dextromethorphan, pseudoephedrine, and pyrilamine

Generic Name: dextromethorphan, pseudoephedrine, and pyrilamine (DEK troe me THOR fan, SOO doe ee FED rin, pir IL a meed)Brand Names: Viravan-PDM

What is dextromethorphan, pseudoephedrine, and pyrilamine?

Dextromethorphan is a cough suppressant. It affects the signals in the brain that trigger cough reflex.

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

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

The combination of dextromethorphan, pseudoephedrine, and pyrilamine is used to treat runny or stuffy nose, cough, and other symptoms caused by allergies or the common cold.

Dextromethorphan will not treat a cough that is caused by smoking, asthma, or emphysema.

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

What is the most important information I should know about dextromethorphan, pseudoephedrine, and pyrilamine?Do not use a cough and cold medicine 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. Serious, life-threatening side effects can occur if you take cough and cold medicine before the MAO inhibitor has cleared from your body. You should not use this medication if you are allergic to dextromethorphan, pseudoephedrine, or pyrilamine, or if you have high blood pressure, circulation problems, if you are having an asthma attack, or if you are breast-feeding a baby.

Before you take dextromethorphan, pseudoephedrine, and pyrilamine, tell your doctor if you have allergies, a stomach ulcer, a blockage in your stomach or intestines, heart disease, diabetes, glaucoma, a thyroid disorder, or urination problems.

Always ask a doctor before giving cough or cold medicine to a child. Death can occur from the misuse of cough or cold medicine in very young children. Avoid drinking alcohol while you are taking this medication. Alcohol can add to drowsiness caused by an antihistamine. Do not use any other over-the-counter cough, cold, allergy, or sleep medication without first asking your doctor or pharmacist. Antihistamines, decongestants, and cough suppressants are contained in many medicines available over the counter. If you take certain products together you may accidentally take too much of one or more types of medicine. Read the label of any other medicine you are using to see if it contains an antihistamine, decongestant, or cough suppressant.What should I discuss with my health care provider before taking dextromethorphan, pseudoephedrine, and pyrilamine?Do not use a cough and cold medicine 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. Serious, life-threatening side effects can occur if you take cough and cold medicine before the MAO inhibitor has cleared from your body. You should not use this medication if you are allergic to dextromethorphan, pseudoephedrine, or pyrilamine, or if you have:

• high blood pressure;

• circulation problems;

• if you are having an asthma attack; or

• if you are breast-feeding a baby.

If you have certain conditions, you may need a dose adjustment or special tests to safely use this medication. Before using dextromethorphan, pseudoephedrine, and pyrilamine, tell your doctor if you have:

• a stomach ulcer;

• a blockage in your stomach or intestines;

• heart disease;

• diabetes;

• glaucoma;

• a thyroid disorder;

• urination problems; or

• if you have allergies.

FDA pregnancy category C. Dextromethorphan, pseudoephedrine, and pyrilamine may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Dextromethorphan, pseudoephedrine, and pyrilamine may pass into breast milk and could harm a nursing baby. Do not use this medication if you are breast-feeding a baby. Older adults may be more likely to have side effects from this medicine.

How should I take dextromethorphan, pseudoephedrine, and pyrilamine?

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

Always ask a doctor before giving cough or cold medicine to a child. Death can occur from the misuse of cough or cold medicine in very young children. Shake the oral suspension (liquid) well just before you measure a dose. To be sure you get the correct dose, measure the liquid with a marked 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. Store dextromethorphan, pseudoephedrine, and pyrilamine at room temperature away from moisture, heat, and light.

See also: Dextromethorphan, pseudoephedrine, and pyrilamine dosage in more detail

What happens if I miss a dose?

Since cough or cold medicine is usually taken only as needed, you may not be on a dosing schedule. If you are taking the medication regularly, 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 your 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 feeling restless or nervous, extreme drowsiness, confusion, weak or shallow breathing, and seizure (convulsions).

What should I avoid while taking dextromethorphan, pseudoephedrine, and pyrilamine?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 drinking alcohol while you are taking this medication. Alcohol can add to drowsiness caused by an antihistamine. Do not use any other over-the-counter cough, cold, allergy, or sleep medication without first asking your doctor or pharmacist. Antihistamines, decongestants, and cough suppressants are contained in many medicines available over the counter. If you take certain products together you may accidentally take too much of one or more types of medicine. Read the label of any other medicine you are using to see if it contains an antihistamine, decongestant, or cough suppressant.

Dextromethorphan, pseudoephedrine, and pyrilamine side effects

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 dextromethorphan, pseudoephedrine, and pyrilamine and call your doctor at once if you have a serious side effect such as:

• feeling like you might pass out;

• fast or pounding heartbeats;

• painful or difficult urination;

• wheezing, tight feeling in your chest, trouble breathing;

• easy bruising or bleeding;

• pale or yellowed skin, dark colored urine, fever, confusion or weakness; or

• high blood pressure (severe headache, blurred vision, buzzing in your ears, anxiety, confusion, chest pain, shortness of breath, uneven heartbeats, seizure).

Less serious side effects may include:

• dizziness, drowsiness, nervousness;

• restlessness or excitability (especially in children);

• dry mouth, nose, or throat;

• nausea, vomiting, loss of appetite, upset stomach;

• diarrhea, constipation;

• itching or skin rash;

• increased sensitivity of your skin to sunlight;

• loss of balance or coordination;

• sleep problems (insomnia); or

• headache.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.

Dextromethorphan, pseudoephedrine, and pyrilamine Dosing Information

Usual Adult Dose for Cough and Nasal Congestion:

Dextromethorphan/pseudoephedrine/pyrilamine 15 mg-15 mg-15 mg/5 mL oral suspension, extended release:5 to 10 mL orally every 12 hours.

Usual Pediatric Dose for Cough and Nasal Congestion:

Dextromethorphan/pseudoephedrine/pyrilamine 15 mg-15 mg-15 mg/5 mL oral suspension, extended release:2 to 5 years: 2.5 mL orally every 12 hours.6 to 11 years: 5 mL orally every 12 hours.12 years or older: 5 to 10 mL orally every 12 hours.

What other drugs will affect dextromethorphan, pseudoephedrine, and pyrilamine?

Before using dextromethorphan, pseudoephedrine, and pyrilamine, tell your doctor if you regularly use other medicines that make you sleepy (such as cold or allergy medicine, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression, or anxiety). They can add to sleepiness caused by dextromethorphan, pseudoephedrine, and pyrilamine.

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

Where can I get more information?

• Your pharmacist can provide more information about dextromethorphan, pseudoephedrine, and pyrilamine.

• Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
• Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2006 Cerner Multum, Inc. Version: 1.02. Revision Date: 4/12/2009 4:46:27 PM.