From the Guidelines
Dextromethorphan is commonly found in several prescription oral preparations in the United States, typically combined with other medications to treat multiple symptoms, with common combinations including Tussinex, Bromfed-DM, and Promethazine-DM. These medications work because dextromethorphan suppresses cough by acting on the cough center in the brain's medulla, while the additional ingredients address other symptoms like congestion, pain, or allergic responses. The recommended dosage of dextromethorphan is 10-30mg per dose, taken every 4-6 hours as needed, as indicated in the study by 1.
Common Combinations
- Tussinex (dextromethorphan with hydrocodone and chlorpheniramine) for cough and congestion
- Bromfed-DM (dextromethorphan with brompheniramine and pseudoephedrine) for cough and cold symptoms
- Promethazine-DM (dextromethorphan with promethazine) for cough and allergies
- Phenergan with dextromethorphan for cough and nausea
- Z-Cof DM (dextromethorphan with pseudoephedrine and guaifenesin) for cough and congestion
Dosage and Administration
The dosage of dextromethorphan varies by product, but typically ranges from 10-30mg per dose, taken every 4-6 hours as needed, as indicated in the study by 1. It is essential to use these combinations only under medical supervision due to potential side effects and drug interactions.
Mechanism of Action
Dextromethorphan suppresses cough by acting on the cough center in the brain's medulla, as mentioned in the study by 1. The additional ingredients in these combinations address other symptoms like congestion, pain, or allergic responses.
Prescription Requirements
These combinations require prescriptions because they either contain controlled substances or higher concentrations of dextromethorphan than available over-the-counter, as indicated in the study by 1. It is crucial to use these medications under medical supervision to minimize potential side effects and drug interactions.
From the FDA Drug Label
Active ingredient (in each 5 mL) Dextromethorphan polistirex equivalent to 30 mg dextromethorphan hydrobromide Package/Label Principal Display Panel Compare to Delsym® active ingredient Dextromethorphan Polistirex Extended-Release Oral Suspension Cough Suppressant The specific prescription and combinations of oral preparations that include dextromethorphan are:
- Dextromethorphan polistirex equivalent to 30 mg dextromethorphan hydrobromide 2
- Dextromethorphan Polistirex Extended-Release Oral Suspension 2 Key points:
- The dextromethorphan preparations are available as oral suspensions
- The preparations are used as a cough suppressant 2
From the Research
Oral Preparations with Dextromethorphan
- Dextromethorphan is a centrally acting cough suppressant used in various oral preparations for cough and cold relief 3.
- It can be combined with other active ingredients such as:
- These combinations are available in various formulations, including tablets and syrups, and can be analyzed using gas chromatography or high-pressure liquid chromatography for quality control purposes 4, 5.
Specific Combinations and Purposes
- Dextromethorphan is used to treat persistent cough, including chronic cough, and can be used in combination with other medications to relieve symptoms 3.
- The specific combinations and purposes of oral preparations with dextromethorphan in the United States include:
- Cough and cold relief: dextromethorphan can be combined with other active ingredients such as acetaminophen, guaifenesin, and pseudoephedrine hydrochloride to relieve cough and cold symptoms 4, 5.
- Chronic cough treatment: dextromethorphan can be used as a cough suppressant to treat chronic cough, either alone or in combination with other medications 3.