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Do not use this medication if you are allergic to Pamelor, or if you have recently had a heart attack. Do not use Pamelor if you have used an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days. Serious, life-threatening side effects can occur if you take Pamelor before the MAO inhibitor has cleared from your body.

Before taking Pamelor, tell your doctor if you are allergic to any drugs, or if you have:

* heart disease;
* a history of heart attack, stroke, or seizures;
* bipolar disorder (manic-depression);
* schizophrenia or other mental illness;
* diabetes (Pamelor may raise or lower blood sugar);
* overactive thyroid;
* glaucoma; or
* problems with urination.

If you have any of these conditions, you may need a dose adjustment or special tests to safely take Pamelor.

You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Tell your doctor if you have worsening symptoms of depression or suicidal thoughts during the first several weeks of treatment, or whenever your dose is changed.

Your family or other caregivers should also be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether Pamelor passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Older adults may be more likely to have side effects from this medication. Do not give this medication to anyone under 18 years old without the advice of a doctor.

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* Elavil may cause dizziness, drowsiness, or blurred vision. Do not drive, operate machinery, or do anything else that could be dangerous until you know how you react to Elavil . Using Elavil alone, with other medicines, or with alcohol may lessen your ability to drive or perform other potentially dangerous tasks.
* Avoid drinking alcohol or taking other medicines that cause drowsiness (eg, sedatives, tranquilizers) while taking Elavil . Elavil will add to the effects of alcohol and other depressants. Ask your pharmacist if you have questions about which medicines are depressants.
* Elavil may cause dizziness, lightheadedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects.
* Involuntary and uncontrollable movements may develop in patients taking Elavil . Occurrence is highest among the elderly, especially women. The risk of developing these involuntary movements and the likelihood they will become permanent are increased with long-term use and with high doses. However, it is possible to develop these symptoms after short-term use at low doses. Contact your health care provider at once if any of the following occur: involuntary movements of the tongue, face, mouth, or jaw (eg, protrusion of tongue, puffing of cheeks, puckering of mouth, chewing movements), sometimes accompanied by involuntary movements of the arms and legs.
* Elavil may cause sensitivity to sunlight. Avoid prolonged exposure to the sun and other ultraviolet light (eg, tanning beds). Use sunscreens and wear protective clothing until tolerance is determined.
* Do not become overheated in hot weather or during exercise or other activities since heatstroke may occur.
* Children, teenagers, and young adults who take Elavil may be at increased risk for suicidal thoughts or actions. Watch all patients who take Elavil closely. Contact the doctor at once if new, worsened, or sudden symptoms such as depressed mood; anxious, restless, or irritable behavior; panic attacks; or any unusual change in mood or behavior occur. Contact the doctor right away if any signs of suicidal thoughts or actions occur.
* Diabetes patients - Elavil may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.
* Before you have any medical or dental treatments, emergency care, or surgery, tell the doctor or dentist that you are using Elavil .
* Use caution in the ELDERLY; they may be more sensitive to its effects, especially lightheadedness upon standing; rapid heartbeat; breathing problems; difficult urination; and constipation.
* PREGNANCY and BREAST-FEEDING: Elavil has been shown to cause harm to the human fetus. If you plan on becoming pregnant, discuss with your doctor the benefits and risks of using Elavil during pregnancy. Elavil is excreted in the breast milk. Do not breast-feed while taking Elavil.

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Do not take Pheniramine if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) in the last 14 days. A dangerous drug interaction could occur, leading to serious side effects.

Do not take other over-the-counter cough, cold, allergy, diet, or sleep aids while taking Pheniramine without first talking to your doctor or pharmacist. Other medications may also contain pheniramine, pyrilamine, phenyltoloxamine, phenylpropanolamine, or other similar drugs. You may accidentally take too much of these medicines.

Pheniramine may increase the effects of other drugs that cause drowsiness, including antidepressants, alcohol, other antihistamines, pain relievers, anxiety medicines, seizure medicines, and muscle relaxants. Dangerous sedation, dizziness, or drowsiness may occur if Pheniramine is taken with any of these medications.

Drugs other than those listed here may also interact with Pheniramine. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including herbal products.

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Serious side effects are unlikely to occur. Stop taking Pheniramine and seek emergency medical attention if you experience an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives).

Other, less serious side effects may be more likely to occur. Continue to take Pheniramine and talk to your doctor or try another similar medication if you experience

* dryness of the eyes, nose, and mouth;
* drowsiness or dizziness;
* blurred vision;
* difficulty urinating; or
* excitation in children.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

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Use caution when driving, operating machinery, or performing other hazardous activities. Pheniramine may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities. Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while taking Pheniramine.

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Seek emergency medical attention. Symptoms of a Pheniramine overdose include a dry mouth, large pupils, flushing, nausea, and vomiting.

Pheniramine missed dose

Take the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the missed dose and take only the next regularly scheduled dose. Do not take a double dose of this medication.

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Take Pheniramine exactly as directed. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.

Take each dose with a full glass of water. Do not crush, chew, or break the long-acting or sustained-release forms of this medication. Swallow them whole. If you are unsure about the formulation of the medicine, ask your pharmacist for help.

If you cannot swallow the tablets or capsules, look for a liquid form of this medication.

To ensure that you get a correct dose, measure the liquid form of Pheniramine with a special dose-measuring spoon or cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist where you can get one. Do not take more of this medication than is recommended. An overdose can cause serious harm.

Do not take Pheniramine for longer than 7 days in a row. If your symptoms do not improve, if they get worse, or if you have a fever, talk to your doctor.

Store Pheniramine at room temperature away from moisture and heat.

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Do not take Pheniramine if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) in the last 14 days. A dangerous drug interaction could occur, leading to serious side effects.

Before taking this medication, tell your doctor if you have

* kidney disease,
* liver disease,
* diabetes,
* glaucoma,
* any type of heart disease or high blood pressure,
* thyroid disease,
* emphysema or chronic bronchitis, or
* difficulty urinating or an enlarged prostate.

You may not be able to take Pheniramine, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.

Pheniramine is in the FDA pregnancy category B. This means that it is unlikely to harm an unborn baby. Do not take this medication without first talking to your doctor if you are pregnant. Pheniramine passes into breast milk and may harm a nursing infant. Do not take this medication without first talking to your doctor if you are breast-feeding a baby. If you are over 65 years of age, you may be more likely to experience side effects from Pheniramine. You may require a lower dose of this medication. Read the package label for directions or consult your doctor or pharmacist before treating a child with this medication. Children are more susceptible than adults to the effects of medicines and may have unusual reactions.

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Phenylpropanolamine, an ingredient in this product, has been associated with an increased risk of hemorrhagic stroke (bleeding into the brain or into tissue surrounding the brain) in women. Men may also be at risk. Although the risk of hemorrhagic stroke is low, the U.S. Food and Drug Administration (FDA) recommends that consumers not use any products that contain phenylpropanolamine.

Use caution when driving, operating machinery, or performing other hazardous activities. Pheniramine may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities. Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while taking this medication.

Do not take more of this medication than is recommended. If your symptoms do not improve, or if they worsen, talk to your doctor.

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Generic Name: pheniramine (fen IR a meen/pie RILL a meen)

What is Pheniramine?

Pheniramine, pyrilamine, and phenyltoloxamine are antihistamines. They block the effects of the naturally occurring chemical histamine in the body. Pheniramine, pyrilamine, and phenyltoloxamine prevent sneezing; itchy, watery eyes and nose; and other symptoms of allergies and hay fever.

Phenylpropanolamine is a decongestant. It constricts (shrinks) blood vessels (veins and arteries). This reduces the blood flow to certain areas and allows nasal and respiratory (breathing) passages to open up.

Pheniramine is used to treat nasal congestion and sinusitis (inflammation of the sinuses) associated with allergies, hay fever, and the common cold.

Phenylpropanolamine, an ingredient in this product, has been associated with an increased risk of hemorrhagic stroke (bleeding into the brain or into tissue surrounding the brain) in women. Men may also be at risk. Although the risk of hemorrhagic stroke is low, the U.S. Food and Drug Administration (FDA) recommends that consumers not use any products that contain phenylpropanolamine.

Pheniramine may also be used for purposes other than those listed in this medication guide.

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