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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
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
67457-0601-30 67457-0601 Levoleucovorin LEVOLEUCOVORIN CALCIUM 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intravenous Oct 21, 2015 Apr 30, 2019 No Longer Used
71205-0908-30 71205-0908 LEUCOVORIN CALCIUM LEUCOVORIN CALCIUM 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Jul 16, 2021 In Use
68001-0285-36 68001-0285 Leucovorin Calcium Leucovorin 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Jul 1, 2016 Feb 1, 2021 No Longer Used
00143-9554-01 00143-9554 Leucovorin Calcium Leucovorin Calcium 100.0 mg/10mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Mar 28, 1988 In Use
71288-0162-30 71288-0162 Leucovorin calcium Leucovorin calcium 200.0 mg/20mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Jul 19, 2023 In Use
76310-0002-01 76310-0002 Dexrazoxane Cardioxane 500.0 mg/1 Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous Jul 28, 2017 In Use
69315-0187-25 69315-0187 Leucovorin calcium Leucovorin calcium 25.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Nov 16, 2020 In Use
62756-0581-42 62756-0581 Amifostine Amifostine 50.0 mg/mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous Mar 14, 2008 Mar 31, 2012 No Longer Used
25021-0813-66 25021-0813 Leucovorin Calcium Leucovorin Calcium 50.0 mg/5mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Dec 1, 2013 Jul 31, 2020 In Use
72266-0101-01 72266-0101 Dexrazoxane for Injection Dexrazoxane 500.0 mg/50mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous Mar 18, 2019 In Use
25021-0201-69 25021-0201 Mesna Mesna 100.0 mg/mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous Apr 30, 2013 Sep 13, 2019 In Use
42806-0133-24 42806-0133 Leucovorin Calcium Leucovorin Calcium 10.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Jan 1, 2021 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
66220-0110-01 66220-0110 Dexrazoxane Hydrochloride Totect 500.0 mg/1 Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous Jul 25, 2017 Oct 30, 2020 No Longer Used
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
00054-4497-10 00054-4497 Leucovorin Calcium Leucovorin Calcium 10.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Feb 22, 1993 In Use
25021-0815-67 25021-0815 Leucovorin Calcium Leucovorin Calcium 200.0 mg/20mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Dec 1, 2013 Sep 30, 2020 In Use
69315-0186-24 69315-0186 Leucovorin calcium Leucovorin calcium 15.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Nov 16, 2020 In Use
50742-0354-01 50742-0354 MESNA MESNA 400.0 mg/1 Ancillary Therapy Chemoprotective Detoxifying Agent Oral Jan 14, 2025 In Use
55390-0045-01 55390-0045 Mesna Mesna Ancillary Therapy Chemoprotective Detoxifying Agent Feb 23, 2004 Jul 31, 2012 No Longer Used
50742-0464-50 50742-0464 Leucovorin Calcium Leucovorin Calcium 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Nov 23, 2018 In Use
71205-0908-60 71205-0908 LEUCOVORIN CALCIUM LEUCOVORIN CALCIUM 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Jul 16, 2021 In Use
10019-0953-02 10019-0953 Mesna Mesna 100.0 mg/mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous Dec 30, 1988 In Use
25021-0814-67 25021-0814 Leucovorin Calcium Leucovorin Calcium 100.0 mg/10mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Dec 1, 2013 Dec 31, 2020 In Use

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