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phenylephrine hydrochloride and
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Cough Suppressant/Antihistamine/Nasal Decongestant/Expectorant
Alcohol Free • Sugar Free
Quartuss™ Syrup is a cough suppressant, antihistamine, nasal decongestant syrup available for oral administration. Each teaspoonful (5mL.) contains:
Sodium Benzoate, Citric Acid, Saccharin Sodium, Propylene Glycol, Sorbitol Solution, Glycerin, Sucralose, Cherry Flavor, D&C Red No. 33, Purified Water.
C9H13NO2HCl M.W. 203.67
Benzenemethanol, 3-hydroxy-α-[(methylamino)methyl]-, hydrochloride (R)-.
C16H19ClN2 • C4H4O4 M.W. 390.86
2-Pyridinepropanamine, γ-(4-chlorophenyl)-N, N-dimethyl-, (Z)-2-butenedioate (1:1)
C18H25NO • HBr • H2O M.W. 370.32
Morphinan, 3-Methoxy-17-methyl-, (9α, 13α, 14α)-, hydrobromide, monohydrate.
Dextromethorphan hydrobromide acts centrally to elevate the threshold for coughing. It has no analgesic or addictive properties. The onset of antitussive action occurs in 15 to 30 minutes after administration and is of long duration.
Chlorpheniramine maleate competitively antagonizes most of the smooth muscle stimulation actions of histamine on the H1 receptors of the GI tract, uterus, large blood vessels and bronchial muscle. It also antagonizes the action of histamine that results in increased capillary permeability and the formation of edema.
Phenylephrine hydrochloride acts predominantly by a direct action on alpha adrenergic receptors. In therapeutic doses, the drug has no significant stimulant effect on the beta adrenergic receptors of the heart. Following oral administration, constriction of blood vessels in the nasal mucosa may relieve nasal congestion. In therapeutic doses, the drug causes little, if any, central nervous system stimulation.
Guaifenesin promotes lower respiratory tract drainage by thinning bronchial secretions, lubricates irritated respiratory tract membranes through increased mucus flow, and facilitates removal of viscous, inspissated mucus. As a result, sinus and bronchial drainage is improved, and dry, nonproductive coughs become more productive and less frequent.
Cough suppressant, antihistamine, nasal decongestant, and expectorant as an aid in the management of cough and mucosal congestion or edema of the respiratory tract, or nasal passages due to the common cold, bronchitis, laryngitis, tracheitis, pharyngitis, pertussis, influenza, measles, or chronic paranasal sinusitis.
Hypersensitivity to any of the ingredients. Also contraindicated in patients with hypertension, hyperthyroidism, prostatic hypertrophy, and patients on MAO inhibitor therapy (or for 14 days after stopping MAOI therapy).
Use with caution in the presence of cardiac disorders, diabetes or peripheral vascular disease.
Keep this and all medications out of the reach of children. In case of accidental overdose, seek professional assistance or contact a Poison Control Center immediately.
Stimulants, such as phenylephrine, are banned and tested for by the U.S. Olympic Committee (USOC) and the National Collegiate Athletic Association (NCAA).
It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when Quartuss™ Syrup is administered to a nursing woman.
May include drowsiness, dizziness, nervousness, insomnia, headache, palpitation, dysuria.
Note: Guaifenesin has been shown to produce a color interference with certain clinical laboratory determinations of 5-hydroxyindoleacetic acid (5-HIAA) and vanillylmandelic acid (VMA).
Signs and Symptoms
Overdosage with Dextromethorphan HBr may produce CNS excitement and mental confusion.
Overdosage with sympathomimetic amines can cause hypertension, headache, convulsions, cerebral hemorrhage and vomiting. Premature ventricular beats and short paroxysms of ventricular tachycardia may also occur. Headache may be a symptom of hypertension. Bradycardia may also be seen early in phenylephrine HCl overdosage through stimulation of baroreceptors. Excessive CNS stimulation may result in excitement, tremor, restlessness, and insomnia. Other effects may include pallor, mydriasis, hyperglycemia, and urinary retention. Severe overdosage may cause tachypnea, or hypernea, hallucinations, convulsions, or delirium, but in some individuals, there may be CNS depression. Arrhythmias (including ventricular fibrillation) may lead to hypotension and circulatory collapse. Severe hypokalemia can occur, probably due to compartmental shift rather than depletion of potassium.
Should antihistamine effects predominate, central action constitutes the greatest danger. In the small child, symptoms include 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.
Overdosage with Guaifenesin is unlikely to produce toxic effects since its toxicity is low. Guaifenesin, when administered by stomach tube to test animals in doses up to 5 gm/kg, produced no signs of toxicity.
The patient should be induced to vomit (pharmacologic vomiting is the preferred method; by the administration of ipecac syrup), unless the patient is comatose, convulsing or has lost the gag reflex, in which case gastric lavage should be performed using a large bore tube. If indicated, follow with activated charcoal and a saline cathartic. Precautions must be taken against aspiration, especially in infants, children and comatose patients.
DOSAGE AND ADMINISTRATION
Adults and Children 12 years of age or older: Two teaspoonfuls. Children 6 to 12 years of age: One teaspoonful. Dose may be repeated every 6 hours. Do not exceed four doses in a 24-hour period. This product is not indicated for use in children under 6 years of age. (see PRECAUTIONS, Pediatric Use.)
Quartuss™ Syrup is a cherry flavored, sugar free, alcohol free liquid supplied in 16 fl. oz. bottles, NDC 51991-513-16.
Dispense in a tight, light-resistant container, with a child-resistant closure as defined in the USP/NF.
Store at 25°C (77°F); excursions permitted to 15°-30°C (59°-86°F). See USP Controlled Room Temperature. Protect from freezing.
All prescription substitutions using this product shall be pursuant to state statues as applicable. This is not an Orange Book product.
Manufactured by: Tri-Med Laboratories, Inc., Somerset, NJ 08873
Distributed by: Breckenridge Pharmaceutical, Inc., Boca Raton, FL 33487
PRINCIPAL DISPLAY PANEL - 473 mL Bottle Label
Description: Each 5ml (one teaspoonful) for oral
INACTIVE INGREDIENTS: Sodium Benzoate,
Revised: 11/2010 Breckenridge Pharmaceutical, Inc.
Reproduced with permission of U.S. National Library of Medicine
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