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TUSNEL (GUAIFENESIN/DEXTROMETHORPHAN HBR/BROMPHENIRAMINE)
- Cold symptoms
- Cough
- Nasal congestion
- Rhinitis
- Rhinorrhea
New Formula 60 mg-30 mg-400 mg tablet
- Dosage information is not available
New Formula 30 mg-15 mg-200 mg/5 mL oral solution
- 10 milliliters by oral route every 6 hours
30 mg-15 mg-200 mg/5 mL oral solution
- 10 milliliters by oral route every 6 hours
Cold symptoms
- 10 milliliters by oral route every 6 hours
- 5 milliliters by oral route every 6 hours
Cough
- 10 milliliters by oral route every 6 hours
- 5 milliliters by oral route every 6 hours
Nasal congestion
- 10 milliliters by oral route every 6 hours
- 5 milliliters by oral route every 6 hours
Rhinitis
- 10 milliliters by oral route every 6 hours
- 5 milliliters by oral route every 6 hours
Rhinorrhea
- 10 milliliters by oral route every 6 hours
- 5 milliliters by oral route every 6 hours
- Azilect
- Eldepryl
- isocarboxazid
- linezolid
- Marplan
- Matulane
- methylene blue (antidote)
- Nardil
- Parnate
- phenelzine
- procarbazine
- rasagiline
- selegiline HCl
- tranylcypromine
- Zelapar
- Zyvox
Contraindicated
- bromocriptine
- cabergoline
- Cafergot
- Cycloset
- D.h.e.45
- dihydroergotamine
- ergoloid
- Ergomar
- ergotamine tartrate
- ergotamine-caffeine
- methylergonovine
- Migergot
- Migranal
- Parlodel
Severe
Moderate
- methyldopa
- methyldopa-hydrochlorothiazide
- methyldopate
- reserpine
- Angle-closure glaucoma
- Severe coronary artery disease
- Severe uncontrolled hypertension
- Urinary retention
Contraindicated
- Benign prostatic hyperplasia
- Diabetes mellitus
- Hypertension
- Hyperthyroidism
- Systemic mastocytosis
Severe
Moderate
- No disease contraindications
TUSNEL (GUAIFENESIN/DEXTROMETHORPHAN HBR/BROMPHENIRAMINE)
- Cold symptoms
- Cough
- Nasal congestion
- Rhinitis
- Rhinorrhea
- None
- Headache disorder
- Insomnia
More Frequent
Severe
Less Severe
- None
- Agitation
- Anorexia
- Dizziness
- Drowsy
- Dysuria
- General weakness
- Nausea
- Nervousness
- Pallor
- Tachycardia
- Tremor
Less Frequent
Severe
Less Severe
Rare / Very Rare
Severe
- Acute generalized exanthematous pustulosis
- Dyspnea
- Hallucinations
- Hypertension
- Ischemic colitis
- Seizure disorder
- Vomiting
Less Severe
- Abdominal pain with cramps
- Cardiac arrhythmia
- Dizziness
- Drowsy
- Dyspepsia
- Excitement
- Gastrointestinal irritation
- Hyperhidrosis
- Nausea
- Palpitations
- Symptoms of anxiety
- Vomiting
Contraindicated
Dextromethorphan (OTC)
Do not use in pediatrics <6 years of age unless clinician consultation.
High risk of adverse CNS effects. Not recommended for use age < 6 years.
- 1 Day – 6 Years
- 1 Do not use in pediatrics <6 years of age unless clinician consultation.
Pseudoephedrine (Immed. Release)
Do not use in pediatrics <6 years of age unless clinician consultation.
High risk of adverse CNS effects. Not recommended for use age < 6 years.
- 1 Day – 6 Years
- 1 High risk of adverse CNS effects. Not recommended for use age < 6 years.
Severe Precaution
Guaifenesin (Liquid)
No established efficacy for cough and cold products age < 2 years. Do not use unless directed by clinician consultation.
- 1 Day – 2 Years
- No established efficacy for cough and cold products age < 2 years. Do not use unless directed by clinician consultation.
Management or Monitoring Precaution
Guaifenesin (solid dose form)
Consult clinician for use in pediatrics age < 12 years.
- 1 Day – 12 Years
- Consult clinician for use in pediatrics age < 12 years.
Dextromethorphan
- Severity Level:
C
- Additional Notes:
Guaifenesin
- Severity Level:
C
- Additional Notes:
Pseudoephedrine
- Severity Level:
C
- Additional Notes: Fda c w/combo prod; poss risk of gastroschisis/sia with 1st trimester exposure
Contraindicated
None
| General | Excretion Potential | Effect on Infant | Notes |
| None |
Precaution Exists
Dextromethorphan
Insufficient data available; molecular wt low enough for possible excretion
Insufficient data available
May decrease milk supply, and cause irritability
| General | Excretion Potential | Effect on Infant | Notes |
| Evaluate use carefully | Unknown | Not known; no or inclusive data | Insufficient data available; molecular wt low enough for possible excretion |
Guaifenesin
Insufficient data available; molecular wt low enough for possible excretion
Insufficient data available
May decrease milk supply, and cause irritability
| General | Excretion Potential | Effect on Infant | Notes |
| Evaluate use carefully | Unknown | Not known; no or inclusive data | Insufficient data available |
Pseudoephedrine
Insufficient data available; molecular wt low enough for possible excretion
Insufficient data available
May decrease milk supply, and cause irritability
| General | Excretion Potential | Effect on Infant | Notes |
| Evaluate use carefully | Excreted | Drug shown to have adverse effect | May decrease milk supply, and cause irritability |
No Known Risk
None
| General | Excretion Potential | Effect on Infant | Notes |
| None |
Contraindicated
None
Precaution Exists
Pseudoephedrine
Cardiovascular-Elderly are more sensitive to tachycardia and hypertensive effects. May exacerbate symptomatic coronary insufficiency. Genitourinary-May cause urinary retention. Neuro/Psych-May worsen cognitive impairment in some elderly with dementia. Insomnia risk.
| Organ / System | HEP | REN | CARD | ENDO | NEURO / PSYCH | PULM |
| Increased Risk / Adverse Effects | Y | N | Y | Y | N | N |
BEERS: N HEDIS: N STOPP: N
No Known Risk
None
- None
| Cold symptoms | |
| J00 | Acute nasopharyngitis [common cold] |
| Cough | |
| R05 | Cough |
| Nasal congestion | |
| R09.81 | Nasal congestion |
| Rhinitis | |
| J30 | Vasomotor and allergic rhinitis |
| J30.0 | Vasomotor rhinitis |
| J30.1 | Allergic rhinitis due to pollen |
| J30.2 | Other seasonal allergic rhinitis |
| J30.5 | Allergic rhinitis due to food |
| J30.8 | Other allergic rhinitis |
| J30.81 | Allergic rhinitis due to animal (cat) (dog) hair and dander |
| J30.89 | Other allergic rhinitis |
| J30.9 | Allergic rhinitis, unspecified |
| J31.0 | Chronic rhinitis |
| Rhinorrhea | |
| R09.82 | Postnasal drip |
| 0-9 | A-Z |
|---|---|
| J00 | Acute nasopharyngitis [common cold] |
| J30 | Vasomotor and allergic rhinitis |
| J30.0 | Vasomotor rhinitis |
| J30.1 | Allergic rhinitis due to pollen |
| J30.2 | Other seasonal allergic rhinitis |
| J30.5 | Allergic rhinitis due to food |
| J30.8 | Other allergic rhinitis |
| J30.81 | Allergic rhinitis due to animal (cat) (dog) hair and dander |
| J30.89 | Other allergic rhinitis |
| J30.9 | Allergic rhinitis, unspecified |
| J31.0 | Chronic rhinitis |
| R05 | Cough |
| R09.81 | Nasal congestion |
| R09.82 | Postnasal drip |
Formulary Reference Tool