Classes
DEA Class; OTC
Common Brand Names; CChildren’s Triaminic Flu, Cough & Fever, Children’s Tylenol Plus Cough & Runny Nose, Coricidin HBP Maximum Strength Flu, Vicks Formula 44 Custom Care Cough & Cold PM, St. Joseph Maximum Strength Flu
- Antitussives, Non-narcotic;
- Antitussives, Non-narcotic Combos;
- Analgesic/Antihistamine/Antitussive Combos
Description
Oral combination of an analgesic/antipyretic, antihistamine, and antitussive
Used for the treatment of symptoms due to the common cold or flu
May cause sedation; excitability may occur, especially in children
Indications
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
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
Do not take dextromethorphan 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; dextromethorphan may slow the breathing
Adverse Effects
Hypotension
Palpitations
Tachycardia
Confusion
Depression
Distress
Dizziness
Euphoria
Fatigue
Headache
Insomnia
Irritability
Sedation
Tremors
Dermatologic rash
Anorexia
GI disturbances
Anemia blood dyscrasias (neutropenia, pancytopenia, leukopenia)
Agranulocytosis
Hemolytic anemia
Thrombocytopenia
Bilirubin and alkaline phosphatase may increase
Thickening of bronchial secretions
Wheezing
Warnings
Caution in asthma, bladder neck obstruction, cardiovascular disease, COPD, GI obstruction, glaucoma, hepatic impairment, hypertension, 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
3,250 mg/day PO acetaminophen; 20 mg/day PO chlorpheniramine; 100 mg/day PO dextromethorphan for tablets and 2,600 mg/day PO acetaminophen; 16 mg/day PO chlorpheniramine; 120 mg/day dextromethorphan for liquid.
3,250 mg/day PO acetaminophen; 20 mg/day PO chlorpheniramine; 100 mg/day PO dextromethorphan for tablets and 2,600 mg/day PO acetaminophen; 16 mg/day PO chlorpheniramine; 120 mg/day dextromethorphan for liquid.
3,250 mg/day PO acetaminophen; 20 mg/day PO chlorpheniramine; 100 mg/day PO dextromethorphan for tablets and 2,600 mg/day PO acetaminophen; 16 mg/day PO chlorpheniramine; 120 mg/day dextromethorphan for liquid.
12 years: 3,250 mg/day PO acetaminophen; 20 mg/day PO chlorpheniramine; 100 mg/day PO dextromethorphan for tablets and 2,600 mg/day PO acetaminophen; 16 mg/day PO chlorpheniramine; 120 mg/day dextromethorphan for liquid.
6 to 11 years: 1600 mg/day PO acetaminophen; 10 mg/day PO chlorpheniramine; 50 mg/day PO dextromethorphan for suspension. Safety and efficacy of tablets and liquid have not been established.
1 to 5 years: Safety and efficacy have not been established.
Safety and efficacy have not been established.
Safety and efficacy have not been established.
How supplied
acetaminophen/chlorpheniramine/dextromethorphan
tablet
- 500mg/2mg/15mg