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What should I discuss with my health care provider before taking acetaminophen, codeine, guaifenesin, and phenylephrine (Phenflu CD, Phenflu CDX)?

Do not use a cough or cold medicine if you have used an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days. Serious, life-threatening side effects can occur if you take cough or cold medicine before the MAO inhibitor has cleared from your body.

You should not use acetaminophen, codeine, guaifenesin, and phenylephrine if you have ever had an allergic reaction to it, or if you have:

• severe or uncontrolled high blood pressure;
• severe coronary artery disease;
• enlarged prostate;
• if you are breast-feeding a baby; or
• if you are having an asthma attack.

If you have certain conditions, you may need a dose adjustment or special tests to safely take acetaminophen, codeine, guaifenesin, and phenylephrine. Before taking this medication, tell your doctor if you have:

• heart disease or high blood pressure;
• ischemic heart disease (reduced circulation of blood to the heart);
• asthma, COPD, or other breathing disorder;
• diabetes;
• glaucoma;
• a history of head injury or brain tumor;
• epilepsy or other seizure disorder;
• a thyroid disorder;
• kidney or liver disease;
• a stomach or intestinal disorder;
• Addison's disease or other adrenal gland disorders; or
• if you have recently had surgery on your stomach, intestines, kidney, or bladder.

FDA pregnancy category C. It is not known whether this medication is harmful to an unborn baby. Codeine can cause breathing problems or addiction/withdrawal symptoms in a newborn. Before taking this medication, tell your doctor if you are pregnant or plan to become pregnant during treatment.

This medication can pass into breast milk and may harm a nursing baby. The use of codeine by some nursing mothers may lead to life-threatening side effects in the baby. Do not use this medication if you are breast-feeding a baby.

Codeine may be habit-forming and should be used only by the person it was prescribed for. This medication should never be shared with another person, especially someone who has a history of drug abuse or addiction. Keep the medication in a secure place where others cannot get to it.

Older adults may be more likely to have side effects from this medication.

How should I take acetaminophen, codeine, guaifenesin, and phenylephrine (Phenflu CD, Phenflu CDX)?

Take this medication exactly as it was prescribed for you. Do not take it in larger amounts, or use it for longer than recommended by your doctor. Follow the directions on your prescription label. Cough and cold medicine is usually taken for only a short time until your symptoms clear up.

Take this medicine with food or milk if it upsets your stomach.

An overdose of acetaminophen can cause serious harm. The maximum amount of acetaminophen for adults is 1 gram (1000 mg) per dose and 4 grams (4000 mg) per day. Taking more acetaminophen could cause damage to your liver. Know the amount of acetaminophen in the specific product you are taking.

Do not give this medication to a child younger than 2 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.

Call your doctor if your cough does not improve after 5 days of treatment, or if you also have a fever.

This medication can cause you to have unusual results with certain medical tests. Tell any doctor who treats you that you are using acetaminophen, codeine, guaifenesin, and phenylephrine.

Store the medicine at room temperature away from moisture, heat, and light.

Keep track of how many pills have been used from each bottle of this medication. Codeine is a drug of abuse and you should be aware if any person in the household is using this medicine improperly or without a prescription.

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