PTC 28160428

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* Please click on the DIN/PIN hyperlink to look up for more details of any group coverage(s) which may apply to that particular drug product.

Products Found: 40

MFR

Review Status/
Past Decision(s)

AMITRIPTYLINE HCL
APO-AMITRIPTYLINE
10 MG
ORL  TAB
0.0664
0.0664
TAB
YES

REGULAR BENEFIT

AMITRIPTYLINE HCL
ELAVIL
10 MG
ORL  TAB
0.0664
0.0664
TAB
YES

REGULAR BENEFIT

 

02429861
AMITRIPTYLINE HCL
MAR-AMITRIPTYLINE
10 MG
ORL  TAB
N/A
N/A
TAB
YES

NOT A BENEFIT *

00654523
AMITRIPTYLINE HCL
PMS-AMITRIPTYLINE
10 MG
ORL  TAB
N/A
N/A
TAB
YES

NOT A BENEFIT *

02326043
AMITRIPTYLINE HCL
TEVA-AMITRIPTYLINE
10 MG
ORL  TAB
N/A
N/A
TAB
YES

NOT A BENEFIT *

AMITRIPTYLINE HCL
PMS-AMITRIPTYLINE
100 MG
ORL  TAB
N/A
N/A
TAB
NO

UNDER REVIEW *

AMITRIPTYLINE HCL
APO-AMITRIPTYLINE
25 MG
ORL  TAB
0.1211
0.0000
TAB
YES

REGULAR BENEFIT

AMITRIPTYLINE HCL
ELAVIL
25 MG
ORL  TAB
0.1211
0.0000
TAB
YES

REGULAR BENEFIT

 

02429888
AMITRIPTYLINE HCL
MAR-AMITRIPTYLINE
25 MG
ORL  TAB
N/A
N/A
TAB
NO

NOT A BENEFIT *

00654515
AMITRIPTYLINE HCL
PMS-AMITRIPTYLINE
25 MG
ORL  TAB
N/A
N/A
TAB
NO

NOT A BENEFIT *

02326051
AMITRIPTYLINE HCL
TEVA-AMITRIPTYLINE
25 MG
ORL  TAB
N/A
N/A
TAB
NO

NOT A BENEFIT *

AMITRIPTYLINE HCL
APO-AMITRIPTYLINE
50 MG
ORL  TAB
0.2347
0.2347
TAB
YES

REGULAR BENEFIT

AMITRIPTYLINE HCL
ELAVIL
50 MG
ORL  TAB
0.2347
0.2347
TAB
YES

REGULAR BENEFIT

 

02429896
AMITRIPTYLINE HCL
MAR-AMITRIPTYLINE
50 MG
ORL  TAB
N/A
N/A
TAB
YES

NOT A BENEFIT *

00654507
AMITRIPTYLINE HCL
PMS-AMITRIPTYLINE
50 MG
ORL  TAB
N/A
N/A
TAB
YES

NOT A BENEFIT *

02326078
AMITRIPTYLINE HCL
TEVA-AMITRIPTYLINE
50 MG
ORL  TAB
N/A
N/A
TAB
YES

NOT A BENEFIT *

AMITRIPTYLINE HCL
APO-AMITRIPTYLINE
75 MG
ORL  TAB
0.3634
0.3634
TAB
YES

REGULAR BENEFIT

AMITRIPTYLINE HCL
ELAVIL
75 MG
ORL  TAB
0.3634
0.3634
TAB
YES

REGULAR BENEFIT

 

02429918
AMITRIPTYLINE HCL
MAR-AMITRIPTYLINE
75 MG
ORL  TAB
N/A
N/A
TAB
YES

NOT A BENEFIT *

CLOMIPRAMINE HCL
ANAFRANIL
10 MG
ORL  TAB
0.3083
N/A
TAB
NO

REGULAR BENEFIT

 

CLOMIPRAMINE HCL
ANAFRANIL
25 MG
ORL  TAB
0.4202
N/A
TAB
NO

REGULAR BENEFIT

 

CLOMIPRAMINE HCL
ANAFRANIL
50 MG
ORL  TAB
0.7737
N/A
TAB
NO

REGULAR BENEFIT

 

DESIPRAMINE HCL
DESIPRAMINE
10 MG
ORL  TAB
0.4056
N/A
TAB
NO

REGULAR BENEFIT

 

DESIPRAMINE HCL
DESIPRAMINE
25 MG
ORL  TAB
0.4056
N/A
TAB
NO

REGULAR BENEFIT

 

DESIPRAMINE HCL
DESIPRAMINE
50 MG
ORL  TAB
0.7150
N/A
TAB
NO

REGULAR BENEFIT

 

DESIPRAMINE HCL
DESIPRAMINE
75 MG
ORL  TAB
0.9507
N/A
TAB
NO

REGULAR BENEFIT

 

DOXEPIN HCL
DOXEPIN
10 MG
ORL  CAP
0.2567
N/A
CAP
NO

REGULAR BENEFIT

 

DOXEPIN HCL
DOXEPIN
100 MG
ORL  CAP
1.3438
N/A
CAP
NO

REGULAR BENEFIT

 

DOXEPIN HCL
DOXEPIN
50 MG
ORL  CAP
0.5845
N/A
CAP
NO

REGULAR BENEFIT

IMIPRAMINE HCL
IMIPRAMINE
10 MG
ORL  TAB
0.1460
N/A
TAB
NO

REGULAR BENEFIT

 

IMIPRAMINE HCL
IMIPRAMINE
25 MG
ORL  TAB
0.2635
N/A
TAB
NO

REGULAR BENEFIT

 

IMIPRAMINE HCL
IMIPRAMINE
50 MG
ORL  TAB
0.5142
N/A
TAB
NO

REGULAR BENEFIT

 

IMIPRAMINE HCL
IMIPRAMINE
75 MG
ORL  TAB
0.6727
N/A
TAB
NO

REGULAR BENEFIT

 

NORTRIPTYLINE HCL
AVENTYL
10 MG
ORL  CAP
0.2632
N/A
CAP
NO

REGULAR BENEFIT

 

NORTRIPTYLINE HCL
AVENTYL
25 MG
ORL  CAP
0.5318
N/A
CAP
NO

REGULAR BENEFIT

 

TRIMIPRAMINE MALEATE
TRIMIPRAMINE
100 MG
ORL  TAB
0.9889
N/A
TAB
NO

REGULAR BENEFIT

 

TRIMIPRAMINE MALEATE
TRIMIPRAMINE
12.5 MG
ORL  TAB
0.2299
N/A
TAB
NO

REGULAR BENEFIT

 

TRIMIPRAMINE MALEATE
TRIMIPRAMINE
25 MG
ORL  TAB
0.2960
N/A
TAB
NO

REGULAR BENEFIT

 

TRIMIPRAMINE MALEATE
TRIMIPRAMINE
50 MG
ORL  TAB
0.5795
N/A
TAB
NO

REGULAR BENEFIT

 

TRIMIPRAMINE MALEATE
TRIMIPRAMINE
75 MG
ORL  CAP
0.7800
N/A
CAP
NO

REGULAR BENEFIT

 


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