Drug Info: C: Cough/Cold Combinations (Systemic)

Some commonly used brand names are:

In the U.S.—

In Canada—

• Antihistaminic (H₁-receptor)-antitussive--Chlorpheniramine and Dextromethorphan; Chlorpheniramineand Hydrocodone; Phenyltoloxamine and Hydrocodone;Promethazine and Codeine; Promethazine and Dextromethorphan; Pyrilamine and Codeine
• Antihistaminic (H₁-receptor)-antitussive-analgesic--Doxylamine, Codeine and Acetaminophen
• Antihistaminic (H₁-receptor)-antitussive-expectorant--Diphenhydramine, Codeine, and Ammonium Chloride ;Diphenhydramine, Dextromethorphan, and Ammonium Chloride;Pheniramine, Codeine, and Guaifenesin; Pheniramine,Pyrilamine, Hydrocodone, Potassium Citrate, and AscorbicAcid; Promethazine, Codeine, and PotassiumGuaiacolsulfonate
• Antihistaminic (H₁-receptor) and decongestant--Promethazine and Phenylephrine ; Pheniramine, Pyrilamine,and Phenyltoloxamine
• Antihistaminic (H ₁-receptor)-decongestant-antitussive --Brompheniramine, Phenylephrine and Codeine;Brompheniramine, Pseudoephedrine, and Dextromethorphan;Carbinoxamine, Pseudoephedrine, and Dextromethorphan;Chlorpheniramine, Pyrilamine, Phenylephrine,Pseudoephedrine and Hydrocodone; Chlorpheniramine,Ephedrine, Phenylephrine, and Carbetapentane;Chlorpheniramine, Phenylephrine, and Dextromethorphan;Chlorpheniramine, Phenylephrine, and Hydrocodone;Chlorpheniramine, Pseudoephedrine, and Codeine;Chlorpheniramine, Pseudoephedrine, and Dextromethorphan;Chlorpheniramine, Pseudoephedrine, and Hydrocodone;Chlorpheniramine, Pseudoephedrine and Hydrocodone;Doxylamine, Etafedrine and Hydrocodone; Pheniramine,Phenylephrine, and Dextromethorphan; Promethazine,Phenylephrine, and Codeine; Triprolidine, Pseudoephedrine,and Codeine
• Antihistaminic (H₁-receptor)-decongestant-antitussive-analgesic--Chlorpheniramine, Pheniramine, Pyrilamine, Phenylephrine,Hydrocodone, Salicylamide, Caffeine, and Ascorbic Acid;Chlorpheniramine, Phenylephrine, Hydrocodone,Acetaminophen, and Caffeine; Chlorpheniramine,Pseudoephedrine, Codeine and Acetaminophen;Chlorpheniramine, Pseudoephedrine, Dextromethorphan, andAcetaminophen, ; Doxylamine, Pseudoephedrine,Dextromethorphan, and Acetaminophen ; Pyrilamine,Pseudoephedrine, Dextromethorphan, and Acetaminophen
• Antihistaminic (H₁-receptor)-decongestant-antitussive-expectorant--Brompheniramine, Phenylephrine, Codeine and Guaifenesin ;Brompheniramine, Phenylephrine, Hydrocodone andGuaifenesin; Chlorpheniramine, Ephedrine, Phenylephrine,Dextromethorphan, Ammonium Chloride, and Ipecac;Chlorpheniramine, Phenylephrine, Codeine, and AmmoniumChloride ; Chlorpheniramine, Phenylephrine, Codeine, andPotassium Iodide; Chlorpheniramine, Phenylephrine,Dextromethorphan, and Guaifenesin; Chlorpheniramine,Phenylephrine, Dextromethorphan, Guaifenesin, and AmmoniumChloride; Chlorpheniramine, Pseudoephedrine,Dextromethorphan and Guaifenesin; Pyrilamine,Phenylephrine, Hydrocodone, and Ammonium Chloride;Triprolidine, Pseudoephedrine, Codeine, andGuaifenesin
• Antihistaminic (H₁-receptor)-decongestant-antitussive-expectorant-analgesic--Pheniramine, Phenylephrine, Codeine, Sodium Citrate,Sodium Salicylate, and Caffeine
• Antihistaminic (H₁-receptor)-decongestant-expectorant--Chlorpheniramine, Ephedrine, and Guaifenesin ;Promethazine, Phenylephrine, and PotassiumGuaiacolsulfonate
• Antitussive-analgesic --Dextromethorphanand Acetaminophen
• Antitussive-anticholinergic --Hydrocodoneand Homatropine
• Antitussive-expectorant --Codeine,Ammonium Chloride, and Guaifenesin; Codeine andGuaifenesin; Dextromethorphan and Guaifenesin;Dextromethorphan and Iodinated Glycerol; Hydrocodone andGuaifenesin; Hydrocodone and PotassiumGuaiacolsulfonate
• Decongestant-antitussive --Phenylephrineand Hydrocodone; Pseudoephedrine and Dextromethorphan
• Decongestant-antitussive-analgesic --Pseudoephedrine, Dextromethorphan, and Acetaminophen
• Decongestant-antitussive-expectorant--Phenylephrine, Codeine and Guaifenesin; Phenylephrine,Hydrocodone, and Guaifenesin; Pseudoephedrine, Codeine, andGuaifenesin; Pseudoephedrine, Dextromethorphan, andGuaifenesin; Pseudoephedrine, Hydrocodone, andGuaiacolsulfonate; Pseudoephedrine, Hydrocodone, andGuaifenesin
• Decongestant-antitussive-expectorant-analgesic--Pseudoephedrine, Dextromethorphan, Guaifenesin, andAcetaminophen
• Decongestant-expectorant --Ephedrine andGuaifenesin; Ephedrine and Potassium Iodide; Phenylephrineand Guaifenesin; Pseudoephedrine and Guaifenesin

Cough/cold combinations are used mainly to relieve thecough due to colds, influenza, or hay fever. They are not tobe used for the chronic cough that occurs with smoking,asthma, or emphysema or when there is an unusually largeamount of mucus or phlegm (pronounced flem) with thecough.

Cough/cold combination products contain more than oneingredient. For example, some products may contain anantihistamine, a decongestant, and an analgesic, in additionto a medicine for coughing. If you are treating yourself, itis important to select a product that is best for yoursymptoms. Also, in general, it is best to buy a product thatincludes only those medicines you really need. If you havequestions about which product to buy, check with yourpharmacist.

Since different products contain ingredients that willhave different precautions and side effects, it is importantthat you know the ingredients of the medicine you are taking.The different kinds of ingredients that may be found incough/cold combinations include:

Antihistamines

Antihistamines are used to relieve or prevent the symptomsof hay fever and other types of allergy. They also helprelieve some symptoms of the common cold, such as sneezingand runny nose. They work by preventing the effects of asubstance called histamine, which is produced by the body.Some examples of antihistamines contained in thesecombinations are: bromodiphenhydramine(broe-moe-dye-fen-HYE-dra-meen) , brompheniramine(brome-fen-EER-a-meen ) , carbinoxamine ( kar-bi-NOX-a-meen), chlorpheniramine (klor-fen-EER-a-meen) ,dexchlorpheniramine (dex-klor-fen-EER-a-meen) ,diphenhydramine (dye-fen-HYE-dra-meen ) , doxylamine(dox-ILL-a-meen ) , phenindamine ( fen-IN-da-meen) ,pheniramine ( fen-EER-a-meen) , phenyltoloxamine (fen-ill-tole-OX-a-meen) , pyrilamine ( peer-ILL-a-meen) ,promethazine ( proe-METH-a-zeen) , and triprolidine (trye-PROE-li-deen) .

Decongestants

Decongestants, such as ephedrine ( e-FED-rin) ,phenylephrine ( fen-ill-EF-rin) , and pseudoephedrine(soo-doe-e-FED-rin) , produce a narrowing of blood vessels.This leads to clearing of nasal congestion. However, thiseffect may also increase blood pressure in patients who havehigh blood pressure.

Antitussives

To help relieve coughing these combinations contain eithera narcotic [codeine (KOE-deen) , dihydrocodeine (dye-hye-droe-KOE-deen) , hydrocodone ( hye-droe-KOE-done) orhydromorphone ( hye-droe-MOR-fone) ] or a nonnarcotic[carbetapentane ( kar-bay-ta-PEN-tane) , caramiphen(kar-AM-i-fen ) , or dextromethorphan (dex-troe-meth-OR-fan )] antitussive. These antitussives act directly on the coughcenter in the brain. Narcotics may become habit-forming,causing mental or physical dependence, if used for a longtime. Physical dependence may lead to withdrawal side effectswhen you stop taking the medicine.

Expectorants

Guaifenesin (gwye-FEN-e-sin) works by loosening the mucusor phlegm in the lungs. Other ingredients added asexpectorants (for example, ammonium chloride, calcium iodide,iodinated glycerol, ipecac, potassium guaiacolsulfonate,potassium iodide, and sodium citrate) have not been proven tobe effective. In general, the best thing you can do to loosenmucus or phlegm is to drink plenty of water.

Analgesics

Analgesics, such as acetaminophen ( a-seat-a-MIN-oh-fen) ,aspirin, and other salicylates [such as salicylamide(sal-i-SILL-a-mide) and sodium salicylate (SOE-dee-umsa-LI-sill-ate ) ] are used in these combination medicines tohelp relieve the aches and pain that may occur with thecommon cold.

The use of too much acetaminophen and salicylates at thesame time may cause kidney damage or cancer of the kidney orurinary bladder. This may occur if large amounts of bothmedicines are taken together for a long time. However, takingthe recommended amounts of combination medicines that containboth acetaminophen and a salicylate for short periods of timehas not been shown to cause these unwanted effects.

Anticholinergics

Anticholinergics such as homatropine ( hoe-MA-troe-peen)may help produce a drying effect in the nose and chest.

Some of these combinations are available only with yourdoctor's prescription. Others are available without aprescription; however, your health care professional may havespecial instructions on the proper dose of the medicine foryour medical condition.

Cough/cold combinations are available in the followingdosage forms:

• • Oral
  • Chlorpheniramine and Codeine
    • Oral suspension (Canada)
  • Chlorpheniramine and Dextromethorphan
    • Oral solution (U.S.)
  • Chlorpheniramine and Hydrocodone
    • Oral solution (U.S.)
    • Oral suspension (U.S.)
  • Phenyltoloxamine and Hydrocodone
    • Oral suspension (Canada)
    • Tablets (Canada)
  • Promethazine and Codeine
    • Oral solution (U.S.)
    • Syrup (U.S.)
  • Promethazine and Dextromethorphan
    • Oral solution (U.S.)
    • Syrup (U.S.)
  • Pyrilamine and Codeine
    • Oral solution (U.S.)
• • Oral
  • Doxylamine, Codeine, and Acetaminophen
    • Tablets (Canada)
• • Oral
  • Diphenhydramine, Codeine, and Ammonium Chloride
    • Syrup (Canada)
  • Diphenhydramine, Dextromethorphan, and AmmoniumChloride
    • Syrup (Canada)
  • Pheniramine, Codeine, and Guaifenesin
    • Syrup (Canada)
  • Pheniramine, Pyrilamine, Hydrocodone, PotassiumCitrate, and Ascorbic Acid
    • Syrup (U.S.)
  • Promethazine, Codeine, and PotassiumGuaiacolsulfonate
    • Syrup (Canada)
• • Oral
  • Promethazine, and phenylephrine
    • Syrup (U.S.)
  • Pheniramine, Pyrilamine and Phenyltoloxamine
    • Syrup (U.S.)
• • Oral
  • Bromopheniramine, Phenylephrine, and Codeine
    • Syrup (Canada)
  • Brompheniramine, Pseudoephedrine, andDextromethorphan
    • Syrup (U.S.)
  • Carbinoxamine, Pseudoephedrine, andDextromethorphan
    • Oral solution (U.S.)
    • Syrup (U.S.)
  • Chlorpheniramine, Pyrilamine, Phenylephrine,Pseudoephedrine, and Hydrocodone
    • Oral solution (U.S.)
  • Chlorpheniramine, Ephedrine, Phenylephrine, andCarbetapentane
    • Oral suspension (U.S.)
    • Tablets (U.S.)
  • Chlorpheniramine, Phenylephrine, andDextromethorphan
    • Oral solution (U.S.)
    • Syrup (U.S.)
    • Tablets (U.S.)
  • Chlorpheniramine, Phenylephrine, and Hydrocodone
    • Oral solution (U.S.)
    • Syrup (U.S.)
  • Chlorpheniramine, Pseudoephedrine, and Codeine
    • Elixir (U.S.)
    • Oral solution (U.S.)
  • Chlorpheniramine, Pseudoephedrine, andDextromethorphan
    • Chewable tablets (U.S.)
    • Oral solution (U.S. and Canada)
    • Syrup (U.S. and Canada)
  • Chlorpheniramine, Pseudoephedrine, and Hydrocodone
    • Oral solution (U.S.)
    • Syrup (U.S.)
  • Chlorpheniramine, Pseudoephedrine, and Hydrocodone
    • Syrup (U.S.)
  • Doxylamine, Etadefrine, and Hydrocodone
    • Syrup (Canada)
  • Pheniramine, Phenylephrine, and Dextromethorphan
    • Oral solution (Canada)
  • Promethazine, Phenylephrine, and Codeine
    • Oral solution (U.S.)
    • Syrup (U.S.)
  • Triprolidine, Pseudoephedrine, and Codeine
    • Oral solution (Canada)
    • Syrup (U.S.)
    • Tablets (Canada)
• • Oral
  • Chlorpheniramine, Pheniramine, Pyrilamine,Phenylephrine, Hydrocodone, Salicylamide, Caffeine, andAscorbic Acid
    • Capsules (U.S.)
  • Chlorpheniramine, Phenylephrine, Hydrocodone,Acetaminophen, and Caffeine
    • Tablets (U.S.)
  • Chlorpheniramine, Pseudoephedrine, Codeine, andAcetaminophen
    • Tablets (Canada)
  • Chlorpheniramine, Pseudoephedrine,Dextromethorphan, and Acetaminophen
    • Capsules (U.S.)
    • Chewable tablets (U.S. and Canada)
    • Oral solution (U.S. and Canada)
    • Syrup (Canada)
    • Tablets (U.S. and Canada)
  • Doxylamine, Pseudoephedrine, Dextromethorphan, andAcetaminophen
    • Capsules (U.S.)
    • Oral solution (U.S.)
  • Pyrilamine, Pseudoephedrine, Dextromethorphan, andAcetaminophen
    • Oral solution (U.S.)
• • Oral
  • Brompheniramine, Phenylephrine, Codeine, andGuaifenesin
    • Oral solution (Canada)
  • Brompheniramine, Phenylephrine, Hydrocodone, andGuaifenesin
    • Oral solution (Canada)
  • Chlorpheniramine, Ephedrine, Phenylephrine,Dextromethorphan, Ammonium Chloride, and Ipecac
    • Syrup (U.S.)