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CerpassRx2019 Preventative Medicine List
www.cerpassrx.com
CATEGORY GENERIC MEDICINE BRAND-NAME MEDICINE
Preventive medications are defined as those prescribed to prevent the occurrence of a chronic disease or condition for those indiviudals with risk factors, or to prevent the recurrence of a disease or condition. Your plan values the impact these medications have on your health. You do not need to meet any deductible for preventive medications and your prescription benefits are paid immediately for these products. This list contains examples of preventive medications organized by therapy class. Medications may be added to or removed from the list periodically and the list is not all inclusive.
Anticoagulant and Hematological Agents
anagrelidecilostazolclopidogreldipyridamolejantoven
warfarin AGGRENOXBRILINTAEFFIENTELIQUISPRADAXA
SAVAYSAXARELTOZONTIVITY
Anticonvulsant Agents
carbamazepinecarbamazepine ERdivalproexdivalproex DRdivalproex ERepitolethosuximidefelbamategabapentinlamotriginelamotrigine ER
levetiracetamlevetiracetam ERoxcarbazepinephenobarbitalphenytoinprimidonetiagabinetopiramatetopiramate ERvalproic acidzonisamide
APTIOMBANZELBRIVIACTCELONTINFYCOMPAGABITRIL
ONFI
PEGANONE
POTIGA
SPRITAMVIMPAT
Antidiabetic Agents
acarbosealogliptinchlorpropamideglimepirideglipizideglipizide erglipizide xlglipizide/metforminglyburideglyburide micronizedglyburide/metforminmetforminmetformin ermiglitolnateglinidepioglitazonepioglitazone/glimepiridepioglitazone/metforminrepagliniderepaglinide/metformintolazamidetolbutamide
ACTOPLUS MET XRAFREZZA
BYETTA
BYDUREONCYCLOSETGLYXAMBIHUMALOGHUMALOG KWIKPENHUMALOG MIX 50/50HUMALOG MIX 50/50 KWIKPENHUMALOG MIX 75/25HUMALOG MIX 75/25 KWIKPENHUMULIN 70/30HUMULIN 70/30 KWIKPENHUMULIN NHUMULIN N KWIKPENHUMULIN RHUMULIN R U-500HUMULIN R U-500 KWIKPEN
INVOKANA XR
INVOKAMETINVOKANA
JANUMETJANUMET XRJANUVIA
JARDIANCEJENTADUETOJENTADUETO XR
LANTUSLANTUS SOLOSTAR
OZEMPIC
SYMLIN PENSYNJARDY
TOUJEOTRADJENTA
TRULICITY
CATEGORY GENERIC MEDICINE BRAND-NAME MEDICINE
Asthma Agents albuterolalbuterol ERbudesonidecromolynipratropiumipratropium/albuterollevalbuterolmetaproterenolmontelukastterbutalinetheochrontheophyllinetheophylline CRtheophylline ERtheophylline SRzafirlukast
CardiovasularAgents
acebutololacetazolamideacetazolamide ERafeditab CRamiloride/HCTZamilorideamiodaroneamlodipineamlodipine/atorvastatinamlodipine/benazaprilamlodipine/olmesartanamlodipine/olmesartan/HCTZamlodipine/valsartanamlodipine/valsartan/HCTZatenololatenolol/chlorthalidonebenazaprilbenazapril/HCTZbetaxololbisoprololbudesonidebisoprolol/HCTZbumetanidecandesartancandesartan/HCTZcaptoprilcaptopril/HCTZ/carvediol
chlorothiazidechlorthalidoneclonidine
digoxinditl-XR
digitekdigox
diltiazemdiltiazem CDdiltiazem ERdisopyramidedofetilidedoxazosinenalaprilenalapril/HCTZeplerenoneeprosartanethacrynic acidezidefelodipine ERflecainidefosinoprilfosinopril/HCTZfurosemidehydralazinehydrochlorothiazideindapamideirbesartanirbesartan/HCTZisosorbide dinitrateisosorbide dinitrate ERisosorbide dinitrate ERisosorbide dinitrate SAisosorbide mononitrateisosorbide mononitrate ERisradipinelabetalol
ADVAIR DISKUSADVAIR HFAAEROSPANANORO ELLIPTA
PERFOROMISTPROAIR HFAPROAIR RESPICLICK
ARCAPTA NEOHALERARNUITY ELLIPTAATROVENT HFA
BREO ELLIPTABROVANACOMBIVENT RESPIMATDALIRESP
PULMICORT FLEXHALER
SEREVENT DISKUSSPIRIVA HANDIHALERSPIRIVA RESPIMATSTIOLTO RESPIMATSTRIVERDI RESPIMATSYMBICORTTHEO-24VENTOLIN HFA
FLOVENT DISKUSFLOVENT HFAINCRUSE ELLIPTA
ALDACTAZIDEBIDIL
TEKTURNA
TEKTURNA HCT
BYSTOLICBYVALSONCARDIZEM LACLORPRESCOREG CRDILATRATE SRDIURILDUTOPROLDYRENIUMEDARBIEDARBYCLORENTRESTOEPANEDHEMANGEOL
INNOPRAN XL
LANOXINLEVATOLMULTAQNITRO-BIDNITRO-DURNITROMIST
NORPACE CRPRESTALIAQBRELISRANEXASOTYLIZE
CATEGORY GENERIC MEDICINE BRAND-NAME MEDICINE
CardiovasularAgents
lisinoprillisinopril/HCTZlosartanlosartan/HCTZmatzim LAmethazolamidemethyclothiazidemethyldopamethyldopa/HCTZmetolazonemetoprolol succinate ERmetoprolol tartratemetoprolol/HCTZmexilietineminitranminoxidilmoexipril
Cholesterol Agents
ALTOPREVANTARALIPOFENLIVALOTRIGLIDEVASCEPA
atorvastatincholestyraminecholestyramine light
colesevelamcolestipol
fenofibrate
ezetimibeezetimibe/simvastatin
fenofibric acidfenofibric acid DRfluvastatinfluvastatin ERgemfibrozillovastatin
niacin ERomega-3-acid
pravastatinprevaliterosuvastatinsimvastatin
moexipril/HCTZnadololnadolol/bendroflumethiazidenicardipinenifediac CCnifedical XLnifedipinenifedipine ERnimodipinenisoldipinenisoldipine ERnitro-timenitroglycerinnitroglycerin ERnitroglycerin lingualnitroglycerin transdermalolmesartanolmesartan/HCTZpaceroneperindopril
pindololprazosinpropafenonepropafenone erpropranololpropranolol erpropranolol/hctzquinaprilquinapril/hctzquinidinequinidine gluconate crquinidine gluconate erramiprilsorinesotalolspironolactonespironolactone/hctztaztia xttelmisartantelmisartan/amlodipinetelmisartan/hctzterazosintimololtorsemidetrandolapriltrandolapril/verapamiltrandolapril/verapamil ertriamterene/hctzvalsartanvalsartan/hctzverapamilverapamil crverapamil erverapamil saverapamil sr
gildess 1/20
FALESSANATAZIANUVARINGQUARTETTE
CATEGORY GENERIC MEDICINE BRAND-NAME MEDICINE
Contraceptives altaveraalyacen 1/35alyacen 7/7/7amethiaamethia loamethystapriaranelleashlynaaubraavianeazurettebalzivabekyreeblisovi fe 1/20blisovi 24 feblisovi fe 1.5/30briellyncamilacamresecamrese locaziantcesiachatealcryselle-28cyclafem 1/35cyclafem 7/7/7cyreddasetta 1/35dasetta 7/7/7dayseedeblitanedelyladesogestrel/ethinyl estradioldrospirenone/ethinyl estradiol
jencyclajolessajolivette
juleberjunel 1/20junel 1.5/30junel fe 24junel fe 1/20junel fe 1.5/30kaitlib fekarivakelnor 1/35kimidisskurvelo larinlarin 1/20larin 1.5/30larin fe 1.5/30larissialayolis feleenalessinalevonestlevonorgestrel/ethinyl estradiollevora 0.15/30-28lomedia 24 felorynalow-ogestrelluteralyzamarlissamedroxyprogesterone acetatemicrogestin 1/20microgestin 1.5/30
elinestemoquetteenpresse-28enskyceerrinestaryllafalminagianvigildagia
gildess 1.5/30gildess fe 1/20gildess 24 fegildess fe 1.5/30
microgestin femicrogestin 24 fe
heatherintrovale
microgestin fe 1.5/30mono-linyamononessamyzilranecon 0.5/35-28necon 1/35necon 1/50-28necon 10/11-28necon 7/7/7nikkinora-benorethindronenorethindrone acetate/ethinyl estradiolnorgestimate/ethinyl estradiolnorlyrocnortrel 0.5/35 (28)nortrel 1/35nortrel 7/7/7ocellaogestrel
Estrogens & Estrogen Combination Products
OsteoporosisAgents
ALORAANGELIQUECLIMARA PROCOMBIPATCHDIVIGELDUAVEEELESTRINEVAMIST
BINOSTO
FORTICALFOSAMAX PLUS D
MENESTMENOSTAR
MINIVELLEPREFESTPREMARINPREMPHASEPREMPRO
CATEGORY GENERIC MEDICINE BRAND-NAME MEDICINE
Contraceptives orsythiaphilithpimtrapirmella 1/35pirmella 7/7/7portia-28previfemprogesteronereclipsensetlakinsharobelsoliasprintec-28sronyxsyedatarina FE 1/20tilia FEtri-estaryllatri-legest FETri-linyahTri-lo-estaryllaTri-lo-marzia
tri-lo-sprintectri-previfemtri-sprintectrinessatrinessa lotrivora-28
covaryxcovaryx hseemtesterified estrogens/methyltestosteroneestradiolestradiol/norethindroneestropipatefyavolv
jevantique lo
jintelilopreezamimveymimvey lonorethindrone acetate/ethinyl estradiol
alendronatecalcitoninibandronateraloxifenerisendronate
velivetvesturavienvaviorelevyfemlawymzya FExulanezarahzenchentzenchent FEzovia 1/35Ezovia 1/50E
Ulcer Agents DEXILANTcimetidineesomeprazolefamotidinelansoprazolemisoprostolnizatidineomeprazoleomeprazole/sodium bicarbonatepantoprazolerabeprazoleranitidinesucralfate