| NDC-11 (Package) | NDC-9 (Product) | Generic Name | Brand Name | Strength | SEER*Rx Category | Major Class | Minor Class | Administration Route | Package Effective Date | Package Discontinuation Date | Status |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 76310-0017-50 | 76310-0017 | Amifostine | Ethyol | 500.0 mg/10mL | Ancillary Therapy | Chemoprotective | Detoxifying Agent | Intravenous | Jan 1, 2020 | In Use | |
| 25021-0814-30 | 25021-0814 | Leucovorin Calcium | Leucovorin Calcium | 100.0 mg/10mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | Sep 15, 2012 | In Use | |
| 62756-0581-40 | 62756-0581 | Amifostine | Amifostine | 50.0 mg/mL | Ancillary Therapy | Chemoprotective | Detoxifying Agent | Intravenous | Mar 14, 2008 | Mar 31, 2012 | No Longer Used |
| 70860-0209-11 | 70860-0209 | Mesna | Mesna | 100.0 mg/mL | Ancillary Therapy | Chemoprotective | Detoxifying Agent | Intravenous | Feb 28, 2018 | In Use | |
| 00054-4497-05 | 00054-4497 | Leucovorin Calcium | Leucovorin Calcium | 10.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Feb 22, 1993 | In Use | |
| 00069-5886-24 | 00069-5886 | Calcium folinate | LEDERLE LEUCOVORIN | 5.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Dec 18, 2025 | Mar 31, 2027 | In Use |
| 71288-0104-10 | 71288-0104 | Levoleucovorin calcium | Levoleucovorin | 50.0 mg/5mL | Ancillary Therapy | Chemoprotective | Antidote | Intravenous | Aug 22, 2019 | Apr 30, 2024 | No Longer Used |
| 00054-4497-10 | 00054-4497 | Leucovorin Calcium | Leucovorin Calcium | 10.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Feb 22, 1993 | In Use | |
| 00054-4496-25 | 00054-4496 | Leucovorin Calcium | Leucovorin Calcium | 5.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Feb 22, 1993 | In Use | |
| 68001-0418-38 | 68001-0418 | Leucovorin Calcium | Leucovorin Calcium | 350.0 mg/17.5mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | Sep 26, 2019 | In Use | |
| 00703-5145-01 | 00703-5145 | Leucovorin Calcium | Leucovorin Calcium | 350.0 mg/17.5mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | Jun 12, 1997 | Sep 30, 2023 | No Longer Used |
| 71288-0160-10 | 71288-0160 | Leucovorin calcium | Leucovorin calcium | 50.0 mg/5mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | Jul 19, 2023 | In Use | |
| 00143-9553-01 | 00143-9553 | Leucovorin Calcium | Leucovorin Calcium | 200.0 mg/20mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | May 23, 1995 | In Use | |
| 10019-0953-62 | 10019-0953 | Mesna | Mesna | 100.0 mg/mL | Ancillary Therapy | Chemoprotective | Detoxifying Agent | Intravenous | Dec 30, 1988 | In Use | |
| 68001-0286-38 | 68001-0286 | Leucovorin Calcium | Leucovorin | 20.0 mg/mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | Jul 1, 2016 | Feb 1, 2021 | No Longer Used |
| 63323-0631-10 | 63323-0631 | Leucovorin Calcium | Leucovorin Calcium | 10.0 mg/mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | Jan 31, 2017 | In Use | |
| 68083-0161-01 | 68083-0161 | Mesna Injection | Mesna | 100.0 mg/mL | Ancillary Therapy | Chemoprotective | Detoxifying Agent | Intravenous | Dec 20, 2017 | In Use | |
| 67457-0528-10 | 67457-0528 | LEUCOVORIN CALCIUM | LEUCOVORIN CALCIUM | 100.0 mg/10mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | Jul 23, 2019 | In Use | |
| 00143-9555-01 | 00143-9555 | Leucovorin Calcium | Leucovorin Calcium | 50.0 mg/5mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | Sep 14, 1987 | In Use | |
| 25021-0816-67 | 25021-0816 | Leucovorin Calcium | Leucovorin Calcium | 350.0 mg/17.5mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | Dec 1, 2013 | Jan 31, 2022 | In Use |
| 70436-0120-80 | 70436-0120 | Leucovorin calcium | Leucovorin Calcium | 500.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | Jul 10, 2023 | In Use | |
| 69468-0151-10 | 69468-0151 | Uridine Triacetate | Vistogard | 951.0 mg/g | Ancillary Therapy | Chemoprotective | Antidote | Oral | Mar 1, 2016 | In Use | |
| 68001-0285-38 | 68001-0285 | Leucovorin Calcium | Leucovorin | 10.0 mg/mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | Jul 1, 2016 | Oct 25, 2016 | No Longer Used |
| 50742-0354-01 | 50742-0354 | MESNA | MESNA | 400.0 mg/1 | Ancillary Therapy | Chemoprotective | Detoxifying Agent | Oral | Jan 14, 2025 | In Use | |
| 55390-0308-03 | 55390-0308 | Amifostine | Amifostine | 500.0 mg/10mL | Ancillary Therapy | Chemoprotective | Detoxifying Agent | Intravenous | Apr 2, 2008 | Dec 31, 2018 | No Longer Used |
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