| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 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 |
| 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 |
| 50742-0183-24 | 50742-0183 | Leucovorin Calcium | Leucovorin Calcium | 15.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Jul 30, 2020 | 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 |
| 25021-0816-67 | 25021-0816 | Leucovorin Calcium | Leucovorin Calcium | 350.0 mg/17.5mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | Dec 1, 2013 | Jan 31, 2022 | In Use |
| 62756-0581-40 | 62756-0581 | Amifostine | Amifostine | 50.0 mg/mL | Ancillary Therapy | Chemoprotective | Detoxifying Agent | Intravenous | Mar 14, 2008 | Mar 31, 2012 | No Longer Used |
| 50742-0354-01 | 50742-0354 | MESNA | MESNA | 400.0 mg/1 | Ancillary Therapy | Chemoprotective | Detoxifying Agent | Oral | Jan 14, 2025 | In Use | |
| 54868-3310-03 | 54868-3310 | Leucovorin Calcium | Leucovorin Calcium | 5.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Apr 15, 2002 | In Use | |
| 53270-0101-01 | 53270-0101 | Levoleucovorin | Fusilev | Ancillary Therapy | Chemoprotective | Antidote | Aug 15, 2008 | Feb 24, 2010 | No Longer Used | ||
| 71288-0105-25 | 71288-0105 | Levoleucovorin calcium | Levoleucovorin | 10.0 mg/mL | Ancillary Therapy | Chemoprotective | Antidote | Intravenous | Aug 16, 2019 | In Use | |
| 42806-0134-34 | 42806-0134 | Leucovorin Calcium | Leucovorin Calcium | 15.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Jan 1, 2021 | In Use | |
| 55390-0053-01 | 55390-0053 | Leucovorin Calcium | Leucovorin Calcium | Ancillary Therapy | Chemoprotective | Antidote | May 1, 1996 | Apr 30, 2014 | No Longer Used | ||
| 47781-0578-07 | 47781-0578 | Dexrazoxane for Injection | Dexrazoxane | 500.0 mg/50mL | Ancillary Therapy | Chemoprotective | Detoxifying Agent | Intravenous | Sep 1, 2017 | Dec 1, 2021 | No Longer Used |
| 50742-0181-01 | 50742-0181 | Leucovorin Calcium | Leucovorin Calcium | 5.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Jul 30, 2020 | In Use | |
| 72266-0101-01 | 72266-0101 | Dexrazoxane for Injection | Dexrazoxane | 500.0 mg/50mL | Ancillary Therapy | Chemoprotective | Detoxifying Agent | Intravenous | Mar 18, 2019 | In Use | |
| 70436-0118-80 | 70436-0118 | Leucovorin calcium | Leucovorin Calcium | 200.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | Jul 10, 2023 | In Use | |
| 68083-0278-01 | 68083-0278 | Levoleucovorin | levoleucovorin | 10.0 mg/mL | Ancillary Therapy | Chemoprotective | Antidote | Intravenous | Sep 20, 2018 | In Use | |
| 50742-0181-30 | 50742-0181 | Leucovorin Calcium | Leucovorin Calcium | 5.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Jul 30, 2020 | In Use | |
| 62756-0581-42 | 62756-0581 | Amifostine | Amifostine | 50.0 mg/mL | Ancillary Therapy | Chemoprotective | Detoxifying Agent | Intravenous | Mar 14, 2008 | Mar 31, 2012 | No Longer Used |
| 47781-0622-22 | 47781-0622 | Mesna | Mesna | 100.0 mg/mL | Ancillary Therapy | Chemoprotective | Detoxifying Agent | Intravenous | Mar 29, 2018 | Mar 1, 2020 | 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 |
| 00069-0189-21 | 00069-0189 | Palbociclib | Ibrance | 125.0 mg/1 | Chemotherapy | Cyclin Dependent Kinase Inhibitor | CDK 4/6 | Oral | Feb 3, 2015 | In Use | |
| 00002-4815-54 | 00002-4815 | Abemaciclib | Verzenio | 100.0 mg/1 | Chemotherapy | Cyclin Dependent Kinase Inhibitor | CDK 4/6 | Oral | Oct 6, 2017 | In Use | |
| 00078-0874-21 | 00078-0874 | Ribociclib | Kisqali | 200.0 mg/1, 200.0 mg/1 | Chemotherapy | Cyclin Dependent Kinase Inhibitor | CDK 4/6 | Oral | Mar 13, 2017 | In Use | |
| 00078-0860-01 | 00078-0860 | Ribociclib | Kisqali | 200.0 mg/1, 200.0 mg/1 | Chemotherapy | Cyclin Dependent Kinase Inhibitor | CDK 4/6 | Oral | Mar 13, 2017 | In Use |
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