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Pheniramine--a much abused drug

N A Buckley1, I M Whyte, A H Dawson

  • 1Department of Clinical Pharmacology and Toxicology, Newcastle Mater Misericordiae Hospital, Waratah, NSW.

The Medical Journal of Australia
|February 21, 1994
PubMed
Summary
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Pheniramine is disproportionately used in self-poisoning cases compared to its market share and is more likely to cause seizures. Regulatory bodies should review its over-the-counter availability.

Area of Science:

  • Pharmacology
  • Clinical Toxicology
  • Public Health

Background:

  • Antihistamines are commonly used for allergic conditions.
  • Overdose of antihistamines can lead to significant clinical toxicity.
  • Pheniramine is a first-generation antihistamine with potential for abuse and toxicity.

Purpose of the Study:

  • To compare the clinical toxicity of pheniramine with other antihistamines in overdose settings.
  • To assess the relative frequency of pheniramine use in self-poisoning incidents.
  • To investigate the association between pheniramine overdose and specific adverse outcomes like seizures.

Main Methods:

  • A prospective follow-up cohort study was conducted.
  • Data on antihistamine self-poisonings were collected from hospital admissions.

Related Experiment Videos

  • Pharmacist surveys were used to determine the market share of pheniramine.

    • Main Results:

    • Pheniramine constituted 33.9% of self-poisoning cases despite a low market share (3.0% of items dispensed).
    • Pheniramine overdose was significantly associated with generalized seizures (13/43 cases) compared to other antihistamines (1/75 cases).
    • A high proportion of pheniramine overdose patients had a history of drug or alcohol abuse (79.9%), including antihistamine abuse (60.5%).

    Conclusions:

    • Pheniramine is overrepresented in self-poisoning incidents relative to its availability and shows a higher propensity for abuse.
    • Pheniramine appears to be more proconvulsant in overdose than other antihistamines.
    • Consideration should be given to alternative antihistamines for individuals at risk of seizures, and regulatory review of pheniramine's over-the-counter status is warranted.