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TRS-ActiveCare maintenance drug list The following maintenance drug list contains medications that you may be taking on a long-term basis for conditions such as high blood pressure or high cholesterol. Your TRS-ActiveCare prescription drug benefit has set a limit on the number of times you can fill prescriptions for these long-term medications (as covered by your plan) at a participating retail pharmacy before your retail co-payment increases. TRS-ActiveCare may have sent you a letter explaining this change, which may have included information about the cost savings you can take advantage of by using Medco By Mail for your long-term medications. To look up a specific medication, click on the letter tab at the right side of the page that corresponds with the name of your medication. For example, if you are looking for Nasonex, click the N tab and scroll through the list of medications. The information in this list is current as of January 1, 2009. This TRS-ActiveCare maintenance drug list is subject to change and may not be complete. Also note that some of the medications on the list may be subject to additional plan coverage rules as determined by your health plan. A B A ACARBOSE ACCOLATE ACCUPRIL ACCURETIC ACEBUTOLOL HCL ACEON ACETAZOLAMIDE ACIPHEX ACTIGALL ACTI-LANCE ACTIVELLA ACTONEL ACTOPLUS MET ACTOS ADALAT ADALAT CC ADDITIVE PRIMARY SET ADDITIVE SECONDARY SET ADD-PRO VENTED NEEDLE ADENOCARD ADENOSINE ADVANCED NATALCARE ADVANCED-RF NATALCARE ADVICOR AEROBID AEROBID-M AFEDITAB CR AGGRASTAT AGGRENOX AKINETON ALBAFORT ALBAFORT S ALBA-LYBE ALBATUSSIN NN ALBERTSONS STARTER ALBUTEROL SULFATE ALDACTAZIDE ALDACTONE ALDOCLOR-250 ALDOMET ALDORIL ALENDRONATE SODIUM ALESSE ALKALINE BATTERIES ALLANFOL RX ALLANTEX ALLEGRA ALLEGRA ODT ALLEGRA-D ALORA ALPHAGAN ALPHAGAN P ALPROSTADIL ALTACE ALTOPREV ALUPENT ALVESCO AMANTADINE HCL AMARYL AMIGESIC AMILORIDE HCL AMILORIDE HCL W/HCTZ AMINATE WITH 90MG IRON AMINOBENZOATE POTASSIUM AMINOPHYLLINE AMIODARONE HCL AMLODIPINE BESYLATE AMLODIPINE BESYLATEBENAZEPRIL AMYL NITRITE ANAPROX ANAPROX DS ANEMAGEN ANEMAGEN FORTE ANEMAGEN OB ANSAID ANTARA ANTI-STICK TUBERCULIN APHRODYNE APPBUTAMONE APPBUTAMONE-D APPFORMIN APPFORMIN-D APRESAZIDE APRESOLINE APRI AQUASOL A AQUATENSEN ARANELLE AREDIA ARICEPT ARICEPT ODT ARMOUR THYROID ARTANE ARTHROTEC ASCOR L ASCOR L NC ASCORBIC ACID ASCOR-B-SOL IN DEXTROSE ASMANEX ASPIRIN ASPIRIN E.C. ASPIRIN SR ASSURA LIGHT EASICLOSE DRAIN ASSURA STANDARD WEAR ATABEX ATACAND ATACAND HCT ATENOLOL ATENOLOL W/CHLORTHALIDONE ATROPEN AUROTHIOGLUCOSE AVALIDE AVANDARYL AVANDIA AVAPRO AVIANE AVODART AXID ORAL SOLUTION AXID PULVULE AYGESTIN AZILECT AZMACORT AZOPT AZOR AZULFIDINE AZURETTE C D E F G H I J K L M N O P P Q R S T U V The information in this list is current as of January 1, 2009. This TRS-ActiveCare maintenance drug list is subject to change and may not be complete. Also note that some of the medications on the list may be subject to additional plan coverage rules as determined by your health plan. W X Y Z A B B B COMPLEX W-VITAMIN C BACMIN BALZIVA BANZEL B-COMPLEX B-D TEST STRIPS B-D ULTRA FINE LANCETS BECONASE AQ BENAZEPRIL HCL BENAZEPRIL HCL-HCTZ BENICAR BENICAR HCT BENZTROPINE MESYLATE BEROCCA BETAC BETAGAN BETAPACE BETAPACE AF BETAXOLOL HCL BETIMOL BETOPTIC S BIDIL BI-FILIN G BIOMIDE 750 BIO-THROID BISOPROLOL FUMARATE BISOPROLOL FUMARATE/HCTZ B-JECT-100 BLOCADREN BONIVA B-PLEX B-PLEX PLUS BRETHINE BRETYLIUM TOSYLATE BREVIBLOC BREVICON BRIGHT BEGINNINGS PRENATAL BRIMONIDINE TARTRATE BROMOCRIPTINE MESYLATE BRONCAPS BRONCODUR BRONCOMAR-1 BRONDIL BRONKOPHYLLINE GG BUDESONIDE BUMETANIDE BUMEX BYSTOLIC C D E F G H I J K L M N O P P Q R S T U V The information in this list is current as of January 1, 2009. This TRS-ActiveCare maintenance drug list is subject to change and may not be complete. Also note that some of the medications on the list may be subject to additional plan coverage rules as determined by your health plan. W X Y Z A B C CADUET CAFFEINE & SODIUM BENZOATE CALAFOL RX CALAN CALAN SR CALCIJEX CALCITONIN-SALMON CALCITRIOL CAL-NATE CALOMIST CAMILA CAPASTAT SULFATE CAPOTEN CAPOZIDE CAPTOPRIL CAPTOPRIL/HYDROCHLOROTHIAZIDE CARAFATE CARBAMAZEPINE CARBATROL CARBEX CARBIDOPA/LEVODOPA CARBOPTIC CARDENE CARDENE SR CARDIOTEK RX CARDIZEM CARDIZEM CD CARDIZEM LA CARDIZEM SR CARDURA CARDURA XL CARENATAL DHA CARENATE 600 CAROMEGA CARRA SCENT CARTEOLOL HCL CARTIA XT CARVEDILOL CATAFLAM CATAPRES CATAPRES-TTS CEFOL CELEBREX CELONTIN CENA-K CENESTIN CENOGEN ULTRA CENOGEN-OB CENOLATE CENTRATEX CEREBYX CEREFOLIN CEREFOLIN NAC CESIA CETIRIZINE HCL CF VITE CHILDREN'S ADVIL CHLOROTHIAZIDE CHLORPROPAMIDE CHLORTHALIDONE CHOLESTYRAMINE CHOLESTYRAMINE LIGHT CHOLINE MAG TRISALICYLATE CHROMAGEN CHROMAGEN FE CHROMAGEN FORTE CIALIS CILOSTAZOL CIMETIDINE CIMETIDINE IN SODIUM CHLORIDE CITRACAL PRENATAL + DHA CITRACAL PRENATAL RX CITRANATAL 90 DHA CITRANATAL ASSURE CITRANATAL DHA CITRANATAL RX CLARINEX CLARINEX-D 12 HOUR CLARINEX-D 24 HOUR CLEVIPREX CLIMARA CLIMARA PRO CLINITEST ANALYSIS SET CLINORIL CLONIDINE HCL CLOPIDOGREL BISULFATE CLORPRES COBAL-1000 COGENTIN COLESTID COLESTIPOL HCL COMBGEN COMBI RX COMBIGAN COMBIPATCH COMBIPRES COMFORT COMTAN CO-NATAL FA CONISON CONTOUR COPD CORDARONE COREG COREG CR CORGARD CORLOPAM CORVERT CORVITA CORVITE CORZIDE COSOPT COVARYX COVARYX H.S. COZAAR CPC-B12 CREON CRESTOR CRNATAL CRYSELLE CUPRIMINE CYANOCOBALAMIN CYCLESSA CYCRIN CYTOMEL CYTOTEC C D E F G H I J K L M N O P P Q R S T U V The information in this list is current as of January 1, 2009. This TRS-ActiveCare maintenance drug list is subject to change and may not be complete. Also note that some of the medications on the list may be subject to additional plan coverage rules as determined by your health plan. W X Y Z A B D DAILYVITE DAYPRO DAYTO-HIMBIN DECADRON TURBINAIRE DELESTROGEN DEMADEX DEMSER DEMULEN DEPACON DEPAKENE DEPAKOTE DEPAKOTE ER DEPAKOTE SPRINKLE DEPEN DEPLIN DEPO-ESTRADIOL DEPO-PROVERA DEPO-SUBQ PROVERA DESOGEN DEX4 GLUCOSE DEXFERRUM DEXFOL DEXTROSE-LACT RINGERS-KCL DHT DIABETA DIABINESE DIALYVITE DIALYVITE 800 WITH IRON DIAMOX DIAMOX SEQUELS DIATX DIATX ZN DIBENZYLINE DICLOFENAC POTASSIUM DICLOFENAC SODIUM DIDRONEL DIETHYLSTILBESTROL DIFIL-G DIFIL-G FORTE DIFLUNISAL DIGESPLEN PLUS DIGEX DIGITEK DIGOXIN DILACOR XR DILANTIN DILATRATE-SR DILEX-G DILT-CD DILTIA XT DILTIAZEM ER DILTIAZEM HCL DILTIAZEM-D5W DILT-XR DIOVAN DIOVAN HCT DIPYRIDAMOLE DISALCID DISOPYRAMIDE PHOSPHATE DIURIL DIURIL SODIUM DIVALPROEX SODIUM DIVIGEL DOCOSAVIT DOLOBID DORZOLAMIDE HCL DORZOLAMIDE-TIMOLOL DOXAZOSIN MESYLATE DRISDOL DRUG EMP STARTER DUANE READE LANCETS DUANE READE STARTER DUET DHA DUET DHA EC DUET DHA EC STUARTNA DUET DHA EC STUARTNATAL DUET DHA STUARTNATAL DUET STUARTNATAL DUETACT DUOVIT DHA DYAZIDE DYFLEX-G DY-G LIQUID DYGASE DYLIX DYNACIRC DYNACIRC CR DYPHYLLINE GG ES DYPHYLLINE-GG DYPHYSIN DYRENIUM C D E F G H I J K L M N O P P Q R S T U V The information in this list is current as of January 1, 2009. This TRS-ActiveCare maintenance drug list is subject to change and may not be complete. Also note that some of the medications on the list may be subject to additional plan coverage rules as determined by your health plan. W X Y Z A B E EASICLOSE WIDE OUTLET EASPRIN ECLIPSE ECLIPSE CONTROL SOLUTION EC-NAPROSYN ED CYTE F ED-BRON G EDECRIN EDECRIN SODIUM EDGE OB EEMT EEMT HS EFFER-K ELDEPRYL ELDERCAPS ELEMENT BLOOD GLUCOSE METER ELEMENT CONTROL SOLUTION ELEMENT TEST STRIPS ELESTRIN ELITE OB ELIXOPHYLLIN ELIXOPHYLLIN GG ELIXOPHYLLIN-KI ENALAPRIL MALEATE ENALAPRIL MALEATE/HCTZ ENALAPRILAT ENCORA ENDURON ENDURONYL FORTE ENJUVIA ENPRESSE ENZYCAP ENZYMAX EPITOL EPLERENONE EQUETRO ERITROGEN ERRIN ESIDRIX ESMOLOL HCL ESSIAN ESSIAN H.S. ESTINYL ESTRACE ESTRADERM ESTRADIOL ESTRADIOL VALERATE ESTRADIOL-NORETHINDRONE ACETAT ESTRASORB ESTRATEST ESTRATEST H.S. ESTRING ESTRO-5 ESTROGEL ESTROGEN & METHYLTESTOSTERONE ESTROPIPATE ESTROSTEP FE ETHAMBUTOL HCL ETHEDENT ETHMOZINE ETHOSUXIMIDE ETIDRONATE DISODIUM ETODOLAC EVAMIST EVENCARE EVISTA EVOLUTION BLOOD GLUCOSE METER EVOLUTION CONTROL SOLUTION EVOLUTION TEST STRIPS EXELON EXFORGE C D E F G H I J K L M N O P P Q R S T U V The information in this list is current as of January 1, 2009. This TRS-ActiveCare maintenance drug list is subject to change and may not be complete. Also note that some of the medications on the list may be subject to additional plan coverage rules as determined by your health plan. W X Y Z A B F FABB FAMOTIDINE FAMOTIDINE-NS FE C FELDENE FELODIPINE ER FEMCON FE FEMHRT FEMRING FEMTABS FEMTRACE FENOFIBRATE FENOGLIDE FENOLDOPAM MESYLATE FENOPROFEN CALCIUM FEOCYTE FA FEOGEN FEOGEN FA FEOGEN FORTE FEROCON FERO-FOLIC FEROTRINSIC FERRAGEN FERRALET 90 FERREX 150 FORTE FERREX 150 FORTE PLUS FERRLECIT FERROCITE PLUS FERROCITE-F FERROGELS FORTE FERROMAR FERRO-PLEX FERRO-PLEX HEMATINIC FE-TINIC 150 FORTE FETRIN FEXOFENADINE HCL FINASTERIDE FIRST-PROGESTERONE MC FIXED FLOW RATE GRAVITY SET FLECAINIDE ACETATE FLOMAX FLONASE FLOVENT FLOVENT DISKUS FLOVENT HFA FLOW-EZE FLUNISOLIDE FLUOR-A-DAY FLUORIDE FLUORITAB FLURBIPROFEN FLUTICASONE PROPIONATE FLUVOXAMINE MALEATE FOLAMIN FOLBALIN FOLBALIN PLUS FOLBECAL FOLBEE FOLBEE PLUS FOLBIC FOLCAPS FOLEVE FOLEVE PLUS FOLGARD RX FOLIC ACID FOLIC ACID-CYANCOBAL-PYRIDOXIN FOLITAB FOLMOR FOLNATE FOLNATE PLUS FOLPACE RX FOLPLEX FOLPLEX 2.2 FOLTABS FOLTABS PRENATAL PLUS DHA FOLTRATE FOLTRIN FOLTX FOLVITE FORMULA B PLUS FORMULA-B FORTAMET FORTAVIT FORTICAL FOSAMAX FOSINOPRIL SODIUM FOSINOPRIL-HYDROCHLOROTHIAZIDE FOSPHENYTOIN SODIUM FUMATINIC FUROSEMIDE GENHEMAT GESTICARE GESTICARE DHA GLIMEPIRIDE GLIPIZIDE GLIPIZIDE ER GLIPIZIDE XL GLIPIZIDE-METFORMIN GLUCO BURST GLUCOPHAGE GLUCOPHAGE XR GLUCOPRO GLUCOSE GLUCOSE GEL GLUCOTROL GLUCOTROL XL GLUCOVANCE GLUMETZA GLUTOFAC-ZX GLUTOSE GLYBURIDE GLYBURIDE MICRONIZED GLYBURIDE-METFORMIN HCL GLYCRON GLYNASE GLYSET GOLD SODIUM THIOMALATE GUANABENZ ACETATE GUANFACINE HCL GYNODIOL C D E F G H I J K L M N G O P GABAPENTIN GABARONE GABITRIL GABOXETINE GALANTAMINE GANITE GASTRINEX GASTROCROM GEMFIBROZIL GENESUPP-500 GENETECT PLUS P Q R S T U V The information in this list is current as of January 1, 2009. This TRS-ActiveCare maintenance drug list is subject to change and may not be complete. Also note that some of the medications on the list may be subject to additional plan coverage rules as determined by your health plan. W X Y Z A B H HCTZ/RESERPINE/HYDRALAZINE HEMATINIC PLUS HEMATINIC WITH FOLIC ACID HEMATOGEN HEMATOGEN FA HEMATOGEN FORTE HEMATRON HEMATRON-AF HEMAX HEMOCYTE PLUS HEMOCYTE-F HUMULIN L HUMULIN U HYDRALAZINE HCL HYDRAZIDE HYDROCHLORIC ACID HYDROCHLOROTHIAZIDE HYDRODIURIL HYDROXOCOBALAMIN HYDROXYCHLOROQUINE SULFATE HYGROTON HYPERSTAT I.V. HYTRIN HYZAAR C D E I F G IBC W/FOLIC IBERET-FOLIC 500 IBUPROFEN ICAR PRENATAL ICAR-C PLUS ICAR-C PLUS SR IFEREX 150 IFEREX 150 FORTE I-FOL PLUS ILETIN II LENTE (PORK) ILETIN II NPH (PORK) ILETIN II REGULAR (PORK) IMDUR INATAL GT INATAL ULTRA INDAPAMIDE INDERAL INDERAL LA INDERIDE INDOCIN INDOCIN I.V. INDOCIN SR INDOMETHACIN INFED INFUVITE INFUVITE ADULT INNOPRAN XL INOMAX INSET 30 TUBING INSPRA INSTA-GLUCOSE INSULIN REACTION GEL INTEGRILIN IODOPEN IOPIDINE IRCON-FA IROFOL IRON DEXTRAN COMPLEX IRON-C IRO-PLEX ISMO ISOCHRON ISONARIF ISONIAZID ISOPTIN S.R. ISOPTO CARBACHOL ISOPTO CARPINE ISORDIL ISOSORBIDE DINITRATE ISOSORBIDE MONONITRATE ISOVEX ISOXSUPRINE HCL ISRADIPINE ISTALOL H I J K L M N O P J P Q JANUMET JANUVIA JAY-PHYL JOLESSA JOLIVETTE JUNEL JUNEL FE R S T U V The information in this list is current as of January 1, 2009. This TRS-ActiveCare maintenance drug list is subject to change and may not be complete. Also note that some of the medications on the list may be subject to additional plan coverage rules as determined by your health plan. W X Y Z A B K K EFFERVESCENT K+ POTASSIUM KAOCHLOR-EFF KAON-CL KARIVA KAY CIEL K-DUR KELNOR 1-35 KEMADRIN KEPPRA KEPPRA XR KESTRONE-5 KETOPROFEN KEY-PLEX KIE K-LOR KLOR-CON KLOR-CON M KLOR-CON-EF KLOTRIX K-LYTE K-LYTE DS K-LYTE-CL K-PRIME K-TAB KUTRASE KU-ZYME KU-ZYME HP L LABETALOL HCL LACTOCAL-F LAMICTAL LAMOTRIGINE LANOXICAPS LANOXIN LANOXIN PEDIATRIC LAPASE LASIX LEENA LESCOL LESCOL XL LESSINA LEVACET LEVATOL LEVETIRACETAM LEVITRA C D E F G LEVLEN LEVLITE LEVOBUNOLOL HCL LEVORA LEVOTHYROXINE SODIUM LEVOXYL LEXXEL LIDOCAINE HCL LIDOCAINE HCL IN DEXTROSE LIOTHYRONINE SODIUM LIPITOR LIPOFEN LIPRAM LIPRAM-CR 10 LIPRAM-CR5 LIPRAM-PN20 LISINOPRIL LISINOPRIL-HCTZ LIVER LIVER,IRON & VITAMINS LO/OVRAL LOCHOLEST LOCHOLEST LIGHT LODINE LODINE XL LODOSYN LOESTRIN LOESTRIN 24 FE LOESTRIN FE LOFIBRA LONITEN LOPID LOPRESSOR LOPRESSOR HCT LOTENSIN LOTENSIN HCT LOTREL LOVASTATIN LOW-OGESTREL LOZI-FLUR LOZOL LUFYLLIN LUFYLLIN-GG LUGOL'S LUMIGAN LUTERA LUVOX LUVOX CR LYBREL LYSIPLEX LYTENSOPRIL H I J K L M N O P P Q R S T U V The information in this list is current as of January 1, 2009. This TRS-ActiveCare maintenance drug list is subject to change and may not be complete. Also note that some of the medications on the list may be subject to additional plan coverage rules as determined by your health plan. W X Y Z A B M M.V.I. ADULT M.V.I. PEDIATRIC M.V.I.-12 MAGSAL MANNITOL MANUVITE SP MARNATAL-F PLUS MARTINIC MATERNA MATERNITY MAVIK MAXARON FORTE MAXINATE MAXZIDE MECLOFENAMATE SODIUM MEDROXYPROGESTERONE ACETATE MEFENAMIC ACID MEGA C-A PLUS MEGATON MELOXICAM MENEST MENOSTAR MEPHYTON MESTINON METAGLIP METANX METAPROTERENOL SULFATE METFORMIN HCL METFORMIN HCL ER METHAZOLAMIDE METHIMAZOLE METHYCLOTHIAZIDE METHYL SALICYLATE METHYLDOPA METHYLDOPA/HYDROCHLOROTHIAZIDE METHYLDOPATE HCL METIPRANOLOL METOLAZONE METOPROLOL SUCCINATE METOPROLOL TARTRATE METOPROLOL-HYDROCHLOROTHIAZIDE MEVACOR MEXILETINE HCL MEXITIL MIACALCIN MICARDIS MICARDIS HCT MICROGESTIN MICROGESTIN FE MICRO-K MICROZIDE MIDAMOR MINIPRESS MINIZIDE MINOXIDIL MIOCHOL-E MIOSTAT MIRAPEX MIRCETTE MIRTAZAPINE MISOPROSTOL MOBIC MODICON MODURETIC MOEXIPRIL HCL MOEXIPRIL-HYDROCHLOROTHIAZIDE MONOJECT MONOJECT INSULIN SYRINGE MONOJECT SYRINGE MONOJECTOR LANCET DEVICE MONOKET MONOLET LANCETS MONOLET NEOLET MONOLET THIN LANCETS MONONESSA MONOPRIL MONOPRIL HCT MOTRIN MST 600 MULTI FERROUS FOLIC 500 MULTI-12 MULTI-B-PLUS MULTICHEW MULTIFOL MULTIFOL PLUS MULTIGEN MULTIGEN PLUS MULTI-RET FOLIC 500 MULTISTIX 10 SG MULTISTIX 2 MULTIVITAMIN MULTIVITAMIN 12 MULTIVITAMIN W/FLUORIDE & IRON MULTIVITAMIN W/MINERALS MULTIVITAMIN WITH FLUORIDE M-VIT MYAMBUTOL MYCI BRON-G MYCOBUTIN MYFERON-150 FORTE MYKIDZ IRON FL MYNATAL MYNATAL ADVANCE MYNATAL PLUS MYNATAL-Z MYNATE 90 PLUS MYO VYT MYOCHRYSINE MYSOLINE C D E F G H I J K L M N O P P Q R S T U V The information in this list is current as of January 1, 2009. This TRS-ActiveCare maintenance drug list is subject to change and may not be complete. Also note that some of the medications on the list may be subject to additional plan coverage rules as determined by your health plan. W X Y Z A B N NABUMETONE NADOLOL NADOLOL-BENDROFLUMETHIAZIDE NAFRINSE NAFRINSE PEDIATRIC NALDOL NALFON NAMENDA NAPRELAN NAPROSYN NAPROXEN NAPROXEN SODIUM NASACORT NASACORT AQ NASALIDE NASAREL NASCOBAL NASONEX NATACAPS NATACHEW NATAFORT NATALCARE NATALCARE PIC NATALCARE PIC FORTE NATALCARE PLUS NATALCARE RX NATALCARE THREE NATALVIT NATATAB NATATAB CFE NATATAB FA NATELLE NATELLE C NATELLE PLUS NATELLE PREFER NATELLE-EZ NATRECOR NATURE-THROID NATURETIN NECON NEEVO NEOPROFEN NEOSTIGMINE BROMIDE NEOSTIGMINE METHYLSULFATE NEPHPLEX RX NEPHROCAPS NEPHRON FA NEPHRONEX NEPHRO-VITE RX NEPTAZANE NERVIDOX NERVIDOX S NERVIDOX-6 NR NERVIDOX-6 S NERVO B-12 NESTABS CBF NESTABS FA NESTABS RX NEUPRO NEURIN-SL NEURO B12 NEURO B12 FORTE NEURO B-12 FORTE S NEURO B-12 S NEURO-B12 NEURO-B12 FORTE NR NEURODEP NEURODEP NR NEURONTIN NEXIUM NIACIN NIACOR NIASPAN NIC 750 NICARDIPINE HCL NICOMIDE NICOTINAMIDE NICOTINAMIDE ZCF NIFEDIAC CC NIFEDICAL XL NIFEDIPINE NIFEDIPINE ER NIFEREX GOLD NIFEREX-150 FORTE NIFEREX-PN FORTE NIMODIPINE NIMOTOP NISOLDIPINE NITROPRESS NIZATIDINE NORA-BE NORDETTE NORETHINDRONE ACETATE NORGESTREL-ETHINY ESTRA NORINYL NORMODYNE NORPACE NORPACE CR NOR-QD NORTHYX NORTREL NORVASC NOVA MAX BLOOD GLUCOSE METER NOVANATAL NOVASAL NOVASTART NOVOLIN R INNOLET NUFOL NU-NATAL ADVANCED NUTRACARE NUTRICAP NUTRIFAC ZX NUTRIJECT NUTRINATE NUTRISPIRE NUTRIVIT NUVARING NYDRAZID C D E F G H I J K L M N O P P Q R S T U V The information in this list is current as of January 1, 2009. This TRS-ActiveCare maintenance drug list is subject to change and may not be complete. Also note that some of the medications on the list may be subject to additional plan coverage rules as determined by your health plan. W X Y Z A B O OB COMPLETE OB COMPLETE DHA OB-NATAL ONE OBSTETRIX EC OBSTETRIX-100 OBTREX OBTREX DHA O-CAL FA O-CAL PRENATAL OCELLA OCTRON OCUPRESS OGEN OGESTREL OMEPRAZOLE OMNARIS ONE TOUCH ULTRALINK OPTINATE OPTIPRANOLOL ORETIC ORINASE ORTHO EVRA ORTHO MICRONOR ORTHO TRI-CYCLEN ORTHO TRI-CYCLEN LO ORTHO-CEPT ORTHO-CYCLEN ORTHO-EST ORTHO-NOVUM ORTHO-PREFEST ORUDIS ORUVAIL OSMITROL OVCON OVCON 35 FE OVRAL OXAPROZIN OXCARBAZEPINE C D E F G P PACERONE PALCAPS 10 PALCAPS 20 PAMIDRONATE DISODIUM PANCREASE PANCREASE MT PANCRECARB MS-16 PANCRECARB MS-4 PANCRECARB MS-8 PANCRELIPASE PANCRON PANFIL G PANGESTYME CN PANGESTYME EC PANGESTYME MT 16 PANGESTYME UL PANOCAPS PANOCAPS MT 16 PANOCAPS MT 20 PANOKASE H I J PANTOPRAZOLE SODIUM PAPAVERINE HCL PARA-TIME PARCOPA PARLODEL PASER P-D NATAL PLUS PEGANONE PENICILLAMINE(D-) PEPCID PERITONEAL DIALYSIS ADMIN SET PERSANTINE PHENOXYBENZAMINE HCL PHENYTEK PHENYTOIN PHENYTOIN SODIUM PHYTONADIONE PILOCARPINE HCL PILOPINE HS PILOPTIC PINDOLOL PIROXICAM PLAQUENIL PLARETASE PLAVIX PLENDIL PLETAL POLY IRON PN POLY IRON PN FORTE POLY-IRON 150 FORTE POLYSACCHARIDE IRON FORTE POLY-VI-FLOR POLY-VI-FLOR W/IRON POLY-VITAMIN WITH FLUORIDE POLYVITAMIN WITH FLUORIDE-IRON POLYVITAMIN WITH IRON-FLUORIDE PONSTEL PORTIA POT CHLORIDE/DEXTROSE/NS POTABA POTASSIUM ACETATE POTASSIUM BICARBONATE POTASSIUM CHL-NORMAL SALINE POTASSIUM CHLORIDE POTASSIUM CHLORIDE/DEXTROSE POTASSIUM CHLORIDE-DW5-LR POTASSIUM IODIDE PRANDIMET PRANDIN PRAVACHOL PRAVASTATIN SODIUM PRAZOSIN HCL PRECARE PRECARE CONCEIVE PRECARE PREMIER PRECARE PRENATAL PRECOSE PREFERA-OB PREFEST PRE-FOLIC P (CLICK HERE) continued on next page K L M N O P P Q R S T U V The information in this list is current as of January 1, 2009. This TRS-ActiveCare maintenance drug list is subject to change and may not be complete. Also note that some of the medications on the list may be subject to additional plan coverage rules as determined by your health plan. W X Y Z A B P (continued) PREMARIN PREMESIS RX PREMPHASE PRENA-CAP PRENAFIRST PRENATABS CBF PRENATABS FA PRENATABS OBN PRENATABS RX PRENATAL PRENATAL 1 + 1 PRENATAL 19 PRENATAL AD PRENATAL ADVANTAGE PRENATAL FORMULA PRENATAL FORMULA 3 PRENATAL LOW IRON PRENATAL MR 90 FE PRENATAL MTR PRENATAL OPTIMA ADVANCE PRENATAL PLUS PRENATAL RX PRENATAL START PRENATAL W/FOLIC ACID PRENATAL Z PRENATAL-H PRENATAL-U PRENATE PRENATE DHA PRENATE ELITE PRENEXA PRETERNA PREVACID PREVACID NAPRAPAC PREVALITE PREVIFEM PRIFTIN PRILOSEC RX PRIMACARE PRIMACARE ADVANTAGE PRIMACARE ONE PRIMIDONE PRINIVIL PRINZIDE PRISTIQ PROCAINAMIDE HCL PROCANBID PROCARDIA PROCARDIA XL PROCHIEVE PRODIGY PRODIGY AUTOCODE PRODIGY DUO PRODIGY EJECT PRODIGY VOICE PROMAR PROMETRIUM PRONESTYL PRONESTYL-SR PROPAFENONE HCL PROPRANOLOL HCL PROPRANOLOL HCL-HCTZ PROPYLTHIOURACIL PROSCAR PROSTIGMIN PROSTIN VR PEDIATRIC PROTECT CARDIO PROTECT PLUS PROTECT PLUS NR PROTECTED NEEDLE PROTONIX PROTONIX IV PROTRIPTYLINE HCL PROVENTIL PROVERA PROVIDER PUMP SET PROZAC PROZAC WEEKLY PRUET DHA PRUET DHA EC PTS PANELS PUBLIX LANCET PULMICORT PULMICORT FLEXHALER PULMOPHYLLINE PYRAZINAMIDE PYRIDOSTIGMINE BROMIDE PYRIDOXINE HCL C D E F G H I J K L M N Q QUASENSE QUESTRAN QUESTRAN LIGHT QUIBRON O P QUIBRON-T QUIBRON-T/SR QUICK-K QUINAPRIL QUINAPRIL-HYDROCHLOROTHIAZIDE QUINARETIC QUINIDEX QUINIDINE GLUCONATE QUINIDINE SULFATE QVAR P Q R S T U V The information in this list is current as of January 1, 2009. This TRS-ActiveCare maintenance drug list is subject to change and may not be complete. Also note that some of the medications on the list may be subject to additional plan coverage rules as determined by your health plan. W X Y Z A B R RAMIPRIL RANEXA RANITIDINE HCL RAZADYNE RAZADYNE ER RE DUALVIT F RE DUALVIT OB RE DUALVIT PLUS RE FAC-X RE KAR C PLUS SR RE OB + DHA RECLAST RECLIPSEN REGONOL RELAFEN RELION ULTIMA RELION ULTRA THIN PLUS REMINYL RENAL CAPS RENAL SOFTGEL RENAPHRO RENATABS RENATABS WITH IRON RENATE RENATE DHA RENATE DHA EXTRA RENA-VITE RX RENAX RENO CAPS REOCYTE PLUS REOPRO REPLIVA 21-7 REQ49+ REQUIP REQUIP XL RESECTISOL RESERPINE RHINOCORT AQUA RIDAURA RIFADIN RIFAMATE RIFAMPIN RIFATER RIMACTANE RIOMET ROCALTROL ROPINIROLE HCL RUBESOL-1000 RUM-K RYTHMOL RYTHMOL SR C D E F G H I J S SALFLEX SALSALATE SEASONALE SEASONIQUE SECTRAL SELECT-OB SELEGILINE HCL SELFEMRA SENETONIC SENILEZOL SENOPHYLLINE SENTROXATINE SEROMYCIN SIDEROL SIMCOR K L SIMVASTATIN SINEMET SINEMET CR SINGULAIR SKELID SLO-BID SLOW-K SOLIA SOLUVITE-F SORBITRATE SORINE SOTALOL SOTALOL AF SPIRONOLACTONE SPIRONOLACTONE W/HCTZ SPRINTEC SRONYX SSKI STALEVO STARLIX STAVZOR STRONG IODINE STRONGSTART STROVITE STROVITE ADVANCE STROVITE ADVANCE + D STROVITE FORTE STROVITE PLUS STUARTNATAL PLUS 3 SUCRALFATE SULAR SULFASALAZINE SULFASALAZINE DR SULFAZINE SULFAZINE EC SULINDAC SUPERVITE SUPPORT SYMLINPEN 120 SYMLINPEN 60 SYMMETREL SYNTEST D.S. SYNTHROID M N O P P Q R S T U V The information in this list is current as of January 1, 2009. This TRS-ActiveCare maintenance drug list is subject to change and may not be complete. Also note that some of the medications on the list may be subject to additional plan coverage rules as determined by your health plan. W X Y Z A B T TAGAMET TALADINE TAMBOCOR TANDEM DHA TANDEM F TANDEM OB TANDEM PLUS TAPAZOLE TARKA TAZTIA XT TEGRETOL TEGRETOL XR TEKTURNA TEKTURNA HCT TENEX TENORETIC TENORMIN TERAZOSIN HCL TERBUTALINE SULFATE TETRA-MAG TEVETEN TEVETEN HCT THALASET THALITONE THEO-24 THEOCAP THEOCHRON THEO-DUR THEOPHYLLINE ANHYDROUS THEOPHYLLINE IN 5% DEXTROSE THERAPEUTIC HEMATINIC THERAPEUTIC VITAMIN W-MINERALS THEROBEC THEROBEC PLUS THIAMINE HCL THINSET THYROID THYROLAR TIA-DOCE TIA-DOCE S TIAZAC TICLID TICLOPIDINE HCL TIKOSYN TILADE TILIA FE TIMOLOL MALEATE TIMOPTIC TIMOPTIC-XE TOLAZAMIDE TOLBUTAMIDE TOLECTIN TOLECTIN 600 TOLECTIN DS TOLINASE TOLMETIN SODIUM TOPAMAX TOPCARE ULTRA COMFORT TOPCARE UNIVERSAL1 THIN LANCET TOPROL XL TORSEMIDE TRANDATE TRANDOLAPRIL TRAVATAN TRAVATAN Z TRAVERT-1/2 NS WITH KCL TRECATOR TRIAMTERENE W/HCTZ TRICARE TRICARE DHA TRICON TRICOR TRICOSAL TRIGLIDE TRIHEXYPHENIDYL HCL TRI-K TRI-LEGEST FE TRILEPTAL TRI-LEVLEN TRILIPIX TRILISATE TRINATE TRINESSA TRI-NORINYL TRINSICON TRIOSTAT TRIPHASIL TRI-PREVIFEM TRISALCID TRI-SPRINTEC TRI-VI-FLOR TRI-VI-FLOR W/IRON TRI-VITAMIN TRI-VITAMIN WITH FLUORIDE TRI-VITAMIN WITH IRON-FLUORIDE TRIVORA TRUE2GO BLOOD GLUCOSE SYSTEM TRUERESULT BLOOD GLUCOSE SYSTEM TRUETEST GLUCOSE CONTROL TRUETEST TEST STRIPS TRUSOPT C D E F G H I J K L M N O P P Q R S T U V The information in this list is current as of January 1, 2009. This TRS-ActiveCare maintenance drug list is subject to change and may not be complete. Also note that some of the medications on the list may be subject to additional plan coverage rules as determined by your health plan. W X Y Z A B U UDAMIN UDAMIN SP ULTILET ULTRA NATALCARE ULTRACAPS MT 20 ULTRA-NATAL ULTRASE ULTRATRAK PRO UNI-FAC ZX UNI-KAR PLUS C UNIPHYL UNIRETIC UNITHROID UNIVASC UROSEX UROSTOMY MULTI-CHAMBER UROXATRAL URSO URSO FORTE URSODIOL C D E V V G TONIC VAGIFEM VALERGEN-20 VALPROATE SODIUM VALPROIC ACID VARIDIN VASERETIC VASODILAN VASOTEC V-C FORTE VELIVET VENLAFAXINE HCL VENOFER VENTAVIS VENTOLIN VERAMYST VERAPAMIL ER VERAPAMIL HCL VERELAN VERELAN PM VEROTIN-BY VEROTIN-GR VERTICAL GLUCOSE VG VIAGRA VI-C FORTE VICA-FORTE VI-CERT C1000 WITH B12 VI-CERT C500 VICON FORTE VI-DAYLIN/F ADC PLUS IRON VINATAL VINATAL FORTE VINATE AZ VINATE CALCIUM VINATE GT VINATE IC VINATE II VINATE ULTRA VINATE-M VIOKASE VISKEN VITA S FORTE VITACEL VITACON FORTE VITAFOL VITAFOL-OB VITAFOL-OB+DHA VITAFOL-PN VITAJECT VITALAN F.A. VITAL-D RX VITAMAX VITAMIN B COMP W-C/D5NS VITAMIN B COMP W-C/D5W VITAMIN B COMPLEX VITAMIN B-12 VITAMIN D VITAMIN K VITA-NUMONYL VITAPHIL VITAPHIL + DHA VITAPHIL AIDE VITAPLEX VITAPLEX PLUS VITA-PREN VITA-RESPA VIVA DHA VIVELLE VIVELLE- DOT VOLMAX VOLTAREN VOLTAREN-XR VOSPIRE ER VYNATAL-FA VYTORIN F G H I J K L M N O P P Q R S T U V The information in this list is current as of January 1, 2009. This TRS-ActiveCare maintenance drug list is subject to change and may not be complete. Also note that some of the medications on the list may be subject to additional plan coverage rules as determined by your health plan. W X Y Z A B W WAVESENSE JAZZ WESTHROID WHEAT GERM OIL WINN DIXIE MEDIC WYTENSIN C D X E XALATAN XYLOCAINE XYZAL F G H I J Y YASMIN YAZ YOCON YODEFAN YOHIMBINE HCL K L M Z N ZANTAC RX ZARONTIN ZAROXOLYN ZEBETA ZEGERID ZELAPAR ZENCHENT ZERO-ORDER RELEASE ASPIRIN ZERVALX ZESTORETIC ZESTRIL ZETIA ZIAC ZOCOR ZOMETA ZONEGRAN ZONISAMIDE ZORPRIN ZOVIA ZYCOSE ZYFLO ZYFLO CR ZYRTEC RX ZYRTEC-D RX O P P Q R S T U V The information in this list is current as of January 1, 2009. This TRS-ActiveCare maintenance drug list is subject to change and may not be complete. Also note that some of the medications on the list may be subject to additional plan coverage rules as determined by your health plan. W X Y Z
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