CONGESTAL SYRUP
PARACETAMOLCHLOPHENIRAMINE MALEATEPSEUDOEPHEDRINE HCLDEXTROMETHORPHAN
What it does
Dextromethorphan is a medicine used to relieve coughing.
Commonly used for: cough, dry cough
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Source: Pharmacy and Poisons Board · fetched 2026-01-28 21:30:13 · updated 2026-07-20 11:04:22
About hcldextromethorphan
Dextromethorphan is a medicine used to relieve coughing.
What it treats
- cough
- dry cough
How it works
It works by suppressing the cough reflex in the brain.
Who it's for
It is suitable for adults and children over 12 years old who have a cough.
AI-assisted summary grounded in BNF data - general information only, not medical advice. Always confirm with your pharmacist or doctor.
About maleatepseudoephedrine
Pseudoephedrine maleate is a medicine used to relieve nasal and sinus congestion.
What it treats
- nasal congestion
- sinus congestion
How it works
It works by narrowing the blood vessels in the nasal passages, reducing swelling and congestion.
Who it's for
This medicine is suitable for adults and children over a certain age with congestion due to colds or allergies.
AI-assisted summary grounded in BNF data - general information only, not medical advice. Always confirm with your pharmacist or doctor.
About paracetamolchlopheniramine
Paracetamol and chlorpheniramine is a combination medicine used to relieve pain and reduce fever, as well as to alleviate allergy symptoms such as runny nose and sneezing.
What it treats
- fever
- pain relief
- allergy symptoms (like runny nose and sneezing)
How it works
Paracetamol works by blocking pain signals in the brain and lowering fever, while chlorpheniramine helps to relieve allergy symptoms by blocking certain natural substances in the body.
Who it's for
This medicine is suitable for adults and children who need relief from pain, fever, or allergy symptoms.
AI-assisted summary grounded in BNF data - general information only, not medical advice. Always confirm with your pharmacist or doctor.
Clinical monograph: hcldextromethorphan
Dextromethorphan is a cough suppressant used primarily to treat coughs associated with colds and other conditions. It is a synthetic morphinan derivative that acts on the brain to suppress the cough reflex. Dextromethorphan is available in various formulations, including syrups, tablets, and lozenges, and is often combined with other medications in over-the-counter cough and cold preparations.
Indications
- Cough suppression
- Symptomatic relief of cough associated with upper respiratory tract infections
- Cough due to bronchitis
- Cough associated with allergies
Dosage
Children: For paediatric dosing, consult the BNF for Children for appropriate age-specific recommendations and formulations.
Adults: Typical adult dosing ranges from 10 to 20 mg every 4 to 6 hours, not exceeding 120 mg per day. Refer to specific product guidelines for exact dosing.
Mechanism of action
Dextromethorphan acts as a non-competitive antagonist of the NMDA receptor, which is implicated in the cough reflex pathway. It also interacts with the sigma-1 receptor and may inhibit the reuptake of serotonin. These actions collectively lead to a decrease in cough frequency and intensity.
Pharmacodynamics
Dextromethorphan's primary effect is the suppression of the cough reflex, which is mediated through its action on the central nervous system. It does not exhibit analgesic or sedative properties at therapeutic doses, making it a preferred choice for cough relief without significant sedation. The onset of action usually occurs within 15 to 30 minutes, and the duration of effect can last several hours.
Pharmacokinetics
Dextromethorphan is rapidly absorbed from the gastrointestinal tract. It undergoes extensive first-pass metabolism in the liver, primarily through the cytochrome P450 system, particularly CYP2D6, leading to various metabolites. The elimination half-life of dextromethorphan is approximately 3 to 6 hours, and it is excreted mainly in urine as metabolites. Its pharmacokinetics can be influenced by genetic polymorphisms in the CYP2D6 enzyme, affecting individual responses to the drug.
Contra-indications
- Hypersensitivity to dextromethorphan or any of its components
- Concurrent use of monoamine oxidase inhibitors (MAOIs)
- Severe respiratory failure
- Pediatric patients under 2 years of age
Adverse effects
- Dizziness
- Drowsiness
- Nausea
- Vomiting
- Constipation
- Nervousness
- Confusion
- Hallucinations
- Serotonin syndrome (in cases of overdose or interaction with serotonergic drugs)
Interactions
- Increased risk of CNS depression when used with alcohol, sedatives, or tranquilizers
- May interact with serotonergic drugs leading to serotonin syndrome
- Potential interaction with MAOIs leading to hypertensive crisis
Precautions
- Use with caution in patients with a history of substance abuse or addiction
- Caution in patients with respiratory conditions such as asthma or chronic obstructive pulmonary disease (COPD)
- Not recommended for chronic cough associated with smoking, asthma, or emphysema
- Monitor for signs of serotonin syndrome in patients taking other serotonergic agents
Pregnancy
Dextromethorphan should be used during pregnancy only if clearly needed, as there is limited data on its safety.
Breast-feeding
Dextromethorphan is excreted in breast milk; caution should be exercised when administering to nursing mothers.
Storage
Store at room temperature, away from light and moisture. Keep out of reach of children.
Formulations
- Oral syrup
- Tablet
- Capsule
- Lozenge
AI-synthesized from BNF references - general information only, not a substitute for professional medical advice or the current BNF. Verify doses with a pharmacist.
Clinical monograph: maleatepseudoephedrine
Maleate pseudoephedrine is a sympathomimetic amine primarily used as a decongestant in the treatment of nasal congestion associated with allergic rhinitis, sinusitis, and colds. It works by constricting blood vessels in the nasal passages, thereby reducing swelling and congestion.
Indications
- Nasal congestion due to allergic rhinitis
- Nasal congestion associated with colds
- Sinusitis-related nasal congestion
Dosage
Children: Refer to the BNF for Children for specific dosing information; paediatric doses typically depend on the child's age and weight.
Adults: Refer to the BNF for specific dosing information; typical adult doses may vary based on formulation and clinical guidelines.
Mechanism of action
Pseudoephedrine acts as an alpha-adrenergic agonist, leading to vasoconstriction of the nasal mucosa. This action decreases edema and hyperemia in the nasal passages, which alleviates nasal congestion. It is also thought to have some effect on the respiratory tract by reducing secretions.
Pharmacodynamics
The pharmacodynamic effects of pseudoephedrine include relief from nasal congestion, improved airflow, and decreased mucosal swelling. The onset of action typically occurs within 30 minutes, with peak effects observed within 1-2 hours. Its duration of action can last up to 6 hours, making it effective for short-term relief.
Pharmacokinetics
Pseudoephedrine is well absorbed from the gastrointestinal tract following oral administration. It undergoes minimal first-pass metabolism in the liver, with its bioavailability being about 100%. The drug is primarily excreted unchanged in the urine, with a half-life of approximately 5-8 hours. Factors such as urinary pH can influence its excretion rate.
Contra-indications
- Severe hypertension
- Severe coronary artery disease
- Hypersensitivity to pseudoephedrine or any component of the formulation
Adverse effects
- Insomnia
- Nervousness
- Dizziness
- Headache
- Dry mouth
- Nausea
- Increased heart rate
- Hypertension
Interactions
- Monoamine oxidase inhibitors (MAOIs) can increase the risk of hypertensive crisis
- Other sympathomimetics may enhance cardiovascular effects
- Antihypertensives may have reduced efficacy
Precautions
- Use with caution in patients with hypertension, diabetes mellitus, or hyperthyroidism
- Caution in individuals with a history of seizures
- May exacerbate urinary retention in males with prostatic hypertrophy
Pregnancy
Use during pregnancy only if clearly needed and the benefit outweighs the risk, as safety in pregnancy has not been established.
Breast-feeding
Pseudoephedrine is excreted in breast milk, caution is advised when used during breastfeeding.
Storage
Store at room temperature, away from moisture and heat. Keep out of reach of children.
Formulations
- Tablets
- Syrup
- Extended-release capsules
AI-synthesized from BNF references - general information only, not a substitute for professional medical advice or the current BNF. Verify doses with a pharmacist.
Clinical monograph: paracetamolchlopheniramine
Paracetamol and chlorpheniramine are often combined to provide both analgesic and antihistaminic effects. Paracetamol is a widely used analgesic and antipyretic agent, effective in alleviating mild to moderate pain and reducing fever. Chlorpheniramine is an antihistamine that is primarily used to relieve symptoms of allergic rhinitis and other allergic conditions. The combination is particularly useful in treating symptoms associated with colds and allergies, such as pain, fever, and runny nose.
Indications
- Mild to moderate pain relief
- Fever reduction
- Symptomatic relief of allergic rhinitis
- Cold symptoms management
Dosage
Children: Refer to
Adults: Refer to specific guidelines or clinical recommendations, as dosages can vary based on the preparation and clinical conditions.
Mechanism of action
Paracetamol acts mainly in the central nervous system, where it inhibits the synthesis of prostaglandins, reducing pain perception and fever. It is thought to involve the inhibition of the cyclooxygenase (COX) enzymes, particularly COX-2, and may also act on cannabinoid receptors. Chlorpheniramine, on the other hand, works by blocking the H1 histamine receptors, which prevents the actions of histamine, thereby alleviating symptoms like sneezing, itching, and runny nose.
Pharmacodynamics
Paracetamol exhibits analgesic and antipyretic properties, providing pain relief and lowering body temperature during fever. Chlorpheniramine provides symptomatic relief from allergic reactions by counteracting the effects of histamine in the body, leading to reduced vascular permeability, decreased bronchoconstriction, and inhibition of mucus secretion.
Pharmacokinetics
Paracetamol is rapidly absorbed from the gastrointestinal tract, with peak plasma concentrations occurring within 30 to 60 minutes after oral administration. It is metabolized primarily in the liver through conjugation pathways, with a small fraction converted to a toxic metabolite, N-acetyl-p-benzoquinone imine (NAPQI), which is usually neutralized by glutathione. Chlorpheniramine is also well absorbed and has a half-life of approximately 12 to 15 hours. It undergoes hepatic metabolism and is excreted primarily in urine, with renal clearance being a significant route of elimination.
Contra-indications
- Hypersensitivity to paracetamol, chlorpheniramine or any of the excipients
- Severe hepatic impairment
- Severe respiratory depression
Adverse effects
- Nausea
- Vomiting
- Rash
- Drowsiness
- Dry mouth
- Constipation
- Urinary retention
Interactions
- Alcohol may enhance the hepatotoxic effect of paracetamol
- Chlorpheniramine may enhance the sedative effects of other central nervous system depressants such as benzodiazepines
- Anticholinergic drugs may increase the risk of side effects from chlorpheniramine
Precautions
- Use with caution in patients with liver disease or alcohol dependence
- Caution in patients with asthma or chronic obstructive pulmonary disease due to the anticholinergic effects of chlorpheniramine
- Monitor for signs of overdose, particularly with paracetamol
Pregnancy
Use only if clearly needed, as risks and benefits must be evaluated. Limited data available on safety.
Breast-feeding
Paracetamol is generally considered safe during breastfeeding, but chlorpheniramine may cause sedation in the infant.
Storage
Store at room temperature, away from moisture and heat. Keep out of reach of children.
Formulations
- Tablets
- Syrup
- Suspension
- Effervescent tablets
AI-synthesized from BNF references - general information only, not a substitute for professional medical advice or the current BNF. Verify doses with a pharmacist.