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These drugs are within the same therapeutic class and may provide you a choice of other medications that could be prescribed by your doctor to save you money.  Prices are subject to change and quantities may vary. Your medication may or may not be in the tier shown.

 

Formulary $10 List

Drug Name
ANTIVERT TAB 12.5MG - 60 TAB
ANTIVERT TAB 25MG - 60 TAB
MECLIZINE CHW 25MG - 60 TAB
MECLIZINE TAB 12.5MG - 30 TAB
MECLIZINE TAB 25MG - 30 TAB
TIGAN INJ 100MG/ML - 2 ML
TRIMETHOBENZ INJ 100MG/ML - 6 ML
TRIMETHOBENZ SUP 100MG - 10 MG
TRIMETHOBENZ SUP 200MG - 10 MG

Formulary $20 List
Drug Name      
TEBAMIDE SUP 100MG - 10 MG