Chlorpheniramine-Phenylephrine

Chlorpheniramine-Phenylephrine is an over-the-counter (OTC) product used for relieving nasal congestion or sneezing caused due to common cold, hay fever, and allergic rhinitis. 

• Chlorpheniramine-Phenylephrine is available under the following different brand names: Actifed Cold and Allergy 

Adult and pediatric dosage

Tablet

• 4 mg /10 mg

Liquid

• (4 mg /10 mg )/5 mL

Liquid (drops)

• (1 mg /2 mg )/1 mL
• (1 mg /2.5 mg )/1 mL
• (1-2 mg /3.5-5 mg )/1 mL
• (2 mg /5 mg )/1 mL

Nasal Congestion or Sneezing Due to Common Cold, Hay Fever, Allergic Rhinitis

Adult dosage

Tablet

• 1 tablet orally every 4 hours; not to exceed 6 tab /24 hours

Liquid

• 5 mL orally every 4-6 hours; not to exceed 30 mL /24 hours

Pediatric dosage

Liquid (drops)

• Children below 2 years: Not recommended
• 2-6 years: 1 mL [(1 mg /2.5 mg )/1 mL] orally every 4-6 hours; not to exceed 4mL/24 hours; alternatively, 1 mL [(2 mg /5 mg )/1 mL] orally every4hour; not to exceed 3 mL/24 hours
• 6-12 years: 2 mL [(1 mg /2.5 mg )/1 mL] orally every4-6 hours; not to exceed 4mL/24 hours; alternatively, 2 mL [(2 mg /5 mg )/1 mL] orally every 4 hours; not to exceed 3 mL/24 hours
• Children above 12 years: 4 mL [(1 mg /2 mg / 1 mL] orally every 4-6 hours; not to exceed 4 mL/24 hours; alternatively, 2 mL [(2 mg /5 mg )/1 mL] orally every 4 hours; not to exceed 3 mL/24 hours

Liquid

• Children above 12 years: 5 mL orally every 4-6 hours; not to exceed 30 mL /24 hours

Tablet

• Children above 12 years: 1 tablet orally every 4 hours; not to exceed 6 tab /24 hours

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”

Common side effects of Chlorpheniramine-Phenylephrine include:

• Low blood pressure (hypotension)
• Palpitations
• Fast heart rate
• Confusion
• Depression
• Distress
• Dizziness
• Euphoria
• Fatigue
• Headache
• Insomnia
• Irritability
• Sedation
• Tremors
• Skin rash
• Loss of appetite
• Gastrointestinal disturbances
• Anemia
• Blood disorders (neutropenia, pancytopenia, leukopenia, thrombocytopenia, agranulocytosis)
• Hemolytic anemia
• Increased bilirubin and alkaline phosphatase
• Thickening of bronchial secretions
• Wheezing

Serious side effects of Chlorpheniramine-Phenylephrine include:

• mental/mood changes (such as confusion, hallucinations), 
• ringing in the ears, 
• difficulty urinating, 
• vision changes (such as blurred/double vision).
• fast/irregular heartbeat, 
• seizure.
• rash,
• itching/swelling (especially of the face/tongue/throat), 
• severe dizziness, and
• trouble breathing.

Rare side effects of Chlorpheniramine-Phenylephrine include:

• none 

Seek medical care or call 911 at once if you have the following serious side effects:

• Severe headache, confusion, slurred speech, arm or leg weakness, trouble walking, loss of coordination, feeling unsteady, very stiff muscles, high fever, profuse sweating, or tremors;
• Serious eye symptoms such as sudden vision loss, blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights;
• Serious heart symptoms such as fast, irregular, or pounding heartbeats; fluttering in your chest; shortness of breath; and sudden dizziness, lightheartedness, or passing out.

This is not a complete list of side effects and other serious side effects or health problems that may occur as a result of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Chlorpheniramine-Phenylephrine has severe interactions with the following drugs:
  • iobenguane I 123
  • isocarboxazid
  • linezolid
  • phenelzine
  • procarbazine
  • selegiline transdermal
  • tranylcypromine
• Chlorpheniramine-Phenylephrine has serious interactions with at least 40 other drugs.
• Chlorpheniramine-Phenylephrine has moderate interactions with at least 273 other drugs.
• Chlorpheniramine-Phenylephrine has minor interactions with atleast 18 other drugs.

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist about all your products. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions or concerns.

Contraindications

• Contraindicated in documented hypersensitivity; asthma attacks, narrow-angle glaucoma, symptomatic prostate hypertrophy, bladder neck obstruction, and stenosing peptic ulcer 

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Chlorpheniramine-Phenylephrine?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Chlorpheniramine-Phenylephrine?”

Cautions

• Caution in elderly patients, hyperthyroidism, myocardial disease, bradycardia, partial heart block, or severe arteriosclerosis when administering phenylephrine; in hypovolemia, phenylephrine use is not a substitute for replacement of blood, fluids, electrolytes, and plasma (promptly restore with loss); dilute IV and administer via large vein; extravasation precautions required
• Chlorpheniramine may cause significant confusional symptoms; not for administration to premature or full-term neonates

Pregnancy & Lactation

• Use with caution if the benefits outweigh the risks during pregnancy.
• Lactation
  • Excretion in milk unknown/contraindicated