This syrup is indicated as an antitussive (cough suppressant) for: Relief of persistent, dry, irritating cough, Promotion of restful sleep (due to the sedative effect of diphenhydramine).

Each 5 mL of syrup contains:

• Diphenhydramine Hydrochloride BP – 14 mg
• Dextromethorphan Hydrobromide BP – 6.5 mg
• Levomenthol BP – 2 mg

Dextromethorphan Hydrobromide is a non-opioid antitussive drug. It exerts its antitussive activity by acting on the cough center in the medulla oblongata, raising the threshold for the cough reflex. Levomenthol has mild local anesthetic and decongestant properties, providing a soothing cooling effect. Diphenhydramine Hydrochloride possesses antitussive, antihistaminic, and anticholinergic properties, which help reduce coughing, relieve allergy symptoms, and induce drowsiness.

Adults and children over 12 years: 2 teaspoonfuls of syrup 4 times a day or as directed by the physicians. Do not take more than 8 teaspoonfuls of syrup in 24 hours.

Use in children & Adolescents: The efficacy and safety of Dextromethorphan Hydrobromide have not been established in pediatric patients and adolescents.

This syrup contains Diphenhydramine Hydrochloride and therefore may potentiate (enhance) the effects of alcohol and other CNS depressants. As Diphenhydramine Hydrochloride possesses some anticholinergic activity, the effects of anticholinergics (e.g., some psychotropic drugs and atropine) may be potentiated by this product. This may result in: Tachycardia (fast heart rate), Dry mouth, Gastrointestinal disturbances (e.g., colic), Urinary retention, Headache. The concomitant use of a Dextromethorphan Hydrobromide-containing product and monoamine oxidase inhibitors (MAOIs) can occasionally result in symptoms such as: Hyperpyrexia (very high fever), Hallucinations, Gross excitation, Coma.

This syrup is contraindicated in individuals with known hypersensitivity to the product or any of its components. This medicine is contraindicated in individuals who are taking, or have taken, monoamine oxidase inhibitors (MAOIs) within the preceding two weeks. Dextromethorphan, in common with other centrally acting antitussive agents, should not be given to subjects in, or at risk of developing, respiratory failure.

This syrup may cause: Drowsiness, Dizziness, Nausea, vomiting, Gastrointestinal disturbance, Dry mouth, nose, and throat, Difficulty in urination, Blurred vision.

Pregnancy: Both Diphenhydramine Hydrochloride and Dextromethorphan Hydrobromide have been in widespread use for many years without apparent ill consequences. However, there is insufficient information on the effects of the administration of Dextromethorphan Hydrobromide during human pregnancy.

Lactation: It is not known whether dextromethorphan or its metabolites are excreted in breast milk. Diphenhydramine Hydrochloride is known to cross the placenta and has also been detected in breast milk. Therefore, the syrup should only be used when the potential benefit of treatment to the mother exceeds any possible hazards to the developing fetus or suckling infant.

This syrup may cause drowsiness; if affected, individuals should not drive or operate machinery. Diphenhydramine Hydrochloride should not be taken by individuals with narrow-angle glaucoma or symptomatic prostatic hypertrophy (enlarged prostate). Caution is particularly recommended for adolescents and young adults, as well as in patients with a history of drug abuse or use of psychoactive substances.

With higher doses, and particularly in children, hallucinations and convulsions may appear. With massive doses, coma or cardiovascular collapse may follow. Management: Treatment of overdose should be symptomatic and supportive. Measures to promote rapid gastric emptying and, in cases of acute poisoning, the use of activated charcoal may be useful. Naloxone has been used successfully as a specific antagonist to dextromethorphan toxicity in children. Convulsions may be controlled with diazepam and thiopental sodium.

Combined cough expectorants ,Combined cough suppressants

Store at a temperature not exceeding 30°C in a dry place. Protect from light and moisture. Keep out of the reach of children.