SymPak DM

Generic Name: phenylephrine/guaifenesin/dextromethorphan (FEN-il-EF-rin/gwye-FEN-e-sin/DEX-troe-meth-OR-fan and KLOR-fen-IR-a-meen/FEN-il-EF-rin/METH-skoe-POL-a-meen)
Brand Name: SymPak DM

SymPak DM is used for:

Relieving nasal and chest congestion, sneezing, runny nose, and itchy, watery eyes due to colds, flu, or allergies. It is also used to reduce coughing and to make a dry cough more productive and less frequent. It may also be used for other conditions as determined by your doctor.

SymPak DM is a combination pack containing a morning dose and an evening dose. The morning dose has a decongestant, expectorant, and cough suppressant. The evening dose has an antihistamine, decongestant, and anticholinergic. The decongestant works by shrinking swollen tissue in the nose. The expectorant works by thinning mucus in the lungs. The cough suppressant works in the brain to reduce coughing. The antihistamine works by blocking histamine, a substance in the body that causes sneezing, runny nose, and watery eyes. The anticholinergic works by drying mucous membranes in the nose and chest.

Do NOT use SymPak DM if:

  • you are allergic to any ingredient in SymPak DM
  • you are pregnant or breast-feeding
  • you are taking droxidopa, furazolidone, sodium oxybate (GHB), or a monoamine oxidase inhibitor (MAOI) (eg, phenelzine), or if you have taken an MAOI within the past 14 days
  • you have severe heart blood vessel problems, severe high blood pressure, narrow-angle glaucoma, difficulty urinating due to enlarged prostate, peptic ulcer, or uncontrolled bleeding
  • you are having an asthma attack

Contact your doctor or health care provider right away if any of these apply to you.

Slideshow: OTC Medication Use In Pregnancy: Wise or Worrisome?

Before using SymPak DM:

Some medical conditions may interact with SymPak DM. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you have bladder blockage, blood vessel problems (eg, hardening of the arteries), diabetes, an enlarged prostate, glaucoma or increased pressure in the eye, heart problems (eg, irregular heartbeat, heart failure), heart blood vessel problems, high blood pressure, inflammation of the esophagus from reflux disease, kidney problems, a hiatal hernia, an adrenal gland tumor (pheochromocytoma), myasthenia gravis (muscle weakness), stomach or bowel problems (eg, constipation, inflammation, motility problems, blockage), trouble sleeping, or an overactive thyroid
  • if you have chronic cough, chronic bronchitis, or any lung or breathing problems, such as asthma, emphysema, sleep apnea, or chronic obstructive pulmonary disease (COPD)
  • if you have a history of alcohol abuse
  • if you take potassium chloride tablets

Some MEDICINES MAY INTERACT with SymPak DM. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Droxidopa or sodium oxybate ( GHB) because the risk of severe drowsiness, breathing problems, seizures, irregular heartbeat, or heart attack may be increased
  • Beta-blockers (eg, propranolol), catechol-O-methyltransferase (COMT) inhibitors (eg, tolcapone), furazolidone, MAOIs (eg, phenelzine), selective serotonin reuptake inhibitors (SSRIs) (eg, fluoxetine), or tricyclic antidepressants (eg, amitriptyline) because they may increase the risk of SymPak DM's side effects
  • Bromocriptine because the risk of its side effects may be increased by SymPak DM
  • Guanadrel, guanethidine, mecamylamine, methyldopa, reserpine, or other medicine for high blood pressure because their effectiveness may be decreased by SymPak DM

This may not be a complete list of all interactions that may occur. Ask your health care provider if SymPak DM may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use SymPak DM:

Use SymPak DM as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • Take SymPak DM by mouth with or without food.
  • Swallow SymPak DM whole. Do not break, crush, or chew before swallowing. Some brands of SymPak DM may be broken in half before taking. If you have difficulty swallowing the whole tablet, ask your pharmacist if your brand of medicine may be broken in half.
  • This product contains 2 different tablets; one for the morning and one for the evening. Be sure you understand how to take SymPak DM. Check with your doctor or pharmacist if you are not sure which tablet to take in the morning or in the evening.
  • If you miss a dose of SymPak DM and you are taking it regularly, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use SymPak DM.

Important safety information:

  • SymPak DM may cause drowsiness, dizziness, or blurred vision. These effects may be worse if you take it with alcohol or certain medicines. Use SymPak DM with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
  • Do not drink alcohol or use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are using SymPak DM; it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness.
  • The risk of dizziness, nervousness, and trouble sleeping may be greater if you take SymPak DM in high doses or for a long time. Do NOT take more than the recommended dose without checking with your doctor.
  • If your cough or other symptoms persist for more than 1 week, come back, or if you also have fever, rash, or persistent headache, check with your doctor.
  • SymPak DM may interfere with certain lab test results. Be sure your doctors and laboratory personnel know that you are taking SymPak DM.
  • Tell your doctor or dentist that you take SymPak DM before you receive any medical or dental care, emergency care, or surgery.
  • SymPak DM may cause dry mouth. To relieve dry mouth, suck on sugarless hard candy or ice chips, chew sugarless gum, drink water, or use a saliva substitute.
  • SymPak DM may reduce sweating. Do not become overheated in hot weather or during exercise or other activities because heatstroke may occur.
  • SymPak DM has phenylephrine, chlorpheniramine, and dextromethorphan in it. Before you start any new medicine, check the label to see if it has phenylephrine, chlorpheniramine, and dextromethorphan in it too. If it does or if you are not sure, check with your doctor or pharmacist.
  • Do not take diet or appetite control medicines while you are taking SymPak DM without checking with your doctor.
  • Diabetes patients - SymPak DM may affect your blood sugar. Check blood sugar levels closely and ask your doctor before adjusting the dose of your diabetes medicine.
  • Use SymPak DM with caution in the ELDERLY; they may be more sensitive to its effects.
  • SymPak DM should be used with extreme caution in CHILDREN younger than 6 years old; safety and effectiveness in these children have not been confirmed.
  • Caution is advised when using SymPak DM in CHILDREN; they may be more sensitive to its effects, especially excitability.
  • PREGNANCY and BREAST-FEEDING: It is not known if SymPak DM can cause harm to the fetus. If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using SymPak DM while you are pregnant. SymPak DM is found in breast milk. Do not breast-feed while taking SymPak DM.

Possible side effects of SymPak DM:

All medicines may cause side effects, but many people have no, or minor side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Blurred vision; dizziness; drowsiness; dry mouth, nose, or throat; excitability or irritability (especially in children); giddiness; headache; lightheadedness; nausea; nervousness; trouble sleeping; unusual tiredness or weakness.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); fast or irregular heartbeat; flushing; hallucinations; mental or mood changes; seizures severe drowsiness; tremor; vomiting.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately.

Proper storage of SymPak DM:

Store SymPak DM in a tightly closed container between 68 and 77 degrees F (20 and 25 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep SymPak DM out of the reach of children and away from pets.

General information:

  • If you have any questions about SymPak DM, please talk with your doctor, pharmacist, or other health care provider.
  • SymPak DM is to be used only by the patient for whom it is prescribed. Do not share it with other people.
  • If your symptoms do not improve or if they become worse, check with your doctor.
  • Check with your pharmacist about how to dispose of unused medicine.

This information is a summary only. It does not contain all information about SymPak DM. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Issue Date: April 2, 2014
Database Edition 14.2.1.001
Copyright © 2014 Wolters Kluwer Health, Inc.

Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.

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