dextromethorphan, phenylephrine, and pyrilam... Health Article

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Doctor-reviewed Information, Multum Drug Directory, 2006

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Generic name(s):

dextromethorphan, phenylephrine, and pyrilamine

Brand name(s):

dextromethorphan/phenylephrine/pyrilamine, Codal-DM Syrup, Codimal DM, Codituss DM, Poly Hist DM

What is the most important information I should know about dextromethorphan, phenylephrine, and pyrilamine?

Always ask a doctor before giving a cough or cold medicine to a child. Death can occur from the misuse of cough and cold medicines in very young children. Do not use a cough or cold medicine if you have used an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days. Serious, life-threatening side effects can occur if you take cough or cold medicine before the MAO inhibitor has cleared from your body. Do not use any other over-the-counter cough, cold, allergy, or sleep medication without first asking your doctor or pharmacist. If you take certain products together you may accidentally take too much of one or more types of medicine. Read the label of any other medicine you are using to see if it contains an antihistamine, decongestant, or cough suppressant. Dextromethorphan, phenylephrine, and pyrilamine can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert. Avoid drinking alcohol. It can increase some of the side effects of this medication.

What is dextromethorphan, phenylephrine, and pyrilamine?

Dextromethorphan is a cough suppressant. It affects the signals in the brain that trigger cough reflex.

Phenylephrine is a decongestant that shrinks blood vessels in the nasal passages. Dilated blood vessels can cause nasal congestion (stuffy nose).

Pyrilamine is an antihistamine that reduces the natural chemical histamine in the body. Histamine can produce symptoms of sneezing, itching, watery eyes, and runny nose.

The combination of dextromethorphan, phenylephrine, and pyrilamine is used to treat sneezing, cough, runny or stuffy nose, itchy or watery eyes, hives, skin rash, itching, and other symptoms of allergies and the common cold.

Dextromethorphan will not treat a cough that is caused by smoking, asthma, or emphysema.

Dextromethorphan, phenylephrine, and pyrilamine may also be used for purposes other than those listed in this medication guide.

What should I discuss with my healthcare provider before taking dextromethorphan, phenylephrine, and pyrilamine?

Do not use a cough or cold medicine if you have used an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days. Serious, life-threatening side effects can occur if you take cough or cold medicine before the MAO inhibitor has cleared from your body.

Before taking this medication, tell your doctor if you are allergic to dextromethorphan, phenylephrine, or pyrilamine, or if you have:

kidney disease;
liver disease;
diabetes;
glaucoma;
heart disease or high blood pressure;
a thyroid disorder;
a stomach ulcer or a stomach obstruction;
emphysema or chronic bronchitis; or
an enlarged prostate or urination problems.

If you have any of these conditions, you may not be able to use dextromethorphan, phenylephrine, and pyrilamine, or you may need a dosage adjustment or special tests during treatment.

FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Dextromethorphan, phenylephrine, and pyrilamine can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Artificially-sweetened liquid forms of cough-and-cold medications may contain phenylalanine. This would be important to know if you have phenylketonuria (PKU). Check the ingredients and warnings on the medication label if you are concerned about phenylalanine.

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