What should I Know Regarding Pregnancy, Nursing and Administering Mar-Cof BP to Children or the Elderly?

If you are PREGNANT

  • Only When Necessary: NEONATAL WITHDRAWAL/RESP.DEPRESS. W/CHRONIC OR HIGH DOSE; SMALL TERATOGENIC RISK
  • Only When Necessary: FDA C W/COMBO PROD; POSS RISK OF GASTROSCHISIS/SIA WITH 1ST TRIMESTER EXPOSURE
  • Only When Necessary: BROMPHENIRAMINE TANNATE FDA CATEGORY C, BROMPHENIRAMINE MALEATE CATEGORY B.

If you are NURSING

  • Absolute Contraindication: CNS/RESPIRATORY DEPRESSION,APNEA POSSIBLE;CAUTION W/ FAST CYP2D6 METABOLIZER
  • Precaution: MAY DECREASE MILK SUPPLY, AND CAUSE IRRITABILITY
  • Precaution: NOT RECOMMENDED. MAY CAUSE PARADOXICAL EXCITATION/INHIBIT LACTATION.

If you are an adult over 60

  • management or monitoring precaution: Cardiovascular-Elderly are more sensitive to tachycardia and hypertensive effects. May exacerbate symptomatic coronary insufficiency. Genitourinary-May cause urinary retention. Neuro/Psych-May worsen cognitive impairment in some elderly with dementia. Insomnia risk.
  • management or monitoring precaution: Neuro/Psych-Anticholinergic effects may cause sedation, worsen cognitive impairment and increase fall risk. Non-sedating agents preferred. Gastrointestinal-May cause or worsen pre-existing constipation. Genitourinary-Best avoided in patients with urinary retention from any cause.
  • management or monitoring precaution: Pulmonary-Life threatening respiratory depression is more likely to occur with high doses, SR products, cachexia, or debilitation due to altered pharmacokinetics with poor fat stores, muscle wasting, or altered clearance. Monitor closely at initiation and with dose titration. Neuro/Psych-Risk for increased confusion and delirium. May increase fall risk. Avoid treatment with 3 or more CNS active drugs. Gastrointestinal-Constipation risk. Urogenital-Urinary retention risk.

Giving Mar-Cof BP to a child under 12

  • Contraindication: Do not use in pediatrics <6 years of age unless clinician consultation. Avoid using with underlying asthma.
  • Severe Precaution: Contraindicated for pain management post-surgical tonsillectomy and or adenoidectomy. Respiratory depression and death reported in CYP2D6 ultra-rapid metabolizer patients post tonsillectomy or adenoidectomy. Avoid in patient with obesity, obstructive sleep apnea, asthma or other underlying breathing problem.
  • Contraindication: Increased risk of CNS and respiratory depression. Contraindicated age < 12 years. Respiratory depression and death reported in CYP2D6 ultra-rapid metabolizers post tonsillectomy or adenoidectomy. Risk increases with obesity, asthma, obstructive sleep apnea or other underlying lung or breathing problem.
  • Contraindication: High risk of adverse CNS effects. Not recommended for use age < 6 years.
  • Contraindication: Possible CNS excitation, convulsions in newborns.