B-DONNA 0.25MG/CAFN 100MG/ERGOTAMINE 2MG/P-BARB 60MG SUPP,RTL (9841) VA PRODUCT (50.68)

Name	Value
NAME	B-DONNA 0.25MG/CAFN 100MG/ERGOTAMINE 2MG/P-BARB 60MG SUPP,RTL
VA GENERIC NAME	BELLADONNA/CAFFEINE/ERGOTAMINE/PHENOBARBITAL
DOSAGE FORM	SUPP,RTL
ACTIVE INGREDIENTS	ERGOTAMINE TARTRATE STRENGTH: 2 UNITS: MG BELLADONNA ALKALOIDS STRENGTH: 0.25 UNITS: MG PHENOBARBITAL STRENGTH: 60 UNITS: MG CAFFEINE STRENGTH: 100 UNITS: MG
CS FEDERAL SCHEDULE	Unscheduled
INACTIVATION DATE	2007-09-18 00:00:00
DSS NUMBER	1
NATIONAL FORMULARY NAME	BELLADONNA/CAFFEINE/ERGOTAMINE/PHENOBARBITAL SUPP,RTL
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	4010241
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2007-09-18 00:00:00 STATUS: INACTIVE