AMITRIPTYLINE HCL 12.5MG/CHLORDIAZEPOXIDE 5MG CAP (6427) VA PRODUCT (50.68)

Name	Value
NAME	AMITRIPTYLINE HCL 12.5MG/CHLORDIAZEPOXIDE 5MG CAP
VA GENERIC NAME	AMITRIPTYLINE/CHLORDIAZEPOXIDE
DOSAGE FORM	CAP,ORAL
FDA MED GUIDE	Amitriptyline-Chlordiazepoxide_(Generic)_(2022).pdf
ACTIVE INGREDIENTS	AMITRIPTYLINE HYDROCHLORIDE STRENGTH: 12.5 UNITS: MG CHLORDIAZEPOXIDE STRENGTH: 5 UNITS: MG
CS FEDERAL SCHEDULE	Schedule IV
INACTIVATION DATE	2007-09-18 00:00:00
DSS NUMBER	3
NATIONAL FORMULARY NAME	AMITRIPTYLINE/CHLORDIAZEPOXIDE CAP,ORAL
CREATE DEFAULT POSSIBLE DOSAGE	YES
CODING SYSTEM	RxNorm CODE:
COPAY TIER	COPAY TIER LEVEL: 2 COPAY EFFECTIVE DATE: 2017-02-27 00:00:00
PGX ELIGIBLE	NO
PGX SUPPRESSED	NO
VA PRINT NAME	AMITRIPTYLIN 12.5/CHLORDIAZEPOXID 5MG CP
VA PRODUCT IDENTIFIER	A0659
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	CAP
MASTER ENTRY FOR VUID	YES
VUID	4006947
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2007-09-18 00:00:00 STATUS: INACTIVE