Acetaminophen (paracetamol) + Pheniramine + Phenylephrine

Indications

Acetaminophen (paracetamol) + Pheniramine + Phenylephrine is used for: Allergy Symptoms & Common Cold

Adult Dose

Allergy Symptoms & Common Cold Dissolve contents of 1 packet in 8 oz of hot water; consume entire 8 oz within 10-15 minutes; not to exceed acetaminophen 1 g/dose or 4 g/day

Child Dose

Allergy Symptoms & Common Cold <12 years: Ask a pediatrician >12 years: Dissolve contents of 1 packet in 8 oz of hot water; consume entire 8 oz within 10-15 minutes; not to exceed acetaminophen 1 g/dose or 4 g/day

Renal Dose

Administration

Contra Indications

Hypersensitivity Asthma < 2 years old Narrow-angle glaucoma Symptomatic prostate hypertrophy Bladder-neck obstruction Stenosing peptic ulcer Use within 14 days of MAO inhibitor therapy G-6-PD deficiency Severe hepatic impairment

Precautions

Pheniramine: May cause significant confusional symptoms; not for administration to premature or full-term neonates Phenylephrine: Caution in elderly patients, hyperthyroidism, myocardial disease, bradycardia, partial heart block or severe atherosclerosis 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 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 Lactation: excreted in breast milk, use caution

Pregnancy-Lactation

Interactions

Adverse Effects

Side effects of Acetaminophen (paracetamol) + Pheniramine + Phenylephrine : Hypotension Palpitations Reflex hypertension Severe peripheral and visceral vasoconstriction Tachycardia Confusion Dizziness Depression Distress Euphoria Fatigue Headache Insomnia Irritability Restlessness Sedation Tremors Dermatologic rash Anorexia Agranulocytosis Anemia blood dyscrasias (neutropenia, pancytopenia, leukopenia) Hemolytic anemia Thrombocytopenia Bilirubin and alkaline phosphatase may increase Thickening of bronchial secretions Wheezing

Mechanism of Action

Acetaminophen: Blocks pain impulse generation peripherally & may inhibit prostaglandin generation in CNS; reduces fever by inhibiting the hypothalamic heat-regulating center Pheniramine: competes with histamine for histamine H1- receptor sites on effector cells; antihistamines antagonize the effects of histamine mediated through activation of H1- receptor sites, thereby reduces intensity of allergic reactions & tissue injury caused by histamine release Phenylephrine: vasoconstrictor & decongestant that relieves symptoms resulting from irritation of upper respiratory tract tissue; shrinks swollen mucous membranes, reduces nasal congestion & tissue hyperemia