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Overview

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This medicine contains an important and useful components, as it consists of
Alpelisibis available in the market in concentration

Name

Chlorpheniramine Maleate

Precaution

Chlorpheniramine Maleate is an antihistamine commonly used to relieve symptoms associated with allergies, such as sneezing, runny nose, and itching. However, it is important to consider the following precautions when using this drug: - **Drowsiness**: Chlorpheniramine is a sedating antihistamine, and it can cause drowsiness, impair cognitive function, and reduce coordination. Patients should avoid operating heavy machinery or driving if experiencing sedation or dizziness. - **Pregnancy and breastfeeding**: Chlorpheniramine is classified as a Category B drug by the FDA, meaning it is generally considered safe during pregnancy but should only be used if necessary. It is excreted into breast milk, and caution is recommended when using it during breastfeeding. A healthcare provider should be consulted to weigh the benefits and risks. - **Pre-existing medical conditions**: Patients with certain medical conditions should use chlorpheniramine with caution. This includes individuals with: - **Glaucoma**: Chlorpheniramine may exacerbate increased intraocular pressure in individuals with narrow-angle glaucoma. - **Asthma and chronic obstructive pulmonary disease (COPD)**: It can thicken bronchial secretions and may worsen breathing difficulties in individuals with asthma or COPD. - **Prostate enlargement**: The drug’s anticholinergic effects may worsen symptoms in individuals with benign prostatic hyperplasia (BPH). - **Cardiovascular conditions**: Chlorpheniramine can cause tachycardia and hypotension in some individuals, so it should be used with caution in patients with heart disease. - **Elderly population**: Older adults are more sensitive to the sedative effects and anticholinergic side effects of chlorpheniramine, which can increase the risk of confusion, dry mouth, constipation, urinary retention, and dizziness. Lower starting doses and close monitoring are advised.

Indication

Chlorpheniramine Maleate is primarily used for its antihistamine effects in the treatment of various allergic conditions. Its primary indications include: - **Allergic Rhinitis**: Chlorpheniramine is widely used to relieve symptoms of hay fever and seasonal allergies, such as sneezing, nasal congestion, runny nose, and itchy/watery eyes. - **Common Cold Symptoms**: It is used to alleviate symptoms of the common cold, including sneezing, runny nose, and itchy throat. - **Urticaria (Hives)**: Chlorpheniramine can be effective in relieving the itching, swelling, and redness associated with hives, which are caused by allergic reactions. - **Conjunctivitis (Allergic Eye Inflammation)**: It can help reduce symptoms of allergic conjunctivitis, such as itchy, watery eyes. - **Off-label Uses**: Chlorpheniramine may occasionally be used off-label for conditions like insomnia due to its sedative properties. However, its use for sleep disorders is less common and should only be considered under a healthcare provider’s guidance.

Contra indication

There are several conditions in which chlorpheniramine should not be used, as it may pose risks or exacerbate symptoms: - **Hypersensitivity**: Individuals who are allergic to chlorpheniramine or any of the ingredients in the formulation should avoid using this drug to prevent severe allergic reactions, such as anaphylaxis, rash, or swelling. - **Acute Narrow-Angle Glaucoma**: Chlorpheniramine can increase intraocular pressure, which may worsen conditions in individuals with glaucoma, particularly those with the narrow-angle form. - **Urinary Retention and Prostate Problems**: The drug’s anticholinergic effects can exacerbate urinary retention and worsen symptoms in men with benign prostatic hyperplasia (BPH) or other prostate conditions. - **Severe Liver Disease**: Chlorpheniramine is metabolized by the liver, and patients with severe liver disease should avoid this drug due to the risk of drug accumulation and toxicity. - **Concurrent Use with Monoamine Oxidase Inhibitors (MAOIs)**: Chlorpheniramine should not be used in combination with MAO inhibitors (a class of antidepressants), as this combination can lead to serious, potentially life-threatening interactions, including hypertensive crisis. - **Children under 2 years old**: Chlorpheniramine is not recommended for infants and toddlers due to the increased risk of side effects, particularly sedation and respiratory depression. For children over 2 years of age, the drug should only be used as directed.

Side Effect

Chlorpheniramine Maleate can cause a range of side effects, both common and severe: - **Common Side Effects**: - **Drowsiness/Sedation**: The most frequently reported side effect is drowsiness, which can impair daily activities such as driving or operating machinery. - **Dry Mouth**: This is a common anticholinergic effect, leading to discomfort and an increased risk of dental problems if used long-term. - **Dizziness and Fatigue**: Some individuals may experience dizziness, confusion, or fatigue, especially in elderly patients. - **Blurred Vision**: Due to its anticholinergic properties, chlorpheniramine may cause blurred vision or difficulty focusing. - **Less Common Side Effects**: - **Urinary Retention**: The anticholinergic effects of chlorpheniramine may cause difficulty urinating or urinary retention, especially in individuals with prostate problems. - **Constipation**: Another common anticholinergic side effect, which can be uncomfortable and lead to other gastrointestinal issues if left unmanaged. - **Hypotension**: In some individuals, chlorpheniramine may cause a drop in blood pressure, leading to lightheadedness or fainting. - **Allergic Reactions**: In rare cases, individuals may develop an allergic reaction to chlorpheniramine, characterized by hives, swelling, and difficulty breathing. - **Severe Reactions**: - **Anaphylaxis**: Severe allergic reactions, although rare, can occur and may include symptoms such as difficulty breathing, swelling of the throat, and low blood pressure. - **Serotonin Syndrome**: When taken with MAOIs or other serotonergic drugs, chlorpheniramine may contribute to serotonin syndrome, a potentially life-threatening condition characterized by agitation, confusion, rapid heart rate, and muscle rigidity.

Pregnancy Category ID

2

Mode of Action

Chlorpheniramine Maleate is a first-generation antihistamine that works by blocking the effects of histamine, a substance produced by the body during allergic reactions. Histamine binds to H1 receptors on various cells, leading to symptoms such as swelling, itching, and vasodilation. Chlorpheniramine competes with histamine for binding to these receptors, thereby reducing the allergic response. - **Antihistamine Action**: Chlorpheniramine primarily blocks H1 receptors, preventing histamine from causing symptoms such as itching, sneezing, and nasal congestion. - **Sedative Effects**: As a first-generation antihistamine, chlorpheniramine also has sedative effects, as it crosses the blood-brain barrier and binds to histamine receptors in the brain, leading to drowsiness. - **Anticholinergic Effects**: Chlorpheniramine possesses mild anticholinergic properties, which contribute to side effects like dry mouth, urinary retention, and blurred vision.

Interaction

Chlorpheniramine Maleate can interact with several other medications, potentially altering its effectiveness or increasing the risk of adverse effects: - **CNS Depressants**: Chlorpheniramine can enhance the sedative effects of other central nervous system (CNS) depressants, including alcohol, sedatives, tranquilizers, and sleeping pills. This can increase drowsiness, dizziness, and risk of accidents. - **Monoamine Oxidase Inhibitors (MAOIs)**: The combination of chlorpheniramine and MAO inhibitors (e.g., phenelzine, tranylcypromine) can cause severe reactions, including hypertensive crises. A minimum of two weeks should pass between stopping an MAOI and starting chlorpheniramine. - **Other Antihistamines**: The use of multiple antihistamines at the same time is not recommended, as it may increase the risk of anticholinergic side effects like dry mouth, constipation, urinary retention, and blurred vision. - **Anticholinergic Drugs**: Chlorpheniramine has anticholinergic properties, so combining it with other drugs that have similar effects (e.g., atropine, scopolamine) can lead to excessive drying, urinary retention, and cognitive disturbances, particularly in elderly patients. - **CYP450 Inhibitors**: Drugs that inhibit the CYP450 enzyme system (e.g., ketoconazole, cimetidine) may increase chlorpheniramine’s concentration in the body, leading to an increased risk of side effects. - **Tricyclic Antidepressants (TCAs)**: Concurrent use with TCAs may increase the risk of anticholinergic side effects like dry mouth and urinary retention and may potentiate the sedative effects of both drugs.

Pregnancy Category Note

Information not available

Adult Dose

For adults, chlorpheniramine is typically administered in tablet or liquid form. The usual dosage is: - **Standard Dose**: 4 mg every 4-6 hours as needed, not to exceed 24 mg per day. - **Extended-Release Formulation**: 8 mg every 12 hours, not exceeding 16 mg per day. Chlorpheniramine should be taken with or without food, depending on individual preference.

Child Dose

Chlorpheniramine dosage in children depends on age and the formulation used. The typical dosages are: - **Children 2-6 years**: 1 mg every 4-6 hours as needed, not exceeding 6 mg per day. - **Children 6-12 years**: 2 mg every 4-6 hours as needed, not exceeding 12 mg per day. - **Children over 12 years**: Same as adult dosage, typically 4 mg every 4-6 hours, not exceeding 24 mg per day. Chlorpheniramine should not be used in children under 2 years without medical supervision, and proper monitoring is essential during treatment.

Renal Dose

Renal dose adjustments are generally not required for chlorpheniramine. However, patients with severe renal impairment should use caution, as reduced clearance may increase the risk of side effects due to drug accumulation. Close monitoring is advised.

Administration

Information not available