aspirin/doxylamine/dextromethorphan/phenylephrine (OTC)Brand and Other Names:Alka-Seltzer Plus Night Cold & Cough Effervescent

 
 
 

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

aspirin/doxylamine/dextromethorphan/phenylephrine

effervescent tablet

  • 500mg/10mg/6.25mg/7.8mg
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Relief of Cold Symptoms

Alka-Seltzer Plus Night Cold & Cough Effervescent: 2 tablets fully dissolved in 4 oz of water qHS; may be taken q4-6hr; not to exceed 8 tablets/day

Dosage Forms & Strengths

aspirin/doxylamine/dextromethorphan/phenylephrine

effervescent tablet

  • 500mg/10mg/6.25mg/7.8mg
more...

Relief of Cold Symptoms

Alka-Seltzer Plus Night Cold & Cough Effervescent

  • <12 years old: Do not use
  • >12 years old: 2 tablets fully dissolved in 4 oz of water qHS; may be taken q4-6hr; not to exceed 8 tablets/day
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Interactions

Interaction Checker

aspirin/doxylamine/dextromethorphan/phenylephrine and

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     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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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

            Rash

            May potential peptic ulcer & cause stomach distress or heartburn

            Dyspepsia

            GI bleeding

            Ulceration & perforation

            Nausea

            Vomiting

            Prolonged prothrombin time

            Sedation

            Sleepiness

            Urinary retention

            Xerostomia

            Increased appetite

            Thickening of mucus in nose or throat

            Restlessness

            Headache

            Hypertension

            Severe peripheral & visceral vasoconstriction

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            Warnings

            Contraindications

            Hypersensitivity

            Liver damage

            Hypoprothrombinemia

            Vitamin K deficiency

            Bleeding disorders

            Asthma

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

            Use within 14 days of MAO inhibitor therapy

            Narrow-angle glaucoma

            Symptomatic prostate hypertrophy

            Bladder-neck obstruction

            Cautions

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

            Dextromethorphan: Do not take for persistent or chronic cough associated with smoking, asthma, or emphysema, or if it is accompanied by excessive phlegm unless directed by a healthcare provider; may decrease respiration rate

            Doxylamine: May exacerbate angle closure glaucoma, hyperthyroidism, peptic ulcer, or urinary tract obstruction; xerostomia may occur

            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 aspirin 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: Stronger inhibitor of both prostaglandin synthesis & platelet aggregation than other salicylic acid derivatives; acetyl group responsible for inactivation of cyclooxygenase via acetylation; hydrolyzed rapidly in plasma, & 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)

            Doxylamine: competitively blocks histamine from binding to H1 receptors; significant antimuscarinic activity and penetrates CNS, which causes pronounced tendency to induce sedation

            Dextromethorphan: cough suppressant that acts centrally on the cough center in medulla

            Phenylephrine: vasoconstrictor & decongestant that relieves symptoms resulting from irritation of upper respiratory tract tissue; shrinks swollen mucous membranes, reduces nasal congestion and tissue hyperemia

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