2 • Unless specifically indicated, drug list products will include all dosage forms. • Log in to Caremark.com to check coverage and cost sharing information for a specific medicine. • • ANALGESICS COX-2 INHIBITORS celecoxib GOUT allopurinol colchicine probenecid NSAIDS diclofenac sodium diclofenac sodium gel 1% diclofenac sodium solution 1.5% ibuprofen meloxicam tablet naproxen (except naproxen CR or naproxen suspension) NSAIDS, COMBINATIONS diclofenac sodium-misoprostol ibuprofen-famotidine OPIOID ANALGESICS codeine-acetaminophen fentanyl transdermal hydrocodone ext-rel hydrocodone-acetaminophen hydromorphone hydromorphone ext-rel methadone morphine morphine ext-rel oxycodone oxycodone-acetaminophen tramadol (except tramadol tablet 100 mg) tramadol ext-rel tablet OPIOID PARTIAL AGONISTS buprenorphine transdermal BELBUCA ANTI-INFECTIVES ANTHELMINTICS ivermectin tablet EMVERM ANTIFUNGALS fluconazole itraconazole terbinafine tablet ANTIVIRALS acyclovir capsule, tablet oseltamivir valacyclovir valganciclovir PAXLOVID RELENZA CEPHALOSPORINS cefdinir cefprozil cefuroxime axetil cephalexin ERYTHROMYCINS/MACROLI DES azithromycin clarithromycin clarithromycin ext-rel erythromycins DIFICID FLUOROQUINOLONES ciprofloxacin levofloxacin moxifloxacin MISCELLANEOUS clindamycin linezolid metronidazole nitrofurantoin (except NDC 16571074024) pyrimethamine sulfamethoxazole- trimethoprim vancomycin capsule XIFAXAN 550 MG PENICILLINS amoxicillin amoxicillin-clavulanate dicloxacillin penicillin vk TETRACYCLINES doxycycline hyclate 20 mg doxycycline hyclate capsule minocycline tetracycline ANTINEOPLASTIC AGENTS ANTIMETABOLITES pemetrexed HORMONAL ANTINEOPLASTIC AGENTS bicalutamide CARDIOVASCULAR ACE INHIBITOR COMBINATIONS fosinopril-hydrochlorothiazide lisinopril-hydrochlorothiazide quinapril-hydrochlorothiazide ACE INHIBITORS enalapril fosinopril lisinopril quinapril ramipril ALDOSTERONE RECEPTOR ANTAGONISTS spironolactone KERENDIA ANGIOTENSIN II RECEPTOR ANTAGONIST COMBINATIONS amlodipine-olmesartan amlodipine-telmisartan amlodipine-valsartan amlodipine-valsartan- hydrochlorothiazide candesartan- hydrochlorothiazide irbesartan-hydrochlorothiazide losartan-hydrochlorothiazide olmesartan-amlodipine- hydrochlorothiazide olmesartan- hydrochlorothiazide telmisartan- hydrochlorothiazide valsartan-hydrochlorothiazide ANGIOTENSIN II RECEPTOR ANTAGONISTS candesartan irbesartan losartan olmesartan telmisartan valsartan ANTIARRHYTHMICS amiodarone disopyramide sotalol MULTAQ ANTILIPEMICS, ACL INHIBITORS/COMBINATION S NEXLETOL NEXLIZET ANTILIPEMICS, BILE ACID RESINS cholestyramine colesevelam ANTILIPEMICS, CHOLESTEROL ABSORPTION INHIBITOR ezetimibe ANTILIPEMICS, FIBRATES fenofibrate (except fenofibrate capsule 30 mg, 50 mg, 90 mg, 130 mg; fenofibrate tablet 40 mg, 120 mg) fenofibric acid delayed-rel ANTILIPEMICS, HMG-COA REDUCTASE INHIBITORS atorvastatin fluvastatin lovastatin pitavastatin pravastatin rosuvastatin simvastatin