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Preventive medications
In addition to a healthy lifestyle, preventive medications can help people avoid many illnesses and conditions. A consumer-directed health (CDH) plan that includespreventive medications can help support the goal ofongoing good health.
This list provides examples of your plan’s preventivemedications by drug category. This is not an all-inclusive list.
Coverage prior to the deductible being met may not beprovided for every dosage form of a listed medication;please check with your plan administrator if you havequestions. This list is periodically reviewed by clinicalexperts. Medications may be added to or removed from thelist based on different factors, including the intendedpurpose of the medication and its availability.
Medications on this list that are not covered
under your plan are not eligible for the
preventive medication program.

This list includes medications sometimes used for prevention and sometimes for treatment. For the prevention of:
Examples of medicines*
Low levels of
vitamins
Pregnancy
• Birth control medicines taken by mouth • Birth control devices (diaphrams, skin patch systems, injectable birth control,intrauterine systems, and implants) Cavities
Anemia in children
• Ferrous sulfate liquid drops for infants Complications
from smoking
• nicotine products (Nicotrol®) • phentermine (Adipex-P®, Ionamin®) *Only example medicines are listed; this is not a complete listing of For the prevention of:
Examples of medicines*
Nausea and
dizziness
• ondansetron (Zofran®, Zofran ODT®) • prochlorperazine (Compazine®) • scopolamine (Transderm Scop®, Scopace®) Breast cancer
recurrence
Heart disease and
• over-the-counter aspirin medicines, 81 mg • warfarin (Coumadin®, Jantoven®) • heparin and low-molecular-weight heparin: [enoxaparin (Lovenox®); fondaparinux(Arixtra®)] benazepril (Lotensin®, Lotensin HCT®);enalapril (Vasotec®, Vaseretic®); fosinopril(Monopril®, Monopril-HCT®); lisinopril(Prinivil®, Prinzide®, Zestril®, Zestoretic®);quinapril (Accupril®, Accuretic®); ramipril(Altace®) • ACE receptor blockers and combinations: candesartan (Atacand®, Atacand HCT®);eprosartan (Teveten®, Teveten HCT®);irbesartan (Avapro®, Avalide®); losartan(Cozaar®, Hyzaar®); olmesartan (Benicar®,Benicar HCT®); telmisartan (Micardis®, MicardisHCT®); valsartan (Diovan®, Diovan HCT®) For the prevention of:
Examples of medicines*
Heart disease and
• Beta blockers and combinations: atenolol stroke (continued)
(Tenormin®, Tenoretic®); bisoprolol (Zebeta®, Ziac®);metoprolol (Lopressor®, Toprol-XL®); nebivolol(BystolicTM); propranolol (Inderal® LA, InnoPran XL®) (Norvasc®); diltiazem (Cardizem®, Cartia XT®,Tiazac®); nifedipine (Adalat®, Procardia®);nisoldipine (Sular®); verapamil (Calan®, Covera-HS®, Isoptin SR®, Verelan®) • Diuretics and combinations: amiloride (Midamor®); hydrochlorothiazide; indapamide;metolazone (Zaroxolyn®); spironolactone(Aldactone®); terazosin (Hytrin®); triamterene-HCTZ (Dyazide®, Maxzide®) • Miscellaneous medicines and combinations: aliskiren (Tekturna®); carvedilol (Coreg®);clonidine (Catapres®, Combipres®, Clorpres®);doxazosin (Cardura®); enalapril-felodipine;hydralazine (Apresoline®);amlodipine/benazepril (Lotrel®);amlodipine/valsartan (Exforge®) • HMG-coA reductase inhibitors: atorvastatin (Lipitor®); lovastatin (Mevacor®, Altoprev®); pravastatin (Pravachol®); rosuvastatin (Crestor®); simvastatin (Zocor®) • Other agents: cholestyramine (Prevalite®, Questran®); colesevelam (WelChol®); colestipol (Colestid®); gemfibrozil (Lopid®); fenofibrate (Fenoglide™, Lipofen®, TriCor®); ezetimibe (Zetia®); ezetimibe/simvastatin (Vytorin®); omega-3-acid ethyl esters (Omacor®) • niacin (Niacor®, Niaspan®); niacin/lovastatin (Advicor®); niacin ER/simvastatin (Simcor®) For the prevention of:
Examples of medicines*
Infection
• Vaccines (diphtheria, pertussis, tetanus, haemophilus influenzae B, hepatitis A and B,human papillomavirus, influenza, measles,meningococcal, mumps, pneumococcal,poliovirus, rotavirus, rubella, and varicella) • Fungal infections: atovaquone (Mepron®); pentamidine (NebuPent®, Pentam®);posaconazole (Noxafil®); acyclovir (Zovirax®) (Malarone®); hydroxychloroquine(Plaquenil®); quinine (Qualaquin®) • Virus: amantadine; famciclovir (Famvir®); foscarnet (Foscavir®); ganciclovir(Cytovene®); oseltamivir (Tamiflu®);valacyclovir (Valtrex®); valganciclovir(Valcyte®); zanamivir (Relenza®) Ulcer disease
• H2-antagonists: cimetidine (Tagamet®); famotidine (Pepcid®); ranitidine (Zantac®) • Miscellaneous agents: sucralfate (Carafate®) (Nexium®); lansoprazole (Prevacid®);pantoprazole (Protonix®); rabeprazole(AcipHex®) Side effects from
cancer treatment
• epoetin alfa (Epogen®, Procrit®)• filgrastim (Neupogen®)• pegfilgrastim (Neulasta®)• sargramostim (Leukine®) Gum disease
Low levels of
• estrogen taken by mouth and by skin patch hormones
• medroxyprogesterone (Cycrin®, Provera®) • progesterone (Crinone®, Prometrium®) For the prevention of:
Examples of medicines*
Bone disease and
• alendronate (Fosamax®, Fosamax Plus D®) fractures
• calcitonin (Fortical®, Miacalcin®) Low levels of
vitamins or
• Iron (Chromagen®, FoltrinTM, Niferex® minerals
bicarbonate/citric acid (Effer-K®, K-Lyte®);potassium chloride, gluconate, andphosphate (K-Dur®, K-Tab®, Klor-Con®,Neutra-Phos® K); potassium and sodiumphosphate (K-Phos® Neutral, Neutra-Phos ®);sodium phosphate High phosphate
levels in kidney
• sevelamer (Renvela®, Renagel®) Complications of
diabetes
• insulin (Humulin®, Novolin®) • glipizide and combinations (Glucotrol®, For the prevention of:
Examples of medicines*
Complications of
• glyburide and combinations (DiaBeta®, diabetes
(continued)
• metformin (Fortamet®, Glucophage®, • pioglitazone and combinations (Actos®, Duetact™, ACTOplus met®) (Avandia®, Avandaryl™, Avandamet®) • sitagliptin and combinations (Januvia™, www.medco.com
Medco Health Solutions, Inc., is the company that your
employer or health plan chose to manage your prescription
drug benefit.

Medco is a registered trademark of Medco Health Solutions, Inc.
All other trademarks are the property of their respective owners.
2010 Medco Health Solutions, Inc. All rights reserved.
Preventive Drug List-1&2 + diabetes 9.10

Source: http://business.we-energies.com/hric-online/wp-content/uploads/2010/10/preventivedruglist2011.pdf

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