PML—Medication Categories Guide Effective October 1, 2006 You can make the most of your pharmacy benefit plan and control your prescription medication costs by using this Preferred Medication List. Be sure to share this list with your doctor to select cost-effective medications that are clinically appropriate to treat your condition or maintain your health.

This Preferred Medication List (PML) was developed by Walgreens Health Initiatives, your plan sponsor’s pharmacy benefit manager, under the direction of a committee of physicians and pharmacists. All medications on this list are preferred by your plan.

• Therapeutic categories are listed alphabetically in all

Understanding Your Tiered Copays

• Preferred medications are listed in UPPERCASE letters

UPPERCASE letters in black boxes. Therapeutic classes in each category are printed in gray boxes. • Types of medications in each class are printed in italics. • Generic medications are listed in lowercase letters below the word “generic.”

Your pharmacy benefit plan offers three categories— or tiers—of drugs that determine your costs (copays): 1st tier: Generics. Generics contain the same active ingredient as their brand name equivalents and offer the same effectiveness and safety. Generics generally have the lowest copay. 2nd tier: Preferred. Medications in this tier have been selected by your pharmacy benefit plan as preferred brand drugs. These drugs have higher copays than generics but are less costly than nonpreferred medications on the third tier. 3rd tier: Nonpreferred. Because they have a generic version or a second-tier alternative available, nonpreferred medications have the highest copays and are not listed on the PML.

How to Use This Guide Whenever possible, have your doctor consult this guide for the lowest-cost brand name and generic medications available for your therapy. Some tips to keep in mind when using this guide:

below the word “BRAND.” • If a medication is used to treat more than one condition, it will be listed under only one category. Check different categories for your medication.

All medications on the PML have been approved by the Food and Drug Administration (FDA).

Additional Information Due to space limitations, not all medications are listed in this PML. Medication coverage and copays may vary from plan to plan. For more information specific to your plan, register on www.mywhi.com and click on “Check Drug Coverage/Copay” to verify coverage. You can also access the alphabetical version at the above web site. Please note: The PML is subject to change without notice.

Call Us With Questions For assistance, please call the Walgreens Health Initiatives Customer Care Center toll free at 800-207-2568.

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CS5101A-1006

Walgreens Health Initiatives 2006 Preferred Medication List Effective October 1, 2006 ANTIASTHMATICS AND COPD Bronchial Dilators generic albuterol albuterol HFA ipratropium bromide BRAND ALUPENT INHALER ATROVENT HFA ATROVENT INHALER COMBIVENT FORADIL SEREVENT DISKUS SPIRIVA

Bronchial Dilator and Glucocorticoid Combinations BRAND ADVAIR DISKUS

Corticosteroid Inhaled Medications BRAND ASMANEX FLOVENT HFA PULMICORT RESPULES PULMICORT TURBUHALER QVAR

Leukotriene Receptor Antagonists BRAND SINGULAIR

Mast Cell Stabilizers generic cromolyn nebulized solution BRAND INTAL INHALER

ANTI-INFECTIVES

Antimalarial Agents generic hydroxychloroquine mefloquine quinine sulfate

generic azithromycin clarithromycin erythromycin oral

BRAND MALARONE

BRAND BIAXIN XL

Antiparasitic and Antiprotozoal Agents generic mebendazole metronidazole permethrin BRAND OVIDE

Antivirals generic acyclovir

Cytomegalovirus generic ganciclovir BRAND VALCYTE

Herpes BRAND VALTREX

Cephalosporins 1st Generation generic cefadroxil cephalexin

2nd Generation generic cefaclor cefprozil cefuroxime

3rd

Generation

BRAND OMNICEF

Antifungal Agents generic fluconazole itraconazole ketoconazole oral nystatin terconazole BRAND GRIS-PEG LAMISIL VFEND

Macrolides

Intravaginal Antibiotics BRAND METROGEL-VAGINAL GEL

Ketolides BRAND KETEK

Nitrofuran Derivatives generic nitrofurantoin macrocrystals

Penicillins generic amoxicillin [Trimox] amoxicillin trihydrate/ potassium clavulanate ampicillin dicloxacillin penicillin V potassium BRAND AUGMENTIN XR

Quinolones generic ciprofloxacin ofloxacin BRAND AVELOX

Sulfonamides generic sulfamethoxazole/ trimethoprim [Sulfatrim] BRAND GANTRISIN

Tetracyclines generic doxycycline minocycline tetracycline

Tuberculosis Agents generic isoniazid rifampin

Miscellaneous Antibiotics generic clindamycin oral trimethoprim

Medication Categories Guide Page 2 BLOOD FORMATION AND COAGULATION Anticoagulants generic warfarin [Jantoven] BRAND COUMADIN

Platelet Inhibitors generic cilostazol dipyridamole pentoxifylline ER BRAND PLAVIX

Miscellaneous generic anagrelide BRAND MEPHYTON

CANCER THERAPY All oral agents under this class are on the PML, if FDA approved.

CARDIOVASCULAR Blood Pressure Agents ACE Inhibitors generic benazepril captopril enalapril fosinopril lisinopril quinapril BRAND ALTACE

ACE Inhibitor Combinations generic benazepril/hctz captopril/hctz enalapril/hctz fosinopril/hctz lisinopril/hctz quinapril/hctz [Quinaretic] BRAND LOTREL

Angiotensin Receptor Blockers (ARBs) BRAND AVAPRO BENICAR COZAAR

Angiotensin Receptor Blocker (ARBs) Combinations BRAND AVALIDE BENICAR HCT HYZAAR

Beta-Blockers generic acebutolol atenolol bisoprolol labetalol metoprolol nadolol pindolol propranolol sotalol BRAND COREG INDERAL LA INNOPRAN XL TOPROL XL

Blood Pressure Agents— Combinations generic atenolol/chlorthalidone bisoprolol/hctz metoprolol/hctz

Calcium Channel Blockers generic diltiazem diltiazem ER [Cartia XT, Dilt XR, Diltia XT, Taztia XT] felodipine ER isradipine nifedipine ER [Afeditab CR, Nifediac CC, Nifedical XL] verapamil verapamil ER BRAND NORVASC

Central Nervous System Agents generic clonidine guanfacine hydralazine methyldopa BRAND CATAPRES-TTS

Vasodilators generic isosorbide dinitrate isosorbide mononitrate ER nitroglycerin [Minitran, Nitroquick, Nitrostat, Nitrotab]

Generic medications are sometimes given specific names by their manufacturers for ease of reference. These are listed in brackets after the generic name.

Walgreens Health Initiatives 2006 Preferred Medication List Effective October 1, 2006 Cholesterol Agents Cholesterol Binding Agents generic cholestyramine BRAND WELCHOL

Cholesterol Reducing Agents—Combination BRAND VYTORIN

Cholesterol Reducing Agents—Miscellaneous generic gemfibrozil BRAND ANTARA LOFIBRA 200MG NIASPAN TRICOR ZETIA

Cholesterol Reducing Agents—Statins generic lovastatin pravastatin simvastatin BRAND CRESTOR LIPITOR

Heart Rhythm Stabilizers generic amiodarone [Pacerone]

Digitalis Glycosides generic digoxin [Digitek] BRAND LANOXICAPS LANOXIN

Miscellaneous BRAND CADUET RANEXA

CENTRAL NERVOUS SYSTEM AGENTS Alzheimer Agents BRAND ARICEPT EXELON NAMENDA RAZADYNE RAZADYNE ER

Analgesics Narcotics

Diuretics Loop generic bumetanide furosemide torsemide

Potassium Sparing generic amiloride spironolactone

Potassium Sparing Combinations generic amiloride/hctz spironolactone/hctz triamterene/hctz

Thiazides generic chlorthalidone hydrochlorothiazide indapamide metolazone

Miscellaneous generic acetazolamide

generic acetaminophen/codeine butalbital/caffeine/ acetaminophen/codeine fentanyl transdermal hydrocodone/ acetaminophen hydrocodone/ibuprofen hydromorphone meperidine morphine sulfate ER oxycodone oxycodone ER oxycodone/acetaminophen [Endocet, Roxicet] propoxyphene/ acetaminophen

Non-Narcotics (NSAIDs) generic diclofenac diflunisal etodolac flurbiprofen ibuprofen indomethacin ketorolac meloxicam nabumetone naproxen naproxen sodium oxaprozin piroxicam salsalate

Medication Categories Guide Page 3 NDRI

sulindac

Non-Narcotic Agents— Aspirin Containing generic butalbital compound

Non-Narcotic Agents— Other generic butalbital/acetaminophen/ caffeine

Miscellaneous generic tramadol tramadol/acetaminophen

Antianxiety Agents generic alprazolam alprazolam XR buspirone clorazepate diazepam lorazepam oxazepam

Anticonvulsants generic carbamazepine clonazepam gabapentin phenobarbital phenytoin ER primidone valproic acid zonisamide BRAND CARBATROL DEPAKENE DEPAKOTE DEPAKOTE ER DIASTAT DILANTIN GABITRIL KEPPRA LAMICTAL PHENYTEK TEGRETOL TEGRETOL XR TOPAMAX TRILEPTAL

Antidepressants Alpha-2 Receptor Antagonist

generic bupropion bupropion ER

SARI generic nefazodone trazodone

SNRI BRAND CYMBALTA EFFEXOR EFFEXOR XR

SSRI generic citalopram fluoxetine fluvoxamine paroxetine BRAND LEXAPRO ZOLOFT

TCA generic amitriptyline desipramine doxepin imipramine nortriptyline

Miscellaneous BRAND SYMBYAX

Antiparkinsonism Agents Anticholinergic generic amantadine benztropine trihexyphenidyl

Miscellaneous generic carbidopa/levodopa selegiline BRAND COMTAN MIRAPEX REQUIP STALEVO

Antipsychotics generic clozapine haloperidol BRAND ABILIFY GEODON RISPERDAL SEROQUEL ZYPREXA ZYPREXA ZYDIS

Attention Deficit Hyperactivity Disorder (ADHD) generic amphetamine mixed salts methylphenidate [Methylin] methylphenidate ER [Methylin ER] BRAND ADDERALL XR CONCERTA METADATE STRATTERA

Bipolar Agents generic lithium carbonate lithium carbonate ER BRAND ESKALITH CR LITHOBID

Migraine Agents BRAND IMITREX MAXALT MAXALT MLT RELPAX ZOMIG ZOMIG ZMT

Sleep Aids generic estazolam flurazepam hydroxyzine temazepam triazolam BRAND AMBIEN AMBIEN CR SONATA

generic mirtazapine mirtazapine soltab

Generic medications are sometimes given specific names by their manufacturers for ease of reference. These are listed in brackets after the generic name.

Walgreens Health Initiatives 2006 Preferred Medication List Effective October 1, 2006 COUGH, COLD, AND ALLERGY AGENTS Antiallergy— Antihistamine Preparations generic fexofenadine

BRAND ACTOPLUS MET ACTOS AVANDAMET AVANDARYL AVANDIA PRANDIN PRECOSE STARLIX

Cough and Cold Preparations

Blood Sugar Diagnostics

generic benzonatate dextromethorphan/ promethazine [promethazine with DM] dextromethorphan/ pseudoephedrine/ brompheniramine [Cardec DM] guaifenesin guaifenesin/codeine [Cheratussin AC, Mytussin AC] guaifenesin/dextromethorphan/pseudoephedrine [Giltuss TR] guaifenesin/pseudoephedrine ER [Guaifen PSE, Guaifenex PSE, Pseudovent 400] hydrocodone compound hydrocodone/guaifenesin phenylephrine/codeine/ promethazine [promethazine VC with codeine] phenylephrine/hydrocodone phenylephrine/hydrocodone/ chlorpheniramine [H-C Tussive, Histenex HC] promethazine/codeine pseudoephedrine/ chlorpheniramine [De-Congestine TR]

BRAND ACCU-CHEK [Active, Advantage Comfort Curve, Aviva, Compact] ONE TOUCH [Basic, FastTake, OneTouch II, Profile, SureStep, Ultra]

DIABETIC AGENTS AND MONITORING Antidiabetic Agents— Oral generic glimepiride glipizide glipizide ER glipizide/metformin glyburide glyburide/metformin glyburide micronized metformin metformin ER

Blood Sugar Increasing Agents BRAND GLUCAGON EMERGENCY KIT

Insulins BRAND HUMALOG HUMALOG MIX 50/50 HUMALOG MIX 75/25 HUMULIN 50/50 HUMULIN 70/30 HUMULIN L HUMULIN N HUMULIN R HUMULIN U LANTUS NOVOLIN 70/30 NOVOLIN INNOLET 70/30 NOVOLIN INNOLET N NOVOLIN L NOVOLIN N NOVOLIN R NOVOLOG NOVOLOG MIX 70/30 NOVOPEN

EYE, EAR, NOSE, AND THROAT AGENTS Allergy Agents and Antihistamines—Eye generic cromolyn BRAND ALAMAST OPTIVAR ZADITOR

Allergy Agents—Nose generic flunisolide fluticasone BRAND NASACORT AQ NASONEX RHINOCORT AQUA

Antibiotics—Ear BRAND FLOXIN OTIC

Antibiotics—Eye generic erythromycin gentamicin [Gentak] neomycin/polymyxin B/ bacitracin ointment neomycin/polymyxin B/ gramicidin solution ofloxacin 0.3% solution polymyxin B/trimethoprim sulfacetamide tobramycin BRAND QUIXIN TOBRADEX VIGAMOX ZYMAR

Antihistamines— Nose BRAND ASTELIN

Anti-Inflammatory Agents—Eye generic neomycin/polymyxin B/ dexamethasone prednisolone 1% drops BRAND ACULAR ACULAR LS ALREX LOTEMAX VOLTAREN OPHTHALMIC

Glaucoma Agents generic brimonidine tartrate levobunolol pilocarpine timolol maleate

Medication Categories Guide Page 4 BRAND ALPHAGAN P BETIMOL COSOPT LUMIGAN TRUSOPT XALATAN

Nose and Ear Topical Preparations generic acetic acid/hydrocortisone [Acetasol HC] antipyrine/benzocaine [A/B Otic]

Miscellaneous generic atropine 1% ophthalmic drops

GASTROINTESTINAL AGENTS Antispasmodics generic dicyclomine hyoscyamine sulfate

Chronic Inflammatory Bowel Disorders generic mesalamine BRAND ASACOL CANASA COLAZAL ENTOCORT EC PENTASA

Diarrhea Treatments generic diphenoxylate/atropine [Lonox]

Gastric Acid Secretion Reducers and Ulcer Therapy generic cimetidine famotidine misoprostol nizatidine omeprazole ranitidine tablets sucralfate BRAND PREVACID PREVACID NAPRAPAC PREVPAC

Intestinal Motility Stimulants generic metoclopramide

Laxatives generic lactulose [Enulose] polyethylene glycol 3350 [Glycolax] polyethylene glycol 3350/electrolyte solution BRAND NULYTELY VISICOL

Nausea Agents generic meclizine prochlorperazine promethazine trimethobenzamide BRAND ZOFRAN ZOFRAN ODT

Pancreatic Enzymes generic pancreatic enzyme preparations BRAND CREON ENZYMAX KU-ZYME KU-ZYME HP PANCREASE MT PANCRECARB ULTRASE VIOKASE

Miscellaneous generic sulfasalazine [Sulfazine EC] ursodiol

HIV AGENTS All medications used for the treatment of HIV are on the PML, if FDA approved.

HORMONES Antidiuretic and Vasopressor Hormones generic desmopressin

Generic medications are sometimes given specific names by their manufacturers for ease of reference. These are listed in brackets after the generic name.

Walgreens Health Initiatives 2006 Preferred Medication List Effective October 1, 2006 Contraceptives Intravaginal BRAND NUVARING

Oral—Monophasic generic ethinyl estradiol/desogestrel [Apri] ethinyl estradiol/ethynodiol [Zovia] ethinyl estradiol/levonorgestrel [Aviane, Lessina, Levora, Lutera, Portia] ethinyl estradiol/norethindrone [Microgestin, Necon, Nortrel] ethinyl estradiol/norethindrone/iron [Junel FE, Microgestin FE] ethinyl estradiol/norgestimate [Sprintec 28] ethinyl estradiol/norgestrel [Cryselle, Low-Ogestrel, Ogestrel] BRAND YASMIN 28

Oral—Biphasic generic ethinyl estradiol/desogestrel [Kariva] ethinyl estradiol/ norethindrone [Necon]

Oral—Triphasic generic ethinyl estradiol/ desogestrel [Velivet 28] ethinyl estradiol/ levonorgestrel [Enpresse, Trivora-28] ethinyl estradiol/ norethindrone [Aranelle, Nortrel 7/7/7] ethinyl estradiol/ norgestimate [TriNessa, Tri-Sprintec] BRAND ESTROSTEP FE

Oral—Progestin generic norethindrone [Camila, Errin, Nora-BE]

Oral—Other BRAND PLAN B

Estrogenic Agents and Combinations generic estradiol estradiol patch estropipate BRAND ACTIVELLA ALORA CENESTIN CLIMARA 0.0375 mg/day, 0.06 mg/day patch COMBIPATCH ESTRACE CREAM ESTRATEST [Syntest DS] ESTRATEST HS [Syntest HS] ESTRING FEMHRT FEMRING GYNODIOL MENEST PREFEST PREMARIN PREMARIN VAGINAL PREMPHASE PREMPRO VIVELLE VIVELLE-DOT

Glucocorticoids generic dexamethasone fludrocortisone hydrocortisone methylprednisolone prednisolone 15 mg/5 ml syrup prednisone

Osteoporosis Agents BRAND ACTONEL ACTONEL WITH CALCIUM EVISTA FOSAMAX FOSAMAX PLUS D

Progestins generic medroxyprogesterone

Thyroid Hormones generic levothyroxine sodium [Levothroid, Levoxyl] methimazole propylthiouracil BRAND ARMOUR THYROID CYTOMEL SYNTHROID THYROLAR

Miscellaneous generic bromocriptine cabergoline

IMMUNE SYSTEM AGENTS All oral immunosuppressant agents under this class are on the PML, if FDA approved.

MUSCULOSKELETAL AGENTS Arthritis Agents generic leflunomide

Cyclooxygenase (COX-2) Inhibitors BRAND CELEBREX

Gout Agents generic allopurinol colchicine probenecid

Muscle Relaxants generic baclofen carisoprodol chlorzoxazone cyclobenzaprine dantrolene methocarbamol orphenadrine tizanidine

SKIN AND MUCOUS MEMBRANE AGENTS Acne Agents—Oral generic isotretinoin [Amnesteem, Claravis]

Acne and Vitamin A Agents—Topical generic tretinoin BRAND AZELEX DIFFERIN RETIN-A MICRO

Medication Categories Guide Page 5 Rosacea Agents

Group II

generic metronidazole topical cream

generic betamethasone dipropionate 0.05% cream, ointment desoximetasone 0.25% cream fluocinonide 0.05% cream, gel, ointment triamcinolone 0.5% cream, ointment

BRAND FINACEA METROGEL METROLOTION NORITATE

Antibiotics generic clindamycin topical erythromycin/benzoyl peroxide gel erythromycin topical mupirocin silver sulfadiazine [SSD]

Antifungals generic ciclopirox topical clotrimazole/betamethasone econazole nitrate ketoconazole topical nystatin powder nystatin/triamcinolone BRAND LOPROX GEL, LOTION, SHAMPOO

Antineoplastics and Immunosuppressants BRAND ALDARA CARAC EFUDEX ELIDEL PROTOPIC SOLARAZE

Antipsoriatic Agents BRAND DOVONEX TAZORAC

Antivirals BRAND ZOVIRAX 5% OINTMENT

Corticosteroids Listed by potency: Group I is most potent; Group IV is least potent.

Group I generic betamethasone dipropionate augmented 0.05% ointment clobetasol 0.05% cream, gel, ointment

Group III generic betamethasone dipropionate 0.05% lotion betamethasone valerate 0.1% cream, lotion hydrocortisone valerate 0.2% cream, ointment mometasone furoate 0.1% ointment triamcinolone 0.025% cream, lotion, ointment triamcinolone 0.1% cream, lotion, ointment BRAND DIPROLENE LOTION

Group IV generic desonide 0.05% cream, lotion, ointment fluocinolone 0.01% solution hydrocortisone 1% cream hydrocortisone 2.5% cream, lotion, ointment

Miscellaneous BRAND REGRANEX

UROLOGIC AGENTS Benign Prostatic Hypertrophy Alpha Blockers generic doxazosin finasteride terazosin BRAND FLOMAX

Voiding Agents generic bethanechol oxybutynin BRAND DETROL DETROL LA ENABLEX VESICARE

Generic medications are sometimes given specific names by their manufacturers for ease of reference. These are listed in brackets after the generic name.

Walgreens Health Initiatives 2006 Preferred Medication List Effective October 1, 2006 Miscellaneous BRAND AVODART

Urinary pH Modifiers generic potassium citrate ER

Urinary Tract Anesthetics and Analgesics generic phenazopyridine BRAND ELMIRON

VITAMINS, MINERALS, AND ELECTROLYTES All generic prenatal vitamins are on the PML.

Electrolyte Replacements generic potassium chloride ER [Klor-Con]

Electrolyte Stabilizers BRAND PHOSLO RENAGEL

MISCELLANEOUS AGENTS Antiallergic and Anaphylaxis BRAND EPIPEN EPIPEN JR

Dry Mouth— Sjogren’s Syndrome generic pilocarpine tablets BRAND EVOXAC

Mastocytosis BRAND GASTROCROM

Myasthenia Gravis generic pyridostigmine

SPECIALTY PHARMACY CATEGORIES Coverage may vary by plans and/or pharmacies. Register on mywhi.com and click on “Check Drug Coverage/ Copay” to verify your coverage.

Antibiotics BRAND TOBI

Medication Categories Guide Page 6

Other Hormones

generic octreotide

BRAND SANDOSTATIN LAR

Heparin and Related Agents (LMWH) BRAND FRAGMIN LOVENOX

Hepatitis Treatment Agents Hepatitis B

Antihemophilic Factors BRAND HUMATE RECOMBINATE

Anti-Inflammatory Agents and DMARDs BRAND ENBREL HUMIRA KINERET

Antiparkinsonism Agents BRAND APOKYN

Blood Cell Stimulators Red Blood Cells BRAND EPOGEN PROCRIT

White Blood Cells BRAND NEUPOGEN

Enzymes BRAND ALDURAZYME CEREZYME PULMOZYME

Growth Hormones BRAND GENOTROPIN HUMATROPE NORDITROPIN NUTROPIN NUTROPIN AQ SAIZEN SEROSTIM

BRAND EPIVIR-HBV HEPSERA

Hepatitis C generic ribavirin BRAND INFERGEN PEGASYS PEG-INTRON

Immunomodulators BRAND INTRON A ROFERON-A

Multiple Sclerosis Agents BRAND AVONEX BETASERON COPAXONE REBIF

Psoriasis BRAND AMEVIVE RAPTIVA

Osteoporosis Agents BRAND FORTEO

Miscellaneous BRAND ACTIMMUNE LUPRON SYNAGIS

BRAND MESTINON SYRUP MESTINON TIMESPAN

Generic medications are sometimes given specific names by their manufacturers for ease of reference. These are listed in brackets after the generic name. Drug names are the property of their respective owners.