Phenobarbital, Hyoscyamine Sulfate, Atropine Sulfate, Scopolamine Hydrobromide Elixir

Phenobarbital, Hyoscyamine Sulfate, Atropine Sulfate, Scopolamine Hydrobromide Elixir
SPL v2
SPL
SPL Set ID 33bf2df5-bc53-4d57-a9e7-41f3fc0a03f0
Route
ORAL
Published
Effective Date 2023-01-12
Document Type 34391-3 Human Prescription Drug Label

Drug Facts

Composition & Product

Active Ingredients
Phenobarbital (16.2 mg) Hyoscyamine (0.1037 mg) Atropine (0.0194 mg) Scopolamine (0.0065 mg)
Inactive Ingredients
Water Glycerin Sorbitol Alcohol Sucrose Saccharin Sodium Fd&c Red No. 3 Fd&c Blue No. 1 Fd&c Yellow No. 5

Identifiers & Packaging

Pill Appearance
Color: purple Color: green
Marketing Status
UNAPPROVED DRUG OTHER Active Since 2021-08-01

Description

Phenobarbital, Hyoscyamine Sulfate, Atropine Sulfate, Scopolamine Hydrobromide Elixir - Grape Each 5 mL (teaspoonful) of elixir (alcohol not more than 23.8%) contains:  Phenobarbital, USP................................. 16.2 mg  Hyoscyamine Sulfate, USP................ 0.1037 mg  Atropine Sulfate, USP......................... 0.0194 mg  Scopolamine Hydrobromide, USP.... 0.0065 mg Inactive Ingredients Purified Water, Glycerin, Sorbitol, Ethyl Alcohol, Sucrose, Saccharin Sodium, Artificial and Natural Grape Flavor, FD&C Red #3, and FD&C Blue #1. Phenobarbital, Hyoscyamine Sulfate, Atropine Sulfate, Scopolamine Hydrobromide Elixir – Mint Each 5 mL (teaspoonful) of elixir (alcohol not more than 23.8%) contains:  Phenobarbital, USP................................. 16.2 mg  Hyoscyamine Sulfate, USP................ 0.1037 mg  Atropine Sulfate, USP......................... 0.0194 mg  Scopolamine Hydrobromide, USP.... 0.0065 mg Inactive Ingredients Purified Water, Glycerin, Sorbitol, Ethyl Alcohol, Sucrose, Saccharin Sodium, Natural Mint Flavor, FD&C Yellow #5, and FD&C Blue #1.

Dosage and Administration

The dosage of Phenobarbital, Hyoscyamine Sulfate, Atropine Sulfate, Scopolamine Hydrobromide Elixir should be adjusted to the needs of the individual patient to assure symptomatic control with a minimum of adverse effects.  Phenobarbital, Hyoscyamine Sulfate, Atropine Sulfate, Scopolamine Hydrobromide Elixir. Adults: One or two teaspoonfuls of elixir three or four times a day according to conditions and severity of symptoms. Pediatric patients: may be dosed every 4 to 6 hours. Use a pediatric dosing device or oral syringe to measure the dose.                                        Starting Dosage Body weight                 Every 4 hours                 Every 6 hours 10 lb. (4.5 kg)                          0.5 mL                           0.75 mL 20 lb. (9.1 kg)                          1 mL                              1.5 mL 30 lb. (13.6 kg)                        1.5 mL                           2 mL 50 lb. (22.7 kg)                        2.5 mL                           3.75 mL 75 lb. (34 kg)                           3.75 mL                         5 mL 100 lb. (45.4 kg)                      5 mL                              7.5 mL

Contraindications

glaucoma;  obstructive uropathy (for example, bladder neck obstruction due to prostatic hypertrophy);  obstructive disease of the gastrointestinal tract (as in achalasia, pyloroduodenal stenosis, etc.);  paralytic ileus, intestinal atony of the elderly or debilitated patient; unstable cardiovascular status in acute hemorrhage;  severe ulcerative colitis especially if complicated by toxic megacolon;  myasthenia gravis;  hiatal hernia associated with reflux esophagitis;  in patients with known hypersensitivity to any of the ingredients. Phenobarbital is contraindicated in acute intermittent porphyria and in those patients in whom phenobarbital produces restlessness and/or excitement.

Adverse Reactions

Adverse reactions may include xerostomia; urinary hesitancy and retention; blurred vision; tachycardia; palpitation; mydriasis; cycloplegia; increased ocular tension; loss of taste sense; headache; nervousness; drowsiness; weakness; dizziness; insomnia; nausea; vomiting; impotence; suppression of lactation; constipation; bloated feeling; musculoskeletal pain; severe allergic reaction or drug idiosyncrasies, including anaphylaxis, urticaria, and other dermal manifestations; and decreased sweating. Acquired hypersensitivity to barbiturates consists chiefly in allergic reactions that occur especially in persons who tend to have asthma, urticaria, angioedema, and similar conditions. Hypersensitivity reactions in this category include localized swelling, particularly of the eyelids, cheeks, or lips, and erythematous dermatitis. Rarely, exfoliative dermatitis (e.g. Stevens-Johnson syndrome and toxic epidermal necrolysis) may be caused by phenobarbital and can prove fatal. The skin eruption may be associated with fever, delirium, and marked degenerative changes in the liver and other parenchymatous organs. In a few cases, megaloblastic anemia has been associated with the chronic use of phenobarbital. Phenobarbital may produce excitement in some patients, rather than a sedative effect. To report SUSPECTED ADVERSE REACTIONS, contact Ingenus Pharmaceuticals, LLC at 1-877-748-1970 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

Drug Interactions

Phenobarbital may decrease the effect of anticoagulants, and necessitate larger doses of the anticoagulant for optimal effect. When the phenobarbital is discontinued, the dose of the anticoagulant may have to be decreased.

How Supplied

Phenobarbital, Hyoscyamine Sulfate, Atropine Sulfate, Scopolamine Hydrobromide Elixir - Grape is a purple colored, grape flavored liquid. 4 fl oz (118 mL) bottles- NDC 50742-666-04. 1 Pint (473 mL) bottles- NDC 50742-666-16. Phenobarbital, Hyoscyamine Sulfate, Atropine Sulfate, Scopolamine Hydrobromide Elixir - Mint is a green colored, mint flavored liquid. 4 fl oz (118 mL) bottles- NDC 50742-665-04. 1 Pint (473 mL) bottles- NDC 50742-665-16. Avoid Freezing Store Phenobarbital, Hyoscyamine Sulfate, Atropine Sulfate, Scopolamine Hydrobromide Elixir at 20° - 25°C (68° - 77°F) [see USP Controlled Room Temperature]. Protect from light and moisture. Dispense in a tight, light-resistant container as defined in the USP using a child-resistant closure. DEA EXEMPT PRODUCT Manufactured for:  Ingenus Pharmaceuticals, LLC Orlando, FL 32839-6408 Revised: 05/2021  LF-122298-01 MPL-100


Medication Information

Dosage and Administration

The dosage of Phenobarbital, Hyoscyamine Sulfate, Atropine Sulfate, Scopolamine Hydrobromide Elixir should be adjusted to the needs of the individual patient to assure symptomatic control with a minimum of adverse effects. 

Phenobarbital, Hyoscyamine Sulfate, Atropine Sulfate, Scopolamine Hydrobromide Elixir. Adults: One or two teaspoonfuls of elixir three or four times a day according to conditions and severity of symptoms.

Pediatric patients: may be dosed every 4 to 6 hours. Use a pediatric dosing device or oral syringe to measure the dose.

                                      Starting Dosage

Body weight                 Every 4 hours                 Every 6 hours

10 lb. (4.5 kg)                          0.5 mL                           0.75 mL

20 lb. (9.1 kg)                          1 mL                              1.5 mL

30 lb. (13.6 kg)                        1.5 mL                           2 mL

50 lb. (22.7 kg)                        2.5 mL                           3.75 mL

75 lb. (34 kg)                           3.75 mL                         5 mL

100 lb. (45.4 kg)                      5 mL                              7.5 mL

Contraindications
  • glaucoma; 
  • obstructive uropathy (for example, bladder neck obstruction due to prostatic hypertrophy); 
  • obstructive disease of the gastrointestinal tract (as in achalasia, pyloroduodenal stenosis, etc.); 
  • paralytic ileus, intestinal atony of the elderly or debilitated patient;
  • unstable cardiovascular status in acute hemorrhage; 
  • severe ulcerative colitis especially if complicated by toxic megacolon; 
  • myasthenia gravis; 
  • hiatal hernia associated with reflux esophagitis; 
  • in patients with known hypersensitivity to any of the ingredients.


Phenobarbital is contraindicated in acute intermittent porphyria and in those patients in whom phenobarbital produces restlessness and/or excitement.

Adverse Reactions

Adverse reactions may include xerostomia; urinary hesitancy and retention; blurred vision; tachycardia; palpitation; mydriasis; cycloplegia; increased ocular tension; loss of taste sense; headache; nervousness; drowsiness; weakness; dizziness; insomnia; nausea; vomiting; impotence; suppression of lactation; constipation; bloated feeling; musculoskeletal pain; severe allergic reaction or drug idiosyncrasies, including anaphylaxis, urticaria, and other dermal manifestations; and decreased sweating.



Acquired hypersensitivity to barbiturates consists chiefly in allergic reactions that occur especially in persons who tend to have asthma, urticaria, angioedema, and similar conditions. Hypersensitivity reactions in this category include localized swelling, particularly of the eyelids, cheeks, or lips, and erythematous dermatitis. Rarely, exfoliative dermatitis (e.g. Stevens-Johnson syndrome and toxic epidermal necrolysis) may be caused by phenobarbital and can prove fatal. The skin eruption may be associated with fever, delirium, and marked degenerative changes in the liver and other parenchymatous organs. In a few cases, megaloblastic anemia has been associated with the chronic use of phenobarbital.



Phenobarbital may produce excitement in some patients, rather than a sedative effect.



To report SUSPECTED ADVERSE REACTIONS, contact Ingenus Pharmaceuticals, LLC at 1-877-748-1970 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

Drug Interactions

Phenobarbital may decrease the effect of anticoagulants, and necessitate larger doses of the anticoagulant for optimal effect. When the phenobarbital is discontinued, the dose of the anticoagulant may have to be decreased.

How Supplied

Phenobarbital, Hyoscyamine Sulfate, Atropine Sulfate, Scopolamine Hydrobromide Elixir - Grape is a purple colored, grape flavored liquid.

  • 4 fl oz (118 mL) bottles- NDC 50742-666-04.
  • 1 Pint (473 mL) bottles- NDC 50742-666-16.

Phenobarbital, Hyoscyamine Sulfate, Atropine Sulfate, Scopolamine Hydrobromide Elixir - Mint is a green colored, mint flavored liquid.

  • 4 fl oz (118 mL) bottles- NDC 50742-665-04.
  • 1 Pint (473 mL) bottles- NDC 50742-665-16.

Avoid Freezing

Store Phenobarbital, Hyoscyamine Sulfate, Atropine Sulfate, Scopolamine Hydrobromide Elixir at 20° - 25°C (68° - 77°F) [see USP Controlled Room Temperature]. Protect from light and moisture.

Dispense in a tight, light-resistant container as defined in the USP using a child-resistant closure.

DEA EXEMPT PRODUCT

Manufactured for: 

Ingenus Pharmaceuticals, LLC

Orlando, FL 32839-6408

Revised: 05/2021 

LF-122298-01

MPL-100

Description

Phenobarbital, Hyoscyamine Sulfate, Atropine Sulfate, Scopolamine Hydrobromide Elixir - Grape

Each 5 mL (teaspoonful) of elixir (alcohol not more than 23.8%) contains:

 Phenobarbital, USP................................. 16.2 mg

 Hyoscyamine Sulfate, USP................ 0.1037 mg

 Atropine Sulfate, USP......................... 0.0194 mg

 Scopolamine Hydrobromide, USP.... 0.0065 mg



Inactive Ingredients

Purified Water, Glycerin, Sorbitol, Ethyl Alcohol, Sucrose, Saccharin Sodium, Artificial and Natural Grape Flavor, FD&C Red #3, and FD&C Blue #1.



Phenobarbital, Hyoscyamine Sulfate, Atropine Sulfate, Scopolamine Hydrobromide Elixir – Mint

Each 5 mL (teaspoonful) of elixir (alcohol not more than 23.8%) contains:

 Phenobarbital, USP................................. 16.2 mg

 Hyoscyamine Sulfate, USP................ 0.1037 mg

 Atropine Sulfate, USP......................... 0.0194 mg

 Scopolamine Hydrobromide, USP.... 0.0065 mg



Inactive Ingredients

Purified Water, Glycerin, Sorbitol, Ethyl Alcohol, Sucrose, Saccharin Sodium, Natural Mint Flavor, FD&C Yellow #5, and FD&C Blue #1.

Abuse

Phenobarbital may be habit forming and should not be administered to individuals known to be addiction prone or to those with a history of physical and/or psychological dependence upon drugs (see WARNINGS ).

General

Use with caution in patients with:

  • autonomic neuropathy
  • hepatic or renal disease
  • hyperthyroidism
  • coronary heart disease
  • congestive heart failure
  • cardiac arrhythmias
  • tachycardia
  • hypertension

Belladonna alkaloids may produce a delay in gastric emptying (antral stasis) which would complicate the management of gastric ulcer.

Do not rely on the use of the drug in the presence of complication of biliary tract disease.

Theoretically, with overdosage, a curare-like action may occur.

Phenobarbital, Hyoscyamine Sulfate, Atropine Sulfate, Scopolamine Hydrobromide Elixir – Mint contains FD&C Yellow No. 5 (tartrazine) which may cause allergic-type reactions (including bronchial asthma) in certain susceptible persons. Although the overall incidence of FD&C Yellow No. 5 (tartrazine) sensitivity in the general population is low, it is frequently seen in patients who also have aspirin hypersensitivity.

Warnings

Phenobarbital, Hyoscyamine Sulfate, Atropine Sulfate, Scopolamine Hydrobromide Elixir can cause fetal harm when administered to a pregnant woman. Animal reproduction studies have not been conducted with Phenobarbital, Hyoscyamine Sulfate, Atropine Sulfate, Scopolamine Hydrobromide Elixir. If this drug is used during pregnancy, or if the patient becomes pregnant while taking this drug, the patient should be apprised of the potential hazard to the fetus.

In the presence of a high environmental temperature, heat prostration can occur with belladonna alkaloids (fever and heatstroke due to decreased sweating).

Diarrhea may be an early symptom of incomplete intestinal obstruction, especially in patients with ileostomy or colostomy. In this instance, treatment with this drug would be inappropriate and possibly harmful.

Phenobarbital, Hyoscyamine Sulfate, Atropine Sulfate, Scopolamine Hydrobromide Elixir may produce drowsiness or blurred vision. The patient should be warned, should these occur, not to engage in activities requiring mental alertness, such as operating a motor vehicle or other machinery, and not to perform hazardous work.

Phenobarbital may decrease the effect of anticoagulants, and necessitate larger doses of the anticoagulant for optimal effect. When the phenobarbital is discontinued, the dose of the anticoagulant may have to be decreased.

Phenobarbital may be habit forming and should not be administered to individuals known to be addiction prone or to those with a history of physical and/or psychological dependence upon drugs.

Since barbiturates are metabolized in the liver, they should be used with caution and initial doses should be small in patients with hepatic dysfunction.

Pregnancy

Animal reproduction studies have not been conducted with Phenobarbital, Hyoscyamine Sulfate, Atropine Sulfate, Scopolamine Hydrobromide Elixir. There is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience or studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks (see WARNINGS ).

Dependence

In patients habituated to barbiturates, abrupt withdrawal may produce delirium or convulsions.

Overdosage

The signs and symptoms of overdose are headache, nausea, vomiting, blurred vision, dilated pupils, hot and dry skin, dizziness, dryness of the mouth, difficulty in swallowing, and CNS stimulation. Treatment should consist of gastric lavage, emetics, and activated charcoal. If indicated, parenteral cholinergic agents such as physostigmine or bethanechol chloride should be used.

Geriatric Use

Elderly patients may react with symptoms of excitement, agitation, drowsiness, and other untoward manifestations to even small doses of the drug.

Nursing Mothers

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 Phenobarbital, Hyoscyamine Sulfate, Atropine Sulfate, Scopolamine Hydrobromide Elixir is administered to a nursing woman.

Clinical Pharmacology

This drug combination provides natural belladonna alkaloids in a specific, fixed ratio combined with phenobarbital to provide peripheral anticholinergic/antispasmodic action and mild sedation.

INDICATIONS AND USAGE

Based on a review of this drug by the National Academy of Sciences-National Research Council and/or other information, FDA has classified the indications as follows: “Possibly” effective: For use as adjunctive therapy in the treatment of irritable bowel syndrome (irritable colon, spastic colon, mucous colitis) and acute enterocolitis.



May also be useful as adjunctive therapy in the treatment of duodenal ulcer.



Final classification of the less-than-effective indications requires further investigation.



IT HAS NOT BEEN SHOWN CONCLUSIVELY WHETHER ANTICHOLINERGIC/ANTISPASMODIC DRUGS AID IN THE HEALING OF A DUODENAL ULCER, DECREASE THE RATE OF RECURRENCES OR PREVENT COMPLICATIONS. 
Information for Patients

Phenobarbital, Hyoscyamine Sulfate, Atropine Sulfate, Scopolamine Hydrobromide Elixir may produce drowsiness or blurred vision. The patient should be warned, should these occur, not to engage in activities requiring mental alertness, such as operating a motor vehicle or other machinery, and not to perform hazardous work.

Package Label.principal Display Panel 4 Oz Mint

NDC 50742-665-04

Phenobarbital, Hyoscyamine Sulfate, Atropine Sulfate, Scopolamine Hydrobromide

Elixir Mint Flavored

Each 5 mL (1 teaspoonful) contains:

Phenobarbital, USP........................ 16.2 mg

Hyoscyamine Sulfate, USP........... 0.1037 mg

Atropine Sulfate, USP................... 0.0194 mg

Scopolamine Hydrobromide, USP....0.0065 mg

Alcohol not more than 23.8%

DO NOT USE IF TAMPER-EVIDENT SEAL UNDER CAP IS BROKEN OR MISSING

Rx Only

4 FL OZ

Ingenus

Package Label.principal Display Panel 4 Oz Grape

NDC 50742-666-04

Phenobarbital, Hyoscyamine Sulfate, Atropine Sulfate, Scopolamine Hydrobromide

Elixir Grape Flavored

Each 5 mL (1 teaspoonful) contains:

Phenobarbital, USP........................ 16.2 mg

Hyoscyamine Sulfate, USP........... 0.1037 mg

Atropine Sulfate, USP................... 0.0194 mg

Scopolamine Hydrobromide, USP....0.0065 mg

Alcohol not more than 23.8%

DO NOT USE IF TAMPER-EVIDENT SEAL UNDER CAP IS BROKEN OR MISSING

Rx Only

4 FL OZ

Ingenus



Package Label.principal Display Panel 1 Pint Mint

NDC 50742-665-16

Phenobarbital, Hyoscyamine Sulfate, Atropine Sulfate, Scopolamine Hydrobromide

Elixir Mint Flavored

Each 5 mL (1 teaspoonful) contains:

Phenobarbital, USP........................ 16.2 mg

Hyoscyamine Sulfate, USP........... 0.1037 mg

Atropine Sulfate, USP................... 0.0194 mg

Scopolamine Hydrobromide, USP.....0.0065 mg

Alcohol not more than 23.8%

contains color additives including FD&C Yellow No. 5 (tartrazine)

DO NOT USE IF TAMPER-EVIDENT SEAL UNDER CAP IS BROKEN OR MISSING

Bulk Container - Not For Household Use

Rx Only

1 Pint

Ingenus



Carcinogenesis, Mutagenesis, Impairment of Fertility

Long-term studies in animals have not been performed to evaluate carcinogenic potential.

Package Label.principal Display Panel 1 Pint Grape

NDC 50742-666-16

Phenobarbital, Hyoscyamine Sulfate, Atropine Sulfate, Scopolamine Hydrobromide

Elixir Grape Flavored

Each 5 mL (1 teaspoonful) contains:

Phenobarbital, USP........................ 16.2 mg

Hyoscyamine Sulfate, USP........... 0.1037 mg

Atropine Sulfate, USP................... 0.0194 mg

Scopolamine Hydrobromide, USP....0.0065 mg

Alcohol not more than 23.8%

DO NOT USE IF TAMPER-EVIDENT SEAL UNDER CAP IS BROKEN OR MISSING

Bulk Container-Not For Household Use

Rx Only

1 Pint

Ingenus




Structured Label Content

Abuse

Phenobarbital may be habit forming and should not be administered to individuals known to be addiction prone or to those with a history of physical and/or psychological dependence upon drugs (see WARNINGS ).

General

Use with caution in patients with:

  • autonomic neuropathy
  • hepatic or renal disease
  • hyperthyroidism
  • coronary heart disease
  • congestive heart failure
  • cardiac arrhythmias
  • tachycardia
  • hypertension

Belladonna alkaloids may produce a delay in gastric emptying (antral stasis) which would complicate the management of gastric ulcer.

Do not rely on the use of the drug in the presence of complication of biliary tract disease.

Theoretically, with overdosage, a curare-like action may occur.

Phenobarbital, Hyoscyamine Sulfate, Atropine Sulfate, Scopolamine Hydrobromide Elixir – Mint contains FD&C Yellow No. 5 (tartrazine) which may cause allergic-type reactions (including bronchial asthma) in certain susceptible persons. Although the overall incidence of FD&C Yellow No. 5 (tartrazine) sensitivity in the general population is low, it is frequently seen in patients who also have aspirin hypersensitivity.

Warnings (WARNINGS)

Phenobarbital, Hyoscyamine Sulfate, Atropine Sulfate, Scopolamine Hydrobromide Elixir can cause fetal harm when administered to a pregnant woman. Animal reproduction studies have not been conducted with Phenobarbital, Hyoscyamine Sulfate, Atropine Sulfate, Scopolamine Hydrobromide Elixir. If this drug is used during pregnancy, or if the patient becomes pregnant while taking this drug, the patient should be apprised of the potential hazard to the fetus.

In the presence of a high environmental temperature, heat prostration can occur with belladonna alkaloids (fever and heatstroke due to decreased sweating).

Diarrhea may be an early symptom of incomplete intestinal obstruction, especially in patients with ileostomy or colostomy. In this instance, treatment with this drug would be inappropriate and possibly harmful.

Phenobarbital, Hyoscyamine Sulfate, Atropine Sulfate, Scopolamine Hydrobromide Elixir may produce drowsiness or blurred vision. The patient should be warned, should these occur, not to engage in activities requiring mental alertness, such as operating a motor vehicle or other machinery, and not to perform hazardous work.

Phenobarbital may decrease the effect of anticoagulants, and necessitate larger doses of the anticoagulant for optimal effect. When the phenobarbital is discontinued, the dose of the anticoagulant may have to be decreased.

Phenobarbital may be habit forming and should not be administered to individuals known to be addiction prone or to those with a history of physical and/or psychological dependence upon drugs.

Since barbiturates are metabolized in the liver, they should be used with caution and initial doses should be small in patients with hepatic dysfunction.

Pregnancy

Animal reproduction studies have not been conducted with Phenobarbital, Hyoscyamine Sulfate, Atropine Sulfate, Scopolamine Hydrobromide Elixir. There is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience or studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks (see WARNINGS ).

Dependence

In patients habituated to barbiturates, abrupt withdrawal may produce delirium or convulsions.

Overdosage (OVERDOSAGE)

The signs and symptoms of overdose are headache, nausea, vomiting, blurred vision, dilated pupils, hot and dry skin, dizziness, dryness of the mouth, difficulty in swallowing, and CNS stimulation. Treatment should consist of gastric lavage, emetics, and activated charcoal. If indicated, parenteral cholinergic agents such as physostigmine or bethanechol chloride should be used.

Description (DESCRIPTION)

Phenobarbital, Hyoscyamine Sulfate, Atropine Sulfate, Scopolamine Hydrobromide Elixir - Grape

Each 5 mL (teaspoonful) of elixir (alcohol not more than 23.8%) contains:

 Phenobarbital, USP................................. 16.2 mg

 Hyoscyamine Sulfate, USP................ 0.1037 mg

 Atropine Sulfate, USP......................... 0.0194 mg

 Scopolamine Hydrobromide, USP.... 0.0065 mg



Inactive Ingredients

Purified Water, Glycerin, Sorbitol, Ethyl Alcohol, Sucrose, Saccharin Sodium, Artificial and Natural Grape Flavor, FD&C Red #3, and FD&C Blue #1.



Phenobarbital, Hyoscyamine Sulfate, Atropine Sulfate, Scopolamine Hydrobromide Elixir – Mint

Each 5 mL (teaspoonful) of elixir (alcohol not more than 23.8%) contains:

 Phenobarbital, USP................................. 16.2 mg

 Hyoscyamine Sulfate, USP................ 0.1037 mg

 Atropine Sulfate, USP......................... 0.0194 mg

 Scopolamine Hydrobromide, USP.... 0.0065 mg



Inactive Ingredients

Purified Water, Glycerin, Sorbitol, Ethyl Alcohol, Sucrose, Saccharin Sodium, Natural Mint Flavor, FD&C Yellow #5, and FD&C Blue #1.

How Supplied (HOW SUPPLIED)

Phenobarbital, Hyoscyamine Sulfate, Atropine Sulfate, Scopolamine Hydrobromide Elixir - Grape is a purple colored, grape flavored liquid.

  • 4 fl oz (118 mL) bottles- NDC 50742-666-04.
  • 1 Pint (473 mL) bottles- NDC 50742-666-16.

Phenobarbital, Hyoscyamine Sulfate, Atropine Sulfate, Scopolamine Hydrobromide Elixir - Mint is a green colored, mint flavored liquid.

  • 4 fl oz (118 mL) bottles- NDC 50742-665-04.
  • 1 Pint (473 mL) bottles- NDC 50742-665-16.

Avoid Freezing

Store Phenobarbital, Hyoscyamine Sulfate, Atropine Sulfate, Scopolamine Hydrobromide Elixir at 20° - 25°C (68° - 77°F) [see USP Controlled Room Temperature]. Protect from light and moisture.

Dispense in a tight, light-resistant container as defined in the USP using a child-resistant closure.

DEA EXEMPT PRODUCT

Manufactured for: 

Ingenus Pharmaceuticals, LLC

Orlando, FL 32839-6408

Revised: 05/2021 

LF-122298-01

MPL-100

Geriatric Use

Elderly patients may react with symptoms of excitement, agitation, drowsiness, and other untoward manifestations to even small doses of the drug.

Nursing Mothers

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 Phenobarbital, Hyoscyamine Sulfate, Atropine Sulfate, Scopolamine Hydrobromide Elixir is administered to a nursing woman.

Adverse Reactions (ADVERSE REACTIONS)

Adverse reactions may include xerostomia; urinary hesitancy and retention; blurred vision; tachycardia; palpitation; mydriasis; cycloplegia; increased ocular tension; loss of taste sense; headache; nervousness; drowsiness; weakness; dizziness; insomnia; nausea; vomiting; impotence; suppression of lactation; constipation; bloated feeling; musculoskeletal pain; severe allergic reaction or drug idiosyncrasies, including anaphylaxis, urticaria, and other dermal manifestations; and decreased sweating.



Acquired hypersensitivity to barbiturates consists chiefly in allergic reactions that occur especially in persons who tend to have asthma, urticaria, angioedema, and similar conditions. Hypersensitivity reactions in this category include localized swelling, particularly of the eyelids, cheeks, or lips, and erythematous dermatitis. Rarely, exfoliative dermatitis (e.g. Stevens-Johnson syndrome and toxic epidermal necrolysis) may be caused by phenobarbital and can prove fatal. The skin eruption may be associated with fever, delirium, and marked degenerative changes in the liver and other parenchymatous organs. In a few cases, megaloblastic anemia has been associated with the chronic use of phenobarbital.



Phenobarbital may produce excitement in some patients, rather than a sedative effect.



To report SUSPECTED ADVERSE REACTIONS, contact Ingenus Pharmaceuticals, LLC at 1-877-748-1970 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

Contraindications (CONTRAINDICATIONS)
  • glaucoma; 
  • obstructive uropathy (for example, bladder neck obstruction due to prostatic hypertrophy); 
  • obstructive disease of the gastrointestinal tract (as in achalasia, pyloroduodenal stenosis, etc.); 
  • paralytic ileus, intestinal atony of the elderly or debilitated patient;
  • unstable cardiovascular status in acute hemorrhage; 
  • severe ulcerative colitis especially if complicated by toxic megacolon; 
  • myasthenia gravis; 
  • hiatal hernia associated with reflux esophagitis; 
  • in patients with known hypersensitivity to any of the ingredients.


Phenobarbital is contraindicated in acute intermittent porphyria and in those patients in whom phenobarbital produces restlessness and/or excitement.

Drug Interactions

Phenobarbital may decrease the effect of anticoagulants, and necessitate larger doses of the anticoagulant for optimal effect. When the phenobarbital is discontinued, the dose of the anticoagulant may have to be decreased.

Clinical Pharmacology (CLINICAL PHARMACOLOGY)

This drug combination provides natural belladonna alkaloids in a specific, fixed ratio combined with phenobarbital to provide peripheral anticholinergic/antispasmodic action and mild sedation.

INDICATIONS AND USAGE

Based on a review of this drug by the National Academy of Sciences-National Research Council and/or other information, FDA has classified the indications as follows: “Possibly” effective: For use as adjunctive therapy in the treatment of irritable bowel syndrome (irritable colon, spastic colon, mucous colitis) and acute enterocolitis.



May also be useful as adjunctive therapy in the treatment of duodenal ulcer.



Final classification of the less-than-effective indications requires further investigation.



IT HAS NOT BEEN SHOWN CONCLUSIVELY WHETHER ANTICHOLINERGIC/ANTISPASMODIC DRUGS AID IN THE HEALING OF A DUODENAL ULCER, DECREASE THE RATE OF RECURRENCES OR PREVENT COMPLICATIONS. 
Information for Patients

Phenobarbital, Hyoscyamine Sulfate, Atropine Sulfate, Scopolamine Hydrobromide Elixir may produce drowsiness or blurred vision. The patient should be warned, should these occur, not to engage in activities requiring mental alertness, such as operating a motor vehicle or other machinery, and not to perform hazardous work.

Dosage and Administration (DOSAGE AND ADMINISTRATION)

The dosage of Phenobarbital, Hyoscyamine Sulfate, Atropine Sulfate, Scopolamine Hydrobromide Elixir should be adjusted to the needs of the individual patient to assure symptomatic control with a minimum of adverse effects. 

Phenobarbital, Hyoscyamine Sulfate, Atropine Sulfate, Scopolamine Hydrobromide Elixir. Adults: One or two teaspoonfuls of elixir three or four times a day according to conditions and severity of symptoms.

Pediatric patients: may be dosed every 4 to 6 hours. Use a pediatric dosing device or oral syringe to measure the dose.

                                      Starting Dosage

Body weight                 Every 4 hours                 Every 6 hours

10 lb. (4.5 kg)                          0.5 mL                           0.75 mL

20 lb. (9.1 kg)                          1 mL                              1.5 mL

30 lb. (13.6 kg)                        1.5 mL                           2 mL

50 lb. (22.7 kg)                        2.5 mL                           3.75 mL

75 lb. (34 kg)                           3.75 mL                         5 mL

100 lb. (45.4 kg)                      5 mL                              7.5 mL

Package Label.principal Display Panel 4 Oz Mint (PACKAGE LABEL.PRINCIPAL DISPLAY PANEL - 4 OZ MINT)

NDC 50742-665-04

Phenobarbital, Hyoscyamine Sulfate, Atropine Sulfate, Scopolamine Hydrobromide

Elixir Mint Flavored

Each 5 mL (1 teaspoonful) contains:

Phenobarbital, USP........................ 16.2 mg

Hyoscyamine Sulfate, USP........... 0.1037 mg

Atropine Sulfate, USP................... 0.0194 mg

Scopolamine Hydrobromide, USP....0.0065 mg

Alcohol not more than 23.8%

DO NOT USE IF TAMPER-EVIDENT SEAL UNDER CAP IS BROKEN OR MISSING

Rx Only

4 FL OZ

Ingenus

Package Label.principal Display Panel 4 Oz Grape (PACKAGE LABEL.PRINCIPAL DISPLAY PANEL - 4 OZ GRAPE)

NDC 50742-666-04

Phenobarbital, Hyoscyamine Sulfate, Atropine Sulfate, Scopolamine Hydrobromide

Elixir Grape Flavored

Each 5 mL (1 teaspoonful) contains:

Phenobarbital, USP........................ 16.2 mg

Hyoscyamine Sulfate, USP........... 0.1037 mg

Atropine Sulfate, USP................... 0.0194 mg

Scopolamine Hydrobromide, USP....0.0065 mg

Alcohol not more than 23.8%

DO NOT USE IF TAMPER-EVIDENT SEAL UNDER CAP IS BROKEN OR MISSING

Rx Only

4 FL OZ

Ingenus



Package Label.principal Display Panel 1 Pint Mint (PACKAGE LABEL.PRINCIPAL DISPLAY PANEL - 1 PINT MINT)

NDC 50742-665-16

Phenobarbital, Hyoscyamine Sulfate, Atropine Sulfate, Scopolamine Hydrobromide

Elixir Mint Flavored

Each 5 mL (1 teaspoonful) contains:

Phenobarbital, USP........................ 16.2 mg

Hyoscyamine Sulfate, USP........... 0.1037 mg

Atropine Sulfate, USP................... 0.0194 mg

Scopolamine Hydrobromide, USP.....0.0065 mg

Alcohol not more than 23.8%

contains color additives including FD&C Yellow No. 5 (tartrazine)

DO NOT USE IF TAMPER-EVIDENT SEAL UNDER CAP IS BROKEN OR MISSING

Bulk Container - Not For Household Use

Rx Only

1 Pint

Ingenus



Carcinogenesis, Mutagenesis, Impairment of Fertility

Long-term studies in animals have not been performed to evaluate carcinogenic potential.

Package Label.principal Display Panel 1 Pint Grape (PACKAGE LABEL.PRINCIPAL DISPLAY PANEL - 1 PINT GRAPE)

NDC 50742-666-16

Phenobarbital, Hyoscyamine Sulfate, Atropine Sulfate, Scopolamine Hydrobromide

Elixir Grape Flavored

Each 5 mL (1 teaspoonful) contains:

Phenobarbital, USP........................ 16.2 mg

Hyoscyamine Sulfate, USP........... 0.1037 mg

Atropine Sulfate, USP................... 0.0194 mg

Scopolamine Hydrobromide, USP....0.0065 mg

Alcohol not more than 23.8%

DO NOT USE IF TAMPER-EVIDENT SEAL UNDER CAP IS BROKEN OR MISSING

Bulk Container-Not For Household Use

Rx Only

1 Pint

Ingenus




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