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dextromethorphan (Benylin DM)

Dextromethorphan is a widely-used antitussive. Indications: cough Contraindications: - drug of abuse 'robo trip' among teens [6] - not effective for cough due to upper respiratory tract infection or common cold [8] Dosage: - 10-30 mg PO every 4-8 hours Liquid: 10 mg/5mL. Pharmacokinetics: -> metabolized in the liver by cyt P450 2D6 Adverse effects: -> used as drug of abuse: a) may cause euphoria & hallucinations; most likely caused by metabolite b) agitation & confusion c) hypertension d) tachycardia Drug interactions: - many pharmaceutical agents - dextromethorphan in combination with SSRI may increase risk of serotonin syndrome [7] Mechanism of action: 1) weak NMDA receptor antagonist [4] 2) allosteric antagonist at NMDA controlled ion channels & an antagonist at voltage dependent ion channels

Interactions

drug interactions drug adverse effects of antitussive agent(s)

Related

cytochrome P450 2D6 (cytochrome P450 2D, cytochrome P450 DB1, debrisoquine-4-hydroxylase, CYP2D6)

Useful

NMDA receptor

General

amine antitussive agent heterocyclic compound, bridged-ring NMDA receptor antagonist

Properties

INHIBITS: NMDA receptor SIZE: hbr salt = 352.32 G/M MISC-INFO: elimination route LIVER MP 122-124 C {HBR_SALT} C18 H25 NO pregnancy-category + safety in lactation ?

Database Correlations

PUBCHEM cid=31329

References

  1. Merck Index 11th ed #8116
  2. Research Biochemicals International 1993-94 catalog
  3. Prescriber's Letter 9(3):15 2002
  4. Prescriber's Letter 10(11) 2003; detail document 191102
  5. Department of Veterans Affairs, VA National Formulary
  6. Prescriber's Letter 14(2): 2007 Dextromethorphan abuse Detail-Document#: 230208 (subscription needed) http://www.prescribersletter.com
  7. Paauw DS Dangerous and Deadly Drug Combinations Medscape. June 30, 2016 http://www.medscape.com/features/slideshow/dangerous-drug-combinations
  8. Medical Knowledge Self Assessment Program (MKSAP) 19 American College of Physicians, Philadelphia 2022

Component-of

acetaminophen/brompheniramine/dextromethorphan/pseudoephedrine acetaminophen/chlorpheniramine/dextromethorphan acetaminophen/chlorpheniramine/dextromethorphan/doxylamine acetaminophen/chlorpheniramine/dextromethorphan/doxylamine/succinate acetaminophen/chlorpheniramine/dextromethorphan/guaifenesin acetaminophen/chlorpheniramine/dextromethorphan/guaifenesin/phenylephrine acetaminophen/chlorpheniramine/dextromethorphan/phenylephrine acetaminophen/chlorpheniramine/dextromethorphan/pseudoephedrine acetaminophen/dextromethorphan acetaminophen/dextromethorphan/diethylcarbamazine/doxylamine/phenylephrine acetaminophen/dextromethorphan/diphenhydramine acetaminophen/dextromethorphan/diphenhydramine/guaifenesin acetaminophen/dextromethorphan/diphenhydramine/guaifenesin/phenylephrine acetaminophen/dextromethorphan/diphenhydramine/phenylephrine acetaminophen/dextromethorphan/diphenhydramine/pseudoephedrine acetaminophen/dextromethorphan/doxylamine acetaminophen/dextromethorphan/doxylamine/guaifenesin acetaminophen/dextromethorphan/doxylamine/guaifenesin/phenylephrine acetaminophen/dextromethorphan/doxylamine/guaifenesin/pseudoephedrine acetaminophen/dextromethorphan/doxylamine/phenylephrine acetaminophen/dextromethorphan/doxylamine/pseudoephedrine acetaminophen/dextromethorphan/doxylamine/zinc acetate/zinc gluconate acetaminophen/dextromethorphan/doxylamine/zinc sulfate acetaminophen/dextromethorphan/guaifenesin acetaminophen/dextromethorphan/guaifenesin/phenylephrine acetaminophen/dextromethorphan/guaifenesin/pseudoephedrine acetaminophen/dextromethorphan/guaifenesin/zinc acetate/zinc gluconate acetaminophen/dextromethorphan/guaifenesin/zinc sulfate acetaminophen/dextromethorphan/phenylephrine acetaminophen/dextromethorphan/pseudoephedrine acetaminophen/dextromethorphan/pseudoephedrine/pyrilamine aspirin/chlorpheniramine/dextromethorphan/phenylephrine aspirin/dextromethorphan/doxylamine/phenylephrine aspirin/dextromethorphan/phenylephrine benzocaine/dextromethorphan benzocaine/dextromethorphan/menthol brompheniramine/dextromethorphan brompheniramine/dextromethorphan/diphenhydramine brompheniramine/dextromethorphan/guaifenesin brompheniramine/dextromethorphan/guaifenesin/phenylephrine brompheniramine/dextromethorphan/guaifenesin/pseudoephedrine brompheniramine/dextromethorphan/phenylephrine brompheniramine/dextromethorphan/phenylpropanolamine brompheniramine/dextromethorphan/pseudoephedrine bupropion/dextromethorphan (Auvelity) carbinoxamine/dextromethorphan/phenylephrine carbinoxamine/dextromethorphan/pseudoephedrine (Cardec-DM, Rondec-DM) carbinoxamine/dextromethorphan/pseudoephedrine/vegf co regulated chemokine 1 carbohydrate/chlorpheniramine/dextromethorphan carbohydrate/dextromethorphan/guaifenesin chlorpheniramine/dextromethorphan chlorpheniramine/dextromethorphan/diethylcarbamazine/phenylephrine chlorpheniramine/dextromethorphan/guaifenesin chlorpheniramine/dextromethorphan/guaifenesin/methscopolamine/phenylephrine chlorpheniramine/dextromethorphan/guaifenesin/phenylephrine chlorpheniramine/dextromethorphan/guaifenesin/pseudoephedrine chlorpheniramine/dextromethorphan/methscopolamine chlorpheniramine/dextromethorphan/phenylephrine chlorpheniramine/dextromethorphan/phenylephrine/phenylpropanolamine chlorpheniramine/dextromethorphan/pseudoephedrine citrate/dextromethorphan/guaifenesin citrate/dextromethorphan/guaifenesin/pyrilamine coricidin HBP cough & cold (CCC, poor man's PCP) dexbrompheniramine/dextromethorphan/guaifenesin/phenylephrine dexbrompheniramine/dextromethorphan/guaifenesin/pseudoephedrine dexbrompheniramine/dextromethorphan/phenylephrine dexbrompheniramine/dextromethorphan/phenylephrine/pyrilamine dexbrompheniramine/dextromethorphan/pseudoephedrine dexchlorpheniramine/dextromethorphan/guaifenesin/phenylephrine dexchlorpheniramine/dextromethorphan/phenylephrine dexchlorpheniramine/dextromethorphan/phenylephrine/pyrilamine dexchlorpheniramine/dextromethorphan/pseudoephedrine dextromethorphan/diphenhydramine/guaifenesin dextromethorphan/diphenhydramine/guaifenesin/phenylephrine dextromethorphan/diphenhydramine/phenylephrine dextromethorphan/doxylamine dextromethorphan/doxylamine/guaifenesin dextromethorphan/doxylamine/pseudoephedrine dextromethorphan/guaiacolsulfonate dextromethorphan/guaiacolsulfonate/guaifenesin dextromethorphan/guaiacolsulfonate/phenylephrine dextromethorphan/guaiacolsulfonate/phenylephrine/pyrilamine dextromethorphan/guaifenesin (Robitussin DM, Naldecon Dx) dextromethorphan/guaifenesin/nov protein/pseudoephedrine dextromethorphan/guaifenesin/phenylephrine dextromethorphan/guaifenesin/phenylpropanolamine dextromethorphan/guaifenesin/phenylpropanolamine/pyrilamine dextromethorphan/guaifenesin/pseudoephedrine (Robitussin CF) dextromethorphan/guaifenesin/ribonuclease/angiogenin inhibitor dextromethorphan/lidocaine/salicylate dextromethorphan/menthol dextromethorphan/menthol/phenylephrine dextromethorphan/pheniramine/phenylephrine dextromethorphan/phenylephrine dextromethorphan/phenylephrine/pyrilamine dextromethorphan/phenylephrine/thonzylamine dextromethorphan/phenylephrine/triprolidine dextromethorphan/potassium iodide dextromethorphan/promethazine (Phenergan with dextromethorphan) dextromethorphan/pseudoephedrine dextromethorphan/pseudoephedrine/pyrilamine dextromethorphan/pseudoephedrine/triprolidine dextromethorphan/pyrilamine dextromethorphan/quinidine (Nuedexta)