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    NDC 62135-0431-30 Disulfiram 250 mg/1 Details

    Disulfiram 250 mg/1

    Disulfiram is a ORAL TABLET in the HUMAN PRESCRIPTION DRUG category. It is labeled and distributed by Chartwell RX, LLC. The primary component is DISULFIRAM.

    Product Information

    NDC 62135-0431
    Product ID 62135-431_06fe77f7-a1e1-f066-e063-6294a90a7653
    Associated GPIs 62802040000325
    GCN Sequence Number 001192
    GCN Sequence Number Description disulfiram TABLET 250 MG ORAL
    HIC3 C0D
    HIC3 Description ANTI-ALCOHOLIC PREPARATIONS
    GCN 02881
    HICL Sequence Number 000529
    HICL Sequence Number Description DISULFIRAM
    Brand/Generic Generic
    Proprietary Name Disulfiram
    Proprietary Name Suffix n/a
    Non-Proprietary Name Disulfiram
    Product Type HUMAN PRESCRIPTION DRUG
    Dosage Form TABLET
    Route ORAL
    Active Ingredient Strength 250
    Active Ingredient Units mg/1
    Substance Name DISULFIRAM
    Labeler Name Chartwell RX, LLC
    Pharmaceutical Class Acetyl Aldehyde Dehydrogenase Inhibitors [MoA], Aldehyde Dehydrogenase Inhibitor [EPC]
    DEA Schedule n/a
    Marketing Category ANDA
    Application Number ANDA091563
    Listing Certified Through 2024-12-31

    Package

    NDC 62135-0431-30 (62135043130)

    NDC Package Code 62135-431-30
    Billing NDC 62135043130
    Package 30 TABLET in 1 BOTTLE (62135-431-30)
    Marketing Start Date 2021-11-02
    NDC Exclude Flag N
    Pricing Information
    Price Per Unit 1.78118
    Pricing Unit EA
    Effective Date 2024-02-21
    NDC Description DISULFIRAM 250 MG TABLET
    Pharmacy Type Indicator C/I
    OTC N
    Explanation Code 1
    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