Palliative Care Drug Plan (Plan P) Formulary
Last updated: July 27, 2023
This formulary is a general guide and may not reflect recent Plan P formulary changes. See PharmaCare Formulary Search for current listings.
A downloadable version of the Plan P formulary (PDF, 178KB) is also available.
- Pharmacists must submit a claim at the time of purchase.
- PharmaCare may not cover all available formulations and strengths of the drugs listed below.
- If PharmaCare covers a generic version of a drug, PharmaCare usually covers only part of the cost of the brand product.
- Some generic products may be only partially covered, depending on the price of competing generic products.
On this page:
Analgesics
Non-opioid
- acetaminophen
NSAIDs (This category excludes topical NSAIDs)
- celecoxib
- diclofenac
- ibuprofen
- meloxicam
- naproxen
Opioids
- codeine products (including acetaminophen combinations)
- fentanyl
- hydromorphone
- methadone
- morphine
- oxycodone
- sufentanil
Miscellaneous analgesics
- ketamine
- mexiletine
- xylocaine
Anticoagulants and coagulants
Anticoagulants
- apixaban
- heparin sodium
- warfarin
Coagulants (antifibrinolytic agents)
- tranexamic acid
Anticonvulsants
- carbamazepine
- gabapentin
- phenobarbital
- phenytoin
- pregabalin
- valproic acid
Antidiarrheals
- bismuth subsalicylate
- diphenoxylate/atropine
- loperamide
- octreotide – as a last resort only
(e.g., currently covered for profuse diarrhea in advanced AIDS not responsive to multiple constipating agents)
Antiemetics
- dexamethasone
- dimenhydrinate
- domperidone
- haloperidol
- metoclopramide – oral, parenteral
- octreotide - as a last resort only (e.g., currently covered for uncontrolled vomiting from an irreversible bowel obstruction not responsive to the use of multiple antiemetics)
- prochlorperazine – oral, suppository
- promethazine
Anti-infectives
Antifungal (oral/topical/vaginal preparations)
- clotrimazole
- fluconazole
- ketoconazole
- nystatin
Antimicrobials
- All antimicrobials normally covered by PharmaCare
Antivirals
- acyclovir
- famciclovir
Antipruritics
- diphenhydramine
- hydroxyzine
Antispasmodics
- atropine
- baclofen
- benztropine
- dantrolene
- dicyclomine
- hyoscyamine
- opium and belladonna – suppositories
- oxybutynin
- scopolamine – oral, parenteral, patch
Bone metabolism regulators
- clodronate
- denosumab(120mg/1.7mL vial)
- pamidronate
- zoledronic acid(4mg/5mL formulation) - covered if a cost-effective usage. For example, if a patient is at home, has an estimated life span of more than 4 weeks, and hospital day care is not available or the patient would need transportation to get to a hospital. In such a case, the physician could administer zoledronic acid over 10-15 minutes via a butterfly needle in a peripheral vein.
Central nervous system stimulants
- methylphenidate
Congestive heart failure therapy
- all ACE inhibitors that are normally PharmaCare benefits
- all antianginals that are normally PharmaCare benefits
- all beta blockers that are normally PharmaCare benefits
- carvedilol
- dapagliflozin
- digoxin
Diabetic agents
- insulin
- dapagliflozin
- glyburide
- metformin
Diuretics
- amiloride
- ethacrynic acid
- furosemide
- hydrochlorothiazide
- metolazone
- spironolactone
- triamterene
H2 blockers and proton pump inhibitors
- pantoprazole magnesium
- rabeprazole
- ranitidine
Hemorrhoid therapy (ointment and suppositories)
- framycetin
- pramoxine with and without hydrocortisone
- pramoxine and zinc with and without hydrocortisone
- zinc sulfate with and without hydrocortisone
Laxatives
- bisacodyl
- cascara
- docusate sodium
- glycerin
- lactulose
- magnesium citrate
- magnesium hydroxide
- mineral oil enema
- sennosides with and without docusate
- sodium citrate, sodium lauryl sulfoacetate and sorbitol enema
Psychiatric medication
Antidepressants
- amitriptyline
- bupropion
- citalopram
- desipramine
- doxepin
- duloxetine
- escitalopram
- fluoxetine
- fluvoxamine
- imipramine
- mirtazapine
- nortriptyline
- paroxetine
- sertraline
- trazodone
- venlafaxine
- zuclopenthixol
Antipsychotics
- chlorpromazine
- haloperidol
- loxapine
- methotrimeprazine
- paliperidone
- quetiapine
- risperidone
Anxiolytics/hypnotics
- alprazolam
- clonazepam
- diazepam – oral, parenteral
- lorazepam – oral, sublingual, parenteral
- midazolam
- oxazepam
Respiratory system therapy
Bronchodilators
- glycopyrronium
- ipratropium – inhalers and nebules
- salbutamol – inhalers and nebules
- theophylline
Inhaled corticosteroids
- beclomethasone
- budesonide
- ciclesonide
- fluticasone
- mometasone furoate
Antitussives
- codeine syrup
Steroids
- dexamethasone
- prednisone
- all topical steroids normally covered by PharmaCare
Wound care
- fucidic acid (topical)
- metronidazole (topical)
- silver sulfadiazine (topical)
Other
- atropine 1% ophthalmic drops
- azelaic acid topical gel
- digestive enzymes
- glycopyrrolate
- potassium chloride solution
- simethicone
Note: PharmaCare formularies are not a replacement for professional medical judgment and advice.
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