Chlorphenaramine
Chlorphenaramine
Chlorphenaramine
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Pronunciation
Synonyms
Chlorpheniramine Maleate; CTM
Generic Available
Yes
Use
Perennial and seasonal allergic rhinitis and other allergic symptoms including urticaria
Contraindications
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.
Warnings/Precautions
Causes sedation, caution must be used in performing tasks which require alertness (eg,
operating machinery or driving). Sedative effects of CNS depressants or ethanol are potentiated.
Use with caution in patients with angle-closure glaucoma, pyloroduodenal obstruction (including
stenotic peptic ulcer), urinary tract obstruction (including bladder neck obstruction and
symptomatic prostatic hyperplasia), hyperthyroidism, increased intraocular pressure, and
cardiovascular disease (including hypertension and tachycardia). High sedative and
anticholinergic properties, therefore may not be considered the antihistamine of choice for
prolonged use in the elderly. May cause paradoxical excitation in pediatric patients, and can
result in hallucinations, coma, and death in overdose.
Adverse Reactions
>10%:
1% to 10%:
Gastrointestinal: Nausea, xerostomia, diarrhea, abdominal pain, appetite increase, weight gain
Ocular: Diplopia
Renal: Polyuria
Respiratory: Pharyngitis
Drug Interactions
Substrate of CYP2D6 (minor), 3A4 (major); Inhibits CYP2D6 (weak)
Increased toxicity (CNS depression): CNS depressants, MAO inhibitors, tricyclic antidepressants,
phenothiazines
Ethanol/Nutrition/Herb Interactions
Ethanol: Avoid ethanol (may increase CNS depression).
Stability
Protect from light
Mechanism of Action
Competes with histamine for H1-receptor sites on effector cells in the gastrointestinal tract, blood
vessels, and respiratory tract
Pharmacodynamics/Kinetics
Half-life elimination, serum: 20-24 hours
Dosage
Children: Oral: 0.35 mg/kg/day in divided doses every 4-6 hours
6-12 years: 2 mg every 4-6 hours, not to exceed 12 mg/day or sustained release 8 mg at bedtime
Children >12 years and Adults: Oral: 4 mg every 4-6 hours, not to exceed 24 mg/day or sustained
release 8-12 mg every 8-12 hours, not to exceed 24 mg/day
Elderly: Oral: 4 mg once or twice daily. Note: Duration of action may be 36 hours or more when
serum concentrations are low.
Administration
Timed release oral forms are to be swallowed whole, not crushed or chewed.
Dietary Considerations
May be taken with food or water.
Patient Education
May cause drowsiness; swallow whole, do not crush or chew sustained release product; avoid
alcohol, may impair coordination and judgment
Nursing Implications
Raise bed rails, institute safety measures, assist with ambulation.
Additional Information
Not effective for nasal stuffiness.
Dosage Forms
Syrup, as maleate:
Diabetic Tussin® Allergy Relief: 2 mg/5 mL (120 mL) [alcohol free, dye free, sugar free]
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