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All about: Phenylephrine Tannate/Chlorpheniramine Tannate

Big Image Pronouncation: (Fen-ill-EFF-rin TAN-ate/klor-fen-AIR-uh-meen TAN-ate)
Class: Antihistamine, Decongestant, Vasopressor used in shock

Trade Names:
Rhinatate-NF
- Pediatric Suspension 5 mg phenylephrine tannate and 4.5 mg chlorpheniramine tannate

Trade Names:
Nuhist
- Suspension 5 mg phenylephrine tannate and 4.5 mg chlorpheniramine tannate

Trade Names:
R-Tanna S
- Pediatric Suspension 5 mg phenylephrine tannate and 4.5 mg chlorpheniramine tannate

Trade Names:
Rynatan
- Pediatric Suspension 5 mg phenylephrine tannate and 4.5 mg chlorpheniramine tannate

Mechanism of Action

Pharmacology

Phenylephrine

Stimulates postsynaptic alpha-receptors, resulting in vasoconstriction, which reduces nasal congestion.

Chlorpheniramine

Competitively antagonizes histamine at H 1 receptor sites.

Indications and Usage

Symptomatic relief of coryza and nasal congestion associated with common cold, sinusitis, allergic rhinitis, and other upper respiratory tract conditions.

Contraindications

Newborns; nursing mothers; sensitivity to any component of product.

Dosage and Administration

Children (over 6 yr)

PO 5 to 10 mL (1 to 2 tsp) q 12 hr.

Children (2 to 6 yr)

PO 2.5 to 5 mL (½ to 1 tsp) q 12 hr.

Children (less than 2 yr)

PO Titrate dose individually.

General Advice

  • Shake well before measuring dose.
  • Give with food or milk if GI upset occurs.
  • Use dosing spoon or syringe for pediatric doses.

Storage/Stability

Store suspension at controlled room temperature (68° to 77°F). Keep tightly capped and protect from freezing.

Drug Interactions

MAO Inhibitors (eg, isocarboxazid)

Avoid or use with caution in patients receiving MAO inhibitor therapy or within 14 days of stopping such treatment. May prolong and intensify the effects of chlorpheniramine and phenylephrine.

Laboratory Test Interactions

May interfere with diagnostic test results for skin tests using allergen extracts.

Adverse Reactions

CNS

Drowsiness; sedation.

GI

GI effects.

Miscellaneous

Dryness of mucous membranes.

Precautions

Pregnancy

Category C .

Lactation

Do not administer.

Elderly

Chlorpheniramine is more likely to cause dizziness, sedation, and hypotension in the elderly.

Special Risk Patients

Use with caution in patients with hypertension, heart disease, hyperthyroidism, narrow angle glaucoma, diabetes mellitus, or prostatic hypertrophy.

Excitation

Chlorpheniramine may cause excitation in pediatric patients; however, in combination with phenylephrine, it may cause mild stimulation or mild sedation.

Overdosage

Symptoms

CNS depression, CNS stimulation, convulsions, death, atropine-like signs and symptoms may be present.

Patient Information

  • Explain name, dose, action, and potential side effects of drug.
  • Remind patient to shake well before measuring dose.
  • Advise patient to take prescribed dose q 12 hr as needed.
  • Advise caregiver to use dosing spoon or syringe when giving suspension to children.
  • Advise patient to take with food or milk if GI upset occurs.
  • Advise patient to take last dose late in the afternoon or early evening to reduce chance of drug causing sleeplessness.
  • Advise patient that if a dose is missed to take as soon as remembered unless it is nearing time for the next dose. Caution patient to not double the dose to catch up.
  • Advise patient that if allergy symptoms are not controlled, not to increase the dose of medication but to inform health care provider.
  • Caution patient that drug may cause drowsiness and to use caution while driving or performing other tasks requiring mental alertness until tolerance is determined.
  • Advise patient to avoid alcohol and other CNS depressants because of risk of excessive sedation.
  • Caution patient not to take any OTC antihistamines or decongestants while taking this medication unless advised by health care provider.
  • If patient is to have allergy skin testing, advise against taking the medication for at least 6 days before the skin testing.
  • Advise women to notify health care provider if pregnant, planning to become pregnant, or breastfeeding.
  • Instruct patient to stop taking drug and immediately report any of the following symptoms to health care provider: nervousness, dizziness, sleeplessness.
  • Caution patient not to take any prescription or OTC medications or dietary supplements unless advised by health care provider.

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