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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
72205-0248-01 72205-0248 Dexrazoxane Dexrazoxane 500.0 mg/50mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous Apr 9, 2025 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
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
50742-0181-30 50742-0181 Leucovorin Calcium Leucovorin Calcium 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Jul 30, 2020 In Use
55390-0825-01 55390-0825 Leucovorin Calcium Leucovorin Calcium Ancillary Therapy Chemoprotective Antidote Sep 28, 2001 May 31, 2013 No Longer Used
00069-5886-99 00069-5886 Calcium folinate LEDERLE LEUCOVORIN 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Dec 18, 2025 Mar 31, 2027 In Use
55390-0053-01 55390-0053 Leucovorin Calcium Leucovorin Calcium Ancillary Therapy Chemoprotective Antidote May 1, 1996 Apr 30, 2014 No Longer Used
58178-0017-01 58178-0017 Amifostine Ethyol Ancillary Therapy Chemoprotective Detoxifying Agent Dec 8, 1995 Apr 30, 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
71288-0105-18 71288-0105 Levoleucovorin calcium Levoleucovorin 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intravenous Aug 16, 2019 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
71205-0908-55 71205-0908 LEUCOVORIN CALCIUM LEUCOVORIN CALCIUM 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Jul 16, 2021 In Use
71205-0908-30 71205-0908 LEUCOVORIN CALCIUM LEUCOVORIN CALCIUM 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Jul 16, 2021 In Use
50742-0354-01 50742-0354 MESNA MESNA 400.0 mg/1 Ancillary Therapy Chemoprotective Detoxifying Agent Oral Jan 14, 2025 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
55390-0014-02 55390-0014 Dexrazoxane Dexrazoxane Ancillary Therapy Chemoprotective Detoxifying Agent Mar 31, 2005 May 31, 2012 No Longer Used
00013-8717-62 00013-8717 Dexrazoxane Zinecard 250.0 mg/25mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous May 26, 1995 Apr 30, 2021 No Longer Used
69468-0151-10 69468-0151 Uridine Triacetate Vistogard 951.0 mg/g Ancillary Therapy Chemoprotective Antidote Oral Mar 1, 2016 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
67457-0530-35 67457-0530 LEUCOVORIN CALCIUM LEUCOVORIN CALCIUM 350.0 mg/17.5mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Jan 2, 2019 In Use
50742-0184-25 50742-0184 Leucovorin Calcium Leucovorin Calcium 25.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Jul 30, 2020 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
00555-0485-04 00555-0485 Leucovorin Calcium Leucovorin Calcium 25.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Jun 30, 1990 In Use
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
54868-3310-03 54868-3310 Leucovorin Calcium Leucovorin Calcium 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Apr 15, 2002 In Use

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