IPECAC 0.17MIN/P-EPHRINE 5MG/K GUAIACOLSULF 44MG/PROMETH 5MG/5ML (6910) VA PRODUCT (50.68)

Name	Value
NAME	IPECAC 0.17MIN/P-EPHRINE 5MG/K GUAIACOLSULF 44MG/PROMETH 5MG/5ML
VA GENERIC NAME	IPECAC/PHENYLEPHRINE/POTASSIUM GUAIACOLSULFONATE/PROMETHAZINE
DOSAGE FORM	SYRUP
DOT SHIPPING CODE
ACTIVE INGREDIENTS	POTASSIUM GUAIACOLSULFONATE STRENGTH: 44 UNITS: MG/5ML ALCOHOL STRENGTH: 7 UNITS: % IPECAC FLUIDEXTRACT STRENGTH: 0.17 UNITS: MIN/5ML CITRIC ACID,ANHYDROUS STRENGTH: 60 UNITS: MG/5ML PHENYLEPHRINE HYDROCHLORIDE STRENGTH: 5 UNITS: MG/5ML PROMETHAZINE HYDROCHLORIDE STRENGTH: 5 UNITS: MG/5ML SODIUM CITRATE STRENGTH: 197 UNITS: MG/5ML
CS FEDERAL SCHEDULE	Unscheduled
INACTIVATION DATE	2004-11-18 00:00:00
DSS NUMBER	1
NATIONAL FORMULARY NAME	IPECAC/PHENYLEPHRINE/POTASSIUM GUAIACOLSULFONATE/PROMETHAZINE SYRUP
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
TRANSMIT TO CMOP	NO
MASTER ENTRY FOR VUID	NO
VUID	4007422
EFFECTIVE DATE/TIME	2004-11-18 00:00:00 STATUS: INACTIVE 2005-12-06 00:00:00 STATUS: INACTIVE 2005-12-08 00:00:00 STATUS: INACTIVE