doxycycline monohydrate 75mg, 150mg

75mg, 150mg — Capsule

Also known as: Monodox, Adoxa

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

1 plan

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 20 hours, 48 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
NC Medicaid Preferred Drug List 2026	Non-Preferred	—	—	—	None