| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 50633-0220-20 | 50633-0220 | Uridine triacetate | VISTOGARD | 951.0 mg/g | Ancillary Therapy | Chemoprotective | Antidote | Oral | Jul 31, 2024 | In Use | |
| 72266-0235-01 | 72266-0235 | Dexrazoxane for Injection | Dexrazoxane | 250.0 mg/25mL | Ancillary Therapy | Chemoprotective | Detoxifying Agent | Intravenous | Nov 1, 2021 | In Use | |
| 25021-0201-69 | 25021-0201 | Mesna | Mesna | 100.0 mg/mL | Ancillary Therapy | Chemoprotective | Detoxifying Agent | Intravenous | Apr 30, 2013 | Sep 13, 2019 | In Use |
| 00591-4130-54 | 00591-4130 | Levoleucovorin | Levoleucovorin | 10.0 mg/mL | Ancillary Therapy | Chemoprotective | Antidote | Intravenous | Feb 6, 2017 | May 31, 2019 | No Longer Used |
| 42806-0358-01 | 42806-0358 | Leucovorin Calcium | Leucovorin Calcium | 5.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Apr 16, 2020 | 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 | |
| 72893-0004-01 | 72893-0004 | Levoleucovorin | KHAPZORY | 175.0 mg/3.5mL | Ancillary Therapy | Chemoprotective | Antidote | Intravenous | Jan 2, 2019 | In Use | |
| 72893-0006-01 | 72893-0006 | Levoleucovorin | KHAPZORY | 300.0 mg/6mL | Ancillary Therapy | Chemoprotective | Antidote | Intravenous | Jan 2, 2019 | Oct 31, 2023 | No Longer Used |
| 63323-0710-50 | 63323-0710 | Leucovorin Calcium | Leucovorin Calcium | 200.0 mg/20mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | Sep 18, 2010 | In Use | |
| 73591-5886-01 | 73591-5886 | CALCIUM FOLINATE | LEDERLE LEUCOVORIN | 5.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Nov 26, 2025 | In Use | |
| 00054-4497-05 | 00054-4497 | Leucovorin Calcium | Leucovorin Calcium | 10.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Feb 22, 1993 | In Use | |
| 55390-0825-01 | 55390-0825 | Leucovorin Calcium | Leucovorin Calcium | Ancillary Therapy | Chemoprotective | Antidote | Sep 28, 2001 | May 31, 2013 | No Longer Used | ||
| 68083-0161-01 | 68083-0161 | Mesna Injection | Mesna | 100.0 mg/mL | Ancillary Therapy | Chemoprotective | Detoxifying Agent | Intravenous | Dec 20, 2017 | In Use | |
| 67108-3565-09 | 67108-3565 | Mesna | Mesnex | 400.0 mg/1 | Ancillary Therapy | Chemoprotective | Detoxifying Agent | Oral | Mar 21, 2002 | 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 | |
| 63323-0631-50 | 63323-0631 | Leucovorin Calcium | Leucovorin Calcium | 10.0 mg/mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | Jul 27, 2018 | In Use | |
| 25021-0816-30 | 25021-0816 | Leucovorin Calcium | Leucovorin Calcium | 350.0 mg/17.5mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | Sep 15, 2012 | In Use | |
| 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 |
| 54868-3310-03 | 54868-3310 | Leucovorin Calcium | Leucovorin Calcium | 5.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Apr 15, 2002 | In Use | |
| 67457-0148-00 | 67457-0148 | Mesna | Mesna | 100.0 mg/mL | Ancillary Therapy | Chemoprotective | Detoxifying Agent | Intravenous | Apr 3, 2012 | Sep 30, 2016 | No Longer Used |
| 47335-0581-42 | 47335-0581 | Amifostine | Amifostine | 50.0 mg/mL | Ancillary Therapy | Chemoprotective | Detoxifying Agent | Intravenous | Mar 14, 2008 | Jul 31, 2013 | No Longer Used |
| 69468-0151-20 | 69468-0151 | Uridine Triacetate | Vistogard | 951.0 mg/g | Ancillary Therapy | Chemoprotective | Antidote | Oral | Mar 1, 2016 | 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 | |
| 00555-0485-04 | 00555-0485 | Leucovorin Calcium | Leucovorin Calcium | 25.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Jun 30, 1990 | In Use | |
| 14335-0340-01 | 14335-0340 | Levoleucovorin injection | LEVOLEUCOVORIN CALCIUM | 10.0 mg/mL | Ancillary Therapy | Chemoprotective | Antidote | Intravenous | May 31, 2023 | In Use |
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