Muscarinic Antagonists, Inhaled
PDL Reference Documents
Newsletters
- August 2023 - 2023 Global Initiative for Chronic Obstructive Lung Disease Report: Focus on Revised Recommendations for Inhaler Products
- May 2017 - Updates in the Management of Chronic Obstructive Pulmonary Disease
- June 2013 - Updates and Future Perspectives in the Management of Stable Chronic Obstructive Pulmonary Disease
PDL Status Values
Y = preferred
N = non-preferred. Non-preferred drugs listed as N but without clinical drug use criteria are subject to the
Non-Preferred Drugs in Select PDL Classes prior authorization criteria.
New drugs will be listed as N until reviewed by the P&T Committee and are subject to the
New Drug Policy.
V = voluntary non-preferred. Non-preferred mental health drugs are listed as V and prior authorization is not required.
Null (i.e. blank) = indicates the class or specific drug has not been reviewed for PDL placement.
To request a Prior Authorization, please use this form.
| Generic Name | Brand Name | Form | PDL Status |
Current Drug Use Criteria | Carveout ‐ Bill FFS |
New Drug Evaluation & Updates |
|---|---|---|---|---|---|---|
| ipratropium bromide | ATROVENT HFA | HFA AER AD | Y | N | ||
| ipratropium bromide | IPRATROPIUM BROMIDE | SOLUTION | Y | N | ||
| ipratropium/albuterol sulfate | IPRATROPIUM-ALBUTEROL | AMPUL-NEB | Y | N | ||
| ipratropium/albuterol sulfate | COMBIVENT RESPIMAT | MIST INHAL | Y | N | ||
| tiotropium bromide | SPIRIVA RESPIMAT | MIST INHAL | Y | N | ||
| umeclidinium bromide | INCRUSE ELLIPTA | BLST W/DEV | Y | N | ||
| aclidinium bromide | TUDORZA PRESSAIR | AER POW BA | N | N | Jan 31, 2013 | |
| revefenacin | YUPELRI | VIAL-NEB | N | N | ||
| tiotropium bromide | TIOTROPIUM BROMIDE | CAP W/DEV | N | N | ||
| tiotropium bromide | SPIRIVA HANDIHALER | CAP W/DEV | N | N |