Dicyclomine

10 Mg — Capsule

Also known as: Dicyclomine 10 Mg Capsule Dicyclomine 10 Mg/5 Ml Oral Solution Dicyclomine 20 Mg Tablet

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

1 plan

Source: PDF · Formulary date: Jan 1, 2026 · Checked: 11 hours, 15 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
Cigna Plus NC 4-Tier Formulary 2026	Tier 1 - Generic	—	—	—	None