Recommended Topic Related To:

Semprex D

"The U.S. Food and Drug Administration recently approved Oralair to treat allergic rhinitis (hay fever) with or without conjunctivitis (eye inflammation) that is induced by certain grass pollens in people ages 10 through 65 years. Oralair is the f"...

Semprex D

Warnings
Precautions

WARNINGS

SEMPREX-D (acrivastine and pseudoephedrine) Capsules should be used with caution in patients with hypertension, diabetes mellitus, ischemic heart disease, increased intraocular pressure, hyperthyroidism, prostatic hypertrophy, stenosing peptic ulcer, or pyloroduodenal obstruction. Overdose of sympathomimetic amines may produce CNS stimulation with convulsions or cardiovascular collapse with accompanying hypotension. The elderly are more likely to have adverse reactions to sympathomimetic amines.

PRECAUTIONS

General

Acrivastine is sedating in some patients. In controlled clinical trials, somnolence (i.e., drowsiness, sedation, sleepiness) was more common with SEMPREX-D (acrivastine and pseudoephedrine) Capsules (by an average of 6%) than with placebo (see ADVERSE EXPERIENCES). Patients should be advised to assess their individual responses to SEMPREX-D (acrivastine and pseudoephedrine) Capsules before engaging in any activity requiring mental alertness, such as driving a motor vehicle or operating machinery. Concurrent use of SEMPREX-D (acrivastine and pseudoephedrine) Capsules with alcohol or other CNS depressants may cause additional reductions in alertness and impairment of CNS performance and should be avoided (see DRUG INTERACTIONS).

Use In Patients With Diminished Renal Function

Acrivastine and pseudoephedrine are excreted primarily through the kidney. Both compounds therefore accumulate in patients with impaired renal function. Due to the differential effects of renal failure on the serum half-life and clearance of acrivastine and pseudoephedrine, use of SEMPREX-D (acrivastine and pseudoephedrine) Capsules, a fixed combination product, in patients with renal impairment (creatinine clearance £ 48 mL/min) is not recommended (see OVERDOSAGE and CLINICAL PHARMACOLOGY).

Carcinogenesis, Mutagenesis, And Impairment Of Fertility

Carcinogenicity studies with the combination of acrivastine and pseudoephedrine have not been performed. Oral doses of acrivastine alone at levels up to 40 mg/kg/day (236 mg/m²/day or 10 times the recommended human daily dose) for 20 to 22 months in rats and up to 250 mg/kg/day (750 mg/m²/day or 32 times the recommended human daily dose) for 20 to 24 months in mice revealed no evidence of carcinogenic potential. No evidence of mutagenicity (with or without metabolic activation) was observed in the Ames Salmonella mutagenicity assay or in the L5178Y/tk+/- mouse lymphoma assay. In an in vitro cytogenetic study performed in cultured human lymphocytes, acrivastine induced structural chromosomal abnormalities in the absence of metabolic activation, but not in its presence. In an in vivo cytogenetic study in rats given single oral doses of acrivastine up to 1000 mg/kg (5900 mg/m² or 249 times the recommended human daily dose) there were no structural chromosomal alterations.

Reproduction-fertility studies in rats given acrivastine alone at levels up to 200 mg/kg/day (1180 mg/m²/day or 50 times the recommended human daily dose) had no effect on male or female fertility. Similarly, no effect on fertility was seen in male rats given acrivastine 20 mg/kg/day and pseudoephedrine 100 mg/kg/ day (118 and 590 mg/m²/day or 5 and 3 times the recommended human daily doses, respectively) or in female rats given acrivastine 4 mg/kg/day and pseudoephedrine 20 mg/kg/day (23.6 and 118 mg/m²/ day or 1 and 0.7 times the recommended human daily doses, respectively).

Pregnancy

Pregnancy Category B
Teratogenic Effects

No evidence of teratogenicity was seen in rats and rabbits given acrivastine 1000 and 400 mg/kg/day, respectively (5900 and 4720 mg/m²/day or 249 and 200 times the recommended human daily dose). No evidence of teratogenicity was seen in rats given a combination of acrivastine 30 mg/kg/day and pseudoephedrine 150 mg/kg/day (177 and 885 mg/m²/day or 8 and 5 times the recommended human daily dose, respectively). Similarly, no evidence of teratogenicity was observed in rabbits given acrivastine 20 mg/kg/day and pseudoephedrine 100 mg/kg/day (236 and 1180 mg/m²/day or 10 and 7 times the recommended human daily doses, respectively). There are, however, no adequate and well-controlled studies in pregnant women. Because animal teratology studies are not always predictive of human responses, SEMPREX-D (acrivastine and pseudoephedrine) Capsules should be used during pregnancy only if the potential benefit justifies the potential risks to the fetus.

Nonteratogenic Effects

In a perinatal-postnatal study in rats, acrivastine given alone at levels up to 500 mg/kg/day (2950 mg/m²/day or 124 times the recommended human daily dose) was associated with maternal and neonatal mortality at the maximum dose level. Neonatal survival was decreased in rats given a combination of acrivastine 20 mg/kg/day and pseudoephedrine 100 mg/ kg/day (118 and 590 mg/m²/day or 5 and 3 times the human dose, respectively).

Nursing Mothers

It is not known whether acrivastine is excreted in human milk; pseudoephedrine is excreted in human milk. SEMPREX-D (acrivastine and pseudoephedrine) Capsules should only be used in nursing mothers when the potential benefit justifies the potential risks to the nursing infant.

Pediatric Use

Safety and effectiveness of SEMPREX-D (acrivastine and pseudoephedrine) Capsules in pediatric patients under the age of 12 years have not been established.

Geriatric Use

Of the total number of subjects in clinical studies of SEMPREX-D (acrivastine and pseudoephedrine) , 349 were 60 years of age or older and 53 were 70 years of age and older. No overall differences in safety or effectiveness were observed between these subjects and younger subjects, and other reported clinical experience has not identified differences in responses between the elderly and younger patients, but greater sensitivity of some older individuals cannot be ruled out. Antihistamines, however, as a pharmaceutical class, are more likely to cause dizziness, sedation, bladder-neck obstruction, and hypotension in elderly patients. The elderly are also more likely to have adverse reactions to sympathomimetics such as pseudoephedrine (see CLINICAL PHARMACOLOGY and WARNINGS).

This drug is known to be substantially excreted by the kidney, and the risk of toxic reactions to this drug may be greater in patients with impaired renal function. Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection, and it may be useful to monitor renal function. Use of SEMPREX-D (acrivastine and pseudoephedrine) in patients with renal impairment (creatinine clearance ≤ 48 mL/min) is not recommended (see PRECAUTIONS, Use In Patients With Diminished Renal Function).

Last reviewed on RxList: 5/20/2009
This monograph has been modified to include the generic and brand name in many instances.

Warnings
Precautions
A A A

Semprex D - User Reviews

Semprex D User Reviews

Now you can gain knowledge and insight about a drug treatment with Patient Discussions.

Here is a collection of user reviews for the medication Semprex D sorted by most helpful. Patient Discussions FAQs

Report Problems to the Food and Drug Administration

 

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.


Allergies & Asthma

Improve treatments & prevent attacks.


NIH talks about Ebola on WebMD