- Side Effects
- Drug Interactions
- Pregnancy & Breastfeeding
- What Else to Know
Generic Name: acetaminophen/pheniramine/phenylephrine
Drug Class: Antitussives, Non-narcotic Combos
What is acetaminophen/pheniramine/phenylephrine, and what is it used for?
Acetaminophen/pheniramine/phenylephrine is a combination medication used for the temporary relief of common cold and flu symptoms, including runny nose, itchy nose and throat, itchy and watery eyes, fever, headache, minor body aches, cough, sore throat, sneezing and nasal and sinus congestion. The three drugs are combined in specific dosages and the combination is available over the counter (OTC).
Each medication in the combination works in a different way and together they provide more effective relief than any of them as a single agent.
- Acetaminophen is an analgesic and antipyretic drug used to relieve pain and fever. Acetaminophen relieves pain by blocking pain impulse generation and inhibiting the synthesis of prostaglandin in the central nervous system (CNS). Prostaglandin is a natural substance in the body that initiates inflammation. Acetaminophen reduces fever by acting on the hypothalamus region of the brain which regulates temperature.
- Pheniramine works by blocking the activity of histamine, a natural compound in the body released by mast cells and basophils, types of immune cells, in response to allergen exposure. Pheniramine binds to histamine H1 receptors in the smooth muscles of blood vessels and the respiratory tract, preventing their activation by histamine that results in allergic reactions such as cough, itching and other symptoms. Pheniramine is a first-generation antihistamine that also causes drowsiness.
- Phenylephrine is a decongestant drug that belongs to a class of medications known as alpha1 agonists. Phenylephrine stimulates alpha1 adrenergic receptors, protein molecules located in smooth muscle tissues around blood vessels, making these muscles contract. This constricts the blood vessels in the nasal and sinus passages, reducing congestion.
- Do not use in patients with known hypersensitivity to acetaminophen, pheniramine, phenylephrine or any component of the formulation.
- Do not take acetaminophen/pheniramine/phenylephrine concurrently or within 14 days after treatment with monoamine oxidase inhibitor (MAOI) type of antidepressant medications. Do not take concurrently with beta-adrenergic blockers.
- Do not take acetaminophen/pheniramine/phenylephrine without checking with your physician if you have any of the following conditions:
- Liver disease
- Kidney disease
- Heart disease
- High blood pressure (hypertension)
- Thyroid disease
- Diabetes mellitus
- Asthma attacks, chronic bronchitis or emphysema
- Enlarged prostate with urinary symptoms
- Bladder neck obstruction
- Stenosing peptic ulcer
- Narrow-angle glaucoma, an eye condition with high intraocular pressure that damages the optic nerve
- G6PD enzyme deficiency, a genetic disorder
- Congenital bilirubinemia
- Pheochromocytoma, a mostly benign type of tumor on the adrenal gland
Check with your physician before taking acetaminophen/pheniramine/phenylephrine if you are taking:
Do not take acetaminophen/pheniramine/phenylephrine concurrently with any other drug combination containing acetaminophen.
Acetaminophen can damage the liver, especially with prolonged use and high doses. Risk factors for severe liver damage include:
- Taking more than 4,000 mg of acetaminophen in 24 hours
- Concurrently taking other drugs containing acetaminophen
- Drinking 3 or more alcoholic drinks while taking acetaminophen
Do not administer to children below 12 years, pheniramine can cause significant excitability and confusion in children.
Use drugs containing phenylephrine with caution in elderly patients.
With acetaminophen use, there have been rare reports of life-threatening skin reactions including Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and acute generalized exanthematous pustulosis (AGEP) with symptoms such as blisters, rash and redness. Discontinue the drug if you develop such symptoms.
What are the side effects of acetaminophen/pheniramine/phenylephrine?
Common side effects of acetaminophen/pheniramine/phenylephrine include:
- Loss of appetite (anorexia)
- Rapid heart rate (tachycardia)
- Low blood pressure (hypotension)
- Severe constriction of blood vessels in peripheral and abdominal region
- Reflex increase in blood pressure (hypertension)
- Skin rash
- Blood disorders including:
- Severely low count of granulocyte immune cells (agranulocytosis)
- Low neutrophil immune cell count (neutropenia)
- Low leukocyte immune cell count (leukopenia)
- Low red blood cell count (anemia)
- Anemia due to premature destruction of red cells (hemolytic anemia)
- Low platelet count (thrombocytopenia)
- Low count of all types of blood cells (pancytopenia)
- Thickening of bronchial secretions
- Increase in bilirubin
- Increase in alkaline phosphatase
Call your doctor immediately if you experience any of the following symptoms or serious side effects while using this drug:
- Serious heart symptoms include fast or pounding heartbeats, fluttering in your chest, shortness of breath, and sudden dizziness;
- Severe headache, confusion, slurred speech, severe weakness, vomiting, loss of coordination, feeling unsteady;
- Severe nervous system reaction with very stiff muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, and feeling like you might pass out; or
- Serious eye symptoms include blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights.
This is not a complete list of all side effects or adverse reactions that may occur from the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may also report side effects or health problems to the FDA at 1-800-FDA-1088.
What is the dosage for acetaminophen/pheniramine/phenylephrine?
- 325 mg/20 mg/10 mg per packet
Adult and Pediatric:
- Children below 12 years: Safety and efficacy not established
- Adults and children 12 years and above: Dissolve contents of 1 packet in 8 oz of hot water; consume entire 8 oz within 10-15 minutes; not to exceed acetaminophen 1 g/dose or 4 g/day
- Overdose of acetaminophen/pheniramine/phenylephrine can result in severe adverse effects that can be life-threatening or fatal.
- Acetaminophen overdose can result in liver damage symptoms that include nausea, vomiting, loss of appetite, sweating, abdominal pain, extreme tiredness, yellowing of eyes and skin, dark urine, agitation, confusion, hallucinations and seizures.
- Pheniramine overdose can cause rapid heart rate (tachycardia), dilated pupils, urinary retention, dry flushed skin, decreased bowel sounds, confusion, mild increase in body temperature, irregular heart rhythms (cardiac arrhythmias), and seizures. In children, overdose may result in excitement first that may be followed by loss of coordination, drowsiness, loss of consciousness and seizures.
- Phenylephrine overdose can cause headache, vomiting, high blood pressure (hypertension), a reflex drop in the heart rate (bradycardia), a sensation of fullness in the head, tingling of limbs, and irregular heart rhythms (cardiac arrhythmias).
- Overdose treatment may include administration of N-acetylcysteine, antidote to acetaminophen, and other symptomatic and supportive measures, including gastric lavage and activated charcoal to eliminate the undigested drug.
What drugs interact with acetaminophen/pheniramine/phenylephrine?
Inform your doctor of all medications you are currently taking, who can advise you on any possible drug interactions. Never begin taking, suddenly discontinue, or change the dosage of any medication without your doctor’s recommendation.
- Severe interactions of acetaminophen/pheniramine/phenylephrine include:
- Acetaminophen/pheniramine/phenylephrine has serious interactions with at least 33 different drugs.
- Acetaminophen/pheniramine/phenylephrine has moderate interactions with at least 188 different drugs.
- Acetaminophen/pheniramine/phenylephrine has mild interactions with at least 58 different drugs.
The drug interactions listed above are not all of the possible interactions or adverse effects. For more information on drug interactions, visit the RxList Drug Interaction Checker.It is important to always tell your doctor, pharmacist, or health care provider of all prescription and over-the-counter medications you use, as well as the dosage for each, and keep a list of the information. Check with your doctor or health care provider if you have any questions about the medication.
Subscribe to MedicineNet's General Health Newsletter
Pregnancy and breastfeeding
- Acetaminophen/pheniramine/phenylephrine should be used by pregnant women only if clearly needed and potential benefits justify potential risks to the fetus. Use the lowest effective dose for the shortest possible time.
- Acetaminophen/pheniramine/phenylephrine is present in breastmilk. Use with caution and check with your physician before use if you are breastfeeding.
- If you are pregnant or breastfeeding, do not take any OTC drug, including acetaminophen/pheniramine/phenylephrine, without first checking with your healthcare provider.
What else should I know about acetaminophen/pheniramine/phenylephrine?
- Take acetaminophen/pheniramine/phenylephrine exactly as prescribed or as per label instructions if taking OTC medication.
- Do not take higher or more frequent doses, do not exceed the daily recommended dosage and do not take for prolonged periods.
- Avoid overdose by checking product labels carefully. Acetaminophen is found in many dosage forms and many combination products. Cumulative doses can be toxic.
- Discontinue the drug immediately if you develop hypersensitivity reactions.
- Discontinue the drug and consult with your physician if:
- Your pain or nasal congestion last longer than 7 days
- Fever lasts longer than 3 days or gets worse
- You have redness or swelling
- New symptoms appear
- You experience dizziness, nervousness or sleeplessness
- You develop severe skin reactions
- Avoid drinking alcohol while taking acetaminophen/pheniramine/phenylephrine, it can damage your liver.
- Avoid engaging in hazardous activities such as driving or operating heavy machinery while taking acetaminophen/pheniramine/phenylephrine, pheniramine can cause drowsiness.
- Store acetaminophen/pheniramine/phenylephrine safely out of reach of children.
- In case of overdose, seek immediate medical help or contact Poison Control.
Acetaminophen/pheniramine/phenylephrine is a combination medication used for the temporary relief of common cold and flu symptoms, including runny nose, itchy nose and throat, itchy and watery eyes, fever, headache, minor body aches, cough, sore throat, sneezing and nasal and sinus congestion. Common side effects of acetaminophen/pheniramine/phenylephrine include dizziness, fatigue, headache, insomnia, sedation, confusion, depression, euphoria, distress, irritability, restlessness, tremors, loss of appetite (anorexia), and others.
Multimedia: Slideshows, Images & Quizzes
Cold, Flu, and Cough: 13 Foods to Eat When Fighting the Flu
The best foods to eat when you have the flu soothe symptoms and help you feel better faster. Good foods to eat with the flu...
Cold Sores Causes, Remedies, & Diagnosis
How do you get rid of cold sores? First learn about the herpes virus and how it causes cold sores. When are cold sores...
Cold, Fever and Flu Symptoms in Children: Medications and Home Remedies
How long does a cold last? How long is a cold contagious? Colds and fevers are some of the most common ailments in children....
Common Cold Quiz: Test Your Medical IQ
Take this quiz to learn the truth behind the infectious, contagious, uncomfortable disease known as the common cold. Test your...
Cold & Flu Quiz: Influenza vs. Common Cold
Aches? Pain? Fever? This Cold & Flu Quiz tests your knowledge on the difference between coming down with the common cold and...
Picture of Herpes Blister (Cold Sore)
Cold sores (fever blisters) are caused by the herpes simplex virus (HSV), passed on through contact with infected skin or body...
Picture of Cold Sores Treatment
You can't cure HSV or a cold sore, but you can alleviate the pain it causes by avoiding spicy or acidic foods, applying ice, and...
Picture of Cold Sore and Canker Sore
Cold sores and canker sores aren't the same. See a picture of Cold Sore and Canker Sore and learn more about the health topic.
Picture of Cold Sore Between Nose and Mouth
Can a cold sore appear somewhere other than your lip? They are not as common, but cold sores can appear anywhere on the face,...
Picture of Cold Sores (Fever Blisters)
Cold sores, sometimes called fever blisters, are groups of small blisters on the lip and around the mouth. See a picture of Cold...
Cold and Flu: Finding Fast Cough Relief
Remedies for coughing to relieve symptoms, thin mucus, and clear phlegm include cough syrup and honey in hot water. Use...
How to Get Rid of a Cold: Natural Remedies
What home remedies work to get rid of a cold fast? Many claim cold symptoms and flu symptoms can be relieved with Echinacea,...
Cold, Flu, and Cough: How to Avoid Infectious Diseases
The right habits will lower your chances of catching an infectious disease. Learn what you can do to help yourself stay healthy.
Cold, Flu, & Cough: How to Clean After Illness
This slideshow gives you a room-by-room look at how and what to disinfect after someone in your family has been sick.
How to Prevent the Common Cold
What home remedies work for the common cold? The common cold is arguably the most common human illness. Learn how long the common...
Nasal Irrigation: Natural Relief for Cold & Allergy Symptoms
Clogged sinuses and congestion bothering you? Nasal irrigation can relieve sinus symptoms associated with colds and allergies....
A Cold or The Flu? How to Tell the Difference
Discover the difference between cold vs. flu symptoms. Learn the difference between cold and flu symptoms. Read about cold and...
Home Remedies for Sick Children
Home remedies for sick babies, toddlers, and kids can help with things like colds, flu, cough, sore throat, stuffy nose, fever,...
Cold and Flu: What Doctors Do to Boost Their Immune Systems
How can you make your immune system stronger? Why not try what the pros try?
Cold and Flu: The Truth About Hand Sanitizer
Hand sanitizers are a convenient way to kill germs. But do they really work? Here's what we found.
Flu Shots: 10 Facts About Flu Shots
What are the side effects of a flu shot? Who should get vaccinated? Learn the benefits and risks of vaccination for seasonal...
Cold, Flu, & Cough: Symptoms of Immune System Problems
Your immune system is your main line of defense against infection and illness. Learn the warning signs that yours isn’t working...
Related Disease Conditions
Cold Sores (Oral Herpes, Herpes Labialis)
Cold sores (labial herpes) are caused by herpes simplex virus type 1 infection and often appear on the mouth and lips. Read about treatment causes, symptoms, treatment, and diagnosis of oral herpes.
Cold and Cough Medicine for Infants and Children
The safety of giving infants and children over-the-counter (OTC) cold and cough medicine is important for caregivers to understand. While there is no "gold standard" recommendation for giving infants and children OTC cold and cough medicine for fever, aches, cough, and runny nose, a few standards have been recommended.
Do Cold Sores Mean You Have an STD?
Having a cold sore does not necessarily mean you have an STD. Most cold sores are caused by herpes simplex virus type 1 (HSV-1), which typically is not transmitted by sexual contact.
Pimple vs. Cold Sore
Pimples are areas of skin inflammation with pus in the center. Cold sores are fluid-filled blisters. Pimples are caused by bacterial overgrowth and inflammation. Cold sores are caused by infection with herpes simplex viruses (HSV-1 and HSV-2). Benzoyl peroxide and sometimes antibiotics treat acne. Antiviral medications accelerate the healing process of oral herpes.
What Does a Cold Sore Look Like on the Chin?
Cold sores on the chin may appear as a cluster of small, fluid-filled bumps surrounded by swollen skin. Check out the center below for more medical references on cold sores, including multimedia (slideshows, images, and quizzes), related disease conditions, treatment and diagnosis, medications, and prevention or wellness.
Influenza (flu) is a respiratory illness caused by a virus. Flu symptoms include fever, cough, sore throat, runny nose, headache, fatigue, and muscle aches. The flu may be prevented with an annual influenza vaccination.
Is It Common to Get a Cold During Early Pregnancy?
It is common to get a cold and the flu during pregnancy. Find out if it affects the baby and how to take care of yourself.
Which Flu Is Worse A or B?
Flu or influenza is a contagious (spreads from person to person) viral illness that affects the respiratory tract (the nose, throat and lungs). Type A influenza is generally considered worse than type B influenza.
How Do You Treat a Cold Sore in Your Nose?
Cold sores are a type of blister that may show up clear and then become cloudy. Treat a cold sore under your nose with home remedies, topical creams and ointments, and prescription medications.
Is It Better to Drink Cold Water or Room Temperature Water?
The effects of drinking both room temperature and cold water vary by person, specifically by health, age, and the amount being consumed.
How Do You Get Rid of a Cold Overnight?
Cold symptoms are part of your body’s healing processes. Most of the time, it does not require any help. However, you can get rid of a cold faster, even overnight, by resting, drinking hot fluids, blowing your nose, gargling with salt water, taking a hot shower, using a humidifier and taking OTC pain relievers and decongestants.
Can You Take Tylenol Cold and Flu While Breastfeeding?
Tylenol is a well-known brand of acetaminophen and it is safe and effective for fever and pain.A void combined products like Tylenol Cold and Flu while you are breastfeeding.
Adenovirus 14 (Killer Cold Virus)
Adenovirus infection, particularly Ad14, or the "killer cold virus" has been on the increase in the past two years. Symptoms range from those experienced with colds, sore throat, bronchitis, pneumonia, diarrhea, pinkeye, fever, bladder infection, and neurological conditions. Diagnosis and treatment options need to be discussed with your physician.
Common Cold: Early Signs and 4 Stages
The common cold or viral rhinitis is an upper respiratory infection caused by several types of viruses. It is one of the most common infectious diseases affecting humans. A common cold may typically follow a certain pattern of progression that has four different stages.
How Long Does Type B Flu Usually Last?
Type B flu symptoms typically last about 5-7 days, although they may go away sooner if you have been vaccinated. Learn about flu symptoms, spread, treatment, and when to seek medical help. Check out the center below for more medical references on the flu, including multimedia (slideshows, images, and quizzes), related diseases, treatment, diagnosis, medications, and prevention or wellness.
How Long Is a Cold or Flu Contagious?
Viruses cause the common cold and the flu. Early symptoms and signs for a cold and the flu are similar, however, flu symptoms are typically more severe than cold symptoms. Cold and flu viruses are transmitted typically via coughing or sneezing.
Are Cold Sores (Fever Blisters) Contagious?
About 20% of cases of cold sores are caused by herpes simplex virus type 2 (HSV-2), and approximately 80% of cold sores are caused by herpes simplex virus type 1 (HSV-1). Cold sores are transmitted by sharing utensils and razors, kissing, and oral sex. There is no cure for cold sores.
How Do I Get Rid of a Cold Sore Overnight?
You cannot get rid of cold sores overnight. There is no cure for cold sores. However, to speed up the healing time of a cold sore, you can consult with your doctor and take prescription medications such as antiviral tablets and creams. A cold sore may go away without treatment within a week or two.
Diabetes and Safe Medications for Colds & Flu
If you have diabetes and catch a cold or the flu, can be more difficult to recover from infections and their complications, for example, pneumonia. Home remedies and over-the-counter (OTC) drugs used for the treatment of the signs and symptoms of colds and the flu may affect blood sugar levels in people with diabetes.Some medications are OK to take if you have diabetes get a cold or the flu include nonsteroidal anti-inflammatory drugs or NSAIDs, like acetaminophen (Tylenol) and ibuprofen (Motrin) to control symptoms of fever and pain. Most cough syrups are safe to take; however, check with your pediatrician to see what medications are safe to give your child if he or she has type 1 or 2 diabetes. If you have diabetes and are sick with a cold or flu, you need to check your blood sugar levels more frequently. Continue taking your regular medications. Eat a diabetic low-glycemic index diet rich in antioxidants. To prevent colds and the flu drink at least eight 8 ounce glasses of water a day. To replenish fluids, drink sports drinks like Gatorade and Pedialyte to replenish electrolytes. Avoid people who are sick, sneezing, coughing, or have other symptoms of a cold or flu.
Genital Herpes and Cold Sores: 10 Myths and Facts
Genital herpes and cold sores (oral herpes) are the names given to two types of infection caused by the two types of herpes simplex virus (HSV): HSV-1 and HSV-2.
How Can I Get Rid of a Cold While Breastfeeding?
The common cold is a viral infection that affects your nose and throat. There is no cure for the cold while breastfeeding, so you’ll need to give it time to clear up.
Are Cold Sores the Same as Herpes?
What is the difference between cold sores and herpes? Cold sores are painful, unsightly sores that usually pop up around your mouth. Certain medications, home care and alternative therapies may help you get rid of cold sores fast.
Is Drinking Cold Water Bad?
About 60 percent of the body is made up of water. It forms a major part of the blood. The cells and the body cannot function right if the water levels go down. Drinking cold water often causes “cold stress” in the body.
Does Being Cold Make Your Muscles Ache?
Cold weather can tighten the muscles and joints, leading to muscle aches and pain.
How Does the Flu Affect the Immunocompromised?
Influenza, or the flu, is a respiratory illness caused by the influenza virus. It is generally a mild illness that can be treated at home with over-the-counter medications and rest. However, for people with compromised immune systems, the flu can be much more serious. This includes the increased risk of complications, prolonged illness, weakened immune system, and increased risk of death.
How Long Does the Flu Last in Seniors?
What is the flu? Learn the signs of the flu in seniors and when you need to call a doctor.
How Cold Is Too Cold to Go Outside?
Human body is capable of maintaining a steady core temperature between 97°F and 99°F. However, it is essential to layer up in cold weather and wear comfortable clothes in warm weather, so that we stay protected from extremes of temperature.
COVID-19 vs. Flu vs. Cold
When you're feeling sick, it can be difficult to distinguish the symptoms of a COVID-19 infection from the symptoms of the common cold or the flu (influenza). While fever is common with the flu and COVID-19, sneezing is typically only associated with colds. Though sore throats are typical with colds, they are uncommon with COVID-19 infections and the flu.
How Do You Cure the Flu Quickly?
Flu or influenza is a common viral disease affecting the respiratory system. This infectious disease is caused by the influenza virus. Most cases of flu are self-limiting and can be easily managed at home.
Can You Have the Flu Without a Fever?
Since not every individual experiences all of the flu symptoms, it is possible to have the flu without having a fever.
Cold vs. Flu
Though the common cold and flu share many signs and symptoms, they are caused by different viruses. Signs and symptoms include sneezing, sore throat, runny nose, fatigue, and cough. Treatment options for the cold and flu are similar and focus on reducing symptoms. Doctors may prescribe antivirals/neuraminidase inhibitors for the flu.
What Can You Take for a Cold While Pregnant?
You may take over-the-counter (OTC) treatment after consulting with the physician because these are generally safe. OTC medications for colds and flus include acetaminophen, guaifenesin syrup and saline nasal drops or spray. You can also use natural remedies to treat a cold during pregnancy.
What Can Trigger a Cold Sore?
After you get infected with HSV, it lies inactively in the nerve cells inside your skin and may appear as another cold sore at the same place as before.
How Long Is a Cold Sore Contagious?
Cold sores are blisters around your mouth and lips. Cold sores are contagious until they are completely healed.
Is It a Cold or a Sinus Infection?
A sinus infection, also known as sinusitis or rhinosinusitis, is a condition in which the delicate membranes that line the sinuses may get swollen and become red. A cold or common cold is a viral infection. It affects the upper respiratory system, which includes the nose, mouth, throat, and lungs.
How Do You Get a Cold Sore on Your Lip?
Cold sores, also called fever blisters or oral herpes, are a viral infection that leaves small blisters around your mouth. You get a cold sore on your lip due to viral infection from herpes simplex virus type 1 (HSV-1).
How Long Does a Cold Last?
Most often, a common cold lasts anywhere from 5 to 10 days in length.
How Do You Treat a Cold Naturally?
Hundreds of viruses and bacteria can cause the common cold and flu. Most cases of cold and flu usually resolve in a week with simple home remedies and over the counter (OTC) medications. If there is no improvement in a few days, it is advised to consult a doctor.
How to Identify Cold Symptoms in Children
When a child is sick, their way of showing it may not always be clear. Here’s what to look for to determine whether your child is sick with a cold.
Can Flu Cause Serious Health Problems?
Influenza can cause serious health problems such as pneumonia, bronchitis, and myositis. Check out the center below for more medical references on the flu, including multimedia (slideshows, images, and quizzes), related disease conditions, treatment and diagnosis, medications, and prevention or wellness.
Treatment & Diagnosis
Medications & Supplements
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.