Antidiarrheals

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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
45963047903 ALOSETRON HCL alosetron HCl TABLET 0.5 mg N Y N Pharmacy PA
53746024830 ALOSETRON HCL alosetron HCl TABLET 0.5 mg N Y N Pharmacy PA
65162024803 ALOSETRON HCL alosetron HCl TABLET 0.5 mg N Y N Pharmacy PA
70756070230 ALOSETRON HCL alosetron HCl TABLET 0.5 mg N Y N Pharmacy PA
71930001030 ALOSETRON HCL alosetron HCl TABLET 0.5 mg N Y N Pharmacy PA
54766089403 LOTRONEX alosetron HCl TABLET 0.5 mg N Y N Pharmacy PA
45963048003 ALOSETRON HCL alosetron HCl TABLET 1 mg N Y N Pharmacy PA
53746024930 ALOSETRON HCL alosetron HCl TABLET 1 mg N Y N Pharmacy PA
65162024903 ALOSETRON HCL alosetron HCl TABLET 1 mg N Y N Pharmacy PA
70756070130 ALOSETRON HCL alosetron HCl TABLET 1 mg N Y N Pharmacy PA
71930001130 ALOSETRON HCL alosetron HCl TABLET 1 mg N Y N Pharmacy PA
54766089503 LOTRONEX alosetron HCl TABLET 1 mg N Y N Pharmacy PA
00904524960 KAO-TIN attapulgite ORAL SUSP 600 mg/15 mL N Y N  
00009033303 KAOPECTATE bismuth subsalicylate ORAL SUSP 262 mg/15 mL N Y N  
00009040002 KAOPECTATE bismuth subsalicylate ORAL SUSP 262 mg/15 mL N Y N  
00536128636 STOMACH RELIEF bismuth subsalicylate ORAL SUSP 262 mg/15 mL N Y N  
46122070326 STOMACH RELIEF bismuth subsalicylate ORAL SUSP 262 mg/15 mL N Y N  
49348019237 STOMACH RELIEF bismuth subsalicylate ORAL SUSP 262 mg/15 mL N Y N  
49348019238 STOMACH RELIEF bismuth subsalicylate ORAL SUSP 262 mg/15 mL N Y N  
70000004401 STOMACH RELIEF bismuth subsalicylate ORAL SUSP 262 mg/15 mL N Y N  
70000004402 STOMACH RELIEF bismuth subsalicylate ORAL SUSP 262 mg/15 mL N Y N  
70000069801 STOMACH RELIEF bismuth subsalicylate ORAL SUSP 262 mg/15 mL N Y N  
70677119101 STOMACH RELIEF bismuth subsalicylate ORAL SUSP 262 mg/15 mL N Y N  
83324002008 STOMACH RELIEF bismuth subsalicylate ORAL SUSP 262 mg/15 mL N Y N  
83324002012 STOMACH RELIEF bismuth subsalicylate ORAL SUSP 262 mg/15 mL N Y N  
83324002208 STOMACH RELIEF bismuth subsalicylate ORAL SUSP 262 mg/15 mL N Y N  
46122074706 PINK BISMUTH bismuth subsalicylate ORAL SUSP 525 mg/15 mL N Y N  
00536128736 STOMACH RELIEF bismuth subsalicylate ORAL SUSP 525 mg/15 mL N Y N  
70000004501 STOMACH RELIEF bismuth subsalicylate ORAL SUSP 525 mg/15 mL N Y N  
83324002108 STOMACH RELIEF bismuth subsalicylate ORAL SUSP 525 mg/15 mL N Y N  
00904720546 BISMUTH bismuth subsalicylate TAB CHEW 262 mg N Y N  
68599474407 BISMUTH bismuth subsalicylate TAB CHEW 262 mg N Y N  
46122070165 PINK BISMUTH bismuth subsalicylate TAB CHEW 262 mg N Y N  
70000059101 STOMACH RELIEF bismuth subsalicylate TAB CHEW 262 mg N Y N  
70000059102 STOMACH RELIEF bismuth subsalicylate TAB CHEW 262 mg N Y N  
70677108001 STOMACH RELIEF bismuth subsalicylate TAB CHEW 262 mg N Y N  
83324013030 STOMACH RELIEF bismuth subsalicylate TAB CHEW 262 mg N Y N  
24385001758 PINK BISMUTH bismuth subsalicylate TABLET 262 mg N Y N  
70000059401 STOMACH RELIEF bismuth subsalicylate TABLET 262 mg N Y N  
70677108201 STOMACH RELIEF bismuth subsalicylate TABLET 262 mg N Y N  
83324006040 STOMACH RELIEF bismuth subsalicylate TABLET 262 mg N Y N  
70564080260 MYTESI crofelemer TABLET DR 125 mg N Y N  
54766020010 MOTOFEN difenoxin HCl/atropine sulfate TABLET 1 mg-0.025 mg N Y N  
00054319446 DIPHENOXYLATE-ATROPINE diphenoxylate HCl/atropine LIQUID 2.5 mg-0.025 mg/5 mL N Y N  
00406123601 DIPHENOXYLATE-ATROPINE diphenoxylate HCl/atropine TABLET 2.5 mg-0.025 mg N Y N  
00406123610 DIPHENOXYLATE-ATROPINE diphenoxylate HCl/atropine TABLET 2.5 mg-0.025 mg N Y N  
59762106101 DIPHENOXYLATE-ATROPINE diphenoxylate HCl/atropine TABLET 2.5 mg-0.025 mg N Y N  
59762106102 DIPHENOXYLATE-ATROPINE diphenoxylate HCl/atropine TABLET 2.5 mg-0.025 mg N Y N  
60687089001 DIPHENOXYLATE-ATROPINE diphenoxylate HCl/atropine TABLET 2.5 mg-0.025 mg N Y N  
60687089011 DIPHENOXYLATE-ATROPINE diphenoxylate HCl/atropine TABLET 2.5 mg-0.025 mg N Y N  
62135061812 DIPHENOXYLATE-ATROPINE diphenoxylate HCl/atropine TABLET 2.5 mg-0.025 mg N Y N  
62559049001 DIPHENOXYLATE-ATROPINE diphenoxylate HCl/atropine TABLET 2.5 mg-0.025 mg N Y N  
62559049010 DIPHENOXYLATE-ATROPINE diphenoxylate HCl/atropine TABLET 2.5 mg-0.025 mg N Y N  
69315091001 DIPHENOXYLATE-ATROPINE diphenoxylate HCl/atropine TABLET 2.5 mg-0.025 mg N Y N  
69315091010 DIPHENOXYLATE-ATROPINE diphenoxylate HCl/atropine TABLET 2.5 mg-0.025 mg N Y N  
75826010700 DIPHENOXYLATE-ATROPINE diphenoxylate HCl/atropine TABLET 2.5 mg-0.025 mg N Y N  
75826010703 DIPHENOXYLATE-ATROPINE diphenoxylate HCl/atropine TABLET 2.5 mg-0.025 mg N Y N  
75826010790 DIPHENOXYLATE-ATROPINE diphenoxylate HCl/atropine TABLET 2.5 mg-0.025 mg N Y N  
76385010701 DIPHENOXYLATE-ATROPINE diphenoxylate HCl/atropine TABLET 2.5 mg-0.025 mg N Y N  
76385010710 DIPHENOXYLATE-ATROPINE diphenoxylate HCl/atropine TABLET 2.5 mg-0.025 mg N Y N  
00025006131 LOMOTIL diphenoxylate HCl/atropine TABLET 2.5 mg-0.025 mg N Y N  
61874010008 VIBERZI eluxadoline TABLET 100 mg N Y N Pharmacy PA
61874010060 VIBERZI eluxadoline TABLET 100 mg N Y N Pharmacy PA
61874007508 VIBERZI eluxadoline TABLET 75 mg N Y N Pharmacy PA
61874007560 VIBERZI eluxadoline TABLET 75 mg N Y N Pharmacy PA
00363052024 ANTI-DIARRHEAL loperamide HCl CAPSULE 2 mg Y N N Quantity Limit
00363052048 ANTI-DIARRHEAL loperamide HCl CAPSULE 2 mg Y N N Quantity Limit
10939091744 ANTI-DIARRHEAL loperamide HCl CAPSULE 2 mg Y N N Quantity Limit
11822489200 ANTI-DIARRHEAL loperamide HCl CAPSULE 2 mg Y N N Quantity Limit
11917006653 ANTI-DIARRHEAL loperamide HCl CAPSULE 2 mg Y N N Quantity Limit
11917006654 ANTI-DIARRHEAL loperamide HCl CAPSULE 2 mg Y N N Quantity Limit
35515099718 ANTI-DIARRHEAL loperamide HCl CAPSULE 2 mg Y N N Quantity Limit
49035052012 ANTI-DIARRHEAL loperamide HCl CAPSULE 2 mg Y N N Quantity Limit
50428014702 ANTI-DIARRHEAL loperamide HCl CAPSULE 2 mg Y N N Quantity Limit
59779052024 ANTI-DIARRHEAL loperamide HCl CAPSULE 2 mg Y N N Quantity Limit
63868087612 ANTI-DIARRHEAL loperamide HCl CAPSULE 2 mg Y N N Quantity Limit
81131005295 ANTI-DIARRHEAL loperamide HCl CAPSULE 2 mg Y N N Quantity Limit
46122058162 ANTI-DIARRHEAL loperamide HCl CAPSULE 2 mg Y Y N Quantity Limit
70000046101 ANTI-DIARRHEAL loperamide HCl CAPSULE 2 mg Y Y N Quantity Limit
70677106201 ANTI-DIARRHEAL loperamide HCl CAPSULE 2 mg Y Y N Quantity Limit
83324020812 ANTI-DIARRHEAL loperamide HCl CAPSULE 2 mg Y Y N Quantity Limit
83324020924 ANTI-DIARRHEAL loperamide HCl CAPSULE 2 mg Y Y N Quantity Limit
00045013712 IMODIUM A-D loperamide HCl CAPSULE 2 mg Y N N Quantity Limit
50580036701 IMODIUM A-D loperamide HCl CAPSULE 2 mg Y N N Quantity Limit
50580036702 IMODIUM A-D loperamide HCl CAPSULE 2 mg Y N N Quantity Limit
00093031101 LOPERAMIDE loperamide HCl CAPSULE 2 mg Y Y N Quantity Limit
00093031105 LOPERAMIDE loperamide HCl CAPSULE 2 mg Y Y N Quantity Limit
00378210001 LOPERAMIDE loperamide HCl CAPSULE 2 mg Y Y N Quantity Limit
00378210005 LOPERAMIDE loperamide HCl CAPSULE 2 mg Y Y N Quantity Limit
00904747261 LOPERAMIDE loperamide HCl CAPSULE 2 mg Y Y N Quantity Limit
42799060501 LOPERAMIDE loperamide HCl CAPSULE 2 mg Y Y N Quantity Limit
42799060502 LOPERAMIDE loperamide HCl CAPSULE 2 mg Y Y N Quantity Limit
50268048211 LOPERAMIDE loperamide HCl CAPSULE 2 mg Y Y N Quantity Limit
50268048215 LOPERAMIDE loperamide HCl CAPSULE 2 mg Y Y N Quantity Limit
51079069001 LOPERAMIDE loperamide HCl CAPSULE 2 mg Y Y N Quantity Limit
51079069020 LOPERAMIDE loperamide HCl CAPSULE 2 mg Y Y N Quantity Limit
59651069101 LOPERAMIDE loperamide HCl CAPSULE 2 mg Y Y N Quantity Limit
59651069105 LOPERAMIDE loperamide HCl CAPSULE 2 mg Y Y N Quantity Limit
60687022901 LOPERAMIDE loperamide HCl CAPSULE 2 mg Y Y N Quantity Limit
60687022911 LOPERAMIDE loperamide HCl CAPSULE 2 mg Y Y N Quantity Limit
69452027120 LOPERAMIDE loperamide HCl CAPSULE 2 mg Y Y N Quantity Limit
69452027130 LOPERAMIDE loperamide HCl CAPSULE 2 mg Y Y N Quantity Limit
72578013801 LOPERAMIDE loperamide HCl CAPSULE 2 mg Y Y N Quantity Limit
72578013805 LOPERAMIDE loperamide HCl CAPSULE 2 mg Y Y N Quantity Limit
72603032801 LOPERAMIDE loperamide HCl CAPSULE 2 mg Y Y N Quantity Limit
72603032802 LOPERAMIDE loperamide HCl CAPSULE 2 mg Y Y N Quantity Limit
72888013001 LOPERAMIDE loperamide HCl CAPSULE 2 mg Y Y N Quantity Limit
72888013005 LOPERAMIDE loperamide HCl CAPSULE 2 mg Y Y N Quantity Limit
10939022833 ANTI-DIARRHEAL loperamide HCl LIQUID 1 mg/5 mL Y N N Quantity Limit
11822340980 ANTI-DIARRHEAL loperamide HCl LIQUID 1 mg/5 mL Y N N Quantity Limit
34575059857 ANTI-DIARRHEAL loperamide HCl LIQUID 1 mg/5 mL Y N N Quantity Limit
49614037716 ANTI-DIARRHEAL loperamide HCl LIQUID 1 mg/5 mL Y N N Quantity Limit
49614055416 ANTI-DIARRHEAL loperamide HCl LIQUID 1 mg/5 mL Y N N Quantity Limit
87701053754 ANTI-DIARRHEAL loperamide HCl LIQUID 1 mg/5 mL Y N N Quantity Limit
37205037716 LOPERAMIDE loperamide HCl LIQUID 1 mg/5 mL Y N N Quantity Limit
37097037716 LOPERAMIDE HCL loperamide HCl LIQUID 1 mg/5 mL Y N N Quantity Limit
37097037726 LOPERAMIDE HCL loperamide HCl LIQUID 1 mg/5 mL Y N N Quantity Limit
94441022984 LOPERAMIDE HCL loperamide HCl LIQUID 1 mg/5 mL Y N N Quantity Limit
94441022985 LOPERAMIDE HCL loperamide HCl LIQUID 1 mg/5 mL Y N N Quantity Limit
00054353550 LOPERAMIDE HCL loperamide HCl LIQUID 1 mg/5 mL Y Y N Quantity Limit
10939091144 ANTI-DIARRHEAL loperamide HCl LIQUID 1 mg/7.5 mL Y N N Quantity Limit
52569014221 ANTI-DIARRHEAL loperamide HCl LIQUID 1 mg/7.5 mL Y N N Quantity Limit
96295013558 ANTI-DIARRHEAL loperamide HCl LIQUID 1 mg/7.5 mL Y N N Quantity Limit
00113164526 ANTI-DIARRHEAL loperamide HCl LIQUID 1 mg/7.5 mL Y Y N Quantity Limit
70000041701 ANTI-DIARRHEAL loperamide HCl LIQUID 1 mg/7.5 mL Y Y N Quantity Limit
70000041801 ANTI-DIARRHEAL loperamide HCl LIQUID 1 mg/7.5 mL Y Y N Quantity Limit
70677110701 ANTI-DIARRHEAL loperamide HCl LIQUID 1 mg/7.5 mL Y Y N Quantity Limit
00450013404 IMODIUM A-D loperamide HCl LIQUID 1 mg/7.5 mL Y N N Quantity Limit
00450013408 IMODIUM A-D loperamide HCl LIQUID 1 mg/7.5 mL Y N N Quantity Limit
00450013444 IMODIUM A-D loperamide HCl LIQUID 1 mg/7.5 mL Y N N Quantity Limit
50580013404 IMODIUM A-D loperamide HCl LIQUID 1 mg/7.5 mL Y N N Quantity Limit
50580013408 IMODIUM A-D loperamide HCl LIQUID 1 mg/7.5 mL Y N N Quantity Limit
50580013444 IMODIUM A-D loperamide HCl LIQUID 1 mg/7.5 mL Y N N Quantity Limit
00363064526 LOPERAMIDE loperamide HCl LIQUID 1 mg/7.5 mL Y N N Quantity Limit
00363064534 LOPERAMIDE loperamide HCl LIQUID 1 mg/7.5 mL Y N N Quantity Limit
11822440980 LOPERAMIDE loperamide HCl LIQUID 1 mg/7.5 mL Y N N Quantity Limit
11917013688 LOPERAMIDE loperamide HCl LIQUID 1 mg/7.5 mL Y N N Quantity Limit
11917017371 LOPERAMIDE loperamide HCl LIQUID 1 mg/7.5 mL Y N N Quantity Limit
17856054502 LOPERAMIDE loperamide HCl LIQUID 1 mg/7.5 mL Y N N Quantity Limit
17856683601 LOPERAMIDE loperamide HCl LIQUID 1 mg/7.5 mL Y N N Quantity Limit
30142064534 LOPERAMIDE loperamide HCl LIQUID 1 mg/7.5 mL Y N N Quantity Limit
41163064526 LOPERAMIDE loperamide HCl LIQUID 1 mg/7.5 mL Y N N Quantity Limit
49035064526 LOPERAMIDE loperamide HCl LIQUID 1 mg/7.5 mL Y N N Quantity Limit
50428036006 LOPERAMIDE loperamide HCl LIQUID 1 mg/7.5 mL Y N N Quantity Limit
50428037774 LOPERAMIDE loperamide HCl LIQUID 1 mg/7.5 mL Y N N Quantity Limit
59779064526 LOPERAMIDE loperamide HCl LIQUID 1 mg/7.5 mL Y N N Quantity Limit
59779064534 LOPERAMIDE loperamide HCl LIQUID 1 mg/7.5 mL Y N N Quantity Limit
81131000577 LOPERAMIDE loperamide HCl LIQUID 1 mg/7.5 mL Y N N Quantity Limit
00904683620 LOPERAMIDE loperamide HCl LIQUID 1 mg/7.5 mL Y Y N Quantity Limit
46122054426 LOPERAMIDE loperamide HCl LIQUID 1 mg/7.5 mL Y Y N Quantity Limit
68094002959 LOPERAMIDE loperamide HCl LIQUID 1 mg/7.5 mL Y Y N Quantity Limit
68094002962 LOPERAMIDE loperamide HCl LIQUID 1 mg/7.5 mL Y Y N Quantity Limit
68094012959 LOPERAMIDE loperamide HCl LIQUID 1 mg/7.5 mL Y Y N Quantity Limit
68094012962 LOPERAMIDE loperamide HCl LIQUID 1 mg/7.5 mL Y Y N Quantity Limit
00363037502 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
00363037506 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
00363037507 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
00363037508 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
00363037522 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
00363037545 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
00363037546 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
10939023633 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
10939037433 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
10960070112 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
11822318460 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
11822331370 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
11822333780 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
11822351990 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
11917005591 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
11917005592 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
11917005594 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
11917005640 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
11917013288 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
11917013427 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
11917014910 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
30142099823 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
30142099862 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
30142099867 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
34575051892 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
34575069860 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
35515099640 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
36800022453 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
36800022462 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
36800022480 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
36800022491 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
41163023348 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
41163024433 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
41163025574 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
41163037502 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
41163037508 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
41163037544 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
41250022453 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
43072000296 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
43072000297 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
43292056079 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
49035022402 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
49035022416 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
49035022423 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
49035022482 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
50428232902 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
50428232907 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
52569013546 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
52569013547 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
57896038113 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
57896038125 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
59779022467 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
59779022480 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
59779070053 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
59779070082 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
59779096062 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
63868055912 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
70030013216 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
70030013217 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
70030014966 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
71205007912 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
81131002246 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
81131010679 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
81131018403 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
81131029776 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
81131069989 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
81131073145 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
87701011896 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
87701079188 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
87701079212 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y N N Quantity Limit
00113022453 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y Y N Quantity Limit
00113022462 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y Y N Quantity Limit
00113022491 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y Y N Quantity Limit
00113222462 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y Y N Quantity Limit
00904772512 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y Y N Quantity Limit
00904772524 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y Y N Quantity Limit
24385055453 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y Y N Quantity Limit
24385055462 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y Y N Quantity Limit
46122073853 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y Y N Quantity Limit
46122073862 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y Y N Quantity Limit
49348052902 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y Y N Quantity Limit
49348052904 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y Y N Quantity Limit
70000058901 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y Y N Quantity Limit
70677110601 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y Y N Quantity Limit
70677110602 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y Y N Quantity Limit
83324006412 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y Y N Quantity Limit
83324006424 ANTI-DIARRHEAL loperamide HCl TABLET 2 mg Y Y N Quantity Limit
47682020033 DIAMODE loperamide HCl TABLET 2 mg Y N N Quantity Limit
47682020046 DIAMODE loperamide HCl TABLET 2 mg Y N N Quantity Limit
47682020050 DIAMODE loperamide HCl TABLET 2 mg Y N N Quantity Limit
47682020064 DIAMODE loperamide HCl TABLET 2 mg Y N N Quantity Limit
47682020069 DIAMODE loperamide HCl TABLET 2 mg Y N N Quantity Limit
54569431800 DIAMODE loperamide HCl TABLET 2 mg Y N N Quantity Limit
00450029532 IMODIUM A-D loperamide HCl TABLET 2 mg Y N N Quantity Limit
50580031701 IMODIUM A-D loperamide HCl TABLET 2 mg Y N N Quantity Limit
50580031703 IMODIUM A-D loperamide HCl TABLET 2 mg Y N N Quantity Limit
10135015801 LOPERAMIDE loperamide HCl TABLET 2 mg Y N N Quantity Limit
10135015810 LOPERAMIDE loperamide HCl TABLET 2 mg Y N N Quantity Limit
10135015812 LOPERAMIDE loperamide HCl TABLET 2 mg Y N N Quantity Limit
10135015818 LOPERAMIDE loperamide HCl TABLET 2 mg Y N N Quantity Limit
10135015850 LOPERAMIDE loperamide HCl TABLET 2 mg Y N N Quantity Limit
10135015851 LOPERAMIDE loperamide HCl TABLET 2 mg Y N N Quantity Limit
58602070176 LOPERAMIDE loperamide HCl TABLET 2 mg Y N N Quantity Limit
37097055453 LOPERAMIDE HCL loperamide HCl TABLET 2 mg Y N N Quantity Limit
37097055489 LOPERAMIDE HCL loperamide HCl TABLET 2 mg Y N N Quantity Limit
37097055491 LOPERAMIDE HCL loperamide HCl TABLET 2 mg Y N N Quantity Limit
94441023118 LOPERAMIDE HCL loperamide HCl TABLET 2 mg Y N N Quantity Limit
94441023119 LOPERAMIDE HCL loperamide HCl TABLET 2 mg Y N N Quantity Limit
94441023133 LOPERAMIDE HCL loperamide HCl TABLET 2 mg Y N N Quantity Limit
11383016008 ULTRA A-D loperamide HCl TABLET 2 mg Y N N Quantity Limit
32363016018 ULTRA A-D loperamide HCl TABLET 2 mg Y N N Quantity Limit
00113008753 ANTI-DIARRHEAL-ANTI-GAS loperamide HCl/simethicone TABLET 2 mg-125 mg N Y N Quantity Limit
00113008762 ANTI-DIARRHEAL-ANTI-GAS loperamide HCl/simethicone TABLET 2 mg-125 mg N Y N Quantity Limit
46122062062 ANTI-DIARRHEAL-ANTI-GAS loperamide HCl/simethicone TABLET 2 mg-125 mg N Y N Quantity Limit
70677110501 ANTI-DIARRHEAL-ANTI-GAS loperamide HCl/simethicone TABLET 2 mg-125 mg N Y N Quantity Limit
69230032512 LOPERAMIDE-SIMETHICONE loperamide HCl/simethicone TABLET 2 mg-125 mg N Y N Quantity Limit
69230032524 LOPERAMIDE-SIMETHICONE loperamide HCl/simethicone TABLET 2 mg-125 mg N Y N Quantity Limit
69230032532 LOPERAMIDE-SIMETHICONE loperamide HCl/simethicone TABLET 2 mg-125 mg N Y N Quantity Limit
42799021701 OPIUM TINCTURE opium tincture TINCTURE 10 mg/mL (morphine) N Y N  
42799021702 OPIUM TINCTURE opium tincture TINCTURE 10 mg/mL (morphine) N Y N  
62559015304 OPIUM TINCTURE opium tincture TINCTURE 10 mg/mL (morphine) N Y N  
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