acetaminophen/chlorpheniramine/dextromethorphan/phenylephrine (OTC)

Brand and Other Names:Children's Dimetapp Multi-Symptom Cold & Flu
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

acetaminophen/chlorpheniramine/dextromethorphan/phenylephrine

oral solution

  • (160mg/1mg/5mg/2.5mg)/5mL
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Cold/Flu

Indicated to temporarily relieve symptoms associated with cold or flu

4 teaspoonfuls (ie, 20 mL) PO q4hr prn

Dosage Forms & Strengths

acetaminophen/chlorpheniramine/dextromethorphan/phenylephrine

oral solution

  • (160mg/1mg/5mg/2.5mg)/5mL
more...

Cold/Flu

Indicated to temporarily relieve symptoms associated with cold or flu

<6 years: Do not use

6-12 years: 2 teaspoonfuls (ie, 10 mL) PO q4hr prn

4 teaspoonfuls (ie, 20 mL) PO q4hr prn

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Interactions

Interaction Checker

and acetaminophen/chlorpheniramine/dextromethorphan/phenylephrine

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            Adverse Effects

            Frequency Not Defined

            Hypertension

            Severe peripheral and visceral vasoconstriction

            Reflex tachycardia

            Dizziness

            Drowsiness

            Excitability

            Headache

            Restlessness

            Tremor

            GI disturbances

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            Warnings

            Contraindications

            Hypersensitivi

            Hepatitis or hepatic/renal dysfunction, alcoholism

            Repeated administration in patients with anemia or cardiac, pulmonary, or renal disease

            Do not use with MAOIs or for 2 weeks after discontinuing MAOIs

            Cautions

            Acetaminophen

            • Acetaminophen in many other dosage forms and products, check label carefully to avoid overdose
            • Risk of hepatotoxicity is higher in alcoholics or with use of more than one acetaminophen-containing product
            • G6PD deficiency
            • Risk for rare, but serious skin reactions that can be fatal; these reactions include Stevens-Johnson Syndrome (SJS), toxic epidermal necrolysis (TEN), and acute generalized exanthematous pustulosis (AGEP); symptoms may include skin redness, blisters and rash

            Chlorpheniramine

            • Marked drowsiness may occur; avoid other sedating drugs and alcohol
            • Paradoxical excitability reaction may occur, especially in children
            • Caution in narrow angle glaucoma, prostatic hypertrophy, stenosing peptic ulcer, pyloroduodenal obstruction, or bladder neck obstruction

            Dextromethorphan may decrease respirations

            Phenylephrine may increase blood pressure

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            Pregnancy & Lactation

            Pregnancy Category: C

            Lactation: excretion in milk unknown; use with caution

            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

            Acetaminophen: Acts on hypothalamus to produce antipyresis; may work peripherally to pain impulse generation; may also inhibit prostaglandin synthesis in CNS

            Chlorpheniramine: Histamine H1-receptor antagonist

            Dextromethorphan is a cough suppressant that acts centrally on the cough center in the medulla

            Phenylephrine is a vasoconstrictor and a 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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