dextromethorphan, guaifenesin, and phenylephrine

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dextromethorphan, guaifenesin, and phenylephrine

Pronunciation:dex troe meth OR fan, gwye FEN e sin, fen il EFF rin
Brand:Certuss-D, Duraphen Forte, Duraphen II DM, Sinutuss DM

Duraphen II DM

oblong, white, imprinted with PE 715

Image of Duraphen II DM
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What is the most important information I should know about dextromethorphan, guaifenesin, and phenylephrine?

nochildDo not give this medication to a child younger than 2 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.
donotDo not use a cough or cold medicine if you have used an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days. Serious, life-threatening side effects can occur if you take cough or cold medicine before the MAO inhibitor has cleared from your body.
donotDo not use any other over-the-counter cough, cold, allergy, or sleep medication without first asking your doctor or pharmacist. If you take certain products together you may accidentally take too much of one or more types of medicine. Read the label of any other medicine you are using to see if it contains a decongestant, expectorant, or cough suppressant.
smokingDextromethorphan will not treat a cough that is caused by smoking, asthma, or emphysema.

What is dextromethorphan, guaifenesin, and phenylephrine?

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

Guaifenesin is an expectorant. It helps loosen congestion in your chest and throat, making it easier to cough out through your mouth.

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

The combination of dextromethorphan, guaifenesin, and phenylephrine is used to treat stuffy nose, sinus congestion, cough, and chest congestion caused by the common cold or flu.

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

Dextromethorphan, guaifenesin, and phenylephrine may also be used for other purposes not listed in this medication guide.

What should I discuss with my healthcare provider before using dextromethorphan, guaifenesin, and phenylephrine?

donotDo not use a cough or cold medicine if you have used an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days. Serious, life-threatening side effects can occur if you take cough or cold medicine before the MAO inhibitor has cleared from your body.
donotDo not use this medicine if you are allergic to dextromethorphan, guaifenesin, or phenylephrine.

Ask a doctor or pharmacist if it is safe for you to take this medication if you have emphysema or chronic bronchitis.

nopregThis medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.
nobrfeedThis medication may pass into breast milk and could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Artificially-sweetened liquid forms of cold medicine may contain phenylalanine. This would be important to know if you have phenylketonuria (PKU). Check the ingredients and warnings on the medication label if you are concerned about phenylalanine.

How should I take dextromethorphan, guaifenesin, and phenylephrine?

Use this medication exactly as directed on the label, or as it has been prescribed by your doctor. Do not use the medication in larger amounts, or use it for longer than recommended. Cold medicine is usually taken only for a short time until your symptoms clear up.

nochildDo not give this medication to a child younger than 2 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.

Measure the liquid form of this medicine with a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

foodTake the medication with food if it upsets your stomach.
waterDrink extra fluids to help loosen the congestion and lubricate your throat while you are taking this medication.
nocrushDo not crush, chew, or break an extended-release tablet. Swallow the pill whole. It is specially made to release medicine slowly in the body. Breaking or opening the pill would cause too much of the drug to be released at one time.
donotTalk with your doctor if your symptoms do not improve after 7 days of treatment, or if you have a fever with a headache, cough, or skin rash.

If you need to have any type of surgery, tell the surgeon ahead of time if you have taken a cold medicine within the past few days.

rtStore this medicine at room temperature, away from heat, light, and moisture.

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at your next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

emtSeek emergency medical attention if you think you have used too much of this medicine.

Overdose symptoms may include feeling restless or nervous.

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

dizzyThis medication can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.
noalcoholAvoid drinking alcohol. It can increase some of the side effects of this medication.

Avoid taking diet pills, caffeine pills, or other stimulants (such as ADHD medications) without your doctor's advice. Taking a stimulant together with cough or cold medicine can increase your risk of unpleasant side effects.

donotDo not use any other over-the-counter cough, cold, allergy, or sleep medication without first asking your doctor or pharmacist. If you take certain products together you may accidentally take too much of one or more types of medicine. Read the label of any other medicine you are using to see if it contains a decongestant, expectorant, or cough suppressant.

What are the possible side effects of dextromethorphan, guaifenesin, and phenylephrine?

emtGet emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
donotStop using this medication and call your doctor at once if you have any of these serious side effects:
  • severe dizziness, anxiety, restless feeling, or nervousness;
  • confusion, hallucinations; or
  • slow, shallow breathing.

Less serious side effects may include:

  • dizziness or headache,
  • a rash, or
  • nausea, vomiting, or stomach upset.

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.

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

Before taking dextromethorphan, guaifenesin, and phenylephrine, tell your doctor if you are using any of the following drugs:

  • celecoxib (Celebrex);
  • cinacalcet (Sensipar);
  • darifenacin (Enablex);
  • imatinib (Gleevec);
  • quinidine (Quinaglute, Quinidex);
  • ranolazine (Ranexa)
  • ritonavir (Norvir);
  • sibutramine (Meridia);
  • terbinafine (Lamisil);
  • medicines to treat high blood pressure; or
  • antidepressant medications such as amitriptyline (Elavil, Etrafon), bupropion (Wellbutrin, Zyban), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), imipramine (Janimine, Tofranil), paroxetine (Paxil), sertraline (Zoloft), and others.

This list is not complete and there may be other drugs that can interact with dextromethorphan, guaifenesin, and phenylephrine. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

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


Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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