100-6926 Core List

2008 List of Preventive Medications Here is your 2008 List of Preventive Medications. This booklet provides information on medications that are excluded from the deductible requirements of your pharmacy benefit. Medications on the 2008 List of Preventive Medications are covered at your pharmacy benefit copay levels regardless of your deductible requirements. Please reference your Prescription Drug List Consumer Reference Guide or go to www.myuhc.com to determine the tier and copay levels for the medications in the 2008 List of Preventive Medications. Medications listed in the first section of the 2008 List of Preventive Medications are sorted alphabetically. Medications in the second section are sorted by therapeutic category by tier. If you have additional questions about your pharmacy benefit, please call the Customer Care number on your ID card. 1 100-6926 Core List 10/07 2008 List of Preventive Medications - Alphabetical Drugs List Accupril Accuretic Acebutolol Aceon Activella Actonel Adalat CC Advicor Aggrenox Aldactone Aldomet Aldoril Alendronate Aliskiren Alora Altace Altocor Altoprev Amiloride Amiloride/HCTZ Amlodipine Amlodipine/Benazepril Antara Apresoline Aspirin/Pravastatin Atacand Atacand HCT Atenolol Atenolol/Chlorthalidone Atorvastatin Avalide Avapro Benazepril Benazepril/Hydrochlorothiazide Bendroflumethiazide Benicar Benicar HCT Betaxolol BiDil Bisoprolol Bisoprolol/Hydrochlorothiazide Blocadren Boniva Bumetanide Caduet Calcitonin – Salmon, Synthetic Calan Calan SR Candesartan Candesartan/Hydrochlorothiazide Capoten Capozide Captopril Captopril/Hydrochlorothiazide Cardene Cardene SR Cardizem CD Cardizem LA Cardizem SR Cardura Carteolol Cartia XT Cartrol Carvedilol Catapres Catapres TTS Chlorothiazide Chlorthalidone Cholestyramine Cholestyramine Light Climara Climara PRO Clonidine Clonidine/Chlorthalidone Clopidogrel Colestid Granules Colestipol Granules Colesevelam Combipatch Combipres Conjugated Estrogens Conjugated Estrogens/Medroxyprogesteron Coreg Corgard Corzide Coumadin Covera-HS Cozaar Crestor Demadex Dilacor XR Diltia XT Diltiazem SR 12 and 24 hr. Diltiazem ER Diltiazem Sustained Action Diltiazem/Enalapril Diovan Diovan HCT Dipyridamole/ASA Doxazosin Dyazide 2 DynaCirc DynaCirc CR Enalapril Enalapril/Felodipine Enalapril/Hydrochlorothiazide Eprosartan Estrace Estraderm Estradiol Estradiol Transdermal System Estropipate Estradiol/Norgestimate Ethacrynic Acid Ethinyl Estradiol/Norethindrone Evista Ezetimibe Ezetimibe/Simvastatin Felodipine Femara Femhrt Fenofibrate Fluvastatin Fluvastatin Extended-Release Forteo Fortical Fosamax Fosinopril Fosinopril/Hydrochlorothiazide Furosemide Gemfibrozil Guanabenz Guanadrel Guanfacine Hydralazine Hydralazine/Isosorbide Hydrochlorothiazide Hydroflumethiazide Hylorel Hytrin Hyzaar Ibandronate Indapamide Inderal Inderal LA Inderide InnoPran XL Irbesartan Irbesartan/Hydrochlorothiazide Isoptin SR Isradipine Kerlone Labetalol 100-6926 Core List 10/07 2008 List of Preventive Medications - Alphabetical Lasix Lescol Lescol XL Letrozole Levatol Lexxel Lipitor Lisinopril Lisinopril/Hydrochlorothiazide LoCHOLEST LoCHOLEST Light Packets Lofibra Loniten Lopid Lopressor Lopressor HCT Losartan Losartan/Hydrochlorothiazide Lotensin Lotensin HCT Lotrel Lovastatin Lovastatin Extended-Release Mavik Maxzide Menostar Methyclothiazide Methyldopa Methyldopa/Hydrochlorothiazide Metolazone Metoprolol Metoprolol/Hydrochlorothiazide Mevacor Miacalcin Micardis Micardis HCT Minipress Minizide Minoxidil Moexipril Moexipril/Hydrochlorothiazide Monopril Monopril/Hydrochlorothiazide Nadolol Nadolol/Bendroflumethiazide Niacin Extended-Release Niacin Extended-Release and Lovastatin Niaspan Nicardipine Nicardipine SR Nifedical XL Nifedipine ER Nisoldipine Nolvadex Normodyne Norvasc Olmesartan Olmesartan/Hydrochlorothiazide Omacor Omega-3-Acid Ethyl Esters Ortho-Prefest Penbutolol Perindopril Pindolol Plavix Plendil Polythiazide Pravachol Pravastatin Pravigard PAC Prazosin Prazosin/Polythiazide Premarin Premphase Prempro Prenatal Multivitamins with iron and folic acid (for example Prenate, Materna, Stuartnatal, Natalins, Nestabs FA) Prevalite Prinivil Prinzide Procardia XL Propranolol Propranolol ER Propranolol/Hydrochlorothiazide Questran Questran Light Quinapril Quinapril/Hydrochlorothiazide Raloxifene Ramipril Reserpine Risedronate Rosuvastatin Sectral Simvastatin Soltamox Spironolactone Spironolactone/HCTZ Sular Tamoxifen Tarka 3 Taztia XT Teczem Tekturna Telmisartan Telmisartan/Hydrochlorothiazide Tenex Tenoretic Tenormin Terazosin Teriparatide Teveten Teveten HCT Tiazac Ticlid Ticlopidine Timolide Timolol Timolol/Hydrochlorothiazide Toprol XL Torsemide Trandate Trandolapril Trandolapril/verapamil Triamterene/HCTZ Trichlormethiazide Tricor Triglide Uniretic Univasc Valsartan Valsartan/Hydrochlorothiazide Vaseretic Vasotec Verapamil Verapamil ER Verapamil SR Verelan Verelan PM Visken Vivelle Vivelle-Dot Vytorin warfarin WelChol Wytensin Zebeta Zestoretic Zestril Zetia Ziac Zocor 100-6926 Core List 10/07 2008 List of Preventive Medications by Drug Class Anti-coagulant (heart attack and stroke prevention) Coumadin Warfarin Antihypertensives (blood pressure) Diuretics Aldactone Amiloride Bendroflumethiazide Bumetanide Chlorothiazide Chlorthalidone Demadex Dyazide Ethacrynic acid Furosemide Hydrochlorothiazide Hydroflumethiazide Indapamide Lasix Maxzide Methylclothiazide Metolazone Polythiazide Spironolactone Spironolactone/HCTZ Torsemide Trichlormethiazide Triamterene/HCTZ Anti-estrogen (breast cancer prevention) Femara Letrozole Nolvadex Soltamox Tamoxifen Anti-platelet (stroke prevention) Aggrenox Clopidogrel Dipyridamole/ASA Plavix Ticlid Ticlopidine Beta Blockers Acebutolol Atenolol Betaxolol Blocadren Bisoprolol Carteolol Cartrol Carvedilol Coreg Corgard Inderal Inderal LA InnoPran XL Kerlone Labetalol Levatol Lopressor Metoprolol Nadolol Normodyne Penbutolol Pindolol Propranolol Propranolol ER Sectral Tenormin Timolol Toprol XL Trandate Visken Zebeta 4 100-6926 Core List 10/07 2008 List of Preventive Medications by Drug Class Calcium Channel Blockers Adalat CC Amlodipine Calan Calan SR Cardene Cardene SR Cardizem CD Cardizem LA Cardizem SR Cartia XT Covera-HS Dilacor XR Diltia XT Diltiazem ER Diltiazem SR 12 hr. Diltiazem SR 24 hr. Diltiazem Sustained Action DynaCirc DynaCirc CR Felodipine Isoptin SR Isradipine Nicardipine Nicardipine SR Nifedical XL Nifedipine ER Nisoldipine Norvasc Plendil Procardia XL Sular Taztia XT Tiazac Verapamil Verapamil ER Verapamil SR Verelan Verelan PM Angiotensin Converting Enzyme Inhibitors Accupril Aceon Altace Benazepril Capoten Captopril Enalapril Fosinopril Lisinopril Lotensin Mavik Moexipril Monopril Perindopril Prinivil Quinapril Ramipril Trandolapril Univasc Vasotec Zestril Angiotensin II Receptor Blockers Atacand Avapro Benicar Candesartan Cozaar Diovan Eprosartan Irbesartan Losartan Micardis Olmesartan Telmisartan Teveten Valsartan Adrenergic Antagonists Aldomet Cardura Catapres Catapres TTS Clonidine Doxazosin Guanabenz Guanadrel Guanfacine Hylorel Hytrin Methyldopa Minipress Prazosin Reserpine Tenex Terazosin Wytensin Vasodilators Apresoline BiDil Hydralazine Hydralazine/Isosorbide Loniten Minoxidil 5 100-6926 Core List 10/07 2008 List of Preventive Medications by Drug Class Combination Antihypertensives Accuretic Aldoril Amiloride/HCTZ Amlodipine/Benazepril Atacand HCT Atenolol/Chlorthalidone Avalide Benazepril/Hydrochorothiazide Benicar HCT Bisoprolol/Hydrochlorothiazide Caduet Candesartan/Hydrochlorothiazide Capozide Captopril/Hydrochlorothiazide Clonidine/Chlorthalidone Combipres Corzide Diltiazem/Enalapril Diovan HCT Enalapril/Felodipine Enalapril/Hydrochlorothiazide Fosinopril/Hydrochlorothiazide Hyzaar Inderide Irbesartan/Hydrochlorothiazide Lexxel Lisinopril/Hydrochlorothiazide Lopressor HCT Losartan/Hydrochlorothiazide Lotensin HCT Lotrel Methyldopa/Chlorothiazide Methyldopa/Hydrochlorothiazide Metoprolol/Hydrochlorothiazide Micardis HCT Minizide Moexipril/Hydrochlorothiazide Monopril HCT Nadolol/Bendroflumethiazide Olmesartan/Hydrochlorothiazide Prazosin/Polythiazide Propranolol/Hydrochlorothiazide Prinzide Quinapril/Hydrochlorothiazide Tarka Teczem Telmisartan/Hydrochlorothiazide Tenoretic Teveten HCT Timolide Timolol/Hydrochlorothiazide Trandolapril/Verapamil Uniretic Valsartan/Hydrochlorothiazide Vaseretic Zestoretic Ziac Renin Inhibitors Aliskiren Tekturna 6 100-6926 Core List 10/07 2008 List of Preventive Medications by Drug Class Lipid/Cholesterol Lowering Agents (heart attack and heart disease prevention) Bile Acid Sequestrants Cholestyramine Cholestyramine Light Colesevelam Colestid Granules Colestipol Granules LoCHOLEST LoCHOLEST Light Packets Prevalite Questran Questran Light WelChol Statins Altocor Altoprev Atorvastatin Crestor Fluvastatin Fluvastatin Extended Release Lescol Lescol XL Lipitor Lovastatin Lovastatin Extended Release Mevacor Pravachol Pravastatin Rosuvastatin Simvastatin Zocor Fibric Acid Derivatives Antara Fenofibrate Gemfibrozil Lofibra Lopid Tricor Triglide Niacin Niacin Extended Release Niaspan Other Ezetimibe Omacor Omega-3-Acid Ethyl Esters Zetia Combinations Advicor Aspirin/Pravastatin Ezetimibe/Simvastatin Niacin Extended Release and Lovastatin Pravigard PAC Vytorin Osteoporosis Therapy (healthy bones) Estrogens Alora Climara Conjugated Estrogens Estrace Estraderm Estradiol Estradiol Transdermal System Estropipate Menostar Premarin Vivelle Vivelle-Dot Estrogen/Progestin Combinations Activella Climara PRO Combipatch Conjugated Estrogens/ Medroxy-progesterone Estradiol/Norgestimate Ethinyl Estradiol/Norethindrone Femhrt Ortho-Prefest Premphase Prempro Bisphosphonates Actonel Alendronate Boniva Fosamax Ibandronate Risedronate Selective Estrogen Receptor Calcitonin – Salmon Calcitonin – Salmon, Synthetic Evista Forteo Fortical Miacalcin Raloxifene Teriparatide 7 100-6926 Core List 10/07 2008 List of Preventive Medications by Drug Class Vitamins & Hematinics Pediatric Vitamins with Fluoride (for example Florvite, Poly-Vi-Flor,Tri-A-Vite F, Tri-Vi-Flor, Florvite, Vi-Daylin/F ADC, Soluvite-f) Generic Products Brand Name Products Prenatal Multivitamins with Iron and Folic Acid (for example Prenate, Materna, Stuartnatal, Natalins, Nestabs FA) Generic Products Brand Name Products 8 100-6926 Core List 10/07