Prescription Drug Guide for Life Products Only

Form No. B2-784 Rev. 3-2011

661 East Davis Street, Elba, AL 36323

If the applicant is taking one of these drugs, he/she is ONLY eligible for EZ LIFE (Graded Benefit Whole Life)

Drug Name Generic Name Condition Treated Aggrenox Heart Attack, Angina, Stroke, TIA ( transient ischemic attack) Akineton Biperiden Parkinson's Disease Amantadine Symmetrel Parkinson's Disease Anaspaz Hyoscyamine Parkinson’s Disease, Parkinsonism Antabuse Disulfiram Chronic Alcoholism & drug abuse Artane Trihexphenidyl Parkinson's Disease Atamet Carbidopa-levodpa Parkinson's disease, parkinsonism Auranofin Ridaura Gold Therapy/ Rheumatoid Arthritis Avonex Interferon beta-1a Multiple sclerosis Azathioprine Imuran Multiple sclerosis, Kidney Transplant, Rheumatoid Arthritis Becaplermin Diabetes requiring insulin or with complications Baclofen Lioresal Multiple sclerosis Bendopa Levodopa Parkinson's Disease Benztropine Cogentin Parkinson's Disease Biperiden Parkinson's disease Bromocriptine Parlodel Parkinson's Disease Capaxone Glatiramer acetate Multiple Sclerosis Carbidopa Sinemet Parkinson's Disease Carbidopa+levodpa Parkinson's disease Cardilate Pindolol Heart Attack, Angina, Stroke, TIA ( transient ischemic attack) Cogentin Benztropine Parkinson's Disease Comtan Entacapone Parkinson's Disease Copaxone Glatiramer Acetate Multiple sclerosis Coumadin Warfarin Heart Attack, Stroke, TIA ( transient ischemic attack) Cycloset Bromocriptine Parkinson’s Disease Dantrium Dantrolene Cerebral palsy/ Multiple Sclerosis Dantrolene Cerebral Palsy/ Multiple Sclerosis Depade Naltrexone Alcohol Abuse Disulfiram Chronic Alcoholism & drug abuse Dopar Levodopa Parkinson's Disease Edrophonium Chloride Tensilon Myasthenia gravis Entacapone Parkinson's Disease Erythrityl-Tetranitrate Heart Attack, Angina, Stroke, TIA ( transient ischemic attack) Glatiramer acetate Copaxone Multiple sclerosis Haldol Haloperidol Mental Health Haloperidol Mental Health Humalog Insulin Lispro Diabetes requiring insulin or with complications Human Insulin Diabetes requiring insulin or with complications Humulin Insulin Isophane Diabetes requiring insulin or with complications Hydrocodone Narcotic Hyoscyamine Parkinson's Disease; parkinsonism Iletin/Humulin Insulin Diabetes requiring insulin or with complications Imdur Heart Attack, Angina, Stroke, TIA ( transient ischemic attack) Imuran Azathioprine Myasthenia gravis/ multiple sclerosis Insulin Diabetes requiring insulin or with complications Insulin aspart Diabetes requiring insulin or with complications Insulin glargine Diabetes requiring insulin or with complications Insulin Lispro Diabetes requiring insulin or with complications Ismo Isorbide Mononitrate Heart Attack, Angina, Stroke, TIA ( transient ischemic attack)

Prescription Drug Guide for Life Products Only

Form No. B2-784 Rev. 3-2011

Isosorbide Mononitrate Heart Attack, Angina, Stroke, TIA ( transient ischemic attack) Kemadrin Parkinson's Disease Lantus Insulin Glargine Diabetes requiring insulin or with complications Larodopa Parkinson's Disease Levbid Hyoscyamine Parkinson's disease Levodopa Carbidopa, Sinemet Parkinson's Disease Levsin Parkinson's Disease Lesinex Parkinson's Disease Lioresal Baclofen Multiple Sclerosis, Cerebral Palsy

Lithium Lithonate, Lithizine, Lithobid Bipolar, depression, mental health

Lithonate Bipolar, depression, mental health Lithizine Bipolar, depression, mental health Lithobid Bipolar, depression, mental health Ludoysn Carbidopa Parkinson's Disease

Mestinon Pyridostigmine Bromide Myasthenia gravis

Mirapex Pramipexide Parkinson's Disease Monoket Isosorbide Heart Attack, Angina, Stroke, TIA ( transient ischemic attack) Naltrexone Alcohol Abuse Naloxone Alcohol and drug abuse Narcan Alcohol and drug abuse Neostigmine Prostigmin Myasthenia gravis Nitroclycerin Heart Attack, Angina, Stroke, TIA ( transient ischemic attack) Novolin Diabetes requiring insulin or with complications Novolog Insulin Aspart Diabetes requiring insulin or with complications NovoPen Diabetes requiring insulin or with complications NuLev Parkinson's Disease Parlodel Bromocriptine Parkinson's Disease Pentaerythritol-tetarnitrate PETN Heart Attack, Angina, Stroke, TIA ( transient ischemic attack) Peritrat Heart Attack, Angina, Stroke, TIA ( transient ischemic attack) Pergolide Permax Parkinson's Disease Permax Parkinson's Disease Plavix Heart Attack, Angina, Stroke, TIA ( transient ischemic attack) Pramipexide Parkinson's Disease Prostigmin Neostigmine Myasthenia gravis Pyridostigmine Bromide Myasthenia gravis

Rebetron Ribavirin+Interferon alfa Hepatitis C

Regonol Myasthenia gravis Regranex Diabetes requiring insulin or with complications Requip Ropinirole Parkinson's Disease Revia Naltrexone Alcohol Abuse Ribavirin+Interferon alfa Hepatitis C Ridaura Auranofin Rheumatoid arthritis Rilutek Riluzole ALS - (aka - Lou Gehrigs Disease) Riluzole ALS - (aka - Lou Gehrigs Disease) Ropinirole Parkinson's disease; parkinsonism Sinemet Carbidopa, Levodopa Parkinson's Disease

Solganal Gold Compound/Therapy Rheumatoid Arthritis

Sorbitrate Heart Attack, Angina, Stroke, TIA ( transient ischemic attack) Suboxone Naoxone Alcohol / Drug abuse Symmetrel Amantadine Parkinson's Disease Tasmar Tolcapone Parkinson's Disease Tensilon Edrophonium Myasthenia gravis Ticlid Cerebral vascular disease-similar to Plavix Tolcapone Tasmar Parkinson's Disease

Prescription Drug Guide for Life Products Only

Form No. B2-784 Rev. 3-2011

Trihexphenidyl Parkinson's Disease Trihexane Parkinson's Disease Velosulin Diabetes-requiring insulin or with complications