Statewide- Patients in all NC Counties
Meck- Mecklenburg County Patients
AirSupra is now available from AstraZeneca. 2/13/2025
Evista is no longer available. Prozac and Cymbalta are now available as generics only. 1/14/2025
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 (Oral) | Antipsychotic | Generic Mfr | Yes | Yes | ||
| Abilify Maintena Injection | Aripiprazole (Injection) | 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 | ||
| azelastine | 1 unit/month | Allergic Rhinitis | Generic Mfr | Yes | Yes | |
| Azithromycin | Antibiotic | Generic Mfr | Yes | Yes | ||
| Benztropine | Parkinson’s Disease/Dystonia | Generic Mfr | Yes | Yes | ||
| bismuth subsalicylate 262mg | 14 day treatment | Gastrointestinal Health | Generic Mfr | Yes | Yes | |
| brimonidine (0.25% only) | Ophthalmic/ Eye drops | 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 | ||
| Invokana | Canagliflozin | Diabetes | Janssen | Yes | Yes | |
| Invokamet | Canagliflozin / Metformin | Diabetes | Janssen | Yes | Yes | |
| Carbamazepine ER (Tablets only) | Anticonvulsant/Bipolar Disorder | Generic Mfr | Yes | Yes | ||
| Carvedilol (IR only) | Antihypertensive Agent/ Heart Failure | Generic Mfr | Yes | Yes | ||
| cefdinir | Antibiotic | Generic Mfr | Yes | Yes | ||
| celecoxib | NSAID | 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 | ||
| clarithromycin | 14 day treatment | Antibiotic | Generic Mfr | Yes | Yes | |
| Clindamycin | Antibiotic | Generic Mfr | Yes | Yes | ||
| clobetasol topical | 30 g/month | Steroid Topical | Generic Mfr | Yes | Yes | |
| Clonidine | Antihypertensive | Generic Mfr | Yes | Yes | ||
| Clopidogrel | Antiplatelet | Generic Mfr | Yes | Yes | ||
| clotrimazole 1% topical | 30 g/month | Antifungal Topical | Generic Mfr | Yes | Yes | |
| Clozapine | Antipsychotic | Generic Mfr | Yes | Yes | ||
| Colchicine | Gout | Generic Mfr | Yes | Yes | ||
| Cyclobenzaprine | Muscle Relaxant | Generic Mfr | Yes | Yes | ||
| Restasis | Cyclosporine Ophthalmic | Ophthalmic Drops | Allergan | No | Yes | |
| digoxin | Antiarrhythmic/Heart Failure | Generic Mfr | Yes | Yes | ||
| diltiazem ER (Cardizem CD equivalent) | Antihypertensive Agent/Atrial Fibrillation | Generic Mfr | Yes | Yes | ||
| Depakote DR/Depakote ER | Divalproex Sodium | Anticonvulsant/Bipolar | AbbVie | Yes | Yes | |
| donepezil | Dementia | Generic Mfr | Yes | Yes | ||
| dorzolamide/timolol (22.3/6.8 only) | Ophthalmic/ Eye drops | Generic Mfr | Yes | Yes | ||
| Doxycycline Hyclate 100mg (capsules only) | Antibiotic | Generic Mfr | Yes | Yes | ||
| Multaq | Dronedarone | Antiarrhythmic | Sanofi | Yes | Yes | |
| Trulicity | Dulaglutide | Diabetes | Eli-Lilly | Yes | Yes | |
| Duloxetine | Antidepressant | Generic Mfr | Yes | Yes | ||
| emtricitabine/tenofovir | HIV PrEP | Generic Mfr | 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 | ||
| estradiol (oral only) | Hormone Therapy | 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 | ||
| famotidine | GERD | Generic Mfr | Yes | Yes | ||
| Ferrous Sulfate (325mg only) | Mineral, Iron Deficiency | Generic Mfr | Yes | Yes | ||
| finasteride | BPH | Generic Mfr | Yes | Yes | ||
| Fluconazole | Antifungal | Generic Mfr | Yes | Yes | ||
| Fluoxetine | Antidepressant | Generic Mfr | Yes | Yes | ||
| Arnuity Ellipta | Fluticasone Furoate | COPD/Asthma | GSK | Yes | Yes | |
| Trelegy Ellipta | Fluticasone furoate /Umeclidinium/Vilanterol | COPD/Asthma | GSK | Yes | Yes | |
| Breo Ellipta | Fluticasone Furoate/Vilanterol | COPD/Asthma | GSK | Yes | Yes | |
| Fluticasone Nasal Spray | 1 unit/month | Steroid | 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 and ER) | Diabetes | Generic Mfr | 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 | ||
| ibandronate | Osteoporosis | Generic Mfr | Yes | Yes | ||
| Ibuprofen (400, 600, 800 mg only) | NSAID | Generic Mfr | Yes | Yes | ||
| Humulin 70/30, N, R | Insulin | Diabetes | Eli-Lilly | Yes | Yes | |
| Toujeo / Toujeo Max | Insulin Glargine | Diabetes | Sanofi | Yes | Yes | |
| Basaglar / Lantus | Insulin Glargine (Pens Only) | Diabetes | Eli-Lilly | 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 / Albuterol Neb Soln | 180 ml/month | Asthma | Generic Mfr | Yes | Yes | |
| Ipratropium Neb Soln | 150 ml/month | Asthma | Generic Mfr | Yes | Yes | |
| Avapro | Irbesartan | Antohypertensive | Sanofi | Yes | Yes | |
| Avalide | Irbesartan/HCTZ | Antihypertensive | 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% ophth susp | Ophthalmic/Eye drops | Generic Mfr | Yes | Yes | ||
| Arava | Leflunomide | Rheumatoid Arthritis | Sanofi | Yes | Yes | |
| levetiracetam | Anticonvulsant | Generic Mfr | 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 (IR Capsules, ER Tablets) | Bipolar Disorder | Generic Mfr | Yes | Yes | ||
| Loratadine | 30 tablets/month | Allergic Rhinitis | Generic Mfr | Yes | Yes | |
| Losartan/HCTZ | 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 | |
| lurasidone | Antidepressant/Antipsychotic/Bipolar Disorder | Generic Mfr | Yes | Yes | ||
| Medroxyprogesterone | Women’s Health | Generic Mfr | Yes | Yes | ||
| Meloxicam | NSAID | Generic Mfr | Yes | Yes | ||
| memantine | Dementia | 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 | ||
| metoclopramide | Gastrointestinal Health | Generic Mfr | Yes | Yes | ||
| metoprolol (succinate & tartrate) | Antihypertensive Agent | Generic Mfr | Yes | Yes | ||
| Metronidazole (Oral) | Antibiotic | Generic Mfr | Yes | Yes | ||
| metronidazole vaginal gel | Antibiotic Topical | Generic Mfr | Yes | Yes | ||
| Mirtazapine | Antidepressant | Generic Mfr | Yes | Yes | ||
| Montelukast (10mg only) | Asthma/Allergies | Generic Mfr | Yes | Yes | ||
| Mupirocin (ointment only) | 22 g/month | Antibiotic, Topical | Generic Mfr | Yes | Yes | |
| Naltrexone (oral only) | 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 | ||
| nitroglycerin SL (0.4mg only) | Heart Failure | 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 | ||
| Olanzapine (Oral only) | Antipsychotic | Eli-Lilly | Yes | Yes | ||
| olmesartan | Antihypertensive Agent | Generic Mfr | Yes | Yes | ||
| Omeprazole (20mg & 40mg only) | GERD | Generic Mfr | Yes | Yes | ||
| Ondansetron (not ODT) | 30 tablets/month | Antiemetic | Generic Mfr | Yes | Yes | |
| oseltamivir | Walk-in’s only | Antiviral | Generic Mfr | No | Yes | |
| Oxcarbazepine | Anticonvulsant | Generic Mfr | Yes | Yes | ||
| Invega Hafyera Injection (6 month) | Paliperidone (Injection only) | Antipsychotic | Janssen | Yes | Yes | |
| Invega Sustenna Injection (1 month) | Paliperidone (Injection only) | Antipsychotic | Janssen | Yes | Yes | |
| Invega Trinza Injection (3 month) | Paliperidone (Injection only) | Antipsychotic | Janssen | Yes | Yes | |
| Creon | pancrelipase | Pancreatic Enzymes | Abbvie | No | Yes | |
| Paroxetine | Antidepressant | Generic Mfr | Yes | Yes | ||
| Penicillin VK | Antibiotic | 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 | ||
| polyethylene glycol & electrolytes (GaviLyte) | Gastrointestinal Health | Generic Mfr | Yes | Yes | ||
| polyethylene glycol 3350 (Miralax) | Bowel Prep Only | Gastrointestinal Health | 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 | ||
| Progesterone (micronized) | Hormone Therapy | Generic Mfr | Yes | Yes | ||
| Promethazine | 90 tablets/month | Antiemetic | Generic Mfr | Yes | Yes | |
| propranolol | Antihypertensive Agent | 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 | |
| rosuvastatin | Antihyperlipidemic | 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 | Excludes NC Medicaid Eligible Individuals | Diabetes | Merck | Yes | Yes |
| Janumet / Janumet XR | Sitagliptin/Metformin | Excludes NC Medicaid Eligible Individuals | 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 | ||
| sumatriptan | Migraine | Generic Mfr | Yes | Yes | ||
| tacrolimus | Organ Transplant | Generic Mfr | Yes | Yes | ||
| tamsulosin | BPH | Generic Mfr | Yes | Yes | ||
| terbinafine | Antifungal | Generic Mfr | Yes | Yes | ||
| tetracycline | 14 day treatment | Antibiotic | Generic Mfr | Yes | Yes | |
| Timolol | Ophthalmic drops | Generic Mfr | Yes | Yes | ||
| Spiriva Respimat | Tiotropium | COPD | Boehringer | No | Yes | |
| Topiramate | Antiseizure, Migraine | Generic Mfr | Yes | Yes | ||
| torsemide | Diuretic | 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 | GSK | Yes | Yes | |
| Anoro Ellipta | Umeclidinium/Vilanterol | COPD/Asthma | GSK | Yes | Yes | |
| valacyclovir | Antiviral | Generic Mfr | Yes | Yes | ||
| varenicline | Alliance Health Catchment Area Only (Cumberland, Durham, Harnett, Johnston, Mecklenburg, Orange, Wake) | Tobacco Cessation | Generic Mfr | No | Yes | |
| Venlafaxine XR (Capsules only) | Antidepressant | Generic Mfr | 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 |