Dextromethorphan

Dextromethorphan is an over-the-counter (OTC) medication used to treat cough.

• Dextromethorphan is available under the following different brand names: Balminil DM, Benylin DM, Bronchophan, Buckleys D, Calylin #1, Delsym, Koffex DM, Novahistex DM, Robitussin Lingering Cold Long-Acting Cough, Robitussin lingering Cold Long-Acting CoughGels, Children's Robitussin Cough Long-Acting, and Sucrets 8 Hour Cough Relief DM Cough Formula.

Dosages of Dextromethorphan:

Tablet (adult and pediatric)

• 15 mg

Capsule (adult)

• 15 mg

Capsule (pediatric)

• 15 mg
• 25 mg

Gel, oral (adult and pediatric)

• 7.5 mg/5 ml

Liquid, oral (adult)

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

Syrup, oral (adult and pediatric)

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

Liquid, extended-release (adult and pediatric)

• 30 mg/5 ml

Lozenge (adult and pediatric)

• 5 mg
• 7.5 mg
• 15 mg

Strip, oral (adult and pediatric)

• 7.5 mg

Dosage Considerations – Should be Given as Follows:

Cough

Adult Dosage

• Liquid and syrup: 10-20 mg orally every 4 hours or 30 mg every 6-8 hours
• Gel: 30 mg orally every 6-8 hours, not to exceed 120 mg per day
• Extended-release: 60 mg orally every 12 hours, not to exceed 120 mg per day
• Lozenges: 5-15 mg orally every 1-4 hours, not to exceed 120 mg per day
• Strips: 30 mg orally every 6-8 hours, not 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

Cough

Pediatric Dosage

• Children under 4 years: prescription only
• Extended-release:
  • Children 4-6 years old: 15 mg orally twice daily, not to exceed 30 mg per day
  • Children 6-12 years: 30 mg orally twice daily, not to exceed 60 mg per day
  • Children over 12 years: 60 mg orally twice daily, not to exceed 120 mg per day
• Liquid/Syrup
  • Children 4-6 years old: 7.5 mg every 6-8 hours, not to exceed 30 mg per day
  • Children 6-12 years old: 15 mg orally every 6-8 hours, not 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 hours, not to exceed 120 mg per day
• Lozenges
  • Children 6-12 years: 5-10 mg every 1-4 hours, not to exceed 60 mg per day
  • Children over 12 years: 5-15 mg orally every 1-4 hours, not to exceed 120 mg per day
• Strips
  • Children 6-12 years: 15 mg orally every 6-8 hours, not to exceed 60 mg per day
  • Children over 12 years: 30 mg orally every 6-8 hours, not 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

Side effects associated with the use of Dextromethorphan, include the following:

• nausea
• vomiting
• constipation
• drowsiness
• dizziness
• sedation
• confusion
• nervousness

This document does not contain all possible side effects and others may occur. Check with your physician for additional information about side effects.

If your doctor has directed you to use this medication, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Severe Interactions of Dextromethorphan include:
  • isocarboxazid
  • phenelzine
  • procarbazine
  • rasagiline
  • safinamide
  • selegiline
  • tranylcypromine
• Dextromethorphan has serious interactions with at least 36 different drugs.
• Dextromethorphan has moderate interactions with at least 38 different drugs.
• Dextromethorphan has mild interactions with at least 24 different drugs.

This information does not contain all possible interactions or adverse effects. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions, concerns, or for more information about this medicine.

Warnings

• Avoid simultaneous use with nonselective monoamine oxidase inhibitors (MAO inhibitors) – serotonin syndrome
• Contains aspartame, use caution in patients with phenylketonuria
• May cause hallucinations, confusion, agitation, overactive reflexes, shivering, twitching of muscles, and rapid heart rate
• Not for use in children under 4 years old and use caution when using in children younger than 6 years old
• Use caution in patients who are sedated, debilitated, or confined to a supine position
• This medication contains dextromethorphan
• Do not take Balminil DM, Benylin DM, Bronchophan, Buckleys D, Calylin #1, Delsym, Koffex DM, Novahistex DM, Robitussin Lingering Cold Long-Acting Cough, Robitussin lingering Cold Long-Acting CoughGels, Children's Robitussin Cough Long-Acting, and Sucrets 8 Hour Cough Relief DM Cough Formula if you are allergic to dextromethorphan or any ingredients contained in this drug
• Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center immediately

Contraindications

• Avoid simultaneous use with nonselective monoamine oxidase inhibitors (MAO inhibitors) – serotonin syndrome.

Effects of Drug Abuse

• No information provided

Short-Term Effects

• May cause hallucinations, confusion, agitation, overactive reflexes, shivering, twitching of muscles, and rapid heart rate
• See "What Are Side Effects Associated with Using Dextromethorphan?"

Long-Term Effects

• See "What Are Side Effects Associated with Using Dextromethorphan?"

Cautions

• Contains aspartame, use caution in patients with phenylketonuria (PKU)
• May cause hallucinations, confusion, agitation, overactive reflexes, shivering, twitching of muscles, and rapid heart rate
• Not for use in children under 4 years old and use caution when using in children younger than 6 years old
• Use caution in patients who are sedated, debilitated, or confined to a supine position

Pregnancy and Lactation

• Use dextromethorphan during pregnancy with caution if the benefits outweigh the risks. Animal studies show risk and human studies are not available, or neither animal nor human studies were done
• It is not known if dextromethorphan is excreted in breast milk, use caution if breastfeeding