Patient leaflets and SmPCs, drug interaction checker, official dosages and NHS pharmacy opening hours — all in one place.
Patient leaflets and SmPCs, drug interaction checker, official dosages and NHS pharmacy opening hours — all in one place.
The electronic medicines compendium (emc) no longer publishes a Summary of Product Characteristics for this product, which usually means it is no longer marketed in the UK. The patient leaflet below is kept for reference, but the product may not be available.
If you were prescribed this medicine, other products containing Alimemazine tartrate may still be available. Do not stop your treatment — ask your pharmacist or GP what to use instead.
for Alfresed contains the active substance alimemazine tartrate and it belongs to a group of medicines called phenothiazines and works by blocking a natural substance (histamine) that your body makes during an allergic reaction. It also works directly on the brain to help you feel more relaxed. What Alfresed is used for To treat itching (pruritus) or an itchy, lumpy rash (urticaria) As a sedative for children aged between 3 and 7 years. This is a medicine given to reduce awareness or make the child feel relaxed and at ease before an operation.
e Alfresed Do not take Alfresed and tell your doctor if you: are allergic (hypersensitive) to:
1.3.1 Package leaflet
have increased pressure in the eye (called narrow angle glaucoma). have a history of a blood or bone marrow disorder called agranulocytosis. Children Alfresed should not be used in children under 3 years of age. Alfresed syrup of a lower strength (7.5mg/5ml) should be used in children to treat itching (pruritus) and urticaria, as it is easier to measure the dose required. Do not take this medicine if any of the above applies to you. If you are not sure, talk to your doctor or pharmacist before taking Alfresed. Warnings and precautions Talk to your doctor or pharmacist before taking Alfresed if: the person taking the medicine is under 3 years of age you are diabetic. This medicine contains sucrose, a type of sugar you have heart problems you have fits (epilepsy). you are elderly and are dehydrated or have been told you have a low blood volume you are elderly and have had constipation for some time you are an elderly male and have problems when passing water (urine) you are elderly and it is very hot or cold. Your body may find it harder to control its temperature when taking this medicine. If you are not sure if any of the above apply to you, talk to your doctor or pharmacist before taking Alfresed. Other medicines and Alfresed Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines. This includes medicines you can buy without prescription, including herbal medicines. This is because Alfresed can affect the way some medicines work. Also some medicines can affect the way Alfresed works. In particular, tell your doctor or pharmacist if you are taking any of the following: Medicines to help you sleep or lower your anxiety Lithium – used to treat some types of mental illness Amfetamine – used for Attention Deficit Hyperactivity Disorder (ADHD) Phenobarbital – used for epilepsy Adrenaline – used for life threatening allergic reactions Medicines for Parkinson's disease such as levodopa Medicines for depression Medicines for severe pain (such as codeine or morphine) Medicines for diabetes. Your doctor may need to change the dose of your medicine Medicines for high blood pressure such as doxazosin, terazosin, guanethidine, clonidine Medicines for indigestion and heartburn (antacids) Anticholinergic medicines – includes some medicines used for irritable bowel syndrome, asthma or incontinence.
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1.3.1 Package leaflet
Alfresed with alcohol Do not drink alcohol or take any medicines containing alcohol while you are taking Alfresed. This is because alcohol can increase the chances of you getting side effects. It can also cause serious breathing difficulties. Pregnancy and breast-feeding If you are pregnant, think you may be pregnant or planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine. You should not take Alfresed if you are breastfeeding. This is because small amounts may pass into mothers' milk. This can be harmful to your baby. If you are breast-feeding or planning to breast-feed, talk to your doctor or pharmacist before taking any medicine. Driving and using machines You may feel drowsy or sleepy while taking this medicine. If this happens, do not drive or use any tools or machines. Alfresed contains Sucrose: If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicine. This should be taken into account in patients with diabetes mellitus. Furthermore, sucrose may be harmful to the teeth if this medicine is taken for long-term use e.g. for two weeks or more. Methyl parahydroxybenzoate (E218), which may cause allergic reactions (possibly delayed). Sodium sulfite anhydrous (E221) and sodium metabisulfite (E223): These may rarely cause severe hypersensitivity reactions and difficulty breathing, wheezing and tightness in the chest (bronchospasm). This medicine contains less than 1 mmol sodium (23 mg) per 5ml, that is to say essentially 'sodium-free'.
Alfresed Always take this medicine exactly as your doctor has told you. Check with your doctor or pharmacist if you are not sure. How much to take The recommended dose is: For itching or an itchy lumpy rash Adults: 10mg (approx. 1.7ml of syrup) two or three times each day Your doctor may increase your dose depending on your illness. Older people: 10mg (approx. 1.7ml of syrup) once or twice each day. VAR/IB-007
1.3.1 Package leaflet
Children over 3 years of age: Alfresed syrup of a lower strength (7.5mg/5ml) should be used. As a sedative before general anaesthesia Children aged between 3 and 7 years: Your child's doctor will decide the amount to give The maximum dose is 2mg (approx. 0.3ml of syrup) per kg of bodyweight Alfresed is given 1-2 hours before the operation. Exposure to sunlight Alfresed can make your skin more sensitive to sunlight. Keep out of direct sunlight while taking this medicine. When taking this medicine Take this medicine by mouth Avoid the syrup touching any part of your skin. This can cause skin redness, swelling and itching (contact skin sensitisation) If you feel the effect of your medicine is too weak or too strong, do not change the dose yourself, but ask your doctor Do not take more than the recommended dose Use the measuring syringe provided in the pack to deliver the required dose. Instructions for the use of syringe: 1. Open the bottle: press the cap and turn it anticlockwise (figure 1). Separate the adaptor from the syringe (figure 2).
2. Insert the adaptor into the bottle neck (figure 3). Ensure it is properly fixed. Take the syringe and put it in the adaptor opening (figure 4).
3. Turn the bottle upside down. Fill the syringe with a small amount of syrup by pulling the piston down (figure 5A), then push the piston upwards in order to remove any possible bubble (figure 5B). Pull the piston down to the graduation mark corresponding to the quantity in millilitres (ml) prescribed by your doctor (figure 5C).
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1.3.1 Package leaflet
4. Turn the bottle the right way up (figure 6A). Remove the syringe from the adaptor (figure 6B).
5. Empty the contents of the syringe into the patient's mouth by pushing the piston to the bottom of the syringe (figure 7). Leave the syringe adaptor in place after first use. Close the bottle with the plastic screw cap. Wash the syringe with water (figure 8).
If you take more Alfresed than you should If you take more Alfresed than you should, tell a doctor or go to a hospital casualty department straight away. Take the medicine pack with you. This is so the doctor knows what you have taken. Also do this if a child under 3 years of age swallows some of this medicine. The following effects may happen: feeling drowsy, loss of consciousness, increased or rapid heartbeat, changes in heart beat, uneven heart beats and feeling very cold. You may also feel dizzy, light headed or faint (due to low blood pressure) and you may notice that you cannot control your movements (for example of the eyes, neck, arms and legs). If you forget to take Alfresed If you forget a dose, take it as soon as you remember it. However, if it is nearly time for the next dose, skip the missed dose. Do not take a double dose to make up for a forgotten dose. If you have any further questions on the use of this medicine, ask your doctor or pharmacist.
Like all medicines, this medicine can cause side effects, although not everybody gets them. Stop taking Alfresed and see a doctor or go to a hospital straight away if you notice any of the following side effects: An allergic reaction. The signs may include: a rash, swallowing or breathing problems, swelling of your lips, face, throat or tongue VAR/IB-007
1.3.1 Package leaflet
Liver problems that may cause the eyes or skin to go yellow (jaundice) High temperature, sweating, stiff muscles, fast heartbeat, fast breathing and feel confused, drowsy or agitated. These could be signs of a serious side effect called 'neuroleptic malignant syndrome' Very fast, uneven or forceful heartbeat (palpitations). You may also have breathing problems such as wheezing, shortness of breath, tightness in the chest and chest pain Convulsions/fits and movements that you cannot control, mainly of the tongue, mouth, jaw, arms and legs You may get infections more easily than normal such as fever, severe chills, sore throat or mouth ulcers. These could be signs of a blood problem. Tell a pharmacist or doctor as soon as possible if you have any of the following side effects: Breathing more slowly or less deeply than normal Feeling restless and not being able to keep still (akathisia) Changes in skin or eye colour Problems with your eyesight Rigid or stiff muscles, trembling or shaking or difficulty moving Feeling dizzy, light-headed or faint when you stand or sit up quickly (due to low blood pressure) Unexpected excitement or hyperactivity. Problems passing urine. Tell your doctor or pharmacist if any of the following side effects gets serious or lasts longer than a few days: Constipation Dry mouth Stuffy nose Difficulty sleeping (insomnia) Feeling agitated Dizziness Headache Drowsiness Being more sensitive to the sun than usual Unusual production of breast milk in men and women Breast enlargement in men Loss of menstrual periods Difficulty in getting or maintaining an erection or in ejaculating (impotence) Skin redness, swelling and itching (contact skin sensitisation) Skin rashes. Reporting of side effects If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme Website at: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store. By reporting side effects you can help provide more information on the safety of this medicine.
Alfresed Keep this medicine out of the sight and reach of children.
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1.3.1 Package leaflet
Do not take this medicine after the expiry date, which is marked on the carton and bottle label after EXP. The expiry date refers to the last day of that month. This medicine does not require any special storage conditions. Discard this medicine 30 days after first opening. Do not use this medicine if you notice that the syrup appears to have deteriorated, such as changes in colour of the syrup or if the syrup becomes cloudy or hazy. Seek the advice of your pharmacist. Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.
What Alfresed contains The active substance is alimemazine tartrate. Each 5ml of syrup contains 30mg alimemazine tartrate. The other ingredients are sucrose, citric acid monohydrate, sodium citrate, methyl parahydroxybenzoate (E218), sodium sulfite anhydrous (E221), sodium metabisulfite (E223), ascorbic acid, caramel flavour, apricot flavour and purified water. What Alfresed looks like and contents of the pack Alfresed is a clear, colourless to pale yellow syrupy liquid with caramel odour supplied in an amber glass bottle of 100ml, with a tamper evident, child resistant white plastic cap and a 5ml oral syringe with 0.1ml graduation and a syringe adaptor. Marketing Authorisation Holder and Manufacturer: Thame Laboratories, Unit 4, Bradfield Road, Ruislip, Middlesex, HA4 0NU, UK. OR SyriMed, Unit 4, Bradfield Road, Ruislip, Middlesex, HA4 0NU, UK.
If this leaflet is hard to see or read, please call +44 (0) 208 515 3700 for help. This leaflet was last revised in 03/2026. Alfresed is the registered trademark of Syri Limited.
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1.3.1 Package leaflet
Alfresed 30mg/5ml Syrup comes as oral solution containing 30mg / 5ml. Always follow the dose your doctor or pharmacist has given you, and read the leaflet that comes with the medicine.
The active substance in Alfresed 30mg/5ml Syrup is alimemazine tartrate.
Medicines with the same active substance, strength and form include: Itzenal 30 mg/ 5ml Oral Solution, Sugar-Free, Alimemazine Tartrate 30 mg/ 5 ml Oral Solution, Alimemazine Tartrate 30mg/5mL Oral Solution, Sugar-Free. In total there are 5 equivalent products. They are interchangeable only if your prescriber or pharmacist says so.
This leaflet reproduces the patient information leaflet approved for Alfresed 30mg/5ml Syrup, as published on the electronic medicines compendium (emc). The version printed inside your medicine’s packaging is the one that applies to you.
Whether a medicine is available over the counter or on prescription only depends on its licence. Check the leaflet, or ask your pharmacist — they can tell you straight away.
The text above reproduces the patient information leaflet approved for this medicine, restructured for easier reading.
Alfresed has a central sedative effect comparable to that of chlorpromazine but largely devoid of the latter's anti adrenaline action.
Alfresed is used asin the second line treatment in the symptomatic relief of urticaria and pruritus for adults and children 3 years and above.
Alfresed may be used in pre-medication as a sedative before anaesthesia in children aged between 3 to 7 years.
Posology
Not recommended for infants less than 3 years old (see also sections 4.3 and 4.4).
DO NOT exceed the recommended dose (see section 4.9).
Urticaria and pruritus
Adults: 10mg (approx. 1.7ml) two or three times daily; up to 100mg per day have been used in intractable cases.
Elderly: dosage should be reduced to 10mg (approx. 1.7ml) once or twice daily.
Children over 3 years of age should be prescribed Alfresed syrup of a lower strength (7.5mg/5ml) for the indication of urticaria and pruritus.
As a sedative before anaesthesia
Children aged 3 -7 years: the maximum dosage recommended is 2mg (approx. 0.33ml) per kg bodyweight 1-2 hours before the operation.
Method of administration
For oral administration.
Alfresed should be avoided in patients with hepatic or renal dysfunction, epilepsy, Parkinson's disease, hypothyroidism, phaeochromocytoma, myasthenia gravis, prostatic hypertrophy. It should be avoided in patients known to be hypersensitive to phenothiazines or to any of the excipients listed in section 6.1 or with history of narrow angle glaucoma, history of agranulocytosis.
Alfresed is contraindicated for use in children less than 3 years of age (see section 4.4).
Precautions for use:
Patients are strongly advised not to consume alcoholic beverages or medicines containing alcohol throughout treatment (see section 4.5).
Exposure to sunlight should be avoided during treatment (see section 4.8).
Alfresed should be used with caution in:
• elderly or volume depleted patients who are more susceptible to orthostatic hypotension (see section 4.8)
• elderly patients presenting chronic constipation (risk of paralytic ileus)
• elderly patients with possible prostatic hypertrophy (see section 4.3)
• elderly patients in hot and cold weather (risk of hyper/hypothermia) (see section 4.8)
• patients with certain cardiovascular diseases: alimemazine may cause arrhythmias due to the tachycardia-inducing and hypotensive effects of phenothiazines (see section 4.8).
• Patients with seizures (see section 4.8).
Paediatric population:
Alfresed is contraindicated for use in children less than 3 years of age due to the risk of marked sedation and respiratory depression.
There is a risk of post-operative restlessness especially if the child is in pain.
Excipient Warnings
This product contains sucrose. Patients with rare hereditary problems of fructose intolerance, glucose-galactose malabsorption or sucrase-isomaltase insufficiency should not take this medicine. This should be taken into account in patients with diabetes mellitus. The sucrose may be harmful to the teeth if this medicine is taken for long-term use e.g. for two weeks or more.
This product also contains methyl parahydroxybenzoate (E218), which may cause allergic reactions (possibly delayed).
This product also contains sodium sulfite anhydrous (E221) and sodium metabisulfite (E223), which may rarely cause severe hypersensitivity reactions and bronchospasm.
This medicine contains less than 1mmol sodium (23mg) per 5ml, that is to say essentially 'sodium-free'.
The sedative effects of phenothiazines may be intensified (additively) by alcohol (see section 4.4), anxiolytics and hypnotics, opiates, barbiturates and other sedatives. There may be increased antimuscarinic and sedative effects of phenothiazines with tricyclic antidepressants and MAOI's (including moclobemide). Respiratory depression may occur.
The hypotensive effect of most antihypertensive drugs especially alpha adrenoreceptor blocking agents may be exaggerated by phenothiazines.
The use of antimuscarinics will increase the risk of antimuscarinic side effects when used in conjunction with antihistamines.
The mild anticholinergic effect of phenothiazines may be enhanced by other anticholinergic drugs possibly leading to constipation, heat stroke, etc. Anticholinergic agents may reduce the antipsychotic effect of phenothiazines.
The action of some drugs may be opposed by phenothiazines. These include amfetamine, levodopa, clonidine, guanethidine and adrenaline.
Some drugs interfere with absorption of phenothiazines: antacids, anti-Parkinson and lithium. Increases or decreases in the plasma concentrations of a number of drugs, eg propranolol, phenobarbital have been observed but were not of clinical significance.
High doses of phenothiazines reduce the response to hypoglycaemic agents, the dosage of which may have to be raised. Adrenaline must not be used in patients overdosed with phenothiazines.
Pregnancy
There is inadequate evidence of the safety of alimemazine in human pregnancy, but it has been widely used for many years without apparent ill consequence. Some phenothiazines have shown evidence of harmful effects in animals. Alimemazine, like other drugs, should be avoided in pregnancy unless the physician considers it essential. Neuroleptics may occasionally prolong labour and at such a time should be withheld until the cervix is dilated 3-4cm. Possible adverse effects on the neonate include lethargy or paradoxical hyperexcitability, tremor and low Apgar score.
Breast-feeding
Phenothiazines may be excreted in milk: breast feeding should be suspended during treatment.
Fertility
Animal studies are insufficient with respect to effect on fertility. However, some phenothiazines show adverse effects on fertility.
Patients should be warned about drowsiness during the early days of treatment, and advised not to drive or operate machinery.
Gastrointestinal disorders:
• Constipation
• Dry mouth
Respiratory, thoracic and mediastinal disorders:
• Nasal congestion
• Respiratory depression is possible in susceptible patients.
Psychiatric disorders:
• Insomnia
• Agitation
Hepatobilliary disorders:
Jaundice, usually transient, occurs in a very small percentage of patients. A premonitory sign may be a sudden onset of fever after one to three weeks of treatment followed by the development of jaundice. Neuroleptic jaundice has the biochemical and other characteristics of obstructive jaundice and is associated with obstructions of the canaliculi by bile thrombi; the frequent presence of an accompanying eosinophilia indicates the allergic nature of this phenomenon. Treatment should be withheld on the development of jaundice.
Renal and urinary disorders:
• Retention of urine
Vascular disorders:
Hypotension, or pallor may occur in children. Elderly or volume depleted subjects are particularly susceptible to postural hypotension (see section 4.4).
Cardiac disorders
Cardiac arrhythmias, including atrial arrhythmia. A-V block, ventricular tachycardia and ventricular fibrillation have been reported during therapy, possibly related to dosage. Pre-existing cardiac disease, old age, hypokalaemia and concurrent tricyclic antidepressants may predispose.
Investigation:
ECG changes, usually benign, include widened QT interval, ST depression, U-waves and T-wave changes.
Eye disorders:
• Accommodation disorders
Blood and lymphatic system disorders:
A mild leukopaenia occurs in up to 30% of patients on prolonged high dosage. Agranulocytosis may occur rarely; it is not dose related. The occurrence of unexplained infections or fever requires immediate haematological investigation.
Nervous system disorders:
• Extrapyramidal effects such as:
- Acute dystonias or dyskinesias, usually transitory are commoner in children and young adults and usually occur within the first 4 days of treatment or after dosage increases.
- Akathisia characteristically occurs after large doses.
- Parkinsonism is commoner in adults and the elderly. It usually develops after weeks or months of treatment. One or more of the following may be seen: tremor, rigidity, akinesia or other features of Parkinsonism (commonly just tremor).
- Tardive dyskinesia: If this occurs it is usually, but not necessarily, after prolonged or high dosage. It can even occur after treatment has been stopped. Dosage should therefore be kept low whenever possible.
• Convulsions have been reported in some patients.
• Dizziness
• Headache
• Drowsiness
Skin and subcutaneous tissue disorders:
Contact skin sensitisation is a serious but rare complication in those frequently handling preparations of phenothiazines: Care must be taken to avoid contact of the drug with the skin. Skin rashes of various kinds may also be seen in patients treated with the drug. Patients on high dosage may develop photosensitivity in sunny weather and should avoid exposure to direct sunlight (see section 4.4). Ocular changes and the development of a metallic greyish-mauve colouration of exposed skin have been noted in some individuals, mainly females, who have received chlorpromazine continuously for long periods (four to eight years).
Endocrine disorders:
Hyperprolactinaemia which may result in galactorrhoea, gynaecomastia, amenorrhoea and impotence.
Neuroleptic malignant syndrome (hyperthermia, rigidity, autonomic dysfunction and altered consciousness) may occur (see section 4.9).
General disorders and administration site conditions:
Paradoxical excitement has been noted.
Reporting of suspected adverse reactions
Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via the Yellow Card Scheme Website at: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store.
Symptoms of phenothiazine overdosage include drowsiness or loss of consciousness, hypotension, tachycardia, ECG changes, ventricular arrhythmias and hypothermia. Severe extra-pyramidal dyskinesias may occur.
If the patient is seen sufficiently soon (up to 6 hours) after ingestion of a toxic dose, gastric lavage may be attempted. Pharmacological induction of emesis is unlikely to be of any use. Activated charcoal should be given. There is no specific antidote. Treatment is supportive.
Generalised vasodilatation may result in circulatory collapse; raising the patient's legs may suffice, in severe cases, volume expansion by intravenous fluids may be needed; infusion fluids should be warmed before administration in order not to aggravate hypothermia.
Positive inotropic agents such as dopamine may be tried if fluid replacement is insufficient to correct the circulatory collapse. Peripheral vasoconstrictor agents are not generally recommended; avoid the use of adrenaline.
Ventricular or supraventricular tachy-arrhythmias usually respond to restoration of normal body temperature and correction of circulatory or metabolic disturbances. If persistent or life- threatening, appropriate antiarrhythmic therapy may be considered. Avoid lidocaine and, as far as possible, long acting anti-arrhythmic drugs.
Pronounced central nervous system depression requires airway maintenance or, in extreme circumstances, assisted respiration. Severe dystonic reactions, usually respond to procyclidine (5-10mg) or orphenadrine (20-40mg) administered intramuscularly or intravenously. Convulsions should be treated with intravenous diazepam.
Neuroleptic malignant syndrome (NMS) has been reported in the context of alimemazine overdose. Symptoms of NMS include a combination of hyperthermia, muscle rigidity, altered mental status and autonomic instability. Since this syndrome is potentially fatal, alimemazine must be discontinued immediately, and intensive clinical monitoring and symptomatic treatment must be initiated.
Strict adherence to the recommended dose is critical (see section 4.2).
Neuroleptic malignant syndrome should be treated with cooling. Dantrolene sodium may be tried.
Ask anything about Alfresed 30mg/5ml Syrup. The assistant answers only from this leaflet — if the leaflet does not cover it, it will say so. It does not give medical advice.
Answers come from the patient leaflet published on the electronic medicines compendium (emc). They are not medical advice. Ask a pharmacist or your GP if you are unsure. For urgent help call NHS 111, or 999 in an emergency.
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