Consists of CHLORPHENIRAMINE MALEATE, PHENYLEPHRINE HCL
Actions of Chlorpheniramine MALEATE (Ban-Tuss) in details
Chlorpheniramine MALEATE (Ban-Tuss) belongs to class of medications called antihistamines. It acts by blocking a natural chemical (histamine) that your body makes during an allergic reaction. Histamine is responsible for many symptoms of allergy.
How should I take Chlorpheniramine MALEATE (Ban-Tuss)?
This section provides information on the proper use of a number of products that contain cough and cold combinations. It may not be specific to Chlorpheniramine MALEATE (Ban-Tuss). Please read with care.
To help loosen mucus or phlegm in the lungs, drink a glass of water after each dose of this medicine, unless otherwise directed by your doctor.
Take this medicine only as directed. Do not take more of it and do not take it more often than recommended on the label, unless otherwise directed by your doctor. To do so may increase the chance of side effects.
Do not give any over-the-counter (OTC) cough and cold medicine to a baby or child under 4 years of age. Using these medicines in very young children might cause serious or possibly life-threatening side effects.
For patients taking the extended-release capsule or tablet form of this medicine:
- Swallow the capsule or tablet whole.
- Do not crush, break, or chew before swallowing.
- If the capsule is too large to swallow, you may mix the contents of the capsule with applesauce, jelly, honey, or syrup and swallow without chewing.
For patients taking the extended-release oral solution or oral suspension form of this medicine:
- Do not dilute with fluids or mix with other drugs.
For patients taking a combination medicine containing an antihistamine and/or aspirin or other salicylate:
- Take with food or a glass of water or milk to lessen stomach irritation, if necessary.
If a combination medicine containing aspirin has a strong vinegar-like odor, do not use it. This odor means the medicine is breaking down. If you have any questions about this, check with your pharmacist.
Missed Dose
If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.
Storage
Keep out of the reach of children.
Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.
Do not keep outdated medicine or medicine no longer needed.
Keep the liquid form of this medicine from freezing. Do not refrigerate the syrup.
Chlorpheniramine MALEATE (Ban-Tuss) administration
Use exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended. This medicine is usually taken only for a short time until your symptoms clear up.
Do not take for longer than 7 days in a row. Talk with your doctor if your symptoms do not improve after 7 days of treatment, or if you have a fever with a headache or skin rash.
Do not crush, chew, or break an extended-release tablet. Swallow it whole. Breaking the pill may cause too much of the drug to be released at one time.
Measure liquid medicine with a special dose-measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.
Do not give this medication to a child younger than 4 years old. 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.
If you need surgery or medical tests, tell the surgeon or doctor ahead of time if you have taken this medicine within the past few days.
Store at room temperature away from moisture and heat. Do not allow the liquid form of this medicine to freeze.
Chlorpheniramine MALEATE (Ban-Tuss) pharmacology
Chlorpheniramine MALEATE (Ban-Tuss) acts directly on both alpha- and, to a lesser degree, beta-adrenergic receptors. Through direct action on alpha-adrenergic receptors in the mucosa of the respiratory tract, pseudoephedrine produces vasoconstriction. Chlorpheniramine MALEATE (Ban-Tuss) relaxes bronchial smooth muscle by stimulating beta2-adrenergic receptors. Like ephedrine, pseudoephedrine releasing norepinephrine from its storage sites, an indirect effect.
Actions of Phenylephrine HCL (Ban-Tuss) in details
In general, α1-adrenergic receptors mediate contraction and hypertrophic growth of smooth muscle cells. α1-receptors are 7-transmembrane domain receptors coupled to G proteins, Gq/11. Three α1-receptor subtypes, which share approximately 75% homology in their transmembrane domains, have been identified: α1A (chromosome 8), α1B (chromosome 5), and α1D (chromosome 20). Phenylephrine HCL (Ban-Tuss) appears to act similarly on all three receptor subtypes. All three receptor subtypes appear to be involved in maintaining vascular tone. The α1A-receptor maintains basal vascular tone while the α1B-receptor mediates the vasocontrictory effects of exogenous α1-agonists. Activation of the α1-receptor activates Gq-proteins, which results in intracellular stimulation of phospholipases C, A2, and D. This results in mobilization of Ca2+ from intracellular stores, activation of mitogen-activated kinase and PI3 kinase pathways and subsequent vasoconstriction. Phenylephrine HCL (Ban-Tuss) produces its local and systemic actions by acting on α1-adrenergic receptors peripheral vascular smooth muscle. Stimulation of the α1-adrenergic receptors results in contraction arteriolar smooth muscle in the periphery. Phenylephrine HCL (Ban-Tuss) decreases nasal congestion by acting on α1-adrenergic receptors in the arterioles of the nasal mucosa to produce constriction; this leads to decreased edema and increased drainage of the sinus cavities.
How should I take Phenylephrine HCL (Ban-Tuss)?
Do not use if the solution turns brown or becomes cloudy.
To use:
- First, wash your hands. Tilt the head back and, pressing your finger gently on the skin just beneath the lower eyelid, pull the lower eyelid away from the eye to make a space. Drop the medicine into this space. Let go of the eyelid and gently close the eyes. Do not blink. Keep the eyes closed and apply pressure to the inner corner of the eye with your finger for 2 or 3 minutes to allow the medicine to be absorbed by the eye.
- Immediately after using the eye drops, wash your hands to remove any medicine that may be on them.
- To keep the medicine as germ-free as possible, do not touch the applicator tip to any surface (including the eye). Also, keep the container tightly closed.
For patients using the 2.5 or 10% eye drops:
- It is very important that you use Phenylephrine HCL (Ban-Tuss) only as directed. Do not use more of it and do not use it more often than your doctor ordered. To do so may increase the chance of too much medicine being absorbed into the body and the chance of side effects. This is especially important when Phenylephrine HCL (Ban-Tuss) is used in children or in patients with heart disease or high blood pressure, since high doses of Phenylephrine HCL (Ban-Tuss) may cause an irregular heartbeat and an increase in blood pressure.
Dosing
The dose of Phenylephrine HCL (Ban-Tuss) will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of Phenylephrine HCL (Ban-Tuss). If your dose is different, do not change it unless your doctor tells you to do so.
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
- For ophthalmic solution (eye drops) dosage form:
- For eye redness:
- Adults and children—Use one drop of 0.12% solution every three or four hours as needed.
- For eye exams:
- Adults and children—Use one drop of 2.5% solution. Depending on the eye test to be done, it will take from fifteen minutes to one or two hours for the medicine to work before you can have the eye test.
- For use before eye surgery:
- Adults and teenagers—Use one drop of 2.5 or 10% solution thirty to sixty minutes before the start of eye surgery.
- Children—Use one drop of 2.5% solution thirty to sixty minutes before the start of eye surgery.
- For certain eye conditions:
- Adults and teenagers—Depending on the eye condition being treated, your doctor may tell you to use one drop of 2.5 or 10% solution in the eye from once a day to three times a day.
- Children—Depending on the eye condition being treated, your doctor may tell you to use one drop of 2.5% solution in the eye from once a day to three times a day.
- For eye redness:
Missed Dose
If you miss a dose of Phenylephrine HCL (Ban-Tuss), take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.
For non-prescription strength eye drops, follow the package directions.
Storage
Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.
Keep out of the reach of children.
Do not keep outdated medicine or medicine no longer needed.
Phenylephrine HCL (Ban-Tuss) administration
IV:
Hypotension/shock: May be administered via continuous infusion (after diluting). When administering as a continuous infusion, central line administration is preferred. IV infusions require an infusion pump.
Hypotension during anesthesia: Administer as an IV bolus over 20 to 30 seconds.
Vesicant; ensure proper needle or catheter placement prior to and during infusion; avoid extravasation.
Extravasation management: If extravasation occurs, stop infusion immediately and disconnect (leave cannula/needle in place); gently aspirate extravasated solution (do NOT flush the line); remove needle/cannula; elevate extremity. Initiate phentolamine (or alternative antidote). Apply dry warm compresses (Hurst 2004; Reynolds 2014).
Phentolamine: Dilute 5 to 10 mg in 10 to 20 mL NS and administer into extravasation site as soon as possible after extravasation; may readminister if patient remains symptomatic (Reynolds 2014).
Alternative to phentolamine: Nitroglycerin topical 2% ointment (based on limited data): Apply a 1-inch strip to the site of ischemia; may repeat every 8 hours as necessary (Reynolds 2014).
Phenylephrine HCL (Ban-Tuss) pharmacology
Phenylephrine HCL (Ban-Tuss) is a powerful vasoconstrictor. It is used as a nasal decongestant and cardiotonic agent. Phenylephrine HCL (Ban-Tuss) is a postsynaptic α1-receptor agonist with little effect on β-receptors of the heart.
Parenteral administration of Phenylephrine HCL (Ban-Tuss) causes a rise in systolic and diastolic pressures, a slight decrease in cardiac output, and a considerable increase in peripheral resistance; most vascular beds are constricted, and renal, splanchnic, cutaneous, and limb blood flows are reduced while coronary blood flow is increased. Phenelephrine also causes pulmonary vessel constriction and subsequent increase in pulmonary arterial pressure. Vasoconstriction in the mucosa of the respiratory tract leads to decreased edema and increased drainage of sinus cavities.
References
- DailyMed. "CHLORPHENIRAMINE POLISTIREX; HYDROCODONE POLISTIREX: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
- NCIt. "Phenylephrine: NCI Thesaurus (NCIt) provides reference terminology for many systems. It covers vocabulary for clinical care, translational and basic research, and public information and administrative activities.". https://ncit.nci.nih.gov/ncitbrowser... (accessed September 17, 2018).
- NCIt. "Chlorpheniramine Maleate: NCI Thesaurus (NCIt) provides reference terminology for many systems. It covers vocabulary for clinical care, translational and basic research, and public information and administrative activities.". https://ncit.nci.nih.gov/ncitbrowser... (accessed September 17, 2018).
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Information checked by Dr. Sachin Kumar, MD Pharmacology
