Carbinoxamine Maleate Prescribing Information
Carbinoxamine maleate is effective for the symptomatic treatment of:
Seasonal and perennial allergic rhinitis.
Vasomotor rhinitis.
Allergic conjunctivitis due to inhalant allergens and foods.
Mild, uncomplicated allergic skin manifestations of urticaria and angio-edema.
Dermatographism.
As therapy for anaphylactic reactions adjunctiveto epinephrine and other standard measures after the acute manifestations have been controlled.
Amelioration of the severity of allergic reactions to blood or plasma.
Carbinoxamine maleate is contraindicated in children younger than 2 years of age (see CONTRAINDICATIONS).
Carbinoxamine maleate should be taken on an empty stomach with water.
DOSAGE SHOULD BE INDIVIDUALIZED ACCORDING TO THE NEEDS AND THE RESPONSE OF THE PATIENT.
Carbinoxamine maleate dosage should bebased on the severity of the condition and the response of the patient. The drug is well tolerated in adults in doses as high as 24 mg daily, in divided doses, over prolonged periods. On the other hand, some patients respond to as little as 4 mg daily.
Clinical experience suggests the followingdosage schedules:
Tablets
Usual Adult Dosage:
1 or 2 tablets (4 to 8 mg)
3 to 4 times daily.
Usual Child’s Dosage:
Six to eleven years – ½ to 1 tablet
(2 to 4 mg) 3 to 4 times daily.
Carbinoxamine maleate is contraindicated in children younger than 2 years of age.
Carbinoxamine maleate is contraindicated in nursing mothers.
Carbinoxamine maleate is contraindicated in patients who are hypersensitive to the drug or on monoamine oxidase inhibitor therapy. (See Drug Interactions section).
The most frequent adverse reactions are underlined:
Body as a Whole:Urticaria, drug rash, anaphylactic shock, photosensitivity, excessive perspiration, chills, dryness of mouth, nose and throat.
Cardiovascular:Hypotension, headache, palpitations, tachycardia, extrasystoles.
Hematologic:Hemolytic anemia, thrombocytopenia, agranulocytosis.
Central Nervous System:Sedation, sleepiness, dizziness, disturbed coordination,fatigue, confusion, restlessness, excitation, nervousness, tremor, irritability, insomnia, euphoria, paresthesia, blurred vision, diplopia, vertigo, tinnitus, acute labyrinthitis, hysteria, neuritis, convulsions.
Gastrointestinal:Epigastric distress,anorexia, nausea, vomiting, diarrhea, constipation.
Urogenital:Urinary frequency, difficult urination, urinary retention, early menses.
Respiratory:Thickening of bronchial secretions,tightness of chest and wheezing, nasal stuffiness.
To report SUSPECTED ADVERSE REACTIONS, contact BioComp Pharma, Inc. at 1-866-762-2365 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch
Drug Interactions
Monoamine oxidase inhibitors prolong and intensify the anticholinergic (drying) effects of antihistamines.
Carbinoxamine maleate has additive effects with alcohol and other CNS depressants (hypnotics, sedatives, tranquilizers, etc.).
Carbinoxamine maleate is a histamine-H1 receptor blocking agent.
Each tablet contains 4 mg carbinoxamine maleate and the following inactive ingredients: anhydrous lactose, magnesium stearate, microcrystalline cellulose, and sodium starch glycolate.
Carbinoxamine maleate is freely soluble in water. Its structure is:
2-[(4-chlorophenyl)-2-pyridinylmethoxy]- N, N- dimethylethanamine(Z)-2-butenedioate (1:1)
C 16H 19CIN 2O•C 4H 4O 4
MW=406.86
Mechanism of Actions
Carbinoxamine maleate, an ethanolamine derivative, is an antihistamine with anticholinergic (drying) and sedative properties. Carbinoxamine appears to compete with histamine (type H 1) for receptor sites on effector cells in the gastrointestinal tract, blood vessels and respiratory tract.
Pharmacokinetics and Metabolism
Carbinoxamine is well absorbed from the GI tract and appears to be extensively metabolized by the liver, and excreted in the urine as inactive metabolites within 24 hours. Virtually no intact drug is extended in the urine.
In a study comparing a controlled-release suspension and a solution of carbinoxamine, healthy volunteers were administered a single dose of 8 mg carbinoxamine. A time to maximum concentration (Tmax) was between 1.5 hours to 5 hours, a peak plasma concentration (Cmax) of about 24 ng/mL was observed, and extent of exposure (AUC) was about 286 ng hr/mL. The serum half-life is reported to be 10 to 20 hours.
Drug/Food Interactions
Carbinoxamine should not be used in patients with hypersensitivity to carbinoxamine.Carbinoxamine may increase the effects of other drugs such as barbiturates, TCAs, MAO inhibitors such as Phenelzine (Nardil), Tranylcypromine (Parnate), or Selegiline (Eldepryl), alcohol, other antihistamines, and CNS depressants. Carbinoxamine can be taken with or without food.
Cardiovascular Effects
Cardiac effects, including prolongation of QT interval have not been adequately studied. Unlike other newer antihistamines, severe adverse cardiovascular effects are uncommon, and usually limited to over dosage situations.
Special Populations
Pediatric Patients
Carbinoxamine should not be used in newborn or premature infants. Neonates have an increased susceptibility to anticholinergic side effects, such as CNS excitation, which may lead to convulsions.
Pregnancy and Lactation
Safe use of carbinoxamine during pregnancy has not been established. Therefore, carbinoxamine should not be used in women who are, or may become pregnant. Carbinoxamine is in the FDA pregnancy Category C.
Women who are breastfeeding should avoid use of carbinoxamine, since small amounts appear to be distributed into breast milk.
Geriatric Patients
Carbinoxamine is more likely to cause dizziness, sedation, and hypotension in elderly patients. The incidence of adverse reactions is higher in the elderly; therefore, a dosing adjustment may be necessary in this sub-population.
Carbinoxamine Maleate Tablets, USP 4 mg are supplied as white, round, scored tablets, debossed "CM" on one side and scored on the other, and supplied in bottles of 100 tablets, NDC44523-825-01.
Store at 20°C to 25°C (68°F to 77°F) [See USP controlled room temperature.]
Dispense in a tight, light-resistant container with a child-resistant closure as defined in the official compendium.
Manufactured for:
BioComp Pharma®, Inc.
San Antonio, TX 78230 1355
L82501R1017
Mechanism of Actions
Carbinoxamine maleate, an ethanolamine derivative, is an antihistamine with anticholinergic (drying) and sedative properties. Carbinoxamine appears to compete with histamine (type H 1) for receptor sites on effector cells in the gastrointestinal tract, blood vessels and respiratory tract.
Deaths have been reported in children less than 2 years of age who were taking antihistamines, including carbinoxamine-containing drug products, therefore, carbinoxamine maleate is contraindicated in children younger than 2 years of age (see CONTRAINDICATIONS).
Antihistamines should be used with considerable caution in patients with: narrow angle glaucoma, stenosing peptic ulcer, symptomatic prostatic hypertrophy, bladder neck obstruction, pyloroduodenald obstruction.