PREVENTIVE DRUG LIST Preventive medications are used for the prevention of conditions such as high blood pressure, high cholesterol, diabetes, asthma, osteoporosis, heart attack, stroke and prenatal nutrient deficiency. Following is a list of generic preventive medications covered at 100%, arranged by type of condition. diltiazem sotalol AF glipizide Asthma related diltiazem ER sotalol HCl glipizide ER albuterol sulfate doxazosin mesylate spironolactone glipizide/metformin HCl albuterol sulfate (nebulizer enalapril maleate spironolactone/hctz glyburide solution) enalapril maleate/hctz telmisartan glyburide micronized albuterol sulfate/ipratropium eplerenone telmisartan/amlodipine glyburide/metformin nebulizer solution eprosartan mesylate telmisartan/hctz Humalog budesonide felodipine ER terazosin HCl Humulin caffeine citrate fosinopril sodium timolol maleate Invokamet cromolyn sodium inhalation fosinopril sodium/hctz torsemide Invokamet XR solution furosemide trandolapril Invokana ipratropium bromide guanfacine HCl trandolapril/verapamil Janumet levalbuterol HCl hydralazine HCl triamterene/hctz Janumet XR levalbuterol tartrate HFA hydrochlorothiazide valsartan Januvia metaproterenol sulfate indapamide valsartan/hctz Kombiglyze XR montelukast irbesartan Vecamyl – mecamylamine HCl Lantus terbutaline sulfate irbesartan/hctz Verapamil Lantus SoloStar TheoChron isradipine Levemir theophylline anhydrous labetalol HCl Blood thinner related Levemir FlexTouch zafirlukast lisinopril aspirin/dipyridamole ER metformin HCl lisinopril/hctz cilostazol miglitol Blood pressure related losartan potassium clopidogrel bisulfate nateglinide losartan/hctz Novolin acebutolol HCl dipyridamole methazolamide Novolog acetazolamide Jantoven methyclothiazide OneTouch Ultra Test Strips Afeditab CR Warfarin methyldopa OneTouch Verio Test Strips amiloride HCl methyldopa/hctz Onglyza amiloride/hctz Cholesterol related metolazone pioglitazone HCl amlodipine besylate amlodipine/atorvastatin metoprolol succinate pioglitazone HCl/metformin amlodipine besylate/benazepril atorvastatin metoprolol tartrate HCl amlodipine/atorvastatin calcium cholestyramine/aspartame metoprolol/hctz pioglitazone/glimepiride amlodipine/olmesartan cholestyramine/sucrose minoxidil repaglinide amlodipine/valsartan colestipol HCl moexipril HCl repaglinide/metformin amlodipine/valsartan/hctz ezetimibe moexipril HCl/hctz SymlinPen atenolol fenofibrate nadolol tolazamide atenolol/chlorthalidone fenofibric acid nadolol/bendroflumethiazide tolbutamide benazepril HCl fluvastatin ER nicardipine HCl Toujeo benazepril HCl/hctz gemfibrozil nifedipine Tresiba FlexTouch betaxolol lovastatin nifedipine ER Trulicity bisoprolol fumarate niacin ER nimodipine Xigduo XR bisoprolol/hctz omega-3 acid ethyl esters nisoldipine bumetanide pravastatin olmesartan Osteoporosis related candesartan rosuvastatin olmesartan/amlodipine/hctz candesartan/hctz simvastatin alendronate sodium olmesartan/hctz captopril calcitonin-salmon perindopril erbumine captopril/hctz Diabetes related etidronate disodium phenoxybenzamine carvedilol ibandronate sodium pindolol acarbose chlorothiazide raloxifene prazosin HCl Bydureon chlorthalidone risedronate sodium propranolol ER Byetta clonidine propranolol HCl chlorpropamide clonidine HCl Prenatal Vitamins propranolol/hctz Diabetic Supplies (i.e. lancets, clorpres quinapril syringes, urine tests, alcohol All prescription strength quinapril HCl/hctz pads) prenatal vitamins are ramipril Farxiga considered preventive Sorine glimepiride

Please note: this list is subject to change and may not include all preventive medications that your plan covers. You can refer to myCigna.com for a complete and up-to-date drug listing for your plan.