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carbinoxamine (Palgic, Arbinoxa, Karbinal ER)

 

Classes: Antihistamines, 1st Generation

Dosing and uses of Palgic, Arbinoxa (carbinoxamine)

 

Adult dosage forms and 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

 

Pediatric dosage forms and strengths

tablet

  • 4mg

oral solution

  • 4mg/5mL

oral suspension, extended-release (Karbinal ER)

  • 4mg/5mL

 

Allergies

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

  • 2-3 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

 

Geriatric dosage forms and strengths

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

 

Palgic, Arbinoxa (carbinoxamine) adverse (side) 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

 

Warnings

Contraindications

Hypersensitivity

Concurrency with MAO inhibitors

Preemies & neonates

Nursing mothers

Lower respiratory tract symptoms, eg, asthma

 

Cautions

Narrow-angle glaucoma, prostatic hypertrophy, peptic ulcer, GI obstruction, bladder outflow obstruction, history of bronchial asthma, incr IOP, HTN, hyperthyroidism, cardiovascular dz

May affect mental alertness

Elderly

 

Pregnancy and lactation

Pregnancy category: C

Lactation: excretion in milk unknown/contraindicated

 

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.

 

Pharmacology of Palgic, Arbinoxa (carbinoxamine)

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