ABACAVIR SO4 600MG/DOLUTEGRAVIR 50MG/LAMIVUDINE 300MG TAB (25023) VA PRODUCT (50.68)

Name	Value
NAME	ABACAVIR SO4 600MG/DOLUTEGRAVIR 50MG/LAMIVUDINE 300MG TAB
VA GENERIC NAME	ABACAVIR/DOLUTEGRAVIR/LAMIVUDINE
DOSAGE FORM	TAB
FDA MED GUIDE	Abacavir-Dolutegravir-Lamivudine_(Triumeq)_(Oct_2022).pdf
FORMULARY DESIGNATOR	PA-F
FORMULARY DESIGNATOR TEXT	Restricted to HIV/ID (or facility designated/authorized provider)
ACTIVE INGREDIENTS	LAMIVUDINE STRENGTH: 300 UNITS: MG ABACAVIR SULFATE STRENGTH: 600 UNITS: MG DOLUTEGRAVIR STRENGTH: 50 UNITS: MG
NATIONAL FORMULARY INDICATOR	YES
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Multisource
NATIONAL FORMULARY NAME	ABACAVIR/DOLUTEGRAVIR/LAMIVUDINE 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	YES
PGX SUPPRESSED	NO
VA PRINT NAME	ABACAV/DOLUTEGR/LAMIVUD 600/50/300MG TAB
VA PRODUCT IDENTIFIER	A1763
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	TAB
MASTER ENTRY FOR VUID	YES
VUID	4033678
EFFECTIVE DATE/TIME	2014-09-15 00:00:00 STATUS: ACTIVE