Generic
Dextromethorphan + Diphenhydramine + Levomenthol
6 brands available in the market
At a glance
Dextromethorphan + Diphenhydramine + Levomenthol is an antitussive syrup used for the nighttime relief of persistent, dry, irritating cough.
Description
Dextromethorphan is a non-opioid antitussive drug that acts on the cough centre in the medulla oblongata, raising the threshold for the cough reflex. Diphenhydramine possesses antitussive, antihistaminic, and anticholinergic properties. Levomenthol has mild local anaesthetic and decongestant properties.
Indications
- Dry, irritating cough
- Persistent nighttime cough
- Aiding restful sleep
Therapeutic class
Combined cough suppressants
Pharmacological class
Antitussive + Antihistamine + Decongestant
Pharmacology
Dextromethorphan is a non-opioid antitussive drug that acts on the cough centre in the medulla oblongata. Diphenhydramine possesses antitussive, antihistaminic, and anticholinergic properties. Levomenthol has mild local anaesthetic and decongestant properties.
Mechanism of action
Dextromethorphan suppresses cough by acting on the medullary cough centre; Diphenhydramine blocks histamine receptors and provides sedative effects; Levomenthol provides local soothing relief.
Dosage
Adults and children aged 12 years and over: 2 teaspoonful at bedtime followed by 2 teaspoonful every 6 hours OR 2 teaspoonful 4 times a day. Do not take more than 4 doses (1 dose = 2 tsp) in 24 hours.
Administration
Take with or without food. Measure with a measuring cup.
Missed dose
If you miss a dose, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose. Do not double the dose.
Side effects
Diphenhydramine: Drowsiness, dizziness, GI disturbance, dry mouth/nose/throat, difficulty in urination, blurred vision.
Dextromethorphan: Dizziness, nausea, vomiting, GI disturbance.
Precautions & warnings
May cause drowsiness; do not drive or operate machinery. Do not use in narrow-angle glaucoma or symptomatic prostatic hypertrophy. Caution in moderate-severe renal or hepatic dysfunction. Caution in CYP2D6 poor metabolizers or patients using CYP2D6 inhibitors.
Contraindications
Hypersensitivity; patients taking MAOIs or within the preceding two weeks; risk of respiratory failure; children under 12 years.
Drug interactions
MAOIs: Concomitant use may result in hyperpyrexia, hallucinations, gross excitation or coma.
Alcohol and other CNS depressants: Effects potentiated by diphenhydramine.
Anticholinergics (psychotropic drugs, atropine): May cause tachycardia, dry mouth, GI disturbances, urinary retention, headache.
Food interactions
Caution is advised when consuming alcohol.
Use in pregnancy
Widespread use of dextromethorphan and diphenhydramine during pregnancy but insufficient data; use only if necessary.
Pregnancy Category: N/A — always consult a doctor before taking during pregnancy.
Use in lactation
Diphenhydramine is excreted in breast milk; unknown for dextromethorphan; caution required.
Pediatric use
Do not use in children under 12 years of age.
Geriatric use
No specific dosage adjustment is necessary for elderly patients.
Renal / hepatic impairment
Caution in moderate-severe renal or hepatic dysfunction.
Overdose effects
Overdose (especially in children) may cause hallucinations and convulsions; massive doses may cause coma or cardiovascular collapse; symptomatic treatment.
Storage conditions
Store at a temperature not exceeding 30°C in a dry place. Protect from light & moisture.
Chemical structure
Dextromethorphan + Diphenhydramine + Levomenthol