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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
00143-9553-01 00143-9553 Leucovorin Calcium Leucovorin Calcium 200.0 mg/20mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous May 23, 1995 In Use
68083-0388-01 68083-0388 Dexrazoxane for Injection Dexrazoxane 250.0 mg/25mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous Dec 16, 2019 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
10019-0953-02 10019-0953 Mesna Mesna 100.0 mg/mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous Dec 30, 1988 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
42806-0133-21 42806-0133 Leucovorin Calcium Leucovorin Calcium 10.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Jan 1, 2021 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
00054-4496-13 00054-4496 Leucovorin Calcium Leucovorin Calcium 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Mar 22, 1993 In Use
00054-4496-25 00054-4496 Leucovorin Calcium Leucovorin Calcium 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Mar 22, 1993 In Use
68001-0417-37 68001-0417 Leucovorin Calcium Leucovorin Calcium 200.0 mg/20mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Sep 26, 2019 In Use
25021-0201-66 25021-0201 Mesna Mesna 100.0 mg/mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous Apr 30, 2013 Aug 31, 2016 In Use
69315-0186-24 69315-0186 Leucovorin calcium Leucovorin calcium 15.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Nov 16, 2020 In Use
68152-0101-00 68152-0101 Levoleucovorin Fusilev 50.0 mg/5mL Ancillary Therapy Chemoprotective Antidote Intravenous Aug 15, 2008 Feb 28, 2019 No Longer Used
71288-0160-10 71288-0160 Leucovorin calcium Leucovorin calcium 50.0 mg/5mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Jul 19, 2023 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
72266-0120-01 72266-0120 Levoleucovorin levoleucovorin 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intravenous Jun 25, 2019 In Use
25021-0201-68 25021-0201 Mesna Mesna 100.0 mg/mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous Apr 30, 2013 Sep 13, 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
70121-1572-01 70121-1572 Levoleucovorin Levoleucovorin Calcium 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intravenous Sep 8, 2017 In Use
55390-0051-10 55390-0051 Leucovorin Calcium Leucovorin Calcium Ancillary Therapy Chemoprotective Antidote May 1, 1996 Aug 31, 2013 No Longer Used
71288-0163-30 71288-0163 Leucovorin calcium Leucovorin calcium 350.0 mg/17.5mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Jul 19, 2023 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
70436-0116-82 70436-0116 Leucovorin calcium Leucovorin Calcium 50.0 mg/1 Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Jul 10, 2023 In Use
38423-0110-01 38423-0110 Dexrazoxane Hydrochloride Totect Ancillary Therapy Chemoprotective Detoxifying Agent Oct 16, 2007 Jul 31, 2014 No Longer Used
00143-9558-01 00143-9558 Levoleucovorin Levoleucovorin 50.0 mg/5mL Ancillary Therapy Chemoprotective Antidote Intravenous Jul 7, 2016 In Use

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