| 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 | |
| 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 |
| 68001-0285-22 | 68001-0285 | Leucovorin Calcium | Leucovorin | 10.0 mg/mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | Jul 1, 2016 | Feb 1, 2021 | No Longer Used |
| 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 |
| 63323-0710-50 | 63323-0710 | Leucovorin Calcium | Leucovorin Calcium | 200.0 mg/20mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | Sep 18, 2010 | In Use | |
| 71205-0908-00 | 71205-0908 | LEUCOVORIN CALCIUM | LEUCOVORIN CALCIUM | 5.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Jul 16, 2021 | 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 | |
| 50742-0495-25 | 50742-0495 | Levoleucovorin | LEVOLEUCOVORIN | 10.0 mg/mL | Ancillary Therapy | Chemoprotective | Antidote | Intravenous | May 8, 2018 | Jun 30, 2021 | In Use |
| 68083-0278-01 | 68083-0278 | Levoleucovorin | levoleucovorin | 10.0 mg/mL | Ancillary Therapy | Chemoprotective | Antidote | Intravenous | Sep 20, 2018 | In Use | |
| 68001-0285-39 | 68001-0285 | Leucovorin Calcium | Leucovorin | 10.0 mg/mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | Jul 1, 2016 | Oct 25, 2016 | No Longer Used |
| 00143-9555-01 | 00143-9555 | Leucovorin Calcium | Leucovorin Calcium | 50.0 mg/5mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | Sep 14, 1987 | In Use | |
| 69315-0187-25 | 69315-0187 | Leucovorin calcium | Leucovorin calcium | 25.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Nov 16, 2020 | 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 | |
| 69315-0184-01 | 69315-0184 | Leucovorin calcium | Leucovorin calcium | 5.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Nov 16, 2020 | In Use | |
| 00703-5145-91 | 00703-5145 | Leucovorin Calcium | Leucovorin Calcium | 350.0 mg/17.5mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | May 13, 2013 | Apr 30, 2023 | No Longer Used |
| 16714-0890-01 | 16714-0890 | LEVOLEUCOVORIN | LEVOLEUCOVORIN | 175.0 mg/17.5mL | Ancillary Therapy | Chemoprotective | Antidote | Intravenous | Sep 26, 2018 | In Use | |
| 69468-0151-04 | 69468-0151 | Uridine Triacetate | Vistogard | 951.0 mg/g | Ancillary Therapy | Chemoprotective | Antidote | Oral | Mar 1, 2016 | In Use | |
| 68001-0285-36 | 68001-0285 | Leucovorin Calcium | Leucovorin | 10.0 mg/mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | Jul 1, 2016 | Feb 1, 2021 | No Longer Used |
| 68001-0649-37 | 68001-0649 | Leucovorin Calcium | Leucovorin Calcium | 200.0 mg/20mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | May 10, 2025 | 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 | |
| 50742-0494-17 | 50742-0494 | Levoleucovorin | LEVOLEUCOVORIN | 10.0 mg/mL | Ancillary Therapy | Chemoprotective | Antidote | Intravenous | May 8, 2018 | Jul 31, 2021 | In Use |
| 68001-0285-40 | 68001-0285 | Leucovorin Calcium | Leucovorin | 10.0 mg/mL | Ancillary Therapy | Chemoprotective | Antidote | Intramuscular, Intravenous | Jul 1, 2016 | Feb 1, 2021 | No Longer Used |
| 70518-3615-00 | 70518-3615 | HYDROXYUREA | HYDROXYUREA | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Jan 10, 2023 | In Use | |
| 67184-0607-01 | 67184-0607 | HYDROXYUREA | HYDROXYUREA | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Mar 6, 2024 | In Use | |
| 54868-4773-01 | 54868-4773 | Hydroxyurea | Hydroxyurea | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Apr 11, 2003 | In Use |
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