PROVON ANTIMICROBIAL FOAM HANDWASH- chlorhexidine gluconate 2% solution 
Gojo Industries, Inc.

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GOJO ADX-LTX

Drug Facts

Active ingredient

Chlorhexidine gluconate 2% solution

Purpose

Antiseptic

Uses

Warnings

For external use only

Allergy alert:

This product may cause a severe allergic reaction. Symptoms may include:

If an allergic reaction occurs, stop use and seek medical help right away

Do not use

  • if you are allergic to chlorhexidine gluconate or any other ingredient in this product

When using this product

Stop use and ask a doctor if irritation, sensitization or allergic reaction occurs. These may be signs of a serious condition.

Keep out of reach of children. If swallowed, get medical help or contact a Poison Control Center right away.

Directions

Surgical hand scrub:

  • wet hands and forearms with water
  • scrub for 3 minutes with 5 ml of product (6 full strokes), with a wet brush, paying close attention to the nails, cuticles, and skin between the fingers
  • a separate nail cleaner may be used
  • rinse thoroughly
  • wash for an additional 3 minutes with 5 mL of product (6 full strokes) and rinse under running water and dry thoroughly

Healthcare personnel handwash:

  • wet hands with water
  • dispense 5 ml of product (6 full strokes) into cupped hands and wash in a vigorous manner for 15 seconds and rinse under running water and dry thoroughly

Other information

Inactive ingredients

citric add. cocamide DEA, hydroxyethylcellulose, isopropyl alcohol, lauramine oxide, purified water

Questions or comments?

call 1-800-321-9647 Monday through Friday 8 AM to 5 PM

PROVON® Antimicrobial Foam Handwash

Chlorhexidine Gluconate 2% Solution - Antiseptic

GOJOADXFLBLC

8842-643-F

ADX Front

PROVON® Antimicrobial Foam Handwash

Chlorhexidine Gluconate 2% Solution - Antiseptic

GOJOLTXFLBLC

1922-643-F

LTX Front

PACKAGE LABEL. SECONDARY DISPLAY PANEL

NDC 21749-850-90

Brought to you by GOJO

PROVON® BRAND

Antimicrobial Foam Handwash with 2% CHG

Chlorhexidine Gluconate 2% Solution - Antiseptic

Distributed by:

GOJO Industries, Inc.

Akron, OH 44309

800-321-9647 • 330-255-6000

www.GOJO.com

©2019. GOJO Industries, Inc.

All rights reserved.

Made in U.S.A.

GOJOADXBLBLB

8842-642-B

42 fl oz (1250 mL)

ADX Back PDP

ADX Back Drug Facts 1

ADX Back Drug Facts 2

NDC 21749-850-89

Brought to you by GOJO

PROVON® BRAND

Antimicrobial Foam Handwash with 2% CHG

Chlorhexidine Gluconate 2% Solution - Antiseptic

Distributed by:

GOJO Industries, Inc.

Akron, OH 44309

800-321-9647 • 330-255-6000

www.GOJO.com

©2019. GOJO Industries, Inc.

All rights reserved.

Made in the USA with U.S. and foreign components

GOJOLTXBLBLB

1922-642-B

40.5 fl oz (1200 mL)

LTX Back PDP

LTX Back Drug Facts 1

LTX Back Drug Facts 2

PROVON ANTIMICROBIAL FOAM HANDWASH 
chlorhexidine gluconate 2% solution
Product Information
Product TypeHUMAN OTC DRUGItem Code (Source)NDC:21749-850
Route of AdministrationTOPICAL
Active Ingredient/Active Moiety
Ingredient NameBasis of StrengthStrength
CHLORHEXIDINE GLUCONATE (UNII: MOR84MUD8E) (CHLORHEXIDINE - UNII:R4KO0DY52L) CHLORHEXIDINE GLUCONATE20 mg  in 1 mL
Inactive Ingredients
Ingredient NameStrength
CITRIC ACID MONOHYDRATE (UNII: 2968PHW8QP)  
COCO DIETHANOLAMIDE (UNII: 92005F972D)  
HYDROXYETHYL CELLULOSE (2000 MPA.S AT 1%) (UNII: S38J6RZN16)  
ISOPROPYL ALCOHOL (UNII: ND2M416302)  
LAURAMINE OXIDE (UNII: 4F6FC4MI8W)  
WATER (UNII: 059QF0KO0R)  
Packaging
#Item CodePackage DescriptionMarketing Start DateMarketing End Date
1NDC:21749-850-891200 mL in 1 BOTTLE, DISPENSING; Type 0: Not a Combination Product07/01/2016
2NDC:21749-850-901250 mL in 1 BOTTLE, DISPENSING; Type 0: Not a Combination Product07/01/2016
Marketing Information
Marketing CategoryApplication Number or Monograph CitationMarketing Start DateMarketing End Date
NDANDA01942207/01/2016
Labeler - Gojo Industries, Inc. (004162038)
Registrant - Xttrium Laboratories, Inc. (007470579)

Revised: 6/2019
Document Id: 8bb397f5-88ef-349d-e053-2995a90ab3fa
Set id: 36803a5b-3075-5d5b-e054-00144ff8d46c
Version: 4
Effective Time: 20190619
 
Gojo Industries, Inc.