4 and 10 Generic Medication List (sorted by disease state)

[Pages:3]$4 and $10 Generic Medication List (sorted by disease state)

Generic Drug Name/ Strength

Form

Allergy, Cough and Cold

Benzonatate 100 Mg

Capsule

Loratadine 10 Mg

Tablet

Promethazine 6.25 Mg/5 Ml*

Syrup

Promethazine Dm

Syrup

Analgesic

Baclofen 10 Mg

Tablet

Cyclobenzaprine 5 Mg

Tablet

Cyclobenzaprine 10 Mg

Tablet

Diclofenac Er 75 Mg

Tablet

Ibuprofen 100 Mg/5 Ml*

Suspension

Ibuprofen 400 Mg

Tablet

Ibuprofen 600 Mg

Tablet

Ibuprofen 800 Mg

Tablet

Indomethacin 25 Mg*

Capsule

Meloxicam 7.5/15 Mg

Tablet

Naproxen 375/500 Mg*

Tablet

Anti-Anxiety

Buspirone 5/10 Mg*

Tablet

Paroxetine 10/20 Mg*

Tablet

Antibiotic

Amoxicillin 125 Mg/5 Ml

Suspension

Amoxicillin 125 Mg/5 Ml

Suspension

Amoxicillin 125 Mg/5 Ml

Suspension

Amoxicillin 200 Mg/5 Ml

Suspension

Amoxicillin 200 Mg/5 Ml*

Suspension

Amoxicillin 200 Mg/5 Ml*

Suspension

Amoxicillin 250 Mg

Capsule

Amoxicillin 250 Mg/5 Ml

Suspension

Amoxicillin 250 Mg/5 Ml

Suspension

Amoxicillin 250 Mg/5 Ml

Suspension

Amoxicillin 400 Mg/5 Ml

Suspension

Amoxicillin 400 Mg/5 Ml*

Suspension

Amoxicillin 400 Mg/5 Ml*

Suspension

Amoxicillin 500 Mg

Capsule

$4 30-Day

QTY

14 30 180 120

30 30 30 60 120 90 60 30 60 30 60

60 30

80 100 150 50 75 100 30 80 100 150 50 75 100 30

$10 90-Day

QTY

42 90 540 360

90 90 90 180 360 270 180 90 180 90 180

180 90

240 300 450 150 225 300 90 240 300 450 150 225 300 90

Generic Drug Name/ Strength Cephalexin 250 Mg Cephalexin 500 Mg Ciprofloxacin 250 Mg Ciprofloxacin 500 Mg Doxycycline Hyclate 50 Mg

Doxycycline Hyclate 100 Mg

Isoniazid 300 Mg Penicillin Vk 125 Mg/5Ml Penicillin Vk 125 Mg/5 Ml Penicillin Vk 250 Mg/5 Ml Penicillin Vk 250 Mg Smz/Tmp 200/40/5 Ml* Smz/Tmp 400/80 Mg Smz/Tmp Ds 800/160 Mg

Antidepressant

Amitriptyline 10/25/50/75/100 Mg Citalopram 20/40 Mg Fluoxetine 10 Mg* Fluoxetine 10/20/40* Mg Nortriptyline 10/25 Mg Paroxetine 10/20 Mg* Trazodone 50/100/150 Mg

Antifungal

Fluconazole 150 Mg Terbinafine 250 Mg*

Anti-Inflammatory

Diclofenac Er 75 Mg Ibuprofen 100 Mg/5 Ml* Ibuprofen 400 Mg Ibuprofen 600 Mg Ibuprofen 800 Mg Indomethacin 25 Mg* Meloxicam 7.5/15 Mg Naproxen 375/500 Mg*

Form Capsule Capsule Tablet Tablet Capsule Capsule/ Tablet Tablet Solution Solution Solution Tablet Suspension Tablet Tablet

Tablet Tablet Tablet Capsule Capsule Tablet Tablet

Tablet Tablet

Tablet Suspension

Tablet Tablet Tablet Capsule Tablet Tablet

$4 30-Day

QTY 28 30 14 20 30

20

30 100 200 100 28 120 28 20

30 30 30 30 30 30 30

1 30

60 120 90 60 30 60 30 60

$10 90-Day

QTY 84 90 42 60 90

60

90 300 600 300 84 360 84 60

90 90 90 90 90 90 90

3 90

180 360 270 180 90 180 90 180

Generic Drug Name/ Strength

Form

Antipsychotic

Fluphenazine 1 Mg

Tablet

Haloperidol 0.5/1/2/5 Mg

Tablet

Lithium Carb 300 Mg*

Capsule

Thioridazine 25/50 Mg

Tablet

Thiothixene 2 Mg

Capsule

Antiviral

Acyclovir 200 Mg

Capsule

Arthritis

Diclofenac Er 75 Mg

Tablet

Ibuprofen 400 Mg

Tablet

Ibuprofen 600 Mg

Tablet

Ibuprofen 800 Mg

Tablet

Indomethacin 25 Mg*

Capsule

Meloxicam 7.5/15 Mg

Tablet

Naproxen 375/500 Mg*

Tablet

Asthma

Albuterol 2 Mg/5 Ml

Syrup

Albuterol 2 Mg

Tablet

Albuterol 4 Mg

Tablet

Albuterol Neb 0.083%*

Solution

Albuterol Neb 0.5%*

Solution

Ipratropium Neb 0.2 Mg/Ml*

Solution

Cancer/Oncology

Megestrol 20 Mg*

Tablet

Cardiac/Hypertension

Amiloride/Hctz 5-50 Mg

Tablet

Atenolol 25/50/100 Mg

Tablet

Atenolol/Chlorthal 100/25 Mg

Tablet

Benazepril 5/10/20/40 Mg

Tablet

Bisoprolol/Hctz 2.5/6.25 Mg

Tablet

Bisoprolol/Hctz 5/6.25 Mg

Tablet

Bisoprolol/Hctz 10/6.25 Mg

Tablet

Bumetanide 0.5/1 Mg

Tablet

$4 30-Day

QTY

$10 90-Day

QTY

30

90

30

90

90

270

30

90

30

90

30

90

60

180

90

270

60

180

30

90

60

180

30

90

60

180

120

360

90

270

60

180

75

225

20

60

75

225

30

90

30

90

30

90

30

90

30

90

30

90

30

90

30

90

30

90

Generic Drug Name/ Strength Captopril 12.5/25/50/100 Mg Carvedilol 3.125/6.25/12.5 Mg Carvedilol 25 Mg* Clonidine 0.1/0.2 Mg Digoxin 0.125/0.25 Mg Diltiazem 30/60/90* Mg Diltiazem 120 Mg Doxazosin 1/2/4/8 Mg Enalapril 2.5/5/10/20 Mg Enalapril/Hctz 5/12.5 Mg Furosemide 20/40/80 Mg Guanfacine 1 Mg Hydralazine 10/25 Mg Hydrochlorothiazide 12.5*/25/50 Mg Indapamide 1.25/2.5 Mg Isosorbide Mononitrate Er 30/60 Mg Lisinopril 2.5/5/10/20 Mg Lisinopril/Hctz 10-12.5 Mg Lisinopril/Hctz 20-12.5 Mg* Lisinopril/Hctz 20-25 Mg* Methyldopa 250 Mg* Methyldopa 500 Mg* Metoprolol Tartrate 25/50/100* Mg Nadolol 20/40* Mg Prazosin Hcl 1/2*/5* Mg Propranolol 10/20/40/80 Mg Sotalol Hcl 80 Mg* Spironolactone 25 Mg* Terazosin 1/2/5/10 Mg Triamterene/Hctz 37.5/25 Mg Triamterene/Hctz 75/50 Mg Verapamil 80/120 Mg Warfarin 1/2/2.5/3/4/5*/6/7.5/10 Mg

Cholesterol

Lovastatin 10/20 Mg* Pravastatin 10/20/40* Mg

Form Tablet Tablet Tablet Tablet Tablet Tablet Tablet Tablet Tablet Tablet Tablet Tablet Tablet

Capsule

Tablet

Tablet

Tablet Tablet Tablet Tablet Tablet Tablet Tablet Tablet Capsule Tablet Tablet Tablet Capsule Tablet Tablet Tablet

Tablet

Tablet Tablet

$4 30-Day

QTY 60 60 60 30 30 60 30 30 30 30 30 30 30

$10 90-Day

QTY 180 180 180 90 90 180 90 90 90 90 90 90 90

30

90

30

90

30

90

30

90

30

90

30

90

30

90

60

180

30

90

60

180

30

90

30

90

60

180

30

90

30

90

30

90

30

90

30

90

30

90

30

90

30

90

30

90

Generic Drug Name/ Strength

Diabetes

Chlorpropamide 100 Mg* Glimepiride 1/2/4 Mg Glipizide 5 Mg Glipizide 10 Mg* Glyburide 2.5/5 Mg Glyburide Micro 3/6 Mg Metformin 500/850/1000* Mg Metformin Er 500 Mg*

Ear Preparations

Antipyrine/Benzocaine

Eye Preparations

Atropine Sulfate 1%

Erythromycin 5 Mg/Gm*

Gentamicin 0.3%

Levobunolol 0.5%

Neo/Polymx/Dexamethasone 0.1% Neo/Polymx/Dexamethasone 0.1%

Pilocarpine 1%/2%

Polymyxin Sulfate/Tmp*

Sulfacetamide Sodium 10%

Timolol Maleate 0.25%/0.5%

Tobramycin 0.3%

Hormones

Estradiol 0.5/1/2 Mg Medroxyprogesterone 2.5/5 Mg Medroxyprogesterone 10 Mg

Incontinence

Oxybutynin 5 Mg*

Form

$4 30-Day

QTY

$10 90-Day

QTY

Tablet Tablet Tablet Tablet Tablet Tablet Tablet Tablet

30

90

30

90

30

90

60

180

30

90

30

90

60

180

60

180

Otic Solution 10

30

Ophthalmic

5

15

Solution

Ophthalmic

4

12

Ointment

Ophthalmic

5

15

Solution

Ophthalmic

5

15

Solution

Ophthalmic

4

12

Ointment

Ophthalmic

5

15

Suspension

Ophthalmic

15

45

Solution

Ophthalmic

10

30

Solution

Ophthalmic

15

45

Solution

Ophthalmic

5

15

SolutioN

Ophthalmic

5

15

Solution

Tablet

30

90

Tablet

30

90

Tablet

10

30

Tablet

60

180

Generic Drug Name/ Strength

Form

$4 30-Day

QTY

$10 90-Day

QTY

Muscle Relaxants

Baclofen 10 Mg

Tablet

30

90

Cyclobenzaprine 5/10 Mg

Tablet

30

90

Other

Allopurinol 100/300 Mg

Tablet

30

90

Carbamazepine 200 Mg*

Tablet

60

180

Chlorhexidine Gluconate 0.12% Solution

473

1419

Cytra-2

Solution

180

540

Phenazopyridine 100 Mg

Tablet

6

18

Phenazopyridine 200 Mg

Tablet

30

90

Prochlorperazine 10 Mg

Tablet

30

90

Parkinson's Disease

Benztropine 2 Mg

Tablet

30

90

Trihexyphenidyl 2 Mg

Tablet

60

180

Prostate/Bph

Doxazosin 1/2/4/8 Mg

Tablet

30

90

Megestrol 20 Mg*

Tablet

30

90

Prazosin Hcl 1/2*/5* Mg

Capsule

30

90

Terazosin 1/2/5/10 Mg

Capsule

30

90

Seizure/Epilepsy

Carbamazepine 200 Mg*

Tablet

60

180

Steroids

Dexamethasone 0.75 Mg

Tablet

12

36

Dexamethasone 0.5 Mg

Tablet

30

90

Dexamethasone 4 Mg

Tablet

6

18

Prednisone 2.5/5/10/20 Mg

Tablet

30

90

Stomach Disorders/Gastrointestinal

Belladonna Alkaloids/Pb

Tablet

60

180

Cimetidine 800 Mg*

Tablet

30

90

Dicyclomine 10 Mg

Capsule

90

270

Dicyclomine 20 Mg

Tablet

60

180

Famotidine 20 Mg

Tablet

60

90

Hydrocortisone Ac 25 Mg

Suppository 12

36

Lactulose 10 Gm/15 Ml

Syrup

237

711

Metoclopramide 5 Mg/5 Ml

Syrup

60

180

Metoclopramide 10 Mg

Tablet

60

180

Prochlorperazine 10 Mg

Tablet

30

90

Promethazine 25 Mg*

Tablet

12

36

Ranitidine 150 Mg

Tablet

60

180

Generic Drug Name/ Strength

Form

Ranitidine 300 Mg

Tablet

Thyroid

Levothyroxine 25/50/75/ 88/100/112/125/137/150/175 */200* Mcg

Tablet

Topical Preparations

Fluocinonide 0.05%*

Cream

Fluocinonide 0.05%*

Cream

Gentamicin 0.1%

Cream/ Ointment

Hydrocortisone 1%

Cream

Hydrocortisone 2.5%

Cream

Lidocaine Viscous 2%

Solution

Nystatin 100,000u*

Cream

Nystatin 100,000u*

Cream

Nystatin/Triamcinolone*

Cream

Nystatin/Triamcinolone*

Cream

Nystatin/Triamcinolone *

Ointment

Silver Sulfadiazine 1%*

Cream

Triamcinolone 0.025%

Cream

Triamcinolone 0.025%

Cream

Triamcinolone 0.1%

Cream/ Ointment

Triamcinolone 0.1%

Cream/ Ointment

Triamcinolone 0.5%

Cream

Tuberculosis

Isoniazid 300 Mg

Tablet

Vitamins/Supplements

Folic Acid 1 Mg

Tablet

Magnesium Oxide 400 Mg

Tablet

Mag64 64 Mg*

Tablet

Prenatal Plus*

Tablet

Sodium Fluoride 0.5 Mg*

Tablet

$4 30-Day

QTY

30

$10 90-Day

QTY

90

30

90

15

45

30

90

15

45

30

90

30

90

100

300

15

45

30

90

15

45

30

90

15

45

50

150

15

45

80

240

15

45

80

240

15

45

30

90

30

90

30

90

60

180

30

N/A

120

N/A

Generic Drug Name/ Strength

Women's Health

Alendronate Sod 35/70 Mg Clomiphene 50 Mg Sprintec 28-Day* Tamoxifen 10 Mg Tamoxifen 20 Mg Tri-Sprintec 28-Day*

Men's Health

Finasteride 5mg

Form

$9 30-Day

Qty

$24 90-Day

Qty

Tablet Tablet Tablet Tablet Tablet Tablet

4

12

5

15

28

N/A

60

180

30

90

28

N/A

Tablet

30

N/A

$4 prescriptions include up to a 30-day supply of covered drugs at commonly prescribed dosages. $10 prescriptions include up to a 90-day supply of covered drugs at commonly prescribed dosages. Physician permission may be required to change a 30-day prescription to a 90-day prescription.

*These drugs may be priced higher in CA, HI, MN, MT, PA, RI, TN, WI, and WY. Please ask your Target Pharmacist for specific pricing in these states.

This list is also available at Pharmacy

May 2012

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