acetaminophen/chlorpheniramine (Coricidin HBP Cold and Flu, St. Joseph Cold and Flu)
Classes: Cough/Cold, Non-narcotic Combos; Antihistamines, Alkylamine Derivatives
- Dosing and uses of Coricidin HBP Cold & Flu, St. Joseph Cold & Flu (acetaminophen/chlorpheniramine)
- Coricidin HBP Cold & Flu, St. Joseph Cold & Flu (acetaminophen/chlorpheniramine) adverse (side) effects
- Warnings
- Pregnancy
- Pharmacology of Coricidin HBP Cold & Flu, St. Joseph Cold & Flu (acetaminophen/chlorpheniramine)
Dosing and uses of Coricidin HBP Cold and Flu, St. Joseph Cold and Flu (acetaminophen/chlorpheniramine)
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