ALABAMA MEDICAID AGENCY Cough and Cold List

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ALABAMA MEDICAID AGENCY Cough and Cold List by Generic Name (continued) Brand Name Generic Name Dosage Form GUAIFENESIN SYRUP GUAIFENESIN ORAL 100MG/5ML LIQUID LIQUID GUIATUSS 100 MG/5 ML SYRUP GUAIFENESIN ORAL 100MG/5ML LIQUID LIQUID IOPHEN NR LIQUID GUAIFENESIN ORAL 100MG/5ML LIQUID LIQUID MEDI‐TUSSIN 100 MG/5 ML SYRUP GUAIFENESIN ORAL 100MG/5ML LIQUID LIQUID MUCUS RELIEF 100 MG/5 ML LIQ GUAIFENESIN ORAL 100MG/5ML LIQUID LIQUID MUCUS RELIEF LIQUID GUAIFENESIN ORAL 100MG/5ML LIQUID LIQUID Q‐TUSSIN 100 MG/5 ML SYRUP GUAIFENESIN ORAL 100MG/5ML LIQUID LIQUID ROBAFEN 100 MG/5 ML SYRUP GUAIFENESIN ORAL 100MG/5ML LIQUID LIQUID ROBITUSSIN CHEST CONGEST LIQ GUAIFENESIN ORAL 100MG/5ML LIQUID LIQUID ROBITUSSIN CHEST CONGEST SYRUP GUAIFENESIN ORAL 100MG/5ML LIQUID LIQUID SB COUGH CONTROL SYRUP GUAIFENESIN ORAL 100MG/5ML LIQUID LIQUID SILTUSSIN DAS LIQUID GUAIFENESIN ORAL 100MG/5ML LIQUID LIQUID SUNMARK TUSSIN ORIGINAL SYRUP GUAIFENESIN ORAL 100MG/5ML LIQUID LIQUID TUSSIN 100 MG/5 ML SYRUP GUAIFENESIN ORAL 100MG/5ML LIQUID LIQUID TUSSIN EXPECTORANT GUAIFENESIN ORAL 100MG/5ML LIQUID LIQUID TUSSIN HONEY SYRUP GUAIFENESIN ORAL 100MG/5ML LIQUID LIQUID TUSSIN SYRUP GUAIFENESIN ORAL 100MG/5ML LIQUID LIQUID COUGHTAB 200 MG TABLET GUAIFENESIN ORAL 200MG TABLET TABLET GUAIFENESIN 200 MG TABLET GUAIFENESIN ORAL 200MG TABLET TABLET ORGAN‐I NR 200 MG TABLET GUAIFENESIN ORAL 200MG TABLET TABLET ALLFEN 400 MG TABLET GUAIFENESIN ORAL 400MG TABLET TABLET COUGHTAB 400 MG TABLET GUAIFENESIN ORAL 400MG TABLET TABLET GUAIFENESIN 400 MG TABLET GUAIFENESIN ORAL 400MG TABLET TABLET MUCUS RELIEF 400 MG TABLET GUAIFENESIN ORAL 400MG TABLET TABLET MUCINEX 600 MG TABLET GUAIFENESIN ORAL 600MG TABLET SA TABLET SA GANI‐TUSS NR LIQUID GUAIFENESIN/CODEINE PHOS ORAL 100‐10MG/5 LIQUID LIQUID IOPHEN‐C NR LIQUID GUAIFENESIN/CODEINE PHOS ORAL 100‐10MG/5 LIQUID LIQUID MYCI‐GC LIQUID GUAIFENESIN/CODEINE PHOS ORAL 100‐10MG/5 LIQUID LIQUID CHERATUSSIN AC SYRUP GUAIFENESIN/CODEINE PHOS ORAL 100‐10MG/5 SYRUP SYRUP GUAIFENESIN‐CODEINE SYRUP GUAIFENESIN/CODEINE PHOS ORAL 100‐10MG/5 SYRUP SYRUP ROBAFEN AC SYRUP GUAIFENESIN/CODEINE PHOS ORAL 100‐10MG/5 SYRUP SYRUP M‐CLEAR WC LIQUID GUAIFENESIN/CODEINE PHOS ORAL 100‐6.3/5 LIQUID LIQUID CODEINE‐GUAIFEN 10MG‐200MG LIQ GUAIFENESIN/CODEINE PHOS ORAL 200‐10MG/5 LIQUID LIQUID EXECLEAR‐C SYRUP GUAIFENESIN/CODEINE PHOS ORAL 200‐10MG/5 LIQUID LIQUID CODEINE 10 MG‐GUAI 300 MG LIQ GUAIFENESIN/CODEINE PHOS ORAL 300‐10MG/5 LIQUID LIQUID DEX‐TUSS LIQUID GUAIFENESIN/CODEINE PHOS ORAL 300‐10MG/5 LIQUID LIQUID GUAIFENESIN‐CODEINE TABLET GUAIFENESIN/CODEINE PHOS ORAL 300MG‐10MG TABLET TABLET CHERACOL D COUGH FORMULA GUAIFENESIN/D‐METHORPHAN HB ORAL 100‐10MG/5 LIQUID LIQUID DIABETIC TUSSIN DM LIQUID GUAIFENESIN/D‐METHORPHAN HB ORAL 100‐10MG/5 LIQUID LIQUID GANI‐TUSS‐DM NR LIQUID GUAIFENESIN/D‐METHORPHAN HB ORAL 100‐10MG/5 LIQUID LIQUID GUAIFENESIN‐DM NR LIQUID GUAIFENESIN/D‐METHORPHAN HB ORAL 100‐10MG/5 LIQUID LIQUID IOPHEN DM LIQUID GUAIFENESIN/D‐METHORPHAN HB ORAL 100‐10MG/5 LIQUID LIQUID MEDI‐TUSSIN DM DIABETIC LIQ GUAIFENESIN/D‐METHORPHAN HB ORAL 100‐10MG/5 LIQUID LIQUID PV TUSSIN DM CLEAR LIQUID GUAIFENESIN/D‐METHORPHAN HB ORAL 100‐10MG/5 LIQUID LIQUID SILTUSSIN DM DAS LIQUID GUAIFENESIN/D‐METHORPHAN HB ORAL 100‐10MG/5 LIQUID LIQUID TUSNEL DIABETIC LIQUID GUAIFENESIN/D‐METHORPHAN HB ORAL 100‐10MG/5 LIQUID LIQUID TUSSIN DM LIQUID GUAIFENESIN/D‐METHORPHAN HB ORAL 100‐10MG/5 LIQUID LIQUID GENATUSS DM SYRUP GUAIFENESIN/D‐METHORPHAN HB ORAL 100‐10MG/5 SYRUP SYRUP 4 Effective 7/1/09
ALABAMA MEDICAID AGENCY Cough and Cold List by Generic Name (continued) Brand Name Generic Name Dosage Form GUAIFENESIN DM SYRUP GUAIFENESIN/D‐METHORPHAN HB ORAL 100‐10MG/5 SYRUP SYRUP GUIATUSS DM SYRUP GUAIFENESIN/D‐METHORPHAN HB ORAL 100‐10MG/5 SYRUP SYRUP Q‐TUSSIN DM SYRUP GUAIFENESIN/D‐METHORPHAN HB ORAL 100‐10MG/5 SYRUP SYRUP Q‐TUSSIN‐DM SYRUP GUAIFENESIN/D‐METHORPHAN HB ORAL 100‐10MG/5 SYRUP SYRUP ROBAFEN‐DM CLEAR SYRUP GUAIFENESIN/D‐METHORPHAN HB ORAL 100‐10MG/5 SYRUP SYRUP ROBAFEN‐DM SYRUP GUAIFENESIN/D‐METHORPHAN HB ORAL 100‐10MG/5 SYRUP SYRUP ROBITUSSIN‐COUGH‐CHEST‐CONG LQ GUAIFENESIN/D‐METHORPHAN HB ORAL 100‐10MG/5 SYRUP SYRUP ROBITUSSIN‐DM COUGH SYRUP GUAIFENESIN/D‐METHORPHAN HB ORAL 100‐10MG/5 SYRUP SYRUP ROBITUSSIN‐DM SYRUP GUAIFENESIN/D‐METHORPHAN HB ORAL 100‐10MG/5 SYRUP SYRUP SB COUGH CONTROL DM SYRUP GUAIFENESIN/D‐METHORPHAN HB ORAL 100‐10MG/5 SYRUP SYRUP SILTUSSIN DM COUGH SYRUP GUAIFENESIN/D‐METHORPHAN HB ORAL 100‐10MG/5 SYRUP SYRUP SM TUSSIN CLEAR SYRUP GUAIFENESIN/D‐METHORPHAN HB ORAL 100‐10MG/5 SYRUP SYRUP SM TUSSIN DM GUAIFENESIN/D‐METHORPHAN HB ORAL 100‐10MG/5 SYRUP SYRUP TUSSIN DM CLEAR SYRUP GUAIFENESIN/D‐METHORPHAN HB ORAL 100‐10MG/5 SYRUP SYRUP TUSSIN DM COUGH SYRUP GUAIFENESIN/D‐METHORPHAN HB ORAL 100‐10MG/5 SYRUP SYRUP TUSSIN DM SYRUP GUAIFENESIN/D‐METHORPHAN HB ORAL 100‐10MG/5 SYRUP SYRUP VICKS PEDIATRIC 44E LIQUID GUAIFENESIN/D‐METHORPHAN HB ORAL 100‐10MG/5 SYRUP SYRUP CHILD MUCUS RELIEF COUGH LIQ GUAIFENESIN/D‐METHORPHAN HB ORAL 100‐5MG/5 LIQUID LIQUID CHILDREN'S MUCINEX COUGH LIQ GUAIFENESIN/D‐METHORPHAN HB ORAL 100‐5MG/5 LIQUID LIQUID MUCUS RELIEF COUGH LIQUID GUAIFENESIN/D‐METHORPHAN HB ORAL 100‐5MG/5 LIQUID LIQUID DIABETIC TUSSIN MAX‐STR LIQ GUAIFENESIN/D‐METHORPHAN HB ORAL 200‐10MG/5 LIQUID LIQUID HT‐TUSS DM ELIXIR GUAIFENESIN/D‐METHORPHAN HB ORAL 200‐20/5ML ELIXIR ELIXIR HYDRO‐TUSSIN DM LIQUID GUAIFENESIN/D‐METHORPHAN HB ORAL 200‐20/5ML ELIXIR ELIXIR SU‐TUSS DM ELIXIR GUAIFENESIN/D‐METHORPHAN HB ORAL 200‐20/5ML ELIXIR ELIXIR SIMUC‐DM ELIXIR GUAIFENESIN/D‐METHORPHAN HB ORAL 225‐25MG/5 SOLUTION SOLUTION DEX‐TUSS DM LIQUID GUAIFENESIN/D‐METHORPHAN HB ORAL 300‐10MG/5 LIQUID LIQUID DM 10 MG‐GUAI 300 MG LIQUID GUAIFENESIN/D‐METHORPHAN HB ORAL 300‐10MG/5 LIQUID LIQUID CHEST CONGEST‐COUGH RELIEF TAB GUAIFENESIN/D‐METHORPHAN HB ORAL 400MG‐20MG TABLET TABLET MUCUS RELIEF DM TABLET GUAIFENESIN/D‐METHORPHAN HB ORAL 400MG‐20MG TABLET TABLET MUCINEX DM TABLET GUAIFENESIN/D‐METHORPHAN HB ORAL 600MG‐30MG TAB.SR 12H TABLET 12H PV TUSSIN CF LIQUID GUAIFENESIN/D‐METHORPHAN HB/PE ORAL 100‐10‐5MG LIQUID LIQUID ROBITUSSIN COUGH‐COLD CF SYR GUAIFENESIN/D‐METHORPHAN HB/PE ORAL 100‐10‐5MG LIQUID LIQUID TUSSIN CF LIQUID GUAIFENESIN/D‐METHORPHAN HB/PE ORAL 100‐10‐5MG LIQUID LIQUID Z‐DEX SYRUP GUAIFENESIN/D‐METHORPHAN HB/PE ORAL 100‐20‐10 SYRUP SYRUP DYNATUSS‐EX SYRUP GUAIFENESIN/D‐METHORPHAN HB/PE ORAL 200‐30‐10 SYRUP SYRUP PDM GG SYRUP GUAIFENESIN/D‐METHORPHAN HB/PE ORAL 200‐30‐10 SYRUP SYRUP DACEX‐DM SYRUP GUAIFENESIN/D‐METHORPHAN HB/PE ORAL 25‐12.5/5 SYRUP SYRUP TRITUSS SYRUP GUAIFENESIN/D‐METHORPHAN HB/PE ORAL 25‐12.5/5 SYRUP SYRUP Z‐DEX PEDIATRIC DROPS GUAIFENESIN/D‐METHORPHAN HB/PE ORAL 35‐3‐2.5/1 DROPS DROPS AMBI 10PEH‐400GFN‐20DM TABLET GUAIFENESIN/D‐METHORPHAN HB/PE ORAL 400‐20‐10 TABLET TABLET SINUTUSS DM TABLET SA GUAIFENESIN/D‐METHORPHAN HB/PE ORAL 600‐30‐15 TABLET TABLET PSEUDOEPHEDRINE GG SYRUP GUAIFENESIN/P‐EPHED HCL ORAL 200‐40MG/5 LIQUID LIQUID PSEUDOVENT CAPSULE SA GUAIFENESIN/P‐EPHED HCL ORAL 250‐120MG CPMP 12HR CAPSULE PSEUDOVENT PED CAPSULE SA GUAIFENESIN/P‐EPHED HCL ORAL 300MG‐60MG CPMP 12HR CAPSULE PSEUDOVENT 400 CAPSULE GUAIFENESIN/P‐EPHED HCL ORAL 400‐120MG CPMP 12HR CAPSULE AMBI 40PSE‐400GFN TABLET GUAIFENESIN/P‐EPHED HCL ORAL 400MG‐40MG TABLET TABLET SUDATEX G TABLET GUAIFENESIN/P‐EPHED HCL ORAL 400MG‐40MG TABLET TABLET AMBI 60PSE‐400GFN TABLET GUAIFENESIN/P‐EPHED HCL ORAL 400MG‐60MG TABLET TABLET 5 Effective 7/1/09
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