| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 71288-0105-18 | 71288-0105 | Levoleucovorin calcium | Levoleucovorin | 10.0 mg/mL | Ancillary Therapy | Chemoprotective | Antidote | Intravenous | Aug 16, 2019 | In Use | |
| 50633-0220-20 | 50633-0220 | Uridine triacetate | VISTOGARD | 951.0 mg/g | Ancillary Therapy | Chemoprotective | Antidote | Oral | Jul 31, 2024 | In Use | |
| 68152-0101-00 | 68152-0101 | Levoleucovorin | Fusilev | 50.0 mg/5mL | Ancillary Therapy | Chemoprotective | Antidote | Intravenous | Aug 15, 2008 | Feb 28, 2019 | No Longer Used |
| 69315-0184-03 | 69315-0184 | Leucovorin calcium | Leucovorin calcium | 5.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Nov 16, 2020 | In Use | |
| 70121-1099-01 | 70121-1099 | Levoleucovorin | Levoleucovorin | 50.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Intravenous | Feb 13, 2017 | In Use | |
| 83831-0147-05 | 83831-0147 | Leucovorin calcium | VYKOURA | 50.0 mg/5mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | Mar 16, 2026 | In Use | |
| 67457-0600-20 | 67457-0600 | Levoleucovorin | LEVOLEUCOVORIN CALCIUM | 10.0 mg/mL | Ancillary Therapy | Chemoprotective | Antidote | Intravenous | Oct 21, 2015 | Apr 30, 2019 | No Longer Used |
| 14335-0340-01 | 14335-0340 | Levoleucovorin injection | LEVOLEUCOVORIN CALCIUM | 10.0 mg/mL | Ancillary Therapy | Chemoprotective | Antidote | Intravenous | May 31, 2023 | In Use | |
| 83831-0149-50 | 83831-0149 | Leucovorin calcium | VYKOURA | 500.0 mg/50mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | Mar 16, 2026 | 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 | |
| 71205-0908-11 | 71205-0908 | LEUCOVORIN CALCIUM | LEUCOVORIN CALCIUM | 5.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Jul 16, 2021 | In Use | |
| 43598-0771-11 | 43598-0771 | LEVOLEUCOVORIN | LEVOLEUCOVORIN | 175.0 mg/17.5mL | Ancillary Therapy | Chemoprotective | Antidote | Intravenous | Sep 26, 2018 | In Use | |
| 55390-0051-10 | 55390-0051 | Leucovorin Calcium | Leucovorin Calcium | Ancillary Therapy | Chemoprotective | Antidote | May 1, 1996 | Aug 31, 2013 | No Longer Used | ||
| 45963-0762-57 | 45963-0762 | Levoleucovorin | Levoleucovorin | 10.0 mg/mL | Ancillary Therapy | Chemoprotective | Antidote | Intravenous | Feb 14, 2017 | Jul 31, 2019 | In Use |
| 63323-0711-00 | 63323-0711 | Leucovorin Calcium | Leucovorin Calcium | 500.0 mg/50mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | Sep 18, 2010 | In Use | |
| 68001-0285-28 | 68001-0285 | Leucovorin Calcium | Leucovorin | 10.0 mg/mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | Jul 1, 2016 | Feb 1, 2021 | No Longer Used |
| 53270-0101-01 | 53270-0101 | Levoleucovorin | Fusilev | Ancillary Therapy | Chemoprotective | Antidote | Aug 15, 2008 | Feb 24, 2010 | 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 |
| 55390-0053-01 | 55390-0053 | Leucovorin Calcium | Leucovorin Calcium | Ancillary Therapy | Chemoprotective | Antidote | May 1, 1996 | Apr 30, 2014 | No Longer Used | ||
| 69315-0185-12 | 69315-0185 | Leucovorin calcium | Leucovorin calcium | 10.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Nov 16, 2020 | 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 | |
| 71288-0161-20 | 71288-0161 | Leucovorin calcium | Leucovorin calcium | 100.0 mg/10mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | Jul 19, 2023 | 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 | |
| 67457-0529-20 | 67457-0529 | LEUCOVORIN CALCIUM | LEUCOVORIN CALCIUM | 200.0 mg/20mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | Jul 23, 2019 | 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 |
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