acetaminophen, dextromethorphan, guaifenesin, and pseudoephedrine

Generic Name: acetaminophen, dextromethorphan, guaifenesin, and pseudoephedrine (a seet a MIN oh fen, dex troe meth OR fan, gwye FEN e sin, soo doe e FED rin)
Brand names: Duraflu, Maxiflu DM, Robitussin Cold Cough and Flu, Theraflu Chest and Cough, Tylenol Cold Severe Congestion Non-Drowsy, Sudafed Cold and Cough Liquicaps, Sudafed Sinus and Cold Liquicaps, Phlemgesic

Acetaminophen is a pain reliever and fever reducer.

Dextromethorphan is a cough suppressant. It affects the signals in the brain that trigger cough reflex.

Guaifenesin is an expectorant. It helps loosen congestion in your chest and throat, making it easier to cough up.

Pseudoephedrine is a decongestant. It constricts (shrinks) blood vessels (veins and arteries). This reduces the blood flow to certain areas, which decreases swelling and allows nasal and respiratory (breathing) passages to open up.

The combination of acetaminophen, dextromethorphan, guaifenesin, and pseudoephedrine is used to treat stuffy nose, sinus congestion, cough, chest congestion, and pain or fever caused by the common cold or flu.

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

Before using acetaminophen, dextromethorphan, guaifenesin, and pseudoephedrine, tell your doctor if you are allergic to any drugs, or if you have:

• liver disease;

• alcoholism or cirrhosis of the liver;

• heart disease or high blood pressure;

• diabetes;

• emphysema or chronic bronchitis;

• glaucoma;

• an enlarged prostate; or

• a thyroid disorder.

If you have any of these conditions, you may need a dose adjustment or special tests to safely take this medication.

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. Cold medicine is usually taken only for a short time until your symptoms clear up.

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.

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 dizziness, drowsiness, feeling restless or nervous, nausea, vomiting, diarrhea, stomach pain, loss of appetite, increased sweating, seizure (convulsions), or coma.

Avoid taking diet pills, caffeine pills, or other stimulants (such as ADHD medications) without your doctor's advice. Taking a stimulant together with cough or cold medicine can increase your risk of unpleasant side effects.

• fast, pounding, or uneven heartbeat;

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

• confusion, hallucinations;

• slow, shallow breathing;

• easy bruising or bleeding, unusual weakness, fever, chills, body aches, flu symptoms;

• increased blood pressure (severe headache, blurred vision, trouble concentrating, chest pain, numbness, seizure); 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:

• mild loss of appetite, upset stomach;

• warmth, tingling, or redness under your skin;

• feeling excited or restless;

• sleep problems (insomnia); or

• 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.

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);

• zidovudine (Retrovir, AZT);

• medicines to treat high blood pressure;

• an antidepressant;

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

• gout medications such as probenecid (Benbemid) or sulfinpyrazone; or

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

This list is not complete and there may be other drugs that can interact with acetaminophen, dextromethorphan, guaifenesin, and pseudoephedrine. 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, dextromethorphan, guaifenesin, and pseudoephedrine.

• 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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