acetaminophen/guaifenesin (OTC)

Brand and Other Names:Tylenol Chest Congestion, Comtrex Deep Chest Cold Non Drowsy, more...Tylenol Chest Congestion Daytime Non-Drowsy
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

acetaminophen/guaifenesin

packet

  • 1000mg/400mg
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Cough, Fever, Headache, Minor Aches & Pains

1 packet dissolved in 8 oz of hot water q6hr; not to exceed 4 packets/day; consume entire drink within 10-15 minutes

Dosage Forms & Strengths

acetaminophen/guaifenesin

tablet

  • 325mg/200mg

capsule

  • 325mg/200mg

oral solution

  • (500mg/200mg)/15mL

packet

  • 1000mg/400mg
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Cough, Fever, Headache, Minor Aches & Pains

<12 years

  • Ask a pediatrician

>12 years

  • 1 packet dissolved in 8 oz of hot water q6hr; not to exceed 4 packets/day; consume entire drink within 10-15 minutes
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Interactions

Interaction Checker

and acetaminophen/guaifenesin

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    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            Frequency Not Defined

            Dizziness

            Drowsiness

            Headache

            Dermatologic rash

            Nausea

            Vomiting

            Anemia blood dyscrasias (neutropenia, pancytopenia, leukopenia)

            Bilirubin and alkaline phosphatase may increase

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            Warnings

            Contraindications

            Hypersensitivity

            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; 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

            Guaifenesin is not for administration in persistent cough associated with chronic bronchitis, smoking, asthma, or accompanied with excessive secretions

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            Pregnancy & Lactation

            Pregnancy category: C

            Lactation: 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 & may inhibit the generation of prostaglandin in the CNS; reduces fever by inhibiting the hypothalamic heat-regulating center

            Guaifenesin increases respiratory tract fluid secretions & helps to loosen phlegm & bronchial secretions

            Pharmacokinetics

            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

            Guaifenesin

            • Half-Life: 1 hr
            • Onset: 30 min
            • Duration: 4-6 hr
            • Metabolism: Liver
            • Metabolite: b-(2-methoxyphenoxy) lactic acid
            • Excretion: Urine
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