Piriton Syrup
SUMMARY OF PRODUCT CHARACTERISTICS
1 NAME OF THE MEDICINAL PRODUCT
Piriton Syrup
2 QUALITATIVE AND QUANTITATIVE COMPOSITION
A colourless syrup containing 2mg of chiorphenamine maleate in 5ml
3 PHARMACEUTICAL FORM
Syrup
4 CLINICAL PARTICULARS
4.1 Therapeutic indications
Piriton Syrup is indicated for symptomatic control of all allergic conditions responsive to antihistamines, including hay fever, vasomotor rhinitis, urticaria, angioneurotic oedema, food allergy, drug and serum reactions, insect bites.
Also indicated for the symptomatic relief of itch associated with chickenpox.
4.2 Posology and method of administration
Oral administration only
Do not exceed the stated dose or frequency of dosing
Adults and children 12 years and over: 10ml (4mg) every 4 to 6 hourly. Maximum daily dose: 60ml (24mg) in any 24 hours.
Elderly: The elderly are more likely to experience neurological anticholinergic effects. Consideration should be given to using a lower daily dose (e.g. a maximum of 12 mg in any 24 hours).
Children aged 6 - 12 years: 5ml (2mg) every 4 to 6 hourly. Maximum daily dose: 30ml (12mg) in any 24 hours.
Children aged 2 - 6 years: 2.5ml (1mg) every 4 to 6 hourly. Maximum daily dose: 15ml (6mg) in any 24 hours.
Children aged 1 - 2 years: 2.5ml (1mg) twice daily. The minimum interval between the doses should be 4 hours. Maximum daily dose: 5ml (2mg) in any 24 hours.
Not recommended for children below 1 year
4.3 Contraindications
Piriton Syrup is contra-indicated in patients who are hypersensitive to antihistamines or to any of the syrup ingredients.
The anticholinergic properties of chlorphenamine are intensified by monoamine oxidase inhibitors (MAOIs). Piriton Syrup is therefore contraindicated in patients who have been treated with MAOIs within the last fourteen days.
4.4 Special warnings and precautions for use
Chlorphenamine, in common with other drugs having anticholinergic effects, should be used with caution in epilepsy; raised intra-ocular pressure including glaucoma; prostatic hypertrophy; severe hypertension or cardiovascular disease; bronchitis, bronchiectasis or asthma; hepatic impairment; renal impairment. Children and the elderly are more likely to experience the neurological anticholinergic effects and paradoxical excitation (eg. Increased energy, restlessness, nervousness).
The anticholinergic properties of chlorphenamine may cause drowsiness, dizziness, blurred vision and psychomotor impairment in some patients which may seriously affect ability to drive and use machinery.
The effects of alcohol may be increased and therefore concurrent use should be avoided.
Should not be used with other antihistamine containing products, including antihistamine containing cough and cold medicines.
Piriton syrup contains 6.3% v/v ethanol. Harmful for those suffering from alcoholism. To be taken into account in pregnant and breast feeding women, children and high risk groups such as patients with liver disease or epilepsy.
Patients with rare hereditary problems of fructose intolerance, glucose-galactose malabsorption or sucrose-isomaltase insufficiency should not take this medicine.
Piriton Syrup contains 2.36 g of sucrose per 5 ml. This should be taken into account in patients with diabetes mellitus.
Long term use increases the risk of dental caries and it is essential that adequate dental hygiene is maintained.
Methyl, ethyl and propyl hydroxybenzoates (E218, E214 and E216) may cause allergic reactions (possibly delayed).
Keep out of the reach and sight of children.
4.5 Interaction with other medicinal products and other forms of interaction
Concurrent use of chlorphenamine and hypnotics or anxiolytics may cause an increase in sedative effects, therefore medical advice should be sought before taking chlorphenamine concurrently with these medicines.
Chlorphenamine inhibits phenytoin metabolism and can lead to phenytoin toxicity.
The anticholinergic effects of chlorphenamine are intensified by MAOIs (see Contra-indications).
4.6 Fertility, Pregnancy and lactation Pregnancy
There are no adequate data from the use of chlorphenamine in pregnant women. The potential risk for humans is unknown, Use during the third trimester may result in reactions in the newborn or premature neonates. Not to be used during pregnancy unless considered essential by a physician.
Lactation
Chlorphenamine maleate and other antihistamines may inhibit lactation and may be secreted in breast milk. Not to be used during lactation unless considered essential by a physician.
4.7 Effects on ability to drive and use machines
The anticholinergic properties of chiorphenamine may cause drowsiness, dizziness, blurred vision and psychomotor impairment, which can seriously hamper the patients’ ability to drive and use machinery.
4.8 Undesirable effects
Specific estimation of the frequency of adverse events for OTC products is inherently difficult (particularly numerator data). Adverse reactions which have been observed in clinical trails and which are considered to be common (occurring in >1% to <10% of subjects) or very common (occurring in >10% of subjects) are listed below by MedDRA System Organ Class. The frequency of other adverse events identified during post-marketing use is unknown.
Blood and lymphatic system disorders
Unknown: haemolytic anaemia, blood dyscrasias Immune system disorders:
Unknown: allergic reaction, angioedema, anaphylactic reactions Metabolism and nutritional disorders:
Unknown: anorexia
Psychiatric disorders:
Unknown: confusion*, excitation*, irritability*, nightmares*, depression
Nervous system disorders*:
Very common: sedation, somnolence
Common: disturbance in attention, abnormal coordination, dizziness, headache
Eye disorders:
Common: blurred vision
Ear and labyrinth disorders
Unknown: tinnitus
Cardiac disorders:
Unknown: palpitations, tachycardia, arrythmias Vascular disorders:
Unknown: Hypotension
Respiratory, thoracic and Mediastinal disorders:
Unknown: thickening of bronchial secretions Gastrointestinal disorders:
Common: nausea, dry mouth
Unknown: vomiting, abdominal pain, diarrhoea, dyspepsia
Hepatobiliary disorders:
Unknown: hepatitis including jaundice Skin and subcutaneous disorders:
Unknown: exfoliative dermatitis, rash, urticaria, photosensitivity, Musculoskeletal and connective tissue disorders:
Unknown: muscular twitching, muscle weakness.
Renal and Urinary disorders:
Unknown: Urinary retention
General disorders and administration site conditions:
Common: fatigue Unknown: chest tightness
*Children and the elderly are more susceptible to neurological anticholinergic effects and paradoxical excitation (eg increased energy, restlessness, nervousness)
Reporting of suspected adverse reactions
Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via the Yellow Card Scheme at:www.mhra. gov.uk/yel l owcard.
4.9 Overdose
Symptoms and signs
The estimated lethal dose of chlorphenamine is 25 to 50mg/kg body weight. Symptoms and signs include sedation, paradoxical excitation of the CNS, toxic psychosis, convulsions, apnoea, anticholinergic effects, dystonic reactions and cardiovascular collapse including arrhythmias.
Treatment
Symptomatic and supportive measures should be provided with special attention to cardiac, respiratory, renal and hepatic functions and fluid and electrolyte balance. If overdosage is by the oral route, treatment with activated charcoal should be considered provided there are no contraindications for use and the overdose has been taken recently (treatment is most effective if given within an hour of ingestion). Treat hypotension and
arrhythmias vigorously. CNS convulsions may be treated with i.v. diazepam. Haemoperfusion may be used in severe cases.
5 PHARMACOLOGICAL PROPERTIES
5.1 Pharmacodynamic properties
ATC Code R06AB02
Chlorphenamine is a potent antihistamine (^-antagonist).
Antihistamines diminish or abolish the actions of histamine in the body by competative reversible blockade of histamine H1-receptor sites on tissues. Chlorphenamine also has anticholinergic activity.
Antihistamines act to prevent the release of histamine, prostaglandins and leukotrines and have been shown to prevent the migration of inflammatory mediators. The actions of chlorphenmine include inhibition of histamine on smooth muscle, cappillary permeability and hence reduction of oedema and wheal in hypersensitivity reactions such as allergy and anaphylaxis.
5.2 Pharmacokinetic properties
Chlorphenamine is well absorbed from the gastro-intestinal tract, following oral administration. The effects develop within 30 minutes, are maximal within I to 2 hours and last 4 to 6 hours. The plasma half-life has been estimated to be 12 to 15 hours.
Chlorphenamine is metabolised to the monodesmethyl and didesmethyl derivatives. About 22% of an oral dose is excreted unchanged in the urine.
5.3 Preclinical safety data
No additional data of relevance.
6 PHARMACEUTICAL PARTICULARS
6.1 List of excipients
Syrup Glycerol Ethanol Tingle flavour Peppermint oil
Mixture of methyl, ethyl and propyl hydroxybenzoates (E 218, E 214, E 216)
Purified Water
6.2 Incompatibilities
None known
6.3 Shelf life
3 years.
6.4 Special precautions for storage
Store below 25°C. Protect from light
6.5 Nature and contents of container
Amber glass bottle containing 150ml Piriton Syrup. Supplied with a measuring spoon or
Amber plastic bottle containing 150ml Piriton Syrup. Supplied with a measuring spoon
6.6 Special precautions for disposal
For detailed instructions for use refer to the Patient Information Leaflet in every pack.
7 MARKETING AUTHORISATION HOLDER
GlaxoSmithKline Consumer Healthcare (UK) Trading Limited,
980 Great West Road
Brentford
Middlesex
TW8 9GS
United Kingdom
8 MARKETING AUTHORISATION NUMBER(S)
PL 44673/0094
DATE OF FIRST AUTHORISATION/RENEWAL OF THE AUTHORISATION
14/02/1997 / 27/10/2005
10
DATE OF REVISION OF THE TEXT
24/03/2016