Rescon tablet, multilayer, extended release
Each yellow and purple, bilayered, capsule-shaped tablet debossed RESCON on one side and IMP on the opposite side is specially formulated to release:
Sustained release layer:
Hydrochloride . . . . . . . . . 40 mg
Maleate . . . . . . . . . . . . . . 12 mg
Immediate release layer:
Nitrate . . . . . . . . . . . . . 1.25 mg
Phenylephrine hydrochloride is a decongestant with the chemical name. (S)-3-hydroxy--[(methylamino) methyl] benzenemethanol hydrochloride. Its structure is as follows:
Figure 1: Phenylephrine HCl
Chlorpheniramine maleate is an antihistamine with the chemical name: 2- Pyridinepropanamine, -(4-chlorophenyl)-N,N-dimethyl-,(Z)-2-butenedioate (1:1). Its chemical structure is as follows:
Figure 2: Chlorpheniramine Maleate
Methscopolamine Nitrate is an anticholinergic belladonna alkaloid derivative with the chemical structure: 3-Oxa-9-azoniatricyclo [126.96.36.199 2,4] nonane, 7-(3-hydroxy-1-oxo-2-phenypropoxy)-9,9 dimethyl, nitrate. Its chemical structure is as follows:
Figure 3: Methscopolamine Nitrate
calcium phosphate dibasic, lactose monohydrate, magnesium stearate, methylcellulose, microcrystalline cellulose, Povidone, Prosolv SMCC 90, sodium starch glycolate, FD&C Blue #1, D&C Red # 30, D&C Yellow #10.
Phenylephrine hydrochloride,a sympathomimetic amine, acts directly on -adrenergic receptors in the mucosa of the respiratory tract to produce vasoconstriction that increases peripheral resistance, resulting in an increase in both systolic and diastolic blood pressure. Accompanying the pressor response is a marked reflex bradycardia due to increased vagal activity. It produces vasoconstriction that lasts longer than that produced by ephedrine and epinephrine, and in therapeutic doses, produces little or no central nervous system (CNS) stimulation. Phenylephrine has reduced bioavailability from the gastrointestinal tract because of first pass metabolism by monoamine oxidase in the stomach and liver.
Chlorpheniramine maleatecompetitively antagonizes most of the smooth muscle stimulating actions of histamine on the H 1receptors 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.
Chlorpheniramine maleate is an alkylamine-type antihistamine. This group of antihistamines is among the most active histamine antagonists and is generally effective in relatively low doses. They thereby prevent, but do not reverse, responses mediated by histamine alone. The anticholinergic actions of most antihistamines provide a drying effect on the nasal mucosa. These drugs are not so prone to produce drowsiness, and are among the most suitable agents for daytime use, but a significant proportion of patients do experience this effect.
Methscopolamine nitrateis one of the principal anticholinergic/ antispasmodic components of the belladonna alkaloids that exhibit antisecretory activity. Methscopolamine inhibits the muscarinic actions of acetylcholine on structures innervated by postganglionic cholinergic nerves: smooth muscle, cardiac muscle, sinoatrial and atrioventricular nodes, and exocrine glands. In general, the smaller doses of anticholinergics inhibit salivary and bronchial secretions, sweating, and accommodation; cause dilation of the pupil; and increase the heart rate.
Indications and usage
This product provides relief of the symptoms resulting from irritation of sinus, nasal, and upper respiratory tract tissue associated with cold, seasonal allergies, and inhaled irritants.
Phenylephrine exerts a vasoconstrictive and decongestive action while chlorpheniramine maleate decreases the symptoms of watering eyes, post-nasal drip, and sneezing.
Methscopolamine nitrate further augments the antisecretory activity of this product.
This product is contraindicated in women who are pregnant or nursing. This product is contraindicated in children under six years of age, because this age group is sensitive to the effects of sympathomimetic amines. It is also contraindicated in newborn or premature infants because this age group has an increased susceptibility to the anticholinergic side effects of chlorpheniramine maleate. Geriatric patients may be more sensitive to the effects of this medication.
Risk-benefit should be considered when the following conditions exist: Sensitivity to phenylephrine, chlorpheniramine or methscopolamine; acute asthma; bladder neck obstruction; brain damage in children; cardiac disease, especially cardiac arrhythmias, congestive heart failure, coronary artery disease, and mitral stenosis; cardiovascular disease; diabetes mellitus; Down's syndrome; esophagitis reflux; glaucoma; acute hemorrhage with unstable cardiovascular status; hepatic function impairment; hernia; hypertension; hyperthyroidism; intestinal atony in the elderly or debilitated patients; chronic lung disease; myasthenia gravis; autonomic neuropathy; paralytic ileus; prostatic hypertrophy; psychiatric disorders; pyloric obstruction; renal function impairment; spastic paralysis, in children; tachycardia; toxemia of pregnancy; ulcerative colitis; urinary retention; or predisposition to: uropathy; xerostomia.
This product may cause drowsiness or blurred vision. Patients taking this product should be warned not to engage in activities requiring mental alertness such as operating a motor vehicle or other machinery or to perform hazardous tasks while taking this drug. Sympathomimetic amines should be used with caution in patients with hypertension, ischemic heart disease, diabetes mellitus, increased intraocular pressure, hyperthyroidism, or prostatic hypertrophy.
Sympathomimetic amines in overdosage may produce CNS stimulation with convulsions or cardiovascular collapse with accompanying hypotension. Do not exceed recommended dosage.
Antihistamines should be used with considerable caution in pyloroduodenal obstruction, symptomatic prostatic hypertrophy, and bladder neck obstruction. Antihistamines may cause excitability, especially in children.
At dosages higher than the recommended dose, nervousness, dizziness or sleeplessness may occur. Do not exceed recommended dosage. Heat prostration can occur with methscopolamine used where the environmental temperature is high.
Diarrhea may be an early symptom of incomplete intestinal obstruction, especially in patients with ileostomy or colostomy; in this instance, use of methscopolamine would be inappropriate and possibly harmful.
Use phenylephrine with caution in patients with hypoxia, acidosis, or a history of arteriosclerosis, bradycardia, partial heart block, hypertension, myocardial disease, thrombosis, or ventricular tachycardia. Antihistamines have an atropine like action and should be used with caution in patients with a history of bronchial asthma, emphysema, increased intraocular pressure, hyperthyroidism, cardiovascular disease and hypertension. Use methscopolamine with caution in patients with hiatal hernia associated with reflux esophagitis. Use extreme caution and only when needed in patients with autonomic neuropathy, hyperthyroidism, coronary heart disease, congestive heart failure, and cardiac arrhythmia. Investigate any tachycardia before giving any anticholinergic drugs since they may increase the heart rate. Prolonged use of anticholinergics may decrease or inhibit salivary flow, thus contributing to the development of caries, periodontal disease, oral candidacies, and discomfort.
Information for patients
Patient consultation should include the following information regarding proper use of this medication:
Caution patients about the signs of potential side effects, especially:
Note:When anticholinergics are given to patients, especially children, where the environmental temperature is high, there is risk of a rapid increase in body temperature because of suppression of sweat gland activity.
Infants, patients with Down's syndrome, and children with spastic paralysis or brain damage may show an increased response to anticholinergics, thus increasing the potential for side effects. Geriatric or debilitated patients may respond to usual doses of anticholinergics with excitement, agitation, drowsiness, or confusion.
The following may be especially important in patient monitoring (other tests may be warranted in some patients depending on conditions): blood pressure determination - recommended at frequent intervals during therapy; electrocardiogram (ECG) - monitoring may be required; intraocular pressure determination - recommended at periodic intervals, as these medications may increase the intraocular pressure.
Do not take this product if you are presently taking, or have taken within the preceding two weeks, a prescription drug for high blood pressure or depression without first consulting your physician. Absorption of other oral medications may be decreased during concurrent use with anticholinergics due to decreased gastrointestinal motility and delayed gastric emptying. Combinations containing any of the following medications, depending on the amount present, may also interact with this product:
Drug & or laboratory test interactions
Laboratory Test Interactions: Antihistamines may interfere with diagnostic test results for skin tests using allergen extracts. Anticholinergics may interfere with diagnostic test results for gastric acid secretion by antagonizing the effect of pentagastrin and histamine, and for radio nucleotide gastric emptying studies by delaying gastric emptying.
Carcinogenesis, mutagenesis, impairment of fertility
No data are available on the long-term potential of the components of this product for carcinogenesis, mutagenesis or impairment of fertility in animals or humans.
Pregnancy Category C: Reproduction studies have been performed with chlorpheniramine maleate. Studies in rabbits and rats at doses up to 50 times and 85 times the human dose revealed no evidence of harm to the fetus. There are, however, no adequate and well controlled studies in pregnant women. Therefore, it is not known whether these drugs can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. Animal reproduction studies have not been conducted with phenylephrine or methscopolamine. This product should be given to a pregnant woman only if clearly needed.
Labor and delivery
Use of phenylephrine during labor may cause fetal anoxia and bradycardia by increasing contractility of the uterus and decreasing uterine blood flow.
Small amounts of sympathomimetic amines and antihistamines are excreted in breast milk; use is not recommended because of the risk of adverse effects, such as unusual excitement or irritability, in infants. Anticholinergics and antihistamines may inhibit lactation.
Use of antihistamines is not recommended in newborn or premature infants because this age group has an increased susceptibility to anticholinergic side effects, such as CNS excitation, and an increased tendency toward convulsion. In infants and children, overdosage may cause hallucinations, convulsions, and death. A paradoxical reaction characterized by hyperexcitability may occur in older children taking antihistamines. Use is not recommended for children under six years of age. Infants and young children are especially susceptible to the toxic effects of anticholinergics. Close supervision is recommended for infants and children with spastic paralysis or brain damage since an increased response to anticholinergics has been reported in these patients, and dosage adjustments are often required. When anticholinergics are given to children where the environmental temperature is high, there is a risk of a rapid increase in body temperature because of the suppression of sweat gland activity. A paradoxical reaction characterized by hyperexcitability may occur in children taking large doses of anticholinergics. Appropriate studies with phenylephrine have not been performed in the pediatric population; however no pediatric-specific problems have been documented to date.
Confusion, hallucinations, seizures and CNS depression may be more likely to occur in geriatric patients taking sympathomimetic amines. Geriatric patients also may be more sensitive to the effects, especially the vasopressor effects, of sympathomimetic amines. Confusion, dizziness, sedation, hypotension, hyperexcitability, and anticholinergic side effects, such as dryness of mouth and urinary retention (especially in males), may be more likely to occur in geriatric patients taking antihistamines. Geriatric patients may respond to usual doses of anticholinergics with excitement, agitation, drowsiness, or confusion. Geriatric patients are especially susceptible to the anticholinergic side effects, such as constipation, dryness of mouth, and urinary retention (especially in males). If these side effects occur and continue or are severe, medication should probably be discontinued. Caution is also recommended when anticholinergics are given to geriatric patients, because of the danger of precipitating undiagnosed glaucoma.
Memory may become severely impaired in geriatric patients, especially those who already have memory problems, with the continued use of anticholinergics, since these drugs block the action of acetylcholine, which is responsible for many functions of the brain, including memory function.
The following adverse reactions have been observed with the use of phenylephrine, chlorpheniramine and methscopolamine: Arrhythmias, blood dyscrasia, CNS depression, CNS stimulation, dizziness, drowsiness, dryness of mouth, hallucinations, hypotension, hypertension, increased sensitivity of skin to sun, increased sweating, loss of appetite, paradoxical reaction, restlessness, skin rash, stomach upset or pain, thickening of mucus, tingling in hands or feet, trembling, troubled breathing, unusual tiredness or weakness, vomiting.
Note: Agitation; confusion; difficult or painful urination; drowsiness; dizziness; and dryness of mouth, nose or throat are more likely to occur in the elderly. Nightmares, unusual excitement, nervousness, restlessness, or irritability are more likely to occur in children and the elderly. When anticholinergics are given to patients, especially children, where the environmental temperature is high, there is risk of a rapid increase in body temperature.
Drug abuse and dependence
Central nervous system stimulants such as phenylephrine have been abused. At high doses, subjects commonly experience an elevation of mood, a sense of increased energy and alertness, and decreased appetite. Some individuals become anxious, irritable and loquacious. In addition to the marked euphoria, the user experiences a sense of markedly enhanced physical strength and mental capacity. With continued use, tolerance develops, the user increases the dose, and toxic signs and symptoms appear. Depression may follow rapid withdrawal.
Stimulants, such as phenylephrine, are banned and tested for by the U.S. Olympic Committee (USOC) and the National Collegiate Athletic Association (NCAA).
This product is comprised of pharmacologically different components (sympathomimetic amine, antihistamine, anticholinergic). Therefore, it is difficult to predict the exact manifestation of symptoms in a given individual. Reaction to an overdose of this product may vary from CNS depression to stimulation. A description of symptoms which are likely to appear after ingestion of an excess of the individual components follows:
General Treatment: Treatment is symptomatic and supportive with possible utilization of the following:
Dosage and administration
Adults and adolescents 12 years of age and older:One (1) tablet every 12 hours.
Not recommended for children under 12 years of age.
Note:Geriatric patients may be more sensitive to the effects of the usual adult dose. Adjust adult dose accordingly.
Supplied as purple and yellow, bilayer, capsule-shaped tablets debossed "RESCON" on one side, and IMP on the opposite side. Available in bottles of 90 tablets, NDC 64543-096-90, and in 2 tablet blister packs, NDC 64543-096-02.
KEEP THIS AND ALL MEDICATIONS OUT OF REACH OF CHILDREN. IN CASE OF ACCIDENTAL OVERDOSE, SEEK PROFESSIONAL ASSISTANCE OR CALL A POISON CONTROL CENTER IMMEDIATLEY.
Storage and handling
Dispense in tight, light resistant containers as described in the USP/NF.
Store at controlled room temperature between 20- 25C (68- 77F), see USP Controlled Room Temperature. Avoid exposure to heat.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Capellon Pharmaceuticals, LLC
Fort Worth, TX 76118
500382 Rev. 07/2010
Ingredients and appearance - Product information
Rescon tablet, multilayer, extended release- Phenylephrine hyhrochloride, chlorpheniramine maleate and methscopolamine nitrate
|Product Type||HUMAN PRESCRIPTION DRUG LABEL||Item Code (Source)||NDC: 64543-096|
|Route of Administration||Oral|
|Phenylephrine hydrochloride ( UNII: 04JA59TNSJ)( Phenylephrine - UNII: 1WS297W6MV )||40 mgin 1|
|Chlorpheniramine maleate ( UNII: V1Q0O9OJ9Z)( Chlorpheniramine - UNII: 3U6IO1965U )||12 mgin 1|
|Methscopolamine nitrate ( UNII: K0813KQM3V)( Methscopolamine - UNII: VDR09VTQ8U )||1.25 mgin 1|
|Tribasic calcium phosphate||( UNII: 91D9GV0Z28)|
|Lactose monohydrate||( UNII: EWQ57Q8I5X)|
|Magnesium stearate||( UNII: 70097M6I30)|
|Hypromellose 2208 (4000 mpa.s)||( UNII: 39J80LT57T)|
|Cellulose, microcrystalline||( UNII: OP1R32D61U)|
|Povidone k30||( UNII: U725QWY32X)|
|Silicon dioxide||( UNII: ETJ7Z6XBU4)|
|Sodium starch glycolate type a potato||( UNII: 5856J3G2A2)|
|Fd&c blue no. 1||( UNII: H3R47K3TBD)|
|D&c red no. 30||( UNII: 2S42T2808B)|
|D&c yellow no. 10||( UNII: 35SW5USQ3G)|
|Marketing Category||Application Number or Monograph Citation||Territorial Authority||Marketing Start Date|
|Unapproved drug other||USA|
Labeler - Capellon Pharmaceuticals, LLC( 124568093)
|Capellon Pharmaceuticals, LLC||124568093||MANUFACTURE()|
Package label.principal display panel
Figure 5: Container Label