trandolapril/verapamil triamterene triamterene/ hydrochlorothiazide valsartan valsartan/ hydrochlorothiazide verapamil verapamil ER Verquvo Dyslipidemics for HIGH CHOLESTEROL amlodipine/atorvastatin atorvastatin cholestyramine colesevelam
omega 3 acid pravastatin
Theo 24 theophylline tiotropium bromide Trelegy Ellipta zafirlukast zileuton ER SMOKING CESSATION bupropion, smoking cessation nicotine gum, lozenge Nicotrol Inhaler
Anoro Ellipta arformoterol, neb
Prevalite Repatha
Arnuity Ellipta Atrovent HFA Breo Ellipta Breztri budesonide ampule-neb Combivent cromolyn sodium Dupixent epinephrine injection Fasenra Pen fluticasone/salmeterol Diskus Formoterol, neb Incruse Ellipta ipratropium/albuterol (nebulizer solution) ipratropium bromide
rosuvastatin simvastatin
Hormonal agents (Parathyroid/Metabolic
bone disease) for OSTEOPOROSIS
alendronate calcitonin-salmon nasal spray Duavee ibandronate sodium raloxifene
Nicotrol NS varenicline
Selective Serotonin reuptake inhibitors for DEPRESSION
risedronate teriparatide Tymlos
colestipol ezetimibe ezetimibe/ simvastatin fenofibrate fenofibric acid fluvastatin fluvastatin ER gemfibrozil
citalopram escitalopram fluoxetine fluoxetine DR fluvoxamine fluvoxamine ER paroxetine paroxetine ER sertraline
Platelet-stimulating agents for HEMATOLOGICAL DISORDERS
levalbuterol montelukast Nucala Pulmicort Flexhaler QVAR roflumilast Serevent Diskus Stiolto Symjepi terbutaline
Doptelet Promacta PRENATAL VITAMINS Generic Rx (only) Respiratory agents for ASTHMA/COPD Advair HFA albuterol sulfate albuterol HFA
lovastatin midodrine Nexletol Nexlizet niacin ER Niacor
› For more information go to harvardpilgrim.org or call 800-848-9995
* Note: Diabetic supplies (i.e., blood glucose meters, test strips, lancets, syringes) are covered under Preventive Drug Benefit with prescription. This Preventive Drug List is not all-inclusive and is subject to change to comply with IRS guidance and as formulary updates are made. For the current Harvard Pilgrim Health Care formulary please see harvardpilgrim.org/rx . Flyer Last Updated October 8, 2024; effective 1/1/25. Harvard Pilgrim Health Care includes Harvard Pilgrim Health Care, Harvard Pilgrim Health Care of New England and HPHC Insurance Company
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