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Program Name: 140



Overview:
This program provides FREE medication to patients who cannot afford to pay for them.

Medications covered:
Advair Diskus 100/50 (fluticasone proprionate 100 mcg and salmeterol 50 mcg
inhalation powder)
Advair Diskus 250/50 (fluticasone proprionate 250 mcg and salmeterol 50 mcg
inhalation powder)
Advair Diskus 500/50 (fluticasone proprionate 500 mcg and salmeterol 50 mcg
inhalation powder)
Agenerase Capsules (amprenavir)
Agenerase Oral Solution (amprenavir)
Albenza Tablets (albendazole)
Amerge Tablets (naratriptan hydrochloride)
Amoxil Capsules (amoxicillin/clavulanate potassium)
Amoxil Chewable Tablets (amoxicillin/clavulanate potassium)
Amoxil Powder (amoxicillin/clavulanate potassium)
Amoxil Pediatric Drops (amoxicillin/clavulanate potassium)
Arixtra Injection (fondaparinux sodium)
Augmentin ES-600TM (amoxicillin/clavulanate potassium)
Augmentin Oral Suspension – Chewable Tablets (amoxicillin/clavulanate
potassium)
Augmentin Powder for Oral Suspension (amoxicillin/clavulanate potassium)
Augmentin Tablets (amoxicillin/clavulanate potassium)
Augmentin Powder for Oral Suspension (amoxicillin/clavulanate potassium)
Augmentin XR Extended-release tablets (amoxicillin/clavulanate potassium)
Avandaryl Tablets (rosiglitazone maleate and glimepiride)
Avandia Tablets (rosiglitazone maleate)
Avodart Soft Gelatin Capsules (dutasteride)
Bactroban Cream (mupirocin calcium cream, 2%)
Bactroban Ointment (mupirocin ointment, 2%)
Beconase AQ Nasal Spray, 0.042% (beclomethasone dipropionate,
monohydrate)
Ceftin Tablets (cefuroxime axetil)
Ceftin for Oral Suspension (cefuroxime axetil powder for oral suspension)
Combivir Tablets (lamivudine/zidovudine tablets)
Coreg Tablets (carvedilol)
Coreg Tablets 6.25 mg (carvedilol)
Daraprim Tablets 25 mg scored tablets (pyrimethamine)
Dexedrine Tablets (dextroamphetamine sulfate)
Dexedrine Spansule Capsules (dextroamphetamine sulfate)
Dyazide Capsules (triamterene/hydrochlorothiazide)
Epivir Oral Suspension (lamivudine)
Epivir Tablets (lamivudine)
Epivir-HBV Oral Suspension (lamivudine)
Epivir-HBV Tablets (lamivudine)
Epzicom Tablets (abacavir sulfate & lamivudine)
Flonase Nasal Spray 50 mcg (fluticasone propionate)
Flovent Inhaler 44 mcg (fluticasone propionate inhalation powder)
Flovent Inhaler 110 mcg (fluticasone propionate inhalation powder)
Flovent Inhaler 220 mcg (fluticasone propionate inhalation powder)
Flovent Aerosol Spray 220 mcg (fluticasone propionate)
Flovent Inhaler 110 mcg (fluticasone propionate)
Flovent Rotadisk 50 mcg (fluticasone propionate inhalation powder)
Flovent Rotadisk 100 mcg (fluticasone propionate inhalation powder)
Flovent Rotadisk 250 mcg (fluticasone propionate inhalation powder)
Fortaz (ceftazidime for injection)
Fortaz (ceftazidime sodium injection)
Imitrex Injection (sumatriptan succinate)
Imitrex Nasal Spray (sumatriptan)
Imitrex Tablets (sumatriptan succinate)
Lamictal Tablets (lamotrigine)
Lamictal Tablets-Chewable (lamotrigine)
Lanoxicaps (digoxin solution in capsules)
Lanoxin Pediatric Elixir 50 mcg/mL (digoxin)
Lanoxin Tablets, USP (digoxin)
Lexiva Tablets (fosamprenavir calcium)
Lotronex Tablets (alosetron hydrochloride)
Malarone Tablets (atovaquone and proguanil hydrochloride)
Malarone Pediatric Tablets (atovaquone and proguanil hydrochloride)
Mepron Suspension (atovaquone)
Parnate Tablets 10 mg (tranylcypromine sulfate)
Paxil CR tablets (paroxetine hydrochloride)
Requip Tablets (ropinirole hydrochloride)
Retrovir Capsules (zidovudine)
Retrovir Syrup (zidovudine)
Retrovir Tablets (zidovudine)
Serevent Diskus (salmeterol xinafoate inhalation powder)
Timentin for IV (sterile ticarcillin disodium and clavulanate potassium)
Timentin Injection (sterile ticarcillin disodium and clavulanate potassium)
Trizivir Tablets (abacavir sulfate, lamivudine and zidovudine)
Valtrex Caplets (valacyclovir hydrochloride)
VESIcare (solifenacin succinate)
Wellbutrin Tablets (bupropion hydrochloride)
Wellbutrin SR (bupropion hydrochloride)
Wellbutrin XL Tablets (bupropion)
Zantac Injection (ranitidine hydrochloride)
Zantac Injection Premixed (ranitidine hydrochloride)
Zantac Syrup, USP (ranitidine hydrochloride)
Zantac 150 Tablets, USP (ranitidine hydrochloride)
Zantac 300 Tablets, USP (ranitidine hydrochloride)
Zantac 150 EFFERdose Tablets (ranitidine hydrochloride effervescent)
Ziagen Oral Solution (abacavir sulfate)
Ziagen Tablets (abacavir sulfate)
Zinacef (cefuroxime for injection)
Zofran Tablets (ondansetron HCl)
Zofran ODT (ondansetron)
Zovirax Capsules (acyclovir)
Zovirax Suspension (acyclovir)
Zovirax Injection (acyclovir sodium)
Zovirax Tablets (acyclovir)
Zyban SR Tablets (bupropion hydrochloride)


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