2013 Chronic and Preventive Medications List

Transcription

1 Quality health plans & benefits Healthier living Financial well-being Intelligent solutions 2013 Chronic and Preventive Medications List ACE INHIBITORS (hypertension, diabetes) benazepril benazepril/hctz captopril captopril/hctz enalapril enalapril/hctz fosinopril fosinopril/hctz lisinopril lisinopril/hctz moexipril moexipril/hctz perindopril quinapril quinapril/hctz ramipril trandolapril ACCUPRIL ACCURETIC ACEON ALTACE LOTENSIN LOTENSIN HCT MAVIK PRINIVIL PRINZIDE UNIRETIC UNIVASC VASERETIC VASOTEC ZESTORETIC ZESTRIL ACE-INHIBITORS/CALCIUM CHANNEL BLOCKER COMBINATION (hypertension/diabetes) amlodipine/benazepril LOTREL TARKA ANGIOTENSIN II RECEPTOR ANTAGONISTS (hypertension) eprosartan EXFORGE ATACAND irbesartan EXFORGE HCT ATACAND HCT irbesartan/hctz MICARDIS AVALIDE losartan MICARDIS HCT AVAPRO losartan/hctz valsartan valsartan/hctz B (9/12) AZOR BENICAR BENICAR HCT COZAAR DIOVAN DIOVAN HCT EDARBI EDARBYCLOR HYZAAR TEVETEN TEVETEN HCT TRIBENZOR TWYNSTA VALTURNA ANTIADRENERGIC ANTIHYPERTENSIVES (hypertension) clonidine CARDURA doxazosin CATAPRES guanabenz CATAPRES-TTS guanfacine CLORPRES methyldopa MINIPRESS methyldopa/hctz NEXICLON XR prazosin TENEX reserpine terazosin MISCELLANEOUS ANTIHYPERTENSIVES (hypertension) hydralazine DIBENZYLINE DEMSER hydralazine/hctz minoxidil ANTIHYPERLIPIDEMICS (high cholesterol) amlodipine/atorvastatin ANTARA ADVICOR atorvastatin CRESTOR ALTOPREV cholestyramine LESCOL XL CADUET cholestyramine light LOVAZA COLESTID colestipol NIASPAN FENOGLIDE fenofibrate SIMCOR FIBRICOR fenofibrate micronized TRILIPIX LESCOL fenofibric acid VYTORIN LIPITOR fluvastatin WELCHOL LIPOFEN gemfibrozil ZETIA LIVALO lovastatin LOFIBRA pravastatin LOPID

2 ANTIHYPERLIPIDEMICS (high cholesterol) prevalite simvastatin BETA-BLOCKERS (hypertension) MEVACOR PRAVACHOL QUESTRAN QUESTRAN LITE TRICOR TRIGLIDE ZOCOR acebutolol BYSTOLIC BETAPACE atenolol COREG CR BETAPACE AF atenolol/chlorthalidone DUTOPROLOL COREG betaxolol bisoprolol bisoprolol/hctz carvedilol labetalol metoprolol metoprolol/hctz nadolol nadolol/ bendroflumethazine pindolol propranolol propranolol SR propranolol/hctz sorin sotalol, sotalol AF timolol BLOOD THINNING AGENTS CORGARD CORZIDE INDERAL LA INNOPRAN XL KERLONE LEVATOL LOPRESSOR LOPRESSOR HCT metoprolol SR SECTRAL TENORETIC TENORMIN TOPROL XL TRANDATE ZEBETA ZIAC anagrelinde AGGRENOX AGRYLIN cilostazol EFFIENT ARIXTRA clopidogrel PRADAXA BRILINTA dipyridamole XARELTO COUMADIN enoxaparin fondaparinux jantoven ticlopidine warfarin CALCIUM CHANNEL BLOCKERS (heart disease, hypertension) afeditab amlodipine amlodipine/benazepril cartia XT FRAGMIN IPRIVASK LOVENOX PERSANTINE PLETAL PLAVIX ADALAT CC CADUET CALAN CALAN SR dilt-cd dilt-xr diltiazem diltiazem CD diltiazem ER diltiazem SR felodipine isradapine matzim LA nicardapine nifediac CC nifedical XL nifedipine nifedipine CR nifedipine ER nifedipine SR nimodipine nisoldipine taztia XT verapamil verapamil ER verapamil SR DIRECT RENIN INHIBITOR (hypertension) DIURETICS (hypertension) acetazolamide amiloride amiloride/hctz bumetanide chlorothiazide chlorthalidone eplerenone furosemide hydrochlorothiazide indapamide methazolamide methyclothiazide metolazone spironolactone spironolactone/hctz torsemide triamterine/hctz CARDENE SR CARDIZEM CARDIZEM CD CARDIZEM LA COVERA-HS DILACOR XR DYNACIRC CR ISOPTIN SR LOTREL NIMOTOP NORVASC PROCARDIA PROCARDIA XL SULAR TARKA TIAZAC VERELAN VERELAN PM VERELAN SR AMTURNIDE TEKAMLO TEKTURNA TEKTURNA HCT ALDACTAZIDE ALDACTONE DEMADEX DIAMOX DIURIL DYAZIDE DYRENIUM EDECRIN INSPRA INTROL LASIX MAXZIDE MICROZIDE MIDAMOR THALITONE ZAROXOLYN

3 ANTIANGINAL AGENTS (heart disease) venlafaxine ER (cap) ZOLOFT amyl nitrite NITROSTAT DILATRATE SR isosorbide dinitrate RANEXA IMDUR isosorbide dinitrate ER isosorbide mononitrate isosorbide mononitrate ER minitran nitro-time nitroglycerin nitroglycerin CR nitroglycerin SL CARDIAC GLYCOSIDES (heart disease) digoxin ANTIDEPRESSANTS (depression) ISORDIL MONOKET NITRO-BID NITRO-DUR NITROLINGUAL NITROMIST LANOXIN amitriptyline CYMBALTA ANAFRANIL amitriptyline / chlodiazepoxide PRISTIQ APLENZIN amoxapine VIIBRYD CELEXA budeprion VIIBRYD KIT EFFEXOR XR budeprion XL WELLBUTRIN XL EMSAM buproprion buproprion SR citalopram clomipramine desipramine doxepin escitalopram fluoxetine fluoxetine delayed release fluvoxamine imipramine maprotiline mirtazapine mirtazapine ODT nortriptyline paroxetine paroxetine ER phenelzine protriptyline sertraline tranylcypromine trazodone trimipramine venlafaxine FLUOXETINE 60 mg LEXAPRO LUVOX CR MARPLAN NARDIL nefazodone NORPRAMIN OLEPTRO PAMELOR PARNATE PAXIL PAXIL CR PEXEVA PROZAC PROZAC WEEKLY REMERON REMERON SOLUTAB SURMONTIL TOFRANIL TOFRANIL-PM VENLAFAXINE ER (tab) VIVACTIL WELLBUTRIN WELLBUTRIN SR venlafaxine SR (tab) ANTIASTHMATICS (asthma) albuterol ADVAIR DISKUS ACCOLATE albuterol/ipratropium ADVAIR HFA ACCUNEB aminophylline ASMANEX ADRENALIN budesonide inhalation suspension COMBIVENT RESPIMAT ALVESCO copd DALIRESP ARCAPTA NEOHALER cromolyn DULERA ATROVENT HFA difil-g (forte) FLOVENT DISKUS BRONCOMAR-1 dyflex-g FLOVENT HFA BRONDIL ipratropium inhaler FORADIL BROVANA levalbuterol inhalation solution PERFOROMIST COMBIVENT montelukast PROAIR HFA DUONEB terbutaline PROVENTIL HFA ED-BRON G theochron QVAR ELIXOPHYLLIN theophylline ER SEREVENT DISKUS LUFYLLIN zafirlukast SINGULAIR MAXAIR AUTOHALER SPIRIVA SYMBICORT XOLAIR ANTIPSYCHOTICS (mental illness) metaproterenol PULMICORT FLEXHALER PULMICORT RESPULES THEO-24 VENTOLIN HFA VOSPIRE ER XOPENEX XOPENEX HFA ZYFLO ZYFLO CR chlorpromazine SEROQUEL XR ABILIFY clozapine compro fluphenazine haloperidol lithium lithium carbonate lithium carbonate ER lithium citrate loxapine olanzapine olanzapine/fluoxetine ABILIFY DISC CLOZARIL EQUETRO FANAPT FAZACLO GEODON INVEGA LATUDA LITHOBID LOXITANE ORAP

4 ANTIPSYCHOTICS (mental illness) olanzapine ODT perphenazine perphenazine/ amitriptyline prochlorperazine quetiapine risperidone risperidone ODT thioridazine thiothixene trifluoperazine ziprasidone ANTIDIABETIC DRUGS (diabetes) RISPERDAL RISPERDAL M SAPHRIS SEROQUEL SYMBYAX ZYPREXA ZYPREXA ZYDIS acarbose BYDUREON ACTOPLUS MET chlorpropamide CYCLOSET ACTOPLUS MET XR glimepiride HUMALOG products ACTOS glipizide HUMULIN products AMARYL glipizide ER JANUMET APIDRA glipizide XL JANUMET XR AVANDAMET glipizide/metformin JANUVIA AVANDARYL glucose tab JENTADUETO AVANDIA glyburide JUVISYNC BYETTA glyburide micronized KOMBIGLYZE DIABETA glyburide/metformin LANTUS DIABINESE metformin LANTUS SOLOSTAR DUETACT metformin ER LEVEMIR FORTAMET nateglinide LEVEMIR FLEXPEN GLUCAGEN pioglitazone NOVOLOG products GLUCAGON pioglitazone/metformin ONGLYZA GLUCOPHAGE tolazamide PRANDIN GLUCOPHAGE XR tolbutamide PROGLYCEM GLUCOTROL SYMLIN SYMLINPEN TRADJENTA VICTOZA GLUCOTROL XL GLUCOVANCE GLUMETZA GLYNASE GLYSET KORLYM METAGLIP NOVOLIN products PRANDIMET PRECOSE RELION products RIOMET STARLIX DIABETIC SUPPLIES (diabetes) insulin syringes BD insulin syringes (any ) BD lancets (all other brands) lancets BD pen needles insulin syringes (any ) EXACTECH (all other brands) pen needles lancets (any ) FREESTYLE (all other brands) pen needles FREESTYLE INSULINX (all other brands) ULTIMA FREESTYLE LITE ONE TOUCH BASIC ONE TOUCH FAST TAKE ONE TOUCH PROFILE ONE TOUCH ULTRA ONE TOUCH VERIO ONE TOUCH VERIO IQ OPTIUM PRECISION Q-I-D PRECISION SOF-TACT PRECISION XTRA PRECISION XTRA ketone test strips SURESTEP

5 OSTEOPOROSIS DRUGS (osteoporosis) alendronate ACTONEL AREDIA calcitonin ATELVIA BONIVA etidronate EVISTA DIDRONEL fortical ibandronate pamidronate PEDIATRIC VITAMINS with FLUORIDE chewable multivit/ fluoride multiple vitamins/ fluoride poly-vitamin/fluoride tri-vitamin/fluoride vitamins A/D/C/fluoride FORTEO FOSAMAX FOSAMAX + D GANITE MIACALCIN INJ MIACALCIN SPRAY PROLIA RECLAST SKELID XGEVA ZOMETA PRENATAL MULTIVITAMIN with IRON and FOLIC ACID mynatal tab MYNATAL cap SMOKING CESSATION MEDICATIONS (Tobacco Cessation) buproban CHANTIX buproban SR NICOTROL INHALER bupropion NICOTROL NS bupropion SR ZYBAN Health benefits and health insurance plans are offered, administered and/or underwritten by Aetna Health Inc., Aetna Health Insurance Company of New York, Aetna Health Insurance Company and/or Aetna Life Insurance Company (Aetna). In Florida, by Aetna Health Inc. and/or Aetna Life Insurance Company. In Maryland, by Aetna Health Inc., 151 Farmington Avenue, Hartford, CT Each insurer has sole financial responsibility for its own products. Please remember that this is not a complete list of covered under your plan. Because there are thousands of included in your pharmacy benefit, we only list the most common ones. Certain drugs such as those for smoking cessation or vitamins may not be covered by your particular pharmacy plan. Diabetic supplies may be covered under your medical plan. If you have any questions about your pharmacy benefits, please visit and log in to your secure member website, Aetna Navigator. If you don t have access to our website, call the Member Services number on your ID card. To check coverage and copay information for a specific medicine, visit and log in to Aetna Navigator. For more details, please call the toll-free number on your member ID card. Aetna Pharmacy Management refers to an internal business unit of Aetna Health Management, LLC. This is not an inclusive list. Products that are not represented on this list may be subject to plan-specific copayment or coinsurance. Void where prohibited by law. Specific prescription benefit plan design may not cover certain categories or may be subject to additional charges or restrictions, regardless of their appearance in this document. Aetna may receive rebates, discounts and service fees from pharmaceutical manufacturers for certain listed products. Your privacy is important to us. Our employees are trained regarding the appropriate way to handle your private health information. Information is believed to be accurate as of the production date; however, it is subject to change. For questions, please call the toll-free number on your member ID card Aetna Inc B (9/12)