Cvs Caremark ® Maintenance Drug List

CVS CAREMARK® MAINTENANCE DRUG LIST EFFECTIVE AS OF 06/06/2018

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 the back of your prescription ID card.

Attention EFFIENT duloxetine ZONTIVITY escitalopram Deficit/Hyperactivity fluoxetine fluvoxamine Disorder (ADHD) Cancer mirtazapine clonidine er anastrozole nefazodone guanfacine er exemestane paroxetine STRATTERA letrozole sertraline

tamoxifen trazodone Allergies FARESTON venlafaxine desloratidine APLENZIN BRINTELLIX levocetirizine Contraceptives/ CLARINEX FETZIMA Hormone Replacement OLEPTRO VIIBRYD Alzheimer’s Disease estradiol estradiol estropipate donepezil estradiol gel galantamine estradiol transdermal Diabetes rivastigmine ethinyl estradiol- desogestrel acarbose NAMENDA ethinyl estradiol- drospirenone chlorpropamide NAMZARIC ethinyl estradiol -ethynodiol glimepiride

ethinyl estradiol- levonorgestrel glipizide Antipsychotics ethinyl estradiol-norelgestromin glyburide metformin loxapine ethinyl estradiol- norethindrone nateglinide olanzapine ethinyl estradiol- norgestimate pioglitazone paliperidone ethinyl estradiol- norgestrel repaglinidine risperidone raloxifene tolazamide thiothixene BEYAZ tolbutamide ziprasidone CENESTIN ADLYXIN ABILIFY CLIMARA PRO AVANDIA EQUETRO COMBIPATCH BYDUREON LATUDA ENJUVIA BYETTA ORAP ESTRING CYCLOSET REXULTI EVAMIST FARXIGA SEROQUEL XR FALESSA GLYSET FEMHRT INSULIN -Combinations LO LOESTRIN MENEST INVOKANA Olanzapine/fluoxetine JANUVIA NATAZIA NUVARING JARDIANCE Blood Modifiers PREMARIN NESINA anagrelide PREMPRO ONGLYZA cilostazol SAFYRAL SYMLIN clopidogrel SYNJARDY IR/XR dipyridamole TANZEUM pentoxifylline Depression TRADJENTA ticlopidine bupropion TRULICITY AGGRENOX citalopram VICTOZA BRILINTA desvenlafaxine

This document contains references to brand-name prescription drugs that are trademarks or registered trademarks of pharmaceutical manufacturers not affiliated with CVS Caremark. ©2018 CVS Caremark. All rights reserved. 106-18393A 061418 1 of 3

-Combinations phospholine BYSTOLIC glipizide/metformin timolol glyburide/metformin AZOPT -Calcium Channel Blockers pioglitazone/glimepiride LUMIGAN amlodipine pioglitazone/metformin RESCULA diltiazem AVANDAMET TRAVATAN felodipine AVANDARYL ZIOPTAN isradipine GLYXAMBI nicardipine INVOKAMET IR/ XR -Combinations nifedipine JANUMET dorzolamide/timolol nisoldipine JENTADUETO IR/ XR COMBIGAN verapamil JUVISYNC SIMBRINZA KAZANO -Combinations KOMBIGLYZE XR Gout amlodipine/atorvastatin OSENI amlodipine/hctz allopurinol PRANDIMET amlodipine/valsartan probenecid/colchicine SOLIQUA amlodipine/valsartan/hctz ULORIC XIGDUO XR atenolol/chlorthalidone ZURAMPIC XULTOPHY benazepril/ hctz bisoprolol/ hctz -Test Strips/Lancets/Meters Heart Disease & High candesartan/ hctz glucose meter clonidine/chlorthalidone insulin pump Blood Pressure captopril/ hctz insulin syringes and needles -Ace Inhibitors enalapril/ hctz ALBUSTIX benazepril fosinopril/ hctz CHEMSTRIPS captopril irbesartan/ hctz NOVA MAX PLUS KETONE enalapril lisinopril / hctz fosinopril losartan/ hctz Digestive Enzymes lisinopril methyldopa/ hctz moexipril metoprolol/ hctz pancrelipase perindopril moexipril/ hctz CREON quinapril nadolol/bendroflumethiazide PANCREAZE ramipril propranolol/ hctz ZENPEP trandolapril quinapril/ hctz

telmisartan/amlodipine Diuretics -Angiotensin II Receptor telmisartan/hctz acetazolamide Antagonists trandolapril/verapamil amiloride candesartan valsartan/hctz chlorthalidone eprosartan AMTURNIDE dyrenium irbesartan AZOR hydrochlorothiazide (hctz) losartan BENICAR HCT methazolamide telmisartan BYVALSON spironolactone valsartan EDARBYCLOR EDARBI ENTRESTO -Combinations TEVETEN PRESTALIA hctz/spironolactone TEKAMLO hctz/triamterene -Antiarrhythmics TEKTURNA HCT TEVETEN HCT amiodarone disopyramide TRIBENZOR Enlarged Prostate flecainide alfuzosin mexiletine -Miscellaneous Cardiovascular finasteride propafenone clonidine tamsulosin quinidine gluconate guanfacine terazosin quinidine sulfate hydralazine AVODART MULTAQ isoxsuprine CARDURA XL methyldopa JALYN -Beta Blockers minoxidil RAPAFLO acebutolol prazosin atenolol reserpine Glaucoma betaxolol BIDIL CORLANOR Betaxolol bisoprolol RANEXA bimatoprost carvedilol TEKTURNA brimonidine labetalol carbachol levatol carteolol metoprolol High Cholesterol nadolol dorzolamide atorvastatin pindolol latanoprost cholestyramine propranolol levobunolol colestipol sotalol methazolamide fenofibrate micronized metipranolol timolol This document contains references to brand-name prescription drugs that are trademarks or registered trademarks of pharmaceutical manufacturers not affiliated with CVS Caremark. ©2018 CVS Caremark. All rights reserved. 106-18393A 061418 2 of 3

fluvastatin Overactive Bladder Rheumatoid Arthritis gemfibrozil darifenacin leflunomide lovastatin flavoxate RHEUMATREX omega-3-acid ethyl ester oxybutynin RIDAURA niacin cr Oxytrol pravastatin tolterodine rosuvastatin trospium simvastatin Seizure Disorders MYRBETRIQ LIPTRUZET carbamazepine TOVIAZ LIVALO divalproex VESICARE SIMCOR ethosuximide

VASCEPA felbamate VYTORIN Parkinson’s Disease lamotrigine levetiracetam WELCHOL benztropine oxcarbazepine ZETIA bromocriptine primidone carbidopa tiagabine carbidopa/levodopa Immune Disorders topiramate carbidopa/levodopa/entacapone azathioprine topiramate er entacapone valproic acid pramipexole zonisamide Inflammatory Bowel ropinirole APTIOM tolcapone Disease CELONTIN trihexyphenidyl sulfasalazine PEGANONE NEUPRO DIPENTUM TROKENDI XR RYTARY

XADAGO Gastrointestinal Agents Thyroid levothyroxine AMITIZA Respiratory Agents liothyronine LINZESS aminophylline thyroid TRULANCE budesonide THYROLAR cromolyn

Kidney Disease dyphylline calcitriol fluticasone/salmeterol (Airduo) Ulcer/Gastroesophageal calcium acetate formoterol ipratropium Reflux Disease (GERD) AURYXIA Cimetidine FOSRENOL ipratropium/albuterol metaproterenol esomeprazole magnesium RENAGEL famotidine tab RENVELA montelukast terbutaline lansoprazole VELPHORO nizatidine theophylline zafirlukast omeprazole Miscellaneous ADVAIR omeprazole/sodium bicarbonate cevimeline AEROSPAN pantoprazole ergoloid mesylate ALVESCO rabeprazole pilocarpine ANORO ELLIPTA ranitidine riluzole ARCAPTA sucralfate ursodiol ARNUITY ELLIPTA ACIPHEX SPRINKLE BRISDELLE ASMANEX DEXILANT CUVPOSA BEVESPI ESOMEPRAZOLE STRONTIUM DUAVEE BREO ELLIPTA NASCOBAL BROVANA NUEDEXTA DALIRESP 500 mg SAVELLA DULERA XIIDRA FLOVENT INCRUSE ELLIPTA QVAR Osteoporosis SEEBRI alendronate SEREVENT calcitonin SPIRIVA ibandronate STIOLTO RESPIMAT risedronate STRIVERDI ACTONEL Plus Calc SYMBICORT BINOSTO TUDORZA FOSAMAX D UTIBRON ZYFLO