guaiFENesin (gwye-fen-e-sin) Alfen Jr, Altarussin, Balminil Expectorant, Benylin Chest Congestion Extra Strength, Breonesin, Bronchophan Expectorant, Chest Congestion, Cough Syrup Expectorant, Diabetic Tussin, Expectorant Syrup, Ganidin NR, Guiatuss, Hytuss, Hytuss-2X, Jack & Jill Expectorant, Mucinex, Naldecon Senior EX, Organidin NR, Robitussin, Scot-tussin Expectorant, Siltussin SA, Siltussin DAS, Vicks Chest Congestion Relief, Vicks Dayquil Mucus Control

 Indications

Coughs associated with viral upper respiratory tract infections.

Action

Reduces viscosity of tenacious secretions by increasing

respiratory tract fluid. Therapeutic Effects: Mobilization

and subsequent expectoration of mucus.

Pharmacokinetics

Absorption: Well absorbed after oral administration.

Distribution: Unknown.

Metabolism and Excretion: Renally excreted as

metabolites.

Half-life: Unknown.

TIME/ACTION PROFILE (expectorant action)

ROUTE ONSET PEAK DURATION

PO 30 min unknown 4–6 hr

PO-ER unknown unknown 12 hr

Contraindications/Precautions

Contraindicated in: Hypersensitivity; Some products

contain alcohol; Avoid in patients with known intolerance;

Some products contain aspartame and

should be avoided in patients with phenylketonuria.

Use Cautiously in: Cough lasting 1 wk or accompanied

by fever, rash, or headache; Patients receiving

disulfiram (liquid products may contain alcohol); Diabetic

patients (some products may contain sugar); OB:

Although safety has not been established, guaifenesin

has been used without adverse effects; Pedi: OTC cough

and cold products containing this medication should be

avoided in children 4 yr. Adverse Reactions/Side Effects

CNS: dizziness, headache. GI: nausea, diarrhea, stomach

pain, vomiting. Derm: rash, urticaria.

Interactions

Drug-Drug: None significant.

Route/Dosage

PO (Adults): 200–400 mg q 4 hr or 600–1200 mg q

12 hr as extended-release product (not to exceed 2400

mg/day).

PO (Children 6–12 yr): 100–200 mg q 4 hr or 600

mg q 12 hr as extended-release product (not to exceed

1200 mg/day).

PO (Children 4–6 yr): 50–100 mg q 4 hr (not to

exceed 600 mg/day).

Availability (generic available)

Syrup: 100 mg/5 mLOTC. Oral solution: 100 mg/5

mLRx, OTC, 200 mg/5 mLOTC. Capsules: 200 mgOTC. Tablets:

100 mgOTC, 200 mgRx, OTC, 1200 mg. Extendedrelease

tablets (Mucinex): 600 mg, 1200 mg. In

combination with: hydrocodone (Flowtuss, Obredon);

hydrocodone and pseudoephedrine (Hycofenix);

analgesics/antipyretics, antihistamines, decongestants,

and cough suppressants. See Appendix B.