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Decohistine DH Side Effects

Generic Name: chlorpheniramine / codeine / pseudoephedrine

Note: This page contains information about the side effects of chlorpheniramine / codeine / pseudoephedrine. Some of the dosage forms included on this document may not apply to the brand name Decohistine DH.

For the Consumer

Applies to chlorpheniramine / codeine / pseudoephedrine: liquid

Other dosage forms:

Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Constipation; dizziness; drowsiness; dry mouth, throat, or nose; excitement; nausea; stomach upset; thickening or mucus in nose or throat; vomiting.

Seek medical attention right away if any of these SEVERE side effects occur while taking chlorpheniramine / codeine / pseudoephedrine:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); confusion; difficulty urinating; fainting; fast, slow, or irregular heartbeat; flushing or redness of face; severe drowsiness; trouble breathing; vision changes.

For Healthcare Professionals

Applies to chlorpheniramine / codeine / pseudoephedrine: oral elixir, oral liquid

General

The more commonly expected adverse effects include nausea, vomiting, constipation, blurred vision, confusion, dizziness, and headache.[Ref]

Respiratory

Codeine:
Frequency not reported: Respiratory depression, dryness of the pharynx and respiratory passages, laryngismus, atelectasis, wheezing, troubled breathing, hiccups[Ref]

Respiratory depression has been associated with antitussive use of codeine in young children. Respiratory depression and death have occurred in children who received codeine in the postoperative period following tonsillectomy and/or adenoidectomy. Further investigation has shown these patients to be ultra-rapid metabolizers of codeine. Children with obstructive sleep apnea who are treated with codeine appear to be particularly sensitive to the respiratory depressant effects of codeine.[Ref]

Cardiovascular

Hypotension is rare and has been reported most frequently with high doses of codeine.

Pseudoephedrine causes vasoconstriction which generally does not produce hypertension, but may be problematic for patients with preexisting hypertension. Arrhythmias may be produced in predisposed patients. Rarely, pseudoephedrine has been reported to cause coronary artery spasm and chest pain.[Ref]

Codeine or Chlorpheniramine:
Frequency not reported: Fast, or slow heartbeat, hypertension, hypotension, orthostatic hypotension, palpitations, shock-like state, syncope

Pseudoephedrine:
Frequency not reported: Tachycardia, palpitations, cardiac arrhythmias, hypertension, impaired circulation to the extremities, coronary artery spasm, chest pain[Ref]

Gastrointestinal

Codeine or Chlorpheniramine:
Frequency not reported: Nausea, vomiting, constipation, abdominal distension, abdominal pain, acute pancreatitis, dry mouth, dyspepsia, epigastric distress, diarrhea, gastro-esophageal reflux, gastrointestinal hypomotility

Pseudoephedrine:
Frequency not reported: Nausea, vomiting, dry mouth[Ref]

Psychiatric

Codeine:
Frequency not reported: Drug dependence, confusion, depression, euphoria, false sense of well-being, excitability, nervousness, agitation, restlessness, insomnia, irritability

Pseudoephedrine:
Frequency not reported: Hallucinations (particularly in children), anxiety, excitability, insomnia[Ref]

Nervous system

Codeine or Chlorpheniramine:
Frequency not reported: Weakness, dizziness, drowsiness, sedation, headache, facial dyskinesia, lightheadedness, somnolence, dyskinesia, tremor

Pseudoephedrine:
Frequency not reported: Restlessness, dizziness, weakness, headache, drowsiness, tremor[Ref]

Nearly all patients treated with chlorpheniramine experience drowsiness. This drowsiness may subside in some patients with extended use. Patients should be warned against driving, as well as concomitant ingestion of alcohol and other sedative-hypnotic drugs, while taking chlorpheniramine.

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.[Ref]

Genitourinary

Codeine or Chlorpheniramine:
Frequency not reported: Ureteral spasm, urinary retention, dysuria, urinary frequency, urinary hesitancy, irritative bladder symptom

Pseudoephedrine:
Frequency not reported: Urinary retention[Ref]

Hypersensitivity

Codeine or Chlorpheniramine:
Frequency not reported: Allergic laryngospasm, nasal stuffiness, bronchospastic allergic reaction, hives, itching, swelling of face[Ref]

Dermatologic

Codeine or Chlorpheniramine:
Frequency not reported: Redness or flushing of face, skin rash, pruritus, erythema, urticaria, excessive perspiration, dermatitis

Pseudoephedrine:
Frequency not reported: Fixed drug eruption in the form of erythematous nodular patches, rash[Ref]

Endocrine

Codeine or Chlorpheniramine:
Frequency not reported: Decreased lactation, early menses, gynecomastia, increased libido, pheochromocytoma stimulation[Ref]

Metabolic

Codeine or Chlorpheniramine:
Frequency not reported: Changes in glucose utilization, glycosuria, hypoglycemia, increased appetite, loss of appetite[Ref]

Ocular

Codeine or Chlorpheniramine:
Frequency not reported: Blurred vision, diplopia, visual disturbances, hypermetropia, lacrimation increased, mydriasis, photophobia

Pseudoephedrine:
Frequency not reported: Angle-closure glaucoma[Ref]

Other

Codeine or Chlorpheniramine:
Frequency not reported: Asthenia, feeling of relaxation, unusual tiredness, labyrinthitis, tinnitus, vertigo[Ref]

References

1. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0

2. "Product Information. Tuzistra XR (chlorpheniramine-codeine)." Vernalis Pharmaceuticals Inc, Morristown, NJ.

3. Mariani PJ "Pseudoephedrine-induced hypertensive emergency: treatment with labetalol." Am J Emerg Med 4 (1986): 141-2

4. Wiener I, Tilkian AG, Palazzolo M "Coronary artery spasm and myocardial infarction in a patient with normal coronary arteries: temporal relationship to pseudoephedrine ingestion." Cathet Cardiovasc Diagn 20 (1990): 51-3

5. "Product Information. Chlortrimeton (chlorpheniramine)." Schering-Plough, Liberty Corner, NJ.

6. Mores N, Campia U, Navarra P, Cardillo C, Preziosi P "No cardiovascular effects of single-dose pseudoephedrine in patients with essential hypertension treated with beta-blockers." Eur J Clin Pharmacol 55 (1999): 251-4

7. "Product Information. Ryna-C Liquid (chlorpheniramine-pseudoephedrine)" Wallace Laboratories, Cranbury, NJ.

8. Rosen RA "Angina associated with pseudoephedrine ." Ann Emerg Med 10 (1981): 230-1

9. Krause LB, Shuster S "A comparison of astemizole and chlorpheniramine in dermographic urticaria." Br J Dermatol 112 (1985): 447-53

10. Millet VM, Dreisbach M, Bryson YJ "Double-blind controlled study of central nervous system side effects of amantadine, rimantadine, and chlorpheniramine." Antimicrob Agents Chemother 21 (1982): 1-4

11. Thach BT, Chase TN, Bosma JF "Oral facial dyskinesia associated with prolonged use of antihistaminic decongestants." N Engl J Med 293 (1975): 486-7

12. Schuller DE, Turkewitz D "Adverse effects of antihistamines." Postgrad Med 79 (1986): 75-86

13. "Letter: Dyskinesia associated with chronic antihistamine use." N Engl J Med 294 (1976): 113

14. Shelley WB, Shelley ED "Nonpigmenting fixed drug eruption as a distinctive reaction pattern: examples caused by sensitivity to pseudoephedrine hydrochloride and tetrahydrozoline." J Am Acad Dermatol 17 (1987): 403-7

15. Quan MB, Chow WC "Nonpigmenting fixed drug eruption after pseudoephedrine." Int J Dermatol 35 (1996): 367-70

16. Vidal C, Prieto A, PerezCarral C, Armisen M "Nonpigmenting fixed drug eruption due to pseudoephedrine." Ann Allergy Asthma Immunol 80 (1998): 309-10

17. Tomb RR, Lepoittevin JP, Espinassouze F, Heid E, Foussereau J "Systemic contact dermatitis from pseudoephedrine." Contact Dermatitis 24 (1991): 86-8

18. Camisa C "Fixed drug eruption due to pseudoephedrine." Cutis 41 (1988): 339-40

19. Hunskaar S, Dragsund S "Scarlatiniform rash and urticaria due to codeine." Ann Allergy 54 (1985): 240-1

20. "Product Information. Calcidrine (codeine)." Abbott Pharmaceutical, Abbott Park, IL.

Not all side effects for Decohistine DH 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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