| Document Date: 2014-08-04 11:01:31
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Company Caremark Rx L.L.C. / CVS/caremark / / Facility CVS/caremark Pharmacy / CVS Caremark Mail Service Pharmacy / / IndustryTerm pharmaceutical manufacturers / certain listed products / sodium solution / generic products / / MedicalCondition ZUBSOLV Osteoarthritis / EFFIENT High Blood Pressure / Overactive Bladder / DIOVAN High Blood Pressure / TRADJENTA KAZANO Diabetes / Hives / Anaphylaxis / Hepatitis C / fluocinonide Diabetes / valacyclovir Asthma / Inhibitors FARXIGA INVOKANA Diabetes / Drug Class Formulary Drug Removals Formulary Options Allergic Reaction / Erectile Dysfunction / EPIPEN JR Allergies / QVAR Asthma / BENICAR HCT High Blood Pressure / Diabetes / NEXIUM Glaucoma / Ulcerative Colitis / PATANASE Allergies / Insulin Sensitizers ACTOS pioglitazone Diabetes / VICTOZA Diabetes / Anticholinergics TUDORZA SPIRIVA Dermatology Skin Inflammation / Inflammation / ext-rel Diabetes / VENTOLIN HFA XOPENEX HFA PROAIR HFA Asthma / / MedicalTreatment Testosterone Replacement / / Organization Therapeutics Committee / / / Product NOVOLOG / pioglitazone / VESICARE / methylprednisolone / VENTOLIN HFA / JANUMET / ASACOL / VALTREX / ARTHROTEC / valsartan / irbesartan / NEXIUM / HUMATROPE / BYETTA / ADDERALL XR / dexamethasone / simvastatin / finasteride / CLOBEX / PREVACID / acyclovir / ROZEREM / HUMALOG / tamsulosin / OMNARIS / NOVOLIN / cromolyn sodium / flunisolide / NOVOLIN N / ANDROGEL / LIALDA / sulfasalazine / meloxicam / sodium bicarbonate / FORTAMET / PROVENTIL / triamcinolone / CRESTOR / SPIRIVA / NOVOLIN R / LIPITOR / LEVITRA / EPIPEN JR / ADVICOR / TEVETEN / SIMCOR / DETROL LA / ANDRODERM / VERAMYST / AMRIX / APIDRA / omeprazole / ACTOS / naproxen / OLUX / NAPRELAN / SYMBICORT / REBIF / PROTONIX / TEVETEN HCT / AVONEX / ATACAND / RHINOCORT / RIOMET / losartan / BECONASE AQ / pantoprazole / NORDITROPIN / AVODART / fluocinonide / PULMICORT FLEXHALER / ATACAND HCT / CELEBREX / GLUMETZA / DIOVAN HCT / naloxone / ALVESCO / PATADAY / SUBOXONE / DIOVAN / telmisartan / XOPENEX HFA / PENTASA / TRICOR / HUMULIN N / VOLTAREN / BENICAR HCT / VYTORIN / OXYTROL / tolterodine / COPAXONE / clobetasol propionate / FLOVENT / desoximetasone / NOVOLOG MIX / LUNESTA / TRAVATAN Z / HUMALOG MIX / PATANOL / PROAIR HFA / NASONEX / TEV-TROPIN / TESTIM / Testosterone / BENICAR / SAIZEN / HUMULIN / CIALIS / diclofenac sodium / clopidogrel / VIAGRA / lansoprazole / ALTOPREV / PLAVIX / GENOTROPIN / EPIPEN / NORVASC / prednisone / LUMIGAN / fenofibrate / JANUVIA / HUMULIN R / valacyclovir / NUTROPIN AQ / OMNITROPE / FLECTOR / LESCOL XL / lovastatin / zolpidem / hydrochlorothiazide / / Technology Anti-infectives / / URL www.caremark.com / /
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January[removed]Formulary Drug Removals Below is a list of medicines by drug class that have been removed from your plan’s formulary. This list is effective January 1, 2015. If you continue using one of the drugs listed