Dextromethorphan information from DrugsUpdate
P - Caution when used during pregnancy
Dextromethorphan (DXM or DM) is an antitussive drug. It is one of the active ingredients used to prevent coughs in many over-the-counter cold and cough medicines. Dextromethorphan has also found other uses in medicine, ranging from pain relief to psychological applications. It is sold in syrup, tablet, spray, and lozenge forms manufactured under several different brand names and generic labels. In its pure form, dextromethorphan occurs as a white powder.
When exceeding label-specified maximum dosages, dextromethorphan acts as a dissociative psychedelic drug. Its mechanism of action is as an NMDA receptor antagonist, producing effects similar to those of the controlled substances ketamine and phencyclidine (PCP).
Pharmacodynamics
Pharmacokinetics
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.
Dextromethorphan Indications / Dextromethorphan Uses
Information Not Available
Dextromethorphan Adverse Reactions / Dextromethorphan Side Effects
Dizziness, GI disturbances
Precautions
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.
Special Precautions
Third 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.
Other Drug Interactions
Tricyclic antidepressants (TCAs), antipsychotics, anxiolytics and hypnotics, cimetidine, ciprofloxacin, domperidone, metoclopramide, mexiletine, CYP2D6 inhibitors, ritonavir, alcohol.
Potentially Fatal: Memantine, moclobemide.
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.
Food(before/after)
May be taken with or without food
List of Contraindications
Dextromethorphan and Pregnancy
Caution when used during pregnancy
Dextromethorphan and Lactation
Information Not Available
Dextromethorphan and Children
Information Not Available
Dextromethorphan and Geriatic
Information Not Available
Dextromethorphan and Other 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.
Storage
Oral: Store at 15-30°C.
Lab interference
Oral: Store at 15-30°C.
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