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Rx90 Drug List Template Maintenance Drug List This list pertains to maintenance drugs that you must obtain a 90-day prescription for and must be filled at a Valley Pharmacy or EnvisionRx Mail Order pharmacy. If you have questions about this list or RX90, please contact the EnvisionRx Customer Service Help Desk at 800-361-4542 RX90 MAINTENANCE (available 24 hours a day, seven days a week to assist you) DRUG LISTING ADHD/ANTI-NARCOLEPSY/ LEFLUNOMIDE ARCAPTA NEOHALER KEPPRA NARDIL ANTI-OBESITY/ANOREXIANTS ANALGESICS - NonNarcotic BROVANA KEPPRA XR PARNATE ADHD Agent - Selective Alpha Salicylates LEVALBUTEROL LAMICTAL PHENELZINE SULFATE Adrenergic Agonists DIFLUNISAL LEVALBUTEROL HCL LAMICTAL CHEWABLE DISPERS TRANYLCYPROMINE SULFATE CLONIDINE HCL ER DISALCID LEVALBUTEROL TARTRATE HFA LAMICTAL ODT Selective Serotonin Reuptake GUANFACINE ER SALSALATE METAPROTERENOL SULFATE LAMICTAL XR Inhibitors (SSRIs) INTUNIV PERFOROMIST LAMOTRIGINE CELEXA KAPVAY ANTIANGINAL AGENTS PROAIR HFA LAMOTRIGINE ER CITALOPRAM HYDROBROMIDE ADHD Agent - Selective Antianginals-Other PROAIR RESPICLICK LAMOTRIGINE ODT ESCITALOPRAM OXALATE Norepinephrine Reuptake Inhibitor RANEXA PROVENTIL HFA LEVETIRACETAM FLUOXETINE DR STRATTERA Nitrates SEREVENT DISKUS LEVETIRACETAM ER FLUOXETINE HCL Anti-Obesity Agents DILATRATE SR STRIVERDI RESPIMAT MYSOLINE FLUVOXAMINE MALEATE SAXENDA GONITRO TERBUTALINE SULFATE NEURONTIN FLUVOXAMINE MALEATE ER ISORDIL TITRADOSE VENTOLIN HFA OXCARBAZEPINE LEXAPRO ANALGESICS - ANTI- ISOSORBIDE DINITRATE VOSPIRE ER OXTELLAR XR PAROXETINE HCL INFLAMMATORY ISOSORBIDE DINITRATE ER XOPENEX PRIMIDONE PAROXETINE HCL ER Analgesics - Anti-Inflammatory ISOSORBIDE MONONITRATE XOPENEX CONCENTRATE QUDEXY XR PAXIL EQUAPAX/IBUPROFEN/MINREX ISOSORBIDE MONONITRATE ER XOPENEX HFA ROWEEPRA PAXIL CR Antirheumatic Antimetabolites MINITRAN Bronchodilators - Anticholinergics SPRITAM PEXEVA OTREXUP NITRO-BID ATROVENT HFA TEGRETOL PROZAC RASUVO NITRO-DUR INCRUSE ELLIPTA TEGRETOL-XR PROZAC WEEKLY Cyclooxygenase 2 (COX-2) NITROGLYCERIN SPIRIVA HANDIHALER TOPAMAX SERTRALINE HCL Inhibitors NITROGLYCERIN ER SPIRIVA RESPIMAT TOPAMAX SPRINKLE ZOLOFT CELEBREX NITROGLYCERIN LINGUAL TUDORZA PRESSAIR TOPIRAMATE CELEXA CELECOXIB NITROGLYCERIN TRANSDERMAL Leukotriene Receptor Antagonists TOPIRAMATE ER CITALOPRAM HYDROBROMIDE Gold Compounds NITROLINGUAL PUMPSPRAY ACCOLATE TRILEPTAL ESCITALOPRAM OXALATE RIDAURA NITROMIST MONTELUKAST SODIUM TROKENDI XR FLUOXETINE DR Nonsteroidal Anti-inflammatory NITROSTAT SINGULAIR ZONEGRAN FLUOXETINE HCL Agent Combinations NITRO-TIME ZAFIRLUKAST ZONISAMIDE FLUVOXAMINE MALEATE ARTHROTEC 50 Selective Phosphodiesterase 4 Carbamates FLUVOXAMINE MALEATE ER ARTHROTEC 75 ANTIARRHYTHMICS (PDE4) Inhibitors FELBAMATE LEXAPRO DICLOFENAC SODIUM/MISOPRO Antiarrhythmics Type I-A DALIRESP FELBATOL PAROXETINE HCL DUEXIS DISOPYRAMIDE PHOSPHATE Steroid Inhalants GABA Modulators PAROXETINE HCL ER VIMOVO NORPACE AEROSPAN GABITRIL PAXIL Nonsteroidal Anti-inflammatory NORPACE CR ALVESCO TIAGABINE HYDROCHLORIDE PAXIL CR Agents (NSAIDs) QUINIDINE GLUCONATE CR ARNUITY ELLIPTA Hydantoins PEXEVA ANAPROX DS QUINIDINE GLUCONATE ER ASMANEX HFA DILANTIN PROZAC DAYPRO QUINIDINE SULFATE ASMANEX TWISTHALER 120 ME DILANTIN INFATABS PROZAC WEEKLY DICLOFENAC POTASSIUM Antiarrhythmics Type I-B ASMANEX TWISTHALER 14 MET DILANTIN-125 SERTRALINE HCL DICLOFENAC SODIUM DR MEXILETINE HCL ASMANEX TWISTHALER 30 MET PEGANONE ZOLOFT DICLOFENAC SODIUM ER Antiarrhythmics Type I-C ASMANEX TWISTHALER 60 MET PHENYTEK Serotonin Modulators EC-NAPROSYN FLECAINIDE ACETATE ASMANEX TWISTHALER 7 METE PHENYTOIN NEFAZODONE HCL ETODOLAC PROPAFENONE HCL BUDESONIDE PHENYTOIN INFATABS TRAZODONE HCL ETODOLAC ER PROPAFENONE HCL ER FLOVENT DISKUS PHENYTOIN SODIUM EXTENDED TRINTELLIX FELDENE RYTHMOL SR FLOVENT HFA Succinimides VIIBRYD FENOPROFEN CALCIUM FLECAINIDE ACETATE PULMICORT CELONTIN Serotonin-Norepinephrine Reuptake FENORTHO PROPAFENONE HCL PULMICORT FLEXHALER ETHOSUXIMIDE Inhibitors (SNRIs) FLURBIPROFEN PROPAFENONE HCL ER QVAR ZARONTIN CYMBALTA IBUPROFEN RYTHMOL SR Xanthines Valproic Acid DESVENLAFAXINE ER INDOCIN Antiarrhythmics Type III ELIXOPHYLLIN DEPAKENE DULOXETINE HCL INDOMETHACIN AMIODARONE HCL THEO-24 DEPAKOTE EFFEXOR XR INDOMETHACIN ER DOFETILIDE THEOCHRON DEPAKOTE ER FETZIMA KETOPROFEN MULTAQ THEOPHYLLINE DEPAKOTE SPRINKLES KHEDEZLA KETOPROFEN ER PACERONE THEOPHYLLINE CR DIVALPROEX SODIUM PRISTIQ LODINE TIKOSYN THEOPHYLLINE ER DIVALPROEX SODIUM DR VENLAFAXINE HCL MECLOFENAMATE SODIUM DIVALPROEX SODIUM ER VENLAFAXINE HCL ER MEFENAMIC ACID ANTIASTHMATIC AND ANTICOAGULANTS SSRIs-Nutritional Supplement MELOXICAM BRONCHODILATOR AGENTS Coumarin Anticoagulants ANTIDEPRESSANTS Combinations MOBIC 5-Lipoxygenase Inhibitors COUMADIN Alpha-2 Receptor Antagonists PRAMLYTE NABUMETONE ZYFLO JANTOVEN (Tetracyclics) Tricyclic Agents NALFON ZYFLO CR WARFARIN SODIUM MIRTAZAPINE AMITRIPTYLINE HCL NAPRELAN Adrenergic Combinations Direct Factor Xa Inhibitors MIRTAZAPINE ODT AMOXAPINE NAPROSYN ADVAIR DISKUS ELIQUIS REMERON ANAFRANIL NAPROXEN ADVAIR HFA SAVAYSA REMERON SOLTAB CLOMIPRAMINE HCL NAPROXEN DR ANORO ELLIPTA XARELTO Antidepressants - Misc. DESIPRAMINE HCL NAPROXEN SODIUM BEVESPI Thrombin Inhibitors - Selective APLENZIN DOXEPIN HCL NAPROXEN SODIUM CR BREO ELLIPTA Direct & Reversible BUPROPION HCL ELAVIL NAPROXEN SODIUM ER COMBIVENT RESPIMAT PRADAXA BUPROPION HCL ER IMIPRAMINE HCL OXAPROZIN DULERA BUPROPION HCL SR IMIPRAMINE PAMOATE PIROXICAM IPRATROPIUM BROMIDE/ALBUT ANTICONVULSANTS BUPROPION HCL XL NORPRAMIN PONSTEL STIOLTO RESPIMAT Anticonvulsants - Misc. FORFIVO XL NORTRIPTYLINE HCL SULINDAC SYMBICORT APTIOM MAPROTILINE HCL PAMELOR TOLMETIN SODIUM Anti-Inflammatory Agents BANZEL WELLBUTRIN SR PROTRIPTYLINE HCL VIVLODEX CROMOLYN SODIUM CARBAMAZEPINE WELLBUTRIN XL SURMONTIL ZORVOLEX Beta Adrenergics CARBAMAZEPINE ER Monoamine Oxidase Inhibitors TOFRANIL ALBUTEROL CARBATROL (MAOIs) TRIMIPRAMINE MALEATE Pyrimidine Synthesis Inhibitors ALBUTEROL SULFATE EPITOL EMSAM ARAVA ALBUTEROL SULFATE ER GABAPENTIN MARPLAN © 2018 EnvisionRx 18-2368 envisionrx.com | 800-361-4542 As of 4/1/2017. Information subject to change. ANTIDIABETICS REPAGLINIDE QUESTRAN ACE Inhibitors & Thiazide/ Antihypertensives - Misc. Alpha-Glucosidase Inhibitors STARLIX QUESTRAN LIGHT Thiazide-Like VECAMYL ACARBOSE Meglitinide-Biguanide Combinations WELCHOL ACCURETIC Beta Blocker & Diuretic GLYSET REPAGLINIDE/METFORMIN HYD Fibric Acid Derivatives BENAZEPRIL HCL/HYDROCHLOR Combinations MIGLITOL Progesterone Receptor Antagonists ANTARA CAPTOPRIL/HYDROCHLOROTHIA ATENOLOL/CHLORTHALIDONE PRECOSE KORLYM FENOFIBRATE ENALAPRIL MALEATE/HYDROCH BISOPROLOL FUMARATE/HYDRO Antidiabetic - Amylin Analogs SGLT2 Inhibitor - DPP-4 Inhibitor FENOFIBRATE MICRONIZED FOSINOPRIL SODIUM/HYDROCH CORZIDE SYMLINPEN 120 Combinations FENOFIBRIC ACID LISINOPRIL/HYDROCHLOROTHI DUTOPROL SYMLINPEN 60 GLYXAMBI FENOFIBRIC ACID DR LOTENSIN HCT LOPRESSOR HCT Antidiabetics, Other Sodium-Glucose Co-Transporter 2 FENOGLIDE MOEXIPRIL/HYDROCHLOROTHIA METOPROLOL SUCCINATE ER/H SOLIQUA 100/33 (SGLT2) Inhibitors FIBRICOR QUINAPRIL/HYDROCHLOROTHIA METOPROLOL/HYDROCHLOROTHI Biguanides FARXIGA GEMFIBROZIL VASERETIC NADOLOL/BENDROFLUMETHIAZI FORTAMET INVOKANA LIPOFEN ZESTORETIC PROPRANOLOL/HYDROCHLOROTH GLUCOPHAGE JARDIANCE LOFIBRA Adrenolytics-Central & TENORETIC 100 GLUCOPHAGE XR Sodium-Glucose Co-Transporter 2 LOPID Thiazide/Thiazide-Like Comb TENORETIC 50 GLUMETZA Inhibitor-Biguanide Comb TRICOR CLORPRES ZIAC METFORMIN HCL INVOKAMET TRIGLIDE METHYLDOPA/HYDROCHLOROTHI Direct Renin Inhibitors METFORMIN HCL ER INVOKAMET XR TRILIPIX Angiotensin II Receptor Antag & TEKTURNA METFORMIN HCL ER (OSMOTIC) SYNJARDY HMG CoA Reductase Inhibitor Beta Blocker Comb Direct Renin Inhibitors & RIOMET XIGDUO XR Combinations BYVALSON Thiazide/Thiazide-Like Comb Diabetic Other Sulfonylurea-Biguanide EQUAPAX/ATORVASTATIN CALC Angiotensin II Receptor Antag & Ca TEKTURNA HCT PROGLYCEM Combinations HMG CoA Reductase Inhibitors Channel Blocker Comb Selective Aldosterone Receptor Dipeptidyl Peptidase-4 (DPP-4) GLIPIZIDE/METFORMIN HCL ALTOPREV AMLODIPINE BESYLATE/VALSA Antagonists (SARAs) Inhibitors GLUCOVANCE ATORVASTATIN CALCIUM AMLODIPINE/OLMESARTAN MED EPLERENONE ALOGLIPTIN GLYBURIDE/METFORMIN HCL CRESTOR AZOR INSPRA JANUVIA Sulfonylureas FLUVASTATIN EXFORGE Vasodilators NESINA AMARYL FLUVASTATIN SODIUM ER TELMISARTAN/AMLODIPINE HYDRALAZINE HCL ONGLYZA CHLORPROPAMIDE LESCOL XL TWYNSTA MINOXIDIL TRADJENTA GLIMEPIRIDE LIPITOR Angiotensin II Receptor Antag & Dipeptidyl Peptidase-4 Inhibitor- GLIPIZIDE LIVALO Thiazide/Thiazide-Like ANTI-INFECTIVE AGENTS - MISC. Biguanide Combinations GLIPIZIDE ER LOVASTATIN ATACAND HCT XIFAXAN ALOGLIPTIN/METFORMIN HCL GLIPIZIDE XL MEVACOR AVALIDE Leprostatics JANUMET GLUCOTROL PRAVACHOL BENICAR HCT DAPSONE JANUMET XR GLUCOTROL XL PRAVASTATIN SODIUM CANDESARTAN CILEXETIL/HYD JENTADUETO GLYBURIDE ROSUVASTATIN CALCIUM DIOVAN HCT ANTIMALARIALS JENTADUETO XR GLYBURIDE MICRONIZED SIMVASTATIN EDARBYCLOR CHLOROQUINE PHOSPHATE KAZANO GLYNASE ZOCOR HYZAAR HYDROXYCHLOROQUINE SULFAT KOMBIGLYZE XR TOLAZAMIDE Intest Cholest Absorp Inhib-HMG IRBESARTAN/HYDROCHLOROTHI MEFLOQUINE HCL Dopamine Receptor Agonists - Ergot TOLBUTAMIDE CoA Reductase Inhib Comb LOSARTAN POTASSIUM/HYDROC PLAQUENIL Derivatives Sulfonylurea-Thiazolidinedione VYTORIN MICARDIS HCT CYCLOSET Combinations Intestinal Cholesterol Absorption OLMESARTAN MEDOXOMIL/HYDR ANTIMYCOBACTERIAL AGENTS DPP-4 Inhibitor-Thiazolidinedione DUETACT Inhibitors TELMISARTAN/HYDROCHLOROTH ISONIAZID Combinations PIOGLITAZONE HCL-GLIMEPIR EZETIMIBE VALSARTAN/HYDROCHLOROTHIA
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