PRESCRIPTION DRUG - Public Employees' Benefits Program (PEBP)

$ prazosin hcl (M) X$ terazosin hcl (M) X$$ CARDURA* (M) X doxazosin mesylate$$ HYTRIN* (M) X terazosin hcl$$ MINIPRESS* (M) X prazosin hcl4.5.2 CENTRALLY ACTING ANTIHYPERTENSIVES$ clonidine hcl (M) X$ guanfacine X$ methyldopa (M) X$$ CATAPRES* X clonidine hcl$$$ CATAPRES TTS QLL= 4 patches/Rx X$$$ NEXICLON XR (ST) trial and failure with clonidine X clonidine hcl$$ TENEX* X guanfacine4.5.4.1 ANGIOTENSIN CONVERTING ENZYME INHIBITORS$ benazepril hcl (M) X$ captopril (M) X$ enalapril maleate (M) X$ fosinopril(M) X$ lisinopril (M) X$ moexipril(M) X$ quinapril(M) X$$ ramipril (M) X$$ trandolapril (M) X$$$ ACCUPRIL* X quinapril$$$ ACEON X lisinopril, benazepril, enalapril(ST) History of diabeticmedications or history ofantihypertensive medications and55 years old or older X lisinopril, benazepril, enalapril$$ ALTACE *$$ CAPOTEN* (M) X captopril$$ LOTENSIN* (M) X benazepril$$ MAVIK* X trandolapril$$ MONOPRIL* X fosinopril$$$ UNIVASC* X moexipril4.5.4.2 ANGIOTENSIN II RECEPTOR ANTAGONISTS$ losartan (M) QLL=30 tabs/Rx x$$ BENICAR X$$ MICARDIS X BENICAR, DIOVAN$$$ ATACAND X BENICAR, DIOVAN$$$ AVAPRO X BENICAR, DIOVAN$$$ COZAAR X BENICAR, DIOVAN$$$ DIOVAN X$$$ EDARBIQLL=30 tabs/Rx (ST) trial andfailure with ACE, ACE combination x losarten, Benicar, Diovan$$$ TEVETEN X BENICAR, DIOVAN4.5.6 OTHER ANTIHYPERTENSIVES$$ amlodipine/benazepril (M) X$ atenolol /chlorthalidone (M) X$ benazepril/ hctz (M) X$ bisoprolol/hctz(M) X$ captopril/hctz (M) X$ enalapril/hctz (M) X$ fosinopril/hctz X$ hydralazine/hctz X$ lisinopril-hctz (M) X$ moexipril/hctz (M) X$ losartan/hctz (M) X$ propranolol /hctz (M) X$ quinapril/hctz (M) X$$$ ACCURETIC* X quinapril/hctz$$$ Caprelsa (ST) requires (amolodipine, X$$$ ATACAND HCT QLL=30 tabs/Rx X BENICAR HCT, DIOVAN HCT$$$ AVALIDE QLL=30 tabs/Rx X BENICAR HCT, DIOVAN HCT(ST) Trial and Failure with ACE,ACE combination, ARB, or ARB$$$ AZORcombination productX$$ BENICAR HCT QLL=30 tabs/Rx X$$ CAPOZIDE* X captopril/hctz$$$ DIOVAN HCT QLL=30 tabs/Rx X$$$ EXFORGE(ST) Trial and Failure with ACE,ACE combination, ARB, or ARBcombination product QLL=30/RxX$$$ HYZAAR QLL=30 tabs/Rx X BENICAR HCT, DIOVAN HCT$$ INDERIDE* X propranolol/hctz$$$ LEXXEL(ST) history of trial and failure ofone fo the following: benazepril,captopril, enalapril, fosinopril,lisinopril, moexipril, quinapril, ortrandolapril X LOTREL$$ LOTENSIN HCT* X benazepril/hctz$$$$ LOTREL* X benazepril/amlodipine$$ MICARDIS HCT QLL=30 tabs/Rx X BENICAR HCT, DIOVAN HCT$$ MONOPRIL HCT* X fosinopril/hctzQLL=30 tabs/Rx (ST) history of trialand failure of one fo the following:benazepril, captopril, lisinopril,$$$ TARKAmoexipril, trandolaprilX$$ TEKTURNA(ST) Trial and Failure with ACE,ACE combination, ARB, or ARBcombination product QLL=30/RxX$$ TEKTURNA HCT(ST) Trial and Failure with ACE,ACE combination, ARB, or ARBcombination product QLL=30/RxX$$ TENORETIC* X atenolol/chlorthalidone$$ TEVETEN QLL=30 tabs/Rx X BENICAR HCT, DIOVAN HCT$$ TEVETEN HCT QLL=30 tabs/Rx X BENICAR HCT, DIOVAN HCT$$$ TWYNSTA 40/5, 40/10, 80/5, 80/10 mg(ST) history of an ACEI or currentlyon an ARBX(ST) history of an ACEI or currently$$$ TRIBENZORon an ARBX$$ UNIRETIC* X moexipril/hctz$$$ VALTURNA 150/160, 300/320 mg(ST) history of an ACEI or currentlyon an ARBX$$ VASORETIC* X enalapril/hctz$$ ZIAC* X bisoprolol/hctz4.5.7 DRUGS FOR PULMONARY HYPERTENSION!!!!! ADCIRCA (PAR); Spec. Pharm. X!!!!! REVATIO (PAR); Spec. Pharm. X5