Sulfonamides
PDL Status Values
Y = preferred
N = non-preferred. Non-preferred drugs listed as N but without clinical drug use criteria are subject to the
Non-Preferred Drugs in Select PDL Classes prior authorization criteria.
New drugs will be listed as N until reviewed by the P&T Committee and are subject to the
New Drug Policy.
V = voluntary non-preferred. Non-preferred mental health drugs are listed as V and prior authorization is not required.
Null (i.e. blank) = indicates the class or specific drug has not been reviewed for PDL placement.
To request a Prior Authorization, please use this form.
| NDC | Brand Name | Generic Name | Form | Strength | PDL Status |
Rebate | Current Drug Use Criteria |
|---|---|---|---|---|---|---|---|
| 16571072348 | SULFAMYLON | mafenide acetate | CREAM (G) | 8.5 % | Y | ||
| 16571072360 | SULFAMYLON | mafenide acetate | CREAM (G) | 8.5 % | Y | ||
| 49884090252 | MAFENIDE ACETATE | mafenide acetate | PACKET | 50 gram | Y | ||
| 49884090278 | MAFENIDE ACETATE | mafenide acetate | PACKET | 50 gram | Y | ||
| 61570013120 | SILVADENE | silver sulfadiazine | CREAM (G) | 1 % | Y | ||
| 61570013125 | SILVADENE | silver sulfadiazine | CREAM (G) | 1 % | Y | ||
| 61570013140 | SILVADENE | silver sulfadiazine | CREAM (G) | 1 % | Y | ||
| 61570013150 | SILVADENE | silver sulfadiazine | CREAM (G) | 1 % | Y | ||
| 61570013155 | SILVADENE | silver sulfadiazine | CREAM (G) | 1 % | Y | ||
| 61570013185 | SILVADENE | silver sulfadiazine | CREAM (G) | 1 % | Y | ||
| 61570013198 | SILVADENE | silver sulfadiazine | CREAM (G) | 1 % | Y | ||
| 59762013100 | SILVER SULFADIAZINE | silver sulfadiazine | CREAM (G) | 1 % | Y | ||
| 59762013102 | SILVER SULFADIAZINE | silver sulfadiazine | CREAM (G) | 1 % | Y | ||
| 59762013104 | SILVER SULFADIAZINE | silver sulfadiazine | CREAM (G) | 1 % | Y | ||
| 59762013105 | SILVER SULFADIAZINE | silver sulfadiazine | CREAM (G) | 1 % | Y | ||
| 59762013106 | SILVER SULFADIAZINE | silver sulfadiazine | CREAM (G) | 1 % | Y | ||
| 59762013108 | SILVER SULFADIAZINE | silver sulfadiazine | CREAM (G) | 1 % | Y | ||
| 67877012405 | SILVER SULFADIAZINE | silver sulfadiazine | CREAM (G) | 1 % | Y | ||
| 67877012420 | SILVER SULFADIAZINE | silver sulfadiazine | CREAM (G) | 1 % | Y | ||
| 67877012425 | SILVER SULFADIAZINE | silver sulfadiazine | CREAM (G) | 1 % | Y | ||
| 67877012440 | SILVER SULFADIAZINE | silver sulfadiazine | CREAM (G) | 1 % | Y | ||
| 67877012450 | SILVER SULFADIAZINE | silver sulfadiazine | CREAM (G) | 1 % | Y | ||
| 67877012485 | SILVER SULFADIAZINE | silver sulfadiazine | CREAM (G) | 1 % | Y | ||
| 43598021025 | SSD | silver sulfadiazine | CREAM (G) | 1 % | Y | ||
| 43598021040 | SSD | silver sulfadiazine | CREAM (G) | 1 % | Y | ||
| 43598021050 | SSD | silver sulfadiazine | CREAM (G) | 1 % | Y | ||
| 43598021055 | SSD | silver sulfadiazine | CREAM (G) | 1 % | Y | ||
| 43598021085 | SSD | silver sulfadiazine | CREAM (G) | 1 % | Y | ||
| 42192010316 | CLEANSING WASH | sulfacetamide sod/sulfur/urea | CLEANSER | 10 %-4 %-10 % | Y | ||
| 42192010406 | BP 10-1 | sulfacetamide sodium/sulfur | CLEANSER | 10 %-1 % | Y | ||
| 00178047508 | AVAR LS | sulfacetamide sodium/sulfur | CLEANSER | 10 %-2 % | Y | ||
| 42192014708 | SODIUM SULFACETAMIDE-SULFUR | sulfacetamide sodium/sulfur | CLEANSER | 10 %-2 % | Y | ||
| 44523055008 | SODIUM SULFACETAMIDE-SULFUR | sulfacetamide sodium/sulfur | CLEANSER | 10 %-2 % | Y | ||
| 58657047108 | SODIUM SULFACETAMIDE-SULFUR | sulfacetamide sodium/sulfur | CLEANSER | 10 %-2 % | Y | ||
| 82429010808 | SODIUM SULFACETAMIDE-SULFUR | sulfacetamide sodium/sulfur | CLEANSER | 10 %-2 % | Y | ||
| 00178048008 | AVAR | sulfacetamide sodium/sulfur | CLEANSER | 10 %-5 % (w/w) | Y | ||
| 42192013606 | SODIUM SULFACETAMIDE-SULFUR | sulfacetamide sodium/sulfur | CLEANSER | 10 %-5 % (w/w) | Y | ||
| 42192013608 | SODIUM SULFACETAMIDE-SULFUR | sulfacetamide sodium/sulfur | CLEANSER | 10 %-5 % (w/w) | Y | ||
| 42192013612 | SODIUM SULFACETAMIDE-SULFUR | sulfacetamide sodium/sulfur | CLEANSER | 10 %-5 % (w/w) | Y | ||
| 44523056006 | SODIUM SULFACETAMIDE-SULFUR | sulfacetamide sodium/sulfur | CLEANSER | 10 %-5 % (w/w) | Y | ||
| 44523056008 | SODIUM SULFACETAMIDE-SULFUR | sulfacetamide sodium/sulfur | CLEANSER | 10 %-5 % (w/w) | Y | ||
| 44523056012 | SODIUM SULFACETAMIDE-SULFUR | sulfacetamide sodium/sulfur | CLEANSER | 10 %-5 % (w/w) | Y | ||
| 58657047206 | SODIUM SULFACETAMIDE-SULFUR | sulfacetamide sodium/sulfur | CLEANSER | 10 %-5 % (w/w) | Y | ||
| 58657047207 | SODIUM SULFACETAMIDE-SULFUR | sulfacetamide sodium/sulfur | CLEANSER | 10 %-5 % (w/w) | Y | ||
| 58657047208 | SODIUM SULFACETAMIDE-SULFUR | sulfacetamide sodium/sulfur | CLEANSER | 10 %-5 % (w/w) | Y | ||
| 58657047212 | SODIUM SULFACETAMIDE-SULFUR | sulfacetamide sodium/sulfur | CLEANSER | 10 %-5 % (w/w) | Y | ||
| 58657047213 | SODIUM SULFACETAMIDE-SULFUR | sulfacetamide sodium/sulfur | CLEANSER | 10 %-5 % (w/w) | Y | ||
| 69367024706 | SODIUM SULFACETAMIDE-SULFUR | sulfacetamide sodium/sulfur | CLEANSER | 10 %-5 % (w/w) | Y | ||
| 69367024708 | SODIUM SULFACETAMIDE-SULFUR | sulfacetamide sodium/sulfur | CLEANSER | 10 %-5 % (w/w) | Y | ||
| 69367024712 | SODIUM SULFACETAMIDE-SULFUR | sulfacetamide sodium/sulfur | CLEANSER | 10 %-5 % (w/w) | Y | ||
| 82429010706 | SODIUM SULFACETAMIDE-SULFUR | sulfacetamide sodium/sulfur | CLEANSER | 10 %-5 % (w/w) | Y | ||
| 82429010708 | SODIUM SULFACETAMIDE-SULFUR | sulfacetamide sodium/sulfur | CLEANSER | 10 %-5 % (w/w) | Y | ||
| 82429010712 | SODIUM SULFACETAMIDE-SULFUR | sulfacetamide sodium/sulfur | CLEANSER | 10 %-5 % (w/w) | Y | ||
| 82429012616 | SULFACETAMIDE SODIUM-SULFUR | sulfacetamide sodium/sulfur | CLEANSER | 8 %-4 % | N | Y | |
| 42192012116 | SODIUM SULFACETAMIDE-SULFUR | sulfacetamide sodium/sulfur | CLEANSER | 9 %-4 % | Y | ||
| 58657047316 | SODIUM SULFACETAMIDE-SULFUR | sulfacetamide sodium/sulfur | CLEANSER | 9 %-4 % | Y | ||
| 82429012816 | SODIUM SULFACETAMIDE-SULFUR | sulfacetamide sodium/sulfur | CLEANSER | 9 %-4 % | Y | ||
| 43538013016 | SUMAXIN | sulfacetamide sodium/sulfur | CLEANSER | 9 %-4 % | Y | ||
| 42192014416 | SODIUM SULFACETAMIDE-SULFUR | sulfacetamide sodium/sulfur | CLEANSER | 9 %-4.5 % | Y | ||
| 44523060516 | SODIUM SULFACETAMIDE-SULFUR | sulfacetamide sodium/sulfur | CLEANSER | 9 %-4.5 % | Y | ||
| 58657047416 | SODIUM SULFACETAMIDE-SULFUR | sulfacetamide sodium/sulfur | CLEANSER | 9 %-4.5 % | Y | ||
| 82429030121 | SODIUM SULFACETAMIDE-SULFUR | sulfacetamide sodium/sulfur | CLEANSER | 9 %-4.5 % | Y | ||
| 43538019016 | SUMADAN | sulfacetamide sodium/sulfur | CLEANSER | 9 %-4.5 % | Y | ||
| 42192015610 | SODIUM SULFACETAMIDE-SULFUR | sulfacetamide sodium/sulfur | CLEANSER | 9.8 %-4.8 % | Y | ||
| 44523074810 | SODIUM SULFACETAMIDE-SULFUR | sulfacetamide sodium/sulfur | CLEANSER | 9.8 %-4.8 % | Y | ||
| 69367024410 | SODIUM SULFACETAMIDE-SULFUR | sulfacetamide sodium/sulfur | CLEANSER | 9.8 %-4.8 % | Y | ||
| 82429010910 | SODIUM SULFACETAMIDE-SULFUR | sulfacetamide sodium/sulfur | CLEANSER | 9.8 %-4.8 % | Y | ||
| 00178046502 | AVAR-E LS | sulfacetamide sodium/sulfur | CREAM (G) | 10 %-2 % | Y | ||
| 42192015002 | SODIUM SULFACETAMIDE-SULFUR | sulfacetamide sodium/sulfur | CREAM (G) | 10 %-2 % | Y | ||
| 44523053502 | SODIUM SULFACETAMIDE-SULFUR | sulfacetamide sodium/sulfur | CREAM (G) | 10 %-2 % | Y | ||
| 00178047002 | AVAR-E | sulfacetamide sodium/sulfur | CREAM (G) | 10 %-5 % (w/w) | Y | ||
| 00178046002 | AVAR-E GREEN | sulfacetamide sodium/sulfur | CREAM (G) | 10 %-5 % (w/w) | Y | ||
| 42192014902 | SODIUM SULFACETAMIDE-SULFUR | sulfacetamide sodium/sulfur | CREAM (G) | 10 %-5 % (w/w) | Y | ||
| 44523052002 | SODIUM SULFACETAMIDE-SULFUR | sulfacetamide sodium/sulfur | CREAM (G) | 10 %-5 % (w/w) | Y | ||
| 44523054202 | SODIUM SULFACETAMIDE-SULFUR | sulfacetamide sodium/sulfur | CREAM (G) | 10 %-5 % (w/w) | Y | ||
| 44523060301 | SODIUM SULFACETAMIDE-SULFUR | sulfacetamide sodium/sulfur | CREAM (G) | 10 %-5 % (w/w) | Y | ||
| 58657046801 | SODIUM SULFACETAMIDE-SULFUR | sulfacetamide sodium/sulfur | CREAM (G) | 10 %-5 % (w/w) | Y | ||
| 58657046802 | SODIUM SULFACETAMIDE-SULFUR | sulfacetamide sodium/sulfur | CREAM (G) | 10 %-5 % (w/w) | Y | ||
| 42192013901 | SSS 10-5 | sulfacetamide sodium/sulfur | CREAM (G) | 10 %-5 % (w/w) | Y | ||
| 00178065301 | AVAR LS | sulfacetamide sodium/sulfur | FOAM | 10 %-2 % | Y | ||
| 42192014301 | SSS 10-5 | sulfacetamide sodium/sulfur | FOAM | 10 %-5 % | Y | ||
| 42192014360 | SSS 10-5 | sulfacetamide sodium/sulfur | FOAM | 10 %-5 % | Y | ||
| 44523060201 | SODIUM SULFACETAMIDE-SULFUR | sulfacetamide sodium/sulfur | LOTION | 10 %-5 % (w/v) | Y | ||
| 44523060701 | SODIUM SULFACETAMIDE-SULFUR | sulfacetamide sodium/sulfur | LOTION | 10 %-5 % (w/w) | Y | ||
| 44523060702 | SODIUM SULFACETAMIDE-SULFUR | sulfacetamide sodium/sulfur | LOTION | 10 %-5 % (w/w) | Y | ||
| 44523060002 | SODIUM SULFACETAMIDE-SULFUR | sulfacetamide sodium/sulfur | LOTION | 9.8 %-4.8 % | Y | ||
| 00178064001 | AVAR LS | sulfacetamide sodium/sulfur | MED. PAD | 10 %-2 % | Y | ||
| 00178064060 | AVAR LS | sulfacetamide sodium/sulfur | MED. PAD | 10 %-2 % | Y | ||
| 42192011360 | SODIUM SULFACETAMIDE-SULFUR | sulfacetamide sodium/sulfur | MED. PAD | 10 %-4 % | Y | ||
| 44523061201 | SODIUM SULFACETAMIDE-SULFUR | sulfacetamide sodium/sulfur | MED. PAD | 10 %-4 % | Y | ||
| 44523061260 | SODIUM SULFACETAMIDE-SULFUR | sulfacetamide sodium/sulfur | MED. PAD | 10 %-4 % | Y | ||
| 42494033101 | SULFACETAMIDE SODIUM-SULFUR | sulfacetamide sodium/sulfur | MED. PAD | 10 %-4 % | Y | ||
| 43538010060 | SUMAXIN | sulfacetamide sodium/sulfur | MED. PAD | 10 %-4 % | Y | ||
| 00178065001 | AVAR | sulfacetamide sodium/sulfur | MED. PAD | 9.5 %-5 % | Y | ||
| 00178065060 | AVAR | sulfacetamide sodium/sulfur | MED. PAD | 9.5 %-5 % | Y | ||
| 44523060401 | SODIUM SULFACETAMIDE-SULFUR | sulfacetamide sodium/sulfur | SUSPENSION | 10 %-5 % (w/w) | Y | ||
| 42192013316 | SODIUM SULFACETAMIDE-SULFUR | sulfacetamide sodium/sulfur | SUSPENSION | 8 %-4 % | Y | ||
| 44523062416 | SODIUM SULFACETAMIDE-SULFUR | sulfacetamide sodium/sulfur | SUSPENSION | 8 %-4 % | Y | ||
| 58657046916 | SODIUM SULFACETAMIDE-SULFUR | sulfacetamide sodium/sulfur | SUSPENSION | 8 %-4 % | Y | ||
| 69367024516 | SODIUM SULFACETAMIDE-SULFUR | sulfacetamide sodium/sulfur | SUSPENSION | 8 %-4 % | Y | ||
| 43538016016 | SUMAXIN TS | sulfacetamide sodium/sulfur | SUSPENSION | 8 %-4 % | Y | ||
| 28595050108 | SODIUM SULFACETAMIDE-SULFUR | sulfacetamide sodium/sulfur | SUSPENSION | 9 %-4.25 % | N | Y | |
| 82429010608 | ZMA CLEAR | sulfacetamide sodium/sulfur | SUSPENSION | 9 %-4.5 % | N | Y | |
| 43538010160 | SUMAXIN CP | sulfacetamide/sulfur/cleansr23 | KIT | 10 %-4 % | Y | ||
| 43538019116 | SUMADAN | sulfacetamide/sulfur/cleansr23 | KIT | 9 %-4.5 % | Y | ||
| 43538019216 | SUMADAN XLT | sulfact sod/sulur/avob/otn/oct | CMB CLN CR | 9 %-4.5 %-SPF 25 | Y | ||
| 42806075760 | SULFADIAZINE | sulfadiazine | TABLET | 500 mg | Y | ||
| 62135084260 | SULFADIAZINE | sulfadiazine | TABLET | 500 mg | Y | ||
| 62135074947 | SULFAMETHOXAZOLE-TRIMETHOPRIM | sulfamethoxazole/trimethoprim | ORAL SUSP | 200 mg-40 mg/5 mL | Y | ||
| 65862049647 | SULFAMETHOXAZOLE-TRIMETHOPRIM | sulfamethoxazole/trimethoprim | ORAL SUSP | 200 mg-40 mg/5 mL | Y | ||
| 66993072757 | SULFAMETHOXAZOLE-TRIMETHOPRIM | sulfamethoxazole/trimethoprim | ORAL SUSP | 200 mg-40 mg/5 mL | Y | ||
| 70954025810 | SULFAMETHOXAZOLE-TRIMETHOPRIM | sulfamethoxazole/trimethoprim | ORAL SUSP | 200 mg-40 mg/5 mL | Y | ||
| 00121085416 | SULFATRIM | sulfamethoxazole/trimethoprim | ORAL SUSP | 200 mg-40 mg/5 mL | Y | ||
| 00121085320 | SULFAMETHOXAZOLE-TRIMETHOPRIM | sulfamethoxazole/trimethoprim | ORAL SUSP | 800 mg-160 mg/20 mL | Y | ||
| 00121085340 | SULFAMETHOXAZOLE-TRIMETHOPRIM | sulfamethoxazole/trimethoprim | ORAL SUSP | 800 mg-160 mg/20 mL | Y | ||
| 60687044224 | SULFAMETHOXAZOLE-TRIMETHOPRIM | sulfamethoxazole/trimethoprim | ORAL SUSP | 800 mg-160 mg/20 mL | Y | ||
| 60687044253 | SULFAMETHOXAZOLE-TRIMETHOPRIM | sulfamethoxazole/trimethoprim | ORAL SUSP | 800 mg-160 mg/20 mL | Y | ||
| 60687044275 | SULFAMETHOXAZOLE-TRIMETHOPRIM | sulfamethoxazole/trimethoprim | ORAL SUSP | 800 mg-160 mg/20 mL | Y | ||
| 62135087324 | SULFAMETHOXAZOLE-TRIMETHOPRIM | sulfamethoxazole/trimethoprim | ORAL SUSP | 800 mg-160 mg/20 mL | Y | ||
| 62135087352 | SULFAMETHOXAZOLE-TRIMETHOPRIM | sulfamethoxazole/trimethoprim | ORAL SUSP | 800 mg-160 mg/20 mL | Y | ||
| 81033001220 | SULFAMETHOXAZOLE-TRIMETHOPRIM | sulfamethoxazole/trimethoprim | ORAL SUSP | 800 mg-160 mg/20 mL | Y | ||
| 81033001240 | SULFAMETHOXAZOLE-TRIMETHOPRIM | sulfamethoxazole/trimethoprim | ORAL SUSP | 800 mg-160 mg/20 mL | Y | ||
| 49708014501 | BACTRIM | sulfamethoxazole/trimethoprim | TABLET | 400 mg-80 mg | Y | ||
| 50268072811 | SULFAMETHOXAZOLE-TRIMETHOPRIM | sulfamethoxazole/trimethoprim | TABLET | 400 mg-80 mg | Y | ||
| 50268072815 | SULFAMETHOXAZOLE-TRIMETHOPRIM | sulfamethoxazole/trimethoprim | TABLET | 400 mg-80 mg | Y | ||
| 53746027105 | SULFAMETHOXAZOLE-TRIMETHOPRIM | sulfamethoxazole/trimethoprim | TABLET | 400 mg-80 mg | Y | ||
| 57237023201 | SULFAMETHOXAZOLE-TRIMETHOPRIM | sulfamethoxazole/trimethoprim | TABLET | 400 mg-80 mg | Y | ||
| 57237023205 | SULFAMETHOXAZOLE-TRIMETHOPRIM | sulfamethoxazole/trimethoprim | TABLET | 400 mg-80 mg | Y | ||
| 60687060311 | SULFAMETHOXAZOLE-TRIMETHOPRIM | sulfamethoxazole/trimethoprim | TABLET | 400 mg-80 mg | Y | ||
| 60687060365 | SULFAMETHOXAZOLE-TRIMETHOPRIM | sulfamethoxazole/trimethoprim | TABLET | 400 mg-80 mg | Y | ||
| 62135089718 | SULFAMETHOXAZOLE-TRIMETHOPRIM | sulfamethoxazole/trimethoprim | TABLET | 400 mg-80 mg | Y | ||
| 62135089790 | SULFAMETHOXAZOLE-TRIMETHOPRIM | sulfamethoxazole/trimethoprim | TABLET | 400 mg-80 mg | Y | ||
| 65162027110 | SULFAMETHOXAZOLE-TRIMETHOPRIM | sulfamethoxazole/trimethoprim | TABLET | 400 mg-80 mg | Y | ||
| 65162027150 | SULFAMETHOXAZOLE-TRIMETHOPRIM | sulfamethoxazole/trimethoprim | TABLET | 400 mg-80 mg | Y | ||
| 65862041901 | SULFAMETHOXAZOLE-TRIMETHOPRIM | sulfamethoxazole/trimethoprim | TABLET | 400 mg-80 mg | Y | ||
| 65862041905 | SULFAMETHOXAZOLE-TRIMETHOPRIM | sulfamethoxazole/trimethoprim | TABLET | 400 mg-80 mg | Y | ||
| 00004011704 | BACTRIM DS | sulfamethoxazole/trimethoprim | TABLET | 800 mg-160 mg | Y | ||
| 00004011714 | BACTRIM DS | sulfamethoxazole/trimethoprim | TABLET | 800 mg-160 mg | Y | ||
| 49708014601 | BACTRIM DS | sulfamethoxazole/trimethoprim | TABLET | 800 mg-160 mg | Y | ||
| 00904272561 | SULFAMETHOXAZOLE-TRIMETHOPRIM | sulfamethoxazole/trimethoprim | TABLET | 800 mg-160 mg | Y | ||
| 53489014601 | SULFAMETHOXAZOLE-TRIMETHOPRIM | sulfamethoxazole/trimethoprim | TABLET | 800 mg-160 mg | Y | ||
| 53489014605 | SULFAMETHOXAZOLE-TRIMETHOPRIM | sulfamethoxazole/trimethoprim | TABLET | 800 mg-160 mg | Y | ||
| 53746027205 | SULFAMETHOXAZOLE-TRIMETHOPRIM | sulfamethoxazole/trimethoprim | TABLET | 800 mg-160 mg | Y | ||
| 57237023301 | SULFAMETHOXAZOLE-TRIMETHOPRIM | sulfamethoxazole/trimethoprim | TABLET | 800 mg-160 mg | Y | ||
| 57237023305 | SULFAMETHOXAZOLE-TRIMETHOPRIM | sulfamethoxazole/trimethoprim | TABLET | 800 mg-160 mg | Y | ||
| 60687061401 | SULFAMETHOXAZOLE-TRIMETHOPRIM | sulfamethoxazole/trimethoprim | TABLET | 800 mg-160 mg | Y | ||
| 60687061411 | SULFAMETHOXAZOLE-TRIMETHOPRIM | sulfamethoxazole/trimethoprim | TABLET | 800 mg-160 mg | Y | ||
| 62135089818 | SULFAMETHOXAZOLE-TRIMETHOPRIM | sulfamethoxazole/trimethoprim | TABLET | 800 mg-160 mg | Y | ||
| 62135089890 | SULFAMETHOXAZOLE-TRIMETHOPRIM | sulfamethoxazole/trimethoprim | TABLET | 800 mg-160 mg | Y | ||
| 65162027210 | SULFAMETHOXAZOLE-TRIMETHOPRIM | sulfamethoxazole/trimethoprim | TABLET | 800 mg-160 mg | Y | ||
| 65162027250 | SULFAMETHOXAZOLE-TRIMETHOPRIM | sulfamethoxazole/trimethoprim | TABLET | 800 mg-160 mg | Y | ||
| 65862042001 | SULFAMETHOXAZOLE-TRIMETHOPRIM | sulfamethoxazole/trimethoprim | TABLET | 800 mg-160 mg | Y | ||
| 65862042005 | SULFAMETHOXAZOLE-TRIMETHOPRIM | sulfamethoxazole/trimethoprim | TABLET | 800 mg-160 mg | Y | ||
| 00004195501 | BACTRIM IV | sulfamethoxazole/trimethoprim | VIAL | 80 mg-16 mg/mL | Y | ||
| 61570005410 | SEPTRA I.V. | sulfamethoxazole/trimethoprim | VIAL | 80 mg-16 mg/mL | Y | ||
| 61570005510 | SEPTRA I.V. | sulfamethoxazole/trimethoprim | VIAL | 80 mg-16 mg/mL | Y | ||
| 61570005610 | SEPTRA I.V. | sulfamethoxazole/trimethoprim | VIAL | 80 mg-16 mg/mL | Y | ||
| 00703950301 | SULFAMETHOXAZOLE-TRIMETHOPRIM | sulfamethoxazole/trimethoprim | VIAL | 80 mg-16 mg/mL | Y | ||
| 00703950303 | SULFAMETHOXAZOLE-TRIMETHOPRIM | sulfamethoxazole/trimethoprim | VIAL | 80 mg-16 mg/mL | Y | ||
| 00703951401 | SULFAMETHOXAZOLE-TRIMETHOPRIM | sulfamethoxazole/trimethoprim | VIAL | 80 mg-16 mg/mL | Y | ||
| 00703951403 | SULFAMETHOXAZOLE-TRIMETHOPRIM | sulfamethoxazole/trimethoprim | VIAL | 80 mg-16 mg/mL | Y | ||
| 00703951481 | SULFAMETHOXAZOLE-TRIMETHOPRIM | sulfamethoxazole/trimethoprim | VIAL | 80 mg-16 mg/mL | Y | ||
| 00703951483 | SULFAMETHOXAZOLE-TRIMETHOPRIM | sulfamethoxazole/trimethoprim | VIAL | 80 mg-16 mg/mL | Y | ||
| 00703951491 | SULFAMETHOXAZOLE-TRIMETHOPRIM | sulfamethoxazole/trimethoprim | VIAL | 80 mg-16 mg/mL | Y | ||
| 00703951493 | SULFAMETHOXAZOLE-TRIMETHOPRIM | sulfamethoxazole/trimethoprim | VIAL | 80 mg-16 mg/mL | Y | ||
| 00703952601 | SULFAMETHOXAZOLE-TRIMETHOPRIM | sulfamethoxazole/trimethoprim | VIAL | 80 mg-16 mg/mL | Y | ||
| 00703952681 | SULFAMETHOXAZOLE-TRIMETHOPRIM | sulfamethoxazole/trimethoprim | VIAL | 80 mg-16 mg/mL | Y | ||
| 67457077800 | SULFAMETHOXAZOLE-TRIMETHOPRIM | sulfamethoxazole/trimethoprim | VIAL | 80 mg-16 mg/mL | Y | ||
| 67457077805 | SULFAMETHOXAZOLE-TRIMETHOPRIM | sulfamethoxazole/trimethoprim | VIAL | 80 mg-16 mg/mL | Y | ||
| 70069036101 | SULFAMETHOXAZOLE-TRIMETHOPRIM | sulfamethoxazole/trimethoprim | VIAL | 80 mg-16 mg/mL | Y | ||
| 70069036110 | SULFAMETHOXAZOLE-TRIMETHOPRIM | sulfamethoxazole/trimethoprim | VIAL | 80 mg-16 mg/mL | Y | ||
| 70069036201 | SULFAMETHOXAZOLE-TRIMETHOPRIM | sulfamethoxazole/trimethoprim | VIAL | 80 mg-16 mg/mL | Y | ||
| 70069036210 | SULFAMETHOXAZOLE-TRIMETHOPRIM | sulfamethoxazole/trimethoprim | VIAL | 80 mg-16 mg/mL | Y | ||
| 70069036301 | SULFAMETHOXAZOLE-TRIMETHOPRIM | sulfamethoxazole/trimethoprim | VIAL | 80 mg-16 mg/mL | Y |