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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
55150-0520-01 55150-0520 MESNA MESNA 100.0 mg/mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous Jan 27, 2026 In Use
53270-0101-01 53270-0101 Levoleucovorin Fusilev Ancillary Therapy Chemoprotective Antidote Aug 15, 2008 Feb 24, 2010 No Longer Used
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
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
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
83831-0148-35 83831-0148 Leucovorin calcium VYKOURA 350.0 mg/35mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Mar 16, 2026 In Use
00054-4496-13 00054-4496 Leucovorin Calcium Leucovorin Calcium 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Mar 22, 1993 In Use
42806-0134-24 42806-0134 Leucovorin Calcium Leucovorin Calcium 15.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Jan 1, 2021 In Use
25021-0828-50 25021-0828 Leucovorin calcium Leucovorin Calcium 500.0 mg/50mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Apr 15, 2018 In Use
68152-0112-01 68152-0112 levoleucovorin KHAPZORY 175.0 mg/3.5mL Ancillary Therapy Chemoprotective Antidote Intravenous Jan 2, 2019 In Use
00143-9558-01 00143-9558 Levoleucovorin Levoleucovorin 50.0 mg/5mL Ancillary Therapy Chemoprotective Antidote Intravenous Jul 7, 2016 In Use
68083-0195-01 68083-0195 Dexrazoxane for Injection Dexrazoxane 500.0 mg/50mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous Dec 5, 2016 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
68001-0648-36 68001-0648 Leucovorin Calcium Leucovorin Calcium 100.0 mg/10mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Aug 14, 2025 In Use
54868-3310-02 54868-3310 Leucovorin Calcium Leucovorin Calcium 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Apr 15, 2002 In Use
50742-0183-24 50742-0183 Leucovorin Calcium Leucovorin Calcium 15.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Jul 30, 2020 In Use
25021-0815-67 25021-0815 Leucovorin Calcium Leucovorin Calcium 200.0 mg/20mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Dec 1, 2013 Sep 30, 2020 In Use
54868-3310-01 54868-3310 Leucovorin Calcium Leucovorin Calcium 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Apr 15, 2002 In Use
51079-0582-05 51079-0582 Leucovorin Calcium Leucovorin Calcium 25.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Aug 27, 1997 Jun 30, 2023 No Longer Used
68001-0417-37 68001-0417 Leucovorin Calcium Leucovorin Calcium 200.0 mg/20mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Sep 26, 2019 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
69315-0185-12 69315-0185 Leucovorin calcium Leucovorin calcium 10.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Nov 16, 2020 In Use
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
50633-0210-11 50633-0210 Glucarpidase Voraxaze 1000.0 [USP'U]/1 Ancillary Therapy Chemoprotective Antidote Intravenous Apr 1, 2012 In Use
70860-0209-10 70860-0209 Mesna Mesna 100.0 mg/mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous Feb 28, 2018 In Use

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