Acetaminophen Chlorpheniramine Dextromethorphan

Acetaminophen/chlorpheniramine/dextromethorphan is an over-the-counter (OTC) product used for the relief of cold and flu symptoms.

Acetaminophen/chlorpheniramine/dextromethorphan is available under the following different brand names: Children's Triaminic Flu, Cough & Fever, Children's Tylenol Plus Cough & Runny Nose, Coricidin HBP Maximum Strength Flu, Vicks Formula 44 Custom Care Cough & Cold PM, and St. Joseph Maximum Strength Flu.

Dosages of Acetaminophen/Chlorpheniramine/Dextromethorphan:

Dosage Forms and Strengths

Tablet

• 500mg/2mg/15mg

Dosage Considerations – Should be Given as Follows:

Relief of Cold and Flu Symptoms

• Adults and children 12 years and older: 2 tablets orally every 6 hours; not to exceed 8 tabs/day

Dosage Modifications

• Renal impairment: No dose adjustment is required
• Mild-to-moderate hepatic impairment: No dose adjustment required
• Severe hepatic impairment: Not recommended; based on the increased inherent risk of bleeding in patients with severe hepatic impairment

Common side effects of Acetaminophen/Chlorpheniramine/Dextromethorphan include:

• Low blood pressure (hypotension)
• Palpitations
• Fast heart rate
• Confusion
• Depression
• Distress
• Dizziness
• Euphoria
• Fatigue
• Headache
• Insomnia
• Irritability
• Sedation
• Tremors
• Skin rash
• Loss of appetite
• Gastrointestinal disturbances
• Anemia
• Blood disorders (neutropenia, pancytopenia, leukopenia, thrombocytopenia, agranulocytosis)
• Hemolytic anemia
• Increased bilirubin and alkaline phosphatase
• Thickening of bronchial secretions
• Wheezing

This document does not contain all possible side effects and others may occur. Check with your physician for additional information about side effects.

Severe interactions of acetaminophen_chlorpheniramine_dextromethorphan include:

• isocarboxazid
• phenelzine
• procarbazine
• rasagiline
• safinamide
• selegiline
• tranylcypromine

Acetaminophen/chlorpheniramine/dextromethorphan has serious interactions with at least 38 different drugs.

Acetaminophen/chlorpheniramine/dextromethorphan has moderate interactions with at least 267 different drugs.

Acetaminophen/chlorpheniramine/dextromethorphan has mild interactions with at least 76 different drugs.

Warnings

This medication contains acetaminophen/chlorpheniramine/dextromethorphan. Do not take Children's Triaminic Flu, Cough & Fever, Children's Tylenol Plus Cough & Runny Nose, Coricidin HBP Maximum Strength Flu, Vicks Formula 44 Custom Care Cough & Cold PM, or St. Joseph Maximum Strength Flu if you are allergic to acetaminophen/chlorpheniramine/dextromethorphan or any ingredients contained in this drug.

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 children under 2 years of age
• Acetaminophen hepatotoxicity is 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

Effects of Drug Abuse

• No information is available.

Short-Term Effects

• See "What Are Side Effects Associated with Using Acetaminophen/Chlorpheniramine/Dextromethorphan?"

Long-Term Effects

• See "What Are Side Effects Associated with Using Acetaminophen/Chlorpheniramine/Dextromethorphan?"

Cautions

• Caution in asthma, bladder neck obstruction, cardiovascular disease, chronic obstructive pulmonary disease (COPD), gastrointestinal obstruction, glaucoma, hepatic impairment, hypertension, hyperthyroidism, increased intraocular pressure, malnutrition, renal impairment, elderly patients, patients taking CNS depressants or children under 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

Pregnancy and Lactation

There is no information available regarding the use of acetaminophen/chlorpheniramine/dextromethorphan during pregnancy or while breastfeeding.

Pregnant or breastfeeding patients should seek the advice of a health professional before using over-the-counter (OTC) drugs.