PACIFIC BLUE ULTRA ANTIMICROBIAL FOAM FRAGRANCE FREE- benzalkonium chloride solution 
Georgia-Pacific Consumer Products

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54622-316

Drug Facts

Active ingredient

Benzalkonium chloride, 0.13% w/w

Purpose

Antiseptic

Use

Handwash to help reduce bacteria that potentially can cause disease.

Warnings

When using this product

Avoid contact with eyes. In case of eye contact, flush with water.

Stop use

if irritation or redness develops. If condition persists for more than 72 hours consult a doctor.

Keep out of reach of children.

If swallowed, seek immediate medical attention or call a poison control center.

Directions

Wet hands, apply soap, rub hands together vigorously for at least 20 seconds.

Rinse and dry hands thoroughly with a disposable paper towel.

Inactive ingredients


Water (Aqua), Lauramine Oxide, Lauryl Betaine, Laurtrimonium
Chloride, Glycerin, Sodium PCA, Tocopheryl Acetate,
Oleth-10, Tetrasodium EDTA, Citric Acid

01

02

PACIFIC BLUE ULTRA ANTIMICROBIAL FOAM FRAGRANCE FREE 
benzalkonium chloride solution
Product Information
Product TypeHUMAN OTC DRUGItem Code (Source)NDC:54622-316
Route of AdministrationTOPICAL
Active Ingredient/Active Moiety
Ingredient NameBasis of StrengthStrength
BENZALKONIUM CHLORIDE (UNII: F5UM2KM3W7) (BENZALKONIUM - UNII:7N6JUD5X6Y) BENZALKONIUM CHLORIDE0.13 g  in 100 mL
Inactive Ingredients
Ingredient NameStrength
WATER (UNII: 059QF0KO0R)  
EDETATE SODIUM (UNII: MP1J8420LU)  
ANHYDROUS CITRIC ACID (UNII: XF417D3PSL)  
OLETH-10 (UNII: JD797EF70J)  
GLYCERIN (UNII: PDC6A3C0OX)  
LAURYL BETAINE (UNII: Y4P927Q133)  
LAURTRIMONIUM CHLORIDE (UNII: A81MSI0FIC)  
LAURAMINE OXIDE (UNII: 4F6FC4MI8W)  
SODIUM PIDOLATE (UNII: 1V74VH163T)  
.ALPHA.-TOCOPHEROL, DL- (UNII: 7QWA1RIO01)  
Packaging
#Item CodePackage DescriptionMarketing Start DateMarketing End Date
1NDC:54622-316-014 in 1 BOX06/14/2023
11200 mL in 1 BOTTLE; Type 0: Not a Combination Product
2NDC:54622-316-023 in 1 BOX06/14/2023
21200 mL in 1 BOTTLE; Type 0: Not a Combination Product
Marketing Information
Marketing CategoryApplication Number or Monograph CitationMarketing Start DateMarketing End Date
OTC Monograph Drug505G(a)(3)06/14/2023
Labeler - Georgia-Pacific Consumer Products (806142217)
Registrant - Cyan Labs S.A. de C.V. (812754130)
Establishment
NameAddressID/FEIBusiness Operations
Cyan Labs S.A. de C.V.812754130manufacture(54622-316) , analysis(54622-316) , label(54622-316) , pack(54622-316)

Revised: 5/2024
Document Id: 177d9892-c908-027f-e063-6294a90a5c99
Set id: fe165a79-6947-eb25-e053-6294a90a98f5
Version: 3
Effective Time: 20240502
 
Georgia-Pacific Consumer Products