First-generation moderately sedating antihistamine
Updated · Methodology
Second line
Allergic rhinitis, symptomatic cold relief. Per ARIA 2023 – second-line after 2nd-generation. Dose 4 mg 3–4 times daily. Mostly as a component of OTC cold combinations.
ICD-10: J30.9 · ICD-11: CA08.0
The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.
Not recommended
Chlorpheniramine while breastfeeding. RID about 0.9%, Hale L3. Compatible as a single low dose. Long-term use may reduce milk supply and cause infant drowsiness. Avoid combination cold products with pseudoephedrine – a single 60 mg dose reduces milk supply by 24%.
Sources
ICD-10: T78.4 · ICD-11: 4A8Z
H1-receptor blocker, included in many OTC cold preparations (Coldrex, Theraflu). Moderate sedation, less than diphenhydramine. Lower anticholinergic activity.
Safe when indicated.
Hale L3. RID 0.9%. Compatible as single dose. Avoid pseudoephedrine combinations.
Reference information, not a clinical decision. Discuss feeding pauses or changes with your physician or an IBCLC.
Verbatim lines from the interaction sections, in the language of the label
«Medicamentos fotosensibilizantes: El uso concomitante de antihistamínicos con otros agentes fotosensibilizantes como amiodarona, quinidina, imipramina, doxepina, amitriptilina, griseofulvina…»AEMPS, section 4.5 · Open on CIMA
Opens the checker prefilled with this drug. Pick the second one from your regimen.
Summary of a multi-drug list →
Medicine list: everything you take in one place →
Chlorpheniramine is evaluated for the following indications with varying evidence strength: Allergic rhinitis (evidence tier B), Allergy during breastfeeding (evidence tier C). See the full indication matrix with dosing and citations above on this page.
Common side effects of Chlorpheniramine (≥ 1 in 100): Drowsiness, Dry mouth, Dizziness. See the Safety section for uncommon and serious reactions.
Safe when indicated.
Hale L3. RID 0.9%. Compatible as single dose. Avoid pseudoephedrine combinations.
Chlorpheniramine is contraindicated in: Hypersensitivity; Narrow-angle glaucoma; Prostatic hypertrophy; Age <2 years. Full list in the Safety section.
Direct links to regulator labels. Open in a new tab.
Desloratadine, Dexchlorpheniramine, Dimenhydrinate, Diphenhydramine, Ebastine, Levocetirizine, Rupatadine, Doxylamine/pyridoxine