CerpassRx 2022 Preventative Medicine List
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CATEGORY GENERIC MEDICINE BRAND-NAME MEDICINE
Preventive medications are defined as those prescribed to prevent the occurrence of a chronic disease or condition for those individuals with risk factors, or to prevent the recurrence of a disease or condition. Your plan values the impact these medications have on your health. You do not need to meet any deductible for preventive medications and your prescription benefits are paid immediately for these products. This list contains examples of preventive medications organized by therapy class. Medications may be added to or removed from the list periodically and the list is not all inclusive.
Anticoagulant and Hematological Agents
Anticonvulsant Agents
Antidiabetic Agents
Asthma Agents
anagrelidecilostazolclopidogreldipyridamoleenoxaparin
carbamazepinecarbamazepine ERdivalproexdivalproex DRdivalproex ERepitolethosuximidefelbamategabapentinlamotriginelamotrigine ERlevetiracetamlevetiracetam ER
acarbosealogliptinglimepirideglipizideglipizide erglipizide xlglipizide/metforminglyburideglyburide micronizedglyburide/metforminmetforminmetformin ermiglitolnateglinidepioglitazonepioglitazone/glimepiride
albuterolbudesonidecromolyn�uticasone/salmeterolipratropiumipratropium/albuterollevalbuterolmontelukastterbutalinetheochrontheophyllinetheophylline CRtheophylline ERza�rlukastde
pioglitazone/metforminrepagliniderepaglinide/metformintolazamidetolbutamide
BYDUREONBYETTAGLYXAMBIJANUMETJANUMET XRJANUVIAJARDIANCELYUMJEVLANTUS SOLOSTARNOVOLIN 70/30 FLEXPENNOVOLIN 70/30 MIXNOVOLIN NNOVOLIN RNOVOLOGNOVOLOG FLEXPENOZEMPIC
ADVAIR HFAANORO ELLIPTAARNUITY ELLIPTAASMANEXASMANEX TWISTHALERBREO ELLIPTACOMBIVENT RESPIMATDULERAFLOVENT DISKUSFLOVENT HFAINCRUSE ELLIPTAQVARQVAR REDIHALERSEREVENT DISKUSSPIRIVA HANDIHALERSPIRIVA RESPIMATSTIOLTO RESPIMAT
SYMBICORTTRELEGY ELLIPTA
RYBELSUSSYNJARDYSYNJARDY XRTOUJEOTRESIBATRIJARDY XRTRULICITY
oxcarbazepinephenobarbitalphenytoinprimidoneroweepraroweepra XRtiagabinetopiramatetopiramate ERvalproic acidvigabatrinvigadronezonisamide
ELIQUISXARELTO
jantovenprasugrelpentoxifylline ERwarfarin
CATEGORY GENERIC MEDICINE BRAND-NAME MEDICINE
CardiovasularAgents
ENTRESTOacebutololacetazolamideacetazolamide ERafeditab CRamiloride/HCTZamilorideamiodaroneamlodipineamlodipine/atorvastatinamlodipine/benazaprilamlodipine/olmesartanamlodipine/olmesartan/HCTZamlodipine/valsartanamlodipine/valsartan/HCTZatenololatenolol/chlorthalidonebenazaprilbenazapril/HCTZbetaxololbisoprololbisoprolol/HCTZbumetanidecandesartancandesartan/HCTZcaptoprilcaptopril/HCTZ/carvediolcartia XTchlorothiazidechlorthalidoneclonidinedigitekdigoxdigoxindiltiazemdiltiazem CDdiltiazem ERdisopyramidedofetilidedoxazosinenalaprilenalapril/HCTZeplerenoneethacrynic acidfelodipine ER�ecainidefosinoprilfosinopril/HCTZfurosemidehydralazinehydrochlorothiazideindapamideirbesartanirbesartan/HCTZisosorbide dinitrateisosorbide mononitrateisosorbide mononitrate ERisradipinelabetalollisinoprillisinopril/HCTZlosartanlosartan/HCTZmatzim LAmethazolamidemethyldopa
methyldopa/HCTZmetolazonemetoprolol succinate ERmetoprolol tartratemetoprolol/HCTZmexilietineminitranminoxidilmoexiprilmoexipril/HCTZnadololnicardipinenifedical XLnifedipinenifedipine ERnimodipinenisoldipinenisoldipine ERnitro-timenitroglycerinnitroglycerin ERnitroglycerin sublingualnitroglycerin transdermalolmesartanolmesartan/HCTZpaceroneperindoprilpindololprazosinpropafenonepropafenone erpropranololpropranolol erpropranolol/hctzquinaprilquinapril/hctzquinidinequinidine gluconate crquinidine gluconate erramiprilsorinesotalolspironolactonespironolactone/hctztaztia xttelmisartantelmisartan/amlodipinetelmisartan/hctzterazosintimololtorsemidetrandolapriltrandolapril/verapamiltrandolapril/verapamil ertriamterene/hctzvalsartanvalsartan/hctzverapamilverapamil crverapamil erverapamil saverapamil sr
CATEGORY GENERIC MEDICINE BRAND-NAME MEDICINE
Cholesterol Agents
atorvastatincholestyraminecholestyramine lightcolesevelamcolestipoezetimibeezetimibe/simvastatinfeno�bratefeno�bric acidfeno�bric acid DR
�uvastatin�uvastatin ERgem�brozillovastatinniacin ERomega-3-acidpravastatinprevaliterosuvastatinsimvastatin
Contraceptives altaveraaalyacen 1/35alyacen 7/7/7amethiaamethia loamethystapriaranelleashlynaaubraavianeazurettebalzivabekyreeblisovi fe 1/20blisovi 24 feblisovi fe 1.5/30briellyncamilacamresecamrese locaziantchatealcryselle-28cyclafem 1/35cyclafem 7/7/7cyreddasetta 1/35dasetta 7/7/7dayseedeblitanedrospirenone/ethinyl estradiolelinesteluryngemoquetteenpresse-28enskyceerrinestaryllafalminagianviheatherintrovalejencyclajolessajolivettejuleberjunel 1/20junel 1.5/30junel fe 24junel fe 1/20junel fe 1.5/30kaitlib fekarivakelnor 1/35
larin 1/20larin 1.5/30larin fe 1.5/30larissialayolis feleenalessinalevonestlevonorgestrel/ethinyl levora 0.15/30-28lorynalow-ogestrelluteralyzamarlissamicrogestin 1/20microgestin 1.5/30microgestin femicrogestin 24 femicrogestin fe 1.5/30mono-linyahmononessamyzilranecon 0.5/35-28necon 1/35necon 10/11-28necon 7/7/7nikkinora-benorlyrocnortrel 0.5/35 (28)nortrel 1/35nortrel 7/7/7orsythiaphilithpirmella 1/35pirmella 7/7/7portia-28previfemprogesteronereclipsensetlakinsharobelsprintec-28
NECON 1/50-28OGESTRELXULANE
Contraceptives sronyxsyedatarina FE 1/20tilia FEtri-estaryllatri-legest FETri-linyahtri-lo-sprintectri-previfemtri-sprintectrinessatrinessa lotrivora-28velivetvesturavienvaviorelevyfemlawymzya FEzarahzenchentzenchent FEzovia 1/35Ezovia 1/50E
Estrogens & Estrogen Combination Products
covaryxcovaryx hsdottieemtesteri�ed estrogens/methyltestosteroneestradiolestradiol/norethindrone
fyavolvjevantique lojintelilopreezamimveymimvey lonorethindrone acetate/ethinyl estradiol
ESTROPIPATEPREMARINPREMPRO
OsteoporosisAgents
alendronatecalcitoninibandronate
raloxifenerisendronate
TYMLOS
Ulcer Agents cimetidineesomeprazolefamotidinelansoprazolemisoprostolnizatidineomeprazoleomeprazole/sodium bicarbonatepantoprazolerabeprazoleranitidinesucralfate
CATEGORY GENERIC MEDICINE BRAND-NAME MEDICINE