Recommended Dosage of Mucinex (Guaifenesin)
The recommended dose of Mucinex (guaifenesin) extended-release formulation is 1,200 mg (two 600 mg tablets) every 12 hours, not to exceed 2,400 mg in 24 hours. 1
Dosage Forms and Administration
- Extended-release (ER) guaifenesin (Mucinex) is available as 600 mg bi-layer tablets, allowing for convenient 12-hour dosing compared to the 4-hour dosing required with immediate-release formulations 1
- For immediate-release guaifenesin formulations, the recommended dose is 200-400 mg every 4 hours, not to exceed 2,400 mg in 24 hours 2
- The extended-release formulation provides equivalent steady-state exposure to the immediate-release formulation when dosed as recommended (1,200 mg ER every 12 hours vs. 400 mg IR every 4 hours) 1
Efficacy and Clinical Use
- Guaifenesin acts as an expectorant by loosening mucus in the airways and making coughs more productive 2
- It is primarily indicated for relief of chest congestion and wet cough due to common cold and upper respiratory tract infections 2
- It also has a secondary professional indication for use in stable chronic bronchitis 2
Safety and Tolerability
- Guaifenesin has a well-established and favorable safety profile in both adult and pediatric populations 2
- Most common adverse events are mild and include gastrointestinal effects, nervous system effects, and skin reactions 3
- In a study of 552 patients taking the recommended dose of 1,200 mg every 12 hours for 7 days, all reported adverse events were mild in severity with no serious adverse events 3
Special Considerations
- The extended-release formulation can be taken without regard to meals, though food may delay the time to maximum concentration (Tmax) 1
- Caution should be exercised with extremely high doses, as there has been a case report of central nervous system depression and asystole following a massive overdose 4
- For patients with productive cough and chest congestion, the extended-release formulation provides convenient twice-daily dosing while maintaining therapeutic effect throughout the day 1, 2
Effectiveness in Respiratory Conditions
- Clinical studies support the utility of guaifenesin in conditions with mucus hypersecretion, including acute upper respiratory tract infections and chronic bronchitis 2
- However, a single-dose study found no significant effect on mucociliary clearance or cough clearance compared to placebo in patients with acute respiratory tract infections 5
- Multiple daily doses may be needed to maintain therapeutic effect over 24 hours with immediate-release formulations, making the extended-release option more convenient 2