Miltuss (Oral)

Dextromethorphan is used to help relieve coughs caused by colds or the flu. It should not be used for long-lasting coughs that happen with smoking, asthma, or emphysema, or if there is a lot of mucus or phlegm with the cough.

Dextromethorphan works by acting directly on the cough center in the brain to relieve the cough.

This medicine can be bought without a prescription.

Do not give any over-the-counter (OTC) cough and cold medicine to a baby or child under 4 years of age. Using these medicines in very young children can lead to serious or possibly life-threatening side effects.

If your cough does not get better after 7 days, if your sore throat does not improve after 2 days, if you have a high fever, skin rash, or a persistent headache with the cough, or if you have asthma or high blood pressure, contact your doctor. These symptoms could indicate other medical issues.

Dissolve lozenges in your mouth carefully to reduce the risk of choking.

In deciding to use a medicine, you and your doctor need to consider the risks and benefits. Here are some important things to think about for this medicine:

Allergies

Inform your doctor if you have ever had any unusual or allergic reactions to this medicine or any other medicines. Also, let your healthcare professional know if you have any other allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or packaging carefully.

Pediatric

There is no specific information about how dextromethorphan affects children compared to other age groups, but it is not expected to cause different side effects or problems in children 4 years of age and older than it does in adults.

Do not give any over-the-counter (OTC) cough and cold medicine to a baby or child under 4 years of age. Using these medicines in very young children might lead to serious or possibly life-threatening side effects.

Geriatric

Many medicines have not been specifically studied in older adults. Therefore, it may not be known if they work the same way in older people as they do in younger adults, or if they cause different side effects or problems. There is no specific information comparing dextromethorphan use in elderly patients with use in other age groups.

Breast Feeding

Studies in women suggest that this medicine poses minimal risk to the infant when used during breastfeeding.

Interactions with Medicines

Some medicines should not be used together at all, while in other cases, two different medicines may be used together despite potential interactions. If you are taking this medicine, it's very important that your healthcare professional knows if you are taking any of the medicines listed below. The following interactions are significant but may not include all possibilities.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medicine or may change some of the other medicines you take.

• Clorgyline
• Furazolidone
• Iproniazid
• Isocarboxazid
• Moclobemide
• Nialamide
• Ozanimod
• Pargyline
• Phenelzine
• Procarbazine
• Rasagiline
• Safinamide
• Selegiline
• Toloxatone
• Tranylcypromine

Using this medicine with any of the following medicines is usually not recommended, but may be necessary in some cases. If both medicines are prescribed together, your doctor may adjust the dose or how often you take one or both of the medicines.

• Adagrasib
• Alfentanil
• Almotriptan
• Amineptine
• Amitriptyline
• Amitriptylinoxide
• Amoxapine
• Amphetamine
• Benzhydrocodone
• Benzphetamine
• Brompheniramine
• Buprenorphine
• Bupropion
• Buspirone
• Butorphanol
• Carbamazepine
• Chlorpheniramine
• Citalopram
• Clomipramine
• Cocaine
• Codeine
• Cyclobenzaprine
• Desipramine
• Desvenlafaxine
• Dextroamphetamine
• Dibenzepin
• Difenoxin
• Dihydrocodeine
• Diphenoxylate
• Dolasetron
• Doxepin
• Duloxetine
• Eletriptan
• Escitalopram
• Ethylmorphine
• Fedratinib
• Fenfluramine
• Fentanyl
• Fluoxetine
• Fluvoxamine
• Frovatriptan
• Gepirone
• Givosiran
• Granisetron
• Hydrocodone
• Hydromorphone
• Hydroxyamphetamine
• Hydroxytryptophan
• Imipramine
• Ketobemidone
• Lasmiditan
• Levomilnacipran
• Levorphanol
• Linezolid
• Lisdexamfetamine
• Lithium
• Lofepramine
• Lorcaserin
• Melitracen
• Memantine
• Meperidine
• Metaxalone
• Methadone
• Methamphetamine
• Methylene Blue
• Milnacipran
• Mirtazapine
• Morphine
• Morphine Sulfate Liposome
• Nalbuphine
• Naratriptan
• Nefazodone
• Nicomorphine
• Nortriptyline
• Ondansetron
• Opipramol
• Opium
• Opium Alkaloids
• Oxycodone
• Oxymorphone
• Palonosetron
• Panobinostat
• Papaveretum
• Paregoric
• Paroxetine
• Pentazocine
• Piritramide
• Protriptyline
• Remifentanil
• Rizatriptan
• Rolapitant
• Sertraline
• Sibutramine
• St John's Wort
• Sufentanil
• Sumatriptan
• Tapentadol
• Tianeptine
• Tilidine
• Tocilizumab
• Tramadol
• Trazodone
• Trimipramine
• Tryptophan
• Venlafaxine
• Vilazodone
• Vortioxetine
• Ziprasidone

Using this medicine with any of the following medicines may increase the risk of certain side effects, but using both may be the best treatment for you. If both medicines are prescribed together, your doctor may adjust the dose or how often you take one or both.

• Abiraterone Acetate
• Haloperidol
• Quinidine
• Terbinafine

Interactions with Food/Tobacco/Alcohol

Some medicines should not be used at the same time as certain foods or drinks because interactions may occur. Using alcohol or tobacco with certain medicines may also lead to interactions. The following interactions are significant but may not include all possibilities.

Other Medical Problems

Other medical conditions may impact how you can use this medicine. Make sure to inform your doctor if you have any other medical problems, especially:

• Asthma—Since dextromethorphan reduces coughing, it makes it harder to clear mucus from the lungs and airways during asthma.

• Diabetes (sugar diabetes)—Some products contain sugar and may affect blood glucose levels.

• Liver disease—Dextromethorphan may accumulate in the body and cause unwanted effects.

• Chronic bronchitis or
• Emphysema or
• Mucus or phlegm with cough—Since dextromethorphan reduces coughing, it makes it harder to eliminate the mucus that may build up in the lungs and airways with some conditions.

• Slowed breathing—Dextromethorphan may further slow your breathing rate.

Along with its needed effects, a medicine may cause some unwanted effects. Not all of these side effects may happen, but if they do, they may require medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

Symptoms of overdose

• Blurred vision
• confusion
• difficulty in urination
• drowsiness or dizziness
• nausea or vomiting (severe)
• shakiness and unsteady walk
• slowed breathing
• unusual excitement, nervousness, restlessness, or irritability (severe)

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Your health care professional may also help you find ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome, or if you have any questions about them:

Less common or rare

• Confusion
• constipation
• dizziness (mild)
• drowsiness (mild)
• headache
• nausea or vomiting
• stomach pain

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

In the U.S.

• Babee Cof Syrup
• Benylin Pediatric Formula
• Children's Pedia Care
• Creomulsion
• Creo-Terpin
• Delsym
• Dexalone
• ElixSure Cough Children's
• Father John's Medicine
• Miltuss
• Nycoff
• Pediacare
• Pediacare Long-Acting Cough
• Robafen Cough
• Robitussin
• Silphen DM
• Simply Cough
• St. Joseph
• Vicks 44 Cough Relief

Available Dosage Forms:

• Suspension, Extended Release
• Solution
• Tablet
• Liquid
• Capsule, Liquid Filled
• Elixir
• Syrup

Therapeutic Class: Antitussive

Make certain your health care professional knows if you are on a low-sodium, low-sugar, or any other special diet. Most medicines contain more than their active ingredient, and many liquid medicines contain alcohol.

Use this medicine only as directed by your doctor or the directions on the label. Do not use more of it, do not use it more often, and do not use it for a longer time than your doctor or the label says. Although this effect has happened only rarely, dextromethorphan has become habit-forming (causing mental or physical dependence) in some persons who used too much for a long time.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For lozenge dosage form: For cough: Adults and children 12 years of age and older—5 to 15 mg every two to four hours, as needed. Children 6 to 12 years of age—5 to 15 mg every two to six hours, as needed. Children 4 to 6 years of age—5 mg every four hours, as needed. Children and infants up to 4 years of age—Use is not recommended.
• For syrup dosage form: For cough: Adults and children 12 years of age and older—30 mg every six to eight hours, as needed. Children 6 to 12 years of age—7 mg every four hours or 15 mg every six to eight hours, as needed. Children 4 to 6 years of age—3.5 mg every four hours or 7.5 mg every six to eight hours, as needed. Children and infants up to 4 years of age—Use is not recommended.
• For extended-release oral suspension dosage form: For cough: Adults and children 12 years of age and older—60 mg every twelve hours, as needed. Children 6 to 12 years of age—30 mg every twelve hours, as needed. Children 4 to 6 years of age—15 mg every twelve hours, as needed. Children and infants up to 4 years of age—Use is not recommended.

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

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