Antispasm Anticholinergics
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.
| NDC | Brand Name | Generic Name | Form | Strength | PDL Status |
Rebate | Carveout ‐ Bill FFS |
Current Drug Use Criteria |
|---|---|---|---|---|---|---|---|---|
| 00409163010 | ATROPINE SULFATE | atropine sulfate | SYRINGE | 0.1 mg/mL | Y | N | ||
| 00409163015 | ATROPINE SULFATE | atropine sulfate | SYRINGE | 0.1 mg/mL | Y | N | ||
| 00409491011 | ATROPINE SULFATE | atropine sulfate | SYRINGE | 0.1 mg/mL | Y | N | ||
| 00409491034 | ATROPINE SULFATE | atropine sulfate | SYRINGE | 0.1 mg/mL | Y | N | ||
| 00409491111 | ATROPINE SULFATE | atropine sulfate | SYRINGE | 0.1 mg/mL | Y | N | ||
| 00409491134 | ATROPINE SULFATE | atropine sulfate | SYRINGE | 0.1 mg/mL | Y | N | ||
| 16729048403 | ATROPINE SULFATE | atropine sulfate | SYRINGE | 0.1 mg/mL | Y | N | ||
| 16729048445 | ATROPINE SULFATE | atropine sulfate | SYRINGE | 0.1 mg/mL | Y | N | ||
| 70121170501 | ATROPINE SULFATE | atropine sulfate | SYRINGE | 0.1 mg/mL | Y | N | ||
| 70121170507 | ATROPINE SULFATE | atropine sulfate | SYRINGE | 0.1 mg/mL | Y | N | ||
| 70121170601 | ATROPINE SULFATE | atropine sulfate | SYRINGE | 0.1 mg/mL | Y | N | ||
| 70121170602 | ATROPINE SULFATE | atropine sulfate | SYRINGE | 0.1 mg/mL | Y | N | ||
| 70121170604 | ATROPINE SULFATE | atropine sulfate | SYRINGE | 0.1 mg/mL | Y | N | ||
| 76329334001 | ATROPINE SULFATE | atropine sulfate | SYRINGE | 0.1 mg/mL | Y | N | ||
| 00409963005 | ATROPINE SULFATE | atropine sulfate | SYRINGE | 0.25 mg/5 mL (0.05 mg/mL) | Y | N | ||
| 00409963015 | ATROPINE SULFATE | atropine sulfate | SYRINGE | 0.25 mg/5 mL (0.05 mg/mL) | Y | N | ||
| 00517100401 | ATROPINE SULFATE | atropine sulfate | VIAL | 0.4 mg/mL | Y | N | ||
| 00517100425 | ATROPINE SULFATE | atropine sulfate | VIAL | 0.4 mg/mL | Y | N | ||
| 00641625101 | ATROPINE SULFATE | atropine sulfate | VIAL | 0.4 mg/mL | Y | N | ||
| 00641625110 | ATROPINE SULFATE | atropine sulfate | VIAL | 0.4 mg/mL | Y | N | ||
| 16729051205 | ATROPINE SULFATE | atropine sulfate | VIAL | 0.4 mg/mL | Y | N | ||
| 16729051243 | ATROPINE SULFATE | atropine sulfate | VIAL | 0.4 mg/mL | Y | N | ||
| 16729052508 | ATROPINE SULFATE | atropine sulfate | VIAL | 0.4 mg/mL | Y | N | ||
| 16729052563 | ATROPINE SULFATE | atropine sulfate | VIAL | 0.4 mg/mL | Y | N | ||
| 63323058003 | ATROPINE SULFATE | atropine sulfate | VIAL | 0.4 mg/mL | Y | N | ||
| 63323058020 | ATROPINE SULFATE | atropine sulfate | VIAL | 0.4 mg/mL | Y | N | ||
| 70069048101 | ATROPINE SULFATE | atropine sulfate | VIAL | 0.4 mg/mL | Y | N | ||
| 70069048110 | ATROPINE SULFATE | atropine sulfate | VIAL | 0.4 mg/mL | Y | N | ||
| 70069063101 | ATROPINE SULFATE | atropine sulfate | VIAL | 0.4 mg/mL | Y | N | ||
| 70069063125 | ATROPINE SULFATE | atropine sulfate | VIAL | 0.4 mg/mL | Y | N | ||
| 00517100101 | ATROPINE SULFATE | atropine sulfate | VIAL | 1 mg/mL | Y | N | ||
| 00517100125 | ATROPINE SULFATE | atropine sulfate | VIAL | 1 mg/mL | Y | N | ||
| 16729052608 | ATROPINE SULFATE | atropine sulfate | VIAL | 1 mg/mL | Y | N | ||
| 16729052663 | ATROPINE SULFATE | atropine sulfate | VIAL | 1 mg/mL | Y | N | ||
| 70069064101 | ATROPINE SULFATE | atropine sulfate | VIAL | 1 mg/mL | Y | N | ||
| 70069064125 | ATROPINE SULFATE | atropine sulfate | VIAL | 1 mg/mL | Y | N | ||
| 70069044101 | DICYCLOMINE HCL | dicyclomine HCl | AMPUL | 10 mg/mL | Y | N | ||
| 70069044105 | DICYCLOMINE HCL | dicyclomine HCl | AMPUL | 10 mg/mL | Y | N | ||
| 00054074825 | DICYCLOMINE HCL | dicyclomine HCl | CAPSULE | 10 mg | Y | N | ||
| 00054074831 | DICYCLOMINE HCL | dicyclomine HCl | CAPSULE | 10 mg | Y | N | ||
| 00527058601 | DICYCLOMINE HCL | dicyclomine HCl | CAPSULE | 10 mg | Y | N | ||
| 00527058610 | DICYCLOMINE HCL | dicyclomine HCl | CAPSULE | 10 mg | Y | N | ||
| 00591079401 | DICYCLOMINE HCL | dicyclomine HCl | CAPSULE | 10 mg | Y | N | ||
| 00591079410 | DICYCLOMINE HCL | dicyclomine HCl | CAPSULE | 10 mg | Y | N | ||
| 00832605310 | DICYCLOMINE HCL | dicyclomine HCl | CAPSULE | 10 mg | Y | N | ||
| 00832605311 | DICYCLOMINE HCL | dicyclomine HCl | CAPSULE | 10 mg | Y | N | ||
| 00904698761 | DICYCLOMINE HCL | dicyclomine HCl | CAPSULE | 10 mg | Y | N | ||
| 00904789680 | DICYCLOMINE HCL | dicyclomine HCl | CAPSULE | 10 mg | Y | N | ||
| 24979020101 | DICYCLOMINE HCL | dicyclomine HCl | CAPSULE | 10 mg | Y | N | ||
| 24979020103 | DICYCLOMINE HCL | dicyclomine HCl | CAPSULE | 10 mg | Y | N | ||
| 31722005201 | DICYCLOMINE HCL | dicyclomine HCl | CAPSULE | 10 mg | Y | N | ||
| 31722005210 | DICYCLOMINE HCL | dicyclomine HCl | CAPSULE | 10 mg | Y | N | ||
| 43547063410 | DICYCLOMINE HCL | dicyclomine HCl | CAPSULE | 10 mg | Y | N | ||
| 43547063411 | DICYCLOMINE HCL | dicyclomine HCl | CAPSULE | 10 mg | Y | N | ||
| 50268019911 | DICYCLOMINE HCL | dicyclomine HCl | CAPSULE | 10 mg | Y | N | ||
| 50268019915 | DICYCLOMINE HCL | dicyclomine HCl | CAPSULE | 10 mg | Y | N | ||
| 59651071901 | DICYCLOMINE HCL | dicyclomine HCl | CAPSULE | 10 mg | Y | N | ||
| 59651071999 | DICYCLOMINE HCL | dicyclomine HCl | CAPSULE | 10 mg | Y | N | ||
| 60687036901 | DICYCLOMINE HCL | dicyclomine HCl | CAPSULE | 10 mg | Y | N | ||
| 60687036911 | DICYCLOMINE HCL | dicyclomine HCl | CAPSULE | 10 mg | Y | N | ||
| 62135071890 | DICYCLOMINE HCL | dicyclomine HCl | CAPSULE | 10 mg | Y | N | ||
| 73473080001 | DICYCLOMINE HCL | dicyclomine HCl | CAPSULE | 10 mg | Y | N | ||
| 73473080010 | DICYCLOMINE HCL | dicyclomine HCl | CAPSULE | 10 mg | Y | N | ||
| 00054062263 | DICYCLOMINE HCL | dicyclomine HCl | SOLUTION | 10 mg/5 mL | Y | N | ||
| 00603116158 | DICYCLOMINE HCL | dicyclomine HCl | SOLUTION | 10 mg/5 mL | Y | N | ||
| 70954026110 | DICYCLOMINE HCL | dicyclomine HCl | SOLUTION | 10 mg/5 mL | Y | N | ||
| 00143122701 | DICYCLOMINE HCL | dicyclomine HCl | TABLET | 20 mg | Y | N | ||
| 00143122710 | DICYCLOMINE HCL | dicyclomine HCl | TABLET | 20 mg | Y | N | ||
| 00527128201 | DICYCLOMINE HCL | dicyclomine HCl | TABLET | 20 mg | Y | N | ||
| 00527128210 | DICYCLOMINE HCL | dicyclomine HCl | TABLET | 20 mg | Y | N | ||
| 00591079501 | DICYCLOMINE HCL | dicyclomine HCl | TABLET | 20 mg | Y | N | ||
| 00591079510 | DICYCLOMINE HCL | dicyclomine HCl | TABLET | 20 mg | Y | N | ||
| 00832605210 | DICYCLOMINE HCL | dicyclomine HCl | TABLET | 20 mg | Y | N | ||
| 00832605211 | DICYCLOMINE HCL | dicyclomine HCl | TABLET | 20 mg | Y | N | ||
| 00904698861 | DICYCLOMINE HCL | dicyclomine HCl | TABLET | 20 mg | Y | N | ||
| 16571025901 | DICYCLOMINE HCL | dicyclomine HCl | TABLET | 20 mg | Y | N | ||
| 16571025910 | DICYCLOMINE HCL | dicyclomine HCl | TABLET | 20 mg | Y | N | ||
| 24979020001 | DICYCLOMINE HCL | dicyclomine HCl | TABLET | 20 mg | Y | N | ||
| 24979020003 | DICYCLOMINE HCL | dicyclomine HCl | TABLET | 20 mg | Y | N | ||
| 31722007901 | DICYCLOMINE HCL | dicyclomine HCl | TABLET | 20 mg | Y | N | ||
| 31722007910 | DICYCLOMINE HCL | dicyclomine HCl | TABLET | 20 mg | Y | N | ||
| 59651072001 | DICYCLOMINE HCL | dicyclomine HCl | TABLET | 20 mg | Y | N | ||
| 59651072099 | DICYCLOMINE HCL | dicyclomine HCl | TABLET | 20 mg | Y | N | ||
| 60687038001 | DICYCLOMINE HCL | dicyclomine HCl | TABLET | 20 mg | Y | N | ||
| 60687038011 | DICYCLOMINE HCL | dicyclomine HCl | TABLET | 20 mg | Y | N | ||
| 62135042801 | DICYCLOMINE HCL | dicyclomine HCl | TABLET | 20 mg | Y | N | ||
| 62135042812 | DICYCLOMINE HCL | dicyclomine HCl | TABLET | 20 mg | Y | N | ||
| 69452031120 | DICYCLOMINE HCL | dicyclomine HCl | TABLET | 20 mg | Y | N | ||
| 69452031132 | DICYCLOMINE HCL | dicyclomine HCl | TABLET | 20 mg | Y | N | ||
| 72888011900 | DICYCLOMINE HCL | dicyclomine HCl | TABLET | 20 mg | Y | N | ||
| 72888011901 | DICYCLOMINE HCL | dicyclomine HCl | TABLET | 20 mg | Y | N | ||
| 73473090201 | DICYCLOMINE HCL | dicyclomine HCl | TABLET | 20 mg | Y | N | ||
| 73473090210 | DICYCLOMINE HCL | dicyclomine HCl | TABLET | 20 mg | Y | N | ||
| 73352011960 | DICYCLOMINE HCL | dicyclomine HCl | TABLET | 40 mg | Y | N | ||
| 00517198001 | DICYCLOMINE HCL | dicyclomine HCl | VIAL | 10 mg/mL | Y | N | ||
| 00517198005 | DICYCLOMINE HCL | dicyclomine HCl | VIAL | 10 mg/mL | Y | N | ||
| 00641617301 | DICYCLOMINE HCL | dicyclomine HCl | VIAL | 10 mg/mL | Y | N | ||
| 00641617310 | DICYCLOMINE HCL | dicyclomine HCl | VIAL | 10 mg/mL | Y | N | ||
| 14789001002 | DICYCLOMINE HCL | dicyclomine HCl | VIAL | 10 mg/mL | Y | N | ||
| 14789001007 | DICYCLOMINE HCL | dicyclomine HCl | VIAL | 10 mg/mL | Y | N | ||
| 31722096331 | DICYCLOMINE HCL | dicyclomine HCl | VIAL | 10 mg/mL | Y | N | ||
| 31722096332 | DICYCLOMINE HCL | dicyclomine HCl | VIAL | 10 mg/mL | Y | N | ||
| 63323084202 | DICYCLOMINE HCL | dicyclomine HCl | VIAL | 10 mg/mL | Y | N | ||
| 63323084221 | DICYCLOMINE HCL | dicyclomine HCl | VIAL | 10 mg/mL | Y | N | ||
| 70069043101 | DICYCLOMINE HCL | dicyclomine HCl | VIAL | 10 mg/mL | Y | N | ||
| 70069043105 | DICYCLOMINE HCL | dicyclomine HCl | VIAL | 10 mg/mL | Y | N | ||
| 70436014780 | DICYCLOMINE HCL | dicyclomine HCl | VIAL | 10 mg/mL | Y | N | ||
| 70436014781 | DICYCLOMINE HCL | dicyclomine HCl | VIAL | 10 mg/mL | Y | N | ||
| 72266012701 | DICYCLOMINE HCL | dicyclomine HCl | VIAL | 10 mg/mL | Y | N | ||
| 72266012705 | DICYCLOMINE HCL | dicyclomine HCl | VIAL | 10 mg/mL | Y | N | ||
| 00259050116 | CUVPOSA | glycopyrrolate | SOLUTION | 1 mg/5 mL (0.2 mg/mL) | Y | N | ||
| 31722001647 | GLYCOPYRROLATE | glycopyrrolate | SOLUTION | 1 mg/5 mL (0.2 mg/mL) | Y | N | ||
| 49884004233 | GLYCOPYRROLATE | glycopyrrolate | SOLUTION | 1 mg/5 mL (0.2 mg/mL) | Y | N | ||
| 51672531609 | GLYCOPYRROLATE | glycopyrrolate | SOLUTION | 1 mg/5 mL (0.2 mg/mL) | Y | N | ||
| 59651043547 | GLYCOPYRROLATE | glycopyrrolate | SOLUTION | 1 mg/5 mL (0.2 mg/mL) | Y | N | ||
| 62135096147 | GLYCOPYRROLATE | glycopyrrolate | SOLUTION | 1 mg/5 mL (0.2 mg/mL) | Y | N | ||
| 71656006116 | GLYCOPYRROLATE | glycopyrrolate | SOLUTION | 1 mg/5 mL (0.2 mg/mL) | Y | N | ||
| 72205007072 | GLYCOPYRROLATE | glycopyrrolate | SOLUTION | 1 mg/5 mL (0.2 mg/mL) | Y | N | ||
| 72603024001 | GLYCOPYRROLATE | glycopyrrolate | SOLUTION | 1 mg/5 mL (0.2 mg/mL) | Y | N | ||
| 68094007301 | GLYCOPYRROLATE | glycopyrrolate | SYRINGE | 1 mg/5 mL | Y | N | ||
| 68094007358 | GLYCOPYRROLATE | glycopyrrolate | SYRINGE | 1 mg/5 mL | Y | N | ||
| 82111051801 | DARTISLA | glycopyrrolate | TAB RAPDIS | 1.7 mg | Y | N | ||
| 00904670961 | GLYCOPYRROLATE | glycopyrrolate | TABLET | 1 mg | Y | N | ||
| 13107001401 | GLYCOPYRROLATE | glycopyrrolate | TABLET | 1 mg | Y | N | ||
| 16571074309 | GLYCOPYRROLATE | glycopyrrolate | TABLET | 1 mg | Y | N | ||
| 23155060601 | GLYCOPYRROLATE | glycopyrrolate | TABLET | 1 mg | Y | N | ||
| 49884006501 | GLYCOPYRROLATE | glycopyrrolate | TABLET | 1 mg | Y | N | ||
| 50268036311 | GLYCOPYRROLATE | glycopyrrolate | TABLET | 1 mg | Y | N | ||
| 50268036315 | GLYCOPYRROLATE | glycopyrrolate | TABLET | 1 mg | Y | N | ||
| 60687045801 | GLYCOPYRROLATE | glycopyrrolate | TABLET | 1 mg | Y | N | ||
| 60687045811 | GLYCOPYRROLATE | glycopyrrolate | TABLET | 1 mg | Y | N | ||
| 62135073460 | GLYCOPYRROLATE | glycopyrrolate | TABLET | 1 mg | Y | N | ||
| 69076047501 | GLYCOPYRROLATE | glycopyrrolate | TABLET | 1 mg | Y | N | ||
| 69315013901 | GLYCOPYRROLATE | glycopyrrolate | TABLET | 1 mg | Y | N | ||
| 70752010810 | GLYCOPYRROLATE | glycopyrrolate | TABLET | 1 mg | Y | N | ||
| 70199000790 | ROBINUL | glycopyrrolate | TABLET | 1 mg | Y | N | ||
| 80056016010 | GLYCATE | glycopyrrolate | TABLET | 1.5 mg | Y | N | ||
| 13107001501 | GLYCOPYRROLATE | glycopyrrolate | TABLET | 2 mg | Y | N | ||
| 16571074409 | GLYCOPYRROLATE | glycopyrrolate | TABLET | 2 mg | Y | N | ||
| 23155060701 | GLYCOPYRROLATE | glycopyrrolate | TABLET | 2 mg | Y | N | ||
| 49884006601 | GLYCOPYRROLATE | glycopyrrolate | TABLET | 2 mg | Y | N | ||
| 62135073560 | GLYCOPYRROLATE | glycopyrrolate | TABLET | 2 mg | Y | N | ||
| 69076047601 | GLYCOPYRROLATE | glycopyrrolate | TABLET | 2 mg | Y | N | ||
| 69315014001 | GLYCOPYRROLATE | glycopyrrolate | TABLET | 2 mg | Y | N | ||
| 70752010910 | GLYCOPYRROLATE | glycopyrrolate | TABLET | 2 mg | Y | N | ||
| 70199000890 | ROBINUL FORTE | glycopyrrolate | TABLET | 2 mg | Y | N | ||
| 00143967901 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 00143967910 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 00143968001 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 00143968025 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 00143968101 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 00143968125 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 00143968201 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 00143968225 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 00517460101 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 00517460125 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 00517460201 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 00517460225 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 00517460525 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 00517462025 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 00781382571 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 00781382596 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 00781382772 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 00781382796 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 00781382975 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 00781382996 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 00781383195 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 16714053601 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 16714053625 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 25021079601 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 25021079602 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 25021079605 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 43547054325 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 43547054425 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 43547063901 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 43547063925 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 43547064001 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 43547064025 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 60505617900 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 60505617905 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 60505618000 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 60505618005 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 60505618100 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 60505618105 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 60505618200 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 60505618204 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 62332060701 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 62332060725 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 62332062702 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 62332062725 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 62332062805 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 62332062825 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 62332062910 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 62332062920 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 63323057801 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 63323057802 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 63323057803 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 63323057804 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 63323057805 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 63323057807 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 63323057811 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 63323057812 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 63323057841 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 63323057842 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 65219080100 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 65219080101 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 66794020202 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 66794020242 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 66794020302 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 66794020342 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 66794020402 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 66794020442 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 66794020502 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 66794020541 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 70069001101 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 70069001125 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 70069001201 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 70069001225 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 70069001301 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 70069001325 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 70069061601 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 70069061610 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 70069061701 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 70069061725 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 70069061801 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 70069061825 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 70069061901 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 70069061925 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 70700016522 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 70700016525 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 70700016622 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 70700016625 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 70700016722 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 70700016725 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 70700016822 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 70700016823 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 70700090222 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 70700090225 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 70700090322 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 70700090323 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 70860078101 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 70860078102 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 70860078105 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 70860078141 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 70860078142 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 70860078143 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 70860078144 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 71288041401 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 71288041402 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 71288041403 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 71288041404 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 71288041491 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 71288041492 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 71288041493 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 71288041494 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 71288041505 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 71288041506 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 71288041520 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 71288041521 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 71288041595 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 71288041596 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 71839012301 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 71839012325 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 71839012401 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 71839012425 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 71839012501 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 71839012525 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 72572022501 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 72572022525 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 72572022601 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 72572022625 | GLYCOPYRROLATE | glycopyrrolate | VIAL | 0.2 mg/mL | Y | N | ||
| 00641621201 | GLYCOPYRROLATE | glycopyrrolate in water/PF | SYRINGE | 0.2 mg/mL | Y | N | ||
| 00641621210 | GLYCOPYRROLATE | glycopyrrolate in water/PF | SYRINGE | 0.2 mg/mL | Y | N | ||
| 70121169801 | GLYCOPYRROLATE | glycopyrrolate in water/PF | SYRINGE | 0.2 mg/mL | Y | N | ||
| 70121169807 | GLYCOPYRROLATE | glycopyrrolate in water/PF | SYRINGE | 0.2 mg/mL | Y | N | ||
| 76045020301 | GLYCOPYRROLATE | glycopyrrolate in water/PF | SYRINGE | 0.2 mg/mL | Y | N | ||
| 76045020310 | GLYCOPYRROLATE | glycopyrrolate in water/PF | SYRINGE | 0.2 mg/mL | Y | N | ||
| 76045020601 | GLYCOPYRROLATE | glycopyrrolate in water/PF | SYRINGE | 0.2 mg/mL | Y | N | ||
| 76045020610 | GLYCOPYRROLATE | glycopyrrolate in water/PF | SYRINGE | 0.2 mg/mL | Y | N | ||
| 70121169901 | GLYCOPYRROLATE | glycopyrrolate in water/PF | SYRINGE | 0.4 mg/2 mL (0.2 mg/mL) | Y | N | ||
| 70121169907 | GLYCOPYRROLATE | glycopyrrolate in water/PF | SYRINGE | 0.4 mg/2 mL (0.2 mg/mL) | Y | N | ||
| 00641621301 | GLYCOPYRROLATE | glycopyrrolate/PF | SYRINGE | 0.4 mg/2 mL (0.2 mg/mL) | Y | N | ||
| 00641621310 | GLYCOPYRROLATE | glycopyrrolate/PF | SYRINGE | 0.4 mg/2 mL (0.2 mg/mL) | Y | N | ||
| 76045020302 | GLYCOPYRROLATE | glycopyrrolate/PF | SYRINGE | 0.4 mg/2 mL (0.2 mg/mL) | Y | N | ||
| 76045020320 | GLYCOPYRROLATE | glycopyrrolate/PF | SYRINGE | 0.4 mg/2 mL (0.2 mg/mL) | Y | N | ||
| 76045020802 | GLYCOPYRROLATE | glycopyrrolate/PF | SYRINGE | 0.4 mg/2 mL (0.2 mg/mL) | Y | N | ||
| 76045020820 | GLYCOPYRROLATE | glycopyrrolate/PF | SYRINGE | 0.4 mg/2 mL (0.2 mg/mL) | Y | N | ||
| 76045002300 | GLYCOPYRROLATE | glycopyrrolate/PF | SYRINGE | 0.6 mg/3 mL (0.2 mg/mL) | Y | N | ||
| 76045002330 | GLYCOPYRROLATE | glycopyrrolate/PF | SYRINGE | 0.6 mg/3 mL (0.2 mg/mL) | Y | N | ||
| 76045022303 | GLYCOPYRROLATE | glycopyrrolate/PF | SYRINGE | 0.6 mg/3 mL (0.2 mg/mL) | Y | N | ||
| 76045022330 | GLYCOPYRROLATE | glycopyrrolate/PF | SYRINGE | 0.6 mg/3 mL (0.2 mg/mL) | Y | N | ||
| 51754601501 | GLYRX-PF | glycopyrrolate/PF | SYRINGE | 1 mg/5 mL (0.2 mg/mL) | Y | N | ||
| 51754601503 | GLYRX-PF | glycopyrrolate/PF | SYRINGE | 1 mg/5 mL (0.2 mg/mL) | Y | N | ||
| 51754600101 | GLYRX-PF | glycopyrrolate/PF | VIAL | 0.2 mg/mL | Y | N | ||
| 51754600104 | GLYRX-PF | glycopyrrolate/PF | VIAL | 0.2 mg/mL | Y | N | ||
| 51991019101 | METHSCOPOLAMINE BROMIDE | methscopolamine bromide | TABLET | 2.5 mg | Y | N | ||
| 72319002904 | METHSCOPOLAMINE BROMIDE | methscopolamine bromide | TABLET | 2.5 mg | Y | N | ||
| 76385010001 | METHSCOPOLAMINE BROMIDE | methscopolamine bromide | TABLET | 2.5 mg | Y | N | ||
| 51991019206 | METHSCOPOLAMINE BROMIDE | methscopolamine bromide | TABLET | 5 mg | Y | N | ||
| 72319003002 | METHSCOPOLAMINE BROMIDE | methscopolamine bromide | TABLET | 5 mg | Y | N | ||
| 76385010160 | METHSCOPOLAMINE BROMIDE | methscopolamine bromide | TABLET | 5 mg | Y | N | ||
| 00254232038 | BELLADONNA W/PHENOBARBITAL | phenobarb/hyoscy/atropine/scop | TABLET | 16.2 mg-0.1037 mg-0.0194 mg-0.0065 mg | Y | N | ||
| 75826011810 | PHENOHYTRO | phenobarb/hyoscy/atropine/scop | TABLET | 16.2 mg-0.1037 mg-0.0194 mg-0.0065 mg | Y | N | ||
| 00054873725 | PROPANTHELINE BROMIDE | propantheline bromide | TABLET | 15 mg | Y | N | ||
| 54092007301 | PRO-BANTHINE | propantheline bromide | TABLET | 7.5 mg | Y | N |