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    NDC 00054-0210-25 Protriptyline Hydrochloride 5 mg/1 Details

    Protriptyline Hydrochloride 5 mg/1

    Protriptyline Hydrochloride is a ORAL TABLET in the HUMAN PRESCRIPTION DRUG category. It is labeled and distributed by Hikma Pharmaceuticals USA Inc.. The primary component is PROTRIPTYLINE HYDROCHLORIDE.

    Product Information

    NDC 00054-0210
    Product ID 0054-0210_472157bf-1092-42ce-891c-80d59d11b168
    Associated GPIs 58200070100305
    GCN Sequence Number 046080
    GCN Sequence Number Description protriptyline HCl TABLET 5 MG ORAL
    HIC3 H2U
    HIC3 Description TRICYCLIC ANTIDEPRESSANTS,REL.NON-SEL.REUPT-INHIB
    GCN 16556
    HICL Sequence Number 001646
    HICL Sequence Number Description PROTRIPTYLINE HCL
    Brand/Generic Generic
    Proprietary Name Protriptyline Hydrochloride
    Proprietary Name Suffix n/a
    Non-Proprietary Name Protriptyline Hydrochloride
    Product Type HUMAN PRESCRIPTION DRUG
    Dosage Form TABLET
    Route ORAL
    Active Ingredient Strength 5
    Active Ingredient Units mg/1
    Substance Name PROTRIPTYLINE HYDROCHLORIDE
    Labeler Name Hikma Pharmaceuticals USA Inc.
    Pharmaceutical Class Tricyclic Antidepressant [EPC]
    DEA Schedule n/a
    Marketing Category ANDA
    Application Number ANDA078913
    Listing Certified Through 2024-12-31

    Package

    NDC 00054-0210-25 (00054021025)

    NDC Package Code 0054-0210-25
    Billing NDC 00054021025
    Package 100 TABLET in 1 BOTTLE (0054-0210-25)
    Marketing Start Date 2008-09-16
    NDC Exclude Flag N
    Pricing Information
    Price Per Unit 2.61989
    Pricing Unit EA
    Effective Date 2021-02-17
    NDC Description PROTRIPTYLINE HCL 5 MG TABLET
    Pharmacy Type Indicator C/I
    OTC N
    Explanation Code 4
    Classification for Rate Setting G
    As of Date 2022-02-16
    This pricing file, entitled the NADAC (National Average Drug Acquisition Cost) files, provide state Medicaid agencies with covered outpatient drug prices by averaging survey invoice prices from retail community pharmacies across the United States. These pharmacies include independent retail community pharmacies and chain pharmacies. The prices are updated on a weekly and monthly basis