Acetaminophen, Dextromethorphan Hydrobromide side effects: what 840 FDA adverse event reports show
Drug class
Not stated in label
Label matched
Acetaminophen (Acetaminophen)
Who reports
840 reports · 38% serious · 19 with death outcome · 69% female
Used for
temporarily relieves minor aches and pains due to: headache muscular aches backache minor pain of arthritis the common cold toothache premenstrual and menstrual cramps temporarily reduces fever
Boxed warning
None in the current label
Causality screen of the 8 strongest signals
What the badges mean
- Reporting / coding artifact An administrative, monitoring or exposure term (product issue, off-label use, 'test normal', overdose...). Not a biological reaction; a high PRR here reflects how reports are coded.
- Lab value / disease marker A laboratory result, investigation or disease-activity marker (antibody positive, CRP abnormal, swollen joint count) not described in the label. These usually mirror the monitored disease or testing protocol rather than a drug effect; not screened further.
- Not in label — unassessed Not found in the label text, not an artifact pattern. This is a genuine candidate for a formal causality assessment (Bradford Hill / WHO-UMC); it has NOT had one here.
Strongest disproportionality signals
Flagged terms (PRR ≥ 2, χ² ≥ 4, n ≥ 10), ranked by PRR; infinite PRRs (no comparator reports) excluded. The EBGM column is a second, shrinkage-based estimate (MGPS) with its 5th percentile EB05 and the BCPNN IC025; a pair flagged by PRR alone is marked PRR-only and should be read as fragile. The strata column recomputes the PRR on serious reports only (and, for the 300 most-reported drugs, adjusted for age band), and flags pairs whose reports are unusually skewed by sex or come mostly from consumers. Each row also shows the PRR against the other drugs of the same FDA class, which removes most confounding by the condition being treated, and a calibrated p-value: on validation, known non-causes average an ROR of about 2, so significance is judged against that empirical null (✓ = p < 0.05 after calibration). 3 further terms are in the interactive explorer. Reaction links open the term's cross-drug page.
| Reaction | Reports | PRR 95% CI · ROR · χ²/p | EBGM EB05 · IC025 | Label screen | Serious-only & strata | Trial cross-check |
|---|---|---|---|---|---|---|
| Disease recurrence | 106 | 55.6 46.5–66.4ROR 63.5 · calibrated p 4e-6 ✓ | 54.9 EB05 46.7 · IC025 +5.1 3/3 methods agree | Reporting / coding artifact | serious PRR 4.7 · 85% consumer | no trial data cached |
| Covid-19 | 132 | 18.6 15.9–21.8ROR 21.9 · calibrated p 0.001 ✓ | 18.6 EB05 16.1 · IC025 +3.8 3/3 methods agree | Not in label — unassessed | serious PRR 4.5 · 80% consumer | no trial data cached |
| Sars-cov-2 test positive | 7 | 13.1 6.3–27.4ROR 13.2 · calibrated p 0.025 ✓ | 10.0 EB05 4.3 · IC025 +1.6 3/3 methods agree | Lab value / disease marker | serious n=2 | no trial data cached |
| Respiratory tract congestion | 7 | 11.0 5.3–23.0ROR 11.1 · calibrated p 0.043 ✓ | 8.0 EB05 3.7 · IC025 +1.4 3/3 methods agree | Not in label — unassessed | serious PRR 10.9 | no trial data cached |
| Anosmia (loss of smell) | 6 | 10.3 4.7–22.9ROR 10.4 · calibrated p 0.056 | 7.1 EB05 3.1 · IC025 +1.2 3/3 methods agree | Not in label — unassessed | serious n=1 | no trial data cached |
| Nasopharyngitis (common cold) | 74 | 10.0 8.0–12.4ROR 10.9 · calibrated p 0.026 ✓ | 9.7 EB05 7.9 · IC025 +2.9 3/3 methods agree | Not in label — unassessed | serious PRR 12.2 | no trial data cached |
| Dysgeusia (altered taste) | 29 | 9.7 6.8–13.9ROR 10.0 · calibrated p 0.038 ✓ | 9.0 EB05 6.4 · IC025 +2.5 3/3 methods agree | Not in label — unassessed | serious PRR 2.8 · 89% consumer | no trial data cached |
| Sinus congestion | 5 | 9.2 3.8–22.1ROR 9.3 · calibrated p 0.083 | 5.9 EB05 2.5 · IC025 +0.8 3/3 methods agree | Not in label — unassessed | – | no trial data cached |
Trial evidence (ClinicalTrials.gov)
Most frequently reported reactions
By raw co-report count, regardless of disproportionality. Common terms here are often the illness itself or generic outcomes.
| Reaction | Reports | PRR 95% CI · ROR · χ²/p | EBGM EB05 · IC025 | Label screen | Serious-only & strata | Trial cross-check |
|---|---|---|---|---|---|---|
| Covid-19 | 132 | 18.6 15.9–21.8ROR 21.9 · calibrated p 0.001 ✓ | 18.6 EB05 16.1 · IC025 +3.8 3/3 methods agree | Not in label — unassessed | serious PRR 4.5 · 80% consumer | no trial data cached |
| Disease recurrence | 106 | 55.6 46.5–66.4ROR 63.5 · calibrated p 4e-6 ✓ | 54.9 EB05 46.7 · IC025 +5.1 3/3 methods agree | Reporting / coding artifact | serious PRR 4.7 · 85% consumer | no trial data cached |
| Nasopharyngitis (common cold) | 74 | 10.0 8.0–12.4ROR 10.9 · calibrated p 0.026 ✓ | 9.7 EB05 7.9 · IC025 +2.9 3/3 methods agree | Not in label — unassessed | serious PRR 12.2 | no trial data cached |
| Dysgeusia (altered taste) | 29 | 9.7 6.8–13.9ROR 10.0 · calibrated p 0.038 ✓ | 9.0 EB05 6.4 · IC025 +2.5 3/3 methods agree | Not in label — unassessed | serious PRR 2.8 · 89% consumer | no trial data cached |
| Completed suicide (death by suicide) | 7 | 2.1 1.0–4.3ROR 2.1 · calibrated p 0.991 | 2.0 EB05 1.1 · IC025 -0.3 PRR-only: not supported by EBGM or IC | Outcome field, not a reaction | serious PRR 3.1 | no trial data cached |
| Respiratory tract congestion | 7 | 11.0 5.3–23.0ROR 11.1 · calibrated p 0.043 ✓ | 8.0 EB05 3.7 · IC025 +1.4 3/3 methods agree | Not in label — unassessed | serious PRR 10.9 | no trial data cached |
| Sars-cov-2 test positive | 7 | 13.1 6.3–27.4ROR 13.2 · calibrated p 0.025 ✓ | 10.0 EB05 4.3 · IC025 +1.6 3/3 methods agree | Lab value / disease marker | serious n=2 | no trial data cached |
| Anosmia (loss of smell) | 6 | 10.3 4.7–22.9ROR 10.4 · calibrated p 0.056 | 7.1 EB05 3.1 · IC025 +1.2 3/3 methods agree | Not in label — unassessed | serious n=1 | no trial data cached |
| Sinus congestion | 5 | 9.2 3.8–22.1ROR 9.3 · calibrated p 0.083 | 5.9 EB05 2.5 · IC025 +0.8 3/3 methods agree | Not in label — unassessed | – | no trial data cached |
| Dysmenorrhoea | 4 | 7.6 2.9–20.3ROR 7.7 · calibrated p 0.143 | 4.6 EB05 1.9 · IC025 +0.4 | Not in label — unassessed | serious n=1 | no trial data cached |
| Mydriasis | 4 | 7.8 2.9–20.7ROR 7.8 · calibrated p 0.137 | 4.7 EB05 2.0 · IC025 +0.4 | Not in label — unassessed | serious PRR 11.4 | no trial data cached |
Unlabeled candidate signals
These flagged terms were not found in the FDA label text and do not match an artifact pattern. They are the pairs that would merit a structured assessment (temporality, dose-response, biological plausibility, consistency across databases, trial or cohort evidence). The screen has not done that; string-matching misses label wording, and a strong PRR can still be stimulated reporting, co-medication, or the disease itself.
- Covid-19 — n=132, PRR 18.6
- Nasopharyngitis — n=74, PRR 10.0
- Dysgeusia — n=29, PRR 9.7
✓ A hand-written Bradford Hill causality assessment exists for this drug: Acetaminophen (paracetamol) ↔ Liver injury / hepatotoxicity.
Want to assess one of these properly? The runbook describes the Bradford Hill / trial-evidence workflow used on the assessment page, and handoff_top1000_signals.csv lists the strongest unassessed pairs across all drugs.
Common questions
What are the most reported side effects of Acetaminophen, Dextromethorphan Hydrobromide?
In FDA FAERS, the most frequently co-reported reaction terms for Acetaminophen, Dextromethorphan Hydrobromide are covid-19, nasopharyngitis, dysgeusia, respiratory tract congestion, sars-cov-2 test positive, anosmia. These are report counts, not rates: FAERS has no denominator, reporting is voluntary and uneven, and a term can be reported because of the illness being treated rather than the drug.
Does Acetaminophen, Dextromethorphan Hydrobromide have an FDA boxed warning?
No. The FDA label retrieved for Acetaminophen, Dextromethorphan Hydrobromide has no boxed warning; see the label's Warnings and Precautions for the recognised risks.
Do FAERS signals prove that Acetaminophen, Dextromethorphan Hydrobromide causes these side effects?
No. A disproportionality signal (PRR, ROR) means a reaction is reported more often with this drug than with others in the database. That can reflect a real effect, but also the disease being treated, stimulated reporting after news or litigation, co-medications, or how reports are coded. Causality needs temporality, dose-response, biological plausibility, consistency across data sources and, ideally, trial or cohort evidence. This page screens each term against the FDA label and ClinicalTrials.gov results; it does not establish causation.
Sources & methods
- FDA label via openFDA (set ID 004c39cd-b4f4-1cae-e063-6394a90a0697, effective 20251003; matched on
openfda.generic_name.exact:"ACETAMINOPHEN") - Bayesian shrinkage measures computed offline over all 1,317,300 cached pairs: BCPNN information component (IC, with Norén closed-form IC025) and MGPS empirical-Bayes geometric mean (EBGM, EB05) with a two-component gamma prior fitted by maximum marginal likelihood (α₁=0.57, β₁=0.02, α₂=1.42, β₂=0.70, w=0.17); unstratified
- FAERS pair statistics from the OpenPV build of 2026-09-14 (openFDA
count=aggregation, fieldpatient.drug.openfda.generic_name.exact, 11 reaction terms, min 3 co-reports); PRR/ROR with 95% CI, chi-square with Yates correction - Serious-only and stratified counts (serious:1, patient.patientsex, primarysource.qualification) from openFDA count queries; serious-only PRR uses the drug serious report total and the term global serious total (N_serious=11,882,979); strata shown only when n ≥ 20
- Seriousness and sex counts from openFDA
count=serious,patient.patientsex,seriousnessdeath
Page generated 2026-10-14. Label and PubChem text are retrieved automatically and may lag the current label; always check the current prescribing information. OpenPV is a beta research tool of the Open Source Medicine Foundation.