Aspirin, chlorpheniramine, and phenylephrine

Generic Name: aspirin, chlorpheniramine, and phenylephrine (ASP rin, KLOR fen IR a meen, and FEN il EFF rin)Brand Names: Alka-Seltzer Plus Cold Formula

What is aspirin, chlorpheniramine, and phenylephrine?

Aspirin is in a group of drugs called salicylates (sa-LIS-il-ates). It works by reducing substances in the body that cause pain, fever, and inflammation.

Chlorpheniramine is an antihistamine that reduces 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 aspirin, chlorpheniramine, and phenylephrine is used to treat symptoms of the common cold including sneezing, runny or stuffy nose, sore throat, headache, fever, and minor aches and pains.

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

What is the most important information I should know about aspirin, chlorpheniramine, and phenylephrine?

Do 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. Aspirin should not be given to a child or teenager who has a fever, especially if the child also has flu symptoms or chicken pox. Aspirin can cause a serious and sometimes fatal condition called Reye's syndrome in children.

What should I discuss with my healthcare provider before taking aspirin, chlorpheniramine, and phenylephrine?

Do not use this medication if you have taken an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) in the last 14 days. Serious, life threatening side effects can occur if you use a cold medicine before the MAO inhibitor has cleared from your body. You should not use this medication if you are allergic to aspirin, chlorpheniramine, or phenylephrine; or if you have:
  • a recent history of stomach or intestinal bleeding;

  • a bleeding disorder such as hemophilia; or

  • if you are unable to urinate.

Ask a doctor or pharmacist about using aspirin, chlorpheniramine, and phenylephrine if you have:

  • kidney disease;
  • liver disease;
  • heart disease, high blood pressure;

  • heartburn, stomach pain, indigestion, ulcer, or other stomach problems;

  • enlarged prostate, urination problems;

  • diabetes;

  • glaucoma;

  • asthma, emphysema, or chronic bronchitis;

  • a thyroid disorder;

  • asthma or seasonal allergies; or

  • if you are on a low-salt diet.

FDA pregnancy category C. It is not known whether aspirin, chlorpheniramine, and phenylephrine is harmful to an unborn baby. Before taking this medication, tell your doctor if you are pregnant or plan to become pregnant during treatment. Aspirin may be harmful to an unborn baby's heart, and may also reduce birth weight or have other dangerous effects. Do not take any medication that contains aspirin during the last 3 months of pregnancy without your doctor's advice. It is not known whether aspirin, chlorpheniramine, and phenylephrine passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby. Older adults may be more likely to have side effects from this medicine. Aspirin should not be given to a child or teenager who has a fever, especially if the child also has flu symptoms or chicken pox. Aspirin can cause a serious and sometimes fatal condition called Reye's syndrome in children.

How should I take aspirin, chlorpheniramine, and phenylephrine?

Use this medication as directed on the label, or as your doctor has prescribed. Do not use the medication in larger amounts or for longer than recommended.

Do 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. Dissolve the effervescent tablet in a glass of water and drink it right away. Do not chew or swallow the tablet whole. Contact your doctor if your symptoms do not improve, or if they get worse, especially if you have:
  • a sore throat that lasts longer than 2 days;

  • a sore throat with a fever and headache, nausea, vomiting, or skin rash; or

  • a cough, stuffy nose, and pain that lasts longer than 7 days.

If you need to have any type of surgery, tell the surgeon ahead of time if you are taking medicine that contains aspirin. You may need to stop taking the medicine for a short time.

Store aspirin, chlorpheniramine, and phenylephrine at room temperature away from moisture and heat.

See also: Aspirin, chlorpheniramine, and phenylephrine dosage in more detail

What happens if I miss a dose?

Since cold medicine is often used as needed, you may not be on a dosing schedule. If you are using the medication regularly, take the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and wait until your next regularly scheduled dose. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

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

Overdose symptoms may include ringing in your ears, headache, dizziness, nausea, vomiting, diarrhea, stomach pain, confusion, feeling restless of excited, hallucinations, rapid breathing, fever, and seizure (convulsions).

What should I avoid while taking aspirin, chlorpheniramine, and phenylephrine?

This 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. Avoid drinking alcohol. It can increase some of the side effects of aspirin, chlorpheniramine, and phenylephrine.

Avoid using other medicines that make you sleepy (such as cold medicine, pain medication, muscle relaxers, and medicine for seizures, depression or anxiety). They can add to sleepiness caused by chlorpheniramine.

Avoid using other medicines that may cause restlessness (such as caffeine, stimulants, diet pills, and decongestants contained in over-the-counter cold medicines). They can add to the stimulant effects of phenylephrine.

Do not use any other over-the-counter medication without first asking your doctor or pharmacist. Aspirin, antihistamines, and decongestants are contained in many medicines available over the counter. If you take certain products together you may accidentally take too much of a certain drug. Read the label of any other medicine you are using to see if it contains aspirin, an antihistamine, or a decongestant.

Avoid taking an NSAID (non-steroidal anti-inflammatory drug) while you are taking aspirin. NSAIDs include ibuprofen (Motrin, Advil), diclofenac (Voltaren), etodolac (Lodine), indomethacin (Indocin), meloxicam (Mobic), nabumetone (Relafen), naproxen (Aleve, Naprosyn), piroxicam (Feldene), and others.

Avoid drinking alcohol while you are taking aspirin. Alcohol may increase your risk of stomach bleeding.

Aspirin, chlorpheniramine, and phenylephrine side effects

Get 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. Stop taking this medication and call your doctor at once if you have any of these serious side effects:
  • black, bloody, or tarry stools;

  • coughing up blood or vomit that looks like coffee grounds;

  • redness or swelling;

  • new cold or flu symptoms;

  • fast or uneven heartbeats;

  • feeling light-headed, fainting;

  • seizure (convulsions);

  • ringing in your ears, hallucinations (seeing things that are not there); or

  • tremors.

Less serious side effects may include:

  • drowsiness;

  • feeling restless or excited (especially in children);

  • sleep problems (insomnia); or

  • heartburn, nausea, vomiting, diarrhea, loss of appetite.

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.

Aspirin, chlorpheniramine, and phenylephrine Dosing Information

Usual Adult Dose for Nasal Congestion:

ASA/chlorpheniramine/phenylephrine 325 mg-2 mg-7.8 mg oral tablet, effervescent:2 tablets dissolved in 4 ounces of water every 4 hours not to exceed 8 tablets daily.

Usual Pediatric Dose for Nasal Congestion:

ASA/chlorpheniramine/phenylephrine 325 mg-2 mg-7.8 mg oral tablet, effervescent:12 years or older: 2 tablets dissolved in 4 ounces of water every 4 hours not to exceed 8 tablets daily.

What other drugs will affect aspirin, chlorpheniramine, and phenylephrine?

Before using this medication, tell your doctor if you regularly use other medicines that make you sleepy (such as allergy medicine, sedatives, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression, or anxiety). They can add to sleepiness caused by chlorpheniramine.

Tell your doctor if you are taking an antidepressant such as citalopram (Celexa), duloxetine (Cymbalta), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem, Symbyax), fluvoxamine (Luvox), paroxetine (Paxil), sertraline (Zoloft), or venlafaxine (Effexor). Taking any of these drugs with aspirin may cause you to bruise or bleed easily.

Tell your doctor about all other medications you use, especially:

  • a blood thinner such as warfarin (Coumadin);

  • gout medication such as probenecid (Benemid);

  • diabetes medication you take by mouth;

  • a barbiturate such as amobarbital (Amytal), butabarbital (Butisol), mephobarbital (Mebaral), secobarbital (Seconal), or phenobarbital (Luminal, Solfoton); or

  • another salicylate such as choline salicylate and/or magnesium salicylate (Magan, Doan's, Bayer Select Backache Pain Formula, Mobidin, Arthropan, Trilisate, Tricosal), or salsalate (Disalcid).

This list is not complete and there may be other drugs that can interact with aspirin, chlorpheniramine, 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 aspirin, chlorpheniramine, 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.
  • Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
Copyright 1996-2006 Cerner Multum, Inc. Version: 1.01. Revision Date: 09/22/2009 12:00:12 PM.