chlorpheniramine/pyrilamine/phenylephrine (Discontinued)

Brand and Other Names:R-Tannate, Triplex AD Liquid
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

chlorpheniramine/pyrilamine/phenylephrine

oral liquid

  • (2mg/12.5mg/5mg)/5mL
  • (2mg/12.5mg/7.5mg)/5mL

tablet

  • 8mg/25mg/25mg
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Congestion

Symptomatic relief of coryza and nasal congestion associated with common cold, sinusitis, allergic rhinitis, and other upper respiratory tract conditions

Liquid: 5-10 mL PO q4-6hr, up to 60 mg phenylephrine in 24 hr

Tablets: 1 tablet PO q12hr PRN

Dosage Forms & Strengths

lansoprazole/amoxicillin/clarithromycin

oral liquid

  • (2mg/12.5mg/5mg)/5mL
  • (2mg/12.5mg/7.5mg)/5mL

tablet

  • 8mg/25mg/25mg
more...

Congestion

<2 years: Titrate dose individually

2-6 years: 2.5-5 mL PO q4-6hr, up to 15 mg phenylephrine in 24 hr

6-12 years: 5 mL PO q4-6hr, up to 30 mg phenylephrine in 24 hr

>12 years: 5-10 mL PO q4-6hr, up to 60 mg phenylephrine in 24 hr

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Adverse Effects

Frequency Not Defined

Chlorpheniramine

  • Anticholinergic effects
  • Somnolence
  • Constipation
  • Diarrhea
  • Nausea
  • Vomiting
  • Blurred vision

Pyrilamine

  • Sedation
  • Xerostomia
  • Blurred vision

Phenylephrine

  • Hypertension
  • Reflex bardycardia
  • Anxiety
  • Headache
  • Burning
  • Rebound congestion
  • Sneezing
  • Pulmonary edema
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Warnings

Contraindications

Do not use within 14 days of MAO inhibitors; risk of hypertension

Chlorpheniramine

  • Acute asthma, sleep apnea

Phenylephrine

  • Hypersensitivity to phenylephrine or sulfites; severe HTN, VTach, closed angle glaucoma

Cautions

Phenylephrine

  • Cerebrovascular insufficiency, CVD, HTN, DM, thyroid disease, prostatic hypertrophy, geriatrics
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Pregnancy & Lactation

Pregnancy category: C

Lactation: Do not administer

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

Chlorpheniramine

Half-Life: 12-43 hr

Duration: 24 hr

Onset: 6 hr

Peak Plasma Time: 2-6 hr

Protein Bound: 69-72%

Vd: 2.5-3.2 L/kg

Metabolism: GI mucosa, liver

Metabolites: monodesmethylchlorpheniramine, didesmethylchlorpheniramine

Excretion: urine

Sedative effect: low

Antihistamine activity: moderate

Anticholinergic acitivity: moderate

Pyrilamine

Onset: 15-60 min

Duration: 8 hours

Metabolism: liver

Excretion: renal

Phenylephrine

Half-Life: 2-3 hr

Onset: 10-15 min

Duration: 15 min

Metabolism: extensivly in intestinal wall, moderately in liver

Metabolites: M-hydroxymandelic acid (inactive)

Excretion: urine: 80-90%

Mechanism of Action

Chlorpheniramine: Histamine H1-receptor antagonist

Pyrilamine: First generation antihistamine

Phenylephrine: Strong alpha effects resulting in increased PVR and BP and decreased CO and renal perfusion

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