ADVIL ALLERGY-CONGESTION RLF (CHLORPHENIRAMINE MALEATE/PHENYLEPHRINE HCL/IBUPROFEN)

Moderate

• A-hydrocort

• A-methapred

• abciximab

• Accolate

• Accupril

• Accuretic

• acebutolol

• Aceon

• adefovir

• Adult Low Dose Aspirin

• Aggrenox

• Alka-seltzer

• Alka-seltzer Extra Strength

• Alka-seltzer Original

• Alka-seltzer Pm

• Altace

• amiloride

• amiloride-hydrochlorothiazide

• amiodarone

• amiodarone in dextrose,iso-osm

• amlodipine-benazepril

• amlodipine-olmesartan

• amlodipine-valsartan

• amlodipine-valsartan-hcthiazid

• Angeliq

• Antacid & Pain Relief

• Anucort-hc

• Anusol-hc

• Aristospan Intra-articular

• Aristospan Intralesional

• Arixtra

• ASA-acetaminophen-caff-buffers

• Aspir-81

• Aspir-low

• Aspir-trin

• aspirin

• Aspirin Childrens

• Aspirin Low Dose

• Aspirin Low-strength

• aspirin, buffered

• aspirin-calcium carbonate

• aspirin-diphenhydramine

• aspirin-sod bicarb-citric acid

• Astagraf Xl

• Atacand

• Atacand Hct

• atenolol

• atenolol-chlorthalidone

• Atripla

• Avalide

• Avapro

• azilsartan med-chlorthalidone

• azilsartan medoxomil

• Azor

• Bayer Advanced

• Bayer Aspirin

• Bayer Chewable Aspirin

• Bayer Childrens Aspirin

• Bayer Plus Extra Strength

• benazepril

• benazepril-hydrochlorothiazide

• Benicar

• Benicar Hct

• betamethasone acet & sod phos

• Betapace

• Betapace Af

• betaxolol

• Beyaz

• bisoprolol fumarate

• bisoprolol-hydrochlorothiazide

• Brevibloc

• Brevibloc In Nacl (iso-osm)

• Brilinta

• Brintellix

• Brisdelle

• budesonide

• Buffered Aspirin

• Bufferin

• bumetanide

• Bystolic

• candesartan

• candesartan-hydrochlorothiazid

• captopril

• captopril-hydrochlorothiazide

• Celestone Soluspan

• Celexa

• Child Aspirin

• Children's Aspirin

• cilostazol

• citalopram

• clopidogrel

• colchicine-probenecid

• Colocort

• Complera

• Cordarone

• Corgard

• Cortef

• Cortenema

• Cortifoam

• cortisone

• Corzide

• Cozaar

• cyclosporine

• cyclosporine modified

• Cymbalta

• Daflonex-xl

• dalteparin (porcine)

• Demadex

• Depo-medrol

• desvenlafaxine

• desvenlafaxine fumarate

• desvenlafaxine succinate

• dexamethasone

• Dexamethasone Intensol

• dexamethasone sodium phos (PF)

• dexamethasone sodium phosphate

• Dexpak 10 Day

• Dexpak 13 Day

• Dexpak 6 Day

• Diflucan

• Digox

• digoxin

• diosmin complex no.1

• Diovan Hct

• dipyridamole-aspirin

• drospirenone-e.estradiol-lm.FA

• drospirenone-estradiol

• drospirenone-ethinyl estradiol

• duloxetine

• Dutoprol

• Dyazide

• Dyrenium

• E.c. Prin

• Ecotrin

• Ecotrin Low Strength

• Edarbi

• Edarbyclor

• efavirenz-emtricitabin-tenofov

• Efferves Pain Relief Antacid

• Effervescent Antacid

• Effervescent Pain Relief

• Effervescent Pain Reliever

• Effexor Xr

• Elmiron

• elvitegr-cobicist-emtric-tenof

• emtricitab-rilpivirine-tenofov

• emtricitabine-tenofovir

• enalapril maleate

• enalapril-hydrochlorothiazide

• enalaprilat

• enoxaparin

• Enteric Coated Aspirin

• Entocort Ec

• Epaned

• eprosartan

• eprosartan-hydrochlorothiazide

• eptifibatide

• erlotinib

• escitalopram oxalate

• esmolol

• esmolol in NaCl (iso-osm)

• ethacrynate sodium

• Exforge

• Exforge Hct

• Extra Strength Bayer

• Ez Use Joint-tunnel-trigger

• Fetzima

• First-duke's

• First-mary's Mouthwash

• Flo-pred

• fluconazole

• fluconazole in dextrose(iso-o)

• fluconazole in NaCl (iso-osm)

• fludrocortisone

• fluoxetine

• fluvoxamine

• fondaparinux

• fosinopril

• fosinopril-hydrochlorothiazide

• Fragmin

• furosemide

• Gengraf

• Gianvi (28)

• Grx Hicort 25

• Hecoria

• Hemril-30

• heparin (porcine)

• heparin (porcine) in D5W

• heparin(porcine) in 0.45% NaCl

• heparin, porcine (PF)

• Hepsera

• hesp-diosm hyd-Ca dobe-diosmin

• hesperid-diosmin-grape seed xt

• hydrocortisone

• hydrocortisone acetate

• hydrocortisone sod succ (PF)

• hydrocortisone sod succinate

• Hyzaar

• Inderal La

• Inderal Xl

• Innopran Xl

• Integrilin

• irbesartan

• irbesartan-hydrochlorothiazide

• Kenalog

• ketoconazole

• Khedezla

• Lanoxin

• Lanoxin Pediatric

• Lasix

• Levatol

• levomilnacipran

• Lexapro

• lisinopril

• lisinopril-hydrochlorothiazide

• Lite Coat Aspirin

• lithium carbonate

• lithium citrate

• Lithobid

• Lo-dose Aspirin

• Lopressor

• Lopressor Hct

• Loryna (28)

• losartan

• losartan-hydrochlorothiazide

• Lotensin

• Lotrel

• Lovenox

• Luvox Cr

• Mavik

• Maxzide

• Maxzide-25Mg

• Medi-seltzer

• Medrol

• Medrol (pak)

• methyldopa

• methyldopa-hydrochlorothiazide

• methyldopate

• methylprednisolone

• methylprednisolone acetate

• methylprednisolone sod suc(PF)

• methylprednisolone sodium succ

• methylprednisolone-bupivacaine

• metoprolol su-hydrochlorothiaz

• metoprolol succinate

• metoprolol ta-hydrochlorothiaz

• metoprolol tartrate

• Micardis

• Micardis Hct

• miconazole

• Millipred

• Millipred Dp

• milnacipran

• moexipril

• moexipril-hydrochlorothiazide

• nadolol

• nadolol-bendroflumethiazide

• nebivolol

• Neoral

• Nexterone

• nystatin-hydrocortisone-diphen

• nystatin-TCN-HC-diphenhydramin

• Ocella

• olanzapine-fluoxetine

• olmesartan

• olmesartan-amlodipin-hcthiazid

• olmesartan-hydrochlorothiazide

• Orapred

• Orapred Odt

• Oravig

• Oxandrin

• oxandrolone

• Pacerone

• paroxetine HCl

• paroxetine mesylate

• Paxil

• Paxil Cr

• Pediapred

• penbutolol

• pentosan polysulfate sodium

• perindopril erbumine

• Pexeva

• Physicians Ez Use M-pred

• pindolol

• Plavix

• Pletal

• prednisolone

• prednisolone acetate

• prednisolone sodium phosphate

• prednisone

• Prednisone Intensol

• Prinivil

• Pristiq

• probenecid

• Proctocort

• Prograf

• propranolol

• propranolol-hydrochlorothiazid

• Prozac

• Prozac Weekly

• quinapril

• quinapril-hydrochlorothiazide

• ramipril

• Rapamune

• Rayos

• Rectacort-hc

• Reopro

• reserpine

• Safyral

• Sandimmune

• Sarafem

• Savella

• Sectral

• sertraline

• sirolimus

• Sodium Edecrin

• Solu-cortef

• Solu-cortef (pf)

• Solu-medrol

• Solu-medrol (pf)

• Sorine

• sotalol

• Sotalol Af

• St Joseph Aspirin

• St. Joseph Aspirin

• Stribild

• Syeda

• Symbyax

• tacrolimus

• Tarceva

• Tarka

• telmisartan

• telmisartan-amlodipine

• telmisartan-hydrochlorothiazid

• tenofovir disoproxil fumarate

• Tenoretic 100

• Tenoretic 50

• Tenormin

• Teveten

• Teveten Hct

• ticagrelor

• timolol maleate

• Toprol Xl

• torsemide

• trandolapril

• trandolapril-verapamil

• Tri-buffered Aspirin

• triamcinolone acetonide

• triamcinolone hexacetonide

• triamcinolone-lidocaine

• triamterene

• triamterene-hydrochlorothiazid

• Tribenzor

• Trombonex-d

• Truvada

• Twynsta

• Uceris

• Uniretic

• Univasc

• valsartan-hydrochlorothiazide

• Vanquish

• Vasculera

• Vaseretic

• Vasoflex Hd

• Vasotec

• Venaliv

• venlafaxine

• Veripred 20

• Vestura (28)

• Vfend

• Vfend Iv

• Viibryd

• vilazodone

• Viread

• vit C-but.broom-hesperidn-dios

• vit C-dios-rut-bioflav-butc br

• voriconazole

• vortioxetine

• Women's Aspirin With Calcium

• Yasmin (28)

• Yaz 28

• zafirlukast

• Zarah

• Zebeta

• Zestoretic

• Zestril

• Ziac

• Zoloft

Moderate

• Acidosis

• Chronic heart failure

• Chronic obstructive pulmonary disease

• Disease of liver

• Hypertension

• Hyperthyroidism

• Hypoxia

• Increased risk of bleeding due to coagulation disorder

• Tobacco smoker

Chlorpheniramine

• Severity Level:

  2

• Additional Notes: Insufficient data available; neonate risk of seizures;avoid during 3rd trimester

Ibuprofen

• Severity Level:

  1

• Additional Notes: Premature closure of ductus arteriosus, 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

Ibuprofen

Low levels in breast milk, with no known resulting adverse effect on infant

General	Excretion Potential	Effect on Infant	Notes
No known risks; does not adversely affect lactation	Excreted	No adverse effect	Low levels in breast milk, with no known resulting adverse effect on infant

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.

Gastrointestinal-Risk for ulceration or serious GI bleed; highest with history of PUD or GI bleed. Renal-Risk of AKI and exacerbation of CKD. Avoid with CrCl <30 mL/min. Cardiovascular-May exacerbate pre-existing hypertension or CHF. Risk of MI and stroke. This risk may occur early in treatment and increases with duration of use. Risk for reinfarction with minimal NSAID use post-MI. Contraindicated with CABG. Hepatic-Elevated hepatic transaminases may occur with chronic use.

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

Ibuprofen

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.

Gastrointestinal-Risk for ulceration or serious GI bleed; highest with history of PUD or GI bleed. Renal-Risk of AKI and exacerbation of CKD. Avoid with CrCl <30 mL/min. Cardiovascular-May exacerbate pre-existing hypertension or CHF. Risk of MI and stroke. This risk may occur early in treatment and increases with duration of use. Risk for reinfarction with minimal NSAID use post-MI. Contraindicated with CABG. Hepatic-Elevated hepatic transaminases may occur with chronic use.

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	Y	Y	Y	N	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.

Gastrointestinal-Risk for ulceration or serious GI bleed; highest with history of PUD or GI bleed. Renal-Risk of AKI and exacerbation of CKD. Avoid with CrCl <30 mL/min. Cardiovascular-May exacerbate pre-existing hypertension or CHF. Risk of MI and stroke. This risk may occur early in treatment and increases with duration of use. Risk for reinfarction with minimal NSAID use post-MI. Contraindicated with CABG. Hepatic-Elevated hepatic transaminases may occur with chronic use.

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

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)