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Dextromethorphan, guaifenesin, and pseudoephedrine

Generic names: dextromethorphan, guaifenesin, and pseudoephedrine [dex-troe-meth-OR-fan, gwye-FEN-e-sin, soo-doe-e-FED-rin].

Brand names: Brands including Capmist DM, Despec Drops, Maxifed DMX, Poly-Vent DM and Trispec PSE… are shown here.
Dosage Forms: Oral liquid (10 mg-187 mg-30 mg/5 mL, 15 mg-200 mg-30 mL/5 mL, 2.5 mg-25 mg-7.5 mL, and 4 mg-20 mg-10 mL)…show all 3 dosage forms.
Drug Class: Upper Respiratory Combinations

What is Dextromethorphan, guaifenesin, and  pseudoephedrine?

Dextromethorphan suppresses coughing. It works by affecting the signals that are sent to the brain and triggering the cough reflex. Guaifenesin acts as an expectorant. It loosens congestion in the chest and throat, making it easier for you to cough through your mouth.Pseudoephedrine acts as a nasal decongestant by constricting blood vessels. Dilated blood vessels can cause congestion in the nasal passages. Combination medicine containing dextromethorphan (guaifenesin), pseudoephedrine, and guaifenesin is used to treat allergies, colds, flu, chest congestion, and stuffy noses. Dextromethorphan is not effective in treating a cough caused by smoking or asthma. This medication guide does not list all possible uses for dextromethorphan.

Side effects of dextromethorphan, guaifenesin, and pseudoephedrine

If you notice symptoms of an allergic reaction such as difficulty breathing, hives or swelling to lips, face, tongue or throat - seek medical help immediately!

This medication can cause serious side effects. If you experience:

  • Fast or irregular heart rate

  • Feeling dizzy or anxious, as if you could pass out.

  • Severe headache

  • Mood changes

  • Fever;

  • High blood pressure can be dangerous (headache, blurred vision or buzzing in the ears, anxiety, chest discomfort, irregular heartbeats, and seizures).

Side effects of dextromethorphan and pseudoephedrine include:

  • Diarrhea;

  • Dizziness, drowsiness;

  • Sleep problems (insomnia);

  • Feeling nervous, restless, or irritable.

There may be other side effects.Call your doctor if experiencing side effects; for information and reporting contact the FDA directly at 1-800-FDA-1088.

Warnings

Use dextromethorphan and guaifenesin only if you've used a MAO inhibitor within the last 14 days. Examples include isocarboxazid linezolid, methylene-blue injection phenelzine, rasagiline, selegiline, or tranylcypromine.

Before you take this drug

If you are allergic to dextromethorphan or guaifenesin, do not use this medicine. You should not take this medication if you've taken a MAO inhibitor within the last 14 days. A dangerous drug interaction may occur.MAO inhibitors include isocarboxazid (linezolid), phenelzine (rasagiline), selegiline (tranylcypromine), and rasagiline.

If you suffer from:

  • High blood pressure, or coronary artery disease.

  • Diabetes;

  • Glaucoma;

  • Epilepsy or another seizure disorder

  • Urination or prostate problems;

  • Pheochromocytoma

  • Chronic bronchitis or emphysema can cause a cough that is mucus-laden.

Dextromethorphan is not known to harm unborn babies. Pregnant women must always consult their healthcare provider prior to taking medication during gestation. This medicine can pass into breastmilk and harm a nursing infant. Decongestants can also reduce breast milk production. Consult your doctor before taking this medication if you're breastfeeding a child. Phenylalanine can be found in artificially sweetened cold medications; check the label of any medication to identify whether or not they contain this amino acid if you have phenylketonuria.

How to take Dextromethorphan, guaifenesin, and  pseudoephedrine?

Do not exceed the recommended dosage or duration. Use the recommended dose and do not exceed it. Cold and cough medicine is typically taken for only a few days until symptoms disappear. This medication should not be given to children younger than four years of age. Ask a doctor first before giving cough or cold medication to your child. Children as young as 4 years old can die from the misuse of cough medicines. Do not chew or crush a tablet. Swallow the entire tablet. Dose your liquid medications using either the provided dosing syringe, dose measuring cup or spoon or by consulting your pharmacist if no device exists for dosing measurements is available to you. While taking this medication, drink extra fluids in order to loosen congestion and lubricate the throat. Tell your doctor or surgeon if you've taken dextromethorphan or guaifenesin within the last few days. Take the medication for no more than seven days. Consult with a medical provider immediately if symptoms do not improve within seven days or you experience fever and headache accompanied by skin rashes. Liquid medicines must not freeze.

Details on dosage

Adult dose for nasal congestion and cough:

Dose referred to by strength of dextromethorphan, guaiFENesin, or pseudoephedrine (in mg) per unit of measurement:

Oral liquids (liquid, drops, solution/syrup):

10/187/30 per 5mL: 10 mg every four hours up to four doses daily

15/200/30/per 5 mL: 5–10 mL every six hours, a maximum of 40 mL a day

Oral Solids

20/380/60 per tablet: Take 1 dose every four hours up to four times in 24 hours.

30/400/30 tablet: One dose every six hours up to four doses in one day.

30/400/60 per tablet: One dose every six hours up to four per day.

The usual pediatric dose for nasal congestion and cough:

Dose referred to by strength of dextromethorphan, guaiFENesin, or pseudoephedrine (in mg) per unit of measurement:

Oral liquids (liquid, drops, solution/syrup):

5/50/15 per 5 mL

From 6 to 12 years old: 10 mL per 4 to 6 hour intervals, maximum of 4 doses daily.

Maximum 4 doses per day for children under 2 years old.

10/187/30 per 5 mL

Under 6 years old: 2.5 mL per 4 hours. Maximum: 4 doses a day.

Maximum 4 doses a day for children under 6 years old

12 years of age and older: 10 mL every four hours, maximum four doses per day

15/200/30 per 5 mL

12+ = 10 mL every 6 hours, maximum 4 doses per day.

15/200/30 per 5 mL

Twelve years of age and older: 5–10 mL every six hours, maximum 40 mL per day

Under 12 years old: 2.5–5 mL every six hours; maximum 20 mL a day.

Oral Solids

20/380/60 per tablet

12 years of age and older: Take 1 tablet every four hours. Maximum: 4 doses per day.

Under 12 years old: 1/2 tablet every four hours. Maximum: 4 doses per week.

30/400/30 per tablet

12 years of age and older: Take 1 tablet every six hours. Maximum: 4 doses per day.

30/400/60 per tablet

12 years of age and older: Take 1 tablet every six hours. Maximum: 4 doses per day.

Under 12 years old: 1/2 tablet every six hours. Maximum: 4 doses per week.

What happens if I miss the dose?

You may not have a regular dosing regimen because this medication is only taken as needed. Take the missed dose immediately if you take the medication regularly. If the next scheduled dose is approaching quickly, do not attempt to make up a missed one with additional medicine. Doing so would only lead to additional side effects than intended and increased overall medical costs.

What happens if I overdose?

Contact the Poison Control Hotline immediately on 1-800-222-1222 if a poisonous situation exists or seek immediate medical advice.

What should be avoided?

Dextromethorphan and pseudoephedrine can cause blurred or impaired vision or affect your thinking or reaction. You should be careful when driving or doing anything else that requires alertness and the ability to see clearly. Certain side effects can be exacerbated by alcohol consumption. Before using any other allergy, cold, or cough medicine, consult your doctor. Many combination medicines contain dextromethorphan (and guaifenesin and pseudoephedrine). You can take too much medication by taking certain products together. You can check the label of a medication to see if it contains decongestants, expectorants, or cough suppressants.

Interaction with other drug

Before using this medication, ask your doctor or pharmacist if you also use any other medications, such as prescription and over-the-counter medicines, vitamins, and herbal products. Some medications when combined can produce unwanted or adverse interactions; unfortunately, this medication guide doesn't list all possible interactions. This medicine could have adverse reactions if combined with drugs that cause sleep or decrease breathing rate, for instance. You should consult your doctor before combining this medication with sleeping pills, narcotics, muscle relaxers, anxiety, depression, or seizure medications.