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Allergies-Tell your doctor if you have ever had any unusual or allergic reaction to antihistamines or to amphetamine, dextroamphetamine (e.g., Dexedrine), ephedrine (e.g., Ephed II), epinephrine (e.g., Adrenalin), isoproterenol (e.g., Isuprel), metaproterenol (e.g., Alupent), methamphetamine (e.g., Desoxyn), norepinephrine (e.g., Levophed), phenylephrine (e.g., Neo-Synephrine), pseudoephedrine (e.g., Sudafed), PPA (e.g., Dexatrim), or terbutaline (e.g., Brethine).

Pregnancy-The occasional use of antihistamine and decongestant combinations is not likely to cause problems in the fetus or in the newborn baby. However, when these medicines are used at higher doses and/or for a long time, the chance that problems might occur may increase. For the individual ingredients of these combinations, the following apply:

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Alcohol-Some of these combination medicines contain alcohol. Too much use of alcohol during pregnancy may cause birth defects. Antihistamines-Antihistamines have not been shown to cause problems in humans. Phenylephrine-Studies on birth defects have not been done in either humans or animals with phenylephrine. Promethazine-Phenothiazines, such as promethazine (contained in some of these combination medicines [e.g., Phenergan-D]), have been shown to cause jaundice and muscle tremors in a few newborn infants whose mothers received phenothiazines during pregnancy. Also, the newborn baby may have blood clotting problems if promethazine is taken by the mother within 2 weeks before delivery. Pseudoephedrine-Studies on birth defects with pseudoephedrine have not been done in humans. In animal studies pseudoephedrine did not cause birth defects but did cause a decrease in average weight, length, and rate of bone formation in the animal fetus when administered in high doses.

Older adults-Confusion, difficult and painful urination, dizziness, drowsiness, dryness of mouth, or convulsions (seizures) may be more likely to occur in the elderly, who are usually more sensitive to the effects of this medicine. Also, nightmares or unusual excitement, nervousness, restlessness, or irritability may be more likely to occur in elderly patients.

Other medicines-Although certain medicines should not be used together at all, in other cases different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking antihistamines it is especially important that your health care professional know if you are taking any of the following:

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Alcohol-Effects such as drowsiness may be worsened. Anticholinergics (medicine for abdominal or stomach spasms or cramps)-Side effects, such as dryness of mouth, of antihistamines or anticholinergics may be more likely to occur Central nervous system (CNS) depressants-Effects, such as drowsiness, of CNS depressants or antihistamines may be worsened Digitalis glycosides (e.g., Digoxin)-Use of this medicine may affect heartbeats. Maprotiline (e.g., Ludiomil) or Tricyclic antidepressants (amitriptyline [e.g., Elavil], amoxapine [e.g., Asendin], clomipramine [e.g., Anafranil], desipramine [e.g., Pertofrane], doxepin [e.g., Sinequan], imipramine [e.g., Tofranil], nortriptyline [e.g., Aventyl], protriptyline [e.g., Vivactil], trimipramine [e.g., Surmontil])-Effects, such as drowsiness, of CNS depressants or antihistamines may be worsened; also, taking these medicines together may cause some of their side effects, such as dryness of mouth, to become more severe Monoamine oxidase (MAO) inhibitor activity ( isocarboxazid [e.g., Marplan], phenelzine [e.g., Nardil], procarbazine [e.g., Matulane], selegiline [e.g., Eldepryl], tranylcypromine [e.g., Parnate])-If you are now taking, or have taken within the past 2 weeks, any of the MAO inhibitors, the side effects of the antihistamines may become more severe; these medicines should not be used together Rauwolfia alkaloids (alseroxylon [e.g., Rauwiloid], deserpidine [e.g., Harmonyl], rauwolfia serpentina [e.g., Raudixin], reserpine [e.g., Serpasil])-These medicines may increase or decrease the effect of the decongestant Also, if you are taking one of the combinations containing pseudoephedrine and are also taking:

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