Acetaminophen, dextromethorphan, guaifenesin, and pseudoephedrine

Generic name: acetaminophen, dextromethorphan, guaifenesin, and pseudoephedrine [ a-SEET-a-MIN-oh-fen, DEX-troe-me-THOR-fan, gwye-FEN-e-sin, SOO-doe-ee-FED-rin ]
Brand names: Duraflu, Robitussin Cold Cough and Flu, Theraflu Max-D Severe Cold & Flu, Sudafed Cold and Cough Liquicaps, Theraflu Chest and Cough, ... show all 12 brands Tylenol Cold Severe Congestion Non-Drowsy, Sudafed Sinus and Cold Liquicaps, Phlemgesic, Maxiflu DM, Flutabs, Theraflu Max-D Severe Cold and Flu, Duraflu (325)
Dosage forms: oral capsule (250 mg-10 mg-100 mg-30 mg), oral powder for reconstitution (1000 mg-30 mg-400 mg-60 mg), oral tablet (250 mg-10 mg-100 mg-30 mg; 325 mg-15 mg-200 mg-30 mg; 325 mg-20 mg-200 mg-60 mg; 500 mg-20 mg-200 mg-60 mg)
Drug class: Upper respiratory combinations

Medically reviewed by Drugs.com on Nov 1, 2022. Written by Cerner Multum.

What is acetaminophen, dextromethorphan, guaifenesin, and pseudoephedrine?

Acetaminophen is a pain reliever and fever reducer.

Dextromethorphan is a cough suppressant. It affects the signals in the brain that trigger cough reflex.

Guaifenesin is an expectorant. It helps loosen congestion in your chest and throat, making it easier to cough out through your mouth.

Pseudoephedrine is a decongestant that shrinks blood vessels in the nasal passages. Dilated blood vessels can cause nasal congestion (stuffy nose).

Acetaminophen, dextromethorphan, guaifenesin, and pseudoephedrine is a combination medicine used to treat headache, fever, body aches, cough, chest congestion, stuffy nose, and sinus congestion caused by allergies, the common cold, or the flu.

acetaminophen, dextromethorphan, guaifenesin, and pseudoephedrine will not treat a cough that is caused by smoking, asthma, or emphysema.

Acetaminophen, dextromethorphan, guaifenesin, and pseudoephedrine may also be used for purposes not listed in this medication guide.

Warnings

Do not take more of this medication than is recommended. An overdose of acetaminophen can damage your liver or cause death. Call your doctor at once if you have nausea, pain in your upper stomach, itching, loss of appetite, dark urine, clay-colored stools, or jaundice (yellowing of your skin or eyes).

In rare cases, acetaminophen may cause a severe skin reaction. Stop taking this medicine and call your doctor right away if you have skin redness or a rash that spreads and causes blistering and peeling.

Acetaminophen is contained in many combination medicines. Taking certain products together can cause you to get too much acetaminophen which can lead to a fatal overdose. Check the label to see if a medicine contains acetaminophen or APAP.

Before taking this medicine

You should not use this medication if you are allergic to acetaminophen, dextromethorphan, guaifenesin, or pseudoephedrine.

Do not use this medicine if you have taken an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, and tranylcypromine.

Ask a doctor or pharmacist if it is safe for you to take this medicine if you have other medical conditions, especially:

• liver disease, alcoholism, or if you drink more than 3 alcoholic beverages per day;

• high blood pressure, heart disease, coronary artery disease, or recent heart attack;

• diabetes;

• glaucoma;

• epilepsy or other seizure disorder;

• enlarged prostate or urination problems;

• cough with mucus, or cough caused by emphysema or chronic bronchitis;

• pheochromocytoma (an adrenal gland tumor); or

• overactive thyroid.

It is not known whether acetaminophen, dextromethorphan, guaifenesin, and pseudoephedrine will harm an unborn baby. Do not use this medicine without your doctor''s advice if you are pregnant.

This medication may pass into breast milk and may harm a nursing baby. Decongestants may also slow breast milk production. Do not use this medicine without your doctor''s advice if you are breast-feeding a baby.

Artificially sweetened liquid medicine may contain phenylalanine. Check the medication label if you have phenylketonuria (PKU).

How should I take acetaminophen, dextromethorphan, guaifenesin, and pseudoephedrine?

Use exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended. This medicine is usually taken only for a short time until your symptoms clear up.

Do not take more of this medication than is recommended. An overdose of acetaminophen can damage your liver or cause death.

Do not give this medication to a child younger than 4 years old. Always ask a doctor before giving cough or cold medicine to a child. Death can occur from the misuse of cough or cold medicine in very young children.

Dissolve one packet of the powder in at least 4 ounces of water. Stir this mixture and drink all of it right away.

Do not take for longer than 7 days in a row. Stop taking the medicine and call your doctor if you still have a fever after 3 days of use, you still have pain after 7 days (or 5 days if treating a child), if your symptoms get worse, or if you have a skin rash, ongoing headache, or any redness or swelling.

If you need surgery or medical tests, tell the surgeon or doctor ahead of time if you have taken this medicine within the past few days.

Store at room temperature away from moisture and heat. Do not allow liquid medicine to freeze.

What happens if I miss a dose?

Since acetaminophen, dextromethorphan, guaifenesin, and pseudoephedrine is taken when needed, you may not be on a dosing schedule. If you are taking the medication regularly, take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of acetaminophen can be fatal.

The first signs of an acetaminophen overdose include loss of appetite, nausea, vomiting, stomach pain, sweating, and confusion or weakness. Later symptoms may include pain in your upper stomach, dark urine, and yellowing of your skin or the whites of your eyes.

What should I avoid while taking acetaminophen, dextromethorphan, guaifenesin, and pseudoephedrine?

Ask a doctor or pharmacist before using any other cold, allergy, pain, or sleep medication. Acetaminophen (sometimes abbreviated as APAP) is contained in many combination medicines. Taking certain products together can cause you to get too much acetaminophen which can lead to a fatal overdose. Check the label to see if a medicine contains acetaminophen or APAP.

Avoid drinking alcohol. It may increase your risk of liver damage while you are taking acetaminophen.

This medication may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

acetaminophen, dextromethorphan, guaifenesin, and pseudoephedrine side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

In rare cases, acetaminophen may cause a severe skin reaction that can be fatal. This could occur even if you have taken acetaminophen in the past and had no reaction. Stop taking this medicine and call your doctor right away if you have skin redness or a rash that spreads and causes blistering and peeling. If you have this type of reaction, you should never again take any medicine that contains acetaminophen.

This medicine may cause serious side effects. Stop using this medicine and call your doctor at once if you have:

• chest pain;

• fast, slow, or uneven heart rate;

• severe dizziness, feeling like you might pass out;

• mood changes, confusion, hallucinations, tremor, seizure (convulsions);

• fever;

• little or no urinating;

• nausea, pain in your upper stomach, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of your skin or eyes); or

• dangerously high blood pressure (severe headache, blurred vision, buzzing in your ears, anxiety, chest pain, uneven heartbeats, seizure).

Common side effects of acetaminophen, dextromethorphan, guaifenesin, and pseudoephedrine may include:

• dizziness, weakness;

• mild headache;

• mild nausea, diarrhea, upset stomach;

• dry mouth, nose, or throat;

• feeling nervous, restless, irritable, or anxious; or

• sleep problems (insomnia).

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Acetaminophen, dextromethorphan, guaifenesin, and pseudoephedrine dosing information

Usual Adult Dose for Cough and Nasal Congestion:

Acetaminophen/dextromethorphan/guaifenesin/PSE 500 mg-20 mg-400 mg-60 mg oral tablet:
1 tablet orally every 4 to 6 hours not to exceed 4 tablets daily.

Usual Pediatric Dose for Cough and Nasal Congestion:

Acetaminophen/dextromethorphan/guaifenesin/PSE 500 mg-20 mg-400 mg-60 mg oral tablet:
6 to 11 years: 1/2 tablet orally every 4 to 6 hours not to exceed 2 tablets daily.
12 years or older: 1 tablet orally every 4 to 6 hours not to exceed 4 tablets daily.

What other drugs will affect acetaminophen, dextromethorphan, guaifenesin, and pseudoephedrine?

Other drugs may interact with acetaminophen, dextromethorphan, guaifenesin, and pseudoephedrine, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

Where can I get more information?

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer

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