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acetaminophen, dextromethorphan, guaifenesin, and pseudoephedrine
Pronunciation: a SEET a MIN oh fen, DEX troe me THOR fan, gwye FEN e sin, SOO doe ee FED rin
Brand: Duraflu, Maxiflu DM, Robitussin Cold Cough and Flu, Theraflu Chest and Cough, Tylenol Cold Severe Congestion Non-Drowsy


What is the most important information I should know about acetaminophen, dextromethorphan, guaifenesin, and pseudoephedrine?
nochild• Do not give this medication to a child younger than 4 years old. Always ask a doctor before giving a cough or cold medicine to a child. Death can occur from the misuse of cough and cold medicines in very young children.
donot• Do not use this medication if you have used an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate) within the past 14 days.
donot• Do not take more of this medication than is recommended. An overdose of acetaminophen can damage your liver.
donot• Ask a doctor or pharmacist before using any other cold, allergy, pain, or sleep medication. Acetaminophen (sometimes abbreviated as APAP), dextromethorphan, guaifenesin, and pseudoephedrine are contained in many combination medicines. Taking certain products together can cause you to get too much of a certain drug. Check the label to see if a medicine contains acetaminophen or APAP, dextromethorphan, guaifenesin, or pseudoephedrine.
noalcohol• Avoid drinking alcohol. It can increase the risk of liver damage while you are taking acetaminophen. If you drink more than three alcoholic beverages per day, do not take acetaminophen without your doctor's advice, and never take more than 2 grams (2000 mg) per day.


What is acetaminophen, dextromethorphan, guaifenesin, and pseudoephedrine?
• 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 out through your mouth.
• Pseudoephedrine is a decongestant that shrinks blood vessels in the nasal passages. Dilated blood vessels can cause nasal congestion (stuffy nose).
• 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.
smoking• Dextromethorphan will not treat a cough that is caused by smoking.
• Acetaminophen, dextromethorphan, guaifenesin, and pseudoephedrine may also be used for other purposes not listed in this medication guide.


What should I discuss with my healthcare provider before taking acetaminophen, dextromethorphan, guaifenesin, and pseudoephedrine?
donot• Do not take this medication if you are allergic to acetaminophen, dextromethorphan, guaifenesin, or pseudoephedrine, or to other decongestants, diet pills, stimulants, or ADHD medications.
donot• Do not use a cough and cold medicine if you have used an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate) in the last 14 days. A dangerous drug interaction could occur, leading to serious side effects.
• Ask a doctor or pharmacist if it is safe for you to take this medicine 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.
nopreg• It is not known whether this medication will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.
nobrfeed• This medication may pass into breast milk and could harm a nursing baby. Do not use without medical advice if you are breast-feeding a baby.


How should I take acetaminophen, dextromethorphan, guaifenesin, and pseudoephedrine?
• Use exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended. Cold medicine is usually taken only for a short time until your symptoms clear up.
water• Drink extra fluids to help loosen the congestion and lubricate your throat while you are taking this medication.
donot• An overdose of acetaminophen can damage your liver. Adults should not take more than 1 gram (1000 mg) of acetaminophen per dose or 4 grams (4000 mg) per day. Taking more can damage your liver. Ask a doctor before taking acetaminophen if you drink more than 3 alcoholic beverages per day, and never take more than 2 grams (2000 mg) of acetaminophen per day.
• One packet of the oral powder may contain up to 1000 mg of acetaminophen. Know the amount of acetaminophen in the specific product you are taking.
nochild• Do not give this medication to a child younger than 4 years old. Always ask a doctor before giving a cough or cold medicine to a child. Death can occur from the misuse of cough and cold medicines in very young children.
donot• Talk with your doctor if your symptoms do not improve after 7 days of treatment, or if you have a fever with a headache, cough, or skin rash.
• If you need surgery, tell the surgeon ahead of time if you have taken a cold medicine within the past few days.
rt• Store at room temperature, away from heat, light, and moisture.


What happens if I miss a dose?
• Since cough or cold medicine is usually taken only as needed, you may not be on a dosing schedule. If you are taking the medication regularly, take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.


What happens if I overdose?
emt• Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
• The first signs of an acetaminophen overdose include loss of appetite, nausea, vomiting, stomach pain, sweating, and confusion or weakness. Later symptoms may include pain in your upper stomach, dark urine, and yellowing of your skin or the whites of your eyes.
• Overdose symptoms may also include dizziness, drowsiness, feeling restless or nervous, diarrhea, seizure (convulsions), or coma.


What should I avoid while taking acetaminophen, dextromethorphan, guaifenesin, and pseudoephedrine?
dizzy• This medication may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.
donot• Ask a doctor or pharmacist before using any other cold, allergy, pain, or sleep medication. Acetaminophen (sometimes abbreviated as APAP), dextromethorphan, guaifenesin, and pseudoephedrine are contained in many combination medicines. Taking certain products together can cause you to get too much of a certain drug. Check the label to see if a medicine contains acetaminophen or APAP, dextromethorphan, guaifenesin, or pseudoephedrine.
noalcohol• Avoid drinking alcohol. It can increase the risk of liver damage while you are taking acetaminophen.
• 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.


What are the possible side effects of acetaminophen, dextromethorphan, guaifenesin, and pseudoephedrine?
emt• Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
donot• Stop using this medication and call your doctor at once if you have any of these serious 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, upper stomach pain, itching, 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.


What other drugs will affect acetaminophen, dextromethorphan, guaifenesin, and pseudoephedrine?
• Tell your doctor about all other medications you use, especially:
     · celecoxib (Celebrex);
     · cinacalcet (Sensipar);
     · darifenacin (Enablex);
     · imatinib (Gleevec);
     · isoniazid;
     · quinidine (Quin-G);
     · 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, Tenoretic), carvedilol (Coreg), labetalol (Normodyne, Trandate), metoprolol (Lopressor, Toprol), nadolol (Corgard), propranolol (Inderal, InnoPran), sotalol (Betapace), and others;
     · gout medications such as probenecid (Benemid); or
     · seizure medication such as phenytoin (Dilantin) or phenobarbital (Solfoton).
• This list is not complete and other drugs may interact with acetaminophen, dextromethorphan, guaifenesin, and pseudoephedrine. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.


Where can I get more information?
• 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.
Copyright 1996-2011 Cerner Multum, Inc. Version: 9.01. Revision Date: 5/19/2011.