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      Drugs & Diseases

      doxylamine/dextromethorphan (OTC)

      Brand and Other Names:Vicks NyQuil Cough, Safetussin PM
      • Print

      Dosing & Uses

      AdultPediatric

      Dosage Forms & Strengths

      doxylamine/dextromethorphan

      oral liquid

      • (6.25mg/15mg)/15mL

      Cough, Rhinorrhea & Sneezing

      30 mL PO q6hr; not to exceed 4 doses/day

      Dosage Forms & Strengths

      doxylamine/dextromethorphan

      oral liquid

      • (6.25mg/15mg)/15mL

      Cough, Rhinorrhea & Sneezing

      <4 years: Do not use

      4-12 years: Ask a pediatrician

      >12 years: 30 mL PO q6hr; not to exceed 4 doses/day

      Next:

      Interactions

      Interaction Checker

      and doxylamine/dextromethorphan

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        Interactions Found

        Contraindicated

          Serious - Use Alternative

            Significant - Monitor Closely

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                 activity indicator 

                Contraindicated (0)

                  Serious - Use Alternative (17)

                  • benzhydrocodone/acetaminophen

                    benzhydrocodone/acetaminophen, doxylamine. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.

                  • calcium/magnesium/potassium/sodium oxybates

                    doxylamine, calcium/magnesium/potassium/sodium oxybates. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.

                  • fentanyl

                    fentanyl, doxylamine. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.

                  • fentanyl intranasal

                    fentanyl intranasal, doxylamine. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.

                  • fentanyl transdermal

                    fentanyl transdermal, doxylamine. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.

                  • fentanyl transmucosal

                    fentanyl transmucosal, doxylamine. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.

                  • hydrocodone

                    hydrocodone, doxylamine. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.

                  • isocarboxazid

                    isocarboxazid increases effects of doxylamine by Other (see comment). Avoid or Use Alternate Drug. Comment: Isocarboxazid should not be administered in combination with antihistamines because of potential additive CNS depressant effects. MAO inhibitors also prolong and intensify anticholinergic effects of antihistamines. .

                  • lemborexant

                    lemborexant, doxylamine. Either increases effects of the other by sedation. Avoid or Use Alternate Drug. Use of lemborexant with other drugs to treat insomnia is not recommended.

                  • methylene blue

                    methylene blue and doxylamine both increase serotonin levels. Avoid or Use Alternate Drug. If drug combination must be administered, monitor for evidence of serotonergic or opioid-related toxicities

                  • metoclopramide intranasal

                    doxylamine, metoclopramide intranasal. Either increases effects of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Avoid use of metoclopramide intranasal or interacting drug, depending on importance of drug to patient.

                  • olopatadine intranasal

                    doxylamine and olopatadine intranasal both increase sedation. Avoid or Use Alternate Drug. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.

                  • selinexor

                    selinexor, doxylamine. unspecified interaction mechanism. Avoid or Use Alternate Drug. Patients treated with selinexor may experience neurological toxicities. Avoid taking selinexor with other medications that may cause dizziness or confusion.

                  • sodium oxybate

                    doxylamine, sodium oxybate. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.

                  • sufentanil SL

                    sufentanil SL, doxylamine. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration may result in hypotension, profound sedation, respiratory depression, coma, and death. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.

                  • tranylcypromine

                    tranylcypromine increases effects of doxylamine by Other (see comment). Avoid or Use Alternate Drug. Comment: Tranylcypromine should not be administered in combination with antihistamines because of potential additive CNS depressant effects. MAO inhibitors also prolong and intensify anticholinergic effects of antihistamines. .

                  • valerian

                    valerian and doxylamine both increase sedation. Avoid or Use Alternate Drug.

                  Monitor Closely (177)

                  • acrivastine

                    acrivastine and doxylamine both increase sedation. Use Caution/Monitor.

                  • alfentanil

                    doxylamine and alfentanil both increase sedation. Use Caution/Monitor.

                  • alprazolam

                    alprazolam and doxylamine both increase sedation. Use Caution/Monitor.

                  • amifampridine

                    doxylamine increases toxicity of amifampridine by Other (see comment). Modify Therapy/Monitor Closely. Comment: Amifampridine can cause seizures. Coadministration with drugs that lower seizure threshold may increase this risk.

                  • amisulpride

                    amisulpride and doxylamine both increase sedation. Use Caution/Monitor.

                  • amitriptyline

                    doxylamine and amitriptyline both increase sedation. Use Caution/Monitor.

                  • amobarbital

                    amobarbital and doxylamine both increase sedation. Use Caution/Monitor.

                  • amoxapine

                    doxylamine and amoxapine both increase sedation. Use Caution/Monitor.

                  • apomorphine

                    doxylamine and apomorphine both increase sedation. Use Caution/Monitor.

                  • aripiprazole

                    doxylamine and aripiprazole both increase sedation. Use Caution/Monitor.

                  • asenapine

                    asenapine and doxylamine both increase sedation. Use Caution/Monitor.

                  • asenapine transdermal

                    asenapine transdermal and doxylamine both increase sedation. Use Caution/Monitor.

                  • avapritinib

                    avapritinib and doxylamine both increase sedation. Use Caution/Monitor.

                  • azelastine

                    azelastine and doxylamine both increase sedation. Use Caution/Monitor.

                  • baclofen

                    doxylamine and baclofen both increase sedation. Use Caution/Monitor.

                  • belladonna and opium

                    doxylamine and belladonna and opium both increase sedation. Use Caution/Monitor.

                  • benperidol

                    doxylamine and benperidol both increase sedation. Use Caution/Monitor.

                  • benzhydrocodone/acetaminophen

                    benzhydrocodone/acetaminophen and doxylamine both increase sedation. Use Caution/Monitor.

                  • benzphetamine

                    doxylamine increases and benzphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                  • brexanolone

                    brexanolone, doxylamine. Either increases toxicity of the other by sedation. Use Caution/Monitor.

                  • brexpiprazole

                    brexpiprazole and doxylamine both increase sedation. Use Caution/Monitor.

                  • brimonidine

                    brimonidine and doxylamine both increase sedation. Use Caution/Monitor.

                  • brivaracetam

                    brivaracetam and doxylamine both increase sedation. Use Caution/Monitor.

                  • brompheniramine

                    brompheniramine and doxylamine both increase sedation. Use Caution/Monitor.

                  • buprenorphine

                    doxylamine and buprenorphine both increase sedation. Use Caution/Monitor.

                  • buprenorphine buccal

                    doxylamine and buprenorphine buccal both increase sedation. Use Caution/Monitor.

                  • buprenorphine subdermal implant

                    buprenorphine subdermal implant and doxylamine both increase sedation. Use Caution/Monitor.

                  • buprenorphine, long-acting injection

                    doxylamine increases toxicity of buprenorphine, long-acting injection by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of buprenorphine and benzodiazepines or other CNS depressants increases risk of adverse reactions including overdose, respiratory depression, and death. Cessation of benzodiazepines or other CNS depressants is preferred in most cases. In some cases, monitoring at a higher level of care for tapering CNS depressants may be appropriate. In others, gradually tapering a patient off of a prescribed benzodiazepine or other CNS depressant or decreasing to the lowest effective dose may be appropriate.

                  • butabarbital

                    butabarbital and doxylamine both increase sedation. Use Caution/Monitor.

                  • butalbital

                    butalbital and doxylamine both increase sedation. Use Caution/Monitor.

                  • butorphanol

                    doxylamine and butorphanol both increase sedation. Use Caution/Monitor.

                  • carbinoxamine

                    carbinoxamine and doxylamine both increase sedation. Use Caution/Monitor.

                  • carisoprodol

                    doxylamine and carisoprodol both increase sedation. Use Caution/Monitor.

                  • cenobamate

                    cenobamate, doxylamine. Either increases effects of the other by sedation. Use Caution/Monitor.

                  • chloral hydrate

                    chloral hydrate and doxylamine both increase sedation. Use Caution/Monitor.

                  • chlordiazepoxide

                    chlordiazepoxide and doxylamine both increase sedation. Use Caution/Monitor.

                  • chlorpheniramine

                    chlorpheniramine and doxylamine both increase sedation. Use Caution/Monitor.

                  • chlorpromazine

                    doxylamine and chlorpromazine both increase sedation. Use Caution/Monitor.

                  • chlorzoxazone

                    doxylamine and chlorzoxazone both increase sedation. Use Caution/Monitor.

                  • cinnarizine

                    cinnarizine and doxylamine both increase sedation. Use Caution/Monitor.

                  • clemastine

                    clemastine and doxylamine both increase sedation. Use Caution/Monitor.

                  • clobazam

                    doxylamine, clobazam. Other (see comment). Use Caution/Monitor. Comment: Concomitant administration can increase the potential for CNS effects (e.g., increased sedation or respiratory depression).

                  • clomipramine

                    doxylamine and clomipramine both increase sedation. Use Caution/Monitor.

                  • clonazepam

                    clonazepam and doxylamine both increase sedation. Use Caution/Monitor.

                  • clonidine

                    clonidine, doxylamine. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration enhances CNS depressant effects.

                  • clorazepate

                    clorazepate and doxylamine both increase sedation. Use Caution/Monitor.

                  • clozapine

                    doxylamine and clozapine both increase sedation. Use Caution/Monitor.

                  • codeine

                    doxylamine and codeine both increase sedation. Use Caution/Monitor.

                  • cyclizine

                    cyclizine and doxylamine both increase sedation. Use Caution/Monitor.

                  • cyclobenzaprine

                    doxylamine and cyclobenzaprine both increase sedation. Use Caution/Monitor.

                  • cyproheptadine

                    cyproheptadine and doxylamine both increase sedation. Use Caution/Monitor.

                  • dantrolene

                    doxylamine and dantrolene both increase sedation. Use Caution/Monitor.

                  • daridorexant

                    doxylamine and daridorexant both increase sedation. Modify Therapy/Monitor Closely. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.

                  • desipramine

                    doxylamine and desipramine both increase sedation. Use Caution/Monitor.

                  • deutetrabenazine

                    doxylamine and deutetrabenazine both increase sedation. Use Caution/Monitor.

                  • dexchlorpheniramine

                    dexchlorpheniramine and doxylamine both increase sedation. Use Caution/Monitor.

                  • dexfenfluramine

                    doxylamine increases and dexfenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                  • dexmedetomidine

                    dexmedetomidine and doxylamine both increase sedation. Use Caution/Monitor.

                  • dextromoramide

                    doxylamine and dextromoramide both increase sedation. Use Caution/Monitor.

                  • diamorphine

                    doxylamine and diamorphine both increase sedation. Use Caution/Monitor.

                  • diazepam

                    diazepam and doxylamine both increase sedation. Use Caution/Monitor.

                  • diazepam intranasal

                    diazepam intranasal, doxylamine. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration may potentiate the CNS-depressant effects of each drug.

                  • difelikefalin

                    difelikefalin and doxylamine both increase sedation. Use Caution/Monitor.

                  • difenoxin hcl

                    doxylamine and difenoxin hcl both increase sedation. Use Caution/Monitor.

                  • dimenhydrinate

                    dimenhydrinate and doxylamine both increase sedation. Use Caution/Monitor.

                  • diphenhydramine

                    diphenhydramine and doxylamine both increase sedation. Use Caution/Monitor.

                  • diphenoxylate hcl

                    doxylamine and diphenoxylate hcl both increase sedation. Use Caution/Monitor.

                  • dipipanone

                    doxylamine and dipipanone both increase sedation. Use Caution/Monitor.

                  • dopexamine

                    doxylamine increases and dopexamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                  • dosulepin

                    doxylamine and dosulepin both increase sedation. Use Caution/Monitor.

                  • doxepin

                    doxylamine and doxepin both increase sedation. Use Caution/Monitor.

                  • droperidol

                    doxylamine and droperidol both increase sedation. Use Caution/Monitor.

                  • esketamine intranasal

                    esketamine intranasal, doxylamine. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.

                  • estazolam

                    estazolam and doxylamine both increase sedation. Use Caution/Monitor.

                  • ethanol

                    doxylamine and ethanol both increase sedation. Use Caution/Monitor.

                  • etomidate

                    etomidate and doxylamine both increase sedation. Use Caution/Monitor.

                  • fenfluramine

                    doxylamine increases and fenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                  • flibanserin

                    doxylamine and flibanserin both increase sedation. Modify Therapy/Monitor Closely. Risk for sedation increased if flibanserin is coadministration with other CNS depressants.

                  • fluphenazine

                    doxylamine and fluphenazine both increase sedation. Use Caution/Monitor.

                  • flurazepam

                    flurazepam and doxylamine both increase sedation. Use Caution/Monitor.

                  • gabapentin

                    gabapentin, doxylamine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.

                  • gabapentin enacarbil

                    gabapentin enacarbil, doxylamine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.

                  • ganaxolone

                    doxylamine and ganaxolone both increase sedation. Use Caution/Monitor.

                  • gotu kola

                    gotu kola increases effects of doxylamine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.

                  • haloperidol

                    doxylamine and haloperidol both increase sedation. Use Caution/Monitor.

                  • hawthorn

                    hawthorn increases effects of doxylamine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.

                  • hops

                    hops increases effects of doxylamine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.

                  • hyaluronidase

                    doxylamine decreases effects of hyaluronidase by Other (see comment). Use Caution/Monitor. Comment: Antihistamines, when given in large systemic doses, may render tissues partially resistant to the action of hyaluronidase. Patients may require larger amounts of hyaluronidase for equivalent dispersing effect. .

                  • hydromorphone

                    doxylamine and hydromorphone both increase sedation. Use Caution/Monitor.

                  • hydroxyzine

                    hydroxyzine and doxylamine both increase sedation. Use Caution/Monitor.

                  • iloperidone

                    doxylamine and iloperidone both increase sedation. Use Caution/Monitor.

                  • imipramine

                    doxylamine and imipramine both increase sedation. Use Caution/Monitor.

                  • kava

                    kava increases effects of doxylamine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.

                  • ketamine

                    ketamine and doxylamine both increase sedation. Use Caution/Monitor.

                  • ketotifen, ophthalmic

                    doxylamine and ketotifen, ophthalmic both increase sedation. Use Caution/Monitor.

                  • lasmiditan

                    lasmiditan, doxylamine. Either increases effects of the other by sedation. Use Caution/Monitor. Coadministration of lasmiditan and other CNS depressant drugs, including alcohol have not been evaluated in clinical studies. Lasmiditan may cause sedation, as well as other cognitive and/or neuropsychiatric adverse reactions.

                  • levorphanol

                    doxylamine and levorphanol both increase sedation. Use Caution/Monitor.

                  • lofepramine

                    doxylamine and lofepramine both increase sedation. Use Caution/Monitor.

                  • lofexidine

                    doxylamine and lofexidine both increase sedation. Use Caution/Monitor.

                  • loprazolam

                    loprazolam and doxylamine both increase sedation. Use Caution/Monitor.

                  • lorazepam

                    lorazepam and doxylamine both increase sedation. Use Caution/Monitor.

                  • lormetazepam

                    lormetazepam and doxylamine both increase sedation. Use Caution/Monitor.

                  • loxapine

                    doxylamine and loxapine both increase sedation. Use Caution/Monitor.

                  • loxapine inhaled

                    doxylamine and loxapine inhaled both increase sedation. Use Caution/Monitor.

                  • lurasidone

                    lurasidone, doxylamine. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Potential for increased CNS depressant effects when used concurrently; monitor for increased adverse effects and toxicity.

                  • maprotiline

                    doxylamine and maprotiline both increase sedation. Use Caution/Monitor.

                  • marijuana

                    doxylamine and marijuana both increase sedation. Use Caution/Monitor.

                  • melatonin

                    doxylamine and melatonin both increase sedation. Use Caution/Monitor.

                  • meperidine

                    doxylamine and meperidine both increase sedation. Use Caution/Monitor.

                  • meprobamate

                    doxylamine and meprobamate both increase sedation. Use Caution/Monitor.

                  • metaxalone

                    doxylamine and metaxalone both increase sedation. Use Caution/Monitor.

                  • methadone

                    doxylamine and methadone both increase sedation. Use Caution/Monitor.

                  • methocarbamol

                    doxylamine and methocarbamol both increase sedation. Use Caution/Monitor.

                  • methylenedioxymethamphetamine

                    doxylamine increases and methylenedioxymethamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                  • midazolam

                    midazolam and doxylamine both increase sedation. Use Caution/Monitor.

                  • midazolam intranasal

                    midazolam intranasal, doxylamine. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Concomitant use of barbiturates, alcohol, or other CNS depressants may increase risk of hypoventilation, airway obstruction, desaturation, or apnea and may contribute to profound and/or prolonged drug effect.

                  • mirtazapine

                    doxylamine and mirtazapine both increase sedation. Use Caution/Monitor.

                  • morphine

                    doxylamine and morphine both increase sedation. Use Caution/Monitor.

                  • motherwort

                    doxylamine and motherwort both increase sedation. Use Caution/Monitor.

                  • moxonidine

                    doxylamine and moxonidine both increase sedation. Use Caution/Monitor.

                  • nabilone

                    doxylamine and nabilone both increase sedation. Use Caution/Monitor.

                  • nalbuphine

                    doxylamine and nalbuphine both increase sedation. Use Caution/Monitor.

                  • nortriptyline

                    doxylamine and nortriptyline both increase sedation. Use Caution/Monitor.

                  • olanzapine

                    doxylamine and olanzapine both increase sedation. Use Caution/Monitor.

                  • oliceridine

                    oliceridine, doxylamine. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.

                  • opium tincture

                    doxylamine and opium tincture both increase sedation. Use Caution/Monitor.

                  • orphenadrine

                    doxylamine and orphenadrine both increase sedation. Use Caution/Monitor.

                  • oxazepam

                    oxazepam and doxylamine both increase sedation. Use Caution/Monitor.

                  • oxycodone

                    doxylamine and oxycodone both increase sedation. Use Caution/Monitor.

                  • oxymorphone

                    doxylamine and oxymorphone both increase sedation. Use Caution/Monitor.

                  • paliperidone

                    doxylamine and paliperidone both increase sedation. Use Caution/Monitor.

                  • papaveretum

                    doxylamine and papaveretum both increase sedation. Use Caution/Monitor.

                  • papaverine

                    doxylamine and papaverine both increase sedation. Use Caution/Monitor.

                  • passion flower

                    passion flower increases effects of doxylamine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.

                  • pentazocine

                    doxylamine and pentazocine both increase sedation. Use Caution/Monitor.

                  • pentobarbital

                    pentobarbital and doxylamine both increase sedation. Use Caution/Monitor.

                  • perphenazine

                    doxylamine and perphenazine both increase sedation. Use Caution/Monitor.

                  • phenelzine

                    phenelzine increases effects of doxylamine by Other (see comment). Modify Therapy/Monitor Closely. Comment: Coadministration of phenelzine and antihistamines may result in additive CNS depressant effects. MAO inhibitors also prolong and intensify anticholinergic effects of antihistamines. .

                  • phenobarbital

                    phenobarbital and doxylamine both increase sedation. Use Caution/Monitor.

                  • phenylephrine PO

                    doxylamine increases and phenylephrine PO decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

                  • pholcodine

                    doxylamine and pholcodine both increase sedation. Use Caution/Monitor.

                  • pimozide

                    doxylamine and pimozide both increase sedation. Use Caution/Monitor.

                  • pregabalin

                    pregabalin, doxylamine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.

                  • primidone

                    primidone and doxylamine both increase sedation. Use Caution/Monitor.

                  • prochlorperazine

                    doxylamine and prochlorperazine both increase sedation. Use Caution/Monitor.

                  • promethazine

                    promethazine and doxylamine both increase sedation. Use Caution/Monitor.

                  • propofol

                    propofol and doxylamine both increase sedation. Use Caution/Monitor.

                  • propylhexedrine

                    doxylamine increases and propylhexedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                  • protriptyline

                    doxylamine and protriptyline both increase sedation. Use Caution/Monitor.

                  • quazepam

                    quazepam and doxylamine both increase sedation. Use Caution/Monitor.

                  • quetiapine

                    doxylamine and quetiapine both increase sedation. Use Caution/Monitor.

                  • ramelteon

                    doxylamine and ramelteon both increase sedation. Use Caution/Monitor.

                  • remimazolam

                    remimazolam, doxylamine. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely. Coadministration may result in profound sedation, respiratory depression, coma, and/or death. Continuously monitor vital signs during sedation and recovery period if coadministered. Carefully titrate remimazolam dose if administered with opioid analgesics and/or sedative/hypnotics.

                  • risperidone

                    doxylamine and risperidone both increase sedation. Use Caution/Monitor.

                  • scullcap

                    doxylamine and scullcap both increase sedation. Use Caution/Monitor.

                  • secobarbital

                    secobarbital and doxylamine both increase sedation. Use Caution/Monitor.

                  • sevoflurane

                    sevoflurane and doxylamine both increase sedation. Use Caution/Monitor.

                  • shepherd's purse

                    doxylamine and shepherd's purse both increase sedation. Use Caution/Monitor.

                  • stiripentol

                    stiripentol, doxylamine. Either increases effects of the other by sedation. Use Caution/Monitor. Concomitant use stiripentol with other CNS depressants, including alcohol, may increase the risk of sedation and somnolence.

                  • sufentanil

                    doxylamine and sufentanil both increase sedation. Use Caution/Monitor.

                  • tapentadol

                    doxylamine and tapentadol both increase sedation. Use Caution/Monitor.

                  • temazepam

                    temazepam and doxylamine both increase sedation. Use Caution/Monitor.

                  • thioridazine

                    doxylamine and thioridazine both increase sedation. Use Caution/Monitor.

                  • thiothixene

                    doxylamine and thiothixene both increase sedation. Use Caution/Monitor.

                  • topiramate

                    doxylamine and topiramate both increase sedation. Modify Therapy/Monitor Closely.

                  • tramadol

                    doxylamine and tramadol both increase sedation. Use Caution/Monitor.

                  • trazodone

                    doxylamine and trazodone both increase sedation. Use Caution/Monitor.

                  • triazolam

                    triazolam and doxylamine both increase sedation. Use Caution/Monitor.

                  • triclofos

                    doxylamine and triclofos both increase sedation. Use Caution/Monitor.

                  • trifluoperazine

                    doxylamine and trifluoperazine both increase sedation. Use Caution/Monitor.

                  • trimipramine

                    doxylamine and trimipramine both increase sedation. Use Caution/Monitor.

                  • triprolidine

                    triprolidine and doxylamine both increase sedation. Use Caution/Monitor.

                  • valerian

                    valerian increases effects of doxylamine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.

                  • xylometazoline

                    doxylamine increases and xylometazoline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                  • ziconotide

                    doxylamine and ziconotide both increase sedation. Use Caution/Monitor.

                  • ziprasidone

                    doxylamine and ziprasidone both increase sedation. Use Caution/Monitor.

                  • zotepine

                    doxylamine and zotepine both increase sedation. Use Caution/Monitor.

                  Minor (6)

                  • ashwagandha

                    ashwagandha increases effects of doxylamine by pharmacodynamic synergism. Minor/Significance Unknown. May enhance CNS depression.

                  • brimonidine

                    brimonidine increases effects of doxylamine by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.

                  • eucalyptus

                    doxylamine and eucalyptus both increase sedation. Minor/Significance Unknown.

                  • nettle

                    nettle increases effects of doxylamine by pharmacodynamic synergism. Minor/Significance Unknown. (High dose nettle; theoretical interaction) May enhance CNS depression.

                  • sage

                    doxylamine and sage both increase sedation. Minor/Significance Unknown.

                  • Siberian ginseng

                    Siberian ginseng increases effects of doxylamine by pharmacodynamic synergism. Minor/Significance Unknown. May enhance CNS depression.

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                  Adverse Effects

                  Common Adverse Effects

                  Agranulocytosis

                  Potential for abuse

                  Leukopenia

                  Serotonin syndrome

                  Dizziness

                  Drowsiness

                  Thrombocytopenia

                  Toxic psychosis

                  GI disturbances

                  Dry mouth, throat, and nose

                  Thickening of mucus in nose or throat

                  Constipation

                  Blurred vision

                  Headache

                  Urinary retention

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                  Warnings

                  Contraindications

                  Hypersensitivity

                  Asthma attacks

                  Use of MAO inhibitors within 14 days

                  < 2 years of age

                  Narrow-angle glaucoma

                  Breastfeeding

                  Symptomatic prostate hypertrophy

                  Bladder-neck obstruction

                  Stenosing peptic ulcer

                  Cautions

                  Caution in patients < 6 years of age

                  Doxylamine: Caution in used concomitantly with another CNS deppressatn; may exacerbate angle closure glaucoma, hyperthyroidism, peptic ulcer, or urinary tract obstruction; xerostomia may occur; caution in COPD, cardiovascular disease, asthma, increased intraocular pressure, elderly patients or GI obstruction

                  Dextromethorphan: Do not take 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; may decrease respiration rate

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                  Pregnancy & Lactation

                  Pregnancy category: C

                  Lactation: excreted in breast milk, use caution

                  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

                  Doxylamine: Competitively blocks histamine from binding to H1 receptors; significant antimuscarinic activity & penetrates CNS, which causes pronounced tendency to induce sedation

                  Dextromethorphan: Cough suppressant that acts centrally on the cough center in medulla

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                  Images

                  No images available for this drug.
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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.
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