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Alahist DM

dextromethorphan / phenylephrine / pheniramine
Used for Nasal Congestion, Allergic Rhinitis, Allergic Conjunctivitis, Cold Symptoms, Cough
Used for Nasal Congestion, Allergic Rhinitis, Allergic Conjunctivitis, Cold Symptoms, Cough

Alahist DM is a combination medication containing three active ingredients: dextromethorphan (a cough suppressant), pheniramine (an antihistamine), and phenylephrine (a decongestant). It's used in adults and children to treat symptoms caused by allergies and the common cold, such as cough, runny nose, and congestion. Alahist DM is taken by mouth, typically every 4 to 6 hours. Possible side effects of this medication include sleepiness and dizziness. It's available over the counter as a sugar-free, alcohol-free, dye-free flavored liquid.

Last reviewed on April 25, 2024
basics-icon

What is Alahist DM?

What is Alahist DM used for?

Short-term relief of symptoms from allergies and the common cold:

  • Runny nose

  • Sneezing

  • Itchy or watery eyes

  • Itching of the nose or throat

  • Cough from throat and lung irritation

  • Stuffy nose (nasal congestion)

How Alahist DM works

Alahist DM is a combination of three medications that work together to relieve symptoms caused by allergies and the common cold.

Drug Facts

Common BrandsAlahist DM
Drug Class Cough suppressant / Antihistamine / Decongestant
Controlled Substance ClassificationNot a controlled medication
Generic StatusNo lower-cost generic available
AvailabilityOver-the-counter
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Avg retail price
$34.79(save 3.03%)
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$33.74
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What are the side effects of Alahist DM?

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

Other Side Effects

Serious Side Effects

Contact your healthcare provider immediately if you experience any of the following.
  • Serotonin syndrome: fast heart rate, sweating, muscle stiffness or spasms, high fever, confusion

Source: 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):

pros-and-cons

Pros and cons of Alahist DM

thumbs-up

Pros

Starts working within 30 minutes to an hour

Available over the counter as a sugar-free, alcohol-free, dye-free flavored liquid

More convenient to take a product that's a combination of three medications

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Cons

Might need to take multiple times a day

More difficult to customize the dose since Alahist DM is a fixed combination of three medications

Older adults are at higher risk for sleepiness

pharmacist-tips

Pharmacist tips for Alahist DM

pharmacist
  • You can take Alahist DM with or without food. If it upsets your stomach, try taking the medication with food.

    • Use a medication dose cup or an oral syringe to measure out your dose of Alahist DM. Don't use household kitchen spoons because they might not be accurate and using them might cause you to take the wrong dose. Ask your pharmacist for a measuring device for your doses if the medication doesn't come with one.

      • The pheniramine (antihistamine) and dextromethorphan (a cough suppressant) in Alahist DM can make some people sleepy or dizzy during the day. This might affect how well you can focus, think, and react. Don't drive until you know how Alahist DM affects you.

        • Avoid drinking alcohol while you're taking Alahist DM because doing so can make sleepiness worse.

          • Although pheniramine (antihistamine) and dextromethorphan (a cough suppressant) usually make adults sleepy, they can cause children to become overly excited or energetic. Stop Alahist DM and speak to a pediatrician if this happens to your child.

            • If your symptoms worsen or last longer than a week even after starting Alahist DM, or you start to have a fever or rash, contact your primary care provider. These might be signs of a more serious condition.

              • 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 DM. 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.

                faqs

                Frequently asked questions about Alahist DM

                What's the difference between Alahist CF and Alahist DM?
                Both Alahist DM and Alahist CF are over-the-counter combination products containing three medications that treat common cold and allergy symptoms. They both have dextromethorphan (cough suppressant) and phenylephrine (decongestant), but they each a different antihistamine. Alahist CF contains dexbrompheniramine whereas Alahist DM contains pheniramine. In addition, Alahist CF comes as a tablet, but Alahist DM comes as a liquid. Ask your pharmacist or primary care provider if you have more questions about either medication.
                Does Alahist DM make you sleepy?
                Yes, it's possible to feel sleepy after you take Alahist DM. It contains pheniramine and dextromethorphan, two medications that can cause sleepiness as a side effect. But Alahist DM also contains phenylephrine, which is a decongestant that can have the opposite effect and keep you awake. When you first start taking Alahist DM, pay attention to how it affects your sleep. Contact your primary care provider to discuss better options for you if it's making you too sleepy or interrupting your sleep and affecting your daily activities.
                Is Alahist DM a narcotic?
                No. Alahist DM isn't considered a narcotic because it doesn't have an opioid pain medication in it.
                Does Alahist DM have codeine in it?
                No, Alahist DM doesn't have codeine in it. Alahist DM is a combination medication that contains dextromethorphan, phenylephrine, and pheniramine.
                Is Alahist DM over the counter?
                Yes, Alahist DM is over the counter. But if you're having trouble finding Alahist DM at your local pharmacy, ask your pharmacist about other cold or allergy medications you can take instead.
                Can you take ibuprofen with Alahist DM?
                Ibuprofen (Advil) doesn't have any known interactions with the ingredients in Alahist DM. But ibuprofen (Advil) might not be an appropriate pain medication for people with certain medical conditions, such as those with heart problems and kidney problems. Before you take ibuprofen (Advil) with Alahist DM, check with your healthcare team to see if this combination is safe and appropriate for you.
                Can I take Alahist DM if I'm pregnant?
                If you're pregnant or breastfeeding, don't take Alahist DM until you've talked to a healthcare professional. There's limited information about whether products containing dextromethorphan, phenylephrine, or pheniramine are safe to take during pregnancy. Your healthcare team can talk with you about other options to treat your cold or allergy symptoms during pregnancy.
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                What are the risks and warnings for Alahist DM?

                Alahist DM 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.

                risk-warning

                Serotonin syndrome

                • Risk factors: Taking monoamine oxidase inhibitors (MAOI) 14 days before starting Alahist DM | Taking other medications that raise serotonin levels in your brain

                  The dextromethorphan in Alahist DM 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 DM so they can make sure this medication is safe for you to take. Don't start any new medications while taking Alahist DM 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.

                  risk-warning

                  Accidental overdose

                  Alahist DM contains a cough suppressant (dextromethorphan), an antihistamine (pheniramine), and a decongestant (phenylephrine). 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. Ask your primary care provider or pharmacist if you're not sure whether you're taking a medication that has the same or similar ingredients as Alahist DM.

                  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.

                  risk-warning

                  Worsening of certain medical conditions

                  • Risk factors: Breathing problems | Glaucoma | Urinary problems | Cough from smoking, asthma, or emphysema | Mucus-producing cough | Heart disease or high blood pressure | Thyroid problems | High blood sugar (diabetes)

                    Make sure your primary care provider and pharmacist know about all your medical conditions before you take Alahist DM. Ask them whether this medication is safe and appropriate for you.

                    People who are 65 years of age or older are at higher risk of more severe side effects from Alahist DM. In addition, Alahist DM might worsen the symptoms of 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.

                    dosage

                    Alahist DM dosage forms

                    The average cost for 1 bottle of 473ml of 10mg/12.5mg/5mg/5ml of Alahist DM is $33.74 with a free GoodRx coupon. This is 3.03% off the average retail price of $34.79.
                    bottle of liquid
                    Bottle of liquid
                    DosageQuantityPrice as low asPrice per unit
                    473ml of 10mg/12.5mg/5mg/5ml1 bottle$33.74$33.74

                    Typical dosing for Alahist DM

                    Each 5 mL of Alahist DM contains 10 mg of dextromethorphan, 12.5 mg of pheniramine, and 5 mg of phenylephrine.

                    • People ages 12 years or older: The typical dose is 10 mL by mouth every 4 to 6 hours. Don't take more than 60 mL in a 24-hour period.

                    • Children ages 6 years to under 12 years old: 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 under 6 years old: Ask your child's pediatrician.

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                    How much does Alahist DM cost?

                    To access savings, use a GoodRx coupon and pay just a fraction of the retail price.View prices & coupons
                    contraindications-icon

                    Alahist DM contraindications

                    Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Alahist DM will not be safe for you to take.
                    alternatives

                    What are alternatives to Alahist DM?

                    There are a number of medications that your doctor can prescribe in place of Alahist DM. Compare a few possible alternatives below.
                    Alahist DM
                    Used for:

                    Short-term relief of symptoms from allergies and the common cold:

                    • Runny nose

                    • Sneezing

                    • Itchy or watery eyes

                    • Itching of the nose or throat

                    • Cough from throat and lung irritation

                    • Stuffy nose (nasal congestion)

                    $33.74 Lowest GoodRx priceView Prices
                    Used for:
                    • Runny nose

                    • Sneezing

                    • Itchy nose or throat

                    • Itchy, watery eyes

                    • Cough

                    • Stuffy nose (nasal congestion)

                    $24.93 Lowest GoodRx priceView Prices
                    Used for:
                    • Cough from scratchy throat

                    • Runny nose

                    • Sneezing

                    • Itchy or watery eyes

                    • Stuffy nose

                    • Itchy nose or throat

                    $56.02 Lowest GoodRx priceView Prices

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                    References

                    Best studies we found

                    Borowy, C. D., et al. (2023). Antihistamine toxicity. StatPearls.

                    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.

                    View All References (3)
                    GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.
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