acetaminophen/chlorpheniramine/dextromethorphan (OTC)

Brand and Other Names:Children's Triaminic Flu, Cough & Fever, Children's Tylenol Plus Cough & Runny Nose, more...Coricidin HBP Maximum Strength Flu, Vicks Formula 44 Custom Care Cough & Cold PM, St. Joseph Maximum Strength Flu
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

acetaminophen/chlorpheniramine/dextromethorphan

tablet

  • 500mg/2mg/15mg

Relief of Cold & Flu Symptoms

2 tab PO q6hr; not to exceed 8 tabs/day

Dosage Forms & Strengths

acetaminophen/chlorpheniramine/dextromethorphan

tablet

  • 500mg/2mg/15mg

Relief of Cold & Flu Symptoms

≥12 years: 2 tablets PO q6hr; not to exceed 8 tabs/day

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Interactions

Interaction Checker

and acetaminophen/chlorpheniramine/dextromethorphan

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            Adverse Effects

            Frequency Not Defined

            Hypotension

            Palpitations

            Tachycardia

            Confusion

            Depression

            Distress

            Dizziness

            Euphoria

            Fatigue

            Headache

            Insomnia

            Irritability

            Sedation

            Tremors

            Dermatologic rash

            Anorexia

            GI disturbances

            Anemia blood dyscrasias (neutropenia, pancytopenia, leukopenia)

            Agranulocytosis

            Hemolytic anemia

            Thrombocytopenia

            Bilirubin and alkaline phosphatase may increase

            Thickening of bronchial secretions

            Wheezing

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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 < 2 years of age

            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

            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

            Cautions

            Caution in asthma, bladder neck obstruction, cardiovascular disease, COPD, GI obstruction, glaucoma, hepatic impairment, hypertension, hyperthyroidism, increased intraocular pressure, malnutrition, renal impairment, elderly patients, patients taking CNS depressants or <6 years of age with chlorpheniramine products

            Caution in severe hypovolemia if taking acetaminophen products

            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

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

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            Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.