Chlorphenamine 10mg/1ml solution for injection ampoules

BackgroundThe common cold and other viral airway infections are highly prevalent in the population, and their treatment often requires the use of medications for symptomatic relief. Paracetamol is as an analgesic and antipyretic; chlorphenamine is an antihistamine; and phenylephrine, a vasoconstrictor and decongestant. This randomized, double-blind, placebo-controlled trial sought to evaluate the efficacy and safety of a fixed-dose combination of paracetamol, chlorphenamine and phenylephrine in the symptomatic treatment of the common cold and flu-like syndrome in adults.MethodsThis study enrolled 146 individuals aged 18 to 60 years who had moderate to severe flu-like syndrome or common cold. After clinical examination and laboratory tests, individuals were randomly assigned to receive the fixed-dose combination (73) or placebo (73), five capsules per day for 48 to 72 hours. The primary efficacy endpoint was the sum of the scores of 10 symptoms on a four-point Likert-type scale. To evaluate treatment safety, the occurrence of adverse events was also measured.ResultsMean age was 33.5 (±9.5) years in the placebo group and 33.8 (±11.5) in the treatment group. There were 55 women and 18 men in the placebo group, and 46 women and 27 men in the treatment group. Comparison of overall symptom scores in the two groups revealed a significantly greater reduction in the treatment group than in the placebo group (p = 0.015). Analysis at the first 13 dose intervals (± 66 h of treatment) showed a greater reduction of symptom scores in the treatment group than in the placebo group (p < 0.05). The number and distribution of adverse events were similar in both groups.ConclusionA fixed-dose combination of paracetamol, chlorphenamine and phenylephrine was safe and more effective than placebo in the symptomatic treatment of the common cold or flu-like syndrome in adults.Trial registrationNCT01389518

Abstract licence: CC BY 2.0

Abstract The common cold is the most frequent upper respiratory viral infection. Although benign, it represents a high socioeconomic burden. Many over-the-counter drugs are available to manage the symptoms of this condition, with antihistamines and vasoconstrictors being the most widely used. This review aimed to compare the potential mechanisms underlying the efficacy and safety of chlorphenamine and pseudoephedrine, the most commonly used agents in these two classes of drugs, and provide a useful perspective to impact appropriate decisions when considering these options for symptomatic common cold treatment. To conduct a comprehensive analysis, we systematically reviewed the use of pseudoephedrine and chlorphenamine using various databases, including MEDLINE, Google Scholar, Scopus, and Embase. We also perused the bibliographies of relevant articles and the EudraVigilance database. The findings suggest that pseudoephedrine may offer specific benefits in rapidly alleviating nasal congestion in the short term. Chlorphenamine appears to exhibit a higher degree of efficacy in alleviating rhinorrhea and other specific cold symptoms compared to pseudoephedrine. Pharmacovigilance data and case report reviews showed that pseudoephedrine may induce a higher incidence of less common but potentially life-threatening adverse effects compared to chlorphenamine. We concluded that antihistamine drugs exhibit a more favorable benefit/risk profile than vasoconstrictors for treating symptomatic common colds.

Abstract licence: CC BY-NC-ND 4.0

Objective and designInvestigate the potential role of histamine and its receptors on the functional expression of the sodium/hydrogen (Na+/H+) exchanger (NHE)3.MaterialThe human epithelial kidney (HK-2) cells were used as an in vitro model of the renal proximal tubule.TreatmentHK-2 cells were exposed to histamine 0-1000 nM alone or in combination with chlorphenamine (10 μM) and JNJ-7777120 (1 μM) for 0-48 h. MAPK involvement was determined using the selective inhibitors SB202190 (p38 MAPK), PD98059 (ERK1/2), and SP600125 (SAPK/JNK).MethodsGene and protein expression were evaluated by qPCR and immunoblotting. The activity of NHE3 was measured by the BCECF-AM-based method.ResultsHistamine (100 nM) induced a concentration-dependent NHE3 gene transcription with a peak 16 h after the treatment, followed by protein translation at 48 h after. A Consistent increase in NHE3 activity was observed at 48 h, but also at 60 min, when both p38 MAPK and ERK1/2 were phosphorylated. JNJ-7777120 blunted the activation and expression of NHE3. Chlorpheniramine was effective only on NHE3 activity.ConclusionsHistamine shows early (within 60 min) and late (48 h) effects on NHE3 expression. The histamine H1 and H4 receptors are shown to contribute to these effects differentially. The findings of this study extends the evidence for a direct contribution of histamine on the renal reabsorptive machinery.

Abstract licence: CC BY

Serotonin syndrome (SS) and hyponatremia are severe, potentially life-threatening adverse reactions to serotonergic medications. Their concurrent manifestation is rare but clinically significant due to overlapping pathophysiological mechanisms. This report describes the fatal outcome of a 30-year-old female who presented to the Emergency Department with agitation following self-administration of duloxetine 60 mg, in addition to ongoing amitriptyline therapy and possible L-tryptophan supplementation. During hospitalization, she was treated with intravenous chlorphenamine for a suspected allergic reaction. Subsequently, she developed severe neurological deterioration, malignant arrhythmia, and profound acute hyponatremia (serum sodium 114 mmol/L), culminating in brain death within 48 h. The synergistic pharmacodynamic and pharmacokinetic interactions between duloxetine, amitriptyline, and chlorphenamine-three agents with serotonin reuptake inhibition properties-were implicated in precipitating SS and syndrome of inappropriate antidiuresis (SIAD)-induced hyponatremia. This combination resulted in extensive cerebral edema and cardiopulmonary arrest. The case highlights the diagnostic challenge posed by overlapping SS and hyponatremia manifestations, particularly when compounded by incomplete pharmacological histories and inappropriate drug administration. Clinicians should maintain high vigilance for SS and hyponatremia in patients receiving serotonergic agents, especially when multiple such drugs are co-administered. Comprehensive medication anamnesis, prompt electrolyte monitoring, and avoidance of pharmacodynamic duplication are essential to prevent similar outcomes.

Abstract licence: CC BY-NC 4.0

Background and purposeHa-rak (HR), an equal-proportion combination of roots from Capparis micracantha DC., Clerodendrum petasites S. Moore., Ficus racemosa L., Harrisonia perforata (Blanco) Merr., and Tiliacora triandra (Colebr.) Diels, Piper betle L. (PB), and Garcinia mangostana L. (GM) are commonly used in traditional Thai medicine to treat skin diseases, including atopic dermatitis (AD). Combining three medicines in adjusted proportions can improve efficacy, reduce toxicity, and reduce medication. This study aimed to evaluate the anti-allergic, anti-inflammatory, antimicrobial, and cytotoxic activities of the ethanolic extracts of different combinations to analyze the relationship among elements, medicinal tastes, and biological activities.Experimental approachThe biological activities (anti-allergic, anti-inflammatory, and anti-microbial activities and cell viability) of ethanolic extracts of plants and their combinations in various proportions were evaluated, as well as the chemical content of the developed remedies using the HPLC technique.Findings/resultsHMB-123 was the most significantly effective combination for AD. HMB-123 reduced β-hexosaminidase release from RBL-2H3 cells to a greater extent than chlorpheniramine. HMB-123 significantly inhibited nitric oxide and TNF-α production in LPS-stimulated RAW 264.7 cells. HMB-123 demonstrated antibacterial activity against all tested bacteria and antifungal activity against Candida albicans. For single extract, PB exhibited the highest anti-fungal activity, while GM exhibited the highest anti-bacterial activity.Conclusion and implicationsThe combined extracts showed potential as an optimized remedy for AD. HMB-123 demonstrated the highest anti-allergic, anti-inflammatory, and antimicrobial activities, making it a promising development candidate for AD treatment. To confirm safety and efficacy, further pre-clinical and clinical testing is necessary.

Abstract licence: CC BY-NC-SA