aspirin / chlorpheniramine / phenylephrine
Alka-Seltzer Plus Cold is an over-the-counter combination medication containing three ingredients: aspirin (an NSAID), chlorpheniramine (an antihistamine), and phenylephrine (a decongestant). It's used to temporarily relieve cold symptoms and lower fever. It can be used for people 12 years of age or older. Alka-Seltzer Plus Cold effervescent tablets are dissolved in water and taken by mouth every 4 hours. Side effects can include sleepiness, dizziness, and dry mouth.
What is Alka-Seltzer Plus Cold?
What is Alka-Seltzer Plus Cold used for?
Short-term relief of fever and symptoms of common cold:
- Nasal congestion
- Sinus pressure and congestion
- Sore throat
- Runny nose
- Sneezing
- Minor aches and pains
- Headache
How Alka-Seltzer Plus Cold works
Alka-Seltzer Plus Cold is a combination of three medications that work together to relieve symptoms of the common cold and fever.
- Aspirin is a nonsteroidal anti-inflammatory drug (NSAID). It blocks proteins in your body that typically cause inflammation, pain, and fever. This helps relieve inflammation, pain, and fever.
- Chlorpheniramine is an antihistamine. It blocks a natural substance in your body called histamine. This helps with runny or itchy nose, sneezing, and watery eyes.
- Phenylephrine is a decongestant. It clears your sinuses by tightening the blood vessels in your nose.
Drug facts
Side effects of Alka-Seltzer Plus Cold
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
- Headache
- Blurry vision
- Trouble urinating
Alka-Seltzer Plus Cold serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Allergic reactions: rash; hives; difficulty breathing; swelling of face, lips, tongue, or throat
- Stomach bleed: feeling faint or dizzy, long-lasting stomach pain, coughing up or vomiting blood, bloody or dark-colored stools
- Excessive sleepiness or dizziness
- Ringing in the ears or loss of hearing
- Taking too much (signs of an overdose): flushed skin, skin that's warm to the touch, vision changes, heart rhythm problems, fast breathing, ringing in the ears, confusion, seizures
Get your GoodRx coupon
Pros and cons of Alka-Seltzer Plus Cold
Pros
- Combination of three medications in a single pill that helps with various cold symptoms at the same time
- Dissolved in water so it's easier to take
- Available over the counter
Cons
- Might have to take up to every 4 hours when you have symptoms
- Shouldn't use long term without asking your provider
- Not for children under 12 years of age
Pharmacist tips for Alka-Seltzer Plus Cold
- Double check your medication label to make sure you have the right Alka-Seltzer Plus Cold product because there are several medications with the Alka-Seltzer brand name. They can contain different active ingredients and different directions.
- You can take Alka-Seltzer Plus Cold with or without food. If it upsets your stomach, try taking the medication with food.
- Alka-Seltzer Plus Cold can make you sleepy or dizzy, which can affect your ability to focus, think, or react. Don't drive until you know how the medication affects you. To prevent daytime sleepiness, it might help to take the least amount of medication possible for your symptoms. Also, avoid alcohol because it can worsen sleepiness and dizziness.
- While Alka-Seltzer Plus Cold might make adults sleepy, it's possible for children who use this medication to become overly excited or energetic. Speak to your child's provider if this happens.
- Since Alka-Seltzer Plus Cold contains aspirin, you're at risk for stomach bleeds. Stop using the medication and get medical help right away if you feel faint, vomit blood, have bloody or black stools, or have stomach pain that doesn't get better. These might be symptoms of a stomach bleed.
- Tell your provider if you notice a ringing in the ears or loss of hearing after you start using Alka-Seltzer Plus Cold. These are possible side effects of aspirin. You'll probably need to stop taking Alka-Seltzer Plus Cold. The ringing sound should go away and your hearing should return after you stop taking this medication.
- Tell your provider and pharmacist about all the medications you're taking, especially if you're taking other NSAIDs, antihistamines, sleep medications, blood thinners, corticosteroids, or monoamine oxidase inhibitors (MAOIs). Some medications can raise your risk for side effects when they're taken with Alka-Seltzer Plus Cold. Your providers can make sure all your medications are safe to take together.
- Don't start any new medications while you're taking Alka-Seltzer Plus Cold, particularly other medications containing similar ingredients (e.g., NSAID, antihistamine, decongestant), without talking to your provider or pharmacist first. Doing so can raise your risk of overdose and severe side effects.
- Each Alka-Seltzer Plus Cold tablet contains 467 mg of sodium (salt). Ask your provider whether Alka-Seltzer Plus Cold is right for you if you have heart problems (e.g., heart failure) or kidney problems. Typically, people with heart or kidney problems need to follow a low-sodium diet to prevent their conditions from getting worse.
- Stop using Alka-Seltzer Plus Cold and contact your provider if you have pain or nasal congestion that gets worse or lasts more than 1 week, or a fever that gets worse or lasts more than 3 days. You should also stop and call your provider if you have any redness, swelling, or any new symptoms that appear while you're taking the medication. These might be signs of a different or more serious medical condition that Alka-Seltzer Plus Cold might not be able to treat.
- Talk to your provider if your sore throat is severe; lasts for more than 2 days; or happens with a fever, headache, rash, nausea, or vomiting.
Common questions about Alka-Seltzer Plus Cold
Adults and children ages 12 years and older can take up to 2 tablets of Alka-Seltzer Plus Cold every 4 hours. But don't take more than 8 tablets in a 24-hour period. If your provider specifically recommended you to take Alka-Seltzer Plus Cold, it's possible they might give you different instructions than what's written on the manufacturer's box; follow your provider's directions in that case. Ask your provider or pharmacist if you're not sure how much Alka-Seltzer Plus Cold you can take and how often you should take the medication.
Take out 2 tablets of Alka-Seltzer Plus Cold from the box and drop them in a cup with 4 ounces (one-half glass) of room temperature water. Let the tablets completely dissolve. Don't use cold water because it will make the tablets dissolve slower, and don't use warm water because it can cause a lot of foaming. After the tablets dissolve, drink the mixture right away. Don't prepare Alka-Seltzer Plus Cold ahead of time; prepare only when it's time for your dose. Also, don't use any liquids other than water to dissolve the tablets because they can affect how fast the medication can dissolve.
No, don't take ibuprofen (Advil) with Alka-Seltzer Plus Cold because it already contains aspirin. Both ibuprofen (Advil) and aspirin are NSAIDs that work in similar ways and have similar side effects and risks. So taking more than one NSAID at the same time raises your risk for severe and life-threatening problems (e.g., heart risks, kidney problems). Consider using acetaminophen (Tylenol) if you need to use another over-the-counter pain reliever while you're taking Alka-Seltzer Plus Cold.
Yes, it's generally safe to take acetaminophen (Tylenol) with Alka-Seltzer Plus Cold for pain relief. But acetaminophen (Tylenol) also has risks to consider that shouldn't be ignored (e.g., liver problems). Before using other pain relievers with Alka-Seltzer Plus Cold, speak with your healthcare provider to make sure it's safe for you to do so.
No, you shouldn't use diphenhydramine (Benadryl) with Alka-Seltzer Plus Cold because it already contains chlorpheniramine. Both diphenhydramine (Benadryl) and chlorpheniramine are antihistamines that work very similarly and have similar side effects and risks. So taking more than one antihistamine at the same time raises your risk for side effects without additional benefit. Mixing them together also raises your risk for an antihistamine overdose, which can be life-threatening. Ask your provider or pharmacist whether there are safer options if you need additional symptom relief from your cold.
Yes, it's possible to feel sleepy after you take Alka-Seltzer Plus Cold because it contains chlorpheniramine, an antihistamine that can cause sleepiness. However, it also contains phenylephrine, which can have the opposite effect and make you stay awake. Pay attention to how Alka-Seltzer Plus Cold affects your sleep. Contact your provider to discuss better options for you if it's making you too sleepy or interrupting your sleep and affecting your daily activities.
Don't take Alka-Seltzer Plus Cold until you've talked to your provider first if you're pregnant or thinking of becoming pregnant. Alka-Seltzer Plus Cold contains aspirin and phenylephrine, which are medications that might not be safe to take while pregnant. The FDA recommends avoiding aspirin doses of 325 mg or greater during pregnancy at 20 weeks or later because of the potential risk for serious harm to the unborn baby. Additionally, it isn't completely clear whether phenylephrine is safe to take during pregnancy. A study showed that this ingredient can raise the risk of birth defects and harm your unborn baby. But another study found that decongestants similar to phenylephrine didn't cause birth defects. Ask your provider whether there are safer options for you.
Talk with your provider if you're considering taking Alka-Seltzer Plus Cold while breastfeeding. This medication contains aspirin, which can get into breast milk. While children with viral infections should avoid aspirin because of the risk for Reye's syndrome, there haven't been any known reports of harm in infants breastfed by mothers who were taking aspirin. It's best to speak with your provider to see what their recommendations are. Your provider or pharmacist can guide you to safer options, if needed.
How to save using GoodRx
Risks and warnings for Alka-Seltzer Plus Cold
Alka-Seltzer Plus Cold 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.
Stomach bleeding and ulcers
- Risk factors: Age 60 years or older | History of stomach bleeding or ulcers | Taking other NSAIDs, blood thinners, or corticosteroids while also taking Alka-Seltzer Plus Cold | Drinking 3 or more alcoholic beverages per day | Taking Alka-Seltzer Plus Cold for a long time | Taking more Alka-Seltzer Plus Cold than instructed
Alka-Seltzer Plus Cold contains aspirin, which can irritate your stomach. This irritation can feel like stomach pain or heartburn. It can also lead to serious stomach problems, including bleeding and ulcers in this area. Stop using Alka-Seltzer Plus Cold and get medical attention right away if you have stomach pain that doesn't get better; vomit or cough up blood or bits that look like coffee grounds; or have bloody or black, tarry stools. These can be signs of stomach bleeding or a stomach ulcer that your provider can help manage and treat.
Kidney problems
- Risk factors: History of kidney or liver problems | History of heart failure | Taking Alka-Seltzer Plus Cold for a long time | Taking certain blood pressure medications (water pills, ACE inhibitors, or ARBs) | Low fluids in the body | Age 65 years and older
Alka-Seltzer Plus Cold contains aspirin, which can sometimes cause kidney damage at higher doses. This damage can happen at any time while you're taking the medication, especially if you have any of the risk factors listed above. Tell your provider if you're taking certain blood pressure medications that can harm your kidneys, such as ACE inhibitors (e.g., lisinopril (Zestril)) and ARBs (e.g., losartan (Cozaar)). Stop taking Alka-Seltzer Plus Cold and let your provider know if you're not urinating as often as usual or if you have muscle weakness, numbness in your arms or legs, or a fast heartbeat. These can be signs of kidney damage.
Reye's syndrome in children
- Risk factors: Children 18 years or younger recovering from chickenpox or flu-like symptoms
Aspirin use in children is linked to a rare, but serious and life-threatening condition called Reye's syndrome. It typically occurs when children who are recovering from flu-like symptoms or other viruses take medications containing aspirin. Early symptoms of Reye's syndrome include vomiting, headache, confusion, and distress. But if left untreated, it can lead to seizures and loss of consciousness. Get medical help as soon as possible if any of these symptoms happen.
To lower the risk for Reye's syndrome, don't give Alka-Seltzer Plus Cold to a child who has a fever due to the flu or who is recovering from chickenpox. Ask a provider for medication recommendations for children who are sick.
Accidentally taking too much (overdose)
Alka-Seltzer Plus Cold contains an NSAID (aspirin), antihistamine (chlorpheniramine), and a decongestant (phenylephrine), which are medications that can be found in other over-the-counter products. Using more than one medication containing an NSAID, chlorpheniramine (or other antihistamine), or a decongestant can lead to an accidental overdose and serious side effects. These serious side effects can potentially include kidney failure, seizures, hallucinations (seeing things that aren't real), or even death.
To prevent an accidental overdose, read package labels carefully. Ask your pharmacist if you're not sure whether a product has any similar ingredients. Get medical help as soon as possible or contact a poison control center at 1-800-222-1222 if you or your loved one has an accidental overdose.
Allergic reactions
- Risk factors: NSAID allergy
Severe allergic reactions to Alka-Seltzer Plus Cold are possible, including anaphylaxis (closing of the throat). Let your provider know if you have an allergy to aspirin or other NSAIDs before you start taking Alka-Seltzer Plus Cold. Call 911 if you have hives; trouble breathing; or swelling of your face, lips, or tongue.
Worsening of certain medical conditions
- Risk factors: History of stomach bleeding or stomach problems (e.g, heartburn) | Liver or kidney problems | Heart disease or high blood pressure | Thyroid disease | High blood sugar (diabetes) | Glaucoma | Breathing problems (e.g., asthma, emphysema, long-term bronchitis) | Urinary conditions
Ask your provider whether it's safe for you to take Alka-Seltzer Plus Cold if you have any of the risk factors listed above. Taking Alka-Seltzer Plus Cold can potentially 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 you start taking Alka-Seltzer Plus Cold.
Caution use in people with phenylketonuria (PKU)
Alka-Seltzer Plus Cold contains phenylalanine, a component of the artificial sweetener aspartame. If you have a genetic condition called phenylketonuria (PKU), taking this medication can be dangerous for you. Let your providers know if you have PKU so they can recommend a different formulation or medication that might be safer for you.
Alka-Seltzer Plus Cold dosage
Carton| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 20 tablets of 325mg/2mg/7.8mg | 1 carton | $5.47 | $5.47 |
Typical dosage for Alka-Seltzer Plus Cold
Each effervescent tablet contains 325 mg of aspirin, 2 mg of chlorpheniramine, and 7.8 mg of phenylephrine.
- Ages 12 years and older: Dissolve 2 tablets in 4 ounces (one-half cup) of water, and drink the mixture. Repeat every 4 hours. Don't use more than 8 tablets in a 24-hour period or as instructed by your provider.
- Ages under 12 years old: Ask your child's provider.
How much does Alka-Seltzer Plus Cold cost?
$5.47
Alka-Seltzer Plus Cold 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 Alka-Seltzer Plus Cold will not be safe for you to take.
What are alternatives to Alka-Seltzer Plus Cold?
Short-term relief of fever and symptoms of common cold:
Alka-Seltzer Plus Cold images
