sirolimus tablet

Solution

Also known as: Rapamune

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

2 plans

Source: PDF · Formulary date: Jul 1, 2026 · Checked: 18 hours, 30 minutes ago

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