Understanding Dose Optimization

Why have I received this information?

This information has been prepared for you by Anthem Prescription Management, your pharmacy benefit manager. From time to time, your physician may prescribe a medication subject to a dose optimization edit. We think you will find this information helpful when you need benefits for a medication subject to this type of edit.


What is dose optimization?

Dose optimization, or dose consolidation, normally involves the conversion from twice-daily dosing to a once-daily dosing schedule. This may increase compliance and decrease expenses for you and your health plan. As always, you should consult with your physician to determine what is most appropriate for you. If your physician feels medical reasons exist for you to take these medications more than once a day, a letter of medical necessity is required for you to access your prescription benefits.

Which medications have dose optimization?

Brand Drugs and their Generic Equivalent Recommended Dosing
Accupril (all strengths except 40mg) Daily Dose 1 per day
Accuretic 10/12.5mg Daily Dose 1 per day
Aceon (all strengths except 8mg) Daily Dose 1 per day
Adalat CC 30mg Daily Dose 1 per day
Altace (all strengths except 10mg) Daily Dose 1 per day
Altoprev (formerly Altocor) 10mg, 20mg Daily Dose 1 per day
Atacand (all strengths except 32mg) Daily Dose 1 per day
Avapro (all strengths except 300mg) Daily Dose 1 per day
Benicar 20mg Daily Dose 1 per day
Benicar HCT 20/12.5mg Daily Dose 1 per day
Cardizem CD 120mg, LA 120mg, LA 180mg Daily Dose 1 per day
Celexa 10mg, 20mg Daily Dose 1 per day
Cozaar 25mg, 50mg Daily Dose 1 per day
Crestor 5mg, 10mg, 20mg Daily Dose 1 per day
Dilacor XR 120mg Daily Dose 1 per day
Diovan (all strength except 320mg) Daily Dose 1 per day
Diovan HCT 80/12.5mg Daily Dose 1 per day
Effexor XR 37.5mg, 75mg Daily Dose 1 per day
Fluoxetine 10mg capsule, tablet Daily Dose 1 per day
Hyzaar50/12.5mg Daily Dose 1 per day
Lescol 20mg, 40mg Daily Dose 1 per day
Lexapro 5mg, 10mg Daily Dose 1 per day
Lipitor 10mg, 20mg, 40mg Daily Dose 1 per day
Lotensin (all strengths except 40mg) Daily Dose 1 per day
Lotensin HCT (all strengths except 20/12.5mg) Daily Dose 1 per day
Luvox 25mg Daily Dose 1 per day
Luvox 50mg Daily Dose 1 per day
Mavik (all strengths except 4mg) Daily Dose 1 per day
Mevacor 10mg, 20mg Daily Dose 1 per day
Micardis (all strengths except 80mg) Daily Dose 1 per day
Monopril (all strengths except 40mg) Daily Dose 1 per day
Norvasc 2.5mg, 5mg Daily Dose 1 per day
Paxil 10mg, 20mg, CR 12.5mg Daily Dose 1 per day
Pexeva 10mg, 20mg Daily Dose 1 per day
Plendil (all strengths except 10mg) Daily Dose 1 per day
Pravachol 10mg, 20mg, 40mg Daily Dose 1 per day
Prinivil (all strengths except 40mg) Daily Dose 1 per day
Prinzide 10/12.5mg Daily Dose 1 per day
Procardia XL 30mg Daily Dose 1 per day
Prozac 10mg cap Daily Dose 1 per day
Sular 10mg, 20mg Daily Dose 1 per day
Tiazac 120mg, 180mg Daily Dose 1 per day
Uniretic 7.5/12.5mg Daily Dose 1 per day
Univasc 7.5mg Daily Dose 1 per day
Verelan PM 100mg Daily Dose 1 per day
Zestoretic 10/12.5mg Daily Dose 1 per day
Zestril (all strengths except 40mg) Daily Dose 1 per day
Zocor 5mg, 10mg, 20mg, 40mg Daily Dose 1 per day
Zoloft 25mg, 50mg Daily Dose 1 per day

Please Note: Due to varying health benefit plans, inclusion of a drug and related items on the drug list/formulary is not a guarantee of coverage. Please refer to your prescription drug benefit description of coverage, limitations and exclusions.