Professional Information

Dextromethorphan Hydrobromide

Pronunciation: (DEX-troe-meth-OR-fan HIGH-droe-BROE-mide)
Class: Nonnarcotic antitussive

Trade Names:
Creo-Terpin
- Liquid 10 mg per 15 mL

Trade Names:
Delsym
- Liquid, sustained-action Dextromethorphan polistirex equivalent to dextromethorphan hydrobromide 30 mg per 5 mL

Trade Names:
Diabetes CF
- Syrup 10 mg per 5 mL

Trade Names:
Drixoral Cough Liquid Caps
- Capsules 30 mg

Trade Names:
Hold DM
- Lozenges 5 mg

Trade Names:
Pediatric Vicks 44d Dry Hacking Cough and Head Congestion
- Syrup 1 mg/mL

Trade Names:
Pertussin CS
- Liquid 3.5 mg per 5 mL

Trade Names:
Pertussin ES
- Liquid 15 mg per 5 mL

Trade Names:
Robitussin Cough Calmers
- Lozenges 5 mg

Trade Names:
Robitussin Pediatric
- Liquid 7.5 mg per 5 mL

Trade Names:
Scot-Tussin DM Cough Chasers
- Lozenges 2.5 mg

Trade Names:
Silphen DM
- Syrup 10 mg per 5 mL

Trade Names:
St. Joseph Cough Suppressant
- Liquid 7.5 mg/5 mL

Trade Names:
Sucrets 4-h Cough
- Lozenges 15 mg

Trade Names:
Sucrets Cough Control
- Lozenges 5 mg

Trade Names:
Sucrets DM Cough Formula
- Lozenges 10 mg

Trade Names:
Sucrets DM Cough Suppressant
- Lozenges 10 mg

Trade Names:
Suppress
- Lozenges 7.5 mg

Trade Names:
Trocal
- Lozenges 7.5 mg

Trade Names:
Vicks Dry Hacking Cough
- Liquid 15 mg per 5 mL

Balminil DM (Canada)
Balminil DM Children (Canada)
Benylin DM (Canada)
Benylin DM for Children (Canada)
Koffex DM (Canada)
Robitussin Children's (Canada)
Robitussin DM CoughGels (Canada)

Pharmacology

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Compare with other drugs.

Suppresses cough by central action on cough center in medulla.

Pharmacokinetics

Absorption

Rapidly absorbed.

Metabolism

Metabolized in the liver.

Elimination

Excreted in the urine as unchanged drug and demethylated metabolites.

Indications and Usage

Management of nonproductive cough.

Contraindications

Standard considerations.

Dosage and Administration

Gelcaps
Adults and Children (12 yr of age and older)

PO 30 mg every 6 to 8 h (max, 120 mg/day).

Lozenges
Adults and children (12 yr of age and older)

PO 5 to 15 mg every 1 to 4 h (max, 120 mg/day).

Children (6 to younger than 12 yr of age)

PO 5 to 10 mg every 1 to 4 h (max, 60 mg/day).

Liquid and syrup
Adults and Children (12 yr of age and older)

PO 10 to 20 mg every 4 h or 30 mg every 6 to 8 h (max, 120 mg/day).

Children (6 to younger than 12 yr of age)

PO 15 mg every 6 to 8 h (max, 60 mg/day).

Children (2 to younger than 6 yr of age)

PO 7.5 mg every 6 to 8 h (max, 30 mg/day).

Extended-release suspension
Adults and Children (12 yr of age and older)

PO 60 mg every 12 h (max, 120 mg/day).

Children (6 to younger than 12 yr of age)

PO 30 mg every 12 h (max, 60 mg/day).

Children (2 to younger than 6 yr of age)

PO 15 mg every 12 h (max, 30 mg/day).

Storage/Stability

Store liquids, lozenges, and syrups at room temperature and out of reach of children.

Drug Interactions

MAOIs

Hypotension, hyperpyrexia, nausea, myoclonic jerks, and coma may develop after coadministration.

Laboratory Test Interactions

None well documented.

Adverse Reactions

Nausea, drowsiness, dizziness.

Precautions

Pregnancy

Category C .

Lactation

Undetermined.

Chronic cough

Do not use for persistent or chronic cough (eg, smoking, asthma, emphysema) or when cough is accompanied by excessive secretions. People with high fever, rash, persistent headache, nausea, or vomiting should use only under medical supervision.

Drug abuse and dependence

Anecdotal reports of abuse have increased. However, abuse and dependency potential is undetermined.

Overdosage

Symptoms

Ataxia, respiratory depression, convulsions (children); altered sensory perception, dysphoria, slurred speech (adults).

Patient Information

Alert patient that many products contain alcohol.
Instruct patient to notify health care provider before taking medication with other prescriptions (eg, MAOIs).
Inform diabetic patients that base may contain sucrose or other sugars.
Encourage increased fluid intake to thin secretions.
Teach patients how to cough and breathe deeply to maximize respiratory efforts.
Explain to parents not to give lozenges to young children.