A-Z Drug Facts > Pseudoephedrine Hydrochloride/Guaifenesin/Dextromethorphan Hydrobromide

Pseudoephedrine Hydrochloride / Guaifenesin / Dextromethorphan Hydrobromide

Pronunciation: (SUE-doe-eh-FED-rin HIGH-droe-KLOR-ide/GWHY-fen-ah-sin/DEX-troe-meth-OR-fan HIGH-droe-BROE-mide)
Class: Antitussive and expectorant combination

Trade Names:
PanMist-DM
- Syrup 15 mg dextromethorphan hydrobromide, 100 mg guaifenesin, 40 mg pseudoephedrine hydrochloride per 5 mL
- Tablets 32 mg dextromethorphan hydrobromide, 595 mg guaifenesin, 48 mg pseudoephedrine hydrochloride

Trade Names:
Z-Cof 8DM
- Suspension 15 mg dextromethorphan hydrobromide, 175 mg guaifenesin, 30 mg pseudoephedrine hydrochloride per 5 mL

Balminil DM + Decongestant + Expectorant (Canada)
Robitussin Cough & Cold (Canada)
Robitussin Extra Strength Cough & Cold (Canada)

Pharmacology

User Reviews & Ratings As a treatment for... Avg User Ratings [?] Cough and Nasal Congestion 5 reviews Rate it! 9.5 Compare with other drugs.

Pseudoephedrine

Causes vasoconstriction and subsequent shrinkage of nasal mucous membranes by alpha-adrenergic stimulation, which promotes nasal drainage.

Guaifenesin

May enhance output of respiratory tract fluid by reducing adhesiveness and surface tension, enhancing removal of viscous mucus and making nonproductive coughs more productive and less frequent.

Dextromethorphan

Suppresses cough by central action on cough center in medulla.

Indications and Usage

Temporary relief of nasal congestion and cough associated with respiratory tract infections and related conditions, such as sinusitis, pharyngitis, bronchitis, and asthma, when these conditions are complicated by tenacious mucus or mucus plugs and congestion.

Contraindications

Hypertension; severe coronary artery disease; MAOI therapy; pregnancy; nursing; hypersensitivity to any component of product or idiosyncrasy to sympathomimetic amines, which may manifest as insomnia, dizziness, weakness, tremor, or arrhythmias.

Dosage and Administration

Pan-Mist DM
Adults and Children older than 12 yr of age

PO 1 or 2 tablets every 12 h (max, 4 tablets in 24 h) or up to 2 tsp of syrup 3 to 4 times daily.

Children 6 to 12 yr of age

PO 1 tablet every 12 h (max, 2 tablets in 24 h) or up to 1 tsp 3 to 4 times daily, not to exceed 4 mg per kilogram of body weight of pseudoephedrine in 24 h.

Z-Cof 8 DM
Adults and Children older than 12 yr of age

PO 2 tsp 3 times daily.

Children 6 to 12 yr of age

PO 1 tsp 3 times daily.

Children 2 to 6 yr of age

PO ½ tsp 3 times daily, not to exceed 4 mg per kg body weight up to a max of 60 mg pseudoephedrine in 24 h.

General Advice

• Tablets may be broken in half for ease of administration. Do not crush or chew tablets or half-tablets.
• Administer without regard to meals. Administer with food if GI upset occurs.
• Measure and administer prescribed dose of syrup using dosing syringe, dosing spoon, or dosing cup.
• Administer with a full glass or water to help loosen mucus in the lungs.

Storage/Stability

Store at 59° to 86°F.

Drug Interactions

Digitalis

Ectopic pacemaker activity may be increased by pseudoephedrine.

Guanethidine, mecamylamine, methyldopa, reserpine, veratrum alkaloids

Antihypertensive effects may be reduced by pseudoephedrine.

Kaolin

May increase pseudoephedrine absorption.

MAOIs (eg, isocarboxazid)

May increase the effects of pseudoephedrine. Dextromethorphan is contraindicated with MAOIs.

Laboratory Test Interactions

Guaifenesin may interfere with the interpretation of the test for urinary 5-hydroxyindoleacetic acid for the diagnosis of carcinoid syndrome.

Adverse Reactions

Cardiovascular

Tachycardia; palpitations; arrhythmias; CV collapse with hypotension.

CNS

Headache; dizziness; drowsiness; fear; anxiety; nervousness; restlessness; tremor; weakness; insomnia; hallucinations; convulsions; CNS depression.

GI

Diarrhea; nausea; stomach pain.

Genitourinary

Dysuria.

Respiratory

Respiratory difficulty.

Miscellaneous

Pallor.

Precautions

Pregnancy

Category C .

Lactation

Contraindicated in nursing women.

Children

Safety and efficacy in children younger than 6 yr of age not established for tablets and in children younger than 2 yr of age for syrup/suspension.

Elderly

Geriatric patients are more likely to exhibit adverse reactions, such as confusion or CNS depression.

Special Risk Patients

Use with caution in patients with hypertension, heart disease, asthma, increased IOP, diabetes mellitus, peripheral vascular disease, prostatic hypertrophy, thyroid disease, difficulty in urination due to enlargement of prostate gland, sedated or debilitated patients or patients confined to a supine position.

Cough

Ascertain underlying cause of cough prior to use of cough suppressants. Do not use for persistent or chronic cough such as occurs with smoking, asthma, emphysema, or where excessive secretions accompany cough.

Drug abuse

Has abuse potential.

Phenylketonurics

Z-Cof 8 DM contains phenylalanine.

Overdosage

Symptoms

Pseudoephedrine

Excessive CNS stimulation (eg, excitement, tremor, restlessness, insomnia), tachycardia, hypertension, pallor, mydriasis, hyperglycemia, urinary retention, tachypnea, hyperpnea, hallucinations, convulsions, delirium, arrhythmias, hypotension, circulatory collapse, hypokalemia

Dextromethorphan

Drowsiness, ataxia, nystagmus, opisthotonos, convulsive disorders

Patient Information

• Advise patient to take prescribed dose every 12 h as needed.
• Advise patient to take with food if GI upset occurs.
• Advise patient that if a dose is missed to take as soon as remembered unless it is nearing time for the next dose. Caution patient not to double the dose to catch up.
• Instruct patient to discontinue use and report any of these symptoms to health care provider: nervousness, dizziness, sleeplessness.
• Advise patient that if symptoms are not controlled, not to increase the dose of medication but to inform health care provider.

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