Chemotherapy - Therapeutic Classification

Alkylating agents
Generic Name(s)	Strength	Dosage Form	ICD Code
Altretamine	50 mg	Capsules
Bendamustine Hydrochloride	25mg in 8 mL, 100mg in 20 mL	Injection	Y43.3
Busulphan	solution in 10 mL	Injection
Carboplatin	50 mg/5 mL, 150 mg/15 mL, 450 mg/45 mL, 600 mg/60 mL	Injection
Carmustine	vial containing 100 mg	Injection	Y43.3
Chlorambucil	2 mg	Tablets
Cisplatin	1 mg/mL; 200 mg/200 mL	Injection
Cyclophosphamide	500 mg vial, carton of 1, 1.0 g vial, carton of 1, .2.0 g vial, carton of 1	Injection
Dacarbazine	100 mg, 200 mg/20ml, 500 mg	Injection
Ifosfamide	500 mg , 1-gram, 3-gram, Single-Dose Vial	Injection
Lomustine	10mg, 40mg, 100mg	Capsule
Mechlorethamine	10 mg	Injection	Y43.3
Melphalan	2 mg film-coated	Tablets
Oxaliplatin	50 mg, 100 mg or 200 mg Vials	Injection
Procarbazine	50 mg	Capsules
Streptozocin	1 gram vials	Sterile Powder
Temozolomide	5 mg, 20mg, 100mg, 140mg, 180mg, 250mg	Capsules
Thiotepa	15 mg , sterile lyophilized powder	Injection

Antimetabolites
Generic Name(s)	Strength	Dosage Form	ICD Code
Azacitidine	100mg single-use vials.	Injection	Y43.1
Capecitabine	150mg, 500mg	Tablets
Cladribine	10 mg (1 mg/mL)	Injection	Y43.3
Clofarabine	20mg/20 mL	Injection	Y43.3
Cytarabine	100 mg, 500 mg, 1 g, 2 g	Injection
Decitabine	50mg/Vial	Injection	Y43.3
Floxuridine	500 mg/vial	Injection
Fludarabine	50 mg	Injection
Fluorouracil	30 gram tube	0.5% Cream
Gemcitabine	200 mg, 1 g white to off-white, lyophilized powder	Injection
Hydroxyurea	500 mg	Capsules
Mercaptopurine	50 mg	Tablets
Methotrexate	5mg, 7.5mg, 10mg, 15mg	Tablets
Nelarabine	250 mg/50 mL (5 mg/mL) vial	Injection
Pemetrexed	100mg/1vial, 500mg/1vial	Injection
Pentostatin	50 mg	Injection
Pralatrexate Solution	20mg / 1mL, 40mg / 2mL	Injection
Thioguanine	40 mg	Tablets

Antitumor Antibiotics
Generic Name(s)	Strength	Dosage Form	ICD Code
Aclarubicin	25 to 100 mg/m2	Injection	Y43.3
Bleomycin	15, 30 units per vial	Injection
Dactinomycin	0.5 mg x 1's	Injection
Daunorubicin	20 mg, single dose vials; carton of 10.	Injection
Doxorubicin	10mg, 20mg, 50mg, 150mg , single dose vial	Injection
Epirubicin	50 mg/25 mL, 200 mg/100 mL single-use vial	Injection
Idarubicin	20 mg single dose vial	Injection,
Mitomycin	5mg, 20mg, 40mg	Injection
Mitoxantrone	20 mg/10 mL/multidose vial	Injection
Plicamycin	2500 mcg/Vial	Injection

Cytoprotective agent
Generic Name(s)	Strength	Dosage Form	ICD Code
Mesna	400mg, 100mg/ml vial	Tablet, Injection

Isocitrate dehydrogenase-2 (IDH2) inhibitor
Generic Name(s)	Strength	Dosage Form	ICD Code
Enasidenib	50 mg, 100 mg	Tablet

Miscellaneous Antineoplastics
Generic Name(s)	Strength	Dosage Form	ICD Code
Aldesleukin	22 million units	Injection	Y43.3
Asparaginase	10, 000 International Units as lyophilized powder	Injection
Bexarotene	75-mg	Capsules	Y43.3
Brentuximab Vedotin	50mg/Vial	Injection	Y43.3
Cabazitaxel	60mg/1.5 mL	Injection	Y43.3
Denileukin Diftitox	2ml/Vial	Injection	Y43.3
Eribulin Mesylate	1 mg/2mL (0.5 mg/mL)/ vial.	Injection	Y43.3
Estramustine	140 mg	Capsules
Exemestane	25mg	Tablets	Y43.3
Gefitinib	250mg	Tablets	Y43.3
Interferon Alfa 2A	3 million IU, 6 million IU , 9 million IU/0.5ml	Injection	Y43.3
Interferon Alfa-N3 -Human Leukocyte Derived	0.05 ml to 0.5ml	Injection	Y43.3
Interferon Beta 1A	30mcg/Vial	Injection	Y43.3
Interferon Beta-1B	0.3mg/vial	Injection
Interferon Gamma 1B	100 mcg (2 million lU)	Injection	Y43.3
Isotretinoin	10mg, 20mg, 40mg	Capsules
Ixabepilone	15mg/8ml	Injection	Y43.3
Lapatinib	250mg	Tablets	Y43.3
Letrozole	2.5mg	Tablets	Y43.3
Mitotane	500 mg	Tablets
Niraparib	100mg	Capsule
Pegaspargase	3,750 IU/5 mL single-use vial	Injection
Tretinoin (ATRA)	45 g tubes	Gel, 0.05%

Plant alkaloids
Generic Name(s)	Strength	Dosage Form	ICD Code
Docetaxel	20 mg, 80 mg, Lyophilized Powder	Injection
Etoposide	45-50 mg pink capsules	Capsules
Paclitaxel	30 mg/5 mL, 100 mg/16.7 mL, 300 mg/50 mL, multidose vial	Injection
Teniposide	165 mg/m2	Injection
Vinblastine	10 mg	Injection
Vincristine	1 mg/1 mL (single dose), 2 mg/2 mL (single dose)	Injection
Vinorelbine Tartrate	10 mg/1 mL Single-Use Vial, Carton of 1, 50 mg/5 mL Single-Use Vial, Carton of 1	Injection

Proteasome Inhibitor
Generic Name(s)	Strength	Dosage Form	ICD Code
Bortezomib	3.5mg/10ml	Injection	Y43.3