A fixed-dose combination (FDC) medication widely used in India for symptomatic relief of common cold, allergic rhinitis, and sinusitis. It combines an antihistamine (Chlorpheniramine), an analgesic-antipyretic (Paracetamol), and a decongestant (Phenylephrine) to provide comprehensive relief from fever, pain, nasal congestion, sneezing, and runny nose.
Adult: One tablet every 4-6 hours. Maximum: 4 tablets in 24 hours.
Note: Take with or without food. Swallow whole with a glass of water. Do not crush or chew. Can be taken after meals to reduce gastric upset. Maintain adequate hydration.
This combination works synergistically. Chlorpheniramine competitively antagonizes histamine at H1 receptors, reducing allergic symptoms. Paracetamol inhibits cyclooxygenase (COX) enzymes, particularly in the CNS, reducing prostaglandin synthesis for analgesia and antipyresis. Phenylephrine is a selective alpha-1 adrenergic agonist causing vasoconstriction in nasal mucosa, reducing edema and congestion.
Pregnancy: Category B (US FDA). Use only if clearly needed. Avoid in third trimester due to potential risk of premature ductus arteriosus closure with paracetamol (theoretical) and anticholinergic effects in neonate.
Driving: May impair ability to drive or operate machinery. Chlorpheniramine causes significant drowsiness. Patients should not engage in these activities until effect is known.
| Monoamine Oxidase Inhibitors (MAOIs) - Phenelzine, Tranylcypromine | Risk of severe hypertensive crisis due to potentiation of phenylephrine. | Contraindicated |
| Other Sedatives (Alcohol, Benzodiazepines, Opioids) | Additive CNS depression and sedation with chlorpheniramine. | Major |
| Other Paracetamol-containing products | Risk of paracetamol overdose leading to hepatotoxicity. | Major |
| Antihypertensives (Beta-blockers, Alpha-blockers) | Phenylephrine may antagonize hypotensive effect; increased risk of hypertension with non-selective beta-blockers. | Moderate |
| Tricyclic Antidepressants (Amitriptyline, Imipramine) | Additive anticholinergic effects and potential increased pressor response to phenylephrine. | Moderate |
| CNS Stimulants (Amphetamines, Methylphenidate) | Additive sympathomimetic effects, increasing risk of hypertension and tachycardia. | Moderate |
| Warfarin | Chronic high-dose paracetamol may potentiate anticoagulant effect (monitor INR). | Moderate |
Same composition (Chlorpheniramine Maleate (2mg) + Paracetamol (500mg) + Phenylephrine (5mg)), different brands: