Avil

Therapeutic indications

Avil tablets are antihistamine containing a derivative of alkylamine and are used in the treatment of allergic conditions. In addition, Avil tablets have sedative effects and anticholinergic effects. Avil is used in the treatment and management of the following conditions:

• Motion sickness 
• Allergic rhinitis ( vasomotor and acute)
• Hay fever
• unny nose
• Rashes on the skin
• Skin itching (neurodermatitis, eczema, chronic and acute urticaria, pruritus of the genitals anus, diabetes and icterus pruritus, sickness due to radiation and lichen planus)
• Ear disorders such as Meniere’s disease
• As a sleeping pill
• Allergic conjunctivitis
• Coughing
• Breathing difficulties
• Swelling of throat, face and tongue
• Food allergy
• Serum sickness

Do I need a Prescription?

Avil tablets can be bought from the closest pharmacy to you and also fromonline drug stores. A doctor’s prescription is a must.

Dosage

The dosage and duration of use of Avil tablets depend on the condition, its severity, age, weight and the reaction to the initial dose. The recommended dosage for Avil tablets is:

• Adults and children over 10 years: 25 mg to be taken two-three times a day.  The dose can be increased up to 50 mg in a day.
• Children from 5 to 10 years: 25 mg two-three times a day.

Avil tablets are not recommended for children below five years.

Chemical composition.

The active ingredient in Avil tablets is:

Pheniramine maleate

Avil tablets are manufactured with different strengths, 25 mg tablet and 50 mg tablet. In addition to the active ingredients, the tablets might contain lactose, silicon dioxide, magnesium stearate, maize starch and gelatinized maize starch.

Facts on Avil

Once administered Avil tablets effects begin within 30 minutes and can last for at least 6 hours.

• Avil tablets are well-absorbed from the gastrointestinal tract, with maximum absorption occurring within 1 -2.5 hours after oral administration.
• The effects of Avil tablets can last for a period of 16 – 19 hours once administered orally and 8-17 hours when administered intravenously.
• Avil tablets do not form habits or addictions thus classified in category H.
• Avil tablets are mostly used for the management of allergic conditions.
• Avil Tablets are excreted from the body through the kidney as the unchanged drug or its metabolites N-Desmethylpheniramine and N-Didesmethylpheniramine.

Mechanism of Action (MOA)

The active ingredient Pheniramine is an antihistamine, thus it antagonizes the effects of histamine. Avil competes for the H1 active sites that mediate the effects of histamine. By binding on H1 receptors, pheniramine prevents allergic reactions that occur when histamine is released. Avil relieves the symptoms of allergy by inhibiting histamine from binding to receptor cells on different cells on nerves, glandular cells, mast cells, vascular smooth muscles. This prevents swelling and flare or vasodilation effects.

Contraindications

The use of Avil tablets is not recommended for use in some conditions. When used in such cases, they can result in worsening of the conditions, toxicity , or adverse reactions. Before using Avil tablets inform your doctor of any medical conditions you have or have had previously as they could affect the prescription. The following conditions are contraindicated:

• Allergy: If you are allergic to the active ingredients of Avil tablets or other antihistamine drugs.
• Children under the age of 5 years: Avil tablets are not to be used in neonates and infants that are premature.
• Benign prostatic hyperplasia: If you have an enlarged prostate Avill tablets can make urination more difficult.
• Pregnancy or planning for pregnancy: Avil tablets are not recommended unless the benefits outweigh the risks.
• Breastfeeding: Avil is not recommended as its effects on the nursing baby are not well known.
• High pressure in the eyes (glaucoma)
• Breathing problems due to asthma, emphysema and bronchitis
• Heart disease such as acute cardiovascular disease
• Scheduled for surgery
• Kidney disease
• Liver disease
• Thyroid disorders
• Seizures due to epilepsy
• Pre-existing depression or a family history of depression.

Side effects

A part from the intended effects of Avil tablets, they can also cause adverse effects. These side effects do not occur in everyone but depend on the reaction of an individual to the medication, the dose being taken and the duration of use. The side effects can be common and less serious and sometimes go away on their own while others can be rare but very serious. Report to your doctor any side effects you experience to get medical advice especially if they do not go away. Common side effects of Avil tablets include:

• Drowsiness
• Nausea
• Vomiting
• Ringing in the ears
• Irritability
• Nervousness
• Sleep disorders( insomnia)
• Diarrhoea
• Muscle weakness
• Anorexia
• Constipation
• Dry mouth
• Eyes being red
• Epigastric pain
• Colic

Serious side effects of Avil tablets include:

• Blurred vision
• Irregular heartbeat
• Retention of urine
• Changes in your usual behaviour
• Hallucinations
• Restlessness
• Confusion
• Eyes and skin yellowing(Jaundice)
• Tremor
• Convulsions
• Cephalalgia
• Blood dyscrasias (agranulocytosis and hemolytic anaemia)
• Increase in intraocular pressure
• Loss of consciousness
• Coordination being impaired

If you get an allergic reaction, stop using Avil tablets and seek medical attention immediately. Signs for a severe allergic reaction include:

• Swelling of lips, throat, face and tongue
• Breathing problems
• Skin Rashes

In case you accidentally take an overdose of Avil tablets, report to your doctor or rush into the emergency centre of the nearest hospital. Carry the medication package with you for identification. Taking an overdose may result in adverse effects of Avil tablets, as they produce CNS depression and excitement. An overdose may lead to hallucinations, being disoriented and convulsions.

Drug interactions

Taking more than two drugs at the same time might result in drug interactions. Drug interactions might affects how your medication works by making it less effective or by increasing the chances of adverse reactions occurring. To avoid drug interactions from occurring, inform your doctor of any medications, both over the counter and prescription medications, dietary supplements and herbal products. The following medications and products interact with Avil tablets:

• Alcohol
• Sedatives
• Monoamine oxidase inhibitors used in the management of depression such as phenelzine, selegiline, moclobemide
• Hypnotics
• Anticholinergic drugs such as atropine, chlorpheniramine
• Aminoglycoside antibiotics
• Opioids
• Hypnotics
• Barbiturates
• Anxiety medications
• Tranquillizers
• Alcohol. When used with Avil tablets, it increases depression of the CNS and can lead to adverse effects.

What to Do If You Skip a Dose

When a dose is skipped, take it as soon as you remember it. If it is time close to your next dose, you can skip it and take the next dose then continue with the normal drug schedule. Do not double the dose to compensate for the skipped dose. Frequent dose missing makes your medication to be less effective. To avoid missing doses, you can set a reminder or have a family member remind you when it is time to take the next dose.

Precautions

A number of precautions should be considered before you begin using Avil tablets. The precautions include:

• Children under the age of five should not use Avil tablets.
• Avil tablets should be used with caution in the elderly due to other complications and reduced liver and kidney function.
• Inform your doctor of any medications, vitamin supplements and herbal products you are using or have been using to avoid drug interactions as some of them can be fatal.
• Inform your doctor of your medical history so as to lower on the chances of adverse reactions.
• Avil should not be used if you are about to have a heart surgery or have already had a heart surgery recently.
• Do not take alcohol or use opioids while using Avil tablets. They increase depression of the CNS and may cause excessive sedation and drowsiness.
• If Avil tablets make you drowsy and dizzy, do not perform duties that require mental alertness like driving or operation of heavy machinery.
• If you are taking Avil tablets to manage motion sickness, it is advised to take them at least 30 minutes prior to driving.
• Antidepressants. Avil tablets should not be used with antidepressants as they increase the chances of adverse reactions occurring such as blurred vision and constipation.
• Take Avil tablets as indicated by your doctor, do not adjust the dosage or take it for another reason not indicated for it.
• Always check the medication package for expiry date. Do not take expired medication as its effectiveness is reduced or it might cause toxicity.
• Avil tablets should be taken with plenty of water, after a meal or during the meal.
• Store Avil tablets at room temperature away from heat, moisture and children.
• Taking steroid-based medication while using Avil tablets is not advised as it decreases adrenaline levels in the body which might result in loss of consciousness.
• Avil tablet might contain some sugar, they should be used with caution if you are diabetic.
• Antiemetic signs when taking Avil tablets can mask other conditions in the body and delay their diagnosis.

Different Brands and Manufacturing Companies of the Drug

Avil tablets are manufactured by Sanofi India Limited. Avil tablets are manufactured with differing strengths that include:

• Avil 25 mg tablet
• Avil 50 mg tablet

Avil is also manufactured in different forms. It can be in tablets, oral suspension or an injection. The syrup contains 15 mg/ml.

Substitute drugs

Substitute drugs with the same composition and strength as Avil 25 mg tablet include:

• Pheniramine Maleate (Sonafi) 25 mg tablet – Sonafi India Ltd
• Intavil 25 mg tablet – Intas Pharmaceuticals Ltd
• Eralet 25 mg tablet – Maxzimaa Pharmaceuticals Pvt Ltd
• Pheniramine 25 mg tablet – Ave-Aventis Pharma
• Apvil 25 mg tablet – Ridley Life Sciences Pvt
• Pheniramine 25 tablet – Penta Pharma

Substitute drugs with the same composition and strength as Avil 50 mg tablet include – Eralet 50 mg tablet – Mazximaa Pharmaceuticals Pvt Ltd

1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4928429/
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2918322/
3. https://www.researchgate.net/publication/19174336_Pharmacokinetics_of_pheniramine_AvilR_and_metabolites_in_healthy_subjects_after_oral_and_intravenous_administration
4. https://www.news-medical.net/drugs/Avil.aspx

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