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   <title>FLORFENICOL<br/> Injectable Solution <br/> 300 mg/mL</title>
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                        <name>Zhejiang Hisoar Pharmaceutical Co. Ltd.</name>
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                        <name>Florfenicol</name>
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                              <name>Florfenicol</name>
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                              <numerator value="250" unit="mL"/>
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               <text>
                  <paragraph>
                     <content styleCode="bold">Approved by FDA under ANADA # 200-588</content>
                  </paragraph>
                  <paragraph>
                     <content styleCode="bold">For intramuscular and subcutaneous use in beef and non-lactating dairy cattle only.</content>
                  </paragraph>
                  <paragraph>
                     <content styleCode="bold">Not for use in female dairy cattle 20 months of age or older or in calves to be processed for veal.</content>
                  </paragraph>
                  <paragraph>
                     <content styleCode="bold">Not for Use in Humans<br/>Keep out of reach of children</content>
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                  <paragraph>
                     <content styleCode="bold">CAUTION</content> Federal law restricts this drug to use by or on the order of a licensed veterinarian.</paragraph>
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                  <paragraph>
                     <content styleCode="bold">DESCRIPTION</content> Each milliliter contains 300 mg of florfenicol, 250 mg N-methyl-2-pyrrolidone (NMP), 150 mg propylene glycol, and polyethylene glycol qs.</paragraph>
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                  <paragraph>
                     <content styleCode="bold">INDICATIONS</content> FLORFENICOL INJECTION is indicated for treatment of bovine respiratory disease (BRD) associated with Mannheimia haemolytica, Pasteurella multocida, and Histophilus somni, and for the treatment of bovine interdigital phlegmon (foot rot, acute interdigital necrobacillosis, infectious pododermatitis) associated with Fusobacterium necrophorum and Bacteroides melaninogenicus. Also, it is indicated for the control of respiratory disease in cattle at high risk of developing BRD associated with Mannheimia haemolytica, Pasteurella multocida, and Histophilus somni.</paragraph>
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                  <paragraph>
                     <content styleCode="bold">DOSAGE AND ADMINISTRATION</content>
                     <br/>
                     <content styleCode="bold">For treatment of bovine respiratory disease (BRD) and bovine interdigital phlegmon (foot rot)</content>: FLORFENICOL INJECTION should be administered by intramuscular injection to cattle at a dose rate of 20 mg/kg body weight (3 mL/100 lbs). A second dose should be administered 48 hours later. Alternatively, FLORFENICOL INJECTION can be administered by a single subcutaneous (SC) injection to cattle at a dose rate of 40 mg/kg body weight (6 mL/100 lbs). Do not administer more than 10 mL at each site. The injection should be given only in the neck.</paragraph>
                  <paragraph>NOTE: Intramuscular injection may result in local tissue reaction which persists beyond 28 days. This may result in trim loss of edible tissue at slaughter. Tissue reaction at injection sites other than the neck is likely to be more severe.</paragraph>
               </text>
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                     <text>
                        <paragraph>
                           <content styleCode="bold">For control of respiratory disease in cattle at high-risk of developing BRD</content>: FLORFENICOL INJECTION should be administered by a single subcutaneous injection to cattle at a dose rate of 40 mg/kg body weight (6 mL/100 lbs). Do not administer more than 10 mL at each site. The injection should be given only in the neck.</paragraph>
                        <table width="75%">
                           <colgroup>
                              <col width="24%" align="center" valign="middle"/>
                              <col width="25%" align="center" valign="middle"/>
                              <col width="25%" align="center" valign="middle"/>
                              <col width="1%" align="center" valign="middle"/>
                              <col width="25%" align="center" valign="middle"/>
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                              <tr>
                                 <td styleCode="Botrule Lrule Rrule Toprule" colspan="3" align="left">FLORFENICOL INJECTION DOSAGE GUIDE</td>
                                 <td align="center"/>
                                 <td align="center"/>
                              </tr>
                              <tr>
                                 <td styleCode="Botrule Lrule Rrule" align="center" valign="bottom">ANIMAL WEIGHT<br/>(lbs)</td>
                                 <td styleCode="Botrule Rrule" align="center" valign="bottom">
                                    <paragraph>IM DOSAGE</paragraph>
                                    <paragraph>3.0 mL/100 lb Body Weight<br/>(mL)</paragraph>
                                 </td>
                                 <td styleCode="Botrule Rrule" align="center" valign="bottom">
                                    <paragraph>SC DOSAGE</paragraph>
                                    <paragraph>6.0 mL/100 lb Body Weight <br/>(mL)</paragraph>
                                 </td>
                                 <td align="center"/>
                                 <td rowspan="6" align="center" valign="top">
                                    <paragraph>
                                       <content styleCode="bold">Recommended Injection Location</content>
                                    </paragraph>
                                    <paragraph>
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                                    </paragraph>
                                 </td>
                              </tr>
                              <tr>
                                 <td styleCode="Botrule Lrule Rrule" align="center">100</td>
                                 <td styleCode="Botrule Rrule" align="center">3.0</td>
                                 <td styleCode="Botrule Rrule" align="center">6.0</td>
                                 <td align="center"/>
                              </tr>
                              <tr>
                                 <td styleCode="Botrule Lrule Rrule" align="center">200</td>
                                 <td styleCode="Botrule Rrule" align="center">6.0</td>
                                 <td styleCode="Botrule Rrule" align="center">12.0</td>
                                 <td align="center"/>
                              </tr>
                              <tr>
                                 <td styleCode="Botrule Lrule Rrule" align="center">300</td>
                                 <td styleCode="Botrule Rrule" align="center">9.0</td>
                                 <td styleCode="Botrule Rrule" align="center">18.0</td>
                                 <td align="center"/>
                              </tr>
                              <tr>
                                 <td styleCode="Botrule Lrule Rrule" align="center">400</td>
                                 <td styleCode="Botrule Rrule" align="center">12.0</td>
                                 <td styleCode="Botrule Rrule" align="center">24.0</td>
                                 <td align="center"/>
                              </tr>
                              <tr>
                                 <td styleCode="Botrule Lrule Rrule" align="center">500</td>
                                 <td styleCode="Botrule Rrule" align="center">15.0</td>
                                 <td styleCode="Botrule Rrule" align="center">30.0</td>
                                 <td align="center"/>
                              </tr>
                              <tr>
                                 <td styleCode="Botrule Lrule Rrule" align="center">600</td>
                                 <td styleCode="Botrule Rrule" align="center">18.0</td>
                                 <td styleCode="Botrule Rrule" align="center">36.0</td>
                                 <td align="center"/>
                                 <td styleCode="Botrule Lrule Rrule Toprule" rowspan="5" align="left">Do not inject more than 10 mL per injection site.</td>
                              </tr>
                              <tr>
                                 <td styleCode="Botrule Lrule Rrule" align="center">700</td>
                                 <td styleCode="Botrule Rrule" align="center">21.0</td>
                                 <td styleCode="Botrule Rrule" align="center">42.0</td>
                                 <td align="center"/>
                              </tr>
                              <tr>
                                 <td styleCode="Botrule Lrule Rrule" align="center">800</td>
                                 <td styleCode="Botrule Rrule" align="center">24.0</td>
                                 <td styleCode="Botrule Rrule" align="center">48.0</td>
                                 <td align="center"/>
                              </tr>
                              <tr>
                                 <td styleCode="Botrule Lrule Rrule" align="center">900</td>
                                 <td styleCode="Botrule Rrule" align="center">27.0</td>
                                 <td styleCode="Botrule Rrule" align="center">54.0</td>
                                 <td align="center"/>
                              </tr>
                              <tr>
                                 <td styleCode="Botrule Lrule Rrule" align="center">1000</td>
                                 <td styleCode="Botrule Rrule" align="center">30.0</td>
                                 <td styleCode="Botrule Rrule" align="center">60.0</td>
                                 <td align="center"/>
                              </tr>
                           </tbody>
                        </table>
                        <paragraph>Clinical improvement should be evident in most treated subjects within 24 hours of initiation of treatment. If a positive response is not noted within 72 hours of initiation of treatment, the diagnosis should be re-evaluated.</paragraph>
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                           <text>Recommended Injection Location</text>
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               <code code="34070-3" codeSystem="2.16.840.1.113883.6.1" displayName="CONTRAINDICATIONS SECTION"/>
               <text>
                  <paragraph>
                     <content styleCode="bold">CONTRAINDICATIONS</content> Do not use in animals that have shown hypersensitivity to florfenicol.</paragraph>
               </text>
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               <code code="34071-1" codeSystem="2.16.840.1.113883.6.1" displayName="WARNINGS SECTION"/>
               <text>
                  <paragraph>
                     <content styleCode="bold">USER SAFETY WARNINGS: NOT FOR HUMAN USE. KEEP OUT OF REACH OF CHILDREN. </content>This product contains materials that can be irritating to skin and eyes. Avoid direct contact with skin, eyes, and clothing. In case of accidental eye exposure, flush with water for 15 minutes. In case of accidental skin exposure, wash with soap and water. Remove contaminated clothing. Consult a physician if irritation persists. Accidental injection of this product may cause local irritation. Consult a physician immediately. Reproductive and developmental toxicities have been reported in laboratory animals following high, repeated exposures to N-methyl-2-pyrrolidone (NMP). Pregnant women should wear gloves and exercise caution or avoid handling this product. The Safety Data Sheet (SDS) contains more detailed occupational safety information.</paragraph>
                  <paragraph/>
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                  <paragraph>
                     <content styleCode="bold">CONTACT INFORMATION:</content> To report suspected adverse drug events, for technical assistance or to obtain a copy of the SDS, contact Sparhawk Laboratories, Inc. at 1-800-255-6368 or www.sparhawklabs.com. For additional information about adverse drug experience reporting for animal drugs, contact FDA at 1-888-FDA-VETS or www.fda.gov/reportanimalae</paragraph>
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               <text>
                  <paragraph>
                     <content styleCode="bold">PRECAUTIONS:</content> Not for use in animals intended for breeding purposes. The effects of florfenicol on bovine reproductive performance, pregnancy, and lactation have not been determined. Toxicity studies in dogs, rats, and mice have associated the use of florfenicol with testicular degeneration and atrophy. Intramuscular injection may result in local tissue reaction which persists beyond 28 days. This may result in trim loss of edible tissue at slaughter. Tissue reaction at injection sites other than the neck is likely to be more severe.</paragraph>
                  <paragraph>
                     <content styleCode="bold">Use within 6 months of first puncture.</content>
                     <br/>
                     <content styleCode="bold">STORAGE INFORMATION: Store between 2°C and 25°C (36°F – 77°F). Protect from light when not in use.</content>
                  </paragraph>
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                  <paragraph>
                     <content styleCode="bold">RESIDUE WARNINGS:</content> Animals intended for human consumption must not be slaughtered within 28 days of the last intramuscular treatment. Animals intended for human consumption must not be slaughtered within 38 days of subcutaneous treatment. This product is not approved for use in female dairy cattle 20 months of age or older, including dry dairy cows. Use in these cattle may cause drug residues in milk and/or in calves born to these cows. A withdrawal period has not been established in pre-ruminating calves. Do not use in calves to be processed for veal.</paragraph>
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               <effectiveTime value="20231012"/>
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                  <paragraph>
                     <content styleCode="bold">ADVERSE REACTIONS</content> Inappetence, decreased water consumption, or diarrhea may occur transiently following treatment.</paragraph>
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               <code code="34090-1" codeSystem="2.16.840.1.113883.6.1" displayName="CLINICAL PHARMACOLOGY SECTION"/>
               <title>CLINICAL PHARMACOLOGY</title>
               <text>
                  <paragraph>
                     <content styleCode="bold">CLINICAL PHARMACOLOGY</content> The pharmacokinetic disposition of florfenicol was evaluated in feeder calves following single intramuscular (IM) administration at the recommended dose of 20 mg/kg body weight. Florfenicol was also administered intravenously (IV) to the same cattle in order to calculate the volume of distribution, clearance, and percent bioavailability1 (Table 1)</paragraph>
                  <table ID="table1" width="75%">
                     <caption>TABLE 1. Pharmacokinetic Parameter Values for Florfenicol Following IM Administration of 20 mg/kg Body Weight to Feeder Calves (n=10).</caption>
                     <colgroup>
                        <col width="35%" align="left" valign="top"/>
                        <col width="30%" align="center" valign="top"/>
                        <col width="35%" align="center" valign="top"/>
                     </colgroup>
                     <thead>
                        <tr styleCode="First Last">
                           <th styleCode="Lrule Rrule" align="left">Parameter</th>
                           <th styleCode="Rrule" align="center">Median</th>
                           <th styleCode="Rrule" align="center">Range</th>
                        </tr>
                     </thead>
                     <tbody>
                        <tr styleCode="First Last">
                           <td colspan="3" align="left"/>
                        </tr>
                     </tbody>
                     <tbody>
                        <tr>
                           <td styleCode="Lrule Rrule" align="left">C<sub>max</sub> (<content styleCode="italics">μ</content>g/mL)</td>
                           <td styleCode="Rrule" align="center">3.07*</td>
                           <td styleCode="Rrule" align="center">1.43 - 5.60</td>
                        </tr>
                        <tr>
                           <td styleCode="Lrule Rrule" align="left">t<sub>max</sub> (hr)</td>
                           <td styleCode="Rrule" align="center">3.33</td>
                           <td styleCode="Rrule" align="center">0.75 - 8.00</td>
                        </tr>
                        <tr>
                           <td styleCode="Lrule Rrule" align="left">T ½ (hr)</td>
                           <td styleCode="Rrule" align="center">18.3**</td>
                           <td styleCode="Rrule" align="center">8.30 - 44.0</td>
                        </tr>
                        <tr>
                           <td styleCode="Lrule Rrule" align="left">AUC (<content styleCode="italics">μ</content>g∙min/mL)</td>
                           <td styleCode="Rrule" align="center">4242</td>
                           <td styleCode="Rrule" align="center">3200 - 6250</td>
                        </tr>
                        <tr>
                           <td styleCode="Lrule Rrule" align="left">Bioavailability (%)</td>
                           <td styleCode="Rrule" align="center">78.5</td>
                           <td styleCode="Rrule" align="center">59.3 - 106</td>
                        </tr>
                        <tr>
                           <td styleCode="Lrule Rrule" align="left">Vd<sub>ss </sub> (L/kg)***</td>
                           <td styleCode="Rrule" align="center">0.77</td>
                           <td styleCode="Rrule" align="center">0.68 - 0.85</td>
                        </tr>
                        <tr>
                           <td styleCode="Lrule Rrule" align="left">Cl<sub>t</sub> (mL/min/kg)***</td>
                           <td styleCode="Rrule" align="center">3.75</td>
                           <td styleCode="Rrule" align="center">3.17 - 4.31</td>
                        </tr>
                     </tbody>
                  </table>
                  <paragraph>** mean value<br/>*** following IV administration<br/>C<sub>max</sub> Maximum serum concentration </paragraph>
                  <paragraph>T<sub>max</sub> Time at which C<sub>max</sub> is observed<br/>T ½ Biological half-life<br/>AUC Area under the curve<br/>Vd<sub>ss</sub> Volume of distribution at steady state </paragraph>
                  <paragraph>Cl<sub>t</sub> Total body clearance</paragraph>
                  <paragraph>Florfenicol was detectable in the serum of most animals through 60 hours after intramuscular administration with a mean concentration of 0.19 µg/mL. The protein binding of florfenicol was 12.7%, 13.2%, and 18.3% at serum concentrations of 0.5, 3.0, and 16.0 µg/mL, respectively.</paragraph>
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               <title>MICROBIOLOGY</title>
               <text>
                  <paragraph>Florfenicol is a synthetic, broad-spectrum antibiotic active against many Gram-negative and Gram-positive bacteria isolated from domestic animals. It acts by binding to the 50S ribosomal subunit and inhibiting bacterial protein synthesis. Florfenicol is generally considered a bacteriostatic drug, but exhibits bactericidal activity against certain bacterial species. In vitro studies demonstrate that florfenicol is active against the bovine respiratory disease (BRD) pathogens Mannheimia haemolytica, Pasteurella multocida, and Histophilus somni, and that florfenicol exhibits bactericidal activity against strains of M. haemolytica and H. somni. Clinical studies confirm the efficacy of florfenical against BRD as well as against commonly isolated bacterial pathogens in bovine interdigital phlegmon including Fusobacterium necrophorum and Bacteroides melaninogenicus.<br/>The minimum inhibitory concentrations (MICs) of florfenicol for BRD organisms were determined using isolates obtained from natural infections from 1990 to 1993. The MICs for interdigital phlegmon organisms were determined using isolates obtained from natural infections from 1973 to 1997 (Table 2).</paragraph>
                  <table ID="table2" width="100%">
                     <caption>TABLE 2. Florfenicol Minimum Inhibitory Concentration (MIC) Values* of Indicated Pathogens Isolated From Natural Infections of Cattle.</caption>
                     <tbody>
                        <tr>
                           <td> Indicated pathogens</td>
                           <td> Years of isolation</td>
                           <td>Number of isolates </td>
                           <td>MIC50** (µg/mL)</td>
                           <td> MIC90** (µg/mL)</td>
                        </tr>
                        <tr>
                           <td> Mannheimia haemolytica</td>
                           <td> 1990 to 1993</td>
                           <td> 398</td>
                           <td> 0.5</td>
                           <td> 1</td>
                        </tr>
                        <tr>
                           <td> Pasteurella multocida</td>
                           <td> 1990 to 1993</td>
                           <td> 350</td>
                           <td> 0.5</td>
                           <td> 0.5</td>
                        </tr>
                        <tr>
                           <td> Histophilus somni</td>
                           <td> 1990 to 1993</td>
                           <td> 66</td>
                           <td> 0.25</td>
                           <td> 0.5</td>
                        </tr>
                        <tr>
                           <td> Fusobacterium necrophorum</td>
                           <td> 1973 to 1997</td>
                           <td> 33</td>
                           <td> 0.25</td>
                           <td> 0.25</td>
                        </tr>
                        <tr>
                           <td> Bacteroides melaninogenicus</td>
                           <td> 1973 to 1997</td>
                           <td> 20</td>
                           <td> 0.25</td>
                           <td> 0.25</td>
                        </tr>
                     </tbody>
                  </table>
                  <paragraph>* The correlation between the in vitro susceptibility data and clinical effectiveness is unknown.</paragraph>
                  <paragraph>** The lowest MIC to encompass 50% and 90% of the most susceptible isolates, respectively.</paragraph>
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               <code code="42229-5" codeSystem="2.16.840.1.113883.6.1" displayName="SPL UNCLASSIFIED SECTION"/>
               <text>
                  <paragraph>
                     <content styleCode="bold">ANIMAL SAFETY</content> A 10X safety study was conducted in feeder calves. Two intramuscular injections of 200 mg/kg were administered at a 48-hour interval. The calves were monitored for 14 days after the second dose. Marked anorexia, decreased water consumption, decreased body weight, and increased serum enzymes were observed following dose administration. These effects resolved by the end of the study.</paragraph>
                  <paragraph>A 1×, 3×, and 5× (20, 60, and 100 mg/kg) safety study was conducted in feeder calves for 3× the duration of treatment (6 injections at 48-hour intervals). Slight decrease in feed and water consumption was observed in the 1× dose group. Decreased feed and water consumption, body weight, urine pH, and increased serum enzymes, were observed in the 3× and 5× dose groups. Depression, soft stool consistency, and dehydration were also observed in some animals (most fre-quently at the 3× and 5× dose levels), primarily near the end of dosing.</paragraph>
                  <paragraph>A 43-day controlled study was conducted in healthy cattle to evaluate effects of NUFLOR Injectable Solution administered at the recommended dose on feed consumption. Although a tran-sient decrease in feed consumption was observed, NUFLOR Injectable Solution administration had no long-term effect on body weight, rate of gain, or feed consumption.</paragraph>
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               <code code="44425-7" codeSystem="2.16.840.1.113883.6.1" displayName="STORAGE AND HANDLING SECTION"/>
               <text>
                  <paragraph>
                     <content styleCode="bold">STORAGE INFORMATION</content>
                     <content styleCode="bold">Store between 2°C and 25°C (36°F – 77°F).</content> Protect from light when not in use. Use within 6 months of first puncture. Refrigeration is not required. The solution is light yellow to straw colored. Color does not affect potency.</paragraph>
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               <code code="34069-5" codeSystem="2.16.840.1.113883.6.1" displayName="HOW SUPPLIED SECTION"/>
               <text>
                  <paragraph>
                     <content styleCode="bold">HOW SUPPLIED</content> FLORFENICOL INJECTION is packaged in 100 mL (NDC 58005-742-04), 250 mL (NDC 58005-742-05), and 500 mL (NDC 58005-742-06) glass sterile multiple-dose vials.</paragraph>
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               <code code="34093-5" codeSystem="2.16.840.1.113883.6.1" displayName="REFERENCES SECTION"/>
               <text>
                  <paragraph>
                     <content styleCode="bold">REFERENCE</content> 1. Lobell RD, Varma KJ, et al. Pharmacokinetics of florfenicol following intravenous and intramuscular doses to cattle. J Vet Pharmacol Therap. 1994;17:253-258.</paragraph>
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               <effectiveTime value="20231012"/>
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               <id root="ac160b57-3bf5-4e52-92ba-a82a3a865f50"/>
               <code code="42229-5" codeSystem="2.16.840.1.113883.6.1" displayName="SPL UNCLASSIFIED SECTION"/>
               <text>
                  <paragraph>Manufactured by Sparhawk Laboratories, Inc. Lenexa, KS 66215, USA</paragraph>
                  <paragraph>Made in USA</paragraph>
                  <paragraph>F-7475</paragraph>
                  <paragraph>Rev. 07-23</paragraph>
                  <paragraph/>
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               <id root="5059f237-718e-4f19-bd6a-a9a90bb460ea"/>
               <code code="51945-4" codeSystem="2.16.840.1.113883.6.1" displayName="PACKAGE LABEL.PRINCIPAL DISPLAY PANEL"/>
               <title>Principal Display Panel</title>
               <text>
                  <paragraph>Injectable Solution <content styleCode="bold">300 mg/m</content>L<br/>Sterile Multiple-Dose Vial</paragraph>
                  <paragraph>
                     <content styleCode="bold">For intramuscular and subcutaneous use in beef and non-lactating dairy cattle only.</content>
                     <br/>
                     <content styleCode="bold">Not for use in female dairy cattle 20 months of age or older or in calves to be processed for veal. Not for Use in Humans</content>
                     <br/>
                     <content styleCode="bold">Keep out of reach of children</content>
                  </paragraph>
                  <paragraph>
                     <content styleCode="bold">Caution:</content> Federal law restricts this drug to use by or on the order of a licensed veterinarian.<br/>Approved by FDA under ANADA # 200-588</paragraph>
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               <effectiveTime value="20231129"/>
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                     <text>Florfenicol Label</text>
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