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NDC 59762-1003-01 Sirolimus 2 mg/1 Details
Sirolimus 2 mg/1
Sirolimus is a ORAL TABLET, SUGAR COATED in the HUMAN PRESCRIPTION DRUG category. It is labeled and distributed by Greenstone LLC. The primary component is SIROLIMUS.
MedlinePlus Drug Summary
Sirolimus is used in combination with other medications to prevent rejection of kidney transplants. Sirolimus is in a class of medications called immunosuppressants. It works by suppressing the body's immune system.
Related Packages: 59762-1003-01Last Updated: 12/01/2022
MedLinePlus Full Drug Details: Sirolimus
Product Information
| NDC | 59762-1003 |
|---|---|
| Product ID | 59762-1003_b7ea5d5d-e82c-413d-a729-3657fa8b1a90 |
| Associated GPIs | 99404070000330 |
| GCN Sequence Number | 051878 |
| GCN Sequence Number Description | sirolimus TABLET 2 MG ORAL |
| HIC3 | Z2E |
| HIC3 Description | IMMUNOSUPPRESSIVES |
| GCN | 19299 |
| HICL Sequence Number | 020519 |
| HICL Sequence Number Description | SIROLIMUS |
| Brand/Generic | Generic |
| Proprietary Name | Sirolimus |
| Proprietary Name Suffix | n/a |
| Non-Proprietary Name | SIROLIMUS |
| Product Type | HUMAN PRESCRIPTION DRUG |
| Dosage Form | TABLET, SUGAR COATED |
| Route | ORAL |
| Active Ingredient Strength | 2 |
| Active Ingredient Units | mg/1 |
| Substance Name | SIROLIMUS |
| Labeler Name | Greenstone LLC |
| Pharmaceutical Class | Decreased Immunologic Activity [PE], Kinase Inhibitor [EPC], Protein Kinase Inhibitors [MoA], mTOR Inhibitor Immunosuppressant [EPC], mTOR Inhibitors [MoA] |
| DEA Schedule | n/a |
| Marketing Category | NDA AUTHORIZED GENERIC |
| Application Number | NDA021110 |
| Listing Certified Through | 2024-12-31 |
Package
NDC 59762-1003-01 (59762100301)
| NDC Package Code | 59762-1003-1 |
|---|---|
| Billing NDC | 59762100301 |
| Package | 100 TABLET, SUGAR COATED in 1 BOTTLE (59762-1003-1) |
| Marketing Start Date | 2014-10-27 |
| NDC Exclude Flag | N |
| Pricing Information | |
| Price Per Unit | 4.93835 |
| Pricing Unit | EA |
| Effective Date | 2023-12-13 |
| NDC Description | SIROLIMUS 2 MG TABLET |
| Pharmacy Type Indicator | C/I |
| OTC | N |
| Explanation Code | 4, 6 |
| 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