Plan for your best health 2019 Aetna Pharmacy Drug Guide Aetna Premier Plus Plan aetna.com 05.02.414.1 O (12/19) Aetna is the brand name used for products and services provided by one or more of the Aetna group of subsidiary companies, including Aetna Life Insurance Company and its affiliates (Aetna). Aetna Pharmacy Management refers to an internal business unit of Aetna Health Management, LLC. Aetna Pharmacy Management administers, but does not offer, insure or otherwise underwrite the prescription drug benefits portion of your health plan and has no financial responsibility therefor. 2019 Aetna Commercial Plan (Premier Plus) Table of Contents INFORMATIONAL SECTION..................................................................................................................7 *5-HT4 RECEPTOR AGONISTS*** - DRUGS FOR THE STOMACH................................................ 18 *ADHD/ANTI-NARCOLEPSY/ANTI-OBESITY/ANOREXIANTS* - DRUGS FOR THE NERVOUS SYSTEM.................................................................................................................................18 *AGENTS FOR NARCOTIC WITHDRAWAL*** - DRUGS FOR ADDICTION............................... 22 *AGENTS FOR OPIOID WITHDRAWAL*** - DRUGS FOR ADDICTION......................................22 *AMEBICIDES* - DRUGS FOR INFECTIONS.....................................................................................22 *AMINO ACIDS*** - DRUGS FOR NUTRITION................................................................................ 22 *AMINOGLYCOSIDES* - DRUGS FOR INFECTIONS.......................................................................22 *AMINOMETHYLCYCLINES*** - DRUGS FOR INFECTIONS....................................................... 22 *ANALGESICS - ANTI-INFLAMMATORY* - DRUGS FOR PAIN AND FEVER............................22 *ANALGESICS - NONNARCOTIC* - DRUGS FOR PAIN AND FEVER.......................................... 26 *ANALGESICS - OPIOID* - DRUGS FOR PAIN AND FEVER.......................................................... 27 *ANDROGENS-ANABOLIC* - HORMONES........................................................................................35 *ANORECTAL AGENTS* - RECTAL PREPARATIONS..................................................................... 36 *ANTHELMINTICS* - DRUGS FOR INFECTIONS............................................................................ 36 *ANTIANGINAL AGENTS* - DRUGS FOR THE HEART................................................................. 37 *ANTIANXIETY AGENTS* - DRUGS FOR THE NERVOUS SYSTEM.............................................38 *ANTIARRHYTHMICS* - DRUGS FOR THE HEART....................................................................... 39 *ANTIASTHMATIC AND BRONCHODILATOR AGENTS* - DRUGS FOR THE LUNGS............ 39 *ANTICOAGULANTS* - DRUGS FOR THE BLOOD..........................................................................44 *ANTICONVULSANTS* - DRUGS FOR THE NERVOUS SYSTEM.................................................. 45 *ANTIDEMENTIA AGENT COMBINATIONS*** - DRUGS FOR THE NERVOUS SYSTEM........50 *ANTIDEPRESSANTS* - DRUGS FOR THE NERVOUS SYSTEM....................................................50 *ANTIDIABETICS* - HORMONES........................................................................................................53 *ANTIDIARRHEALS* - DRUGS FOR THE STOMACH..................................................................... 61 *ANTIDOTES AND SPECIFIC ANTAGONISTS* - DRUGS FOR OVERDOSE OR POISONING...61 *ANTIDOTES* - DRUGS FOR OVERDOSE OR POISONING............................................................ 61 *ANTIEMETICS* - DRUGS FOR THE STOMACH..............................................................................62 *ANTIFUNGALS* - DRUGS FOR INFECTIONS.................................................................................63 *ANTIHEMOPHILIC PRODUCTS - MONOCLONAL ANTIBODIES*** - DRUGS FOR THE BLOOD...................................................................................................................................................... 64 *ANTIHISTAMINES* - DRUGS FOR THE LUNGS.............................................................................64 *ANTIHYPERLIPIDEMICS* - DRUGS FOR THE HEART.................................................................66 *ANTIHYPERTENSIVES* - DRUGS FOR THE HEART..................................................................... 68 *ANTI-INFECTIVE AGENTS - MISC.* - DRUGS FOR INFECTIONS...............................................73 *ANTIMALARIALS* - DRUGS FOR INFECTIONS............................................................................ 74 *ANTIMYASTHENIC AGENTS* - DRUGS FOR NERVES AND MUSCLES....................................74 *ANTIMYASTHENIC/CHOLINERGIC AGENTS* - DRUGS FOR NERVES AND MUSCLES.......75 *ANTIMYCOBACTERIAL AGENTS* - DRUGS FOR INFECTIONS................................................ 75 *ANTINEOPLASTIC - BCL-2 INHIBITORS*** - DRUGS FOR CANCER......................................... 76 *ANTINEOPLASTIC - FGFR KINASE INHIBITORS*** - DRUGS FOR CANCER......................... 76 *ANTINEOPLASTIC - TROPOMYOSIN RECEPTOR KINASE INHIBITORS*** - DRUGS FOR CANCER....................................................................................................................................................76 *ANTINEOPLASTIC - XPO1 INHIBITORS*** - DRUGS FOR CANCER.......................................... 76 *ANTINEOPLASTICS AND ADJUNCTIVE THERAPIES* - DRUGS FOR CANCER......................76 *ANTIPARKINSON AGENTS* - DRUGS FOR THE NERVOUS SYSTEM....................................... 82 TOC-3 *ANTIPSYCHOTICS/ANTIMANIC AGENTS* - DRUGS FOR THE NERVOUS SYSTEM..............84 *ANTIRETROVIRALS ADJUVANTS*** - DRUGS THAT ALTER METABOLISM.........................87 *ANTISENSE OLIGONUCLEOTIDE (ASO) INHIBITOR AGENTS*** - HORMONES....................88 *ANTISEPTICS & DISINFECTANTS* - ANTISEPTICS AND DISINFECTANTS.............................88 *ANTIVIRALS* - DRUGS FOR INFECTIONS..................................................................................... 88 *ANTI-VON WILLEBRAND FACTOR AGENTS*** - DRUGS FOR THE BLOOD.......................... 93 *ASSORTED CLASSES* - VITAMINS AND MINERALS.................................................................... 93 *ATOPIC DERMATITIS - MONOCLONAL ANTIBODIES*** - DRUGS FOR THE LUNGS.......... 96 *BETA BLOCKERS* - DRUGS FOR THE HEART...............................................................................96 *BILE ACID SYNTHESIS DISORDER AGENTS*** - DRUGS FOR THE STOMACH.....................98 *BIOLOGICALS MISC* - BIOLOGICAL AGENTS...............................................................................98 *CALCITONIN GENE-RELATED PEPTIDE (CGRP) RECEPTOR ANTAG*** - DRUGS FOR THE NERVOUS SYSTEM........................................................................................................................98 *CALCIUM CHANNEL BLOCKERS* - DRUGS FOR THE HEART..................................................98 *CARDIOTONICS* - DRUGS FOR THE HEART...............................................................................100 *CARDIOVASCULAR AGENTS - MISC.* - DRUGS FOR THE HEART......................................... 100 *CEPHALOSPORINS* - DRUGS FOR INFECTIONS.........................................................................101 *CHEMICALS*....................................................................................................................................... 102 *CIC AGENTS - GUANYLATE CYCLASE-C (GC-C) AGONISTS*** - DRUGS FOR THE STOMACH...............................................................................................................................................102 *CONTRACEPTIVES* - DRUGS FOR WOMEN.................................................................................102 *CORTICOSTEROIDS* - HORMONES................................................................................................111 *COUGH/COLD/ALLERGY* - DRUGS FOR THE LUNGS.............................................................. 112 *CYCLIN-DEPENDENT KINASES (CDK) INHIBITORS*** - DRUGS FOR CANCER.................114 *CYSTIC FIBROSIS AGENT - COMBINATIONS*** - DRUGS FOR THE LUNGS........................ 114 *DERMATOLOGICALS* - DRUGS FOR THE SKIN......................................................................... 114 *DIAGNOSTIC PRODUCTS*................................................................................................................127 *DIGESTIVE AIDS* - DRUGS FOR THE STOMACH........................................................................135 *DIRECT-ACTING P2Y12 INHIBITORS*** - DRUGS FOR THE BLOOD...................................... 136 *DIURETICS* - DRUGS FOR THE HEART........................................................................................136 *DOPAMINE AND NOREPINEPHRINE REUPTAKE INHIBITORS (DNRIS)*** - DRUGS FOR THE NERVOUS SYSTEM......................................................................................................................137 *ENDOCRINE AND METABOLIC AGENTS - MISC.* - HORMONES............................................ 137 *ESTROGENS* - HORMONES............................................................................................................. 142 *ESTROGEN-SELECTIVE ESTROGEN RECEPTOR MODULATOR COMB*** - HORMONES.. 143 *FARNESOID X RECEPTOR (FXR) AGONISTS*** - DRUGS FOR THE LIVER.......................... 143 *FLUOROQUINOLONES* - DRUGS FOR INFECTIONS................................................................. 143 *GASTROINTESTINAL