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ibuprofen/chlorpheniramine/pseudoephedrine (Advil Allergy Sinus)

 

Classes: Antihistamine/Decongestant/Analgesic Combos

Dosing and uses of Advil Allergy Sinus (ibuprofen/chlorpheniramine/pseudoephedrine)

 

Adult dosage forms and strengths

ibuprofen/chlorpheniramine/pseudoephedrine

caplet

  • 200mg/2mg/30mg

 

Allergy & Cold Symptoms

1 caplet PO q4-6hr prn while symptoms persist

Not to exceed 6 caplets/24 hr

 

Administration

Take with food or milk if stomach upset occurs

 

Pediatric dosage forms and strengths

ibuprofen/chlorpheniramine/pseudoephedrine

caplet

  • 200mg/2mg/30mg

 

Allergy & Cold Symptoms

<12 years: Safety and efficacy not established

12 years or older: 1 caplet PO q4-6hr prn while symptoms persist; not to exceed 6 caplets/24 hr

 

Administration

Take with food or milk if stomach upset occurs

 

Advil Allergy Sinus (ibuprofen/chlorpheniramine/pseudoephedrine) adverse (side) effects

Frequency not defined

Drowsiness

GI upset

Insomnia

Urinary retention

Xerostomia

 

Warnings

Contraindications

Hypersensitivity

Do not use immediately before or after heart surgery

Do not use with MAO inhibitors or for 2 weeks after discontinuing MAO inhibitors because of risk for hypertensive crisis

 

Cautions

Caution with hypertension, heart disease, hepatic or renal impairment, asthma, thyroid disease, diabetes, glaucoma, or BPH

NSAID content

  • May increase risk for GI ulceration
  • Coadministration with antiplatelets/anticoagulants
  • May decrease benefit of cardioprotective low-dose aspirin

Antihistamine content

  • Additive risk for sedation when coadministered with other sedatives or alcohol
  • Caution when driving or operating machinery
  • May cause urinary retention, blurred vision, or dry mouth

Decongestant content

  • May exacerbate poorly controlled hypertension
  • Caution if underlying cardiovascular risks present

 

Pregnancy and lactation

Do not take NSAIDs within 3 months before delivery, NSAIDs are know to cause premature closure of the ductus arteriosus

The Quebec Pregnancy Registry identified 4705 women who had spontaneous abortions by 20 weeks' gestation; each case was matched to 10 control subjects (n=47,050) who had not had spontaneous abortions; exposure to nonaspirin NSAIDs during pregnancy was documented in approximately 7.5% of cases of spontaneous abortions and in approximately 2.6% of controls. (CMAJ, September 6, 2011; DOI:10.1503/cmaj.110454)

Lactation: NSAIDs and pseudoephedrine excreted in breast milk, AAP states compatible with breastfeeding

 

Pregnancy categories

A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

NA: Information not available.

 

Pharmacology of Advil Allergy Sinus (ibuprofen/chlorpheniramine/pseudoephedrine)

Mechanism of action

Ibuprofen: Inhibits synthesis of prostaglandins by inhibiting cyclooxygenase (COX-1, COX-2)

Chlorpheniramine: H1-receptor antagonist

Pseudoephedrine: Sympathomimetic; alpha adrenergic agonist