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    NDC 50991-0121-16 Polytussin DM 2; 15; 7.5 mg/5mL; mg/5mL; mg/5mL Details

    Polytussin DM 2; 15; 7.5 mg/5mL; mg/5mL; mg/5mL

    Polytussin DM is a ORAL LIQUID in the HUMAN OTC DRUG category. It is labeled and distributed by Poly Pharmaceuticals,. The primary component is DEXBROMPHENIRAMINE MALEATE; DEXTROMETHORPHAN HYDROBROMIDE; PHENYLEPHRINE HYDROCHLORIDE.

    Product Information

    NDC 50991-0121
    Product ID 50991-121_cf4c931c-d9e1-8599-e053-2995a90a2623
    Associated GPIs 43995803500930
    GCN Sequence Number 076700
    GCN Sequence Number Description d-methorphan/pe/dexbromphenir LIQUID 15-7.5-2/5 ORAL
    HIC3 B3R
    HIC3 Description NON-OPIOID ANTITUS-1ST GEN.ANTIHISTAMINE-DECONGEST
    GCN 42443
    HICL Sequence Number 025559
    HICL Sequence Number Description DEXTROMETHORPHAN HBR/PHENYLEPHRINE HCL/DEXBROMPHENIRAMINE
    Brand/Generic Brand
    Proprietary Name Polytussin DM
    Proprietary Name Suffix n/a
    Non-Proprietary Name Dexbrompheniramine Maleate, Dextromethorphan HBr, Phenylephrine HCl
    Product Type HUMAN OTC DRUG
    Dosage Form LIQUID
    Route ORAL
    Active Ingredient Strength 2; 15; 7.5
    Active Ingredient Units mg/5mL; mg/5mL; mg/5mL
    Substance Name DEXBROMPHENIRAMINE MALEATE; DEXTROMETHORPHAN HYDROBROMIDE; PHENYLEPHRINE HYDROCHLORIDE
    Labeler Name Poly Pharmaceuticals,
    Pharmaceutical Class Adrenergic alpha1-Agonists [MoA], Sigma-1 Agonist [EPC], Sigma-1 Receptor Agonists [MoA], Uncompetitive N-methyl-D-aspartate Receptor Antagonist [EPC], Uncompetitive NMDA Receptor Antagonists [MoA], alpha-1 Adrenergic Agonist [EPC]
    DEA Schedule n/a
    Marketing Category OTC MONOGRAPH FINAL
    Application Number part341
    Listing Certified Through 2022-12-31

    Package

    NDC 50991-0121-16 (50991012116)

    NDC Package Code 50991-121-16
    Billing NDC 50991012116
    Package 473 mL in 1 BOTTLE (50991-121-16)
    Marketing Start Date 2021-10-20
    NDC Exclude Flag N
    Pricing Information
    Price Per Unit 0.04468
    Pricing Unit ML
    Effective Date 2024-01-17
    NDC Description POLYTUSSIN DM 2-15-7.5 MG/5 ML
    Pharmacy Type Indicator C/I
    OTC Y
    Explanation Code 4, 5
    Classification for Rate Setting G
    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

    Standard Product Labeling (SPL)/Prescribing Information SPL cf4c931c-d9e0-8599-e053-2995a90a2623 Details

    Revised: 10/2021