cyproheptadine hcl

2 mg/5 mL, 4 mg — Syrup

Also known as: cyproheptadine hcl oral cyproheptadine hcl syrup 2 mg/5ml cyproheptadine hcl tab 4 mg

Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.

5 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 1 hour, 52 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
BCBSNC Blue Local 2026	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Advantage 2026	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Home with UNC Health Alliance 2026	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Care 2026	Tier 1 - Lowest Cost Generic	—	—	—	None
BCBSNC Blue Value 2026	Tier 1 - Lowest Cost Generic	—	—	—	None

1 plan

Source: Excel (XLSX) · Formulary date: Jan 5, 2026 · Checked: 1 hour, 52 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
TRICARE Uniform Formulary 2026	Tier 1 - Basic Core Formulary	—	—	—	None

1 plan

Source: PDF · Formulary date: Jan 1, 2026 · Checked: 1 hour, 52 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
UnitedHealthcare NC Individual & Family 2026	Tier 2 - Lower Cost	—	—	—	None