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Informational only — Formulary data may be inaccurate or outdated. Always verify with official plan documents, your pharmacy, or your clinician before acting.
31 results for "Benzodiazepine"
Page 1 of 2| Drug Name | Generic Name | Strength | Form | Plans Covering | Actions |
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midazolam hcl
Benzodiazepine Also: midazolam hcl soln 2mg/2ml, 5mg/5ml, 5mg/ml, 10mg/10ml, 10mg/2ml, 25mg/5ml, 50mg/10ml; syrp 2mg/ml, midazolam hcl soln 2mg/2ml, 5mg/5ml, |
— | 2mg/2ml, 5mg/5ml, 5mg | Solution | 3 plans | Details |
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lorazepam
GENITOURINARY AGENTS - MISC. Also: lorazepam oral concentrate 2 mg/, lorazepam oral tablet, lorazepam tab 0.5 mg, 1 mg, 2 mg, Lorazepam 2 Mg/Ml Oral Concentrate, Lorazepam 0.5 Mg Tablet, Lorazepam 1 Mg Tablet, Lorazepam 2 Mg Tablet, LOREEV XR |
— | 1 mg, 1.5 mg, 2 mg, 3 mg | Tablet | 172 plans | Details |
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flumazenil
Benzodiazepine Antagonist Also: flumazenil soln .5mg/5ml, 1mg/10ml |
— | 5mg/5ml, 1mg/10ml | Solution | 3 plans | Details |
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diazepam intensol conc
Brand for diazepam intensol conc 5mg/ml BENZODIAZEPINES Also: diazepam intensol conc 5mg/ml, Diazepam Intensol Conc 5mg/ml |
diazepam intensol conc 5mg/ml | 5mg | — | 6 plans | Details |
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diazepam intensol
Benzodiazepines |
— | — | — | 1 plan | Details |
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diazepam (anticonvulsant)
ANTICONVULSANTS - BENZODIAZEPINES Also: diazepam (anticonvulsant) gel 2.5mg, 10mg, 20mg, diazepam (anticonvulsant) gel 2.5mg, 10mg, |
— | 2.5mg, 10mg, 20mg | Gel | 6 plans | Details |
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diazepam
Brand for Libervant Buccal GENITOURINARY AGENTS - MISC. Also: diazepam oral concentrate, diazepam oral solution, diazepam oral tablet, DIAZEPAM SOLN 5MG/ML, diazepam oral soln 1 mg/ml, diazepam tab 2 mg, 5 mg, 10 mg, Diazepam 5 Mg/Ml Oral Concentrate, Diazepam 25 Mg/5 Ml Oral Concentrate, Diazepam 5 Mg/5 Ml Oral Solution, Diazepam 2.5 Mg Rectal Gel (2Pk), Diazepam 10 Mg Rectal Gel (2Pk), Diazepam 20 Mg Rectal Gel (2Pk), Diazepam 10 Mg Rectal Gel Syringe, Diazepam 20 Mg Rectal Gel Syringe, Diazepam 2 Mg Tablet, Diazepam 5 Mg Tablet, Diazepam 10 Mg Tablet, VALIUM |
Libervant Buccal | 2 mg, 5 mg, 10 mg | Tablet | 180 plans | Details |
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clobazam
Brand for Sympazan ANTICONVULSANTS Also: clobazam oral suspension 2 .5 mg/ml, clobazam oral tablet, clobazam susp 2.5mg/ml; tabs 10mg, 20mg, clobazam suspension 2.5 mg/ml, clobazam tab 10 mg, 20 mg, Clobazam 2.5 Mg/Ml Oral Suspension, Clobazam 10 Mg Tablet, Clobazam 20 Mg Tablet, SYMPAZAN |
Sympazan | 10 mg, 20 mg, 5 mg | Suspension | 178 plans | Details |
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alprazolam xr tb24 .5mg
Brand for alprazolam xr (base equiv) Also: alprazolam xr tb24 .5mg, 1mg, 2mg, 3mg, Alprazolam Xr Tb24 .5mg, 1mg, 2mg, 3mg |
alprazolam xr | 5mg, 1mg, 2mg, 3mg | — | 3 plans | Details |
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alprazolam er
Benzodiazepines |
— | — | — | 1 plan | Details |
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alprazolam
GENITOURINARY AGENTS - MISC. Also: alprazolam oral tablet, alprazolam oral tablet dispersible, alprazolam tabs .25mg, .5mg, 1mg, 2mg; tb24 .5mg, 1mg, 2mg, 3mg; tbdp .25mg, .5mg, 1mg, 2mg, alprazolam tab er 24hr 0.5 mg, 1 mg, 2 mg, 3 mg, alprazolam tab 0.25 mg, 0.5 mg, 1 mg, 2 mg, Alprazolam 0.25 Mg Odt Tablet, Alprazolam 0.5 Mg Odt Tablet, Alprazolam 1 Mg Odt Tablet, Alprazolam 2 Mg Odt Tablet, Alprazolam 0.25 Mg Tablet, Alprazolam 0.5 Mg Tablet, Alprazolam 1 Mg Tablet, Alprazolam 2 Mg Tablet, Alprazolam Er 0.5 Mg Tablet, Alprazolam Er 1 Mg Tablet, Alprazolam Er 2 Mg Tablet, Alprazolam Er 3 Mg Tablet, alprazolam tabs .25mg, .5mg, 1mg, 2mg; tb24 |
— | 0.25 mg, 0.5 mg, 1 mg, 2 mg | Tablet | 176 plans | Details |
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Xanax Xr Tb24 .5Mg
BENZODIAZEPINES Also: XANAX XR TB24 .5MG, 1MG, 2MG, 3MG |
— | 5MG, 1MG, 2MG, 3MG | Extended Release Tablet | 3 plans | Details |
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Xanax Xr
Brand for alprazolam GENITOURINARY AGENTS - MISC. Also: XANAX XR TB24 2MG |
alprazolam | 2MG | Extended Release Tablet | 7 plans | Details |
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Xanax
Brand for alprazolam BENZODIAZEPINES Also: XANAX TABS .25MG, .5MG, 1MG, 2MG |
alprazolam | 25MG | Tablet | 10 plans | Details |
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Valium
Brand for diazepam BENZODIAZEPINES Also: VALIUM TABS 2MG, 5MG, 10MG |
diazepam | 2MG, 5MG, 10MG | Tablet | 10 plans | Details |
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Sympazan
Brand for clobazam Second Generation — Patients with a diagnosis of seizure disorder are exempt from T/F criteria and may use any second generation product. Also: clobazam |
clobazam | 10 MG | Film | 141 plans | Details |
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Quazepam
Benzodiazepines Also: Doral, quazepam tabs 15mg, Quazepam 15 Mg Tablet |
— | 15 Mg | Tablet | 6 plans | Details |
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Onfi
Brand for clobazam ANTICONVULSANTS - BENZODIAZEPINES Also: ONFI SUSP 2.5MG/ML; TABS 10MG, 20MG |
clobazam | 2.5MG | Suspension | 10 plans | Details |
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Nayzilam
Brand for midazolam ANTICONVULSANTS Also: NAYZILAM SOLN 5MG/0.1ML, midazolam, Nayzilam 5 Mg Nasal Spray |
midazolam | 5MG/0.1ML | Nasal Spray | 182 plans | Details |
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Midazolam Hydrochloride
Benzodiazepine Also: MIDAZOLAM HYDROCHLORIDE SOLN 2MG/2ML, 5MG/5ML, MIDAZOLAM HYDROCHLORIDE SOLN |
— | 2MG/2ML, 5MG/5ML | Solution | 3 plans | Details |
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Midazolam
Brand for Nayzilam Benzodiazepine Also: midazolam 100 mg/100ml-sodium chloride 0.9% iv soln, Midazolam 2 Mg/Ml Syrup, Midazolam 10 Mg/5 Ml Syrup, midazolam 100 mg/100ml-sodium chloride |
Nayzilam | 100 mg/100ml | Syrup | 4 plans | Details |
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Lorazepam Intensol
Benzodiazepines Also: Lorazepam Intensol 2 Mg/Ml Oral Concentrate |
— | — | Tablet | 2 plans | Details |
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Libervant Buccal
Brand for diazepam Second Generation — Patients with a diagnosis of seizure disorder are exempt from T/F criteria and may use any second generation product. Also: diazepam, LIBERVANT FILM 5MG, 7.5MG, 10MG, 12.5MG, 15MG, LIBERVANT FILM 5MG, 7.5MG, 10MG, 12.5MG, |
diazepam | 5MG, 7.5MG, 10MG, 12.5MG, 15MG | Film | 4 plans | Details |
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Doral
Brand for Quazepam Sedative Hypnotics — Quantity limits apply to all sedative hypnotics |
Quazepam | — | Tablet | 1 plan | Details |
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Clorazepate
Benzodiazepine Also: Clorazepate 3.75 Mg Tablet, Clorazepate 7.5 Mg Tablet, Clorazepate 15 Mg Tablet |
— | 3.75 Mg | Tablet | 1 plan | Details |