TRIPTORELIN PAMOATE 3.75MG/VIL INJ,SUSP,SA (19788)    VA PRODUCT (50.68)

Name Value
NAME TRIPTORELIN PAMOATE 3.75MG/VIL INJ,SUSP,SA
VA GENERIC NAME TRIPTORELIN
DOSAGE FORM INJ,SUSP,SA
FDA MED GUIDE Triptorelin_(Triptodur)_(Dec_2022).pdf
HAZARDOUS TO DISPOSE NO
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 3.75
SINGLE/MULTI SOURCE PRODUCT Single source
UNITS MG/VIAL
NATIONAL FORMULARY NAME TRIPTORELIN INJ,SUSP,SA
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   3
    COPAY EFFECTIVE DATE:   2017-02-27 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME TRIPTORELIN 3.75MG/VIL SUSP SA INJ
VA PRODUCT IDENTIFIER T0691
TRANSMIT TO CMOP NO
VA DISPENSE UNIT VI
MASTER ENTRY FOR VUID YES
VUID 4027718
EFFECTIVE DATE/TIME
  • 2008-08-20 00:00:00
    STATUS:   ACTIVE
  • 2020-12-14 00:00:00
    STATUS:   ACTIVE
  • 2021-07-14 00:00:00
    STATUS:   ACTIVE
  • 2021-11-04 00:00:00
    STATUS:   ACTIVE