EQUIPTO - AMITRIPTYLINE EXTERNAL CREAM COMPOUNDING KIT- amitriptyline 
Alvix Laboratories, LLC

Disclaimer: This drug has not been found by FDA to be safe and effective, and this labeling has not been approved by FDA. For further information about unapproved drugs, click here.

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Equipto-Amitriptyline External Cream Compounding Kit
For Pharmacy Prescription Compounding Only / Rx Only
For Topical Use Only

DESCRIPTION

Amitriptyline 2% External Cream Base
FOR PHARMACY PRESCRIPTION COMPOUNDING ONLY / Rx ONLY

Each Equipto - Amitriptyline External Cream Compounding Kit provides 2.4 grams of Amitriptyline powder for incorporation into 117.6 grams of a Base. The resulting mixture is intended for topical use.

CAS-No. : 549-18-8

10,11-Dihydro-N,N-dimethyl-5 H-dibenzo[a,d] cycloheptene-Δ 5, γ-propylamine hydrochloride

chemical structure

WARNINGS

Pictogram

skull and cross boneshealth hazard pictogram

Signal word Danger Hazard statement(s)

H301 Toxic if swallowed. H361 Suspected of damaging fertility or the unborn child. Precautionary statement(s)

P201 Obtain special instructions before use.

P202 Do not handle until all safety precautions have been read and understood. P264 Wash skin thoroughly after handling.

P270 Do not eat, drink or smoke when using this product.

P281 Use personal protective equipment as required.

P301 + P310 IF SWALLOWED: Immediately call a POISON CENTER or doctor/ physician.

P308 + P313 IF exposed or concerned: Get medical advice/ attention.

P321 Specific treatment (see supplemental first aid instructions on this label).

P330 Rinse mouth. P405 Store locked up.

P501 Dispose of contents/ container to an approved waste disposal plant.

KIT COMPONENTS

Kit Components: 1 color coded teal bottle of 2.4g Amitriptyline, 1 bottle of 117.6g Base, 1 stirring rod, and 1 empty white mixing jar.

SIZE120 grams
NDC #15455-0112-2
Amatriptyline2.4 grams
Base117.6 grams

Avoid contact with eyes. Keep container tightly closed. Keep out of reach of children. Protect from light. Dispose of the product after 30 days of being compounded.

* Certificate of analysis on file.

The FDA has not approved Equipto - Amitriptyline External Cream Compounding Kit to cure, treat, or mitigate disease.

Equipto - Amitriptyline External Cream Compounding Kit is intended for preparation in accordance with state and federal regulation governing compounding and is available to patients by prescription only.

Rx ONLY

Logo

STORAGE AND HANDLING

Prior to compounding, store Equipto - Amitriptyline External Cream Compounding Kit at room temperature between 15 - 30 degrees C (59 - 86 degrees F). Protect from light. For external use only.

INSTRUCTIONS FOR USE

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PRINCIPAL DISPLAY PANEL

NDC 15455-0112-2

Equipto - Amitriptyline External Cream Compounding Kit

Amitriptyline 2% External Cream in Base

FOR PRESCRIPTION COMPOUNDING ONLY

RX ONLY

Carton Label

TDC MAX Cream - Base 117.6 g

NDC# 15455-0999-2

FOR PRESCRIPTION COMPOUNDING ONLY

Rx ONLY

Base 117.6 g

Amatriptyline USP Powder 2.4 g

NDC# 15455-9507-7

FOR PRECSRIPTION COMPOUNDING ONLY

Rx ONLY

Amitriptyline Label 2.4 g

EQUIPTO - AMITRIPTYLINE EXTERNAL CREAM COMPOUNDING KIT 
amitriptyline kit
Product Information
Product TypeHUMAN PRESCRIPTION DRUGItem Code (Source)NDC:15455-0112
Packaging
#Item CodePackage DescriptionMarketing Start DateMarketing End Date
1NDC:15455-0112-21 in 1 CARTON01/20/201503/08/2018
Quantity of Parts
Part #Package QuantityTotal Product Quantity
Part 11 BOTTLE, GLASS 2.4 g
Part 21 BOTTLE, PLASTIC 117.6 g
Part 1 of 2
AMITRIPTYLINE 
amitriptyline powder, for suspension
Product Information
Route of AdministrationTOPICAL
Active Ingredient/Active Moiety
Ingredient NameBasis of StrengthStrength
AMITRIPTYLINE HYDROCHLORIDE (UNII: 26LUD4JO9K) (AMITRIPTYLINE - UNII:1806D8D52K) AMITRIPTYLINE HYDROCHLORIDE1 g  in 2.4 g
Packaging
#Item CodePackage DescriptionMarketing Start DateMarketing End Date
12.4 g in 1 BOTTLE, GLASS; Type 1: Convenience Kit of Co-Package
Marketing Information
Marketing CategoryApplication Number or Monograph CitationMarketing Start DateMarketing End Date
unapproved drug other
Part 2 of 2
TDC MAX CREAM 
cream base suspension
Product Information
Route of AdministrationTOPICAL
Inactive Ingredients
Ingredient NameStrength
POLYSORBATE 60 (UNII: CAL22UVI4M)  
PEG-150 STEARATE (UNII: 7BSG7DF10Q)  
STEARETH-20 (UNII: L0Q8IK9E08)  
WATER (UNII: 059QF0KO0R)  
CETOSTEARYL ALCOHOL (UNII: 2DMT128M1S)  
CYCLOMETHICONE 5 (UNII: 0THT5PCI0R)  
METHYLISOTHIAZOLINONE (UNII: 229D0E1QFA)  
SORBITOL (UNII: 506T60A25R)  
ALOE VERA LEAF (UNII: ZY81Z83H0X)  
ALPHA-TOCOPHEROL ACETATE (UNII: 9E8X80D2L0)  
EDETATE DISODIUM (UNII: 7FLD91C86K)  
METHYLCHLOROISOTHIAZOLINONE (UNII: DEL7T5QRPN)  
ETHYLHEXYL STEARATE (UNII: EG3PA2K3K5)  
Packaging
#Item CodePackage DescriptionMarketing Start DateMarketing End Date
1117.6 g in 1 BOTTLE, PLASTIC; Type 1: Convenience Kit of Co-Package
Marketing Information
Marketing CategoryApplication Number or Monograph CitationMarketing Start DateMarketing End Date
unapproved drug other11/22/2015
Marketing Information
Marketing CategoryApplication Number or Monograph CitationMarketing Start DateMarketing End Date
unapproved drug other01/20/201503/08/2018
Labeler - Alvix Laboratories, LLC (962445925)

Revised: 3/2018
 
Alvix Laboratories, LLC