Saturday 12 March 2011

dextromethorphan, diphenhydramine, and phenylephrine


Generic Name: dextromethorphan, diphenhydramine, and phenylephrine (DEX troe me THOR fan, DYE fen HYE dra meen, and FEN il EFF rin)

Brand names: Dytan-DM, Triaminic Day Time Night Time Cold & Cough, Duratuss AC 12, D-Tann DM, Triaminic Day Time Night Time Cold & Cough


What is dextromethorphan, diphenhydramine, and phenylephrine?

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


Diphenhydramine is an antihistamine that reduces the effects of the natural chemical histamine in the body. Histamine can produce symptoms of sneezing, itching, watery eyes, and runny nose.


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


The combination of diphenhydramine, dextromethorphan, and phenylephrine is used to treat runny or stuffy nose, sneezing, itching, watery eyes, cough, and sinus congestion caused by allergies, the common cold, or the flu.


This medicine will not treat a cough that is caused by smoking, asthma, or emphysema.

Diphenhydramine, dextromethorphan, and phenylephrine may also be used for purposes not listed in this medication guide.


What is the most important information I should know about dextromethorphan, diphenhydramine, and phenylephrine?


Do not give this medication to a child younger than 4 years old. Always ask a doctor before giving a cough or cold medicine to a child. Death can occur from the misuse of cough and cold medicines in very young children. You should not use this medication if you have severe constipation, a blockage in your stomach or intestines, or if you are unable to urinate. Do not use cough or cold medicine if you have untreated or uncontrolled diseases such as glaucoma, asthma or COPD, high blood pressure, heart disease, coronary artery disease, or overactive thyroid. Do not use cough or cold medicine if you have used an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate) in the last 14 days. A dangerous drug interaction could occur, leading to serious side effects.

What should I discuss with my healthcare provider before taking dextromethorphan, diphenhydramine, and phenylephrine?


Do not use cough or cold medicine if you have used an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate) in the last 14 days. A dangerous drug interaction could occur, leading to serious side effects. You should not use this medication if you have severe constipation, a blockage in your stomach or intestines, or if you are unable to urinate. Do not use cough or cold medicine if you have untreated or uncontrolled diseases such as glaucoma, asthma or COPD, high blood pressure, heart disease, coronary artery disease, or overactive thyroid.

Ask a doctor or pharmacist if it is safe for you to take this medication if you have:



  • a blockage in your digestive tract (stomach or intestines), a colostomy or ileostomy;




  • diabetes;




  • liver or kidney disease;




  • epilepsy or other seizure disorder;




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




  • enlarged prostate or urination problems;




  • low blood pressure;




  • pheochromocytoma (an adrenal gland tumor); or




  • if you take potassium (Cytra, Epiklor, K-Lyte, K-Phos, Kaon, Klor-Con, Polycitra, Urocit-K).




FDA pregnancy category C. It is not known whether this medication will harm an unborn baby. Do not use cough or cold medicine without medical advice if you are pregnant. This medicine may pass into breast milk and may harm a nursing baby. Antihistamines and decongestants may also slow breast milk production. Do not use cough or cold medicine without medical advice if you are breast-feeding a baby.

How should I take dextromethorphan, diphenhydramine, and phenylephrine?


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. Cough or cold medicine is usually taken only for a short time until your symptoms clear up.


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

Do not take for longer than 7 days in a row. Talk with your doctor if your symptoms do not improve after 7 days of treatment, or if you have a fever with a headache or skin rash.


Shake the oral suspension (liquid) well just before you measure a dose. Measure the liquid with a special dose-measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one. If you need surgery or medical tests, tell the surgeon or doctor ahead of time if you have taken a cough or cold medicine within the past few days. Store at room temperature away from moisture and heat. Do not freeze.

What happens if I miss a dose?


Since cough or cold medicine 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.

Overdose symptoms may include severe forms of some of the side effects listed in this medication guide.


What should I avoid while taking dextromethorphan, diphenhydramine, and phenylephrine?


This medicine may cause blurred vision and may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert and able to see clearly. Drinking alcohol can increase certain side effects of this medication. Ask a doctor or pharmacist before using any other cold, allergy, cough, or sleep medicine. Antihistamines, cough suppressants, and decongestants are contained in many combination medicines. Taking certain products together can cause you to get too much of a certain drug. Check the label to see if a medicine contains an antihistamine, cough suppressant, or decongestant.

Avoid taking this medication if you also take diet pills, caffeine pills, or other stimulants (such as ADHD medications). Taking a stimulant together with a decongestant can increase your risk of unpleasant side effects.


Avoid becoming overheated or dehydrated during exercise and in hot weather. This medication can decrease sweating and you may be more prone to heat stroke.

Dextromethorphan, diphenhydramine, and phenylephrine side effects


Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat. Stop using this medicine and call your doctor at once if you have a serious side effect such as:

  • fast, slow, or uneven heart rate;




  • severe headache, mood changes, hallucinations;




  • severe dizziness or anxiety, feeling like you might pass out;




  • tremor, seizure (convulsions);




  • easy bruising or bleeding, unusual weakness;




  • fever;




  • urinating less than usual or not at all;




  • feeling short of breath; or




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



Less serious side effects may include:



  • mild headache;




  • mild dizziness, drowsiness;




  • dry mouth, nose, or throat;




  • nausea, diarrhea, constipation, upset stomach;




  • feeling nervous, restless, or irritable;




  • blurred vision; 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.


Dextromethorphan, diphenhydramine, and phenylephrine Dosing Information


Usual Adult Dose for Allergic Rhinitis:

Dextromethorphan/diphenhydrAMINE/PE 15 mg-12.5 mg-15 mg/5 mL oral suspension, extended release: 5 to 10 mL orally every 12 hours.

Dextromethorphan/diphenhydrAMINE/PE 75 mg-25 mg-7.5 mg/5 mL oral suspension, extended release: 5 to 10 mL orally every 12 hours.

Usual Adult Dose for Cold Symptoms:

Dextromethorphan/diphenhydrAMINE/PE 15 mg-12.5 mg-15 mg/5 mL oral suspension, extended release: 5 to 10 mL orally every 12 hours.

Dextromethorphan/diphenhydrAMINE/PE 75 mg-25 mg-7.5 mg/5 mL oral suspension, extended release: 5 to 10 mL orally every 12 hours.

Usual Adult Dose for Cough and Nasal Congestion:

Dextromethorphan/diphenhydrAMINE/PE 15 mg-12.5 mg-15 mg/5 mL oral suspension, extended release: 5 to 10 mL orally every 12 hours.

Dextromethorphan/diphenhydrAMINE/PE 75 mg-25 mg-7.5 mg/5 mL oral suspension, extended release: 5 to 10 mL orally every 12 hours.

Usual Adult Dose for Sinusitis:

Dextromethorphan/diphenhydrAMINE/PE 15 mg-12.5 mg-15 mg/5 mL oral suspension, extended release: 5 to 10 mL orally every 12 hours.

Dextromethorphan/diphenhydrAMINE/PE 75 mg-25 mg-7.5 mg/5 mL oral suspension, extended release: 5 to 10 mL orally every 12 hours.

Usual Pediatric Dose for Allergic Rhinitis:

Dextromethorphan/diphenhydrAMINE/PE 15 mg-12.5 mg-15 mg/5 mL oral suspension, extended release:
2 to 5 years: 2.5 mL orally every 12 hours.
6 to 11 years: 5 mL orally every 12 hours.
12 years or older: 5 to 10 mL orally every 12 hours.

Dextromethorphan/diphenhydrAMINE/PE 75 mg-25 mg-7.5 mg/5 mL oral suspension, extended release
2 to 5 years: 1.25 to 2.5 mL orally every 12 hours.
6 to 11 years: 2.5 to 5 mL orally every 12 hours.
12 years or older: 5 to 10 mL orally every 12 hours.

Usual Pediatric Dose for Cold Symptoms:

Dextromethorphan/diphenhydrAMINE/PE 15 mg-12.5 mg-15 mg/5 mL oral suspension, extended release:
2 to 5 years: 2.5 mL orally every 12 hours.
6 to 11 years: 5 mL orally every 12 hours.
12 years or older: 5 to 10 mL orally every 12 hours.

Dextromethorphan/diphenhydrAMINE/PE 75 mg-25 mg-7.5 mg/5 mL oral suspension, extended release
2 to 5 years: 1.25 to 2.5 mL orally every 12 hours.
6 to 11 years: 2.5 to 5 mL orally every 12 hours.
12 years or older: 5 to 10 mL orally every 12 hours.

Usual Pediatric Dose for Cough and Nasal Congestion:

Dextromethorphan/diphenhydrAMINE/PE 15 mg-12.5 mg-15 mg/5 mL oral suspension, extended release:
2 to 5 years: 2.5 mL orally every 12 hours.
6 to 11 years: 5 mL orally every 12 hours.
12 years or older: 5 to 10 mL orally every 12 hours.

Dextromethorphan/diphenhydrAMINE/PE 75 mg-25 mg-7.5 mg/5 mL oral suspension, extended release
2 to 5 years: 1.25 to 2.5 mL orally every 12 hours.
6 to 11 years: 2.5 to 5 mL orally every 12 hours.
12 years or older: 5 to 10 mL orally every 12 hours.

Usual Pediatric Dose for Sinusitis:

Dextromethorphan/diphenhydrAMINE/PE 15 mg-12.5 mg-15 mg/5 mL oral suspension, extended release:
2 to 5 years: 2.5 mL orally every 12 hours.
6 to 11 years: 5 mL orally every 12 hours.
12 years or older: 5 to 10 mL orally every 12 hours.

Dextromethorphan/diphenhydrAMINE/PE 75 mg-25 mg-7.5 mg/5 mL oral suspension, extended release
2 to 5 years: 1.25 to 2.5 mL orally every 12 hours.
6 to 11 years: 2.5 to 5 mL orally every 12 hours.
12 years or older: 5 to 10 mL orally every 12 hours.


What other drugs will affect dextromethorphan, diphenhydramine, and phenylephrine?


Ask a doctor or pharmacist before using this medicine if you regularly use other medicines that make you sleepy (such as narcotic pain medication, sedatives, sleeping pills, muscle relaxers, and medicine for seizures, depression or anxiety). They can add to sleepiness caused by diphenhydramine or dextromethorphan.


Ask a doctor or pharmacist if it is safe for you to take this medication if you are also using any of the following drugs:



  • atropine (Atreza, Sal-Tropine);




  • benztropine (Cogentin);




  • diphenhydramine (Benadryl) applied to the skin;




  • topiramate (Topamax);




  • zonisamide (Zonegran);




  • an antidepressant such as citalopram (Celexa), duloxetine (Cymbalta), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem, Symbyax), paroxetine (Paxil, Pexeva), sertraline (Zoloft), venlafaxine (Effexor), and others;




  • anti-nausea medications such as belladonna (Donnatal), dimenhydrinate (Dramamine), droperidol (Inapsine), methscopolamine (Pamine), or scopolamine (Transderm Scop);




  • bladder or urinary medications such as darifenacin (Enablex), flavoxate (Urispas), oxybutynin (Ditropan, Oxytrol), solifenacin (Vesicare), tolterodine (Detrol), or Urogesic Blue;




  • bronchodilators such as ipratropium (Atrovent) or tiotropium (Spiriva);




  • irritable bowel medications such as dicyclomine (Bentyl), hyoscyamine (Hyomax), or propantheline (Pro Banthine); or




  • ulcer medicine such as glycopyrrolate (Robinul) or mepenzolate (Cantil).



This list is not complete and other drugs may interact with diphenhydramine, dextromethorphan, and phenylephrine. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.



More dextromethorphan, diphenhydramine, and phenylephrine resources


  • Dextromethorphan, diphenhydramine, and phenylephrine Use in Pregnancy & Breastfeeding
  • Dextromethorphan, diphenhydramine, and phenylephrine Drug Interactions
  • Dextromethorphan, diphenhydramine, and phenylephrine Support Group
  • 0 Reviews for Dextromethorphan, diphenhydramine, and phenylephrine - Add your own review/rating


Compare dextromethorphan, diphenhydramine, and phenylephrine with other medications


  • Cold Symptoms
  • Cough and Nasal Congestion
  • Hay Fever
  • Sinusitis


Where can I get more information?


  • Your pharmacist can provide more information about diphenhydramine, dextromethorphan, and phenylephrine.


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