Home Drug Guide Carbinoxamine Maleate

Drug Guide

Generic Name

Carbinoxamine Maleate

Brand Names Clistin, Karbinal ER

Classification

Therapeutic: Antihistamine, first-generation

Pharmacological: Histamine H1 receptor antagonist

FDA Approved Indications

Relief of allergic symptoms such as hay fever, rhinitis, urticaria, and conjunctivitis

Mechanism of Action

Carbinoxamine competitively inhibits the effects of histamine at H1 receptor sites, thereby reducing allergic symptoms.

Dosage and Administration

Adult: Typically 4 mg every 4-6 hours as needed, not to exceed 24 mg per day.

Pediatric: Children 6-12 years: 2-4 mg every 4-6 hours; max 12 mg/day. Children 2-6 years: 1-2 mg every 4-6 hours; max 6 mg/day.

Geriatric: Use with caution; start at lower end of dosing range due to increased sensitivity and risk of CNS effects.

Renal Impairment: Adjust dosing based on severity of impairment; consult specific guidelines.

Hepatic Impairment: Use with caution; dose adjustments may be necessary.

Pharmacokinetics

Absorption: Well absorbed from the gastrointestinal tract.

Distribution: Widely distributed, crosses the blood-brain barrier.

Metabolism: Partially metabolized in the liver.

Excretion: Excreted mainly in urine.

Half Life: Approximately 10-20 hours.

Contraindications

Known hypersensitivity to carbinoxamine or other antihistamines.
Acute asthma attacks.
Prostatic hypertrophy with urinary retention.

Precautions

Use with caution in elderly patients, those with glaucoma, cardiovascular disease, hypertension, bronchial asthma, or urinary retention.
CNS depression may be enhanced in elderly or debilitated patients.
Potential for sedation and impairment of mental and physical alertness.

Adverse Reactions - Common

Sedation, dizziness, dry mouth, blurred vision (Common)
Drowsiness, fatigue (Common)

Adverse Reactions - Serious

Extrapyramidal symptoms, allergic reactions (rash, pruritus, swelling) (Serious but rare)
Paradoxical excitation in children (Rare)

Drug-Drug Interactions

CNS depressants (additive sedative effect)
MAO inhibitors (risk of hypertensive crisis)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for effectiveness in relieving allergic symptoms.

Diagnoses:

Ineffective airway clearance due to allergic rhinitis.
Risk for CNS depression.

Implementation: Instruct patient to avoid operating heavy machinery. Assess response to medication.

Evaluation: Determine reduction in allergy symptoms and monitor for adverse effects.

Patient/Family Teaching

Take medication as prescribed, do not exceed recommended dose.
Avoid alcohol and CNS depressants.
Caution regarding drowsiness; avoid driving or operating machinery.
Inform about potential dry mouth and encourage hydration.

Special Considerations

Black Box Warnings:

None specific for this drug but caution advised due to sedative effects.

Genetic Factors: No widely recognized pharmacogenetic considerations.

Lab Test Interference: No specific known interference.

Overdose Management

Signs/Symptoms: Severe drowsiness, agitation, hallucinations, tremors, seizures.

Treatment: Supportive care, activated charcoal if ingestion is recent, anticonvulsants for seizures, symptomatic treatment.

Storage and Handling

Storage: Store at room temperature away from light and moisture.

Stability: Stable within expiration date when stored properly.