Dextromethorphan Syrup
Dextromethorphan Hydrobromide
Indications
Dextromethorphan is indicated in-
- Chronic dry cough
- Unproductive cough
- Acute dry cough which is interfering with normal function or sleep.
Composition
Syrup: Each 5 ml sugar-free syrup contains Dextromethorphan Hydrobromide BP 10 mg.
Pharmacology
Dextromethorphan Hydrobromide is a cough suppressant which has a central action on the cough centre in the medulla. Although structurally related to morphine, it has no analgesic properties and in general it has little sedative activity. Addiction has not been observed after the administration of rather large doses for prolonged period. It is rapidly absorbed from the GI tract and exerts its effects in 15-30 minutes after oral administration. The duration of action is approximately 3-6 hours with conventional dosage form. Dextromethorphan hydrobromide is extensively metabolised in the liver and excreted in the urine as unchanged Dextromethorphan and demethylated metabolites including Dextrophan which has some cough suppressant activity. Urinary excretion of parent and metabolites accounts for up to 50% of the ingested dose over 24 hours. About 8% of the dose is excreted unchanged in the urine over the first 6 hours.
Dosage & Administration
Adults and Children over 12 years: 15 to 30 mg three to four times per day. However, 60 mg doses up to four times per day have been used without increased side effects.
Children between 6 and 12 years: 5-15 mg up to four times per day.
Children between 2 and 6 years: 2.5-5 mg up to four times per day.
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Interaction
Two fatal interactions have been reported in patients taking therapeutic doses of phenelzine and dextromethorphan.
Contraindications
Concomitant use of monoamine oxidase inhibitors is contraindicated with Dextromethorphan Hydrobromide. Dextromethorphan is extensively metabolised in the liver and should be prescribed with caution to patients with liver disease.
Side Effects
Adverse effects with Dextromethorphan are rare, but nausea and dizziness sometimes occur. The drug produces no analgesia or addiction and little or no CNS depression. Excitation, confusion and respiratory depression may occur after overdosage.
Pregnancy & Lactation
There is little information on the use of this drug in pregnancy and therefore it should be avoided in the first three months of pregnancy. No information is available on secretion of dextromethorphan into breast milk, so nursing mothers should be advised not to take the drug.
Precautions & Warnings
Do not use Dextromethorphan to control a cough that is associated with smoking, asthma, or emphysema, or a cough that is productive (produces sputum or phlegm).
Therapeutic Class
Cough suppressant
Storage Conditions
Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.
