ACTION AND MECHANISM

- Combination of an [ANALGESIC] [ANTIPYRETIC], a [HISTAMINERGIC (H-1) ANTAGONIST] and a [NASO/PHARYNGEAL DECONGESTANT]. Acetylsalicylic acid exerts analgesic and antipyretic effects due to the inhibition of central prostaglandin synthesis. Phenylephrine is an alpha-1 adrenergic agonist, which causes vasoconstriction, reducing nasal congestion. Finally, chlorphenamine acts as a histaminergic and muscarinic antagonist, eliminating cold symptoms such as sneezing, whining or rhinorrhea.

SPECIAL WARNINGS

- Dosage adjustments may be necessary when administering products containing acetylsalicylic acid to patients treated with anticoagulants, phenytoin, digoxin or methotrexate, among others.

SENIORS

Elderly patients may be more susceptible to the adverse effects of this medication, so it is recommended to use it with caution and discontinue its administration if adverse reactions are not tolerable.

PATIENT ADVICE

- This medicine should be administered after meals.
- It is advisable to drink plenty of water during treatment, avoiding alcoholic beverages as much as possible.
- It is recommended not to exceed the recommended daily doses and avoid treatments lasting longer than ten days without a doctor's prescription.
- If the fever persists for more than 3 days or symptoms continue or worsen after 5 days, it is recommended to consult a doctor.
- Before starting treatment, the doctor must be notified of any illness the patient suffers from or any medication he or she is taking.
- It is advisable to see a doctor if you experience blood in your stool or vomit, stomach pain, general weakness, dizziness, or the perception of beeping or whistling sounds.
- It can cause drowsiness, so it is recommended to be cautious when driving and not to combine it with medications or other sedative substances such as alcohol.
- Do not administer products containing acetylsalicylic acid to children under 16 years of age.
- It is advisable to discontinue treatment several days before surgery.

CONTRAINDICATIONS

- Hypersensitivity to any component of the medication, such as [SALICYLATE ALLERGY] or [NSAID ALLERGY].
- [PEPTIC ULCER], [GASTROINTESTINAL HEMORRHAGE]. Gastric mucosal erosion may be increased.
- [COAGULATION DISORDERS], such as [HEMOPHILIA], [HYPOPROTHROMBINEMIA] or [VITAMIN K DEFICIENCY]. ASA increases the risk of bleeding due to its antiplatelet effects.
- [PORPHYRIA]. H1 antihistamines are not considered safe in patients with porphyria.
- Children under 16 years of age, since the use of acetylsalicylic acid has been linked to Reye's Syndrome.
- Severe heart disease or uncontrolled diabetes mellitus. There is a risk of severe decompensation.
- Patients receiving treatment with MAOI antidepressants in the 14 days prior to starting phenylephrine therapy (See Interactions).

EFFECTS ON DRIVING

This medication may substantially impair the ability to drive and/or operate machinery. Patients should avoid operating hazardous machinery, including automobiles, until they are reasonably certain that drug treatment does not adversely affect them.

PREGNANCY

Some active ingredients in this specialty are capable of crossing the placental barrier.
Aspirin: Epidemiological studies suggest an increased risk of miscarriage and congenital malformations (including cardiac malformations and gastroschisis). During the first and second trimesters of pregnancy, aspirin should not be administered unless strictly necessary, with the lowest possible dose and the shortest possible duration of treatment. During the third trimester of pregnancy, the use of prostaglandin synthesis inhibitors may expose the fetus to cardiopulmonary toxicity (with premature closure of the ductus arteriosus and pulmonary hypertension) and renal impairment, which may lead to renal failure and oligohydramnios. Therefore, salicylates should only be taken during pregnancy after a strict benefit-risk assessment, and are contraindicated during the third trimester.
Phenylephrine: No controlled studies have been conducted in humans. It causes contraction of smooth muscles, including the urinary sphincter and uterus. Sympathomimetics with vasoconstrictive effects may reduce placental perfusion and should therefore not be used during pregnancy.
Chlorphenamine: Animal studies have not demonstrated adverse effects on the fetus. No controlled studies have been conducted in humans.
There is insufficient data on the use of the active ingredients of this medicine in pregnant women.
This medicine should not be used during pregnancy unless the potential benefit justifies any potential risk to the fetus.

INDICATIONS

- [COMMON COLD]. Symptomatic treatment of catarrhal processes and [FLU] that present with fever, moderate pain, headache, watery eyes, nasal congestion and rhinorrhea.

INTERACTIONS

- Acetazolamide. ASA has led to increases in acetazolamide levels of up to 80–200%, probably due to displacement from plasma protein binding. There is a risk of poisoning, so its administration is recommended to be avoided. Furthermore, acetazolamide may cause systemic acidosis, potentially delaying salicylate elimination. Although no cases of this interaction have been reported with other carbonic anhydrase inhibitors, it cannot be ruled out.
- Urinary acidifiers (ascorbic acid, ammonium chloride, methionine) or urinary alkalizers (absorbable antacids). ASA is a weak acid whose elimination in urine depends on urinary pH. Drugs that lower pH will decrease renal elimination, while those that increase pH will increase elimination.
- Tiludronic acid. A pharmacokinetic interaction has been detected, as ASA could decrease tiludronate bioavailability by up to 50% when taken within an hour of tiludronate. It is recommended to separate administrations of these drugs by at least 2 hours.
- Valproic acid. Increased valproate levels have been reported in association with the administration of aspirin. The interaction could be due to competition between the two drugs for the same renal elimination mechanism. Dosage adjustment may be necessary.
- NSAIDs. The coadministration of aspirin with other NSAIDs, including coxibs, may increase the risk of peptic ulcers and gastric bleeding. Furthermore, aspirin has been shown to reduce plasma levels of other NSAIDs, especially those with arylpropionic acid structures such as ibuprofen.
-Aliskiren. Possible reduction in the antihypertensive effect of aliskiren (NSAIDs act on the renin-angiotensin system). In patients with compromised renal function (dehydrated or elderly), this may precipitate deterioration of renal function (possible acute renal failure, usually reversible). Caution should be exercised, especially in the elderly, with monitoring of the antihypertensive effect and renal function.
- Antacids. Antacids may delay and decrease the absorption of ASA. Furthermore, absorbable antacids may increase the elimination of ASA.
- Antiplatelet agents. Clopidogrel and ticlopidine may enhance the antiplatelet effects of aspirin. Dipyridamole, in turn, has increased Cmax and AUC by 31.5% and 37%, respectively, in pharmacokinetic studies, probably due to inhibition of metabolism, with the consequent risk of toxicity. In the case of prasugrel, concomitant administration is indicated, since the efficacy and safety of prasugrel were studied in patients receiving aspirin.
- Oral anticoagulants. ASA has been shown to potentiate the effects of anticoagulants such as acenocoumarol, with a consequent risk of bleeding, particularly of gastric origin. This interaction could be due to the hypoprothrombinemic effects of ASA at high doses (more than 3 g) or to the inhibition of platelet aggregation. The administration of single doses of ASA does not appear to entail a significant risk. However, it is advisable to avoid the combination in patients treated with ASA for long periods, using salicylates or other NSAIDs without antiplatelet effects. If this is not possible, extreme caution should be exercised and the INR monitored.
- Antiulcer drugs. Pharmacokinetic studies have shown that the increase in gastric pH produced by H2 antihistamines or hydrogen pump inhibitors could increase the absorption of ASA, with a possible risk of poisoning. In patients receiving high doses of ASA, a dosage reduction may be necessary.
- Barbiturates. ASA may increase barbiturate concentrations, with the consequent risk of poisoning.
- Beta-blockers. Administration of aspirin at high doses, above 2 g, has resulted in a decrease in the antihypertensive effects of beta-blockers. Although the cause is unknown, it is likely due to the inhibition of prostaglandin synthesis, which appears to mediate the antihypertensive effects of beta-blockers. Therefore, it is recommended to avoid high-dose aspirin in patients receiving a beta-blocker.
- Cyclosporine. NSAIDs may increase cyclosporine-induced nephrotoxicity. Periodic assessment of renal function is recommended, especially in the elderly.
- Corticosteroids. There is an increased risk of damage to the gastric mucosa. Furthermore, corticosteroids appear to reduce plasma levels of aspirin, although the mechanism is unclear. However, it is thought that this could be due to an increase in glomerular filtration and a decrease in tubular reabsorption. For its part, aspirin could displace corticosteroids from protein binding, leading to toxic effects.
- Digoxin. ASA may increase digoxin concentrations, increasing the risk of toxicity. Dosage adjustment may be necessary.
- Diuretics. Several trials have shown that aspirin may slightly reduce the diuretic effects of drugs such as furosemide and the natriuretic agents spironolactone. Furthermore, acute kidney failure may be more common, especially in dehydrated patients treated with thiazide diuretics.
- Ototoxic drugs. ASA may increase the ototoxicity of drugs such as aminoglycosides, cisplatin, erythromycin, furosemide, or vancomycin, especially at high doses.
- Phenytoin. ASA may, at high doses, displace phenytoin from its protein binding sites, leading to toxic effects. However, symptoms of this interaction usually do not appear, as free phenytoin undergoes redistribution into tissues, decreasing its plasma concentrations. Patient monitoring is recommended.
- Griseofulvin. Griseofulvin may significantly decrease the absorption of ASA, so it is recommended to avoid the combination.
- Heparin. A large number of cases have been described in which the administration of heparin with aspirin resulted in enhanced anticoagulant effects, with an increased risk of bleeding. Although heparin has been combined with aspirin to reduce mortality associated with postoperative thromboembolism, the risk should be assessed in each patient, and their coagulation parameters monitored.
- Ibuprofen. Experimental data suggest that ibuprofen may inhibit the effect of
Low-dose aspirin has been shown to have an effect on platelet aggregation when administered concomitantly. However, there is no clinical evidence, and occasional use of ibuprofen is unlikely to have a significant effect.
- ACE inhibitors. Studies have shown an antagonistic effect of NSAIDs at doses greater than 1 g on ACE inhibitors, probably due to the inhibition of prostaglandin synthesis, which have vasodilatory effects. Regular blood pressure monitoring is recommended.
- SSRIs. There is an increased risk of bleeding in general, and gastric bleeding in particular, so it is recommended to avoid the combination.
- Lithium. ASA may decrease lithium clearance, increasing the risk of lithium poisoning. Dosage adjustment may be necessary.
- Methotrexate. Numerous cases have been reported in which the administration of aspirin potentiated the effects of methotrexate. These effects could be due to the displacement of methotrexate from its protein binding sites by aspirin, or to decreased renal clearance due to inhibition of tubular secretion. This effect is especially significant in elderly patients with renal failure. Extreme caution is recommended, given the risk of severe pancytopenia.
- Nitroglycerin. Pharmacokinetic studies have shown that aspirin may increase plasma nitroglycerin levels by up to 54%, perhaps due to a decrease in hepatic flow and nitroglycerin metabolism. Conversely, prolonged treatment with aspirin resulted in an increased requirement for nitroglycerin for the same effect, perhaps due to a decrease in the production of vasodilatory prostaglandins. Patient monitoring is recommended.
- Pentazocine. A case of reversible renal toxicity from ASA has been reported with the addition of pentazocine. It is recommended to assess the patient's renal function.
- Sulfonylureas. Administration of aspirin at high doses, above 2 g, may potentiate the hypoglycemic effects of sulfonylureas. The mechanism is unknown, but aspirin may displace sulfonylureas from their plasma protein binding sites, while also reducing the renal elimination of some of them, such as chlorpropamide. Monitoring blood glucose is recommended, especially when starting and stopping treatment with aspirin, and adjusting the dosage of the sulfonylurea if necessary.
- Uricosurics. ASA has uricosuric effects at high doses, above 3 g, but at low doses, it has been shown to antagonize the effects of probenecid or sulfinpyrazone. Furthermore, uricosurics may decrease the elimination of ASA. Accumulation of uric acid and ASA may occur. Therefore, the combination is recommended to be avoided.
- Verapamil. Cases of verapamil potentiating the antiplatelet effects of aspirin have been reported. Patient monitoring is recommended.
- Zafirlukast. Pharmacokinetic studies have shown that aspirin may increase zafirlukast levels by up to 45%, with a potential risk of toxicity. Patient monitoring is recommended.
- Zidovudine. Plasma concentrations of zidovudine may be increased by competitively inhibiting glucuronidation or by directly inhibiting microsomal metabolism.
hepatic, which can reach toxic levels. Caution should be exercised. It also increases the toxicity of aspirin.
- Food. Pharmacokinetic studies have shown that administering ASA after meals can reduce absorption by up to 50%. Therefore, if rapid effects are desired, it is advisable to administer ASA on an empty stomach. However, administration with meals reduces the risk of gastric irritation.
- Ethyl alcohol. There is an increased risk of gastric damage, so it is recommended to avoid alcohol consumption, especially within 8-10 hours after a dose of ASA. Patients who consume more than three alcoholic drinks daily should avoid using ASA and replace it with another NSAID.

LACTATION

Salicylates and their metabolites are excreted in breast milk in small amounts.
Since no adverse effects have been observed in newborns following occasional use of salicylates, discontinuing breastfeeding is usually not necessary. However, if salicylates are taken regularly or at high doses, breastfeeding should be discontinued promptly.
Phenylephrine: Information is limited regarding the excretion of phenylephrine in human or animal milk. A risk to the nursing infant cannot be ruled out.
Chlorphenamine: Since small amounts of antihistamines are excreted in breast milk, there is a risk of adverse effects in the child, such as unusual excitability, and chlorphenamine may inhibit lactation due to its anticholinergic actions.
This medication should not be used during breastfeeding.

CHILDREN

The use of aspirin in children under 16 years of age with fever associated with viral infections such as influenza or chickenpox has been associated with the development of Reye's syndrome, which is potentially fatal. The use of aspirin-containing products in children under 16 years of age is contraindicated.

RULES FOR CORRECT ADMINISTRATION

The effervescent tablets should be dissolved in half a glass of water and then taken after the effervescence has stopped, preferably after meals. This medication should be started at the first onset of symptoms. As these symptoms disappear, the medication should be discontinued.

POSOLOGY

- Adults, oral: 1 tablet/6-8 hours.
- Children, oral:
* Children 16 years and older: 1 tablet/6-8 hours.
* Children under 16 years of age: The safety and efficacy of this medicine have not been evaluated.

DOSAGE IN LIVER FAILURE

* Serious: Not recommended for use.

DOSAGE IN KIDNEY FAILURE

* Mild or moderate: Caution, due to increased risk of toxicity.
* Serious: Not recommended for use.

PRECAUTIONS

- [KIDNEY FAILURE], [LIVER FAILURE]. Accumulation of the active ingredients in this medicine may occur.
- Patients with [GLAUCOMA], [HEART DISEASE] ([CORONARY HEARING FAILURE], [ISCHAEMIC HEART DISEASE]), [HEART ARRHYTHMIA], [HYPERTHYROIDISM], [PHEOCHROMOCYTOMA], [PROSTATIC HYPERPLASIA], [URINARY BLADDER OBSTRUCTION], [MYASTHENIA GRAVIS] or [INTESTINAL OBSTRUCTION]. Both phenylephrine and chlorphenamine may aggravate symptoms. In severe cases, it may be advisable to avoid administration.
- Chronic [ASTHMA]. There is an increased risk of hypersensitivity reactions and bronchospasm. Furthermore, in these patients, as well as in those with [PULMONARY EMPHYSEMA] or [CHRONIC OBSTRUCTIVE PULMONARY DISEASE], chlorphenamine may worsen the disease due to its anticholinergic effects.
- [DIABETES]. Both phenylephrine and aspirin may alter blood glucose levels, so it is recommended to monitor blood glucose levels periodically.
- [GLUCOSE-6-PHOSPHATE DEHYDROGENASE DEFICIENCY]. ASA may induce the development of hemolytic anemia.
- Uncontrolled [HIGH PRESSURE] or [HEART FAILURE]. ASA or phenylephrine may worsen these conditions.
- [GOUT]. Aspirin can compete with urates for elimination, potentially increasing their levels. Caution is recommended in patients with gout.
- [SURGERY]. It is recommended that influenza products containing ASA be discontinued at least 5-7 days before surgery, due to the risk of bleeding during the procedure.
- [EPILEPSY]. Some H1 antihistamines have been associated with the occurrence of seizures.
- History of peptic ulcer. May cause ulcer reactivation. In cases of active ulcer, it is recommended to avoid administration (See Contraindications).
- Alcohol. Alcohol should not be consumed, as it increases the gastrointestinal side effects of ASA and is a triggering factor in chronic irritation. Regular alcohol consumption can cause gastric bleeding. Furthermore, alcohol enhances the sedative effect of chlorphenamine.
- [HEMORRHAGY]. Concomitant treatment with medications that may increase the risk of bleeding, especially upper gastrointestinal bleeding, such as corticosteroids, NSAIDs, SSRI antidepressants, antiplatelet agents, and anticoagulants, should be avoided. Otherwise, it should be used with caution, and the patient should be warned of possible signs and symptoms (melena, hematemesis, hypotension, cold sweats, abdominal pain, dizziness), as well as the need to discontinue treatment and seek medical advice immediately.
-Medicines containing aspirin should not be given to children, particularly those under 16 years of age and adolescents suffering from viral illnesses with or without fever, without consulting a doctor or pharmacist. In some viral illnesses, especially influenza A, influenza B, and chickenpox, there is a risk of developing Reye's syndrome. The risk of suffering from this disease increases with concomitant use of aspirin; however, no cause-effect relationship has been proven between the two. In some children, aspirin may be, among other factors, a triggering factor in the development of Reye's syndrome. If persistent vomiting or lethargy occur, this could be a symptom of Reye's syndrome, so treatment should be discontinued immediately.

ADVERSE REACTIONS

Adverse reactions are described according to each frequency interval, considering very frequent (>10%), frequent (1-10%), unfrequent (0.1-1%), rare (0.01-0.1%), very rare (<0.01%) or of unknown frequency (cannot be estimated from the available data).
* Adverse reactions due to acetylsalicylic acid:
- Hematological: Common: [HEMORRHAGE] (increased risk), perioperative bleeding, [HEMATOMA], [EPISTAXIS], [GENITOURINARY HEMORRHAGE], [GUM BLEEDING], [HYPOPROTHROMBINEMIA]. Uncommon: [ANEMIA]. Rare: chronic post-hemorrhagic anemia due to hemorrhage or occult bleeding, which will present with typical symptoms such as [ASTHENIA], [PALENESS], hypoperfusion. Very rare: [CEREBRAL HEMORRHAGE], especially in patients with uncontrolled hypertension and concomitantly taking anticoagulant agents.
- Respiratory: Common: [BRONCHIAL SPASM], [DYSPNEA], [RHINITIS], [ASTHMA], [NASAL CONGESTION]. Very rare: [ANAPHYLAXIS].
- Digestive: Common: [GASTRIC ULCER], [DUODENAL ULCER], [GASTROINTESTINAL HEMORRHAGE], [MELA], [HEMATEMESIS], [ABDOMINAL PAIN], [DYSPEPSIA], [VOMITING], [NAUSEA]. Rare: [INFLAMATION] of the intestine. Very rare: [GASTRIC PERFORATION].
- Dermatological: Frequent: [URTICARIA], [EXANTHEMATOUS ERUPTIONS], [ANGIOEDEMA], [PRURITUS].
- Hepatic: Uncommon: [HEPATITIS] (particularly in patients with juvenile arthritis). Very rare: Transient [LIVER FAILURE] with [ELEVATED TRANSAMINASES].
- Neurological/psychological: Unknown frequency: [DIZZINESS], [HEADACHE], [CONFUSION].
- Otics: Unknown frequency: [TINNITUS], [DEAFNESS].
- Genitourinary: Unknown frequency: [RENAL FAILURE], [ACUTE TUBULOINTERSTIAL NEPHRITIS].
- General: Uncommon: [REYE'S SYNDROME] (in children under 16 years of age with fever, flu or chickenpox). In patients
Anaphylactic or anaphylactoid reactions may occur in patients with a history of hypersensitivity to aspirin and other nonsteroidal anti-inflammatory drugs. Cases of hemolysis and hemolytic anemia have been reported in patients with severe glucose-6-phosphate dehydrogenase deficiency.
* Most frequently occurring adverse reactions due to phenylephrine
- Neurological/psychological: Frequency unknown: [NERVOUSNESS], [ANXIETY], [MYASTHENIA], [DIZZINESS], [TREMOR], [INSOMNIA], [IRRITABILITY], [HEADACHE] (at high doses may be a symptom of hypertension). At high doses [SEIZURES], [PARESTHESIA], [PSYCHOSIS], [HALLUCINATIONS] may occur.
- Cardiovascular: Unknown frequency: [CHEST PAIN], [BRADYCARDIA], increased cardiac work due to increased peripheral arterial resistance, [HEART FAILURE] (exacerbation), [PALPITATIONS] (at high doses), [ARTERIAL HYPERTENSION] (at high doses or in susceptible individuals), [PERIPHERAL VASOCONSTRICTION], [COLDNESS IN THE EXTREMITIES], [HYPOTENSION].
- Respiratory: Unknown frequency: [DYSPNEA], [RESPIRATORY DISTRESS], [FLUSHING].
- Digestive: Unknown frequency: [VOMITING].
- Genitourinary: Unknown frequency: [URINARY RETENTION].
- Dermatological: Unknown frequency: [PALENESS], [CHILLS], [EXCESSIVE SWEATING].
- Metabolic: Unknown frequency: [HYPERGLYCEMIA], [HYPOKALEMIA], [METABOLIC ACIDOSIS].
* Most frequently occurring adverse reactions due to chlorphenamine:
- Neurological/psychological: Unknown frequency: [CENTRAL NERVOUS SYSTEM DEPRESSION] with [DROWSY], [DIZZINESS], [MYASTHENIA] which in some patients disappear after 2-3 days, facial [DYSKINESIA], [PSYCHOMOTOR INCOORDINATION], [TREMOR], [PARESTHESIA].
- Ophthalmological: Unknown frequency: [BLURRED VISION], [DIPLOPIA].
- Respiratory: Unknown frequency: [DRY NOSE] and throat, thickening of mucous membranes.
- Digestive: Unknown frequency: [DRY MOUTH], [ANOREXIA], [DYSGEUSIA], gastrointestinal discomfort ([NAUSEA], [VOMITING], [DIARRHEA], [CONSTIPATION], [EPIGASTRIC PAIN]) which are reduced by administering the drug with food.
- Genitourinary: Unknown frequency: [URINARY RETENTION].
- Dermatological: [EXCESSIVE SWEATING].

OVERDOSE

Doses of more than 100 mg/kg/day for more than two days can cause salicylism. A distinction can be made between chronic and acute toxicity. Signs of salicylism appear when plasma salicylate concentrations exceed 300 mg/L.
- Symptoms: Symptoms of overintoxication include dizziness, vertigo, ringing in the ears, nausea, vomiting, deafness, sweating, headaches and confusion, vasodilation and hyperventilation, blurred vision, and occasionally diarrhea. Vasodilation and sweating are the result of an accelerated metabolism. Symptoms of chronic toxicity can be controlled by reducing the dose.
In acute toxicity, the alteration in acid-base balance can influence salicylate toxicity, altering its distribution between plasma and tissues. The most common presentation in children is metabolic acidosis. Stimulation of respiration produces hyperventilation and respiratory alkalosis. Impaired oxidative phosphorylation produces metabolic acidosis. In children up to four years of age, the metabolic component tends to predominate, while respiratory alkalosis is more common in older children and adults. Aspirin absorption may be impaired due to slowed gastric emptying, stone formation, or as a result of ingesting enteric-coated preparations.
- Treatment: There is no antidote for salicylate poisoning. In the event of an overdose, the patient should be observed for at least 24 hours, since symptoms and blood salicylate levels may not become apparent for several hours. Overdose is treated with gastric lavage, forced alkaline diuresis, repeated administration of activated charcoal, and supportive therapy with fluid and electrolyte administration. Restoration of acid-base balance, along with hemodialysis, may be required in acute cases.
Phenylephrine and chlorphenamine overdose:
Phenylephrine overdose produces excessive stimulation of the sympathetic nervous system with effects such as anxiety, fear, agitation, headache (may be a symptom of hypertension), convulsions, insomnia, confusion, irritability, tremors, anorexia, nausea, vomiting, psychosis with hallucinations (more frequent in children) and effects on the cardiovascular system such as hypertension (sometimes with cerebral hemorrhage and pulmonary edema), arrhythmias, palpitations, peripheral and visceral vasoconstriction, reduced blood flow to vital organs, which may decrease renal perfusion, with reduced urine production and metabolic acidosis; increased cardiac work due to increased peripheral arterial resistance; severe vasoconstrictive effects may be more likely to occur in hypovolemic patients, severe bradycardia. Prolonged use may cause plasma volume depletion.
In addition, other symptoms associated with chlorphenamine overdose may occur, such as anticholinergic effects (clumsiness or unsteadiness, severe drowsiness, severe dry mouth, nose, or throat, flushing, dyspnea), cardiac arrhythmias, CNS depression, CNS stimulation (hallucinations, seizures, insomnia), the latter symptoms may appear late; hypotension (feeling faint).
Treatment of chlorphenamine and phenylephrine overdose is symptomatic and supportive.

COMPOSITION

ACETYLSALYLICYLIC ACID: 500 MILLIGRAMS
CHLORPHENAMINE: 2 MILIGRAMS - MALEATO
PHENYLEPHRINE: 7.5 MILLIGRAMS - HYDROCHLORIDE