EMPAGLIFLOZIN 25/LINAGLIPTIN 5/METFORMIN 1000MG TAB,SA (29998) VA PRODUCT (50.68)

Name	Value
NAME	EMPAGLIFLOZIN 25/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	METFORMIN HYDROCHLORIDE STRENGTH: 1000 UNITS: MG LINAGLIPTIN STRENGTH: 5 UNITS: MG EMPAGLIFLOZIN STRENGTH: 25 UNITS: MG
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 25/5/1000MG 24HR SA TAB
VA PRODUCT IDENTIFIER	T1058
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	TAB
MASTER ENTRY FOR VUID	YES
VUID	4039227
EFFECTIVE DATE/TIME	2020-03-19 00:00:00 STATUS: ACTIVE