EMPAGLIFLOZIN 10/LINAGLIPTIN 5/METFORMIN 1000MG TAB,SA (29997)    VA PRODUCT (50.68)

Name Value
NAME EMPAGLIFLOZIN 10/LINAGLIPTIN 5/METFORMIN 1000MG TAB,SA
VA GENERIC NAME EMPAGLIFLOZIN/LINAGLIPTIN/METFORMIN
DOSAGE FORM TAB,SA
FDA MED GUIDE Empagliflozin-Linagliptin-Metformin_SA_(Trijardy_XR)_(2021).pdf
HAZARDOUS TO DISPOSE NO
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
SINGLE/MULTI SOURCE PRODUCT Multisource
NATIONAL FORMULARY NAME EMPAGLIFLOZIN/LINAGLIPTIN/METFORMIN TAB,SA
CREATE DEFAULT POSSIBLE DOSAGE NO
POSSIBLE DOSAGES TO CREATE 1x Possible Dosage
PACKAGE Both Inpatient and Outpatient
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   3
    COPAY EFFECTIVE DATE:   2020-03-19 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME TRIJARDY 10/5/1000MG 24HR SA TAB
VA PRODUCT IDENTIFIER T1056
TRANSMIT TO CMOP NO
VA DISPENSE UNIT TAB
MASTER ENTRY FOR VUID YES
VUID 4039225
EFFECTIVE DATE/TIME
  • 2020-03-19 00:00:00
    STATUS:   ACTIVE