PROVON ANTIMICROBIAL FOAM HANDWASH- chlorhexidine gluconate 2% solution 
Xttrium Laboratories, Inc.

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2% GOJO ADX/LTX

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:

• wheezing/difficulty breathing

• shock

• facial swelling

• hives

• rash

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

Healthcare personnel handwash:

Surgical hand scrub:

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 8:00 AM to 5:00 PM EST

PROVON® Antimicrobial Foam Handwash

Chlorhexidine Gluconate 2% Solution - Antiseptic

GOJOADXFLBLC

8842-643-F

ADX front

8842

NDC 21749-850-90

Brought to you by GOJO

PROVON ®

Antimicrobial Foam Handwash with 2% CHG

Chlorhexidine Gluconate 2% Solution - Antiseptic

42 fl oz (1250 mL)

GOJOADXBLBLB

8842-642-B

ADX Back PDP

ADX Back DF1

ADX Back DF2

PROVON ® Antimicrobial Foam Handwash

Chlorhexidine Gluconate 2% Solution - Antiseptic

GOJOLTXFLBLC

1922-643-F

LTX front .

1922

NDC 21749-850-89

Brought to you by GOJO

PROVON ®

Antimicrobial Foam Handwash with 2% CHG

Chlorhexidine Gluconate 2% Solution - Antiseptic

40.5 fl oz (1200 mL)

GOJOLTXBLBLB

1922-642-B

LTX Back PDP

LTX back DF1

LTX back DF2

PROVON ANTIMICROBIAL FOAM HANDWASH 
chlorhexidine gluconate 2% solution
Product Information
Product TypeHUMAN OTC DRUGItem Code (Source)NDC:0116-8500
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:0116-8500-891200 mL in 1 BOTTLE, DISPENSING; Type 0: Not a Combination Product07/01/2016
2NDC:0116-8500-901250 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 - Xttrium Laboratories, Inc. (007470579)
Registrant - Xttrium Laboratories, Inc. (007470579)
Establishment
NameAddressID/FEIBusiness Operations
Xttrium Laboratories, Inc.007470579manufacture(0116-8500)

Revised: 11/2019
Document Id: 973e0c34-8585-ba4d-e053-2995a90a8fb0
Set id: 46dd136c-d569-0450-e054-00144ff8d46c
Version: 4
Effective Time: 20191113
 
Xttrium Laboratories, Inc.