PML— Alphabetical Guide Effective January 1, 2006 Revised December 1, 2005

You can make the most of your pharmacy benefi t plan and control your prescription medication costs by using this Preferred Medication List. Be sure to share this list with your doctor to select cost-effective medications that are clinically appropriate to treat your condition or maintain your health.

This Preferred Medication List (PML) was Whenever possible, have your doctor consult developed by Walgreens Health Initiatives, your this guide for the lowest-cost brand name and plan sponsor’s pharmacy benefi t manager, under generic medications available for your therapy. the direction of a committee of physicians and The generic and preferred medications here are pharmacists. All medications on this list are listed alphabetically. Preferred brand drugs appear preferred by your plan. in UPPERCASE letters; generic drugs appear in lowercase letters. To keep an eye on costs, Understanding Your Tiered Copays remember to always ask your doctor if a generic Your pharmacy benefi t plan has three categories— medication is right for you. or tiers—of drugs that determine your costs (copays): All medications on the PML have been approved by the Food and Drug Administration (FDA). 1st tier: Generics. Generics contain the same active ingredient as their brand name equivalents Additional Information and offer the same effectiveness and safety. Gener- Medication coverage and copays may vary from ics generally have the lowest copay. plan to plan. For more information specifi c to 2nd tier: Preferred. Medications in this tier have your plan, register on www.mywhi.com and click been selected by your pharmacy benefi t plan as on “Check Drug Coverage/Copay” to verify your preferred brand drugs. These drugs have higher coverage. copays than generics but are less costly than Please note: The PML is subject to change with- nonpreferred medications on the third tier. out notice.

3rd tier: Nonpreferred. Because they have a Call Us With Questions generic version or a second-tier alternative avail- For assistance, please call the Walgreens Health able, nonpreferred medications have the highest Initiatives Customer Care Center toll free at copays and are not listed on the PML. 1-800-207-2568.

Continued PBM3545C-1205 Walgreens Health Initiatives 2006 Preferred Medication List Alphabetical Guide Effective January 1, 2006 (Revised December 1, 2005) Page 2

All oral cancer and AMBIEN CR betamethasone dipropion- chlorthalidone immunosuppressant AMEVIVE ate 0.05% cream, lotion, chlorzoxazone medications; HIV amiloride ointment cholestyramine medications; and generic amiloride/hctz betamethasone dipropion- ciclopirox topical prenatal vitamins are on amiodarone [Pacerone] ate 0.05% ointment, cilostazol the PML, if the medication amitriptyline augmented cimetidine is FDA approved. amoxicillin [Trimox] betamethasone valerate ciprofloxacin amoxicillin trihydrate/ 0.1% cream, lotion citalopram —A— potassium clavulanate BETASERON clarithromycin ABILIFY amphetamine mixed salts bethanechol CLIMARA 0.0375 mg/day ACCU-CHEK [Active, ampicillin BETIMOL patch Advantage Comfort anagrelide BIAXIN XL CLIMARA 0.06 mg/day Curve, Aviva, ANTARA bisoprolol/hctz patch Compact] antipyrine/benzocaine brimonidine tartrate clindamycin oral acebutolol [A/B Otic] bromocriptine clindamycin topical acetaminophen/codeine APOKYN bumetanide clobetasol 0.05% acetazolamide ARICEPT bupropion clonazepam acetic acid/hydrocortisone ARMOUR THYROID bupropion ER clonidine [Acetasol HC] ASACOL buspirone clorazepate ACTIMMUNE ASMANEX butalbital compound clotrimazole/ ACTIVELLA ASTELIN butalbital/acetaminophen/ betamethasone ACTONEL atenolol caffeine COLAZAL ACTONEL with CALCIUM atenolol/chlorthalidone butalbital/caffeine/ colchicine ACTOPLUS MET atropine 1% ophthalmic acetaminophen/codeine COMBIPATCH ACTOS ATROVENT INHALER COMBIVENT ACULAR ATROVENT HFA —C— COMTAN ACULAR LS AUGMENTIN XR CADUET CONCERTA acyclovir AVALIDE CANASA COPAXONE ADDERALL XR AVANDAMET captopril COPEGUS ADVAIR DISKUS AVANDIA captopril/hctz COREG ALAMAST AVAPRO CARAC COSOPT albuterol AVELOX carbamazepine COUMADIN albuterol HFA AVONEX CARBATROL COZAAR ALDARA AZELEX CREAM carbidopa/levodopa CREON ALDURAZYME azithromycin carisoprodol CRESTOR allopurinol CATAPRES-TTS cromolyn 4% ophthalmic ALORA —B— cefaclor drops ALPHAGAN P baclofen cefadroxil cromolyn nebulized solution alprazolam benazepril cefuroxime cyclobenzaprine ALREX benazepril/hctz CEFZIL CYMBALTA ALTACE BENICAR CELEBREX CYTOMEL ALUPENT INHALER BENICAR HCT CENESTIN amantadine benzonatate cephalexin —D— AMBIEN benztropine CEREZYME DANTRIUM

Generic medications are sometimes given specific names by their manufacturers for ease of reference. These are listed in brackets after the generic name. Walgreens Health Initiatives 2006 Preferred Medication List Alphabetical Guide Effective January 1, 2006 (Revised December 1, 2005) Page 3

DEPAKENE ELMIRON ethinyl estradiol/norgestrel GEODON DEPAKOTE ENABLEX [Cryselle, Low-Ogestrel, glimepiride DEPAKOTE ER enalapril Ogestrel] glipizide desipramine enalapril/hctz etodolac glipizide ER desmopressin ENBREL EVISTA glipizide/metformin desonide 0.05% cream, ENTOCORT EC EVOXAC GLUCAGON lotion, ointment ENZYMAX EXELON EMERGENCY KIT desoximetasone 0.25% EPIPEN —F— glyburide cream EPIPEN JR famotidine glyburide micronized DETROL EPIVIR-HBV FEMHRT glyburide/metformin DETROL LA EPOGEN FEMRING GRIS-PEG dexamethasone erythromycin ophthalmic felodipine ER guaifenesin dextromethorphan/ erythromycin oral fentanyl transdermal guaifenesin/codeine promethazine erythromycin topical fexofenadine [Cheratussin AC, [Promethazine with DM] erythromycin/benzoyl gel FINACEA GEL Mytussin AC] dextromethorphan/ ESKALITH CR FLOMAX guaifenesin/dextromethor- pseudoephedrine/brom- estazolam FLOVENT phan/pseudoephedrine pheniramine [Cardec DM] ESTRACE CREAM FLOVENT HFA [Giltuss TR] DIASTAT estradiol FLOXIN OTIC guaifenesin/pseudoephed- diazepam estradiol patch fluconazole rine ER [Guaifen PSE, diclofenac ESTRATEST [Syntest DS] flunisolide Guaifenex PSE, dicloxacillin ESTRATEST HS [Syntest fluocinolone 0.01% solution Pseudovent 400] dicyclomine HS] fluocinonide 0.05% cream, guanfacine DIFFERIN ESTRING gel, ointment GYNODIOL diflunisal estropipate fluoxetine digoxin [Digitek] ESTROSTEP FE flurazepam —H— DILANTIN ethinyl estradiol/ flurbiprofen haloperidol diltiazem ER [Cartia XT, desogestrel [Apri, Kariva, FORADIL HEPSERA Dilt XR, Diltia XT, Taztia Velivet 28] FORTEO HUMALOG XT] ethinyl estradiol/ethynodiol FOSAMAX HUMALOG MIX 75/25 diphenoxylate/atropine [Zovia] FOSAMAX PLUS D HUMATE [Lonox] ethinyl estradiol/levonor- fosinopril HUMATROPE DIPROLENE LOTION gestrel [Aviane, fosinopril/hctz HUMIRA dipyridamole Enpresse, Lessina, FRAGMIN HUMULIN 50/50 DOSTINEX Levora, Lutera, Portia furosemide HUMULIN 70/30 DOVONEX Trivora-28] HUMULIN L doxazosin ethinyl estradiol/norethin- —G— HUMULIN N doxepin drone [Aranelle, gabapentin HUMULIN R doxycycline Microgestin, Necon, GABITRIL HUMULIN U Nortrel, Nortrel 7/7/7] ganciclovir hydralazine —E— ethinyl estradiol/norethin- GANTRISIN hydrochlorothiazide econazole nitrate drone/iron [Junel FE, GASTROCROM hydrocodone compound EFFEXOR Microgestin Fe] gemfibrozil hydrocodone/ EFFEXOR XR ethinyl estradiol/norgesti- GENOTROPIN acetaminophen EFUDEX mate [Sprintec 28, gentamicin ophthalmic hydrocodone/guaifenesin ELIDEL TriNessa, Tri-Sprintec] [Gentak] hydrocortisone

Generic medications are sometimes given specific names by their manufacturers for ease of reference.These are listed in brackets after the generic name. Walgreens Health Initiatives 2006 Preferred Medication List Alphabetical Guide Effective January 1, 2006 (Revised December 1, 2005) Page 4 hydrocortisone 1% cream levothyroxine sodium metolazone norethindrone [Camila, hydrocortisone [Levoxyl, Levothroid] metoprolol Errin, Nora-BE] 2.5% cream, lotion, LEXAPRO metoprolol/hctz NORITATE ointment LIPITOR METROGEL nortriptyline hydrocortisone valerate lisinopril METROGEL-VAGINAL NORVASC 0.2% cream, ointment lisinopril/hctz GEL NOVOLIN 70/30 hydroxychloroquine lithium carbonate METROLOTION NOVOLIN INNOLET 70/30 hydroxyzine lithium carbonate ER metronidazole NOVOLIN INNOLET N hyoscyamine sulfate LITHOBID metronidazole topical NOVOLIN L HYZAAR LOFIBRA 200 MG cream NOVOLIN N LOPROX GEL, LOTION, minocycline NOVOLIN R —I— SHAMPOO MIRAPEX NOVOLOG ibuprofen lorazepam mirtazapine NOVOLOG MIX 70/30 imipramine LOTEMAX mirtazapine soltab NOVOPEN IMITREX LOTREL misoprostol NULYTELY INDERAL LA lovastatin mometasone furoate NUTROPIN indomethacin LOVENOX 0.1% ointment NUTROPIN AQ INFERGEN LUMIGAN morphine sulfate ER NUVARING INNOPRAN XL LUPRON mupirocin nystatin INTAL INHALER nystatin powder INTRON A —M— —N— nystatin/triamcinolone ipratropium bromide MALARONE nabumetone isoniazid MAXALT nadolol —O— isosorbide mononitrate ER MAXALT MLT NAMENDA ofloxacin isotretinoin [Amnesteem, mebendazole naproxen ofloxacin 0.3% ophthalmic Claravis] meclizine naproxen sodium solution medroxyprogesterone NASACORT AQ omeprazole —K— mefloquine NASONEX OMNICEF KEPPRA MENEST neomycin/polymyxin B/ ONE TOUCH [Basic, KETEK meperidine bacitracin ointment FastTake, OneTouch II, ketoconazole oral MEPHYTON neomycin/polymyxin B/ Profile, SureStep, Ultra] ketoconazole topical mesalamine dexamethasone OPTIVAR ketorolac MESTINON SYRUP neomycin/polymyxin B/ orphenadrine KINERET MESTINON TIMESPAN gramicidin solution OVIDE KU-ZYME METADATE CD 20 MG NEUPOGEN oxaprozin KU-ZYME HP mesalamine NIASPAN oxazepam metformin nifedipine ER [Afeditab CR, oxybutynin —L— metformin ER Nifediac CC, Nifedical oxycodone labetalol methimazole XL] oxycodone ER lactulose [Enulose] methocarbamol nitrofurantoin macrocrystals oxycodone/acetaminophen LAMICTAL methyldopa nitroglycerin [Minitran, [Endocet, Roxicet] LAMISIL methylphenidate [Methylin] Nitroquik, Nitrostat, LANOXICAPS methylphenidate ER Nitrotab] —P— LANOXIN [Methylin ER] nizatidine PANCREASE MT LANTUS methylprednisolone NORDITROPIN pancreatic enzyme levobunolol metoclopramide preparations

Generic medications are sometimes given specific names by their manufacturers for ease of reference.These are listed in brackets after the generic name. Walgreens Health Initiatives 2006 Preferred Medication List Alphabetical Guide Effective January 1, 2006 (Revised December 1, 2005) Page 5

PANCRECARB PREMARIN VAGINAL ROFERON-A torsemide paroxetine PREMPHASE —S— tramadol PEGASYS PREMPRO SAIZEN tramadol/acetaminophen PEG-INTRON PREVACID SANDOSTATIN trazodone penicillin V potassium PREVACID NAPRAPAC selegiline tretinoin PENTASA PREVPAC SEREVENT DISKUS triamcinolone pentoxifylline ER primidone SEROQUEL 0.025% cream, lotion, permethrin probenecid SEROSTIM ointment phenazopyridine prochlorperazine silver sulfadiazine [SSD] triamcinolone 0.1% cream, phenobarbital PROCRIT SINGULAIR lotion, ointment phenylephrine/codeine/ propoxyphene/ SOLARAZE triamcinolone 0.5% cream, promethazine acetaminophen SONATA ointment [Promethazine VC with propranolol sotalol triamterene/hctz codeine] PROTOPIC SPIRIVA triazolam phenylephrine/ pseudoephedrine/ spironolactone TRICOR hydrocodone chlorpheniramine spironolactone/hctz trihexyphenidyl phenylephrine/hydroco- [De-Congestine TR] STALEVO TRILEPTAL done/CP [H-C Tussive, PULMICORT RESPULES STARLIX trimethobenzamide Histenex HC] PULMICORT STRATTERA trimethoprim promethazine/ TURBUHALER sucralfate TRUSOPT codeine PULMOZYME sulfacetamide ophthalmic PHENYTEK pyridostigmine sulfamethoxazole/ —U— phenytoin ER trimethoprim [Sulfatrim] ULTRASE PHOSLO —Q— sulfasalazine [Sulfazine UROCIT-K pilocarpine eye drops quinapril EC] ursodiol pilocarpine tablets quinapril/hctz [Quinaretic] sulindac pindolol quinine sulfate SYMBYAX —V— piroxicam QUIXIN SYNAGIS VALCYTE PLAN B QVAR SYNTHROID valproic acid PLAVIX VALTREX polyethylene glycol 3350 —R— —T— verapamil [Glycolax] ranitidine tablets TAZORAC verapamil ER polyethylene glycol 3350/ RAPTIVA TEGRETOL VFEND electrolyte solution RAZADYNE TEGRETOL XR VIGAMOX polymyxin B/trimethoprim RAZADYNE ER temazepam VIOKASE potassium chloride ER REBIF terazosin VISICOL [Klor-Con] RECOMBINATE terconazole vaginal cream VIVELLE PRANDIN REGRANEX tetracycline VIVELLE-DOT PRECOSE RELPAX THYROLAR VOLTAREN OPHTHALMIC prednisolone RENAGEL timolol maleate VYTORIN 1% ophthalmic drops REQUIP tizanidine prednisolone 15 mg/5 ml RETIN-A MICRO TOBI —W— syrup RHINOCORT AQUA TOBRADEX warfarin prednisone ribavirin tobramycin ophthalmic WELCHOL PREFEST rifampin TOPAMAX PREMARIN RISPERDAL TOPROL XL

Generic medications are sometimes given specific names by their manufacturers for ease of reference.These are listed in brackets after the generic name. Walgreens Health Initiatives 2006 Preferred Medication List Alphabetical Guide Effective January 1, 2006 (Revised December 1, 2005) Page 6

—X— XALATAN

—Y— YASMIN 28

—Z— ZADITOR ZETIA ZITHROMAX SUSPENSION ZOFRAN ZOFRAN ODT ZOLOFT ZOMIG ZOMIG ZMT ZONEGRAN ZOVIRAX 5% OINTMENT ZYMAR ZYPREXA ZYPREXA ZYDIS

Generic medications are sometimes given specific names by their manufacturers for ease of reference.These are listed in brackets after the generic name.