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Doxylamine/Dextromethorphan

    Brands

    DEA Class; OTC

    Common Brand Names; Vicks NyQuil Cough, Safetussin PM

    • Antitussives, Non-narcotic Combos

    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

    Indicated for the Cough, Rhinorrhea & Sneezing

    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

    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

    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 category: C

    Lactation: excreted in breast milk, use caution

    Pregnant or breastfeeding patients should seek advice of health professional before using OTC drugs

    30 mL PO q6hr; not to exceed 4 doses/day

    Doxylamine/dextromethorphan

    oral liquid

    • (6.25mg/15mg)/15mL