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   <title>SparMectin-E</title>
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               <code code="34089-3" codeSystem="2.16.840.1.113883.6.1" displayName="DESCRIPTION SECTION"/>
               <text>
                  <paragraph>
                     <content styleCode="bold">(ivermectin)</content>
                  </paragraph>
                  <paragraph>
                     <content styleCode="bold">Liquid for Horses<br/>10 mg per mL</content>
                  </paragraph>
                  <paragraph>
                     <content styleCode="bold">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 (U.S.A.) law restricts this drug to use by or on the order of a licensed veterinarian.</paragraph>
                  <paragraph>
                     <content styleCode="bold">INTRODUCTION</content>
                  </paragraph>
                  <paragraph>SparMectin-E (ivermectin) Liquid for Horses has been formulated for professional administration by stomach tube or oral drench. One low-volume dose is effective against important internal parasites, including the arterial stages of <content styleCode="italics">Strongylus vulgaris</content>, and bots.</paragraph>
                  <paragraph>
                     <content styleCode="bold">PRODUCT DESCRIPTION</content>
                  </paragraph>
                  <paragraph>Ivermectin is derived from the avermectins, a family of potent, broad-spectrum anti-parasitic agents, which are isolated from fermentation of <content styleCode="italics">Streptomyces avermitilis</content>.</paragraph>
                  <paragraph>SparMectin-E Liquid is a clear, ready-to-use solution with each mL containing 1% ivermectin (10 mg), 0.2 mL propylene glycol, 80 mg polysorbate 80, 9 mg sodium phosphate monobasic monohydrate, 1.3 mg sodium phosphate dibasic anhydrous, 1 mg butylated hydroxytoluene, 0.1 mg disodium edetate, 0.54% w/v methyl paraben, 0.06% w/v propyl paraben and purified water q.s. ad 100%.</paragraph>
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               <title>INDICATIONS</title>
               <text>
                  <paragraph>SparMectin-E (ivermectin) Liquid is indicated for the effective treatment and control of the following parasites in horses.</paragraph>
                  <paragraph>
                     <content styleCode="bold">Large Strongyles</content> (adults):<br/>
                     <content styleCode="italics">Strongylus vulgaris</content> (also early forms in blood vessels)<br/>
                     <content styleCode="italics">Strongylus edentatus</content> (also tissue stages)<br/>
                     <content styleCode="italics">Strongylus equinus</content>
                     <br/>
                     <content styleCode="italics">Triodontophorus</content> spp. including:<br/>
                     <content styleCode="italics">Triodontophorus brevicauda<br/>   Triodontophorus serratus<br/>Craterostomum acuticaudatum </content>
                     <br/>
                     <content styleCode="bold">Small Strongyles</content> (adults, including those resistant to some benzimidazole class compounds):<br/>
                     <content styleCode="italics">Coronocyclus</content> spp. including:<br/>
                     <content styleCode="italics">Coronocyclus coronatus<br/>   Coronocyclus labiatus<br/>   Coronocyclus labratus</content>
                     <br/>
                     <content styleCode="italics">Cyathostomum</content> spp. including:<br/>
                     <content styleCode="italics">Cyathostomum catinatum<br/>   Cyathostomum pateratum</content>
                     <br/>
                     <content styleCode="italics">Cylicocyclus</content> spp. including:<br/>
                     <content styleCode="italics">Cylicocyclus insigne<br/>   Cylicocyclus leptostomum<br/>   Cylicocyclus nassatus<br/>   Cylicocyclus brevicapsulatus<br/>   Cylicodontophorus</content> spp.<br/>
                     <content styleCode="italics">Cylicostephanus</content> spp. including:<br/>
                     <content styleCode="italics">Cylicostephanus calicatus<br/>   Cylicostephanus goldi<br/>   Cylicostephanus longibursatus<br/>   Cylicostephanus minutus</content>
                     <br/>
                     <content styleCode="italics">Petrovinema poculatum</content>
                     <br/>
                     <content styleCode="bold">Small Strongyles</content>: Fourth-stage larvae<br/>
                     <content styleCode="bold">Pinworms</content> (adults and fourth-stage larvae) - <content styleCode="italics">Oxyuris equi</content>
                     <br/>
                     <content styleCode="bold">Roundworms</content>
                     <content styleCode="bold"> or ascarids</content> (adults and third- and fourth-stage larvae) - <content styleCode="italics">Parascaris equorum</content>
                     <br/>
                     <content styleCode="bold">Hairworms</content> (adults) - <content styleCode="italics">Trichostrongylus axei</content>
                     <br/>
                     <content styleCode="bold">Large-mouth Stomach worms</content> (adults) - <content styleCode="italics">Habronema muscae</content>
                     <br/>
                     <content styleCode="bold">Bots</content> (oral and gastric stages) - <content styleCode="italics">Gasterophilus</content> spp. including <content styleCode="italics">G. intestinalis</content> and <content styleCode="italics">G. nasalis</content>
                     <br/>
                     <content styleCode="bold">Lungworms</content> (adults and fourth-stage larvae) - <content styleCode="italics">Dictyocaulus arnfieldi</content>
                     <br/>
                     <content styleCode="bold">Intestinal threadworms</content> (adults) - <content styleCode="italics">Strongyloides westeri</content>
                     <br/>
                     <content styleCode="bold">Summer sores</content> caused by <content styleCode="italics">Habronema</content> and <content styleCode="italics">Draschia </content>spp. cutaneous third-stage larvae; dermatitis caused by neck threadworm microfilariae, <content styleCode="italics">Onchocerca </content>sp.</paragraph>
                  <paragraph/>
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                  <paragraph>
                     <content styleCode="bold">DOSAGE</content>
                  </paragraph>
                  <paragraph>SparMectin-E Liquid for Horses is formulated for administration by stomach tube (nasogastric intubation) or as an oral drench. The recommended dose is 91 mcg of ivermectin per lb (200 mcg/kg) of body weight. Each mL contains sufficient ivermectin to treat 110 lb (50 kg) of body weight: 10 mL will treat an 1100 lb (500 Kg) horse.</paragraph>
                  <paragraph>
                     <content styleCode="bold">ADMINISTRATION</content>
                  </paragraph>
                  <paragraph>Use a calibrated dosing syringe inserted into the bottle of measure the appropriate dose, or pour the SparMectin-E Liquid into a graduated cylinder for dose measurement. Use a clean syringe if accessing the bottle to avoid contaminating the remaining product.</paragraph>
                  <paragraph>Special consideration should be given to effects of potential for injury from handling, restraint, and placement of the stomach tube during administration of SparMectin-E Liquid. SparMectin-E Liquid should be administered by drench if the risks associated with tubing are of concern. Due to the potential consequences of improper administration, SparMectin-E Liquid is intended for use by a veterinarian only and is not recommended for dispensing.</paragraph>
                  <paragraph>SparMectin-E Liquid in 1 to 20 and 1 to 40 dilutions with tap water has been shown to be stable for 72 hours under the conditions recommended for the product (i.e., at room temperature, in a tightly closed container, protected from light). The diluted product does not promote the growth of common organisms. However, prolonged storage of the diluted product cannot be recommended, as the effects of possible contaminations and interactions with untested materials are unknown.</paragraph>
                  <paragraph>
                     <content styleCode="bold">Administration by stomach tube</content> (gravity or positive flow): The recommended dose can be used undiluted or diluted up to 40 times with clean tepid water. Use tepid water to flush any drug remaining in the tube into the horse's stomach.</paragraph>
                  <paragraph>
                     <content styleCode="bold">Administration by drench</content>: For administration of SparMectin-E by drench, an undiluted dose is recommended. Clear the horse's mouth of any food material, elevate the horse's head, and using a syringe, deposit the appropriated dose in the back of the mouth. In order to avoid unnecessary coughing or the potential for material to enter the trachea and lungs, do not use excessive pressure (squirting), do not use a large (diluted) dose volume, and do not deposit the dose in the laryngeal area. Increased dose rejection may occur if the dose is deposited in the buccal space. Keep horse's head elevated and observe the horse to insure the dose is retained.</paragraph>
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                  <paragraph>
                     <content styleCode="bold">PARASITE CONTROL PROGRAM</content>
                  </paragraph>
                  <paragraph>All horses should be included in a regular parasite control program with particular attention being paid to mares, foals and yearlings. Foals should be treated initially at 6 to 8 weeks of age and routine treatment repeated as appropriate. SparMectin-E (ivermectin) Liquid effectively controls gastrointestinal nematodes and bots in horses. Regular treatment will reduce the chances of verminous arteritis and colic caused by <content styleCode="italics">Strongylus vulgaris</content>. </paragraph>
                  <paragraph>
                     <content styleCode="bold">PRODUCT ADVANTAGES Broad-spectrum Control</content>
                  </paragraph>
                  <paragraph>SparMectin-E Liquid kills important internal parasites, including bots and the arterial stages of S. vulgaris, with a single dose. SparMectin-E Liquid is a potent anti-parasitic agent that is neither a benzimidazole nor a organophosphate.</paragraph>
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                  <paragraph>
                     <content styleCode="bold">WARNINGS</content>
                  </paragraph>
                  <paragraph>Not for use in humans. Keep this and all drugs out of the reach of children. <content styleCode="bold">Do not use in horses intended for human consumption</content>. Refrain from smoking and eating when handling. Wash hands after use. Avoid contact with eyes. The Safety Data Sheet (SDS) contains more detailed occupational safety information.</paragraph>
                  <paragraph/>
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               <code code="42229-5" codeSystem="2.16.840.1.113883.6.1" displayName="SPL UNCLASSIFIED SECTION"/>
               <title>CONTACT INFORMATION </title>
               <text>
                  <paragraph>To report suspected adverse events, for technical assistance or to obtain a copy of the SDS, contact Sparhawk Laboratories Inc at 1-800-255-6388 or 1-913-888-7500. For additional information about adverse drug experience reporting for animal drugs, contact FDA at 1-888-FDA-VETS or http://www.fda.gov/reportanimalae</paragraph>
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               <text>
                  <paragraph>SparMectin-E (ivermectin) Liquid has been formulated specifically for use in horses only. This product should not be used in other animal species as severe adverse reactions, including fatalities in dogs, may result.</paragraph>
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               <title>ENVIRONMENTAL SAFETY</title>
               <text>
                  <paragraph>Ivermectin and excreted ivermectin residues may adversely affect aquatic organisms. Do not contaminate ground or surface water. Dispose of drug container in an approved landfill or by incineration.<br/>
                  </paragraph>
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               <title>INFORMATION FOR HORSE OWNERS</title>
               <text>
                  <paragraph>Owners should be advised of the potential that swelling and itching reactions may occur after treatment with SparMectin-E Liquid in horses carrying heavy infections of neck threadworm microfilarie, <content styleCode="italics">Onchocerca sp</content>. These reactions are most likely the result of microfilarie dying in large numbers. Symptomatic treatment may be advisable.</paragraph>
                  <paragraph>Healing of summer sores involving extensive tissue changes may require other therapy in conjunction with SparMectin-E Liquid. Reinfection, and measures for its prevention, should also be considered.</paragraph>
                  <paragraph>Owners should be advised to consult their veterinarian if these conditions do no improve.<br/>
                  </paragraph>
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               <title>CLINICAL PHARMACOLOGY</title>
               <text>
                  <paragraph>
                     <content styleCode="bold">Mode of Action</content>: Ivermectin is a member of the macrocyclic lactone class  of endectocides which have a unique  mode of action. Compounds of the class bind selectively and with high affinity to glutamate-gated chloride ion channels which occur in invertebrate nerve and muscle cells. This leads to an increase in the permeability of the cell membrane to chloride ions with hyperpolarization of the never or muscle cell, resulting in paralysis and death of the parasite. Compounds of this class may also interact with other ligand-gated chloride channels, such as those gated by the neurotransmitter gamma-aminobutyric acid (GABA).</paragraph>
                  <paragraph>The margin of safety is attributable to the fact that mammals do not have glutamate-gated chloride channels, the macrocyclic lactions have a low affinity for other mammalian ligand-gated chloride channels and they do not readily cross the blood-brain barrier.<br/>
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               <title>ANIMAL SAFETY</title>
               <text>
                  <paragraph>SparMectin-E Liquid may be used in horses of all ages, including mares at any stage of pregnancy. Stallions may be treated without adversely affecting their fertility.<br/>
                  </paragraph>
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               <title>STORAGE INFORMATION</title>
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                  <paragraph>Store in a tightly closed container refrigerated between 2<sup>o</sup>C and 8<sup>o</sup>C (36<sup>o</sup>F and 46<sup>o</sup>F) with excursions up to 25<sup>o</sup>C (77<sup>o</sup>F) allowed. Protect SparMectin-E Liquid (undiluted or diluted) from light.<br/>
                  </paragraph>
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               <title>HOW SUPPLIED</title>
               <text>
                  <paragraph>SparMectin-E Liquid for Horses is available in a 100 mL plastic bottle. Each bottle contains sufficient ivermectin to treat 10-500 kg (1100 lb) horses. Contents may be poured into a graduated cylinder for dose measurements. Alternatively, a clean syringe may be inserted directly into the bottle to draw off the appropriate dose.<br/>
                  </paragraph>
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