Drug Detail:Cough relief (Dextromethorphan [ dex-troe-me-thor-fan ])
Drug Class: Antitussives
Usual Adult Dose for Cough
Immediate-release: 10 to 20 mg orally every 4 hours or 30 mg orally ever 6 to 8 hours
Extended-release: 60 mg orally every 12 hours
Maximum dose: 120 mg in 24 hours
Use: For the temporary relief of cough due to minor throat and bronchial irritation as may occur with the common cold or inhaled irritants.
Usual Pediatric Dose for Cough
Under 4 years: Not recommended
4 to 6 years:
Immediate-release: 2.5 to 5 mg orally every 4 hours or 7.5 mg orally every 6 to 8 hours
Extended-release: 15 mg orally every 12 hours
Maximum dose: 30 mg in 24 hours
6 to 12 years:
Immediate-release: 5 to 10 mg orally every 4 hours or 15 mg orally every 6 to 8 hours
Extended-release: 30 mg every 12 hours
Maximum dose: 60 mg in 24 hours
12 years or older:
Immediate-release: 10 to 20 mg orally every 4 hours or 30 mg orally ever 6 to 8 hours
Extended-release: 60 mg orally every 12 hours
Maximum dose: 120 mg in 24 hours
Comments:
- To prevent and reduce the misuse of cough and cold products in children, over the counter (OTC) cough and cold products are labeled "Do not use in children under 4 years of age".
Use: For the temporary relief of cough due to minor throat and bronchial irritation as may occur with the common cold or inhaled irritants.
Renal Dose Adjustments
No adjustment recommended
Liver Dose Adjustments
Use with caution; this drug undergoes extensive hepatic metabolism
Precautions
In 2008, manufacturers of over-the-counter (OTC) pediatric cough and cold products, in consultation with the Food and Drug Administration (FDA), recommended changes to product labeling in children. The new product labeling states "Do not use in children under 4 years of age."
Safety and efficacy have not been established in patients younger than 2 years.
Consult WARNINGS section for additional precautions.
Dialysis
Data not available
Other Comments
Administration advice:
- Use included measuring devices; a household spoon is not an accurate measuring device
- Suspensions should be shaken prior to measuring
- Lozenges should be slowly sucked 1 after another or as directed
Follow label instructions:
- Do not give adult medications to children
- Do not exceed recommended doses
- Do not give more than 1 product containing the same drug
Storage requirements:
- Protect from light
- Avoid exposure to temperatures above 104F (40C)
General:
- Cough suppressants are intended to temporarily relieve a non-productive cough; they should not be used for a cough that is accompanied by excessive secretions.
Patient advice:
- Patients should understand that over-the-counter (OTC) cough and cold medications do not cure colds or coughs; there is no evidence to show any effect on duration of illness.
- Patients should be instructed to read labels and follow directions; overuse and misuse can result in potentially serious side effects, especially in children.
- Patients should be discouraged from using multiple cough and cold products, however, if used they should be instructed to check the active ingredient section of the label to ensure they are not doubling up on the same or similar active ingredients.
- Patients should be instructed to talk with a health care professional for any questions regarding use of cough and cold products.
- Patients should be instructed to stop taking product and consult with their health care provider if cough lasts more than 7 days, if it returns, or is accompanied by persistent fevers, rashes, or headaches, as it could be a sign of a more serious condition.
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