Carbinoxamine Maleate

Carbinoxamine maleate is a histamine-H ₁ 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.

Each 5 mL (teaspoonful) of oral solution contains 4 mg carbinoxamine maleate and the following inactive ingredients: artificial bubble gum flavor, citric acid (anhydrous), glycerin, methylparaben, propylene glycol, propylparaben, purified water, sodium citrate (hydrous) and sorbitol solution.

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

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 angioedema.

Dermatographism.

As therapy for anaphylactic reactions adjunctive to 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.

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).

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, pyloroduodenal obstruction.

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.

Manifestations: Antihistamine overdosage reactions may vary from central nervous system depression to stimulation. Stimulation is particularly likely in children. Atropine-like signs and symptoms - dry mouth; fixed, dilated pupils; flushing; and gastrointestinal symptoms may also occur.

Especially in infants and children, antihistamine overdosage may cause hallucinations, convulsions, or death.

The oral LD ₅₀ of carbinoxamine maleate in guinea pigs is 411 mg/kg.

Treatement: The treatment of overdosage with carbinoxamine maleate is essentially symptomatic and supportive. Vital signs (including respiration, pulse, blood pressure, and temperature) and EKG should be monitored. Induction of vomiting is not recommended. Activated charcoal should be given and gastric lavage should be considered after ingestion of a potentially life-threatening amount of drug. In the presence of severe anticholinergic effects, physostigmine may be useful. Vasopressors may be used to treat hypotension.

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 be based 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 following dosage 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 – 1/2 to 1 tablet (2 to 4 mg) 3 to 4 times daily.

Oral Solution

Usual Adult Dosage:

1 or 2 teaspoonfuls (4 to 8 mg) 3 to 4 times daily

Usual Child's Dosage (approximately 0.2 to 0.4 mg/kg/day, divided into 3 to 4 doses):

Six to eleven years - ½ to 1 teaspoonful (2 to 4 mg) 3 to 4 times daily.

Dosing for children 2 to 5 years of age should be based on weight whenever possible. The usual dosage for children 2 to 5 years of age is approximately 0.2 to 0.4 mg/kg/day, divided into 3 to 4 daily doses. In general, this corresponds to a dose of 1/4 to 1/2 teaspoonful (1 to 2 mg) 3 to 4 times daily.

Carbinoxamine Maleate Tablets, USP 4 mg are supplied as white, round, scored tablets, debossed “109” on one side and score over “C” on the other side, and is supplied in bottles of 100 tablets, NDC 51991-333-01.

Carbinoxamine Maleate Oral Solution, 4 mg/5 mL is supplied as clear, colorless liquid with a bubble gum aroma, and is supplied in 4 fl. oz. bottles, NDC 51991-334-04.

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.

Distributed by:

Breckenridge Pharmaceutical, Inc.

Berlin, CT 06037

Manufactured by:

MIKART, LLC

Atlanta, GA 30318

Code 838F00

Rev. 05/19

Carbinoxamine Maleate Tablets

Carbinoxamine Maleate Oral Solution