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Trade Names:
Decohistine DH
- Liquid 10 mg codeine phosphate, 2 mg chlorpheniramine maleate, 30 mg pseudoephedrine hydrochloride

Trade Names:
Dihistine DH
- Liquid 10 mg codeine phosphate, 2 mg chlorpheniramine maleate, 30 mg pseudoephedrine hydrochloride

Mechanism of Action

Pharmacology

Competitively antagonizes histamine at H ₁ receptor sites.

Causes vasoconstriction and subsequent shrinkage of nasal mucous membranes by alpha-adrenergic stimulation, which promotes nasal drainage.

Suppresses cough reflex.

Indications and Usage

Temporary relief of runny nose, sneezing, and itchy, watery eyes due to hay fever (allergic rhinitis); temporary relief of cough due to minor bronchial irritation and nasal congestion caused by common cold; temporary relief of sinus congestion and pressure.

Contraindications

Hypersensitivity or idiosyncratic reaction to any ingredients of product; severe hypertension; severe coronary artery disease; narrow-angle glaucoma; urinary retention; peptic ulcer; asthma attack; MAOI therapy or for 2 wk after stopping MAOI therapy.

Dosage and Administration

PO 2 tsp (10 mL) every 6 h, not to exceed 4 doses/24 h.

PO 1 tsp (5 mL) every 6 h, not to exceed 4 doses/24 h.

Consult health care provider.

General Advice

• Give with food or milk if GI upset occurs.
• Use dosing spoon or syringe for pediatric doses.

Storage/Stability

Store elixir at controlled room temperature (68° to 77°F). Keep tightly capped.

Drug Interactions

Effects may be enhanced by carbinoxamine.

May prolong and intensify the effects of chlorpheniramine and increase the effects of pseudoephedrine.

Antihypertensive effects may be reduced by pseudoephedrine.

Laboratory Test Interactions

May interfere with diagnostic test results for skin tests using allergen extracts.

Adverse Reactions

Cardiovascular

Cardiac arrhythmia; increased heart rate; increased BP.

CNS

Sedation; dizziness; headache; nervousness; rare excitability in children.

Convulsions; CNS stimulation; hallucinations; tremors; nervousness; insomnia.

Lightheadedness; disorientation; drowsiness; dizziness.

EENT

Miosis.

GI

Vomiting; diarrhea; dry mouth; nausea; anorexia; heartburn.

Nausea; vomiting; constipation; abdominal pain; anorexia; biliary tract spasm.

Genitourinary

Polyuria; dysuria; urinary retention in patients with prostatic hypertrophy.

Dysuria.

Respiratory

Respiratory difficulties.

Miscellaneous

Pallor.

Precautions

Pregnancy

Consult health care provider before use.

Lactation

Consult health care provider before use.

Special Risk Patients

Use with caution in patients with hypertension, heart disease, asthma, hyperthyroidism, increased IOP, diabetes mellitus, prostatic hypertrophy.

Overdosage

Symptoms

Decreased mental alertness, ataxia, hallucinations, convulsions, death

Somnolence, sedation, profuse sweating, hypotension, shock, coma, elderly patients may experience hallucinations, seizures, CNS depression, death

Miosis, respiratory and CNS depression, circulatory collapse, seizures, cardiopulmonary arrest, death

Patient Information

• Advise patient to take prescribed dose every 6 h as needed, up to 4 times daily.
• Advise caregiver to use dosing spoon or syringe when giving elixir to children.
• Advise patient to take with food or milk if GI upset occurs.
• Advise patient to take last dose late in the afternoon or early evening to reduce chance of drug causing sleeplessness.
• Advise patient that if a dose is missed to take as soon as remembered unless it is nearing time for the next dose. Caution patient to not double the dose to catch up.
• Advise patient that if allergy symptoms are not controlled, not to increase the dose of medication but to inform health care provider.
• Caution patient that drug may cause drowsiness and to use caution while driving or performing other tasks requiring mental alertness until tolerance is determined.
• Advise patient to avoid alcohol and other CNS depressants due to risk of excessive sedation.
• Caution patient not to take any OTC antihistamines or decongestants while taking this medication unless advised by health care provider.
• If patient is to have allergy skin testing, advise to not take the medication for at least 6 days before the skin testing.
• Instruct patient to stop taking drug and immediately report any of the following symptoms to health care provider if occurring: nervousness, dizziness, sleeplessness.