dihydroergotamine mesylate nasal

Spray

MIGRAINE PRODUCTS

Also known as: dihydroergotamine mesylate nasal spray 4 mg/ml

Coverage by Insurer

Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
Source: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 1 hour, 43 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBSNC Blue Advantage 2026 Tier 2 - Medium Cost Generic/Brand Restricted Access PA | QL
BCBSNC Blue Home with UNC Health Alliance 2026 Tier 2 - Medium Cost Generic/Brand Restricted Access PA | QL
BCBSNC Blue Local 2026 Tier 2 - Medium Cost Generic/Brand Restricted Access PA | QL
BCBSNC Blue Care 2026 Tier 2 - Medium Cost Generic/Brand Restricted Access PA | QL
BCBSNC Blue Value 2026 Tier 2 - Medium Cost Generic/Brand Restricted Access PA | QL
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