Doxylamine + Dextromethorphan

Indications

Doxylamine + Dextromethorphan is used for: Cough, Rhinorrhea & Sneezing

Adult Dose

Cough, Rhinorrhea & Sneezing 30 mL PO q6hr; not to exceed 4 doses/day

Child Dose

Cough, Rhinorrhea & Sneezing >12 years: 30 mL PO q6hr; not to exceed 4 doses/day

Renal Dose

Administration

Contra Indications

Hypersensitivity Asthma attacks Use of MAO inhibitors within 14 days < 2 years of age Narrow-angle glaucoma Breastfeeding Symptomatic prostate hypertrophy Bladder-neck obstruction Stenosing peptic ulcer

Precautions

Caution in patients < 6 years of age Doxylamine: Caution in used concomitantly with another CNS deppressatn; may exacerbate angle closure glaucoma, hyperthyroidism, peptic ulcer, or urinary tract obstruction; xerostomia may occur; caution in COPD, cardiovascular disease, asthma, increased intraocular pressure, elderly patients or GI obstruction Dextromethorphan: Do not take for persistent or chronic cough associated with smoking, asthma, or emphysema, or if it is accompanied by excessive phlegm unless directed by a healthcare provider; may decrease respiration rate

Pregnancy-Lactation

Pregnancy category: C Lactation: excreted in breast milk, use caution

Interactions

Adverse Effects

Side effects of Doxylamine + Dextromethorphan : Common Adverse Effects Agranulocytosis Potential for abuse Leukopenia Serotonin syndrome Dizziness Drowsiness Thrombocytopenia Toxic psychosis GI disturbances Dry mouth, throat, and nose Thickening of mucus in nose or throat Constipation Blurred vision Headache Urinary retention

Mechanism of Action

Doxylamine: Competitively blocks histamine from binding to H1 receptors; significant antimuscarinic activity & penetrates CNS, which causes pronounced tendency to induce sedation Dextromethorphan: Cough suppressant that acts centrally on the cough center in medulla