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Paracetamol/Doxylamine/Dextromethorphan/Pseudoephedrine

    DEA Class;  OTC

    Common Brand Names; Vicks NyQuil D, Vicks NyQuil

    • Cough/Cold, Non-narcotic Combos

    Acetaminophen: Blocks pain impulse generation peripherally & may inhibit the generation of prostaglandin in the CNS; reduces fever by inhibiting the hypothalamic heat-regulating center

    Dextromethorphan: Cough suppressant that acts centrally on cough center in medulla

    Doxylamine: Competitively blocks histamine from binding to H1 receptors; significant antimuscarinic activity and penetrates CNS, which causes pronounced tendency to induce sedation

    Pseudoephedrine: Stimulates the alpha-adrenergic receptors causing bronchodilation & vasoconstriction

    Indicated in Nasal Congestion, Rhinorrhea, Sore Throat, Cough, Fever, Headache

    Hypersensitivity to any of the drugs

    Narrow-angle glaucoma

    <2 years of age

    Use of MAO inhibitors within 14 days

    Stenosing peptic ulcer

    Severe hepatic impairment

    Arrhythmia

    Palpitations

    Convulsion

    Dizziness

    Drowsiness

    Excitability

    Tremor

    Weakness

    Dermatologic rash

    GI disturbances

    Anemia blood dyscrasias (neutropenia, pancytopenia, leukopenia)

    Bilirubin and alkaline phosphatase may increase

    Dry mouth, throat, and nose

    Thickening of mucus in nose or throat

    Severe or recurrent pain or high or continued fever may indicate a serious illness

    Severe or recurrent pain or high or continued fever may indicate a serious illness

    Pregnancy category: C

    Lacation: excreted in breast milk, use caution

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

    Adults

    30 mL PO q6-8hr; not to exceed 4 doses/day

    Pediatric

    <12 years old: Ask a pediatrician

    >12 years old: 30 mL PO q6-8hr; not to exceed 4 doses/day

    acetaminophen/doxylamine/dextromethorphan/pseudoephedrine

    liquid

    • (325mg/6.25mg/15mg/30mg)/15mL