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NDC-11 (Package) NDC-9 (Product) Generic Name Brand Name Strength SEER*Rx Category Major Class Minor Class Administration Route (Descending) Package Effective Date Package Discontinuation Date Status
70518-2711-00 70518-2711 Methotrexate Sodium Methotrexate Sodium 2.5 mg/1 Chemotherapy Antimetabolite Folic Acid Analog Oral April 27, 2020 In Use
75840-0111-00 75840-0111 Methotrexate sodium Methotrexate Sodium 2.5 mg/1 Chemotherapy Antimetabolite Folic Acid Analog Oral Oct. 1, 2012 In Use
75840-0111-01 75840-0111 Methotrexate sodium Methotrexate Sodium 2.5 mg/1 Chemotherapy Antimetabolite Folic Acid Analog Oral Oct. 1, 2012 In Use
76189-0113-18 76189-0113 Brigatinib Alunbrig 30.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor ALK/ROS1/ EGFR Oral April 28, 2017 Dec. 12, 2020 No Longer Used
76189-0113-21 76189-0113 Brigatinib Alunbrig 30.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor ALK/ROS1/ EGFR Oral April 28, 2017 Dec. 12, 2020 No Longer Used
76189-0533-30 76189-0533 Ponatinib Hydrochloride Iclusig 30.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral April 22, 2015 July 26, 2020 No Longer Used
76189-0534-30 76189-0534 Ponatinib Hydrochloride Iclusig 45.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Dec. 14, 2012 July 26, 2020 No Longer Used
76189-0534-90 76189-0534 Ponatinib Hydrochloride Iclusig 45.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Dec. 14, 2012 July 26, 2020 No Longer Used
76189-0535-30 76189-0535 Ponatinib Hydrochloride Iclusig 15.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Dec. 14, 2012 July 26, 2020 No Longer Used
76189-0535-60 76189-0535 Ponatinib Hydrochloride Iclusig 15.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Dec. 14, 2012 July 26, 2020 No Longer Used
76189-0535-80 76189-0535 Ponatinib Hydrochloride Iclusig 15.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor BCR-ABL Oral Dec. 14, 2012 July 26, 2020 No Longer Used
00054-0482-13 00054-0482 Everolimus Everolimus 10.0 mg/1 Chemotherapy Enzyme Inhibitor mTOR Oral Dec. 7, 2021 In Use
00009-0050-02 00009-0050 Medroxyprogesterone Acetate Provera 10.0 mg/1 Hormonal Therapy Progestin Oral Dec. 1, 1959 Nov. 30, 2021 In Use
00009-0050-11 00009-0050 Medroxyprogesterone Acetate Provera 10.0 mg/1 Hormonal Therapy Progestin Oral Dec. 1, 1959 Nov. 30, 2021 In Use
00093-7290-01 00093-7290 Raloxifene Hydrochloride Raloxifene Hydrochloride 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral March 28, 2014 In Use
00093-7290-10 00093-7290 Raloxifene Hydrochloride Raloxifene Hydrochloride 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral March 28, 2014 April 30, 2018 In Use
00093-7290-56 00093-7290 Raloxifene Hydrochloride Raloxifene Hydrochloride 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral March 28, 2014 In Use
00179-0224-01 00179-0224 Tamoxifen Citrate Tamoxifen Citrate 10.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Jan. 12, 2017 Feb. 29, 2020 No Longer Used
00378-8170-91 00378-8170 Dronabinol Dronabinol 2.5 mg/1 Ancillary Therapy Antiemetic CB1/CB2 Oral Nov. 1, 2011 March 31, 2016 No Longer Used
00378-8171-91 00378-8171 Dronabinol Dronabinol 5.0 mg/1 Ancillary Therapy Antiemetic CB1/CB2 Oral Nov. 1, 2011 June 30, 2016 No Longer Used
00378-8172-91 00378-8172 Dronabinol Dronabinol 10.0 mg/1 Ancillary Therapy Antiemetic CB1/CB2 Oral Nov. 1, 2011 May 31, 2016 No Longer Used
00009-0064-04 00009-0064 Medroxyprogesterone Acetate Provera 2.5 mg/1 Hormonal Therapy Progestin Oral June 3, 1959 April 30, 2020 In Use
00009-0064-06 00009-0064 Medroxyprogesterone Acetate Provera 2.5 mg/1 Hormonal Therapy Progestin Oral June 3, 1959 April 23, 2007 In Use
00009-0286-03 00009-0286 Medroxyprogesterone Acetate Provera 5.0 mg/1 Hormonal Therapy Progestin Oral June 3, 1959 June 30, 2019 In Use
59572-0402-00 59572-0402 Lenalidomide Revlimid 2.5 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral May 9, 2012 In Use
59572-0402-28 59572-0402 Lenalidomide Revlimid 2.5 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral May 9, 2012 In Use
59572-0405-00 59572-0405 Lenalidomide Revlimid 5.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Dec. 27, 2005 In Use
59572-0405-28 59572-0405 Lenalidomide Revlimid 5.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 3, 2009 In Use
59572-0410-00 59572-0410 Lenalidomide Revlimid 10.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral Dec. 27, 2005 In Use
59572-0410-28 59572-0410 Lenalidomide Revlimid 10.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 3, 2009 In Use
59572-0415-00 59572-0415 Lenalidomide Revlimid 15.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral July 7, 2006 In Use
59572-0415-21 59572-0415 Lenalidomide Revlimid 15.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral July 7, 2006 In Use
59572-0420-00 59572-0420 Lenalidomide Revlimid 20.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral June 10, 2013 In Use
59572-0420-21 59572-0420 Lenalidomide Revlimid 20.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral June 10, 2013 In Use
59572-0425-00 59572-0425 Lenalidomide Revlimid 25.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral July 7, 2006 In Use
59572-0425-21 59572-0425 Lenalidomide Revlimid 25.0 mg/1 Immunotherapy Immunomodulator Thalidomide Analog Oral March 3, 2009 In Use
00078-0672-01 00078-0672 Topotecan Hydrochloride Hycamtin 0.25 mg/1 Chemotherapy Topoisomerase I Inhibitor Camptothecin Analogs Oral July 7, 2017 In Use
00078-0673-01 00078-0673 Topotecan Hydrochloride Hycamtin 1.0 mg/1 Chemotherapy Topoisomerase I Inhibitor Camptothecin Analogs Oral Feb. 24, 2017 In Use
00378-7096-01 00378-7096 Bromocriptine Mesylate Bromocriptine Mesylate 5.0 mg/1 Chemotherapy Dopamine Agonist Ergot Derivative Oral July 1, 2013 In Use
00378-7096-93 00378-7096 Bromocriptine Mesylate Bromocriptine Mesylate 5.0 mg/1 Chemotherapy Dopamine Agonist Ergot Derivative Oral June 17, 2013 In Use
00597-0141-30 00597-0141 Afatinib Gilotrif 20.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor EGFR Oral Aug. 13, 2013 In Use
00904-6012-60 00904-6012 METHOTREXATE Methotrexate 2.5 mg/1 Chemotherapy Antimetabolite Folic Acid Analog Oral June 1, 2009 March 31, 2015 No Longer Used
16729-0072-12 16729-0072 Capecitabine Capecitabine 150.0 mg/1 Chemotherapy Antimetabolite Pyrimidine Analog Oral June 9, 2015 In Use
16729-0073-29 16729-0073 Capecitabine Capecitabine 500.0 mg/1 Chemotherapy Antimetabolite Pyrimidine Analog Oral May 20, 2015 In Use
42388-0014-25 42388-0014 Cabozantinib COMETRIQ 20.0 mg/1 Chemotherapy Tyrosine Kinase Inhibitor VEGFR Oral Nov. 29, 2012 May 31, 2016 No Longer Used
50881-0010-01 50881-0010 Ruxolitinib Jakafi 10.0 mg/1 Chemotherapy Enzyme Inhibitor JAK 1 and JAK 2 (Janus Kinase Inhibitor) Oral Nov. 16, 2011 In Use
50881-0010-60 50881-0010 Ruxolitinib Jakafi 10.0 mg/1 Chemotherapy Enzyme Inhibitor JAK 1 and JAK 2 (Janus Kinase Inhibitor) Oral Nov. 16, 2011 In Use
51285-0366-01 51285-0366 Methotrexate Trexall 5.0 mg/1 Chemotherapy Antimetabolite Folic Acid Analog Oral May 3, 2001 In Use
51285-0367-01 51285-0367 Methotrexate Trexall 7.5 mg/1 Chemotherapy Antimetabolite Folic Acid Analog Oral May 3, 2001 In Use
51285-0368-01 51285-0368 Methotrexate Trexall 10.0 mg/1 Chemotherapy Antimetabolite Folic Acid Analog Oral May 3, 2001 In Use

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