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    NDC 00173-0478-00 IMITREX 6 mg/.5mL Details

    IMITREX 6 mg/.5mL

    IMITREX is a SUBCUTANEOUS INJECTION in the HUMAN PRESCRIPTION DRUG category. It is labeled and distributed by GlaxoSmithKline LLC. The primary component is SUMATRIPTAN SUCCINATE.

    Product Information

    NDC 00173-0478
    Product ID 0173-0478_9aa62440-fca5-4d1b-a077-0955e7c7daeb
    Associated GPIs
    GCN Sequence Number 019239
    GCN Sequence Number Description sumatriptan succinate CARTRIDGE 6 MG/0.5ML SUBCUT
    HIC3 H3F
    HIC3 Description ANTIMIGRAINE PREPARATIONS
    GCN 24708
    HICL Sequence Number 006587
    HICL Sequence Number Description SUMATRIPTAN SUCCINATE
    Brand/Generic Brand
    Proprietary Name IMITREX
    Proprietary Name Suffix n/a
    Non-Proprietary Name sumatriptan
    Product Type HUMAN PRESCRIPTION DRUG
    Dosage Form INJECTION
    Route SUBCUTANEOUS
    Active Ingredient Strength 6
    Active Ingredient Units mg/.5mL
    Substance Name SUMATRIPTAN SUCCINATE
    Labeler Name GlaxoSmithKline LLC
    Pharmaceutical Class Serotonin 1b Receptor Agonists [MoA], Serotonin 1d Receptor Agonists [MoA], Serotonin-1b and Serotonin-1d Receptor Agonist [EPC]
    DEA Schedule n/a
    Marketing Category NDA
    Application Number NDA020080
    Listing Certified Through 2024-12-31

    Package

    NDC 00173-0478-00 (00173047800)

    NDC Package Code 0173-0478-00
    Billing NDC 00173047800
    Package 2 SYRINGE in 1 CARTON (0173-0478-00) / .5 mL in 1 SYRINGE
    Marketing Start Date 1997-01-27
    NDC Exclude Flag N
    Pricing Information
    Price Per Unit 442.679
    Pricing Unit ML
    Effective Date 2024-01-01
    NDC Description IMITREX 6 MG/0.5 ML CARTRIDGES
    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