dextromethorphan hydrobromide

(dex troe meth or' fan)

Balminil DM (CAN), Benylin Adult, Benylin Pediatric, Creo-Terpin, Delsym,
DexAlone, Hold DM, Koffex (CAN), Novahistex DM (CAN), Novahistine DM
(CAN), Robitussin Pediatric (CAN), Trocal, Vicks Dry Hacking Cough

Pregnancy Category C

Drug class
Nonopioid antitussive

Therapeutic actions
Lacks analgesic and addictive properties; controls cough spasms by depressing the cough
center in the medulla; analog of codeine.

Indication
• Control of nonproductive cough

Contraindications and cautions

• Hypersensitivity to any component (check label of products for flavorings,
vehicles); sensitivity to bromides; cough that persists for more than 1 wk, tends to
recur, is accompanied by excessive secretions, high fever, rash, nausea, vomiting,
or persistent headache (dextromethorphan should not be used; patient should
consult a physician); lactation, pregnancy.

Available forms
Capsules—30 mg; lozenges—5, 7.5 mg; liquid—7.5 mg/5 mL; 10 mg/15 mL,
15 mg/5 mL, 30 mg/5 mL; syrup—7.5 mg/5 mL, 10 mg/5 mL; sustained action liquid—
30 mg/5 mL

Dosages
ADULTS AND PATIENTS > 12 YR
Lozenges, syrup, and chewy squares
10–30 mg q 4–8 hr PO. Do not exceed 120 mg/24 hr.
Sustained-action liquid
60 mg bid PO up to 120 mg/day.
PEDIATRIC PATIENTS
Lozenges, syrup, and chewy squares
6–12 yr: 5–10 mg q 1–4 hr PO. Do not exceed 60 mg/24 hr.
Sustained-action liquid
30 mg bid PO.
Syrup and chewy squares
2–6 yr: 7.5 mg q 6–8 hr PO. Do not exceed 30 mg/24 hr. Do not give lozenges to this age
group.
Sustained-action liquid
15 mg bid PO up to 30 mg/day.
< 2 yr: Use only as directed by a physician.
Pharmacokinetics
Route Onset Peak Duration
Oral 15–30 min 2 hr 3–6 hr

Metabolism: Hepatic; T1/2: 2–4 hr

Distribution: Crosses placenta; enters breast milk
Excretion: Urine

Adverse effects
• Respiratory: Respiratory depression (with overdose)

Interactions
Drug-drug
• Concomitant MAOI use may cause hypotension, fever, nausea, myoclonic jerks
and coma; avoid this combination

Nursing considerations
Assessment
• History: Hypersensitivity to any component; sensitivity to bromides; cough that
persists for more than 1 wk or is accompanied by excessive secretions, high fever,
rash, nausea, vomiting, or persistent headache; lactation, pregnancy
• Physical: T; R, adventitious sounds

Interventions
• Ensure drug is used only as recommended. Coughs may be symptomatic of a
serious underlying disorder that should be diagnosed and properly treated; drug
may mask symptoms of serious disease.

Teaching points
• Take this drug exactly as prescribed. Do not take more than or for longer than
recommended.
• Report continued or recurring cough, cough accompanied by fever, rash,
persistent headache, nausea, vomiting.

Adverse effects in Italic are most common; those in Bold are life-threatening.