Vykat Xr

Generic: diazoxide choline

25MG, 75MG, 150MG — Extended Release Tablet

Also known as: VYKAT XR TB24 25MG, 75MG, 150MG

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

2 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 19 hours, 2 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
BCBS Federal Standard Option 2026	Tier 3 - Non-Preferred Brand	✓	—	—	PA
BCBS Federal Basic Option 2026	Tier 3 - Non-Preferred Brand	✓	—	—	PA

5 plans

Source: PDF · Formulary date: Apr 1, 2026 · Checked: 19 hours, 2 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
BCBSNC Blue Local 2026	Tier 5 - Specialty	✓	—	✓ Limited Distribution	PA \| QL
BCBSNC Blue Advantage 2026	Tier 5 - Specialty	✓	—	✓ Limited Distribution	PA \| QL
BCBSNC Blue Value 2026	Tier 5 - Specialty	✓	—	✓ Limited Distribution	PA \| QL
BCBSNC Blue Care 2026	Tier 5 - Specialty	✓	—	✓ Limited Distribution	PA \| QL
BCBSNC Blue Home with UNC Health Alliance 2026	Tier 5 - Specialty	✓	—	✓ Limited Distribution	PA \| QL