Dextromethorphan

(dex troe meth or' fan)

P  - Caution when used during pregnancy

Molecule Info

 
Indication & Dosage Oral
Cough suppressant
Adult: 10-20 mg every 4 hr, or 30 mg every 6-8 hr. Extended-release oral suspension: 60 mg bid. Max: 120 mg/day. 
Child: 6-12 yr: 5-10 mg every 4 hr or 15 mg every 6-8 hr; 2-6 yr: 2.5-5 mg every 4 hr or 7.5 mg every 6-8 hr; up to 2 yr: Individualised dosage. Extended release oral suspension: 6-12 yr: 30 mg bid; 2-6 yr: 15 mg bid. Max: 6-12 yr: 60 mg/day; 2-6 yr: 30 mg/day.
Administration

Should be taken with food.

Overdosage

Symptoms: In mild overdose, tachycardia, hypertension, vomiting, mydriasis, diaphoresis, nystagmus, euphoria, loss of motor coordination, and giggling; in moderate intoxication, in addition to those listed above, hallucinations and a plodding ataxic gait; in severely intoxication, agitation or somnolence. Management: treatment is symptomatic and supportive. Naloxone may be useful in reversing toxicity.

Contraindications

Patients at risk of developing resp failure. During an acute attack. Patients receiving MAOI or for 2 wk after discontinuing them. Persistent or chronic cough.

Special Precautions

3rd trimester of pregnancy; atopic childn; child <1 yr; sedated or debilitated patients; patients confined to supine position; history of asthma. Moderate to severe renal impairment; liver disease.

Adverse Drug Reactions

Dizziness, GI disturbances.

Drug Interactions

Tricyclic antidepressants (TCAs), antipsychotics, anxiolytics and hypnotics, cimetidine, ciprofloxacin, domperidone, metoclopramide, mexiletine, CYP2D6 inhibitors, ritonavir, alcohol.
Potentially Fatal: Memantine, moclobemide.

Pregnancy Category (US FDA)

Category C: Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.

Storage Store at 15-30°C.
Pharmacology Dextromethorphan, a derivative of levorphanol, is an antitussive agent. It has a central action on the cough center in the medulla.
Onset: Oral: 30 minutes.
Duration: Oral: Up to 6 hr.
Absorption: Rapidly absorbed in the GI tract.
Metabolism: Hepatically metabolised.
Excretion: Excreted in the urine unchanged.
mph Class Cough & Cold Preparations
ATC Classification R05DA09 - dextromethorphan ; Belongs to the class of cough suppressants, opium alkaloids and derivatives. Used in the treatment of dry cough.
 

Search Google: Dextromethorphan

Brand/Product Info


Total Products : 10          
Brand Name Manufacturer/Marketer Composition Dosage Form Pack Size & Price
BROFEX SYP Square Pharmaceuticals Ltd. Dextromethorphan 10mg/5 ml Syrup 100 ml: 40.13 MRP
COLDFLU Amico Laboratories Ltd. Dextromethorphan 10mg/5ml Syrup 100ml: 23.00 MRP
D-COUGH Opsonin Pharma Limited Dextromethorphan 10mg/5ml Syrup 100ml: 25.00 MRP
DEXOPHAN Somatec Pharmaceuticals Ltd. Dextromethorphan 10mg/5ml Syrup 100ml: 24.09 MRP
DEXPOTEN Eskayef Bangladesh Ltd Dextromethorphan Hydrobromide BP 10mg/5ml Syrup 100ml MRP: 55.00
DEXSOL Gaco Pharmaceutical Ltd. Dextromethorphan 10mg/5ml Syrup 100ml: 25.00 MRP
DEXTROMETHORPHAN Beximco Pharmaceuticals Ltd Dextromethorphan Hydrobromide BP 10mg/5ml Syrup 100ml: 35.00 MRP
EXOPHAN Apollo Pharmaceutical Laboratories Ltd. Dextromethorphan 10mg/5ml Syrup 100ml: 24.00 IP
METODEX Ad-din pharmaceuticals Ltd. Dextromethorphan 10mg/5ml Syrup 100ml: 25.00 MRP
Tomephen Incepta Pharmaceuticals Limited Dextromethorphan Hydrobromide BP 10mg/5ml Syrup 100ml:MRP 40 Tk

Gen. MedInfo

 IMPORTANT WARNING:

US FDA Intends to Remove Some Unapproved Cough, Cold and Allergy Drugs from the Market

This safety alert does not apply to this medication, but only to some products which contain this medication. In addition, it is important that you know that there is not a problem with most of the products described in this medication monograph. And some drug companies (in the USA) may decide to seek full approval from the FDA so that they can continue marketing their products.

On March 2, 2011, the Food and Drug Administration (FDA) issued a safety alert about certain unapproved prescription cough, cold, and allergy products containing this drug in combination with other drugs. These products are not currently approved by the FDA for safety, effectiveness, and quality. FDA asked drug companies to stop shipping most of these products for sale in the US within the next 6 months. Although some of these products have been marketed for many years, laws about what a company must prove to FDA for drug product approval have gotten tougher and increased enforcement of these laws is now taking place. The FDA took this action due to concerns about certain potential risks associated with use of these medications. These risks may include:

  • the possibility of improper use in infants and young children

  • potentially risky combinations of ingredients

  • patients receiving too much or too little of the medication because of problems with the way some ''timed-release'' products are made

If you are concerned that the prescription cough, cold, and allergy medication you are taking is not approved by the FDA, you should talk to your doctor or pharmacist. If the medication you are taking is not approved, your doctor can prescribe another prescription medication or your doctor or pharmacist can suggest an over-the-counter (OTC) cough, cold, and allergy product for your condition. There are many safe and effective alternative approved products that can be taken instead. Your doctor probably prescribed the medicine without knowing that FDA had not approved it. This is because it has been so difficult for doctors and pharmacists to find out that these products are unapproved. For additional information:

Why is this medication prescribed?

Dextromethorphan is used to temporarily relieve cough caused by the common cold, the flu, or other conditions. Dextromethorphan will relieve a cough but will not treat the cause of the cough or speed recovery. Dextromethorphan is in a class of medications called antitussives. It works by decreasing activity in the part of the brain that causes coughing.

How should this medicine be used?

Dextromethorphan may come as a syrup (mostly in Bangladesh), a liquid-filled capsule, a chewable tablet, a dissolving strip, an extended-release (long-acting) suspension (liquid), and a lozenge to take by mouth. It is usually taken every 4 to 12 hours as needed. Follow the directions on the package or prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand.

Dextromethorphan should only be used according to the label or package directions. Do not take more than the recommended amount of dextromethorphan in a 24-hour period. Refer to the package or prescription label to determine the amount contained in each dose. Taking dextromethorphan in large amounts can cause serious side effects or death.

Dextromethorphan comes alone and in combination with antihistamines, cough suppressants, and decongestants. Ask your doctor or pharmacist for advice on which product is best for your symptoms. Check nonprescription cough and cold product labels carefully before using 2 or more products at the same time. These products may contain the same active ingredient(s) and taking them together could cause you to receive an overdose. This is especially important if you will be giving cough and cold medications to a child.

Nonprescription cough and cold combination products, including products that contain dextromethorphan, can cause serious side effects or death in young children. Do not give these products to children younger than 4 years of age. If you give these products to children 4-11 years of age, use caution and follow the package directions carefully.

If you are giving dextromethorphan or a combination product that contains dextromethorphan to a child, read the package label carefully to be sure that it is the right product for a child of that age. Do not give dextromethorphan products that are made for adults to children.

Before you give a dextromethorphan product to a child, check the package label to find out how much medication the child should receive. Give the dose that matches the child's age on the chart. Ask the child's doctor if you don't know how much medication to give the child.

If you are taking the liquid, do not use a household spoon to measure your dose. Use the measuring spoon or cup that came with the medication or use a spoon made especially for measuring medication.

If you are using the dissolving strips, place them on your tongue and swallow after they melt.

If you are taking the chewable tablets you can allow them to melt in your mouth or you can chew them before swallowing.

If you are taking the extended-release suspension, shake the bottle well before each use to mix the medication evenly.

If you are taking the lozenges, allow them to slowly melt in your mouth.

Stop taking dextromethorphan and call your doctor if your cough does not get better within 7 days, if your cough goes away and comes back, or if your cough occurs with a fever, rash, or headache.

Other uses for this medicine

This medication is sometimes prescribed for other uses; ask your doctor for more information.

What special precautions should I follow?
Before taking dextromethorphan,
  • tell your doctor if you are allergic to dextromethorphan, any other medications, or any of the ingredients in the product you plan to take. Check the package label for a list of the ingredients.
  • do not take dextromethorphan if you are taking a monoamine oxidase (MAO) inhibitor such as isocarboxazid, phenelzine, selegiline, and tranylcypromine, or if you have stopped taking an MAO inhibitor within the past 2 weeks.
  • tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take.
  • tell your doctor if you smoke, if you have a cough that occurs with a large amount of phlegm (mucus), or if you have or have ever had breathing problems such as asthma, emphysema, or chronic bronchitis.
  • tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking dextromethorphan, call your doctor.
  • if you have phenylketonuria (PKU, an inherited condition in which a special diet must be followed to prevent mental retardation), you should know that some brands of chewable tablets that contain dextromethorphan may be sweetened with aspartame, a source of phenylalanine.

What special dietary instructions should I follow?

Unless your doctor tells you otherwise, continue your normal diet.

What should I do if I forget a dose?

Dextromethorphan is usually taken as needed. If your doctor has told you to take dextromethorphan regularly, take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

What side effects can this medication cause?
Dextromethorphan may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
  • dizziness

  • lightheadedness

  • drowsiness

  • n ervousness

  • restlessness

  • nausea

  • vomiting

  • stomach pain

If you experience any of the following symptoms, call your doctor immediately:
  • rash

Dextromethorphan may cause other side effects. Consult your doctor if you experience any unusual problems while you are taking this medication.

What should I know about storage and disposal of this medication?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed.

In case of emergency/overdose

In case of overdose, consult your doctor. If the victim has collapsed or is not breathing, consult local medical emergency services.

Symptoms of overdose may include:
  • nausea

  • vomiting

  • drowsiness

  • dizzines s

  • unsteadiness

  • changes in vision

  • difficulty breathing

  • fast heartbeat

  • hallucinating (seeing things or hearing voices that do not exist)

  • seizures

  • coma (loss of consciousness for a period of time)

What other information should I know?

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

 

This information is provided for reference only and not a replacement for and should only be used in conjunction with full consultation with a registered medical practitioner. It may not contain all the available information you require and cannot substitute professional medical care, nor does it take into account all individual circumstances. Although great effort has been made to ensure content accuracy, mph-bd shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise.