Generic Name: acetaminophen, chlorpheniramine, and codeine (a seet a MIN oh fen, klor fen IR a meen, KOE deen)
Brand Names: Cotabflu
What is acetaminophen, chlorpheniramine, and codeine?
Acetaminophen is a pain reliever and fever reducer.
Chlorpheniramine is an antihistamine that reduces the effects of the natural chemical histamine in the body. Histamine can produce symptoms of sneezing, itching, watery eyes, and runny nose.
Codeine is a narcotic cough suppressant.
The combination of acetaminophen, chlorpheniramine, and codeine is used to treat headache, fever, body aches, cough, runny nose, sneezing, itching, and watery eyes caused by allergies, the common cold, or the flu. This medicine will not treat a cough that is caused by smoking, asthma, or emphysema.
Acetaminophen, chlorpheniramine, and codeine may also be used for purposes not listed in this medication guide.
What is the most important information I should know about acetaminophen, chlorpheniramine, and codeine?
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. 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. 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. 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.
What should I discuss with my healthcare provider before taking acetaminophen, chlorpheniramine, and codeine?
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. 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. 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;
a blockage in your digestive tract (stomach or intestines);
diabetes, kidney disease;
epilepsy or other seizure disorder;
cough with mucus, or cough caused by emphysema or chronic bronchitis;
enlarged prostate or urination problems;
sleep apnea (breathing stops during sleep);
an adrenal gland tumor or disorder (pheochromocytoma or Addison's disease);
low blood pressure, if you are dehydrated; or
if you take potassium (Cytra, Epiklor, K-Lyte, K-Phos, Kaon, Klor-Con, Polycitra, Urocit-K).
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. Codeine can pass into breast milk. The use of codeine by some nursing mothers may lead to life-threatening side effects in the baby. Antihistamines and 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, chlorpheniramine, and codeine?
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.
Do not take more of this medication than is recommended. An overdose of acetaminophen can damage your liver or cause death. Do not give this medication to a child younger than 4 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. 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. 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. Store at room temperature away from moisture and heat. Never share this medicine with another person, especially someone with a history of drug abuse or addiction.
See also: Acetaminophen, chlorpheniramine, and codeine dosage (in more detail)
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?
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, chlorpheniramine, and codeine?
Ask a doctor or pharmacist before using any other cold, allergy, pain, 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. 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. 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.
Acetaminophen, chlorpheniramine, and codeine 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 using this medication and call your doctor at once if you have a serious side effect such as:
fast, slow, or uneven heart rate;
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);
fever, easy bruising or bleeding, unusual weakness;
urinating less than usual or not at all;
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, blurred vision;
dry mouth, nose, or throat;
mild nausea, upset stomach, constipation;
feeling restless or nervous; 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.
Acetaminophen, chlorpheniramine, and codeine Dosing Information
Usual Adult Dose for Allergic Rhinitis:
Acetaminophen/chlorpheniramine/codeine 500 mg-4 mg-20 mg oral tablet:
1 tablet orally every 4 to 6 hours not to exceed 6 tablets daily.
Usual Adult Dose for Cough and Nasal Congestion:
Acetaminophen/chlorpheniramine/codeine 500 mg-4 mg-20 mg oral tablet:
1 tablet orally every 4 to 6 hours not to exceed 6 tablets daily.
Usual Pediatric Dose for Allergic Rhinitis:
Acetaminophen/chlorpheniramine/codeine 500 mg-4 mg-20 mg oral tablet:
6 to 11 years: 0.5 tablet orally every 4 to 6 hours not to exceed 3 tablets daily.
12 years or older: 1 tablet orally every 4 to 6 hours not to exceed 6 tablets daily.
Usual Pediatric Dose for Cough and Nasal Congestion:
Acetaminophen/chlorpheniramine/codeine 500 mg-4 mg-20 mg oral tablet:
6 to 11 years: 0.5 tablet orally every 4 to 6 hours not to exceed 3 tablets daily.
12 years or older: 1 tablet orally every 4 to 6 hours not to exceed 6 tablets daily.
What other drugs will affect acetaminophen, chlorpheniramine, and codeine?
Ask a doctor or pharmacist before using this medicine 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 chlorpheniramine or codeine.
Tell your doctor about all other medicines you use, especially:
leflunomide (Arava);
naloxone (Narcan, Suboxone);
topiramate (Topamax);
tramadol (Ultram, Ultracet);
zonisamide (Zonegran);
an antibiotic, antifungal medicine, sulfa drug, or tuberculosis medicine;
an antidepressant;
birth control pills or hormone replacement therapy;
bladder or urinary medications;
blood pressure medication;
bowel cleansing preparations (Half Lytely, Fleet Prep Kit, Evac-Q-Kwik, GoLytely, Supraprep, and others);
a bronchodilator;
cancer medicine;
cholesterol-lowering medications such as Lipitor, Niaspan, Zocor, Vytorin, and others;
gout or arthritis medications (including gold injections);
HIV/AIDS medication;
medication for nausea and vomiting, stomach ulcers, or irritable bowel syndrome;
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 other drugs may interact with acetaminophen, chlorpheniramine, and codeine. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.
More acetaminophen, chlorpheniramine, and codeine resources
- Acetaminophen, chlorpheniramine, and codeine Dosage
- Acetaminophen, chlorpheniramine, and codeine Drug Interactions
- Acetaminophen, chlorpheniramine, and codeine Support Group
- 1 Review for Acetaminophen, chlorpheniramine, and codeine - Add your own review/rating
Compare acetaminophen, chlorpheniramine, and codeine with other medications
- Cold Symptoms
- Cough and Nasal Congestion
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Where can I get more information?
- Your pharmacist can provide more information about acetaminophen, chlorpheniramine, and codeine.
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