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Children younger than 2 years of age
Nursing mothers
Patients with known hypersensitivity to the drug or any of its inactive ingredients
Patients taking monoamine oxidase inhibitors (MAOI)

Deaths have been reported in children less than 2 years of age who were taking carbinoxamine-containing drug products. Do not give Karbinal ER to children younger than 2 years of age.
Caution patients to avoid engaging in hazardous tasks requiring mental alertness and motor coordination, such as driving or operating machinery.
Use with caution in patients with increased intraocular pressure, narrow angle glaucoma, hyperthyroidism, cardiovascular disease, hypertension, stenosing peptic ulcer, symptomatic prostatic hypertrophy, bladder neck obstruction, or pyloroduodenal obstruction.
Karbinal ER contains sodium metabisulfite, a sulfite which may cause anaphylaxis and life-threatening or less severe asthmatic episodes in susceptible individuals.

The most common adverse reactions include sedation, sleepiness, dizziness, disturbed coordination, epigastric distress, and thickening of bronchial secretions.

Avoid use of Karbinal ER with monoamine oxidase inhibitors (MAOIs) which prolong and intensify the anticholinergic (drying) effects of antihistamines.
Avoid use of Karbinal ER with alcohol and CNS depressants (hypnotics, sedatives, tranquilizers, etc.) due to additive adverse effects.

Because of the higher risk of mortality in infants, Karbinal ER is contraindicated in children younger than 2 years of age, and in nursing mothers.
May cause sedation or excitation in young children.
May cause dizziness, sedation, and hypotension in elderly patients. Start elderly patients on lower doses and observe closely for confusion and over-sedation.

Karbinal™ ER (carbinoxamine maleate) Extended-release Oral Suspension is an H1 receptor antagonist indicated for the symptomatic treatment of:
Seasonal and perennial allergic rhinitis
Vasomotor rhinitis
Allergic conjunctivitis due to inhalant allergens and foods
Mild, uncomplicated allergic skin manifestations of urticaria and angioedema
As therapy for anaphylactic reactions adjunctive to epinephrine and other standard measures after the acute manifestations have been controlled
Amelioration of the severity of allergic reactions to blood or plasma.

Before prescribing Karbinal ER, please read the Full Prescribing Information.

To report suspected adverse reactions, please contact FSC at 1-866-764-7822 or contact FDA at 1-800-FDA-1088 or www.fda.gov/medwatch