Paracetamol + Chlorpheniramine + Dextromethorphan

Indications

Paracetamol + Chlorpheniramine + Dextromethorphan is used for: Relief of Cold & Flu Symptoms

Adult Dose

Relief of Cold & Flu Symptoms 2 tab PO q6hr; not to exceed 8 tabs/day

Child Dose

Relief of Cold & Flu Symptoms >12 years: 2 tablets PO q6hr; not to exceed 8 tabs/day

Renal Dose

Administration

Contra Indications

Contraindicated in documented hypersensitivity; asthma attacks, narrow-angle glaucoma, symptomatic prostate hypertrophy, bladder-neck obstruction, and stenosing peptic ulcer; known G-6-PD deficiency Chlorpheniramine may cause significant confusional symptoms; not for administration to < 2 years of age 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

Precautions

Caution in asthma, bladder neck obstruction, cardiovascular disease, COPD, GI obstruction, glaucoma, hepatic impairment, hypertension, hyperthyroidism, increased intraocular pressure, malnutrition, renal impairment, elderly patients, patients taking CNS depressants or <6 years of age with chlorpheniramine products Caution in severe hypovolemia if taking acetaminophen products 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

Pregnancy-Lactation

Interactions

Side Effects

Side effects of Paracetamol + Chlorpheniramine + Dextromethorphan : Frequency Not Defined Hypotension Palpitations Tachycardia Confusion Depression Distress Dizziness Euphoria Fatigue Headache Insomnia Irritability Sedation Tremors Dermatologic rash Anorexia GI disturbances Anemia blood dyscrasias (neutropenia, pancytopenia, leukopenia) Agranulocytosis Hemolytic anemia Thrombocytopenia Bilirubin and alkaline phosphatase may increase Thickening of bronchial secretions Wheezing

Mode of Action

Chlorpheniramine blocks muscle responses in histamine and acts as an antagonism of the constrictor effects of histamine on respiratory smooth muscle Paracetamol 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