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† SMZ/TMP PEDIATRIC 200-40MG/5ML ANtiFuNgAl
generic Name
Brand Name Qty Form
Allergy & AsthmA
generic Name
Brand Name Qty Form
ANtivirAl
generic Name
Brand Name Qty Form
Arthritis & PAiN
generic Name
Brand Name Qty Form
ANtiBiotics
generic Name
Brand Name Qty Form
AMOXICILLIN PEDIATRIC 50MG/ML AMOXIL® GAstrointestinAl HeAltH continued. cholesterol
generic Name
Brand Name Qty Form
cough & cold
generic Name
Brand Name Qty Form
heArt heAlth
DEC-CHLORPHEN DM 3.5-1-3MG/ML RONDEC DM® 30 generic Name
Brand Name Qty Form
diABetes
generic Name
Brand Name Qty Form
eye & eAr
generic Name
Brand Name Qty Form
ENALAPRIL MALEATE/HCTZ 10-25MG VASERETIC® gAstroiNtestiNAl heAlth
generic Name
Brand Name Qty Form
HYDROCHLOROTHIAZIDE 12.5MG MICROZIDE® 30 HYDROCHLOROTHIAZIDE 25MG HYDRODIURIL® 30 HYDROCHLOROTHIAZIDE 50MG HYDRODIURIL® 30 *†ISOSORBIDE MONO ER 30MG IMDUR® *†ISOSORBIDE MONO ER 60MG IMDUR® *† HYDROXYZINE HCL 10MG/5ML ATARAX® HYDROXYZINE PAMOATE 25MG VISTARIL® HYDROXYZINE PAMOATE 50MG VISTARIL® METOPROLOL TARTRATE 25MG LOPRESSOR® 60 METOPROLOL TARTRATE 50MG LOPRESSOR® 60 METOPROLOL TARTRATE 100MG LOPRESSOR® 60 *†NITROGLYCERIN SUBLINGUAL 0.3MG NITROSTAT® *†NITROGLYCERIN SUBLINGUAL 0.4MG NITROSTAT® generic Name
Brand Name Qty Form
CHLORHEXIDINE GLUCONATE 0.12% PERIDEX® METHYLPREDNISOLONE DOSEPAK 4MG MEDROL® *† PREDNISONE DOSEPACK 5MG STERAPRED® 48 *† PREDNISONE DOSEPACK 10MG STERAPRED DS® 21 *† PREDNISONE DOSEPACK 10MG STERAPRED DS® 48 SODIUM FLUORIDE DENTAL 5000 PREVIDENT skiN coNditioNs
generic Name
Brand Name Qty Form
BETAMETHASONE DIPROPIONATE 0.05% DIPROSONE® BETAMETHASONE DIPROPIONATE 0.05% DIPROSONE® BETAMETHASONE VALERATE 0.10% VALISONE® meNtAl heAlth
BETAMETHASONE VALERATE 0.10% VALISONE® generic Name
Brand Name Qty Form
BETAMETHASONE VALERATE 0.10% VALISONE® BETAMETHASONE VALERATE 0.10% VALISONE® *†FLUOCINOLONE ACETONIDE 0.01% SYNALAR® †CARBAMAZEPINE CHEWABLE 100MG TEGRETOL® generic Name
Brand Name Qty Form
vitAmiNs & suPPlemeNts
generic Name
Brand Name Qty Form
CYANOCOBALAMIN 1000MCG/ML VITIAMIN B12 INJ® 10 MULTI-VITAMIN/FL CHEWABLE 0.25MG POLY-VI-FLOR® 30 MULTI-VITAMIN/FL CHEWABLE 0.5MG POLY-VI-FLOR® 30 MULTI-VITAMIN/FL CHEWABLE 0.5MG POLY-VI-FLOR FE® 30 MULTI-VITAMIN/FL CHEWABLE 1MG POLY-VI-FLOR® 30 MULTI-VITAMIN/FL/FE CHEWABLE 1MG POLY-VI-FLOR® 30 POTASSIUM CHLORID CR 8MEQ SLOW-K® POTASSIUM CHLORIDE CR 10MEQ K-DUR® POTASSIUM CHLORIDE CR 20MEQ K-DUR® SODIUM FLUORIDE CHEWABLE 0.25MG LURIDE® SODIUM FLUORIDE CHEWABLE 0.5MG LURIDE® SODIUM FLUORIDE CHEWABLE 1MG LURIDE® WomeN’s heAlth
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Brand Name Qty Form
MEDROXYPROGESTERONE 2.5MG PROVERA® MEDROXYPROGESTERONE 5MG PROVERA® MEDROXYPROGESTERONE 10MG PROVERA® *Due to state laws, these drugs are not covered under the 30-day program in MN and WI; however, they have been competitively priced. †Due to state laws, these drugs are not covered under the 90-day program in MN and WI; however, they have been competitively priced. Please ask your pharmacist for specific pricing in these states. $4 prescriptions are for up to a 30-day supply at commonly prescribed dosages. Drug list subject to change. This list was created on 6-9-09. Please visit our website at www.hy-veepharmacy.com for a current list of affected

Source: http://www.augie.edu/hr/employees/forms/Hy-Vee%20List%202009.pdf