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acetaminophen/doxylamine/dextromethorphan (Coricidin HBP Nighttime Multi-Symptom Cold, Tylenol Cough and Sore Throat Nighttime, Vicks NyQuil Cold and Flu, Contac Cold + Flu Night Cooling Relief)

 

Classes: Antitussives, Non-narcotic Combos; Cough/Cold, Non-narcotic Combos

Dosing and uses of Coricidin HBP Nighttime Multi-Symptom Cold, Tylenol Cough and Sore Throat Nighttime (acetaminophen/doxylamine/dextromethorphan)

 

Adult dosage forms and strengths

acetaminophen/doxylamine/dextromethorphan

liquid

  • (325mg/6.25mg/15mg)/15mL
  • (500mg/6.25mg/15mg)/15mL
  • (650mg/7.5mg/30mg)/30mL
  • (650mg/12.5mg/30mg)/30mL

liquid capsule

  • 325mg/6.25mg/15mg

 

Cough, Sore Throat, Rhinorrhea, Fever, Headache, Minor Aches & Pains

1-2 Tablespoons (15-30mL) PO q6hr; not to exceed a cumulative dose of acetaminophen 4 g/day and dextromethorphan 120 mg/day

2 capsules PO q6hr; not to exeed 8 capsules/day

Liquid formulation ingredients vary in dosage; follow specific brand instructions

 

Pediatric dosage forms and strengths

acetaminophen/doxylamine/dextromethorphan

liquid

  • (500mg/6.25mg/15mg)/15mL
  • (650mg/7.5mg/30mg)/30mL
  • (650mg/12.5mg/30mg)/30mL

liquid capsule

  • 325mg/6.25mg/15mg

 

Cough, Sore Throat, Rhinorrhea, Fever, Headache, Minor Aches & Pains

<12 Years Old

  • Ask a pediatrician

>12 Years Old

  • 2 Tablespoons (30mL) PO q6hr; not to exceed 120 mL/day
  • 2 capsules PO q6hr; not to exeed 8 capsules/day

 

Coricidin HBP Nighttime Multi-Symptom Cold, Tylenol Cough and Sore Throat Nighttime (acetaminophen/doxylamine/dextromethorphan) adverse (side) effects

Frequency not defined

Angioedema

Laryngeal edema

Dizziness

Drowsiness

Pruritic maculopapular rash

Urticaria

Dry mouth, throat, and nose

Agranulocytosis

Leukopenia

Neutropenia

Pancytopenia

Thrombocytopenia

Thrombocytopenic purpura

Hepatotoxicity

Thickening of mucus in nose or throat

Anaphylactoid reaction

 

Warnings

Contraindications

Hypersensitivity

Asthma

Narrow-angle glaucoma

Symptomatic prostate hypertrophy

Bladder-neck obstruction

Stenosing peptic ulcer

G-6-PD deficiency

Severe hepatic impairment

 

Cautions

Acetaminophen hepatotoxicity possible in chronic alcoholics following various dose levels

Severe or recurrent pain or high or continued fever may indicate a serious illness

Acetaminophen 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

Doxylamine may exacerbate angle closure glaucoma, hyperthyroidism, peptic ulcer, or urinary tract obstruction; xerostomia may occur

Do not take dextromethorphan for persistent or chronic cough associated with smoking, asthma, or emphysema, or if it is accompanied by excessive phlegm unless directed by a healthcare provider; dextromethorphan may slow the breathing

 

Pregnancy and lactation

Pregnancy category: C

Lacation: excreted in breast milk, use 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 Coricidin HBP Nighttime Multi-Symptom Cold, Tylenol Cough and Sore Throat Nighttime (acetaminophen/doxylamine/dextromethorphan)

Mechanism of action

Acetaminophen: Blocks pain impulse generation peripherally and may inhibit prostaglandin generation in CNS; reduces fever by inhibiting hypothalamic heat-regulating center

Doxylamine: Competitively blocks histamine from binding to H1 receptors; significant antimuscarinic activity and penetrates CNS, which causes pronounced tendency to induce sedation

Dextromethorphan: Cough suppressant that acts centrally on cough center in medulla