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
02326043 AMITRIPTYLINE HCL TEVA-AMITRIPTYLINE 10 MG ORAL TABLET N/A
TAB
TEV 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 0.3083
TAB
AAP N/A N/A NO REGULAR BENEFIT Details
00324019 CLOMIPRAMINE HCL ANAFRANIL 25 MG ORAL TABLET 0.4202
TAB
AAP N/A N/A NO REGULAR BENEFIT Details
00402591 CLOMIPRAMINE HCL ANAFRANIL 50 MG ORAL TABLET 0.7737
TAB
AAP N/A N/A NO REGULAR BENEFIT Details
02216248 DESIPRAMINE HCL DESIPRAMINE 10 MG ORAL TABLET 0.4056
TAB
AAP N/A N/A NO REGULAR BENEFIT Details
02216256 DESIPRAMINE HCL DESIPRAMINE 25 MG ORAL TABLET 0.4056
TAB
AAP N/A N/A NO REGULAR BENEFIT Details
02216264 DESIPRAMINE HCL DESIPRAMINE 50 MG ORAL TABLET 0.7150
TAB
AAP N/A N/A NO REGULAR BENEFIT Details
02216272 DESIPRAMINE HCL DESIPRAMINE 75 MG ORAL TABLET 0.9507
TAB
AAP N/A N/A NO REGULAR BENEFIT Details
02049996 DOXEPIN HCL DOXEPIN 10 MG ORAL CAPSULE 0.2567
CAP
AAP N/A N/A NO REGULAR BENEFIT Details
02050048 DOXEPIN HCL DOXEPIN 100 MG ORAL CAPSULE 1.3438
CAP
AAP N/A N/A NO REGULAR BENEFIT Details
02050013 DOXEPIN HCL DOXEPIN 50 MG ORAL CAPSULE 0.5845
CAP
AAP N/A N/A NO REGULAR BENEFIT Details
00360201 IMIPRAMINE HCL IMIPRAMINE 10 MG ORAL TABLET 0.1460
TAB
AAP N/A N/A NO REGULAR BENEFIT Details
00312797 IMIPRAMINE HCL IMIPRAMINE 25 MG ORAL TABLET 0.2635
TAB
AAP N/A N/A NO REGULAR BENEFIT Details
00326852 IMIPRAMINE HCL IMIPRAMINE 50 MG ORAL TABLET 0.5142
TAB
AAP N/A N/A NO REGULAR BENEFIT Details
00644579 IMIPRAMINE HCL IMIPRAMINE 75 MG ORAL TABLET 0.6727
TAB
AAP N/A N/A NO REGULAR BENEFIT Details
00015229 NORTRIPTYLINE HCL AVENTYL 10 MG ORAL CAPSULE 0.2632
CAP
AAP N/A N/A NO REGULAR BENEFIT Details
00015237 NORTRIPTYLINE HCL AVENTYL 25 MG ORAL CAPSULE 0.5318
CAP
AAP N/A N/A NO REGULAR BENEFIT Details
00740829 TRIMIPRAMINE MALEATE TRIMIPRAMINE 100 MG ORAL TABLET 0.9889
TAB
AAP N/A N/A NO REGULAR BENEFIT Details
00740799 TRIMIPRAMINE MALEATE TRIMIPRAMINE 12.5 MG ORAL TABLET 0.2299
TAB
AAP N/A N/A NO REGULAR BENEFIT Details
00740802 TRIMIPRAMINE MALEATE TRIMIPRAMINE 25 MG ORAL TABLET 0.2960
TAB
AAP N/A N/A NO REGULAR BENEFIT Details
00740810 TRIMIPRAMINE MALEATE TRIMIPRAMINE 50 MG ORAL TABLET 0.5795
TAB
AAP N/A N/A NO REGULAR BENEFIT Details
02070987 TRIMIPRAMINE MALEATE TRIMIPRAMINE 75 MG ORAL CAPSULE 0.7800
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 02326043
Generic Name AMITRIPTYLINE HCL
Product Name, Strength & Dosage Form TEVA-AMITRIPTYLINE 10 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 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 0.3083
Manufacturer AAP
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 0.4202
Manufacturer AAP
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 0.7737
Manufacturer AAP
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 0.4056
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 0.4056
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 0.7150
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 0.9507
Manufacturer AAP
LCA Price N/A
MAC Price N/A
Interchangeable Products NO
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 02049996
Generic Name DOXEPIN HCL
Product Name, Strength & Dosage Form DOXEPIN 10 MG ORAL CAPSULE
Unit Price, Unit of Issue 0.2567
Manufacturer AAP
LCA Price N/A
MAC Price N/A
Interchangeable Products NO
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 02050048
Generic Name DOXEPIN HCL
Product Name, Strength & Dosage Form DOXEPIN 100 MG ORAL CAPSULE
Unit Price, Unit of Issue 1.3438
Manufacturer AAP
LCA Price N/A
MAC Price N/A
Interchangeable Products NO
Coverage Status REGULAR BENEFIT
Details
DIN/NPN/ PIN 02050013
Generic Name DOXEPIN HCL
Product Name, Strength & Dosage Form DOXEPIN 50 MG ORAL CAPSULE
Unit Price, Unit of Issue 0.5845
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 0.1460
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 0.2635
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 0.5142
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 0.6727
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 0.2632
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 0.5318
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 0.9889
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 0.2299
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 0.2960
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 0.5795
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 0.7800
Manufacturer AAP
LCA Price N/A
MAC Price N/A
Interchangeable Products NO
Coverage Status REGULAR BENEFIT
Details
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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.