carbinoxamine, hydrocodone, and phenylephrine

Generic Name: carbinoxamine, hydrocodone, and phenylephrine (kar bi NOX a meen, hy dro KOE done, fen il EFF rin)Brand names: Donatussin MAX, Excof, Excof-SF, Max HC

What is carbinoxamine, hydrocodone, and phenylephrine?

Carbinoxamine is an antihistamine that reduces the natural chemical histamine in the body. Histamine can produce symptoms of sneezing, itching, watery eyes, and runny nose.

Hydrocodone is a narcotic cough suppressant. It suppresses an area in the brain that causes coughing.

Phenylephrine is a decongestant that shrinks blood vessels in the nasal passages. Dilated blood vessels can cause nasal congestion (stuffy nose).

Carbinoxamine, hydrocodone, and phenylephrine is used to treat sneezing, cough, runny or stuffy nose, itchy or watery eyes, hives, skin rash, itching, and other symptoms of allergies and the common cold.

This medication may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about carbinoxamine, hydrocodone, and phenylephrine?Always ask a doctor before giving a cough or cold medicine to a child, even if the medicine label provides dosing instructions for children. Death can occur from the misuse of cough and cold medicines in very young children. Do not use carbinoxamine, hydrocodone, and phenylephrine if you have used an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days. Serious, life-threatening side effects can occur if you take carbinoxamine, hydrocodone, and phenylephrine before the MAO inhibitor has cleared from your body. Carbinoxamine, hydrocodone, and phenylephrine can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert. Avoid drinking alcohol. It can increase some of the side effects of this medication.

Call your doctor if you have a fever, or if your symptoms get worse or do not improve after taking this medicine for 7 days.

Do not take this product for cough caused by smoking, asthma, or emphysema. Do not take this medicine if your cough produces a lot of mucus, unless your doctor has told you to.

Hydrocodone may be habit-forming and should be used only by the person it was prescribed for. This medicine should never be given to another person, especially someone who has a history of drug abuse or addiction. Keep the medication in a secure place where others cannot get to it.What should I discuss with my health care provider before taking carbinoxamine, hydrocodone, and phenylephrine?Do not give this medication to a child younger than 2 years old, even if the medicine label provides dosing intructions for children in this age group. Deaths have been reported in children under 2 years old who had received carbinoxamine, although it has not been determined that carbinoxamine was the cause of these deaths. Talk with your doctor about other FDA-approved products available for use in young children with cold or allergy symptoms. Do not use carbinoxamine, hydrocodone, and phenylephrine if you have used an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days. Serious, life-threatening side effects can occur if you take carbinoxamine, hydrocodone, and phenylephrine before the MAO inhibitor has cleared from your body.

Before taking this medication, tell your doctor if you are allergic to carbinoxamine, hydrocodone, or phenylephrine, or if you have:

• a history of drug or alcohol addiction;

• kidney disease;
• liver disease;

• diabetes;

• glaucoma;

• heart disease or high blood pressure;

• coronary artery disease;

• a stomach ulcer or an obstruction in your stomach or intestines;

• an enlarged prostate or urination problems;

• head injury, brain injury, or brain tumor;

• Addison's disease;

• thyroid problems;

• emphysema or chronic bronchitis;

• asthma.

If you have any of these conditions, you may not be able to take this medication, or you may require a dosage adjustment or special monitoring during treatment.

FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Carbinoxamine, hydrocodone, and phenylephrine can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby. Older adults may be more likely to have side effects from this medicine.

How should I take carbinoxamine, hydrocodone, and phenylephrine?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

You may take this medication with or without food.

If the medication upsets your stomach, you may take it with food or milk.

Measure the liquid medicine with a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist where you can get one.

Hydrocodone may cause constipation. Drink 6 to 8 full glasses of water each day while you are taking this medicine. Increasing the amount of fiber in your diet may also help relieve constipation.

Call your doctor if you have a fever, or if your symptoms get worse or do not improve after taking this medicine for 7 days.

Hydrocodone may be habit-forming and should be used only by the person it was prescribed for. This medicine should never be given to another person, especially someone who has a history of drug abuse or addiction. Keep the medication in a secure place where others cannot get to it. Store the medication at room temperature away from moisture and heat.

See also: Carbinoxamine, hydrocodone, and phenylephrine dosage in more detail

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have taken too much of this medicine.

Symptoms of an overdose may include dizziness, ringing in the ears, blurred vision, large pupils, dry mouth, a weak heartbeat, extreme drowsiness, sweating, shaking, pale skin, blue lips and fingernails, hallucinations, confusion, seizures, shallow breathing, coma, and death.

What should I avoid while taking carbinoxamine, hydrocodone, and phenylephrine?

This medication can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert. Avoid drinking alcohol. It can increase some of the side effects of this medication. Do not use any other over-the-counter cough, cold, allergy, or sleep medication without first asking your doctor or pharmacist. Antihistamines, decongestants, and cough suppressants are contained in many medicines available over the counter. If you take certain products together you may accidentally take too much of one or more types of medicine. Read the label of any other medicine you are using to see if it contains an antihistamine, decongestant, or cough suppressant.

Avoid using other medicines that make you sleepy (such as cold medicine, other narcotics, pain medication, muscle relaxers, and medicine for seizures, depression or anxiety). They can add to sleepiness caused by carbinoxamine, hydrocodone, and phenylephrine.

Carbinoxamine, hydrocodone, and phenylephrine side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using this medication and call your doctor at once if you have any of these serious side effects:

• seizure (convulsions);

• unusual behavior or hallucinations;

• an irregular or fast heartbeat;

• feeling light-headed, fainting;

• urinating less than usual or not at all;

• wheezing, tightness in your chest;

• fast or pounding heartbeat;

• jaundice (yellowing of the skin or eyes);

• pale skin, easy bruising or bleeding;

• slow or weak breathing; or

• swelling, rapid weight gain.

Continue taking this medication and talk to your doctor if you have any of these less serious side effects:

• drowsiness, dizziness;

• lack of coordination;

• upset stomach, nausea, stomach cramps, or constipation;

• stuffy nose, chest congestion;

• sleep problems (insomnia);

• itchy skin rash;

• decreased hearing or ringing in the ears;

• feeling restless or excited (especially in children);

• dry mouth or nose; or

• blurred vision.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

The hydrocodone in this medication may cause constipation. Drink plenty of water (six to eight full glasses a day) to lessen this side effect. Increasing the amount of fiber in your diet may also help to alleviate constipation.

Carbinoxamine, hydrocodone, and phenylephrine Dosing Information

Usual Adult Dose for Cough and Nasal Congestion:

Carbinoxamine/hydrocodone/phenylephrine 4 mg-5 mg-8 mg/5 mL oral liquid:5 mL orally 3 to 4 times daily.Carbinoxamine/hydrocodone/phenylephrine 2 mg-5 mg-6 mg/5 mL oral liquid:5 to 10 mL orally every 4 to 6 hours, not to exceed 4 doses in 24 hours.

Usual Pediatric Dose for Cough and Nasal Congestion:

Carbinoxamine/hydrocodone/phenylephrine 4 mg-5 mg-8 mg/5 mL oral liquid:>= 12 yrs: 5 mL orally 3 to 4 times daily.>= 6 yrs <12 yrs: 2.5 mL orally 3 to 4 times daily.>= 2 yrs <6 yrs: 1.25 mL orally 3 to 4 times daily.Carbinoxamine/hydrocodone/phenylephrine 2 mg-5 mg-6 mg/5 mL oral liquid:>= 12 yrs: 5 to 10 mL orally every 4 to 6 hours, not to exceed 4 doses in 24 hours.>= 6 yrs <12 yrs: 2.5 to 5 mL orally every 4 to 6 hours, not to exceed 4 doses in 24 hours.>= 3 yrs <6 yrs: 1.25 to 2.5 mL orally every 4 to 6 hours, not to exceed 4 doses in 24 hours.

What other drugs will affect carbinoxamine, hydrocodone, and phenylephrine?

Do not take this medication if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), tranylcypromine (Parnate), or selegiline (Eldepryl) in the last 14 days. A dangerous drug interaction could occur, leading to serious side effects.

Before taking carbinoxamine, hydrocodone, and phenylephrine, tell your doctor if you are taking any of the following medicines:

• medicine to treat high blood pressure or a heart condition;

• medicine to treat diabetes;

• weight loss medication;

• another decongestant (cold or allergy product); or

• antidepressants such as amitriptyline (Elavil, Etrafon), amoxapine (Ascendin), clomipramine (Anafranil), desipramine (Norpramin), imipramine (Janimine, Tofranil), nortriptyline (Pamelor), protriptyline (Vivactil), or trimipramine (Surmontil).

If you are using any of these drugs, you may not be able to use carbinoxamine, hydrocodone, and phenylephrine or you may need dosage adjustments or special tests during treatment.

There may be other drugs not listed that can affect carbinoxamine, hydrocodone, and phenylephrine. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

• Your pharmacist has additional information about carbinoxamine, hydrocodone, and phenylephrine written for health professionals that you may read.

What does my medication look like?

Carbinoxamine, hydrocodone, and phenylephrine is available with a prescription under the brand names Donatussin and Excof. Other brand and generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

• Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
• Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2006 Cerner Multum, Inc. Version: 1.05. Revision Date: 04/14/2007 10:28:12 AM.