carbinoxamine (Rx)

Brand and Other Names:Karbinal ER
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Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

tablet

  • 4mg

oral solution

  • 4mg/5mL

oral suspension, extended-release (Karbinal ER)

  • 4mg/5mL

Allergies

4-8 mg PO q6-8hr PO; not to exceed 24 mg/day

Karbinal ER: 6-16 mg (7.5-20 mL) PO q12hr

Other Indications & Uses

Seasonal & perennial allergic rhinitis, vasomotor rhinitis, allergic conjunctivitis, urticaria & angioedema, dermatographism, anaphylactic reactions adjunctive to epinephrine, amelioration of the severity of allergic reactions to blood or plasma

Dosage Forms & Strengths

tablet

  • 4mg

oral solution

  • 4mg/5mL

oral suspension, extended-release (Karbinal ER)

  • 4mg/5mL

Allergies

<2 years: Contraindicated

2-6 years: 0.2-0.4 mg/kg/day PO divided q6-8hr or 1-2 mg (2.5 mL) PO q6-8hr  

>6 years: 2-4 mg (5-7.5 mL) PO q6-8hr

Karbinal ER

  • <2 years: Contraindicated
  • 2-3 years: 3-4 mg (3.75-5 mL) PO q12hr
  • 4-5 years: 3-8 mg (3.75-10 mL) PO q12hr
  • 6-11 years: 6-12 mg (7.5-15 mL) PO q12hr
  • ≥12 years: 6-16 mg (7.5-20 mL) PO q12hr

Start at lower end of dosage range (4-8 mg PO q6-8hr) and decrease frequency if needed

Nonanticholinergic antihistamines should be considered first when treating allergic reactions (Beers Criteria)

Avoid use in elderly because of high incidence of anticholinergic effects

Clearance reduced with advanced age, greater risk of confusion, dry mouth, constipation, and other anticholinergic effects and toxicity

May exacerbate existing lower urinary conditions or benign prostatic hyperplasia

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Interactions

Interaction Checker

and carbinoxamine

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              Serious - Use Alternative (9)

              • calcium/magnesium/potassium/sodium oxybates

                carbinoxamine, calcium/magnesium/potassium/sodium oxybates. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.

              • eluxadoline

                carbinoxamine, eluxadoline. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid coadministration with other drugs that cause constipation. Increases risk for constipation related serious adverse reactions.

              • isocarboxazid

                isocarboxazid increases effects of carbinoxamine by Other (see comment). Avoid or Use Alternate Drug. Comment: Isocarboxazid should not be administered in combination with antihistamines because of potential additive CNS depressant effects. MAO inhibitors also prolong and intensify anticholinergic effects of antihistamines. .

              • metoclopramide intranasal

                carbinoxamine, metoclopramide intranasal. Either increases effects of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Avoid use of metoclopramide intranasal or interacting drug, depending on importance of drug to patient.

              • olopatadine intranasal

                carbinoxamine and olopatadine intranasal both increase sedation. Avoid or Use Alternate Drug. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.

              • pitolisant

                carbinoxamine decreases effects of pitolisant by Other (see comment). Avoid or Use Alternate Drug. Comment: Pitolisant increases histamine levels in the brain; therefore, H1 receptor antagonists that cross the blood-brain barrier may reduce the efficacy of pitolisant.

              • selinexor

                selinexor, carbinoxamine. unspecified interaction mechanism. Avoid or Use Alternate Drug. Patients treated with selinexor may experience neurological toxicities. Avoid taking selinexor with other medications that may cause dizziness or confusion.

              • sodium oxybate

                carbinoxamine, sodium oxybate. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.

              • tranylcypromine

                tranylcypromine increases effects of carbinoxamine by Other (see comment). Avoid or Use Alternate Drug. Comment: Tranylcypromine should not be administered in combination with antihistamines because of potential additive CNS depressant effects. MAO inhibitors also prolong and intensify anticholinergic effects of antihistamines. .

              Monitor Closely (197)

              • albuterol

                carbinoxamine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • alfentanil

                carbinoxamine and alfentanil both increase sedation. Use Caution/Monitor.

              • alprazolam

                carbinoxamine and alprazolam both increase sedation. Use Caution/Monitor.

              • amitriptyline

                carbinoxamine and amitriptyline both increase sedation. Use Caution/Monitor.

              • amobarbital

                carbinoxamine and amobarbital both increase sedation. Use Caution/Monitor.

              • amoxapine

                carbinoxamine and amoxapine both increase sedation. Use Caution/Monitor.

              • apomorphine

                carbinoxamine and apomorphine both increase sedation. Use Caution/Monitor.

              • arformoterol

                carbinoxamine increases and arformoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • aripiprazole

                carbinoxamine and aripiprazole both increase sedation. Use Caution/Monitor.

              • armodafinil

                carbinoxamine increases and armodafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • azelastine

                azelastine and carbinoxamine both increase sedation. Use Caution/Monitor.

              • baclofen

                carbinoxamine and baclofen both increase sedation. Use Caution/Monitor.

              • belladonna and opium

                carbinoxamine and belladonna and opium both increase sedation. Use Caution/Monitor.

              • benperidol

                carbinoxamine and benperidol both increase sedation. Use Caution/Monitor.

              • benzphetamine

                carbinoxamine increases and benzphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • brexanolone

                brexanolone, carbinoxamine. Either increases toxicity of the other by sedation. Use Caution/Monitor.

              • brompheniramine

                brompheniramine and carbinoxamine both increase sedation. Use Caution/Monitor.

              • buprenorphine

                carbinoxamine and buprenorphine both increase sedation. Use Caution/Monitor.

              • buprenorphine buccal

                carbinoxamine and buprenorphine buccal both increase sedation. Use Caution/Monitor.

              • butabarbital

                carbinoxamine and butabarbital both increase sedation. Use Caution/Monitor.

              • butalbital

                carbinoxamine and butalbital both increase sedation. Use Caution/Monitor.

              • butorphanol

                carbinoxamine and butorphanol both increase sedation. Use Caution/Monitor.

              • caffeine

                carbinoxamine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • carisoprodol

                carbinoxamine and carisoprodol both increase sedation. Use Caution/Monitor.

              • cenobamate

                cenobamate, carbinoxamine. Either increases effects of the other by sedation. Use Caution/Monitor.

              • chloral hydrate

                carbinoxamine and chloral hydrate both increase sedation. Use Caution/Monitor.

              • chlordiazepoxide

                carbinoxamine and chlordiazepoxide both increase sedation. Use Caution/Monitor.

              • chlorpheniramine

                carbinoxamine and chlorpheniramine both increase sedation. Use Caution/Monitor.

              • chlorpromazine

                carbinoxamine and chlorpromazine both increase sedation. Use Caution/Monitor.

              • chlorzoxazone

                carbinoxamine and chlorzoxazone both increase sedation. Use Caution/Monitor.

              • cinnarizine

                carbinoxamine and cinnarizine both increase sedation. Use Caution/Monitor.

              • clemastine

                carbinoxamine and clemastine both increase sedation. Use Caution/Monitor.

              • clobazam

                carbinoxamine, clobazam. Other (see comment). Use Caution/Monitor. Comment: Concomitant administration can increase the potential for CNS effects (e.g., increased sedation or respiratory depression).

              • clomipramine

                carbinoxamine and clomipramine both increase sedation. Use Caution/Monitor.

              • clonazepam

                carbinoxamine and clonazepam both increase sedation. Use Caution/Monitor.

              • clorazepate

                carbinoxamine and clorazepate both increase sedation. Use Caution/Monitor.

              • clozapine

                carbinoxamine and clozapine both increase sedation. Use Caution/Monitor.

              • codeine

                carbinoxamine and codeine both increase sedation. Use Caution/Monitor.

              • cyclizine

                carbinoxamine and cyclizine both increase sedation. Use Caution/Monitor.

              • cyclobenzaprine

                carbinoxamine and cyclobenzaprine both increase sedation. Use Caution/Monitor.

              • cyproheptadine

                carbinoxamine and cyproheptadine both increase sedation. Use Caution/Monitor.

              • dantrolene

                carbinoxamine and dantrolene both increase sedation. Use Caution/Monitor.

              • daridorexant

                carbinoxamine and daridorexant both increase sedation. Modify Therapy/Monitor Closely. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.

              • desflurane

                desflurane and carbinoxamine both increase sedation. Use Caution/Monitor.

              • desipramine

                carbinoxamine and desipramine both increase sedation. Use Caution/Monitor.

              • deutetrabenazine

                carbinoxamine and deutetrabenazine both increase sedation. Use Caution/Monitor.

              • dexchlorpheniramine

                carbinoxamine and dexchlorpheniramine both increase sedation. Use Caution/Monitor.

              • dexfenfluramine

                carbinoxamine increases and dexfenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • dexmedetomidine

                carbinoxamine and dexmedetomidine both increase sedation. Use Caution/Monitor.

              • dexmethylphenidate

                carbinoxamine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • dextroamphetamine

                carbinoxamine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • dextromoramide

                carbinoxamine and dextromoramide both increase sedation. Use Caution/Monitor.

              • diamorphine

                carbinoxamine and diamorphine both increase sedation. Use Caution/Monitor.

              • diazepam

                carbinoxamine and diazepam both increase sedation. Use Caution/Monitor.

              • diazepam intranasal

                diazepam intranasal, carbinoxamine. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration may potentiate the CNS-depressant effects of each drug.

              • diethylpropion

                carbinoxamine increases and diethylpropion decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • difelikefalin

                difelikefalin and carbinoxamine both increase sedation. Use Caution/Monitor.

              • difenoxin hcl

                carbinoxamine and difenoxin hcl both increase sedation. Use Caution/Monitor.

              • dimenhydrinate

                carbinoxamine and dimenhydrinate both increase sedation. Use Caution/Monitor.

              • diphenhydramine

                carbinoxamine and diphenhydramine both increase sedation. Use Caution/Monitor.

              • diphenoxylate hcl

                carbinoxamine and diphenoxylate hcl both increase sedation. Use Caution/Monitor.

              • dipipanone

                carbinoxamine and dipipanone both increase sedation. Use Caution/Monitor.

              • dobutamine

                carbinoxamine increases and dobutamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • donepezil transdermal

                donepezil transdermal, carbinoxamine. Either decreases effects of the other by pharmacodynamic antagonism. Use Caution/Monitor.

              • dopamine

                carbinoxamine increases and dopamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • dopexamine

                carbinoxamine increases and dopexamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • dosulepin

                carbinoxamine and dosulepin both increase sedation. Use Caution/Monitor.

              • doxepin

                carbinoxamine and doxepin both increase sedation. Use Caution/Monitor.

              • doxylamine

                carbinoxamine and doxylamine both increase sedation. Use Caution/Monitor.

              • droperidol

                carbinoxamine and droperidol both increase sedation. Use Caution/Monitor.

              • ephedrine

                carbinoxamine increases and ephedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • epinephrine

                carbinoxamine increases and epinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • epinephrine racemic

                carbinoxamine increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • esketamine intranasal

                esketamine intranasal, carbinoxamine. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.

              • estazolam

                carbinoxamine and estazolam both increase sedation. Use Caution/Monitor.

              • ethanol

                carbinoxamine and ethanol both increase sedation. Use Caution/Monitor.

              • etomidate

                etomidate and carbinoxamine both increase sedation. Use Caution/Monitor.

              • fenfluramine

                carbinoxamine increases and fenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • fentanyl

                fentanyl, carbinoxamine. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of fentanyl with anticholinergics may increase risk for urinary retention and/or severe constipation, which may lead to paralytic ileus.

              • fentanyl intranasal

                fentanyl intranasal, carbinoxamine. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of fentanyl with anticholinergics may increase risk for urinary retention and/or severe constipation, which may lead to paralytic ileus.

              • fentanyl transdermal

                fentanyl transdermal, carbinoxamine. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of fentanyl with anticholinergics may increase risk for urinary retention and/or severe constipation, which may lead to paralytic ileus.

              • fentanyl transmucosal

                fentanyl transmucosal, carbinoxamine. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of fentanyl with anticholinergics may increase risk for urinary retention and/or severe constipation, which may lead to paralytic ileus.

              • flibanserin

                carbinoxamine and flibanserin both increase sedation. Modify Therapy/Monitor Closely. Risk for sedation increased if flibanserin is coadministration with other CNS depressants.

              • fluphenazine

                carbinoxamine and fluphenazine both increase sedation. Use Caution/Monitor.

              • flurazepam

                carbinoxamine and flurazepam both increase sedation. Use Caution/Monitor.

              • formoterol

                carbinoxamine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • gabapentin

                gabapentin, carbinoxamine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.

              • gabapentin enacarbil

                gabapentin enacarbil, carbinoxamine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.

              • ganaxolone

                carbinoxamine and ganaxolone both increase sedation. Use Caution/Monitor.

              • glycopyrronium tosylate topical

                glycopyrronium tosylate topical, carbinoxamine. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration of glycopyrronium tosylate topical with other anticholinergic medications may result in additive anticholinergic adverse effects.

              • gotu kola

                gotu kola increases effects of carbinoxamine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.

              • haloperidol

                carbinoxamine and haloperidol both increase sedation. Use Caution/Monitor.

              • hawthorn

                hawthorn increases effects of carbinoxamine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.

              • hops

                hops increases effects of carbinoxamine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.

              • hyaluronidase

                carbinoxamine decreases effects of hyaluronidase by Other (see comment). Use Caution/Monitor. Comment: Antihistamines, when given in large systemic doses, may render tissues partially resistant to the action of hyaluronidase. Patients may require larger amounts of hyaluronidase for equivalent dispersing effect.

              • hydromorphone

                carbinoxamine and hydromorphone both increase sedation. Use Caution/Monitor.

              • hydroxyzine

                carbinoxamine and hydroxyzine both increase sedation. Use Caution/Monitor.

              • iloperidone

                carbinoxamine and iloperidone both increase sedation. Use Caution/Monitor.

              • imipramine

                carbinoxamine and imipramine both increase sedation. Use Caution/Monitor.

              • isoproterenol

                carbinoxamine increases and isoproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • kava

                kava increases effects of carbinoxamine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.

              • ketamine

                ketamine and carbinoxamine both increase sedation. Use Caution/Monitor.

              • ketotifen, ophthalmic

                carbinoxamine and ketotifen, ophthalmic both increase sedation. Use Caution/Monitor.

              • lasmiditan

                lasmiditan, carbinoxamine. Either increases effects of the other by sedation. Use Caution/Monitor. Coadministration of lasmiditan and other CNS depressant drugs, including alcohol have not been evaluated in clinical studies. Lasmiditan may cause sedation, as well as other cognitive and/or neuropsychiatric adverse reactions.

              • lemborexant

                lemborexant, carbinoxamine. Either increases effects of the other by sedation. Modify Therapy/Monitor Closely. Dosage adjustment may be necessary if lemborexant is coadministered with other CNS depressants because of potentially additive effects.

              • levalbuterol

                carbinoxamine increases and levalbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • levorphanol

                carbinoxamine and levorphanol both increase sedation. Use Caution/Monitor.

              • lisdexamfetamine

                carbinoxamine increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • lofepramine

                carbinoxamine and lofepramine both increase sedation. Use Caution/Monitor.

              • lofexidine

                carbinoxamine and lofexidine both increase sedation. Use Caution/Monitor.

              • loprazolam

                carbinoxamine and loprazolam both increase sedation. Use Caution/Monitor.

              • lorazepam

                carbinoxamine and lorazepam both increase sedation. Use Caution/Monitor.

              • lormetazepam

                carbinoxamine and lormetazepam both increase sedation. Use Caution/Monitor.

              • loxapine

                carbinoxamine and loxapine both increase sedation. Use Caution/Monitor.

              • loxapine inhaled

                carbinoxamine and loxapine inhaled both increase sedation. Use Caution/Monitor.

              • lurasidone

                lurasidone, carbinoxamine. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Potential for increased CNS depressant effects when used concurrently; monitor for increased adverse effects and toxicity.

              • maprotiline

                carbinoxamine and maprotiline both increase sedation. Use Caution/Monitor.

              • marijuana

                carbinoxamine and marijuana both increase sedation. Use Caution/Monitor.

              • melatonin

                carbinoxamine and melatonin both increase sedation. Use Caution/Monitor.

              • meperidine

                carbinoxamine and meperidine both increase sedation. Use Caution/Monitor.

              • meprobamate

                carbinoxamine and meprobamate both increase sedation. Use Caution/Monitor.

              • metaproterenol

                carbinoxamine increases and metaproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • metaxalone

                carbinoxamine and metaxalone both increase sedation. Use Caution/Monitor.

              • methadone

                carbinoxamine and methadone both increase sedation. Use Caution/Monitor.

              • methamphetamine

                carbinoxamine increases and methamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • methocarbamol

                carbinoxamine and methocarbamol both increase sedation. Use Caution/Monitor.

              • methylenedioxymethamphetamine

                carbinoxamine increases and methylenedioxymethamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • midazolam

                carbinoxamine and midazolam both increase sedation. Use Caution/Monitor.

              • midodrine

                carbinoxamine increases and midodrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • mirtazapine

                carbinoxamine and mirtazapine both increase sedation. Use Caution/Monitor.

              • modafinil

                carbinoxamine increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • morphine

                carbinoxamine and morphine both increase sedation. Use Caution/Monitor.

              • motherwort

                carbinoxamine and motherwort both increase sedation. Use Caution/Monitor.

              • moxonidine

                carbinoxamine and moxonidine both increase sedation. Use Caution/Monitor.

              • nabilone

                carbinoxamine and nabilone both increase sedation. Use Caution/Monitor.

              • nalbuphine

                carbinoxamine and nalbuphine both increase sedation. Use Caution/Monitor.

              • norepinephrine

                carbinoxamine increases and norepinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • nortriptyline

                carbinoxamine and nortriptyline both increase sedation. Use Caution/Monitor.

              • olanzapine

                carbinoxamine and olanzapine both increase sedation. Use Caution/Monitor.

              • opium tincture

                carbinoxamine and opium tincture both increase sedation. Use Caution/Monitor.

              • orphenadrine

                carbinoxamine and orphenadrine both increase sedation. Use Caution/Monitor.

              • oxazepam

                carbinoxamine and oxazepam both increase sedation. Use Caution/Monitor.

              • oxycodone

                carbinoxamine and oxycodone both increase sedation. Use Caution/Monitor.

              • oxymorphone

                carbinoxamine and oxymorphone both increase sedation. Use Caution/Monitor.

              • paliperidone

                carbinoxamine and paliperidone both increase sedation. Use Caution/Monitor.

              • papaveretum

                carbinoxamine and papaveretum both increase sedation. Use Caution/Monitor.

              • papaverine

                carbinoxamine and papaverine both increase sedation. Use Caution/Monitor.

              • passion flower

                passion flower increases effects of carbinoxamine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.

              • pentazocine

                carbinoxamine and pentazocine both increase sedation. Use Caution/Monitor.

              • pentobarbital

                carbinoxamine and pentobarbital both increase sedation. Use Caution/Monitor.

              • perphenazine

                carbinoxamine and perphenazine both increase sedation. Use Caution/Monitor.

              • phendimetrazine

                carbinoxamine increases and phendimetrazine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • phenelzine

                phenelzine increases effects of carbinoxamine by Other (see comment). Modify Therapy/Monitor Closely. Comment: Coadministration of phenelzine and antihistamines may result in additive CNS depressant effects. MAO inhibitors also prolong and intensify anticholinergic effects of antihistamines. .

              • phenobarbital

                carbinoxamine and phenobarbital both increase sedation. Use Caution/Monitor.

              • phentermine

                carbinoxamine increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • phenylephrine

                carbinoxamine increases and phenylephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • phenylephrine PO

                carbinoxamine increases and phenylephrine PO decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

              • pholcodine

                carbinoxamine and pholcodine both increase sedation. Use Caution/Monitor.

              • pimozide

                carbinoxamine and pimozide both increase sedation. Use Caution/Monitor.

              • pirbuterol

                carbinoxamine increases and pirbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • pregabalin

                pregabalin, carbinoxamine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.

              • primidone

                carbinoxamine and primidone both increase sedation. Use Caution/Monitor.

              • prochlorperazine

                carbinoxamine and prochlorperazine both increase sedation. Use Caution/Monitor.

              • promethazine

                carbinoxamine and promethazine both increase sedation. Use Caution/Monitor.

              • propofol

                propofol and carbinoxamine both increase sedation. Use Caution/Monitor.

              • propylhexedrine

                carbinoxamine increases and propylhexedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • protriptyline

                carbinoxamine and protriptyline both increase sedation. Use Caution/Monitor.

              • quazepam

                carbinoxamine and quazepam both increase sedation. Use Caution/Monitor.

              • quetiapine

                carbinoxamine and quetiapine both increase sedation. Use Caution/Monitor.

              • ramelteon

                carbinoxamine and ramelteon both increase sedation. Use Caution/Monitor.

              • risperidone

                carbinoxamine and risperidone both increase sedation. Use Caution/Monitor.

              • salmeterol

                carbinoxamine increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • scullcap

                carbinoxamine and scullcap both increase sedation. Use Caution/Monitor.

              • secobarbital

                carbinoxamine and secobarbital both increase sedation. Use Caution/Monitor.

              • sevoflurane

                sevoflurane and carbinoxamine both increase sedation. Use Caution/Monitor.

              • shepherd's purse

                carbinoxamine and shepherd's purse both increase sedation. Use Caution/Monitor.

              • stiripentol

                stiripentol, carbinoxamine. Either increases effects of the other by sedation. Use Caution/Monitor. Concurrent use of medications with CNS depressant effects together with thalidomide should be avoided due to the risk for additive sedative effects.

              • sufentanil

                carbinoxamine and sufentanil both increase sedation. Use Caution/Monitor.

              • tapentadol

                carbinoxamine and tapentadol both increase sedation. Use Caution/Monitor.

              • temazepam

                carbinoxamine and temazepam both increase sedation. Use Caution/Monitor.

              • terbutaline

                carbinoxamine increases and terbutaline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • thioridazine

                carbinoxamine and thioridazine both increase sedation. Use Caution/Monitor.

              • thiothixene

                carbinoxamine and thiothixene both increase sedation. Use Caution/Monitor.

              • topiramate

                carbinoxamine and topiramate both increase sedation. Modify Therapy/Monitor Closely.

              • tramadol

                carbinoxamine and tramadol both increase sedation. Use Caution/Monitor.

              • trazodone

                carbinoxamine and trazodone both increase sedation. Use Caution/Monitor.

              • triazolam

                carbinoxamine and triazolam both increase sedation. Use Caution/Monitor.

              • triclofos

                carbinoxamine and triclofos both increase sedation. Use Caution/Monitor.

              • trifluoperazine

                carbinoxamine and trifluoperazine both increase sedation. Use Caution/Monitor.

              • trimipramine

                carbinoxamine and trimipramine both increase sedation. Use Caution/Monitor.

              • triprolidine

                carbinoxamine and triprolidine both increase sedation. Use Caution/Monitor.

              • valerian

                valerian increases effects of carbinoxamine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.

              • xylometazoline

                carbinoxamine increases and xylometazoline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • yohimbine

                carbinoxamine increases and yohimbine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • ziconotide

                carbinoxamine and ziconotide both increase sedation. Use Caution/Monitor.

              • ziprasidone

                carbinoxamine and ziprasidone both increase sedation. Use Caution/Monitor.

              • zotepine

                carbinoxamine and zotepine both increase sedation. Use Caution/Monitor.

              Minor (6)

              • ashwagandha

                ashwagandha increases effects of carbinoxamine by pharmacodynamic synergism. Minor/Significance Unknown. May enhance CNS depression.

              • brimonidine

                brimonidine increases effects of carbinoxamine by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

              • eucalyptus

                carbinoxamine and eucalyptus both increase sedation. Minor/Significance Unknown.

              • nettle

                nettle increases effects of carbinoxamine by pharmacodynamic synergism. Minor/Significance Unknown. (High dose nettle; theoretical interaction) May enhance CNS depression.

              • sage

                carbinoxamine and sage both increase sedation. Minor/Significance Unknown.

              • Siberian ginseng

                Siberian ginseng increases effects of carbinoxamine by pharmacodynamic synergism. Minor/Significance Unknown. May enhance CNS depression.

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              Adverse Effects

              Varies in incidence & severity with the individual drug; also individual patients vary in susceptibility

              Frequency Not Defined

              CNS depression

              Drowsiness

              Sedation ranging from mild drowsiness to deep sleep (most frequent)

              Dizziness

              Lassitude

              Disturbed coordination

              Muscular weakness

              Restlessness, insomnia, tremors, euphoria, nervousness, delirium, palpitation, seizures is less common

              Epigastric distress

              Anorexia

              Nausea

              Vomiting

              Diarrhea

              Constipation

              Cholestasis, hepatitis, hepatic failure, hepatic function abnormality, jaundice is rare

              Tachycardia, palpitation ECG changes (eg, widened QRS)

              Arrhythmias (eg, extrasystole, heart block)

              Hypotension

              Hypertension

              Dizziness, sedation, and hypotension may occur in geriatric patients

              Dryness of mouth, nose, and throat

              Dysuria

              Urinary retention

              Impotence

              Vertigo

              Visual disturbances

              Blurred vision

              Diplopia; tinnitus

              Acute labyrinthitis

              Insomnia

              Tremors

              Nervousness

              Irritability

              Facial dyskinesia

              Tightness of the chest

              Thickening of bronchial secretions

              Wheezing

              Nasal stuffiness

              Sweating

              Chills

              Early menses

              Toxic psychosis

              Headache

              Faintness

              Paresthesia

              Agranulocytosis

              Hemolytic anemia

              Leukopenia

              Thrombocytopenia

              Pancytopenia

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              Warnings

              Contraindications

              Hypersensitivity

              Concurrent therapy with MAO inhibitors

              Children ≤2 years

              Cautions

              Deaths reported in children 2 years of age and younger treated with carbinoxamine-containing medications; therefore, contraindicated in children aged ≤2 years

              May produce marked drowsiness and impair the mental or physical abilities required for the performance of potentially hazardous tasks such as driving a car or operating machinery;

              Advise patients to avoid engaging in hazardous tasks requiring mental alertness and motor coordination after ingestion of drug; avoid concurrent use of drug with alcohol or other central nervous system depressants because additional impairment of central nervous system performance may occur

              Drug has anticholinergic (atropine-like) properties and, therefore, should be used with caution in patients with increased intraocular pressure, narrow angle glaucoma, hyperthyroidism, cardiovascular disease, hypertension, stenosing peptic ulcer, symptomatic prostatic hypertrophy, bladder neck obstruction, or pyloroduodenal obstruction

              Drug contains sodium metabisulfite, a sulfite that may cause allergic-type reactions, including anaphylaxis and life-threatening or less severe asthmatic episodes, in susceptible individuals; the overall prevalence of sulfite sensitivity in the general population is unknown and probably low; sulfite sensitivity is seen more frequently in asthmatic than in nonasthmatic individuals

              Drug interactions overview

              • CNS depressants
                • Avoid coadministration
                • Alcohol or other CNS depressants may potentiate the impairment of CNS performance
              • Monoamine oxidase inhibitors
                • Avoid coadministration
                • Monoamine oxidase inhibitors (MAOIs), which prolong and intensify the anticholinergic (drying) effects of antihistamines
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              Pregnancy & Lactation

              Pregnancy

              Published data over decades of use of antihistamines, including carbinoxamine, have not identified a drug-associated risk of major birth defects, miscarriage or adverse maternal or fetal outcomes; however, published data specifically evaluating risk of carbinoxamine were not found

              No animal reproductive studies have been conducted

              Lactation

              Based on physical properties of carbinoxamine, it is likely is present in breast milk

              Drowsiness and irritability in infants exposed antihistamines via breast milk have been reported

              Postmarketing reports of death in children <2 years exposed to oral carbinoxamine

              No data are available on effects on milk production

              Not recommended to breastfeed during treatment

              Pregnancy Categories

              A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

              B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

              C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

              D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

              X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

              NA: Information not available.

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              Pharmacology

              Mechanism of Action

              Histamine H1-receptor antagonist in blood vessels, respiratory tract, and gastrointestinal tract

              Pharmacokinetics

              Half-Life: 10-20 hr

              Metabolism: Hepatic

              Excretion: Urine

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              Administration

              Oral Administration

              Oral route only

              Take on an empty stomach with water

              Oral solution

              • Measure with an accurate milliliter measuring device
              • A household teaspoon is not an accurate measuring device and could lead to overdosage
              • A pharmacist can provide an appropriate measuring device and can provide instructions for measuring correct dose

              Storage

              • Store at 20-25ºC (68-77ºF)
              • Dispense in a tight, light-resistant container with a child-resistant closure
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              Images

              No images available for this drug.
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              Patient Handout

              A Patient Handout is not currently available for this monograph.
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              Formulary

              FormularyPatient Discounts

              Adding plans allows you to compare formulary status to other drugs in the same class.

              To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

              Adding plans allows you to:

              • View the formulary and any restrictions for each plan.
              • Manage and view all your plans together – even plans in different states.
              • Compare formulary status to other drugs in the same class.
              • Access your plan list on any device – mobile or desktop.

              The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

              Tier Description
              1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
              2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
              3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
              4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              NC NOT COVERED – Drugs that are not covered by the plan.
              Code Definition
              PA Prior Authorization
              Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
              QL Quantity Limits
              Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
              ST Step Therapy
              Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
              OR Other Restrictions
              Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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              Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.