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Preventive medications
In addition to supporting a healthy lifestyle, preventive medications can
help people avoid many illnesses and conditions. HDHP options that
include preventive medications can help achieve the goal of ongoing good
health. For ConocoPhillips participants who enroll in the HDHP option is
coverage for certain preventive prescription drugs (treating, for example,
high cholesterol, hypertension, and other ailments). For ConocoPhillips
participants who enroll in the HDHP option, coverage is provided for
certain preventive prescription drugs. Participants will be reimbursed at
100 percent, up to $1,500 per person per year. A more extensive list of
the preventive prescription drugs will be available at hr.conocophillips.com
under the HDHP Web page for current employees. If you have any
questions regarding this benefit, you may also contact Medco Member
Services at 1 800 770-2810 or go online to www.medco.com.
This list provides examples of the HDHP medical option’s preventivemedications by drug category. This is not an all-inclusive list. Medicationsmay be added to or removed from the list depending on different factors,including the intended purpose(s) of the medication and medicationavailability.
Some of the prescription drugs on this list are considered alwayspreventive while others are considered sometimes preventive but mayalso be prescribed for the treatment of an existing condition. The $1,500preventive prescription drug allowance that ConocoPhillips provides isapplicable only to medications that are prescribed for prevention and notfor treating a diagnosed condition. Please call Medco to confirm thatyour medication is on the preventive medication list.
Medications on this list that are not covered under your plan
are not eligible for the preventive medications program.
Preventive medications list
This list includes both medications used always for prevention and
medications used sometimes for prevention and sometimes for treatment.
Drug category
Examples of products
Anticoagulants/
• aspirin/dipyridamole (Aggrenox ®) antiplatelets
• warfarin (Coumadin ®, Jantoven ®) Antiemetics/
antivertigo agents
• ondansetron (Zofran ®, Zofran ODT ®) • prochlorperazine (Compazine ®) • scopolamine (Transderm Scop ®; Scopace ®) Antiestrogens
Antihypertensives
• ACE inhibitors: benazepril (Lotensin ®); benazepril-HCTZ (Lotensin HCT ®); captopril(Capoten ®); captopril-HCTZ (Capozide ®);enalapril (Vasotec ®); enalapril-HCTZ (Vaseretic ®); fosinopril (Monopril ®); fosinopril-HCTZ (Monopril-HCT ®); lisinopril(Prinivil ®, Zestril ®); lisinopril-HCTZ (Prinzide ®,Zestoretic ®); moexipril (Univasc ®); moexipril-HCTZ (Uniretic ®); perindopril (Aceon ®); quinapril (Accupril ®); quinapril-HCTZ(Accuretic ®); ramipril (Altace ®); trandolapril(Mavik ®) Drug category
Examples of products
Antihypertensives
• Angiotensin II receptor blockers: eprosartan (continued)
(Teveten ®); eprosartan-HCTZ (Teveten HCT ®);losartan (Cozaar ®); losartan-HCTZ (Hyzaar ®);telmisartan (Micardis ®); telmisartan-HCTZ(Micardis HCT ®); valsartan (Diovan ®); valsartan-HCTZ (Diovan HCT ®) • Beta blockers: acebutolol (Sectral ®); atenolol (Tenormin ®); atenolol-chlorthalidone (Tenoretic ®); betaxolol(Kerlone ®); bisoprolol (Zebeta ®); bisoprolol-HCTZ (Ziac ®); carteolol (Cartrol ®);labetalol (Normodyne ®, Trandate ®);metoprolol (Lopressor ®, Toprol-XL ®);metoprolol-HCTZ (Lopressor HCT ®,Dutoprol™); nadolol (Corgard ®); nadolol-bendroflumethiazide (Corzide ®);penbutolol (Levatol ®); pindolol (Visken ®);propranolol (Inderal ®, Inderal ® LA, InnoPran XL ®); timolol (Blocadren ®); timolol-HCTZ (Timolide ®) (Norvasc ®); bepridil (Vascor ®); diltiazem(Cardizem ®, Cardizem ® CD, Cardizem ® SR,Cartia XT ®, Tiazac ®); felodipine (Plendil ®);isradipine (DynaCirc ®, DynaCirc CR ®);nicardipine (Cardene ®, Cardene ® SR);nifedipine (Adalat ®, Adalat ® CC, Procardia ®, Procardia XL ®); nisoldipine(Sular ®); verapamil (Calan ®, Calan ® SR,Covera-HS ®, Isoptin SR ®, Verelan ®, Verelan PM ®) • Miscellaneous antihypertensives: aliskiren (Tekturna ®); carvedilol (Coreg ®, Coreg CR ®); clonidine (Catapres ®); clonidine-chlorthalidone (Combipres ®, Clorpres ®);doxazosin (Cardura ®); enalapril-felodipine(Lexxel ®); hydralazine (Apresoline ®);methyldopa (Aldomet ®); Drug category
Examples of products
Antihypertensives
methyldopa-chlorothiazide (Aldoclor ®); (continued)
methyldopa-HCTZ (Aldoril ®); prazosin(Minipress ®);prazosin-polythiazide (Minizide ®); trandolapril-verapamil (Tarka ®); amlodipine/benazepril (Lotrel ®);amlodipine/valsartan (Exforge ®); • Thiazide diuretics and related diuretics: amiloride (Midamor ®); amiloride-HCTZ(Moduretic ®); eplerenone (Inspra ®);hydrochlorothiazide (HydroDIURIL ®, Esidrix ®); indapamide (Lozol ®); metolazone(Zaroxolyn ®); spironolactone (Aldactone ®);spironolactone-HCTZ (Aldactazide ®);terazosin (Hytrin ®); triamterene (Dyrenium ®); triamterene-HCTZ (Dyazide ®, Maxzide ®) Anti-infectives
• pentamidine (NebuPent ®, Pentam ®) Antimalarials
• atovaquone/proguanil (Malarone ®) • hydroxychloroquine (Plaquenil ®) • pyrimethamine-sulfadoxine (Fansidar ®) Anti-ulcer agents
• H2-antagonists: cimetidine (Tagamet ®); famotidine (Pepcid ®); nizatidine (Axid ®);ranitidine (Zantac ®) (Cytotec ®); sucralfate (Carafate ®) (Nexium ®); omeprazole (Prilosec ®) Drug category
Examples of products
Antivirals
• acyclovir tablets (Zovirax ®) Asthma therapies
Bowel evacuant
• polyethylene glycaol 3350 combination products
products (Colyte®, GoLYTELY®, HalfLytely®,NuLYTELY®, TriLyte®, MoviPrep® • sodium phoshate salts (Visicol®, Osmoprep®) replacement
products
Cancer (adjunctive
• dexrazoxane (Zinecard ®, Totect ™) • epoetin alfa (Epogen ®, Procrit ®) Cholesterol-
• atorvastatin/amlodipine (Caduet ®) lowering agents
• cholestyramine (LoCholest ®; Prevalite ®; Questran ®; Questran ® Light) Drug category
Examples of products
Cholesterol-
lowering agents
• ezetimibe/simvastatin (Vytorin ®) (continued)
• fenofibrate (Antara ®, Lofibra ®, TriCor ®) • HMG-coA reductase inhibitors: atorvastatin (Lipitor ®); fluvastatin (Lescol ®, Lescol ® XL); Lovastatin (Mevacor ®, Altocor ®); pravastatin (Pravachol ®); rosuvastatin(Crestor ®); simvastatin (Zocor ®) • niacin (Niacor ®, Niaspan ®); niacin/lovastatin • omega-3-acid ethyl esters (Omacor ®)• Trilipix® Contraceptives,
• intravaginal system (NuvaRing ®) non-oral
• transdermal system (Ortho Evra ®) Contraceptives,
• Estrostep Fe ®• Lybrel ®• Ortho Tri-Cyclen ®• Ortho Tri-Cyclen ® Lo• Ovcon ®• Seasonale ®• TriNessa ®• Trivora ®• Yasmin ®• Seasonique ®• YAZ ® Dental aids
• minocycline (Arestin ®)• tetracycline (Actisite ®) Estrogen
• conjugated estrogens, tablets (Premarin ®) replacement
• esterified estrogens/methyltestosterone products
(Estratest ®, Estratest ® H.S., Syntest™ DS,Syntest™ HS) Drug category
Examples of products
Estrogen
• estradiol (Alora ®, Climara ®, Esclim ®, replacement
Estrace ® tablets, Estraderm ®, Vivelle ®) products
• estradiol gel (Estrogel ®, Elestrin™, Divigel ®) (continued)
• estradiol acetate (Femtrace ®, Femring ®)• estradiol/levonorgestrel (Climara Pro ®)• estradiol/norethindrone (Activella ®, • estradiol/norgestimate (Ortho-Prefest ®)• estrogen/medroxyprogesterone • ethinyl estradiol/norethindrone (Femhrt ®)• synthetic conjugated estrogens, A Fluoride
preparations, oral
and topical
Heparin/low
molecular weight
heparin products
• low-molecular-weight heparin: dalteparin (Fragmin ®); enoxaparin (Lovenox ®);fondaparinux (Arixtra ®); tinzaparin (Innohep ®) Iron replacement
(prescription only)
Drug category
Examples of products
Magnesium
replacement
products
(prescription only)
Miscellaneous
• hepatitis B immune globulin (HepaGam B™) Osteoporosis
alendronate/cholecalciferol (Fosamax Plus D™) • calcitonin (Fortical ®, Miacalcin ®) Phosphate/
potassium
replacement
• potassium chloride (K-Dur ®, K-Tab ®, products
Klotrix ®, Klor-Con ®, Slow-K ®) • potassium gluconate• potassium phosphate (Neutra-Phos ® K)• potassium and sodium phosphate (K-Phos ® Neutral, Neutra-Phos ®) Prenatal vitamins
• Natachew ®• Natafort ®• Natelle ®• PreCare ®• Prenatal Plus ®, Prenatal RX™• PrimaCare ®• Vitafol-OB™ Prescription
vitamins
• multivitamin w/fluoride• Strovite Advance ®, Strovite Plus ®• Theragran ®• Therobec™, Therobec Plus™ Drug category
Examples of products
Progestins
• medroxyprogesterone (Amen ®, Cycrin ®, Depo-Provera ®, Provera ®) • progesterone, micronized (Crinone ®, Prochieve ®, Prometrium ®) Renal disease
Smoking-cessation
products
• nicotine products (Nicotrol® Inhaler, (prescription only)
Vitamin A
products
Vitamin B
products
Vitamin B1
products
Vitamin B6
products
Vitamin B12
products
• cyanocobalamin/folic acid (Foltrate®) Vitamin D
products
• dihydrotachysterol (DHT™, Hytakerol ®) Vitamin K
products
Vitamins with
folic acid
Drug category
Examples of products
Weight-loss
agents (Prior
authorization may
be required)
• phendimetrazine (Bontril® PDM, Bontril® Slow-Release, Melfiat®-105, Prelu-2 ®) • phendimetrazine (Adipex-P®, Ionamin ®) Zinc replacement
products
Abbreviations: HCTZ = hydrochlorothiazide ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Medco Health Solutions, Inc., manages your prescription drug benefit for
your employer or health plan.
www.medco.com
Medco is a registered trademark of Medco Health Solutions, Inc.
All other trademarks are the property of their respective owners.
2010 Medco Health Solutions, Inc. All rights reserved.

Source: http://hrcpdocctr.conocophillips.com/Documents/2011%20Health%20and%20Welfare/HDHP/Preventive%20Medications%20Drug%20List%20Summary%20-%20Short%20List.pdf