NDC Code(s) : 67091-200-24, 67091-200-10
Packager : WinCo Foods, LLC

Category : HUMAN OTC DRUG LABEL

DEA Schedule : none

Marketing Status : New Drug Application

INGREDIENTS AND APPEARANCE

Allergy Relief Diphenhydramine HCl TABLET, FILM COATED
Product Information
Product Type HUMAN OTC DRUG Item Code (Source) NDC:67091-200
Route of Administration ORAL DEA Schedule
Active Ingredient/Active Moiety
Ingredient Name Basis of Strength Strength
DIPHENHYDRAMINE HYDROCHLORIDE(UNII: TC2D6JAD40)
(DIPHENHYDRAMINE - UNII:8GTS82S83M) 		DIPHENHYDRAMINE HYDROCHLORIDE25 mg
Inactive Ingredients
Ingredient Name Strength
STARCH, CORN(UNII: O8232NY3SJ)
D&C RED NO. 27 ALUMINUM LAKE(UNII: ZK64F7XSTX)
DIBASIC CALCIUM PHOSPHATE DIHYDRATE(UNII: O7TSZ97GEP)
MAGNESIUM STEARATE(UNII: 70097M6I30)
MICROCRYSTALLINE CELLULOSE(UNII: OP1R32D61U)
POLYETHYLENE GLYCOL, UNSPECIFIED(UNII: 3WJQ0SDW1A)
POLYVINYL ALCOHOL, UNSPECIFIED(UNII: 532B59J990)
SILICON DIOXIDE(UNII: ETJ7Z6XBU4)
STEARIC ACID(UNII: 4ELV7Z65AP)
TALC(UNII: 7SEV7J4R1U)
TITANIUM DIOXIDE(UNII: 15FIX9V2JP)
Product Characteristics
Color pink Score no score
Shape OVAL Size 11 mm
Flavor Imprint Code 44;329
Contains
Packaging
# Item Code Package Description Marketing Start Date Marketing End Date
1NDC:67091-200-242 in 1 CARTON 03/02/1990
112 in 1 BLISTER PACK Type 0: Not a Combination Product
2NDC:67091-200-101 in 1 CARTON 03/02/1990
2100 in 1 BOTTLE, PLASTIC Type 0: Not a Combination Product
Marketing Information
Marketing Category Application Number or Monograph Citation Marketing Start Date Marketing End Date
OTC Monograph Drug M012 03/02/1990

LABELER - WinCo Foods, LLC(056098817)

Establishment
Name Address ID/FEI Business Operations
LNK International, Inc. 038154464 pack(67091-200)

Establishment
Name Address ID/FEI Business Operations
LNK International, Inc. 832867837 manufacture(67091-200), pack(67091-200)

Establishment
Name Address ID/FEI Business Operations
LNK International, Inc. 832867894 manufacture(67091-200)

Establishment
Name Address ID/FEI Business Operations
LNK International, Inc. 868734088 manufacture(67091-200)

Establishment
Name Address ID/FEI Business Operations
LNK International, Inc. 967626305 pack(67091-200)

PRINCIPAL DISPLAY PANEL

WinCo®
FOODS

*Compare to the active ingredient
in BENADRYL® Allergy Ultratab®

COMPLETE
Allergy
Relief

DIPHENHYDRAMINE HCl 25 mg/
ANTIHISTAMINE

Relieves: Sneezing,
Runny Nose,
Itchy, Watery Eyes
& Itchy Throat

24
Minitabs 

DISTRIBUTED BY:
WINCO FOODS, LLC, BOISE, ID 83704

*This product is not manufactured or distributed by
JOHNSON & JOHNSON CORPORATION, distributor of
BENADRYL® Allergy Ultratab®.

50844    REV0721B32908     WF2107

The Supermarket Low Price Leader®

100% SATISFACTION GUARANTEE
Comments & Questions? 800-824-1706 

TAMPER EVIDENT: DO NOT USE IF PACKAGE IS
OPENED OR IF BLISTER UNIT IS TORN, BROKEN  
OR SHOWS ANY SIGNS OF TAMPERING

Winco B-2150-329-08 REV0721B

Winco B-2150-329-08 REV0721B