TRIMO-SAN JELLY
FDA nonproprietary name: oxyquinoline sulfate and sodium lauryl sulfate
For 113.4 g
Pharmacies pay
$27.56 filed
113.4 × $0.24306 per GM
CMS NADAC · nadac-national-average-drug-acquisition-cost-20261014.csv · eff. 2026-01-21 · as of 2026-10-14 · retrieved 2026-10-17
Medicare
We don’t know yet
No Medicare reference price. Part D: OpenBill did not match this NDC to a usable Medicare Part D spending row. Either Part D has none for it, or the rows that share its name could not safely be tied to it (for example, they mix units, routes or release forms, or the drug is sold over the counter, which Part D does not cover). Part B: This NDC is not in the current quarter’s Medicare Part B NDC-HCPCS crosswalk, so it has no Part B payment limit.
The spread
We don’t know yet
There is no Medicare figure to compare with, so there is no spread.
Cost-plus estimate
$36.69 estimated
$27.56 + $4.13 (15%) + $5.00 fee per fill = $36.69
This is a model, not a price any pharmacy quoted. Shipping is not included. How it is worked out
OpenBill calculation · nadac-national-average-drug-acquisition-cost-20261014.csv · NADAC eff. 2026-01-21 (file of 2026-10-14, retrieved 2026-10-17)
Open the interactive card Change the quantity, type what you were charged, and see every record in full.
What it is
TRIMO-SAN JELLY is how the CMS NADAC file names this product. The FDA NDC Directory lists it as oxyquinoline sulfate and sodium lauryl sulfate, under the trade name “TRIMO SAN”.
FDA gives its dosage form as jelly and its route as vaginal.
The labeler, the company named on the label, is CooperSurgical, Inc.
FDA lists no Established Pharmacologic Class for it.
The NADAC file of 2026-10-14 prices it under one NDC (National Drug Code), 59365-5030-00.
NADAC classes it as a brand-name drug (rate-setting class B), and does not mark it as sold over the counter.
What pharmacies pay
Pharmacies pay $27.56 for 113.4 g (113.4 × $0.24306 per GM, rounded to the cent), by the CMS NADAC file of 2026-10-14; that price took effect on 2026-01-21. That is what pharmacies pay their suppliers, not what they charge you.
NADAC’s explanation codes for it: 4, carried forward from the previous file; 5, calculated based on package size; 6, the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.
This NDC’s NADAC was carried forward from an earlier file (NADAC explanation code 2 or 4), not newly surveyed: it took effect on 2026-01-21. The file is new; the price is not.
What NADAC measures · NADAC explanation codes · Carried-forward prices
The NDC
- 59365-5030-00 · CooperSurgical, Inc. · $0.24306 per GM · eff. 2026-01-21 filed carried forward
What Medicare paid
We don’t know yet; the card above says why.
Which Medicare figure OpenBill compares · How Part D is matched · How Part B is matched
What to ask at the counter
None of these figures is your price: what you pay depends on your pharmacy, your insurance, coupons and discounts.
- What is your cash price for 113.4 g? Is it lower than what I would pay through my insurance?
- How much is in the package I am getting? This page uses 113.4 g; your package may hold a different amount.
- These are questions about price, not medical advice. Do not change or stop a medicine without talking to your prescriber or pharmacist.
Questions
- Why does this page start at 113.4 g?
- NADAC prices this product per GM. The FDA NDC Directory’s package description gives 113.4 g in one package for this product’s NDC (“113.4 g in 1 TUBE (59365-5030-0)”), so the card starts at one package: 113.4 GM. Change it to match your prescription.