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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
55390-0014-02 55390-0014 Dexrazoxane Dexrazoxane Ancillary Therapy Chemoprotective Detoxifying Agent Mar 31, 2005 May 31, 2012 No Longer Used
25021-0201-67 25021-0201 Mesna Mesna 100.0 mg/mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous Apr 30, 2013 Sep 30, 2016 In Use
63323-0710-59 63323-0710 Leucovorin Calcium Leucovorin Calcium 200.0 mg/20mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Sep 18, 2010 In Use
68152-0112-01 68152-0112 levoleucovorin KHAPZORY 175.0 mg/3.5mL Ancillary Therapy Chemoprotective Antidote Intravenous Jan 2, 2019 In Use
68083-0278-01 68083-0278 Levoleucovorin levoleucovorin 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intravenous Sep 20, 2018 In Use
25021-0201-11 25021-0201 Mesna Mesna 100.0 mg/mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous Dec 1, 2010 In Use
60687-0227-94 60687-0227 Leucovorin Calcium Leucovorin Calcium 25.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Feb 17, 2017 In Use
00143-9554-01 00143-9554 Leucovorin Calcium Leucovorin Calcium 100.0 mg/10mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Mar 28, 1988 In Use
50742-0181-01 50742-0181 Leucovorin Calcium Leucovorin Calcium 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Jul 30, 2020 In Use
55390-0052-10 55390-0052 Leucovorin Calcium Leucovorin Calcium Ancillary Therapy Chemoprotective Antidote May 1, 1996 Aug 31, 2014 No Longer Used
72266-0235-01 72266-0235 Dexrazoxane for Injection Dexrazoxane 250.0 mg/25mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous Nov 1, 2021 In Use
42806-0358-30 42806-0358 Leucovorin Calcium Leucovorin Calcium 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Apr 16, 2020 In Use
55390-0054-01 55390-0054 Leucovorin Calcium Leucovorin Calcium Ancillary Therapy Chemoprotective Antidote Jun 8, 2000 Feb 28, 2015 No Longer Used
68001-0285-29 68001-0285 Leucovorin Calcium Leucovorin 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Oct 25, 2016 Feb 1, 2021 No Longer Used
00143-9558-01 00143-9558 Levoleucovorin Levoleucovorin 50.0 mg/5mL Ancillary Therapy Chemoprotective Antidote Intravenous Jul 7, 2016 In Use
51079-0582-05 51079-0582 Leucovorin Calcium Leucovorin Calcium 25.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Aug 27, 1997 Jun 30, 2023 No Longer Used
00781-3201-94 00781-3201 Levoleucovorin Levoleucovorin 175.0 mg/17.5mL Ancillary Therapy Chemoprotective Antidote Intravenous Apr 23, 2015 Apr 30, 2023 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
52125-0453-02 52125-0453 Leucovorin Calcium Leucovorin Calcium 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Mar 12, 2013 Mar 12, 2014 No Longer Used
51079-0581-01 51079-0581 Leucovorin Calcium Leucovorin Calcium 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Feb 26, 1996 In Use
63323-0733-10 63323-0733 Mesna Mesna 100.0 mg/mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous Sep 5, 2001 In Use
00703-4805-01 00703-4805 Mesna Mesna 100.0 mg/mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous May 1, 2002 Oct 31, 2020 No Longer Used
25021-0815-30 25021-0815 Leucovorin Calcium Leucovorin Calcium 200.0 mg/20mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Sep 15, 2012 In Use
10019-0953-01 10019-0953 Mesna Mesna 100.0 mg/mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous Dec 30, 1988 In Use
83831-0149-50 83831-0149 Leucovorin calcium VYKOURA 500.0 mg/50mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Feb 3, 2026 In Use

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