Dexchlorpheniramine

What is Dexchlorpheniramine?

• Dexchlorpheniramine (Polaramine) is an antihistamine with anticholinergic properties used to treat allergic conditions such as hay fever or urticaria.
• It is the pharmacologically active dextrorotatory isomer of chlorpheniramine.

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Dexchlorpheniramine

Dexchlorpheniramine molecule ball

Dexchlorpheniramine

What are the uses of this medicine?

Dexchlorpheniramine (Polaramine) is used for the treatment of:

• Perennial and seasonal allergic rhinitis
• Vasomotor rhinitis
• Allergic conjunctivitis due to inhalant allergens and foods
• Mild, uncomplicated allergic skin manifestations of urticaria and angioedema
• Amelioration of allergic reactions to blood or plasma
• Dermographism
• anaphylactic reactions adjunctive to epinephrine and other standard measures after the acute manifestations have been controlled.

How does this medicine work?

• Brompheniramine (brome" fen ir' a meen) and chlorpheniramine (klor" fen ir' a meen) are first generation antihistamines that are used widely in the therapy of the symptoms of sneezing, cough, runny note, watery eyes and itching.
• They are similar in chemical structure and constitute the alkylamine class of antihistamines.
• They are probably the most commonly used over-the-counter antihistamines, being present alone or in combination with other agents in more than 1000 products used for the symptoms of the common cold, sinusitis, urticaria and hay fever.
• Both agents are also available as their dextrorotatory isomers, dexbrompheniramine and dexchlorpheniramine, which have similar profiles of action and side effects.
• Isomers: Brompheniramine and Chlorpheniramine
• Isomers: Dexbrompheniramine and Dexchlorpheniramine

• The maleate salt form of dexchlorpheniramine, an alkylamine, and first-generation histamine antagonist with anti-allergic activity. Dexchlorpheniramine maleate competitively blocks H1 receptors, thereby preventing the actions of histamine on bronchial smooth muscle, capillaries and gastrointestinal (GI) smooth muscle.
• This prevents histamine-induced bronchoconstriction, vasodilation, increased capillary permeability, and GI smooth muscle spasms.

Who Should Not Use this medicine ?

This medicine cannot be used:

• in newborn or premature infants.
• in nursing mothers.
• to treat lower respiratory tract symptoms including asthma.
• In patients with hypersensitivity to dexchlorpheniramine maleate or other antihistamines of similar chemical structure.
• wtih monoamine oxidase inhibitor therapy.

What drug interactions can this medicine cause?

• Tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take.

Be sure to mention any of the following:

• Monoamine oxidase inhibitors

Is this medicine FDA approved?

• It came into medical use in 1959 and was patented in 1962.

How should this medicine be used?

Recommended dosage:

• Adults and Children 12 years of age and older: 2 mg (1 teaspoonful)
• Children 6 to 11 years: 1 mg (1/2 teaspoonful)
• Children 2 to 5 years: 0.5 mg (1/4 teaspoonful)

Administration:

• Doses are generally given every 4 to 6 hours.

What are the dosage forms and brand names of this medicine?

This medicine is available in fallowing doasage form:

• As Oral Solution

This medicine is available in fallowing brand namesː

• Polaramine
• Common brand name preparations include Chlor-Trimeton, Dimetane, Drixoral and Durahist, and most are available without a prescription and in combination with sympathomimetic agents (such as pseudoephedrine or phenylephrine) or analgesics or both.
• RYCLORA

What side effects can this medication cause?

The most common side effects of this medicine may include:

• sedation, impairment of motor function, confusion, dizziness, blurred vision, dry mouth and throat, palpitations, tachycardia, abdominal distress, constipation and headache.

• Antihistamines can worsen urinary retention and glaucoma.

Less common, but serious side effects may include:

• General: Urticaria, drug rash, anaphylactic shock, photosensitivity, excessive perspiration, chills, dryness of mouth, nose and the throat.
• Cardiovascular System: Hemolytic anemia, thrombocytopenia, agranulocytosis.
• Hematologic System: Hemolytic anemia, thrombocytopenia, agranulocytosis.
• Nervous System: Sedation, sleepiness, dizziness, disturbed coordination, fatigue, confusion, restlessness, excitation, nervousness, tremor, irritability, insomnia, euphoria, paresthesias, blurred vision, diplopia, vertigo, tinnitus, acute labyrinthitis, hysteria, neuritis, convulsions.
• G.I. System: Epigastric distress, anorexia, nausea, vomiting, diarrhea, constipation.
• G.U. System: Urinary frequency, difficult urination, urinary retention, early menses.
• Respiratory System: Thickening of bronchial secretions, tightness of chest and wheezing, nasal stuffiness.

What special precautions should I follow?

• Antihistamines should be used with considerable caution in patients with:Narrow angle glaucoma; Stenosing peptic ulcer; Pyloroduodenal obstruction ; Symptomatic prostatic hypertrophy; Bladder neck obstruction.
• In infants and children, especially, antihistamines in overdosage may cause hallucinations, convulsions, or death.
• As in adults, antihistamines may diminish mental alertness in children. In the young child, particularly, they may produce excitation.
• Dexchlorpheniramine has additive effects with alcohol and other CNS depressants (hypnotics, sedatives, tranquilizers, etc.).
• Patients should be warned about engaging in activities requiring mental alertness such as driving a car or operating appliances, machinery, etc.
• Antihistamines are more likely to cause dizziness, sedation, and hypotension in elderly patients.
• Dexchlorpheniramine has an atropine-like action and, therefore, should be used with caution in patients with: History of bronchial asthma; Increased intraocular pressure; Hyperthyroidism; Cardiovascular disease; Hypertension.

What to do in case of emergency/overdose?

Symptoms of overdosage may include:

• Antihistamine overdosage reactions may vary from central nervous system depression to stimulation. Stimulation is particularly likely in children.

Atropine-like signs and symptoms:

• dry mouth, fixed, dilated pupils, flushing, and gastrointestinal symptoms.

Management of overdosage:

• In case of overdose, call the poison control helpline of your country. In the United States, call 1-800-222-1222.

• Overdose related information is also available online at poisonhelp.org/help.
• In the event that the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services. In the United States, call 911.
• If vomiting has not occurred spontaneously the patient should be induced to vomit.
• This is best done by having the patient drink a glass of water or milk after which the patient should be made to gag.
• Precautions against aspiration must be taken, especially in infants and children.
• Saline cathartics, such as milk of magnesia, draw water into the bowel by osmosis and therefore, are valuable for their action in rapid dilution of bowel content.
• Stimulants should not be used.
• Vasopressors may be used to treat hypotension.

Can this medicine be used in pregnancy?

• There are no adequate and well-controlled studies of Dexchlorpheniramine in pregnant women.

Can this medicine be used in children?

• This drug should not be used in newborn or premature infants.
• In infants and children, especially, antihistamines in overdosage may cause hallucinations, convulsions, or death.

What are the active and inactive ingredients in this medicine?

Active ingredient:

• Dexchlorpheniramine Maleate

Inactive ingredients:

• Citric Acid Monohydrate
• FD&C Red No. 40
• glycerin
• menthol, unspecified form
• methylparaben
• propylene glycol
• propylparaben
• water
• trisodium citrate dihydrate
• sucrose

Who manufactures and distributes this medicine?

Manufactured for:

• Carwin Pharmaceutical Associates, LLC
• Hazlet, NJ

What should I know about storage and disposal of this medication?

• Store at 20° to 25°C (68° to 77°F).
• Dispense in a tight, light-resistant container as defined in the USP, with child-resistant closure.

First Generation Antihistamines

• Brompheniramine
• Carbinoxamine
• Chlorcyclizine
• Chlorpheniramine
• Clemastine
• Cyclizine
• Cyproheptadine
• Dexbrompheniramine
• Dexchlorpheniramine
• Dimenhydrinate
• Diphenhydramine
• Doxylamine
• Hydroxyzine
• Meclizine
• Phenyltoloxamine
• Promethazine
• Triprolidine

Second Generation Antihistamines

• Acrivastine
• Cetirizine
• Fexofenadine
• Levocetirizine
• Loratadine
• Desloratadine

• Dailymed label info on Dexchlorpheniramine
• FDA Dexchlorpheniramine

Dexchlorpheniramine Resources
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First Generation Antihistamines

• Brompheniramine
• Carbinoxamine
• Chlorcyclizine
• Chlorpheniramine
• Clemastine
• Cyclizine
• Cyproheptadine
• Dexbrompheniramine
• Dexchlorpheniramine
• Dimenhydrinate
• Diphenhydramine
• Doxylamine
• Hydroxyzine
• Meclizine
• Phenyltoloxamine
• Promethazine
• Triprolidine

Second Generation Antihistamines

• Acrivastine
• Cetirizine
• Fexofenadine
• Levocetirizine
• Loratadine
• Desloratadine