sodium sulfate/potassium sulfate/magnesium sulfate

17.5 gram-3.13 gram-1.6 gram — Solution

Also known as: SUPREP SOD SULF-POTASS SULF-MAG SULF

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

1 plan

Source: Excel (XLSX) · Formulary date: Jan 5, 2026 · Checked: 20 hours, 54 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
TRICARE Uniform Formulary 2026	Tier 3 - Non-Formulary	—	—	—	None