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                     <manufacturedProduct>
                        <code code="23243-2395" codeSystem="2.16.840.1.113883.6.69"/>
                        <name>Tilmovet 90<suffix>Type A Medicated Article</suffix>
                        </name>
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                              <name>Tilmicosin phosphate</name>
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                              <code code="SMH7U1S683" codeSystem="2.16.840.1.113883.4.9"/>
                              <name>TILMICOSIN PHOSPHATE</name>
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                                    <code code="XL4103X2E3" codeSystem="2.16.840.1.113883.4.9"/>
                                    <name>TILMICOSIN</name>
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                              <name>corn cob</name>
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                              <name>castor oil</name>
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                              <numerator value="20" unit="kg"/>
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                  <paragraph>
                     <content styleCode="bold">Tilmovet® 90                   LB496v8Til90mp20-USA0421</content>
                     <br/>
                     <content styleCode="bold">(tilmicosin)</content>
                     <br/>
                     <content styleCode="bold">Type A Medicated Article</content>
                  </paragraph>
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               <text>
                  <paragraph>CAUTION: Federal law restricts medicated feed containing this veterinary feed directive (VFD) drug to use by or<br/>on the order of a licensed veterinary.</paragraph>
               </text>
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                  <paragraph>
                     <content styleCode="bold">For Use in Swine and Cattle Feeds Only</content>
                  </paragraph>
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                        <tr styleCode="First Last">
                           <td valign="top">
                              <paragraph>Do Not Feed Undiluted</paragraph>
                           </td>
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                  <paragraph>
                     <content styleCode="bold">Active Drug Ingredient:</content> Tilmicosin (as tilmicosin phosphate) 90.7 g per lb (200 g per kg).</paragraph>
                  <paragraph>
                     <content styleCode="bold">Inert Ingredients:</content> Corncobs, macrogolglycerol ricinoleate.</paragraph>
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                  <paragraph>
                     <content styleCode="bold">Description:</content> Tilmovet® (tilmicosin) 90 is a formulation of the antibiotic tilmicosin.<br/>Tilmicosin is produced semi-synthetically and is in the macrolide class of antibiotics.<br/>Each kilogram of Type A Medicated Article contains 200 grams (0.44 lbs) of tilmicosin<br/>adsorbed onto ground corncobs.</paragraph>
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                  <paragraph>
                     <content styleCode="bold">Indications:</content>
                     <br/>
                     <content styleCode="bold">Swine:</content> For the control of swine respiratory disease (SRD) associated with <content styleCode="italics">Actinobacillus</content>
                     <br/>
                     <content styleCode="italics">pleuropneumoniae </content>and<content styleCode="italics"> Pasteurella multocida</content>.<br/>
                     <content styleCode="bold">Cattle:</content> For the control of bovine respiratory disease (BRD) associated with <content styleCode="italics">Mannheimia</content>
                     <br/>
                     <content styleCode="italics">haemolytica, Pasteurella multocida </content>and<content styleCode="italics"> Histophilus somni</content> in groups of beef and nonlactating<br/>dairy cattle, where active BRD has been diagnosed in at least 10% of the animals<br/>in the group.</paragraph>
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               <text>
                  <paragraph>
                     <content styleCode="bold">Feeding Directions:</content>
                     <br/>
                     <content styleCode="bold">Swine:</content> Tilmicosin is to be fed continuously at 181 grams to 363 grams per ton (200 ppm to<br/>400 ppm) of Type C medicated feed as the sole ration for a 21-day period, beginning<br/>approximately 7 days before an anticipated disease outbreak.<br/>
                     <content styleCode="bold">Cattle:</content> Tilmicosin is to be fed continuously for a single, 14 day period at 568 grams to 757<br/>grams (626 ppm to 834 ppm) per ton on a 100% dry matter basis of Type C medicated feed<br/>as the sole ration to provide 12.5 mg/kg of body weight/day.</paragraph>
                  <paragraph>
                     <content styleCode="bold">IMPORTANT: Must be thoroughly mixed in swine or cattle feeds before use.</content>
                  </paragraph>
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               <text>
                  <paragraph>
                     <content styleCode="bold">Mixing Directions:</content>
                     <br/>
                     <content styleCode="bold">For Incorporation into Swine Feeds:</content> Thoroughly mix Tilmovet Type A medicated article with<br/>feed to provide a Type B medicated feed containing up to 36,300 grams tilmicosin per ton or<br/>to provide a complete Type C medicated feed containing 181 to 363 g tilmicosin per ton. Do<br/>not use in any feeds containing bentonite. Bentonite in feeds may affect the efficacy of<br/>tilmicosin.</paragraph>
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                     <content styleCode="bold">For Incorporation into Cattle Feeds:</content> Thoroughly mix Tilmovet 90 Type A medicated article<br/>with feed to provide a Type B medicated feed containing up to 36,300 grams tilmicosin per<br/>ton on a 100% dry matter basis or to provide a complete Type C medicated feed containing<br/>568 to 757 g tilmicosin per ton on a 100% dry matter basis. Complete Type C medicated<br/>feeds should not be pelleted. Do not use in any feeds containing bentonite, cottonseed<br/>meal, or cottonseed hulls. Bentonite, cottonseed meal, or cottonseed hulls in feeds may<br/>affect the efficacy of tilmicosin.</paragraph>
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                  <paragraph>
                     <content styleCode="bold">LOT</content>
                  </paragraph>
                  <paragraph>
                     <content styleCode="bold">EXP</content>
                  </paragraph>
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               <text>
                  <paragraph>
                     <content styleCode="bold">Net weight:20 kg (44.0 lb)</content>
                  </paragraph>
                  <paragraph>
                     <content styleCode="bold">CAUTION:</content>
                     <br/>Do not allow horses or other equines access to feeds containing tilmicosin. The safety of<br/>tilmicosin has not been established in cattle or male swine intended for breeding purposes.<br/>To assure both food safety and responsible use in cattle, the treatment of cattle with this<br/>medicated feed is required to be initiated within the first 45 days of the production period.<br/>The treatment should not occur concurrent with or following administration of an injectable<br/>macrolide, or within 3 days following administration of a non-macrolide injectable BRD<br/>therapy.</paragraph>
                  <paragraph>
                     <content styleCode="bold">Swine:</content> Feed containing tilmicosin shall not be fed to pigs for more than 21 days during each<br/>phase of production without ceasing administration for reevaluation of antimicrobial use by<br/>a licensed veterinarian before re-initiating a further course of therapy with an appropriate<br/>antimicrobial. Veterinary Feed Directive (VFD) expiration date for swine must not exceed 90<br/>days from the time of issuance. VFDs for tilmicosin phosphate shall not be refilled.</paragraph>
                  <paragraph>
                     <content styleCode="bold">Cattle:</content> Use only in cattle fed in confinement for slaughter. Tilmicosin medicated feed<br/>treatment has not been evaluated in cattle with severe clinical disease. Cattle with severe<br/>clinical illness should be evaluated for individual treatment with an alternative nonmacrolide<br/>therapy. The expiration date for a tilmicosin Veterinary Feed Directive (VFD) for<br/>cattle must not exceed 45 days from the time of issuance. VFDs for tilmicosin phosphate<br/>shall not be refilled.</paragraph>
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               <text>
                  <paragraph>
                     <content styleCode="bold">WARNINGS:</content>
                     <br/>
                     <content styleCode="bold">RESIDUE WARNING: Swine:</content> Swine intended for human consumption must not be<br/>slaughtered within 7 days of the last treatment of this drug product.<br/>
                     <content styleCode="bold">RESIDUE WARNING: Cattle:</content> Cattle intended for human consumption must not be<br/>slaughtered within 28 days of the last treatment with this drug product.<br/>This drug product is not approved for use in female dairy cattle 20 months of<br/>age or older. Use in these cattle may cause drug residues in milk. This drug product<br/>is not approved for use in calves intended to be processed for veal. A withdrawal<br/>period has not been established in pre-ruminating calves.</paragraph>
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               <text>
                  <paragraph>
                     <content styleCode="bold">User Safety Warnings:</content> Avoid inhalation, oral exposure and direct contact with skin or eyes.<br/>Operators mixing and handling Tilmovet 90 should use protective clothing, impervious<br/>gloves, goggles and a NIOSH-approved dust mask. Wash thoroughly with soap and water<br/>after handling. If accidental eye contact occurs, immediately rinse thoroughly with water. If<br/>irritation persists, seek medical attention. Not for human consumption. Keep out of reach of<br/>children. The Safety Data Sheet contains more detailed occupational safety information. To<br/>report adverse effects in users, to obtain more information, or to obtain a Safety Data Sheet,<br/>call 1-877-426-7765.</paragraph>
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               <text>
                  <paragraph>
                     <content styleCode="bold">Clinical Pharmacology:</content> Oral dosing of tilmicosin phosphate to swine at 181 to 363 g/ton of<br/>feed results in serum tilmicosin levels, which do not correlate with efficacy. Lung<br/>concentrations of tilmicosin are significantly higher than serum. Following 7 consecutive<br/>days of administering tilmicosin-medicated feeds to swine, the concentration of tilmicosin<br/>in respiratory tissues, phagocytic cells, and nasal secretions was significantly higher than<br/>that of plasma or serum. Lung levels are achieved within 2 days after beginning feeding<br/>and plateau by 4 days. Using <content styleCode="italics">in-vitro</content> incubation techniques, the ratio of intracellular to<br/>extracellular concentrations of tilmicosin for neutrophils, monocyte-macrophages and<br/>alveolar macrophages were 69, 19 and 17, respectively, after four hours of incubation.<br/>Although lower levels of accumulation were observed <content styleCode="italics">in-vivo</content>, swine alveolar macrophages<br/>have been shown <content styleCode="italics">in-vitro</content> and <content styleCode="italics">in-vivo </content>to concentrate large amounts of tilmicosin; these cells<br/>may be important for <content styleCode="italics">in-vivo</content> distribution of the drug and may serve as an important<br/>reservoir for tilmicosin in lung tissue.<br/>Oral dosing of tilmicosin phosphate to cattle to target a dose of 12.5 mg/kg body weight<br/>resulted in serum tilmicosin concentrations above the analytical limit of quantification (0.5<br/>ng/mL) within 12 hours following treatment administration.<br/>The relationship of serum tilmicosin concentration to lung tilmicosin concentration has not<br/>been determined following oral administration of tilmicosin.</paragraph>
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                  <paragraph>
                     <content styleCode="bold">Toxicology:</content> The cardiovascular system is the target of toxicity in laboratory and domestic<br/>animals given tilmicosin by oral or parenteral routes. Primary cardiac effects are increased<br/>heart rate (tachycardia) and decreased contractility (negative inotropy). Given orally, the<br/>median lethal dose is 800 mg/kg in fasted rats and 2250 mg/kg in non-fasted rats. No<br/>compound-related lesions were found at necropsy. Results of genetic toxicology studies<br/>were all negative. Results of teratology and reproduction studies in rats were all negative.<br/>The no effect level in dogs after daily oral doses for up to one year is 4 mg/kg of body<br/>weight. Tilmicosin was included in the diet of 18 adult horses for a period of 14 days at dose<br/>levels of 400, 1200 and 2000 ppm. Some horses at both the low and high dose levels<br/>demonstrated gastrointestinal disturbance with more severe colic evident at the higher<br/>levels. One horse died after consuming the 2000 ppm diet. A study was conducted in cattle<br/>administered oral tilmicosin at 12.5, 25.0 or 37.5 mg/kg for 42 days or administered 12.5<br/>mg/kg of oral tilmicosin for 14 days followed by 20 mg/kg injection of tilmicosin or saline<br/>(volume equivalent). Cardiac lesions observed (one animal in the 12.5 mg/kg for 42 days<br/>treatment group; one animal in the 12.5 mg/kg for 14 days followed by tilmicosin injection<br/>treatment group) were not considered clinically significant as no other abnormalities were<br/>seen and the affected animals were clinically normal.</paragraph>
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               <text>
                  <paragraph>To report suspected adverse drug events, for technical assistance or to obtain a copy of the<br/>Safety Data Sheet (SDS), contact Huvepharma, Inc. at 1-877-994-4883 or<br/>www.huvepharma.us. For additional information about adverse drug experience reporting<br/>for animal drugs, contact FDA at 1-888-FDA-VETS or http://www.fda.gov/reportanimalae.</paragraph>
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               <text>
                  <paragraph>Storage Information: Store at room temperature 20 – 25 ºC (68 – 77 ºF).<br/>Excursions permitted to 30°C (86°F).<br/>Avoid moisture and excessive heat 40°C (104°F).</paragraph>
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                  <paragraph>Not to be used after the date printed on the bag<br/>
                     <content styleCode="bold">Not for Use in Humans</content>
                     <br/>
                     <content styleCode="bold">Restricted Drug (California) - Use Only as Directed</content>
                     <br/>
                     <content styleCode="bold">Approved by FDA under ANADA # 200-509</content>
                     <br/>
                     <content styleCode="bold">Manufactured For:</content>
                     <br/>
                     <content styleCode="bold">Huvepharma, Inc., Peachtree City, GA 30269, USA</content>
                     <br/>
                     <content styleCode="bold">Huvepharma and Tilmovet are registered trademarks</content>
                     <br/>
                     <content styleCode="bold">of Huvepharma AD.</content>
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                     <content styleCode="bold">Rev. 03-2022</content>
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