BCBSM Maintenance Drug List!



Drugs which can be dispensed in unit quantities, or a 34-day supply, whichever is greater.

Brand Name Generic Name
ACCOLATE ZAFIRLUKAST
ACCUPRIL QUINAPRIL HCL
ADALAT CC NIFEDIPINE
ALDACTAZIDE SPIRONOLACTONE/HCTZ
ALDACTONE SPIRONOLACTONE
ALDOMET METHYLDOPA
ALTACE RAMIPRIL
ALUPENT METAPROTERENOL SULFATE
AMARYL GLIMEPIRIDE
ANAPROX NAPROXEN SODIUM
ANSAID FLURBIPROFEN
APRESOLINE HYDRALAZINE HCL
ARTANE TRIHEXYPHENIDYL HCL
BENEMID PROBENECID
BLOCADREN TIMOLOL MALEATE
BRETHINE TERBUTALINE SULFATE
BUMEX BUMETANIDE
CALAN/ISOPTIN/VERELAN VERPAMIL HCL
CAPOTEN CAPTOPRIL
CAPOZIDE CAPTOPRIL/HCTZ
CARDENE NICARDIPINE HCL
CARDIZEM DILTIAZEM HYDROCHLORIDE
CARDURA DOXAZOSIN MESYLATE
CATAPRES CLONIDINE HCL
CLINORIL SULINDAC
COGENTIN BENZTROPINE MESYLATE
COMBIPRES CLONIDONE/CHLORTHALIDONE
CORGARD NADOLOL
COZAAR LOSARTAN POTASSIUM
CRYSTODIGIN DIGITOXIN
DIABINESE CHLORPROPAMIDE
DIAMOX ACETAZOLAMIDE
DIOVAN VALSARTAN
DIURIL CHLOROTHIAZIDE
DYAZIDE/MAXZIDE HCTZ/TRIAMTERENE
DYMELOR ACETOHEXAMIDE
DYNACIRC ISRADIPINE
DYRENIUM TRIAMTERENE
EC-NAPROSYN NAPROXEN EC
ELDEPRYL SELEGILINE HCL
ENDURON METHYCLOTHIAZIDE
ESTRACE ESTRADIOL
ESTRATEST METHYLTEST.;ESTROG.;ESTD
ESTRATEST H.S. METHYLTEST,;ESTROG.;ESTD
EUTHROID/THYROLAR LIOTRIX
EXNA BENZTHIAZIDE
GLUCOPHAGE METFORMIN HYDROCHLORIDE
GLUCOTROL GLIPIZIDE
GLUCOTROL XL GLIPIZIDE
GLYNASE GLYBURIDE (MICRONIZED)
HYDRODIURIL HYDROCHLOROTHIAZIDE
HYGROTON CHLORTHALIDONE
HYTRIN TERAZOSIN HCL
INDERAL PROPRANOLOL HCL
INDERIDE PROPRANOLOL/HCTZ
INDOCIN INDOMETHACIN
ISORDIL/SORBITRATE ISOSORBIDE DINITRATE
KAON POTASSIUM GLUCONATE
KAY CIEL/SLOW K/K DUR POTASSIUM CHLORIDE
K-DUR POTASSIUM CHLORIDE
KERLONE BETAXOLOL HYDRACHLORIDE
LANOXIN DIGOXIN
LASIX FUROSEMIDE
LESCOL FLUVASTATIN SODIUM
LIPITOR ATORVASTATIN CALCIUM
LODINE ETODOLAC
LONITEN MINOXIDIL
LOPID GEMFIBROZIL
LOPRESSOR METOPROLOL TARTRATE
LOTENSIN BENAZAPRIL HYDROCHLORIDE
LOZOL INDAPAMIDE
MAVIK TRANDOLAPRIL
MEVACOR LOVASTATIN
MICRONASE/DIABETA GLYBURIDE
MIDAMOR AMILORIDE HYDROCHLORIDE
MINIPRESS PRAZOSIN HCL
MODURETIC AMILORIDE/HCTZ
MONOPRIL FOSINOPRIL/SODIUM
MOTRIN IBUPROFEN
NAPRELAN NAPROXEN SODIUM
NAPROSYN NAPROXEN
NAQUA TRICHLORMETHIAZIDE
NATURETIN BENDROFLUMETHIAZIDE
NEPTAZENE METHAZOLAMIDE
NITROBID/NITROSTAT NITROGLYCERIN
NORMODYNE/TRANDATE LABETALOL HYDROCHLORIDE
NORPACE DISOPYRAMIDE PHOSPHATE
NORVASC AMOLDIPINE BESYLATE
OGEN/ORTHO-EST ESTROPIPATE
ORINASE TOLBUTAMIDE
PAVABID PAPAVERINE HYDROCHLORIDE
PERSATINE DIPYRIDAMOLE
PLENDIL FELODIPINE
PRAVACHOL PRAVASTATIN SODIUM
PREMARIN/ESTRATAB ESTROGENS (CONJ OR ESTD)
PREMARIN E/METHYLTEST METHYLTEST.ESTROG., CONJ
PREMPHASE ESTROGEN, CON/M-PROGEST ACET
PREMPRO ESTROGEN,CON/M-PROGREST
PROCAN/PRONESTYL PROCAINAMIDE HCL
PROCARDIA /PROCARDIA XL NIFEDIPINE
PROVENTIL/VENTOLIN ALBUTEROL SULFATE
PROVERA MEDROXYPROGEST.ACETATE
QUINAGLUTE QUINIDINE GLUCONATE
QUINIDEX QUINIDINE SULFATE
RELAFEN NABUMETONE
RENESE POLYTHIAZIDE
SECTRAL ACEBUTOLOL HYDROCHLORIDE
SER-AP-ES HCTZ/HYDRALAZINE/RESERPINE
SERPASIL RESERPINE
SINEMET CARBIDOPA/LEVODOPA
SINGULAIR MONTELUKAST SODIUM
SULAR NISOLDIPINE
TENEX GUANFACINE HCL
TENORETIC ATENOLOL/CHLORTHALIDONE
TENORMIN ATENOLOL
THEO-24 THEOPHYLLINE ANHYDROUS
THEODUR/SLOPHYLLIN THEOPHYLLINE ANHYDROUS
TIAZAC DILTIAZEM HYDROCHLORIDE
TIMOPTIC TIMOLOL MALEATE
TOLINASE TOLAZAMIDE
TOPROL XL METOPROLOL SUCCINATE
UNIVASC MOEXIPRIL HYDROCHLORIDE
VASORETIC ENALAPRIL MALEATE/HCTZ
VASOTEC ENALAPRIL MALEATE
VICKEN PINDOLOL
VOLTAREN DICLOFENAC SODIUM
ZAROXOLYN METOLAZONE
ZEBETA BISOPROLOL FUMARATE
ZESTORETIC/ PRINZIDE LISINOPRIL/HCTZ
ZESTRIL/PRINIVIL LISINOPRIL
ZOCOR SIMVASTATIN
ZYLOPRIM ALLOPURINOL


Drugs which can be dispensed in 200 unit quantities or a 34-day supply, whichever is greater.

Brand Name Generic Name
ARMOUR THYROID THYROID
CYTOMEL LIOTHYRONINE SODIUM
DILANTIN PHENYTOIN SODIUM
IHN ISONIAZID
LEVOTHROID/SYNTHROID LEVOTHTROXINE SODIUM
MYSOLINE PRIMIDONE
PAS PARA-AMINOSALICYLIC ACID
PTU PROPYLTHIOURACIL


Flu Medications Covered

  Relenza® and Tamiflu® are two new products recently approved for the treatment of influenza. Each of these drugs is used to treat uncomplicated acute illness due to influenza that has been symptomatic for no more than two days. These products are not approved for preventing the flu.

  BCBSM members with prescription drug coverage may obtain 1 kit of Relenza® or 10 capsules of Tamiflu® per prescription, which covers five days of therapy. The members regular prescription drug co-payment will apply. Neither Relenza® nor Tamiflu® will be available through the mail order prescription drug program because therapy must be initiated within the first two days of the onset of flu-like symptoms for it to be effective.