chlorpheniramine, methscopolamine, and pseudoephedrine

What is the most important information I should know about chlorpheniramine, methscopolamine, and pseudoephedrine?

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.

Do not use a cough or cold 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.

Do not use this medication if you are allergic to chlorpheniramine or methscopolamine, or if you have severe high blood pressure or coronary artery disease, narrow-angle glaucoma, a stomach ulcer, or if you are unable to urinate.

Do not use this medication during an asthma attack.

Avoid drinking alcohol while you are taking this medication.

What is chlorpheniramine, methscopolamine, and pseudoephedrine?

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

Methscopolamine reduces the secretions of certain organs in the body.

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

The combination of chlorpheniramine, methscopolamine, and pseudoephedrine is used to treat symptoms of the common cold or seasonal allergies, including sneezing, runny or stuffy nose, and itchy, watery eyes.

Chlorpheniramine, methscopolamine, and pseudoephedrine may also be used for other purposes not listed in this medication guide.

What should I discuss with my healthcare provider before taking chlorpheniramine, methscopolamine, and pseudoephedrine?

Do not use a cough or cold 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. Dangerous side effects may occur if you take a cough or cold medicine before the MAO inhibitor has cleared from your body.

Do not use this medication if you are allergic to chlorpheniramine, methscopolamine, or pseudoephedrine, or if you have:

• severe or uncontrolled high blood pressure;
• severe coronary artery disease;
• narrow angle glaucoma;
• a stomach ulcer;
• if you are unable to urinate; or
• if you are having an asthma attack.

Before using chlorpheniramine, methscopolamine, and pseudoephedrine, tell your doctor if you are allergic to any drugs, or if you have:

• kidney disease;
• liver disease;
• diabetes;
• glaucoma;
• heart disease, high blood pressure, or circulation problems;
• overactive thyroid;
• a seizure disorder such as epilepsy;
• asthma, emphysema or chronic bronchitis; or
• urination problems or an enlarged prostate.

If you have any of these conditions, you may need a dose adjustment or special tests to safely take this medication.

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.

Chlorpheniramine, methscopolamine, and pseudoephedrine 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.

How should I take chlorpheniramine, methscopolamine, and pseudoephedrine?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the instructions on your prescription label. Cold medicine is usually taken for only a short time until your symptoms clear up.

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.

Take this medicine with a full glass of water.

Do not crush, chew, or break an extended-release tablet. Swallow the pill whole. It is specially made to release medicine slowly in the body. Breaking the pill would cause too much of the drug to be released at one time.

Contact your doctor if your symptoms do not improve or if they get worse while using this medication.

This medication can cause you to have unusual results with certain medical tests. Tell any doctor who treats you that you are taking an antihistamine.

Store chlorpheniramine, methscopolamine, and pseudoephedrine at room temperature away from moisture, heat, and light.

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine.

Overdose symptoms may include nausea, vomiting, severe drowsiness, shallow breathing, ringing in your ears, problems with balance or coordination, hallucinations (seeing things), sleep problems (insomnia), feeling restless or excited, blurred vision, tremors, flushed face, and seizure (convulsions).

What should I avoid while taking chlorpheniramine, methscopolamine, and pseudoephedrine?

This medication 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 becoming overheated in hot weather. Chlorpheniramine, methscopolamine, and pseudoephedrine increases the risk of heat stroke because it causes decreased sweating and can make you more sensitive to sunlight.

Avoid drinking alcohol. It can increase some of the side effects of chlorpheniramine, methscopolamine, and pseudoephedrine.

Narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression or anxiety can add to sleepiness caused by chlorpheniramine or methscopolamine. Tell your doctor if you regularly use any of these medicines, or any other cold or allergy medications.

What are the possible side effects of chlorpheniramine, methscopolamine, and pseudoephedrine?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop using this medication and call your doctor at once if you have a serious side effect such as:

• numbness, tingling, or cold feeling in your hands or feet;
• fast, pounding, or uneven heart beats;
• painful or difficult urination;
• confusion, hallucinations, unusual thoughts or behavior;
• feeling short of breath;
• tremors or shaking; or
• severe drowsiness, feeling light-headed, fainting.

Less serious side effects may include:

• dry mouth, stomach pain, changes in appetite;
• drowsiness, dizziness, weakness, headache;
• dry eyes, blurred vision;
• increased sweating;
• skin rash; or
• feeling nervous or excited (especially in children).

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect chlorpheniramine, methscopolamine, and pseudoephedrine?

Many drugs can interact with chlorpheniramine, methscopolamine, and pseudoephedrine. Below is just a partial list. Tell your doctor if you are using any of these drugs:

• antacids;
• medicine to treat diarrhea (such as Immodium, Kaopectate, Pepto-Bismol);
• atropine (Donnatal, and others), benztropine (Cogentin), dimenhydrinate (Dramamine), methscopolamine (Pamine), or scopolamine (Transderm-Scop);
• bronchodilators such as ipratroprium (Atrovent) or tiotropium (Spiriva);
• glycopyrrolate (Robinul);
• mepenzolate (Cantil);
• bladder or urinary medications such as darifenacin (Enablex), oxybutynin (Ditropan, Oxytrol), tolterodine (Detrol), or solifenacin (Vesicare);
• irritable bowel medications such as dicyclomine (Bentyl), hyoscyamine (Anaspaz, Cystospaz, Levsin, and others), or propantheline (Pro-Banthine);
• a beta-blocker such as atenolol (Tenormin), bisoprolol (Zebeta, Ziac), labetalol (Normodyne, Trandate), metoprolol (Lopressor, Toprol), propranolol (Inderal, InnoPran), timolol (Blocadren), and others;
• a barbiturate such as phenobarbital (Luminal, Solfoton); or
• an antidepressant such as amitriptyline (Elavil, Etrafon), clomipramine (Anafranil), desipramine (Norpramin), imipramine (Janimine, Tofranil), and others.

This list is not complete and there may be other drugs that can interact with chlorpheniramine, methscopolamine, and pseudoephedrine. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

Your pharmacist can provide more information about chlorpheniramine, methscopolamine, and pseudoephedrine written for health professionals that you may read.