Inside Rx

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