Advil Allergy & Congestion is used for the symptomatic treatment of cold, flu, and upper respiratory tract symptoms. It contains three ingredients:

• an NSAID - Ibuprofen,
• a Vasoconstrictor drug (alpha agonist) - Phenylephrine, and
• an antihistamine - chlorpheniramine

Ibuprofen, phenylephrine, and chlorpheniramine Uses:

• Common cold and upper respiratory allergies:

  • Temporarily relieves common cold, hay fever, and other upper respiratory symptoms (eg, runny nose, itchy watery eyes; itching of the nose or throat, sneezing, nasal congestion, sinus pressure, headache, minor body aches and pains, fever).

Ibuprofen, phenylephrine, and chlorpheniramine Dose in Adults:

Advil Allergy & Congestion Dose in the treatment of Common cold and upper respiratory allergies:

• P/O: One tablet (ibuprofen 200 mg/phenylephrine 10 mg/chlorpheniramine 4 mg) q4 hours.
• Do not exceed: 6 tablets (ibuprofen 1,200 mg/phenylephrine 60 mg/chlorpheniramine 24 mg)/ 24 hours

Ibuprofen, phenylephrine, and chlorpheniramine Dose in Children:

Refer to adults dosing.

Ibuprofen, phenylephrine, and chlorpheniramine Dose in Pregnancy & Laction

See Individual drugs (Ibuprofen, Phenylephrine, and Chlorpheniramine)

Dose in Kidney Disease:

Use with caution; No dosage adjustments provided in the manufacturer’s labeling

Dose in Liver disease:

Use with caution; No dosage adjustments provided in the manufacturer’s labeling

Advil Allergy & Congestion Side effects:

See individual agents (Ibuprofen, phenylephrine, and chlorpheniramine)

Contraindications to Advil Allergy & Congestion (ibuprofen, phenylephrine, and chlorpheniramine):

• Use this medication only for self-medication. Do not use if your body is sensitive to any pain reliever/fever reduction.
• Children younger than 12 years
• Before or after cardiac surgery
• Or, in combination with or within 14-days of stopping a monoamine oxide inhibitor (MAOI).

Warnings and precautions

• Anaphylactoid reactions

  • Even patients who have never been exposed to an allergic reaction, anaphylactoid reactions can occur.
  • Patients who suffer from the "aspirin trifecta" (bronchial asthma, aspirin sensitivity, and rhinitis) may be at higher risk.
  • Not to be administered to individuals using NSAIDs or aspirin who also have bronchospasm, asthma, rhinitis, or urticaria.

• Cardiovascular events

  • A deadly MI or stroke, as well as other serious (and perhaps fatal) adverse cardiovascular thrombotic events, are all made more likely by NSAID use.
  • This danger can materialise during treatment and could get worse as treatment continues.
    Acute or deteriorating hypertension can lead to the development of hypertension. NSAIDs may alter how some medications react when used.also maybe linked to cardiovascular events
  • Hypertension patients should be cautious and keep an eye on their BP.
  • It may cause fluid retention and sodium buildup; caution is advised for patients at high risk of developing edema.
  • Patients with heart disease should not use this product.
  • If you have a history or recent MI, do not use this medication unless the benefits outweigh any potential cardiovascular thrombotic events.
  • To reduce cardiovascular events, the lowest effective dose should only be used for the most short time possible. Patients at high risk may also consider alternative therapies.

• CNS depression:

  • CNS depression can lead to impairment of mental or physical abilities.
  • Patients should be warned about driving or operating machinery that requires mental alertness.

• Events GI:

  • NSAIDs can cause serious GI inflammation, bleeding, ulceration, and even death.
  • Patients who have a history of peptic ulcer disease or prior gastrointestinal bleeding are more likely to experience major GI problems.
  • These things can happen at any time while you're in therapy.
  • Patients with active GI bleeding should not use.
  • Non-aspirin NSAIDs shouldn't be given to patients who have a history of or a propensity for acute lower GI bleeding.
  • Concurrent therapy, if used with caution, can increase the risk for GI bleeding in patients who have had GI ulcers 
  • The shortest amount of time at the lowest effective dose should be utilised to reduce cardiovascular events. This is in line with the objectives of each patient.
  • For patients with high-risk conditions, consider alternative therapies.

• Hematologic effects

  • Reduces platelet adhesion
  • May prolong BT (bleeding Time)
  • Aggregation
  • Patients with coagulation disorders and those on anticoagulant therapy need to be closely monitored.
  • Anemia may occur.
  • Rarely, NSAIDs may cause severe blood disorders (eg, thrombocytopenia or agranulocytosis), but it is possible.

• Hyperkalemia:

  • The use of NSAIDs may raise the risk of hyperkalemia, especially in older adults, diabetics, those with kidney disease, and people taking other medications that can cause hyperkalemia (such as ACE-inhibitors and spironolactone).
  • Potassium should always be monitored closely

• Effects on the renal system:

  • Renal function may be hampered by NSAIDs. A dose-dependent decrease in prostaglandin production is to blame for this.
  • This lowers renal blood flow, which could result in renal decompensation (usually reversible).
  • Patients who take diuretics or ACE inhibitors, have hypovolemia, have heart failure, or have poor renal function are more likely to have nephrotoxicity.
  • Patients should be hydrated before beginning therapy.

• Reactions to skin:

  There may be an increased chance of serious skin adverse reactions from NSAIDs.
  • Exfoliative dermatitis
  • Stevens-Johnson syndrome (SJS)
  • Toxic epidermal necrolysis (TEN).
  • Stop using the product immediately if you develop skin rash or other hypersensitivity.

• Aseptic meningitis

  • Aseptic meningitis is more common in patients who have systemic lupus erymatosus (SLE), and those with mixed connective tissue disorders that include NSAID use.

• Asthma

  • Patients with asthma that is aspirin-sensitive should not be given. This can lead to severe bronchospasm.
  • Patients with other forms or asthma should be cautious.

• Bariatric surgery

  • Gastric ulceration: Do not use P/O nonselective, NSAIDs for long periods of time after bariatric surgery.
  • Perforations and anastomotic ulceration can develop.
  • Celecoxib and IV ketorolac are recommended for short-term pain relief after surgery.

• Diabetes:

  • Diabetes patients should be cautious.

• Hepatic impairment

  • Patients with hepatic impairment should be cautious as there is an increased chance of GI bleeding from NSAIDs.

• Increased intraocular pressure

  • Patients with higher IOP should be cautious.

• Prostatic hyperplasia, urinary obstruction

  • Take care.

• Renal impairment

  • Take care.

• Thyroid disease:

  • Take care.

Monitoring parameters:

• Relief of symptoms
• Signs and symptoms of GI adverse effects (abdominal pain, bleeding)
• Signs and symptoms of hypersensitivity.

How to administer Advil Allergy & Congestion?

Administer with food or milk if gastric upset occurs.

Mechanism of action of Ibuprofen, phenylephrine, and chlorpheniramine:

Ibuprofen:

• Reversible inhibition of cyclooxygenase-1 (COX-1) enzymes. This results in decreased production of prostaglandin precursors.
• It has antipyretic, analgesic and anti-inflammatory properties.

Phenylephrine:

• Decreases nasal congestion by stimulating postsynaptic alpha-receptors, which causes vasoconstriction.

Chlorpheniramine:

• Histamine is competitively antagonistic at histamine 1 receptor sites.

See individual agents.

International Brands of Ibuprofen, phenylephrine, and chlorpheniramine:

• Advil Allergy & Congestion
• Aseptobron Antigripal NF

Ibuprofen, phenylephrine, and chlorpheniramine Brands Names in Pakistan:

No Brands Available in Pakistan.