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NDC 39822-5525-03 PROMETHAZINE HYDROCHLORIDE 25 mg/mL Details
PROMETHAZINE HYDROCHLORIDE 25 mg/mL
PROMETHAZINE HYDROCHLORIDE is a INTRAMUSCULAR; INTRAVENOUS INJECTION, SOLUTION in the HUMAN PRESCRIPTION DRUG category. It is labeled and distributed by XGen Pharmaceuticals DJB, Inc.. The primary component is PROMETHAZINE HYDROCHLORIDE.
Product Information
| NDC | 39822-5525 |
|---|---|
| Product ID | 39822-5525_0e3526e1-38be-1d89-e063-6294a90a775d |
| Associated GPIs | 41400020102005 |
| GCN Sequence Number | 003866 |
| GCN Sequence Number Description | promethazine HCl AMPUL 25 MG/ML INJECTION |
| HIC3 | Z2P |
| HIC3 Description | ANTIHISTAMINES - 1ST GENERATION |
| GCN | 14970 |
| HICL Sequence Number | 012014 |
| HICL Sequence Number Description | PROMETHAZINE HCL |
| Brand/Generic | Generic |
| Proprietary Name | PROMETHAZINE HYDROCHLORIDE |
| Proprietary Name Suffix | n/a |
| Non-Proprietary Name | PROMETHAZINE HYDROCHLORIDE |
| Product Type | HUMAN PRESCRIPTION DRUG |
| Dosage Form | INJECTION, SOLUTION |
| Route | INTRAMUSCULAR; INTRAVENOUS |
| Active Ingredient Strength | 25 |
| Active Ingredient Units | mg/mL |
| Substance Name | PROMETHAZINE HYDROCHLORIDE |
| Labeler Name | XGen Pharmaceuticals DJB, Inc. |
| Pharmaceutical Class | Phenothiazine [EPC], Phenothiazines [CS] |
| DEA Schedule | n/a |
| Marketing Category | ANDA |
| Application Number | ANDA040737 |
| Listing Certified Through | 2025-12-31 |
Package
NDC 39822-5525-03 (39822552503)
| NDC Package Code | 39822-5525-3 |
|---|---|
| Billing NDC | 39822552503 |
| Package | 25 AMPULE in 1 CARTON (39822-5525-3) / 1 mL in 1 AMPULE (39822-5525-2) |
| Marketing Start Date | 2015-01-30 |
| NDC Exclude Flag | N |
| Pricing Information | |
| Price Per Unit | 1.78064 |
| Pricing Unit | ML |
| Effective Date | 2021-09-22 |
| NDC Description | PROMETHAZINE 25 MG/ML AMPUL |
| Pharmacy Type Indicator | C/I |
| OTC | N |
| Explanation Code | 4, 5 |
| Classification for Rate Setting | G |
| As of Date | 2022-09-14 |
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