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Common Over-The-Counter (OTC) Medications

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Common Over-The-Counter (OTC) Medications Commonly Covered Over-the Counter Items Legend In each class, drugs are listed alphabetically by either brand name or generic name. Brand name drug: Uppercase in bold type Generic drug: Lowercase in plain type AL: Age Limit Restrictions OTC: Over the counter medication available with a prescription. (Prescribers please indicate OTC on the prescription) PA: Prior authorization is required. Prior authorization is the process of obtaining approval of benefits before certain prescriptions are filled. QL: Quantity limits; certain prescription medications have specific quantity limits per prescription or per month. BlueChoice® HealthPlan of South Carolina is an independent licensee of the Blue Cross and Blue Shield Association. BlueChoice HealthPlan has contracted with Amerigroup Partnership Plan, LLC, an independent company, for services to support administration of Healthy Connections. CURRENT AS OF 7/23/2019 Drug Name Reference Notes ALTERNATIVE THERAPY ALTERNATIVE THERAPY ANTIOXIDANT A/C/E/SELENIUM ORAL OTC CAPSULE e-400 c-500 and beta carotene oral tablet OTC eye health plus lutein oral tablet OTC glucosamine-chondroitin complx oral OTC capsule healthy eyes oral tablet OTC healthy eyes supervision oral capsule OTC icaps areds oral capsule OTC i-vite oral tablet OTC i-vite protect oral tablet OTC kelp-lecithin-b6 oral tablet OTC lecithin-kelp-b6 (100-8.3) oral tablet OTC lecithin-kelp-b6 (400-20) oral tablet OTC lecithin-kelp-b6 oral capsule OTC opti-vitamins oral tablet OTC prosight oral tablet OTC super antioxidant oral capsule OTC ULTRA ANTIOXIDANT FORMULA OTC ORAL TABLET ANALGESIC, ANTI- INFLAMMATORY OR ANTIPYRETIC ANALGESIC/ANTIPYRETICS, NON-SALICYLATE acetadryl oral tablet AL; OTC aceta-gesic oral tablet AL; OTC acetaminophen pm extra str oral tablet OTC acetaminophen pm oral tablet OTC diphenhydramine-acetaminophen oral Acetadryl OTC tablet headache pm oral tablet OTC headache relief pm oral tablet OTC mapap pm oral tablet OTC 2 Drug Name Reference Notes menstrual relief oral tablet OTC midol pm oral tablet OTC non-aspirin pain relief pm oral tablet OTC non-aspirin pm oral tablet OTC pain relief pm oral tablet OTC pain relief pm rapid release oral tablet OTC pain reliever pm ex-strength oral tablet AL; OTC pain reliever pm oral tablet AL; OTC percogesic extra strength oral tablet AL; OTC percogesic oral tablet AL; OTC ANALGESIC/ANTIPYRETICS, SALICYLATES added strength headache relief oral tablet OTC antacid and pain relief oral tablet, OTC effervescent aspir-81 oral tablet,delayed release (dr/ec) OTC aspirin childrens oral tablet,chewable OTC aspirin low dose oral tablet,delayed OTC release (dr/ec) aspirin oral tablet Bayer Aspirin OTC aspirin oral tablet,chewable Aspirin Childrens OTC aspirin oral tablet,delayed release (dr/ec) OTC aspirin rectal suppository OTC aspirin, buffered oral tablet Buffered Aspirin OTC aspir-low oral tablet,delayed release OTC (dr/ec) aspir-trin oral tablet,delayed release OTC (dr/ec) back and body pain reliever oral tablet OTC bayer advanced oral tablet OTC bayer aspirin oral tablet OTC bufferin oral tablet OTC children's aspirin oral tablet,chewable OTC e.c. prin oral tablet,delayed release (dr/ec) OTC efferves pain relief antacid oral tablet, OTC effervescent headache relief (asa-acet-caf) oral tablet OTC lite coat aspirin oral tablet OTC 3 Drug Name Reference Notes migraine formula oral tablet OTC migraine relief oral tablet OTC pain reliever (acetam-aspirin) oral tablet OTC pain reliever plus oral tablet OTC pain-off oral tablet OTC tri-buffered aspirin oral tablet OTC ANALGESICS, NON-NARCOTIC 8 hour pain reliever oral tablet extended OTC release acetaminophen extra strength oral tablet OTC acetaminophen oral elixir Non-Aspirin OTC acetaminophen oral liquid Children's Silapap OTC acetaminophen oral solution Mapap (acetaminophen) OTC acetaminophen oral suspension BetaTemp OTC acetaminophen oral tablet Athenol OTC acetaminophen oral tablet extended 8 Hour Pain Reliever OTC release acetaminophen oral tablet,disintegrating Children's Acetaminophen OTC acetaminophen pain relief oral tablet OTC acetaminophen rectal suppository Feverall OTC arthritis pain relief (acetam) oral tablet OTC extended release arthritis pain reliever oral tablet extended OTC release athenol oral tablet OTC betatemp oral suspension OTC child pain rel-fever reducer rectal OTC suppository children's acetaminophen oral suspension OTC children's acetaminophen oral OTC tablet,chewable children's acetaminophen oral OTC tablet,disintegrating children's easy-melts oral OTC tablet,disintegrating children's fever reducing rectal OTC suppository children's non-aspirin oral suspension OTC children's non-aspirin oral tablet,chewable OTC 4 Drug Name Reference Notes children's pain relief oral suspension OTC children's pain reliever oral suspension OTC children's pain-fever relief oral suspension OTC children's pain-fever relief oral OTC tablet,disintegrating children's silapap oral liquid OTC children's tactinal oral tablet,chewable OTC ed-apap oral liquid OTC fever reducer an pain reliever oral OTC suspension fever reducer rectal suppository OTC feverall rectal suppository OTC infant fever reducer-pain relf oral OTC suspension infant pain reliever oral suspension OTC infants' pain and fever oral suspension OTC infant's pain relief oral drops,suspension OTC infants' pain relief oral suspension OTC infant's pain relief oral suspension OTC infant's pain reliever oral OTC drops,suspension jr. acetaminophen oral OTC tablet,disintegrating jr. str non-aspirin pain oral OTC tablet,disintegrating jr. strength pain reliever oral OTC tablet,disintegrating little remedies fever and pain oral liquid OTC mapap (acetaminophen) oral capsule OTC mapap (acetaminophen) oral liquid OTC mapap (acetaminophen) oral tablet OTC mapap arthritis pain oral tablet extended OTC release mapap extra strength oral tablet OTC masophen oral tablet OTC non-aspirin childrens oral drops OTC non-aspirin extra strength oral liquid OTC non-aspirin extra strength oral tablet OTC non-aspirin oral elixir OTC 5 Drug Name Reference Notes non-aspirin oral suspension OTC non-aspirin oral tablet OTC non-aspirin oral tablet,chewable OTC non-aspirin pain relief oral tablet OTC nortemp oral drops OTC nortemp oral suspension OTC pain and fever oral tablet OTC pain relief adult oral liquid OTC pain relief extra strength oral tablet OTC pain relief oral liquid OTC pain relief oral tablet OTC pain relief oral tablet extended release OTC pain relief regular strength oral tablet OTC pain reliever extra strength oral tablet OTC pain reliever jr strength oral OTC tablet,chewable pain reliever oral tablet OTC pediacare fever reducer oral suspension OTC pharbetol oral tablet OTC pre-menstrual relief oral tablet OTC premsyn pms oral tablet OTC tactinal extra strength oral tablet OTC tactinal oral tablet OTC tylophen oral capsule OTC NSAIDS advil oral tablet OTC advil oral tablet,chewable OTC all day pain relief oral tablet OTC all day relief oral tablet OTC children's advil oral suspension OTC children's ibuprofen oral suspension 100 OTC mg/5 ml children's profen ib oral suspension OTC flanax (naproxen) oral tablet OTC ibuprofen ib oral tablet OTC ibuprofen ib oral tablet,chewable OTC ibuprofen jr strength oral tablet,chewable OTC 6 Drug Name Reference Notes ibuprofen oral capsule Advil Liqui-Gel OTC ibuprofen oral drops,suspension Infant's Advil OTC ibuprofen oral suspension Children's Advil OTC ibuprofen oral tablet Advil OTC ibuprofen pm oral tablet OTC infant's ibuprofen oral drops,suspension OTC infants profenib oral drops,suspension OTC i-prin oral tablet OTC mediproxen oral tablet OTC motrin pm oral tablet OTC naproxen sodium oral capsule Aleve OTC naproxen sodium oral tablet Aleve OTC provil oral tablet OTC QC CHILD IBUPROFEN 100 MG/5 ML OTC wal-profen oral capsule OTC wal-profen oral tablet OTC wal-proxen oral tablet OTC ANORECTAL PREPARATIONS HEMORRHOIDAL PREPARATIONS hemorrhoid rectal ointment OTC hemorrhoidal (phenyleph-cocoa) rectal OTC suppository hemorrhoidal rectal ointment OTC hemorrhoidal rectal suppository OTC hemorrhoidal suppository rectal OTC suppository ANTI-INFECTIVE AGENTS ANTHELMINTICS reese's pinworm medicine oral suspension OTC ANTISEPTICS AND DISINFECTANTS ANTISEPTICS, GENERAL alcohol pads topical pads, medicated OTC alcohol prep pads topical pads, medicated OTC alcohol swabs topical pads, medicated Alcohol Pads OTC alcohol wipes topical pads, medicated OTC 7 Drug Name Reference Notes antiseptic skin clnsr(chlorhe) topical liquid OTC betasept surgical scrub topical liquid OTC chlorhexidine gluconate topical liquid Dyna-Hex OTC curity alcohol swabs topical pads, OTC medicated easy touch alcohol prep pads topical OTC pads, medicated hibiclens topical liquid OTC hydrogen peroxide solution OTC sure comfort alcohol prep pads topical OTC pads, medicated webcol topical pads, medicated OTC DISINFECTANTS - OTHER alcoh-wipe towelette OTC CARDIOVASCULAR THERAPY AGENTS LIPOTROPICS fish oil concentrate oral capsule OTC fish oil oral capsule,delayed release(dr/ec) OTC GRAM-O-LECI ORAL OTC TABLET,CHEWABLE inositol oral tablet OTC lecithin oral capsule OTC lecithin, soy oral capsule OTC maxepa oral capsule OTC niacin oral tablet Niacor OTC omega-3 fatty acids oral capsule Fish Oil Concentrate OTC prenatal dha oral capsule OTC super omega-3 oral capsule OTC SUPER TWIN EPA-DHA ORAL OTC CAPSULE vitamin e oral capsule OTC CENTRAL NERVOUS SYSTEM AGENTS SEDATIVE-HYPNOTICS, NON- BARBITURATES alka-seltzer plus allergy oral tablet OTC diphenhydramine 50 mg capsule (otc) Banophen OTC
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