Comprehensive medication guide to Pyrilamine including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
Most pyrilamine products are OTC and not covered without a prescription; when prescribed, Tier 2–3 copays may apply ($5–$20); FSA/HSA funds can be used for OTC purchases under the CARES Act.
Estimated Cash Pricing
$5–$15 OTC retail for combination products like Midol Complete or Pamprin; generic acetaminophen/pamabrom/pyrilamine available for as low as $3.20 with GoodRx coupons for a 24-count supply.
Medfinder Findability Score
82/100
Summarize with AI
On this page
Pyrilamine (also known as pyrilamine maleate or mepyramine) is a first-generation antihistamine belonging to the ethylenediamine class. It works by blocking histamine H1 receptors, reducing the cascade of allergy symptoms including runny nose, sneezing, itchy eyes, and hives. It has been in medical use since 1949 and remains a component in numerous OTC combination products.
Pyrilamine is found in OTC menstrual relief products such as Midol Complete and Pamprin Multi-Symptom, as well as in prescription combination cough and cold formulations. Unlike second-generation antihistamines, pyrilamine readily crosses the blood-brain barrier and causes significant drowsiness — a property that can be both therapeutic and a side effect.
A notable pharmacological distinction: pyrilamine has 130,000-fold selectivity for H1 receptors over muscarinic receptors, giving it significantly lower anticholinergic activity than diphenhydramine (Benadryl). This makes it potentially better tolerated in patients where anticholinergic effects are a concern.
We have a 99% success rate finding medications, even during nationwide shortages.
Need this medication?
Pyrilamine acts as an inverse agonist at histamine H1 receptors. It binds to G protein-coupled H1 receptors and promotes an inactive receptor conformation, preventing histamine from activating the allergic response cascade. This suppresses histamine-induced effects including capillary leakage (edema), vasodilation (flare), and pruritus.
Because pyrilamine is highly lipophilic, it readily crosses the blood-brain barrier. In the CNS, it blocks H1 receptors involved in regulating wakefulness, causing the characteristic sedation associated with first-generation antihistamines. This sedative property also makes pyrilamine useful in combination with analgesics for menstrual symptom relief.
Pyrilamine also possesses mild local anesthetic activity — an additional property of the ethylenediamine antihistamine class — which contributes to its antipruritic effects. It is absorbed orally and begins working within 30-60 minutes, with effects lasting approximately 4-6 hours.
15 mg — tablet (combination - Midol Complete)
Per caplet; 2 caplets = 30 mg pyrilamine per dose
16 mg — chewable tablet (combination - Deconsal CT Rx)
With phenylephrine 10 mg; 1-2 tablets every 12 hours
25 mg — tablet (standalone - Pyrlex)
Standalone pyrilamine; very limited distribution
7.5 mg/5 mL — oral suspension (combination)
Pyrilamine/dextromethorphan combination; 5-10 mL every 12 hours
As of 2026, pyrilamine is not on the FDA's active drug shortage list. OTC combination products containing pyrilamine — such as Midol Complete, Pamprin Multi-Symptom, and store-brand generics — are widely available at major pharmacies and retailers. For most patients, availability is not a significant issue.
However, standalone pyrilamine tablets (Pyrlex) are rarely stocked at major retail pharmacies and have very limited distribution. Specific prescription combination formulations (such as Deconsal CT) are manufactured by smaller specialty companies and may not be available at all pharmacies — particularly in rural or suburban areas with limited pharmacy options.
If you're having trouble locating pyrilamine or a specific product containing it, medfinder can help — we call pharmacies near you to check which ones have your specific medication in stock and text you the results.
Pyrilamine is not a controlled substance, so there are no DEA prescribing restrictions. Any licensed healthcare provider with prescribing authority can write a prescription for pyrilamine or a pyrilamine combination product. Most patients obtain pyrilamine OTC without a prescription.
Prescribers who commonly recommend or prescribe pyrilamine-containing products include:
Telehealth providers can also prescribe pyrilamine combination products without restriction, since it is not a controlled substance. Platforms like Teladoc, MDLive, and Amazon Clinic can issue same-day prescriptions for pyrilamine combination products.
No. Pyrilamine maleate is not a controlled substance and is not scheduled by the DEA. It is freely available in OTC combination products without a prescription. Any licensed prescriber can write a prescription for pyrilamine or a pyrilamine combination product without DEA registration restrictions.
Important note: Some combination products containing pyrilamine also include controlled substances. For example, codeine/phenylephrine/pyrilamine cough syrups are Schedule V or Schedule III controlled substances — but the scheduling applies to the codeine component, not the pyrilamine itself. These combination products require a prescription and must be dispensed under DEA regulations.
The most common side effects of pyrilamine include:
Know what you need? Skip the search.
Diphenhydramine (Benadryl)
Most widely available first-generation antihistamine; similar sedating profile; OTC; higher anticholinergic burden than pyrilamine
Doxylamine (Unisom)
First-generation antihistamine; more sedating than pyrilamine; used in sleep aids and NyQuil; Rx form (Diclegis) used for pregnancy morning sickness
Cetirizine (Zyrtec)
Second-generation antihistamine; once daily; minimal sedation; widely available OTC; preferred for daytime allergy control
Loratadine (Claritin)
Second-generation, non-drowsy antihistamine; once daily; OTC; first-line for seasonal allergies
Fexofenadine (Allegra)
Second-generation antihistamine; minimal CNS effects; once daily; best option for patients who cannot tolerate any sedation
Prefer Pyrilamine? We can find it.
MAOIs (phenelzine, tranylcypromine)
majorContraindicated — MAOIs prolong and intensify anticholinergic effects of antihistamines; do not use within 14 days of MAOI therapy
Alcohol
majorStrictly avoid — significantly potentiates CNS depression; dangerous sedation possible
Opioids (codeine, hydrocodone, oxycodone)
majorAdditive CNS and respiratory depression; use with extreme caution or avoid
Benzodiazepines (alprazolam, diazepam, lorazepam)
majorAdditive CNS depression; increased sedation and impaired coordination
Tricyclic antidepressants (amitriptyline, nortriptyline)
moderateIncreased anticholinergic burden; risk of delirium, hyperthermia, urinary retention
Warfarin
moderateAcetaminophen in combination products may potentiate anticoagulant effect; monitor INR with regular use
Aminoglycoside antibiotics
moderatePyrilamine may mask ototoxicity symptoms (dizziness, hearing changes) caused by aminoglycosides
Pyrilamine maleate is a reliable first-generation antihistamine with over 75 years of clinical use. While it's rarely sold as a standalone product today, it remains a key active ingredient in widely-used OTC menstrual relief products and in select prescription combination formulations for cough and cold symptoms. Its unusually low anticholinergic activity compared to diphenhydramine gives it a distinct pharmacological advantage in certain patient populations.
Availability of OTC pyrilamine combination products is generally good at major retailers nationwide. Standalone pyrilamine tablets and some prescription combination products have more limited distribution and may require a special order or pharmacy search. The key precautions to remember: never combine with MAOIs, avoid alcohol, and use with caution in elderly patients and young children.
If you're having trouble finding your specific pyrilamine product, medfinder can help you locate it at a pharmacy near you — quickly and without hold times.
Medfinder Editorial Standards
Our medication guides are researched and written to help patients make informed decisions. All content is reviewed for accuracy and updated regularly. Learn more about our standards
ChatGPT
Claude
Perplexity
Grok
Gemini