Drug Interactions of First Generation Antihistamines:
More presentations from Naina Mohamed Pakkir Maideen
§ First-Generation OTC Antihistamines include Brompheniramine, Chlorpheniramine, Dimenhydrinate, Diphenhydramine, and Doxylamine.
§ The risk of serotonin syndrome (hypertension, hyperthermia, myoclonus, mental status changes) is elevated by the concomitant administration of Brompheniramine or Chlorpheniramine with Antidepressants (SSRIs, SNRIs, TCAs, Trazodone, Vortioxetine, Amoxapine) or serotonergic drugs (Lorcaserin, Almotriptan, Hydroxytryptophan, Fentanyl and Tramadol).
§ Excessive anticholinergic activity (severe dry mouth, constipation, decreased urination, excessive sedation, blurred vision) may resulted due to combination of Chlorpheniramine or Diphenhydramine and drugs having anticholinergic activity (Belldonna, Clomipramine, Amitriptyline, Triflupromazine, amoxapine and Linezolid).
§ Coadministration of Diphenhydramine and Opioids (Hydromorphone, Oxycodone, Hydrocodone, Fentanyl, Tapentadol), Other CNS depressants (Zolpidem, Loxapine, Meclizine, Carbinoxamine) or Ethanol increase the risk of CNS depression.
§ The American Congress of Obstetricians and Gynecologists (ACOG) and the American College of Allergy, Asthma and Immunology (ACAAI) recommend Chlorpheniramine as the antihistamine of choice during pregnancy.
§ According to the World Health Organization, use of chlorpheniramine in nursing mothers should be avoided if possible.
§ Patients should thoroughly read the labels of all over-the-counter and prescription medicines.
§ Patients should talk to their doctor or pharmacist before taking any new prescription or over the counter medication.
§ Physicians should be aware of potential drug interactions with OTC medicines when prescribing new medications.
§ Pharmacists can be instrumental in assisting patients with using OTC medications safely and effectively.
§ Pharmacists should warn consumers of the risks of misusing OTC drugs.
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