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Paracetamol/Pheniramine/Phenylephrine

    DEA Class;  OTC

    Common Brand Names; Theraflu Cold & Sore Throat, Theraflu Flu & Sore Throat

    • Antitussives, Non-narcotic Combos

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

    Pheniramine: competes with histamine for histamine H1- receptor sites on effector cells; antihistamines antagonize the effects of histamine mediated through activation of H1- receptor sites, thereby reduces intensity of allergic reactions & tissue injury caused by histamine release

    Phenylephrine: vasoconstrictor & decongestant that relieves symptoms resulting from irritation of upper respiratory tract tissue; shrinks swollen mucous membranes, reduces nasal congestion & tissue hyperemia

    Indicated for Allergy Symptoms & Common Cold

    Hypersensitivity

    Asthma

    < 2 years old

    Narrow-angle glaucoma

    Symptomatic prostate hypertrophy

    Bladder-neck obstruction

    Stenosing peptic ulcer

    Use within 14 days of MAO inhibitor therapy

    G-6-PD deficiency

    Severe hepatic impairment

    Hypotension

    Palpitations

    Reflex hypertension

    Severe peripheral and visceral vasoconstriction

    Tachycardia

    Confusion

    Dizziness

    Depression

    Distress

    Euphoria

    Fatigue

    Headache

    Insomnia

    Irritability

    Restlessness

    Sedation

    Tremors

    Dermatologic rash

    Anorexia

    Agranulocytosis

    Pheniramine: May cause significant confusional symptoms; not for administration to premature or full-term neonates

    Phenylephrine: Caution in elderly patients, hyperthyroidism, myocardial disease, bradycardia, partial heart block or severe atherosclerosis

    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

    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: C

    Lactation: excreted in breast milk, use caution

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

    Adults

    Dissolve contents of 1 packet in 8 oz of hot water; consume entire 8 oz within 10-15 minutes; not to exceed acetaminophen 1 g/dose or 4 g/day

    Pediatric

    <12 years: Ask a pediatrician

    ≥12 years: Dissolve contents of 1 packet in 8 oz of hot water; consume entire 8 oz within 10-15 minutes; not to exceed acetaminophen 1 g/dose or 4 g/day

    acetaminophen/pheniramine/phenylephrine

    powder

    • 325mg/20mg/10mg per packet