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Related to Delsym: dextromethorphan, Robitussin, Mucinex

dextromethorphan hydrobromide

Adult Dry Cough (UK), Balminil DM (CA), Broncho-Grippol-DM (CA), Calmylin #1 (CA), Creo-Terpin, Creomulsion, Delsym, DexAlone, Hold DM, Koffex-DM (CA), Neo-DM (CA), Robitussin Children's Cough Long-Acting, Robitussin for Dry Coughs (UK), Robitussin Maximum Strength Cough Suppressant, Scot-Tussin Diabetes, Sedatuss (CA), Triaminic Children's Long-Acting Cough, Trocal, Vicks DayQuil Cough, Vicks Vaposyrup for Dry Cough (UK), Vicks 44 Cough Relief

Pharmacologic class: Levorphanol derivative

Therapeutic class: Antitussive (nonnarcotic)

Pregnancy risk category C


Depresses cough reflex through direct effect on cough center in medulla. Has no expectorant action and does not inhibit ciliary action. Although related to opioids structurally, lacks analgesic and addictive properties.


Gelcaps: 15 mg, 30 mg

Liquid: 3.5 mg/5 ml, 5 mg/5 ml, 7.5 mg/5 ml, 15 mg/5 ml

Lozenges: 5 mg, 7.5 mg

Oral suspension (extended-release): 30 mg/5 ml

Syrup: 7.5 mg/5 ml, 10 mg/15 ml

Indications and dosages

Cough caused by minor viral upper respiratory tract infections or inhaled irritants

Adults and children over age 12: 10 to 20 mg P.O. q 4 hours, or 30 mg P.O. q 6 to 8 hours, or 60 mg of extended-release form P.O. b.i.d. (not to exceed 120 mg/day)

Children ages 6 to 12: 5 to 10 mg P.O. q 4 hours, or 15 mg P.O. q 6 to 8 hours, or 30 mg of extended-release form P.O. q 12 hours (not to exceed 60 mg/day)

Children ages 4 to 6: 2.5 to 7.5 mg (syrup) P.O. q 4 to 8 hours or 15 mg (extended-release form) P.O. b.i.d. Not to exceed 30 mg/day.

Dosage adjustment

• Elderly patients


• Hypersensitivity to drug

• Chronic productive cough

• MAO inhibitor use within past 14 days


Use cautiously in:

• tartrazine sensitivity

• diabetes mellitus (with sucrose-containing drug products)

• pregnant or breastfeeding patients

• children younger than age 2 (safety not established).


• Don't administer lozenges to children younger than age 6.

Don't give within 14 days of MAO inhibitors.

Adverse reactions

CNS: dizziness and sedation

GI: nausea, vomiting, stomach pain


Drug-drug. Amiodarone, fluoxetine, quinidine: increased dextromethorphan blood level, greater risk of adverse reactions

Antidepressants, antihistamines, opioids, sedative-hypnotics: additive CNS depression

MAO inhibitors, sibutramine: serotonin syndrome (nausea, confusion, blood pressure changes)

Drug-behaviors. Alcohol use: additive CNS depression

Patient monitoring

• Monitor cough frequency and type, and assess sputum characteristics.

• Assess hydration status. Increase patient's fluid input to help moisten secretions.

Patient teaching

• Advise patient to avoid irritants, such as smoking, dust, and fumes. Suggest use of humidifier to filter air pollutants.

• Inform patient that treatment aims to decrease coughing frequency and intensity without completely eliminating protective cough reflex.

• Instruct patient to contact health care provider if cough lasts more than 7 days.

• As appropriate, review all other significant adverse reactions and interactions, especially those related to the drugs and behaviors mentioned above.

McGraw-Hill Nurse's Drug Handbook, 7th Ed. Copyright © 2013 by The McGraw-Hill Companies, Inc. All rights reserved


(dex-troe-meth-or-fan) ,

Balminil DM

(trade name),

Benylin DM

(trade name),

Bronchophan Forte DM

(trade name),

Buckley's DM

(trade name),

Cough Syrup DM

(trade name),


(trade name),

Creomulsion Adult Formula

(trade name),

Creomulsion for Children

(trade name),


(trade name),

Delsym DM

(trade name),

DM Children's Cough Syrup

(trade name),

DM Cough Syrup

(trade name),

Dry Cough Syrup

(trade name),

Father John's

(trade name),

Hold DM

(trade name),

Koffex DM

(trade name),

Neocitran Thin Strips Cough

(trade name),

Pediacare Children's Long-Acting Cough

(trade name),

Robafin Cough

(trade name),

Robitussin Children's Cough Long-Acting

(trade name),

Robitussin Cough Long-Acting

(trade name),

Robitussin CoughGels Long-Acting

(trade name),

Robitussin Lingering Cold Long-Acting CoughGels

(trade name),

Scot-Tussin Diabetes

(trade name),

Sedatuss DM

(trade name),

Sucrets Cough Control

(trade name),

Sucrets DM

(trade name),

Triaminic DM

(trade name),

Triaminic Long-Acting Cough

(trade name),

Triaminic Thin Strips Children's Long-Acting Cough

(trade name),

Triaminic Children's Cough Long-Acting

(trade name),

Vicks 44 Cough Relief

(trade name),

Vicks Custom Care Dry Cough

(trade name),

Vicks DayQuil Cough

(trade name),

Vicks Nature Fusion Cough

(trade name)


Therapeutic: allergy cold cough remedies
Pregnancy Category: C


Symptomatic relief of coughs caused by minor viral upper respiratory tract infections or inhaled irritants.Most effective for chronic nonproductive cough.A common ingredient in nonprescription cough and cold preparations.


Suppresses the cough reflex by a direct effect on the cough center in the medulla. Related to opioids structurally but has no analgesic properties.

Therapeutic effects

Relief of irritating nonproductive cough.


Absorption: Rapidly absorbed from the GI tract. Extended-release product is slowly absorbed.
Distribution: Unknown. Probably crosses the placenta and enters breast milk.
Metabolism and Excretion: Metabolized to dextrorphan, an active metabolite. Dextromethorphan and dextrorphan are renally excreted.
Half-life: Unknown.

Time/action profile (cough suppression)

PO15–30 minunknown3–6 hr†
PO-ERunknownunknown9–12 hr
†Up to 8 hr for gelcaps


Contraindicated in: Hypersensitivity;Patients taking MAO inhibitors or SSRIs;Should not be used for chronic productive coughs;Some products contain alcohol and should be avoided in patients with known intolerance.
Use Cautiously in: Cough that lasts more than 1 wk or is accompanied by fever, rash, or headache—health care professional should be consulted;History of drug abuse or drug-seeking behavior (capsules have been abused resulting in deaths);Diabetes (some products contain sucrose); Obstetric: Pregnancy (has been used safely); Lactation: Lactation; Pediatric: Children <4 yr (OTC cough and cold products containing this medication should be avoided).

Adverse Reactions/Side Effects

Central nervous system

  • high dose—dizziness, sedation


  • nausea


Drug-Drug interaction

Use with MAO inhibitors may result in serotonin syndrome (nausea, confusion, changes in BP); concurrent use should be avoided.↑ CNS depression with antihistamines, alcohol, antidepressants, sedative/hypnotics, or opioids.Amiodarone, fluoxetine, or quinidine may ↑ blood levels and adverse reactions from dextromethorphan.


Oral (Adults and Children >12 yr) 10–20 mg q 4 hr or 30 mg q 6–8 hr or 60 mg of extended-release preparation bid (not to exceed 120 mg/day).
Oral (Children 6–12 yr) 5–10 mg q 4 hr or 15 mg q 6–8 hr or 30 mg of extended-release preparation q 12 hr (not to exceed 60 mg/day).
Oral (Children 4–6 yr) 2.5–5 mg q 4 hr or 7.5 mg q 6–8 hr or 15 mg of extended-release preparation q 12 hr (not to exceed 30 mg/day).

Availability (generic available)

Gelcaps: 30 mgOTC
Lozengescherry: 2.5 mgOTC, 5 mgOTC
Liquidcherry, grape: 3.5 mg/5 mLOTC, 5 mg/5 mL, 7.5 mg/5 mLOTC, 15 mg/5 mLOTC, 30 mg/5 mLOTC
Syrupcherry, cherry bubblegum: 7.5 mg/5 mLOTC, 15 mg/15 mLOTC, 10 mg/5 mLOTC
Extended-release suspensionorange: 30 mg/5 mLOTC
DropsGrape: 7.5 mg/0.8 mLOTC, 7.5 mg/1 mLOTC
Orally-disintegrating stripscherry, grape: 7.5 mgOTC, 15 mgOTC
In combination with: antihistamines, decongestants, and expectorants in cough and cold preparationsOTC, quinidine sulfate (Nuedextra). See combination drugs.

Nursing implications

Nursing assessment

  • Assess frequency and nature of cough, lung sounds, and amount and type of sputum produced. Unless contraindicated, maintain fluid intake of 1500–2000 mL to decrease viscosity of bronchial secretions.

Potential Nursing Diagnoses

Ineffective airway clearance (Indications)


  • Dextromethorphan 15–30 mg is equivalent in cough suppression to codeine 8–15 mg.
  • Oral: Do not give fluids immediately after administering to prevent dilution of vehicle. Shake oral suspension well before administration.

Patient/Family Teaching

  • Instruct patient to cough effectively: Sit upright and take several deep breaths before attempting to cough.
  • Advise patient to minimize cough by avoiding irritants, such as cigarette smoke, fumes, and dust. Humidification of environmental air, frequent sips of water, and sugarless hard candy may also decrease the frequency of dry, irritating cough.
  • Caution patient to avoid taking more than the recommended dose or taking alcohol or other CNS depressants concurrently with this medication; fatalities have occurred. Caution parents to avoid OTC cough and cold products while breast feeding or to children <4 yrs.
  • May occasionally cause dizziness. Caution patient to avoid driving or other activities requiring alertness until response to the medication is known.
  • Advise patient that any cough lasting over 1 wk or accompanied by fever, chest pain, persistent headache, or skin rash warrants medical attention.

Evaluation/Desired Outcomes

  • Decrease in frequency and intensity of cough without eliminating patient’s cough reflex.
Drug Guide, © 2015 Farlex and Partners


A trademark for an over-the-counter preparation containing a form of the drug dextromethorphan.
The American Heritage® Medical Dictionary Copyright © 2007, 2004 by Houghton Mifflin Company. Published by Houghton Mifflin Company. All rights reserved.
References in periodicals archive ?
That growth, fueled by its Delsym brand, which offers 12-hour cough relief, enabled Reckitt to move ahead of Pfizer Consumer Health Care, which owns the Dimetapp and Robitussin brands, formerly part of Wyeth Consumer Healthcare.
The company, which recently became an indirect, wholly owned subsidiary of Reckitt Benckiser, has expanded its lineup of products to include such items as Maximum Strength Mucinex, Maximum Strength Mucinex DM, Maximum Strength Mucinex D, Mucinex Cold Liquid and grape-flavor Delsym.
-- Adams Respiratory Therapeutics Inc., the maker of Mucinex expectorant and Delsym cough syrup, has said it has entered into an agreement to be acquired by the Reckitt Benckiser Group for $2.3 billion.
have launched a product that they say is equivalent to Delsym extended-release oral liquid suspension containing dextromethorphan polistirex.
-- Adams Respiratory Therapeutics, best known for its Mucinex and Delsym product lines, continues to make strides in becoming a preeminent specialty pharmaceutical company and a respected leader in both the over-the-counter and prescription respiratory drugs markets.
The company, which includes such high-profile brands as Clearasil, Mucinex and Lysol, is adding Delsym Cough Relief Plus lozenges to its Delsym line of cough medicines, expanding its Cepacol line of throat lozenges with Cepacol Sensations, and extending the Mucinex line with Maximum Strength Mucinex Fast-Max caplets.
The supplier also announced that its Delsym line of O-T-C cough liquids has added a grape flavor in both the adult and children's lines.
Adams also markets Delsym, an orange-flavor cough suppressant that the company maintains is the only over-the-counter 12-hour cough relief formula for children.
(+5.5%) Market Dollar sales Dollar sales LEADING BRANDS ** share (000) % change Vicks NyQuil 16.0% $19,957 + 3.8% Mucinex 12.0% 14,957 + 413.2% Theraflu 5.4% 6,791 - 16.3% Triaminic 4.3% 5,408 + 3.49% Robitussin 3.4% 4,266 + 13.4% Vicks DayQuil 3.1% 3,917 - 24.8% Vicks NyQuil/DayQuil 2.9% 3,661 + 249.0% Combo Pack Tylenol Cold 2.9% 3,570 + 48.6% Dimetapp 2.2% 2,688 - 13.4% Delsym 2.1% 2,589 -- TOTAL UNIT SALES * 30.7 mil.
Today Adams has 10 individual O-T-C products on the market, including a new line of Children's Mucinex products and the newly acquired line of Delsym liquid cough suppressants.
Seal whiteners 41 Gillette Mach3 cartridges 49,281,950 -3.57 42 Delsym cough syrup 48,146,720 +2.07 43 L'Oreal Excellence women's 48,071,630 +6.22 hair coloring 44 Theraflu cold/allergy/sinus 46,562,740 +3.81 tablets/packets 45 Olay Regenerist facial 43,859,380 -2.23 antiaging 46 LifeScan OneTouch Ultra 43,469,960 -0.98 glucose monitors 47 Gamier Nutrisse women's hair 43,275,240 +10.38 coloring 48 Dulcolax laxative tablets 43,211,860 +5.66 49 Clairol Nice 'N Easy women's 41,872,560 +3.50 hair coloring 50 Icy Hot external analgesic 41,323,020 +2.88 rubs % CHANGE RANK BRANDS UNIT SALES * VS.
For example, UCB Pharma Inc.'s Delsym brand has prospered by being the only O-T-C cough remedy that offers 12 hours of relief.