$4 Prescription Program at Walmart

These are the prescriptions Wal-Mart offers at $4:

http://www.walmart.com/catalog/catalog.gsp?cat=546834&fromPageCatId=5431


$4 Prescription Program
October 23, 2007
Allergies & Cold and Flu QTY
Benzonatate 100mg 14
Ceron DM syrup 120ml
Ceron drops 30ml*
Dec-Chlorphen drops 30ml*
Dec-Chlorphen DM syrup 118ml*
Loratadine 10mg 30
Promethazine DM syrup 120ml
Trivent DPC syrup 120ml*

Antibiotic Treatments QTY
Amoxicillin 125mg/5ml suspension 80ml
Amoxicillin 125mg/5ml suspension 100ml
Amoxicillin 125mg/5ml suspension 150ml
Amoxicillin 200mg/5ml suspension 50ml
Amoxicillin 200mg/5ml suspension 75ml*
Amoxicillin 200mg/5ml suspension 100ml*
Amoxicillin 250mg/5ml suspension 80ml
Amoxicillin 250mg/5ml suspension 100ml
Amoxicillin 250mg/5ml suspension 150ml
Amoxicillin 400mg/5ml suspension 50ml
Amoxicillin 400mg/5ml suspension 75ml*
Amoxicillin 400mg/5ml suspension 100ml*
Amoxicillin 250mg 30
Amoxicillin 500mg 30
Amoxil 50mg/ml drops 30ml*
Cephalexin 250mg 28
Cephalexin 500mg 30
Ciprofloxacin 250mg 14
Ciprofloxacin 500mg 20
Doxycycline 50mg 30
Doxycycline 100mg 20
Erythrocin 250mg 40*
Erythromycin EC 250mg 28*
Metronidazole 250mg 28
Metronidazole 500mg 14
Penicillin VK 125mg/5ml suspension 200ml
Penicillin VK 250mg/5ml suspension 100ml
Penicillin VK 250mg 28
SMZ-TMP 400mg-80mg 28
SMZ-TMP DS 800mg-160mg 20
SMZ-TMP 200mg-40mg/5ml susp. 120ml
Tetracycline 250mg 60
Tetracycline 500mg 60

Arthritis & Pain QTY
Allopurinol 100mg 30
Allopurinol 300mg 30
Baclofen 10mg 30
Colchicine 0.6mg 30
Cyclobenzaprine 5mg 30
Cyclobenzaprine 10mg 30
Dexamethasone 0.5mg 30
Dexamethasone 0.75mg 12
Dexamethasone 4mg 6
Diclofenac DR 75mg 60
Ibuprofen 100mg/5ml suspension 120ml*
Ibuprofen 400mg 90
Ibuprofen 600mg 60
Ibuprofen 800mg 30
Indomethacin 25mg 60*
Meloxicam 7.5mg 30
Meloxicam 15mg 30
Naproxen 375mg 60*
Naproxen 500mg 60*
Piroxicam 20mg 30
Salsalate 500mg 60

Asthma QTY
Albuterol 2mg 90
Albuterol 4mg 60
Albuterol 2mg/5ml syrup 120ml
Albuterol 0.5% nebulizer solution 20ml
New Albuterol 0.083% neb. solution 75ml*
(25 vials)
New Ipratropium 0.02% neb. sol’n 75ml*
(25 vials)

Cholesterol QTY
Lovastatin 10mg 30
Lovastatin 20mg 30*
Pravastatin 10mg 30
Pravastatin 20mg 30
Pravastatin 40mg 30*

Diabetes QTY
Chlorpropamide 100mg 30*
Glimepiride 1mg 30
Glimepiride 2mg 30
Glimepiride 4mg 30
Glipizide 5mg 30
$4 prescriptions are for up to a 30-day supply of a covered drug at a commonly prescribed dosage for $4 per prescription fill or refill. Your participation in
certain prescription drug coverage plans may entitle you to pay even less than $4 for certain prescriptions. If you are eligible, you will be charged the
lowest applicable amount. Certain drugs are priced higher in CA, CO, HI, MN, MT, PA, TN, WI, and WY due to state laws. Program not available in North
Dakota. You can get these prescription drug savings whether or not you have any prescription drug coverage through your company, under Medicare or
any other plan. The list of covered drugs is subject to change. Not all prescription drugs are covered by this program. Only prescriptions initially filled in
person at a participating pharmacy are eligible for the $4 rate; refills must also be picked up in-store, but may be ordered in person, online or by phone.
This program is not available for prescriptions filled by mail order. See your Wal-Mart pharmacist for more information. *Priced higher than $4 in CA, CO,
HI, MN, MT, PA, TN, WI and WY due to state laws; Customers in these states should see their Wal-Mart or Sam’s Club pharmacist for pricing. **Not
covered under this program in CA, CO, HI, MN, MT, PA, TN, WI and WY due to state laws.

Page 1

$4 Prescription Program
October 23, 2007
Diabetes
(continued) QTY
Glipizide 10mg 60*
Glyburide 2.5mg 30
Glyburide 5mg 30
Glyburide, micronized 3mg 30
Glyburide, micronized 6mg 30
Metformin 500mg 60
Metformin 850mg 60
Metformin 1000mg 60*
Metformin ER 500mg 60*

Ear Health QTY
Antipyrine/Benzocaine otic 10ml

Fungal Infections QTY
Fluconazole 150mg 1
Nystatin/Triamcin cream 15gm
Nystatin/Triamcin cream 30gm
Nystatin/Triamcin ointment 15gm
Nystatin cream 15gm
Nystatin cream 30gm
Nystatin ointment 15gm
Nystatin ointment 30gm
New Terbinafine 250mg 30*

Gastrointestinal Health QTY
Belladonna Alkaloid/PB 60
Cimetidine 800mg 30*
Cytra2 solution 180ml
Dicyclomine 10mg 90
Dicyclomine 20mg 60
Famotidine 20mg 60
Hyoscyamine drops 15ml*
Hyoscyamine 0.125mg sublingual 30
Hyoscyamine 0.125mg 60
Hyoscyamine ER 0.375 30
Lactulose syrup 237ml
Metoclopramide 10mg 60
Metoclopramide syrup 60ml
Promethazine 25mg 12
Promethazine plain syrup 180ml*
Ranitidine 150mg 60
Ranitidine 300mg 30


Glaucoma & Eye Care QTY
Atropine Sulfate 1% op. solution 5ml
Bacitracin op. ointment 4gm
Erythromycin op. ointment 4gm
Gentamicin 0.3% op. solution 5ml
New Levobunolol 0.5% op solution 5ml
Neomycin/Polymyxin/Dexamethasone
0.1% op. ointment
4gm
Neomycin/Polymyxin/Dexamethasone
0.1% op. suspension
5ml
Pilocarpine 1% op. solution 15ml
Pilocarpine 2% op. solution 15ml
Polymyxin Sulfate/TMP op. solution 10ml*
Sulfacet Sodium 10% op. solution 15ml
New Timolol Maleate 0.25% op.
solution
5ml
New Timolol Maleate 0.5% op
solution
5ml
Tobramycin 0.3% op. solution 5ml

Heart Health & Blood Pressure QTY
Amiloride-HCTZ 5mg-50mg 30
Atenolol-Chlorthalidone 50mg-25mg 30
Atenolol-Chlorthalidone 100mg-25mg 30
Atenolol 25mg 30
Atenolol 50mg 30
Atenolol 100mg 30
Benazepril 5mg 30
Benazepril 10mg 30
Benazepril 20mg 30
Benazepril 40mg 30
Bisoprolol-HCTZ 2.5mg-6.25mg 30
Bisoprolol-HCTZ 5mg-6.25mg 30
Bisoprolol-HCTZ 10mg-6.25mg 30
Bumetanide 0.5mg 30
Bumetanide 1mg 30
Captopril 12.5mg 60
Captopril 25mg 60
Captopril 50mg 60
Captopril 100mg 60
New Carvedilol 3.125mg 60
New Carvedilol 6.25mg 60
New Carvedilol 12.5mg 60
New Carvedilol 25mg 60*
Chlorthalidone 25mg 30
Chlorthalidone 50mg 30
$4 prescriptions are for up to a 30-day supply of a covered drug at a commonly prescribed dosage for $4 per prescription fill or refill. Your participation in
certain prescription drug coverage plans may entitle you to pay even less than $4 for certain prescriptions. If you are eligible, you will be charged the
lowest applicable amount. Certain drugs are priced higher in CA, CO, HI, MN, MT, PA, TN, WI, and WY due to state laws. Program not available in North
Dakota. You can get these prescription drug savings whether or not you have any prescription drug coverage through your company, under Medicare or
any other plan. The list of covered drugs is subject to change. Not all prescription drugs are covered by this program. Only prescriptions initially filled in
person at a participating pharmacy are eligible for the $4 rate; refills must also be picked up in-store, but may be ordered in person, online or by phone.
This program is not available for prescriptions filled by mail order. See your Wal-Mart pharmacist for more information. *Priced higher than $4 in CA, CO,
HI, MN, MT, PA, TN, WI and WY due to state laws; Customers in these states should see their Wal-Mart or Sam’s Club pharmacist for pricing. **Not
covered under this program in CA, CO, HI, MN, MT, PA, TN, WI and WY due to state laws.

Page 2

$4 Prescription Program
October 23, 2007
Heart Health & Blood Pressure
(continued) QTY
Clonidine 0.1mg 30
Clonidine 0.2mg 30
Digitek 0.125mg 30
Digitek 0.25mg 30
Diltiazem 30mg 60
Diltiazem 60mg 60
Diltiazem 90mg 60*
Diltiazem 120mg 30
Doxazosin 1mg 30
Doxazosin 2mg 30
Doxazosin 4mg 30
Doxazosin 8mg 30
Enalapril-HCTZ 5mg-12.5mg 30
Enalapril 2.5mg 30
Enalapril 5mg 30
Enalapril 10mg 30
Enalapril 20mg 30
Furosemide 20mg 30
Furosemide 40mg 30
Furosemide 80mg 30
Guanfacine 1mg 30
Hydralazine 10mg 30
Hydralazine 25mg 30
Hydrochlorothiazide (HCTZ) 12.5mg 30*
Hydrochlorothiazide (HCTZ) 25mg 30
Hydrochlorothiazide (HCTZ) 50mg 30
Indapamide 1.25mg 30
Indapamide 2.5mg 30
Isosorbide Mononitrate ER 30mg 30
Isosorbide Mononitrate ER 60mg 30
Lisinopril-HCTZ 10mg-12.5mg 30
Lisinopril-HCTZ 20mg-12.5mg 30*
Lisinopril-HCTZ 20mg-25mg 30*
Lisinopril 2.5mg 30
Lisinopril 5mg 30
Lisinopril 10mg 30
Lisinopril 20mg 30
Methyldopa 250mg 60*
Methyldopa 500mg 30*
Metoprolol Tartrate 25mg 60
Metoprolol Tartrate 50mg 60
Metoprolol Tartrate 100mg 60*
Nadolol 20mg 30
Nadolol 40mg 30
Heart Health & Blood Pressure
(continued) QTY
New Nitroglycerin 0.3mg sublingual 100*
New Nitroglycerin 0.4mg sublingual 100*
Pindolol 5mg 30
Pindolol 10mg 30
Prazosin HCL 1mg 30
Prazosin HCL 2mg 30
Prazosin HCL 5mg 30
Propranolol 10mg 60
Propranolol 20mg 60
Propranolol 40mg 60
Propranolol 80mg 60
Sotalol HCL 80mg 30*
Spironolactone 25mg 30*
Terazosin 1mg 30
Terazosin 2mg 30
Terazosin 5mg 30
Terazosin 10mg 30
Triamterene-HCTZ 37.5mg-25mg 30
Triamterene-HCTZ 75mg-50mg 30
Verapamil 80mg 30
Verapamil 120mg 30
New Warfarin 1mg 30
New Warfarin 2mg 30
New Warfarin 2.5mg 30
New Warfarin 3mg 30
New Warfarin 4mg 30
Warfarin 5mg 30*
New Warfarin 6mg 30
New Warfarin 7.5mg 30
New Warfarin 10mg 30

Mental health QTY
Amitriptyline 10mg 30
Amitriptyline 25mg 30
Amitriptyline 50mg 30
Amitriptyline 75mg 30
Amitriptyline 100mg 30
Benztropine 2mg 30
Buspirone 5mg 60
Buspirone 10mg 60*
Carbamazepine 200mg 60*
Citalopram 20mg 30
Citalopram 40mg 30
Doxepin HCL 10mg 30
$4 prescriptions are for up to a 30-day supply of a covered drug at a commonly prescribed dosage for $4 per prescription fill or refill. Your participation in
certain prescription drug coverage plans may entitle you to pay even less than $4 for certain prescriptions. If you are eligible, you will be charged the
lowest applicable amount. Certain drugs are priced higher in CA, CO, HI, MN, MT, PA, TN, WI, and WY due to state laws. Program not available in North
Dakota. You can get these prescription drug savings whether or not you have any prescription drug coverage through your company, under Medicare or
any other plan. The list of covered drugs is subject to change. Not all prescription drugs are covered by this program. Only prescriptions initially filled in
person at a participating pharmacy are eligible for the $4 rate; refills must also be picked up in-store, but may be ordered in person, online or by phone.
This program is not available for prescriptions filled by mail order. See your Wal-Mart pharmacist for more information. *Priced higher than $4 in CA, CO,
HI, MN, MT, PA, TN, WI and WY due to state laws; Customers in these states should see their Wal-Mart or Sam’s Club pharmacist for pricing. **Not
covered under this program in CA, CO, HI, MN, MT, PA, TN, WI and WY due to state laws.

Page 3

$4 Prescription Program
October 23, 2007
Mental health
(continued) QTY
Doxepin HCL 25mg 30
Doxepin HCL 50mg 30
Doxepin HCL 75mg 30
Doxepin HCL 100mg 30
Fluoxetine 10mg tablet 30*
Fluoxetine 10mg 30
Fluoxetine 20mg 30
Fluoxetine 40mg 30
Fluphenazine 1mg 30
Haloperidol 0.5mg 30
Haloperidol 1mg 30
Haloperidol 2mg 30
Haloperidol 5mg 30
Hydroxyzine HCL 10mg/5ml syrup 120ml
Lithium Carbonate 300mg 90*
Nortriptyline 10mg 30
Nortriptyline 25mg 30
Paroxetine 10mg 30*
Paroxetine 20mg 30*
Prochlorperazine 10mg 30
Thioridazine 25mg 30
Thioridazine 50mg 30
Thiothixene 2mg 30
Trazodone 50mg 30
Trazodone 100mg 30
Trazodone 150mg 30
Trihexyphenidyl 2mg 60

Skin Conditions QTY
New Benzoyl Peroxide 4% creamy
wash
171ml*
Betamethasone Dipropionate 0.05%
cream
15gm
Betamethasone Dipropionate 0.05%
cream
45gm
Betamethasone Valerate 0.1% cream 15gm
Betamethasone Val. 0.1% cream 45gm
Betamethasone Val. 0.1% ointment 15gm
Betamethasone Val. 0.1% ointment 45gm
Erythromycin 2% solution 60ml
Fluocinolone Acet. 0.01% solution 60ml
Fluocinonide 0.05% cream 15gm
Fluocinonide 0.05% cream 30gm
Gentamicin 0.1% cream 15gm
Skin Conditions
(continued) QTY
Gentamicin 0.1% ointment 15gm
Hydrocortisone 1% cream 30gm
Hydrocortisone 2.5% cream 30gm
Selenium Sulfide 2.5% lotion 120ml*
Triamcinolone 0.025% cream 15gm
Triamcinolone 0.025% cream 80gm
Triamcinolone 0.1% cream 15gm
Triamcinolone 0.1% cream 80gm
Triamcinolone 0.1% ointment 15gm
Triamcinolone 0.1% ointment 80gm
Triamcinolone 0.5% cream 15gm

Thyroid Conditions QTY
Levothyroxine 25mcg 30
Levothyroxine 50mcg 30
Levothyroxine 75mcg 30
Levothyroxine 88mcg 30
Levothyroxine 100mcg 30
Levothyroxine 112mcg 30
Levothyroxine 125mcg 30
New Levothyroxine 137mcg 30
Levothyroxine 150mcg 30
Levothyroxine 175mcg 30*
Levothyroxine 200mcg 30*

Viruses QTY
Acyclovir 200mg 30

Vitamins & Nutritional Health QTY
Ethedent 0.25mg chewable 120*
Folic Acid 1mg 30
Klorcon 8 8mEq ER 30
Klorcon 10 10mEq ER 30
Klorcon M10 10mEq 30
Mag 64 64mg 60*
Magnesium Oxide 400mg 30
Multivitamin Fl (Fluoride) 0.25mg
chewable
30
Multivitamin Fl (Fluoride) 0.5mg
chewable
30
Multivitamin Fl (Fluoride) 1mg
chewable
30
Multivitamin Fl + Fe (Fluoride + Iron)
0.5mg chewable
30
$4 prescriptions are for up to a 30-day supply of a covered drug at a commonly prescribed dosage for $4 per prescription fill or refill. Your participation in
certain prescription drug coverage plans may entitle you to pay even less than $4 for certain prescriptions. If you are eligible, you will be charged the
lowest applicable amount. Certain drugs are priced higher in CA, CO, HI, MN, MT, PA, TN, WI, and WY due to state laws. Program not available in North
Dakota. You can get these prescription drug savings whether or not you have any prescription drug coverage through your company, under Medicare or
any other plan. The list of covered drugs is subject to change. Not all prescription drugs are covered by this program. Only prescriptions initially filled in
person at a participating pharmacy are eligible for the $4 rate; refills must also be picked up in-store, but may be ordered in person, online or by phone.
This program is not available for prescriptions filled by mail order. See your Wal-Mart pharmacist for more information. *Priced higher than $4 in CA, CO,
HI, MN, MT, PA, TN, WI and WY due to state laws; Customers in these states should see their Wal-Mart or Sam’s Club pharmacist for pricing. **Not
covered under this program in CA, CO, HI, MN, MT, PA, TN, WI and WY due to state laws.

Page 4

$4 Prescription Program
October 23, 2007
Vitamins & Nutritional Health
(continued) QTY
Natalcare Pic 30*
Natalcare Plus 30*
Potassium Chloride 10% liquid 473ml
Prenatal Rx 30*

Women’s Health QTY
Estradiol 0.5mg 30
Estradiol 1mg 30
Estradiol 2mg 30
Estropipate 0.75mg 30
Estropipate 1.5mg 30*
Medroxyprogesterone Acetate 2.5mg 30
Medroxyprogesterone Acetate 5mg 30
Medroxyprogesterone Acetate 10mg 10

In addition, these family planning items are now
available for $9*
New Clomiphene 50mg 5**
New Sprintec 28-day 28**
New Tri-Sprintec 28-day 28**
*Up to a 30-day supply at commonly prescribed dosage for
fill or re-fill. Discount pricing not available in CA, CO, HI,
MN, MT, PA, TN, WI and WY.


Other Medical Conditions QTY
Chlorhexidine Gluconate 0.12% solution 473ml
Hydrocortisone AC 25mg suppositories 12
Isoniazid 300mg 30
Lidocaine 2% viscous solution 100ml
Megestrol 20mg 30*
Methylpred 4mg dose pak 21
Methylpred 4mg tablet 21
Oxybutynin 5mg tablet 60
Phenazopyridine 100mg 6
Phenazopyridine 200mg 30
Prednisone 2.5mg tablet 30
Prednisone 5mg tablet 30
Prednisone 5mg dose pak 21
Prednisone 5mg dose pak 48*
Prednisone 10mg tablet 30
Prednisone 10mg dose pak 21
Prednisone 10mg dose pak 48*
Prednisone 20mg tablet 30


$4 prescriptions are for up to a 30-day supply of a covered drug at a commonly prescribed dosage for $4 per prescription fill or refill. Your participation in
certain prescription drug coverage plans may entitle you to pay even less than $4 for certain prescriptions. If you are eligible, you will be charged the
lowest applicable amount. Certain drugs are priced higher in CA, CO, HI, MN, MT, PA, TN, WI, and WY due to state laws. Program not available in North
Dakota. You can get these prescription drug savings whether or not you have any prescription drug coverage through your company, under Medicare or
any other plan. The list of covered drugs is subject to change. Not all prescription drugs are covered by this program. Only prescriptions initially filled in
person at a participating pharmacy are eligible for the $4 rate; refills must also be picked up in-store, but may be ordered in person, online or by phone.
This program is not available for prescriptions filled by mail order. See your Wal-Mart pharmacist for more information. *Priced higher than $4 in CA, CO,
HI, MN, MT, PA, TN, WI and WY due to state laws; Customers in these states should see their Wal-Mart or Sam’s Club pharmacist for pricing. **Not
covered under this program in CA, CO, HI, MN, MT, PA, TN, WI and WY due to state laws.

Page 5