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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
67457-0528-10 67457-0528 LEUCOVORIN CALCIUM LEUCOVORIN CALCIUM 100.0 mg/10mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Jul 23, 2019 In Use
00703-5145-01 00703-5145 Leucovorin Calcium Leucovorin Calcium 350.0 mg/17.5mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Jun 12, 1997 Sep 30, 2023 No Longer Used
55390-0825-01 55390-0825 Leucovorin Calcium Leucovorin Calcium Ancillary Therapy Chemoprotective Antidote Sep 28, 2001 May 31, 2013 No Longer Used
00054-4498-10 00054-4498 Leucovorin Calcium Leucovorin Calcium 15.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Feb 22, 1993 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
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
50742-0464-50 50742-0464 Leucovorin Calcium Leucovorin Calcium 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Nov 23, 2018 In Use
70121-1099-01 70121-1099 Levoleucovorin Levoleucovorin 50.0 mg/1 Ancillary Therapy Chemoprotective Antidote Intravenous Feb 13, 2017 In Use
50742-0182-24 50742-0182 Leucovorin Calcium Leucovorin Calcium 10.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Jul 30, 2020 In Use
72266-0120-01 72266-0120 Levoleucovorin levoleucovorin 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intravenous Jun 25, 2019 In Use
70436-0120-80 70436-0120 Leucovorin calcium Leucovorin Calcium 500.0 mg/1 Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Jul 10, 2023 In Use
72266-0121-01 72266-0121 Levoleucovorin levoleucovorin 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intravenous Jun 25, 2019 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
68001-0416-36 68001-0416 Leucovorin Calcium Leucovorin Calcium 100.0 mg/10mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Sep 26, 2019 In Use
68083-0279-01 68083-0279 Levoleucovorin levoleucovorin 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intravenous Sep 20, 2018 In Use
45963-0762-57 45963-0762 Levoleucovorin Levoleucovorin 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intravenous Feb 14, 2017 Jul 31, 2019 In Use
25021-0814-30 25021-0814 Leucovorin Calcium Leucovorin Calcium 100.0 mg/10mL Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Sep 15, 2012 In Use
42806-0358-01 42806-0358 Leucovorin Calcium Leucovorin Calcium 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Apr 16, 2020 In Use
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
71205-0908-90 71205-0908 LEUCOVORIN CALCIUM LEUCOVORIN CALCIUM 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Jul 16, 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
43598-0771-11 43598-0771 LEVOLEUCOVORIN LEVOLEUCOVORIN 175.0 mg/17.5mL Ancillary Therapy Chemoprotective Antidote Intravenous Sep 26, 2018 In Use
55390-0826-01 55390-0826 Leucovorin Calcium Leucovorin Calcium Ancillary Therapy Chemoprotective Antidote Sep 28, 2001 Jun 30, 2013 No Longer Used
70436-0118-80 70436-0118 Leucovorin calcium Leucovorin Calcium 200.0 mg/1 Ancillary Therapy Chemoprotective Antidote Intramuscular, Intravenous Jul 10, 2023 In Use
42806-0133-21 42806-0133 Leucovorin Calcium Leucovorin Calcium 10.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral Jan 1, 2021 In Use

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