All oral FDA-approved antineoplastic (chemotherapy), immunosuppressive, HIV treatment, and related infection agents are eligible for coverage as preferred agents under the prescription drug benefit.

Generic Medications are Preferred.

• Abilify
• Accolate
• Accu-Chek Test Strips/Lancets
• Aclovate Ointment
• Alclometasone (Generic for Aclovate Cream)
• Actiq
• Activella
• Actonel
• Actos/Actoplus Met
• Acyclovir (generic for Zovirax)
• Adderall XR
• Advair Diskus
• Advicor
• Aggrenox
• Agrylin
• Albuterol Inhaler (generic for Proventil HFA/VentolinHFA)
• Albuterol Tablets/Syrup (generic for Ventolin)
• Allegra D
• Aldara
• Alomide
• Alora
• Alphagan P
• Alprazolam (generic for Xanax)
• Altace
• Amantadine (generic for Symmetrel)
• Ambien
• Aminophylline (generic medication)
• Amiodarone (generic for Cordarone)
• Amitriptyline (generic for Elavil)
• Amnesteem (generic for Accutane)
• Amoxicillin (generic for Amoxil)

• Amoxicillin\clavulanate potassium (generic for Augmentin)
• Amphetamine/Dextroamphetamine (generic for Adderall, Adderall XR)
• Ampicillin (generic for Principen)
• Androderm*
• Androgel*
• Antara
• APAP/Caffeine/Butalbital (generic for Fioricet)
• APAP/Codeine (generic for Tylenol w/ Codeine)
• APAP/Hydrocodone (generic for Vicodin)
• Apokyn
• Aranesp*
• Aricept/Aricept ODT
• Arixtra*
• Armour Thyroid
• Arthrotec 50
• ASA/Caffeine/Butalbital (generic for Fiorinal)
• ASA/Codeine (generic for Empirin w/ Codeine)
• Asacol
• Astelin
• Atenolol (generic for Tenormin)
• Atrovent Inhaler
• Augmentin XR
• Avalide
• Avandia/Avandamet
• Avapro
• Avodart
• Avonex*
• Azithromycin (generic for Zithromax)
• Azmacort
• Azopt

• Baclofen (generic for Lioresal)
• Belladonna Alkaloids/PB (generic for Donnatal)
• BenzaClin
• Benzamycin (generic avialable)
• Benazepril/Benazepril hctz
• Benztropine Mesylate (generic for Cogentin)
• Betamethasone Dipropionate (generic for Diprosone)
• Betamethasone Valerate (generic for Valisone)
  

• Betapace AF
• Betaseron*
• Betaxolol (generic for Betoptic/S)
• Bethanechol (generic for Urecholine)
• Biaxin XL
• Bisoprolol/HCTZ (generic for Ziac)
• Bravelle*
• Brimonidine (generic for Alphagan)
• Bromocriptine (generic for Parlodel)
• Bupropion (generic for Wellbutrin,
  Wellbutrin SR*)
• Buspirone (generic for Buspar)

• Caduet
• Canasa
• Capex
• Captopril (generic for Capoten)
• Carbamazepine (generic for Tegretol)
• Carbatrol
• Carbidopa/Levodopa (generic for Sinemet/CR)
• Carbinoxamine/Pseudoephedrine (generic for Rondec)
• Carbinoxamine/Pseudoephedrine/DM (generic for Rondec DM)
• Carisoprodol (generic for Soma)
• Casodex
• Catapres TTS
• Caverject*
• Cefadroxil (generic for Duricef)
• Cefuroxime (generic for Ceftin)
• Cefzil
• Celebrex*
• Cellcept
• Cenestin
• Cephalexin (generic for Keflex)
• Cephradine (generic for Velosef)
• Cerumenex
• Cetrotide*
• Chlordiazepoxide (generic for Librium)
• Chlorpromazine (generic for Thorazine)
• Cholestyramine (generic for Questran/Light)
• Choline Magnesium Trisalicylate (generic for Trilisate)
• Chorionic Gonadotropins* (generic medication)

• Cimetidine (generic for Tagamet)
• Cipro Suspension
• Ciprodex
• Ciprofloxacin (generic for Cipro)
• Clarithromycin (generic for Biaxin)
• Cleocin Vaginal Cream
• Clidinium/Chlordiazepoxide (generic for Librax)
• Climara/Climara Pro
• Clindamycin (generic for Cleocin T)
• Clindamycin HCl (generic for Cleocin)
• Clobetasol Propionate (generic for Temovate)
• Clomiphene* (generic for Clomid*)
• Clonazepam (generic for Klonopin)
• Clonidine (generic for Catapres)
• Clorazepate (generic for Tranxene)
• Codeine Phosphate/Aspirin/Caffeine/Butalbital (generic for Fiorinal w/ Codeine)
• Colazal
• Colestid
• Colchicine
• Combivent
• COMTan
• Copaxone*
• Copegus
• Coreg
• Coumadin (generic avialable)
• Cromolyn Sodium
• Cyclobenzaprine (generic for Flexeril)
• Cytadren
• Cytomel
• Cytovene

• Depakote, Depakote ER
• Desipramine (generic for Norpramin)
• Desmopressin (generic for DDAVP, Minirin)
• Desonide (generic for Tridesilon)
• Detrol/Detrol LA
• Dexamethasone (generic for Decadron)
• Diamox Sequels
• Diastat
• Diazepam (generic for Valium)
• Diclofenac (generic for Voltaren)
• Dicloxacillin (generic for Dynapen)
• Differin*
• Digoxin (generic for Lanoxin)
• Dilatrate-SR

• Diovan/Diovan HCT
• Diltiazem SR (generic for Cardizem CD/Dilacor XR)
• Dipentum
• Diprolene/Diprolene AF
• Disopyramide (generic for Norpace & Norpace CR)
• Dovonex
• Doxazosin Mesylate (generic for Cardura)
• Doxycycline (generic for Doryx/Vibramycin)
• Duac
• Duoneb

E (Back to Top)

• Edex*
• Effexor XR
• Efudex
• Elidel
• Emend*
• Enalapril (generic for Vasotec)
• Enalapril/HCTZ (generic for Vaseretic)
• Enbrel*
• Epipen/Epipen Jr.
• Epivir HBV
• Epogen*
• Ergomar
• Ergotamine/Caffeine (generic for Wigraine & Cafergot)
• Erythromycin (generic for A/T/S)
• Erythromycin (generic for Ilotycin)
• Erythromycin Base (generic for Film Tab or Enteric)
• Erythromycin-Benzoyl Peroxide (generic for Benzamycin)
• Erythromycin ES/Sulfisoxazole (generic for Pediazole)
• Erythromycin Ethylsuccinate (generic for E.E.S.)
• Erythromycin Stearate (generic for Erythrocin)

• Estradiol (generic for Estrace)
• Estring
• Estrogens, Esterified (generic for Estratab)
• Estropipate (generic for Ortho-Est/Ogen)
• Estrostep Fe
• Ethambutol (generic for Myambutol)
• Ethosuximide (generic for Zarontin)
• Ethinyl Estradiol/Desogestrel (generic for Desogen, Apri)
• Ethinyl Estradiol/Norgestrel (generic for Lo-Ovral/Ovral)
• Ethinyl Estradiol/Ethynodiol (generic for Demulen)
• Ethinyl Estradiol/Levonorgestrel (generic for Triphasil)
• Ethinyl Estradiol/Norethindrone (generic for Brevicon 0.5-35, Norinyl 1+35)
• Ethinyl Estradiol/Norethindrone (generic for Ortho Novum 10/11)
• Etodolac (generic for Lodine)
• Evista
• Evoxac
• Exelon

F (Back to Top)

• Fareston
• Felbatol
• FemHRT
• Fexofenadine (generic for Allegra)
• Finacea
• Flecainide (generic for Tambocor)
• Flomax
• Flonase
• Flovent/Flovent HFA
• Floxin Otic
• Fluocinolone Acetonide (generic for Synalar, Derma-Smoothe)
• Fluocinolone Acetonide (generic for Synalar & Synalar-HP)

• Fluocinonide (generic for Lidex & Lidex E)
• Fluoxetine (generic for Prozac)
• Fluphenazine (generic for Prolixin & Permitil)
• Flurbiprofen (generic for Ansaid)
• Fluvoxamine (generic for Luvox)
• Foradil
• Forteo*
• Fosamax/Fosamax Plus D
• Fosinopril (generic for Monopril)
• Fosrenol
• Furosemide (generic for Lasix)

• Gabapentin (generic for Neurontin)
• Gabitril
• Gemfibrozil (generic for Lopid)
• Gentamicin (generic for Garamycin)
• Glimiperide (generic for Amaryl)
• Glipizide (generic for Glucotrol, Glucotrol XL)
• Glucagon
• Glyburide (generic for Micronase/ DiaBeta/ Glynase/ PresTab)

• Glyset
• Gonal-F*/Gonal-F RFF*
• Guaifenesin 550mg/Pseudeophedrine 60mg (generic for Maxifed-G)
• Guaifenesin PSE SR (generic for Sudal SR)
• Guaifenesin/Codeine (generic for Robitussin AC)
• Gynazole-1

• Haloperidol (generic for Haldol)
• Halobetasol (Generic for Ultravate)
• Hydrochlorothiazide/Triamterene (generic for Dyazide/Maxzide)
• Humalog/Humalog Mix
• Humira*
• Humulin R, U & 50/50
• Hydralazine (generic for Apresoline)
• Hydrochlorothiazide (generic for Esidrix)

• Hydrocodone/Homatropine (generic for Hycodan)
• Hydroxychloroquine (generic for Plaquenil)
• Hydroxyzine HCI (generic for Atarax)
• Hydroxyzine Pamoate (generic for Vistaril)
• Hyoscyamine (generic for Levsin)

• Ibuprofen (generic for Motrin)
• Imipramine (generic for Tofranil)
• Imitrex*
• Indocin Suspension/Suppositories
• Indomethacin (generic for Indocin/Indocin SR)
• Infergen
• Innopran XL
• Inspra
• Insulin Lente Human (Novolin L)

• Intal Inhaler
• Ipratropium bromide (generic for Atrovent Spray/Solution)
• Isotretinoin (Amnesteem, Claravis)
• Isosorbide Dinirate (generic for Isordil)
• Itraconazole (generic for Sporanox)

• Jantoven (generic for Coumadin)
• Junel Fe (generic for Microgestin Fe)
• Kadian
• Keppra
• Ketek
• Ketoconazole (generic for Nizoral)
• Ketorolac (generic for Toradol)
• Kineret*
• Lamisil*
• Lamotrigine (generic for Lamictal)
• Lantus
• Leuprolide Acetate* (generic for Lupron/Lupron Depot*)
• Levaquin
• Levobunolol (generic for Betagan)
• Levothyroxine
• Levoxyl
• Lexapro

• Lipitor
• Lisinopril (generic for Zestril/Prinivil)
• Lisinopril/HCTZ (generic for Zestoretic/Prinzide)
• Lithium Carbonate (generic for Eskalith, Lithobid)
• Livostin
• Lofibra
• Loprox
• Lorazepam (generic for Ativan)
• Lotrel
• Lotrisone Lotion
• Lovastatin (generic for Mevacor)
• Lovenox*
• Lumigan
• Luxiq

• Maxalt*/Maxalt MLT*
• Medroxyprogesterone Acetate (generic for Provera)
• Megestrol Acetate (generic for Megace)
• Menest
• Menopur
• Meperidine (generic for Demerol)
• Mepron*
• Mesalamine (generic for Rowasa)
• Mestranol/Norethindrone (generic for Norinyl 1+50)
• Metadate-CD
• Metformin (generic for Glucophage, Glucophage XR)
• Methadone (generic for Dolophine)
• Methocarbamol (generic for Robaxin)
• Methotrexate (generic medication)
• Methylphenidate (generic for Ritalin, Ritalin-SR, Metadate-ER)
• Methylprednisolone (generic for Medrol)
• Metoclopramide (generic for Reglan)

• Metolazone (generic for Zaroxolyn)
• Metoprolol (generic for Lopressor)
• MetroCream
• MetroGel/MetroGel Vaginal
• MetroLotion
• Metronidazole (generic for Flagyl)
• Miacalcin NS
• Migranal
• Minocycline (generic for Minocin)
• Minoxidil (generic for Loniten)
• Mintezol
• Mirapex
• Mirtazapine (generic for Remeron, Remeron Solutabs)
• Misoprostol (generic for Cytotec)
• Morphine Sulfate (generic for MSIR)
• Morphine Sulfate, SR (generic for MS Contin)

• Nabumetone (generic for Relafen)
• Namenda
• Naphazoline (generic for Vasocon)
• Naphazoline/Antazoline (generic for Vasocon-A)
• Naproxen (generic for Naprosyn/EC-Naprosyn)
• Nasonex
• Neulasta*
• Neupogen*
• Nexium
• Niaspan
• Nitrofurantoin (generic for Macrodantin)
• Nifedipine, SR (generic for Adalat CC)
• Nitroglycerin Patch (generic for Nitrek, Nitro-Dur, Minitran)
• Nitroglycerin Sublingual (generic for Nitrostat)

• Nitroglycerin, SR (generic medication)
• Nitroglycerin, Topical (generic for Nitrol)
• Nitrolingual
• Norethindrone (generic for Nor-Q-D)
• Norethindrone Acetate (generic for Aygestin)
• Noritate
• Nortriptyline (generic for Aventyl)
• Norvasc
• Novarel
• Novolin L, N, R, & 70/30
• NovoLog/NovoLog Mix 70/30
• Nutropin, Nutropin AQ, Nutropin Depot*
• NuvaRing*
• Nystatin (generic for Mycostatin)
• Nystatin/Triamcinolone (generic for Mycolog II)

• Olux
• Omeprazole (generic for Prilosec)
• Omnicef
• One Touch Test Strips/Lancets
• Ortho-Evra
• Ovidrel*
• Oxaprozin (generic for Daypro)
• Oxistat
• Oxsoralen/Oxsoralen Ultra

• Oxybutynin Chloride (generic for Ditropan)
• Oxycodone
• Oxycodone/APAP (generic for Percocet)
• Oxycodone/ASA (generic for Percodan)
• Oxytrol

• Pancrelipase (generic for Creon, Pancrelipase Viokase)
• Paroxetine (generic for Paxil)
• Patanol
• Paxil CR
• Paxil Oral Suspension
• Pegasys*
• Peg-Intron*
• Penicillin VK (generic for Pen-Vee K)
• Pentasa
• Pentoxifylline (generic for Trental)
• Phenobarbital
• Phenytek
• Phenytoin (generic for Dilantin)
• PhosLo
• Plavix
• Polyethylene Glycol (generic for CoLyte/ Golytely)
• Potassium Chloride (generic for K-Dur)
• Prandin
• Precose
• Prednisolone Acetate (generic for Pred Forte & Pred Mild)
• Prednisolone Liquid, Pediapred/Orapred, generic for Prelone)
• Prednisone (generic for Deltasone/Orasone)

• Prefest
• Premarin
• Premarin Vaginal Cream
• Premphase
• Prempro/Prempro Low Dose
• Prevacid
• Prevacid NapraPAC
• PrevPac
• Primidone (generic for Mysoline)
• Prochieve 4%
• Prochlorperazine (generic for Compazine)
• Procrit*
• Promethazine (generic for Phenergan)
• Promethazine/Codeine (generic for Phenergan/Codeine)
• Promethazine DM (generic for Phenergan DM)
• Prometrium
• Propoxyphene Napsylate/APAP (generic for Darvocet N-100)
• Propranolol (generic for Inderal & Inderal LA)
• Proscar
• Protopic
• Protropin*
• Provigil*
• Pulmicort

• Quinaretic (generic for Accuretic)
• Quinapril (generic for Accupril)
• Qvar
• Ranitidine (generic for Zantac)
• Rapamune
• Razadyne/Razadyne ER
• Rebif*
• Regranex*
• Remicade*

• Renagel
• Repronex*
• Rhinocort Aqua
• Ribavirin (Generic for Rebetol, Copegus)
• Ridura
• Rifamate
• Risperdal
• Ritalin LA*
• Roferon-A

• Seasonale*
• Sensipar
• Serentil
• Serevent/Serevent Diskus
• Seroquel
• Singulair
• Sodium Sulfacetamide/Sulfur (Sulfacet-R Lotion)
• Soriatane
• Sotalol (generic for Betapace/Betapace AF)

• Spiriva
• Spironolactone (generic for Aldactone)
• Stalevo
• Starlix
• Sucralfate (generic for Carafate)
• Sulfacetamide (generic for Sulamyd/Bleph 10)
• Synarel
• Syntest
• Synthroid

• Tamiflu
• Tamoxifen (generic for Nolvadex)
• Tazorac*
• Tegretol XR
• Temodar
• Terazol
• Terazosin (generic for Hytrin)
• Testoderm*
• Testim*
• Tetracycline (generic for Achromycin V)
• Theophylline SR (generic for Theo-Dur, Uniphyl, Theo-24)
• Tizanidine (generic for Zanaflex)
• TMP-SMX DS (generic for Septra DS)
• TOBI
• Tobradex

• Tobramycin (generic for Tobrex)
• Tonocard
• Topamax
• Toprol XL
• Torecan
• Torsemide (generic for Demadex)
• Tracleer*
• Transderm-Scop*
• Tranxene SD
• Trazodone (generic for Desyrel)
• Tretinoin (generic for Retin-A, Avita, Retin-A Micro)*
• Triamcinolone Acetonide (generic for Aristocort & Aristocort-HP)
• Tricor
• Trileptal
• Triple Sulfa Cream (generic for Sultrin)

• Ultrase M-12
• URSO (generic available)
• Ursodiol (generic for Actigall)
• Vagifem
• Valcyte
• Valproic Acid (generic for Depakene)
• Valtrex
• Velosef
• Verapamil (generic for Calan)

• Verapamil SR (generic for Calan SR, Verelan)
• Vfend*
• Viagra*
• Vigamox
• Vira-A
• Vivelle/DOT
• Volmax
• Vytorin

• Warfarin Sodium (generic for Coumadin)
• Wellbutrin XL/Wellbutrin SR 200mg
• Xalatan
• Xeloda
• Xenical*
• Xolair*
• Xyrem*
• Yasmin
• Zaditor
• Zavesca

• Zetia
• Zofran*/Zofran-ODT*
• Zoloft
• Zomig*/Zomig ZMT*
• Zonegran
• Zovirax Ointment/Oral Suspension
• Zyprexa
• Zyrtec/Zyrtec D
• Zyvox*

CBCA Rx
675 Foxon Road, Suite 204
East Haven, CT 06513
www.cbca.com

Revised 1/2006

Administered in partnership with HealthTrans.