CYCLO/MAG 10MG/200MG - cyclobenzaprine hydrochloride, magnesium oxide 
Living Well Pharmacy, Inc.

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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CYCLO/MAG KIT

RX #: 278390    1/4/2010     LWP MD

CYLCOBENZAPRINE HCL #3 GM

LOT: 292090707                                HEALTH: 2

MFG: APOTHECARES                    FIRE:1

NDC: 37803-0368-08                          REACTIVITY:0

BATCH #: 01041004                          CAS:6202-23-9

CyclobenzaprineHCL

RX #: 267654   11/10/2009     LWP MD

MAGNESIUM OXIDE POWDER HVY #60 GM

LOT: YP0232                                  HEALTH: 2

MFG: SPECTRUM                        FIRE:0

NDC: 49452-4260-02                                 REACTIVITY:0

BATCH #: 11100901                                CAS:1309-48-4

MagnesiumOxidePowder

  1. RX Only

For Prescription Compounding Only


Cyclo/Mag Kit
Cyclobenzaprine HCl and Magnesium  Oxide Compound Kit

Description

Each Cyclo/Mag Kit is comprised of 3 grams of cyclobenzaprine hydrochloride powder, USP and
60 grams of magnesium oxide heavy powder.

Certificate of Analysis on File

Cyclo/Mag Kit also contains 60 grams of Lactose Monohydrate (Spray dried) powder and 0.15 grams of
riboflavin USP powder. When compounded, the final product provides a homogeneous product of 300
capsules each capsule containing 10mg of cyclobenzaprine and 200mg of magnesium oxide.

Equipment

Required supplies needed to compound this kit


Equipment
Item
Quantity
Cyclobenzaprine HCl  (Included)
3 grams
Magnesium Oxide Heavy Powder (Included)
60 grams
Lactose Monohydrate Spray Dried Powder ( Included)
60 grams
Riboflavin Powder (Included)
0.15 grams
Red 1 Capsules ( Required Not Included)
300 Capsules




Equipment 

Recommended supplies not included in this kit

Equipment
Item
Quantity
16 oz Glass Mortar and Pestle
1 each
300 Capsule Machine Number 2 Notch
1
Scraper ( Recommended Not Included)
1
Tamper (Recommended Not Included)
1
Capsule Locker (Recommended Not Included)
1


Directions

1. Using a 16 oz mortar and pestle triturate powders well to reduce particle size until uniform. Do not use metal bowls or spatulas while

compounding this product.

2.  Using a 300 capsule machine encapsulate triturate powder mixture into number 1 red capsules

Prior to compounding, store Cyclo/Mag Kit at room temperature. Store the final product at room temperature.

Final product for oral use only. Keep out the reach of children. Compounded product, as dispensed,

is stable for at least 180 days or the time remaining on the expiration date of any given ingredient,

which ever is shorter.

Directions

CYCLO/MAG 10MG/200MG 
cyclobenzaprine hydrochloride, magnesium oxide kit
Product Information
Product TypeHUMAN PRESCRIPTION DRUGItem Code (Source)NDC:64038-630
Packaging
#Item CodePackage DescriptionMarketing Start DateMarketing End Date
1NDC:64038-630-041 in 1 KIT
Quantity of Parts
Part #Package QuantityTotal Product Quantity
Part 11 BOTTLE 3 g
Part 21 BOTTLE 60 g
Part 1 of 2
CYCLOBENZAPRINE HCL 
cyclobenzaprine hydrochloride powder
Product Information
Item Code (Source)NDC:64038-620
Route of AdministrationNOT APPLICABLE
Active Ingredient/Active Moiety
Ingredient NameBasis of StrengthStrength
CYCLOBENZAPRINE HYDROCHLORIDE (UNII: 0VE05JYS2P) (CYCLOBENZAPRINE - UNII:69O5WQQ5TI) CYCLOBENZAPRINE HYDROCHLORIDE1 g  in 1 g
Packaging
#Item CodePackage DescriptionMarketing Start DateMarketing End Date
1NDC:64038-620-033 g in 1 BOTTLE
Marketing Information
Marketing CategoryApplication Number or Monograph CitationMarketing Start DateMarketing End Date
unapproved drug other02/17/2010
Part 2 of 2
MAGNESIUM OXIDE 
magnesium oxide powder
Product Information
Item Code (Source)NDC:64038-139
Route of AdministrationNOT APPLICABLE
Active Ingredient/Active Moiety
Ingredient NameBasis of StrengthStrength
MAGNESIUM OXIDE (UNII: 3A3U0GI71G) (MAGNESIUM OXIDE - UNII:3A3U0GI71G) MAGNESIUM OXIDE1 g  in 1 g
Packaging
#Item CodePackage DescriptionMarketing Start DateMarketing End Date
1NDC:64038-139-6060 g in 1 BOTTLE
Marketing Information
Marketing CategoryApplication Number or Monograph CitationMarketing Start DateMarketing End Date
unapproved drug other02/17/2010
Marketing Information
Marketing CategoryApplication Number or Monograph CitationMarketing Start DateMarketing End Date
unapproved drug other02/17/2010
Labeler - Living Well Pharmacy, Inc. (070488957)
Registrant - Living Well Pharmacy, Inc. (070488957)
Establishment
NameAddressID/FEIBusiness Operations
Living Well Pharmacy, Inc.070488957api manufacture
Establishment
NameAddressID/FEIBusiness Operations
Apotheca Supply859501871api manufacture
Establishment
NameAddressID/FEIBusiness Operations
Spectrum Laboratory Products, Inc.075295246api manufacture

Revised: 2/2010
Document Id: 38c7d64b-ee76-4d72-b3d0-6d05eb5aa2a3
Set id: c2b6213c-3397-42cf-8080-59d6a5c31d0a
Version: 1
Effective Time: 20100217
 
Living Well Pharmacy, Inc.