Calcough Six Plus (Formerly Calcough Chesty)

1. Name Of The Medicinal Product

BENYLIN Children's Chesty Coughs

Calcough Six Plus

2. Qualitative And Quantitative Composition

BENYLIN Children's Chesty Coughs contains 50 mg guaifenesin in each 5 ml.

3. Pharmaceutical Form

Syrup

4. Clinical Particulars

4.1 Therapeutic Indications

BENYLIN Children's Chesty Coughs is an expectorant for the symptomatic relief of acute productive (chesty) coughs.

4.2 Posology And Method Of Administration

Adults and children aged 12 years and over:

Not applicable.

Children aged 6 to 12 years:

Oral. 10 ml syrup four times daily.

Maximum daily dose: 40 ml syrup (400 mg guaifenesin)

Not to be used for more than 5 days without the advice of a doctor. Parents and carers should seek medical attention if the child's condition deteriorates during treatment.

Children under 6 years:

Benylin Children's Chesty Coughs is contraindicated in children under the age of 6 years (see section 4.3).

Do not exceed the stated dose.

Keep out of the reach and sight of children.

4.3 Contraindications

BENYLIN Children's Chesty Coughs is contraindicated in individuals with known hypersensitivity to the product, or any of its components.

Not to be used in children under the age of 6 years.

4.4 Special Warnings And Precautions For Use

Ask a doctor before use if your child suffers from chronic cough, if he/she has asthma or is suffering from an acute asthma attack.

Stop use and ask a healthcare professional if your child's cough lasts for more than 5 days, comes back, or is accompanied by a fever, rash or persistent headache.

Do not give with a cough suppressant.

Caution should be exercised in the presence of severe renal or severe hepatic impairment.

Not more than 4 doses should be given in any 24 hours.

Do not exceed the stated dose.

Do not take with any other cough and cold medicine.

4.5 Interaction With Other Medicinal Products And Other Forms Of Interaction

If urine is collected within 24 hours of a dose of BENYLIN Children's Chesty Coughs a metabolite of guaifenesin may cause a colour interference with laboratory determinations of urinary 5-hydroxyindoleacetic acid (5-HIAA) and vanillylmandelic acid (VMA).

4.6 Pregnancy And Lactation

This product has been formulated specifically for children, and would therefore not normally be taken during pregnancy and lactation.

Insufficient information is available on the effects of BENYLIN Children's Chesty Coughs during human pregnancy. BENYLIN Children's Chesty Coughs, like most medicines, should not be used during pregnancy unless the potential benefit of treatment to the mother outweighs the possible risks to the developing foetus.

Guaifenesin is excreted in breast milk in small amounts with no effect expected on the infant.

4.7 Effects On Ability To Drive And Use Machines

Not applicable.

4.8 Undesirable Effects

The following side effects may be associated with the use of Guaifenesin:

Gastrointestinal Disorders: Nausea, vomiting

Immune System Disorders: Hypersensitivity reactions

4.9 Overdose

Symptoms and signs

The effects of acute toxicity from guaifenesin may include gastrointestinal discomfort, nausea and drowsiness.

Treatment

Treatment should be symptomatic and supportive.

5. Pharmacological Properties

5.1 Pharmacodynamic Properties

Guaifenesin is thought to exert its pharmacological action by stimulating receptors in the gastric mucosa. This increases the output from secretory glands of the gastrointestinal system and reflexly increases the flow of fluids from glands lining the respiratory tract. The result is an increase in volume and decrease in viscosity of bronchial secretions. Other actions may include stimulating vagal nerve endings in bronchial secretory glands and stimulating certain centres in the brain, which in turn enhance respiratory fluid flow. Guaifenesin produces its expectorant action within 24 hours.

5.2 Pharmacokinetic Properties

Absorption

Guaifenesin is well absorbed from the gastro-intestinal tract following oral administration, although limited information regarding its pharmacokinetics is available. After the administration of 600 mg guaifenesin to healthy adult volunteers, the C_max was approximately 1.4 ug/ml, with t_max occurring approximately 15 minutes after drug administration.

Distribution

No information is available on the distribution of guaifenesin in humans.

Metabolism and elimination

Guaifenesin appears to undergo both oxidation and demethylation. Following an oral dose of 600 mg guaifenesin to 3 healthy male volunteers, the t½ was approximately 1 hour and the drug was not detectable in the blood after approximately 8 hours.

Pharmacokinetics in Renal/Hepatic Impairment

There have been no specific studies of BENYLIN Children's Chesty Coughs or guaifenesin in subjects with renal or hepatic impairment.

Caution is therefore recommended when administering this product to subjects with severe renal or hepatic impairment.

Pharmacokinetics in the Elderly

Not applicable.

5.3 Preclinical Safety Data

Mutagenicity

There is insufficient information available to determine whether guaifenesin has mutagenic potential.

Carcinogenicity

There is insufficient information available to determine whether guaifenesin has carcinogenic potential.

Teratogenicity

There is insufficient information available to determine whether guaifenesin has teratogenic potential.

Fertility

There is insufficient information available to determine whether guaifenesin has the potential to impair fertility.

6. Pharmaceutical Particulars

6.1 List Of Excipients

Glycerol

Sorbitol liquid (non-crystallising)

Sodium citrate

Citric acid monohydrate

Sodium saccharin

Sodium benzoate

Carmellose Sodium

Strawberry 580.193/T

Purified water

6.2 Incompatibilities

None known

6.3 Shelf Life

3 years

6.4 Special Precautions For Storage

Do not store above 25°C. Store in the original package.

6.5 Nature And Contents Of Container

BENYLIN Children's Chesty Coughs is stored in 125 ml, 300 ml or 30 ml amber glass bottles with a polyester wadded white aluminium ROPP cap

Or

a 3 piece plastic child resistant, tamper evident closure fitted with a polyester faced wad, or polyethylene/expanded polyethylene laminated wad

or

a 2 piece plastic child resistant, tamper evident closure fitted with a PVDC wad.

6.6 Special Precautions For Disposal And Other Handling

None applicable.

Administrative Data

7. Marketing Authorisation Holder

McNeil Products Limited

Foundation Park

Roxborough Way

Maidenhead

Berkshire

SL6 3UG

United Kingdom

8. Marketing Authorisation Number(S)

PL 15513/0052

9. Date Of First Authorisation/Renewal Of The Authorisation

16/6/97

10. Date Of Revision Of The Text

5th March 2010