Drug Safety-related Labeling Changes (SrLC)

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Drug Safety-related Labeling Changes (SrLC) Database

ANDA	Abbreviated New Drug Application
BLA	Biologics License Application
CDER	Center for Drug Evaluation and Research
MG	Medication Guide
NDA	New Drug Application
PCI	Patient Counseling Information
PI	Patient Information
PLR	Physician Labeling Rule
PLLR	Pregnancy and Lactation Labeling Rule
Italics	For the most part, italics indicate an FDA comment such as: Additions and/or revisions underlined These italics usually appear at the beginning of the section. In some cases, italics may be an inherent part of the label, and will most often appear in the body of the section.
Underlines	Any text that is underlined indicates text that has been added or revised. There are exceptions where underlining occurs in a section subtitle or heading. This is the case when there is just one word underlined in the body of the text.

Sections

BW	Box Warning
WP	Warnings and Precautions all in one section (PLR-format) Warnings as one section (pre-PLR format) Precautions as one section (pre-PLR format)
AR	Adverse Reactions (in pre-PLR format, this may be a subheading under precautions).
DI	Drug Interactions (in pre-PLR format, this may be a subheading under precautions).
USP	Use in Specific Populations (Inclusive on one or more of the following: Pregnancy; Lactation (PLLR- format); Nursing Mothers (pre-PLLR format); Females and Males of Reproductive Potential (PLLR format only); Pediatric Use, Geriatric Use, Renal Impairment, Hepatic Impairment, Sex, Race (these last six may be a subheading of precautions if label in pre-PLLR format.
PCI/PI/MG	Patient Counseling Information (PLR format only) - summarizes the information that a health care provider should convey to a patient (or caregiver when applicable) when a counseling discussion is taking place (e.g., a physician prescribing a drug during an office visit, a nurse providing discharge instructions at a hospital, or a pharmacist conveying information at a pharmacy). Patient Information - FDA approved patient labeling. Medication Guide - paper handouts that come with many prescription medicines. The guides address issues that are specific to particular drugs and drug classes, and they contain FDA-approved information that can help patients avoid serious adverse events.

Only NDAs and CDER regulated BLAs are included in this database. ANDAs are not included.

Applications that remain active, even if the product has been discontinued, undergo safety-related labeling changes.

KARBINAL ER (NDA-022556)

(CARBINOXAMINE MALEATE)

Safety-related Labeling Changes Approved by FDA Center for Drug Evaluation and Research (CDER)

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03/25/2021 (SUPPL-6)

Approved Drug Label (PDF)

5 Warnings and Precautions

5.1 Somnolence and Impaired Mental Alertness

(Section title updated)

5.4 Allergic Reactions due to Sulfites, including Anaphylaxis

(Section title updated)

6 Adverse Reactions

(Newly added information)

The following clinically significant adverse reactions are described elsewhere in the labeling:

Somnolence and Impaired Mental Alertness [see Warnings and Precautions (5.2)]
Allergic Reactions due to Sulfites, including Anaphylaxis [see Warnings and Precautions (5.4)]

7 Drug Interactions

(Additions and/or revisions underlined)

Do not use Karbinal ER in patients who are taking monoamine oxidase inhibitors (MAOIs), which prolong and intensify the anticholinergic (drying) effects of antihistamines.

8 Use in Specific Populations

8.1 Pregnancy

(PLLR conversion. Please refer to label for complete information.)

8.2 Lactation

(PLLR conversion. Please refer to label for complete information.)

8.4 Pediatric Use

(Additions and/or revisions underlined)

Karbinal ER is contraindicated in pediatric patients younger than 2 years of age because deaths have been reported in this patient population who were taking carbinoxamine-containing drug products

[see Contraindications (4) and Warnings and Precautions (5.1)].

The safety and effectiveness of Karbinal ER in pediatric patients aged 2 years and older have been established and is based on demonstration of bioequivalence to the immediate-release reference product [see Clinical Pharmacology (12.3)]. Carbinoxamine may diminish mental alertness or produce sedation in children. Paradoxical reactions with excitation are more likely in younger children.

17 PCI/PI/MG (Patient Counseling Information/Patient Information/Medication Guide)

(Newly added information)

Lactation

Advise women that breastfeeding is not recommended during treatment with Karbinal ER [see Warnings and Precautions (5.1) and Use in Specific Populations (8.2)].