dextromethorphan/pseudoephedrine/guaifenesin (OTC)

Brand and Other Names:Capmist DM Tablets, ExeFen DMX Tablets
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

dextromethorphan/pseudoephedrine/guaifenesin

liquid

  • 10mg/20mg/200mg

tablet

  • 20mg/30mg/400mg
  • 20mg/20mg/400mg
  • 20mg/60mg/400mg
  • 20mg/40mg/400mg
more...

Temporary Relief of Nasal Congestion & Cough Due to Bronchial Irritation

5 mL PO q4-6hr; not to exceed 30 mL/day

1 tab [(20mg/30mg/400mg)] PO q4-6hr; not to exceed 6 tabs/day

1 tab [(20mg/40mg/400mg)] PO q4-6hr; not to exceed 6 tabs/day

Dosage Forms & Strengths

dextromethorphan/pseudoephedrine/guaifenesin

liquid

  • 10mg/20mg/200mg

tablet

  • 20mg/30mg/400mg
  • 20mg/20mg/400mg
  • 20mg/60mg/400mg
  • 20mg/40mg/400mg
more...

Temporary Relief of Nasal Congestion & Cough Due to Bronchial Irritation

<6 Years

  • Ask a pediatrician

6-12 Years

  • 2.5 mL PO q4-6hr; not to exceed 15 mL/day
  • ½ tablet [(20mg/40mg/400mg/tab)] PO q4-6hr; not to exceed 3 tablets/day

>12 Years

  • 5 mL PO q4-6hr; not to exceed 30 mL/day
  • 1 tab [(20mg/30mg/400mg)] PO q4-6hr; not to exceed 6 tabs/day
  • 1 tab [(20mg/40mg/400mg)] PO q4-6hr; not to exceed 6 tabs/day
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Interactions

Interaction Checker

and dextromethorphan/pseudoephedrine/guaifenesin

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    Interactions Found

    Contraindicated

      Serious - Use Alternative

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          Minor

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            Adverse Effects

            Frequency Not Defined

            Arrhythmia

            Palpitations

            Convulsion

            Dizziness

            Headache

            Drowsiness

            Excitability

            Weakness

            Tremor

            Nausea

            Vomiting

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            Warnings

            Contraindications

            Contraindicated in documented hypersensitivity to the drugs or within 14 days of MAO inhibitor therapy; known G-6-PD deficiency

            Cautions

            Caution in cardiovascular disease, diabetes mellitus, prostatic hypertrophy and increased intraocular pressure when taking pseudoephedrine

            Acetaminophen hepatotoxicity possible in chronic alcoholics following various dose levels; severe or recurrent pain or high or continued fever may indicate a serious illness; contained in many OTC products and combined use with these products may result in toxicity due to cumulative doses exceeding recommended maximum dose

            Do not take dextromethorphan for persistent or chronic cough associated with smoking, asthma, or emphysema, or if it is accompanied by excessive phlegm unless directed by a healthcare provider; dextromethorphan may slow the breathing

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            Pregnancy & Lactation

            Pregnancy Category: C

            Lactation: excretion in milk unknown/contraindicated

            Pregnant or breastfeeding patients should seek advice of health professional before using OTC drugs

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

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            Pharmacology

            Mechanism of Action

            Dextromethorphan is a cough suppressant that acts centrally on the cough center in the medulla.

            Guaifenesin increases respiratory tract fluid secretions and helps to loosen phlegm and bronchial secretions.

            Pseudoephedrine stimulates the alpha-adrenergic receptors causing bronchodilation and vasoconstriction.

            Pharmacokinetics

            Dextromethorphan

            • Onset: 15-30 min
            • Duration: 3-6 hr
            • Metabolism: Hepatic P450 enzyme CYP2D6
            • Excretion: Urine
            • Half-life: 2-4 hr (extensive metabolizers); 24 hr (poor metabolizers)
            • Peak plasma time: 2-3 hr

            Guaifenesin

            • Half-Life: 1 hr
            • Onset: 30 min
            • Duration: 4-6 hr
            • Metabolism: Liver
            • Metabolite: b-(2-methoxyphenoxy) lactic acid
            • Excretion: Urine

            Pseudoephedrine

            • Half-Life: 3 hr (children); 9-16 hr (adults)
            • Onset: 30 min (decongestant)
            • Duration: 3-8 hr  Peak Plasma
            • Time: 1.97 hr
            • Concentration: 422 ng/mL
            • Metabolism: Liver, by N-demethylation
            • Metabolites: Inactive
            • Clearance: 7.3-7.6 mL/min/kg
            • Excretion: Urine (43-96%)
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            Images

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