Acetaminophen Chlorpheniramine Phenylephrine

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

Acetaminophen/chlorpheniramine/phenylephrine is available under the following different brand names: Tylenol Allergy Multi-Symptom, Dristan Cold, Children's Tylenol Plus Cold, Tylenol Sinus Congestion & Pain Nighttime, and Robitussin Peak Cold Nighttime Nasal Relief.

Dosage Forms and Strengths

Tablet

• 325mg/2mg/5mg

Dosage Considerations – Should be Given as Follows:

Relief of Cold and Flu Symptoms

Adults and Children over 12 years:

• Dristan Cold: 2 tablets orally every 4 hours; not to exceed 12 tablets/day
• Tylenol Allergy Multi-Symptom: 2 tablets orally every 4 hours; not to exceed 12 tablets/day
• Tylenol Sinus Congestion & Pain Nighttime: 2 tablets orally every 4 hours; not to exceed 12 tablets/day
• Robitussin Peak Cold Nighttime Nasal Relief: 2 tablets every 4 hours as needed; not to exceed 12 tablets/day

Children under 12 years: Ask a pediatrician

Common side effects of Acetaminophen/Chlorpheniramine/Phenylephrine 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_phenylephrine include:
  • iobenguane I 123
  • isocarboxazid
  • linezolid
  • phenelzine
  • procarbazine
  • selegiline transdermal
  • tranylcypromine
• Acetaminophen/chlorpheniramine/phenylephrine has serious interactions with at least 28 different drugs.
• Acetaminophen/chlorpheniramine/phenylephrine has moderate interactions with at least 281 different drugs.
• Acetaminophen/chlorpheniramine/phenylephrine has mild interactions with at least 64 different drugs.

Warnings

This medication contains acetaminophen/chlorpheniramine/phenylephrine. Do not take Tylenol Allergy Multi-Symptom, Dristan Cold, Children's Tylenol Plus Cold, Tylenol Sinus Congestion & Pain Nighttime, or Robitussin Peak Cold Nighttime Nasal Relief if you are allergic to acetaminophen/chlorpheniramine/phenylephrine 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 under 2 years of age
• Use of monoamine oxidase inhibitor (MAOI) within 14 days
• 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 over-the-counter (OTC) products and combined use with these products may result in toxicity due to cumulative doses exceeding recommended maximum dose

Effects of Drug Abuse

• No information available.

Short-Term Effects

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

Long-Term Effects

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

Cautions

• Caution in elderly patients, hyperthyroidism, myocardial disease, bradycardia, partial heart block or severe arteriosclerosis when administering phenylephrine; in hypovolemia, phenylephrine use is not a substitute for replacement of blood, fluids and electrolytes, and plasma (promptly restore with loss); dilute IV and administer via large vein; extravasation precautions required
• Caution in asthma, bladder neck obstruction, cardiovascular disease, chronic obstructive pulmonary disease (COPD), gastrointestinal (GI) obstruction, glaucoma, hepatic impairment, hyperthyroidism, increased intraocular pressure, malnutrition, renal impairment, elderly patients, patients taking central nervous system (CNS) depressants or 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 use of acetaminophen/chlorpheniramine/phenylephrine during pregnancy or while breastfeeding.

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