acetaminophen, codeine, guaifenesin, and phenylephrine

Pronunciation: a SEET oh MIN oh fen, KOE deen, gwye FEN e sin, FEN il EFF rin

Brand: Phenflu CD, Phenflu CDX

What is the most important information I should know about acetaminophen, codeine, guaifenesin, and phenylephrine?

Multum donot

Do not take more of this medication than is recommended. An overdose of acetaminophen can damage your liver or cause death. Tell your doctor if you have ever had alcoholic liver disease (cirrhosis) or if you drink more than 3 alcoholic beverages per day.

Multum emt

You should not use this medicine if you have inflammatory bowel disease, severe constipation, a blockage in your stomach or intestines, severe colitis or toxic megacolon, if you have a colostomy or ileostomy, if you are unable to urinate, if you have been sick with diarrhea, if you recently drank large amounts of alcohol, or if you have a head injury or brain tumor.

Multum donot

Do not use this medicine if you have untreated or uncontrolled diseases such as glaucoma, asthma or COPD, high blood pressure, heart disease, coronary artery disease, or overactive thyroid.

Multum noalcohol

Do not drink alcohol while you are taking this medicine.

Do not use this medicine if you have used an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate) in the last 14 days. A dangerous drug interaction could occur, leading to serious side effects.

What is acetaminophen, codeine, guaifenesin, and phenylephrine?

Acetaminophen is a pain reliever and fever reducer.

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

Guaifenesin is an expectorant. It helps loosen mucus 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 acetaminophen, codeine, guaifenesin, and phenylephrine is used to treat headache, fever, body aches, cough, chest congestion, stuffy nose, and sinus congestion caused by allergies, the common cold, or the flu.

Multum smoking

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

Acetaminophen, codeine, 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 taking this medicine?

Multum emt

You should not use this medicine if you have inflammatory bowel disease, severe constipation, a blockage in your stomach or intestines, severe colitis or toxic megacolon, if you have a colostomy or ileostomy, if you are unable to urinate, if you have been sick with diarrhea, if you recently drank large amounts of alcohol, or if you have a head injury or brain tumor.

Multum donot

Do not use this medicine if you have used an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate) in the last 14 days. A dangerous drug interaction could occur, leading to serious side effects.

Multum emt

Do not use this medicine if you have untreated or uncontrolled diseases such as glaucoma, asthma or COPD, high blood pressure, heart disease, coronary artery disease, or overactive thyroid.

To make sure you can safely take this medicine, tell your doctor if you have any of these other conditions:

  • liver disease, cirrhosis, a history of alcoholism or drug addiction, or if you drink more than 3 alcoholic beverages per day;
  • diabetes;
  • kidney disease;
  • enlarged prostate, urination problems;
  • epilepsy or other seizure disorder;
  • sleep apnea (breathing stops during sleep);
  • an adrenal gland tumor or disorder (pheochromocytoma or Addison's disease); or
  • low blood pressure, or if you are dehydrated.
Multum nopreg

FDA pregnancy category C. Codeine may cause addiction or withdrawal symptoms in a newborn if the mother takes the medication during pregnancy. Do not use this medicine without telling your doctor if you are pregnant.

Multum nobrfeed

Codeine can pass into breast milk. The use of codeine by some nursing mothers may lead to life-threatening side effects in the baby. Decongestants may also slow breast milk production. Do not use this medicine without telling your doctor if you are breast-feeding a baby.

How should I take acetaminophen, codeine, guaifenesin, and phenylephrine?

Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label. This medicine is usually taken for only a short time until your symptoms clear up.

Multum donot

Do not take more of this medication than is recommended. An overdose of acetaminophen can damage your liver or cause death.

Multum nochild

Do not give this medication to a child younger than 6 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.

Multum emt

Do not take for longer than 7 days in a row. Stop taking the medicine and call your doctor if you still have a fever after 3 days of use, you still have pain after 7 days (or 5 days if treating a child), if your symptoms get worse, or if you have a skin rash, ongoing headache, or any redness or swelling.

Multum emt

If you need surgery or medical tests, tell the surgeon or doctor ahead of time if you have taken this medicine within the past few days.

Multum rt

Store at room temperature away from moisture and heat. Never share this medicine with another person. Keep track of the amount of medicine used from each new bottle. Codeine is a drug of abuse and you should be aware if anyone is using your medicine improperly or without a prescription.

What happens if I miss a dose?

Since this medicine is taken when needed, you may not be on a dosing schedule. If you are taking the medication regularly, take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Multum emt

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of acetaminophen or codeine can be fatal.

The first signs of an acetaminophen overdose include loss of appetite, nausea, vomiting, stomach pain, sweating, and confusion or weakness. Later symptoms may include pain in your upper stomach, dark urine, and yellowing of your skin or the whites of your eyes.

Overdose symptoms may include confusion, extreme weakness, pinpoint pupils, cold and clammy skin, weak pulse, slow breathing, fainting, or breathing that stops.

What should I avoid while taking acetaminophen, codeine, guaifenesin, and phenylephrine?

Multum donot

Ask a doctor or pharmacist before using any other pain, cold, allergy, or sleep medication. Acetaminophen (sometimes abbreviated as APAP) is contained in many combination medicines. Taking certain products together can cause you to get too much acetaminophen which can lead to a fatal overdose. Check the label to see if a medicine contains acetaminophen or APAP.

Multum noalcohol

Do not drink alcohol while you are taking this medicine. Dangerous side effects or death can occur when alcohol is combined with a narcotic medicine. Alcohol may also increase your risk of liver damage while you are taking acetaminophen. Check your food and medicine labels to be sure these products do not contain alcohol.

Multum dizzy

This medicine may cause blurred vision or impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert and able to see clearly.

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

Multum emt

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.

Multum donot

Stop using this medication and call your doctor at once if you have a serious side effect such as:

  • confusion, mood changes, severe dizziness or anxiety, feeling like you might pass out;
  • sudden severe headache or vomiting, pain or numbness in the arms or legs;
  • tremor, seizure (convulsions);
  • nausea, pain in your upper stomach, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of your skin or eyes); or
  • dangerously high blood pressure (severe headache, blurred vision, buzzing in your ears, anxiety, chest pain, uneven heartbeats, seizure).

Less serious side effects may include:

  • dizziness, drowsiness, mild headache;
  • mild nausea, upset stomach, constipation;
  • runny nose;
  • feeling nervous, restless, or anxious; or
  • sleep problems (insomnia).

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 acetaminophen, codeine, guaifenesin, and phenylephrine?

Multum dizzy

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

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

  • bupropion (Wellbutrin, Zyban);
  • droperidol (Inapsine);
  • leflunomide (Arava);
  • naloxone (Narcan, Suboxone);
  • tramadol (Ultram, Ultracet);
  • an antibiotic, antifungal medicine, sulfa drug, or tuberculosis medicine;
  • birth control pills or hormone replacement therapy;
  • blood pressure medication;
  • bowel cleansing preparations (Half Lytely, Fleet Prep Kit, Evac-Q-Kwik, GoLytely, Supraprep, and others);
  • cancer medicine;
  • cholesterol-lowering medications such as Lipitor, Niaspan, Zocor, Vytorin, and others;
  • gout or arthritis medications (including gold injections);
  • HIV/AIDS medication;
  • medicines to treat psychiatric disorders;
  • an NSAID such as Advil, Aleve, Arthrotec, Cataflam, Celebrex, Indocin, Motrin, Naprosyn, Treximet, Voltaren, others; or
  • seizure medication.

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

Where can I get more information?

Your pharmacist can provide more information about acetaminophen, codeine, 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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