acetaminophen/chlorpheniramine (OTC)

Brand and Other Names:Coricidin HBP Cold & Flu, St. Joseph Cold & Flu
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

acetaminophen/chlorpheniramine

tablet

  • 325mg/2mg
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Relief of Cold & Flu Symptoms

2 tablets PO q4hr

Hepatic Impairment

May tolerate low dose therapy but use caution; cases of hepatotoxicity at doses < 4 g/day reported

Dosage Forms & Strengths

acetaminophen/chlorpheniramine

tablet

  • 325mg/2mg
more...

Relief of Cold & Flu Symptoms

≥12 years: 2 tablets PO q4hr

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Interactions

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            Adverse Effects

            Frequency Not Defined

            Hypotension

            Palpitations

            Tachycardia

            Anxiety

            Confusion

            Depression

            Dizziness

            Drowsiness

            Euphoria

            Fatigue

            Headache

            Insomnia

            Irritability

            Nervousness

            Tremors

            Anorexia

            Constipation

            Diarrhea

            Nausea

            Vomiting

            Agranulocytosis

            Anemia

            Blood dyscrasias (neutropenia, pancytopenia, leukopenia, thrombocytopenia)

            Hemolytic anemia

            Bilirubin and alkaline phosphatase may increase

            Thickening of bronchial secretions

            Wheezing

            Dry mouth, nose, throat

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            Warnings

            Contraindications

            Contraindicated in documented hypersensitivity; asthma attacks, narrow-angle glaucoma, symptomatic prostate hypertrophy, bladder-neck obstruction, and stenosing peptic ulcer; known G-6-PD deficiency

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

            Acetaminophen hepatotoxicity possible in chronic alcoholics following various dose levels; severe or recurrent pain or high or continued fever may indicate a serious illness; contained in many OTC products and combined use with these products may result in toxicity due to cumulative doses exceeding recommended maximum dose

            Acetaminophen: 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

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            Pregnancy & Lactation

            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

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

            Acetaminophen blocks pain impulse generation peripherally and may inhibit the generation of prostaglandin in the CNS. Reduces fever by inhibiting the hypothalamic heat-regulating center.

            Pharmacokinetics

            Chlorpheniramine

            • Vd: 4-7 L/kg (children); 6-12 L/kg (adults)
            • Protein binding: 33%
            • Half-life: 10-13 hr (children); 14-24 hr (adults)
            • Peak plasma time: 2-4 hr
            • Excretion: Urine

            Acetaminophen

            • Peak plasma time: 10-60 min (PO immediate release); 60-120 min (PO extended release); 6 hr (PO 500 mg tablet); 8 hr (PO 650 mg extended release tablet)
            • Vd: 1 L/kg
            • Protein binding: 10-25%
            • Metabolism: Liver (microsomal enzyme systems); conjugation (glucuronic acid)
            • Half-life: 1.25-3hr
            • Excretion: Urine
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            Images

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