Rx Outreach Medication* Similar Medication Available Strengths 30-Day Supply 90-Day Supply 180-Day Supply
Acamprosate Calcium DR tablet Campral® 333mg
Acyclovir capsule Zovirax® 200mg $10 $13 $20
Acyclovir tablet Zovirax® 400mg, 800mg $10 $13 $20
Acyclovir 5% Ointment Zovirax® 15g
Acyclovir 5% Ointment Zovirax® 30g
Albuterol Inhalation Solution Proventil® / Ventolin® 0.083%/3mL
Albuterol Sulfate HFA ProAir HFA® / Proventil® HFA / Ventolin® 90mcg (200 inhalations)
Alclometasone Dipropionate Cream Aclovate® 15gm (0.05%)
Alendronate tablet Fosamax® 70mg (once a week dosage) $20 (limit 12) $40 (limit 24)
Alfuzosin ER tablet Uroxatral® 10mg (see Uroxatral®)
Allopurinol tablet Zyloprim® / Aloprim® 100mg, 300mg $10 $13 $20
Alprazolam tablet (CS) Xanax® / Niravam® 0.25mg, 0.5mg, 1mg, 2mg
Alprazolam XR tablet (CS) Xanax XR® / Niravam® 0.5mg, 1mg
Alprazolam XR tablet (CS) Xanax XR® / Niravam® 2mg, 3mg
Amantadine tablet Symmetrel® 100mg $14 $30 n/a
Amitriptyline tablet HCL Elavil® 10mg
Amitriptyline tablet Elavil® 25mg, 50mg
Amitriptyline tablet Elavil® 75mg, 100mg
Amitriptyline tablet Elavil® 150mg
Amlodipine tablet Norvasc® 2.5mg, 5mg, 10mg $11 $20 $40
Amlodipine/Benazepril capsule Lotrel® 5/10mg, 5/20mg, 10/20mg
Amlodipine/Benazepril capsule Lotrel® 10/40mg
Amlodipine/Olmesartan tablet Azor® 5/20mg, 5/40mg, 10/20mg, 10/40mg
Amlodipine/Valsartan tablet Exforge® 5/160mg, 5/320mg, 10/160mg, 10/320mg
Amlodipine/Valsartan/HCTZ tabletExforge HCT®
5/160/12.5mg, 5/160/25mg, 10/160/12.5mg, 10/160/25mg,
10/320/25mg
Amoxapine tablet Asendin® 100mg
Anastrozole tablet Arimidex® 1mg
Aricept® tablet Donepezil 23mg $25
Aripiprazole tablet Abilify® 2mg, 5mg, 10mg, 15mg, 20mg, 30mg
Armodafinil tablet (CS) Nuvigil® 50mg, 150mg, 200mg, 250mg
Artificial Tears 1.4% drops (OTC) N/A 15ml bottle (No prescription required)
Aspirin EC tablet (OTC) Bufferin® / Ecotrin® 325mg (No prescription required)
Aspirin EC tablet (OTC) Ecotrin® 81mg (No prescription required)
Atenolol tablet Tenormin® 25mg, 50mg, 100mg $7 $9 $18
Atenolol/Chlorthalidone tablet Tenoretic® 50/25mg, 100/25mg $10 $13 $20
Atomoxetine HCL capsule Strattera® 10mg, 18mg, 25mg
Atomoxetine HCL capsule Strattera® 40mg, 60mg
Atomoxetine HCL capsule Strattera® 80mg, 100mg
Atorvastatin tablet Lipitor® 10mg, 20mg, 40mg, 80mg $12 $25 $45
Azathioprine tablet Imuran® / Azasan® 50mg
Azelastine nasal spray Astelin® 137mcg
Baclofen tablet Lioresal® 10mg, 20mg $9 $15 n/a
Balsalazide Disodium capsule Colazal® / Giazo® 750mg
Banzel® Rufinamide 200mg, 400mg tablets; 40mg/mL Oral Suspension
Benazepril tablet Lotensin® 5mg, 10mg, 20mg, 40mg $10 $13 $20
Benazepril/HCTZ tablet Lotensin HCT® 5/6.25mg, 10/12.5mg, 20/12.5mg, 20/25mg $12 $25 $45
Benzonatate capsule Tessalon® / Zonatuss® 100mg
Benzonatate capsule Tessalon Perles® 200mg
Benztropine tablet Cogentin® 0.5mg, 1mg, 2mg $20
Betamethasone Dipropionate Cream, Aug Diprolene® AF / Alphatrex®/ Diprosone®/ Del-Beta® 15gm
Bethanechol tablet Urecholine® 5mg, 10mg, 25mg, 50mg $12 $25 n/a
Bicalutamide tablet Casodex® 50mg $12 $35 $65
Bisoprolol/HCTZ tablet Ziac® 2.5/6.25mg, 5/6.25mg, 10/6.25mg $10 $13 $20
Blood Glucose Monitor (Prodigy® Autocode) N/A N/A (No prescription required)
Blood Glucose Monitor Control Sol, Low (Prodigy®) N/A 4ml. Vial (No prescription required)
Blood Glucose Test Strips (Prodigy®) N/A Box of 50 (No prescription required)
Blood Glucose Twist Top Lancets 28G (Prodigy®) N/A Box of 100; min order - 2 boxes (No prescription required)
Brimonidine Tartrate 0.2% Solution N/A 0.2%/10ml dropper
Bromocriptine tablet Parlodel® 2.5mg
Budesonide EC capsule Entocort EC(R)® 3mg
Budesonide Inhalation Solution Pulmicort Respules® 0.25mg/2mL
Budesonide Inhalation Solution Pulmicort Respules® 0.5mg/2mL
Budesonide Nasal Spray OTC Rhinocort® Allergy OTC 8.6g/32mcg (No prescription required)
Bumetanide tablet Bumex® 0.5mg, 1mg, 2mg
Buprenorphine/Naloxone tablet (CS) Zubsolv®/ Suboxone® 2mg/0.5mg (opioid dependence treatment only)
Buprenorphine/Naloxone tablet (CS) Zubsolv®/ Suboxone® 8mg/2mg (opioid dependence treatment only)
Bupropion HCL SR tablet Wellbutrin SR® 100mg, 150mg, 200mg $30 $65 n/a
Bupropion HCL tablet Wellbutrin® 75mg $17 $40 n/a
Bupropion HCL tablet Wellbutrin® 100mg
Bupropion HCL XL tablet Wellbutrin XL® / Zyban® 150mg,
Bupropion HCL XL tablet Wellbutrin XL® / Zyban® 300mg
Buspirone tablet BuSpar® 5mg, 10mg, 15mg $11 $20 n/a
Buspirone tablet BuSpar® 30mg $26 $35 n/a
Buspirone tablet BuSpar® 7.5mg
Calcitonin-Salmon Nasal Spray Miacalcin® 200 units per spray
Calcitriol capsule Rocaltrol® 0.25mcg
Calcitriol capsule Rocaltrol® 0.5mcg
Calcium Acetate capsule PhosLo® Gelcap 667mg
Candesartan Cilexetil-HCTZ tablet Atacand HCT® 16/12.5mg
Candesartan Cilexetil-HCTZ tablet Atacand HCT® 32/12.5mg, 32/25mg
Candesartan Cilexetil tablet Atacand® 16mg, 32mg
Candesartan Cilexetil tablet Atacand® 4mg, 8mg
Capecitabine tablet Xeloda® 150mg
Capecitabine tablet Xeloda® 500mg
Capsaicin Cream, 0.025% (OTC) Zostrix® 60gm (No prescription required)
Captopril tablet Capoten® 100mg
Captopril tablet Capoten® 12.5mg, 25mg, 50mg
Carbamazepine ER tablet Tegretol XR® / Equetro® 200mg, 400mg
Carbamazepine tablet Tegretol® / Epitol® 200mg
Carbidopa / Levodopa SR tablet Sinemet CR® 25/100mg, 50/200mg $22 $55 n/a
Carbidopa / Levodopa tablet Sinemet® / Parcopa® 10/100mg, 25/100mg, 25/250mg $19 $45 $85
Carbidopa/Levodopa/Entacapone tablet Stalevo® 12.5/50/200mg, 18.75/75/200mg, 25/100/200mg,
31.25/125/200mg, 37.5/150/200mg, 50/200/200mg
Carvedilol tablet Coreg® 3.125mg, 6.25mg, 12.5mg, 25mg $10 $13 $20
Celecoxib capsule Celebrex® 400mg
Celecoxib capsule Celebrex® 50mg, 100mg, 200mg
Cetirizine HCL tablet - OTC Zyrtec® OTC / Alleroff® 10mg (no prescription required)
Cevimeline HCL capsule Evoxac® 30mg
Chlordiazepoxide capsule (CS) Librium® 5mg, 10mg, 25mg
$40 per tube
$65 per tube
$35 per inhaler canister
$15 for up to 75 vials
$30 for up to 30 tablets
$9 for up to 90 tablets$16 up to 30 tabs / $35 up to 90 tabs
$21 up to 30 tabs / $50 up to 90 tabs
$33 for up to 90 tablets
$45 for up to 90 tablets
$15 per tube
$22 up to 30 caps / $45 up to 90 caps
$12 up to 30 caps / $26 up to 90 caps
$7 for a bottle of 100
$9 for a bottle of 120
$14 up to 30 tabs / $30 up to 90 tabs
$90 for up to 30 capsules
$95 for up to 30 capsules
$98 for up to 30 capsules
$35 for up to 30 tablets
$25 for up to 30 tablets
$60 for up to 30 tablets
$14 up to 30 tabs / $30 up to 90 tabs
$16 up to 30 tabs / $35 up to 90 tabs
$15 for up to 90 tablets
$20 for up to 90 tablets
$30 per nasal spray
$14 up to 30 caps / $30 up to 90 caps
$65 for up to 30 tablets
Refer to Patient Forms on Website
$15 for up to 30 capsules
$25 per tube
One free monitor annually
$5 per vial
$15 per box
Rx Outreach Medication List
$20 for up to 30 capsules
$13 up to 30 caps / $25 up to 90 caps
$40 for up to 30 tablets
$40 for up to 30 tablets
$12 per tube
$17 up to 30 tabs / $40 up to 90 tabs
$24 up to 30 tabs / $55 up to 90 tabs
$13 up to 30 tabs / $25 up to 90 tabs
$13 up to 30 tabs / $25 up to 90 tabs
$45 for up to 60 tablets
$35 for up to 30 tablets
$9 per bottle
$32 for up to 10 vials
$11 up to 30 tabs / $20 up to 90 tabs
$25 for up to 28 tablets
$16 up to 30 tabs / $35 up to 90 tabs$20 up to 30 tabs / $50 up to 90 tabs
$32 for up to 30 tablets
$25 up to 30 tabs / $60 up to 90 tabs
$45 for up to 28 tablets
$5 per box; min order $10
$45 for up to 90 tablets
$50 for up to 28 tablets
$50 for up to 30 tablets
$12 for up to 30 capsules
$17 for up to 30 capsules
$15 for up to 30 capsules
$30 for up to 30 capsules
$10 per bottle of 100 tabs (min. 2 bottles)
$31 up to 30 caps / $80 up to 90 caps
$15 per dropper
$37 for up to 10 vials
$22 per bottle (min. 2 bottles)
$50 for up to 30 capsules
$13 up to 30 tabs / $30 up to 90 tabs
$65 for two (2) bottles
$17 up to 30 tabs / $40 up to 90 tabs
$15 for up to 180 capsules
$40 for up to 30 tablets
September 2020
Chlorpromazine HCL tablet Thorazine® 10mg, 25mg, 50mg, 100m, 200mg $16 $35 n/a
Chlorthalidone tablet Hygroton® 25mg, 50mg
Chlorzoxazone tablet Parafon Forte® DSC / Lorzone® / Parafon® 500mg
Cilostazol tablet Pletal® 50mg, 100mg $14 $30 $55
Citalopram tablet Celexa® 10mg, 20mg, 40mg $11 $20 n/a
Clindamycin HCL capsule Cleocin® 150mg $19 $45 $85
Clobetasol cream 0.05% Temovate® 30g
Clomiphene Citrate tablet Clomid® / Serophene® 50mg
Clomipramine capsule Anafranil® 25mg, 50mg, 75mg $40
Clonazepam tablet (CS) Klonopin® 0.5mg
Clonazepam tablet (CS) Klonopin® 1mg, 2mg
Clonidine HCL tablet Catapres® 0.1mg, 0.2mg, 0.3mg $10 $13 $20
Clonidine patch Catapres-TTS® -3 0.3mg/day
Clopidogrel tablet Plavix® 75mg
Clotrimazole/Betamethasone Cream Lotrisone® 15g (1%/0.05%)
Colesevelam HCL tablet Welchol® 625mg
Colestipol Micronized tablet Colestid® 1gm
Cyclobenzaprine tablet Flexeril® 5mg, 10mg $12 $25 n/a
Dalfampridine ER tablet Ampyra® 10mg
Darifenacin ER tablet Enablex® 7.5mg, 15mg
Desonide ointment 0.05% Tridesilon® 60gm
Desvenlafaxine Succ ER tablet Pristiq® 25mg, 50mg, 100mg
Dexmethylphenidate HCL tablet (CS) Focalin® 2.5mg
Dexmethylphenidate HCL tablet (CS) Focalin® 5mg
Dexmethylphenidate HCL tablet (CS) Focalin® 10mg
Dextroamphetamine-Amphetamine ER capsule (CS) Dexedrine® 5mg, 10mg, 15mg, 20mg
Dextroamphetamine-Amphetamine ER capsule (CS) Dexedrine® 25mg, 30mg
Dextroamphetamine-Amphetamine tablet (CS) Adderall® XR 5mg, 10mg, 15mg, 20mg, 30mg
Dextroamphetamine sulfate ER capsule (CS) Adderall® XR 5mg, 10mg
Dextroamphetamine sulfate ER capsule (CS) Adderall® 15mg
Diazepam tablet (CS) Valium® 2mg, 5mg, 10mg
Diclofenac Sodium EC tablet Voltaren Gel® 50mg, 75mg $12 $25 n/a
Diclofenac Sodium ER tablet Voltaren® / Zorvolex® 100mg $17 $40 n/a
Diclofenac Sodium 1% gel Voltaren XR® 100g tube
Dicyclomine capsule Bentyl® 10mg $10 $13 $20
Dicyclomine tablet Bentyl® 20mg $10 $13 $20
Digoxin tablet Lanoxin® / Digitek® 0.125mg, 0.25mg
Diltiazem ER capsule (24hr) (Dilt-XR) Dilacor XR®/Cardizem CD®/Cartia XT®/Dilt-XR®/Diltia XT® 120mg, 180mg, 240mg
Diltiazem ER capsule (Dilt-CD) Cardizem CD®/Dilacor XR®/Cartia XT®/Dilt-XR®/Diltia XT® 120mg, 180mg, 240mg, 300mg, 360mg
Diltiazem ER capsule (24hr)(Dilt-CD) Tiazac®/Cardizem CD®/Dilacor XR® 360mg
Diphenoxylate/Atropine tablet (CS) Lomotil®/Lonox® 2.5/0.025mg
Divalproex NA DR tablet Depakote® 125mg, 250mg, 500mg $16 $35 $65
Divalproex SOD ER tablet Depakote ER® 250mg, 500mg
Dofetilide capsule Tikosyn® 125mcg, 250mcg, 500 mcg
DOK™ soft gel (OTC) Docusate Sodium 250mg (No prescription required)
Donepezil tablet Aricept® 5mg, 10mg $15 n/a
Donnatal® elixir (CS) (mint or grape) N/A 16.2/0.1037/0.0194/0.0065mg $0* n/a
Donnatal® tablet (CS) N/A 16.2/0.1037/0.0194/0.0065mg $0* n/a
Dorzolamide HCL 2% Solution Trusopt® 10ml dropper
Doxazosin Mesylate tablet Cardura® 1mg, 2mg, 4mg, 8mg
Doxepin capsule Sinequan® 10mg
Doxepin capsule Sinequan® 25mg, 50mg
Doxepin capsule Sinequan® 75mg, 100mg
Doxycycline Hyclate capsule Vibramycin® 50mg, 100mg $0* n/a
Duloxetine HCL DR capsule Cymbalta® 20mg, 30mg, 60mg $19 $45 n/a
Dutasteride capsule Avodart® 0.5mg
Dutoprol tablet Metoprolol Succinate ER/HCTZ 25/12.5mg, 50/12.5mg, 100/12.5mg $0* n/a
Dyrenium capsule Triamterene 50mg, 100mg $0* n/a
Econazole Nitrate 1% cream Spectazole® 15g tube
Econazole Nitrate 1% cream Spectazole® 30g tube
Eletriptan HBR tablet Relpax® 20mg
Eletriptan HBR tablet Relpax® 40mg
Enalapril Maleate Tablet Vasotec® 2.5mg, 5mg, 10mg, 20mg $10 $13 $20
Enalapril / HCTZ tablet Vaseretic® 5/12.5mg, 10/25mg $10 $13 $20
Entecavir tablet Baraclude® 0.5mg, 1mg
Epinephrine Auto Injector Adrenaclick / Epipen® / Epipen Jr® 0.15mg/0.15mL, 0.3mg/0.3mL
Eplerenone tablet Inspra® 25mg, 50mg $25 $65 n/a
Escitalopram tablet Lexapro® 5mg, 10mg, 20mg $9 $15 n/a
Esomeprazole DR capsule Nexium® 20mg, 40mg
Estradiol 0.01% Cream Estrace® 42.5g / 0.01%
Estradiol tablet Estrace® 0.5mg, 1mg, 2mg $10 $13 $20
Eszopiclone tablet (CS) Lunesta® 1mg, 2mg, 3mg
Etodolac capsule Lodine® 200mg, 300mg
Etodolac tablet Lodine® 400mg
Etodolac tablet Lodine® 500mg
Exemestane tablet Aromasin® 25mg
Ezetimibe tablet Zetia® 10mg
Famciclovir tablet Famvir® 250mg
Famciclovir tablet Famvir® 500mg
Famotidine tablet Pepcid® 20mg, 40mg $10 $13 $20
Febuxostat tablet Uloric® 40mg, 80mg
Felodipine ER tablet Plendil® ER 10mg
Felodipine ER tablet Plendil® ER 2.5mg, 5mg
Fenofibrate, micronized capsule Lofibra® (micronized) 134mg $25 $70 n/a
Fenofibrate tablet Tricor® 145mg
Fenofibrate tablet Tricor® 48mg
Fenofibrate tablet Tricor® / Lipofen® / Lofibra® 54mg, 160mg $22 $55 $95
Fenofibric Acid DR capsule Trilipix® 135mg
Ferrous Sulfate EC tablet Iron 325mg (No prescription required)
Fexofenadine OTC tablet Allegra® OTC 60mg, 180mg (No prescription required)
Finasteride tablet Propecia® 1mg
Finasteride tablet Proscar® 5mg $12 $25 $45
Flecainide Acetate tablet Tambocor® 50mg, 100mg, 150mg
Fluconazole tablet Diflucan® 100mg, 200mg
Fluocinonide topical solution Vanos® 0.05% 60ml
Fluoxetine capsule Prozac® / Sarafem® 10mg, 20mg, 40mg $9 $15 n/a
Fluticasone Nasal Spray Flonase® 50mcg
Fluticasone / Salmeterol diskus Advair Diskus® 100 / 50mcg
Fluticasone / Salmeterol diskus Advair Diskus® 250 / 50mcg
Fluticasone / Salmeterol diskus Advair Diskus® 500 / 50mcg
Fluticasone / Salmeterol Inhaler Advair®, AirDuo RespiClick® 55/14mcg, 113/14mcg, 232/14mcg (60 inhalations)
Fluvoxamine Maleate tablet Luvox® 100mg
Folic Acid tablet N/A 1mg $10 $13 $20
$35 per tube
$15 per tube
$20 per tube
$19 up to 30 tabs / $45 up to 90 tabs
$55 for up to 30 tablets
$55 for up to 30 capsules
$6 per bottle 100 tabs (min 2 bottles)
$40 for 100 tablets
$16 up to 30 tabs / $35 up to 90 tabs
$35 for up to 30 tablets
$90 per inhaler canister
$12 up to 30 tabs / $25 up to 90 tabs
$15 per nasal spray
$11 for up to 30 tablets
$120 per diskus
$150 per diskus
$18 up to 30 caps / $40 up to 90 caps
$18 up to 30 tabs / $40 up to 90 tabs
$19 up to 30 tabs / $45 up to 90 tabs
$18 up to 30 tabs / $40 up to 90 tabs
$18 up to 30 caps / $40 up to 90 caps
$30 for up to 30 tablets
$25 for up to 120 tablets
$12 up to 30 caps / $25 up to 90 caps
$16 up to 30 tabs / $35 up to 90 tabs
$40 per 6 tablets/up to 30 tablets
$40 per 6 tablets/up to 60 tablets
$50 per tube
$45 for up to 60 tablets
$55 for up to 60 tablets
$16 for up to 30 tablets
$25 up to 30 caps / $60 up to 90 caps
$16 up to 30 caps / $35 up to 90 caps
$60 for up to 60 tablets
$30 for up to 30 tablets
$35 up to 30 caps / $85 up to 90 caps
$30 for a 2 unit pack
$20 for up to 30 capsules
$16 up to 30 tabs / $35 up to 90 tabs
$80 per pack of 4
$10 for up to 90 tablets
$15 per tube
$60 for up to 60 tablets
$17 up to 30 tabs (30 day supply only)
$22 up to 30 tabs (30 day supply only)
$40 for up to 30 tablets
$18 up to 30 caps / $40 up to 90 caps
$65 for up to 60 tablets
$23 for up to 30 tablets
$15 per bottle
$8 for up to 90 tablets
$18 up to 30 tabs / $40 up to 90 tabs
$26 for up to 30 tablets
$16 up to 30 tabs / $35 up to 90 tabs
$18 up to 30 caps / $40 up to 90 caps
$9 per bottle (100 ct.)
$45 for up to 30 tablets
$100 per diskus
$60 up to 30 caps (30 day supply only)
$20 per tube
$65 per tube
$25 up to 30 caps / $65 up to 90 caps
$30 per bottle
$25 up to 30 tabs (30 day supply only)
$70 up to 30 caps (30 day supply only)
$80 up to 30 caps (30 day supply only)
$20 up to 30 caps (30 day supply only)
$50 up to 30 caps (30 day supply only)
$14 up to 30 tabs / $25 up to 90 tabs
$60 for up to 30 tablets
$9 for up to 90 tablets
$30 for up to 30 tablets
$8 up to 30 tabs / $18 up to 90 tabs
Furosemide tablet Lasix® 20mg, 40mg, 80mg $7 $9 $18
Gabapentin capsule Neurontin® / Gabarone® 100mg, 300mg, 400mg
Gabapentin tablet Neurontin® / Gabarone® 600mg, 800mg
Galantamine tablet Razadyne ER® 4mg, 8mg, 12mg
Galantamine ER capsule Razadyne ER® 8mg
Galantamine ER capsule Razadyne® 16mg, 24mg
Gemfibrozil tablet Lopid® 600mg $14 $30 $55
Glimepiride tablet Amaryl® 1mg, 2mg, 4mg $10 $13 $20
Glipizide ER tablet Glucotrol XL® 2.5mg, 5mg, 10mg $16 $35 $65
Glipizide tablet Glucotrol® 5mg, 10mg $10 $13 $20
Glyburide tablet Diabeta® / Micronase® 1.25mg, 2.5mg, 5mg $10 $13 $20
Glyburide, micronized tablet Glynase® / PresTab® 1.5mg, 3mg, 6mg $10 $13 $20
Glyburide/Metformin tablet Glucovance® 1.25/250mg, 2.5/500mg, 5/500mg $14 $30 $55
Guanfacine ER tablet Intuniv® / Tenex® 1mg, 2mg, 3mg, 4mg
Halobetasol Prop ointment, 0.05% Ultravate® 15gm
Haloperidol tablet Haldol® 0.5mg, 1mg, 2mg, 5mg $12 $25 n/a
Hydralazine tablet Apresoline® 10mg, 25mg, 50mg, 100mg $12 $25 $45
Hydrochlorothiazide capsule Microzide® 12.5mg $10 $13 $20
Hydrochlorothiazide tablet Hydrodiuril® 25mg, 50mg $10 $13 $20
Hydrocortisone tablet Cortef® 5mg
Hydrocortisone tablet Cortef® 10mg
Hydroxychloroquine tablet Plaquenil® 200mg
Hydroxyurea capsule Hydrea® / Droxia® 500mg
Hydroxyzine HCL tablet Atarax® 10mg, 25mg, 50mg $12 $25 n/a
Hydroxyzine Pamoate capsule Vistaril® 25mg, 50mg $12 $25 n/a
Ibuprofen tablet Advil® / Motrin® 400mg, 600mg, 800mg $11 $20 n/a
Imatinib tablet Gleevec® 100mg
Indapamide tablet Lozol® 1.25mg, 2.5mg $10 $13 $20
Indomethacin capsule Indocin® 25mg
Indomethacin capsule Indocin® 50mg
Indomethacin ER capsule Indocin SR® 75mg
Insulin Syringes (Prodigy®) N/A 28G 12.7mm - 1cc, 31G 8mm - 1/2cc, 31G 8mm - 1/3cc
Ipratropium / Albuterol Inhalation Solution DuoNeb® 0.5-3(2.5)mg / 3mL vial
Irbesartan tablet Avapro® 75mg, 150mg, 300mg $14 $30 $55
Irbesartan / HCTZ tablet Avalide® 150mg/12.5mg, 300mg/12.5mg $14 $30 $55
Isoniazid tablet Isoniazid / INH® / Nydrazid® 300mg $20
Isosorbide Mononitrate ER tablet Imdur® / Monoket® 30mg, 60mg
Isosorbide Mononitrate ER tablet Imdur® / Monoket® 120mg
Isosorbide Mononitrate tablet Monoket® / Imdur® 10mg, 20mg $10 $13 $20
Jantoven® (Warfarin) tablet Coumadin mg: 1, 2, 2.5, 3, 4, 5, 6, 7.5, 10 $12 $25 n/a
Kapvay ER® tablet Clonidine ER 0.1mg
Ketotifen Fumarate OTC Solution Alaway®/Zaditor®/Zyrtec Itchy Eye®/Claritin Eye® 0.025% / 5mL (No prescription required)
Klor-Con packet Potassium Chloride ER 20meq
Labetalol HCL tablet Trandate®/Normodyne® 100mg, 200mg, 300mg
Lactulose Oral Solution Enulose® / Constulose®/ Generlac® 10gm/15mL
Lamotrigine ER tablet Lamictal XR® 25mg
Lamotrigine ER tablet Lamictal XR® 50mg, 100mg
Lamotrigine ER tablet Lamictal XR® 200mg
Lamotrigine tablet Lamictal® 25mg, 100mg, 150mg, 200mg $14 $30 $55
Lancets 28G Twist Top (Prodigy®) OTC N/A Box of 100; min order - 2 boxes (No prescription required)
Lanoxin® tablet Digoxin / Digitek® .0625mg, .125mg, .1875mg, .25mg
Lansoprazole DR capsule Prevacid® 30mg
Latanoprost 0.005% Solution Xalatan® 2.5ml dropper $45 (limit 3) n/a
Leflunomide tablet Arava® 10mg, 20mg
Letrozole tablet Femara® 2.5mg $14 $30 $55
Levalbuterol Solution Xopenex® 1.25mg/3mL
Levetiracetam ER tablet Keppra XR® 500mg, 750mg
Levetiracetam tablet Keppra® 1000mg
Levetiracetam tablet Keppra® 250mg, 500mg, 750mg $21 $50 $95
Levocetirizine tablet Xyzal® 5mg $16 $35 $65
Levothyroxine tablet Levoxyl®/Synthroid® Levothroid®/Unithroid®/Tirosint® mcg: 25, 50, 75, 88, 100, 112, 125, 137, 150, 175, 200, 300 $10 $13 $20
Lidocaine 2% viscous solution Xylocaine® Viscous 2% 100ml
Lidocaine 5% patch Lidoderm® 5% of lidocaine per patch
Liothyronine Sodium tablet Cytomel® 5mcg, 25mcg
Liothyronine Sodium tablet Cytomel® 50mcg
Lisinopril tablet Zestril® / Prinivil® 2.5mg, 5mg, 10mg, 20mg, 30mg, 40mg $7 $9 $18
Lisinopril/HCTZ tablet Zestoretic® / Prinzide® 10/12.5mg, 20/12.5mg, 20/25mg $7 $9 $18
Lithium Carbonate capsule Eskalith® 150mg, 300mg
Lithium Carbonate ER tablet Lithobid ER® / Eskalith® CR 300mg, 450mg $16 $35 n/a
Loperamide capsule Imodium® 2mg
Loratadine OTC tablet Claritin® OTC / Alavert® 10mg (No prescription required)
Lorazepam tablet (CS) Ativan® 0.5mg $12 $25 n/a
Lorazepam tablet (CS) Ativan® 1mg, 2mg $14 $30 n/a
Losartan Potassium tablet Cozaar® 25mg, 50mg, 100mg $11 $20 $40
Losartan/HCTZ tablet Hyzaar® 50/12.5mg, 100/12.5mg, 100/25mg $12 $25 $45
Lovastatin tablet Mevacor® 10mg, 20mg, 40mg $7 $9 $18
Loxapine capsule Loxitane® 5mg, 10mg
Loxapine capsule Loxitane® 25mg, 50mg
Magnesium Oxide tablet (OTC) MaxOx® / Uro-Mag® 400mg (No prescription required)
Meclizine HCL tablet Antivert®/Dramamine II®/Meclicot®/Meni-D®/Bonine® 12.5mg $12 $25 $50
Meclizine HCL tablet Antivert®/Dramamine II®/Meclicot®/Meni-D®/Bonine® 25mg $14 $30 $55
Medroxyprogesterone tablet Provera® 2.5mg, 5mg, 10mg $9 $15 n/a
Melatonin tablet (OTC) N/A 5mg (No prescription required)
Meloxicam tablet Mobic®/Vivlodex® 7.5mg, 15mg $11 $20 n/a
Memantine HCL tablet Namenda® 5mg, 10mg
Meprobamate tablet (CS) Equanil® 200mg, 400mg
Mesalamine DR tablet Lialda® 1.2g
Metformin HCL ER tablet Glucophage XR®/Glumetza®/Fortamet® 500mg, 750mg $10 $13 $20
Metformin HCL tablet Glucophage® 500mg, 850mg, 1000mg $10 $13 $20
Methimazole tablet Northyx® 5mg, 10mg
Methocarbamol tablet Robaxin® 500mg, 750mg
Methotrexate tablet Rheumatrex® / MTX® 2.5mg
Methylphenidate CD capsule (CS) Metadate CD® 10mg
Methylphenidate CD capsule (CS) Metadate CD® 20mg, 30mg
Methylphenidate CD capsule (CS) Metadate CD® 40mg, 50mg, 60mg
Methylphenidate LA capsule (CS) Ritalin® LA 20mg, 30mg, 40mg
Methylphenidate tablet (CS) Ritalin® 5mg, 10mg
Methylphenidate tablet (CS) Ritalin® 20mg
Methylphenidate LA capsule (CS) Ritalin® LA 10mg
Metoclopramide HCL tablet Reglan® 5mg, 10mg (1 Fill Only / No Refills) $11 $20 n/a
Metolazone tablet Zaroxolyn® / Mykrox® 2.5mg, 5mg
Metoprolol Succinate ER tablet Toprol-XL® 25mg, 50mg, 100mg $16 $35 $65
Metoprolol Succinate ER tablet Toprol-XL® 200mg $20 $45 $85
$0* Supported through a partnership
$85 up to 30 capsules (30-day supply only)
$35 for up to 30 tablets
$85 for up to 60 tablets
$13 per box of 100
$0* Supported through a partnership
$45 for up to 30 tablets
$30 for up to 30 vials
$25 for up to 60 tablets
$11 up to 30 tabs / $20 up to 90 tabs
$7 per bottle
$8 for a bottle of 120
$5 per box; min order $10
$45 for up to 60 capsules
$10 per bottle of 100 tabs (min 2 bottles)
$115 up to 30 capsules (30-day supply only)
$15 up to 30 tablets (30-day supply only)
$25 up to 30 tablets (30-day supply only)
$20 for up to 60 capsules
$13 per 2 bottles (60 ct)
$9 for up to 30 tablets
$65 up to 30 capsules (30-day supply only)
$40 for up to 180 tablets
$35 for up to 30 capsules
$40 for up to 30 capsules
$9 up to 30 tabs / $15 up to 90 tabs
$20 per 12 tablets
$10 per bottle
$20 for up to 30 capsules
$12 up to 30 caps / $25 up to 90 caps
$9 up to 30 caps / $15 up to 90 caps
$11 up to 30 caps / $20 up to 90 caps
$11 up to 30 caps / $20 up to 90 caps
$35 for up to 30 tablets
$40 for up to 30 tablets
$99 for box of 30 patches
$15 up to 30 tabs / $35 up to 90 tabs
$20 up to 30 tabs / $45 up to 90 tabs
$9 for up to 30 capsules
$75 up to 30 capsules (30-day supply only)
$95 up to 30 capsules (30-day supply only)
$40 for up to 30 tablets
$10 for up to 270 capsules
$9 up to 30 tabs / $15 up to 90 tabs
$11 up to 30 tabs / $20 up to 90 tabs
$9 per dropper
$14 up to 30 tabs / $30 up to 90 tabs
$25 for up to 60 tablets
$14 up to 30 tabs / $30 up to 90 tabs
$25 for up to 270 capsules
$45 for up to 270 tablets
$50 for up to 60 tablets
$35 per tube
$9 up to 30 tabs / $15 up to 90 tabs
$12 up to 30 tabs / $25 up to 90 tabs
$25 for up to 60 tablets
$50 for up to 30 tablets
$25 for up to 90 vials
$18 up to 30 pkts / $40 up to 90 pkts
Metoprolol Tartrate tablet Lopressor® 25mg, 50mg, 100mg $10 $13 $20
Metoprolol Tartrate/HCTZ tablet Lopressor HCT® 50mg/25mg, 10mg/25mg
Midodrine HCL tablet Proamatine® / Orvaten® 2.5mg, 5mg, 10mg
Minocycline capsule Minocin/Dynacin®/Myrac®/Solodyn®/Ximino® 50mg, 75mg, 100mg $19 $45 $85
Mirtazapine tablet Remeron® 15mg, 30mg, 45mg $14 $30 n/a
Modafinil tablet (CS) Provigil® 100mg, 200mg $35 $80 n/a
Mometasone Furoate Cream Elocon® 15gm
Mometasone Furoate Ointment Elocon® 15gm
Montelukast Sodium tablet Singulair® 10mg, 5mg chewable
Mupirocin 2% ointment Bactroban® 22g
Mycophenolate Mofetil capsule CellCept® 250mg
Mycophenolate Mofetil tablet CellCept® 500mg
Mycophenolic Acid DR tablet Myfortic 180mg
Mycophenolic Acid DR tablet Myfortic 360mg
Nabumetone tablet Relafen® 500mg, 750mg $17 $40 n/a
Naltrexone HCL tablet Revia® 50mg
Naproxen Sodium tablet Anaprox® DS/ Aleve /Aflaxen®/Naprelan® 550mg $13 $25 n/a
Naproxen tablet Naprosyn® 250mg, 375mg, 500mg $10 $20 n/a
Niacin ER tablet Niaspan® ER 500mg
Niacin ER tablet Niaspan® ER 1000mg
Niacin SA capsule (OTC) N/A 250mg (No prescription required)
Nifedipine capsule Procardia® / Nifediac ® / Adalat® 10mg
Nifedipine capsule Procardia® / Nifediac® / Adalat® 20mg
Nifedipine ER tablet Procardia® XL/Adalat® CC/Afeditab® CR/Nifediac® CC 30mg, 60mg, 90mg $21 $50 $95
Nilandron® tablet Nilutamide 150mg
Nitroglycerin SA capsule N/A 2.5mg
Nitroglycerin SA capsule N/A 6.5mg, 9mg
Nitroglycerin SL tablet Nitrostat® 0.3mg, 0.4mg, 0.6mg
Norethindrone Acetate tablet Aygestin® 5mg
Norethindrone tablet Ortho Micronor®/Camila®/Errin® 28's (0.35mg) $15 $35 $65
Norethindrone/Ethinyl Estradiol tablet Ovcon® 35/Balziva/Briellyn/Femcon FE 28's (0.4mg/0.035mg) $15 $35 $65
Nortriptyline HCL capsule Pamelor® / Aventyl® 10mg, 25mg, 50mg, 75mg $11 $20 n/a
Nyamyc® Topical Powder Nystatin 100,000U/g (60g bottle)
Nystatin tablet N/A 500,000 units
Nystatin/Triamcinolone ointment Mycolog II® 30gm
Olanzapine tablet Zyprexa® 2.5mg, 5mg, 7.5mg, 10mg
Olanzapine tablet Zyprexa® 15mg, 20mg
Olmesartan Medoxomil tablet Benicar® 20mg
Olmesartan Medoxomil tablet Benicar® 5mg, 40mg
Olopatadine Nasal Spray Patanase® 665mcg
Olmesartan/HCTZ tablet Benicar HCT® 20/12.5mg, 40/12.5mg, 40/25mg
Olopatadine 0.2% solution Patanol®/Pataday®/Pazeo® 0.2% / 2.5ml
Omega-3-acid ethyl esters capsule Lovaza® / Omtryg® 1gm
Omeprazole capsule Prilosec® 10mg, 20mg, 40mg $16 $35 $65
Ondansetron tablet Zofran® 4mg, 8mg
Ondansetron / Ondansetron ODT tablet Zofran ODT® 4mg, 8mg
Oxandrolone tablet (CS) Oxandrin® 2.5mg, 10mg (Requires statement of diagnosis by provider)
Oxcarbazepine tablet Trileptal® 150mg, 300mg, 600mg $15 $30 n/a
Oxybutynin Chloride ER tablet Ditropan XL® 5mg, 10mg, 15mg $19 $45 $85
Oxybutynin tablet Ditropan® 5mg $10 $13 $20
Pacerone® tablet Cordarone® / Amiodarone 100mg, 200mg, 400mg $12 $25 $45
Panretin® gel 0.1% Alitretinoin 60gm
Pantoprazole tablet Protonix® 20mg, 40mg $11 $20 n/a
Paroxetine ER tablet Paxil CR® 12.5mg, 25mg, 37.5mg
Paroxetine HCL tablet Paxil® (HCL) 10mg, 20mg, 30mg, 40mg $11 $20 n/a
Pentoxifylline ER tablet Trental® / Pentoxil® 400mg $15 $30 $55
Perphenazine tablet Trilafon® 2mg, 4mg
Perphenazine tablet Trilafon® 8mg, 16mg
Phenelzine sulfate tablet Nardil 15mg
Phentermine capsule (CS) Adipex-P® 15mg, 30mg
Phenytoin Sodium capsule Dilantin® 100mg
Pioglitazone HCL tablet Actos® 15mg, 30mg, 45mg $12 $25 n/a
Plaquenil® tablet Hydroxychloroquine 200mg (Letter of necessity required)
PNV Prenatal Multivitamin+ Iron & Folic Acid tablet N/A 27mg/1mg
Polystyrene Sulfonate Powder Kalexate®/ Kionex® 454g
Potassium Chloride ER tablet Klor-Con® / K-Dur® / K-tab® 600mg (8mEQ), 750mg (10mEQ), 1500mg (20mEQ)
Potassium Citrate ER tablet Urocit-K® 540mg (5mEQ), 1080mg (10mEQ)
Pramipexole ER tablet Mirapex ER® 0.375mg, 0.75mg, 1.5mg, 3mg, 4.5mg
Pramipexole ER tablet Mirapex ER® 2.25mg
Pramipexole tablet Mirapex® 0.125mg, 0.25mg, 0.5mg, 1mg, 1.5mg
Prasugrel tablet Effient® 5mg, 10mg
Pravastatin tablet Pravachol® 10mg, 20mg, 40mg, 80mg
Prazosin capsule Minipress® 1mg, 2mg
Prazosin capsule Minipress® 5mg
Prednisone tablet Deltasone® 1mg, 2.5mg, 5mg, 10mg, 20mg, 50mg $9 $20 n/a
Pregabalin capsule Lyrica® 50mg, 75mg, 100mg, 150mg, 200mg, 225mg, 300mg
Prevalite® Powder Cholestyramine / Questran® 4g/5.5g dose packet
Prevalite® Powder Cholestyramine / Questran® 4g/5.5g powder can (231g)
Primidone tablet Mysoline® 50mg
Primidone tablet Mysoline® 250mg
Prochlorperazine tablet N/A 5mg, 10mg $10 $13 $20
Progesterone capsule Prometrium® 100mg, 200mg
Propafenone HCL tablet Rythmol® 150mg, 225mg $18 $40 $75
Propafenone HCL tablet Rythmol® 300mg
Propranolol HCL ER capsule Inderal® LA / Inderal®XL / InnoPran® XL 60mg, 80mg, 120mg 160mg
Propranolol tablet Inderal® 10mg
Propranolol tablet Inderal® 20mg
Propranolol tablet Inderal® 40mg
Propranolol tablet Inderal® 80mg
Propylthiouracil tablet N/A 50mg
Pyridostigmine BR tablet Mestinon® 60mg
Quetiapine Fumarate ER tablet Seroquel XR® 50mg
Quetiapine Fumarate ER tablet Seroquel XR® 150mg, 200mg
Quetiapine Fumarate ER tablet Seroquel XR® 300mg, 400mg
Quetiapine Fumarate tablet Seroquel® 25mg, 50mg, 100mg
Quetiapine Fumarate tablet Seroquel® 200mg, 300mg
Quetiapine Fumarate tablet Seroquel® 400mg
Quinapril tablet Accupril® 5mg, 10mg, 20mg, 40mg $15 $30 $55
Quinapril/HCTZ tablet Accuretic® 10/12.5mg, 20/12.5mg, 20/25mg
Rabeprazole Sodium DR tablet Aciphex® 20mg
Raloxifene tablet Evista® 60mg
Ramipril capsule Altace® 1.25mg, 2.5mg, 5mg, 10mg $12 $25 $45
Ranitidine tablet Zantac® / Taladine® 150mg, 300mg
$0* Supported through a partnership
$0* through partnership (90 days)
$15 for up to 90 tablets
Currently Unavailable / Products Recalled
$20 per bottle of 100 tabs
$25 for up to 30 tablets
$55 per bottle (240 sprays)
$13 up to 30 tabs / $25 up to 90 tabs
$25 per bottle
$16 up to 30 tabs / $35 up to 90 tabs
$21 up to 30 tabs / $50 up to 90 tabs
$30 for up to 90 tablets
$9 for a bottle of 100
$30 for up to 30 tablets
$20 for up to 60 capsules
$21 up to 30 tabs / $50 up to 90 tabs
$14 up to 30 tabs / $30 up to 90 tabs
$14 up to 30 tabs / $30 up to 90 tabs
$13 per tube
$25 for up to 60 capsules
$16 up to 30 tabs / $35 up to 90 tabs
$15 per tube
$15 per tube
$20 for up to 30 capsules
$0* Supported through a partnership
$12 up to 30 tabs / $22 up to 90 tabs
$11 up to 30 tabs / $20 up to 90 tabs
$25 for up to 90 tablets
$16 for up to 60 tablets
$30 for up to 30 capsules
$0 supported through partnership
$13 up to 30 tabs / $25 up to 90 tabs
$12 up to 30 tabs / $25 up to 90 tabs
$20 for up to 180 capsules
$100 for up to 30 tablets
$16 up to 30 tabs / $35 up to 90 tabs
$18 up to 30 tabs / $40 up to 90 tabs
$45 for up to 30 capsules
$25 per can
$18 up to 30 tabs / $40 up to 90 tabs
$18 up to 30 caps / $40 up to 90 caps
$12 for up to 30 packets
$11 up to 30 caps / $20 up to 90 caps
$10 for up to 60 tablets
$22 up to 30 tabs / $55 up to 90 tabs
$40 per dropper
$30 for up to 30 tablets
$9 up to 30 tabs / $15 up to 90 tabs
$25 up to 30 tabs / $72 up to 90 tabs
$16 up to 30 caps / $35 up to 90 caps
$60 for up to 120 tablets
$35 for up to 30 tablets
$9 for up to 30 tablets
$40 per can
$45 for up to 30 tablets
$25 for up to 180 tablets
$120 for up to 30 tablets
$25 up to 30 tabs / $72 up to 90 tabs
$80 for up to 120 capsules
$0 Supported through partnership
$25 up to 30 tabs / $72 up to 90 tabs
$20 for up to 30 tablets
$12 up to 30 tabs / $25 up to 90 tabs
$14 up to 30 tabs / $30 up to 90 tabs
$12 up to 30 tabs / $25 up to 90 tabs
$19 up to 30 tabs / $45 up to 90 tabs
$17 up to 30 tabs / $37 up to 90 tabs
$45 for up to 30 tablets
$15 for up to 30 capsules
$45 for up to 30 tablets
$50 for up to 30 tablets
$36 for up to 30 tablets
$17 up to 30 tabs / $40 up to 90 tabs
$65 for up to 180 capsules
$65 for up to 180 tablets
$55 for up to 60 tablets
$20 for up to 90 capsules
$20 per tube
Ranolazine ER tablet Ranexa® 1000mg
Ranolazine ER tablet Ranexa® 500mg
Rasagiline Mesylate tablet Azilect® 0.5mg
Rasagiline Mesylate tablet Azilect® 1mg
Repaglinide tablet Prandin® 0.5mg, 1mg, 2mg
Risedronate Sodium tablet Actonel® / Atelvia® 150mg (once a month dosage)
Risedronate Sodium tablet Actonel® / Atelvia® 35mg (once a week dosage)
Risperidone tablet Risperdal® 0.25mg, 0.5mg, 1mg, 2mg, 3mg, 4mg $20 $45 n/a
Rivastigmine Tartrate capsule Exelon® 1.5mg, 3mg, 4.5mg, 6mg
Rizatriptan tablet Maxalt® / Maxalt-MLT 5mg, 10mg
Ropinirole ER tablet Requip XL® 2mg
Ropinirole ER tablet Requip XL® 4mg
Ropinirole ER tablet Requip XL® 6mg
Ropinirole ER tablet Requip XL® 8mg,12mg
Ropinirole HCL tablet Requip® 0.25mg, 0.5mg, 1mg, 2mg, 4mg, 5mg $20 $45 $85
Rosuvastatin Calcium tablet Crestor® 5mg, 10mg, 20mg, 40mg
Salagen® tablet Pilocarpine 5mg, 7.5mg
Sertraline tablet Zoloft® 25mg, 50mg, 100mg $13 $25 n/a
Sevelamer Carbonate tablet Renvela® 800mg
Sildenafil Citrate tablet Revatio® 20mg
Sildenafil Citrate tablet Viagra® 25mg, 50mg, 100mg
Silodosin capsule Rapaflo® 4mg, 8mg
Simvastatin tablet Zocor® 5mg, 10mg, 20mg, 40mg, 80mg $10 $20 $35
Solifenacin tablet Vesicare® 5mg, 10mg
Sotalol tablet Sorine® / Betapace 80mg,120mg,160mg, 240mg $10 $20 n/a
Spironolactone tablet Aldactone® 25mg, 50mg, 100mg $11 $20 $30
Spironolactone/HCTZ tablet Aldactazide® 25mg/25mg
Sprintec® tablet Ortho-Cyclen® / Estarylla / Mononessa / Previfem 28's $35 (limit 3) $65 (limit 6)
Sucralfate tablet Carafate® 1gm
Sulfamethoxazole/Trimethoprim DS Bactrim® DS / Septra® DS 800mg/160mg $10 $13 $20
Sulfasalazine tablet Sulfazine® / Azulfidine® 500mg
Sulfasalazine DR tablet Azulfidine EN-tabs / Sulfazine EC® 500mg
Sumatriptan Succ tablet Imitrex® 25mg
Sumatriptan Succ tablet Imitrex® 50mg
Sumatriptan Succ tablet Imitrex® 100mg
Tacrolimus capsule Prograf® / Astagraf XL® 0.5mg, 1mg
Tacrolimus capsule Prograf® / Astagraf XL® 5mg
Tadalafil tablet Cialis® 2.5mg, 5mg
Tadalafil tablet Cialis® 10mg
Tadalafil tablet Adcirca® / Cialis® 20mg
Tamoxifen Citrate tablet Soltamox® 10mg
Tamoxifen Citrate tablet Soltamox® 20mg
Tamsulosin capsule Flomax® 0.4mg $14 $30 $55
Tazarotene 0.1% cream Tazorac® 30g
Telmisartan tablet Micardis® 20mg, 40mg, 80mg $16 $35 $65
Telmesartan HCTZ tablet Micardis HCT® 40/12.5mg, 80/12.5mg, 80/25mg
Temazepam capsule (CS) Restoril® 15mg, 30mg
Tenofovir Disoproxil Fumarate tablet Viread® 300mg
Terazosin capsule Hytrin® 1mg, 2mg, 5mg, 10mg $10 $13 $20
Testosterone Cypionate Solution (CS) Depo® - Testosterone 200mg/ml - 1ml vial
Testosterone Gel packet (CS) Vogelxo® / AndroGel® / Testim® / Fortesta® 50mg (5g of gel per packet)
Testosterone Gel packet (CS) AndroGel® 1.62% (1.25g of gel per packet)
Testosterone Gel pump (CS) Vogelxo® / AndroGel® / Testim® / Fortesta® 88g pump (12.5mg per pump actuation)
Testosterone Gel pump (CS) AndroGel® 1.62% 88g pump 1.62% (20.25mg per pump actuation)
Testosterone Gel tube (CS) Vogelxo® 50mg (5g of gel per tube)
Theophylline ER tablet Theochron 300mg, 450mg
Tizanidine HCL tablet Zanaflex® 2mg, 4mg $17 $40 n/a
Tolterodine ER capsule Detrol LA® 2mg, 4mg
Tolterodine Tartrate tablet Detrol® 1mg, 2mg
Topiramate ER capsule Qudexy XR® / Trokendi XR® 25mg, 50mg, 100mg, 150mg, 200mg $10 $25 $45
Topiramate tablet Topamax® / Topiragen® 25mg, 50mg, 100mg, 200mg $16 $35 $65
Tramadol HCL ER tablet (CS) Ultram® ER/Ryzolt®/ConZip® 100mg, 200mg
Tramadol HCL ER tablet (CS) Ultram® ER/Ryzolt®/ConZip® 300mg
Tramadol tablet (CS) Ultram® 50mg
Tramadol/Acetaminophen tablet (CS) Ultracet® 37.5mg/325mg
Trandolapril tablet Mavik® 1mg, 2mg, 4mg $14 $30 $55
Trazodone tablet Desyrel® 50mg, 100mg, 150mg $7 $10 n/a
Tretinoin 0.025% cream Avita® 20g
Tretinoin 0.05% cream Retin-A® 20g
Tri-Sprintec® tablet Ortho-Tri-Cyclen®/Tri-Estarylla/Tri-Previfem 28's $35 (limit 3) $65 (limit 6)
Triamcinolone cream 0.1% N/A 454gm (0.1%)
Triamcinolone cream Kenalog® 30gm (0.1%)
Triamcinolone ointment 0.1% N/A 454gm (0.1%)
Triamcinolone ointment N/A 80gm (0.10%)
Triamterene/HCTZ capsule Dyazide® 37.5/25mg $10 $13 $20
Triamterene/HCTZ tablet Maxzide® 37.5/25mg, 75/50mg $10 $13 $20
Trospium Chloride tablet Sanctura® 20mg
Uroxatral® tablet Alfuzosin HCL ER 10mg
Ursodiol capsule Actigall® 300mg
Ursodiol tablet Urso 250® 250mg
Ursodiol tablet Urso Forte® 500mg
Valacyclovir HCL tablet Valtrex® 1gm
Valacyclovir HCL tablet Valtrex® 500mg
Valproic acid capsule Depakene® / Stavzor® 250mg $20 $50 $80
Valsartan tablet Diovan® 40mg, 80mg
Valsartan tablet Diovan® 160mg, 320mg
Valsartan/HCTZ tablet Diovan HCT® 80/12.5mg, 160/12.5mg, 160/25mg, 320/12.5mg, 320/25mg $16 $35 $65
Vandazole 0.75% Gel Metronidazole Vaginal 70g tube
Venlafaxine ER capsule Effexor XR® 37.5mg, 75mg, 150mg $19 $45 n/a
Venlafaxine tablet Effexor® 25mg, 37.5mg, 50mg, 75mg, 100mg $19 $45 n/a
Verapamil ER capsule Verelan® 120mg, 180mg, 240mg
Verapamil SR tablet Calan-SR® / Isoptin-SR® 120mg, 180mg, 240mg $12 $25 $40
Verapamil tablet Calan® 40mg, 80mg, 120mg
Vitamin B-6 tablet (OTC) N/A 50mg (No prescription required)
Vitamin B-6 tablet (OTC) N/A 100mg (No prescription required)
Vitamin D3 tablet (OTC) (cholecalciferol) N/A 400IU (No prescription required)
Vitamin D3 capsule (OTC) N/A 50,000IU (No prescription required)
Zafirlukast tablet Accolate® 10mg, 20mg
Zaleplon capsule (CS) Sonata® 5mg, 10mg
Zidovudine tablet AZT / Retrovir® 300mg
Ziprasidone capsule Geodon® 20mg, 40mg, 60mg, 80mg
Zolpidem Tartrate ER tablet (CS) Ambien CR® 6.25mg, 12.5mg
Zolpidem Tartrate tablet (CS) Ambien® 5mg, 10mg $14 $30 n/a
$0 Supported through partnership
$0 Supported through partnership
$30 for up to 30 tablets
$90 per tube
$25 for a carton of 2 pumps
$10 up to 30 caps / $16 up to 90 caps
$20 per vial
$25 for a carton of 30 packets
$25 for a carton of 30 tubes
$29 up to 30 tabs / $75 up to 90 tabs
$16 up to 30 tabs / $35 up to 90 tabs
$0 Supported through partnership
$40 for up to 30 tablets
$75 for up to 15 packets
$35 for up to 27 tablets
$9 up to 30 tabs / $13 up to 90 tabs
$11 up to 30 tabs / $20 up to 90 tabs
$50 per pack of 4 tablets
$100 for up to 30 tablets
$35 for up to 72 tablets
$20 for up to 60 capsules
$13 up to 30 tabs / $25 up to 90 tabs
$16 up to 30 tabs / $35 up to 90 tabs
$35 for up to 54 tablets
$80 for up to 60 capsules
$30 for up to 30 tablets
$20 per jar
$45 for up to 30 capsules
$30 for up to 120 tablets
$15 for up to 30 tablets
$80 per dosage
$50 for up to 60 capsules
$60 for up to 30 tablets
$25 for up to 18 tablets
$25 for up to 30 tablets
$40 for up to 30 tablets
$50 for up to 30 tablets
$18 up to 30 tabs / $40 up to 90 tabs
$18 up to 30 tabs / $40 up to 90 tabs
$20 for up to 30 tablets
$80 for up to 30 tablets
$40 per tube
$50 per tube
$45 for up to 30 tablets
$21 up to 30 caps / $50 up to 90 caps
$18 up to 30 tabs / $40 up to 90 tabs
$30 for up to 30 tablets
$50 for up to 60 tablets
$60 for up to 30 capsules
$18 per jar
$30 for up to 120 tablets
$40 for up to 30 tablets
$60 for up to 30 tablets
$14 up to 30 tabs / $30 up to 90 tabs
$7 for up to 90 tablets
$30 up to 30 tabs / $75 up to 90 tabs
$21 up to 30 tabs / $50 up to 90 tabs
$30 per tube
$0 Supported through partnership
$8 up to 30 tabs / $12 up to 90 tabs
$11 for a bottle of 100
$7 for a bottle of 100
$11 for a bottle of 100
$15 for 12 capsules
$16 up to 30 caps / $35 up to 90 caps
$26 up to 30 caps / $65 up to 90 caps
$25 up to 30 tabs / $72 up to 90 tabs
$30 for 60 tablets
$30 for up to 60 tablets
$53 for up to 60 tablets
$63 for up to 60 tablets
$55 for up to 60 capsules
$30 for up to 30 tablets
$70 per pump
$25 for up to 30 tablets
$12 per tube
$20 per tube
$15 for up to 30 tablets
Zonegran® capsule Zonisamide 25mg Letter of necessity required $30 n/a
Zonegran® capsule Zonisamide 100mg Letter of necessity required
Zonisamide capsule Zonegran® 50mg, 100mg
(CS) Controlled Substance
Rx Outreach is a fully licensed pharmacy.
Rx Outreach reserves the right to add or delete medicines available, change fees, or discontinue the program at any time
These are the only medications we offer at this time. If a medication is not on this list, it is not currently available from Rx Outreach.
All prescriptions are evaluated by a pharmacist before being filled. For some medications, the quantity may be less because of dose restrictions set by therapeutic guidelines and state regulations.
Rx Outreach, Inc. / P. O. Box 66536 / St. Louis, MO 63166-6536 / 888-RXO-1234 / www.rxoutreach.org
$20 for up to 90 capsules
$18 for up to 90 capsules