Uses

This combination product is used for the temporary treatment of cough, stuffy nose, and sinus pain/pressure caused by infection (such as the common cold, flu) or other breathing illnesses (such as hay fever, bronchitis). This product contains a decongestant (such as pseudoephedrine, phenylephrine) that works by narrowing the blood vessels to help relieve stuffy nose symptoms and sinus pressure. This product also contains a non-opioid cough suppressant (such as dextromethorphan, chlophedianol). It affects a certain part of the brain (cough center) to help you stop coughing. Talk with your doctor before using this product for a chronic cough from smoking or a cough with too much/thick mucus.

Cough-and-cold products have not been shown to be safe or effective in children younger than 6 years. Do not use this product to treat cold symptoms in children younger than 6 years unless specifically directed by the doctor. Some products (such as long-acting tablets/capsules) are not recommended for use in children younger than 12 years. Ask your doctor or pharmacist for more details about using your product safely.

These products do not cure or shorten the length of the common cold and may cause serious side effects. To decrease the risk for serious side effects, carefully follow all dosage directions. Do not use this product to make a child sleepy. Do not give other cough-and-cold medication that might contain the same or similar ingredients (see also Drug Interactions section). Ask the doctor or pharmacist about other ways to relieve cough and cold symptoms (such as drinking enough fluids, using a humidifier or saline nose drops/spray).

How To Use

If you are taking the over-the-counter product to self-treat, follow all directions on the product package before taking this medication. If you have any questions, ask your doctor or pharmacist. If your doctor has prescribed this medication, take it as directed.

Take the tablet, capsule, or liquid form by mouth with or without food. This medication may be taken with food or milk if stomach upset occurs.

The dosage is based on your age, medical condition, and response to treatment. Do not increase your dose or take this drug more often than directed. Do not take more of this medication than recommended for your age. There are many brands and forms of this product available. Read the dosing instructions carefully for each product because the amount of cough suppressant and decongestant may be different between products.

If you are using the chewable tablets, chew each tablet well and swallow. If you are using the liquid form of this medication, measure the dose carefully using a special measuring device/cup. Do not use a household spoon because you may not get the correct dose.

If you are using a product made to dissolve in the mouth (such as strips), dry your hands before handling the medication. Place each dose on the tongue and allow to dissolve completely, then swallow it with saliva or with water.

Caffeine can increase the side effects of this medication. Avoid drinking large amounts of beverages containing caffeine (coffee, tea, colas), eating large amounts of chocolate, or taking nonprescription products that contain caffeine.

Improper use of dextromethorphan (abuse) may result in serious harm (such as brain damage, seizure, death). Do not increase your dose, take it more often, or use it for a longer time than directed.

If your symptoms do not improve after 7 days, if they worsen or return, if you develop a headache that doesn't go away, fever, or rash, or if you think you may have a serious medical problem, get medical help right away.

Side Effects

Nausea, vomiting, trouble sleeping, dizziness, headache, or nervousness may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly. Stop taking this medication and tell your doctor promptly if you have dizziness, nervousness, or trouble sleeping.

If your doctor has directed you to use this medication, remember that your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Stop taking this medication and tell your doctor right away if you have any serious side effects, including:

• fast/irregular/pounding heartbeat
• mental/mood changes (such as confusion, hallucinations, nervousness)
• seizures
• shaking (tremors)
• trouble urinating

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including:

• rash
• itching/swelling (especially of the face/tongue/throat)
• severe dizziness
• trouble breathing

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US -

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Precautions

Before taking this medication, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. Also tell your doctor if you have had negative reactions to any sympathomimetics (such as pseudoephedrine, phenylephrine). This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

If you have any of the following health problems, consult your doctor or pharmacist before using this product:

• couch with a lot of mucus
• chronic cough (such as with asthma, emphysema, smoking)
• diabetes
• a certain eye condition (glaucoma)
• heart problems (such as heart attack, chest pain, heart failure)
• fast/irregular heart beat
• high blood pressure
• liver disease
• overactive thyroid (hyperthyroidism)
• difficulty urinating (such as due to enlarged prostate)

This drug may make you dizzy. Alcohol or marijuana (cannabis) can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).

Liquid forms, chewable tablets, or forms of this product made to dissolve in the mouth may contain sugar, alcohol, or aspartame. Caution is advised if you have diabetes, alcohol dependence, liver disease, phenylketonuria (PKU), or any other condition that requires you to limit/avoid these substances in your diet. Ask your doctor or pharmacist about using this product safely.

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Older adults may be more sensitive to the side effects of this drug, especially fast/irregular heartbeat, dizziness, problems urinating, trouble sleeping, or confusion.

Children may be more sensitive to the effects of this medication, especially agitation.

During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.

Pseudoephedrine passes into breast milk. Consult your doctor before breast-feeding.

Drug Interactions

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

Taking certain MAO inhibitors with this medication may cause a serious (possibly fatal) drug interaction. Avoid taking isocarboxazid, metaxalone, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, selegiline, or tranylcypromine during treatment with this medication. Most MAO inhibitors should also not be taken for two weeks before treatment with this medication. Ask your doctor when to start or stop taking this medication.

Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain similar ingredients (decongestants such as phenylephrine or cough suppressants). Ask your pharmacist about using those products safely.

Overdose

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Alberta residents can call PADIS (Poison and Drug Information Service) 24 hours a day at 1-800-332-1414. Canada residents can call a provincial poison control center. Symptoms of overdose may include: agitation, confusion, hallucinations, seizures.

Notes

This medication is for temporary use only. Do not use for more than 7 days without first consulting your doctor.

Missed Dose

If you are taking this product on a regular schedule and miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

If you have questions about missing a dose or you don't have more medication, contact your healthcare provider or pharmacist.

Storage

Different brands of this medication have different storage needs. Check the product package for instructions on how to store your brand, or ask your pharmacist. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.