D Cough

Indications

Dextromethorphan Hydrobromide is a cough suppressant. It is used for:

• Short-term relief of a dry, tickly cough (a cough that does not bring up mucus), such as with a cold or throat irritation.

It is often found in combination cough and cold medicines.

How It Works

Dextromethorphan acts on the cough centre in the brain and raises the threshold that triggers coughing. This reduces how often you cough. It does not treat the cause of the cough.

Dosage and Administration

• Adults and children over 12 years: usually 10 to 20 mg every 4 hours, or 30 mg every 6 to 8 hours, when needed. Do not take more than 120 mg in 24 hours.
• Children aged 6 to 12 years: only a children's product, as directed on the pack or by a doctor.
• Children under 6 years: do not give unless a doctor advises.

Use the measuring spoon or cup that comes with the syrup. Do not use for more than 7 days without seeing a doctor. Check the labels of other cold medicines so you do not take dextromethorphan twice.

Interactions

• Never take it with, or within 14 days of, MAO inhibitor medicines; this can cause a dangerous reaction.
• Some antidepressants (such as Fluoxetine, Paroxetine and Sertraline), Tramadol, Linezolid and some migraine medicines raise the risk of serotonin syndrome.
• Fluoxetine, Paroxetine, Quinidine and Bupropion can raise dextromethorphan levels.
• Alcohol, sedating antihistamines and sleeping tablets increase drowsiness.

Contraindications

• Allergy to dextromethorphan or any ingredient of the product.
• Use of MAO inhibitors now or in the past 14 days.
• Breathing failure or risk of it, and a cough with a lot of mucus (chesty cough) or asthma attacks.
• Children under 6 years, unless a doctor advises.

Side Effects

Uncommon at normal doses: drowsiness, dizziness, nausea, stomach upset and constipation.

Get urgent medical help for confusion, agitation, hallucinations, a high temperature with shivering, sweating, muscle twitching or stiffness (possible serotonin syndrome), slowed breathing, or signs of a serious allergy such as swelling of the face or throat. See a doctor if the cough lasts more than a week, comes back, or comes with high fever, rash, chest pain, breathlessness or coughing up blood.

Pregnancy and Lactation

Use in pregnancy and breastfeeding only if a doctor or pharmacist advises it, for the shortest time needed. Some combination products contain other ingredients that are not suitable in pregnancy.

Precautions and Warnings

• Do not use for a chesty cough with mucus, as stopping the cough can trap mucus in the lungs.
• Take care in liver disease, asthma and long-term lung disease.
• It can cause drowsiness; do not drive if affected, and avoid alcohol.
• It can be misused in large doses; keep it away from teenagers and store safely.
• Some syrups contain sugar or alcohol; check the label if you have diabetes.

Overdose

Overdose can cause nausea, vomiting, severe drowsiness or excitement, confusion, hallucinations, unsteady walking, fast heartbeat, slowed breathing and fits. Get urgent medical help.

Therapeutic Class

Centrally acting cough suppressant (antitussive).

Storage

Store below 30°C, away from light. Do not freeze syrup. Keep the bottle tightly closed and use within the time stated on the label after opening. Keep out of reach of children.