St. Joseph (Oral)

Dextromethorphan is used to help relieve coughs caused by colds or influenza (flu). It should not be used for long-term coughs that happen with smoking, asthma, or emphysema, or when 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 coughing.

This medicine is available 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 might cause 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, a skin rash, or a persistent headache with the cough, or if you have asthma or high blood pressure, contact your doctor. These symptoms may indicate other health issues.

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

In deciding to use a medicine, it is important to consider the risks of taking it against the benefits it may provide. This is a choice you will make with your doctor. For this medicine, the following points should be taken into account:

Allergies

Inform your doctor if you have ever had any unusual or allergic reactions to this medicine or any other medicines. Also, let your health care professional know if you have any other allergies, such as to foods, dyes, preservatives, or animals. If you are using non-prescription products, carefully read the label or package ingredients.

Pediatric

There is no specific information comparing the use of dextromethorphan in children to its use in other age groups, but this medicine is not expected to cause different side effects or issues in children aged 4 years and older compared to 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 could lead to serious or possibly life-threatening side effects.

Geriatric

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

Breast Feeding

Research in women suggests that this medication 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 even if an interaction might happen. In these situations, your doctor may adjust the dose, or other precautions may be needed. When you are taking this medicine, it is especially important for your healthcare professional to know if you are on any of the medicines listed below. The following interactions are noted for their potential significance and are not necessarily complete.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or adjust 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, your doctor may change the dose or frequency of use for one or both 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 drugs may be the best treatment for you. If both medicines are prescribed, your doctor may adjust the dose or frequency of use for one or both medicines.

• Abiraterone Acetate
• Haloperidol
• Quinidine
• Terbinafine

Interactions with Food/Tobacco/Alcohol

Some medicines should not be taken around the time of eating food or certain types of food due to possible interactions. Using alcohol or tobacco with certain medicines may also cause interactions. The following interactions are noted for their potential significance and are not necessarily complete.

Other Medical Problems

Having other medical conditions may influence the use of this medicine. Be sure to inform your doctor if you have any other medical issues, especially:

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

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

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

• Chronic bronchitis or
• Emphysema or
• Mucus or phlegm with cough—Since dextromethorphan decreases coughing, it can make it harder to clear mucus that may build up in the lungs and airways with certain conditions.

• Slowed breathing—Dextromethorphan may further reduce the rate of breathing.

Along with its needed effects, a medicine may cause some unwanted effects. Not all of these side effects may occur, but if they do, they may need 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 be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue, 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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