hydroxyzine hcl

10 mg, 10 mg/5 mL, 10 mg/5 mL (5 mL), 25 mg, 50 mg — Syrup

GENITOURINARY AGENTS - MISC.

Also known as: hydroxyzine hcl oral hydroxyzine hcl soln 25mg/ml, 50mg/ml hydroxyzine hcl syrup 10 mg/5ml hydroxyzine hcl tab 10 mg, 25 mg, 50 mg hydroxyzine hcl soln 25mg/ml; syrp 10mg/5ml; tabs 10mg, 25mg, 50mg

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: 22 hours, 26 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBS Federal Basic Option 2026 Tier 1 - Generic None
BCBS Federal Focus 2026 Tier 1 - Generic None
BCBS Federal Standard Option 2026 Tier 1 - Generic None
Source: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 22 hours, 26 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBSNC Blue Local 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
BCBSNC Blue Advantage 2026 Tier 1 - Lowest Cost Generic None
BCBSNC Blue Home with UNC Health Alliance 2026 Tier 1 - Lowest Cost Generic None
Source: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 22 hours, 26 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC State Health Plan - 80/20 Plus PPO 2026 Tier 2 - Non-Preferred Generic None
NC State Health Plan - HDHP 2026 Tier 2 - Non-Preferred Generic None
NC State Health Plan - 70/30 Standard PPO 2026 Tier 2 - Non-Preferred Generic None
Source: Excel (XLSX)  ·  Formulary date: Jan 5, 2026  ·  Checked: 22 hours, 26 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
TRICARE Uniform Formulary 2026 Tier 1 - Basic Core Formulary None
Source: PDF  ·  Formulary date: Jan 1, 2026  ·  Checked: 22 hours, 26 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
UnitedHealthcare NC Individual & Family 2026 Tier 2 - Lower Cost None
Something not right?