Home Health iDBL
Interactive Drug Benefit List
DIN/NPN/ PIN Generic Name Product Name, Strength & Dosage Form Unit Price, Unit of Issue Manufacturer LCA Price MAC Price Interchangeable Products Coverage Status
02403137 AMITRIPTYLINE HCL APO-AMITRIPTYLINE 10 MG ORAL TABLET 0.0664
TAB 		APX 0.0664 N/A YES REGULAR BENEFIT Details
00335053 AMITRIPTYLINE HCL ELAVIL 10 MG ORAL TABLET 0.0664
TAB 		AAP 0.0664 N/A YES REGULAR BENEFIT Details
02429861 AMITRIPTYLINE HCL MAR-AMITRIPTYLINE 10 MG ORAL TABLET N/A
TAB 		MAR N/A N/A YES NOT A BENEFIT Details
00654523 AMITRIPTYLINE HCL PMS-AMITRIPTYLINE 10 MG ORAL TABLET N/A
TAB 		PMS N/A N/A YES NOT A BENEFIT Details
02468409 AMITRIPTYLINE HCL PMS-AMITRIPTYLINE 100 MG ORAL TABLET N/A
TAB 		PMS N/A N/A NO UNDER REVIEW Details
02403145 AMITRIPTYLINE HCL APO-AMITRIPTYLINE 25 MG ORAL TABLET 0.1211
TAB 		APX 0.1211 N/A YES REGULAR BENEFIT Details
00335061 AMITRIPTYLINE HCL ELAVIL 25 MG ORAL TABLET 0.1211
TAB 		AAP 0.1211 N/A YES REGULAR BENEFIT Details
02429888 AMITRIPTYLINE HCL MAR-AMITRIPTYLINE 25 MG ORAL TABLET N/A
TAB 		MAR N/A N/A YES NOT A BENEFIT Details
00654515 AMITRIPTYLINE HCL PMS-AMITRIPTYLINE 25 MG ORAL TABLET N/A
TAB 		PMS N/A N/A YES NOT A BENEFIT Details
02326051 AMITRIPTYLINE HCL TEVA-AMITRIPTYLINE 25 MG ORAL TABLET N/A
TAB 		TEV N/A N/A YES NOT A BENEFIT Details
02403153 AMITRIPTYLINE HCL APO-AMITRIPTYLINE 50 MG ORAL TABLET 0.2347
TAB 		APX 0.2347 N/A YES REGULAR BENEFIT Details
00335088 AMITRIPTYLINE HCL ELAVIL 50 MG ORAL TABLET 0.2347
TAB 		AAP 0.2347 N/A YES REGULAR BENEFIT Details
02429896 AMITRIPTYLINE HCL MAR-AMITRIPTYLINE 50 MG ORAL TABLET N/A
TAB 		MAR N/A N/A YES NOT A BENEFIT Details
00654507 AMITRIPTYLINE HCL PMS-AMITRIPTYLINE 50 MG ORAL TABLET N/A
TAB 		PMS N/A N/A YES NOT A BENEFIT Details
02326078 AMITRIPTYLINE HCL TEVA-AMITRIPTYLINE 50 MG ORAL TABLET N/A
TAB 		TEV N/A N/A YES NOT A BENEFIT Details
02403161 AMITRIPTYLINE HCL APO-AMITRIPTYLINE 75 MG ORAL TABLET 0.3634
TAB 		APX 0.3634 N/A YES REGULAR BENEFIT Details
00754129 AMITRIPTYLINE HCL ELAVIL 75 MG ORAL TABLET 0.3634
TAB 		AAP 0.3634 N/A YES REGULAR BENEFIT Details
02429918 AMITRIPTYLINE HCL MAR-AMITRIPTYLINE 75 MG ORAL TABLET N/A
TAB 		MAR N/A N/A YES NOT A BENEFIT Details
00330566 CLOMIPRAMINE HCL ANAFRANIL 10 MG ORAL TABLET 0.3191
TAB 		APX N/A N/A NO REGULAR BENEFIT Details
00324019 CLOMIPRAMINE HCL ANAFRANIL 25 MG ORAL TABLET 0.4349
TAB 		APX N/A N/A NO REGULAR BENEFIT Details
02497506 CLOMIPRAMINE HCL TARO-CLOMIPRAMINE 25 MG ORAL CAPSULE 0.3417
CAP 		TAR N/A N/A NO REGULAR BENEFIT Details
00402591 CLOMIPRAMINE HCL ANAFRANIL 50 MG ORAL TABLET 0.8008
TAB 		APX N/A N/A NO REGULAR BENEFIT Details
02497514 CLOMIPRAMINE HCL TARO-CLOMIPRAMINE 50 MG ORAL CAPSULE 0.6291
CAP 		TAR N/A N/A NO REGULAR BENEFIT Details
02216248 DESIPRAMINE HCL DESIPRAMINE 10 MG ORAL TABLET 0.4852
TAB 		AAP N/A N/A NO REGULAR BENEFIT Details
02216256 DESIPRAMINE HCL DESIPRAMINE 25 MG ORAL TABLET 0.4852
TAB 		AAP N/A N/A NO REGULAR BENEFIT Details
02216264 DESIPRAMINE HCL DESIPRAMINE 50 MG ORAL TABLET 0.8553
TAB 		AAP N/A N/A NO REGULAR BENEFIT Details
02216272 DESIPRAMINE HCL DESIPRAMINE 75 MG ORAL TABLET 1.1373
TAB 		AAP N/A N/A NO REGULAR BENEFIT Details
00360201 IMIPRAMINE HCL IMIPRAMINE 10 MG ORAL TABLET 0.1747
TAB 		AAP N/A N/A NO REGULAR BENEFIT Details
00312797 IMIPRAMINE HCL IMIPRAMINE 25 MG ORAL TABLET 0.3152
TAB 		AAP N/A N/A NO REGULAR BENEFIT Details
00326852 IMIPRAMINE HCL IMIPRAMINE 50 MG ORAL TABLET 0.6152
TAB 		AAP N/A N/A NO REGULAR BENEFIT Details
00644579 IMIPRAMINE HCL IMIPRAMINE 75 MG ORAL TABLET 0.8048
TAB 		AAP N/A N/A NO REGULAR BENEFIT Details
00015229 NORTRIPTYLINE HCL AVENTYL 10 MG ORAL CAPSULE 0.3148
CAP 		AAP N/A N/A NO REGULAR BENEFIT Details
00015237 NORTRIPTYLINE HCL AVENTYL 25 MG ORAL CAPSULE 0.6363
CAP 		AAP N/A N/A NO REGULAR BENEFIT Details
00740829 TRIMIPRAMINE MALEATE TRIMIPRAMINE 100 MG ORAL TABLET 1.1830
TAB 		AAP N/A N/A NO REGULAR BENEFIT Details
00740799 TRIMIPRAMINE MALEATE TRIMIPRAMINE 12.5 MG ORAL TABLET 0.2749
TAB 		AAP N/A N/A NO REGULAR BENEFIT Details
00740802 TRIMIPRAMINE MALEATE TRIMIPRAMINE 25 MG ORAL TABLET 0.3542
TAB 		AAP N/A N/A NO REGULAR BENEFIT Details
00740810 TRIMIPRAMINE MALEATE TRIMIPRAMINE 50 MG ORAL TABLET 0.6932
TAB 		AAP N/A N/A NO REGULAR BENEFIT Details
02070987 TRIMIPRAMINE MALEATE TRIMIPRAMINE 75 MG ORAL CAPSULE 0.9332
CAP 		AAP N/A N/A NO REGULAR BENEFIT Details
DIN/NPN/ PIN 02403137
Generic Name AMITRIPTYLINE HCL
Product Name, Strength & Dosage Form APO-AMITRIPTYLINE 10 MG ORAL TABLET
Unit Price, Unit of Issue 0.0664
Manufacturer APX
LCA Price 0.0664
MAC Price N/A
Interchangeable Products YES
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 00335053
Generic Name AMITRIPTYLINE HCL
Product Name, Strength & Dosage Form ELAVIL 10 MG ORAL TABLET
Unit Price, Unit of Issue 0.0664
Manufacturer AAP
LCA Price 0.0664
MAC Price N/A
Interchangeable Products YES
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 02429861
Generic Name AMITRIPTYLINE HCL
Product Name, Strength & Dosage Form MAR-AMITRIPTYLINE 10 MG ORAL TABLET
Unit Price, Unit of Issue N/A
Manufacturer MAR
LCA Price N/A
MAC Price N/A
Interchangeable Products YES
Coverage Status NOT A BENEFIT
Details
DIN/NPN/ PIN 00654523
Generic Name AMITRIPTYLINE HCL
Product Name, Strength & Dosage Form PMS-AMITRIPTYLINE 10 MG ORAL TABLET
Unit Price, Unit of Issue N/A
Manufacturer PMS
LCA Price N/A
MAC Price N/A
Interchangeable Products YES
Coverage Status NOT A BENEFIT
Details
DIN/NPN/ PIN 02468409
Generic Name AMITRIPTYLINE HCL
Product Name, Strength & Dosage Form PMS-AMITRIPTYLINE 100 MG ORAL TABLET
Unit Price, Unit of Issue N/A
Manufacturer PMS
LCA Price N/A
MAC Price N/A
Interchangeable Products NO
Coverage Status UNDER REVIEW
Details
DIN/NPN/ PIN 02403145
Generic Name AMITRIPTYLINE HCL
Product Name, Strength & Dosage Form APO-AMITRIPTYLINE 25 MG ORAL TABLET
Unit Price, Unit of Issue 0.1211
Manufacturer APX
LCA Price 0.1211
MAC Price N/A
Interchangeable Products YES
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 00335061
Generic Name AMITRIPTYLINE HCL
Product Name, Strength & Dosage Form ELAVIL 25 MG ORAL TABLET
Unit Price, Unit of Issue 0.1211
Manufacturer AAP
LCA Price 0.1211
MAC Price N/A
Interchangeable Products YES
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 02429888
Generic Name AMITRIPTYLINE HCL
Product Name, Strength & Dosage Form MAR-AMITRIPTYLINE 25 MG ORAL TABLET
Unit Price, Unit of Issue N/A
Manufacturer MAR
LCA Price N/A
MAC Price N/A
Interchangeable Products YES
Coverage Status NOT A BENEFIT
Details
DIN/NPN/ PIN 00654515
Generic Name AMITRIPTYLINE HCL
Product Name, Strength & Dosage Form PMS-AMITRIPTYLINE 25 MG ORAL TABLET
Unit Price, Unit of Issue N/A
Manufacturer PMS
LCA Price N/A
MAC Price N/A
Interchangeable Products YES
Coverage Status NOT A BENEFIT
Details
DIN/NPN/ PIN 02326051
Generic Name AMITRIPTYLINE HCL
Product Name, Strength & Dosage Form TEVA-AMITRIPTYLINE 25 MG ORAL TABLET
Unit Price, Unit of Issue N/A
Manufacturer TEV
LCA Price N/A
MAC Price N/A
Interchangeable Products YES
Coverage Status NOT A BENEFIT
Details
DIN/NPN/ PIN 02403153
Generic Name AMITRIPTYLINE HCL
Product Name, Strength & Dosage Form APO-AMITRIPTYLINE 50 MG ORAL TABLET
Unit Price, Unit of Issue 0.2347
Manufacturer APX
LCA Price 0.2347
MAC Price N/A
Interchangeable Products YES
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 00335088
Generic Name AMITRIPTYLINE HCL
Product Name, Strength & Dosage Form ELAVIL 50 MG ORAL TABLET
Unit Price, Unit of Issue 0.2347
Manufacturer AAP
LCA Price 0.2347
MAC Price N/A
Interchangeable Products YES
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 02429896
Generic Name AMITRIPTYLINE HCL
Product Name, Strength & Dosage Form MAR-AMITRIPTYLINE 50 MG ORAL TABLET
Unit Price, Unit of Issue N/A
Manufacturer MAR
LCA Price N/A
MAC Price N/A
Interchangeable Products YES
Coverage Status NOT A BENEFIT
Details
DIN/NPN/ PIN 00654507
Generic Name AMITRIPTYLINE HCL
Product Name, Strength & Dosage Form PMS-AMITRIPTYLINE 50 MG ORAL TABLET
Unit Price, Unit of Issue N/A
Manufacturer PMS
LCA Price N/A
MAC Price N/A
Interchangeable Products YES
Coverage Status NOT A BENEFIT
Details
DIN/NPN/ PIN 02326078
Generic Name AMITRIPTYLINE HCL
Product Name, Strength & Dosage Form TEVA-AMITRIPTYLINE 50 MG ORAL TABLET
Unit Price, Unit of Issue N/A
Manufacturer TEV
LCA Price N/A
MAC Price N/A
Interchangeable Products YES
Coverage Status NOT A BENEFIT
Details
DIN/NPN/ PIN 02403161
Generic Name AMITRIPTYLINE HCL
Product Name, Strength & Dosage Form APO-AMITRIPTYLINE 75 MG ORAL TABLET
Unit Price, Unit of Issue 0.3634
Manufacturer APX
LCA Price 0.3634
MAC Price N/A
Interchangeable Products YES
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 00754129
Generic Name AMITRIPTYLINE HCL
Product Name, Strength & Dosage Form ELAVIL 75 MG ORAL TABLET
Unit Price, Unit of Issue 0.3634
Manufacturer AAP
LCA Price 0.3634
MAC Price N/A
Interchangeable Products YES
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 02429918
Generic Name AMITRIPTYLINE HCL
Product Name, Strength & Dosage Form MAR-AMITRIPTYLINE 75 MG ORAL TABLET
Unit Price, Unit of Issue N/A
Manufacturer MAR
LCA Price N/A
MAC Price N/A
Interchangeable Products YES
Coverage Status NOT A BENEFIT
Details
DIN/NPN/ PIN 00330566
Generic Name CLOMIPRAMINE HCL
Product Name, Strength & Dosage Form ANAFRANIL 10 MG ORAL TABLET
Unit Price, Unit of Issue 0.3191
Manufacturer APX
LCA Price N/A
MAC Price N/A
Interchangeable Products NO
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 00324019
Generic Name CLOMIPRAMINE HCL
Product Name, Strength & Dosage Form ANAFRANIL 25 MG ORAL TABLET
Unit Price, Unit of Issue 0.4349
Manufacturer APX
LCA Price N/A
MAC Price N/A
Interchangeable Products NO
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 02497506
Generic Name CLOMIPRAMINE HCL
Product Name, Strength & Dosage Form TARO-CLOMIPRAMINE 25 MG ORAL CAPSULE
Unit Price, Unit of Issue 0.3417
Manufacturer TAR
LCA Price N/A
MAC Price N/A
Interchangeable Products NO
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 00402591
Generic Name CLOMIPRAMINE HCL
Product Name, Strength & Dosage Form ANAFRANIL 50 MG ORAL TABLET
Unit Price, Unit of Issue 0.8008
Manufacturer APX
LCA Price N/A
MAC Price N/A
Interchangeable Products NO
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 02497514
Generic Name CLOMIPRAMINE HCL
Product Name, Strength & Dosage Form TARO-CLOMIPRAMINE 50 MG ORAL CAPSULE
Unit Price, Unit of Issue 0.6291
Manufacturer TAR
LCA Price N/A
MAC Price N/A
Interchangeable Products NO
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 02216248
Generic Name DESIPRAMINE HCL
Product Name, Strength & Dosage Form DESIPRAMINE 10 MG ORAL TABLET
Unit Price, Unit of Issue 0.4852
Manufacturer AAP
LCA Price N/A
MAC Price N/A
Interchangeable Products NO
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 02216256
Generic Name DESIPRAMINE HCL
Product Name, Strength & Dosage Form DESIPRAMINE 25 MG ORAL TABLET
Unit Price, Unit of Issue 0.4852
Manufacturer AAP
LCA Price N/A
MAC Price N/A
Interchangeable Products NO
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 02216264
Generic Name DESIPRAMINE HCL
Product Name, Strength & Dosage Form DESIPRAMINE 50 MG ORAL TABLET
Unit Price, Unit of Issue 0.8553
Manufacturer AAP
LCA Price N/A
MAC Price N/A
Interchangeable Products NO
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 02216272
Generic Name DESIPRAMINE HCL
Product Name, Strength & Dosage Form DESIPRAMINE 75 MG ORAL TABLET
Unit Price, Unit of Issue 1.1373
Manufacturer AAP
LCA Price N/A
MAC Price N/A
Interchangeable Products NO
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 00360201
Generic Name IMIPRAMINE HCL
Product Name, Strength & Dosage Form IMIPRAMINE 10 MG ORAL TABLET
Unit Price, Unit of Issue 0.1747
Manufacturer AAP
LCA Price N/A
MAC Price N/A
Interchangeable Products NO
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 00312797
Generic Name IMIPRAMINE HCL
Product Name, Strength & Dosage Form IMIPRAMINE 25 MG ORAL TABLET
Unit Price, Unit of Issue 0.3152
Manufacturer AAP
LCA Price N/A
MAC Price N/A
Interchangeable Products NO
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 00326852
Generic Name IMIPRAMINE HCL
Product Name, Strength & Dosage Form IMIPRAMINE 50 MG ORAL TABLET
Unit Price, Unit of Issue 0.6152
Manufacturer AAP
LCA Price N/A
MAC Price N/A
Interchangeable Products NO
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 00644579
Generic Name IMIPRAMINE HCL
Product Name, Strength & Dosage Form IMIPRAMINE 75 MG ORAL TABLET
Unit Price, Unit of Issue 0.8048
Manufacturer AAP
LCA Price N/A
MAC Price N/A
Interchangeable Products NO
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 00015229
Generic Name NORTRIPTYLINE HCL
Product Name, Strength & Dosage Form AVENTYL 10 MG ORAL CAPSULE
Unit Price, Unit of Issue 0.3148
Manufacturer AAP
LCA Price N/A
MAC Price N/A
Interchangeable Products NO
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 00015237
Generic Name NORTRIPTYLINE HCL
Product Name, Strength & Dosage Form AVENTYL 25 MG ORAL CAPSULE
Unit Price, Unit of Issue 0.6363
Manufacturer AAP
LCA Price N/A
MAC Price N/A
Interchangeable Products NO
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 00740829
Generic Name TRIMIPRAMINE MALEATE
Product Name, Strength & Dosage Form TRIMIPRAMINE 100 MG ORAL TABLET
Unit Price, Unit of Issue 1.1830
Manufacturer AAP
LCA Price N/A
MAC Price N/A
Interchangeable Products NO
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 00740799
Generic Name TRIMIPRAMINE MALEATE
Product Name, Strength & Dosage Form TRIMIPRAMINE 12.5 MG ORAL TABLET
Unit Price, Unit of Issue 0.2749
Manufacturer AAP
LCA Price N/A
MAC Price N/A
Interchangeable Products NO
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 00740802
Generic Name TRIMIPRAMINE MALEATE
Product Name, Strength & Dosage Form TRIMIPRAMINE 25 MG ORAL TABLET
Unit Price, Unit of Issue 0.3542
Manufacturer AAP
LCA Price N/A
MAC Price N/A
Interchangeable Products NO
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 00740810
Generic Name TRIMIPRAMINE MALEATE
Product Name, Strength & Dosage Form TRIMIPRAMINE 50 MG ORAL TABLET
Unit Price, Unit of Issue 0.6932
Manufacturer AAP
LCA Price N/A
MAC Price N/A
Interchangeable Products NO
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 02070987
Generic Name TRIMIPRAMINE MALEATE
Product Name, Strength & Dosage Form TRIMIPRAMINE 75 MG ORAL CAPSULE
Unit Price, Unit of Issue 0.9332
Manufacturer AAP
LCA Price N/A
MAC Price N/A
Interchangeable Products NO
Coverage Status REGULAR BENEFIT
Details
To return to the printable Drug Benefit List and related publications, click here
Last Updated:
NOTICE:
The DBL, DBS and related publications require knowledgeable interpretation and are intended primarily for professional health care practitioners, pharmacies, hospitals and organizations associated with the manufacture, distribution and use of pharmaceutical preparations.
Electronic versions of all DBL and DBS related publications are unofficial versions and are provided for convenience and private use only. Official paper versions can be obtained from Alberta Blue Cross who publishes them on behalf of Alberta Health and Alberta Human Services.
Alberta Health reserves the right to make changes, without notice, to the List through the Interactive DBL(iDBL), and any such changes to the Interactive DBL(iDBL) are effective the date of the change (unless otherwise stated) and regardless of the date of publication in the paper version or updates.