Citron Chaud DM

The d-isomer of the codeine analog of levorphanol. Dextromethorphan (Citron Chaud DM) shows high affinity binding to several regions of the brain, including the medullary cough center. This compound is an NMDA receptor antagonist (receptors, N-methyl-D-aspartate) and acts as a non-competitive channel blocker. It is one of the widely used antitussives, and is also used to study the involvement of glutamate receptors in neurotoxicity.

One of the histamine H1 antagonists with little sedative action. It is used in treatment of hay fever, rhinitis, allergic dermatoses, and pruritus. [PubChem]

Phenylephrine (Citron Chaud DM) is a sympathomimetic amine that acts predominantly on α-adrenergic receptors. It is mainly used to treat nasal congestion, but may also be useful in treating hypotension and shock, hypotension during spinal anaesthesia, prolongation of spinal anaesthesia, paroxysmal supraventricular tachycardia, symptomatic relief of external or internal hemorrhoids, and to increase blood pressure as an aid in the diagnosis of heart murmurs.

A six carbon compound related to glucose. It is found naturally in citrus fruits and many vegetables. Ascorbic acid is an essential nutrient in human diets, and necessary to maintain connective tissue and bone. Its biologically active form, Vitamin C (Citron Chaud DM), functions as a reducing agent and coenzyme in several metabolic pathways. Vitamin C (Citron Chaud DM) is considered an antioxidant.

used to treat symptoms caused by the common cold, flu, allergies, hay fever, or other breathing illnesses (e.g., sinusitis, bronchitis). Dextromethorphan (Citron Chaud DM) is a cough suppressant that affects a certain part of the brain (cough center), reducing the urge to cough. Decongestants help relieve stuffy nose symptoms. Antihistamines relieve watery eyes, itchy eyes/nose/throat, runny nose, and sneezing.

Oral

Allergic conditions

Adult: As maleate: Syrup: 15-30 mg bid or tid. Tablet: Up to 45 mg tid. Max: 3 mg/kg/day.

Child: As maleate: 5-10 yr: Half a 45-mg tablet up to tid; >10 yr: Syrup: 15-30 mg bid or tid. Tablet: Up to 45 mg tid. Max: 3 mg/kg/day.

Elderly: As maleate: Syrup: 15-30 mg bid or tid. Tablet: Up to 45 mg tid. Max: 3 mg/kg/day.

Oral

Prophylaxis of motion sickness

Adult: As maleate: Syrup: 15-30 mg bid or tid. Tablet: Up to 45 mg tid. Max: 3 mg/kg/day. Take 1st dose at least 30 min before travelling.

Child: As maleate: 5-10 yr: Half a 45-mg tablet up to tid; >10 yr: Syrup: 15-30 mg bid or tid. Tablet: Up to 45 mg tid. Max: 3 mg/kg/day. Take 1st dose at least 30 min before travelling.

Ophthalmic

Allergic conjunctivitis

Adult: Pheniramine (Citron Chaud DM) maleate 0.3% in combination with naphazoline hydrochloride 0.025%: 1 or 2 drops in the affected eye/s up to 4 times a day.

Child: ≥6 yr: Pheniramine (Citron Chaud DM) maleate 0.3% in combination with naphazoline hydrochloride 0.025%: 1 or 2 drops in the affected eye/s up to 4 times a day.

Phenylephrine (Citron Chaud DM) is used for the temporary relief of stuffy nose, sinus, and ear symptoms caused by the common cold, flu, allergies, or other breathing illnesses (e.g., sinusitis, bronchitis). This medication works by decreasing swelling in the nose and ears, thereby lessening discomfort and making it easier to breathe.

Cough-and-cold products have not been shown to be safe or effective in children younger than 6 years. Therefore, do not use this product to treat cold symptoms in children younger than 6 years unless specifically directed by the doctor. Some products (such as long-acting tablets/capsules) are not recommended for use in children younger than 12 years. Ask your doctor or pharmacist for more details about using your product safely.

For systemic use of Vitamin C (Citron Chaud DM): prevention and treatment of hypo- and avitaminosis of Vitamin C (Citron Chaud DM); providing increased need for Vitamin C (Citron Chaud DM) during growth, pregnancy, lactation, with heavy loads, fatigue and during recovery after prolonged severe illness; in winter with an increased risk of infectious diseases.

For intravaginal use: chronic or recurrent vaginitis (bacterial vaginosis, nonspecific vaginitis) caused by the anaerobic flora (due to changes in pH of the vagina) in order to normalize disturbed vaginal microflora.

Dextromethorphan (Citron Chaud DM) is a cough suppressant. It affects the signals in the brain that trigger cough reflex.

Dextromethorphan (Citron Chaud DM) is used to treat a cough.

Dextromethorphan (Citron Chaud DM) will not treat a cough that is caused by smoking, asthma, or emphysema.

Dextromethorphan (Citron Chaud DM) may also be used for purposes not listed in this medication guide.

Phenylephrine (Citron Chaud DM) ophthalmic causes constriction of blood vessels in the eyes. It also enlarges the pupils, reduces the production of fluid in the eyes, and increases the amount of fluid that drains from the eyes.

Phenylephrine (Citron Chaud DM) ophthalmic available over-the-counter is used to relieve redness, burning, irritation, and dryness of the eye caused by wind, sun, and other minor irritants. Prescription-strength Phenylephrine (Citron Chaud DM) ophthalmic is used to constrict blood vessels in the eye and to dilate (make bigger) the pupil for conditions such as glaucoma, before surgery, and before eye examinations.

Phenylephrine (Citron Chaud DM) ophthalmic may also be used for purposes other than those listed in this medication guide.

Ascorbic acid (Vitamin C (Citron Chaud DM)) occurs naturally in foods such as citrus fruit, tomatoes, potatoes, and leafy vegetables. Vitamin C (Citron Chaud DM) is important for bones and connective tissues, muscles, and blood vessels. Vitamin C (Citron Chaud DM) also helps the body absorb iron, which is needed for red blood cell production.

Ascorbic acid is used to treat and prevent Vitamin C (Citron Chaud DM) deficiency.

Ascorbic acid may also be used for purposes not listed in this medication guide.

Dosage Forms

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Capsule,

Oral, as hydrobromide:

Robafen Cough: 15 mg [contains brilliant blue fcf (fd&c blue #1), fd&c red #40]

Robitussin Lingering CoughGels: 15 mg [contains brilliant blue fcf (fd&c blue #1), fd&c red #40, polyethylene glycol, propylene glycol]

Gel,

Oral, as hydrobromide:

ElixSure Cough: 7.5 mg/5 mL (120 mL) [alcohol free; contains carbomer 934p, propylene glycol, propylparaben; cherry bubblegum flavor]

Liquid,

Oral, as hydrobromide:

Buckleys Cough: 12.5 mg/5 mL (118 mL) [alcohol free, sugar free; contains butylparaben, menthol, propylparaben, saccharin sodium]

Little Colds Cough Formula: 7.5 mg/mL (30 mL) [alcohol free, dye free, saccharin free; contains sodium benzoate; grape flavor]

PediaCare Childrens Long-Act: 7.5 mg/5 mL (118 mL) [contains brilliant blue fcf (fd&c blue #1), saccharin sodium, sodium benzoate]

Robitussin Lingering LA Cough: 15 mg/5 mL (118 mL [DSC]) [contains alcohol, usp, fd&c red #40, menthol, saccharin sodium, sodium benzoate]

Dextromethorphan (Citron Chaud DM): 10 mg/5 mL (480 mL [DSC], 3780 mL [DSC]) [alcohol free, dye free, fructose free, sodium free, sorbitol free, sugar free]

Triaminic Long Acting Cough: 7.5 mg/5 mL (118 mL) [alcohol free, dye free, pseudoephedrine free; contains benzoic acid, propylene glycol]

Lozenge, Mouth/Throat, as hydrobromide:

Hold: 5 mg (10 ea)

Hold: 5 mg (10 ea) [cherry flavor]

Trocal Cough Suppressant: 7.5 mg (1 ea [DSC])

Strip,

Oral, as hydrobromide:

Triaminic Long Acting Cough: 7.5 mg (14 ea, 16 ea) [contains alcohol, usp, fd&c red #40; cherry flavor]

Triaminic Long Acting Cough: 7.5 mg (14 ea) [contains alcohol, usp, fd&c red #40, isopropyl alcohol]

Suspension Extended Release,

Oral:

Cough DM: Dextromethorphan (Citron Chaud DM) polistirex [equivalent to Dextromethorphan (Citron Chaud DM) hydrobromide 30 mg/5 mL] (89 mL) [alcohol free; contains fd&c yellow #10 aluminum lake, methylparaben, polysorbate 80, propylparaben, sodium metabisulfite; orange flavor]

Dextromethorphan (Citron Chaud DM): Dextromethorphan (Citron Chaud DM) polistirex [equivalent to Dextromethorphan (Citron Chaud DM) hydrobromide 30 mg/5 mL] (89 mL, 148 mL) [alcohol free; contains brilliant blue fcf (fd&c blue #1), disodium edta, methylparaben, polyethylene glycol, polysorbate 80, propylene glycol, propylparaben; grape flavor]

Dextromethorphan (Citron Chaud DM): Dextromethorphan (Citron Chaud DM) polistirex [equivalent to Dextromethorphan (Citron Chaud DM) hydrobromide 30 mg/5 mL] (89 mL, 148 mL) [alcohol free; contains edetate disodium, fd&c yellow #6 (sunset yellow), methylparaben, polyethylene glycol, polysorbate 80, propylene glycol, propylparaben; orange flavor]

Dextromethorphan (Citron Chaud DM) Cough Childrens: Dextromethorphan (Citron Chaud DM) polistirex [equivalent to Dextromethorphan (Citron Chaud DM) hydrobromide 30 mg/5 mL] (89 mL, 148 mL) [alcohol free; contains brilliant blue fcf (fd&c blue #1), edetate disodium, methylparaben, polyethylene glycol, polysorbate 80, propylene glycol, propylparaben, soybean oil; grape flavor]

Dextromethorphan (Citron Chaud DM) Cough Childrens: Dextromethorphan (Citron Chaud DM) polistirex [equivalent to Dextromethorphan (Citron Chaud DM) hydrobromide 30 mg/5 mL] (89 mL, 148 mL) [alcohol free; contains edetate disodium, fd&c yellow #6 (sunset yellow), methylparaben, polyethylene glycol, polysorbate 80, propylene glycol, propylparaben, soybean oil; orange flavor]

GoodSense Cough DM: Dextromethorphan (Citron Chaud DM) polistirex [equivalent to Dextromethorphan (Citron Chaud DM) hydrobromide 30 mg/5 mL] (148 mL) [alcohol free, gluten free; contains fd&c yellow #10 aluminum lake, methylparaben, polysorbate 80, propylparaben, sodium metabisulfite]

GoodSense Cough DM Childrens: Dextromethorphan (Citron Chaud DM) polistirex [equivalent to Dextromethorphan (Citron Chaud DM) hydrobromide 30 mg/5 mL] (89 mL, 148 mL) [alcohol free, gluten free; contains fd&c yellow #10 aluminum lake, methylparaben, polysorbate 80, propylparaben, sodium metabisulfite]

Robitussin 12 Hour Cough: Dextromethorphan (Citron Chaud DM) polistirex [equivalent to Dextromethorphan (Citron Chaud DM) hydrobromide 30 mg/5 mL] (89 mL) [alcohol free; contains brilliant blue fcf (fd&c blue #1), methylparaben, polysorbate 80, propylparaben, sodium metabisulfite]

Robitussin 12 Hour Cough: Dextromethorphan (Citron Chaud DM) polistirex [equivalent to Dextromethorphan (Citron Chaud DM) hydrobromide 30 mg/5 mL] (89 mL) [alcohol free; contains fd&c yellow #10 (quinoline yellow), methylparaben, polysorbate 80, propylparaben, sodium metabisulfite]

Robitussin 12 Hour Cough

Child: Dextromethorphan (Citron Chaud DM) polistirex [equivalent to Dextromethorphan (Citron Chaud DM) hydrobromide 30 mg/5 mL] (89 mL) [alcohol free; contains brilliant blue fcf (fd&c blue #1), methylparaben, polysorbate 80, propylparaben, sodium metabisulfite]

Generic: Dextromethorphan (Citron Chaud DM) polistirex [equivalent to Dextromethorphan (Citron Chaud DM) hydrobromide 30 mg/5 mL] (89 mL)

Syrup,

Oral, as hydrobromide:

Creomulsion

Adult: 20 mg/15 mL (118 mL [DSC])

Creomulsion for Children: 5 mg/5 mL (118 mL [DSC]) [cherry flavor]

Robitussin Childrens Cough LA: 7.5 mg/5 mL (118 mL) [alcohol free; contains fd&c red #40, propylene glycol, saccharin sodium, sodium benzoate; fruit punch flavor]

Silphen DM Cough: 10 mg/5 mL (118 mL) [contains alcohol, usp; strawberry flavor]

Triaminic Long Acting Cough: 7.5 mg/5 mL (118 mL [DSC]) [alcohol free, dye free; contains benzoic acid, edetate disodium, propylene glycol]

Dosing: Adult

Cough suppressant:

Oral: 10 to 20 mg every 4 hours

Dosing: Geriatric

Refer to adult dosing.

Dosing: Pediatric

Note: Safety and efficacy for the use of cough and cold products in infants and young children limited; the AAP warns against the use of these products for respiratory illnesses in infants and young children (AAP 2018; FDA 2017).

Cough suppressant:

Oral:

Oral syrup (immediate release):

Children 2 to <6 years: 5 mg every 4 hours as needed; do not exceed 6 doses in 24 hours.

Children 6 to <12 years: 10 mg every 4 hours as needed; do not exceed 6 doses in 24 hours.

Children ≥12 years and Adolescents: 20 mg every 4 hours as needed; do not exceed 6 doses in 24 hours.

Long-acting liquid: Children ≥12 years and Adolescents: 30 mg every 6 to 8 hours as needed; do not exceed 4 doses in 24 hours.

Oral capsule: Children ≥12 years and Adolescents: 30 mg every 6 to 8 hours as needed; do not exceed 4 doses in 24 hours.

Extended-release suspension (Dextromethorphan (Citron Chaud DM) polistirex):

Children 4 to <6 years: 15 mg every 12 hours as needed; do not exceed 30 mg in 24 hours.

Children 6 to <12 years: 30 mg every 12 hours as needed; do not exceed 60 mg in 24 hours.

Children ≥12 years and Adolescents: 60 mg every 12 hours as needed; do not exceed 120 mg in 24 hours.

Oral

Allergic conditions

Adult: As maleate: Syrup: 15-30 mg bid or tid. Tablet: Up to 45 mg tid. Max: 3 mg/kg/day.

Child: As maleate: 5-10 yr: Half a 45-mg tablet up to tid; >10 yr: Syrup: 15-30 mg bid or tid. Tablet: Up to 45 mg tid. Max: 3 mg/kg/day.

Elderly: As maleate: Syrup: 15-30 mg bid or tid. Tablet: Up to 45 mg tid. Max: 3 mg/kg/day.

Oral

Prophylaxis of motion sickness

Adult: As maleate: Syrup: 15-30 mg bid or tid. Tablet: Up to 45 mg tid. Max: 3 mg/kg/day. Take 1st dose at least 30 min before travelling.

Child: As maleate: 5-10 yr: Half a 45-mg tablet up to tid; >10 yr: Syrup: 15-30 mg bid or tid. Tablet: Up to 45 mg tid. Max: 3 mg/kg/day. Take 1st dose at least 30 min before travelling.

Ophthalmic

Allergic conjunctivitis

Adult: Pheniramine (Citron Chaud DM) maleate 0.3% in combination with naphazoline hydrochloride 0.025%: 1 or 2 drops in the affected eye/s up to 4 times a day.

Child: ≥6 yr: Pheniramine (Citron Chaud DM) maleate 0.3% in combination with naphazoline hydrochloride 0.025%: 1 or 2 drops in the affected eye/s up to 4 times a day.

Prolonged exposure to air or strong light may cause oxidation and discoloration. Do not use if solution is brown or contains a precipitate.

Vasoconstriction and Pupil Dilatation

Phenylephrine (Citron Chaud DM) (Phenylephrine (Citron Chaud DM) hydrochloride ophthalmic solution) hydrochloride 10 percent ophthalmic solutions are especially useful when rapid and powerful dilatation of the pupil and reduction of congestion in the capillary bed are desired. A drop of a suitable topical anesthetic may be applied, followed in a few minutes by 1 drop of the Phenylephrine (Citron Chaud DM) (Phenylephrine (Citron Chaud DM) hydrochloride ophthalmic solution) hydrochloride 10 percent ophthalmic solutions on the upper limbus. The anesthetic prevents stinging and consequent dilution of the solution by lacrimation. It may occasionally be necessary to repeat the instillation after one hour, again preceded by the use of the topical anesthetic.

Uveitis: Posterior Synechiae

Phenylephrine (Citron Chaud DM) (Phenylephrine (Citron Chaud DM) hydrochloride ophthalmic solution) hydrochloride 10 percent ophthalmic solutions may be used in patients with uveitis when synechiae are present or may develop. The formation of synechiae may be prevented by the use of the 10 percent ophthalmic solutions and atropine to produce wide dilatation of the pupil. It should be emphasized, however, that the vasoconstrictor effect of Phenylephrine (Citron Chaud DM) (Phenylephrine (Citron Chaud DM) hydrochloride ophthalmic solution) hydrochloride may be antagonistic to the increase of local blood flow in uveal infection.

To free recently formed posterior synechiae, 1 drop of the 10 percent ophthalmic solutions may be applied to the upper surface of the cornea. On the following day, treatment may be continued if necessary. In the interim, hot compresses should be applied for five or ten minutes three times a day, with 1 drop of a 1 or 2 percent solution of atropine sulfate before and after each series of compresses.

Glaucoma

In certain patients with glaucoma, temporary reduction of intraocular tension may be attained by producing vasoconstriction of the intraocular vessels; this may be accomplished by placing 1 drop of the 10 percent ophthalmic solutions on the upper surface of the cornea. This treatment may be repeated as often as necessary.

Phenylephrine (Citron Chaud DM) (Phenylephrine (Citron Chaud DM) hydrochloride ophthalmic solution) hydrochloride may be used with miotics in patients with wide angle glaucoma. It reduces the difficulties experienced by the patient because of the small field produced by miosis, and still it permits and often supports the effect of the miotic in lowering the intraocular pressure. Hence, there may be marked improvement in visual acuity after using Phenylephrine (Citron Chaud DM) (Phenylephrine (Citron Chaud DM) hydrochloride ophthalmic solution) hydrochloride in conjunction with miotic drugs.

Surgery

When a short-acting mydriatic is needed for wide dilatation of the pupil before intraocular surgery, the 10 percent ophthalmic solutions or 2.5 percent ophthalmic solution may be applied topically from 30 to 60 minutes before the operation.

Refraction

Prior to determination of refractive errors, Phenylephrine (Citron Chaud DM) (Phenylephrine (Citron Chaud DM) hydrochloride ophthalmic solution) hydrochloride 2.5 percent ophthalmic solution may be used effectively with homatropine hydrobromide, atropine sulfate, or a combination of homatropine and cocaine hydrochloride.

For adults, a drop of the preferred cycloplegic is placed in each eye, followed in five minutes by 1 drop of Phenylephrine (Citron Chaud DM) (Phenylephrine (Citron Chaud DM) hydrochloride ophthalmic solution) hydrochloride 2.5 percent ophthalmic solution and in ten minutes by another drop of the cycloplegic. In 50 to 60 minutes, the eyes are ready for refraction.

For children, a drop of atropine sulfate 1 percent is placed in each eye, followed in 10 to 15 minutes by 1 drop of Phenylephrine (Citron Chaud DM) (Phenylephrine (Citron Chaud DM) hydrochloride ophthalmic solution) hydrochloride 2.5 percent ophthalmic solution and in five to ten minutes by a second drop of atropine sulfate 1 percent. In one to two hours, the eyes are ready for refraction.

For a “one application method,” Phenylephrine (Citron Chaud DM) (Phenylephrine (Citron Chaud DM) hydrochloride ophthalmic solution) hydrochloride 2.5 percent ophthalmic solution may be combined with a cycloplegic to elicit synergistic action. The additive effect varies depending on the patient. Therefore, when using a “one application method,” it may be desirable to increase the concentration of the cycloplegic.

Ophthalmoscopic Examination

One drop of Phenylephrine (Citron Chaud DM) (Phenylephrine (Citron Chaud DM) hydrochloride ophthalmic solution) hydrochloride 2.5 percent ophthalmic solution is placed in each eye. Sufficient mydriasis to permit examination is produced in 15 to 30 minutes. Dilatation lasts from one to three hours.

Diagnostic Procedures

Provocative Test for Angle Block in Patients with Glaucoma: The 2.5 percent ophthalmic solution may be used as a provocative test when latent increased intraocular pressure is suspected. Tension is measured before application of Phenylephrine (Citron Chaud DM) (Phenylephrine (Citron Chaud DM) hydrochloride ophthalmic solution) hydrochloride and again after dilatation. A 3 to 5 mm of mercury rise in pressure suggests the presence of angle block in patients with glaucoma; however, failure to obtain such a rise does not preclude the presence of glaucoma from other causes.

Shadow Test (Retinoscopy): When dilatation of the pupil without cycloplegic action is desired for the shadow test, the 2.5 percent ophthalmic solution may be used alone.

Blanching Test: One or 2 drops of the 2.5 percent ophthalmic solution should be applied to the injected eye. After five minutes, examine for perilimbal blanching. If blanching occurs, the congestion is superficial and probably does not indicate iritis.

How supplied

In Mono-Drop ® plastic dropper bottle: Low surface tension solutions

2.5 percent ophthalmic solution - Phenylephrine (Citron Chaud DM) (Phenylephrine (Citron Chaud DM) hydrochloride ophthalmic solution) hydrochloride 2.5 percent in a sterile, isotonic, buffered, low surface tension vehicle with sodium phosphate, sodium biphosphate, boric acid, and, as antiseptic preservative, benzalkonium chloride, NF, 1:7500. The pH is adjusted with phosphoric acid or sodium hydroxide. Bottles of 15 mL (NDC 0024-1358-01).

10 percent ophthalmic solution- Phenylephrine (Citron Chaud DM) (Phenylephrine (Citron Chaud DM) hydrochloride ophthalmic solution) hydrochloride 10 percent in a sterile, buffered, low surface tension vehicle with sodium phosphate, sodium biphosphate, and, as antiseptic preservative, benzalkonium chloride 1:10,000. The pH is adjusted with phosphoric acid or sodium hydroxide. Bottles of 5 mL (NDC 0024-1359-01).

Viscous solution

10 percent ophthalmic solution- Phenylephrine (Citron Chaud DM) (Phenylephrine (Citron Chaud DM) hydrochloride ophthalmic solution) hydrochloride 10 percent in a sterile, buffered, viscous vehicle with sodium phosphate, sodium biphosphate, methylcellulose, and, as antiseptic preservative, benzalkonium chloride 1:10,000. The pH is adjusted with phosphoric acid or sodium hydroxide. Bottles of 5 mL (NDC 0024-1362-01).

Store at 25° C (77° F); excursions permitted to 15° - 30° C (59° - 86° F)

Manufactured for Sanofi-Synthelabo Inc. New York, NY 10016 by Abbott Laboratories North Chicago, IL 60064. Revised September 1999. FDA revision date: n/a

This medication administered orally, IM, IV, intravaginally.

For the prevention of deficiency conditions Vitamin C (Citron Chaud DM) dose is 25-75 mg / day, for the treatment - 250 mg / day or more in divided doses.

For intravaginal used ascorbic acid drugs in appropriate dosage forms.

See also:
What is the most important information I should know about Dextromethorphan (Citron Chaud DM)?

Do not use Dextromethorphan (Citron Chaud DM) if you have used an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days. Serious, life-threatening side effects can occur if you take Dextromethorphan (Citron Chaud DM) before the MAO inhibitor has cleared from your body.

Do not use any other over-the-counter cough, cold, or allergy medication without first asking your doctor or pharmacist. If you take certain products together you may accidentally take too much of one or more types of medicine. Read the label of any other medicine you are using to see if it contains Dextromethorphan (Citron Chaud DM).

Do not take this medicine if you:

• are taking an antidepressant medicine known as a MAO Inhibitor

• are male and you have an enlarged prostate

Do not take this medicine if you are allergic to it or any of the ingredients listed at the end of this leaflet.

Some symptoms of an allergic reaction include skin rash, itching, asthma, wheezing, shortness of breath or swelling of the fact, lips or tongue,

which may cause difficulty in swallowing or breathing, fainting.

Do not take it after the expiry date (EXP) printed on the pack.

If you take it after the expiry date has passed, it may not work as well.

Do not take it if the packaging is torn or shows signs of tampering.

Do not give this medicine to a premature or newborn baby.

See also:
What is the most important information I should know about Phenylephrine (Citron Chaud DM)?

Do not touch the dropper to any surface, including the eyes or hands. The dropper is sterile. If it becomes contaminated, it could cause an infection in the eye.

If you wear contact lenses, remove them before applying Phenylephrine (Citron Chaud DM) ophthalmic. Ask your doctor if contact lenses can be reinserted after application of the medication. Phenylephrine (Citron Chaud DM) ophthalmic may contains preservative (benzalkonium chloride), which may cause discoloration of contact lenses.

Do not use Phenylephrine (Citron Chaud DM) ophthalmic more often or continuously for longer than 48 to 72 hours without consulting a doctor. Chronic use of this medication may damage the blood vessels (veins and arteries) in the eyes. Consult a doctor if your symptoms do not improve or appear to worsen.

Use caution when driving, operating machinery, or performing other hazardous activities. Phenylephrine (Citron Chaud DM) ophthalmic may cause blurred vision. If you experience blurred vision, avoid these activities.

See also:
What is the most important information I should know about Vitamin C (Citron Chaud DM)?

AV-block II and III degree, sinoatrial block, SSS, bradycardia (HR < 40 bpm), hypotension (in case of myocardial infarction, systolic blood pressure less than 100 mm Hg), cardiogenic shock, congestive heart failure IIB-III stages, acute heart failure, Prinzmetal's angina, lactation, concomitant use of MAO inhibitors, hypersensitivity to atenolol.

Use Dextromethorphan (Citron Chaud DM) orally disintegrating strips as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Take Dextromethorphan (Citron Chaud DM) orally disintegrating strips by mouth with or without food. If stomach upset occurs, take with food to reduce stomach irritation.
• Do not remove the strip from the pouch until you are ready to take Dextromethorphan (Citron Chaud DM) orally disintegrating strips. Be sure that your hands are dry when you touch the strip.
• Remove the strip from the pouch and place it onto the tongue. The strip dissolves quickly and can be swallowed with saliva. It may be taken with or without water.
• Use the strip right away after you open the pouch. Do not store it for future use.
• If you miss a dose of Dextromethorphan (Citron Chaud DM) orally disintegrating strips and you are taking it regularly, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Dextromethorphan (Citron Chaud DM) orally disintegrating strips.

Use Phenylephrine (Citron Chaud DM) drops as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Phenylephrine (Citron Chaud DM) drops is for use in the eye only. Avoid contact with the nose or mouth.
• To use Phenylephrine (Citron Chaud DM) drops, first, wash your hands. Tilt your head back. Using your index finger, pull the lower eyelid away from the eye to form a pouch. Drop the medicine into the pouch and gently close your eyes. Immediately use your finger to apply pressure to the inside corner of the eye for 1 to 2 minutes. Do not blink. Remove excess medicine around your eye with a clean tissue, being careful not to touch your eye. Wash your hands to remove any medicine that may be on them.
• To prevent germs from contaminating your medicine, do not touch the applicator tip to any surface, including your eye. Keep the container tightly closed.
• Do not wear contact lenses while you are using Phenylephrine (Citron Chaud DM) drops. Sterilize contact lenses according to the manufacturer's directions and check with your doctor before using them.
• Do not use Phenylephrine (Citron Chaud DM) drops if it is brown or contains particles.
• If you miss a dose of Phenylephrine (Citron Chaud DM) drops, use it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not use 2 doses at once.

Ask your health care provider any questions you may have about how to use Phenylephrine (Citron Chaud DM) drops.

This medication is used for temporary relief of coughs without phlegm that are caused by certain infections of the air passages (e.g., sinusitis, common cold). This product should not usually be used for an ongoing cough from smoking or long-term breathing problems (e.g., chronic bronchitis, emphysema) unless directed by your doctor. This product contains Dextromethorphan (Citron Chaud DM). It is a cough suppressant that works by decreasing the feeling of needing to cough.

Cough-and-cold products have not been shown to be safe or effective in children younger than 6 years. Therefore, do not use this product to treat cold symptoms in children younger than 6 years unless specifically directed by the doctor. Ask your doctor or pharmacist for more details about using your product safely.

These products do not cure or shorten the length of the common cold and may cause serious side effects. To decrease the risk for serious side effects, carefully follow all dosage directions. Do not use this product to make a child sleepy. Do not give other cough-and-cold medication that might contain the same or similar ingredients. Ask the doctor or pharmacist about other ways to relieve cough and cold symptoms (such as drinking enough fluids, using a humidifier or saline nose drops/spray).

How to use Dextromethorphan (Citron Chaud DM)

Take this medication by mouth, usually every 4 to 12 hours as needed or as directed by your doctor. If stomach upset occurs, take with food or milk. Use a medication-measuring device to measure your dose of liquid medication. Do not use a household spoon because you may not get the correct dose. If you are taking a suspension, shake the product well before measuring out your dose.

Dosage is based on the product you are taking and your age, medical condition, and response to treatment. If you are using this medication for self-treatment (without a prescription from your doctor), follow the specific dosing instructions on the packaging to find the correct dose for your age.

If your doctor directs you to take this medication daily, take it regularly to get the most benefit from it. To help you remember, take it at the same time(s) each day.

Improper use of this medication (abuse) may result in serious harm (e.g., brain damage, seizure, death). Do not increase your dose, take it more frequently, or use it for a longer time than prescribed. Properly stop the medication when so directed.

Tell your doctor if your symptoms persist or worsen after more than 1 week or if you also have fever, chills, headache, or rash. These may be signs of a more serious condition.

Pheniramine (Citron Chaud DM) is used for treatment of symptoms of allergic rhinitis (e.g. sneezing, runny and itchy nose and eye irritation) and other symptoms of allergy and hay fever.

Use: Labeled Indications

Hypotension/shock: Treatment of hypotension, vascular failure in shock. Note: Not recommended for routine use in the treatment of septic shock; use should be limited until more evidence demonstrating positive clinical outcomes becomes available (Rhodes 2017).

Guideline recommendations:

Cardiogenic shock: The 2017 American Heart Association (AHA) scientific statement for the Contemporary Management of Cardiogenic Shock recommends Phenylephrine (Citron Chaud DM), if needed, be considered for initial vasoactive management of cardiogenic shock due to aortic stenosis, mitral stenosis, or dynamic left ventricular outflow tract (LVOT) obstruction (AHA [van Diepen 2017]).

Hypotension during anesthesia: As a vasoconstrictor in regional analgesia

Nasal congestion: As a decongestant [OTC]

Off Label Uses

Hypotension in patients with obstructive hypertrophic cardiomyopathy

Phenylephrine (Citron Chaud DM) is a pure alpha1 agonist that will increase systemic vascular resistance without increasing heart rate or contractility. This is advantageous in patients with obstructive hypertrophic cardiomyopathy and hypotension since increases in both heart rate and contractility may cause the obstruction to worsen, leading to a decrease in cardiac output. Other vasopressors like dopamine, epinephrine, and norepinephrine may increase contractility and/or heart rate. Additional trials may be necessary to further define the role of Phenylephrine (Citron Chaud DM) in this condition.

Based on the American Urological Association guidelines for the management of priapism, due to the low risk of cardiovascular side effects intracavernous injection of Phenylephrine (Citron Chaud DM) is recommended for ischemic priapism that persists following aspiration/irrigation.

Ascorbic acid (Vitamin C (Citron Chaud DM)) is used to prevent or treat low levels of Vitamin C (Citron Chaud DM) in people who do not get enough of the vitamin from their diets. Most people who eat a normal diet do not need extra ascorbic acid. Low levels of Vitamin C (Citron Chaud DM) can result in a condition called scurvy. Scurvy may cause symptoms such as rash, muscle weakness, joint pain, tiredness, or tooth loss.

Vitamin C (Citron Chaud DM) plays an important role in the body. It is needed to maintain the health of skin, cartilage, teeth, bone, and blood vessels. It is also used to protect your body's cells from damage. It is known as an antioxidant.

OTHER USES: This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by your health care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional.

This vitamin may also be used with other vitamins for a certain eye condition (macular degeneration).

How to use Vitamin C (Citron Chaud DM)

Take this vitamin by mouth with or without food, usually 1 to 2 times daily. Follow all directions on the product package, or take as directed by your doctor.

If you are taking the extended-release capsules, swallow them whole. Do not crush or chew extended-release capsules or tablets. Doing so can release all of the drug at once, increasing the risk of side effects. Also, do not split extended-release tablets unless they have a score line and your doctor or pharmacist tells you to do so. Swallow the whole or split tablet without crushing or chewing. Take this product with a full glass of water (8 ounces/240 milliliters) unless your doctor directs you otherwise.

If you are taking the wafers or chewable tablets, chew them thoroughly and then swallow. If you are taking the lozenges, place the lozenge in your mouth and allow it to slowly dissolve.

If you are taking the powder, mix it thoroughly in the proper amount of liquid and stir well. Drink all of the liquid right away. Do not prepare a supply for future use. If you are using the liquid form of this vitamin, carefully measure the dose using a special measuring device/spoon. Do not use a household spoon because you may not get the correct dose.

Dosage is based on your medical condition and response to treatment.

Use this vitamin regularly to get the most benefit from it. To help you remember, take it at the same time(s) each day.

If you think you may have a serious medical problem, seek immediate medical attention.

See also:
What other drugs will affect Dextromethorphan (Citron Chaud DM)?

MAO inhibitors (including furazolidone, procarbazine, selegiline) when administered simultaneous with Dextromethorphan (Citron Chaud DM) may cause adrenergic crisis, collapse, coma, dizziness, agitation, increased blood pressure, hyperpyrexia, intracranial hemorrhage, lethargy, nausea, cramps, tremor. In combination with tricyclic antidepressants (amitriptyline, etc.) Dextromethorphan (Citron Chaud DM) Lafayette Pharmaceutical Laboratory may appeal serotonin syndrome and possible subsequent death. Amiodarone, fluoxetine, quinidine, inhibiting system cytochrome P450, may increase the drug concentration in the blood. Tobacco smoke can lead to increased secretion of glands in the background of inhibition of cough reflex. Some inhibitors of CYP450 (such as quinidine) increase and extended effects of this medicine.

May mask ototoxicity produced by aminoglycoside antibiotics.

Potentially Fatal: Potentiation of CNS depression by alcohol, sedatives, opioids, barbiturates, hypnotics, narcoleptics. May increase antimuscarinic effect of MAOIs, atropine and TCAs.

See also:
What other drugs will affect Phenylephrine (Citron Chaud DM)?

Acetaminophen: May increase the serum concentration of Phenylephrine (Citron Chaud DM) (Systemic). Monitor therapy

Alpha1-Blockers: May diminish the vasoconstricting effect of Alpha1-Agonists. Similarly, Alpha1-Agonists may antagonize Alpha1-Blocker vasodilation. Monitor therapy

AtoMOXetine: May enhance the hypertensive effect of Sympathomimetics. AtoMOXetine may enhance the tachycardic effect of Sympathomimetics. Monitor therapy

Benzylpenicilloyl Polylysine: Alpha1-Agonists may diminish the diagnostic effect of Benzylpenicilloyl Polylysine. Management: Consider use of a histamine skin test as a positive control to assess a patient's ability to mount a wheal and flare response. Consider therapy modification

Cannabinoid-Containing Products: May enhance the tachycardic effect of Sympathomimetics. Exceptions: Cannabidiol. Monitor therapy

Chloroprocaine: May enhance the hypertensive effect of Phenylephrine (Citron Chaud DM) (Systemic). Monitor therapy

CloZAPine: May diminish the therapeutic effect of Phenylephrine (Citron Chaud DM) (Systemic). Monitor therapy

Cocaine (Topical): May enhance the hypertensive effect of Sympathomimetics. Management: Consider alternatives to use of this combination when possible. Monitor closely for substantially increased blood pressure or heart rate and for any evidence of myocardial ischemia with concurrent use. Consider therapy modification

Doxofylline: Sympathomimetics may enhance the adverse/toxic effect of Doxofylline. Monitor therapy

Ergot Derivatives: May enhance the hypertensive effect of Alpha1-Agonists. Ergot Derivatives may enhance the vasoconstricting effect of Alpha1-Agonists. Exceptions: Ergoloid Mesylates; Nicergoline. Avoid combination

FentaNYL: Alpha1-Agonists may decrease the serum concentration of FentaNYL. Specifically, fentanyl nasal spray serum concentrations may decrease and onset of effect may be delayed. Monitor therapy

Guanethidine: May enhance the arrhythmogenic effect of Sympathomimetics. Guanethidine may enhance the hypertensive effect of Sympathomimetics. Monitor therapy

Hyaluronidase: May enhance the vasoconstricting effect of Phenylephrine (Citron Chaud DM) (Systemic). Management: Avoid the use of hyaluronidase to enhance dispersion or absorption of Phenylephrine (Citron Chaud DM). Use of hyaluronidase for other purposes in patients receiving Phenylephrine (Citron Chaud DM) may be considered as clinically indicated. Avoid combination

Iobenguane Radiopharmaceutical Products: Alpha1-Agonists may diminish the therapeutic effect of Iobenguane Radiopharmaceutical Products. Management: Discontinue all drugs that may inhibit or interfere with catecholamine transport or uptake for at least 5 biological half-lives before iobenguane administration. Do not administer these drugs until at least 7 days after each iobenguane dose. Avoid combination

Ioflupane I 123: Phenylephrine (Citron Chaud DM) (Systemic) may diminish the diagnostic effect of Ioflupane I 123. Monitor therapy

Linezolid: May enhance the hypertensive effect of Sympathomimetics. Management: Reduce initial doses of sympathomimetic agents, and closely monitor for enhanced pressor response, in patients receiving linezolid. Specific dose adjustment recommendations are not presently available. Consider therapy modification

Monoamine Oxidase Inhibitors: May enhance the hypertensive effect of Alpha1-Agonists. While linezolid is expected to interact via this mechanism, management recommendations differ from other monoamine oxidase inhibitors. Refer to linezolid specific monographs for details. Exceptions: Linezolid. Avoid combination

Ozanimod: May enhance the hypertensive effect of Sympathomimetics. Management: Concomitant use of ozanimod with sympathomimetic agents is not recommended. If combined, monitor patients closely for the development of hypertension, including hypertensive crises. Consider therapy modification

Propacetamol: May increase the serum concentration of Phenylephrine (Citron Chaud DM) (Systemic). Management: Monitor patients closely for increased side effects of Phenylephrine (Citron Chaud DM) if propacetamol is used concomitantly. Patients with underlying blood pressure issues or arrhythmias may need closer monitoring and may warrant consideration of alternative therapies. Monitor therapy

Solriamfetol: Sympathomimetics may enhance the hypertensive effect of Solriamfetol. Sympathomimetics may enhance the tachycardic effect of Solriamfetol. Monitor therapy

Sympathomimetics: May enhance the adverse/toxic effect of other Sympathomimetics. Monitor therapy

Tedizolid: May enhance the hypertensive effect of Sympathomimetics. Tedizolid may enhance the tachycardic effect of Sympathomimetics. Monitor therapy

Tricyclic Antidepressants: May enhance the therapeutic effect of Alpha1-Agonists. Tricyclic Antidepressants may diminish the therapeutic effect of Alpha1-Agonists. Monitor therapy

See also:
What other drugs will affect Vitamin C (Citron Chaud DM)?

In an application with barbiturates, primidone increases the excretion of ascorbic acid in the urine.

With the simultaneous use of oral contraceptives reduces the concentration of ascorbic acid in blood plasma.

In an application of Vitamin C (Citron Chaud DM) with iron preparations ascorbic acid, due to its regenerative properties, transforms ferric iron in the bivalent, which improves its absorption.

Ascorbic acid in high doses can decrease urine pH that while the application reduces the tubular reabsorption of amphetamine and tricyclic antidepressants.

With the simultaneous use of aspirin reduces the absorption of ascorbic acid by about a third.

Vitamin C (Citron Chaud DM) in an application with warfarin may decrease effects of warfarin.

With the simultaneous application of ascorbic acid increases the excretion of iron in patients receiving deferoxamine. In the application of ascorbic acid at a dose of 500 mg / day possibly left ventricular dysfunction.

In an application with tetracycline is increased excretion of ascorbic acid in the urine.

There is a described case of reducing the concentration of fluphenazine in plasma in patients treated with ascorbic acid 500 mg 2 times / day.

May increase the concentration of ethinyl estradiol in the blood plasma in its simultaneous application in the oral contraceptives.

See also:
What are the possible side effects of Dextromethorphan (Citron Chaud DM)?

Applies to Dextromethorphan (Citron Chaud DM): oral capsule, oral capsule liquid filled, oral elixir, oral liquid, oral lozenge/troche, oral solution, oral suspension, oral suspension extended release, oral syrup, oral tablet

In addition to its needed effects, some unwanted effects may be caused by Dextromethorphan (Citron Chaud DM) (the active ingredient contained in Dextromethorphan (Citron Chaud DM) HBr Adult Formula). In the event that any of these side effects do occur, they may require medical attention.

Severity: Moderate

If any of the following side effects occur while taking Dextromethorphan (Citron Chaud DM), check with your doctor or nurse as soon as possible:

Symptoms of overdose:

• Blurred vision
• confusion
• difficulty in urination
• drowsiness or dizziness
• nausea or vomiting (severe)
• shakiness and unsteady walk
• slowed breathing
• unusual excitement, nervousness, restlessness, or irritability (severe)

Minor Side Effects

Some of the side effects that can occur with Dextromethorphan (Citron Chaud DM) may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

Less common or rare:

• Confusion
• constipation
• dizziness (mild)
• drowsiness (mild)
• headache
• nausea or vomiting
• stomach pain

All medicines can have some unwanted side effects. Sometimes they are serious, most of the time they are not. Your doctor or pharmacist has weighed the risks of using this medicine against

the benefits they expect it will have for you. Do not be alarmed by this list of possible side effects.

You may not experience any of them.

Tell your doctor or pharmacist as soon as possible if you do not feel well while you are taking this medicine.

Tell your pharmacist or doctor if you notice

any of the following and they worry you:

• drowsiness

• nervousness, irritability, incoordination, lack of concentration

• dizziness

• tinnitus (ringing in the ears)

• nausea and vomiting

• difficulty passing urine

Tell your doctor immediately if you notice any of the following:

• changes in your usual behaviour or mood

• severe sedation, confusion or restlessness

• hallucinations

• vision problems

• irregular heart beat

See also:
What are the possible side effects of Phenylephrine (Citron Chaud DM)?

Applies to Phenylephrine (Citron Chaud DM): intravenous solution

In addition to its needed effects, some unwanted effects may be caused by Phenylephrine (Citron Chaud DM) (the active ingredient contained in Phenylephrine (Citron Chaud DM)). In the event that any of these side effects do occur, they may require medical attention.

If any of the following side effects occur while taking Phenylephrine (Citron Chaud DM), check with your doctor or nurse immediately:

Incidence not known:

• Blurred vision
• chest pain or discomfort
• difficult or labored breathing
• dizziness
• fainting
• fast, slow, or irregular heartbeat
• headache
• nausea or vomiting
• nervousness
• pain in the shoulders, arms, jaw, or neck
• pounding in the ears
• sweating
• tightness in the chest
• unusual tiredness

If any of the following symptoms of overdose occur while taking Phenylephrine (Citron Chaud DM), get emergency help immediately:

Symptoms of overdose:

• Feeling of fullness in the head
• pounding or rapid pulse
• tingling in the arms or legs
• vomiting

Minor Side Effects

Some of the side effects that can occur with Phenylephrine (Citron Chaud DM) may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

Incidence not known:

• Heartburn
• itching skin
• nausea
• pain in the neck
• pain or discomfort in chest, upper stomach, or throat

See also:
What are the possible side effects of Vitamin C (Citron Chaud DM)?

Applies to ascorbic acid: oral capsule, oral capsule extended release, oral capsule liquid filled, oral granule, oral liquid, oral lozenge/troche, oral powder, oral powder for solution, oral powder for suspension, oral solution, oral syrup, oral tablet, oral tablet chewable, oral tablet extended release, oral wafer

As well as its needed effects, ascorbic acid (the active ingredient contained in Vitamin C (Citron Chaud DM)) may cause unwanted side effects that require medical attention.

Severity: Moderate

If any of the following side effects occur while taking ascorbic acid, check with your doctor or nurse as soon as possible:

Less common or rare: - with high doses

• Side or lower back pain

Minor Side Effects

Some ascorbic acid side effects may not need any medical attention. As your body gets used to the medicine these side effects may disappear. Your health care professional may be able to help you prevent or reduce these side effects, but do check with them if any of the following side effects continue, or if you are concerned about them:

Less common or rare: - with high doses

• Diarrhea
• dizziness or faintness (with the injection only)
• flushing or redness of skin
• headache
• increase in urination (mild)
• nausea or vomiting
• stomach cramps