acetaminophen/chlorpheniramine/dextromethorphan/phenylephrine (Children's Dimetapp Multi-Symptom Cold and Flu)

Dosing and uses of Children's Dimetapp Multi-Symptom Cold and Flu (acetaminophen/chlorpheniramine/dextromethorphan/phenylephrine)

• Adult
• Pediatric

 

Adult dosage forms and strengths

acetaminophen/chlorpheniramine/dextromethorphan/phenylephrine

oral solution

• (160mg/1mg/5mg/2.5mg)/5mL

 

Cold/Flu

Indicated to temporarily relieve symptoms associated with cold or flu

4 teaspoonfuls (ie, 20 mL) PO q4hr prn

 

Pediatric dosage forms and strengths

acetaminophen/chlorpheniramine/dextromethorphan/phenylephrine

oral solution

• (160mg/1mg/5mg/2.5mg)/5mL

 

Cold/Flu

Indicated to temporarily relieve symptoms associated with cold or flu

<6 years: Do not use

6-12 years: 2 teaspoonfuls (ie, 10 mL) PO q4hr prn

4 teaspoonfuls (ie, 20 mL) PO q4hr prn

 

Children's Dimetapp Multi-Symptom Cold and Flu (acetaminophen/chlorpheniramine/dextromethorphan/phenylephrine) adverse (side) effects

Frequency not defined

Hypertension

Severe peripheral and visceral vasoconstriction

Reflex tachycardia

Dizziness

Drowsiness

Excitability

Headache

Restlessness

Tremor

GI disturbances

 

Warnings

Contraindications

Hypersensitivi

Hepatitis or hepatic/renal dysfunction, alcoholism

Repeated administration in patients with anemia or cardiac, pulmonary, or renal disease

Do not use with MAOIs or for 2 weeks after discontinuing MAOIs

 

Cautions

Acetaminophen

• Acetaminophen in many other dosage forms and products, check label carefully to avoid overdose
• Risk of hepatotoxicity is higher in alcoholics or with use of more than one acetaminophen-containing product
• G6PD deficiency
• 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

Chlorpheniramine

• Marked drowsiness may occur; avoid other sedating drugs and alcohol
• Paradoxical excitability reaction may occur, especially in children
• Caution in narrow angle glaucoma, prostatic hypertrophy, stenosing peptic ulcer, pyloroduodenal obstruction, or bladder neck obstruction

Dextromethorphan may decrease respirations

Phenylephrine may increase blood pressure

 

Pregnancy and lactation

Pregnancy category: C

Lactation: excretion in milk unknown; use with caution

Pregnant or breastfeeding patients should seek advice of health professional before using OTC drugs

 

Pregnancy categories

A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

NA: Information not available.

 

Pharmacology of Children's Dimetapp Multi-Symptom Cold and Flu (acetaminophen/chlorpheniramine/dextromethorphan/phenylephrine)

Mechanism of action

Acetaminophen: Acts on hypothalamus to produce antipyresis; may work peripherally to pain impulse generation; may also inhibit prostaglandin synthesis in CNs

Chlorpheniramine: Histamine H1-receptor antagonist

Dextromethorphan is a cough suppressant that acts centrally on the cough center in the medulla

Phenylephrine is a vasoconstrictor and a decongestant that relieves symptoms resulting from irritation of upper respiratory tract tissue; shrinks swollen mucous membranes, reduces nasal congestion and tissue hyperemia