Acetaminophen and Dextromethorphan

Acetaminophen and Dextromethorphan Brand Names

Delsym Children’s Cough + Sore Throat | Delsym Cough + Sore Throat | PediaCare Cough & Sore Throat Plus Acetaminophen | Robitussin CF MAX Severe Cough + Sore Throat | Triaminic Cough & Sore Throat | Triaminic Cough and Sore Throat | Triaminic Cough and Sore Throat Softchew | Tylenol Children’s Cold + Cough + Sore Throat | Tylenol Children’s Plus Cough and Sore Throat | Tylenol Cough and Sore Throat

What is Acetaminophen and Dextromethorphan

Acetaminophen and dextromethorphan are used together to provide temporary relief from body aches, cough, minor pain due to a headache or sore throat, and fever.

Acetaminophen possesses analgesic and antipyretic activity similar to aspirin; however, acetaminophen has no peripheral anti-inflammatory activity or effects on platelet function.

Acetaminophen is the preferred analgesic/antipyretic for patients in whom aspirin is contraindicated (e.g., those who have a history of gastric ulcer or a coagulation disorder).

In addition, acetaminophen has been recommended by the American Lung Association as the first line treatment for aches and pains associated with the flu. Dextromethorphan is a cough suppressant related to the opiate agonists; however, it does not exhibit typical opiate agonist characteristics.

The only morphine-like characteristic dextromethorphan retains is its antitussive property.

Dextromethorphan is effective in inhibiting dry, nonproductive coughs.

It is not intended to treat coughs associated with excessive mucus production such as may occur with smoking, emphysema, or chronic bronchitis.

Acetaminophen and dextromethorphan is available in nonprescription liquid formulations for adults and children.

Indications

  • cough
  • fever
  • headache
  • mild pain
  • pharyngitis

For relief from body aches, cough, mild pain due to a headache or sore throat (pharyngitis), and fever

Side Effects

  1. acute generalized exanthematous pustulosis (AGEP)
  2. agranulocytosis
  3. anaphylactic shock
  4. anaphylactoid reactions
  5. angioedema
  6. bleeding
  7. confusion
  8. contact dermatitis
  9. dizziness
  10. drowsiness
  11. dysarthria
  12. encephalopathy
  13. erythema
  14. excitability
  15. exfoliative dermatitis
  16. fatigue
  17. fever
  18. hemolysis
  19. hemolytic anemia
  20. hepatic necrosis
  21. hypoprothrombinemia
  22. interstitial nephritis
  23. irritability
  24. jaundice
  25. maculopapular rash
  26. methemoglobinemia
  27. myocarditis
  28. nausea
  29. pancytopenia
  30. pruritus
  31. purpura
  32. rash
  33. renal failure (unspecified)
  34. renal papillary necrosis
  35. renal tubular necrosis
  36. restlessness
  37. thrombocytopenia
  38. thrombocytosis
  39. toxic epidermal necrolysis
  40. urticaria
  41. vomiting

Monitoring Parameters

  • LFTs
  • serum creatinine/BUN: in chronic use or acute toxicity

Contraindications

  • alcoholism
  • asthma
  • bone marrow suppression
  • breast-feeding
  • bronchitis
  • children
  • chronic obstructive pulmonary disease (COPD)
  • driving or operating machinery
  • emphysema
  • G6PD deficiency
  • geriatric
  • heart failure
  • hepatic disease
  • hepatitis
  • immunosuppression
  • infants
  • infection
  • MAOI therapy
  • neonates
  • neutropenia
  • pregnancy
  • renal disease
  • renal failure
  • renal impairment
  • tobacco smoking

Interactions

  • Abacavir; Lamivudine, 3TC; Zidovudine, ZDV
  • Abiraterone
  • Acetaminophen; Aspirin, ASA; Caffeine
  • Acetaminophen; Butalbital
  • Acetaminophen; Butalbital; Caffeine
  • Acetaminophen; Butalbital; Caffeine; Codeine
  • Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
  • Acetaminophen; Codeine
  • Alfentanil
  • Amiodarone
  • Amlodipine; Celecoxib
  • Amobarbital
  • Antacids
  • Aprepitant, Fosaprepitant
  • Artemether; Lumefantrine
  • Articaine; Epinephrine
  • Aspirin, ASA
  • Aspirin, ASA; Butalbital; Caffeine
  • Aspirin, ASA; Butalbital; Caffeine; Codeine
  • Aspirin, ASA; Caffeine; Dihydrocodeine
  • Aspirin, ASA; Caffeine; Orphenadrine
  • Aspirin, ASA; Carisoprodol
  • Aspirin, ASA; Carisoprodol; Codeine
  • Aspirin, ASA; Citric Acid; Sodium Bicarbonate
  • Aspirin, ASA; Dipyridamole
  • Aspirin, ASA; Omeprazole
  • Aspirin, ASA; Oxycodone
  • Aspirin, ASA; Pravastatin
  • Atazanavir; Cobicistat
  • Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
  • Atropine; Hyoscyamine; Phenobarbital; Scopolamine
  • Barbiturates
  • Belladonna Alkaloids; Ergotamine; Phenobarbital
  • Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
  • Bismuth Subsalicylate
  • Bismuth Subsalicylate; Metronidazole; Tetracycline
  • Boceprevir
  • Bupivacaine
  • Bupivacaine Liposomal
  • Bupivacaine; Lidocaine
  • Buprenorphine
  • Buprenorphine; Naloxone
  • Busulfan
  • Butabarbital
  • Carbamazepine
  • Celecoxib
  • Charcoal
  • Chloroprocaine
  • Chlorpheniramine; Codeine
  • Cholestyramine
  • Choline Salicylate; Magnesium Salicylate
  • Cinacalcet
  • Citalopram
  • Clobazam
  • Cobicistat
  • Codeine
  • Codeine; Guaifenesin
  • Codeine; Phenylephrine; Promethazine
  • Codeine; Promethazine
  • Dacomitinib
  • Dapsone
  • Darifenacin
  • Darunavir; Cobicistat
  • Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
  • Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
  • Delavirdine
  • Desvenlafaxine
  • Diflunisal
  • Donepezil; Memantine
  • Dronedarone
  • Drospirenone; Ethinyl Estradiol
  • Drospirenone; Ethinyl Estradiol; Levomefolate
  • Duloxetine
  • Efavirenz
  • Efavirenz; Emtricitabine; Tenofovir
  • Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
  • Eliglustat
  • Eltrombopag
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
  • Escitalopram
  • Ethanol
  • Ethinyl Estradiol
  • Ethinyl Estradiol; Desogestrel
  • Ethinyl Estradiol; Ethynodiol Diacetate
  • Ethinyl Estradiol; Etonogestrel
  • Ethinyl Estradiol; Levonorgestrel
  • Ethinyl Estradiol; Levonorgestrel; Ferrous bisglycinate
  • Ethinyl Estradiol; Levonorgestrel; Folic Acid; Levomefolate
  • Ethinyl Estradiol; Norelgestromin
  • Ethinyl Estradiol; Norethindrone
  • Ethinyl Estradiol; Norethindrone Acetate
  • Ethinyl Estradiol; Norethindrone Acetate; Ferrous fumarate
  • Ethinyl Estradiol; Norethindrone; Ferrous fumarate
  • Ethinyl Estradiol; Norgestimate
  • Ethinyl Estradiol; Norgestrel
  • Exenatide
  • Fedratinib
  • Fentanyl
  • Fluoxetine
  • Fluoxetine; Olanzapine
  • Fluvoxamine
  • Givosiran
  • grapefruit juice
  • Hydantoins
  • Hydroxyprogesterone
  • Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
  • Imatinib
  • Insulin Glargine; Lixisenatide
  • Isavuconazonium
  • Isocarboxazid
  • Isoniazid, INH
  • Isoniazid, INH; Pyrazinamide, PZA; Rifampin
  • Isoniazid, INH; Rifampin
  • Lamivudine, 3TC; Zidovudine, ZDV
  • Lamotrigine
  • Lanthanum Carbonate
  • Lasmiditan
  • Levomilnacipran
  • Lidocaine
  • Lidocaine; Prilocaine
  • Linezolid
  • Lixisenatide
  • Lomitapide
  • Lopinavir; Ritonavir
  • Lorcaserin
  • Magnesium Salicylate
  • Memantine
  • Mephobarbital
  • Mepivacaine
  • Mepivacaine; Levonordefrin
  • Methenamine; Sodium Acid Phosphate; Methylene Blue; Hyoscyamine
  • Methohexital
  • Methylene Blue
  • Metyrapone
  • Milnacipran
  • Mipomersen
  • Mirabegron
  • Mirtazapine
  • Mitotane
  • Monoamine oxidase inhibitors
  • Nefazodone
  • Ombitasvir; Paritaprevir; Ritonavir
  • Omeprazole; Amoxicillin; Rifabutin
  • Omeprazole; Sodium Bicarbonate
  • Oritavancin
  • Ozanimod
  • Panobinostat
  • Paroxetine
  • Pazopanib
  • Peginterferon Alfa-2b
  • Penicillin G Benzathine; Penicillin G Procaine
  • Penicillin G Procaine
  • Pentobarbital
  • Phenelzine
  • Phenobarbital
  • Pneumococcal Vaccine, Polyvalent
  • Posaconazole
  • Pramlintide
  • Prilocaine
  • Prilocaine; Epinephrine
  • Primidone
  • Procarbazine
  • Propafenone
  • Quinine
  • Rasagiline
  • Rifabutin
  • Rifampin
  • Ritonavir
  • Rolapitant
  • Ropivacaine
  • Safinamide
  • Salsalate
  • Secobarbital
  • Segesterone Acetate; Ethinyl Estradiol
  • Selegiline
  • Serotonin-Receptor Agonists
  • Sertraline
  • Sibutramine
  • Sodium Bicarbonate
  • St. John’s Wort, Hypericum perforatum
  • Sulfinpyrazone
  • Tedizolid
  • Telaprevir
  • Telotristat Ethyl
  • Terbinafine
  • Tetracaine
  • Thiopental
  • Tizanidine
  • tobacco
  • Tocilizumab
  • Tranylcypromine
  • Tricyclic antidepressants
  • Trimetrexate
  • Vemurafenib
  • Venlafaxine
  • Vilazodone
  • Vortioxetine
  • Warfarin
  • Zidovudine, ZDV
  • Zolmitriptan
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