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    NDC 00173-0523-00 IMITREX 20 mg/1 Details

    IMITREX 20 mg/1

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

    Product Information

    NDC 00173-0523
    Product ID 0173-0523_9cc089f2-eafa-47cb-8d41-be00fd3d55c3
    Associated GPIs 67406070002040
    GCN Sequence Number 030742
    GCN Sequence Number Description sumatriptan SPRAY 20 MG NASAL
    HIC3 H3F
    HIC3 Description ANTIMIGRAINE PREPARATIONS
    GCN 50744
    HICL Sequence Number 012779
    HICL Sequence Number Description SUMATRIPTAN
    Brand/Generic Brand
    Proprietary Name IMITREX
    Proprietary Name Suffix n/a
    Non-Proprietary Name sumatriptan
    Product Type HUMAN PRESCRIPTION DRUG
    Dosage Form SPRAY
    Route NASAL
    Active Ingredient Strength 20
    Active Ingredient Units mg/1
    Substance Name SUMATRIPTAN
    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 NDA020626
    Listing Certified Through 2024-12-31

    Package

    NDC 00173-0523-00 (00173052300)

    NDC Package Code 0173-0523-00
    Billing NDC 00173052300
    Package 6 CONTAINER in 1 BOX (0173-0523-00) / 1 SPRAY in 1 CONTAINER
    Marketing Start Date 1997-09-18
    NDC Exclude Flag N
    Pricing Information
    Price Per Unit 88.9863
    Pricing Unit EA
    Effective Date 2023-11-22
    NDC Description IMITREX 20 MG NASAL SPRAY
    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