Dextromethorphan + Phenylpropanolamine + Diphenhydramine Pharmacology

Dextromethorphan + Phenylpropanolamine + Diphenhydramine

About Dextromethorphan + Phenylpropanolamine + Diphenhydramine
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Mechanism of Action of Dextromethorphan + Phenylpropanolamine + Diphenhydramine
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Pharmacokinets of Dextromethorphan + Phenylpropanolamine + Diphenhydramine
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Onset of Action for Dextromethorphan + Phenylpropanolamine + Diphenhydramine
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Duration of Action for Dextromethorphan + Phenylpropanolamine + Diphenhydramine
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Half Life of Dextromethorphan + Phenylpropanolamine + Diphenhydramine
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Side Effects of Dextromethorphan + Phenylpropanolamine + Diphenhydramine
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Contra-indications of Dextromethorphan + Phenylpropanolamine + Diphenhydramine
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Special Precautions while taking Dextromethorphan + Phenylpropanolamine + Diphenhydramine
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Pregnancy Related Information
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Old Age Related Information
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Breast Feeding Related Information
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Children Related Information
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Indications for Dextromethorphan + Phenylpropanolamine + Diphenhydramine
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Interactions for Dextromethorphan + Phenylpropanolamine + Diphenhydramine
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Typical Dosage for Dextromethorphan + Phenylpropanolamine + Diphenhydramine
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Schedule of Dextromethorphan + Phenylpropanolamine + Diphenhydramine
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Storage Requirements for Dextromethorphan + Phenylpropanolamine + Diphenhydramine
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Effects of Missed Dosage of Dextromethorphan + Phenylpropanolamine + Diphenhydramine
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Effects of Overdose of Dextromethorphan + Phenylpropanolamine + Diphenhydramine
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Dextromethorphan

About Dextromethorphan
A synthetic morphine (((dextrorotatory methyl ether of Levorphanol))) derivative,A synthetic narcotic antitussive.
Mechanism of Action of Dextromethorphan
Dextromethorphan hydrobromide is a selective antitussive which raises threshold of cough centre and suppresses the cough reflex by direct action on the cough centre in the medulla. It does not depress mucociliary function of the airway mucosa and is also devoid of constipating and addicting actions. (((Its antitussive action is not exerted through opioid receptors)))
Pharmacokinets of Dextromethorphan
Absorption: Well absorbed orally, Metabolism: Extensively metabolized by liver, Excretion: Excreted primarily through urine as metabolites; about 7 to 10% is excreted through faeces.
Onset of Action for Dextromethorphan
Below ? an hour
Duration of Action for Dextromethorphan
3 to 6 hours
Half Life of Dextromethorphan
11 hours
Side Effects of Dextromethorphan
1. Dizziness
2. Nausea
3. Vomiting
4. Stomach pain
5. Drowsiness
6. Ataxia.
Contra-indications of Dextromethorphan
Patients currently taking MAO inhibitors or within two weeks of discontinuing MAO inhibitors.
Special Precautions while taking Dextromethorphan
1. Atopic children
2. Sedated or deliberate patients
3. Those patients confined to the supine position
4. Patients sensitive to aspirin
Pregnancy Related Information
Contraindicated
Old Age Related Information
N/A
Breast Feeding Related Information
N/A
Children Related Information
May be used
Children below 2 years: Syrup, tablets, or lozenges are contraindicated
Indications for Dextromethorphan
Chronic nonproductive cough.
Interactions for Dextromethorphan
N/A
Typical Dosage for Dextromethorphan
Oral:
Chronic nonproductive cough:
Adults and children above 12 years: 10 to 20mg every 4 hours; or 30mg three to four times daily.
Maximum dose: 120mg daily.
Children (((age 6 to 12))): 5 to 10mg every four hours
Maximum dose: 60mg daily
Children (((age 2 to 6))): 2.5 to 5mg every four hours.
Maximum dose: 30mg daily.
Schedule of Dextromethorphan
N/A
Storage Requirements for Dextromethorphan
Store at room temperature in a well closed light resistant container. Protect from excess heat and moisture. Keep out of reach of children.
Effects of Missed Dosage of Dextromethorphan
Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.
Effects of Overdose of Dextromethorphan
Remove drug from the body by administration of activated charcoal and provide symptomatic treatment and supportive measures.

Phenylpropanolamine

About Phenylpropanolamine
Alfa-and Beta-adrenergic agonist, Phenethylamine derivative, a stimulant, decongestant,anorectic.
Mechanism of Action of Phenylpropanolamine
It is a mixed acting sympathomimetic amine with predominant alpha adrenergic agonistic action. It exerts nasal decongestant action by acting through alpha adrenergic receptors in the respiratory tract mucosa; and produces vasoconstriction. It temporarily reduces the swelling associated with inflammation of nasal mucosa.
Phenylpropanolamine also suppresses the appetite control center in the hypothalamus

Pharmacokinets of Phenylpropanolamine
Absorption: Well absorbed orally, Metabolism: Metabolized in to an active metabolite in liver, Excretion: Excreted mainly through urine.
Onset of Action for Phenylpropanolamine
15 to 30 minutes
Duration of Action for Phenylpropanolamine
3 hours
Half Life of Phenylpropanolamine
N/A
Side Effects of Phenylpropanolamine
1. Hypertension
2. Stroke
3. Arrhythmias
4. Renal failure
5. Rhabdomyolysis
6. Psychotic disturbances
7. Hallucinations
8. Seizures
Contra-indications of Phenylpropanolamine
1. Hypersensitivity to Phenylpropanolamine or other sympathomimetics
2. Coronary artery disease
3. Hypertension
4. Arteriosclerosis
5. Depression
6. Angle-closure glaucoma
7. Diabetes
8. Renal impairment
9. Hyperthyroidism
10. During or within 14 days of use of MAO inhibitors
11. Use as an anorexiant for children less than 12 years of age
12. Sustained-release forms during lactation and in children less than 12 years of age
Special Precautions while taking Phenylpropanolamine
1. Cardiovascular disorders
2. Mild Hypertension
3. Prostatic hypertrophy
4. Psychosis or other psychiatric disorders (Phenylpropanolamine may precipitate psychiatric disorders)
5. Not drinking large amounts of caffeine-containing beverages, such as coffee, tea, or colas
6. Do not engage in driving, using machines, or doing anything else that requires mental alertness while taking medication
7. Inform the physician if cold symptoms do not improve within 7 days or if fever is present
Pregnancy Related Information
Contraindicated
Old Age Related Information
Use with caution
Breast Feeding Related Information
Use with caution
Children Related Information
Use with caution
Indications for Phenylpropanolamine
1. Nasal congestion

Interactions for Phenylpropanolamine
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Typical Dosage for Phenylpropanolamine
Oral:
Adults:
As decongestant: 25mg every four hours or 50mg every 8 hours daily. Not to exceed 150mg/day
Anorexiant: 25mg thrice daily; 30minutes before meals.
Extended release tablets or capsules:As decongestant: 75mg twice daily
Anorexiant: 75mg once daily in the morning.
As decongestant:
Children (6 to 12 years): 12.5mg up to every four hours. Not to exceed 75mg/day
Children (2 to 6years): 6.25mg up to every four hours. Not to exceed 37.5mg/day

Schedule of Phenylpropanolamine
H
Storage Requirements for Phenylpropanolamine
Store at controlled room temperature at range of 15 to 30 degree C.; in a well closed container. Protect from light.
Effects of Missed Dosage of Phenylpropanolamine
Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.
Effects of Overdose of Phenylpropanolamine
Provide symptomatic treatment and supportive measures.Remove drug from the body by induced emesis or gastric lavage. Barbiturate sedatives are sometimes used to control excessive CNS stimulation. Monitor Cardiovascular and respiratory functions. Administer intravenous fluids to control hypotension. Correct hypertension with Intravenous phentolamine or nitrates. Perform forced diuresis by acidification of urine.

Diphenhydramine

About Diphenhydramine
First Generation H1 Antagonist ,Ethanolamine derivative, Antihistamine, antiemetic, antivertigo,sedative, and hypnotic.
Mechanism of Action of Diphenhydramine
Antiallergic action: It produces its antihistamine action by competitively blocking H1 receptors. It binds to the H1 receptors present in the smooth muscles of the gastrointestinal tract, bronchi, large blood vessels and uterus and inhibit Histamine induced allergic symptoms. They do not inhibit the release of Histamine.
Antivertigo and antiemetic actions: Central antimuscarinic actions of antihistamines are responsible for these effects of Diphenhydramine.
Parkinsonism: Acetyl choline receptor antagonists are used for the treatment of Parkinsonism. Diphenhydramine reduces the unbalanced cholinergic activity in striatum of parkinsonian patients.
Antitussive action: Diphenhydramine suppresses the cough reflex by a direct effect on the cough centre.
Migraine: Diphenhydramine is used in migraine due to its sedative as well as antiemetic actions.
Pharmacokinets of Diphenhydramine
Absorption: It is well absorbed after oral administration. Distribution: Diphenhydramine is widely distributed in the body including CNS in protein bound form. Metabolism: It is extensively metabolised in the liver. Excretion: Excreted primarily in urine
Onset of Action for Diphenhydramine
15 minutes
Duration of Action for Diphenhydramine
6 - 8 hours
Half Life of Diphenhydramine
2.5 - 9 hours
Side Effects of Diphenhydramine
1.Headache
2.Dry mouth
3.Rash
4.Thrombocytopenia
5.Anaemia
6.Anorexia
7.Insomnia
8.Confusion
9.Dizziness
10.Fatigue
11.Nausea
12.Abdominal pain
13.Urine retention
14.Thickening of bronchial secretions.
Contra-indications of Diphenhydramine
1.Hypersensitivity to Diphenhydramine
2.Porphyria.
Special Precautions while taking Diphenhydramine
1.Hypertension
2.Asthma
3.Hyperthyroidism
4.Angle closure glaucoma
5.Prostatic hyperplasia
6.Urinary tract obstruction
7.Use with caution while operating machine, driving vehicle or activities requiring mental alertness
Pregnancy Related Information
Use with caution.
Old Age Related Information
Use with caution.
Breast Feeding Related Information
Contraindicated.
Children Related Information
Use with caution
NEONATES: contraindicated
Indications for Diphenhydramine
1.Parkinson`s disease
2.Motion sickness
3.Rhinitis
4.Allergy disorders
5.Insomnia
6.Productive cough
7.Vertigo
8.Migraine
Interactions for Diphenhydramine
Incompatibility reported with amphotericin, cephalothine sodium, hydrocortisone, sodium succinate, some soluble barbiturates, some contrast media.
Typical Dosage for Diphenhydramine
Adult: 25 - 50 mg 3 - 4 times daily. Dosage should be individualised according to the needs and the response of the patient
Nonproductive cough: 100 mg / day in 4-6 times daily.
Insomnia: 50 mg at bed time
Children above 12 years: 25 - 50 mg 3 - 4 times daily. Dosage should be individualised according to the needs and the response of the patient
Nonproductive cough: 100 mg / day in 4-6 divided dose
Insomnia: 50 mg at bed time
Children age 2 -12 years: 12.5 - 25 mg 3 - 4 times daily. Dosage should be individualised according to the needs and the response of the patient.
Maximum dose: 300mg / day
Nonproductive cough: 6.25 - 12.5 mg in 4-6 times daily. Dosage should be individualised according to the needs and the response of the patient
Schedule of Diphenhydramine
G
Storage Requirements for Diphenhydramine
Store at 15 - 30 degree C. Protect from heat, light and moisture. Keep out of the reach of children.
Effects of Missed Dosage of Diphenhydramine
Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.
Effects of Overdose of Diphenhydramine
Give supportive measures and symptomatic treatment. Drug can be removed from the body by gastric lavage or by inducing emesis. Absorption of the drug can be reduced by administration of activated charcoal. Hypotension can be counteracted by administration of vasopressors and seizure with Phenytoin or Diazepam.

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