Welcome to the Colgate® Prescription Pad Request Site
Did you know that pharmacies may dispense alternative high-fluoride toothpastes?
Did you know that you can ensure your prescription is dispensed as prescribed? Here’s how:
Write/Check the NDC code for one of the following five unique patented Liquid Gel 5000 ppm formulas:
Contains
Tricalcium
Phosphate
Tricalcium
Phosphate

PreviDent® 5000 ppm Ortho Defense
(1.1% Sodium Fluoride) Toothpaste
NDC: 0126-0289-92
Contains
Tricalcium
Phosphate
Tricalcium
Phosphate

PreviDent® 5000 ppm Booster Plus
(1.1% Sodium Fluoride) Toothpaste
Spearmint NDC: 0126-0074-92 Fruitastic NDC: 0126-0072-92
PreviDent® 5000 ppm Sensitive
(1.1% Sodium Fluoride and 5%
Potassium Nitrate) Toothpaste
SLS
free
free

PreviDent® 5000 ppm Dry Mouth
(1.1% Sodium Fluoride) Toothpaste
NDC: 0126-0016-61
PreviDent® 5000 ppm Enamel Protect
(1.1% Sodium Fluoride and 5%
Potassium Nitrate) Toothpaste