From the Guidelines
The maximum recommended dose of dextromethorphan is 120 mg per day. When considering the use of dextromethorphan for cough suppression, it's crucial to adhere to the recommended dosing guidelines to minimize the risk of adverse effects. According to the provided evidence 1, the dosage for dextromethorphan is listed as 10-15 mg tid or qid, with some publications suggesting a range of 10-30 mg, and a maximum dose of 120 mg/d. Key points to consider when prescribing dextromethorphan include:
- The medication should be used with caution in patients with underlying health conditions or those taking other medications that could interact with dextromethorphan.
- Patients should be advised to follow the specific product's dosing instructions and not exceed the recommended daily dose.
- Monitoring for side effects such as confusion, dizziness, and impaired coordination is essential, especially in vulnerable populations like the elderly or children.
- Combination with certain medications like MAO inhibitors, antidepressants, or alcohol should be avoided due to potential dangerous interactions 1. In clinical practice, it's essential to weigh the benefits of cough suppression against the potential risks associated with dextromethorphan use, particularly at higher doses 1.
From the FDA Drug Label
Directions • shake bottle well before use • measure only with dosing cup provided • do not use dosing cup with other products • dose as follows or as directed by doctor adults and children 12 years of age and over 10 mL every 12 hours, not to exceed 20 mL in 24 hours children 6 to under 12 years of age 5 mL every 12 hours, not to exceed 10 mL in 24 hours children 4 to under 6 years of age 2.5 mL every 12 hours, not to exceed 5 mL in 24 hours children under 4 years of age do not use The maximum dose of dextromethorphan is:
- 20 mL in 24 hours for adults and children 12 years of age and over 2
- 10 mL in 24 hours for children 6 to under 12 years of age 2
- 5 mL in 24 hours for children 4 to under 6 years of age 2
From the Research
Dextromethorphan Dosage
The maximum dose of dextromethorphan is not explicitly stated in the provided studies. However, the following information is available:
- A study published in 1983 compared the antitussive activity of dextromethorphan and codeine in patients with chronic cough, with both preparations administered at a dose of 20 mg 3.
- Another study published in 1993 evaluated the efficacy of cough suppressants in children, but does not specify the maximum dose of dextromethorphan used 4.
- A report by the American Academy of Pediatrics in 1997 discusses the use of codeine- and dextromethorphan-containing cough remedies in children, but does not provide information on the maximum dose of dextromethorphan 5.
- A review published in 2013 on antitussives and substance abuse mentions the abuse of dextromethorphan, but does not specify the maximum dose 6.
Key Points
- The studies provided do not specify the maximum dose of dextromethorphan.
- Dextromethorphan is commonly used as a cough suppressant, but its efficacy and safety in certain populations, such as children, are still being researched 4, 5.
- The abuse of dextromethorphan is a continuing problem, and its pharmacology, clinical effects, and management of toxicity are important considerations 6.