acetaminophen/doxylamine/dextromethorphan (OTC)

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Brand and Other Names:Coricidin HBP Nighttime Multi-Symptom Cold, Tylenol Cough & Sore Throat Nighttime, more...Vicks NyQuil Cold & Flu, Contac Cold + Flu Night Cooling Relief

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

acetaminophen/doxylamine/dextromethorphan

liquid

  • (325mg/6.25mg/15mg)/15mL
  • (500mg/6.25mg/15mg)/15mL
  • (650mg/7.5mg/30mg)/30mL
  • (650mg/12.5mg/30mg)/30mL

liquid capsule

  • 325mg/6.25mg/15mg
more...

Cough, Sore Throat, Rhinorrhea, Fever, Headache, Minor Aches & Pains

1-2 Tablespoons (15-30mL) PO q6hr; not to exceed a cumulative dose of acetaminophen 4 g/day and dextromethorphan 120 mg/day

2 capsules PO q6hr; not to exeed 8 capsules/day

Liquid formulation ingredients vary in dosage; follow specific brand instructions

Dosage Forms & Strengths

acetaminophen/doxylamine/dextromethorphan

liquid

  • (500mg/6.25mg/15mg)/15mL
  • (650mg/7.5mg/30mg)/30mL
  • (650mg/12.5mg/30mg)/30mL

liquid capsule

  • 325mg/6.25mg/15mg
more...

Cough, Sore Throat, Rhinorrhea, Fever, Headache, Minor Aches & Pains

<12 Years Old

  • Ask a pediatrician

>12 Years Old

  • 2 Tablespoons (30mL) PO q6hr; not to exceed 120 mL/day
  • 2 capsules PO q6hr; not to exeed 8 capsules/day
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Interactions

Interaction Checker

and acetaminophen/doxylamine/dextromethorphan

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            Adverse Effects

            Frequency Not Defined

            Angioedema

            Laryngeal edema

            Dizziness

            Drowsiness

            Pruritic maculopapular rash

            Urticaria

            Dry mouth, throat, and nose

            Agranulocytosis

            Leukopenia

            Neutropenia

            Pancytopenia

            Thrombocytopenia

            Thrombocytopenic purpura

            Hepatotoxicity

            Thickening of mucus in nose or throat

            Anaphylactoid reaction

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            Warnings

            Contraindications

            Hypersensitivity

            Asthma

            Narrow-angle glaucoma

            Symptomatic prostate hypertrophy

            Bladder-neck obstruction

            Stenosing peptic ulcer

            G-6-PD deficiency

            Severe hepatic impairment

            Cautions

            Acetaminophen hepatotoxicity possible in chronic alcoholics following various dose levels

            Severe or recurrent pain or high or continued fever may indicate a serious illness

            Acetaminophen 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

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

            Do not take dextromethorphan 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; dextromethorphan may slow the breathing

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            Pregnancy & Lactation

            Pregnancy category: C

            Lacation: excreted in breast milk, use 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: Blocks pain impulse generation peripherally and may inhibit prostaglandin generation in CNS; reduces fever by inhibiting hypothalamic heat-regulating center

            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 cough center in medulla

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            Images

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