Lohist-D Liquid
It is used to treat nose stuffiness.It is used to ease allergy signs.
Drug Class
Antihistamine and Decongestant Combination
Pharmacologic Class
H1-receptor antagonist (Chlorpheniramine), Alpha-adrenergic agonist (Pseudoephedrine)
Pregnancy Category
Category C
FDA Approved
Jan 1970
DEA Schedule
Not Controlled
Overview
What is this medicine?
Lohist-D Liquid is a combination medicine used to relieve symptoms of the common cold, allergies, and hay fever. It helps with sneezing, runny nose, watery eyes, and nasal congestion.
How to Use This Medicine
Taking Your Medication Correctly
To get the most benefit from your medication, follow your doctor's instructions carefully. Read all the information provided with your medication and follow the instructions closely. You can take this medication with or without food. If it causes stomach upset, take it with food to help minimize this side effect. When taking the liquid form of this medication, measure the dose carefully using the measuring device that comes with it. If no device is provided, ask your pharmacist for a suitable measuring tool.
Storing and Disposing of Your Medication
Store your medication at room temperature in a dry place, avoiding the bathroom. Keep all medications in a safe location, out of the reach of children and pets. Dispose of unused or expired medications properly. Do not flush them down the toilet or pour them down the drain unless instructed to do so by your pharmacist. If you have questions about disposing of your medication, consult your pharmacist, who can also inform you about potential drug take-back programs in your area.
What to Do If You Miss a Dose
If you take this medication on a regular basis and miss a dose, take it as soon as you remember. However, if it's close to the time for your next scheduled dose, skip the missed dose and continue with your regular dosing schedule. Do not take two doses at the same time or take extra doses. If you take this medication as needed, do not take it more frequently than directed by your doctor.
To get the most benefit from your medication, follow your doctor's instructions carefully. Read all the information provided with your medication and follow the instructions closely. You can take this medication with or without food. If it causes stomach upset, take it with food to help minimize this side effect. When taking the liquid form of this medication, measure the dose carefully using the measuring device that comes with it. If no device is provided, ask your pharmacist for a suitable measuring tool.
Storing and Disposing of Your Medication
Store your medication at room temperature in a dry place, avoiding the bathroom. Keep all medications in a safe location, out of the reach of children and pets. Dispose of unused or expired medications properly. Do not flush them down the toilet or pour them down the drain unless instructed to do so by your pharmacist. If you have questions about disposing of your medication, consult your pharmacist, who can also inform you about potential drug take-back programs in your area.
What to Do If You Miss a Dose
If you take this medication on a regular basis and miss a dose, take it as soon as you remember. However, if it's close to the time for your next scheduled dose, skip the missed dose and continue with your regular dosing schedule. Do not take two doses at the same time or take extra doses. If you take this medication as needed, do not take it more frequently than directed by your doctor.
Lifestyle & Tips
- Avoid alcohol and other sedating medications while taking this product, as it can increase drowsiness.
- Use caution when driving or operating machinery until you know how this medication affects you.
- Stay hydrated to help with dry mouth, a common side effect.
- Do not exceed the recommended dose, especially in children, as serious side effects can occur.
Available Forms & Alternatives
Available Strengths:
Dosing & Administration
Adult Dosing
Standard Dose:
10 mL (2 mg Chlorpheniramine / 30 mg Pseudoephedrine per 5 mL) orally every 4-6 hours as needed
Dose Range:
5 - 10 mg
Condition-Specific Dosing:
maxDailyDose:
Do not exceed 4 doses (40 mL) in 24 hours
Pediatric Dosing
Neonatal:
Not established (Contraindicated for children under 2 years)
Infant:
Not established (Contraindicated for children under 2 years)
Child:
Ages 6 to under 12 years: 5 mL orally every 4-6 hours as needed (Do not exceed 4 doses in 24 hours); Ages 2 to under 6 years: Not recommended without physician consultation due to risk of serious side effects.
Adolescent:
Ages 12 years and older: 10 mL orally every 4-6 hours as needed (Do not exceed 4 doses in 24 hours)
Dose Adjustments
Renal Impairment:
Mild:
No specific adjustment typically needed, monitor for increased side effects.
Moderate:
Consider dose reduction (e.g., 50%) or extended dosing interval (e.g., every 8-12 hours) due to pseudoephedrine accumulation.
Severe:
Contraindicated or significant dose reduction (e.g., 25% of normal dose) and extended interval (e.g., every 12-24 hours) due to risk of accumulation and toxicity.
Dialysis:
Pseudoephedrine is dialyzable; Chlorpheniramine is not significantly. Avoid use or use with extreme caution and monitor closely.
Hepatic Impairment:
Mild:
No specific adjustment typically needed.
Moderate:
Use with caution; consider dose reduction (e.g., 50%) for chlorpheniramine due to impaired metabolism.
Severe:
Use with caution; significant dose reduction (e.g., 25-50%) for chlorpheniramine and monitor for increased side effects.
Pharmacology
Mechanism of Action
Chlorpheniramine is an alkylamine antihistamine that competitively blocks H1-receptors, thereby preventing the effects of histamine (e.g., sneezing, rhinorrhea, itching, watery eyes). It also possesses anticholinergic properties. Pseudoephedrine is a sympathomimetic amine that acts directly and indirectly on adrenergic receptors. It causes vasoconstriction in the nasal mucosa, leading to reduced swelling and congestion.
Pharmacokinetics
Absorption:
Bioavailability:
Chlorpheniramine: ~25-60%; Pseudoephedrine: ~80-90%
Tmax:
Chlorpheniramine: 2-6 hours; Pseudoephedrine: 0.5-2 hours
FoodEffect:
Minimal effect on absorption, but may delay Tmax.
Distribution:
Vd:
Chlorpheniramine: 1-10 L/kg (large); Pseudoephedrine: ~2.5 L/kg
ProteinBinding:
Chlorpheniramine: ~70%; Pseudoephedrine: Low (~10-20%)
CnssPenetration:
Chlorpheniramine: Yes (causes sedation); Pseudoephedrine: Limited (causes CNS stimulation)
Elimination:
HalfLife:
Chlorpheniramine: 12-43 hours (variable); Pseudoephedrine: 9-16 hours
Clearance:
Not available for combination product
ExcretionRoute:
Both primarily renal (urine)
Unchanged:
Chlorpheniramine: 10-30%; Pseudoephedrine: 55-90%
Pharmacodynamics
OnsetOfAction:
30-60 minutes
PeakEffect:
1-3 hours
DurationOfAction:
4-6 hours
Safety & Warnings
Side Effects
Urgent Side Effects: Seek Medical Help Right Away
Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor or seek immediate medical attention:
Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Other Possible Side Effects
Like all medications, this drug can cause side effects. While many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. If you experience any of the following side effects or any other unusual symptoms that bother you or do not go away, contact your doctor:
Feeling dizzy or sleepy
Feeling nervous and excitable
Trouble sleeping
Reporting Side Effects
This list is not exhaustive, and you may experience other side effects not mentioned here. If you have questions or concerns about side effects, consult your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor or seek immediate medical attention:
Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Other Possible Side Effects
Like all medications, this drug can cause side effects. While many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. If you experience any of the following side effects or any other unusual symptoms that bother you or do not go away, contact your doctor:
Feeling dizzy or sleepy
Feeling nervous and excitable
Trouble sleeping
Reporting Side Effects
This list is not exhaustive, and you may experience other side effects not mentioned here. If you have questions or concerns about side effects, consult your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Seek Immediate Medical Attention If You Experience:
- Severe dizziness or persistent drowsiness.
- Rapid, pounding, or irregular heartbeat.
- Difficulty urinating or painful urination.
- Blurred vision or other vision changes.
- Severe nervousness, anxiety, or restlessness.
- Hallucinations or unusual behavior.
- Signs of an allergic reaction (rash, itching, swelling, severe dizziness, trouble breathing).
Before Using This Medicine
Before taking this medication, it is essential to inform your doctor about the following:
Any allergies you have, including allergies to this drug, its components, or other substances, such as foods or medications. Be sure to describe the allergic reaction you experienced, including any symptoms that occurred.
If you have taken certain medications for depression or Parkinson's disease within the last 14 days, including isocarboxazid, phenelzine, tranylcypromine, selegiline, or rasagiline, as this may increase the risk of very high blood pressure.
* If you are currently taking linezolid or methylene blue, as these medications can interact with this drug.
It is crucial to provide your doctor and pharmacist with a comprehensive list of all your medications, including prescription and over-the-counter drugs, natural products, and vitamins, as well as any health problems you are experiencing. This will enable them to assess potential interactions and ensure it is safe for you to take this medication. Do not initiate, discontinue, or modify the dose of any medication without first consulting your doctor.
Any allergies you have, including allergies to this drug, its components, or other substances, such as foods or medications. Be sure to describe the allergic reaction you experienced, including any symptoms that occurred.
If you have taken certain medications for depression or Parkinson's disease within the last 14 days, including isocarboxazid, phenelzine, tranylcypromine, selegiline, or rasagiline, as this may increase the risk of very high blood pressure.
* If you are currently taking linezolid or methylene blue, as these medications can interact with this drug.
It is crucial to provide your doctor and pharmacist with a comprehensive list of all your medications, including prescription and over-the-counter drugs, natural products, and vitamins, as well as any health problems you are experiencing. This will enable them to assess potential interactions and ensure it is safe for you to take this medication. Do not initiate, discontinue, or modify the dose of any medication without first consulting your doctor.
Precautions & Cautions
It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication. Adhere strictly to the dosage instructions provided by your doctor, as taking more than the prescribed amount can increase your risk of experiencing severe side effects. Additionally, do not take this medication for a longer duration than recommended by your doctor.
Until you are aware of how this medication affects you, it is crucial to avoid operating a vehicle or engaging in any activities that require your full attention. It is also advisable to refrain from consuming alcohol while taking this medication. Before using marijuana, other forms of cannabis, or any prescription or over-the-counter drugs that may cause drowsiness, consult with your doctor to discuss potential interactions.
When administering this medication to a child, it is vital to consult with the doctor beforehand, as different brands may have varying dosage recommendations for children. Exercise caution when giving this medication to a child, as they may be at a higher risk of experiencing excitability. This medication should not be used as a means to induce sleep in children; instead, consult with the doctor to discuss appropriate alternatives.
If you are pregnant, planning to become pregnant, or breastfeeding, inform your doctor, as it is necessary to weigh the benefits and risks of this medication to both you and the baby.
Until you are aware of how this medication affects you, it is crucial to avoid operating a vehicle or engaging in any activities that require your full attention. It is also advisable to refrain from consuming alcohol while taking this medication. Before using marijuana, other forms of cannabis, or any prescription or over-the-counter drugs that may cause drowsiness, consult with your doctor to discuss potential interactions.
When administering this medication to a child, it is vital to consult with the doctor beforehand, as different brands may have varying dosage recommendations for children. Exercise caution when giving this medication to a child, as they may be at a higher risk of experiencing excitability. This medication should not be used as a means to induce sleep in children; instead, consult with the doctor to discuss appropriate alternatives.
If you are pregnant, planning to become pregnant, or breastfeeding, inform your doctor, as it is necessary to weigh the benefits and risks of this medication to both you and the baby.
Overdose Information
Overdose Symptoms:
- Severe drowsiness or sedation, leading to coma.
- Confusion, disorientation, hallucinations, psychosis.
- Seizures.
- Rapid heart rate (tachycardia), irregular heart rhythm (arrhythmias).
- High blood pressure (hypertension), potentially leading to hypertensive crisis.
- Dilated pupils (mydriasis).
- Dry mouth, flushed skin, fever.
- Urinary retention.
- Respiratory depression (chlorpheniramine) or stimulation (pseudoephedrine).
What to Do:
Seek immediate medical attention. Call 911 or your local poison control center (e.g., 1-800-222-1222 in the US).
Drug Interactions
Contraindicated Interactions
- Monoamine Oxidase Inhibitors (MAOIs) (concurrent use or within 14 days of MAOI discontinuation) - risk of hypertensive crisis and prolonged anticholinergic effects.
Major Interactions
- Other sympathomimetics (e.g., decongestants, appetite suppressants, amphetamines) - additive cardiovascular effects.
- Tricyclic Antidepressants (TCAs) - enhanced pressor effects of pseudoephedrine.
- Beta-blockers - pseudoephedrine may reduce antihypertensive effect and increase risk of hypertension.
- Methyldopa, Reserpine - pseudoephedrine may reduce antihypertensive effect.
- CNS Depressants (e.g., alcohol, sedatives, hypnotics, opioids, anxiolytics) - additive CNS depression (drowsiness, dizziness).
Moderate Interactions
- Anticholinergic drugs (e.g., atropine, some antipsychotics, tricyclic antidepressants) - additive anticholinergic effects (dry mouth, urinary retention, blurred vision).
- Digoxin - increased risk of cardiac arrhythmias with pseudoephedrine.
- Urinary alkalinizers (e.g., sodium bicarbonate) - may decrease pseudoephedrine excretion, increasing its effects.
- Urinary acidifiers (e.g., ammonium chloride) - may increase pseudoephedrine excretion, decreasing its effects.
Minor Interactions
- Not typically listed for OTC products, but general caution with other medications.
Monitoring
Symptom Monitoring
- Effectiveness of symptom relief (nasal congestion, sneezing, runny nose, watery eyes)
- Adverse effects: Drowsiness, dizziness, nervousness, insomnia, dry mouth, blurred vision, urinary retention, palpitations, increased blood pressure, headache.
- Signs of overdose or severe reactions (e.g., severe agitation, hallucinations, seizures, severe hypertension, tachycardia).
Special Patient Groups
Pregnancy
Category C. Use only if the potential benefit justifies the potential risk to the fetus. Pseudoephedrine use in the first trimester has been inconsistently associated with gastroschisis, though overall risk is low. Chlorpheniramine is generally avoided in the third trimester due to potential for neonatal withdrawal symptoms or irritability.
Trimester-Specific Risks:
First Trimester:
Pseudoephedrine: Possible, but low, association with gastroschisis. Chlorpheniramine: Limited data, generally avoided if possible.
Second Trimester:
Generally considered safer than first or third trimester, but still Category C.
Third Trimester:
Chlorpheniramine: Potential for neonatal irritability, tremors, or withdrawal symptoms. Pseudoephedrine: Risk of maternal hypertension, reduced uterine blood flow.
Lactation
L3 (Moderately Safe). Both chlorpheniramine and pseudoephedrine are excreted into breast milk. Chlorpheniramine can cause sedation in the infant and may decrease milk supply. Pseudoephedrine can cause irritability in the infant and may decrease milk supply. Use with caution; consider alternative agents or monitor infant closely for adverse effects and milk supply.
Infant Risk:
Risk of infant sedation, irritability, and potential decrease in milk supply.
Pediatric Use
Contraindicated for children under 2 years of age due to risk of serious and life-threatening side effects (e.g., convulsions, rapid heart rates, death). Use with extreme caution and only as directed by a healthcare professional for children 2-12 years, adhering strictly to age-appropriate dosing.
Geriatric Use
Elderly patients are more susceptible to the adverse effects of both chlorpheniramine (sedation, anticholinergic effects like urinary retention, confusion) and pseudoephedrine (cardiovascular effects like hypertension, tachycardia). Start with lower doses and monitor closely for side effects.
Clinical Information
Clinical Pearls
- This combination product is not recommended for children under 2 years of age due to the risk of serious side effects.
- Advise patients to avoid alcohol and other CNS depressants due to additive sedative effects.
- Caution patients about potential for drowsiness and impaired ability to drive or operate machinery.
- Pseudoephedrine can increase blood pressure and heart rate; use with caution in patients with hypertension, heart disease, or thyroid disorders.
- Chlorpheniramine's anticholinergic effects can cause dry mouth, blurred vision, and urinary retention, especially in elderly men with prostatic hypertrophy.
- Ensure patients understand the correct liquid measurement (e.g., using a dosing spoon or cup provided with the product).
Alternative Therapies
- Single-ingredient oral antihistamines (e.g., loratadine, cetirizine, fexofenadine for less sedation; diphenhydramine for more sedation)
- Single-ingredient oral decongestants (e.g., pseudoephedrine, phenylephrine)
- Nasal saline rinses or sprays
- Intranasal corticosteroids (for allergic rhinitis)
- Nasal decongestant sprays (short-term use only to avoid rebound congestion)
Cost & Coverage
Average Cost:
$5 - $20 per 4 oz (120 mL) bottle
Generic Available:
Yes
Insurance Coverage:
Over-the-counter (OTC) products are generally not covered by prescription insurance plans, but may be eligible for FSA/HSA reimbursement.
General Drug Facts
If your symptoms or health issues persist or worsen, it's essential to contact your doctor for further guidance. To ensure your safety, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so be sure to check with your pharmacist for more information. If you have any questions or concerns about your medication, don't hesitate to reach out to your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek emergency medical attention. When seeking help, be prepared to provide details about the medication taken, the amount, and the time it happened.