748-347-02

Thiamine Hydrochloride Injection USP

AP

B1 Vitamins

Rufinamide Oral Suspension

40 mg/mL

460ml

68180-797-01

Banzel®

AB

Antiepileptic

Tiotropium Bromide Inhalation Powder Capsules

18mcg / capsules

30

68180-964-12

Spiriva® HandiHaler®

AB

Anticholinergics

Turqoz™

0.3mg/0.03mg

28 x 3

68180-895-13

Lo/Ovral-28®

AB

Oral Contraceptives

Diazepam Rectal Gel

10 mg & 20 mg

4.4 cm & 6.0 cm

43386-281-01
43386-280-01

Bromfenac Ophthalmic Solution 0.07%

0.07%

3mL

68180-433-02

Prolensa®

AT

Nonsteroidal anti-inflammatory drugs (NSAIDs)

Varenicline Tartrate Tablets

0.5mg
1.0mg
0.5mg-1.0mg

53
56

70748-125-13
70748-127-49
70748-128-49

Chantix®

AB

Smoking Cessation Aids

Cyanocobalamin Nasal Spray

500mcg/ spray

4 UD

43386-237-70

Nascobal®

AB

B12 Vitamins

Ganirelix Acetate Injection

250mcg/0.5mL

(1) 250mcg single-dose pre-filled syringe

70748-274-01

Ganirelix Acetate Injection

AP

Competitive gonadotropin-releasing hormone antagonist (GnRH antagonist)

Bromfenac Ophthalmic Solution 0.075%

0.075%

5ml

68180-434-01

Bromsite®

AT

Nonsteroidal anti-inflammatory drugs (NSAIDs)

Bromfenac Ophthalmic Solution 0.09%

0.09%

1.7mL

68180-436-01

Bromday®

AT2

Nonsteroidal anti-inflammatory drugs (NSAIDs)

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