Tylenol Cold& Flu
Ingredient: Phenylephrine HCl (PE), dextromethorphan HBr (DXT), acetaminophen (APAP), guaifenesin (GUA).
Dosage Form:
Sinus Severe Caplets: Acetaminophen 325 mg, guaifenesin 200 mg, and phenylephrine HCl 5 mg in each caplet.
Sinus + Headache Caplets: Acetaminophen 325 mg and phenylephrine HCl 5 mg in each caplet.
Cold & Flu Severe Caplets and Liquid: Each caplet or 15 mL contains acetaminophen 325 mg and phenylephrine 5 mg.
Cold Max Daytime Caplets and Liquid: Each caplet or 15 mL contains acetaminophen 325 mg, dextromethorphan HBr 10 mg, and phenylephrine 5 mg.
Cold + Head Congestion Severe: Each caplet contains PE 5 mg, acetaminophen 325 mg, and guaifenesin 200 mg.
Cold + Mucus Severe Liquid: Acetaminophen 325 mg, dextromethorphan HBr 10 mg, guaifenesin 200 mg, and phenylephrine 5 mg in each 15 mL (tablespoon).
FDA Indication/Dosages:
Products containing phenylephrine are indicated for the temporary treatment of sinus congestion.
Products containing dextromethorphan are indicated for the temporary relief of cough due to minor throat irritation.
Products containing acetaminophen are indicated for the temporary relief of minor pain and fever reduction.
Products containing guaifenesin are indicated for the temporary relief of chest congestion.
Dose: One to two tablets, caplets, gelcaps, or tablespoonfuls every 6 hours, not to exceed 8 doses every 24 hours.
Pharmacology: Phenylephrine stimulates α-1-adrenergic receptors in smooth muscle causing vasoconstriction. This vasoconstriction decreases swelling in the nasal passages and relieves congestion. Acetaminophen relieves pain by inhibiting prostaglandin synthesis in the CNS and through a peripheral action by blocking pain impulse generation. The CNS effects also lower the elevated temperature set-point which results in fever reduction. Dextromethorphan is structurally similar to codeine and has equal antitussive properties without CNS effects or addiction. It depresses the cough reflex center in the medulla oblongata without decreasing ciliary function. Its effects last for 5 or more hours. Guaifenesin promotes lower respiratory tract drainage by thinning bronchial secretions, lubricating irritated respiratory tract membranes through increased mucus flow, and facilitating removal of viscous, inspissated mucous.
Evaluation: Allergies and the common cold are caused by different mechanisms, but the symptoms associated with each are similar. Allergies of the upper respiratory tract are caused by antibody-mediated reactions to inhaled antigens. The common cold is caused by any number of viruses. Allergies may occur year-round or during seasons in which the offending antigen is present. Major symptoms of allergies are rhinitis, nasal congestion, sneezing, and conjunctivitis. Colds may also have these symptoms plus pharyngitis, cough, and body aches and pains. Pharyngitis, especially in children, may be a sign of a more serious condition and should be examined by a physician.
Contraindications/Precautions: Decongestants may cause severe hypertension when combined with furazolidone or monoamine oxidase inhibitors. Urine alkalinizers, including sodium bicarbonate, may increase toxicity of decongestants. Do not use in patients with high blood pressure, diabetes, heart disease, and thyroid disease unless under the direction of a physician. Prolonged use at therapeutic doses may cause hepatotoxicity, especially in alcoholics. Acetaminophen may be given at therapeutic doses during all stages of pregnancy and lactation. Hepatotoxicity potential is increased when acetaminophen is used with hydantoins, sulfinpyrazone, or alcohol. If no improvement is seen after 7 days or in the presence of a high fever, consult a physician. Pregnancy Category B.
Adverse Effects: May cause nervousness, dizziness, or sleeplessness.
Patient Consultation:
Ask the patient about their medical history including heart disease, hypertension, thyroid disease, and drug therapy.
Consult a physician if no improvement is seen after 7 days or in the presence of a high fever.
