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Dr. Andrew Rynne

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Exp 50 years

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Having dry cough and runny nose. Not cured by prescribed medicine. Is it safe to take Piriton Cs?

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Dr. Sujoy Khan

Allergist and Immunologist

Practicing since :1999

Answered : 584 Questions

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Posted on Tue, 5 Feb 2013 in Asthma and Allergy
Question: I am 28 and on three anti seizure medicines, viz Carbamazepine 200 mg 2-0-2, Levetiracetam 500 mg 2-0-2 and Lamotrigine 100 mg 2-0-2. For the past two weeks I am having cough, mostly dry
irritating one and running nose. I took as per prescription of a doctor Cefixime, Bromhexine, etc. but to no relief. Doing gorgling with hot water, steam inhalation, etc. Is is safe to now try Piriton Cs which contains Chlorpheniramine maleate 4 mg and Dextromethorphan 10 mg per 5 ml. The dosage is 5ml every 4 hours. Thanks. XXXXXXX ( email YYYY@YYYY )
doctor
Answered by Dr. Sujoy Khan 1 hour later
Hello XXXXXXX
Welcome to Healthcare Magic and thank you for writing to us.

It is possible that you have dust allergy and allergy testing with either skin prick tests or blood test (specific IgE) against all aero-allergens may reveal the cause. However, non-allergic rhinitis is also a possibility when all tests (including total IgE is low) are negative.

The treatment is antihistamines such as cetirizine 10mg twice daily and flixonase nasal spray 2 sprays per nostril twice daily.
Cough syrups are not helpful for rhinitis related cough.
Also if you have acid reflux, you can have a cough for which either esomeprazole or rabeprazole once daily will be helpful.

Best Wishes.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sujoy Khan 1 hour later
Since I am on anti seizure medication, my neurologist had advised about avoiding
Cetrizine 10mg, CPM 8 mg and Ciprofloxacin among many drugs. Have you taken this into account? Even Azithromycin and Cefixime are to be avoided. As such
Piriton CS can be tried as in the past some relief was felt in cases of dry cough. Immediately it is not possible to get the tests done. Till then I have to take something to get some relief. I hope I have made my point clear. Thanks.
doctor
Answered by Dr. Sujoy Khan 9 hours later
Hello,
You will need to get in touch with your neurologist to find out the reason for avoiding the mentioned drugs.
Some neurological conditions such as myasthenia gravis you need to avoid antibiotics and anticholinergic drugs, but I am not sure then what your exact neuological diagnosis is.
If cetirizine was specifically asked to be avoided, you can ask him about fexofenadine 120 or 180mg OR loratidine 10mg.
At the same tome, enquire about use of steroid nasal sprays, whether it is contraindicated or not.
Try and sparingly use the cough suppressant.

Best Wishes.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sujoy Khan 4 hours later

The simple question that comes to mind is whether if there are any drugs, including the ones that you have mentioned, which
Can trigger seizure in a patient who is under anit-seizure medication. Thank you for your attention. Please give final
Clarification and close the case.
doctor
Answered by Dr. Sujoy Khan 4 hours later
Hello,

I agree with you entirely that the question is simple enough - do antihistamines trigger seizure episodes? However, the answer is just not straight forward given the complexity of epileptiform disorders, hence my suggestion to discuss with your neurologist.

As far as evidence goes, a rare adverse effect of cetirizine happens to be convulsions (see link: underdesirable effects - WWW.WWWW.WW uk/emc/medicine/0000/spc#UNDESIRABLE_EFFECTS).
However, I have never seen a patient who was affected by this side effect.

With fexofenadine: there is none such reported
WWW.WWWW.WW uk/EMC/medicine/6659/SPC/Telfast+120mg+film-coated+tablets/#UNDESIRABLE_EFFECTS

With Loratadine: no such side effect has been reported
link: WWW.WWWW.WW uk/EMC/medicine/0000/SPC/Clarityn+Allergy+10mg+Tablets/#UNDESIRABLE_EFFECTS

I hope that answers your question.
Best Wishes.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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