Gastrointestinal Health
*Due to state laws, these drugs are not covered under the 30-day program in MN and WI; however, they have been competitively priced. Please ask your pharmacist for specific pricing in these states.
†Due to state laws, these drugs are not covered under the 90-day program in MN and WI; however, they have been competitively priced. Please ask your pharmacist for specific pricing in these states.
$4 prescriptions are for up to a 30-day supply at commonly prescribed dosages. List subject to change.
| GENERIC NAME | BRAND NAME | QTY | FORM |
| BELLADONNA ALK/PB 16.2MG | DONNATAL® | 60 | TABLET |
| CIMETIDINE 400MG | TAGAMET® | 60 | TABLET |
| CIMETIDINE 800MG | TAGAMET® | 30 | TABLET |
| DICYCLOMINE 10MG | BENTYL® | 90 | CAPSULE |
| DICYCLOMINE 20MG | BENTYL® | 60 | TABLET |
| FAMOTIDINE 20MG | PEPCID® | 60 | TABLET |
| † FAMOTIDINE 40MG | PEPCID® | 30 | TABLET |
| LACTULOSE 10GM/15ML | CHRONULAC® | 240 | SYRUP |
| METOCLOPRAMIDE 5MG/5ML | REGLAN® | 60 | SYRUP |
| METOCLOPRAMIDE 10MG | REGLAN® | 60 | TABLET |
| OXYBUTYNIN 5MG | DITROPAN® | 60 | TABLET |
| PHENAZOPYRIDINE 100MG | PYRIDIUM® | 6 | TABLET |
| PHENAZOPYRIDINE 200MG | PYRIDIUM® | 30 | TABLET |
| PROMETHAZINE 25MG | PHENERGAN® | 12 | TABLET |
| RANITIDINE 150MG | ZANTAC® | 60 | TABLET |
| RANITIDINE 300MG | ZANTAC® | 30 | TABLET |
| SODIUM CITRATE/CITRIC ACID | BICITRA® | 180 | SOLUTION |
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