What are the uses of diphenhydramine and phenylephrine combination. How does this medication work to relieve allergy and cold symptoms. What are the potential side effects and precautions to be aware of when taking this drug.

Understanding Diphenhydramine and Phenylephrine Combination

Diphenhydramine and phenylephrine is a combination medication used to treat various symptoms associated with allergies, the common cold, and flu. This powerful duo combines the antihistamine properties of diphenhydramine with the decongestant effects of phenylephrine to provide comprehensive relief from multiple symptoms.

How does this combination work?

Diphenhydramine, an antihistamine, works by blocking the effects of histamine in the body, which is responsible for allergy symptoms such as sneezing, itching, and watery eyes. Phenylephrine, a decongestant, reduces nasal congestion by constricting blood vessels in the nasal passages. Together, these two active ingredients provide a multi-faceted approach to symptom relief.

Common Uses and Applications

This combination medication is primarily used to address the following symptoms:

• Runny or stuffy nose
• Sneezing
• Itching
• Watery eyes
• Sinus congestion

These symptoms are often associated with allergies, the common cold, or influenza. The versatility of this combination makes it a popular choice for those seeking relief from multiple symptoms simultaneously.

Important Warnings and Precautions

Before taking diphenhydramine and phenylephrine, it’s crucial to be aware of certain warnings and precautions:

MAO Inhibitor Interaction

Do not use this medication if you have taken an MAO inhibitor in the past 14 days. This can lead to a dangerous drug interaction. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, and tranylcypromine, among others.

Proper Dosage and Administration

It’s essential to use diphenhydramine and phenylephrine exactly as directed. Taking excessive amounts of diphenhydramine can result in serious heart problems, seizures, coma, or even death. This medication should not be used to induce sleep in children, and a doctor should be consulted before administering it to children under 6 years old.

Potential for Overdose

Be cautious when using other medications that may contain diphenhydramine, as taking too much can lead to a fatal overdose. Always consult a doctor or pharmacist before combining this medication with other drugs.

Medical Conditions and Diphenhydramine-Phenylephrine Use

Certain medical conditions may affect the safety and efficacy of this medication. Consult a healthcare professional if you have a history of:

• Asthma or COPD
• Chronic cough with mucus
• Cough caused by smoking, emphysema, or chronic bronchitis
• High blood pressure or heart disease
• Enlarged prostate or urination problems
• Glaucoma
• Diabetes
• Thyroid disorders

Special Considerations

This medication may contain phenylalanine, which is important for individuals with phenylketonuria (PKU) to be aware of. Additionally, pregnant or breastfeeding individuals should consult a doctor before using this medication.

Proper Administration and Dosage Guidelines

To ensure safe and effective use of diphenhydramine and phenylephrine:

1. Follow the label instructions or your doctor’s prescription precisely.
2. Use the medication only for short-term relief of cold or cough symptoms.
3. Be cautious when administering to children, following age-appropriate guidelines.
4. Measure liquid medicine carefully using the provided dosing syringe or a medicine dose-measuring device.
5. Consult a doctor if symptoms persist after 7 days of treatment or if you develop a fever with a headache, cough, or skin rash.

Storage and Handling

Store the medication at room temperature, away from moisture and heat. Inform your healthcare provider about any cold medicine use before undergoing surgery or medical tests.

Managing Missed Doses and Potential Overdose

If you miss a dose, take it as soon as you remember. However, if it’s almost time for your next dose, skip the missed dose and continue with your regular schedule. Never take two doses at once to make up for a missed one.

Recognizing Overdose Symptoms

An overdose of diphenhydramine and phenylephrine can be life-threatening. Symptoms may include:

• Vomiting
• Confusion
• Severe drowsiness
• Ringing in the ears
• Absence of urination
• Very dry eyes and mouth
• Dilated pupils
• Rapid heartbeat
• Tremors
• Agitation
• Hallucinations
• Seizures

If you suspect an overdose, seek emergency medical attention immediately or contact the Poison Help line at 1-800-222-1222.

Lifestyle Considerations and Drug Interactions

While taking diphenhydramine and phenylephrine, it’s important to be aware of potential lifestyle impacts and drug interactions:

Driving and Operating Machinery

Avoid driving or engaging in hazardous activities until you understand how this medication affects you, as it may impair your reactions and alertness.

Alcohol Consumption

It’s advisable to limit or avoid alcohol consumption while taking this medication, as it can intensify drowsiness and other side effects.

Other Medications Containing Diphenhydramine

Be cautious when using other medicines that may contain diphenhydramine, including over-the-counter sleep aids, allergy medications, and motion sickness treatments. Always consult a healthcare professional before combining medications.

Potential Side Effects and Adverse Reactions

While diphenhydramine and phenylephrine can provide effective symptom relief, it’s important to be aware of potential side effects:

Common Side Effects

• Drowsiness
• Dizziness
• Dry mouth
• Blurred vision
• Constipation
• Difficulty urinating

Serious Side Effects

While less common, some individuals may experience more severe side effects, including:

• Rapid or irregular heartbeat
• Severe dizziness
• Anxiety
• Confusion
• Uncontrolled shaking
• Seizures

If you experience any of these serious side effects, seek medical attention immediately.

Long-term Use and Alternatives

Diphenhydramine and phenylephrine combination is primarily intended for short-term use. For chronic allergy or sinus issues, consider discussing alternative treatments with your healthcare provider.

Non-medicinal Alternatives

Some non-medicinal approaches to managing allergy and cold symptoms include:

• Using a humidifier to moisten the air
• Nasal irrigation with saline solution
• Staying hydrated
• Getting adequate rest
• Using air purifiers to reduce allergens in the environment

Long-term Management Strategies

For individuals with chronic allergies or recurrent cold symptoms, consider discussing the following options with your healthcare provider:

• Allergy testing to identify specific triggers
• Immunotherapy (allergy shots)
• Prescription-strength allergy medications
• Lifestyle modifications to reduce exposure to allergens

By understanding the proper use, potential side effects, and alternatives to diphenhydramine and phenylephrine combination, you can make informed decisions about managing your allergy and cold symptoms effectively. Always consult with a healthcare professional for personalized advice and treatment options tailored to your specific needs and medical history.

Diphenhydramine and phenylephrine Uses, Side Effects & Warnings

Generic name: diphenhydramine and phenylephrine [ DYE-fen-HYE-dra-meen-and-FEN-il-EFF-rin ]
Brand names: Children’s Triacting Night Time, Dimetapp Nighttime Cold and Congestion, Dytan-D, Triaminic Night Time Cold and Cough, Diphentann-D,
… show all 22 brands
D-Tann, Uni-Tann D, Aldex-CT, Diphenmax D, Alahist LQ, Robitussin Night Time Cough and Cold, Robitussin Night Time Cough and Cold Pediatric, PediaCare Children’s Allergy and Cold, Robitussin Night Time Cough and Cold Children’s, Zoden PD, Benadryl-D Children’s Allergy and Sinus, Delsym Children’s Night Time Cough and Cold, Children’s Allergy Plus Congestion, Benadryl Allergy Plus Congestion, Kindermed Kids’ Night Time Cold and Cough, Vicks Children’s Cough Congestion Night, Sudafed PE Sinus Congestion Daytime/Nighttime

Dosage forms: oral liquid (12.5 mg-5 mg/5 mL; 6.25 mg-2.5 mg/5 mL), oral suspension, extended release (25 mg-7. 5 mg/5 mL), oral tablet (25 mg-10 mg)
Drug class: Upper respiratory combinations

Medically reviewed by Drugs.com on Apr 27, 2022. Written by Cerner Multum.

What is diphenhydramine and phenylephrine?

Diphenhydramine is an antihistamine. Phenylephrine is a decongestant.

Diphenhydramine and phenylephrine is a combination medicine used to treat runny or stuffy nose, sneezing, itching, watery eyes, and sinus congestion caused by allergies, the common cold, or the flu.

Diphenhydramine and phenylephrine may also be used for purposes not listed in this medication guide.

Warnings

Do not use diphenhydramine and phenylephrine if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, and tranylcypromine, and others.

Use diphenhydramine and phenylephrine exactly as directed. Taking too much diphenhydramine can lead to serious heart problems, seizures, coma, or death.

Do not use this medicine to make a child sleepy. Ask a doctor before giving the medicine to a child younger than 6 years old.

Ask a doctor or pharmacist before using any other medicine that may contain diphenhydramine. Taking too much of this medicine can lead to a fatal overdose.

Before taking this medicine

Do not use diphenhydramine and phenylephrine if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, and tranylcypromine, and others.

Ask a doctor or pharmacist if this medicine is safe to use if you have ever had:

• asthma or COPD, cough with mucus, or cough caused by smoking, emphysema, or chronic bronchitis;

• high blood pressure, heart disease;

• an enlarged prostate or urination problems;

• glaucoma;

• diabetes; or

• a thyroid disorder.

This medicine may contain phenylalanine. Check the medication label if you have phenylketonuria (PKU).

Ask a doctor before using this medicine if you are pregnant or breastfeeding.

How should I take diphenhydramine and phenylephrine?

Use exactly as directed on the label, or as prescribed by your doctor. Cold or cough medicine is only for short-term use.

Always follow directions on the medicine label about giving cough or cold medicine to a child. Do not use the medicine only to make a child sleepy. Death can occur from the misuse of cough or cold medicines in very young children.

Ask a doctor before giving the medicine to a child.

Measure liquid medicine carefully. Use the dosing syringe provided, or use a medicine dose-measuring device (not a kitchen spoon).

Call your doctor if your symptoms do not improve after 7 days of treatment, or if you have a fever with a headache, cough, or skin rash.

If you need surgery or medical tests, tell the doctor ahead of time if you have taken a cold medicine within the past few days.

Store at room temperature away from moisture and heat.

What happens if I miss a dose?

Since diphenhydramine and phenylephrine is used when needed, you may not be on a dosing schedule. Skip any missed dose if it’s almost time for your next dose. Do not use two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of diphenhydramine and phenylephrine can be fatal.

Overdose symptoms may include vomiting, confusion, severe drowsiness, ringing in your ears, no urination, very dry eyes and mouth, dilated pupils, fast heartbeats, tremor, agitation, hallucinations, or seizure.

What should I avoid while taking diphenhydramine and phenylephrine?

Avoid driving or hazardous activity until you know how diphenhydramine and phenylephrine will affect you. Your reactions could be impaired.

Ask a doctor or pharmacist before using any other medicine that may contain diphenhydramine. This includes medicines for sleep, cold/allergy symptoms, or anti-itch medicine used on the skin. Using too much diphenhydramine may lead to a fatal overdose.

Drinking alcohol with this medicine can cause side effects.

Diphenhydramine and phenylephrine side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

This medicine may cause serious side effects. Stop using this medicine and call your doctor at once if you have:

• severe drowsiness;

• sleeplessness;

• painful or difficult urination;

• fast, pounding, or uneven heartbeats;

• trouble breathing;

• anxiety, nervousness;

• a seizure; or

• problems with balance or speech.

Common side effects of diphenhydramine and phenylephrine may include:

• dizziness, drowsiness, headache;

• dry mouth, nose, or throat;

• nausea, vomiting, constipation;

• blurred vision; or

• trouble sleeping.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1 800 FDA 1088.

Diphenhydramine and phenylephrine dosing information

Usual Adult Dose for Allergic Rhinitis:

Diphenhydramine 12.5 mg / phenylephrine 5 mg per 10 mL liquid: 20 mL every 4 hours
Maximum dose: 6 doses per 24 hours

Diphenhydramine 25 mg / phenylephrine 10 mg per tablet: 1 tablet every 4 hours
Maximum dose: 6 doses per 24 hours

Usual Adult Dose for Cold Symptoms:

Diphenhydramine 12.5 mg / phenylephrine 5 mg per 10 mL liquid: 20 mL every 4 hours
Maximum dose: 6 doses per 24 hours

Diphenhydramine 25 mg / phenylephrine 10 mg per tablet: 1 tablet every 4 hours
Maximum dose: 6 doses per 24 hours

Usual Pediatric Dose for Allergic Rhinitis:

Diphenhydramine 6.25 mg / phenylephrine 2.5 mg per 5 mL liquid:
6 to under 12 years: 10 mL every 4 hours
Maximum dose: 6 doses per 24 hours

Diphenhydramine 12. 5 mg / phenylephrine 5 mg per 10 mL liquid:
12 years and older: 20 mL every 4 hours
6 to under 12 years: 10 mL every 4 hours
Maximum dose: 6 doses per 24 hours

Diphenhydramine 25 mg / phenylephrine 10 mg per tablet:
12 years and older: 1 tablet every 4 hours
Maximum dose: 6 doses per 24 hours

Usual Pediatric Dose for Cold Symptoms:

Diphenhydramine 6.25 mg / phenylephrine 2.5 mg per 5 mL liquid:
6 to under 12 years: 10 mL every 4 hours
Maximum dose: 6 doses per 24 hours

Diphenhydramine 12.5 mg / phenylephrine 5 mg per 10 mL liquid:
12 years and older: 20 mL every 4 hours
6 to under 12 years: 10 mL every 4 hours
Maximum dose: 6 doses per 24 hours

Diphenhydramine 25 mg / phenylephrine 10 mg per tablet:
12 years and older: 1 tablet every 4 hours
Maximum dose: 6 doses per 24 hours

What other drugs will affect diphenhydramine and phenylephrine?

Ask a doctor or pharmacist before using diphenhydramine and phenylephrine with any other medicines, especially drugs that can cause drowsiness (such as opioid medication, sleep medicine, a muscle relaxer, or medicine for anxiety or seizures). Tell your doctor about all your current medicines and any medicine you start or stop using. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here.

More about diphenhydramine / phenylephrine

• Check interactions
• Compare alternatives
• Reviews (1)
• Drug images
• Side effects
• Dosage information
• During pregnancy
• Drug class: upper respiratory combinations

Patient resources

Other brands

Children’s Triacting Night Time, Dytan-D

Related treatment guides

• Sinusitis
• Allergic Rhinitis
• Cold Symptoms

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer

Copyright 1996-2023 Cerner Multum, Inc. Version: 6.01.

acetaminophen, diphenhydramine, and phenylephrine | Cigna

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acetaminophen, diphenhydramine, and phenylephrine

What is the most important information I should know about this medicine?

What is the most important information I should know about this medicine?

Do not use this medicine if you have taken an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, and tranylcypromine.

Use this medicine exactly as directed. An overdose of acetaminophen can damage your liver or cause death. Taking too much diphenhydramine can lead to serious heart problems, seizures, coma, or death.

Do not use this medicine to make a child sleepy. Some brands of acetaminophen, diphenhydramine, and phenylephrine are not approved for use in anyone younger than 12 years old.

Drinking alcohol may increase your risk of liver damage while taking acetaminophen.

Stop taking this medicine and call your doctor right away if you have skin redness or a rash that spreads and causes blistering and peeling.

What is acetaminophen, diphenhydramine, and phenylephrine?

What is acetaminophen, diphenhydramine, and phenylephrine?

Acetaminophen is a pain reliever and fever reducer. Diphenhydramine is an antihistamine. Phenylephrine is a decongestant.

Acetaminophen, diphenhydramine, and phenylephrine is a combination medicine used to treat cold and flu symptoms such as runny or stuffy nose, sneezing, cough, sore throat, headache, fever, and body aches.

There are many brands and forms of acetaminophen, diphenhydramine, and phenylephrine available. Not all brands are listed on this leaflet.

Acetaminophen, diphenhydramine, and phenylephrine may also be used for purposes not listed in this medication guide.

What should I discuss with my healthcare provider before taking this medicine?

What should I discuss with my healthcare provider before taking this medicine?

Ask a doctor before taking medicine that contains acetaminophen if you have ever had liver disease, or if you drink more than 3 alcoholic beverages per day.

Do not use this medicine if you have taken an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, and tranylcypromine.

Ask a doctor or pharmacist if this medicine is safe to use if you have ever had:

• asthma or COPD, cough with mucus, or cough caused by smoking, emphysema, or chronic bronchitis;
• liver disease;
• high blood pressure, heart disease;
• an enlarged prostate or urination problems;
• a thyroid disorder;
• diabetes;
• glaucoma; or
• a condition for which you take warfarin (Coumadin, Jantoven).

Ask a doctor before using this medicine if you are pregnant or breastfeeding.

How should I take this medicine?

How should I take this medicine?

Use exactly as directed on the label, or as prescribed by your doctor. Cold or cough medicine is only for short-term use until your symptoms clear up.

Do not take more of this medicine than is recommended. An overdose of acetaminophen can damage your liver or cause death. Taking too much diphenhydramine can lead to serious heart problems, seizures, coma, or death.

Some brands of acetaminophen, diphenhydramine, and phenylephrine are not approved for use in anyone younger than 12 years old.

Always follow directions on the medicine label about giving this medicine to a child. Do not use the medicine only to make a child sleepy. Death can occur from the misuse of antihistamines in very young children.

Measure liquid medicine carefully. Use the dosing syringe provided, or use a medicine dose-measuring device (not a kitchen spoon).

Dissolve one packet of the powder in at least 4 ounces of water. Stir this mixture and drink all of it right away.

Call your doctor if you still have a sore throat after 2 days, or if you also have a fever, headache, nausea, vomiting, or rash.

Stop taking this medicine and talk with your doctor if you still have a fever after 3 days, or you still have pain, stuffy nose, or a cough after 7 days (5 days if treating a child). Also call your doctor if your symptoms get worse, or if you have any redness or swelling.

If you need surgery or medical tests, tell the surgeon or doctor ahead of time if you have taken this medicine within the past few days.

Store at room temperature away from moisture and heat.

What happens if I miss a dose?

What happens if I miss a dose?

Since this medicine is used when needed, you may not be on a dosing schedule. Skip any missed dose if it’s almost time for your next dose. Do not use two doses at one time.

What happens if I overdose?

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose can be fatal or cause liver damage.

Overdose symptoms may include loss of appetite, vomiting, weakness, confusion, ringing in your ears, upper stomach pain, dark urine, no urination, very dry eyes and mouth, yellowing of your skin or eyes, dilated pupils, fast heartbeats, tremor, agitation, hallucinations, or seizure.

What should I avoid while taking this medicine?

What should I avoid while taking this medicine?

Avoid driving or hazardous activity until you know how this medicine will affect you. Your reactions could be impaired.

Ask a doctor or pharmacist before using any other medicine that may contain acetaminophen or diphenhydramine. This includes medicines for pain, fever, swelling, cold/flu symptoms, or anti-itch medicine used on the skin. Using too much acetaminophen or diphenhydramine can lead to a fatal overdose.

Drinking alcohol may increase your risk of liver damage while taking this medicine.

What are the possible side effects of this medicine?

What are the possible side effects of this medicine?

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

In rare cases, acetaminophen may cause a severe skin reaction that can be fatal. This could occur even if you have taken acetaminophen in the past and had no reaction. Stop taking this medicine and call your doctor right away if you have skin redness or a rash that spreads and causes blistering and peeling. If you have this type of reaction, you should never again take any medicine that contains acetaminophen.

Stop using this medicine and call your doctor at once if you have:

• severe drowsiness;
• painful or difficult urination;
• dizziness, trouble sleeping, nervousness; or
• liver problems –loss of appetite, stomach pain (upper right side), tiredness, itching, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Common side effects may include:

• drowsiness;
• dry eyes, blurred vision;
• dry mouth, nose, or throat;
• constipation; or
• feeling restless or excited (especially in children).

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect this medicine?

What other drugs will affect this medicine?

Ask a doctor or pharmacist before using acetaminophen, diphenhydramine, and phenylephrine with any other medicines, especially drugs that can cause drowsiness (such as opioid medication, sleep medicine, a muscle relaxer, or medicine for anxiety or seizures). Tell your doctor about all your current medicines and any medicine you start or stop using. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here.

Where can I get more information?

This information does not replace the advice of a doctor. Healthwise, Incorporated, disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. Learn how we develop our content.

Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.

Table 4 – Vasoconstrictor drugs (decongenants, alpha-adrenergic agents) \ ConsultantPlus

Table 4 – Vasoconstrictor drugs (decongeners, )

Phenylephrine-based drugs** should be used in the treatment of acute sinusitis in preschool children, as they do not and the use of other vasoconstrictors is not desirable due to possible toxic effects.

In childhood, a group of combined preparations of decongestants with antihistamines (dimethindene + phenylephrine**) is of particular interest. This combination allows you to enhance the anti-edematous effect, especially for children with manifestations of atopy. Combinations of xylometazoline with dexpanthenol (vitamin B5 substance) stimulate the regeneration of the nasal mucosa and restore mucociliary clearance, provide optimal hydration of the nasal mucosa. Combinations of xylometazoline** with dexpanthenol can be used in children and adults, including after surgical interventions in the nasal cavity, as it leads to an increase in reparative processes and a rapid restoration of the respiratory function of the nose.

All topical decongestants, as well as irrigation and elimination preparations, must be used in the form that corresponds to this age category – drops – up to 2 years, spray from 2 years, gel for older children. The use of decongestants should be limited to 5 to 7 days due to the risk of drug-induced rhinitis and tachyphylaxis. Preparations based on phenylephrine** can be used for a longer period of time, up to 10-14 days.

– Local glucocorticosteroid therapy recommended [12].

Strength of recommendations – A (level of evidence I)

Comments: Glucocorticosteroids inhibit the development of mucosal edema, restore the functional capacity of fistulas, suppress the release of fluid from the vascular bed, prevent eosinophilic inflammation and degradation of immunoglobulins, reduce neurogenic inflammatory factors. By acting on the bacterial factors that provoke rhinosinusitis, they indirectly reduce bacterial colonization. Thus, local glucocorticosteroid therapy can be considered an important multifactorial component of the treatment of acute sinusitis.

Five types of topical corticosteroids are currently registered in Russia: beclomethasone**, budesonide**, fluticasone, mometasone** and fluticasone furoate. Of these, only mometasone is registered in Russia as a therapeutic agent as monotherapy for acute uncomplicated sinusitis without signs of bacterial infection, as well as for combined therapy of exacerbations of chronic sinusitis.

The high level of systemic safety of mometasone (no effect on the growth of children, the hypothalamus-pituitary-adrenal system, etc.) is due to its minimal bioavailability when administered intranasally (less than 1%) and is an extremely important property of the drug, especially when administered to children.

– Mucolytic therapy recommended [3, 16, 17].

Strength of recommendation – C (level of evidence IV)

Comments: The physiologically important mucociliary clearance of the nose and paranasal sinuses is provided by the functioning of the ciliated epithelium cilia, as well as their optimal quality, quantity and transportability of mucus. The consequence of acute sinusitis is an imbalance between secretion production in goblet cells and seromucosal glands and secretion evacuation by ciliated epithelial cells, which leads to impaired mucociliary clearance.

The use of drugs with a differentiated effect on secretion production, a decrease in the viscosity of mucus and an improvement in the function of cilia allow the restoration of impaired drainage function. Drugs that have a similar therapeutic effect are combined into groups of mucolytic, secretomotor and secretolytic drugs.

The complexity of the pharmacological evaluation of mucolytic, secretolytic and secretomotor drugs lies in the fact that there is still no reliable method for experimental confirmation of their effectiveness. This is the reason for the complete absence of mucolytic therapy in the international recommendations EPOS-2012.

In the treatment of sinusitis, it is categorically impossible to extrapolate the effect of all mucolytics that have proven themselves in the pathology of the bronchi and sinuses, and before prescribing one or another drug from this group, you must familiarize yourself with the instructions for use and the registered indications indicated in it.

Only substances containing free SH-groups are able to have a direct mucolytic effect and, due to their direct action on mucus, have the most rapid mucolytic effect. Acetylcysteine** has a direct mucolytic effect, breaking the chains of mucoprotein mucus. In addition to direct mucolytic action, acetylcysteine ​​also has antioxidant, detoxifying and anti-inflammatory effects, which is important in the treatment of sinusitis. Acetylcysteine ​​preparations are included in the modern Russian standards for the treatment of acute and chronic sinusitis.

Drugs that reduce surface tension also have a mucolytic effect, i. e. acting on the gel phase of the discharge and thinning both sputum and nasopharyngeal secretions. Carbocysteine ​​belongs to this group. Its mucolytic effect is due to the activation of sialic transferase, an enzyme of goblet cells of the mucous membrane. Carbocysteine ​​normalizes the quantitative ratio of acidic and neutral nasal sialomucins, restores the viscosity and elasticity of mucus.

The classic secretolytic drug for the treatment of acute sinusitis is a herbal preparation that contains five herbal ingredients: gentian root, primrose flowers, sorrel herb, elder flowers, verbena herb. The drug has anti-inflammatory, antiviral and immunomodulatory effects. All this has a positive effect on the dynamics of the treatment of sinusitis, and in any of its forms – from the initial catarrhal manifestations to severe purulent sinusitis.

– Antihistamine therapy recommended [14].

Level of recommendation – D (level of evidence IV)

Comments: Histamine is one of the leading inflammatory mediators mentioned above. Therefore, the question of the role of antihistamines in the treatment of acute sinusitis cannot be avoided.

Antihistamines are widely used in the treatment of acute sinusitis, although their use is often unjustified. In the case when acute sinusitis develops against the background of allergic rhinitis, the appointment of antihistamines causes blockade of h2-histamine receptors and prevents the action of histamine released from mast cells as a result of an IgE-mediated reaction. In infectious sinusitis, the appointment of these drugs also makes some sense, but only in the early stage of a viral infection, when the blockade of h2 receptors prevents the action of histamine secreted by basophils under the influence of various viruses (respiratory syncytial, paramyxovirus).

– In acute viral rhinosinusitis, it is recommended to use antiviral drugs in complex treatment. It is possible to use preparations of natural origin with antiviral activity [15].

Strength of recommendation – D (level of evidence IV)

Comments: It is possible to use drugs of natural origin with antiviral activity [15].

– The use of complex homeopathic preparations in the treatment of OS is recommended.

Level of persuasiveness of recommendations – D (level of evidence IV)

Comments: The use of homeopathic medicines in the Russian Federation in medical practice is legally justified [22, 23]. In particular, complex homeopathic coryzalium tablets are registered as a drug and can be recommended by a doctor as part of the complex treatment of OS, since their clinical efficacy and safety have been confirmed [24–26].

Allergy treatment | Haleon HealthPartner

Diagnosis of Allergic Rhinitis

The American Academy of Allergy, Asthma and Immunology (AAAAI) published practice guidelines for the treatment of rhinitis in 2008. These guidelines recommend an individualized approach to pharmacological treatment, which should depend on a number of factors, including: ²

• The type of rhinitis is seasonal allergic rhinitis (SAR), perennial allergic rhinitis (CAR) or non-allergic rhinitis (NAR).
• Symptoms, duration and severity
• Physical examination results
• Concomitant diseases
• Age
• Patient preference

Nasal congestion leading symptom:

Treatment should include:

• Intranasal glucocorticosteroids (InGCS), eg budesonide, fluticasone furoate, fluticasone propionate, or triamcinolone acetonide
• Decongestants, eg xylometazoline, oxymetazoline or phenylephrine

Mild symptoms such as intermittent/episodic sneezing, nasal itching and rhinorrhea:

Treatment should include:

• Oral antihistamines, eg cetirizine, loratadine, fexofenadine, diphenhydramine, levocetirizine

Moderate/severe symptoms:

Treatment should include:

• InGCS
• Combination therapy

InGCS are considered the most effective drugs for the treatment of moderate, intermittent and all stages of persistent allergic rhinitis, as well as nasal, ocular symptoms and sinusitis. ⁴

The role of InGCS in the treatment of allergic rhinitis (AR)

InGCS are recognized as the most effective class of drugs for symptom control in the long-term treatment of allergic rhinitis because they: ^2.4

• symptoms
• Active in both early and late phases of the allergic cascade
• High concentrations at the receptor level are achieved with a single dose

According to the AAAAI Rhinitis Practice Guideline Update 2008, inGCSs are the most effective first-line drug class for controlling AR symptoms. ²

InGCS have been shown to be more effective than combined antihistamines and leukotriene (LT) antagonists in the treatment of SAD. ²

Inglucocorticoids can provide significant symptomatic relief in patients with SAD, whether they are used on a regular basis or as needed. ²

• AR in young children (

  <2 years)

  AR in young children (

  <2 years)

  AR is rare in children under two years of age. Before making a diagnosis of AR, other diseases such as adenoid hypertrophy or chronic rhinosinusitis should be considered. ⁵

  Treatment options include the following:

  Cromolyn sodium nasal spray:

  Some parents and physicians prefer cromolyn sodium because of its safety profile. However, it is less effective than IGCS. ⁶

  Second generation antihistamines:

  Cetirizine, loratadine, and fexofenadine are available in liquid dosage forms and approved for use in children ≥6 months of age. ^7.8

  Intranasal glucocorticosteroids spray:

  InGCS are very effective in relieving nasal symptoms. However, they should be used for a limited period of time (less than two weeks) due to age restrictions on the dosage regimen and concerns about the possibility of systemic side effects in children (eg, adrenal suppression) at higher doses. ^9.10

Allergy Prevention Guidelines

In addition to oral antihistamines and intranasal corticosteroids, first-line allergy therapy also includes avoidance of trigger factors that can cause an allergic reaction.