Antiemetics, Conventional

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PDL Reference Documents

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.

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NDC Brand Name Generic Name Form Strength PDL
Status		 Rebate Carveout
‐ Bill FFS		 Current Drug Use Criteria
00904205159 DRIMINATE dimenhydrinate TABLET 50 mg N Y N Pharmacy PA
00904677212 DRIMINATE dimenhydrinate TABLET 50 mg N Y N Pharmacy PA
70677002201 MOTION SICKNESS dimenhydrinate TABLET 50 mg N Y N Pharmacy PA
70677108701 MOTION SICKNESS dimenhydrinate TABLET 50 mg N Y N Pharmacy PA
46122053653 MOTION SICKNESS RELIEF dimenhydrinate TABLET 50 mg N Y N Pharmacy PA
70000040401 MOTION SICKNESS RELIEF dimenhydrinate TABLET 50 mg N Y N Pharmacy PA
83324003212 MOTION SICKNESS RELIEF dimenhydrinate TABLET 50 mg N Y N Pharmacy PA
63323036600 DIMENHYDRINATE dimenhydrinate VIAL 50 mg/mL Y N  
63323036601 DIMENHYDRINATE dimenhydrinate VIAL 50 mg/mL Y N  
31722096260 DRONABINOL dronabinol CAPSULE 10 mg N Y N Pharmacy PA
42858086906 DRONABINOL dronabinol CAPSULE 10 mg N Y N Pharmacy PA
67877075560 DRONABINOL dronabinol CAPSULE 10 mg N Y N Pharmacy PA
00904714461 DRONABINOL dronabinol CAPSULE 2.5 mg N Y N Pharmacy PA
31722096060 DRONABINOL dronabinol CAPSULE 2.5 mg N Y N Pharmacy PA
42858086706 DRONABINOL dronabinol CAPSULE 2.5 mg N Y N Pharmacy PA
60687037511 DRONABINOL dronabinol CAPSULE 2.5 mg N Y N Pharmacy PA
60687037521 DRONABINOL dronabinol CAPSULE 2.5 mg N Y N Pharmacy PA
67877075360 DRONABINOL dronabinol CAPSULE 2.5 mg N Y N Pharmacy PA
53097057160 MARINOL dronabinol CAPSULE 2.5 mg N Y N Pharmacy PA
00904714504 DRONABINOL dronabinol CAPSULE 5 mg N Y N Pharmacy PA
31722096160 DRONABINOL dronabinol CAPSULE 5 mg N Y N Pharmacy PA
42858086806 DRONABINOL dronabinol CAPSULE 5 mg N Y N Pharmacy PA
60687038611 DRONABINOL dronabinol CAPSULE 5 mg N Y N Pharmacy PA
60687038694 DRONABINOL dronabinol CAPSULE 5 mg N Y N Pharmacy PA
67877075460 DRONABINOL dronabinol CAPSULE 5 mg N Y N Pharmacy PA
70199001801 ANTIVERT meclizine HCl TAB CHEW 25 mg N Y N Pharmacy PA
00536129901 MECLIZINE HCL meclizine HCl TAB CHEW 25 mg N Y N Pharmacy PA
00536129910 MECLIZINE HCL meclizine HCl TAB CHEW 25 mg N Y N Pharmacy PA
16571082401 MECLIZINE HCL meclizine HCl TAB CHEW 25 mg N Y N Pharmacy PA
16571082410 MECLIZINE HCL meclizine HCl TAB CHEW 25 mg N Y N Pharmacy PA
68001052900 MECLIZINE HCL meclizine HCl TAB CHEW 25 mg N Y N Pharmacy PA
68001052908 MECLIZINE HCL meclizine HCl TAB CHEW 25 mg N Y N Pharmacy PA
71800005203 MECLIZINE HCL meclizine HCl TAB CHEW 25 mg N Y N Pharmacy PA
70677129001 MOTION SICKNESS meclizine HCl TAB CHEW 25 mg N Y N Pharmacy PA
46122077451 MOTION SICKNESS RELIEF meclizine HCl TAB CHEW 25 mg N Y N Pharmacy PA
49483033301 MOTION-TIME meclizine HCl TAB CHEW 25 mg N Y N Pharmacy PA
49483033310 MOTION-TIME meclizine HCl TAB CHEW 25 mg N Y N Pharmacy PA
83324002716 TRAVEL EASE meclizine HCl TAB CHEW 25 mg N Y N Pharmacy PA
00536129701 MECLIZINE HCL meclizine HCl TABLET 12.5 mg N Y N Pharmacy PA
00536129710 MECLIZINE HCL meclizine HCl TABLET 12.5 mg N Y N Pharmacy PA
00904737561 MECLIZINE HCL meclizine HCl TABLET 12.5 mg N Y N Pharmacy PA
16571066001 MECLIZINE HCL meclizine HCl TABLET 12.5 mg N Y N Pharmacy PA
16571066050 MECLIZINE HCL meclizine HCl TABLET 12.5 mg N Y N Pharmacy PA
24689013801 MECLIZINE HCL meclizine HCl TABLET 12.5 mg N Y N Pharmacy PA
42806001201 MECLIZINE HCL meclizine HCl TABLET 12.5 mg N Y N Pharmacy PA
42806001210 MECLIZINE HCL meclizine HCl TABLET 12.5 mg N Y N Pharmacy PA
50268052211 MECLIZINE HCL meclizine HCl TABLET 12.5 mg N Y N Pharmacy PA
50268052215 MECLIZINE HCL meclizine HCl TABLET 12.5 mg N Y N Pharmacy PA
52536012901 MECLIZINE HCL meclizine HCl TABLET 12.5 mg N Y N Pharmacy PA
53746044101 MECLIZINE HCL meclizine HCl TABLET 12.5 mg N Y N Pharmacy PA
53746044110 MECLIZINE HCL meclizine HCl TABLET 12.5 mg N Y N Pharmacy PA
57237033301 MECLIZINE HCL meclizine HCl TABLET 12.5 mg N Y N Pharmacy PA
59651080701 MECLIZINE HCL meclizine HCl TABLET 12.5 mg N Y N Pharmacy PA
59746012206 MECLIZINE HCL meclizine HCl TABLET 12.5 mg N Y N Pharmacy PA
59746012210 MECLIZINE HCL meclizine HCl TABLET 12.5 mg N Y N Pharmacy PA
60687077501 MECLIZINE HCL meclizine HCl TABLET 12.5 mg N Y N Pharmacy PA
60687077511 MECLIZINE HCL meclizine HCl TABLET 12.5 mg N Y N Pharmacy PA
60687077565 MECLIZINE HCL meclizine HCl TABLET 12.5 mg N Y N Pharmacy PA
62135095290 MECLIZINE HCL meclizine HCl TABLET 12.5 mg N Y N Pharmacy PA
62559084101 MECLIZINE HCL meclizine HCl TABLET 12.5 mg N Y N Pharmacy PA
62559084110 MECLIZINE HCL meclizine HCl TABLET 12.5 mg N Y N Pharmacy PA
65162044110 MECLIZINE HCL meclizine HCl TABLET 12.5 mg N Y N Pharmacy PA
65162044111 MECLIZINE HCL meclizine HCl TABLET 12.5 mg N Y N Pharmacy PA
68001052800 MECLIZINE HCL meclizine HCl TABLET 12.5 mg N Y N Pharmacy PA
70710116100 MECLIZINE HCL meclizine HCl TABLET 12.5 mg N Y N Pharmacy PA
70710116101 MECLIZINE HCL meclizine HCl TABLET 12.5 mg N Y N Pharmacy PA
00904737661 MECLIZINE HCL meclizine HCl TABLET 25 mg N Y N Pharmacy PA
16571066101 MECLIZINE HCL meclizine HCl TABLET 25 mg N Y N Pharmacy PA
16571066110 MECLIZINE HCL meclizine HCl TABLET 25 mg N Y N Pharmacy PA
24689013901 MECLIZINE HCL meclizine HCl TABLET 25 mg N Y N Pharmacy PA
24689014601 MECLIZINE HCL meclizine HCl TABLET 25 mg N Y N Pharmacy PA
42806001401 MECLIZINE HCL meclizine HCl TABLET 25 mg N Y N Pharmacy PA
42806001410 MECLIZINE HCL meclizine HCl TABLET 25 mg N Y N Pharmacy PA
50268052311 MECLIZINE HCL meclizine HCl TABLET 25 mg N Y N Pharmacy PA
50268052315 MECLIZINE HCL meclizine HCl TABLET 25 mg N Y N Pharmacy PA
52536013301 MECLIZINE HCL meclizine HCl TABLET 25 mg N Y N Pharmacy PA
53746044201 MECLIZINE HCL meclizine HCl TABLET 25 mg N Y N Pharmacy PA
53746044210 MECLIZINE HCL meclizine HCl TABLET 25 mg N Y N Pharmacy PA
59651080801 MECLIZINE HCL meclizine HCl TABLET 25 mg N Y N Pharmacy PA
59651080899 MECLIZINE HCL meclizine HCl TABLET 25 mg N Y N Pharmacy PA
59746012106 MECLIZINE HCL meclizine HCl TABLET 25 mg N Y N Pharmacy PA
59746012110 MECLIZINE HCL meclizine HCl TABLET 25 mg N Y N Pharmacy PA
60687073001 MECLIZINE HCL meclizine HCl TABLET 25 mg N Y N Pharmacy PA
60687073011 MECLIZINE HCL meclizine HCl TABLET 25 mg N Y N Pharmacy PA
60687073065 MECLIZINE HCL meclizine HCl TABLET 25 mg N Y N Pharmacy PA
62135095390 MECLIZINE HCL meclizine HCl TABLET 25 mg N Y N Pharmacy PA
62559084201 MECLIZINE HCL meclizine HCl TABLET 25 mg N Y N Pharmacy PA
62559084210 MECLIZINE HCL meclizine HCl TABLET 25 mg N Y N Pharmacy PA
65162044210 MECLIZINE HCL meclizine HCl TABLET 25 mg N Y N Pharmacy PA
65162044211 MECLIZINE HCL meclizine HCl TABLET 25 mg N Y N Pharmacy PA
70710116200 MECLIZINE HCL meclizine HCl TABLET 25 mg N Y N Pharmacy PA
70710116201 MECLIZINE HCL meclizine HCl TABLET 25 mg N Y N Pharmacy PA
70677108801 MOTION SICKNESS meclizine HCl TABLET 25 mg N Y N Pharmacy PA
46122053551 MOTION SICKNESS RELIEF meclizine HCl TABLET 25 mg N Y N Pharmacy PA
70000009701 MOTION SICKNESS RELIEF meclizine HCl TABLET 25 mg N Y N Pharmacy PA
70199000401 ANTIVERT meclizine HCl TABLET 50 mg Y N  
16571066201 MECLIZINE HCL meclizine HCl TABLET 50 mg Y N  
62135095460 MECLIZINE HCL meclizine HCl TABLET 50 mg Y N  
00054356444 METOCLOPRAMIDE HCL INTENSOL metoclopramide HCl ORAL CONC 10 mg/mL Y Y N  
00121157610 METOCLOPRAMIDE HCL metoclopramide HCl SOLUTION 10 mg/10 mL Y Y N  
60687083742 METOCLOPRAMIDE HCL metoclopramide HCl SOLUTION 10 mg/10 mL Y Y N  
60687083748 METOCLOPRAMIDE HCL metoclopramide HCl SOLUTION 10 mg/10 mL Y Y N  
60687083756 METOCLOPRAMIDE HCL metoclopramide HCl SOLUTION 10 mg/10 mL Y Y N  
62135052610 METOCLOPRAMIDE HCL metoclopramide HCl SOLUTION 10 mg/10 mL Y Y N  
62135052624 METOCLOPRAMIDE HCL metoclopramide HCl SOLUTION 10 mg/10 mL Y Y N  
00054356363 METOCLOPRAMIDE HCL metoclopramide HCl SOLUTION 5 mg/5 mL Y Y N  
00054856304 METOCLOPRAMIDE HCL metoclopramide HCl SOLUTION 5 mg/5 mL Y Y N  
00093610516 METOCLOPRAMIDE HCL metoclopramide HCl SOLUTION 5 mg/5 mL Y Y N  
00121057616 METOCLOPRAMIDE HCL metoclopramide HCl SOLUTION 5 mg/5 mL Y Y N  
62135052647 METOCLOPRAMIDE HCL metoclopramide HCl SOLUTION 5 mg/5 mL Y Y N  
62559019016 METOCLOPRAMIDE HCL metoclopramide HCl SOLUTION 5 mg/5 mL Y Y N  
64950034416 METOCLOPRAMIDE HCL metoclopramide HCl SOLUTION 5 mg/5 mL Y Y N  
72089030715 GIMOTI metoclopramide HCl SPRAY/PUMP 15 mg/spray N Y N Pharmacy PA
00074217302 METOCLOPRAMIDE HCL metoclopramide HCl SYRINGE 10 mg/2 mL (5 mg/mL) Y N  
00409217332 METOCLOPRAMIDE HCL metoclopramide HCl SYRINGE 10 mg/2 mL (5 mg/mL) Y N  
76045021300 METOCLOPRAMIDE HCL metoclopramide HCl SYRINGE 10 mg/2 mL (5 mg/mL) Y N  
76045021320 METOCLOPRAMIDE HCL metoclopramide HCl SYRINGE 10 mg/2 mL (5 mg/mL) Y N  
00093220301 METOCLOPRAMIDE HCL metoclopramide HCl TABLET 10 mg Y Y N  
00093220305 METOCLOPRAMIDE HCL metoclopramide HCl TABLET 10 mg Y Y N  
00093220310 METOCLOPRAMIDE HCL metoclopramide HCl TABLET 10 mg Y Y N  
49884068901 METOCLOPRAMIDE HCL metoclopramide HCl TABLET 10 mg Y Y N  
49884068905 METOCLOPRAMIDE HCL metoclopramide HCl TABLET 10 mg Y Y N  
50228023301 METOCLOPRAMIDE HCL metoclopramide HCl TABLET 10 mg Y Y N  
50228023305 METOCLOPRAMIDE HCL metoclopramide HCl TABLET 10 mg Y Y N  
50228023310 METOCLOPRAMIDE HCL metoclopramide HCl TABLET 10 mg Y Y N  
51079088801 METOCLOPRAMIDE HCL metoclopramide HCl TABLET 10 mg Y Y N  
51079088820 METOCLOPRAMIDE HCL metoclopramide HCl TABLET 10 mg Y Y N  
60687063101 METOCLOPRAMIDE HCL metoclopramide HCl TABLET 10 mg Y Y N  
60687063111 METOCLOPRAMIDE HCL metoclopramide HCl TABLET 10 mg Y Y N  
62559029601 METOCLOPRAMIDE HCL metoclopramide HCl TABLET 10 mg Y Y N  
83980001101 METOCLOPRAMIDE HCL metoclopramide HCl TABLET 10 mg Y Y N  
83980001105 METOCLOPRAMIDE HCL metoclopramide HCl TABLET 10 mg Y Y N  
83980001110 METOCLOPRAMIDE HCL metoclopramide HCl TABLET 10 mg Y Y N  
62559016601 REGLAN metoclopramide HCl TABLET 10 mg Y Y N  
00093220401 METOCLOPRAMIDE HCL metoclopramide HCl TABLET 5 mg Y Y N  
00093220405 METOCLOPRAMIDE HCL metoclopramide HCl TABLET 5 mg Y Y N  
50228023201 METOCLOPRAMIDE HCL metoclopramide HCl TABLET 5 mg Y Y N  
50228023205 METOCLOPRAMIDE HCL metoclopramide HCl TABLET 5 mg Y Y N  
51079088601 METOCLOPRAMIDE HCL metoclopramide HCl TABLET 5 mg Y Y N  
51079088620 METOCLOPRAMIDE HCL metoclopramide HCl TABLET 5 mg Y Y N  
60687062001 METOCLOPRAMIDE HCL metoclopramide HCl TABLET 5 mg Y Y N  
60687062011 METOCLOPRAMIDE HCL metoclopramide HCl TABLET 5 mg Y Y N  
62559029501 METOCLOPRAMIDE HCL metoclopramide HCl TABLET 5 mg Y Y N  
62584078501 METOCLOPRAMIDE HCL metoclopramide HCl TABLET 5 mg Y Y N  
62584078533 METOCLOPRAMIDE HCL metoclopramide HCl TABLET 5 mg Y Y N  
83980001001 METOCLOPRAMIDE HCL metoclopramide HCl TABLET 5 mg Y Y N  
83980001005 METOCLOPRAMIDE HCL metoclopramide HCl TABLET 5 mg Y Y N  
62559016501 REGLAN metoclopramide HCl TABLET 5 mg Y Y N  
00409341401 METOCLOPRAMIDE HCL metoclopramide HCl VIAL 5 mg/mL Y N  
00409341411 METOCLOPRAMIDE HCL metoclopramide HCl VIAL 5 mg/mL Y N  
00409341418 METOCLOPRAMIDE HCL metoclopramide HCl VIAL 5 mg/mL Y N  
00409341421 METOCLOPRAMIDE HCL metoclopramide HCl VIAL 5 mg/mL Y N  
00409341461 METOCLOPRAMIDE HCL metoclopramide HCl VIAL 5 mg/mL Y N  
00409525502 METOCLOPRAMIDE HCL metoclopramide HCl VIAL 5 mg/mL Y N  
00409525510 METOCLOPRAMIDE HCL metoclopramide HCl VIAL 5 mg/mL Y N  
00409525515 METOCLOPRAMIDE HCL metoclopramide HCl VIAL 5 mg/mL Y N  
00409525525 METOCLOPRAMIDE HCL metoclopramide HCl VIAL 5 mg/mL Y N  
00703450201 METOCLOPRAMIDE HCL metoclopramide HCl VIAL 5 mg/mL Y N  
00703450204 METOCLOPRAMIDE HCL metoclopramide HCl VIAL 5 mg/mL Y N  
00703450291 METOCLOPRAMIDE HCL metoclopramide HCl VIAL 5 mg/mL Y N  
00703450293 METOCLOPRAMIDE HCL metoclopramide HCl VIAL 5 mg/mL Y N  
23155024031 METOCLOPRAMIDE HCL metoclopramide HCl VIAL 5 mg/mL Y N  
23155024041 METOCLOPRAMIDE HCL metoclopramide HCl VIAL 5 mg/mL Y N  
83634077902 METOCLOPRAMIDE HCL metoclopramide HCl VIAL 5 mg/mL Y N  
83634077941 METOCLOPRAMIDE HCL metoclopramide HCl VIAL 5 mg/mL Y N  
10939039933 ANTI-NAUSEA phosphorated carbo(dext-fruct) SOLUTION Y N N  
11822309880 ANTI-NAUSEA phosphorated carbo(dext-fruct) SOLUTION Y N N  
11917004542 ANTI-NAUSEA phosphorated carbo(dext-fruct) SOLUTION Y N N  
12810029126 ANTI-NAUSEA phosphorated carbo(dext-fruct) SOLUTION Y N N  
37097029126 ANTI-NAUSEA phosphorated carbo(dext-fruct) SOLUTION Y N N  
41280021272 ANTI-NAUSEA phosphorated carbo(dext-fruct) SOLUTION Y N N  
52569013550 ANTI-NAUSEA phosphorated carbo(dext-fruct) SOLUTION Y N N  
63868070404 ANTI-NAUSEA phosphorated carbo(dext-fruct) SOLUTION Y N N  
68013015912 ANTI-NAUSEA phosphorated carbo(dext-fruct) SOLUTION Y N N  
91899001888 ANTI-NAUSEA phosphorated carbo(dext-fruct) SOLUTION Y N N  
94441021272 ANTI-NAUSEA phosphorated carbo(dext-fruct) SOLUTION Y N N  
00536130297 ANTI-NAUSEA phosphorated carbo(dext-fruct) SOLUTION Y Y N  
46122072926 ANTI-NAUSEA phosphorated carbo(dext-fruct) SOLUTION Y Y N  
83324021704 ANTI-NAUSEA phosphorated carbo(dext-fruct) SOLUTION Y Y N  
65197020104 EMETROL phosphorated carbo(dext-fruct) SOLUTION Y N N  
00927015012 ESPECOL phosphorated carbo(dext-fruct) SOLUTION Y N N  
00363070804 NAUSEA CONTROL phosphorated carbo(dext-fruct) SOLUTION Y N N  
11917010841 NAUSEA CONTROL phosphorated carbo(dext-fruct) SOLUTION Y N N  
59779040726 NAUSEA RELIEF phosphorated carbo(dext-fruct) SOLUTION Y N N  
87701042657 NAUSEA RELIEF phosphorated carbo(dext-fruct) SOLUTION Y N N  
70000005201 NAUSEA RELIEF phosphorated carbo(dext-fruct) SOLUTION Y Y N  
00574722612 COMPRO prochlorperazine SUPP.RECT 25 mg Y Y N  
00007336344 COMPAZINE prochlorperazine edisylate SYRUP 5 mg/5 mL Y Y N  
00641613501 PROCHLORPERAZINE EDISYLATE prochlorperazine edisylate VIAL 10 mg/2 mL (5 mg/mL) Y N  
00641613525 PROCHLORPERAZINE EDISYLATE prochlorperazine edisylate VIAL 10 mg/2 mL (5 mg/mL) Y N  
00713035102 PROCHLORPERAZINE EDISYLATE prochlorperazine edisylate VIAL 10 mg/2 mL (5 mg/mL) Y N  
00713035109 PROCHLORPERAZINE EDISYLATE prochlorperazine edisylate VIAL 10 mg/2 mL (5 mg/mL) Y N  
00713035125 PROCHLORPERAZINE EDISYLATE prochlorperazine edisylate VIAL 10 mg/2 mL (5 mg/mL) Y N  
14789070002 PROCHLORPERAZINE EDISYLATE prochlorperazine edisylate VIAL 10 mg/2 mL (5 mg/mL) Y N  
14789070007 PROCHLORPERAZINE EDISYLATE prochlorperazine edisylate VIAL 10 mg/2 mL (5 mg/mL) Y N  
23155029431 PROCHLORPERAZINE EDISYLATE prochlorperazine edisylate VIAL 10 mg/2 mL (5 mg/mL) Y N  
23155029441 PROCHLORPERAZINE EDISYLATE prochlorperazine edisylate VIAL 10 mg/2 mL (5 mg/mL) Y N  
23155029442 PROCHLORPERAZINE EDISYLATE prochlorperazine edisylate VIAL 10 mg/2 mL (5 mg/mL) Y N  
23155049731 PROCHLORPERAZINE EDISYLATE prochlorperazine edisylate VIAL 10 mg/2 mL (5 mg/mL) Y N  
23155049742 PROCHLORPERAZINE EDISYLATE prochlorperazine edisylate VIAL 10 mg/2 mL (5 mg/mL) Y N  
23155052331 PROCHLORPERAZINE EDISYLATE prochlorperazine edisylate VIAL 10 mg/2 mL (5 mg/mL) Y N  
23155052341 PROCHLORPERAZINE EDISYLATE prochlorperazine edisylate VIAL 10 mg/2 mL (5 mg/mL) Y N  
25021079002 PROCHLORPERAZINE EDISYLATE prochlorperazine edisylate VIAL 10 mg/2 mL (5 mg/mL) Y N  
25021079003 PROCHLORPERAZINE EDISYLATE prochlorperazine edisylate VIAL 10 mg/2 mL (5 mg/mL) Y N  
43066009001 PROCHLORPERAZINE EDISYLATE prochlorperazine edisylate VIAL 10 mg/2 mL (5 mg/mL) Y N  
43066009025 PROCHLORPERAZINE EDISYLATE prochlorperazine edisylate VIAL 10 mg/2 mL (5 mg/mL) Y N  
65145011901 PROCHLORPERAZINE EDISYLATE prochlorperazine edisylate VIAL 10 mg/2 mL (5 mg/mL) Y N  
65145011910 PROCHLORPERAZINE EDISYLATE prochlorperazine edisylate VIAL 10 mg/2 mL (5 mg/mL) Y N  
67457064000 PROCHLORPERAZINE EDISYLATE prochlorperazine edisylate VIAL 10 mg/2 mL (5 mg/mL) Y N  
67457064002 PROCHLORPERAZINE EDISYLATE prochlorperazine edisylate VIAL 10 mg/2 mL (5 mg/mL) Y N  
67457064099 PROCHLORPERAZINE EDISYLATE prochlorperazine edisylate VIAL 10 mg/2 mL (5 mg/mL) Y N  
70069037101 PROCHLORPERAZINE EDISYLATE prochlorperazine edisylate VIAL 10 mg/2 mL (5 mg/mL) Y N  
70069037125 PROCHLORPERAZINE EDISYLATE prochlorperazine edisylate VIAL 10 mg/2 mL (5 mg/mL) Y N  
72266020401 PROCHLORPERAZINE EDISYLATE prochlorperazine edisylate VIAL 10 mg/2 mL (5 mg/mL) Y N  
72266020410 PROCHLORPERAZINE EDISYLATE prochlorperazine edisylate VIAL 10 mg/2 mL (5 mg/mL) Y N  
72572058001 PROCHLORPERAZINE EDISYLATE prochlorperazine edisylate VIAL 10 mg/2 mL (5 mg/mL) Y N  
72572058025 PROCHLORPERAZINE EDISYLATE prochlorperazine edisylate VIAL 10 mg/2 mL (5 mg/mL) Y N  
83634077802 PROCHLORPERAZINE EDISYLATE prochlorperazine edisylate VIAL 10 mg/2 mL (5 mg/mL) Y N  
83634077841 PROCHLORPERAZINE EDISYLATE prochlorperazine edisylate VIAL 10 mg/2 mL (5 mg/mL) Y N  
00007335216 COMPAZINE prochlorperazine edisylate VIAL 5 mg/mL Y N  
00904738206 PROCHLORPERAZINE MALEATE prochlorperazine maleate TABLET 10 mg Y Y N  
27241028701 PROCHLORPERAZINE MALEATE prochlorperazine maleate TABLET 10 mg Y Y N  
50268068511 PROCHLORPERAZINE MALEATE prochlorperazine maleate TABLET 10 mg Y Y N  
50268068515 PROCHLORPERAZINE MALEATE prochlorperazine maleate TABLET 10 mg Y Y N  
59746011506 PROCHLORPERAZINE MALEATE prochlorperazine maleate TABLET 10 mg Y Y N  
60219203901 PROCHLORPERAZINE MALEATE prochlorperazine maleate TABLET 10 mg Y Y N  
60687082511 PROCHLORPERAZINE MALEATE prochlorperazine maleate TABLET 10 mg Y Y N  
60687082565 PROCHLORPERAZINE MALEATE prochlorperazine maleate TABLET 10 mg Y Y N  
62135067490 PROCHLORPERAZINE MALEATE prochlorperazine maleate TABLET 10 mg Y Y N  
68462089001 PROCHLORPERAZINE MALEATE prochlorperazine maleate TABLET 10 mg Y Y N  
68462094701 PROCHLORPERAZINE MALEATE prochlorperazine maleate TABLET 10 mg Y Y N  
69315026601 PROCHLORPERAZINE MALEATE prochlorperazine maleate TABLET 10 mg Y Y N  
69452031020 PROCHLORPERAZINE MALEATE prochlorperazine maleate TABLET 10 mg Y Y N  
69452047220 PROCHLORPERAZINE MALEATE prochlorperazine maleate TABLET 10 mg Y Y N  
70710166801 PROCHLORPERAZINE MALEATE prochlorperazine maleate TABLET 10 mg Y Y N  
70954068910 PROCHLORPERAZINE MALEATE prochlorperazine maleate TABLET 10 mg Y Y N  
72603016901 PROCHLORPERAZINE MALEATE prochlorperazine maleate TABLET 10 mg Y Y N  
63304059001 PROCHLORPERAZINE prochlorperazine maleate TABLET 5 mg Y Y N  
00904738106 PROCHLORPERAZINE MALEATE prochlorperazine maleate TABLET 5 mg Y Y N  
27241028601 PROCHLORPERAZINE MALEATE prochlorperazine maleate TABLET 5 mg Y Y N  
50268068411 PROCHLORPERAZINE MALEATE prochlorperazine maleate TABLET 5 mg Y Y N  
50268068415 PROCHLORPERAZINE MALEATE prochlorperazine maleate TABLET 5 mg Y Y N  
59746011306 PROCHLORPERAZINE MALEATE prochlorperazine maleate TABLET 5 mg Y Y N  
60219203801 PROCHLORPERAZINE MALEATE prochlorperazine maleate TABLET 5 mg Y Y N  
60687081411 PROCHLORPERAZINE MALEATE prochlorperazine maleate TABLET 5 mg Y Y N  
60687081465 PROCHLORPERAZINE MALEATE prochlorperazine maleate TABLET 5 mg Y Y N  
62135067390 PROCHLORPERAZINE MALEATE prochlorperazine maleate TABLET 5 mg Y Y N  
68462088901 PROCHLORPERAZINE MALEATE prochlorperazine maleate TABLET 5 mg Y Y N  
69315026501 PROCHLORPERAZINE MALEATE prochlorperazine maleate TABLET 5 mg Y Y N  
69452030920 PROCHLORPERAZINE MALEATE prochlorperazine maleate TABLET 5 mg Y Y N  
69452047120 PROCHLORPERAZINE MALEATE prochlorperazine maleate TABLET 5 mg Y Y N  
70710166701 PROCHLORPERAZINE MALEATE prochlorperazine maleate TABLET 5 mg Y Y N  
70954068810 PROCHLORPERAZINE MALEATE prochlorperazine maleate TABLET 5 mg Y Y N  
00641608201 PHENERGAN promethazine HCl AMPUL 25 mg/mL Y N  
00641608225 PHENERGAN promethazine HCl AMPUL 25 mg/mL Y N  
00641094831 PROMETHAZINE HCL promethazine HCl AMPUL 25 mg/mL Y N  
00641094835 PROMETHAZINE HCL promethazine HCl AMPUL 25 mg/mL Y N  
00641149531 PROMETHAZINE HCL promethazine HCl AMPUL 25 mg/mL Y N  
00641149535 PROMETHAZINE HCL promethazine HCl AMPUL 25 mg/mL Y N  
39822552502 PROMETHAZINE HCL promethazine HCl AMPUL 25 mg/mL Y N  
39822552503 PROMETHAZINE HCL promethazine HCl AMPUL 25 mg/mL Y N  
00641608301 PHENERGAN promethazine HCl AMPUL 50 mg/mL Y N  
00641608325 PHENERGAN promethazine HCl AMPUL 50 mg/mL Y N  
00641094931 PROMETHAZINE HCL promethazine HCl AMPUL 50 mg/mL Y N  
00641094935 PROMETHAZINE HCL promethazine HCl AMPUL 50 mg/mL Y N  
00641149631 PROMETHAZINE HCL promethazine HCl AMPUL 50 mg/mL Y N  
00641149635 PROMETHAZINE HCL promethazine HCl AMPUL 50 mg/mL Y N  
39822555005 PROMETHAZINE HCL promethazine HCl AMPUL 50 mg/mL Y N  
39822555006 PROMETHAZINE HCL promethazine HCl AMPUL 50 mg/mL Y N  
31722004031 PROMETHAZINE HCL promethazine HCl SUPP.RECT 12.5 mg Y Y N  
45802075800 PROMETHAZINE HCL promethazine HCl SUPP.RECT 12.5 mg Y Y N  
45802075830 PROMETHAZINE HCL promethazine HCl SUPP.RECT 12.5 mg Y Y N  
51672529605 PROMETHAZINE HCL promethazine HCl SUPP.RECT 12.5 mg Y Y N  
31722004131 PROMETHAZINE HCL promethazine HCl SUPP.RECT 25 mg Y Y N  
31722004132 PROMETHAZINE HCL promethazine HCl SUPP.RECT 25 mg Y Y N  
45802075900 PROMETHAZINE HCL promethazine HCl SUPP.RECT 25 mg Y Y N  
45802075930 PROMETHAZINE HCL promethazine HCl SUPP.RECT 25 mg Y Y N  
51672529704 PROMETHAZINE HCL promethazine HCl SUPP.RECT 25 mg Y Y N  
00116402316 PROMETHAZINE HCL promethazine HCl SYRUP 6.25 mg/5 mL Y Y N  
00121185416 PROMETHAZINE HCL promethazine HCl SYRUP 6.25 mg/5 mL Y Y N  
27808005102 PROMETHAZINE HCL promethazine HCl SYRUP 6.25 mg/5 mL Y Y N  
62135077405 PROMETHAZINE HCL promethazine HCl SYRUP 6.25 mg/5 mL Y Y N  
62135077410 PROMETHAZINE HCL promethazine HCl SYRUP 6.25 mg/5 mL Y Y N  
62135077423 PROMETHAZINE HCL promethazine HCl SYRUP 6.25 mg/5 mL Y Y N  
62135077424 PROMETHAZINE HCL promethazine HCl SYRUP 6.25 mg/5 mL Y Y N  
62135077441 PROMETHAZINE HCL promethazine HCl SYRUP 6.25 mg/5 mL Y Y N  
62135077447 PROMETHAZINE HCL promethazine HCl SYRUP 6.25 mg/5 mL Y Y N  
70752013812 PROMETHAZINE HCL promethazine HCl SYRUP 6.25 mg/5 mL Y Y N  
81033001605 PROMETHAZINE HCL promethazine HCl SYRUP 6.25 mg/5 mL Y Y N  
81033001650 PROMETHAZINE HCL promethazine HCl SYRUP 6.25 mg/5 mL Y Y N  
53746074501 PROMETHAZINE HCL promethazine HCl TABLET 12.5 mg Y Y N  
60687066001 PROMETHAZINE HCL promethazine HCl TABLET 12.5 mg Y Y N  
60687066011 PROMETHAZINE HCL promethazine HCl TABLET 12.5 mg Y Y N  
65162074510 PROMETHAZINE HCL promethazine HCl TABLET 12.5 mg Y Y N  
68001016100 PROMETHAZINE HCL promethazine HCl TABLET 12.5 mg Y Y N  
68382004001 PROMETHAZINE HCL promethazine HCl TABLET 12.5 mg Y Y N  
68382004010 PROMETHAZINE HCL promethazine HCl TABLET 12.5 mg Y Y N  
00591530701 PROMETHAZINE HCL promethazine HCl TABLET 25 mg Y Y N  
00591530710 PROMETHAZINE HCL promethazine HCl TABLET 25 mg Y Y N  
00904730461 PROMETHAZINE HCL promethazine HCl TABLET 25 mg Y Y N  
10702000301 PROMETHAZINE HCL promethazine HCl TABLET 25 mg Y Y N  
10702000310 PROMETHAZINE HCL promethazine HCl TABLET 25 mg Y Y N  
10702000350 PROMETHAZINE HCL promethazine HCl TABLET 25 mg Y Y N  
53746052101 PROMETHAZINE HCL promethazine HCl TABLET 25 mg Y Y N  
53746052110 PROMETHAZINE HCL promethazine HCl TABLET 25 mg Y Y N  
62584083801 PROMETHAZINE HCL promethazine HCl TABLET 25 mg Y Y N  
65162052110 PROMETHAZINE HCL promethazine HCl TABLET 25 mg Y Y N  
65162052111 PROMETHAZINE HCL promethazine HCl TABLET 25 mg Y Y N  
68001016200 PROMETHAZINE HCL promethazine HCl TABLET 25 mg Y Y N  
68001016203 PROMETHAZINE HCL promethazine HCl TABLET 25 mg Y Y N  
68084015501 PROMETHAZINE HCL promethazine HCl TABLET 25 mg Y Y N  
68084015511 PROMETHAZINE HCL promethazine HCl TABLET 25 mg Y Y N  
68382004101 PROMETHAZINE HCL promethazine HCl TABLET 25 mg Y Y N  
68382004105 PROMETHAZINE HCL promethazine HCl TABLET 25 mg Y Y N  
68382004110 PROMETHAZINE HCL promethazine HCl TABLET 25 mg Y Y N  
00591531901 PROMETHAZINE HCL promethazine HCl TABLET 50 mg Y Y N  
10702000401 PROMETHAZINE HCL promethazine HCl TABLET 50 mg Y Y N  
53746052201 PROMETHAZINE HCL promethazine HCl TABLET 50 mg Y Y N  
65162052210 PROMETHAZINE HCL promethazine HCl TABLET 50 mg Y Y N  
68001016300 PROMETHAZINE HCL promethazine HCl TABLET 50 mg Y Y N  
68382004201 PROMETHAZINE HCL promethazine HCl TABLET 50 mg Y Y N  
68382004210 PROMETHAZINE HCL promethazine HCl TABLET 50 mg Y Y N  
00641608401 PHENERGAN promethazine HCl VIAL 25 mg/mL Y N  
00641608425 PHENERGAN promethazine HCl VIAL 25 mg/mL Y N  
00641092821 PROMETHAZINE HCL promethazine HCl VIAL 25 mg/mL Y N  
00641092825 PROMETHAZINE HCL promethazine HCl VIAL 25 mg/mL Y N  
00641095521 PROMETHAZINE HCL promethazine HCl VIAL 25 mg/mL Y N  
00641095525 PROMETHAZINE HCL promethazine HCl VIAL 25 mg/mL Y N  
00641620801 PROMETHAZINE HCL promethazine HCl VIAL 25 mg/mL Y N  
00641620825 PROMETHAZINE HCL promethazine HCl VIAL 25 mg/mL Y N  
00456100910 ANERGAN 50 promethazine HCl VIAL 50 mg/mL Y N  
00641608501 PHENERGAN promethazine HCl VIAL 50 mg/mL Y N  
00641608525 PHENERGAN promethazine HCl VIAL 50 mg/mL Y N  
00641092921 PROMETHAZINE HCL promethazine HCl VIAL 50 mg/mL Y N  
00641092925 PROMETHAZINE HCL promethazine HCl VIAL 50 mg/mL Y N  
00641095621 PROMETHAZINE HCL promethazine HCl VIAL 50 mg/mL Y N  
00641095625 PROMETHAZINE HCL promethazine HCl VIAL 50 mg/mL Y N  
00378647016 SCOPOLAMINE scopolamine PATCH TD 3 1 mg/3 day N Y N Pharmacy PA
00378647044 SCOPOLAMINE scopolamine PATCH TD 3 1 mg/3 day N Y N Pharmacy PA
00378647097 SCOPOLAMINE scopolamine PATCH TD 3 1 mg/3 day N Y N Pharmacy PA
00378647099 SCOPOLAMINE scopolamine PATCH TD 3 1 mg/3 day N Y N Pharmacy PA
00591225804 SCOPOLAMINE scopolamine PATCH TD 3 1 mg/3 day N Y N Pharmacy PA
00591225823 SCOPOLAMINE scopolamine PATCH TD 3 1 mg/3 day N Y N Pharmacy PA
00591225854 SCOPOLAMINE scopolamine PATCH TD 3 1 mg/3 day N Y N Pharmacy PA
00591225879 SCOPOLAMINE scopolamine PATCH TD 3 1 mg/3 day N Y N Pharmacy PA
42858015014 SCOPOLAMINE scopolamine PATCH TD 3 1 mg/3 day N Y N Pharmacy PA
42858015040 SCOPOLAMINE scopolamine PATCH TD 3 1 mg/3 day N Y N Pharmacy PA
42858015070 SCOPOLAMINE scopolamine PATCH TD 3 1 mg/3 day N Y N Pharmacy PA
45802058001 SCOPOLAMINE scopolamine PATCH TD 3 1 mg/3 day N Y N Pharmacy PA
45802058046 SCOPOLAMINE scopolamine PATCH TD 3 1 mg/3 day N Y N Pharmacy PA
45802058062 SCOPOLAMINE scopolamine PATCH TD 3 1 mg/3 day N Y N Pharmacy PA
45802058084 SCOPOLAMINE scopolamine PATCH TD 3 1 mg/3 day N Y N Pharmacy PA
50742050501 SCOPOLAMINE scopolamine PATCH TD 3 1 mg/3 day N Y N Pharmacy PA
50742050504 SCOPOLAMINE scopolamine PATCH TD 3 1 mg/3 day N Y N Pharmacy PA
50742050510 SCOPOLAMINE scopolamine PATCH TD 3 1 mg/3 day N Y N Pharmacy PA
50742050524 SCOPOLAMINE scopolamine PATCH TD 3 1 mg/3 day N Y N Pharmacy PA
70710184601 SCOPOLAMINE scopolamine PATCH TD 3 1 mg/3 day N Y N Pharmacy PA
70710184602 SCOPOLAMINE scopolamine PATCH TD 3 1 mg/3 day N Y N Pharmacy PA
70710184604 SCOPOLAMINE scopolamine PATCH TD 3 1 mg/3 day N Y N Pharmacy PA
70710184607 SCOPOLAMINE scopolamine PATCH TD 3 1 mg/3 day N Y N Pharmacy PA
10019055303 TRANSDERM-SCOP scopolamine PATCH TD 3 1 mg/3 day N Y N Pharmacy PA
10019055304 TRANSDERM-SCOP scopolamine PATCH TD 3 1 mg/3 day N Y N Pharmacy PA
10019055390 TRANSDERM-SCOP scopolamine PATCH TD 3 1 mg/3 day N Y N Pharmacy PA
62135077330 TRIMETHOBENZAMIDE HCL trimethobenzamide HCl CAPSULE 300 mg N Y N Pharmacy PA
42023011925 TIGAN trimethobenzamide HCl VIAL 100 mg/mL Y N  
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