Cabal-D

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Cabal-D

Method of action: Antitussive, Nasal Preparations

Treatment option: Rhinitis, Hay Fever

Medically reviewed

Marina Burgos

Last updated on 10/01/2026

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Cabal-D

Quick Facts

Property Description
Active Ingredients Cetirizine Hydrochloride, Pseudoephedrine
Form Oral formulation (Tablet, Capsule)
Pharmacological Class Antihistamine-Decongestant Combination
Origin Synthetic
Type Fixed-dose Combination Product

What Type of Medicine is Cabal-D?

Cabal-D is defined as a synthetic, systemic fixed-dose combination product categorized within the antihistamine-decongestant combination pharmacological class. It is supplied as an oral formulation, typically a tablet or capsule, designed for systemic absorption. This structure means the product combines two distinct therapeutic agents, a strategy used for addressing symptoms that involve both allergic and inflammatory responses. This classification is rooted in this dual composition, targeting concurrent symptoms in the upper respiratory tract.

Composition of Cabal-D: Cetirizine and Pseudoephedrine

The active ingredients in Cabal-D are the INNs Cetirizine Hydrochloride and Pseudoephedrine. Cetirizine Hydrochloride serves as the second-generation antihistamine component, functioning as a selective peripheral H1-receptor antagonist. The complementary agent, Pseudoephedrine, is a sympathomimetic amine that operates as a nasal decongestant. Cetirizine effectively reduces allergy symptoms caused by histamine release. The formulation is frequently used for adolescents and adults needing the combined antiallergic and vasoconstrictive effects.

General Purpose and Benefit of the Combination

The general purpose of Cabal-D is to provide comprehensive relief for multiple upper respiratory tract symptoms associated with allergic rhinitis or the common cold that involve both allergic irritation and congestion. The benefit is derived from this synergistic therapeutic approach: the antihistamine component mitigates histaminic symptoms like sneezing and rhinorrhea, while the sympathomimetic amine component causes vasoconstriction to physically alleviate the obstruction and pressure of nasal and sinus congestion. This dual-action strategy targets the overall burden of symptoms where both allergy and nasal blockage are present.

What side effects are possible with Cabal-D?

Possible Side Effects and Safety Information

The safety profile of Cabal-D (Cetirizine Hydrochloride and Pseudoephedrine) is defined by officially documented adverse reactions, their frequency classifications, and specific limitations, as outlined in governmental regulatory documents.


Adverse Reaction Scope

The following table summarizes key adverse reactions and their classifications based on clinical trial data and regulatory grouping:

Category Examples and Classification Affected Systems (SOC)
Common Reactions Drowsiness, Fatigue, Dry Mouth, Pharyngitis, Dizziness (incidence ge 2% and greater than placebo) Nervous System Disorders, Gastrointestinal Disorders, General Disorders
Other Reactions Headache, Sleeplessness, Nervousness, Nausea, Constipation, Restlessness, Muscle Weakness Nervous System, Gastrointestinal, Musculoskeletal

Serious Safety Constraints

The official labeling notes specific safety restrictions and conditions for caution:

  • Contraindications: Use is prohibited with, or within two weeks of discontinuing, a Monoamine Oxidase Inhibitor (MAOI). Use is also contraindicated in case of known Hypersensitivity to any component or to Hydroxyzine.
  • Cardiovascular Caution: Caution is required for individuals with pre-existing conditions such as High Blood Pressure, Heart Disease, Diabetes, or Glaucoma, due to the sympathomimetic component (Pseudoephedrine).

Population and Duration Notes

  • Population-Specific Considerations: Older Adults (65 and over) and patients with Liver or Kidney Disease may require dosage determination by a healthcare professional. Use is not recommended during breast-feeding.
  • Duration-Related Patterns: Cases of severe itching (pruritus) upon stopping the medication have been reported, particularly following long-term exposure to the antihistamine component.

Overdose and Emergency Response

Overdose and when to seek help

Official regulatory documents define the Cabal-D overdose profile by detailing its recognized manifestations and the required emergency response. The severity of an overdose can range from excessive Central Nervous System (CNS) depression to life-threatening outcomes. Documented signs may include somnolence, confusion, nausea, vomiting, and cardiovascular changes such as hypotension or bradycardia.

A severe overdose presents a risk of serious, escalating complications, including respiratory depression, profound coma, or cardiovascular collapse. These are recognized severe outcomes that necessitate immediate medical intervention.


Immediate Emergency Action

Regulatory labeling requires immediate action upon the suspicion of an overdose or the appearance of any severe manifestation. The patient must seek urgent medical attention and the drug must be discontinued. Specific instructions in the official labeling state to contact a Poison Control Center or emergency services immediately.

Management procedures, as described in regulatory sources, include the use of general supportive measures, such as maintaining a patent airway and continuous monitoring of vital signs (e.g., ECG). For recent ingestion, administration of activated charcoal may be considered. Population-specific considerations are noted, warning that overdose may be more severe in pediatric patients or those with existing renal or hepatic impairment, requiring specialized monitoring protocols.

Therapeutic Uses of Cabal-D

The primary therapeutic role of Cabal-D is to provide supportive symptomatic relief across domains where additional symptomatic support is needed for symptoms that are both irritative and obstructive. This combination is commonly used across conditions presenting with acute episodes, such as seasonal and perennial allergic rhinitis, where short-term symptomatic assistance is needed. The combination is relevant in contexts involving heightened systemic burden.

“The combination is used to help manage symptoms that interfere with routine activities, supporting patients during episodes of heightened discomfort.”

The medication helps address symptom clusters that may become intense or disruptive, including sneezing, a runny nose, watery eyes, and the associated itching of the nose or throat, alongside nasal stuffiness and sinus pressure. It is generally applied in scenarios where additional management of discomfort is required.


Quick Fact: Relevant for Co-Occurring Symptoms Cabal-D is relevant for managing symptom patterns characterized by the presence of both allergic symptoms and physical nasal congestion, and may help patients cope more steadily when symptoms become more noticeable.

Regulatory References

  1. Health Canada Drug and Health Product Register

Eligibility and Restrictions for Use

Who Can and Cannot Use Cabal-D?

Eligibility to use Cabal-D is strictly defined by regulatory guidelines and depends on age, pre-existing conditions, and physiological status. The medicine is approved for use in adults and adolescents aged 12 years and older.

Contraindications and Restrictions

Official labeling specifies that Cabal-D is contraindicated (must not be used) for several populations, primarily due to the Pseudoephedrine component. These include individuals with severe hypertension (high blood pressure), severe coronary artery disease, end-stage renal disease, narrow-angle glaucoma, or urinary retention.

Use is also contraindicated if a patient is currently taking, or has stopped taking within the last 14 days, a Monoamine Oxidase Inhibitor (MAOI). The combination product is not recommended for use in children under 12 years due to a lack of established safety and efficacy in this age group.

Special Population Eligibility Status (Regulatory Label)
Pregnancy Not recommended (Consultation advised)
Breastfeeding Contraindicated or Not recommended
Renal/Hepatic Impairment Caution; Dose adjustment/restriction required
Older Adults (≥65) Use with caution; Requires consultation

What should I know about interactions with other medicines?

Cabal-D is a fixed-dose combination product whose official interaction profile is defined by both the antihistamine (Cetirizine) and sympathomimetic amine (Pseudoephedrine) components.

Contraindicated and Restricted Combinations

Co-administration with Monoamine Oxidase Inhibitors (MAOIs) is formally contraindicated by government regulators, due to the severe risk of hypertensive crisis from the Pseudoephedrine component. This restriction requires a separation period: the medicine must not be started for at least 14 days after discontinuing MAOI therapy. The combination is also strictly prohibited with vasoconstrictive Ergot Derivatives (e.g., ergotamine) due to the risk of enhanced sympathetic effects and significant blood pressure increases.

Pharmacodynamic and Exposure Interactions

Official labeling documents a risk of additive CNS depressant effects when co-administered with alcohol or other CNS depressants (e.g., sedatives, tranquilizers), which may increase the risk of sedation. Furthermore, the Pseudoephedrine component may cause additive sympathetic stimulation when combined with other sympathomimetic amines or certain antihypertensive drugs. Pharmacokinetic interactions are noted, including a documented reduction in Cetirizine clearance leading to increased exposure (AUC) when co-administered with Ritonavir or Theophylline.

Population-Specific Notes

Official prescribing information notes that patients with renal or hepatic impairment may experience reduced clearance of the components, which could increase the severity of any potential interactions.

Mechanism of Action

Cabal-D is a small molecule that selectively targets and modulates the Wnt/beta-catenin intracellular signaling pathway. Its primary biological target is glycogen synthase kinase 3beta ( GSK-3beta). Cabal-D acts as an inhibitor by binding directly to the active site of GSK-3beta. This interaction prevents the kinase from phosphorylating its substrate, beta-catenin, effectively stabilizing the protein.

The resultant increase in the unphosphorylated beta-catenin concentration in the cytoplasm promotes its translocation to the cell nucleus. Once nuclear, beta-catenin functions as a co-activator for the TCF/ LEF family of transcription factors, upregulating the expression of target genes. This transcriptional activity promotes the differentiation and function of osteoblast lineage cells.

Dosage and Administration Information

How to Use Cabal-D: Administration Guidelines

The administration of Cabal-D, a fixed-dose combination product containing Cetirizine Hydrochloride and Pseudoephedrine, follows a specific protocol. The instructions below describe the use protocol, focused on dosage and administration.


Official Administration Scope

Component Instruction
Route of Administration Oral (taken by mouth).
Dosage Form Extended-Release Tablet (Cetirizine 5 mg / Pseudoephedrine 120 mg).
Standard Dosing Adults and Children 12 years and over: One tablet.
Maximum Dose No more than 2 tablets in a 24-hour period.
Dosing Frequency Take one tablet every 12 hours (twice daily).

Specific Instructions and Constraints

Procedural Requirements

The tablet must be swallowed whole with water. It is a critical procedural requirement that the tablet must not be broken, crushed, or chewed due to its extended-release design. The medicine may be taken with or without food.

Course Duration

Use is generally intended to be short-term. If symptoms do not improve or persist beyond 7 days, discontinue use and seek consultation from a healthcare professional.

Population-Specific Rules

Caution or consultation is necessary for specific patient populations. A healthcare provider should be consulted prior to use by children under 12 years of age, older adults (65 years and over), and individuals with a history of kidney or liver impairment.

Recent Clinical Evidence

Cabal-D: Recent Clinical Evidence


Evidence for use in Correcting Vitamin D Levels

Research has explored the use of the compound in subjects with low circulating levels of 25-hydroxyvitamin D [25(OH)D], which is a condition characterized by functional limitations related to the body's store of Vitamin D. Short-term randomized trials examined the compound's effect on achieving and maintaining specified target ranges of 25(OH)D. Studies monitored these outcomes reflecting daily functioning or activity level in various adult populations. Findings describe patterns observed in the studies where use of the compound was associated with reaching and maintaining target 25(OH)D levels over a follow-up duration of several months.

Evidence for use in Bone Health Outcomes

Other large-scale, long-term randomized controlled trials were evaluated in populations seeking to prevent bone fracture. These studies focused on outcomes related to physical discomfort and structural integrity in older adults and individuals with specific comorbidities, such as Chronic Kidney Disease. In community-dwelling individuals, evidence suggests a lack of significant association between the compound's use and a reduction in fracture risk. However, evidence may differ in institutionalized individuals, where calcium plus the compound was observed in some studies to reduce the risk of certain fractures. Findings were mixed across different research designs.


Long-term Studies and Follow-up

Research examining long-term outcomes monitored the durability of stable 25(OH)D levels and explored outcomes related to systemic or functional imbalance over several years. While short-term responses are well characterized, the evidence contributes to understanding symptom patterns but long-term effects are not fully established for fracture prevention or non-skeletal conditions. Follow-up durations were limited in many studies evaluating sustained benefit.

What is Still Uncertain about Research

Research is ongoing to clarify the compound’s potential role in a broader spectrum of conditions, including autoimmune disorders and cardiovascular health. For these indications, data are still emerging, and comparative evidence is lacking to draw firm conclusions. Results apply only to the populations studied, and subgroup findings are uncertain, meaning research provides context but not individual predictions regarding the most appropriate uses beyond correcting deficiency.

Key Studies & References Efficacy and Safety of Calcifediol in Young Adults with Vitamin D Deficiency: A Phase I, Multicentre, Clinical Trial—POSCAL Study

Frequently Asked Questions (FAQ)

Common questions about Cabal-D (FAQ)

Q: How is Cabal-D different from other medicines used for similar conditions?

Cabal-D is officially designated as a fixed-dose combination product. This means it contains two distinct active ingredients, an antihistamine (Cetirizine) and a decongestant (Pseudoephedrine), in a single tablet. This combination is designed to provide dual action against symptoms involving both allergic irritation and congestion.

Q: How long does it usually take for a person to notice the effects of Cabal-D?

Pharmacokinetic data in regulatory documents provides an indication of the medicine's time to onset. For the extended-release formulation, the decongestant component generally reaches its maximum concentration in the blood within 2 to 6 hours, which reflects how quickly the medicine is absorbed and enters the blood.

Q: Is Cabal-D a newer drug or has it been available for many years?

Regulatory labeling documents contain the date of initial approval by the governing health authority. This official approval history provides the clearest indication of how long the product has been available on the market.

Q: Are there different formulations or types of Cabal-D available?

According to official product information, Cabal-D is specifically supplied as an Extended-Release Tablet. This formulation is available at a fixed concentration of its two active ingredients.

Q: What is the absorption rate of Cabal-D when taken orally?

The regulatory pharmacokinetic profile includes detailed information on the absorption rate of the medicine. This profile describes specifics such as the fraction of the drug absorbed and the time required to reach maximum concentration for each component when taken by mouth.

Q: What is the official classification of Cabal-D (e.g., controlled substance schedule)?

Due to the presence of Pseudoephedrine, the medicine is classified as a scheduled listed chemical product by national regulatory agencies. This classification requires the medicine to be subject to specific retail sales restrictions in certain regions.

Q: What is the official position on the risk of dependence or misuse with Cabal-D?

Regulatory labeling addresses the potential for abuse or misuse, primarily associated with the Pseudoephedrine component. This labeling includes statements about its potential for misuse and its classification status.

Q: Are there any known food or dietary restrictions associated with Cabal-D?

According to official administration instructions, Cabal-D may be taken either with or without food. Regulatory documentation does not generally describe specific dietary restrictions that must be followed while using this medicine.

Q: Are there any known drug interactions between Cabal-D and common over-the-counter medicines?

Official labeling advises caution regarding certain over-the-counter (OTC) medicines. This includes other decongestants (sympathomimetic amines) or medicines that cause central nervous system (CNS) depression, due to the risk of additive effects.

Q: Can Cabal-D be taken only as needed or is continuous use described?

Official administration guidelines describe that Cabal-D is prescribed to be taken on a scheduled basis, typically twice daily. Its use is generally intended to be short-term.

Q: What happens in the body when Cabal-D is stopped suddenly?

Official documentation includes reports of one specific adverse effect upon stopping the medicine. Cases of severe itching, known as pruritus, have been described, particularly in patients who have used the antihistamine component for a long period of time.

Q: How does Cabal-D affect general mood or alertness?

Regulatory documents list several officially reported adverse reactions that can affect alertness and mood. These include common effects such as drowsiness, fatigue, nervousness, and sleeplessness.

Q: Are there any warnings about taking Cabal-D before driving or operating machinery?

Due to the potential for adverse effects like drowsiness and dizziness, official warnings indicate that caution is advised regarding activities that require full alertness, such as driving a motor vehicle or operating heavy machinery.

Q: Why is Cabal-D sometimes associated with neurological side effects?

The active ingredients in Cabal-D both interact with the nervous system. The Pseudoephedrine component is classified as a sympathomimetic amine, and the Cetirizine component can also cause central effects like drowsiness. These actions relate to the officially reported nervous system disorders, such as dizziness and restlessness.

Q: Is it possible for Cabal-D to cause skin reactions or rashes?

Regulatory documents indicate that use of Cabal-D is officially prohibited in cases of known hypersensitivity to any of its components. Hypersensitivity reactions may manifest as severe skin reactions or rashes.

Q: What types of patients are generally excluded from Cabal-D clinical trials?

Clinical studies typically exclude patients for whom the medicine is officially contraindicated in general use. This includes patients with severe underlying conditions like severe hypertension or coronary artery disease, as well as those currently taking specific interacting medications like Monoamine Oxidase Inhibitors (MAOIs).

Q: What is the official recommended action if a dose of Cabal-D is missed?

Official patient instructions generally include a specific recommendation for managing a missed dose. The recommendation generally states that the missed dose may be taken as soon as possible, unless it is near the time for the next scheduled dose.

How should Cabal-D be stored and disposed of?

How to Store and Dispose of Cabal-D

Cabal-D (Cetirizine/Pseudoephedrine) must be stored at controlled room temperature, specifically between 20^circmathrmC and 25^circmathrmC (68^circmathrmF and 77^circmathrmF). It is mandatory to keep the medicine from freezing and to protect it from heat, moisture, and direct light.

Storage and Protection

The medicine should remain in its original container, tightly closed, and should not be used if the seal or blister is broken. For safety, it must be stored out of the reach of children; always lock safety caps and place the product out of their sight.

Disposal Requirements

Discard any outdated or unused medicine properly. The preferred method is using a drug take-back program. If a take-back option is unavailable, the medication may be mixed with an undesirable substance, sealed in a bag, and then placed in the household trash, following official guidance.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

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