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dextromethorphan

Generic Name: dextromethorphan

Brand Names: Balminil DMBenylin DM, BronchophanBuckleys DMCalmylin #1DelsymKoffex DMNovahistex DMRobitussin Lingering Cold Long-Acting CoughRobitussin Lingering Cold Long-Acting CoughGelsChildren's Robitussin Cough Long-ActingSucrets 8 Hour Cough Relief DM Cough Formula

Drug Class: Antitussives

What is dextromethorphanand what is it used for?

Dextromethorphan is a medication used to control coughs caused by the common coldfluor other conditions. Dextromethorphan can temporarily relieve coughbut does not treat the cause of the cough or help with recovery.

Dextromethorphan is available over-the-counter under multiple brand names. Dextromethorphan is also often combined with other medications such as antihistamines and painkillers (analgesics).

Dextromethorphan suppresses cough by reducing the sensitivity of cough receptors in the brain region that stimulate the cough reflex and preventing the transmission of cough impulses. Dextromethorphan is a non-opioid drug derived from levorphanolan opioid analgesicand is structurally similar to opioid drugs such as codeine.

Dextromethorphan does not interact with opioid receptors and hencedoes not have analgesic or addictive propertieshoweverit increases the levels of chemical messengers such as serotoninand has the potential for abuse.

Warnings

  • Do not take dextromethorphan if you are allergic to it or any of its components
  • Do not use dextromethorphan simultaneously with monoamine oxidase inhibitors (MAOIs)which prevent break down of brain chemicals; can lead to serotonin syndrome
  • Do not administer dextromethorphan OTC to children younger than 4 years; it can cause serious side effects; use with caution in children of 4-11 years
  • Dextromethorphan may cause hallucinationsconfusionagitationoveractive reflexesshiveringmuscle twitching and rapid heart rate
  • Do not take for persistent or chronic cough associated with smokingasthmaor emphysemaor if you have excessive phlegmunless prescribed by your doctor; may slow respiration rate
  • Some brands of dextromethorphan may contain aspartamea source of the amino acid phenylalanine; use with caution in patients with phenylketonuriaan inherited condition that causes buildup of phenylalanine
  • Use with caution in patients who are sedateddebilitated or confined to supine position

What are the side effects of dextromethorphan?

Common side effects of dextromethorphan include:

This is not a complete list of all side effects or adverse reactions that may occur from the use of this drug.

Call your doctor for medical advice about serious side effects or adverse reactions. You may also report side effects or health problems to the FDA at 1-800-FDA-1088.

What are the dosages of dextromethorphan?

Tablet

  • 15 mg

Capsule

  • 15 mg
  • 25 mg

Geloral

  • 7.5 mg/5 ml

Liquidoral

  • 7.5 mg/5 ml
  • 10 mg/5 ml
  • 15 mg/5 ml

Syruporal

  • 5 mg/5 ml
  • 7.5 mg/5 ml
  • 10 mg/5 ml
  • 15 mg/5 ml
  • 20 mg/15 ml

Liquidextended-release

  • 30 mg/5 ml

Lozenge

  • 5 mg
  • 7.5 mg
  • 15 mg

Striporal

  • 7.5 mg

Adult

Cough

  • Liquid and syrup: 10-20 mg orally every 4 hours or 30 mg every 6-8 hours
  • Gel: 30 mg orally every 6-8 hoursnot to exceed 120 mg per day
  • Extended-release: 60 mg orally every 12 hoursnot to exceed 120 mg per day
  • Lozenges: 5-15 mg orally every 1-4 hoursnot to exceed 120 mg per day
  • Strips: 30 mg orally every 6-8 hoursnot to exceed 120 mg per day

Dosing considerations

  • Abuse potential is much lower than codeine
  • About 15-30 mg dextromethorphan is equal to 8-15 mg codeine as an antitussive

Pediatric

Cough

  • Children under 4 years: prescription only

Extended-release:

  • Children 4-6 years old: 15 mg orally twice dailynot to exceed 30 mg per day
  • Children 6-12 years: 30 mg orally twice dailynot to exceed 60 mg per day
  • Children over 12 years: 60 mg orally twice dailynot to exceed 120 mg per day

Liquid/Syrup

  • Children 4-6 years old: 7.5 mg every 6-8 hoursnot to exceed 30 mg per day
  • Children 6-12 years old: 15 mg orally every 6-8 hoursnot to exceed 60 mg per day
  • Children over 12 years: 10-20 mg orally every 4 hours or 30 mg every 6-8 hours not to exceed 120 mg per day

Gel

  • Children over 12 years: 30 mg every 6-8 hoursnot to exceed 120 mg per day

Lozenges

  • Children 6-12 years: 5-10 mg every 1-4 hoursnot to exceed 60 mg per day
  • Children over 12 years: 5-15 mg orally every 1-4 hoursnot to exceed 120 mg per day

Strips

  • Children 6-12 years: 15 mg orally every 6-8 hoursnot to exceed 60 mg per day
  • Children over 12 years: 30 mg orally every 6-8 hoursnot to exceed 120 mg per day

Dosing Considerations

  • Potential toxic doses children under 6 years: 10 mg/kg
  • About 15-30 mg dextromethorphan is equal to 8-15 mg codeine as an antitussive

QUESTION

Which illness is known as a viral upper respiratory tract infection? See Answer

Addiction/overdose

  • Dextromethorphan is not addictive like opioid medications but has the potential for abuse. There have been reports of abuse of dextromethorphan-containing productsespecially among teenagers.
  • Overdose can cause severe side effectsparticularly in children. In case of overdoseseek medical help or contact the Poison Control Center immediately.

What drugs interact with dextromethorphan?

Inform your doctor of all medications you are currently takingwho can advise you on any possible drug interactions. Never begin takingsuddenly discontinueor change the dosage of any medication without your doctor’s recommendation.

  • Severe Interactions of dextromethorphan include:
    • isocarboxazid
    • phenelzine
    • procarbazine
    • rasagiline
    • safinamide
    • selegiline
    • tranylcypromine
  • Dextromethorphan has serious interactions with at least 34 different drugs.
  • Dextromethorphan has moderate interactions with at least 58 different drugs.
  • Dextromethorphan has mild interactions with at least 22 different drugs.

The drug interactions listed above are not all of the possible interactions or adverse effects. For more information on drug interactionsvisit the RxList Drug Interaction Checker.

It is important to always tell your doctorpharmacistor health care provider of all prescription and over-the-counter medications you useas well as the dosage for eachand keep a list of the information.

Check with your doctor or health care provider if you have any questions about the medication.

Pregnancy and breastfeeding

  • There is insufficient information available on the use of dextromethorphan during pregnancy and breastfeeding.
  • Check with your doctor before taking dextromethorphan if you are pregnantplan to become pregnant or breastfeeding.

What else should I know about dextromethorphan?

  • Follow package instructions exactly while taking OTC drugs. Do not take higher or more frequent doses than recommended.
  • Store dextromethorphan out of reach of children and dispose of unused medication carefully.
  • Stop taking dextromethorphan and see your doctor if your cough does not get better within 7 daysgoes away and comes backor is accompanied by other symptoms such as feverrashor headache.

Summary

Dextromethorphan is an over-the-counter (OTC) cough suppressant used to relieve coughing caused by the common coldfluor other illnesses. Common side effects of dextromethorphan include dizzinesslightheadednessdrowsinesssedationnervousnessrestlessnessconfusionnauseavomitingstomach painand constipation. Dextromethorphan is not addictive but has potential for abuse. Consult your doctor before taking dextromethorphan if pregnant or breastfeeding.

Treatment & Diagnosis

Medications & Supplements

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Report Problems to the Food and Drug Administration

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.

References
https://www.rxlist.com/consumer_dextromethorphan/drugs-condition.htm

https://reference.medscape.com/drug/balminil-dm-benylin-dm-dextromethorphan-343401#0

https://medlineplus.gov/druginfo/meds/a682492.html

https://www.uptodate.com/contents/dextromethorphan-drug-information

https://www.ncbi.nlm.nih.gov/books/NBK538216/

https://www.sciencedirect.com/topics/neuroscience/dextromethorphan

https://pubchem.ncbi.nlm.nih.gov/compound/Dextromethorphan
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