Paracetamol/Dextromethorphan/Pseudoephedrine/Guaifenesin

DEA Class;  OTC

Common Brand Names; Tylenol Cold Severe Congestion

  •  Cough/Cold, Non-narcotic Combos; 
  • Analgesic/Antitussive/Decongestant/Expectorant Combos

Acetaminophen blocks pain impulse generation peripherally and may inhibit the generation of prostaglandin in the CNS. Reduces fever by inhibiting the hypothalamic heat-regulating center.

Dextromethorphan is a cough suppressant that acts centrally on the cough center in the medulla.

Pseudoephedrine stimulates the alpha-adrenergic receptors causing bronchodilation and vasoconstriction.

Guaifenesin increases respiratory tract fluid secretions and helps to loosen phlegm and bronchial secretions.

For Symptomatic Relief of Cough & Congestion

Documented hypersensitivity to the drugs or within 14 days of MAO inhibitor therapy; known G-6-PD deficiency

Arrhythmia

Palpitations

Convulsion

Dizziness

Drowsiness

Excitability

Headache

Tremor

Weakness

Dermatologic rash

GI disturbances

Nausea

Vomiting

Anemia blood dyscrasias (neutropenia, pancytopenia, leukopenia)

Bilirubin and alkaline phosphatase may increase

Caution in cardiovascular disease, diabetes mellitus, prostatic hypertrophy and increased intraocular pressure when taking pseudoephedrine

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

Guaifenesin is not for administration in persistent cough associated with chronic bronchitis, smoking, asthma, or accompanied with excessive secretions

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

Pregnant or breastfeeding patients should seek advice of health professional before using OTC drugs

Adults

2 tablets PO q6hr; not to exceed 8 tablets/day

Pediatric

<12 Years Old

Not recommended

>12 Years Old

2 tablets PO q6hr; not to exceed 8 tablets/day

acetaminophen/dextromethorphan/pseudoephedrine/guaifenesin

tablet

  • 325mg/15mg/30mg/200mg

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