Sildec DM Syrup

Antihistamine/Decongestant/Antitussive for oral use.

For adults and pediatric patients (2 years and older)

Brompheniramine Maleate/Pseudoephedrine Hydrochloride/Dextromethorphan Hydrobromide Syrup

Each teaspoonful (5 mL) contains brompheniramine maleate, 4 mg; pseudoephedrine hydrochloride, 45 mg; dextromethorphan hydrobromide,15 mg.

Inactive ingredients: citric acid, D&C Red No. 33, FD&C Blue No. 1, glycerin, flavor, purified water, saccharin sodium, sodium benzoate, sodium
citrate, sorbitol.

Brompheniramine maleate (2-Pyridnepropanamine, y-(4-bromophenyl)- N, N-dimethyl-, (±)-, (Z)-2-butenedioate).

Pseudoephedrine hydrochloride (Benzenemethanol, α-[1-(methylamino)ethyl]-,[S-(R*,R*)]-, hydrochloride) is the hydrochloride of pseudoephedrine, a naturally occurring dextro-rotatory stereoisomer of ephedrine.

Dextromethorphan hydrobromide (Morphinan, 3-methoxy-17-methyl-, (9α, 13α, 14α)-, hydrobromide monohydrate) is the hydrobromide of dform race methorphan.

Patients with hypersensitivity or idiosyncrasy to any of its ingredients. Sympathomimetic amines are contraindicated in patients with severe hypertension, severe coronary artery disease and patients on monoamine oxidase (MAO) inhibitor therapy. Antihistamines are contraindicated in patients with narrow-angle glaucoma, urinary retention, peptic ulcer, and during an asthma attack. Dextromethorphan should not be used in patients receiving a monoamine oxidase inhibitor (MAOI) or for 2 weeks after stopping the MAOI drug.

The signs, symptoms, and treatment described below are those for H1 antihistamines, pseudoephedrine and dextromethorphan overdose. Symptoms: Should antihistamine effects predominate, central action constitutes the greatest danger. In the small child, predominate symptoms are 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.

Should sympathomimetic symptoms predominate, central effects include restlessness, dizziness, tremor, hyperactive reflexes, talkativeness, irritability, and insomnia. Cardiovascular and renal effects include difficulty in micturition, headache, flushing, palpitation, cardiac arrhythmia, hypertension with subsequent hypotension and circulatory collapse. Gastrointestinal effects include dry mouth, metallic taste, anorexia, nausea, vomiting, diarrhea, and abdominal cramps.

Dextromethorphan may cause respiratory depression with a large overdose.

Treatment: a) Evacuate stomach as condition warrants. Activated charcoal may be useful. b) Maintain a non-stimulating environment. c) Monitor cardiovascular status. d) Do not give stimulants. e) Reduce fever with sponging. f) Treat respiratory depression with naloxone if dextromethorphan toxicity is suspected. g) Use sedatives or anticonvulsants to control CNS excitation, and convulsions. h) Physostigmine may reverse anticholinergic symptoms. i) Ammonium chloride may acidify the urine to increase urinary excretion of pseudoephedrine. j) Further care is symptomatic and supportive.

Brompheniramine Maleate/Pseudoephedrine Hydrochloride/Dextromethorphan Hydrobromide Syrup, grape flavored, in 4 fl oz and 16 fl oz bottles.

Dispense in a tight, light-resistant container as defined in USP.
Store between 46°-86°F (8°-30°C). Avoid exposure to heat. Keep tightly closed.

Rx only.

Manufactured by:
Silarx Pharmaceuticals, Inc.
Spring Valley, NY 10977

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

• Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
• Trouble passing urine.
• A fast heartbeat.
• A heartbeat that does not feel normal.
• Very bad dizziness or passing out.
• Shortness of breath.
• Shakiness.
• Seizures.
• Blurred eyesight.

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

• Dizziness.
• Feeling nervous and excitable.
• Not able to sleep.
• Feeling sleepy.

These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.

You may report side effects to the FDA at 1-800-FDA-1088. You may also report side effects at http://www.fda.gov/medwatch.

Some side effects of Sildec DM may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.