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.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.