Search by Drug Name or NDC

    NDC 00169-2911-15 Xultophy 100/3.6 100; 3.6 [iU]/mL; mg/mL Details

    Xultophy 100/3.6 100; 3.6 [iU]/mL; mg/mL

    Xultophy 100/3.6 is a SUBCUTANEOUS INJECTION, SOLUTION in the HUMAN PRESCRIPTION DRUG category. It is labeled and distributed by Novo Nordisk. The primary component is INSULIN DEGLUDEC; LIRAGLUTIDE.

    Product Information

    NDC 00169-2911
    Product ID 0169-2911_be581c25-3626-46b1-b1a7-41d7467b262e
    Associated GPIs 2799100225D220
    GCN Sequence Number 073919
    GCN Sequence Number Description insulin degludec/liraglutide INSULN PEN 100-3.6/ML SUBCUT
    HIC3 C4X
    HIC3 Description ANTIHYPERGLY,INSULIN,LONG ACT-GLP-1 RECEPT.AGONIST
    GCN 38348
    HICL Sequence Number 041880
    HICL Sequence Number Description INSULIN DEGLUDEC/LIRAGLUTIDE
    Brand/Generic Brand
    Proprietary Name Xultophy 100/3.6
    Proprietary Name Suffix n/a
    Non-Proprietary Name (insulin degludec and liraglutide)
    Product Type HUMAN PRESCRIPTION DRUG
    Dosage Form INJECTION, SOLUTION
    Route SUBCUTANEOUS
    Active Ingredient Strength 100; 3.6
    Active Ingredient Units [iU]/mL; mg/mL
    Substance Name INSULIN DEGLUDEC; LIRAGLUTIDE
    Labeler Name Novo Nordisk
    Pharmaceutical Class GLP-1 Receptor Agonist [EPC], Glucagon-Like Peptide 1 [CS], Glucagon-like Peptide-1 (GLP-1) Agonists [MoA], Insulin Analog [EPC], Insulin [CS]
    DEA Schedule n/a
    Marketing Category BLA
    Application Number BLA208583
    Listing Certified Through 2024-12-31

    Package

    NDC 00169-2911-15 (00169291115)

    NDC Package Code 0169-2911-15
    Billing NDC 00169291115
    Package 5 SYRINGE, PLASTIC in 1 CARTON (0169-2911-15) / 3 mL in 1 SYRINGE, PLASTIC
    Marketing Start Date 2016-11-21
    NDC Exclude Flag N
    Pricing Information
    Price Per Unit 82.7032
    Pricing Unit ML
    Effective Date 2024-01-01
    NDC Description XULTOPHY 100 UNIT-3.6 MG/ML PEN
    Pharmacy Type Indicator C/I
    OTC N
    Explanation Code 4, 5
    Classification for Rate Setting B
    As of Date 2024-02-21
    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