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ibuprofen and pseudoephedrine

Generic Name: ibuprofen and pseudoephedrine (eye byoo PRO fen and soo doe e FED rin)
Brand Names: Advil Cold and Sinus, Dayquil Pressure and Pain Caplet, Dimetapp Sinus, Dristan Sinus, Motrin Cold and Flu, Motrin IB Sinus, Sine-Aid IB

What is ibuprofen and pseudoephedrine?

Ibuprofen is in a group of drugs called nonsteroidal anti-inflammatory drugs (NSAIDs). Ibuprofen works by reducing hormones that cause inflammation and pain in the body.

Pseudoephedrine is a decongestant that shrinks blood vessels in the nasal passages. Dilated blood vessels can cause nasal congestion (stuffy nose).

The combination of ibuprofen and pseudoephedrine is used to treat stuffy nose, sinus congestion, cough, and pain or fever caused by the common cold or flu.

Ibuprofen and pseudoephedrine may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about ibuprofen and pseudoephedrine?

Ibuprofen can increase your risk of life-threatening heart or circulation problems, including heart attack or stroke. Do not use this medicine just before or after having heart bypass surgery (also called coronary artery bypass graft, or CABG).

Seek emergency medical help if you have symptoms of heart or circulation problems, such as chest pain, weakness, shortness of breath, slurred speech, or problems with vision or balance.

Ibuprofen can also increase your risk of serious effects on the stomach or intestines, including bleeding or perforation (forming of a hole). These conditions can be fatal and can occur without warning at any time while you are taking ibuprofen.

Call your doctor at once if you have symptoms of bleeding in your stomach or intestines. This includes black, bloody, or tarry stools, or coughing up blood or vomit that looks like coffee grounds.

What should I discuss with my doctor before taking ibuprofen and pseudoephedrine?

Taking an NSAID can increase your risk of life-threatening heart or circulation problems, including heart attack or stroke. This risk will increase the longer you use an NSAID. Do not use this medicine just before or after having heart bypass surgery (also called coronary artery bypass graft, or CABG).

NSAIDs can also increase your risk of serious effects on the stomach or intestines, including bleeding or perforation (forming of a hole). These conditions can be fatal and gastrointestinal effects can occur without warning at any time while you are taking an NSAID. Older adults may have an even greater risk of these serious gastrointestinal side effects.

• a stomach ulcer or active bleeding in your stomach or intestines;

• polyps in your nose; or

• a history of allergic reaction to aspirin or other NSAIDs.

Before taking ibuprofen and pseudoephedrine, tell your doctor if you are allergic to any drugs, or if you have:

• a history of stomach ulcers or bleeding;

• heart disease, congestive heart failure, high blood pressure;

• systemic lupus erythematosus (SLE);

• liver or kidney disease;

• a thyroid disorder;

• diabetes;

• enlarged prostate or problems with urination;

• a bleeding or blood clotting disorder; or

• if you smoke.

If you have any of these conditions, you may not be able to use ibuprofen and pseudoephedrine, or you may need a dosage adjustment or special tests during treatment.

How should I take ibuprofen and pseudoephedrine?

Use this medication exactly as directed on the label, or as it has been prescribed by your doctor. Do not use the medication in larger amounts, or use it for longer than recommended. Cold medicine is usually taken only for a short time until your symptoms clear up.

If you need to have any type of surgery, tell the surgeon ahead of time if you have taken a cold medicine within the past few days.

What happens if I miss a dose?

Since cold medicine is usually taken only as needed, you may not be on a dosing schedule. If you are taking the medication regularly, take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at your next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Symptoms of an ibuprofen and pseudoephedrine overdose may include nausea, vomiting, stomach pain, dizziness, feeling restless or nervous, blurred vision, sweating, breathing problems, or seizure (convulsions).

What should I avoid while taking ibuprofen and pseudoephedrine?

Ibuprofen and pseudoephedrine side effects

• chest pain, weakness, shortness of breath, slurred speech, problems with vision or balance;

• black, bloody, or tarry stools, coughing up blood or vomit that looks like coffee grounds;

• fast, pounding, or uneven heartbeat;

• severe dizziness, anxiety, restless feeling, or nervousness;

• easy bruising or bleeding, unusual weakness, fever, chills, body aches, flu symptoms;

• increased blood pressure (severe headache, blurred vision, trouble concentrating, chest pain, numbness, seizure);

• urinating less than usual or not at all;

• skin rash, bruising, severe tingling, numbness, pain, muscle weakness; or

• fever, headache, neck stiffness, chills, increased sensitivity to light, purple spots on the skin, and/or seizure (convulsions).

Continue taking ibuprofen and pseudoephedrine and talk to your doctor if you have any of these less serious side effects:

• upset stomach, nausea, heartburn, diarrhea, constipation;

• bloating, gas, loss of appetite;

• warmth, tingling, or redness under your skin;

• dizziness, headache, feeling excited or restless;

• sleep problems (insomnia);

• skin itching or rash; or

• ringing in your ears.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect ibuprofen and pseudoephedrine?

Before taking ibuprofen and pseudoephedrine, tell your doctor if you are taking any of the following drugs:

• a blood thinner such as warfarin (Coumadin);

• steroids (prednisone and others);

• diuretics (water pills), or medicines to treat high blood pressure;

• a beta-blocker such as atenolol (Tenormin), carteolol (Cartrol), metoprolol (Lopressor, Toprol), propranolol (Inderal), sotalol (Betapace), timolol (Blocadren), and others;

• antidepressants such as amitriptyline (Elavil), clomipramine (Anafranil), imipramine (Janimine, Tofranil), and others; or

• aspirin or other NSAIDs (non-steroidal anti-inflammatory drugs) such as diclofenac (Voltaren), etodolac (Lodine), flurbiprofen (Ansaid), indomethacin, ketoprofen (Orudis), ketorolac (Toradol), mefenamic acid (Ponstel), meloxicam (Mobic), nabumetone (Relafen), naproxen (Aleve, Naprosyn), piroxicam (Feldene), and others.

If you are using any of these drugs, you may not be able to use ibuprofen and pseudoephedrine, or you may need dosage adjustments or special tests during treatment.

There may be other drugs not listed that can affect ibuprofen and pseudoephedrine. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

• Your pharmacist has information about ibuprofen and pseudoephedrine written for health professionals that you may read.

What does my medication look like?

Ibuprofen and pseudoephedrine is available over-the-counter (without a prescription) under many different brand and generic names and formulations.

• Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
• Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ("Multum") is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum"s drug information does not endorse drugs, diagnose patients or recommend therapy. Multum"s drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.