aspirin/chlorpheniramine/phenylephrine (OTC)

Brand and Other Names:Alka-Seltzer Plus Cold
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

aspirin/chlorpheniramine/phenylephrine

effervescent tablet

  • 325mg/2mg/7.8mg
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Temporary Relief of Common Cold Cough & Upper Respiratory Symptoms

2 tablets fully dissolved in 4 oz of water q4hr; not to exceed 8 tablets/day

Dosage Forms & Strengths

aspirin/chlorpheniramine/phenylephrine

effervescent tablet

  • 325mg/2mg/7.8mg
more...

Temporary Relief of Common Cold Cough & Upper Respiratory Symptoms

Alka-Seltzer Plus Cold

  • <12 years old: Ask a pediatrician
  • >12 years: 2 tablets fully dissolved in 4 oz of water q4hr; not to exceed 8 tablets/day
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Interactions

Interaction Checker

and aspirin/chlorpheniramine/phenylephrine

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            Adverse Effects

            Frequency Not Defined

            Dysrhythmias

            Hypotension

            Tachycardia

            Agitation

            Cerebral edema

            Coma

            Confusion

            Dizziness

            Headache

            Subdural or intracranial hemorrhage

            Lethargy

            Hives

            Rashes

            May potentiate peptic ulcer and cause stomach distress or heartburn

            Dyspepsia

            GI bleeding

            Ulceration and perforation

            Nausea

            Vomiting

            Prolonged prothrombin time

            Palpitations

            Sedation

            Fatigue

            Confusion

            Depression

            Tremors

            Irritability

            Insomnia

            Euphoria

            Hemolytic anemia

            Thrombocytopenia

            Agranulocytosis

            Anorexia

            Wheezing

            Thickening of bronchial secretions

            Restlessness

            Headache

            Hypertension

            Severe peripheral and visceral vasoconstriction

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            Warnings

            Contraindications

            Hypersensitivity

            Liver damage

            Hypoprothrombinemia

            Vitamin K deficiency

            Bleeding disorders

            Asthma

            Due to association of aspirin with Reye syndrome, do not use in children (<16 y) with viral infections

            Narrow-angle glaucoma

            Symptomatic prostate hypertrophy

            Bladder-neck obstruction

            Stenosing peptic ulcer

            Cautions

            Aspirin: May cause transient decrease in renal function & aggravate chronic kidney disease; avoid use in patients with severe anemia, with history of blood coagulation defects, or taking anticoagulants

            Chlorpheniramine: May cause significant confusional symptoms; not for administration to premature or full-term neonates

            Phenylephrine: Caution in elderly patients, hyperthyroidism, myocardial disease, bradycardia, partial heart block or severe arteriosclerosis

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            Pregnancy & Lactation

            Pregnancy category D; avoid during pregnancy, especially during third trimester (risk for premature closure of ductus arteriosus)

            Lactation: Excreted in breast milk; do not breast feed

            Pregnant or breastfeeding patients should seek advice of health professional before using OTC drugs

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

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            Pharmacology

            Mechanism of Action

            Aspirin is a stronger inhibitor of both prostaglandin synthesis and platelet aggregation than other salicylic acid derivatives. Acetyl group is responsible for inactivation of cyclooxygenase via acetylation.

            Aspirin is hydrolyzed rapidly in plasma, and elimination follows zero order pharmacokinetics. Aspirin irreversibly inhibits platelet aggregation by inhibiting platelet cyclooxygenase. This, in turn, inhibits conversion of arachidonic acid to PGI2 (potent vasodilator and inhibitor of platelet activation) and thromboxane A2 (potent vasoconstrictor and platelet aggregate).

            Chlorpheniramine blocks muscle responses in histamine and acts as an antagonism of the constrictor effects of histamine on respiratory smooth muscle.

            Phenylephrine is a vasoconstrictor and a decongestant that relieves symptoms resulting from irritation of upper respiratory tract tissue. It shrinks swollen mucous membranes, reduces nasal congestion and tissue hyperemia.

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