Dextromethorphan / Guaifenesin / Pseudoephedrine

What it is and how it works

Dextromethorphan is a morphinan derivative without opioid analgesic activity that suppresses the cough centre in the medulla; guaifenesin is an expectorant intended to loosen bronchial secretions; pseudoephedrine is a sympathomimetic that constricts nasal blood vessels and reduces congestion.

Indications

Short-term symptomatic relief of cough with nasal and sinus congestion in colds and upper respiratory tract infections.

Contraindications

Concurrent or recent (within 14 days) MAOI therapy; severe hypertension or coronary artery disease; children below the age limits set by national guidance (cough and cold products are not recommended in young children).

Warnings and precautions

Use with caution in hypertension, cardiovascular disease, hyperthyroidism, diabetes, prostatic hypertrophy, glaucoma and in asthma or chronic productive cough. Dextromethorphan has potential for misuse and may cause serotonin syndrome with serotonergic drugs. Do not combine with other cold preparations containing the same ingredients.

Pregnancy

Avoid in pregnancy, particularly in the first trimester, unless advised by a doctor.

Storage and supply

Store below 25 °C, protected from light.

Source: reference summary prepared from the EU SmPC/EPAR, BNF and WHO Model Formulary. The approved product information in Iran governs.