Monday, 30 April 2012

First Mouthwash BLM





Dosage Form: oral compounding kit
FIRST - Mouthwash BLM

FIRST ® - Mouthwash BLM Rx


Diphenhydramine HCl, Lidocaine HCl, Aluminum Hydroxide, Magnesium Hydroxide, and Simethicone Compounding Kit


FOR PRESCRIPTION COMPOUNDING ONLY



DESCRIPTION


Each FIRST®— Mouthwash BLM Compounding Kit is comprised of 0.2 grams of diphenhydramine hydrochloride powder USP and 1.6 grams of lidocaine hydrochloride powder USP for oral use.* FIRST®— Mouthwash BLM Compounding Kit also contains a 236 mL suspension containing 3.15 grams of aluminum hydroxide USP (equivalent to dried gel USP), 3.15 grams of magnesium hydroxide USP, and 0.315 grams of simethicone USP with benzyl alcohol, butylparaben, flavor, hydroxyethylcellulose, propylparaben, purified water, saccharin sodium, sorbitol solution, D&C red #28, and FD&C red #40.* When compounded, the final product provides an homogeneous suspension containing diphenhydramine hydrochloride, lidocaine hydrochloride, and aluminum hydroxide, magnesium hydroxide, and simethicone comparable to the active ingredients (Benadryl®, Lidocaine HCl 2% Viscous, Maalox® 1:1:1) contained in Magic Mouthwash.**



How Supplied and Compounding Directions












Size8 FL OZ (237 mL)
NDC#65628-050-01
Diphenhydramine HCl0.2g
Lidocaine HCl1.6g
FIRST®-Mouthwash Suspension236 mL

TO THE PHARMACIST


Everything you need to make this is included…



1. FIRST®— Mouthwash BLM Compounding Kit contains premeasured diphenhydramine hydrochloride powder, lidocaine hydrochloride powder and mouthwash suspension (aluminum hydroxide, magnesium hydroxide, simethicone plus inactive ingredients)



2. Important - Before dispensing, tap the top and bottom of the bottle containing diphenhydramine hydrochloride to loosen the powder and remove the cap. Empty the diphenhydramine hydrochloride powder into the bottle containing the mouthwash liquid suspension. Likewise, tap the top and bottom of the bottle containing lidocaine hydrochloride to loosen the powder and remove the cap. Empty the lidocaine hydrochloride powder into the bottle containing the mouthwash liquid suspension.


The appropriate quantities of diphenhydramine hydrochloride powder and lidocaine hydrochloride powder have been packaged in each bottle to deliver the required dosage of each drug. Residual quantities remaining in the bottles after emptying need not be rinsed out.



3. Close the bottle and shake for 20 to 30 seconds. Instruct the patient to shake bottle well before each use.


Prior to compounding, store FIRST®— Mouthwash BLM Compounding Kit at room temperature between 15°-30°C (59°-86°F) [see USP]. Also store final formulation at room temperature, 15°-30°C (59°-86°F).


FIRST®— Mouthwash BLM Compounding Kit components have a three-year expiration date.*** Based on real time controlled room temperature and humidity testing, compounded FIRST®— Mouthwash BLM Compounding Kit is stable for at least six months.***


FIRST®— Mouthwash suspension meets the requirements for total aerobic microbial count of not more than 100 cfu/mL, as well as for the absence of the specified microorganisms Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, and Salmonella spp. when tested as described in the current USP under <61> Microbial Enumeration Tests and <62> Tests for Specified Microorganisms. FIRST®— Mouthwash suspension also meets the requirements as described in the current USP under <51> Antimicrobial Effectiveness Testing for Category 4 products.


For oral use only. Avoid contact with eyes. Keep container tightly closed. Keep out of the reach of children. Protect from light. Protect from freezing. Compounded product, as dispensed, is stable for at least 180 days at room temperature.


*       Certificate of analysis on file


**       This product is not manufactured by Pfizer, Inc., manufacturer of Benadryl® or by Novartis Consumer Health, Inc. manufacturer of Maalox® 


***       Data and documentation on file


RX ONLY


Revised: February 2010


U.S. Patent No. 6,708,822 B1


Additional U.S. Patent Pending


Distributed By:


CutisPharma, Inc.


SMART PRODUCTS FOR SMART PEOPLE®


Woburn, MA 01801, USA www.cutispharma.com



PRINCIPAL DISPLAY PANEL


NDC 65628-050-01

FIRST® Mouthwash BLM

Each kit contains:

Active Ingredients:

Diphenhydramine hydrochloride 0.2g

Lidocaine hydrochloride 1.6g

Aluminum hydroxide 3.15g in 236mL suspension (equivalent to dried gel USP)

Magnesium hydroxide 3.15g in 236mL suspension

Simethicone 0.315g in 236mL suspension

8 FL OZ (237 mL) as dispensed
































First Mouthwash BLM 
diphenhydramine hydrochloride and lidocaine hydrochloride and aluminum hydroxide and magnesium hydro  kit






Product Information
Product TypeHUMAN PRESCRIPTION DRUGNDC Product Code (Source)65628-050










Packaging
#NDCPackage DescriptionMultilevel Packaging
165628-050-011 KIT In 1 CONTAINERNone














QUANTITY OF PARTS
Part #Package QuantityTotal Product Quantity
Part 11 BOTTLE, GLASS  1.6 g
Part 21 BOTTLE, PLASTIC  236 mL
Part 31 BOTTLE, GLASS  0.2 g



Part 1 of 3
LIDOCAINE HYDROCHLORIDE 
lidocaine hydrochloride  powder, for suspension










Product Information
   
Route of AdministrationORALDEA Schedule    








Active Ingredient/Active Moiety
Ingredient NameBasis of StrengthStrength
LIDOCAINE HYDROCHLORIDE (LIDOCAINE)LIDOCAINE HYDROCHLORIDE1.6 g  in 1.6 g





Inactive Ingredients
Ingredient NameStrength
No Inactive Ingredients Found


















Product Characteristics
Color    Score    
ShapeSize
FlavorImprint Code
Contains      










Packaging
#NDCPackage DescriptionMultilevel Packaging
11.6 g In 1 BOTTLE, GLASSNone










Marketing Information
Marketing CategoryApplication Number or Monograph CitationMarketing Start DateMarketing End Date
UNAPPROVED DRUG OTHER




Part 2 of 3
FIRST MOUTHWASH SUSPENSION 
aluminum hydroxide and dimethicone 410 and magnesium hydroxide  suspension










Product Information
   
Route of AdministrationORALDEA Schedule    














Active Ingredient/Active Moiety
Ingredient NameBasis of StrengthStrength
ALUMINUM HYDROXIDE (ALUMINUM HYDROXIDE)ALUMINUM HYDROXIDE3.15 g  in 236 mL
MAGNESIUM HYDROXIDE (MAGNESIUM HYDROXIDE)MAGNESIUM HYDROXIDE3.15 g  in 236 mL
DIMETHICONE 410 (DIMETHICONE 410)DIMETHICONE 4100.315 g  in 236 mL






















Inactive Ingredients
Ingredient NameStrength
BENZYL ALCOHOL 
BUTYLPARABEN 
PROPYLPARABEN 
WATER 
SACCHARIN SODIUM 
SORBITOL 
D&C RED NO. 28 
FD&C RED NO. 40 
HYDROXYETHYL CELLULOSE (4000 CPS AT 1%) 


















Product Characteristics
Color    Score    
ShapeSize
FlavorCHERRYImprint Code
Contains      










Packaging
#NDCPackage DescriptionMultilevel Packaging
1236 mL In 1 BOTTLE, PLASTICNone










Marketing Information
Marketing CategoryApplication Number or Monograph CitationMarketing Start DateMarketing End Date
UNAPPROVED DRUG OTHER




Part 3 of 3
DIPHENHYDRAMINE HYDROCHLORIDE 
diphenhydramine hydrochloride  powder, for suspension










Product Information
   
Route of AdministrationORALDEA Schedule    








Active Ingredient/Active Moiety
Ingredient NameBasis of StrengthStrength
DIPHENHYDRAMINE HYDROCHLORIDE (DIPHENHYDRAMINE)DIPHENHYDRAMINE HYDROCHLORIDE.2 g  in .2 g





Inactive Ingredients
Ingredient NameStrength
No Inactive Ingredients Found


















Product Characteristics
Color    Score    
ShapeSize
FlavorImprint Code
Contains      










Packaging
#NDCPackage DescriptionMultilevel Packaging
1.2 g In 1 BOTTLE, GLASSNone










Marketing Information
Marketing CategoryApplication Number or Monograph CitationMarketing Start DateMarketing End Date
UNAPPROVED DRUG OTHER











Marketing Information
Marketing CategoryApplication Number or Monograph CitationMarketing Start DateMarketing End Date
UNAPPROVED DRUG OTHER11/01/2004


Labeler - CutisPharma, Inc. (090598256)
Revised: 10/2010CutisPharma, Inc.




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