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Phenylephrine Tannate / Chlorpheniramine Tannate / Pyrilamine Tannate

Pronunciation: FEN-il-EF-rin TAN-ate/KLOR-fen-IR-a-meen TAN-ate/pir-IL-a-meen TAN-ate
Class: Antihistamine, Decongestant, Vasopressor used in shock

Trade Names

Triotann Pediatric
- Suspension phenylephrine 5 mg, chlorpheniramine 2 mg, pyrilamine 12.5 mg

Triotann-S Pediatric
- Suspension phenylephrine 5 mg, chlorpheniramine 2 mg, pyrilamine 12.5 mg

Pharmacology

Phenylephrine

Stimulates postsynaptic alpha-receptors, resulting in vasoconstriction, which reduces nasal congestion.

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Chlorpheniramine and pyrilamine

Competitively antagonizes histamine at H 1 receptor sites.

Indications and Usage

Symptomatic relief of coryza and nasal congestion associated with common cold, sinusitis, allergic rhinitis, and other upper respiratory tract conditions.

Contraindications

Newborns; breast-feeding mothers; sensitivity to any component of product.

Dosage and Administration

Maximum dose

The following maximum doses are according to the prescribing information:

Adults and Children 12 y of age and older

Phenylephrine tannate 60 mg/day, chlorpheniramine tannate 24 mg/day, pyrilamine tannate 150 mg/day (60 mL/day).

Children 6 to 11 y of age

Phenylephrine tannate 20 mg/day, chlorpheniramine tannate 8 mg/day, pyrilamine tannate 50 mg/day (20 mL/day).

Children 2 to 5 y of age

Phenylephrine tannate 10 mg/day, chlorpheniramine tannate 4 mg/day, pyrilamine tannate 25 mg/day (10 mL/day).

Adults FDA-approved uses Upper respiratory tract conditions

For specific dosing by product, see the individual manufacturer prescribing information.

Usual dosage

30 mL every 12 h.

Maximum dosage

Phenylephrine tannate 60 mg/day, chlorpheniramine tannate 24 mg/day, pyrilamine tannate 150 mg/day (60 mL/day).

Children FDA-approved uses Upper respiratory tract conditions

For specific dosing by product, see the individual manufacturer prescribing information.

12 y of age and older Usual dosage

30 mL every 12 h.

Maximum dosage

Phenylephrine tannate 60 mg/day, chlorpheniramine tannate 24 mg/day, pyrilamine tannate 150 mg/day (60 mL/day).

6 to 11 y of age Usual dosage

5 to 10 mL every 12 h.

Maximum dosage

Phenylephrine tannate 20 mg/day, chlorpheniramine tannate 8 mg/day, pyrilamine tannate 50 mg/day (20 mL/day).

2 to 5 y of age Usual dosage

2.5 to 5 mL every 12 h.

Maximum dosage

Phenylephrine tannate 10 mg/day, chlorpheniramine tannate 4 mg/day, pyrilamine tannate 25 mg/day (10 mL/day).

Younger than 2 y of age

Titrate dose individually. Contraindicated in newborns.

Elderly

Chlorpheniramine and pyrilamine are more likely to cause dizziness, sedation, and hypotension in elderly patients.

General Advice

  • Shake well before measuring dose.
  • Give with food or milk if GI upset occurs.
  • Use dosing spoon or syringe for pediatric doses.

Storage/Stability

Store between 59° and 77°F. Protect from freezing.

Drug Interactions

MAOIs (eg, isocarboxazid [certain drugs for depression, psychiatric or emotional conditions, Parkinson disease])

Do not use in patients receiving MAOI therapy or within 14 days of stopping such treatment. May prolong and intensify the effects of chlorpheniramine, pyrilamine, and phenylephrine.

Laboratory Test Interactions

May interfere with diagnostic test results for skin tests using allergen extracts.

Adverse Reactions

CNS

Drowsiness, sedation.

GI

GI effects.

Miscellaneous

Dryness of mucous membranes.

Precautions

Pregnancy

Category C .

Lactation

Do not administer.

Elderly

Chlorpheniramine and pyrilamine are more likely to cause dizziness, sedation, and hypotension in the elderly.

Special Risk Patients

Use with caution in patients with hypertension, heart disease, hyperthyroidism, narrow angle glaucoma, diabetes mellitus, and prostatic hypertrophy.

Excitation

Chlorpheniramine and pyrilamine may cause excitation in children; however, combination with phenylephrine may cause mild stimulation or mild sedation.

Overdosage

Symptoms

CNS depression, CNS stimulation, convulsions, death.

Patient Information

  • Remind patient to shake well before measuring dose.
  • Advise patient to take prescribed dose every 12 h as needed.
  • Advise caregiver to use dosing spoon or syringe when giving suspension to children.
  • Advise patient to take with food or milk if GI upset occurs.
  • Advise patient to take last dose late in the afternoon or early evening to reduce chance of drug causing sleeplessness.
  • Advise patient that if a dose is missed to take as soon as remembered unless it is nearing time for the next dose. Caution patient to not double the dose to catch up.
  • Advise patient that if allergy symptoms are not controlled, not to increase the dose of medication but to inform health care provider.
  • Caution patient that drug may cause drowsiness and to use caution while driving or performing other tasks requiring mental alertness until tolerance is determined.
  • Advise patient to avoid alcohol and other CNS depressants due to risk of excessive sedation.
  • Caution patient not to take any OTC antihistamines or decongestants while taking this medication unless advised by health care provider.
  • If patient is to have allergy skin testing, advise not to take the medication for at least 6 days before the skin testing.
  • Instruct patient to stop taking drug and immediately report any of the following symptoms to health care provider: dizziness, nervousness, sleeplessness.

Copyright © 2009 Wolters Kluwer Health.

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