Aspirin/Chlorpheniramine/Dextromethorphan/Phenylephrine

DEA Class;  OTC

Common Brand Names; Alka-Seltzer Plus Cold & Cough Effervescent

Analgesic/Antihistamine/Antitussive/Decongestant Combos

Temporary Relief of Common Cold Cough & Upper Respiratory Symptoms

Indicated for temporary relief of common Cold, cough and upper respiratory track infection.

Hypersensitivity

Liver damage

< 2 years of age

Hypoprothrombinemia

Vitamin K deficiency

Bleeding disorders

Asthma

G6PD deficiency

Uncontrolled or severe hypertension

Due to association of aspirin with Reye syndrome, do not use in children (<16 y) with viral infections

Narrow-angle glaucoma

Symptomatic prostate hypertrophy

Bladder-neck obstruction

Stenosing peptic ulcer

Dysrhythmias

Hypotension

Tachycardia

Agitation

Cerebral edema

Coma

Confusion

Dizziness

Headache

Subdural or intracranial hemorrhage

Lethargy

Hives

Rashes

May potentiate peptic ulcer and cause stomach distress or heartburn

Dyspepsia

GI bleeding

Ulceration & perforation

Nausea

Vomiting

Prolongation of prothrombin time

Aspirin: May cause transient decrease in renal function and aggravate chronic kidney disease; avoid use in patients with severe anemia, with history of blood coagulation defects, or taking anticoagulants

Dextromethorphan: Do not take 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; may decrease respiration rate

Chlorpheniramine: May cause significant confusional symptoms; not for administration to premature or full-term neonates

Phenylephrine: Caution in elderly patients, hyperthyroidism, myocardial disease, bradycardia, partial heart block or severe arteriosclerosis

Pregnancy category: D; avoid during pregnancy, particularly in third trimester because of risk for premature closure of the ductus arteriosus

Lactation: Excreted in breast milk; do not breast feed

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

Adults

2 tabs fully dissolved in 4 oz of water q4hr; not to exceed 8 tablets/day

Pediatric 

<12 years old: Ask a pediatrician

>12 years old: 2 tablets fully dissolved in 4 oz of water q4hr; not to exceed 8 tablets/day

Effervescent Tablet

325mg/2mg/10mg/7.8mg