RX BENEFITS - MoreCare360

RX FORMULARY

We want to make sure you have all the information you need to make the best decision for you and your family. To help out, we've put together a list of the most frequently asked questions we get from our current members.

ADHD

MIXED AMPHETAMINE 10,15,20,30MG: Adderall Tabs
CLONIDINE 0.1, 0.2, 0.3MG: Catapres
GUANFACINE 1,2MG: Tenex

ALZHEIMER’S

DONEPEZIL 5,10MG: Aricept
MEMANTINE 5,10MG: Namenda

ANTIBIOTICS

AMOXICILLIN 250,500MG: Amoxil
AMOXICILLIN/CLAV 875/125MG: Augmentin
AZITHROMYCIN 250MG: Z-pak
CEPHALEXIN 250,500,MG: Keflex
CIPROFLOXACIN 250,500,750MG: Cipro
CLINDAMYCIN 150MG: Cleocin
DOXYCYCLINE 50,100,MG: Vibratab
LEVOFLOXACIN 250,500,750MG: Levaquin
METRONIDAZOLE 250,500MG: Flagyl
PENICILLIN 250,500MG: Pen-Vee K
TRIMETH/SULFA SS&DS: Septra/Bactrim
MINOCYCLINE 50,75,100MG: Minocin

ANTIBIOTIC TOPICAL

MUPIROCIN ointment: Bactroban
SILVER SULFADIAZINE: Silvadene

ANTICHOLINERGIC

BENZTROPINE 0.5,1,2MG: Cogentin
HYOSCYAMINE 0.125MG: Levsin Oral or SL

ANTICOAGULANT/ANTI-PLATELET

CLOPIDOGREL 75MG: Daily Plavix
ASPIRIN 81MG: Daily
WARFARIN 1,2,2.5,3,4,5,7.5,10MG: Coumadin

ANTICONVULSANTS

GABAPENTIN 100,300,400,600,800MG: Neurontin
LAMOTRIGINE 25,100,150,200MG: Lamictal
LEVETIRACETAM Tablets 250,500,750,1000mg: Keppra
PHENYTOIN 100MG: Dilantin
PRIMIDONE 50,250MG: Mysoline
TOPIRAMATE 25,50,100,200MG: Topamax

ANTIDEPRESSANT

AMITRIPTYLINE 10,25,50MG: Elavil
NORTIPTYLINE 10,25,50MG: Pamelor
CITALOPRAM10,20,40MG: Celexa
ESCITALOPRAM 10,20MG: Lexapro
FLUOXETINE 10,20MG: Prozac
SERTRALINE 25,50,100MG: Zoloft
VENLAFAXINE-XR 37.5,75,150MG: Effexor
DULOXETINE 20,30,60MG: Cymbalta
TRAZODONE 50,100,150MG: Desyrel
BUPROPION SR 100,150MG: Wellbutrin
MIRTAZAPINE 15,20,45MG: Remeron

ANTIESTROGEN

TAMOXIFEN 10,20MG: Nolvadex
LETROZOLE 2.5MG: Femara
ANASTROZOLE 1MG: ArimIdex

ANTIFUNGAL

CLOTRIMAZOLE 1%: Lotrimin
MICONAZOLE 2%: Micatin
TERBINAFINE 250MG: Lamisil

ANTIHISTAMINE

HYROXYZINE 10,25,50MG: Atarax
LORATADINE 10MG: Claritin
CETIRIZINE: Zyrtec

BACTERIAL VAGINOSIS

METRONIDAZOLE 250,500MG: Flagyl

CARDIAC

AMIODARONE 200MG: Cordarone
ISOSORBIDE MN 30,60MG: Imdur
NITROGLYCERIN 0.4MG: Nitrostat
CARVEDILOL (all strengths):: Coreg
METOPROLOL TARTRATE – 25,50,100MG Lopressor
METOPROLOL SUCCINATE ER – 25,50,100MG: Toprol XL
SOTALOL 80,120MG: Betapace
DILTIAZEM – CD 120,180,240,300MG: Cardizem “CD”
FUROSEMIDE 20,40,80MG: Lasix

COUGH

PROMETHAZINE/Codeine: Phenergan/cod
GUAIFENESIN/Codeine: Robitussin AC
BENZONATATE 100,200MG: Tessalon

DERMATOLOGY

PREDNISONE 10MG: Sterapred DS
PERMETHRIN crème rinse: NIX crème rinse
HYDROCORTISONE 2.5% ointment
HYDROXYZINE 10,25,50MG: Atarax
TRIAMCINOLONE cr/oint: Kenalog
Augmented Betameth dip cream: Diprolene
MOMETASONE cr/oint (mid potency): Elocon

DIABETES TYPE-2

METFORMIN 500,850,1000MG: Glucophage
GLIMEPIRIDE 1,2,4MG: Amaryl
GLIPIZIDE 5,10,MG: Glucotrol
GLIPIZIDE XL 5,10MG: Glucotrol-XL
PIOGLITAZONE 15,30MG: Actos
BLOOD GLUCOSE
MONITOR/STRIPS
SYRINGES 30,50,100 Units
PEN NEEDLES 100’

GASTRO

DICYCLOMINE 10,20MG: Bentyl
FAMOTIDINE 20,40MG: Pepcid
OMEPRAZOLE 20,40MG: Prilosec
PANTOPRAZOLE 20,40MG: Protonix
METOCLOPRAMIDE 5,10MG: Reglan
ONDANSETRON 4,8MG: Zofran Tabs
ONDANSETRON-ODT 4,8MG: Zofran-ODT
PROCHLORPERAZINE 5,10MG: Compazine
PROMETHAZINE 12.5,25MG: Phenergan
MECLIZINE 12.5,25MG: Antivert
LACTULOSE Syrup: Chronulac
POLYETHYLENE GLYCOL 255MG: Miralax

GOUT

INDOMETHACIN 25,50MG: Indocin
NAPROXEN 250,375,500MG: Naprosyn
PREDNISONE 10MG: Sterapred DS
ALLOPURINOL 100,300MG: Zyloprim

HEENT- EYE

GENTAMICIN eye drops: Garamycin
OFLOXACIN eye drops: Ocuflox
CIPROFLOXACIN: Ciloxan
TOBRAMYCIN: Tobrex
NEO/POLY/DEX eye ointment: Maxitrol ointment
TRIMETH/POLY drops: PolyTrim
KETOTIFEN EYE drops: Zatidor/Alaway

HEENT - GLAUCOMA

DORZOLAMIDE drops: Trusopt
TIMOLOL OPTH drops: Timoptic plain
DORZOLAMIDE + TIMOLOL: CoSopt
LATANOPROST drops: Xalatan
BRIMONIDINE .2%: Alphagan

HEENT – EAR

NEO/POLY/DEX EYE drops: Maxitrol
OFLOXACIN EYE drops

HEENT – MOUTH

LIDOCAINE VISCOUS: Xylocaine visc

HEENT - ALLERGY

CETIRIZINE 10MG: Zyrtec
LORATADINE 10MG: Claritin
FLUTICASONE nasal spray: Flonase
IPRATROPIUM NASAL SPRAY 0.03%,0.06%: Atrovent Nasal Spray
MONTELUKAST 4,5,10MG: Singulair

HYPERLIPIDEMIA

SIMVASTATIN 5,10,20,40MG: Zocor
ATORVASTATIN 10,20,40,80MG: Lipitor
ROSUVASTATIN 5,10,20,40MG: Crestor
FENOFIBRATE 48,145MG: Tricor
GEMFIBROZIL 600MG: Lopid

HYPERTENSION

HCTZ 12.5,25MG: HydroDiuril
SPIRONOLACTONE 25,50,100MG: Aldactone
TRIAMTERENE/HCTZ 37.5/25 TABS: Maxzide – 25 Tabs
LISINOPRIL 2.5,5,10,20,30,40MG: Prinivil/Zestril
LISINOPRIL/HCTZ (all strengths): Zestoretic
QUINAPRIL 5,10,20,40MG: Accupril
RAMIPRIL 1.25,2.5,5,10MG: Altace
AMLODIPINE 2.5,5,10MG: Norvasc
DILTIAZEM-CD 120,180,240,300MG: Cardizem “CD”
VERAPAMIL ER 120,180,240MG: Calan SR
LOSARTAN 25,50,100MG: Cozaar
IRBESARTAN 75,150,300MG: Avapro
IRBESARTAN/HCTZ: Avalide
OLMESARTAN 5mg, 20mg 40mg: Benicar

HYPERTENSION – BBs

ATENOLOL 25,50,100MG: Tenormin
METOPROLOL 25,50,100MG: Lopressor
METOPROLOL ER 25,50,100MG: Toprol-XL
PROPRANOLOL 10,20,40MG: Inderal
CARVEDILOL 3.125,6.25,12.5,25MG BID: Coreg

HYPERTENSION – Sympatholytic

CLONIDINE 0.1, 0.2, 0.3MG: Catapres
GUANFACINE 1,2MG: Tenex

MEN’S HEALTH

FINASTERIDE 5MG: Proscar
DUTASTERIDE: Avodart
ALFUZOSIN 10MG: Uroxatral
TAMSULOSIN 0.4MG: Flomax
TERAZOSIN 1,2,5,10MG: Hytrin

MENTAL HEALTH

ALPRAZOLAM 0.25,0.5,1,2MG: Xanax
DIAZEPAM 2,5,10MG: Valium
CLONAZEPAM 0.5,1,2MG: Klonopin
BUSPIRONE 5,10,15MG: Buspar
CHLORDIAZEPOXIDE 5,10,25MG: Librium
LITHIUM 300MG: LithoBid, Eskalith
OLANZAPINE 2.5,5,7.5,10MG: Zyprexa
RISPERIDONE .5,1,2,3,4MG: Risperdal
QUETIAPINE 25,50,100,200,300MG: Seroquel
TEMAZEPAM 15,30MG: Restoril
ZOLPIDEM 5,10MG: Ambien
ARIPIPRAZOLE 2mg,5mg 10mg 15mg,20mg: Abilify

MIGRAINE

SUMATRIPTAN 25,50,100MG: Imitrex
RIZATRIPTAN 5,10MG: Maxalt
RIZATRIPTAN ODT 5,10MG: Maxalt MLT
AMITRIPTYLINE 10,20,50MG: Elavil
NORTRIPTYLINE 10,25,50MG: Pamelor
METOPROLOL 25,50,100MG: Lopressor
METOPROLOL ER 25,50,100MG: Toprol-XL
PROPRANOLOL 10,20,40,80MG: Inderal
TOPIRAMATE 25,50,100,200MG: Topamax

OAB

OXYBUTYNIN 5MG: Ditropan

OSTEOPOROSIS

ALENDRONATE 25,70MG: Fosamax
VITAMIN D 50,000 IU: Drisdol
CALCIUM CARBONATE: OS-CAL
CALCIUM CITRATE: Citracal

PAIN MANAGEMENT

CYCLOBENZAPRINE 5,10MG: Flexeril
ORPHENADRINE: Norflex
BACLOFEN 10,20MG: Lioresal
TIZANIDINE 2,4MG: Zanaflex
METHOCARBAMOL 500,750MG: Robaxin
IBUPROFEN 200,400,600,800MG: Motrin
MELOXICAM 7.5,15MG: Mobic
NAPROXEN 250,350,500MG: Naprosyn
GABAPENTIN 100,300,400,600MG: Neurontin
DULOXETINE 20,30,60MG: Cymbalta
CELECOXIB 100mg, 200mg: Celebrex

PAIN

OPIOIDS (MAX=120MME): Follow Clinic Opioid Policy
CODEINE/ACETAMINOPHEN #3: Tylenol #3
HYDRO/APAP 5/325, 7.5/325,10/325: Norco
OXYCODONE 5,10,15MG IR Tabs: OXY-IR
TRAMADOL 50MG: Ultram
MORPHINE IR 15,30MG: MSIR
ROPINIROLE .25,5,1,2,3,4MG: Requip
PRAMIPEXOLE 0.125,0.25,0.5,0.75,1,1.5MG: Mirapex

PARKINSONS

BENZTROPINE 0.5,1,2MG: Cogentin
CARBIDOPA/LEVODOPA: Sinemet
ROPINIROLE .25,.5,1,2,3,4MG: Requip
PRAMIPEXOLE (All Strengths): Mirapex

RHEUMATOID ARTHRITIS

METHOTREXATE 2.5MG

RESPIRATORY

ALBUTEROL MDI KIT 8MG MAX: Ventolin
ALBUTEROL NEB SOLN 2.5MG: Ventolin soln
IPRATROPIUM NEB SOLN: Atrovent
ALBUTEROL/IPRATROPIUM: Duoneb

THYROID

LEVOTHYROXINE (All Strengths): Synthroid

WOMEN’S HEALTH

ESTRADIOL 0.5,1,2MG: Estrace
NORETHINDRONE-ETHINYL ESTRADIOL: Microgestin/Ortho-Novum
NORGESTREL-ETHINYL ESTRADIOL: Lo/Oral/Lo/Orgestrel
LEVONORGESTREL-ETHINYL ESTRADIOL: Nordette Orsythia
PRENATAL VITAMINS PNV: Prenatal Plus
FERROUS SULFATE: Iron Supplement
MICONAZOLE VAG CR/SUPPS: Monistat
CLOTRIMAZOLE VAG CR: Gyne-Lotrimin cream
FLUCONAZOLE 150MG: Diflucan

UTI PAIN

PHENAZOPYRIDINE 95MG (OTC): AZO-Standard