Xopenex HFA

Generic: levalbuterol tartrate

Inhaler

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

1 plan

Source: PDF · Formulary date: Jul 1, 2026 · Checked: 16 hours, 38 minutes ago

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

1 plan

Source: Excel (XLSX) · Formulary date: Jun 24, 2026 · Checked: 16 hours, 38 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
TRICARE Uniform Formulary 2026 via levalbuterol tartrate	Tier 3 - Non-Formulary	—	—	✓	QL