2018 Aetna Preventive Drug List

1 Preventive Medicine Reducing your out-of-pocket costs for the medicine you need 2018 Preventive medicine list Health benefits and health insurance plans are offered and/or underwritten by Aetna Health Inc., Aetna Health Insurance Company of New York, Aetna Health Insurance Company, Aetna HealthAssurance Pennsylvania Inc. and/or Aetna Life Insurance Company ( Aetna ). In Florida, by Aetna Health Inc. and/or Aetna Life Insurance Company. In Utah and Wyoming, by Aetna Health of Utah Inc. and Aetna Life Insurance Company. In Maryland, by Aetna Health Inc., 151 Farmington Avenue, Hartford, CT 06156. Each insurer has sole financial responsibility for its own products. Aetna Pharmacy Management refers to an internal business unit of Aetna Health Management, LLC. Q (10/17). Receive Preventive medicine without first having to meet your deductible. For conditions such as high blood pressure, high cholesterol and diabetes, we can help you manage the cost of your medicine.

2 We understand how important it is to take the medicine your doctor prescribes. The Aetna Preventive medicine feature makes it easier for you to do that. For chronic conditions, forget the health savings account deductible just pay your copay or coinsurance when buying these medications. Category Generic medicine Brand-name medicine Antihypertensive medicine (high blood pressure). Angiotensin- benazepril lisinopril ACCUPRIL PRINZIDE. converting enzyme benazepril/ lisinopril/HCTZ ACCURETIC QBRELIS. (ACE) inhibitors/ hydrochlorothiazide moexipril ACEON TARKA. combinations (HCTZ) moexipril/HCTZ ALTACE UNIRETIC. captopril perindopril EPANED UNIVASC. captopril/HCTZ quinapril LOTENSIN VASERETIC. enalapril quinapril/HCTZ LOTENSIN HCT VASOTEC. enalapril/HCTZ ramipril MAVIK ZESTORETIC. fosinopril trandolapril PRINIVIL ZESTRIL. fosinopril/HCTZ trandolapril/verapamil Angiotensin II amlodipine/olmesartan losartan/HCTZ ATACAND EDARBYCLOR.

3 Receptor amlodipine/valsartan olmesartan ATACAND HCT EXFORGE. antagonists/renin amlodipine/valsartan/ olmesartan/HCTZ AVALIDE EXFORGE HCT. inhibitor HCTZ olmesartan/amlodipine/ AVAPRO HYZAAR. combinations candesartan HCTZ AZOR MICARDIS. candesartan/HCTZ telmisartan BENICAR MICARDIS HCT. eprosartan telmisartan/HCTZ BENICAR HCT TEKTURNA. irbesartan valsartan COZAAR TEKTURNA HCT. irbesartan/HCTZ valsartan/HCTZ DIOVAN TRIBENZOR. losartan DIOVAN HCT E TWYNSTA. EDARBI VALTURNA. Alpha-adrenergic/ acebutolol nadolol/ BETAPACE KERLONE. beta-adrenergic atenolol bendroflumethiazide BETAPACE AF LEVATOL. blockers atenolol/chlorthalidone prazosin BYSTOLIC LOPRESSOR. betaxolol propranolol BYVALSON LOPRESSOR HCT. bisoprolol propranolol ER CARDURA MINIPRESS. bisoprolol/HCTZ propranolol/HCTZ COREG SECTRAL. carvedilol pindolol COREG CR SOTYLIZE. doxazosin sorine CORGARD TENORMIN. labetalol sotalol CORZIDE TENORETIC. metoprolol sotalol AF DUTOPROL TOPROL XL.

4 Metoprolol ER terazosin INDERAL LA ZEBETA. metoprolol/HCTZ timolol INNOPRAN XL ZIAC. nadolol Calcium channel afeditab CR nifedical XL ADALAT CC NORVASC. blockers/ amlodipine nifedipine CALAN NYMALIZE. miscellaneous amlodipine/benazepril nifedipine ER CALAN SR PRESTALIA. combinations cartia XT nimodipine CARDENE SR PROCARDIA. diltiazem nisoldipine CARDIZEM PROCARDIA XL. diltiazem CD/ER/XR nisoldipine ER CARDIZEM CD/LA SULAR. dilt-XR taztia XT COVERA-HS TIAZAC. felodipine ER telmisartan/amlodipine LOTREL VERELAN PM. isradipine verapamil matzim LA verapamil ER. nicardipine Category Generic medicine Brand-name medicine Diuretics acetazolamide furosemide/HCTZ ALDACTAZIDE EDECRIN. acetazolamide ER indapamide ALDACTONE INSPRA. amiloride methazolamide BUMEX KEVEYIS. amiloride/HCTZ methyclothiazide DEMADEX LASIX. bumetanide metolazone DIAMOX MAXZIDE. chlorothiazide spironolactone DIURIL MICROZIDE. chlorthalidone spironolactone/HCTZ DYAZIDE NEPTAZANE.

5 Eplerenone torsemide DYRENIUM. ethacrynic acid triamterene/HCTZ. Antihypertensive clonidine methyldopa CATAPRES NEXICLON XR. miscellaneous guanfacine methyldopa/HCTZ CLORPRES TENEX. hydralazine minoxidil DEMSER VECAMYL. DIBENZYLINE. Antihyperlipidemia medicine (high cholesterol). HMG-CoA reductase atorvastatin lovastatin ALTOPREV MEVACOR. inhibitors (statins)/ amlodipine/atorvastatin pravastatin CADUET PRAVACHOL. miscellaneous ezetimibe rosuvastatin CRESTOR VYTORIN. ezetimibe-simvastatin simvastatin LESCOL XL ZETIA. fluvastatin LIPITOR ZOCOR. LIVALO. Miscellaneous none JUXTAPID PRALUENT. antihyperlipidemics KYNAMRO REPATHA. Bile acid cholestyramine gemfibrozil ANTARA NIASPAN. sequestrants/ colestipol niacin ER COLESTID QUESTRAN. fibric acids/ fenofibrate omega-3 acid FENOGLIDE QUESTRAN LITE. miscellaneous other fenofibric prevalite FIBRICOR TRICOR. antihyperlipidemics fenofibric DR LIPOFEN TRIGLIDE. LOFIBRA TRILIPIX.

6 LOPID VASCEPA. LOVAZA WELCHOL. NIACOR. Respiratory medicine Anti-asthmatics albuterol levalbuterol HCl ACCOLATE PERFOROMIST. (asthma)/chronic albuterol ER levalbuterol tartrate HFA ADVAIR DISKUS PROAIR HFA. obstructive aminophylline metaproterenol sulfate ADVAIR HFA PROAIR RESPICLICK. pulmonary disease budesonide montelukast sodium AEROSPAN PROVENTIL HFA. (COPD) cromolyn sodium terbutaline sulfate AIRDUO RESPICLICK PULMICORT. fluticasone/salmeterol theochron ALVESCO PULMICORT FLEXHALER. ipratropium bromide theophylline ANORO ELLIPTA QVAR. ipratropium bromide/ theophylline ER ARCAPTA NEOHALER SEEBRI NEOHALER. albuterol zafirlukast ARNUITY ELLIPTA SEREVENT DISKUS. zileuton er ASMANEX HFA SINGULAIR. ASMANEX TWISTHALER SPIRIVA HANDIHALER. ATROVENT HFA STIOLTO RESPIMAT. BEVESPI AEROSPHERE STRIVERDI RESPIMAT. BREO ELLIPTA SYMBICORT. BROVANA THEO-24. COMBIVENT RESPIMAT TUDORZA PRESSAIR. DALIRESP UTIBRON NEOHALER. DULERA VENTOLIN HFA.

7 ELIXOPHYLLIN VOSPIRE ER. FLOVENT DISKUS XOPENEX. FLOVENT HFA XOPENEX CONC. INCRUSE ELLIPTA XOPENEX HFA. ISUPREL ZYFLO. LUFYLLIN ZYFLO CR. MAXAIR AUTOHALER. Category Generic medicine Brand-name medicine Antidiabetic medicine Insulins none AFREZZA LEVEMIR FLEXPEN. APIDRA LEVEMIR FLEXTOUCH. APIDRA SOLOSTAR NOVOLIN products BASAGLAR KWIKPEN NOVOLOG products HUMALOG products RELION products HUMULIN products SOLIQUA. LANTUS TOUJEO SOLOSTAR. LANTUS SOLOSTAR TRESIBA. LEVEMIR XULTOPHY. Antidiabetic orals/ acarbose metformin HCl ACTOPLUS MET INVOKANA. injectables alogliptin metformin HCl ER ACTOPLUS MET XR JANUMET. alogliptin/metformin miglitol ACTOS JANUMET XR. alogliptin/pioglitazone nateglinide ADLYXIN JANUVIA. chlorpropamide pioglitazone HCl AMARYL JARDIANCE. glimepiride pioglitazone HCl/ AVANDARYL JENTADUETO. glipizide metformin HCl AVANDIA JENTADUETO XR. glipizide ER pioglitazone HCl/ BYDUREON KAZANO. glipizide XL glimepiride BYETTA KOMBIGLYZE XR.

8 Glipizide/metformin HCl repaglinide CYCLOSET KORLYM. glyburide repaglinide/metformin DUETACT NESINA. glyburide micronized tolazamide FARXIGA ONGLYZA. glyburide/metformin HCl tolbutamide FORTAMET OSENI. GLUCAGEN HYPOKIT PRANDIN. GLUCAGON PRECOSE. EMERGENCY KIT PROGLYCEM. GLUCOPHAGE RIOMET. GLUCOPHAGE XR STARLIX. GLUCOTROL SYMLIN. GLUCOTROL XL SYMLINPEN. GLUCOVANCE SYNJARDY. GLUMETZA TANZEUM. GLYNASE TRADJENTA. GLYSET TRULICITY. GLYXAMBI VICTOZA. INVOKAMET XIGDUO XR. Diabetic supplies insulin syringes any generic BD insulin syringes PRECISION XTRA. (diabetes) lancets any generic BD pen needles glucose test strips pen needles any generic FREESTYLE PRECISION XTRA. glucose test strips ketone test strips FREESTYLE INSULINX ALL OTHER BRANDS. glucose test strips glucose test strips FREESTYLE LITE ALL OTHER BRANDS. glucose test strips insulin syringes ONETOUCH VERIO ALL OTHER BRANDS. glucose test strips lancets ONETOUCH ULTRA ALL OTHER BRANDS.

9 Glucose test strips pen needles Miscellaneous medicine Blood-thinning anagrelide enoxaparin AGGRENOX IPRIVASK. agents argatroban fondaparinux AGRYLIN LOVENOX. aspirin/dipyridamole heparin ARIXTRA PERSANTINE. cilostazol jantoven BRILINTA PLAVIX. clopidogrel warfarin COUMADIN PRADAXA. dipyridamole DURLAZA SAVAYSA. EFFIENT XARELTO. ELIQUIS YOSPRALA. FRAGMIN ZONTIVITY. Category Generic medicine Brand-name medicine Opioid dependence buprenorphine HCl/ naltrexone tab BUNAVAIL VIVITROL injection treatment naloxone tab SUBOXONE film ZUBSOLV. buprenorphine SL tab Osteoporosis agents alendronate pamidronate ACTONEL FOSAMAX PLUS D. calcitonin spray raloxifene ATELVIA MIACALCIN injection etidronate risedronate BINOSTO MIACALCIN spray ibandronate zoledronic BONIVA NATPARA. EVISTA PROLIA. FORTEO RECLAST. FORTICAL XGEVA. FOSAMAX ZOMETA. Prenatal many choices available many choices available multivitamin with folic acid Pediatric vitamins many choices available many choices available with fluoride Smoking-cessation buproban bupropion SR CHANTIX NICOTROL NS.

10 Medicine NICOTROL INHALER. Some drugs may require prior authorization, step therapy or be formulary excluded for certain members, depending on their pharmacy benefits plan. This list indicates the common uses for which the drug is prescribed. Some drugs are prescribed for more than one condition. Brand-name drugs not listed here may be covered by your plan without the use of a generic first. Information provided here is not a substitute for medical advice or treatment. Step therapy does not apply to fully insured members in New Jersey. However, these programs are available to self-funded plans. Discuss this information with your doctor or health care provider. Aetna assumes no liability for the information provided or for any diagnosis or treatment made in reliance thereon, nor is it responsible for the reliability of the content. Subject to state law restrictions. This document contains references to brand-name prescription drugs that are trademarks or registered trademarks of pharmaceutical manufacturers that are not affiliated with Aetna .