acetaminophen, chlorpheniramine, and dextromethorphan

Generic Name: acetaminophen, chlorpheniramine, and dextromethorphan (a SEET a MIN oh fen, klor fen IR a meen, dex troe meth OR fan)
Brand names: Coricidin HBP Maximum Strength Flu, Triaminic Flu Cough & Fever, Tylenol Childrens Plus Cough & Runny Nose, Coricidin II Extra Strength Cold and Flu, Triaminic Flu Cough & Fever, Tylenol Childrens Plus Cough & Runny Nose

Acetaminophen is a pain reliever and fever reducer.

Chlorpheniramine is an antihistamine that reduces the natural chemical histamine in the body. Histamine can produce symptoms of sneezing, itching, watery eyes, and runny nose.

Dextromethorphan is a cough suppressant. It affects the cough reflex in the brain that triggers coughing.

The combination of acetaminophen, chlorpheniramine, and dextromethorphan is used to treat runny nose, cough, and pain or fever caused by the common cold or flu.

Acetaminophen, chlorpheniramine, and dextromethorphan may also be used for other purposes not listed in this medication guide.

Do not take more of this medication than is recommended. An overdose of acetaminophen can cause damage to your liver. The maximum amount of acetaminophen for adults is 1 gram (1000 mg) per dose and 4 grams (4000 mg) per day. If you drink more than three alcoholic beverages per day, do not take this medication without your doctor's advice, and never take more than 2 grams (2000 mg) of acetaminophen per day.

Do not use any other cough, cold, or allergy medication without first asking your doctor or pharmacist. If you take certain products together you may accidentally take too much of a certain drug. Read the label of any other medicine you are using to see if it contains acetaminophen (sometimes abbreviated as "APAP"), chlorpheniramine, or dextromethorphan.

Do not use this medication if you have used an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days. Serious, life-threatening side effects can occur if you take dextromethorphan before the MAO inhibitor has cleared from your body.

Before taking acetaminophen, chlorpheniramine, and dextromethorphan, tell your doctor if you are allergic to any drugs, or if you have:

• asthma, emphysema, or chronic bronchitis;

• cough with a large amount of mucus (phlegm);

• liver disease;

• alcoholism or cirrhosis of the liver;

• heart disease;

• diabetes;

• a thyroid disorder;

• glaucoma;

• kidney disease;

• an enlarged prostate; or

• problems with urination.

If you have any of these conditions, you may not be able to use this medication, or you may need a dosage adjustment or special tests during treatment.

Some forms of this medication may contain phenylalanine. This would be important to know if you have phenylketonuria (PKU). Check the ingredients and warnings on the medication label if you are concerned about phenylalanine.

Use this medication exactly as directed on the label, or as it has been prescribed by your doctor. Do not use the medication in larger amounts, or use it for longer than recommended. Cough-and-cold medicines should be taken only for a short time until your symptoms clear up.

Measure the liquid form of this medicine with a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

If you need to have any type of surgery, tell the surgeon ahead of time if you have taken a cold medicine within the past few days.

Since cough or cold medicine is usually taken only as needed, you may not be on a dosing schedule. If you are taking the medication regularly, take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at your next regularly scheduled time. Do not take extra medicine to make up the missed dose.

Overdose symptoms may include dry mouth, feeling restless or nervous, dizziness, drowsiness, nausea, vomiting, diarrhea, stomach pain, loss of appetite, increased sweating, vision changes, fast heart rate, warmth or tingly feeling, hallucinations, seizure (convulsions), or coma.

Tell your doctor if you regularly use other medicines that make you sleepy (such as cold or allergy medicine, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression, or anxiety). They can add to sleepiness caused by chlorpheniramine.

• fast, pounding, or uneven heartbeats;

• confusion, hallucinations, unusual thoughts or behavior;

• severe dizziness, anxiety, restless feeling, or nervousness;

• urinating less than usual or not at all;

• easy bruising or bleeding, unusual weakness; or

• nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Less serious side effects may include:

• dry eyes, blurred vision;

• dry mouth, upset stomach, constipation;

• warmth, tingling, or redness under your skin;

• dizziness, drowsiness;

• restless or excitability (especially in children);

• sleep problems (insomnia);

• problems with memory or concentration;

• ringing in your ears; or

• mild skin rash or itching.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Usual Adult Dose for Cold Symptoms:

APAP/chlorpheniramine/dextromethorphan 500 mg-2 mg-15 mg tablets: 2 tablets orally every 6 hours, while symptoms persist, not to exceed 8 tablets in 24 hours, or as directed by a doctor.

Usual Adult Dose for Influenza:

APAP/chlorpheniramine/dextromethorphan 500 mg-2 mg-15 mg tablets: 2 tablets orally every 6 hours, while symptoms persist, not to exceed 8 tablets in 24 hours, or as directed by a doctor.

Usual Pediatric Dose for Cold Symptoms:

APAP/chlorpheniramine/dextromethorphan 160 mg-1 mg-5 mg/5 mL oral suspension:
Greater than or equal to 6 years to less than 12 years: 10 mL orally every 4 hours not to exceed 5 doses daily.

APAP/chlorpheniramine/dextromethorphan 160 mg-1 mg-7.5 mg/5 mL oral liquid:
Greater than or equal to 6 years to less than 12 years: 10 mL orally every 6 hours not to exceed 4 doses daily.

APAP/chlorpheniramine/dextromethorphan 500 mg-2 mg-15 mg tablets:
Greater than or equal to 12 years: 2 tablets orally every 6 hours, while symptoms persist, not to exceed 8 tablets in 24 hours, or as directed by a doctor.

Usual Pediatric Dose for Influenza:

APAP/chlorpheniramine/dextromethorphan 160 mg-1 mg-5 mg/5 mL oral suspension:
Greater than or equal to 6 years to less than 12 years: 10 mL orally every 4 hours not to exceed 5 doses daily.

APAP/chlorpheniramine/dextromethorphan 160 mg-1 mg-7.5 mg/5 mL oral liquid:
Greater than or equal to 6 years to less than 12 years: 10 mL orally every 6 hours not to exceed 4 doses daily.

APAP/chlorpheniramine/dextromethorphan 500 mg-2 mg-15 mg tablets:
Greater than or equal to 12 years: 2 tablets orally every 6 hours, while symptoms persist, not to exceed 8 tablets in 24 hours, or as directed by a doctor.

Before taking this medication, tell your doctor if you are using any of the following drugs:

• celecoxib (Celebrex);

• cinacalcet (Sensipar);

• darifenacin (Enablex);

• imatinib (Gleevec);

• isoniazid;

• quinidine (Quinaglute, Quinidex);

• ranolazine (Ranexa)

• ritonavir (Norvir);

• sibutramine (Meridia);

• terbinafine (Lamisil);

• an antidepressant;

• a bronchodilator;

• a diuretic (water pill);

• gout medications such as sulfinpyrazone (Anturane);

• medication to treat irritable bowel syndrome, bladder spasms, or urinary incontinence;

• a beta-blocker such as atenolol (Tenormin), carteolol (Cartrol), metoprolol (Lopressor, Toprol), nadolol (Corgard), propranolol (Inderal), sotalol (Betapace), timolol (Blocadren), and others; or

• seizure medication such as phenytoin (Dilantin) or phenobarbital (Luminal, Solfoton).

This list is not complete and there may be other drugs that can affect acetaminophen, chlorpheniramine, and dextromethorphan. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

• Your pharmacist can provide more information about acetaminophen, chlorpheniramine, and dextromethorphan.

• Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
• Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

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