| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 69468-0151-04 | 69468-0151 | Uridine Triacetate | Vistogard | 951.0 mg/g | Ancillary Therapy | Chemoprotective | Antidote | Oral | Mar 1, 2016 | In Use | |
| 50633-0220-04 | 50633-0220 | Uridine triacetate | VISTOGARD | 951.0 mg/g | Ancillary Therapy | Chemoprotective | Antidote | Oral | Jul 31, 2024 | In Use | |
| 55390-0826-01 | 55390-0826 | Leucovorin Calcium | Leucovorin Calcium | Ancillary Therapy | Chemoprotective | Antidote | Sep 28, 2001 | Jun 30, 2013 | No Longer Used | ||
| 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 |
| 54868-3310-00 | 54868-3310 | Leucovorin Calcium | Leucovorin Calcium | 5.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Apr 15, 2002 | In Use | |
| 69468-0151-10 | 69468-0151 | Uridine Triacetate | Vistogard | 951.0 mg/g | Ancillary Therapy | Chemoprotective | Antidote | Oral | Mar 1, 2016 | In Use | |
| 43598-0773-11 | 43598-0773 | LEVOLEUCOVORIN | LEVOLEUCOVORIN | 250.0 mg/25mL | Ancillary Therapy | Chemoprotective | Antidote | Intravenous | Sep 26, 2018 | 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 | |
| 00143-9553-01 | 00143-9553 | Leucovorin Calcium | Leucovorin Calcium | 200.0 mg/20mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | May 23, 1995 | In Use | |
| 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 |
| 71288-0162-30 | 71288-0162 | Leucovorin calcium | Leucovorin calcium | 200.0 mg/20mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | Jul 19, 2023 | 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 |
| 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 |
| 70121-1572-01 | 70121-1572 | Levoleucovorin | Levoleucovorin Calcium | 10.0 mg/mL | Ancillary Therapy | Chemoprotective | Antidote | Intravenous | Sep 8, 2017 | In Use | |
| 00555-0485-27 | 00555-0485 | Leucovorin Calcium | Leucovorin Calcium | 25.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Jun 30, 1990 | In Use | |
| 68083-0278-01 | 68083-0278 | Levoleucovorin | levoleucovorin | 10.0 mg/mL | Ancillary Therapy | Chemoprotective | Antidote | Intravenous | Sep 20, 2018 | In Use | |
| 51079-0582-01 | 51079-0582 | Leucovorin Calcium | Leucovorin Calcium | 25.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Aug 27, 1997 | No Longer Used | |
| 70436-0119-80 | 70436-0119 | Leucovorin calcium | Leucovorin Calcium | 350.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | Dec 27, 2024 | 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 |
| 72266-0120-01 | 72266-0120 | Levoleucovorin | levoleucovorin | 10.0 mg/mL | Ancillary Therapy | Chemoprotective | Antidote | Intravenous | Jun 25, 2019 | In Use | |
| 00703-5145-91 | 00703-5145 | Leucovorin Calcium | Leucovorin Calcium | 350.0 mg/17.5mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | May 13, 2013 | Apr 30, 2023 | 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 | |
| 63323-0710-59 | 63323-0710 | Leucovorin Calcium | Leucovorin Calcium | 200.0 mg/20mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | Sep 18, 2010 | In Use | |
| 00054-4498-10 | 00054-4498 | Leucovorin Calcium | Leucovorin Calcium | 15.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Feb 22, 1993 | 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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