Alahist CF
Alahist CF is a combination of three medications: dexbrompheniramine (an antihistamine), dextromethorphan (a cough suppressant), and phenylephrine (a decongestant). It's used to treat allergy and common cold symptoms in adults and children, such as cough, runny nose, and itchy or watery eyes. Alahist CF is a tablet that's taken by mouth, typically every 4 to 6 hours. The combination of medications (dexbrompheniramine, dextromethorphan, and phenylephrine) can also be found as oral solutions under other brand names, such as Brantussin DM. Some side effects of Alahist CF include sleepiness, dizziness, and dry mouth.
What is Alahist CF?
What is Alahist CF used for?
Short-term relief of symptoms from allergies and the common cold:
Cough from throat and lung irritation
Runny nose
Sneezing
Itchy or watery eyes
Itching of the nose or throat
Stuffy nose (nasal congestion)
How Alahist CF works
Alahist CF is a combination of three medications that work together to relieve symptoms caused by allergies and the common cold.
Dexbrompheniramine is a first-generation antihistamine. It blocks a natural substance in your body called histamine. In doing so, dexbrompheniramine lowers inflammation (swelling) and relieves runny nose, itchy nose, and sneezing.
Dextromethorphan is a cough suppressant. It works in the brain to lower your urge to cough.
Phenylephrine is a decongestant. It's thought to work by narrowing the blood vessels in the nose to relieve sinus pressure.
Drug Facts
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What are the side effects of Alahist CF?
Common Side Effects
- Sleepiness
- Restlessness
- Dizziness
- Dry mouth, nose, or throat
Other Side Effects
- Trouble sleeping
- Trouble urinating
Serious Side Effects
- Serotonin syndrome: fast heart rate, sweating, muscle stiffness or spasms, high fever, confusion
Source:Â DailyMed
The following side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Heart palpitations—rapid, pounding, or irregular heartbeat
- Increase in blood pressure
- Sudden eye pain or change in vision such as blurry vision, seeing halos around lights, vision loss
- Trouble passing urine
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
- Anxiety, nervousness
- Confusion
- Constipation
- Dizziness
- Drowsiness
- Dry mouth
- Fatigue
Pros and cons of Alahist CF
Pros
Convenient to take three medications in a single product (e.g., liquid, tablet)
Starts working within 30 minutes to an hour
Can treat a wide variety of allergy and common cold symptoms
Available over the counter
Cons
Might need to take multiple times a day
More difficult to customize the dose since Alahist CF is a fixed combination of three medications
Alahist CF tablets are available as a brand-name medication only
Older adults are at higher risk for sleepiness
Pharmacist tips for Alahist CF
You can take Alahist CF with or without food. If it upsets your stomach, try taking the medication with food.
The dexbrompheniramine (an antihistamine) and dextromethorphan (a cough suppressant) in Alahist CF can make you feel sleepy or dizzy during the day. This can affect your ability to think, or react. Don't drive or do any task that needs a lot of focus until you know how the medication affects you.
The dexbrompheniramine (an antihistamine) and phenylephrine (a decongestant) in Alahist CF might cause children to become overly excited or energetic. Stop Alahist CF and speak to a pediatrician if this happens to your child.
If you're pregnant or breastfeeding, don't take Alahist CF until you've talked to a healthcare provider first about the risks and benefits of taking this medication. It's not clear how safe it is to take Alahist CF while pregnant or breastfeeding.
Alahist CF is only meant to temporarily relieve cold or flu symptoms. If your symptoms worsen or last longer than a week, or you start to have a fever or rash, let your healthcare team know. These might be signs that you need more medical attention.
Stop taking Alahist CF and contact your healthcare team if you experience dizziness, nervousness, or trouble sleeping. These might be side effects from the phenylephrine or other medications in Alahist CF. Depending on how severe your symptoms are, your care team might lower your dose of Alahist CF or ask you to consider alternative medications.
Read the ingredients label on all the medications you're taking. Many over-the-counter cold and flu medications contain the same ingredients as those in Alahist CF. Taking more than one cough suppressant, antihistamine, or decongestant at the same time can raise the risk of overdose and severe side effects, such as agitation and trouble breathing.
Don't take Alahist CF at the same time as or within 2 weeks of taking a monoamine oxidase inhibitor (MAOI), such as selegiline. Doing so can raise your risk for severe side effects, like serotonin syndrome and dangerously high blood pressure. If needed, contact your primary care provider for other options to treat your cold or allergy symptoms.
More tips for oral liquids containing dexbrompheniramine / dextromethorphan / phenylephrine (e.g., Brantussin DM)
Store Brantussin DM or other liquid formulations of this medication at room temperature. Keep the medication in the original bottle it came in.
Use a medication dose cup or an oral syringe to measure your dose of Brantussin DM. Don't use household spoons, because they might not be accurate and might cause you to take the wrong dose. Ask your pharmacy to provide you with one if the product doesn't include it in its packaging.
Frequently asked questions about Alahist CF
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What are the risks and warnings for Alahist CF?
Alahist CF can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Serotonin syndrome
Risk factors: Taking monoamine oxidase inhibitors (MAOI) 14 days before starting Alahist CF | Taking other medications that raise serotonin levels in your brain
The dextromethorphan in Alahist CF can raise your risk for serotonin syndrome, a rare, but potentially life-threatening side effect. Your risk is higher if you're also taking other medications that affect serotonin levels, such as certain antidepressants, MAOIs, and certain migraine medications.
Make sure your healthcare team knows about all the medications you take (including over-the-counter medications and supplements) before starting Alahist CF so they can make sure this medication is safe for you to take. Don't start any new medications while taking Alahist CF without letting your pharmacist or prescriber know. Symptoms of serotonin syndrome include fast heart rate, sweating, muscle stiffness or spasms, high fever, and confusion. Get medical help right away if you have any of these symptoms.
Accidental overdose
Alahist CF contains an antihistamine (dexbrompheniramine), cough suppressant (dextromethorphan), and a decongestant (phenylephrine), which are all in many other over-the-counter products. Taking more than one medication containing an antihistamine, cough suppressant, or a decongestant can lead to an accidental overdose, which can be life-threatening.
To prevent an accidental overdose, read the medication box and package labels carefully so you're aware of the ingredients, age-cut offs, and maximum dosing of your particular product. If you're not sure, ask your pharmacist to help you check for medication interactions.
Some signs of taking too much medication can include anxiety or other behavior changes, high blood pressure, and trouble breathing. If you or your loved one experiences an accidental overdose, get medical help as soon as possible.
Worsening of certain medical conditions
Risk factors: Cough from smoking, asthma, or emphysema | Mucus-producing cough | Breathing problems | Heart disease or high blood pressure | Thyroid problems | High blood sugar (diabetes) | Glaucoma | Urinary problems
Let your primary care provider and pharmacist know about all the medical conditions you have before you start taking Alahist CF. Ask them whether this medication is safe for you to take.
People who are 65 years of age or older might feel side effects from Alahist CF more intensely. In addition, Alahist CF might worsen certain medical conditions, such as high blood pressure and glaucoma. This medication also might not be appropriate for your condition. For example, you might need other treatment if you have a cough that's lasted for a long time; a cough that occurs with smoking, asthma, or emphysema; or a cough with a lot of mucus.
Alahist CF dosage forms
| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 2mg/20mg/10mg | 20 tablets | $16.72 | $0.84 |
Typical dosing for Alahist CF
Dexbrompheniramine / dextromethorphan / phenylephrine combinations are made by several manufacturers. Be sure to check the medication box for specific instructions for your product.
Some examples include:
Tablets:
Alahist CF: Each tablet contains 2 mg of dexbrompheniramine, 20 mg of dextromethorphan, and 10 mg of phenylephrine.
People ages 12 years or older: The typical dose is 1 tablet by mouth every 4 to 6 hours. Don't take more than 6 tablets in a 24-hour period.
Children ages 6 years to under 12 years old: The typical dose is one-half tablet by mouth every 4 to 6 hours. Don't take more than 3 tablets in a 24-hour period.
Children under 6 years old: Ask your child's pediatrician for an alternative option.
Liquids:
Brantussin DM and generic equivalent: Each 5 mL of solution contains 2 mg of dexbrompheniramine, 15 mg of dextromethorphan, and 7.5 mg of phenylephrine.
People ages 12 years or older: The typical dose is 5 mL by mouth every 4 to 6 hours. Don't take more than 30 mL in a 24-hour period.
Children ages 6 years to under 12 years old: The typical dose is 2.5 mL by mouth every 4 to 6 hours. Don't take more than 15 mL in a 24-hour period.
Children under 6 years old: Ask your child's pediatrician.
Bionatuss DXP: Each 5 mL of solution contains 2 mg of dexbrompheniramine, 20 mg of dextromethorphan, and 10 mg of phenylephrine.
People ages 12 years or older: The typical dose is 5 mL by mouth every 4 hours. Don't take more than 30 mL in a 24-hour period.
Children ages 6 years to under 12 years old: The typical dose is 2.5 mL by mouth every 4 hours. Don't take more than 15 mL in a 24-hour period.
Children under 6 years old: Ask your child's pediatrician.
How much does Alahist CF cost?
Alahist CF contraindications
Currently take or have taken a monoamine oxidase inhibitor (MAOI) in the last 2 weeks
What are alternatives to Alahist CF?
Short-term relief of symptoms from allergies and the common cold:
Cough from throat and lung irritation
Runny nose
Sneezing
Itchy or watery eyes
Itching of the nose or throat
Stuffy nose (nasal congestion)
Cough from throat and lung irritation
Runny nose
Sneezing
Itchy or watery eyes
Itching of the nose or throat
Stuffy nose (nasal congestion)
Runny nose
Sneezing
Itchy nose or throat
Itchy, watery eyes
Cough
Stuffy nose (nasal congestion)
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References
Best studies we foundAddGen Pharmaceuticals, Inc. (2023). Dexbrompheniramine-DM-phenylephrine 2-15-7.5- dexbrompheniramine maleate, dextromethorphan hydrobromide and phenylephrine hydrochloride liquid [package insert]. DailyMed.
Advanced Generic Corporation. (2020). Bionatuss DXP- dexbrompheniramine maleate, dextromethorphan, phenylephrine liquid [package insert]. DailyMed.
Atkinson, H. C., et al. (2015). Potential cardiovascular adverse events when phenylephrine is combined with paracetamol: Simulation and narrative review. European Journal of Clinical Pharmacology.
Borowy, C. D., et al. (2023). Antihistamine toxicity. StatPearls.
Brandywine Pharmaceuticals, LLC. (2024). Brantussin DM- dexbrompheniramine maleate, dextromethorphan hbr, phenylephrine hcl liquid [package insert]. DailyMed.
Department of Justice/Drug Enforcement Administration. (2020). Narcotics.
Gelotte, C. K., et al. (2015). Pharmacokinetics, safety, and cardiovascular tolerability of phenylephrine HCl 10, 20, and 30 mg after a single oral administration in healthy volunteers. Clinical Drug Investigation.
Hoeft, D. (2014). An overview of clinically significant drug interactions between medications used to treat psychiatric and medical conditions. Mental Health Clinician.
Oh, S., et al. (2023). Dextromethorphan. StatPearls.
Poly Pharmaceuticals, Inc. (2022). Alahist CF- dexbrompheniramine maleate, dextromethorphan hbr, phenylephrine hcl tablet [package insert]. DailyMed.
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