Home Drug Guide Chlorpheniramine Maleate; Pseudoephedrine Hydrochloride

Drug Guide

Generic Name

Chlorpheniramine Maleate; Pseudoephedrine Hydrochloride

Brand Names Isoclor, Pseudoephedrine Hydrochloride And Chlorpheniramine Maleate, Codimal-l.a. 12

Classification

Therapeutic: Decongestant, Antihistamine

Pharmacological: Antihistamine (Chlorpheniramine), Sympathomimetic (Pseudoephedrine)

FDA Approved Indications

Allergic rhinitis
Common cold symptoms including nasal congestion, sneezing, and runny nose

Mechanism of Action

Chlorpheniramine Maleate is an H1 antihistamine that blocks histamine receptors, reducing allergy symptoms. Pseudoephedrine is a sympathomimetic agent that constricts blood vessels in the nasal mucosa, decreasing swelling and congestion.

Dosage and Administration

Adult: Typically, 4 mg of chlorpheniramine every 4-6 hours as needed; pseudoephedrine 60 mg every 4-6 hours. Dose adjustments based on clinical response.

Pediatric: Chlorpheniramine: 2-4 mg every 4-6 hours for children age 6 and over; Pseudoephedrine: 30-60 mg every 4-6 hours for children age 6 and over.

Geriatric: Start at lower doses due to increased sensitivity and risk of side effects.

Renal Impairment: Adjust dosage based on severity of impairment.

Hepatic Impairment: Use with caution; no specific dosage adjustments established.

Pharmacokinetics

Absorption: Well absorbed from gastrointestinal tract

Distribution: Widely distributed including into breast milk

Metabolism: Metabolized in the liver

Excretion: Primarily via urine

Half Life: Chlorpheniramine approximately 20 hours; Pseudoephedrine approximately 6-8 hours

Contraindications

Hypersensitivity to antihistamines or sympathomimetics
Serious conditions like severe hypertension, significant cardiovascular disease
MAOI use within 14 days

Precautions

Use with caution in patients with hypertension, glaucoma, BPH, hyperthyroidism, elderly, pregnant, or lactating women

Adverse Reactions - Common

Drowsiness, dizziness (Common)
Dry mouth, blurred vision (Likely)

Adverse Reactions - Serious

Arrhythmias, hypertension, central nervous system depression (Rare)
Paradoxical excitation in children (Rare)

Drug-Drug Interactions

Effenor, MAOIs (risk of hypertensive crisis with pseudoephedrine)
CNS depressants (increased sedation)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for allergy symptoms, blood pressure, heart rate, sedation levels.

Diagnoses:

Risk for falls due to sedation
Ineffective airway clearance

Implementation: Administer with food if gastrointestinal upset occurs. Monitor patient response, blood pressure, and signs of adverse effects.

Evaluation: Assess symptom relief, side effects, and vital signs periodically.

Patient/Family Teaching

Avoid operating heavy machinery or driving until response is known
Advise about potential sedative effects and interactions with alcohol
Instruct to rise slowly to prevent orthostatic hypotension
Encourage reporting of any adverse effects or unusual reactions

Special Considerations

Black Box Warnings:

Pseudoephedrine can increase blood pressure and should be used cautiously in hypertensive patients.

Genetic Factors: Poor metabolizers of certain drugs may experience increased side effects.

Lab Test Interference: N/A

Overdose Management

Signs/Symptoms: Severe dizziness, hallucinations, seizures, severe hypertension, arrhythmias

Treatment: Supportive care, activated charcoal if ingestion is recent, symptomatic treatment for blood pressure and heart rhythm abnormalities, airway management.

Storage and Handling

Storage: Store at room temperature away from moisture, heat, and light

Stability: Stable under proper storage conditions for the duration of the shelf life