Chlorpheniramine/ dihydrocodeine/ phenylephrine liquid

Generic Name: chlorpheniramine/dihydrocodeine/phenylephrine (KLOR-fen-IR-a-meen/dye-HYE-droe-KOE-deen/FEN-il-EF-rin)
Brand Name: Examples include Duohist DH and Despec-PD

Some children have had serious and sometimes fatal breathing problems when using codeine after surgery to remove tonsils or adenoids. Talk with your doctor for more information.


Chlorpheniramine/ dihydrocodeine/ phenylephrine liquid is used for:

Treating symptoms of the common cold, flu, or hay fever, and other upper respiratory allergies such as cough, congestion, runny nose, sneezing, itching of the nose and throat, and itchy, watery eyes. It may also be used for other conditions as determined by your doctor.

Chlorpheniramine/dihydrocodeine/phenylephrine liquid is a narcotic antitussive (cough suppressant), antihistamine, and decongestant combination. The antitussive works by suppressing the cough center in the brain. The antihistamine works by blocking the action of histamine, which reduces the symptoms of an allergic reaction such as itchy, watery eyes and runny nose. The decongestant shrinks swollen nasal passages, which relieves nasal congestion.

Do NOT use chlorpheniramine/ dihydrocodeine/ phenylephrine liquid if:

  • you are allergic to any ingredient in chlorpheniramine/dihydrocodeine/phenylephrine liquid or any other codeine-related medicine (eg, codeine)
  • you have diarrhea associated with poisoning, antibiotic use, or a bacterial infection (from eating or drinking contaminated food or water)
  • you have severe high blood pressure, severe heart blood vessel disease, rapid heartbeat, or severe heart problems
  • you are taking sodium oxybate (GHB) or you have taken furazolidone or a monoamine oxidase inhibitor (MAOI) (eg, phenelzine) within the last 14 days
  • the patient is a child and has just had surgery to remove tonsils or adenoids

Contact your doctor or health care provider right away if any of these apply to you.

Before using chlorpheniramine/ dihydrocodeine/ phenylephrine liquid:

Some medical conditions may interact with chlorpheniramine/dihydrocodeine/phenylephrine liquid. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you have a history of alcohol or drug abuse, dependence on narcotics, or suicidal thoughts or behaviors
  • if you have increased pressure in the head, an unusual growth in the brain (eg, tumor), a recent head injury, Parkinson disease, Reye syndrome, the blood disease porphyria, or a blockage of your stomach, bowel, or bladder
  • if you have a history of epilepsy or seizures, asthma or other breathing problems (eg, sleep apnea), stomach or intestinal problems, chronic constipation, liver problems, glaucoma, an enlarged prostate gland or other prostate problems, difficulty urinating, heart problems, diabetes, high blood pressure, blood vessel problems, adrenal gland problems, overactive thyroid, seizures, or stroke
  • if you have recently had abdominal surgery

Some MEDICINES MAY INTERACT with chlorpheniramine/dihydrocodeine/phenylephrine liquid. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Barbiturate anesthetics (eg, thiopental), beta-blockers (eg, propranolol), cimetidine, catechol-O-methyltransferase (COMT) inhibitors (eg, tolcapone), furazolidone, indomethacin, ketorolac, MAOIs (eg, phenelzine), naltrexone, sodium oxybate (GHB), or tricyclic antidepressants (eg, amitriptyline) because they may increase the risk of chlorpheniramine/dihydrocodeine/phenylephrine liquid's side effects, including dangerous sleepiness and a decrease in the ability to breathe
  • Digoxin or droxidopa because the risk of irregular heartbeat or heart attack may be increased
  • Rifampin or risperidone because they may decrease chlorpheniramine/dihydrocodeine/phenylephrine liquid's effectiveness
  • Bromocriptine or hydantoins (eg, phenytoin) because their actions and the risk of their side effects may be increased by chlorpheniramine/dihydrocodeine/phenylephrine liquid
  • Guanadrel, guanethidine, mecamylamine, methyldopa, mexiletine, or reserpine because their effectiveness may be decreased by chlorpheniramine/dihydrocodeine/phenylephrine liquid
  • Naltrexone because it may decreases chlorpheniramine/dihydrocodeine/phenylephrine liquid's effectiveness and withdrawal symptoms may occur in patients who have become physically dependent on opioids. You must not take naltrexone until you have stopped taking chlorpheniramine/dihydrocodeine/phenylephrine liquid for 7 to 10 days and after a naloxone challenge test is negative.

This may not be a complete list of all interactions that may occur. Ask your health care provider if chlorpheniramine/dihydrocodeine/phenylephrine liquid may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use chlorpheniramine/ dihydrocodeine/ phenylephrine liquid:

Use chlorpheniramine/dihydrocodeine/phenylephrine liquid as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • Take chlorpheniramine/dihydrocodeine/phenylephrine liquid by mouth with or without food. If stomach upset occurs, take with food to reduce stomach irritation.
  • Use a measuring device marked for medicine dosing. Ask your pharmacist for help if you are unsure of how to measure your dose.
  • If you miss a dose of chlorpheniramine/dihydrocodeine/phenylephrine liquid and you are taking it regularly, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use chlorpheniramine/dihydrocodeine/phenylephrine liquid.

Important safety information:

  • Chlorpheniramine/dihydrocodeine/phenylephrine liquid may cause drowsiness or dizziness. These effects may be worse if you take it with alcohol or certain medicines. Use chlorpheniramine/dihydrocodeine/phenylephrine liquid with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
  • Do not drink alcohol or use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are using chlorpheniramine/dihydrocodeine/phenylephrine liquid; it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness.
  • If your symptoms do not get better within 7 days or if they get worse, or if you develop a high fever or persistent headache, check with your doctor.
  • Use chlorpheniramine/dihydrocodeine/phenylephrine liquid with caution in the ELDERLY; they may be more sensitive to its effects, especially possible breathing problems and drowsiness.
  • Chlorpheniramine/dihydrocodeine/phenylephrine liquid should be used with extreme caution in CHILDREN; safety and effectiveness in children have not been confirmed.
  • PREGNANCY and BREAST-FEEDING: It is not known if chlorpheniramine/dihydrocodeine/phenylephrine liquid can cause harm to the fetus. If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using chlorpheniramine/dihydrocodeine/phenylephrine liquid while you are pregnant. Chlorpheniramine/dihydrocodeine/phenylephrine liquid is found in breast milk. If you are or will be breast-feeding while you use chlorpheniramine/dihydrocodeine/phenylephrine liquid, check with your doctor. Discuss any possible risks to your baby.

When used for long periods of time or at high doses, chlorpheniramine/dihydrocodeine/phenylephrine liquid may not work as well and may require higher doses to obtain the same effect as when originally taken. This is known as TOLERANCE. Talk with your doctor if chlorpheniramine/dihydrocodeine/phenylephrine liquid stops working well. Do not take more than prescribed.

When used for longer than a few weeks or at high doses, some people develop a need to continue taking chlorpheniramine/dihydrocodeine/phenylephrine liquid. This is known as DEPENDENCE or addiction. If you suddenly stop taking chlorpheniramine/dihydrocodeine/phenylephrine liquid, you may experience WITHDRAWAL symptoms including anxiety; diarrhea; fever, runny nose, or sneezing; goose bumps and abnormal skin sensations; nausea; vomiting; pain; rigid muscles; rapid heartbeat; seeing, hearing, or feeling things that are not there; shivering or tremors; sweating; and trouble sleeping.

Possible side effects of chlorpheniramine/ dihydrocodeine/ phenylephrine liquid:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Constipation; dizziness; drowsiness; dry mouth, throat, or nose; excitement; nausea; stomach upset; thickening or mucus in nose or throat.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); difficulty urinating; fast or irregular heartbeat; flushing or redness of face.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include agitation; coma; confusion; deep sleep or loss of consciousness; difficulty breathing; diminished mental alertness; hallucinations; hot or cold skin; large and unchanging pupils; sedation; seizures; shaking; sleeplessness; slow heartbeat; slowed breathing.

Proper storage of chlorpheniramine/dihydrocodeine/phenylephrine liquid:

Store chlorpheniramine/dihydrocodeine/phenylephrine liquid at room temperature, between 59 and 86 degrees F (15 and 30 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep chlorpheniramine/dihydrocodeine/phenylephrine liquid out of the reach of children and away from pets.

General information:

  • If you have any questions about chlorpheniramine/dihydrocodeine/phenylephrine liquid, please talk with your doctor, pharmacist, or other health care provider.
  • Chlorpheniramine/dihydrocodeine/phenylephrine liquid is to be used only by the patient for whom it is prescribed. Do not share it with other people.
  • If your symptoms do not improve or if they become worse, check with your doctor.
  • Check with your pharmacist about how to dispose of unused medicine.

This information should not be used to decide whether or not to take chlorpheniramine/dihydrocodeine/phenylephrine liquid or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about chlorpheniramine/dihydrocodeine/phenylephrine liquid. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to chlorpheniramine/dihydrocodeine/phenylephrine liquid. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using chlorpheniramine/dihydrocodeine/phenylephrine liquid.

Issue Date: November 5, 2014
Database Edition 14.4.1.002
Copyright © 2014 Wolters Kluwer Health, Inc.

Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.

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