Dextromethorphan Hydrobromide is indicated in:

• Chronic dry cough
• Unproductive cough
• Acute dry cough that interferes with normal function or sleep.

Syrup: Each 5 ml sugar-free syrup contains Dextromethorphan Hydrobromide BP 10 mg.

Dextromethorphan Hydrobromide is a cough suppressant that acts centrally on the cough centre in the medulla. Although it is structurally related to morphine, it has no analgesic properties and generally shows little sedative effect. Dependence or addiction has not been observed even after prolonged use of relatively large doses. It is rapidly absorbed from the gastrointestinal tract and begins to act within 15–30 minutes after oral administration. The duration of action is approximately 3–6 hours in conventional dosage forms. Dextromethorphan Hydrobromide is extensively metabolized in the liver and excreted in urine as unchanged drug and demethylated metabolites, including Dextrorphan, which also has some cough suppressant activity. Urinary excretion of the parent drug and metabolites accounts for up to 50% of the administered dose within 24 hours. About 8% of the dose is excreted unchanged in urine within the first 6 hours.

Adults and Children over 12 years: 15 to 30 mg three to four times per day. However, 60 mg doses up to four times per day have been used without increased side effects.

Children between 6 and 12 years: 5–15 mg up to four times per day.

Children between 2 and 6 years: 2.5–5 mg up to four times per day.

Two fatal interactions have been reported in patients receiving therapeutic doses of phenelzine and dextromethorphan together.

Concomitant use of monoamine oxidase inhibitors (MAOIs) is contraindicated with Dextromethorphan Hydrobromide. Dextromethorphan is extensively metabolized in the liver and should be used with caution in patients with liver disease.

Adverse effects with Dextromethorphan are rare, but nausea and dizziness may occasionally occur. The drug does not produce analgesia, addiction, or significant central nervous system (CNS) depression. However, overdosage may lead to excitation, confusion, and respiratory depression.

There is limited information on the use of this drug during pregnancy; therefore, it should be avoided during the first three months of pregnancy. No data are available regarding its secretion into breast milk, so breastfeeding mothers should avoid its use.

Do not use Dextromethorphan for cough associated with smoking, asthma, or emphysema, or for productive cough producing sputum or phlegm.

Cough suppressant

Store below 30°C, protected from light and moisture. Keep out of the reach of children.