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brompheniramine, diphenhydramine, and phenylephrine

Generic Name: brompheniramine, diphenhydramine, and phenylephrine (BROM fen IR a meen, DYE fen HYE dra meen, FEN il EFF rin)
Brand Name: Ala-Hist D

What is brompheniramine, diphenhydramine, and phenylephrine?

Brompheniramine and diphenhydramine are antihistamines that reduce the effects of the natural chemical histamine in the body. Histamine can produce symptoms of sneezing, itching, watery eyes, and runny nose.

Phenylephrine is a decongestant that shrinks blood vessels in the nasal passages. Dilated blood vessels can cause nasal congestion (stuffy nose).

The combination of brompheniramine, diphenhydramine, and phenylephrine is used to treat runny or stuffy nose, sneezing, itching, watery eyes, and sinus congestion caused by allergies, the common cold, or the flu.

Brompheniramine, diphenhydramine, and phenylephrine may also be used for purposes not listed in this medication guide.

What is the most important information I should know about brompheniramine, diphenhydramine, and phenylephrine?

Do not give this medication to a child younger than 4 years old. Always ask a doctor before giving a cough or cold medicine to a child. Death can occur from the misuse of cough and cold medicines in very young children.

You should not use this medication if you have severe constipation, a blockage in your stomach or intestines, or if you are unable to urinate.

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Do not use cold medicine if you have untreated or uncontrolled diseases such as glaucoma, asthma or COPD, high blood pressure, heart disease, coronary artery disease, or overactive thyroid.

Do not use a cold medicine if you have used an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate) in the last 14 days. A dangerous drug interaction could occur, leading to serious side effects.

What should I discuss with my healthcare provider before taking brompheniramine, diphenhydramine, and phenylephrine?

Do not use a cold medicine if you have used an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate) in the last 14 days. A dangerous drug interaction could occur, leading to serious side effects.

You should not use this medication if you have severe constipation, a blockage in your stomach or intestines, or if you are unable to urinate.

Do not use cold medicine if you have untreated or uncontrolled diseases such as glaucoma, asthma or COPD, high blood pressure, heart disease, coronary artery disease, or overactive thyroid.

Ask a doctor or pharmacist if it is safe for you to take this medication if you have:

  • a blockage in your digestive tract (stomach or intestines), a colostomy or ileostomy;

  • diabetes;

  • liver or kidney disease;

  • epilepsy or other seizure disorder;

  • cough with mucus, or cough caused by smoking, emphysema, or chronic bronchitis;

  • enlarged prostate or urination problems;

  • low blood pressure;

  • pheochromocytoma (an adrenal gland tumor); or

  • if you take potassium (Cytra, Epiklor, K-Lyte, K-Phos, Kaon, Klor-Con, Polycitra, Urocit-K).

FDA pregnancy category C. It is not known whether this medication will harm an unborn baby. Do not use cough or cold medicine without medical advice if you are pregnant.

This medicine may pass into breast milk and may harm a nursing baby. Antihistamines and decongestants may also slow breast milk production. Do not use cough or cold medicine without medical advice if you are breast-feeding a baby.

How should I take brompheniramine, diphenhydramine, and phenylephrine?

Use exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended. Cold medicine is usually taken only for a short time until your symptoms clear up.

Do not give this medication to a child younger than 4 years old. Always ask a doctor before giving a cough or cold medicine to a child. Death can occur from the misuse of cough and cold medicines in very young children.

Do not take for longer than 7 days in a row. Talk with your doctor if your symptoms do not improve after 7 days of treatment, or if you have a fever with a headache or skin rash.

If you need surgery or medical tests, tell the surgeon or doctor ahead of time if you have taken a cold medicine within the past few days.

Store at room temperature away from moisture and heat.

What happens if I miss a dose?

Since cold medicine is taken when needed, you may not be on a dosing schedule. If you are taking the medication regularly, take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include severe forms of some of the side effects listed in this medication guide.

What should I avoid while taking brompheniramine, diphenhydramine, and phenylephrine?

This medicine may cause blurred vision and may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert and able to see clearly.

Drinking alcohol can increase certain side effects of this medication.

Ask a doctor or pharmacist before using any other cold, allergy, cough, or sleep medicine. Antihistamines and decongestants are contained in many combination medicines. Taking certain products together can cause you to get too much of a certain drug. Check the label to see if a medicine contains an antihistamine or decongestant.

Avoid taking this medication if you also take diet pills, caffeine pills, or other stimulants (such as ADHD medications). Taking a stimulant together with a decongestant can increase your risk of unpleasant side effects.

Avoid becoming overheated or dehydrated during exercise and in hot weather. This medication can decrease sweating and you may be more prone to heat stroke.

Brompheniramine, diphenhydramine, and phenylephrine side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Stop using this medicine and call your doctor at once if you have a serious side effect such as:

  • fast or uneven heart rate;

  • mood changes;

  • tremor, seizure (convulsions);

  • easy bruising or bleeding, unusual weakness;

  • urinating less than usual or not at all;

  • feeling short of breath; or

  • dangerously high blood pressure (severe headache, blurred vision, buzzing in your ears, anxiety, confusion, chest pain, uneven heartbeats, seizure).

Less serious side effects may include:

  • dizziness, drowsiness;

  • dry mouth, nose, or throat;

  • constipation;

  • blurred vision; or

  • feeling nervous or restless.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Brompheniramine, diphenhydramine, and phenylephrine dosing information

Usual Adult Dose for Allergic Rhinitis:

Brompheniramine/diphenhydramine/phenylephrine 6 mg-25 mg-20 mg oral tablet, extended release:
1 to 2 tablets orally every 12 hours not to exceed 4 tablets daily.

Usual Adult Dose for Cold Symptoms:

Brompheniramine/diphenhydramine/phenylephrine 6 mg-25 mg-20 mg oral tablet, extended release:
1 to 2 tablets orally every 12 hours not to exceed 4 tablets daily.

Usual Pediatric Dose for Allergic Rhinitis:

Brompheniramine/diphenhydramine/phenylephrine 6 mg-25 mg-20 mg oral tablet, extended release:
6 to 11 years: 0.5 to 1 tablet orally every 12 hours not to exceed 2 tablets daily.
12 years or older: 1 to 2 tablets orally every 12 hours not to exceed 4 tablets daily.

Usual Pediatric Dose for Cold Symptoms:

Brompheniramine/diphenhydramine/phenylephrine 6 mg-25 mg-20 mg oral tablet, extended release:
6 to 11 years: 0.5 to 1 tablet orally every 12 hours not to exceed 2 tablets daily.
12 years or older: 1 to 2 tablets orally every 12 hours not to exceed 4 tablets daily.

What other drugs will affect brompheniramine, diphenhydramine, and phenylephrine?

Ask a doctor or pharmacist before using this medicine if you regularly use other medicines that make you sleepy (such as narcotic pain medication, sedatives, sleeping pills, muscle relaxers, and medicine for seizures, depression or anxiety). They can add to sleepiness caused by brompheniramine and diphenhydramine.

Ask a doctor or pharmacist if it is safe for you to take this medication if you are also using any of the following drugs:

  • atropine (Atreza, Sal-Tropine);

  • benztropine (Cogentin);

  • diphenhydramine (Benadryl) applied to the skin;

  • topiramate (Topamax);

  • zonisamide (Zonegran);

  • anti-nausea medications such as belladonna (Donnatal), dimenhydrinate (Dramamine), droperidol (Inapsine), methscopolamine (Pamine), or scopolamine (Transderm Scop);

  • bladder or urinary medications such as darifenacin (Enablex), flavoxate (Urispas), oxybutynin (Ditropan, Oxytrol), solifenacin (Vesicare), tolterodine (Detrol), or Urogesic Blue;

  • bronchodilators such as ipratropium (Atrovent) or tiotropium (Spiriva);

  • irritable bowel medications such as dicyclomine (Bentyl), hyoscyamine (Hyomax), or propantheline (Pro Banthine); or

  • ulcer medicine such as glycopyrrolate (Robinul) or mepenzolate (Cantil).

This list is not complete and other drugs may interact with brompheniramine, diphenhydramine, and phenylephrine. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

  • Your pharmacist can provide more information about brompheniramine, diphenhydramine, and phenylephrine.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 1.01. Revision Date: 2011-11-16, 12:45:11 PM.

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