| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 00703-5140-01 | 00703-5140 | Leucovorin Calcium | Leucovorin Calcium | 100.0 mg/10mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | Feb 1, 1994 | Sep 30, 2023 | No Longer Used |
| 70436-0120-80 | 70436-0120 | Leucovorin calcium | Leucovorin Calcium | 500.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | Jul 10, 2023 | 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 | |
| 45963-0762-57 | 45963-0762 | Levoleucovorin | Levoleucovorin | 10.0 mg/mL | Ancillary Therapy | Chemoprotective | Antidote | Intravenous | Feb 14, 2017 | Jul 31, 2019 | In Use |
| 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 |
| 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 |
| 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 |
| 50742-0464-50 | 50742-0464 | Leucovorin Calcium | Leucovorin Calcium | 10.0 mg/mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | Nov 23, 2018 | In Use | |
| 69468-0151-10 | 69468-0151 | Uridine Triacetate | Vistogard | 951.0 mg/g | Ancillary Therapy | Chemoprotective | Antidote | Oral | Mar 1, 2016 | In Use | |
| 42806-0358-30 | 42806-0358 | Leucovorin Calcium | Leucovorin Calcium | 5.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Apr 16, 2020 | In Use | |
| 71288-0163-30 | 71288-0163 | Leucovorin calcium | Leucovorin calcium | 350.0 mg/17.5mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | Jul 19, 2023 | 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 | |
| 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 |
| 71288-0160-10 | 71288-0160 | Leucovorin calcium | Leucovorin calcium | 50.0 mg/5mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | Jul 19, 2023 | In Use | |
| 69315-0185-24 | 69315-0185 | Leucovorin calcium | Leucovorin calcium | 10.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Nov 16, 2020 | In Use | |
| 68001-0285-37 | 68001-0285 | Leucovorin Calcium | Leucovorin | 10.0 mg/mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | Jul 1, 2016 | Feb 1, 2021 | No Longer Used |
| 71205-0908-11 | 71205-0908 | LEUCOVORIN CALCIUM | LEUCOVORIN CALCIUM | 5.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Jul 16, 2021 | In Use | |
| 42806-0134-24 | 42806-0134 | Leucovorin Calcium | Leucovorin Calcium | 15.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Jan 1, 2021 | In Use | |
| 51079-0581-06 | 51079-0581 | Leucovorin Calcium | Leucovorin Calcium | 5.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Feb 26, 1996 | In Use | |
| 50633-0220-20 | 50633-0220 | Uridine triacetate | VISTOGARD | 951.0 mg/g | Ancillary Therapy | Chemoprotective | Antidote | Oral | Jul 31, 2024 | In Use | |
| 54868-3310-00 | 54868-3310 | Leucovorin Calcium | Leucovorin Calcium | 5.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Apr 15, 2002 | In Use | |
| 68083-0279-01 | 68083-0279 | Levoleucovorin | levoleucovorin | 10.0 mg/mL | Ancillary Therapy | Chemoprotective | Antidote | Intravenous | Sep 20, 2018 | 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 | |
| 42806-0133-21 | 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 |
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