CVS CAREMARK® MAINTENANCE DRUG LIST EFFECTIVE AS OF 03/03/2021

Maintenance drugs are prescriptions commonly used to treat conditions that are considered chronic or long-term. These conditions usually require regular, daily use of medicines. Examples of maintenance drugs are those used to treat high blood pressure, heart disease, asthma and diabetes.

Due to the large number of available medicines, this list is not all inclusive. Please note that this list does not guarantee coverage and is subject to change. Your prescription benefit plan may not cover certain products or categories, regardless of their appearance on this list. Where a generic is available, it is listed by the generic name. If no generic is available, then the brand name appears. This list represents brand products in CAPS and generic products in lower case italics.

If you have questions about your prescription benefits, please log on to your account at Caremark.com or call Customer Care at the number on your ID card.

Allergies pentoxifylline Depression desloratidine prasugrel bupropion levocetirizine ticlopidine citalopram ZONTIVITY desvenlafaxine Alzheimer’s Disease duloxetine donepezil Cancer escitalopram galantamine anastrozole fluoxetine memantine exemestane fluvoxamine rivastigmine letrozole mirtazapine NAMZARIC tamoxifen nefazodone toremifene paroxetine Antipsychotics sertraline trazodone Aripiprazole Contraceptives venlafaxine brexipiprazole ethinyl estradiol-desogestrel APLENZIN loxapine ethinyl estradiol-drospirenone FETZIMA olanzapine ethinyl estradiol-ethynodiol TRINTELLIX paliperidone ethinyl estradiol- etonogestrel VIIBRYD quetiapine IR/ER ethinyl estradiol-levonorgestrel risperidone ethinyl estradiol-norelgestromin thiothixene ethinyl estradiol-norethindrone Diabetes ethinyl estradiol-norgestimate acarbose -Combinations ethinyl estradiol-norgestrel chlorpropamide Olanzapine/fluoxetine ethinyl estradiol-drospirenone- glimepiride levomefo glipizide LO LOESTRIN glyburide Attention NATAZIA metformin Deficit/Hyperactivity miglitol Disorder (ADHD) Hormone Replacement nateglinide atomoxetine estradiol pioglitazone clonidine er estradiol gel repaglinidine guanfacine er estradiol transdermal tolazamide ESTRING tolbutamide Blood Modifiers EVAMIST AVANDIA Anagrelide IMVEXXY CYCLOSET aspirin-dipyridamole MENEST SYMLIN cilostazol PREMARIN clopidogrel dipyridamole

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-Combinations ZIOPTAN -Calcium Channel Blockers alogliptin/pioglitazone amlodipine glipizide/metformin -Combinations diltiazem glyburide/metformin dorzolamide/timolol felodipine pioglitazone/glimepiride COMBIGAN isradipine pioglitazone/metformin nicardipine Gout nifedipine -Test Strips/Lancets/Meters allopurinol nisoldipine glucose meter probenecid/colchicine verapamil glucose test strip insulin pump Heart Disease & High Blood -Combinations insulin syringes and needles Pressure amlodipine/atorvastatin ALBUSTIX amlodipine/hctz CHEMSTRIPS -Angiotensin-Converting-Enzyme amlodipine/olmesartan NOVA MAX PLUS KETONE (ACE) Inhibitors amlodipine/valsartan benazepril amlodipine/olmesartan/hctz Digestive Enzymes captopril amlodipine/valsartan/hctz enalapril pancrelipase atenolol/chlorthalidone fosinopril CREON benazepril/hctz lisinopril PANCREAZE bisoprolol/hctz moexipril ZENPEP candesartan/hctz perindopril clonidine/chlorthalidone quinapril Diuretics captopril/hctz ramipril enalapril/hctz acetazolamide trandolapril fosinopril/hctz amiloride irbesartan/hctz chlorthalidone -Angiotensin II Receptor lisinopril/hctz dyrenium Antagonists losartan/hctz hydrochlorothiazide (hctz) candesartan methyldopa/hctz methazolamide eprosartan metoprolol/hctz spironolactone irbesartan moexipril/hctz

losartan nadolol/bendroflumethiazide -Combinations telmisartan olmesartan/hctz hctz/spironolactone valsartan propranolol/hctz hctz/triamterene EDARBI quinapril/hctz telmisartan/amlodipine Enlarged Prostate -Antiarrhythmics telmisartan/hctz Alfuzosin amiodarone trandolapril/verapamil Dutasteride disopyramide valsartan/hctz dutasteride/tamsulosin flecainide EDARBYCLOR finasteride mexiletine PRESTALIA silodosin propafenone TEKTURNA HCT tamsulosin quinidine gluconate terazosin quinidine sulfate -Miscellaneous Cardiovascular CARDURA XL MULTAQ aliskiren clonidine Glaucoma -Beta Blockers guanfacine betaxolol acebutolol hydralazine bimatoprost atenolol isoxsuprine brimonidine betaxolol methyldopa carbachol bisoprolol minoxidil carteolol carvedilol prazosin dorzolamide labetalol ranolazine latanoprost levatol reserpine levobunolol metoprolol BIDIL methazolamide nadolol metipranolol pindolol High Cholesterol phospholine propranolol atorvastatin timolol sotalol cholestyramine travoprost timolol colesevelam AZOPT BYSTOLIC colestipo LUMIGAN ezetimibe

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ezetimibe/simvastatin Parkinson’s Disease Seizure Disorders fenofibrate micronized benztropine carbamazepine fluvastatin bromocriptine divalproex gemfibrozil carbidopa ethosuximide lovastatin carbidopa/levodopa felbamate omega-3-acid ethyl ester (fda carbidopa/levodopa/entacapone lamotrigine approved) entacapone levetiracetam niacin cr pramipexole oxcarbazepine pravastatin ropinirole primidone rosuvastatin tolcapone tiagabine simvastatin trihexyphenidyl topiramate LIVALO NEUPRO topiramate er VASCEPA ONGENTYS valproic acid RYTARY zonisamide Immune Disorders XADAGO APTIOM azathioprine CELONTIN Respiratory Agents PEGANONE Inflammatory Bowel Disease aminophylline TROKENDI XR sulfasalazine budesonide DIPENTUM budesonide/formoterol Thyroid cromolyn levothyroxine Gastrointestinal Agents dyphylline liothyronine fluticasone/salmeterol thyroid AMITIZA formoterol

ipratropium Ulcer/Gastroesophageal Kidney Disease ipratropium/albuterol Reflux Disease (GERD) calcitriol metaproterenol cimetidine calcium acetate montelukast esomeprazole magnesium lanthanum carbonate terbutaline famotidine tab sevelamer hcl theophylline lansoprazole sevelamer carbonate zafirlukast nizatidine AURYXIA ADVAIR HFA omeprazole VELPHORO ALVESCO omeprazole/sodium bicarbonate ANORO ELLIPTA pantoprazole Miscellaneous ARCAPTA rabeprazole cevimeline ARNUITY ELLIPTA ranitidine ergoloid mesylate ASMANEX sucralfate pilocarpine BEVESPI DEXILANT ursodiol BREO ELLIPTA ESOMEPRAZOLE STRONTIUM CUVPOSA BREZTRI AEROSPHERE

NASCOBAL BROVANA

DULERA

Osteoporosis FLOVENT alendronate INCRUSE ELLIPTA calcitonin QVAR REDIHALER ibandronate SEEBRI NEOHALER raloxifene SEREVENT risedronate SPIRIVA BINOSTO STIOLTO RESPIMAT FOSAMAX D STRIVERDI TRELEGY ELLIPTA Overactive Bladder TUDORZA UTIBRON darifenacin ZYFLO flavoxate oxybutynin solifenacin Rheumatoid Arthritis tolterodine leflunomide trospium RIDAURA TOVIAZ

This document contains references to brand-name prescription drugs that are trademarks or registered trademarks of pharmaceutical manufacturers not affiliated with CVS Caremark. ©2021 CVS Caremark. All rights reserved. 106-18393A 031221 3 of 3