Statewide- Patients in all NC Counties
Meck- Mecklenburg County Patients
Effective 11/20/2024, Trulicity will not be dispensed to new patients, or patients that have not had Trulicity dispensed by NCMA within the past 6 months due to manufacturer supply shortages in the marketplace. 11/21/2024
New eye products from Alcon are now available: Eysuvis, Inveltys, Rhopressa, Rocklatan, and Simbrinza. 11/7/2024
We are no longer taking new patients for Fluticasone/salmeterol. Effective 11/1/2024, This medication will be removed from the formulary. 9/12/2024
As of December 1, 2023, if you are eligible, regardless if you enroll or not, for NC Medicaid, you will not be eligible to receive products from Merck. You must provide a denial letter. These products are currently Januvia and Janumet.
| Brand Name | Generic Name | Dispensing Limits | Therapeutic Class | Drug Manufacturer | Statewide Availability | Mecklenburg County Availability |
|---|---|---|---|---|---|---|
| Acyclovir | Antiviral | Generic Mfr | Yes | Yes | ||
| Albuterol HFA Inhaler | 1 unit/month | Asthma | Generic Mfr | Yes | Yes | |
| Albuterol Nebulizer Soln | 180 ml/month | Asthma | Generic Mfr | Yes | Yes | |
| Combivent Respimat | Albuterol/Ipratropium Inhaler | COPD | Boehringer | No | Yes | |
| Alendronate | Osteoporosis | Generic Mfr | Yes | Yes | ||
| Allopurinol | Gout | Generic Mfr | Yes | Yes | ||
| Amiodarone | Antiarrhythmic | Generic Mfr | Yes | Yes | ||
| Amitriptyline | Antidepressant | Generic Mfr | Yes | Yes | ||
| Amlodipine | Antihypertensive Agent | Generic Mfr | Yes | Yes | ||
| Amoxicillin | Antibiotic | Generic Mfr | Yes | Yes | ||
| Amoxicillin/Clavulanate | Antibiotic | Generic Mfr | Yes | Yes | ||
| Anastrozole | Oncology | Generic Mfr | Yes | Yes | ||
| Aripiprazole | Antipsychotic | Generic Mfr | Yes | Yes | ||
| Abilify Maintena Injection (1 month) | Aripiprazole | Antipsychotic | Otsuka | No | Yes | |
| Aspirin (EC) (81, 325mg only) | Antiplatelet, NSAID | Generic Mfr | Yes | Yes | ||
| Atomoxetine | ADHD | Generic Mfr | Yes | Yes | ||
| Atorvastatin | Antihyperlipidemic | Generic Mfr | Yes | Yes | ||
| Azithromycin | Antibiotic | Generic Mfr | Yes | Yes | ||
| Benztropine | Parkinson’s Disease/Dystonia | Generic Mfr | Yes | Yes | ||
| Simbrinza 1%/0.2% | Brinzolamide/Brimonidine Tartrate | Ophthalmic/ Eye drops | Alcon | Yes | Yes | |
| Bupropion (SR or XL only) | Antidepressant | Generic Mfr | Yes | Yes | ||
| Buspirone | Antianxiety | Generic Mfr | Yes | Yes | ||
| Invokamet | Canagliflozin / Metformin | Diabetes | Janssen | Yes | Yes | |
| Invokana | Canagliflozin | Diabetes | Janssen | Yes | Yes | |
| Carbamazepine ER | Anticonvulsant/Bipolar Disorder | Generic Mfr | Yes | Yes | ||
| Carvedilol (IR only) | Antihypertensive Agent/ Heart Failure | Generic Mfr | Yes | Yes | ||
| Cephalexin | Antibiotic | Generic Mfr | Yes | Yes | ||
| Cetirizine | 30 tablets/month | Antihistamine | Generic Mfr | Yes | Yes | |
| Ciprofloxacin | Antibiotic | Generic Mfr | Yes | Yes | ||
| Citalopram | Antidepressant | Generic Mfr | Yes | Yes | ||
| Clindamycin | Antibiotic | Generic Mfr | Yes | Yes | ||
| Clonidine | Antihypertensive | Generic Mfr | Yes | Yes | ||
| Clopidogrel | Antiplatelet | Generic Mfr | Yes | Yes | ||
| Clozaril | Clozapine | Antipsychotic | Teva | No | Yes | |
| Colchicine | Gout | Generic Mfr | Yes | Yes | ||
| Cyclobenzaprine | Muscle Relaxant | Generic Mfr | Yes | Yes | ||
| Restasis | Cyclosporine Ophthalmic | Ophthalmic Drops | Allergan | No | Yes | |
| Depakote DR / Depakote ER | Divalproex Sodium | Anticonvulsant/Bipolar | AbbVie | Yes | Yes | |
| Multaq | Dronedarone | Antiarrhythmic | Sanofi | Yes | Yes | |
| Trulicity | Dulaglutide | Diabetes | Eli-Lilly | Yes | Yes | |
| Cymbalta | Duloxetine | Antidepressant | Eli-Lilly | Yes | Yes | |
| Lovenox | Enoxaparin | Anticoagulant | Sanofi | Yes | Yes | |
| Erythromycin 0.5% Ophthalmic Ointment | Ophthalmic/Eye ointment | Generic Mfr | Yes | Yes | ||
| Escitalopram | Antidepressant | Generic Mfr | Yes | Yes | ||
| Premarin | Estrogens Conjugated | Women’s Health | Pfizer | Yes | Yes | |
| Premarin Vaginal Cream | Estrogens Conjugated | Women’s Health | Pfizer | Yes | Yes | |
| Prempro | Estrogens Conjugated/ Medroxyprogesterone | Women’s Health | Pfizer | Yes | Yes | |
| Premphase | Estrogens Conjugated/ Medroxyprogesterone | Women’s Health | Pfizer | Yes | Yes | |
| Ezetimibe | Antihyperlipidemic | Generic Mfr | Yes | Yes | ||
| Ferrous Sulfate (325mg only) | Mineral, Iron Deficiency | Generic Mfr | Yes | Yes | ||
| Fluconazole | Antifungal | Generic Mfr | Yes | Yes | ||
| Prozac | Fluoxetine | Antidepressant | Eli-Lilly | Yes | Yes | |
| Arnuity Ellipta | Fluticasone Furoate | COPD/Asthma | GlaxoSmithKline (GSK) | Yes | Yes | |
| Breo Ellipta | Fluticasone Furoate/Vilanterol | COPD/Asthma | GlaxoSmithKline (GSK) | Yes | Yes | |
| Trelegy Ellipta | Fluticasone furoate/Umeclidinium /Vilanterol | COPD/Asthma | GlaxoSmithKline (GSK) | Yes | Yes | |
| Fluticasone Nasal Spray | 1 unit/month | Steroid | Generic Mfr | Yes | Yes | |
| Fluticasone/Salmeterol Inhaler (Diskus only) | No new patients | COPD/Asthma | Generic Mfr | Yes | Yes | |
| Fluvoxamine | Antidepressant | Generic Mfr | Yes | Yes | ||
| Folic Acid (1 mg only) | Vitamin, Folate Deficiency | Generic Mfr | Yes | Yes | ||
| Furosemide | Diuretic | Generic Mfr | Yes | Yes | ||
| Glipizide (IR only) | Diabetes | Generic Mfr | Yes | Yes | ||
| Baqsimi Nasal Powder | Glucagon | 1 kit/month | Diabetes | Eli-Lilly | Yes | Yes |
| Glucagon Emergency Injection Kit | Glucagon | 1 kit/month | Diabetes | Eli-Lilly | Yes | Yes |
| Haloperidol (oral only) | Antipsychotic | Generic Mfr | Yes | Yes | ||
| Hydralazine | Antihypertensive Agent | Generic Mfr | Yes | Yes | ||
| Hydrochlorothiazide | Antihypertensive Agent/ Diuretic | Generic Mfr | Yes | Yes | ||
| Hydrocortisone 2.5% (Cream or Ointment Only) | 30 g/month | Steroid, Topical | Generic Mfr | Yes | Yes | |
| Hydroxyzine Hcl | Antipruritic | Generic Mfr | Yes | Yes | ||
| Hydroxyzine Pamoate | Insomnia,Antianxiety, Anti-pruritic | Generic Mfr | Yes | Yes | ||
| Ibuprofen (400,600,800mg only) | NSAID | Generic Mfr | Yes | Yes | ||
| Humulin 70/30, N, R | Insulin | Diabetes | Eli-Lilly | Yes | Yes | |
| Basaglar / Lantus | Insulin Glargine (Pens Only) | Diabetes | Eli-Lilly | Yes | Yes | |
| Toujeo / Toujeo Max | Insulin Glargine | Diabetes | Sanofi | Yes | Yes | |
| Soliqua | Insulin Glargine / Lixisenatide | Diabetes | Sanofi | Yes | Yes | |
| Humalog | Insulin lispro | Diabetes | Eli-Lilly | Yes | Yes | |
| Humalog Mix 75/25 | Insulin protamine/lispro | Diabetes | Eli-Lilly | Yes | Yes | |
| Ipratropium Nebulizer Soln | 150 ml/month | Asthma | Generic Mfr | Yes | Yes | |
| Ipratropium / Albuterol Nebulizer Soln | 180 ml/month | Asthma | Generic Mfr | Yes | Yes | |
| Avalide | Irbesartan/HCTZ | Antihypertensive | Sanofi | Yes | Yes | |
| Avapro | Irbesartan | Antohypertensive | Sanofi | Yes | Yes | |
| Isosorbide Mononitrate | Vasodilators/Nitrates | Generic Mfr | Yes | Yes | ||
| Sporanox | Itraconazole | Antifungal | Janssen | Yes | Yes | |
| Lamotrigine (IR Only) | Anticonvulsant/Bipolar | Generic Mfr | Yes | Yes | ||
| Latanoprost 0.005% ophthalmic suspension | Ophthalmic/Eye drops | Generic Mfr | Yes | Yes | ||
| Arava | Leflunomide | Rheumatoid Arthritis | Sanofi | Yes | Yes | |
| Levofloxacin | Antibiotic | Generic Mfr | Yes | Yes | ||
| Synthroid | Levothyroxine | Thyroid | AbbVie | Yes | Yes | |
| Linzess | Linaclotide | Irritable Bowel Syndrome | Forest Labs | No | Yes | |
| Lisinopril | Antihypertensive Agent | Generic Mfr | Yes | Yes | ||
| Lisinopril HCTZ | Antihypertensive Agent | Generic Mfr | Yes | Yes | ||
| Lithium (Capsules only) | Bipolar Disorder | Generic Mfr | Yes | Yes | ||
| Loratadine | 30 tablets/month | Allergic Rhinitis | Generic Mfr | Yes | Yes | |
| Losartan | Antiypertensive | Generic Mfr | Yes | Yes | ||
| Eysuvis 0.25% | Loteprednol Etabonate | Ophthalmic/Eye Drops | Alcon | Yes | Yes | |
| Inveltys 1% | Loteprednol Etabonate | Ophthalmic/Eye Drops | Alcon | Yes | Yes | |
| Medroxyprogesterone | Women’s Health | Generic Mfr | Yes | Yes | ||
| Meloxicam | NSAID | Generic Mfr | Yes | Yes | ||
| Metformin | Diabetes | Generic Mfr | Yes | Yes | ||
| Methimazole | Thyroid | Generic Mfr | Yes | Yes | ||
| Methotrexate (oral only) | Rheumatoid Arthritis | Generic Mfr | Yes | Yes | ||
| Methylprednisolone (4mg Dose Pack Only) | Steroid | Generic Mfr | Yes | Yes | ||
| Metoprolol Tartrate | Antihypertensive | Generic Mfr | Yes | Yes | ||
| Metronidazole (oral only) | Antibiotic | Generic Mfr | Yes | Yes | ||
| Mirtazapine | Antidepressant | Generic Mfr | Yes | Yes | ||
| Montelukast (10mg only) | Asthma/Allergies | Generic Mfr | Yes | Yes | ||
| Lagevrio | Molnupiravir | Antiviral | Merck | Yes | Yes | |
| Mupirocin (ointment only) | 22 g/month | Antibiotic, Topical | Generic Mfr | Yes | Yes | |
| Naltrexone | Substance Use | Generic Mfr | Yes | Yes | ||
| Naproxen (500mg only) | NSAID | Generic Mfr | Yes | Yes | ||
| Neomycin/polymyxin B/ hydrocortisone Otic Suspension | Otic/Ear drops | Generic Mfr | Yes | Yes | ||
| Rhopressa 0.02% | Netarsudil | Ophthalmic/Eye drops | Alcon | Yes | Yes | |
| Rocklatan 0.02%/0.005% | Netarsudil and Latanoprost | Ophthalmic/Eye drops | Alcon | Yes | Yes | |
| Nitrofurantoin Mono/ Micro 100mg (Macrobid) | Antibiotic | Generic Mfr | Yes | Yes | ||
| Nortriptyline | Antidepressant | Generic Mfr | Yes | Yes | ||
| Nystatin | 15 g/month | Antifungal, Topical | Generic Mfr | Yes | Yes | |
| Ofloxacin 0.3% ophthalmic suspension | Ophthalmic/Eye drops | Generic Mfr | Yes | Yes | ||
| Zyprexa (not Zydis) | Olanzapine | Antipsychotic | Eli-Lilly | Yes | Yes | |
| Omeprazole (20mg & 40mg only) | GERD | Generic Mfr | Yes | Yes | ||
| Ondansetron (not ODT) | 30 tablets/month | Antiemetic | Generic Mfr | Yes | Yes | |
| Oxcarbazepine | Anticonvulsant | Generic Mfr | Yes | Yes | ||
| Invega Hafyera Injection (6 month) | Paliperidone | Antipsychotic | Janssen | No | Yes | |
| Invega Sustenna Injection (1 month) | Paliperidone | Antipsychotic | Janssen | No | Yes | |
| Invega Trinza Injection (3 month) | Paliperidone | Antipsychotic | Janssen | No | Yes | |
| Paroxetine | Antidepressant | Generic Mfr | Yes | Yes | ||
| Penicillin VK | Antibiotic | Generic Mfr | Yes | Yes | ||
| Pen Needles (31g/6mm) | Diabetes | Generic Mfr | Yes | Yes | ||
| Elmiron | Pentosan Polysulfate Sodium | Cystitis Pain | Janssen | Yes | Yes | |
| Perphenazine | Antipsychotic | Generic Mfr | Yes | Yes | ||
| Phenytoin | Anticonvulsant | Generic Mfr | Yes | Yes | ||
| Potassium (10mEq, 20mEq tablet only) | Hypokalemia | Generic Mfr | Yes | Yes | ||
| Prednisolone Acetate 1% ophthalmic suspension | Ophthalmic/Eye drops | Generic Mfr | Yes | Yes | ||
| Prednisone | Steroid | Generic Mfr | Yes | Yes | ||
| Promethazine | 90 tablets/month | Antiemetic | Generic Mfr | Yes | Yes | |
| Quetiapine (IR only) | Schizophrenia, Bipolar, Antipsychotic | Generic Mfr | Yes | Yes | ||
| Risperidone | Antipsychotic | Generic Mfr | Yes | Yes | ||
| Xarelto | Rivaroxaban | Anticoagulant | Janssen | Yes | Yes | |
| Rizatriptan | 12 tablets/month | Migraine | Generic Mfr | Yes | Yes | |
| Entresto | Sacubitril/Valsartan | Heart Failure | Novartis | No | Yes | |
| Sertraline | Antidepressant | Generic Mfr | Yes | Yes | ||
| Sevelamer HCl | Hyperphosphatemia (CKD) | Generic Mfr | Yes | Yes | ||
| Januvia | Sitagliptin | Diabetes | Merck | Yes | Yes | |
| Janumet / Janumet XR | Sitagliptin/Metformin | Diabetes | Merck | Yes | Yes | |
| Solifenacin | Overactive Bladder | Generic Mfr | Yes | Yes | ||
| Spironolactone | Heart failure/Diuretic | Generic Mfr | Yes | Yes | ||
| Sulfamethoxazole/ Trimethoprim | Antibiotic | Generic Mfr | Yes | Yes | ||
| Timolol | Ophthalmic drops | Generic Mfr | Yes | Yes | ||
| Spiriva Handihaler / Respimat | Tiotropium | COPD | Boehringer | No | Yes | |
| Topiramate | Antiseizure, Migraine | Generic Mfr | Yes | Yes | ||
| Trazodone | Antidepressant, Insomnia | Generic Mfr | Yes | Yes | ||
| Triamcinolone 0.025, 0.1, 0.5% (Cream or Ointment Only) | 30 g/month | Steroid, Topical | Generic Mfr | Yes | Yes | |
| Incruse Ellipta | Umeclidinium | COPD/Asthma | GlaxoSmithKline (GSK) | Yes | Yes | |
| Anoro Ellipta | Umeclidinium/Vilanterol | COPD/Asthma | GlaxoSmithKline (GSK) | Yes | Yes | |
| Venlafaxine XR (Capsules only) | Antidepressant | Generic Mfr | Yes | Yes | ||
| Verquvo | Vericiguat | Heart Failure | Merck | Yes | Yes | |
| Vitamin D2 (ergocalciferol) (50,000 IU only) | 8 capsules/month | Vitamin, Vit D Deficiency | Generic Mfr | Yes | Yes | |
| Warfarin | Anticoagulant | Generic Mfr | Yes | Yes | ||
| Ziprasidone | Antipsychotic | Generic Mfr | Yes | Yes |