acetaminophen/chlorpheniramine (Coricidin HBP Cold and Flu, St. Joseph Cold and Flu)

Dosing and uses of Coricidin HBP Cold and Flu, St. Joseph Cold and Flu (acetaminophen/chlorpheniramine)

• Adult
• Pediatric

 

Adult dosage forms and strengths

acetaminophen/chlorpheniramine

tablet

• 325mg/2mg

 

Relief of Cold & Flu Symptoms

2 tablets PO q4hr

 

Hepatic Impairment

May tolerate low dose therapy but use caution; cases of hepatotoxicity at doses < 4 g/day reported

 

Pediatric dosage forms and strengths

acetaminophen/chlorpheniramine

tablet

• 325mg/2mg

 

Relief of Cold & Flu Symptoms

≥12 years: 2 tablets PO q4hr

 

Coricidin HBP Cold and Flu, St. Joseph Cold and Flu (acetaminophen/chlorpheniramine) adverse (side) effects

Frequency not defined

Hypotension

Palpitations

Tachycardia

Anxiety

Confusion

Depression

Dizziness

Drowsiness

Euphoria

Fatigue

Headache

Insomnia

Irritability

Nervousness

Tremors

Anorexia

Constipation

Diarrhea

Nausea

Vomiting

Agranulocytosis

Anemia

Blood dyscrasias (neutropenia, pancytopenia, leukopenia, thrombocytopenia)

Hemolytic anemia

Bilirubin and alkaline phosphatase may increase

Thickening of bronchial secretions

Wheezing

Dry mouth, nose, throat

 

Warnings

Contraindications

Contraindicated in documented hypersensitivity; asthma attacks, narrow-angle glaucoma, symptomatic prostate hypertrophy, bladder-neck obstruction, and stenosing peptic ulcer; known G-6-PD deficiency

Chlorpheniramine may cause significant confusional symptoms; not for administration to premature or full-term neonates

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

 

Pregnancy and lactation

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 Coricidin HBP Cold and Flu, St. Joseph Cold and Flu (acetaminophen/chlorpheniramine)

Mechanism of action

Chlorpheniramine blocks muscle responses in histamine and acts as an antagonism of the constrictor effects of histamine on respiratory smooth muscle.

Acetaminophen blocks pain impulse generation peripherally and may inhibit the generation of prostaglandin in the CNS. Reduces fever by inhibiting the hypothalamic heat-regulating center.

 

Pharmacokinetics

Chlorpheniramine

• Vd: 4-7 L/kg (children); 6-12 L/kg (adults)
• Protein binding: 33%
• Half-life: 10-13 hr (children); 14-24 hr (adults)
• Peak plasma time: 2-4 hr
• Excretion: Urine

Acetaminophen

• Peak plasma time: 10-60 min (PO immediate release); 60-120 min (PO extended release); 6 hr (PO 500 mg tablet); 8 hr (PO 650 mg extended release tablet)
• Vd: 1 L/kg
• Protein binding: 10-25%
• Metabolism: Liver (microsomal enzyme systems); conjugation (glucuronic acid)
• Half-life: 1.25-3hr
• Excretion: Urine