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Guaifenesin and Phenylephrine

Pronunciation

(gwye FEN e sin & fen il EF rin)

Index Terms

  • Guaifenesin and Phenylephrine Tannate
  • Guaifenesin/Phenylephrine HCl
  • Phenylephrine Hydrochloride and Guaifenesin

Dosage Forms

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Liquid, oral:

Ed Bron GP: Guaifenesin 100 mg and phenylephrine hydrochloride 5 mg per 5 mL (480 mL) [dye free, ethanol free, sugar free; contains propylene glycol; orange flavor]

Mucinex® Cold: Guaifenesin 100 mg and phenylephrine hydrochloride 2.5 mg per 5 mL (480 mL) [contains propylene glycol, sodium 3 mg/5 mL; mixed berry flavor]

Nu-COPD: Guaifenesin 200 mg and phenylephrine hydrochloride 10 mg per 5 mL (480 mL)

Rescon GG: Guaifenesin 100 mg and phenylephrine hydrochloride 5 mg per 5 mL (120 mL [DSC], 480 mL [DSC]) [dye free, ethanol free; contains propylene glycol; wild cherry flavor]

Syrup, oral:

J-Max: Guaifenesin 200 mg and phenylephrine hydrochloride 5 mg per 5 mL (473 mL) [ethanol free, sugar free; contains propylene glycol; strawberry cream flavor]

Triaminic® Children's Chest & Nasal Congestion: Guaifenesin 50 mg and phenylephrine hydrochloride 2.5 mg per 5 mL (118 mL) [contains benzoic acid, propylene glycol, sodium 3 mg/5 mL; tropical flavor]

Tablet, oral:

Ambi 10PEH/400GFN: Guaifenesin 400 mg and phenylephrine hydrochloride 10 mg

Deconex IR: Guaifenesin 385 mg and phenylephrine hydrochloride 10 mg [contains tartrazine]

Fenesin PE IR: Guaifenesin 400 mg and phenylephrine hydrochloride 10 mg

Liquibid® D-R: Guaifenesin 400 mg and phenylephrine hydrochloride 10 mg

Liquibid® PD-R: Guaifenesin 200 mg and phenylephrine hydrochloride 5 mg

Medent®-PEI: Guaifenesin 400 mg and phenylephrine hydrochloride 10 mg

MucaphEd: Guaifenesin 400 mg and phenylephrine hydrochloride 10 mg

Mucus Relief Sinus: Guaifenesin 400 mg and phenylephrine hydrochloride 10 mg

Nu-COPD: Guaifenesin 400 mg and phenylephrine hydrochloride 10 mg

OneTab™ Congestion & Cold: Guaifenesin 400 mg and phenylephrine hydrochloride 10 mg

Refenesen™ PE: Guaifenesin 400 mg and phenylephrine hydrochloride 10 mg

Relcof IR: Guaifenesin 380 mg and phenylephrine hydrochloride 10 mg

Sudafed PE® Non-Drying Sinus: Guaifenesin 200 mg and phenylephrine hydrochloride 5 mg

Brand Names: U.S.

  • Ambi 10PEH/400GFN [OTC]
  • Deconex IR [OTC]
  • Ed Bron GP [OTC]
  • Fenesin PE IR
  • J-Max [OTC]
  • Liquibid® D-R [OTC]
  • Liquibid® PD-R [OTC]
  • Medent®-PEI [OTC]
  • MucaphEd [OTC]
  • Mucinex® Cold [OTC]
  • Mucus Relief Sinus [OTC]
  • Nu-COPD [OTC]
  • OneTab™ Congestion & Cold [OTC]
  • Refenesen™ PE [OTC]
  • Relcof IR [OTC]
  • Rescon GG [OTC] [DSC]
  • Sudafed PE® Non-Drying Sinus [OTC]
  • Triaminic® Children's Chest & Nasal Congestion [OTC]

Pharmacologic Category

  • Decongestant
  • Expectorant

Pharmacology

See individual agents.

Use: Labeled Indications

Temporary relief of nasal congestion, sinusitis, rhinitis, and hay fever; temporary relief of cough associated with upper respiratory tract conditions, especially when associated with dry, nonproductive cough

Contraindications

Hypersensitivity to guaifenesin, phenylephrine, sympathomimetic amines, or any component of the formulation; severe hypertension; severe cardiovascular disease; use with or within 2 weeks of discontinuing MAO inhibitor

Dosing: Adult

Expectorant/decongestant: Oral (Rescon GG): 10 mL every 4-6 hours; maximum: 40 mL/24 hours

Dosing: Geriatric

Refer to adult dosing.

Dosing: Pediatric

Expectorant/decongestant: Oral:

Children 2-5 years (Rescon GG): 2.5 mL every 4-6 hours; maximum: 10 mL/24 hours

Children 6-11 years (Rescon GG): 5 mL every 4-6 hours; maximum: 20 mL/24 hours

Children ≥12 years (Rescon GG): Refer to adult dosing

Dietary Considerations

May be taken with or without food. Taking with food, water or milk may help decrease gastric irritation. Some products may contain sodium.

Drug Interactions

Acetaminophen: May increase the serum concentration of Phenylephrine (Systemic). Monitor therapy

Alpha1-Blockers: May diminish the vasoconstricting effect of Alpha1-Agonists. Similarly, Alpha1-Agonists may antagonize Alpha1-Blocker vasodilation. Monitor therapy

AtoMOXetine: May enhance the hypertensive effect of Sympathomimetics. AtoMOXetine may enhance the tachycardic effect of Sympathomimetics. Monitor therapy

Benzylpenicilloyl Polylysine: Alpha1-Agonists may diminish the diagnostic effect of Benzylpenicilloyl Polylysine. Management: Consider use of a histamine skin test as a positive control to assess a patient's ability to mount a wheal and flare response. Consider therapy modification

Cannabinoid-Containing Products: May enhance the tachycardic effect of Sympathomimetics. Exceptions: Cannabidiol. Monitor therapy

Doxofylline: Sympathomimetics may enhance the adverse/toxic effect of Doxofylline. Monitor therapy

Ergot Derivatives: May enhance the hypertensive effect of Alpha1-Agonists. Ergot Derivatives may enhance the vasoconstricting effect of Alpha1-Agonists. Exceptions: Ergoloid Mesylates; Nicergoline. Avoid combination

FentaNYL: Alpha1-Agonists may decrease the serum concentration of FentaNYL. Specifically, fentanyl nasal spray serum concentrations may decrease and onset of effect may be delayed. Monitor therapy

Hyaluronidase: May enhance the vasoconstricting effect of Phenylephrine (Systemic). Management: Avoid the use of hyaluronidase to enhance dispersion or absorption of phenylephrine. Use of hyaluronidase for other purposes in patients receiving phenylephrine may be considered as clinically indicated. Avoid combination

Iobenguane I 123: Sympathomimetics may diminish the therapeutic effect of Iobenguane I 123. Avoid combination

Ioflupane I 123: Phenylephrine (Systemic) may diminish the diagnostic effect of Ioflupane I 123. Monitor therapy

Linezolid: May enhance the hypertensive effect of Sympathomimetics. Management: Reduce initial doses of sympathomimetic agents, and closely monitor for enhanced pressor response, in patients receiving linezolid. Specific dose adjustment recommendations are not presently available. Consider therapy modification

MAO Inhibitors: May enhance the hypertensive effect of Alpha1-Agonists. While linezolid is expected to interact via this mechanism, management recommendations differ from other monoamine oxidase inhibitors. Refer to linezolid specific monographs for details. Exceptions: Linezolid; Tedizolid. Avoid combination

Propacetamol: May increase the serum concentration of Phenylephrine (Systemic). Management: Monitor patients closely for increased side effects of phenylephrine if propacetamol is used concomitantly. Patients with underlying blood pressure issues or arrhythmias may need closer monitoring and may warrant consideration of alternative therapies. Monitor therapy

Sympathomimetics: May enhance the adverse/toxic effect of other Sympathomimetics. Monitor therapy

Tedizolid: May enhance the hypertensive effect of Sympathomimetics. Tedizolid may enhance the tachycardic effect of Sympathomimetics. Monitor therapy

Tricyclic Antidepressants: May enhance the vasopressor effect of Alpha1-Agonists. Tricyclic Antidepressants may diminish the vasopressor effect of Alpha1-Agonists. Monitor therapy

Adverse Reactions

See individual agents.

Warnings/Precautions

Disease-related concerns:

• Cardiovascular disease: Use with caution in patients with cardiovascular disease (including hypertension and ischemic heart disease); contraindicated with severe disease.

• Diabetes: Use with caution in patients with diabetes mellitus.

• Increased intraocular pressure/glaucoma: Use with caution in patients with increased intraocular pressure or glaucoma.

• Prostatic hyperplasia/urinary obstruction: Use with caution in patients with prostatic hyperplasia and/or GU obstruction.

• Thyroid dysfunction: Use with caution in patients with thyroid dysfunction.

Special populations:

• Elderly: Use with caution in the elderly; may be more sensitive to adverse effects.

Other warnings/precautions:

• Cough: Appropriate use: Underlying cause of cough should be determined prior to prescribing.

Pregnancy Considerations

See individual agents.

Patient Education

• Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?)

• Patient may experience dizziness, anxiety, insomnia, or fatigue (HCAHPS).

• Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions.

Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for healthcare professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience and judgment in diagnosing, treating and advising patients.

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