Consists of Acetaminophen, chlorpheniramine maleate, K sulphoguaiacolate, phenylephrine
What is Acetaminophen (Zacoldine)?
Acetaminophen (Zacoldine) is used together with other medicines (eg, narcotic pain relievers) to relieve moderate to severe pain.
Acetaminophen (Zacoldine) is used to relieve mild to moderate pain and reduce fever in patients. It does not become habit-forming when taken for a long time. Acetaminophen (Zacoldine) may cause unwanted effects when taken in large doses, including liver damage.
Acetaminophen (Zacoldine) is available only with your doctor's prescription.
Acetaminophen (Zacoldine) indications
Acetaminophen (Zacoldine) is indicated for
- the management of mild to moderate pain in adult and pediatric patients 2 years and older
- the management of moderate to severe pain with adjunctive opioid analgesics in adult and pediatric patients 2 years and older
- the reduction of fever in adult and pediatric patients.
How should I use Acetaminophen (Zacoldine)?
Use Acetaminophen (Zacoldine) as directed by your doctor. Check the label on the medicine for exact dosing instructions.
- Acetaminophen (Zacoldine) is usually given as an injection at your doctor's office, hospital, or clinic. If you will be using Acetaminophen (Zacoldine) at home, a health care provider will teach you how to use it. Be sure you understand how to use Acetaminophen (Zacoldine). Follow the procedures you are taught when you use a dose. Contact your health care provider if you have any questions.
- Do not mix other medicines (especially chlorpromazine or diazepam) in the same container or IV line as Acetaminophen (Zacoldine). Contact your health care provider if you have any questions about how to give Acetaminophen (Zacoldine) with other medicines.
- Do not use Acetaminophen (Zacoldine) if it contains particles, is cloudy or discolored, or if the vial is cracked or damaged.
- Use Acetaminophen (Zacoldine) within 6 hours after opening.
- If you miss a dose of Acetaminophen (Zacoldine) and you are using it regularly, use it as soon as possible. If several hours have passed or if it is nearing time for the next dose, do not double the dose to catch up, unless advised by your health care provider. Do not use 2 doses at once.
Ask your health care provider any questions you may have about how to use Acetaminophen (Zacoldine).
Uses of Acetaminophen (Zacoldine) in details
This drug is used to treat mild to moderate pain (from headaches, menstrual periods, toothaches, backaches, osteoarthritis, or cold/flu aches and pains) and to reduce fever.
How to use Acetaminophen (Zacoldine)
Take this product by mouth as directed. Follow all directions on the product package. If you are uncertain about any of the information, consult your doctor or pharmacist.
There are many brands and forms of Acetaminophen (Zacoldine) available. Read the dosing instructions carefully for each product because the amount of Acetaminophen (Zacoldine) may be different between products. Do not take more Acetaminophen (Zacoldine) than recommended.
If you are giving Acetaminophen (Zacoldine) to a child, be sure you use a product that is meant for children. Use your child's weight to find the right dose on the product package. If you don't know your child's weight, you can use their age.
For suspensions, shake the medication well before each dose. Some liquids do not need to be shaken before use. Follow all directions on the product package. Measure the liquid medication with the provided dose-measuring spoon/dropper/syringe to make sure you have the correct dose. Do not use a household spoon.
For rapidly-dissolving tablets, chew or allow to dissolve on the tongue, then swallow with or without water. For chewable tablets, chew thoroughly before swallowing.
Do not crush or chew extended-release tablets. Doing so can release all of the drug at once, increasing the risk of side effects. Also, do not split the tablets unless they have a score line and your doctor or pharmacist tells you to do so. Swallow the whole or split tablet without crushing or chewing.
For effervescent tablets, dissolve the dose in the recommended amount of water, then drink.
Pain medications work best if they are used as the first signs of pain occur. If you wait until the symptoms have worsened, the medication may not work as well.
Do not take this medication for fever for more than 3 days unless directed by your doctor. For adults, do not take this product for pain for more than 10 days (5 days in children) unless directed by your doctor. If the child has a sore throat (especially with high fever, headache, or nausea/vomiting), consult the doctor promptly.
Tell your doctor if your condition persists or worsens or if you develop new symptoms. If you think you may have a serious medical problem, get medical help right away.
Acetaminophen (Zacoldine) description
Acetaminophen (Zacoldine) (with the Optizorb formulation) also contains the following excipients: Pregelatinized maize starch, calcium carbonate, alginic acid, crospovidone, povidone, magnesium stearate, colloidal anhydrous silica, parahydroxybenzoates (sodium methyl, ethyl and propyl), OPADRY YS-1-7003 white, carnauba wax, purified water.
It contains no sugar, lactose or gluten.
Acetaminophen (Zacoldine) dosage
General Dosing Information
Acetaminophen (Zacoldine) may be given as a single or repeated dose for the treatment of acute pain or fever. No dose adjustment is required when converting between oral Acetaminophen (Zacoldine) and Acetaminophen (Zacoldine) dosing in adults and adolescents who weigh 50 kg and above. Calculated maximum daily dose of Acetaminophen (Zacoldine) is based on all routes of administration (i.e., intravenous, oral, and rectal) and all products containing Acetaminophen (Zacoldine). Exceeding the maximum mg/kg daily dose of Acetaminophen (Zacoldine) as described in Tables 1 to 3 may result in hepatic injury, including the risk of liver failure and death. To avoid the risk of overdose, ensure that the total amount of Acetaminophen (Zacoldine) from all routes and from all sources does not exceed the maximum recommended dose.
Recommended
Dosage: Adults and Adolescents
Adults and adolescents weighing 50 kg and over: the recommended dosage of Acetaminophen (Zacoldine) is 1,000 mg every 6 hours or 650 mg every 4 hours, with a maximum single dose of Acetaminophen (Zacoldine) of 1,000 mg, a minimum dosing interval of 4 hours, and a maximum daily dose of Acetaminophen (Zacoldine) of 4,000 mg per day (includes all routes of administration and all Acetaminophen (Zacoldine)-containing products including combination products).
Adults and adolescents weighing under 50 kg: the recommended dosage of Acetaminophen (Zacoldine) is 15 mg/kg every 6 hours or 12.5 mg/kg every 4 hours, with a maximum single dose of Acetaminophen (Zacoldine) of 15 mg/kg, a minimum dosing interval of 4 hours, and a maximum daily dose of Acetaminophen (Zacoldine) of 75 mg/kg per day (includes all routes of administration and all Acetaminophen (Zacoldine)-containing products including combination products).
| Age group | Dose given every 4 hours | Dose given every 6 hours | Maximum single dose | Maximum total daily dose of Acetaminophen (Zacoldine) (by all routes) |
|---|---|---|---|---|
| Adults and adolescents (13 years and older) weighing ≥ 50 kg | 650 mg | 1,000 mg | 1,000 mg | 4,000 mg in 24 hours |
| Adults and adolescents (13 years and older) weighing < 50 kg | 12.5 mg/kg | 15 mg/kg | 15 mg/kg (up to 750 mg) | 75 mg/kg in 24 hours (up to 3,750 mg) |
Recommended
Dosage: Children
Children 2 to 12 years of age: the recommended dosage of Acetaminophen (Zacoldine) is 15 mg/kg every 6 hours or 12.5 mg/kg every 4 hours, with a maximum single dose of Acetaminophen (Zacoldine) of 15 mg/kg, a minimum dosing interval of 4 hours, and a maximum daily dose of Acetaminophen (Zacoldine) of 75 mg/kg per day.
| Age group | Dose given every 4 hours | Dose given every 6 hours | Maximum single dose | Maximum total daily dose of Acetaminophen (Zacoldine) (by all routes) |
| Children 2 to 12 years of age | 12.5 mg/kg | 15 mg/kg | 15 mg/kg (up to 750 mg) | 75 mg/kg in 24 hours (up to 3,750 mg) |
Recommended Dosage for Treatment of Fever in Neonates and Infants
Neonates, including premature neonates born at ≥ 32 weeks gestational age, up to 28 days chronological age: the recommended dosage of Acetaminophen (Zacoldine) is 12.5 mg/kg every 6 hours, to a maximum daily dose of Acetaminophen (Zacoldine) of 50 mg/kg per day, with a minimum dosing interval of 6 hours.
Infants 29 days to 2 years of age: the recommended dosage of Acetaminophen (Zacoldine) is 15 mg/kg every 6 hours, to a maximum daily dose of Acetaminophen (Zacoldine) of 60 mg/kg per day, with a minimum dosing interval of 6 hours.
| Age group | Dose given every 6 hours | Maximum total daily dose of Acetaminophen (Zacoldine) (by all routes) |
| Neonates (birth to 28 days) | 12.5 mg/kg | 50 mg/kg |
| Infants (29 days to 2 years) | 15 mg/kg | 60 mg/kg |
Instructions for
Intravenous Administration
For adult and adolescent patients weighing ≥ 50 kg requiring 1,000 mg doses of Acetaminophen (Zacoldine), administer the dose by inserting a vented intravenous set through the septum of the 100 mL vial. Acetaminophen (Zacoldine) may be administered without further dilution. Examine the container contents before dose preparation or administering. DO NOT USE if particulate matter or discoloration is observed. Administer the contents of the vial intravenously over 15 minutes. Use aseptic technique when preparing Acetaminophen (Zacoldine) for intravenous infusion. Do not add other medications to the Acetaminophen (Zacoldine) vial or infusion device.
For doses less than 1,000 mg, the appropriate dose must be withdrawn from the container and placed into a separate container prior to administration. Using aseptic technique, withdraw the appropriate dose (650 mg or weight-based) from an intact sealed Acetaminophen (Zacoldine) container and place the measured dose in a separate empty, sterile container (e.g., glass bottle, plastic intravenous container, or syringe) for intravenous infusion to avoid the inadvertent delivery and administration of the total volume of the commercially available container. The entire 100 mL container of Acetaminophen (Zacoldine) is not intended for use in patients weighing less than 50 kg. Acetaminophen (Zacoldine) is supplied in a single-dose container and the unused portion must be discarded.
Place small volume pediatric doses up to 60 mL in volume in a syringe and administer over 15 minutes using a syringe pump.
Monitor the end of the infusion in order to prevent the possibility of an air embolism, especially in cases where the Acetaminophen (Zacoldine) infusion is the primary infusion.
Once the container seal has been penetrated, or the contents transferred to another container, administer the dose of Acetaminophen (Zacoldine) within 6 hours.
Do not add other medications to the Acetaminophen (Zacoldine) solution. Diazepam and chlorpromazine hydrochloride are physically incompatible with Acetaminophen (Zacoldine), therefore do not administer simultaneously.
Acetaminophen (Zacoldine) interactions
See also:
What other drugs will affect Acetaminophen (Zacoldine)?
Acetaminophen (Zacoldine) is metabolized (eliminated by conversion to other chemicals) by the liver. Therefore drugs that increase the action of liver enzymes that metabolize Acetaminophen (Zacoldine) [for example, carbamazepine (Tegretol), isoniazid (INH, Nydrazid, Laniazid), rifampin (Rifamate, Rifadin, Rimactane)] reduce the levels of Acetaminophen (Zacoldine) and may decrease the action of Acetaminophen (Zacoldine). Doses of Acetaminophen (Zacoldine) greater than the recommended doses are toxic to the liver and may result in severe liver damage. The potential for Acetaminophen (Zacoldine) to harm the liver is increased when it is combined with alcohol or drugs that also harm the liver.
Cholestyramine (Questran) reduces the effect of Acetaminophen (Zacoldine) by decreasing its absorption into the body from the intestine. Therefore, Acetaminophen (Zacoldine) should be administered 3 to 4 hours after cholestyramine or one hour before cholestyramine.
Acetaminophen (Zacoldine) doses greater than 2275 mg per day may increase the blood thinning effect of warfarin (Coumadin) by an unknown mechanism. Therefore, prolonged administration or large doses of Acetaminophen (Zacoldine) should be avoided during warfarin therapy
Acetaminophen (Zacoldine) side effects
See also:
What are the possible side effects of Acetaminophen (Zacoldine)?
Applies to Acetaminophen (Zacoldine) / caffeine: oral tablet, oral tablet disintegrating
Get emergency medical help if you have any of these signs of an allergic reaction while taking Acetaminophen (Zacoldine) / caffeine: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
In rare cases, Acetaminophen (Zacoldine) may cause a severe skin reaction that can be fatal. This could occur even if you have taken Acetaminophen (Zacoldine) in the past and had no reaction. Stop taking this medicine and call your doctor right away if you have skin redness or a rash that spreads and causes blistering and peeling. If you have this type of reaction, you should never again take any medicine that contains Acetaminophen (Zacoldine).
Stop using Acetaminophen (Zacoldine) and caffeine and call your doctor at once if you have:
-
low fever with nausea, stomach pain, and loss of appetite;
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dark urine, clay-colored stools; or
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jaundice (yellowing of the skin or eyes).
Common side effects may include:
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sleep problems (insomnia); or
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feeling nervous, irritable, or jittery.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.
Acetaminophen (Zacoldine) contraindications
See also:
What is the most important information I should know about Acetaminophen (Zacoldine)?
There are many brands and forms of Acetaminophen (Zacoldine) available and not all brands are listed on this leaflet.
Do not take more of this medication than is recommended. An overdose of Acetaminophen (Zacoldine) can damage your liver or cause death.
Know the amount of Acetaminophen (Zacoldine) in the specific product you are taking.
Do not take this medication without a doctor's advice if you have ever had alcoholic liver disease (cirrhosis) or if you drink more than 3 alcoholic beverages per day. You may not be able to take Acetaminophen (Zacoldine).
Avoid drinking alcohol. It may increase your risk of liver damage while taking Acetaminophen (Zacoldine).
Ask a doctor or pharmacist if it is safe for you to take this medicine if you have liver disease or a history of alcoholism.
Ask a doctor or pharmacist before using any other cold, allergy, pain, or sleep medication. Acetaminophen (Zacoldine) (sometimes abbreviated as APAP) is contained in many combination medicines. Taking certain products together can cause you to get too much Acetaminophen (Zacoldine) which can lead to a fatal overdose. Check the label to see if a medicine contains Acetaminophen (Zacoldine) or APAP.
What is Chlorpheniramine maleate (Zacoldine)?
Chlorpheniramine maleate (Zacoldine) is an antihistamine that reduces the effects of natural chemical histamine in the body. Histamine can produce symptoms of sneezing, itching, watery eyes, and runny nose.
Chlorpheniramine maleate (Zacoldine) is used to treat runny nose, sneezing, itching, and watery eyes caused by allergies, the common cold, or the flu.
Chlorpheniramine maleate (Zacoldine) may also be used for purposes not listed in this medication guide.
Chlorpheniramine maleate (Zacoldine) indications
Temporary relief of sneezing, itchy, watery eyes, itchy nose or throat, and runny nose caused by hay fever (allergic rhinitis), or other respiratory allergies.
How should I use Chlorpheniramine maleate (Zacoldine)?
Use Chlorpheniramine maleate (Zacoldine) as directed by your doctor. Check the label on the medicine for exact dosing instructions.
- Chlorpheniramine maleate (Zacoldine) may be taken with or without food.
- Shake well before using.
- Use the dropper that comes with Chlorpheniramine maleate (Zacoldine) to measure your dose. Ask your pharmacist for help if you are unsure of how to measure your dose.
- If you miss a dose of Chlorpheniramine maleate (Zacoldine), take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.
Ask your health care provider any questions you may have about how to use Chlorpheniramine maleate (Zacoldine).
Uses of Chlorpheniramine maleate (Zacoldine) in details
This medication is used to treat itching and pain caused by minor burns/cuts/scrapes, sunburn, insect bites, minor skin irritations, or rashes from poison ivy, poison oak, or poison sumac.
Diphenhydramine belongs to a class of drugs known as antihistamines. It works by preventing the effects of a certain natural substance (histamine) that causes itching. Calamine helps to dry the oozing and weeping caused by irritation from poisonous plants.
Use of this medication is not recommended in children younger than 2 years unless directed by the doctor.
How to use Chlorpheniramine maleate (Zacoldine) topical
Use this medication on the skin only. Some products may need to be shaken well before use. Follow all directions on the product package, or use as directed by your doctor. Before applying, clean the affected area with soap and water. Gently pat dry. Apply to the affected area as directed, usually 3 to 4 times a day. Wash hands immediately after use, unless the area being treated includes the hands.
Do not use on large areas of the body or apply more often than directed. Do not use on chickenpox or measles. Do not use with other products that contain diphenhydramine (e.g., allergy medication taken by mouth). Your condition will not clear faster, but side effects may be increased.
Avoid getting the product in your eyes, nose, ears, or mouth. If the medication gets in these areas, rinse the area right away with clean water.
Tell your doctor if your condition persists or worsens after 7 days of treatment. If you think you may have a serious medical problem, seek immediate medical attention.
Chlorpheniramine maleate (Zacoldine) description
An alpha- and beta-adrenergic agonist that may also enhance release of norepinephrine. It has been used in the treatment of several disorders including asthma, heart failure, rhinitis, and urinary incontinence, and for its central nervous system stimulatory effects in the treatment of narcolepsy and depression. It has become less extensively used with the advent of more selective agonists.
Chlorpheniramine maleate (Zacoldine) dosage
Tab Adult & childn >12 yr 1 tab tds-qds. Childn 6-12 yr ½ tab tds-qds. Syr Adult 5 mL tds-qds. Childn 6-12 yr 2.5 mL tds-qds, 2-5 yr 1.25 mL tds-qds.
Chlorpheniramine maleate (Zacoldine) interactions
See also:
What other drugs will affect Chlorpheniramine maleate (Zacoldine)?
Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.
Some products that may interact with this drug include: antihistamines applied to the skin (such as diphenhydramine cream, ointment, spray), antispasmodics (e.g., atropine, belladonna alkaloids), drugs for Parkinson's disease (e.g., anticholinergics such as benztropine, trihexyphenidyl), scopolamine, tricyclic antidepressants (e.g., amitriptyline).
Tell your doctor or pharmacist if you also take drugs that cause drowsiness such as: certain antihistamines (e.g., diphenhydramine), anti-seizure drugs (e.g., carbamazepine), medicine for sleep or anxiety (e.g., alprazolam, diazepam, zolpidem), muscle relaxants, narcotic pain relievers (e.g., codeine), psychiatric medicines (e.g., chlorpromazine, risperidone, amitriptyline, trazodone). Check the labels on all your medicines (e.g., cough-and-cold products) because they may contain drowsiness-causing ingredients. Ask your pharmacist about the safe use of those products.
Chlorpheniramine maleate (Zacoldine) is very similar to dexchlorpheniramine. Do not use medications containing dexchlorpheniramine while using Chlorpheniramine maleate (Zacoldine).
This medication may interfere with certain laboratory tests (including allergy skin testing), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug.
Chlorpheniramine maleate (Zacoldine) side effects
See also:
What are the possible side effects of Chlorpheniramine maleate (Zacoldine)?
Mild stinging, redness, swelling, or dry/flaky skin may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.
If your doctor has directed you to use this medication, remember that he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.
A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.
This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.
In the US -
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.
In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
Chlorpheniramine maleate (Zacoldine) contraindications
See also:
What is the most important information I should know about Chlorpheniramine maleate (Zacoldine)?
Hypersensitivity to antihistamines; narrow-angle glaucoma; stenosing peptic ulcer; symptomatic prostatic hypertrophy; asthmatic attack; bladder neck obstruction; pyloroduodenal obstruction; MAO therapy; use in newborn or premature infants and in breast-feeding mothers.
What is Phenylephrine (Zacoldine)?
Phenylephrine (Zacoldine) (Phenylephrine (Zacoldine)) is a decongestant that shrinks blood vessels in the nasal passages. Dilated blood vessels can cause nasal congestion (stuffy nose).
Phenylephrine (Zacoldine) is used to treat nasal and sinus congestion, or congestion of the tubes that drain fluid from your inner ears, called the eustachian (yoo-STAY-shun) tubes.
Phenylephrine (Zacoldine) may also be used for purposes not listed in this medication guide.
Phenylephrine (Zacoldine) indications
Phenylephrine (Zacoldine) is used for the temporary relief of stuffy nose, sinus, and ear symptoms caused by the common cold, flu, allergies, or other breathing illnesses (e.g., sinusitis, bronchitis). This medication works by decreasing swelling in the nose and ears, thereby lessening discomfort and making it easier to breathe.
Cough-and-cold products have not been shown to be safe or effective in children younger than 6 years. Therefore, do not use this product to treat cold symptoms in children younger than 6 years unless specifically directed by the doctor. Some products (such as long-acting tablets/capsules) are not recommended for use in children younger than 12 years. Ask your doctor or pharmacist for more details about using your product safely.
How should I use Phenylephrine (Zacoldine)?
Use Phenylephrine (Zacoldine) as directed by your doctor. Check the label on the medicine for exact dosing instructions.
- Phenylephrine (Zacoldine) is for use in the eye only. Avoid contact with the nose or mouth.
- To use Phenylephrine (Zacoldine), first, wash your hands. Tilt your head back. Using your index finger, pull the lower eyelid away from the eye to form a pouch. Drop the medicine into the pouch and gently close your eyes. Immediately use your finger to apply pressure to the inside corner of the eye for 1 to 2 minutes. Do not blink. Remove excess medicine around your eye with a clean tissue, being careful not to touch your eye. Wash your hands to remove any medicine that may be on them.
- To prevent germs from contaminating your medicine, do not touch the applicator tip to any surface, including your eye. Keep the container tightly closed.
- Do not wear contact lenses while you are using Phenylephrine (Zacoldine). Sterilize contact lenses according to the manufacturer's directions and check with your doctor before using them.
- Do not use Phenylephrine (Zacoldine) if it is brown or contains particles.
- If you miss a dose of Phenylephrine (Zacoldine), use it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not use 2 doses at once.
Ask your health care provider any questions you may have about how to use Phenylephrine (Zacoldine).
Uses of Phenylephrine (Zacoldine) in details
Use: Labeled Indications
Hypotension/shock: Treatment of hypotension, vascular failure in shock. Note: Not recommended for routine use in the treatment of septic shock; use should be limited until more evidence demonstrating positive clinical outcomes becomes available (Rhodes 2017).
Guideline recommendations:
Cardiogenic shock: The 2017 American Heart Association (AHA) scientific statement for the Contemporary Management of Cardiogenic Shock recommends Phenylephrine (Zacoldine), if needed, be considered for initial vasoactive management of cardiogenic shock due to aortic stenosis, mitral stenosis, or dynamic left ventricular outflow tract (LVOT) obstruction (AHA [van Diepen 2017]).
Hypotension during anesthesia: As a vasoconstrictor in regional analgesia
Nasal congestion: As a decongestant [OTC]
Off Label Uses
Hypotension in patients with obstructive hypertrophic cardiomyopathy
Phenylephrine (Zacoldine) is a pure alpha1 agonist that will increase systemic vascular resistance without increasing heart rate or contractility. This is advantageous in patients with obstructive hypertrophic cardiomyopathy and hypotension since increases in both heart rate and contractility may cause the obstruction to worsen, leading to a decrease in cardiac output. Other vasopressors like dopamine, epinephrine, and norepinephrine may increase contractility and/or heart rate. Additional trials may be necessary to further define the role of Phenylephrine (Zacoldine) in this condition.
Based on the American Urological Association guidelines for the management of priapism, due to the low risk of cardiovascular side effects intracavernous injection of Phenylephrine (Zacoldine) is recommended for ischemic priapism that persists following aspiration/irrigation.
Phenylephrine (Zacoldine) description
Phenylephrine (Zacoldine) is a sympathomimetic amine that acts predominantly on α-adrenergic receptors. It is mainly used to treat nasal congestion, but may also be useful in treating hypotension and shock, hypotension during spinal anaesthesia, prolongation of spinal anaesthesia, paroxysmal supraventricular tachycardia, symptomatic relief of external or internal hemorrhoids, and to increase blood pressure as an aid in the diagnosis of heart murmurs.
Phenylephrine (Zacoldine) dosage
Phenylephrine (Zacoldine) Dosage
Generic name: Phenylephrine (Zacoldine) HYDROCHLORIDE 10mg in 1mL
Dosage form: injection
The information at Drugs.com is not a substitute for medical advice. Always consult your doctor or pharmacist.
General Dosage and Administration Instructions
Phenylephrine (Zacoldine) (Phenylephrine (Zacoldine) hydrochloride) Injection, 10 mg/mL must be diluted before administration as an intravenous bolus or continuous intravenous infusion to achieve the desired concentration:
- Bolus: Dilute with normal saline or 5% dextrose in water.
- Continuous infusion: Dilute with normal saline or 5% dextrose in water.
Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration. Do not use if the solution is colored or cloudy, or if it contains particulate matter. The diluted solution should not be held for more than 4 hours at room temperature or for more than 24 hours under refrigerated conditions. Discard any unused portion.
During Phenylephrine (Zacoldine) administration:
- Correct intravascular volume depletion.
- Correct acidosis. Acidosis may reduce the effectiveness of Phenylephrine (Zacoldine).
Dosing for Treatment of Hypotension during Anesthesia
The following are the recommended dosages for the treatment of hypotension during anesthesia.
- The recommended initial dose is 40 to 100 mcg administered by intravenous bolus. May administer additional boluses every 1-2 minutes as needed; not to exceed a total dosage of 200 mcg.
- If blood pressure is below the target goal, start a continuous intravenous infusion with an infusion rate of 10 to 35 mcg/minute; not to exceed 200 mcg/minute.
- Adjust dosage according to the blood pressure goal.
Prepare a 100 mcg/mL Solution for Bolus
Intravenous Administration
For bolus intravenous administration, prepare a solution containing a final concentration of 100 mcg/mL of Phenylephrine (Zacoldine):
- Withdraw 10 mg (1 mL of 10 mg/mL) of Phenylephrine (Zacoldine) and dilute with 99 mL of 5% Dextrose Injection, USP or 0.9% Sodium Chloride Injection, USP.
- Withdraw an appropriate dose from the 100 mcg/mL solution prior to bolus intravenous administration.
Prepare a Solution for Continuous
Intravenous Administration
For continuous intravenous infusion, prepare a solution containing a final concentration of 20 mcg/mL of Phenylephrine (Zacoldine) in 5% Dextrose Injection, USP or 0.9% Sodium Chloride Injection, USP:
- Withdraw 10 mg (1 mL of 10 mg/mL) of Phenylephrine (Zacoldine) and dilute with 500 mL of 5% Dextrose Injection, USP or 0.9% Sodium Chloride Injection, USP.
Directions for Dispensing from Pharmacy Bulk Vial
The Pharmacy Bulk Vial is intended for dispensing of single doses to multiple patients in a pharmacy admixture program and is restricted to the preparation of admixtures for infusion. Each closure shall be penetrated only one time with a suitable sterile transfer device or dispensing set that allows measured dispensing of the contents. The Pharmacy Bulk Vial is to be used only in a suitable work area such as a laminar flow hood (or an equivalent clean air compounding area). Dispensing from a pharmacy bulk vial should be completed within 4 hours after the vial is penetrated.
More about Phenylephrine (Zacoldine) (Phenylephrine (Zacoldine))
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Consumer resources
- Phenylephrine (Zacoldine)
- Phenylephrine (Zacoldine) (Advanced Reading)
- Other brands: Neo-Synephrine, Phenylephrine (Zacoldine) Congestion, Sudogest PE, Phenylephrine (Zacoldine) Children's Nasal Decongestant, More (9) »
Professional resources
- Phenylephrine (Zacoldine) (FDA)
- Phenylephrine (Zacoldine) Hydrochloride (AHFS Monograph)
Related treatment guides
- Hypotension
Phenylephrine (Zacoldine) interactions
See also:
What other drugs will affect Phenylephrine (Zacoldine)?
Phenylephrine (Zacoldine): May increase the serum concentration of Phenylephrine (Zacoldine) (Systemic). Monitor therapy
Alpha1-Blockers: May diminish the vasoconstricting effect of Alpha1-Agonists. Similarly, Alpha1-Agonists may antagonize Alpha1-Blocker vasodilation. Monitor therapy
AtoMOXetine: May enhance the hypertensive effect of Sympathomimetics. AtoMOXetine may enhance the tachycardic effect of Sympathomimetics. Monitor therapy
Benzylpenicilloyl Polylysine: Alpha1-Agonists may diminish the diagnostic effect of Benzylpenicilloyl Polylysine. Management: Consider use of a histamine skin test as a positive control to assess a patient's ability to mount a wheal and flare response. Consider therapy modification
Cannabinoid-Containing Products: May enhance the tachycardic effect of Sympathomimetics. Exceptions: Cannabidiol. Monitor therapy
Chloroprocaine: May enhance the hypertensive effect of Phenylephrine (Zacoldine) (Systemic). Monitor therapy
CloZAPine: May diminish the therapeutic effect of Phenylephrine (Zacoldine) (Systemic). Monitor therapy
Cocaine (Topical): May enhance the hypertensive effect of Sympathomimetics. Management: Consider alternatives to use of this combination when possible. Monitor closely for substantially increased blood pressure or heart rate and for any evidence of myocardial ischemia with concurrent use. Consider therapy modification
Doxofylline: Sympathomimetics may enhance the adverse/toxic effect of Doxofylline. Monitor therapy
Ergot Derivatives: May enhance the hypertensive effect of Alpha1-Agonists. Ergot Derivatives may enhance the vasoconstricting effect of Alpha1-Agonists. Exceptions: Ergoloid Mesylates; Nicergoline. Avoid combination
FentaNYL: Alpha1-Agonists may decrease the serum concentration of FentaNYL. Specifically, fentanyl nasal spray serum concentrations may decrease and onset of effect may be delayed. Monitor therapy
Guanethidine: May enhance the arrhythmogenic effect of Sympathomimetics. Guanethidine may enhance the hypertensive effect of Sympathomimetics. Monitor therapy
Hyaluronidase: May enhance the vasoconstricting effect of Phenylephrine (Zacoldine) (Systemic). Management: Avoid the use of hyaluronidase to enhance dispersion or absorption of Phenylephrine (Zacoldine). Use of hyaluronidase for other purposes in patients receiving Phenylephrine (Zacoldine) may be considered as clinically indicated. Avoid combination
Iobenguane Radiopharmaceutical Products: Alpha1-Agonists may diminish the therapeutic effect of Iobenguane Radiopharmaceutical Products. Management: Discontinue all drugs that may inhibit or interfere with catecholamine transport or uptake for at least 5 biological half-lives before iobenguane administration. Do not administer these drugs until at least 7 days after each iobenguane dose. Avoid combination
Ioflupane I 123: Phenylephrine (Zacoldine) (Systemic) may diminish the diagnostic effect of Ioflupane I 123. Monitor therapy
Linezolid: May enhance the hypertensive effect of Sympathomimetics. Management: Reduce initial doses of sympathomimetic agents, and closely monitor for enhanced pressor response, in patients receiving linezolid. Specific dose adjustment recommendations are not presently available. Consider therapy modification
Monoamine Oxidase Inhibitors: May enhance the hypertensive effect of Alpha1-Agonists. While linezolid is expected to interact via this mechanism, management recommendations differ from other monoamine oxidase inhibitors. Refer to linezolid specific monographs for details. Exceptions: Linezolid. Avoid combination
Ozanimod: May enhance the hypertensive effect of Sympathomimetics. Management: Concomitant use of ozanimod with sympathomimetic agents is not recommended. If combined, monitor patients closely for the development of hypertension, including hypertensive crises. Consider therapy modification
Propacetamol: May increase the serum concentration of Phenylephrine (Zacoldine) (Systemic). Management: Monitor patients closely for increased side effects of Phenylephrine (Zacoldine) if propacetamol is used concomitantly. Patients with underlying blood pressure issues or arrhythmias may need closer monitoring and may warrant consideration of alternative therapies. Monitor therapy
Solriamfetol: Sympathomimetics may enhance the hypertensive effect of Solriamfetol. Sympathomimetics may enhance the tachycardic effect of Solriamfetol. Monitor therapy
Sympathomimetics: May enhance the adverse/toxic effect of other Sympathomimetics. Monitor therapy
Tedizolid: May enhance the hypertensive effect of Sympathomimetics. Tedizolid may enhance the tachycardic effect of Sympathomimetics. Monitor therapy
Tricyclic Antidepressants: May enhance the therapeutic effect of Alpha1-Agonists. Tricyclic Antidepressants may diminish the therapeutic effect of Alpha1-Agonists. Monitor therapy
Phenylephrine (Zacoldine) side effects
See also:
What are the possible side effects of Phenylephrine (Zacoldine)?
Applies to Phenylephrine (Zacoldine): intravenous solution
As well as its needed effects, Phenylephrine (Zacoldine) (the active ingredient contained in Phenylephrine (Zacoldine)) may cause unwanted side effects that require medical attention.
If any of the following side effects occur while taking Phenylephrine (Zacoldine), check with your doctor or nurse immediately:
Incidence not known:
- Blurred vision
- chest pain or discomfort
- difficult or labored breathing
- dizziness
- fainting
- fast, slow, or irregular heartbeat
- headache
- nausea or vomiting
- nervousness
- pain in the shoulders, arms, jaw, or neck
- pounding in the ears
- sweating
- tightness in the chest
- unusual tiredness
If any of the following symptoms of overdose occur while taking Phenylephrine (Zacoldine), get emergency help immediately:
Symptoms of overdose:
- Feeling of fullness in the head
- pounding or rapid pulse
- tingling in the arms or legs
- vomiting
Minor Side Effects
Some Phenylephrine (Zacoldine) side effects may not need any medical attention. As your body gets used to the medicine these side effects may disappear. Your health care professional may be able to help you prevent or reduce these side effects, but do check with them if any of the following side effects continue, or if you are concerned about them:
Incidence not known:
- Heartburn
- itching skin
- nausea
- pain in the neck
- pain or discomfort in chest, upper stomach, or throat
Phenylephrine (Zacoldine) contraindications
See also:
What is the most important information I should know about Phenylephrine (Zacoldine)?
Phenylephrine (Zacoldine) hydrochloride should not be used in patients with severe hypertension, ventricular tachycardia, or in patients who are hypersensitive to it or to any of the components.
Active ingredient matches for Zacoldine:
Acetaminophen/chlorpheniramine maleate/K sulphoguaiacolate/phenylephrine in Indonesia.
| Unit description / dosage (Manufacturer) | Price, USD |
| Zacoldine 60 mL x 1's | $ 1.09 |
List of Zacoldine substitutes (brand and generic names): | |
| Acetaminophen/chlorpheniramine maleate/K sulphoguaiacolate/phenylephrine (Indonesia) | |
References
- DailyMed. "CHLORPHENIRAMINE POLISTIREX; HYDROCODONE POLISTIREX: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
- DailyMed. "ACETAMINOPHEN; ASPIRIN; CAFFEINE: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
- PubChem. "phenylephrine". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).
Reviews
The results of a survey conducted on ndrugs.com for Zacoldine are given in detail below. The results of the survey conducted are based on the impressions and views of the website users and consumers taking Zacoldine. We implore you to kindly base your medical condition or therapeutic choices on the result or test conducted by a physician or licensed medical practitioners.User reports
Consumer reported useful
No survey data has been collected yetConsumer reported price estimates
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Information checked by Dr. Sachin Kumar, MD Pharmacology
