NUMARK CHESTY COUGH EXPECTORANT
Active substance(s): AMMONIUM CHLORIDE / DIPHENHYDRAMINE HYDROCHLORIDE
Numark Chesty Cough Expectorant
Asda Strong Expectorant Cough Liquid
Tesco Chesty Cough Linctus
QUALITATIVE AND QUANTITATIVE COMPOSITION
Each 5ml contains
Diphenhydramine hydrochloride BP 14 mg
Ammonium chloride BP 130 mg
Each 5ml of solution contains Sucrose 3.9g
Each 5ml of solution contains 3.6% vol% Ethanol (alcohol)
For a full list of excipients, see section 6.1
For the symptomatic relief from coughs due to upper respiratory tract
Posology and method of administration
Adults: 5 ml to 10 ml every two or three hours
Children: 6 to 12 years: 5 ml every three or four hours
Elderly as adults.
This medicinal product is contraindicated in children under the age of 6 years
(see section 4.3)
Children of 6-12 years of age: not to be used for more than 5 days without the
advice of a doctor. Parents or carers should seek medical attention if the
child’s condition deteriorates during treatment.
Do not exceed the stated dose
Keep out of the sight and reach of children
Ammonium chloride is contraindicated in the presence of impaired hepatic or
Monoamine oxidase inhibitors (MAOIs) or within 14 days of stopping treatment
(see section 4.5)
• Hypersensitivity to the active substances(s) or any of the excipients
• Not to be used in children under the age of 6 years
Special warnings and precautions for use
Do not exceed stated dose
Use with caution in prostatic hypertrophy, urinary retention, susceptibility to angle
closure, hepatic disease.
The product may cause drowsiness. This product should not be used to sedate a child.
Ask a doctor before use if you suffer from a chronic or persistent cough, if you have
asthma, suffering from an acute asthma attack or where cough is accompanied by
Patients with rare hereditary problems of fructose intolerance, glucose galactose
malabsorption or sucrase-isomaltase insufficiency should not take this medicine.
It contains 3.9g of sucrose per 5ml. To be taken into account in people with diabetes
mellitus. If you have been told by your doctor that you have an intolerance to some
sugars, contact your doctor before taking this medicine.
This medicinal product contains 7.2% vol% ethanol (alcohol) i.e. up to 568 mg per 10 ml
dose, equivalent to 14.1 ml beer, 6 ml of wine per 10 ml dose. Harmful for those
suffering from alcoholism. To be taken into account in pregnant or breast-feeding
women, children and high risk groups such as patient with liver disease or epilepsy.
Interaction with other medicinal products and other forms of interaction
CNS depressants: may enhance the sedative effects of CNS depressants including
barbiturates, hypnotics, opioid analgesics, anxiolytic sedatives, antipsychotics and alcohol.
Antimuscarinic drugs: may have an additive muscarinic action with other drugs, such as
atropine and some antidepressants.
MAOIs: Not to be used in patients taking MAOIs or within 14 days of stopping treatment as
ther is a risk of serotonin syndrome.
Pregnancy and lactation
Diphenhydramine: significant incidence of cleft palate and clefts with other defects in
children whose mothers had taken diphenhydramine during pregnancy. The warning “Do not
take during pregnancy” is included on the label.
Effects on ability to drive and use machines
Diphenhydramine may cause drowsiness. The warning “may cause drowsiness. If affected, do
not drive or operate machinery. Avoid alcoholic drink” is included on the label.
4.8 Undesirable effects
Common side effects
CNS effects: Drowsiness (usually diminishes within a few days), paradoxical stimulation, headache,
Antimuscarinic effects: Urinary retention, dry mouth, blurred vision, gastrointestinal disturbances,
thickened respiratory tract secretions.
Rare side-effects: Hypotension, extrapyramidal effects, dizziness, confusion, depression, sleep
disturbances, tremor, convulsions, palpitation, arrhythmia, hypersensitivity reactions, blood disorders
and liver dysfunction.
Reporting of suspected adverse reactions
Reporting suspected adverse reactions after authorisation of the medicinal product is important. It
allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare
professionals are asked to report any suspected adverse reactions via the Yellow Card Scheme at:
Ammonium chloride: large doses may cause nausea, vomiting, thirst, headache,
hyperventilation and progressive drowsiness and lead to profound acidosis and hypokalaemia.
Diphenhydramine: Antihistamines may cause gastrointestinal disturbances, headache, blurred
vision, tinnitus, elation or depression, irritability, nightmares, anorexia, difficulty in
micturition, dryness of the mouth, tightness of the chest and tingling, heaviness and weakness
of the hands.
Ammonium chloride has an irritant effect on the gastric mucous membrane.
Diphenhydramine has pronounced sedative properties. It also has anti-emetic, anticholinergic
and local anaesthetic properties.
Ammonium chloride is effectively absorbed from the gastro-intestinal tract. The ammonium
ion is converted into urea in the liver. The anion liberated into the blood stream and extracellular fluid causes a metabolic acidosis and decreases the pH of the urine. This is followed
by transient diuresis.
Antihistamines are readily absorbed from the gastro intestinal tract, metabolised in the liver
and excreted usually mainly as metabolites in the urine.
Preclinical safety data
List of excipients
Sugar glucose mix
Sorbitol solution 70%
Citric acid anhydrous
36 months in unopened bottle.
Special precautions for storage
Protect from light
Nature and contents of container
Bottle: Amber (Type III) glass
Closures: Child resistant closure (CRC) fitted with low density polyethylene
Roll on pilfer proof (ROPP) screw cap fitted with low density polyethylene
Sizes: 100ml, 125ml, 150ml and 200ml.
30 ml CE marked polypropylene measuring cup with 2.5 ml, 3.3 ml 4 ml, 5 ml,
7.5 ml, 10 ml, 15 ml, 20 ml and 25 ml graduations.
(May not be included in all marketed products)
Instructions for Use/Handling
MARKETING AUTHORISATION HOLDER
Name or style and permanent address or registered place of business of the holder of the
Bell, Sons & Co (Druggists) Ltd
MARKETING AUTHORISATION NUMBER
DATE OF FIRST AUTHORISATION/RENEWAL OF THE AUTHORISATION
07/06/1996 / 07/02/2011
DATE OF REVISION OF THE TEXT