| Generic Name |
Drug Name |
Dosage Form |
Strength |
Unit Cost
|
| |
|
|
|
|
| Codeine phosphate |
|
tablet |
15mg |
$ 0.18 |
| |
|
tablet |
30mg |
$ 0.83 |
| |
|
oral soln |
30mg/ml |
$ 0.48 |
| |
|
|
|
|
| Codeine/APAP |
Tylenol/codeine |
elixir |
|
$ 0.01 for 5mls |
| |
Tylenol #3 |
tablet |
|
$ 0.04 |
| |
(each 12.5ml or tablet
contains 30mg codeine and 325mg APAP) |
|
|
|
| |
|
|
|
|
| Codeine/butalbital/caffeine/APAP |
Fioricet |
capsule |
|
$ 0.32 |
| |
(contains butalbital 50mg,
APAP 325mg & caffeine 40mg) |
|
|
|
| |
|
|
|
|
| Fentanyl |
Duragesic |
patch |
25mcg/h |
$ 5.89 |
| |
|
patch |
50mcg/h |
$ 8.85 |
| |
|
patch |
100mcg/h |
$ 24.78 |
| |
|
|
|
|
| |
|
|
|
|
| |
Sublimaze |
Injection |
100mcg/2ml |
$ 0.02 |
| |
|
Injection |
0.05mg/ml (20ml) |
$ 0.22 |
| |
|
Injecton |
250mcg/5ml |
$ 0.06 |
| |
|
|
|
|
| |
|
|
|
|
| Hydromorphone |
Dilaudid |
oral soln |
4mg/5ml 120mls |
$ 0.75 for 5 mls |
| |
|
tablet |
2mg |
$ 0.08 |
| |
|
Injection |
2mg/ml (1ml) |
$ 0.50 |
| |
|
Injection |
10mg/ml (5ml) |
$ 1.68 |
| |
|
|
|
|
| Meperidine |
Demerol |
oral soln |
50mg/5ml |
$ 0.49 |
| |
|
tablet |
50mg |
$ 0.23 |
| |
|
injection |
50mg/ml |
$ 0.38 |
| |
|
|
|
|
| Methadone |
Dolophine |
oral soln |
5mg/5ml |
$ 3.48 |
| |
|
tablet |
5mg |
$ 0.12 |
| |
|
|
|
|
| Morphine sulfate |
|
oral soln |
2mg/ml |
$ 0.25 |
| |
|
injection |
8mg/1ml |
$ 0.43 |
| |
|
injection |
10mg/1ml |
$ 0.05 |
| |
|
injection |
25mg/ml(20ml) |
$ 0.33 |
| |
|
|
|
|
| |
Duramorph PF |
injection |
1mg/ml (10ml) |
$ 1.29 |
| |
|
|
|
|
| |
MS Contin |
extended release
tablet |
30mg |
$ 0.11 |
| |
|
extended release
tablet |
15mg |
$ 0.08 |
| |
|
extended release
tablet |
100mg |
$ 0.41 |
| |
|
|
|
|
| |
Roxanol |
oral soln |
20mg/ml(30ml) |
$ 0.16 |
| |
|
oral soln |
20mg/ml(120ml) |
$ 0.11 |
| |
|
Rectal supp |
5mg |
$ 1.84 |
| |
|
|
|
|
| Opium/Belladona |
B&O Supprettes |
Rectal supp |
30mg |
$ 1.38 |
| |
|
|
|
|
| Opium tincture |
|
oral solution |
|
$ 0.25 |
| |
|
|
|
|
| Oxycodone |
Roxicodone |
tablet |
5mg |
$ 0.14 |
| |
|
|
|
|
| Oxycodone/APAP |
Percocet |
tablet |
|
$ 0.05 |
| |
(contains oxycodone 5mg
& APAP 325mg) |
|
|
|
| |
|
|
|
|
| Oxymorphone |
Numorphan |
rectal supp |
5mg |
$ 3.18 |
| |
|
|
|
|
| Propoxyphene HCL |
Darvon |
capsule |
65mg |
$ 0.03 |
| |
|
|
|
|
| Propoxyphene
Napsylate/APAP |
Darvocet-N100 |
coated tablet |
|
$ 0.04 |
| |
(contains propxyphene
napyslate 100mg & APAP 650mg) |
|
|
|
| |
|
|
|
|
| Remifentanil HCL |
Ultiva |
injection |
1mg |
$ 6.96 |
