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BCBSNC Medication DedicationSM Copay Waiver Drug List (2007)*
DRUGS TO TREAT HIGH BLOOD PRESSURE AND OTHER CARDIOVASCULAR CONDITIONS
AMILORIDE/HYDROCHLOROTHIAZIDE (Generic for Moduretic) BISOPROLOL FUMARATE (Generic for Zebeta) LABETOLOL (Generic for Trandate, Normodyne) METOPROLOL SUCCINATE (Generic for Toprol XL) DIURETICS
METOPROLOL TARTRATE (Generic for Lopressor) SPIRONOLACTONE/HYDROCHLOROTHIAZIDE (Generic for Aldactazide) PROPRANOLOL EXTENDED-RELEASE (Generic for Inderal LA) TRIAMTERENE/HYDROCHLOROTHIAZIDE (Generic for Dyazide, Maxzide)
AMLODIPINE BESYLATE (Generic for Norvasc)
DOXAZOSIN MESYLATE (Generic for Cardura) DILTIAZEM EXTENDED-RELEASE (Generic for Cardizem CD, Cardizem SR, Dilacor XR, Tiazac) GUANABENZ ACETATE (Generic for Wytensin) NIFEDIPINE (Generic for Procardia, Adalat) YPERTENSIVES
NIFEDIPINE EXTENDED-RELEASE (Generic for Procardia XL, Adalat CC) ANTI TERAZOSIN (Generic for Hytrin)
VERAPAMIL EXTENDED-RELEASE (Generic for Calan SR, Isoptin SR, Verelan, Verelan PM) *Please note this list is subject to change based on safety considerations and availability of new medications. PO Box 2291 • Durham, NC 27702-2291 • www.bcbsnc.com An Independent Licensee of the Blue Cross and Blue Shield Association BCBSNC Medication DedicationSM Copay Waiver Drug List (2007)*
DRUGS TO TREAT HIGH BLOOD PRESSURE AND OTHER CARDIOVASCULAR CONDITIONS
AMLODIPINE/BENAZEPRIL (Generic for Lotrel) – not all strengths ATENOLOL/CHLORTHALIDONE (Generic for Tenoretic) BENAZEPRIL/HYDROCHLOROTHIAZIDE (Generic for Lotensin HCT) FOSINOPRIL SODIUM (Generic for Monopril) BISOPROL/HYDROCHLOROTHIAZIDE (Generic Generic for Ziac) LISINOPRIL (Generic for Zestril, Prinivil) CAPTOPRIL/HYDROCHLOROTHIAZIDE (Generic for Capozide) CLONIDINE HCL/CHLORTHALIDONE (Generic for Combipres) ENALAPRIL/HYDROCHLOROTHIAZIDE (Generic for Vaseretic) FOSINOPRIL/HYDROCHLOROTHIAZIDE (Generic for Monopril HCT) HYPERTENS
HYDRALAZINE/RESERPINE/HCTZ LISINOPRIL/HYDROCHLOROTHIAZIDE (Generic for Zestoretic, Prinzide) METHYLDOPA/HYDROCHLOROTHIAZIDE (Generic for Aldoril) METOPROL/HYDROCHLOROTHIAZIDE (Generic for Lopressor HCT) MOEXIPRIL/HYDROCHLOROTHIAZIDE (Generic for Uniretic) NADOLOL/BENDROFLUMETHIAZIDE (Generic for Corzide) PROPRANOLOL/HYDROCHLOROTHIAZIDE (Generic for Inderide) QUINAPRIL/HYDROCHLOROTHIAZIDE (Generic for Accuretic) *Please note this list is subject to change based on safety considerations and availability of new medications. PO Box 2291 • Durham, NC 27702-2291 • www.bcbsnc.com An Independent Licensee of the Blue Cross and Blue Shield Association BCBSNC Medication DedicationSM Copay Waiver Drug List (2007)*
DRUGS TO TREAT DIABETES
DRUGS TO TREAT HIGH CHOLESTEROL
CHOLESTYRAMINE/SUCROSE (Generic for Questran) CHOLESTYRAMINE/ASPARTAME (Generic for Locholest Light, Questran GLIPIZIDE/METFORMIN (Generic for Metaglip) FENOFIBRATE MICRONIZED (Generic for Lofibra) GLYBURIDE (Generic for Micronase, Diabeta) GLYBURIDE,MICRONIZED (Generic for Glynase, Glycron) RING AGEN
DIABETES
GLYBURIDE/METFORMIN Generic for Glucovance) PRAVASTATIN SODIUM (Generic for Pravachol) ORAL AGENTS FOR
METFORMIN ER (Generic for Glucophage XR) LIPID/CHOLESTEROL
*Please note this list is subject to change based on safety considerations and availability of new medications. PO Box 2291 • Durham, NC 27702-2291 • www.bcbsnc.com An Independent Licensee of the Blue Cross and Blue Shield Association

Source: http://www.duplincountync.com/pdfs/medication_dedication_copay_waive_drug_list.pdf

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