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2020 Preventive Medication List forConsumer Driven Health PlansCore Plus ListCDH preventive drug lists may also be used with non-CDH plans
Effective July 1, 2020
This is a list of Preventive Medications that may be covered under your plan. If your plan covers these Preventive Medications, your insurance benefit is applied before you meet your deductible.
Some medications may have other requirements or limits depending on your benefit plan and are noted below. To find out if a drug is covered, please check your plan benefits on the health plan’s member website. Or, call the toll-free phone number on your health plan ID card. This list may not be all-inclusive. Brand and generic drugs may not always be available due to market changes.
This list applies to UnitedHealthcare and Oxford medical plans. It is correct as of February 1, 2020 and is subject to change after this date. The next anticipated update will occur with the next PDL cycle.
Core Plus Drug List
Requirements Therapeutic Drug Classes & Limits
Breast Cancer Prevention
Anastrozole
Arimidex E
Aromasin
Exemestane
Fareston
Femara E
Letrozole
Soltamox E
Tamoxifen
Toremifene
Requirements Therapeutic Drug Classes & Limits
Cardiovascular/Heart Disease: Blood Clot/Platelet Therapy
Aggrenox
Arixtra
Aspirin-Dipyridamole
Bevyxxa
Brilinta
Cilostazol
Clopidogrel
Coumadin
Dipyridamole
Effient E
Eliquis
Bold type = Brand-name drug[Plain type = Generic drug]
E = May be excluded from coverage or subject to prior authorization (sometimes referred to as precertification)
*Coverage is provided for oral formulations1 SSRIs are included only for employer groups who have specifically requested coverage.
2
Bold type = Brand-name drug[Plain type = Generic drug]
E = May be excluded from coverage or subject to prior authorization (sometimes referred to as precertification)
*Coverage is provided for oral formulations1 SSRIs are included only for employer groups who have specifically requested coverage.
Requirements Therapeutic Drug Classes & Limits
Enoxaparin
Fragmin
Fondaparinux
Heparin
Jantoven
Lovenox E
Persantine
Plavix E
Pletal
Pradaxa
Prasugrel
Savaysa
Ticlopidine
Warfarin
Xarelto
Zontivity
Cardiovascular/Heart Disease: High Blood Pressure
Accupril
Accuretic
Acebutolol
Aceon
Adalat CC
Afeditab
Aldactazide
Aldactone
Aliskiren
Altace
Amiloride
Amiloride-Hydrochlorothiazide
Amlodipine
Amlodipine-Benazepril
Amlodipine-Olmesartan E
Amlodipine-Olmesartan- EHydrochlorothiazide
Requirements Therapeutic Drug Classes & Limits
Amlodipine-Valsartan
Amlodipine-Valsartan-Hydrochlorothiazide E
Amturnide E
Atacand
Atacand HCT
Atenolol
Atenolol-Chlorthalidone
Avalide
Avapro
Azor E
Benazepril
Benazepril-Hydrochlorothiazide
Benicar E
Benicar HCT E
Betaxolol*
Bidil
Bisoprolol
Bisoprolol-Hydrochlorothiazide
Bumetanide
Bystolic
Byvalson
Calan
Calan SR
Candesartan
Candesartan-Hydrochlorothiazide
Captopril
Captopril-Hydrochlorothiazide
Cardene SR
Cardizem E
Cardizem CD E
Cardizem LA E
Cardura
Carospir
Cartia XT
3
Bold type = Brand-name drug[Plain type = Generic drug]
E = May be excluded from coverage or subject to prior authorization (sometimes referred to as precertification)
*Coverage is provided for oral formulations1 SSRIs are included only for employer groups who have specifically requested coverage.
Requirements Therapeutic Drug Classes & Limits
Carvedilol
Carvedilol ER E
Catapres
Catapres TTS
Chlorothiazide
Clonidine
Clonidine Patch
Clorpress
Coreg
Coreg CR E
Corgard
Corzide
Covera HS
Cozaar
Demadex
Dilacor XR
Dilt CD
Dilt XR
Diltia XT
Diltiazem
Diltiazem ER
Diltzac ER
Diovan E
Diovan HCT E
Diuril
Doxazosin
Dutoprol E
Dyazide
Dynacirc CR
Dyrenium
Edarbi
Edarbyclor
Edecrin
Enalapril
Enalapril-Hydrochlorothiazide
Requirements Therapeutic Drug Classes & Limits
Epaned
Eplerenone
Eprosartan
Ethacrynic Acid
Exforge E
Exforge HCT E
Felodipine ER
Fosinopril
Fosinopril-Hydrochlorothiazide
Furosemide
Guanfacine
Hydralazine
Hydrochlorothiazide
Hyzaar
Indapamide
Inderal
Inderal LA E
Innopran XL
Inspra
Irbesartan
Irbesartan-Hydrochlorothiazide
Isoptin SR
Isradipine
Kapspargo
Katerzia E
Labetalol
Lasix
Levatol
Lisinopril
Lisinopril-Hydrochlorothiazide
Lopressor
Lopressor HCT
Losartan
Losartan-Hydrochlorothiazide
4
Bold type = Brand-name drug[Plain type = Generic drug]
E = May be excluded from coverage or subject to prior authorization (sometimes referred to as precertification)
*Coverage is provided for oral formulations1 SSRIs are included only for employer groups who have specifically requested coverage.
Requirements Therapeutic Drug Classes & Limits
Lotensin
Lotensin HCT
Lotrel
Matzim LA
Mavik
Maxzide
Methyclothiazide
Methyldopa
Methyldopa-Hydrochlorothiazide
Metolazone
Metoprolol 37.5, 75 mg E
Metoprolol-Hydrochlorothiazide
Metoprolol Succinate
Metoprolol Tartrate
Micardis E
Micardis HCT E
Microzide
Midamor
Minipress
Minoxidil
Moexipril
Moexipril-Hydrochlorothiazide
Nadolol
Nadolol-Bendroflumethazide
Nicardipine
Nifedipine
Nifedipine ER
Nimodipine
Nisoldipine
Norvasc E
Olmesartan
Olmesartan-Hydrochlorothiazide
Perindopril
Pindolol
Requirements Therapeutic Drug Classes & Limits
Prazosin
Prestalia E
Prinivil
Procardia
Procardia XL
Propranolol
Propranolol-Hydrochlorothiazide
Qbrelis E
Quinapril
Quinapril-Hydrochlorothiazide
Ramipril
Reserpine
Sectral
Spironolactone
Spironolactone-Hydrochlorothiazide
Sular
Tarka
Taztia XT
Tekturna
Tekturna HCT
Telmisartan
Telmisartan-Amlodipine E
Telmisartan-Hydrochlorothiazide
Tenex
Tenoretic E
Tenormin E
Terazosin
Teveten
Teveten HCT
Thalitone
Tiazac
Timolol*
Toprol XL
Torsemide
5
Bold type = Brand-name drug[Plain type = Generic drug]
E = May be excluded from coverage or subject to prior authorization (sometimes referred to as precertification)
*Coverage is provided for oral formulations1 SSRIs are included only for employer groups who have specifically requested coverage.
Requirements Therapeutic Drug Classes & Limits
Trandate
Trandolapril
Trandolapril-Verapamil
Triamterene
Triamterene-Hydrochlorothiazide
Tribenzor E
Twynsta E
Uniretic
Univasc
Valsartan
Valsartan-Hydrochlorothiazide
Vaseretic E
Vasotec E
Verapamil
Verapamil ER
Verelan
Verelan PM
Zaroxolyn
Zebeta
Zestoretic E
Zestril E
Ziac
Cardiovascular/Heart Disease: High Cholesterol
Altoprev E
Antara E
Atorvastatin
Cholestyramine
Cholestyramine Light
Choline Fenofibrate E
Colesevelam Tablets, Powder for ESuspension
Colestid
Colestipol
Crestor E
Ezallor Sprinkle
Requirements Therapeutic Drug Classes & Limits
Ezetimibe
Fenofibrate 43, 50, 67, 130, 134, 150, E200 mg Capsule
Fenofibrate 40, 48, 120, 145 mg Tablet E
Fenofibrate 54, 160 mg Tablet
Fenofibric Acid E
Fenoglide E
Fibricor E
Flolipid
Fluvastatin
Fluvastatin ER
Gemfibrozil
Lescol
Lescol XL E
Lipitor E
Lipofen E
Livalo E
Lofibra E
Lopid
Lovastatin
Lovaza E
Mevacor
Niacin Extended-Release
Niacor
Niaspan
Omega-3 Acid Ethyl Esters
Pravachol
Pravastatin
Prevalite
Questran
Questran Light
Rosuvastatin
Simvastatin
Simvastatin-Ezetimibe
Simvastatin Suspension (Flolipid EAuthorized Generic)
6
Bold type = Brand-name drug[Plain type = Generic drug]
E = May be excluded from coverage or subject to prior authorization (sometimes referred to as precertification)
*Coverage is provided for oral formulations1 SSRIs are included only for employer groups who have specifically requested coverage.
Requirements Therapeutic Drug Classes & Limits
Tricor E
Triglide E
Trilipix E
Vascepa
Vytorin E
Welchol
Zetia E
Zocor
Zypitamag E
Depression: Selective Serotonin Reuptake Inhibitors (SSRIs)1
Celexa E
Citalopram
Escitalopram
Fluoxetine Capsules
Fluoxetine 10 mg, 20 mg Tablets
Fluoxetine 60 mg Tablets E
Fluvoxamine
Fluvoxamine Extended-Release
Lexapro E
Paroxetine
Paroxetine Extended-Release
Paxil
Paxil CR
Pexeva
Prozac E
Sertraline
Zoloft E
Diabetes: Diabetic Supplies
Contour Next EZ Meters
Contour Next Meters
Contour Next One Meters
Contour Next Test Strips
Diabetic Testing - Lancets
Insulin Needles/Syringes
Requirements Therapeutic Drug Classes & Limits
OneTouch Diabetic Meters
OneTouch Diabetic Test Strips
Diabetes: Insulin
Admelog, Admelog SoloStar E
Afrezza E
Apidra, Apidra SoloStar E
Basaglar E
Fiasp, Fiasp FlexTouch E
Humalog
Humalog Junior
Humalog Mix 50/50
Humalog Mix 75/25
Humulin 50/50
Humulin 70/30
Humulin N
Humulin R
Insulin Aspart E
Insulin Aspart Protamine/Insulin Aspart E
Insulin Lispro E
Lantus
Levemir E
Novolin 70/30 E
Novolin N E
Novolin R E
Novolog, Novolog FlexPen E
Novolog Mix 70/30 E
Soliqua
Toujeo
Tresiba E
Diabetes: Non-Insulin
Acarbose
ACTOplus Met
ACTOplus Met XR
Actos E
Adlyxin
7
Bold type = Brand-name drug[Plain type = Generic drug]
E = May be excluded from coverage or subject to prior authorization (sometimes referred to as precertification)
*Coverage is provided for oral formulations1 SSRIs are included only for employer groups who have specifically requested coverage.
Requirements Therapeutic Drug Classes & Limits
Alogliptin E
Alogliptin-Metformin E
Alogliptin-Pioglitazone E
Amaryl
Avandia
Bydureon
Bydureon BCise
Byetta
Cycloset
Diabeta
Duetact
Farxiga E
Fortamet E
Glimepiride
Glipizide
Glipizide ER
Glipizide-Metformin
Glucophage
Glucophage XR
Glucotrol
Glucotrol XL
Glucovance
Glumetza E
Glyburide
Glyburide Micronized
Glyburide-Metformin
Glynase
Glyset
Glyxambi
Invokamet
Invokamet XR
Invokana
Janumet E
Janumet XR E
Januvia E
Requirements Therapeutic Drug Classes & Limits
Jardiance
Jentadueto
Jentadueto XR
Kazano
Kombiglyze XR
Metformin
Metformin ER (generic Fortamet) E
Metformin ER (generic Glucophage XR)
Metformin ER (generic Glumetza) E
Miglitol
Nateglinide
Nesina
Onglyza
Oseni
Ozempic
Pioglitazone
Pioglitazone-Glimepiride
Pioglitazone-Metformin
PrandiMet
Prandin
Precose
Qtern E
Repaglinide
Repaglinide-Metformin
Riomet
Rybelsus
Segluromet E
Starlix
Steglatro E
Steglujan E
SymlinPen
Synjardy
Synjardy XR
Tolbutamide
Tradjenta
8
Bold type = Brand-name drug[Plain type = Generic drug]
E = May be excluded from coverage or subject to prior authorization (sometimes referred to as precertification)
*Coverage is provided for oral formulations1 SSRIs are included only for employer groups who have specifically requested coverage.
Requirements Therapeutic Drug Classes & Limits
Trulicity
Victoza
Xigduo XR E
Xultophy E
Immunosuppressant: Organ Rejection
Astagraf XL E
Azasan
Azathioprine
Cellcept E
Cyclosporine
Envarsus XR E
Gengraf
Imuran E
Mycophenolate
Mycophenolic Acid
Myfortic E
Neoral E
Prograf E
Rapamune E
Sandimmune E
Sirolimus
Tacrolimus
Zortress
Musculoskeletal: Osteoporosis
Actonel
Alendronate
Atelvia E
Binosto E
Boniva
Calcitonin (Salmon)
Didronel
Etidronate
Evista E
Forteo
Fortical
Requirements Therapeutic Drug Classes & Limits
Ibandronate
Miacalcin
Raloxifene
Risedronate
Tymlos
Respiratory: Asthma/COPD
Accolate
Accuneb
Advair Diskus
Advair HFA
Albuterol HFA (ProAir HFA, Proventil HFA authorized generic)
Albuterol HFA (Ventolin HFA authorized Egeneric)
AirDuo RespiClick E
Albuterol Nebulized Solution
Albuterol Oral Tablet
Alvesco
Aminophylline
Anoro Ellipta
Arcapta Neohaler
ArmonAir RespiClick E
Arnuity Ellipta
Asmanex HFA
Asmanex Twisthaler
Atrovent HFA
Bevespi Aerosphere
Breo Ellipta
Brovana
Budesonide/Formoterol (Symbicort EAuthorized Generic)
Budesonide Nebulized Solution
Combivent Respimat
Cromolyn
Daliresp
Duaklir Pressair E
9
Bold type = Brand-name drug[Plain type = Generic drug]
E = May be excluded from coverage or subject to prior authorization (sometimes referred to as precertification)
*Coverage is provided for oral formulations1 SSRIs are included only for employer groups who have specifically requested coverage.
Requirements Therapeutic Drug Classes & Limits
Dulera E
Duoneb
Elixophyllin
Flovent Diskus
Flovent HFA
Fluticasone/Salmeterol Diskus E
Fluticasone/Salmeterol RespiClick
Foradil
Gastrocrom
Incruse Ellipta
Ipratropium
Ipratropium/Albuterol
Levalbuterol HFA
Levalbuterol Nebulized Solution
Lonhala Magnair E
Lufyllin
Metaproterenol
Montelukast
Perforomist
Proair HFA
Proair RespiClick
Proventil HFA
Pulmicort Flexhaler
Pulmicort Nebulized Solution E
QVAR Redihaler
Seebri NeoHaler
Serevent Diskus
Singulair E
Spiriva HandiHaler
Spiriva Respimat
Requirements Therapeutic Drug Classes & Limits
Stiolto Respimat E
Striverdi Respimat
Symbicort
Terbutaline
Theo-24
Theophylline
Theophylline/Guaifenesin
Trelegy Ellipta
Tudorza Pressair E
Utibron NeoHaler E
Ventolin HFA
VoSpire ER
Xopenex HFA
Xopenex Nebulized Solution E
Yupelri
Zafirlukast
Zyflo
Zyflo CR
Vitamins
Pediatric Flouride Preparations (for example: Florvite, Poly-Vi-Flor, Tri-Vi-Flor) - Brand Name and Generic Products
Prenatal Vitamins (for example: Citranatal Assure, Prenate DHA, Stuartnatal) - Brand Name and Generic Products
10
IndexA
Acarbose .................................................... 6Accolate ...................................................... 8Accuneb ...................................................... 8Accupril ....................................................... 2Accuretic ..................................................... 2Acebutolol .................................................. 2Aceon .......................................................... 2Actonel ........................................................ 8ACTOplus Met ........................................... 6ACTOplus Met XR .................................... 6Actos ............................................................ 6Adalat CC ................................................... 2Adlyxin ......................................................... 6Admelog, Admelog SoloStar ................. 6Advair Diskus ............................................. 8Advair HFA.................................................. 8Afeditab ....................................................... 2Afrezza......................................................... 6Aggrenox .................................................... 1AirDuo RespiClick .................................... 8Albuterol HFA ............................................ 8Albuterol Nebulized Solution ................. 8Albuterol Oral Tablet ................................ 8Aldactazide ................................................ 2Aldactone ................................................... 2Alendronate ................................................ 8Aliskiren....................................................... 2Alogliptin ..................................................... 7Alogliptin-Metformin ................................ 7Alogliptin-Pioglitazone ............................. 7Altace ........................................................... 2Altoprev ....................................................... 5Alvesco ........................................................ 8Amaryl ......................................................... 7Amiloride ..................................................... 2Amiloride-Hydrochlorothiazide ............. 2Aminophylline ............................................ 8Amlodipine ................................................. 2Amlodipine-Benazepril ............................ 2Amlodipine-Olmesartan .......................... 2Amlodipine-Olmesartan-
Hydrochlorothiazide ............................. 2Amlodipine-Valsartan .............................. 2Amlodipine-Valsartan-
Hydrochlorothiazide ............................. 2Amturnide ................................................... 2Anastrozole ................................................ 1
Anoro Ellipta ............................................... 8Antara .......................................................... 5Apidra, Apidra SoloStar .......................... 6Arcapta Neohaler ..................................... 8Arimidex ...................................................... 1Arixtra .......................................................... 1ArmonAir RespiClick ............................... 8Arnuity Ellipta ............................................. 8Aromasin ..................................................... 1Asmanex HFA ............................................ 8Asmanex Twisthaler ................................. 8Aspirin-Dipyridamole ............................... 1Astagraf XL ................................................. 8Atacand ....................................................... 2Atacand HCT ............................................. 2Atelvia .......................................................... 8Atenolol ....................................................... 2Atenolol-Chlorthalidone .......................... 2Atorvastatin ................................................ 5Atrovent HFA .............................................. 8Avalide ......................................................... 2Avandia........................................................ 7Avapro ......................................................... 2Azasan......................................................... 8Azathioprine ............................................... 8Azor .............................................................. 2
B
Basaglar ...................................................... 6Benazepril .................................................. 2Benazepril-Hydrochlorothiazide ........... 2Benicar ........................................................ 2Benicar HCT .............................................. 2Betaxolol ..................................................... 2Bevespi Aerosphere................................. 8Bevyxxa....................................................... 1Bidil .............................................................. 2Binosto ........................................................ 8Bisoprolol .................................................... 2Bisoprolol-Hydrochlorothiazide ............ 2Boniva .......................................................... 8Breo Ellipta ................................................. 8Brilinta.......................................................... 1Brovana ....................................................... 8Budesonide/Formoterol ........................ 8Budesonide Nebulized Solution ........... 8Bumetanide ................................................ 2Bydureon .................................................... 7
Bydureon BCise ........................................ 7Byetta .......................................................... 7Bystolic ........................................................ 2Byvalson ..................................................... 2
C
Calan ............................................................ 2Calan SR ..................................................... 2Calcitonin (Salmon) .................................. 8Candesartan .............................................. 2Candesartan-Hydrochlorothiazide ....... 2Captopril ..................................................... 2Captopril-Hydrochlorothiazide .............. 2Cardene SR................................................ 2Cardizem..................................................... 2Cardizem CD ............................................. 2Cardizem LA .............................................. 2Cardura ....................................................... 2Carospir....................................................... 2Cartia XT ..................................................... 2Carvedilol .................................................... 3Carvedilol ER ............................................. 3Catapres ..................................................... 3Catapres TTS ............................................ 3Celexa .......................................................... 6Cellcept ....................................................... 8Chlorothiazide ........................................... 3Cholestyramine ......................................... 5Cholestyramine Light .............................. 5Choline Fenofibrate .................................. 5Cilostazol .................................................... 1Citalopram .................................................. 6Clonidine ..................................................... 3Clonidine Patch ......................................... 3Clopidogrel ................................................. 1Clorpress .................................................... 3Colesevelam Tablets, Powder for
Suspension ............................................ 5Colestid ....................................................... 5Colestipol .................................................... 5Combivent Respimat ............................... 8Contour Next EZ Meters ......................... 6Contour Next Meters ............................... 6Contour Next One Meters ...................... 6Contour Next Test Strips ........................ 6Coreg ........................................................... 3Coreg CR .................................................... 3Corgard ....................................................... 3
11
Corzide ........................................................ 3Coumadin ................................................... 1Covera HS .................................................. 3Cozaar ......................................................... 3Crestor ......................................................... 5Cromolyn .................................................... 8Cycloset ...................................................... 7Cyclosporine .............................................. 8
D
Daliresp ....................................................... 8Demadex .................................................... 3Diabeta ........................................................ 7Diabetic Testing - Lancets ...................... 6Didronel ....................................................... 8Dilacor XR ................................................... 3Dilt CD ......................................................... 3Dilt XR .......................................................... 3Diltia XT ....................................................... 3Diltiazem ..................................................... 3Diltiazem ER ............................................... 3Diltzac ER ................................................... 3Diovan .......................................................... 3Diovan HCT ................................................ 3Dipyridamole .............................................. 1Diuril ............................................................. 3Doxazosin ................................................... 3Duaklir Pressair ........................................ 8Duetact ........................................................ 7Dulera .......................................................... 9Duoneb ....................................................... 9Dutoprol ...................................................... 3Dyazide ....................................................... 3Dynacirc CR ............................................... 3Dyrenium .................................................... 3
E
Edarbi .......................................................... 3Edarbyclor .................................................. 3Edecrin ........................................................ 3Effient ........................................................... 1Eliquis .......................................................... 1Elixophyllin .................................................. 9Enalapril ...................................................... 3Enalapril-Hydrochlorothiazide ............... 3Enoxaparin ................................................. 2Envarsus XR ............................................... 8Epaned ........................................................ 3Eplerenone ................................................. 3Eprosartan .................................................. 3Escitalopram .............................................. 6
Ethacrynic Acid ......................................... 3Etidronate ................................................... 8Evista ........................................................... 8Exemestane ............................................... 1Exforge ........................................................ 3Exforge HCT .............................................. 3Ezallor Sprinkle ......................................... 5Ezetimibe .................................................... 5
F
Fareston ...................................................... 1Farxiga ......................................................... 7Felodipine ER ............................................ 3Femara ........................................................ 1Fenofibrate 40, 48, 120, 145 mg
Tablet ....................................................... 5Fenofibrate 43, 50, 67, 130,
134, 150, 200 mg Capsule ................ 5Fenofibrate 54, 160 mg Tablet .............. 5Fenofibric Acid .......................................... 5Fenoglide .................................................... 5Fiasp, Fiasp FlexTouch ............................ 6Fibricor ........................................................ 5Flolipid ......................................................... 5Flovent Diskus ........................................... 9Flovent HFA ................................................ 9Fluoxetine 10 mg, 20 mg Tablets ......... 6Fluoxetine 60 mg Tablets ....................... 6Fluoxetine Capsules ................................. 6Fluticasone/Salmeterol Diskus ............. 9Fluticasone/Salmeterol RespiClick ...... 9Fluvastatin .................................................. 5Fluvastatin ER ............................................ 5Fluvoxamine ............................................... 6Fluvoxamine Extended-Release ........... 6Fondaparinux............................................. 2Foradil .......................................................... 9Fortamet ..................................................... 7Forteo .......................................................... 8Fortical ......................................................... 8Fosinopril .................................................... 3Fosinopril-Hydrochlorothiazide ............. 3Fragmin ....................................................... 2Furosemide ................................................ 3
G
Gastrocrom ................................................ 9Gemfibrozil ................................................. 5Gengraf ....................................................... 8Glimepiride ................................................. 7Glipizide ...................................................... 7
Glipizide ER ................................................ 7Glipizide-Metformin .................................. 7Glucophage ............................................... 7Glucophage XR ......................................... 7Glucotrol ..................................................... 7Glucotrol XL ............................................... 7Glucovance ................................................ 7Glumetza .................................................... 7Glyburide .................................................... 7Glyburide Micronized .............................. 7Glyburide-Metformin ................................ 7Glynase ....................................................... 7Glyset ........................................................... 7Glyxambi ..................................................... 7Guanfacine ................................................. 3
H
Heparin ........................................................ 2Humalog ..................................................... 6Humalog Junior......................................... 6Humalog Mix 50/50 ................................. 6Humalog Mix 75/25 ................................. 6Humulin 50/50 .......................................... 6Humulin 70/30 .......................................... 6Humulin N ................................................... 6Humulin R ................................................... 6Hydralazine ................................................ 3Hydrochlorothiazide ................................. 3Hyzaar ......................................................... 3
I
Ibandronate ................................................ 8Imuran ......................................................... 8Incruse Ellipta ............................................ 9Indapamide ................................................ 3Inderal .......................................................... 3Inderal LA ................................................... 3Innopran XL................................................ 3Inspra ........................................................... 3Insulin Aspart ............................................ 6Insulin Aspart Protamine/
Insulin Aspart ......................................... 6 Insulin Lispro .............................................. 6Insulin Needles/Syringes ........................ 6Invokamet ................................................... 7Invokamet XR ............................................ 7Invokana ...................................................... 7Ipratropium ................................................. 9Ipratropium/Albuterol .............................. 9Irbesartan ................................................... 3Irbesartan-Hydrochlorothiazide ............ 3
12
Isoptin SR ................................................... 3Isradipine .................................................... 3
J
Jantoven...................................................... 2Janumet ...................................................... 7Janumet XR ............................................... 7Januvia ........................................................ 7Jardiance .................................................... 7Jentadueto ................................................. 7Jentadueto XR ........................................... 7
K
Kapspargo .................................................. 3Katerzia ....................................................... 3Kazano ........................................................ 7Kombiglyze XR .......................................... 7
L
Labetalol ..................................................... 3Lantus .......................................................... 6Lasix ............................................................. 3Lescol .......................................................... 5Lescol XL .................................................... 5Letrozole ..................................................... 1Levalbuterol HFA ...................................... 9Levalbuterol Nebulized Solution ........... 9Levatol ......................................................... 3Levemir ........................................................ 6Lexapro ....................................................... 6Lipitor ........................................................... 5Lipofen ........................................................ 5Lisinopril ...................................................... 3Lisinopril-Hydrochlorothiazide .............. 3Livalo ............................................................ 5Lofibra ......................................................... 5Lonhala Magnair ....................................... 9Lopid ............................................................ 5Lopressor ................................................... 3Lopressor HCT .......................................... 3Losartan ...................................................... 3Losartan-Hydrochlorothiazide ............... 3Lotensin ...................................................... 4Lotensin HCT ............................................. 4Lotrel ............................................................ 4Lovastatin ................................................... 5Lovaza ......................................................... 5Lovenox ....................................................... 2Lufyllin ......................................................... 9
M
Matzim LA .................................................. 4Mavik ........................................................... 4Maxzide....................................................... 4Metaproterenol .......................................... 9Metformin ................................................... 7Metformin ER ............................................. 7Methyclothiazide ....................................... 4Methyldopa ................................................ 4Methyldopa-Hydrochlorothiazide ......... 4Metolazone ................................................. 4Metoprolol 37.5, 75 mg ........................... 4Metoprolol Succinate ............................... 4Metoprolol Tartrate ................................... 4Metoprolol-Hydrochlorothiazide ........... 4Mevacor ...................................................... 5Miacalcin ..................................................... 8Micardis....................................................... 4Micardis HCT ............................................. 4Microzide .................................................... 4Midamor ...................................................... 4Miglitol ......................................................... 7Minipress .................................................... 4Minoxidil ...................................................... 4Moexipril ..................................................... 4Moexipril-Hydrochlorothiazide .............. 4Montelukast ............................................... 9Mycophenolate ......................................... 8Mycophenolic Acid .................................. 8Myfortic ....................................................... 8
N
Nadolol ........................................................ 4Nadolol-Bendroflumethazide ................ 4Nateglinide ................................................. 7Neoral .......................................................... 8Nesina ......................................................... 7Niacin Extended-Release ....................... 5Niacor .......................................................... 5Niaspan ....................................................... 5Nicardipine ................................................. 4Nifedipine ................................................... 4Nifedipine ER ............................................. 4Nimodipine ................................................. 4Nisoldipine.................................................. 4Norvasc ....................................................... 4Novolin 70/30 ............................................ 6Novolin N .................................................... 6Novolin R .................................................... 6Novolog Mix 70/30 .................................. 6
Novolog, Novolog FlexPen ..................... 6
O
Olmesartan ................................................ 4Olmesartan-Hydrochlorothiazide ......... 4Omega-3 Acid Ethyl Esters .................... 5OneTouch Diabetic Meters ..................... 6OneTouch Diabetic Test Strips .............. 6Onglyza ....................................................... 7Oseni ............................................................ 7Ozempic ...................................................... 7
P
Paroxetine ................................................... 6Paroxetine Extended-Release ............... 6Paxil.............................................................. 6Paxil CR ...................................................... 6Pediatric Flouride Preparations ............. 9Perforomist ................................................. 9Perindopril .................................................. 4Persantine .................................................. 2Pexeva ......................................................... 6Pindolol ....................................................... 4Pioglitazone ............................................... 7Pioglitazone-Glimepiride ........................ 7Pioglitazone-Metformin ........................... 7Plavix ............................................................ 2Pletal ............................................................ 2Pradaxa ....................................................... 2PrandiMet ................................................... 7Prandin ........................................................ 7Prasugrel ..................................................... 2Pravachol .................................................... 5Pravastatin .................................................. 5Prazosin ...................................................... 4Precose ....................................................... 7Prenatal Vitamins ...................................... 9Prestalia ...................................................... 4Prevalite ....................................................... 5Prinivil .......................................................... 4Proair HFA ..............................................8, 9Proair RespiClick ...................................... 9Procardia .................................................... 4Procardia XL .............................................. 4Prograf ......................................................... 8Propranolol ................................................. 4Propranolol-Hydrochlorothiazide ......... 4Proventil HFA .........................................8, 9Prozac ........................................................ 6Pulmicort Flexhaler .................................. 9Pulmicort Nebulized Solution ................ 9
13
Q
Qbrelis ......................................................... 4Qtern ............................................................ 7Questran ..................................................... 5Questran Light ........................................... 5Quinapril ..................................................... 4Quinapril-Hydrochlorothiazide .............. 4QVAR Redihaler ........................................ 9
R
Raloxifene ................................................... 8Ramipril ....................................................... 4Rapamune .................................................. 8Repaglinide ................................................ 7Repaglinide-Metformin ........................... 7Reserpine ................................................... 4Riomet ......................................................... 7Risedronate ................................................ 8Rosuvastatin .............................................. 5Rybelsus ..................................................... 7
S
Sandimmune ............................................. 8Savaysa ....................................................... 2Sectral ......................................................... 4Seebri NeoHaler ....................................... 9Segluromet ................................................. 7Serevent Diskus ........................................ 9Sertraline..................................................... 6Simvastatin ................................................. 5Simvastatin-Ezetimibe ............................. 5Simvastatin Suspension ......................... 5Singulair ...................................................... 9Sirolimus ..................................................... 8Soliqua ........................................................ 6Soltamox ..................................................... 1Spiriva HandiHaler ................................... 9Spiriva Respimat ....................................... 9Spironolactone .......................................... 4Spironolactone-Hydrochlorothiazide ... 4Starlix ........................................................... 7Steglatro ...................................................... 7Steglujan ..................................................... 7Stiolto Respimat ........................................ 9Striverdi Respimat .................................... 9Sular ............................................................. 4Symbicort ...............................................8, 9SymlinPen................................................... 7Synjardy ...................................................... 7Synjardy XR ................................................ 7
T
Tacrolimus .................................................. 8Tamoxifen ................................................... 1Tarka ............................................................ 4Taztia XT ..................................................... 4Tekturna ...................................................... 4Tekturna HCT ............................................ 4Telmisartan ................................................. 4Telmisartan-Amlodipine .......................... 4Telmisartan-Hydrochlorothiazide.......... 4Tenex ........................................................... 4Tenoretic ..................................................... 4Tenormin ..................................................... 4Terazosin..................................................... 4Terbutaline .................................................. 9Teveten ........................................................ 4Teveten HCT .............................................. 4Thalitone ..................................................... 4Theo-24 ....................................................... 9Theophylline .............................................. 9Theophylline/Guaifenesin ...................... 9Tiazac .......................................................... 4Ticlopidine .................................................. 2Timolol ......................................................... 4Tolbutamide ............................................... 7Toprol XL..................................................... 4Toremifene ................................................. 1Torsemide ................................................... 4Toujeo .......................................................... 6Tradjenta ..................................................... 7Trandate ...................................................... 5Trandolapril ................................................ 5Trandolapril-Verapamil ............................ 5Trelegy Ellipta ............................................ 9Tresiba ......................................................... 6Triamterene ............................................... 5Triamterene-Hydrochlorothiazide ......... 5Tribenzor ..................................................... 5Tricor ............................................................ 6Triglide ......................................................... 6Trilipix ........................................................... 6Trulicity ........................................................ 8Tudorza Pressair ....................................... 9Twynsta ....................................................... 5Tymlos ......................................................... 8
U
Uniretic ........................................................ 5Univasc ........................................................ 5Utibron NeoHaler ...................................... 9
V
Valsartan ..................................................... 5Valsartan-Hydrochlorothiazide .............. 5Vascepa ...................................................... 6Vaseretic ..................................................... 5Vasotec ........................................................ 5Ventolin HFA ..........................................8, 9Verapamil .................................................... 5Verapamil ER ............................................. 5Verelan ........................................................ 5Verelan PM ................................................. 5Victoza ......................................................... 8VoSpire ER ................................................. 9Vytorin ......................................................... 6
W
Warfarin ....................................................... 2Welchol ....................................................... 6
X
Xarelto ......................................................... 2Xigduo XR................................................... 8Xopenex HFA ............................................. 9Xopenex Nebulized Solution ................. 9Xultophy ...................................................... 8
Y
Yupelri .......................................................... 9
Z
Zafirlukast ................................................... 9Zaroxolyn .................................................... 5Zebeta ......................................................... 5Zestoretic .................................................... 5Zestril ........................................................... 5Zetia ............................................................. 6Ziac............................................................... 5Zocor ........................................................... 6Zoloft ............................................................ 6Zontivity ....................................................... 2Zortress ....................................................... 8Zyflo ............................................................. 9Zyflo CR ...................................................... 9Zypitamag ................................................... 6
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