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NOHIST-DM (DEXTROMETHORPHAN HBR/PHENYLEPHRINE HCL/CHLORPHENIRAMINE)
- Cold symptoms
- Allergic rhinitis
- Cough
- Nasal congestion
- Rhinorrhea
- Vasomotor rhinitis
4 mg-10 mg-15 mg/5 mL oral liquid
- Dosage information is not available
Ed A-Hist DM 4 mg-10 mg-15 mg/5 mL oral liquid
- Dosage information is not available
- 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
- methyldopa
- methyldopa-hydrochlorothiazide
- methyldopate
- reserpine
- 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
- Gastrointestinal obstruction
- Hypertension
- Hyperthyroidism
- Incomplete AV heart block
- Severe arteriosclerotic vascular disease
- Stenosing peptic ulcer
- Systemic mastocytosis
- Urinary retention
Severe
Moderate
- Acidosis
- Chronic heart failure
- Chronic obstructive pulmonary disease
- Hypertension
- Hyperthyroidism
- Hypoxia
NOHIST-DM (DEXTROMETHORPHAN HBR/PHENYLEPHRINE HCL/CHLORPHENIRAMINE)
- Cold symptoms
- Allergic rhinitis
- Cough
- Nasal congestion
- Rhinorrhea
- Vasomotor rhinitis
- None
- Dizziness
- Drowsy
- Thick bronchial secretions
More Frequent
Severe
Less Severe
- None
- Sedation
Less Frequent
Severe
Less Severe
Rare / Very Rare
Severe
- Anaphylaxis
- Blood dyscrasias
- Cardiac arrhythmia
- Dizziness
- Extrasystoles
- Hallucinations
- Headache disorder
- Hemolytic anemia
- Hyperhidrosis
- Hypotension
- Insomnia
- Nervousness
- Pallor
- Seizure disorder
- Tachycardia
- Tremor
- Vomiting
Less Severe
- Abdominal distension
- Abdominal pain with cramps
- Acute abdominal pain
- Acute confusion
- Anorexia
- Ataxia
- Blurred vision
- Chest discomfort
- Chills
- Constipation
- Diarrhea
- Diplopia
- Dizziness
- Drowsy
- Dry nose
- Dry throat
- Dyspnea
- Dysuria
- Euphoria
- Excitement
- Fatigue
- Headache disorder
- Hyperhidrosis
- Insomnia
- Irritability
- Maculopapular rash
- Malaise
- Migraine
- Nausea
- 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.
Do not use in pediatrics <6 years of age unless clinician consultation.
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.
Dextromethorphan (OTC)
Possible paradoxical CNS excitation. Seizure risk in newborns.
Do not use in pediatrics <6 years of age unless clinician consultation.
Risk of CNS excitation. Do not use age <6 years without clinician consult.
- 1 Day – 2 Years
- 1 Do not use in pediatrics <6 years of age unless clinician consultation.
- 1 Day – 6 Years
- 1 Do not use in pediatrics <6 years of age unless clinician consultation.
Phenylephrine (Oral,Rectal)
Possible paradoxical CNS excitation. Seizure risk in newborns.
Do not use in pediatrics <6 years of age unless clinician consultation.
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
None
Chlorpheniramine
- Severity Level:
2
- Additional Notes: Insufficient data available; neonate risk of seizures;avoid during 3rd trimester
Dextromethorphan
- Severity Level:
C
- Additional Notes:
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
Insufficient data available; molecular wt low enough for possible excretion
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 |
Dextromethorphan
Insufficient data available; may cause sedation and inhibit lactation
Insufficient data available; molecular wt low enough for possible excretion
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; molecular wt low enough for possible excretion |
Phenylephrine
Insufficient data available; may cause sedation and inhibit lactation
Insufficient data available; molecular wt low enough for possible excretion
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
None
| General | Excretion Potential | Effect on Infant | Notes |
| None |
Contraindicated
None
Precaution Exists
Chlorpheniramine
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
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 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 |
| Cold symptoms | |
| J00 | Acute nasopharyngitis [common cold] |
| Cough | |
| R05 | Cough |
| Nasal congestion | |
| R09.81 | Nasal congestion |
| Rhinorrhea | |
| R09.82 | Postnasal drip |
| Vasomotor rhinitis | |
| J30.0 | Vasomotor rhinitis |
| 0-9 | A-Z |
|---|---|
| J00 | Acute nasopharyngitis [common cold] |
| J30.0 | Vasomotor 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 |
| R05 | Cough |
| R09.81 | Nasal congestion |
| R09.82 | Postnasal drip |
Formulary Reference Tool