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(klor-fen-AIR-uh-meen MAL-ee-ate)
Aller-Chlor
Tablets — 4 mg, Syrup — 2 mg/5 mL<
Allergy
Tablets — 4 mg
Chlo-Amine
Tablets, chewable — 2 mg
Chlor-Trimeton Allergy 8 Hour
Tablets, extended-release — 8 mg
Chlor-Trimeton Allergy 12 Hour
Tablets, extended-release — 12 mg
Efidac 24
Tablet, extended-release — 16 mg
Chlor-Tripolon
Chlor-Tripolon Repetabs
Class: Antihistamine, Alkylamine

 Action Competitively antagonizes histamine at H1 receptor sites.

 Indications Temporary relief of sneezing, itchy, watery eyes, itchy nose or throat, and runny nose caused by hay fever (allergic) rhinitis or other respiratory allergies.

 Contraindications Hypersensitivity to antihistamines; narrow-angle glaucoma; stenosing peptic ulcer; symptomatic prostatic hypertrophy; asthmatic attack; bladder neck obstruction; pyloroduodenal obstruction; MAO therapy; use in newborn or premature infants and in nursing mothers.

 Route/Dosage

Symptomatic Allergic Conditions Adults and Children over 12 yr: PO 4 mg q 4 to 6 hr (immediate-release form) or 8 to 12 mg at bedtime or q 8 to 12 hr (sustained-release form) (max, 24 mg/24 hr). Efidac: 16 mg q 24 hr (max, 16 mg/24 hr). SC/IM/IV: 5 to 20 mg as single dose (max, 40 mg/24 hr).

Children 6 to 12 yr: PO 2 mg q 4 to 6 hr (immediate-release form) or 8 mg at bedtime or during day as indicated (sustained-release form) (max, 12 mg/24 hr).

Children 2 to 6 yr: PO (only tablet or syrup; sustained-release not recommended) 1 mg q 4 to 6 hr (max, 4 mg/24 hr).

Allergic Reactions to Blood or Plasma Adults: SC/IM/IV 10 to 20 mg as single dose (max, 40 mg/24 hr).

Anaphylaxis Adults: IV 10 to 20 mg as single dose.

 Interactions

Alcohol and CNS depressants: May cause additive CNS depressant effects.

MAO Inhibitors: May increase anticholinergic effects of chlorpheniramine.

 Lab Test Interferences

Skin testing procedures: Antihistamines may prevent or diminish otherwise positive reaction to dermal reactivity indicators.

 Adverse Reactions

CARDIOVASCULAR: Orthostatic hypotension; palpitations; bradycardia; tachycardia; reflex tachycardia; extrasystoles; faintness. CNS: Drowsiness (often transient); sedation; dizziness; faintness; disturbed coordination; nervousness; restlessness. GI: Dry mouth; epigastric distress; anorexia; nausea; vomiting; diarrhea; constipation; change in bowel habits. GU: Urinary frequency or retention; dysuria. HEMATOLOGIC: Hemolytic anemia; thrombocytopenia; agranulocytosis. METABOLIC: Increased appetite; weight gain. RESPIRATORY: Thickening of bronchial secretions; chest tightness; wheezing; nasal stuffiness; dry nose and throat; sore throat; respiratory depression. OTHER: Hypersensitivity reactions; photosensitivity.

 Precautions

Pregnancy: Category B. Do not use during third trimester. Lactation: Contraindicated in nursing mothers. Children: Overdosage may cause hallucinations, convulsions, and death. Antihistamines may diminish mental alertness. In young child, they may produce paradoxical excitation. Contraindicated in newborn or premature infants. Sustained-release form not recommended in children less than 6 yr. Elderly: Greater likelihood of dizziness, excessive sedation, syncope, toxic confusional states and hypotension in patients greater than 60 yr. Dosage reduction may be required. Special risk patients: Use drug with caution in patients with predisposition to urinary retention, history of bronchial asthma, increased IOP, hyperthyroidism, cardiovascular disease, or hypertension. Avoid in patients with sleep apnea. Hepatic impairment: Use drug with caution in patients with cirrhosis or other liver disease. Hypersensitivity reactions: May occur. Have epinephrine 1:1000 immediately available. Respiratory disease: Generally not recommended to treat lower respiratory tract symptoms including asthma.

PATIENT CARE CONSIDERATIONS

 Administration/Storage

  • Administer with food or milk to decrease GI upset.
  • Instruct patient not to chew or crush sustained-release tablets; have patient swallow tablet whole.
  • Instruct patient to chew chewable tablets and not to swallow tablet whole.
  • Administer 10 mg/mL solution IV, IM, or SC.
  • Administer 100 mg/mL solution IM or SC only; do not administer IV.
  • Administer IV solution undiluted in 10 mg dose over at least 1 min.
  • Store at room temperature. Protect syrup and injectable forms from light.

 Assessment/Interventions

  • Obtain patient history, including drug history and any known allergies.
  • Note baseline vital signs and monitor throughout therapy.
  • Monitor I&O. Note any urinary retention or problems with voiding.
  • Notify health care provider if patient has history of asthma.
  • If signs of allergy or difficulty breathing occur, notify health care provider.
  • Monitor breath sounds and report abnormalities to health care provider.
OVERDOSAGE: SIGNS & SYMPTOMS
  Diminished mental alertness, ataxia, hallucinations, convulsions, death

 Patient/Family Education

  • Caution patient to avoid intake of alcoholic beverages or other CNS depressants.
  • Instruct patient to notify health care provider if blurred vision occurs.
  • Advise patient to use good oral hygiene, to take sips of water frequently, suck on ice chips or sugarless hard candy, or chew sugarless gum if dry mouth occurs.
  • Advise patient that coadministration of MAO inhibitors may prolong and intensify effects of medication.
  • Instruct patient to maintain adequate fluid intake to avoid thickening of respiratory secretions.
  • Caution patient to avoid exposure to sunlight and to use sunscreen or wear protective clothing to avoid photosensitivity reaction.
  • Advise patient that drug may cause drowsiness and to use caution while driving or performing other tasks requiring mental alertness.
  • Advise patient to carry Medi-Alert identification noting allergic condition.

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