Dextromethorphan

Table of contents

  • Brand Names
  • Drug Combinations
  • Chemistry
  • Pharmacologic Category
  • Mechanism of Action
  • Therapeutic Use
  • Unlabeled Use
  • Contraindications
  • Warnings and Precautions
  • Adverse Reactions
  • Caution and personalized dose adjustment in patients with the following genotypes
  • Other genes that may be involved
  • Substrate of
  • Inhibits
  • Drug Interactions
  • Dosage
  • Pharmacokinetics and Pharmacodynamics
  • Special Considerations

Brand Names

Europe

Austria: Tussastopp, Wick Formel; Belgium: Actifed, Bronchosedal, Dexir, Dextromethorphan, Nortoussine Mono, Romilar, Touxium Antitussivum, Tussipect; Bulgaria: Tussipress; Cyprus: Actifed; Czech Republic: Dr. Rentschler Hustenstiller Saft, Humex, Robitussin Antitussicum, Stopex, Tussidrill; Denmark: Dexofan; Finland: Resilar, Rometor; France: Atuxane, Capsyl, Dexir, Dextrocidine, Dextromethorphane, Drill Toux Seche, Ergix Toux Seche, Fluditec, Humex, Nodex, Nortussine, Pulmodexane, Tussidane, Tuxium, Vicks Adultes Toux Seche Miel; Germany: Dextro Bolder, Dextrocap, Hustenstiller, Lairant, NeoTussan, Silomat; Greece: Alexofen, Vaposyrup; Hungary: Drill Szirup Felnőtteknek, Methor; Ireland: Delsym, Robitussin Dry Cough, Tussidrill; Italy: Actifed, Aricodiltosse, Bechilar, Bisolvon Tosse, Bronchenolo Tosse, Bronchetab, Broncofama, Formitrol, Lisomucil Tosse, Metorfan, Ozopulmin, Polised, Tossemed, Vicks; Latvia: Dexofan, Fluditec; Luxembourg: Akindex, Bronchosedal, Capsyl, NeoTussan, Romilar, Soludril Toux Seches, Touxium Antitussivum; Malta: Formitrol, Numark Adult Dry Cough Linctus, Robitussin; Netherlands: Bisoltussin, Dampo, Darolan, Dextromethorfan, Pectofree, Vicks Hoestsiroop; Poland: Acodin, Argotussin, Dekstromet, Dexapini, Dexatussin, Mucotussin, Robitussin, Tussal Antitussicom, Tussidex, TussiDrill; Portugal: Bisoltussin, Diacol, Drill Tosse Seca, Rhinathiol, Setustop, Tussilene, Vicks Pastilhas, Vicks Xarope Antitussico; Romania: Humex, Robitussin, Rofedex, Tusalin, Tussidril, Tussin; Slovakia: Robitussin Antitussicum, Stopex; Slovenia: Formel; Spain: Aquitos, Bexatus, Bicasan, Couldetos, Dextrolaf, Dextrometorfano, Formulatus, Frenatus, Fritusil, Hibitos, Inistolin, Iniston, Lafnitos, Laitos, Notus, Novag Tuss, Parlatos, Romilar, Tip, Tusorama, Tussidrill, Valdatos; UK: Nirolex Dry Cough Relief, Robitussin.

North America

Canada: Balminil DM, Bronchophan Forte DM, Buckley’s DM, Children’s Cough Strips, Cough Syrup DM, Delsym, DM Children’s Cough Syrup, DM Sans Sucre Liq, DM Syrup, Dristan DM, Dry Cough Syrup, Jack & Jill Thin Strips Cough, Koffex DM, Neocitran Thin Strips Cough, Robitussin, Sedatuss DM, Sucrets DM, Triaminic DM, Vicks Custom Care Dry Cough; USA: Delsym.

Latin America

Argentina: Dextrometorfano, Dextrotos, Romilar; Mexico: Atassol, Athos, Balbek, Balsedrina, Bioquidan, Brocolan, Brogal, Bromelip, Dextrometorfano, Flex Metak, Jarabe Garde, Neo-Ulcoid, Protan, Quimofan, Romilar, Tosifan.

Asia

Japan: Astomari, Detomefan, Dextophan, Hihustan, Medicon, Mezec, Sisaal, Trimpus.

Drug combinations

Dextromethorphan and Acetaminophen

Dextromethorphan and Albuterol

Dextromethorphan and Chlorpheniramine

Dextromethorphan and Ephedrine

Dextromethorphan and Guaifenesin

Dextromethorphan and Promethazine

Dextromethorphan and Pseudoephedrine

Dextromethorphan and Quinidine

Dextromethorphan and Triprolidine

Dextromethorphan, Acetaminophen, and Doxylamine

Dextromethorphan, Acetaminophen, and Phenylephrine

Dextromethorphan, Acetaminophen, and Promethazine

Dextromethorphan, Acetaminophen, and Pseudoephedrine

Dextromethorphan, Ammonium Chloride, and Chlorpheniramine

Dextromethorphan, Brompheniramine, and Pseudoephedrine

Dextromethorphan, Chlorpheniramine, and Ephedrine

Dextromethorphan, Chlorpheniramine, and Phenylephrine

Dextromethorphan, Chlorpheniramine, and Pseudoephedrine

Dextromethorphan, Guaifenesin, and Phenylephrine

Dextromethorphan, Guaifenesin, and Pseudoephedrine

Dextromethorphan, Phenylephrine, and Pyrilamine

Dextromethorphan, Pseudoephedrine, and Triprolidine

Dextromethorphan, Acetaminophen, Chlorpheniramine, and Pseudoephedrine

Dextromethorphan, Acetaminophen, Doxylamine, and Ephedrine

Dextromethorphan, Acetaminophen, Doxylamine, and Pseudoephedrine

Dextromethorphan, Acetaminophen, Guaifenesin, and Pseudoephedrine

Dextromethorphan, Bromhexine, Diphenhydramine, and Ephedrine

Dextromethorphan, Chlorpheniramine, Ephedrine, and Guaifenesin

Dextromethorphan, Chlorpheniramine, Guaifenesin, and Phenylephrine

Dextromethorphan, Guaifenesin, Mepyramine, and Phenylephrine

Dextromethorphan, Acetaminophen, Bromhexine, Chlorpheniramine, and Phenylephrine

Chemistry

Dextromethorphan Hydrobromide: C~18~H~25~NO HBr H~2~O. Mw: 370.32. (1) Morphinan, 3-methoxy-17-methyl-, (9α,13α,14α)-, hydrobromide, monohydrate; (2) 3-Methoxy-17-methyl-9α,13α,14α-morphinan hydrobromide monohydrate. CAS-6700-34-1; CAS-125-69-9 (anhydrous); CAS-125-71-3 (dextromethorphan).

Pharmacologic Category

Antitussives. (ATC-Code: R05DA09).

Mechanism of action

Chemical relative of morphine lacking narcotic properties except in overdose. Controls cough by depressing the medullary cough center.

Therapeutic use

Symptomatic relief of cough caused by minor viral upper respiratory tract infections or inhaled irritants. Treatment of chronic nonproductive cough. The drug is a common ingredient in commercial cough mixtures available without prescription.

Pregnancy and lactiation implications

Unlabeled use

N-methyl-D-aspartate (NMDA) antagonist in cerebral injury.

Contraindications

Hypersensitivity to dextromethorphan or any component of the formulation. Avoid use with or within 2 weeks of an MAO inhibitor.

Warnings and precautions

Caution in atopic children and in patients who are sedated, debilitated or confined to a supine position. May contain coconut oil or tartrazine. Over-the-counter cough and cold medications should not be used to treat infants and children <2 years of age.

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