Dextromethorphan duplication and interaction risk in OTC cough products
Key Questions
What is dextromethorphan (DM) duplication risk?
DM duplication occurs in OTC cough products like Mucinex DM, Robitussin, Alka, NyQuil, and Dallergy, leading to CNS depression and serotonin syndrome risks. Combinations with codeine, benzonatate, hydrocodone amplify effects.
What interactions does DM have with antidepressants or sedatives?
DM interacts with insulin, sedatives, SSRIs, bupropion, triptans, tryptophan, causing CNS/serotonin issues, falls, and delirium. Flags include Alka+alogliptin, chlorphen/DM, bromphen+DM.
Why avoid combining Robitussin with tryptophan?
Robitussin Cough & Cold Long-Acting and tryptophan have 18 interactions, heightening serotonin syndrome risk. This combo with bupropion or naratriptan worsens CNS effects.
What risks come with acetaminophen/DM/diphenhydramine and thalidomide?
This combo has multiple interactions with thalidomide, increasing sedation and respiratory depression. ER visits for falls and delirium are noted in polypharmacy.
Are there new flags for DM in products like Dallergy?
New flags for Dallergy bromphen+DM and hyoscyamine+DM highlight duplication and interaction risks with CNS/serotonin effects, contributing to ER cases.
Mucinex DM/Robitussin/Alka/NyQuil/Dallergy dupes + codeine/benzonatate/hydrocodone + insulin/sedatives/SSRI/bupropion/triptans/tryptophan/alogliptin/bromphen/hyoscyamine CNS/serotonin; Alka+alogliptin, chlorphen/DM, bromphen+DM flags ER falls/delirium. New Dallergy bromphen+DM, hyoscyamine+DM.