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
PhenylephrineStimulates postsynaptic alpha-receptors, resulting in vasoconstriction, which reduces nasal congestion.
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 doseThe following maximum doses are according to the prescribing information:
Adults and Children 12 y of age and olderPhenylephrine tannate 60 mg/day, chlorpheniramine tannate 24 mg/day, pyrilamine tannate 150 mg/day (60 mL/day).
Children 6 to 11 y of agePhenylephrine tannate 20 mg/day, chlorpheniramine tannate 8 mg/day, pyrilamine tannate 50 mg/day (20 mL/day).
Children 2 to 5 y of agePhenylephrine tannate 10 mg/day, chlorpheniramine tannate 4 mg/day, pyrilamine tannate 25 mg/day (10 mL/day).
Adults FDA-approved uses Upper respiratory tract conditionsFor specific dosing by product, see the individual manufacturer prescribing information.
Usual dosage30 mL every 12 h.
Maximum dosagePhenylephrine tannate 60 mg/day, chlorpheniramine tannate 24 mg/day, pyrilamine tannate 150 mg/day (60 mL/day).
Children FDA-approved uses Upper respiratory tract conditionsFor specific dosing by product, see the individual manufacturer prescribing information.
12 y of age and older Usual dosage30 mL every 12 h.
Maximum dosagePhenylephrine tannate 60 mg/day, chlorpheniramine tannate 24 mg/day, pyrilamine tannate 150 mg/day (60 mL/day).
6 to 11 y of age Usual dosage5 to 10 mL every 12 h.
Maximum dosagePhenylephrine tannate 20 mg/day, chlorpheniramine tannate 8 mg/day, pyrilamine tannate 50 mg/day (20 mL/day).
2 to 5 y of age Usual dosage2.5 to 5 mL every 12 h.
Maximum dosagePhenylephrine tannate 10 mg/day, chlorpheniramine tannate 4 mg/day, pyrilamine tannate 25 mg/day (10 mL/day).
Younger than 2 y of ageTitrate dose individually. Contraindicated in newborns.
ElderlyChlorpheniramine 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.
