Phenobarbital (Page 4 of 4)

PRINCIPAL DISPLAY PANEL

DRUG: Phenobarbital

GENERIC: phenobarbital

DOSAGE: TABLET

ADMINSTRATION: ORAL

NDC: 70518-0722-0

COLOR: white

SHAPE: ROUND

SCORE: Two even pieces

SIZE: 10 mm

IMPRINT: 5014;V

PACKAGING: 30 in 1 BLISTER PACK

ACTIVE INGREDIENT(S):

• PHENOBARBITAL 97.2mg in 1

INACTIVE INGREDIENT(S):

• SILICON DIOXIDE
• LACTOSE MONOHYDRATE
• MAGNESIUM STEARATE
• CELLULOSE, MICROCRYSTALLINE
• SODIUM STARCH GLYCOLATE TYPE A POTATO

PHENOBARBITAL phenobarbital tablet

Product Information Product Type HUMAN PRESCRIPTION DRUG Item Code (Source) NDC:70518-0722(NDC:0603-5168) Route of Administration ORAL DEA Schedule CIV

Active Ingredient/Active Moiety Ingredient Name Basis of Strength Strength PHENOBARBITAL (PHENOBARBITAL) PHENOBARBITAL 97.2 mg

Inactive Ingredients Ingredient Name Strength SILICON DIOXIDE LACTOSE MONOHYDRATE MAGNESIUM STEARATE CELLULOSE, MICROCRYSTALLINE SODIUM STARCH GLYCOLATE TYPE A POTATO

Product Characteristics Color white Score 2 pieces Shape ROUND Size 10mm Flavor Imprint Code 5014;V Contains

Packaging # Item Code Package Description Multilevel Packaging 1 NDC:70518-0722-0 30 TABLET in 1 BLISTER PACK None

Marketing Information Marketing Category Application Number or Monograph Citation Marketing Start Date Marketing End Date unapproved drug other 06/27/2019

Labeler — REMEDYREPACK INC. (829572556)

Revised: 01/2021 REMEDYREPACK INC.