Classes
DEA Class; OTC
Common Brand Names; Tylenol Allergy Multi-Symptom, Dristan Cold, Children’s Tylenol Plus Cold, Tylenol Sinus Congestion & Pain Nighttime, Robitussin Peak Cold Nighttime Nasal Relief
- Antihistamine/Decongestant/Analgesic Combos
Description
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.
Phenylephrine is a vasoconstrictor and a decongestant that relieves symptoms resulting from irritation of upper respiratory tract tissue. It shrinks swollen mucous membranes, reduces nasal congestion and tissue hyperemia.
Indications
Indicated in Relief of Cold & Flu Symptoms
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
Use of MAO inhibitor 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 OTC products and combined use with these products may result in toxicity due to cumulative doses exceeding recommended maximum dose
Adverse Effects
Hypotension
Hypertension
Palpitations
Reflex tachycardia
Severe peripheral and visceral vasoconstriction
Tachycardia
Confusion
Depression
Distress
Dizziness
Euphoria
Excitability
Fatigue
Headache
Insomnia
Irritability
Restlessness
Sedation
Tremors
Dermatologic rash
Warnings
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, COPD, GI obstruction, glaucoma, hepatic impairment, 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
Pregnancy and Lactation
Pregnant or breastfeeding patients should seek advice of health professional before using OTC drugs
Maximum Dosage
Adults
Dristan Cold: 2 tablets PO q4hr; not to exceed 12 tablets/day
Pediatric
<12 years
: Ask a peditrician
>12 years
Dristan Cold: 2 tablets PO q4hr; not to exceed 12 tablets/day
Tylenol Allergy Multi-Symptom: 2 tablets PO q4hr; not to exceed 12 tablets/day
Tylenol Sinus Congestion & Pain Nighttime: 2 tablets PO q4hr; not to exceed 12 tablets/day
Robitussin Peak Cold Nighttime Nasal Relief: 2 tablets q4hr prn
How supplied
acetaminophen/chlorpheniramine/phenylephrine
tablet
- 325mg/2mg/5mg