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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
00143-9555-01 00143-9555 Leucovorin Calcium Leucovorin Calcium 50.0 mg/5mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Sep 14, 1987 In Use
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
66220-0017-03 66220-0017 Amifostine Ethyol 500.0 mg/10mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous Aug 1, 2016 Oct 31, 2020 No Longer Used
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
54868-3310-02 54868-3310 Leucovorin Calcium Leucovorin Calcium 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Apr 15, 2002 In Use
38423-0110-01 38423-0110 Dexrazoxane Hydrochloride Totect Ancillary Therapy Chemoprotective Detoxifying Agent Oct 16, 2007 Jul 31, 2014 No Longer Used
68152-0102-01 68152-0102 Levoleucovorin Fusilev 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intravenous Sep 15, 2011 Feb 28, 2019 No Longer Used
68001-0286-39 68001-0286 Leucovorin Calcium Leucovorin 20.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Jul 1, 2016 Feb 1, 2021 No Longer Used
68083-0195-01 68083-0195 Dexrazoxane for Injection Dexrazoxane 500.0 mg/50mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous Dec 5, 2016 In Use
51991-0942-98 51991-0942 Dexrazoxane Hydrochloride Dexrazoxane 500.0 mg/50mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous Jun 26, 2017 Aug 31, 2024 No Longer Used
68083-0161-10 68083-0161 Mesna Injection Mesna 100.0 mg/mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous Dec 20, 2017 In Use
76310-0017-50 76310-0017 Amifostine Ethyol 500.0 mg/10mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous Jan 1, 2020 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
72611-0716-01 72611-0716 Dexrazoxane for Injection Dexrazoxane 500.0 mg/50mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous Sep 1, 2020 In Use
25021-0813-10 25021-0813 Leucovorin Calcium Leucovorin Calcium 50.0 mg/5mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Sep 15, 2012 In Use
68001-0285-22 68001-0285 Leucovorin Calcium Leucovorin 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Jul 1, 2016 Feb 1, 2021 No Longer Used
54868-5915-00 54868-5915 Leucovorin Calcium Leucovorin Calcium 15.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Jul 8, 2008 In Use
69468-0151-10 69468-0151 Uridine Triacetate Vistogard 951.0 mg/g Ancillary Therapy Chemoprotective Antidote Oral Mar 1, 2016 In Use
42806-0133-21 42806-0133 Leucovorin Calcium Leucovorin Calcium 10.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Jan 1, 2021 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
00143-9553-01 00143-9553 Leucovorin Calcium Leucovorin Calcium 200.0 mg/20mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous May 23, 1995 In Use
60687-0227-11 60687-0227 Leucovorin Calcium Leucovorin Calcium 25.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Jan 24, 2017 In Use
68001-0416-36 68001-0416 Leucovorin Calcium Leucovorin Calcium 100.0 mg/10mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Sep 26, 2019 In Use
10019-0953-62 10019-0953 Mesna Mesna 100.0 mg/mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous Dec 30, 1988 In Use

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