chlorpheniramine/dextromethorphan/pseudoephedrine (OTC)Brand and Other Names:Forte Kidkare Cough and Cold, Rescon DM, more...Pedia Relief

 
 
 

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

chlorpheniramine/dextromethorphan/pseudoephedrine

liquid

  • (1mg/5mg/15mg)/5mL
  • (4mg/20mg/20mg)/5mL
  • (2mg/15mg/15mg)/5mL
  • (2mg/10mg/30mg)/5mL

oral drops

  • (0.8mg/3mg/8mg)/1mL

tablet

  • 4mg/60mg/20mg

tablet chewable

  • 2mg/10mg/30mg
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Relief of Cold & Flu Symptoms

10 mL [(2mg/15mg/15mg)/5mL] PO q6hr; not to exceed 40 mL/day

10 mL [(2mg/10mg/30mg)/5mL] PO q4-6hr; not to exceed 40 mL/day

5 mL [(4mg/20mg/20mg)/5mL] PO q4-6hr; not to exceed 30 mL/day

2 tabs [(2mg/10mg/30mg)/tab] PO q4-6hr; not to exceed 8 tabs/day

1 tab [(4mg/60mg/20mg)/tab] PO q4-6hr; not to exceed 4 tabs/day

Dosage Forms & Strengths

chlorpheniramine/dextromethorphan/pseudoephedrine

liquid

  • (1mg/5mg/15mg)/5mL
  • (4mg/20mg/20mg)/5mL
  • (2mg/15mg/15mg)/5mL
  • (2mg/10mg/30mg)/5mL

oral drops

  • (0.8mg/3mg/8mg)/1mL

tablet

  • 4mg/60mg/20mg

tablet chewable

  • 2mg/10mg/30mg
more...

Relief of Cold & Flu Symptoms

<6 Years Old

  • Ask a pediatrician

6-12 Years Old

  • 2 mL [(0.8mg/3mg/8mg)/1mL] PO q4-6hr; not to exceed 8 mL/24hr
  • 10 mL [(1mg/5mg/15mg)/5mL] PO q4-6hr; not to exceed 40 mL/24hr
  • 5 mL [(2mg/15mg/15mg)/5mL] PO q4-6hr; not to exceed 20 mL/24hr
  • 2.5 mL [(4mg/20mg/20mg)/5mL] PO q4-6hr; not to exceed 15 mL/24hr
  • 1 tab [(2mg/10mg/30mg/tab)] PO q4-6hr; not to exceed 4 tabs/24hr
  • ½ tab [(4mg/60mg/20mg/tab)] PO q4-6hr; not to exceed 2 tabs/24hr

>12 Years Old

  • 10 mL [(2mg/15mg/15mg)/5mL] PO q6hr; not to exceed 40 mL/day
  • 10 mL [(2mg/10mg/30mg)/5mL] PO q4-6hr; not to exceed 40 mL/day
  • 5 mL [(4mg/20mg/20mg)/5mL] PO q4-6hr; not to exceed 30 mL/day
  • 2 tabs [(2mg/10mg/30mg)/tab] PO q4-6hr; not to exceed 8 tabs/day
  • 1 tab [(4mg/60mg/20mg)/tab] PO q4-6hr; not to exceed 4 tabs/day
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Interactions

Interaction Checker

chlorpheniramine/dextromethorphan/pseudoephedrine and

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     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            Frequency Not Defined

            Arrhythmia

            Hypotension

            Palpitations

            Tachycardia

            Confusion

            Convulsion

            Depression

            Distress

            Dizziness

            Drowsiness

            Euphoria

            Excitability

            Fatigue

            Headache

            Insomnia

            Irritability

            Sedation

            Tremors

            Weakness

            Anorexia

            GI disturbances

            Agranulocytosis

            Hemolytic anemia

            Thrombocytopenia

            Thickening of bronchial secretions

            Wheezing

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            Warnings

            Contraindications

            Contraindicated in documented hypersensitivity to the drugs or within 14 days of MAO inhibitor therapy; asthma attacks, narrow-angle glaucoma, symptomatic prostate hypertrophy, bladder-neck obstruction, and stenosing peptic ulcer

            Cautions

            Caution in cardiovascular disease, diabetes mellitus, prostatic hypertrophy and increased intraocular pressure when taking pseudoephedrine

            Do not take dextromethorphan for persistent or chronic cough associated with smoking, asthma, or emphysema, or if it is accompanied by excessive phlegm unless directed by a healthcare provider; may decrease respiration rate

            Chlorpheniramine may cause significant confusional symptoms; not for administration to premature or full-term neonates

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            Pregnancy & Lactation

            Pregnancy Category: C

            Lactation: excretion in milk unknown/not recommended

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

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            Pharmacology

            Mechanism of Action

            Chlorpheniramine blocks muscle responses in histamine and acts as an antagonism of the constrictor effects of histamine on respiratory smooth muscle.

            Dextromethorphan is a cough suppressant that acts centrally on the cough center in medulla

            Pseudoephedrine stimulates the alpha-adrenergic receptors causing bronchodilation and vasoconstriction.

            Pharmacokinetics

            Chlorpheniramine

            • Vd: 4-7 L/kg (children); 6-12 L/kg (adults)
            • Protein binding: 33%
            • Half-life: 10-13 hr (children); 14-24 hr (adults)
            • Peak plasma time: 2-4 hr
            • Excretion: Urine

            Dextromethorphan

            • Onset: 15-30 min
            • Duration: 3-6 hr
            • Metabolism: Hepatic P450 enzyme CYP2D6
            • Excretion: Urine
            • Half-life: 2-4 hr (extensive metabolizers); 24 hr (poor metabolizers)
            • Peak plasma time: 2-3 hr

            Pseudoephedrine

            • Half-Life: 3 hr (children); 9-16 hr (adults)
            • Onset: 30 min (decongestant)Duration: 3-8 hr  
            • Peak PlasmaTime: 1.97 hr
            • Concentration: 422 ng/mL
            • Metabolism: Liver, by N-demethylation
            • Metabolites: Inactive
            • Clearance: 7.3-7.6 mL/min/kg
            • Excretion: Urine (43-96%)
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