Ofkof(10 mg+30 mg+1.25 mg)/5 ml

This oral combination syrup pairs a cough suppressant, a decongestant, and a sedating antihistamine, and is used for the short-term, symptomatic relief of:

• Dry, irritating cough associated with the common cold or minor throat/bronchial irritation
• Nasal and sinus congestion
• Sneezing, runny nose, and watery eyes associated with the common cold or upper respiratory allergies

This combination does not treat the underlying cause of the cold and does not shorten its duration; it provides only temporary symptomatic relief. It should not be used for a productive (mucus-producing) cough, since suppressing this type of cough can impair clearance of respiratory secretions.

Contains dextromethorphan hydrobromide (a cough suppressant), pseudoephedrine hydrochloride (a decongestant), and triprolidine hydrochloride (a sedating antihistamine) as active ingredients in an oral syrup. The exact concentration of each active ingredient per 5 mL varies between marketed products; the generic name alone does not identify a single fixed strength. Always confirm the exact strength on the specific product's own label before determining a dose.

This is a combination cold and cough syrup that pairs three complementary ingredients: dextromethorphan to suppress a dry, irritating cough; pseudoephedrine to relieve nasal and sinus congestion; and triprolidine, a sedating antihistamine, to reduce sneezing, runny nose, and watery eyes. It is intended for short-term, symptomatic relief of common cold symptoms and is not a cure for the underlying infection.

Therapeutic Class: Cold and Cough Combination (Antitussive, Decongestant, Antihistamine)

Dextromethorphan is metabolized mainly by CYP2D6 to an active metabolite; genetic variability in this enzyme can affect individual response and interaction risk. Pseudoephedrine has direct and indirect sympathomimetic activity, effective as a decongestant with substantially less central nervous system stimulation than similar compounds. Triprolidine is a potent, competitive H1-receptor antihistamine with sedating central nervous system properties, contributing the drowsiness commonly associated with this type of combination product.

• Shake the bottle well before each use, if applicable to the product
• Use the measuring device provided with the product for accurate dosing; do not use a household spoon
• May be taken with or without food
• Avoid taking with other cold, cough, allergy, or sleep-aid products that contain a decongestant, antihistamine, or cough suppressant, to prevent duplicating active ingredients

The following should be assessed by a healthcare professional before combining with this syrup:

• Monoamine oxidase inhibitors (MAOIs): contraindicated, due to the risk of a hypertensive crisis from the pseudoephedrine component and the risk of serotonin syndrome from the dextromethorphan component; do not use during or within 14 days of stopping an MAOI.
• Other sedating medicines, alcohol, or additional antihistamines: may increase drowsiness when combined with the triprolidine component.
• SSRIs and other serotonergic medicines: may increase the risk of serotonin syndrome when combined with the dextromethorphan component.
• Antihypertensive medicines: their effect may be reduced by the pseudoephedrine component.
• Other sympathomimetic decongestants or stimulants: may increase the risk of raised blood pressure and heart rate when combined with pseudoephedrine.

Common side effects

• Drowsiness or sedation (mainly from the antihistamine component)
• Dry mouth, nose, or throat
• Nervousness or difficulty sleeping (mainly from the decongestant component)
• Dizziness
• Mild nausea or upset stomach

Serious side effects (seek medical attention)

• Signs of a fast or irregular heartbeat, chest pain, or severe increase in blood pressure
• Signs of serotonin syndrome: agitation, confusion, rapid heartbeat, muscle rigidity, fever - particularly if combined with other serotonergic medicines
• Signs of a severe allergic reaction: rash, swelling of the face or throat, difficulty breathing
• Difficulty urinating
• Severe drowsiness, confusion, or hallucinations, particularly in young children or elderly patients

Pregnancy

There are no specific controlled studies on this exact triple combination in human pregnancy. Caution should be exercised, balancing the potential benefit of symptom relief against any possible risk to the developing fetus, and use should be discussed with a doctor.

Breastfeeding

All three components are excreted in breast milk in small amounts; caution should be exercised, particularly given the potential for sedation in the nursing infant, unless the potential benefit to the mother outweighs any possible risk, in consultation with a healthcare professional.

• Use with caution in patients with hypertension, heart disease, diabetes, hyperthyroidism, raised intraocular pressure, or prostatic enlargement, due to the sympathomimetic (decongestant) component.
• This syrup may cause drowsiness and impair the ability to drive or operate machinery; avoid alcohol and other sedating substances while using it.
• Do not use for a persistent cough (more than about 7 days), a cough that recurs, or one accompanied by fever, rash, or persistent headache, without consulting a doctor.
• Do not use for a productive (chesty, mucus-producing) cough, asthma, or emphysema without medical advice.
• Avoid combining with other products containing a decongestant, antihistamine, or cough suppressant, to prevent unintentional excess dosing.
• Not recommended for children under 6 years without specific medical advice.

Overdose may cause a combination of effects from each ingredient: from dextromethorphan, dissociative or hallucinogenic effects and, at very high doses, serotonin syndrome; from pseudoephedrine, restlessness, rapid heartbeat, and raised blood pressure; and from triprolidine, marked drowsiness or, particularly in children, paradoxical excitation, hallucinations, or seizures. Suspected overdose, especially in a child, requires prompt medical attention; do not attempt home treatment.

Store at room temperature, away from direct sunlight and moisture, and keep tightly closed and out of reach of children. Follow the specific product's label for exact storage instructions.

• Children: Dosing is age-based and should follow the specific product's labeled dosing chart; not generally recommended under 6 years without specific medical advice, given combined decongestant/antihistamine/antitussive exposure.
• Elderly: May be more sensitive to anticholinergic effects (such as urinary retention, confusion) and to the stimulant effects of the decongestant; use with caution.
• Patients with cardiovascular disease, hypertension, diabetes, hyperthyroidism, or prostatic enlargement: Use with caution due to the sympathomimetic component.

This combination is intended for short-term, symptomatic use, generally not more than about 7 days for cough or as directed on the product label for other symptoms. If symptoms persist beyond this period, worsen, or recur, medical review is recommended.

Drug Class: Non-opioid antitussive (dextromethorphan) combined with a sympathomimetic decongestant (pseudoephedrine) and a first-generation (sedating) antihistamine (triprolidine)

Dextromethorphan raises the threshold for triggering the cough reflex in the brain's cough centre, reducing dry cough. Pseudoephedrine narrows swollen blood vessels in the nasal passages, reducing congestion and swelling. Triprolidine blocks histamine H1 receptors, reducing symptoms such as sneezing, itching, and watery eyes triggered by histamine release during a cold or allergic reaction.

Use in children should follow the specific product's age-based dosing chart. This combination is generally not recommended for children under 6 years without a doctor's advice, given the combined presence of a decongestant, sedating antihistamine, and cough suppressant, each of which carries its own age-related safety considerations in young children.