chlorpheniramine, dihydrocodeine, and phenylephrine

Use caution when driving, operating machinery, or performing other hazardous activities. Chlorpheniramine, dihydrocodeine, and phenylephrine may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities.

Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while taking chlorpheniramine, dihydrocodeine, and phenylephrine.

Chlorpheniramine, dihydrocodeine, and phenylephrine may increase the effects of other drugs that cause drowsiness, including antidepressants, alcohol, antihistamines, sedatives (used to treat insomnia), pain relievers, anxiety medicines, seizure medicines, and muscle relaxants. Tell your doctor about all medicines that you are taking, and do not take any other medicine without first talking to your doctor.

Dihydrocodeine is habit forming. It is possible become physically and/or psychologically dependent on the medication. Do not take more than the prescribed amount of medication or take it for longer than is directed by your doctor. Withdrawal effects may occur if chlorpheniramine, dihydrocodeine, and phenylephrine is stopped suddenly after several weeks of continuous use. Your doctor may recommend a gradual reduction in dose.

Chlorpheniramine is an antihistamine. It blocks the effects of the naturally occurring chemical histamine in the body and reduces congestion.

Dihydrocodeine is a narcotic. It is a pain reliever and a cough suppressant.

Phenylephrine is a decongestant. It works by constricting (shrinking) blood vessels (veins and arteries) in the body. Constriction of blood vessels in the sinuses and nose decreases congestion.

Chlorpheniramine, dihydrocodeine, and phenylephrine is used to treat cough and nasal congestion associated with upper respiratory tract infections and allergies.

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

Do not take chlorpheniramine, dihydrocodeine, and phenylephrine if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) in the last 14 days. A dangerous drug interaction could occur, leading to serious side effects.

Before taking chlorpheniramine, dihydrocodeine, and phenylephrine, tell your doctor if you have

• epilepsy or another seizure disorder;
• been diagnosed with sleep apnea (periods of not breathing during sleep);
• thyroid problems;
• asthma;
• gallbladder disease;
• a head injury;
• Addison's disease;
• diabetes;
• glaucoma;
• an ulcer or an obstruction in the stomach;
• bladder problems or difficulty urinating;
• an enlarged prostate;
• high blood pressure, irregular heartbeats, or any type of heart disease;
• kidney problems; or
• liver problems.

You may not be able to take chlorpheniramine, dihydrocodeine, and phenylephrine, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.

Chlorpheniramine, dihydrocodeine, and phenylephrine is in the FDA pregnancy category C. This means that it is not known whether chlorpheniramine, dihydrocodeine, and phenylephrine will be harmful to an unborn baby. Do not take chlorpheniramine, dihydrocodeine, and phenylephrine without first talking to your doctor if you are pregnant or could become pregnant during treatment.

It is not known whether chlorpheniramine, dihydrocodeine, and phenylephrine passes into breast milk. Do not take chlorpheniramine, dihydrocodeine, and phenylephrine without first talking to your doctor if you are breast-feeding a baby.

If you are over 60 years of age, you may be more likely to experience side effects from chlorpheniramine, dihydrocodeine, and phenylephrine. Your doctor may prescribe a lower dose of this medication.

The safety of chlorpheniramine, dihydrocodeine, and phenylephrine for children younger than 2 years of age has not been established.

Take chlorpheniramine, dihydrocodeine, and phenylephrine exactly as directed by your doctor. If you do not understand the directions on your prescription bottle, ask your pharmacist, nurse, or doctor to explain the instructions to you.

Chlorpheniramine, dihydrocodeine, and phenylephrine can be taken with or without food.

To ensure that you get a correct dose, measure the liquid form of chlorpheniramine, dihydrocodeine, and phenylephrine with a special dose-measuring spoon or cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist where you can get one.

Store chlorpheniramine, dihydrocodeine, and phenylephrine at room temperature away from moisture and heat.

Take the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the missed dose and take only the next regularly scheduled dose. Do not take a double dose of this medication unless otherwise directed by your doctor.

Seek emergency medical attention if an overdose is suspected.

Symptoms of a chlorpheniramine, dihydrocodeine, and phenylephrine overdose include severe drowsiness, dizziness, headache, seizures, dry mouth, cold and clammy skin, flushing, nausea, vomiting, difficulty or decreased breathing, and unconsciousness.

Use caution when driving, operating machinery, or performing other hazardous activities. Chlorpheniramine, dihydrocodeine, and phenylephrine may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities.

Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while taking chlorpheniramine, dihydrocodeine, and phenylephrine.

Chlorpheniramine, dihydrocodeine, and phenylephrine may increase the effects of other drugs that cause drowsiness, including antidepressants, alcohol, antihistamines, sedatives (used to treat insomnia), pain relievers, anxiety medicines, seizure medicines, and muscle relaxants. Tell your doctor about all medicines that you are taking, and do not take any other medicine without first talking to your doctor.

If you experience any of the following serious side effects, stop taking chlorpheniramine, dihydrocodeine, and phenylephrine and seek emergency medical attention or contact your doctor immediately:

• an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives); or
• confusion, hallucinations, or unusual behavior.

Other, less serious side effects may be more likely to occur. Continue to take chlorpheniramine, dihydrocodeine, and phenylephrine and talk to your doctor if you experience

• dizziness, drowsiness, or sleepiness;
• restlessness or irritability;
• blurred vision;
• constipation;
• dry mouth, nausea, vomiting, or decreased appetite;
• muscle twitches;
• sweating;
• itching;
• decreased urination;
• increased sensitivity to sunlight.

Dihydrocodeine is habit forming. It is possible become physically and/or psychologically dependent on the medication. Do not take more than the prescribed amount of medication or take it for longer than is directed by your doctor. Withdrawal effects may occur if chlorpheniramine, dihydrocodeine, and phenylephrine is stopped suddenly after several weeks of continuous use. Your doctor may recommend a gradual reduction in dose.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

Do not take chlorpheniramine, dihydrocodeine, and phenylephrine if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) in the last 14 days. A dangerous drug interaction could occur, leading to serious side effects.

Chlorpheniramine, dihydrocodeine, and phenylephrine may increase the effects of other drugs that cause drowsiness, including antidepressants, alcohol, sedatives (used to treat insomnia), pain relievers, anxiety medicines, and muscle relaxants. Tell your doctor about all medicines that you are taking, and do not take any medicine unless your doctor approves.

Drugs other than those listed here may also interact with chlorpheniramine, dihydrocodeine, and phenylephrine. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including vitamins, minerals, and herbal products.

Your pharmacist has more information about chlorpheniramine, dihydrocodeine, and phenylephrine written for health professionals that you may read.

Chlorpheniramine, dihydrocodeine, and phenylephrine is available with a prescription under the brand name Pancof PD. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.