Chlorpheniramine Maleate
Pronouncation: (klor-fen-AIR-uh-meen MAL-ee-ate)Class: Alkylamine, nonselective
Trade Names:
Aller-Chlor
- Tablets 4 mg
- Syrup 2 mg per 5 mL
Trade Names:
Allergy
- Tablets 4 mg
Trade Names:
Allergy Relief
- Tablets 4 mg
Trade Names:
Chlor-Trimeton
- Tablets 4 mg
Trade Names:
Chlor-Trimeton Allergy 8 Hour
- Tablets, extended-release 8 mg
Trade Names:
Chlor-Trimeton Allergy 12 Hour
- Tablets, extended-release 12 mg
Trade Names:
Chlorpheniramine Maleate
- Capsules, sustained-release 8 mg
- Capsules, sustained-release 12 mg
Trade Names:
Chlorpheniramine Maleate
- Tablets 4 mg
Pharmacology
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Feedback for Chlorpheniramine Maleate
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Competitively antagonizes histamine at H 1 receptor sites.
Pharmacokinetics
Absorption
Readily absorbed.
Distribution
72% protein bound.
Metabolism
Metabolized predominantly in the liver, but also in the lung and kidneys.
Elimination
Renally eliminated, mostly as metabolites within 24 h.
Indications and Usage
Temporary relief of sneezing, itchy, watery eyes, itchy nose or throat, and runny nose caused by hay fever (allergic rhinitis), or other respiratory allergies.
Contraindications
Hypersensitivity to antihistamines; narrow-angle glaucoma; stenosing peptic ulcer; symptomatic prostatic hypertrophy; asthmatic attack; bladder neck obstruction; pyloroduodenal obstruction; MAO therapy; use in newborn or premature infants and in breast-feeding mothers.
Dosage and Administration
Immediate-release tablet or syrupAdults and children 12 yr of age and older
PO 4 mg every 4 to 6 h (max, 24 mg/day).
Children 6 to younger than 12 yr of agePO 2 mg every 4 to 6 h (max, 12 mg/day).
Children younger than 5 yr of agePO As recommended by health care provider.
Extended-release tabletsAdults and children 12 yr of age and older
PO 8 mg every 8 to 12 h or 12 mg every 12 h (max, 24 mg/day).
Extended-release capsulesAdults and children 12 yr of age and older
PO 8 or 12 mg in the morning and evening (max, 24 mg/day).
General Advice
- Administer without regard to meals. Administer with food if GI upset occurs.
- Measure and administer prescribed dose of oral syrup using dosing syringe, dosing spoon, or dosing cup.
- Advise patient receiving extended-release tablets or sustained-release capsules to swallow tablets or capsules whole and not to crush, chew, break, or open.
Storage/Stability
Store all dose forms at controlled room temperature (59° to 86°F).
Drug Interactions
Alcohol, CNS depressants, and tricyclic antidepressantsMay cause additive CNS depressant effects.
MAOIsMay increase anticholinergic effects of chlorpheniramine.
Ototoxic medicationsConcurrent use may mask the symptoms of ototoxicity.
Laboratory Test Interactions
Skin testing proceduresAntihistamines may prevent or diminish otherwise positive reaction to dermal reactivity indicators.
Adverse Reactions
Cardiovascular
Bradycardia; extrasystoles; orthostatic hypotension; palpitations; reflex tachycardia; tachycardia.
CNS
Confusion; convulsions; disturbed coordination; dizziness; drowsiness; euphoria; excitation; faintness; fatigue; headache; hysteria; insomnia; irritability; nervousness; neuritis; paresthesias; restlessness; sedation; tremor; vertigo.
EENT
Acute labyrinthitis; blurred vision; diplopia; dry nose and throat; nasal stuffiness; sore throat; tinnitus.
GI
Anorexia; constipation; diarrhea; dry mouth; epigastric distress; nausea; vomiting.
Genitourinary
Difficult urination; dysuria; early menses; urinary frequency or retention.
Hematologic
Agranulocytosis; hemolytic anemia; thrombocytopenia.
Metabolic
Increased appetite; weight gain.
Respiratory
Chest tightness; respiratory depression; thickening of bronchial secretions; wheezing.
Miscellaneous
Chills; excessive perspiration; hypersensitivity reactions; photosensitivity.
Precautions
MonitorAllergy symptomsAssess allergy symptoms (eg, cough, rhinitis, nasal congestion, sneezing, watery eyes, or itching nose, throat, or eyes) before starting therapy and periodically during therapy. Notify health care provider if symptoms are not improving or are getting worse. Dizziness/DrowsinessMonitor patient for dizziness and excessive drowsiness. If noted, hold therapy and notify health care provider. Review therapyEnsure therapy periodically is reviewed to determine if it needs to be continued without change or if a dose change (eg, increase, decrease, discontinuation) is indicated. |
Pregnancy
Category C . Do not use during third trimester.
Lactation
Contraindicated in breast-feeding mothers.
Children
Overdosage may cause hallucinations, convulsions, and death. Antihistamines may diminish mental alertness. In young children, they may produce paradoxical excitation. Contraindicated in newborn or premature infants. Sustained-release form not recommended in children younger than 12 yr of age.
Elderly
Use with caution, usually starting at the low end of the dosage range because of the greater frequency of decreased hepatic, renal, or cardiac function, and concomitant diseases or other drug therapy.
Hypersensitivity
May occur. Have epinephrine 1:1,000 immediately available.
Hepatic Function
Use drug with caution in patients with cirrhosis or other liver disease.
Special Risk Patients
Use drug with caution in patients with predisposition to urinary retention, history of bronchial asthma, increased IOP, hyperthyroidism, CV disease, or hypertension. Avoid in patients with sleep apnea.
RESP disease
Generally not recommended to treat lower respiratory tract symptoms, including asthma.
Overdosage
Symptoms
CNS depression (including sedation, apnea, CV collapse), CNS stimulation (including insomnia, hallucination, tremors, convulsions), tinnitus, blurred vision, dizziness, ataxia, hypotension. Stimulation and atropine-like signs and symptoms (including dry mouth, fixed dilated pupils, flushing, hyperthermia, GI symptoms) are more likely in children.
Patient Information
- Caution patient using OTC chlorpheniramine that each product has specific dosing instructions and to read package label before using and not to exceed dose or frequency of administration instructions.
- Advise patient to take each dose without regard to meals, but to take with food if stomach upset occurs.
- Advise patient or caregiver using oral syrup to measure and administer prescribed dose using dosing syringe, dosing spoon, or dosing cup.
- Advise patient that if a dose is missed, to take it as soon as possible unless it is nearing time for the next scheduled dose. If it is nearing time for next scheduled dose, advise patient to skip the missed dose and take the next dose at the regularly scheduled time. Caution patient not to double the dose to catch up.
- Advise patient that if allergy symptoms are not controlled, not to increase the dose of medication or frequency of use but to inform health care provider. Caution patient that larger doses or more frequent dosing does not increase efficacy and may cause excessive drowsiness or other adverse reactions.
- Instruct patient to stop taking drug and immediately report any of these symptoms to health care provider: persistent dizziness; excessive drowsiness; severe dry mouth, nose, or throat; flushing; unexplained shortness of breath or difficulty breathing; unusual tiredness or weakness; sore throat, fever, or other signs of infection; bleeding or unusual bruising; fast or irregular heartbeat; excitability, confusion, or changes in thinking or behavior; chest tightness; difficulty with urination.
- Advise patient medication may cause drowsiness or dizziness and not to drive or perform other activities requiring mental alertness until tolerance is determined.
- Advise patient to take sips of water, suck on ice chips or sugarless hard candy, or chew sugarless gum if dry mouth occurs.
- Caution patient alcohol and other CNS depressants (eg, sedatives) will have additional sedative effects if taken with chlorpheniramine.
- Caution patient not to take any other OTC antihistamines while taking this medication unless advised by health care provider.
- Caution patient that medication may cause sensitivity to sunlight and to avoid excessive exposure to the sun or UV light (eg, tanning booths) and to wear protective clothing and use sunscreens until tolerance is determined.
- If patient is to have allergy skin testing, advise patient not to take the medication for at least 4 days before the skin testing.
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More Chlorpheniramine Maleate resources:
QDALL AR Sustained-Release Capsules
Aller-Chlor - Includes detailed dosage instructions.
Chlorpheniramine Maleate Images
Chlorpheniramine Maleate Drug Interactions
Allergic Reactions, Hay Fever, Hives, Cold Symptoms
