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    NDC 65757-0404-03 ARISTADA 1064 mg/3.9mL Details

    ARISTADA 1064 mg/3.9mL

    ARISTADA is a INTRAMUSCULAR INJECTION, SUSPENSION, EXTENDED RELEASE in the HUMAN PRESCRIPTION DRUG category. It is labeled and distributed by Alkermes, Inc.. The primary component is ARIPIPRAZOLE LAUROXIL.

    Product Information

    NDC 65757-0404
    Product ID 65757-404_d7e63a3f-06f0-41fd-a4db-8c0646fda89a
    Associated GPIs 5925001520E450
    GCN Sequence Number 077464
    GCN Sequence Number Description aripiprazole lauroxil SUSER SYR 1064MG/3.9 INTRAMUSC
    HIC3 H7X
    HIC3 Description ANTIPSYCHOTICS, ATYP, D2 PARTIAL AGONIST/5HT MIXED
    GCN 43488
    HICL Sequence Number 042595
    HICL Sequence Number Description ARIPIPRAZOLE LAUROXIL
    Brand/Generic Brand
    Proprietary Name ARISTADA
    Proprietary Name Suffix n/a
    Non-Proprietary Name aripiprazole lauroxil
    Product Type HUMAN PRESCRIPTION DRUG
    Dosage Form INJECTION, SUSPENSION, EXTENDED RELEASE
    Route INTRAMUSCULAR
    Active Ingredient Strength 1064
    Active Ingredient Units mg/3.9mL
    Substance Name ARIPIPRAZOLE LAUROXIL
    Labeler Name Alkermes, Inc.
    Pharmaceutical Class n/a
    DEA Schedule n/a
    Marketing Category NDA
    Application Number NDA207533
    Listing Certified Through 2024-12-31

    Package

    NDC 65757-0404-03 (65757040403)

    NDC Package Code 65757-404-03
    Billing NDC 65757040403
    Package 1 SYRINGE in 1 CARTON (65757-404-03) / 3.9 mL in 1 SYRINGE
    Marketing Start Date 2017-06-05
    NDC Exclude Flag N
    Pricing Information
    Price Per Unit 912.395
    Pricing Unit ML
    Effective Date 2024-01-05
    NDC Description ARISTADA ER 1,064 MG/3.9 ML SYR
    Pharmacy Type Indicator C/I
    OTC N
    Explanation Code 4, 5
    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