Can I Take acetaminophen-phenylephrine-dextromethorphan with ibuprofen?

SUMMARY:

Taking an acetaminophen/phenylephrine/dextromethorphan cold product together with ibuprofen is generally acceptable for most people, but use caution — especially if you have high blood pressure, heart disease, or are taking other sympathomimetic or blood-pressure–affecting drugs.

ADDITIONAL NOTES:

Key points: 1) Phenylephrine is a decongestant (alpha-agonist) that can raise blood pressure or heart rate; NSAIDs (like ibuprofen) can also raise blood pressure or blunt control of hypertension, so the combination may worsen blood pressure control or increase cardiovascular risk in susceptible patients. 2) The combination does not have a major pharmacologic interaction with dextromethorphan, but monitor for dizziness or nervousness. 3) Watch total acetaminophen intake — do not exceed recommended daily limits (check other products to avoid acetaminophen overdose). 4) Use caution and consult a clinician if you have uncontrolled hypertension, heart disease, or are on medications for blood pressure or certain antidepressants; seek urgent care for chest pain, marked shortness of breath, severe headache, or markedly elevated blood pressure.