chlorpheniramine maleate
(klor fen ir' a meen)
Aller-Chlor; Allergy; Chlo-Amine; Chlor-Trimeton Allergy 4 hr, 8 hr, and
12 hr; Chlor-Tripolon (CAN); Efidac 24
Pregnancy Category B
Drug class
Antihistamine (alkylamine type)
Therapeutic actions
Competitively blocks the effects of histamine at H1-receptor sites; has atropine-like,
antipruritic, and sedative effects.
Indications
• Symptomatic relief of symptoms associated with perennial and seasonal allergic
rhinitis; vasomotor rhinitis; allergic conjunctivitis.
Contraindications and cautions
• Contraindicated with allergy to any antihistamines, narrow-angle glaucoma,
stenosing peptic ulcer, symptomatic prostatic hypertrophy, asthmatic attack,
bladder neck obstruction, pyloroduodenal obstruction, third trimester of
pregnancy, lactation.
• Use cautiously in pregnancy.
Available forms
Chewable tablets—2 mg; tablets—4 mg; ER tablets—8, 12, 16 mg; syrup—2 mg/5 mL;
SR capsules—8, 12 mg
Dosages
ADULTS AND CHILDREN > 12 YR
Tablets or syrup
4 mg PO q 4–6 hr; do not exceed 24 mg in 24 hr.
Sustained-release
8–12 mg PO hs or q 8–12 hr during the day; do not exceed 24 mg in 24 hr.
Extended-release (Efidac 24)
16 mg with liquid PO q 24 hr.
PEDIATRIC PATIENTS
Tablets or syrup
2–< 6 yr: 1 mg q 4–6 hr PO; do not exceed 4 mg in 24 hr.
6–12 yr: 2 mg q 4–6 hr PO; do not exceed 12 mg in 24 hr.
Sustained-release
< 6 yr: Not recommended.
6–12 yr: 8 mg PO hs or during the day.
GERIATRIC PATIENTS
More likely to cause dizziness, sedation, syncope, toxic confusional states, and
hypotension in elderly patients; use with caution.
Pharmacokinetics
Route Onset Peak
Oral 0.5–6 hr 2–6 hr
Metabolism: Hepatic; T1/2: 12–15 hr
Distribution: Crosses placenta; may enter breast milk
Excretion: Urine
Adverse effects
• CNS: Drowsiness, sedation, dizziness, disturbed coordination, fatigue, confusion,
restlessness, excitation, nervousness, tremor, headache, blurred vision, diplopia,
vertigo, tinnitus, acute labyrinthitis, hysteria, tingling, heaviness and weakness of
the hands
• CV: Hypotension, palpitations, bradycardia, tachycardia, extrasystoles
• GI: Epigastric distress, anorexia, increased appetite and weight gain, nausea,
vomiting, diarrhea or constipation
• GU: Urinary frequency, dysuria, urinary retention, early menses, decreased libido,
impotence
• Hematologic: Hemolytic anemia, hypoplastic anemia, thrombocytopenia,
leukopenia, agranulocytosis, pancytopenia
• Respiratory: Thickening of bronchial secretions, chest tightness, wheezing, nasal
stuffiness, dry mouth, dry nose, dry throat, sore throat
• Other: Urticaria, rash, anaphylactic shock, photosensitivity, excessive
perspiration, chills
Interactions
Drug-drug
• Increased depressant effects with alcohol, other CNS depressants
Nursing considerations
Assessment
• History: Allergy to any antihistamines; narrow-angle glaucoma, stenosing peptic
ulcer, symptomatic prostatic hypertrophy, asthmatic attack, bladder neck
obstruction, pyloroduodenal obstruction, pregnancy, lactation
• Physical: Skin color, lesions, texture; orientation, reflexes, affect; vision exam; P,
BP; R, adventitious sounds; bowel sounds; prostate palpation; CBC with
differential
Interventions
• Administer with food if GI upset occurs.
• Caution patient not to crush or chew sustained-release preparations.
• Arrange for periodic blood tests during prolonged therapy.
Teaching points
• Take as prescribed; avoid excessive dosage. Take with food if GI upset occurs; do
not cut, crush, or chew the sustained-release preparations.
• Avoid over-the-counter drugs; many contain ingredients that could cause serious
reactions if taken with this antihistamine.
• Avoid alcohol; serious sedation may occur.
• These side effects may occur: Dizziness, sedation, drowsiness (use caution
driving or performing tasks that require alertness); epigastric distress, diarrhea, or
constipation (take with meals; consult care provider if severe); dry mouth
(perform frequent mouth care; suck sugarless lozenges); thickening of bronchial
secretions, dryness of nasal mucosa (use a humidifier).
• Report difficulty breathing; hallucinations, tremors, loss of coordination; unusual
bleeding or bruising; visual disturbances; irregular heartbeat.
Adverse effects in Italic are most common; those in Bold are life-threatening.
