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Maintenance Medical Drug List To Maintenance drugs Drugs that are taken on a regular basis 2021 Maintenance medicine list 05.03.396.1O (1/21) Maintenance medicines are the kind of drugs that are taken on a regular basis. They’re used to treat ongoing conditions such as the ones shown in the categories listed below. Key UPPERCASE Brand-name medicine lowercase italics Generic medicine 2021 Maintenance Medicine List Category Generic medicine Brand-name medicine Allergies desloratadine levocetirizine Alzheimer’s disease donepezil memantine NAMZARIC galantamine rivastigmine Antipsychotics aripiprazole quetiapine IR/ER brexipiprazole risperidone loxapine thiothixene olanzapine olanzapine/fluoxetine paliperidone Attention deficit atomoxetine guanfacine ER hyperactivity clonidine ER disorder (ADHD) Blood modifiers anagrelide dipyridamole ZONTIVITY aspirin-dipyridamole pentoxifylline cilostazol prasugrel clopidogrel ticlopidine Cancer anastrozole tamoxifen exemestane toremifene letrozole Contraceptives/ estradiol ethinyl estradiol-ethynodiol ESTRING hormone replacement estradiol gel ethinyl estradiol-etonogestrel EVAMIST estradiol transdermal ethinyl estradiol-levonorgestrel IMVEXXY ethinyl estradiol-desogestrel ethinyl estradiol-norelgestromin LO LOESTRIN ethinyl estradiol-drospirenone ethinyl estradiol-norethindrone MENEST ethinyl estradiol- ethinyl estradiol norgestimate NATAZIA drospirenone-evomefo ethinyl estradiol-norgestrel PREMARIN Health benefits and health insurance plans are offered and/or underwritten by Aetna Health Inc., Aetna Health Insurance Company of New York, Aetna HealthAssurance Pennsylvania Inc., Aetna Health Insurance Company and/or Aetna Life Insurance Company (Aetna). In Florida by Aetna Health Inc. and/or Aetna Life Insurance Company. In Utah and Wyoming by Aetna Health of Utah Inc. and/or Aetna Life Insurance Company. In Maryland by Aetna Health Inc., 151 Farmington Avenue, Hartford, CT 06156. Each insurer has sole financial responsibility for its own products. 2 Category Generic medicine Brand-name medicine Depression bupropion fluvoxamine APLENZIN citalopram mirtazapine FETZIMA desvenlafaxine nefazodone TINTELLIX duloxetine paroxetine VIIBRYD escitalopram sertraline fluoxetine trazodone venlafaxine Diabetes acarbose miglitol AVANDIA chlorpropamide nateglinide CYCLOSET glimepiride pioglitazone SYMLIN glipizide repaglinide glyburide tolazamide metformin tolbutamide Diabetes: alogliptin/pioglitazone pioglitazone/ glimepiride Combinations glipizide/metformin pioglitazone/metformin glyburide/metformin Diabetes: glucose meter insulin pump ALBUSTIX Test strips/lancets/meters glucose test strip insulin syringes and needles CHEMSTRIPS NOVA MAX PLUS KETONE Digestive enzymes pancrelipase CREON PANCREAZE ZENPEP Diuretics acetazolamide hydrochlorothiazide (HCTZ) amiloride methazolamide chlorthalidone spironolactone dyrenium Diuretics: HCTZ/pironolactone Combinations HCTZ/triamterene Enlarged prostate alfuzosin silodosin CARDURA XL dutasteride tamsulosin dutasteride/tamsulosin terazosin finasteride Gastrointestinal Agents AMITIZA Glaucoma betaxolol levobunolol AZOPT bimatoprost methazolamide LUMIGAN brimonidine metipranolol ZIOPTAN carbachol phospholine carteolol timolol dorzolamide travoprost latanoprost Glaucoma: dorzolamide/timolol COMBIGAN Combinations Gout allopurinol probenecid/colchicine 3 Category Generic medicine Brand-name medicine Heart disease and benazepril moexipril high blood pressure: captopril perindopril Angiotensin-converting enalapril quinapril enzyme (ACE) inhibitors fosinopril ramipril lisinopril trandolapril Heart disease and candesartan losartan EDARBI high blood pressure: eprosartan telmisartan Angiotensin II receptor irbesartan valsartan antagonists Heart disease and amiodarone propafenone MULTAQ high blood pressure: disopyramide quinidine gluconate Antiarrhythmics flecainide quinidine sulfate mexiletine Heart disease and acebutolol metoprolol BYSTOLIC high blood pressure: atenolol nadolol Beta blockers betaxolol pindolol bisoprolol propranolol carvedilol sotalol labetalol timolol levatol Heart disease and amlodipine nicardipine high blood pressure: diltiazem nifedipine Calcium channel blockers felodipine nisoldipine isradipine verapamil Heart disease and amlodipine/atorvastatin irbesartan/hctz EDARBYCLOR high blood pressure: amlodipine/hctz lisinopril/hctz PRESTALIA Combinations amlodipine/olmesartan losartan/hctz TEKTURNA HCT amlodipine/valsartan methyldopa/hctz amlodipine/olmesartan/hctz metoprolol/hctz amlodipine/valsartan/hctz moexipril/hctz atenolol/chlorthalidone nadolol/bendroflumethiazide benazepril/hctz olmesartan/hctz bisoprolol/hctz propranolol/hctz candesartan/hctz quinapril/hctz clonidine/chlorthalidone telmisartan/amlodipine captopril/hctz telmisartan/hctz enalapril/hctz trandolapril/verapamil fosinopril/hctz valsartan/hctz Heart disease and aliskiren methyldopa BIDIL high blood pressure: clonidine minoxidil Miscellaneous guanfacine prazosin cardiovascular hydralazine ranolazine isoxsuprine reserpine High cholesterol atorvastatin gemfibrozil LIVALO cholestyramine lovastatin VASCEPA colesevelam omega-3-acid ethyl ester colestipo (fda approved) ezetimibe niacin cr ezetimibe/simvastatin pravastatin fenofibrate micronized rosuvastatin fluvastatin simvastatin 4 Category Generic medicine Brand-name medicine Immune disorders azathioprine Inflammatory sulfasalazine DIPENTUM bowel disease Kidney disease calcitriol sevelamer hcl AURYXIA calcium acetate sevelamer carbonate VELPHORO lanthanum carbonate Miscellaneous cevimeline pilocarpine CUVPOSA ergoloid mesylate ursodiol NASCOBAL Osteoporosis alendronate raloxifene BINOSTO calcitonin risedronate FOSAMAX D ibandronate Overactive bladder darifenacin solifenacin TOVIAZ flavoxate tolterodine oxybutynin trospium Parkinson’s disease benztropine entacapone NEUPRO bromocriptine pramipexole ONGEN carbidopa ropinirole RYTARY carbidopa/levodopa tolcapone XADAGO carbidopa/levodopa/ trihexyphenidyl entacapone Respiratory agents aminophylline ipratropium ADVAIR HFA budesonide ipratropium/albuterol ALVESCO budesonide/formoterol metaproterenol ANORO ELLIPTA cromolyn montelukast ARCAPTA dyphylline terbutaline ARNUITY ELLIPTA fluticasone/salmeterol theophylline ASMANEX formoterol zafirlukast BEVESPI BREO ELLIPTA BREZTRI AEROSPHERE BROVANA DULERA FLOVENT INCRUSE ELLIPTA QVAR REDIHALER SEEBRI NEOHALER SEREVENT SPIRIVA STIOLTO RESPIMAT STRIVERDI TRELEGY ELLIPTA TUDORZA UTIBRON ZYFLO Rheumatoid arthritis leflunomide RIDAURA 5 Category Generic medicine Brand-name medicine Seizure disorders carbamazepine primidone APTIOM divalproex tiagabine CELONTIN ethosuximide topiramate PEGANONE felbamate topiramate er TROKENDI XR lamotrigine valproic acid levetiracetam zonisamide oxcarbazepine Thyroid levothyroxine liothyronine thyroid Ulcer/gastroesophageal cimetidine omeprazole/ DEXILANT reflux disease (GERD) esomeprazole magnesium sodium bicarbonate ESOMEPRAZOLE famotidine tab pantoprazole STRONTIUM lansoprazole rabeprazole nizatidine ranitidine omeprazole sucralfate This document contains references to brand-name prescription drugs that are trademarks or registered trademarks of pharmaceutical manufacturers not affiliated with Aetna. To check coverage and copay information for a specific medicine, visit aetna.com and log in to your secure member website. For more details, please call the toll-free number on your member ID card. This is not an inclusive list. It is subject to change. Products that are not represented on this list may be subject to plan- specific copayment or coinsurance. Void where prohibited by law. Specific prescription benefits plan design may not cover certain categories or may be subject to additional charges or restrictions, regardless of their appearance in this document. Aetna or its affiliate(s) may receive rebates from drug manufacturers. Rebates may reduce the amount a member pays the pharmacy for covered prescriptions. Information is believed to be accurate as of the production date; however, it is subject to change. For questions, please call the toll- free number on your Aetna ID card. Policy forms issued in Oklahoma include: HMO OK COC-5 09/07, HMO/OK GA-3 11/01, HMO OK POS RIDER 08/07, GR-23, GR-29/GR-29N. Policy forms issued in Missouri include: AL HGrpPol 01R5, HI HGrpAg 05, HO HGrpPol 04. AL SG GrpPOLAmend 2020 01, HI SG GrpAgAmend 2020 01. HI HGrpAG SG 01R. ©2021 Aetna Inc. 05.03.396.1O (1/21) .
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