Chlorpheniramine/Dextromethorphan Hydrobromide/Phenylephrine Hydrochloride

What are other names for this medicine?

Type of medicine: cold medicine; antihistamine; decongestant; cough suppressant

Generic and brand names: chlorpheniramine, dextromethorphan hydrobromide, and phenylephrine hydrochloride; Alka-Seltzer Plus Cold and Cough Medicine; Amerituss AD; Father John's Medicine Plus; Norel DM

What is this medicine used for?

This medicine combines a cough suppressant, an antihistamine, and a decongestant. It is taken by mouth to relieve the symptoms of coughs, colds, and allergies.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• an allergy to any medicine
• an enlarged prostate gland or trouble urinating
• asthma or other breathing problems
• diabetes
• glaucoma
• heart disease or heart rhythm problems
• high or low blood pressure
• kidney or liver disease
• stomach ulcers
• thyroid disease.

Females of childbearing age: Talk with your healthcare provider if you are pregnant or plan to become pregnant. It is not known whether this medicine will harm an unborn baby. Do not breast-feed while taking this medicine without your healthcare provider's approval.

How do I take it?

Take this medicine exactly as your healthcare provider prescribes or follow the directions on the package. Do not take more medicine or take it more often than specified because of the increased risk of side effects.

This medicine may come in different forms. If you have extended-release tablets, do not break, crush, or chew them. Swallow them whole. Ask your pharmacist if you have the extended-release tablets. If you are using the liquid form of this medicine, use a special dose measuring spoon or cup to measure out the correct dose.

Because the decongestant in this medicine can cause you to feel excited or active, take the last dose of the day before 6 PM to avoid problems sleeping.

If you miss a dose, take it as soon as you remember unless it is almost time for the next scheduled dose. In that case, skip the missed dose and take the next one as directed. Do not take double doses. If you are not sure of what to do if you miss a dose, or if you miss more than one dose, contact your healthcare provider.

What should I watch out for?

The antihistamine in this medicine may make you drowsy. Do not drive or operate machinery unless you are fully alert.

The antihistamine increases the effects of alcohol and other drugs that slow down the central nervous system. Do not drink alcohol or take other medicines unless your healthcare provider approves.

The decongestant in this medicine may increase the effects of some diet medicines. Do not take any diet medicines unless your healthcare provider approves.

This medicine may make your skin more sensitive to the sun, which may lead to painful sunburns. While you are taking this medicine, avoid long exposure to the sun. Wear protective clothing, a hat, and sunscreen lotion when you need to be outdoors. Do not use a sunlamp. After you stop this medicine, you may continue to be sensitive to the sun for a while. If you get a severe sunburn, contact your healthcare provider right away.

This medicine may make you dizzy or drowsy. Do not drive or operate machinery unless you are fully alert.

Contact your healthcare provider if your symptoms do not improve or get worse after taking the medicine for a few days.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help): Allergic reaction (hives; itching; rash; trouble breathing; tightness in your chest; swelling of your lips, tongue, and throat).

Serious (report these to your healthcare provider right away): Fast or irregular heartbeat, chest tightness or pain, extreme tiredness, decreased urination, mood changes, sore throat, fever, slowed breathing, unusual bruising or bleeding, severe confusion or hallucinations.

Other: Drowsiness, dizziness, loss of appetite, dry mouth, nervousness, nausea or vomiting, diarrhea, constipation, trouble sleeping, headache, blurred vision, weakness, clumsiness.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• antianxiety medicines such as clonazepam (Klonopin), alprazolam (Xanax), clorazepate (Tranxene), diazepam (Valium), lorazepam (Ativan), and oxazepam (Serax)
• antiarrhythmics (medicines to treat irregular heartbeat) such as procainamide (Procanbid, Rhythmin) and quinidine
• antiseizure medicines such as carbamazepine (Tegretol), phenytoin (Dilantin), and valproic acid (Depakote, Depakene)
• beta blockers such as atenolol (Tenormin), acebutolol (Sectral), betaxolol (Kerlone), carteolol, bisoprolol (Zebeta), pindolol, metoprolol (Lopressor, Toprol XL), timolol, sotalol (Betapace), nadolol (Corgard), propranolol (Inderal), labetalol (Normodyne, Trandate), and carvedilol (Coreg)
• dihydroergotamine (DHE)
• herbal remedies such as St. John's wort, valerian, kava, and gotu kola
• linezolid (Zyvox)
• MAO inhibitor antidepressants such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl), and tranylcypromine (Parnate) (Do not take an MAO inhibitor and this medicine within 14 days of each other.)
• methyldopa (Aldomet)
• muscle relaxants such as tizanidine (Zanaflex), cyclobenzaprine (Flexeril), carisoprodol (Soma), methocarbamol (Robaxin), dantrolene Dantrium), and baclofen (Lioresal)
• narcotic analgesics (painkillers) such as codeine, hydrocodone (Vicodin, Lortab), oxycodone (Percocet, Tylox, OxyContin), morphine (MS Contin), propoxyphene (Darvocet N-100), pentazocine (Talwin), meperidine (Demerol), fentanyl (Duragesic patches), methadone (Dolophine), and hydromorphone (Dilaudid)
• phenothiazines such as chlorpromazine (Thorazine), prochlorperazine (Compazine), perphenazine, promazine (Sparine), thioridazine, and trifluoperazine (Stelazine)
• procarbazine (Matulane)
• sedatives such as phenobarbital (Luminal, Solfoton), amobarbital (Amytal, pentobarbital (Nembutal), zolpidem (Ambien), triazolam (Halcion), butabarbital (Butisol), zaleplon (Sonata), temazepam (Restoril), and flurazepam (Dalmane)
• sibutramine (Meridia)
• SSRI antidepressants such as sertraline (Zoloft), fluoxetine (Prozac), citalopram (Celexa), escitalopram (Lexapro), paroxetine (Paxil), venlafaxine (Effexor), and fluvoxamine (Luvox)
• stimulants (for example, diet pills)
• tricyclic antidepressants such as amitriptyline, nortriptyline (Aventyl, Pamelor), imipramine (Tofranil), trazodone (Desyrel), and doxepin (Sinequan).

Do not drink alcohol while you are taking this medicine.

Keep a list of all your medicines (prescription, nonprescription, supplements, natural remedies, and vitamins) with you. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.