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