Medirex

A histamine H1 antagonist used in allergic reactions, hay fever, rhinitis, urticaria, and asthma. It has also been used in veterinary applications. One of the most widely used of the classical antihistaminics, it generally causes less drowsiness and sedation than promethazine. [PubChem]

Paracetamol (Medirex) is an organic compound that consists of a six-membered ring containing two opposing nitrogen atoms. Paracetamol (Medirex) exists as small alkaline deliquescent crystals with a saline tasteacinol was introduced to medicine as a solvent for uric acid. When taken into the body the drug is partly oxidized and partly eliminated unchanged. Outside the body, piperazine has a remarkable power to dissolve uric acid and producing a soluble urate, but in clinical experience it has not proved equally successfulacinol was first introduced as an anthelmintic in 1953. A large number of piperazine compounds have anthelmintic Paracetamol (Medirex). Their mode of Paracetamol (Medirex) is generally by paralysing parasites, which allows the host body to easily remove or expel the invading organism.

Ammonium Chloride (Medirex) Injection, USP, after dilution in isotonic sodium chloride injection, may be indicated in the treatment of patients with (1) hypochloremic states and (2) metabolic alkalosis.

Infectious-inflammatory diseases caused by microorganisms susceptible to ciprofloxacin, including respiratory diseases, diseases of abdominal and pelvic organs, bones, joints, skin, septicemia; severe infections of ENT organs. Treatment of postoperative infections. Prevention and treatment of infections in patients with reduced immunity.

For Chlorphenamine (Medirex) Citadel Fine Pharmaceuticals local use: acute and subacute conjunctivitis, blepharoconjunctivitis, blepharitis, bacterial corneal ulcers, keratitis, keratoconjunctivitis, chronic dacryocystitis, meybomity. Infectious lesions in the eyes from injury or contact with foreign bodies. Preoperative prophylaxis in ophthalmic surgery.

For systemic use of Paracetamol (Medirex) Sante Naturelle: prevention and treatment of hypo- and avitaminosis of vitamin C; providing increased need for vitamin C 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.

Chlorphenamine (Medirex) is an antihistamine that reduces the effects of natural chemical histamine in the body. Histamine can produce symptoms of sneezing, itching, watery eyes, and runny nose.

Chlorphenamine (Medirex) is used to treat runny nose, sneezing, itching, and watery eyes caused by allergies, the common cold, or the flu.

Chlorphenamine (Medirex) may also be used for purposes not listed in this medication guide.

Paracetamol (Medirex) (acetaminophen) is a pain reliever and a fever reducer. The exact mechanism of Paracetamol (Medirex) of is not known.

Paracetamol (Medirex) is used to treat many conditions such as headache, muscle aches, arthritis, backache, toothaches, colds, and fevers. It relieves pain in mild arthritis but has no effect on the underlying inflammation and swelling of the joint.

Paracetamol (Medirex) may also be used for other purposes not listed in this medication guide.

Ammonium Chloride (Medirex) Injection, USP is administered intravenously and must be diluted before use. Solutions for intravenous infusion should not exceed a concentration of 1% to 2% of Ammonium Chloride (Medirex).

Dosage is dependent upon the condition and tolerance of the patient. It is recommended that the contents of one to two vials (100 to 200 mEq) be added to 500 or 1000 mL of isotonic (0.9%) sodium chloride injection. The rate of intravenous infusion should not exceed 5 mL per minute in adults (approximately 3 hours for infusion of 1000 mL). Dosage should be monitored by repeated serum bicarbonate determinations.

Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit. See PRECAUTIONS.

Dosage Forms

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

Liquid,

Oral, as maleate:

Ed ChlorPed: 2 mg/mL (60 mL [DSC]) [contains fd&c red #40, propylene glycol, saccharin sodium, sodium benzoate; cotton candy flavor]

Syrup,

Oral, as maleate:

Aller-Chlor: 2 mg/5 mL (120 mL [DSC]) [contains alcohol, usp, fd&c yellow #6 (sunset yellow), menthol, methylparaben, propylene glycol, propylparaben]

Chlor-Trimeton: 2 mg/5 mL (120 mL) [contains alcohol, usp]

Ed Chlorped Jr: 2 mg/5 mL (118 mL [DSC], 473 mL) [alcohol free, sugar free; contains fd&c red #40, methylparaben, propylene glycol, propylparaben; cherry flavor]

Tablet,

Oral, as maleate:

Aller-Chlor: 4 mg [scored; contains fd&c yellow #10 aluminum lake]

Allergy: 4 mg [scored; contains corn starch, fd&c yellow #10 aluminum lake]

Allergy Relief: 4 mg [contains fd&c yellow #10 aluminum lake]

Allergy-Time: 4 mg [contains fd&c yellow #10 aluminum lake]

Chlor-Trimeton: 4 mg [scored]

Ed-Chlortan: 4 mg [DSC] [scored; contains fd&c yellow #10 aluminum lake]

Pharbechlor: 4 mg

Generic: 4 mg

Tablet Extended Release,

Oral, as maleate:

Chlor-Trimeton Allergy: 12 mg [contains fd&c blue #2 aluminum lake, fd&c yellow #10 aluminum lake, fd&c yellow #6 aluminum lake]

Chlor-Trimeton Allergy: 12 mg [contains fd&c yellow #6 (sunset yellow), fd&c yellow #6 aluminum lake]

Generic: 12 mg

Dosing: Adult

Allergic symptoms, allergic rhinitis, urticaria, pruritus:

Oral:

Immediate release: 4 mg every 4 to 6 hours; do not exceed 24 mg/24 hours

Extended release: 12 mg every 12 hours; do not exceed 24 mg/24 hours

Motion sickness (off-label use): Immediate release: 4 to 12 mg administered 3 hours prior to initiating stimulus for motion sickness (Buckey 2004). Note: Avoid use if it is unsafe for patient to be sedated.

Dosing: Geriatric

Avoid use (Beers Criteria [AGS 2019]).

Dosing: Pediatric

Note: Safety and efficacy for the use of cough and cold products in infants and young children is limited; the AAP warns against the use of these products for respiratory illnesses in infants and young children; the FDA does not recommend OTC use in infants and children <2 years of age due to the risk of serious and life-threatening adverse effects (including death) and recommends to use with caution in pediatric patients ≥2 years of age (AAP 2018; FDA 2017).

Allergic symptoms:

Oral:

Immediate release:

Oral liquid (2 mg/5 mL):

Children 2 to <6 years: 1 mg every 4 to 6 hours; maximum daily dose: 6 mg/day.

Children 6 to <12 years: 2 mg every 4 to 6 hours; maximum daily dose: 12 mg/day.

Children ≥12 years and Adolescents: 4 mg every 4 to 6 hours; maximum daily dose: 24 mg/day.

Tablets:

Children 6 to <12 years: 2 mg every 4 to 6 hours; maximum daily dose: 12 mg/day.

Children ≥12 years and Adolescents: 4 mg every 4 to 6 hours; maximum daily dose: 24 mg/day.

Extended-release tablet: Children ≥12 years and Adolescents: 12 mg every 12 hours; maximum dose: 24 mg in 24 hours.

Usual Adult Paracetamol (Medirex) Dose for Fever:

General Dosing Guidelines: 325 to 650 mg every 4 to 6 hours or 1000 mg every 6 to 8 hours orally or rectally.

Paracetamol (Medirex) 500mg tablets: Two 500 mg tablets orally every 4 to 6 hours

Usual Adult Paracetamol (Medirex) Dose for Pain:

General Dosing Guidelines: 325 to 650 mg every 4 to 6 hours or 1000 mg every 6 to 8 hours orally or rectally.

Paracetamol (Medirex) 500mg tablets: Two 500 mg tablets orally every 4 to 6 hours

Usual Pediatric Dose for Fever:

Oral or Rectal:

<=1 month: 10 to 15 mg/kg/dose every 6 to 8 hours as needed.

>1 month to 12 years: 10 to 15 mg/kg/dose every 4 to 6 hours as needed (Maximum: 5 doses in 24 hours)

Fever: 4 months to 9 years: Initial Dose: 30 mg/kg (Reported by one study (n=121) to be more effective in reducing fever than a 15 mg/kg maintenance dose with no difference regarding clinical tolerance.)

>=12 years: 325 to 650 mg every 4 to 6 hours or 1000 mg every 6 to 8 hours.

Usual Pediatric Dose for Pain:

Oral or Rectal:

<=1 month: 10 to 15 mg/kg/dose every 6 to 8 hours as needed.

>1 month to 12 years: 10 to 15 mg/kg/dose every 4 to 6 hours as needed (Maximum: 5 doses in 24 hours)

Fever: 4 months to 9 years: Initial Dose: 30 mg/kg (Reported by one study (n=121) to be more effective in reducing fever than a 15 mg/kg maintenance dose with no difference regarding clinical tolerance.)

>=12 years: 325 to 650 mg every 4 to 6 hours or 1000 mg every 6 to 8 hours.

Ammonium Chloride (Medirex) is contraindicated in patients with severe impairment of renal or hepatic function.

Ammonium Chloride (Medirex) should not be administered when metabolic alkalosis due to vomiting of hydrochloric acid is accompanied by loss of sodium (excretion of sodium bicarbonate in the urine).

See also:
What is the most important information I should know about Chlorphenamine (Medirex)?

Injection: Chlorphenamine (Medirex) is contraindicated in comatose states, in patients who have received large amounts of central-nervous-system depressants (alcohol, sedative hypnotics, including barbiturates, general anesthetics, narcotics, narcotic analgesics, tranquilizers, etc.), and in patients who have demonstrated an idiosyncrasy or hypersensitivity to promethazine.

Under no circumstances should promethazine be given by intra-arterial injection due to the likelihood of severe arteriospasm and the possibility of resultant gangrene

Chlorphenamine (Medirex) HCl injection should not be given by the subcutaneous route; evidence of chemical irritation has been noted, and necrotic lesions have resulted on rare occasions following subcutaneous injection. The preferred parenteral route of administration is by deep intramuscular injection.

Syrup, Tablets and Suppositories: Phenergan Tablets and Suppositories are contraindicated for use in pediatric patients less than two years of age.

Phenergan Tablets and Suppositories are contraindicated in comatose states, and in individuals known to be hypersensitive or to have had an idiosyncratic reaction to promethazine or to other phenothiazines.

Antihistamines are contraindicated for use in the treatment of lower respiratory tract symptoms including asthma.

See also:
What is the most important information I should know about Paracetamol (Medirex)?

Paracetamol (Medirex) should not be used in patients who have previously exhibited hypersensitivity to aspirin and/or nonsteroidal antiinflammatory agents. Paracetamol (Medirex) should not be given to patients with a recent history of gastrointestinal bleeding or in patients with bleeding disorders (e.g., hemophilia).

Use Chlorphenamine (Medirex) as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Chlorphenamine (Medirex) may be taken with or without food.
• If you miss a dose of Chlorphenamine (Medirex), 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 Chlorphenamine (Medirex).

Use Paracetamol (Medirex) exactly as directed on the label, or as prescribed by your doctor.

Do not use more of this medication than is recommended. An overdose of Paracetamol (Medirex) can cause serious harm. The maximum amount for adults is 1 gram (1000 mg) per dose and 4 grams (4000 mg) per day. Using more Paracetamol (Medirex) could cause damage to your liver. If you drink more than three alcoholic beverages per day, talk to your doctor before taking Paracetamol (Medirex) and never use more than 2 grams (2000 mg) per day. If you are treating a child, use a pediatric form of Paracetamol (Medirex). Carefully follow the dosing directions on the medicine label. Do not give the medication to a child younger than 2 years old without the advice of a doctor.

Measure the liquid form of Paracetamol (Medirex) with a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one. You may need to shake the liquid before each use. Follow the directions on the medicine label.

The Paracetamol (Medirex) chewable tablet must be chewed thoroughly before you swallow it.

Make sure your hands are dry when handling the Paracetamol (Medirex) disintegrating tablet. Place the tablet on your tongue. It will begin to dissolve right away. Do not swallow the tablet whole. Allow it to dissolve in your mouth without chewing.

To use the Paracetamol (Medirex) effervescent granules, dissolve one packet of the granules in at least 4 ounces of water. Stir this mixture and drink all of it right away. To make sure you get the entire dose, add a little more water to the same glass, swirl gently and drink right away.

Do not take a Paracetamol (Medirex) rectal suppository by mouth. It is for use only in your rectum. Wash your hands before and after inserting the suppository.

Try to empty your bowel and bladder just before using the Paracetamol (Medirex) suppository. Remove the outer wrapper from the suppository before inserting it. Avoid handling the suppository too long or it will melt in your hands.

For best results from the suppository, lie down and insert the suppository pointed tip first into the rectum. Hold in the suppository for a few minutes. It will melt quickly once inserted and you should feel little or no discomfort while holding it in. Avoid using the bathroom just after inserting the suppository.

Stop using Paracetamol (Medirex) and call your doctor if:

• you still have a fever after 3 days of use;

• you still have pain after 7 days of use (or 5 days if treating a child);

• you have a skin rash, ongoing headache, or any redness or swelling; or

• if your symptoms get worse, or if you have any new symptoms.

Urine glucose tests may produce false results while you are taking Paracetamol (Medirex). Talk to your doctor if you are diabetic and you notice changes in your glucose levels during treatment.

Store Paracetamol (Medirex) at room temperature away from heat and moisture. The rectal suppositories can be stored at room temperature or in the refrigerator.

Ammonium Chloride (Medirex) is used for the relief of cough in the form of cough expectorant. It is also used as an injection to treat patients with hypochloremia and metabolic alkalosis.

Use: Labeled Indications

Allergic symptoms, allergic rhinitis, urticaria, pruritus: Perennial and seasonal allergic rhinitis and other allergic symptoms including urticaria, pruritus

Off Label Uses

Motion sickness

Data from a limited number of patients studied suggests that Chlorphenamine (Medirex) may be beneficial in the treatment of motion sickness. Additional data may be necessary to further define its role in this condition.

This drug is used to treat mild to moderate pain (from headaches, menstrual periods, toothaches, backaches, osteoarthritis, or cold/flu aches and pains) and to reduce fever.

How to use Paracetamol (Medirex)

Take this product by mouth as directed. Follow all directions on the product package. If you are uncertain about any of the information, consult your doctor or pharmacist.

There are many brands and forms of acetaminophen available. Read the dosing instructions carefully for each product because the amount of acetaminophen may be different between products. Do not take more acetaminophen than recommended.

If you are giving acetaminophen to a child, be sure you use a product that is meant for children. Use your child's weight to find the right dose on the product package. If you don't know your child's weight, you can use their age.

For suspensions, shake the medication well before each dose. Some liquids do not need to be shaken before use. Follow all directions on the product package. Measure the liquid medication with the provided dose-measuring spoon/dropper/syringe to make sure you have the correct dose. Do not use a household spoon.

For rapidly-dissolving tablets, chew or allow to dissolve on the tongue, then swallow with or without water. For chewable tablets, chew thoroughly before swallowing.

Do not crush or chew extended-release tablets. Doing so can release all of the drug at once, increasing the risk of side effects. Also, do not split the 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.

For effervescent tablets, dissolve the dose in the recommended amount of water, then drink.

Pain medications work best if they are used as the first signs of pain occur. If you wait until the symptoms have worsened, the medication may not work as well.

Do not take this medication for fever for more than 3 days unless directed by your doctor. For adults, do not take this product for pain for more than 10 days (5 days in children) unless directed by your doctor. If the child has a sore throat (especially with high fever, headache, or nausea/vomiting), consult the doctor promptly.

Tell your doctor if your condition persists or worsens or if you develop new symptoms. If you think you may have a serious medical problem, get medical help right away.

In a treatment, patients should be monitored closely for signs of ammonia poisoning: pallor, sweating, irregular breathing, vomiting, bradycardia, arrhythmias, tremors, convulsions and coma.

Ammonium Chloride (Medirex) should be used with caution in patients with heart and lung failure.

A longer-term correction of a hypochloraemia in patients with secondary metabolic alkalosis due to an intracellular potassium depletion can not be achieved by the sole administration of Ammonium Chloride (Medirex). Concomitant administration of potassium is also necessary.

See also:
What other drugs will affect Chlorphenamine (Medirex)?

Activity increases when combined with beta-lactam antibiotics, aminoglycosides, vancomycin, clindamycin, metronidazole. Sukralfat, bismuth preparations, antacids containing aluminum ions, magnesium or calcium, cimetidine, ranitidine, vitamin and mineral supplement, iron sulfate, zinc, didanosine (recommended for 2 hours before or 4 hours after these drugs) reduce the suction. Probenecid, azlocillin increase the concentration in the blood. Decreases clearance and increases in plasma caffeine, aminophylline and theophylline (increased likelihood of side effects). Chlorphenamine (Medirex) Citadel Fine Pharmaceuticals enhances the effect of warfarin and other oral anticoagulants (prolongs bleeding time). Increases nephrotoxicity of cyclosporine, increase the risk of CNS excitability and convulsive reactions against the background of NSAIDs. Medicines alkalinizing the urine (citrates, sodium bicarbonate, carbonic anhydrase inhibitors) reduce the solubility (increases the probability of crystalluria). Infusion solutions of ciprofloxacin ready to use can be combined with infusion solutions: 0.9% sodium chloride solution, Ringer's solution, Ringer lactate, 5 and 10% dextrose, 10% solution of fructose, and a solution containing 5% dextrose with 0,225 or 0.45% sodium chloride. Incompatible with solutions having a pH > 7.

See also:
What other drugs will affect Paracetamol (Medirex)?

With the simultaneous use with inducers of microsomal liver enzymes, means having hepatotoxic effect, increasing the risk of hepatotoxic Paracetamol (Medirex) of Paracetamol (Medirex).

With the simultaneous use of anticoagulants may be slight to moderate increase in prothrombin time.

With the simultaneous use of anticholinergics may decrease absorption of Paracetamol (Medirex).

With the simultaneous use of oral contraceptives accelerated excretion of Paracetamol (Medirex) from the body and may reduce its analgesic Paracetamol (Medirex).

With the simultaneous use with urological means reduced their effectiveness.

With the simultaneous use of activated charcoal reduced bioavailability of Paracetamol (Medirex).

When Paracetamol (Medirex) Guardian applied simultaneously with diazepam may decrease excretion of diazepam.

There have been reports about the possibility of enhancing mielodepression effect of zidovudine while applying with Paracetamol (Medirex). A case of severe toxic liver injury.

Described cases of toxic effects of Paracetamol (Medirex), while the use of isoniazid.

When applied simultaneously with carbamazepine, phenytoin, phenobarbital, primidonom decreases the effectiveness of Paracetamol (Medirex), which is caused by an increase in its metabolism and excretion from the body. Cases of hepatotoxicity, while the use of Paracetamol (Medirex) and phenobarbital.

In applying cholestyramine a period of less than 1 h after administration of Paracetamol (Medirex) may decrease of its absorption.

At simultaneous application with lamotrigine moderately increased excretion of lamotrigine from the body.

With the simultaneous use of metoclopramide may increase absorption of Paracetamol (Medirex) and its increased concentration in blood plasma.

When applied simultaneously with probenecid may decrease clearance of Paracetamol (Medirex), with rifampicin, sulfinpyrazone - may increase clearance of Paracetamol (Medirex) due to increasing its metabolism in the liver.

At simultaneous application of Paracetamol (Medirex) Guardian with ethinylestradiol increases absorption of Paracetamol (Medirex) from the gut.

Enhances the effect of indirect anticoagulants (coumarin derivatives and indandione). Antipyretic and analgesic activity of caffeine increases, reduce - rifampicin, phenobarbital and alcohol (accelerated biotransformation, inducing microsomal liver enzymes).

See also:
What are the possible side effects of Ammonium Chloride (Medirex)?

Rapid intravenous administration of Ammonium Chloride (Medirex) may be accompanied by pain or irritation at the site of injection or along the venous route.

Reactions which may occur because of the solution or the technique of administration include febrile response, infection at the site of injection, venous thrombosis or phlebitis extending from the site of injection, extravasation and hypervolemia (from large volume diluent).

If an adverse reaction does occur, discontinue the infusion, evaluate the patient, institute appropriate therapeutic countermeasures and save the remainder of the fluid for examination if deemed necessary.

See also:
What are the possible side effects of Chlorphenamine (Medirex)?

Applies to Chlorphenamine (Medirex): capsules, controlled-release capsules, suspension drops, sustained-release capsules, syrup, tablets

Other dosage forms:

• suspension

Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Constipation; diarrhea; dizziness; drowsiness; dry mouth, nose, or throat; excitability; headache; loss of appetite; nausea; nervousness or anxiety; trouble sleeping; upset stomach; vomiting; weakness.

Seek medical attention right away if any of these SEVERE side effects occur while taking Chlorphenamine (Medirex) (the active ingredient contained in Chlorphenamine (Medirex) (Allergy))

Severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); difficulty urinating or inability to urinate; fast or irregular heartbeat; hallucinations; seizures; severe dizziness, lightheadedness, or headache; tremor; trouble sleeping; vision changes.

See also:
What are the possible side effects of Paracetamol (Medirex)?

Effects due to the presence of acetylsalicylic acid.

Accidents awareness with respiratory or skin reactions (angioedema, urticaria, asthma, anaphylactic shock);

Cross hypersensitivity reactions with NSAIDs and with tartrazine;

At low doses recommended for the use of Paracetamol (Medirex), side effects of aspirin are generally limited to some irritation of the gastro-intestinal tract.

At higher doses, side effects include gastrointestinal mucosal erosions, gastric ulcer or duodenal ulcer, occult blood loss, melena.

Acetylsalicylic acid may also increase the tendency to bleeding and bleeding time (the lengthening of bleeding continues 4-6 days after stopping the drug).

It may also worsen renal function including cases of pre-existing condition (the long-term use can cause chronic kidney disease).

The signs of salicylic overdose described under.

Effects due to the presence of Paracetamol (Medirex).

At the doses and duration of recommended treatment, side effects are usually negligible, but the prolonged use of Paracetamol (Medirex) in therapeutic doses large (2-4 g per day, or 10-20 tablets Paracetamol (Medirex)) may cause the appearance chronic hepatitis. This justifies the recommendations of caution especially in patients with liver disease prior.

Very rarely, it can produce thrombocytopenia.

The acute liver toxicity in overdose massive (doses greater than 8 g of Paracetamol (Medirex)) is described in paragraph overdose.