Drug rider $10/$40

Your drug benefit provides coverage for Tier 1 medications for a $10 copayment and for Tier 2 medications with a $40 copayment. Drugs in Tier 3 are not covered unless your physician and BCN agree that the nonformulary drug is medically necessary. Go to our Drug Formulary for a definition of Tier 1, Tier 2 and Tier 3.

Note that some drugs require prior authorization (PA) or step therapy (ST), and certain clinical criteria must be met prior to coverage. Refer to Some Drugs Require Prior Authorization for more details. The members' rider has specific information regarding the mail order copayment.

Blue Care Network requires that prescriptions for Tier 1 drugs be automatically filled with the generic equivalent, if available. The brand-name version can be dispensed if the member pays the difference between the cost of the brand and generic versions in addition to the required Tier 2 copayment. The following table identifies the tier for some of our more commonly prescribed drugs.

The following table lists the tier and copay for some of our more commonly prescribed drugs. Click on a letter in the index below to find Brand Name drugs beginning with that letter.





Brand Name Generic Name Generic Available PA
/
ST
Tier Copay
- A -[ Return to Top ]
Abilify, DiscmeltaripiprazoleNo2$40
AccolatezafirlukastNo2$40
Accunebalbuterol sulfateYes1$10
Accuprilquinapril hclYes1$10
Accureticquinapril/hydrochlorothiazideYes1$10
Accutane (req Derm Consult) isotretinoinYes1$10
Accuzyme, Ethezyme, Gladasepapain/ureaYes1$10
Aceonperindopril erbumineYes1$10
Acetasol, HC/vosol, HCacetic acid/hydrocortisoneYes1$10
Aclovatealclometasone dipropionateYes1$10
ActigallursodiolYes1$10
Actimmuneinterferon gamma-1b,recomb.No2$40
Actiqfentanyl citrateYesPA1$10
Activellaestradiol/noreth acYes1$10
Actonel with Calciumrisedron sod/calcium carbonateNoST2$40
Actonel, Weekly, 150mgrisedronate sodiumNoST2$40
Actospioglitazone hclNoST2$40
Acular, LSketorolac tromethamineYes1$10
Adderall, XRamphet asp/amphet/d-amphetYes1$10
Adipex-Pphentermine hclYesPA1$10
Adoxadoxycycline monohydrateYes1$10
Advairfluticasone/salmeterolNo2$40
AfinitoreverolimusNoPA2$40
Agrylinanagrelide hclYes1$10
Albalonnaphazoline hclYes1$10
Albuterol Nebulizer Solnalbuterol sulfateYes1$10
Aldactazidespironolact/hydrochlorothiazidYes1$10
AldactonespironolactoneYes1$10
AldometmethyldopaYes1$10
Aldorilmethyldopa/hydrochlorothiazideYes1$10
Alesse, Levlitelevonorgestrel-eth estraYes1$10
Alferon Ninterferon alfa-n3No2$40
AlinianitazoxanideNo2$40
AlkeranmelphalanNo2$40
Allegrafexofenadine hclYes1$10
Allegra-D 12 Hourp-ephed hcl/fexofenadine hclYesST1$10
Allegra-D 24 Hourp-ephed hcl/fexofenadine hclNoST2$40
Alocrilnedocromil sodiumNo2$40
Alomidelodoxamide tromethamineNo2$40
AloraestradiolNo2$40
Alphagan, Pbrimonidine tartrateYes1$10
Altace CapsuleramiprilYes1$10
Alupentmetaproterenol sulfateYes1$10
Alvesco (tier 1-BCN only)ciclesonideNo1$10
AmarylglimepirideYes1$10
Ambienzolpidem tartrateYes1$10
Amicaraminocaproic acidYes1$10
AmoxapineamoxapineYes1$10
Amoxilamoxicillin trihydrateYes1$10
Ampicillinampicillin trihydrateYes1$10
Anafranilclomipramine hclYes1$10
Analpram HChc acetate/pramoxine hclYes1$10
Anamantle HClidocaine hcl/hcYes1$10
Anaprox, DSnaproxen sodiumYes1$10
AncobonflucytosineNo2$40
AndrodermtestosteroneNo2$40
Androxy 10mgfluoxymesteroneYes1$10
Annusol HC, Proctocream HChydrocortisoneYes1$10
AnsaidflurbiprofenYes1$10
AntabusedisulfiramNo2$40
Antivertmeclizine hclYes1$10
Apidrainsulin glulisineNo2$40
Apokynapomorphine hclNo2$40
Apresolinehydralazine hclYes1$10
Aptivus (must be used with Norvir)tipranavirNo2$40
Aralenchloroquine phosphateYes1$10
AravaleflunomideYes1$10
ArcalystrilonaceptNoPA2$40
Aricept, ODTdonepezil hclNo2$40
ArimidexanastrozoleNo2$40
Aristocort, Kenalogtriamcinolone acetonideYes1$10
Aristocort, Kenalog 0.5% CRtriamcinolone acetonideYes1$10
AromasinexemestaneNo2$40
Artanetrihexyphenidyl hclYes1$10
Asacol, HDmesalamineNo2$40
Asmanex (tier 1-BCN only)mometasone furoateNo1$10
Aspirin w/codeinecodeine phos/aspirinYes1$10
Astelin/Astepro nasal sprayazelastine hclNo2$40
Asteproazelastine hclNo2$40
Atarax, VistarilhydroxyzineYes1$10
AtivanlorazepamYes1$10
Atriplaefavirenz/emtricitab/tenofovirNo2$40
Atrovent Inhaleripratropium bromideNo2$40
Atrovent Nasal Sprayipratropium bromideYes1$10
Atrovent Soln ipratropium bromideYes1$10
Augmentin, ESamox tr/potassium clavulanateYes1$10
Auralganaa/antpy/bcaine/polico/al acetYes1$10
Avandiarosiglitazone maleateNoST2$40
Avelox, ABCmoxifloxacin hclNo2$40
Avonexinterferon beta-1aNo2$40
Axid (Rx only)nizatidineYes1$10
Aygestinnorethindrone acetateYes1$10
Azmacort (tier 1-BCN only)triamcinolone acetonideNo1$10
AzoptbrinzolamideNo2$40
Azulfidine, En-tabsulfasalazineYes1$10
- B -[ Return to Top ]
BacitracinbacitracinYes1$10
Bactrim, DS, Septra, DSsulfamethoxazole/trimethoprimYes1$10
Bactroban Cream, Nasalmupirocin calciumNo2$40
Bactroban OintmentmupirocinYes1$10
BanzelrufinamideNo2$40
BaracludeentecavirNo2$40
Bellamine/bellaspasergotamine tart/bellad alk/pbYes1$10
Benadryldiphenhydramine hclYes1$10
Benicar, HCTolmesartan medoxomilNoST2$40
Bentyldicyclomine hclYes1$10
Benzamycinerythromycin base/benz perYes1$10
Benzashave, Brevoxyl Gelbenzoyl peroxideYes1$10
Benzoyl Peroxide-Rxbenzoyl peroxideYes1$10
Betaganlevobunolol hclYes1$10
Betapace, AFsotalol hclYes1$10
Betoptic Sbetaxolol hclNo2$40
Betoptic Solnbetaxolol hclYes1$10
Biaxin, XLclarithromycinYes1$10
Bidilisosorb dinit/hydralazine hclNo2$40
BiltricidepraziquantelNo2$40
Bleph-10, Sodium Sulamydesulfacetamide sodiumYes1$10
Blephamide Drops, Ointna sulfacetm/prednisol acNo2$40
Blocadrentimolol maleateYes1$10
Bontrilphendimetrazine tartrateYesPA1$10
Bravelleurofollitropin (fsh)No2$40
Brethineterbutaline sulfateYes1$10
Bromfed, PD, DMp-ephed hcl/brompheniraminYes1$10
BumexbumetanideYes1$10
Bupapbutalbital/acetaminophenYes1$10
Busparbuspirone hclYes1$10
- C -[ Return to Top ]
Cafergotergotamine tartrate/caffeineYes1$10
Calan SR/Isoptin SRverapamil hclYes1$10
CalciferolergocalciferolYes1$10
CanasamesalamineNo2$40
Capex Shampoofluocinolone acetonideNo2$40
CapotencaptoprilYes1$10
Capozidecaptopril/hydrochlorothiazideYes1$10
Carafate, SuspsucralfateYes1$10
Cardenenicardipine hclYes1$10
Cardizem, SR, CDdiltiazem hclYes1$10
Carduradoxazosin mesylateYes1$10
CarnitorlevocarnitineYes1$10
CasodexbicalutamideYes1$10
Cataflamdiclofenac potassiumYes1$10
Catapresclonidine hclYes1$10
Catapres-TTSclonidine hclNo2$40
CaverjectalprostadilNoPA2$40
Ceclor, ERcefaclorYes1$10
CeenulomustineNo2$40
Ceftincefuroxime axetilYes1$10
CefzilcefprozilYes1$10
Celexacitalopram hydrobromideYes1$10
Cellceptmycophenolate mofetilYes1$10
Cellcept Suspmycophenolate mofetilNo2$40
CelontinmethsuximideNo2$40
Cetrotidecetrorelix acetateNo2$40
Chantixvarenicline tartrateNo2$40
Chloral Hydratechloral hydrateYes1$10
Chlorpromazine HCLchlorpromazine hclYes1$10
CialistadalafilNoPA2$40
Ciloxan Dropsciprofloxacin hclYes1$10
Ciloxan Ointciprofloxacin hclNo2$40
Ciprociprofloxacin hclYes1$10
Cipro 500mgciprofloxacin hclNo2$40
Cipro HCciprofloxacin hcl/hcNo2$40
Cipro XRciprofloxacin hcl-betaine combYesPA1$10
Ciprodexciprofloxacin hcl/dexamethNo2$40
Claritin, Alavert(OTC)loratadineYes1$10
Claritin-d 12hr, 24hr(OTC)p-ephed sul/loratadineYes1$10
Cleocinclindamycin hclYes1$10
Cleocin Tclindamycin phosphateYes1$10
Cleocin Vag Creamclindamycin phosphateYes1$10
ClimaraestradiolYes1$10
ClinorilsulindacYes1$10
Clodermclocortolone pivalateNo2$40
Clomidclomiphene citrateYes1$10
ClozarilclozapineYes1$10
CNL 8ciclopirox/nail lacquer removrYes1$10
Coartemartemether/lumefantrineNo2$40
Codeine Sulfatecodeine sulfate(g)Yes1$10
Cogentinbenztropine mesylateYes1$10
Colazalbalsalazide disodiumYes1$10
Colbenemidcolchicine/probenecidYes1$10
ColchicinecolchicineYes1$10
Colestidcolestipol hclYes1$10
Colytesod sulf/sod/nahco3/kcl/peg'sYes1$10
Combiventalbuterol sulfate/ipratropiumNo2$40
Combivirlamivudine/zidovudineNo2$40
Commit Lozenge OTCnicotine polacrilexYes1$10
Compazineprochlorperazine maleateYes1$10
ComtanentacaponeNo2$40
Concertamethylphenidate hclNo2$40
Condylox GelpodofiloxNo2$40
Condylox SolnpodofiloxYes1$10
Copaxoneglatiramer acetateNo2$40
CopegusribavirinYesPA1$10
Cordaroneamiodarone hclYes1$10
Cordran, Tape, SPflurandrenolideNo2$40
CoregcarvedilolYes1$10
CorgardnadololYes1$10
Cortef, HydrocortisonehydrocortisoneYes1$10
Cortenemahydrocortisone acetateYes1$10
Corticosteroidssee chapter 7cYes1$10
Cortifoamhydrocortisone acetateNo2$40
Cortisone Acetatecortisone acetateYes1$10
Cortisporinneomy sulf/polymyx b sulf/hcYes1$10
Corzidenadolol/bendroflumethiazideYes1$10
Cosopttimolol maleate/dorzolam hclYes1$10
Coumadinwarfarin sodiumYes1$10
Covera-HSverapamil hclNo2$40
Cozaarlosartan potassiumNoST2$40
Creonamylase/lipase/proteaseNo2$40
Crestorrosuvastatin calciumNoST2$40
Crinoneprogesterone,micronizedNo2$40
Crixivanindinavir sulfateNo2$40
CupriminepenicillamineNo2$40
Cutivatefluticasone propionateYes1$10
Cyanocobalamin InjcyanocobalaminYes1$10
Cyclessadesogestrel-ethinyl estradiolYes1$10
CyclocortamcinonideYes1$10
Cyclogylcyclopentolate hclYes1$10
Cytomelliothyronine sodiumYes1$10
CytotecmisoprostolYes1$10
CytoveneganciclovirYes1$10
CytoxancyclophosphamideYes1$10
Cytra-2, 3, Kcitric acid/potassium citrateYes1$10
- D -[ Return to Top ]
D.H.E.45dihydroergotamine mesylateYes1$10
Dalmaneflurazepam hclYes1$10
DanocrinedanazolYes1$10
Dantriumdantrolene sodiumYes1$10
DapsonedapsoneYes1$10
DaraprimpyrimethamineNo2$40
Darvocet-Npropoxyphene hcl/acetaminophenYes1$10
Darvonpropoxyphene hclYes1$10
Darvon Compoundpropoxyphene hcl/asa/caffeineYes1$10
DayprooxaprozinYes1$10
DDAVP Soln/Spraydesmopressin acetateYes1$10
DDAVP Tabsdesmopressin acetateYes1$10
DecadrondexamethasoneYes1$10
Decadron Opthdexamethasone sod phosphateYes1$10
Deconamine CX, SrRguaifenesin/p-ephed hcl/hcodYes1$10
Deconamine Syrup, SRpseudoephedrine hcl/chlor-malYes1$10
Delatestryltestosterone enanthateNo2$40
DemadextorsemideYes1$10
Demerolmeperidine hclYes1$10
Demulenethynodiol d-ethinyl estradiolYes1$10
Depakenevalproate sodiumYes1$10
Depakote, ERdivalproex sodiumYes1$10
Depo-provera 150mgmedroxyprogesterone acetYes1$10
Depo-provera 400mgmedroxyprogesterone acetNo2$40
Depo-subq Provera 104medroxyprogesterone acetNo2$40
Depo-testosteronetestosterone cypionateYes1$10
Dermacort, Hytone (Rx only)hydrocortisoneYes1$10
DermatopprednicarbateYes1$10
Desferaldeferoxamine mesylateYes1$10
Desogen, Ortho-ceptdesogestrel-ethinyl estradiolYes1$10
Desowen, TridesilondesonideYes1$10
Desoxynmethamphetamine hclNo2$40
Desyreltrazodone hclYes1$10
Detroltolterodine tartrateNo2$40
Detrol LAtolterodine tartrateNo2$40
Dexedrined-amphetamine sulfateYes1$10
Diabeta, MicronaseglyburideYes1$10
DiabinesechlorpropamideYes1$10
Diamox, SequelsacetazolamideYes1$10
DiastatdiazepamNo2$40
Dicloxacillindicloxacillin sodiumYes1$10
Didrexbenzphetamine hclYesPA1$10
Didroneletidronate disodiumYes1$10
DifferinadapaleneNo2$40
DiflucanfluconazoleYes1$10
Digoxin ElixirdigoxinNo2$40
Digoxin TabsdigoxinYes1$10
Dilantinphenytoin sodium extendedYes1$10
Dilantin Chew TabsphenytoinNo2$40
Dilatrate-SRisosorbide dinitrateNo2$40
Dilaudidhydromorphone hclYes1$10
Diprolene AF, Gel, Cr, Lot, Ointbetamet diprop/prop glyYes1$10
Diprosone, Maxivatebetamethasone dipropionateYes1$10
Disalcid, SalflexsalsalateYes1$10
Ditropan, XLoxybutynin chlorideYes1$10
DiurilchlorothiazideYes1$10
DolobiddiflunisalYes1$10
Domeboro Oticacetic acid/aluminum acetateYes1$10
Donnatalbelladonna alkaloids/phenobarbYes1$10
DostinexcabergolineYes1$10
DovonexcalcipotrieneNo2$40
Dovonex SolutioncalcipotrieneYes1$10
Doxycycline Hyclatedoxycycline hyclateYes1$10
Dritho-scalpanthralinNo2$40
DroxiahydroxyureaNo2$40
Drysolaluminum chlorideYes1$10
Duonebipratropium/albuterol sulfateYes1$10
DuragesicfentanylYes1$10
Duricefcefadroxil hydrateYes1$10
Dygaseamylase/lipase/proteaseNo2$40
DynacircisradipineYes1$10
DyreniumtriamtereneNo2$40
- E -[ Return to Top ]
Ec-naprosynnaproxenYes1$10
Edecrinethacrynic acidNo2$40
Effexorvenlafaxine hclYes1$10
Effexor XRvenlafaxine hclNoST2$40
Effientprasugrel hydrochlorideNo2$40
EfudexfluorouracilYes1$10
Elavilamitriptyline hclYes1$10
Eldeprylselegiline hclYes1$10
ElidelpimecrolimusNoST2$40
ElimitepermethrinYes1$10
Elmironpentosan polysulfate sodiumNo2$40
Eloconmometasone furoateYes1$10
Emcytestramustine phosphate sodiumNo2$40
Emend 80,125mg CapsulesaprepitantNo2$40
Emlalidocaine/prilocaineYes1$10
EmtrivaemtricitabineNo2$40
EnbreletanerceptNoPA2$40
Endometrinprogesterone, micronizedNo2$40
Epipen, JRepinephrineNo2$40
EpivirlamivudineNo2$40
Epivir HBVlamivudineNo2$40
Epzicomabacavir sulfate/lamivudineNo2$40
Ergomarergotamine tartrateNo2$40
Erythromycin Topical Soln, Gelerythromycin base/ethanolYes1$10
Erythromycin, Stearate, Baseerythromycin baseYes1$10
Eskalith, CRlithium carbonateYes1$10
EstraceestradiolYes1$10
EstradermestradiolNo2$40
Estratest, H.S.estrogen,ester/me-testosteroneYes1$10
EstringestradiolNo2$40
Estrostep FEnoreth a-et estra/fe fumarateYes1$10
Ethambutolethambutol hclYes1$10
Etrafonamitriptyline hcl/perphenazineYes1$10
EulexinflutamideYes1$10
EuraxcrotamitonNo2$40
Evistaraloxifene hclNo2$40
Exelonrivastigmine tartrateNo2$40
- F -[ Return to Top ]
FamvirfamciclovirYes1$10
Farestontoremifene citrateNo2$40
FaslodexfulvestrantNo2$40
FelbatolfelbamateNo2$40
FeldenepiroxicamYes1$10
FemaraletrozoleNo2$40
Femhrtethinyl estradiol/noreth acNo2$40
Fertinexurofollitropin (fsh)No2$40
Fibricorfenofibric acidYes1$10
Fioricet w/codeinecodeine/butalbut/acetamin/caffYes1$10
Fioricet;esgic, Plusbutalb/acetaminophen/caffeineYes1$10
Fiorinalbutalbital/aspirin/caffeineYes1$10
Fiorinal w/codeinecodeine/butalbital/asa/caffeinYes1$10
FlagylmetronidazoleYes1$10
Flagyl ERmetronidazoleNo2$40
Flexerilcyclobenzaprine hclYes1$10
Flonasefluticasone propionateYes1$10
Florineffludrocortisone acetateYes1$10
Flovent HFA, Diskus (tier 1-BCN only)fluticasone propionateNo1$10
FloxinofloxacinYes1$10
Floxin OticofloxacinYes1$10
Flumadinerimantadine hclYes1$10
Fluvoxamine Maleatefluvoxamine maleateYes1$10
FMLfluorometholoneNo2$40
Folvitefolic acidYes1$10
Foradilformoterol fumarateNo2$40
Fosamax, Weeklyalendronate sodiumYes1$10
FuzeonenfuvirtideNo2$40
- G -[ Return to Top ]
Gabitriltiagabine hclNo2$40
Ganirelix Acetateganirelix acetateNo2$40
Garamycingentamicin sulfateYes1$10
Gentamicin Cr, Ointgentamicin sulfateYes1$10
Geodonziprasidone hclNo2$40
Gleevecimatinib mesylateNo2$40
Glucagon Emergency Kitglucagon,human recombinantNo2$40
Glucophage, XRmetformin hclYes1$10
Glucotrol, XLglipizideYes1$10
Glucovanceglyburide/metformin hclYes1$10
Glycolaxpolyethylene glycol 3350Yes1$10
Glynaseglyburide,micronizedYes1$10
Golytelypeg 3350/na sulf,bicarb,cl/kclYes1$10
Gonal-f, RFFfollitropin alpha,recombNo2$40
Granulextrypsin/balsam peru/castor oilYes1$10
Grifulvin V 500mggriseofulvin,microsizeNo2$40
Grifulvin V Suspgriseofulvin,microsizeYes1$10
Gris Peggriseofulvin ultramicrosizeNo2$40
Guaifed, Entex Pseguaifenesin/p-ephed hclYes1$10
Guaifed-PDguaifenesin/phenylephrine hclYes1$10
- H -[ Return to Top ]
HalciontriazolamYes1$10
HaldolhaloperidolYes1$10
Helidactetracyc hcl/bis ss/metronidNo2$40
Heparinheparin sodium,porcineYes1$10
Hepseraadefovir dipivoxilNo2$40
HexalenaltretamineNo2$40
Hiprex/urexmethenamine hippurateYes1$10
Humabid DMguaifenesin/d-methorphan hbYes1$10
Humalog, Mixinsulin npl/insulin lisproNo2$40
Humatinparomomycin sulfateYes1$10
HumiraadalimumabNoPA2$40
Humulin 70/30 humulinNo2$40
Humulin Nnph, human insulin isophaneNo2$40
Humulin R insulin regular human recNo2$40
Hycamtintopotecan hclNoPA2$40
HydreahydroxyureaYes1$10
Hydrodiuril, MicrozidehydrochlorothiazideYes1$10
Hygroton, ThalitonechlorthalidoneYes1$10
Hytrinterazosin hclYes1$10
Hyzaarlosartan/hydrochlorothiazideNoST2$40
- I -[ Return to Top ]
Ilotycinerythromycin baseYes1$10
Imdurisosorbide mononitrateYes1$10
Imitrex Injectionsumatriptan succinateYes1$10
Imitrex Nasal SpraysumatriptanYes1$10
Imitrex Tabletssumatriptan succinateYes1$10
ImuranazathioprineYes1$10
Inderal, LApropranolol hclYes1$10
Inderidepropranolol/hydrochlorothiazidYes1$10
Indocin SuppositoryindomethacinNo2$40
Indocin, SRindomethacinYes1$10
Infergeninterferon alfacon-1NoPA2$40
Inflamase, Forteprednisolone sod phosphateYes1$10
InspraeplerenoneYes1$10
Intal Solutioncromolyn sodiumYes1$10
IntelenceetravirineNo2$40
Intron Ainterferon alfa-2b,recomb.No2$40
Invirasesaquinavir mesylateNo2$40
Ionaminphentermine resinNoPA2$40
Iopidine Dropsapraclonidine hclYes1$10
IressagefitinibNoPA2$40
Isentressraltegravir potassiumNo2$40
Ismo, Monoketisosorbide mononitrateYes1$10
IsoniazidisoniazidYes1$10
Isopto Atropineatropine sulfateYes1$10
Isopto CarbacholcarbacholNo2$40
Isopto Homatropinehomatropine hbrYes1$10
Isopto Hyoscinescopolamine hydrobromideNo2$40
Isordilisosorbide dinitrateYes1$10
- K -[ Return to Top ]
Kaletraritonavir/lopinavirNo2$40
Kayciel, Kaon-CL, Kaon Liquidpotassium chlorideYes1$10
Kayexalatesodium polystyrene sulfonateYes1$10
Keflexcephalexin monohydrateYes1$10
KeppralevetiracetamYes1$10
Kerlonebetaxolol hclYes1$10
KetoprofenketoprofenYes1$10
Klonopin, WaferclonazepamYes1$10
K-lor, Klor-conpotassium chlorideYes1$10
K-lyte, Klor-con/EFpotassium bicarbonate/cit acYes1$10
K-phos Neutralphosphorus #1Yes1$10
K-tab, K-dur, Slow-k, Kaon Clpotassium chlorideYes1$10
Kuvansapropterin dihydrochlorideNoPA2$40
Kytrilgranisetron hclYes1$10
- L -[ Return to Top ]
Lacriserthydroxypropyl celluloseNo2$40
LactuloselactuloseYes1$10
Lamictal, DispertabslamotrigineYes1$10
Lamisil Tabletsterbinafine hclYes1$10
Lantusinsulin glargine,hum.rec.anlogNo2$40
Lapaseamylase/lipase/proteaseNo2$40
Lariammefloquine hclYes1$10
LasixfurosemideYes1$10
LetairisambrisentanNoPA2$40
Leucovorinleucovorin calciumYes1$10
LeukeranchlorambucilNo2$40
LeukinesargramostimNo2$40
Levbidhyoscyamine sulfateYes1$10
Levemirinsulin detemirNo2$40
Levothyroxinelevothyroxine sodiumYes1$10
Levsin, SLhyoscyamine sulfateYes1$10
Levsinexhyoscyamine sulfateYes1$10
Lexaproescitalopram oxalateNoST2$40
Lexivafosamprenavir calciumNo2$40
Libraxclidinium br/chlordiazepoxideYes1$10
Libriumchlordiazepoxide hclYes1$10
Lidex, EfluocinonideYes1$10
Limbitrol, DSamitrip hcl/chlordiazepoxideYes1$10
LindanelindaneYes1$10
LioresalbaclofenYes1$10
Lipram-ul20amylase/lipase/proteaseNo2$40
Lithium Citratelithium citrateYes1$10
Lithobidlithium carbonateYes1$10
Lo/ovralnorgestrel-ethinyl estradiolYes1$10
Locoid Cm, Oint, Solnhydrocortisone butyrateYes1$10
Locoid Lipocreamhydrocortisone butyrate/emollYes1$10
Lodine, XLetodolacYes1$10
Loestrin, FEnoreth a-et estra/fe fumarateYes1$10
LofibrafenofibrateYes1$10
Lomotildiphenoxylate hcl/atrop sulfYes1$10
LonitenminoxidilYes1$10
LopidgemfibrozilYes1$10
Lopressor, HCTmetoprol/hydrochlorothiazideYes1$10
Loprox Cr, Lotion, Gelciclopirox olamineYes1$10
Loprox ShampoociclopiroxYes1$10
Lotensin, HCTbenazepril/hydrochlorothiazideYes1$10
Lotrelamlodipine besylate/benazeprilYes1$10
Lotrel 5/40, 10/40amlodipine besylate/benazeprilNo2$40
LotriminclotrimazoleYes1$10
Lotrisone Cr, Lotionclotrimazole/betamet dipropYes1$10
Lovenoxenoxaparin sodiumNo2$40
Loxitaneloxapine succinateYes1$10
LozolindapamideYes1$10
LumiganbimatoprostNo2$40
Lupronleuprolide acetateYes1$10
Lupron Depot, Pedleuprolide acetateNo2$40
Luridesodium fluorideYes1$10
Lybrellevonorgestrel-eth estraNo2$40
LysodrenmitotaneNo2$40
- M -[ Return to Top ]
Macrobidnitrofurantoin/nitrofuran macYes1$10
Macrodantinnitrofurantoin macrocrystalYes1$10
Malaroneatovaquone/proguanil hclNo2$40
Mandelaminemethenamine mandelateYes1$10
Maprotiline HCLmaprotiline hclYes1$10
MarinoldronabinolYes1$10
Matulaneprocarbazine hclNo2$40
MaviktrandolaprilYes1$10
Maxair Autohalerpirbuterol acetateNo2$40
Maxalt, MLTrizatriptan benzoateNoST2$40
Maxitrolneo/polymyx b sulf/dexamethYes1$10
Maxzide, Dyazidetriamterene/hydrochlorothiazidYes1$10
MebaralmephobarbitalYes1$10
Mebaral 50mgmephobarbitalNo2$40
Meclomenmeclofenamate sodiumYes1$10
Medrol, DosepakmethylprednisoloneYes1$10
Megacemegestrol acetateYes1$10
Mellarilthioridazine hclYes1$10
MephytonphytonadioneNo2$40
MepronatovaquoneNo2$40
MesnexmesnaNo2$40
Mestinonpyridostigmine bromideYes1$10
Mestinon Timespan, Syruppyridostigmine bromideNo2$40
Metadate CDmethylphenidate hclNo2$40
Metaglipglipizide/metformin hclYes1$10
Metaproterenol Solnmetaproterenol sulfateYes1$10
Methadonemethadone hclYes1$10
Metherginemethylergonovine maleateNo2$40
Methotrexatemethotrexate sodium/pfYes1$10
Metrocream, Gel, LotionmetronidazoleYes1$10
Metrogel 1%metronidazole/skin cleanserNo2$40
Metrogel-vaginalmetronidazoleYes1$10
MevacorlovastatinYes1$10
Mexitilmexiletine hclYes1$10
Miacalcin Nasal Spraycalcitonin,salmon,syntheticYes1$10
Miacalcin Vialcalcitonin,salmon,syntheticNo2$40
Micro-kpotassium chlorideYes1$10
Midamoramiloride hclYes1$10
Midrinisometheptene/apap/dichlphenYes1$10
Migranaldihydroergotamine mesylateNo2$40
Miltown, EquanilmeprobamateYes1$10
Minipressprazosin hclYes1$10
Minocin, Dynacinminocycline hclYes1$10
Mirapexpramipexole di-hclNo2$40
Mircettedesog-et estra/ethin estraYes1$10
Mobanmolindone hclNo2$40
MobicmeloxicamYes1$10
Modiconnorethindrone-ethinyl estradYes1$10
Modureticamiloride/hydrochlorothiazideYes1$10
Monistat-dermmiconazole nitrateYes1$10
Monodoxdoxycycline monohydrateYes1$10
Monopril, HCTfosinopril/hydrochlorothiazideYes1$10
MotrinibuprofenYes1$10
Ms Contin/Oramorph SRmorphine sulfateYes1$10
MSIRmorphine sulfateYes1$10
MucomystacetylcysteineYes1$10
MusealprostadilNoPA2$40
Mycelex TrocheclotrimazoleYes1$10
MycobutinrifabutinNo2$40
MycostatinnystatinYes1$10
MydriacyltropicamideYes1$10
MyleranbusulfanNo2$40
MysolineprimidoneYes1$10
- N -[ Return to Top ]
Nalfonfenoprofen calciumNo2$40
Namenda, Solnmemantine hclNo2$40
NaprosynnaproxenYes1$10
Nardilphenelzine sulfateNo2$40
Nasacort AQtriamcinolone acetonideNoST2$40
Nasalideflunisolide 0.025% sprayYes1$10
NasarelflunisolideYes1$10
NatacynnatamycinNo2$40
NavanethiothixeneYes1$10
Nebupent Aerosolpentamidine isethionateNo2$40
Necon 10/11norethindrone-ethinyl estradYes1$10
Neomycinneomycin sulfateYes1$10
Neoralcyclosporine, modifiedYes1$10
Neosporin Ophth Solnneomycin/gramicidin/polymyxn bYes1$10
Neosporin Opth Ointneomy sulf/bacitra/polymyxin bYes1$10
Neo-synephrinephenylephrine hclYes1$10
NeumegaoprelvekinNo2$40
NeupogenfilgrastimNo2$40
NeurontingabapentinYes1$10
Neurontin SolutiongabapentinNo2$40
Nexavarsorafenib tosylateNoPA2$40
NiaspanniacinNo2$40
Nicotine Gum, Nicorettenicotine polacrilexYes1$10
Nicotine PatchnicotineYes1$10
NilandronnilutamideNo2$40
NimotopnimodipineYes1$10
NiravamalprazolamYes1$10
Nitorglycerin PatchnitroglycerinYes1$10
Nitro-bid OintmentnitroglycerinNo2$40
Nitroglycerin Sa CapnitroglycerinYes1$10
Nitrolingual SpraynitroglycerinNo2$40
NitrostatnitroglycerinNo2$40
NizoralketoconazoleYes1$10
Nizoral CreamketoconazoleYes1$10
Nizoral Shampoo 2%ketoconazoleYes1$10
Nordette, Levlenlevonorgestrel-eth estraYes1$10
Norflexorphenadrine citrateYes1$10
Norgesic, Forteorphenadrine/aspirin/caffeineYes1$10
Norinyl 1/35, Ortho-novum 1/35norethindrone-mestranolYes1$10
Norinyl 1/50, Ortho-novum 1/50norethindrone-ethinyl estradYes1$10
Normodynelabetalol hclYes1$10
Norpacedisopyramide phosphateYes1$10
Norpace Crdisopyramide phosphateNo2$40
Norpramindesipramine hclYes1$10
Norvascamlodipine besylateYes1$10
NorvirritonavirNo2$40
Novarel, Pregnyl, Profasigonadotropin,chorionic,humanNo2$40
Novolininsulin regular human recNo2$40
Novolog insulin aspartNo2$40
NoxafilposaconazoleNo2$40
Nulytelysod sulf/sod/nahco3/kcl/peg'sYes1$10
Nutropin, Aq, NuspinsomatropinNoPA2$40
NystatinnystatinYes1$10
Nystatin W/triamcinolonenystatin/triamcinoloneYes1$10
- O -[ Return to Top ]
Ocufenflurbiprofen sodiumYes1$10
OcufloxofloxacinYes1$10
Ocupresscarteolol hclYes1$10
Ogen, Ortho-estestropipateYes1$10
Oluxclobetasol propionateYes1$10
Omeprazole OTComeprazoleYes1$10
OmnicefcefdinirYes1$10
Opticromcromolyn sodiumYes1$10
OptipranololmetipranololYes1$10
Optivarazelastine hclYes1$10
OrappimozideNo2$40
Orapredprednisolone sod phosphateYes1$10
OrfadinnitisinoneNo2$40
OrinasetolbutamideYes1$10
Ortho Evraethinyl estradiol/norelgestNo2$40
Ortho Micronor, Nor-qdnorethindroneYes1$10
Ortho Tri-cyclennorgestimate-ethinyl estradiolYes1$10
Ortho Tri-cyclen Lonorgestimate-ethinyl estradiolNo2$40
Ortho-cyclennorgestimate-ethinyl estradiolYes1$10
Ortho-novum 7/7/7norethindrone-ethinyl estradYes1$10
OrudisketoprofenYes1$10
Ovcon 35norethindrone-ethinyl estradYes1$10
OvidemalathionYes1$10
Ovidrelhcg alpha,recombinantNo2$40
Ovralnorgestrel-ethinyl estradiolYes1$10
OxandrinoxandroloneYesPA1$10
Oxsoralen, Ultramethoxsalen, rapidNo2$40
Oxycodone Immediate Releaseoxycodone hclYes1$10
- P -[ Return to Top ]
Paceroneamiodarone hclYes1$10
Pamelor, Aventylnortriptyline hclYes1$10
Pancrease Mt 4, 10, 16, 20amylase/lipase/proteaseNo2$40
Pancrelipase ECamylase/lipase/proteaseNo2$40
Pangestyme UL 12amylase/lipase/proteaseNo2$40
PanretinalitretinoinNo2$40
Papaverine Capspapaverine hclYes1$10
Paraflex, Parafon Forte DSCchlorzoxazoneYes1$10
Parcopacarbidopa/levodopaYes1$10
ParegoricparegoricYes1$10
Parlodelbromocriptine mesylateYes1$10
Parnatetranylcypromine sulfateYes1$10
Patanololopatadine hclNo2$40
Paxil, Crparoxetine hclYes1$10
Pediazoleery e-succ/sulfisoxazoleYes1$10
PeganoneethotoinNo2$40
Pegasyspeginterferon alfa-2aNoPA2$40
Peg-intron, Redipenpeginterferon alfa-2bNoPA2$40
Penicillin VKpenicillin v potassiumYes1$10
PenlacciclopiroxYes1$10
PentasamesalamineNo2$40
Pepcid (Rx only)famotidineYes1$10
Percocetoxycodone hcl/acetaminophenYes1$10
Percodanoxycodone hcl/aspirinYes1$10
Periactincyproheptadine hclYes1$10
Peridexchlorhexidine gluconateYes1$10
Periostatdoxycycline hyclateYes1$10
PerphenazineperphenazineYes1$10
PersantinedipyridamoleYes1$10
Phenerganpromethazine hclYes1$10
Phenergan DMd-methorphan hb/prometh hclYes1$10
Phenergan VCphenylephrine hcl/prometh hclYes1$10
Phenergan w/codeinecodeine/promethazine hclYes1$10
PhenobarbitalphenobarbitalYes1$10
Phoslocalcium acetateYes1$10
Phospholine Iodideechothiophate iodideNo2$40
Phrenilinbutalbital/acetaminophenYes1$10
Phrenilin Fortebutalbital/acetaminophenNo2$40
Pilocar, Isopto-carpinepilocarpine hclYes1$10
Pilopine HSpilocarpine hclNo2$40
PindololpindololYes1$10
Plan BlevonorgestrelYes1$10
Plaquenilhydroxychloroquine sulfateYes1$10
Plavixclopidogrel bisulfateNo2$40
PlendilfelodipineYes1$10
PletalcilostazolYes1$10
Plexion, TSsulfacetamide sodium/sulfurYes1$10
Polaraminedexchlorpheniramine maleateYes1$10
Polycitrasod/potass/k cit/sod cit/caYes1$10
Poly-predneomy sulf/polymyx b sulf/predNo2$40
Polysporinbacitracin/polymyxin b sulfateYes1$10
Polytrimpolymyxin b sulfate/tmpYes1$10
Poly-vi-florfluoride ion/multivitaminsYes1$10
Ponstelmefenamic acidNo2$40
Pramosone Creamhc acetate/pramoxine hclYes1$10
PrandinrepaglinideNo2$40
Pravacholpravastatin sodiumYes1$10
PrecoseacarboseYes1$10
Pred Forteprednisolone acetateYes1$10
Pred Mildprednisolone acetateNo2$40
Prednisolone, Tabs, SyrupprednisoloneYes1$10
PrednisoneprednisoneYes1$10
Premarin Creamestrogens,conjugatedNo2$40
Premarin, Premarin Low Doseestrogens,conjugatedNo2$40
Prempro, Low Dose/premphaseestrogen,con/m-progest acetNo2$40
Prenatal Vitsprenatal vit/iron,carb/doss/faYes1$10
PrevacidlansoprazoleYesST1$10
Prevacid SolutablansoprazoleNoPA2$40
Previdentsodium fluorideYes1$10
Prevpaclansoprazole/amox tr/clarithNo2$40
Prezista(must be used with Norvir)darunavir ethanolateNo2$40
PrilosecomeprazoleYes1$10
Prilosec 40mgomeprazoleYesPA1$10
Prilosec OTComeprazole magnesiumYes1$10
Primaquineprimaquine phosphateNo2$40
Prinivil, ZestrillisinoprilYes1$10
Prinzide, Zestoreticlisinopril/hydrochlorothiazideYes1$10
Proair, Proventil,Ventolin, HFAalbuterolNo2$40
Proamatinemidodrine hclYes1$10
Pro-banthine 15mgpropantheline bromideYes1$10
ProbenecidprobenecidYes1$10
Procardia, Xl;Adalat CCnifedipineYes1$10
Prochieveprogesterone,micronizedNo2$40
Procritepoetin alfaNoPA2$40
Proctocort Suppositoryhydrocortisone acetateYes1$10
Profasi 5000unitsgonadotropin,chorionic,humanNo2$40
Progesterone In Oil (inj)progesteroneYes1$10
Prograftacrolimus anhydrousYes1$10
Prolixinfluphenazine hclYes1$10
Promactaeltrombopag olamineNoPA2$40
Prometriumprogesterone,micronizedNo2$40
Pronestyl, SRprocainamide hclYes1$10
Propinedipivefrin hclNo2$40
PropylthiouracilpropylthiouracilYes1$10
ProscarfinasterideYes1$10
ProsomestazolamYes1$10
Prostigminneostigmine bromideNo2$40
Protonixpantoprazole sodiumYesPA1$10
Proventil Solutionalbuterol sulfateYes1$10
Proveramedroxyprogesterone acetYes1$10
ProvigilmodafinilNoPA2$40
Prozac, Sarafemfluoxetine hclYes1$10
Psorcon, Floronediflorasone diacetateYes1$10
Pulmicort (tier 1-BCN only)budesonideNo1$10
Pulmozymedornase alfaNo2$40
PurinetholmercaptopurineYes1$10
PyrazinamidepyrazinamideYes1$10
Pyridiumphenazopyridine hclYes1$10
- Q -[ Return to Top ]
Questran, Questran LightcholestyramineYes1$10
Quinidexquinidine sulfateYes1$10
Quinidine Gluconate SAquinidine gluconateYes1$10
Qvar (tier 1-BCN only)beclomethasone dipropionateNo1$10
- R -[ Return to Top ]
Radiogardaseprussian blueNo2$40
Rapamune Tabs, SolutionsirolimusNo2$40
Razadyne Solutiongalantamine hydrobromideYes1$10
Razadyne,ERgalantamine hydrobromideYes1$10
RebetolribavirinYesPA1$10
Rebetol SolutionribavirinNoPA2$40
Rebifinterferon beta-1a/albuminNo2$40
Reglan Tab, Solutionmetoclopramide hclYes1$10
RelafennabumetoneYes1$10
RelenzazanamivirNo2$40
RelistormethylnaltrexoneNoPA2$40
Remeron, SoltabmirtazapineYes1$10
Renacidinmag carb/citric acid/g-lactoneNo2$40
Renagelsevelamer hclNo2$40
Renvela Packet 2.4gsevelamer carbonateNo2$40
Renvela Tabletsevelamer carbonateNo2$40
RepronexmenotropinsNo2$40
Requipropinirole hclYes1$10
Rescriptordelavirdine mesylateNo2$40
ReserpinereserpineYes1$10
RestasiscyclosporineNo2$40
RestoriltemazepamYes1$10
Retin-A Microtretinoin microspheresNo2$40
Retin-A, AvitatretinoinYes1$10
RetrovirzidovudineYes1$10
Revatiosildenafil citrateNoPA2$40
Revianaltrexone hclYes1$10
Reyatazatazanavir sulfateNo2$40
Rheumatrex, Trexallmethotrexate sodiumNo2$40
Rheumatrex, Trexall Injectionmethotrexate sodium/pfYes1$10
RidauraauranofinNo2$40
RifadinrifampinYes1$10
Rifamaterifampin/isoniazidYes1$10
RilutekriluzoleNo2$40
Risperdal M-tabrisperidoneYes1$10
Ritalin, Ritalin-SR; Methylin, ERmethylphenidate hclYes1$10
Rms Suppositorymorphine sulfateYes1$10
RobaxinmethocarbamolYes1$10
Robinul, ForteglycopyrrolateYes1$10
RocaltrolcalcitriolYes1$10
Rondec, DMphenylephrine hcl/chlor-malYes1$10
Rosulasulfacetamide sod/sulfur/ureaYes1$10
Rowasa EnemamesalamineYes1$10
Roxanolmorphine sulfateYes1$10
Rynatan, Ped Suspphenylephrine/chlor-tanYes1$10
Rythmolpropafenone hclYes1$10
- S -[ Return to Top ]
SabrilvigabatrinNo2$40
SaizensomatropinNoPA2$40
Salagenpilocarpine hclYes1$10
SamscatolvaptanNo2$40
SandimmunecyclosporineNo2$40
Sandostatinoctreotide acetateYesPA1$10
Sandostatin LARoctreotide acetateNoPA2$40
SantylcollagenaseNo2$40
Seasonalelevonorgestrel-eth estraYes1$10
Sectralacebutolol hclYes1$10
Selsun Rxselenium sulfideYes1$10
SelzentrymaravirocNo2$40
Sensiparcinacalcet hclNo2$40
SeraxoxazepamYes1$10
Serevent Diskussalmeterol xinafoateNo2$40
SeromycincycloserineYes1$10
Seroquelquetiapine fumarateNo2$40
Silvadenesilver sulfadiazineYes1$10
Sinemet, Crcarbidopa/levodopaYes1$10
Sinequan, Adapindoxepin hclYes1$10
Singulairmontelukast sodiumNoST2$40
SkelaxinmetaxaloneNo2$40
Solodynminocycline hclYesPA1$10
SomacarisoprodolYes1$10
Soma Compoundcarisoprodol/aspirinYes1$10
Soma Compound w/codeinecodeine phos/carisoprodol/asaYes1$10
Somatuline Depotlanreotide acetateNo2$40
SomavertpegvisomantNo2$40
SonatazaleplonYes1$10
SoriataneacitretinNo2$40
Spectazoleeconazole nitrateYes1$10
Spirivatiotropium bromideNo2$40
Sporanox CapsitraconazoleYes1$10
Sporanox SolnitraconazoleNo2$40
SpryceldasatinibNoPA2$40
SSKIpotassium iodideYes1$10
Stadol NSbutorphanol tartrateYes1$10
Stalevocarbidopa/levodopa/entacaponeNo2$40
StarlixnateglinideYes1$10
Stelazinetrifluoperazine hclYes1$10
Stimatedesmopressin acetateNo2$40
Stromectrol - Single DoseivermectinNo2$40
Suboxonebuprenorphine hcl/naloxone hclNoPA2$40
SularnisoldipineYes1$10
Sulfacet-Rsulfacetamide sodium/sulfurYes1$10
SulfadiazinesulfadiazineYes1$10
Surmontiltrimipramine maleateYes1$10
Surmontil 100mgtrimipramine maleateNo2$40
SustivaefavirenzNo2$40
Sutentsunitinib malateNoPA2$40
Symbicortbudesonide/formoterol fumarateNo2$40
Symmetrelamantadine hclYes1$10
Synalar 0.025% Cream, Ointfluocinolone acetonideYes1$10
Synalar Cream, Solnfluocinolone acetonideYes1$10
Synalgos-DCdihydrocodeine/aspirin/caffeinNo2$40
Synarelnafarelin acetateNo2$40
- T -[ Return to Top ]
Tagamet (Rx only)cimetidineYes1$10
Talacenpentazocine hcl/acetaminophenYes1$10
Talwin NXpentazocine hcl/naloxone hclYes1$10
Tambocorflecainide acetateYes1$10
Tamiflu Cap, Susposeltamivir phosphateNo2$40
Tamoxifen Citratetamoxifen citrateYes1$10
TapazolemethimazoleYes1$10
Tarcevaerlotinib hclNoPA2$40
Tasignanilotinib hydrochlorideNo2$40
Tavist Rx (2.68mg, Syrup)clemastine fumarateYes1$10
TazoractazaroteneNo2$40
Tegretol, XRcarbamazepineYes1$10
TemodartemozolomideNo2$40
Temovate, Clobevateclobetasol propionateYes1$10
Tenexguanfacine hclYes1$10
Tenoreticatenolol/chlorthalidoneYes1$10
TenorminatenololYes1$10
Tenuatediethylpropion hclYesPA1$10
Terazol- 3, 7terconazoleYes1$10
Tessalon, PerlesbenzonatateYes1$10
Tetracyclinetetracycline hclYes1$10
ThalomidthalidomideNo2$40
Theo-24theophylline anhydrousNo2$40
Theophylline Anhydroustheophylline anhydrousYes1$10
ThioguaninethioguanineNo2$40
Thorazinechlorpromazine hclYes1$10
ThyrolarliotrixNo2$40
Tiazacdiltiazem hclYes1$10
Ticlidticlopidine hclYes1$10
Tigantrimethobenzamide hclYes1$10
TikosyndofetilideNo2$40
Timoptic - XEtimolol maleateYes1$10
Timoptic, Istaloltimolol maleateYes1$10
TindamaxtinidazoleNo2$40
Tobitobramycin/0.25 normal salineNo2$40
Tobradextobramycin sulfate/dexamethYes1$10
Tobradex Ointtobramycin sulfate/dexamethNo2$40
Tobrextobramycin sulfateYes1$10
Tofranil, PMimipramine hcl, pamoateYes1$10
Tolectin, DStolmetin sodiumYes1$10
TolinasetolazamideYes1$10
Topamax, SprinkletopiramateYes1$10
Topicort Cr, Gel, Oint, LpdesoximetasoneYes1$10
Toprol XLmetoprolol succinateYes1$10
Toradolketorolac tromethamineYes1$10
TracleerbosentanNoPA2$40
Transderm-scopscopolamine hydrobromideNo2$40
Tranxeneclorazepate dipotassiumYes1$10
Travatan, ZtravoprostNo2$40
Trelstar Depot, LAtriptorelin pamoateNo2$40
TrentalpentoxifyllineYes1$10
Trileptal, SuspoxcarbazepineYes1$10
Trilisatechol sal/magnesium salicylateYes1$10
TrimethoprimtrimethoprimYes1$10
Tri-nornylnorethindrone-ethinyl estradYes1$10
Triphasil, Trilevlenlevonorgestrel-eth estraYes1$10
Tri-vi-florfluoride ion/vit a,c&dYes1$10
Trizivirabacavir/lamivudine/zidovudineNo2$40
Trusoptdorzolamide hclYes1$10
Truvadaemtricitabine/tenofovirNo2$40
Tussicapshydrocodone/chlorphen polisNo2$40
Tussionexhydrocodone/chlorphen polisNo2$40
Tykerblapatinib ditosylateNoPA2$40
Tylenol w/codeinecodeine phos/acetaminophenYes1$10
Tyloxoxycodone hcl/acetaminophenYes1$10
Tyvasotreprostinil/nebulizer/accesorNoPA2$40
- U -[ Return to Top ]
Ultracettramadol hcl/acetaminophenYes1$10
Ultramtramadol hclYes1$10
Ultram ER 100, 200mgtramadol hclYesPA1$10
Ultrase MTamylase/lipase/proteaseNo2$40
Ultravatehalobetasol propionateYes1$10
Uniphyltheophylline anhydrousYes1$10
Unireticmoexipril/hydrochlorothiazideYes1$10
Univascmoexipril hclYes1$10
Urecholinebethanechol chlorideYes1$10
Uretron D-Smth/me blue/ba/salicy/atp/hyosNo2$40
Urispasflavoxate hclYes1$10
Urocit-Kpotassium citrateYes1$10
Uroxatralalfuzosin hclNo2$40
UrsoursodiolYes1$10
Urso ForteursodiolYes1$10
- V -[ Return to Top ]
Valcytevalganciclovir hydrochlorideNo2$40
Valisone Cr, Lotion, Ointbetamethasone valerateYes1$10
ValiumdiazepamYes1$10
Valtrexvalacyclovir hclYes1$10
Vancocin HCLvancomycin hclNo2$40
Vantincefpodoxime proxetilYes1$10
Vasereticenalapril/hydrochlorothiazideYes1$10
Vasocidinna sulfacetm/prednis spYes1$10
Vasodilanisoxsuprine hclYes1$10
Vasotecenalapril maleateYes1$10
Venlafaxine HCL Ervenlafaxine hclNoPA/ST2$40
VentavisiloprostNoPA2$40
VepesidetoposideYes1$10
Verelan, PMverapamil hclYes1$10
VermoxmebendazoleYes1$10
VesanoidtretinoinNo2$40
VexolrimexoloneNo2$40
VfendvoriconazoleNo2$40
Viagrasildenafil citrateNoPA2$40
Vibramycin, Vibratabsdoxycycline hyclateYes1$10
Vicodin, Lortabhydrocodone bit/acetaminophenYes1$10
Vicoprofenhydrocodone/ibuprofenYes1$10
VidexdidanosineNo2$40
Videx ECdidanosineYes1$10
Vigamoxmoxifloxacin hclNo2$40
VimpatlacosamideNo2$40
Viokaseamylase/lipase/proteaseNo2$40
Viraceptnelfinavir mesylateNo2$40
ViramunenevirapineNo2$40
Vireadtenofovir disoproxil fumarateNo2$40
ViroptictrifluridineYes1$10
Vivactilprotriptyline hclYes1$10
VivelleestradiolYes1$10
Vivelle-dotestradiolNo2$40
Voltaren, XRdiclofenac sodiumYes1$10
Vospire ERalbuterol sulfateYes1$10
- W -[ Return to Top ]
Welcholcolesevelam hclNo2$40
Wellbutrin, SR, XLbupropion hclYes1$10
Westcorthydrocortisone valerateYes1$10
- X -[ Return to Top ]
Xanax, XRalprazolamYes1$10
XelodacapecitabineNo2$40
XenazinetetrabenazineNoPA2$40
Xopenex 1.25mg/0.5mllevalbuterol hclYes1$10
Xylocaine (Rx only)lidocaine hclYes1$10
Xylocaine Viscouslidocaine hclYes1$10
- Y -[ Return to Top ]
Yasmin 28ethinyl estradiol/drospirenoneYes1$10
Yazethinyl estradiol/drospirenoneNo2$40
Yohimbine HCLyohimbine hclYes1$10
- Z -[ Return to Top ]
Zantac (Rx only)ranitidine hclYes1$10
ZarontinethosuximideYes1$10
ZaroxolynmetolazoneYes1$10
Zebetabisoprolol fumarateYes1$10
Zebutalbutalb/acetaminophen/caffeineNo2$40
ZeritstavudineYes1$10
ZetiaezetimibeNoST2$40
Ziacbisoprol/hydrochlorothiazideYes1$10
Ziagenabacavir sulfateNo2$40
ZithromaxazithromycinYes1$10
ZocorsimvastatinYes1$10
Zofran, ODTondansetronYes1$10
Zoladexgoserelin acetateNo2$40
ZolinzavorinostatNoPA2$40
Zoloftsertraline hclYes1$10
Zonalon, Prudoxindoxepin hclNo2$40
ZonegranzonisamideYes1$10
ZorprinaspirinNo2$40
ZoviraxacyclovirYes1$10
Zovirax Cream, OintacyclovirNo2$40
Zybanbupropion hclYes1$10
ZyloprimallopurinolYes1$10
Zyprexa, ZydisolanzapineNo2$40
Zyrtec, D (OTC)cetirizine hclYes1$10
ZyvoxlinezolidNo2$40

page modified 03/09/2009