BCBSM Maintenance Drug List |
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DRUGS WHICH CAN BE DISPENSED IN 100-UNIT QUANTITIES, OR A 34-DAY SUPPLY, WHICHEVER IS GREATER |
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EFFECTIVE 1/1/2004 |
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BRAND NAME |
GENERIC NAME |
Accolate |
Zafirlukast |
Accupril |
Quinapril HCl |
Adalat CC |
Nifedipine |
Aldactazide |
Spironolactone/HCTZ |
Aldactone |
Spironolactone |
Aldomet |
Methyldopa |
Altace |
Ramipril |
Alupent |
Metaproterenol Sulfate |
Amaryl |
Glimepiride |
Anaprox |
Naproxen Sodium |
Ansaid |
Flurbiprofen |
Apresoline |
Hydralazine HCl |
Artane |
Trihexyphenidyl HCl |
Benemid |
Probenecid |
Blocadren |
Timolol Maleate |
Brethine |
Terbutaline Sulfate |
Bumex |
Bumetanide |
Calan/Isoptin/Verelan |
Verapamil Hcl |
Capoten |
Captopril |
Capozide |
Captopril/HCTZ |
Cardene |
Nicardipine HCl |
Cardizem |
Diltiazem Hydrochloride |
Cardura |
Doxazosin Mesylate |
Clinoril |
Sulindac |
Cogentin |
Benztropine Mesylate |
Cmbipres |
Clonidone/Chlorthalidone |
Corgard |
Nadolol |
Corzaar |
Losartan Potassium |
Crystodigin |
Digitoxin |
Diabinese |
Chlorpropamide |
Diamox |
Acetazolamide |
Diovan |
Valsartan |
Diuril |
Chlorothiazide |
Dyazide/Maxzide |
HCTZ/Triamterene |
Dymelor |
Acetohexamide |
Dynacirc |
Isradipine |
Dyrenium |
Triamterene |
EC-Naprosyn |
Naproxaen EC |
Elderepryl |
Selegiline HCl |
Enduron |
Methyclothiazide |
Estrace |
Estradiol |
Estratest |
Methyltest., Estrog., Estd. |
Estratest H.S. |
Methyltest., Estrog., Estd. |
Euthroid/Thyrolar |
Liotrix |
Exna |
Benzthiazide |
Glucophage |
Metformine Hydrochloride |
Glucotrol |
Glipizide |
Glucotrol XL |
Glipizide |
Glynase |
Glyburide (Micronized) |
Hydrodiuril |
Hydrochlorothiazide |
Hygroton |
Chlorthalidone |
Hytrin |
Terazosin HCl |
Inderal |
Propanolol HCl |
Inderide |
Propanolol/HCTZ |
Indocin |
Indomethacin |
Isordil / Sorbitrate |
Isosorbide Dinitrate |
Kaon |
Potassium Gluconate |
Kay Ciel / Slow K / K Dur |
Potassium Chloraide |
K-Dur |
Potassium Chloride |
Kerlone |
Betaxolol Hydrochloride |
Lanoxin |
Digoxin |
Lasix |
Furosemide |
Lescol |
Fluvastatin Sodium |
Lipitor |
Atorvastatin Calcium |
Lodine |
Etodolac |
Loniten |
Minoxidil |
Lopid |
Gemfibrozil |
Lopressor |
Metoprolol Tartrate |
Lotensin |
Benazapril Hydrochloride |
Lozol |
Indapamide |
Mavik |
Trandolapril |
Mevacor |
Lovastatin |
Micronase / Diabeta |
Glyburide |
Midamor |
Amiloride Hydrochloride |
Minipress |
Prazosin HCl |
Moduretic |
Amiloride/HCTZ |
Monopril |
Fosinopril Sodium |
Motrin |
Ibuprofen |
Naprelan |
Naproxan Sodium |
Naprosyn |
Naproxen |
Naqua |
Trichlormethiazide |
Naturetin |
Bendroflumethiazide |
Neptazane |
Methazolamide |
Nitrobid / Nitrostat |
Nitroglycerin |
Normodyne/ Trandate |
Labetalol Hydrochloride |
Norpace |
Disopyramide Phosphate |
Norvasc |
Amoldipine Besylate |
Ogen / Ortho-EST |
Estropipate |
Orinase |
Tolbutamide |
Pavabid |
Papaverine Hydrochloride |
Persantine |
Dipyridamole |
Plendil |
Felodipine |
Pravachol |
Pravastatin Sodium |
Premarin / Estratab |
Estrogens (Conj or ESTD) |
Premarin w/ Methyltest |
Methyltest, Estorg., Conj. |
Premphase |
Estrogen, Con/M-Progest Acet |
Prempro |
Estrogen, Con/M-Progest Acet |
Procan / Pronestyl |
Procainamide HCl |
Proventil / Ventolin |
Albuterol Sulfate |
Provera |
Medroxyproget. Acetate |
Quinaglute |
Quinidine Gluconate |
Quinadex |
Quinadine Sulfate |
Relafen |
Nabumetone |
Renese |
Polythiazide |
Sectral |
Acebutolol Hydrochloride |
SER-AP-ES |
HCTZ/Hydralazine/Reserpine |
Serpasil |
Reserpine |
Sinemet |
Carbidopa/Levodopa |
Singulair |
Montelukast sodium |
Sular |
Nisoldipine |
Tenex |
Guanfacine HCl |
Tenoretic |
Atenolol/ Chlorthalidone |
Tenormin |
Atenolol |
Theo-24 |
Theophylline Anhydrous |
Theodur / Slophyllin |
Theophylline Anhydrous |
Tiazac |
Diltiazem Hydrochloride |
Timoptic |
Timolol Maleate |
Tolinase |
Tolazamide |
Toprol XL |
Metoprolol Succinate |
Univasc |
Moexipril Hydrochloride |
Vasoretic |
Enalapril Maleate/HCTZ |
Vasotec |
Enalapril Maleate |
Visken |
Pindolol |
Voltaren |
Diclofenac Sodium |
Zaroxolyn |
Metolazone |
Zebeta |
Bisoprolol Fumarate |
Zestoretic / Prinzide |
Lisinopril/HCTZ |
Zestril / Prinivil |
Lisinopril |
Zocor |
Simvastatin |
Zyloprim |
Allopurinol |
