Chlorpheniramine/Dextromethorphan/Guaifenesin/Pseudoephedrine/Sodium Citrate Uses

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Consists of Chlorpheniramine, Dextromethorphan, Guaifenesin, Pseudoephedrine, Sodium Citrate

What is Chlorpheniramine?

Chlorpheniramine is an antihistamine that reduces the effects of natural chemical histamine in the body. Histamine can produce symptoms of sneezing, itching, watery eyes, and runny nose.

Chlorpheniramine is used to treat runny nose, sneezing, itching, and watery eyes caused by allergies, the common cold, or the flu.

Chlorpheniramine may also be used for purposes not listed in this medication guide.

Chlorpheniramine indications

An indication is a term used for the list of condition or symptom or illness for which the medicine is prescribed or used by the patient. For example, acetaminophen or paracetamol is used for fever by the patient, or the doctor prescribes it for a headache or body pains. Now fever, headache and body pains are the indications of paracetamol. A patient should be aware of the indications of medications used for common conditions because they can be taken over the counter in the pharmacy meaning without prescription by the Physician.
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this medicine is indicated for symptomatic control of all allergic conditions responsive to antihistamines, including hay fever, vasomotor rhinitis, urticaria, angioneurotic oedema, food allergy, drug and serum reactions, insect bites.

Also indicated for the symptomatic relief of itch associated with chickenpox

How should I use Chlorpheniramine?

Use Chlorpheniramine as directed by your doctor. Check the label on the medicine for exact dosing instructions.

Ask your health care provider any questions you may have about how to use Chlorpheniramine.

Uses of Chlorpheniramine in details

There are specific as well as general uses of a drug or medicine. A medicine can be used to prevent a disease, treat a disease over a period or cure a disease. It can also be used to treat the particular symptom of the disease. The drug use depends on the form the patient takes it. It may be more useful in injection form or sometimes in tablet form. The drug can be used for a single troubling symptom or a life-threatening condition. While some medications can be stopped after few days, some drugs need to be continued for prolonged period to get the benefit from it.
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Use: Labeled Indications

Allergic symptoms, allergic rhinitis, urticaria, pruritus: Perennial and seasonal allergic rhinitis and other allergic symptoms including urticaria, pruritus

Off Label Uses

Motion sickness

Data from a limited number of patients studied suggests that chlorpheniramine may be beneficial in the treatment of motion sickness. Additional data may be necessary to further define its role in this condition.

Chlorpheniramine description

An alpha- and beta-adrenergic agonist that may also enhance release of norepinephrine. It has been used in the treatment of several disorders including asthma, heart failure, rhinitis, and urinary incontinence, and for its central nervous system stimulatory effects in the treatment of narcolepsy and depression. It has become less extensively used with the advent of more selective agonists.

Chlorpheniramine dosage

Chlorpheniramine Dosage

Applies to the following strength(s): 2 mg; 1 mg/5 mL; 16 mg; 4 mg; 12 mg; 10 mg/mL; 8 mg; 2 mg/5 mL; tannate 8 mg; 2 mg/mL; 4 mg/5 mL; 8 mg/5 mL

The information at Drugs.com is not a substitute for medical advice. Always consult your doctor or pharmacist.

Usual Adult Dose for:

Usual Pediatric Dose for:

Additional dosage information:

Usual Adult Dose for Allergic Rhinitis

Tablets or syrup: 4 mg orally every 4 to 6 hours.

Sustained-release: 8 to 16 mg orally every 8 to 12 hours as needed or 16 mg orally once a day as needed.

Maximum dose 32 mg/day.

Usual Adult Dose for Cold Symptoms

Tablets or syrup: 4 mg orally every 4 to 6 hours.

Sustained-release: 8 to 16 mg orally every 8 to 12 hours as needed or 16 mg orally once a day as needed.

Maximum dose 32 mg/day.

Usual Adult Dose for Urticaria

Tablets or syrup: 4 mg orally every 4 to 6 hours.

Sustained-release: 8 to 16 mg orally every 8 to 12 hours as needed or 16 mg orally once a day as needed.

Maximum dose 32 mg/day.

Usual Adult Dose for Allergic Reaction

Injectable solution:

Allergic reactions to blood or plasma infusions: 10 to 20 mg by intravenous, intramuscular, or subcutaneous injection as a single dose.

Anaphylaxis: 10 to 20 mg intravenous injection as a single dose.

Uncomplicated Allergic Conditions: 5 to 20 mg by intravenous, intramuscular, or subcutaneous injection as a single dose.

Maximum dose by injection is 40 mg/day.

Tablets or syrup: 4 mg orally every 4 to 6 hours.

Sustained-release: 8 to 16 mg orally every 8 to 12 hours as needed or 16 mg orally once a day as needed.

Maximum dose 32 mg/day.

Usual Pediatric Dose for Allergic Rhinitis

3 months to 5 months:

Sustained-release syrup: 0.5 mg orally every 12 hours.

6 months to 8 months:

Sustained-release syrup: 1 mg orally every 12 hours.

9 months to 18 months:

Sustained-release syrup: 1 to 1.5 mg orally every 12 hours.

18 months to 6 years:

Sustained-release syrup: 2 mg orally every 12 hours.

2 to 5 years:

Tablets or syrup: 1 mg every 4 to 6 hours.

Sustained-release: 2 mg orally two times a day, not to exceed 8 mg in 24 hours.

Maximum dose 6 mg/day.

6 to 11 years:

Tablets or syrup: 2 mg every 4 to 6 hours.

Sustained-release: 4 to 8 mg orally two times a day, not to exceed 16 mg in 24 hours or 8 mg orally at bedtime or during the day as indicated.

Maximum dose 16 mg/day.

12 years or older:

Tablets or syrup: 4 mg orally every 4 to 6 hours.

Sustained-release: 8 to 16 mg orally every 8 to 12 hours as needed or 16 mg orally once a day as needed

Maximum dose 32 mg/day.

Usual Pediatric Dose for Cold Symptoms

3 months to 5 months:

Sustained-release syrup: 0.5 mg orally every 12 hours.

6 months to 8 months:

Sustained-release syrup: 1 mg orally every 12 hours.

9 months to 18 months:

Sustained-release syrup: 1 to 1.5 mg orally every 12 hours.

18 months to 6 years:

Sustained-release syrup: 2 mg orally every 12 hours.

2 to 5 years:

Tablets or syrup: 1 mg every 4 to 6 hours.

Sustained-release: 2 mg orally two times a day, not to exceed 8 mg in 24 hours.

Maximum dose 6 mg/day.

6 to 11 years:

Tablets or syrup: 2 mg every 4 to 6 hours.

Sustained-release: 4 to 8 mg orally two times a day, not to exceed 16 mg in 24 hours or 8 mg orally at bedtime or during the day as indicated.

Maximum dose 16 mg/day.

12 years or older:

Tablets or syrup: 4 mg orally every 4 to 6 hours.

Sustained-release: 8 to 16 mg orally every 8 to 12 hours as needed or 16 mg orally once a day as needed

Maximum dose 32 mg/day.

Usual Pediatric Dose for Urticaria

3 months to 5 months:

Sustained-release syrup: 0.5 mg orally every 12 hours.

6 months to 8 months:

Sustained-release syrup: 1 mg orally every 12 hours.

9 months to 18 months:

Sustained-release syrup: 1 to 1.5 mg orally every 12 hours.

18 months to 6 years:

Sustained-release syrup: 2 mg orally every 12 hours.

2 to 5 years:

Tablets or syrup: 1 mg every 4 to 6 hours.

Sustained-release: 2 mg orally two times a day, not to exceed 8 mg in 24 hours.

Maximum dose 6 mg/day.

6 to 11 years:

Tablets or syrup: 2 mg every 4 to 6 hours.

Sustained-release: 4 to 8 mg orally two times a day, not to exceed 16 mg in 24 hours or 8 mg orally at bedtime or during the day as indicated.

Maximum dose 16 mg/day.

12 years or older:

Tablets or syrup: 4 mg orally every 4 to 6 hours.

Sustained-release: 8 to 16 mg orally every 8 to 12 hours as needed or 16 mg orally once a day as needed

Maximum dose 32 mg/day.

Usual Pediatric Dose for Allergic Reaction

Injectable solution:

2 years to 11 years: 0.35 mg/kg/day in divided doses every 4 to 6 hours as needed.

12 years or older:

Allergic reactions to blood or plasma infusions: 10 to 20 mg by intravenous, intramuscular, or subcutaneous injection as a single dose.

Anaphylaxis: 10 to 20 mg intravenous injection as a single dose.

Uncomplicated Allergic Conditions: 5 to 20 mg by intravenous, intramuscular, or subcutaneous injection as a single dose.

Maximum dose by injection is 40 mg/day.

Tablets or syrup:

2 to 5 years: 1 mg every 4 to 6 hours.

Maximum dose 6 mg/day.

Sustained-release: 2 mg orally two times a day, not to exceed 8 mg in 24 hours.

6 to 11 years: 2 mg every 4 to 6 hours.

Sustained-release: 4 to 8 mg orally two times a day, not to exceed 16 mg in 24 hours or 8 mg at bedtime or during the day as indicated.

Maximum dose 16 mg/day.

12 years or older: 4 mg orally every 4 to 6 hours.

Sustained-release: 8 to 16 mg orally every 8 to 12 hours as needed or 16 mg orally once a day as needed

Maximum dose 32 mg/day.

Renal Dose Adjustments

The elimination of chlorpheniramine may be prolonged in patients with renal dysfunction. These patients should be monitored for excessive sedation and other adverse effects that may result from chlorpheniramine accumulation.

Liver Dose Adjustments

Data not available

Precautions

Use chlorpheniramine with caution in patients with asthma.

Chlorpheniramine should not be used in premature or newborn infants.

Dialysis

Data not available

Other Comments

The 100 mg/mL injection is for IM or subcutaneous use only.

The 10 mg/mL injection is for IV, IM, or subcutaneous use.

More about chlorpheniramine

Consumer resources

Professional resources

Related treatment guides

Chlorpheniramine interactions

See also:
What other drugs will affect Chlorpheniramine?

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Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

Some products that may interact with this drug include: antihistamines applied to the skin (such as diphenhydramine cream, ointment, spray), antispasmodics (e.g., atropine, belladonna alkaloids), drugs for Parkinson's disease (e.g., anticholinergics such as benztropine, trihexyphenidyl), scopolamine, tricyclic antidepressants (e.g., amitriptyline).

Tell your doctor or pharmacist if you also take drugs that cause drowsiness such as: certain antihistamines (e.g., diphenhydramine), anti-seizure drugs (e.g., carbamazepine), medicine for sleep or anxiety (e.g., alprazolam, diazepam, zolpidem), muscle relaxants, narcotic pain relievers (e.g., codeine), psychiatric medicines (e.g., chlorpromazine, risperidone, amitriptyline, trazodone). Check the labels on all your medicines (e.g., cough-and-cold products) because they may contain drowsiness-causing ingredients. Ask your pharmacist about the safe use of those products.

Chlorpheniramine is very similar to dexchlorpheniramine. Do not use medications containing dexchlorpheniramine while using chlorpheniramine.

This medication may interfere with certain laboratory tests (including allergy skin testing), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug.

Chlorpheniramine side effects

See also:
What are the possible side effects of Chlorpheniramine?

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Applies to chlorpheniramine: capsules, controlled-release capsules, suspension drops, sustained-release capsules, syrup, tablets

Other dosage forms:

Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Constipation; diarrhea; dizziness; drowsiness; dry mouth, nose, or throat; excitability; headache; loss of appetite; nausea; nervousness or anxiety; trouble sleeping; upset stomach; vomiting; weakness.

Seek medical attention right away if any of these SEVERE side effects occur while taking chlorpheniramine (the active ingredient contained in Chlorpheniramine (Allergy))

Severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); difficulty urinating or inability to urinate; fast or irregular heartbeat; hallucinations; seizures; severe dizziness, lightheadedness, or headache; tremor; trouble sleeping; vision changes.

Chlorpheniramine contraindications

See also:
What is the most important information I should know about Chlorpheniramine?

Hypersensitivity to chlorpheniramine maleate or any component of the formulation; narrow-angle glaucoma; bladder neck obstruction; symptomatic prostate hypertrophy; during acute asthmatic attacks; stenosing peptic ulcer; pyloroduodenal obstruction. Avoid use in premature and term newborns due to possible association with SIDS.

OTC labeling: When used for self-medication, do not use to make a child sleep

What is Dextromethorphan?

Dextromethorphan is a cough suppressant. It affects the signals in the brain that trigger cough reflex.

Dextromethorphan is used to treat a cough.

Dextromethorphan will not treat a cough that is caused by smoking, asthma, or emphysema.

Dextromethorphan may also be used for purposes not listed in this medication guide.

Dextromethorphan indications

An indication is a term used for the list of condition or symptom or illness for which the medicine is prescribed or used by the patient. For example, acetaminophen or paracetamol is used for fever by the patient, or the doctor prescribes it for a headache or body pains. Now fever, headache and body pains are the indications of paracetamol. A patient should be aware of the indications of medications used for common conditions because they can be taken over the counter in the pharmacy meaning without prescription by the Physician.

used to treat symptoms caused by the common cold, flu, allergies, hay fever, or other breathing illnesses (e.g., sinusitis, bronchitis). Dextromethorphan is a cough suppressant that affects a certain part of the brain (cough center), reducing the urge to cough. Decongestants help relieve stuffy nose symptoms. Antihistamines relieve watery eyes, itchy eyes/nose/throat, runny nose, and sneezing.

How should I use Dextromethorphan?

Use Dextromethorphan as directed by your doctor. Check the label on the medicine for exact dosing instructions.

Ask your health care provider any questions you may have about how to use Dextromethorphan.

Uses of Dextromethorphan in details

There are specific as well as general uses of a drug or medicine. A medicine can be used to prevent a disease, treat a disease over a period or cure a disease. It can also be used to treat the particular symptom of the disease. The drug use depends on the form the patient takes it. It may be more useful in injection form or sometimes in tablet form. The drug can be used for a single troubling symptom or a life-threatening condition. While some medications can be stopped after few days, some drugs need to be continued for prolonged period to get the benefit from it.

This medication is used for temporary relief of coughs without phlegm that are caused by certain infections of the air passages (e.g., sinusitis, common cold). This product should not usually be used for an ongoing cough from smoking or long-term breathing problems (e.g., chronic bronchitis, emphysema) unless directed by your doctor. This product contains dextromethorphan. It is a cough suppressant that works by decreasing the feeling of needing to cough.

Cough-and-cold products have not been shown to be safe or effective in children younger than 6 years. Therefore, do not use this product to treat cold symptoms in children younger than 6 years unless specifically directed by the doctor. Ask your doctor or pharmacist for more details about using your product safely.

These products do not cure or shorten the length of the common cold and may cause serious side effects. To decrease the risk for serious side effects, carefully follow all dosage directions. Do not use this product to make a child sleepy. Do not give other cough-and-cold medication that might contain the same or similar ingredients. Ask the doctor or pharmacist about other ways to relieve cough and cold symptoms (such as drinking enough fluids, using a humidifier or saline nose drops/spray).

How to use Dextromethorphan

Take this medication by mouth, usually every 4 to 12 hours as needed or as directed by your doctor. If stomach upset occurs, take with food or milk. Use a medication-measuring device to measure your dose of liquid medication. Do not use a household spoon because you may not get the correct dose. If you are taking a suspension, shake the product well before measuring out your dose.

Dosage is based on the product you are taking and your age, medical condition, and response to treatment. If you are using this medication for self-treatment (without a prescription from your doctor), follow the specific dosing instructions on the packaging to find the correct dose for your age.

If your doctor directs you to take this medication daily, take it regularly to get the most benefit from it. To help you remember, take it at the same time(s) each day.

Improper use of this medication (abuse) may result in serious harm (e.g., brain damage, seizure, death). Do not increase your dose, take it more frequently, or use it for a longer time than prescribed. Properly stop the medication when so directed.

Tell your doctor if your symptoms persist or worsen after more than 1 week or if you also have fever, chills, headache, or rash. These may be signs of a more serious condition.

Dextromethorphan description

The d-isomer of the codeine analog of levorphanol. Dextromethorphan shows high affinity binding to several regions of the brain, including the medullary cough center. This compound is an NMDA receptor antagonist (receptors, N-methyl-D-aspartate) and acts as a non-competitive channel blocker. It is one of the widely used antitussives, and is also used to study the involvement of glutamate receptors in neurotoxicity.

Dextromethorphan dosage

Dosage Forms

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

Capsule,

Oral, as hydrobromide:

Robafen Cough: 15 mg [contains brilliant blue fcf (fd&c blue #1), fd&c red #40]

Robitussin Lingering CoughGels: 15 mg [contains brilliant blue fcf (fd&c blue #1), fd&c red #40, polyethylene glycol, propylene glycol]

Gel,

Oral, as hydrobromide:

ElixSure Cough: 7.5 mg/5 mL (120 mL) [alcohol free; contains carbomer 934p, propylene glycol, propylparaben; cherry bubblegum flavor]

Liquid,

Oral, as hydrobromide:

Buckleys Cough: 12.5 mg/5 mL (118 mL) [alcohol free, sugar free; contains butylparaben, menthol, propylparaben, saccharin sodium]

Little Colds Cough Formula: 7.5 mg/mL (30 mL) [alcohol free, dye free, saccharin free; contains sodium benzoate; grape flavor]

PediaCare Childrens Long-Act: 7.5 mg/5 mL (118 mL) [contains brilliant blue fcf (fd&c blue #1), saccharin sodium, sodium benzoate]

Robitussin Lingering LA Cough: 15 mg/5 mL (118 mL [DSC]) [contains alcohol, usp, fd&c red #40, menthol, saccharin sodium, sodium benzoate]

Dextromethorphan: 10 mg/5 mL (480 mL [DSC], 3780 mL [DSC]) [alcohol free, dye free, fructose free, sodium free, sorbitol free, sugar free]

Triaminic Long Acting Cough: 7.5 mg/5 mL (118 mL) [alcohol free, dye free, pseudoephedrine free; contains benzoic acid, propylene glycol]

Lozenge, Mouth/Throat, as hydrobromide:

Hold: 5 mg (10 ea)

Hold: 5 mg (10 ea) [cherry flavor]

Trocal Cough Suppressant: 7.5 mg (1 ea [DSC])

Strip,

Oral, as hydrobromide:

Triaminic Long Acting Cough: 7.5 mg (14 ea, 16 ea) [contains alcohol, usp, fd&c red #40; cherry flavor]

Triaminic Long Acting Cough: 7.5 mg (14 ea) [contains alcohol, usp, fd&c red #40, isopropyl alcohol]

Suspension Extended Release,

Oral:

Cough DM: Dextromethorphan polistirex [equivalent to dextromethorphan hydrobromide 30 mg/5 mL] (89 mL) [alcohol free; contains fd&c yellow #10 aluminum lake, methylparaben, polysorbate 80, propylparaben, sodium metabisulfite; orange flavor]

Delsym: Dextromethorphan polistirex [equivalent to dextromethorphan hydrobromide 30 mg/5 mL] (89 mL, 148 mL) [alcohol free; contains brilliant blue fcf (fd&c blue #1), disodium edta, methylparaben, polyethylene glycol, polysorbate 80, propylene glycol, propylparaben; grape flavor]

Delsym: Dextromethorphan polistirex [equivalent to dextromethorphan hydrobromide 30 mg/5 mL] (89 mL, 148 mL) [alcohol free; contains edetate disodium, fd&c yellow #6 (sunset yellow), methylparaben, polyethylene glycol, polysorbate 80, propylene glycol, propylparaben; orange flavor]

Delsym Cough Childrens: Dextromethorphan polistirex [equivalent to dextromethorphan hydrobromide 30 mg/5 mL] (89 mL, 148 mL) [alcohol free; contains brilliant blue fcf (fd&c blue #1), edetate disodium, methylparaben, polyethylene glycol, polysorbate 80, propylene glycol, propylparaben, soybean oil; grape flavor]

Delsym Cough Childrens: Dextromethorphan polistirex [equivalent to dextromethorphan hydrobromide 30 mg/5 mL] (89 mL, 148 mL) [alcohol free; contains edetate disodium, fd&c yellow #6 (sunset yellow), methylparaben, polyethylene glycol, polysorbate 80, propylene glycol, propylparaben, soybean oil; orange flavor]

GoodSense Cough DM: Dextromethorphan polistirex [equivalent to dextromethorphan hydrobromide 30 mg/5 mL] (148 mL) [alcohol free, gluten free; contains fd&c yellow #10 aluminum lake, methylparaben, polysorbate 80, propylparaben, sodium metabisulfite]

GoodSense Cough DM Childrens: Dextromethorphan polistirex [equivalent to dextromethorphan hydrobromide 30 mg/5 mL] (89 mL, 148 mL) [alcohol free, gluten free; contains fd&c yellow #10 aluminum lake, methylparaben, polysorbate 80, propylparaben, sodium metabisulfite]

Robitussin 12 Hour Cough: Dextromethorphan polistirex [equivalent to dextromethorphan hydrobromide 30 mg/5 mL] (89 mL) [alcohol free; contains brilliant blue fcf (fd&c blue #1), methylparaben, polysorbate 80, propylparaben, sodium metabisulfite]

Robitussin 12 Hour Cough: Dextromethorphan polistirex [equivalent to dextromethorphan hydrobromide 30 mg/5 mL] (89 mL) [alcohol free; contains fd&c yellow #10 (quinoline yellow), methylparaben, polysorbate 80, propylparaben, sodium metabisulfite]

Robitussin 12 Hour Cough

Child: Dextromethorphan polistirex [equivalent to dextromethorphan hydrobromide 30 mg/5 mL] (89 mL) [alcohol free; contains brilliant blue fcf (fd&c blue #1), methylparaben, polysorbate 80, propylparaben, sodium metabisulfite]

Generic: Dextromethorphan polistirex [equivalent to dextromethorphan hydrobromide 30 mg/5 mL] (89 mL)

Syrup,

Oral, as hydrobromide:

Creomulsion

Adult: 20 mg/15 mL (118 mL [DSC])

Creomulsion for Children: 5 mg/5 mL (118 mL [DSC]) [cherry flavor]

Robitussin Childrens Cough LA: 7.5 mg/5 mL (118 mL) [alcohol free; contains fd&c red #40, propylene glycol, saccharin sodium, sodium benzoate; fruit punch flavor]

Silphen DM Cough: 10 mg/5 mL (118 mL) [contains alcohol, usp; strawberry flavor]

Triaminic Long Acting Cough: 7.5 mg/5 mL (118 mL [DSC]) [alcohol free, dye free; contains benzoic acid, edetate disodium, propylene glycol]

Dosing: Adult

Cough suppressant:

Oral: 10 to 20 mg every 4 hours

or 20 to 30 mg every 6 to 8 hours; extended release: 60 mg twice daily; maximum: 120 mg/24 hours

Dosing: Geriatric

Refer to adult dosing.

Dosing: Pediatric

Note: Safety and efficacy for the use of cough and cold products in infants and young children limited; the AAP warns against the use of these products for respiratory illnesses in infants and young children (AAP 2018; FDA 2017).

Cough suppressant:

Oral:

Oral syrup (immediate release):

Children 2 to <6 years: 5 mg every 4 hours as needed; do not exceed 6 doses in 24 hours.

Children 6 to <12 years: 10 mg every 4 hours as needed; do not exceed 6 doses in 24 hours.

Children ≥12 years and Adolescents: 20 mg every 4 hours as needed; do not exceed 6 doses in 24 hours.

Long-acting liquid: Children ≥12 years and Adolescents: 30 mg every 6 to 8 hours as needed; do not exceed 4 doses in 24 hours.

Oral capsule: Children ≥12 years and Adolescents: 30 mg every 6 to 8 hours as needed; do not exceed 4 doses in 24 hours.

Extended-release suspension (dextromethorphan polistirex):

Children 4 to <6 years: 15 mg every 12 hours as needed; do not exceed 30 mg in 24 hours.

Children 6 to <12 years: 30 mg every 12 hours as needed; do not exceed 60 mg in 24 hours.

Children ≥12 years and Adolescents: 60 mg every 12 hours as needed; do not exceed 120 mg in 24 hours.

Dextromethorphan interactions

See also:
What other drugs will affect Dextromethorphan?

MAO inhibitors (including furazolidone, procarbazine, selegiline) when administered simultaneous with dextromethorphan may cause adrenergic crisis, collapse, coma, dizziness, agitation, increased blood pressure, hyperpyrexia, intracranial hemorrhage, lethargy, nausea, cramps, tremor. In combination with tricyclic antidepressants (amitriptyline, etc.) Dextromethorphan Lafayette Pharmaceutical Laboratory may appeal serotonin syndrome and possible subsequent death. Amiodarone, fluoxetine, quinidine, inhibiting system cytochrome P450, may increase the drug concentration in the blood. Tobacco smoke can lead to increased secretion of glands in the background of inhibition of cough reflex. Some inhibitors of CYP450 (such as quinidine) increase and extended effects of this medicine.

Dextromethorphan side effects

See also:
What are the possible side effects of Dextromethorphan?

Applies to dextromethorphan: oral capsule, oral capsule liquid filled, oral elixir, oral liquid, oral lozenge/troche, oral solution, oral suspension, oral suspension extended release, oral syrup, oral tablet

In addition to its needed effects, some unwanted effects may be caused by dextromethorphan (the active ingredient contained in Dextromethorphan). In the event that any of these side effects do occur, they may require medical attention.

Severity: Moderate

If any of the following side effects occur while taking dextromethorphan, check with your doctor or nurse as soon as possible:

Symptoms of overdose:

Minor Side Effects

Some of the side effects that can occur with dextromethorphan may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

Less common or rare:

Dextromethorphan contraindications

See also:
What is the most important information I should know about Dextromethorphan?

Do not use dextromethorphan if you have used an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days. Serious, life-threatening side effects can occur if you take dextromethorphan before the MAO inhibitor has cleared from your body.

Do not use any other over-the-counter cough, cold, or allergy medication without first asking your doctor or pharmacist. If you take certain products together you may accidentally take too much of one or more types of medicine. Read the label of any other medicine you are using to see if it contains dextromethorphan.

What is Guaifenesin?

Geri-Guaifenesin Expectorant is used to reduce chest congestion caused by the common cold, flu, or chronic bronchitis.

Geri-Guaifenesin Expectorant helps loosen congestion in your chest and throat, making it easier to cough out through your mouth.

There are many brands and forms of guaifenesin available. Not all brands are listed on this leaflet.

Geri-Guaifenesin Expectorant may also be used for purposes not listed in this medication guide.

Guaifenesin indications

An indication is a term used for the list of condition or symptom or illness for which the medicine is prescribed or used by the patient. For example, acetaminophen or paracetamol is used for fever by the patient, or the doctor prescribes it for a headache or body pains. Now fever, headache and body pains are the indications of paracetamol. A patient should be aware of the indications of medications used for common conditions because they can be taken over the counter in the pharmacy meaning without prescription by the Physician.

Guaifenesin and hydrocodone is used to treat cough and reduce chest congestion caused by the common cold, flu, or allergies.

How should I use Guaifenesin?

Use Guaifenesin as directed by your doctor. Check the label on the medicine for exact dosing instructions.

Ask your health care provider any questions you may have about how to use Guaifenesin.

Uses of Guaifenesin in details

There are specific as well as general uses of a drug or medicine. A medicine can be used to prevent a disease, treat a disease over a period or cure a disease. It can also be used to treat the particular symptom of the disease. The drug use depends on the form the patient takes it. It may be more useful in injection form or sometimes in tablet form. The drug can be used for a single troubling symptom or a life-threatening condition. While some medications can be stopped after few days, some drugs need to be continued for prolonged period to get the benefit from it.

Guaifenesin is used to treat coughs and congestion caused by the common cold, bronchitis, and other breathing illnesses. This product is usually not used for ongoing cough from smoking or long-term breathing problems (such as chronic bronchitis, emphysema) unless directed by your doctor. Guaifenesin is an expectorant. It works by thinning and loosening mucus in the airways, clearing congestion, and making breathing easier.

If you are self-treating with this medication, it is important to read the package instructions carefully before you start using this product to be sure it is right for you.

Cough-and-cold products have not been shown to be safe or effective in children younger than 6 years. Therefore, do not use this product to treat cold symptoms in children younger than 6 years unless specifically directed by the doctor. Some products (such as long-acting tablets/capsules) are not recommended for use in children younger than 12 years. Ask your doctor or pharmacist for more details about using your product safely.

These products do not cure or shorten the length of the common cold. To decrease the risk for side effects, carefully follow all dosage directions. Do not give other cough-and-cold medication that might contain the same or similar ingredients. Ask the doctor or pharmacist about other ways to relieve cough and cold symptoms (such as drinking enough fluids, using a humidifier or saline nose drops/spray).

How to use 2/G

Take this medication by mouth with or without food, as directed by your doctor, usually every 4 hours. If you are self-treating, follow all directions on the product package. If you are uncertain about any of the information, ask your doctor or pharmacist.

Guaifenesin may have a bitter taste. Do not split the tablets unless they have a score line and your doctor or pharmacist tells you to do so. Swallow the whole or split tablet without crushing or chewing.

If you are using the liquid form of this medication, carefully measure the dose using a special measuring device/spoon. Do not use a household spoon because you may not get the correct dose.

For powder packets, empty the entire contents of the packet onto the tongue and swallow. To prevent a bitter taste, do not chew.

Dosage is based on your age, medical condition, and response to treatment. Do not take more than 6 doses in a day. Do not increase your dose or take this drug more often than directed.

Drink plenty of fluids while taking this medication. Fluids will help to break up mucus and clear congestion.

Tell your doctor if your cough is accompanied by fever, severe sore throat, rash, persistent headache, or if it persists, returns, or worsens after 7 days. These may be signs of a serious medical problem. Seek immediate medical attention if you think you may have a serious medical problem.

Guaifenesin description

A synthetic opioid that is used as the hydrochloride. It is an opioid analgesic that is primarily a mu-opioid agonist. It has actions and uses similar to those of morphine. It also has a depressant action on the cough center and may be given to control intractable cough associated with terminal lung cancer. Guaifenesin is also used as part of the treatment of dependence on opioid drugs, although prolonged use of methadone itself may result in dependence. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1082-3)

Guaifenesin dosage

Guaifenesin Dosage

Applies to the following strength(s): 200 mg/5 mL; 200 mg; 100 mg/5 mL; 50 mg/5 mL; 600 mg; 1200 mg; 400 mg; 100 mg; 800 mg; 1000 mg; 300 mg; 575 mg; 50 mg

The information at Drugs.com is not a substitute for medical advice. Always consult your doctor or pharmacist.

Usual Adult Dose for:

Usual Pediatric Dose for:

Additional dosage information:

Usual Adult Dose for Cough

Immediate release formulation: 200 to 400 mg orally every 4 hours as needed, not to exceed 2.4 g/day

Sustained release formulation: 600 to 1200 mg orally every 12 hours, not to exceed 2.4 g/day

Usual Pediatric Dose for Cough

Immediate release formulation:

less than 2 years: 12 mg/kg/day orally in 6 divided doses

2 to 5 years: 50 to 100 mg orally every 4 hours as needed, not to exceed 600 mg/day

6 to 11 years: 100 to 200 mg orally every 4 hours as needed, not to exceed 1.2 g/day

12 years or older: 200 to 400 mg orally every 4 hours as needed, not to exceed 2.4 g/day

Sustained release formulation:

2 to 5 years: 300 mg orally every 12 hours, not to exceed 600 mg/day

6 to 11 years: 600 mg orally every 12 hours, not to exceed 1.2 g/day

12 years or older: 600 to 1200 mg orally every 12 hours, not to exceed 2.4 g/day

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Data not available

Dialysis

Data not available

Other Comments

Guaifenesin should be administered with plenty of fluids.

More about guaifenesin

Consumer resources

Professional resources

Related treatment guides

Guaifenesin interactions

See also:
What other drugs will affect Guaifenesin?

In vitro results suggest that methadone undergoes hepatic N-demethylation by cytochrome P450 enzymes, principally CYP3A4, CYP2B6, CYP2C19 and to a lesser extent by CYP2C9 and CYP2D6. Coadministration of methadone with CYP inducers of these enzymes may result in a more rapid metabolism and potential for decreased effects of methadone, whereas administration with CYP inhibitors may reduce metabolism and potentiate methadones effects. Although antiretroviral drugs such as efavirenz, nelfinavir, nevirapine, ritonavir, lopinavir+ritonavir combination are known to inhibit CYPs, they are shown to reduce the plasma levels of methadone, possibly due to their CYP induction activity. Therefore, drugs administered concomitantly with methadone should be evaluated for interaction potential; clinicians are advised to evaluate individual response to drug therapy.

Opioid Antagonists, Mixed Agonist/Antagonists, and Partial Agonists

As with other mu-agonists, patients maintained on methadone may experience withdrawal symptoms when given opioid antagonists, mixed agonist/antagonists, and partial agonists. Examples of such agents are naloxone, naltrexone, pentazocine, nalbuphine, butorphanol, and buprenorphine.

Anti-retroviral Agents

Abacavir, amprenavir, efavirenz, nelfinavir, nevirapine, ritonavir, lopinavir+ritonavir combination - Coadministration of these anti-retroviral agents resulted in increased clearance or decreased plasma levels of methadone. Guaifenesin-maintained patients beginning treatment with these antiretroviral drugs should be monitored for evidence of withdrawal effects and methadone dose should be adjusted accordingly.

Didanosine and Stavudine - Experimental evidence demonstrated that methadone decreased the AUC and peak levels for didanosine and stavudine, with a more significant decrease for didanosine. Guaifenesin disposition was not substantially altered.

Zidovudine - Experimental evidence demonstrated that methadone increased the area under the concentration-time curve (AUC) of zidovudine which could result in toxic effects.

Cytochrome P450 Inducers

Guaifenesin-maintained patients beginning treatment with CYP3A4 inducers should be monitored for evidence of withdrawal effects and methadone dose should be adjusted accordingly. The following drug interactions were reported following coadministration of methadone with inducers of cytochrome P450 enzymes:

Rifampin - In patients well-stabilized on methadone, concomitant administration of rifampin resulted in a marked reduction in serum methadone levels and a concurrent appearance of withdrawal symptoms.

Phenytoin - In a pharmacokinetic study with patients on methadone maintenance therapy, phenytoin administration (250 mg b.i.d. initially for 1 day followed by 300 mg QD for 3 to 4 days) resulted in an approximately 50% reduction in methadone exposure and withdrawal symptoms occurred concurrently. Upon discontinuation of phenytoin, the incidence of withdrawal symptoms decreased and methadone exposure increased to a level comparable to that prior to phenytoin administration.

St. Johns Wort, Phenobarbital, Carbamazepin/strong>Administration of methadone along with other CYP3A4 inducers may result in withdrawal symptoms.

Cytochrome P450 Inhibitors

Since the metabolism of methadone is mediated primarily by CYP3A4 isozyme, coadministration of drugs that inhibit CYP3A4 activity may cause decreased clearance of methadone. The expected clinical results would be increased or prolonged opioid effects. Thus, methadone-treated patients coadministered strong inhibitors of CYP3A4, such as azole antifungal agents (e.g., ketoconazole) and macrolide antibiotics (e.g., erythromycin), with methadone should be carefully monitored and dosage adjustment should be undertaken if warranted. Some selective serotonin reuptake inhibitors (SSRIs) (e.g., sertraline, fluvoxamine) may increase methadone plasma levels upon coadministration with methadone and result in increased opiate effects and/or toxicity.

Voriconazole - Repeat dose administration of oral voriconazole (400mg Q12h for 1 day, then 200mg Q12h for 4 days) increased the Cmax and AUC of (R)-methadone by 31% and 47%, respectively, in subjects receiving a methadone maintenance dose (30 to 100 mg QD). The Cmax and AUC of (S)-methadone increased by 65% and 103%, respectively. Increased plasma concentrations of methadone have been associated with toxicity including QT prolongation. Frequent monitoring for adverse events and toxicity related to methadone is recommended during coadministration. Dose reduction of methadone may be needed.

Others

Monoamine Oxidase (MAO) Inhibitors - Therapeutic doses of meperidine have precipitated severe reactions in patients concurrently receiving monoamine oxidase inhibitors or those who have received such agents within 14 days. Similar reactions thus far have not been reported with methadone. However, if the use of methadone is necessary in such patients, a sensitivity test should be performed in which repeated small, incremental doses of methadone are administered over the course of several hours while the patients condition and vital signs are under careful observation.

Desipramine - Blood levels of desipramine have increased with concurrent methadone administration.

Potentially Arrhythmogenic Agents

Extreme caution is necessary when any drug known to have the potential to prolong the QT interval is prescribed in conjunction with methadone. Pharmacodynamic interactions may occur with concomitant use of methadone and potentially arrhythmogenic agents such as class I and III antiarrhythmics, some neuroleptics and tricyclic antidepressants, and calcium channel blockers.

Caution should also be exercised when prescribing methadone concomitantly with drugs capable of inducing electrolyte disturbances (hypomagnesemia, hypokalemia) that may prolong the QT interval. These drugs include diuretics, laxatives, and, in rare cases, mineralocorticoid hormones.

Interactions with Alcohol and Drugs of Abuse

Guaifenesin may be expected to have additive effects when used in conjunction with alcohol, other opioids or CNS depressants, or with illicit drugs that cause central nervous system depression. Deaths have been reported when methadone has been abused in conjunction with benzodiazepines.

Anxiety - Since methadone as used by tolerant patients at a constant maintenance dosage does not act as a tranquilizer, patients who are maintained on this drug will react to life problems and stresses with the same symptoms of anxiety as do other individuals. The physician should not confuse such symptoms with those of narcotic abstinence and should not attempt to treat anxiety by increasing the dose of methadone. The action of methadone in maintenance treatment is limited to the control of narcotic withdrawal symptoms and is ineffective for relief of general anxiety.

Acute Pain - Maintenance patients on a stable dose of methadone who experience physical trauma, postoperative pain or other acute pain cannot be expected to derive analgesia from their existing dose of methadone. Such patients should be administered analgesics, including opioids, in doses that would otherwise be indicated for non-methadone-treated patients with similar painful conditions. Due to the opioid tolerance induced by methadone, when opioids are required for management of acute pain in methadone patients, somewhat higher and/or more frequent doses will often be required than would be the case for non-tolerant patients.

Risk of Relapse in Patients on Guaifenesin Maintenance Treatment of Opioid Addiction

Abrupt opioid discontinuation can lead to development of opioid withdrawal symptoms. Presentation of these symptoms have been associated with an increased risk of susceptible patients to relapse to illicit drug use and should be considered when assessing the risks and benefit of methadone use.

Tolerance and Physical Dependence

Tolerance is the need for increasing doses of opioids to maintain a defined effect such as analgesia (in the absence of disease progression or other external factors). Physical dependence is manifested by withdrawal symptoms after abrupt discontinuation of a drug or upon administration of an antagonist. Physical dependence and/or tolerance are not unusual during chronic opioid therapy.

If methadone is abruptly discontinued in a physically dependent patient, an abstinence syndrome may occur. The opioid abstinence or withdrawal syndrome is characterized by some or all of the following: restlessness, lacrimation, rhinorrhea, yawning, perspiration, chills, myalgia, and mydriasis. Other symptoms also may develop, including irritability, anxiety, backache, joint pain, weakness, abdominal cramps, insomnia, nausea, anorexia, vomiting, diarrhea, or increased blood pressure, respiratory rate, or heart rate.

In general, chronically administered methadone should not be abruptly discontinued.

Special-Risk Patients

Guaifenesin should be given with caution and the initial dose reduced in certain patients, such as the elderly and debilitated and those with severe impairment of hepatic or renal function, hypothyroidism, Addisons disease, prostatic hypertrophy, or urethral stricture. The usual precautions appropriate to the use of parenteral opioids should be observed and the possibility of respiratory depression should always be kept in mind.

Guaifenesin side effects

See also:
What are the possible side effects of Guaifenesin?

Applies to guaifenesin: oral liquid, oral packet, oral solution, oral syrup, oral tablet, oral tablet extended release

Side effects requiring immediate medical attention

Along with its needed effects, guaifenesin (the active ingredient contained in Guaifenesin) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Side effects not requiring immediate medical attention

Some side effects of guaifenesin may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common or rare

  • Diarrhea
  • dizziness
  • headache
  • hives
  • nausea or vomiting
  • skin rash
  • stomach pain

Managing side effects (general information)

Guaifenesin contraindications

See also:
What is the most important information I should know about Guaifenesin?

Guaifenesin is contraindicated in patients with a known hypersensitivity to methadone hydrochloride or any other ingredient in DOLOPHINE.

Guaifenesin is contraindicated in any situation where opioids are contraindicated such as: patients with respiratory depression (in the absence of resuscitative equipment or in unmonitored settings), and in patients with acute bronchial asthma or hypercarbia.

Guaifenesin is contraindicated in any patient who has or is suspected of having a paralytic ileus.

What is Pseudoephedrine?

Pseudoephedrine (pseudoephedrine) is a decongestant that shrinks blood vessels in the nasal passages. Dilated blood vessels can cause nasal congestion (stuffy nose).

Pseudoephedrine is used to treat nasal and sinus congestion, or congestion of the tubes that drain fluid from your inner ears, called the eustachian (yoo-STAY-shun) tubes.

Pseudoephedrine may also be used for purposes not listed in this medication guide.

Pseudoephedrine indications

An indication is a term used for the list of condition or symptom or illness for which the medicine is prescribed or used by the patient. For example, acetaminophen or paracetamol is used for fever by the patient, or the doctor prescribes it for a headache or body pains. Now fever, headache and body pains are the indications of paracetamol. A patient should be aware of the indications of medications used for common conditions because they can be taken over the counter in the pharmacy meaning without prescription by the Physician.

Temporary relief of symptoms of upper respiratory tract disorders such as sinusitis, vasomotor rhinitis, and hay fever; temporary relief of coughs associated with respiratory tract infections and related conditions such as sinusitis, pharyngitis, bronchitis, and asthma when tenacious mucus and/or mucus plugs and congestion complicate these conditions.

How should I use Pseudoephedrine?

Use Pseudoephedrine (24 hour) as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • Take Pseudoephedrine (24 hour) with food, water, or milk to minimize stomach irritation.
  • Swallow Pseudoephedrine (24 hour) whole. Do not break, crush, or chew before swallowing.
  • Do not take more than 1 tablet in 24 hours.
  • If you miss a dose of Pseudoephedrine (24 hour) and are taking it regularly, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Pseudoephedrine (24 hour).

Uses of Pseudoephedrine in details

There are specific as well as general uses of a drug or medicine. A medicine can be used to prevent a disease, treat a disease over a period or cure a disease. It can also be used to treat the particular symptom of the disease. The drug use depends on the form the patient takes it. It may be more useful in injection form or sometimes in tablet form. The drug can be used for a single troubling symptom or a life-threatening condition. While some medications can be stopped after few days, some drugs need to be continued for prolonged period to get the benefit from it.

Pseudoephedrine is used for the temporary relief of stuffy nose and sinus pain/pressure caused by infection (such as the common cold, flu) or other breathing illnesses (such as hay fever, allergies, bronchitis). Pseudoephedrine is a decongestant (sympathomimetic). It works by narrowing the blood vessels to decrease swelling and congestion.

If you are self-treating with this medication, it is important to read the manufacturer's package instructions carefully so you know when to consult your doctor or pharmacist.

Cough-and-cold products have not been shown to be safe or effective in children younger than 6 years. Long-acting tablets/capsules are not recommended for use in children younger than 12 years. Do not use this pseudoephedrine product in children younger than 12 years unless specifically directed by the doctor. Ask your doctor or pharmacist for more details about using your product safely.

These products do not cure or shorten the length of the common cold and may cause serious side effects. To decrease the risk for serious side effects, carefully follow all dosage directions. Do not use this product to make a child sleepy. Do not give other cough-and-cold medication that might contain the same or similar ingredients. Ask the doctor or pharmacist about other ways to relieve cough and cold symptoms (such as drinking enough fluids, using a humidifier or saline nose drops/spray).

OTHER USES: This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by your health care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional.

Your doctor may direct you to use pseudoephedrine to decrease pain and swelling in the ear or to help "open up" the ear canal when there is a change in air pressure (such as during air travel, underwater diving). Follow your doctor's directions carefully.

How to use Pseudoephedrine

If you are taking the over-the-counter product to self-treat, read all directions on the product package before taking this medication. If you have any questions, ask your doctor or pharmacist. If your doctor has prescribed this medication, take it as directed.

Take this medication by mouth with or without food, usually every 12 or 24 hours, depending on the product or as directed by your doctor or the product package. Do not take more than 240 milligrams in a day. Dosage is based on your age, medical condition, and response to treatment. Do not increase your dose or take this drug more often than directed. Do not take more of this medication than recommended for your age.

If you are using the suspension (liquid), shake the bottle well before each dose. Use a medication-measuring device or spoon to carefully measure the dose. Do not use a household spoon because you may not get the correct dose.

Take the capsules or tablets with a glass of water. Swallow the capsules whole. Do not crush or chew the capsules or tablets. Doing so can release all of the drug at once, increasing the risk of side effects. Also, do not split the tablets unless they have a score line and your doctor or pharmacist tells you to do so. Swallow the whole or split tablet without crushing or chewing.

There are many brands and forms of pseudoephedrine available. Read the dosing instructions carefully for each product because the amount of pseudoephedrine may be different between products. Do not take more pseudoephedrine than recommended.

Caffeine can increase the side effects of this medication. Avoid drinking large amounts of beverages containing caffeine (coffee, tea, colas), eating large amounts of chocolate, or taking nonprescription products that contain caffeine.

If your symptoms do not improve after 7 days, if they worsen or return, if you develop fever, rash, or a persistent headache, or if you think you may have a serious medical problem, seek immediate medical attention.

Pseudoephedrine description

Pseudoephedrine has been withdrawn in Canada. In November 2000, the Food and Drug Administration (FDA) issued a public health advisory against the use of the drug.

Pseudoephedrine dosage

Pseudoephedrine Dosage

Applies to the following strength(s): 7.5 mg/0.8 mL; 30 mg; 120 mg; 15 mg/5 mL; 60 mg; 15 mg; 240 mg; 30 mg/5 mL; 50 mg/5 mL; 22.5 mg/5 mL

The information at Drugs.com is not a substitute for medical advice. Always consult your doctor or pharmacist.

Usual Adult Dose for:

  • Nasal Congestion

Usual Pediatric Dose for:

  • Nasal Congestion

Additional dosage information:

  • Renal Dose Adjustments
  • Liver Dose Adjustments
  • Precautions
  • Dialysis
  • Other Comments

Usual Adult Dose for Nasal Congestion

Immediate release: 30 to 60 mg orally every 4 to 6 hours as needed

12-hour extended- release: 120 mg orally every 12 hours as needed

24-hour extended-release: 240 mg orally every 24 hours as needed

Maximum dose: 240 mg per day

Comment: Recommended doses should not be exceeded.

Uses:

-Temporarily relieves nasal congestion due to the common cold, hay fever, or other upper respiratory allergies.

-Temporarily relieve sinus congestion and pressure.

Usual Pediatric Dose for Nasal Congestion

4 to 5 years:

Immediate release: 15 mg orally every 4 to 6 hours as needed

Maximum dose: 60 mg in 24 hours

6 to 12 years:

Immediate release: 30 mg orally every 4 to 6 hours as needed

Maximum dose: 120 mg in 24 hours

12 years or older:

Immediate release: 30 to 60 mg orally every 4 to 6 hours as needed

12-hour extended- release: 120 mg orally every 12 hours as needed

24-hour extended-release: 240 mg orally every 24 hours as needed

Maximum dose: 240 mg in 24 hours

Comments:

-Recommended doses should not be exceeded.

-Giving more than 1 cough and cold medicine to a child could result in overdose; there are many products that have similar names and it is critical to identify the active ingredients in the product to ensure the correct dosage is being used.

Uses:

-Temporarily relieves nasal congestion due to the common cold, hay fever, or other upper respiratory allergies.

-Temporarily relieve sinus congestion and pressure.

Renal Dose Adjustments

Severe renal impairment: Use caution, especially in patients with concurrent cardiovascular disease.

Liver Dose Adjustments

Severe hepatic impairment: Use caution, especially in patients with concurrent cardiovascular disease.

Precautions

On March 9, 2006, The Combat Methamphetamine Epidemic Act of 2005 was enacted which requires sellers of this drug ensure that: employees have been trained; records of the training are being maintained; sales limits are being enforced; products are being stored appropriately; and a written or electronic logbook is being maintained. The law requires that retailers place pseudoephedrine products where customers do not have direct access to such products before a sale is made. The FDA defines pseudoephedrine as an OTC drug in accordance with the monograph and FDA regulations.

The US FDA strongly recommends that over- the- counter (OTC) cough and cold products not be used in children younger than 2 years of age because serious and potentially life-threatening side effects can occur including death, convulsions, rapid heart rates, and decreased levels of consciousness. OTC cough and cold products include decongestants, expectorants, antihistamines, and antitussives.

Safety and efficacy have not been established in patients younger than 2 years.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration advice:

Oral Liquid:

-Use only with enclosed measuring device or measuring devices specifically designed for measuring drugs.

Extended-release tablets:

-Swallow whole; do not divide crush, chew, or dissolve

Storage requirements:

-Protect from light

General:

-Over the counter cough and cold products can be harmful if more than the recommended amount is consumed; this may happen if more than 1 product containing the same active ingredient is used.

Patient advice:

-Patients should be instructed to pay close attention to drugs labels, particularly to the active ingredients section to ensure they are not receiving duplicate therapy.

-Adult cough and cold products should not be used for children; appropriate measuring devices should be used with liquid products.

-Patients should check with their health care provider if they are receiving concomitant medications.

-Patients should understand that over the counter cough and cold medications do not cure or shorten the duration of the common cold, these products are for the management of symptoms.

More about pseudoephedrine

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Consumer resources

  • Pseudoephedrine
  • Pseudoephedrine drops
  • Pseudoephedrine gel syrup
  • Pseudoephedrine liquid
  • Pseudoephedrine suspension
  • More (3) »
  • Other brands: Sudafed Congestion, SudoGest, Sudafed 12-Hour, Pseudoephedrine, More (16) »

Professional resources

  • Pseudoephedrine (AHFS Monograph)
  • Pseudoephedrine (Wolters Kluwer)

Related treatment guides

  • Nasal Congestion

Pseudoephedrine interactions

See also:
What other drugs will affect Pseudoephedrine?

The effects of some drugs can change if you take other drugs or herbal products at the same time. This can increase your risk for serious side effects or may cause your medications not to work correctly. These drug interactions are possible, but do not always occur. Your doctor or pharmacist can often prevent or manage interactions by changing how you use your medications or by close monitoring.

To help your doctor and pharmacist give you the best care, be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products) before starting treatment with this product. While using this product, do not start, stop, or change the dosage of any other medicines you are using without your doctor's approval.

Some products that may interact with this drug include: stimulants (such as caffeine, dextroamphetamine, methamphetamine, herbal products like ephedra/ma huang), terbutaline.

Taking MAO inhibitors with this medication may cause a serious (possibly fatal) drug interaction. Avoid taking MAO inhibitors (isocarboxazid, linezolid, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, selegiline, tranylcypromine) during treatment with this medication. Most MAO inhibitors should also not be taken for two weeks before treatment with this medication. Ask your doctor when to start or stop taking this medication.

Pseudoephedrine may decrease the effectiveness of blood pressure medications (such as beta blockers, calcium channel blockers, reserpine, guanethidine, methyldopa).

Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain similar ingredients (decongestants such as phenylephrine). Ask your pharmacist about using those products safely.

This document does not contain all possible drug interactions. Keep a list of all the products you use. Share this list with your doctor and pharmacist to lessen your risk for serious medication problems.

Pseudoephedrine side effects

See also:
What are the possible side effects of Pseudoephedrine?

Applies to pseudoephedrine: oral capsule, oral capsule extended release, oral capsule liquid filled, oral liquid, oral solution, oral suspension, oral syrup, oral tablet, oral tablet chewable, oral tablet extended release

In addition to its needed effects, some unwanted effects may be caused by pseudoephedrine (the active ingredient contained in Pseudoephedrine). In the event that any of these side effects do occur, they may require medical attention.

Severity: Moderate

If any of the following side effects occur while taking pseudoephedrine, check with your doctor or nurse as soon as possible:

Rare - more common with high doses

  • Convulsions (seizures)
  • hallucinations (seeing, hearing, or feeling things that are not there)
  • irregular or slow heartbeat
  • shortness of breath or troubled breathing
Symptoms of overdose:
  • Convulsions (seizures)
  • fast breathing
  • hallucinations (seeing, hearing, or feeling things that are not there)
  • increase in blood pressure
  • irregular heartbeat (continuing)
  • shortness of breath or troubled breathing (severe or continuing)
  • slow or fast heartbeat (severe or continuing)
  • unusual nervousness, restlessness, or excitement

Minor Side Effects

Some of the side effects that can occur with pseudoephedrine may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

More common:

  • Nervousness
  • restlessness
  • trouble in sleeping
Less common:
  • Difficult or painful urination
  • dizziness or light-headedness
  • fast or pounding heartbeat
  • headache
  • increased sweating
  • nausea or vomiting
  • trembling
  • unusual paleness
  • weakness

Pseudoephedrine contraindications

See also:
What is the most important information I should know about Pseudoephedrine?

this medicine is contraindicated in individuals who have previously exhibited intolerance to it or to pseudoephedrine or triprolidine.

this medicine is contraindicated in patients who are taking or have taken monoamine oxidase inhibitors within the preceding two weeks. The concomitant use of pseudoephedrine and this type of product may occasionally cause a rise in blood pressure.

this medicine is contraindicated in patients with severe hypertension or severe coronary artery disease.

The antibacterial agent furazolidone, is known to cause a dose-related inhibition of monoamine oxidase. Although there are no reports of hypertensive crises caused by the concurrent administration of Multi-Action ACTIFED Tablets and furazolidone they should not be taken together.

Sodium Citrate indications

An indication is a term used for the list of condition or symptom or illness for which the medicine is prescribed or used by the patient. For example, acetaminophen or paracetamol is used for fever by the patient, or the doctor prescribes it for a headache or body pains. Now fever, headache and body pains are the indications of paracetamol. A patient should be aware of the indications of medications used for common conditions because they can be taken over the counter in the pharmacy meaning without prescription by the Physician.

Prophylaxis & treatment of cystine & uric acid renal calculi. Urinary alkalizer in gout therapy. Treatment of acidosis in renal tubular disorders; chronic metabolic acidosis resulting from chronic renal insufficiency or the syndrome of renal tubular acidosis especially when administration of K salts is contraindicated. Prophylactic agent for acid-aspiration pneumonitis. Used in pre-anaesth medication as a non-particulate acid-neutralizing buffer of gastric acid to lessen the danger from acid-aspiration pneumonitis.

Uses of Sodium Citrate in details

There are specific as well as general uses of a drug or medicine. A medicine can be used to prevent a disease, treat a disease over a period or cure a disease. It can also be used to treat the particular symptom of the disease. The drug use depends on the form the patient takes it. It may be more useful in injection form or sometimes in tablet form. The drug can be used for a single troubling symptom or a life-threatening condition. While some medications can be stopped after few days, some drugs need to be continued for prolonged period to get the benefit from it.

Use: Labeled Indications

Anticoagulant:

Concentrate (triCitrasol): Anticoagulant used in granulocytapheresis procedures

Solution: Anticoagulant for use with cytapheresis device only

Off Label Uses

Regional anticoagulation for continuous renal replacement therapy circuit

Data from several small randomized, controlled trials support the use of regional Sodium Citrate to reduce the risk of clot formation in continuous renal replacement therapy (CRRT) circuits, thus prolonging circuit life and avoiding interruptions in therapy. It should be noted that patients with high bleeding risk, severe coagulopathy, metabolic abnormalities, or liver dysfunction were excluded from these trials.

Sodium Citrate description

Each 4 g of Sodium Citrate contains sodium bicarbonate 1760 mg, anhydrous sodium citrate 630 mg, anhydrous citric acid 720 mg and tartaric acid 890 mg.

It also contains the following excipients: Nature identical lemon flavor oil, terpeneless and sodium saccharin.

Sodium Citrate consists of formulation and pleasantly flavored granules. When added to water, Sodium Citrate effervesces and dissolves, forming a clear or orange-colored alkaline solution.

Sodium Citrate dosage

Adult: Add the contents of 1-2 sachets to a glass of cool water and mix. Sodium Citrate may be taken up to 4 times daily. Do not take for >5 days unless advised to do so by the physician.

Sodium Citrate interactions

General: Alkalinization of the urine due to the use of Sodium Citrate, theoretically, may result in a decreased therapeutic effect of the following medications: Chlorpropamide, lithium, salicylates and tetracyclines. Alternatively, alkalinization of the urine due to the use of Sodium Citrate, theoretically, may result in an increased therapeutic effect of the following medications: Amphetamines, ephedrine/Sodium Citrate.

Antacids: Concurrent use of antacids with citrates may result in systemic alkalosis. Concomitant administration of antacids with sodium citrate and sodium bicarbonate may promote the development of calcium stones in patients with uric acid stones and may also cause hypernatremia. Concurrent use of aluminum-containing antacids with citrate salts can increase aluminum absorption, possibly resulting in acute aluminum toxicity, especially in patients with renal insufficiency.

Quinolones: Citrates may reduce the solubility of ciprofloxacin, norfloxacin or ofloxacin in the urine. Patients should be observed for signs of crystalluria and nephrotoxicity.

Laxatives: Concurrent administration of citrates with laxatives may have an additive effect.

Sodium Citrate side effects

The tartrate component of Sodium Citrate may be incompletely absorbed. Because of this Sodium Citrate may be exert a mild laxative effect. Prolonged and excessive use may cause a systemic alkolosis and / or hypernatremia.

Sodium Citrate contraindications

Renal failure or hypernatremia; in conjunction with hexamine mandelate or hexamine hippurate therapy because an acidic urine is needed.

Caution is advised in overt and occult cardiac failure. Concomitant use of urinary alkalinizers and quinolone antibiotics should be avoided. Crystalluria may be more likely to occur in alkaline urine.

Active ingredient matches for Chlorpheniramine/Dextromethorphan/Guaifenesin/Pseudoephedrine/Sodium Citrate:

Chlorpheniramine/Dextromethorphan/Guaifenesin/Pseudoephedrine/Sodium Citrate


List of Chlorpheniramine/Dextromethorphan/Guaifenesin/Pseudoephedrine/Sodium Citrate substitutes (brand and generic names)

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Unit description / dosage (Manufacturer)Price, USD
Syrup; Oral; Chlorpheniramine Maleate; Dextromethorphan Hydrobromide; Guaifenesin; Pseudoephedrine Hydrochloride; Sodium Citrate
Iyafin junior 12 Bottle 30 mL
Iyafin junior 1 Box 12 Bottle x 30 mL

References

  1. DailyMed. "CHLORPHENIRAMINE POLISTIREX; HYDROCODONE POLISTIREX: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
  2. DailyMed. "SODIUM CITRATE: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
  3. DailyMed. "PSEUDOEPHEDRINE SULFATE: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).

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Information checked by Dr. Sachin Kumar, MD Pharmacology

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