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Chlorpheniramine/ dihydrocodeine/ pseudoephedrine syrup
Generic Name: chlorpheniramine/dihydrocodeine/pseudoephedrine (klor-fen-EER-a-meen/dye-hye-droe-KOE-deen/sue-do-eh-FED-rin)
Brand Name: Examples include Pancof and Tricof
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/ pseudoephedrine syrup 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. Chlorpheniramine/dihydrocodeine/pseudoephedrine syrup may also be used for other conditions as determined by your doctor.
Chlorpheniramine/dihydrocodeine/pseudoephedrine syrup 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 itch, watery eyes and runny nose. The decongestant shrinks swollen nasal passages, which relieves nasal congestion.
Do NOT use chlorpheniramine/ dihydrocodeine/ pseudoephedrine syrup if:
- you are allergic to any ingredient in chlorpheniramine/dihydrocodeine/pseudoephedrine syrup 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 if you have taken furazolidone or a monoamine oxidase (MAO) inhibitor (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/ pseudoephedrine syrup:
Some medical conditions may interact with chlorpheniramine/dihydrocodeine/pseudoephedrine syrup. 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/pseudoephedrine syrup. 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, MAO inhibitors (eg, phenelzine), naltrexone, sodium oxybate (GHB), or tricyclic antidepressants (eg, amitriptyline) because side effects of chlorpheniramine/dihydrocodeine/pseudoephedrine syrup may be increased, 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 the effectiveness of chlorpheniramine/dihydrocodeine/pseudoephedrine syrup may be decreased
- Bromocriptine or hydantoins (eg, phenytoin) because the actions and side effects may be increased by chlorpheniramine/dihydrocodeine/pseudoephedrine syrup
- Guanadrel, guanethidine, mecamylamine, methyldopa, mexiletine, or reserpine because the effectiveness may be decreased by chlorpheniramine/dihydrocodeine/pseudoephedrine syrup
- Naltrexone because the effectiveness of chlorpheniramine/dihydrocodeine/pseudoephedrine syrup will be decreased 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/pseudoephedrine syrup 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/pseudoephedrine syrup 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/ pseudoephedrine syrup:
Use chlorpheniramine/dihydrocodeine/pseudoephedrine syrup as directed by your doctor. Check the label on the medicine for exact dosing instructions.
- Chlorpheniramine/dihydrocodeine/pseudoephedrine syrup may be taken 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/pseudoephedrine syrup 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/pseudoephedrine syrup.
Important safety information:
- Chlorpheniramine/dihydrocodeine/pseudoephedrine syrup may cause dizziness or drowsiness. Do not drive, operate machinery, or do anything else that could be dangerous until you know how you react to chlorpheniramine/dihydrocodeine/pseudoephedrine syrup. Using chlorpheniramine/dihydrocodeine/pseudoephedrine syrup alone, with other medicines, or with alcohol may lessen your ability to drive or to perform other potentially dangerous tasks.
- Do not drink alcohol while you are using chlorpheniramine/dihydrocodeine/pseudoephedrine syrup. Avoid taking other medications that cause drowsiness (eg, sedatives, tranquilizers) while taking chlorpheniramine/dihydrocodeine/pseudoephedrine syrup. Chlorpheniramine/dihydrocodeine/pseudoephedrine syrup will add to the effects of alcohol and other depressants. Ask your pharmacist if you have questions about which medicines are depressants.
- If your symptoms do not improve within 7 days or if you develop a high fever or persistent headache, check with your doctor.
- Use chlorpheniramine/dihydrocodeine/pseudoephedrine syrup with caution in the ELDERLY because they may be more sensitive to its effects, especially possible breathing problems and drowsiness.
- Use chlorpheniramine/dihydrocodeine/pseudoephedrine syrup with extreme caution in CHILDREN. Safety and effectiveness have not been confirmed.
- PREGNANCY and BREAST-FEEDING: It is unknown if chlorpheniramine/dihydrocodeine/pseudoephedrine syrup can cause harm to the fetus. If you become pregnant while taking chlorpheniramine/dihydrocodeine/pseudoephedrine syrup, discuss with your doctor the benefits and risks of using chlorpheniramine/dihydrocodeine/pseudoephedrine syrup during pregnancy. Chlorpheniramine/dihydrocodeine/pseudoephedrine syrup is excreted in breast milk. If you are or will be breast-feeding while you are using chlorpheniramine/dihydrocodeine/pseudoephedrine syrup, check with your doctor or pharmacist to discuss the risks to your baby.
Use of chlorpheniramine/dihydrocodeine/pseudoephedrine syrup can lead to TOLERANCE. When using for an extended period, chlorpheniramine/dihydrocodeine/pseudoephedrine syrup may not work as well and may require different dosing. Talk with your doctor if chlorpheniramine/dihydrocodeine/pseudoephedrine syrup stops working well.
Long-term use of chlorpheniramine/dihydrocodeine/pseudoephedrine syrup can lead to physical DEPENDENCE. The early sign of addiction is medicine ineffectiveness. Dependence is not an issue in terminal illness, when pain relief is more important. If using chlorpheniramine/dihydrocodeine/pseudoephedrine syrup for an extended period of time, do not suddenly stop taking chlorpheniramine/dihydrocodeine/pseudoephedrine syrup without your doctor's approval. WITHDRAWAL symptoms have occurred when chlorpheniramine/dihydrocodeine/pseudoephedrine syrup is suddenly stopped and may include anxiety; diarrhea; fever; runny nose or sneezing; goose bumps and abnormal skin sensations; nausea and vomiting; pain; rigid muscles; seeing, hearing, or feeling things that are not there; shivering or tremors; sweating; trouble sleeping. Contact your doctor if you notice any of these symptoms after stopping use of chlorpheniramine/dihydrocodeine/pseudoephedrine syrup.
Possible side effects of chlorpheniramine/ dihydrocodeine/ pseudoephedrine syrup:
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:
Seek medical attention right away if any of these SEVERE side effects occur:
Constipation; dizziness; drowsiness; dry mouth, throat, or nose; excitement; nausea; stomach upset; thickening or mucus in nose or throat.
Severe allergic reactions (rash; hives; 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; slowed breathing; slow heartbeat.Proper storage of chlorpheniramine/dihydrocodeine/pseudoephedrine syrup:
Store chlorpheniramine/dihydrocodeine/pseudoephedrine syrup 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/pseudoephedrine syrup out of the reach of children and away from pets.
- If you have any questions about chlorpheniramine/dihydrocodeine/pseudoephedrine syrup, please talk with your doctor, pharmacist, or other health care provider.
- Chlorpheniramine/dihydrocodeine/pseudoephedrine syrup 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/pseudoephedrine syrup 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/pseudoephedrine syrup. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to chlorpheniramine/dihydrocodeine/pseudoephedrine syrup. 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/pseudoephedrine syrup.