TUSSIDEX

Dextromethorphan is a levorphanol derivative and codeine analog commonly used as a cough suppressant and also a drug of abuse.

Although similar in structure to other opioids, it has minimal interaction with opioid receptors.

Dextromethorphan was granted

FDA approval before 3 December 1957. 11, 17.

Dextromethorphan is indicated in combination with brompheniramine and pseudoephedrine in the treatment of coughs and upper respiratory symptoms associated with allergies or the common cold.

Dextromethorphan is also used in combination with guaifenesin as an over-the-counter product to relieve a cough.

Dextromethorphan in combination with quinidine is indicated in the treatment of pseudobulbar affect.

Dextromethorphan is an opioid-like molecule indicated in combination with other medication in the treatment of coughs and pseudobulbar affect. 14, 15, 13 It has a moderate therapeutic window, as intoxication can occur at higher doses.

Dextromethorphan has a moderate duration of action.

Patients should be counselled regarding the risk of intoxication.

Sigma non-opioid intracellular receptor 1 Agonist Glutamate receptor ionotropic, NMDA 3A Antagonist.

A 30 mg oral dose of dextromethorphan reaches a C max of 2.9 ng/mL, with a T max of 2.86 h, and an AUC of 17.8 ng*h/mL.

The volume of distribution of dextromethorphan is 5-6.7 L/kg.

Dextromethorphan can be

N-demethylated to 3-methoxymorphinan by CYP3A4, CYP2D6, and CYP2C9 or O-demethylated to dextrorphan by CYP2D6 and CYP2C9.

Dextrorphan is N-demethylated by

CYP3A4 and CYP2D6, while 3-methoxymorphinan is O-demethylated by CYP2D6.

Both are metabolized to form 3-hydroxymorphinan.

Dextrorphan and 3-hydroxymorphinan are both O-glucuronidated or O-sulfated.

Hover over products below to view reaction partners Dextromethorphan Dextrorphan 3-Hydroxymorphinan 3-Hydroxymorphinan sulfate 3-Hydroxymorphinan O-glucuronide Dextrorphan sulfate Dextrorphan O-glucuronide (+)-3-Methoxymorphinan 3-Hydroxymorphinan.

Dextromethorphan has a half life of 3-30 hours.

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A dextromethorphan overdose may present as nausea, vomiting, stupor, coma, respiratory depression, seizures, tachycardia, hyperexcitability, toxic psychosis, ataxia, nystagmus, dystonia, blurred vision, changes in muscle reflexes, and serotonin syndrome.

Overdose should be managed through symptomatic and supportive measures.