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Chlorpheniramine: Pediatric drug information

Chlorpheniramine: Pediatric drug information
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For additional information see "Chlorpheniramine: Drug information" and "Chlorpheniramine: Patient drug information"

For abbreviations, symbols, and age group definitions show table
Brand Names: US
  • Aller-Chlor [OTC];
  • Allergy Relief [OTC];
  • Allergy [OTC];
  • Chlor-Trimeton Allergy [OTC];
  • Chlor-Trimeton [OTC] [DSC];
  • Chlorphen [OTC];
  • Ed Chlorped Jr [OTC];
  • FT Allergy Relief [OTC];
  • GoodSense Allergy Relief [OTC];
  • Pharbechlor [OTC]
Therapeutic Category
  • Antihistamine
Dosing: Pediatric

Dosage guidance:

Safety: Safety and efficacy for the use of cough and cold products in infants and young children are limited; the AAP warns against the use of these products for respiratory illnesses in infants and young children; the FDA does not recommend OTC use in infants and children <2 years of age due to the risk of serious and life-threatening adverse effects (including death) and recommends to use with caution in pediatric patients ≥2 years of age (Ref).

Upper respiratory allergy symptoms [hay fever]

Upper respiratory allergy symptoms [hay fever]:

Immediate release:

Oral syrup (eg, Ed Chlorped Jr): 2 mg chlorpheniramine per 5 mL:

Children 2 to <6 years: Limited data available: Oral: 1 mg every 4 to 6 hours; maximum daily dose: 6 mg/day (Ref).

Children 6 to <12 years: Oral: 2 mg every 4 to 6 hours; maximum daily dose: 12 mg/day.

Children ≥12 years and Adolescents: Oral: 4 mg every 4 to 6 hours; maximum daily dose: 24 mg/day.

Tablets (eg, Allergy, Allergy Relief, Chlor-Trimeton, GoodSense Allergy):

Children 6 to <12 years: Oral: 2 mg every 4 to 6 hours; maximum daily dose: 12 mg/day.

Children ≥12 years and Adolescents: Oral: 4 mg every 4 to 6 hours; maximum daily dose: 24 mg/day.

Extended release: Tablet (eg, Chlor-Trimeton Allergy): Children ≥12 years and Adolescents: Oral: 12 mg every 12 hours; maximum dose: 24 mg in 24 hours.

Dosing: Kidney Impairment: Pediatric

Children ≥6 years and Adolescents: Oral: There are no pediatric dosage adjustments provided in manufacturer's labeling; in adult patients with severe kidney disease, greatly prolonged half-lives have been reported; use with caution (Ref).

Dosing: Liver Impairment: Pediatric

Children ≥6 years and Adolescents: Oral: There are no dosage adjustments provided in manufacturer's labeling; however, chlorpheniramine is metabolized via the liver; therefore, a dose adjustment may be necessary.

Dosing: Adult

(For additional information see "Chlorpheniramine: Drug information")

Motion sickness

Motion sickness (off-label use): Immediate release: Oral: 4 to 12 mg administered 3 hours prior to initiating stimulus for motion sickness (Ref). Note: Avoid use if it is unsafe for patient to be sedated.

Upper respiratory tract conditions

Upper respiratory tract conditions:

Note: Second-generation H1-antihistamines are generally preferred due to less sedating and anticholinergic effects. Avoid use in patients with high-risk occupations (eg, pilots, bus drivers) or who may be more prone to anticholinergic effects (eg, older adults) (Ref).

Immediate release: Oral: 4 mg every 4 to 6 hours; do not exceed 24 mg/24 hours.

Extended release: Oral: 12 mg every 12 hours; do not exceed 24 mg/24 hours.

Urticaria, new onset and chronic spontaneous

Urticaria, new onset and chronic spontaneous (alternative agent) (off-label use):

Note: Second-generation H1-antihistamines are preferred due to less sedating and anticholinergic effects (Ref). May consider use in combination with a second-generation H1-antihistamine in patients in whom bedtime sedating effects may be beneficial; avoid use in patients with high-risk occupations (eg, pilots, bus drivers) or who may be more prone to anticholinergic effects (eg, older adults) (Ref). Dosing is based on manufacturer’s labeling for use in upper respiratory tract conditions.

Immediate release: Oral: 4 mg every 4 to 6 hours; do not exceed 24 mg/24 hours.

Extended release: Oral: 12 mg every 12 hours; do not exceed 24 mg/24 hours.

Dosing: Kidney Impairment: Adult

The renal dosing recommendations are based upon the best available evidence and clinical expertise. Senior Editorial Team: Bruce Mueller, PharmD, FCCP, FASN, FNKF; Jason A. Roberts, PhD, BPharm (Hons), B App Sc, FSHP, FISAC; Michael Heung, MD, MS.

Note: Limited information exists regarding the disposition of chlorpheniramine in patients with kidney impairment.

Altered kidney function:

eGFR >30 mL/minute/1.73 m2: No dosage adjustment necessary (Ref).

eGFR ≤30 mL/minute/1.73 m2: No initial dosage adjustment necessary; however, greatly prolonged half-lives in patients with severe kidney disease have been reported; use with caution (Ref).

Hemodialysis, intermittent (thrice weekly): Unlikely to be dialyzed (large Vd): Dose as for eGFR ≤30 mL/minute/1.73 m2 (Ref).

Peritoneal dialysis: Unlikely to be dialyzed (large Vd): Dose as for eGFR ≤30 mL/minute/1.73 m2 (Ref).

CRRT: Dose as for eGFR ≤30 mL/minute/1.73 m2 (Ref).

PIRRT (eg, sustained, low-efficiency diafiltration): Dose as for eGFR ≤30 mL/minute/1.73 m2 (Ref).

Dosing: Liver Impairment: Adult

There are no dosage adjustments provided in the manufacturer's labeling; however, chlorpheniramine is metabolized via the liver; therefore, a dose adjustment may be necessary.

Adverse Reactions

There are no adverse reactions listed in the manufacturer’s labeling.

Contraindications

OTC labeling: When used for self-medication, do not use to make a child sleep.

Warnings/Precautions

Concerns related to adverse effects:

• CNS depression: May cause CNS depression, which may impair physical or mental abilities; patients must be cautioned about performing tasks which require mental alertness (eg, operating machinery or driving).

Special populations:

• Pediatric: Antihistamines may cause excitation in young children.

Dosage form specific issues:

• Benzyl alcohol and derivatives: Some dosage forms may contain sodium benzoate/benzoic acid; benzoic acid (benzoate) is a metabolite of benzyl alcohol; large amounts of benzyl alcohol (≥99 mg/kg/day) have been associated with a potentially fatal toxicity (“gasping syndrome”) in neonates; the “gasping syndrome” consists of metabolic acidosis, respiratory distress, gasping respirations, CNS dysfunction (including convulsions, intracranial hemorrhage), hypotension, and cardiovascular collapse (AAP ["Inactive" 1997]; CDC 1982); some data suggests that benzoate displaces bilirubin from protein binding sites (Ahlfors 2001); avoid or use dosage forms containing benzyl alcohol derivative with caution in neonates. See manufacturer's labeling.

• Propylene glycol: Some dosage forms may contain propylene glycol; large amounts are potentially toxic and have been associated with hyperosmolality, lactic acidosis, seizures, and respiratory depression; use caution (AAP 1997; Zar 2007).

Other warnings/precautions:

• Self-medication (OTC use): When used for self-medication (OTC), notify health care provider prior to use if you have breathing problems (eg, chronic bronchitis, emphysema), glaucoma, difficultly in urination due to enlargement of the prostate gland, or are currently taking sedatives, tranquilizers.

Warnings: Additional Pediatric Considerations

Safety and efficacy for the use of cough and cold products in pediatric patients <4 years of age is limited; the AAP warns against the use of these products for respiratory illnesses in young children. Serious adverse effects including death have been reported. Many of these products contain multiple active ingredients, increasing the risk of accidental overdose when used with other products. The FDA does not recommend OTC uses for these products in pediatric patients <2 years of age and recommends to use with caution in pediatric patients ≥2 years of age. Health care providers are reminded to ask caregivers about the use of OTC cough and cold products in order to avoid exposure to multiple medications containing the same ingredient (AAP 2018; CDC 2007; FDA 2017; FDA 2018).

Some dosage forms may contain propylene glycol; in neonates large amounts of propylene glycol delivered orally, intravenously (eg, >3,000 mg/day), or topically have been associated with potentially fatal toxicities which can include metabolic acidosis, seizures, renal failure, and CNS depression; toxicities have also been reported in children and adults including hyperosmolality, lactic acidosis, seizures and respiratory depression; use caution (AAP 1997; Shehab 2009).

Dosage Forms: US

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Syrup, Oral, as maleate:

Chlor-Trimeton: 2 mg/5 mL (120 mL [DSC]) [contains alcohol, usp]

Ed Chlorped Jr: 2 mg/5 mL (473 mL) [alcohol free, sugar free; contains fd&c red #40 (allura red ac dye), methylparaben, propylene glycol, propylparaben; cherry flavor]

Tablet, Oral, as maleate:

Aller-Chlor: 4 mg [scored; contains quinoline (d&c yellow #10) aluminum lake]

Allergy: 4 mg [scored; contains corn starch, quinoline (d&c yellow #10) aluminum lake]

Allergy Relief: 4 mg [contains corn starch, quinoline (d&c yellow #10) aluminum lake]

Allergy Relief: 4 mg [scored; contains corn starch, quinoline (d&c yellow #10) aluminum lake]

Chlor-Trimeton: 4 mg [DSC]

Chlorphen: 4 mg [scored; contains corn starch, quinoline (d&c yellow #10) aluminum lake]

FT Allergy Relief: 4 mg [contains corn starch, quinoline (d&c yellow #10) aluminum lake]

GoodSense Allergy Relief: 4 mg [contains quinoline (d&c yellow #10) aluminum lake]

Pharbechlor: 4 mg

Generic: 4 mg

Tablet Extended Release, Oral, as maleate:

Chlor-Trimeton Allergy: 12 mg [contains fd&c blue #2 (indigo carm) aluminum lake, fd&c yellow #6(sunset yellow)alumin lake, quinoline (d&c yellow #10) aluminum lake]

Chlor-Trimeton Allergy: 12 mg [DSC] [contains fd&c yellow #6 (sunset yellow), fd&c yellow #6(sunset yellow)alumin lake]

Generic: 12 mg

Generic Equivalent Available: US

Yes

Pricing: US

Tablet, controlled release (Chlor-Trimeton Allergy Oral)

12 mg (per each): $0.46

Tablet, controlled release (Chlorpheniramine Maleate ER Oral)

12 mg (per each): $0.63

Tablets (Chlorpheniramine Maleate Oral)

4 mg (per each): $0.01

Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.

Administration: Pediatric

Oral:

Immediate release:

Tablet: May be administered with food or water.

Syrup: Administer liquid formulations with an accurate measuring device; do not use a household teaspoon (overdosage may occur).

Extended release: Tablet: Swallow whole; do not crush or chew. May be administered with food or water.

Administration: Adult

Oral:

May be administered with food or water. Timed release oral forms are to be swallowed whole, not crushed or chewed. Administer liquid formulations with an accurate measuring device; do not use a household teaspoon (overdosage may occur). If used for motion sickness, administer 3 hours before stimulus.

Bariatric surgery: Capsule and tablet, extended release: Some institutions may have specific protocols that conflict with these recommendations; refer to institutional protocols as appropriate. Switch to IR formulation.

Storage/Stability

Store at room temperature.

Use

Temporary relief of symptoms associated with hay fever and other respiratory allergies (eg, runny nose; itchy, watery eyes; sneezing; itching of nose or throat) (OTC products: Oral liquid: FDA approved in ages ≥6 years and adults; tablets [immediate release]: FDA approved in ages ≥6 years and adults; tablets [extended release: 12 hours]: FDA approved in ages ≥12 years and adults); Note: Approved ages and uses for products may vary; consult labeling for specific information.

Medication Safety Issues
Sound-alike/look-alike issues:

Chlor-Trimeton may be confused with Chloromycetin

High alert medication:

The Institute for Safe Medication Practices (ISMP) includes this medication among its list of drugs (pediatric liquid medications requiring measurement) which have a heightened risk of causing significant patient harm when used in error (High-Alert Medications in Community/Ambulatory Care Settings).

Older Adult: High-Risk Medication:

Beers Criteria: Chlorpheniramine, a first-generation antihistamine, is identified in the Beers Criteria as a potentially inappropriate medication to be avoided in patients 65 years and older (independent of diagnosis or condition) because of its potent anticholinergic properties resulting in increased risk of confusion, dry mouth, constipation, and other anticholinergic effects or toxicity; use should also be avoided because of reduced clearance with advanced age and tolerance associated with use as a hypnotic. Exposure to concurrent anticholinergic drugs also increases risk of falls, delirium, and dementia; consider total anticholinergic burden when conducting medication reviews (Beers Criteria [AGS 2023]).

Metabolism/Transport Effects

Substrate of CYP2D6 (Major), CYP3A4 (Minor); Note: Assignment of Major/Minor substrate status based on clinically relevant drug interaction potential;

Drug Interactions

Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the drug interactions program by clicking on the “Launch drug interactions program” link above.

Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the drug interactions program

Acetylcholinesterase Inhibitors: May decrease therapeutic effects of Agents with Clinically Relevant Anticholinergic Effects. Agents with Clinically Relevant Anticholinergic Effects may decrease therapeutic effects of Acetylcholinesterase Inhibitors. Risk C: Monitor

Aclidinium: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk X: Avoid

Acrivastine: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk C: Monitor

Acrivastine: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Ajmaline: May increase serum concentration of CYP2D6 Substrates (High risk with Inhibitors). Risk C: Monitor

Alcohol (Ethyl): CNS Depressants may increase CNS depressant effects of Alcohol (Ethyl). Risk C: Monitor

Alizapride: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Amantadine: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk C: Monitor

Amezinium: Antihistamines may increase stimulatory effects of Amezinium. Risk C: Monitor

Amisulpride (Oral): May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Artemether and Lumefantrine: May increase serum concentration of CYP2D6 Substrates (High risk with Inhibitors). Risk C: Monitor

Articaine: May increase CNS depressant effects of CNS Depressants. Management: Consider reducing the dose of articaine if possible when used in patients who are also receiving CNS depressants. Monitor for excessive CNS depressant effects with any combined use. Risk D: Consider Therapy Modification

Azelastine (Nasal): May increase CNS depressant effects of CNS Depressants. Risk X: Avoid

Benperidol: Agents with Clinically Relevant Anticholinergic Effects may decrease therapeutic effects of Benperidol. Risk C: Monitor

Benperidol: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Benztropine: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Benztropine. Risk C: Monitor

Benzylpenicilloyl Polylysine: Coadministration of Antihistamines and Benzylpenicilloyl Polylysine may alter diagnostic results. Management: Suspend systemic H1 antagonists for benzylpenicilloyl-polylysine skin testing and delay testing until systemic antihistaminic effects have dissipated. A histamine skin test may be used to assess persistent antihistaminic effects. Risk D: Consider Therapy Modification

Betahistine: Antihistamines may decrease therapeutic effects of Betahistine. Betahistine may decrease therapeutic effects of Antihistamines. Risk C: Monitor

Biperiden: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Biperiden. Risk C: Monitor

Blonanserin: CNS Depressants may increase CNS depressant effects of Blonanserin. Management: Use caution if coadministering blonanserin and CNS depressants; dose reduction of the other CNS depressant may be required. Strong CNS depressants should not be coadministered with blonanserin. Risk D: Consider Therapy Modification

Bornaprine: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Bornaprine. Risk C: Monitor

Botulinum Toxin-Containing Products: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk C: Monitor

Brexanolone: CNS Depressants may increase CNS depressant effects of Brexanolone. Risk C: Monitor

Brimonidine (Topical): May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Bromopride: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Bromperidol: May increase CNS depressant effects of CNS Depressants. Risk X: Avoid

Buclizine: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Buclizine. Risk C: Monitor

Buclizine: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Buprenorphine: CNS Depressants may increase CNS depressant effects of Buprenorphine. Management: Consider reduced doses of other CNS depressants, and avoiding such drugs in patients at high risk of buprenorphine overuse/self-injection. Initiate buprenorphine at lower doses in patients already receiving CNS depressants. Risk D: Consider Therapy Modification

BusPIRone: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Cannabinoid-Containing Products: Agents with Clinically Relevant Anticholinergic Effects may increase tachycardic effects of Cannabinoid-Containing Products. Risk C: Monitor

Cannabinoid-Containing Products: CNS Depressants may increase CNS depressant effects of Cannabinoid-Containing Products. Risk C: Monitor

Certoparin: Antihistamines may increase therapeutic effects of Certoparin. Risk C: Monitor

Cetirizine (Systemic): May increase CNS depressant effects of CNS Depressants. Management: Consider avoiding this combination if possible. If required, monitor for excessive sedation or CNS depression, limit the dose and duration of combination therapy, and consider CNS depressant dose reductions. Risk D: Consider Therapy Modification

Chloral Hydrate/Chloral Betaine: CNS Depressants may increase CNS depressant effects of Chloral Hydrate/Chloral Betaine. Management: Consider alternatives to the use of chloral hydrate or chloral betaine and additional CNS depressants. If combined, consider a dose reduction of either agent and monitor closely for enhanced CNS depressive effects. Risk D: Consider Therapy Modification

Chlormethiazole: May increase CNS depressant effects of CNS Depressants. Management: Monitor closely for evidence of excessive CNS depression. The chlormethiazole labeling states that an appropriately reduced dose should be used if such a combination must be used. Risk D: Consider Therapy Modification

Chlorphenesin Carbamate: May increase adverse/toxic effects of CNS Depressants. Risk C: Monitor

Chlorprothixene: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Chlorprothixene. Risk C: Monitor

Cimetropium: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Cimetropium. Risk X: Avoid

CloZAPine: Agents with Clinically Relevant Anticholinergic Effects may increase constipating effects of CloZAPine. Management: Consider alternatives to this combination whenever possible. If combined, monitor closely for signs and symptoms of gastrointestinal hypomotility and consider prophylactic laxative treatment. Risk D: Consider Therapy Modification

CNS Depressants: May increase adverse/toxic effects of CNS Depressants. Risk C: Monitor

Cyclizine: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk C: Monitor

CYP2D6 Inhibitors (Strong): May increase serum concentration of Chlorpheniramine. Risk C: Monitor

Dantrolene: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Daridorexant: May increase CNS depressant effects of CNS Depressants. Management: Dose reduction of daridorexant and/or any other CNS depressant may be necessary. Use of daridorexant with alcohol is not recommended, and the use of daridorexant with any other drug to treat insomnia is not recommended. Risk D: Consider Therapy Modification

Darifenacin: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Darifenacin. Risk C: Monitor

DexmedeTOMIDine: CNS Depressants may increase CNS depressant effects of DexmedeTOMIDine. Management: Monitor for increased CNS depression during coadministration of dexmedetomidine and CNS depressants, and consider dose reductions of either agent to avoid excessive CNS depression. Risk D: Consider Therapy Modification

Dicyclomine: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Dicyclomine. Risk C: Monitor

Difelikefalin: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Difenoxin: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Dihydralazine: CNS Depressants may increase hypotensive effects of Dihydralazine. Risk C: Monitor

Dimethindene (Systemic): Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Dimethindene (Systemic). Risk C: Monitor

Dimethindene (Topical): May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Dothiepin: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Doxylamine: CNS Depressants may increase CNS depressant effects of Doxylamine. Risk C: Monitor

DroNABinol: Agents with Clinically Relevant Anticholinergic Effects may increase tachycardic effects of DroNABinol. Risk X: Avoid

DroPERidol: May increase CNS depressant effects of CNS Depressants. Management: Consider dose reductions of droperidol or of other CNS agents (eg, opioids, barbiturates) with concomitant use. Risk D: Consider Therapy Modification

Eluxadoline: Agents with Clinically Relevant Anticholinergic Effects may increase constipating effects of Eluxadoline. Risk X: Avoid

Emedastine (Systemic): May increase CNS depressant effects of CNS Depressants. Management: Consider avoiding this combination if possible. If required, monitor for excessive sedation or CNS depression, limit the dose and duration of combination therapy, and consider CNS depressant dose reductions. Risk C: Monitor

Entacapone: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Esketamine (Nasal): May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Fesoterodine: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Fesoterodine. Risk C: Monitor

Flunarizine: CNS Depressants may increase CNS depressant effects of Flunarizine. Risk X: Avoid

Flunitrazepam: CNS Depressants may increase CNS depressant effects of Flunitrazepam. Management: Reduce the dose of CNS depressants when combined with flunitrazepam and monitor patients for evidence of CNS depression (eg, sedation, respiratory depression). Use non-CNS depressant alternatives when available. Risk D: Consider Therapy Modification

FluPHENAZine: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk C: Monitor

Fosphenytoin-Phenytoin: Chlorpheniramine may increase serum concentration of Fosphenytoin-Phenytoin. Risk C: Monitor

Gastrointestinal Agents (Prokinetic): Agents with Clinically Relevant Anticholinergic Effects may decrease therapeutic effects of Gastrointestinal Agents (Prokinetic). Risk C: Monitor

Gepotidacin: May decrease anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk C: Monitor

Glucagon: Agents with Clinically Relevant Anticholinergic Effects may increase adverse/toxic effects of Glucagon. Specifically, the risk of gastrointestinal adverse effects may be increased. Risk C: Monitor

Glycopyrrolate (Oral Inhalation): Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Glycopyrrolate (Oral Inhalation). Risk X: Avoid

Glycopyrrolate (Systemic): Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Glycopyrrolate (Systemic). Risk C: Monitor

Glycopyrronium (Topical): May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk X: Avoid

Haloperidol: QT-prolonging Agents (Indeterminate Risk - Caution) may increase QTc-prolonging effects of Haloperidol. Risk C: Monitor

Hyaluronidase: Antihistamines may decrease therapeutic effects of Hyaluronidase. Risk C: Monitor

HydrOXYzine: May increase CNS depressant effects of CNS Depressants. Management: Consider a decrease in the CNS depressant dose, as appropriate, when used together with hydroxyzine. Increase monitoring of signs/symptoms of CNS depression in any patient receiving hydroxyzine together with another CNS depressant. Risk D: Consider Therapy Modification

Ipratropium (Nasal): May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk C: Monitor

Ipratropium (Oral Inhalation): May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk X: Avoid

Isoproterenol: Chlorpheniramine may increase therapeutic effects of Isoproterenol. Risk C: Monitor

Itopride: Agents with Clinically Relevant Anticholinergic Effects may decrease therapeutic effects of Itopride. Risk C: Monitor

Ixabepilone: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Kava Kava: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Ketotifen (Systemic): May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Kratom: May increase CNS depressant effects of CNS Depressants. Risk X: Avoid

Lemborexant: May increase CNS depressant effects of CNS Depressants. Management: Dosage adjustments of lemborexant and of concomitant CNS depressants may be necessary when administered together because of potentially additive CNS depressant effects. Close monitoring for CNS depressant effects is necessary. Risk D: Consider Therapy Modification

Levocetirizine: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Levosulpiride: Agents with Clinically Relevant Anticholinergic Effects may decrease therapeutic effects of Levosulpiride. Risk X: Avoid

Lisuride: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Lofepramine: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Lofexidine: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Loxapine: CNS Depressants may increase CNS depressant effects of Loxapine. Management: Consider reducing the dose of CNS depressants administered concomitantly with loxapine due to an increased risk of respiratory depression, sedation, hypotension, and syncope. Risk D: Consider Therapy Modification

Magnesium Sulfate: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Maprotiline: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Maprotiline. Risk C: Monitor

Mavorixafor: May increase serum concentration of CYP2D6 Substrates (High risk with Inhibitors). Risk X: Avoid

Melitracen [INT]: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Melperone: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk C: Monitor

Mequitazine: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Metergoline: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Methotrimeprazine: CNS Depressants may increase CNS depressant effects of Methotrimeprazine. Methotrimeprazine may increase CNS depressant effects of CNS Depressants. Management: Reduce the usual dose of CNS depressants by 50% if starting methotrimeprazine until the dose of methotrimeprazine is stable. Monitor patient closely for evidence of CNS depression. Risk D: Consider Therapy Modification

Methoxyflurane: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Methscopolamine: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Methscopolamine. Risk C: Monitor

Metoclopramide: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

MetyroSINE: CNS Depressants may increase sedative effects of MetyroSINE. Risk C: Monitor

Minocycline (Systemic): May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Mirabegron: Agents with Clinically Relevant Anticholinergic Effects may increase adverse/toxic effects of Mirabegron. Risk C: Monitor

Moxonidine: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Nabilone: May increase CNS depressant effects of CNS Depressants. Risk X: Avoid

Nalfurafine: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Nitroglycerin: Agents with Clinically Relevant Anticholinergic Effects may decrease absorption of Nitroglycerin. Specifically, anticholinergic agents may decrease the dissolution of sublingual nitroglycerin tablets, possibly impairing or slowing nitroglycerin absorption. Risk C: Monitor

Noscapine: CNS Depressants may increase adverse/toxic effects of Noscapine. Risk X: Avoid

OLANZapine: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of OLANZapine. Risk C: Monitor

Olopatadine (Nasal): May increase CNS depressant effects of CNS Depressants. Risk X: Avoid

Opicapone: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Opioid Agonists: CNS Depressants may increase CNS depressant effects of Opioid Agonists. Management: Avoid concomitant use of opioid agonists and benzodiazepines or other CNS depressants when possible. These agents should only be combined if alternative treatment options are inadequate. If combined, limit the dosages and duration of each drug. Risk D: Consider Therapy Modification

Opipramol: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk C: Monitor

Opipramol: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Orphenadrine: CNS Depressants may increase CNS depressant effects of Orphenadrine. Risk X: Avoid

Oxatomide: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk X: Avoid

Oxomemazine: May increase CNS depressant effects of CNS Depressants. Risk X: Avoid

Oxybate Salt Products: CNS Depressants may increase CNS depressant effects of Oxybate Salt Products. Management: Consider alternatives to this combination when possible. If combined, dose reduction or discontinuation of one or more CNS depressants (including the oxybate salt product) should be considered. Interrupt oxybate salt treatment during short-term opioid use Risk D: Consider Therapy Modification

OxyBUTYnin: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of OxyBUTYnin. Risk C: Monitor

OxyCODONE: CNS Depressants may increase CNS depressant effects of OxyCODONE. Management: Avoid concomitant use of oxycodone and benzodiazepines or other CNS depressants when possible. These agents should only be combined if alternative treatment options are inadequate. If combined, limit the dosages and duration of each drug. Risk D: Consider Therapy Modification

Paliperidone: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Paraldehyde: CNS Depressants may increase CNS depressant effects of Paraldehyde. Risk X: Avoid

Peginterferon Alfa-2b: May decrease serum concentration of CYP2D6 Substrates (High risk with Inhibitors). Peginterferon Alfa-2b may increase serum concentration of CYP2D6 Substrates (High risk with Inhibitors). Risk C: Monitor

Perampanel: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Perazine: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk C: Monitor

Periciazine: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Perphenazine: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Perphenazine. Risk C: Monitor

Pipamperone: May increase adverse/toxic effects of CNS Depressants. Risk C: Monitor

Piribedil: CNS Depressants may increase CNS depressant effects of Piribedil. Risk C: Monitor

Pitolisant: Antihistamines may decrease therapeutic effects of Pitolisant. Risk X: Avoid

Pizotifen: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Potassium Chloride: Agents with Clinically Relevant Anticholinergic Effects may increase ulcerogenic effects of Potassium Chloride. Management: Patients on drugs with substantial anticholinergic effects should avoid using any solid oral dosage form of potassium chloride. Risk X: Avoid

Potassium Citrate: Agents with Clinically Relevant Anticholinergic Effects may increase ulcerogenic effects of Potassium Citrate. Management: Patients on drugs with substantial anticholinergic effects should avoid using any solid oral dosage form of potassium citrate. Risk X: Avoid

Pramipexole: CNS Depressants may increase sedative effects of Pramipexole. Risk C: Monitor

Pramlintide: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. These effects are specific to the GI tract. Risk X: Avoid

Procarbazine: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Promethazine: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Promethazine. Risk C: Monitor

Propantheline: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Propantheline. Risk C: Monitor

Propiverine: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk C: Monitor

QT-prolonging Agents (Highest Risk): QT-prolonging Agents (Indeterminate Risk - Caution) may increase QTc-prolonging effects of QT-prolonging Agents (Highest Risk). Management: Monitor for QTc interval prolongation and ventricular arrhythmias when these agents are combined. Patients with additional risk factors for QTc prolongation may be at even higher risk. Risk C: Monitor

QuiNIDine: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk C: Monitor

Ramosetron: Agents with Clinically Relevant Anticholinergic Effects may increase constipating effects of Ramosetron. Risk C: Monitor

Revefenacin: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Revefenacin. Risk X: Avoid

Rilmenidine: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Rivastigmine: Agents with Clinically Relevant Anticholinergic Effects may decrease therapeutic effects of Rivastigmine. Rivastigmine may decrease therapeutic effects of Agents with Clinically Relevant Anticholinergic Effects. Management: Use of rivastigmine with an anticholinergic agent is not recommended unless clinically necessary. If the combination is necessary, monitor for reduced anticholinergic effects. Risk D: Consider Therapy Modification

Ropeginterferon Alfa-2b: CNS Depressants may increase adverse/toxic effects of Ropeginterferon Alfa-2b. Specifically, the risk of neuropsychiatric adverse effects may be increased. Management: Avoid coadministration of ropeginterferon alfa-2b and other CNS depressants. If this combination cannot be avoided, monitor patients for neuropsychiatric adverse effects (eg, depression, suicidal ideation, aggression, mania). Risk D: Consider Therapy Modification

ROPINIRole: CNS Depressants may increase sedative effects of ROPINIRole. Risk C: Monitor

Rotigotine: CNS Depressants may increase sedative effects of Rotigotine. Risk C: Monitor

Scopolamine: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Scopolamine. Risk C: Monitor

Secretin: Agents with Clinically Relevant Anticholinergic Effects may decrease therapeutic effects of Secretin. Management: Avoid concomitant use of anticholinergic agents and secretin. Discontinue anticholinergic agents at least 5 half-lives prior to administration of secretin. Risk D: Consider Therapy Modification

Sofpironium: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Sofpironium. Risk X: Avoid

Suvorexant: CNS Depressants may increase CNS depressant effects of Suvorexant. Management: Dose reduction of suvorexant and/or any other CNS depressant may be necessary. Use of suvorexant with alcohol is not recommended, and the use of suvorexant with any other drug to treat insomnia is not recommended. Risk D: Consider Therapy Modification

Thalidomide: CNS Depressants may increase CNS depressant effects of Thalidomide. Risk X: Avoid

Thiazide and Thiazide-Like Diuretics: Agents with Clinically Relevant Anticholinergic Effects may increase serum concentration of Thiazide and Thiazide-Like Diuretics. Risk C: Monitor

Thiothixene: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Thiothixene. Risk C: Monitor

Tiapride: Agents with Clinically Relevant Anticholinergic Effects may decrease therapeutic effects of Tiapride. Risk C: Monitor

Tiotropium: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Tiotropium. Risk X: Avoid

Tolterodine: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Tolterodine. Risk C: Monitor

Topiramate: Agents with Clinically Relevant Anticholinergic Effects may increase adverse/toxic effects of Topiramate. Risk C: Monitor

Tranylcypromine: May increase anticholinergic effects of Antihistamines, First Generation. Risk X: Avoid

Tricyclic Antidepressants: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Tricyclic Antidepressants. Risk C: Monitor

Trimeprazine: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Trimethobenzamide: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Trimethobenzamide. Risk C: Monitor

Trospium: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Trospium. Risk C: Monitor

Umeclidinium: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk X: Avoid

Valerian: May increase CNS depressant effects of CNS Depressants. Risk C: Monitor

Zolpidem: CNS Depressants may increase CNS depressant effects of Zolpidem. Management: Reduce the Intermezzo brand sublingual zolpidem adult dose to 1.75 mg for men who are also receiving other CNS depressants. No such dose change is recommended for women. Avoid use with other CNS depressants at bedtime; avoid use with alcohol. Risk D: Consider Therapy Modification

Zuclopenthixol: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Zuclopenthixol. Risk C: Monitor

Zuranolone: May increase CNS depressant effects of CNS Depressants. Management: Consider alternatives to the use of zuranolone with other CNS depressants or alcohol. If combined, consider a zuranolone dose reduction and monitor patients closely for increased CNS depressant effects. Risk D: Consider Therapy Modification

Pregnancy Considerations

Outcome data following maternal use of chlorpheniramine during pregnancy are available (Aselton 1985; Diav-Citrin 2003; Gilboa 2009; Gilboa 2014; Heinonen 1977; Jick 1981; Li 2013).

Algorithms are available for the treatment of acute rhinitis and urticaria. First-generation oral antihistamines are generally not recommended for use in pregnant patients due to side effects (AAAAI/ACAAI [Dykewicz 2020]; EAACI [Zuberbier 2022]). However, chlorpheniramine may be used when a first-generation antihistamine is needed during pregnancy (Murase 2014; Stefaniak 2022).

Mechanism of Action

Competes with histamine for H1-receptor sites on effector cells in the gastrointestinal tract, blood vessels, and respiratory tract

Pharmacokinetics (Adult Data Unless Noted)

Note: Data from chlorpheniramine maleate:

Distribution: Vd: Children and Adolescents 6 to 16 years: 7 ± 2.8 L/kg (Simons 1982); Adults: 6-12 L/kg (Paton 1985)

Protein binding: ~70% (Rumore 1984).

Metabolism: Hepatic via CYP450 enzymes (including CYP2D6 and other unidentified enzymes) to active and inactive metabolites; significant first-pass effect (Sharma 2003)

Half-life elimination: Serum: Children and Adolescents 6 to 16 years: 13.1 ± 6.6 hours (range: 6.3 to 23.1 hours) (Simons, 1982); Adults: 14-24 hours (Paton 1985)

Time to peak: Children and Adolescents 6 to 16 years: Oral : 2.5 ± 1.5 hours (range: 1 to 6 hours) (Simons 1982); Adults: 2-3 hours (Sharma 2003)

Excretion: Urine (Sharma 2003)

Pharmacokinetics: Additional Considerations (Adult Data Unless Noted)

Altered kidney function: Severe chronic kidney impairment: Half-life prolonged to 280 to 330 hours (Paton 1985).

Brand Names: International
International Brand Names by Country
For country code abbreviations (show table)

  • (AE) United Arab Emirates: Allerfin | Anallerge | Chlorohistol | Histan | Histop | Omvil | Pirafene;
  • (AR) Argentina: Alergitrat | Desenfriolitos;
  • (BD) Bangladesh: Adhista | Alejess | Alergyl | Alkamin | Allerfin | Allergex | Allergo | Allermine | Anti-Hist | Antismine | Antista | Biocin | Clomin | Dayhista | Denamine | Distamin | Dolcin | Eramin | Ethista | Expilin | G-antihistamin | Hisnol | Hispacin | Histacin | Histaco | Histadex | Histal | Histalex | Histalock | Histamex | Histamin | Histamol | Histaseem | Histex | Histocin | Histolet | Histrol | Hitagen | Lergigan | Mystacin | Niramin | Pheramin | Piriton | Promalin | Remacin | Sedilux m | Servinin | Tymin | Winkol;
  • (BE) Belgium: Kelargine;
  • (BF) Burkina Faso: Chlorphenamine;
  • (CL) Chile: Clorfenamina maleato | Clorferaton | Clorprimeton | Histafed | Nipolen | Prodel | Respide | Scadan;
  • (CN) China: Chlor trimeton | Chlorpheniramine c | Chlorpheniramine maleate | Mei min | Yi ke an;
  • (CO) Colombia: Anti allergy | Clodryl | Clorfam | Clorfeniramina | Clorfeniramina maleato | Clorotrimeton | Codilan | Hismedex | Isticol;
  • (CR) Costa Rica: Clorfenamina;
  • (DO) Dominican Republic: Clorfeniramina | Clorotrimeton;
  • (EC) Ecuador: Clorfenamina | Histal | Kronodryl | Nipolen;
  • (EE) Estonia: Alergamons | Chlorpheniramine | Piriton;
  • (EG) Egypt: Allergyl | Anallerge | Chlorantine m | Chlorpheniramine | Pirafene;
  • (ET) Ethiopia: Aspi m | Chlorphenamine | Chlorpheniramine maleate | Cipium;
  • (GB) United Kingdom: Allercalm | Allerief | Alunex | Boots allergy relief | Boots allergy relief 1 year plus | Boots children's allergy relief antihistamine | Calimal | Chlorphenamine | Chlorphenira almus | Chlorpheniram | Chlorpheniram cox | Chlorpheniram dc | Chlorpheniram kent | Hayleve | Piriton | Pollenase | Rhino syrup allergy;
  • (GR) Greece: Istamex;
  • (HK) Hong Kong: Allergex | Allermin | Allersin f | Antamin | Antihist | Antimine | Antitamin | Apomin | Aromin | Axcel chlorpheniramine | Bf-Chlorphenamine | Chlor-Diamine | Chloramine | Chlormale | Chlormine | Chlorminol | Chloroton | Chlorpheniramine | Chlorpheniramine maleate | Chlorpyrimine | Coriton | Euromine | Flentist | Histal | Horamine | Marpheniramine | Piriton | Qualiton | Sprinsol | Telamin | U b | U-Chlormine | Uni-Ramine | Vida-His;
  • (ID) Indonesia: Alermax | Alleron | Chlorpheniramine | Chlorphenon | Cohistan | Ctm | Dehista | Hufaphenon | Klorfeniramina | Kofiren | Metachlor | Orphen | Paraphenon | Pehachlor | Piriton | Zecamex;
  • (IE) Ireland: Anti Hist | Piriton;
  • (IL) Israel: Ahiston;
  • (IN) India: Allercalm | Allerkil | Alphinine | Cadistin | Cepiam-tr | Chlorfen | Chlorpheniramine | Chlorpheniramine maleate | Cpmine | Histanil;
  • (IQ) Iraq: Alerdain | Allerjix | Antihist | Chlomal | Histadin | Histofen | Klofenamin awa | Poramine | Safastin;
  • (IT) Italy: Trimeton | Trimeton AR;
  • (JO) Jordan: Allerfin | Anallerge | Chlorhistol | Histanore | Istamex | Jofamin;
  • (JP) Japan: Allergin | Bismilla | C meton | Chlodamin | Chlometon | Chlor trimeton | Chloramine hexal | Chlorphenamine Maleate Daiko | Chlorphenamine maleate merck hoei | Chlorphenamine Maleate Nipro | Cibena | Histal | Kohiston | Malemirane r hexal | Neo restar fuji | Neorestamin kowa | Reston | Teiporin | Telgin;
  • (KE) Kenya: Allercol | Allerex | Allergex | Allerief | Alleston | Anhistina | Aspi m | Cariton | Chaleate | Chlorhist | Chlorpheniramine | Chlorpheniramine maleate | Cipi m | Cipium | Dawa cpm | Dinlamin | Phenalin | Phenamine | Piriclor | Pirioss | Piriton | Rinalin | Rinovil | Seepem | Toramin | Unihist;
  • (KR) Korea, Republic of: Chloramine | Peniramin | Pheniramine;
  • (KW) Kuwait: Allergetin | Allergyl | Anallerge | Chlorohistol | Histan | Histop | Omvil | Pheniram;
  • (MX) Mexico: Alerdil | Antadex h | Blendox | Clorfenamin ultra | Clorfenamina | Clorfenamina gi br | Cloro trimeton | Cronal | Derimeton | Docsi | Padamina | Puntura;
  • (MY) Malaysia: Aller | Allermine | Allerphen | Allersin | Allersin f | Alleryl | Antamin | Antismine | Axcel Chlorphenira | Axcel chlorpheniramine | Chloriton | Chlorpheniramine | Chlorpheniramine maleate | Chlorpyrimine | Cloramina | Dyriton | Hismine | Horamine | Kotamin | Piri Expectorant | Piriton | Sensitamin | Tromine | Zoramine;
  • (NG) Nigeria: Ac fed | Actnaza | Allergin | Areactin | Avro chlorpheniramine maleate | Bond cpm | Chlorpheniramine maleate | Dana cpm | Fenclor syrup | Gauze chlorpheniramine maleate | Labriton | Mobitin | Mopson chlorpheniramine | Prytune | Sam chlorpheniramine | Shree mansifed | Sinufed cold paediatric | Stactifed | Sterlin chlorpheniramine maleate | Supritin | Vamafed | Zunafed;
  • (NZ) New Zealand: Histafen;
  • (OM) Oman: Omvil;
  • (PE) Peru: Allermed | Antihistamin | Bioalergan | Biolergan | Ciralerg | Clorfenamina | Clorfenamina maleato | Clorfenamina maleato fmndtria | Clorhistamin | Cloro alergan | Cloro toxin | Cloroalerfin | Clorotrimeton | Clorph allergy | Clorph max | Corifan | Histaclorf | Histafed | Histaton | Namine | Nastimed;
  • (PH) Philippines: Allermax | Antamin | Barominic | Chlor trimeton | Chlorphenamimine maleate | Chlorphenamine | Chlorpheniramine | Clormetamine | Cohistan | Corantish | Fahrenal | Histapen | Mervilar | Riphen | Synestal | Ul chlorphenamine | Valemine;
  • (PK) Pakistan: Afdaphen | Alerphene | Allergex | Allergine | Allergon | Allermin | Allerphene | Apiton | Bariton | Briphen | Cfr | Chlorpheniramin | Chlorpheniramine maleate | Chlortab | Cpm | Fenamin | Fenram | Histagic | Histalif | Histalon | Histamol | Histanil | Multivil | Oceton | Panagic | Phemin | Phenamine | Phenermin | Piriton | Ploraton | Rest | Unihist;
  • (PR) Puerto Rico: Allergy | Allergy Relief | Allergy Time | Chlor trimeton | Chlorpheniramine | Chlorpheniramine maleate | Ed chlorped pediatric | Ed Chlortan | Pharbechlor | Teldrin hbp;
  • (PY) Paraguay: Analer | Biocort | Clorfen | Clorfeniramina dasanti | Clorfeniramina dutriec | Clorfeniramina heisecke | Clorfeniramina maleato mintlab | Clorfeniramina maleato quimfa | Clorhistam | Flurox | Nestaler | Romaler;
  • (QA) Qatar: Allerfin | Anallerge | Chlorohistol | Histan | Histop (Spimaco) | Omvil | Pheniram | Piriton;
  • (RO) Romania: Clorfeniramin;
  • (SA) Saudi Arabia: Allerfin | Anallerge | Chlorohistol | Chlorpheniramine maleate | Histan | Histop | Lergicol | Pheniram | Pirafene | Zistan;
  • (SG) Singapore: Allermin | Allerphen | Allersin | Allersin f | Alleryl | Antamin | Axcel chlorpheniramine | Chloramine | Chlormine | Chlorpheniramine | Chlorpheniramine maleate | Chlorpyrimine | Clomine | Horamine | Litacidin | Piriton;
  • (SR) Suriname: Chlorphenamine | Chlorpheniramine | Chlorpheniramine maleate | Histal;
  • (SV) El Salvador: Fenaler;
  • (TH) Thailand: Allergin | Aly | Antamin | Anteehist | Antihist | Arc-chlor | Bevon | Cafen | Chlophe | Chlophen | Chlor | Chlorahist | Chloramin | Chloramine S | Chlordon | Chlorhist | Chlorimin | Chloriton | Chlorleate | Chlormin | Chlormine | Chlorphemine | Chlorphen | Chlorphen-y | Chlorphenamine | Chlorpheniramine | Chlorpheno | Chlorpheril | Chlorpyrimine | Chlortab g | Chlortab gr | Chlortab gray | Chlortab r | Chlortrimin | Chlovelon | Cohistan | Collumine | Coriton | Diabemed | Hisdaron | Histatab | Ilcid | Iwatt | Jcl chlorphen | Kloramin | Kresschlorphen | Lichlorphen | Manohista | Medcor | P.k. ramin | Patarphen | Phedamin | Pheramine | Piriton | Pophen | Pyramine | Ramine | Sichlorphen | Sinchlormin | Suramine;
  • (TN) Tunisia: Chlorohistol;
  • (TR) Turkey: Alerfin;
  • (TW) Taiwan: Allermin | Anti-amine | Arellmin | Beina | Benda | Chlopamine | Chloramine | Chlorimin | Chlorpheniramine | Chlorpheniramine maleate | Com-trimeton | Demin | Dexferin | Evenin | Heamin | Lontomin | Malenate | Neo antihistamine | Neo benamin | Niramine | Phenamin | Pheniramine;
  • (UA) Ukraine: Suprostilin;
  • (UG) Uganda: Ago cpm | Allergex | Aspi m | Chaleate | Chlorpheniramine | Cipium | Cough linctus | Dawa cpm | Koflin | Phenirex | Piriton | Rinalin;
  • (UY) Uruguay: Alercel | Analerg | Clorfeniramina | Clorfeniramina Callion & Hamonet | Clorotrimeton | Hibernyl | Kalitron;
  • (VE) Venezuela, Bolivarian Republic of: Clorfeniramina | Clorotrimeton | Clorotrimeton inyectable | Diclorfam | Inquiramin;
  • (VN) Viet Nam: Agitec f | Allerfar;
  • (ZA) South Africa: Allergex | Chlorhist | Chlorphen | Rhineton;
  • (ZM) Zambia: Cadiphen | Chlorpheniramine | Cipium | Dawa cpm | Horamine | Metadil | Milmaleate | Rinalin;
  • (ZW) Zimbabwe: Allergex | Chlorpheniramine | Sensitamine
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