background image
Abacavir; abacavir/lamivudine; abacavir/lamivu-
dine/zidovudine; acarbose; acebutolol; acyclo-
vir; adefovir dipivoxil; aerosolized pentamidine;
alprazolam; amitriptyline; amlodipine; amoxicil-
lin; amoxicillin/potassium clavulanate; ampicillin;
atenolol; atazanavir; atovaquone; azithromy-
cin; benazepril; buprenorphine; bupropion;
buspirone; captopril; carvedilol; cefpodoxime;
ceftriaxone; cephalexin; chlordiazepoxide;
cidofovir; ciprofloxacin; citalopram; clarithro-
mycin; clindamycin; clonazepam; clotrimazole;
codeine/APAP; codeine phosphate/sulfate;
cyancobalamin; dapsone; darunavir; delavir-
dine; diabetic supplies; diazepam; dicloxacil-
lin; didanosine; diltiazem; diphtheria/tetanus;
diphtheria/tetanus toxoids/pertussis vaccine;
doxazosin; doxycycline; efavirenz; elvitegravir/
cobicistat/emtricitabine/tenfovir; emtricitabine;
emtricitabine/rilpivirine/tenofovir; emtricitabine/
tenofovir; emtricitabine/tenofovir/efavirenz;
enalapril; enfuvirtide; entecavir; epoetin-alpha;
erythromycin; ethambutol; etravirine; felodipine;
fentanyl; filgrastim; flurazepam; fluoxetine; folic
acid; fomivirsen; fosamprenavir; foscarnet; fu-
rosemide; ganciclovir; glimepiride; glipizide; gly-
buride; haloperidol; hemophilus influenza Type
B vaccine; hepatitis A vaccine; hepatitis B vac-
cine; hepatitis A/Hepatitis B vaccine; hepatitis
B Immune Globulin; human papillomavirus/HPV;
hydralazine; hydrocholorthiazide; hydrocodone/
APAP; hydrocodone/ibuprofen; hydroxyzine;
ibuprofen; imiquimod cream; immune globulin
IM; influenza virus vaccine; indinavir; insulin/
injection kits/glucose test strips; interferon
alfa-2a' inteferon alfa-2b; interferon alfacon
1; interferon alfa-N3; isoniazid; lamivudine;
lamivudine/zidovudine; leucovorin; levofloxacin;
lisinopril; lopinavir/ritonavir; lorazepam; losartan;
maraviroc; metformin; metformin/repaglinide;
metformin/rosiglitazone; metformin/sitagliptin;
methadone; metoprolol; mirtazapine; morphine
sulfate; moxifloxacin; nelfinavir; nevirapine;
nifedipine; ofloxacin; olanzapine; oseltamivir;
oxycodone; oxycodone/APAP; oxycodone/ASA;
naproxen; oxazepam; paroxetine; pegylated in-
terferons; penicillin; perphenazine; pioglitazone;
potassium supplements; pneumococcal vac-
cine; propranolol; pyrazinamide; pyrimethamine;
quetiapine; quinapril; raltegravir; repaglinide;
ribavirin; ribavirin/interferon alfa 2B; rifabu-
tin; rifampin; rilpivirine; risperidone; ritonavir;
rosiglitazone; saquinavir; sertraline; sitagliptin;
spironolactone; stavudine; sulfadiazine; sulfa/
pyrimethamine; telbivudine; temazepam; te-
nofovir; tetracycline; thiothixene; tipranavir;
trazadone; trimethoprim; TMP/SMX; valacyclovir;
valganciclovir; vancomycin oral; varenicline;
venlafaxine; verapamil; vitamin D; zanamivir;
zidovudine; ziprasidone.
PeNNsylvANiA
800-922-9384 (ADAP)
maximum qualifying income (single): $57,450
Waiting list: No
Website: www.portal.state.pa.us/portal/server.
pt/community/hiv___aids/14241/special_phar-
maceutical_benefits_program/1314737
Additional information: program is referred to
as: the special pharmaceutical benefits program.
Abacavir; abacavir/lamivudine; abacavir/
lamivudine/zidovudine; acyclovir/valacyclovir;
amikacin; amphotericin B; atazanavir; atova-
quone; azithromycin; bleomycin; capreomycin;
cidofovir injection; ciprofloxacin; clarithromycin;
clindamycin; clofazimine; clotrimazole; dap-
sone; darunavir; delavirdine; dexamethasone;
didanosine; doxorubicin; dronabinol; efavirenz;
efavirenz/tenofovir/emtricitabine; elvitegravir/
cobicistat/emtricitabine/tenfovir; emtricitabine;
emtricitabine/rilpivirine/tenofovir; emtricitabine/
tenofovir; enfuvirtide; ethambutol; ethionamide;
etravirine; famciclovir; fluconazole; flucyto-
sine; fosamprenavir; foscarnet; ganciclovir;
indinavir; isoniazid; itraconazole; ketoconazole;
lamivudine; lamivudine/zidovudine; leucovorin;
lopinavir/ritonavir; lovaza; maraviroc; megestrol;
nelfinavir; nevirapine; nevirapine XR; nystatin;
ofloxacin; paromomycin sulfate; pentamidine;
prednisone; primaquine phosphate; pyrazin-
amide; pyrimethamine; rifabutin; rifampin;
rilpivirine; ritonavir; saquinavir; stavudine; sulfa-
diazine; sulfadoxine/pyrimethamine; tenofovir;
terconazole; tipranavir; TMP/SMX; trimetrexate;
valganciclovir; vinblastine sulfate; vincristine
sulfate; zidovudine.
List of drugs for HIV-related side-effects is exten-
sive. please call for complete listing or visit the
following link for the complete list: www.health.state.
pa.us/pdf/spbp/SPBP_Formulary.pdf
rHoDe islAND
401-222-4610 (ADAP)
hivpositivemagazine.com 27
ADAP