RX BENEFITS

RX FORMULARY

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 250,500MG: 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
ANTIBIOTICS - PEDIATRIC LIQUID
  • AMOXICILLIN 250MG/5ML (sizes: 80ML,100ML,150ML): Amoxil
  • AMOXICILLIN 400MG/5ML (sizes: 75MGL,100ML): Amoxil
  • AMOXICILLIN/Clav 400MG/5ML (sizes: 50MGL,75ML,100ML): Augmentin
  • AMOXICILLIN/Clav ES 600MG/5ML (sizes: 75ML,125ML,200ML): Augmentin ES
  • AZITHROMYCIN 100MG/5ML (size: 15ML): Zithromax
  • AZITHROMYCIN 200MG/5ML (sizes: 15ML,22.5ML,30ML): Zithromax
  • CEFDINIR 125MG/5ML (sizes: 60ML,100ML): Omnicef
  • CEFDINIR 250MG/5ML (sizes: 60ML,100ML): Omnicef
  • FLUCONAZOLE 10MG/ML - 35ML: Diflucan
  • FLUCONAZOLE 40MG/ML - 35ML: Diflucan
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: Plavix
  • ASPIRIN 81MG
  • 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
  • CITALOPRAM 10,20,40MG: Celexa
  • ESCITALOPRAM 10,20MG: Lexapro
  • FLUOXETINE 10,20,40MG: Prozac
  • SERTRALINE 25,50,100MG: Zoloft
  • VENLAFAXINE-ER 37.5,75,150MG Capsules: Effexor XR Capsules
  • DULOXETINE 20,30,60MG: Cymbalta
  • TRAZODONE 50,100,150MG: Desyrel
  • BUPROPION SR 100,150MG: Wellbutrin SR
  • BUPROPION LX 150,300MG: Wellburtin XL
  • 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
ANTIVIRAL
  • ACYCLOVIR 400,800mg: Zovirax
  • VALCYCLOVIR 500,100MG: Valtrex
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 5,10,20,50MG: 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
  • METHYLPREDNISOLONE 4MG Dosepack: Medrol Dosepack
DIABETES TYPE-2
  • METFORMIN 500,850,1000MG: Glucophage
  • METFORMIN ER 500MG: Glucophage XR
  • GLIMEPIRIDE 1,2,4MG: Amaryl
  • GLIPIZIDE 5,10,MG: Glucotrol
  • GLIPIZIDE XL 5,10MG: Glucotrol-XL
  • PIOGLITAZONE 15,30MG: Actos
  • BLOOD GLUCOSE MONITOR STRIPS/LANCETS
  • 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 5,10,20,50MG: 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 10,20,40,80MG: Inderal
  • CARVEDILOL 3.125,6.25,12.5,25MG: 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
  • SILDENAFIL 25,50,100MG (max 8 per month): Viagra
  • TADALAFIL 10,20MG (max 8 per month): Cialis
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
  • HYDROXYZINE PAMOATE 25,50MG: Vistaril
MIGRAINE
  • SUMATRIPTAN 25,50,100MG: Imitrex
  • RIZATRIPTAN 5,10MG: Maxalt
  • RIZATRIPTAN ODT 5,10MG: Maxalt MLT
  • AMITRIPTYLINE 10,25,50MG: 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 35,70MG: 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 250,375,500MG: Naprosyn
  • GABAPENTIN 100,300,400,600MG: Neurontin
  • DULOXETINE 20,30,60MG: Cymbalta
  • CELECOXIB 100mg, 200mg: Celebrex
  • DICLOFENAC 1% Gel: Voltaren Gel
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 25/100MG: Sinemet
  • ROPINIROLE .25,.5,1,2,3,4MG: Requip
  • PRAMIPEXOLE (All Strengths): Mirapex
RHEUMATOID ARTHRITIS
  • METHOTREXATE 2.5MG
  • FOLIC ACID 1MG
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: Cryselle
  • LEVONORGESTREL-ETHINYL ESTRADIOL: Nordette, Orsythia
  • TRI-ESTARYLLA: Tri-Sprintec
  • PRENATAL VITAMINS PNV: Prenatal Plus
  • MICONAZOLE VAG CR/SUPPS: Monistat
  • CLOTRIMAZOLE VAG CR: Gyne-Lotrimin cream
  • FLUCONAZOLE 150MG: Diflucan
UTI PAIN
  • PHENAZOPYRIDINE 100MG (Max 6 Tablets): Pyridium
VITAMINS/SUPPLMENTS
  • VITAMIN B1 - 100MG
  • VITAMIN B2 - 100MG
  • VITAMIN B6 - 50MG
  • VITAMIN B12 - 500,1000MG
  • VITAMIN C - 500MG
  • VITAMIN D - 1000,2000,5000IU
  • DAILY-VITE MULTIVITAMIN
  • MAGNESIUM OXIDE 400MG
  • VITAMIN D - 400IU/ML Drops
  • FERROUS SULFATE - 325MG: Iron Supplement