Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine

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Brand names: Alka-Seltzer Plus® Cold and CoughAlka-Selzter Plus® Nose & ThroatCold Head Congestion Night/Day Comtrex® Cold and Cough Day and Night Comtrex® Cold and Cough NighttimeTheraflu® Severe Cold NighttimeTylenol® Childrens Plus Multi-Symptom ColdTylenol® Cold Head Congestion Day/NightTylenol® Cold Head Congestion NighttimeTylenol® Cold Multi-Symptom Day/NightTylenol® Cold Multi-Symptom Nighttime

Drug Forms:
• Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine effervescent tablets (below)
• Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hydrobromide, Phenylephrine Hydrochloride Effervescent tablet
• Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hydrobromide, Phenylephrine Hydrochloride Oral solution
• Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hydrobromide, Phenylephrine Hydrochloride Oral suspension
• Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hydrobromide, Phenylephrine Hydrochloride Oral tablet
• Acetaminophen, Chlorpheniramine Maleate, Dextromethorphan Hydrobromide, Phenylephrine Hydrochloride Oral tablet, Acetaminophen, Dextromethorphan Hydrobromide, Phenylephrine Hydrochloride Oral tablet

Español:
• Combinaciones de antihistamínicos con analgésicos, Tableta efervescente
• Combinaciones de antihistamínicos con analgésicos, Solución oral
• Combinaciones de antitusivo con analgésicos, Suspensión oral
• Combinaciones de antihistamínicos con analgésicos, Tableta oral
• Combinaciones de antitusivo con analgésicos, Tableta oral

Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine effervescent tablets

What are Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine effervescent tablets?

ACETAMINOPHEN, CHLORPHENIRAMINE, DEXTROMETHORPHAN, AND PHENYLEPHRINE (Alka-Seltzer Plus® Cold & Cough effervescent tablets) are used together to decrease symptoms caused by colds or the flu. Acetaminophen helps lower fever, and relieve muscle aches or headache. Chlorpheniramine is an antihistamine that relieves runny nose, sneezing, and watery eyes. Dextromethorphan helps to stop cough. Phenylephrine helps reduce nasal and sinus congestion. Generic acetaminophen; chlorpheniramine; dextromethorphan; phenylephrine effervescent tablets are not available.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:
• anemia or blood disease
• asthma
• diabetes
• difficulty passing urine or other bladder problems
• chronic cough
• emphysema, bronchitis, or other lung disease
• enlarged prostate
• glaucoma
• head injury
• heart disease including angina, history of heart attack, blockage in heart vessels, heart failure
• high blood pressure
• history of stroke or mini-strokes (TIAs)
• problems with immune system
• irregular heart beat
• kidney disease
• liver disease
• phenylketonuria
• poor circulation (peripheral vascular disease)
• salt restricted diet
• stomach ulcers or bleeding
• over active thyroid
• an unusual reaction to acetaminophen, chlorpheniramine, dextromethorphan, phenylephrine, aspirin, other medicines, foods, dyes, or preservatives
• pregnant or trying to get pregnant
• breast-feeding

How should this medicine be used?

Completely dissolve 2 effervescent tablets in 4 ounces (1/2 cup) of room temperature water, and drink the mixture. Do not use hot water or the mixture may overflow from the cup. Alka-Seltzer Plus® products should be dissolved in water only, since other liquids have not been tested and it is not known how well the medicine will work mixed with these liquids. If the tablets don't fizz when placed in water, they should not be used.

Take your doses at regular intervals as directed on the product label. Do not take your medicine more often than directed. Do not take more than 8 tablets in 24 hours or as directed by your physician.

Try to avoid grapefruit juice while using this medicine because this may increase the chance of side effects from dextromethorphan.

Contact your pediatrician or health care professional regarding the use of this medicine in children. Special care may be needed.

What drug(s) may interact with Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine?

• busulfan
• caffeine
• cholestyramine
• cocaine
• delavirdine
• doxercalciferol
• ergot medicines like ergotamine or ergonovine
• exenatide
• furazolidone
• gefitinib
• grapefruit juice
• imatinib
• isoniazid
• linezolid
• mecamylamine
• medicines for chest pain, heart disease, high blood pressure, or heart rhythm problems
• medicine for diabetes
• medicines known as MAO inhibitors, like phenelzine (Nardil®), tranylcypromine (Parnate®), isocarboxazid (Marplan®), and selegiline (Carbex®, Eldepryl®)
• medicines for mental depression
• medicines for mental problems and psychotic disturbances
• medicines for motion sickness
• medicines for movement abnormalities as in Parkinson's disease, or for gastrointestinal problems
• medicines for weight loss
• prilocaine
• procarbazine
• rifabutin
• rifampin
• ritonavir
• ropinirole
• St. John's wort
• sulfinpyrazone
• terbinafine
• theophylline
• thyroid hormones
• valdecoxib
• warfarin
• zidovudine

Because this product can cause drowsiness, other medicines that also cause drowsiness may increase this effect. Some medicines that cause drowsiness are:
• alcohol and alcohol-containing medicines
• barbiturate medicines for inducing sleep or treating seizures (convulsions)
• medicines for anxiety or sleeping problems, such as diazepam or temazepam
• medicines for hay fever and other allergies
• muscle relaxers
• prescription pain medicines

Tell your prescriber or health care professional about all other medicines you are taking, including non-prescription medicines, nutritional supplements, or herbal products. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines.

What should I watch for while taking Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine?

If you have a fever, skin rash, or persistent headache as well as a cough, see your prescriber or health care professional. Do not treat yourself for fever longer than 3 days, or for congestion, cough, or pain for longer than 7 days without consulting a health care professional. If your sore throat is severe, lasts more than 2 days, or if you also have a fever, headache, rash, nausea, and vomiting, see a health care professional immediately.

You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this medicine affects you. Alcohol can increase the chance of drowsiness, dizziness, confusion, or liver problems while using this medicine. Avoid alcoholic drinks. If you drink 3 or more alcoholic beverages every day, check with your doctor before taking medicines which contain acetaminophen because of the possibility of liver damage.

Do not smoke cigarettes. This may increase the irritation to your stomach when taking this medicine, and may increase the chance of side effects.

If this medicine makes it difficult for you to sleep at night, take your last dose at least a few hours before bedtime.

Your mouth may get dry. Chewing sugarless gum or sucking hard candy, and drinking plenty of water will help.

Elderly patients over 60 years old may have a stronger reaction to this medicine and need smaller doses.

This medicine may cause dry eyes and blurred vision. If you wear contact lenses you may feel some discomfort. Lubricating drops may help. See your ophthalmologist if the problem does not go away or is severe.

What side effects may I notice from receiving Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine?

Side effects that you should report to your prescriber or health care professional as soon as possible:
• agitation, nervousness, excitability, not able to sleep (these are more likely in children)
• bloody stools
• chest pain
• confusion
• difficulty breathing, or wheezing
• difficulty urinating
• headache, especially if severe or gets worse
• high blood pressure
• irregular heart beat
• nausea and vomiting
• seizures
• skin rash or hives
• slurred speech
• tremors
• unusual bleeding or bruising, pinpoint red spots on the skin
• unusual tiredness or weakness
• yellowing of the skin or eyes

Side effects that usually do not require medical attention (report to your prescriber or health care professional if they continue or are bothersome):
• constipation
• loss of appetite
• nausea
• sensitive to sun
• stomach ache

Where can I keep my medicine?

Keep out of the reach of children in a container that small children cannot open.

Store at room temperature between 15—30 degrees C (59—86 degrees F). Protect from heat. Throw away any unused medicine after the expiration date.

Last updated: 1/11/2006 1:50:00 PM

Important Disclaimer: The drug information provided here is for educational purposes only. It is intended to supplement, not substitute for, the diagnosis, treatment and advice of a medical professional. This drug information does not cover all possible uses, precautions, side effects and interactions. It should not be construed to indicate that this or any drug is safe for you. Consult your medical professional for guidance before using any prescription or over the counter drugs.