acetaminophen/doxylamine/phenylephrine (Alka-Seltzer Plus Severe Allergy Sinus Congestion and Headache, Vicks NyQuil Sinus, QlearQuil Nighttime Sinus and Congestion Relief)
- Dosing and uses of Alka-Seltzer Plus Severe Allergy Sinus Congestion & Headache, Vicks NyQuil Sinus (acetaminophen/doxylamine/phenylephrine)
- Alka-Seltzer Plus Severe Allergy Sinus Congestion & Headache, Vicks NyQuil Sinus (acetaminophen/doxylamine/phenylephrine) adverse (side) effects
- Warnings
- Pregnancy
- Pharmacology of Alka-Seltzer Plus Severe Allergy Sinus Congestion & Headache, Vicks NyQuil Sinus (acetaminophen/doxylamine/phenylephrine)
Dosing and uses of Alka-Seltzer Plus Severe Allergy Sinus Congestion and Headache, Vicks NyQuil Sinus (acetaminophen/doxylamine/phenylephrine)
Adult dosage forms and strengths
acetaminophen/doxylamine/phenylephrine
capsule
- 325mg/6.25mg/5mg
Sinus Pain, Congestion, Rhinorrhea, Sneezing, Headache
2 capsules PO q4hr; not to exceed 6 doses/day
Pediatric dosage forms and strengths
acetaminophen/doxylamine/phenylephrine
capsule
- 325mg/6.25mg/5mg
Sinus Pain, Congestion, Rhinorrhea, Sneezing, Headache
Vicks NyQuil Sinus
- <12 years: Ask a pediatrician
- ≥12 years: 2 capsules PO q4hr; not to exceed 6 doses/day
Alka-Seltzer Plus Severe Allergy Sinus Congestion and Headache, Vicks NyQuil Sinus (acetaminophen/doxylamine/phenylephrine) adverse (side) effects
Frequency not defined
Hypertension
Reflex tachycardia
Severe peripheral & visceral vasoconstriction
Dizziness
Drowsiness
Excitability
Headache
Restlessness
Tremor
Dermatologic rash
Anemia blood dyscrasias (neutropenia, pancytopenia, leukopenia)
Bilirubin & alkaline phosphatase may increase
Dry mouth, throat, and nose
Thickening of mucus in nose or throat
Warnings
Contraindicated in documented hypersensitivity; asthma attacks, narrow-angle glaucoma, symptomatic prostate hypertrophy, bladder-neck obstruction, and stenosing peptic ulcer; known G-6-PD deficiency
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
Doxylamine may exacerbate angle closure glaucoma, hyperthyroidism, peptic ulcer, or urinary tract obstruction; xerostomia may occur
Phenylephrine is a vasoconstrictor and a decongestant that relieves symptoms resulting from irritation of upper respiratory tract tissue. It shrinks swollen mucous membranes, reduces nasal congestion and tissue hyperemia.
Contraindications
Documented hypersensitivity
Asthma
Narrow-angle glaucoma
Symptomatic prostate hypertrophy
Bladder-neck obstruction
Stenosing peptic ulcer
Known G-6-PD deficiency
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; 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
Phenylephrine is a vasoconstrictor and may increase blood pressure
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 Alka-Seltzer Plus Severe Allergy Sinus Congestion and Headache, Vicks NyQuil Sinus (acetaminophen/doxylamine/phenylephrine)
Mechanism of action
Acetaminophen: Blocks pain impulse generation peripherally & may inhibit the generation of prostaglandin in the CNS; reduces fever by inhibiting hypothalamic heat-regulating center
Doxylamine: Competitively blocks histamine from binding to H1 receptors; significant antimuscarinic activity & penetrates CNS, which causes pronounced tendency to induce sedation
Phenylephrine: Vasoconstrictor & decongestant that relieves symptoms resulting from irritation of upper respiratory tract tissue; shrinks swollen mucous membranes, reduces nasal congestion & tissue hyperemia