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These combination products are presented in groups based on the components of their formulations.

Antiasthmatic Combinations

Antiasthmatic combinations contain xanthine derivatives and sympathomimetics for bronchodilation. Many products also contain expectorants to facilitate mobilization of mucus.

Upper Respiratory Combinations

Upper respiratory combinationsare used primarily for relief of symptoms associated with colds, upper respiratory infections, and allergic conditions (eg, acute rhinitis, sinusitis).

Ingredients

Antihistamines: Antihistamines are used for symptomatic relief from allergic rhinitis (hay fever) including runny nose, sneezing, itching of the nose or throat, and itchy and watery eyes. The anticholinergic effects of antihistamines may cause a thickening of bronchial secretions; therefore, these agents may be counterproductive in respiratory conditions characterized by congestion. Antihistamines may cause drowsiness.

Xanthines: Xanthines, primarily theophylline, relieve bronchial spasm by direct action on the bronchial smooth muscle in bronchospastic conditions such as asthma and chronic bronchitis. Some xanthine-containing combination products are available over-the-counter, but asthmatic patients should use them only under physician supervision.

Sympathomimetics: Sympathomimetics are used for their vasoconstrictor/decongestant or bronchodilator effects.

Decongestants: Decongestants are used for temporary relief of nasal congestion due to colds or allergy. Given orally, they are less effective than topical nasal decongestants and have a potential for systemic side effects. Frequent or prolonged topical use may lead to local irritation and rebound congestion.

Bronchodilators: Ephedrine is common in these combinations; however, it stimulates cardiac (b1) receptors. Bronchodilation is weaker than with the catecholamines: a-adrenergic effects may decrease congestion of mucous membranes. Other b-active agents are effective bronchodilators, but pseudoephedrine is not.

Analgesics: Analgesics (eg, acetaminophen, aspirin, ibuprofen, sodium salicylate) are frequently included for symptoms of headache, fever, muscle aches, and pain.

Anticholinergics: Anticholinergics are included for their drying effects on mucous secretions. This action may be beneficial in acute rhinorrhea; however, drying of respiratory secretions may lead to obstruction. Traditionally, anticholinergics have been avoided in patients with asthma or chronic obstructive pulmonary disease (COPD); however, some patients respond well to these agents. Caution is still advised in this group.

An anticholinergic for oral inhalation is available as a bronchodilator for maintenance of bronchospasm associated with COPD, including chronic bronchitis and emphysema.

Papaverine HCl: Papaverine HCl relaxes the smooth muscle of the bronchial tree.

Barbiturates: Barbiturates are included for their sedative effects as “correctives” in combination with xanthines or sympathomimetics, which may cause CNS stimulation. The sedative efficacy of low doses (eg, 8 mg phenobarbital) is questionable.

Caffeine: Caffeine is included in some combinations for CNS stimulation to counteract antihistamine depression and to enhance concomitant analgesics.

Antiasthmatic Combinations
Trade Name Strength/Ingredient Average Dose
Quibron-300 Capsules 300 mg theophylline, 180 mg guaifenesin 16/mg/kg/day or 400 mg/day in divided doses, q 6 to 8 h
Bronchial Capsules, Quibron Capsules 150 mg theophylline, 90 mg guaifenesin 16/mg/kg/day or 400 mg/day in divided doses, q 6 to 8 h
Glyceryl-T Capsules 150 mg theophylline, 90 mg guaifenesin 1 or 2 bid or tid
Slo-Phyllin GG Capsules1,2 150 mg theophylline, 90 mg guaifenesin 3 mg/kg/day q 6 to 8 h
Mudrane GG-2-Tablets 111 mg theophylline, (130 mg aminophylline anhydrous), 100 mg guaifenesin 1 tid or qid
Dilor-G Tablets 200 mg dyphylline, 200 mg guaifenesin 1 tid or qid
Dyflex-G Tablets 200 mg dyphylline, 200 mg guaifenesin 1 or 2 qid
Dyline G.G. Tablets 200 mg dyphylline, 200 mg guaifenesin 1 tid or qid
Lufyllin-GG Tablets 200 mg dyphylline, 200 mg guaifenesin 1 qid
Glyceryl-T Liquid, Theolate Liquid 150 mg theophylline, 90 mg guaifenesin per 15 ml 15 ml q 6 to 8 h
Slo-Phyllin GG Syrup1,3,4 150 mg theophylline, 90 mg guaifenesin per 15 ml 3 mg/kg/day q 6 to 8 h
Synophylate-GG Syrup1,3,4 150 mg theophylline, (300 mg theophylline sodium glycinate), 100 mg guaifenesin, 10% alcohol per 15 ml 3 mg/kg q 8 h
Elixophyllin GG Liquid1 100 mg theophylline, 100 mg guaifenesin per 15 ml 3 mg/kg q 8 h
Theophylline Kl Elixer 80 mg theophylline, 130 mg potassium iodide per 15 ml, 3 mg/kg q 8 h
Trade Name Strength/Ingredient Average Dose
Elixophyllin-Kl Elixir3,4 80 mg theophylline, 130 mg potassium iodide, per 15 ml, 10% alcohol, sodium bisulfite, anise oil 3 mg/kg q 8 h
Iophylline Elixir 120 mg theophylline, 30 mg iodinated glycerol per 15 ml 15 to 30 ml tid
Dilor-G Liquid,1,3,4
Dyline-GG Liquid1,3,4		 300 mg dyphylline, 300 mg guaifenesin per 15 ml 5 or 10 ml tid or qid
Lufyllin-GG Elixir3,4 100 mg dyphylline, 100 mg guaifenesin per 15 ml, 17% alcohol 30 ml qid
Brondelate Elixir 192 mg theophylline (300 mg oxtriphylline), 150 mg guaifenesin per 15 ml, alcohol 10 ml qid
Hydrophed Tablets, Marax Tablets 130 mg theophylline, 25 mg ephedrine sulfate, 10 mg hydroxyzine HCl 1 bid to qid
Mudrane GG Tablets 111 mg theophylline (130 mg aminophylline anhydrous), 16 mg ephedrine HCl, 100 mg guaifenesin, 8 mg phenobarbital 1 tid or qid
Mudrane Tablets 111 mg theophylline (130 mg aminophylline anhydrous), 16 mg ephedrine HCl, 195 guaifenesin, 8 mg phenobarbital 1 tid or qid
Quadrinal Tablets 65 mg theophylline (130 mg theophylline calcium salicylate), 24 mg ephedrine HCl, 320 mg potassium iodide, 24 mg phenobarbital 1 tid or qid
Lufylline-EPG Tablets5 100 mg dyphylline, 16 mg ephedrine HCl, 200 mg guaifenesin, 16 mg phenobarbital 1 to 2 q 6 h
Lufylline-EPG Elixir3,4 150 mg dyphylline, 24 mg ephedrine HCl, 300 mg guaifenesin, 24 mg phenobarbital per 15 ml, 5.5% alcohol, methylparaben 10 to 20 ml q 6 h
Theomax DF Syrup 97.5 mg theophylline, 18.75 ephedrine, 7.5 mg hydroxyzine HCl per 15 ml, alcohol Children (> 5 yrs): 5 ml tid or qid; (2 to 5 yrs) 2.5 to 5 ml tid or qid

1 Contains sorbitol.
2 Contains parabens.
3 Contains sucrose.
4 Contains saccharin.
5 Contains lactose.

Combination Drugs

  1. Respiratory Combination Products
  2. Upper Respiratory Combinations
  3. Antibiotic Combinations
  4. Gastrointestinal Anticholinergic Combinations
  5. Narcotic Analgesic Combinations
  6. Nonnarcotic Analgesic Combinations
  7. Diuretic Combinations
  8. Migraine Combinations

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