Dextromethorphan duplication and interaction risk in OTC cough products
Key Questions
What is the risk of dextromethorphan duplication in OTC products?
Products like Mucinex DM, Robitussin, Alka-Seltzer, NyQuil, and Dallergy often duplicate dextromethorphan (DM), leading to overdose risks when combined with codeine, benzonatate, or hydrocodone.
What interactions does dextromethorphan have with other medications?
DM interacts with insulin, sedatives, SSRIs, bupropion, triptans, tryptophan, and alogliptin, causing CNS depression or serotonin syndrome. Specific flags include Alka-Seltzer + alogliptin and chlorpheniramine/DM.
Why are falls and delirium risks highlighted with these products?
Combinations like Alka-Seltzer + alogliptin or chlorpheniramine/DM increase emergency room visits due to falls and delirium, especially in polypharmacy scenarios.
What interactions are reported with bupropion and triptans?
Bupropion with dextromethorphan and naratriptan shows 42 potential interactions, primarily serotonin-related risks.
How does thioridazine interact with cough products?
Thioridazine with XL-3 Xtra Cold and Cough has 58 potential interactions, amplifying CNS effects and risks like serotonin syndrome.
Mucinex DM/Robitussin/Alka/NyQuil/Dallergy dupes + codeine/benzonatate/hydrocodone + insulin/sedatives/SSRI/bupropion/triptans/tryptophan/alogliptin CNS/serotonin; Alka+alogliptin, chlorphen/DM flags ER falls/delirium.