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Product Name Strength Image (not to scale) Pack Size NDC # RLD / Brand Name TE Rating Therapeutic Category
Jencycla™

0.35mg

28 x 3

68180-0877-73

Ortho-Micronor®

AB2

Oral Contraceptive

Imipramine Pamoate Capsules

75mg
100mg
125mg
150mg

30

68180-314-06
68180-315-06
68180-316-06
68180-317-06

Tofranil-PM®

AB

Antidepressant

Ibuprofen and Famotidine Tablets

800mg/ 26.6mg

90

70748-312-09

Duexis®

AB

NSaID

Hydrocortisone Valerate Cream USP

0.2%

15 g
45 g
60 g

68180-954-01
68180-954-02
68180-954-03

Westcort®

AB

Anti-inflammatory

Hydrocortisone Butyrate Lotion

0.1%

59 mL
118 mL

68180-951-01
68180-951-02

Locoid®

AB

Corticosteroid
Intermediate

GaviLyteâ„¢ – G

236-5.86-2.97-6.74-22.74 gm

4 L

43386-090-19

GoLYTELY®

AA

Hyperosmotic
Laxative

GaviLyteâ„¢ – C

240 -5.84-2.98-6.72-22.72gm

4 L

43386-060-19

Colyte®

AA

Hyperosmotic
Laxative

GaviLAX (PEG3350) Powder for Oral Solution

17gm/scoopful

238g
510g

43386-312-14
43386-312-08

MiraLAX®

AA

Laxative

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)

Fyavolv™

0.5mg/0.0025mg
1mg/0.005mg

28 x 3
90

68180-827-09
68180-827-73
68180-828-09
68180-828-73

FemHRT®

AB

Hormone Replacement Therapy

Fosaprepitant Dimeglumine for Injection

150mg

5mL single-dose vial

68180-690-01

Emend®

AP

Antiemetic

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

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