oral

5ml — Tablet

Also known as: oral suspension 200-40 mg/5ml sulfamethoxazole-trimethoprim

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: 17 hours, 26 minutes ago

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

1 plan

Source: PDF · Formulary date: Jan 1, 2026 · Checked: 17 hours, 26 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
UnitedHealthcare NC Individual & Family 2026	Tier 2 - Lower Cost	—	—	—	None