ALABAMA MEDICAID AGENCY Cough and Cold List
ALABAMA MEDICAID AGENCY Cough and Cold List
ALABAMA MEDICAID AGENCY Cough and Cold List
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<strong>ALABAMA</strong> <strong>MEDICAID</strong> <strong>AGENCY</strong><br />
<strong>Cough</strong> <strong>and</strong> <strong>Cold</strong> <strong>List</strong><br />
by Generic Name (continued)<br />
Br<strong>and</strong> Name Generic Name Dosage Form<br />
ANDEHIST‐DM NR SYRUP D‐METHORPHAN HB/P‐EPD HCL/BPM ORAL 15‐45‐4/5 SYRUP SYRUP<br />
CARBOFED DM SYRUP D‐METHORPHAN HB/P‐EPD HCL/BPM ORAL 15‐45‐4/5 SYRUP SYRUP<br />
SILDEC‐DM SYRUP D‐METHORPHAN HB/P‐EPD HCL/BPM ORAL 15‐45‐4/5 SYRUP SYRUP<br />
NEO DM SYRUP D‐METHORPHAN HB/P‐EPD HCL/BPM ORAL 30‐50‐3MG LIQUID LIQUID<br />
BROMPHENEX DM SYRUP D‐METHORPHAN HB/P‐EPD HCL/BPM ORAL 30‐60‐4/5 SYRUP SYRUP<br />
BROMPHENEX DM SYRUP D‐METHORPHAN HB/P‐EPD HCL/BPM ORAL 30‐60‐4/5 SYRUP SYRUP<br />
BROMPLEX DM SYRUP D‐METHORPHAN HB/P‐EPD HCL/BPM ORAL 30‐60‐4/5 SYRUP SYRUP<br />
ENDACOF‐DM SYRUP D‐METHORPHAN HB/P‐EPD HCL/BPM ORAL 30‐60‐4/5 SYRUP SYRUP<br />
PSE BROM DM SYRUP D‐METHORPHAN HB/P‐EPD HCL/BPM ORAL 30‐60‐4/5 SYRUP SYRUP<br />
ALLANHIST PDX DROPS D‐METHORPHAN HB/P‐EPD HCL/BPM ORAL 3‐12.5‐1/1 DROPS DROPS<br />
BROMHIST PDX DROPS D‐METHORPHAN HB/P‐EPD HCL/BPM ORAL 3‐12.5‐1/1 DROPS DROPS<br />
ENDACOF‐PD DROPS D‐METHORPHAN HB/P‐EPD HCL/BPM ORAL 3‐12.5‐1/1 DROPS DROPS<br />
BROMHIST‐DM DROPS D‐METHORPHAN HB/P‐EPD HCL/BPM ORAL 4‐15‐1MG/1 DROPS DROPS<br />
PEDIAHIST DM DROPS D‐METHORPHAN HB/P‐EPD HCL/BPM ORAL 4‐15‐1MG/1 DROPS DROPS<br />
P‐HIST DM DROPS D‐METHORPHAN HB/P‐EPD HCL/BPM ORAL 5‐12‐1MG/1 DROPS DROPS<br />
TRIAMINIC COUGH LIQUID D‐METHORPHAN HB/P‐EPHED HCL ORAL 5‐15MG/5ML SYRUP SYRUP<br />
PEDIACARE LONG‐ACTING LIQ D‐METHORPHAN HB/P‐EPHED HCL ORAL 7.5‐15MG/5 SYRUP SYRUP<br />
TRIAMINIC COUGH‐NASAL CONG LIQ D‐METHORPHAN HB/P‐EPHED HCL ORAL 7.5‐15MG/5 SYRUP SYRUP<br />
AMBI 60PSE‐4CPM‐20DM TABLET D‐METHORPHAN HB/P‐EPHED HCL/CP ORAL 20‐60‐4MG TABLET TABLET<br />
NEUTRAHIST PDX DROPS D‐METHORPHAN HB/P‐EPHED HCL/CP ORAL 3‐9‐0.8/ML DROPS DROPS<br />
KIDCARE COUGH & COLD LIQUID D‐METHORPHAN HB/P‐EPHED HCL/CP ORAL 5‐15‐1MG/5 LIQUID LIQUID<br />
PEDIA RELIEF COUGH‐COLD LIQUID D‐METHORPHAN HB/P‐EPHED HCL/CP ORAL 5‐15‐1MG/5 LIQUID LIQUID<br />
PEDIATRIC COUGH‐COLD LIQUID D‐METHORPHAN HB/P‐EPHED HCL/CP ORAL 5‐15‐1MG/5 LIQUID LIQUID<br />
TRIAMINIC COLD & COUGH LIQUID D‐METHORPHAN HB/P‐EPHED HCL/CP ORAL 5‐15‐1MG/5 LIQUID LIQUID<br />
PROMETHAZINE‐DM SYRUP D‐METHORPHAN HB/PROMETH HCL ORAL 15‐6.25/5 SYRUP SYRUP<br />
ALLANVAN‐DM SUSPENSION DM‐PE‐PYRILAMINE TANNATES ORAL 25‐12.5‐30 ORAL SUSP SUSPENSION<br />
TANNATE‐V‐DM SUSPENSION DM‐PE‐PYRILAMINE TANNATES ORAL 25‐12.5‐30 ORAL SUSP SUSPENSION<br />
VIRATAN‐DM SUSPENSION DM‐PE‐PYRILAMINE TANNATES ORAL 25‐12.5‐30 ORAL SUSP SUSPENSION<br />
DM‐PE‐PYRILAMINE TANN SUSP DM‐PE‐PYRILAMINE TANNATES ORAL 25‐15.5/5 ORAL SUSP SUSPENSION<br />
VIRATAN‐DM TABLET CHEWABLE DM‐PE‐PYRILAMINE TANNATES ORAL 25‐25‐30MG TAB CHEW CHEW TAB<br />
PSEUDO DM GG SYRUP GUAIFEN/DM HB/P‐EPHEDRINE ORAL 100‐15‐40 SYRUP SYRUP<br />
RU‐TUSS DM LIQUID GUAIFEN/DM HB/P‐EPHEDRINE ORAL 100‐15‐45 LIQUID LIQUID<br />
DONATUSSIN DM SYRUP GUAIFEN/DM HB/P‐EPHEDRINE ORAL 150‐15‐30 LIQUID LIQUID<br />
EXECLEAR‐DM SYRUP GUAIFEN/DM HB/P‐EPHEDRINE ORAL 150‐15‐30 LIQUID LIQUID<br />
PSEUDO COUGH LIQUID GUAIFEN/DM HB/P‐EPHEDRINE ORAL 175‐15‐32 SOLUTION SOLUTION<br />
AMBI 40PSE‐400GFN‐20DM TABLET GUAIFEN/DM HB/P‐EPHEDRINE ORAL 400‐20‐40 TABLET TABLET<br />
AMBI 60PSE‐400GFN‐20DM TABLET GUAIFEN/DM HB/P‐EPHEDRINE ORAL 400‐20‐60 TABLET TABLET<br />
EXEFEN DMX TABLET GUAIFEN/DM HB/P‐EPHEDRINE ORAL 400‐20‐60 TABLET TABLET<br />
BROMHIST‐DM PEDIATRIC SYRUP GUAIFEN/DM HB/P‐EPHEDRINE/BPM ORAL 50‐5‐30‐2 SYRUP SYRUP<br />
HISTACOL DM PEDIATRIC SYRUP GUAIFEN/DM HB/P‐EPHEDRINE/BPM ORAL 50‐5‐30‐2 SYRUP SYRUP<br />
PEDIAHIST DM SYRUP GUAIFEN/DM HB/P‐EPHEDRINE/BPM ORAL 50‐5‐30‐2 SYRUP SYRUP<br />
HYDRO‐TUSSIN EXP SYRUP GUAIFEN/P‐EPHED HCL/DIHY‐COD ORAL 100‐15‐7.5 SYRUP SYRUP<br />
ADULT MUCUS RELIEF LIQ GUAIFENESIN ORAL 100MG/5ML LIQUID LIQUID<br />
CHILD MUCUS RELIEF LIQUID GUAIFENESIN ORAL 100MG/5ML LIQUID LIQUID<br />
CHILD'S MUCINEX 100 MG/5 ML LQ GUAIFENESIN ORAL 100MG/5ML LIQUID LIQUID<br />
DIABETIC TUSSIN EX LIQUID GUAIFENESIN ORAL 100MG/5ML LIQUID LIQUID<br />
GUAIFENESIN 100 MG/5 ML SYRUP GUAIFENESIN ORAL 100MG/5ML LIQUID LIQUID<br />
GUAIFENESIN NR 100 MG/5 ML GUAIFENESIN ORAL 100MG/5ML LIQUID LIQUID<br />
3 Effective 7/1/09
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