Brand name listed below and for reference only and do not signify the product dispensed.
LEGEND
-Shaded Items indicate controlled substances -Bold items indicated changes this year -1 PA Form Required for patients under 50
Patrick AFB Formulary NOV 2009 1-800-615-3354 (321)494-8739 **Formulary Requests ONLY** E-Mail: 45MDGPharmacy@patrick.af.mil
-2 PA Form is required and only 6 or 12 weeks with no refills -3 PA Form Required -* must have tried Ambien