Phil Zhou Medical · Upland, CA

US Outpatient Medication List

507 medications · Generic name A–Z
Revised Aug 2026 · adult dosing

For clinicians. This is Dr. Zhou’s own working reference, published openly so patients can see the standards the practice works from and so colleagues can use it. It is not medical advice and is no substitute for a visit. Doses assume a non-pregnant adult with normal renal and hepatic function, and guidelines change — verify against current labeling before acting on anything here. Questions about your own care: (562) 575-6816.

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Starting doses assume a non-pregnant adult with normal renal and hepatic function. Prices are self-pay estimates as of August 2026 — Cost Plus Drugs, GoodRx, or Walmart tier for a typical 30-day supply, or one course for anti-infectives; list/WAC is shown where a brand has no US generic. Prices move constantly, so confirm before quoting a patient.

A

Acamprosate

Campral

Alcohol use disorder agent

Start 666 mg PO TID

Range 666 mg TID

Renally dosed. Best evidence for maintaining abstinence after detox.

$40–60/mo

generic

Acarbose

Precose

Alpha-glucosidase inhibitor

Start 25 mg PO TID with the first bite

Range 25–100 mg TID

Flatulence limits adherence. Treat hypoglycemia with glucose, not sucrose.

$21.60/mo

generic

Acetaminophen

Tylenol

under $15

Analgesic / antipyretic

Start 650–1000 mg PO q6h

Range max 4 g/day (3 g if elderly, hepatic disease, or regular alcohol)

Ineffective for low back pain. Check every combination product for hidden acetaminophen.

$3–7 (OTC)

generic

Acetaminophen (pediatric)

Tylenol Children's

under $15

Analgesic / antipyretic

Start 15 mg/kg PO q4–6h

Range max 75 mg/kg/day or 4 g

Dose by weight, never by age. Confirm the concentration — 160 mg/5 mL is standard.

$6 (OTC)

generic

Acetazolamide

Diamox

Carbonic anhydrase inhibitor

Start 125–250 mg PO BID

Range up to 250 mg QID

Altitude sickness prophylaxis 125 mg BID. Also IIH, metabolic alkalosis.

$17/mo

generic

Acyclovir

Zovirax

under $15

Nucleoside antiviral

Start 400 mg PO TID (HSV) or 800 mg 5x daily (zoster)

Range 200–800 mg

Cheapest option but frequent dosing. Renally adjust. Hydrate.

$6–10/course

generic

Adapalene

Differin

under $15

Topical retinoid

Start 0.1% gel qhs

Range 0.1–0.3%

OTC and better tolerated than tretinoin.

$12–19 (OTC)

generic

Albendazole

Albenza

Anthelmintic

Start 400 mg PO × 1 (pinworm, repeat in 2 wk)

Range 400 mg daily

$37/course

generic

Albuterol HFA

ProAir, Ventolin, Proventil

under $15

SABA (short-acting beta agonist)

Start 2 puffs q4–6h PRN (with spacer)

Range max 8 puffs q20min in exacerbation

SABA-only asthma treatment is no longer recommended at any step. Track canister use — >1/month signals poor control.

$12–39/inhaler

generic

Albuterol nebulizer solution

AccuNeb

under $15

SABA

Start 2.5 mg nebulized q4–6h PRN

Range 2.5–5 mg

No advantage over MDI with spacer in cooperative patients.

$9/25 vials

generic

Albuterol (pediatric)

ProAir, Ventolin

under $15

SABA

Start 2–4 puffs with a spacer and mask q4–6h PRN

Range up to 8 puffs q20min acutely

MDI with spacer is as good as a nebulizer, and faster.

$12–39/inhaler

generic

Albuterol-budesonide

Airsupra

brand only

ICS + SABA reliever

Start 1–2 puffs PRN

Range max 12 puffs/day

The as-needed anti-inflammatory reliever for GINA Track 2.

~$500/inhaler

List $504

Alendronate

Fosamax

under $15

Bisphosphonate

Start 70 mg PO weekly

Range 70 mg weekly

Upright with a full glass of water, nothing else for 30 min. Check vitamin D first. Drug holiday at 5 years.

$13.60/mo

generic

Alfuzosin

Uroxatral

under $15

Alpha-1 blocker

Start 10 mg ER PO daily after a meal

Range 10 mg daily

$10–30/mo

generic

Alirocumab

Praluent

brand only

PCSK9 inhibitor

Start 75 mg SC q2wk

Range 75–150 mg q2wk

$533/mo

List: ~$533/mo

Allopurinol

Zyloprim

under $15

Xanthine oxidase inhibitor

Start 100 mg PO daily (50 mg if CKD stage ≥3)

Range titrate q2–5 wk to urate <6.0; 300–600 mg, max 800

Never stop during a flare. Prophylax with colchicine 0.6 mg daily × 3–6 mo while titrating. Consider HLA-B*5801 in Han Chinese, Thai, Korean patients.

$9–29/mo

generic

Alprazolam

Xanax

C-IV

Benzodiazepine

Start 0.25–0.5 mg PO TID PRN

Range max 4 mg/day

Shortest acting, highest abuse liability, worst rebound anxiety. Avoid starting it. Check CURES.

$15/mo

generic

Aluminum chloride 20%

Drysol

Antiperspirant

Start Apply to dry skin qhs, wash off in the morning

Range 2–3 nights/week

Primary focal hyperhidrosis first line.

$15–30

generic

Amantadine

Symmetrel, Gocovri

under $15

Antiviral / dopaminergic

Start 100 mg PO BID

Range 100–400 mg/day

Levodopa-induced dyskinesia, fatigue in MS. Livedo reticularis, ankle edema. Renally dosed.

$9/mo

generic

Amiodarone

Cordarone, Pacerone

under $15

Class III antiarrhythmic

Start 200 mg PO daily (after load)

Range 100–400 mg daily

Baseline and q6mo TSH, LFTs, CXR, eye exam. Countless interactions; halve the warfarin dose.

$7.90/mo

generic

Amitriptyline

Elavil

under $15

Tricyclic antidepressant

Start 10–25 mg PO qhs

Range up to 150 mg (much lower for pain/migraine)

Migraine prophylaxis, neuropathic pain, insomnia. Beers-list — anticholinergic. Lethal in overdose.

$4/mo

generic

Amlodipine

Norvasc

under $15

Dihydropyridine CCB

Start 5 mg PO daily (2.5 mg if frail/elderly)

Range 5–10 mg daily

Ankle edema is dose-dependent — add or switch to ACEi/ARB rather than a diuretic.

$5.30/mo

generic

Amlodipine-benazepril

Lotrel

under $15

Combination antihypertensive

Start 5/10 mg PO daily

Range up to 10/40

Single-pill combinations improve adherence and are now preferred for stage 2 HTN.

$8–15/mo

generic

Amoxicillin

Amoxil

under $15

Aminopenicillin

Start 500 mg PO TID or 875 mg BID; strep 500 mg BID × 10 d; CAP 1 g TID

Range 250–1000 mg TID

Peds AOM 80–90 mg/kg/day divided BID. Rash with EBV is not a true allergy.

$7/course

generic

Amoxicillin (dental prophylaxis)

Amoxil

under $15

Aminopenicillin

Start 50 mg/kg (peds) or 2 g PO 30–60 min before the procedure

Range single dose

Only for prosthetic valves, prior endocarditis, certain congenital heart disease, or transplant valvulopathy.

generic

Amoxicillin (pediatric)

Amoxil suspension

under $15

Aminopenicillin

Start AOM 80–90 mg/kg/day PO divided BID; strep 50 mg/kg daily

Range max 4 g/day

Duration: <2 yr or severe 10 d; 2–5 yr 7 d; ≥6 yr 5–7 d.

$8/bottle

generic

Amoxicillin-clavulanate

Augmentin

under $15

Aminopenicillin + BL inhibitor

Start 875/125 mg PO BID × 5–7 d (sinusitis); high-dose 2000/125 BID

Range 500 mg TID to 2000 mg BID

Diarrhea is the limiting effect. Avoid the ER (XR) form — 14x the price.

$10–21/course

generic

Amoxicillin-clavulanate (pediatric)

Augmentin ES-600

Aminopenicillin + BL inhibitor

Start 90/6.4 mg/kg/day PO divided BID

Range max 4 g amoxicillin/day

Use the 600 mg/5 mL (ES) formulation to keep clavulanate low and limit diarrhea.

$15/bottle

generic

Amphetamine salts IR

Adderall

C-II

CNS stimulant

Start 5 mg PO daily–BID

Range 5–20 mg BID

$17/mo

generic

Amphetamine salts XR

Adderall XR

C-II

CNS stimulant

Start 10 mg PO qAM

Range 10–30 mg daily

$15.30/mo

generic

Apixaban

Eliquis

brand only

DOAC (factor Xa)

Start 5 mg PO BID (2.5 mg if 2 of: age ≥80, weight ≤60 kg, Cr ≥1.5)

Range 5 mg BID

Lowest bleeding risk DOAC. No US generic until ~2028 — the single biggest cash-pay cost cliff.

~$345/mo

WAC $346/mo

Aripiprazole

Abilify

under $15

Atypical antipsychotic

Start 2–5 mg PO daily (adjunct in depression); 10–15 mg (psychosis)

Range 2–30 mg daily

Least metabolic effect. Akathisia is the main limiting effect. Impulse-control disorders.

$9.60/mo

generic

Artificial tears

Systane, Refresh

under $15

Ocular lubricant

Start 1–2 drops QID PRN

Range as needed

Preservative-free vials if using more than 4x daily.

$6 (OTC)

generic

Aspirin

Bayer, Ecotrin

under $15

Antiplatelet

Start 81 mg PO daily

Range 81–325 mg daily

No longer routine for primary prevention. Secondary prevention: lifelong.

$5/300 tabs (OTC)

generic

Atenolol

Tenormin

under $15

Beta-1 selective blocker

Start 25–50 mg PO daily

Range 25–100 mg daily

Renally cleared. Weaker stroke-prevention data than other agents.

$5.40/mo

generic

Atogepant

Qulipta

brand only

CGRP antagonist (gepant)

Start 10, 30, or 60 mg PO daily

Range 10–60 mg daily

Oral daily prevention.

$1,058/mo

List: $1,185/mo

Atomoxetine

Strattera

Selective NRI

Start 40 mg PO daily × 4 d → 80 mg

Range 40–100 mg daily

Non-stimulant, no DEA schedule. Takes 4–6 wk. Suicidality warning in youth.

$15.30/mo

generic

Atorvastatin

Lipitor

under $15

Statin (high intensity ≥40 mg)

Start 10–20 mg PO daily (40–80 for high intensity)

Range 10–80 mg daily

Any time of day. Recheck lipids in 4–12 wk. Routine CK/LFTs not needed.

$5.45/mo

generic

Atovaquone-proguanil

Malarone

Antimalarial

Start 1 tab PO daily starting 1–2 days before travel, through 7 days after

Range daily

Best tolerated malaria prophylaxis; shortest post-travel tail.

$40–80/course

generic

Azelastine (nasal)

Astelin, Astepro

Intranasal antihistamine

Start 1–2 sprays each nostril BID

Range BID

Works within minutes — good for breakthrough. Bitter taste.

$17/bottle

generic

Azithromycin

Zithromax, Z-Pak

under $15

Macrolide

Start 500 mg PO day 1, then 250 mg days 2–5

Range 500 mg × 1; traveler's diarrhea 1 g × 1

Chlamydia first line is now doxycycline 100 mg BID × 7 d, not azithromycin. NOT for sinusitis or CAP monotherapy — pneumococcal macrolide resistance is ~40% in the US. QT prolongation.

$7.50/Z-Pak

generic

Azithromycin (traveler's diarrhea)

Zithromax

under $15

Macrolide

Start 1000 mg PO × 1 (or 500 mg daily × 3 d)

Range single dose preferred

Preferred in South and Southeast Asia and for dysentery — fluoroquinolone-resistant Campylobacter.

$7.50

generic

B

Baclofen

Lioresal, Ozobax

under $15

GABA-B agonist

Start 5 mg PO TID

Range 5–20 mg TID (max 80 mg/day)

Spasticity of central origin (MS, spinal cord). Never stop abruptly — withdrawal seizures.

$9.60/mo

generic

Baloxavir

Xofluza

brand only

Cap-endonuclease inhibitor

Start 40 mg PO × 1 (80 mg if ≥80 kg)

Range single dose

Single dose. Avoid in pregnancy, breastfeeding, severe immunosuppression, hospitalized patients. Separate from dairy/antacids.

$172/course

WAC $169

Beclomethasone

Qvar RediHaler

Inhaled corticosteroid

Start 40–80 mcg 1–2 puffs BID

Range GINA low dose 100–200 mcg/day (HFA)

$190–230/inhaler

generic

Bempedoic acid

Nexletol

brand only

ACL inhibitor

Start 180 mg PO daily

Range 180 mg daily

Statin-intolerant patients. Raises uric acid; tendon rupture signal.

$231/mo

List: $430–511/mo

Benazepril

Lotensin

under $15

ACE inhibitor

Start 10 mg PO daily

Range 10–40 mg daily

Contraindicated in pregnancy.

$6.45/mo

generic

Benzathine penicillin G

Bicillin L-A

Long-acting penicillin

Start 2.4 million units IM × 1 (early syphilis)

Range weekly × 3 for late latent

The only treatment for syphilis in pregnancy — desensitize if allergic. Never IV.

$150–250/dose

generic

Benzonatate

Tessalon Perles

under $15

Antitussive

Start 100–200 mg PO TID PRN

Range max 600 mg/day

Swallow whole — chewing causes oropharyngeal anesthesia. Fatal in pediatric overdose.

$9.50/30

generic

Benzoyl peroxide

PanOxyl

under $15

Topical antibacterial

Start 5% wash or gel daily–BID

Range 2.5–10%

Always pair with topical antibiotics to prevent resistance. Bleaches fabric.

$9 (OTC)

generic

Betamethasone dipropionate 0.05%

Diprolene

under $15

High-potency topical steroid

Start Apply BID

Range BID

$8–11

generic

Bictegravir-emtricitabine-tenofovir AF

Biktarvy

brand only

INSTI single-tablet regimen

Start 1 tab PO daily

Range fixed

First-line HIV treatment. Refer to ID/HIV specialist.

$4,126/mo

WAC $4,216/mo

Bisacodyl

Dulcolax

under $15

Stimulant laxative

Start 5–10 mg PO qhs or 10 mg PR

Range 5–15 mg

$4–10 (OTC)

generic

Bismuth subsalicylate

Pepto-Bismol

under $15

Antidiarrheal / antacid

Start 524 mg PO QID PRN

Range max 8 doses/day

Blackens tongue and stool. Avoid in renal disease, gout, aspirin allergy, children under 3, and pregnancy.

$6 (OTC)

generic

Bisoprolol

Zebeta

under $15

Beta-1 selective blocker

Start 2.5–5 mg PO daily

Range 2.5–10 mg daily

HFrEF-proven. Most cardioselective.

$6.80/mo

generic

Budesonide EC

Entocort EC, Uceris

Enteric corticosteroid

Start 9 mg PO daily × 8 wk

Range 9 mg daily

Ileal/right-colon Crohn's and UC. High first-pass metabolism — fewer systemic effects. Write Entocort generic, not Uceris.

$51–204/mo

generic

Budesonide (inhaled)

Pulmicort

Inhaled corticosteroid

Start Respules 0.5 mg nebulized daily–BID; Flexhaler 180–360 mcg BID

Range low 200–400 mcg/day

Respules are the pediatric option.

$41/60 mL respules

generic

Budesonide-formoterol

Symbicort, Breyna

ICS + LABA

Start 80/4.5 or 160/4.5, 2 puffs BID

Range up to 160/4.5 2 puffs BID

The MART/SMART agent — can serve as both controller and reliever. GoodRx often beats Cost Plus here.

$97–195/inhaler

generic

Bumetanide

Bumex

under $15

Loop diuretic

Start 0.5–1 mg PO daily

Range 0.5–10 mg/day

1 mg ≈ 40 mg furosemide.

$6.50/mo

generic

Buprenorphine-naloxone

Suboxone, Zubsolv

C-III

Partial opioid agonist (OUD)

Start Induction 2/0.5–4/1 mg SL, titrate to 8–16 mg day 1

Range 8–24 mg daily

X-waiver eliminated — any DEA registrant may prescribe. Start in moderate withdrawal (COWS ≥8) to avoid precipitated withdrawal.

$32/mo

Brand $271/mo

Bupropion SR

Wellbutrin SR, Zyban

under $15

NDRI antidepressant

Start 150 mg PO qAM × 3 d then BID

Range 150 mg BID (max 200 BID)

Also the smoking cessation agent — start 1–2 wk before the quit date.

$12.60/mo

generic

Bupropion XL

Wellbutrin XL

under $15

NDRI antidepressant

Start 150 mg PO qAM

Range 150–450 mg daily

No sexual dysfunction, no weight gain, mildly activating. Contraindicated in seizure disorder, eating disorders, abrupt alcohol/benzo withdrawal. Write 'XL'.

$11.70/mo

generic

Buspirone

BuSpar

under $15

Azapirone anxiolytic

Start 7.5 mg PO BID

Range 15–60 mg/day divided

Non-addictive GAD option. Takes 2–4 wk. Useless PRN. No withdrawal.

$8.20/mo

generic

Butalbital-acetaminophen-caffeine

Fioricet

C-III in some statesunder $15

Barbiturate combination

Start 1–2 tabs PO q4h PRN

Range max 6 tabs/day

Federally, butalbital/APAP/caffeine is a DEA-exempted product (unscheduled); Fiorinal (with aspirin) is C-III, and many states schedule both. High medication-overuse headache risk — avoid.

$12/30

generic

C

Cabergoline

Dostinex

Dopamine agonist

Start 0.25 mg PO twice weekly

Range 0.25–1 mg twice weekly

Prolactinoma. Echo monitoring at high doses.

$23–33/mo

generic

Calcipotriene

Dovonex

Vitamin D analog

Start 0.005% cream/ointment BID

Range max 100 g/week

Plaque psoriasis. Often combined with a steroid.

$77/60 g

generic

Calcium carbonate + vitamin D

Caltrate, Os-Cal

under $15

Mineral supplement

Start 500–600 mg elemental PO BID with food

Range 1000–1200 mg/day total from all sources

Needs stomach acid — use calcium citrate with a PPI. Dietary calcium is preferable.

$8–15/mo

generic

Canagliflozin

Invokana

brand only

SGLT2 inhibitor

Start 100 mg PO daily before the first meal

Range 100–300 mg daily

Amputation and fracture signals; least favored SGLT2i.

~$580/mo

List: ~$580/mo

Candesartan

Atacand

ARB

Start 8 mg PO daily (4 mg if volume-depleted)

Range 8–32 mg daily

Contraindicated in pregnancy. Also has migraine prophylaxis evidence.

$16/mo

generic

Capsaicin

Zostrix

under $15

Topical counterirritant

Start 0.075% cream QID

Range QID

Burning for the first 1–2 weeks is expected and required for effect. Wash hands.

$8.50 (OTC)

generic

Captopril

Capoten

under $15

ACE inhibitor

Start 25 mg PO BID–TID

Range 25–150 mg/day divided

Contraindicated in pregnancy. Short-acting, TID dosing. Take on empty stomach. Largely historical.

$10.70/mo

generic

Carbamazepine

Tegretol

Anticonvulsant

Start 200 mg PO BID

Range 400–1200 mg/day

First line for trigeminal neuralgia. HLA-B*1502 screening in Asian ancestry. Autoinduces its own metabolism. Hyponatremia.

$38.40/mo

generic

Carbidopa-levodopa

Sinemet

under $15

Dopamine precursor

Start 25/100 mg PO TID

Range titrate to effect

Take on an empty stomach; protein competes for absorption. Never stop abruptly. Dyskinesia with long use.

$9/mo

generic

Carvedilol

Coreg

under $15

Alpha/beta blocker

Start 3.125 mg PO BID

Range up to 25 mg BID (50 mg BID if >85 kg)

HFrEF first line. Take with food to limit orthostasis.

$5.70/mo

generic

Cefadroxil

Duricef

1st-gen cephalosporin

Start 1 g PO daily or 500 mg BID

Range 500 mg–1 g/day

$15/course

generic

Cefdinir

Omnicef

3rd-gen cephalosporin

Start 300 mg PO BID × 5–10 d

Range 300 mg BID or 600 mg daily

Red stool with iron — harmless. Peds AOM alternative.

$15/course

generic

Cefdinir (pediatric)

Omnicef suspension

3rd-gen cephalosporin

Start 14 mg/kg/day PO divided daily–BID

Range max 600 mg/day

$15/bottle

generic

Cefixime

Suprax

3rd-gen cephalosporin

Start 400 mg PO × 1 (gonorrhea alternative)

Range 400 mg daily

Only when ceftriaxone IM is unavailable — inferior for pharyngeal infection.

$25–40

generic

Cefpodoxime

Vantin

3rd-gen cephalosporin

Start 200 mg PO BID

Range 100–400 mg BID

Cefdinir is a cheaper equivalent for most indications.

$53/course

generic

Ceftriaxone

Rocephin

under $15

3rd-gen cephalosporin

Start 1 g IM/IV × 1 (250 mg IM for gonorrhea is now 500 mg)

Range 1–2 g daily

Gonorrhea: 500 mg IM × 1 (1 g if ≥150 kg). Reconstitute IM with lidocaine.

$6.72/vial

generic

Cefuroxime

Ceftin

2nd-gen cephalosporin

Start 250–500 mg PO BID

Range 250–500 mg BID

$19/course

generic

Celecoxib

Celebrex

under $15

COX-2 selective NSAID

Start 200 mg PO daily or 100 mg BID

Range 100–200 mg BID

Best GI profile. Sulfa-related. CV risk similar to other NSAIDs at moderate dose.

$10.80/mo

generic

Cephalexin

Keflex

under $15

1st-gen cephalosporin

Start 500 mg PO QID × 5 d (cellulitis); 1 g q8h if obese

Range 250–1000 mg QID

Write 500 mg QID — the 750 mg strength costs 13x more.

$8–24/course

generic

Cetirizine

Zyrtec

under $15

2nd-gen antihistamine

Start 10 mg PO daily

Range up to 40 mg/day for urticaria

Mildly sedating. For chronic urticaria, guidelines support up to 4x dosing. Buy OTC — never write it.

$5.80 (OTC)

generic

Chlorhexidine gluconate

Peridex

under $15

Antiseptic

Start 0.12% rinse 15 mL swish 30 s BID

Range BID

Gingivitis, pre-procedure oral decolonization. Stains teeth with prolonged use.

$10–20/bottle

generic

Chlorthalidone

Thalitone

under $15

Thiazide-type diuretic

Start 12.5 mg PO daily

Range 12.5–25 mg daily (max 50)

Preferred thiazide — longer acting, better outcome data. Watch hyponatremia.

$5.85/mo

generic

Cholecalciferol (vitamin D3)

(OTC)

under $15

Fat-soluble vitamin

Start 1000–2000 IU PO daily; deficiency 50,000 IU weekly × 8 wk

Range 800–4000 IU daily

Target 25-OH vitamin D 30–50 ng/mL. Recheck at 3 months.

$5–10/mo

generic

Cholestyramine

Questran

Bile acid sequestrant

Start 4 g PO daily–BID

Range 4–24 g/day

Also for bile acid diarrhea. Packets, not bulk cans (cans run $1,200+).

$46/mo

generic

Ciprofloxacin

Cipro

under $15

Fluoroquinolone

Start 500 mg PO BID × 7 d (pyelonephritis)

Range 250–750 mg BID

FDA: reserve for patients without alternatives in uncomplicated infections. Tendon rupture, aortic aneurysm, neuropathy, QT. Separate from calcium/iron/antacids by 2–6 h.

$6–32/course

generic

Ciprofloxacin otic

Cetraxal

Otic fluoroquinolone

Start 0.2% single-use container BID × 7 days

Range BID

Otitis externa without a steroid component.

$40–60

generic

Ciprofloxacin-dexamethasone otic

Ciprodex

Otic antibiotic + steroid

Start 4 drops BID × 7 d

Range BID

Otitis externa with intact TM, or AOM with tubes.

$160/7.5 mL

generic

Citalopram

Celexa

under $15

SSRI

Start 20 mg PO daily

Range 20–40 mg (max 20 if >60 yr)

QT prolongation caps the dose.

$9.55/mo

generic

Clarithromycin

Biaxin

Macrolide

Start 500 mg PO BID

Range 250–500 mg BID

Strong CYP3A4 inhibitor — check statins, colchicine, DOACs.

$17/course

generic

Clindamycin

Cleocin

under $15

Lincosamide

Start 300–450 mg PO TID–QID

Range 150–450 mg QID

Highest C. difficile risk of the common oral agents. Inducible resistance in MRSA — ask for a D-test.

$9/course

generic

Clindamycin (topical)

Cleocin T

under $15

Topical antibiotic

Start 1% solution or gel BID

Range BID

Never as monotherapy for acne — combine with benzoyl peroxide.

$11–18

generic

Clindamycin (vaginal)

Cleocin vaginal

Vaginal antibiotic

Start 2% cream 1 applicator intravaginally qhs × 7 days

Range 7 days

Weakens latex condoms and diaphragms for 5 days.

$25–45

generic

Clobetasol 0.05%

Temovate

under $15

Ultra-high-potency topical steroid

Start Apply BID × ≤2 wk

Range max 50 g/week

Never on the face or in skin folds. Limit to 2 weeks — atrophy, HPA suppression.

$9–12

generic

Clomiphene

Clomid

SERM (ovulation induction)

Start 50 mg PO daily days 5–9 of the cycle

Range 50–150 mg daily

Multiple gestation ~8%. Usually managed with cycle monitoring.

$111–156/cycle

generic

Clonazepam

Klonopin

C-IVunder $15

Benzodiazepine

Start 0.25–0.5 mg PO BID

Range max 4 mg/day

Long acting; less inter-dose rebound.

$8.30/mo

generic

Clonidine

Catapres

under $15

Central alpha-2 agonist

Start 0.1 mg PO BID

Range 0.1–0.6 mg BID

Rebound hypertension on abrupt stop — taper. Patch costs roughly 10–15x the tablet.

$6.20/mo

generic

Clonidine ER

Kapvay

under $15

Alpha-2 agonist

Start 0.1 mg PO qhs

Range 0.1–0.4 mg/day

$13.50/mo

generic

Clopidogrel

Plavix

under $15

P2Y12 inhibitor

Start 75 mg PO daily (300–600 mg load)

Range 75 mg daily

CYP2C19 poor metabolizers (~30% of East Asians) get reduced effect.

$5.85/mo

generic

Clotrimazole

Lotrimin, Mycelex

under $15

Topical azole antifungal

Start 1% cream BID × 2–4 wk; troche 10 mg 5x daily

Range BID

$5.40/tube

generic

Colchicine

Colcrys, Mitigare

under $15

Anti-inflammatory

Start Flare: 1.2 mg PO, then 0.6 mg one hour later; prophylaxis 0.6 mg daily–BID

Range max 1.8 mg per flare

Reduce or avoid with CrCl <30, hepatic impairment, or strong CYP3A4/P-gp inhibitors (clarithromycin, azoles, diltiazem, verapamil, ritonavir) — that combination is fatal.

$5–30/mo

generic

Colesevelam

Welchol

Bile acid sequestrant

Start 1.875 g PO BID (3 tabs BID)

Range 3.75 g/day

Also lowers A1c ~0.5%. Separate other drugs by 4 h. Raises TG.

$27/mo

generic

Combined oral contraceptive

Junel Fe, Sprintec, Lo Loestrin

under $15

Estrogen-progestin contraceptive

Start 1 tab PO daily, same time

Range continuous or cyclic

Contraindicated in migraine with aura, smoking over 35, VTE history, uncontrolled HTN, <21 days postpartum. No exam needed to prescribe.

$10–22/pack

generic

Conjugated estrogens

Premarin

brand only

Estrogen

Start 0.3 mg PO daily

Range 0.3–1.25 mg daily

$99/mo

List: ~$215/mo

Copper IUD

Paragard

brand only

Intrauterine device

Start 1 device, effective 10 years

Range 10 years

Hormone-free. The most effective emergency contraception if placed within 5 days.

$938–1,123

List: $1,123

Cromolyn (nasal)

NasalCrom

Mast cell stabilizer

Start 1 spray each nostril TID–QID

Range QID

Must be started before allergen exposure. Safe in pregnancy.

$16 (OTC)

generic

Cyanocobalamin (vitamin B12)

(OTC / injection)

under $15

Water-soluble vitamin

Start 1000 mcg PO daily, or 1000 mcg IM weekly × 4 then monthly

Range 1000 mcg

Oral works even in pernicious anemia at 1000 mcg/day. Check with metformin, PPIs, bariatric surgery, vegan diet.

$5–15/mo

generic

Cyclobenzaprine

Flexeril, Amrix

under $15

Muscle relaxant

Start 5–10 mg PO qhs

Range 5–10 mg TID (max 30 mg/day)

Structurally a TCA — anticholinergic, sedating. Beers-list. Short courses only (≤2–3 wk).

$5.60–7/mo

generic

Cyclosporine (ophthalmic)

Restasis

Ophthalmic immunomodulator

Start 0.05% 1 drop BID

Range BID

Chronic dry eye. Takes 3–6 months to work.

$265/30 vials

Brand $323

D

Dabigatran

Pradaxa

DOAC (direct thrombin)

Start 150 mg PO BID (75 mg if CrCl 15–30)

Range 150 mg BID

Dyspepsia ~10%. Keep in the original bottle — moisture sensitive.

$23.40/mo

Brand ~$600/mo

Dantrolene

Dantrium

Direct muscle relaxant

Start 25 mg PO daily

Range up to 100 mg TID–QID

Hepatotoxicity boxed warning — monitor LFTs.

$26/mo

generic

Dapagliflozin

Farxiga

SGLT2 inhibitor

Start 10 mg PO daily (5 mg for T2DM initiation)

Range 5–10 mg daily

Generic since April 2026 — make this the default SGLT2i for cash patients. Hold for illness or surgery (euglycemic DKA).

$20/mo

Brand ~$377/mo

Dapagliflozin-metformin ER

Xigduo XR

Combination antidiabetic

Start 5/500 mg PO daily

Range up to 10/2000

$32/mo

generic

Denosumab

Prolia

brand only

RANKL inhibitor

Start 60 mg SC q6 months

Range fixed

Never stop without transitioning to a bisphosphonate — rebound vertebral fractures. Biosimilars available.

~$1,870/dose

List: ~$1,895/dose

Desonide 0.05%

DesOwen

under $15

Low-potency topical steroid

Start Apply BID

Range BID

Face and pediatric option.

$11–15

generic

Desvenlafaxine

Pristiq

SNRI

Start 50 mg PO daily

Range 50–100 mg daily

$24/mo

generic

Dexamethasone

Decadron

under $15

Systemic corticosteroid

Start 0.5–10 mg PO daily; croup 0.6 mg/kg × 1

Range varies

Longest acting, no mineralocorticoid effect. Croup, cerebral edema, antiemetic.

$9.70/mo

generic

Dexamethasone (croup)

Decadron

under $15

Systemic corticosteroid

Start 0.6 mg/kg PO/IM × 1 (max 16 mg)

Range single dose

Single dose works even in mild croup. Add nebulized epinephrine for stridor at rest.

generic

Dexmethylphenidate

Focalin

C-II

CNS stimulant

Start 2.5 mg PO BID

Range 2.5–10 mg BID

$25/mo

generic

Dextromethorphan

Delsym, Robitussin DM

under $15

Antitussive

Start 20 mg PO q4h or 60 mg ER q12h

Range max 120 mg/day

Serotonin syndrome risk with SSRIs and MAOIs.

$9.50 (OTC)

generic

Diazepam

Valium

C-IVunder $15

Benzodiazepine

Start 2–10 mg PO BID–QID PRN

Range max 40 mg/day

Long half-life with active metabolites — accumulates in the elderly. Muscle spasm indication.

$7.40/mo

generic

Diclofenac 1% gel

Voltaren Arthritis Pain

under $15

Topical NSAID

Start 4 g QID per knee/ankle/foot; 2 g QID per hand/elbow

Range max 16 g/joint/day, 32 g/day total

First line for knee and hand OA, especially over 75 or with GI/renal/CV risk. Available OTC.

$11–13/100 g

generic

Diclofenac (oral)

Voltaren, Cataflam

NSAID

Start 50 mg PO BID–TID (or 75 mg DR BID)

Range max 150 mg/day

Highest CV risk NSAID — avoid with cardiac disease.

$17/mo

generic

Dicloxacillin

Dynapen

Antistaphylococcal penicillin

Start 250–500 mg PO QID

Range 250–500 mg QID

MSSA skin infections. Take on an empty stomach.

$18/course

generic

Dicyclomine

Bentyl

Antispasmodic

Start 20 mg PO QID

Range 20–40 mg QID

IBS cramping. Anticholinergic — avoid in the elderly.

$19–33/mo

generic

Digoxin

Lanoxin

under $15

Cardiac glycoside

Start 0.125 mg PO daily

Range 0.125–0.25 mg daily

Narrow therapeutic index — target 0.5–0.9 ng/mL in HF. Renally cleared. Watch K+.

$6.20/mo

generic

Dihydroergotamine

D.H.E. 45, Migranal

Ergot alkaloid

Start 1 mg IM/SC, may repeat hourly ×2

Range max 3 mg/day, 6 mg/week

Never within 24 h of a triptan. Contraindicated in CAD, pregnancy, and with CYP3A4 inhibitors.

$251/vial

generic

Diltiazem ER

Cardizem CD, Tiazac

under $15

Non-DHP CCB

Start 120–180 mg PO daily

Range 120–480 mg daily

Rate control in AF. Avoid in HFrEF. CYP3A4 inhibitor.

$11/mo

generic

Dimenhydrinate

Dramamine

under $15

Antihistamine

Start 50 mg PO q4–6h PRN

Range max 400 mg/day

$6 (OTC)

generic

Diphenhydramine

Benadryl

under $15

1st-gen antihistamine

Start 25–50 mg PO q4–6h

Range max 300 mg/day

Beers-list — avoid in the elderly. Anticholinergic burden and dementia association.

$4.80 (OTC)

generic

Dipyridamole-aspirin ER

Aggrenox

Antiplatelet combination

Start 25/200 mg PO BID

Range fixed

Secondary stroke prevention. Headache limits use.

$26.60/mo

generic

Disulfiram

Antabuse

Aldehyde dehydrogenase inhibitor

Start 250 mg PO daily

Range 125–500 mg daily

Requires full abstinence and supervision. Severe reaction with any alcohol, including in sauces and mouthwash.

$40–70/mo

generic

Divalproex

Depakote

Anticonvulsant / mood stabilizer

Start 250–500 mg PO BID

Range 750–3000 mg/day

Level 50–125 mcg/mL. Never in women of childbearing potential — neural tube defects and IQ loss. Hepatotoxicity, pancreatitis, hyperammonemia.

$16.30/mo

generic

Docusate

Colace

under $15

Stool softener

Start 100 mg PO BID

Range 100–300 mg/day

Essentially no better than placebo — PEG or senna is a better choice.

$5–8 (OTC)

generic

Donepezil

Aricept

under $15

Cholinesterase inhibitor

Start 5 mg PO qhs × 4–6 wk

Range →10 mg (max 23 mg)

Modest symptomatic benefit in Alzheimer's. Bradycardia, syncope, GI upset, vivid dreams.

$6/mo

generic

Doxazosin

Cardura

under $15

Alpha-1 blocker

Start 1 mg PO qhs

Range 1–8 mg daily

First-dose orthostasis — start at bedtime. Dual benefit in BPH.

$6.45/mo

generic

Doxepin

Silenor, Sinequan

under $15

Tricyclic antidepressant

Start 3–6 mg PO qhs (insomnia); 25–150 mg (depression)

Range varies

Low-dose form is a pure H1 antagonist hypnotic with no next-day effect.

$14–21/mo

generic

Doxycycline hyclate

Vibramycin

under $15

Tetracycline

Start 100 mg PO BID

Range 100 mg BID

Workhorse: CAP, cellulitis/MRSA, tick-borne illness, acne, chlamydia. Avoid in pregnancy and <8 yr. Esophagitis — sit up, full glass of water.

$6–18/course

generic

Doxycycline (malaria prophylaxis)

Vibramycin

under $15

Tetracycline

Start 100 mg PO daily from 1–2 days before through 4 weeks after

Range daily

Cheapest option, but 4 weeks of post-travel dosing and photosensitivity.

$10–20/course

generic

Doxycycline monohydrate

Monodox

Tetracycline

Start 100 mg PO BID

Range 100 mg BID

Better GI tolerance than hyclate. Avoid the delayed-release (Doryx) — 10x the price.

$17/course

generic

Doxycycline (PEP)

(doxy-PEP)

under $15

Tetracycline

Start 200 mg PO within 72 h of condomless sex

Range ≤200 mg per 24 h

Bacterial STI prevention in MSM and transgender women with a bacterial STI in the past year.

$6–18

generic

Dulaglutide

Trulicity

brand only

GLP-1 receptor agonist

Start 0.75 mg SC weekly

Range →1.5 →3 →4.5 mg, ≥4 wk apart

$986/mo

List: $991/mo

Duloxetine

Cymbalta

under $15

SNRI

Start 30 mg PO daily × 1 wk

Range →60 mg daily (max 60 for pain)

Dual benefit in depression + neuropathic pain, fibromyalgia, knee OA. Avoid if GFR <30 or any hepatic impairment.

$10.40/mo

generic

Dutasteride

Avodart

under $15

5-alpha reductase inhibitor

Start 0.5 mg PO daily

Range 0.5 mg daily

Blocks both isoenzymes. Long half-life — no blood donation for 6 months.

$11–32/mo

generic

E

Edoxaban

Savaysa

brand only

DOAC (factor Xa)

Start 60 mg PO daily (30 mg if CrCl 15–50 or weight ≤60 kg)

Range 30–60 mg daily

Do NOT use if CrCl >95 — reduced efficacy.

$483/mo

List: ~$483/mo

Eletriptan

Relpax

Triptan

Start 40 mg PO at onset

Range max 80 mg/day

$26/6 tabs

generic

Empagliflozin

Jardiance

brand only

SGLT2 inhibitor

Start 10 mg PO daily

Range 10–25 mg daily

No generic. Clinically interchangeable with dapagliflozin for most indications at 1/12 the cost.

$249/mo

List: ~$473–760/mo

Empagliflozin-metformin

Synjardy

brand only

Combination antidiabetic

Start 5/500 mg PO BID

Range up to 12.5/1000 BID

$250+/mo

Emtricitabine-tenofovir DF

Truvada

NRTI combination (PrEP)

Start 1 tab PO daily

Range fixed

HIV PrEP. Baseline and q3mo HIV test, renal function, STI screen. Generic is 65x cheaper than brand.

$23–28/mo

Brand $1,807/mo

Enalapril

Vasotec

under $15

ACE inhibitor

Start 5 mg PO daily

Range 5–40 mg daily, may divide BID

Contraindicated in pregnancy — stop immediately if pregnancy is detected. Same class cautions as lisinopril.

$5.70/mo

generic

Enoxaparin

Lovenox

Low-molecular-weight heparin

Start 1 mg/kg SC q12h (treatment) or 40 mg SC daily (prophylaxis)

Range weight-based

Renally adjust if CrCl <30 (1 mg/kg q24h). Preferred anticoagulant in pregnancy and cancer.

$30/10 syringes

Brand ~$100

Epinephrine auto-injector

EpiPen, Auvi-Q, Adrenaclick

Adrenergic agonist

Start 0.3 mg IM anterolateral thigh (0.15 mg if 15–30 kg)

Range repeat q5–15 min PRN

Prescribe the authorized generic. Two-pack always. Call 911 after use — biphasic reactions.

$110–175/2-pack

List: EpiPen $602/2-pack

Eplerenone

Inspra

under $15

Aldosterone antagonist

Start 25 mg PO daily

Range 25–50 mg daily

No gynecomastia. Post-MI HF indication.

$9.90/mo

generic

Eptinezumab

Vyepti

brand only

CGRP ligand mAb

Start 100 mg IV q3 months

Range 100–300 mg q3mo

~$675/mo equiv

List: ~$2,026/infusion

Erenumab

Aimovig

brand only

CGRP receptor mAb

Start 70 mg SC monthly

Range 70–140 mg monthly

CGRP agents are now first line for prevention — AHS says no step therapy required. Constipation.

$299/mo

List: $773/mo

Ergocalciferol (vitamin D2)

Drisdol

under $15

Fat-soluble vitamin

Start 50,000 IU PO weekly × 8–12 weeks

Range then maintenance D3

The prescription repletion form.

$10–20/course

generic

Ertugliflozin

Steglatro

brand only

SGLT2 inhibitor

Start 5 mg PO daily

Range 5–15 mg daily

$350/mo

List: $357/mo

Erythromycin

Ery-Tab

Macrolide

Start 250–500 mg PO QID

Range 250–500 mg QID

GI upset limits use. Write the DR form — the IR costs 2.5x more.

$85/course (DR)

generic

Erythromycin ophthalmic

Ilotycin

Ophthalmic antibiotic

Start 0.5% ointment, 1 cm ribbon QID × 5–7 d

Range QID

Bacterial conjunctivitis. Blurs vision briefly.

$15/tube

generic

Escitalopram

Lexapro

under $15

SSRI

Start 10 mg PO daily (5 mg if elderly)

Range 10–20 mg daily

Cleanest SSRI interaction profile. Max 10 mg over 60 yr (QT).

$7.85/mo

generic

Esomeprazole

Nexium

under $15

Proton pump inhibitor

Start 20–40 mg PO daily

Range 20–40 mg daily

$10–15/mo

generic

Estradiol (oral)

Estrace

under $15

Estrogen

Start 0.5–1 mg PO daily

Range 0.5–2 mg daily

Add a progestin if the uterus is intact. Lowest effective dose, shortest duration.

$12–25/mo

generic

Estradiol patch

Vivelle-Dot, Climara

Estrogen

Start 0.025–0.05 mg/24 h patch twice weekly

Range 0.025–0.1 mg/24 h

Transdermal avoids first-pass — lower VTE risk than oral. Preferred route.

$28–50/mo

generic

Eszopiclone

Lunesta

C-IVunder $15

Non-benzodiazepine hypnotic

Start 1 mg PO qhs

Range 1–3 mg

Metallic taste. Same boxed warning as zolpidem.

$10.60/mo

generic

Ethambutol

Myambutol

Antimycobacterial

Start 15–25 mg/kg PO daily

Range weight-based

Baseline and monthly visual acuity and color vision — optic neuritis.

$30/mo

generic

Etodolac

Lodine

NSAID

Start 300–400 mg PO BID–TID

Range max 1200 mg/day

$15/mo

generic

Etonogestrel implant

Nexplanon

brand only

Contraceptive implant

Start 1 implant subdermally, replace every 5 years

Range 5 years

Duration extended from 3 to 5 years in Jan 2026. Most effective reversible method; irregular bleeding is the main reason for removal.

$1,275 device

List: $1,275

Evolocumab

Repatha

brand only

PCSK9 inhibitor

Start 140 mg SC q2wk or 420 mg monthly

Range fixed

Add when LDL goal unmet on statin + ezetimibe. Amgen self-pay program.

$239/mo direct

WAC ~$584/mo

Ezetimibe

Zetia

under $15

Cholesterol absorption inhibitor

Start 10 mg PO daily

Range 10 mg daily

First add-on when LDL goal isn't met on max statin. ~20% further LDL reduction.

$6.40/mo

generic

Ezetimibe-simvastatin

Vytorin

under $15

Combination lipid agent

Start 10/20 mg PO qhs

Range 10/10 to 10/40

Convenient, but writing the two generics separately is usually cheaper.

$12/mo

generic

F

Famciclovir

Famvir

Nucleoside antiviral

Start 500 mg PO TID × 7 d (zoster)

Range 125–500 mg

$19–36/course

generic

Famotidine

Pepcid

under $15

H2 receptor antagonist

Start 20 mg PO BID

Range 20–40 mg BID

Renally adjust. Useful adjunct in urticaria. Available OTC.

$12–16/mo

generic

Febuxostat

Uloric

Xanthine oxidase inhibitor

Start 40 mg PO daily

Range 40–80 mg daily

CV mortality boxed warning — second line to allopurinol.

$20–31/mo

generic

Felodipine ER

Plendil

under $15

Dihydropyridine CCB

Start 2.5–5 mg PO daily

Range 2.5–10 mg daily

$7.35/mo

generic

Fenofibrate

Tricor, Lipofen

under $15

Fibrate

Start 145 mg PO daily

Range 48–145 mg daily

Triglycerides ≥500 to prevent pancreatitis. Raises Cr. Not for CV risk reduction with a statin.

$7.55/mo

generic

Ferrous sulfate

Feosol

under $15

Oral iron

Start 325 mg (65 mg elemental) PO every other day

Range every other day dosing absorbs better

Alternate-day dosing beats daily — hepcidin blocks absorption. Take with vitamin C, away from calcium and PPI.

$5–10/mo

generic

Fexofenadine

Allegra

under $15

2nd-gen antihistamine

Start 180 mg PO daily

Range 60 mg BID or 180 daily

Don't take with fruit juice — reduces absorption 40%.

$5.60 (OTC)

generic

Fidaxomicin

Dificid

brand only

Macrocyclic antibacterial

Start 200 mg PO BID × 10 d

Range fixed

Preferred for C. difficile by guideline, but cost makes oral vancomycin the practical choice.

~$5,092/course

List: ~$5,092

Finasteride

Proscar, Propecia

under $15

5-alpha reductase inhibitor

Start 5 mg PO daily (BPH); 1 mg daily (alopecia)

Range 1–5 mg daily

Halves PSA — double the measured value. 6 months for effect. Sexual side effects; rare persistence.

$6–10/mo

generic

Finerenone

Kerendia

brand only

Non-steroidal MRA

Start 10 mg PO daily (20 mg if eGFR ≥60)

Range 10–20 mg daily

CKD + T2DM with albuminuria. Check K+ at 4 wk. Not generic.

$641/mo

List: ~$959/mo

Flecainide

Tambocor

under $15

Class IC antiarrhythmic

Start 50 mg PO BID

Range 50–150 mg BID

Structurally normal hearts only — CAST trial mortality signal. Use with an AV nodal blocker.

$11/mo

generic

Fluconazole

Diflucan

under $15

Triazole antifungal

Start 150 mg PO × 1 (vaginal candidiasis); 100–200 mg daily

Range 100–800 mg daily

CYP2C9/3A4 inhibitor — raises warfarin INR. Single dose is fine in most; avoid high dose in pregnancy.

$6–21

generic

Fludrocortisone

Florinef

Mineralocorticoid

Start 0.05–0.1 mg PO daily

Range 0.05–0.2 mg daily

Primary adrenal insufficiency, orthostatic hypotension.

$23/mo

generic

Fluocinonide 0.05%

Lidex

under $15

High-potency topical steroid

Start Apply BID–TID

Range BID

$11.60

generic

Fluorouracil 5% (topical)

Efudex

Topical antineoplastic

Start Apply BID × 2–4 weeks to actinic keratoses

Range BID

Expect a florid inflammatory reaction — that is the treatment working. Photograph and counsel.

$60–120/tube

generic

Fluoxetine

Prozac

under $15

SSRI

Start 20 mg PO qAM

Range 20–80 mg daily

Longest half-life — self-tapering, good for non-adherent patients. Activating. FDA-approved from age 8 for depression and age 7 for OCD.

$3/mo

generic

Fluticasone furoate-vilanterol

Breo Ellipta

brand only

ICS + LABA

Start 100/25 1 inhalation daily

Range 100–200/25 daily

Authorized generic is approved but not marketed as of Aug 2026. Once-daily dosing aids adherence.

$223–390

Fluticasone (nasal)

Flonase

under $15

Intranasal corticosteroid

Start 2 sprays each nostril daily

Range 1–2 sprays daily

First line for allergic rhinitis. Aim away from the septum — epistaxis. Takes days to work.

$12–15 (OTC)

generic

Fluticasone propionate HFA

fluticasone propionate HFA (Prasco authorized generic)

Inhaled corticosteroid

Start 44 mcg 2 puffs BID (low dose)

Range 44–220 mcg 2 puffs BID

Brand Flovent HFA was discontinued in Jan 2024 — the Prasco authorized generic replaced it. Rinse and spit to prevent thrush. Low dose = 100–250 mcg/day.

$171–226/inhaler

generic

Fluticasone-azelastine (nasal)

Dymista

Combination nasal spray

Start 1 spray each nostril BID

Range BID

More effective than either agent alone in moderate-severe allergic rhinitis.

$40–70/bottle

generic

Fluticasone-salmeterol

Advair Diskus, Wixela Inhub

ICS + LABA

Start 100/50 1 inhalation BID

Range 100–500/50 BID

Cheapest ICS/LABA. Salmeterol cannot be used as a reliever.

$100–106/inhaler

generic

Fluticasone-umeclidinium-vilanterol

Trelegy Ellipta

brand only

Triple therapy (ICS/LAMA/LABA)

Start 100/62.5/25 mcg 1 inhalation daily

Range up to 200/62.5/25

COPD Group E with eosinophils ≥300, or severe asthma.

$326/28 doses

WAC $698/mo

Fluvastatin

Lescol

Statin (low–moderate)

Start 40 mg PO BID or 80 mg XL daily

Range 20–80 mg daily

Weakest statin and not cheap — rarely the right choice.

$53–101/mo

generic

Fluvoxamine

Luvox

SSRI

Start 50 mg PO qhs

Range 100–300 mg daily

OCD indication. Potent CYP1A2 inhibitor.

$28.60/mo

generic

Folic acid

under $15

Vitamin

Start 0.4 mg PO daily preconception; 4 mg if prior NTD

Range 0.4–4 mg daily

Start at least 1 month before conception.

$4/mo

generic

Folic acid (supplement)

under $15

Water-soluble vitamin

Start 1 mg PO daily

Range 0.4–5 mg daily

Mandatory 1 mg daily with methotrexate.

$4/mo

generic

Fosfomycin

Monurol

Phosphonic antibacterial

Start 3 g PO × 1 dose

Range single dose

Lower efficacy than nitrofurantoin. Useful for resistant organisms or single-dose need.

$16–105/dose

generic

Fremanezumab

Ajovy

brand only

CGRP ligand mAb

Start 225 mg SC monthly or 675 mg q3 months

Range either schedule

$749/mo

WAC $733/mo

Frovatriptan

Frova

Triptan

Start 2.5 mg PO at onset

Range max 7.5 mg/day

Longest half-life (26 h) — short-term menstrual migraine prophylaxis.

$28/9 tabs

generic

Furosemide

Lasix

under $15

Loop diuretic

Start 20–40 mg PO daily

Range 20–600 mg/day

Oral bioavailability ~50% and erratic. Solution costs 30x the tablet.

$5.65/mo

generic

G

Gabapentin

Neurontin

under $15

Gabapentinoid

Start 300 mg PO qhs day 1 → 300 BID → 300 TID

Range 900–1800 mg/day divided TID (max 3600 off-label)

Renal-adjust: CrCl 30–59 → 400–1400 mg/day; 15–29 → 200–700; <15 → 100–300. Not scheduled in California; C-V in ~10 other states.

$7–12/mo

generic

Galcanezumab

Emgality

brand only

CGRP ligand mAb

Start 240 mg SC loading (2 × 120 mg), then 120 mg monthly

Range 120 mg monthly

Also approved for episodic cluster headache.

$709/mo

List: $754/mo

Gemfibrozil

Lopid

under $15

Fibrate

Start 600 mg PO BID before meals

Range 600 mg BID

Never combine with a statin — rhabdomyolysis. Prefer fenofibrate.

$9.50/mo

generic

Glimepiride

Amaryl

under $15

Sulfonylurea

Start 1–2 mg PO daily with breakfast

Range 1–8 mg daily

$14.40/mo

generic

Glipizide

Glucotrol

under $15

Sulfonylurea

Start 5 mg PO daily 30 min before breakfast

Range 2.5–20 mg/day usual (label max 40); divide above 15 mg

Preferred sulfonylurea — shorter acting, safer in CKD and the elderly than glyburide.

$12.90/mo

generic

Glyburide

DiaBeta, Micronase

Sulfonylurea

Start 2.5–5 mg PO daily with breakfast

Range 1.25–20 mg/day

Avoid in elderly and CKD — prolonged hypoglycemia. Beers-list drug.

$22.55/mo

generic

Glycopyrrolate

Robinul

Anticholinergic

Start 1 mg PO BID–TID

Range 1–2 mg BID–TID

Hyperhidrosis, sialorrhea. Anticholinergic burden.

$15–30/mo

generic

Griseofulvin

Grifulvin V

Antifungal

Start Microsize 500–1000 mg PO daily with fatty food

Range 20–25 mg/kg/day (peds)

Tinea capitis in children. Take with fat for absorption.

$80–196/mo

generic

Guaifenesin

Mucinex

under $15

Expectorant

Start 600 mg PO BID (ER) or 200–400 mg q4h

Range max 2400 mg/day

Weak evidence; hydration matters more.

$5–9 (OTC)

generic

Guanfacine ER

Intuniv

under $15

Alpha-2A agonist

Start 1 mg PO qhs

Range 1–4 mg daily

Non-stimulant. Useful with tics or aggression. Sedation, hypotension.

$12.80/mo

generic

H

Haloperidol

Haldol

under $15

Typical antipsychotic

Start 0.5–5 mg PO BID–TID

Range 1–30 mg/day

High EPS; give with an anticholinergic if needed. IM for acute agitation.

$9.40/mo

generic

Hydralazine

Apresoline

under $15

Direct vasodilator

Start 25 mg PO TID

Range 25–100 mg TID

Reflex tachycardia; drug-induced lupus at high dose. Use with a nitrate in HFrEF.

$6.35/mo

generic

Hydrochlorothiazide

Microzide

under $15

Thiazide diuretic

Start 25 mg PO daily

Range 12.5–50 mg daily

Check Na+, K+, uric acid. Less potent than chlorthalidone.

$5.25/mo

generic

Hydrocodone-acetaminophen

Norco, Vicodin

C-IIunder $15

Opioid combination

Start 5/325 mg PO q6h PRN

Range limited by acetaminophen 4 g/day

Check CURES before every prescription. Lowest effective dose, shortest duration. Offer naloxone at ≥50 MME/day.

$8.20/mo

generic

Hydrocortisone

Cortef

Systemic corticosteroid

Start 15–25 mg/day divided (adrenal insufficiency)

Range varies

Physiologic replacement. Double or triple during illness — stress dosing.

$27/mo

generic

Hydrocortisone 2.5%

Hytone

under $15

Low-potency topical steroid

Start Apply BID

Range BID

Safe for face, groin, and children.

$6–8

generic

Hydroquinone 4%

Eldoquin

Depigmenting agent

Start Apply BID to hyperpigmented areas

Range BID

Melasma. Strict sun protection or it fails. Ochronosis with prolonged use.

$44/28 g

generic

Hydroxychloroquine

Plaquenil

under $15

Antimalarial / DMARD

Start 200–400 mg PO daily

Range ≤5 mg/kg/day actual body weight

Baseline and annual eye exam after 5 years — retinal toxicity is dose- and duration-related.

$13–18/mo

generic

Hydroxyzine

Atarax, Vistaril

under $15

1st-gen antihistamine / anxiolytic

Start 25 mg PO qhs or TID PRN

Range 25–100 mg

Non-addictive alternative to benzodiazepines for anxiety. Sedating; QT at high dose.

$6.50–7.80/mo

generic

Hyoscyamine

Levsin, Levbid

under $15

Antispasmodic

Start 0.125 mg PO/SL q4h PRN

Range max 1.5 mg/day

$12–27/mo

generic

I

Ibandronate

Boniva

Bisphosphonate

Start 150 mg PO monthly

Range 150 mg monthly

Vertebral fracture data only — weaker than alendronate.

$25/mo

generic

Ibuprofen

Motrin, Advil

under $15

NSAID

Start 400–600 mg PO q6h with food

Range max 3200 mg/day (2400 OTC)

Lowest CV risk NSAID at low dose. Interferes with aspirin's antiplatelet effect — take 8 h before or 30 min after.

$6.60/mo

generic

Ibuprofen (pediatric)

Motrin Children's

under $15

NSAID

Start 10 mg/kg PO q6–8h

Range max 40 mg/kg/day

Not under 6 months. Give with food.

$6 (OTC)

generic

Icosapent ethyl

Vascepa

Omega-3 (EPA)

Start 2 g PO BID with food

Range 2 g BID (4 g/day)

TG 150–499 in high-risk patients. Small AF and bleeding signal.

$39.50/mo

Brand $354/mo

Imipramine

Tofranil

under $15

Tricyclic antidepressant

Start 25 mg PO qhs

Range 50–150 mg daily

Also used for pediatric enuresis.

$9/mo

generic

Imiquimod 5%

Aldara

Immune response modifier

Start Apply 3 nights/week × 16 weeks (genital warts) or 5 nights/week × 6 weeks (AK)

Range varies

Local inflammation and flu-like symptoms are expected.

$40–90

generic

Inclisiran

Leqvio

brand only

siRNA PCSK9

Start 284 mg SC at 0 and 3 mo, then q6mo

Range fixed

Twice-yearly dosing after loading — best adherence option.

~$633/mo equiv

List: $3,798/dose

Indapamide

Lozol

under $15

Thiazide-type diuretic

Start 1.25 mg PO daily

Range 1.25–2.5 mg daily

$6.80/mo

generic

Indomethacin

Indocin

under $15

NSAID

Start 25–50 mg PO TID

Range max 200 mg/day

Gout flare and pericarditis. Most CNS effects (headache, confusion) of the class.

$13–15/mo

generic

Insulin aspart

Novolog, Fiasp

Rapid-acting insulin

Start 4 units or 10% of basal at the largest meal

Range carb-ratio dosed

$77/vial

generic

Insulin degludec

Tresiba

brand only

Ultra-long-acting insulin

Start 0.1–0.2 units/kg SC daily

Range titrate

42-h duration — most forgiving of timing. Best for erratic schedules.

$122/mo (or $35 cap)

List: $146/5 pens

Insulin detemir

Levemir

brand only

Long-acting insulin

Start 0.1–0.2 units/kg SC daily

Range often BID

Being discontinued in the US.

$104/mo (or $35 cap)

Insulin glargine

Lantus, Basaglar, Semglee

Long-acting insulin

Start 0.1–0.2 units/kg SC daily (or ~10 units)

Range titrate to fasting glucose 80–130

Titrate by 2 units q3 days. Semglee is the interchangeable biosimilar — cheapest.

$35–70/mo

generic

Insulin lispro

Humalog, Lyumjev, Admelog

Rapid-acting insulin

Start 4 units or 10% of basal at the largest meal

Range 1 unit per 10–15 g carbohydrate

Inject 0–15 min before eating. Unbranded biologic is the cheap version.

$29/vial

generic

Ipratropium

Atrovent

under $15

SAMA (anticholinergic)

Start 500 mcg nebulized q6h; 2 puffs QID

Range q6h

Nebulizer solution is $11; the HFA aerosol is $265 for the same molecule.

$11/neb bottle

generic

Ipratropium (nasal)

Atrovent nasal

Intranasal anticholinergic

Start 2 sprays each nostril BID–TID

Range 0.03% or 0.06%

Best agent for pure rhinorrhea, including gustatory rhinitis.

$26–31/bottle

generic

Ipratropium-albuterol

DuoNeb, Combivent Respimat

under $15

SAMA + SABA

Start 1 vial nebulized QID; Respimat 1 puff QID

Range QID

Neb solution is 36x cheaper than the Respimat inhaler.

$14/neb; $515 Respimat

generic

Ipratropium-albuterol HFA

Combivent Respimat

brand only

SAMA + SABA inhaler

Start 1 inhalation QID

Range max 6 inhalations/day

Use the nebulizer solution instead at 1/36 the price where feasible.

$515/inhaler

Irbesartan

Avapro

under $15

ARB

Start 150 mg PO daily

Range 150–300 mg daily

Contraindicated in pregnancy. Good diabetic nephropathy data.

$8.60/mo

generic

Isoniazid

INH

under $15

Antimycobacterial

Start 300 mg PO daily (LTBI, 9 mo) or 900 mg weekly with rifapentine × 12

Range 5 mg/kg daily

Add pyridoxine 25–50 mg daily. Monitor LFTs; stop for symptoms or ALT >3x ULN with symptoms.

$8.70/mo

generic

Isosorbide dinitrate

Isordil

under $15

Nitrate

Start 10–20 mg PO TID

Range up to 40 mg TID

With hydralazine in HFrEF, especially Black patients.

$11.90/mo

generic

Isosorbide mononitrate ER

Imdur

under $15

Nitrate

Start 30 mg PO daily

Range 30–120 mg daily

Needs a 10–12 h nitrate-free interval to prevent tolerance.

$6.40/mo

generic

Isotretinoin

Accutane, Absorica

Systemic retinoid

Start 0.5 mg/kg/day divided BID with fat

Range cumulative 120–150 mg/kg

iPLEDGE registry, monthly pregnancy tests, two forms of contraception. Monitor lipids and LFTs.

$777/mo

generic

Itraconazole

Sporanox

Triazole antifungal

Start 200 mg PO daily

Range 100–400 mg daily

Negative inotrope — avoid in HF. Many CYP3A4 interactions. Needs acid for absorption.

$36/mo

generic

Ivabradine

Corlanor

If channel inhibitor

Start 5 mg PO BID

Range 2.5–7.5 mg BID

HFrEF with HR ≥70 in sinus rhythm on max beta blocker. Visual phosphenes.

$29.50/mo

Brand $619/mo

Ivermectin

Stromectol

Antiparasitic

Start 200 mcg/kg PO × 1 (scabies, repeat in 1–2 wk)

Range weight-based

Scabies, strongyloides, head lice. Not for COVID.

$77/course

generic

K

Ketoconazole (topical)

Nizoral

under $15

Topical antifungal

Start 2% cream daily–BID; shampoo 2x weekly

Range daily–BID

Seborrheic dermatitis and tinea versicolor. Never write the 2% foam — $164 vs $10 for cream.

$10–16

generic

Ketorolac

Toradol

NSAID

Start 10 mg PO q6h (continuation only, after a parenteral dose); 30–60 mg IM × 1

Range oral max 40 mg/day; 5 days total, all routes

Hard 5-day ceiling — GI and renal toxicity. Do not combine with another NSAID.

$30/20 tabs

generic

Ketotifen (ophthalmic)

Zaditor, Alaway

under $15

Ophthalmic antihistamine

Start 1 drop BID

Range BID

$8–12 (OTC)

generic

L

Labetalol

Trandate

under $15

Alpha/beta blocker

Start 100 mg PO BID

Range 100–800 mg BID

First line for chronic hypertension in pregnancy.

$8.80/mo

generic

Lacosamide

Vimpat

C-V

Anticonvulsant

Start 50 mg PO BID

Range 100–200 mg BID

$24/mo

generic

Lactulose

Enulose

under $15

Osmotic laxative

Start 15–30 mL PO daily

Range titrate to 2–3 soft stools/day

Hepatic encephalopathy: titrate to 2–3 stools daily.

$13–33/bottle

generic

Lamotrigine

Lamictal

under $15

Anticonvulsant / mood stabilizer

Start 25 mg PO daily × 2 wk → 50 mg × 2 wk → 100 → 200

Range 100–400 mg daily

Slow titration is mandatory — Stevens-Johnson. Halve the rate on valproate. Bipolar depression first line.

$6/mo

generic

Lansoprazole

Prevacid

under $15

Proton pump inhibitor

Start 15–30 mg PO daily

Range 15–30 mg daily

$8.70/mo

generic

Lasmiditan

Reyvow

C-Vbrand only

5-HT1F agonist (ditan)

Start 50–100 mg PO at onset

Range max 200 mg, 1 dose/24 h

No vasoconstriction. No driving for 8 hours after a dose.

$720/8 tabs

Latanoprost

Xalatan

under $15

Prostaglandin analog

Start 1 drop in the affected eye(s) qhs

Range nightly

Glaucoma first line. Iris darkening, lash growth, periorbital fat loss.

$11/bottle

Brand $284

Leflunomide

Arava

under $15

DMARD

Start 20 mg PO daily

Range 10–20 mg daily

Teratogen with a very long half-life — cholestyramine washout needed. Monitor LFTs.

$13.20/mo

generic

Lemborexant

Dayvigo

C-IVbrand only

Orexin antagonist

Start 5 mg PO before bed

Range 5–10 mg

$135/mo

List: ~$362/mo

Levalbuterol

Xopenex

SABA

Start 1.25 mg nebulized q6–8h; HFA 2 puffs q4–6h

Range 1.25 mg

No meaningful advantage over albuterol despite the price.

$23–59

generic

Levetiracetam

Keppra

Anticonvulsant

Start 500 mg PO BID

Range 500–1500 mg BID

Few interactions — the go-to add-on. Irritability and mood change in ~10%; pyridoxine may help.

$31/mo

generic

Levocetirizine

Xyzal

under $15

2nd-gen antihistamine

Start 5 mg PO qhs

Range 2.5–5 mg daily

$6.40 (OTC)

generic

Levofloxacin

Levaquin

under $15

Fluoroquinolone

Start 750 mg PO daily × 5 d (CAP); 500 mg daily

Range 250–750 mg daily

Same class warnings as ciprofloxacin.

$9/course

generic

Levonorgestrel (EC)

Plan B One-Step

under $15

Emergency contraception

Start 1.5 mg PO × 1 within 72 h (up to 120 h)

Range single dose

Less effective above BMI 30 — a copper IUD or ulipristal is better there.

$9–24 (OTC)

generic

Levonorgestrel IUD

Mirena, Kyleena, Liletta

brand only

Intrauterine system

Start 1 device, effective up to 8 years

Range 5–8 years

Also treats heavy menstrual bleeding and provides endometrial protection.

$1,046–1,303

List: $1,303

Levothyroxine

Synthroid, Levoxyl, Unithroid

under $15

Thyroid hormone

Start 1.6 mcg/kg/day (25–50 mcg if elderly, CAD, or subclinical)

Range 25–200 mcg daily

Fasting, 30–60 min before food; separate from calcium, iron, PPI by 4 h. Recheck TSH at 6–8 wk.

$4–10/mo

generic

Lidocaine 5% patch

Lidoderm

Topical anesthetic

Start 1–3 patches to the painful area, 12 h on / 12 h off

Range max 3 patches

Post-herpetic neuralgia, localized neuropathic pain. 4% is available OTC for $7.

$32/15 patches

generic

Lidocaine viscous 2%

Xylocaine Viscous

Topical anesthetic

Start 15 mL swish and spit q3h PRN

Range max 8 doses/day

Never in infants — seizures and cardiac arrest with swallowing. Also kills insects in the ear canal.

$15–25/bottle

generic

Linaclotide

Linzess

brand only

GC-C agonist

Start 145 mcg PO daily on an empty stomach (72 mcg for CIC)

Range 72–290 mcg daily

IBS-C and chronic idiopathic constipation. Contraindicated under 2 years (boxed warning); avoid ages 2 to <6.

$287/mo

List: ~$551/mo

Linagliptin

Tradjenta

brand only

DPP-4 inhibitor

Start 5 mg PO daily

Range 5 mg daily

No renal adjustment needed — the DPP-4 for advanced CKD. Generic approved but not marketed until ~2027.

$278/mo

List: ~$632/mo

Linezolid

Zyvox

Oxazolidinone

Start 600 mg PO BID

Range 600 mg BID

MRSA and VRE. Weak MAOI — serotonin syndrome with SSRIs. Cytopenias after 2 wk.

$47/course

generic

Liothyronine

Cytomel

Thyroid hormone (T3)

Start 5 mcg PO daily

Range 5–25 mcg daily

Not routinely recommended. Short half-life, cardiac risk.

$25/mo

generic

Liraglutide

Victoza

GLP-1 receptor agonist

Start 0.6 mg SC daily × 1 wk

Range →1.2 →1.8 mg daily

Now generic — the only daily GLP-1 with a cheap option.

$144/mo

Brand ~$716/mo

Liraglutide (weight)

Saxenda

GLP-1 receptor agonist

Start 0.6 mg SC daily

Range ↑0.6 mg weekly to 3 mg daily

$372/mo

Brand ~$1,313/mo

Lisdexamfetamine

Vyvanse

C-II

CNS stimulant prodrug

Start 30 mg PO qAM

Range 30–70 mg daily

Prodrug — lower abuse potential. Also approved for binge-eating disorder.

$60/mo

generic

Lisinopril

Zestril, Prinivil

under $15

ACE inhibitor

Start 10 mg PO daily (5 mg if elderly or volume-depleted)

Range 10–40 mg daily

Cough 10–15%. Check K+ and Cr 1–2 wk. Contraindicated in pregnancy and prior angioedema.

$5.40/mo

generic

Lisinopril-HCTZ

Zestoretic

under $15

Combination antihypertensive

Start 10/12.5 mg PO daily

Range up to 20/25

$4–8/mo

generic

Lithium carbonate

Lithobid

under $15

Mood stabilizer

Start 300 mg PO BID–TID

Range 900–1800 mg/day

Level 0.6–1.2 mEq/L, drawn 12 h post-dose. Check level, TSH, Cr q6mo. NSAIDs, ACEi, and thiazides raise the level. The only agent with anti-suicide data.

$4/mo

generic

Loperamide

Imodium

under $15

Antidiarrheal

Start 4 mg PO × 1, then 2 mg after each loose stool

Range max 16 mg/day

Never with fever, bloody stool, or suspected C. difficile or STEC. Cardiac arrest in abuse-level doses.

$5 (OTC)

generic

Loratadine

Claritin

under $15

2nd-gen antihistamine

Start 10 mg PO daily

Range 10 mg daily

Least sedating.

$6 (OTC)

generic

Lorazepam

Ativan

C-IVunder $15

Benzodiazepine

Start 0.5–1 mg PO q6–8h PRN

Range max 10 mg/day

No active metabolites — the choice in liver disease and the elderly.

$10.50/mo

generic

Losartan

Cozaar

under $15

ARB

Start 50 mg PO daily (25 mg if elderly)

Range 50–100 mg daily

Contraindicated in pregnancy — boxed fetal toxicity warning. No cough. Mild uricosuric — useful in gout + HTN.

$5.50/mo

generic

Losartan-HCTZ

Hyzaar

under $15

Combination antihypertensive

Start 50/12.5 mg PO daily

Range up to 100/25

$4–8/mo

generic

Lovastatin

Mevacor

under $15

Statin (moderate intensity)

Start 20 mg PO with evening meal

Range 10–80 mg daily

$5.70/mo

generic

Lurasidone

Latuda

Atypical antipsychotic

Start 20–40 mg PO daily with food (≥350 kcal)

Range 20–120 mg daily

Best metabolic profile. Bipolar depression indication. Now cheap as a generic.

$15.70/mo

Brand ~$1,435/mo

M

Magic mouthwash

(compounded)

Oral rinse

Start 5–10 mL swish and spit or swallow QID PRN

Range QID

Typically diphenhydramine + lidocaine + antacid ± nystatin. Mucositis and aphthous ulcers.

$25–50

generic

Magnesium oxide

Mag-Ox

under $15

Electrolyte

Start 400 mg PO daily

Range 400–800 mg daily

Diarrhea is dose-limiting; magnesium glycinate is better tolerated.

$5–10/mo

generic

Mebendazole

Emverm

Anthelmintic

Start 100 mg PO × 1, repeat in 2 wk

Range 100 mg BID × 3 d for other worms

Supply is erratic and expensive — albendazole is usually easier to get.

$158–318

generic

Meclizine

Antivert

under $15

Antihistamine / antivertigo

Start 25 mg PO q6–8h PRN

Range 25–100 mg/day

Motion sickness and acute vestibular neuritis only. Explicitly recommended AGAINST in BPPV — delays central compensation.

$8–15/mo

generic

Medroxyprogesterone

Provera

under $15

Progestin

Start 5–10 mg PO daily × 10–14 days/month

Range 2.5–10 mg daily

Endometrial protection with estrogen; withdrawal bleed induction.

$8/mo

generic

Medroxyprogesterone (injection)

Depo-Provera

under $15

Injectable progestin

Start 150 mg IM every 12–13 weeks

Range q12wk

Delayed return of fertility (up to 18 months). Reversible bone density loss.

$34/injection (~$11/mo)

generic

Mefloquine

Lariam

Antimalarial

Start 250 mg PO weekly

Range weekly

Neuropsychiatric boxed warning — rarely first choice now.

$30–60/course

generic

Melatonin

(supplement)

under $15

Chronobiotic

Start 0.5–3 mg PO 1–2 h before bed

Range 0.5–5 mg

Best for circadian shift, not primary insomnia. Lower doses often work better. Unregulated potency.

$3–11 (OTC)

generic

Meloxicam

Mobic

under $15

NSAID

Start 7.5 mg PO daily

Range 7.5–15 mg daily

Once-daily, partially COX-2 selective. Slower onset — not ideal for acute pain.

$5.40–10/mo

generic

Memantine

Namenda

under $15

NMDA antagonist

Start 5 mg PO daily, ↑5 mg weekly

Range 10 mg BID

Moderate to severe Alzheimer's. Often combined with donepezil.

$11.40/mo

generic

Mesalamine

Lialda, Asacol HD, Pentasa

5-ASA anti-inflammatory

Start 1.2–2.4 g PO daily

Range 2.4–4.8 g daily

Mild to moderate ulcerative colitis. Monitor renal function.

$46/mo

generic

Metaxalone

Skelaxin

Muscle relaxant

Start 800 mg PO TID–QID

Range 800 mg TID–QID

Least sedating but pricier. Avoid in hepatic disease.

$20/mo

generic

Metformin ER

Glucophage XR, Fortamet

under $15

Biguanide

Start 500 mg PO with the evening meal

Range 500–2000 mg daily

Better GI tolerance than IR. Ghost tablet in stool is normal.

$11.70/mo

generic

Metformin IR

Glucophage

under $15

Biguanide

Start 500 mg PO BID with meals

Range ↑500 mg weekly to 2000 mg/day (max 2550)

Contraindicated eGFR <30; don't start 30–45. GI upset — take with food, or use ER. Check B12 periodically.

$7/mo

generic

Methadone

Dolophine

C-II

Long-acting opioid

Start 2.5 mg PO q8h (pain, opioid-tolerant only)

Range titrate very slowly

QT prolongation and unpredictable long half-life — deaths cluster in the first 2 weeks. Specialist use.

$21/mo

generic

Methenamine hippurate

Hiprex

Urinary antiseptic

Start 1 g PO BID

Range 1 g BID

Non-antibiotic recurrent UTI prevention — as effective as prophylactic antibiotics in the ALTAR trial. Needs acidic urine.

$25–50/mo

generic

Methimazole

Tapazole

under $15

Antithyroid

Start 10–20 mg PO daily

Range 5–40 mg daily

First line for hyperthyroidism except first-trimester pregnancy. Agranulocytosis — check CBC if febrile/sore throat.

$4–30/mo

generic

Methocarbamol

Robaxin

under $15

Muscle relaxant

Start 1500 mg PO QID × 2–3 d, then 750–1500 mg QID

Range up to 8 g/day acutely

Least sedating of the class; reasonable choice in the elderly. Urine may turn brown.

$3.80/mo

generic

Methotrexate

Trexall, Otrexup

under $15

Antimetabolite DMARD

Start 7.5–15 mg PO ONCE WEEKLY

Range up to 25 mg weekly

WEEKLY, not daily — daily dosing is lethal. Folic acid 1 mg daily. Monitor CBC, LFTs, Cr q8–12 wk. Teratogen.

$9–30/mo

generic

Methyldopa

Aldomet

Central alpha-2 agonist

Start 250 mg PO BID

Range 250–1000 mg BID

Mostly reserved for pregnancy now. Hemolytic anemia, hepatitis.

$97/mo

generic

Methylphenidate ER

Concerta, Ritalin LA

C-II

CNS stimulant

Start 18 mg PO qAM

Range 18–72 mg daily

OROS shell appears in stool — normal.

$36.70/mo

generic

Methylphenidate IR

Ritalin

C-II

CNS stimulant

Start 5 mg PO BID before meals

Range 5–20 mg BID–TID

Check baseline HR, BP, height/weight, cardiac and substance history. Monitor growth in children.

$25/mo

generic

Methylprednisolone

Medrol Dosepak

under $15

Systemic corticosteroid

Start 21-tablet dose pack: 24 mg day 1, tapering over 6 days

Range 4–48 mg/day

Convenient but a short taper; often underdosed for a real asthma exacerbation.

$11/pack

generic

Metoclopramide

Reglan

under $15

Prokinetic / antiemetic

Start 5–10 mg PO QID before meals and qhs

Range max 12 weeks total

Tardive dyskinesia boxed warning — hard 12-week limit.

$4–9/mo

generic

Metolazone

Zaroxolyn

under $15

Thiazide-like diuretic

Start 2.5 mg PO daily

Range 2.5–10 mg daily

Give 30 min before the loop for sequential nephron blockade. Potent — watch K+.

$7.85/mo

generic

Metoprolol succinate ER

Toprol-XL

under $15

Beta-1 selective blocker

Start 25 mg PO daily (12.5 mg in HF)

Range 25–200 mg in HF; up to 400 mg/day for HTN

The HFrEF-proven metoprolol. Titrate slowly, double q2 wk.

$5.50/mo

generic

Metoprolol tartrate

Lopressor

under $15

Beta-1 selective blocker

Start 25–50 mg PO BID

Range up to 200 mg BID

BID dosing. Post-MI and rate control. Not the HF agent.

$5.90/mo

generic

Metronidazole

Flagyl

under $15

Nitroimidazole

Start 500 mg PO TID (BV and trichomoniasis in women: 500 mg BID × 7 d; trich in men: 2 g × 1)

Range 250–750 mg TID

Metallic taste. Disulfiram reaction with alcohol is largely myth but still counseled.

$6–8/course

generic

Metronidazole (vaginal)

MetroGel-Vaginal

Vaginal antimicrobial

Start 0.75% gel 1 applicator intravaginally qhs × 5 days

Range 5 days

Bacterial vaginosis alternative to oral.

$24–34

generic

Mexiletine

Mexitil

Class IB antiarrhythmic

Start 150–200 mg PO TID

Range up to 300 mg TID

$23.50/mo

generic

Midodrine

ProAmatine

Alpha-1 agonist

Start 2.5–5 mg PO TID

Range up to 10 mg TID

Orthostatic hypotension. Never within 4 h of bedtime — supine hypertension.

$15–30/mo

generic

Minocycline

Minocin

under $15

Tetracycline

Start 100 mg PO BID

Range 50–100 mg BID

Vestibular side effects, blue-grey pigmentation with long use.

$14/course

generic

Minoxidil (oral)

Loniten

under $15

Direct vasodilator

Start 2.5–5 mg PO daily

Range up to 40 mg/day

Refractory HTN only. Requires a beta blocker and a loop diuretic. Hypertrichosis.

$6.65/mo

generic

Minoxidil (topical)

Rogaine

under $15

Topical vasodilator

Start 5% foam applied daily–BID to the scalp

Range daily–BID

Shedding in the first 4–8 weeks is expected. Must continue indefinitely.

$10 (OTC)

generic

Mirabegron

Myrbetriq

Beta-3 agonist

Start 25 mg PO daily

Range 25–50 mg daily

No anticholinergic burden — preferred in the elderly. Can raise BP; check it.

$121/mo

Brand ~$452/mo

Mirtazapine

Remeron

under $15

Tetracyclic antidepressant

Start 15 mg PO qhs

Range 15–45 mg qhs

Sedating and appetite-stimulating at low dose — useful in cachectic or insomniac elderly. Less sedating as the dose rises.

$4.50/mo

generic

Modafinil

Provigil

C-IV

Wakefulness agent

Start 200 mg PO qAM

Range 100–400 mg daily

Narcolepsy, OSA residual sleepiness, shift work. Reduces OCP efficacy.

$30–50/mo

generic

Molnupiravir

Lagevrio

brand only

Nucleoside analog

Start 800 mg PO BID × 5 d

Range fixed

Last-line COVID antiviral. Not in pregnancy; contraception during and 3 months after.

~$1,030/course

Mometasone (inhaled)

Asmanex

brand only

Inhaled corticosteroid

Start 220 mcg 1 inhalation daily–BID

Range low 110–220 mcg/day

$44–173/inhaler

Mometasone (nasal)

Nasonex

under $15

Intranasal corticosteroid

Start 2 sprays each nostril daily

Range daily

$14–22 (OTC)

generic

Montelukast

Singulair

under $15

Leukotriene antagonist

Start 10 mg PO qhs (adults); 5 mg chewable 6–14 yr

Range 10 mg daily

Boxed warning for neuropsychiatric events — counsel and document. Second line to ICS.

$5.80/mo

generic

Morphine sulfate ER

MS Contin

C-II

Long-acting opioid

Start 15 mg PO q12h

Range titrate

Never for opioid-naive patients or acute pain. Renally cleared — accumulates in CKD.

$18.60/mo

generic

Moxifloxacin

Avelox

Fluoroquinolone

Start 400 mg PO daily

Range 400 mg daily

No renal adjustment, but poor urinary levels — not for UTI. Most QT prolongation of the class.

$20/course

generic

Moxifloxacin (ophthalmic)

Vigamox

Ophthalmic fluoroquinolone

Start 1 drop TID × 7 d

Range TID

Required for contact lens wearers — covers Pseudomonas.

$21/3 mL

generic

Mupirocin (topical)

Bactroban

under $15

Topical antibacterial

Start 2% ointment applied TID × 5 d

Range TID

Impetigo, MRSA nasal decolonization (BID × 5 d intranasal).

$8–10/tube

generic

N

Nabumetone

Relafen

NSAID

Start 500–1000 mg PO daily

Range up to 2000 mg/day

$15–33/mo

generic

Naloxone (nasal)

Narcan

Opioid antagonist

Start 4 mg intranasal, repeat q2–3 min PRN

Range repeat as needed

OTC. Co-prescribe with any opioid at ≥50 MME/day, or with benzodiazepine co-use or OUD history.

$43/2-pack

generic

Naltrexone

ReVia, Vivitrol

Opioid antagonist

Start 50 mg PO daily; 380 mg IM monthly

Range 50 mg daily

Alcohol and opioid use disorder. Must be opioid-free 7–10 days first. Check LFTs.

$32/mo

generic

Naltrexone-bupropion ER

Contrave

brand only

Combination anorectic

Start 8/90 mg 1 tab qAM wk 1

Range wk2 1 BID; wk3 2 AM/1 PM; wk4+ 2 BID

Contraindicated in uncontrolled HTN, seizure, eating disorder, chronic opioid use, MAOI within 14 d.

$99–199/mo

List: $619/mo

Naproxen

Naprosyn, Aleve

under $15

NSAID

Start 500 mg PO BID with food

Range max 1000–1500 mg/day

Lowest CV risk of the NSAIDs; preferred with CV disease. Avoid the EC and Na-ER forms (7–30x the price).

$5–29/mo

generic

Naratriptan

Amerge

Triptan

Start 2.5 mg PO at onset

Range max 5 mg/day

Slower onset, longer duration — good for prolonged or menstrual migraine.

$22/9 tabs

generic

Nebivolol

Bystolic

under $15

Beta-1 selective + NO

Start 5 mg PO daily

Range 5–40 mg daily

Best side-effect profile; less fatigue and sexual dysfunction.

$6.25/mo

generic

Niacin ER

Niaspan

under $15

Nicotinic acid

Start 500 mg PO qhs

Range 500–2000 mg qhs

No longer recommended for CV risk reduction. Flushing — pretreat with aspirin.

$7.60/mo

generic

Nicardipine

Cardene

Dihydropyridine CCB

Start 20 mg PO TID

Range 20–40 mg TID

TID dosing; rarely used PO outpatient.

$82/mo

generic

Nicotine replacement

NicoDerm CQ, Nicorette

under $15

Nicotine replacement

Start Patch 21 mg/24 h if >10 cigs/day; gum 2–4 mg q1–2h

Range taper over 8–10 wk

Combine patch + short-acting for best results. Available OTC.

$8–13 (OTC)

generic

Nifedipine ER

Procardia XL, Adalat CC

under $15

Dihydropyridine CCB

Start 30 mg PO daily

Range 30–90 mg daily

ER only — never IR for HTN. Preferred in pregnancy.

$7.35/mo

generic

Nirmatrelvir-ritonavir

Paxlovid

brand only

Protease inhibitor combination

Start 300/100 mg PO BID × 5 d, within 5 days of onset

Range see renal notes

eGFR 30–<60 → 150/100 BID. eGFR <30 → 300/100 day 1 then 150/100 daily. Screen every med — dozens of contraindications.

~$1,469/course

WAC ~$1,390

Nitrofurantoin

Macrobid, Macrodantin

under $15

Urinary antibacterial

Start 100 mg PO BID × 5 d

Range 100 mg BID

Cystitis only — no renal parenchymal levels, so never for pyelonephritis. Avoid if CrCl <30. Take with food.

$7–8/course

generic

Nitrofurantoin macrocrystals

Macrodantin

under $15

Urinary antibacterial

Start 50–100 mg PO QID

Range QID

Macrobid (mono/macro) BID is the usual choice — this form is QID.

$6.50/course

generic

Nitrofurantoin (prophylaxis)

Macrobid

under $15

Urinary antibacterial

Start 50–100 mg PO qhs

Range nightly

Recurrent UTI prophylaxis. Pulmonary fibrosis and hepatotoxicity with long-term use — reassess every 6 months.

$7–10/mo

generic

Nitroglycerin SL

Nitrostat

under $15

Nitrate

Start 0.4 mg SL q5min × 3 PRN

Range 0.3–0.6 mg per dose

Call 911 if no relief after the first tablet. Never with PDE5 inhibitor within 24–48 h. Pump spray is ~$55–200 — a reasonable alternative if tablets are hard to handle.

$12/bottle

generic

Norethindrone (POP)

Camila, Ortho Micronor, Errin

under $15

Progestin-only contraceptive

Start 0.35 mg PO daily, same time every day

Range continuous

3-hour window — much stricter than combined pills. Safe while breastfeeding and with migraine with aura.

$5–19/pack

generic

Norgestrel

Opill

Progestin-only contraceptive (OTC)

Start 0.075 mg PO daily, same time every day

Range continuous

The first OTC oral contraceptive — no prescription, no exam, no age restriction. Same 3-hour window as other progestin-only pills.

$20/mo (OTC)

generic

Nortriptyline

Pamelor

under $15

Tricyclic antidepressant

Start 10–25 mg PO qhs

Range 25–150 mg daily

Better tolerated than amitriptyline. Therapeutic level 50–150 ng/mL.

$4/mo

generic

NPH insulin

Humulin N, Novolin N, ReliOn N

Intermediate insulin

Start 0.1–0.2 units/kg SC BID

Range titrate

Cheapest insulin in America — no prescription needed at Walmart. Peaks at 4–8 h; hypoglycemia risk.

$25/vial (ReliOn, OTC)

generic

Nystatin

Mycostatin

under $15

Polyene antifungal

Start Oral suspension 500,000 units swish/swallow QID; cream BID

Range QID

Oral thrush; not absorbed systemically.

$7–8

generic

O

Ofloxacin otic

Floxin Otic

Otic fluoroquinolone

Start 10 drops in the affected ear daily × 7 d

Range daily

The only otic FDA-labeled for a perforated TM — use when integrity is uncertain.

$18–31/bottle

generic

Olanzapine

Zyprexa

Atypical antipsychotic

Start 5–10 mg PO qhs

Range 5–20 mg daily

Most effective for many but the worst metabolic profile.

$29.45/mo

generic

Olmesartan

Benicar

under $15

ARB

Start 20 mg PO daily

Range 20–40 mg daily

Contraindicated in pregnancy. Rare sprue-like enteropathy with chronic use.

$6.30/mo

generic

Olopatadine

Pataday, Patanol

under $15

Ophthalmic antihistamine

Start 1 drop daily (0.7%) or BID (0.1%)

Range daily–BID

Allergic conjunctivitis first line.

$10–16 (OTC)

generic

Omeprazole

Prilosec

under $15

Proton pump inhibitor

Start 20 mg PO daily 30–60 min before breakfast

Range 20–40 mg daily

8-week course, then reassess. Long-term: B12, magnesium, C. difficile, fracture risk. Write the capsule, not the Mg tablet.

$6–8/mo

generic

OnabotulinumtoxinA

Botox

brand only

Neurotoxin

Start 155 units IM across 31 sites q12 weeks

Range 155–195 units

Chronic migraine only (≥15 headache days/month).

varies

Ondansetron

Zofran ODT

under $15

5-HT3 antagonist

Start 4 mg PO/ODT q8h PRN

Range 4–8 mg q8h

QT prolongation at high doses. Constipation. ODT for active vomiting.

$6–18/mo

generic

Ondansetron (pediatric)

Zofran ODT

under $15

5-HT3 antagonist

Start 2 mg (8–15 kg), 4 mg (15–30 kg), 8 mg (>30 kg) PO × 1

Range q8h PRN

Single dose in gastroenteritis improves oral rehydration success.

$6–18

generic

Oral rehydration solution

Pedialyte

under $15

Electrolyte replacement

Start As tolerated, small frequent volumes

Range ad lib

The treatment for gastroenteritis. 5 mL every 1–2 minutes in children who are vomiting.

$6 (OTC)

generic

Orforglipron

Foundayo

brand only

Oral non-peptide GLP-1 RA

Start 0.8 mg PO daily

Range →2.5 →5.5 →9 →14.5 →17.2 mg, ≥30 d each

No food, water, or timing restrictions — the adherence advantage. Restart lower if ≥7 doses missed.

$149/mo self-pay

List: $649/mo

Oseltamivir

Tamiflu

Neuraminidase inhibitor

Start 75 mg PO BID × 5 d

Range 75 mg BID

Best within 48 h but treat later if high-risk or severe. Renal-adjust if CrCl <60. Prophylaxis 75 mg daily × 7 d.

$20/course

generic

Oxcarbazepine

Trileptal

under $15

Anticonvulsant

Start 300 mg PO BID

Range 600–2400 mg/day

Fewer interactions than carbamazepine, but more hyponatremia.

$9/mo

generic

Oxybutynin

Ditropan XL

under $15

Antimuscarinic

Start 5 mg PO BID–TID (ER 5–10 mg daily)

Range 5–30 mg/day

Highest anticholinergic burden — avoid in the elderly and in dementia. Beers-list.

$5–20/mo

generic

Oxycodone IR

Roxicodone

C-IIunder $15

Opioid

Start 5 mg PO q4–6h PRN

Range titrate

5 mg oxycodone ≈ 7.5 MME. CURES check required.

$14.30/mo

generic

Oxycodone-acetaminophen

Percocet

C-II

Opioid combination

Start 5/325 mg PO q6h PRN

Range limited by acetaminophen

$27/mo

generic

Oxymetazoline (nasal)

Afrin

under $15

Topical decongestant

Start 2 sprays each nostril BID

Range maximum 3 days

Hard 3-day limit — rhinitis medicamentosa. Useful as an epistaxis vasoconstrictor.

$6 (OTC)

generic

P

Paliperidone ER

Invega

Atypical antipsychotic

Start 6 mg PO qAM

Range 3–12 mg daily

$32.50/mo

generic

Pancrelipase

Creon, Zenpep

brand only

Pancreatic enzymes

Start 500 lipase units/kg per meal (start 25,000–40,000 per meal)

Range titrate to stool

Take with the first bite. Half the dose with snacks.

$860–1,278/mo

Pantoprazole

Protonix

under $15

Proton pump inhibitor

Start 40 mg PO daily

Range 40 mg daily–BID

Fewest CYP2C19 interactions — the PPI to use with clopidogrel.

$6–10/mo

generic

Paroxetine

Paxil

under $15

SSRI

Start 20 mg PO daily

Range 20–50 mg daily

Most anticholinergic and most weight gain; worst discontinuation syndrome. Avoid with tamoxifen.

$10/mo

generic

Penicillin VK

Veetids

under $15

Natural penicillin

Start 500 mg PO BID × 10 d (strep pharyngitis)

Range 250–500 mg QID

GAS has never been reported resistant to penicillin.

$9/course

generic

Permethrin 1%

Nix

under $15

Pediculicide

Start Apply to damp hair 10 min, repeat in 9 days

Range two applications

Head lice. Resistance is common — consider ivermectin lotion or spinosad.

$12 (OTC)

generic

Permethrin 5%

Elimite

Topical scabicide

Start Apply neck-down, leave 8–14 h, repeat in 1 wk

Range one application

First line for scabies. Treat all household contacts simultaneously; wash bedding in hot water.

$31/tube

generic

Phenazopyridine

Pyridium, Azo

under $15

Urinary analgesic

Start 200 mg PO TID after meals × 2 days

Range max 2 days

Turns urine orange and stains contact lenses. Does not treat the infection.

$8–29 (OTC)

generic

Phentermine

Adipex-P, Lomaira

C-IVunder $15

Sympathomimetic anorectic

Start 37.5 mg PO qAM (or 15–30 mg)

Range up to 37.5 mg/day

Avoid evening dosing. Contraindicated in CVD, hyperthyroidism, glaucoma, substance use history, pregnancy.

$10–16/mo

generic

Phentermine-topiramate ER

Qsymia

C-IV

Combination anorectic

Start 3.75/23 mg PO qAM × 14 d

Range →7.5/46; if <3% loss at 12 wk →11.25/69 ×14 d →15/92

Stop if <5% loss at 12 wk on 15/92. Taper before stopping (seizure risk). Teratogen — contraception + pregnancy testing.

$75–98/mo

List: $205–227/mo

Phenytoin

Dilantin

Anticonvulsant

Start 300 mg PO daily

Range level 10–20 mcg/mL (free 1–2)

Zero-order kinetics — small dose changes cause big level changes. Gingival hyperplasia, hirsutism. Correct for albumin.

$20/mo

generic

Pioglitazone

Actos

under $15

Thiazolidinedione

Start 15 mg PO daily

Range 15–45 mg daily

Fluid retention and HF — contraindicated in NYHA III/IV. Fracture risk in women. Helps MASH.

$9.30/mo

generic

Piroxicam

Feldene

NSAID

Start 20 mg PO daily

Range 20 mg daily

Long half-life; highest GI risk. Avoid in the elderly.

$16/mo

generic

Pitavastatin

Livalo

Statin (moderate intensity)

Start 2 mg PO daily

Range 1–4 mg daily

Minimal drug interactions; niche use.

$20/mo

generic

Podofilox 0.5%

Condylox

Antimitotic

Start Apply BID × 3 days, then 4 days off; repeat up to 4 cycles

Range 4 cycles

Patient-applied for external genital warts. Not in pregnancy.

$40–80

generic

Polyethylene glycol 3350

Miralax

Osmotic laxative

Start 17 g PO in 8 oz liquid daily

Range 17 g daily–BID

First-line for chronic constipation — safe long term, including in pregnancy and children.

$16 (OTC)

generic

Polyethylene glycol (pediatric)

Miralax

Osmotic laxative

Start 0.4–0.8 g/kg PO daily (disimpaction 1–1.5 g/kg/day × 3–6 d)

Range titrate

Safe long term. Most pediatric constipation needs months of maintenance.

$16 (OTC)

generic

Polymyxin B-trimethoprim

Polytrim

Ophthalmic antibiotic

Start 1–2 drops q3–6h × 5–7 d

Range QID

$84/10 mL

generic

Potassium chloride

Klor-Con, K-Tab

under $15

Electrolyte

Start 20 mEq PO daily

Range 10–40 mEq daily–BID

Check K+ and Cr. Avoid with ACEi/ARB/spironolactone without monitoring.

$8–15/mo

generic

Potassium citrate

Urocit-K

Alkalinizing agent

Start 10 mEq PO TID with meals

Range 10–20 mEq TID

Uric acid and calcium oxalate stone prevention. Target urine pH 6.0–7.0.

$20–27/mo

generic

Pramipexole

Mirapex

under $15

Dopamine agonist

Start 0.125 mg PO qhs (RLS)

Range 0.125–0.5 mg (RLS)

Same impulse-control counseling as ropinirole.

$13.50/mo

generic

Prasugrel

Effient

under $15

P2Y12 inhibitor

Start 10 mg PO daily (60 mg load)

Range 5–10 mg daily

Contraindicated with prior stroke/TIA; avoid if ≥75 yr or <60 kg.

$8.50/mo

generic

Pravastatin

Pravachol

under $15

Statin (moderate intensity)

Start 40 mg PO daily

Range 10–80 mg daily

Not CYP3A4 metabolized — best choice with HIV protease inhibitors or transplant meds.

$5.85/mo

generic

Prazosin

Minipress

under $15

Alpha-1 blocker

Start 1 mg PO qhs

Range 1–15 mg/day divided

Off-label for PTSD nightmares: 1 mg qhs → 2–15 mg.

$14.70/mo

generic

Prednisolone

Orapred, Prelone

under $15

Systemic corticosteroid

Start 1–2 mg/kg/day (peds); 5–60 mg (adult)

Range varies

Preferred pediatric form (15 mg/5 mL solution — the 10 mg/5 mL costs 6x more).

$7/mo

generic

Prednisolone acetate ophthalmic

Pred Forte

Ophthalmic corticosteroid

Start 1 drop QID

Range varies

Never start without slit-lamp exam — worsens herpes keratitis and raises IOP. Ophthalmology should direct.

$25–41/bottle

generic

Prednisone

Deltasone, Rayos

under $15

Systemic corticosteroid

Start varies: 40–60 mg daily (asthma/COPD, 5 d), 5–10 mg daily (RA), 40 mg (gout)

Range 1–60 mg daily

No taper needed for courses under 3 weeks. Take in the morning. Watch glucose, BP, mood.

$10/mo

generic

Pregabalin

Lyrica

C-Vunder $15

Gabapentinoid

Start 75 mg PO BID

Range →150 mg BID; max 300 mg/day for DPN, 600 for PHN

Faster titration and more predictable kinetics than gabapentin. Edema, weight gain.

$9.50/mo

generic

Prenatal vitamin

(various)

under $15

Vitamin/mineral supplement

Start 1 tab PO daily

Range daily

Look for at least 400 mcg folic acid, 27 mg iron, and iodine.

$10–32/mo

generic

Probenecid

Benemid

Uricosuric

Start 250 mg PO BID × 1 wk, then 500 mg BID

Range up to 2 g/day

Requires good renal function (CrCl >50) and adequate hydration. Not with a history of stones.

$46/mo

generic

Progesterone (micronized)

Prometrium

Progestin

Start 200 mg PO qhs × 12 days/month

Range 100–200 mg daily

Peanut oil capsule. Sedating — give at bedtime.

$15–20/mo

generic

Promethazine

Phenergan

under $15

Phenothiazine antiemetic

Start 12.5–25 mg PO q6h PRN

Range 25 mg q6h

Never IV peripherally — tissue necrosis. Contraindicated under 2 years. Very sedating.

$7.90/mo

generic

Propafenone

Rythmol

under $15

Class IC antiarrhythmic

Start 150 mg PO TID

Range 150–300 mg TID

Same structural-heart-disease restriction as flecainide.

$11.40/mo

generic

Propranolol

Inderal

under $15

Non-selective beta blocker

Start 20 mg PO BID–TID (LA: 60–80 mg daily)

Range up to 320 mg/day

Also for essential tremor, performance anxiety, migraine prophylaxis, thyroid storm.

$7.80/mo

generic

Propylthiouracil

PTU

Antithyroid

Start 100 mg PO TID

Range 100–300 mg TID

First-trimester pregnancy and thyroid storm only — hepatotoxicity boxed warning.

$27/mo

generic

Pseudoephedrine

Sudafed

under $15

Decongestant

Start 60 mg PO q4–6h; 120 mg ER q12h; 240 mg ER q24h

Range max 240 mg/day

Behind the counter; photo ID required. Raises BP — caution in HTN, and avoid with MAOIs.

$8–15 (OTC-BTC)

generic

Pyrazinamide

PZA

Antimycobacterial

Start 20–25 mg/kg PO daily

Range weight-based

Hyperuricemia, hepatotoxicity.

$173/course

generic

Pyridostigmine

Mestinon

Cholinesterase inhibitor

Start 30–60 mg PO TID

Range up to 120 mg q3–4h

Myasthenia gravis symptomatic control.

$30–60/mo

generic

Q

Quetiapine

Seroquel

under $15

Atypical antipsychotic

Start 25 mg PO qhs (insomnia/adjunct); 50 mg BID (psychosis)

Range 50–800 mg daily

Very sedating at low dose. Metabolic monitoring — weight, lipids, A1c at baseline, 3 mo, then annually.

$4.20/mo

generic

R

Raloxifene

Evista

SERM

Start 60 mg PO daily

Range 60 mg daily

Also reduces breast cancer risk. VTE risk; worsens hot flashes.

$20–37/mo

generic

Ramelteon

Rozerem

Melatonin receptor agonist

Start 8 mg PO 30 min before bed

Range 8 mg

No abuse potential, no schedule. Modest efficacy for sleep-onset insomnia.

$32.50/mo

generic

Ramipril

Altace

under $15

ACE inhibitor

Start 2.5 mg PO daily

Range 2.5–20 mg daily

Contraindicated in pregnancy. HOPE-trial agent; good post-MI/high CV risk data.

$5.80/mo

generic

Ranolazine ER

Ranexa

under $15

Anti-anginal

Start 500 mg PO BID

Range 500–1000 mg BID

Chronic angina add-on. No effect on HR or BP. QT prolongation.

$11.80/mo

generic

Regular insulin

Humulin R, Novolin R, ReliOn R

Short-acting insulin

Start dose with meals, 30 min before

Range carb-ratio dosed

OTC. The budget option when rapid analogs aren't affordable.

$25/vial (ReliOn, OTC)

generic

Repaglinide

Prandin

Meglitinide

Start 0.5–1 mg PO before each meal

Range 0.5–4 mg per meal

Skip the dose if the meal is skipped. Useful in CKD.

$38–48/mo

generic

Rifampin

Rifadin

Rifamycin

Start 600 mg PO daily

Range 300–600 mg daily

Orange body fluids (stains contact lenses). Potent CYP inducer — wrecks OCPs, warfarin, DOACs, statins.

$26/mo

generic

Rifaximin

Xifaxan

brand only

Non-absorbed antibiotic

Start 550 mg PO BID (hepatic encephalopathy); 200 mg TID × 3 d (traveler's diarrhea)

Range varies

Also 550 mg TID × 14 d for IBS-D. Cost is prohibitive without coverage.

$2,352–3,949

List: ~$3,949

Rifaximin (traveler's diarrhea)

Xifaxan

brand only

Non-absorbed antibiotic

Start 200 mg PO TID × 3 days

Range 3 days

Watery, non-febrile diarrhea only — never for dysentery or fever.

$300+/course

Riluzole

Rilutek

Glutamate modulator

Start 50 mg PO BID

Range 50 mg BID

ALS — extends survival ~3 months. Monitor LFTs.

$36/mo

generic

Rimegepant

Nurtec ODT

brand only

CGRP antagonist (gepant)

Start 75 mg ODT at onset

Range max 1 dose/24 h (or q other day for prevention)

The only agent approved for both acute treatment and prevention.

$480/8 tabs

List: ~$1,058/8

Risedronate

Actonel, Atelvia

Bisphosphonate

Start 35 mg PO weekly

Range 35 mg weekly or 150 mg monthly

$41.50/mo

generic

Risperidone

Risperdal

Atypical antipsychotic

Start 0.5–1 mg PO BID

Range 1–6 mg/day

Most EPS and hyperprolactinemia of the atypicals.

$17–29/mo

generic

Rivaroxaban

Xarelto

DOAC (factor Xa)

Start 20 mg PO daily with the evening meal (15 mg if CrCl 15–50)

Range 15–20 mg daily

Generic since 2025. Must be taken with food for absorption. The rational cash-pay DOAC.

$30/mo

Brand ~$600/mo

Rivastigmine

Exelon

Cholinesterase inhibitor

Start Patch 4.6 mg/24 h daily; capsule 1.5 mg BID

Range up to 13.3 mg/24 h patch

Patch reduces GI effects. Also for Parkinson's dementia.

$43/mo

generic

Rizatriptan

Maxalt MLT

under $15

Triptan

Start 10 mg PO/ODT at onset

Range max 30 mg/day

Highest 2-hour pain-free rate. Use 5 mg with propranolol.

$9.75/9 tabs

generic

Roflumilast

Daliresp

PDE4 inhibitor

Start 250 mcg PO daily × 4 wk, then 500 mcg

Range 500 mcg daily

Severe COPD with chronic bronchitis and exacerbations. Weight loss, diarrhea, psychiatric effects.

$31/mo

generic

Ropinirole

Requip

under $15

Dopamine agonist

Start 0.25 mg PO qhs (RLS) or TID (PD)

Range 0.25–4 mg (RLS); up to 24 mg (PD)

Impulse-control disorders — ask directly about gambling and shopping. Augmentation in RLS.

$6/mo

generic

Rosuvastatin

Crestor

under $15

Statin (high intensity ≥20 mg)

Start 5–10 mg daily (20–40 for high intensity)

Range 5–40 mg daily

Most potent per mg. Lower dose in Asian patients.

$5.65/mo

generic

S

Sacubitril-valsartan

Entresto

ARNI (HF)

Start 24/26 mg PO BID (49/51 if already on high-dose ACEi/ARB)

Range up to 97/103 mg BID

Contraindicated in pregnancy. Wash out ACEi 36 h before starting. HFrEF first line over ACEi/ARB.

$28–35/mo (generic)

Brand ~$700/mo

Saxagliptin

Onglyza

DPP-4 inhibitor

Start 2.5–5 mg PO daily

Range 2.5–5 mg daily

$41/mo

generic

Scopolamine patch

Transderm Scop

Anticholinergic

Start 1.5 mg patch behind the ear q72h

Range 1 patch q3 days

Apply 4 h before travel. Wash hands — mydriasis if it reaches the eye.

$30–60/patch

generic

Selenium sulfide

Selsun

under $15

Topical antifungal

Start 2.5% lotion applied 10 min daily × 7 d

Range daily then weekly

Tinea versicolor.

$12/bottle

generic

Semaglutide (injectable)

Ozempic

brand only

GLP-1 receptor agonist

Start 0.25 mg SC weekly × 4 wk

Range →0.5 →1 →2 mg, ≥4 wk apart

Boxed warning: thyroid C-cell tumors — no personal/family MTC or MEN2. NovoCare self-pay pricing.

$149–199/mo direct

WAC $1,028/mo

Semaglutide (oral, T2DM)

Rybelsus

brand only

GLP-1 receptor agonist

Start 3 mg PO daily × 30 d

Range →7 mg → 14 mg

Take on waking with ≤4 oz plain water; nothing else for 30 min.

$149–299/mo direct

List: ~$1,028/mo

Semaglutide (oral, weight)

Wegovy tablets

brand only

GLP-1 receptor agonist

Start 1.5 mg PO daily × 30 d

Range →4 mg × 30 d → 9 mg × 30 d → 25 mg maintenance

Strict administration: on waking, ≤4 oz plain water, nothing for 30 min.

$149–299/mo direct

Semaglutide (weight)

Wegovy

brand only

GLP-1 receptor agonist

Start 0.25 mg SC weekly × 4 wk

Range →0.5 →1.0 →1.7 →2.4 mg (HD 7.2 mg)

BMI ≥30, or ≥27 with a comorbidity. ~15% weight loss (21% at 7.2 mg).

$199–349/mo direct

WAC $1,349/mo

Senna

Senokot

under $15

Stimulant laxative

Start 2 tabs (17.2 mg) PO qhs

Range max 4 tabs BID

First line with opioids — pair with a softener.

$6 (OTC)

generic

Sertraline

Zoloft

under $15

SSRI

Start 50 mg PO daily (25 mg if anxious or elderly)

Range 50–200 mg daily

Good first choice for both depression and anxiety. Allow 4–6 wk at a therapeutic dose. GI upset early, sexual dysfunction late.

$7.50/mo

generic

Sildenafil

Viagra, Revatio

under $15

PDE5 inhibitor

Start ED: 50 mg PO 1 h before activity. PAH: 20 mg TID

Range 25–100 mg PRN

Never within 24 h of any nitrate. Start 25 mg with alpha blockers or age >65.

$6–12/mo

generic

Silodosin

Rapaflo

Alpha-1A blocker

Start 8 mg PO daily with a meal

Range 4–8 mg daily

Most uroselective — least orthostasis, most retrograde ejaculation.

$17–38/mo

generic

Silver sulfadiazine

Silvadene

under $15

Topical antibacterial

Start 1% cream applied daily–BID to burns

Range daily–BID

Avoid on the face and in sulfa allergy.

$14–19

generic

Simvastatin

Zocor

under $15

Statin (moderate intensity)

Start 20 mg PO qhs

Range 10–40 mg (80 mg not recommended)

Most interactions of the statins — amlodipine caps it at 20 mg, never with gemfibrozil.

$5.50/mo

generic

Sitagliptin

Januvia

DPP-4 inhibitor

Start 100 mg PO daily (50 if eGFR 30–45, 25 if <30)

Range 25–100 mg daily

Weight neutral, no hypoglycemia. Generic since 2026. Rare pancreatitis and joint pain.

$43.70/mo

Brand ~$527/mo

Sitagliptin-metformin

Janumet

Combination antidiabetic

Start 50/500 mg PO BID

Range up to 50/1000 BID

$40–60/mo

generic

Sodium bicarbonate

under $15

Alkalinizing agent

Start 650 mg PO TID

Range 650 mg–1.3 g TID

Metabolic acidosis of CKD; target bicarbonate ≥22.

$5.50/100

generic

Sodium chloride 5% (ophthalmic)

Muro 128

Hyperosmotic

Start 1 drop QID or ointment qhs

Range QID

Corneal edema, recurrent erosion.

$15–25

generic

Sodium citrate/citric acid

Bicitra, Cytra-2

Alkalinizing agent

Start 15–30 mL PO QID after meals, diluted in water

Range 15–30 mL

Contains NO potassium — the potassium-containing solution is Polycitra-K/Cytra-K. Check which one you mean in CKD or hyperkalemia risk.

$25/bottle

generic

Solifenacin

Vesicare

under $15

Antimuscarinic

Start 5 mg PO daily

Range 5–10 mg daily

$12–25/mo

generic

Sotalol

Betapace

under $15

Class III antiarrhythmic

Start 80 mg PO BID

Range 80–160 mg BID

Requires inpatient initiation with QT monitoring. Renally dosed.

$7.20/mo

generic

Spironolactone

Aldactone

under $15

Aldosterone antagonist

Start 25 mg PO daily

Range 25–100 mg daily (12.5–50 in HF)

Check K+ and Cr at 1 wk and 1 mo. Gynecomastia ~10%. Also used for acne and PCOS.

$5.90/mo

generic

Spironolactone (acne)

Aldactone

under $15

Antiandrogen

Start 50 mg PO daily

Range 50–200 mg daily

Adult female hormonal acne. Not for men (gynecomastia). Contraception advised.

$6–7.50/mo

generic

Sucralfate

Carafate

Mucosal protectant

Start 1 g PO QID on an empty stomach

Range 1 g QID

Binds other drugs — separate by 2 h. Aphthous ulcers, mucositis, bile reflux.

$27–42/mo

generic

Sulfasalazine

Azulfidine

DMARD

Start 500 mg PO BID

Range 1–3 g/day divided

Sulfa-related. Monitor CBC and LFTs. Also for IBD.

$18.70/mo

generic

Sumatriptan

Imitrex

under $15

Triptan

Start 50–100 mg PO at onset, may repeat in 2 h

Range max 200 mg/day (SC 6 mg, max 12)

Combine with naproxen 500 mg — strongest evidence. Contraindicated in CAD, stroke, uncontrolled HTN, hemiplegic migraine.

$10.40/9 tabs

generic

Sumatriptan-naproxen

Treximet

Combination migraine agent

Start 85/500 mg PO at onset

Range max 2 tabs/day

Write the two components separately for ~$13.

$72/9

generic

Suvorexant

Belsomra

C-IVbrand only

Orexin antagonist

Start 10 mg PO 30 min before bed

Range 10–20 mg

$463/mo

List: ~$474/mo

T

Tacrolimus (topical)

Protopic

Topical calcineurin inhibitor

Start 0.03–0.1% ointment BID

Range BID

Steroid-sparing for face and eyelids in atopic dermatitis. Burning on first applications.

$52–59/30 g

generic

Tadalafil

Cialis, Adcirca

under $15

PDE5 inhibitor

Start ED: 10 mg PRN, or 2.5–5 mg daily. BPH: 5 mg daily

Range 2.5–20 mg

36-hour duration means a 48-hour nitrate-free interval is required — longer than sildenafil. Daily dosing treats both ED and BPH.

$6–14/mo

generic

Tamsulosin

Flomax

under $15

Alpha-1A blocker

Start 0.4 mg PO daily 30 min after the same meal

Range 0.4–0.8 mg daily

Floppy iris syndrome — tell the ophthalmologist before cataract surgery. Retrograde ejaculation.

$5–11/mo

generic

Telmisartan

Micardis

under $15

ARB

Start 40 mg PO daily

Range 20–80 mg daily

Contraindicated in pregnancy. Longest half-life ARB — best 24 h coverage.

$6.60/mo

generic

Temazepam

Restoril

C-IVunder $15

Benzodiazepine hypnotic

Start 7.5–15 mg PO qhs

Range max 30 mg

$9.20/mo

generic

Terazosin

Hytrin

under $15

Alpha-1 blocker

Start 1 mg PO qhs

Range 1–20 mg daily

Same as doxazosin.

$7.45/mo

generic

Terbinafine (oral)

Lamisil

under $15

Allylamine antifungal

Start 250 mg PO daily

Range 250 mg daily

Onychomycosis: 6 wk fingernails, 12 wk toenails. Confirm with KOH/PAS first. Baseline LFTs.

$13.70/mo

generic

Terbinafine (topical)

Lamisil AT

under $15

Topical antifungal

Start 1% cream BID × 1–2 wk (4 wk for tinea pedis)

Range BID

$9.70/tube

generic

Terconazole

Terazol

Vaginal antifungal

Start 0.4% cream 1 applicator intravaginally qhs × 7 days

Range 7 days

For fluconazole failure or non-albicans species.

$25–40

generic

Testosterone cypionate

Depo-Testosterone

C-III

Androgen

Start 50–100 mg IM q1–2 wk (or 200 mg q2wk)

Range titrate to mid-normal trough

Check testosterone twice before starting. Monitor hematocrit, PSA, symptoms. Suppresses fertility.

$20–24/vial

generic

Testosterone gel

AndroGel, Testim

C-III

Androgen

Start 50 mg (4 pumps of 1.62%) topically daily

Range 50–100 mg daily

Transference risk to partners and children — wash hands, cover the site.

$33–53/mo

generic

Theophylline ER

Theo-24, Uniphyl

Methylxanthine

Start 300 mg PO daily

Range 300–600 mg daily

Narrow therapeutic index (5–15 mcg/mL). Largely obsolete.

$80/mo

generic

Thiamine (vitamin B1)

under $15

Water-soluble vitamin

Start 100 mg PO daily

Range 100 mg daily–TID

Alcohol use disorder — give before glucose to prevent Wernicke's.

$5–12/mo

generic

Ticagrelor

Brilinta

under $15

P2Y12 inhibitor

Start 90 mg PO BID (180 mg load)

Range 60–90 mg BID

Dyspnea ~14%. Aspirin must be ≤100 mg. Now generic and cheap.

$10.65/mo

Brand $462/mo

Timolol (ophthalmic)

Timoptic

under $15

Ophthalmic beta blocker

Start 0.5% 1 drop BID

Range BID

Systemic absorption is real — avoid in asthma, COPD, bradycardia. Punctal occlusion helps.

$9/bottle

generic

Tiotropium

Spiriva HandiHaler, Respimat

LAMA

Start 18 mcg 1 capsule daily; Respimat 2 puffs daily

Range daily

COPD mainstay; add-on in severe asthma.

$333–395/inhaler

generic

Tirzepatide (T2DM)

Mounjaro

brand only

GIP/GLP-1 receptor agonist

Start 2.5 mg SC weekly × 4 wk

Range →5 mg, ↑2.5 mg q4wk, max 15 mg

Most potent agent for both A1c and weight. LillyDirect self-pay.

$499/mo direct

WAC $1,112/mo

Tirzepatide (weight)

Zepbound

brand only

GIP/GLP-1 receptor agonist

Start 2.5 mg SC weekly × 4 wk

Range →5 mg, ↑2.5 mg q4wk, max 15 mg

~21% weight loss — beats semaglutide head to head. LillyDirect vials; refill within 45 days to hold the price.

$299–449/mo direct

WAC $1,086/mo

Tizanidine

Zanaflex

under $15

Alpha-2 agonist muscle relaxant

Start 2 mg PO qhs or TID PRN

Range 2–8 mg TID (max 36 mg/day)

Hypotension and dry mouth. Ciprofloxacin raises levels 10x — avoid the combination. Monitor LFTs.

$5.60–26/mo

generic

TMP-SMX

Bactrim DS, Septra DS

under $15

Sulfonamide

Start 1 DS tab PO BID × 3 d (cystitis) or 5–7 d (skin)

Range 1–2 DS BID

Hyperkalemia with ACEi/ARB/spironolactone; potentiates warfarin; raises Cr without hurting GFR. Avoid at term in pregnancy.

$6–8/course

generic

Tolterodine

Detrol LA

Antimuscarinic

Start 2 mg PO BID (LA 4 mg daily)

Range 1–4 mg

$22/mo

generic

Topiramate

Topamax

under $15

Anticonvulsant

Start 25 mg PO qhs × 1 wk

Range →50–100 mg/day (migraine); up to 400 mg (seizure)

Migraine prophylaxis. Cognitive slowing ('dopamax'), paresthesias, weight loss, kidney stones. Teratogen — cleft lip.

$3.60/mo

generic

Torsemide

Demadex

under $15

Loop diuretic

Start 10–20 mg PO daily

Range 10–200 mg daily

More reliable absorption than furosemide (~80–100%). 20 mg ≈ 40 mg furosemide.

$6.30/mo

generic

Tramadol

Ultram

C-IVunder $15

Weak opioid / SNRI

Start 50 mg PO q6h PRN

Range max 400 mg/day (300 if >75 yr)

Seizure risk, serotonin syndrome with SSRIs. CYP2D6-dependent — ineffective in poor metabolizers.

$7.80/mo

generic

Tranexamic acid

Lysteda

Antifibrinolytic

Start 1300 mg PO TID × 5 days during menses

Range max 5 days per cycle

Heavy menstrual bleeding. Contraindicated with active thromboembolic disease.

$27–37/cycle

generic

Trazodone

Desyrel

under $15

SARI

Start 50 mg PO qhs for insomnia

Range 25–100 mg qhs (150–400 for depression)

The default non-controlled hypnotic. Priapism is rare but a true emergency. Orthostasis.

$4.20/mo

generic

Tretinoin (topical)

Retin-A

Topical retinoid

Start 0.025% cream applied qhs to dry skin

Range 0.025–0.1%

Acne and photoaging. Pea-sized amount; expect irritation for 4–6 wk. Teratogen — contraception.

$15–29/tube

generic

Triamcinolone 0.1%

Kenalog

under $15

Medium-potency topical steroid

Start Apply thin layer BID × 2 wk

Range BID

The workhorse topical steroid. Not for the face, axilla, or groin. The 454 g jar is $14 — great value for chronic eczema.

$5–14

generic

Triamterene-HCTZ

Dyazide, Maxzide

under $15

K-sparing + thiazide

Start 37.5/25 mg PO daily

Range 1–2 tabs daily

$6.50/mo

generic

U

Ubrogepant

Ubrelvy

brand only

CGRP antagonist (gepant)

Start 50 or 100 mg PO at onset, may repeat once

Range max 200 mg/24 h

No vasoconstriction — usable when triptans are contraindicated.

$1,104/10 tabs

List: $1,121/10

Umeclidinium

Incruse Ellipta

LAMA

Start 62.5 mcg 1 inhalation daily

Range daily

$290–354/inhaler

generic

Umeclidinium-vilanterol

Anoro Ellipta

LAMA + LABA

Start 62.5/25 mcg 1 inhalation daily

Range daily

GOLD Group B COPD first line.

$398/60 doses

generic

Urea cream

Carmol, Urea 40

under $15

Keratolytic emollient

Start 20–40% applied BID

Range BID

Xerosis, keratosis pilaris, thickened nails.

$11–67

generic

Ursodiol

Actigall, Urso

Bile acid

Start PBC 13–15 mg/kg/day PO divided BID; gallstone dissolution 8–10 mg/kg/day

Range 300–1200 mg/day

PBC, gallstone dissolution, intrahepatic cholestasis of pregnancy.

$18/mo

generic

V

Vaginal estrogen

Estrace cream, Vagifem, Imvexxy

Local estrogen

Start 0.5–1 g cream intravaginally 2–3x weekly

Range 2–3x weekly

Genitourinary syndrome of menopause and recurrent UTI prevention. Minimal systemic absorption — safe in most breast cancer survivors after oncology discussion.

$30–80/mo

generic

Valacyclovir

Valtrex

under $15

Nucleoside antiviral

Start Zoster 1 g TID × 7 d; HSV first episode 1 g BID × 10 d; recurrence 500 mg BID × 3 d

Range 500 mg–1 g

Renal-adjust in the elderly: CrCl 30–49 → 1 g q12h, 10–29 → 1 g q24h, <10 → 500 mg q24h. Neurotoxicity if not adjusted.

$11–20/course

generic

Valacyclovir (suppression)

Valtrex

Nucleoside antiviral

Start 500 mg PO daily (1 g if ≥10 outbreaks/year)

Range daily

Reduces transmission to partners by ~50%.

$20/mo

generic

Valsartan

Diovan

under $15

ARB

Start 80 mg PO daily

Range 80–320 mg daily

Contraindicated in pregnancy.

$6.40/mo

generic

Vancomycin (oral)

Vancocin, Firvanq

Glycopeptide

Start 125 mg PO QID × 10 d (C. difficile)

Range 125–500 mg QID

Not absorbed — oral form is for C. difficile only.

$96/course

generic

Varenicline

Chantix

Nicotinic partial agonist

Start 0.5 mg PO daily × 3 d → 0.5 mg BID × 4 d → 1 mg BID × 12 wk

Range 1 mg BID

Most effective single agent for smoking cessation. Set a quit date 1 week in. Nausea and vivid dreams.

$189/mo

generic

Venlafaxine ER

Effexor XR

under $15

SNRI

Start 37.5–75 mg PO daily with food

Range 75–225 mg daily

Raises BP above 150 mg — check it. Severe discontinuation syndrome; taper slowly.

$12.75/mo

generic

Verapamil ER

Calan SR, Verelan

under $15

Non-DHP CCB

Start 120–180 mg PO daily

Range 120–480 mg daily

Constipation is the dose-limiting effect. Avoid in HFrEF.

$9.55/mo

generic

Vilazodone

Viibryd

SSRI/5-HT1A partial agonist

Start 10 mg PO daily × 7 d

Range →20 →40 mg with food

$42/mo

generic

Viloxazine ER

Qelbree

brand only

Selective NRI

Start 100 mg PO daily

Range 100–600 mg daily

$392/mo

List: ~$399/mo

Vitamin D (infant)

D-Vi-Sol

under $15

Fat-soluble vitamin

Start 400 IU PO daily from birth

Range 400 IU daily

All breastfed infants until they take 1 L/day of fortified formula.

$8/bottle

generic

Vortioxetine

Trintellix

brand only

Multimodal antidepressant

Start 10 mg PO daily

Range 5–20 mg daily

Cognitive symptom claims; cost rarely justifies it over generics.

$299/mo

WAC ~$490/mo

W

Warfarin

Coumadin, Jantoven

under $15

Vitamin K antagonist

Start 5 mg PO daily (2.5 mg if elderly, low BW, or on amiodarone)

Range titrate to INR

INR 2–3 for AF/VTE; 2.5–3.5 for mechanical mitral valve. The only oral option in mechanical valves and severe renal failure.

$6.25/mo

generic

Z

Zavegepant

Zavzpret

brand only

CGRP antagonist (nasal)

Start 10 mg intranasal, 1 spray one nostril

Range max 1 dose/24 h

Fastest onset — useful with vomiting.

$595/6 sprays

List: $1,170/6

Ziprasidone

Geodon

Atypical antipsychotic

Start 20 mg PO BID with food

Range 20–80 mg BID

Must be taken with ≥500 kcal for absorption. QT prolongation.

$17.50/mo

generic

Zolmitriptan

Zomig

Triptan

Start 5 mg PO or nasal at onset

Range max 10 mg/day

$15/6 tabs

generic

Zolpidem

Ambien

C-IVunder $15

Non-benzodiazepine hypnotic

Start 5 mg PO qhs (women and elderly); 10 mg (men)

Range max 10 mg

Complex sleep behaviors — boxed warning. Take only with ≥7–8 h of sleep opportunity.

$7.70/mo

generic

Zonisamide

Zonegran

under $15

Anticonvulsant

Start 100 mg PO daily

Range 100–600 mg daily

Sulfa-related. Kidney stones, weight loss, oligohidrosis.

$13.80/mo

generic