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Chlorpheniramine, Pyrilamine, and Phenylephrine


General


Pronunciation

(klor fen IR a meen, pye RIL a meen, & fen il EF rin)


Brand Names: U.S.

  • MyHist-PD [DSC]
  • Ru-Hist Forte [DSC]

Indications


Use: Labeled Indications

Symptomatic relief of rhinitis and nasal congestion due to colds or allergy


Contraindications


Hypersensitivity to phenylephrine, chlorpheniramine, pyrilamine, any sympathomimetic amines, or any component; severe hypertension; severe coronary artery disease; diabetes mellitus; hyperthyroidism; use with or within 14 days of MAO inhibitor; premature or newborn infants; acute asthma


Dosing and Administration


Dosing: Adult

Rhinitis, nasal congestion due to colds or allergy: Oral:

Tablet (Ru-Hist Forte): 1 tablet 2-3 times/day

Liquid (MyHist-PD): 5-10 mL every 4-6 hours, not to exceed 40 mL/day


Dosing: Pediatric

Rhinitis, nasal congestion due to colds or allergy: Oral:

Tablet (Ru-Hist Forte):

Children <6 years: Dosage not established.

Children 6-12 years: 1/2 tablet 2-3 times/day

Children >12 years: Refer to adult dosing.

Liquid (MyHist-PD):

Children 2-6 years: 2.5 mL every 4-6 hours, not to exceed 10 mL/day

Children 6-12 years: 5 mL every 4-6 hours, not to exceed 20 mL/day

Children >12 years: Refer to adult dosing.


Administration

Do not break or crush tablets. Shake liquid suspension well before use.


Storage

Store at 25 ‚ °C (77 ‚ °F); excursions permitted to 15 ‚ °C to 30 ‚ °C (59 ‚ °F to 86 ‚ °F). Protect liquid from freezing.


Dosage Forms/Strengths


Dosage Forms

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Liquid, oral:

MyHist-PD: Chlorpheniramine maleate 2 mg, pyrilamine maleate 12.5 mg, and phenylephrine hydrochloride 7.5 mg per 5 mL (473 mL) [dye free, ethanol free, sugar free; bubblegum flavor] [DSC]

Tablet, time-released, oral:

Ru-Hist Forte: Chlorpheniramine maleate 4 mg, pyrilamine maleate 25 mg, and phenylephrine hydrochloride 10 mg [DSC]


Drug Interactions

AtoMOXetine: May enhance the hypertensive effect of Sympathomimetics. AtoMOXetine may enhance the tachycardic effect of Sympathomimetics. Monitor therapy

Benzylpenicilloyl Polylysine: Alpha1-Agonists may diminish the diagnostic effect of Benzylpenicilloyl Polylysine. Management: Consider use of a histamine skin test as a positive control to assess a patients ability to mount a wheal and flare response. Consider therapy modification

Cannabinoids: May enhance the tachycardic effect of Sympathomimetics. Monitor therapy

Ergot Derivatives: May enhance the hypertensive effect of Alpha1-Agonists. Ergot Derivatives may enhance the vasoconstricting effect of Alpha1-Agonists. Exceptions: Ergoloid Mesylates. Avoid combination

FentaNYL: Alpha1-Agonists may decrease the serum concentration of FentaNYL. Specifically, fentanyl nasal spray serum concentrations may decrease and onset of effect may be delayed. Monitor therapy

Hyaluronidase: May enhance the vasoconstricting effect of Phenylephrine (Systemic). Avoid combination

Iobenguane I 123: Sympathomimetics may diminish the therapeutic effect of Iobenguane I 123. Avoid combination

MAO Inhibitors: May enhance the hypertensive effect of Alpha1-Agonists. Avoid combination

Sympathomimetics: May enhance the adverse/toxic effect of other Sympathomimetics. Monitor therapy

Tricyclic Antidepressants: May enhance the vasopressor effect of Alpha1-Agonists. Consider therapy modification


Lab Test Interferences


Test Interactions

Chlorpheniramine: May suppress the wheal and flare reactions to skin test antigens.


Adverse Reactions


Frequency not defined.

Cardiovascular: Hyper-/hypotension, palpitation

Central nervous system: Dizziness, excitation (children), headache, nervousness, sedation, seizure

Dermatologic: Drug rash, urticaria

Gastrointestinal: Anorexia, constipation, diarrhea, dry mouth, GI upset, nausea, vomiting

Genitourinary: Urinary frequency, urinary retention

Hematologic: Agranulocytosis, leukopenia, thrombocytopenia

Ocular: Blurred vision

Respiratory: Dry nose/throat, stuffy nose, thickening of bronchial secretions, tightness of chest, wheezing


Warnings/Precautions


Concerns related to adverse effects:

- CNS depression: May cause CNS depression, which may impair physical or mental abilities; patients must be cautioned about performing tasks which require mental alertness (eg, operating machinery or driving).

Disease-related concerns:

- Cardiovascular disease: Use with caution in patients with cardiovascular disease (including hypertension and ischemic heart disease); contraindicated with severe hypertension.

- Diabetes: Use with caution in patients with diabetes mellitus.

- Increased intraocular pressure: Use with caution in patients with increased intraocular pressure.

- Prostatic hyperplasia/urinary obstruction: Use with caution in patients with prostatic hyperplasia and/or urinary obstruction.

- Pyloroduodenal obstruction: Use with caution in patients with pyloroduodenal obstruction (including stenotic peptic ulcer).

- Respiratory disease: Use with caution in patients with asthma or other chronic breathing disorders.

- Thyroid dysfunction: Use with caution in patients with thyroid dysfunction.

Concurrent drug therapy issues:

- Sedatives: Effects may be potentiated when used with other sedative drugs or ethanol.

Special populations:

- Elderly: Use with caution in the elderly; may be more sensitive to adverse effects.

- Pediatrics: Antihistamines may cause excitation in young children.


Pregnancy Risk Factor

C


Pregnancy Considerations

Animal reproduction studies have not been conducted with this combination. See individual agents.


Patient and Family Education


Patient Education

See individual agents.

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