123 COLD Price

Overview

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This medicine contains an important and useful components, as it consists of
Caffeine, Carbinoxamine, Codeine, Paracetamol, Phenylephrineis available in the market in concentration

Name

Caffeine, Carbinoxamine, Codeine, Paracetamol, Phenylephrine

Precaution

<ul> <li>Use with caution in patients with respiratory conditions like asthma or COPD (due to Codeine).</li> <li>Risk of CNS depression and sedation; avoid driving or operating heavy machinery.</li> <li>Patients with liver dysfunction should avoid excessive use (due to Paracetamol).</li> <li>May cause dependence with prolonged use (especially Codeine).</li> <li>Avoid alcohol as it increases CNS and liver toxicity risk.</li> <li>Use cautiously in hypertensive patients (due to Phenylephrine).</li> </ul>

Indication

<ul> <li>Relief of symptoms of upper respiratory tract infections including:</li> <ul> <li>Nasal congestion</li> <li>Cough and cold</li> <li>Sneezing and allergy</li> <li>Headache, fever, and body aches</li> </ul> <li>Provides analgesic, antipyretic, antihistamine, decongestant, and cough suppressant effects.</li> </ul>

Contra indication

<ul> <li>Hypersensitivity to any of the components.</li> <li>Severe respiratory depression or asthma attacks (Codeine).</li> <li>Severe hypertension or coronary artery disease (Phenylephrine).</li> <li>Severe liver disease (Paracetamol risk).</li> <li>Concurrent use of MAO inhibitors or within 14 days of stopping them.</li> </ul>

Side Effect

<ul> <li><strong>CNS:</strong> Drowsiness, dizziness, sedation, headache.</li> <li><strong>Gastrointestinal:</strong> Nausea, vomiting, constipation (Codeine).</li> <li><strong>Allergic:</strong> Rash, itching, anaphylaxis (rare).</li> <li><strong>Cardiovascular:</strong> Increased blood pressure (Phenylephrine).</li> <li><strong>Others:</strong> Dry mouth, blurred vision (Carbinoxamine).</li> </ul>

Pregnancy Category ID

Information not available

Mode of Action

<ul> <li><strong>Caffeine:</strong> CNS stimulant, enhances analgesic effects.</li> <li><strong>Carbinoxamine:</strong> H1 receptor blocker; reduces allergic symptoms.</li> <li><strong>Codeine:</strong> Binds to opioid receptors in CNS to suppress cough and relieve pain.</li> <li><strong>Paracetamol:</strong> Inhibits prostaglandin synthesis in the CNS for analgesic and antipyretic effects.</li> <li><strong>Phenylephrine:</strong> Alpha-1 agonist causing vasoconstriction and nasal decongestion.</li> </ul>

Interaction

<ul> <li>MAO inhibitors: Hypertensive crisis or serotonin syndrome risk.</li> <li>CNS depressants (alcohol, benzodiazepines): Potentiates sedation and respiratory depression.</li> <li>Beta-blockers or antihypertensives: Phenylephrine may reduce their efficacy.</li> <li>Warfarin: Paracetamol may increase bleeding risk with long-term use.</li> <li>Enzyme inducers (e.g. phenytoin): May increase risk of Paracetamol-induced hepatotoxicity.</li> </ul>

Pregnancy Category Note

<ul> <li><strong>Carbinoxamine:</strong> Category C – Use if benefits outweigh risks.</li> <li><strong>Codeine:</strong> Category C/D – Risk of neonatal respiratory depression or withdrawal; avoid especially in late pregnancy.</li> <li><strong>Paracetamol:</strong> Category B – Generally safe in pregnancy at therapeutic doses.</li> <li><strong>Phenylephrine:</strong> Category C – May reduce uterine blood flow; avoid unless necessary.</li> </ul>

Adult Dose

<ul> <li>Typically 1 tablet or 10 ml syrup every 4–6 hours as needed.</li> <li>Maximum Paracetamol dose should not exceed 4 g/day.</li> <li>Maximum Codeine dose: 120 mg/day to avoid toxicity and dependence.</li> <li>Total daily dosage should not exceed product-specific recommendations.</li> </ul>

Child Dose

<ul> <li>Use only if specifically formulated for pediatric use.</li> <li><strong>Age 6–12 years:</strong> Half adult dose every 6 hours.</li> <li><strong>Below 6 years:</strong> Usually not recommended (especially due to Codeine and Carbinoxamine).</li> <li>Always adjust based on weight and under medical supervision.</li> </ul>

Renal Dose

<ul> <li><strong>Mild impairment:</strong> Use with caution; increase dosing interval.</li> <li><strong>Moderate to severe impairment:</strong> Avoid Codeine due to accumulation and risk of toxicity.</li> <li>Monitor renal function and adjust Paracetamol accordingly.</li> </ul>

Administration

<ul> <li>Can be taken with or without food, though taking with food may reduce gastric irritation.</li> <li>Oral route only: tablet or syrup formulation.</li> <li>Ensure adequate hydration during treatment.</li> <li>Do not crush or chew extended-release forms.</li> <li>Use calibrated measuring device for liquid forms.</li> </ul>