Drug Name Tier Notes true laxative oral powder 1 or 1b* $0 *SALINE LAXATIVES*** citrate of magnesia oral solution 1 or 1a* $0 citroma oral solution 1 or 1a* $0 cvs magnesium citrate oral solution 1 or 1a* $0 cvs milk of magnesia oral suspension 1200 mg/15ml 1 or 1b* $0 dulcolax milk of magnesia oral suspension 1 or 1b* $0 dulcolax oral suspension 1 or 1b* $0 eq magnesium citrate oral solution 1 or 1a* $0 eql magnesium citrate oral solution 1 or 1a* $0 FRESKARO MAGNESIUM CITRATE ORAL SOLUTION 1 or 1a* $0 ft magnesium citrate oral solution 1 or 1a* $0 ft milk of magnesia oral suspension 1 or 1b* $0 gentle laxative oral suspension 1 or 1b* $0 gnp magnesium citrate oral solution 1 or 1a* $0 gnp milk of magnesia oral suspension 1 or 1b* $0 goodsense magnesium citrate oral solution 1 or 1a* $0 goodsense milk of magnesia oral suspension 1 or 1b* $0 magnesium citrate oral solution 1.745 gm/30ml 1 or 1a* $0 milk of magnesia oral suspension 1 or 1b* $0 ONELAX MAGNESIUM CITRATE ORAL SOLUTION 1 or 1a* $0 phillips milk of magnesia oral suspension 400 mg/5ml 1 or 1b* $0 qc magnesium citrate oral solution 1 or 1a* $0 qc milk of magnesia oral suspension 1 or 1b* $0 ra magnesium citrate oral solution 1 or 1a* $0 Drug Name Tier Notes ra milk of magnesia oral suspension 1 or 1b* $0 sb magnesium citrate oral solution 1 or 1a* $0 sb milk of magnesia oral suspension 1 or 1b* $0 *STIMULANT LAXATIVES*** bisacodyl ec oral tablet delayed release 1 or 1a* $0 cvs c-lax laxative oral tablet delayed release 1 or 1a* $0 cvs gentle laxative oral tablet delayed release 1 or 1a* $0 cvs gentle laxative womens oral tablet delayed release 1 or 1a* $0 eq gentle laxative oral tablet delayed release 1 or 1a* $0 eql gentle laxative oral tablet delayed release 1 or 1a* $0 eql laxative oral tablet delayed release 1 or 1a* $0 ex-lax ultra oral tablet delayed release 1 or 1a* $0 FLEET STIMULANT ORAL TABLET DELAYED RELEASE 1 or 1a* $0 ft laxative oral tablet delayed release 1 or 1a* $0 gentle laxative oral tablet delayed release 1 or 1a* $0 gnp gentle laxative oral tablet delayed release 1 or 1a* $0 gnp womens gentle laxative oral tablet delayed release 1 or 1a* $0 goodsense bisacodyl laxative oral tablet delayed release 1 or 1a* $0 kp bisacodyl oral tablet delayed release 1 or 1a* $0 qc gentle laxative oral tablet delayed release 1 or 1a* $0 qc gentle laxative womens oral tablet delayed release 1 or 1a* $0 qc laxative oral tablet delayed release 1 or 1a* $0 ra laxative oral tablet delayed release 1 or 1a* $0 ra womens laxative oral tablet delayed release 1 or 1a* $0 * Your plan may include Tiers 1a/1b. Refer to your pharmacy benefit summary for more information. Effective 08012025 61