Chlorpheniramine / dihydrocodeine / pseudoephedrine Side Effects
For the Consumer
Applies to chlorpheniramine / dihydrocodeine / pseudoephedrine: syrup
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 while taking chlorpheniramine / dihydrocodeine / pseudoephedrine:
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.
For Healthcare Professionals
Applies to chlorpheniramine / dihydrocodeine / pseudoephedrine: oral syrup
General side effects including light-headedness, dizziness, drowsiness, headache, fatigue, and sedation have been among the most frequently reported with opioid use. Confusion, abdominal pain, lassitude, giddiness, increased irritability or excitement (especially in children) have been reported. Hallucinations, severe narcosis, and vivid dreams have been reported rarely.[Ref]
Gastrointestinal side effects of chlorpheniramine have included dry mouth and constipation in up to one-third of treated patients.
Gastrointestinal side effects including nausea, vomiting, and constipation have been among the most frequently reported with opioid use. Diarrhea, dry mouth, indigestion, anorexia, spasm of biliary tract have been reported.
Gastrointestinal side effects of pseudoephedrine have included anorexia and gastric irritation in approximately 5% of patients. Dry mouth, nose, or throat have occurred in up to 15% of patients.[Ref]
Nervous system side effects of chlorpheniramine have included drowsiness in 75% or more of treated patients. Dyskinesias have rarely been reported following chronic use of chlorpheniramine.
Nervous system side effects of pseudoephedrine have included insomnia in up to 30% of patients. Tremor, anxiety, nervousness, and headache have also been reported.[Ref]
Nearly all patients treated with chlorpheniramine experience drowsiness. This drowsiness may subside in some patients with extended use.
Few cases of dyskinesias and tremors, often of the face, have been reported in patients whose chronic use of chlorpheniramine extended over a period of 3 to 10 years. Some of these cases were only partially relieved by discontinuation of the drug. Haloperidol was successful in relieving symptoms.[Ref]
Dermatologic side effects including sweating, pruritus, and skin reactions have been among the most frequently reported with opioid use. Flushing has been reported.[Ref]
Other side effects of dihydrocodeine have included psychological dependence, physical dependence, and tolerance have been reported to develop upon repeated administration.[Ref]
Symptoms of dihydrocodeine withdrawal consist of irritability, restlessness, insomnia, diaphoresis, anxiety, and palpitations.[Ref]
Renal side effects including granulomatous interstitial nephritis and acute renal failure have been reported rarely during dihydrocodeine administration.[Ref]
Cardiovascular side effects of chlorpheniramine have included hypotension, tachycardia, and palpitations.
Cardiovascular side effects of pseudoephedrine have included tachycardia. Some patients have developed hypertension and/or arrhythmias.[Ref]
Respiratory side effects including respiratory depression have been reported.[Ref]
Ocular side effects including miosis and blurred vision have been reported.[Ref]
Genitourinary side effects including urinary retention have been reported.[Ref]
Hypersensitivity side effects including anaphylactoid reactions have been reported rarely.[Ref]
1. "Product Information. Hydro-Tussin DHC (chlorpheniramine/dihydrocodeine/PSE)." Ethex Corporation, Saint Louis, MO.
Not all side effects for chlorpheniramine / dihydrocodeine / pseudoephedrine may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.
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