chlorphenaramine
Transcript of chlorphenaramine
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Chlorpheniramine
Table of Contents > Drugs >
Chlorpheniramine
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Pronunciation
U.S. Brand Names
Synonyms
Generic Available
Canadian Brand Names
Use
Pregnancy Risk Factor
Contraindications
Warnings/Precautions
Adverse ReactionsDrug Interactions
Ethanol/Nutrition/HerbInteractions
Stability
Mechanism of Action
Pharmacodynamics/Kinetics
Dosage
Administration
Dietary Considerations
Patient Education
Nursing Implications
Additional Information
Dental Health: Effects on DentalTreatmentDental Health:Vasoconstrictor/Local Anesthetic
PrecautionsMental Health: Effects on MentalStatusMental Health: Effects onPsychiatric Treatment
Dosage Forms
International Brand Names
Pronunciation
(klor fen IR a meen)
U.S. Brand Names
Aller-Chlor [OTC]; Chlorphen [OTC]; Chlor-Trimeton [OTC]; Diabetic Tussin Allergy Relief
[OTC]; Teldrin HBP [OTC]
Synonyms
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Chlorpheniramine Maleate; CTM
Generic AvailableYes
Canadian Brand Names
Chlor-Tripolon; Novo-Pheniram
Use
Perennial and seasonal allergic rhinitis and other allergic symptoms including urticaria
Pregnancy Risk Factor
B
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
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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%:
Central nervous system: Slight to moderate drowsiness
Respiratory: Thickening of bronchial secretions
1% to 10%:
Central nervous system: Headache, excitability, fatigue, nervousness, dizziness
Gastrointestinal: Nausea, xerostomia, diarrhea, abdominal pain, appetite increase, weight gain
Genitourinary: Urinary retention
Neuromuscular & skeletal: Arthralgia, weakness
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
CYP3A4 inhibitors: May increase the levels/effects of chlorpheniramine. Example inhibitors
include azole antifungals, ciprofloxacin, clarithromycin, diclofenac, doxycycline, erythromycin,
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imatinib, isoniazid, nefazodone, nicardipine, propofol, protease inhibitors, quinidine, and
verapamil.
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
2-6 years: 1 mg every 4-6 hours, not to exceed 6 mg in 24 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
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serum concentrations are low.
Hemodialysis: Supplemental dose is not necessary
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.
Dental Health: Effects on Dental Treatment
Key adverse event(s) related to dental treatment: Xerostomia (normal salivary flow resumes upon
discontinuation). Chronic use of antihistamines will inhibit salivary flow, particularly in elderly
patients; this may contribute to periodontal disease and oral discomfort.
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