Side Effects of chlorpheniramine: A Synthesis of Findings from 28 Studies

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Original Abstract of the Article

Major Research Findings

Chlorpheniramine is a first-generation antihistamine commonly used to alleviate allergy and cold symptoms. It is known for its anticholinergic effects, which are thought to contribute to its effectiveness in relieving cold symptoms. 20 However, it has been shown that chlorpheniramine can have a significant impact on the central nervous system, potentially leading to adverse effects, especially drowsiness. 10 11 3 This effect may pose a risk for individuals engaged in activities that require alertness, such as driving or operating machinery. 28 In contrast, terfenadine, a second-generation antihistamine, has been reported to have fewer anticholinergic side effects and is less likely to cause drowsiness. 20

Reasons for Side Effects

Chlorpheniramine exerts its effects by blocking histamine H1 receptors, which are found throughout the body, including the central nervous system. The blockage of these receptors can lead to various side effects, including drowsiness, fatigue, and cognitive impairments. 3

General Side Effects

Drowsiness

Chlorpheniramine is known to cause drowsiness as a common side effect. 10 11 3 13 14 28 25 2 8 It can impair cognitive function, including attention and memory. 14 2 25

Dry Mouth

Dry mouth is another common side effect of chlorpheniramine. 20 23

Constipation

Chlorpheniramine can also lead to constipation. 20 23

Blurred Vision

Blurred vision is a potential side effect. 20

Dizziness

Dizziness is another reported side effect. 20

Difficulty Urinating

Chlorpheniramine can cause difficulty urinating. 20 23

Effects on the Heart

Chlorpheniramine has been reported to have some impact on the heart. 20

Countermeasures for Side Effects

Drowsiness

If you experience drowsiness, avoid driving or operating machinery. It is advisable to avoid activities that require alertness. 10 11 3

Dry Mouth

To alleviate dry mouth, make sure to drink plenty of fluids. 20 23

Constipation

To address constipation, consume a diet rich in fiber and ensure adequate hydration. If these measures do not provide relief, consult your doctor. 20 23

Blurred Vision

If you experience blurred vision, refrain from driving or operating machinery. If the condition persists, seek medical advice from your doctor. 20

Dizziness

If you experience dizziness, exercise caution when getting up or moving around. Utilize handrails for support to prevent falls. 20

Difficulty Urinating

If you experience difficulty urinating, consult your doctor. 20 23

Effects on the Heart

If you have a pre-existing heart condition, consult your doctor before taking chlorpheniramine. 20

Comparison between Studies

Commonalities of Studies

Multiple studies have confirmed that chlorpheniramine can cause drowsiness and fatigue as side effects. 10 11 3 13 14 28 25 2

Differences between Studies

Some studies have demonstrated that chlorpheniramine can negatively impact cognitive function, including attention and memory. 14 2 25 Conversely, other studies have found no evidence of chlorpheniramine affecting cognitive function. 13 11 These conflicting findings suggest that the impact of chlorpheniramine on cognitive function may be influenced by individual differences and the dosage administered.

Precautions for Application in Daily Life

Chlorpheniramine can cause drowsiness, so exercise caution when driving or operating machinery. It is also recommended to avoid activities that require a high level of alertness. 3 28 When using chlorpheniramine, strictly adhere to your doctor's instructions and follow the prescribed dosage. Consult your doctor before taking chlorpheniramine if you plan to participate in activities that require concentration and attention, such as driving or operating machinery.

Limitations of Current Research

The mechanisms underlying the various side effects of chlorpheniramine are not fully understood. Furthermore, the impact of chlorpheniramine on cognitive function remains inconsistent, requiring further investigation.

Future Research Directions

More research is necessary to thoroughly investigate the effects of chlorpheniramine on cognitive function. It is also crucial to elucidate the mechanisms by which chlorpheniramine causes various side effects and develop strategies to mitigate these adverse effects.

Conclusion

Chlorpheniramine, while effective in relieving allergy and cold symptoms, can cause side effects such as drowsiness and fatigue. When using chlorpheniramine, it is important to follow your doctor's instructions, adhere to the prescribed dosage, and be aware of potential side effects. Exercise extra caution when engaging in activities that require concentration and attention, such as driving or operating machinery. The influence of chlorpheniramine on cognitive function is still not completely understood, making further research in this area essential.

Literature analysis of 28 papers
Positive Content
17
Neutral Content
2
Negative Content
9
Article Type
7
0
0
3
26
1.

Comparison of CNS adverse effects between astemizole and chlorpheniramine in children: a randomized, double-blind study.

Author: ShanonA, FeldmanW, LeikinL, PongA H, PetersonR, WilliamsV

No antihistamine CNS effects

Chlorpheniramine and astemizole had no adverse effects on the performance of children in a study of central nervous system side effects.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

2.

[The potential P300 in the evaluation of the side effects of dexchlorpheniramine].

Author: Serra-GrabulosaJ M, Sánchez-TuretM, GrauC, EsceraC

Central nervous system effects

This study investigated the effects of a single 4 mg dose of dexchlorpheniramine, an antihistamine, on the P300 evoked potential, a measure of cognitive processing. Dexchlorpheniramine was found to have no significant effect on P300 amplitude or latency, suggesting that this dose may not have a significant impact on cognitive function.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Controlled Clinical TrialA clinical trial that evaluates the effectiveness of a treatment by comparing a group that receives the intervention with a group that receives a placebo or standard treatment.
English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : Spanish

3.

Effects of a sedative antihistamine, D-chlorpheniramine, on regional cerebral perfusion and performance during simulated car driving.

Author: TashiroManabu, SakuradaYumiko, MochizukiHideki, HorikawaEtsuo, MaruyamaMasahiro, OkamuraNobuyuki, WatanukiShoichi, AraiHiroyuki, ItohMasatoshi, YanaiKazuhiko

Sedative side effects

This study examined regional cerebral blood flow (rCBF) responses during a simulated car-driving task following oral administration of D-chlorpheniramine using positron emission tomography (PET) and [15O]H2O. This research aimed to elucidate the mechanism underlying the sedative side effects of antihistamines, which are potentially dangerous in car driving.

Controlled Clinical TrialA clinical trial that evaluates the effectiveness of a treatment by comparing a group that receives the intervention with a group that receives a placebo or standard treatment.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

4.

South Korean geriatrics on Beers Criteria medications at risk of adverse drug events.

Author: KimGrace Juyun, LeeKye Hwa, KimJu Han

Drug-related adverse events
Medication exposure

This study evaluated the exposure of South Korean geriatrics to potentially inappropriate medications according to the Beers Criteria. 166,822 geriatrics were included. Over half of South Korean geriatrics were exposed to medications on the Beers Criteria list.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

5.

Premedication prevents infusion reactions and improves retention rate during infliximab treatment.

Author: BartoliFrancesca, BruniCosimo, CometiLaura, BlagojevicJelena, FioriGinevra, TofaniLorenzo, GalluccioFelice, FurstDaniel E, Matucci CerinicMarco

IR reduction
Infusion reactions

This retrospective study evaluated the incidence of infusion reactions (IR) in patients with joint inflammatory diseases receiving infliximab (IFX) with and without premedication. The use of premedication significantly reduced the number of IR to IFX.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

7.

A Benefit Risk Review of Pediatric Use of Hydrocodone/Chlorpheniramine, a Prescription Opioid Antitussive Agent for the Treatment of Cough.

Author: SloanVictor S, JonesAlphia, MadukaChidi, BentzJürgen W G

Breathing problems
Overdose

This benefit-risk review of hydrocodone/chlorpheniramine use as an antitussive agent in patients aged 6 to < 18 years found no robust efficacy data and identified four fatalities in this age group. This evidence contributed to the FDA's decision to no longer indicate hydrocodone-containing cough and cold medications for treatment of cough in patients < 18 years.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

8.

Histamine H1 receptor occupancy in human brains after single oral doses of histamine H1 antagonists measured by positron emission tomography.

Author: YanaiK, RyuJ H, WatanabeT, IwataR, IdoT, SawaiY, ItoK, ItohM

Drowsiness
Sedation

The study used positron emission tomography to measure histamine H1 receptor occupancy in the brain after taking antihistamines. (+)-chlorpheniramine occupied 76.8% of H1 receptors, while terfenadine occupied 17.2%. These results suggest that PET can be used to estimate the side effects of antihistamines.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

9.

H1-receptor antagonist treatment of seasonal allergic rhinitis.

Author: KaiserH B

Minimal side effects
Treat allergic rhinitis
Anticholinergic side effects
Sedative side effects

The four new second-generation H1-receptor antagonists, terfenadine, astemizole, loratadine, and cetirizine, demonstrate efficacy, convenience, and minimal side effects on the central nervous system.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

10.

Central nervous system effects of antihistamines on evoked potentials.

Author: LoringD W, MeadorK J

Reduced sedation

Terfenadine produces significantly less cognitive slowing than chlorpheniramine, supporting the subjective findings of reduced sedative side effects.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

11.

Central nervous system side-effects of antihistamines in schoolchildren.

Author: FeldmanW, ShanonA, LeikenL, Ham-pongA, PetersonR

No sedative effects in children
Somnolence in children

Two new antihistamines, astemizole and terfenadine, did not cause significant sedation in children, unlike classical antihistamines. A study in schoolchildren showed that both drugs did not negatively affect performance.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

12.

Adverse reactions to intravenous N-acetylcysteine in Chinese patients with paracetamol (acetaminophen) poisoning.

Author: ChanT Y, CritchleyJ A

Treatment of paracetamol poisoning
Fever
Skin rash

Intravenous N-acetylcysteine (NAC) was found to be generally safe for the treatment of paracetamol poisoning in Chinese patients, with mild side effects such as skin rash and fever being common.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

13.

Double-blind controlled study of central nervous system side effects of amantadine, rimantadine, and chlorpheniramine.

Author: MilletV M, DreisbachM, BrysonY J

No effect on cognitive performance
Enhanced side effects with combination therapy
Side effects

Amantadine, rimantadine, and chlorpheniramine did not affect cognitive performance in 52 healthy volunteers. Subjective side effects were minimal and comparable across groups. Combining amantadine and chlorpheniramine appeared to enhance side effects.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

15.

Chlorpheniramine poisoning as a potential cause of rhabdomyolysis.

Author: GuoQingqing, LinHao, LinJiandong

Acute kidney injury
Rhabdomyolysis

This case report describes a patient who developed rhabdomyolysis and acute kidney injury after acute chlorpheniramine poisoning, highlighting the need for awareness of this rare but potentially serious side effect.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.

Language : English

16.

[Antiemetic protocol in oncohematologic polychemotherapy].

Author: BianconciniG, MazzaliF, MoriniA, GobbiF

Antiemetic efficacy
Further studies needed
Open and preliminary study

A combination of chlorpheniramine maleate, sulpiride, and 6-methyl-prednisolone was highly effective in preventing chemotherapy-induced nausea and vomiting in 26 patients.

English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : Italian

17.

Accidental death of elderly persons under the influence of chlorpheniramine.

Author: SuzukiHideto, ShigetaAkio, FukunagaTatsushige

Accidental death
Drowsiness

This report describes two cases of accidental death in elderly individuals under the influence of chlorpheniramine. The report emphasizes the importance of forensic pathologists notifying physicians/pharmacists of findings pertaining to unexpected drug side effects.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

18.

Geriatrics on beers criteria medications at risk of adverse drug events using real-world data.

Author: ShinHyunah, KimNanyeong, ChaJaehun, KimGrace Juyun, KimJu Han, KimJong-Yeup, LeeSuehyun

Safety concern
Side effects

Beers Criteria medications (BCMs) are often used appropriately under unavoidable circumstances despite potential side effects and safety concerns in elderly patients.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

19.

Budesonide in grass pollen rhinitis.

Author: NormanP S, CreticosP S, TobeyR, ProudD G, Kagey-SobotkaA, MeyersD A, PerssonT

Reduced allergic rhinitis symptoms

Budesonide nasal spray was found to be significantly more effective than placebo in treating seasonal allergic rhinitis. Patients receiving budesonide had a greater reduction in symptoms of sneezing, stuffy nose, and nasal secretion. There was no difference in eye itch or rescue medication use between the two groups.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

20.

Affinities of brompheniramine, chlorpheniramine, and terfenadine at the five human muscarinic cholinergic receptor subtypes.

Author: YasudaS U, YasudaR P

Anticholinergic effects

Anticholinergic effects are thought to contribute to the effectiveness of chlorpheniramine in treating the common cold. This study evaluated the affinities of brompheniramine, chlorpheniramine, and terfenadine, commonly used antihistamines, for human muscarinic cholinergic receptor subtypes. Results showed that all three drugs exhibited similar affinities for the five subtypes, while terfenadine demonstrated subtype selectivity at m3.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

21.

Dramatic Clinical Response of Relapsed Metastatic Extramammary Paget's Disease to Trastuzumab Monotherapy.

Author: WakabayashiS, TogawaY, YoneyamaK, SuehiroK, KambeN, MatsueH

Tumor regression
Well tolerated
Flushing
Headache

Trastuzumab monotherapy showed effectiveness in a 68-year-old Japanese woman with metastatic HER2-positive extramammary Paget's disease. The treatment had few side effects and was well tolerated by the elderly patient.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.

Language : English

23.

Inhibition of human liver steroid sulfotransferase activities by drugs: a novel mechanism of drug toxicity?

Author: BamforthK J, DalglieshK, CoughtrieM W

Hormone disruption
Sexual dysfunction

This study investigated the inhibitory effects of various drugs on steroid and phenol sulfotransferase activities in human liver cytosol. Several drugs were found to strongly inhibit these activities, with potential implications for understanding adverse drug reactions.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

24.

Nonsteroidal management of canine pruritus: chlorpheniramine and a fatty acid supplement (DVM Derm Caps) in combination, and the fatty acid supplement at twice the manufacturer's recommended dosage.

Author: ScottD W, MillerW H

Pruritus control
Mild side effects

Chlorpheniramine, an antihistamine, combined with a fatty acid supplement was effective in controlling pruritus in 34.8% of dogs, while the fatty acid supplement alone was not effective. Both treatments were well tolerated.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

25.

Central nervous system side effects of first- and second-generation antihistamines in school children with perennial allergic rhinitis: a randomized, double-blind, placebo-controlled comparative study.

Author: NgKar Hui, ChongDaniel, WongChin Khoon, OngHian Tat, LeeChien Yee, LeeBee Wah, ShekLynette Pei-Chi

Allergic rhinitis treatment
Sedation

This study assesses the sedating effects of cetirizine (second-generation antihistamine) and chlorpheniramine (first-generation antihistamine) compared to placebo in children using an objective neurophysiological test.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

26.

Snake bites in north east Sri Lanka.

Author: WhitehallJ S, Yarlini, Arunthathy, Varan, Kaanthan, Isaivanan, Vanprasath

Snake bite management
Antivenom side effects

In a retrospective review of snake bites in north-east Sri Lanka, the study found that public knowledge and an established protocol for management, including adrenaline, has compensated for shortages in medical staff and infrastructure.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

27.

Preincisional dextromethorphan treatment decreases postoperative pain and opioid requirement after laparoscopic cholecystectomy.

Author: WuC T, YuJ C, YehC C, LiuS T, LiC Y, HoS T, WongC S

Preemptive analgesia

Preincisional treatment with dextromethorphan (DM) was found to provide preemptive analgesia in patients undergoing laparoscopic cholecystectomy. DM administered before surgery resulted in a longer time to first meperidine injection, lower total meperidine consumption, and lower worst pain scores compared to DM administered after surgery.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

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