Promethazine-Pe

5 Ml — Syrup

Also known as: Promethazine-Pe 6.25-5 Mg/5 Ml Syrup

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

1 plan

Source: PDF · Formulary date: Jan 1, 2026 · Checked: 15 hours, 16 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
Cigna Plus NC 4-Tier Formulary 2026	Tier 1 - Generic	—	—	—	None