Allergy & Asthma
*Due to state laws, these drugs are not covered under the 30-day program in MN and WI; however, they have been competitively priced. Please ask your pharmacist for specific pricing in these states.
†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. List subject to change.
| GENERIC NAME | BRAND NAME | QTY | FORM |
| ALBUTEROL 2MG/5ML | PROVENTIL® | 120 | SYRUP |
| *† ALBUTEROL 2MG | PROVENTIL® | 90 | TABLET |
| *† ALBUTEROL 4MG | PROVENTIL® | 60 | TABLET |
| ALBUTEROL NEBULIZER 0.50% | PROVENTIL® | 20 | SOLUTION |
| ALBUTEROL SULFATE NEBULIZER 0.08% | PROVENTIL® | 75 | SOLUTION |
| CYPROHEPTADINE 4MG | PERIACTIN® | 30 | TABLET |
| DIPHENHYDRAMINE HCL 50MG | BENADRYL® | 30 | CAPSULE |
| † IPRATROPIUM BROMIDE NEBULIZER 0.02% | ATROVENT® | 75 | SOLUTION |
| *† LORATADINE 5MG/5ML | CLARITIN® | 120 | SYRUP |
| LORATADINE 10MG | CLARITIN® | 30 | TABLET |
| PROMETHAZINE 6.25MG/5ML | PHENERGAN® | 120 | SYRUP |
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