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Aspirin/Chlorpheniramine/Dextromethorphan/Phenylephrine

    DEA Class;  OTC

    Common Brand Names; Alka-Seltzer Plus Cold & Cough Effervescent

    Analgesic/Antihistamine/Antitussive/Decongestant Combos

    Temporary Relief of Common Cold Cough & Upper Respiratory Symptoms

    Indicated for temporary relief of common Cold, cough and upper respiratory track infection.

    Hypersensitivity

    Liver damage

    < 2 years of age

    Hypoprothrombinemia

    Vitamin K deficiency

    Bleeding disorders

    Asthma

    G6PD deficiency

    Uncontrolled or severe hypertension

    Due to association of aspirin with Reye syndrome, do not use in children (<16 y) with viral infections

    Narrow-angle glaucoma

    Symptomatic prostate hypertrophy

    Bladder-neck obstruction

    Stenosing peptic ulcer

    Dysrhythmias

    Hypotension

    Tachycardia

    Agitation

    Cerebral edema

    Coma

    Confusion

    Dizziness

    Headache

    Subdural or intracranial hemorrhage

    Lethargy

    Hives

    Rashes

    May potentiate peptic ulcer and cause stomach distress or heartburn

    Dyspepsia

    GI bleeding

    Ulceration & perforation

    Nausea

    Vomiting

    Prolongation of prothrombin time

    Aspirin: May cause transient decrease in renal function and aggravate chronic kidney disease; avoid use in patients with severe anemia, with history of blood coagulation defects, or taking anticoagulants

    Dextromethorphan: Do not take for persistent or chronic cough associated with smoking, asthma, or emphysema, or if it is accompanied by excessive phlegm unless directed by a healthcare provider; may decrease respiration rate

    Chlorpheniramine: 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 arteriosclerosis

    Pregnancy category: D; avoid during pregnancy, particularly in third trimester because of risk for premature closure of the ductus arteriosus

    Lactation: Excreted in breast milk; do not breast feed

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

    Adults

    2 tabs fully dissolved in 4 oz of water q4hr; not to exceed 8 tablets/day

    Pediatric 

    <12 years old: Ask a pediatrician

    >12 years old: 2 tablets fully dissolved in 4 oz of water q4hr; not to exceed 8 tablets/day

    Effervescent Tablet

    325mg/2mg/10mg/7.8mg