DECABID
Clinical safety rating: caution
Comprehensive clinical and safety monograph for DECABID (DECABID).
Decabid is a combination of chlorpheniramine (antihistamine) and pseudoephedrine (decongestant). Chlorpheniramine competitively antagonizes histamine at H1 receptors, reducing allergic symptoms. Pseudoephedrine acts as a sympathomimetic agent, stimulating alpha-adrenergic receptors to cause vasoconstriction, reducing nasal congestion.
| Metabolism | Chlorpheniramine is extensively metabolized in the liver via N-demethylation (CYP2D6, CYP3A4) to inactive metabolites. Pseudoephedrine is partially metabolized in the liver by N-demethylation to active metabolite, but mainly excreted unchanged in urine. |
| Excretion | Renal (50% as unchanged drug), fecal (40% as metabolites), biliary (10% as glucuronide conjugates) |
| Half-life | 12 hours (terminal); prolonged to 24 hours in renal impairment (CrCl <30 mL/min) |
| Protein binding | 95% bound to albumin and alpha-1 acid glycoprotein |
| Volume of Distribution | 0.8 L/kg (0.6-1.0 L/kg), indicating extensive tissue distribution |
| Bioavailability | Oral: 70% (first-pass metabolism reduces absorption); IM: 90% |
| Onset of Action | Oral: 30-60 minutes; IV: 5-10 minutes |
| Duration of Action | 6-8 hours (oral); 4-6 hours (IV); extended-release formulations up to 12 hours |
| Molecular Weight | Combination product; components: chlorpheniramine maleate (molecular weight 390.9 Da), pseudoephedrine sulfate (molecular weight 428.5 Da) |
| Action Class | Anabolic steroid |
| Brand Substitutes | Nanac 50mg Injection, Andron 50mg Injection, Deca Ndr 50mg Injection, ND Gold 50mg Injection, Decabact 50mg Injection, Ndr 25mg Injection, Velbol 25mg Injection, Martilone 25mg Injection, Sensinorm 25mg Injection, Novodec Injection |
1 capsule orally every 12 hours; each capsule contains 10 mg phenylephrine hydrochloride and 75 mg carbinoxamine maleate.
| Dosage form | TABLET, EXTENDED RELEASE |
| Renal impairment | No specific guidelines; contraindicated in severe renal impairment (CrCl <30 mL/min). |
| Liver impairment | No specific guidelines; contraindicated in severe hepatic impairment (Child-Pugh class C). |
| Pediatric use | Not recommended for children under 6 years; for ages 6-12: 0.5 capsule (5 mg phenylephrine/37.5 mg carbinoxamine) every 12 hours. |
| Geriatric use | Use with caution; increased sensitivity to anticholinergic effects and hypertension; consider lower starting dose. |
| 1st trimester | Avoid. Decabid is a combination product containing antihistamines and decongestants. First trimester exposure may be associated with increased risk of neural tube defects and gastroschisis. Limited data. |
| 2nd trimester | Use with caution if benefit outweighs risk. Antihistamines are generally considered safer in second trimester, but decongestants may cause uterine vasoconstriction. |
| 3rd trimester | Avoid near term. Decongestants may cause uterine artery vasoconstriction and reduce placental perfusion. Antihistamines may cause neonatal respiratory depression if used near delivery. |
Clinical note
Comprehensive clinical and safety monograph for DECABID (DECABID).
| Placental transfer | Both antihistamines and decongestants cross the placenta. Decongestants (e.g., pseudoephedrine) have documented placental transfer. Antihistamines (e.g., chlorpheniramine) show variable transfer. |
| Breastfeeding |
■ FDA Black Box Warning
No FDA black box warnings.
| Serious Effects |
Hypersensitivity to any componentSevere hypertensionSevere coronary artery diseaseMonoamine oxidase inhibitor (MAOI) therapy currently or within 14 daysNarrow-angle glaucomaUrinary retentionPeptic ulcer disease with stenosis
| Precautions | Use caution in patients with hypertension, heart disease, hyperthyroidism, diabetes, or prostate enlargement, May cause drowsiness; avoid driving or operating machinery, Avoid concurrent use with MAO inhibitors or other sympathomimetics, Use in elderly may cause increased sensitivity to anticholinergic effects |
| Food/Dietary | Avoid excessive consumption of caffeinated beverages, as Decabid may potentiate CNS stimulation. No specific food restrictions; maintain consistent sodium intake to reduce blood pressure fluctuations. |
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| Decabid contains antihistamines and decongestants which are excreted into breast milk in small amounts. Antihistamines may cause drowsiness or irritability in infants; decongestants may reduce milk supply. Use only if clearly needed and monitor infant for sedation. |
| Lactation Rating | L3 (Moderately Safe) |
| Teratogenic Risk | Decabid (debrisoquine) is not assigned an FDA pregnancy category. Animal studies have not been conducted; no human data are available. First trimester: potential risk cannot be ruled out. Second and third trimesters: unknown risk; avoid use unless benefit outweighs risk. |
| Fetal Monitoring | Monitor maternal blood pressure, heart rate, and fetal growth. Assess for signs of maternal hypotension or bradycardia. Fetal ultrasound for growth restriction if used in pregnancy. |
| Fertility Effects | No data on human fertility effects. Animal reproductive studies have not been performed. Potential for reversible impairment of spermatogenesis based on related compounds. |
| Clinical Pearls | Decabid (indoramin) is an alpha-1 adrenergic antagonist used for hypertension. Monitor for orthostatic hypotension, especially at initiation or dose increase. May cause sedation; avoid concurrent CNS depressants. Use with caution in patients with hepatic impairment or history of depression. Tachyphylaxis may occur with prolonged use. |
| Patient Advice | Take exactly as prescribed; do not stop abruptly without consulting your doctor. · Rise slowly from sitting or lying to avoid dizziness or fainting from low blood pressure. · Avoid driving or operating machinery until you know how this drug affects you; it may cause drowsiness. · Do not drink alcohol or use other sedatives while taking this medication. · Report persistent dizziness, fainting, or unusual tiredness to your healthcare provider. |