IRINOTECAN HCL LIPOSOME 4.3MG/ML INJ (26238)    VA PRODUCT (50.68)

Name Value
NAME IRINOTECAN HCL LIPOSOME 4.3MG/ML INJ
VA GENERIC NAME IRINOTECAN
DOSAGE FORM INJ
HAZARDOUS TO DISPOSE NO
FORMULARY DESIGNATOR TEXT 
Restrict to Hematology/Oncology
ACTIVE INGREDIENTS
NATIONAL FORMULARY INDICATOR NO
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 4.3
SINGLE/MULTI SOURCE PRODUCT Multisource
UNITS MG/ML
NATIONAL FORMULARY NAME IRINOTECAN INJ
CREATE DEFAULT POSSIBLE DOSAGE NO
POSSIBLE DOSAGES TO CREATE No Possible Dosages
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 IRINOTECAN HCL LIPOSOME 4.3MG/ML INJ
VA PRODUCT IDENTIFIER I0606
TRANSMIT TO CMOP NO
VA DISPENSE UNIT ML
MASTER ENTRY FOR VUID YES
VUID 4035036
EFFECTIVE DATE/TIME
  • 2015-11-17 00:00:00
    STATUS:   ACTIVE