This combination product is used to treat symptoms
caused by the common cold, flu, allergies, hay fever, or other breathing
illnesses (such as sinusitis, bronchitis). Decongestants help relieve
stuffy nose symptoms. This product also contains an opioid cough
suppressant (antitussive) that affects a certain part of the brain,
reducing the urge to cough. Antihistamines relieve watery eyes, itchy
eyes/nose/throat, runny nose, and sneezing.
Opioid cough suppressants should not be used by children
younger than 18 years. Children are at higher risk for serious (even fatal)
side effects, especially breathing problems. Talk with the doctor about the
risks and benefits of this medication.
Cough-and-cold products do not cure colds. Cough due to
a common cold often does not need to be treated with medicine. Ask your
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.
Read the Medication Guide if available from your
pharmacist before you start taking this product and each time you get a
refill. If you have any questions, ask your doctor or
pharmacist.
If you are taking the over-the-counter product to
self-treat, read all directions on the product package before taking this
medication. If you have any questions, consult your pharmacist. If your
doctor has prescribed this medication, take it as directed.
Take this medication by mouth with or without food with
a full glass of water (8 ounces or 240 milliliters) or as directed by your
doctor. This medication may be taken with food or milk if stomach upset
occurs. The dosage is based on your medical condition and response to
treatment.
If you are using a liquid form, use a
medication-measuring device or spoon to carefully measure the prescribed
dose. Do not use a household spoon because you may not get the correct
dose. If your liquid form is a suspension, shake the bottle well before
each dose.
If you are using sustained-release tablets or capsules,
swallow the medication whole. Do not crush, chew, or break the tablets or
capsules. Doing so can destroy the long action of the drug and may increase
side effects.
Do not increase your dose or use this product more often
or for longer than directed. Your condition will not improve any faster,
and your risk of side effects will increase.
If you suddenly stop using this medication, you may have
withdrawal symptoms (such as restlessness, watering eyes, runny nose,
nausea, sweating, muscle aches). To help prevent withdrawal, your doctor
may lower your dose slowly. Withdrawal is more likely if you have used this
medication for a long time (more than a few weeks) or in high doses. Tell
your doctor or pharmacist right away if you have
withdrawal.
Though it helps many people, this medication has a risk
for abuse and may sometimes cause addiction. This risk may be higher if you
have a substance use disorder (such as overuse of or addiction to
drugs/alcohol). Take this medication exactly as directed to lower the risk
of addiction. Ask your doctor or pharmacist for more
details.
When used for an extended time, this medication may not
work as well and may require different dosing. Talk with your doctor if
this medication stops working well.
Tell your doctor if your cough does not get better in 5
days. Also, tell your doctor if your condition gets worse, or if you have a
headache that doesn't go away, fever, or rash. These may be symptoms of a
serious medical problem and should be checked by a doctor.
See also Warning section.
Drowsiness, dizziness, headache, blurred vision, upset
stomach, nausea, constipation, or dry mouth/nose/throat may occur. If any
of these effects last or get worse, notify your doctor or pharmacist
promptly.
To relieve dry mouth, suck on (sugarless) hard candy or
ice chips, chew (sugarless) gum, drink water, or use a saliva substitute.
This medication can dry up and thicken mucus in your lungs, making it more
difficult to breathe and clear your lungs. To help prevent this effect,
drink plenty of fluids unless otherwise directed by your
doctor.
To reduce the risk of dizziness and lightheadedness, get
up slowly when rising from a sitting or lying position.
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.
Tell your doctor right away if you have any serious side
effects, including:
- interrupted breathing during sleep (sleep apnea)
- mental/mood changes (such as hallucinations)
- ringing in the ears
- shaking (tremors)
- trouble urinating
- weakness
- easy bruising/bleeding
- fast/slow/irregular heartbeat
Get medical help right away if you have any very serious
side effects, including:
This product may cause serious mental/mood changes and
very serious (rarely fatal) breathing problems. This product may contain
codeine or dihydrocodeine. Codeine and dihydrocodeine are changed into
strong opioid drugs (morphine or dihydromorphine) in your body. In some
people this happens faster and more completely than usual, which increases
the risk of very serious side effects. Get medical help right away if you
notice any of the following:
- slow/shallow breathing
- severe drowsiness/difficulty waking up
- confusion
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.
Before taking this product, tell your doctor or
pharmacist if you are allergic to it; or if you have any other allergies.
This product may contain inactive ingredients, which can cause allergic
reactions or other problems. Talk to your pharmacist for more
details.
Before using this medication, tell your doctor or
pharmacist your medical history, especially of:
- abdominal problems (such as chronic constipation, ileus,
gallbladder disease, pancreatitis)
- adrenal gland problem (such as Addison's disease)
- certain brain disorders (such as head injury, tumor,
increased intracranial pressure)
- breathing problems (such as asthma, emphysema, sleep
apnea)
- diabetes
- a certain eye problem (glaucoma)
- heart problems
- high blood pressure
- kidney problems
- liver disease
- mental/mood problems (such as depression, psychosis)
- seizures
- stomach/intestinal problems (such as ulcers, blockage)
- thyroid problems (such as hyperthyroidism,
hypothyroidism)
- urination problems (such as trouble urinating due to enlarged
prostate, urinary retention)
- personal or family history of a substance use disorder (such
as overuse of or addiction to drugs/alcohol)
- obesity
This drug may make you dizzy or drowsy or blur your
vision. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy.
Do not drive, use machinery, or do anything that needs alertness or clear
vision until you can do it safely. Avoid alcoholic beverages. Talk to your
doctor if you are using marijuana (cannabis).
This medicine may contain aspartame. If you have
phenylketonuria (PKU) or any other condition that requires you to restrict
your intake of aspartame (or phenylalanine), consult your doctor or
pharmacist regarding the safe use of this medicine.
This medication may contain sugar and/or alcohol.
Caution is advised if you have diabetes, alcohol dependence, or liver
disease. Ask your doctor or pharmacist about the safe use of this
product.
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 confusion, dizziness, drowsiness, slow/shallow
breathing, fast heartbeat, constipation, and trouble urinating. Confusion,
dizziness, and drowsiness can increase the risk of falling.
Tell your doctor if you are pregnant or think you may be
pregnant. During pregnancy, this product is not recommended. It may harm an
unborn baby. Talk to your doctor about the risks and benefits of this
medication. See also Warning section.
This product may pass into breast milk and may have
undesirable effects on a nursing infant (such as unusual sleepiness,
difficulty feeding, trouble breathing, or unusual limpness). Consult your
doctor before breastfeeding.
See also Warning section.
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.
Some products that may interact with this drug
include:
- antihistamines applied to the skin (such as diphenhydramine
cream, ointment, spray)
- naltrexone
- samidorphan
Taking MAO inhibitors with this medication may cause a
serious (possibly fatal) drug interaction. Avoid taking MAO inhibitors
(isocarboxazid, linezolid, metaxalone, methylene blue, moclobemide,
phenelzine, procarbazine, rasagiline, safinamide, selegiline,
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.
The risk of serious side effects (such as slow/shallow
breathing, severe drowsiness/dizziness) may be increased if this medication
is taken with other products that may also cause drowsiness or breathing
problems. Tell your doctor or pharmacist if you are taking other products
such as other opioid pain or cough relievers (such as codeine,
hydrocodone), alcohol, marijuana (cannabis), drugs for sleep or anxiety
(such as alprazolam, lorazepam, zolpidem), muscle relaxants (such as
carisoprodol, cyclobenzaprine), or other antihistamines (such as
cetirizine, diphenhydramine).
Check the labels on all your medicines (such as allergy
or cough-and-cold products) because they may contain ingredients that cause
drowsiness. Ask your pharmacist about using those products
safely.
Other medications can affect the removal of this product
from your body, which may affect how this product works. Examples include
azole antifungals (such as ketoconazole), bupropion, fluoxetine, macrolide
antibiotics (such as erythromycin), paroxetine, quinidine, rifamycins (such
as rifabutin, rifampin), ritonavir, certain drugs used to treat seizures
(such as carbamazepine, phenytoin), among others.
This medication may interfere with certain medical/lab
tests (such as amylase/lipase levels, allergy skin test, brain scan for
Parkinson's disease), possibly causing false test results. Make sure lab
personnel and all your doctors know you use this drug.
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 1-800-222-1222. Canada
residents can call 1-844-764-7669. Symptoms of overdose may include:
confusion, cold/clammy skin, fast/slow/irregular heartbeat, slow/shallow
breathing, seizures, coma.
If your doctor has prescribed this medication, do not
share it with others. Sharing it is against the law.
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.
Store at room temperature away from light and moisture.
Do not store in the bathroom. Do not freeze liquid forms of this
medication. 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.