dextromethorphan/quinidine (Nuedexta)
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Indications
- treatment of pseudobulbar affect associated with amyotrophic lateral sclerosis, multiple sclerosis & other disorders
- agitation in patients with Alzheimer's disease
Dosage
Adverse effects
- most common
- diarrhea
- vomiting
- flatulence
- dyspepsia
- cough
- xeropthalmia, xerostomia
- muscle weakness, muscle spasms
- peripheral edema
- urinary frequency, dysuria
- cloudy urine, malodorous urine
- potentially serious effects
Drug interactions
- mefloquine (Lariam), pimozide (Orap), quinine (Qualaquin) thioridazine
- also see dextromethorphan & quinidine
- drug interaction(s) of dextromethorphan with SSRIs
- drug interaction(s) of beta-adrenergic receptor antagonists with quinidine
Mechanism of action
- dextromethorphan* is the active component, mechanism unknown
- quinidine increases half life of dextromethorphan
* dextromethorphan is an antitussive agent & a weak NMDA receptor antagonist (probably less potent than memantine)
Notes
- CNN reports drug over prescribed in nursing home
More general terms
Components
- dextromethorphan (Benylin DM)
- quinidine [gluconate (Quinaglute, Quinalan) & sulfate (Quinidex, Quinora)]
References
- ↑ PubMed Health Dextromethorphan and Quinidine http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0016263/
- ↑ Cummings JL. Lyketsos CG, Peskind ER et al Effect of Dextromethorphan-Quinidine on Agitation in Patients With Alzheimer Disease Dementia. A Randomized Clinical Trial. JAMA. 2015;314(12):1242-1254 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/26393847 <Internet> http://jama.jamanetwork.com/article.aspx?articleid=2442936
Ballard C, Sharp S, BSc1; Anne Corbett A Dextromethorphan and Quinidine for Treating Agitation in Patients With Alzheimer Disease Dementia JAMA. 2015;314(12):1233-1235. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/26393843 <Internet> http://jama.jamanetwork.com/article.aspx?articleid=2442913 - ↑ Ellis B, Hicken M, Hernandez S The little red pill being pushed on the elderly. CNN investigation exposes inappropriate use of drug in nursing homes. http://www.cnn.com/2017/10/12/health/nuedexta-nursing-homes-invs/index.html
- ↑ HIGHLIGHTS OF PRESCRIBING INFORMATION http://www.nuedexta.com/NUEDEXTA_Full_Prescribing_Information-1.pdf