STAVUDINE (d4T) 20MG CAP (12112)    VA PRODUCT (50.68)

Name Value
NAME STAVUDINE (d4T) 20MG CAP
VA GENERIC NAME STAVUDINE (d4T)
DOSAGE FORM CAP,ORAL
FDA MED GUIDE Stavudine_Cap_(Generic)_(2018).pdf
FORMULARY DESIGNATOR PA-F
FORMULARY DESIGNATOR TEXT 
Restricted to HIV/ID (or facility designated/authorized provider)
ACTIVE INGREDIENTS
NATIONAL FORMULARY INDICATOR YES
NATIONAL FORMULARY RESTRICTION 
Refer to HIV/AIDS TAG treatment guidelines
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 20
SINGLE/MULTI SOURCE PRODUCT Multisource
UNITS MG
DSS NUMBER 2
NATIONAL FORMULARY NAME STAVUDINE (DT4) CAP,ORAL
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   2
    COPAY EFFECTIVE DATE:   2017-02-27 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME STAVUDINE (d4T) 20MG CAP
VA PRODUCT IDENTIFIER S0158
TRANSMIT TO CMOP NO
VA DISPENSE UNIT CAP
MASTER ENTRY FOR VUID YES
VUID 4012478
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE
  • 2007-04-14 00:00:00
    STATUS:   INACTIVE
  • 2007-04-25 00:00:00
    STATUS:   ACTIVE