dextromethorphan (Benylin DM)
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Introduction
Dextromethorphan is a widely-used antitussive.
Indications
Contraindications
- drug of abuse 'robo trip' among teens[6]
- not effective for cough due to upper respiratory tract infection or common cold[8]
Dosage
- 10-30 mg PO every 4-8 hours
Liquid: 10 mg/5mL.
Pharmacokinetics
- metabolized in the liver by cyt P450 2D6
elimination via liver
Adverse effects
- used as drug of abuse:
- may cause euphoria & hallucinations; most likely caused by metabolite
- agitation & confusion
- hypertension
- tachycardia
Drug interactions
- many pharmaceutical agents
- dextromethorphan in combination with SSRI may increase risk of serotonin syndrome[7]
Mechanism of action
- weak NMDA receptor antagonist[4]
- allosteric antagonist at NMDA controlled ion channels & an antagonist at voltage dependent ion channels
More general terms
Additional terms
- cytochrome P450 2D6 (cytochrome P450 2D, cytochrome P450 DB1, debrisoquine-4-hydroxylase, CYP2D6)
- NMDA receptor
Component of
- bupropion/dextromethorphan (Auvelity)
- dextromethorphan/phenylephrine/triprolidine
- dextromethorphan/menthol/phenylephrine
- dextromethorphan/lidocaine/salicylate
- dextromethorphan/doxylamine/guaifenesin
- dextromethorphan/diphenhydramine/guaifenesin/phenylephrine
- dextromethorphan/diphenhydramine/guaifenesin
- brompheniramine/dextromethorphan/diphenhydramine
- aspirin/chlorpheniramine/dextromethorphan/phenylephrine
- acetaminophen/dextromethorphan/guaifenesin/zinc acetate/zinc gluconate
- acetaminophen/dextromethorphan/guaifenesin
- acetaminophen/dextromethorphan/doxylamine/zinc acetate/zinc gluconate
- acetaminophen/dextromethorphan/diphenhydramine/guaifenesin
- acetaminophen/chlorpheniramine/dextromethorphan/doxylamine/succinate
- dextromethorphan/pyrilamine
- dextromethorphan/pseudoephedrine/triprolidine
- dextromethorphan/potassium iodide
- dextromethorphan/phenylephrine/thonzylamine
- dextromethorphan/pheniramine/phenylephrine
- dextromethorphan/menthol
- dextromethorphan/guaifenesin/ribonuclease/angiogenin inhibitor
- dextromethorphan/guaifenesin/phenylpropanolamine/pyrilamine
- dextromethorphan/guaifenesin/phenylpropanolamine
- dextromethorphan/guaifenesin/nov protein/pseudoephedrine
- dextromethorphan/guaiacolsulfonate/phenylephrine/pyrilamine
- dextromethorphan/guaiacolsulfonate/phenylephrine
- dextromethorphan/guaiacolsulfonate/guaifenesin
- dextromethorphan/doxylamine/pseudoephedrine
- dexchlorpheniramine/dextromethorphan/guaifenesin/phenylephrine
- dexbrompheniramine/dextromethorphan/pseudoephedrine
- dexbrompheniramine/dextromethorphan/phenylephrine/pyrilamine
- dexbrompheniramine/dextromethorphan/guaifenesin/pseudoephedrine
- dexbrompheniramine/dextromethorphan/guaifenesin/phenylephrine
- citrate/dextromethorphan/guaifenesin/pyrilamine
- citrate/dextromethorphan/guaifenesin
- chlorpheniramine/dextromethorphan/phenylephrine/phenylpropanolamine
- chlorpheniramine/dextromethorphan/guaifenesin/pseudoephedrine
- chlorpheniramine/dextromethorphan/guaifenesin/methscopolamine/phenylephrine
- chlorpheniramine/dextromethorphan/guaifenesin
- carbinoxamine/dextromethorphan/pseudoephedrine/vegf co regulated chemokine 1
- carbinoxamine/dextromethorphan/phenylephrine
- brompheniramine/dextromethorphan/phenylpropanolamine
- brompheniramine/dextromethorphan/guaifenesin
- brompheniramine/dextromethorphan
- benzocaine/dextromethorphan/menthol
- aspirin/dextromethorphan/phenylephrine
- aspirin/dextromethorphan/doxylamine/phenylephrine
- acetaminophen/dextromethorphan/guaifenesin/zinc sulfate
- acetaminophen/dextromethorphan/doxylamine/zinc sulfate
- acetaminophen/dextromethorphan/doxylamine/guaifenesin/pseudoephedrine
- acetaminophen/dextromethorphan/doxylamine/guaifenesin/phenylephrine
- acetaminophen/dextromethorphan/doxylamine/guaifenesin
- acetaminophen/dextromethorphan/diphenhydramine/pseudoephedrine
- acetaminophen/dextromethorphan/diphenhydramine/guaifenesin/phenylephrine
- acetaminophen/chlorpheniramine/dextromethorphan/guaifenesin/phenylephrine
- acetaminophen/chlorpheniramine/dextromethorphan/doxylamine
- acetaminophen/brompheniramine/dextromethorphan/pseudoephedrine
- dextromethorphan/quinidine (Nuedexta)
- dextromethorphan/guaiacolsulfonate
- dexbrompheniramine/dextromethorphan/phenylephrine
- chlorpheniramine/dextromethorphan/methscopolamine
- acetaminophen/chlorpheniramine/dextromethorphan/guaifenesin
- dextromethorphan/pseudoephedrine/pyrilamine
- carbohydrate/dextromethorphan/guaifenesin
- dextromethorphan/diphenhydramine/phenylephrine
- dextromethorphan/phenylephrine/pyrilamine
- dextromethorphan/pseudoephedrine
- dextromethorphan/doxylamine
- dexchlorpheniramine/dextromethorphan/pseudoephedrine
- dexchlorpheniramine/dextromethorphan/phenylephrine
- dexchlorpheniramine/dextromethorphan/phenylephrine/pyrilamine
- dextromethorphan/phenylephrine
- chlorpheniramine/dextromethorphan/diethylcarbamazine/phenylephrine
- carbohydrate/chlorpheniramine/dextromethorphan
- chlorpheniramine/dextromethorphan/guaifenesin/phenylephrine
- chlorpheniramine/dextromethorphan
- chlorpheniramine/dextromethorphan/pseudoephedrine
- brompheniramine/dextromethorphan/guaifenesin/pseudoephedrine
- brompheniramine/dextromethorphan/guaifenesin/phenylephrine
- brompheniramine/dextromethorphan/pseudoephedrine
- brompheniramine/dextromethorphan/phenylephrine
- benzocaine/dextromethorphan
- acetaminophen/dextromethorphan/diphenhydramine
- acetaminophen/dextromethorphan/diethylcarbamazine/doxylamine/phenylephrine
- acetaminophen/dextromethorphan/guaifenesin/phenylephrine
- acetaminophen/dextromethorphan
- acetaminophen/chlorpheniramine/dextromethorphan
- acetaminophen/chlorpheniramine/dextromethorphan/pseudoephedrine
- acetaminophen/chlorpheniramine/dextromethorphan/phenylephrine
- acetaminophen/dextromethorphan/guaifenesin/pseudoephedrine
- acetaminophen/dextromethorphan/doxylamine/pseudoephedrine
- acetaminophen/dextromethorphan/pseudoephedrine/pyrilamine
- acetaminophen/dextromethorphan/doxylamine
- acetaminophen/dextromethorphan/phenylephrine
- acetaminophen/dextromethorphan/doxylamine/phenylephrine
- acetaminophen/dextromethorphan/pseudoephedrine
- dextromethorphan/guaifenesin/phenylephrine
- chlorpheniramine/dextromethorphan/phenylephrine
- acetaminophen/dextromethorphan/diphenhydramine/phenylephrine
- carbinoxamine/dextromethorphan/pseudoephedrine (Cardec-DM, Rondec-DM)
- dextromethorphan/promethazine (Phenergan with dextromethorphan)
- dextromethorphan/guaifenesin/pseudoephedrine (Robitussin CF)
- dextromethorphan/guaifenesin (Robitussin DM, Naldecon Dx)
- coricidin HBP cough & cold (CCC, poor man's PCP)
References
- ↑ Merck Index 11th ed #8116
- ↑ Research Biochemicals International 1993-94 catalog
- ↑ Prescriber's Letter 9(3):15 2002
- ↑ 4.0 4.1 Prescriber's Letter 10(11) 2003; detail document 191102
- ↑ Department of Veterans Affairs, VA National Formulary
- ↑ 6.0 6.1 Prescriber's Letter 14(2): 2007 Dextromethorphan abuse Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=230208&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ 7.0 7.1 Paauw DS Dangerous and Deadly Drug Combinations Medscape. June 30, 2016 http://www.medscape.com/features/slideshow/dangerous-drug-combinations
- ↑ 8.0 8.1 Medical Knowledge Self Assessment Program (MKSAP) 19 American College of Physicians, Philadelphia 2022