For Healthcare Professionals only

What is
Cariban?

This page is intended for Irish Healthcare Professionals only

What is Cariban?

Cariban is an effective¹, first-line pharmacological treatment for NVP² that is now fully reimbursed and available for prescribing by all HCPs.

It is indicated for the symptomatic treatment of nausea and vomiting during pregnancy in adults who do not respond to conservative management. (Limitations of use: The combination doxylamine/pyridoxine has not been studied in case of hyperemesis gravidarum)¹

The active ingredients in Cariban are 10mg doxylamine succinate and 10mg of pyridoxine hydrochloride.¹ Cariban comes in a pack of 24 modified-release hard capsules – size 3.¹

Why Cariban?

First Line pharmacological treatment for NVP²

Effectively relieves NVP symptoms¹

Fully reimbursed for patients on the Drugs Payment Scheme or with a Medical Card

Dosage and administration of Cariban¹

Cariban is for oral use. The capsules should be swallowed whole with water, without chewing, and must be taken on an empty stomach as onset of action may be delayed, and absorption reduced when administered with meals.

Dosing:

If nausea occurs in the morning take 2 capsules at bedtime (Day 1). If this dose controls symptoms the next day, continue taking two capsules daily at bedtime.
If symptoms persist into the afternoon of Day 2, the patient should continue the usual dose of two capsules at bedtime (Day 2) and on Day 3 take three capsules (one capsule in the morning and two capsules at bedtime).
If these three capsules do not adequately control symptoms on Day 3, the patient can take four capsules starting on Day 4 (one capsule in the morning, one capsule mid-afternoon and two capsules at bedtime).

The maximum recommended dose is 4 capsules (one in the morning, one in the mid-afternoon & two at bedtime) daily.

Discover more about Cariban

How does Cariban work?¹

Doxylamine is an ethanolamine derivative, a first-generation antihistamine that competitively, reversibly and non-specifically blocks H1 receptors. It is also a non-specific antagonist that can block other receptors, such as central or peripheral muscarinic receptors. The antiemetic action of doxylamine is also associated with blocking of the central cholinergic and H1 receptors, although the mechanism of action is unknown.

Pyridoxine is a water-soluble vitamin factor (vitamin B₆) whose active form is pyridoxal 5’-phosphate. It acts as an enzyme co-factor in numerous biochemical reactions involved in the digestive breakdown of proteins and amino acids and, to a lesser extent, lipids and carbohydrates. Pyridoxine is also involved in the metabolism of unsaturated fatty acids (conversion of linoleic acid into arachidonic acid). It is a coenzyme for transaminases and decarboxylases and allows the conversion of tryptophan into nicotinic acid.

What are the common side effects?¹

Adverse reactions associated with the use of the combination of doxylamine / pyridoxine are comparable to those occurring with the sedating antihistamines as the sole active ingredient.

The most frequent adverse reactions include somnolence and anticholinergic effects (1%-9%) such as dry mouth, constipation, urinary retention, increased bronchial secretion and blurred vision.

Refer to the Summary of Product Characteristics for a full list of adverse reactions.

What are the contraindications for Cariban?¹

Hypersensitivity to the active substances or to any of the excipients.
Hypersensitivity reactions to any other ethanolamine derivative antihistamines.
Concomitant use with monoamine oxidase (MAO) inhibitors, since the adverse central nervous system effects of Cariban are intensified and prolonged.
Concomitant use with potent inhibitors of CYP450 isoenzymes.
Porphyria.