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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
68001-0648-36 68001-0648 Leucovorin Calcium Leucovorin Calcium 100.0 mg/10mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous May 10, 2025 In Use
63323-0710-59 63323-0710 Leucovorin Calcium Leucovorin Calcium 200.0 mg/20mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Sep 18, 2010 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
25021-0828-50 25021-0828 Leucovorin calcium Leucovorin Calcium 500.0 mg/50mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Apr 15, 2018 In Use
25021-0201-10 25021-0201 Mesna Mesna 100.0 mg/mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous Dec 1, 2010 In Use
00054-4498-10 00054-4498 Leucovorin Calcium Leucovorin Calcium 15.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Feb 22, 1993 In Use
50633-0210-11 50633-0210 Glucarpidase Voraxaze 1000.0 [USP'U]/1 Ancillary Therapy Chemoprotective Antidote Intravenous Apr 1, 2012 In Use
47781-0622-91 47781-0622 Mesna Mesna 100.0 mg/mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous Mar 29, 2018 Mar 1, 2020 In Use
00555-0484-02 00555-0484 Leucovorin Calcium Leucovorin Calcium 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Jun 30, 1990 In Use
68152-0102-02 68152-0102 Levoleucovorin Fusilev 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intravenous Sep 15, 2011 Feb 28, 2019 No Longer Used
76126-0075-01 76126-0075 Mesna Mesna 100.0 mg/mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous Jul 19, 2014 Sep 1, 2017 No Longer Used
10019-0953-01 10019-0953 Mesna Mesna 100.0 mg/mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous Dec 30, 1988 In Use
00143-9555-01 00143-9555 Leucovorin Calcium Leucovorin Calcium 50.0 mg/5mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Sep 14, 1987 In Use
50742-0354-01 50742-0354 MESNA MESNA 400.0 mg/1 Ancillary Therapy Chemoprotective Detoxifying Agent Oral Jan 14, 2025 In Use
55390-0826-01 55390-0826 Leucovorin Calcium Leucovorin Calcium Ancillary Therapy Chemoprotective Antidote Sep 28, 2001 Jun 30, 2013 No Longer Used
55390-0266-01 55390-0266 Mesna Mesna Ancillary Therapy Chemoprotective Detoxifying Agent Jan 9, 2004 Jul 31, 2012 No Longer Used
50742-0494-17 50742-0494 Levoleucovorin LEVOLEUCOVORIN 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intravenous May 8, 2018 Jul 31, 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
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
25021-0815-30 25021-0815 Leucovorin Calcium Leucovorin Calcium 200.0 mg/20mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Sep 15, 2012 In Use
55390-0052-10 55390-0052 Leucovorin Calcium Leucovorin Calcium Ancillary Therapy Chemoprotective Antidote May 1, 1996 Aug 31, 2014 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
55390-0054-01 55390-0054 Leucovorin Calcium Leucovorin Calcium Ancillary Therapy Chemoprotective Antidote Jun 8, 2000 Feb 28, 2015 No Longer Used
55390-0308-03 55390-0308 Amifostine Amifostine 500.0 mg/10mL Ancillary Therapy Chemoprotective Detoxifying Agent Intravenous Apr 2, 2008 Dec 31, 2018 No Longer Used
52125-0018-02 52125-0018 Leucovorin Calcium Leucovorin Calcium 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Jul 18, 2012 Jul 19, 2013 No Longer Used

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