Acetaminophen and DiphenhydramineU.S. Brand Names: Anacin PM Aspirin Free [OTC] [DSC]; Excedrin�(r) P.M. [OTC]; Goody's PM�(r) Powder; Legatrin PM�(r) [OTC]; Percogesic�(r) Extra Strength [OTC]; Tylenol�(r) PM Extra Strength [OTC]; Tylenol�(r) Severe Allergy [OTC]
Synonyms: Diphenhydramine and Acetaminophen
Generic Available: Yes: Excludes powder
Use: Aid in the relief of insomnia accompanied by minor pain
Adverse Reactions: See individual agents.
Drug Interactions: Acetaminophen: Substrate (minor) of CYP1A2, 2A6, 2C8/9, 2D6, 2E1, 3A4; Inhibits CYP3A4 (weak) Diphenhydramine: Inhibits CYP2D6 (moderate) Also see individual agents.
Ethanol/Nutrition/Herb Interactions: Ethanol: Excessive intake of ethanol may increase the risk of acetaminophen-induced hepatotoxicity. Avoid ethanol or limit to <3 drinks/day.
Pharmacodynamics/Kinetics: See individual agents.
Dosage: Oral: Adults: 50 mg of diphenhydramine HCl (76 mg diphenhydramine citrate) at bedtime or as directed by physician; do not exceed recommended dosage; not for use in children <12 years of age
Patient Education: If you consume 3 or more alcoholic drinks per day, ask your prescriber whether you should take acetaminophen, other pain relievers, or fever reducers. Acetaminophen may cause liver damage.
Dental Health: Effects on Dental Treatment: Key adverse event(s) related to dental treatment: Xerostomia (normal salivary flow resumes upon discontinuation).
Dental Health: Vasoconstrictor/Local Anesthetic Precautions: No information available to require special precautions
Mental Health: Effects on Mental Status: Drowsiness is common
Mental Health: Effects on Psychiatric Treatment: Concurrent use with CNS depressant may result in additive CNS depression. MAO inhibitor may cause additive anticholinergic effects.
Dosage Forms: [DSC] = Discontinued product Caplet: Acetaminophen 500 mg and diphenhydramine hydrochloride 25 mg Excedrin�(r) P.M.: Acetaminophen 500 mg and diphenhydramine citrate 38 mg [contains benzoic acid] Legatrin PM�(r): Acetaminophen 500 mg and diphenhydramine hydrochloride 50 mg Percogesic�(r) Extra Strength: Acetaminophen 500 mg and diphenhydramine hydrochloride 25 mg Tylenol�(r) PM Extra Strength: Acetaminophen 500 mg and diphenhydramine hydrochloride 25 mg Tylenol�(r) Severe Allergy: Acetaminophen 500 mg and diphenhydramine hydrochloride 12.5 mg Gelcap (Tylenol�(r) PM Extra Strength): Acetaminophen 500 mg and diphenhydramine hydrochloride 25 mg [contains benzyl alcohol] Geltab: Acetaminophen 500 mg and diphenhydramine hydrochloride 25 mg Excedrin�(r) P.M.: Acetaminophen 500 mg and diphenhydramine citrate 38 mg [contains benzoic acid] Tylenol�(r) PM Extra Strength: Acetaminophen 500 mg and diphenhydramine hydrochloride 25 mg [contains benzyl alcohol] Powder for oral solution (Goody's PM�(r) Powder): Acetaminophen 500 mg and diphenhydramine citrate 38 mg Tablet: Acetaminophen 500 mg and diphenhydramine hydrochloride 25 mg Anacin�(r) PM Aspirin-Free [DSC], Tylenol�(r) PM Extra Strength: Acetaminophen 500 mg and diphenhydramine hydrochloride 25 mg Excedrin�(r) P.M.: Acetaminophen 500 mg and diphenhydramine citrate 38 mg [contains benzoic acid]
References: Barker JD Jr, de Carle DJ, and Anuras S, "Chronic Excessive Acetaminophen Use in Liver Damage,"Ann Intern Med, 1977, 87(3):299-301. Dionne RA, Campbell RA, Cooper SA, et al, "Suppression of Postoperative Pain by Preoperative Administration of Ibuprofen in Comparison to Placebo, Acetaminophen, and Acetaminophen Plus Codeine,"J Clin Pharmacol, 1983, 23(1):37-43. Licht H, Seeff LB, and Zimmerman HJ, "Apparent Potentiation of Acetaminophen Hepatotoxicity by Alcohol,"Ann Intern Med, 1980, 92(4):511. Mokhlesi B, Leikin JB, Murray P, et al, "Adult Toxicology in Critical Care: Part II: Specific Poisonings,"Chest, 2003, 123(3):897-922.
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