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Triotann-S Pediatric®

This drug is a combination of two antihistamines, pyrilamine and chlorpheniramine, and a decongestant, phenylephrine. Triotann-S is used to treat symptoms associated with the common cold and hay fever, such as runny nose, itchy eyes, and sneezing.

Interactions with Herbs

Korean or Chinese ginseng (Panax ginseng)
Laboratory studies have shown that compounds found in Panax ginseng enhance the ability of phenylephrine to constrict blood vessels.1 Controlled studies are necessary to determine whether taking Panax ginseng at the same time as phenylephrine will enhance the beneficial effects of the drug.

Polygonum multiflorum
Many drugs used in the treatment of high blood pressure cause relaxation or dilation of blood vessels. Laboratory studies show that emodin, a compound in Polygonum multiflorum, also relaxes blood vessels. However, animal studies reveal that phenylephrine blocks the action of emodin.2 Controlled studies are needed to determine whether Polygonum multiflorum helps people with high blood pressure and whether phenylephrine blocks its beneficial effects.

Henbane (Hyoscyamus niger)
Antihistamines, including chlorpheniramine, can cause “anticholinergic” side effects such as dryness of mouth and heart palpitations. Henbane also has anticholinergic activity and side effects. Therefore, use of henbane with chlorpheniramine could increase the risk of anticholinergic side effects,3 though apparently no interactions have yet been reported. Henbane should not be taken except by prescription from a physician trained in its use, as it is extremely toxic.

Interactions with Foods and Other Compounds

Alcohol
Drinking alcoholic beverages together with antihistamines can enhance side effects such as drowsiness and dizziness.4 Consequently, people who are taking pyrilamine and chlorpheniramine should avoid alcohol, especially when staying alert is necessary.

Summary of Interactions for Triotann-S Pediatric

Depletion or interference Polygonum multiflorum*
Adverse interaction Henbane*
Side effect reduction/prevention None known
Supportive interaction Panax ginseng*
Reduced drug absorption/bioavailability None known

For the convenience of the reader, the information in the summary is categorized as follows: “Depletion or interference” indicates the drug may deplete or interfere with the absorption or function of the supplement or herb. “Adverse interaction” indicates that the supplement or herb used together with the drug may result in undesirable effects. “Side effect reduction/prevention” indicates the supplement or herb may reduce the likelihood and/or severity of a potential side effect caused by the drug. “Supportive interaction” indicates the supplement or herb may support or aid the function of the drug. “Reduced drug absorption/bioavailability” indicates that the supplement or herb may decrease the absorption and/or activity of the drug in the body. An asterisk (*) next to an item in the summary indicates that the interaction is supported only by weak, fragmentary, and/or contradictory scientific evidence.

References:

1. Kwan CY. Vascular effects of selected antiphypertensive drugs derived from traditional medicinal herbs. Clin Exp Pharmacol Physiol 1995;22 Suppl 1:S297–9.

2. Huang HC, Lee CR, Chao PD, et al. Vasorelaxant effect of emodin, an anthraquinone from a Chinese herb. Eur J Pharmacol 1991;205:289–94.

3. Blumenthal M, ed. The Complete German Commission E Monographs. Austin, TX: American Botanical Council, 1998, 146.

4. Olin BR, ed. Respiratory Drugs, Antihistamines. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, 1993, 964–79.