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Select Generic Medications
at Commonly Prescribed Dosages
Simply bring in your prescription and your Giant Eagle Advantage Card® to a Giant Eagle
Pharmacy®.
Note: Prescription required. Not all dosage strengths and forms apply. Supply based on
commonly prescribed dosing. Prescription required to convert from a 30-day to a 90-day supply.
This list is not intended to be a recommendation for a particular prescription drug nor a
substitute for a discussion with your physician about the proper prescription drug for you. If you
have any questions, you should contact your physician. Eligible drug list is subject to change.
Free antibiotics available with a valid prescription on qualifying medications for a limited time
through 2/28/14.
State*:
Ohio
Medication Type:
Generic Name:
Brand Name:
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Type of
Medicatio
n
Generic Name
Brand
Name
Strength Form
30-D
ay
Qty
30-D
ay
Pric
e
90-D
ay
Qty
90-D
ay
Pric
e
Allergy &
Asthma ALBUTEROL
PROVENTI
L®
2MG/5M
L SYRUP 120 $4 360 $10
Allergy &
Asthma
ALBUTEROL
NEBULIZER
PROVENTI
L® 0.5%
SOLUTIO
N 20 $4 60 $10
Allergy &
Asthma
ALBUTEROL
SULFATE
NEBULIZER
PROVENTI
L® 0.083%
SOLUTIO
N 75 $4 225 $10
Allergy &
Asthma
IPRATROPIUM
BROMIDE NEB
ATROVEN
T® 0.02%
SOLUTIO
N 75 $4 225 $10
Allergy &
Asthma LORATADINE
CLARITIN
® 10MG TABLET 30 $4 90 $10
Antibiotic
s AMOXICILLIN AMOXIL®
400MG/5
ML
SUSPENSI
ON 50 $0 150 $0
Antibiotic
s AMOXICILLIN AMOXIL®
400MG/5
ML
SUSPENSI
ON 100 $0 300 $0
Antibiotic
s AMOXICILLIN AMOXIL®
250MG/5
ML
SUSPENSI
ON 80 $0 240 $0
Antibiotic
s AMOXICILLIN AMOXIL® 250MG CAPSULE 42 $0 90 $0
Antibiotic
s AMOXICILLIN AMOXIL® 500MG CAPSULE 42 $0 90 $0
Antibiotic
s AMOXICILLIN AMOXIL® 875MG TABLET 28 $0 84 $0
Antibiotic
s AMOXICILLIN AMOXIL®
125MG/5
ML
SUSPENSI
ON 80 $0 240 $0
Antibiotic
s AMOXICILLIN AMOXIL®
125MG/5
ML
SUSPENSI
ON 100 $0 300 $0
Antibiotic
s AMOXICILLIN AMOXIL®
125MG/5
ML
SUSPENSI
ON 150 $0 450 $0
Antibiotic
s AMOXICILLIN AMOXIL®
200MG/5
ML
SUSPENSI
ON 75 $0 225 $0
Antibiotic
s AMOXICILLIN AMOXIL®
200MG/5
ML
SUSPENSI
ON 50 $0 150 $0
Antibiotic
s AMOXICILLIN AMOXIL®
250MG/5
ML
SUSPENSI
ON 150 $0 450 $0
Antibiotic
s AMOXICILLIN AMOXIL®
250MG/5
ML
SUSPENSI
ON 100 $0 300 $0
Antibiotic
s
AMOXICILLIN
CHEWABLE AMOXIL® 125MG TABLET 42 $0 126 $0
Antibiotic
s
AMOXICILLIN
CHEWABLE AMOXIL® 250MG TABLET 42 $0 90 $0
Antibiotic
s
AMOXICILLIN
PEDIATRIC AMOXIL®
50MG/M
L DROP 30 $4 90 $10
Antibiotic
s AMPICILLIN
PRINCIPEN
® 250MG CAPSULE 56 $0 120 $0
Antibiotic
s AMPICILLIN
PRINCIPEN
® 500MG CAPSULE 56 $0 120 $0
Antibiotic
s CEPHALEXIN KEFLEX® 250MG CAPSULE 42 $0 120 $0
Antibiotic
s CEPHALEXIN KEFLEX®
125MG/5
ML
SUSPENSI
ON 100 $0 300 $0
Antibiotic
s CEPHALEXIN KEFLEX®
250MG/5
ML
SUSPENSI
ON 100 $0 300 $0
Antibiotic
s CEPHALEXIN KEFLEX® 500MG CAPSULE 42 $0 120 $0
Antibiotic
s
CHLORHEXIDINE
GLUCONATE PERIDEX® 0.12%
SOLUTIO
N 480 $4 1440 $10
Antibiotic
s CIPROFLOXACIN CIPRO® 500MG TABLET 28 $0 60 $0
Antibiotic
s CIPROFLOXACN CIPRO® 750MG TABLET 28 $0 60 $0
Antibiotic
s CIPROFLOXACN CIPRO® 250MG TABLET 28 $0 60 $0
Antibiotic
s ERYTHROMYCIN
ILOTYCIN
®
OPHTHA
LMIC
OINTMEN
T
4 $4 12 $10
Antibiotic
s GENTAMICIN
GARAMYC
IN® 0.1% CREAM 15 $4 45 $10
Antibiotic
s GENTAMICIN
GARAMYC
IN® 0.1%
OINTMEN
T 15 $4 45 $10
Antibiotic
s ISONIAZID
NYDRAZID
® 300MG TABLET 30 $4 90 $10
Antibiotic
s PENICILLIN VK
V-CILLIN
K®
125MG/5
ML
SUSPENSI
ON 200 $0 600 $0
Antibiotic
s PENICILLIN VK
V-CILLIN
K®
250MG/5
ML
SUSPENSI
ON 100 $0 300 $0
Antibiotic
s PENICILLIN VK
V-CILLIN
K®
250MG/5
ML
SUSPENSI
ON 200 $0 600 $0
Antibiotic
s PENICILLIN VK
V-CILLIN
K® 500MG TABLET 56 $0 120 $0
Antibiotic
s PENICILLIN VK
V-CILLIN
K®
125MG/5
ML
SUSPENSI
ON 100 $0 300 $0
Antibiotic
s PENICILLIN VK VEETIDS® 250MG TABLET 56 $0 120 $0
Antibiotic
s
SILVER
SULFADIAZINE
SILVADEN
E® 1% CREAM 50 $4 150 $10
Antibiotic
s SMZ / TMP BACTRIM®
400-
80MG TABLET 28 $0 84 $0
Antibiotic
s SMZ / TMP DS
BACTRIM
DS®
800-
160MG TABLET 28 $0 60 $0
Antibiotic
s
SMZ / TMP
PEDIATRIC
BACTRIM
PED®
200-
40MG/5
ML
SUSPENSI
ON 200 $0 360 $0
Antifungal FLUCONAZOLE DIFLUCAN
® 150MG TABLET 1 $4 3 $10
Antifungal NYSTATIN MYCOSTA
TIN® 100000U
SUSPENSI
ON 60 $4 180 $10
Antifungal NYSTATIN NILSTAT® 100000U CREAM 15 $4 45 $10
Antifungal NYSTATIN NILSTAT® 100000U CREAM 30 $4 90 $10
Antiviral ACYCLOVIR ZOVIRAX® 200MG CAPSULE 30 $4 90 $10
Arthritis
& Pain ALLOPURINOL
ZYLOPRIM
® 300MG TABLET 30 $4 90 $10
Arthritis
& Pain ALLOPURINOL
ZYLOPRIM
® 100MG TABLET 30 $4 90 $10
Arthritis
& Pain BACLOFEN
LIORESAL
® 10MG TABLET 30 $4 90 $10
Arthritis
& Pain
CYCLOBENZAPRI
NE
FLEXERIL
® 5MG TABLET 30 $4 90 $10
Arthritis
& Pain
CYCLOBENZAPRI
NE
FLEXERIL
® 10MG TABLET 30 $4 90 $10
Arthritis
& Pain
DEXAMETHASON
E
DECADRO
N® 4MG TABLET 6 $4 18 $10
Arthritis
& Pain
DEXAMETHASON
E
DECADRO
N® 0.75MG TABLET 12 $4 36 $10
Arthritis
& Pain
DEXAMETHASON
E
DECADRO
N® 0.5MG TABLET 30 $4 90 $10
Arthritis
& Pain DICLOFENAC
VOLTARE
N® 75MG TABLET 60 $4 180 $10
Arthritis
& Pain IBUPROFEN MOTRIN® 800MG TABLET 30 $4 90 $10
Arthritis
& Pain IBUPROFEN MOTRIN®
100MG/5
ML
SUSPENSI
ON 120 $4 360 $10
Arthritis
& Pain IBUPROFEN MOTRIN® 400MG TABLET 90 $4 270 $10
Arthritis
& Pain IBUPROFEN MOTRIN® 600MG TABLET 60 $4 180 $10
Arthritis
& Pain INDOMETHACIN INDOCIN® 25MG CAPSULE 60 $4 180 $10
Arthritis
& Pain MELOXICAM MOBIC® 7.5MG TABLET 30 $4 90 $10
Arthritis
& Pain MELOXICAM MOBIC® 15MG TABLET 30 $4 90 $10
Arthritis NAPROXEN NAPROSY 500MG TABLET 60 $4 180 $10
& Pain N®
Arthritis
& Pain NAPROXEN
NAPROSY
N® 375MG TABLET 60 $4 180 $10
Cholestero
l LOVASTATIN
MEVACOR
® 10MG TABLET 30 $4 90 $10
Cholestero
l LOVASTATIN
MEVACOR
® 20MG TABLET 30 $4 90 $10
Cholestero
l PRAVASTATIN
PRAVACH
OL® 40MG TABLET 30 $4 90 $10
Cholestero
l PRAVASTATIN
PRAVACH
OL® 10MG TABLET 30 $4 90 $10
Cholestero
l PRAVASTATIN
PRAVACH
OL® 20MG TABLET 30 $4 90 $10
Cough &
Cold BENZONATATE
TESSALON
® 100MG CAPSULE 14 $4 42 $10
Cough &
Cold
DEC-CHLORPHEN
DM
CARDEC-
DM® SYRUP 120 $4 360 $10
Cough &
Cold PROMETHAZINE
PHENERG
AN®
6.25MG/
5ML SYRUP 180 $4 540 $10
Cough &
Cold
PROMETHAZINE
DM
PHENERG
AN DM® SYRUP 120 $4 360 $10
Cough &
Cold TRI-VENT DPC ATUS DR®
6-2-
15MG/5
ML
SYRUP 120 $4 360 $10
Diabetes CHLORPROPAMID
E
DIABINESE
® 100MG TABLET 30 $4 90 $10
Diabetes GLIMEPIRIDE AMARYL® 2MG TABLET 30 $4 90 $10
Diabetes GLIMEPIRIDE AMARYL® 4MG TABLET 30 $4 90 $10
Diabetes GLIMEPIRIDE AMARYL® 1MG TABLET 30 $4 90 $10
Diabetes GLIPIZIDE GLUCOTR
OL® 10MG TABLET 60 $4 180 $10
Diabetes GLIPIZIDE GLUCOTR
OL® 5MG TABLET 30 $4 90 $10
Diabetes GLIPIZIDE ER GLUCOTR
OL XL® 5MG TABLET 30 $4 90 $10
Diabetes GLYBURIDE DIABETA® 5MG TABLET 30 $4 90 $10
Diabetes GLYBURIDE DIABETA® 1.25MG TABLET 30 $4 90 $10
Diabetes GLYBURIDE MICRONAS
E® 2.5MG TABLET 30 $4 90 $10
Diabetes GLYBURIDE MCR GLYNASE
PRESTAB® 6MG TABLET 30 $4 90 $10
Diabetes GLYBURIDE MCR GLYNASE
PRESTAB® 3MG TABLET 30 $4 90 $10
Diabetes METFORMIN GLUCOPH
AGE® 500MG TABLET 60 $4 180 $10
Diabetes METFORMIN GLUCOPH
AGE® 850MG TABLET 60 $4 180 $10
Diabetes METFORMIN GLUCOPH
AGE® 1000MG TABLET 60 $4 180 $10
Diabetes METFORMIN ER GLUCOPH
AGE XR® 500MG TABLET 60 $4 180 $10
Eye & Ear ANTIPYRINE /
BENZOCAINE
AURALGA
N®
OTIC
SOLUTIO
N
10 $4 30 $10
Eye & Ear ATROPINE
SULFATE
ISOPTO
ATROPINE
®
1%
OPHTHA
LMIC
SOLUTIO
N
5 $4 15 $10
Eye & Ear GENTAK GARAMYC
IN® 0.3%
OPHTHA
LMIC
SOLUTIO
N
5 $4 15 $10
Eye & Ear LEVOBUNOLOL BETAGAN
® 0.5%
OPHTHA
LMIC
SOLUTIO
N
5 $4 15 $10
Eye & Ear
NEOMYCIN /
POLYMYXIN /
DEXAMETHASON
E
MAXITROL
® 0.1%
OPHTHA
LMIC
OINTMEN
T
4 $4 12 $10
Eye & Ear
NEOMYCIN /
POLYMYXIN /
DEXAMETHASON
E
MAXITROL
® 0.1%
OPHTHA
LMIC
SUSPENSI
ON
5 $4 15 $10
Eye & Ear POLYMIXIN B
SULFATE / TMP
POLYTRIM
®
OPHTHA
LMIC
SOLUTIO
N
10 $4 30 $10
Eye & Ear SULFACETAMIDE
SODIUM
SODIUM
SULAMYD
®
10%
OPHTHA
LMIC
SOLUTIO
N
15 $4 45 $10
Eye & Ear TIMOLOL
MALEATE
TIMOPTIC
® 0.5%
OPHTHA
LMIC
DROP
5 $4 15 $10
Eye & Ear TIMOLOL
MALEATE
TIMOPTIC
® 0.25%
OPHTHA
LMIC
DROP
5 $4 15 $10
Eye & Ear TOBRAMYCIN TOBREX® 0.3%
OPHTHA
LMIC
SOLUTIO
N
5 $4 15 $10
Family
Planning
CLOMIPHENE
CITRATE CLOMID® 50MG TABLET 5 $9 15 $24
Gastrointe
stinal
Health
BELLADONNA
ALK / PB
DONNATA
L® 16.2MG TABLET 60 $4 180 $10
Gastrointe
stinal
Health
CIMETIDINE TAGAMET
® 800MG TABLET 30 $4 90 $10
Gastrointe
stinal
Health
DICYCLOMINE BENTYL® 10MG CAPSULE 90 $4 270 $10
Gastrointe
stinal
Health
DICYCLOMINE BENTYL® 20MG TABLET 60 $4 180 $10
Gastrointe
stinal
Health
FAMOTIDINE PEPCID® 20MG TABLET 60 $4 180 $10
Gastrointe
stinal
Health
LACTULOSE CHRONUL
AC®
10GM/15
ML SYRUP 240 $4 720 $10
Gastrointe
stinal
Health
METOCLOPRAMID
E REGLAN®
5MG/5M
L SYRUP 180 $4 540 $10
Gastrointe METOCLOPRAMID REGLAN® 10MG TABLET 60 $4 180 $10
stinal
Health
E
Gastrointe
stinal
Health
OXYBUTYNIN DITROPAN
® 5MG TABLET 60 $4 180 $10
Gastrointe
stinal
Health
PHENAZOPYRIDIN
E
PYRIDIUM
® 200MG TABLET 30 $4 90 $10
Gastrointe
stinal
Health
PHENAZOPYRIDIN
E
PYRIDIUM
® 100MG TABLET 6 $4 18 $10
Gastrointe
stinal
Health
PROMETHAZINE PHENERG
AN® 25MG TABLET 12 $4 36 $10
Gastrointe
stinal
Health
RANITIDINE ZANTAC® 300MG TABLET 30 $4 90 $10
Gastrointe
stinal
Health
RANITIDINE ZANTAC® 150MG TABLET 60 $4 180 $10
Gastrointe
stinal
Health
SODIUM CITRATE
/ CITRIC ACID BICITRA®
SOLUTIO
N 180 $4 540 $10
Heart
Health
AMILORIDE /
HCTZ
MODURETI
C® 5-50MG TABLET 30 $4 90 $10
Heart
Health ATENOLOL
TENORMIN
® 25MG TABLET 30 $4 90 $10
Heart
Health ATENOLOL
TENORMIN
® 50MG TABLET 30 $4 90 $10
Heart
Health ATENOLOL
TENORMIN
® 100MG TABLET 30 $4 90 $10
Heart
Health
ATENOLOL /
CHLORTHALIDON
E
TENORETI
C®
100-
25MG TABLET 30 $4 90 $10
Heart
Health
ATENOLOL /
CHLORTHALIDON
E
TENORETI
C®
50-
25MG TABLET 30 $4 90 $10
Heart
Health BENAZEPRIL
LOTENSIN
® 20MG TABLET 30 $4 90 $10
Heart
Health BENAZEPRIL
LOTENSIN
® 5MG TABLET 30 $4 90 $10
Heart
Health BENAZEPRIL
LOTENSIN
® 40MG TABLET 30 $4 90 $10
Heart
Health BENAZEPRIL
LOTENSIN
® 10MG TABLET 30 $4 90 $10
Heart
Health
BISOPROLOL /
HCTZ ZIAC®
10-
6.25MG TABLET 30 $4 90 $10
Heart
Health
BISOPROLOL /
HCTZ ZIAC®
2.5-
6.25MG TABLET 30 $4 90 $10
Heart
Health
BISOPROLOL /
HCTZ ZIAC®
5-
6.25MG TABLET 30 $4 90 $10
Heart
Health BUMETANIDE BUMEX® 0.5MG TABLET 30 $4 90 $10
Heart
Health BUMETANIDE BUMEX® 1MG TABLET 30 $4 90 $10
Heart
Health CAPTOPRIL
CAPOTEN
® 12.5MG TABLET 60 $4 180 $10
Heart
Health CAPTOPRIL
CAPOTEN
® 50MG TABLET 60 $4 180 $10
Heart
Health CAPTOPRIL
CAPOTEN
® 100MG TABLET 60 $4 180 $10
Heart
Health CAPTOPRIL
CAPOTEN
® 25MG TABLET 60 $4 180 $10
Heart
Health CAPTOPRIL / HCTZ
CAPOZIDE
® 50/25 TABLET 30 $4 90 $10
Heart
Health CAPTOPRIL / HCTZ
CAPOZIDE
® 25/25mg TABLET 30 $4 90 $10
Heart
Health CAPTOPRIL / HCTZ
CAPOZIDE
® 25/15mg TABLET 30 $4 90 $10
Heart
Health CAPTOPRIL / HCTZ
CAPOZIDE
® 50/15mg TABLET 30 $4 90 $10
Heart
Health CARVEDILOL COREG® 25MG TABLET 60 $4 180 $10
Heart
Health CARVEDILOL COREG® 12.5MG TABLET 60 $4 180 $10
Heart
Health CARVEDILOL COREG® 3.125MG TABLET 60 $4 180 $10
Heart
Health CARVEDILOL COREG® 6.25MG TABLET 60 $4 180 $10
Heart
Health CLONIDINE
CATAPRES
® 0.1MG TABLET 30 $4 90 $10
Heart
Health CLONIDINE
CATAPRES
® 0.2MG TABLET 30 $4 90 $10
Heart
Health DIGOXIN LANOXIN® 0.125MG TABLET 30 $4 90 $10
Heart
Health DIGOXIN LANOXIN® 0.25MG TABLET 30 $4 90 $10
Heart
Health DILTIAZEM
CARDIZEM
® 90MG TABLET 60 $4 180 $10
Heart
Health DILTIAZEM
CARDIZEM
® 120MG TABLET 30 $4 90 $10
Heart
Health DILTIAZEM
CARDIZEM
® 30MG TABLET 60 $4 180 $10
Heart
Health DILTIAZEM
CARDIZEM
® 60MG TABLET 60 $4 180 $10
Heart
Health DOXAZOSIN
CARDURA
® 4MG TABLET 30 $4 90 $10
Heart
Health DOXAZOSIN
CARDURA
® 2MG TABLET 30 $4 90 $10
Heart
Health DOXAZOSIN
CARDURA
® 1MG TABLET 30 $4 90 $10
Heart
Health DOXAZOSIN
CARDURA
® 8MG TABLET 30 $4 90 $10
Heart
Health ENALAPRIL
VASOTEC
® 20MG TABLET 30 $4 90 $10
Heart
Health ENALAPRIL
VASOTEC
® 2.5MG TABLET 30 $4 90 $10
Heart
Health ENALAPRIL
VASOTEC
® 10MG TABLET 30 $4 90 $10
Heart
Health ENALAPRIL
VASOTEC
® 5MG TABLET 30 $4 90 $10
Heart
Health
ENALAPRIL /
HCTZ
VASERETI
C®
5-
12.5MG TABLET 30 $4 90 $10
Heart
Health FUROSEMIDE LASIX® 20MG TABLET 30 $4 90 $10
Heart
Health FUROSEMIDE LASIX® 40MG TABLET 30 $4 90 $10
Heart
Health FUROSEMIDE LASIX® 80MG TABLET 30 $4 90 $10
Heart
Health GUANFACINE TENEX® 1MG TABLET 30 $4 90 $10
Heart
Health HYDRALAZINE
APRESOLI
NE® 10MG TABLET 30 $4 90 $10
Heart
Health HYDRALAZINE
APRESOLI
NE® 25MG TABLET 30 $4 90 $10
Heart
Health
HYDROCHLOROT
HIAZIDE
HYDRODI
URIL® 25MG TABLET 30 $4 90 $10
Heart
Health
HYDROCHLOROT
HIAZIDE
HYDRODI
URIL® 50MG TABLET 30 $4 90 $10
Heart
Health
HYDROCHLOROT
HIAZIDE
MICROZID
E® 12.5MG CAPSULE 30 $4 90 $10
Heart
Health INDAPAMIDE LOZOL® 1.25MG TABLET 30 $4 90 $10
Heart
Health INDAPAMIDE LOZOL® 2.5MG TABLET 30 $4 90 $10
Heart
Health
ISOSORBIDE
MONO ER IMDUR® 30MG TABLET 30 $4 90 $10
Heart
Health
ISOSORBIDE
MONO ER IMDUR® 60MG TABLET 30 $4 90 $10
Heart
Health LISINOPRIL
PRINIVIL®
/ ZESTRIL® 5MG TABLET 30 $4 90 $10
Heart
Health LISINOPRIL
PRINIVIL®
/ ZESTRIL® 2.5MG TABLET 30 $4 90 $10
Heart
Health LISINOPRIL
PRINIVIL®
/ ZESTRIL® 40MG TABLET 30 $4 90 $10
Heart
Health LISINOPRIL
PRINIVIL®
/ ZESTRIL® 20MG TABLET 30 $4 90 $10
Heart
Health LISINOPRIL
PRINIVIL®
/ ZESTRIL® 10MG TABLET 30 $4 90 $10
Heart
Health LISINOPRIL ZESTRIL® 30MG TABLET 30 $4 90 $10
Heart
Health LISINOPRIL / HCTZ
PRINZIDE®
/
ZESTORET
IC®
20-
12.5MG TABLET 30 $4 90 $10
Heart
Health LISINOPRIL / HCTZ
PRINZIDE®
/
ZESTORET
IC®
10-
12.5MG TABLET 30 $4 90 $10
Heart
Health LISINOPRIL / HCTZ
PRINZIDE®
/
ZESTORET
20-
25MG TABLET 30 $4 90 $10
IC®
Heart
Health METHYLDOPA
ALDOMET
® 250MG TABLET 60 $9 180 $24
Heart
Health METHYLDOPA
ALDOMET
® 500MG TABLET 30 $9 90 $24
Heart
Health
METOPROLOL
TARTRATE
LOPRESSO
R® 100MG TABLET 60 $4 180 $10
Heart
Health
METOPROLOL
TARTRATE
LOPRESSO
R® 50MG TABLET 60 $4 180 $10
Heart
Health
METOPROLOL
TARTRATE
LOPRESSO
R® 25MG TABLET 60 $4 180 $10
Heart
Health PRAZOSIN HCL
MINIPRESS
® 5MG CAPSULE 30 $4 90 $10
Heart
Health PRAZOSIN HCL
MINIPRESS
® 2MG CAPSULE 30 $4 90 $10
Heart
Health PRAZOSIN HCL
MINIPRESS
® 1MG CAPSULE 30 $4 90 $10
Heart
Health PROPRANOLOL INDERAL® 80MG TABLET 60 $4 180 $10
Heart
Health PROPRANOLOL INDERAL® 40MG TABLET 60 $4 180 $10
Heart
Health PROPRANOLOL INDERAL® 20MG TABLET 60 $4 180 $10
Heart
Health PROPRANOLOL INDERAL® 10MG TABLET 60 $4 180 $10
Heart
Health SOTALOL HCL
BETAPACE
® 80MG TABLET 30 $4 90 $10
Heart
Health
SPIRONOLACTON
E
ALDACTO
NE® 25MG TABLET 30 $4 90 $10
Heart
Health TERAZOSIN HYTRIN® 5MG CAPSULE 30 $4 90 $10
Heart
Health TERAZOSIN HYTRIN® 1MG CAPSULE 30 $4 90 $10
Heart
Health TERAZOSIN HYTRIN® 2MG CAPSULE 30 $4 90 $10
Heart
Health TERAZOSIN HYTRIN® 10MG CAPSULE 30 $4 90 $10
Heart
Health
TRIAMTERENE /
HCTZ
MAXZIDE
®
75-
50MG TABLET 30 $4 90 $10
Heart
Health
TRIAMTERENE /
HCTZ
MAXZIDE
®
37.5-
25MG TABLET 30 $4 90 $10
Heart
Health VERAPAMIL CALAN® 80MG TABLET 30 $4 90 $10
Heart
Health VERAPAMIL CALAN® 120MG TABLET 30 $4 90 $10
Heart
Health
WARFARIN /
JANTOVEN
COUMADI
N® 2.5MG TABLET 30 $4 90 $10
Heart
Health
WARFARIN /
JANTOVEN
COUMADI
N® 3MG TABLET 30 $4 90 $10
Heart
Health
WARFARIN /
JANTOVEN
COUMADI
N® 4MG TABLET 30 $4 90 $10
Heart
Health
WARFARIN /
JANTOVEN
COUMADI
N® 5MG TABLET 30 $4 90 $10
Heart
Health
WARFARIN /
JANTOVEN
COUMADI
N® 1MG TABLET 30 $4 90 $10
Heart
Health
WARFARIN /
JANTOVEN
COUMADI
N® 10MG TABLET 30 $4 90 $10
Heart
Health
WARFARIN /
JANTOVEN
COUMADI
N® 2MG TABLET 30 $4 90 $10
Heart
Health
WARFARIN /
JANTOVEN
COUMADI
N® 6MG TABLET 30 $4 90 $10
Heart
Health
WARFARIN /
JANTOVEN
COUMADI
N® 7.5MG TABLET 30 $4 90 $10
Mental
Health AMITRIPTYLINE ELAVIL® 100MG TABLET 30 $4 90 $10
Mental
Health AMITRIPTYLINE ELAVIL® 25MG TABLET 30 $4 90 $10
Mental
Health AMITRIPTYLINE ELAVIL® 50MG TABLET 30 $4 90 $10
Mental
Health AMITRIPTYLINE ELAVIL® 75MG TABLET 30 $4 90 $10
Mental
Health AMITRIPTYLINE ELAVIL® 10MG TABLET 30 $4 90 $10
Mental
Health BENZTROPINE
COGENTIN
® 2MG TABLET 30 $4 90 $10
Mental
Health BUSPIRONE BUSPAR® 10MG TABLET 60 $4 180 $10
Mental
Health BUSPIRONE BUSPAR® 5MG TABLET 60 $4 180 $10
Mental
Health CARBAMAZAPINE
TEGRETOL
® 200MG TABLET 60 $4 180 $10
Mental
Health CITALOPRAM CELEXA® 20MG TABLET 30 $4 90 $10
Mental
Health CITALOPRAM CELEXA® 40MG TABLET 30 $4 90 $10
Mental
Health CITALOPRAM HBR CELEXA® 10MG TABLET 30 $4 90 $10
Mental
Health DESIPRAMINE
NORPRAMI
N® 10MG TABLET 30 $4 90 $10
Mental
Health FLUOXETINE PROZAC® 40MG CAPSULE 30 $4 90 $10
Mental
Health FLUOXETINE PROZAC® 10MG TABLET 30 $4 90 $10
Mental
Health FLUOXETINE PROZAC® 20MG CAPSULE 30 $4 90 $10
Mental
Health FLUOXETINE PROZAC® 10MG CAPSULE 30 $4 90 $10
Mental
Health FLUPHENAZINE
PROLIXIN
® 1MG TABLET 30 $4 90 $10
Mental
Health HALOPERIDOL HALDOL® 1MG TABLET 30 $4 90 $10
Mental
Health HALOPERIDOL HALDOL® 0.5MG TABLET 30 $4 90 $10
Mental
Health HALOPERIDOL HALDOL® 5MG TABLET 30 $4 90 $10
Mental
Health HALOPERIDOL HALDOL® 2MG TABLET 30 $4 90 $10
Mental
Health
LITHIUM
CARBONATE CAP
ESKALITH
® 300MG CAPSULE 90 $4 270 $10
Mental
Health NORTRIPTYLIN
PAMELOR
® 25MG CAPSULE 30 $4 90 $10
Mental
Health NORTRIPTYLIN
PAMELOR
® 10MG CAPSULE 30 $4 90 $10
Mental
Health PAROXETINE PAXIL® 20MG TABLET 30 $4 90 $10
Mental
Health PAROXETINE PAXIL® 10MG TABLET 30 $4 90 $10
Mental
Health
PROCHLORPERAZI
NE
COMPAZIN
E® 10MG TABLET 30 $4 90 $10
Mental
Health
PROCHLORPERAZI
NE
COMPAZIN
E® 5MG TABLET 30 $4 90 $10
Mental
Health THIORIDAZINE
MELLARIL
® 25MG TABLET 30 $4 90 $10
Mental
Health THIORIDAZINE
MELLARIL
® 50MG TABLET 30 $4 90 $10
Mental
Health THIOTHIXENE NAVANE® 2MG CAPSULE 30 $4 90 $10
Mental
Health TRAZODONE DESYREL® 100MG TABLET 30 $4 90 $10
Mental
Health TRAZODONE DESYREL® 150MG TABLET 30 $4 90 $10
Mental
Health TRAZODONE DESYREL® 50MG TABLET 30 $4 90 $10
Mental
Health
TRIHEXYPHENIDY
L ARTANE® 2MG TABLET 60 $4 180 $10
Oncology MEGESTROL MEGACE® 20MG TABLET 30 $4 90 $10
Other HEMORRHOIDAL-
HC
ANUSOL-
HC® 25MG
SUPPOSIT
ORY 12 $4 36 $10
Other LIDOCAINE
VISCOUS
XYLOCAIN
E® 2%
SOLUTIO
N 100 $4 300 $10
Other PREDNISONE DELTASON
E® 20MG TABLET 30 $4 90 $10
Other PREDNISONE DELTASON
E® 10MG TABLET 30 $4 90 $10
Other PREDNISONE DELTASON
E® 2.5MG TABLET 30 $4 90 $10
Other PREDNISONE DELTASON
E® 5MG TABLET 30 $4 90 $10
Skin
Condition
s
FLUOCINONIDE LIDEX® 0.05% CREAM 30 $4 90 $10
Skin
Condition
s
FLUOCINONIDE LIDEX® 0.05% CREAM 15 $4 45 $10
Skin
Condition
s
HYDROCORTISON
E HYTONE® 2.5% CREAM 30 $4 90 $10
Skin
Condition
HYDROCORTISON
E HYTONE® 1% CREAM 15 $4 45 $10
s
Skin
Condition
s
TERBINAFINE LAMISIL® 250MG TABLET 30 $9 90 $24
Skin
Condition
s
TRIAMCINOLONE ARISTOCO
RT® 0.5% CREAM 15 $4 45 $10
Skin
Condition
s
TRIAMCINOLONE ARISTOCO
RT® 0.1%
OINTMEN
T 15 $4 45 $10
Skin
Condition
s
TRIAMCINOLONE ARISTOCO
RT® 0.025% CREAM 15 $4 45 $10
Skin
Condition
s
TRIAMCINOLONE ARISTOCO
RT® 0.025% CREAM 80 $4 240 $10
Skin
Condition
s
TRIAMCINOLONE ARISTOCO
RT® 0.1%
OINTMEN
T 80 $4 240 $10
Skin
Condition
s
TRIAMCINOLONE KENALOG
® 0.1% CREAM 30 $4 90 $10
Skin
Condition
s
TRIAMCINOLONE KENALOG
® 0.1% CREAM 80 $4 240 $10
Skin
Condition
s
TRIAMCINOLONE KENALOG
® 0.1% CREAM 15 $4 45 $10
Thyroid LEVOTHYROXINE SYNTHORI
D® 25MCG TABLET 30 $4 90 $10
Thyroid LEVOTHYROXINE SYNTHROI
D® 112MCG TABLET 30 $4 90 $10
Thyroid LEVOTHYROXINE SYNTHROI
D® 125MCG TABLET 30 $4 90 $10
Thyroid LEVOTHYROXINE SYNTHROI
D® 150MCG TABLET 30 $4 90 $10
Thyroid LEVOTHYROXINE SYNTHROI
D® 200MCG TABLET 30 $9 90 $24
Thyroid LEVOTHYROXINE SYNTHROI
D® 75MCG TABLET 30 $4 90 $10
Thyroid LEVOTHYROXINE SYNTHROI
D® 88MCG TABLET 30 $4 90 $10
Thyroid LEVOTHYROXINE SYNTHROI
D® 175MCG TABLET 30 $9 90 $24
Thyroid LEVOTHYROXINE SYNTHROI
D® 137MCG TABLET 30 $4 90 $10
Thyroid LEVOTHYROXINE SYNTHROI
D® 100MCG TABLET 30 $4 90 $10
Thyroid LEVOTHYROXINE SYNTHROI
D® 50MCG TABLET 30 $4 90 $10
Vitamins ADVANCED
NATALCARE
VINATE
GT® TABLET 30 $0 90 $0
Vitamins FOLIC ACID FOLVITE® 1MG TABLET 30 $4 90 $10
Vitamins MAG 64 SLOW-
MAG® 64MG TABLET 60 $4 180 $10
Vitamins MAGNESIUM
OXIDE MAG-OX® 400MG TABLET 30 $4 90 $10
Vitamins
MULTI-VITAMIN /
FL / FE
CHEWABLE
POLY-VI-
FLOR® 1MG TABLET 30 $4 90 $10
Vitamins NATALCARE PIC NIFEREX-
PN® TABLET 30 $0 90 $0
Vitamins PRENATAL PLUS PRENATAL
PLUS® TABLET 30 $0 75 $0
Vitamins
SODIUM
FLUORIDE
CHEWABLE
LURIDE® 0.25MG TABLET 30 $4 90 $10
Women's
Health
ALENDRONATE
SOD
FOSAMAX
® 35 MG TABLET 4 $9 12 $24
Women's
Health
ALENDRONATE
SOD
FOSAMAX
® 70MG TABLET 4 $9 12 $24
Women's
Health ESTRADIOL ESTRACE® 2MG TABLET 30 $4 90 $10
Women's
Health ESTRADIOL ESTRACE® 1MG TABLET 30 $4 90 $10
Women's
Health ESTRADIOL ESTRACE® 0.5MG TABLET 30 $4 90 $10
Women's
Health
MEDROXYPROGE
STERONE
PROVERA
® 10MG TABLET 10 $4 30 $10
Women's
Health
MEDROXYPROGE
STERONE
PROVERA
® 2.5MG TABLET 30 $4 90 $10
Women's
Health
MEDROXYPROGE
STERONE
PROVERA
® 5MG TABLET 30 $4 90 $10
Women's
Health SPRINTEC 28-Day
ORTHO
CYCLEN® TABLET 28 $9 84 $24
Women's
Health TAMOXIFEN
NOLVADE
X® 10MG TABLET 60 $9 180 $24
Women's
Health TAMOXIFEN
NOLVADE
X® 20MG TABLET 30 $9 90 $24
Women's
Health
TRI-SPRINTEC 28-
Day
ORTHO
TRI-
CYCLEN®
TABLET 28 $9 84 $24
Generic pricing covers a 30-day supply for $4.00 or a 90-day supply for $10.00. Additional
medications are offered at various reduced rates. See Gianteagle.com or a pharmacist for
details. $4 program covers medications for a 30-day supply of eligible drugs at commonly
prescribed dosages. $10 program covers medications for a 90-day supply of eligible drugs at
commonly prescribed dosages. Prices for less than a 90-day supply are prorated based on the
30-day price. Prices for more than a 90-day supply are prorated based on the 90-day price on
the $10 program. Physician prescription required to convert from a 30-day to 90-day supply.
Some insurance plans, including government-funded prescription programs, may not cover a
90-day supply. Program enrollment may be required to receive reduced pricing, depending on
state of residence. Some restrictions may apply. See pharmacy for details. Giant Eagle
reserves the right to discontinue or modify these programs at any time.
