- Karbinal ER
allergy, cold and cough remedies
Relief of allergic symptoms caused by histamine release including seasonal/perennial allergic rhinitis, vasomotor rhinitis, allergic conjunctivitis (due to inhalant allergens or foods), mild/uncomplicated allergic skin conditions (urticaria or angioedema), dermatographism, as adjunctive management (with epinephrine and other standard acute treatments) of anaphylaxis, and to decrease severity of allergic reactions to blood/plasma
Antagonizes the effects of histamine at H1 –receptor sites; does not bind to or inactivate histamine. Significant CNS depressant and anticholinergic properties.
Decreased symptoms of histamine excess (sneezing, rhinorrhea, nasal/ocular pruritus, ocular tearing/redness and skin itching/urticaria).
Absorption: Well absorbed following oral administration
Metabolism and Excretion: Extensively metabolized by the liver, inactive metabolites excreted in urine. Negligable renal elimination of unchanged drug.
Half-life: 17 hr
TIME/ACTION PROFILE (antihistaminic effects)
|PO||unk||6.7 hr||12 hr|
- Hypersensitivity, including sulfite allergy
- Lactation: Avoid if breast-feeding (risk of death in infant);
- Concurrent use of MAOIs
- Pedi: Children <2 yr (deaths have been reported).
Use Cautiously in:
- Increased intraocular pressure or narrow angle glaucoma
- Cardiovascular disease including hypertension
- Stenosing peptic ulcer or pyloroduodenal obstruction
- Symptomatic prostatic hypertrophy or bladder neck obstruction
- Geri: Elderly may be more susceptible to adverse reactions;
- OB: Use in pregnancy only if clearly needed
- Pedi: Younger children may be more sensitive to sedation or excitation.
Adverse Reactions/Side Effects
CNS: dizziness, drowsiness, sedation
Resp: thickened bronchial secretions
GI: epigastric distress
Neuro: disturbed coordination
* CAPITALS indicate life-threatening.
Underline indicate most frequent.
- Concurrent use with MAOIs may ↑ anticholinergic effects.
- ↑ risk of CNS depression with other CNS depressants including alcohol, other antihistamines , opioid analgesics and sedative/hypnotics.
Use appropriate measuring device
PO (Adults and Children ≥ 12 yr): 6–16 mg (7.5–20 mL) every 12 hr.
PO (Children 2–11 yr): 0.2–0.4 mg/kg/day in divided doses every 12 hr; Children 6–11 yr– 6–12 mg (7.5–15 mL) every 12 hr; Children 4–5 yr– 3–8 mg (3.75–10 mL) every 12 hr; Children 2–3 yr– 3–4 mg (3.75–5 mL) every 12 hr.
Extended-release oral suspension (contains metabisulfite) (strawberry banana): 4 mg/5 mL
- Assess allergy symptoms (rhinitis, conjunctivitis, hives) before and periodically during therapy
- Assess lung sounds and character of bronchial secretions. Maintain fluid intake of 1500–2000 mL/day to decrease viscosity of secretions
Lab Test Considerations:
May case ↑ uric acid levels.
- Begin with lowest dose and increase as needed and tolerated. Dose is based on condition severity and patient response.
- PO Administer twice daily.
- Use a calibrated measuring device for accurate dose; household tablespoon is not accurate and could lead to overdose.
- Instruct patient to take medication as directed
- May cause dizziness and drowsiness. Caution patient to avoid driving or other activities requiring alertness until response to medication is known
- Advise patient to avoid taking alcohol or other CNS depressants concurrently with this drug
- Advise patient that good oral hygiene, frequent rinsing of mouth with water, and sugarless gum or candy may minimize dry mouth. Patient should notify dentist if dry mouth persists >2 wk
- Instruct female patient to notify health care professional if pregnancy is planned or suspected or if breastfeeding.
Decrease in allergic symptoms
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