montelukast sodium chew

4 mg, 5 mg — Tablet

COUGH/COLD/ALLERGY

Also known as: montelukast sodium chew 4mg, 5mg; pack 4mg; tabs 10mg montelukast sodium chew tab 4 mg (base equiv), 5 mg (base equiv) montelukast sodium chew 4mg, 5mg; pack

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: 3 hours, 29 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
BCBS Federal Standard Option 2026 Tier 1 - Generic None
BCBS Federal Basic Option 2026 Tier 1 - Generic None
BCBS Federal Focus 2026 Tier 1 - Generic None
Source: PDF  ·  Formulary date: Apr 1, 2026  ·  Checked: 3 hours, 29 minutes ago
Plan Tier Prior Auth Step Therapy Quantity Limit Restrictions
NC State Health Plan - 80/20 Plus PPO 2026 Tier 1 - Preferred Generic None
NC State Health Plan - 70/30 Standard PPO 2026 Tier 1 - Preferred Generic None
NC State Health Plan - HDHP 2026 Tier 1 - Preferred Generic None
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