Paracetamol + Doxylamine + Dextromethorphan
Indications
Paracetamol + Doxylamine + Dextromethorphan is used for:
Cough, Sore Throat, Rhinorrhea, Fever, Headache, Minor Aches & Pains
Adult Dose
Cough, Sore Throat, Rhinorrhea, Fever, Headache, Minor Aches & Pains
1-2 Tablespoons (15-30mL) PO q6hr; not to exceed a cumulative dose of acetaminophen 4 g/day and dextromethorphan 120 mg/day
2 capsules PO q6hr; not to exeed 8 capsules/day
Child Dose
Cough, Sore Throat, Rhinorrhea, Fever, Headache, Minor Aches & Pains
>12 Years Old
2 Tablespoons (30mL) PO q6hr; not to exceed 120 mL/day
2 capsules PO q6hr; not to exeed 8 capsules/day
Renal Dose
Administration
Contra Indications
Hypersensitivity
Asthma
Narrow-angle glaucoma
Symptomatic prostate hypertrophy
Bladder-neck obstruction
Stenosing peptic ulcer
G-6-PD deficiency
Severe hepatic impairment
Precautions
Paracetamol hepatotoxicity possible in chronic alcoholics following various dose levels
Severe or recurrent pain or high or continued fever may indicate a serious illness
Paracetamol contained in many OTC products and combined use with these products may result in toxicity due to cumulative doses exceeding recommended maximum dose
Paracetamol: 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
Doxylamine may exacerbate angle closure glaucoma, hyperthyroidism, peptic ulcer, or urinary tract obstruction; xerostomia may occur
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
Pregnancy-Lactation
Pregnancy category: C
Lacation: excreted in breast milk, use caution
Interactions
Side Effects
Side effects of Paracetamol + Doxylamine + Dextromethorphan :
Frequency Not Defined
Angioedema
Laryngeal edema
Dizziness
Drowsiness
Pruritic maculopapular rash
Urticaria
Dry mouth, throat, and nose
Agranulocytosis
Leukopenia
Neutropenia
Pancytopenia
Thrombocytopenia
Thrombocytopenic purpura
Hepatotoxicity
Thickening of mucus in nose or throat
Anaphylactoid reaction
Mode of Action
Paracetamol Blocks pain impulse generation peripherally and may inhibit prostaglandin generation in CNS; reduces fever by inhibiting hypothalamic heat-regulating center
Doxylamine: Competitively blocks histamine from binding to H1 receptors; significant antimuscarinic activity and penetrates CNS, which causes pronounced tendency to induce sedation
Dextromethorphan: Cough suppressant that acts centrally on cough center in medulla