Promethegan Suppository (12.5 mg and 25 mg)

Generic: promethazine

12.5mg, 25mg, 50mg

Also known as: promethazine promethegan supp 12.5mg, 25mg, 50mg Promethegan Supp 12.5mg, 25mg, 50mg

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

3 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 22 hours, 27 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

1 plan

Source: PDF · Formulary date: Jan 1, 2026 · Checked: 22 hours, 27 minutes ago

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

1 plan

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 22 hours, 27 minutes ago

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

3 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 22 hours, 27 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 - 70/30 Standard PPO 2026	Tier 2 - Non-Preferred Generic	—	—	—	None
NC State Health Plan - HDHP 2026	Tier 2 - Non-Preferred Generic	—	—	—	None