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Pronunciation:

(trye PROE li deen & soo doe e FED rin)

U.S. Brand Names:

Actifed® Cold and Allergy [OTC]; Allerfrim® [OTC]; Allerphed® [OTC]; Aphedrid™ [OTC]; Aprodine® [OTC]; Genac® [OTC]; Silafed® [OTC]; Tri-Sudo® [OTC]; Uni-Fed® [OTC]

Synonyms:

Pseudoephedrine and Triprolidine

Generic Available:

Yes

Canadian Brand Names:

Actifed®

Use:

Temporary relief of nasal congestion, decongest sinus openings, running nose, sneezing, itching of nose or throat and itchy, watery eyes due to common cold, hay fever, or other upper respiratory allergies

Pregnancy Risk Factor:

Contraindications:

Hypersensitivity to pseudoephedrine or any component of the formulation; MAO therapy, hypertension, coronary artery disease

Warnings/Precautions:

Not recommended for OTC use for longer than 7 days or if symptoms are accompanied by fever. Consult healthcare provider prior to OTC use with heart disease, hypotension, thyroid disease, diabetes, emphysema, chronic bronchitis, glaucoma, or enlarged prostate. Not for OTC use in children <6 years of age.

Adverse Reactions:

Frequency not defined.

Cardiovascular: Tachycardia

Central nervous system: Drowsiness, nervousness, insomnia, transient stimulation, headache, fatigue, dizziness

Respiratory: Thickening of bronchial secretions, pharyngitis

Gastrointestinal: Appetite increase, weight gain, nausea, diarrhea, abdominal pain, xerostomia

Genitourinary: Dysuria

Neuromuscular & skeletal: Arthralgia, weakness

Miscellaneous: Diaphoresis

Drug Interactions:

Triprolidine: Inhibits CYP2D6 (weak)

Decreased effect of guanethidine, reserpine, methyldopa

Increased toxicity with MAO inhibitors (hypertensive crisis), sympathomimetics, CNS depressants, ethanol (sedation)

Mechanism of Action:

Refer to Pseudoephedrine monograph

Triprolidine is a member of the propylamine (alkylamine) chemical class of H1-antagonist antihistamines. As such, it is considered to be relatively less sedating than traditional antihistamines of the ethanolamine, phenothiazine, and ethylenediamine classes of antihistamines. Triprolidine has a shorter half-life and duration of action than most of the other alkylamine antihistamines. Like all H1-antagonist antihistamines, the mechanism of action of triprolidine is believed to involve competitive blockade of H1-receptor sites resulting in the inability of histamine to combine with its receptor sites and exert its usual effects on target cells. Antihistamines do not interrupt any effects of histamine which have already occurred. Therefore, these agents are used more successfully in the prevention rather than the treatment of histamine-induced reactions.

Pharmacodynamics/Kinetics:

See Pseudoephedrine monograph.

Dosage:

Oral:

Children:

Syrup:

4 months to 2 years: 1.25 mL 3-4 times/day

2-4 years: 2.5 mL 3-4 times/day

4-6 years: 3.75 mL 3-4 times/day

6-12 years: 5 mL every 4-6 hours; do not exceed 4 doses in 24 hours

Tablet: ¹/2 every 4-6 hours; do not exceed 4 doses in 24 hours

Children >12 years and Adults:

Syrup: 10 mL every 4-6 hours; do not exceed 4 doses in 24 hours

Tablet: 1 every 4-6 hours; do not exceed 4 doses in 24 hours

Patient Education:

May impair ability to perform hazardous activities requiring mental alertness

Dental Health: Effects on Dental Treatment:

Key adverse event(s) related to dental treatment: Pseudoephedrine: Xerostomia (normal salivary flow resumes upon discontinuation). Chronic use of antihistamines will inhibit salivary flow, particularly in elderly patients; this may contribute to periodontal disease and oral discomfort.

Dental Health: Vasoconstrictor/Local Anesthetic Precautions:

Use with caution since pseudoephedrine is a sympathomimetic amine which could interact with epinephrine to cause a pressor response

Mental Health: Effects on Mental Status:

Drowsiness, nervousness, and insomnia are common; may cause dizziness; may rarely cause depression, hallucinations, or paradoxical excitement

Mental Health: Effects on Psychiatric Treatment:

Contraindicated with MAO inhibitors; concurrent use with psychotropics may produce additive sedation

Dosage Forms:

Syrup: Triprolidine hydrochloride 1.25 mg and pseudoephedrine hydrochloride 30 mg per 5 mL (120 mL)

Allerfrim®: Triprolidine hydrochloride 1.25 mg and pseudoephedrine hydrochloride 30 mg per 5 mL (120 mL, 480 mL)

Allerphed®, Aprodine®: Triprolidine hydrochloride 1.25 mg and pseudoephedrine hydrochloride 30 mg per 5 mL (120 mL)

Silafed®: Triprolidine hydrochloride 1.25 mg and pseudoephedrine hydrochloride 30 mg per 5 mL (120 mL, 240 mL)

Tablet (Actifed® Cold and Allergy, Allerfrim®, Aphedrid™, Aprodine®, Genac®, Tri-Sudo®, Uni-Fed®): Triprolidine hydrochloride 2.5 mg and pseudoephedrine hydrochloride 60 mg

International Brand Names:

Actifed® (CA)

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