dextromethorphan/menthol (Delsym Cough + Soothing Action)

Dosing and uses of Delsym Cough + Soothing Action (dextromethorphan/menthol)

• Adult
• Pediatric

 

Adult dosage forms and strengths

dextromethorphan/menthoL

lozenge

• 5mg/5mg

 

Cough & Sore Throat

Indicated for temporary relieve of sore throat, sore mouth, minor mouth irritation, and cough due to minor throat and bronchial irritation as with the common cold

2 lozenges dissolved in mouth, 1 immediately after the other, q4hr prn; not to exceed 12 lozenges/day

 

Pediatric dosage forms and strengths

dextromethorphan/menthoL

lozenge

• 5mg/5mg

 

Cough & Sore Throat

Indicated for temporary relieve of sore throat, sore mouth, minor mouth irritation, and cough due to minor throat and bronchial irritation as with the common cold

<6 years: Safety and efficacy not established

6-11 years: 1 lozenge dissolved in mouth q4hr prn; not to exceed 6 lozenges/day

≥12 years: 2 lozenges dissolved in mouth, 1 immediately after the other, q4hr prn; not to exceed 12 lozenges/day

 

Delsym Cough + Soothing Action (dextromethorphan/menthol) adverse (side) effects

Frequency not defined

Dextromethorphan

• Nausea
• Vomiting
• Constipation
• Drowsiness
• Dizziness
• Sedation
• Confusion
• Nervousness

 

Warnings

Contraindications

Hypersensitivity

Concurrent use MOAIs or within 2 weeks after stopping MAOIs

 

Cautions

Contact physician promptly if sore throat is severe, persists for >2 days, is accompanied or followed by fever, headache, rash, nausea or vomiting

Ask physician before use for persistent or chronic cough associated with smoking, asthma, or emphysema

Ask physician before use for cough accompanied by excessive phlegm

Stop and contact physician or dentist if sore mouth does not improve in 7 days, irritation, pain or redness persists or worsens, swelling develops, or for a cough that last >7 days, reoccurs, or is accompanied by fever, rash, or persistent headache

 

Pregnancy and lactation

Pregnancy category: C

Lactation: Unknown if distributed in human breast milk

Pregnant or breastfeeding patients should seek advice of health professional before using OTC drugs

 

Pregnancy categories

A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

NA: Information not available.

 

Pharmacology of Delsym Cough + Soothing Action (dextromethorphan/menthol)

Mechanism of action

Dextromethorphan: Derivative of levorphanol; acts on cough center in medulla; decreases sensitivity of cough receptors and interrupts cough impulse transmission

Menthol: Topical anesthetic that reversibly blocks nerve conduction near the application site, thereby producing temporary loss of sensation in a limited area

 

Pharmacokinetics

Dextromethorphan

• Onset: 15-30 min
• Duration: ≤6 hr
• Time to peak: 2-3hr
• Metabolism: Hepatic P450 enzyme CYP2D6
• Half-life: 2-4hr (extensive metabolizers); 24 hr (poor metabolizers)
• Excretion: Urine