Maintenance drug list
Effective January 1, 2023
The Maintenance Drug List includes drugs that are commonly used to treat conditions that are considered chronic or long-term such as high cholesterol, high blood pressure, asthma, diabetes, or heart disease. Depending on your specific prescription drug benefit plan, these medications may require a 90-day supply through Home Delivery or a preferred retail pharmacy.
This list is not a complete list, does not guarantee coverage, and does not include applicable prior authorization, step therapy or quantity level limit program requirements for the drug that are included in this list.
Refer to your respective formulary for the programs tied to these drugs on our drug page.
Key:
UPPERCASE names = Brand
lowercase names = Generic
Drug names(s) |
||
|
acarbose |
ACCOLATE |
ACCUPRIL |
|
ACCURETIC |
acebutolol hcl |
acetazolamide |
|
acetazolamide er |
ACIPHEX |
ACIPHEX SPRINKLE |
|
ACTIGALL |
ACTIVELLA |
ACTONEL |
|
ACTOPLUS MET |
ACTOS |
ADLYXIN |
|
ADVAIR DISKUS |
ADVAIR HFA |
afeditab cr |
|
afirmelle |
AIRDUO DIGIHALER |
AIRDUO RESPICLICK |
|
ALDACTAZIDE |
ALDACTONE |
ALENDRONATE SOL |
|
alendronate tab |
alfuzosin hcl er |
aliskiren |
|
allopurinol |
ALOGLIPTIN |
ALOGLIPTIN/METFORMIN HCL |
|
ALOGLIPTIN/PIOGLITAZONE |
ALORA |
alosetron hcl |
|
ALPHAGAN P |
ALTACE |
altavera |
|
ALTOPREV |
ALVESCO |
alyacen |
|
amabelz |
amantadine hcl |
AMARYL |
|
amethia |
amethia lo |
amethyst |
|
amiloride hcl |
amiloride/hctz |
amiodarone hcl |
|
AMITIZA |
amlodipine besylate |
amlodipine besylate / atorvastatin calcium |
|
amlodipine besylate/benazepril hcl |
amlodipine besylate/valsartan |
amlodipine/olmesartan medoxomil |
|
amlodipine/valsartan/hctz |
ANASPAZ |
ANGELIQ |
|
ANORO ELLIPTA |
ANTARA |
apri |
|
APRISO |
aranelle |
ARCAPTA NEOHALER |
|
arformoterol tartrate |
ARMONAIR DIGIHALER |
ARNUITY ELLIPTA |
|
ashlyna |
ASMANEX HFA |
ASMANEX TWISTHALER |
|
aspirin/dipyridamole |
aspirin/dipyridamole er |
ASPIRIN/OMEPRAZOLE |
|
ATACAND |
ATACAND HCT |
ATELVIA |
|
atenolol |
atenolol/chlorthalidone |
atorvastatin calcium |
|
ATROVENT HFA |
aubra |
aubra eq |
|
aurovela |
aurovela 24 fe |
aurovela fe |
|
AURYXIA |
AVALIDE |
AVANDIA |
|
AVAPRO |
aviane |
AVODART |
|
AYGESTIN |
ayuna |
AZILECT |
|
AZOPT |
AZOR |
AZULFIDINE |
|
AZULFIDINE EN-TABS |
azurette |
BALCOLTRA |
|
balziva |
bekyree |
benazepril hcl |
|
benazepril hcl/hctz |
BENICAR |
BENICAR HCT |
|
benztropine mesylate |
BETAPACE |
BETAPACE AF |
|
betaxolol hcl |
BETIMOL |
BETOPTIC-S |
|
BEVESPI AEROSPHERE |
BEYAZ |
BIDIL |
|
BIJUVA |
bimatoprost |
BINOSTO |
|
bisoprolol fumarate |
bisoprolol fumarate/hctz |
blisovi 24 fe |
|
blisovi fe |
BONIVA |
BREO ELLIPTA |
|
BREZTRI AEROSPHERE |
briellyn |
BRILINTA |
|
brimonidine tartrate |
brimonidine tartrate/timolol maleate |
brinzolamide |
|
bromocriptine mesylate |
BROVANA |
budesonide |
|
BUDESONIDE/FORMOTEROL FUMARATE DIHYDRATE |
bumetanide |
BUMEX |
|
BYDUREON BCISE |
BYDUREON PEN |
BYETTA |
|
BYSTOLIC |
CADUET |
CALAN SR |
|
calcitonin salmon |
calcitriol |
calcium acetate |
|
calphron |
camila |
camrese |
|
camrese lo |
candesartan cilexetil |
candesartan cilexetil/hctz |
|
captopril |
CAPTOPRIL/HCTZ |
carbidopa |
|
carbidopa/levodopa |
carbidopa/levodopa er |
CARDIZEM |
|
CARDIZEM CD |
CARDIZEM LA |
CARDURA |
|
CARDURA XL |
CAROSPIR |
CARTEOLOL HCL |
|
cartia xt |
carvedilol |
carvedilol phosphate er |
|
CATAPRES |
CATAPRES-TTS |
cavarest |
|
caziant |
cevimeline hcl |
charlotte 24 fe |
|
chateal |
chateal eq |
chlorthalidone |
|
cholestyramine |
cholestyramine light |
cilostazol |
|
cimetidine |
cimetidine hcl |
CLIMARA |
|
CLIMARA PRO |
clinpro 5000 |
clonidine hcl |
|
clopidogrel |
colesevelam hcl |
COLESTID |
|
COLESTID FLAVORED |
colestipol hcl |
COMBIGAN |
|
COMBIPATCH |
COMTAN |
CONJUPRI |
|
constulose |
COREG |
COREG CR |
|
CORGARD |
COSOPT |
COSOPT PF |
|
COZAAR |
CREON |
CRESTOR |
|
cromolyn sodium |
cryselle-28 |
cyclafem |
|
CYCLOSET |
cyclosporine |
cyred |
|
cyred eq |
CYTOTEC |
dabigatran etexilate |
|
DALIRESP |
dapsone |
darifenacin hydrobromide er |
|
dasetta |
daysee |
deblitane |
|
delyla |
DELZICOL |
denta 5000 plus |
|
dentagel |
desogestrel/ethinyl estradiol |
DETROL |
|
DETROL LA |
DEXILANT |
DEXLANSOPRAZOLE |
|
DHIVY |
digitek |
DIGOXIN SOL 50MCG/ML |
|
digoxin |
DILATRATE SR |
dilt-xr |
|
diltiazem cd |
diltiazem hcl |
diltiazem hcl er |
|
DIOVAN |
DIOVAN HCT |
DIPENTUM |
|
dipyridamole |
disopyramide phosphate |
DITROPAN XL |
|
DIURIL |
DIVIGEL |
dofetilide |
|
dolishale |
dorzolamide hcl |
dorzolamide hcl/timolol maleate |
|
dotti |
doxazosin |
doxazosin mesylate |
|
doxercalciferol |
DRISDOL |
drospirenone/ethinyl estradiol |
|
drospirenone/ethinyl estradiol/levomefolate calcium |
DUAKLIR PRESSAIR |
DUAVEE |
|
DUETACT |
DULERA |
DUOPA |
|
DURLAZA |
dutasteride |
dutasteride/tamsulosin hcl |
|
DUTOPROL |
DYRENIUM |
ed-spaz |
|
EDARBI |
EDARBYCLOR |
EDECRIN |
|
EFFIENT |
ELESTRIN |
elinest |
|
ELIQUIS |
ELIXOPHYLLIN |
eluryng |
|
emoquette |
ENABLEX |
enalapril maleate |
|
enalapril maleate |
enalapril maleate/hctz |
enpresse-28 |
|
enskyce |
entacapone |
ENTRESTO |
|
enulose |
EPANED |
eplerenone |
|
ergocalciferol |
errin |
esomeprazole magnesium |
|
ESOMEPRAZOLE STRONTIUM |
estarylla |
ESTRACE |
|
estradiol |
estradiol/norethindrone acetate |
ESTRING |
|
ESTROGEL |
ESTROSTEP FE |
ethacrynic acid |
|
ethynodiol diacetate/ethinyl estradiol |
etonogestrel/ethinyl estradiol |
EVAMIST |
|
EVISTA |
EVOXAC |
EXFORGE |
|
EXFORGE HCT |
EZALLOR SPRINKLE |
ezetimibe |
|
EZETIMIBE/ROSUVASTATIN |
ezetimibe/simvastatin |
falmina |
|
famotidine |
FARXIGA |
fayosim |
|
febuxostat |
felodipine er |
FEMHRT |
|
FEMRING |
femynor |
fenofibrate cap |
|
fenofibrate cap 43mg |
fenofibrate tab |
fenofibrate micronized cap |
|
fenofibric acid dr |
FENOGLIDE |
fesoterodine fumarate er |
|
FIBRICOR |
finasteride |
finzala |
|
flecainide acetate |
FLOLIPID |
FLOMAX |
|
FLOVENT DISKUS |
FLOVENT HFA |
fluoride |
|
fluoritab |
fluticasone/salmeterol aer |
FLUTIC/SALME INH |
|
FLUTICASONE FUROATE /VILANTEROL ELLIPTA |
FLUTICASONE PROPIONATE HFA |
fluticasone propionate/ salmeterol diskus |
|
fluvastatin |
fluvastatin sodium er |
folic acid |
|
formoterol fumarate |
FORTAMET |
FOSAMAX |
|
FOSAMAX PLUS D |
fosinopril sodium |
fosinopril sodium/hctz |
|
FOSRENOL |
furosemide sol |
furosemide tab |
|
fyavolv |
GASTROCROM |
GELNIQUE |
|
gemfibrozil |
gemmily |
GEMTESA |
|
GENERESS FE |
generlac |
gianvi |
|
glimepiride |
glipizide |
glipizide er |
|
glipizide xl |
glipizide/metformin hcl |
GLUCOTROL |
|
GLUCOTROL XL |
GLUMETZA |
glyburide |
|
glyburide micronized |
glyburide/metformin hcl |
GLYNASE |
|
GLYXAMBI |
guanfacine hcl |
hailey |
|
hailey 24 fe |
hailey fe |
heather |
|
hydralazine hcl |
hydrochlorothiazide |
HYZAAR |
|
ibandronate sodium |
iclevia |
icosapent ethyl |
|
IMVEXXY MAINTENANCE PACK |
incassia |
INCRUSE ELLIPTA |
|
indapamide |
INDERAL LA |
INDERAL XL |
|
INNOPRAN XL |
INSPRA |
INTRAROSA |
|
introvale |
INVOKAMET |
INVOKAMET XR |
|
INVOKANA |
ipratropium bromide |
irbesartan |
|
irbesartan/hctz |
isibloom |
ISOPTO CARPINE |
|
ISORDIL TITRADOSE |
isosorbide dinitrate |
isosorbide dinitrate/ hydralazine hcl |
|
isosorbide mononitrate |
isosorbide mononitrate er |
isradipine |
|
ISTALOL |
jaimiess |
JALYN |
|
JANUMET |
JANUMET XR |
JANUVIA |
|
JARDIANCE |
jasmiel |
jencycla |
|
JENTADUETO |
JENTADUETO XR |
jinteli |
|
jolessa |
juleber |
junel |
|
junel fe |
junel fe 24 |
K-TAB |
|
kaitlib fe |
kalliga |
KAPSPARGO SPRINKLE |
|
kariva |
KATERZIA |
KAZANO |
|
kelnor |
klor-con |
KOMBIGLYZE XR |
|
KRISTALOSE |
kurvelo |
labetalol hcl |
|
LACTULOSE PAK 10GM |
lactulose sol |
LANOXIN |
|
lansoprazole |
lansoprazole odt |
lanthanum carbonate |
|
larin |
larin 24 fe |
larin fe |
|
larissia |
LASIX |
latanoprost sol 0.005% |
|
layolis fe |
leena |
LESCOL XL |
|
lessina |
LEVAMLODIPINE |
LEVBID |
|
LEVOBUNOLOL HCL |
levonest |
levonorgestrel/ethinyl estradiol |
|
levora |
LEVSIN |
LEVSIN/SL |
|
LIALDA |
lillow |
LINZESS |
|
LIPITOR |
LIPOFEN |
lisinopril |
|
lisinopril/hctz |
LIVALO |
LO LOESTRIN FE |
|
lo-zumandimine |
LODOSYN |
loestrin |
|
lojaimiess |
LOKELMA |
LOPID |
|
LOPRESSOR |
loryna |
losartan potassium |
|
losartan potassium/hctz |
LOSEASONIQUE |
LOTENSIN |
|
LOTENSIN HCT |
LOTREL |
LOTRONEX |
|
lovastatin |
LOVAZA |
low-ogestrel |
|
LUBIPROSTONE |
LUMIGAN |
lutera |
|
lyleq |
lyllana |
lyza |
|
marlissa |
matzim la |
MAVIK |
|
MAXZIDE |
MAXZIDE-25 |
medroxyprogesterone acetate |
|
megestrol acetate |
melodetta 24 fe |
MENEST |
|
MENOSTAR |
merzee |
mesalamine dr |
|
mesalamine er |
metformin hcl |
metformin hcl |
|
metformin hcl er |
metformin hcl er |
methazolamide |
|
methyldopa tab |
METHYLDOPA/hctz |
metolazone |
|
metoprolol succinate er |
metoprolol tartrate |
metoprolol/hctz |
|
mexiletine hcl |
mibelas 24 fe |
MICARDIS |
|
MICARDIS HCT |
microgestin |
microgestin 24 fe |
|
microgestin fe |
miglitol |
mili |
|
mimvey |
MINASTRIN 24 FE |
MINIPRESS |
|
minitran |
MINIVELLE |
minoxidil |
|
MIRAPEX |
MIRAPEX ER |
MIRCETTE |
|
misoprostol |
moexipril hcl |
mono-linyah |
|
montelukast sodium |
MOTEGRITY |
MULTAQ |
|
MYRBETRIQ |
nadolol |
nafrinse |
|
NASCOBAL |
NATAZIA |
nateglinide |
|
nebivolol hcl |
necon |
NESINA |
|
NEUPRO |
NEXIUM |
NEXLETOL |
|
NEXLIZET |
NEXTSTELLIS |
niacin er |
|
NIASPAN |
nicardipine hcl |
nifedipine |
|
nifedipine er |
nikki |
nisoldipine tab er |
|
NITRO-BID |
NITRO-DUR |
NITRO-TIME |
|
NITROGLYCERIN ER |
nitroglycerin transdermal |
NIZATIDINE |
|
NIZATIDINE |
nora-be |
norethindrone |
|
norethindrone & ethinyl estradiol ferrous fumarate |
norethindrone acetate |
norethindrone acetate/ethinyl estradiol |
|
norethindrone/ethinyl estradiol/ferrous fumarate |
norgestimate/ethinyl estradiol |
norlyda |
|
norlyroc |
NORPACE |
NORPACE CR |
|
nortrel |
NORVASC |
nulev |
|
NUVARING |
nylia |
nymyo |
|
ocella |
olmesartan medoxomil |
olmesartan medoxomil /amlodipine/hctz |
|
olmesartan medoxomil/hctz |
omega-3-acid ethyl esters |
omeprazole |
|
omeprazole/sodium bicarbonate |
ONGENTYS |
ONGLYZA |
|
orsythia |
ORTHO MICRONOR |
ORTHO TRI-CYCLEN LO |
|
oscimin |
oscimin sr |
OSENI |
|
OSMOLEX ER |
OSPHENA |
oxybutynin chloride |
|
oxybutynin chloride er |
OZEMPIC |
pacerone |
|
PANCREAZE |
pantoprazole sodium |
paricalcitol |
|
PARLODEL |
PENTASA |
pentoxifylline cr |
|
pentoxifylline er |
PERFOROMIST |
perindopril erbumine |
|
periomed |
PERTZYE |
philith |
|
PHOSLYRA |
pilocarpine hcl |
pimtrea |
|
pindolol |
pioglitazone hcl |
pioglitazone hcl-glimepiride |
|
pioglitazone hcl/metformin hcl |
pirmella |
PLAVIX |
|
portia-28 |
potassium chloride |
potassium chloride cr |
|
potassium chloride sr |
PRADAXA |
pramipexole dihydrochloride |
|
pramipexole dihydrochloride er |
prasugrel |
PRAVACHOL |
|
pravastatin sodium |
prazosin hcl |
PRECOSE |
|
PREFEST |
PREMARIN |
PREMPHASE |
|
PREMPRO |
PRESTALIA |
PREVACID |
|
PREVACID SOLUTAB |
prevalite |
PREVIDENT 5000 BOOSTER PLUS |
|
PREVIDENT 5000 DRY MOUTH |
PREVIDENT 5000 ORTHO DEFENSE |
PREVIDENT 5000 PLUS |
|
PREVIDENT FLUORIDE |
PREVIDENT RINSE |
previfem |
|
PRILOSEC |
PRINIVIL |
probenecid |
|
probenecid/colchicine |
PROCARDIA |
PROCARDIA XL |
|
progesterone |
PROMETRIUM |
propafenone hcl |
|
propafenone hcl er |
propranolol sol |
propranolol hcl er |
|
propranolol hcl |
PROPRANOLOL/hctz |
PROSCAR |
|
PROTONIX |
PROVERA |
PULMICORT |
|
PULMICORT FLEXHALER |
QBRELIS |
QTERN |
|
QUARTETTE |
QUESTRAN |
QUESTRAN LIGHT |
|
quinapril hcl |
quinapril/hctz |
quinidine gluconate cr |
|
quinidine gluconate er |
QUINIDINE SU TAB |
QVAR REDIHALER |
|
rabeprazole sodium |
RABEPRAZOLE SODIUM DR SPRINKLE |
raloxifene hcl |
|
ramipril |
RANEXA |
ranolazine er |
|
RAPAFLO |
rasagiline mesylate |
RAYALDEE |
|
reclipsen |
RELTONE |
RENAGEL |
|
RENVELA |
repaglinide |
RESTASIS |
|
RESTASIS MULTIDOSE |
RHOPRESSA |
RIOMET |
|
RIOMET ER |
risedronate sodium |
risedronate sodium dr |
|
rivelsa |
ROCALTROL |
ROCKLATAN |
|
ropinirole er |
ropinirole hcl |
rosuvastatin calcium |
|
ROSZET |
RYBELSUS |
RYTARY |
|
RYTHMOL SR |
SAFYRAL |
SALAGEN |
|
SAVAYSA |
SEASONIQUE |
SEGLUROMET |
|
selegiline hcl |
SEREVENT DISKUS |
setlakin |
|
sevelamer tab |
sodium fluoride 5000 plus |
sharobel |
|
silodosin |
SIMBRINZA |
simliya |
|
simpesse |
simvastatin |
SINEMET |
|
SINGULAIR |
SLYND |
SOAANZ |
|
sod fluoride chw |
sodium fluoride dro |
sodium fluoride sol |
|
SOD FLUORIDE TAB F |
sodium fluoride gel 1.1% |
solia |
|
solifenacin succinate |
sorine |
sotalol hcl |
|
sotalol hcl af |
SOTYLIZE |
SPIRIVA HANDIHALER |
|
SPIRIVA RESPIMAT |
spironolactone |
spironolactone/hctz |
|
sprintec 28 |
sronyx |
STALEVO |
|
STARLIX |
STEGLATRO |
STEGLUJAN |
|
STIOLTO RESPIMAT |
STRIVERDI RESPIMAT |
SULAR |
|
sulfasalazine |
syeda |
SYMAX DUOTAB |
|
symax-sl |
symax-sr |
SYMBICORT |
|
SYMLINPEN |
SYNJARDY |
SYNJARDY XR |
|
tamsulosin hcl |
tarina 24 fe |
tarina fe |
|
TARKA |
TASMAR |
taysofy |
|
TAYTULLA |
taztia xt |
TEKTURNA |
|
TEKTURNA HCT |
telmisartan |
telmisartan/amlodipine |
|
telmisartan/hctz |
TENORETIC |
TENORMIN |
|
terazosin hcl |
THEO-24 |
theophylline |
|
theophylline cr |
theophylline tab er |
tiadylt er |
|
TIAZAC |
TIKOSYN |
tilia fe |
|
timolol maleate |
TIMOPTIC |
TIMOPTIC OCUDOSE |
|
TIMOPTIC-XE |
TOLBUTAMIDE |
tolcapone |
|
tolterodine tartrate |
tolterodine tartrate er |
TOPROL XL |
|
torsemide |
TOVIAZ |
TRADJENTA |
|
trandolapril |
TRANDOLAPRIL/VERAPAMIL HCL ER |
TRAVATAN Z |
|
travoprost |
TRELEGY ELLIPTA |
tri femynor |
|
tri-estarylla |
tri-legest fe |
tri-linyah |
|
tri-lo-estarylla |
tri-lo-marzia |
tri-lo-mili |
|
tri-lo-sprintec |
tri-mili |
tri-nymyo |
|
tri-previfem |
tri-sprintec |
tri-vylibra |
|
tri-vylibra lo |
triamterene |
triamterene/hctz |
|
TRIBENZOR |
TRICOR |
TRIHEXYPHEN SOL 0.4MG/ML |
|
trihexyphenidyl hcl |
TRIJARDY XR |
TRILIPIX |
|
trinessa |
trivora-28 |
trospium chloride |
|
trospium chloride er |
TRULANCE |
TRULICITY |
|
TRUSOPT |
TUDORZA PRESSAIR |
tulana |
|
TWIRLA |
TWYNSTA |
TYBLUME |
|
tydemy |
ULORIC |
UROXATRAL |
|
URSO 250 |
URSO FORTE |
URSODIOL CAP |
|
ursodiol cap |
ursodiol tab |
UTIBRON NEOHALER |
|
VAGIFEM |
valsartan |
valsartan/hctz |
|
VASCEPA |
VASERETIC |
VASOTEC |
|
VELIVET |
VELPHORO |
VELTASSA |
|
verapamil cap er |
verapamil cap sr |
VERAPAMIL CAP 360MG SR |
|
verapamil tab er |
verapamil tab sr |
verapamil hcl |
|
verapamil hcl cr |
verapamil hcl sa |
VERELAN |
|
VERELAN PM |
VERQUVO |
VESICARE |
|
VESICARE LS |
vestura |
VICTOZA |
|
vienva |
VIOKACE |
viorele |
|
vitamin d |
VIVELLE-DOT |
volnea |
|
vyfemla |
vylibra |
VYTORIN |
|
VYZULTA |
WELCHOL |
wera |
|
wixela inhub |
wymzya fe |
XADAGO |
|
XALATAN |
XARELTO |
XELPROS |
|
XIGDUO XR |
XIIDRA |
xulane |
|
YASMIN 28 |
YAZ |
YOSPRALA |
|
YUPELRI |
yuvafem |
zafemy |
|
zafirlukast |
zarah |
ZEGERID |
|
ZELAPAR |
ZEMPLAR |
ZENPEP |
|
ZESTORETIC |
ZESTRIL |
ZETIA |
|
ZIAC |
ZIOPTAN |
ZOCOR |
|
ZONTIVITY |
zovia |
zumandimine |
|
ZYLOPRIM |
ZYPITAMAG |
|