Clickable Table

Generic Name Brand Name Strength Dosing 90 Day Cost Coverage Comments Category 1 Category 2
Temazepam Restoril 30 mg PRN $40 BC / IA - Covered

90 tablets

Psychiatry Anxiolytic Sedative
Amphetamines, Mixed Salts Adderall XR 10 mg QD $265 BC - NC / IA - Covered Psychiatry Stimulants (ADHD)
Methylphenidate Concerta 36 mg QD $345 BC - NC / IA - Covered Psychiatry Stimulants (ADHD)
Methylphenidate Ritalin 10 mg BID $30 BC / IA - Covered Psychiatry Stimulants (ADHD)
Lisdexamfetamine Vyvanse 20 mg QD $290 BC - RST / IA - Covered Psychiatry Stimulants (ADHD)
Citalopram Celexa 20 mg QD $25 BC / IA - Covered Psychiatry Antidepressants
Escitalopram Cipralex 10 mg QD $45 BC / IA - Covered Psychiatry Antidepressants
Duloxetine Cymbalta 30 mg QD $60 BC / IA - Covered Psychiatry Antidepressants
Venlafaxine Effexor XR 75 mg QD $30 BC / IA - Covered Psychiatry Antidepressants
Paroxetine Paxil 20 mg QD $45 BC / IA - Covered Psychiatry Antidepressants
Desvenlafaxine Pristiq 50 mg QD $255 BC / IA - NC Psychiatry Antidepressants
Fluoxetine Prozac 20 mg QD $45 BC / IA - Covered Psychiatry Antidepressants
Mirtazapine Remeron 30 mg HS $35 BC / IA - Covered Psychiatry Antidepressants
Vortioxetine Trintellix 20 mg QD $345 BC / IA - NC Psychiatry Antidepressants
Sertraline Zoloft 50 mg QD $45 BC / IA - Covered Psychiatry Antidepressants
Aripiprazole Abilify 15 mg QD $140 BC - RST / IA - SA Psychiatry Antipsychotics
Risperidone Risperdal 1 mg QD $40 BC / IA - Covered Psychiatry Antipsychotics
Quetiapine Seroquel 25 mg HS $20 BC / IA - Covered Psychiatry Antipsychotics
Quetiapine Seroquel XR 300 mg QD $110 BC / IA - Covered Psychiatry Antipsychotics
Olanzapine Zyprexa 5 mg, 10 mg QD $85 BC / IA - Covered Psychiatry Antipsychotics
Lorazepam Ativan 1 mg PRN $20 BC / IA - Covered

90 tablets

Psychiatry Anxiolytic Sedative
Trazodone Desyrel 50 mg PRN $20 BC / IA - Covered

90 tablets

Psychiatry Anxiolytic Sedative
Zopiclone Imovane 7.5 mg PRN $25 BC - Covered / IA - NC

90 tablets

Psychiatry Anxiolytic Sedative
Legend:
BC = Alberta Blue Cross, IA = Indian Affairs, NC = Not covered, SA = special authorization, SR = sustained release, OTC = over the counter, SQ = subcutaneous injection, SS=Social Services