La tétracycline, connue sous le nom commercial Sumycin, agit en bloquant la fixation de l’ARNt sur la sous-unité 30S ribosomale, interrompant l’élongation de la chaîne protéique bactérienne. Ce mécanisme confère une activité sur un spectre large, incluant bactéries Gram positives, Gram négatives, rickettsies et spirochètes. Sa biodisponibilité digestive varie selon la prise alimentaire et les interactions avec les ions divalents comme calcium et magnésium. Sa diffusion tissulaire est importante, notamment dans les voies respiratoires et génito-urinaires. L’élimination se fait par voie rénale et biliaire. Les effets indésirables incluent photosensibilisation, troubles digestifs et coloration dentaire en cas d’administration précoce. Les guides thérapeutiques mentionnent sumycin prix, en soulignant la nécessité de restreindre son utilisation afin de limiter les résistances acquises.

Missionhealth.com

Doxycycline hyclate* (Vibramycin)
GENERIC DRUGS
Minocycline* (Minocin, Dynacin)
Ascension Health endorses the use of FDA Tetracycline* (Sumycin)
ANTIFUNGAL AGENTS (ORAL) ________________
encourages the prescribing and dispensing of Clotrimazole* (Mycelex)
these generic medications whenever medically Fluconazole* (Diflucan) (QL)
Itraconazole* (Sporanox)
Ketoconazole* (Nizoral)
EXCLUDED DRUGS
Nystatin* (Mycostatin)
Terbinafine* (Lamisil)(QL)
Ascension Health has excluded the following Voriconazole* (Vfend)
drugs or drug classes from coverage under the ANTI-MALARIALS ___________________________
pharmacy benefit: cosmetic products (e.g. Egrifta, Latisse, Vaniqa), cough & cold Chloroquine* (Aralen)
combinations, allergy ophthalmics (e.g. Patanol), Hydroxychloroquine* (Plaquenil)
Mefloquine* (Lariam)
sedating antihistamines (e.g. Allegra, Clarinex), Quinine* (generic)
meperidine (Demerol), Lazanda/Subsys (fentanyl ANTI-TUBERCULOSIS AGENTS ________________
Ethambutol* (Myambutol)
ASCENSION (doxycycline), Duexis (ibuprofen/famotidine), Isoniazid* (Nydrazid)
Pyrazinamide* (pyrazinamide)
combinations and over-the-counter products. Rifampin* (Rifadin)
OTHER ANTI-INFECTIVES _____________________
professional (e.g. infused or vaccines) are Clindamycin* (Cleocin)
Iodoquinol* (iodoquinol)
Metronidazole* (Flagyl)
ORMULARY
PRIOR AUTHORIZATION / STEP THERAPY /
QUANTITY LIMITS
Trimethoprim* (Proloprim)
ANTI-VIRAL AGENTS
Select drugs require prior authorization (PA) of
benefits. Medication utilization must meet FDA approved indications as well as Ascension (CONDENSED VERSION)
Abacavir/Lamivudine/Zidovudine (Trizivir) Step Therapy Protocols (ST): Step therapy
Acyclovir* (Zovirax)
requires the use of one or more medications before benefits for the use of another medication Amantadine* (Symmetrel)
Quantity Limits (QL): Ascension Health has
January 2013
identified a number of select medications which Darunavir (Prezista) Delavirdine (Rescriptor) will be subject to quantity limits. A quantity limit Didanosine* (Videx EC)
Please note: This is not a comprehensive list of prescription medication Ascension Health will cover as a benefit within a defined period of time. Efavirenz/Emtricitabine/Tenofovir (Atripla) Quantity limits may be implemented on a per day basis (e.g. 1 tablet per day), per prescription or per 30 days. Enfuvirtide (Fuzeon)(SP)
SPECIALTY DRUGS
approved generic is available, the generic Ascension Health has specified certain specialty Famciclovir* (Famvir)
name is bolded and asterisked.
drugs are to be filled only through the in-house Foscarnet* (generic)
pharmacies or from Coram. These drugs are noted in the list below with (SP).
Ganciclovir* (Cytovene)
ANTI-INFECTIVE AGENTS
ANTIBIOTICS _______________________________
copayment. Example: Cefaclor* (Ceclor)
Cephalosporins .
means that the generic Cefaclor is Cefaclor* (Ceclor)
formulary and the brand is non-formulary Cefdinir* (Omnicef)
Cefditoren* (Spectracef)
Cefadroxil* (Duracef)
Ribavirin* (Rebetol)
Cefprozil* (Cefzil)
Rimantadine* (Flumadine)
active ingredient is only available as a Cefuroxime* (Ceftin)
Cefpodoxime* (Vantin)
Example: Tiotropium (Spiriva) means Cephalexin* (Keflex)
Stavudine* (Zerit)
that the brand, Spiriva is covered and Macrolides .
there is no generic available. Spiriva is Azithromycin* (Zithromax)(QL)
Clarithromycin XL* (Biaxin XL)
Erythromycin* (Eryc, PCE)
Valacyclovir* (Valtrex)
If the word 'generic' and the brand name Erythromycin/Sulfisoxazole* (Pediazole)
both appear within the parenthesis, both Penicillins .
Zidovudine* (Retrovir)
Amoxicillin* (Amoxil)
AUTONOMIC AND
Amoxicillin/Clavulanate* (Augmentin)
CENTRAL NERVOUS SYSTEM AGENTS
Example: Phenytoin (Dilantin / generic) Ampicillin* (Principen)
means that both the brand and generic Dicloxacillin* (Pathocil)
ANALGESICS, NARCOTIC _____________________
are available. Therefore, the brand Penicillin* (Veetids)
Acetaminophen/Codeine* (Tylenol w/codeine)
Dilantin and the generic phenytoin are on Quinolones .
Aspirin/Codeine* (Empirin w/codeine)
Ciprofloxacin/XR* (Cipro/XR) (QL)
Fentanyl* (Duragesic)(QL)
Levofoxacin* (Levaquin)(QL)
Fentanyl Citrate* (Actiq, Fentora)(PA/QL)
Ofloxacin* (Floxin)
Hydrocodone/Acetaminophen* (Lortab) (QL)
formulary listing shall be considered non- Sulfonamides .
Hydromorphone* (Dilaudid)
Morphine Sulfate* (MS Contin)(QL)
Erythromycin/Sulfisoxazole* (Pediazole)
Oxycodone/Acetaminophen* (Percocet) (QL)
Sulfamethoxazole/Trimethoprim* (Bactrim)
Oxycodone/Aspirin* (Percodan)
Sulfisoxazole* (generic)
Tetracyclines .
Oxycodone* (Oxycontin)(QL)
Analgesics, Non-Narcotic .
Antipsychotic Agents .
Simvastatin* (Zocor) (80mg requires PA)
APAP/Isometheptene/Dichlphen* (Midrin)
Chlorpromazine* (Thorazine)
BETA-ADRENERGIC BLOCKERS _______________
Acetaminophen/Caffeine/Butalbital* (Fioricet)
Clomipramine* (Anafranil)
Acebutolol* (Sectral))
Aspirin/Caffeine/Butalbital* (Fiorinal)
Clozapine* (Clozaril)
Atenolol/Chlorthalidone* (Tenoretic)
Ergotamine/Caffeine* (Cafergot)
Fluphenazine* (Prolixin)
Bisoprolol/HCTZ* (Zebeta)
Naratriptan* (Amerge) (QL)
Haloperidol* (Haldol)
Carvedilol* (Coreg/CR)
Sumatriptan* (Imitrex)(QL)
Loxapine* (Loxitane)
Labetalol* (Trandate)
Tramadol* (Ultram)
Olanzapine* (Zyprexa)
Metoprolol/HCTZ* (Lopressor)(QL)
ANALGESICS, NONSTEROIDAL
Perphenazine* (Trilafon)
Metoprolol ER* (Toprol XL) (QL)
ANTI-INFLAMMATORY ________________________
Prochlorperazine* (Compazine)
Nadolol* (Corgard)
Diclofenac* (Voltaren)
Quetiapine* (Seroquel)
Pindolol* (Viskin)
Etodolac* (etodolac)
Propranolol/XL/HCTZ* (Inderal)
Fenoprofen* (Nalfon)
Risperidone* (Risperdal)
Sotalol* (Betapace)
Flurbiprofen* (Ansaid)
Thioridazine* (Mellaril)
Timolol* (Blocadren)
Ibuprofen* (Motrin)
Thiothixene* (Navane)
CALCIUM CHANNEL BLOCKERS ______________
Indomethacin* (Indocin)
Trifluoperazine* (Stelazine)
Amlodipine* (Norvasc)(QL)
Ketoprofen* (ketoprofen)
Ziprasidone* (Geodon)
Diltiazem* (Cardizem)
Ketorolac* (Toradol)
SEDATIVES, HYPNOTICS AND ANTI-ANXIETY ____
Felodipine* (Plendil)
Meloxicam* (Mobic)
Alprazolam* (Xanax)
Nicardipine* (Cardene)
Nabumetone* (nabumetone)
Buspirone* (BuSpar)
Nifedipine* (Procardia/Adalat CC)
Naproxen* (Naprosyn)
Chloral Hydrate* (Noctec)
Nimodipine* (Nimotop)
Oxaprozin* (Daypro)
Chlordiazepoxide* (Librium)
Verapamil* (Calan,Verelan)
Piroxicam* (Feldene)
Clorazepate* (generic)
CENTRALLY ACTING ANTIHYPERTENSIVES _____
Sulindac* (Clinoril)
Diazepam* (Valium)
Clonidine* (Catapres)
Tolmetin* (Tolectin)
Estazolam* (generic)
Methyldopa* (generic)
ANALGESICS, SALICYLATES __________________
Flurazepam* (flurazepam)
DIURETICS _________________________________
Aspirin* (generic)
Lorazepam* (Ativan)
Acetazolamide* (Diamox Sequels)
Chol Sal/Magnesium Salicylate* (generic)
Meprobamate* (Miltown)
Chlorthalidone* (Hygroton)
Diflunisal* (Dolobid)
Oxazepam* (Serax)
Ethacrynic Acid* (Edecrin)
Salsalate* (Disalcid)
Temazepam* (Restoril)
Eplerenone* (Inspra)
ANTICONVULSANTS _________________________
Triazolam* (Halcion)
Zalpelon* (Sonata) (QL)
Furosemide* (Lasix)
Carbamazepine* (Tegretol XR/generic)
Zolpidem* (Ambien/CR) (QL)
HCTZ/Triamterene* (Dyazide/Maxzide)
Clonazepam* (Klonopin)
Hydrochlorothiazide* (generic)
Divalproex Sodium* (Depakote
CARDIOVASCULAR AGENTS
Indapamide* (generic)
Methazolamide* (generic)
Ethosuximide* (Zarontin)
ANGIOTENSIN CONVERTING ENZYME
Metolazone* (Zaroxolyn)
Gabapentin* (Neurontin)
INHIBITORS AND RECEPTOR BLOCKERS &
Spironolactone/HCTZ* (Aldactone)
Fosphenytoin*(Cerebyx)
COMBINATIONS _____________________________
Torsemide* (Demadex)
Lamotrigine* (Lamictal)
Benazepril/HCTZ* (Lotensin)
Triamterene* (Dyrenium)
Levetiracetam* (Keppra)
Benazepril/Amlodipine* (Lotrel)(QL)
VASODILATORS ____________________________
Phenobarbital* (generic)
Captopril/HCTZ* (Capoten/Capozide)
Hydralazine* (Apresoline)
Phenytoin* (Dilantin/generic)
Enalapril/HCTZ* (Vasotec/Vaseretic)
Isosorbide Dinitrate* (Isordil)
Primidone* (Mysoline)
Fosinopril/HCTZ* (Monopril)
Isosorbide Mononitrate* (Imdur, Monoket)
Oxcarbazepine* (Trileptal)
Irbesartan/HCTZ* (Avapro/Avalide)
Minoxidil* (generic)
Topiramate* (Topamax)
Lisinopril/HCTZ* (Zestril/Zestoretic)
Nitroglycerin* (generic)
Valproic Acid* (Depakene)
Losartan/HCTZ* (Cozaar/Hyzaar) (QL)
Zonisamide* (Zonegran)
Moexipril/HCTZ* (Univasc/Uniretic)
DERMATOLOGICALS
ANTIPARKINSON AGENTS ____________________
Olmesartan (Benicar/ Benicar HCT)(ST)(QL)
ACNE _____________________________________
Amantadine* (Symmetrel)
Quinapril/HCTZ* (Accupril/Accuretic)
Clindamycin* (Cleocin)
Benztropine* (Cogentin)
Ramipril* (Altace/generic)
Erythromycin* (Emgel)
Bromocriptine* (Parlodel)
Trandolapril* (Mavik)
Isotretinoin* (Accutane)
Carbidopa/Levodopa* (Sinemet/CR)
Trandolapril/verapamil* (Tarka)
Metronidazole* (MetroLotion,MetroGel)
Pramipexole* (Mirapex)
Valsartan/HCTZ (Diovan/Diovan HCT)(ST)(QL)
Minocycline* (Minocin/Solodyne)
Ropinirole* (Requip)
ANTI-ADRENERGIC BLOCKERS ________________
Sodium Sulfacetamide* (Sulfacet-R)
Selegiline*(Eldepryl)
Doxazosin* (Cardura)
Tretinoin* (Retin-A) (MAX AGE 34)
Trihexyphenidyl* (Artane)
Prazosin* (Minipress)
ANTIBIOTICS/ANTIVIRALS ____________________
CEREBRAL STIMULANTS _____________________
Terazosin* (Hytrin)
Acyclovir* (Zovirax/generic)
Amphet Asp/Amphet/D-Amphet*
ANTIARRHYTHMICS _________________________
Metronidazole* (MetroGel/MetroLotion)
(Adderall/Adderall XR)(QL)(MIN AGE 3/6)
Amiodarone* (Cordarone)
Mupirocin* (Bactroban)
Dexmethylphenidate* (Focalin)
Digoxin* (Lanoxin)
Sodium Sulfacetamide* (Sulfacet-R)
Dextroamphetamine* (Dexedrine)
Disopyramide* (Norpace)
FUNGICIDES ________________________________
Methylphenidate ER* (Concerta)
Flecainide* (Tambocor)
Ciclopirox* (Loprox)
Methylphenidate* (Ritalin)
Mexiletine* (Mexitil)
Clotrimazole/Betamethazone* (Lotrisone)
PSYCHOTHERAPEUTIC AGENTS _______________
Procainamide* (Pronestyl)
Ketoconazole* (Nizoral)
Antidepressants .
Propafenone* (Rythmol)
Nystatin/Triamcinolone* (Mycolog II)
Amitriptyline* (Elavil)
Quinidine Gluconate* (Quinidex)
TOPICAL ANTI-INFLAMMATORY AGENTS _______
Bupropion/-XL* (Wellbutrin/XL)(QL)
Sotalol* (Betapace AF)
Low Potency .
Citalopram* (Celexa)(QL)
ANTICOAGULANTS/ANTITHROMBOTICS ________
Desonide* (Desowen)
Desipramine* (Norpramin)
Anagrelide* (Agrylin)
Fluocinolone* (Synalar)
Doxepin* (Sinequan)
Cilostazol* (Pletal)
Hydrocortisone* (generic)
Escitalopram* (Lexapro)
Clopidogrel* (Plavix)(QL)
Fluoxetine* (Prozac)
Dipyridamole* (Persantine)
Medium Potency .
Fluvoxamine* (Luvox)
Pentoxifylline* (Trental)
Desoximetasone* (Topicort)
Imipramine* (Tofranil)
Ticlopidine* (Ticlid)
Fluocinolone* (Synalar)
Mirtazapine* (Remeron)
Warfarin* (generic/Coumadin)
Mometasone* (Elocon)
Nortriptyline* (Norpramin)
ANTILIPEMICS ______________________________
Prednicarbate* (Dermatop E)
Paroxetine* (Paxil /CR) (QL)
Atorvastatin* (Lipitor)
Triamcinolone* (Aristocort)
Sertraline* (Zoloft)
Cholestyramine* (Questran)
High Potency .
Trazodone* (trazodone)
Colestipol* (Colestid)
Betamethasone Dipropionate* (Diprosone)
Venlafaxine* (Effexor XR/Effexor)(QL)
Fenofibrate* (Lofibra)
Fluocinonide* (Lidex)
Antimanic Agents .
Gemfibrozil* (Lopid)
Ultra-High Potency .
Lithium Carbonate* (Eskalith)
Lovastatin* (Mevacor)
Augmented Betamethasone* (Diprolene)
Lithium Citrate* (Cibalith-S)
Niacin* (Niaspan/generic)
Clobetasol* (Temovate)
Pravastatin* (Pravachol)
Diflorasone* (Psorcon)
VAGINAL/RECTAL PREPARATIONS _____________
HORMONES
Corticosteroids .
Hydrocortisone* (Proctocort)
Mesalamine* (Rowasa)
ANTIESTROGENS ___________________________
Budesonide* (Pulmicort)
Metronidazole* (MetroGel Vaginal)
Tamoxifen* (Nolvadex)
Sulfanilamide* (AVC)
AROMATASE INHIBITORS _____________________
MISCELLANEOUS DERMATOLOGICALS _________
Anastrozole* (Arimidex)
Fluticasone/Salmeterol (Advair/Advair HFA) Calcipotriene* (Dovonex)
Exemestane* (Aromasin)
Sympathomimetics .
Fluorouracil* (Efudex)
Letrozole* (Femara)
Lindane* (Kwell)
ESTROGENS ________________________________
Metaproterenol* (Alupent)
Permethrin* (Elimite)
Podofilox* (Condylox)
Estradiol* (Estrace)
Terbutaline* (Brethine)
Selenium Sulfide* (Selsun RX)
Estradiol Patch* (Climara)
Xanthine Derivatives .
Silver Sulfadiazine* (Silvadene)
Estropipate* (Ogen)
Aminophylline* (generic)
ENDOCRINE AGENTS
PROGESTINS _______________________________
Theophylline* (Uniphyl)
ANTIDIABETIC AGENTS-INJECTABLE ___________
Medroxyprogesterone* (Provera)
OTHER AGENTS ____________________________
Megestrol* (Megace)
Insulin (Novolin/Novolog/Levemir)
ANTIDIABETIC AGENTS-ORAL _________________
Norethindrone* (Aygestin)
Albuterol/Ipratropium* (DuoNeb)
MISCELLANEOUS HORMONE PRODUCTS _______
Cromolyn* (Intal)
Acarbose* (Precose)
Flutamide* (generic)
Chlorpropamide* (Diabinese)
Montelukast* (Singulair)(QL)(PA)
Glimepiride* (Amaryl)
OPHTHALMICS
Glipizide* (Glucotrol)
ALPHA-AGONIST ____________________________
NASAL MEDICATIONS________________________
Glipizide/Metformin* (Metaglip)
Brimonidine Tartrate* (Alphagan P)
Azelastine* (Astelin) (QL)
Glyburide/Metformin* (Glucovance)
Fluticasone* (Flonase)
Glyburide/Micronized* (Glynase)
ANTI-INFECTIVE AGENTS _____________________
Flunisolide* (Nasarel)(QL)
Metformin* (Glucophage)
Chloramphenicol* (generic)
Nateglinide* (Starlix)
Ciprofloxacin* (Ciloxin)
SKELETAL AGENTS
Pioglitazone* (Actos)
Erythromycin* (Romycin)
ANTIRHEUMATICS ___________________________
Pioglitazone/Metformin* (ActoPlus Met)
Gentamicin* (Garamycin)
Tolazamide* (Tolinase)
Neomycin/Bacitracin/Polymyxin* (NeoSporin)
Azathioprine* (Imuran)
Tolbutamide* (Orinase)
Ofloxacin* (Ocuflox)
Hydroxychloroquine* (Plaquenil)
ANTIDIABETIC SUPPLIES _____________________
Polymyxin B/Trimethoprim* (Polytrim)
Methotrexate* (Rheumatrex)
Sulfacetamide* (Bleph-10)
BONE ENHANCING AGENTS __________________
Accu-Chek Meters and Test Strips (QL)
Tobramycin* (Tobrex)
One Touch Meters and Test Strips (QL)
Alendronate* (Fosamax)(QL)
ANTITHYROID _______________________________
ANTI-INFLAMMATORY AGENTS ________________
Calcitonin-Salmon* (Midrin)
Cromolyn* (Opticrom)
Etidronate* (Didronel)
Methimazole* (Tapazole)
Dexamethasone* (Maxidex)
Propylthiouracil* (generic)
THYROID ___________________________________
Diclofenac* (Voltaren)
SKELETAL MUSCLE RELAXANTS
Fluorometholone* (Flarex)
Levothyroxine* (Synthroid, Levothroid, Levoxyl,
Flurbiprofen* (Ocufen)
Baclofen* (Lioresal)
Prednisolone* (Inflamase Forte)
Carisoprodol* (Soma)
Thyroid* (Armour Thyroid)
ANTI-INFECTIVE AND
Cyclobenzaprine* (Amrix/Fexmid/Flexeril)
GASTROINTESTINAL AGENTS
ANTI-INFLAMMATORY COMBINATIONS _________
Diazepam* (Valium)
Methocarbamol* (Robaxin)
ANTIEMETIC/ANTIVERTIGO ___________________
Na Sulfacetm/Prednisolone* (Vasocidin)
Tizanidine* (Zanaflex)
Granisetron* (Kytril)
Neomy/Bacitracin/Polymyxin/Hydrocort*
Meclizine* (Antivert)
URINARY AGENTS
Metoclopramide* (Reglan)
Neomycin/Dexamethasone* (NeoDecadron)
ANTI-INFECTIVES ___________________________
Ondansetron* (Zofran)
Neomycin/Polymyx B/Dexamethasone*
Prochlorperazine* (Compazine)
Sulfadiazine* (generic)
Promethazine* (Phenergan)
ANTIVIRAL AGENTS _________________________
Sulfisoxazole* (Gantrisin)
Trimethobenzamide* (Tigan)
Trifluridine* (Viroptic)
Trimethoprim/Sulfamethoxazole* (Bactrim,
ANTISPASMODIC/GI MOTILITY _________________
BETA-BLOCKERS ___________________________
CHOLINERGIC AGENTS ______________________
Belladonna/Phenobarbital* (Donnatal)
Betaxolol* (Betoptic)
Clidinium/Chlordiazepoxide* (Librax)
Carteolol* (Ocupress)
Bethanechol* (Urecholine)
Dicyclomine* (Bentyl)
Levobunolol* (Betagan)
Flavoxate* (Urispas)
Hyoscyamine* (Levsin)
Metipranolol* (OptiPranolol)
OTHER URINARY AGENTS ____________________
Propantheline* (Pro-Banthine)
Timolol* (Timoptic)
Doxazosin* (generic)
ANTIULCER ________________________________
MIOTICS ___________________________________
Finasteride* (Proscar) (QL)
Misoprostol* (Cytotec)
Phenazopyridine* (Pyridium)
Dorzolamide* (Trusopt)
Prazosin* (generic)
OTHER GI PRODUCTS ________________________
Dorzolamide/timolol* (Cosopt)
Oxybutynin*/Ex rel* (Ditropan/XL) (QL)
Tamsulosin* (Flomax)
Balsalazide* (Colazal)
Latanoprost* (Xalatan)
Terazosin* (generic)
Lactulose* (Cephulac)
Pilocarpine* (Isopto Carbachol)
Tolterodine* (Detrol)
Mesalamine* (Asacol/Asacol HD/generic)
MYDRIATICS ________________________________
Trospium* (Sanctura) (QL)
Atropine* (Isopto Atropine)
Sulfasalazine* (Azulfidine)
Cyclopentolate* (Cyclogyl)
Ursodiol* (Actigall)
Homatropine* (Isopto Homatropine)
VITAMINS AND ELECTROLYTES
SYMPATHOMIMETICS ________________________
Prenatal Vitamins requiring prescription* GLUCOCORTICOIDS
Dipivefrin* (generic)
Dexamethasone* (Decadron)
Fludrocortisone* (Florinef)
GS REQUIRIN
Methylprednisolone* (generic)
ANTI-INFECTIVE AGENTS _____________________
Prednisolone* (Prelone)
Acetic Acid* (Vosol)
Prednisone* (generic)
Acetic Acid/Benzethonium* (generic)
Ofloxacin* (Floxin)
GOUT THERAPY
ANTI-INFECTIVE AND
Allopurinol* (Zyloprim)
ANTI-INFLAMMATORY COMBINATIONS _________
G STEP THERAPY UGS REQUIRING
Acetic acid/Hydrocortisone*(Vosol HC)
Colchicine/Probenecid* (generic)
Neomycin/Polymxin/HC* (Cortisporin)
Indomethacin* (Indocin)
Probenecid* (generic)
RESPIRATORY
ANTI-ASTHMATIC AGENTS ____________________

Source: http://missionhealth.com/documents/Human%20Resources/2013%20Ascension%20Health%20Formulary.pdf