Alarzil

• Treatment and relief of allergic conditions including:
• Allergic rhinitis (hay fever)
• Urticaria (hives)
• Angioedema
• Atopic dermatitis and other allergic skin conditions
• Management of pruritus (itching) related to allergic reactions
• Adjunctive therapy in anaphylaxis management
• Prevention and treatment of allergic transfusion reactions
• Symptomatic relief of mild drug hypersensitivity reactions
• Sometimes used in combination cold and cough preparations to relieve allergy symptoms

• Route: Oral, intramuscular (IM), intravenous (IV), or topical depending on formulation
• Adults and Adolescents (≥12 years):
• Oral: 25 mg every 4 to 6 hours as needed, not exceeding 100 mg daily
• IM/IV: 22.7 to 45.4 mg per day divided into 2–3 doses
• Pediatrics (6 to 12 years):
• Oral: 12.5 mg every 4 to 6 hours; maximum 50 mg daily
• Elderly:
• Use lowest effective dose due to increased sensitivity to sedative effects
• Special Populations:
• Renal or hepatic impairment: Use cautiously; dose adjustments may be necessary
• Duration: Use for the shortest duration needed to control symptoms

Pheniramine maleate is a first-generation antihistamine that competitively blocks histamine H1 receptors on vascular smooth muscle and sensory nerve endings. This inhibition prevents the typical effects of histamine such as vasodilation, increased capillary permeability, and stimulation of sensory nerves responsible for itching and sneezing. Additionally, it crosses the blood-brain barrier, exerting sedative and anticholinergic effects by antagonizing central H1 receptors.

• Absorption: Rapid and complete oral absorption; peak plasma levels within 1–2 hours
• Distribution: Widely distributed including CNS penetration
• Metabolism: Extensively metabolized in the liver via hepatic enzymes
• Half-life: Approximately 12 to 15 hours
• Excretion: Primarily renal excretion as metabolites; minor amounts unchanged

• Pregnancy: FDA Category B; animal studies show no harm, but controlled human data are limited. Use only if clearly needed.
• Lactation: Excreted in breast milk in small amounts; caution advised due to potential infant sedation

• Class: Antihistamine
• Subclass: First-generation H1 receptor antagonist

• Known hypersensitivity to pheniramine or formulation excipients
• Neonates and premature infants (due to risk of CNS depression)
• Breastfeeding mothers (relative contraindication; use cautiously)
• Narrow-angle glaucoma and urinary retention (due to anticholinergic effects)
• Concurrent or recent use of monoamine oxidase inhibitors (MAOIs), unless medically supervised

• Use caution in patients with asthma or chronic obstructive pulmonary disease (may dry bronchial secretions)
• Increased risk of sedation, dizziness, and falls in elderly patients
• Avoid use with other CNS depressants or alcohol due to additive sedative effects
• Potential to lower seizure threshold; caution in epilepsy
• Monitor for paradoxical CNS stimulation, especially in children and elderly

• Common: Sedation, drowsiness, dry mouth, blurred vision, dizziness, urinary retention, gastrointestinal discomfort
• Serious but rare: Paradoxical CNS stimulation (insomnia, nervousness), allergic reactions (rash, angioedema), cardiac arrhythmias

• Enhanced CNS depression with alcohol, benzodiazepines, opioids, and other sedatives
• Additive anticholinergic effects with drugs such as tricyclic antidepressants and antipsychotics
• MAO inhibitors may prolong and intensify anticholinergic and sedative effects
• Possible decreased efficacy with cholinergic agents

• Emphasis on cautious use in elderly due to sedative and anticholinergic side effects
• Avoidance of concomitant use with other CNS depressants unless medically supervised
• No major changes in approved indications or dosing in recent years

• Store at controlled room temperature 20°C to 25°C (68°F to 77°F)
• Protect from moisture and light
• Keep container tightly closed
• Do not freeze
• Keep out of reach of children