DOXEPIN 3MG TAB,UD (21873)    VA PRODUCT (50.68)

Name Value
NAME DOXEPIN 3MG TAB,UD
VA GENERIC NAME DOXEPIN
DOSAGE FORM TAB
FDA MED GUIDE Doxepin_Tab_(Generic)_(2020).pdf
FORMULARY DESIGNATOR PA-F
FORMULARY DESIGNATOR TEXT
For patients >65 with insomnia characterized by sleep maintenance difficulties; or < 65 years of age with insomnia characterized by sleep maintenance difficulties with demonstrated intolerance to 10 mg cap. CBT-I remains the first-line therapy.
ACTIVE INGREDIENTS
NATIONAL FORMULARY INDICATOR YES
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 3
SINGLE/MULTI SOURCE PRODUCT Single source
INACTIVATION DATE 2016-01-22 00:00:00
UNITS MG
NATIONAL FORMULARY NAME DOXEPIN TAB
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 DOXEPIN 3MG TAB UD
VA PRODUCT IDENTIFIER D0860
TRANSMIT TO CMOP NO
VA DISPENSE UNIT TAB
MASTER ENTRY FOR VUID YES
VUID 4030072
EFFECTIVE DATE/TIME
  • 2010-09-08 00:00:00
    STATUS:   ACTIVE