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ALLERGY MULTI-SYMPTOM (PHENYLEPHRINE HCL/ACETAMINOPHEN/CHLORPHENIRAMINE)
- Allergic rhinitis
- Allergic conjunctivitis
- Flu-like symptoms
- Nasal congestion
- Rhinorrhea
- Sinus headache
- Sinutrol Pe Tablet
- Sinus Congestion And Pain (chlorpheniramine) Tablet
- Sinus Congestion & Pain Tablet
- Pain Relief Allergy Sinus Tablet
- Medicidin-d Tablet
- Dristan Cold Tablet
- Allergy Sinus Pe Tablet
- Allergy Relief Multi-symptom Tablet
- Allergy Multi-symptom Tablet
- By Indication
2 mg-5 mg-325 mg tablet
- 2 tablets by oral route every 4 hours as needed not to exceed 8 tablets per 24Hrs
Sinus Congestion and Pain (chlorpheniramine) 2 mg-5 mg-325 mg tablet
- 2 tablets by oral route every 4 hours as needed not to exceed 8 tablets per 24Hrs
Sinus Congestion and Pain 5 mg-325 mg tablet
- Dosage information is not available
Sinus 2 mg-5 mg-325 mg tablet
- 2 tablets by oral route every 4 hours as needed not to exceed 8 tablets per 24Hrs
2 mg-5 mg-325 mg tablet
- 2 tablets by oral route every 4 hours as needed not to exceed 8 tablets per 24Hrs
2 mg-5 mg-325 mg tablet
- 2 tablets by oral route every 4 hours as needed not to exceed 8 tablets per 24Hrs
2 mg-5 mg-325 mg tablet
- 2 tablets by oral route every 4 hours as needed not to exceed 8 tablets per 24Hrs
2 mg-5 mg-325 mg tablet
- 2 tablets by oral route every 4 hours as needed not to exceed 8 tablets per 24Hrs
2 mg-5 mg-325 mg tablet
- 2 tablets by oral route every 4 hours as needed not to exceed 8 tablets per 24Hrs
Allergy Multi-Symptom 2 mg-5 mg-325 mg tablet
- 2 tablets by oral route every 4 hours as needed not to exceed 8 tablets per 24Hrs
Nasal congestion
- 2 tablets by oral route every 4 hours as needed not to exceed 8 tablets per 24Hrs
Sinus headache
- 2 tablets by oral route every 4 hours as needed not to exceed 8 tablets per 24Hrs
- Azilect
- Eldepryl
- isocarboxazid
- linezolid
- Marplan
- Matulane
- methylene blue (antidote)
- Nardil
- Parnate
- phenelzine
- procarbazine
- rasagiline
- selegiline HCl
- tranylcypromine
- Zelapar
- Zyvox
Contraindicated
- bromocriptine
- cabergoline
- Cafergot
- Compound 347
- Cycloset
- D.h.e.45
- dihydroergotamine
- enflurane
- ergoloid
- Ergomar
- ergotamine tartrate
- ergotamine-caffeine
- Forane
- isoflurane
- methylergonovine
- Migergot
- Migranal
- Parlodel
- sevoflurane
- Sojourn
- Terrell
- Ultane
Severe
Moderate
- Coumadin
- isoniazid
- isoniazid-rifamp-pyrazinamide
- Jantoven
- methyldopa
- methyldopa-hydrochlorothiazide
- methyldopate
- reserpine
- Rifamate
- rifampin-isoniazid
- Rifater
- warfarin
- Acetaminophen overdose
- Acute hepatic failure
- Acute hepatitis C
- Acute myocardial infarction
- Arterial thrombosis
- Severe uncontrolled hypertension
- Ventricular tachycardia
Contraindicated
- Acute hepatitis
- Acute pancreatitis
- Angle-closure glaucoma
- Benign prostatic hyperplasia
- Bladder outflow obstruction
- Bradycardia
- Chronic idiopathic constipation
- Coronary artery disease
- Disease of liver
- Gastrointestinal obstruction
- Hypertension
- Hyperthyroidism
- Incomplete AV heart block
- Protein-calorie malnutrition
- Severe arteriosclerotic vascular disease
- Severe renal impairment
- Shock
- Stenosing peptic ulcer
- Urinary retention
Severe
Moderate
- Acidosis
- Chronic heart failure
- Chronic obstructive pulmonary disease
- Hypertension
- Hyperthyroidism
- Hypoxia
ALLERGY MULTI-SYMPTOM (PHENYLEPHRINE HCL/ACETAMINOPHEN/CHLORPHENIRAMINE)
- Allergic rhinitis
- Allergic conjunctivitis
- Flu-like symptoms
- Nasal congestion
- Rhinorrhea
- Sinus headache
- None
- Dizziness
- Drowsy
- Thick bronchial secretions
More Frequent
Severe
Less Severe
- Abnormal hepatic function tests
- Sedation
Less Frequent
Severe
Less Severe
Rare / Very Rare
Severe
- Acute generalized exanthematous pustulosis
- Acute hepatic failure
- Agranulocytosis
- Allergic dermatitis
- Anaphylaxis
- Angioedema
- Blood dyscrasias
- Cardiac arrhythmia
- Dizziness
- Drug-induced hepatitis
- Extrasystoles
- Hallucinations
- Headache disorder
- Hemolytic anemia
- Hyperhidrosis
- Hypotension
- Insomnia
- Laryngeal edema
- Leukopenia
- Maculopapular rash
- Nervousness
- Neutropenic disorder
- Pallor
- Seizure disorder
- Stevens-johnson syndrome
- Tachycardia
- Thrombocytopenic disorder
- Toxic epidermal necrolysis
- Tremor
Less Severe
- Abdominal distension
- Acute abdominal pain
- Acute confusion
- Anorexia
- Ataxia
- Blurred vision
- Chest discomfort
- Chills
- Constipation
- Diarrhea
- Diplopia
- Dry nose
- Dry throat
- Dyspnea
- Dysuria
- Erythema
- Euphoria
- Excitement
- Fatigue
- Headache disorder
- Hyperhidrosis
- Insomnia
- Irritability
- Maculopapular rash
- Malaise
- Medication overuse headache
- Migraine
- Nervousness
- Nightmares
- Palpitations
- Paresthesia
- Pruritus of skin
- Skin photosensitivity
- Skin rash
- Symptoms of anxiety
- Tachycardia
- Tinnitus
- Tremor
- Urinary retention
- Urticaria
- Vertigo
- Visual changes
- Wheezing
- Xerostomia
Contraindicated
Chlorpheniramine (Oral)
Possible paradoxical CNS excitation. Seizure risk in newborns.
Risk of CNS excitation. Do not use age <6 years without clinician consult.
- 1 Day – 2 Years
- 1 Possible paradoxical CNS excitation. Seizure risk in newborns.
- 1 Day – 6 Years
- 1 Possible paradoxical CNS excitation. Seizure risk in newborns.
Phenylephrine (Oral,Rectal)
Possible paradoxical CNS excitation. Seizure risk in newborns.
Risk of CNS excitation. Do not use age <6 years without clinician consult.
- 1 Day – 2 Years
- 1 Risk of CNS excitation. Do not use age <6 years without clinician consult.
- 1 Day – 6 Years
- 1 Risk of CNS excitation. Do not use age <6 years without clinician consult.
Severe Precaution
Chlorpheniramine
Not recommended in children under 6 years unless clinician consultation.
- 2 Years – 6 Years
- Not recommended in children under 6 years unless clinician consultation.
Management or Monitoring Precaution
Acetaminophen (oral,rectal)
Use weight based dosing in children less than 12 years.
- 1 Day – 12 Years
- Use weight based dosing in children less than 12 years.
Acetaminophen
- Severity Level:
2
- Additional Notes: Available data suggest no known risk; otc product, no fda pregnancy warnings
Chlorpheniramine
- Severity Level:
2
- Additional Notes: Insufficient data available; neonate risk of seizures;avoid during 3rd trimester
Phenylephrine
- Severity Level:
2
- Additional Notes: Insufficient human data available.
Contraindicated
None
| General | Excretion Potential | Effect on Infant | Notes |
| None |
Precaution Exists
Chlorpheniramine
Insufficient data available; may cause sedation and inhibit lactation
Oral bioavailability low; infant exposure may be minimal
| General | Excretion Potential | Effect on Infant | Notes |
| Evaluate use carefully | Unknown | Not known; no or inclusive data | Insufficient data available; may cause sedation and inhibit lactation |
Phenylephrine
Insufficient data available; may cause sedation and inhibit lactation
Oral bioavailability low; infant exposure may be minimal
| General | Excretion Potential | Effect on Infant | Notes |
| Evaluate use carefully | Excreted | Not known; no or inclusive data | Oral bioavailability low; infant exposure may be minimal |
No Known Risk
Acetaminophen
Low levels excreted with low risk for adverse effects in infant
| General | Excretion Potential | Effect on Infant | Notes |
| No known risks; does not adversely affect lactation | Excreted | No adverse effect | Low levels excreted with low risk for adverse effects in infant |
Contraindicated
None
Precaution Exists
Acetaminophen (oral,rectal)
Hepatic-Elderly may be more susceptible to hepatotoxicity. Strict adherence to a maximum daily dose is recommended, and the maximum dose recommendation varies between 3000-3800 mg depending on strength used and source of the recommendation.
Neuro/Psych-Anticholinergic effects may cause sedation, worsen cognitive impairment and increase fall risk. Non-sedating antihistamine preferred. Gastrointestinal-May cause or worsen pre-existing constipation. Genitourinary-Best avoided in patients with urinary retention from any cause.
Cardiovascular-Elderly are more sensitive to tachycardia and hypertensive effects. May exacerbate symptomatic coronary insufficiency. Genitourinary-May cause urinary retention. Neuro/Psych-May worsen cognitive impairment in some elderly with dementia. Insomnia risk.
| Organ / System | HEP | REN | CARD | ENDO | NEURO / PSYCH | PULM |
| Increased Risk / Adverse Effects | N | Y | N | N | N | N |
BEERS: N HEDIS: N STOPP: N
Chlorpheniramine
Hepatic-Elderly may be more susceptible to hepatotoxicity. Strict adherence to a maximum daily dose is recommended, and the maximum dose recommendation varies between 3000-3800 mg depending on strength used and source of the recommendation.
Neuro/Psych-Anticholinergic effects may cause sedation, worsen cognitive impairment and increase fall risk. Non-sedating antihistamine preferred. Gastrointestinal-May cause or worsen pre-existing constipation. Genitourinary-Best avoided in patients with urinary retention from any cause.
Cardiovascular-Elderly are more sensitive to tachycardia and hypertensive effects. May exacerbate symptomatic coronary insufficiency. Genitourinary-May cause urinary retention. Neuro/Psych-May worsen cognitive impairment in some elderly with dementia. Insomnia risk.
| Organ / System | HEP | REN | CARD | ENDO | NEURO / PSYCH | PULM |
| Increased Risk / Adverse Effects | N | N | N | Y | N | N |
BEERS: Y HEDIS: Y STOPP: Y
Phenylephrine
Hepatic-Elderly may be more susceptible to hepatotoxicity. Strict adherence to a maximum daily dose is recommended, and the maximum dose recommendation varies between 3000-3800 mg depending on strength used and source of the recommendation.
Neuro/Psych-Anticholinergic effects may cause sedation, worsen cognitive impairment and increase fall risk. Non-sedating antihistamine preferred. Gastrointestinal-May cause or worsen pre-existing constipation. Genitourinary-Best avoided in patients with urinary retention from any cause.
Cardiovascular-Elderly are more sensitive to tachycardia and hypertensive effects. May exacerbate symptomatic coronary insufficiency. Genitourinary-May cause urinary retention. Neuro/Psych-May worsen cognitive impairment in some elderly with dementia. Insomnia risk.
| Organ / System | HEP | REN | CARD | ENDO | NEURO / PSYCH | PULM |
| Increased Risk / Adverse Effects | N | N | Y | Y | N | N |
BEERS: N HEDIS: N STOPP: N
No Known Risk
None
- None
| Allergic conjunctivitis | |
| H10.1 | Acute atopic conjunctivitis |
| H10.10 | Acute atopic conjunctivitis, unspecified eye |
| H10.11 | Acute atopic conjunctivitis, right eye |
| H10.12 | Acute atopic conjunctivitis, left eye |
| H10.13 | Acute atopic conjunctivitis, bilateral |
| H10.44 | Vernal conjunctivitis |
| H10.45 | Other chronic allergic conjunctivitis |
| H16.26 | Vernal keratoconjunctivitis, with limbar and corneal involvement |
| H16.261 | Vernal keratoconjunctivitis, with limbar and corneal involvement, right eye |
| H16.262 | Vernal keratoconjunctivitis, with limbar and corneal involvement, left eye |
| H16.263 | Vernal keratoconjunctivitis, with limbar and corneal involvement, bilateral |
| H16.269 | Vernal keratoconjunctivitis, with limbar and corneal involvement, unspecified eye |
| Allergic rhinitis | |
| J30.1 | Allergic rhinitis due to pollen |
| J30.2 | Other seasonal allergic rhinitis |
| J30.5 | Allergic rhinitis due to food |
| J30.8 | Other allergic rhinitis |
| J30.81 | Allergic rhinitis due to animal (cat) (dog) hair and dander |
| J30.89 | Other allergic rhinitis |
| J30.9 | Allergic rhinitis, unspecified |
| Flu-like symptoms | |
| J02.9 | Acute pharyngitis, unspecified |
| R05 | Cough |
| R09.81 | Nasal congestion |
| R50.9 | Fever, unspecified |
| R53.1 | Weakness |
| R53.81 | Other malaise |
| R53.83 | Other fatigue |
| R68.83 | Chills (without fever) |
| Nasal congestion | |
| R09.81 | Nasal congestion |
| Rhinorrhea | |
| R09.82 | Postnasal drip |
| Sinus headache | |
| R51 | Headache |
| 0-9 | A-Z |
|---|---|
| H10.1 | Acute atopic conjunctivitis |
| H10.10 | Acute atopic conjunctivitis, unspecified eye |
| H10.11 | Acute atopic conjunctivitis, right eye |
| H10.12 | Acute atopic conjunctivitis, left eye |
| H10.13 | Acute atopic conjunctivitis, bilateral |
| H10.44 | Vernal conjunctivitis |
| H10.45 | Other chronic allergic conjunctivitis |
| H16.26 | Vernal keratoconjunctivitis, with limbar and corneal involvement |
| H16.261 | Vernal keratoconjunctivitis, with limbar and corneal involvement, right eye |
| H16.262 | Vernal keratoconjunctivitis, with limbar and corneal involvement, left eye |
| H16.263 | Vernal keratoconjunctivitis, with limbar and corneal involvement, bilateral |
| H16.269 | Vernal keratoconjunctivitis, with limbar and corneal involvement, unspecified eye |
| J02.9 | Acute pharyngitis, unspecified |
| J30.1 | Allergic rhinitis due to pollen |
| J30.2 | Other seasonal allergic rhinitis |
| J30.5 | Allergic rhinitis due to food |
| J30.8 | Other allergic rhinitis |
| J30.81 | Allergic rhinitis due to animal (cat) (dog) hair and dander |
| J30.89 | Other allergic rhinitis |
| J30.9 | Allergic rhinitis, unspecified |
| R05 | Cough |
| R09.81 | Nasal congestion |
| R09.81 | Nasal congestion |
| R09.82 | Postnasal drip |
| R50.9 | Fever, unspecified |
| R51 | Headache |
| R53.1 | Weakness |
| R53.81 | Other malaise |
| R53.83 | Other fatigue |
| R68.83 | Chills (without fever) |
Formulary Reference Tool