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Available from Medco’s mail-order pharmacy
$10 for 90 days of 400+ generics*
You’ll pay about $10* for a 90-day supply† of more than 400 generic drugs when
you use Medco’s mail-service pharmacy. Plus you’ll get:
> Access to specialist pharmacists who are specially trained experts in medications used to treat a specific condition, such as diabetes, asthma, or heart disease Medco specialist
pharmacists are available
> Safety checks that help to protect you from potential drug interactions to help you manage
> Convenient delivery to you with free standard shipping
your medications.
*In addition, a nominal charge of up to $0.35 per order may apply.
Antibiotics/antifungals/antivirals
Anticoagulants
Acyclovir 200mg capsule . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .90 4mg, 5mg, 6mg, 7.5mg, 10mg tablet . . . . . . . . . . . . . . . . . . . . . . . .90 250mg/5mL suspension . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .240mLAmoxicillin Trihydrate 200mg/5mL, Antiseizure medications
400mg/5mL suspension . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .150mL Carbamazepine 200mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . . . . .180 Amoxicillin Trihydrate 250mg, 500mg capsule . . . . . . . . . . . . .90 Amoxicillin Trihydrate 500mg tablet . . . . . . . . . . . . . . . . . . . . . . .90 32.4mg, 64.8mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .180 Amoxicillin Trihydrate 50mg/mL drops . . . . . . . . . . . . . . . . . .90mL Phenobarbital 97.2mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .90 Cephalexin Monohydrate 250mg capsule . . . . . . . . . . . . . . . . . .84 Zinc Sulfate 220(50)mg capsule . . . . . . . . . . . . . . . . . . . . . . . . . . . .90 Cephalexin Monohydrate 500mg capsule . . . . . . . . . . . . . . . . . .90 Arthritis/pain
Ciprofloxacin HCl 250mg capsule . . . . . . . . . . . . . . . . . . . . . . . . . . .42 Diclofenac Sodium 75mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . . .180 Ciprofloxacin HCl 500mg capsule . . . . . . . . . . . . . . . . . . . . . . . . . .60 Ibuprofen 100mg/5mL suspension . . . . . . . . . . . . . . . . . . . . .360mL Doxycycline Hyclate 100mg tablet . . . . . . . . . . . . . . . . . . . . . . . . .90 Ibuprofen 400mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .270 Doxycycline Hyclate 50mg, 100mg capsule . . . . . . . . . . . . . . . . .90 Ibuprofen 600mg, 800mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . .180 Erythromycin Base 250mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . . .84 Indomethacin 25mg capsule . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .180 Erythromycin Stearate 250mg capsule . . . . . . . . . . . . . . . . . . . . .120 Meloxicam 7.5mg, 15mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . . . . .90 Fluconazole 150mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3 Naproxen 375mg, 500mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . . .180 Isoniazid 100mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .120 Piroxicam 20mg capsule . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .90 Isoniazid 300mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .90 Salsalate 500mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .180 Metronidazole 250mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .84Metronidazole 500mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .42 Asthma/respiratory
Penicillin V potassium 125mg/5mL suspension . . . . . . . . .600mL Albuterol Sulfate 2.5mg/3mL inhalant solution . . . . . . . . .225mL Penicillin V potassium 250mg tablet . . . . . . . . . . . . . . . . . . . . . . . .84 Albuterol Sulfate 2mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .270 Penicillin V potassium 250mg/5mL suspension . . . . . . . .300mL Albuterol Sulfate 2mg/5mL syrup . . . . . . . . . . . . . . . . . . . . .1440mL Albuterol Sulfate 4mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .180 5 suspension . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .360mL Albuterol Sulfate 5mg/mL inhalant solution . . . . . . . . . . . .60mL Sulfamethoxazole/Trimethoprim 400mg-80mg tablet . . . . .84 Aminophylline 100mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .180 Sulfamethoxazole/Trimethoprim 800-160mg DS tablet . . .60 Aminophylline 200mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .270 Terbinafine HCl 250mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .90 Ipratropium Bromide 0.2mg/mL inhalant solution . . . . . .225mL Tetracycline HCl 250mg capsule . . . . . . . . . . . . . . . . . . . . . . . . . . .180Tetracycline HCl 500mg capsule . . . . . . . . . . . . . . . . . . . . . . . . . . . .90 *The $10 price applies to a 90-day supply of each generic drug in the commonly prescribed dosages shown on the program drug list. In addition, a nominal charge of up to $0.35 per order may apply. If your prescription
is written for a different days’ supply or quantity, your cost may vary. For example, if your 90-day prescription is written for half this quantity, you may pay $5. If your 90-day prescription is written for three times this
quantity, you may pay $30. Prescriptions written for less than a 45-day supply may not qualify for the $10 price and could therefore cost your more. The medications and pricing on the program drug list are subject to
change without notice, so visit www.medco.com/lowcostgenerics for the latest information.
†Prepackaged drugs are only available for $10 in the package sizes specified on the list.
‡If your mail-order co-payment or coinsurance for generics is less than $10, you'll pay the lower amount.The coverage and prices of certain medications are also subject to the specific terms of your plan. In applicablestates, sales tax may be added to the cost of your prescriptions. This program does not provide coverage for medications excluded from coverage under the terms of your plan, so please check your plan terms for more information.
Medco and At the heart of health are registered trademarks of Medco Health Solutions, Inc.
2011 Medco Health Solutions, Inc. All rights reserved.
If your medication isn’t listed here, visit www.medco.com/choices
For more information, please call Medco Member Services at for other potential lower cost alternatives.
the toll-free number shown on your prescription drug ID card.
Blood pressure/heart health
Cold and allergy therapy
Amiloride/Hydrochlorothiazide 5mg-50mg tablet . . . . . . . . .90 Benzonatate 100mg capsule . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .42 Atenolol 25mg, 50mg, 100mg tablet . . . . . . . . . . . . . . . . . . . . . . .90 Diphenhydramine HCl 50mg capsule . . . . . . . . . . . . . . . . . . . . . .90 Atenolol/Chlorthalidone 100mg-25mg tablet . . . . . . . . . . . . . .90 Diphenhydramine HCl 50mg/mL vial . . . . . . . . . . . . . . . . . . . .10mL Atenolol/Chlorthalidone 50mg-25mg tablet . . . . . . . . . . . . . . .90 D-methorphan HB/PE/Chlorphenir 15-12.5-4, Benazepril HCl 5mg, 10mg, 20mg, 40mg tablet . . . . . . . . . . . .90 15-6-2mg/5 syrup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .360mL Bisoprolol/Hydrochlorothiazide 10-6.25mg tablet . . . . . . . . . .90 D-Methorphan HB/P-EPD HCl/BPM 30-60-4/5 syrup . . .180mL Bisoprolol/Hydrochlorothiazide 2.5-6.25mg tablet . . . . . . . . . .90 D-Methorphan HB/Prometh HCl 15-6.25/5 syrup . . . . . . .360mL Bisoprolol/Hydrochlorothiazide 5-6.25mg tablet . . . . . . . . . . .90 Guaifenesin/D-Methorphan HB 600mg-30mg tablet . . . . .180 Bumetanide 0.5mg, 1mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . . . . .90 Guaifenesin/Dyphylline 100-100/15 elixer . . . . . . . . . . . . . .240mL Captopril 12.5mg, 25mg, 50,mg, 100mg tablet . . . . . . . . . . . . .180 Guaifenesin/P-Ephed HCl 600mg-60mg tablet . . . . . . . . . . . .90Hydroxyzine Pam 25mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . . . . .120 Carvedilol 3.125mg, 6.25mg, 12.5mg, 25mg tablet . . . . . . . . . . .180 Loratadine 10mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .90 Chlorothiazide 250mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .90 Phenylephrine HCl/Chlor-Mal 3.5-1mg/mL drops . . . . . . . .90mL Chlorthalidone 25mg, 50mg tablet . . . . . . . . . . . . . . . . . . . . . . . . .90 Phenylephrine/Chlor-Mal/Scop 10-2-0.625 drops . . . . . .480mL Clonidine HCl 0.1mg, 0.2mg tablet . . . . . . . . . . . . . . . . . . . . . . . . .180 Phenylephrine/Hydrocodone/CP 5-2.5-2 drops . . . . . . . . .240mL Digoxin 125mcg, 250mcg tablet . . . . . . . . . . . . . . . . . . . . . . . . . . . .90 Promethazine HCl 25mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . . . . .90 Diltiazem HCl 30mg, 60mg, 90mg, 120mg tablet . . . . . . . . . .180 Promethazine HCl 6.25mg/5mL syrup . . . . . . . . . . . . . . . . . .540mL Doxazosin Mesylate 1mg, 2mg, 4mg, 8mg tablet . . . . . . . . . . .90Enalapril Maleate 2.5mg, 5mg, 10mg, 20mg tablet . . . . . . . . .90 Diabetes
Enalapril/Hydrochlorothiazide 5-12.5mg tablet . . . . . . . . . . . . .90 Chlorpropamide 100mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . . . . .90 Furosemide 20mg, 40mg, 80mg tablet . . . . . . . . . . . . . . . . . . . .90 Glimepiride 1mg, 2mg, 4mg tablet . . . . . . . . . . . . . . . . . . . . . . . . .90 Guanfacine HCl 1mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .90 Glipizide 10mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .180 Hydralazine HCl 10mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .180 Glipizide 5mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .90 Hydralazine HCl 25mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .90 Glyburide 2.5mg, 5mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .90 Hydrochlorothiazide 12.5mg capsule . . . . . . . . . . . . . . . . . . . . . . .90 Glyburide, Micronized 3mg, 6mg tablet . . . . . . . . . . . . . . . . . . . .90 Hydrochlorothiazide 25mg, 50mg tablet . . . . . . . . . . . . . . . . . . .90 Metformin HCl 500mg ER tablet . . . . . . . . . . . . . . . . . . . . . . . . . .180 Indapamide 1.25mg, 2.5mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . .90 Metformin HCl 500mg, 850mg, 1000mg tablet . . . . . . . . . . .180 Isosorbide DN 10mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .270Isosorbide DN 5mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .180 Ear health
Isosorbide Mononitrate 30mg, 60mg tablet . . . . . . . . . . . . . . .90 Acetic Acid/Aluminum Acetate 2% drops . . . . . . . . . . . . . . . .60mL Lisinopril 2.5mg, 5mg, 10mg, 20mg tablet . . . . . . . . . . . . . . . . . .90 Antipyrine/Benzocaine/Glycerin 5.4%-1.4% drops . . . . . . .30mL Lisinopril/Hydrochlorothiazide 10-12.5mg, 20-12.5mg, Phenylephrine/Antipy/B-Caine 0.25-5-5% drops . . . . . . . . . .15mL 20-25mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .90Methyldopa 250mg, 500mg tablet . . . . . . . . . . . . . . . . . . . . . . . .180 Eye health
Metoprolol Tartrate 25mg, 50mg, 100mg tablet . . . . . . . . . . .180 Atropine Sulfate 1% drops . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15mL Nadolol 20mg, 40mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .90 Atropine Sulfate 1% ointment . . . . . . . . . . . . . . . . . . . . . . . . . . . .4gm Niacin 500mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .90 Bacitracin 500 unit/g ointment . . . . . . . . . . . . . . . . . . . . . . . . . .4gm Nitroglycerin 0.3mg, 0.4mg, 0.6mg SL tablet . . . . . . . . . . . . . .300 Cyclopentolate 1% drops . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15mL Pindolol 5mg, 10mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .90 Erythromycin Base 5mg/g ointment . . . . . . . . . . . . . . . . . . . . . .4gm Prazosin HCl 1mg, 2mg, 5mg capsule . . . . . . . . . . . . . . . . . . . . . . .90 Gentamicin Sulfate 0.3% drops . . . . . . . . . . . . . . . . . . . . . . . . . .15gm Propranolol HCl 10mg, 20mg, 40mg, 80mg tablet . . . . . . . . .180 Levobunolol HCl 0.5% drops . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15mL Propranolol HCl 40mg/5mL solution . . . . . . . . . . . . . . . . . . . .30mL Naphazoline 0.1%HCl drops . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15mL Sotalol HCl 80mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .90 Neo/Polymyx B Sulf/Dexameth 0.1% drops . . . . . . . . . . . . . .15mL Spironolactone 25mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .90 Neo/Polymyx B Sulf/Dexameth 3.5-10k-1 ointment . . . . . . .4gm Terazosin HCl 1mg, 2mg, 5mg, 10mg capsule . . . . . . . . . . . . . . . .90 Neomy Sulf/Bacitra/Polymyxin B 3.5mg-400 ointment . . .4gm Triamterene/Hydrochlorothiazide 37.5-25mg capsule . . . . . . .90 Neomy Sulf/Bacitrac ZN/Poly/HC 3.5-10k-1 ointment . . . . .4gm Phenylephrine HCl 2.5%, 10% drops . . . . . . . . . . . . . . . . . . . . . .15mL 37.5-25mg, 75-50mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .90 Pilocarpine HCl 0.5%, 3% drops . . . . . . . . . . . . . . . . . . . . . . . . . . .15mL Verapamil HCl 80mg, 120mg tablet . . . . . . . . . . . . . . . . . . . . . . . .180 Pilocarpine HCl 1%, 2% drops . . . . . . . . . . . . . . . . . . . . . . . . . . . .45mL If your medication isn’t listed here, visit www.medco.com/choices
For more information, please call Medco Member Services at for other potential lower cost alternatives.
the toll-free number shown on your prescription drug ID card.
Pilocarpine HCl 4% drops . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .30mL Lactulose 10g/15mL solution . . . . . . . . . . . . . . . . . . . . . . . . . . .960mL Polymyxin B Sulfate/TMP 10k u-0.1% drops . . . . . . . . . . . . . .30mL Metoclopramide HCl 10mg tablet . . . . . . . . . . . . . . . . . . . . . . . . .180 Sulfacetamide Sodium 10% drops . . . . . . . . . . . . . . . . . . . . . . . .15mL Metoclopramide HCl 5mg/5mL solution . . . . . . . . . . . . . . . .180mL Timolol Maleate 0.25%, 0.5% drops . . . . . . . . . . . . . . . . . . . . . . .15mL Prochlorperazine Maleate 10mg tablet . . . . . . . . . . . . . . . . . . . . .90 Tobramycin Sulfate 0.3% drops . . . . . . . . . . . . . . . . . . . . . . . . . . .15mLTropicamide 1% drops . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15mL Other medications
Allopurinol 100mg, 300mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . .90 Heartburn/ulcer
Atropine Sulfate 1mg/mL vial . . . . . . . . . . . . . . . . . . . . . . . . . . . .15mL Cimetidine 800mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .90 Bacteriostatic Water Vial . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .90mL Famotidine 20mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .90 Chlorhexidine Gluconate 0.12% solution . . . . . . . . . . . . . . .1419mL Ranitidine HCl 150mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .180 Citric Acid/Sodium Citrate 334-500mg solution . . . . . . . .540mL Ranitidine HCl 300mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .90 Colchicine 0.6mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .90Dexamethasone 0.5mg, 0.75mg tablet . . . . . . . . . . . . . . . . . . . . .90 High cholesterol
Dexamethasone 4mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18 Lovastatin 10mg, 20mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .90 Dexamethasone Sodium Phosphate 4mg/mL vial . . . . . . .10mL Pravastatin Sodium 10mg, 20mg, 40mg tablet . . . . . . . . . . . . .90 Methylprednisolone 4mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . . . .63Methylprednisolone 4mg, dose pak . . . . . . . . . . . . . . . . . . . . . . . .63 Mental health
Oxybutynin Chloride 5mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . .180 Alprazolam 0.25mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .90 Phenazopyridine HCl 100mg, 200mg tablet . . . . . . . . . . . . . . . .90 Alprazolam 0.5mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .120 Prednisolone 5mg . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .90 Amitriptyline HCl 10mg, 25mg, 50mg, 75mg,100mg tablet . . .90 Prednisone 10mg tablet, dose pak . . . . . . . . . . . . . . . . . . . . . . . . . .40 Buspirone HCl 5mg, 10mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . .180 Prednisone 2.5mg, 5mg, 10mg, 20mg tablet . . . . . . . . . . . . . . . .90 Citalopram Hydrobromide 20mg, 40mg tablet . . . . . . . . . . . . .90 Prednisone 50mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .30 Diazepam 2mg, 5mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .90 Prednisone 5mg tablet, dose pak . . . . . . . . . . . . . . . . . . . . . . . . . . .63 Doxepin HCl 10mg, 25mg, 50mg, 75mg, 100mg capsule . . . .90Fluoxetine HCl 10mg tablets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .90 Parkinson’s disease
Fluoxetine HCl 10mg, 20mg, 40mg capsules . . . . . . . . . . . . . . .90 Benztropine Mesylate 2mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . .90 Fluphenazine Decanoate 25mg/mL vial . . . . . . . . . . . . . . . . . . .5mL Trihexyphenidyl HCl 2mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . . .180 Fluphenazine HCl 1mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .180Haloperidol 0.5mg, 1mg, 2mg, 5mg tablet . . . . . . . . . . . . . . . . . .90 Skin conditions
Lithium Carbonate 300mg capsule . . . . . . . . . . . . . . . . . . . . . . . .270 Betamethasone Dipropionate 0.05% cream . . . . . . . . . . . .135gm Nortriptyline HCl 10mg, 25mg capsule . . . . . . . . . . . . . . . . . . . . .90 Betamethasone Dipropionate 0.05% ointment . . . . . . . . .60gm Paroxetine HCl 10mg, 20mg tablet . . . . . . . . . . . . . . . . . . . . . . . . .90 Betamethasone Valerate 0.1% cream . . . . . . . . . . . . . . . . . . .135gm Perphen-Amitrip 2mg-10mg . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .90 Betamethasone Valerate 0.1% lotion . . . . . . . . . . . . . . . . . . .120gm Thioridazine HCl 25mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .180 Betamethasone Valerate 0.1% ointment . . . . . . . . . . . . . . . .135gm Thioridazine HCl 50mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .90 Fluocinolone 0.025% cream . . . . . . . . . . . . . . . . . . . . . . . . . . . .60gm Thiothixene 2mg capsule . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .180 Fluocinolone 0.025% ointment . . . . . . . . . . . . . . . . . . . . . . . . .60gm Trazodone HCl 50mg, 100mg, 150mg tablet . . . . . . . . . . . . . . . .90 Fluocinolone Acetonide 0.01% cream . . . . . . . . . . . . . . . . . . .60gmFluocinolone Acetonide 0.01% solution . . . . . . . . . . . . . . . . .180mL Muscle relaxants
Fluocinonide 0.05% cream . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .90gm Baclofen 10mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .180 Gentamicin Sulfate 0.1%, cream . . . . . . . . . . . . . . . . . . . . . . . . .45gm Cyclobenzaprine HCl 5mg, 10mg tablet . . . . . . . . . . . . . . . . . . . . .90 Gentamicin Sulfate 0.1%, ointment . . . . . . . . . . . . . . . . . . . . . .45gmHydrocortisone 1%, 2.5% cream . . . . . . . . . . . . . . . . . . . . . . . . .90gm Other GI drugs
Hydrocortisone 2.5% ointment . . . . . . . . . . . . . . . . . . . . . . . . .60gm Belladonna Alkaloids/Phenobarb 16.2mg . . . . . . . . . . . . . . . . . .180 Hydroquinone 30mg/mL solution . . . . . . . . . . . . . . . . . . . . . . .30mL Belladonna Alkaloids/Phenobarb 16.2mg/5mL elixir . . .480mL Lidocaine HCl 20mg/mL solution . . . . . . . . . . . . . . . . . . . . . .300mL Dicyclomine HCl 10mg capsule . . . . . . . . . . . . . . . . . . . . . . . . . . . .270 Nystatin 100000u/g cream . . . . . . . . . . . . . . . . . . . . . . . . . . . . .90gm Dicyclomine HCl 20mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . . . . .180 Nystatin 100000u/g ointment . . . . . . . . . . . . . . . . . . . . . . . . .90gm Hydrocortisone Acetate 25mg suppository . . . . . . . . . . . . . . . . .36 Nystatin/Triamcin 100000u-0.1 cream . . . . . . . . . . . . . . . . .90gm Hyoscyamine Sulfate 0.125mg/mL drops . . . . . . . . . . . . . . . . .45mL Nystatin/Triamcin 100000u-0.1 ointment . . . . . . . . . . . . . . .45gm If your medication isn’t listed here, visit www.medco.com/choices
For more information, please call Medco Member Services at for other potential lower cost alternatives.
the toll-free number shown on your prescription drug ID card.
Selenium Sulfide 2.5% shampoo . . . . . . . . . . . . . . . . . . . . . . .360mL Potassium Chloride 10meq sustained release tablet . . . . . . . .90 Triamcinolone Acetonide 0.025% ointment . . . . . . . . . . . . .80gm Triamcinolone Acetonide 0.025%, 0.1% cream . . . . . . . . .240gm 40meq/15mL solution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1440mL Triamcinolone Acetonide 0.1%, ointment . . . . . . . . . . . . . .240gm Potassium Chloride 20meq/15mL solution . . . . . . . . . . . .1440mL Triamcinolone Acetonide 0.5% cream . . . . . . . . . . . . . . . . . . .45gm Potassium Chloride 8meq, 10meq sustained action tablet . .90 Triamcinolone Acetonide 0.5% ointment . . . . . . . . . . . . . . . .45gm Prenatal Rx1 tablet 60-1mg . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .90Prenatal Rx tablet 27-0.5mg . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .90 Thyroid therapy
29mg-1mg, 60mg-1mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .90 137mcg, 150mcg, 175mcg, 200mcg tablet . . . . . . . . . . . . . . . . . . .90 Prenatal Vit/Fe Fumarate/Fa/Se 27-1mg tablet . . . . . . . . . . . . .90 Pyridoxine HCl 25mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .90 75mcg, 88mcg, 100mcg tablet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .90 Sodium Fluoride 0.25mg, 0.5mg, 1mg chewable tablet . . . . .90 Thyroid 32.5mg, 65mg, 130mg, 195mg tablet . . . . . . . . . . . . . . .90 Sodium Fluoride 0.5mg/mL drops . . . . . . . . . . . . . . . . . . . . . . .50mLTherapeutic Multivitamins with Folic Acid, Vitamins and electrolytes
27-0.8mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .90 Tri-Vit-Fluor-Iron 0.25mg/mL drops . . . . . . . . . . . . . . . . . . . . .100mL 0.5mg, 1mg chewable tablet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .90 Vitacon Forte 1mg capsule . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .90 Fluoride Ion/Multivitamins 0.25mg/mL, 0.5mg/mL drops . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .100mL Vitamin B Comp W-C, tablet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .90 Fluoride Ion/Multivits W-Fe 0.5mg/mL drops . . . . . . . . . . .100mL Women’s health
Fluoride Ion/Vitamins A,C & D 0.25mg, 0.5mg drops . . . .50mL Estradiol 0.5mg, 1mg, 2mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . . .90 Folic Acid 0.4mg, 0.8mg, 1mg tablet . . . . . . . . . . . . . . . . . . . . . . . .90 Estropipate 0.75mg, 1.5mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . . .90 Folic Acid/Vitamin B Comp W-C 1-100mg tablet . . . . . . . . . . . .90 Medroxyprogesterone Acet 10mg tablet . . . . . . . . . . . . . . . . . . . .42 Magnesium Chloride 64mg tablet . . . . . . . . . . . . . . . . . . . . . . . .180 Medroxyprogesterone Acet 2.5mg, 5mg tablet . . . . . . . . . . . . .90 Magnesium Oxide 400mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . .90 Megestrol Acetate 20mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . . .180 Natalcare PIC 60mg-1mg tablet . . . . . . . . . . . . . . . . . . . . . . . . . . . .90Polyvit-Iron-FL 0.25mg/mL drops . . . . . . . . . . . . . . . . . . . . . . .100mL If your medication isn’t listed here, visit www.medco.com/choices
For more information, please call Medco Member Services at for other potential lower cost alternatives.
the toll-free number shown on your prescription drug ID card.

Source: http://uhwellness.org/pdf/LCG_BoB_DrugList_DL929665.pdf