PROMETHAZINE VC W/CODEINE SYRUP (7173) VA PRODUCT (50.68)

Name	Value
NAME	PROMETHAZINE VC W/CODEINE SYRUP
VA GENERIC NAME	CODEINE/IPECAC/PHENYLEPHRINE/POTASSIUM/PROMETHAZINE
DOSAGE FORM	SYRUP
DOT SHIPPING CODE
ACTIVE INGREDIENTS	POTASSIUM GUAIACOLSULFONATE STRENGTH: 44 UNITS: MG ALCOHOL STRENGTH: 7 UNITS: % IPECAC FLUIDEXTRACT STRENGTH: 0.17 UNITS: MIN PHENYLEPHRINE HYDROCHLORIDE STRENGTH: 5 UNITS: MG PROMETHAZINE HYDROCHLORIDE STRENGTH: 5 UNITS: MG CODEINE PHOSPHATE STRENGTH: 10 UNITS: MG
CS FEDERAL SCHEDULE	Unscheduled
INACTIVATION DATE	2007-09-27 00:00:00
DSS NUMBER	2
NATIONAL FORMULARY NAME	CODEINE/IPECAC/PHENYLEPHRINE/POTASSIUM/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	YES
VUID	4007683
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2007-09-27 00:00:00 STATUS: INACTIVE