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   <title>AGRI-MECTIN
(ivermectin)
</title>
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               <text>
                  <content styleCode="bold">
                     <br/>
                  </content>ANADA 200-429, Approved by FDA<br/>
                  <br/>
                  <content styleCode="bold">Injection for Cattle and Swine<br/>1% Sterile Solution<br/>
                     <br/>A Parasiticide for the Treatment and Control of Internal and External Parasites of Cattle and Swine<br/>
                     <br/>Consult your veterinarian for assistance in the diagnosis, treatment, and control of parasitism.<br/>
                  </content>
               </text>
               <effectiveTime value="20130125"/>
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               <text>
                  <content styleCode="bold">
                     <br/>
                  </content>
                  <content styleCode="bold">Introduction</content>
                  <br/>
                  <br/>AGRI-MECTIN is an injectable parasiticide for cattle and swine. One low-volume dose effectively treats and controls the following internal and external parasites that may impair the health of cattle and swine: gastrointestinal roundworms (including inhibited <content styleCode="italics">Ostertagia ostertagi</content> in cattle), lungworms, grubs, sucking lice, and mange mites of cattle; and gastrointestinal roundworms, lungworms, lice, and mange mites in swine.<br/>
                  <content styleCode="bold">
                     <br/>Product Description</content>
                  <br/>
                  <br/>Ivermectin is derived from the avermectins, a family of potent, broad-spectrum antiparasitic agents isolated from fermentation of<content styleCode="italics"> Streptomyces avermitilis.<br/>
                  </content>AGRI-MECTIN Injection is a clear, ready-to-use, sterile solution containing 1% ivermectin, 40% glycerol formal, and propylene glycol, q.s. ad 100%. AGRI-MECTIN Injection is formulated to deliver the recommended dose level of 200 mcg ivermectin/kilogram of body weight in cattle when given subcutaneously at the rate of 1 mL/110 lb (50 kg). In Swine, AGRI-MECTIN Injection is formulated to deliver the recommended dose level of 300 mcg ivermectin/kilogram body weight when given subcutaneously in the neck at the rate of 1 mL/75 lbs (33 kg).<br/>
                  <content styleCode="bold">
                     <content styleCode="bold">
                        <content styleCode="bold">
                           <br/>
                        </content>
                     </content>
                  </content>
                  <br/>
                  <content styleCode="bold">
                     <content styleCode="bold"/>
                  </content>
               </text>
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               <code code="43679-0" codeSystem="2.16.840.1.113883.6.1" displayName="MECHANISM OF ACTION SECTION"/>
               <title>Mode of Action</title>
               <text>
                  <paragraph>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 nerve 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 for compounds of this class is attributable to the fact that mammals do not have glutamate-gated chloride channels, the macrocyclic lactones have a low affinity for other mammalian ligand-gated chloride channels and they do not readily cross the blood-brain barrier.<br/>
                  </paragraph>
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               <id root="ad392bdb-74b6-4335-840a-30564d701eed"/>
               <code code="34067-9" codeSystem="2.16.840.1.113883.6.1" displayName="INDICATIONS &amp; USAGE SECTION"/>
               <title>Indications</title>
               <text>
                  <br/>
                  <content styleCode="bold">Cattle</content>: AGRI-MECTIN Injection is indicated for the effective treatment and control of the following harmful species of gastrointestinal roundworms, lungworms, grubs, sucking lice and mange mites in cattle:<br/>
                  <content styleCode="bold">Gastrointestinal Roundworms<br/>
                  </content>(adults and fourth-stage larvae):<br/>
                  <content styleCode="italics">Ostertagia ostertagi<br/>
                  </content>    (Including inhibited <content styleCode="italics">O. ostertagi</content>)<br/>
                  <content styleCode="italics">O. lyrata<br/>Haemonchus placei<br/>Trichostrongylus axei<br/>T. colubriformis<br/>Cooperia oncophora<br/>C. punctata<br/>C. pectinata<br/>Oesophagostomum radiatum<br/>Bunostomum phlebotomum<br/>Nematodirus helvetianus<br/>    </content>(adults only)<content styleCode="italics">
                     <br/>N. spathiger</content> (adults only)<br/>
                  <br/>
                  <content styleCode="bold">Lungworms</content>
                  <br/>(adults and fourth-stage larvae):<br/>
                  <content styleCode="italics">Dictyocaulus viviparus<br/>
                  </content>
                  <content styleCode="bold">Cattle Grubs</content>(parasitic stages):<br/>
                  <content styleCode="italics">Hypoderma bovis<br/>H. lineatum<br/>
                  </content>
                  <content styleCode="bold">Sucking Lice</content>:<br/>
                  <content styleCode="italics">Linognathus vituli<br/>Haematopinus eurysternus<br/>Solenopotes capillatus<br/>
                  </content>
                  <content styleCode="bold">Mites</content> (scabies):<br/>
                  <content styleCode="italics">Psoroptes ovis<br/>
                  </content>    (syn.<content styleCode="italics"> P. communis</content> var.<content styleCode="italics"> bovis</content>)<br/>
                  <content styleCode="italics">Sarcoptes scabiei </content>var.<content styleCode="italics"> bovis<br/>
                  </content>
               </text>
               <effectiveTime value="20130125"/>
               <component>
                  <section>
                     <id root="a1f7b334-0161-4263-b6a9-703b0301b0b7"/>
                     <code code="34067-9" codeSystem="2.16.840.1.113883.6.1" displayName="INDICATIONS &amp; USAGE SECTION"/>
                     <title>Persistent Activity</title>
                     <text>
                        <paragraph>AGRI-MECTIN Injection has been proved to effectively control infections and to protect cattle from reinfection with<content styleCode="italics"> Dictyocaulus viviparus </content>and <content styleCode="italics">Oesophagostomum radiatum</content> for 28 days after treatment;<content styleCode="italics"> Ostertagia ostertagi, Trichostrongylus axei </content>and<content styleCode="italics"> Cooperia punctata</content> for 21 days after treatment;<content styleCode="italics"> Haemonchus placei </content>and<content styleCode="italics"> Cooperia oncophora </content>for 14 days after treatment.</paragraph>
                        <paragraph>
                           <content styleCode="bold">Swine</content>:  AGRI-MECTIN Injection is indicated for the effective treatment and control of the following harmful species of gastrointestinal roundworms, lungworms, lice and mange mites in swine:</paragraph>
                        <content styleCode="bold">Gastrointestinal roundworms</content>
                        <br/>Large roundworm,<content styleCode="italics"> Ascaris suum<br/>
                        </content>(adults and fourth-stage larvae)<br/>Red stomach worm,<content styleCode="italics"> Hyostrongylus rubidus</content>
                        <br/>(adults and fourth-stage larvae)<br/>Nodular worm,<content styleCode="italics"> Oesophagostomum spp.</content>
                        <br/>(adults and fourth-stage larvae)<br/>Threadworm,<content styleCode="italics"> Strongyloides ransomi</content> (adults)<br/>
                        <content styleCode="bold">Somatic Roundworm Larvae:</content>
                        <br/>Threadworm, <content styleCode="italics">Strongyloides ransomi </content>(somatic larvae)<br/>Sows must be treated at least seven days before farrowing to prevent infection in piglets.<br/>
                        <content styleCode="bold">Lungworm:<br/>
                        </content>
                        <content styleCode="italics">Metastrongylus spp</content>. (adults)<br/>
                        <content styleCode="bold">Lice:<br/>
                        </content>
                        <content styleCode="italics">Haematopinus suis<br/>
                        </content>
                        <content styleCode="bold">Mange Mites:<br/>
                        </content>
                        <content styleCode="italics">Sarcoptes scabiei  </content>var. <content styleCode="italics">suis</content>
                        <content styleCode="italics">
                           <content styleCode="italics"/>
                        </content>
                     </text>
                  </section>
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            </section>
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         <component>
            <section>
               <id root="dd5ccaa6-bbfc-41f9-b08b-2afc277e43c6"/>
               <code code="43678-2" codeSystem="2.16.840.1.113883.6.1" displayName="DOSAGE FORMS &amp; STRENGTHS SECTION"/>
               <title>Dosage</title>
               <text>
                  <paragraph>
                     <content styleCode="bold">Cattle</content>: AGRI-MECTIN should be given only by subcutaneous injection under the loose skin in front of or behind the shoulder at the recommended dose level of 200 mcg ivermectin per kilogram of body weight. Each mL of AGRI-MECTIN contains 10 mg of ivermectin, sufficient to treat 110 lb (50 kg) of body weight (maximum 10 mL per injection site.).<br/>
                     <br/>
                     <renderMultiMedia referencedObject="MM1"/>
                     <br/>
                  </paragraph>
                  <paragraph>
                     <content styleCode="bold">Swine</content>: AGRI-MECTIN should be given only by subcutaneous injection in the neck of swine at the recommended dose level of 300 mcg ivermectin per kilogram (2.2 lb) of body weight. Each mL of AGRI-MECTIN contains 10 mg of ivermectin, sufficient to treat 75 lb of body weight.</paragraph>
               </text>
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                     <text>AL-Agrimectin Inj-Chart-13 label</text>
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               <code code="34068-7" codeSystem="2.16.840.1.113883.6.1" displayName="DOSAGE &amp; ADMINISTRATION SECTION"/>
               <title>Administration</title>
               <text>
                  <paragraph>
                     <content styleCode="bold">Cattle: AGRI-MECTIN Injection is to
be given subcutaneously only, to reduce risk of potentially fatal
clostridial infection of the injection site.<br/>
                     </content>Animals should be appropriately restrained to achieve the proper
route of administration. Use of a 16-gauge, 1/2 to 3/4" needle is
suggested. Inject under the loose skin in front of or behind the
shoulder (see illustration). When using the 200 mL, 500 mL size, use only automatic syringe equipment. Use sterile equipment and sanitize the injection site by applying a suitable disinfectant. Clean, properly disinfected needles should be used to reduce the potential for injection site infections. No special handling or protective clothing is necessary.</paragraph>
                  <paragraph>
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                  </paragraph>
                  <content styleCode="bold">Swine</content>:  AGRI-MECTIN Injection is to be given subcutaneously in the neck. Animals should be appropriately restrained to achieve the proper route of administration. Use of a 16- or 18-gauge needle is suggested for sows and boars, while an 18- or 20-gauge needle may be appropriate for young animals. Inject under the skin, immediately behind the ear (see illustration). When using the 200 mL, 500 mL size, use only automatic syringe equipment. As with any injection, sterile equipment should be used. The injection site should be cleaned and disinfected with alcohol before injection. The rubber stopper should also be disinfected with alcohol to prevent contamination of the contents. Mild and transient pain reactions may be seen in some swine following subcutaneous administration.</text>
               <effectiveTime value="20130117"/>
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                  <observationMedia classCode="OBS" moodCode="EVN" ID="MM2">
                     <text>AL-Agrimectin Inj-Administration-13 label</text>
                     <value xsi:type="ED" mediaType="image/jpeg">
                        <reference value="AL-Agrimectin Inj-Administration-13.jpg"/>
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            </section>
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         <component>
            <section>
               <id root="fbb60864-02cf-457b-baf8-928877e2020d"/>
               <code code="60562-6" codeSystem="2.16.840.1.113883.6.1" displayName="ROUTE, METHOD AND FREQUENCY OF ADMINISTRATION"/>
               <title>Recommended Treatment Program</title>
               <text>
                  <paragraph>
                     <content styleCode="bold">SWINE</content>: At the time of initiating any parasite control program, it is important to treat all breeding animals in the herd. After the initial treatment, use AGRI-MECTIN Injection regularly as follows:<br/>
                     <content styleCode="bold">BREEDING ANIMALS</content>:<br/>
                     <content styleCode="bold">Sows</content>:  Treat prior to farrowing, preferably 7 - 14 days before, to minimize infection of piglets.<br/>
                     <content styleCode="bold">Gilts</content>:   Treat 7 - 14 days prior to breeding.<br/>            Treat 7 - 14 days prior to farrowing.<br/>
                     <content styleCode="bold">Boars</content>: Frequency and need for treatment are dependent upon exposure.  Treat at least two times a year.<br/>
                     <content styleCode="bold">FEEDER PIGS</content>
                     <br/>
                     <content styleCode="bold">(Weaners/Growers/Finishers)</content>
                     <br/>All weaner/feeder pigs should be treated before placement in clean quarters.<br/>Pigs exposed to contaminated soil or pasture may need retreatment if reinfection occurs.<br/>
                     <content styleCode="bold">NOTE</content>:<br/>(1) AGRI-MECTIN Injection has a persistent drug level sufficient to control mite infestations throughout the egg to adult life cycle. However, since the ivermectin effect is not immediate, care must be taken to prevent reinfestation from exposure to untreated animals or contaminated facilities. Generally, pigs should not be moved to clean quarters or exposed to uninfested pigs for approximately one week  after treatment. Sows should be treated at least one week before farrowing to minimize transfer of mites to newborn baby pigs.<br/>(2) Louse eggs are unaffected by AGRI-MECTIN Injection and may require up to three weeks to hatch. Louse infestations developing from hatching eggs may require retreatment.<br/>(3) Consult a veterinarian for aid in the diagnosis and control of internal and external parasites of swine.</paragraph>
                  <content styleCode="bold">Special Minor Use</content>
                  <br/>
                  <content styleCode="bold">Reindeer</content>: For the treatment and control of warbles (<content styleCode="italics">Oedemagena tarandi</content>) in reindeer, inject 200 micrograms ivermectin per kilogram of body weight, subcutaneously. Follow use directions for cattle as described under <content styleCode="bold">ADMINISTRATION</content>.<br/>
                  <content styleCode="bold">American Bison</content>: For the treatment and control of grubs (<content styleCode="italics">Hypoderma bovis</content>) in American bison, inject 200 micrograms ivermectin per kilogram of body weight, subcutaneously. Follow use directions for cattle as described under <content styleCode="bold">ADMINISTRATION</content>.<paragraph>
                     <br/>
                  </paragraph>
                  <content styleCode="bold"/>
               </text>
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            <section>
               <id root="6f33fcc1-3a01-464c-9f41-78f37a380cea"/>
               <code code="34071-1" codeSystem="2.16.840.1.113883.6.1" displayName="WARNINGS SECTION"/>
               <text>
                  <paragraph>
                     <content styleCode="bold">RESIDUE WARNING</content>: Do not treat reindeer or American bison within 8 weeks (56 days) of slaughter. </paragraph>
                  <paragraph>
                     <content styleCode="bold">WARNING</content>
                  </paragraph>
                  <paragraph>
                     <content styleCode="bold">Not for use in humans.</content>
                  </paragraph>
                  <paragraph>
                     <content styleCode="bold">Keep this and all drugs out of the reach of children</content>.</paragraph>
                  <paragraph>The Material Safety Data Sheet (MSDS) contains more detailed occupational safety information. To report adverse effects, obtain a MSDS or for assistance, contact Agri Laboratories, Ltd. at 1-800-542-8916.</paragraph>
                  <paragraph>  <content styleCode="bold">RESIDUE WARNING</content>: Do not treat cattle within 35 days of slaughter. Because a withdrawal time in milk has not been established, do not use in female dairy cattle of breeding age.  <br/>  A withdrawal period has not been established for this product in pre-ruminating calves. Do not use in calves to be processed for veal.<br/>  Do not treat swine within 18 days of slaughter.</paragraph>
               </text>
               <effectiveTime value="20130125"/>
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         <component>
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               <id root="1413e23c-942d-45f1-b0fc-5405c8fd7741"/>
               <code code="42232-9" codeSystem="2.16.840.1.113883.6.1" displayName="PRECAUTIONS SECTION"/>
               <title>Precautions</title>
               <text>
                  <paragraph>Transitory discomfort has been observed in some cattle following subcutaneous administration. A low incidence of soft tissue swelling at the injection site has been observed. These reactions have disappeared without treatment. For cattle, divide doses greater than 10 mL between two injection sites to reduce occasional discomfort or site reaction.</paragraph>
                  <paragraph>Use sterile equipment and sanitize the injection site by applying a suitable disinfectant. Clean, properly disinfected needles should be used to reduce the potential for injection site infection.</paragraph>
                  <paragraph>Observe cattle for injection site reactions. Reactions may be due to clostridial infection and should be aggressively treated with appropriate antibiotics. If injection site infections are suspected, consult your veterinarian.</paragraph>
                  <paragraph>This product is not for intravenous or intramuscular use.</paragraph>
                  <paragraph>Protect product from light.<br/>
                  </paragraph>
                  <paragraph>AGRI-MECTIN Injection for Cattle and Swine has been developed specifically for use in cattle, swine, reindeer and American bison <content styleCode="bold">only</content>. This product should not be used in other animal species as severe adverse reactions, including fatalities in dogs may result.</paragraph>
                  <paragraph>
                     <content styleCode="bold">When to Treat Cattle with Grubs</content>
                     <br/>AGRI-MECTIN effectively controls all stages of cattle grubs. However, proper timing of treatment is important. For most effective results, cattle should be treated as soon as possible after the end of the heel fly (warble fly) season. Destruction of<content styleCode="italics"> Hypoderma</content> larvae (cattle grubs) at the period when these grubs are in vital areas may cause undesirable host-parasite reactions including the possibility of fatalities. Killing <content styleCode="italics">Hypoderma lineatum</content> when it is in the tissue surrounding the esophagus (gullet) may cause salivation and bloat.: Killing <content styleCode="italics">H. bovis</content> when it is in the vertebral canal may cause staggering or paralysis. These reactions are not specific to treatment with AGRI-MECTIN, but can occur with any successful treatment of grubs. Cattle should be treated either before or after these stages of grub development. Consult your veterinarian concerning the proper time for treatment. Cattle treated with AGRI-MECTIN after the end of the heel fly season may be retreated with AGRI-MECTIN during the winter for internal parasites, mange mites, or sucking lice without danger of grub-related reactions. A planned parasite control program is recommended.</paragraph>
               </text>
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               <code code="50742-6" codeSystem="2.16.840.1.113883.6.1" displayName="ENVIRONMENTAL WARNING SECTION"/>
               <title>Environmental Safety</title>
               <text>
                  <paragraph>Studies indicate that when ivermectin comes in contact with the soil, it readily and tightly binds to the soil and becomes inactive over time. Free ivermectin may adversely affect fish and certain water-borne organisms on which they feed. Do not permit water runoff from feedlots or production sites to enter lakes, streams, or ponds. Do not contaminate water by direct application or by the improper disposal of drug containers. Dispose of containers in an approved landfill or by incineration.<br/>As with other avermectins, ivermectin is excreted in the dung of treated animals and can inhibit the reproduction and growth of pest and beneficial insects that use dung as a source of food and for reproduction. The magnitude and duration of such effects are species and lifestyle specific. When used according to label directions, the product is not expected to have an adverse impact on populations of dung-dependent insects.</paragraph>
               </text>
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               <id root="47f154fb-abef-48b2-8f1a-7dd4d0c678f9"/>
               <code code="34069-5" codeSystem="2.16.840.1.113883.6.1" displayName="HOW SUPPLIED SECTION"/>
               <title>How Supplied</title>
               <text>
                  <paragraph>50 mL, 200 mL, 500 mL</paragraph>
               </text>
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            </section>
         </component>
         <component>
            <section>
               <id root="b926f75b-16b2-4aa4-84e7-9ab30ea9012e"/>
               <code code="44425-7" codeSystem="2.16.840.1.113883.6.1" displayName="STORAGE AND HANDLING SECTION"/>
               <text>
                  <br/>
                  <paragraph>Store at 20-25<sup>o</sup>C.</paragraph>
                  <paragraph>Restricted Drug (California) - use only as directed.</paragraph>
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                  <content styleCode="bold">Manufactured for<br/> Agri Laboratories, Ltd.</content>
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                  <content styleCode="bold">St. Joseph, MO 64503<br/>
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                  </content>ANADA 200-429, Approved by FDA<br/>
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