NEW: Duloxetine HCL DR (Cymbalta®)– Valsartan (Diovan®) - Telmisartan (Micardis®) – Propranolol HCL ER (Inderal® LA) - Divalproex SOD ER (Depakote ER®) - Fenofibrate (Tricor®) – Metoprolol Succinate ER (Toprol-XL®)

Medications Available

Use the search box below or browse the entire list to see if your medications are available from Rx Outreach.
Then see if you qualify for the program.
DiseaseDisease - LinkRx Outreach Medication ListBrand/Generic EquivalentLink to the Brand DrugAvailable strengths offered through Rx OutreachFee per 90 day supplyFee per 180 day supplyFee by Quantity
Heartburn/Acid Reflux/UlcersAcipHex® tabletRabeprazole 20mg$35N/A
Viral InfectionAcyclovir capsuleZovirax®200mg$20
Viral InfectionAcyclovir tabletZovirax®400mg, 800mg$20
Blood Pressure / HeartNifedipine ER tabletNifediac CC®30mg, 60mg$50$95
DermatologyAlclometasone Dipropionate CreamAclovate®15gm$15 per tube
OsteoporosisAlendronate tabletFosamax®70mg (Once a week dosage)$25 (limit 12)$45 (limit 24)
GoutAllopurinol tabletZyloprim®100mg, 300mg$20
AnxietyAlprazolam tablet (CS)Xanax®0.25mg, 0.5mg, 1mg$20N/A
AnxietyAlprazolam tablet (CS)Xanax®2 mg$25N/A
Parkinson’sAmantadine tabletN/A100mg$30N/A
Heartheart diseaseAmiodarone tabletCordarone® or Pacerone®200mg$25$45
DepressiondepressionAmitriptyline tabletN/A10mg, 25mg, 50mg, 75mg, 100mg, 150mg$20N/A
Blood Pressure / HeartAmlodipine tabletNorvasc®2.5mg, 5mg, 10mg$20$40
Blood Pressure/HeartAmlodipine/Benazepril capsuleLotrel®5/10mg, 5/20mg, 10/20mgN/AN/A$50 for up to 90 capsules
Alzheimer'sAricept® tabletDonepezil5mg, 10mg$25N/A
Alzheimer'sAricept® tabletDonepezil23mgFor Rx Outreach patients that received a prescription for Aricept 23mg in 2013; you are eligible to continue to receive Aricept 23mg in 2014. Patients can either submit refills or a new prescription.
Blood Pressure / HeartAtenolol/Chlorthalidone tabletTenoretic®50/25mg, 100/25mg$20
Blood Pressure / HeartAtenolol tabletTenormin®25mg, 50mg, 100mg$9$18
Cholesterol / TriglyceridesAtorvastatin tabletLipitor®10mg, 20mg, 40mg, 80mg$25$45
Muscle RelaxerBaclofen tabletN/A10mg, 20mg$15N/A
Blood Pressure / HeartBenazepril/HCTZ tabletLotensin HCT®5/6.25mg, 10/12.5mg, 20/12.5mg, 20/25mg$25$45
Blood Pressure / HeartBenazepril tabletLotensin®5mg, 10mg, 20mg, 40mg$20
Parkinson'sBenztropine tabletN/A0.5mg, 1mg, 2mg$20
DermatologyBetamethasone Dipropionate Cream, AugmentedDiprolene® AF15gm$25 per tube
ProstateBicalutamide tabletCasodex®50mg$35$65
Blood Pressure / HeartBisoprolol/HCTZ tabletZiac®2.5/6.25mg, 5/6.25mg, 10/6.25mg$20
DiabetesBlood Glucose Monitor (Prodigy AutoCode™)N/AN/AN/AN/AOne Free Monitor Annually (no prescription required)
DiabetesBlood Glucose Strips, No Coding (Prodigy™)N/ABox of 50N/AN/A$15 per box (no prescription required)
DepressiondepressionBupropion HCL tabletWellbutrin®Wellbutrin®75mg$40N/A
DepressiondepressionBupropion HCL tabletWellbutrin®Wellbutrin®100mg$40 for up to 90 tabletsN/A
DepressiondepressionBupropion HCL SRWellbutrin SR®100mg, 150mg, 200mg$65N/A
DepressiondepressionBupropion HCL XLWellbutrin XL®150mg, 300mg$65N/A
AnxietyBuspirone tabletN/A5mg, 10mg, 15mg$20N/A
AnxietyBuspirone tabletN/A30mg$35N/A
Blood Pressure / HeartCaptopril tabletCapoten®12.5mg, 25mg, 50mg, 100mgN/AN/A$40 for up to 90 tablets
SeizuresseizuresCarbamazepine tabletTegretol®200mg$20
Parkinson'sCarbidopa / Levodopa SR tabletSinemet CR®25/100mg, 50/200mg$45$85
Parkinson'sCarbidopa / Levodopa tabletSinemet®10/100mg, 25/100mg, 25/250mg$45$85
Blood Pressure/HeartCarvedilol tabletCoreg®3.125mg, 6.25mg, 12.5mg, 25mg$20
PsychosisChlorpromazine HCL tabletN/A10mg, 25mg, 50mg, 100mg, 200mg$35N/A
Blood Pressure / HeartChlorthalidone tabletN/A25mg, 50mg$20
Bloodintermittent claudicationCilostazol tabletPletal®50mg, 100mg$30$55
DepressiondepressionCitalopram tabletCelexa®10mg, 20mg, 40mg$20N/A
Anti-infectiveClindamycin HCL capsuleCleocin®150mg$45$85
Seizures / Anxiety / InsomniaseizuresClonazepam tablet (CS)Klonopin®0.5mg, 1mg, 2mg$35N/A
Blood Pressure / HeartClonidine HCL tabletCatapres®0.1mg, 0.2mg, 0.3mg$20
Blood/HeartClopidogrel TabletPlavix®75mgN/AN/A$20 for up to 90 tablets
Muscle SpasmsspasmCyclobenzaprine tabletN/A5mg, 10mg$25N/A
CancerDacogen® vialDecitabine50mg/vialN/AN/A$50 for up to 5 vials
Anxiety / SeizuresDiazepam tablet (CS)Valium®2mg, 5mg, 10mg$35N/A
Arthritis / PainarthritisDiclofenac EC tabletN/A50mg, 75mg$25N/A
Arthritis / PainDiclofenac ER tabletVoltaren XR®100mg$40N/A
Irritable Bowl SyndromeDicyclomine capsuleBentyl®10mg$20
Irritable Bowl SyndromeDicyclomine tabletBentyl®20mg$20
HeartDigoxin tabletLanoxin®0.125mgN/AN/A$45 for up to 90 tablets
HeartDigoxin tabletLanoxin®0.25mg$20N/A
Blood Pressure / HeartDiltiazem ER capsule (24hr) (Dilt-XR)Dilacor XR®120mg, 180mg, 240mgN/AN/A$40 for up to 90 capsules
Blood Pressure / HeartDiltiazem ER capsule (Dilt-CD)Cardizem CD®120mg, 180mg, 240mg, 300mgN/AN/A$40 for up to 90 capsules
DiarrheaDiphenoxylate/Atropine tablet (CS)Lomotil® or Lonox®2.5/0.025mg$35N/A
SeizuresDivalproex NA DR tabletDepakote®125mg, 250mg, 500mg$35$65
Blood Pressure / HeartDoxazosin Mesylate tabletCardura®1mg, 2mg, 4mg, 8mg$20
DepressiondepressionDoxepin capsuleN/A10mg, 25mg, 50mg, 75mg, 100mg$25N/A
Blood Pressure / HeartEnalapril/HCTZ tabletVaseretic®5/12.5mg, 10/25mg$20
Blood Pressure / HeartEnalapril Maleate tabletVasotec®2.5mg, 5mg, 10mg, 20mg$20
DepressionEscitalopram tabletLexapro®5mg, 10mg, 20mg$20
HormonesEstradiol tabletEstrace®0.5mg, 1mg, 2 mg$20
HormonesEstropipate tabletOgen®0.625(0.75mg), 1.25(1.5mg)$20
Arthritis / PainEtodolac capsuleN/A200mg, 300mg$30N/A
Arthritis / PainEtodolac tabletN/A400mg, 500mg$30N/A
Heartburn / Acid Reflux / UlcersFamotidine tabletPepcid®20mg, 40mg$20
Blood Pressure/HeartFelodipine ER TabletPlendil® ER2.5mg, 5mg$40 up to 90 tablets
Blood Pressure/HeartFelodipine ER TabletPlendil® ER10mg$70 up to 90 tablets
Prostateheart diseaseFinasteride tabletProscar®Proscar®5mg$50$95
AntifungalFluconazole tabletDiflucan®100mg, 200mg$35 for up to 30 tablets
DepressiondepressionFluoxetine capsuleProzac®10mg, 20mg, 40mg$15N/A
AllergyFluticasone nasal sprayFlonase®50mcg$50 (limit 3)$90 (limit 6)
Blood / HeartFolic Acid tabletN/A1mg$20
AnticoagulantFragmin® SyringeDalteparin Sodium Injection2500 IU/0.2mL, 5000 IU/0.2mL$50 for up to 30 syringes
Blood Pressure / HeartFurosemide tabletLasix®20mg, 40mg, 80mg$9$18
SeizuresseizuresGabapentin capsuleNeurontin®100mg, 300mg, 400mgN/AN/A$25 for up to 270 capsules
Seizures / PainGabapentin tabletNeurontin®600mg, 800mgN/AN/A$45 for up to 270 tablets
Cholesterol / Triglyceridesheart diseaseGemfibrozil tabletLopid®600mg$30$55
DiabetesdiabetesGlimepiride tabletAmaryl®Amaryl®1mg, 2mg, 4mg$20
DiabetesdiabetesGlipizide ER tabletGlucotrol XL®2.5mg, 5mg, 10mg$35$65
DiabetesdiabetesGlipizide tabletGlucotrol®5mg, 10mg$20
DiabetesdiabetesGlyburide, micronized tabletGlynase® PresTab®1.5mg, 3mg, 6mg$20
DiabetesGlyburide/Metformin tabletGlucovance®1.25/250mg, 2.5/500mg, 5/500mg$30$55
DiabetesdiabetesGlyburide tabletN/A1.25mg, 2.5mg, 5mg$20
PsychosisHaloperidol tabletN/A0.5mg, 1mg, 2mg, 5mg$25N/A
CancerHexalen capsuleAltretamine50mg$40 for a 30-day SupplyN/A
Blood Pressure / HeartHydralazine tabletN/A10mg, 25mg, 50mg$25$45
Blood Pressure / HeartHydrochlorothiazide capsuleMicrozide®12.5mg$20
Blood Pressure / HeartHydrochlorothiazide tabletN/A25mg, 50mg$20
Arthritis / MalariaHydroxychloroquine tabletPlaquenil®200mg$25$45
Cancer /Sickle Cell / PsoriasisHydroxyurea capsuleHydrea®500mg$25 for up to 90 capsulesN/A
AllergyHydroxyzine HCL tabletN/A25mg, 50mg$25N/A
AllergyHydroxyzine pamoate capsuleN/A25mg, 50mg$25N/A
ArthritisarthritisIbuprofen tabletN/A400mg, 600mg, 800mg$20N/A
Blood Pressure / HeartIndapamide tabletN/A1.25mg, 2.5mg$20
DiabetesdiabetesInsulin Syringes (Prodigy®)N/A28G 12.7mm – 1cc, 31G 8mm – 1/2cc, 31G 8mm – 1/3cc
$13 for a box of 100
Blood Pressure / HeartIrbesartan/HCTZ tabletAvalide®150mg/12.5mg, 300mg/12.5mg$30$55
Blood Pressure / HeartIrbesartan tabletAvapro®75mg, 150mg, 300mg$30$55
TuberculosistuberculosisIsoniazid tabletIsoniazid/INH®Isoniazid/INH®300mg$20
Angina / Heartheart diseaseIsosorbide Mononitrate ER tabletN/A30mg, 60mg 120mg$20
Angina / Heartheart diseaseIsosorbide Mononitrate tabletMonoket®10mg, 20mg$20
Blood Pressure / HeartLabetalol HCL tabletN/A100mg, 200mg, 300mg$30 for up to 90 tabs
SeizuresLamotrigine tabletLamictal®25mg, 100mg, 150mg, 200mg$40$75
DiabetesdiabetesLancets 28G, Twist Top (Prodigy™)N/ABox of 100 (minimum order - 2 boxes)N/AN/A$5 per box - minimum order $10 (no prescription required)
Rheumatoid ArthritisLeflunomide tabletArava®10mg, 20mg$50N/A
CancerLetrozole tabletFemara®2.5mg$30$55
SeizuresLevetiracetam ER tabletKeppra XR®500mg, 750mgN/AN/A$80 for up to 180 tablets
SeizuresLevetiracetam tabletKeppra®250mg, 500mg 750mg$50$95
ThyroidLevothyroxine tabletLevoxyl® or Synthroid®25mcg, 50mcg, 75mcg, 88mcg, 100mcg, 112mcg, 125mcg, 137mcg, 150mcg, 175mcg, 200mcg, 300mcg$20
Blood Pressure / HeartLisinopril/HCTZ tabletZestoretic® or Prinzide®10/12.5mg, 20/12.5mg, 20/25mg$9$18
Blood Pressure / HeartLisinopril tabletZestril® or Prinivil®2.5mg, 5mg, 10mg, 20mg, 30mg, 40mg$9$18
Bipolar DisorderLithium Carbonate capsuleN/A300mg$25N/A
AnxietyLorazepam tablet (CS)Ativan®0.5mg, 1mg, 2mg$35N/A
Blood Pressure / HeartLosartan Potassium tabletCozaar®25mg, 50mg, 100mg$25$45
Blood Pressure / HeartLosartan/HCTZ tabletHyzaar®50/12.5mg, 100/12.5mg, 100/25mg$25$45
Cholesterol / Triglyceridesheart diseaseLovastatin tabletN/A10mg, 20mg, 40mg$9$18
NauseaMeclizine HCL tabletAntivert®12.5mg, 25mg$30$55
HormonesMedroxyprogesterone tabletProvera®2.5mg, 5mg, 10mg$15N/A
Arthritis / PainarthritisMeloxicam tabletMobic®7.5mg, 15mg$20N/A
DiabetesdiabetesMetformin HCL ER tabletGlucophage XR®500mg, 750mg$20
DiabetesdiabetesMetformin HCL tabletGlucophage®Glucophage®500mg, 850mg, 1000mg$20
Cancer / Rheumatoid ArthritisMethotrexate tabletN/A2.5mg$20 per 12 tabletsN/A
Nausea / StomachMetoclopramide HCL tabletReglan®5mg, 10mg$20 (1 fill only:no refills)N/A
Blood Pressure / HeartMetolazone tabletZaroxolyn®2.5mg, 5mg$35$65
Blood Pressure / HeartMetoprolol Tartrate tabletLopressor®25mg, 50mg, 100mg$20
Anti-infectiveMinocycline capsuleMinocin / Dynacin®50mg, 75mg, 100mg$45$85
DermatologyMometasone Furoate CreamElocon®15gm$15 per tube
DermatologyMometasone Furoate OintmentElocon®15gm$15 per tube
AsthmaMontelukast Sodium tabletSingulair®10mg, 5mg chewableN/AN/A$40 for up to 90 tablets
DepressiondepressionMirtazapine tabletRemeron®15mg, 30mg, 45mg$30N/A
ImmunosuppressantMycophenolate Mofetil CapsuleCellCept®250mg$65 for up to 180 capsules
ImmunosuppressantMycophenolate Mofetil TabletCellCept®500mg$65 for up to 180 tablets
Arthritis / PainarthritisNabumetone tabletN/A500mg, 750mg$40N/A
Arthritis / PainarthritisNaproxen Sodium tabletAnaprox® DS550mg$25N/A
ArthritisarthritisNaproxen tabletNaprosyn®250mg, 375mg, 500mg$20N/A
Angina / Chest PainNitroglycerin SA capsuleN/A2.5mg, 6.5mg, 9mg$45$85
Oral ContraceptiveNorethindrone TabletOrtho Micronor®28's (0.35mg)$35$65
Oral ContraceptiveNorethindrone/Ethinyl Estradiol Tablet Ovcon® 3528's (0.4mg/0.035mg)$35$65
HormonesNorethindrone Acetate TabletN/A5mg$75 up to 50 tablets
DepressiondepressionNortriptyline HCL capsulePamelor®10mg, 25mg, 50mg, 75mg$20N/A
AntifungalNystatin TabletN/A500000 units$25 for up to 90 tablets
PsychosisOlanzapine TabletZyprexa®2.5mg, 5mg, 7.5mg 10mg$25 for up to 90 tabletsN/A
PsychosisOlanzapine TabletZyprexa®15mg, 20mg$50 for up to 90 tabletsN/A
Heartburn / Acid Reflux / UlcersOmeprazole capsulePrilosec®10mg, 20mg, 40mg$35$65
NauseaOndansetron ODT tabletZofran ODT®4mg$50 for up to 135 tabletsN/A
NauseaOndansetron ODT tabletZofran ODT®8mg$50 for up to 90 tabletsN/A
NauseaOndansetron tabletZofran ®4mg$50 for up to 135 tabletsN/A
NauseaOndansetron tabletZofran ®8mg$50 for up to 90 tabletsN/A
SeizureOxcarbazepine tabletTrileptal®150mg, 300mg, 600mg$60N/A
BladderOxybutynin tablet5mg$20
HeartPacerone® tabletAmiodarone100mg, 200mg, 400mg$25$45
Heartburn/Acid Reflux/UlcersPantoprazole tabletProtonix®20mg, 40mg$20N/A
CancerPanretin® gel 0.1%Alitretinoin60gmN/AN/A$40 per tube
DepressiondepressionParoxetine HCL tabletPaxil® (HCL)10mg, 20mg, 30mg, 40mg$20N/A
BloodPentoxifylline ER tabletTrental®400mg$30$55
SeizuresseizuresPhenytoin Sodium capsuleDilantin®Dilantin®100mg$45$85
DiabetesPioglitazone HCL tabletActos®15mg, 30mg, 45mg$25N/A
Blood / HeartPotassium Chloride, PowderKlor-Con® Powder 20mEQ1.5g (20mEQ)N/AN/A$15 for up to 90 packets
Blood / HeartPotassium Chloride, PowderKlor-Con® Powder 25mEQ1.875g (25mEQ)N/AN/A$15 for up to 90 packets
Blood / HeartPotassium CitrateCytra-K540mg (5mEQ), 1080mg (10mEQ)N/AN/A$15 for up to 90 tablets
Blood / HeartPotassium Chloride ER tabletKlor-Con® 8mEQ600mg (8mEQ)N/AN/A$15 for up to 90 tablets
Blood / HeartPotassium Chloride ER tabletKlor-Con® 10mEQ750mg (10mEQ)N/AN/A$15 for up to 90 tablets
Blood / HeartPotassium Chloride ER tabletKlor-Con® M10750mg (10mEQ)N/AN/A$15 for up to 90 tablets
Blood / HeartPotassium Chloride ER tabletK-Dur® 20/Klor-Con® M201500mg (20mEQ)N/AN/A$15 for up to 90 tablets
Parkinson'sPramipexole TabletMirapex®0.125mg, 0.25mg, 0.5mg, 1mg, 1.5mg $25 up to 180 tablets
Cholesterol / Triglyceridesheart diseasePravastatin tabletPravachol®10mg, 20mg, 40mg$40 for up to 90 tablets
Blood Pressure / HeartPrazosin capsuleN/A1mg, 2mg, 5mg$20$40
AsthmaProAir® HFAAlbuterol Sulfate8.5g (200 inhalations)N/AN/A$35 per inhaler canister
HormonesPrednisone tabletN/A1mg, 2.5mg, 5mg, 10mg, 20mg, 50mg$20N/A
Cholesterol/TriglyceridesPrevalite® PowderCholestyramine4g/5.5g dose packetN/AN/A$25 for a carton of 42 packets
Nausea / PsychosisProchlorperazine tabletN/A5mg, 10mg$20
Heartheart diseasePropafenone HCL tabletRythmol®Rythmol®150mg, 225mg, 300mg$40$75
HypertensionPropranolol HCL ER capsuleInderal® LA60mg, 80mg, 120mg, 160mgN/AN/A$45 for up to 90 capsules
Blood Pressure / HeartPropranolol tabletN/A10mg, 20mg, 40mg, 80mg$20
Anti-thyroidPropylthiouracil tabletN/A50mg$35$65
PsychosisQuetiapine FumaratetabletSeroquel®25mg, 50mg, 100mg$25 for up to 90 tabletsN/A
PsychosisQuetiapine FumaratetabletSeroquel®200mg, 300mg$40 for up to 90 tabletsN/A
PsychosisQuetiapine FumaratetabletSeroquel®400mg$50 for up to 90 tabletsN/A
Blood Pressure / HeartQuinapril tabletAccupril®5mg, 10mg, 20mg, 40mg$30$55
Blood Pressure / HeartRamipril capsuleAltace®1.25mg, 2.5mg, 5mg, 10mg$25$45
Heartburn / Acid Reflux / UlcersRanitidine tabletZantac®150mg, 300mgN/A$20
PsychosisRisperidone tabletRisperdal®0.25mg, 0.5mg, 1mg, 2mg, 3mg, 4mg$45N/A
Parkinson'sRopinirole HCL tabletRequip®0.25mg, 0.5mg, 1mg, 2mg$45$85
DepressiondepressionSertraline tabletZoloft®25mg, 50mg, 100mg$25N/A
HeartSorine® tabletSotalol HCl80mg, 120mg, 160mg, 240mg$20N/A
Cholesterol / Triglyceridesheart diseaseSimvastatin tabletZocor®Zocor®5mg, 10mg, 20mg, 40mg, 80mg$25$45
Blood Pressure / HeartSpironolactone tabletAldactone®25mg$20
Blood Pressure / HeartSpironolactone/HCTZ tabletN/A25mg/25mg$20 for up to 90 tablets
Oral ContraceptivesSprintec® tabletOrtho-Cyclen®28's$35 (limit 3)$65 (limit 6)
Anti-infectiveSulfamethoxazole/Trimethoprim DSBactrim® DS or Septra® DS800mg/160mg$20
DiarrheaSulfasalazine tabletN/A500mg$50$95
MigrainesSumatriptan Succ tabletImitrex®25mg$35 for up to 72 tabletsN/A
MigrainesSumatriptan Succ tabletImitrex®50mg$35 for up to 54 tabletsN/A
MigrainesSumatriptan Succ tabletImitrex®100mg$35 for up to 27 tabletsN/A
CancerTamoxifen Citrate tabletN/A10mg, 20mg$25$45
HypertensionTelmisartan tabletMicardis®20mg, 40mg, 80mg$35$65
ProstateTamsulosin capsuleFlomax®0.4mg$30$55
InsomniaTemazepam capsule (CS)Restoril®15mg, 30mg$35N/A
Blood Pressure / HeartTerazosin capsuleN/A1mg, 2mg, 5mg, 10mg$20
AsthmaTheophylline ER tabletN/A100mg, 200mg, 300mg$30$55
Blood / HeartTiclopidine tabletTiclid®250mg$35$65
Muscle SpasmsspasmTizanidine HCL tabletZanaflex®Zanaflex®2mg, 4mg$55N/A
SeizuresTopiramate tabletTopamax®25mg, 50mg, 100mg, 200mg$35$65
PainTramadol tablet (CS)Ultram®50mg$35N/A
Blood Pressure / HeartTrandolapril tabletMavik®1mg, 2mg, 4mg$30$55
Depression / AnxietydepressionTrazodone tabletN/A50mg, 100mg, 150mg$20N/A
Oral ContraceptivesTri-Sprintec® tabletOrtho-Tri-Cyclen®28's$35 (limit 3)$65 (limit 6)
Blood Pressure / HeartTriamterene/HCTZ capsuleDyazide®37.5/25mg$20
Blood Pressure / HeartTriamterene/HCTZ tabletMaxzide®37.5/25mg, 75/50mg$20
HypertensionValsartan tabletDiovan®40mg, 80mgN/AN/A$50 for 30 tablets
HypertensionValsartan tabletDiovan®160mg, 320mgN/AN/A$75 for 30 tablets
Blood Pressure / HeartValsartan/HCTZ tabletDiovan HCT®80/12.5mg, 160/12.5mg, 160/25mg, 320/12.5mg, 320/25mg$35$65
DepressiondepressionVenlafaxine tabletN/A25mg, 37.5mg, 50mg, 75mg, 100mg$45N/A
DepressiondepressionVenlafaxine ER capsuleEffexor XR®37.5mg, 75mg, 150mg$45N/A
Blood Pressure / HeartVerapamil SR tabletCalan-SR® or Isoptin-SR®120mg, 180mg, 240mg$35$65
Blood Pressure / HeartVerapamil tabletCalan®40mg, 80mg, 120mg$20
Blood / HeartWarfarin tabletJantoven®1mg, 2mg, 2.5mg, 3mg, 4mg, 5mg, 6mg, 7.5mg, 10mg$25N/A
AsthmaZafirlukast tabletAccolate®10mg, 20mg N/AN/A$30 for 60 tablets
Sleep/insomniaZaleplon capsule (CS)Sonata®5mg, 10mg$35N/A
InsomniaZolpidem tablet (CS)Ambien®Ambien®5mg, 10mg$35N/A
InsomniaZolpidem ER tablet (CS)Ambien CR®Ambien®6.25mg, 12.5mg$45 for up to 30 tabletsN/A
SeizuresZonegran® capsuleZonisamide25mg, 100mgFor Rx Outreach patients that received a prescription for Zonegran in 2013; you are eligible to continue to receive Zonegran in 2014. Patients can either submit refills or a new prescription.
Seizures
Divalproex SOD ER tablet
Depakote ER®250mg$65N/A
Seizures
Divalproex SOD ER tablet
Depakote ER®500mg$95N/A
DepressionDuloxetine HCL DR capsuleCymbalta®20mg, 30mg, 60mg$65N/A
Cholesterol/TriglyceridesFenofibrate tablet
Tricor®48mg$55$95
Cholesterol/TriglyceridesFenofibrate tablet
N/A54mg, 160mg$55$95
Bipolar DisorderLithium Carbonate ER tablet
Lithobid ER®300mg$35N/A
Bipolar DisorderLithium Carbonate ER tablet
N/A450mg$35N/A
Blood Pressure/HeartMetoprolol Succinate ER tablet
Toprol-XL®25mg, 50mg, 100mg$35$65
Blood Pressure/HeartMetoprolol Succinate ER tablet
Toprol-XL®200mg$45$85
NarcolepsyModafinil tablet (CS)
Provigil®100mg, 200mg$80N/A
BladderOxybutynin Chloride ER tablet
Ditropan XL®5mg, 10mg, 15mg$45$85
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