COLD & FLU RELIEF (DIPHENHYDRAMINE HCL/PHENYLEPHRINE HCL/ACETAMINOPHEN)
- Allergic rhinitis
- Allergic conjunctivitis
- Flu-like symptoms
- Nasal congestion
- Rhinorrhea
- Sinus headache
- Robitussin Cold-flu Night (pe) Oral Liquid
- Mucinex Sinus-max Nite Congestion-cough Oral Liquid
- Mucinex Fast-max Nite Cold-flu Oral Liquid
- Delsym Cough-cold Nighttime Oral Liquid
- Cold And Flu Relief (diphen-pe) Oral Liquid
- Children's Mucinex Night Time Oral Liquid
12.5 mg-5 mg-325 mg/10 mL oral liquid
- Dosage information is not available
ion-Cough 12.5-5-325 mg/10 mL oral liq
- Dosage information is not available
12.5 mg-5 mg-325 mg/10 mL oral liquid
- Dosage information is not available
12.5 mg-5 mg-325 mg/10 mL oral liquid
- Dosage information is not available
Cold and Flu Relief (diphen-pe) 12.5 mg-5 mg-325 mg/10 mL oral liquid
- Dosage information is not available
Children's Mucinex Night Time 12.5 mg-5 mg-325 mg/10 mL oral liquid
- Dosage information is not available
- isocarboxazid
- Marplan
- Matulane
- methylene blue (antidote)
- Nardil
- Parnate
- phenelzine
- procarbazine
- tranylcypromine
Contraindicated
- Azilect
- bromocriptine
- cabergoline
- Cafergot
- Compound 347
- Cycloset
- D.h.e.45
- dihydroergotamine
- Eldepryl
- enflurane
- ergoloid
- Ergomar
- ergotamine tartrate
- ergotamine-caffeine
- Forane
- isoflurane
- linezolid
- methylergonovine
- Migergot
- Migranal
- Parlodel
- rasagiline
- selegiline HCl
- sevoflurane
- Sojourn
- Soltamox
- tamoxifen
- Terrell
- Ultane
- Zelapar
- Zyvox
Severe
Moderate
- Coumadin
- isoniazid
- isoniazid-rifamp-pyrazinamide
- Jantoven
- methyldopa
- methyldopa-hydrochlorothiazide
- methyldopate
- reserpine
- Rifamate
- rifampin-isoniazid
- Rifater
- warfarin
- Acetaminophen overdose
- Acute hepatic failure
- Acute hepatitis C
- Acute myocardial infarction
- Arterial thrombosis
- Severe uncontrolled hypertension
- Ventricular tachycardia
Contraindicated
- Acute hepatitis
- Acute pancreatitis
- Angle-closure glaucoma
- Benign prostatic hyperplasia
- Bladder outflow obstruction
- Bradycardia
- Chronic idiopathic constipation
- Coronary artery disease
- Disease of liver
- Hypertension
- Hyperthyroidism
- Incomplete AV heart block
- Protein-calorie malnutrition
- Severe arteriosclerotic vascular disease
- Severe renal impairment
- Shock
- Stenosing peptic ulcer
- Urinary retention
Severe
Moderate
- Acidosis
- Chronic heart failure
- Hypertension
- Hyperthyroidism
- Hypoxia
- Ocular hypertension
COLD & FLU RELIEF (DIPHENHYDRAMINE HCL/PHENYLEPHRINE HCL/ACETAMINOPHEN)
- Allergic rhinitis
- Allergic conjunctivitis
- Flu-like symptoms
- Nasal congestion
- Rhinorrhea
- Sinus headache
- None
- Dizziness
- Drowsy
- Thick bronchial secretions
More Frequent
Severe
Less Severe
- Abnormal hepatic function tests
- Sedation
Less Frequent
Severe
Less Severe
Rare / Very Rare
Severe
- Acute generalized exanthematous pustulosis
- Acute hepatic failure
- Agranulocytosis
- Allergic dermatitis
- Anaphylaxis
- Angioedema
- Blood dyscrasias
- Cardiac arrhythmia
- Dizziness
- Drug-induced hepatitis
- Extrasystoles
- Hallucinations
- Headache disorder
- Hemolytic anemia
- Hyperhidrosis
- Hypotension
- Insomnia
- Laryngeal edema
- Leukopenia
- Maculopapular rash
- Nervousness
- Neutropenic disorder
- Pallor
- Seizure disorder
- Stevens-johnson syndrome
- Tachycardia
- Thrombocytopenic disorder
- Toxic epidermal necrolysis
- Tremor
Less Severe
- Abdominal distension
- Acute abdominal pain
- Acute confusion
- Anorexia
- Ataxia
- Blurred vision
- Chest discomfort
- Chills
- Constipation
- Diarrhea
- Diplopia
- Dry nose
- Dry throat
- Dyspnea
- Dysuria
- Erythema
- Euphoria
- Excitement
- Fatigue
- Headache disorder
- Hyperhidrosis
- Insomnia
- Irritability
- Maculopapular rash
- Malaise
- Medication overuse headache
- Migraine
- Nervousness
- Nightmares
- Palpitations
- Paresthesia
- Pruritus of skin
- Skin photosensitivity
- Skin rash
- Symptoms of anxiety
- Tachycardia
- Tinnitus
- Tremor
- Urinary retention
- Urticaria
- Vertigo
- Visual changes
- Wheezing
- Xerostomia
Contraindicated
Diphenhydramine (Cough-Cold)
Do not use unless as directed by clinician consultation. Risk of adverse CNS effects include sedation or paradoxical excitation.
Possible risk of CNS excitation, convulsions in newborns.
Risk of CNS excitation. Do not use age <6 years without clinician consult.
- 30 Days – 6 Years
- 1 Do not use unless as directed by clinician consultation. Risk of adverse CNS effects include sedation or paradoxical excitation.
- 1 Day – 29 Days
- 1 Do not use unless as directed by clinician consultation. Risk of adverse CNS effects include sedation or paradoxical excitation.
- 1 Day – 6 Years
- 1 Do not use unless as directed by clinician consultation. Risk of adverse CNS effects include sedation or paradoxical excitation.
Diphenhydramine (Systemic)
Do not use unless as directed by clinician consultation. Risk of adverse CNS effects include sedation or paradoxical excitation.
Possible risk of CNS excitation, convulsions in newborns.
Risk of CNS excitation. Do not use age <6 years without clinician consult.
- 30 Days – 6 Years
- 1 Possible risk of CNS excitation, convulsions in newborns.
- 1 Day – 29 Days
- 1 Possible risk of CNS excitation, convulsions in newborns.
- 1 Day – 6 Years
- 1 Possible risk of CNS excitation, convulsions in newborns.
Phenylephrine (Oral,Rectal)
Do not use unless as directed by clinician consultation. Risk of adverse CNS effects include sedation or paradoxical excitation.
Possible risk of CNS excitation, convulsions in newborns.
Risk of CNS excitation. Do not use age <6 years without clinician consult.
- 30 Days – 6 Years
- 1 Risk of CNS excitation. Do not use age <6 years without clinician consult.
- 1 Day – 29 Days
- 1 Risk of CNS excitation. Do not use age <6 years without clinician consult.
- 1 Day – 6 Years
- 1 Risk of CNS excitation. Do not use age <6 years without clinician consult.
Severe Precaution
None
Management or Monitoring Precaution
Acetaminophen (oral,rectal)
Use weight based dosing in children less than 12 years.
- 1 Day – 12 Years
- Use weight based dosing in children less than 12 years.
Acetaminophen
- Severity Level:
2
- Additional Notes: Available data suggest no known risk; otc product, no fda pregnancy warnings
Diphenhydramine
- Severity Level:
B
- Additional Notes:
Phenylephrine
- Severity Level:
2
- Additional Notes: Insufficient human data available.
Contraindicated
None
General | Excretion Potential | Effect on Infant | Notes |
None |
Precaution Exists
Diphenhydramine
Limited data suggest increased drowsiness, and irritability
Oral bioavailability low; infant exposure may be minimal
General | Excretion Potential | Effect on Infant | Notes |
Evaluate use carefully | Excreted | Not known; no or inclusive data | Limited data suggest increased drowsiness, and irritability |
Phenylephrine
Limited data suggest increased drowsiness, and irritability
Oral bioavailability low; infant exposure may be minimal
General | Excretion Potential | Effect on Infant | Notes |
Evaluate use carefully | Excreted | Not known; no or inclusive data | Oral bioavailability low; infant exposure may be minimal |
No Known Risk
Acetaminophen
Low levels excreted with low risk for adverse effects in infant
General | Excretion Potential | Effect on Infant | Notes |
No known risks; does not adversely affect lactation | Excreted | No adverse effect | Low levels excreted with low risk for adverse effects in infant |
Contraindicated
None
Precaution Exists
Acetaminophen (oral,rectal)
Hepatic-Elderly may be more susceptible to hepatotoxicity. Strict adherence to a maximum daily dose is recommended, and the maximum dose recommendation varies between 3000-3800 mg depending on strength used and source of the recommendation.
Neuro/Psych-Anticholinergic effects may cause sedation, worsen cognitive impairment and increase fall risk. Maximum of 25mg/day. Cardiovascular-May cause orthostatic hypotension at higher doses. Gastrointestinal-May cause or worsen pre-existing constipation. Genitourinary-Best avoided in patients with urinary retention from any cause.
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 | N | Y | N | N | N | N |
BEERS: N HEDIS: N STOPP: N
Diphenhydramine
Hepatic-Elderly may be more susceptible to hepatotoxicity. Strict adherence to a maximum daily dose is recommended, and the maximum dose recommendation varies between 3000-3800 mg depending on strength used and source of the recommendation.
Neuro/Psych-Anticholinergic effects may cause sedation, worsen cognitive impairment and increase fall risk. Maximum of 25mg/day. Cardiovascular-May cause orthostatic hypotension at higher doses. Gastrointestinal-May cause or worsen pre-existing constipation. Genitourinary-Best avoided in patients with urinary retention from any cause.
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 | N | N | N | Y | N | N |
BEERS: Y HEDIS: Y STOPP: Y
Phenylephrine
Hepatic-Elderly may be more susceptible to hepatotoxicity. Strict adherence to a maximum daily dose is recommended, and the maximum dose recommendation varies between 3000-3800 mg depending on strength used and source of the recommendation.
Neuro/Psych-Anticholinergic effects may cause sedation, worsen cognitive impairment and increase fall risk. Maximum of 25mg/day. Cardiovascular-May cause orthostatic hypotension at higher doses. Gastrointestinal-May cause or worsen pre-existing constipation. Genitourinary-Best avoided in patients with urinary retention from any cause.
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 | N | N | Y | Y | N | N |
BEERS: N HEDIS: N STOPP: N
No Known Risk
None
- None
Allergic conjunctivitis | |
H10.1 | Acute atopic conjunctivitis |
H10.10 | Acute atopic conjunctivitis, unspecified eye |
H10.11 | Acute atopic conjunctivitis, right eye |
H10.12 | Acute atopic conjunctivitis, left eye |
H10.13 | Acute atopic conjunctivitis, bilateral |
H10.44 | Vernal conjunctivitis |
H10.45 | Other chronic allergic conjunctivitis |
H16.26 | Vernal keratoconjunctivitis, with limbar and corneal involvement |
H16.261 | Vernal keratoconjunctivitis, with limbar and corneal involvement, right eye |
H16.262 | Vernal keratoconjunctivitis, with limbar and corneal involvement, left eye |
H16.263 | Vernal keratoconjunctivitis, with limbar and corneal involvement, bilateral |
H16.269 | Vernal keratoconjunctivitis, with limbar and corneal involvement, unspecified eye |
Allergic 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 |
Flu-like symptoms | |
J02.9 | Acute pharyngitis, unspecified |
R05 | Cough |
R09.81 | Nasal congestion |
R50.9 | Fever, unspecified |
R53.1 | Weakness |
R53.81 | Other malaise |
R53.83 | Other fatigue |
R68.83 | Chills (without fever) |
Nasal congestion | |
R09.81 | Nasal congestion |
Rhinorrhea | |
R09.82 | Postnasal drip |
Sinus headache | |
R51 | Headache |
0-9 | A-Z |
---|---|
H10.1 | Acute atopic conjunctivitis |
H10.10 | Acute atopic conjunctivitis, unspecified eye |
H10.11 | Acute atopic conjunctivitis, right eye |
H10.12 | Acute atopic conjunctivitis, left eye |
H10.13 | Acute atopic conjunctivitis, bilateral |
H10.44 | Vernal conjunctivitis |
H10.45 | Other chronic allergic conjunctivitis |
H16.26 | Vernal keratoconjunctivitis, with limbar and corneal involvement |
H16.261 | Vernal keratoconjunctivitis, with limbar and corneal involvement, right eye |
H16.262 | Vernal keratoconjunctivitis, with limbar and corneal involvement, left eye |
H16.263 | Vernal keratoconjunctivitis, with limbar and corneal involvement, bilateral |
H16.269 | Vernal keratoconjunctivitis, with limbar and corneal involvement, unspecified eye |
J02.9 | Acute pharyngitis, unspecified |
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 |
R05 | Cough |
R09.81 | Nasal congestion |
R09.81 | Nasal congestion |
R09.82 | Postnasal drip |
R50.9 | Fever, unspecified |
R51 | Headache |
R53.1 | Weakness |
R53.81 | Other malaise |
R53.83 | Other fatigue |
R68.83 | Chills (without fever) |