Generic Prescription Drug List

PCHC’s 4 full service pharmacies, located in Bangor, Brewer, Old Town, and Belfast, work to offer the most complete list of discount medications in the area. We include more generic medications on the $4 pricing list than most of our local competitors, which means we can offer you the best prices in town! These discounts are available to ALL PCHC patients with a prescription written by a PCHC provider. The prices are available to patients with or without insurance.

How much could you save?

Look up your medications in the chart below to find out how much you could be saving by filling your prescriptions at a PCHC pharmacy. For example, for patients with osteoporosis, 1 month supply of alendronate costs $9 here vs. $15 at a local pharmacy. Patients using our pharmacy would save $72 a year!  For patients with high cholesterol, 1 month supply of atorvastatin costs: $4 here vs. $15 at a local pharmacy. Patients using our pharmacy would save $132 a year!

Download the below PDFs of the Generic Prescriptions we offer at a discount. If you do not see your medication on this list, call your PCHC Pharmacist to check the price!

PCHC Generic Prescriptions - Alphabetized List
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PCHC Generic Prescriptions - Categorized List
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How to read the chart below:

  1. Look for the reason the medication is taken, listed in Red Letters.
  2. Look for the medication name in the “Drug Name” column.
  3. The 30 Day column shows the amount of medication that can be purchased for a 30 day period for the price listed under the next column, Patient Cost.  For example, if the number 30 is listed under the 30 Day column and the Patient Cost is $4, you could buy 30 capsules for $4.  If you take 2 capsules a day, and would need 60 capsules to fill a prescription for one month, the cost would be $8.
  4. The 90 Day column shows how you might save money by purchasing more medication at once. For example, if you take 30 capsules of a medication and pick it up every month for $4, three months would cost you $12. The 90 Day option allows you to pick up 90 capsules of your medication at one time and pay $10 for it, instead of the $12.

It is important to read the table carefully, as some prices vary. If the medication that you take is not listed, ask your provider if you are able to switch medications from the one you are taking to one on this list. (Remember that not all medications can be switched.)  If you have any questions about your medications, ask your PCHC pharmacist or call our Pharmacies at 207-992-4100.

Are you in PCHC’s ACP (Affordable Care Program)?

PCHC’s ACP (sliding fee) program offers additional discounted medications to PCHC patients.

> Click here to learn about the ACP Discount Medications


Drug Name

30 Day

Price

90 Day

Price

Allergies, Cold and Flu
BENZONATATE 100MG CAPSULE14capsules$4.0042capsules$10.00
Anaphylaxis
EPINEPHRINE 0.15MG AUTO-INJCT2pens$20.00
EPINEPHRINE 0.3 MG AUTO-INJEC2pens$20.00
Antibiotic Treatments
AMOX TR-K CLV 200-28.5/5 SUSP50ml$10.00
AMOX TR-K CLV 200-28.5/5 SUSP75ml$10.00
AMOX TR-K CLV 200-28.5/5 SUSP100ml$10.00
AMOX TR-K CLV 250-62.5/5 SUSP75ml$20.00
AMOX TR-K CLV 250-62.5/5 SUSP100ml$20.00
AMOX TR-K CLV 400-57/5 SUSP50ml$10.00
AMOX TR-K CLV 400-57/5 SUSP75ml$10.00
AMOX TR-K CLV 400-57/5 SUSP100ml$10.00
AMOX TR-K CLV 500-125 TAB30tablets$10.00
AMOX TR-K CLV 600-42.9/5 SUSP75ml$10.00
AMOX TR-K CLV 600-42.9/5 SUSP125ml$10.00
AMOX TR-K CLV 600-42.9/5 SUSP200ml$20.00
AMOX TR-K CLV 875-125 TAB20tablets$10.00
AMOXICILLIN 125MG/5ML SUSP80ml$4.00
AMOXICILLIN 125MG/5ML SUSP100ml$4.00
AMOXICILLIN 125MG/5ML SUSP150ml$4.00
AMOXICILLIN 200MG/5ML SUSP50ml$4.00
AMOXICILLIN 200MG/5ML SUSP75ml$4.00
AMOXICILLIN 200MG/5ML SUSP100ml$4.00
AMOXICILLIN 250MG CAPSULE30capsules$4.0090capsules$10.00
AMOXICILLIN 250MG/5ML SUSP80ml$4.00
AMOXICILLIN 250MG/5ML SUSP100ml$4.00
AMOXICILLIN 250MG/5ML SUSP150ml$4.00
AMOXICILLIN 400MG/5ML SUSP50ml$4.00
AMOXICILLIN 400MG/5ML SUSP75ml$4.00
AMOXICILLIN 400MG/5ML SUSP100ml$4.00
AMOXICILLIN 500MG CAPSULE30capsules$4.0090capsules$10.00
AMOXICILLIN 875MG TABLET20tablets$4.0060tablets$10.00
AZITHROMYCIN 100MG/5ML SUSP15ml$10.00
AZITHROMYCIN 200MG/5ML SUSP15ml$10.00
AZITHROMYCIN 200MG/5ML SUSP23ml$15.00
AZITHROMYCIN 200MG/5ML SUSP30ml$15.00
CEPHALEXIN 250MG CAPSULE30capsules$4.0090capsules$10.00
CEPHALEXIN 500MG CAPSULE30capsules$4.0090capsules$10.00
CIPROFLOXACIN 0.3% EYE DROP2.5ml$4.00
CIPROFLOXACIN 0.3% EYE DROP5ml$4.00
CIPROFLOXACIN 0.3% EYE DROP10ml$8.00
CIPROFLOXACIN HCL 250MG TAB20tablets$4.0060tablets$10.00
CIPROFLOXACIN HCL 500MG TAB20tablets$4.0060tablets$10.00
CLINDAMYCIN HCL 150MG CAP30capsules$4.0090capsules$10.00
DOXYCYCLINE (HYC & MONO) 100MG CAP2capsules$4.0020capsules$20.00
DOXYCYCLINE (HYC & MONO) 100MG TAB2tablets$4.0020tablets$20.00
DOXYCYCLINE HYC 50MG CAP20capsules$20.00
DOXYCYCLINE MON 50MG TAB20tablets$20.00
DOXYCYCLINE MON 75MG TAB20tablets$20.00
DOXYCYCYLINE HYC 20MG TAB20tablets$20.00
ERYTHROMYCIN EYE OINTMENT3.5grams$15.00
GENTAMICIN 3MG/ML EYE DROP5ml$4.00
ISONIAZID 300 MG TAB30tablets$4.0090tablets$10.00
NEO/POLY/DEXAMET EYE OINT3.5grams$4.00
PENICILLIN VK 250MG TAB28tablets$4.0056tablets$8.00
PENICILLIN VK 250MG/5ML SOLN100ml$4.00
PENICILLIN VK 250MG/5ML SOLN200ml$8.00
PENICILLIN VK 500MG TAB30tablets$4.00
POLYMYXIN B/TMP EYE DROPS10ml$4.00
SULFAMETHOXAZOLE/TMP DS TAB20tablets$4.0060tablets$10.00
SULFAMETHOXAZOLE/TMP SS TAB28tablets$4.0084tablets$10.00
TOBRAMYCIN 0.3% EYE DROPS5ml$4.00
Anti-Viral
ACYCLOVIR 200MG CAPSULE30capsules$4.0060capsules$8.00
ACYCLOVIR 400MG TABLET30tablets$4.00
Arthritis and Pain
ALLOPURINOL 100MG TABLET30tablets$4.0090tablets$10.00
ALLOPURINOL 300MG TABLET30tablets$4.0090tablets$10.00
BACLOFEN 10MG TABLET30tablets$4.0090tablets$10.00
CYCLOBENZAPRINE 10MG TAB30tablets$4.0090tablets$10.00
CYCLOBENZAPRINE 5MG TAB30tablets$4.0090tablets$10.00
DEXAMETHASONE 0.5MG TABLET30tablets$4.0090tablets$10.00
DEXAMETHASONE 4MG TABLET6tablets$4.0018tablets$10.00
IBUPROFEN 400MG TABLET90tablets$4.00270tablets$10.00
IBUPROFEN 600MG TABLET60tablets$4.00180tablets$10.00
IBUPROFEN 800MG TABLET30tablets$4.0090tablets$10.00
INDOMETHACIN 25MG CAP60capsules$4.00180capsules$10.00
INDOMETHACIN 50MG CAP30capsules$4.0090capsules$10.00
INDOMETHACIN ER 75MG CAP30capsules$10.00
MELOXICAM 15MG TABLET30tablets$4.0090tablets$10.00
MELOXICAM 7.5MG TABLET30tablets$4.0090tablets$10.00
METHOCARBAMOL 500MG TAB60tablets$4.00180tablets$10.00
NAPROXEN 250MG TABLET60tablets$4.00180tablets$10.00
NAPROXEN 375MG TABLET60tablets$4.00180tablets$10.00
NAPROXEN 500MG TABLET60tablets$4.00180tablets$10.00
PREDNISONE 10MG TABLET30tablets$4.0090tablets$10.00
PREDNISONE 1MG TABLET30tablets$4.0090tablets$10.00
PREDNISONE 2.5MG TABLET30tablets$4.0090tablets$10.00
PREDNISONE 20MG TABLET30tablets$4.0090tablets$10.00
PREDNISONE 5MG TABLET30tablets$4.0090tablets$10.00
Asthma
ALBUTEROL 0.83MG/ML SOLN75ml$4.00
ALBUTEROL 0.83MG/ML SOLN90ml$4.00
IPRATROPIUM BR 0.02% SOLN63ml$4.00
IPRATROPIUM BR 0.02% SOLN75ml$4.00
MONTELUKAST CHEW 4MG TAB30tablets$10.00
MONTELUKAST CHEW 5MG TAB30tablets$10.00
MONTELUKAST SOD 10MG TAB30tablets$10.00
Blood Glucose Monitoring
PRODIGY NO CODING TEST STRIPS50strips$5.00
PRODIGY POCKET METER KIT1unit$9.00
PRODIGY TWIST TOP 28G LANCET100each$2.50
Diabetes
GLIMEPIRIDE 1 MG TABLET30tablets$4.0090tablets$10.00
GLIMEPIRIDE 2 MG TABLET30tablets$4.0090tablets$10.00
GLIMEPIRIDE 4 MG TABLET30tablets$4.0090tablets$10.00
glipiZIDE 10MG TABLET60tablets$4.00180tablets$10.00
glipiZIDE 5MG TABLET60tablets$4.00180tablets$10.00
glipiZIDE XL 2.5MG TABLET30tablets$4.0090tablets$10.00
glipiZIDE XL 5MG TABLET30tablets$4.0090tablets$10.00
glyBURIDE 1.25MG TABLET30tablets$4.0090tablets$10.00
glyBURIDE 2.5MG TABLET30tablets$4.0090tablets$10.00
glyBURIDE 5MG TABLET30tablets$4.0090tablets$10.00
glyBURIDE MICRO 3MG TAB30tablets$4.0090tablets$10.00
glyBURIDE MICRO 6MG TAB30tablets$4.0090tablets$10.00
glyBURIDE-METFORMIN 1.25-25060tablets$4.00180tablets$10.00
glyBURIDE-METFORMIN 2.5-50060tablets$4.00180tablets$10.00
glyBURIDE-METFORMIN 5-50060tablets$4.00180tablets$10.00
METFORMIN HCL 1000MG TAB60tablets$4.00180tablets$10.00
METFORMIN HCL 500MG TAB60tablets$4.00180tablets$10.00
METFORMIN HCL 850MG TAB60tablets$4.00180tablets$10.00
METFORMIN HCL ER 500MG TAB60tablets$4.00180tablets$10.00
METFORMIN HCL ER 750MG TAB30tablets$4.0090tablets$10.00
NOVOLIN 70/30 100U/ML VIAL10ml$10.00
NOVOLIN N 100U/ML VIAL10ml$10.00
NOVOLIN R 100U/ML VIAL10ml$10.00
PIOGLITAZONE HCL 15MG TAB30tablets$4.0090tablets$10.00
PIOGLITAZONE HCL 30MG TAB30tablets$4.0090tablets$10.00
PIOGLITAZONE HCL 45MG TAB30tablets$4.0090tablets$10.00
Fungal Infections
FLUCONAZOLE 150MG TABLET1tablets$4.003tablets$10.00
TERBINAFINE HCL 250MG TAB30tablets$4.0090tablets$10.00
Gastrointestinal
DICYCLOMINE 10MG CAPS90capsules$4.00270capsules$10.00
DICYCLOMINE 20MG TABLET60tablets$4.00180tablets$10.00
FAMOTIDINE 20MG TABLET60tablets$4.00180tablets$10.00
FAMOTIDINE 40MG TABLET30tablets$4.0090tablets$10.00
LACTULOSE 10GM/15ML SOLN237ml$4.00
METOCLOPRAMIDE 10MG TAB60tablets$4.00180tablets$10.00
METOCLOPRAMIDE 5MG TAB60tablets$4.00180tablets$10.00
OMEPRAZOLE DR 10MG CAPS30capsules$8.0090capsules$20.00
OMEPRAZOLE DR 20MG CAPS30capsules$8.0090capsules$20.00
OMEPRAZOLE DR 40MG CAPS30capsules$8.0090capsules$20.00
ONDANSETRON HCL 4MG TABLET20tablets$4.0060tablets$10.00
ONDANSETRON HCL 8MG TABLET20tablets$4.0060tablets$10.00
ONDANSETRON ODT 4MG TABLET20tablets$4.0060tablets$10.00
ONDANSETRON ODT 8MG TABLET20tablets$4.0060tablets$10.00
PANTOPRAZOLE 20MG TAB30tablets$4.0090tablets$10.00
PANTOPRAZOLE 40MG TAB30tablets$4.0090tablets$10.00
PROCHLORPERAZINE 10MG TAB30tablets$4.0090tablets$10.00
PROCHLORPERAZINE 5MG TAB30tablets$4.0090tablets$10.00
PROMETHAZINE 25MG TABLET12tablets$4.0036tablets$10.00
PROMETHAZINE 6.25MG/5 ML S180ml$4.00
RANITIDINE 150MG TABLET60tablets$4.00180tablets$10.00
RANITIDINE 300MG TABLET30tablets$4.0090tablets$10.00
Glaucoma and Eye Care
TIMOLOL 0.25% EYEDROPS5ml$4.00
TIMOLOL 0.5% EYE DROPS5ml$4.00
TIMOLOL 0.5% EYE DROPS10ml$8.00
Heart Health and Blood Pressure
AMIODARONE HCL 200MG TAB30tablets$4.0090tablets$10.00
AMLODIPINE BESYLATE 10MG TAB30tablets$4.0090tablets$10.00
AMLODIPINE BESYLATE 2.5MG TAB30tablets$4.0090tablets$10.00
AMLODIPINE BESYLATE 5MG TAB30tablets$4.0090tablets$10.00
ATENOLOL 100MG TABLET30tablets$4.0090tablets$10.00
ATENOLOL 25MG TABLET30tablets$4.0090tablets$10.00
ATENOLOL 50MG TABLET30tablets$4.0090tablets$10.00
ATORVASTATIN 10MG TAB30tablets$4.0090tablets$10.00
ATORVASTATIN 20MG TAB30tablets$4.0090tablets$10.00
ATORVASTATIN 40MG TAB30tablets$4.0090tablets$10.00
ATORVASTATIN 80MG TAB30tablets$10.00
BENAZEPRIL HCL 10MG TAB30tablets$4.0090tablets$10.00
BENAZEPRIL HCL 20MG TAB30tablets$4.0090tablets$10.00
BENAZEPRIL HCL 40MG TAB30tablets$4.0090tablets$10.00
BISOPROLOL/HCTZ 10/6.25 TAB30tablets$4.0090tablets$10.00
BISOPROLOL/HCTZ 2.5/6.25 TAB30tablets$4.0090tablets$10.00
BISOPROLOL/HCTZ 5/6.25 TAB30tablets$4.0090tablets$10.00
CARVEDILOL 12.5MG TAB60tablets$4.00180tablets$10.00
CARVEDILOL 25MG TAB60tablets$4.00180tablets$10.00
CARVEDILOL 3.125MG TAB60tablets$4.00180tablets$10.00
CARVEDILOL 6.25MG TAB60tablets$4.00180tablets$10.00
CLONIDINE HCL 0.1MG TABLET30tablets$4.0090tablets$10.00
CLONIDINE HCL 0.2MG TABLET30tablets$4.0090tablets$10.00
CLOPIDOGREL 75MG TAB30tablets$4.0090tablets$10.00
DILTIAZEM 30MG TABLET60tablets$4.00180tablets$10.00
ENALAPRIL/HCTZ 5-12.5MG TAB30tablets$4.0090tablets$10.00
FOSINOPRIL SODIUM 10MG TAB30tablets$4.0090tablets$10.00
FOSINOPRIL SODIUM 20MG TAB30tablets$4.0090tablets$10.00
FUROSEMIDE 20MG TABLET30tablets$4.0090tablets$10.00
FUROSEMIDE 40MG TABLET30tablets$4.0090tablets$10.00
FUROSEMIDE 80MG TABLET30tablets$4.0090tablets$10.00
GUANFACINE 1MG TABLET30tablets$4.0090tablets$10.00
GUANFACINE 2MG TABLET30tablets$4.0090tablets$10.00
HYDRALAZINE 100MG TABLET30tablets$4.0090tablets$10.00
HYDRALAZINE 10MG TABLET30tablets$4.0090tablets$10.00
HYDRALAZINE 25MG TABLET30tablets$4.0090tablets$10.00
HYDRALAZINE 50MG TABLET30tablets$4.0090tablets$10.00
HYDROCHLOROTHIAZIDE 12.5MG CA30capsules$4.0090capsules$10.00
HYDROCHLOROTHIAZIDE 12.5MG TB30tablets$4.0090tablets$10.00
HYDROCHLOROTHIAZIDE 25MG TAB30tablets$4.0090tablets$10.00
HYDROCHLOROTHIAZIDE 50MG TAB30tablets$4.0090tablets$10.00
INDAPAMIDE 1.25MG TABLET30tablets$4.0090tablets$10.00
INDAPAMIDE 2.5MG TABLET30tablets$4.0090tablets$10.00
LISINOPRIL 10MG TAB30tablets$4.0090tablets$10.00
LISINOPRIL 2.5MG TAB30tablets$4.0090tablets$10.00
LISINOPRIL 20MG TAB30tablets$4.0090tablets$10.00
LISINOPRIL 30MG TAB30tablets$4.0090tablets$10.00
LISINOPRIL 40MG TAB30tablets$4.0090tablets$10.00
LISINOPRIL 5MG TAB30tablets$4.0090tablets$10.00
LISINOPRIL-HCTZ 10-12.5 TAB30tablets$4.0090tablets$10.00
LISINOPRIL-HCTZ 20-12.5 TAB30tablets$4.0090tablets$10.00
LISINOPRIL-HCTZ 20-25 TAB30tablets$4.0090tablets$10.00
LOSARTAN POT 100MG TAB30tablets$4.0090tablets$10.00
LOSARTAN POT 25MG TAB30tablets$4.0090tablets$10.00
LOSARTAN POT 50MG TAB30tablets$4.0090tablets$10.00
LOSARTAN-HCTZ 100-12.5MG TAB30tablets$4.0090tablets$10.00
LOSARTAN-HCTZ 100-25MG TAB30tablets$4.0090tablets$10.00
LOSARTAN-HCTZ 50-12.5MG TAB30tablets$4.0090tablets$10.00
LOVASTATIN 10MG TAB30tablets$4.0090tablets$10.00
LOVASTATIN 20MG TAB30tablets$4.0090tablets$10.00
METOPROLOL TART 100MG TAB60tablets$4.00180tablets$10.00
METOPROLOL TART 25MG TAB60tablets$4.00180tablets$10.00
METOPROLOL TART 50MG TAB60tablets$4.00180tablets$10.00
QUINAPRIL 10MG TABLET30tablets$4.0090tablets$10.00
QUINAPRIL 20MG TABLET30tablets$4.0090tablets$10.00
QUINAPRIL 40MG TABLET30tablets$4.0090tablets$10.00
QUINAPRIL 5MG TABLET30tablets$4.0090tablets$10.00
SIMVASTATIN 10MG TABLET30tablets$4.0090tablets$10.00
SIMVASTATIN 20MG TABLET30tablets$4.0090tablets$10.00
SIMVASTATIN 40MG TABLET30tablets$4.0090tablets$10.00
SIMVASTATIN 5MG TABLET30tablets$4.0090tablets$10.00
SOTALOL 80MG TABLET30tablets$4.0090tablets$10.00
SPIRONOLACTONE 25MG TABLET30tablets$4.0090tablets$10.00
TERAZOSIN 10MG CAPSULE30capsules$4.0090capsules$10.00
TERAZOSIN 1MG CAPSULE30capsules$4.0090capsules$10.00
TERAZOSIN 2MG CAPSULE30capsules$4.0090capsules$10.00
TERAZOSIN 5MG CAPSULE30capsules$4.0090capsules$10.00
TORSEMIDE 10MG TABLET30tablets$4.0090tablets$10.00
TORSEMIDE 20MG TABLET30tablets$4.0090tablets$10.00
TORSEMIDE 5MG TABLET30tablets$4.0090tablets$10.00
TRIAMTERENE/HCTZ 37.5-25 CAP30capsules$4.0090capsules$10.00
TRIAMTERENE/HCTZ 37.5-25 TAB30tablets$4.0090tablets$10.00
VERAPAMIL 120MG TABLET30tablets$4.0090tablets$10.00
VERAPAMIL 80MG TABLET30tablets$4.0090tablets$10.00
WARFARIN SODIUM 10MG TAB30tablets$4.0090tablets$10.00
WARFARIN SODIUM 1MG TAB30tablets$4.0090tablets$10.00
WARFARIN SODIUM 2.5MG TAB30tablets$4.0090tablets$10.00
WARFARIN SODIUM 2MG TAB30tablets$4.0090tablets$10.00
WARFARIN SODIUM 3MG TAB30tablets$4.0090tablets$10.00
WARFARIN SODIUM 4MG TAB30tablets$4.0090tablets$10.00
WARFARIN SODIUM 5MG TAB30tablets$4.0090tablets$10.00
WARFARIN SODIUM 6MG TAB30tablets$4.0090tablets$10.00
WARFARIN SODIUM 7.5MG TAB30tablets$4.0090tablets$10.00
Men’s Health
FINASTERIDE 5MG TABLET30tablets$9.00
SILDENAFIL 20MG TABLET1tablets$4.005tablets$10.00
TAMSULOSIN HCL 0.4MG CAP30capsules$4.00
Mental Health
AMITRIPTYLINE HCL 10MG TAB30tablets$4.0090tablets$10.00
AMITRIPTYLINE HCL 25MG TAB30tablets$4.0090tablets$10.00
AMITRIPTYLINE HCL 50MG TAB30tablets$4.0090tablets$10.00
AMITRIPTYLINE HCL 75MG TAB30tablets$4.0090tablets$10.00
BENZTROPINE MES 2MG TAB30tablets$4.0090tablets$10.00
BUPROPION 100MG TAB30tablets$10.00
BUPROPION 75MG TAB30tablets$10.00
BUPROPION SR 100MG TAB60tablets$10.00
BUPROPION SR 150MG TAB60tablets$10.00
BUPROPION SR 200MG TAB60tablets$20.00
BUSPIRONE HCL 10MG TAB60tablets$4.00180tablets$10.00
BUSPIRONE HCL 15MG TAB60tablets$4.00180tablets$10.00
BUSPIRONE HCL 5MG TAB60tablets$4.00180tablets$10.00
CITALOPRAM HBR 10MG TABLET30tablets$4.0090tablets$10.00
CITALOPRAM HBR 20MG TABLET30tablets$4.0090tablets$10.00
CITALOPRAM HBR 40MG TABLET30tablets$4.0090tablets$10.00
DONEPEZIL 10MG TAB30tablets$4.0090tablets$10.00
DONEPEZIL 5MG TAB30tablets$4.0090tablets$10.00
DULOXETINE DR 20MG CAP30capsules$20.0090capsules$40.00
DULOXETINE DR 30MG CAP30capsules$20.0090capsules$40.00
DULOXETINE DR 60MG CAP30capsules$20.0090capsules$40.00
ESCITALOPRAM 10MG TAB30tablets$4.0090tablets$10.00
ESCITALOPRAM 20MG TAB30tablets$4.0090tablets$10.00
ESCITALOPRAM 5MG TAB30tablets$4.0090tablets$10.00
FLUOXETINE 10MG CAPSULE30capsules$4.0090capsules$10.00
FLUOXETINE 20MG CAPSULE30capsules$4.0090capsules$10.00
FLUOXETINE 40MG CAPSULE30capsules$4.0090capsules$10.00
GABAPENTIN 100MG CAP90capsules$4.00
GABAPENTIN 300MG CAP90capsules$4.00
HALOPERIDOL 0.5MG TABLET30tablets$4.0090tablets$10.00
HYDROXYZINE HCL 10MG TAB30tablets$4.0090tablets$10.00
HYDROXYZINE HCL 25MG TAB30tablets$4.0090tablets$10.00
HYDROXYZINE PAM 25MG CAP30capsules$4.0090capsules$10.00
HYDROXYZINE PAM 50MG CAP30capsules$4.0090capsules$10.00
IMIPRAMINE HCL 10MG TABLET30tablets$4.0090tablets$10.00
IMIPRAMINE HCL 25MG TABLET30tablets$4.0090tablets$10.00
IMIPRAMINE HCL 50MG TABLET30tablets$4.0090tablets$10.00
LAMOTRIGINE 100MG TAB60tablets$4.00180tablets$10.00
LAMOTRIGINE 150MG TAB60tablets$4.00180tablets$10.00
LAMOTRIGINE 200MG TAB60tablets$4.00180tablets$10.00
LAMOTRIGINE 25MG TAB60tablets$4.00180tablets$10.00
LITHIUM CARBONATE 150MG CAP30capsules$4.0090capsules$10.00
LITHIUM CARBONATE 300MG CAP90capsules$4.00270capsules$10.00
MIRTAZAPINE 15MG TAB30tablets$4.0090tablets$10.00
MIRTAZAPINE 30MG TAB30tablets$4.0090tablets$10.00
NORTRIPTYLINE HCL 10MG CAP30capsules$4.0090capsules$10.00
NORTRIPTYLINE HCL 25MG CAP30capsules$4.0090capsules$10.00
NORTRIPTYLINE HCL 50MG CAP30capsules$4.0090capsules$10.00
OLANZAPINE 10MG TABLET30tablets$10.00
OLANZAPINE 15MG TABLET30tablets$10.00
OLANZAPINE 2.5MG TABLET30tablets$10.00
OLANZAPINE 20MG TABLET30tablets$10.00
OLANZAPINE 5MG TABLET30tablets$10.00
OLANZAPINE 7.5MG TABLET30tablets$10.00
PAROXETINE HCL 10MG TABLET30tablets$4.0090tablets$10.00
PAROXETINE HCL 20MG TABLET30tablets$4.0090tablets$10.00
PAROXETINE HCL 30MG TABLET30tablets$4.0090tablets$10.00
PAROXETINE HCL 40MG TABLET30tablets$4.0090tablets$10.00
PRAMIPEXOLE 0.125MG TAB30tablets$4.0090tablets$10.00
PRAMIPEXOLE 0.25MG TAB30tablets$4.0090tablets$10.00
PRAMIPEXOLE 0.5MG TAB30tablets$4.0090tablets$10.00
QUETIAPINE FUM 100MG TAB30tablets$4.0090tablets$10.00
QUETIAPINE FUM 25MG TAB30tablets$4.0090tablets$10.00
QUETIAPINE FUM 50MG TAB30tablets$4.0090tablets$10.00
RISPERIDONE 0.25MG TABLET30tablets$4.0090tablets$10.00
RISPERIDONE 0.5MG TABLET30tablets$4.0090tablets$10.00
RISPERIDONE 1MG TABLET30tablets$4.0090tablets$10.00
RISPERIDONE 2MG TABLET30tablets$4.0090tablets$10.00
RISPERIDONE 3MG TABLET30tablets$4.0090tablets$10.00
RISPERIDONE 4MG TABLET30tablets$4.0090tablets$10.00
ROPINIROLE HCL 0.25MG TAB30tablets$4.00
ROPINIROLE HCL 0.5MG TAB30tablets$4.00
ROPINIROLE HCL 1MG TAB30tablets$4.00
ROPINIROLE HCL 2MG TAB30tablets$4.00
ROPINIROLE HCL 3MG TAB30tablets$4.00
ROPINIROLE HCL 4MG TAB30tablets$4.00
ROPINIROLE HCL 5MG TAB30tablets$4.00
SERTRALINE HCL 100MG TAB30tablets$4.0090tablets$10.00
SERTRALINE HCL 25MG TABLET30tablets$4.0090tablets$10.00
SERTRALINE HCL 50MG TABLET30tablets$4.0090tablets$10.00
TOPIRAMATE 100MG TABLET30tablets$4.0090tablets$10.00
TOPIRAMATE 200MG TABLET30tablets$4.0090tablets$10.00
TOPIRAMATE 25MG TABLET30tablets$4.0090tablets$10.00
TOPIRAMATE 50MG TABLET30tablets$4.0090tablets$10.00
TRAZODONE 100MG TABLET30tablets$4.0090tablets$10.00
TRAZODONE 150MG TABLET30tablets$4.0090tablets$10.00
TRAZODONE 50MG TABLET30tablets$4.0090tablets$10.00
TRIHEXYPHENIDYL 2MG TAB60tablets$4.00180tablets$10.00
VENLAFAXINE HCL 100 MG TAB30tablets$10.00
VENLAFAXINE HCL 25 MG TAB30tablets$10.00
VENLAFAXINE HCL 37.5MG TAB30tablets$10.00
VENLAFAXINE HCL 50 MG TAB30tablets$10.00
VENLAFAXINE HCL 75 MG TAB30tablets$10.00
VENLAFAXINE HCL ER 150 MG CAP30capsules$10.00
VENLAFAXINE HCL ER 37.5MG CAP30capsules$10.00
VENLAFAXINE HCL ER 75 MG CAP30capsules$10.00
Other
ALENDRONATE SODIUM 35MG TAB4tablets$9.00
ALENDRONATE SODIUM 70MG TAB4tablets$9.00
CHLORHEXIDINE 0.12% RINSE473ml$4.00
CLOMIPHENE CITRATE 50MG TAB5tablets$9.0015tablets$24.00
LIDOCAINE 2% VISCOUS SOLN100ml$4.00
SUMATRIPTAN SUCC 100MG TAB9tablets$10.00
SUMATRIPTAN SUCC 25MG TAB9tablets$10.00
SUMATRIPTAN SUCC 50MG TAB9tablets$10.00
Skin Conditions
HYDROCORTISONE 1% CREAM15grams$4.00
HYDROCORTISONE 1% CREAM28grams$4.00
HYDROCORTISONE 1% CREAM28grams$4.00
HYDROCORTISONE 1% OINT28grams$4.00
HYDROCORTISONE 1% OINT28grams$4.00
HYDROCORTISONE 1% OINT30grams$4.00
HYDROCORTISONE 2.5% CREAM20grams$4.00
HYDROCORTISONE 2.5% CREAM28grams$4.00
HYDROCORTISONE 2.5% CREAM28grams$4.00
HYDROCORTISONE 2.5% CREAM30grams$4.00
SILVER SULFADIAZINE 1% CRM20grams$4.00
SILVER SULFADIAZINE 1% CRM25grams$4.00
SILVER SULFADIAZINE 1% CRM50grams$10.00
SILVER SULFADIAZINE 1% CRM85grams$10.00
TRIAMCINOLONE 0.025% CRM15grams$4.00
TRIAMCINOLONE 0.1% CREAM15grams$4.00
TRIAMCINOLONE 0.1% CREAM30grams$4.00
TRIAMCINOLONE 0.1% CREAM80grams$4.00
TRIAMCINOLONE 0.1% OINT15grams$4.00
TRIAMCINOLONE 0.1% OINT80grams$4.00
TRIAMCINOLONE 0.5% CREAM15grams$4.00
Thyroid
LEVOTHYROXINE 100MCG TAB30tablets$4.00
LEVOTHYROXINE 112MCG TAB30tablets$4.00
LEVOTHYROXINE 125MCG TAB30tablets$4.00
LEVOTHYROXINE 137MCG TAB30tablets$6.00
LEVOTHYROXINE 150MCG TAB30tablets$4.00
LEVOTHYROXINE 175MCG TAB30tablets$4.00
LEVOTHYROXINE 200MCG TAB30tablets$4.00
LEVOTHYROXINE 25MCG TAB30tablets$4.00
LEVOTHYROXINE 300MCG TAB30tablets$4.00
LEVOTHYROXINE 50MCG TAB30tablets$4.00
LEVOTHYROXINE 75MCG TAB30tablets$4.00
LEVOTHYROXINE 88MCG TAB30tablets$4.00
Vitamins and Nutritional
FOLIC ACID 1MG TABLET30tablets$4.0090tablets$10.00
Women’s Health
ESTRADIOL 0.5MG TABLET30tablets$4.0090tablets$10.00
ESTRADIOL 1MG TABLET30tablets$4.0090tablets$10.00
ESTRADIOL 2MG TABLET30tablets$4.0090tablets$10.00
MEDROXYPROGESTERONE 10MG TAB30tablets$4.0090tablets$10.00
MEDROXYPROGESTERONE 2.5MG TAB30tablets$4.0090tablets$10.00
MEDROXYPROGESTERONE 5MG TAB30tablets$4.0090tablets$10.00
ORTHO TRI-CYCLEN 28 TABLET28tablets$9.00
ORTHO TRI-CYCLEN LO TABLET28tablets$9.00
ORTHO-CYCLEN 28 TABLET28tablets$9.00
PRENATAL TABLET30tablets$4.0090tablets$10.00
SPRINTEC 28 DAY TABLET28tablets$9.00
TRINESSA TABLET28tablets$9.00
TRI-SPRINTEC 28  TAB28tablets$9.00

Affordable Care Program (ACP) Discount Medication List

PCHC patients who are approved for PCHC’s affordable care program can receive discounted costs for their medical visits, as well as for their medications. Patients with ACP receive up to 40% off of their prescription medication costs, and can get medications on the ACP Discount Medications List for free, when they are available from PCHC pharmacies.

To talk to a PCHC Outreach and Enrollment Specialist about the Affordable Care Program, please CLICK HERE for the contact for your health center.

If you are unsure if your medications can be switched to a medications on this list or you have other trouble paying for your medications, please speak with your provider or your pharmacist, or call your PCHC pharmacy at 207-992-4100.

Our ACP discount medication program includes all of the following medications, available at no cost to the patient, to those PCHC patients with active ACP (paperwork completed and on file). These programs require that the first fill be limited to a 30 day supply. Refills after that may be done for 90 day supplies.

Supplies may be limited for these medications, and providers are encouraged to call ahead to the pharmacy to verify amounts in stock.

Affordable Care Program Discount Medications
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Direct Relief

Cymbalta (Duloxetine) 20mg, 30mg, 60mg
Ditropan XL (Oxybutinin Extended Release) 5mg
Elmiron (Pentosan) 100mg
Invega (Paliperidone Extended Release) 3mg, 9mg
Levaquin (Levofloxacin) 750mg
Prozac (Fluoxetine) 10mg, 20mg, 40mg
Risperdal (Risperidone) 1mg
Synthroid (Levothyroxine) 50mcg, 75mcg, 88mcg, 100mcg, 112mcg, 125mcg, 137mcg, 150mcg, 175mcg
Zyprexa (Olanzapine) 2.5mg, 5mg, 7.5mg, 10mg, 15mg, 20mg

Merck

Januvia (Sitagliptin) 25mg, 50mg, 100mg
Proventil (Albuterol) 90mcg/inhalation
Asmanex (Mometasone) 220mcg/inhalation
Nasonex (Mometasone) 50mcg/spray
Maxalt (Rizatriptan) 5mg, 10mg
Maxalt MLT (Rizatriptan Disintegrating Tablets) 5mg, 10mg
Zetia (Ezetimibe) 10mg
Dulera (Mometasone/ Formoterol) 100/5mcg /inhalation, 200/5mcg /inhalation
Janumet (Sitagliptin/ Metformin) 50/500mg, 50/1000mg
Janumet XR (Sitagliptin/ Metformin Extended Release) 50/500mg, 50/1000mg, 100/1000mg

Pfizer

Celebrex (Celecoxib) 100mg, 200mg
Chantix (Varenicline) 0.5mg, 1mg
Depo-Provera (Medroxyprogesterone) 150mg/mL
Lyrica (Pregabalin) 50mg, 75mg, 100mg, 150mg, 225mg
Premarin (Estrogens) 0.3mg, 0.45mg, 0.625mg
Premarin Cream (Estrogens) 0.625mg/g
Prempro (Estrogen/Medroxyprogesterone) 0.30/1.45mg, 0.45/1.45mg
Pristiq (Desvenlafaxine) 50mg, 100mg
Relpax (Eletriptan) 40mg
Viagra (Sildenafil) 50mg, 100mg

Other

Apidra (Insulin Glulisine) 100 units/mL vials
Humalog (Insulin Lispro) 100 units/ml vials and Flexpen
Insulin syringes/some pen needles
Levemir (Insulin Detemir) 100 units/ml vials and Flexpen
Novolog (Insulin Aspart) 100 units/ml vials and Flexpen
Novolin R/Novolin N 100 units/ml vials

Discounted items (some charge applies, contact pharmacy for details)

Prodigy Meter
Prodigy Testing Strips
TrueMetrix Meter
TrueMetrix Testing strips

PCHC Generic Prescriptions - Alphabetized List
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PCHC Generic Prescriptions - Categorized List
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