Nohist-Lq 4-10/5ml 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 (first-generation) and Alpha-1 adrenergic agonist
Pregnancy Category
Category C
FDA Approved
Jan 1970
DEA Schedule
Not Controlled
Overview
What is this medicine?
This medicine is a combination of an antihistamine and a decongestant. The antihistamine helps relieve sneezing, runny nose, and watery eyes caused by allergies or the common cold. The decongestant helps clear up stuffy nose by shrinking blood vessels in the nasal passages.
How to Use This Medicine
Taking Your Medication Correctly
To use this medication safely and effectively, follow your doctor's instructions and read all the information provided. You can take this medication with or without food, but if it causes stomach upset, take it with food to help minimize discomfort. When taking the liquid form, measure the dose carefully using the measuring device that comes with the medication. If one is not provided, ask your pharmacist for a suitable measuring device.
Storing and Disposing of Your Medication
Store this medication at room temperature in a dry location, avoiding the bathroom. Keep all medications in a secure place, 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. If you have questions about the best way to dispose of your medication, consult your pharmacist. You may also want to check if there are any drug take-back programs available in your area.
What to Do If You Miss a Dose
If you take this medication on a regular schedule, take the missed dose as soon as you remember. However, if it's close to the time for your next dose, skip the missed dose and resume 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 use this medication safely and effectively, follow your doctor's instructions and read all the information provided. You can take this medication with or without food, but if it causes stomach upset, take it with food to help minimize discomfort. When taking the liquid form, measure the dose carefully using the measuring device that comes with the medication. If one is not provided, ask your pharmacist for a suitable measuring device.
Storing and Disposing of Your Medication
Store this medication at room temperature in a dry location, avoiding the bathroom. Keep all medications in a secure place, 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. If you have questions about the best way to dispose of your medication, consult your pharmacist. You may also want to check if there are any drug take-back programs available in your area.
What to Do If You Miss a Dose
If you take this medication on a regular schedule, take the missed dose as soon as you remember. However, if it's close to the time for your next dose, skip the missed dose and resume 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 driving or operating heavy machinery until you know how this medicine affects you, as it can cause drowsiness or dizziness.
- Avoid alcohol and other CNS depressants, as they can increase drowsiness.
- Stay hydrated to help with dry mouth.
- Do not exceed the recommended dose, as this can lead to serious side effects.
Available Forms & Alternatives
Available Strengths:
Dosing & Administration
Adult Dosing
Standard Dose:
5 mL to 10 mL orally every 4 to 6 hours
Dose Range:
5 - 10 mg
Condition-Specific Dosing:
maxDailyDose:
Do not exceed 6 doses (60 mL) in 24 hours.
Pediatric Dosing
Neonatal:
Not established
Infant:
Not established (generally not recommended for children under 2 years)
Child:
Children 6 to under 12 years: 2.5 mL to 5 mL orally every 4 to 6 hours (Do not exceed 6 doses in 24 hours). Consult a physician for children under 6 years.
Adolescent:
Adolescents 12 years and older: 5 mL to 10 mL orally every 4 to 6 hours (Do not exceed 6 doses in 24 hours).
Dose Adjustments
Renal Impairment:
Mild:
No specific adjustment guidelines; use with caution.
Moderate:
Use with caution; consider dose reduction due to potential for accumulation of chlorpheniramine and phenylephrine metabolites. Monitor for adverse effects.
Severe:
Use with caution; significant dose reduction may be necessary. Avoid if possible. Monitor closely for adverse effects.
Dialysis:
Not well studied; use with extreme caution. Chlorpheniramine is not significantly dialyzable. Phenylephrine is not significantly dialyzable.
Hepatic Impairment:
Mild:
No specific adjustment guidelines; use with caution.
Moderate:
Use with caution; consider dose reduction due to chlorpheniramine's hepatic metabolism. Monitor for increased sedation or other adverse effects.
Severe:
Use with caution; significant dose reduction may be necessary. Avoid if possible due to extensive hepatic metabolism of both components. Monitor closely for adverse effects.
Pharmacology
Mechanism of Action
Chlorpheniramine is a first-generation antihistamine that acts as a competitive antagonist of H1-receptors, thereby preventing histamine from binding and reducing symptoms like sneezing, rhinorrhea, and watery eyes. It also possesses anticholinergic properties. Phenylephrine is a direct-acting sympathomimetic amine that primarily acts as an alpha-1 adrenergic receptor agonist, causing vasoconstriction in the nasal mucosa, leading to reduced swelling and congestion.
Pharmacokinetics
Absorption:
Bioavailability:
Chlorpheniramine: Approximately 25-50% (variable due to first-pass metabolism); Phenylephrine: Low oral bioavailability (approx. 38%) due to extensive first-pass metabolism.
Tmax:
Chlorpheniramine: 2.5-6 hours; Phenylephrine: 0.5-2 hours (oral).
FoodEffect:
Food may delay absorption but generally does not significantly affect the extent of absorption.
Distribution:
Vd:
Chlorpheniramine: 1-10 L/kg; Phenylephrine: Not well established for oral route.
ProteinBinding:
Chlorpheniramine: 69-72%; Phenylephrine: Not extensively protein bound.
CnssPenetration:
Chlorpheniramine: Yes (causes sedation); Phenylephrine: Limited (does not readily cross the blood-brain barrier).
Elimination:
HalfLife:
Chlorpheniramine: 12-43 hours (highly variable); Phenylephrine: 2-3 hours (oral).
Clearance:
Not precisely quantified for combination.
ExcretionRoute:
Renal (primarily urine).
Unchanged:
Chlorpheniramine: 3-10% (unchanged in urine); Phenylephrine: Approximately 2.6% (unchanged in urine).
Pharmacodynamics
OnsetOfAction:
Chlorpheniramine: 15-60 minutes; Phenylephrine: 15-30 minutes (oral).
PeakEffect:
Chlorpheniramine: 2-6 hours; Phenylephrine: 1-2 hours (oral).
DurationOfAction:
Chlorpheniramine: 4-6 hours; Phenylephrine: 4-6 hours (oral).
Safety & Warnings
Side Effects
Urgent Side Effects: Seek Medical Attention Immediately
While rare, some people may experience severe and potentially life-threatening side effects when taking this medication. If you notice any of the following symptoms, contact your doctor or seek medical help right away:
- 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, or swelling of the mouth, face, lips, tongue, or throat.
Other Possible Side Effects
Like all medications, this drug can cause side effects, although not everyone will experience them. Many people have no side effects or only minor ones. If you experience any of the following side effects, or if they bother you or do not go away, contact your doctor or seek medical help:
- Feeling dizzy or sleepy
- Feeling nervous and excitable
- Trouble sleeping
Reporting Side Effects
These are not all the possible side effects of this medication. If you have questions or concerns about side effects, contact your doctor for advice. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
While rare, some people may experience severe and potentially life-threatening side effects when taking this medication. If you notice any of the following symptoms, contact your doctor or seek medical help right away:
- 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, or swelling of the mouth, face, lips, tongue, or throat.
Other Possible Side Effects
Like all medications, this drug can cause side effects, although not everyone will experience them. Many people have no side effects or only minor ones. If you experience any of the following side effects, or if they bother you or do not go away, contact your doctor or seek medical help:
- Feeling dizzy or sleepy
- Feeling nervous and excitable
- Trouble sleeping
Reporting Side Effects
These are not all the possible side effects of this medication. If you have questions or concerns about side effects, contact your doctor for advice. 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 drowsiness
- Nervousness, restlessness, or trouble sleeping
- Fast, pounding, or irregular heartbeat
- Significant increase in blood pressure
- Difficulty urinating
- Blurred vision
- Allergic reaction (rash, itching, swelling, severe dizziness, trouble breathing)
- Hallucinations or seizures (rare, but serious)
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.
To minimize the risk of severe side effects, do not exceed the dosage prescribed by your doctor. Taking more than the recommended amount may increase your chance of experiencing severe side effects. Additionally, do not take this medication for a longer duration than specified by your doctor.
Until you understand how this medication affects you, avoid operating a vehicle or engaging in activities that require alertness. It is also recommended to avoid consuming alcohol while taking this drug.
Before using marijuana, other forms of cannabis, or prescription and over-the-counter (OTC) medications that may cause drowsiness, consult with your doctor.
If you are considering giving this medication to a child, it is crucial to discuss the appropriate dosage with their doctor, as different brands may have varying dosage recommendations for children. When administering this medication to a child, exercise caution, as they may be at a higher risk of experiencing excitability. Furthermore, do not use this medication as a means to induce sleep in children; instead, consult with their doctor.
If you are pregnant, planning to become pregnant, or breastfeeding, inform your doctor. It is necessary to discuss the potential benefits and risks of this medication to both you and your baby.
To minimize the risk of severe side effects, do not exceed the dosage prescribed by your doctor. Taking more than the recommended amount may increase your chance of experiencing severe side effects. Additionally, do not take this medication for a longer duration than specified by your doctor.
Until you understand how this medication affects you, avoid operating a vehicle or engaging in activities that require alertness. It is also recommended to avoid consuming alcohol while taking this drug.
Before using marijuana, other forms of cannabis, or prescription and over-the-counter (OTC) medications that may cause drowsiness, consult with your doctor.
If you are considering giving this medication to a child, it is crucial to discuss the appropriate dosage with their doctor, as different brands may have varying dosage recommendations for children. When administering this medication to a child, exercise caution, as they may be at a higher risk of experiencing excitability. Furthermore, do not use this medication as a means to induce sleep in children; instead, consult with their doctor.
If you are pregnant, planning to become pregnant, or breastfeeding, inform your doctor. It is necessary to discuss the potential benefits and risks of this medication to both you and your baby.
Overdose Information
Overdose Symptoms:
- Severe drowsiness or agitation
- Hallucinations
- Seizures
- Dilated pupils
- Flushed skin
- Fever
- Dry mouth
- Urinary retention
- Rapid or irregular heartbeat
- High blood pressure, followed by low blood pressure
- Coma
What to Do:
Seek immediate medical attention. Call 911 or Poison Control at 1-800-222-1222. Bring the medication container with you.
Drug Interactions
Contraindicated Interactions
- Monoamine Oxidase Inhibitors (MAOIs) (e.g., Isocarboxazid, Phenelzine, Selegiline, Tranylcypromine, Linezolid, Methylene Blue): Concomitant use or use within 14 days of MAOIs can lead to hypertensive crisis (due to phenylephrine) and prolonged/intensified anticholinergic effects and CNS depression (due to chlorpheniramine).
Major Interactions
- Other Sympathomimetics (e.g., pseudoephedrine, ephedrine, amphetamines, decongestants): Increased risk of cardiovascular effects (hypertension, tachycardia, arrhythmias).
- Tricyclic Antidepressants (TCAs) (e.g., Amitriptyline, Imipramine): May potentiate the pressor effects of phenylephrine and increase anticholinergic effects of chlorpheniramine.
- Beta-blockers (non-selective) (e.g., Propranolol): May increase the pressor effects of phenylephrine due to unopposed alpha-adrenergic stimulation.
- CNS Depressants (e.g., Alcohol, Sedatives, Hypnotics, Opioids, Anxiolytics): Enhanced CNS depression (drowsiness, dizziness) due to chlorpheniramine.
- Anticholinergics (e.g., Atropine, Scopolamine, certain antipsychotics, tricyclic antidepressants): Increased risk of anticholinergic side effects (dry mouth, urinary retention, blurred vision, constipation).
Moderate Interactions
- Digoxin: Phenylephrine may increase the risk of arrhythmias.
- Ergot Alkaloids (e.g., Ergotamine): Increased risk of vasoconstriction and hypertension.
- Antihypertensives: Phenylephrine may reduce the effectiveness of antihypertensive medications.
- Metoclopramide: May antagonize the effects of metoclopramide on gastrointestinal motility due to chlorpheniramine's anticholinergic effects.
Minor Interactions
- Antacids: May increase absorption of chlorpheniramine.
- Kaolin/Pectin: May decrease absorption of chlorpheniramine.
Monitoring
Baseline Monitoring
Blood Pressure and Heart Rate
Rationale: Phenylephrine can increase blood pressure and heart rate, especially in susceptible individuals.
Timing: Before initiation in patients with pre-existing cardiovascular conditions.
Routine Monitoring
Symptom Relief (nasal congestion, sneezing, rhinorrhea)
Frequency: Daily, as needed
Target: Reduction or resolution of symptoms
Action Threshold: If symptoms persist or worsen after 7 days, discontinue and consult a healthcare provider.
Adverse Effects (drowsiness, dizziness, dry mouth, insomnia, nervousness, increased blood pressure)
Frequency: Daily, as needed
Target: Absence or mild, tolerable side effects
Action Threshold: If severe or persistent adverse effects occur, discontinue and seek medical attention.
Symptom Monitoring
- Effectiveness of symptom relief (nasal congestion, sneezing, runny nose, watery eyes)
- Signs of CNS depression (drowsiness, dizziness, impaired coordination)
- Signs of CNS stimulation (insomnia, nervousness, anxiety, tremor)
- Cardiovascular effects (palpitations, increased heart rate, chest discomfort)
- Anticholinergic effects (dry mouth, blurred vision, urinary retention, constipation)
Special Patient Groups
Pregnancy
Category C. Use only if the potential benefit justifies the potential risk to the fetus. Chlorpheniramine has been used, but phenylephrine is a vasoconstrictor and could theoretically reduce uterine blood flow. Consult a healthcare provider.
Trimester-Specific Risks:
First Trimester:
Limited data; generally avoided if possible due to potential for vasoconstriction with phenylephrine.
Second Trimester:
Generally considered safer than first trimester, but still use with caution.
Third Trimester:
Avoid close to term due to potential for vasoconstriction and possible effects on the fetus (e.g., increased heart rate, irritability).
Lactation
L3 (Moderate Concern). Both chlorpheniramine and phenylephrine are excreted in breast milk. Chlorpheniramine can cause drowsiness/irritability in the infant and may decrease milk supply. Phenylephrine can also cause irritability and theoretically decrease milk supply. Use with caution; consider alternative agents or monitor infant closely.
Infant Risk:
Drowsiness, irritability, paradoxical excitation, potential for decreased milk supply.
Pediatric Use
Not recommended for children under 2 years of age due to potential for serious side effects, including respiratory depression and death. Use with extreme caution and only under medical supervision for children 2-5 years. For children 6 years and older, use age-appropriate dosing and do not exceed recommended doses. Always use a calibrated measuring device.
Geriatric Use
Elderly patients are more susceptible to the anticholinergic effects of chlorpheniramine (e.g., sedation, confusion, dry mouth, urinary retention) and the sympathomimetic effects of phenylephrine (e.g., increased blood pressure, tachycardia, insomnia). Use with caution, starting with the lowest effective dose and monitoring closely for adverse effects. Avoid in elderly patients with glaucoma, prostatic hypertrophy, or severe cardiovascular disease.
Clinical Information
Clinical Pearls
- This combination product is intended for temporary relief of cold and allergy symptoms. It is not a cure.
- Advise patients to read the label carefully and use a calibrated measuring spoon or cup, not a household spoon, to ensure accurate dosing.
- Warn patients about potential drowsiness and to avoid activities requiring mental alertness until they know how the medication affects them.
- Counsel patients to avoid other medications containing antihistamines or decongestants to prevent accidental overdose.
- Patients with high blood pressure, heart disease, thyroid disease, diabetes, glaucoma, or prostate enlargement should consult a doctor before using this product.
- If symptoms do not improve within 7 days or are accompanied by fever, rash, or persistent headache, advise patients to consult a healthcare professional.
Alternative Therapies
- Single-ingredient antihistamines (e.g., Loratadine, Cetirizine for non-drowsy options; Diphenhydramine for drowsy option)
- Single-ingredient decongestants (e.g., Pseudoephedrine, Oxymetazoline nasal spray)
- Saline nasal sprays (for congestion)
- Nasal corticosteroids (for allergic rhinitis)
- Non-pharmacological measures (e.g., humidifiers, rest, fluids)
Cost & Coverage
Average Cost:
$10 - $30 per 120 mL or 240 mL bottle
Generic Available:
Yes
Insurance Coverage:
Generally OTC (Over-The-Counter), typically not covered by insurance unless prescribed and deemed medically necessary by the plan.
General Drug Facts
If your symptoms or health issues persist or worsen, it is essential to contact your doctor promptly. To ensure safe and effective treatment, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so it is a good idea to consult with your pharmacist. If you have any questions or concerns about this medication, do not hesitate to discuss them with 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 detailed information about the overdose, including the medication taken, the amount, and the time it occurred.