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Generic Name: aspirin, chlorpheniramine, and dextromethorphan (AS prin, klor feh NEER ah meen, and dex troe meh THOR fan)
Brand Names: Alka-Seltzer Cold Plus Flu Medicine

What is Alka-Seltzer Cold Plus Flu Medicine (aspirin, chlorpheniramine, and dextromethorphan)?

Aspirin is in a class of drugs called salicylates. Aspirin is a pain reliever, an anti-inflammatory, and a fever reducer. It is used to treat many conditions, such as headache, muscle aches, arthritis, backache, toothaches, colds, and fevers.

Chlorpheniramine is an antihistamine. It blocks the naturally occurring chemical histamine in the body. Chlorpheniramine prevents sneezing; itchy, watery eyes and nose; and other symptoms of allergies and hay fever.

Dextromethorphan is a cough suppressant. It suppresses an area in the brain that causes coughing.

Together, aspirin, chlorpheniramine, and dextromethorphan are used to treat nasal congestion; sinusitis (inflammation of the sinuses); headache; fever; and aches, pains, and coughs associated with allergies, hay fever, the common cold, and the flu.

Aspirin, chlorpheniramine, and dextromethorphan may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about Alka-Seltzer Cold Plus Flu Medicine (aspirin, chlorpheniramine, and dextromethorphan)?

Do not take more of this medication than is recommended. If your symptoms do not improve or if they worsen, see your doctor.

What should I discuss with my healthcare provider before taking take Alka-Seltzer Cold Plus Flu Medicine (aspirin, chlorpheniramine, and dextromethorphan)?

Do not take this medication without first talking to your doctor if you drink more than three alcoholic beverages per day. Combined with alcohol, aspirin can be damaging to the stomach.

Before taking this medication, tell your doctor if you have

• an ulcer;

• a bleeding or blood clotting disorder;

• kidney disease;
• liver disease;

• diabetes;

• glaucoma;

• any type of heart disease or high blood pressure;

• thyroid disease;

• cough with excessive phlegm;

• persistent or chronic cough that may occur due to smoking, asthma, or emphysema;

• emphysema or chronic bronchitis; or

• difficulty urinating or an enlarged prostate.

You may not be able to take aspirin, chlorpheniramine, and dextromethorphan, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.

The Alka-Seltzer Cold Plus Flu effervescent tablets contain 6.7 mg phenylalanine per tablet. Individuals with phenylketonuria may need to monitor their intake of this additive.

The Alka-Seltzer Cold Plus Flu effervescent tablets contain 386 mg sodium per tablet. Individuals on a sodium-restricted diet may need to monitor their intake of this additive.

How should I take Alka-Seltzer Cold Plus Flu Medicine (aspirin, chlorpheniramine, and dextromethorphan)?

Take aspirin, chlorpheniramine, and dextromethorphan exactly as directed. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.

The Alka-Seltzer Cold Plus Flu effervescent tablets should be dissolved in 4 ounces of water before administration. When the tablet has completely dissolved, the whole mixture should be consumed immediately. Do not save for later use.

Do not take aspirin, chlorpheniramine, and dextromethorphan for longer than 7 days in a row to treat cold symptoms or longer than 3 days to treat a fever. If your symptoms do not improve or if they get worse, see your doctor.

What happens if I miss a dose?

Take the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the missed dose and take only the next regularly scheduled dose. Do not take a double dose of this medication.

What happens if I overdose?

Symptoms of an aspirin, chlorpheniramine, and dextromethorphan overdose may include dry mouth, large pupils, flushing, ringing in the ears, dizziness, hallucinations, seizures, rapid breathing, nausea, and vomiting.

What should I avoid while taking Alka-Seltzer Cold Plus Flu Medicine (aspirin, chlorpheniramine, and dextromethorphan)?

Aspirin, chlorpheniramine, and dextromethorphan may increase the effects of other drugs that cause drowsiness, including antidepressants, alcohol, other antihistamines, pain relievers, anxiety medicines, seizure medicines, and muscle relaxants. Dangerous sedation, dizziness, or drowsiness may occur if aspirin, chlorpheniramine, and dextromethorphan is taken with any of these medications.

Be aware of the aspirin content of other over-the-counter and prescription products. Any aspirin content in these products counts toward your total daily dose.

Alka-Seltzer Cold Plus Flu Medicine (aspirin, chlorpheniramine, and dextromethorphan) side effects

• an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives);

• black, bloody, or tarry stools;

• blood in vomit or urine;

• nausea, vomiting, or abdominal pain; or

• ringing in the ears or loss of hearing.

Other, less serious side effects may be more likely to occur. Continue to take aspirin, chlorpheniramine, and dextromethorphan and talk to your doctor, or try another similar medication if you experience

• dryness of the eyes, nose, or mouth;

• drowsiness, lightheadedness, dizziness, or weakness; or

• upset stomach or indigestion.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect Alka-Seltzer Cold Plus Flu Medicine (aspirin, chlorpheniramine, and dextromethorphan)?

Before taking aspirin, chlorpheniramine, and dextromethorphan, talk to your doctor if you are taking any of the following medicines:

• an anticoagulant such as warfarin (Coumadin), heparin, enoxaparin (Lovenox), dalteparin (Fragmin), danaparoid (Orgaran), ardeparin (Normiflo), or tinzaparin (Innohep);

• a nonsteroidal anti-inflammatory drug (NSAID) such as ibuprofen (Motrin, Advil, Nuprin, others), ketoprofen (Orudis, Orudis KT, Oruvail), naproxen (Naprosyn, Anaprox, Aleve), diclofenac (Voltaren, Cataflam), nabumetone (Relafen), oxaprozin (Daypro), piroxicam (Feldene), etodolac (Lodine), fenoprofen (Nalfon), flurbiprofen (Ansaid), indomethacin (Indocin), ketorolac (Toradol), sulindac (Clinoril), or tolmetin (Tolectin); or

• another salicylate (form of aspirin) such as aspirin (Acuprin, Ecotrin, Ascriptin, Bayer, others); choline salicylate and/or magnesium salicylate (Magan, Doan's, Bayer Select Backache Pain Formula, Mobidin, Arthropan, Trilisate, Tricosal), or salsalate (Disalcid).

You may not be able to take aspirin, chlorpheniramine, and dextromethorphan, or you may require a dosage adjustment or special monitoring if you are taking any of the medicines listed above.

Do not take other over-the-counter cough, cold, allergy, diet, pain, fever, or sleep medicines while taking aspirin, chlorpheniramine, and dextromethorphan without first talking to your doctor or pharmacist. Other medications may also contain aspirin, chlorpheniramine, dextromethorphan, or other similar drugs, and you may accidentally take too much and harm yourself.

Aspirin, chlorpheniramine, and dextromethorphan may increase the effects of other drugs that cause drowsiness, including antidepressants, alcohol, other antihistamines, pain relievers, anxiety medicines, seizure medicines, and muscle relaxants. Dangerous sedation, dizziness, or drowsiness may occur if aspirin, chlorpheniramine, and dextromethorphan is taken with any of these medications.

Drugs other than those listed here may also interact with aspirin, chlorpheniramine, and dextromethorphan. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including vitamins, minerals, and herbal products.

Where can I get more information?

• Your pharmacist has additional information about aspirin, chlorpheniramine, and dextromethorphan written for health professionals that you may read.

What does my medication look like?

Aspirin, chlorpheniramine, and dextromethorphan is available over the counter under the brand name Alka-Seltzer Plus Cough and Cold Tablets. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

• 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.