Robitussin (Dextromethorphan) Dosing
For adults, dextromethorphan is typically dosed at 20 mg every 4-6 hours for cough suppression, with this dose demonstrating effective antitussive activity in clinical trials. 1
Adult Dosing
- Standard dose: 20 mg every 4-6 hours as needed for cough suppression 1
- This dosing has been validated in controlled trials comparing dextromethorphan to codeine, showing similar efficacy in reducing cough frequency 1
- Dextromethorphan at 20 mg demonstrated superior reduction in cough intensity compared to codeine at the same dose (p < 0.0008) 1
Pediatric Dosing
Specific pediatric dosing for dextromethorphan is not well-established in the provided guidelines. The American Academy of Pediatrics drug formularies reviewed do not include specific dextromethorphan dosing recommendations. 2
- For pediatric patients, weight-based and age-specific factors must be considered when determining appropriate dosing 3
- Consultation with current product labeling or a pediatric pharmacist is recommended for children
Safety Profile
- Dextromethorphan has a reassuring safety profile with infrequent and usually non-severe adverse reactions 4
- Adverse effects are typically dose-related and include neurological, cardiovascular, and gastrointestinal disturbances 4
- The drug is safe even in overdose situations 1
- It lacks the CNS side effects of opiates including respiratory depression, abuse liability (in therapeutic use), and analgesic properties 5
Critical Drug Interactions
Avoid concurrent use with monoamine oxidase inhibitors (MAOIs) - this represents the most significant safety concern with dextromethorphan. 4
Abuse Potential
- Chronic abuse represents the most significant hazard identified through adverse event reporting 4
- Recurrent high-dose use can lead to bromism (chronic bromide toxicity) when using bromide-containing formulations like Robitussin HBr, manifesting as hyperchloremia and decreased anion gap 6
- Patients presenting with repeated overdoses should be evaluated for substance abuse 6