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3
Print and fax it to the pharmacy at 401-284-4506.
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Tirzepatide
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Semaglutide
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Testosterone
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Phentolamine
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Papaverine
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Ivermectin
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Ketamine
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Diazepam
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Gabapentin
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Amitriptyline
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Metformin
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Theophylline
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Arginine
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Spironolactone
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Clobetasol Propionate
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Ketotifen
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Hydrocortisone
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Acyclovir
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Chlorhexidine Gluconate
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Nystatin
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Boric Acid
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Tri-Est
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Bi-Est
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Dehydroepiandrosterone
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Progesterone
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Estriol
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Estradiol
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Tetracaine
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Lidocaine
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Benzocaine
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Sodium Hyaluronate
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Niacinamide
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Tranexamic Acid
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Kojic Acid
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Hydroquinone
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Metronidazole
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Miconazole
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Betamethasone
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Mupirocin
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Sodium Butynate
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Sodium Acetate
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Naltrexone
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Mesalamine
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Budesonide
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Sucralfate
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Baclofen
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Tacrolimus
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Nitroglycerin
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Nifedipine
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Diltiazem
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Atropine Sulfate
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Cyclosporin
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Acetylcysteine
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Voriconazole
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Amphotericin
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Ceftriaxone
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Ceftazidime
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Quad-Mix
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Tri-Mix
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Alprostadil
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Atropine Tri-Mix
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Bi-Mix
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Vardenafil
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Sildenafil RDT
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Sildenafil
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Tadalafil RDT
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Tadalafil
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Scopolamine Hydrobromide
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Glycopyrrolate
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Gentamicin
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Vancomycin
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Tobramycin
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Atropine
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Other
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Tretinoin
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Azelaic Acid
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Finasteride
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Minoxidil
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Pantoprazole
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Omeprazole
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Lansoprazole
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Esomeprazole
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Dexmedetomidine HCl 40 mcg/mL Intravenous Infusion
Cancer, Heart Failure, Chronic Obstructive Pulmonary Disease, Alzheimer's Disease, Amyotrophic Lateral Sclerosis
Haloperidol Lactate 1 mg/mL Intravenous Infusion
Delirium, Agitation, Nausea, Vomiting, Terminal Restlessness
Hydromorphone 1 mg/mL Intravenous Infusion
Cancer, Heart Failure, Chronic Obstructive Pulmonary Disease, Kidney Failure, Liver Failure
Hydromorphone 10 mg/mL Intravenous Infusion
Cancer, Heart Failure, Chronic Obstructive Pulmonary Disease, Kidney Failure, Liver Failure
Hydromorphone 20 mg/mL Intravenous Infusion
Cancer, Heart Failure, Chronic Obstructive Pulmonary Disease, Kidney Failure, Liver Failure
Hydromorphone 40 mg/mL Intravenous Infusion
Cancer, Heart Failure, Chronic Obstructive Pulmonary Disease, Kidney Failure, Liver Failure
Hydromorphone 5 mg/mL Intravenous Infusion
Cancer, Heart Failure, Chronic Obstructive Pulmonary Disease, Kidney Failure, Liver Failure
Ketamine 10 mg/mL Intravenous Infusion
Cancer Pain, Neuropathic Pain, Refractory Depression, Complex Regional Pain Syndrome, Post-Traumatic Stress Disorder
Ketamine 50 mg/mL Intravenous Infusion
Cancer Pain, Neuropathic Pain, Refractory Depression, Anxiety, Post-Traumatic Stress Disorder
Midazolam 5 mg/mL Intravenous Infusion
Cancer, Chronic Obstructive Pulmonary Disease, Congestive Heart Failure, Alzheimer's Disease, Amyotrophic Lateral Sclerosis
Morphine Sulfate 20 mg/mL Intravenous Infusion
Cancer, Heart Failure, Chronic Obstructive Pulmonary Disease, Kidney Failure, Liver Failure
Morphine Sulfate 40 mg/mL Intravenous Infusion
Cancer, Heart Failure, Chronic Obstructive Pulmonary Disease, Kidney Failure, Liver Failure
Morphine Sulfate 5 mg/mL Intravenous Infusion
Cancer, Heart Failure, Chronic Obstructive Pulmonary Disease, Kidney Failure, Liver Failure
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