Exall-D Liquid

Patients should be instructed to take ExallTM-D Liquid only as prescribed. If nervousness,
dizziness, or sleeplessness occur, discontinue use and consult a physician.

Concurrent use of digitalis glycosides may increase the possibility of cardiac arrhythmias.
Sympathomimetics may reduce the hypotensive effects of guanethidine, mecamylamine,
methyldopa, reserpine and veratrum alkaloids. Concurrent use of tricyclic antidepressants
may antagonize the effects of pseudoephedrine. Use of other vasopressor drugs during
halothane anesthesia may cause serious cardiac arrhythmias.

Carbetapentane citrate should not be used in patients receiving MAO inhibitors, including
14 days after stopping the MAOI drug. The use of carbetapentane citrate may result in
additive CNS depressant effects when coadministered with alcohol, antihistamines,
psychotropics or other drugs that produce CNS depression.

Guaifenesin may produce an increase in urinary 5-hydroxyindoleacetic acid and may
therefore interfere with the interpretation of this test for the diagnosis of carcinoid syndrome.
It may also falsely elevate the VMA test for catechols. Administration of this drug should be
discontinued 48 hours prior to the collection of urine specimens for such tests.

Pseudoephedrine has additive effects with alcohol and other CNS depressants (hypnotics,
sedatives, tranquilizers, etc.). MAO inhibitors prolong and intensify the anticholinergic
(drying) effects of antihistamines and the overall effects of sympathomimetic agents.

Pregnancy Category C: Animal reproduction studies have not been conducted with this
product. It is also not known whether it can cause fetal harm when administered to a
pregnant woman or can affect reproduction capacity. This product should not be
administered to pregnant women.

Patients aged 60 and older are more likely to experience adverse reactions to
sympathomimetics. Overdosage of sympathomimetics in this age group may cause
hallucinations, convulsions, CNS depression, and death. In general, dose selection
for an elderly patient should be cautious, usually starting at the low end of the dosing
range, reflecting the greater frequency of decreased hepatic, renal or cardiac function,
and of concomitant disease or drug therapy.

Adverse effects associated with carbetapentane citrate are rare, but nausea and/or other
gastrointestinal disturbances sometimes occur.

Hyperreactive individuals may display ephedrine-like reactions such as tachycardia,
palpitations, headache, dizziness or nausea. Sympathomimetics have been associated
with certain untoward reactions including fear, anxiety, nervousness, restlessness, tremor,
weakness, pallor, respiratory difficulty, dysuria, insomnia, hallucinations, convulsions,
CNS depression, arrhythmias, and cardiovascular collapse with hypotension.

Guaifenesin is well tolerated and has a wide margin of safety. Side effects are generally
mild and infrequent. Nausea and vomiting are the most frequently occurring side effects.