Category/Indication | Drugs or Classes of Drugs that May be Prescribed with Prescriptive Endorsement | Application and Other Limitations |
Analgesics | All drugs within the NSAID class may be prescribed. | |
Anesthetics | All drugs within the local anesthetics class may be prescribed. | |
Antiaddiction/Substance abuse treatment agents | Naltrexone Nicotine | |
Antibacterials | Neomycin Gentamicin (topical only) Tobramycin (topical only) Amoxicillin Amoxicillin/Clavulanate potassium Penicillin G Doxycycline Clarithromycin Clindamycin (topical only) Nitrofurantoin Metronidazole Acetic acid Polymyxin B sulfate Rifaximin | May not administer any drugs in this category via intravenous administration. |
Antiemetics | Ondansetron Diphenhydramine hydrochloride Hydroxyzine hydrochloride Meclizine hydrochloride Metoclopramide hydrochloride Scopolamine | |
Antifungals | Terbinafine (topical only) Miconazole nitrate (topical only) Ketoconazole (topical only) Terconazole (topical only) Fluconazole Nystatin | |
Antigout agents | Probenecid Allopurinol Colchicine | |
Antimigraine agents | Propranolol hydrochloride | |
Antineoplastics | Anastrozole Alitretinoin Tretinoin | Topical only All drugs may only be prescribed for noncancer purposes and uses. |
Antiobesity agents | Orlistat | |
Antiparasitics | Albendazole Ivermectin Mebendazole | Topical only |
Antispasticity agents | Baclofen Tizanidine hydrochloride | |
Antivirals | Acyclovir Valacyclovir Oseltamivir | |
Anxiolytics | Buspirone Hydroxyzine | |
Blood glucoses regulators | All drugs within the antidiabetic agents and glycemic agents class may be prescribed. All drugs within the biguanide and DPP 4 inhibitors group may be prescribed. | |
Blood products and modifiers | Aspirin Heparin sodium (for nontherapeutic blood thinning only) | Not allowed to do blood transfusions. |
Cardiovascular agents | All drugs within the following classes may be prescribed: * Alpha-adrenergic agonists; * Alpha-adrenergic blocking agents; * Angiotensin II receptor antagonists; * Angiotensin-converting enzyme (ACE) inhibitors; * Calcium channel blocking agents - Dihydropyridines and nondihydropyridines; * Loop diuretics; * Potassium-sparing diuretics; * Thiazide diuretics; * Dyslipidemics - Fibric acid derivatives, HMG CoA reductase inhibitors, and PCSK9 inhibitors. | Beta adrenergics medications are limited to 100 mg. Nondihydropyridines medications are limited to 120 mg. |
Central nervous system agents | Clonidine hydrochloride | |
Contraceptives Dental and oral agents | All drugs within the oral contraceptives combinations and oral progestins classes may be prescribed. Citric acid/Lactic acid/Potassium bitartate Ethinyl estradiol/Etonogestrel Ethyinyl estradiol/Norelgestromin Levonorgestrel Doxycycline hyclate Minocycline hyclate Prilocaine hydrochloride Triamcinolone acetonide | May not prescribe any drug within this category that would require a procedure such as implantable contraceptives. |
Dermatological agents | All drugs within this category may be prescribed. | Topical only except can allow triamcinolone injection. |
Electrolytes - Minerals -Metals - Vitamins | All drugs within this category may be prescribed. | |
Gastrointestinal agents | All drugs within the following classes may be prescribed: * Anticonstipation agents; * Antidiarrheal agents; * Antispasmodics, gastrointestinal; * Histamine receptor antagonists; * Protectants; * Proton pump inhibitors. Metoclopramide hydrochloride Rifaximin Ursodiol Cholic acid Betaine Betaine hydrochloride Cromolyn sodium Amoxicillin/Clarithromycin/Omeprazole | |
Genitourinary agents | All drugs within this category may be prescribed. | |
Hormonal agents: stimulant, replacement, modifying (adrenal) | Hydrocortisone (dose limit: 30 mg daily) Prednisone (dose limit: 5 mg daily) Methylprednisolone acetate (burst dose pack -dose limit of 1 pack per 60 days) Triamcinolone acetonide | |
Hormonal agents: stimulant, replacement, modifying (sex hormones, modifies) | Testosterone (no more than 400 mg/month) All drugs within the androgens and progestins classes may be prescribed. All drugs within the estrogens class may only be prescribed as topical and vaginal HRT. Exception for oral estrogens prescribed for purposes of contraception. Estradiol/Levonorgestrel Estradiol/Norethindrone acetate Estradiol/Norgestimate Estradiol/Progesterone | |
Hormonal agents: stimulant, replacement, modifying (thyroid) | All drugs within this category may be prescribed. | |
Immunological agents | All drugs within the vaccines class may be prescribed. All drugs within the other immunological agents - Allergen specific immunotherapy group may be prescribed. | |
Inflammatory bowel disease agents | Hydrocortisone Prednisone | |
Metabolic bone disease agents | Alendronate Ibandronate Cholecalciferol Calcitriol Doxercalciferol Paricalcitol | |
Ophthalmic agents Otic agents | All drugs within antiallergy agents class may be prescribed. All drugs within the anti-infectives class may be prescribed (topical only). Diclofenac sodium Ketorolac tromethamine Nepafenac Bacitracin zinc/Hydrocortisone acetate/Neomycin sulfate/Polymyxin B sulfate Bacitracin zinc/Hydrocortisone acetate/Polymyxin B sulfate Hydrocortisone acetate/Neomycin sulfate/Polymyxin B sulfate Ciprofloxacin (topical only) All drugs within this category may be prescribed. | Topical use only |
Respiratory tract/ Pulmonary agents | All drugs within the following classes may be prescribed: * Antihistamines; * Anti-inflammatories - Inhaled corticosteroids; * Antileukotrienes; * Anticholinergic bronchodilators; * Sympathomimetic bronchodilators; * Combination bronchodilators; * Cold-cough; and * Mast cell stabilizers. Acetylcysteine | |
Sexual disorder agents | All drugs within the sexual disorder agents (male) class may be prescribed. | |
Skeletal muscle relaxants | Cyclobenzaprine hydrochloride |
N.D. Admin Code 50-06-02-08
General Authority: NDCC 43-58-03.1
Law Implemented: NDCC 43-58-08(3)(c)