MUCINEX SINUS-MAX DAY NIGHT Lifestyle Interactions

Acetaminophen 325mg, DM HBr 10mg, Doxylamine Succinate 6.25mg, Phenylephrine HCl 5mg, Oral capsule, liquid filled

Tobacco

· Severity: Moderate

· Notes for Consumers: If you are a tobacco smoker, use of Acetaminophen can increase the risk of liver side effects. Immediately tell your doctor if you get severe abdominal pain, nausea, vomiting, or yellowing of the skin. Do not exceed 4 g acetaminophen/day in adults. Tell your doctor if Acetaminophen does not help your headache or other pain. Tobacco smoke may reduce the effectiveness of Acetaminophen.

· Notes for Professionals: Tobacco smoking induces the cytochrome P450 isoenzyme CYP1A2 and may potentially increase the risk for acetaminophen-induced hepatotoxicity during overdose via enhanced generation of acetaminophen's hepatotoxic metabolite, NAPQI. In one study, current tobacco smoking was found to be very frequent in patients admitted with acetaminophen poisoning. Tobacco smoking appears to be an independent risk factor of severe hepatotoxicity, acute liver failure and death following acetaminophen overdose.

Acetaminophen 325mg, DM HBr 10mg, Guaifenesin 200mg, Phenylephrine Hydrochloride 5mg, Oral capsule, liquid filled

Caffeine-containing Foods/Beverages

· Severity: Moderate

· Notes for Consumers: Limit caffeine intake (examples: coffee, teas, colas, chocolate and some herbal supplements) while taking Phenylephrine. Also avoid medicines containing additional Caffeine whenever possible. Side effects from Phenylephrine may get worse if you take excessive Caffeine. Taking a high amount of Caffeine can increase the risk of nausea, nervousness, palpitations, problems with sleep, rapid heartbeat, tremor, or other side effects.

· Notes for Professionals: Caffeine is a CNS-stimulant and such actions are expected to be additive when coadministered with other CNS stimulants or psychostimulants.

Acetaminophen 325mg, DM HBr 10mg, Doxylamine Succinate 6.25mg, Phenylephrine HCl 5mg, Oral capsule, liquid filled

Alcohol

· Severity: Major

· Notes for Consumers: Patients who drink more than 3 alcohol-containing drinks a day and take Acetaminophen are at increased risk of developing liver side effects. Limit alcohol intake while taking Acetaminophen. Avoid alcohol-containing drinks if you are taking Acetaminophen on a regular basis.

· Notes for Professionals: The risk of developing hepatotoxicity from acetaminophen appears to be increased in patients who regularly consume alcohol. Patients who drink more than 3 alcohol-containing drinks a day and take acetaminophen are at increased risk of developing hepatotoxicity. Acute or chronic alcohol use increases acetaminophen-induced hepatotoxicity by inducing cytochrome P450 CYP 2E1 leading to increased formation of the hepatotoxic metabolite of acetaminophen. Also, chronic alcohol use can deplete liver glutathione stores. Administration of acetaminophen should be limited or avoided altogether in patients with alcoholism or patients who consume alcohol regularly.

Acetaminophen 325mg, DM HBr 10mg, Doxylamine Succinate 6.25mg, Phenylephrine HCl 5mg, Oral capsule, liquid filled

Alcohol

· Severity: Moderate

· Notes for Consumers: It is best to limit or avoid alcoholic drinks while you are taking this medicine. Using this medicine with alcohol can lead to additive side effects such as increased drowsiness. Do not drive or operate machinery if you are drinking alcohol-containing beverages. If you notice slurred speech, confusion, severe weakness, or difficulty breathing, contact your health care provider immediately.

· Notes for Professionals: Drowsiness may occur with the use of sedating antihistamines. Caution patients about the simultaneous use of alcohol, and caution that the effects of alcohol may be increased. Additive drowsiness and psychomotor impairment may occur.

Acetaminophen 325mg, DM HBr 10mg, Guaifenesin 200mg, Phenylephrine Hydrochloride 5mg, Oral capsule, liquid filled

Alcohol

· Severity: Major

· Notes for Consumers: Patients who drink more than 3 alcohol-containing drinks a day and take Acetaminophen are at increased risk of developing liver side effects. Limit alcohol intake while taking Acetaminophen. Avoid alcohol-containing drinks if you are taking Acetaminophen on a regular basis.

· Notes for Professionals: The risk of developing hepatotoxicity from acetaminophen appears to be increased in patients who regularly consume alcohol. Patients who drink more than 3 alcohol-containing drinks a day and take acetaminophen are at increased risk of developing hepatotoxicity. Acute or chronic alcohol use increases acetaminophen-induced hepatotoxicity by inducing cytochrome P450 CYP 2E1 leading to increased formation of the hepatotoxic metabolite of acetaminophen. Also, chronic alcohol use can deplete liver glutathione stores. Administration of acetaminophen should be limited or avoided altogether in patients with alcoholism or patients who consume alcohol regularly.

Acetaminophen 325mg, DM HBr 10mg, Doxylamine Succinate 6.25mg, Phenylephrine HCl 5mg, Oral capsule, liquid filled

Caffeine-containing Foods/Beverages

· Severity: Moderate

· Notes for Consumers: Limit caffeine intake (examples: coffee, teas, colas, chocolate and some herbal supplements) while taking Phenylephrine. Also avoid medicines containing additional Caffeine whenever possible. Side effects from Phenylephrine may get worse if you take excessive Caffeine. Taking a high amount of Caffeine can increase the risk of nausea, nervousness, palpitations, problems with sleep, rapid heartbeat, tremor, or other side effects.

· Notes for Professionals: Caffeine is a CNS-stimulant and such actions are expected to be additive when coadministered with other CNS stimulants or psychostimulants.

Acetaminophen 325mg, DM HBr 10mg, Guaifenesin 200mg, Phenylephrine Hydrochloride 5mg, Oral capsule, liquid filled

Tobacco

· Severity: Moderate

· Notes for Consumers: If you are a tobacco smoker, use of Acetaminophen can increase the risk of liver side effects. Immediately tell your doctor if you get severe abdominal pain, nausea, vomiting, or yellowing of the skin. Do not exceed 4 g acetaminophen/day in adults. Tell your doctor if Acetaminophen does not help your headache or other pain. Tobacco smoke may reduce the effectiveness of Acetaminophen.

· Notes for Professionals: Tobacco smoking induces the cytochrome P450 isoenzyme CYP1A2 and may potentially increase the risk for acetaminophen-induced hepatotoxicity during overdose via enhanced generation of acetaminophen's hepatotoxic metabolite, NAPQI. In one study, current tobacco smoking was found to be very frequent in patients admitted with acetaminophen poisoning. Tobacco smoking appears to be an independent risk factor of severe hepatotoxicity, acute liver failure and death following acetaminophen overdose.

Acetaminophen 325mg, DM HBr 10mg, Guaifenesin 200mg, Phenylephrine Hydrochloride 5mg, Oral capsule, liquid filled

Grapefruit juice

· Severity: Mild

· Notes for Consumers: Grapefruit juice may increase the actions of Dextromethorphan, which may make some people feel drowsiness or other side effects (dizziness, nervousness or restlessness, nausea, vomiting, stomach upset) of Dextromethorphan that do not usually occur with prescribed or nonprescription product doses. It may be best to limit intake of grapefruit juice while you are taking Dextromethorphan-containing products.

· Notes for Professionals: Intake of grapefruit juice or seville orange juice increased dextromethorphan bioavailability in one study. Patients with increased concentrations of dextromethorphan may experience drowsiness or serotonergic side effects (dizziness, nervousness or restlessness, nausea, vomiting, stomach upset) not usually noted with prescribed or nonprescription product doses. Grapefruit juice and seville orange juice contain compounds that can inhibit P-glycoprotein in the intestinal wall, and dextromethorphan absorption may be affected by P-glycoprotein activity. Dextromethorphan is largely metabolized by CYP2D6, so this particular interaction with grapefruit juice may be more relevant in patients who are poor CYP2D6 metabolizers.

Acetaminophen 325mg, DM HBr 10mg, Doxylamine Succinate 6.25mg, Phenylephrine HCl 5mg, Oral capsule, liquid filled

Grapefruit juice

· Severity: Mild

· Notes for Consumers: Grapefruit juice may increase the actions of Dextromethorphan, which may make some people feel drowsiness or other side effects (dizziness, nervousness or restlessness, nausea, vomiting, stomach upset) of Dextromethorphan that do not usually occur with prescribed or nonprescription product doses. It may be best to limit intake of grapefruit juice while you are taking Dextromethorphan-containing products.

· Notes for Professionals: Intake of grapefruit juice or seville orange juice increased dextromethorphan bioavailability in one study. Patients with increased concentrations of dextromethorphan may experience drowsiness or serotonergic side effects (dizziness, nervousness or restlessness, nausea, vomiting, stomach upset) not usually noted with prescribed or nonprescription product doses. Grapefruit juice and seville orange juice contain compounds that can inhibit P-glycoprotein in the intestinal wall, and dextromethorphan absorption may be affected by P-glycoprotein activity. Dextromethorphan is largely metabolized by CYP2D6, so this particular interaction with grapefruit juice may be more relevant in patients who are poor CYP2D6 metabolizers.

<b>DISCLAIMER:</b><em> This drug information content is provided for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Patients should always consult their physician with any questions regarding a medical condition and to obtain medical advice and treatment. Drug information is sourced from GSDD (Gold Standard Drug Database ) provided by Elsevier.</em>

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