Discount Restrictions

Inside Rx covers thousands of medications. Only a few medications and strengths have discount restrictions. These tables list all medications with additional restrictions.

Age Restrictions refers to medications where our discounts are not available if you are 65 or older.

Benefit Restrictions refers to medications where our discounts are not available if you are covered by a federal or state funded benefit, such as Medicare, Medicaid, or Tricare.

These restrictions do not apply to pets.

Medications with Age and Benefit Restrictions

Medication Name	Strength(s)
Advair HFA	CFC free 115 mcg-21 mcg/inh
	CFC free 230 mcg-21 mcg/inh
	CFC free 45 mcg-21 mcg/inh
Anoro Ellipta	62.5 mcg-25 mcg/inh
Arnuity Ellipta	furoate 50 mcg
	furoate 100 mcg
	furoate 200 mcg
Breo Ellipta	100 mcg-25 mcg/inh
	200 mcg-25 mcg/inh
Flovent Diskus	100 mcg
	250 mcg
	50 mcg
Flovent HFA	CFC free 110 mcg/inh
	CFC free 220 mcg/inh
	CFC free 44 mcg/inh
Incruse Ellipta	62.5 mcg (0.0625 mg)/inh
Trelegy Ellipta	60 blisters of 100mcg/62.5mcg/25mcg/inh
Advair HFA	CFC free 115 mcg-21 mcg/inh
	CFC free 230 mcg-21 mcg/inh
	CFC free 45 mcg-21 mcg/inh
Anoro Ellipta	62.5 mcg-25 mcg/inh
Arnuity Ellipta	furoate 50 mcg
	furoate 100 mcg
	furoate 200 mcg
Breo Ellipta	100 mcg-25 mcg/inh
	200 mcg-25 mcg/inh
Flovent Diskus	100 mcg
	250 mcg
	50 mcg
Flovent HFA	CFC free 110 mcg/inh
	CFC free 220 mcg/inh
	CFC free 44 mcg/inh
Incruse Ellipta	62.5 mcg (0.0625 mg)/inh
Trelegy Ellipta	60 blisters of 100mcg/62.5mcg/25mcg/inh

Medications with Benefit Restrictions

Medication Name	Strength(s)
Absorica	10 mg
	20 mg
	25 mg
	30 mg
	35 mg
	40 mg
Absorica LD	micronized 16 mg
	micronized 24 mg
	micronized 32 mg
	micronized 8 mg
Accu-Chek FastClix lancets	102 count of 30 gauge
Accu-Chek Guide test strips	50 count
	100 count
Acticlate	hyclate 150 mg
	hyclate 75 mg
Aczone	60.0g of 5%
	90.0g of 5%
	60.0g of 7.5%
	90.0g of 7.5%
Adalat CC	30 mg
	60 mg
	90 mg
Addyi	100 mg
Adzenys ER	1.25mg/ml of 360ml
Adzenys XR-ODT	12.5 mg
	15.7 mg
	18.8 mg
	3.1 mg
	6.3 mg
	9.4 mg
Afrezza	12 units
	4 units
	8 units
Afrezza 4 unit (90)- 8 unit (90)	4 units- 8 units
Afrezza 8 unit (90)- 12 unit (90)	8 units-12 units
Afrezza Titration Pack	4 units-8 units-12 units
Afstyla	1000 unit
	1500 unit
	2000 unit
	2500 unit
	250 unit
	3000 unit
	500 unit
AirDuo RespiClick	113 mcg-14 mcg/inh
	232 mcg-14 mcg/inh
	55 mcg-14 mcg/inh
Ajovy	1.5mL of 225mg/1.5mL
Ala-Quin	28.4g of 3%-0.5%
	80g of 3%-0.5%
Ala-Scalp HP	29.6 ml of 2%
Alvesco	6.1g of CFCfree80mcg/inh
Alvesco HFA	CFC free 160 mcg/inh
	CFC free 80 mcg/inh
Amitiza	24 mcg
	8 mcg
Apidra	10ml vial of 100 units/ml
Apidra SoloStar Pen	5 pens (3ml/pen) of 100 units/ml
Arakoda	100 mg
Auryxia	210 mg
Avonex	30 mcg
Avonex Pen	30 mcg/0.5 mL
Avonex Prefilled Syringe	30 mcg/0.5 mL
AzaSite	1%
Balcoltra	with iron 20 mcg-100 mcg
Basaglar KwikPen	5 KwikPens (3ml/KwikPen) of 100 units/ml
Baxdela	300 mg (package)
	450 mg (package)
	10.0ea of 450mg
BenzaClin	25g of 1%/5% (jar of gel)
BenzaClin with pump	35g of 1%/5% (gel w/pump)
	50g of 1%/5% (gel w/pump)
Bethkis	4.0mL of 75mg/mL
Betimol	5.0mL of hemihydrate0.25%
	5.0mL of hemihydrate0.5%
Beyaz	28 tablets of 3 mg/0.02 mg/0.451 mg
BiDil	37.5 mg-20 mg
Binosto	70 MG
Bonjesta	20-20mg
Brilinta (ticagrelor)	60 mg
	90 mg
BromSite	0.075%
Bydureon BCise	4 pens of 2MG/0.85ML
Bydureon Pen	2 mg
Bydureon Tray	2 mg
Caduet	10 mg-10 mg
	10 mg-20 mg
	10 mg-40 mg
	10 mg-80 mg
	5 mg-10 mg
	5 mg-20 mg
	5 mg-40 mg
	5 mg-80 mg
Cambia	potassium 50 mg
Capex	0.01% 120ml (shampoo)
Celebrex	100 mg
	200 mg
	400 mg
	50 mg
Cequa	60 vials of 0.09%
CeQur Simplicity	10 patches of 2 units
CerefolinNAC	Vitamin B12, Folate, and Acetylcysteine
CitraNatal 90 DHA	30 day of 90mg/1mg/300mg
CitraNatal Assure	1mg Folic Acid (30 day supply per kit)
CitraNatal B-Calm	1mg Folic Acid (30 day supply per kit)
CitraNatal Bloom	90 mg/1 mg/50 mg
CitraNatal DHA	Prenatal Multivitamins with Folic Acid 1 mg
CitraNatal Harmony	Prenatal Multivitamins with Folic Acid 1 mg and Docusate
CitraNatal Rx	Prenatal Multivitamins with Folic Acid 1 mg and Docusate
Climara	4 once-weekly patches of 0.025mg/day
	4 once-weekly patches of 0.05mg/day
	4 once-weekly patches of 0.075mg/day
	4 once-weekly patches of 0.1mg/day
	4 once-weekly patches of 0.0375mg/day
	4 once-weekly patches of 0.06mg/day
Clindesse	2%
Clobex	0.05% 118ml (shampoo)
	0.05% 59ml (lotion)
	0.05% 125ml (lotion)
	0.05% 59ml (spray)
	0.05% 125ml (spray)
Colchicine	0.6 mg (caplets)
Colcrys	0.6 mg
Combivent Respimat	100 mcg-20 mcg/inh
Contrave	90 mg-8 mg
Cordran	60.0g of 0.05%
	120.0mL of 0.05%
Cordran SP	120.0g of 0.025%
	120.0g of 0.05%
Cosopt PF	2%-0.5% preservative-free
Cotempla XR-ODT	17.3 mg/24 hr
	25.9 mg/24 hr
	8.6 mg/24 hr
Crestor	10 mg
	20 mg
	40 mg
	5 mg
Deplin	15 mg
	7.5 mg
Dermasorb HC	295.8ml of 2%
Dermasorb TA	two 3 oz tube of 0.1%
DesOwen	0.05% 59g (lotion)
	0.05% 118g (lotion)
	0.05% 60g (cream)
Dexilant	30 mg
	60 mg
Differin	0.3% 45g
	0.3% 45g (gel w/pump)
	0.1% 45g (cream)
	0.1% 59ml (lotion)
Dilantin	100 mg
	30 mg
	50 mg (chewable tablet)
Dilantin Infatabs	50 mg
Doryx	hyclate 200 mg
	hyclate 50 mg
Doryx MPC	120 mg
Duavee	0.45mg/20mg
Dyanavel XR	2.5 mg/mL
Dymista	137 mcg-50 mcg/inh
Edarbi	40 mg
	80 mg
Edarbyclor	40 mg-12.5 mg
	40 mg-25 mg
Efudex	40g of 5% (cream)
Emgality Prefilled Pen	1.0mL of 120mg/mL
Emgality Prefilled Syringe	1.0mL of 120mg/mL
Endari	1 packets (5g/packet)
	60 packets (5g/packet)
Epiduo	0.1%-2.5% 45g (gel w/pump)
Epiduo Forte	45g of 0.3%-2.5%
	60g of 0.3%-2.5%
Epiduo Pump	45.0g of 0.1%-2.5%
Ertaczo	60g of 2% (cream)
EstroGel Pump	50g of 0.06%
Eurax	10% (cream)
	10% 60g (lotion)
	10% 454g (lotion)
Evamist	1.53 mg/spray
Evekeo ODT	10 mg
	15 mg
	20 mg
	5 mg
Fabior	100.0g of 0.1%
	50.0g of 0.1%
Farxiga	10 mg
	5 mg
Flarex	acetate 0.1%
Flector Patch	1.3%
Flolipid	20 MG/5 ML oral susp
	40 MG/5 ML oral susp
Fluticasone-Salmeterol	55 mcg-14 mcg/inh
	113 mcg-14 mcg/inh
	232 mcg-14 mcg/inh
Foltx	Vitamin B Complex with Folic Acid
Forfivo XL	450 mg/24 hours
Gel-One	10 mg/mL
Genotropin	5 mg (cartridge)
	12 mg (cartridge)
	7 MiniQuick devices of 0.2mg
	7 MiniQuick devices of 0.4mg
	7 MiniQuick devices of 0.6mg
	7 MiniQuick devices of 0.8mg
	7 MiniQuick devices of 1mg
	7 MiniQuick devices of 1.2mg
	7 MiniQuick devices of 1.4mg
	7 MiniQuick devices of 1.6mg
	7 MiniQuick devices of 1.8mg
	7 MiniQuick devices of 2mg
Gloperba	0.6mg/5ml
Glucocard Expression Test Strip	50 count
Glucocard Vital Sensor	50 count
Glyxambi	10 mg-5 mg
	25 mg-5 mg
Gralise	300 mg/24 hours
	600 mg/24 hours
	78 tablets of 300mg and 600mg
Grastek	2800 BAU
Gynazole-1	2%
Halog	0.1% 30g (cream)
	0.1% 60g (cream)
	0.1% 216g (cream)
	0.1% 30g (ointment)
	0.1% 60g (ointment)
	0.1% solution
Horizant	enacarbil 300 mg
	enacarbil 600 mg
HumaLOG Junior KwikPen	3.0mL of 100units/mL
Humalog KwikPen (Concentrated)	200 units/mL
Humalog Mix 50/50	50 units-50 units/mL
Humalog Mix 50/50 KwikPen	5 KwikPens (3ml/KwikPen) of 100 units/ml
Humalog Mix 75/25	10ml vial
Humalog Mix 75/25 KwikPen	5 KwikPens (3ml/KwikPen) of 100 units/ml
Humalog U-100	100 units/ml
Humalog U-100 KwikPen	3ml of 100 units/ml
Humatrope	12 mg
	24 mg
	5 mg (Vial)
	6 mg
Humulin 70/30	10ml vial
Humulin 70/30 KwikPen	5 KwikPens (3ml/KwikPen) of 100 units/ml
Humulin N	human recombinant 100 units/mL
Humulin N KwikPen	5 KwikPens (3ml/KwikPen) of 100 units/ml
Humulin R	10 ml vial of 100 units/ml
Hyalgan	10 mg/mL
Hymovis	8 mg/mL
Ilumya	1.0mL of 100mg/mL
Impoyz	60g of 0.025 %
	100g of 0.025 %
Inbrija	60 capsules of 42mg
Intrarosa	6.5 mg
Inveltys	2.8ml of 1%
Jardiance	10 mg
	25 mg
Jentadueto	2.5 mg-1000 mg
	2.5 mg-500 mg
	2.5 mg-850 mg
Jentadueto XR	2.5 mg-1000 mg
	5 mg-1000 mg
Jornay PM	(evening dose) 100 mg/24 hr
	(evening dose) 20 mg/24 hr
	(evening dose) 40 mg/24 hr
	(evening dose) 60 mg/24 hr
	(evening dose) 80 mg/24 hr
Kitabis Pak	5.0mL of 60mg/mL
Kombiglyze XR	1000 mg-2.5 mg
	1000 mg-5 mg
	500 mg-5 mg
Kristalose	10 g
	20 g
Lantus	10ml vial
Lantus Solostar Pen	5 pens (3ml/pen) of 100 units/ml
Levoxyl	25 mcg (0.025 mg)
	50 mcg (0.05 mg)
	75 mcg (0.075 mg)
	88 mcg (0.088 mg)
	100 mcg (0.1 mg)
	112 mcg (0.112 mg)
	125 mcg (0.125 mg)
	137 mcg (0.137 mg)
	150 mcg (0.15 mg)
	175 mcg (0.175 mg)
	200 mcg (0.2 mg)
Lexette	50.0g of 0.05%
Livalo	1 mg
	2 mg
	4 mg
Locoid	15g of 0.10%
	45g of 0.10%
Lyrica	20 mg/mL (oral solution)
	25 mg
	50 mg
	75 mg
	100 mg
	150 mg
	200 mg
	225 mg
	300 mg
Lyrica CR	82.5 mg
	165 mg
	330 mg
Macrobid	macrocrystals-monohydrate 100 mg
Macrodantin	macrocrystals 100 mg
	macrocrystals 25 mg
	macrocrystals 50 mg
Makena Auto-Injector	1.1mL of 275mg/1.1mL
Metanx	Vitamin B Complex
MetroCream	45g of 0.75% (cream)
MetroGel	1%
MetroGel Pump	1%
MetroLotion	0.75%
Minocin	50 mg
Mirvaso	0.33% 30g (gel)
	0.33% 30g (gel w/pump)
Mirvaso Pump	30.0g of 0.33%
Mitigare	0.6 mg
Naprelan 750	750 mg (as sodium)
Narcan	4 mg/0.1 mL
NeevoDHA	Prenatal Multivitamins with Vitamin B Complex, Vitamin C and Minerals with L-Methylfolate
Nexium	10 mg (package)
	2.5 mg (package)
	20 mg (package)
	40 mg (package)
	5 mg (package)
	20 mg
	40 mg
Niaspan ER	1000 mg
	500 mg
	750 mg
Nityr	10 mg
	5 mg
	2 mg
Odactra	12 SQ-HDM
Omeclamox-Pak	20mg/500mg/500mg
OneTouch Ultra Test Strips	25 count
	50 count
	100 count
OneTouch Verio Test Strips	25 count
	50 count
	100 count
Onglyza	2.5 mg
	5 mg
Onzetra Xsail	11 mg
Oracea	40 mg
Oralair	30 SL tablets of 300 IR
Orfadin	4 mg/mL (package)
	10 mg
	2 mg
	20 mg
	5 mg
Osphena	60 mg
Otovel	0.3%-0.025%
Otrexup	10 mg/0.4 mL
	12.5 mg/0.4 mL
	15 mg/0.4 mL
	17.5 mg/0.4 mL
	20 mg/0.4 mL
	22.5 mg/0.4 mL
	25 mg/0.4 mL
Oxtellar XR	150 mg
	300 mg
	600 mg
Pancreaze	10,500 units-61,500 units-35,500 units
	16,800 units-98,400 units-56,800 units
	21,000 units-83,900 units-54,700 units
	2600 units-10,850 units-6200 units
	4200 units-24,600 units-14,200 units
Phoslyra	667 MG/5 ML Solution
Plegridy	125 mcg/0.5 mL
	63 and 94 mcg
Plegridy Pen	125 mcg/0.5 mL
	63 and 94 mcg
Pradaxa	110 mg
	150 mg
	75 mg
Premarin Vaginal	0.625 mg/g
Premphase	0.625-5mg
Prempro	0.3 mg-1.5 mg
	0.45 mg-1.5 mg
	0.625 mg-2.5 mg
	0.625 mg-5 mg
Prenate	Prenatal Multivitamins with Folic Acid 1 mg
Prenate DHA	Prenatal Multivitamins with Folic Acid 1 mg
Prenate Elite	Prenatal Multivitamins with Folic Acid 1 mg
Prenate Enhance with DHA	Prenatal Multivitamins with Folic Acid 1 mg
Prenate Essential	Prenatal Multivitamins with Folic Acid 1 mg
Prenate Mini with DHA	Prenatal Multivitamins with Folic Acid 1 mg
Prenate Pixie	Prenatal Multivitamins with Folic Acid 1 mg
Prenate Restore	Prenatal Multivitamins with Folic Acid 1 mg
PrimaCare	Prenatal Multivitamins with Folic Acid 1 mg
Pristiq	100 mg
	25 mg
	50 mg
ProAir RespiClick	90 mcg/inh
Protonix	40 mg (oral suspension)
	20 mg
	40 mg
Pulmicort Flexhaler	180 mcg/inh
	90 mcg/inh
Qnasl	40 mcg/inh
	80 mcg/inh
QuilliChew ER	20 mg/24 hr
	30 mg/24 hr
	40 mg/24 hr
Quillivant XR	300 mg/60 ml
	600 mg/120 ml
	750 mg/150 ml
	900 mg/180 ml
QVAR RediHaler	40 mcg/inh
	80 mcg/inh
Ragwitek	12 Amb a 1-U
Rasuvo	10 mg/0.2 mL
	12.5 mg/0.25 mL
	15 mg/0.3 mL
	17.5 mg/0.35 mL
	20 mg/0.4 mL
	22.5 mg/0.45 mL
	25 mg/0.5 mL
	30 mg/0.6 mL
	7.5 mg/0.15 mL
Rayaldee	30 mcg
Relpax	20 mg
	40 mg
Riomet	500 mg/5 mL
Riomet ER	500 mg/5 mL
Safyral	28 tablets of 3mg/0.03mg/0.451mg
Sernivo	dipropionate 0.05%
Sklice	0.5%
Slynd	4 mg
Soolantra	30g of 1% (cream)
	45g of 1% (cream)
Sorilux	120.0g of 0.005%
	60.0g of 0.005%
Spiriva Respimat	1.25 mcg/inh
	2.5 mcg/inh
Spiriva Respimat 60 ACT	4.0g of 2.5mcg/inh
Stendra	50 mg
	100 mg
	200 mg
Stiolto Respimat	2.5 mcg-2.5 mcg/inh
Striverdi Respimat	2.5 mcg/inh
Suprep Bowel Prep Kit	1.6 g-3.13 g-17.5 g/177 mL
Symbicort	80 mcg-4.5 mcg/inh (120 doses)
	160 mcg-4.5 mcg/inh (120 doses)
Symjepi	2 injectors of 0.15 mg
	2 injectors of 0.3 mg
Sympazan	10 mg
	20 mg
	5 mg
Symproic	0.2 mg
Synjardy	12.5 mg-1000 mg
	12.5 mg-500 mg
	5 mg-1000 mg
	5 mg-500 mg
Synjardy XR	10 mg-1000 mg
	12.5 mg-1000 mg
	25 mg-1000 mg
	5 mg-1000 mg
Tecfidera	120 mg
	240 mg
	60 capsules of 120mg and 240 mg
Techlite Pen Needle	100 count 5/16" of 32 gauge
	100 count 5/32" of 32 gauge
	100 count 1/4" of 31 gauge
	100 count 1/4" of 32 gauge
Tekturna	150 mg
	300 mg
Tekturna HCT	150 mg-12.5 mg
	150 mg-25 mg
	300 mg-12.5 mg
	300 mg-25 mg
Temixys	300 mg-300 mg
Tenoretic 100	100 mg-25 mg
Tenoretic 50	50 mg-25 mg
Tenormin	100 mg
	25 mg
	50 mg
Tiglutik	600ml of 50/10ML
TobraDex ST	0.05%-0.3%
Topiramate ER	100 mg
	150 mg
	200 mg
	25 mg
	50 mg
Tosymra	10 mg/inh
Toujeo Max SoloStar	3.0mL of 300units/mL
Toujeo SoloStar	3 pens (1.5 ml/pens) of 300 units/ml
Toviaz	4 mg
	8 mg
Tradjenta	5 mg
Tri-Luma	0.01%-4%-0.05%
Tricor	145 mg
	48 mg
Trilipix	135 mg
	45 mg
Trintellix	10 mg
	20 mg
	5 mg
Triptodur	22.5 mg
Trokendi XR	100 mg
	200 mg
	25 mg
	50 mg
True Metrix Test Strips	100 glucose test strips
	50 glucose test strips
Trulicity Pen	0.75 mg/0.5 mL
	1.5 mg/0.5 mL
Tudorza Pressair	400 mcg/inh
Ultravate	0.05%
Ultravate X	0.05% (ointment)
	0.05% (cream)
Vascepa	0.5 g
	1 g
Vectical	3 mcg/g
Veltin	1.2%-0.025%
Vgo	20units/24hrs
	30units/24hrs
	40units/24hrs
Viagra	100 mg
	50 mg
	25 mg
VSL#3	60 capsules of 112.5 billion CFU
	30 packets of 450 billion CFU
VSL#3 DS	20 packets of 900 billion CFU
Vyleesi	0.3mL of 1.75mg/0.3mL
Vyvanse	10 mg
	20 mg
	30 mg
	40 mg
	50 mg
	60 mg
	70 mg
Xhance	16ml of 93mcg/inh
Xigduo XR	10 mg-1000 mg
	10 mg-500 mg
	5 mg-1000 mg
	5 mg-500 mg
	2.5 mg-1000mg
Xofluza	2 tablets of 20mg
	2 tablets of 40mg
Xyosted	0.5mL of enanthate100mg/0.5mL
	0.5mL of enanthate50mg/0.5mL
	0.5mL of enanthate75mg/0.5mL
Yasmin	28 tablets of 3mg/0.03mg
Yaz	28 tablets of 3mg/0.02mg
Yonsa	125 mg
Zelnorm	6 mg
Zembrace SymTouch	3 mg/0.5 mL
Zestoretic	12.5 mg-10 mg
	12.5 mg-20 mg
	25 mg-20 mg
Zestril	10 mg
	2.5 mg
	20 mg
	30 mg
	40 mg
	5 mg
Zioptan	0.0015%
Zoloft	20 mg/mL (oral solution)
	25 mg
	50 mg
	100 mg
Zolpimist	4.5mL of 5mg/spray
	7.7mL of 5mg/spray
Zyvox	100 mg/5 mL (package)
	600 mg