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    NDC 65757-0653-42 LYBALVI 15; 10 mg/1; mg/1 Details

    LYBALVI 15; 10 mg/1; mg/1

    LYBALVI is a ORAL TABLET, FILM COATED in the HUMAN PRESCRIPTION DRUG category. It is labeled and distributed by Alkermes, Inc.. The primary component is OLANZAPINE; SAMIDORPHAN L-MALATE.

    Product Information

    NDC 65757-0653
    Product ID 65757-653_f4ad4266-1f28-451a-bfb0-a31e7d746f6b
    Associated GPIs 62994802500330
    GCN Sequence Number 082337
    GCN Sequence Number Description olanzapine/samidorphan malate TABLET 15 MG-10MG ORAL
    HIC3 H7T
    HIC3 Description ANTIPSYCHOTIC,ATYPICAL,DOPAMINE,SEROTONIN ANTAGNST
    GCN 49727
    HICL Sequence Number 047406
    HICL Sequence Number Description OLANZAPINE/SAMIDORPHAN MALATE
    Brand/Generic Brand
    Proprietary Name LYBALVI
    Proprietary Name Suffix n/a
    Non-Proprietary Name olanzapine and samidorphan L-malate
    Product Type HUMAN PRESCRIPTION DRUG
    Dosage Form TABLET, FILM COATED
    Route ORAL
    Active Ingredient Strength 15; 10
    Active Ingredient Units mg/1; mg/1
    Substance Name OLANZAPINE; SAMIDORPHAN L-MALATE
    Labeler Name Alkermes, Inc.
    Pharmaceutical Class Atypical Antipsychotic [EPC], Opioid Antagonist [EPC], Opioid Antagonists [MoA]
    DEA Schedule n/a
    Marketing Category NDA
    Application Number NDA213378
    Listing Certified Through 2024-12-31

    Package

    NDC 65757-0653-42 (65757065342)

    NDC Package Code 65757-653-42
    Billing NDC 65757065342
    Package 1 BOTTLE in 1 CARTON (65757-653-42) / 30 TABLET, FILM COATED in 1 BOTTLE
    Marketing Start Date 2021-09-20
    NDC Exclude Flag N
    Pricing Information
    Price Per Unit 49.9964
    Pricing Unit EA
    Effective Date 2024-01-05
    NDC Description LYBALVI 15-10 MG TABLET
    Pharmacy Type Indicator C/I
    OTC N
    Explanation Code 4
    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