chlorpheniramine/pyrilamine/phenylephrine (R-Tannate, Triplex AD Liquid)
Classes: Antihistamine/Decongestant Combos
Dosing and uses of R-Tannate, Triplex AD Liquid (chlorpheniramine/pyrilamine/phenylephrine)
Adult dosage forms and strengths
chlorpheniramine/pyrilamine/phenylephrine
oral liquid
- (2mg/12.5mg/5mg)/5mL
- (2mg/12.5mg/7.5mg)/5mL
tablet
- 8mg/25mg/25mg
Congestion
Symptomatic relief of coryza and nasal congestion associated with common cold, sinusitis, allergic rhinitis, and other upper respiratory tract conditions
Liquid: 5-10 mL PO q4-6hr, up to 60 mg phenylephrine in 24 hr
Tablets: 1 tablet PO q12hr PRn
Pediatric dosage forms and strengths
lansoprazole/amoxicillin/clarithromycin
oral liquid
- (2mg/12.5mg/5mg)/5mL
- (2mg/12.5mg/7.5mg)/5mL
tablet
- 8mg/25mg/25mg
Congestion
<2 years: Titrate dose individually
2-6 years: 2.5-5 mL PO q4-6hr, up to 15 mg phenylephrine in 24 hr
6-12 years: 5 mL PO q4-6hr, up to 30 mg phenylephrine in 24 hr
>12 years: 5-10 mL PO q4-6hr, up to 60 mg phenylephrine in 24 hr
R-Tannate, Triplex AD Liquid (chlorpheniramine/pyrilamine/phenylephrine) adverse (side) effects
Frequency not defined
Chlorpheniramine
- Anticholinergic effects
- Somnolence
- Constipation
- Diarrhea
- Nausea
- Vomiting
- Blurred vision
Pyrilamine
- Sedation
- Xerostomia
- Blurred vision
Phenylephrine
- Hypertension
- Reflex bardycardia
- Anxiety
- Headache
- Burning
- Rebound congestion
- Sneezing
- Pulmonary edema
Warnings
Contraindications
Do not use within 14 days of MAO inhibitors; risk of hypertension
Chlorpheniramine
- Acute asthma, sleep apnea
Phenylephrine
- Hypersensitivity to phenylephrine or sulfites; severe HTN, VTach, closed angle glaucoma
Cautions
Phenylephrine
- Cerebrovascular insufficiency, CVD, HTN, DM, thyroid disease, prostatic hypertrophy, geriatrics
Pregnancy and lactation
Pregnancy category: C
Lactation: Do not administer
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 R-Tannate, Triplex AD Liquid (chlorpheniramine/pyrilamine/phenylephrine)
Chlorpheniramine
Half-Life: 12-43 hr
Duration: 24 hr
Onset: 6 hr
Peak Plasma Time: 2-6 hr
Protein Bound: 69-72%
Vd: 2.5-3.2 L/kg
Metabolism: GI mucosa, liver
Metabolites: monodesmethylchlorpheniramine, didesmethylchlorpheniramine
Excretion: urine
Sedative effect: low
Antihistamine activity: moderate
Anticholinergic acitivity: moderate
Pyrilamine
Onset: 15-60 min
Duration: 8 hours
Metabolism: liver
Excretion: renaL
Phenylephrine
Half-Life: 2-3 hr
Onset: 10-15 min
Duration: 15 min
Metabolism: extensivly in intestinal wall, moderately in liver
Metabolites: M-hydroxymandelic acid (inactive)
Excretion: urine: 80-90%
Mechanism of action
Chlorpheniramine: Histamine H1-receptor antagonist
Pyrilamine: First generation antihistamine
Phenylephrine: Strong alpha effects resulting in increased PVR and BP and decreased CO and renal perfusion
