Dextromethorphan Hydrobromide

Registered South African indications:

• Dry cough

Contraindications

• Hypersensitivity to the active ingredient or any of its excipients
• Current or risk factors for respiratory failure
• Coadministration with monoamine oxidase inhibitors or within 14 days of their use
• Coadministration with selective serotonin reuptake inhibitors

Cautions

• Pregnancy
• Breastfeeding
• Moderate to severe hepatic impairment
• Chronic cough
• Asthma
• History of substance abuse
• Slow metabolisers of CYP2D6
• Atopic children
• Epilepsy
• Fructose intolerance
• Glucose-galactose malabsorption
• Sucrase-isomaltase insufficiency

Forms avail. in SA and covered in this monograph: syr

Cough
- Dry
- Non-productive 

• Oral (syr): 30mg, 6-8hrly OR 15mg, 4hrly; Max: 120mg/24hrs

Paed. forms avail. in SA and covered in this monograph: syr

Cough
- Dry
- Non-productive

Younger than 4 year

• Contraindicated

Between 4-6 years

• Oral (syr): 7.5mg, 6-8hrly

Between 6-12 years

• Oral (syr): 7.5-15mg, 6-8hrly

Older than 12 years

• See adult dosage

Pregnancy

• Caution; not recommended
• There are no adequate and well-controlled studies in pregnant women. Dextromethorphan should not be used during pregnancy unless the potential benefit of treatment to the mother outweighs the possible risk to the developing foetus

Breastfeeding

• Caution; not recommended
• There are no adequate and well-controlled studies in pregnant women. Dextromethorphan should not be used during breastfeeding unless the potential benefit of treatment to the mother outweighs the possible risk to the nursing infant

Renal Impairment

• No dose adjustment recommended

Hepatic Impairment

• Moderate to severe: Caution; no dose adjustment recommended

Elderly

• No dose adjustment recommended

Porphyria Information

• Not yet classified (NC)

Drugs in Sport

• Permitted - No warnings

Central Nervous System Disorders

• Somnolence
• Psychomotor hyperactivity
• Dizziness
• Seizure
• Confusional state
• Insomnia

Respiratory Disorders

• Respiratory depression

Gastrointestinal Disorders

• Nausea and vomiting
• Diarrhoea
• Abdominal pain

Skin and Subcutaneous Tissue Disorders

• Angioedema
• Pruritus
• Rash
• Urticaria

• Monoamine oxidase inhibitors
• Selective serotonin reuptake inhibitors
• Central nervous system depressants
• CYP2D6 inhibitors

None routine

Dextromethorphan is a non-opioid antitussive drug. It exerts its antitussive activity by acting on the cough centre in the medulla oblongata, raising the threshold for the cough reflex.

Syrup (per 5ml) 15mg

• Benylin Dry cough (Johnson & Johnson) originator
• Dilinct Dry syrup (Adcock)