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    NDC 00173-0777-02 LAMICTAL 200 mg/1 Details

    LAMICTAL 200 mg/1

    LAMICTAL is a ORAL TABLET, ORALLY DISINTEGRATING in the HUMAN PRESCRIPTION DRUG category. It is labeled and distributed by GlaxoSmithKline LLC. The primary component is LAMOTRIGINE.

    Product Information

    NDC 00173-0777
    Product ID 0173-0777_d15a5607-7757-4f62-9269-154d706b67e9
    Associated GPIs 72600040007250
    GCN Sequence Number 065169
    GCN Sequence Number Description lamotrigine TAB RAPDIS 200 MG ORAL
    HIC3 H4B
    HIC3 Description ANTICONVULSANTS
    GCN 23274
    HICL Sequence Number 007378
    HICL Sequence Number Description LAMOTRIGINE
    Brand/Generic Brand
    Proprietary Name LAMICTAL
    Proprietary Name Suffix ODT
    Non-Proprietary Name lamotrigine
    Product Type HUMAN PRESCRIPTION DRUG
    Dosage Form TABLET, ORALLY DISINTEGRATING
    Route ORAL
    Active Ingredient Strength 200
    Active Ingredient Units mg/1
    Substance Name LAMOTRIGINE
    Labeler Name GlaxoSmithKline LLC
    Pharmaceutical Class Anti-epileptic Agent [EPC], Decreased Central Nervous System Disorganized Electrical Activity [PE], Dihydrofolate Reductase Inhibitors [MoA], Mood Stabilizer [EPC], Organic Cation Transporter 2 Inhibitors [MoA]
    DEA Schedule n/a
    Marketing Category NDA
    Application Number NDA022251
    Listing Certified Through 2024-12-31

    Package

    NDC 00173-0777-02 (00173077702)

    NDC Package Code 0173-0777-02
    Billing NDC 00173077702
    Package 1 DOSE PACK in 1 CARTON (0173-0777-02) / 30 TABLET, ORALLY DISINTEGRATING in 1 DOSE PACK
    Marketing Start Date 2009-06-05
    NDC Exclude Flag N
    Pricing Information
    Price Per Unit 17.508
    Pricing Unit EA
    Effective Date 2023-01-01
    NDC Description LAMICTAL ODT 200 MG TABLET
    Pharmacy Type Indicator C/I
    OTC N
    Explanation Code 4
    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