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2011 Clinically Preferred
Drug List
Updated May 19, 2011
Table of Contents
Forward 4 Hypotensives, Miscellaneous 13
Coverage Limitation 4 Calcium Channel Blockers 13
DESI Drugs 4 ACE Inhibitors 14
Selection Process for the Clinically Preferred Drug List 5 ACE Inhibitors W/ Diuretics 14
Generic Substitution 6 ACE Inhibitor / CCB Combination 14
Specialty Pharmacy Products 6 A-2 Antagonists (ARBs) 14
ANTI-INFECTIVES A-2 Antagonists (ARBs) W/ Diuretics 14
Penicillins & Cephalosporins 7 Antianginal / Anti-Ischemic Agents 15
Tetracyclines 7 Antiarrhythmics 15
Macrolides, Clindamycins & Ketolides 7 Cardiac Glycosides 15
Sulfonamides, Sulfones & Nitrofurantoins 7 Sympatholytic Agents 15
Quinolones 8 Vasodilators, Hypotensive 15
Miscellaneous Antibiotics 8 Vasodilators, Coronary 15
Antivirals 8 Statins 16
HIV Antivirals & Related Agents 8 Statin-Calcium Channel Blocker Combination 16
Amebicides & Trichamonacides 8 Bile Acid Sequestrants (BAS) 16
Antiparasitics 9 Fibrates 16
Antimalarials & Antiprotazoals 9 Other Antihyperlipidemic Agents 16
Antihelmintic Agents 9 PANCREATIC AGENTS
Leprostatic Agents 9 Pancreatic Agents 16
Antifungals 9 KIDNEY & UROLOGICAL AGENTS
ANTINEOPLASTICS Diuretics 17
Antineoplastics 10 Benign Prostatic Hyperplasia Agents 17
Immunosuppressant Agents 10 Urologic Agents 17
ANTIEMETICS Urinary pH Modifiers 17
Antiemetics 10 Electrolyte Depleters 18
NEUROLOGIC AGENTS Potassium & Electrolytes 18
Anti-Parkinsons Agents 11 SKELETAL MUSCLE RELAXANTS
Anti-Migraine Agents 11 Skeletal Muscle Relaxants 18
Alzheimer’s Agents 11 OSTEOPOROSIS
Anticonvulsants 12 Osteoporosis Agents 19
BLOOD MODIFIERS ANALGESICS
Anticoagulants & Heparin-Related Products 12 Anti-Inflammatory Agents (NSAID) 19
Platelet Aggregation Inhibitors 12 COX-II Agents 19
Hematopoietic Agents (Iron Replacement) 12 Analgesics, Narcotics 20
CARDIOVASCULAR Analgesics, Salicylates 20
Alpha Blockers 13 Analgesics, Non-Salicylates 20
Beta Blockers 13 CENTRAL NERVOUS SYSTEM AGENTS
Rite Aid Health Solutions Clinically Preferred Drug List – Subject to update 2 BOLD INDICATES BRAND NAME
Anti-Anxiety Agents 21 Respiratory Aids / Supplies 31
Sedatives/Hypnotics (Non-Barbiturate) 21 SKIN & SKIN STRUCTURE
Sedatives/Hypnotics (Barbiturate/CNS) 21 Acne / Rosacea Products (Oral & Topical) 32
Attention Deficit Disorder (ADD/ADHD) / Narcolepsy 21 Antifungals (Topical) 32
Serotonin Specific Reuptake Inhibitors (SSRIs) 22 Keratolytics / Wound Care 32
Serotonin Non-Specific Reuptake Inhibitors (SNRIs) 22 Psoriasis (Oral & Topical) 33
SSRI / Anti-Psychotic Combinations 22 Scabies & Pediculosis 33
Monoamine Oxidase Inhibitors (MAOIs) 22 Topical Corticosteroids 33
Antidepressants, Others 22 Topical Immunosuppressives / Immunomodulator Agents 33
Antipsychotic Agents 23 Topical Local Anesthetics 33
Bipolar Disorders (Anti-Mania Agents) 23 VAGINAL ANTI-INFECTIVES
GASTROINTESTINAL Vaginal Antibiotics / Sulfonamides 34
Anti-Ulcer / GERD Agents (PPIs) 24 Vaginal Antifungals 34
Anti-Spasmodic Agents (Anticholinergics) 24 OPHTHALMICS
Bowel & Colon Agents 24 Ophthalmic Antibiotics & Sulfonamides 34
Irritable Bowel Syndrome (IBS) Agents 24 Ophthalmic Antivirals 34
Laxatives & Cathartics 24 Ophthalmic Antihistamines 35
HORMONAL AGENTS Ophthalmic Anti-Inflammatory 35
Contraceptives 25 Ophthalmic Immunomodulators 35
Estrogens 25 Ophthalmic Mast Cell Stabilizers 35
Estrogen Combinations 26 Ophthalmic Miotics 35
Androgenic Agents 26 Ophthalmic Mydriatics 36
Progestational Agents 26 Ophthalmic Vasoconstrictors 36
Other Contraception Agents 26 Ophthalmic Antibiotic-Steroid Combination Agents 36
Prenatal Vitamins 27 OTIC AGENTS 36
Glucocorticoids / Mineralocorticoids (oral) 27 MISCELLANEOUS
Anti-Thyroid & Thyroid Replacement Products 27 Alcohol Dependency Agents 37
DIABETES AGENTS Dental Preparations 37
Insulins 28 Hyperparathyroid Agents 37
Injectable Hypoglycemics, Other 28 Metallic Poison Treatment Agents 37
Oral Hypoglycemics 28 Parasympathetic Agents 37
Diabetes Supplies 29 Smoking Cessation Products 37
Urine Glucose / Ketone Strips 29 SPECIALTY PRODUCTS
Hyperglycemics 29 Hepatitis Agents 38
RESPIRATORY Human Growth Hormones 38
Allergy Agents 30 Pulmonary Agents 38
Asthma Agents 30 Multiple Sclerosis Agents 39
Corticosteroid Inhalers 31 Rheumatoid Arthritis Agents 37,39
COPD Agents 31 INDEX 40
Xanthine Derivatives 31
Rite Aid Health Solutions Clinically Preferred Drug List – Subject to update 3 BOLD INDICATES BRAND NAME
Preface
FORWARD
The Clinically Drug Preferred List is a continually updated list of prescription medications that represents the current clinical judgment of
providers and experts in the diagnosis and treatment of disease. This document represents the efforts of our clinical team to provide
physicians, pharmacists and members with a method to evaluate the various drug products available. The Clinically Preferred Drug List
shows both the generic and brand names for reference and convenience. All applicable dosage forms and strengths of a particular drug
are included in the Clinically Preferred Drug List under the specific entry unless otherwise noted. Health plans are provided the option of
imposing further restrictions or may choose not to reimburse some products listed in the Clinically Preferred Drug List.
COVERAGE LIMITATION
The Clinically Preferred Drug List does not provide information regarding the specific coverage and limitations a member may have,
including specific exclusions, copays, or a lack of coverage that is not reflected in the Clinically Preferred Drug List. The Clinically
Preferred Drug List applies only to outpatient drugs provided to members, including most specialty injectable drugs and does not apply to
medications used in the in-patient setting or many injectables administered in a physican’s office. Injectable drug coverage is determined
by individual plans and may not be included for all members. Note: if a drug is covered and listed as “preferred”, all strengths and
forms of that drug are considered preferred unless specifically listed.
DESI DRUGS
DESI (Drug Efficacy Study Implementation) designated drugs are those drugs first marketed between 1938 and 1962 that were approved
as safe but were not required to prove effectiveness for FDA product approval. In 1963, Congress passed the Kefauver-Harris
Amendment, which required that manufacturers of drug products provide proof to the FDA of both safety and effectiveness before the
product could be marketed. The DESI Program was implemented to determine which of the drugs approved between 1938 and 1962
could indeed claim, in clinical trials, effectiveness for their specific indications.
DESI drugs, and those identical, related and similar to them, may continue to be marketed until studies and administrative proceedings
regarding their effectiveness have been concluded. Once the proceedings are concluded, continued marketing of the drug will only be
permitted once a New Drug Application (NDA) is approved by the FDA. New Drug Applications must contain data from clinical trials
demonstrating that a medication is both safe and effective for the specified indication. Many health plans do not cover DESI designated
medications, as their effectiveness has not been proven for the condition that the product is marketed to treat.
Rite Aid Health Solutions Clinically Preferred Drug List – Subject to update 4 BOLD INDICATES BRAND NAME
Preface (Continued)
SELECTION PROCESS FOR THE CLINICALLY PREFERRED DRUG LIST
New agents are continually being developed and approved by the FDA for the treatment of different disease states. Due to the availability
of numerous medication therapies and treatments, a process of drug selection and drug usage has been developed.
The development, maintenance, and improvement of the Clinically Preferred Drug List are processes that require the attention of our
Pharmacy &Therapeutics (P&T) Committee. The Clinically Preferred Drug List is a continually reviewed and revised list of drug products
that mirrors the prevailing clinical opinion of the P&T Committee.
New agents being considered for formulary inclusion will be reviewed for their safety, efficacy, FDA-approved indications,
contraindications, side effects, pharmacokinetic profile, patient compliance potential, drug cost and effects on other indirect health costs.
The thorough medical literature review conducted by the P&T Committee places emphasis on the following characteristics:
- Safety and effectiveness of the product
- Comparison studies with similar products if available
- Potential for patient clinical or utilization abuse
- Therapeutic outcomes and pharmacoeconomic data
Agents that are given a "priority" review by the FDA will be immediately reviewed for possible inclusion into the formulary. New drugs will
have their characteristics compared to other similar agents within a therapeutic class if possible. New drugs that are added to an existing
therapeutic class may result in the deletion of other drug(s) within a particular therapeutic class as clinical application warrants. This
process ensures and promotes the selection of the most clinically useful and cost-effective agents within a specific therapeutic class.
Rite Aid Health Solutions Clinically Preferred Drug List – Subject to update 5 BOLD INDICATES BRAND NAME
GENERIC SUBSTITUTION
Whenever available, FDA approved generic drugs considered bioequivalent with the respective brand name drug should be used
regardless of the brand name indicated. Greater economy is realized using generic equivalents. This policy is not meant to preclude any
state statutes that may exist (e.g., Non-Substitutable Drugs). Inclusion of a drug product for generic substitution is subject to the following:
FDA Rating of "A" for generic equivalency, denoting bioequivalency, as well as thorough review by the P&T Committee for efficacy and
safety.
SPECIALTY PHARMACY PRODUCTS
Depending on drug coverage parameters regarding injectable medications, which is often the route of administration of specialty
products, categories of drugs covered will generally include the specialty pharmacy products although these products often require
prior authorization and higher copayments due to complexity of therapy and high costs.
Rite Aid Health Solutions Clinically Preferred Drug List – Subject to update 6 BOLD INDICATES BRAND NAME
Antibiotics
GENERIC DRUGS PREFERRED BRANDS NON-PREFERRED BRANDS
Penicillins & Cephalosporins
Amoxicillin / Amoxil Augmentin 125mg and 250mg Chewable Tablets Ceclor CD (Cefaclor ER)
Amoxicillin Potassium Clavulanate / Augmentin 125mg/5mL Susp Cefaclor ER
Augmentin/ES/XR Ceftin Susp (Cefuroxime axetil) Cedax (Ceftibuten)
Ampicillin / Omnipen, Polycillin Lorabid (Loracarbef)
Cefaclor / Ceclor Moxatag (Amoxicillin)
Cefadroxil / Duricef, Ultracef Suprax (Cefixime)
Cefdinir / Omnicef Spectracef (Cefditoren pivoxil)
Cefuroxime Axetil / Ceftin Dispermox (Amoxicillin)
Cephalexin / Keflex, Biocef
Cefpodoxime proxetil / Vantin
Cefprozil / Cefzil
Dicloxacillin / Dynapen
Penicillin VK / Veetids, V-Cillin K
Tetracyclines Declomycin (Demeclocycline)
Demeclocycline
Doxycycline / Vibramycin, Monodox, Vibra-Tabs Adoxa Pak (Doxycycline monohydrate) Doryx (Doxycycline hyclate)
Minocycline / Minocin, Dynacin Oracea (Doxycycline monohydrate) Solodyn (Minocycline)
Tetracycline / Sumycin
Macrolides, Clindamycins & Ketolides
Azithromycin / Zithromax Ilosone (Erythro-Estolate)
Clindamycin / Cleocin Erythro-Estolate
Erythro-Base / Ery-Tab, E-Mycin Ketek (Telithromycin)
Erythro-Ethylsuccinate / EES, Eryped Z-Max (Azithromycin)
Erythro-Stearate / Erythrocin
Erythro & Sulfa / Pediazole
Clarithromcyin / Biaxin/XL
Sulfonamides, Sulfones & Nitrofurantoins
Nitrofurantoin / Macrodantin Furadantin (Nitrofurantoin) Macrodantin (Nitrofurantoin Macro)
Sulfa-Trimethoprim / Septra, Bactrim/DS
Sulfasalazine / Azulfidine
Rite Aid Health Solutions Clinically Preferred Drug List – Subject to update 7 BOLD INDICATES BRAND NAME
Antibiotics (Continued) / Anti-infectives
GENERIC DRUGS PREFERRED BRANDS NON-PREFERRED BRANDS
Quinolones
Ciprofloxacin / Cipro/XR Cipro Susp (Ciprofloxacin) Avelox (Moxifloxacin)
Ofloxacin / Floxin Levaquin (Levofloxacin) Factive (Gemifloxacin)
Noroxin (Norfloxacin) Proquin XR (Ciprofloxacin)
Miscellaneous Antibiotics
Dapsone (Dapsone) Xifaxan 200mg (Rifaximin)
Vancocin (Vancomycin)
Xifaxan 550mg (Rifaximin)
Zyvox (Linezolid)
Antivirals
Acyclovir / Zovirax Relenza (Zanamivir) Cytovene (Ganciclovir)
Amantadine / Symmetrel Tamiflu (Oseltamivir) Ganciclovir
Famciclovir / Famvir Synagis (Palivizumab)* Flumadine (Rimantadine)
Valacyclovir / Valtrex Valcyte (Valganciclovir) Rimantadine
Virazole (Ribavirin)
Amebicides, Trichomonacides
Metronidazole / Flagyl Tindamax (Tinidazole) Flagyl ER (Metronidazole)
Paromomycin Sulfate / Humatin Yodoxin (Iodoquinol)
PREFERRED BRANDS
HIV Antivirals/Related Agents* Intelence (Etravirine) Selzentry (Maraviroc)
Agenerase (Amprenavir) Invirase (Saquinavir) Sustiva (Efavirenz)
Aptivus (Tipranavir) Isentress (raltegravir) Trizivir (Abacavir / Lamivudine / Zidovudine)
Atripla (Efavirenz / Emtricitab / Tenofovir) Kaletra (Ritonavir / Lopinavir) Truvada (Emtricitabine / Tenofovir)
Combivir (Lamivudine / Zidovudine) Lexiva (Fosamprenavir) Videx pediatric soln/chewable (Didanosine)
Crixivan (Indinavir) Norvir (Ritonavir) Videx/EC (Didanosine)
Emtriva, Tabs Only (Emtricitabine) Prezista (Darunavir ethanolate) Viracept (Nelfinavir)
Epivir (Lamivudine) Rescriptor (Delavirdine) Viramune (Nevirapine)
Epzicom (Abacavir / Lamivudine) Retrovir (Zidovudine) Viread (Tenofovir)
Fuzeon (Enfuvirtide) Reyataz (Atazanavir) Zerit (Stavudine)
*Use generic equivalents where available if Ziagen (Abacavir)
covered by plan design.
*Specialty products may have a higher copayment, depending on plan benefit design.
Rite Aid Health Solutions Clinically Preferred Drug List – Subject to update 8 BOLD INDICATES BRAND NAME
Anti-infectives (Continued)
GENERIC DRUGS PREFERRED BRANDS NON-PREFERRED BRANDS
Antiparasitics
Alinia Suspension/Tablets (Nitazoxanide)
Antimalarials & Antiprotozoals Coartem (Artemether/Lumefantrine)
Chloroquine Phosphate / Chloroquine/ Aralen Malarone (Atovaquone / Proguanil)
Hydroxychloroquine / Plaquenil, Quineprox Qualaquin (Quinine sulfate)
Mefloquine / Lariam Daraprim (Pyrimethamine)
Mepron (Atovaquone)
Nebupent (Pentamidine)
Primaquine (Primaquine Phosphate)
Antihelmintic Agents
Mebendazole / Vermox Albenza (Albendazole)
Biltricide (Praziquantel)
Mintezol (Thiabendazole)
Stromectol (Ivermectin)
Leprostatic Agents
Thalomid (Thalidomide)
Antimycobacterials
Mycobutin (Rifabutin)
Seromycin (Cycloserine)
Miscellaneous Topical Agents
Mupirocin / Bactroban Zovirax (Acyclovir) Altabax (Retapamulin)
Denavir (Penciclovir)
Bactroban Nasal (Mupirocin)
Xerese (Acyclovir / Hydrocortisone)
Antifungals
Microsize Griseofulvin / Grifulvin V Ancobon (Flucytosine) Oravig (Miconazole)
Nystatin / Mycostatin Lamisil Granules (Terbinafine) Vfend Susp (Voriconazole)
Clotrimazole / Mycelex Troches Noxafil (Posaconazole)
Fluconazole / Diflucan Sporanox Oral Solution (Itraconazole)
Itraconazole / Sporanox
Ketoconazole / Nizoral
Terbinafine / Lamisil
Voriconazole / Vfend Tablets
Rite Aid Health Solutions Clinically Preferred Drug List – Subject to update 9 BOLD INDICATES BRAND NAME
Antineoplastics, Immunosuppressant Agents, Antiemetics
PREFERRED BRANDS NON-PREFERRED BRANDS
Antineoplastics*
Afinitor / Everolimus Gleevec / Imatinib Sprycel / Dasatinib Eligard / Leuprolide
Alkeran / Melphalan Hexalen / Altretamine Sutent / Sunitinib Malate Fareston / Toremifene Citrate
Arimidex / Anastrozole Hycamtin / Topotecan Tarceva / Erlotinib Faslodex / Fulvestrant
Aromasin / Exemestane Leucovorin / leucovorin Tasigna / Nilotinib Iressa / Gefitinib
Carac, Efudex, Fluoroplex/ Leukeran / Chlorambucil Temodar /Temozolomide Nilandron / Nilutamide
Fluorouracil Lysodren / Mitotane Teslac / Testolactone Targretin / Bexarotene
Casodex / Bicalutamide Matulane / Procarbazine Thioguanine / Thioguanine Zolinza / Vorinostat
CEENU / Lomustine Mesnex / Mesna Trexall / Methotrexate
Cytoxan / Cyclophosphamide Myleran / Busulfan Tykerb / Lapatinib
Droxia, Hydrea / Hydroxyurea Nolvadex / Tamoxifen Vepesid / Etoposide
Emcyt / Estramustine Oforta / Fludarabine Vesanoid / Tretinoin
Eulexin / Flutamide Panretin / Alitretinoin Votrient / Pazopanib
Femara / Letrozole Purinethol / Mercaptopurine Xeloda / Capecitabine
Fludarabine, oral Revlimid / Lenalidomide Zoladex / Goserelin
Sprycel / Dasatinib
*Note: Use generic equivalents where available if covered by plan benefit design.
GENERIC DRUGS PREFERRED BRANDS NON-PREFERRED BRANDS
Immunosuppressant Agents
Azathioprine / Imuran Azasan (Azathioprine) Myfortic (Mycophenolate sodium)
Cyclosporine / Sandimmune, Neoral Cellcept Oral Soln (Mycophenolate mofetil) Simulect (Basiliximab)
Mycophenolate mofetil / Cellcept Neoral (Cyclosporine) Orthoclone OKT-3 (Muromonab-CD3)
Tacrolimus anhydrous / Prograf Rapamune (Sirolimus) Zenapax (Daclizumab)
Sandimmune (Cyclosporine) Zortress (Everolimus)
Antiemetics
Granisetron / Kytril Transderm-Scop Patch (Scopalamine) Cesamet (Nabilone)
Meclizine / Antivert, Vertin Anzemet (Dolasetron) Dronabinol
Prochlorperazine / Compazine Emend (Aprepitant) Marinol (Dronabinol)
Promethazine HCL / Phenergan Sancuso Patch (Granisetron) Zuplenz Film (Ondansetron)
Trimethobenzamide / Tigan
Ondansetron / Zofran/ODT
Rite Aid Health Solutions Clinically Preferred Drug List – Subject to update 10 BOLD INDICATES BRAND NAME
Neurologic Drugs
GENERIC DRUGS PREFERRED BRANDS NON-PREFERRED BRANDS
Anti-Parkinsons Agents
Amantadine / Symmetrel Apokyn (Apomorphine) Akineton (Biperiden)
Benztropine / Cogentin Azilect (Rasagiline) Kemadrin (Procyclidine)
Bromocriptine / Parlodel Comtan (Entacapone) Neupro (Rotigotine)
Cabergoline / Dostinex Lodosyn (Carbidopa) Requip XL (Ropinirole)
Carbidopa/Levodopa / Sinemet/CR, Parcopa Mirapex ER (Pramipexole) Stalevo (Carbidopa/Levodopa/Entacapone)
Ropinirole / Requip Tasmar (Tolcapone)
Selegiline / Eldepryl, Carbex Zelapar (Selegiline)
Trihexyphenidyl / Artane
Pramipexole / Mirapex
Anti-Migraine Agents
Sumatriptan / Imitrex inj, tabs, nasal spray Triptans: Triptans:
Amerge (Naratriptan) Alsuma (Sumatriptan)
Frova (Frovatriptan) Axert (Almotriptan)
Maxalt/MLT (Rizatriptan) Sumavel (Sumatriptan)
Relpax (Eletriptan)
Treximet (Sumatriptan / Naproxen)
Zomig/ZMT (Zolmitriptan)
Ergotamines/Others:
Ergotamines/Others: Ergomar (Ergotamine)
Aspirin/Butalbital/Caff / Fiorinal Ergotamines/Others:
APAP/Butalbital/Caff / Fioricet Migranal Nasal (Dihydroergotamine)
Ergotamine/Caffeine / Cafergot Cambia (Diclofenac potassium)
Isometheptene / APAP/ Dichlorlphenazone / Midrin Phrenilin/Forte (Acetaminophen/Butalbital)
Isometheptene/APAP/Caffeine / Migralam
Dihydroergotamine/ DHE 45
Alzheimer’s Agents
AchE Inhibitors AchE Inhibitors
Galantamine / Razadyne Aricept 23mg (Donepezil) Cognex (Tacrine)
Rivastigmine / Exelon caps Exelon Patch (Rivastigmine) Mytelase (Ambenonium)
Donepezil / Aricept/ODT Mestinon (Pyridostigmine) Razadyne ER (Galantamine)
Prostigmin (Neostigmine)
NMDA Receptor Antagonists
Namenda (Memantine)
ALS Agents
Rilutek (Riluzole)
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Neurologic Drugs (Continued)
GENERIC DRUGS PREFERRED BRANDS NON-PREFERRED BRANDS
Anticonvulsants
Carbamazepine / Tegretol/XR Banzel (Rufinamide) Banzel Susp (Rufinamide)
Clonazepam / Klonopin Carbatrol (Carbamazepine) Equetro (Carbamazepine)
Diazepam gel / Diastat Celontin (Methsuximide) Sabril (Vigabatrin)
Divalproex sodium / Depakote, Depakote ER Dilantin 30mg/50mg ONLY (Phenytoin) Stavzor (Valproic Acid)
Ethosuximide / Zarontin Felbatol (Felbamate) Zonegran (Zonisamide)
Lamotrigine /Lamictal Gabitril (Tiagabine) Zonisamide
Levetiracetam / Keppra Keppra XR (Levetiracetam)
Gabapentin / Neurontin, Gabarone Lamictal ODT/XR (Lamotrigine)
Mephobarbital / Mebaral Lyrica (Pregabalin)
Oxcarbazepine / Trileptal Peganone (Ethotoin)
Phenobarbital / Phenobarbital Tegretol XR 100mg (Carbamazepine)
Phenytoin / Dilantin, Phenytek Vimpat (Lacosamide)
Primidone / Mysoline
Topiramate / Topamax
Valproic Acid / Depakene
Blood Modifiers
GENERIC DRUGS PREFERRED BRANDS NON-PREFERRED BRANDS
Anticoagulants / Heparins
Warfarin sodium / Coumadin Arixtra (Fondaparinux)* Innohep (Tinzaparin)*
Heparin sodium Fragmin (Dalteparin)*
Enoxaparin / Lovenox * Pradaxa (Dabigatran)
Platelet Aggregation Inhibitors
Cilostazol / Pletal Aggrenox (Dipyridamole / Aspirin)
Dipyridamole / Persantine Plavix (Clopidogrel)
Ticlopidine / Ticlid Effient (Prasugrel)
Pentoxifylline / Trental
Anagrelide / Agrylin
Hematopoietic Agents
Ferrous Sulfate Ferrous Gluconate Aranesp (Darbepoetin)* CaloMist (cyanocobalamin)
Ferrous Fumarate Folic Acid Foltx (FA/ B12 / B 6) Chromagen Fa/Forte
Ferrogen Niferex-150 Forte Conison
Cyanocobalamin injection Procrit (Epoetin)* Epogen (Epoetin)*
Repliva Ferrogels Forte
Feraheme (Ferumoxytol)
Folgard RX (FA/ B12 / B 6)
InFed (Iron dextran)
*Specialty products may have a higher copayment, depending on plan benefit design.
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Cardiovascular Agents
GENERIC DRUGS PREFERRED BRANDS NON-PREFERRED BRANDS
Alpha Blockers
Doxazosin / Cardura Dibenzyline (Phenoxybenzamine)
Prazosin / Minipress
Terazosin / Hytrin
Beta Blockers
Acebutolol / Sectral Coreg CR (Carvedilol) Levatol (Penbutolol)
Atenolol / Tenormin Bystolic (Nebivolol) Innopran XL (Propranolol)
Betaxolol / Kerlone
Bisoprolol / Zebeta
Carvedilol / Coreg
Labetalol / Trandate
Metoprolol / Lopressor, Toprol XL
Nadolol / Corgard
Pindolol / Visken
Propranolol / Inderal/SR/LA
Sotalol / Betapace/AF
Timolol / Blocadren
Hypotensives, Miscellaneous
Atenolol/Chlorthalidone / Tenoretic Demser (Metyrosine)
Bisoprolol/HCTZ / Ziac
Propranolol/HCTZ / Inderide
Metoprolol/HCTZ/ Lopressor HCT
Nadolol/Bendroflumethiazide / Corzide
Calcium Channel Blockers
Amlodipine / Norvasc Cardizem LA 120mg (Diltiazem) Caduet (Amlodipine/Atorvastatin)
Diltiazem / Cardizem/CD/LA Cardene / SR (Nicardipine)
Diltiazem / Dilacor XR, Tiazac Nicardipine
Felodipine / Plendil Covera HS (Verapamil)
Isradipine / Dynacirc Dynacirc/CR (Isradipine)
Nifedipine / Adalat/CC, Procardia/XL,
Nifedipine/ER
Nimodipine / Nimotop
Nisoldipine / Sular
Verapamil / Calan/SR, Isoptin/SR, Verelan/PM
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Cardiovascular Agents (Continued)
GENERIC DRUGS PREFERRED BRANDS NON-PREFERRED BRANDS
ACE Inhibitors
Benazepril / Lotensin
Captopril / Capoten
Enalapril / Vasotec
Fosinopril /Monopril
Lisinopril / Prinivil, Zestril
Moexipril / Univasc
Perindopril / Aceon
Quinapril / Accupril
Ramipril / Altace
Trandolapril / Mavik
ACE Inhibitors with Diuretics
Benazepril/HCTZ / Lotensin HCT
Captopril /HCTZ / Capozide
Enalapril/HCTZ / Vaseretic
Fosinopril/HCTZ / Monopril HCT
Lisinopril/HCTZ / Prinzide, Zestoretic
Quinapril/HCTZ / Accuretic
Moexipril/HCTZ / Uniretic
ACE Inhibitor / CCB Combination
Benazepril/Amlodipine / Lotrel Lexxel (Felodipine/Enalapril)
Tarka (Trandolapril/Verapamil)
A-2 Antagonists (ARBs)
Losartan / Cozaar Atacand (Candesartan) Avapro (Irbesartan)
Benicar (Olmesartan) Teveten (Eprosartan)
Diovan (Valsartan)
Micardis (Telmisartan)
A-2 Antagonists (ARBs) with Diuretics
Losartan/HCTZ / Hyzaar Atacand HCT (Candesartan/HCTZ) Avalide (Irbesartan/HCTZ)
Benicar HCT (Olmesartan/HCTZ) Teveten HCT (Eprosartan/HCTZ)
Diovan HCT (Valsartan/HCTZ)
Micardis HCT (Telmisartan/HCTZ)
A-2 Antagonist (ARB) with CCB AZOR (Olmesartan/Amlodipine)
Exforge (Valsartan/Amlodipine)
Exforge HCT (Valsartan/Amlodipine/HCTZ)
Twynsta (Telmisartan/Amlodipine)
Tribenzor (Olmesartan/Amlodipine/HCTZ)
Renin Inhibitors / Combinations Tekamlo (Aliskiren/Amlodipine)
Tekturna (Aliskiren) Amturnide (Aliskiren/Amlodipine/HCTZ)
Tekturna HCT (Aliskiren/HCTZ)
Valturna (Aliskiren/Valsartan)
Rite Aid Health Solutions Clinically Preferred Drug List – Subject to update 14 BOLD INDICATES BRAND NAME
Cardiovascular Agents (Continued)
GENERIC DRUGS PREFERRED BRANDS NON-PREFERRED BRANDS
Antianginal / Anti-Ischemic
Ranexa (Ranolazine)
Antiarrhythmics
Amiodarone / Cordarone, Pacerone Ethmozine (Moricizine) Norpace CR (Disopyramide)
Disopyramide / Norpace Multaq (Dronedarone)
Flecainide / Tambocor Procanbid (Procainamide)
Mexiletine / Mexitil Tikosyn (Dofetilide)
Procainamide / Pronestyl/SR
Propafenone / Rythmol/SR
Quinidine Gluconate / Quinaglute
Cardiac Glycosides
Digoxin / Digitek, Lanoxin Lanoxicaps (Digoxin)
Sympatholytic Agents
Clonidine / Catapres, Catapres TTS Clorpres (Clonidine/Chlorthalidone)
Guanfacine / Tenex Guanabenz
Methyldopa / Aldomet
Methyldopa/HCTZ / Aldoril
Vasodilators, Hypotensive
Hydralazine / Apresoline Hydra-zide (Hydralazine/HCTZ)
Minoxidil / Loniten
Vasodilators, Coronary
Nitrates Nitrates Nitrates
Isosorbide Dinitrate / Isordil, Sorbitrate, Isochron Nitrolingual (Nitroglycerin Spray) Nitromist (Nitroglycerin spray)
Isosorbide Mononitrate / ISMO, Imdur, Monoket Dilatrate-SR (Isosorbide dinitrate)
Nitroglycerin (Orals) / Nitroquick, Nitrostat Nitro-BID (Nitroglycerin)
Nitroglycerin (Discs) / Nitrodisc Minitran (Nitroglycerin)
Nitroglycerin (Patch) / Nitro-Dur Nitrostat (Nitroglycerin)
Combinations
Combinations
BiDil (Isosorb Dinitrate/Hydralazine)
Rite Aid Health Solutions Clinically Preferred Drug List – Subject to update 15 BOLD INDICATES BRAND NAME
Antihyperlipidemics
GENERIC DRUGS PREFERRED BRANDS NON-PREFERRED BRANDS
Statins
Lovastatin / Mevacor Altoprev (Lovastatin) Advicor (Niacin/Lovastatin)
Pravastatin / Pravachol Crestor (Rosuvastatin) Lescol/XL (Fluvastatin)
Simvastatin / Zocor Lipitor (Atorvastatin) Livalo (Pitavastatin)
Vytorin (Ezetimibe/Simvastatin)
Statin – CCB Combination
Caduet (Amlodipine / Atorvastatin)
Bile Acid Sequestrants
Cholestyramine / Questran Welchol tabs / susp (Colesevelam)
Colestipol granules, tab / Colestid
Fibrates
Gemfibrozil / Lopid Antara (Fenofibrate, micronized) Fibricor (Fenofibric acid)
Fenofibrate, micronized / Lofibra, Tricor Lipofen (Fenofibrate) Fenoglide (Fenofibrate)
Tricor Tablets (Fenofibrate nanocrystallized)
Triglide (Fenofibrate)
Trilipix (Fenofibric acid)
Other Antihyperlipidemic Agents
Zetia (Ezetimibe) Niacor (niacin)
Niaspan (Niacin Extend Release)
Lovaza (Omega-3 Acid Ethyl Esters)
Simcor (Simvastatin / Niaspan)
Pancreatic Agents
GENERIC DRUGS PREFERRED BRANDS NON-PREFERRED BRANDS
Amylase/Lipase/Protease / Pancrease MT Creon (Amylase/Lipase/Protease) Kutrase, Pancrecarb (Amylase/Lipase/Protease)
Lipram (Amylase/Lipase/Protease) Enzymax (Pancreatin)
Ultrase (Amylase/Lipase/Protease) Ku-zyme HP (Pancreatin)
Viokase (Amylase/Lipase/Protease) Pancreaze (Pancrelipase)
Zenpep (Amylase/Lipase/Protease)
Rite Aid Health Solutions Clinically Preferred Drug List – Subject to update 16 BOLD INDICATES BRAND NAME
Kidney & Urologic Agents
GENERIC DRUGS PREFERRED BRANDS NON-PREFERRED BRANDS
Diuretics
Acetazolamide / Diamox Diamox Sequels (Acetazolamide)
Amiloride/ HCTZ / Midamor, Moduretic Dyrenium (Triamterene)
Bumetanide / Bumex Edecrin (Ethacrynic acid)
Chlorothiazide / Diuril
Chlorthalidone / Hygroton
Eplerenone / Inspra
Furosemide / Lasix
HCTZ / Esidrix / Hydrodiuril
Indapamide / Lozol
Methyclothiazide / Enduron
Methazolamide / Neptazane
Metolazone / Zaroxolyn
Spironolactone/HCTZ / Aldactone, Aldactazide
Torsemide / Demadex
Triamterene / HCTZ / Dyazide, Maxzide
Benign Prostatic Hyperplasia Agents
Doxazosin / Cardura Avodart (Dutasteride) Cardura XL (Doxazosin mesylate)
Finasteride / Proscar Jalyn (Dutasteride/Tamsulosin) Rapaflo (Silodosin)
Prazosin / Minipress Uroxatral (Alfuzosin)
Terazosin / Hytrin
Tamsulosin / Flomax
Urologic Agents Erectile dysfunction agents
Erectile dysfunction agents Cialis (Tadalafil) Erectile dysfunction agents
Viagra (Sildenafil) Levitra (Vardenafil)
MUSE, Caverject (Alprostadil) Edex (Alprostadil)
Miscellaneous Staxyn ODT (Vardenafil)
Flavoxate / Urispas Miscellaneous Yocon, Viritab (Yohimbine)
Oxybutynin / Ditropan/XL Detrol/ LA (Tolterodine) Yohimbine
Phenazopyridine / Pyridium VESICare (Solifenacin)
Trospium / Sanctura Elmiron (Pentosan polysulfate) Miscellaneous
Cystagon (Cysteamine) Monurol (Fosfomycin)
Enablex (Darifenacin) Hiprex (Methenamine)
Oxytrol (Oxybutynin) Toviaz (Fesoterodine)
Sanctura XR (Trospium)
Gelnique (Oxybutynin Gel)
Urinary pH Modifiers Bicitra (Citric Acid + Sodium Citrate)
Potassium Citrate / Urocit-K Citric Acid + Sodium or Potassium Citrate
Poly-Citra/K (Citric Acid + Potassium Citrate)
Renacidin (Mag carb/citric acid/lact)
Shohl’s Modified (Citric acid/Sod citrate)
UroQid-acid (Methen mand/NaPhos)
K-Phos Original (Potassium Acid Phosphate)
K-Phos MF(Sodium Phos/Potassium Phos)
K-Phos N° 2 (Sodium Phos/Potassium Phos)
Rite Aid Health Solutions Clinically Preferred Drug List – Subject to update 17 BOLD INDICATES BRAND NAME
Kidney & Urologic Agents (Continued)
GENERIC DRUGS PREFERRED BRANDS NON-PREFERRED BRANDS
Electrolyte Depleters
Sodium Polystyrene Sulfonate / Kayexalate, Fosrenol (Lanthanum Carbonate) Magnebind (Calcium Carb/Mag Carb)
Kionex, SPS Renagel (Sevelamer HCl)
Calcium acetate / PhosLo Renvela (Sevelamer Carbonate)
Potassium & Electrolytes
Potassium Chloride / K-Dur, Ktab, K-Lor, Kay-Ciel, Klor-Con (Potassium chloride) Kaochlor-EFF (Potass chloride/pot bicar)
Kaochlor Kaon elixir (Potassium chloride)
Potassium Bicarb+Potassium Cit / K-Lyte K-Lyte DS (Potass bicarb/Potass cit/Ca)
Potassium Gluconate / Kaon Micro-K (Potassium Chloride)
Rum-K (Potassium chloride)
Tri-K (Potassium Acetate/Bicarb/Citrate)
Gout & Hyperuricemia
Allopurinol / Zyloprim Colcrys (Colchicine) Colchicine/Probenecid
Colchicine Krystexxa (Pegloticase) Uloric (Febuxostat)
Probenecid
Vasopressin Antagonist
Samsca (Tolvaptan)
Skeletal Muscle Relaxants
GENERIC DRUGS PREFERRED BRANDS NON-PREFERRED BRANDS
Skeletal Muscle Relaxants
Baclofen / Lioresal Skelaxin (Metaxalone) Amrix (cyclobenzaprine)
Carisoprodol / Soma, Vanadom Sux-Cert (Succinylcholine)
Chlorzoxazone / Parafon Forte Norflex (Orphenadrine)
Cyclobenzaprine / Flexeril Orphenadrine
Dantrolene / Dantrium Norgesic/Forte (Orphenadrine/ASA/Caff)
Methocarbamol / Robaxin Orphenadrine/ASA/Caff
Tizanidine
Zanaflex (Tizanidine)
Rite Aid Health Solutions Clinically Preferred Drug List – Subject to update 18 BOLD INDICATES BRAND NAME
Osteoporosis Agents
GENERIC DRUGS PREFERRED BRANDS NON-PREFERRED BRANDS
Osteoporosis / Paget’s Disease Agents
Alendronate / Fosamax Boniva (Ibandronate) Actonel (Risedronate)
Etidronate / Didronel Evista (Raloxifene) Actonel w/Calcium (Risedronate/Calcium)
Fosamax Plus D (Alendronate-Vitamin D3) Aredia (Pamidronate)
Miacalcin (Calcitonin – Nasal / Injectable) Atelvia (Risedronate)
Fortical (Calcitonin) Ganite (Gallium Nitrate)
Pamidronate
Injectables Injectables Prolia (Denosumab)
Forteo (Teriparatide) Reclast (zoledronic acid)
Skelid (Tiludronate)
Anti-Inflammatory & Analgesic Agents
GENERIC DRUGS PREFERRED BRANDS NON-PREFERRED BRANDS
Anti-Inflammatory Agents (NSAIDs)
Etodolac / Lodine/XL Vimovo (Naproxen/Esomeprazole) Arthrotec (Diclofenac/Misoprostol)
Flurbiprofen / Ansaid Cataflam (Diclofenac Potassium)
Ibuprofen / Motrin Diclofenac Potassium
Indomethacin / Indocin/SR Diclofenac Sodium
Ketoprofen / Orudis, Oruvail Fenoprofen
Meclofenamate / Meclomen Flector Patch (Diclofenac epolamine)
Nabumetone / Relafen Ketorolac
Naproxen / Naprosyn/EC Nalfon (Fenoprofen)
Naproxen Sodium / Anaprox/DS Naprelan (Naproxen sodium)
Oxaprozin / Daypro Pennsaid (Diclofenac)
Piroxicam / Feldene Ponstel (Mefenamic acid)
Sulindac / Clinoril Toradol (Ketorolac)
Tolmetin / Tolectin/DS Sprix (Ketorolac)
Meloxicam/ Mobic Voltaren Gel (Diclofenac)
Voltaren/XR (Diclofenac Sodium)
Zipsor (Diclofenac Potassium)
COX-II Agents
Celebrex (Celecoxib)
Rite Aid Health Solutions Clinically Preferred Drug List – Subject to update 19 BOLD INDICATES BRAND NAME
Anti-Inflammatory & Analgesic Agents (continued)
GENERIC DRUGS PREFERRED BRANDS NON-PREFERRED BRANDS
Narcotic Analgesics
Acetaminophen w/Codeine / Tylenol #2/3/4 Avinza (Morphine Sulfate Extend Release) Abstral (fentanyl SL tablet)
Aspirin w/Codeine / Empirin #2/3/4 Dilaudid Oral Solution (Hydromorphone) Alcet (Oxycodone w/Acetaminophen)
Buprenorphine / Subutex Embeda (Morphine ER/Naltrexone) Butrans (Buprenorphine)
Butorphanol / Stadol MSIR (Morphine Sulfate) Codeine/Carisoprodol/Aspirin
Codeine/Aspirin/Butalbital/Caff / Fiorinal #3 Nucynta (Tapentadol) Exalgo (Hydromorphone ER)
Codeine/Acetam/Butalbital/Caffeine / Fioricet OxyFast (Oxycodone) Kadian (Morphine Sulfate Sust Release)
Fentanyl Citrate / Duragesic Patches, Actiq OxyContin (Oxycodone) Levo-Dromoran (Levorphanol)
Hydrocodone/Acet /Vicodin, Lorcet, Lortab, Norco Suboxone (Buprenorphine/Naloxone) Levorphanol
Hydrocodone/Ibuprofen / Vicoprofen Magnacet (Oxycodone w/Acetaminophen)
Hydromorphone / Dilaudid Numorphan (Oxymorphone)
Meperidine / Demerol Onsolis (Fentanyl Soluable Film)
Methadone / Dolophine Opana/ER (Oxymorphone)
Morphine Sulfate / Roxanol, MS Contin OxyIR (Oxycodone)
Oxycodone w/Acetaminophen / Percocet, Tylox Rybix ODT (Tramadol)
Oxycodone w/Aspirin / Percodan Ryzolt (Tramadol)
Oxycodone/Ibuprofen / Combunox Soma Compound (Codeine/Carisoprodol/Aspirin)
Pentazocine/Naloxone / Talwin NX Vopac (Codeine/ Acetaminophen)
Pentazocine/Acetaminophen / Talacen Xodol (Hydrocodone/Acetaminophen)
Tramadol / Ultram, Ultram ER Zydone (Hydrocodone/Acetaminophen)
Tramadol w/Acetaminophen / Ultracet Fentora (Fentanyl buccal)
Salicylate Analgesics
Aspirin/Butalbital/Caff / Fiorinal Equagesic (Aspirin/Meprobamate)
Chol Sal w/ Mag Salicylate / Trilisate, Tricosal
Aspirin/Sal-amide/Acetamin/Caff / Levacet
Diflunisal / Dolobid
Salsalate / Disalcid
Non-Salicylate Analgesics Flextra (Acetaminophen/Phenyltolox/Caff)
Acetaminophen/Butalbital / Axocet
Acetaminophen/Caffeine/Butalbital / Esgic, Fioricet
Rite Aid Health Solutions Clinically Preferred Drug List – Subject to update 20 BOLD INDICATES BRAND NAME
Central Nervous System Agents
GENERIC DRUGS PREFERRED BRANDS NON-PREFERRED BRANDS
Anti-Anxiety Agents
Alprazolam / Xanax/XR, Niravam Tranxene SD (Clorazepate)
Buspirone / Buspar Alprazolam oral concentrate
Chlordiazepoxide / Librium Meprobamate
Clonazepam / Klonopin Miltown (Meprobamate)
Clorazepate / Tranxene
Diazepam / Valium
Lorazepam / Ativan
Oxazepam / Serax
Sedative-Hypnotics, Non-Barbiturate
Chloral Hydrate solution Aquachloral (Chloral hydrate)
Estazolam / Prosom Silenor (Doxepin) Doral (Quazepam)
Flurazepam / Dalmane Edluar (Zolpidem)
Temazepam / Restoril Lunesta (Eszopiclone)
Triazolam / Halcion Rozerem (Ramelteon)
Zaleplon / Sonata Somnote (Chloral hydrate)
Zolpidem / Ambien/CR Zolpimist (zolpidem)
Sedative-Hypnotics, Barbiturate
Mephobarbital / Mebaral Butisol (Butabarbital)
Phenobarbital Seconal (Secobarbital)
Attention Deficit Disorder (ADD/ADHD),
Narcolepsy & Adrenergic Agents Desoxyn (Methamphetamine)
Amphetamine/D-Amphetamine / Adderall/XR Daytrana Patches (Methylphenidate) Focalin XR (Dexmethylphenidate)
D-Amphetamine / Dexedrine, Dextrostat Intuniv (Guanfacine ER) Kapvay (Clonidine ER)
Dexmethylphenidate / Focalin Metadate CD (Methylphenidate) Methylin Solution (Methylphenidate)
Methylphenidate / Ritalin/SR/ Metadate/ER Provigil (Modafinil) Nuvigil (Armodafinil)
Methylphenidate / Concerta Strattera (Atomoxetine) Ritalin LA (Methylphenidate)
Vyvanse (Lisdexamfetamine) Liquadd (Dextroamphetamine)
Xyrem (Sodium Oxybate)
Rite Aid Health Solutions Clinically Preferred Drug List – Subject to update 21 BOLD INDICATES BRAND NAME
Central Nervous System Agents (Continued)
GENERIC DRUGS PREFERRED BRANDS NON-PREFERRED BRANDS
Serotonin Specific Reuptake Inhibitors
(SSRIs) Lexapro (Escitalopram)
Citalopram / Celexa Luvox CR (Fluvoxamine)
Fluoxetine / Prozac, Sarafem, Rapiflux Pexeva (Paroxetine Mesylate)
Fluvoxamine / Luvox Prozac Weekly (Fluoxetine)
Paroxetine / Paxil/CR, Paxil Suspension
Sertraline / Zoloft
Serotonin Non-Specific Reuptake Inhibitors
(SNRIs) Cymbalta (Duloxetine) Savella (Milnacipran)
Venlafaxine / Effexor, Effexor XR Pristiq (Desvenlafaxine) Venlafaxine ER
SSRI / Antipsychotic Combinations
Symbyax (Fluoxetine / Olanzapine)
Monoamine Oxidase Inhibitors (MAOIs)
Tranylcypromine / Parnate Emsam (Selegiline)
Phenylzine / Nardil Marplan (Isocarboxazid)
Antidpressants, Other
Amitriptyline / Elavil, Endep Surmontil 100mg (Trimipramine) Aplenzin (Bupropion)
Amoxapine / Asendin Imipramine Pamoate
Bupropion / Wellbutrin/SR/ XL Nefazodone
Clomipramine / Anafranil Oleptro (Trazodone ER)
Desipramine / Norpramin Serzone (Nefazodone)
Doxepin / Adapin, Sinequan Amitriptyline / perphenazine
Imipramine / Tofranil/PM Viibryd (Vilazadone)
Maprotiline / Ludiomil
Mirtazapine / Remeron, Remeron Soltab
Nortriptyline / Aventyl, Pamelor
Protriptyline / Vivactil
Trazodone / Desyrel
Trimipramine / Surmontil 25mg and 50mg
Rite Aid Health Solutions Clinically Preferred Drug List – Subject to update 22 BOLD INDICATES BRAND NAME
Central Nervous System Agents (Continued)
GENERIC DRUGS PREFERRED BRANDS NON-PREFERRED BRANDS
Antipsychotic Agents, Typical
Chlorpromazine / Thorazine Orap (Pimozide) Mellaril (Thioridazine)
Fluphenazine / Prolixin Moban (Molindone) Thioridazine
Haloperidol / Haldol
Loxapine / Loxitane
Perphenazine / Trilafon
Trifluoperazine / Stelazine
Thiothixene / Navane
Antipsychotic Agents, Atypical
Clozapine / Clozaril Clozaril (Clozapine) Abilify (Aripiprazole)
Risperidone / Risperdal Geodon (Ziprasidone) Fanapt (Iloperidone)
Seroquel/XR (Quetiapine) Fazaclo (Clozapine)
Zyprexa/ZYDIS (Olanzapine) Invega (Paliperidone)
Invega Sustenna (Paliperidone inj)
Latuda (Lurasidone)
Saphris (Asenapine)
Zyprexa Relprevv (Olanzapine inj)
Bipolar Disorder (Anti-Mania) Agents
Lithium Carbonate / Eskalith
Lithium Carbonate / Lithobid
Pseudobulbar Affect
Nuedexta (dextromethorphan / quinidine)
Rite Aid Health Solutions Clinically Preferred Drug List – Subject to update 23 BOLD INDICATES BRAND NAME
Gastrointestinal Agents
GENERIC DRUGS PREFERRED BRANDS NON-PREFERRED BRANDS
Anti-Ulcer / GERD Agents
Cimetidine / Tagamet Axid Solution (Nizatidine) Aciphex (Rabeprazole)
Famotidine / Pepcid/AC/RPD Nexium (Esomeprazole) Helidac (Tetracyc/Bis subsal/Metronidazole)
Lansoprazole / Prevacid Carafate Suspension (Sucralfate) Dexilant (Dexlansoprazole)
Metoclopramide / Reglan Pylera (Biskalcitrate/Metronidazole/Tetracycline) Metozolv ODT (Metoclopramide)
Misoprostol / Cytotec Prevacid NapraPac (Lansoprazole/Naproxen)
Nizatidine / Axid PrevPac (Lansoprazole/Amox/Clarithrom)
Omeprazole / Prilosec Prilosec OTC (Omeprazole)
Omeprazole-bicarb / Zegerid Protonix Susp (Pantoprazole)
Pantoprazole / Protonix
Ranitidine / Zantac/Syrup, Taladine
Sucralfate / Carafate
Anti-Spasmodic Agents Colytrol (Belladonna alkaloids)
Atropine sulfate / Sal-Tropine Pamine/Forte (Methscopalamine) Donnamar (Hyoscyamine)
Belladona w/phenobarb / Donnatal Spacol T/S (Hyoscyamine) IB-STAT (Hyoscyamine)
Dicyclomine / Bentyl Levsinex, Levsin, NuLev (Hyoscyamine)
Hyoscyamine/ Cystospaz, Spacol I.D. Pro-Banthine (Propantheline)
Simetyl (Atrop/Scopolam/Hyoscyamine)
Spacol (Belladonna alkaloids)
Symax Duotab (Hyoscyamine)
Bowel & Colon Agents
Mesalamine / Rowasa Apriso (Mesalamine) Chenodal (Chenodeoxycholic acid)
Loperamide/ Imodium Asacol / HD (Mesalamine) Dipentum (Olsalazine)
Diphenoxylate/Atropine/ Lomotil Canasa (Mesalamine) Lialda (Mesalamine, extended-release)
Ursodiol / Actigall Colazal (Balsalazide Disodium)
Ursodiol / Urso/Forte Entocort EC (Budesonide)
Motofen (Difenoxin/Atropine sulfate)
Pentasa (Mesalamine)
Irritable Bowel Syndrome Agents
Lotronex (Alosetron)
Laxatives & Cathartics Colyte (Sod sulf/sod/NAHCO3/KCL/PEG's)
Lactulose Amitiza (Lubiprostone) Osmoprep Tab (NaPhos MB m-h/na Phos,Di-Ba)
PEG 3350 / Miralax Golytely pack (Sod sulf/sod/NaHCO3/KCL/PEG's) Trilyte (Sod chloride/NAHCO3/KCl/PEG's)
PEG 3350/electrolyte soln Halflytely (Bisac/NaCl/NaHCO3/KCL/PEG 3350) Visicol (Na PHOS mono&dibasic/cellulose)
Kristalose (Lactulose) OCL soln (Sod sulf/sod/NAHCO3/KCL/PEG's
Nulytely (Sod chloride/NAHCO3/KCl/PEG's) Moviprep (PEG 3350/Sod Sul/NaCl/ASB/KCL)
Relistor (Methylnaltrexone) Suprep (Mg, K, Na Sulfates)
Rite Aid Health Solutions Clinically Preferred Drug List – Subject to update 24 BOLD INDICATES BRAND NAME
Oral Contraceptives & Hormone Replacement
GENERIC DRUGS PREFERRED BRANDS NON-PREFERRED BRANDS
Contraceptives
Orals – Monophasic Orals - Monophasic Orals - Monophasic
Apri Aviane Balziva Cryselle Gianvi Kariva Beyaz Alesse Brevicon Desogen Demulen
Kelnor Low-Ogestrel Lessina Lutera Ocella Safyral Loestrin 24 Fe Levlen Levlite Loestrin/Fe
Ogestrel Levora Mononessa Junel/Fe Yaz Mircette Nordette Modicon Norinyl Ortho-
Necon Microgestin/Fe Nortrel Portia Cept Ortho-Novum Ortho Cyclen Ovcon/Fe
Previfem Reclipsen Solia Sronyx Sprintec Ovral Lo Loestrin FE Lo/Ovral Femcon Fe
Zovia Yasmin
Orals - Biphasic
Orals – Biphasic Necon 10/11
Orals – Biphasic
Ortho-Novum 10/11
Orals – Triphasic
Orals – Triphasic
Aranelle Caziant Cesia Enpresse Leena
Necon 7/7/7 Nortrel 7/7/7 Trinessa Tri-Legest Fe
Orals – Triphasic
Tri-Sprintec Tri-Previfem Trivora Velivet
Estrostep/Fe Ortho-Novum 7/7/7 Tri-Levlen
Orals – Extended-Cycle Tri-Norinyl Triphasil Ortho Tri-Cyclen
Orals – Extended-Cycle Seasonique Ortho Tri-Cyclen Lo Cyclessa
Quasense Jolessa Lybrel
LoSeasonique Orals – Extended-Cycle
Seasonale
Progestins
Progestins
Camila Jolivette Progestins
Plan B One-Step
Errin Nora-Be Nor-QD Ortho-Micronor
Ovrette
Next Choice Mirena
Others Others
Natazia Ortho-Evra
Nuvaring
Estrogens, Oral
Estropipate / Ogen, Ortho-Est Cenestin (Conjugated Estrogen) Femtrace (Estradiol)
Estradiol / Estrace, Esclim Enjuvia (Conjugated Estrogen) Menest (Esterified Estrogen)
Gynodiol (Estradiol)
Ortho-Est (Estropipate)
Premarin (Conjugated Estrogen)
Estrogens, Patches & Gels Alora (Estradiol)
Estradiol / Climara Climara (Estradiol) Elestrin (Estradiol)
Estraderm (Estradiol) Estrogel (Estradiol)
Evamist (Estradiol) Menostar (Estrogen)
Vivelle DOT (Estradiol Patch)
Divigel (Estradiol)
Estrogens, Vaginal Estrace (Estradiol)
Estring (Estradiol) Femring (Estradiol)
Vagifem (Estradiol) Premarin Cream (Conjugated Estrogens)
Rite Aid Health Solutions Clinically Preferred Drug List – Subject to update 25 BOLD INDICATES BRAND NAME
Oral Contraceptives & Hormone Replacement (Continued)
GENERIC DRUGS PREFERRED BRANDS NON-PREFERRED BRANDS
Estrogen Combinations
ME-Testosterone/Estrogen/Ester / EEMT/HS Orals Orals
(Estradiol / Norethin AC) / Activella 1-0.5 Prempro (Conj. Estrogen/Medroxyprogest) Activella 0.5-0.1 (Estradiol / Noreth AC)
Premphase (Conj. Estrogen/Medroxyprogest) Angeliq (Estradiol / Drospirenone)
Estratest/HS (ME-Testosterone/Estrogen/Ester)
FemHRT (Estradiol / Norethin)
Patches Prefest (Estradiol/Norgestimate)
Combipatch (Estradiol / Norethindrone)
Patches
Climara PRO (Estradiol/ Levonorgestrel)
Androgenic Agents
Androderm (Testosterone Patch) Anadrol (Oxymetholone)
Prasterone / DHEA Androgel (Testosterone Gel) Android (Methyltestosterone)
Androxy (Fluoxymesterone) Axiron (Testosterone)
Methitest (Methyltestosterone) Delatestryl (Testosterone enanthate)
Testim (Testosterone) Depo-Testosterone (Testosterone cypio)
First-Testosterone (Testosterone prop)
Fortesta (Testosterone gel)
Nandrolone DE (Nandrolone dec)
Oxandrin (Oxandrolone)
Oxandrolone
Striant (Testosterone)
Testopel (Testosterone)
Testred (Methyltestosterone)
Testosterone cypionate
Testosterone enanthate
Testosterone propionate
Progestational Agents
Medroxyprogesterone / Provera Prometrium (Progesterone, micronized) Depo-Provera (Medroxyprogesterone)
Norethindrone acetate / Aygestin Crinone (Progesterone) Endometrin (Progesterone)
Progesterone oil First-Progesterone MC (Progesterone)
Prochieve (Progesterone, Micron.)
Other Contraception Agents
ella (Ulipristal) Mifeprex (Mifepristone)
Miscellaneous
Megestrol acetate suspension / Megace Synarel (Naferellin) Megace ES (Megestrol acetate suspension)
Rite Aid Health Solutions Clinically Preferred Drug List – Subject to update 26 BOLD INDICATES BRAND NAME
Prenatal Vitamins
GENERIC DRUGS PREFERRED BRANDS NON-PREFERRED BRANDS
Prenatal Vitamins
Natalcare CFE, Nutrinate, Natacaps, Perry Neevo/DHA Cenogen OB/Ultra, Citracal Prenatal RX,
Prenatal, Vinatal, Prenatal Start, Prenatal Plus, Niferex-PN/Forte Duet/DHA, Embrex-600, Materna, Mynate 90
Maternity, Prenatal Advantage, Vinate GT, Precare Plus, Natachew, Natafort, Nestabs CBF/FA,
Prenatabs CBF, Prenatal 19, PR Natal 400 EC Precare Conceive/Prenatal Novanatal, Prena-Cap, Prenatal MR 90 FE,
Prenate Elite, Prenate DHA, Prenate Essential Prenate Advance, Prenate GT, Strongstart,
PrimaCare/One Stuartnatal Plus, Premesis RX
Prefera-OB/One, Prefera-OB + DHA
Corticosteroids
GENERIC DRUGS PREFERRED BRANDS NON-PREFERRED BRANDS
Glucocorticoids / Mineralocorticoids (Oral)
Cortisone Acetate / Cortone Entocort EC (Budesonide) Celestone (Betamethasone)
Dexamethasone / Decadron, Dexpak Medrol (Methylprednisolone)
Fludrocortisone / Florinef Orapred ODT (Prednisolone sod phos)
Hydrocortisone / Cortef
Methylprednisolone / Medrol
Prednisone / Deltasone, Sterapred
Prednisolone / Prelone, Pediapred, Orapred
Glucocorticoids (Rectal)
ProctoFoamHC (Hydrocortisone/Pramoxine)
Cortifoam (Hydrocortisone acetate)
Thyroid Replacement and Anti-Thyroid Agents
GENERIC DRUGS PREFERRED BRANDS NON-PREFERRED BRANDS
Levothyroxine / Synthroid Levoxyl (Levothyroxine) Thyrolar (Liotrix)
Liothyronine / Cytomel Nature-Throid (Thyroid, pork) Tirosint (Levothyroxine)
Methimazole / Tapazole Westhroid (Thyroid, pork)
Propylthiouracil / Propylthiouracil
Potassium Iodide / Lugol’s
Thyroid / Armour Thyroid, Unithroid
Rite Aid Health Solutions Clinically Preferred Drug List – Subject to update 27 BOLD INDICATES BRAND NAME
Diabetes Agents
GENERIC DRUGS PREFERRED BRANDS NON-PREFERRED BRANDS
Insulins
Apidra/SoloStar (Insulin Glulisine) Exubera (Insulin Regular Human Rec)
Lantus (Insulin Glargine) Novolin, Novalog Innolet Insulins & Pens
Levemir (Insulin Detemir)
Humulin & Humalog Insulins & Pens
Injectable Hypoglycemics, Other
Symlin (Pramlintide Acetate) Victoza (Liraglutide)
Byetta (Exenatide)
Oral Hypoglycemics
Acarbose / Precose Januvia (Sitagliptin Phosphate) Fortamet (Metformin Extended Release)
Acetohexamide / Dymelor Janumet (Sitagliptin / Metformin) Cycloset (Bromocriptine)
Chlorpropamide / Diabinese Onglyza (Saxagliptin) Glumetza (Metformin)
Glimepiride / Amaryl Prandin (Repaglinide) Glycron (Glyburide, micronized)
Glipizide / Glucotrol, Glucotrol XL Kombiglyze XR (Saxagliptin / Metformin) Glyset (Miglitol)
Glipizide/Metformin / Metaglip Prandimet (Repaglinide / Metformin)
Glyburide / Diabeta, Glynase, Micronase Riomet (Metformin)
Glyburide/Metformin / Glucovance
Metformin / Glucophage/XR
Nateglinide / Starlix
Tolazamide / Tolinase Thiazolidinediones
Tolbutamide / Orinase Actos (Pioglitazone) Thiazolidinediones
Avandia (Rosiglitazone)
Thiazolidinediones
Thiazolidinedione Combinations
ActoPlusMet (Pioglitazone/Metformin) Thiazolidinedione Combinations
Avandamet (Rosiglitazone/ Metformin) ActoPlusMet XR (Pioglitazone/Metformin)
Thiazolidinedione Combinations Avandaryl (Rosiglitazone/ Glimepiride)
Duetact (Pioglitazone/Glimepiride)
Rite Aid Health Solutions Clinically Preferred Drug List – Subject to update 28 BOLD INDICATES BRAND NAME
Diabetes Products
GENERIC DRUGS PREFERRED BRANDS NON-PREFERRED BRANDS
Diabetes Supplies
Accuchek / III / Simplicity Ascensia Products
B-D Syringes B-D Logic & Latitude Products
Lifescan Products: OneTouch Ultra meters, Freestyle Products
OneTouch meters InDuo
Soft Clix Lancet Device & Lancets Precision Products
Soft Touch Lancet Device & Lancets Therasense Products
Prestige / TrueTrack Products
Urine Glucose / Ketone Strips
ChemStrips K ChemStrips/BG
Hyperglycemics
Proglycem (Diazoxide)
Rite Aid Health Solutions Clinically Preferred Drug List – Subject to update 29 BOLD INDICATES BRAND NAME
Respiratory Agents
GENERIC DRUGS PREFERRED BRANDS NON-PREFERRED BRANDS
Antihistamines, Non/Low Sedating
Fexofenadine / Allegra Allegra Suspension (Fexofenadine) Clarinex-D 12 Hour, 24 Hour (Desloratadine)
Fexofenadine w/ Decongestant / Allegra D 12/24H Clarinex (Desloratadine) Clarinex Syrup (Desloratadine)
Levocetirizine / Xyzal Allegra ODT (Fexofenadine)
Loratadine / Claritin*
Cetirizine / Zyrtec/D*
*OTC
Antihistamines, First Generation
Brompheniramine / Lodrane, Brovex Deconamine Syr, Chew, SR (Chlorphenir/pseud) Ahist (Chlorpheniramine Tannate)
Diphenhydramine / Benadryl, Hydramine, Dytan Palgic Liquid (Carbinoxamine) Carbinoxamine 4mg, 10mg
Hydroxyzine / Atarax Tussionex (Chlorphenir/Hydrocodone) Conex (Brompheniramine Tannate)
Hydroxyzine Pamoate / Vistaril Histex SR (Carbinoxamine)
Cyproheptadine / Periactin J-Tan (Brompheniramine Tannate)
Chlorpheniramine Lodrane 24 (Brompheniramine Maleate)
Clemastine P-Tex (Brompheniramine Tannate)
Dexbrompheniramine/PSE Palgic (Carbinoxamine)
Dexchlorpheniramine Pediatan (Chlorpheniramine Tannate)
P-Ephed+Bromphen Qdall AR (Chlorpheniramine Maleate)
Ricobid-H (Chlorpheniramine Maleate)
Semprex-D (Pseudoephedrine/Acrivastine)
Vazol (Brompheniramine Maleate)
Zymine (Tripolidine)
Other Allergy Agents
Ipratropium / Atrovent Nasal Spray Astelin (Azelastine) Patanase (Olopatadine)
Astepro (Azelastine)
Asthma Agents
Albuterol / Ventolin Advair Diskus/ HFA (Fluticasone/Salmeterol) Proventil HFA (Albuterol)
Albuterol Sulfate / Vospire ER, Accuneb Dulera (Formoterol/Mometasone) Ventolin HFA (Albuterol)
Cromolyn Sodium solution / Intal Foradil (Formoterol)
Levalbuterol solution / Xopenex 1.25mg-0.5mL Intal (Cromolyn sodium)
Metaproterenol / Alupent Maxair (Pirbuterol)
Terbutaline / Brethine ProAir (Albuterol HFA)
Serevent Diskus (Salmeterol)
Symbicort (Budesonide/Formoterol)
Leukotriene Modifiers Xopenex/HFA (Levalbuterol) Leukotriene Modifiers
Zafirlukast / Accolate Zyflo/CR (Zileuton)
Leukotriene Modifiers
Singulair (Montelukast) Injectables
Xolair (Omalizumab)
Rite Aid Health Solutions Clinically Preferred Drug List – Subject to update 30 BOLD INDICATES BRAND NAME
Respiratory Agents (Continued)
GENERIC DRUGS PREFERRED BRANDS NON-PREFERRED BRANDS
Corticosteroid Inhalers
Budesonide / Pulmicort Respules 0.25, 0.5mg Asmanex (Mometasone Furoate) Aerobid/M (Flunisolide/Menthol)
Flovent/ HFA (Fluticasone) Alvesco (Ciclesonide)
Pulmicort (Budesonide)
Qvar (Beclomethasone)
Intranasal Corticosteroids
Fluticasone / Flonase Nasacort AQ (Triamcinolone) Beconase/AQ (Beclomethasone)
Flunisolide Nasonex (Mometasone) Nasarel (Flunisolide)
Rhinocort Aqua (Budesonide) Omnaris (Ciclesonide)
Veramyst (Fluticasone furoate)
COPD Agents
Albuterol/Ipratropium / DuoNeb Atrovent/ HFA (Ipratropium) Brovana (Arformoterol)
Ipratropium / Atrovent (Nebulization ampules) Combivent (Albuterol/Ipratropium)
Perforomist (Formoterol)
Spiriva (Tiotropium)
Xanthine Derivatives
Theophylline / Theochron, Theocap Elixophyllin (Theophylline anhydrous) Cafcit (Caffeine citrated)
Slo-Bid 50mg, 100mg (Theophylline anhydrous) Caffeine citrated
Dilor (Dyphylline)
Dyphylline
Lufyllin (Dyphylline)
Theo-24 (Theophylline anhydrous)
Uniphyl (Theophylline anhydrous)
Miscellaneous Respiratory Products
Cayston (Azetreonam) MD Turbo
Epipen/Jr (Epinephrine) Twinject (Epinephrine)
Tobi (Tobramycin)
Respi-Tann/ PD (Carbetapentane/Pseud)
Pulmozyme (Dornase alfa)
Rite Aid Health Solutions Clinically Preferred Drug List – Subject to update 31 BOLD INDICATES BRAND NAME
Skin & Skin Structure Agents
GENERIC DRUGS PREFERRED BRANDS NON-PREFERRED BRANDS
Acne / Rosacea Products (Oral & Topical)
Benzoyl Peroxide w/ E-mycin / Benzamycin/Pak Acanya (Clindamycin/Benzoyl Peroxide) Aczone (dapsone gel)
Clindamycin / Cleocin-T Solution Azelex (Azelaic acid) Avar (Sulfacetamide/sulfur)
Erythromycin/ Emgel, T-Stat Benzaclin (Benzoyl Peroxide / Clindamycin) Akne-mycin (Erythromycin base)
Isotretinoin / Accutane, Sotret, Claravis Differin (Adapalene) Atralin (Tretinoin 0.05% Gel)
Metronidazole / Metrolotion/Gel, Nydamax Duac (Clindamycin/benzoyl peroxide) Brevoxyl (Benzoyl Peroxide)
Sulfacetamide 10% / Klaron Finacea (Azelaic acid) Clindareach (Clindamycin)
Sulfacetamide w/ Sulfur / Novacet, Zetacet, Lavoclen-4, 8 (Benzoyl peroxide) Epiduo (Adapalene/Benzoyl Peroxide)
Plexion, Rosula Metrogel (Metronidazole) Noritate (Metronidazole)
Tretinoin / Retin-A, Avita Rosula Clarifying Wash/CLK Retin-A Micro (Tretinoin microspheres)
(Sulfacetamide/Sulfur/Urea/Meth Sulfoxyl (Benzoyl peroxide/Sulfur)
Anthranilate/Titanium dioxide) Tretin-X (Tretinoin)
Veltin (Clindamycin/Tretinoin)
Z-clinz (Clindamycin/Benzoyl peroxide)
Ziana Gel (Clindamicin/Tretinoin)
Antifungals (Topical)
Clotrimazole / Lotrimin, Mycelex Bensal-HP (Benzoic acid/Salicylic acid)
Clotrimazole+Betamethisone/ Lotrisone Mentax (Butenafine) Ertaczo (Sertaconazole)
Ciclopirox / Penlac Exelderm (Sulconazole)
Econazole nitrate / Spectazole Loprox (Ciclopirox)
Ketoconazole / Nizoral Naftin (Naftifine)
Miconazole / Monistat-Derm Oxistat (Oxiconazole)
Nystatin / Mycostatin Triple Dye (Gent viol/Brlnt Grn/Prof)
Nystatin w/Triamcinolone / Mycolog II Versiclear (Sodium Thiosulfate/SA)
Vusion (Miconazole/Zinc oxide)
Xolegel (Ketoconazole)
Extina (Ketoconazole)
Keratolytics / Wound Care
Ammonium Lactate / Lac-Hydrin Condylox Gel/Solution (Podofilox) Regranex (Becaplermin)
Benzoyl Peroxide / Benzac AC, Desquam/X, Triaz Keralac (Urea) Santyl (Collagenase)
Benzoyl Peroxide/Urea / Zoderm Zoderm (Benzoyl Peroxide/Urea) Sulfamylon (Mafenide)
Lactic Acid / Lactinol Salex Shampoo (Salicylic Acid)
Podofilox / Condylox solution Umecta (Urea)
Salicylic Acid / Duofilm, Salex Veregen (Sinecatechins)
Silver Sulfadiazine / Silvadene
Trypsin-Balsam Peru-Castor / Granulex, Xenaderm
Urea / Carmol
Rite Aid Health Solutions Clinically Preferred Drug List – Subject to update 32 BOLD INDICATES BRAND NAME
Skin & Skin Structure (Continued)
GENERIC DRUGS PREFERRED BRANDS NON-PREFERRED BRANDS
Psoriasis Agents (Oral & Topical)
Anthralin / Psoriatec Dovonex (Calcipotriene) 8-MOP (Methoxsalen)
Calcipotriene Sol’n / Dovonex Solution Dritho-Scalp (Anthralin) Taclonex (Calcipotriene/Betameth)
Oxsoralen (Methoxsalen) Vectical (Calcitriol)
Soriatane (Acitretin)
Tazorac (Tazarotene)
Scabies & Pediculosis Agents
Permethrin 5% / Elimite Eurax (Crotamiton) Lindane / Lindane
Malathion / Ovide Ulesfia (Benzyl alcohol)
Natroba (Spinosad)
Topical Corticosteroids
Alclometasone Dipropionate / Aclovate IV Capex Shampoo (Fluocinolone acet) III Cloderm (Clocortolone pivalate) II
Amcinonide / Cyclocort II Clobex (Clobetasol propionate) I Cordran (Flurandrenolide) I-III
Aug Betameth Diprop / Diprolene I/II Locoid Lipocream (Hydrocortisone But) IV Derma-Smoothe/FS (Fluocinolone acet) III
Betameth Diprop, Valerate / Diprosone, Valisone II Locoid Liquid (Hydrocortisone But) IV Dermatop (Prednicarbate) III
Clobetasol Propionate / Temovate, Olux I Desonate (Desonide) IV
Desonide / Desowen IV First-Hydrocortisone (Hydrocortisone) IV
Desoximetasone / Topicort II Halog (Halcinonide) II
Diflorasone Diacetate / Psorcon I Luxiq (Betamethasone valerate) III
Fluocinolone Acetonide / Synalar III Olux/E (Clobetasol propionate) I
Fluocinonide / Lidex II Pandel (Hydrocortisone probutate) III
Fluticasone propionate / Cutivate III Prednicarbate III
Halobetasol Propionate / Ultravate I Vanos (Fluocinonide) I
Hydrocortisone / Hytone, Cortizone IV Verdeso (Desonide) IV
Hydrocortisone butyr / Locoid III
Hydrocortisone Valerate / Westcort III
Mometasone Furoate / Elocon III
Triamcinolone / Aristocort, Kenalog III
Topical immunosuppressives &
Miscellaneous Elidel (Pimecrolimus)
Imiquimod / Aldara Protopic (Tacrolimus) Atopiclair (Dl-e ac/Grape/Hyaluronic acid)
Mimyx (Emollient Combination)
Zyclara (imiquimod)
Topical Local Anesthetics Analpram-HC, Analpram-E (HC/Pramoxine)
Lidocaine-prilocaine / EMLA Analpram Advanced (HC/Pramoxine) Americaine, Anacaine Oint (Benzocaine)
Lidocaine / Lidamantle Americaine Spray (Benzocaine) Cetacaine (Tetracaine/Benzocaine)
Lidoderm (Lidocaine) Epifoam (HC acetate/pramoxine HCl)
Pramosone / E (HC acetate/Pramoxine)
Relative potency of topical corticosteroids: I = Very High Potency II = High Potency III = Medium Potency IV = Low Potency
Rite Aid Health Solutions Clinically Preferred Drug List – Subject to update 33 BOLD INDICATES BRAND NAME
Vaginal Agents
GENERIC DRUGS PREFERRED BRANDS NON-PREFERRED BRANDS
Vaginal Antibiotics
Metronidazole / Metrogel-vaginal AVC (Sulfanilamide) Cleocin supp (Clindamycin phosphate)
Clindamycin / Cleocin cream Clindesse (Clindamycin phosphate) Dayto-Sulf (Sulfathiaz/Sulfacetam/S-Benz)
Triple Sulfa / Sultrin
Vaginal Antifungals
Miconazole / Monistat-7 Gynazole-1 (Butoconazole)
Nystatin Vaginal tabs
Terconazole / Terazol 3, 7
Menorrhagia Agent Lysteda (Tranexamic acid)
Ophthalmics
GENERIC DRUGS PREFERRED BRANDS NON-PREFERRED BRANDS
Ophthalmic Antibiotics
Bacitracin / AK Tracin Vigamox (Moxifloxacin) Terramycin Polymyxin B
Ciprofloxacin / Ciloxan Zymar 0.3% (Gatifloxacin) AzaSite (Azithromycin)
Erythromycin / Ilotycin Zymaxid 0.5%(Gatifloxacin) Besivance (Besifloxacin)
Gentamycin / Garamycin, Gentak Blephamide/SOP (Na sulfacet/Prednisln)
Neomycin/Polymyxin/Gramicidin / Neosporin Iquix (Levofloxacin)
Neomycin/Polymyxin/Bacitracin Moxeza (Moxifloxacin)
Ofloxacin / Ocuflox Quixin (Levofloxacin)
Polymyxin w/Bacitracin / Polysporin
Polymyxin/Trimethoprim / Polytrim
Sulfacetamide 10% / Bleph-10
Sulfacetamide oint
Sulfacetam w/prednisolone / Vasocidin
Tobramycin / Tobrex
Ophthalmic Antivirals
Trifluridine / Viroptic Natacyn (Natamycin) Vitrasert (Ganciclovir)
Vitravene (Fomivirsen sodium)
Zirgan (Ganciclovir)
Rite Aid Health Solutions Clinically Preferred Drug List – Subject to update 34 BOLD INDICATES BRAND NAME
Ophthalmics (Continued)
GENERIC DRUGS PREFERRED BRANDS NON-PREFERRED BRANDS
Ophthalmic Antihistamines
Azelastine / Optivar Patanol (Olopatadine) Bepreve (Bepotastine)
Ketotifen / Zaditor Pataday (Olopatadine) Elestat (Epinastine)
Emadine (Emedastine)
Lastacaft (Alcaftadine)
Ophthalmic Anti-Inflammatory Agents
Dexamethasone / Decadron, Ak-Dex Alrex (Loteprednol) Acular PF (Ketorolac)
Diclofenac / Voltaren FML SOP (Fluorometholone) Acuvail (Ketorolac)
Fluorometholone / FML Lotemax (Loteprednol) Durezol (Difluprednate)
Flurbiprofen / Ocufen Pred Mild (Prednisolone acetate) Flarex (Fluorometholone)
Ketorolac / Acular/ LS Retisert (Fluocinolone acetonide) FML Forte (Fluorometholone)
Prednisolone acetate / Pred Forte Ozurdex (Dexamethasone implant) Inflamase Mild (Prednisolone sod)
Prednisolone sod / Inflamase Forte, Maxidex (Dexamethasone)
Econopred Plus Nevanac (Nepafenac)
Vexol (Rimexolone)
Bromday (Bromfenac sod)
Ophthalmic Immunomodulators /Lubricants
Restasis (Cyclosporine)
Lacrisert (Hydroxypropyl Cellulose)
Ophthalmic Mast Cell Stabilizers
Cromolyn Sodium / Crolom Alocril (Nedocromil)
Alamast (Pemirolast)
Alomide (Lodoxamide)
Ophthalmic Miotics
Apraclonidine / Iopidine Alphagan P 0.1% (Brimonidine) Betimol (Timolol)
Betaxolol / Betoptic Azopt (Brinzolamide) Combigan (Brimonidine/timolol)
Brimonidine / Alphagan, Alphagan P 0.15% Betoptic-S (Betaxolol) Istalol (Timolol maleate)
Carbachol / Carbastat, IsoptoCarbachol Lumigan (Bimatoprost) Miochol-E (Acetylcholine chloride)
Carteolol / Ocupress Phospholine Iodide (Echothiophate iod)
Dorzolamide / Trusopt Pilopine HS (Pilocarpine)
Latanoprost / Xalatan Travatan/Z (Travoprost)
Levobunolol / Betagan
Metipranolol / Optipranolol
Pilocarpine / Isopto Carpine, Pilocar
Timolol / Timoptic/XE
Timolol/Dorzolamide / Cosopt
Rite Aid Health Solutions Clinically Preferred Drug List – Subject to update 35 BOLD INDICATES BRAND NAME
Ophthalmics (Continued)
GENERIC DRUGS PREFERRED BRANDS NON-PREFERRED BRANDS
Ophthalmic Mydriatics
Atropine / Isopto Atropine Cyclomydril (Phenylephrine/Cyclopent)
Cyclopentolate / Cyclogyl Isopto Hyoscine (Scopolamine)
Dipivefrin / Propine Murocoll-2 (Phenylephrine/Scopolam)
Homatropine / Isopto Homatropine Paremyd (Hydroxyamphetam/Tropic)
Phenylephrine / Neofrin
Tropicamide / Mydriacyl
Ophthalmic Vasoconstrictors
Naphazoline / Albalon
Phenylephrine / Mydfrin
Ophthalmic Antibiotic-Steroid
Combinations Blephamide (Prednisolone/Sulfacetamide) FML-S (Fluorometh/Sulfacetam)
Neomycin Sulfate + Dex NA Ph Zylet (Tobramycin / Loteprednol) Pred-G (Gentamicin/Prednisol)
Neomycin + Polymyxin + HC / Cortisporin Tobradex ST (Tobramycin + Dexamethasone) Poly-Pred (Neomyc/Polymyxin/Prednis)
Neomycin + Polymyxin + Dexam / Maxitrol
Tobramycin + Dexamethasone / Tobradex
Otic Agents
GENERIC DRUGS PREFERRED BRANDS NON-PREFERRED BRANDS
Otic Agents
Acetic Acid/Hydrocortisone / Acetasol CiproDex (Ciprofloxacin / Dexamethasone) Alba-3 (Pramoxine/Chloroxylenol)
Acetic acid/Aluminum acet / Domeboro Cetraxal (Ciprofloxacin otic sol)
Antipyrine+Benzocaine+Glycer / Benzotic, Cipro HC (Ciprofloxacin/HC)
Otogesic Coly-Mycin S (Neomycin/Colist sul)
Benzocaine / Otocain Cresylate (Cresyl ace/Ben Alc/Butanol)
HC+Pramoxine+Chloroxyl / Cortane-B, Zoto-HC Dermotic (Fluocinolone Acetonide)
Ofloxacin / Floxin OTIC Otilam (Antipyrine/Benzocaine/Gly/Urea)
Polymyxin+Neomycin+Hydrocortisone / Cortisporin Oticin HC (HC/Pramoxine/Chloroxyl)
Otic Pediotic (Neo Sul/Polymyxin B/HC)
Pramotic (Pramoxine/Chloroxylenol)
Rite Aid Health Solutions Clinically Preferred Drug List – Subject to update 36 BOLD INDICATES BRAND NAME
Miscellaneous Products
GENERIC DRUGS PREFERRED BRANDS NON-PREFERRED BRANDS
Alcohol Dependancy Agents
Naltrexone / Revia Antabuse (Disulfiram) Campral (Acamprosate)
Vivitrol (Naltrexone Microspheres)
Anorexiants
Phentermine / Ionamin, Adipex-P Xenical (Orlistat) Benzphetamine
Didrex (Benzphetamine)
Dental Preparations
Chlorhexidine / Peridex Fluorabon Chewable Fluorabon Drops(Sodium fluoride)
Doxycycline hyclate / Periostat Fluor-a-Day Chewable Fluor-a-day Drops (Sodium fluoride)
Sodium Fluoride / Cavarest, Cavirinse, Ethedent, Prevident (Sodium fluoride)
Luride, Fluor-a-Day, Phos-Flur, Prevident Thera-Flur-N (Sodium fluoride)
Stannous Fluoride / Gel-Kam, Omni Gel
Hyperparathyroid Agents
Calcitriol / Rocaltrol Hectorol (Doxercalciferol)
Sensipar (Cinacalcet)
Zemplar (Paricalcitol)
Metallic Poison Treatment Agents Deferoxamine Mesylate
Chemet (Succimer) Desferal (Deferoxamine Mesylate)
Exjade (Deferasirox) Galzin (Zinc acetate)
Syprine (Trientine)
Nutritional Agents
Levocarnitine / Carnitor
Oxytocics
Methergine (Methylergonovine)
Parasympathetic Agents
Bethanecol / Urecholine Evoxac (Cevimeline) Guanidine (Guanidine)
Pilocarpine / Salagen Ilopan (Dexpanthenol)
Rheumatoid Arthritis Agents
Ridaura (Auranofin) Depen (Penicillamine)
Smoking Cessation Products
Bupropion / Zyban Chantix (Varenicline Tartrate) Nicotrol Nasal Inhaler (Nicotine)
Nicotrol Cartridge Inhaler (Nicotine)
Agents for Drooling Cuvposa (Glycopyrrolate)
Rite Aid Health Solutions Clinically Preferred Drug List – Subject to update 37 BOLD INDICATES BRAND NAME
Specialty Products*
GENERIC DRUGS PREFERRED BRANDS NON-PREFERRED BRANDS
Hepatitis Treatment Agents
Hepatitis B Agents Hepatitis B Agents Hepatitis B Agents
Baraclude (Adefovir Dipivoxil) Tyzeka (Telbivudine)
Hepsera (Entecavir)
Epivir HBV (Lamivudine)
Hepatitis C Agents Hepatitis C Agents Hepatitis C Agents
Ribavirin / Rebetol, Ribasphere, Ribatab Peg-Intron (Peginterferon Alfa-2B) Copegus (Ribavirin)
Pegasys (Peginterferon Alfa-2A) Infergen (Interferon Alfacon-1)
Human Growth Hormones (HGH)
Genotropin (Somatropin) Norditropin (Somatropin)
Humatrope (Somatropin) Nutropin/ AQ (Somatropin)
Norditropin Flexpro (Somatropin) Omnitrope (Somatropin)
Saizen (Somatropin)
Serostim (Somatropin)
Tev-tropin (Somatropin)
Zorbtive (Somatropin)
Pulmonary Agents
Orals
Adcirca (Tadalafil)
Tracleer (Bosentan)
Revatio (Sildenafil)
Letairis (Ambrisentan) Inhalation
Curosurf (Poractant alfa)
Inhalation Infasurf (Calfactant)
Ventavis (Iloprost) Survanta (Beractant)
Injectables Tyvaso (Treprostinil)
Alpha-1 proteinase inhibitor / Prolastin
Epoprostenol / Flolan Injectables Injectables
Remodulin (Treprostinil) Aralast (Alpha-1 Proteinase inhibitor)
Prolastin-C (Alpha-1 proteinase inhibitor) Glassia (Alpha-1 Proteinase inhibitor)
Zemaira (Alpha-1 Proteinase inhibitor)
*Specialty products may have higher copayments, depending on plan benefit design.
Rite Aid Health Solutions Clinically Preferred Drug List – Subject to update 38 BOLD INDICATES BRAND NAME
Specialty Products (Continued)*
GENERIC DRUGS PREFERRED BRANDS NON-PREFERRED BRANDS
Multiple Sclerosis Agents
Acthar HP (Corticotropin) Ampyra (dalfampridine)
Avonex (Interferon Beta-1A) Extavia (Interferon Beta 1B)
Betaseron (Interferon Beta 1B) Tysabri (Natalizumab)
Copaxone (Glatiramer Acetate)
Gilenya (Fingolimod)
Rebif (Interferon Beta-1A/Albumin)
Rheumatoid Arthritis Agents
Leflunomide / Arava Actemra (Tocilizumab) Cimzia (Certolizumab pegol)
Enbrel (Etanercept) Kineret (Anakinra)
Humira (Adalimumab) Rheumatrex (Methotrexate)
Orencia (Abatacept) Simponi (Golimumab)
Remicade (Infliximab)
Somatostatin Analogues
Octreotide / Sandostatin Somavert (Pegvisomant)
Sandostatin LAR (Octreotide)
Somatuline Depot (Lanreotide)
Hyaluronic Acid Agents Synvisc (Hylan G-F 20) Euflexxa (Hyaluronate sodium)
Synvisc-One (Hylan G-F 20) Hyalgan (Hyaluronate sodium)
Orthovisc (Hyaluronate sodium)
Supartz (Hyaluronate sodium)
Miscellaneous
Arcalyst (Rilonacept) Amevive (Alefacept)
Berinert (C1 esterase inhibitor) Botox (OnabotulinumtoxinA)
Carbaglu (Carglumic acid) Dysport (AbobotulinumtoxinA)
Cerezyme (Imiglucerase) Egrifta (tesamorelin)
Cinryze (C1-esterase inhibitor) Ilaris (Canakinumab)
Kuvan (Sapropterin) Kalbitor (Ecallentide)
Lumizyme (Aglucosidase alpha) Makena (hydroxyprogesterone caproate)
Mozobil (Plerixafor) Xeomin (IncobotulinumtoxinA)
Myobloc (RimabotulinumtoxinB) Xgeva (Denosumab)
Nplate (Romiplostim)
Promacta (Eltrombopag)
Stelara (Ustekinumab)
VPRIV (Velaglucerase alpha)
Xenazine (Tetrabenazine)
Xiaflex (Collagenase)
*Specialty products may have higher copayments, depending on plan benefit design.
Rite Aid Health Solutions Clinically Preferred Drug List – Subject to update 39 BOLD INDICATES BRAND NAME
Index
8-MOP, 34 Acular LS/PF, 36 Aldomet, 15
A-2 Antagonists (ARBs), 2, 14 Acuvail, 36 Aldoril, 15
A-2 Antagonists (ARBs) with Diuretics, 14 Acyclovir, 8, 9 Alefacept, 40
Abacavir, 8 Acyclovir / Hydrocortisone, 9 Alendronate, 19
Abacavir / Lamivudine, 8 Aczone, 33 Alendronate-Vitamin D3, 19
Abacavir / Lamivudine / Zidovudine, 8 Adalat/CC, 13 Alesse, 25
Abatacept, 40 Adalimumab, 40 Alfuzosin, 17
Abilify, 23 Adapalene, 33 Alinia, 9
AbobotulinumtoxinA, 40 Adapalene/Benzoyl Peroxide, 33 Aliskiren, 14
Abstral, 20 Adapin, 22 Aliskiren/Amlodipine, 14
Acamprosate, 38 Adcirca, 39 Aliskiren/Amlodipine/HCTZ, 14
Acanya, 33 Adderall, 21 Aliskiren/HCTZ, 14
Acarbose, 29 Adderall/XR, 21 Aliskiren/Valsartan, 14
Accolate, 31 Adefovir Dipivoxil, 39 Alitretinoin, 10
Accucheck Products, 30 Adipex-P, 38 Alkeran, 10
Accupril, 14 Adoxa Pak, 7 Allegra, 31
Accuretic, 14 Advair Diskus/ HFA, 31 Allegra D, 31
Accutane, 33 Advicor, 16 Allegra D 12/24 H, 31
ACE Inhibitor / CCB Combination, 2, 14 Aerobid/M, 32 Allegra ODT, 31
ACE Inhibitors, 2, 14 Afinitor, 10 Allopurinol, 18
ACE Inhibitors with Diuretics, 14 Agenerase, 8 Almotriptan, 11
Acebutolol, 13 Aggrenox, 12 Alocril, 36
Aceon, 14 Aglucosidase alpha, 40 Alomide, 36
Acetaminophen w/Codeine, 20 Agrylin, 12 Alora, 25
Acetaminophen/Butalbital, 11 Ahist, 31 Alosetron, 24
Acetasol, 37 AK Tracin, 35 Alpha Blockers, 2, 13
Acetazolamide, 17 Ak-Dex, 36 Alpha-1 proteinase inhibitor, 39
Acetic acid/Aluminum acet, 37 Akineton, 11 Alpha-1 Proteinase inhibitor, 39
Acetic Acid/Hydrocortisone, 37 Akne-mycin, 33 Alphagan, 36
Acetohexamide, 29 Alamast, 36 Alphagan P, 36
Acetylcholine chloride, 36 Alba-3, 37 Alprazolam, 21
Aciphex, 24 Albalon, 37 Alprazolam oral concentrate, 21
Acitretin, 34 Albendazole, 9 Alprostadil, 17
Aclovate, 34 Albenza, 9 Alrex, 36
Acne / Rosacea Products (Oral & Topical), 3, Albuterol, 31, 32 ALS Agents, 11
33 Albuterol HFA, 31 Alsuma, 11
Actemra, 40 Albuterol Sulfate, 31 Altabax, 9
Acthar HP, 40 Albuterol/Ipratropium, 32 Altace, 14
Actigall, 24 Alcaftadine, 36 Altoprev, 16
Actiq, 20 Alcet, 20 Alupent, 31
Activella, 26 Alclometasone Dipropionate, 34 Alvesco, 32
Actonel, 19 Alcohol Dependancy Agents, 38 Amantadine, 8, 11
Actonel w/Calcium, 19 Aldactazide, 17 Amaryl, 29
ActoPlusMet, 29 Aldactone, 17 Ambenonium, 11
Actos, 29 Aldara, 34 Ambien/CR, 21
Rite Aid Health Solutions Clinically Preferred Drug List – Subject to update 40 BOLD INDICATES BRAND NAME
Ambrisentan, 39 Antianginal / Anti-Ischemic, 2, 15 Aripiprazole, 23
Amcinonide, 34 Anti-Anxiety Agents, 3, 21 Aristocort, 34
Amebicides, Trichomonacides, 8 Antiarrhythmics, 2, 15 Arixtra, 12
Amerge, 11 Anticoagulants / Heparins, 12 Armodafinil, 21
Americaine, 34 Anticonvulsants, 2, 12 Armour Thyroid, 27
Amevive, 40 Antidpressants, Other, 22 Aromasin / Exemastane, 10
Amiloride/ HCTZ, 17 Antiemetics, 2, 10 Artemether/Lumefantrine, 9
Amiodarone, 15 Antifungals, 2, 3, 9, 33 Arthrotec, 19
Amitiza, 24 Antifungals (Topical), 3, 33 Asacol, 24
Amitriptyline, 22 Antihelmintic Agents, 2, 9 Asacol / HD, 24
Amitriptyline / perphenazine, 22 Antihistamines, First Generation, 31 Ascensia Products, 30
Amlodipine, 13, 16 Antihistamines, Non/Low Sedating, 31 Asenapine, 23
Amlodipine / Atorvastatin, 16 Anti-Inflammatory Agents (NSAIDs), 19 Asendin, 22
Amlodipine/Atorvastatin, 13 Antimalarials & Antiprotozoals, 9 Asmanex, 32
Ammonium Lactate, 33 Anti-Migraine Agents, 2, 11 Aspirin w/Codeine, 20
Amoxapine, 22 Antimycobacterials, 9 Aspirin/Butalbital/Caff, 11, 20
Amoxicillin, 7 Antineoplastics*, 10 Astelin, 31
Amoxicillin Potassium Clavulanate, 7 Antiparasitics, 2, 9 Astepro, 31
Amoxil, 7 Anti-Parkinsons Agents, 2, 11 Asthma Agents, 3, 31
Amphetamine/D-Amphet, 21 Antipsychotic Agents, Atypical, 23 Atacand, 14
Amphetamine/D-Amphetamine, 21 Antipsychotic Agents, Typical, 23 Atacand HCT, 14
Ampicillin, 7 Anti-Spasmodic Agents, 3, 24 Atarax, 31
Amprenavir, 8 Anti-Ulcer / GERD Agents, 3, 24 Atazanavir, 8
Ampyra, 40 Antivert, 10 Atelvia, 19
Amrix, 18 Antivirals, 2, 8 Atenolol, 13
Amturnide, 14 Anzemet (Dolasetron), 10 Atenolol/Chlorthalidone, 13
Amylase/Lipase/Protease, 16 APAP/Butalbital/Caff, 11 Ativan, 21
Anacaine, 34 Apidra, 29 Atomoxetine, 21
Anadrol, 26 Apidra/SoloStar, 29 Atopiclair, 34
Anafranil, 22 Aplenzin, 22 Atorvastatin, 16
Anagrelide, 12 Apokyn, 11 Atovaquone, 9
Anakinra, 40 Apomorphine, 11 Atovaquone / Proguanil, 9
Analpram Advanced, 34 Apraclonidine, 36 Atralin, 33
Analpram-E, 34 Aprepitant, 10 Atripla, 8
Analpram-HC, 34 Apresoline, 15 Atropine, 24, 37
Anaprox/DS, 19 Apri, 25 Atropine sulfate, 24
Anastrozole, 10 Apriso, 24 Atrovent, 31, 32
Ancobon, 9 Aptivus, 8 Atrovent HFA, 32
Androderm, 26 Aquachloral, 21 Atrovent Nasal Spray, 31
Androgel, 26 Aralast, 39 Attention Deficit Disorder (ADD/ADHD),
Androgenic Agents, 3, 26 Aralen, 9 Narcolepsy & Adrenergic Agents, 21
Android, 26 Aranelle, 25 Aug Betameth Diprop, 34
Androxy, 26 Aranesp, 12 Augmentin/ES, 7
Angeliq, 26 Arava, 40 Augmentin/ES/XR, 7
Anorexiants, 38 Arcalyst, 40 Auranofin, 38
Ansaid, 19 Aredia, 19 Avalide, 14
Antabuse, 38 arformoterol, 32 Avandamet, 29
Antara, 16 Aricept/ODT, 11 Avandaryl, 29
Anthralin, 34 Arimidex, 10 Avandia, 29
Rite Aid Health Solutions Clinically Preferred Drug List – Subject to update 41 BOLD INDICATES BRAND NAME
Avapro, 14 Benazepril/Amlodipine, 14 Bisac/NaCl/NaHCO3/KCL/PEG 3350, 24
Avar, 33 Benazepril/HCTZ, 14 Biskalcitrate/Metronidazole/Tetracycline, 24
AVC, 35 Benicar, 14 Bisoprolol, 13
Avelox, 8 Benicar HCT, 14 Bisoprolol/HCTZ, 13
Aventyl, 22 Benign Prostatic Hyperplasia Agents, 2, 17 Bleph-10, 35
Aviane, 25 Bensal-HP, 33 Blephamide, 35, 37
Avinza, 20 Bentyl, 24 Blephamide/SOP, 35
Avita, 33 Benzac AC, 33 Blocadren, 13
Aviva Products, 30 Benzaclin, 33 Boniva, 19
Avodart, 17 Benzamycin, 33 Bosentan, 39
Avonex, 40 Benzocaine, 34, 37 Botox, 40
Axert, 11 Benzotic, 37 Bowel & Colon Agents, 3, 24
Axid, 24 Benzoyl Peroxide, 33 Brethine, 31
Axid Solution, 24 Benzoyl Peroxide / Clindamycin, 33 Brevoxyl, 33
Axiron, 26 Benzoyl Peroxide w/ E-mycin, 33 Brimonidine, 36
Axocet, 20 Benzoyl Peroxide/Urea, 33 Brimonidine/timolol, 36
Aygestin, 26 Benzphetamine, 38 Brinzolamide, 36
Azasan, 10 Benztropine, 11 Bromday, 36
AzaSite, 35 Benzyl alcohol, 34 Bromfenac sod, 36
Azathioprine, 10 Bepotastine, 36 Bromocriptine, 11, 29
Azelaic acid, 33 Bepreve, 36 Brompheniramine, 31
Azelastine, 31, 36 Beractant, 39 Brompheniramine Maleate, 31
Azelex, 33 Berinert, 40 Brompheniramine Tannate, 31
Azetreonam, 32 Besifloxacin, 35 Brovana, 32
Azilect, 11 Besivance, 35 Brovex, 31
azithromycin, 35 Beta Blockers, 2, 13 Budesonide, 24, 27, 32
Azithromycin, 7 Betagan, 36 budesonide/Formoterol, 31
Azopt, 36 Betameth Diprop, Valerate, 34 Bumetanide, 17
AZOR, 14 Betamethasone, 27, 34 Bumex, 17
Azulfidine, 7 Betamethasone valerate, 34 Buprenorphine, 20
Bacitracin, 35 Betapace/AF, 13 Bupropion, 22, 38
Baclofen, 18 Betaseron, 40 Buspar, 21
Bactrim/DS, 7 Betaxolol, 13, 36 Buspirone, 21
Bactroban/Nasal, 9 Bethanecol, 38 Busulfan, 10
Balsalazide Disodium, 24 Betimol, 36 Butabarbital, 21
Balziva, 25 Betoptic, 36 Butenafine, 33
Banzel, 12 Betoptic-S, 36 Butisol, 21
Banzel Susp, 12 Bexarotene, 10 Butoconazole, 35
Baraclude, 39 Beyaz, 25 Butorphanol, 20
Basiliximab, 10 Biaxin/XL, 7 Butrans, 20
B-D Logic & Latitude Products, 30 Bicalutamide, 10 Byetta, 29
B-D Syringes, 30 Bicitra, 17 Bystolic, 13
Becaplermin, 33 BiDil, 15 C1 esterase inhibitor, 40
Beclomethasone, 32 Bile Acid Sequestrants, 2, 16 C1-esterase inhibitor, 40
Beconase/AQ, 32 Biltricide, 9 Cabergoline, 11
Belladona w/phenobarb, 24 Bimatoprost, 36 Caduet, 13, 16
Belladonna alkaloids, 24 Biocef, 7 Cafcit, 32
Benadryl, 31 Biperiden, 11 Cafergot, 11
Benazepril, 14 Bipolar Disorder (Anti-Mania) Agents, 23 Caffeine citrated, 32
Rite Aid Health Solutions Clinically Preferred Drug List – Subject to update 42 BOLD INDICATES BRAND NAME
Calan/SR, 13 Carnitor, 38 Chloral Hydrate solution, 21
Calcipotriene, 34 Carteolol, 36 Chlorambucil, 10
Calcipotriene/Betameth, 34 Carvedilol, 13 Chlordiazepoxide, 21
Calcitonin, 19 Casodex, 10 Chlorhexidine, 38
Calcitonin – Nasal / Injectable, 19 Cataflam, 19 Chloroquine, 9
Calcitriol, 34, 38 Catapres, 15 Chloroquine Phosphate, 9
Calcium acetate, 18 Catapres TTS, 15 Chlorothiazide, 17
Calcium Carb/Mag Carb, 18 Cavarest, 38 Chlorphenir/pseud, 31
Calcium Channel Blockers, 2, 13 Caverject, 17 Chlorpheniramine, 31
Calfactant, 39 Cavirinse, 38 Chlorpheniramine Maleate, 31
CaloMist, 12 Cayston, 32 Chlorpheniramine Tannate, 31
Cambia, 11 Caziant, 25 Chlorpromazine, 23
Camila, 25 Ceclor CD, 7 Chlorpropamide, 29
Campral, 38 Ceclor, Ceclor CD, 7 Chlorthalidone, 17
Canakinumab, 40 Cedax, 7 Chlorzoxazone, 18
Canasa, 24 CEENU, 10 Chol Sal w/ Mag Salicylate, 20
Candesartan, 14 Cefaclor, 7 Cholestyramine, 16
Candesartan/HCTZ, 14 Cefaclor ER, 7 Chromagen Fa/Forte, 12
Capecitabine, 10 Cefadroxil, 7 Cialis, 17
Capex Shampoo, 34 Cefdinir, 7 Ciclesonide, 32
Capoten, 14 Cefditoren pivoxil, 7 Ciclopirox, 33
Capozide, 14 Cefixime, 7 Cilostazol, 12
Captopril, 14 Cefprozil, 7 Ciloxan, 35
Captopril /HCTZ, 14 Ceftibuten, 7 Cimetidine, 24
Carac, 10 Ceftin, 7 Cimzia, 40
Carafate, 24 Cefuroxime Axetil, 7 Cinacalcet, 38
Carbachol, 36 Cefzil, 7 Cinryze, 40
Carbaglu, 40 Celebrex, 19 Cipro, 8, 37
Carbamazepine, 12 Celecoxib, 19 Cipro HC, 37
Carbastat, 36 Celestone, 27 Cipro Susp, 8
Carbatrol, 12 Cellcept, 10 CiproDex, 37
Carbetapentane/Pseud, 32 Celontin, 12 Ciprofloxacin, 8, 35, 37
Carbex, 11 Cenestin, 25 Ciprofloxacin / Dexamethasone, 37
Carbidopa, 11 Cenogen OB/Ultra, 27 Ciprofloxacin otic sol, 37
Carbidopa/Levodopa, 11 Cephalexin, 7 Ciprofloxacin/HC, 37
Carbidopa/Levodopa/Entacapone, 11 Cerezyme, 40 Citalopram, 22
Carbinoxamine, 31 Certolizumab pegol, 40 Citracal Prenatal PX, 27
Carbonoxamine, 31 Cesamet, 10 Citric Acid + Potassium Citrate, 17
Cardene, 13 Cesia, 25 Citric Acid + Sodium Citrate, 17
Cardene / SR, 13 Cetacaine, 34 Claravis, 33
Cardene SR, 13 Cetirizine, 31 Clarinex/D, 31
Cardiac Glycosides, 2, 15 Cetraxal, 37 Clarithromcyin, 7
Cardizem LA, 13 Cevimeline, 38 Claritin, 31
Cardizem/CD, 13 Chantix, 38 Clemastine, 31
Cardura, 13, 17 Chemet, 38 Cleocin, 7, 33, 35
Cardura XL, 17 ChemStrips, 30 Cleocin cream, 35
Carglumic acid, 40 Chenodal, 24 Cleocin supp, 35
Carisoprodol, 18 Chenodeoxycholic acid, 24 Cleocin-T Solution, 33
Carmol, 33 Chloral hydrate, 21 Climara, 25, 26
Rite Aid Health Solutions Clinically Preferred Drug List – Subject to update 43 BOLD INDICATES BRAND NAME
Climara PRO, 26 Comtan, 11 Cyclocort, 34
Clindamicin/Tretinoin, 33 Concerta, 21 Cyclogyl, 37
Clindamycin, 7, 33, 35 Condylox Gel, 33 Cyclomydril, 37
Clindamycin phosphate, 35 Condylox solution, 33 Cyclopentolate, 37
Clindamycin/benzoyl peroxide, 33 Conex, 31 Cyclophosphamide, 10
Clindamycin/Tretinoin, 33 Conj. Estrogen/Medroxyprogest, 26 Cycloserine, 9
Clindareach, 33 Conjugated Estrogen, 25, 26 Cycloset, 29
Clindesse, 35 Contraceptives, 3, 25, 26 Cyclosporine, 10, 36
Clinoril, 19 Copaxone, 40 Cymbalta, 22
Clobetasol propionate, 34 COPD Agents, 3, 32 Cyproheptadine, 31
Clobetasol Propionate, 34 Copegus, 39 Cystagon, 17
Clobex, 34 Cordarone, 15 Cysteamine, 17
Cloderm, 34 Cordran, 34 Cytomel, 27
Clomipramine, 22 Coreg/CR, 13 Cytotec, 24
Clonazepam, 12, 21 Corgard, 13 Cytovene, 8
Clonidine, 15 Cortane-B, 37 Cytoxan, 10
Clonidine ER, 21 Cortef, 27 Dabigatran, 12
Clonidine/Chlorthalidone, 15 Corticosteroid Inhalers, 3, 32 Daclizumab, 10
Clopidogrel, 12 Corticotropin, 40 dalfampridine, 40
Clorazepate, 21 Cortifoam, 27 Dalmane, 21
Clorpres, 15 Cortisone Acetate, 27 Dalteparin, 12
Clotrimazole, 9, 33 Cortisporin, 37 D-Amphetamine, 21
Clotrimazole+Betamethisone, 33 Cortisporin Otic, 37 Dantrium, 18
Clozapine, 23 Cortizone, 34 Dantrolene, 18
Clozaril, 23 Cortone, 27 Dapsone, 8
Coartem, 9 Corzide, 13 dapsone gel, 33
Codeine/ Acetaminophen, 20 Cosopt, 36 Daraprim, 9
Codeine/Acetam/Butalbital/Caffeine, 20 Coumadin, 12 Darifenacin, 17
Codeine/Aspirin/Butalbital/Caff, 20 Covera HS, 13 Darunavir ethanolate, 8
Codeine/Carisoprodol/Aspirin, 20 COX-II Agents, 2, 19 Dasatinib, 10
Cogentin, 11 Cozaar, 14 Daypro, 19
Cognex, 11 Creon, 16 Dayto-Sulf, 35
Colazal, 24 Crestor, 16 Daytrana Patches, 21
Colchicine, 18 Cresyl ace/Ben Alc/Butanol, 37 Decadron, 27, 36
Colchicine/Probenecid, 18 Cresylate, 37 Declomycin, 7
Colcrys, 18 Crinone, 26 Deconamine Syr, 31
Colesevelam, 16 Crixivan, 8 Deferasirox, 38
Colestid, 16 Crolom, 36 Deferoxamine Mesylate, 38
Colestipol, 16 Cromolyn sodium, 31 Delatestryl, 26
Colestipol granules, 16 Cromolyn Sodium, 31, 36 Delavirdine, 8
Collagenase, 33, 40 Cromolyn Sodium solution, 31 Deltasone, 27
Coly-Mycin S, 37 Crotamiton, 34 Demadex, 17
Colytrol, 24 Cryselle, 25 Demeclocycline, 7
Combigan, 36 Curosurf, 39 Demerol, 20
Combipatch, 26 Cutivate, 34 Demser, 13
Combivent, 32 Cuvposa, 38 Demulen, 25
Combivir, 8 cyanocobalamin, 12 Denavir, 9
Combunox, 20 Cyclessa, 25 Denosumab, 19, 40
Compazine, 10 Cyclobenzaprine, 18 Dental Preparations, 3, 38
Rite Aid Health Solutions Clinically Preferred Drug List – Subject to update 44 BOLD INDICATES BRAND NAME
Depakene, 12 Diclofenac Potassium, 19 Doryx, 7
Depakote ER, 12 Diclofenac/Misoprostol, 19 Dorzolamide, 36
Depen, 38 Dicloxacillin, 7 Dostinex, 11
Depo-Provera, 26 Dicyclomine, 24 Dovonex, 34
Depo-Testosterone, 26 Didanosine, 8 Doxazosin, 13, 17
Derma-Smoothe/FS, 34 Didrex, 38 Doxepin, 21, 22
Dermatop, 34 Didronel, 19 Doxercalciferol, 38
Dermotic, 37 Difenoxin/Atropine sulfate, 24 Doxycycline, 7, 38
Desferal, 38 Differin, 33 Doxycycline hyclate, 7, 38
Desipramine, 22 Diflorasone Diacetate, 34 Doxycycline monohydrate, 7
Desloratadine, 31 Diflucan, 9 Dritho-Scalp, 34
Desogen, 25 Diflunisal, 20 Dronabinol, 10
Desonate, 34 Difluprednate, 36 Dronedarone, 15
Desonide, 34 Digitek, 15 Droxia, 10
Desowen, 34 Digoxin, 15 Duac, 33
Desoximetasone, 34 Dihydroergotamine, 11 Duet DHA, 27
Desoxyn, 21 Dilacor XR, 13 Duetact, 29
Desquam/X, 33 Dilantin, 12 Dulera, 31
Desvenlafaxine, 22 Dilatrate-SR, 15 Duloxetine, 22
Desyrel, 22 Dilaudid, 20 Duofilm, 33
Detrol/ LA, 17 Dilor, 32 DuoNeb, 32
Dexamethasone, 27, 36 Diltiazem, 13 Duragesic Patches, 20
Dexamethasone implant, 36 Diovan, 14 Durezol, 36
Dexbrompheniramine/PSE, 31 Diovan HCT, 14 Duricef, 7
Dexchlorpheniramine, 31 Dipentum, 24 Dutasteride, 17
Dexedrine, 21 Diphenhydramine, 31 Dutasteride/Tamsulosin, 17
Dexilant, 24 Diphenoxylate/Atropine, 24 Dyazide, 17
Dexlansoprazole, 24 Dipivefrin, 37 Dymelor, 29
Dexmethylphenidate, 21 Diprolene, 34 Dynacin, 7
Dexpak, 27 Diprosone, 34 Dynacirc/CR, 13
Dexpanthenol, 38 Dipyridamole, 12 Dynapen, 7
Dextroamphetamine, 21 Dipyridamole / Aspirin, 12 Dyphylline, 32
dextromethorphan / quinidine, 23 Diruetics, 17 Dyrenium, 17
Dextrostat, 21 Disalcid, 20 Dysport, 40
DHE 45, 11 Disopyramide, 15 Dytan, 31
DHEA, 26 Dispermox, 7 Ecallentide, 40
Diabeta, 29 Disulfiram, 38 Echothiopate iod, 36
Diabetes Supplies, 3, 30 Ditropan/XL, 17 Econazole nitrate, 33
Diabinese, 29 Diuril, 17 Econopred Plus, 36
Diamox, 17 Divigel, 25 Edecrin, 17
Diamox Sequels, 17 Dofetilide, 15 Edex, 17
Diastat, 12 Dolobid, 20 Edluar, 21
Diazepam, 21 Dolophine, 20 EEMT/HS, 26
Diazepam gel, 12 Domeboro, 37 EES, 7
Diazoxide, 30 Donepezil, 11 Efavirenz, 8
Dibenzyline, 13 Donnamar, 24 Efavirenz / Emtricitab / Tenofovir, 8
Diclofenac, 19, 36 Donnatal, 24 Effexor, 22
Diclofenac epolamine, 19 Doral, 21 Effexor XR, 22
Diclofenac potassium, 11 Dornase alfa, 32 Effient, 12
Rite Aid Health Solutions Clinically Preferred Drug List – Subject to update 45 BOLD INDICATES BRAND NAME
Efudex, 10 Epipen/Jr, 32 Estrogens, Oral, 25
Egrifta, 40 Epivir, 8, 39 Estrogens, Patches & Gels, 25
Elavil, 22 Epivir HBV, 39 Estrogens, Vaginal, 26
Eldepryl, 11 Eplerenone, 17 Estropipate, 25
Electrolyte Depleters, 2, 18 Epogen, 12 Estrostep/Fe, 25
Elestat, 36 Epoprostenol, 39 Eszopiclone, 21
Elestrin, 25 Eprosartan, 14 Etanercept, 40
Eletriptan, 11 Eprosartan/HCTZ, 14 Ethacrynic acid, 17
Elidel, 34 Epzicom, 8 Ethedent, 38
Eligard, 10 Equagesic, 20 Ethmozine, 15
Elimite, 34 Equetro, 12 Ethosuximide, 12
Elixophyllin, 32 Ergomar, 11 Ethotoin, 12
ella, 26 Ergotamine, 11 Etidronate, 19
Elmiron, 17 Ergotamine/Caffeine, 11 Etodolac, 19
Elocon, 34 Errin, 25 Etoposide, 10
Eltrombopag, 40 Ertaczo, 33 Etravirine, 8
Emadine, 36 Eryped, 7 Euflexxa, 40
Embeda, 20 Ery-Tab, 7 Eulexin, 10
Embrex-600, 27 Erythro & Sulfa, 7 Eurax, 34
Emcyt, 10 Erythro-Base, 7 Evamist, 25
Emedastine, 36 Erythrocin, 7 Everolimus, 10
Emend, 10 Erythro-Estolate, 7 Evista, 19
Emgel, 33 Erythro-Ethylsuccinate, 7 Evoxac, 38
EMLA, 34 Erythromycin, 33, 35 Exalgo, 20
Empirin #2/3/4, 20 Erythromycin base, 33 Exelderm, 33
Emsam, 22 Erythro-Stearate, 7 Exelon, 11
Emtricitabine, 8 Escitalopram, 22 Exenatide, 29
Emtricitabine / Tenofovir, 8 Esclim, 25 Exforge, 14
Emtriva, 8 Esgic, 20 Exforge HCT, 14
E-Mycin, 7 Esidrix, 17 Exjade, 38
Enablex, 17 Eskalith, 23 Extavia, 40
Enalapril, 14 Esomeprazole, 24 Extina, 33
Enalapril/HCTZ, 14 Estazolam, 21 Exubera, 29
Enbrel, 40 Esterified Estrogen, 25 Ezetimibe, 16
Endep, 22 Estrace, 25, 26 Ezetimibe/Simvastatin, 16
Endometrin, 26 Estraderm, 25 FA/ B12 / B 6, 12
Enduron, 17 Estradiol, 25, 26 Factive, 8
Enfuvirtide, 8 Estradiol / Norethindrone, 26 Famotidine, 24
Enjuvia, 25 Estradiol / Norethrin, 26 Fanapt, 23
Enoxaparin, 12 Estradiol / Norethrin AC, 26 Fareston, 10
Enpresse, 25 Estradiol Patch, 25 Faslodex, 10
Entacapone, 11 Estradiol/ Levonorgestrel, 26 Fazaclo, 23
Entecavir, 39 Estradiol/Norgestimate, 26 Febuxostat, 18
Entocort EC, 24, 27 Estramustine, 10 Felbamate, 12
Enzymax, 16 Estratest/HS, 26 Felbatol, 12
Epiduo, 33 Estring, 26 Feldene, 19
Epifoam, 34 Estrogel, 25 Felodipine, 13, 14
Epinastine, 36 Estrogen, 3, 25, 26 Felodipine/Enalapril, 14
Epinephrine, 32 Estrogen Combinations, 3, 26 Femara, 10
Rite Aid Health Solutions Clinically Preferred Drug List – Subject to update 46 BOLD INDICATES BRAND NAME
Femcon Fe, 25 Flucytosine, 9 Fosamax Plus D, 19
FemHRT, 26 Fludarabine, 10 Fosamprenavir, 8
Femring, 26 Fludarabine, oral, 10 Fosfomycin, 17
Femtrace, 25 Fludrocortisone, 27 Fosinopril, 14
Fenofibrate, 16 Flumadine, 8 Fosinopril/HCTZ, 14
Fenofibrate nanocrystallized, 16 Flunisolide, 32 Fosrenol, 18
Fenofibrate, micronized, 16 Flunisolide/Menthol, 32 Fragmin, 12
Fenofibric acid, 16 Fluocinolone acet, 34, 36 Freestyle Products, 30
Fenoglide, 16 Fluocinolone acetonide, 36 Frova, 11
Fenoprofen, 19 Fluocinolone Acetonide, 34, 37 Frovatriptan, 11
Fentanyl Citrate, 20 Fluocinonide, 34 Fulvestrant, 10
Fentanyl Soluable Film, 20 Fluorabon, 38 Furadantin, 7
Fentora, 20 Fluor-a-day drops, 38 Furosemide, 17
Feraheme, 12 Fluorometh/Sulfacetam, 37 Fuzeon, 8
Ferrogels Forte, 12 Fluorometholone, 36 Gabapentin, 12
Ferrogen, 12 Fluoroplex, 10 Gabarone, 12
Ferrous Fumarate, 12 Fluorouracil, 10 Gabitril, 12
Ferrous Gluconate, 12 Fluoxetine, 22 Galantamine, 11
Ferrous Sulfate, 12 Fluoxetine / Olanzapine, 22 Gallium Nitrate, 19
Ferumoxytol, 12 Fluoxymesterone, 26 Galzin, 38
Fesoterodine, 17 Fluphenazine, 23 Ganciclovir, 8, 35
Fexofenadine, 31 Flurandrenolide, 34 Ganite, 19
Fexofenadine w/ Decongestant, 31 Flurazepam, 21 Garamycin, 35
Fibrates, 2, 16 Flurbiprofen, 19, 36 Gatifloxacin, 35
Fibricor, 16 Flutamide, 10 Gel-Kam, 38
Finacea, 33 Fluticasone, 31, 32, 34 Gelnique, 17
Finasteride, 17 Fluticasone propionate, 34 Gemfibrozil, 16
Fingolimod, 40 Fluticasone/Salmeterol, 31 Gemifloxacin, 8
Fioricet, 11, 20 Fluvastatin, 16 Genotropin, 39
Fiorinal, 11, 20 Fluvoxamine, 22 Gentak, 35
Fiorinal #3, 20 FML, 36, 37 Gentamycin, 35
First-Hydrocortisone, 34 FML Forte/SOP, 36 Geodon, 23
First-Progesterone MC, 26 FML SOP, 36 Gianvi, 25
First-Testosterone, 26 FML-S, 37 Gilenya, 40
Flagyl, 8 Focalin/ XR, 21 Glassia, 39
Flagyl ER, 8 Folgard RX, 12 Glatiramer Acetate, 40
Flarex, 36 Folic Acid, 12 Gleevec, 10
Flavoxate, 17 Foltx, 12 Glimepiride, 29
Flecainide, 15 Fomivirsen sodium, 35 Glipizide, 29
Flector Patch, 19 Fondaparinux, 12 Glipizide/Metformin, 29
Flexeril, 18 Foradil, 31 Glucocorticoids (Rectal), 27
Flextra, 20 formoterol, 32 Glucocorticoids / Mineralocorticoids (Oral), 27
Flolan, 39 Formoterol, 31 Glucophage/XR, 29
Flomax, 17 Formoterol/Mometasone, 31 Glucovance, 29
Flonase, 32 Fortamet, 29 Glumetza, 29
Florinef, 27 Forteo, 19 Glyburide, 29
Flovent HFA, 32 Fortesta, 26 Glyburide, micronized, 29
Floxin, 8 Fortical, 19 Glyburide/Metformin, 29
Fluconazole, 9 Fosamax, 19 Glycopyrrolate, 38
Rite Aid Health Solutions Clinically Preferred Drug List – Subject to update 47 BOLD INDICATES BRAND NAME
Glycron, 29 Hydrea, 10 Inderide, 13
Glynase, 29 Hydrocodone/Acetaminophen, 20 Indinavir, 8
Glyset, 29 Hydrocodone/Ibuprofen, 20 Indocin, 19
Golimumab, 40 Hydrocortisone, 27, 34 Indocin/SR, 19
Golytely, 24 Hydrocortisone acetate, 27 Indomethacin, 19
Golytely pack, 24 Hydrocortisone probutate, 34 Infasurf, 39
Goserelin, 10 Hydrocortisone/Pramoxine, 27 InFed, 12
Gout & Hyperuricemia, 18 Hydrodiuril, 17 Infergen, 39
Granisetron, 10 Hydromorphone, 20 Inflamase Mild, 36
Granulex, 33 Hydromorphone ER, 20 Inflammase Forte, 36
Grifulvin V, 9 Hydroxyamphetam/Tropic, 37 Infliximab, 40
Guanfacine, 15 Hydroxychloroquine, 9 Injectable Hypoglycemics, Other, 3, 29
Guanfacine ER, 21 hydroxyprogesterone caproate, 40 Innohep, 12
Guanidine, 38 Hydroxyurea, 10 Innopran XL, 13
Gynazole, 35 Hydroxyzine, 31 Inspra, 17
Gynodiol, 25 Hydroxyzine Pamoate, 31 Insulin Detemir, 29
Halcinonide, 34 Hygroton, 17 Insulin Glargine, 29
Halcion, 21 Hylan G-F 20, 40 Insulin Glulisine, 29
Haldol, 23 Hyoscamine, 24 Insulin Regular Human Rec, 29
Halflytely, 24 Hyoscyamine, 24 Insulins, 3, 29
Halobetasol Propionate, 34 Hyperglycemics, 3, 30 Intal, 31
Halog, 34 Hyperparathyroid Agents, 3, 38 Intelence, 8
Haloperidol, 23 Hypotensives, Miscellaneous, 2, 13 Interferon Alfacon-1, 39
HC acetate/Pramoxine, 34 Hytone, 34 Interferon Beta 1B, 40
HC acetate/pramoxine HCl, 34 Hytrin, 13, 17 Interferon Beta-1A, 40
Hectorol, 38 Hyzaa, 14 Interferon Beta-1A/Albumin, 40
Helidac, 24 Ibandronate, 19 Intranasal Corticosteroids, 32
Hematopoietic Agents, 2, 12 IB-STAT, 24 Intuniv, 21
Heparin sodium, 12 Ibuprofen, 19 Invega, 23
Hepatitis Treatment Agents, 39 Ilaris, 40 Invega Sustenna, 23
Hepsera, 39 Ilopan, 38 Invirase, 8
Hexalen, 10 Iloperidone, 23 Iodoquinol, 8
Hiprex, 17 Iloprost, 39 Ionamin, 38
Histex, 31 Ilosone, 7 Iopidine, 36
Histex Liquid/SR, 31 Ilotycin, 35 Ipratropium, 31, 32
HIV Antivirals/Related Agents, 8 Imatinib, 10 Iquix, 35
Homatropine, 37 Imdur, 15 Irbesartan, 14
Human Growth Hormones (HGH), 39 Imiglucerase, 40 Irbesartan/HCTZ, 14
Humatin, 8 Imipramine, 22 Iressa, 10
Humatrope, 39 Imipramine Pamoate, 22 Iron dextran, 12
Humira, 40 imiquimod, 34 Irritable Bowel Syndrome Agents, 24
Humulin & Humalog Insulins & Pens, 29 Imiquimod, 34 Isentress, 8
Hyalgan, 40 Imitrex, 11 ISMO, 15
Hyaluronate sodium, 40 Immunosuppressant Agents, 2, 10 Isocarboxazid, 22
Hycamtin, 10 Imodium, 24 Isochron, 15
Hydralazine, 15 Imuran, 10 Isometheptene / APAP/ Dichlorlphenazone, 11
Hydralazine/HCTZ, 15 IncobotulinumtoxinA, 40 Isometheptene/APAP/Caffeine, 11
Hydramine, 31 Indapamide, 17 Isoptin/SR, 13
Hydra-zide, 15 Inderal/SR/LA, 13 Isopto Atropine, 37
Rite Aid Health Solutions Clinically Preferred Drug List – Subject to update 48 BOLD INDICATES BRAND NAME
Isopto Carpine, 36 Klaron, 33 Leprostatic Agents, 2, 9
Isopto Homatropine, 37 Klonopin, 12, 21 Lescol/XL, 16
Isopto Hyoscine, 37 K-Lor, 18 Lessina, 25
IsoptoCarbachol, 36 Klor-Con, 18 Letairis, 39
Isordil, 15 K-Lyte, 18 Letrozole, 10
Isosorb Dinitrate/Hydralazine, 15 K-Lyte DS, 18 Leucovorin, 10
Isosorbide Dinitrate, 15 Kombiglyze XR, 29 Leukeran, 10
Isosorbide Mononitrate, 15 K-Phos MF, 17 Leuprolide, 10
Isotretinoin, 33 K-Phos N° 2, 17 Levacet, 20
Isradipine, 13 K-Phos Original, 17 Levalbuterol, 31
Istalol, 36 Kristalose, 24 Levalbuterol solution, 31
Itraconazole, 9 Krystexxa, 18 Levaquin, 8
Ivermectin, 9 Ktab, 18 Levatol, 13
Jalyn, 17 Kutrase, 16 Levemir, 29
Janumet, 29 Kuvan, 40 Levetiracetam, 12
Januvia, 29 Ku-zyme HP, 16 Levitra, 17
Jolessa, 25 Kytril, 10 Levlen, 25
Jolivette, 25 Labetolol, 13 Levlite, 25
J-Tan, 31 Lac-Hydrin, 33 Levobunolol, 36
Junel/Fe, 25 Lacosamide, 12 Levocarnitine, 38
Kadian, 20 Lacrisert, 36 Levocetirizine, 31
Kalbitor, 40 Lactic Acid, 33 Levo-Dromoran, 20
Kaletra, 8 Lactinol, 33 Levofloxacin, 8, 35
Kaochlor, 18 Lactulose, 24 Levora, 25
Kaochlor-EFF, 18 Lamictal, 12 Levorphanol, 20
Kaon, 18 Lamictal ODT/XR, 12 Levothyroxine, 27
Kaon elixir, 18 Lamisil, 9 Levoxy, 27
Kapidex, 24 Lamivudine, 8, 39 Levsin, 24
Kapvay, 21 Lamivudine / Zidovudine, 8 Levsinex, 24
Kariva, 25 Lamotrigine, 12 Lexapro, 22
Kay-Ciel, 18 Lanoxicaps, 15 Lexiva, 8
Kayexalate, 18 Lanoxin, 15 Lexxel, 14
K-Dur, 18 lanreotide, 40 Lialda, 24
Keflex, 7 Lansoprazole, 24 Librium, 21
Kelnor, 25 Lansoprazole/Amox/Clarithrom, 24 Lidamantle, 34
Kemadrin, 11 Lansoprazole/Naproxen, 24 Lidex, 34
Kenalog, 34 Lanthanum Carbonate, 18 Lidocaine, 34
Keppra, 12 Lantus, 29 Lidocaine-prilocaine, 34
Keppra XR, 12 Lapatinib, 10 Lidoderm, 34
Keralac, 33 Lariam, 9 Lifescan Products, 30
Keratolytics / Wound Care, 3, 33 Lasix, 17 Lindane, 34
Kerlone, 13 Lastacaft, 36 Linezolid, 8
Ketek, 7 Latanoprost, 36 Lioresal, 18
Ketoconazole, 9, 33 Latuda, 23 Liothyronine, 27
Ketoprofen, 19 Lavoclen-4, 8, 33 Liotrix, 27
Ketorolac, 19, 36 Laxatives & Cathartics, 3, 24 Lipitor, 16
Ketotifen, 36 Leena, 25 Lipofen, 16
Kineret, 40 Leflunomide, 40 Lipram, 16
Kionex, 18 Lenalidomide, 10 Liquadd, 21
Rite Aid Health Solutions Clinically Preferred Drug List – Subject to update 49 BOLD INDICATES BRAND NAME
Liraglutide, 29 Loxitane, 23 Mefenamic acid, 19
Lisdexamfetamine, 21 Lozol, 17 Mefloquine, 9
Lisinopril, 14 Lubiprostone, 24 Megace, 27
Lisinopril/HCTZ, 14 Ludiomil, 22 Megace ES, 27
Lithium Carbonate, 23 Lufyllin, 32 Megestrol acetate suspension, 27
Lithobid, 23 Lugol’s, 27 Mellaril, 23
Livalo, 16 Lumigan, 36 Meloxicam, 19
Lo Loestrin FE, 25 Lumizyme, 40 Melphalan, 10
Lo/Ovral, 25 Lunesta, 21 Memantine, 11
Locoid, 34 Lurasidone, 23 Menest, 25
Locoid Lipocream, 34 Luride, 38 Menostar, 25
Lodine/XL, 19 Lutera, 25 Mentax, 33
Lodosyn, 11 Luvox, 22 Meperidine, 20
Lodoxamide, 36 Luvox CR, 22 Mephobarbital, 12, 21
Lodrane, 31 Luxiq, 34 Meprobamate, 20, 21
Lodrane 24, 31 Lybrel, 25 Mepron, 9
Loestrin 24 Fe, 25 Lyrica, 12 Mercaptopurine, 10
Loestrin/Fe, 25 Lysodren, 10 Mesalamine, 24
Lofibra, 16 Lysteda, 35 Mesna, 10
Lomotil, 24 Macrodantin, 7 Mesnex, 10
Lomustine, 10 Macrolides, Clindamycins & Ketolides, 2, 7 Mestinon, 11
Loniten, 15 Mafenide, 33 Metadate CD, 21
Loperamide, 24 Mag carb/citric acid/lact, 17 Metadate/ER, 21
Lopid, 16 Magnacet, 20 Metaglip, 29
Lopressor, 13 Magnebind, 18 Metallic Poison Treatment Agents, 3, 38
Lopressor HCT, 13 Makena, 40 Metaproterenol, 31
Loprox, 33 Malarone, 9 Metaxalone, 18
Lorabid, 7 Malathion, 34 ME-Testosterone/Estrogen/Ester, 26
Loracarbef, 7 Maprotiline, 22 Metformin, 29
Loratadine, 31 Maraviroc, 8 Metformin Extended Release, 29
Lorazepam, 21 Marinol, 10 Methadone, 20
Lorcet, 20 Marplan, 22 Methamphetamine, 21
Lortab, 20 Materna, 27 Methazolamide, 17
Losartan, 14 Maternity, 27 Methenamine, 17
Losartan/HCTZ, 14 Matulane, 10 Methergine, 38
LoSeasonique, 25 Mavik, 14 Methimazole, 27
Lotemax, 36 Maxair, 31 Methitest, 26
Lotensin, 14 Maxalt/MLT, 11 Methocarbamol, 18
Lotensin HCT, 14 Maxidex, 36 Methotrexate, 10, 40
Loteprednol, 36 Maxitrol, 37 Methoxsalen, 34
Lotrel, 14 Maxzide, 17 Methscopalamine, 24
Lotrimin, 33 MD Turbo, 32 Methsuximide, 12
Lotrisone, 33 Mebaral, 12, 21 Methyclothiazide, 17
Lotronex, 24 Mebendazole, 9 Methyldopa, 15
Lovastatin, 16 Meclizine, 10 Methyldopa/HCTZ, 15
Lovaza, 16 Meclofenamate, 19 Methylergonovine, 38
Lovenox, 12 Meclomen, 19 Methylin, 21
Low-Ogestrel, 25 Medrol, 27 Methylnaltrexone, 24
Loxapine, 23 Medroxyprogesterone, 26 Methylphenidate, 21
Rite Aid Health Solutions Clinically Preferred Drug List – Subject to update 50 BOLD INDICATES BRAND NAME
Methylprednisolone, 27 Mitotane, 10 Mydriacyl, 37
Methyltestosterone, 26 Moban, 23 Myfortic, 10
Metipranolol, 36 Mobic, 19 Myleran, 10
Metoclopramide, 24 Modafinil, 21 Mynate 90 Plus, 27
Metolazone, 17 Modicon, 25 Myobloc, 40
Metoprolol, 13 Moduretic, 17 Mysoline, 12
Metoprolol/HCTZ, 13 Moexipril, 14 Mytelase, 11
Metozolv ODT, 24 Moexipril/HCTZ, 14 Na PHOS mono&dibasic/cellulose, 24
Metrogel, 33, 35 Molindone, 23 Na sulfacet/Prednisln, 35
Metrogel-vaginal, 35 Mometasone, 32, 34 Nabilone, 10
Metrolotion, 33 Mometasone Furoate, 32, 34 Nabumetone, 19
Metronidazole, 8, 24, 33, 35 Monistat-7, 35 Nadolol, 13
Metyrosine, 13 Monistat-Derm, 33 Naferellin, 27
Mevacor, 16 Monoamine Oxidase Inhibitors (MAOIs), 3, 22 Naftifine, 33
Mexiletine, 15 Monodox, 7 Naftin, 33
Mexitil, 15 Monoket, 15 Nalfon, 19
Mg, K, Na Sulfates, 24 Mononessa, 25 Naltrexone, 38
Miacalcin, 19 Monopril, 14 Naltrexone Microspheres, 38
Micardis, 14 Monopril HCT, 14 Namenda, 11
Micardis HCT, 14 Montelukast, 31 Nandrolone DE, 26
Miconazole, 9, 33, 35 Monurol, 17 Nandrolone dec, 26
Microgestin/Fe, 25 Moricizine, 15 Naphazoline, 37
Micro-K, 18 Morphine ER/Naltrexone, 20 NaPhos MB m-h/na Phos,Di-Ba, 24
Micronase, 29 Morphine Sulfate, 20 Naprelan, 19
Microsize Griseofulvin, 9 Morphine Sulfate Extend Release, 20 Naprosyn/EC, 19
Midamor, 17 Morphine Sulfate Sust Release, 20 Naproxen, 19
Midrin, 11 Motofen, 24 Naproxen sodium, 19
Mifeprex, 26 Motrin, 19 Naproxen Sodium, 19
Mifepristone, 26 Moviprep, 24 Naproxen/Esomeprazole, 19
Miglitol, 29 Moxatag, 7 Naratriptan, 11
Migralam, 11 Moxeza, 35 Narcotic Analgesics, 20
Migranal Nasal, 11 Moxifloxacin, 8, 35 Nardil, 22
Milnacipran, 22 Mozobil, 40 Nasacort AQ, 32
Miltown, 21 MS Contin, 20 Nasarel, 32
Mimyx, 34 MSIR, 20 Nasonex, 32
Minipress, 13, 17 Multaq, 15 Natacaps, 27
Minitran, 15 Multiple Sclerosis Agents, 3, 40 Natachew, 27
Minocin, 7 Mupirocin, 9 Natacyn, 35
Minocycline, 7 Murocoll-2, 37 Natafort, 27
Minoxidil, 15 Muromonab-CD3, 10 Natalcare CFE, 27
Mintezol, 9 MUSE, 17 Natalizumab, 40
Miochol-E, 36 Mycelex, 9, 33 Natamycin, 35
Miralax, 24 Mycelex Troches, 9 Natazia, 25
Mirapex, 11 Mycobutin, 9 Nateglinide, 29
Mirapex ER, 11 Mycolog, 33 Natroba, 34
Mircette, 25 Mycophenolate mofetil, 10 Nature-Throid, 27
Mirena, 25 Mycophenolate sodium, 10 Navane, 23
Mirtazapine, 22 Mycostatin, 9, 33 Nebivolol, 13
Misoprostol, 24 Mydfrin, 37 Nebupent, 9
Rite Aid Health Solutions Clinically Preferred Drug List – Subject to update 51 BOLD INDICATES BRAND NAME
Necon, 25 Nitroglycerin (Discs), 15 Octreotide, 40
Necon 10/11, 25 Nitroglycerin (Orals), 15 Ocufen, 36
Necon 7/7/7, 25 Nitroglycerin Spray, 15 Ocuflox, 35
Nedocromil, 36 Nitrolingual, 15 Ocupress, 36
Neevo, 27 Nitromist, 15 Ofloxacin, 8, 35
Neevo/DHA, 27 Nitroquick, 15 Oforta, 10
Nefazodone, 22 Nitrostat, 15 Ogen, 25
Nelfinavir, 8 Nizatidine, 24 Ogestrel, 25
Neo Sul/Polymyxin B/HC, 37 Nizoral, 9, 33 Olanzapine, 23
Neofrin, 37 Nolvadex, 10 Oleptro, 22
Neomycin + Polymyxin + HC, 37 Non-Salicylate Analgesics, 20 Olmesartan, 14
Neomycin/Polymyxin/Bacitracin, 35 Nora-Be, 25 Olmesartan/Amlodipine/HCTZ, 14
Neomycin/Polymyxin/Gramicidin, 35 Norco, 20 Olmesartan/Amlodpine, 14
Neoral, 10 Nordette, 25 Olmesartan/HCTZ, 14
Neosporin, 35 Norditropin, 39 Olopatadine, 31, 36
Neostigmine, 11 Norethindone acetate, 26 Olsalazine, 24
Nepafenac, 36 Norflex, 18 Olux, 34
Neptazane, 17 Norfloxacin, 8 Omacor, 16
Nestabs CBF/FA, 27 Norgesic/Forte, 18 Omalizumab, 31
Neupro, 11 Norinyl, 25 Omega-3 Acid Ethyl Esters, 16
Neurontin, 12 Noritate, 33 Omeprazole, 24
Nevanac, 36 Noroxin, 8 Omeprazole-bicarb, 24
Nevirapine, 8 Norpace, 15 Omnaris, 32
Nexium, 24 Norpace CR, 15 Omni Gel, 38
Next Choice, 25 Norpramin, 22 Omnicef, 7
Niacin, 16 Nor-QD, 25 Omnipen, 7
Niacin Extend Release, 16 Nortrel, 25 Omnitrope, 39
Niacin/Lovastatin, 16 Nortriptyline, 22 OnabotulinumtoxinA, 40
Niacor, 16 Norvir, 8 Onglyza, 29
Niaspan, 16 Novacet, 33 Onsolis, 20
Nicardipine, 13 Novanatal, 27 Opana/ER, 20
Nicotine, 38 Noxafil, 9 Ophthalmic Antibiotics, 3, 35
Nicotrol Cartridge Inhaler, 38 Nplate, 40 Ophthalmic Antibiotic-Steroid Combinations,
Nicotrol Nasal Inhaler, 38 Nucynta, 20 37
Niferex Forte / 150, 12 Nuedexta, 23 Ophthalmic Antihistamines, 3, 36
Niferex-PN/Forte, 27 NuLev, 24 Ophthalmic Anti-Inflammatory Agents, 36
Nilandron, 10 Nulytely, 24 Ophthalmic Antivirals, 3, 35
Nilotinib, 10 Numorphan, 20 Ophthalmic Immunomodulators /Lubricants,
Nimodipine, 13 Nutrinate, 27 36
Nimotop, 13 Nutritional Agents, 38 Ophthalmic Mast Cell Stabilizers, 3, 36
Niravam, 21 Nutropin/ AQ, 39 Ophthalmic Miotics, 3, 36
Nisoldipine, 13 Nuvaring, 25 Ophthalmic Mycriatics, 37
Nitazoxanide, 9 Nuvigil, 21 Ophthalmic Vasoconstrictors, 3, 37
Nitro-BID, 15 Nydamax, 33 Optipranolol, 36
Nitrodisc, 15 Nystatin, 9, 33, 35 Optivar, 36
Nitro-Dur, 15 Nystatin Vaginal tabs, 35 Oracea, 7
Nitrofurantoin, 7 Nystatin w/Triamcinolone, 33 Oral Hypoglycemics, 3, 29
Nitrofurantoin Macro, 7 Ocella, 25 Orap, 23
Nitroglycerin, 15 OCL soln, 24 Orapred, 27
Rite Aid Health Solutions Clinically Preferred Drug List – Subject to update 52 BOLD INDICATES BRAND NAME
Orapred ODT, 27 Oxymetholone, 26 Pegvisomant, 40
Oravig, 9 Oxymorphone, 20 Pemirolast, 36
Orencia, 40 Oxytocics, 38 Penbutolol, 13
Orinase, 29 Oxytrol, 17 Penciclovir, 9
Orlistat, 38 Ozurdex, 36 Penicillamine, 38
Orphenadrine, 18 Pacerone, 15 Penicillin VK, 7
Orphenadrine/ASA/Caff, 18 Palgic, 31 Penicillins & Cephalosporins, 2, 7
Ortho Cyclen, 25 Palgic Liquid, 31 Pennsaid, 19
Ortho Tricyclen/ Lo, 25 Paliperidone, 23 Pentamidine, 9
Ortho-Cept, 25 Paliperidone inj, 23 Pentasa, 24
Orthoclone OKT-3, 10 Palivizumab, 8 Pentazocine/Acetaminophen, 20
Ortho-Est, 25 Pamelor, 22 Pentazocine/Naloxone, 20
Ortho-Evra, 25 Pamidronate, 19 Pentosan polysulfate, 17
Ortho-Micronor, 25 Pamine/Forte, 24 Pentoxifylline, 12
Ortho-Novum, 25 Pancreatin, 16 Pepcid/AC/RPD, 24
Ortho-Novum 10/11, 25 Pancreaze, 16 Percocet, 20
Ortho-Novum 7/7/7, 25 Pancrecarb, 16 Percodan, 20
Orthovisc, 40 Pancrelipase, 16 Perforomist, 32
Orudis, 19 Pandel, 34 Periactin, 31
Oruvail, 19 Panretin, 10 Peridex, 38
Oseltamivir, 8 Pantoprazole, 24 Perindopril, 14
Osmoprep Tab, 24 Parafon Forte, 18 Periostat, 38
Osteoporosis / Paget’s Disease Agents, 19 Parasympathetic Agents, 3, 38 Permethrin 5%, 34
Other Allergy Agents, 31 Parcopa, 11 Perphenazine, 23
Other Antihyperlipidemic Agents, 2, 16 Paremyd, 37 Perry Prenatal, 27
Other Contraception Agents, 3, 26 Paricalcitol, 38 Persantine, 12
Otic Agents, 37 Parlodel, 11 Pexeva, 22
Oticin HC, 37 Parnate, 22 Phenazopyridine, 17
Otilam, 37 Paromomycin Sulfate, 8 Phenergan, 10
Otocain, 37 Paroxetine, 22 Phenobarbital, 12, 21
Otogesic, 37 Paroxetine Mesylate, 22 Phenoxybenzamine, 13
Ovcon/Fe, 25 Pataday, 36 Phentermine, 38
Ovide, 34 Patanase, 31 Phenylephrine, 37
Ovral, 25 Patanol, 36 Phenylzine, 22
Ovrette, 25 Paxil, Paxil Suspension, 22 Phenytek, 12
Oxandrin, 26 Pazopanib, 10 Phenytoin, 12
Oxandrolone, 26 Pediapred, 27 Phos-Flur, 38
Oxaprozin, 19 Pediatan, 31 PhosLo, 18
Oxazepam, 21 Pediazole, 7 Phospholine Iodide, 36
Oxcarbazepine, 12 Pediotic, 37 Phrenilin/Forte, 11
Oxiconazole, 33 PEG 3350, 24 Pilocar, 36
Oxistat, 33 PEG 3350/electrolyte soln, 24 Pilocarpine, 36, 38
Oxsoralen, 34 PEG 3350/Sod Sul/NaCl/ASB/KCL, 24 Pilopine HS, 36
Oxybutynin, 17 Peganone, 12 Pimecrolimus, 34
Oxycodone, 20 Pegasys, 39 Pimozide, 23
Oxycodone w/Acetaminophen, 20 Peginterferon Alfa-2A, 39 Pindolol, 13
Oxycodone w/Aspirin, 20 Peginterferon Alfa-2B, 39 Pioglitazone, 29
Oxycodone/Ibuprofen, 20 Peg-Intron, 39 Pioglitazone/Glimepiride, 29
OxyIR, 20 Pegloticase, 18 Pioglitazone/Metformin, 29
Rite Aid Health Solutions Clinically Preferred Drug List – Subject to update 53 BOLD INDICATES BRAND NAME
Pirbuterol, 31 Pravastatin, 16 Primaquine, 9
Piroxicam, 19 Praziquantel, 9 Primaquine Phosphate, 9
Pitavastatin, 16 Prazosin, 13, 17 Primidone, 12
Plan B, 25 Precare, 27 Prinivil, 14
Plan B One-Step, 25 Precare Conceive/Prenata, 27 Prinzide, 14
Plaquenil, 9 Precision Products, 30 Pristiq, 22
Platelet Aggregation Inhibitors, 2, 12 Precose, 29 ProAir, 31
Plavix, 12 Pred Forte, 36 Pro-Banthine, 24
Plendil, 13 Pred Mild, 36 Probenecid, 18
Plerixafor, 40 Pred-G, 37 Procainamide, 15
Pletal, 12 Prednicarbate, 34 Procanbid, 15
Plexion, 33 Prednisolone, 27, 36, 37 Procarbazine, 10
Podofilox, 33 Prednisolone acetate, 36 Procardia/XL, 13
Polycillin, 7 Prednisolone sod, 27, 36 Prochieve, 26
Poly-Citra/K, 17 Prednisolone sod phos, 27 Prochlorperazine, 10
Polymyxin w/Bacitracin, 35 Prednisone, 27 Procrit, 12
Polymyxin/Trimethoprim, 35 Prefera-OB + DHA, 27 ProctoFoamHC, 27
Polymyxin+Neomycin+Hydrocortisone, 37 Prefera-OB/One, 27 Procyclidine, 11
Poly-Pred, 37 Prefest, 26 Progestational Agents, 3, 26
Polysporin, 35 Pregabalin, 12 Progesterone, 26
Polytrim, 35 Prelone, 27 Progesterone oil, 26
Ponstel, 19 Premarin, 25, 26 Progesterone, Micron., 26
Poractant alfa, 39 Premarin Cream, 26 Progesterone, micronized, 26
Portia, 25 Premesis RX, 27 Proglycem, 30
Posaconazole, 9 Premphase, 26 Prograf, 10
Potass bicarb/Potass cit/Ca, 18 Prempro, 26 Prolastin, 39
Potass chloride/pot bicar, 18 Prena-Cap, 27 Prolastin-C, 39
Potassium & Electrolytes, 2, 18 Prenatabs CBF, 27 Prolia, 19
Potassium Acetate/Bicarb/Citrate, 18 Prenatal, 3, 27 Prolixin, 23
Potassium Acid Phosphate, 17 Prenatal 19, 27 Promacta, 40
Potassium Bicarb+Potassium Cit, 18 Prenatal Advantage, 27 Promethazine HCL, 10
Potassium chloride, 18 Prenatal MR 90 FE, 27 Prometrium, 26
Potassium Chloride, 18 Prenatal Plus, 27 Pronestyl/SR, 15
Potassium Citrate, 17 Prenatal Start, 27 Propafenone, 15
Potassium Gluconate, 18 Prenatal Vitamins, 3, 27 Propantheline, 24
Potassium Iodide, 27 Prenate Advance, 27 Propine, 37
PR Natal 400 EC, 27 Prenate DHA, 27 Propranolol, 13
Pradaxa, 12 Prenate Elite, 27 Propranolol/HCTZ, 13
Pramipexole, 11 Prenate Essential, 27 Propylthiouracil, 27
Pramlintide Acetate, 29 Prenate GT, 27 Proquin XR, 8
Pramosone, 34 Prestige / TrueTrack Products, 30 Proscar, 17
Pramosone / E, 34 Prevacid, 24 Prosom, 21
Pramotic, 37 Prevacid NapraPac, 24 Prostigmin, 11
Pramoxine/Chloroxylenol, 37 Prevident, 38 Protonix, 24
Prandimet, 29 Previfem, 25 Protopic, 34
Prandin, 29 PrevPac, 24 Protriptyline, 22
Prasterone, 26 Prezista, 8 Proventil / HFA, 31
Prasugrel, 12 Prilosec, 24 Provera, 26
Pravachol, 16 PrimaCare 1, 27 Provigil, 21
Rite Aid Health Solutions Clinically Preferred Drug List – Subject to update 54 BOLD INDICATES BRAND NAME
Prozac, 22 Relafen, 19 Risperidone, 23
Prozac Weekly, 22 Relenza, 8 Ritalin LA, 21
Pseudoephedrine/Acrivastine, 31 Relion, 29 Ritalin/SR, 21
Psorcon, 34 Relistor, 24 Ritonavir, 8
Psoriasis Agents (Oral & Topical), 34 Relpax, 11 Ritonavir / Lopinavir, 8
Psoriatec, 34 Remeron, Remeron Soltab, 22 Rivastigmine, 11
P-Tex, 31 Remicade, 40 Rizatriptan, 11
Pulmicort, 32 Remodulin, 39 Robaxin, 18
Pulmonary Agents, 3, 39 Renacidin, 17 Rocaltrol, 38
Pulmozyme, 32 Renagel, 18 Romiplostim, 40
Purinethol, 10 Renvela, 18 Ropinirole, 11
Pylera, 24 Repaglinide, 29 Rosiglitazone, 29
Pyridium, 17 Repaglinide / Metformin, 29 Rosiglitazone/ Glimepiride, 29
Pyridostigmine, 11 Repliva, 12 Rosiglitazone/ Metformin, 29
Pyrimethamine, 9 Requip, 11 Rosula, 33
Qdall AR, 31 Requip XL, 11 Rosula Clarifying Wash/CLK, 33
Qualaquin, 9 Rescriptor, 8 Rosuvastatin, 16
Quasense, 25 Respi-Tann PD, 32 Rotigotine, 11
Quazepam, 21 Restasis, 36 Rowasa, 24
Questran, 16 Restoril, 21 Roxanol, 20
Quetiapine, 23 Retapamulin, 9 Rozerem, 21
Quinaglute, 15 Retin-A, 33 Rufinamide, 12
Quinapril, 14 Retin-A Micro, 33 Rum-K, 18
Quinapril/HCTZ, 14 Retisert, 36 Rybix ODT, 20
Quineprox, 9 Retrovir, 8 Rythmol, 15
Quinidine Gluconate, 15 Revatio, 39 Rythmol/SR, 15
Quinine sulfate, 9 Revia, 38 Ryzolt, 20
Quinolones, 2, 8 Revlimid, 10 Sabril, 12
Quixin, 35 Reyataz, 8 Safyral, 25
Qvar, 32 Rheumatoid Arthritis Agents, 3, 38, 40 Saizen, 39
Rabeprazole, 24 Rheumatrex, 40 Salagen, 38
Raloxifene, 19 Rhinocort Aqua, 32 Salex, 33
raltegravir, 8 Ribasphere, 39 Salex Shampoo, 33
Ramelteon, 21 Ribatab, 39 Salicylate Analgesics, 20
Ramipril, 14 Ribavirin, 8, 39 Salicylic Acid, 33
Ranexa, 15 Ricobid-H, 31 Salmeterol, 31
Ranitidine, 24 Ridaura, 38 Salsalate, 20
Ranolazine, 15 Rifabutin, 9 Sal-Tropine, 24
Rapaflo, 17 Rifamixin, 8 Samsca, 18
Rapamune, 10 Rilonacept, 40 Sanctura, 17
Rapiflux, 22 Rilutek, 11 Sanctura XR, 17
Rasagiline, 11 Riluzole, 11 Sancuso Patch, 10
Razadyne/ER, 11 RimabotulinumtoxinB, 40 Sandimmune, 10
Rebetol, 39 Rimantadine, 8 Sandostatin, 40
Rebif, 40 Rimexolone, 36 Sandostatin LAR, 40
Reclast, 19 Riomet, 29 Santyl, 33
Reclipsen, 25 Risedronate, 19 Saphris, 23
Reglan, 24 Risedronate/Calcium, 19 Sapropterin, 40
Regranex, 33 Risperdal, 23 Saquinavir, 8
Rite Aid Health Solutions Clinically Preferred Drug List – Subject to update 55 BOLD INDICATES BRAND NAME
Sarafem, 22 Sitagliptin Phosphate, 29 Starlix, 29
Savella, 22 Skelaxin, 18 Statin – CCB Combination, 16
Saxagliptin, 29 Skeletal Muscle Relaxants, 2, 18 Statins, 2, 16
Saxagliptin / Metformin, 29 Skelid, 19 Stavudine, 8
Scabies & Pediculosis Agents, 34 Slo-Bid, 32 Stavzor, 12
Scopalamine, 10 Smoking Cessation Products, 3, 38 Staxyn ODT, 17
Scopolamine, 37 Sod chloride/NAHCO3/KCl/PEG's, 24 Stelara, 40
Seasonale, 25 Sod sulf/sod/NaHCO3/KCL/PEG's, 24 Stelazine, 23
Secobarbital, 21 Sod sulf/sod/NAHCO3/KCL/PEG's, 24 Sterapred, 27
Seconal, 21 Sodium fluoride, 38 Strattera, 21
Sectral, 13 Sodium Fluoride, 38 Striant, 26
Sedative-Hypnotics, Barbiturate, 21 Sodium Oxybate, 21 Stromectol, 9
Sedative-Hypnotics, Non-Barbiturate, 21 Sodium Phos/Potassium Phos, 17 Strongstart, 27
Selegiline, 11, 22 Sodium Polystyrene Sulfonate, 18 Stuartnatal Plus, 27
Selzentry, 8 Sodium Thiosulfate/SA, 33 Suboxone, 20
Semprex-D, 31 Soft Clix Lancet Device & Lancets, 30 Subutex, 20
Sensipar, 38 Soft Touch Lancet Device & Lancets, 30 Succimer, 38
Septra, 7 Solia, 25 Succinylcholine, 18
Serax, 21 Solifenacin, 17 Sucralfate, 24
Serevent Diskus, 31 Solodyn, 7 Sular, 13
Seromycin, 9 Soma, 18, 20 Sulconazole, 33
Seroquel, 23 Soma Compound, 20 Sulfacetam w/prednisolone, 35
Serostim, 39 Somatropin, 39 Sulfacetamide 10%, 33, 35
Serotonin Non-Specific Reuptake Inhibitors Somatuline, 40 Sulfacetamide w/ Sulfur, 33
(SNRIs), 3, 22 Somavert, 40 Sulfacetamide/sulfur, 33
Serotonin Specific Reuptake Inhibitors Somnote, 21 Sulfacetamide/Sulfur/Urea/Meth
(SSRIs), 3, 22 Sonata, 21 Anthranilate/Titanium dioxide, 33
Sertaconazole, 33 Sorbitrate, 15 Sulfamylon, 33
Sertraline, 22 Soriatane, 34 Sulfanilamide, 35
Serzone, 22 Sotalol, 13 Sulfasalazine, 7
Sevelamer, 18 Sotret, 33 Sulfathiaz/Sulfacetam/S-Benz, 35
Sevelamer Carbonate, 18 Spacol, 24 Sulfa-Trimethoprim, 7
Sildenafil, 17, 39 Spacol T/S, 24 Sulfonamides, Sulfones & Nitrofurantoins, 2, 7
Silenor, 21 Spectazole, 33 Sulfoxyl, 33
Silodosin, 17 Spectracef, 7 Sulindac, 19
Silvadene, 33 Spinosad, 34 Sultrin, 35
Silver Sulfadiazine, 33 Spiriva, 32 Sumatriptan, 11
Simcor, 16 Spironolactone/HCTZ, 17 Sumatriptan / Naproxen, 11
Simetyl, 24 Sporanox, 9 Sumavel, 11
Simponi, 40 Sporanox Oral Solution, 9 Sumycin, 7
Simulect, 10 Sprintec, 25 Sunitinib Malate, 10
Simvastatin, 16 Sprix, 19 Supartz, 40
Simvastatin / Niaspan, 16 Sprycel, 10 Suprax, 7
Sinecatechins, 33 SPS, 18 Suprep, 24
Sinemet/CR, 11 Sronyx, 25 Surmontil, 22
Sinequan, 22 SSRI / Antipsychotic Combinations, 22 Survanta, 39
Singulair, 31 Stadol, 20 Sustiva, 8
Sirolimus, 10 Stalevo, 11 Sutent, 10
Sitagliptin / Metformin, 29 Stannous Fluoride, 38 Sux-Cert, 18
Rite Aid Health Solutions Clinically Preferred Drug List – Subject to update 56 BOLD INDICATES BRAND NAME
Symax Duotab, 24 Tenex, 15 Tiazac, 13
Symbicort, 31 Tenofovir, 8 Ticlid, 12
Symbyax, 22 Tenoretic, 13 Ticlopidine, 12
Symlin, 29 Tenormin, 13 Tigan, 10
Symmetrel, 8, 11 Terazol 3, 7, 35 Tikosyn, 15
Sympatholytic Agents, 2, 15 Terazosin, 13, 17 Tiludronate, 19
Synagis, 8 Terbinafine, 9 Timolol, 13, 36
Synalar, 34 Terbutaline, 31 Timolol maleate, 36
Synarel, 27 Terconazole, 35 Timolol/Dorzolamide, 36
Synthroid, 27 Teriparatide, 19 Timoptic/XE, 36
Synvisc, 40 Terramycin Polymixyn B, 35 Tindamax, 8
Synvisc-One, 40 tesamorelin, 40 Tinidazole, 8
Syprine, 38 Teslac, 10 Tinzaparin, 12
Taclonex, 34 Testim, 26 Tiotropium, 32
Tacrine, 11 Testolactone, 10 Tipranavir, 8
Tacrolimus, 10, 34 Testopel, 26 Tirosint, 27
Tacrolimus anhydrous, 10 Testosterone, 26 Tizanidine, 18
Tadalafil, 17, 39 Testosterone cypionate, 26 Tobi, 32
Tagamet, 24 Testosterone enanthate, 26 Tobradex, 37
Talacen, 20 Testosterone Gel, 26 Tobradex ST, 37
Taladine, 24 Testosterone Patch, 26 Tobramycin, 32, 35, 37
Talwin NX, 20 Testosterone prop, 26 Tobramycin / Loteprednol, 37
Tambocor, 15 Testosterone propionate, 26 Tobramycin + Dexamethasone, 37
Tamiflu, 8 Testred, 26 Tobrex, 35
Tamoxifen, 10 Tetrabenazine, 40 Tocilizumab, 40
Tamsulosin, 17 Tetracaine/Benzocaine, 34 Tofranil/PM, 22
Tapazole, 27 Tetracycline, 7 Tofranil-PM, 22
Tapentadol, 20 Tetracyclines, 2, 7 Tolazamide, 29
Tarceva, 10 Teveten, 14 Tolbutamide, 29
Targretin, 10 Teveten HCT, 14 Tolcapone, 11
Tarka, 14 Tev-tropin, 39 Tolectin/DS, 19
Tasigna, 10 Thalidomide, 9 Tolinase, 29
Tasmar, 11 Thalomid, 9 Tolmetin, 19
Tazarotene, 34 Theo-24, 32 Tolterodine, 17
Tazorac, 34 Theocap, 32 Tolvaptan, 18
Tegretol, 12 Theochron, 32 Topamax, 12
Tegretol XR, 12 Theophylline, 32 Topical Corticosteroids, 3, 34
Tekamlo, 14 Theophylline anhydrous, 32 Topical immunosuppressives &
Tekturna, 14 Thera-Flur-N, 38 Miscellaneous, 34
Tekturna HCT, 14 Therasense Products, 30 Topical Local Anesthetics, 3, 34
Telbivudine, 39 Thiabendazole, 9 Topicort, 34
Telithromycin, 7 Thioguanine, 10 Topiramate, 12
Telmisartan, 14 Thioridazine, 23 Topotecan, 10
Telmisartan/Amlodipine, 14 Thiothixene, 23 Toprol XL, 13
Telmisartan/HCTZ, 14 Thorazine, 23 Toradol, 19
Temazepam, 21 Thyroid, 3, 27 Torsemide, 17
Temodar, 10 Thyroid, pork, 27 Toviaz, 17
Temovate, 34 Thyrolar, 27 Tracleer, 39
Temozolomide, 10 Tiagabine, 12 Tramadol, 20
Rite Aid Health Solutions Clinically Preferred Drug List – Subject to update 57 BOLD INDICATES BRAND NAME
Tramadol w/Acetaminophen, 20 Tripolidine, 31 Valacyclovir, 8
Trandate, 13 Tri-Previfem, 25 Valcyte, 8
Trandolapril, 14 Tri-Sprintec, 25 Valganciclovir, 8
Trandolapril/Verapamil, 14 Trivora, 25 Valisone, 34
Tranexamic acid, 35 Trizivir, 8 Valium, 21
Transderm-Scop Patch, 10 Tropicamide, 37 Valproic Acid, 12
Tranxene, 21 Trospium, 17 Valsartan, 14
Tranxene SD, 21 Trusopt, 36 Valsartan/Amlodipine, 14
Tranylcypromine, 22 Truvada, 8 Valsartan/Amlodipine/HCTZ, 14
Travatan/Z, 36 Trypsin-Balsam Peru-Castor, 33 Valsartan/HCTZ, 14
Travoprost, 36 T-Stat, 33 Valtrex, 8
Trazodone, 22 Tussionex, 31 Valturna, 14
Trazodone ER, 22 Twinject, 32 Vanadom, 18
Trental, 12 Twynsta, 14 Vancocin, 8
Treprostinil, 39 Tykerb, 10 Vancomycin, 8
Tretinoin, 10, 33 Tylenol #2/3/4, 20 Vanos, 34
Tretinoin 0.05% Gel, 33 Tylox, 20 Vardenafil, 17
Tretinoin microspheres, 33 Tysabri, 40 Varenicline Tartrate, 38
Tretin-X, 33 Tyvaso, 39 Vaseretic, 14
Trexall, 10 Tyzeka, 39 Vasocidin, 35
Treximet, 11 Ulesfia, 34 Vasodilators, Coronary, 2, 15
Triamcinolone, 32, 34 Ulipristal, 26 Vasodilators, Hypotensive, 2, 15
Triamterene, 17 Uloric, 18 Vasotec, 14
Triamterene / HCTZ, 17 Ultracef, 7 Vazol, 31
Triaz, 33 Ultracet, 20 V-Cillin K, 7
Triazolam, 21 Ultram, 20 Vectical, 34
Tribenzor, 14 Ultram ER, 20 Veetids, 7
Tricor, 16 Ultrase, 16 Velaglucerase alpha, 40
Tricosal, 20 Ultravate, 34 Velivet, 25
Trientine, 38 Umecta, 33 Veltin, 33
Trifluoperazine, 23 Uniphyl, 32 Venlafaxine, 22
Trifluridine, 35 Uniretic, 14 Ventavis, 39
Triglide, 16 Unithroid, 27 Ventolin, 31
Trihexyphenidyl, 11 Univasc, 14 Ventolin HFA, 31
Tri-K, 18 Urea, 33, 37 Vepesid, 10
Trilafon, 23 Urecholine, 38 Veramyst, 32
Tri-Legest Fe, 25 Urinary pH Modifiers, 2, 17 Verapamil, 13
Trileptal, 12 Urine Glucose / Ketone Strips, 3, 30 Verdeso, 34
Tri-Levlen, 25 Urispas, 17 Veregen, 33
Trilipix, 16 Urocit-K, 17 Verelan, 13
Trilisate, 20 Urologic Agents, 2, 17, 18 Vermox, 9
Trilyte, 24 UroQid-acid, 17 Versiclear, 33
Trimethobenzamide, 10 Uroxatral, 17 Vertin, 10
Trimipramine, 22 Urso/Forte, 24 Vesanoid, 10
Trinessa, 25 Ursodiol, 24 VESICare, 17
Tri-Norinyl, 25 Ustekinumab, 40 Vexol, 36
Triphasil, 25 Vagifem, 26 Vfend, 9
Triple Dye, 33 Vaginal Antibiotics, 3, 35 Viagra, 17
Triple Sulfa, 35 Vaginal Antifungals, 3, 35 Vibramycin, 7
Rite Aid Health Solutions Clinically Preferred Drug List – Subject to update 58 BOLD INDICATES BRAND NAME
Vibra-Tabs, 7 Westhroid, 27 Zetia, 16
Vicodin, 20 Xalatan, 36 Ziac, 13
Vicoprofen, 20 Xanax/XR, 21 Ziagen, 8
Victoza, 29 Xanthine Derivatives, 3, 32 Ziana Gel, 33
Videx pediatric soln/chewable, 8 Xeloda, 10 Zidovudine, 8
Videx/EC, 8 Xenaderm, 33 Zileuton, 31
Vigabatrin, 12 Xenazine, 40 Zinc acetate, 38
Vigamox, 35 Xenical, 38 Ziprasidone, 23
Viibryd, 22 Xeomin, 40 Zipsor, 19
Vilazadone, 22 Xerese, 9 Zirgan, 35
Vimovo, 19 Xgeva, 40 Zithromax, 7
Vimpat, 12 Xiaflex, 40 Z-Max, 7
Vinatal Forte, 27 Xifaxan, 8 Zocor, 16
Vinate GT, 27 Xodol, 20 Zoderm, 33
Viokase, 16 Xolair, 31 Zoladex, 10
Viracept, 8 Xolegel, 33 Zolinza, 10
Viramune, 8 Xopenex/HFA, 31 Zolmitriptan, 11
Virazole, 8 Xyrem, 21 Zoloft, 22
Viread, 8 Xyzal, 31 Zolpidem, 21
Viritab, 17 Yasmin, 25 Zolpimist, 21
Viroptic, 35 Yaz, 25 Zomig/ZMT, 11
Visicol, 24 Yocon, 17 Zonegran, 12
Visken, 13 Yodoxin, 8 Zonisamide, 12
Vistaril, 31 Yohimbine, 17 Zorbtive, 39
Vitrasert, 35 Zaditor, 36 Zortress, 10
Vitravene, 35 Zafirlukast, 31 Zoto-HC, 37
Vivactil, 22 Zaleplon, 21 Zovia, 25
Vivelle DOT, 25 Zanaflex, 18 Zovirax, 8, 9
Vivitrol, 38 Zanamivir, 8 Zuplenz Film, 10
Voltaren, 19 Zantac, 24 Zyban, 38
Voltaren Gel, 19 Zarontin, 12 Zyclara, 34
Voltaren/XR, 19 Zaroxolyn, 17 Zydone, 20
Vopac, 20 Z-clinz, 33 Zyflo, 31
Vorinostat, 10 Zebeta, 13 Zyflo/CR, 31
Vospire ER, 31 Zegerid, 24 Zyflo/CR (, 31
Votrient, 10 Zelapar, 11 Zylet, 37
VPRIV, 40 Zemaira, 39 Zyloprim, 18
Vusion, 33 Zemplar, 38 Zymar, 35
Vytorin, 16 Zenapax, 10 Zymaxid 0.5%, 35
Vyvanse, 21 Zenpep, 16 Zymine, 31
Warfarin sodium, 12 Zerit, 8 Zyprexa Relprevv, 23
Welchol, 16 Zestoretic, 14 Zyprexa/ZYDIS, 23
Wellbutrin/SR/ XL, 22 Zestril, 14 Zyrtec/D, 31
Westcort, 34 Zetacet, 33 Zyvox, 8
Rite Aid Health Solutions Clinically Preferred Drug List – Subject to update 59 BOLD INDICATES BRAND NAME
