GENERIC DISCOUNT FORMULARY March 2015
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1 Antibiotic Amoxicillin Amoxil 250mg Amoxicillin Amoxil 500mg Amoxicillin Amoxil 125mg/5ml Amoxicillin Amoxil 250mg/5ml Amoxicillin Bid Amoxil 400mg/5ml Amoxicillin Bid Amoxil 200mg/5ml Ampicillin Polycillin 250mg Cephalexin Keflex 500mg Clindamycin Cleocin 150mg Penicillin VK Vcillin K 250gm/5ml Penicillin VK Vcillin K 125mg/5ml Penicillin VK Vcillin K 250mg Sulfameth/Trimeth Bactrim 400/80mg Sulfameth/Trimeth Bactrim/Septra DS 800/160mg Antifungal Fluconazole Diflucan 150mg AntiViral Acyclovir Zovirax 200mg Amantadine Symmetrel 50mg/5ml Arthritis/Pain Ibuprofen Motrin 400mg Ibuprofen Motrin 600mg Ibuprofen Motrin 800mg Ibuprofen Motrin 100mg/5ml Indomethacin Indocin 25mg Meloxicam Mobic 7.5mg Meloxicam Mobic 15mg Naproxen Naprosyn 250mg Naproxen Naprosyn 375mg Naproxen Naprosyn 500mg Asthma/Respiratory/Antihistamine Albuterol Proventil Ipratropium Bromide Atrovent Cholesterol Lovastatin Mevacor 10mg Lovastatin Mevacor 20mg Lovastatin Mevacor 40mg
2 CNS Hydroxyzine HCL Atarax 10mg Hydroxyzine HCL Atarax 25mg Hydroxyzine HCL Atarax 50mg Hydroxyzine Pamoate Vistaril 25mg Hydroxyzine Pamoate Vistaril 50mg Ropinirole Requip.25mg Trihexyphenidyl Artane 2mg Trihexyphenidyl Artane 5mg Valproic Acid Depakene 250mg/5ml Cough Prometh/DM Phenergan/DM Promethazine Phenergan 6.25mg/5ml Promethazine Phenergan 25mg Diabetes Glimepiride Amaryl 1mg Glimepiride Amaryl 2mg Glimepiride Amaryl 4mg Glipizide Glucotrol 10mg Glipizide Glucotrol 5mg Glyburide/Metformin Glucovance 1.25/250mg Glyburide Micronized Glynase 3mg Glyburide Micronized Glynase 6mg Metformin Glucophage 500mg Metformin Glucophage 850mg Metformin Glucophage 1000mg Metformin ER Glucophage XR 500mg Eye Levobunolol Betagan Timolol Timoptic Timolol Timoptic GastroIntestinal Dicyclomine Bentyl 10mg Dicyclomine Bentyl 20mg Famotidine Pepcid 20mg Famotidine Pepcid 40mg Lactulose Enulose 10gm/15ml Lactulose Constulose 10gm/15ml
3 Metoclopramide Reglan 5mg/5ml Metoclopramide Reglan 10mg Metoclopramide Reglan 5mg Promethazine Phenergan 12.5mg Promethazine Phenergan 25mg Promethazine Phenergan 50mg Ranitidine Zantac 150mg Ranitidine Zantac 300mg Heart and BP Amlodipine Besylate Norvasc 2.5mg Amlodipine Besylate Norvasc 5mg Amlodipine Besylate Norvasc 10mg Atenolol Tenormin 100mg Atenolol Tenormin 50mg Atenolol Tenormin 25mg Benazepril Lotensin 5mg Benazepril Lotensin 10mg Benazepril Lotensin 20mg Benazepril Lotensin 40mg Carvedilol Coreg 25mg Carvedilol Coreg 12.5mg Carvedilol Coreg 3.125mg Carvedilol Coreg 6.25mg Clonidine Catapres.1mg Clonidine Catapres.2mg Clonidine Catapres.3mg Clopidogrel Plavix 75mg Diltiazem Cardizem 30mg Diltiazem Cardizem 60mg Enalapril Vasotec 2.5mg Enalapril/HCTZ Vaseretic 10mg/25mg Enalapril/HCTZ Vaseretic 5mg/12.5mg Fosinopril Monopril 10mg Furosemide Lasix 20mg Furosemide Lasix 40mg Furosemide Lasix 80mg Guanfacine Tenex 1mg Guanfacine Tenex 2mg Hydralazine Apresoline 10mg Hydralazine Apresoline 25mg Hydralazine Apresoline 50mg Hydrochlorothiazide Hydrodiuril 25mg Hydrochlorothiazide Hydrodiuril 50mg
4 Hydrochlorothiazide Microzide 12.5mg Lisinopril Prinivil/Zestril 10mg Lisinopril Prinivil/Zestril 20mg Lisinopril Prinivil/Zestril 40mg Lisinopril Prinivil/Zestril 5mg Lisinopril Prinivil/Zestril 2.5mg Lisinopril Prinivil/Zestril 30mg Lisinopril/HCTZ Prinzide/Zestoretic 20/12.5mg Lisinopril/HCTZ Prinzide/Zestoretic 20/25mg Lisinopril/HCTZ Prinzide/Zestoretic 10/12.5mg Metoprolol Lopressor 100mg Metoprolol Lopressor 50mg Metoprolol Lopressor 25mg Propranolol Inderal 10mg Propranolol Inderal 20mg Propranolol Inderal 40mg Propranolol Inderal 80mg Ramipril Altace 2.5mg Sotalol Betapace 80mg Spironolactone Aldactone 25mg Terazosin Hytrin 1mg Terazosin Hytrin 2mg Terazosin Hytrin 5mg Terazosin Hytrin 10mg Torsemide Demadex 20mg Verapamil Calan 120mg Verapamil Calan 80mg Mental Health Buspirone Buspar 10mg Buspirone Buspar 5mg Buspirone Buspar 15mg Citalopram Celexa 20mg Citalopram Celexa 40mg Citalopram Celexa 10mg Fluoxetine Prozac 20mg Fluphenazine Prolixin 1mg Lithium Carbonate Eskalith 150mg Lithium Carbonate Eskalith 300mg Paroxetine Paxil 10mg Paroxetine Paxil 20mg Prochlorperazine Compazine 10mg Prochlorperazine Compazine 5mg Trazodone Desyrel 50mg
5 Trazodone Desyrel 100mg Trazodone Desyrel 150mg Muscle Relaxants Cyclobenzaprine Flexeril 10mg Cyclobenzaprine Flexeril 5mg Other Bethanechol Urecholine 25mg Chlorhexidine Gluconate Peridex Dexamethasone Decadron 4mg Lidocaine Xylocaine Viscous 0.02 Oxybutynin Ditropan 5mg/5ml Prednisone Deltasone 2.5mg Skin Hydrocortisone Hytone Hydrocortisone Cortdome Triamcinolone Kenalog Triamcinolone Kenalog Vitamins/Nutritional Folic Acid Folic Acid 1mg Prenatal Plus Stuartnatal Plus Sodium Fluoride Luride.25mg Sodium Fluoride Luride.5mg Sodium Fluoride Luride 1mg Womens Health Alendronate Fosamax 70mg Alendronate Fosamax 35mg Estradiol Estrace 1mg Estradiol Estrace 2mg Estradiol Estrace.5mg Program prices are for commonly prescribed dosages. Higher dosages may cost more. Restrictions apply. See program details or your AuBurn Pharmacist for details.
Penicillin VK Vcillin K 250gm/5ml Penicillin VK Vcillin K 250mg Sulfameth/Trimeth Bactrim 400/80mg Sulfameth/Trimeth Bactrim/Septra DS 800/160mg
Antibiotic Amoxicillin Amoxil 250mg Amoxicillin Amoxil 500mg Amoxicillin Amoxil 125mg/5ml Amoxicillin Amoxil 250mg/5ml Amoxicillin Bid Amoxil 400mg/5ml Amoxicillin Bid Amoxil 200mg/5ml Ampicillin Polycillin
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Acyclovir Capsules 200mg Viruses 30 90 Albuterol Syrup 2mg/5ml Asthma 120 360 Albuterol Sulfate Solution 0.05% * Asthma ----- ----- 20 60 Albuterol Sulfate Solution 0.083% Asthma ----- ----- 75 225 Alendronate
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Antibiotics Antifungal Antiviral Arthritis/ Pain 30 Day Qty* Free AMOXICILLIN 125 MG/5 ML (150 ML BOTTLE) AMOXICILLIN 125 MG/5 ML (100 ML BOTTLE) AMOXICILLIN 125 MG/5 ML (80 ML BOTTLE) AMOXICILLIN 200
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Allergy, Cold & Flu Antibiotic Treatments Arthritis & Pain Benzonatate 100mg cap 14 42 Diphenhydramine HCl Cap 50 MG 30 90 Diphenhydramine HCl Inj 50MG/ML 1 3 Diphenhydramine HCl Liquid 12.5 MG/5ML 720ml
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Allergy, Cold & Flu Antibiotic Treatments Arthritis & Pain Benzonatate 100mg cap 14 42 Diphenhydramine HCl Cap 50 MG 30 90 Diphenhydramine HCl Inj 50MG/ML 1 3 Diphenhydramine HCl Liquid 12.5 MG/5ML 720ml
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Drug Category Allergy, Cold & Flu Antibiotic Treatments Arthritis & Pain Riesbeck's Benzonatate 100mg cap 14 42 Diphenhydramine HCl Cap 50 MG 30 90 Diphenhydramine HCl Liquid 12.5 MG/5ML 720ml 2160ml Hydroxyzine
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Allergies & Cold and Flu Benzonatate 100mg 14 Ceron DM syrup Ceron drops Dec-Chlorphen drops Dec-Chlorphen DM syrup 118ml* Loratadine 10mg Promethazine DM syrup Trivent DPC syrup * Antibiotic Treatments
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