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Use and Dosing

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Temporary relief of cold/flu symptoms

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Temporary relief of cold/flu symptoms


[Outline]

Indications

Contraindications

Black Box Warnings

Dosing Adjustment

Renal Dose Adjustment (Based on CrCl)

Hepatic Dose Adjustment

Warnings/Precautions

See Supplemental Patient Information

Cautions: Use cautiously in

Supplemental Patient Information

Pregnancy/Breast Feeding

Pregnancy Category:B (acetaminophen), C (dextromethorphan), C (guaifenesin), C (phenylephrine)

Breastfeeding: Acetaminophen is a good choice for analgesia and fever reduction in nursing mothers. Amounts excreted in milk are much less than doses usually given to infants. Adverse effects in breastfed infants appear to be rare. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 11 May 2011). Maternal medication is usually compatible with breastfeeding; no observable change was seen in the nursing infant while the mother was ingesting the compound. This information is based upon data from AAP Policy Guidelines (available at http://aappolicy.aappublications.org/cgi/content/full/pediatrics;108/3/776/T6 last accessed 11 May 2011).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 a 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 11 May 2011). No studies have been conducted on excretion of guaifenesin in milk or its effect on breastfed infants. This medication can be given to infants as young as 2 month of age; it is unlikely that usual maternal doses amounts in milk are as large as those given directly to infants and would harm the breastfed infants, especially in infants over 2 months of age. Avoid the use of products with a high alcohol content while nursing. This information is based on based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 11 May 2011).Phenylephrine is unlikely to reach the infant in large amounts, as the oral bioavailability of phenylephrine is only about 40%. However, oral administration of phenylephrine decreases milk production. As no information is available on the use of oral phenylephrine during breastfeeding, an alternate drug may be preferred, especially while nursing a newborn or preterm infant. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 11 May 2011). Manufacturer advises to consult a health professional.

Adverse Reactions

Clinical Pharmacology

Acetaminophen

Dextromethorphan

Guaifenesin

Phenylephrine

Brands and Availability

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US Trade Name(s)

US Availability

Children's Mucinex Cold, Cough & Sore Throat (acetaminophen/dextromethorphan/guaifenesin/phenylephrine)

Children's Mucinex Multi-Symptom Cold & Fever (acetaminophen/dextromethorphan/guaifenesin/phenylephrine)

Mucinex Fast-Max Cold, Flu & Sore Throat

Sine-Off Cold/Cough (acetaminophen/dextromethorphan/guaifenesin/phenylephrine)

Sudafed PE Cold + Cough (acetaminophen/dextromethorphan/guaifenesin/phenylephrine)

Tylenol Cold Head Congestion Severe (acetaminophen/dextromethorphan/guaifenesin/phenylephrine)

Tylenol Cold Multi-Symptom Severe (acetaminophen/dextromethorphan/guaifenesin/phenylephrine)

Tylenol Cough & Severe Congestion Daytime (acetaminophen/dextromethorphan/guaifenesin/phenylephrine)

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Canadian Trade Name(s)

Canadian Availability

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UK Trade Name(s)

UK Availability

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Australian Trade Name(s)

Australian Availability


[Outline]

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Classification

ENT

Upper Respiratory Combinations

Pulmonary

Upper Respiratory Combinations