AVOBENZONE, HOMOSALATE, OCTISALATE- avobenzone, homosalate, octisalate lotion 
Rite Aid Corporation

Disclaimer: Most OTC drugs are not reviewed and approved by FDA, however they may be marketed if they comply with applicable regulations and policies. FDA has not evaluated whether this product complies.

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Sport Sunscreen Lotion SPF 30
D39.000/D39AA

Active Ingredients

Avobenzone 3%

Homosalate 10%

Octisalate 5%

Purpose

Sunscreen

Uses

Warnings

For external use only

Do not use

When using this product

Stop use and ask a doctor if

Keep out of reach of children.

if swallowed, get medical help or contact a Poison Control Center right away

Directions

Other information

Inactive ingredients

water, diethylhexyl 2,6-naphthalate, aluminum starch octenylsuccinate, styrene/acrylates copolymer, butyloctyl salicylate, glycerin, polyester-7, silica, chlorphenesin, benzyl alcohol, arachidyl alcohol, acrylates/C10-30 alkyl acrylate crosspolymer, neopentyl glycol diheptanoate, behenyl alcohol, tocopherol, beeswax, arachidyl glucoside, potassium hydroxide, glyceryl stearate, PEG-100 stearate, disodium EDTA, sodium ascorbyl phosphate, fragrance, amyl cinnamal

Adverse event

*This product is not manufactured or distributed by Beiersdorf AG, distributor of Coppertone® Sunscreen Lotion Sport Broad Spectrum SPF 30.

May stain or damage some fabrics or surfaces.

DISTRIBUTED BY: RITE AID

200 NEWBERRY COMMONS, ETTERS, PA 17319

www.riteaid.com

Principal display panel

Comapre to Coppertone® Sunscreen Lotion Sport Broad Spectrum SPF 30*

SPORT

WATER RESISTANT

(80 MINUTES)

SUNSCREEN LOTION

BROAD SPECTRUM SPF 30

UVA/UVB Sunscreen

Won't run when you start to sweat

Helps prevent sunburn

30

8 FL OZ (236 mL)

image description

AVOBENZONE, HOMOSALATE, OCTISALATE 
avobenzone, homosalate, octisalate lotion
Product Information
Product TypeHUMAN OTC DRUGItem Code (Source)NDC:11822-9393
Route of AdministrationTOPICAL
Active Ingredient/Active Moiety
Ingredient NameBasis of StrengthStrength
AVOBENZONE (UNII: G63QQF2NOX) (AVOBENZONE - UNII:G63QQF2NOX) AVOBENZONE30 mg  in 1 mL
HOMOSALATE (UNII: V06SV4M95S) (HOMOSALATE - UNII:V06SV4M95S) HOMOSALATE100 mg  in 1 mL
OCTISALATE (UNII: 4X49Y0596W) (OCTISALATE - UNII:4X49Y0596W) OCTISALATE50 mg  in 1 mL
Inactive Ingredients
Ingredient NameStrength
WATER (UNII: 059QF0KO0R)  
DIETHYLHEXYL 2,6-NAPHTHALATE (UNII: I0DQJ7YGXM)  
ALUMINUM STARCH OCTENYLSUCCINATE (UNII: I9PJ0O6294)  
STYRENE/ACRYLAMIDE COPOLYMER (500000 MW) (UNII: 5Z4DPO246A)  
BUTYLOCTYL SALICYLATE (UNII: 2EH13UN8D3)  
GLYCERIN (UNII: PDC6A3C0OX)  
POLYESTER-7 (UNII: 0841698D2F)  
SILICON DIOXIDE (UNII: ETJ7Z6XBU4)  
CHLORPHENESIN (UNII: I670DAL4SZ)  
BENZYL ALCOHOL (UNII: LKG8494WBH)  
ARACHIDYL ALCOHOL (UNII: 1QR1QRA9BU)  
CARBOMER COPOLYMER TYPE B (ALLYL PENTAERYTHRITOL CROSSLINKED) (UNII: 809Y72KV36)  
NEOPENTYL GLYCOL DIHEPTANOATE (UNII: 5LKW3C543X)  
DOCOSANOL (UNII: 9G1OE216XY)  
TOCOPHEROL (UNII: R0ZB2556P8)  
YELLOW WAX (UNII: 2ZA36H0S2V)  
ARACHIDYL GLUCOSIDE (UNII: 6JVW35JOOJ)  
POTASSIUM HYDROXIDE (UNII: WZH3C48M4T)  
GLYCERYL MONOSTEARATE (UNII: 230OU9XXE4)  
PEG-100 STEARATE (UNII: YD01N1999R)  
EDETATE DISODIUM ANHYDROUS (UNII: 8NLQ36F6MM)  
SODIUM ASCORBYL PHOSPHATE (UNII: 836SJG51DR)  
.ALPHA.-AMYLCINNAMALDEHYDE (UNII: WC51CA3418)  
Packaging
#Item CodePackage DescriptionMarketing Start DateMarketing End Date
1NDC:11822-9393-4236 mL in 1 BOTTLE, PLASTIC; Type 0: Not a Combination Product07/06/2023
Marketing Information
Marketing CategoryApplication Number or Monograph CitationMarketing Start DateMarketing End Date
OTC monograph finalpart35207/06/2023
Labeler - Rite Aid Corporation (014578892)
Registrant - Vi-Jon, LLC (790752542)
Establishment
NameAddressID/FEIBusiness Operations
Vi-Jon, LLC088520668manufacture(11822-9393)
Establishment
NameAddressID/FEIBusiness Operations
Vi-Jon, LLC790752542manufacture(11822-9393)

Revised: 7/2023
Document Id: 8f8af79a-80b9-42a2-8c24-a0cc4c4f0bcf
Set id: c3f2bb28-53a9-4142-b6e0-88f03440564d
Version: 2
Effective Time: 20230706
 
Rite Aid Corporation