NDC-11 (Package) | NDC-9 (Product) | Generic Name | Brand Name | Strength | SEER*Rx Category | Major Class (Ascending) | Minor Class | Administration Route | Package Effective Date | Package Discontinuation Date | Status |
---|---|---|---|---|---|---|---|---|---|---|---|
50742-0183-24 | 50742-0183 | Leucovorin Calcium | Leucovorin Calcium | 15.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | July 30, 2020 | In Use | |
50742-0184-25 | 50742-0184 | Leucovorin Calcium | Leucovorin Calcium | 25.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | July 30, 2020 | In Use | |
76310-0017-50 | 76310-0017 | Amifostine | Ethyol | 500.0 mg/10mL | Ancillary Therapy | Chemoprotective | Detoxifying Agent | Intravenous | Jan. 1, 2020 | In Use | |
72893-0004-01 | 72893-0004 | Levoleucovorin | KHAPZORY | 175.0 mg/3.5mL | Ancillary Therapy | Chemoprotective | Antidote | Intravenous | Jan. 2, 2019 | In Use | |
72893-0006-01 | 72893-0006 | Levoleucovorin | KHAPZORY | 300.0 mg/6mL | Ancillary Therapy | Chemoprotective | Antidote | Intravenous | Jan. 2, 2019 | In Use | |
71288-0105-18 | 71288-0105 | Levoleucovorin calcium | Levoleucovorin | 10.0 mg/mL | Ancillary Therapy | Chemoprotective | Antidote | Intravenous | Aug. 16, 2019 | In Use | |
71288-0105-25 | 71288-0105 | Levoleucovorin calcium | Levoleucovorin | 10.0 mg/mL | Ancillary Therapy | Chemoprotective | Antidote | Intravenous | Aug. 16, 2019 | 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 | |
69315-0184-03 | 69315-0184 | Leucovorin calcium | Leucovorin calcium | 5.0 mg/1 | Ancillary Therapy | Chemoprotective | Antidote | Oral | Nov. 16, 2020 | 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 |
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