Vancomycin Hydrochloride 125 mg Capsule, 20-count — NDC 0121-0867-20 (Billing 00121-0867-20)
by PAI Holdings, LLC · 2 BLISTER PACK in 1 CARTON / 10 CAPSULE in 1 BLISTER PACK
This is a package of 20 capsules of Vancomycin Hydrochloride 125 mg Capsule from PAI Holdings, LLC, no longer marketed, no longer in the FDA NDC Directory; retail pharmacies pay about $1.44 per capsule (NADAC). It is the main listing for this product, which comes in 2 package sizes.
NDC 00121-0867-20
🏷️ FDA NDC (as labeled)
0121-0867-20
billing pads the labeler segment with a zero
This package
Also priced by: Medicaid pays $1.52/unit — full pricing hub ↓
Main listing for product 0121-0867 · Also comes in:
50 capsules 0121-0867-50
🗂️ FDA directory synced Oct 1, 2026 · this listing last changed Mar 13, 2024 · sources: openFDA · FDA label (DailyMed) · FDA Orange & Purple Book · First Databank · CMS NADAC, ASP, Medicare & Medicaid · RxNorm
📋 All sources & update times →
⚠️
Other active recalls for Vancomycin Hydrochloride (different manufacturers) — 2 · tap to view
These affect other manufacturers’ products for the same ingredient — not necessarily the exact NDC on this page.
Class II · Aug 6, 2026 — CGMP Deviations (Baxter Healthcare Corporation) · FDA recall D-0820-2026
Class II · Aug 6, 2026 — CGMP Deviations (Baxter Healthcare Corporation) · FDA recall D-0805-2026
Each entry is an official FDA enforcement report — look up any recall number in the FDA recall database ↗
⚠️
Excluded from the active FDA NDC Directory.
The labeler reported this product as discontinued, so it is excluded from the active NDC Directory. The listing was last certified through Nov 2023. A label may still appear on DailyMed, but the NDC is no longer in the current FDA NDC Directory.
Search the FDA NDC Directory ↗
Identity & classification
Regulatory identifiers FDA, NLM and CMS codes for this package
FDA NDC (as labeled)
0121-0867-20
Product NDC
0121-0867
11-digit billing NDC
00121086720
NCPDP billing unit
EA — each (per item)
Application #
ANDA210729
Chemical class
Glycopeptide Antibacterial [EPC], Glycopeptides
DEA schedule
Non-controlled
Marketing category
ANDA
Marketing status
Discontinued
FDA listing status
Discontinued by firm (certified through Nov 2023)
Route
ORAL
Dosage form
CAPSULE
Substance
VANCOMYCIN HYDROCHLORIDE
TE code (Orange Book)
AB · RLD · RS
Drug-database identifiers Medi-Span GPI and First Databank GCN / HICL / AHFS classification
GCN Seq No
009326
GCN
41370
HICL code
004042
Ingredient (HICL)
Vancomycin Hcl
HIC1 code
W
Therapeutic class — broad (HIC1)
Anti-Infecting Agents
HIC2 code
W1
Therapeutic class — intermediate (HIC2)
Antibiotics
HIC3 code
W1J
Therapeutic class — specific (HIC3)
Vancomycin Antibiotics And Derivatives
AHFS code
08:12.28.16
AHFS class
Glycopeptide Antibiotics
FDB label name
VANCOMYCIN HCL 125 MG CAPSULE
FDB brand name
Vancomycin Hcl
Legend status
F — Federal legend — prescription drug or device
Quick answers
- GSN (GCN sequence number): 009326
- GCN: 41370
- HICL (First Databank): 004042
- AHFS class code: 08:12.28.16
Why two NDCs?
The FDA registers this code as 0121-0867-20 — a 4-4-2 layout, and that's what's printed on the package and shown on DailyMed. For insurance claims, every NDC is standardized to a uniform 11-digit 5-4-2 format by adding a zero to the labeler segment → 00121-0867-20. Same drug, same package — only the format differs.
Where does this data come from?
Identifiers from the FDA openFDA NDC Directory and Structured Product Labeling; RxCUI from RxNorm (NLM); GPI from Medi-Span; GCN / HIC / AHFS / legend from First Databank.
- FDA openFDA NDC Directory · synced Oct 1, 2026
- FDA label on DailyMed · label index refreshed Oct 1, 2026
- RxNorm (NLM RxNav) · catalog refreshed Oct 1, 2026
- Medi-Span GPI (licensed)
- First Databank (licensed) · refreshed Oct 1, 2026
Clinical
Label name VANCOMYCIN HCL 125 MG CAPSULE Ingredient Vancomycin Hcl
📖 What it is MedlinePlus · NLM
Vancomycin is used to treat colitis (inflammation of the intestine caused by certain bacteria) that may occur after taking an antibiotic. Vancomycin is in a class of medications called glycopeptide antibiotics. It works by killing bacteria in the intestines. Vancomycin will not kill bacteria in any other part of the body when taken by mouth. Antibiotics such as vancomycin will not work for colds, flu, or other viral infections. Taking antibiotics when they are not needed increases your risk of getting an infection later that resists antibiotic treatment.
Read the full MedlinePlus article ↗📗 Our plain-language guide HelloPharmacist
- It is an antibiotic. By IV, it treats serious infections like bloodstream, heart valve, bone, skin and lung infections. By mouth, it treats C. difficile diarrhea and staph infectio...
- Oral capsules or liquid are usually taken 3 or 4 times a day for about 7 to 10 days. IV doses are given slowly by a healthcare team. Follow your prescriber's directions and finish...
- With oral vancomycin, nausea, stomach pain, vomiting and low potassium are most common. Call your doctor promptly for hearing changes, ringing in the ears, rash or blisters, less u...
- Yes. It can cause kidney injury and hearing problems, especially with higher levels, older age, kidney disease, or other drugs that affect these organs. Your care team may check ki...
Patient education
Supplement & herbal interactions
Some supplements/herbs that may interact with Vancomycin Hydrochloride — tap one for details:
7
Nutrient depletion considerations
Vancomycin Hydrochloride may be associated with lower levels of 7 nutrients — worth a chat with your pharmacist, not a cause for alarm.
BIOTIN
Insignificant Depletion
FOLIC ACID
Insignificant Depletion
RIBOFLAVIN
Insignificant Depletion
THIAMINE
Insignificant Depletion
VITAMIN B12
Insignificant Depletion
+2 more
An association is not a deficiency. Educational only — don't start or stop anything without professional guidance.
Where does this data come from?
Plain-language summary from MedlinePlus (U.S. National Library of Medicine); supplement & herbal interactions and nutrient depletion data from the Natural Medicines database; our full guide is HelloPharmacist editorial content.
- MedlinePlus (NLM) · refreshed Oct 1, 2026
- FDA label on DailyMed · label index refreshed Oct 1, 2026
💬 Questions about VANCOMYCIN HYDROCHLORIDE?
Ask a pharmacist →
Ask a licensed pharmacist directly — free, answered by our team.
Pricing
A drug doesn't have one price. Each row is a different public payment system, and none is what you'd pay at the counter — that depends on your insurance. The ⓘ on each row explains what it measures.
| Price system | Per ea | Per package |
|---|---|---|
| Retail pharmacies payNADAC · weekly | $1.440 | $28.79 / 20 capsules |
| Medicaid paysCMS SDUD · 12 mo | $1.52 | $30.36 / 20 capsules |
| Medicare drug plans payPart D · quarterly | No Part D plan price is available for this NDC in our data. | |
NADAC price history (per ea) — tap or hover for the price & month
▼ Down 17% over the last 15 months.
Where does this data come from?
NADAC (National Average Drug Acquisition Cost) is the CMS weekly pharmacy-acquisition-cost survey — what pharmacies pay. ASP (Average Sales Price) is the CMS Medicare Part B drug-payment file, published quarterly. Medicaid pays is computed by us from CMS State Drug Utilization Data (total reimbursed ÷ units, trailing 12 months) — gross of rebates and inclusive of dispensing fees, so it reflects what Medicaid paid, not an acquisition cost. Medicare drug plans pay is the median negotiated point-of-sale unit cost across plans listing this NDC in the CMS quarterly Prescription Drug Plan pricing files, before rebates. The VA pays is the federal contract price (FSS, and the statutory Big 4 ceiling where listed) from the VA National Acquisition Center pharmaceutical price file. All are free public government data; each measures a different payer, so the figures are not directly comparable.
- CMS NADAC weekly file · file of Feb 21, 2024
- CMS ASP pricing files · refreshed Sep 20, 2026
- CMS Medicaid State Drug Utilization Data · through Q4 2025
- CMS Part D plan pricing files · refreshed Sep 24, 2026
- VA National Acquisition Center price file
Packaging — all sizes for this product
| Package NDC | Description | Per unit | Per pack | Marketing start | Marketing end | Status |
|---|---|---|---|---|---|---|
| 00121-0867-20 You're viewing this Main listing | 2 BLISTER PACK in 1 CARTON / 10 CAPSULE in 1 BLISTER PACK | $1.44 / ea | $28.79 | 2019-07-25 | — | Discontinued by firm |
| 00121-0867-50 0121-0867-50 | 50 CAPSULE in 1 BOTTLE | $1.44 / ea | $71.98 | 2020-03-10 | — | Discontinued by firm |
This pack has the lowest per-ea cost of the 2 priced pack sizes ($1.44 NADAC).
Pack size FAQ
What quantity is in this package?
This is a 20-count package — 2 blister pack in 1 carton / 10 capsule in 1 blister pack.
How does this package differ from NDC 00121-0867-50?
Both are Vancomycin Hydrochloride 125 mg Capsule — the drug itself is identical. This page's package is the 20-count one, while NDC 00121-0867-50 is the 50 capsules package.
What NDC number is used to bill for this package of Vancomycin Hydrochloride 125 mg Capsule?
Use the 11-digit billing form listed in the identifiers section of this page. Pharmacy and medical claims use the 11-digit form; the FDA label may print a shorter form of the same code.
Prices are the latest CMS NADAC pharmacy acquisition cost per NDC; per-pack figures are per-unit × pack quantity, shown only when the pack is denominated in the same measure NADAC prices.
Therapeutic equivalents
| Product | Labeler | Pack | NADAC/unit | TE | Status | Price vs. this |
|---|---|---|---|---|---|---|
| Vancomycin Hydrochloride 125 mg 00121-1032-20 | PAI | 20 capsules | $1.329 | AB | Availability likely | save 8% |
| vancomycin hydrochloride 125 mg 23155-0858-25 | Heritage | 50 capsules | $1.329 | AB | Availability likely | save 8% |
| Vancomycin Hydrochloride 125 mg 42494-0450-20 | Cameron | 20 capsules | $1.329 | AB | Availability likely | save 8% |
| vancomycin hydrochloride 125 mg 62559-0390-20 | ANI | 20 capsules | $1.329 | AB | Availability likely | save 8% |
| vancomycin hydrochloride 125 mg 64380-0729-02 | Strides | 20 capsules | $1.329 | AB | Availability likely | save 8% |
| Vancomycin Hydrochloride 125 mgthis 00121-0867-20 | PAI | 20 capsules | $1.440 | AB | Discontinued | — |
| Vancocin 125 mg 62559-0310-20 | ANI | 20 capsules | — | AB | FDA listed | — |
| vancomycin hydrochloride 125 mg 67296-2143-04 | Redpharm | 40 capsules | — | AB | FDA listed | — |
| Vancomycin Hydrochloride 125 mg 72162-2305-04 | Bryant | 50 capsules | — | AB | FDA listed | — |
About this product: this is a generic version of the medicine. FDA equivalence ratings are shown when available, and other versions are listed above, least expensive first.
Where does this data come from?
Equivalents are other NDCs of the same ingredient, form and route from the openFDA NDC Directory, ranked least-expensive-first by NADAC. Therapeutic-equivalence (AB) ratings come from the FDA Orange Book; biologics use the FDA Purple Book for biosimilar & interchangeable status.
- FDA openFDA NDC Directory · synced Oct 1, 2026
- FDA Orange Book · refreshed Sep 3, 2026
- CMS NADAC weekly file · file of Feb 21, 2024
Availability & generic status
📍
2026
Currently FDA-listed
listed with the FDA
🔓
·
Generic on the market
this product is a generic
✅This is a generic drug
This product is an FDA-approved generic. Other versions of the same drug are listed under Therapeutic equivalents, least expensive first.
Where does this data come from?
Patents and exclusivity from the FDA Orange Book (small-molecule drugs), refreshed from public FDA data. Generic launch timing is an estimate, not a guarantee.
- FDA Orange Book · refreshed Sep 3, 2026
Inactive Ingredients / Excipients
Inactive ingredients, also called excipients, are components of the drug product other than the active ingredient. They may include fillers, dyes, coatings, preservatives, flavors, or other formulation ingredients.
We could not link this NDC to a current FDA Structured Product Label. An inactive-ingredient list is therefore not available from this source.
Where does this data come from?
Source: official FDA Structured Product Labeling (SPL) via DailyMed and the openFDA label index. Structured
IACT rows and label-wide narrative are kept separate; availability and product-level specificity depend on the submitted label.- FDA label on DailyMed · label index refreshed Oct 1, 2026
- FDA openFDA NDC Directory · synced Oct 1, 2026
Inactive ingredient FAQ
Are inactive ingredients the same for every manufacturer?
No. Inactive ingredients can differ by manufacturer, dosage form, strength, and package / product version.
Why might an inactive ingredient be missing?
Some SPLs do not provide a complete structured inactive-ingredient list, and older or unusual labels may only include the information in narrative text.
Can inactive ingredients matter?
Yes. They can matter for allergies, intolerances, dyes, gluten / lactose concerns, preservatives, and formulation differences — but confirm with a pharmacist or the manufacturer when it’s clinically important.
Manufacturer & labeler
LabelerPAI Holdings, LLC
Application holderORIENT PHARMA CO LTD
FDA applicationANDA210729 (ANDA)
Labeler code00121
Product typeHuman Prescription Drug
Portfolio5 products on file
The labeler markets the product; the application holder owns the FDA approval. They’re often the same company but can differ (e.g. a repackager or an authorized generic). A mailing address / phone appears here when the manufacturer includes it in the product’s FDA label (not all do).
Where does this data come from?
Labeler, application holder and registered establishment from the FDA openFDA NDC Directory and Drugs@FDA; address/contact from the product’s FDA label.
- FDA openFDA NDC Directory · synced Oct 1, 2026
- Drugs@FDA
Full prescribing information FDA SPL
The complete FDA label for this product — the official prescribing information, verbatim, section by section. Jump with a chip, search within the label, or expand everything.
📄 FDA label ▾
No FDA label is on file for this product yet. Labels load from openFDA / DailyMed and refresh weekly.
No label section mentions that — try another word, or open the full label on DailyMed below.
Source: FDA Structured Product Labeling, mirrored from DailyMed / openFDA.
Medicaid utilization & spend
📍 This exact package only: Medicaid data is reported per full 11-digit NDC — labeler, product and pack size — so every number here is for this package alone, not the drug overall. Other pack sizes report separately.
💊 Pharmacy benefit only: These are Medicaid outpatient pharmacy claims, billed by NDC. They exclude the medical benefit — clinic- or hospital-administered drugs billed under HCPCS J-codes — so drugs used mostly that way (e.g. Avastin, Lucentis, Keytruda) can look low or missing here. That’s expected, not an error.
📅 Q1 2025 – Q4 2025 · 4 quarters of data
ⓘ The newest quarter is usually incomplete when first published; states restate recent quarters in later CMS releases, so the latest figures typically revise upward. State coverage-policy changes can also shift quarter-to-quarter totals.
Prescriptions last 4 qtrs
89
Units reimbursed last 4 qtrs
2.9K
Gross reimbursed last 4 qtrs
$4.4K
Avg / prescription
$49.79
Avg / unit
$1.5181
Latest quarter Q4 2025
0Rx
Medicaid pays / ea
$1.5181
gross reimbursed
vs
NADAC / ea
$1.4396
acquisition cost
=
Spread
+$0.0785
+5% vs cost
What Medicaid paid per ea (before rebates; includes the pharmacy’s dispensing fee) compared with NADAC — the average price pharmacies pay to buy the drug. A positive spread means Medicaid reimbursed more than the purchase price, before manufacturer rebates.
Fee-for-service vs managed care ⓘ
Fee-for-service · 74 Rx Managed care · 15 Rx
State Medicaid map
Units reimbursed · per 100k residents
0.910.5
gray = no data reported ⓘ
Colors are per 100,000 residents, so big states don’t automatically dominate. Tap or hover a state for its actual totals.
Tap or hover a state
…for its Medicaid breakdown
Prescriptions—
Units—
Reimbursed—
🏆 Top states by units · per 100k residents
National units — by quarter
💵 About the dollar figures: “reimbursed” is what Medicaid paid pharmacies before confidential manufacturer rebates, so the program’s real net cost is lower than these numbers. Fee-for-service and managed-care claims are combined unless split above. Source: CMS State Drug Utilization Data; per-100k rates use 2023 Census population estimates.
Medicaid utilization by pack size
Medicaid (SDUD) totals over the four most recent reported quarters for every package size of this drug — handy when a specific package (e.g. a starter/titration pack) carries little or no Medicaid volume on its own.
Drug total (last 4 qtrs): 89 Rx · 2,919 units · $4,431 gross reimbursed
Tap a pack size to open its page. Source: CMS State Drug Utilization Data, last 4 quarters.
About this NDC listing & data coverage
Finished prescription product
No longer marketed (per FDA listing data)
What data is (and isn’t) available for this NDC — tap to expand
| NDC identity (package / product / labeler codes) | ✓ Available |
| Labeler | ✓ Available |
| Product & package description | ✓ Available |
| Marketing category & status | ✓ Available |
| Active ingredient / dosage form / route | ✓ Available |
| FDA label (SPL via DailyMed) | — Not published for this NDC No structured label is linked to this listing in DailyMed/openFDA. |
| Package photos | — Not published for this NDC The FDA label for this product carries no photos. |
| Inactive ingredients (structured) | — Not published for this NDC The labeler did not submit a structured excipient list, or no SPL is available. |
| NADAC pharmacy acquisition price (CMS) | ✓ Available |
| Orange Book / therapeutic-equivalence data | ✓ Available |
| HCPCS J-code billing crosswalk | — Not published for this NDC Most self-administered / retail products have no J-code — that is normal. |
| Medicaid utilization (CMS SDUD) | ✓ Available |
“Not published” reflects what the public FDA / CMS / NLM sources provide for this exact package code — it is a property of the data feeds, not a judgment about the product.
Questions about this listing
Why is there no full label on this page?
No structured FDA label (SPL) is currently linked to this NDC in DailyMed/openFDA. That can happen with older listings, certain OTC and repackaged products, and recently updated listings whose label has not yet propagated. The listing itself is still valid — this page shows everything the public feeds provide for this package.
What does the discontinued status mean for this NDC?
The labeler reported a marketing end date (or the listing was delisted), so this specific package is no longer actively marketed. Remaining stock may still be dispensed for a time, and the NDC stays valid for historical records and claims — but data feeds (pricing, labeling) typically stop updating for it. Other package sizes or other manufacturers' versions of the same medication may still be marketed — see the equivalents section where available.
Is the NDC printed on the package the same as the 11-digit billing NDC?
Yes, they identify this exact package in different formats. The form printed on the packaging and shown on DailyMed is the one the FDA registered. Insurance claims use a fixed 11-digit 5-4-2 format, so the short segment is padded with a leading zero and the dashes are dropped. The Identity section at the top of this page lists each form of this code.
Does this product come in other package sizes?
Yes — the FDA directory lists 1 other package presentation of this same product, including 50 capsules (00121-0867-50). Each has its own NDC and its own page — see the package list near the top of this page.
Who lists this product with the FDA?
PAI Holdings, LLC is the labeler of record for this NDC — the company under whose FDA-assigned code the package is listed. The labeler may be the manufacturer itself or a distributor marketing the product under its own code.
Do I need a prescription for this product?
This NDC is listed with FDA as a prescription product, so it is dispensed under a prescriber's order. Your pharmacist can tell you whether any over-the-counter forms of the same medication exist.
This page identifies an FDA-listed package (the NDC) and reports public regulatory and pricing data about the listing. It is reference information, not a medical recommendation — talk to your pharmacist or prescriber about your own medication.
Where does this data come from?
Listing facts (marketing category, packager status, marketing dates) from the FDA openFDA NDC Directory; label availability from DailyMed; pricing coverage from CMS NADAC; equivalence scope from the FDA Orange Book.
For educational and professional reference only — not medical advice. Pricing reflects published
NADAC and CMS ASP (free public data) and may differ from your acquisition cost; always verify before billing or dispensing.