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a lot of people Carbofed DM Generic Name: brompheniramine maleate, dextromethorphan hydrobromide and pseudoephedrine hydrochloride Dosage Form: syrup Side Effects Dosage Professional Interactions Reviews More Support Group Q & A Disclaimer: This drug has not been found by FDA to be safe and effective, and this labeling has not been approved by FDA. For further information about unapproved drugs, click here. BROMPHENIRAMINE-PSEUDOEPHEDRINE-DEXTROMETHORPHAN SYRUP (Carbofed DM Syrup) Carbofed DM Description Antihistamine/Decongestant/Antitussive for oral use For adults and pediatric patients (2 years and older) Carbofed DM Syrup Each teaspoonful (5 mL) contains brompheniramine maleate, 4 mg; pseudoephedrine hydrochloride, 45 mg; dextromethorphan hydrobromide, 15 mg. Inactive ingredients: Citric acid, FD&C blue #1, FD&C red #33, glycerin, natural & artificial grape flavor, purified water, sodium benzoate, sodium citrate, sorbitol. Brompheniramine maleate (2-Pyridinepropanamine, γ-(4-bromophenyl)- N,N -dimethyl-, ( )-, (Z)-2-butenedioate). Pseudoephedrine hydrochloride (Benzenemethol, α-[1-methylamino)ethyl]-,[S-(R*,R*)]-, hydrochloride) is the hydrochloride of pseudoephedrine, a naturally occurring dextrorotatory stereoisomer of ephedrine. Dextromethorphan hydrobromide (Morphinan, 3-methoxy-17-methyl-, (9α, 13α, 14α)-, hydrobromide monohydrate) is the hydrobromide of d-form race methorphan. Slideshow Over the Counter Cold Remedies - Which One is Right For You? Carbofed DM - Clinical Pharmacology Antihistaminic, decongestant and antitussive actions. Brompheniramine maleate possesses H 1 antihistaminic activity and mild anticholinergic and sedative effects. Peak plasma concentration is reached in 5 hours. Urinary excretion is the major route of elimination. The liver is assumed to be the major site of metabolic transformation. Pseudoephedrine hydrochloride is an oral sympathomimetic amine that acts as a decongestant to respiratory tract mucous membranes. While its vasoconstrictor action is similar to that of ephedrine, pseudoephedrine has less pressor effect in normotensive adults. Serum half-life for pseudoephedrine is 6 to 8 hours. Acidic urine is associated with faster elimination of the drug. About one-half of the administered dose is excreted in the urine. Dextromethorphan hydrobromide is a nonnarcotic antitussive with effectiveness equal to codeine. It acts in the medulla oblongata to elevate the cough threshold. Dextromethorphan does not produce analgesia or induce tolerance, and has no potential for addiction. At usual doses, it will not depress respiration or inhibit ciliary activity. Dextromethorphan is rapidly metabolized with trace amounts of the parent compound in blood and urine. About onehalf of the administered dose is excreted in the urine as conjugated metabolites. Indications and Usage for Carbofed DM For relief of coughs and upper respiratory symptoms, including nasal congestion, associated with allergy or the common cold. Contraindications Patients with hypersensitivity or idiosyncrasy to any of its ingredients. Sympathomimetic amines are contraindicated in patients with severe hypertension, severe coronary artery disease and patients on monoamine oxidase (MAO) inhibitor therapy. Antihistamines are contraindicated in patients with narrow-angle glaucoma, urinary retention, peptic ulcer, and during an asthma attack. Dextromethorphan should not be used in patients receiving a monoamine oxidase inhibitor (MAOI) or for 2 weeks after stopping the MAOI drug. Warnings Sympathomimetic amines should be used judiciously and sparingly in patients with hypertension, diabetes, ischemic heart disease, hyperthyroidism, increased intraocular pressure or prostatic hypertrophy. See CONTRAINDICATIONS . Sympathomimetic amines may produce CNS stimulation with convulsions or cardiovascular collapse with accompanying hypotension. The elderly (60 years and older) are more likely to exhibit adverse reactions. Antihistamines may cause excitability, especially in children. At doses higher than the recommended dose, nervousness, dizziness or sleeplessness may occur. Do not exceed recommended dosage. Administration of dextromethorphan may be accompanied by histamine release and should be used with caution in atopic children. Precautions General Before prescribing medication to suppress or modify cough, identify and provide therapy for the underlying cause of the cough and take caution that modification of cough does not increase the risk of clinical or physiologic complications. Dextromethorphan should be used with caution in sedated or debilitated patients and in patients confined to supine positions. Use with caution in patients with hypertension, heart disease, asthma, hyperthyroidism, increased intraocular pressure, diabetes mellitus and prostatic hypertrophy. Information for patients Avoid alcohol and other CNS depressants while taking this product. Patients sensitive to antihistamines may experience moderate to severe drowsiness. Patients sensitive to sympathomimetics amines may note CNS stimulation. Drug interactions Antihistamines may enhance the effects of tricyclic antidepressants, barbiturates, alcohol, and other CNS depressants. MAO inhibitors prolong and intensify the anticholinergic effects of antihistamines. Sympathomimetic amines may reduce the antihypertensive effects of reserpine, veratrum alkaloids, methyldopa and mecamylamine. Effects of sympathomimetics are increased with MAO inhibitors and beta-adrenergic blockers. The cough-suppressant action of dextromethorphan and narcotic antitussives are additive. Dextromethorphan is contraindicated with monoamine oxidase inhibitors (MAOI). (See CONTRAINDICATIONS section.) Pregnancy Preganncy Category C Animal reproduction studies have not been concluded with Carbofed DM Syrup. It is not known whether these products can cause fetal harm when administered to a pregnant woman or affect reproductive capacity. Give to pregnant women only if clearly needed. Nursing mothers It is not known if the drugs in Carbofed DM Syrup are excreted in human milk. Since many drugs may be excreted into human milk and because of the potential for serious side effects in the nursing infant, this product should only be given to nursing mothers if clearly needed. Pediatric use Safety and effectiveness of Carbofed DM Syrup in pediatric patients below the age of two years have not been established. Adverse Reactions Antihistamines: Sedation, dizziness, diplopia, vomiting, diarrhea, dry mouth, headache, nervousness, nausea, anorexia, heartburn, weakness, polyuria and dysuria and, rarely, excitability in children. Urinary retention may occur in patients with prostatic hypertrophy. Sympathomimetic amines: Convulsions, CNS stimulation, cardiac arrhythmia, respiratory difficulties, increased heart rate or blood pressure, hallucinations, tremors, nervousness, insomnia, pallor and dysuria. Dextromethorphan: Drowsiness, dizziness, and GI disturbance. To report SUSPECTED ADVERSE REACTIONS, contact Hi-Tech Pharmacal Co., Inc at 1-800-262-9010. The signs, symptoms and treatment described below are those for H 1 antihistamines, pseudoephedrine and dextromethorphan overdose. Overdosage The signs, symptoms and treatment described below are those for H 1 antihistamines, pseudoephedrine and dextromethorphan overdose. Symptoms Should antihistamine effects predominate, central action constitutes the greatest danger. In the small child, predominate symptoms are excitation, hallucination, ataxia, incoordination, tremors, flushed face and fever. Convulsions, fixed and dilated pupils, coma and death may occur in severe cases. In the adult, fever and flushing are uncommon; excitement leading to convulsions and postictal depression is often preceded by drowsiness and coma. Respiration is usually not seriously depressed; blood pressure is usually stable. Should sympathomimetic symptoms predominate, central effects include restlessness, dizziness, tremor, hyperactive reflexes, talkativeness, irritability and insomnia. Cardiovascular and renal effects include difficulty in micturition, headache, flushing, palpitation, cardiac arrhythmia, hypertension with subsequent hypotension and circulatory collapse. Gastrointestinal effects include dry mouth, metallic taste, anorexia, nausea, vomiting, diarrhea and abdominal cramps. Dextromethorphan may cause respiratory depression with a large overdose. Treatment a) Evacuate stomach as condition warrants. Activated charcoal may be useful. b) Maintain a nonstimulated environment. c) Monitor cardiovascular status. d) Do not give stimulants. e) Reduce fever with sponging. f) Treat respiratory depression with naloxone if dextromethorphan toxicity is suspected. g) Use sedatives or anticonvulsants to control CNS excitation and convulsions. h) Physostigmine may reverse anticholinergic symptoms. i) Ammonium chloride may acidify the urine to increase urinary excretion of pseudoephedrine. j) Further care is symptomatic and supportive. Carbofed DM Dosage and Administration * In mild cases or in particularly sensitive patients, less frequent or reduced doses may be adequate. AGE DOSE * FREQUENCY 2-6 years 1/2 teaspoonful (2.5 mL) QID adults and pediatric patients 6 years and over 1 teaspoonful (5 mL) QID How is Carbofed DM Supplied Carbofed DM Syrup, grape flavored, in 16-fl-oz bottles. Dispense in USP tight, light-resistant, glass container. Store between 46º-86ºF (8º-30ºC). Avoid exposure to heat. Keep tightly closed. Rx only. Manufactured by: Hi-Tech Pharmacal Co., Inc. Amityville, NY 11701 Rev. 575:01 3/09 MG# 16623 PRINCIPAL DISPLAY PANEL NDC 50383-575-16 Carbofed DM Syrup Antihistamine/Decongestant/Antitussive Sugar Free Alcohol Free EACH 5mL (ONE TEASPOONFUL) CONTAINS: Brompheniramine..........................................4 mg Pseudoephedrine Hydrochloride..................45 mg Dextromethorphan Hydrobromide...............15 mg DOSAGE AND ADMINISTATION: USUAL DOSAGE*: 2 to 6 years, 1/2 teaspoonful (2.5 mL), 4 times a day. Adults and pediatric patients 6 years and over, 1 teaspoonful (5 mL), 4 times a day. *In mild cases or in particularly sensitive patients, less frequent or reduced doses may be adequate. See package insert for full prescribing information. KEEP THIS AND ALL DRUGS OUT OF REACH OF CHILDREN. In case of accidental overdose, seek professional assistance or contact a Poison Control Center Immediately. IMPORTANT: Use safety closures when dispensing this product unless otherwise directed by the physician or requested by purchaser. STORE BETWEEN 46 -86 F (8 -30 C) AVOID EXPOSURE TO HEAT CAP SEALED WITH BREAKAWAY BAND DO NOT USE IF BROKEN OR MISSING 16 fl oz (473 mL) HI-TECH PHARMACAL CO., INC. Amityville, NY 11701 Carbofed DM brompheniramine pseudoephedrine and dextromethorphan syrup Product Information Product Type HUMAN PRESCRIPTION DRUG LABEL Item Code (Source) NDC:50383-575 Route of Administration ORAL DEA Schedule Active Ingredient/Active Moiety Ingredient Name Basis of Strength Strength BROMPHENIRAMINE MALEATE (BROMPHENIRAMINE) BROMPHENIRAMINE MALEATE 4 mg in 5 mL DEXTROMETHORPHAN HYDROBROMIDE (DEXTROMETHORPHAN) DEXTROMETHORPHAN HYDROBROMIDE 15 mg in 5 mL PSEUDOEPHEDRINE HYDROCHLORIDE (PSEUDOEPHEDRINE) PSEUDOEPHEDRINE HYDROCHLORIDE 45 mg in 5 mL Inactive Ingredients Ingredient Name Strength ANHYDROUS CITRIC ACID D&C RED NO. 33 FD&C BLUE NO. 1 GLYCERIN GRAPE SODIUM BENZOATE SODIUM CITRATE SORBITOL WATER Packaging # Item Code Package Description 1 NDC:50383-575-16 473 mL in 1 BOTTLE Marketing Information Marketing Category Application Number or Monograph Citation Marketing Start Date Marketing End Date Unapproved drug other 09/03/2001 11/03/2011 Labeler - Hi-Tech Pharmacal Co., Inc. (101196749) Revised: 11/2009 Hi-Tech Pharmacal Co., Inc. Next Interactions Print this page Add to My Med List More about Carbofed DM Syrup (brompheniramine / dextromethorphan / pseudoephedrine) Side Effects Dosage Information Drug Interactions Support Group 0 Reviews Add your own review/rating Drug class: upper respiratory combinations Consumer resources Professional resources Brompheniramine, Pseudoephedrine, Dextromethorpan Syrup (FDA) Other brands: Bromfed DM , Bromdex D , EndaCof PD Drops , Myphetane DX , Sildec DM Related treatment guides Cough and Nasal Congestion} FEATURED: CAR-T Cell Therapy Overview Mechanism of Action KTE-C19 Studies KTE-C19 Cancer Targets Adverse Events Manufacturing Drug Status Rx OTC Availability Rx and/or OTC C Pregnancy Category Risk cannot be ruled out N/A CSA Schedule Not a controlled drug WADA Class Anti-Doping Classification Drug Class Upper respiratory combinations Related Drugs upper respiratory combinations Promethazine DM , Cheratussin AC , Mucinex DM Cough and Nasal Congestion Promethazine VC with Codeine , Bromfed DM , Mucinex D , Vanacof , Deconex , codeine / phenylephrine / promethazine , Vicks NyQuil Severe Cold & Flu , Resperal-DM , Coricidin HBP Cough & Cold , Vicks Nyquil Cough , Deconex DMX , Crantex , Tussin CF , Robitussin Allergy & Cough , Robitussin Nighttime Cough DM , Relasin-HC , Mucinex Fast-Max Severe Congestion & Cough , Dimetapp Children's Cold & Cough , More... 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