Dosing & Uses
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
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
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)
Adverse Effects
Frequency Not Defined
Dextromethorphan
- Nausea
- Vomiting
- Constipation
- Drowsiness
- Dizziness
- Sedation
- Confusion
- Nervousness
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
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.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
