ammonium chloride/diphenhydramine hydrochloride/levomenthol

Action and Spectrum

Actions and Spectrum: 

Actions: 

The combination covers a range of respiratory and allergy issues. Ammonium chloride aids expectoration – it thins mucus to ease clearing airways. Diphenhydramine hydrochloride is an antihistamine reducing allergy symptoms like sneezing, itchiness, watering eyes, and nasal drip. Levomenthol soothes topically with a cooling, mild anesthetic effect to relieve irritation and itching. This trio allows multi-symptom treatment through varied mechanisms for cough, cold, and allergy conditions. 

Spectrum:

This mix of medicines works to ease many symptoms. It can help blocked or runny noses. It relieves hay fever, coughing, and colds. It stops itching and sneezing. And it soothes watery, red eyes. 

Drug Interaction

Adverse Reaction

Frequency not defined 

Thickening of bronchial secretions 

Tremor 

Hepatic impairment 

Gastro-intestinal symptoms 

Dizziness 

Blood disorders 

Confusion 

Palpitations 

Psychomotor impairment 

Depression 

Dry mouth 

Arrhythmias 

Excitement (paradoxical) 

Urinary retention 

Extrapyramidal effects 

Blurred vision 

Hypotension 

Headache 

Sleep disturbances 

Hypersensitivity reactions 

Drowsiness 

Black Box Warning

Black Box Warning: 

This medicine could make you sleepy, so don’t drive or use machines after taking it. Don’t drink alcohol when using this syrup. Also, avoid taking other cough or cold medications simultaneously with this one. 

Contraindication / Caution

Contraindication/Caution: 

Contraindications 

• Hypersensitivity 
• Children under age 12 years 
• Pregnancy 
• Within 14 days of MAOIs discontinuation 
• Breastfeeding 
• Fructose intolerance (hereditary) 

Cautions 

• Drug interactions 
• Benign prostatic hyperplasia 
• Glucose-galactose malabsorption syndrome 
• Hepatic impairment 
• Asthma 
• Narrow-angle glaucoma 
• Epileptic disorder 
• Urinary retention 
• Renal impairment 

Additional precautions and advice: 

• Patients should know that drowsy feelings could impact driving ability or machinery use.  
• The oral liquid has hydroxybenzoate, so caution is wise if you have                               hypersensitivity. 
• Propylene glycol exists in the oral liquid form.  
• Specific formulations contain sucrose. Ponceau 4R (E124) is present in some formulations and may trigger allergic reactions.  
• Do not take this medicine with other cough or cold medications.  
• Avoid alcohol while taking this treatment. Never exceed the prescribed dosage.  
• If symptoms persist despite treatment, consult your doctor immediately. 

Pregnancy / Lactation

Pregnancy consideration:  

Contraindicated  

Breastfeeding warnings:  

Contraindicated  

Pregnancy category: 

Category A: well-controlled and satisfactory studies show no risk to the fetus in the first or later trimester. 

<b>Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women. 

Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.    

Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.    

Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.    

Category N: No data is available for the drug under this category. 

Pharmacology

Pharmacology: 

The medicine mix works differently. Ammonium Chloride makes mucus thinner, so you can cough it out easier. Diphenhydramine Hydrochloride stops sneezing and itching from allergies, hay   fever, and colds by blocking histamine.      Levomenthol cools and numbs skin or mucous membranes, so they don’t hurt or itch anymore. Together, they treat coughing, stuffiness, and allergy problems. 

Pharmacodynamics: 

Diphenhydramine stops coughing and allergies. It also makes you sleepy. It blocks histamine and other receptors in the brain. Antitussive action happens specifically in the brain stem. Effects last from 4 to 8 hours. Peak sedation occurs during absorption. Menthol numbs and                decongest. It works through cold receptors in the larynx. The cold sensation opposes the cough reflex. This is unlike substances, which cause a hot sensation that triggers coughing. 

Pharmacokinetics: (diphenhydramine hydrochloride) 

Absorption 

The drug rapidly absorbs in the body. 

Distribution 

It tightly attaching to blood proteins. Its vast distribution indicates tissues saturated by it. 

Metabolism 

Metabolism happens in both kidneys and liver.  

Elimination and Excretion 

Short-lived with 1–4-hour half-life, it primarily exits through urine unchanged. 

Adminstartion

Administration: 

For adults, take 5-10ml every 4 hours. For sleep, begin with 10ml at bedtime. After 6 hours, take 10ml again. Don’t exceed four doses (2 spoonfuls of 5ml = 1 dose) in 24 hours. Over 12 years old, follow adult dosage recommendations. Check product info or ask a healthcare pro for accurate directions. 

Patient Information Leaflet

Patient information leaflet 

Generic Name: ammonium chloride/diphenhydramine hydrochloride/levomenthol 

Pronounced: uh-MOH-nee-um KLYE-ride/dye-fen-HYE-dra-meen HYE-droh-KLOR-ide/LEE-voe-MEN-thol  

Why do we use ammonium chloride/diphenhydramine hydrochloride/levomenthol? 

Ammonium chloride is an ingredient that helps loosen mucus. When, you cough, it moves the thinned mucus out. Diphenhydramine hydrochloride is an antihistamine that eases hay fever, allergy, and cold symptoms like sneezing, itching, watery eyes, and runny nose. It includes levomenthol too, which numbs pain and itching. Levomenthol also cools skin and mucous membranes. This medicine combines those ingredients. It’s used for allergy-caused coughs, congestion, and respiratory discomfort. Many cough and cold medicines have it to provide relief.