2651-101518
1
Adhere 90: Maintenance Drug List
Effective 1/1/2020
1014 Vine Street, Cincinnati, OH 45202 • Phone 800.917.4926 • Fax 866.762.1014 Copyright © 2018 Kroger Prescription Plans, Inc. All Rights Reserved.
Maintenance medications are commonly prescribed and taken continuously to manage chronic conditions, such as high blood pressure, asthma, diabetes and high cholesterol. Adhere 90 is a program that requires members to receive a 90-day supply of certain maintenance medications after their first 2 fills of a prescription. Receiving a 90-day supply of medication helps increase adherence to medication regimens and is convenient for members. 90-day supplies of medications can be filled at a 90-day retail pharmacy or through mail order. The Adhere 90 program only applies to the list above; other medications may be filled at any network pharmacy.
ASTHMA AND COPD ACCOLATE
ADVAIR DISKUS
ADVAIR HFA
AEROSPAN
ALVESCO
ANORO ELLIPTA
ARCAPTA NEOHALER
ARMONAIR RESPICLICK
ARNUITY ELLIPTA
ASMANEX
ASMANEX HFA
ATAZANAVIR
BREO ELLIPTA
BROVANA
BUDESONIDE
COMBIVENT
COMBIVENT RESPIMAT
CROMOLYN SODIUM
DALIRESP
DULERA
DUONEB
FLOVENT DISKUS
FLOVENT HFA
FORADIL
INCRUSE ELLIPTA
IPRATROPIUM-ALBUTEROL
METAPROTERENOL SULFATE
MONTELUKAST SODIUM
PERFOROMIST
PULMICORT
PULMICORT FLEXHALER
QVAR
SEEBRI NEOHALER
SEREVENT DISKUS
SINGULAIR
SPIRIVA
SPIRIVA RESPIMAT
STIOLTO RESPIMAT
STRIVERDI RESPIMAT
SYMBICORT
TRELEGY ELLIPTA
TUDORZA PRESSAIR
UTIBRON NEOHALER
ZAFIRLUKAST
ZILEUTON
ZYFLO
ZYFLO CR
AUTONOMIC NERVOUS SYSTEM
ARICEPT
ARICEPT ODT
DONEPEZIL HCL
DONEPEZIL HCL ODT
EXELON
GALANTAMINE HBR
GALANTAMINE HYDROBROMIDE
MEMANTINE HCL
MEMANTINE HCL ER
MESTINON
NAMENDA
NAMENDA XR
NAMZARIC
PYRIDOSTIGMINE BROMIDE
PYRIDOSTIGMINE BROMIDE ER
RAZADYNE
RAZADYNE ER
RIVASTIGMINE
2
Adhere 90: Maintenance Drug List
Copyright © 2018 Kroger Prescription Plans, Inc. All Rights Reserved.
BEHAVIORAL HEALTH – ANTIDEPRESSANTS
AMITRIPTYLINE HCL
AMOXAPINE
ANAFRANIL
APLENZIN
BRINTELLIX
BUDEPRION SR
BUDEPRION XL
BUPROPION HCL
BUPROPION HCL SR
BUPROPION XL
CELEXA
CHLORDIAZEPOXIDE-AMITRIPTYLINE
CITALOPRAM HBR
CLOMIPRAMINE HCL
CYMBALTA
DESIPRAMINE HCL
DESVENLAFAXINE
DESVENLAFAXINE ER
DESVENLAFAXINE FUMARATE ER
DOXEPIN HCL
DULOXETINE HCL
EFFEXOR XR
ESCITALOPRAM OXALATE
FETZIMA
FLUOXETINE DR
FLUOXETINE HCL
FLUVOXAMINE MALEATE
FLUVOXAMINE MALEATE ER
FORFIVO XL
IMIPRAMINE HCL
IMIPRAMINE PAMOATE
IRENKA
KHEDEZLA
LEXAPRO
LUVOX CR
MAPROTILINE HCL
MARPLAN
MIRTAZAPINE
NARDIL
NEFAZODONE HCL
NORPRAMIN
NORTRIPTYLINE HCL
OLEPTRO ER
PAMELOR
PARNATE
PAROXETINE HCL
PAXIL
PAXIL CR
PERPHENAZINE-AMITRIPTYLINE
PEXEVA
PHENELZINE SULFATE
PRISTIQ ER
PROTRIPTYLINE HCL
PROZAC
PROZAC WEEKLY
REMERON
SARAFEM
SERTRALINE HCL
SURMONTIL
TOFRANIL
TOFRANIL-PM
TRANYLCYPROMINE SULFATE
TRAZODONE HCL
TRIMIPRAMINE MALEATE
TRINTELLIX
VENLAFAXINE HCL
VENLAFAXINE HCL ER
VIIBRYD
VIVACTIL
WELLBUTRIN
WELLBUTRIN SR
WELLBUTRIN XL
ZOLOFT
BEHAVIORAL HEALTH – OTHER
ABILIFY
ACAMPROSATE CALCIUM
ANTABUSE
ARIPIPRAZOLE
ARIPIPRAZOLE ODT
CAMPRAL
CHLORPROMAZINE HCL
DISULFIRAM
EMSAM
3
Adhere 90: Maintenance Drug List
Copyright © 2018 Kroger Prescription Plans, Inc. All Rights Reserved.
BEHAVIORAL HEALTH – OTHER (Cont.)
EQUETRO
FANAPT
FAZACLO
FLUPHENAZINE HCL
GEODON
HALOPERIDOL
HALOPERIDOL LACTATE
INVEGA
LATUDA
LITHIUM
LITHIUM CARBONATE
LITHIUM CARBONATE ER
LITHIUM CITRATE
LITHOBID
LOXAPINE
LOXITANE
MOBAN
MOLINDONE HCL
NAVANE
OLANZAPINE
OLANZAPINE ODT
OLANZAPINE-FLUOXETINE HCL
ORAP
PALIPERIDONE ER
PERPHENAZINE
PIMOZIDE
QUETIAPINE FUMARATE
QUETIAPINE FUMARATE XR
REXULTI
RISPERDAL
RISPERDAL M-TAB
RISPERIDONE
RISPERIDONE ODT
SAPHRIS
SEROQUEL
SEROQUEL XR
SYMBYAX
THIORIDAZINE HCL
THIOTHIXENE
TRIFLUOPERAZINE HCL
VERSACLOZ
VRAYLAR
ZIPRASIDONE HCL
ZYPREXA
ZYPREXA ZYDIS
CV DISEASE – ARRHYTHMIA AMIODARONE HCL
CORDARONE
DISOPYRAMIDE PHOSPHATE
FLECAINIDE ACETATE
MEXILETINE HCL
MULTAQ
NORPACE
NORPACE CR
PACERONE
PROPAFENONE HCL
PROPAFENONE HCL ER
QUINIDINE GLUCONATE
QUINIDINE SULFATE
RYTHMOL
RYTHMOL SR
TAMBOCOR
TIKOSYN
CV DISEASE – CARDIAC STIMULANT
DIGITEK
DIGOX
DIGOXIN
LANOXIN
CV DISEASE – HYPERTENSION ACCUPRIL
ACCURETIC
ACEBUTOLOL HCL
ACEON
ADALAT CC
AFEDITAB CR
ALDACTAZIDE
ALDACTONE
ALTACE
AMILORIDE HCL
AMILORIDE-HYDROCHLOROTHIAZIDE
AMLODIPINE BESYLATE
4
Adhere 90: Maintenance Drug List
Copyright © 2018 Kroger Prescription Plans, Inc. All Rights Reserved.
CV DISEASE – HYPERTENSION (Cont.)
AMLODIPINE BESYLATE-BENAZEPRIL
AMLODIPINE-OLMESARTAN
AMLODIPINE-VALSARTAN
AMLODIPINE-VALSARTAN-HCTZ
AMTURNIDE
ATACAND
ATACAND HCT
ATENOLOL
ATENOLOL-CHLORTHALIDONE
AVALIDE
AVAPRO
AZOR
BENAZEPRIL HCL
BENAZEPRIL-HYDROCHLOROTHIAZIDE
BENICAR
BENICAR HCT
BETAPACE
BETAPACE AF
BETAXOLOL HCL
BIDIL
BISOPROLOL FUMARATE
BISOPROLOL-HYDROCHLOROTHIAZIDE
BUMETANIDE
BYSTOLIC
CALAN
CALAN SR
CANDESARTAN CILEXETIL
CANDESARTAN-HYDROCHLOROTHIAZID
CAPTOPRIL
CAPTOPRIL-HYDROCHLOROTHIAZIDE
CARDENE SR
CARDIZEM
CARDIZEM CD
CARDIZEM LA
CARDURA
CARDURA XL
CARTIA XT
CARVEDILOL
CARVEDILOL CR
CATAPRES
CATAPRES-TTS 1
CATAPRES-TTS 2
CATAPRES-TTS 3
CHLOROTHIAZIDE
CHLORTHALIDONE
CLONIDINE
CLONIDINE HCL
CLORPRES
COREG
COREG CR
CORGARD
CORZIDE
COVERA-HS
COZAAR
DEMADEX
DILACOR XR
DILT-CD
DILTIA XT
DILTIAZEM 12HR ER
DILTIAZEM 24HR CD
DILTIAZEM 24HR ER
DILTIAZEM ER
DILTIAZEM HCL
DILT-XR
DILTZAC ER
DIOVAN
DIOVAN HCT
DIURIL
DOXAZOSIN MESYLATE
DUTOPROL
DYAZIDE
DYNACIRC CR
DYRENIUM
EDARBI
EDARBYCLOR
EDECRIN
ENALAPRIL MALEATE
ENALAPRIL-HYDROCHLOROTHIAZIDE
EPANED
EPLERENONE
EPROSARTAN MESYLATE
EXFORGE
EXFORGE HCT
FELODIPINE ER
FOSINOPRIL SODIUM
5
Adhere 90: Maintenance Drug List
Copyright © 2018 Kroger Prescription Plans, Inc. All Rights Reserved.
CV DISEASE – HYPERTENSION (Cont.)
FOSINOPRIL-HYDROCHLOROTHIAZIDE
FUROSEMIDE
GUANABENZ ACETATE
GUANFACINE HCL
HYDRALAZINE HCL
HYDROCHLOROTHIAZIDE
HYZAAR
INDAPAMIDE
INDERAL LA
INDERAL XL
INNOPRAN XL
INSPRA
IRBESARTAN
IRBESARTAN-HYDROCHLOROTHIAZIDE
ISOPTIN SR
ISRADIPINE
KERLONE
LABETALOL HCL
LASIX
LEVATOL
LISINOPRIL
LISINOPRIL-HYDROCHLOROTHIAZIDE
LOPRESSOR
LOPRESSOR HCT
LOSARTAN POTASSIUM
LOSARTAN-HYDROCHLOROTHIAZIDE
LOTENSIN
LOTENSIN HCT
LOTREL
MATZIM LA
MAVIK
MAXZIDE
MAXZIDE-25 MG
METHYCLOTHIAZIDE
METHYLDOPA
METHYLDOPA-HYDROCHLOROTHIAZIDE
METOLAZONE
METOPROLOL SUCCINATE
METOPROLOL TARTRATE
METOPROLOL-HYDROCHLOROTHIAZIDE
METOPROLOL SUCCINATE ER HYDROCHLOROTHIAZIDE
MICARDIS
MICARDIS HCT
MICROZIDE
MIDAMOR
MINIPRESS
MINOXIDIL
MOEXIPRIL HCL
MOEXIPRIL-HYDROCHLOROTHIAZIDE
NADOLOL
NADOLOL-BENDROFLUMETHIAZIDE
NEXICLON XR
NICARDIPINE HCL
NIFEDIAC CC
NIFEDICAL XL
NIFEDIPINE
NIFEDIPINE ER
NISOLDIPINE
NORVASC
OLMESARTAN
OLMESARTAN - HYDROCHLOROTHIAZIDE
OLMESARTAN – HYDROCHLOROTHIAZIDE - AMLODIPINE
PERINDOPRIL ERBUMINE
PINDOLOL
PRAZOSIN HCL
PRESTALIA
PRINIVIL
PRINZIDE
PROCARDIA
PROCARDIA XL
PROPRANOLOL HCL
PROPRANOLOL HCL ER
PROPRANOLOL-HYDROCHLOROTHIAZID
QUINAPRIL HCL
QUINAPRIL-HYDROCHLOROTHIAZIDE
RAMIPRIL
RESERPINE
SECTRAL
SORINE
SOTALOL
SOTALOL AF
SOTYLIZE
SPIRONOLACTONE
6
Adhere 90: Maintenance Drug List
Copyright © 2018 Kroger Prescription Plans, Inc. All Rights Reserved.
CV DISEASE – HYPERTENSION (Cont.)
SPIRONOLACTONE-HCTZ
SULAR
TARKA
TAZTIA XT
TEKAMLO
TEKTURNA
TEKTURNA HCT
TELMISARTAN
TELMISARTAN-AMLODIPINE
TELMISARTAN-HYDROCHLOROTHIAZID
TENEX
TENORETIC 100
TENORETIC 50
TENORMIN
TERAZOSIN HCL
TEVETEN
TEVETEN HCT
THALITONE
TIAZAC
TIMOLOL MALEATE
TOPROL XL
TORSEMIDE
TRANDATE
TRANDOLAPRIL
TRANDOLAPRIL-VERAPAMIL
TRANDOLAPRIL-VERAPAMIL ER
TRIAMTERENE W/HCTZ
TRIAMTERENE-HYDROCHLOROTHIAZID
TRIBENZOR
TWYNSTA
UNIRETIC
UNIVASC
VALSARTAN
VALSARTAN-HYDROCHLOROTHIAZIDE
VALTURNA
VASERETIC
VASOTEC
VERAPAMIL ER
VERAPAMIL ER PM
VERAPAMIL HCL
VERAPAMIL SR
VERELAN
VERELAN PM
ZAROXOLYN
ZEBETA
ZESTORETIC
ZESTRIL
ZIAC
CV DISEASE – LIPID IRREGULARITY
ALTOPREV
ANTARA
ATORVASTATIN CALCIUM
CHOLESTYRAMINE
CHOLESTYRAMINE LIGHT
COLESTID
COLESTIPOL HCL
CRESTOR
EZETIMIBE
FENOFIBRATE
FENOFIBRIC ACID
FENOGLIDE
FIBRICOR
FLOLIPID
FLUVASTATIN ER
FLUVASTATIN SODIUM
GEMFIBROZIL
LESCOL
LESCOL XL
LIPITOR
LIPOFEN
LIPTRUZET
LIVALO
LOFIBRA
LOPID
LOVASTATIN
LOVAZA
MEVACOR
NIACIN ER
NIACIN SR 250MG
NIACOR
NIASPAN
OMEGA-3 ACID ETHYL ESTERS
PRAVACHOL
7
Adhere 90: Maintenance Drug List
Copyright © 2018 Kroger Prescription Plans, Inc. All Rights Reserved.
CV DISEASE – LIPID IRREGULARITY (Cont.)
PRAVASTATIN SODIUM
PREVALITE
QUESTRAN
QUESTRAN LIGHT
ROSUVASTATIN CALCIUM
SIMVASTATIN
SIMVASTATIN-EZETIMIBE
TRICOR
TRIGLIDE
TRILIPIX
VASCEPA
VYTORIN
WELCHOL
ZETIA
ZOCOR
CV DISEASE – MISC AMLODIPINE-ATORVASTATIN
ASPIRIN
CADUET
CORLANOR
ENTRESTO
RANEXA
CV DISEASE – VASODILATION DILATRATE-SR
ERGOLOID MESYLATES
IMDUR
ISOCHRON
ISODITRATE
ISORDIL
ISORDIL TITRADOSE
ISOSORBIDE DINITRATE
ISOSORBIDE MONONITRATE
ISOSORBIDE MONONITRATE ER
ISOXSUPRINE HCL
MINITRAN
MONOKET
NITRO-BID
NITRO-DUR
NITROGLYCERIN
NITROGLYCERIN PATCH
NITROLINGUAL
NITRO-TIME
PAPAVERINE HCL
CONTRACEPTION/OXYTOCICS (ORAL) – GENERICS ONLY
ALTAVERA
ALYACEN
AMETHIA
AMETHIA LO
AMETHYST
APRI
ARANELLE
ASHLYNA
AUBRA
AVIANE
AZURETTE
BALZIVA
BEKYREE
BEYAZ
BLISOVI 24 FE
BLISOVI FE
BREVICON
BRIELLYN
CAMILA
CAMRESE
CAMRESE LO
CAZIANT
CHATEAL
CRYSELLE
CYCLAFEM
CYCLESSA
CYRED
DASETTA
DAYSEE
DEBLITANE
DELYLA
DEMULEN 1-50-21
DEMULEN 1-50-28
DESOGEN
DESOGESTREL-ETHINYL ESTRADIOL
DESOGESTR-ETH ESTRAD ETH ESTRA
DROSPIRENONE-ETHINYL ESTRADIOL
8
Adhere 90: Maintenance Drug List
Copyright © 2018 Kroger Prescription Plans, Inc. All Rights Reserved.
CONTRACEPTION/OXYTOCICS ORAL – GENERICS ONLY (Cont.)
ELINEST
EMOQUETTE
ENPRESSE
ENSKYCE
ERRIN
ESTARYLLA
ESTROSTEP FE
FALMINA
FAYOSIM
FEMCON FE
GENERESS FE
GIANVI
GILDAGIA
GILDESS
GILDESS 24 FE
GILDESS FE
HEATHER
INTROVALE
JENCYCLA
JOLESSA
JOLIVETTE
JULEBER
JUNEL
JUNEL FE
JUNEL FE 24
KAITLIB FE
KARIVA
KELNOR 1-35
KIMIDESS
KURVELO
LARIN
LARIN 24 FE
LARIN FE
LAYOLIS FE
LEENA
LESSINA
LEVONEST
LEVONORGESTREL-ETH ESTRADIOL
LEVONORG-ETH ESTRAD ETH ESTRAD
LEVORA-28
LO LOESTRIN FE
LOESTRIN
LOESTRIN 24 FE
LOESTRIN FE
LOMEDIA 24 FE
LO-OVRAL-28
LO-OVRAL-8
LORYNA
LOSEASONIQUE
LOW-OGESTREL
LUTERA
LYZA
MARLISSA
MIBELAS 24 FE
MICROGESTIN
MICROGESTIN 24 FE
MICROGESTIN FE
MINASTRIN 24 FE
MIRCETTE
MODICON
MONO-LINYAH
MONONESSA
MYZILRA
NATAZIA
NECON
NIKKI
NORA-BE
NORDETTE-28
NORETHINDRONE
NORETHINDRONE-ETHIN ESTRADIOL
NORETHINDRON-ETHINYL ESTRADIOL
NORETHIN-ETH ESTRA-FERROUS FUM
NORGESTIMATE-ETHINYL ESTRADIOL
NORGESTREL-ETHINY ESTRA
NORINYL 1+35
NORINYL 1+50
NORLYROC
NOR-Q-D
NORTREL
OCELLA
OGESTREL
ORSYTHIA
ORTHO MICRONOR
ORTHO TRI-CYCLEN
ORTHO TRI-CYCLEN LO
9
Adhere 90: Maintenance Drug List
Copyright © 2018 Kroger Prescription Plans, Inc. All Rights Reserved.
CONTRACEPTION/OXYTOCICS ORAL – GENERICS ONLY (Cont.)
ORTHO-CEPT
ORTHO-CYCLEN
ORTHO-NOVUM
OVCON-35
OVCON-50
PHILITH
PIMTREA
PIRMELLA
PORTIA
PREVIFEM
QUARTETTE
QUASENSE
RECLIPSEN
RIVELSA
SAFYRAL
SEASONALE
SEASONIQUE
SETLAKIN
SHAROBEL
SOLIA
SPRINTEC
SRONYX
SYEDA
TARINA FE
TILIA FE
TRI-ESTARYLLA
TRI-LEGEST FE
TRI-LINYAH
TRI-LO-ESTARYLLA
TRI-LO-MARZIA
TRI-LO-SPRINTEC
TRINESSA
TRINESSA LO
TRI-NORINYL
TRI-PREVIFEM
TRI-SPRINTEC
TRIVORA-28
TYDEMY
VELIVET
VESTURA
VIENVA
VIORELE
VYFEMLA
WERA
WYMZYA FE
YASMIN 28
YAZ
ZARAH
ZENCHENT
ZENCHENT FE
ZEOSA
ZOVIA 1-35E
ZOVIA 1-50E
CONTRACEPTION/ OXYTOCICS – OTHER
DEPO-SUBQ PROVERA 104MG
MEDROXYPROGESTERONE 150MG
NUVARING
ORTHO EVRA
XULANE
DIABETES ACARBOSE
ACTOPLUS MET
ACTOPLUS MET XR
ACTOS
ALOGLIPTIN
ALOGLIPTIN-METFORMIN
ALOGLIPTIN-PIOGLITAZONE
AMARYL
AVANDAMET
AVANDARYL
AVANDIA
CHLORPROPAMIDE
CYCLOSET
DIABETA
DUETACT
FARXIGA
FORTAMET
GLIMEPIRIDE
GLIPIZIDE
GLIPIZIDE ER
GLIPIZIDE XL
GLIPIZIDE-METFORMIN
10
Adhere 90: Maintenance Drug List
Copyright © 2018 Kroger Prescription Plans, Inc. All Rights Reserved.
DIABETES (Cont.)
GLUCOPHAGE
GLUCOPHAGE XR
GLUCOTROL
GLUCOTROL XL
GLUCOVANCE
GLUMETZA
GLYBURIDE
GLYBURIDE MICRONIZED
GLYBURIDE-METFORMIN HCL
GLYNASE
GLYSET
GLYXAMBI
INVOKAMET
INVOKANA
JANUMET
JANUMET XR
JANUVIA
JARDIANCE
JENTADUETO
KAZANO
KOMBIGLYZE XR
METFORMIN HCL
METFORMIN HCL ER
NATEGLINIDE
NESINA
ONGLYZA
OSENI
PIOGLITAZONE HCL
PIOGLITAZONE-GLIMEPIRIDE
PIOGLITAZONE-METFORMIN
PRANDIMET
PRANDIN
PRECOSE
PROGLYCEM
QTERN
REPAGLINIDE
REPAGLINIDE-METFORMIN HCL
RIOMET
SEGLUROMET
STARLIX
STEGLATRO
STEGLUJAN
SYNJARDY
SYNJARDY XR
TOLAZAMIDE
TOLBUTAMIDE
TRADJENTA
XIGDUO XR
ELECTROLYTE REGULATION AURYXIA
CALCIUM ACETATE
EFFER-K
ELIPHOS
EPIKLOR
FOSRENOL
K EFFERVESCENT
KAOCHLOR-EFF
KLOR-CON
KLOR-CON 10
KLOR-CON 8
KLOR-CON M10
KLOR-CON M15
KLOR-CON M20
KLOR-CON SPRINKLE
KLOR-CON-EF
K-SOL
K-TAB
K-TAB ER
MICRO-K
PHOSLO
PHOSLYRA
POTASSIUM BICARBONATE
POTASSIUM CHLORIDE
RENAGEL
RENVELA
SEVELAMER CARBONATE
VELPHORO
VELTASSA
ENDOCRINE DISORDERS – OTHER
ACTONEL
ALENDRONATE SODIUM
ATELVIA
BINOSTO
11
Adhere 90: Maintenance Drug List
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ENDOCRINE DISORDERS – OTHER (Cont.)
BONIVA
CABERGOLINE
CALCITONIN-SALMON
DDAVP
DESMOPRESSIN ACETATE
DIDRONEL
DOXERCALCIFEROL
ETIDRONATE DISODIUM
EVISTA
FORTICAL
FOSAMAX
FOSAMAX PLUS D
HECTOROL
IBANDRONATE SODIUM
MIACALCIN
OSPHENA
PARICALCITOL
RALOXIFENE HCL
RISEDRONATE SODIUM
RISEDRONATE SODIUM DR
SKELID
STIMATE
ZEMPLAR
ENDOCRINE DISORDERS – THYROID
ARMOUR THYROID
CYTOMEL
DUMMY NDC ARMOUR THYROID
LEVOTHROID
LEVOTHYROXINE SODIUM
LEVOXYL
LIOTHYRONINE SODIUM
METHIMAZOLE
NATURE-THROID
NP THYROID
PROPYLTHIOURACIL
SYNTHROID
TAPAZOLE
THYROLAR-1
THYROLAR-1/2
THYROLAR-1/4
THYROLAR-2
THYROLAR-3
TIROSINT
UNITHROID
WESTHROID
WESTHROID-P
WP THYROID
EYE – GLAUCOMA ACETAZOLAMIDE
AK-PENTOLATE
ALPHAGAN P
ATROPINE CARE
ATROPINE SULFATE
AZOPT
BETAGAN
BETIMOL
BETOPTIC S
BIMATOPROST
BRIMONIDINE TARTRATE
CARTEOLOL HCL
COMBIGAN
COSOPT
COSOPT PF
CYCLOGYL
CYCLOMYDRIL
CYCLOPENTOLATE HCL
DIAMOX SEQUELS
DORZOLAMIDE HCL
DORZOLAMIDE-TIMOLOL
HOMATROPAIRE
HOMATROPINE HYDROBROMIDE
ISOPTO ATROPINE
ISOPTO CARBACHOL
ISOPTO CARPINE
ISOPTO HOMATROPINE
ISOPTO HYOSCINE
ISTALOL
LATANOPROST
LEVOBUNOLOL HCL
LUMIGAN
METHAZOLAMIDE
METIPRANOLOL
12
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EYE – GLAUCOMA (Cont.)
MYDRIACYL
NEPTAZANE
OPTIPRANOLOL
PHOSPHOLINE IODIDE
PILOCARPINE HCL
PILOPINE HS
RESCULA
SIMBRINZA
TIMOPTIC
TIMOPTIC OCUDOSE
TIMOPTIC-XE
TRAVATAN Z
TRAVOPROST
TROPICAMIDE
TRUSOPT
XALATAN
ZIOPTAN
GOUT AND RELATED DISEASES
ALLOPURINOL
COLCHICINE
COLCRYS
DUZALLO
MITIGARE
PROBENECID
ULORIC
ZYLOPRIM
HEMATOLOGICAL DISORDERS
AGGRENOX
ANAGRELIDE HCL
ASPIRIN-DIPYRIDAMOLE ER
BEVYXXA
BRILINTA
CILOSTAZOL
CLOPIDOGREL
DIPYRIDAMOLE
DROXIA
DURLAZA
EFFIENT
ELIQUIS
JANTOVEN
LYSTEDA
PENTOXIFYLLINE
PERSANTINE
PLAVIX
PLETAL
PRADAXA
PRASUGREL
SAVAYSA
TICLOPIDINE HCL
TRANEXAMIC ACID
TRENTAL
XARELTO
ZONTIVITY
HORMONAL DEFICIENCY
ACTIVELLA
ALORA
ANGELIQ
AYGESTIN
CENESTIN
CLIMARA
CLIMARA PRO
COMBIPATCH
DIVIGEL
DUAVEE
ELESTRIN
ENJUVIA
ESTRACE
ESTRADERM
ESTRADIOL TAB/CREAM
ESTRADIOL-NORETHINDRONE ACETAT
ESTRASORB
ESTRING
ESTROGEL
ESTROPIPATE
FEMHRT
FEMRING
FORTESTA
FYAVOLV
JEVANTIQUE
JEVANTIQUE LO
JINTELI
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HORMONAL DEFICIENCY (Cont.)
LOPREEZA
MEDROXYPROGESTERONE ACETATE
MENEST
MENOSTAR
MIMVEY
MIMVEY LO
MINIVELLE
NORETHINDRONE ACETATE
NORETHINDRON-ETHINYL ESTRADIOL
ORTHO-PREFEST
PREFEST
PREMARIN
PREMPHASE
PREMPRO
PROGESTERONE
PROMETRIUM
PROVERA
VAGIFEM
VIVELLE-DOT
VOGELXO
YUVAFEM
IMMUNOSUPPRESSION/ MODULATION
AZASAN
AZATHIOPRINE
CELLCEPT
CYCLOSPORINE
IMURAN
MYCOPHENOLATE MOFETIL
MYCOPHENOLIC ACID
PROGRAF
TACROLIMUS
INFECTIOUS DISEASE – VIRAL ABACAVIR
ABACAVIR-LAMIVUDINE
ABACAVIR-LAMIVUDINE- ZIDOVUDINE
ACYCLOVIR
APTIVUS
ATRIPLA
BIKTARVY
COMBIVIR
COMPLERA
CRIXIVAN
DESCOVY
DIDANOSINE
EDURANT
EFAVIRENZ
EMTRIVA
EPIVIR
EPIVIR HBV
EPZICOM
EVOTAZ
FUZEON
GENVOYA
INTELENCE
INVIRASE
ISENTRESS
ISENTRESS HD
KALETRA
LAMIVUDINE
LAMIVUDINE-ZIDOVUDINE
LEXIVA
LOPINAVIR-RITONAVIR SLN
NEVIRAPINE
NEVIRAPINE ER
NORVIR
ODEFSEY
PREZCOBIX
PREZISTA
RESCRIPTOR
RETROVIR
REYATAZ
RITONAVIR
SELZENTRY
STRIBILD
STAVUDINE
SUSTIVA
TENOFOVIR
TIVICAY
TRIUMEQ
TRIZIVIR
TRUVADA
TYBOST
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INFECTIOUS DISEASE – VIRAL (Cont.)
VALACYCLOVIR
VALCYTE
VALGANCICLOVIR HCL
VALTREX
VIDEX
VIDEX EC
VIRACEPT
VIRAMUNE
VIRAMUNE XR
VIREAD
VITEKTA
ZERIT
ZIAGEN
ZIDOVUDINE
ZOVIRAX
INFLAMMATORY DISEASE ARAVA
CORTEF
FLUDROCORTISONE ACETATE
HYDROCORTISONE
LEFLUNOMIDE
RHEUMATREX
LOWER GI DISORDER – BOWEL INFLAMMATION
APRISO
ASACOL
ASACOL HD
AZULFIDINE
CANASA
DELZICOL
DIPENTUM
LIALDA
LINZESS
MESALAMINE
PENTASA
ROWASA
SFROWASA
SULFASALAZINE
SULFASALAZINE DR
TRULANCE
VIBERZI
LOWER GI DISORDER – OTHER
ACTIGALL
AMITIZA
CONSTULOSE
ENULOSE
GENERLAC
KRISTALOSE
LACTULOSE
LOPERAMIDE
URSO
URSO FORTE
URSODIOL
MISCELLANEOUS AGENTS CEVIMELINE HCL
EVOXAC
SALAGEN
NEOPLASTIC DISEASE ANASTROZOLE
ARIMIDEX
AROMASIN
BICALUTAMIDE
CASODEX
EXEMESTANE
FEMARA
FLUTAMIDE
HYDREA
HYDROXYUREA
LETROZOLE
METHOTREXATE
SOLTAMOX
TAMOXIFEN CITRATE
TREXALL
NEUROLOGICAL DISEASE –MISC
HORIZANT
SAVELLA
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ORAL/PHARYNGEAL DISORDERS
ATROVENT
IPRATROPIUM BROMIDE
OTHER DRUGS CARNITOR
CARNITOR SF
LEVOCARNITINE
MEGACE
MEGACE ES
MEGESTROL ACETATE
PARKINSON’S DISEASE AMANTADINE
AZILECT
BENZTROPINE MESYLATE
BROMOCRIPTINE MESYLATE
CARBIDOPA
CARBIDOPA-LEVODOPA
CARBIDOPA-LEVODOPA ER
CARBIDOPA-LEVODOPA-ENTACAPONE
COMTAN
DUOPA
ELDEPRYL
ENTACAPONE
LODOSYN
MIRAPEX
MIRAPEX ER
NEUPRO
PARCOPA
PARLODEL
PRAMIPEXOLE DIHYDROCHLORIDE
PRAMIPEXOLE ER
REQUIP
REQUIP XL
ROPINIROLE ER
ROPINIROLE HCL
RYTARY
SELEGILINE HCL
SINEMET 10-100
SINEMET 25-100
SINEMET 25-250
SINEMET CR
STALEVO 100
STALEVO 125
STALEVO 150
STALEVO 200
STALEVO 50
STALEVO 75
TASMAR
TOLCAPONE
TRIHEXYPHENIDYL HCL
ZELAPAR
SEIZURE DISORDER APTIOM
BANZEL
CARBAMAZEPINE
CARBAMAZEPINE ER
CARBAMAZEPINE XR
CARBATROL
CELONTIN
DEPAKENE
DEPAKOTE
DEPAKOTE ER
DEPAKOTE SPRINKLE
DILANTIN
DILANTIN-125
DIVALPROEX SODIUM
DIVALPROEX SODIUM ER
EPITOL
ETHOSUXIMIDE
FANATREX
FELBAMATE
FELBATOL
FYCOMPA
GABITRIL
KEPPRA
KEPPRA XR
LAMICTAL
LAMICTAL ODT
LAMICTAL XR
LAMOTRIGINE
LAMOTRIGINE ER
LAMOTRIGINE ODT
LEVETIRACETAM
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SEIZURE DISORDER (Cont.)
LEVETIRACETAM ER
MYSOLINE
NEURONTIN
OXCARBAZEPINE
OXTELLAR XR
PEGANONE
PHENYTEK
PHENYTOIN
PHENYTOIN SODIUM EXTENDED
POTIGA
PRIMIDONE
QUDEXY XR
ROWEEPRA
SPRITAM
STAVZOR
TEGRETOL
TEGRETOL XR
TIAGABINE HCL
TOPAMAX
TOPIRAGEN
TOPIRAMATE
TOPIRAMATE ER
TRILEPTAL
TROKENDI XR
VALPROIC ACID
VIMPAT
ZARONTIN
ZONEGRAN
ZONISAMIDE
UPPER GI DISORDERS – DIGESTIVE
CREON
PANCREAZE
PANCRELIPASE 5,000
PERTZYE
ULTRESA
VIOKACE
VIOKASE
ZENPEP
UPPER GI DISORDERS – SPASTIC DISEASE
HYOSCYAMINE SULFATE ER
HYOSCYAMINE SULFATE SR
LEVBID
OSCIMIN SR
SYMAX DUOTAB
SYMAX-SR
UPPER GI DISORDERS – ULCER AXID
CARAFATE
CIMETIDINE
CUVPOSA
CYTOTEC
DEPRIZINE
MISOPROSTOL
NIZATIDINE
PEPCID
RANITIDINE 150MG
RANITIDINE HCL
SUCRALFATE
ZANTAC
ZANTAC 25
URINARY TRACT – FUNCTIONAL DISORDERS
ALFUZOSIN HCL ER
AVODART
CYSTAGON
DARIFENACIN ER
DETROL
DETROL LA
DITROPAN XL
DUTASTERIDE
DUTASTERIDE-TAMSULOSIN
ENABLEX
FINASTERIDE
FLAVOXATE HCL
FLOMAX
GELNIQUE
JALYN
MYRBETRIQ
OXYBUTYNIN CHLORIDE
OXYBUTYNIN CHLORIDE ER
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URINARY TRACT – FUNCTIONAL DISORDERS (Cont.)
OXYTROL
POTASSIUM CITRATE ER
PROSCAR
RAPAFLO
SANCTURA
SANCTURA XR
TAMSULOSIN HCL
TOLTERODINE TARTRATE
TOLTERODINE TARTRATE ER
TOVIAZ
TROSPIUM CHLORIDE
TROSPIUM CHLORIDE ER
UROCIT-K
UROXATRAL
VESICARE
VAGINAL DISORDERS ESTRING
FEMRING
VAGIFEM
VITAMIN/MINERAL DEFICIENCY
ACTIVE OB
ATABEX EC
BAL-CARE DHA
BAL-CARE DHA ESSENTIAL
B-NEXA
CADEAU DHA
CALCITRIOL
CALCIUM PNV
CAVAN-ALPHA KIT
CAVAN-EC SOD DHA
CHOICE-OB + DHA
CITRANATAL 90 DHA
CITRANATAL ASSURE
CITRANATAL B-CALM
CITRANATAL DHA
CITRANATAL HARMONY
CITRANATAL RX
C-NATE DHA
COMPLETE NATAL DHA
COMPLETENATE
CONCEPT DHA
CONCEPT OB
DIALYVITE ZINC
DOTHELLE DHA
DRISDOL
DUET DHA
DUET DHA 400
DUET DHA BALANCED
DUET DHA EC
ELITE OB DHA
ELITE-OB 400
ENBRACE HR
ERGOCALCIFEROL (VITAMIN D2)
EXTRA-VIRT PLUS DHA
FOCALGIN 90 DHA
FOCALGIN CA
FOCALGIN-B
FOLBECAL
FOLCAL DHA
FOLCAPS OMEGA-3
FOLET DHA
FOLET ONE
FOLIC ACID
FOLINATAL PLUS B
FOLIVANE-OB
FOLIVANE-PRX DHA NF
GESTICARE DHA
HEMENATAL OB
HEMENATAL OB + DHA
INATAL ADVANCE
INATAL ULTRA
INFANATE BALANCE
INFANATE PLUS
KOSHER PRENATAL PLUS IRON
LEVOMEFOLATE DHA
L-METHYLFOLATE PNV DHA
LOZI-FLUR
MACNATAL CN DHA
MACUZIN
MARNATAL-F
MAXINATE
M-VIT
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VITAMIN/MINERAL DEFICIENCY (Cont.)
MYNATAL
MYNATAL ADVANCE
MYNATAL PLUS
MYNATAL-Z
MYNATE 90 PLUS
NASCOBAL
NATA KOMPLETE
NATACHEW
NATAFORT
NATAL-V RX
NATALVIRT 90 DHA
NATALVIRT CA
NATALVIT
NATELLE ONE
NEEVO
NEEVO DHA
NEEVODHA
NEPHPLEX RX
NEPHRO-VITE RX
NESTABS
NESTABS ABC
NESTABS DHA
NEWGEN
NEXA PLUS
NEXA SELECT
NIVA-PLUS
NUTRI-TAB OB
NUTRI-TAB OB + DHA
OB COMPLETE
OB COMPLETE 400
OB COMPLETE GOLD
OB COMPLETE ONE
OB COMPLETE PETITE
OB COMPLETE PREMIER
OB COMPLETE WITH DHA
OBSTETRIX DHA
OBSTETRIX EC
OBTREX
OBTREX DHA
O-CAL FA
O-CAL PRENATAL
PAIRE OB PLUS DHA
PNV 29-1
PNV FOLIC ACID + IRON
PNV OB+DHA
PNV-DHA
PNV-DHA + DOCUSATE
PNV-FERROUS FUMARATE-DOCU-FA
PNV-FIRST
PNV-OB WITH DHA
PNV-OMEGA
PNV-SELECT
PNV-TOTAL
PNV-VP-U
POTABA
PR NATAL 400
PR NATAL 400 EC
PR NATAL 430
PR NATAL 430 EC
PREFERA OB
PREFERA-OB ONE
PREFERA-OB PLUS DHA
PREFOL-DHA
PRENA1
PRENA1 CHEW
PRENA1 PEARL
PRENA1 PLUS
PRENAISSANCE
PRENAISSANCE 90 DHA
PRENAISSANCE BALANCE
PRENAISSANCE DHA
PRENAISSANCE DHA HARMONY
PRENAISSANCE HARMONY DHA
PRENAISSANCE NEXT
PRENAISSANCE NEXT-B
PRENAISSANCE PLUS
PRENAISSANCE PROMISE
PRENAPLUS
PRENATA
PRENATABS FA
PRENATABS RX
PRENATAL 19
PRENATAL AD
PRENATAL LOW IRON
PRENATAL MV & MIN
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VITAMIN/MINERAL DEFICIENCY (Cont.)
PRENATAL PLUS
PRENATAL VITAMIN PLUS LOW IRON
PRENATAL Z
PRENATAL-U
PRENATE AM
PRENATE CHEWABLE
PRENATE DHA
PRENATE ELITE
PRENATE ENHANCE
PRENATE ESSENTIAL
PRENATE MINI
PRENATE PIXIE
PRENATE RESTORE
PRENATE STAR
PRENEXA
PREPLUS
PREQUE 10
PRETAB
PROTECT NATAL
PROVIDA DHA
PROVIDA OB
PUREFE OB PLUS
PUREFE PLUS
RELNATE DHA
RENA-VITE RX
R-NATAL OB
ROCALTROL
RULAVITE DHA
SELECT-OB
SELECT-OB + DHA
SE-NATAL 19
SE-TAN DHA
SETONET
SETONET-EC
SF
SODIUM FLUORIDE
TARON-BC
TARON-C DHA
TARON-DUO EC
TARON-PREX PRENATAL
THRIVITE 19
THRIVITE RX
TL FOLATE
TL-CARE DHA
TL-SELECT
TL-SELECT DHA
TRI RX
TRIADVANCE
TRICARE
TRICARE PRENATAL COMPLEAT
TRICARE PRENATAL DHA ONE
TRIMESIS RX
TRINATAL GT
TRINATAL RX 1
TRINATAL ULTRA
TRINATE
TRISTART DHA
TRI-TABS DHA
TRIVEEN-DUO DHA
TRIVEEN-ONE
TRIVEEN-PRX RNF
TRIVEEN-TEN
TRIVEEN-U
TRUST NATAL DHA
ULTIMATE OB DHA
ULTIMATECARE ONE
ULTIMATECARE ONE NF
VEMAVITE-PRX 2
VENA-BAL DHA
VENATAL COMPLETE DHA
VENATAL-FA
VINACAL
VINATE AZ
VINATE CALCIUM
VINATE CARE
VINATE DHA
VINATE DHA RF
VINATE GT
VINATE IC
VINATE II
VINATE ONE
VINATE PN CARE
VINATE ULTRA
VINATE-M
VIRT NATE
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VITAMIN/MINERAL DEFICIENCY (Cont.)
VIRT-ADVANCE
VIRT-BAL DHA
VIRT-BAL DHA PLUS
VIRT-C DHA
VIRT-CARE ONE
VIRT-NATE
VIRT-NATE DHA
VIRT-PN
VIRT-PN DHA
VIRT-PN PLUS
VIRTPREX
VIRT-SELECT
VIRT-VITE GT
VITAFOL FE+
VITAFOL GUMMIES
VITAFOL NANO
VITAFOL ULTRA
VITAFOL-OB
VITAFOL-OB+DHA
VITAFOL-ONE
VITAFOL-PN
VITAMEDMD ONE RX
VITAMEDMD PLUS RX
VITAMEDMD REDICHEW RX
VITAMIN D2
VITAPEARL
VITASPIRE
VITATRUE
VIVA CT
VIVA DHA
V-NATAL
V-NATAL DHA
VOL-CARE RX
VOL-NATE
VOL-PLUS