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(dex-klor-fen-AIR-uh-meen MAL-ee-ate)
Dexchlorpheniramine maleate
Tablets, extended-release
4 mg
Tablets, extended-release
6 mg
Class: Antihistamine

 Action Competitively antagonizes histamine at H1 receptor sites.

Absorption: Cmax is approximately 7 ng/mL; Tmax is approximately 3 hr.

Distribution: Dexchlorpheniramine is 69% to 72% protein bound.

Metabolism: Extensively metabolized.

Elimination: The t1/2 is 20 to 24 hr. Approximately 19% of dose is excreted in urine as parent drug and metabolites in 24 hr.

 Indications Treatment of perennial and seasonal allergic rhinitis; vasomotor rhinitis; allergic conjunctivitis; mild, uncomplicated allergic skin manifestations of urticaria and angioedema; amelioration of allergic reactions to blood or plasma; dermographism; and adjunctive anaphylactic therapy.

 Contraindications Treatment of lower respiratory tract symptoms; MAO inhibitor therapy; any component of the product or other antihistamines of similar chemical structure.

 Route/Dosage

ADULTS and CHILDREN (12 yr and over): PO 6 mg at bedtime or q 8 to 10 hr.

 Interactions

Alcohol, other sedative: Will potentiate the sedative effects of dexchlorpheniramine.

MAO inhibitors: May cause severe hypotension.

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

 Adverse Reactions

CARDIOVASCULAR: Palpitations; tachycardia; extrasystoles; hypotension. CNS: Drowsiness; headache; sedation; dizziness; vertigo; disturbed coordination; fatigue; confusion; restlessness; excitation; nervousness; tremor; irritability; insomnia; euphoria; paresthesia; hysteria; neuritis; convulsions. DERMATOLOGIC: Urticaria; drug rash. EENT: Tinnitus; acute labyrinthitis; blurred vision; nasal stuffiness. GI: Dryness of mouth, nose and throat; epigastric distress; anorexia; nausea; vomiting; diarrhea; constipation. GU: Urinary frequency; difficult urination; urinary retention; early menstruation. HEMATOLOGIC: Hemolytic anemia; hypoplastic anemia; thrombocytopenia; agranulocytosis. RESPIRATORY: Thickening of bronchial secretions; tightness of chest; wheezing. OTHER: Anaphylactic shock; photosensitivity; excessive perspiration; chills.

 Precautions

Pregnancy: Category B. Lactation: Undetermined. Children: Safety and efficacy not established in children under 12 yr. Special risk patients: Use with caution in patients with hypertension, heart disease, asthma, hyperthyroidism, increased intraocular pressure, diabetes mellitus, prostatic hypertrophy, bronchial asthma.

PATIENT CARE CONSIDERATIONS

 Administration/Storage

  • Give 1 to 3 times daily as prescribed without regard to meals. Give with food if GI upset occurs.
  • Store tablets at controlled room temperature (36° to 77°F).

 Assessment/Interventions

  • Obtain patient history, including drug history and any known allergies. Note history of narrow angle glaucoma, stenosing peptic ulcer, pyloric obstruction, prostatic hypertrophy, bladder neck obstruction, hyperthyroidism, asthma, hypertension, cardiovascular disease, and concurrent or recent use of MAO inhibitors or oral anticoagulants.
  • Assess for allergy symptoms (eg, rhinitis, nasal congestion, sneezing, itching, watery eyes) before and periodically throughout therapy.
  • Monitor patient for dizziness and excessive drowsiness. If noted hold therapy and notify health care provider.
  • Monitor patient for CNS, CV, GI, RESP, and general body side effects. Inform health care provider if noted and significant.
OVERDOSAGE: SIGNS & SYMPTOMS
  CNS depression and stimulation (particularly in children), death, dizziness, tinnitus, ataxia, blurred vision, hypotension

 Patient/Family Education

  • Explain name, dose, action, and potential side effects of drug.
  • Advise patient to take as prescribed without regard to meals, but to take with food if GI upset occurs.
  • Advise patient that if allergy symptoms are not controlled not to increase the dose of medication or frequency of use but to inform health care provider. Inform patient that larger or more frequent dosing does not increase effectiveness and may cause drowsiness.
  • Advise patient that medication may cause drowsiness or dizziness and to not drive or perform other activities requiring mental alertness until tolerance is determined.
  • Caution patient that alcohol and other CNS depressants (eg, sedatives)
    will have additional sedative effects if taken with dexclorpheniramine.

  • Caution patient not to take any OTC antihistamines while taking this medication unless advised by health care provider.
  • Advise patient to take sips of water, suck on ice chips or sugarless hard candy, or chew sugarless gum if dry mouth occurs.
  • Caution patient that medication may cause sensitivity to sunlight and to avoid excessive exposure to the sun or UV light (eg, tanning booths), and to use protective clothing and sunscreens until tolerance is determined.
  • If patient is to have allergy skin testing, advise to not take the medication for at least 7 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: dizziness or excessive drowsiness.
  • Caution patient to not take any prescription or OTC medications or dietary supplements unless advised by health care provider.

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