chlorpheniramine/dextromethorphan/pseudoephedrine (Forte Kidkare Cough and Cold, Rescon DM, Pedia Relief)
Classes: Cough/Cold, Non-narcotic Combos; Antihistamine/Antitussive/Decongestant Combos
- Dosing and uses of Forte Kidkare Cough and Cold, Rescon DM (chlorpheniramine/dextromethorphan/pseudoephedrine)
- Forte Kidkare Cough and Cold, Rescon DM (chlorpheniramine/dextromethorphan/pseudoephedrine) adverse (side) effects
- Warnings
- Pregnancy
- Pharmacology of Forte Kidkare Cough and Cold, Rescon DM (chlorpheniramine/dextromethorphan/pseudoephedrine)
Dosing and uses of Forte Kidkare Cough and Cold, Rescon DM (chlorpheniramine/dextromethorphan/pseudoephedrine)
Adult dosage forms and strengths
chlorpheniramine/dextromethorphan/pseudoephedrine
liquid
- (1mg/5mg/15mg)/5mL
- (4mg/20mg/20mg)/5mL
- (2mg/15mg/15mg)/5mL
- (2mg/10mg/30mg)/5mL
oral drops
- (0.8mg/3mg/8mg)/1mL
tablet
- 4mg/60mg/20mg
tablet chewable
- 2mg/10mg/30mg
Relief of Cold & Flu Symptoms
10 mL [(2mg/15mg/15mg)/5mL] PO q6hr; not to exceed 40 mL/day
10 mL [(2mg/10mg/30mg)/5mL] PO q4-6hr; not to exceed 40 mL/day
5 mL [(4mg/20mg/20mg)/5mL] PO q4-6hr; not to exceed 30 mL/day
2 tabs [(2mg/10mg/30mg)/tab] PO q4-6hr; not to exceed 8 tabs/day
1 tab [(4mg/60mg/20mg)/tab] PO q4-6hr; not to exceed 4 tabs/day
Pediatric dosage forms and strengths
chlorpheniramine/dextromethorphan/pseudoephedrine
liquid
- (1mg/5mg/15mg)/5mL
- (4mg/20mg/20mg)/5mL
- (2mg/15mg/15mg)/5mL
- (2mg/10mg/30mg)/5mL
oral drops
- (0.8mg/3mg/8mg)/1mL
tablet
- 4mg/60mg/20mg
tablet chewable
- 2mg/10mg/30mg
Relief of Cold & Flu Symptoms
<6 Years Old
- Ask a pediatrician
6-12 Years Old
- 2 mL [(0.8mg/3mg/8mg)/1mL] PO q4-6hr; not to exceed 8 mL/24hr
- 10 mL [(1mg/5mg/15mg)/5mL] PO q4-6hr; not to exceed 40 mL/24hr
- 5 mL [(2mg/15mg/15mg)/5mL] PO q4-6hr; not to exceed 20 mL/24hr
- 2.5 mL [(4mg/20mg/20mg)/5mL] PO q4-6hr; not to exceed 15 mL/24hr
- 1 tab [(2mg/10mg/30mg/tab)] PO q4-6hr; not to exceed 4 tabs/24hr
- ½ tab [(4mg/60mg/20mg/tab)] PO q4-6hr; not to exceed 2 tabs/24hr
>12 Years Old
- 10 mL [(2mg/15mg/15mg)/5mL] PO q6hr; not to exceed 40 mL/day
- 10 mL [(2mg/10mg/30mg)/5mL] PO q4-6hr; not to exceed 40 mL/day
- 5 mL [(4mg/20mg/20mg)/5mL] PO q4-6hr; not to exceed 30 mL/day
- 2 tabs [(2mg/10mg/30mg)/tab] PO q4-6hr; not to exceed 8 tabs/day
- 1 tab [(4mg/60mg/20mg)/tab] PO q4-6hr; not to exceed 4 tabs/day
Forte Kidkare Cough and Cold, Rescon DM (chlorpheniramine/dextromethorphan/pseudoephedrine) adverse (side) effects
Frequency not defined
Arrhythmia
Hypotension
Palpitations
Tachycardia
Confusion
Convulsion
Depression
Distress
Dizziness
Drowsiness
Euphoria
Excitability
Fatigue
Headache
Insomnia
Irritability
Sedation
Tremors
Weakness
Anorexia
GI disturbances
Agranulocytosis
Hemolytic anemia
Thrombocytopenia
Thickening of bronchial secretions
Wheezing
Warnings
Contraindications
Contraindicated in documented hypersensitivity to the drugs or within 14 days of MAO inhibitor therapy; asthma attacks, narrow-angle glaucoma, symptomatic prostate hypertrophy, bladder-neck obstruction, and stenosing peptic ulcer
Cautions
Caution in cardiovascular disease, diabetes mellitus, prostatic hypertrophy and increased intraocular pressure when taking pseudoephedrine
Do not take dextromethorphan for persistent or chronic cough associated with smoking, asthma, or emphysema, or if it is accompanied by excessive phlegm unless directed by a healthcare provider; may decrease respiration rate
Chlorpheniramine may cause significant confusional symptoms; not for administration to premature or full-term neonates
Pregnancy and lactation
Pregnancy category: C
Lactation: excretion in milk unknown/not recommended
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 Forte Kidkare Cough and Cold, Rescon DM (chlorpheniramine/dextromethorphan/pseudoephedrine)
Mechanism of action
Chlorpheniramine blocks muscle responses in histamine and acts as an antagonism of the constrictor effects of histamine on respiratory smooth muscle.
Dextromethorphan is a cough suppressant that acts centrally on the cough center in medulla
Pseudoephedrine stimulates the alpha-adrenergic receptors causing bronchodilation and vasoconstriction.
Pharmacokinetics
Chlorpheniramine
- Vd: 4-7 L/kg (children); 6-12 L/kg (adults)
- Protein binding: 33%
- Half-life: 10-13 hr (children); 14-24 hr (adults)
- Peak plasma time: 2-4 hr
- Excretion: Urine
Dextromethorphan
- Onset: 15-30 min
- Duration: 3-6 hr
- Metabolism: Hepatic P450 enzyme CYP2D6
- Excretion: Urine
- Half-life: 2-4 hr (extensive metabolizers); 24 hr (poor metabolizers)
- Peak plasma time: 2-3 hr
Pseudoephedrine
- Half-Life: 3 hr (children); 9-16 hr (adults)
- Onset: 30 min (decongestant)Duration: 3-8 hr
- Peak PlasmaTime: 1.97 hr
- Concentration: 422 ng/mL
- Metabolism: Liver, by N-demethylation
- Metabolites: Inactive
- Clearance: 7.3-7.6 mL/min/kg
- Excretion: Urine (43-96%)