Value-Priced Medication List
In addition to the discounts on thousands of brand-name and most other generic medications that
Walgreens Prescription Savings Club members enjoy, club members receive greater discounts on
three-tiers of value priced generics.*
The price for a generic drug is based on its tier and whether it is a 30-day or 90-day supply:
30-day-supply drugs cost $5 (tier 1), $10 (tier 2) or $15 (tier 3)
90-day-supply drugs cost $10 (tier 1), $20 (tier 2) or $30 (tier 3)
VALUE GENERICS
Asthma (cont.)
Antifungal
Drug Name
FLUCONAZOLE 150MG TAB
TERBINAFINE 250MG TAB
Tier
2
2
Antiviral
Drug Name
ACYCLOVIR 200MG TAB
Tier
2
Quantity
30 90
1
30
3
90
Quantity
30 90
60
180
Arthritis or Pain
Drug Name
BACLOFEN 10MG TAB
CYCLOBENZAPRINE 5MG TAB
CYCLOBENZAPRINE 10MG TAB
DICLOFENAC POTASSIUM 50MG TAB
DICLOFENAC SODIUM 25MG TAB
DICLOFENAC SODIUM 50MG TAB
DICLOFENAC SODIUM 75MG EC TAB
DICLOFENAC SODIUM 100MG ER TAB
FLURBIPROFEN 100MG TAB
IBUPROFEN 100MG/5ML ORAL SUSP
IBUPROFEN 400MG TAB
IBUPROFEN 600MG TAB
IBUPROFEN 800MG TAB
INDOMETHACIN 25MG CAP
INDOMETHACIN 50MG CAP
KETOPROFEN 50MG CAP
KETOPROFEN 75MG CAP
KETOROLAC 10MG TAB
KETOROLAC 30MG/ML INJ, 2ML
LEFLUNOMIDE 10MG TAB
MELOXICAM 7.5MG TAB
MELOXICAM 15MG TAB
NABUMETONE 500MG TAB
NAPROXEN 250MG TAB
NAPROXEN 375MG TAB
NAPROXEN 500MG TAB
NAPROXEN 375MG DR TAB
NAPROXEN DR 500MG TAB
NAPROXEN SODIUM 275MG TAB
NAPROXEN SODIUM 550MG TAB
SULINDAC 150MG TAB
TIZANIDINE 2MG TAB
TRAMADOL 50MG TAB
Tier
3
2
2
3
3
3
3
3
3
2
2
2
2
2
1
3
3
2
3
3
2
2
3
1
1
1
3
3
1
3
3
3
3
Quantity
30 90
90
30
30
60
60
60
60
30
60
120
90
60
60
60
30
90
60
15
15
30
30
30
60
60
60
60
60
60
30
30
60
60
120
270
90
90
180
180
180
180
90
180
360
270
180
180
180
90
270
180
45
45
90
90
90
180
180
180
180
180
180
90
90
180
180
360
Asthma
Drug Name
ALBUTEROL 0.083% INH SOLN 25X3ML
ALBUTEROL 0.5% INH SOL 20ML
ALBUTEROL SULF INH SOLN 1.25MG/3ML
ALBUTEROL SULFATE SYRUP (2MG/5ML)
AMINOPHYLLINE 100MG TAB
Tier
2
2
3
1
2
Quantity
30 90
75
20
90
120
60
225
60
270
360
180
Drug Name
AMINOPHYLLINE 200MG TAB
DYPHYLLINE-GG 100-100 ELIXIR
DYPHYLLIN-GG TAB
IPRATROPIUM INHAL SOLN 60 X 2.5ML
Blood Pressure/Heart Health (cont.)
Tier
2
2
3
2
Quantity
30 90
60
240
30
75
180
720
90
225
Blood Pressure/Heart Health
Drug Name
AMILORIDE 5MG / HCTZ 50MG TAB
AMIODARONE 200MG TAB
AMLODIPINE BESYLATE 2.5MG TAB
AMLODIPINE BESYLATE 5MG TAB
AMLODIPINE BESYLATE 10MG TAB
AMLODIPINE-BENAZ 2.5/10MG CAP
AMLODIPINE-BENAZ 5/10MG CAP
AMLODIPINE-BENAZ 5/20MG CAP
AMLODIPINE-BENAZ 10/20MG CAP
ATENOLOL 100MG TAB
ATENOLOL 100MG/CHLORTHAL 25MG TAB
ATENOLOL 25MG TAB
ATENOLOL 50MG TAB
ATENOLOL/CHLORTHALIDONE 50/25 TAB
BENAZEPRIL 5MG TAB
BENAZEPRIL 10MG TAB
BENAZEPRIL 20MG TAB
BENAZEPRIL 40MG TAB
BISOPROLOL FUMARATE 5MG TAB
BISOPROLOL/HCTZ 2.5MG/6.25MG TAB
BISOPROLOL/HCTZ 5MG/6.25MG TAB
BISOPROLOL/HCTZ 10MG/6.25MG TAB
CARTIA 120MG XT CAP
CARVEDILOL 3.125MG TAB
CARVEDILOL 6.25MG TAB
CARVEDILOL 12.5MG TAB
CARVEDILOL 25MG TAB
CILOSTAZOL 50MG TAB
CILOSTAZOL 100MG TAB
CLONIDINE 0.1MG TAB
CLONIDINE 0.2MG TAB
CLONIDINE 0.3MG TAB
DILTIAZEM 30MG TAB
DILTIAZEM 60MG TAB
DILTIAZEM 90MG TAB
DILTIAZEM 120MG TAB
DILTIAZEM ER 120MG CAP (XR-24HR)
DIPYRIDAMOLE 25MG TAB
DIPYRIDAMOLE 50MG TAB
DIPYRIDAMOLE 75MG TAB
DOXAZOSIN 1MG TAB
DOXAZOSIN 2MG TAB
DOXAZOSIN 4MG TAB
ENALAPRIL 2.5MG TAB
ENALAPRIL 5MG TAB
ENALAPRIL 10MG TAB
ENALAPRIL 20MG TAB
ENALAPRIL-HCTZ 5-12.5MG TAB
Tier
2
1
2
2
2
3
3
3
3
1
2
2
2
2
2
2
2
2
2
2
2
2
3
2
2
2
2
3
3
2
2
2
2
2
2
2
3
3
3
3
3
3
3
2
1
2
3
2
Quantity
30 90
30
30
30
30
30
30
30
30
30
30
30
60
60
30
30
30
30
30
30
30
30
30
30
60
60
60
60
60
60
60
60
60
60
60
60
30
30
60
60
60
30
30
30
60
60
60
60
60
90
90
90
90
90
90
90
90
90
90
90
180
180
90
90
90
90
90
90
90
90
90
90
180
180
180
180
180
180
180
180
180
180
180
180
90
90
180
180
180
90
90
90
180
180
180
180
180
Drug Name
ENALAPRIL-HCTZ 10-25MG TAB
FELODIPINE 2.5MG TAB
FOSINOPRIL 10MG TAB
FOSINOPRIL 20MG TAB
FOSINOPRIL 40MG TAB
FUROSEMIDE 8MG/ML SOLN
FUROSEMIDE 10MG/ML ORAL SOLN 60ML
FUROSEMIDE 20MG TAB
FUROSEMIDE 40MG TAB
FUROSEMIDE 80MG TAB
GUANFACINE 1MG TAB
GUANFACINE 2MG TAB
HYDRALAZINE 10MG TAB
HYDRALAZINE 25MG TAB
HYDRALAZINE 50MG TAB
HYDROCHLOROTHIAZIDE 12.5MG CAP
HYDROCHLOROTHIAZIDE 12.5MG TAB
HYDROCHLOROTHIAZIDE 25MG TAB
HYDROCHLOROTHIAZIDE 50MG TAB
INDAPAMIDE 1.25MG TAB
INDAPAMIDE 2.5MG TAB
ISOSORBIDE DINITRATE 2.5MG SL TAB
ISOSORBIDE DINITRATE 5MG SUBL TAB
ISOSORBIDE MONONITRATE 10MG TAB
ISOSORBIDE MONONITRATE 20MG TAB
ISOSORBIDE MONONITRATE 30MG ER TAB
ISOSORBIDE MONONITRATE 60MG ER TAB
LISINOPRIL 2.5MG TAB
LISINOPRIL 5MG TAB
LISINOPRIL 10MG TAB
LISINOPRIL 20MG TAB
LISINOPRIL 30MG TAB
LISINOPRIL 40MG TAB
LISINOPRIL-HCTZ 10/12.5MG TAB
LISINOPRIL-HCTZ 20/12.5MG TAB
LISINOPRIL-HCTZ 20/25MG TAB
LOSARTAN/HCTZ 100/12.5MG TAB
METHYLDOPA 250MG TAB
METHYLDOPA 500MG TAB
METOPROLOL TARTRATE 25MG TAB
METOPROLOL TARTRATE 50MG TAB
METOPROLOL TARTRATE 100MG TAB
PENTOXIFYLLINE 400MG ER TAB
PRAZOSIN 1MG CAP
PROPAFENONE 150MG TAB
PROPRANOLOL 10MG TAB
PROPRANOLOL 20MG TAB
PROPRANOLOL 40MG TAB
PROPRANOLOL 60MG TAB
PROPRANOLOL 80MG TAB
QUINAPRIL 5MG TAB
QUINAPRIL 10MG TAB
QUINAPRIL 20MG TAB
QUINAPRIL 40MG TAB
QUINAPRIL/HCTZ 10-12.5MG TAB
RAMIPRIL 1.25MG CAP
Tier
2
3
2
2
2
3
3
1
1
1
2
2
1
2
3
2
3
1
1
2
2
2
3
3
3
2
2
2
2
1
1
2
2
2
2
2
3
3
3
2
2
2
3
2
3
2
2
2
3
2
2
2
2
2
3
3
Quantity
30 90
30
30
30
30
30
120
90
60
60
30
30
30
60
60
90
30
30
30
30
30
30
30
120
60
60
30
30
30
30
30
30
30
30
30
30
30
30
60
60
60
60
60
60
30
90
60
60
60
60
60
30
30
30
30
30
30
90
90
90
90
90
360
270
180
180
90
90
90
180
180
270
90
90
90
90
90
90
90
360
180
180
90
90
90
90
90
90
90
90
90
90
90
90
180
180
180
180
180
180
90
270
180
180
180
180
180
90
90
90
90
90
90
Blood Pressure/Heart Health (cont.)
Drug Name
SOTALOL 120MG TAB
SOTALOL 160MG TAB
SPIRONOLACTONE 25MG TAB
SPIRONOLACTONE 50MG TAB
SPIRONOLACTONE 25MG W/HCTZ 25MG TAB
TERAZOSIN 1MG CAP
TERAZOSIN 2MG CAP
TERAZOSIN 5MG CAP
TERAZOSIN 10MG CAP
TICLOPIDINE 250MG TAB
TORSEMIDE 5MG TAB
TORSEMIDE 10MG TAB
TORSEMIDE 20MG TAB
TORSEMIDE 100MG** TAB
TRANDOLAPRIL 1MG TAB
TRANDOLAPRIL 2MG TAB
TRANDOLAPRIL 4MG TAB
TRIAMTERENE 37.5MG/ HCTZ 25MG CAP
TRIAMTERENE 37.5MG/ HCTZ 25MG TAB
TRIAMTERENE 75MG/ HCTZ 50MG TAB
VERAPAMIL 40MG TAB
VERAPAMIL 80MG TAB
VERAPAMIL 120MG TAB
VERAPAMIL ER 100MG CAP (24 HR)
WARFARIN SOD 1MG TAB
WARFARIN SOD 2.5MG TAB
WARFARIN SOD 2MG TAB
WARFARIN SOD 3MG TAB
WARFARIN SOD 4MG TAB
WARFARIN SOD 5MG TAB
WARFARIN SOD 6MG TAB
WARFARIN SOD 7.5MG TAB
WARFARIN SOD 10MG** TAB
Tier
2
3
2
2
2
2
2
2
2
3
3
3
3
3
2
1
2
2
3
1
3
1
2
3
2
2
2
2
2
2
2
2
2
Cough/Cold/Allergy (cont.)
Quantity
30 90
60
60
30
30
30
30
30
30
30
60
30
30
30
30
30
30
30
30
30
30
60
30
30
30
30
30
30
30
30
30
30
30
30
180
180
90
90
90
90
90
90
90
180
90
90
90
90
90
90
90
90
90
90
180
90
90
90
90
90
90
90
90
90
90
90
90
Cholesterol
Drug Name
FENOFIBRATE 54MG TAB
GEMFIBROZIL 600MG TAB
LOVASTATIN 10MG TAB
LOVASTATIN 20MG TAB
LOVASTATIN 40MG TAB
PRAVASTATIN 10MG TAB
PRAVASTATIN 20MG TAB
PRAVASTATIN 40MG TAB
PRAVASTATIN 80MG TAB
SIMVASTATIN 5MG TAB
SIMVASTATIN 10MG TAB
SIMVASTATIN 20MG TAB
SIMVASTATIN 40MG TAB
SIMVASTATIN 80MG TAB
Tier
3
3
1
1
1
2
2
3
3
2
2
2
3
3
Cough/Cold/Allergy
Drug Name
ALLER-CHLOR 4MG TAB
BENZONATATE 100MG CAP
BENZONATATE 200MG CAP
CETIRIZINE 1MG/ML SYRUP
CYPROHEPTADINE 2MG/5ML SYRUP
DE-CHLOR DM LIQUID
DE-CHLOR DR SYRUP
DEHISTINE SYRUP
DIPHENHYDRAMINE 50MG CAP
FLUTICASONE NASAL SP (120INH) 16GM
LORATADINE 10MG TAB
NOHIST TAB
ORGAN-I NR 200MG TAB
PBM ALLERGY SYRUP
PHENYLTOLOXAMINE PE CPM SYRUP
PROMETHAZINE 12.5MG TAB
PROMETHAZINE 25MG TAB
PROMETHAZINE 50MG TAB
PROMETHAZINE DM SYRUP
Tier
1
2
3
3
3
2
2
3
2
3
1
3
3
3
2
2
1
2
2
Quantity
30 90
30
60
30
30
30
30
30
30
30
30
30
30
30
30
90
180
90
90
90
90
90
90
90
90
90
90
90
90
Quantity
30 90
100
30
30
120
120
120
180
240
30
16
30
30
120
120
240
30
12
60
180
300
90
90
360
360
360
540
720
90
48
90
90
360
360
720
90
36
180
540
Drug Name
QUARTUSS DM DROPS 30ML
QV-ALLERGY SYRUP
REME TUSSIN DM SYRUP
SILDEC PE-DM SYRUP
SILDEC-PE SYRUP
SUPRESS-DX PED DROPS 30ML
TRIPOHIST LIQUID
Gastrointestinal Health (cont.)
Tier
3
3
3
1
1
3
3
Quantity
30 90
30
240
150
120
120
30
120
90
720
450
360
360
90
360
Diabetes
Drug Name
GLIMEPIRIDE 1MG TAB
GLIMEPIRIDE 2MG TAB
GLIMEPIRIDE 4MG TAB
GLIPIZIDE 5MG TAB
GLIPIZIDE 10MG TAB
GLIPIZIDE ER 10MG TAB
GLIPIZIDE XL 2.5MG TAB
GLIPIZIDE XL 5MG TAB
GLYBURIDE 1.25MG TAB
GLYBURIDE 2.5MG TAB
GLYBURIDE 5MG TAB
GLYBURIDE MICRO 1.5MG TAB
GLYBURIDE MICRO 3MG TAB
GLYBURIDE MICRO 6MG TAB
GLYBURIDE/METFORMIN 1.25/250MG TAB
GLYBURIDE/METFORMIN 2.5/500MG TAB
GLYBURIDE/METFORMIN 5/500MG TAB
METFORMIN 500MG TAB
METFORMIN 850MG TAB
METFORMIN 1000MG TAB
METFORMIN ER 500MG 24HR TAB
METFORMIN ER 750MG 24HR TAB
Tier
1
1
1
1
1
3
3
3
1
2
2
1
1
1
1
1
3
1
1
1
1
3
Quantity
30 90
30
30
30
30
60
30
60
30
30
30
30
30
30
30
60
60
90
90
90
90
60
60
90
90
90
90
180
90
180
90
90
90
90
90
90
90
180
180
270
270
270
270
180
180
Ear Care
Drug Name
ACETIC ACID 2% OTIC SOLN
ANTIPYRINE BENZOCAINE OTIC SOL 15ML
Tier
3
2
Eye Care
Drug Name
BACITRACIN/POLYMYX OPHTHOINT 3.5GM
CARTEOLOL HCL 1% OPH SOL 5ML
CARTEOLOL HCL 1% OPH SOL 10ML
CARTEOLOL HCL 1% OPH SOL 15ML
CROMOLYN SODIUM 4% OPHTH SOLN 10ML
CYCLOPENTOL 1% OPTH SOLN 15ML
DEXAMETHASONE 0.1% OPHTH SOLN 5ML
DORZOLAMIDE 2% OPHTH SOLN 10ML
ERYTHROMYCIN OPHTH OINT 3.5GM
GENTAMICIN 0.3% OPHTH SOLN 5ML
KETOROLAC 0.5% OPHTH SOLN 5ML
LEVOBUNOLOL 0.5% OPTH SOLN 5ML
PILOCARPINE 0.5% OPHTH SOLN
POLYMYXIN-B/TRIMETHOPRIMOPHTH SOLN
SULFACETAMIDE NA 10% OPH SOL 15ML
TIMOLOL MALEATE .25% OPHTH SOL 5ML
TIMOLOL MALEATE 0.5% OPHTH SOLN 5ML
TOBRAMYCIN 0.3% OPH SOL 5ML
TROPICAMIDE 1% OP SOLN
Tier
3
3
3
3
3
3
3
3
2
2
3
2
3
2
2
2
2
2
3
Quantity
30 90
15
15
45
45
Quantity
30 90
3.5
5
10
15
10
15
5
10
3.5
5
5
5
15
10
15
5
5
5
15
10.5
15
30
45
30
45
15
30
10.5
15
15
15
45
30
45
15
15
15
45
Gastrointestinal Health
Drug Name
CIMETIDINE 200MG TAB
CIMETIDINE 300MG TAB
CIMETIDINE ORAL LIQ 300MG/5ML
DICYCLOMINE 10MG CAP
DICYCLOMINE 20MG TAB
Tier
3
3
3
2
1
Quantity
30 90
60
60
240
90
60
180
180
720
270
180
Drug Name
DOC-Q-LACE 100MG CAP
FAMOTIDINE 20MG TAB
FAMOTIDINE 40MG TAB
GENERLAC 10GM/15ML SOLN
LACTULOSE 10GM/15ML SOLN
METOCLOPRAMIDE 5MG TAB
METOCLOPRAMIDE 10MG TAB
METOCLOPRAMIDE HCL 5MG/5ML SOLN
NIZATIDINE 150MG CAP
NIZATIDINE 300MG CAP
OMEPRAZOLE 20MG CAP
RANITIDINE 150MG TAB
RANITIDINE 300MG TAB
RANITIDINE 15MG/ML (75MG/5ML) SYRUP
Tier
Quantity
30 90
2
2
3
2
3
2
2
1
3
3
3
2
2
3
60 180
60 180
30
90
237 711
473 1,419
60 180
60 180
60 180
60 180
30
90
30
90
60 180
30
90
120 360
Tier
Quantity
30 90
Tier
Quantity
30 90
Gout
Drug Name
ALLOPURINOL 100MG TAB
ALLOPURINOL 300MG TAB
2
2
60
60
180
180
Infections
Drug Name
AMOX-CLAV 400MG CHEW TAB
AMOX-CLAV 200MG/5ML SUSP 100ML
AMOX-CLAV 400MG/5ML SUSP 100ML
AMOX-CLAV ES 600MG/5ML SUSP 125ML
AMOXICILLIN 250MG CAP
AMOXICILLIN 500MG CAP
AMOXICILLIN 125MG CHEWABLE TAB
AMOXICILLIN 250MG CHEW TAB
AMOXICILLIN 125MG/5ML SUSP 80ML
AMOXICILLIN 125MG/5ML SUSP 100ML
AMOXICILLIN 125MG/5ML SUSP 150ML
AMOXICILLIN 200MG/5ML SUSP 75ML
AMOXICILLIN 200MG/5ML SUSP 100ML
AMOXICILLIN 250MG/5ML SUSP 150ML
AMOXICILLIN 250MG/5ML SUSP 100ML
AMOXICILLIN 250MG/5ML SUSP 80ML
AMOXICILLIN 400MG/5ML SUSP 50ML
AMOXICILLIN 400MG/5ML SUSP 75ML
AMOXICILLIN 400MG/5ML SUSP 100ML
AMOXICILLIN 500MG TAB
AMOXICILLIN 875MG TAB
AMPICILLIN 250MG CAP
AMPICILLIN 500MG CAP
CEFACLOR 250MG CAP
CEFADROXIL 500MG CAP
CEFPROZIL 125MG/5ML SUSP 50ML
CEFPROZIL 125MG/5ML SUSP 75ML
CEFPROZIL 125MG/5ML SUSP 100ML
CEPHALEXIN 250MG CAP
CEPHALEXIN 500MG CAP
CIPROFLOXACIN 250MG TAB
CIPROFLOXACIN 500MG TAB
CIPROFLOXACIN 750MG TAB
CLINDAMYCIN 150MG CAP
CLINDAMYCIN 300MG CAP
DOXYCYCLINE MONOHYDRATE 50MG TAB
DOXYCYCLINE MONOHYDRATE 100MG TAB
METRONIDAZOLE 250MG TAB
METRONIDAZOLE 500MG TAB
MINOCYCLINE 50MG CAP
PENICILLIN VK 125MG/5ML SOLN 100ML
PENICILLIN VK 125MG/5ML SOLN 200ML
PENICILLIN VK 250MG/5ML SOLN 100ML
PENICILLIN VK 250MG/5ML SOLN 200ML
PENICILLIN VK 250MG TAB
PENICILLIN VK 500MG TAB
SMZ/TMP REGULAR STRENGTH TAB
SULFAMETH/TRIMETHOPRIM 800/160 TAB
TRIMETHOPRIM 100MG TAB
3
3
3
3
1
1
2
3
2
2
2
1
1
1
1
1
1
1
1
3
3
2
3
3
3
3
3
3
1
1
1
1
3
3
3
3
3
2
3
3
1
1
1
1
1
1
1
2
3
20
100
100
125
30
30
30
40
80
100
150
75
100
150
100
80
50
75
100
30
20
40
60
30
20
50
75
100
28
30
14
20
20
30
28
30
30
28
14
60
100
200
100
200
30
20
28
28
30
60
300
300
375
90
90
90
120
240
300
450
225
300
450
300
240
150
225
300
90
60
120
180
90
60
150
225
300
84
90
42
60
60
90
84
90
90
84
42
180
300
600
300
600
90
60
84
84
90
Medical Devices
Drug Name
PROCHAMBER AERO SPACER
Mental Health (cont.)
Tier
3
Mental Health
Drug Name
AMITRIPTYLINE 10MG TAB
AMITRIPTYLINE 25MG TAB
AMITRIPTYLINE 50MG TAB
AMITRIPTYLINE 75MG TAB
AMITRIPTYLINE 100MG** TAB
AMITRIPTYLINE 150MG TAB
BENZTROPINE 0.5MG TAB
BENZTROPINE 1MG TAB
BENZTROPINE 2MG TAB
BUSPIRONE 5MG TAB
BUSPIRONE 10MG TAB
BUSPIRONE 15MG TAB
CARBAMAZEPINE 100MG CHEWABLE TAB
CITALOPRAM 10MG TAB
CITALOPRAM 20MG TAB
CITALOPRAM 40MG TAB
CLOZAPINE 25MG TAB
DIVALPROEX DR 125MG TAB
DOXEPIN 10MG CAP
DOXEPIN 25MG CAP
DOXEPIN 50MG CAP
DOXEPIN HCL 10MG/ML CONC 118ML
FLUOXETINE 10MG CAP
FLUOXETINE 20MG CAP
FLUOXETINE 40MG CAP
FLUOXETINE 10MG TAB
FLUOXETINE 20MG/5ML LIQUID
FLUPHENAZINE 2.5MG TAB
FLUPHENAZINE 5MG TAB
FLUVOXAMINE 25MG TAB
FLUVOXAMINE 100MG TAB
GABAPENTIN 100MG CAP
GABAPENTIN 300MG CAP
GABAPENTIN 400MG CAP
GABAPENTIN 250MG/5ML SOLN
HALOPERIDOL 0.5MG TAB
HALOPERIDOL 1MG TAB
HALOPERIDOL 2MG TAB
HALOPERIDOL 2MG/ML CONCENTRATE
HYDROXYZINE 10MG/5ML SYRUP
HYDROXYZINE HCL 10MG TAB
HYDROXYZINE HCL 25MG TAB
HYDROXYZINE HCL 50MG TAB
HYDROXYZINE PAMOATE 25MG CAP
IMIPRAMINE 10MG TAB
IMIPRAMINE 25MG TAB
IMIPRAMINE 50MG TAB
LAMOTRIGINE 5MG CHEWABLE TAB
LAMOTRIGINE 25MG CHEWABLE TAB
LITHIUM CARBONATE 150MG CAP
LITHIUM CARBONATE 300MG CAP
LITHIUM CARBONATE 300MG TAB
LITHIUM CARBONATE 600MG CAP
LITHIUM CARBONATE ER 450MG TAB
METHOCARBAMOL 500MG TAB
METHOCARBAMOL 750MG TAB
MIRTAZAPINE 15MG TAB
MIRTAZAPINE 30MG TAB
NORTRIPTYLINE 10MG CAP
NORTRIPTYLINE 25MG CAP
NORTRIPTYLINE 50MG CAP
NORTRIPTYLINE 75MG CAP
OXCARBAZEPINE 150MG TAB
PAROXETINE 10MG TAB
PAROXETINE 20MG TAB
PAROXETINE 30MG TAB
PRAMIPEXOLE 0.125MG TAB
Tier
1
1
1
2
1
2
2
3
2
2
2
3
3
2
2
2
3
3
2
2
3
3
1
1
1
1
3
3
3
3
3
2
3
3
3
3
2
3
3
3
3
2
3
3
3
3
3
3
3
3
2
3
3
3
2
3
1
3
2
2
3
3
3
2
2
3
3
Quantity
30 90
1
3
Quantity
30 90
30
30
30
30
30
30
30
60
30
60
60
60
120
30
30
30
30
90
30
30
30
90
30
30
30
30
150
30
30
30
60
90
90
90
236
60
30
30
135
240
60
30
30
90
60
60
30
150
180
60
90
60
60
60
30
60
30
30
30
30
60
30
90
30
30
30
30
90
90
90
90
90
90
90
180
90
180
180
180
360
90
90
90
90
270
90
90
90
270
90
90
90
90
450
90
90
90
180
270
270
270
708
180
90
90
405
720
180
90
90
270
180
180
90
450
540
180
270
180
180
180
90
180
90
90
90
90
180
90
270
90
90
90
90
Drug Name
PRAMIPEXOLE 0.25MG TAB
PRAMIPEXOLE 0.5MG TAB
PRAMIPEXOLE 1MG TAB
PRAMIPEXOLE 1.5MG TAB
PRIMIDONE 50MG TAB
PROCHLORPERAZINE 5MG TAB
PROCHLORPERAZINE 10MG TAB
RISPERIDONE 0.25MG TAB
ROPINIROLE 0.25MG TAB
ROPINIROLE 3MG TAB
SERTRALINE 25MG TAB
SERTRALINE 50MG TAB
SERTRALINE 100MG TAB
THIORIDAZINE 25MG TAB
THIORIDAZINE 50MG TAB
TRAZODONE 50MG TAB
TRAZODONE 100MG TAB
TRAZODONE 150MG TAB
TRIHEXYPHENIDYL 2MG TAB
TRIHEXYPHENIDYL 5MG TAB
VALPROIC ACID 250MG/5ML SYRUP
VENLAFAXINE 25MG TAB
VENLAFAXINE 37.5MG TAB
VENLAFAXINE 50MG TAB
VENLAFAXINE 75MG TAB
VENLAFAXINE 100MG TAB
Thyroid Conditions
Tier
Quantity
30 90
3
3
3
3
3
2
2
3
3
3
2
3
3
3
3
2
1
2
2
3
3
3
3
3
3
3
30
90
60 180
60 180
60 180
60 180
30
90
30
90
60 180
60 180
30
90
30
90
30
90
30
90
30
90
30
90
30
90
30
90
30
90
60 180
90 270
540 1620
60 180
60 180
60 180
60 180
60 180
CHLORHEXIDINE ORAL RINSE 473ML
LIDOCAINE VISCOUS 2% ORAL SOL 100ML
PILOCARPINE 5MG TAB
SF 5000 PLUS 1.1% CREAM 51GM
SOD FLUORIDE 0.2% MINT SOLUTION
STANNOUS FLUORIDE 0.63% RINSE
Tier
Quantity
30 90
2
2
3
3
2
3
473 1419
100 300
90 270
60 180
473 1419
300 900
Tier
Quantity
30 90
Skin Conditions
Drug Name
BENZOYL PEROXIDE 5% AQ GEL 60GM
BETAMETHASONE VAL 0.1% CRM 15GM
CICLOPIROX TOPICAL SUSPENSION 30ML
CICLOPIROX TOPICAL SUSPENSION 60ML
CLOTRIMAZOLE 1% SOLN 30ML
FLUTICASONE 0.005% OINT 30GM
HYDROCORTISONE 1% CREAM 28.35GM
HYDROCORTISONE 1% OINT 28.35GM
HYDROCORTISONE 2.5% CREAM 30GM
HYDROCORTISONE 2.5% OINT 28.35GM
HYPERCARE 20% SOL DAB-O-MATIC 60ML
MELQUIN 3% SOLN 30ML
MOMETASONE 0.1% OINT 15GM
MOMETASONE 0.1% OINT 45GM
MOMETASONE 0.1% TOPICAL SOLN 30ML
MOMETASONE 0.1% TOPICAL SOLN 60ML
NYSTATIN OINT 15GM
SALICYLIC AC 6% SHAMPOO 177ML
SELENIUM SULFIDE 2.5% SHAMPOO (LOTN)
TRIAMCINOLONE 0.025% CREAM 15GM
TRIAMCINOLONE 0.5% CREAM 15GM
TRIAMCINOLONE 0.1% CREAM 80GM
TRIAMCINOLONE 0.1% OINT 80GM
UREA 40% LOTION 236.6ML
UREA 50% NAIL GEL 18ML
Tier
LEVOTHROID 0.1MG TAB
LEVOTHYROXINE 0.025MG (25MCG) TAB
LEVOTHYROXINE 0.05MG (50MCG) TAB
LEVOTHYROXINE 0.075MG (75MCG) TAB
LEVOTHYROXINE 0.088MG (88MCG) TAB
LEVOTHYROXINE 0.100MG (100MCG) TAB
LEVOTHYROXINE 0.112MG (112MCG) TAB
LEVOTHYROXINE 0.125MG (125MCG) TAB
LEVOTHYROXINE 0.137MG (137MCG) TAB
LEVOTHYROXINE 0.150MG (150MCG) TAB
LEVOTHYROXINE 0.175MG (175MCG) TAB
LEVOTHYROXINE 0.2MG (200MCG) TAB
LEVOTHYROXINE 0.3MG (300MCG) TAB
METHIMAZOLE 5MG TAB
METHIMAZOLE 10MG TAB
NATURE-THROID 0.5GR (32.5MG) TAB
2
2
2
2
2
2
2
2
2
2
2
2
2
2
3
2
Quantity
30 90
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
60
90
90
90
90
90
90
90
90
90
90
90
90
90
90
90
180
Urinary Health
Drug Name
BETHANECHOL 10MG TAB
BETHANECHOL 25MG TAB
OXYBUTYNIN 5MG/5ML SYRUP
OXYBUTYNIN ER 5MG TAB
OXYBUTYNIN ER 15MG TAB
Tier
3
3
3
3
3
Quantity
30 90
60
90
240
30
30
180
270
720
90
90
Vitamins and Nutritional Health
Mouth/Throat/Dental
Drug Name
Drug Name
3
3
3
3
3
3
2
2
2
3
3
3
3
3
3
3
3
3
2
1
2
2
3
3
3
60 180
15
45
30
90
60 180
30
90
30
90
28.35 85.05
28.35 85.05
30
90
60 180
60 180
30
90
15
45
45 135
30
90
60 180
15
45
177 531
118 354
15
45
15
45
80 240
80 240
236.6 709.8
18
54
Drug Name
CYANOCOBALAMIN 1000MCG/ML INJ, 1ML
FABB TAB
FE C PLUS TAB
FEROTRIN CAP
FERREX 150 FORTE CAP
FLUORIDE 0.25MG F CHEWABLE TAB
FLUORIDE 0.5MG F CHEWABLE TAB
FLUORIDE 1.0MG F CHEWABLE TAB
FOLBECAL TAB
FOLBEE PLUS TAB
FOLBEE TAB
FOLIC ACID 1MG TAB
HEMATINIC/ FA TAB
HEMATINIC PLUS TAB 10 X 10
KLOR-CON 10MEQ TAB
MULTIGEN FOLIC TAB
MULTIGEN TAB
MULTIVIT/F 0.25MG CHEWABLE TAB
MULTI-VITA-F 0.5MG CHEW TAB
MULTI-VIT/FLUORIDE 1MG CHEW TAB
MULTIVITAMINS W/ FL 1.0MG CHEW TAB
MULTIVITS W/FL 1MG & IRON CHEW TAB
NATALCARE PLUS TAB (1MG FOLIC ACID)
OB-NATAL ONE CAP
POLY-IRON 150 CAP
POLY-IRON 150 FORTE CAP
POTASSIUM CL 10MEQ ER TAB
PRENAFIRST TAB
PRENATAB FA TAB
PRENATAL 19 TAB
PRENATAL PLUS TAB
RE DUALVIT F CAP
RE PRENATAL MULTIVIT W/IRON CHEW TB
RENA-VITE RX TAB
RENAL SOFTGEL CAP
THEROBEC PLUS TAB
VINATE AZ TAB
VINATE CARE CHEWABLE TAB
VINATE C TAB
VINATE GT TAB
VINATE M TAB
VINATE ONE TAB
VITAMIN B-12 100MCG TAB
VITAMIN D 50,000IU CAP
Tier
3
3
3
3
2
2
1
2
3
3
3
1
2
3
3
3
3
2
1
2
3
1
1
3
2
3
3
3
3
2
3
3
3
1
3
3
3
3
3
2
2
2
1
1
Quantity
30 90
3
30
30
60
45
120
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
60
45
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
100
4
9
90
90
180
135
360
90
90
90
90
90
90
90
90
90
90
90
90
90
90
90
90
90
90
180
135
90
90
90
90
90
90
90
90
90
90
90
90
90
90
90
90
300
12
VALUE BRAND-NAME
Women’s Health
Drug Name
ALENDRONATE 5MG TAB
ALENDRONATE 10MG TAB
ALENDRONATE 35MG TAB
ALENDRONATE 70MG TAB
ANASTROZOLE 1MG TAB
CLOMIPHENE CITRATE 50MG TAB
ESTRADIOL 0.5MG TAB
ESTRADIOL 1MG TAB
ESTRADIOL 2MG TAB
ESTROPIPATE 0.625MG (0.75MG) TAB
MEDROXYPROGESTERONE 2.5MG TAB
MEDROXYPROGESTERONE 5MGTAB
MEDROXYPROGESTERONE 10MGTAB
MEGESTROL ACETATE 20MG TAB
Tier
3
3
3
3
3
2
1
1
1
3
2
1
1
2
Quantity
30 90
30
30
4
4
30
5
30
30
30
30
30
30
10
30
90
90
12
12
90
15
90
90
90
90
90
90
30
90
Other
Drug Name
CYTRA-2 SOLN
DEXAMETHASONE 0.5MG TAB
DEXAMETHASONE 0.75MG TAB
DEXAMETHASONE 1MG TAB
DEXAMETHASONE 1.5MG TAB
DEXAMETHASONE 4MG TAB
FINASTERIDE 5MG TAB
HYDROCORTISONE 5MG TAB
ISONIAZID 100MG TAB
LIDOCAINE 4% TOP SOLN 50ML
PHENAZOPYRIDINE 100MG TAB
PREDNISOLONE 15MG/5ML SOLN
PREDNISOLONE SOD PHOS 15MG/5ML SOL
PREDNISONE 1MG TAB
PREDNISONE 2.5MG TAB
PREDNISONE 5MG TAB
PREDNISONE 10MG** TAB
PREDNISONE 20MG TAB
PREDNISONE 5MG TAB PACK 21’S
Tier
3
2
2
3
3
2
2
3
2
2
2
3
2
3
2
2
1
2
3
Quantity
30 90
473 1419
60 180
12
36
30
90
45 135
30
90
30
90
50 150
100 300
50 150
6
18
60 180
30
90
90 270
60 180
30
90
30
90
30
90
21
63
LIFESTYLE MEDICATIONS
Insulins
LEVEMIR FLEXPEN
LEVEMIR FLEXTOUCH
LEVEMIR 100 UNITS/ML VIAL
NOVOLIN N 100 UNITS/ML VIAL
NOVOLIN R 100 UNITS/ML VIAL
NOVOLIN 70/30 100 UNIT/ML VIAL
NOVOLOG MIX 70/30 VIAL
NOVOLOG MIX 70/30 FLEXPEN
NOVOLOG FLEXPEN
NOVOLOG PENFILL 3 ML
NOVOLOG 100 UNIT/ML VIAL
1 BOX
1 BOX
1 VIAL
1 VIAL
1 VIAL
1 VIAL
1 VIAL
1 BOX
1 BOX
1 BOX
1 VIAL
$283.16
$283.16
$188.78
$58.12
$58.12
$58.12
$162.96
$303.90
$303.41
$291.80
$157.08
Birth Control –
Special Price at $12 for 1-month supply
MONONESSA TAB
TRINESSA TAB
28
28
$18.99 for 1-month supply
MICROGESTIN 1.5/30 FE TAB
MICROGESTIN 1/20 FE TAB
28
28
$24.99 for 1-month supply
LEVORA 0.15/30 TAB
RECLIPSEN 0.15MG-30MCG TAB
Diabetic Supplies
WALGREENS TRUE RESULT METER
1 METER
WALGREENS TRUE TEST STRIPS 25’S
1 BOX
WALGREENS TRUE TEST STRIPS 50’S
1 BOX
WALGREENS TRUE TEST STRIPS 100’S
1 BOX
FREE
$17.99
$24.99
$41.99
BAYER CONTOUR NEXT METER
BAYER CONTOUR NEXT STRIPS 25’S
BAYER CONTOUR NEXT STRIPS 50’S
BAYER CONTOUR NEXT STRIPS 100’S
1 METER
1 BOX
1 BOX
1 BOX
FREE
$23.99
$39.99
$78.99
BAYER CONTOUR METER
BAYER CONTOUR USB METER
BAYER CONTOUR TEST STRIPS 50’S
BAYER CONTOUR TEST STRIPS 100’S
1 METER
1 METER
1 BOX
1 BOX
FREE
FREE
$47.99
$93.99
BAYER BREEZE 2 METER KIT
BAYER BREEZE 2 TEST DISCS 50'S
BAYER BREEZE 2 TEST DISCS 100'S
1 METER
1 BOX
1 BOX
FREE
$48.99
$93.99
28
28
$26.99 for 1-month supply
LOW-OGESTREL TAB
NECON 1/35 TAB
28
28
$29.99 for 1-month supply
JOLIVETTE 0.35MG TAB
LUTERA TAB
28
28
Discounted Lifestyle Medications
CIALIS 5MG TAB (QTY 6)
CIALIS 10MG TAB (QTY 6)
CIALIS 20MG TAB (QTY 6)
LATISSE 0.03% OPHTH SOLN
VIAGRA 50MG TAB (QTY 6)
VIAGRA 100MG TAB (QTY 6)
$39.99
$231.99
$231.99
$118.99
$208.99
$209.99
AVERAGE SAVINGS90-day supply of a
value-priced generic
Tier 1
Tier 2
Tier 3
$39.61
$38.09
$100.31
Commonly prescribed quantities
of all other generics
$27.54
Brand-name drugs
$31.29
Membership fee required ($20 individual or $35 family per year). Persons receiving benefits from Medicare, Medicaid or other federal or state healthcare
programs are ineligible. Some restrictions apply to 10% bonus. Pet medications are for human-equivalent medications only. Membership may be cancelled
within 30 days of issue date for a full refund. If by the end of the 1-year membership, member has not achieved total savings on all eligible Pharmacy and
Walgreens Bonus Program items and services purchased with the PSC card that is equal to or greater than membership fee, member is eligible for store
credit equal to the difference between membership fee and the member's total savings. For complete terms and conditions, call 866-922-7312 or visit
Walgreens.com/rxsavingsclub. WAGDCO, LLC, 104 Wilmot Road, Deerfield, IL 60015.
THIS PROGRAM DOES NOT CONSTITUTE INSURANCE.
*List of drugs is not all-inclusive. Ask your Walgreens pharmacist if your medication is a value-priced generic.
Drug names are the property of their respective owners.
©2012 Walgreen Co. All rights reserved. 12SC0026 - Revised: 12/19/2014