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Paracetamol/Dextromethorphan/Phenylephrine

    Brands

    DEA Class;  OTC

    Common Brand Names; Alka-Seltzer Plus Day Cold, Theraflu Daytime Severe Cold & Cough, Tylenol Cold Multi-Symptom Daytime, Tylenol Cold Head Congestion Daytime, Vicks DayQuil Cold/Flu, Alka-Seltzer Plus Day Severe Cold, Cough & Flu, Alka-Seltzer Plus Day Sinus Congestion, Allergy & Cough, Alka-Seltzer Plus Severe Sinus Congestion & Cough

    • Cough/Cold, Non-narcotic Combos; 
    • Analgesic/Decongestant Combos

    Combination of an analgesic (acetaminophen), non-opiate antitussive (dextromethorphan) and sympathomimetic decongestion (phenylephrine)
    Used for symptomatic relief of mild pain, fever, cough, nasal congestion, headache, sore throat due to a common cold or influenza
    Do not exceed recommended daily dosages, particularly for acetaminophen due to hepatotoxicity

    For temporary relief from common cold or flu symptoms such as mild pain, cough, nasal congestion, headache, sore throat (pharyngitis), and fever.

    Documented hypersensitivity to the drugs

    Within 14 days of MAO inhibitor therapy; known G-6-PD deficiency

    Hypertension

    Reflex tachycardia

    Severe peripheral and visceral vasoconstriction

    Dizziness

    Drowsiness

    Excitability

    Headache

    Restlessness

    Tremor

    GI disturbances

    Anemia blood dyscrasias (neutropenia, pancytopenia, leukopenia)

    Bilirubin and alkaline phosphatase may increase

    Do not use if currently taking a prescription for monoamine oxidase inhibitor for depression or emotional conditions, or Parkinson disease, or within two weeks of taking a MAO inhibitor

    Ask a healthcare professional if the chronic cough is associated with smoking, asthma, or emphysema or if occurs with heavy phlegm or mucus

    Discontinue use if cough lasts more than seven days, reoccurs, or occurs with fever, rash, or long-lasting headaches as it could be signs of a serious condition

    Some products may contain sulfites, which may cause allergic reactions in susceptible individuals

    Closely monitor in hyperthyroidism, DM, heart disease, bowel obstruction/narrowing, increased intraocular pressure, BPH

    Discontinue and inform healthcare provider if dizziness, nervousness, or sleeplessness occur

    Avoid or use with extreme caution in patients with heart failure or cardiogenic shock; cardiac output may decrease with increased systemic vascular resistance

    May cause excessive peripheral and visceral vasoconstriction and ischemia to vital organs, especially in patients with peripheral vascular disease

    Pregnant or breastfeeding patients should seek advice of health professional before using OTC drugs

    Adults

    Acetaminophen 3,900 mg/day PO; dextromethorphan 100 mg/day PO; phenylephrine 50 mg/day PO.

    Geriatric

    Acetaminophen 3,900 mg/day PO; dextromethorphan 100 mg/day PO; phenylephrine 50 mg/day PO.

    Adolescents

    Acetaminophen 3,900 mg/day PO; dextromethorphan 100 mg/day PO; phenylephrine 50 mg/day PO.

    Children

    12 years: Acetaminophen 3,900 mg/day PO; dextromethorphan 100 mg/day PO; phenylephrine 50 mg/day PO.
    6 to 11 years: Acetaminophen 1,600 mg/day PO; dextromethorphan 50 mg/day PO; phenylephrine 25 mg/day PO.
    Less than 6 years: Safety and efficacy have not been established.

    acetaminophen/dextromethorphan/phenylephrine

    caplet

    • 325mg/10mg/5mg

    rapid release gelcap

    • 325mg/10mg/5mg

    capsule

    • 325mg/10mg/5mg

    liquid

    • (325mg/10mg/5mg)/15mL

    powder for solution

    • (650mg/20mg/10mg)/packet

    • (500mg/20mg/10mg)/packet

    syrup

    • (325mg/10mg/5mg)/15mL