This list shows which prescription drugs are included in the Kroger Rx Savings Club. s listed are for the most commonly dispensed versions of these prescriptions. Please note that prices may vary for certain forms or dosages. Stated prices are not guaranteed. See the full list of covered drugs, forms, dosages and prices at KrogerSC.com. ALLERGIES, COLD AND FLU Benzonatate (Tessalon) 0/ Cetirizine HCL (Zyrtec) 1mg/ml solution Fluticasone Propionate (Flonase, Cutivate) mcg spray 16 48 Loratadine (Claritin) Promethazine (Phenadoz, Phenergan) 12.5/25mg ARTHRITIS AND PAIN RELIEF Aspirin 81mg chewable Aspirin EC 81/325mg Celecoxib (Celebrex) Cyclobenzaprine (Flexeril) 5/ Diclofenac Sodium DR (Voltaren, Solaraze) /75mg Hydroxychloroquine (Plaquenil) Meloxicam (Mobic) 7.5/15mg ASTHMA Albuterol SUL (Accuneb) 2.5mg/3ml solution 75 225 Montelukast SOD (Singulair) 4/5mg CHOLESTEROL chew 120 Atorvastatin (Lipitor) /20/40mg Fenofibrate (Tricor) 145/1mg Lovastatin (Mevacor) /20/40mg Pravastatin Sodium (Pravachol) 20/40/80mg Simvastatin (Zocor) /20/40mg Glimepiride (Amaryl) 1/2mg 4mg DIABETES Glipizide (Glucotrol) 5/ Glipizide ER (Glucotrol XL) 2.5/5/ Glyburide (Micronase) 5mg 3 Metformin IR (Glucophage) 0/8/00mg EYE CARE Gentamicin (Garamycin, Gentafair) 3mg/ml eye drops 5 15 Latanoprost (Xalatan).005% eye drops 2.5 7.5 Tobramycin (Tobrex) 0.3% / ml solution / bottle 5 15 Page 1 of 5
Fluconazole (Diflucan) FUNGAL INFECTIONS 7 1 2 Ketoconazole (Nizoral) 2% shampoo 120 3 Nystatin (Nystop) 0000 unit/gm 0000 unit/ml 0000 unit/gm cream suspension ointment Terbinafine HCL (Lamisil) Dicyclomine (Bentyl) Famotidine (Pepcid) GASTROINTESTINAL HEALTH 40mg Omeprazole DR (Prilosec) 20/40mg Pantoprazole SOD DR (Protonix) 20/40mg Ranitidine (Zantac) 15mg/ml 0mg GOUT syrup Allopurinol (Lopurin, Zyloprim) 0/0mg HEART HEALTH AND BLOOD PRESSURE 21 3 6 Amlodipine Besylate (Norvasc) 2.5/5/ Atenolol (Tenormin) 25// Atenolol-Chlorthalidone (Tenoretic) 0-25/-25mg Benazepril HCL (Lotensin) 5//20/40mg Bisoprolol-HCTZ (Ziac) 2.5-6.25/5-6.25/ -6.25mg Carvedilol (Coreg) 3.125/6.25/ 12.5/25mg Clonidine HCL (Catapres) 0.1/0.2/0.3mg Clopidogrel (Plavix) 75mg Enalapril Maleate (Vasotec) 2.5/5mg / Enalapril-HCTZ (Vaseretic) 5-12.5/-25mg Furosemide (Lasix) 20/40mg Guanfacine (Tenex) 1/2mg Hydralazine (Dralzine) /25// Hydrochlorothiazide (Microzide) 12.5mg 12.5/25/mg 270 Page 2 of 5
HEART HEALTH AND BLOOD PRESSURE (cont.) Indapamide (Lozol) 1.25/2.5mg Isosorbide Mononitrate ER (Imdur) /mg Lisinopril (Prinivil, Zestril) Lisinopril-HCTZ (Zestoretic, Prinzide) 2.5/5//20/ /40mg -12.5/20-12.5/ 20-25mg Losartan Potassium (Cozaar) 25// Metoprolol SUCC ER (Toprol XL) 25// Metoprolol Tartrate (Lopressor) 25// Propranolol (Inderal) / Sotalol (Betapace) 80/120/1mg Spironolactone (Aldactone) Timolol Maleate (Blocadron, Timoptic XE, Timoptic) Triamterene-HCTZ (Maxzide, Dyazide) Verapamil (Isoptin, Calan) 25/mg 0.5% / 5ml 37.5-25/75-mg 37.5-25mg 40/1 80mg eye drops / bottle cap 5 15 Verapamil ER (Calan SR, Verelan) 120//240mg Warfarin Sodium (Coumadin) Cephalexin (Keflex) 1/2/2.5/3/4/5/ 6/7.5/ INFECTIONS AND ANTIBIOTIC TREATMENTS 270 Ciprofloxacin (Cipro) 0.3% eye drop 5 15 Ciprofloxacin HCL (Cipro, Cetraxal, Ciloxan) Clindamycin HCL (Cleocin T, Cleocin, Evoclin) Levofloxacin (Levaquin) Metronidazole (Flagyl) 7mg 0mg 7mg Penicillin VK (Veetids) 20 Sulfamethoxazole-TMP (Bactrim, Sulfatrim, Septra) DS SS 40 6 14 20 28 5 21 14 20 120 18 42 84 15 63 42 Page 3 of 5
Prednisone (Sterapred, Deltasone) Prednisolone (Prelone) INFLAMMATION (SKIN, JOINTS, LUNGS, OTHER) 5/ mg 15mg/5ml 15mg/5ml MEN S HEALTH solution syrup 5 Finasteride (Proscar) 1/5mg Tamsulosin HCL (Flomax) 0.4mg MENTAL HEALTH Citalopram HBR (Celexa) /20/40mg Duloxetine HCL DR (Cymbalta) 20//mg cap Escitalopram (Lexapro) 5// Fluoxetine HCL (Prozac) /20/40mg Guanfacine HCL ER (Intuniv) 1/2/3/4mg Lamotrigine (Lamictal) 25/ 0/ Nortriptyline HCL (Pamelor, Aventyl) /25/mg cap Paroxetine HCL (Paxil, Brisdelle) /20//40mg 15 1 1 Quetiapine Fumarate (Seroquel) 25//0/ Sertraline HCL (Zoloft) 25// Topiramate (Topamax) 25// Trazodone (Desyrel) /0/ Venlafaxine HCL (Effexor) 75mg Venlafaxine HCL ER (Effexor XR) 75/ cap MIGRAINES Sumatriptan SUCC (Imitrex) / 9 27 MOUTH / THROAT / DENTAL Chlorhexidine Gluconate (Peridex) 0.12% / 473ml solution / bottle 473 1419 NAUSEA AND VOMITING Ondansetron HCL (Zofran) 4/8mg Ondansetron ODT (Zofran) 4mg 8mg SEIZURES Levetiracetam (Keppra) SKIN CONDITIONS Clobetasol (Temovate, Clodan, Cormax, Olux, Clobex).05% solution 1 Hydrocortisone (Cortef) mg, 2.5% cream 28.35 85.05 Mupirocin (Bactroban) 2% ointment 22 66 Page 4 of 5
Levothyroxine (Synthroid) Isoniazid (Stanozide, Dow-Isoniazid, Nydrazid, Rimifon, Hyzyd, Laniazid) Acyclovir (Zovirax) THYROID CONDITIONS 25//75/88/ 0/112/125/ 137/ TUBERCULOSIS 0mg 400mg 800mg VIRUSES VITAMINS AND NUTRITIONAL HEALTH Folic Acid (Folvite) 1mg WOMEN S HEALTH Alendronate Sodium (Fosamax) 35/70mg 4 12 Clomiphene Citrate (Clomid, Serophene) mg 5 15 Estradiol (Estrace) 0.5/1/2mg Medroxyprogesterone (Depo-Provera) 2.5/5mg 25 75 1 *The Kroger Rx Savings Club is not insurance. It cannot be combined with federally funded health care programs, including, but not limited to Medicaid, Medicare and Tricare. The Kroger Rx Savings Club does not meet any creditable coverage requirements under any state law. s are for specific dosages and days supplies of the drug; prices may vary for different dosages and days supplies. Please visit KrogerSC.com for exact prices. You will be charged $72.00 for a family plan, or 6.00 for an individual plan upon registration. You can cancel your subscription at any time during the first days and receive a full refund. You will be charged to the credit card number you provided. You may update your billing details on your account page. Your subscription will auto-renew on the one-year anniversary of your original registration date unless you cancel. Restrictions and exclusions may apply. Not valid in the state of Washington. For additional Terms and Conditions and our Privacy Policy, please visit KrogerSC.com. Page 5 of 5