FAQ

What is Dextromethorphan (DXM)?

When dealing with a cough due to cold or flu, dextromethorphan, sometimes referred to as DXM, is often part of the remedy. But what is dextromethorphan, exactly?

DXM is a cough suppressant that’s found in many over-the-counter medications. It’s used to temporarily relieve a cough caused by the common cold or flu.

How does it work?

Dextromethorphan doesn’t actually treat the cause of your cough or speed up recovery—but it can offer you some much-needed relief.

  • Dextromethorphan works by decreasing activity in the part of the brain that causes coughing.
  • It comes alone or in combination with antihistamines, cough suppressants, pain relievers and decongestants.
    o NyQuil Cough is a great example of a cough syrup that combines dextromethorphan with an antihistamine. It offers you powerful cough relief during the night so you can get the sleep you need.
    o DayQuil Cough, on the other hand, contains just DXM as its active ingredient, and gives you up to 8 hours of non-drowsy cough relief so you can have a productive day.

How should I take it?

It’s important to follow the directions on the package carefully—and ask your doctor or pharmacist to explain anything you don’t understand.

  • Also, ask your doctor or pharmacist which product is best for your symptoms.
  • If you are taking DXM in liquid form, don’t use a household spoon to measure your dose—use the cup that came with the medication.
  • Stop taking dextromethorphan and call your doctor if your cough doesn’t get better within 7 days, if it goes away but then comes back, or if it’s accompanied with a fever, rash, or headache that lasts.

What do I need to be aware of?

Taking dextromethorphan in large amounts can cause serious side effects. That’s why it’s so important that you only use it as specified on the label or package directions.

  • Refer to the medicine’s package or prescription label to determine the amount contained in each dose.
  • Do not take more than the recommended amount of dextromethorphan in a 24-hour period.
  • Check nonprescription cough and cold product labels carefully before using two or more of them at the same time. If they contain the same active ingredient(s), taking them together could cause an overdose.
  • Nonprescription cough and cold combination products, including products that contain DXM, can cause serious side effects or death in young children.

How should I store the medication?

Now that you know what dextromethorphan (DXM) is, let’s make sure you store it properly:

  • Keep all DXM medication in the container it came in, tightly closed, and out of reach of children.
  • Store it at room temperature and away from excess heat and moisture (not in the bathroom).
  • Throw away any medication that is outdated or no longer needed. You can talk to your pharmacist about how to properly dispose of it.

Take a look at other great cough remedies that can give you some relief. And feel better soon!

Information on Doxylamine (DOX)

What is doxylamine?

Doxylamine succinate is a powerful antihistamine used in products such as nighttime cold medicines to provide relief from runny nose and sneezing.

Is it safe?

Yes. When used as directed, doxylamine is a safe and effective antihistamine drug used to help people suffering from cough, cold, and flu symptoms.

Why should I be worried about it?

Exceeding the recommended dosage can cause drowsiness, dizziness, and lightheadedness, interfering with cognitive and decision-making abilities.

Who should not take doxylamine?

While safe when taken correctly by adults, there are a few groups who should not take doxylamine. Children younger than age 12 also are susceptible to these reactions, and should not take doxylamine unless under instruction by a doctor. Pregnant or breast-feeding women should talk to their doctor before using doxylamine or any OTC medication.

Why can’t I take doxylamine if I’m pregnant or breast-feeding?

If you are pregnant or breast-feeding, what you ingest can be passed to your baby. Talk to your doctor before you take doxylamine, for the health of both your baby and yourself. For more information, check out the safety of over-the-counter medications.

Information on Dextromethorphan (DXM)

What is dextromethorphan?

When it comes to making decisions about the OTC products you purchase for your family, it can be a daunting task; store shelves house a wide range of products with various active ingredients. Vicks® wants to provide clear and concise information about the safe and responsible use of OTC products as well as the active ingredients. To help answer your questions, Vicks has created the following FAQ with help from the Consumer Healthcare Products Association (CHPA) and their websites www.chpa-info.org and StopMedicineAbuse.org.

Watch an interview with Five Moms member and Deputy Sheriff Becky Dyer.

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Frequently Asked Questions About Dextromethorphan

What is Vicks doing to ensure the safe use of OTC medications?

The health and well-being of our consumers is our number one priority, and we strive to provide the most up-to-date information about the safe use of our OTC products. In addition, we have placed a logo on the product packaging of our products that contain DXM. Vicks wants their products to be used only as directed, for the intended purpose. That’s why they’ve teamed up with the Consumer Healthcare Products Association. Visit StopMedicineAbuse.org to get the resources you need to make informed and educated decisions.

Should I be worried about my teen abusing over-the-counter products that contain dextromethorphan?

Dextromethorphan abuse is found primarily among teens. According to research conducted by the Partnership for a Drug-Free America™, five percent of teens have intentionally abused cough medication to get high. This form of abuse involves taking extreme amounts of cough medicine to get high. It is not possible to accidentally abuse dextromethorphan; it takes vast amounts that are far beyond the recommended dosage. Abuse of DXM can cause serious adverse events, such as blurred vision, seizure, loss of consciousness, and irregular heartbeat. Recently, the Drug Enforcement Administration (DEA) has become concerned about the abuse of this drug. The agency is working with other health and law enforcement authorities to address this serious issue and warn the public of potential harm.

What is dextromethorphan?

Dextromethorphan is an effective, non-narcotic, non-addictive cough suppressant that works by raising the coughing threshold in the brain. It is a safe and effective active ingredient found in more than 100 over-the-counter cough and cold products. First approved by the U.S. Food and Drug Administration (FDA) in the 1950s, it is the most widely used cough suppressant in the United States.2

Is dextromethorphan safe?

Dextromethorphan is safe when used according to the medicine label directions. Cough medicine containing dextromethorphan produces few side effects and has a long history of both safety and effectiveness. These medicines are used safely by millions of Americans each year to relieve coughs due to the common cold or flu.3

Is dextromethorphan addictive?

Dextromethorphan is not addictive. Clinical trials confirm that dextromethorphan does not produce physical addiction, lose effectiveness through increased tolerance, or cause withdrawal, even in high experimental doses. While the ingredient itself is not physically addictive, teens engaged in this sort of substance abuse behavior may develop a pattern of habitual DXM use.4

What should parents know about dextromethorphan and abuse?

Dextromethorphan abuse is preventable. Substance abuse experts tell us that education is the most effective way to keep kids from abusing all types of substances, including over-the-counter medicines containing dextromethorphan. To help prevent or stop teen medicine abuse, parents should:
Educate themselves about the problem of teens looking to otherwise safe and beneficial products, such as medications, as a means to a high, and know the warning signs.
Talk to their teens about all types of drug abuse, including cough medicine abuse.
Safeguard their medicine cabinets and know what products they have and how many.
Monitor their teen’s Internet use.
Seek professional help if they think their child has a substance abuse problem.

Parents also need to be aware that:
Over-the-counter medicine—just like any medicine—is a serious substance, and should be taken only as directed.
Dextromethorphan-containing medicines, like all medicines, should be stored in a safe, secure location.

What are some of the slang terms for dextromethorphan?

Slang terms for dextromethorphan vary by product and region. Adults should be familiar with the most common terms, which include “Dex,” “DXM,” “Robo,” “Skittles,” “Syrup,” “Triple-C,” and “Tussin.” Terms for using dextromethorphan include “Robo-ing,” “Robo-tripping,” and “Skittling,” among others.5

What are the effects of abusing dextromethorphan?

The effects of the abuse of cough medicines containing dextromethorphan can vary with the amount taken and from person to person. Common effects include confusion, dizziness, blurred vision, slurred speech, loss of physical coordination, stomach pain, vomiting, and rapid heartbeat. Those who have abused dextromethorphan describe different “plateaus,” ranging from mild distortions of color and sound to visual hallucinations, “out of-body” dissociative sensations, and loss of motor control. The effects worsen as the dose increases.
Side effects can also be worsened when the cough medicine being abused contains other ingredients to treat more than just coughs or when it is combined with alcohol or illegal drugs.6

What are CHPA, Vicks, and other makers of OTC cough medicines doing to stop this abuse?

Vicks (Procter & Gamble) is working on a number of legislative initiatives on the federal level to complement the industry’s educational efforts to curb teen cough medicine abuse.
CHPA and the makers of OTC cough medicines are working to pass federal legislation that would restrict the sale of raw, unfinished dextromethorphan. CHPA supports legislation ensuring that only legitimate entities registered with FDA or relevant state agencies can purchase dextromethorphan in its raw, unfinished form. Currently, there are no national sales or purchase restrictions for dextromethorphan in this form. The Dextromethorphan Distribution Act (H.R. 1259) was passed by the U.S. House of Representatives on March 31, 2009. Similar legislation passed in the House in the 110th Congress. CHPA is working to see that a companion bill is introduced and passed in the Senate as well.
Additionally, CHPA supports legislative and retail efforts to implement sales restrictions prohibiting the sale of OTC cough medicine to minors. In the 110th Congress, the Dextromethorphan Abuse Reduction Act (S. 2274) was introduced to accomplish this goal. CHPA—and partners, such as the Community Anti-Drug Coalitions of America, the Food Marketing Institute, the National Association of Chain Drug Stores, and the Partnership for a Drug-Free America—are working with members of Congress to see that similar legislation is introduced and passed.7

Where can I get more information on this topic?

For more questions and answers about dextromethorphan visit the Consumer Health Products Association FAQ at http://www.chpa.org/FAQsDXM.aspx.
For more information on stopping medicine abuse, visit StopMedicineAbuse.org and www.FiveMoms.com.

Acetaminophen

What is acetaminophen?

Acetaminophen, also abbreviated as APAP, is called paracetamol in other countries. It is a safe and effective pain reliever that benefits millions of consumers. There are about 600 products that contain acetaminophen, including cough and cold products and combination pain reliever/sleep aids. It also is an ingredient in many prescription pain relievers.

What does acetaminophen have to do with my liver?

Your liver helps break down and remove many chemicals or drugs that enter your body. Too much acetaminophen can overload your liver’s ability to process the drug safely and eliminate the breakdown products. Under certain circumstances, particularly when more acetaminophen is ingested than is recommended on the label, a toxic breakdown product accumulates in the liver and can result in serious damage.

What are the symptoms of liver damage?

Acetaminophen can cause liver injury through the production of a toxic metabolite. The body eliminates acetaminophen by changing it into substances (metabolites) that the body can easily eliminate in the stool or urine. Under certain circumstances, particularly when more acetaminophen is ingested than is recommended on the label, more of the harmful metabolite is produced than the body can easily eliminate. This harmful metabolite can seriously damage the liver.

The signs of acute liver toxicity, which can result from an overdose of acetaminophen, include:

• Nausea and vomiting, sometimes within the first 12 to 24 hours after ingestion • Abdominal pain
• Abnormally yellow skin and eyes, dark urine, light-colored stools, and loss of appetite. 
• Renal failure
• Pancreatitis

The signs can be similar to flu symptoms and might go unnoticed for several days if you believe they are related to a cold or flu you might already have. Additionally, there might be a brief 12 to 24 hour period in which no symptoms occur, followed by vomiting, abdominal pain, and other symptoms of liver failure. To avoid accidental overdosing, it’s very important not to take more than the recommended dose on the label. Also, you should not take acetaminophen for more days than recommended, or take more than one drug product that contains acetaminophen at the same time. Consumers should be aware that taking more than the recommended dose will not provide more relief. If you think you have taken too much acetaminophen, either because of taking too much of one product or perhaps because you took more than one product containing acetaminophen, call your doctor right away. Serious cases of liver disease might lead to mental confusion, coma, and death. For more information, visit www.fda.gov or call 1-888-INFOFDA (463-6332).

I still don’t feel well… can I take more than the recommended dose?

To avoid accidental overdosing, it’s very important not to take more than the recommended dose listed on any over-the-counter (OTC) drug label. Also, you should not take acetaminophen for more days than recommended, or take more than one drug product that contains acetaminophen at the same time. Taking more than the recommended dose will not provide more or faster relief.

Can I give it to my kids?

Parents should be cautious when giving acetaminophen to children. You should read and follow the directions on the label every time you use a medicine. If you have any questions, seek the advice of a health professional. For more information, visit www.fda.gov or call 1-888-INFOFDA.

For more information, check out the safety of over-the-counter medications.

Vicks ZzzQuil FAQ

Q: What is ZzzQuil?

A: ZzzQuil is a non-habit forming sleep-aid that helps you get the sound sleep you need by providing relief of occasional sleeplessness. The active ingredient in ZzzQuil that helps you sleep is diphenhydramine HCl, which is an antihistamine.

Q: What does ZzzQuil do?

A: ZzzQuil helps you get a good night’s rest and provides relief of occasional sleeplessness. The ZzzQuil line of products helps you sleep soundly so you can wake up feeling refreshed. It also reduces the amount of time it takes to fall asleep, if you have difficulty falling asleep.

Q: How does ZzzQuil work?

A: ZzzQuil contains diphenhydramine, an antihistamine that causes drowsiness. To help you stay awake and alert, your body produces histamine, a naturally occurring substance that interacts with receptors in your brain to promote wakefulness. If an antihistamine enters the brain, it can block the effects of histamine and cause the opposite effect – drowsiness. The result? You fall asleep faster.

Q: How often can I take ZzzQuil?

A: ZzzQuil should only be taken once a day before bedtime, as needed for occasional sleeplessness.

Q: How much ZzzQuil can I take?

A: Adults and children 12 years of age and older may take two ZzzQuil LiquiCaps or 30 mL of ZzzQuil Liquid at bedtime, as needed. Children under 12 years of age should not take ZzzQuil.

Q: How long does ZzzQuil last?

A: There are many factors that could influence how long ZzzQuil lasts. It is recommended that you take ZzzQuil when you have adequate time to get a full night’s sleep (about eight hours).

Q: Can I take ZzzQuil every night?

A: ZzzQuil should only be used for occasional sleeplessness. Stop use and ask a doctor if sleeplessness persists continuously for more than two weeks. Insomnia may be a symptom of a serious underlying medical illness.

Q: Will ZzzQuil make me feel groggy in the morning?

A: There are many factors that could influence how rested you feel in the morning. These could include the number of hours you sleep, the time that you take ZzzQuil, and other individual factors. It is recommended that you take ZzzQuil when you have adequate time to get a full night’s sleep.

Q: Can I take ZzzQuil if I wake up in the middle of the night?

A: You can take ZzzQuil in the middle of the night if you’ll still have time to get a sufficient night’s sleep (about 7 to 8 hours). In general, it is best to take ZzzQuil at bedtime.

Q: What is in ZzzQuil?

A: The active ingredient in ZzzQuil is diphenhydramine HCl, an antihistamine that is a nighttime sleep-aid. Do not take ZzzQuil if you are taking any other product containing diphenhydramine, even one used on skin.

Q: How is ZzzQuil different from “PM” products?

A: Some “PM” products contain a pain reliever such as acetaminophen or ibuprofen in addition to a sleep-aid ingredient. ZzzQuil is different from these products because it does not contain any pain reliever. ZzzQuil: Not for pain. Not for colds. Just for sleep.

Q: How much alcohol is in ZzzQuil?

A: ZzzQuil Calming Vanilla Cherry Liquid and ZzzQuil Warming Berry Liquid contain 10 percent alcohol. ZzzQuil LiquiCaps and ZzzQuil Alcohol Free Liquid do not contain alcohol.

Q: Will I become addicted to ZzzQuil?

A: Diphenhydramine HCl, the active ingredient in ZzzQuil, is not habit forming.

Q: Is ZzzQuil the same thing as NyQuil?

A: No, ZzzQuil is not the same thing as NyQuil. ZzzQuil reduces the amount of time it takes to fall asleep and relieves occasional sleeplessness, while NyQuil treats nighttime symptoms of the common cold and flu such as sneezing, sore throat, headache, minor aches and pains, fever, runny nose, and cough.

Q: Is ZzzQuil safe and effective?

A: Yes, ZzzQuil is safe and effective when taken as directed. Ask a doctor before use if you have: a breathing problem such as emphysema or chronic bronchitis; glaucoma; or difficulty urinating due to enlargement of the prostate gland. Also talk to your doctor before use if you are taking sedatives or tranquilizers.

Q: Can I use ZzzQuil if I am pregnant or nursing?

A: If you are pregnant or breast-feeding, ask a health professional before using ZzzQuil.

Vicks VapoRub FAQ

Q: What does Vicks VapoRub do?

A: Vicks VapoRub temporarily relieves cough due to minor throat and bronchial irritation associated with the common cold. It can also be used to temporarily relieve minor aches and pains on muscles and joints.

Q: How does Vicks VapoRub work?

A: Vicks VapoRub contains medicated vapors that enter the nose and mouth to help soothe a cough.

Q: What is Vicks VapoRub?

A: Vicks VapoRub—the #1-selling branded children’s cough cold product* appropriate for children ages two and up—is a topical cough medicine with medicated vapors. It starts working super quickly for adults, as well, to relieve cough symptoms. Vicks VapoRub may also be applied to muscles and joints to temporarily relieve minor aches and pains. 

 
*P&G calculation based in part on value sales data reported by The Nielsen Company through its Retail Scantrack Services in the US market to which P&G subscribes for the Respiratory Care Category for the 52 week period ending 05/23/15.

Q: How do I use Vicks VapoRub?

A: For cough suppression, rub a thick layer of Vicks VapoRub on your chest and throat. Cover with a warm, dry cloth if desired. Keep clothing around your throat and chest loose to allow the vapors to reach the nose and mouth. For muscle and joint pain, rub Vicks VapoRub onto the affected area no more than three to four times daily.

Q: What ingredients are in Vicks VapoRub?

A: The active ingredients in Vicks VapoRub are camphor (a cough suppressant and topical analgesic), eucalyptus oil (a cough suppressant) and menthol (a cough suppressant and topical analgesic). The inactive ingredients in Vicks VapoRub include cedarleaf oil, nutmeg oil, petrolatum, thymol and turpentine oil.

Q: How often can I use Vicks VapoRub?

A: For cough suppression, Vicks VapoRub may be used up to three times daily. Simply rub a thick layer on your chest and throat. For muscle/joint minor aches and pains, Vicks VapoRub may be applied to the affected area no more than three to four times daily.

Q: Can Vicks VapoRub be used on babies?

A: No. Vicks VapoRub should only be used on children ages two years and up. Vicks BabyRub may be used on babies three months and up.

Q: Does Vicks VapoRub expire?

A: Yes. Do not use Vicks VapoRub beyond the expiration date on the package.

Q: Can I heat Vicks VapoRub?

A: You should not heat or microwave the product. Do not add Vicks VapoRub to hot water or any container where heating water. Doing so may cause splattering and result in burns.

 
Vicks Sinex FAQ

Q: What is Sinex?

A. Sinex is an over-the-counter nasal spray that helps relieve the nasal stuffiness that often accompanies colds, hay fever, or upper respiratory allergies.

Q: What does Sinex do?
A: The Sinex line of products alleviates sinus pressure and shrinks swollen nasal membranes to help you breathe more freely—no matter how stuffy you may be.

Q: How often can I use Sinex?

A: Sinex provides 12-hour relief of nasal stuffiness and can be used every 10 to 12 hours.

Q: How much Sinex can I take?

A: Adults and children 6 years of age or older can administer 2 or 3 sprays in each nostril every 10 to 12 hours.

Q: How much Sinex is safe?

A: You should not exceed two doses of Sinex in a 24-hour period.

Q: Can I give Sinex to a child?

A: Children 6 years of age and older may use Sinex (with adult supervision). Children ages 2 to 6 may use Sinex if approved by a doctor. Children 2 years of age or younger should not use Sinex.

Q: Can I take Sinex while pregnant or breast-feeding?

A: If you are pregnant or breast-feeding, check with your health professional before using Sinex. He or she can determine if it is appropriate for you.

Q: What is the active ingredient in Sinex?

A: The active ingredient in Sinex is oxymetazoline HCl (a nasal decongestant).

Q: Does Sinex expire?

A: Yes. Do not use Sinex beyond the expiration date on the package.

Q: What are the side effects of Sinex?

A: Sinex may cause temporary discomfort such as burning, stinging, sneezing, or increased nasal discharge. Prolonged use may cause nasal congestion to recur or worsen.

Q: Are there any warnings I should be aware of when taking Sinex?

A: Ask a doctor before use if you have heart disease, thyroid disease, diabetes, high blood pressure, or trouble urinating due to an enlarged prostate gland. Do not exceed the recommended dosage of Sinex. Do not use Sinex for more than three days. Frequent or prolonged use may cause nasal congestion to recur or worsen. Stop use and ask a doctor if symptoms persist or worsen.

Vicks NyQuil FAQ

Q: What is NyQuil?

A: NyQuil is an over-the-counter medication that treats nighttime symptoms of the common cold and flu such as sneezing, sore throat, headache, minor aches and pains, fever, runny nose, and cough.

Q: What does NyQuil do?

A: NyQuil relieves your sneezing, sore throat, headache, minor aches and pains, fever, runny nose, and cough, so you can get the rest you need.

Q: How often can I take NyQuil?

A: Adults and children 12 years of age or older can take NyQuil every six hours

Q: How much NyQuil can I take?

A: If you are taking NyQuil LiquiCaps, you can take two LiquiCaps with water every six hours. If you are taking NyQuil Liquid, you can take 30 mL every six hours.

Q: How long does it take for NyQuil to work?

A: This depends on many factors but it usually takes 30 minutes for NyQuil to start working.

Q: How much NyQuil is safe?

A: You should not exceed four doses of NyQuil in a 24-hour period.

Q: How much alcohol is in NyQuil?

A: NyQuil Liquid contains 10 percent alcohol. NyQuil LiquiCaps does not contain alcohol. Alcohol-Free NyQuil Cold & Flu Nighttime Relief Liquid does not contain alcohol.

Q: Can I give NyQuil to a child?

A: No, children under the age of 12 should not take NyQuil. However, children ages six to 11 may take Children’s NyQuil. Use as directed (15 mL every six hours). Do not exceed four doses within 24 hours. Children ages four to six may take Children’s NyQuil if prescribed by a doctor. Children under four years old should not take Children’s NyQuil.

Q: Can I take NyQuil while pregnant or breast-feeding?

A: If you are pregnant or breast-feeding, check with your health professional before taking NyQuil. He or she can determine if it is safe for you.

Q: What is the active ingredient in NyQuil?

A: NyQuil has three active ingredients: acetaminophen (a pain reliever/fever reducer), dextromethorphan HBr (a cough suppressant) and doxylamine succinate (an antihistamine).

Q: Does NyQuil expire?

A: Yes. Do not use NyQuil beyond the expiration date on the package.

Q: What are the side effects of NyQuil?

A: NyQuil may cause marked drowsiness. It is important to avoid alcoholic drinks when taking NyQuil and be careful when driving a motor vehicle or operating machinery. In children, NyQuil may cause excitability.

Q: Will NyQuil make me sleepy?

A: Yes. NyQuil may cause marked drowsiness.

Q: What are the different types of NyQuil?

A: NyQuil comes as a liquid or gel caps. NyQuil relieves your sneezing, sore throat, headache, minor aches and pains, fever, runny nose, and cough, so you can get the rest you need. NyQuil SEVERE delivers maximum symptom-fighting ingredients to relieve your worst cold symptoms at night. NyQuil Cough Suppressant relieves your cough so you can get the sleep you need.

Q: What’s the difference between NyQuil and NyQuil SEVERE?

A: NyQuil SEVERE delivers maximum symptom-fighting ingredients* to relieve your worst cold symptoms. Besides the active ingredients in NyQuil, NyQuil SEVERE contains 10 mg of phenylephrine HCl, a nasal decongestant. *Among OTC cold & flu medicines

Q: Are there any warnings I should be aware of when taking NyQuil?

A: NyQuil contains acetaminophen. Severe liver damage may occur if you: take more than four doses of NyQuil within 24 hours, take NyQuil with other drugs containing acetaminophen, consume three or more alcoholic drinks every day while taking NyQuil. If you have a severe sore throat and it persists for more than two days and is accompanied or followed by fever, headache, rash, nausea, or vomiting, consult a doctor promptly. Be sure to read the label carefully, and use NyQuil as directed. Learn more about the active ingredients in NyQuil and NyQuil SEVERE.

Q: Can I take NyQuil if I have high blood pressure?

A: In patients with hypertension, the use of certain medications may raise their blood pressure. Decongestants provide relief by narrowing blood vessels to reduce nasal stuffiness, but this can potentially affect other blood vessels, which may increase blood pressure. NyQuil™ HBP is free of decongestants for people with high blood pressure. To learn more, click here