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Home > Medical Reference > Encyclopedia (English)



 

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U.S. Brand Names:

Alka-Seltzer® Plus Flu Liqui-Gels® [OTC]; Comtrex® Non-Drowsy Cold and Cough Relief [OTC]; Contac® Severe Cold and Flu/Non-Drowsy [OTC]; Infants' Tylenol® Cold Plus Cough Concentrated Drops [OTC]; Sudafed® Severe Cold [OTC]; Thera-Flu® Severe Cold Non-Drowsy [OTC] [DSC]; Triaminic® Cough and Sore Throat Formula [OTC]; Tylenol® Cold Day Non-Drowsy [OTC]; Tylenol® Flu Non-Drowsy Maximum Strength [OTC]; Vicks® DayQuil® Multi-Symptom Cold and Flu [OTC]

Synonyms:

Dextromethorphan, Acetaminophen, and Pseudoephedrine; Pseudoephedrine, Acetaminophen, and Dextromethorphan; Pseudoephedrine, Dextromethorphan, and Acetaminophen

Generic Available:

Yes

Canadian Brand Names:

Contac® Cough, Cold and Flu Day & Night™; Sudafed® Cold & Cough Extra Strength; Tylenol® Cold Daytime

Use:

Treatment of mild to moderate pain and fever; symptomatic relief of cough and congestion

Adverse Reactions:

See individual agents.

Drug Interactions:

Acetaminophen: Substrate (minor) of CYP1A2, 2A6, 2C8/9, 2D6, 2E1, 3A4; Inhibits CYP3A4 (weak)

Dextromethorphan: Substrate of CYP2B6 (minor), 2C8/9 (minor), 2C19 (minor), 2D6 (major), 2E1 (minor), 3A4 (minor); Inhibits CYP2D6 (weak)

Also see individual agents.

Ethanol/Nutrition/Herb Interactions:

Ethanol: Excessive intake of ethanol may increase the risk of acetaminophen-induced hepatotoxicity. Avoid ethanol or limit to <3 drinks/day.

Pharmacodynamics/Kinetics:

See individual agents.

Dosage:

Oral:

Analgesic: Based on acetaminophen component:

Children: 10-15 mg/kg/dose every 4-6 hours as needed; do not exceed 5 doses/24 hours

Adults: 325-650 mg every 4-7 hours as needed; do not exceed 4 g/day

Cough suppressant: Based on dextromethorphan component:

Children 6-12 years: 15 mg every 6-8 hours; do not exceed 60 mg/24 hours

Children >12 years and Adults: 10-20 mg every 4-8 hours or 30 mg every 8 hours; do not exceed 120 mg/24 hours

Decongestant: Based on pseudoephedrine component:

Children:

2-6 years: 15 mg every 4 hours (maximum: 90 mg/24 hours)

6-12 years: 30 mg every 4 hours (maximum: 180 mg/24 hours)

Children >12 years and Adults: 60 mg every 4 hours (maximum: 360 mg/24 hours)

Product labeling:

Alka-Seltzer Plus® Cold and Flu Liqui-Gels®:

Children 6-12 years: 1 dose every 4 hours (maximum: 4 doses/24 hours)

Children >12 years and Adults: 2 dose every 4 hours (maximum: 4 doses/24 hours)

Infants' Tylenol® Cold Plus Cough Concentrated Drops: Children 2-3 years (24-55 lb): 2 dropperfuls every 4-6 hours (maximum: 4 doses/24 hours)

Sudafed® Severe Cold, Thera-Flu® Non-Drowsy Maximum Strength (gelcap), Tylenol® Flu Non-Drowsy Maximum Strength: Children >12 years and Adults: 2 doses every 6 hours (maximum: 8 doses/24 hours)

Tylenol® Cold Non-Drowsy:

Children 6-11 years: 1 dose every 6 hours (maximum: 4 doses/24 hours)

Children 12 years and Adults: 2 doses every 6 hours (maximum: 8 doses/24 hours)

Thera-Flu® Non-Drowsy Maximum Strength: Children >12 years and Adults: 1 packet dissolved in hot water every 6 hours (maximum: 4 packets/24 hours)

Dietary Considerations:

Thera-Flu® Severe Cold Non-Drowsy contains phenylalanine 17 mg/packet.

Dental Health: Effects on Dental Treatment:

Key adverse event(s) related to dental treatment: Pseudoephedrine: Xerostomia (normal salivary flow resumes upon discontinuation).

Dental Health: Vasoconstrictor/Local Anesthetic Precautions:

Use with caution since pseudoephedrine is a sympathomimetic amine which could interact with epinephrine to cause a pressor response

Mental Health: Effects on Mental Status:

Sedation with dextromethorphan tends to be countered by the excitability associated with pseudoephedrine; one effect may predominate in any particular patient

Mental Health: Effects on Psychiatric Treatment:

Increased toxicity and hypertensive crisis may be seen with concurrent use of MAO inhibitors and CNS depressants, effects of CNS depressants may be lessened

Dosage Forms:

[DSC] = Discontinued product

Caplet:

Contac® Severe Cold and Flu/Non-Drowsy, Sudafed® Severe Cold, Tylenol® Cold Non-Drowsy: Acetaminophen 325 mg, dextromethorphan hydrobromide 15 mg, and pseudoephedrine hydrochloride 30 mg

Comtrex® Non-Drowsy Cold and Cough Relief: Acetaminophen 500 mg, dextromethorphan hydrobromide 15 mg, and pseudoephedrine hydrochloride 30 mg [contains benzoic acid]

Thera-Flu® Severe Cold Non-Drowsy: Acetaminophen 500 mg, dextromethorphan hydrobromide 15 mg, and pseudoephedrine hydrochloride 30 mg [contains lactose] [DSC]

Tylenol® Cold Day Non-Drowsy: Acetaminophen 325 mg dextromethorphan hydrobromide 15 mg, and pseudoephedrine hydrochloride 30 mg

Capsule, liquid

Alka-Seltzer Plus® Flu Liqui-Gels®: Acetaminophen 325 mg, dextromethorphan hydrobromide 10 mg, and pseudoephedrine hydrochloride 30 mg

Vicks® DayQuil® Multi-Symptom Cold and Flu: Acetaminophen 250 mg, dextromethorphan hydrobromide 10 mg, and pseudoephedrine hydrochloride 30 mg

Gelcap:

Tylenol® Cold Day Non-Drowsy: Acetaminophen 325 mg dextromethorphan hydrobromide 15 mg, and pseudoephedrine hydrochloride 30 mg [contains benzyl alcohol]

Tylenol® Flu Non-Drowsy Maximum Strength: Acetaminophen 500 mg, dextromethorphan hydrobromide 15 mg, and pseudoephedrine hydrochloride 30 mg

Liquid:

Triaminic® Cough and Sore Throat Formula: Acetaminophen 160 mg, dextromethorphan hydrobromide 7.5 mg, and pseudoephedrine hydrochloride 15 mg per 5 mL (120 mL, 240 mL) [contains benzoic acid; grape flavor]

Vicks® DayQuil® Multi-Symptom Cold and Flu: Acetaminophen 325 mg, dextromethorphan hydrobromide 10 mg, and pseudoephedrine hydrochloride 30 mg per 15 mL (175 mL)

Powder for oral solution [packet] (Thera-Flu® Severe Cold Non-Drowsy): Acetaminophen 1000 mg, dextromethorphan hydrobromide 30 mg, and pseudoephedrine hydrochloride 60 mg [contains phenylalanine 17 mg/packet; lemon flavor] [DSC]

Suspension, oral drops (Infants' Tylenol® Cold Plus Cough Concentrated Drops): Acetaminophen 160 mg, dextromethorphan hydrobromide 5 mg, and pseudoephedrine hydrochloride 15 mg per 1.6 mL (15 mL) [1.6 mL = 2 dropperfuls] [cherry flavor]

International Brand Names:

Contac® Cough, Cold and Flu Day & Night™ (CA); Sudafed® Cold & Cough Extra Strength (CA); Tylenol® Cold Daytime (CA)

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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