Pseudoephedrine (NA) + Chlorpheniramine Maleate (NA) + Dextromethorphan Hydrobromide (NA) (Medical Monograph)

Overview

A fixed-dose combination (FDC) of a sympathomimetic decongestant (Pseudoephedrine), a first-generation sedating antihistamine (Chlorpheniramine Maleate), and a centrally-acting antitussive (Dextromethorphan Hydrobromide). It is primarily used for the symptomatic relief of cough and cold, providing decongestion, reduction of allergic symptoms, and suppression of non-productive cough. The combination is widely used in India, though its FDC status has been under regulatory scrutiny.

The combination provides multi-modal symptomatic relief. Pseudoephedrine acts as a decongestant by stimulating alpha-adrenergic receptors in the nasal mucosa, causing vasoconstriction and reduced edema. Chlorpheniramine is a competitive H1-histamine receptor antagonist, reducing allergic symptoms like rhinorrhea and sneezing, with significant CNS penetration causing sedation. Dextromethorphan suppresses the cough reflex by acting on the medullary cough center, primarily via NMDA receptor antagonism and sigma-1 receptor agonism.