Norel AD
Norel AD is a combination of three active ingredients: acetaminophen (a pain reliever), chlorpheniramine (an antihistamine), and phenylephrine (a decongestant). It's an over-the-counter medication used to treat symptoms of the common cold or flu in adults and children. Norel AD comes as a tablet that's taken by mouth every 4 hours as needed. The combination of medications (acetaminophen, chlorpheniramine, and phenylephrine) can also be found under other brand names. Some people might experience drowsiness as a side effect.
What is Norel AD?
What is Norel AD used for?
Short-term relief of symptoms from the common cold or flu:
Stuffy nose (nasal congestion)
Runny nose
Sneezing
Sore throat
Itchy or watery eyes
Itching of the nose or throat
Sinus congestion and pressure
Minor aches, pains, or headache
Fever
How Norel AD works
Norel AD is a combination of three medications that work together to relieve symptoms caused by the common cold or flu.
Acetaminophen a pain reliever. It blocks chemicals in your body to help treat pain and lower fever.
Chlorpheniramine is a first-generation antihistamine. It blocks a natural substance in your body called histamine. In doing so, chlorpheniramine lowers inflammation (swelling) and relieves runny nose, itchy nose, and sneezing.
Phenylephrine is a decongestant. It's thought to work by narrowing the blood vessels in the nose to relieve sinus pressure.
Drug Facts
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What are the side effects of Norel AD?
Common Side Effects
- Sleepiness or restlessness
- Dizziness
- Dry mouth
Other Side Effects
- Restlessness
- Headache
- Constipation
- Diarrhea
- Trouble urinating
- Blurry vision
Serious Side Effects
- Allergic reactions: rash, hives, difficulty breathing, swelling of face, lips, tongue, or throat
- Serious skin reaction: skin reddening, blisters, rash
- Liver problems: severe stomach pain, yellowing of skin or eyes, nausea, vomiting, loss of appetite
- Excessive sleepiness or dizziness
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
- Sudden eye pain or change in vision such as blurry vision, seeing halos around lights, vision loss
- Trouble passing urine
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
- Anxiety, nervousness
- Confusion
- Constipation
- Dizziness
- Drowsiness
- Dry mouth
- Fatigue
Pros and cons of Norel AD
Pros
Taken by mouth
Starts working within 30 minutes
Can treat a wide variety of common cold or flu symptoms
More convenient to take three medications in one pill
Available over the counter
Cons
Taken every 4 hours when you have symptoms
More difficult to customize the dose since Norel AD is a combination of three medications
Can cause liver problems if you take too much acetaminophen or combine it with alcohol
Older adults are at higher risk for sleepiness
Pharmacist tips for Norel AD
The chlorpheniramine in Norel AD can make you feel sleepy or dizzy during the day. This can affect your ability to think, or react. Don't drive or do any task that needs a lot of focus until you know how the medication affects you.
Norel AD is only meant to temporarily relieve cold or flu symptoms. This medication isn't appropriate for you if your condition worsens or if your symptoms last more than a few days. If you still have a fever after 3 days, or if your pain or congestion isn't getting better after a week, contact your primary care provider (PCP). These might be signs that you need more medical attention.
Speak to your primary care 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. Norel AD might not be the best option for your condition.
Tell your primary care provider or pharmacist about all the medications you're taking, especially if you're taking warfarin (Coumadin) or stimulant medications. These medications can have potentially harmful interactions with Norel AD. Your healthcare team can make sure your medications are safe for you to take.
Make sure you read the ingredients label on all the medications you're taking. Many over-the-counter cold and flu medications contain the same ingredients as those in Norel AD. Taking more than one pain reliever, antihistamine, or decongestant at the same time can raise the risk of overdose and severe side effects, such as sleepiness and liver problems.
Don't take Norel AD at the same time as or within 2 weeks of taking a monoamine oxidase inhibitor (MAOI), such as selegiline or phenelzine (Nardil). This combination can raise your risk for severe side effects (e.g., serotonin syndrome, dizziness). Instead, contact your primary care provider for other options to treat your cold or flu symptoms.
Frequently asked questions about Norel AD
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What are the risks and warnings for Norel AD?
Norel AD 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 Norel AD | 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 HCP's instructions. For children, ask your child's pediatrician.
Speak to your HCP before using Norel AD 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 eyes. If you notice any of these symptoms, call your HCP right away.
Accidental overdose
Norel AD contains an analgesic (acetaminophen), antihistamine (chlorpheniramine), and a decongestant (phenylephrine), which are all in many other over-the-counter products. Using more than one medication containing acetaminophen, chlorpheniramine, 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 HCP or pharmacist about the medications you take before starting Norel AD to make sure it's safe for you. Don't start any new medications while taking Norel AD without talking to your HCP 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: Liver disease | Heart disease or high blood pressure | Thyroid disease | High blood sugar (diabetes) | Glaucoma | Breathing problems (e.g., emphysema, long-term bronchitis) | Urinary conditions
Norel AD is generally safe to take, but it's not the best choice for everyone. If you're 65 years of age or older, you might feel side effects from this medication more intensely. Norel AD might also worsen certain medical conditions, such as liver problems, high blood pressure, glaucoma, thyroid disease, diabetes, trouble urinating, or breathing problems. Let your primary care provider or pharmacist know about the medical conditions you have. Ask them whether Norel AD is safe and appropriate for you to take.
Allergic skin reactions
Although rare, Norel AD can cause serious skin reactions, such as rash, blisters, skin reddening, or skin peeling. If you notice changes in your skin, stop using Norel AD and get medical attention right away.
Norel AD dosage forms
| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 325mg/4mg/10mg | 20 tablets | $19.17 | $0.96 |
Typical dosing for Norel AD
Acetaminophen / chlorpheniramine / phenylephrine combinations are made by several manufacturers. Be sure to check the medication box for specific instructions for your product.
Each tablet contains 325 mg of acetaminophen, 4 mg of chlorpheniramine, and 10 mg of phenylephrine.
Ages 12 years and older: The typical dose is 1 tablet by mouth every 4 hours while you're having symptoms. Don't use more than 6 tablets in a 24-hour period unless your prescriber specifically told you to do so.
Ages under 12 years old: Ask your child's pediatrician.
How much does Norel AD cost?
Norel AD contraindications
Take any other medication containing acetaminophen
Currently take or have taken a monoamine oxidase inhibitor (MAOI) in the last 2 weeks
What are alternatives to Norel AD?
Short-term relief of symptoms from the common cold or flu:
Stuffy nose (nasal congestion)
Runny nose
Sneezing
Sore throat
Itchy or watery eyes
Itching of the nose or throat
Sinus congestion and pressure
Minor aches, pains, or headache
Fever
Runny nose
Stuffy nose
Itchy nose or throat
Sneezing
Itchy or watery eyes
Sinus pressure
Headache
Minor aches and pains
Fever
Short-term relief of symptoms from allergies and the common cold: runny nose, itchy or watery eyes, itchy nose or throat, sneezing, nasal congestion, sinus pressure, headache, minor aches and pains, fever
Lowers swelling in the sinuses around the nose
Restores breathing through the nose
Norel AD images
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References
Best studies we foundAtkinson, H. C., et al. (2015). Potential cardiovascular adverse events when phenylephrine is combined with paracetamol: Simulation and narrative review. European Journal of Clinical Pharmacology.
Botting, R. M. (2000). Mechanism of action of acetaminophen: Is there a cyclooxygenase 3? Clinical Infectious Diseases.
Gelotte, C. K., et al. (2015). Pharmacokinetics, safety, and cardiovascular tolerability of phenylephrine HCl 10, 20, and 30 mg after a single oral administration in healthy volunteers. Clinical Drug Investigation.
OPMX LLC. (2023). Acetaminophen, chlorpheniramine maleate, phenylephrine HCl tablet [package insert]. DailyMed.
Lee, S., et al. (2019). Chlorpheniramine-induced anaphylaxis. Medicine.
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.
U.S. Pharmaceutical Corporation. (2023). Norel AD- acetaminophen, chlorpheniramine maleate, and phenylephrine hcl tablet, multilayer [package insert]. DailyMed.
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