acetaminophen / guaifenesin / phenylephrine
Mucinex Sinus Max is a combination medication that contains acetaminophen (a pain reliever), guaifenesin (an expectorant), and phenylephrine (a decongestant). It's used for allergy and common cold symptoms in adults and children ages 12 years and older. Mucinex Sinus Max is typically taken by mouth every 4 hours. Side effects aren't common, but generally include upset stomach and dizziness. This medication is available over the counter as tablets and a liquid, and also under other brand names, including Tylenol Sinus Severe.
What is Mucinex Sinus Max?
What is Mucinex Sinus Max used for?
Short-term relief of symptoms from allergies and the common cold:
Sinus congestion and pressure
Stuffy nose
Headache
Minor aches and pains
Phlegm (mucus) in the lungs
Fever
How Mucinex Sinus Max works
Mucinex Sinus Max is a combination of three medications that work together to relieve symptoms caused by allergies and the common cold.
Acetaminophen is an analgesic. It blocks chemicals in your body to help treat pain and lower fever.
Guaifenesin is an expectorant. It thins and loosens mucus that's stuck in your lungs, making it easier to cough it up.
Phenylephrine is a decongestant that clears your sinuses to relieve sinus pressure.
Drug Facts
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What are the side effects of Mucinex Sinus Max?
Common Side Effects
- Upset stomach
- Headache
- Dizziness
Other Side Effects
- Nervousness
- Trouble sleeping
Serious Side Effects
- Allergic reactions: rash; hives; difficulty breathing; swelling of face, lips, tongue, or throat
- Serious skin reaction: skin reddening, blisters, rash
- Liver damage: severe stomach pain, yellowing of skin or eyes, nausea, vomiting, loss of appetite
Source: DailyMed
The following side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Heart palpitations—rapid, pounding, or irregular heartbeat
- Increase in blood pressure
- Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue
- Redness, blistering, peeling, or loosening of the skin, including inside the mouth
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
- Anxiety, nervousness
- Dizziness
- Drowsiness
- Headache
- Nausea
- Trouble sleeping
- Upset stomach
Pros and cons of Mucinex Sinus Max
Pros
Available as pills and a liquid
Can relieve a wide variety of common cold symptoms, minor aches, and fever
More convenient to take three medications in one product
Available over the counter and as a lower-cost, generic form
Cons
Some products contain sodium, which could be a problem for people on a low salt diet.
Might need to take as often as every 4 hours when you have symptoms
More difficult to customize the dose since it's a fixed combination of three medications
Pharmacist tips for Mucinex Sinus Max
Always check the medication box carefully for specific directions, since your dose depends on the manufacturer of your product. Products can have different formulations (e.g., tablet, solution), different amounts of each ingredient, and different age cut-offs for use. Ask your pharmacist if you have any questions about your product.
You can take Mucinex Sinus Max with or without food. If it upsets your stomach, try taking the medication with food.
Some products contain sodium, so make sure to check the manufacturer package for the sodium content. Ask your provider if it's okay to use a product with sodium if you have a history of heart problems and you're on a low-salt diet.
Stop using Mucinex Sinus Max and contact your provider if you experience: 1) pain, stuffy nose, or cough that gets worse or lasts more than 7 days; 2) fever that gets worse or lasts more than 3 days; or 3) cough that comes back or occurs with a fever, rash, or headache. These might be signs of another medical condition that your provider needs to check out.
Don't start any new medications while taking Mucinex Sinus Max — especially other acetaminophen, guaifenesin, or decongestant products — without talking to your provider or pharmacist first. Doing so can raise your risk of overdose and severe side effects, including seizures, hallucinations (seeing things that aren't real), high blood pressure and fast heart rate, or even death.
Don't take Mucinex Sinus Max with a monoamine oxidase inhibitor (MAOI), such as selegiline, phenelzine (Nardil), or tranylcypromine (Parnate). This combination can raise your risk for severe side effects (e.g., high blood pressure, dizziness). If you're currently taking an MAOI or have taken one in the last 2 weeks, don't use Mucinex Sinus Max and contact your provider for other options.
Avoid drinking alcohol while taking Mucinex Sinus Max because it can raise your risk for liver problems. Talk to your provider if avoiding alcohol while taking this medication concerns you.
More tips for the liquid form:
Use a medication dose cup or an oral syringe to measure your dose of Mucinex Sinus Max. Don't use household spoons because they aren't always accurate and might cause you to take the wrong dose.
Liquid forms of Mucinex Sinus Max are typically stored at room temperature. Always check the packaging to make sure you don't need to put it in the refrigerator.
Frequently asked questions about Mucinex Sinus Max
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What are the risks and warnings for Mucinex Sinus Max?
Mucinex Sinus Max 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 Mucinex Sinus Max | History of liver disease
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 Mucinex Sinus Max 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 skin or whites of the eyes. If you notice any of these symptoms, call your provider right away.
Accidental overdose
Mucinex Sinus Max contains an analgesic (acetaminophen), guaifenesin, and a decongestant (phenylephrine), which are all found in many other over-the-counter products. Using more than one medication containing acetaminophen, guaifenesin, or a decongestant can lead to an accidental overdose and cause serious side effects. These serious side effects include liver failure, seizures, or even death. Tell your provider or pharmacist about the medications you take before starting Mucinex Sinus Max to make sure it's safe for you. Don't start any new medications while taking Mucinex Sinus Max 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.
Worsening of medical conditions
Risk factors: Cough from smoking, asthma, or emphysema | Mucus-producing cough | Liver disease | Heart disease or high blood pressure | High blood sugar (diabetes) | Thyroid disease | Urinary problems
Don't take Mucinex Sinus Max if you have any of the risk factors listed above unless your provider said it's safe to do so. Taking Mucinex Sinus Max 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 Mucinex Sinus Max.
Allergic skin reactions
Although rare, Mucinex Sinus Max can cause serious skin reactions, such as rash, blisters, skin reddening, or skin peeling. If you notice changes in your skin, stop using Mucinex Sinus Max and get medical attention right away.
Mucinex Sinus Max dosage forms
| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 325mg/200mg/5mg | 30 tablets | $5.59 | $0.19 |
Typical dosing for Mucinex Sinus Max
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 differ slightly depending on which manufacturer of the medication you have.
Be sure to check the medication box carefully for specific directions. Ask your pharmacist if you have any questions about your product.
Below are a few examples of product names with their dosing instructions.
Caplets
Tylenol Sinus Severe and its generic: Each caplet contains 325 mg of acetaminophen, 200 mg of guaifenesin, and 5 mg of phenylephrine.
Adults and children age 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 younger than 12 years old: Ask your child's provider.
Mucinex Sinus-Max Severe Congestion and Pain: Each caplet contains 325 mg of acetaminophen, 200 mg of guaifenesin, and 5 mg of phenylephrine.
Adults and children age 12 years and older: The typical dose is 2 caplets by mouth every 4 hours. Don't take more than 12 caplets in a 24-hour period.
Children younger than 12 years old: Ask your child's provider.
Oral solution
Mucinex Sinus-Max Severe Congestion and Pain: Each 20 mL contains 650 mg of acetaminophen, 400 mg of guaifenesin, and 10 mg of phenylephrine.
Adults and children age 12 years or older: The typical dose is 20 mL by mouth every 4 hours while you're having symptoms. Don't use more than 6 doses in a 24-hour period.
Children younger than 12 years old: Ask your child's provider.
How much does Mucinex Sinus Max cost?
Mucinex Sinus Max contraindications
Currently take or have taken an MAOI in the last 14 days
Using Mucinex Sinus Max with any other medication containing acetaminophen
What are alternatives to Mucinex Sinus Max?
Short-term relief of symptoms from allergies and the common cold:
Sinus congestion and pressure
Stuffy nose
Headache
Minor aches and pains
Phlegm (mucus) in the lungs
Fever
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
Short-term relief of symptoms from the common cold and flu:
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References
Best studies we foundAlbrecht, H. H., et al. (2017). Role of guaifenesin in the management of chronic bronchitis and upper respiratory tract infections. Multidisciplinary Respiratory Medicine.
Atkinson, H. C., et al. (2015). Potential cardiovascular adverse events when phenylephrine is combined with paracetamol: Simulation and narrative review. European Journal of Clinical Pharmacology.
Johnson & Johnson Consumer Inc. (2024). Tylenol Sinus Severe- acetaminophen, guaifenesin, and phenylephrine hydrochloride tablet, coated [package insert]. DailyMed.
RB Health (US) LLC. (2022). Maximum Strength Mucinex Sinus-Max Severe Congestion And Pain- acetaminophen, guaifenesin, and phenylephrine hydrochloride tablet, film coated [package insert]. DailyMed.
Richards, E., et al. (2023). Phenylephrine. StatPearls.
U.S. Food and Drug Administration. (2016). FDA Drug Safety Communication: FDA warns of rare but serious skin reactions with the pain reliever/fever reducer acetaminophen.
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