dextromethorphan/menthol (OTC)

Brand and Other Names:Delsym Cough + Soothing Action
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

dextromethorphan/menthol

lozenge

  • 5mg/5mg

Cough & Sore Throat

Indicated for temporary relieve of sore throat, sore mouth, minor mouth irritation, and cough due to minor throat and bronchial irritation as with the common cold

2 lozenges dissolved in mouth, 1 immediately after the other, q4hr prn; not to exceed 12 lozenges/day

Dosage Forms & Strengths

dextromethorphan/menthol

lozenge

  • 5mg/5mg

Cough & Sore Throat

Indicated for temporary relieve of sore throat, sore mouth, minor mouth irritation, and cough due to minor throat and bronchial irritation as with the common cold

<6 years: Safety and efficacy not established

6-11 years: 1 lozenge dissolved in mouth q4hr prn; not to exceed 6 lozenges/day

≥12 years: 2 lozenges dissolved in mouth, 1 immediately after the other, q4hr prn; not to exceed 12 lozenges/day

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Interactions

Interaction Checker

and dextromethorphan/menthol

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Contraindicated (0)

              Serious - Use Alternative (0)

                Monitor Closely (1)

                • letermovir

                  letermovir increases levels of dextromethorphan/menthol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

                Minor (0)

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                  Adverse Effects

                  Frequency Not Defined

                  Dextromethorphan

                  • Nausea
                  • Vomiting
                  • Constipation
                  • Drowsiness
                  • Dizziness
                  • Sedation
                  • Confusion
                  • Nervousness
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                  Warnings

                  Contraindications

                  Hypersensitivity

                  Concurrent use MOAIs or within 2 weeks after stopping MAOIs

                  Cautions

                  Contact physician promptly if sore throat is severe, persists for >2 days, is accompanied or followed by fever, headache, rash, nausea or vomiting

                  Ask physician before use for persistent or chronic cough associated with smoking, asthma, or emphysema

                  Ask physician before use for cough accompanied by excessive phlegm

                  Stop and contact physician or dentist if sore mouth does not improve in 7 days, irritation, pain or redness persists or worsens, swelling develops, or for a cough that last >7 days, reoccurs, or is accompanied by fever, rash, or persistent headache

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                  Pregnancy & Lactation

                  Pregnancy Category: C

                  Lactation: Unknown if distributed in human breast milk

                  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: Derivative of levorphanol; acts on cough center in medulla; decreases sensitivity of cough receptors and interrupts cough impulse transmission

                  Menthol: Topical anesthetic that reversibly blocks nerve conduction near the application site, thereby producing temporary loss of sensation in a limited area

                  Pharmacokinetics

                  Dextromethorphan

                  • Onset: 15-30 min
                  • Duration: ≤6 hr
                  • Time to peak: 2-3hr
                  • Metabolism: Hepatic P450 enzyme CYP2D6
                  • Half-life: 2-4hr (extensive metabolizers); 24 hr (poor metabolizers)
                  • Excretion: Urine
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                  Images

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                  Patient Handout

                  A Patient Handout is not currently available for this monograph.
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                  Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.