Adult Dosing
Common cold and flu symptoms
- 2 tablets (1000 mg/4 mg/30 mg) PO q6 hrs
- Max: 8 tabs [4000 mg/16 mg/120 mg)/day
Note:
- Dissolve effervescent tabs in 4 oz of water; do not chew or swallow the tablet whole
Pediatric Dosing
Common cold and flu symptoms
- Children <12 yrs: Consult a pediatrician
- Children >12 yrs
- 2 tablets (1000 mg/4 mg/30 mg) PO q6 hrs
- Max: 8 tabs [4000 mg/16 mg/120 mg)/day
Note:
- Dissolve effervescent tabs in 4 oz of water; do not chew or swallow the tablet whole
[Outline]
See Supplemental Patient Information
- Aspirin component of this combination drug may cause a severe allergic reaction including hives, facial swelling, difficulty breathing, and shock
- NSAID component of this combination drug is associated with an increased risk of severe stomach bleeding; this risk is higher in patients
60yrs, having history of stomach ulcers or bleeding problems, receiving treatment with blood thinning agents (anticoagulant) or steroid drug, using other drugs containing prescription or nonprescription NSAIDs, consuming 3 alcoholic drinks/day, and those exceeding recommended dosages - Advise patients to avoid using a cough or cold medicine if they have used MAO inhibitors within the past 2 weeks. Serious, fatal side effects may occur if they receive cough or cold medicine before the MAOI is completely eliminated from the body
- Potential for development of Reye’s syndrome, a rare but serious illness, exists with aspirin; avoid use of this product in children and teenagers who have or are recovering from chicken pox or flu-like symptoms. Advise patients/caregivers to consult a physician if they observe changes in behavior with nausea and vomiting during therapy
- Dizziness, drowsiness, or blurred vision may occur with this drug; concomitant use of other sedatives and tranquilizers and alcohol abuse may worsen these effects. Hence, avoid use of these drugs and advise patients to avoid alcohol during therapy
- Instruct patients to avoid using any other OTC cough, cold, allergy, pain, or sleep medication without consulting their physicians during therapy
- Dextromethorphan component of this combination drug will not treat a cough caused by smoking, asthma, or emphysema
- Instruct patients to avoid using this medication if they have a recent history of stomach or intestinal bleeding, a bleeding disorder such as hemophilia, or an allergy to an NSAID
- Aspirin component of this combination drug is associated with fetal harm and complications during delivery; avoid use of this combination drug in the last trimester of pregnancy unless it is deemed important to the mothers
- Discontinue therapy and consult a clinician if new symptoms occur, redness or swelling is noted, pain/cough/nasal congestion gets worse or lasts more than 7 days, fever gets worse or lasts >3 days; nervousness, dizziness or sleeplessness occurs, or if cough comes back or occurs with rash or headache that lasts; further evaluate the patients as these could be signs of a serious condition
- Therapy may cause marked drowsiness. Exercise caution when driving a motor vehicle or operating machinery
- Antihistamine produces paradoxical excitation in young children. Use of antihistamines is contraindicated in children <2 yrs
- Avoid use of this combination therapy to sedate children
Cautions: Use cautiously in
- Hepatic impairment
- Renal impairment
- Bladder neck obstruction
- Asthma
- Cardiovascular disease
- Chronic alcoholism
- Use of CNS depressants
- COPD
- Increased intracranial pressure
- Intracranial lesion
- GERD
- History of GI bleed
- GI obstruction
- Angle-closure glaucoma
- Gout
- PUD
- Hypertension
- Hyperthyroidism
- Prostatic hypertrophy
- Increased IOP
- Geriatric patients
- Surgery or trauma
- Lower respiratory tract symptoms
- Sodium-restricted diet
- Thrombocytopenia
- Poor CYP2D6 metabolizer
- High environmental temperature
Supplemental Patient Information
- Instruct patients to avoid alcohol consumption while taking this medication as it may increase the risk of stomach bleeding
- Advise patients to avoid driving a motor vehicle or operating machinery, as drowsiness may occur with this product
- Instruct patients to inform their clinician if they are pregnant or breast-feeding prior to initiating therapy
Pregnancy Category:D
Breastfeeding: It is best to avoid aspirin during breastfeeding, especially with very young infants. As per some expert opinion, low dose aspirin (75-162 mg) may be used as an antiplatelet drug in nursing mothers; avoid chronic, high-dose aspirin. Avoid breastfeeding for 1-2 hours after a dose of aspirin to minimize antiplatelet effects in the infant. The risk of Reye's syndrome caused by salicylate in breastmilk is unknown. Small, occasional doses of chlorpheniramine would not be expected to cause any adverse effects in breastfed infants. Larger doses or more prolonged use may cause adverse effects in the infant or interfere with lactation, particularly in combination with a sympathomimetic agent or when lactation is not well established. However, the nonsedating antihistamines are preferred alternatives. No studies conducted on the excretion of dextromethorphan in milk or its effect on breastfed infants. However, this medication can be administered to infants as young as 1 month of age. It is unlikely that with usual maternal doses amounts in milk are as large as those given directly to infants or that breastfed infants would be harmed by the drug in breastmilk, especially in infants over 1 month of age. Avoid the use of products with high alcohol content while nursing. This information is based upon Lactmed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 6 Dec 2011). Manufacturer advises to consult a health professional.
US Trade Name(s)
US Availability
Alka-Seltzer Plus Flu (aspirin/chlorpheniramine/dextromethorphan)
- OTC Effervescent TABS: 500 mg/2 mg/15 mg
Canadian Trade Name(s)
Canadian Availability
UK Trade Name(s)
UK Availability
Australian Trade Name(s)
Australian Availability
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