Select Preventive Prescription Drugs Jan. 1, 2018
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1 Select Preventive Prescription Drugs Jan. 1, 2018 In addition to a healthy lifestyle, preventive medications can help you avoid some illnesses and conditions. Zimmer Biomet's medical options Value HSA, Premium HSA and HRA include preventive medications at no cost to participants enrolled in a medical option to support the goal of ongoing good health. This list provides examples of commonly prescribed preventive medications. The medications are categorized based on the medical conditions that they are used to prevent. Select preventive prescription drugs shown in all capital letters are brand name drugs. All others are generic drugs. This list is periodically reviewed and updated to ensure that the drugs listed meet the criteria for inclusion. Anticoagulants/Antiplatelets (blood thinners) Aspirin/dipyridamole Bivalirudin Clopidogrel Enoxaparin sodium Fondiparinux Heparin sodium (in vials) JANTOVEN Prasugrel Warfarin sodium Antiemetics (for the prevention of nausea and vomiting)* Aprepitant COMPRO Dimenhydrinate Dronabinol Granisetron Meclizine Ondansetron Palonosetron PHENADOZ Prochlorperazine Promethazine PROMETHEGAN Trimethobenzamide
2 Antihypertensives ACE Inhibitors (blood pressure lowering agents) Amlodipine with Benazepril Benazepril Benazepril with hydrochlorothiazide Captopril Captopril with hydrochlorothiazide Enalapril Enalapril with hydrochlorothiazide Fosinopril Fosinopril wirh hydrochlorothiazide Lisinopril Lisinopril with hydrochlorothiazide Moexipril and Moexipril with hydrocholorothiazide Perindopril Quinapril Quinapril with hydrochlorothiazide Ramipril Trandolapril Trandolapril/verapamil Antimalarials (prevent malaria) Atovaquone/proguanil Chloroquine phosphate Hydroxychloroquine sulfate Mefloquin Antiplatelets (prevent blood clots) Cilostazol Dipyridamole Eptifibatide Ticlopidine Cholesterol-Lowering Agents, Statins Atorvastatin and Atorvastatin/Amlodipine Fluvastatin Lovastatin Pravastatin Rosuvastatin Simvastatin Contraceptives (prevent pregnancy) Medroxyprogesterone acetate All generic forms of birth control
3 Osteoporosis Agents (prevent fractures) Alendronate ESSIAN EST ESTROGEN Estradiol Estradiol with testosterone Estrogen with methyltestosterone Estrone Estropipate Ethinyl estradiol FORTICAL Ibandronate Pamidronate disodium Raloxifene Risedronate Prenatal Vitamins (vitamins for pregnant women) All generic forms of prenatal vitamins Prescription Vitamins All generic forms of children s prescription vitamins with fluoride (consult your healthcare provider for strength) Smoking Cessation Agents* Bupropion Vaccines All generic forms of vaccines Weight Loss Agents** Diethlypropion Phendimetrazine Phentermine Select preventive prescription drugs are those used to prevent certain health conditions, rather than to treat symptoms or conditions. For example, prenatal vitamins are considered preventive because they have been shown to be effective in preventing certain birth defects. However, Pepcid (Famotidine) is non-preventive because it treats the condition and symptoms of gastroesophageal reflux disease or GERD. * There may be a limit on the quantity allowed per month or per year for certain drugs in this category. ** Prior authorization is required for these to drugs to be covered by the plan. Antiestrogens (for prevention of recurrence of breast cancer) Anastrazole Exemestane Letrozole Tamoxifen and SOLTAMOX
4 Antihypertensives Angiotensin Receptor Blockers (blood pressure lowering agents) Candesartan Candesartan-hydrochlorothiazide Irbesartan Irbesartan-hydrochlorothiazide Losartan Losartan-hydrochlorothiazide Olmesartan Olmesartan-hydrochlorothiazide Telmisartan Telmisartan-hydrochlorothiazide Valsartan Valsartan-hydrochlorothiazide Antihypertensives Beta Blockers (blood pressure lowering agents) Acebutolol Atenolol Atenolol-chlorthalidone Bisoprolol with hydrochlorothiazide Labetalol Metoprolol Metoprolol with hydrochlorothiazide Nadolol Nadolol with bendroflumethiazide Propranolol and Propranolol with hydrochlorothiazide Timolol Timolol with hydrochlorothiazide Antihypertensives Calcium Channel Blockers (blood pressure lowering agents) Amlodipine, Amlodipine/benazeprilAmlodipine/valsartan, Amlodipine/telmisartan, Amlodipine/olmesartan and Amlodipine/olmesartan/hydrochlorothiazide Diltiazem Felodipine Isradipine Nicardipine Nifedipine Nisoldipine Verapamil
5 Antihypertensives Miscellaneous (blood pressure lowering agents) Amiloride Carvedilol Clonidine Clonidine-chlorthalidone Doxazosin Hydralazine Methyldopa Methyldopa-hydrochlorothiazide Prazosin Terazosin Antihypertensives Thiazide Diuretics and related Diuretics (blood pressure lowering agents) Amiloride and Amiloride with hydrochlorothiazide Chlorothiazide Chlorthalidone Eplerenone Hydrochlorothiazide Inapamide Methylclothiazide Metolazone Spironolactone Spironolactone with hydrochlorothiazide Triamterene Triamterene with hydrochlorothiazide Cavities Chlorhexadine rinse Oralone paste Peridex liquid Periogard rinse Triamcinolone paste Colonoscopy Preparation Medication Gavilyte PEG-3350 and electrolytes solution Trilyte with flavor packets Organ Transplant Medications Azathioprine Cyclosporine Gengraf Mycophenolate Sirolimus Tacrolimus Express Scripts, Inc. manages the prescription drug benefit. All rights in the product names of all third-party products appearing here, whether or not appearing with the trademark symbol, belong exclusively to their respective owners.
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