30 Day Prescription List
The following prescriptions are available in 30 Day quantities for $4 per prescription at The Pharmacy at Pascagoula Hospital and The Pharmacy at Ocean Springs Hospital.
Click here to download a .pdf of this list.
| Product Name | Up to Quantity | Tier | Default Price |
|---|---|---|---|
| LIDOCAINE VISCOUS 2 % | 100 | 30 Days | $4.00 |
| PENICILLIN V POTASSIUM 125 MG/5ML | 100 | 30 Days | $4.00 |
| PENICILLIN V POTASSIUM 250 MG/5ML | 100 | 30 Days | $4.00 |
| AMOXICILLIN 125 MG/5ML | 100 | 30 Days | $4.00 |
| AMOXICILLIN 250 MG/5ML | 100 | 30 Days | $4.00 |
| AMOXICILLIN 200 MG/5ML | 100 | 30 Days | $4.00 |
| AMOXICILLIN 400 MG/5ML | 100 | 30 Days | $4.00 |
| CHLORHEXIDINE GLUCONATE 0.12 % | 473 | 30 Days | $4.00 |
| PERIOGARD 0.12 % | 473 | 30 Days | $4.00 |
| TRIAMCINOLONE ACETONIDE 0.5 % | 15 | 30 Days | $4.00 |
| TRIAMCINOLONE ACETONIDE 0.025 % | 15 | 30 Days | $4.00 |
| TRIAMCINOLONE ACETONIDE 0.1 % | 15 | 30 Days | $4.00 |
| NYSTATIN 100000 UNIT/GM | 15 | 30 Days | $4.00 |
| GENTAMICIN SULFATE 0.1 % | 15 | 30 Days | $4.00 |
| HYDROCORTISONE 2.5 % | 30 | 30 Days | $4.00 |
| PILOCARPINE HCL 1 % | 15 | 30 Days | $4.00 |
| PILOCARPINE HCL 2 % | 15 | 30 Days | $4.00 |
| PERIDEX 0.12 % | 473 | 30 Days | $4.00 |
| LEVOBUNOLOL HCL 0.5 % | 5 | 30 Days | $4.00 |
| MAXITROL 0.1 % | 5 | 30 Days | $4.00 |
| IPRATROPIUM BROMIDE 0.02 % | 62.5 | 30 Days | $4.00 |
| ALBUTEROL SULFATE 0.083 % | 75 | 30 Days | $4.00 |
| SILVER SULFADIAZINE 1 % | 50 | 30 Days | $4.00 |
| ERYTHROMYCIN 5 MG/GM | 3.5 | 30 Days | $4.00 |
| ALBUTEROL SULFATE 0.5 % | 20 | 30 Days | $4.00 |
| TIMOLOL MALEATE 0.5 % | 5 | 30 Days | $4.00 |
| TIMOLOL MALEATE 0.25 % | 5 | 30 Days | $4.00 |
| RECORT PLUS 1 % | 30 | 30 Days | $4.00 |
| NEOMYCIN/POLYMYXIN/DEXAME THASONE 0.1 % | 3.5 | 30 Days | $4.00 |
| GENTAMICIN SULFATE 0.3 % | 5 | 30 Days | $4.00 |
| HYDROCORTISONE 1 % | 30 | 30 Days | $4.00 |
| THERMAZENE 1 % | 50 | 30 Days | $4.00 |
| TOBRAMYCIN SULFATE 0.3 % | 5 | 30 Days | $4.00 |
| TRIMETHOPRIM SULFATE/POLY MYXIN B SULFATE 10000-0.1 UNIT/ML-% | 10 | 30 Days | $4.00 |
| POLYMYXIN B SULFATE/TRIME THOPRIM SULFATE 10000-0.1 UNIT/ML-% | 10 | 30 Days | $4.00 |
| ATROPINE-CARE 1 % | 5 | 30 Days | $4.00 |
| ANTIPYRINE/BENZOCAINE 1.4-5.4 % | 15 | 30 Days | $4.00 |
| ATROPINE SULFATE 1 % | 5 | 30 Days | $4.00 |
| SSD 1 % | 50 | 30 Days | $4.00 |
| EPIFLUR 1.1 MG | 120 | 30 Days | $4.00 |
| LUDENT 0.5 MG | 120 | 30 Days | $4.00 |
| SILVADENE 1 % | 50 | 30 Days | $4.00 |
| MED-DERM HYDROCORTISONE 1 % | 30 | 30 Days | $4.00 |
| SSD AF 1 % | 50 | 30 Days | $4.00 |
| POLYTRIM 10000-0.1 UNIT/ML-% | 10 | 30 Days | $4.00 |
| CHLORHEXIDINE GLUCONATE ORAL RINSE 0.12 % | 473 | 30 Days | $4.00 |
| FLUORIDE 1.1 MG | 120 | 30 Days | $4.00 |
| SODIUM FLUORIDE 0.5 MG | 120 | 30 Days | $4.00 |
| PAROEX 0.12 % | 473 | 30 Days | $4.00 |
| LIDOCAINE HCL 2 % | 100 | 30 Days | $4.00 |
| TOBREX 0.3 % | 5 | 30 Days | $4.00 |
| TOBRASOL 0.3 % | 5 | 30 Days | $4.00 |
| POLY-DEX 0.1 % | 3.5 | 30 Days | $4.00 |
| ROMYCIN 5 MG/GM | 3.5 | 30 Days | $4.00 |
| TIMOPTIC 0.25 % | 5 | 30 Days | $4.00 |
| BETAGAN C CAP QD 0.5 % | 5 | 30 Days | $4.00 |
| TIMOPTIC 0.5 % | 5 | 30 Days | $4.00 |
| BETAGAN 0.5 % | 5 | 30 Days | $4.00 |
| TRIMETHOPRIM/POLYMYXIN B 10000-0.1 UNIT/ML-% | 10 | 30 Days | $4.00 |
| TRIMETHOPRIM/POLYMYXIN B SULFATE 10000-0.1 UNIT/ML-% | 10 | 30 Days | $4.00 |
| FLUORIDE 0.5 MG | 120 | 30 Days | $4.00 |
| SODIUM FLUORIDE 1.1 MG | 120 | 30 Days | $4.00 |
| AUROTO 1.4-5.4 % | 15 | 30 Days | $4.00 |
| ACYCLOVIR 200 MG | 30 | 30 Days | $4.00 |
| ALBUTEROL SULFATE 2 MG | 90 | 30 Days | $4.00 |
| ALBUTEROL SULFATE 2 MG/5ML | 120 | 30 Days | $4.00 |
| ALENDRONATE SODIUM 35 MG | 4 | 30 Days | $9.00 |
| ALENDRONATE SODIUM 70 MG | 4 | 30 Days | $9.00 |
| ALLOPURINOL 100 MG | 30 | 30 Days | $4.00 |
| ALLOPURINOL 300 MG | 30 | 30 Days | $4.00 |
| AMITRIPTYLINE HCL 10 MG | 30 | 30 Days | $4.00 |
| AMITRIPTYLINE HCL 100 MG | 30 | 30 Days | $4.00 |
| AMITRIPTYLINE HCL 25 MG | 30 | 30 Days | $4.00 |
| AMITRIPTYLINE HCL 50 MG | 30 | 30 Days | $4.00 |
| AMITRIPTYLINE HCL 75 MG | 30 | 30 Days | $4.00 |
| AMOXICILLIN 250 MG | 30 | 30 Days | $4.00 |
| AMOXICILLIN 500 MG | 30 | 30 Days | $4.00 |
| ATENOLOL 100 MG | 30 | 30 Days | $4.00 |
| ATENOLOL 25 MG | 30 | 30 Days | $4.00 |
| ATENOLOL 50 MG | 30 | 30 Days | $4.00 |
| ATENOLOL/CHLORTHALIDONE 100-25 MG | 30 | 30 Days | $4.00 |
| BACLOFEN 10 MG | 30 | 30 Days | $4.00 |
| BENAZEPRIL HCL 10 MG | 30 | 30 Days | $4.00 |
| BENAZEPRIL HCL 20 MG | 30 | 30 Days | $4.00 |
| BENAZEPRIL HCL 40 MG | 30 | 30 Days | $4.00 |
| BENAZEPRIL HCL 5 MG | 30 | 30 Days | $4.00 |
| BENZONATATE 100 MG | 14 | 30 Days | $4.00 |
| BENZTROPINE MESYLATE 2 MG | 30 | 30 Days | $4.00 |
| BISOPROLOL FUMARATE/HYDRO CHLOROTHIAZIDE 10-6.25 MG | 30 | 30 Days | $4.00 |
| BISOPROLOL FUMARATE/HYDRO CHLOROTHIAZIDE 2.5-6.25 MG | 30 | 30 Days | $4.00 |
| BISOPROLOL FUMARATE/HYDRO CHLOROTHIAZIDE 5-6.25 MG | 30 | 30 Days | $4.00 |
| BUSPIRONE HCL 10 MG | 60 | 30 Days | $4.00 |
| BUSPIRONE HCL 5 MG | 60 | 30 Days | $4.00 |
| CARBAMAZEPINE 200 MG | 60 | 30 Days | $4.00 |
| CARVEDILOL 12.5 MG | 60 | 30 Days | $4.00 |
| CARVEDILOL 25 MG | 60 | 30 Days | $4.00 |
| CARVEDILOL 3.125 MG | 60 | 30 Days | $4.00 |
| CARVEDILOL 6.25 MG | 60 | 30 Days | $4.00 |
| CEPHALEXIN 250 MG | 28 | 30 Days | $4.00 |
| CEPHALEXIN 500 MG | 30 | 30 Days | $4.00 |
| CIMETIDINE 800 MG | 30 | 30 Days | $4.00 |
| CIPROFLOXACIN HCL 250 MG | 14 | 30 Days | $4.00 |
| CIPROFLOXACIN HCL 500 MG | 20 | 30 Days | $4.00 |
| CITALOPRAM HYDROBROMIDE 20 MG | 30 | 30 Days | $4.00 |
| CITALOPRAM HYDROBROMIDE 40 MG | 30 | 30 Days | $4.00 |
| CITRIC ACID/SODIUM CITRAT E 500-334 MG/5ML | 180 | 30 Days | $4.00 |
| CLONIDINE HCL 0.1 MG | 30 | 30 Days | $4.00 |
| CLONIDINE HCL 0.2 MG | 30 | 30 Days | $4.00 |
| CYCLOBENZAPRINE HCL 10 MG | 30 | 30 Days | $4.00 |
| CYCLOBENZAPRINE HCL 5 MG | 30 | 30 Days | $4.00 |
| DEXAMETHASONE 0.5 MG | 30 | 30 Days | $4.00 |
| DEXAMETHASONE 0.75 MG | 12 | 30 Days | $4.00 |
| DEXAMETHASONE 4 MG | 6 | 30 Days | $4.00 |
| DICLOFENAC SODIUM DR 75 MG | 60 | 30 Days | $4.00 |
| DICYCLOMINE HCL 10 MG | 90 | 30 Days | $4.00 |
| DICYCLOMINE HCL 20 MG | 60 | 30 Days | $4.00 |
| ENALAPRIL MALEATE 10 MG | 30 | 30 Days | $4.00 |
| ENALAPRIL MALEATE 2.5 MG | 30 | 30 Days | $4.00 |
| ENALAPRIL MALEATE 20 MG | 30 | 30 Days | $4.00 |
| ENALAPRIL MALEATE 5 MG | 30 | 30 Days | $4.00 |
| ENALAPRIL MALEATE/HYDROCH LOROTHIAZIDE 5-12.5 MG | 30 | 30 Days | $4.00 |
| ESTRADIOL 0.5 MG | 30 | 30 Days | $4.00 |
| ESTRADIOL 1 MG | 30 | 30 Days | $4.00 |
| ESTRADIOL 2 MG | 30 | 30 Days | $4.00 |
| FAMOTIDINE 20 MG | 60 | 30 Days | $4.00 |
| FLUCONAZOLE 150 MG | 1 | 30 Days | $4.00 |
| FLUOXETINE HCL 10 MG | 30 | 30 Days | $4.00 |
| FLUPHENAZINE HCL 1 MG | 30 | 30 Days | $4.00 |
| FOLIC ACID 1 MG | 30 | 30 Days | $4.00 |
| FUROSEMIDE 20 MG | 30 | 30 Days | $4.00 |
| FUROSEMIDE 40 MG | 30 | 30 Days | $4.00 |
| FUROSEMIDE 80 MG | 30 | 30 Days | $4.00 |
| GLIMEPIRIDE 1 MG | 30 | 30 Days | $4.00 |
| GLIMEPIRIDE 2 MG | 30 | 30 Days | $4.00 |
| GLIMEPIRIDE 4 MG | 30 | 30 Days | $4.00 |
| GLIPIZIDE 10 MG | 60 | 30 Days | $4.00 |
| GLIPIZIDE 5 MG | 30 | 30 Days | $4.00 |
| GLYBURIDE 2.5 MG | 30 | 30 Days | $4.00 |
| GLYBURIDE 5 MG | 30 | 30 Days | $4.00 |
| GLYBURIDE MICRONIZED 3 MG | 30 | 30 Days | $4.00 |
| GLYBURIDE MICRONIZED 6 MG | 30 | 30 Days | $4.00 |
| GUANFACINE HCL 1 MG | 30 | 30 Days | $4.00 |
| HALOPERIDOL 0.5 MG | 30 | 30 Days | $4.00 |
| HALOPERIDOL 1 MG | 30 | 30 Days | $4.00 |
| HALOPERIDOL 2 MG | 30 | 30 Days | $4.00 |
| HALOPERIDOL 5 MG | 30 | 30 Days | $4.00 |
| HYDRALAZINE HCL 10 MG | 30 | 30 Days | $4.00 |
| HYDRALAZINE HCL 25 MG | 30 | 30 Days | $4.00 |
| HYDROCHLOROTHIAZIDE 12.5 MG | 30 | 30 Days | $4.00 |
| HYDROCHLOROTHIAZIDE 25 MG | 30 | 30 Days | $4.00 |
| HYDROCHLOROTHIAZIDE 50 MG | 30 | 30 Days | $4.00 |
| IBUPROFEN 100 MG/5ML | 120 | 30 Days | $4.00 |
| IBUPROFEN 400 MG | 90 | 30 Days | $4.00 |
| IBUPROFEN 600 MG | 60 | 30 Days | $4.00 |
| IBUPROFEN 800 MG | 30 | 30 Days | $4.00 |
| INDAPAMIDE 1.25 MG | 30 | 30 Days | $4.00 |
| INDAPAMIDE 2.5 MG | 30 | 30 Days | $4.00 |
| INDOMETHACIN 25 MG | 60 | 30 Days | $4.00 |
| ISONIAZID 300 MG | 30 | 30 Days | $4.00 |
| ISOSORBIDE MONONITRATE ER 30 MG | 30 | 30 Days | $4.00 |
| ISOSORBIDE MONONITRATE ER 60 MG | 30 | 30 Days | $4.00 |
| LACTULOSE 10 GM/15ML | 236 | 30 Days | $4.00 |
| LACTULOSE 20 GM/30ML | 236 | 30 Days | $4.00 |
| LISINOPRIL 10 MG | 30 | 30 Days | $4.00 |
| LISINOPRIL 2.5 MG | 30 | 30 Days | $4.00 |
| LISINOPRIL 20 MG | 30 | 30 Days | $4.00 |
| LISINOPRIL 5 MG | 30 | 30 Days | $4.00 |
| LISINOPRIL/HYDROCHLOROTHI AZIDE 10-12.5 MG | 30 | 30 Days | $4.00 |
| LISINOPRIL/HYDROCHLOROTHI AZIDE 20-12.5 MG | 30 | 30 Days | $4.00 |
| LISINOPRIL/HYDROCHLOROTHI AZIDE 20-25 MG | 30 | 30 Days | $4.00 |
| LITHIUM CARBONATE 300 MG | 90 | 30 Days | $4.00 |
| LORATADINE 10 MG | 30 | 30 Days | $4.00 |
| LOVASTATIN 10 MG | 30 | 30 Days | $4.00 |
| LOVASTATIN 20 MG | 30 | 30 Days | $4.00 |
| MAG-SR 535 MG | 60 | 30 Days | $4.00 |
| MAG-SR 64 MG | 60 | 30 Days | $4.00 |
| MAGNESIUM OXIDE 400 MG | 30 | 30 Days | $4.00 |
| MEDROXYPROGESTERONE ACETA TE 10 MG | 10 | 30 Days | $4.00 |
| MEDROXYPROGESTERONE ACETA TE 2.5 MG | 30 | 30 Days | $4.00 |
| MEDROXYPROGESTERONE ACETA TE 5 MG | 30 | 30 Days | $4.00 |
| MEGESTROL ACETATE 20 MG | 30 | 30 Days | $4.00 |
| MELOXICAM 15 MG | 30 | 30 Days | $4.00 |
| MELOXICAM 7.5 MG | 30 | 30 Days | $4.00 |
| METFORMIN HCL 1000 MG | 60 | 30 Days | $4.00 |
| METFORMIN HCL 500 MG | 60 | 30 Days | $4.00 |
| METFORMIN HCL 850 MG | 60 | 30 Days | $4.00 |
| METFORMIN HCL ER 500 MG | 60 | 30 Days | $4.00 |
| METOCLOPRAMIDE HCL 10 MG | 60 | 30 Days | $4.00 |
| METOPROLOL TARTRATE 100 MG | 60 | 30 Days | $4.00 |
| METOPROLOL TARTRATE 25 MG | 60 | 30 Days | $4.00 |
| METOPROLOL TARTRATE 50 MG | 60 | 30 Days | $4.00 |
| NAPROXEN 375 MG | 60 | 30 Days | $4.00 |
| NAPROXEN 500 MG | 60 | 30 Days | $4.00 |
| NORTRIPTYLINE HCL 10 MG | 30 | 30 Days | $4.00 |
| NORTRIPTYLINE HCL 25 MG | 30 | 30 Days | $4.00 |
| PAROXETINE HCL 10 MG | 30 | 30 Days | $4.00 |
| PAROXETINE HCL 20 MG | 30 | 30 Days | $4.00 |
| PENICILLIN V POTASSIUM 250 MG | 28 | 30 Days | $4.00 |
| PHENAZOPYRIDINE HCL 100 MG | 6 | 30 Days | $4.00 |
| PREDNISONE 2.5 MG | 30 | 30 Days | $4.00 |
| PREDNISONE 5 MG | 30 | 30 Days | $4.00 |
| PROCHLORPERAZINE MALEATE 10 MG | 30 | 30 Days | $4.00 |
| PROMETHAZINE HCL 25 MG | 12 | 30 Days | $4.00 |
| PROMETHAZINE HCL 6.25 MG/5ML | 180 | 30 Days | $4.00 |
| PROMETHAZINE/DEXTROMETHOR PHAN 6.25-15 MG/5ML | 120 | 30 Days | $4.00 |
| PROPRANOLOL HCL 10 MG | 60 | 30 Days | $4.00 |
| PROPRANOLOL HCL 20 MG | 60 | 30 Days | $4.00 |
| PROPRANOLOL HCL 40 MG | 60 | 30 Days | $4.00 |
| PROPRANOLOL HCL 80 MG | 60 | 30 Days | $4.00 |
| RANITIDINE HCL 150 MG | 60 | 30 Days | $4.00 |
| RANITIDINE HCL 300 MG | 30 | 30 Days | $4.00 |
| SOTALOL HCL 80 MG | 30 | 30 Days | $4.00 |
| SPIRONOLACTONE 25 MG | 30 | 30 Days | $4.00 |
| SULFAMETHOXAZOLE/TRIMETHO PRIM 200-40 MG/5ML | 120 | 30 Days | $4.00 |
| SULFAMETHOXAZOLE/TRIMETHO PRIM 400-80 MG | 28 | 30 Days | $4.00 |
| TERAZOSIN HCL 1 MG | 30 | 30 Days | $4.00 |
| TERAZOSIN HCL 10 MG | 30 | 30 Days | $4.00 |
| TERAZOSIN HCL 2 MG | 30 | 30 Days | $4.00 |
| TERAZOSIN HCL 5 MG | 30 | 30 Days | $4.00 |
| TERBINAFINE HCL 250 MG | 30 | 30 Days | $4.00 |
| TRAZODONE HCL 100 MG | 30 | 30 Days | $4.00 |
| TRAZODONE HCL 150 MG | 30 | 30 Days | $4.00 |
| TRAZODONE HCL 50 MG | 30 | 30 Days | $4.00 |
| TRIAMTERENE/HYDROCHLOROTH IAZIDE 37.5-25 MG | 30 | 30 Days | $4.00 |
| TRIAMTERENE/HYDROCHLOROTH IAZIDE 75-50 MG | 30 | 30 Days | $4.00 |
| TRIHEXYPHENIDYL HCL 2 MG | 60 | 30 Days | $4.00 |
| VERAPAMIL HCL 120 MG | 30 | 30 Days | $4.00 |
| VERAPAMIL HCL 80 MG | 30 | 30 Days | $4.00 |
| WARFARIN SODIUM 1 MG | 30 | 30 Days | $4.00 |
| WARFARIN SODIUM 10 MG | 30 | 30 Days | $4.00 |
| WARFARIN SODIUM 2 MG | 30 | 30 Days | $4.00 |
| WARFARIN SODIUM 2.5 MG | 30 | 30 Days | $4.00 |
| WARFARIN SODIUM 3 MG | 30 | 30 Days | $4.00 |
| WARFARIN SODIUM 4 MG | 30 | 30 Days | $4.00 |
| WARFARIN SODIUM 5 MG | 30 | 30 Days | $4.00 |
| WARFARIN SODIUM 6 MG | 30 | 30 Days | $4.00 |
| WARFARIN SODIUM 7.5 MG | 30 | 30 Days | $4.00 |