Revised
9/14/11
$2 / $5 Platinum Generic Drug Plan * Our price is the lowest price guaranteed. No one beats us! * You must sign up to be a Platinum Member to receive discounts. * Autofill - We can automatically get your refills ready each month. * Check out our SyncRX Program to organize your life better. * We can text you to remind you when to take your medications. * The most convenient location in Coffeyville + Drive-Thru
Allergies & Cold and Flu
$2/30 Days 14 30 120mL
$5/90 Days 42 90 360mL
Antibiotic Treatments
$2/30 Days 1 1 1 1 1 1 1 1 1 1 1 1 30 30 28 30 14 20 30 20
$5/90 Days 3 3 3 3 3 3 3 3 3 3 3 3 90 90 84 90 42 60 90 60
Benzonatate 100mg cap Loratadine 10mg tab Promethazine DM syrup
Amoxicillin 125mg/5ml susp (80ml bottle)† Amoxicillin 125mg/5ml susp (100ml bottle)† Amoxicillin 125mg/5ml susp (150ml bottle)† Amoxicillin 200mg/5ml susp (50ml bottle)† Amoxicillin 200mg/5ml susp (75ml bottle)† Amoxicillin 200mg/5ml susp (100ml bottle)† Amoxicillin 250mg/5ml susp (80ml bottle)† Amoxicillin 250mg/5ml susp (100ml bottle)† Amoxicillin 250mg/5ml susp (150ml bottle)† Amoxicillin 400mg/5ml susp (50ml bottle)† Amoxicillin 400mg/5ml susp (75ml bottle)† Amoxicillin 400mg/5ml susp (100ml bottle)† Amoxicillin 250mg cap Amoxicillin 500mg cap Cephalexin 250mg cap Cephalexin 500mg cap Ciproloxacin 250mg tab Ciproloxacin 500mg tab Doxycycline Hyclate 50mg cap Doxycycline Hyclate 100mg cap
The $2/$5 Platinum Generic Program includes many generics up to a 30-day supply for $2 or a 90-day supply for $5 at commonly prescribed dosages. †Only covered in the unit size listed on the drug list.
20 28 14 28 1 1 1 120mL 28 20 60 60
60 84 42 84 3 3 3 360mL 84 60 180 180
Arthritis & Pain
$2/30 Days 30 30 30 30 30 30 12 6 60 120mL 90 60 30 60 30 30 60 60
$5/90 Days 90 90 90 90 90 90 36 18 180 360mL 270 180 90 180 90 90 180 180
Asthma
$2/30 Days 90 60 120mL 1 1 1
$5/90 Days 270 180 360mL 3 3 3
Cholesterol
$2/30 Days 30 30 30 30 30
$5/90 Days 90 90 90 90 90
Doxycycline Hyclate 100mg tab Metronidazole 250mg tab Metronidazole 500mg tab Penicillin VK 250mg tab Penicillin VK 125mg/5ml susp (100ml bottle)† Penicillin VK 125mg/5ml susp (200ml bottle)† Penicillin VK 250mg/5ml susp (100ml bottle)† SMZ-TMP 200mg-40mg/5ml susp SMZ-TMP 400mg-80mg tab SMZ-TMP DS 800mg-160mg tab Tetracycline 250mg cap Tetracycline 500mg cap Allopurinol 100mg tab Allopurinol 300mg tab Baclofen 10mg tab Cyclobenzaprine 5mg tab Cyclobenzaprine 10mg tab Dexamethasone 0.5mg tab Dexamethasone 0.75mg tab Dexamethasone 4mg tab Diclofenac DR 75mg tab Ibuprofen 100mg/5ml susp Ibuprofen 400mg tab Ibuprofen 600mg tab Ibuprofen 800mg tab Indomethacin 25mg cap Meloxicam 7.5mg tab Meloxicam 15mg tab Naproxen 375mg tab Naproxen 500mg tab Albuterol 2mg tab Albuterol 4mg tab Albuterol 2mg/5ml syrup Albuterol 0.5% nebulizer soln (20ml bottle)† Albuterol 0.083% nebulizer soln (25x3ml vials)† Ipratropium 0.02% nebulizer soln (25x2.5ml vials)† Lovastatin 10mg tab Lovastatin 20mg tab Pravastatin 10mg tab Pravastatin 20mg tab Pravastatin 40mg tab
The $2/$5 Platinum Generic Program includes many generics up to a 30-day supply for $2 or a 90-day supply for $5 at commonly prescribed dosages. †Only covered in the unit size listed on the drug list.
Diabetes
$2/30 Days 30 30 30 30 30 60 30 30 30 30 60 60 60 60
$5/90 Days 90 90 90 90 90 180 90 90 90 90 180 180 180 180
Ear Health
$2/30 Days 1
$5/90 Days 3
Fungal Infections
$2/30 Days 1 1 1 1 1 1 30
$5/90 Days 3 3 3 3 3 3 90
Gastrointestinal Health
$2/30 Days 60 30 180mL 90 60 60 237mL 60 60mL 12 180mL 60 30
$5/90 Days 180 90 540mL 270 180 180 711mL 180 180mL 36 540mL 180 90
Glaucoma & Eye Care
$2/30 Days 1 1 1 1 1 1
$5/90 Days 3 3 3 3 3 3
Chlorpropamide 100mg tab Glimepiride 1mg tab Glimepiride 2mg tab Glimepiride 4mg tab Glipizide 5mg tab Glipizide 10mg tab Glyburide 2.5mg tab Glyburide 5mg tab Glyburide, micronized 3mg tab Glyburide, micronized 6mg tab Metformin 500mg tab Metformin 850mg tab Metformin 1000mg tab Metformin 500mg ER tab Antipyrine/Benzocaine otic (10ml bottle)† Fluconazole 150mg tab Nystatin/Triamcin cream (15gm tube)† Nystatin/Triamcin cream (30gm tube)† Nystatin/Triamcin ointment (15gm tube)† Nystatin cream (15gm tube)† Nystatin cream (30gm tube)† Terbinafine 250mg tab Belladonna Alkaloid/PB tab Cimetidine 800mg tab Cytra-K solution Dicyclomine 10mg cap Dicyclomine 20mg tab Famotidine 20mg tab Lactulose syrup Metoclopramide 10mg tab Metoclopramide syrup Promethazine 25mg tab Promethazine plain syrup Ranitidine 150mg tab Ranitidine 300mg tab
Atropine Sulfate 1% op. soln (5ml bottle)† Erythromycin opth ointment (3.5gm tube)† Gentamicin 0.3% op. soln (5ml bottle)† Levobunolol 0.5% op soln (5ml bottle)† Neomycin/Polymyxin/Dexamethasone 0.1% op. ointment (3.5gm tube)† Neomycin/Polymyxin/Dexamethasone 0.1% op. susp (5ml bottle)†
The $2/$5 Platinum Generic Program includes many generics up to a 30-day supply for $2 or a 90-day supply for $5 at commonly prescribed dosages. †Only covered in the unit size listed on the drug list.
Pilocarpine 1% op. soln (15ml bottle)† Pilocarpine 2% op. soln (15ml bottle)† Polymyxin Sulfate/TMP op. soln (10ml bottle)† Sulfacet Sodium 10% op. soln (15ml bottle)† Timolol Maleate 0.25% op. soln (5ml bottle)† Timolol Maleate 0.5% op soln (5ml bottle)† Tobramycin 0.3% op. soln (5ml bottle)†
Heart Health & Blood Pressure
Amiloride-HCTZ 5mg-50mg tab Atenolol-Chlorthalidone 50mg-25mg tab Atenolol-Chlorthalidone 100mg-25mg tab Atenolol 25mg tab Atenolol 50mg tab Atenolol 100mg tab Benazepril 5mg tab Benazepril 10mg tab Benazepril 20mg tab Benazepril 40mg tab Bisoprolol-HCTZ 2.5mg-6.25mg tab Bisoprolol-HCTZ 5mg-6.25mg tab Bisoprolol-HCTZ 10mg-6.25mg tab Bumetanide 0.5mg tab Bumetanide 1mg tab Captopril 12.5mg tab Captopril 25mg tab Captopril 50mg tab Captopril 100mg tab Carvedilol 3.125mg tab Carvedilol 6.25mg tab Carvedilol 12.5mg tab Carvedilol 25mg tab Clonidine 0.1mg tab Clonidine 0.2mg tab Digoxin 0.125mg tab Digoxin 0.25mg tab Diltiazem 30mg tab Diltiazem 60mg tab Diltiazem 90mg tab Diltiazem 120mg tab Doxazosin 1mg tab Doxazosin 2mg tab Doxazosin 4mg tab Doxazosin 8mg tab Enalapril-HCTZ 5mg-12.5mg tab Enalapril 2.5mg tab Enalapril 5mg tab Enalapril 10mg tab Enalapril 20mg tab Furosemide 20mg tab Furosemide 40mg tab
1 1 1 1 1 1 1
3 3 3 3 3 3 3
$2/30 Days 30 30 30 30 30 30 30 30 30 30 30 30 30 30 30 60 60 60 60 60 60 60 60 30 30 30 30 60 60 60 30 30 30 30 30 30 30 30 30 30 30 30
$5/90 Days 90 90 90 90 90 90 90 90 90 90 90 90 90 90 90 180 180 180 180 180 180 180 180 90 90 90 90 180 180 180 90 90 90 90 90 90 90 90 90 90 90 90
The $2/$5 Platinum Generic Program includes many generics up to a 30-day supply for $2 or a 90-day supply for $5 at commonly prescribed dosages. †Only covered in the unit size listed on the drug list.
Furosemide 80mg tab Guanfacine 1mg tab Hydralazine 10mg tab Hydralazine 25mg tab Hydrochlorothiazide(HCTZ)12.5mg cap Hydrochlorothiazide (HCTZ) 25mg tab Hydrochlorothiazide (HCTZ) 50mg tab Indapamide 1.25mg tab Indapamide 2.5mg tab Isosorbide Mononitrate 30mg ER tab Isosorbide Mononitrate 60mg ER tab Lisinopril-HCTZ 10mg-12.5mg tab Lisinopril-HCTZ 20mg-12.5mg tab Lisinopril-HCTZ 20mg-25mg tab Lisinopril 2.5mg tab Lisinopril 5mg tab Lisinopril 10mg tab Lisinopril 20mg tab Methyldopa 250mg tab Methyldopa 500mg tab Metoprolol Tartrate 25mg tab Metoprolol Tartrate 50mg tab Metoprolol Tartrate 100mg tab Nadolol 20mg tab Nadolol 40mg tab Prazosin HCL 1mg cap Prazosin HCL 2mg cap Prazosin HCL 5mg cap Propranolol 10mg tab Propranolol 20mg tab Propranolol 40mg tab Propranolol 80mg tab Sotalol HCL 80mg tab Spironolactone 25mg tab Terazosin 1mg cap Terazosin 2mg cap Terazosin 5mg cap Terazosin 10mg cap Triamterene-HCTZ 37.5mg-25mg cap Triamterene-HCTZ 37.5mg-25mg tab Triamterene-HCTZ 75mg-50mg tab Verapamil 80mg tab Verapamil 120mg tab Warfarin 1mg tab Warfarin 2mg tab Warfarin 2.5mg tab Warfarin 3mg tab Warfarin 4mg tab Warfarin 5mg tab Warfarin 6mg tab Warfarin 7.5mg tab
30 30 30 30 30 30 30 30 30 30 30 30 30 30 30 30 30 30 60 30 60 60 60 30 30 30 30 30 60 60 60 60 30 30 30 30 30 30 30 30 30 30 30 30 30 30 30 30 30 30 30
90 90 90 90 90 90 90 90 90 90 90 90 90 90 90 90 90 90 180 90 180 180 180 90 90 90 90 90 180 180 180 180 90 90 90 90 90 90 90 90 90 90 90 90 90 90 90 90 90 90 90
The $2/$5 Platinum Generic Program includes many generics up to a 30-day supply for $2 or a 90-day supply for $5 at commonly prescribed dosages. †Only covered in the unit size listed on the drug list.
Warfarin 10mg tab
30
Men’s Health
90 $9 per 30 $9 per tab
Finasteride 5mg Levitra 20mg (limit 10 per customer per month)
Mental Health
$2/30 Days 30 30 30 30 30 30 60 60 60 30 30 30 30 30 30 30 30 30 30 30 30 30 30 30 30 90 30 30 30 30 30 30 30 30 30 30 30 60
$5/90 Days 90 90 90 90 90 90 180 180 180 90 90 90 90 90 90 90 90 90 90 90 90 90 90 90 90 270 90 90 90 90 90 90 90 90 90 90 90 180
Skin Conditions
$2/30 Days 1 1
$5/90 Days 3 3
Amitriptyline 10mg tab Amitriptyline 25mg tab Amitriptyline 50mg tab Amitriptyline 75mg tab Amitriptyline 100mg tab Benztropine 2mg tab Buspirone 5mg tab Buspirone 10mg tab Carbamazepine 200mg tab Citalopram 20mg tab Citalopram 40mg tab Doxepin HCL 10mg cap Doxepin HCL 25mg cap Doxepin HCL 50mg cap Doxepin HCL 75mg cap Doxepin HCL 100mg cap Fluoxetine 10mg tab Fluoxetine 10mg cap Fluoxetine 20mg cap Fluoxetine 40mg cap Fluphenazine 1mg tab Haloperidol 0.5mg tab Haloperidol 1mg tab Haloperidol 2mg tab Haloperidol 5mg tab Lithium Carbonate 300mg cap Nortriptyline 10mg cap Nortriptyline 25mg cap Paroxetine 10mg tab Paroxetine 20mg tab Prochlorperazine 10mg tab Thioridazine 25mg tab Thioridazine 50mg tab Thiothixene 2mg cap Trazodone 50mg tab Trazodone 100mg tab Trazodone 150mg tab Trihexyphenidyl 2mg tab Fluocinonide 0.05% cream (15gm tube)† Fluocinonide 0.05% cream (30gm tube)†
The $2/$5 Platinum Generic Program includes many generics up to a 30-day supply for $2 or a 90-day supply for $5 at commonly prescribed dosages. †Only covered in the unit size listed on the drug list.
1 1 1 1 1 1 1 1 1 1 1 1
3 3 3 3 3 3 3 3 3 3 3 3
Thyroid Conditions
$2/30 Days 30 30 30 30 30 30 30 30 30 30 30
$5/90 Days 90 90 90 90 90 90 90 90 90 90 90
Viruses
$2/30 Days 30
$5/90 Days 90
Vitamins & Nutritional Health
$2/30 Days 30 60 30 30 473mL 1
$5/90 Days 90 180 90 90 1419mL n/a
Women’s Health
$2/30 Days 30 30 30 30 30 30 30 10
$5/90 Days 90 90 90 90 90 90 90 30
Gentamicin 0.1% cream (15gm tube)† Gentamicin 0.1% ointment (15gm tube)† Hydrocortisone 1% cream (28.35-30g tube)† Hydrocortisone 2.5% cream (30gm tube)† Silver Sulfadiazine 1% cream (50gm tube)† Triamcinolone 0.025% cream (15gm tube)† Triamcinolone 0.025% cream (80gm tube)† Triamcinolone 0.1% cream (15gm tube)† Triamcinolone 0.1% cream (80gm tube)† Triamcinolone 0.1% ointment (15gm tube)† Triamcinolone 0.1% ointment (80gm tube)† Triamcinolone 0.5% cream (15gm tube)† Levothyroxine 25mcg tab Levothyroxine 50mcg tab Levothyroxine 75mcg tab Levothyroxine 88mcg tab Levothyroxine 100mcg tab Levothyroxine 112mcg tab Levothyroxine 125mcg tab Levothyroxine 137mcg tab Levothyroxine 150mcg tab Levothyroxine 175mcg tab Levothyroxine 200mcg tab Acyclovir 200mg cap Folic Acid 1mg tab Mag 64mg tab Magnesium Oxide 400mg tab Prenatal Plus qty 30 Potassium Chloride 10% liquid Sodium Fluoride .25mg chewable (120ct bottle) † Estradiol 0.5mg tab Estradiol 1mg tab Estradiol 2mg tab Estropipate 0.75mg tab Estropipate 1.5mg tab MedroxyprogesteroneAcetate 2.5mg tab Medroxyprogesterone Acetate 5mg tab Medroxyprogesterone Acetate 10mg tab
The $2/$5 Platinum Generic Program includes many generics up to a 30-day supply for $2 or a 90-day supply for $5 at commonly prescribed dosages. †Only covered in the unit size listed on the drug list.
Alendronate Sod 35mg tab Alendronate Sod 70mg tab Clomiphene 50mg tab Mononessa 28-day tab Tri-nessa 28-day tab Tamoxifen 10mg tab Tamoxifen 20mg tab
Other Medical Conditions
Chlorhexidine Gluconate 0.12% soln (473ml bottle)† Hydrocortisone AC 25mg suppositories Isoniazid 300mg tab Lidocaine 2% viscous solution (100ml bottle)† Megestrol 20mg tab Methylpred 4mg tab Oxybutynin 5mg tab Phenazopyridine 100mg tab Phenazopyridine 200mg tab Prednisone 2.5mg tab Prednisone 5mg tab Prednisone 5mg dose pak (21 tablets)† Prednisone 5mg dose pak* (48 tablets)† Prednisone 10mg tab Prednisone 10mg dose pak (21 tablets)† Prednisone 10mg dose pak* (48 tablets)† Prednisone 20mg tab
$9/30 day 4 4 5 28 28 60 30
$24/90 day 12 12 15 n/a n/a 180 90
$2/30 Days 1 12 30 1 30 21
$5/90 Days 3 36 90 3 90 63
60 6 30 30 30 1 1 30 1 1 30
180 18 90 90 90 3 3 90 3 n/a 90
The $2/$5 Platinum Generic Program includes many generics up to a 30-day supply for $2 or a 90-day supply for $5 at commonly prescribed dosages. †Only covered in the unit size listed on the drug list.
The Prescription Shop $2/$5 Platinum Generic Program Details 1) The program covers only the drugs on the plan list. Higher dosages will likely cost more and getting higher quantities of covered meds will be pro-rated to determine the price. The list of medications can be found on our website @ www.myrxshop.org. 2) Program pricing not available when the covered drug is used in a compound. 3) Not all drugs covered by the $2/30 Day Platinum program will be covered by the $5/90 Day Platinum Program. When the drug is covered by both, the price is pro-rated when a quantity falls between the 30 and 90 day quanties as well as for quantities above 90 days. 4) There are several drugs that are not covered by the $2/$5 Platinum Program, but are covered by the $9/$24 Platinum Program. These items can be seen on the generic drug list with these prices noted. 5) Customers enrolled in the Platinum Generic Programs will not be allowed to charge their purchases. Payment must be received at the time of delivery or pickup. Only cash, check or credit card are allowed. 6) Purchases may be delivered to the customer if requested. Delivery charges will apply to all tickets that are not $10 or more. A delivery charge will be applied in the amount of $3. 7) Prescriptions that are packaged for patients in blister cards/bingo cards will not be allowed to utilize this program. 8) Prepackaged drugs are covered in the program only in the unit sizes specified on the list of covered drugs. Unit sizes not listed on the covered drug list are not covered. 9) Drug List prices may be limited to select generic manufacturers of a covered drug and is available as long as supplies from the manufacturer are available to our pharmacy. 10) These Platinum Generic Program Details are subject to change without advance notice. Changes to the program will be printed in the most up-to-date covered drug listing.
The $2/$5 Platinum Generic Program includes many generics up to a 30-day supply for $2 or a 90-day supply for $5 at commonly prescribed dosages. †Only covered in the unit size listed on the drug list.