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Generic Drug Listings

Keystone Pharmacy offers generic medications — $4 for a 30 day supply or $10 for a 90 day supply. Keystone Pharmacy is open to everyone, not just Keystone patients. You don’t need any prescription drug insurance to participate in this program – it’s available to everyone.

If you are a Keystone Health patient you may be able to purchase prescription drugs at a discounted price through another discount drug program. Click here for more information on our 340 B Discount Drug Program.

Spanish language prescriptions and consultations are available.

 

Keystone Pharmacy  $4.00/$10.00 Medication List   Revised 04/27/17
Please Note:
***All reconsituted medications are based on one bottle.
***Creams are based on one tube.
***Capsules/Tablets are based on 30 cap/tab (30 day supply) & 90 cap/tab
(90 day supply) unless otherwise marked.
***If the price column says N/A for a 90 day supply, that medication is not
available for $10/90 day supply.
$4 $10   $4 $10
Drug Name/Strength 30 day  90 day Drug Name/Strength 30 day  90 day
Allergies & Cold and Flu Diabetes
Benzonatate 100mg cap 14 42 Glimepiride 1mg tab 30 90
Loratadine 10mg tab 30 90 Glimepiride 2mg tab 30 90
Promethazine DM syrup 120ml 360ml Glipizide 5mg tab 30 90
Glipizide 10mg tab 30 90
Antibiotic Treatments Metformin 500mg tab 60 180
Amoxicillin 125mg/5ml (100ml) 1 3 Metformin 850mg tab 60 180
Amoxicillin 250mg/5ml (100ml) 1 3 Metformin 1000mg tab 60 180
Amoxicillin 250mg/5ml (150ml) 1 3
Amoxicillin 400mg/5ml (75ml) 1 3
Amoxicillin 400mg/5ml (100ml) 1 3 Gastrointestinal Health
Amoxicillin 500mg cap 30 90 Famotidine 20mg tab 60 180
Cephalexin 250mg cap 28 84 Promethazine 25mg tab 30 N/A
Cephalexin 500mg cap 30 90 Promethazine Syrup (Plain) 120ml N/A
Ciprofloxacin 250mg tab 14 42 Ranitidine 150mg tab 60 180
Penicillin VK 500mg tab 28 84 Ranitidine 300mg tab 30 60
SMZ-TMP 400mg-80mg tab 28 84
SMZ-TMP 800mg-160mg tab 28 84 Mental Health
Buspirone 5mg tab 60 180
Arthritis & Pain Buspirone 10mg tab 60 $180.00
Baclofen 10mg tab 30 90 Citalopram 10mg tab 30 90
Cyclobenzaprine 5mg tab 30 90 Citalopram 20mg tab 30 90
Cyclobenzaprine 10mg tab 30 90 Citalopram 40mg tab 30 90
Ibuprofen 400mg tab 90 270 Fluoxetine 10mg cap 30 90
Ibuprofen 600mg tab 60 180 Fluoxetine 20mg cap 30 90
Ibuprofen 800mg tab 30 90 Lithium Carbonate 300mg cap 90 270
Meloxicam 7.5mg tab 30 90 Paroxetine 10mg tab 30 90
Meloxicam 15mg tab 30 90 Paroxetine 20mg tab 30 90
Naproxen 500mg tab 30 90 Paroxetine 30mg tab 30 90
Prochlorperazine 10mg tab 30 90
Asthma Trihexyphenidyl 2mg tab 60 180
Albuterol 2mg/5ml Syrup 120ml 360ml
Albuterol 0.0.83% Nebulizer  25x3ml 1 box N/A
Ipratropium 0.02% Nebulizer 25×2.5ml 1 box N/A
Cholesterol
Lovastatin 10mg tab 30 90
Lovastatin 20mg tab 30 90 Heart Health & Blood Pressure  (continued)
Atorvastatin 10mg tab 30 90 Spironolactone 25mg tab 30 N/A
Atorvastatin 20mg tab 30 90 Terazosin 1mg cap 30 90
Atorvastatin 40mg tab 30 90 Terazosin 2mg cap 30 90
Atorvastatin 80mg tab 30 90 Terazosin 5mg cap 30 90
Terazosin 10mg cap 30 90
Verapamil 80mg tab 30 N/A
Heart Health & Blood Pressure Skin Conditions
Amlodipine 2.5mg tab 30 90 Hydrocortisone 1% Cream 28.5-30gm 1 3
Amlodipine 5mg tab 30 90 Hydrocortisone 2.5% Cream 28gm 1 3
Amlodipine 10mg 30 90 Triamcinolone 0.025% Cream 15gm 1 3
Atenolol 25mg tab 30 90 Triamcinolone 0.1% Cream 15gm 1 3
Atenolol 50mg tab 30 90 Triamcinolone 0.1% Ointment 15gm 1 3
Atenolol 100mg tab 30 90
Benazepril 5mg tab 30 90 Viruses
Benazepril 20mg tab 30 90 Acyclovir 200mg cap 30 90
Bisoprolol HCTZ 2.5mg-6.25mg tab 30 90
Bisoprolol HCTZ 5mg-6.25mg tab 30 90 Vitamins & Nutritional Health
Bisoprolol HCTZ 10-6.25mg tab 30 90 Folic Acid 1mg tab 30 90
Carvedilol 3.125mg tab 60 180 Prenatal Plus tab 30 90
Carvedilol 6.25mg tab 60 180
Carvedilol 12.5mg tab 60 180 Women’s Health
Carvedilol 25mg tab 60 180 Medroxyprogesterone Acetate 2.5mg tab 30 90
Clonidine 0.1mg tab 30 90 Medroxyprogesterone Acetate 10mg tab 30 N/A
Clonidine 0.2mg tab 30 90 Alendronate Sodium 35mg tab 4 12
Clonidine 0.3mg tab 30 90 Alendronate Sodium 70mg tab 4 12
Diltiazem 30mg tab 60 180
Enalapril HCTZ 10mg-25mg tab 30 90 Other Medical Conditions
Furosemide 20mg tab 30 90 Chlorhexidine Gluconate 0.12% Soln 473ml 1 bottle N/A
Furosemide 40mg tab 30 90
Furosemide 80mg tab 30 90
Guanfacine 1mg tab 30 90
Guanfacine 2mg tab 30 90
Hydralazine 10mg tab 30 90
Hydralazine 25mg tab 30 90
Hydrochlorothiazide 12.5mg cap 30 90
Hydrochlorothiazide 25mg tab 30 90
Hydrochlorothiazide 50 mg tab 30 90
Lisinopril-HCTZ 10mg-12.5mg tab 30 90
Lisinopril-HCTZ 20mg-12.5mg tab 30 90
Lisinopril-HCTZ 20mg-25mg tab 30 90
Lisinopril 2.5mg tab 30 90
Lisinopril 5mg tab 30 90
Lisinopril 10mg tab 30 90
Lisinopril 20mg tab 30 90
Metoprolol Tartrate 25mg tab 60 180
Metoprolol Tartrate 50mg tab 60 180
Metoprolol Tartrate 100mg tab 60 180