acetaminophen / diphenhydramine / phenylephrine
Robitussin Severe Multi-symptom Nighttime is a combination of three medications: acetaminophen (an analgesic), diphenhydramine (an antihistamine), and phenylephrine (a decongestant). It's used to treat symptoms from the common cold or flu and is available over-the-counter.
What is Robitussin Severe Multi-symptom Nighttime?
What is Robitussin Severe Multi-symptom Nighttime used for?
Short-term relief of symptoms due to the common cold, flu, or allergies:
- Cough from minor throat irritations
- Stuffy nose (nasal congestion)
- Runny nose
- Sneezing
- Sore throat
- Sinus pressure
- Itchy, watery eyes
- Itchy nose and throat
- Minor aches and pains
- Headache
- Fever
How Robitussin Severe Multi-symptom Nighttime works
Robitussin Severe Multi-symptom Nighttime is a combination of three medications that work together to relieve symptoms caused by the common cold, flu, or allergies.
- Acetaminophen is an analgesic. It stops the production of certain chemicals in your body to help treat pain and lower fever.
- Diphenhydramine is an antihistamine. It blocks a natural substance in your body called histamine that normally causes runny or itchy nose, sneezing, and watery eyes.
- Phenylephrine is a decongestant. It works by making the blood vessels around your nose and sinus more narrow, which helps to relieve congestion and pressure.
Drug facts
Side effects of Robitussin Severe Multi-symptom Nighttime
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Sleepiness
- Dizziness
- Dry mouth
Less Common Side Effects
- Restlessness
- Headache
- Constipation
- Diarrhea
- Trouble urinating
- Blurry vision
Robitussin Severe Multi-symptom Nighttime serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Excessive sleepiness or dizziness
- Serious liver problems: severe stomach pain, yellowing of skin or eyes, nausea, vomiting, loss of appetite
- Taking too much medication: seizures, hallucinations, confusion, flushed skin, skin that's warm to the touch, vision changes
Pros and cons of Robitussin Severe Multi-symptom Nighttime
Pros
- Available as pills, liquid solution, and a powder
- Liquids are fruit-flavored for better taste
- Can treat a wide variety of common cold, flu, and allergy symptoms
- More convenient to take three medications in one dose
- Available over the counter and as lower cost generics
Cons
- Some liquids contain sodium, which can be problematic for people on a low salt diet
- Might need to take multiple times a day
- More difficult to customize the dose since it's a combination of three medications
- Can cause liver damage if you take too much acetaminophen or combine it with alcohol
- Not the best choice for people 65 years or older or people with certain medical conditions
Pharmacist tips for Robitussin Severe Multi-symptom Nighttime
- If you're using Robitussin Severe Multi-symptom Nighttime liquid solution, use a medication dose cup or an oral syringe to measure your dose. Don't use household spoons, because they aren't accurate and might cause you to take the wrong dose.
- Robitussin Severe Multi-symptom Nighttime liquid solutions are typically stored at room temperature. But, make sure to check the manufacturer packaging to see if it needs to be stored in the refrigerator.
- Robitussin Severe Multi-symptom Nighttime can make you sleepy or dizzy during the day, which can affect your ability to focus, think, or react. Don't drive until you know how the medication affects you.
- Some products contain sodium. Ask your provider if it's okay to use a product with sodium if you have a history of heart problems and are supposed to be on a low-salt diet.
- Stop using Robitussin Severe Multi-symptom Nighttime and contact your provider if you experience any of the following: 1) pain, cough, or nasal congestion that gets worse or lasts more than 1 week, 2) fever gets worse or lasts more than 3 days, 3) redness or swelling, 4) feel nervous, dizzy, or have trouble sleeping, 5) if any new symptoms appear, or 6) your cough comes back or occurs with a rash or headache that lasts. Contact your provider because these might be signs of a more serious medical condition.
- Speak to your provider if your sore throat pain is severe, lasts for more than 2 days, or occurs with or is followed by fever, headache, rash, nausea, or vomiting. They can help determine if you need a more appropriate treatment.
- Tell your provider or pharmacist about all the medications you're taking, especially if you're taking warfarin (Coumadin), other nasal decongestants, other pain relievers/fever reducers, or sleep medications. They can make sure Robitussin Severe Multi-symptom Nighttime is safe for you to take.
- Don't start any new medications while taking Robitussin Severe Multi-symptom Nighttime, especially other medications with acetaminophen, antihistamines, or decongestants, without talking to your provider or pharmacist first. Doing so can raise your risk of overdose and severe side effects, including severe liver damage.
- Don't take Robitussin Severe Multi-symptom Nighttime with a monoamine oxidase inhibitor (MAOI), such as selegiline, phenelzine (Nardil), or tranylcypromine (Parnate). This combination can cause dangerous changes to your blood pressure. If you're currently taking or have taken an MAOI in the last 2 weeks, don't use Robitussin Severe Multi-symptom Nighttime. Contact your provider for other options to treat your symptoms.
Common questions about Robitussin Severe Multi-symptom Nighttime
Robitussin Severe Multi-symptom Nighttime is generally safe to take, but it's not the best choice for everyone. If you're 65 years or older or taking sedatives, you're at higher risk for certain side effects from diphenhydramine, such as falls and trouble urinating. In addition, let your provider know what other medical conditions you have before starting Robitussin Severe Multi-symptom Nighttime. If you have certain medical conditions, such as liver problems, heart problems, or high blood pressure, you might not be able to take this medication.
Yes, you can take Robitussin Severe Multi-symptom Nighttime as needed per the package directions for cold, flu, or allergy symptoms. Your provider might recommend you to take the medication on a scheduled basis while you're having symptoms. Use the lowest effective dose for the shortest amount of time possible to lower your risk of side effects.
Robitussin Severe Multi-symptom Nighttime contains phenylephrine, which might not be safe for pregnant females due to the risk of harm to unborn babies. It's also not clear if it's safe to breastfeed while taking a medication with phenylephrine. If you're pregnant or breastfeeding, don't use Robitussin Severe Multi-symptom Nighttime until you've talked to your provider first.
Children who don't meet the age cut-offs can't use Robitussin Severe Multi-symptom Nighttime because the dosage is too high for them, which raises the risk for overdose and side effects. Make sure to carefully check the manufacturer packaging to see if your child meets the age cut-offs for using the product. If your child is having allergy or common cold symptoms, ask your child's provider or pharmacist for safe options.
Avoid drinking alcohol while taking Robitussin Severe Multi-symptom Nighttime. This medication contains diphenhydramine and acetaminophen. Drinking alcohol and taking diphenhydramine at the same time can raise your risk of sleepiness and dizziness. Also, drinking alcohol and taking acetaminophen together isn't recommended because doing so (especially on a regular basis) can raise your risk for liver problems.
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Risks and warnings for Robitussin Severe Multi-symptom Nighttime
Robitussin Severe Multi-symptom Nighttime can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Liver damage
- Risk factors: Drinking 3 or more alcoholic beverages a day | Taking other medications containing acetaminophen | Taking too much Robitussin Severe Multi-symptom Nighttime | History of liver problems
Taking too much acetaminophen can cause permanent and life-threatening liver damage. For adults, the maximum amount of acetaminophen is 3 or 4 grams in a 24-hour period, depending on your provider's instructions. For children, ask your child's provider.
Speak to your provider before using Robitussin Severe Multi-symptom Nighttime if you have liver problems, since it can cause further damage to your liver. Avoid drinking alcohol while taking this medication.
Signs of liver problems include dark urine, feeling tired, upset stomach or stomach pain, or yellowing of the skin or whites of the eyes. If you notice any of these symptoms, call your provider right away.
Accidental overdose
Robitussin Severe Multi-symptom Nighttime contains an analgesic (acetaminophen), antihistamine (diphenhydramine), and a decongestant (phenylephrine), which are all in many other over-the-counter products. Using more than one medication containing acetaminophen, an antihistamine, or a decongestant can lead to an accidental overdose and cause serious side effects. These serious side effects include liver failure, seizures, hallucinations (seeing things that aren't real), or even death. Tell your provider or pharmacist about the medications you take before starting Robitussin Severe Multi-symptom Nighttime to make sure it's safe for you. Don't start any new medications while taking Robitussin Severe Multi-symptom Nighttime without talking to your provider or pharmacist.
To prevent an accidental overdose, read package labels carefully. If you're not sure if a product has any similar ingredients, ask your pharmacist. If you or your loved one experiences an accidental overdose, get medical help right away or contact a poison control center at 1-800-222-1222.
Sleepiness
- Risk factors: Drinking alcohol while taking Robitussin Severe Multi-symptom Nighttime | Taking other medications that cause sleepiness | Age 65 and older
Robitussin Severe Multi-symptom Nighttime can make you very sleepy, which can affect your ability to focus, think, or react. This side effect is more likely to happen or be more intense if you're over 65 years old, drink alcohol while taking this medication, or take other medications that cause sleepiness (e.g., opioids, benzodiazepines, sleep medications). Don't drive or operate machinery until you know how this medication affects you.
Worsening of medical conditions
- Risk factors: Liver problems | Heart problems or high blood pressure | Thyroid problems | High blood sugar (diabetes) | Glaucoma | Breathing problems (e.g., emphysema, long-term bronchitis) | Urinary conditions | Cough with too much mucus
Don't take Robitussin Severe Multi-symptom Nighttime if you have any of the risk factors listed above unless your provider said it's safe to do so. Taking Robitussin Severe Multi-symptom Nighttime can worsen your condition(s) and cause serious side effects. Make sure your provider knows about all medical conditions you have or have had in the past before starting Robitussin Severe Multi-symptom Nighttime.
Allergic skin reactions
Although rare, Robitussin Severe Multi-symptom Nighttime can cause serious skin reactions, such as rash, blisters, skin reddening, or skin peeling. If you notice changes in your skin, stop using Robitussin Severe Multi-symptom Nighttime and get medical attention right away.
Robitussin Severe Multi-symptom Nighttime dosage
Typical dosage for Robitussin Severe Multi-symptom Nighttime
There are several manufacturers of this medication with different strengths of each ingredient, different dosage forms (e.g., tablet, solution), and different age cut-offs. The dose might slightly differ depending on which manufacturer of the medication you choose. Be sure to check the medication box carefully for specific directions. Ask your pharmacist if you have any questions about your product.
Examples include:
Robitussin Severe Multi-Symptom Cough Cold and Flu and its generic solution
Each 20 mL of solution contains 650 mg of acetaminophen, 25 mg of diphenhydramine, and 10 mg of phenylephrine.
- Adults and children 12 years and older: The typical dose is 20 mL by mouth every 4 hours. Don't take more than 6 doses in a 24-hour period.
- Children under 12 years old: Don't use.
Generic acetaminophen / diphenhydramine / phenylephrine caplets
Each caplet contains 325 mg of acetaminophen, 12.5 mg of diphenhydramine, and 5 mg of phenylephrine.
- Adults and children 12 years and older: The typical dose is 2 caplets by mouth every 4 hours. Don't take more than 10 caplets in a 24-hour period.
- Children under 12 years old: Ask your child's provider.
Robitussin Severe Multi-symptom Nighttime contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Robitussin Severe Multi-symptom Nighttime will not be safe for you to take.
- Use to make a child sleepy
- Severe allergy to acetaminophen, diphenhydramine (or another antihistamine), or phenylephrine (or another decongestant)
- Taking other medication(s) containing acetaminophen or diphenhydramine
- Currently take or have taken an MAOI in the last 2 weeks
What are alternatives to Robitussin Severe Multi-symptom Nighttime?
Short-term relief of symptoms due to the common cold, flu, or allergies: