RX #: 278390    1/4/2010     LWP MD

CYLCOBENZAPRINE HCL #3 GM

LOT: 292090707                                HEALTH: 2

MFG: APOTHECARES                    FIRE:1

NDC: 37803-0368-08                          REACTIVITY:0

BATCH #: 01041004                          CAS:6202-23-9

RX #: 267654   11/10/2009     LWP MD

MAGNESIUM OXIDE POWDER HVY #60 GM

LOT: YP0232                                  HEALTH: 2

MFG: SPECTRUM                        FIRE:0

NDC: 49452-4260-02                                 REACTIVITY:0

BATCH #: 11100901                                CAS:1309-48-4

1. RX Only

For Prescription Compounding Only

Cyclo/Mag Kit
Cyclobenzaprine HCl and Magnesium  Oxide Compound Kit

Description

Each Cyclo/Mag Kit is comprised of 3 grams of cyclobenzaprine hydrochloride powder, USP and
60 grams of magnesium oxide heavy powder.

Certificate of Analysis on File

Cyclo/Mag Kit also contains 60 grams of Lactose Monohydrate (Spray dried) powder and 0.15 grams of
riboflavin USP powder. When compounded, the final product provides a homogeneous product of 300
capsules each capsule containing 10mg of cyclobenzaprine and 200mg of magnesium oxide.

Equipment

Required supplies needed to compound this kit

Equipment 

Recommended supplies not included in this kit

Directions

1. Using a 16 oz mortar and pestle triturate powders well to reduce particle size until uniform. Do not use metal bowls or spatulas while

compounding this product.

2.  Using a 300 capsule machine encapsulate triturate powder mixture into number 1 red capsules

Prior to compounding, store Cyclo/Mag Kit at room temperature. Store the final product at room temperature.

Final product for oral use only. Keep out the reach of children. Compounded product, as dispensed,

is stable for at least 180 days or the time remaining on the expiration date of any given ingredient,

which ever is shorter.