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NDC 00456-2202-28 Fetzima Details
Fetzima
Fetzima is a ORAL KIT in the HUMAN PRESCRIPTION DRUG category. It is labeled and distributed by Allergan, Inc.. The primary component is .
MedlinePlus Drug Summary
Levomilnacipran is used to treat depression. Levomilnacipran is in a class of medications called selective serotonin and norepinephrine reuptake inhibitors (SNRIs). It works by increasing the amount of serotonin and norepinephrine, natural substances in the brain that helps maintain mental balance.
Related Packages: 00456-2202-28Last Updated: 11/30/2022
MedLinePlus Full Drug Details: Levomilnacipran
Product Information
| NDC | 00456-2202 |
|---|---|
| Product ID | 0456-2202_7b3b300a-81f4-4b72-ad88-71e95d182456 |
| Associated GPIs | 5818005010B620 |
| GCN Sequence Number | 071499 |
| GCN Sequence Number Description | levomilnacipran HCl CAP24HDSPK 20 MG-40MG ORAL |
| HIC3 | H7C |
| HIC3 Description | SEROTONIN-NOREPINEPHRINE REUPTAKE-INHIB (SNRIS) |
| GCN | 35335 |
| HICL Sequence Number | 040632 |
| HICL Sequence Number Description | LEVOMILNACIPRAN HCL |
| Brand/Generic | Brand |
| Proprietary Name | Fetzima |
| Proprietary Name Suffix | n/a |
| Non-Proprietary Name | LEVOMILNACIPRAN HYDROCHLORIDE |
| Product Type | HUMAN PRESCRIPTION DRUG |
| Dosage Form | KIT |
| Route | ORAL |
| Active Ingredient Strength | n/a |
| Active Ingredient Units | n/a |
| Substance Name | n/a |
| Labeler Name | Allergan, Inc. |
| Pharmaceutical Class | n/a |
| DEA Schedule | n/a |
| Marketing Category | NDA |
| Application Number | NDA204168 |
| Listing Certified Through | 2024-12-31 |
Package
NDC 00456-2202-28 (00456220228)
| NDC Package Code | 0456-2202-28 |
|---|---|
| Billing NDC | 00456220228 |
| Package | 1 KIT in 1 BLISTER PACK (0456-2202-28) |
| Marketing Start Date | 2013-07-25 |
| NDC Exclude Flag | N |
| Pricing Information | |
| Price Per Unit | 16.1266 |
| Pricing Unit | EA |
| Effective Date | 2024-01-02 |
| NDC Description | FETZIMA 20-40 MG TITRATION PAK |
| 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