<?xml version="1.0" encoding="UTF-8" standalone="no"?><?xml-stylesheet href="../../stylesheet/spl.xsl" type="text/xsl"?><document xmlns="urn:hl7-org:v3" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="urn:hl7-org:v3 https://www.accessdata.fda.gov/spl/schema/spl.xsd">
  <id root="3bb1affd-e321-496d-8bec-0feb8cc15e51"/>
  <code code="34391-3" codeSystem="2.16.840.1.113883.6.1" displayName="HUMAN PRESCRIPTION DRUG LABEL"/>
  <title>
    <content styleCode="bold">Anusol-HC<sup>® </sup>Hydrocortisone Acetate Rectal Suppositories, 25 mg</content>
    <br/>
    <content styleCode="bold">Rx only</content>
  </title>
  <effectiveTime value="20240701"/>
  <setId root="a562f3d7-2692-4357-aade-ae50afcbfddd"/>
  <versionNumber value="7"/>
  <author>
    <time/>
    <assignedEntity>
      <representedOrganization>
        <id extension="793108036" root="1.3.6.1.4.1.519.1"/>
        <name>Salix Pharmaceuticals, Inc</name>
        <assignedEntity>
          <assignedOrganization>
            <assignedEntity>
              <assignedOrganization>
                <id extension="967694121" root="1.3.6.1.4.1.519.1"/>
                <name>Paddock Laboratories, LLC</name>
              </assignedOrganization>
              <performance>
                <actDefinition>
                  <code code="C43360" codeSystem="2.16.840.1.113883.3.26.1.1" displayName="MANUFACTURE"/>
                  <product>
                    <manufacturedProduct classCode="MANU">
                      <manufacturedMaterialKind>
                        <code code="65649-411" codeSystem="2.16.840.1.113883.6.69"/>
                      </manufacturedMaterialKind>
                    </manufacturedProduct>
                  </product>
                </actDefinition>
              </performance>
            </assignedEntity>
          </assignedOrganization>
        </assignedEntity>
      </representedOrganization>
    </assignedEntity>
  </author>
  <component>
    <structuredBody>
      <component>
        <section>
          <id root="ca0c0e90-bfac-485d-9736-28e63e2c0847"/>
          <code code="48780-1" codeSystem="2.16.840.1.113883.6.1" displayName="SPL product data elements section"/>
          <effectiveTime value="20240701"/>
          <subject>
            <manufacturedProduct>
              <manufacturedProduct>
                <code code="65649-411" codeSystem="2.16.840.1.113883.6.69"/>
                <name>Anusol HC</name>
                <formCode code="C42993" codeSystem="2.16.840.1.113883.3.26.1.1" displayName="SUPPOSITORY"/>
                <asEntityWithGeneric>
                  <genericMedicine>
                    <name>HYDROCORTISONE ACETATE</name>
                  </genericMedicine>
                </asEntityWithGeneric>
                <ingredient classCode="ACTIB">
                  <quantity>
                    <numerator unit="mg" value="25"/>
                    <denominator unit="1" value="1"/>
                  </quantity>
                  <ingredientSubstance>
                    <code code="3X7931PO74" codeSystem="2.16.840.1.113883.4.9"/>
                    <name>HYDROCORTISONE ACETATE</name>
                    <activeMoiety>
                      <activeMoiety>
                        <code code="WI4X0X7BPJ" codeSystem="2.16.840.1.113883.4.9"/>
                        <name>HYDROCORTISONE</name>
                      </activeMoiety>
                    </activeMoiety>
                  </ingredientSubstance>
                </ingredient>
                <ingredient classCode="IACT">
                  <ingredientSubstance>
                    <code code="257THB963H" codeSystem="2.16.840.1.113883.4.9"/>
                    <name>HYDROGENATED PALM OIL</name>
                  </ingredientSubstance>
                </ingredient>
                <ingredient classCode="IACT">
                  <ingredientSubstance>
                    <code code="ETJ7Z6XBU4" codeSystem="2.16.840.1.113883.4.9"/>
                    <name>SILICON DIOXIDE</name>
                  </ingredientSubstance>
                </ingredient>
                <ingredient classCode="IACT">
                  <ingredientSubstance>
                    <code code="REK4960K2U" codeSystem="2.16.840.1.113883.4.9"/>
                    <name>BUTYLATED HYDROXYANISOLE</name>
                  </ingredientSubstance>
                </ingredient>
                <asContent>
                  <quantity>
                    <numerator unit="1" value="12"/>
                    <denominator value="1"/>
                  </quantity>
                  <containerPackagedProduct>
                    <code code="65649-411-12" codeSystem="2.16.840.1.113883.6.69"/>
                    <formCode code="C43178" codeSystem="2.16.840.1.113883.3.26.1.1" displayName="BOX"/>
                  </containerPackagedProduct>
                  <subjectOf>
                    <marketingAct>
                      <code code="C53292" codeSystem="2.16.840.1.113883.3.26.1.1"/>
                      <statusCode code="active"/>
                      <effectiveTime>
                        <low value="20040601"/>
                      </effectiveTime>
                    </marketingAct>
                  </subjectOf>
                  <subjectOf>
                    <characteristic classCode="OBS">
                      <code code="SPLCMBPRDTP" codeSystem="2.16.840.1.113883.1.11.19255"/>
                      <value code="C112160" codeSystem="2.16.840.1.113883.3.26.1.1" displayName="Type 0: Not a Combination Product" xsi:type="CE"/>
                    </characteristic>
                  </subjectOf>
                </asContent>
                <asContent>
                  <quantity>
                    <numerator unit="1" value="24"/>
                    <denominator value="1"/>
                  </quantity>
                  <containerPackagedProduct>
                    <code code="65649-411-24" codeSystem="2.16.840.1.113883.6.69"/>
                    <formCode code="C43178" codeSystem="2.16.840.1.113883.3.26.1.1" displayName="BOX"/>
                  </containerPackagedProduct>
                  <subjectOf>
                    <marketingAct>
                      <code code="C53292" codeSystem="2.16.840.1.113883.3.26.1.1"/>
                      <statusCode code="active"/>
                      <effectiveTime>
                        <low value="20040601"/>
                      </effectiveTime>
                    </marketingAct>
                  </subjectOf>
                  <subjectOf>
                    <characteristic classCode="OBS">
                      <code code="SPLCMBPRDTP" codeSystem="2.16.840.1.113883.1.11.19255"/>
                      <value code="C112160" codeSystem="2.16.840.1.113883.3.26.1.1" displayName="Type 0: Not a Combination Product" xsi:type="CE"/>
                    </characteristic>
                  </subjectOf>
                </asContent>
              </manufacturedProduct>
              <subjectOf>
                <approval>
                  <code code="C73627" codeSystem="2.16.840.1.113883.3.26.1.1" displayName="Unapproved drug other"/>
                  <author>
                    <territorialAuthority>
                      <territory>
                        <code code="USA" codeSystem="2.16.840.1.113883.5.28"/>
                      </territory>
                    </territorialAuthority>
                  </author>
                </approval>
              </subjectOf>
              <subjectOf>
                <marketingAct>
                  <code code="C53292" codeSystem="2.16.840.1.113883.3.26.1.1"/>
                  <statusCode code="active"/>
                  <effectiveTime>
                    <low value="20040601"/>
                  </effectiveTime>
                </marketingAct>
              </subjectOf>
              <consumedIn>
                <substanceAdministration>
                  <routeCode code="C38295" codeSystem="2.16.840.1.113883.3.26.1.1" displayName="RECTAL"/>
                </substanceAdministration>
              </consumedIn>
            </manufacturedProduct>
          </subject>
        </section>
      </component>
      <component>
        <section ID="e11a8e20-f660-4c7e-8c83-e857d70e2fd4">
          <id root="0b6fb90e-0e35-430d-8af4-d71ce6e0fddd"/>
          <code code="34089-3" codeSystem="2.16.840.1.113883.6.1" displayName="DESCRIPTION SECTION"/>
          <title>DESCRIPTION</title>
          <text>
            <paragraph>Each Anusol-HC<sup>®</sup> 25 mg Suppository contains 25 mg hydrocortisone acetate in a hydrogenated vegetable oil base.  Hydrocortisone acetate is a corticosteroid. Chemically, hydrocortisone acetate is pregn-4-ene-3, 20-dione, 21-(acetyloxy)-11, 17-dihydroxy (11β)- with the following structural formula:</paragraph>
            <paragraph>
              <renderMultiMedia ID="id217" referencedObject="MM10"/> </paragraph>
          </text>
          <effectiveTime value="20240701"/>
          <component>
            <observationMedia ID="MM10">
              <text>Structural Formula</text>
              <value mediaType="image/jpeg" xsi:type="ED">
                <reference value="anusol-hc_7335-figure-1-2-17-2011_2-31-54_PM.jpg"/>
              </value>
            </observationMedia>
          </component>
        </section>
      </component>
      <component>
        <section ID="af067bcb-f8c5-417c-8c0d-8527e4e0050b">
          <id root="6da301b1-52fd-4b08-bf0f-7c16c4848711"/>
          <code code="34090-1" codeSystem="2.16.840.1.113883.6.1" displayName="CLINICAL PHARMACOLOGY SECTION"/>
          <title>CLINICAL PHARMACOLOGY</title>
          <text>
            <paragraph>In normal subjects, about 26 percent of hydrocortisone acetate is absorbed when the hydrocortisone acetate suppository is applied to the rectum. Absorption of hydrocortisone acetate may vary across abraded or inflamed surfaces.</paragraph>
            <paragraph>Topical steroids are primarily effective because of their anti-inflammatory, anti-pruritic and vasoconstrictive action.</paragraph>
          </text>
          <effectiveTime value="20240701"/>
        </section>
      </component>
      <component>
        <section ID="bdfa31a2-1905-476e-8aac-7198b24284c9">
          <id root="27a3510a-5a9b-4a90-b0a5-d44685eac8d4"/>
          <code code="34067-9" codeSystem="2.16.840.1.113883.6.1" displayName="INDICATIONS &amp; USAGE SECTION"/>
          <title>INDICATIONS AND USAGE</title>
          <text>
            <paragraph>For use in inflamed hemorrhoids, post-irradiation (factitial) proctitis, as an adjunct in the treatment of chronic ulcerative colitis,  cryptitis, other inflammatory conditions of the anorectum, and pruritus ani.</paragraph>
          </text>
          <effectiveTime value="20240701"/>
        </section>
      </component>
      <component>
        <section ID="c04fdc15-ea34-4d77-8ae4-1c839e32c533">
          <id root="63bcdb49-d78c-40af-89e6-7fb004c64cce"/>
          <code code="34070-3" codeSystem="2.16.840.1.113883.6.1" displayName="CONTRAINDICATIONS SECTION"/>
          <title>CONTRAINDICATION</title>
          <text>
            <paragraph> Anusol-HC<sup>®</sup> suppositories are contraindicated in those patients with a history of hypersensitivity to any of the components. </paragraph>
          </text>
          <effectiveTime value="20240701"/>
        </section>
      </component>
      <component>
        <section ID="d6767861-ca0e-4885-8cfe-90a23c3fc31b">
          <id root="c71ffc41-1ac3-41c8-9fcb-1d141994863d"/>
          <code code="42232-9" codeSystem="2.16.840.1.113883.6.1" displayName="PRECAUTIONS SECTION"/>
          <title>PRECAUTIONS</title>
          <text>
            <paragraph>Do not use unless adequate proctologic examination is made.</paragraph>
            <paragraph>If irritation develops, the product should be discontinued and appropriate therapy instituted.</paragraph>
            <paragraph>In the presence of an infection, the use of an appropriate antifungal or antibacterial agent should be instituted. If a favorable response does not occur promptly, the corticosteroid should be discontinued until the infection has been adequately controlled.</paragraph>
            <paragraph>No long-term studies in animals have been performed to evaluate the carcinogenic potential of corticosteroid suppositories.</paragraph>
          </text>
          <effectiveTime value="20240701"/>
        </section>
      </component>
      <component>
        <section ID="e03e784c-257f-42e9-ad05-fe9963771492">
          <id root="2cb4eb1f-bc15-4cf6-9b40-4502fb0f70aa"/>
          <code code="34076-0" codeSystem="2.16.840.1.113883.6.1" displayName="INFORMATION FOR PATIENTS SECTION"/>
          <title>Information for Patients:</title>
          <text>
            <paragraph>Staining of fabric may occur with use of the suppository.  Precautionary measures are recommended.</paragraph>
          </text>
          <effectiveTime value="20240701"/>
        </section>
      </component>
      <component>
        <section ID="e31f5a81-5620-409c-bb20-1196c6066776">
          <id root="86a38cce-22cd-46da-8197-873d1026420e"/>
          <code code="42228-7" codeSystem="2.16.840.1.113883.6.1" displayName="PREGNANCY SECTION"/>
          <title>Pregnancy: <br/>
          </title>
          <text>
            <paragraph>In laboratory animals, topical steroids have been associated with an increase in the incidence of fetal abnormalities when gestating females have been exposed to rather low dosage levels. There are no adequate and well-controlled studies in pregnant women.  Anusol-HC<sup>®</sup> suppositories should only be used during pregnancy if the potential benefit justifies the risk of the fetus.  Drugs of this class should not be used extensively on pregnant patients, in large amounts, or for prolonged periods of time.</paragraph>
            <paragraph>
              <content styleCode="bold">Nursing Mothers:</content>
            </paragraph>
            <paragraph>It is not known whether this drug is excreted in human milk, and because many drugs are excreted in human milk and because of the potential for serious adverse reactions in nursing infants from Anusol-HC<sup>®</sup> suppositories, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.</paragraph>
          </text>
          <effectiveTime value="20240701"/>
        </section>
      </component>
      <component>
        <section ID="a971c8f4-3225-4e55-b8bf-1aafa8833d88">
          <id root="66a77029-806c-4e40-b3e7-03737bc48058"/>
          <code code="34084-4" codeSystem="2.16.840.1.113883.6.1" displayName="ADVERSE REACTIONS SECTION"/>
          <title>ADVERSE REACTIONS</title>
          <text>
            <paragraph>The following local adverse reactions have been reported with corticosteroid suppositories.</paragraph>
            <list listType="ordered">
              <item>
                <caption>1.</caption>Burning</item>
              <item>
                <caption>2.</caption>Itching</item>
              <item>
                <caption>3.</caption>Irritation</item>
              <item>
                <caption>4.</caption>Dryness</item>
              <item>
                <caption>5.</caption>Folliculitis</item>
              <item>
                <caption>6.</caption>Hypopigmentation</item>
              <item>
                <caption>7.</caption>Allergic contact dermatitis</item>
              <item>
                <caption>8.</caption>Secondary infection</item>
            </list>
            <paragraph>
              <content styleCode="bold">To report SUSPECTED ADVERSE REACTIONS, contact Salix Pharmaceuticals at 1-800-321-4576 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch</content>.</paragraph>
          </text>
          <effectiveTime value="20240701"/>
        </section>
      </component>
      <component>
        <section ID="d41ee0c1-aaeb-4a49-88b5-8e18df401b65">
          <id root="1283eefc-d671-40f3-99f2-c5a321f867b7"/>
          <code code="42227-9" codeSystem="2.16.840.1.113883.6.1" displayName="DRUG ABUSE AND DEPENDENCE SECTION"/>
          <title>DRUG ABUSE AND DEPENDENCE</title>
          <text>
            <paragraph>Drug abuse and dependence has not been reported in patients treated with Anusol-HC<sup>®</sup> suppositories.</paragraph>
          </text>
          <effectiveTime value="20240701"/>
        </section>
      </component>
      <component>
        <section ID="e9b67879-aa75-40b1-8f36-7af7459ea722">
          <id root="02d2ac20-cf1e-4764-a010-3897698cd06d"/>
          <code code="34088-5" codeSystem="2.16.840.1.113883.6.1" displayName="OVERDOSAGE SECTION"/>
          <title>OVERDOSAGE</title>
          <text>
            <paragraph>If signs and symptoms of systemic overdosage occur, discontinue use.</paragraph>
          </text>
          <effectiveTime value="20240701"/>
        </section>
      </component>
      <component>
        <section ID="f4deb7d1-6128-4b2f-8d13-18407ad26045">
          <id root="3b500aca-a663-43cc-ad2e-c2f5a5604732"/>
          <code code="34068-7" codeSystem="2.16.840.1.113883.6.1" displayName="DOSAGE &amp; ADMINISTRATION SECTION"/>
          <title>DOSAGE AND ADMINISTRATION</title>
          <text>
            <paragraph>
              <content styleCode="emphasis">
                <content styleCode="bold">Usual Dosage: </content>
              </content>One suppository in the rectum morning and night for two weeks, in nonspecific proctitis. In more severe cases, one suppository three times daily; or two suppositories twice daily. In factitial proctitis, recommended therapy is six to eight weeks or less, according to response.</paragraph>
          </text>
          <effectiveTime value="20240701"/>
        </section>
      </component>
      <component>
        <section ID="b61d80d5-d8b5-4d87-ae01-6b4e4506f590">
          <id root="e377633a-05ad-4b04-ab55-641eef940360"/>
          <code code="34069-5" codeSystem="2.16.840.1.113883.6.1" displayName="HOW SUPPLIED SECTION"/>
          <title>HOW SUPPLIED</title>
          <text>
            <paragraph>Anusol-HC<sup>®</sup> 25 mg Suppositories are white, cylinder shaped, with one end tapered. <br/>NDC  65649-411-12   25 mg  12  suppositories<br/>NDC  65649-411-24   25 mg  24 suppositories</paragraph>
            <paragraph>
              <content styleCode="emphasis">
                <content styleCode="bold">Store at 20° to 25°C (68° to 77°F) [see USP Controlled Room Temperature].  Store away from heat. PROTECT FROM FREEZING.</content>
              </content>
            </paragraph>
            <paragraph>
              <content styleCode="bold">Distributed by:</content> Salix Pharmaceuticals, a division of Bausch Health US, LLC, Bridgewater, NJ 08807 USA</paragraph>
            <paragraph>Anusol-HC is a trademark of Salix Pharmaceuticals, Inc. or its affiliates.</paragraph>
            <paragraph>© 2024 Salix Pharmaceuticals, Inc. or its affiliates<renderMultiMedia ID="ID0ECLAE" referencedObject="ID0E6KAE"/>
            </paragraph>
            <paragraph>
              <content styleCode="bold">OPENING INSTRUCTIONS</content>
            </paragraph>
            <paragraph>
              <content styleCode="bold">Avoid excessive handling of the suppository.</content> It is designed to melt at body temperature.</paragraph>
            <paragraph>1. Separate plastic film at top opening and pull downward. </paragraph>
            <paragraph>2. Continue pulling downward to almost the full length of the suppository.</paragraph>
            <paragraph>3. Gently remove the suppository from the film pocket. </paragraph>
            <paragraph>Rev. 07/2024</paragraph>
            <paragraph>9520702</paragraph>
          </text>
          <effectiveTime value="20240701"/>
          <component>
            <observationMedia ID="ID0E6KAE">
              <text>Opening Instructions</text>
              <value mediaType="image/jpeg" xsi:type="ED">
                <reference value="900177a6-ffb4-4a0e-aa77-94959a9faaf5-00.jpg"/>
              </value>
            </observationMedia>
          </component>
        </section>
      </component>
      <component>
        <section ID="ee4f6440-471e-4ba3-9b78-7356f3ef0bb1">
          <id root="76ab80d8-025f-4dea-91a4-91d3adeda3c1"/>
          <code code="51945-4" codeSystem="2.16.840.1.113883.6.1" displayName="PACKAGE LABEL.PRINCIPAL DISPLAY PANEL"/>
          <text>
            <paragraph>
              <content styleCode="emphasis">
                <content styleCode="bold">PACKAGE LABEL PRINCIPAL DISPLAY PANEL - Carton</content>
              </content>
            </paragraph>
            <paragraph>
              <content styleCode="emphasis">
                <content styleCode="bold">NDC </content>65649-411-12</content>
            </paragraph>
            <paragraph>
              <content styleCode="emphasis">
                <content styleCode="bold">Rx only</content>
              </content>
            </paragraph>
            <paragraph>
              <content styleCode="emphasis">
                <content styleCode="bold">Anusol-HC<sup>®        </sup>
                </content>
              </content>
            </paragraph>
            <paragraph>
              <content styleCode="emphasis">
                <content styleCode="bold">(Hydrocortisone Acetate in a</content>
              </content>
            </paragraph>
            <paragraph>
              <content styleCode="emphasis">
                <content styleCode="bold">Hydrogenated Vegetable Oil Base)</content>
              </content>
            </paragraph>
            <paragraph>
              <content styleCode="emphasis">
                <content styleCode="bold">25 mg</content>
              </content>
            </paragraph>
            <paragraph>
              <content styleCode="bold">For rectal use only.</content>
            </paragraph>
            <paragraph>
              <content styleCode="bold">Not for oral use.</content>
            </paragraph>
            <paragraph>
              <content styleCode="emphasis">
                <content styleCode="bold">12 Suppositories</content>
              </content>
            </paragraph>
            <renderMultiMedia ID="id1646776262" referencedObject="ID_913cd598-7812-4784-b4ea-9c0f0f1d29b2"/>
            <paragraph> </paragraph>
          </text>
          <effectiveTime value="20240701"/>
          <component>
            <observationMedia ID="ID_913cd598-7812-4784-b4ea-9c0f0f1d29b2">
              <text>carton</text>
              <value mediaType="image/jpeg" xsi:type="ED">
                <reference value="carton.jpg"/>
              </value>
            </observationMedia>
          </component>
        </section>
      </component>
    </structuredBody>
  </component>
</document>