D-methorphan

D-methorphan Uses, Dosage, Side Effects, Food Interaction and all others data.

D-methorphan suppresses the cough reflex by a direct action on the cough center in the medulla of the brain. D-methorphan shows high affinity binding to several regions of the brain, including the medullary cough center. This compound is an NMDA receptor antagonist and acts as a non-competitive channel blocker. It is one of the widely used antitussives, and is also used to study the involvement of glutamate receptors in neurotoxicity.

D-methorphan is an opioid-like molecule indicated in combination with other medication in the treatment of coughs and pseudobulbar affect. It has a moderate therapeutic window, as intoxication can occur at higher doses. D-methorphan has a moderate duration of action. Patients should be counselled regarding the risk of intoxication.

Trade Name D-methorphan
Availability Rx and/or OTC
Generic Dextromethorphan
Dextromethorphan Other Names D-methorphan, delta-Methorphan, Dextromethorfan, Dextromethorphan, Dextrométhorphane, Dextromethorphanum, Dextrometorfano
Related Drugs diphenhydramine, Benadryl, benzonatate, guaifenesin, codeine, Mucinex
Type
Formula C18H25NO
Weight Average: 271.404
Monoisotopic: 271.193614429
Protein binding

Dextromethorphan is 60-70% protein bound in serum.

Groups Approved
Therapeutic Class Cough suppressant
Manufacturer
Available Country
Last Updated: September 19, 2023 at 7:00 am
D-methorphan
D-methorphan

How D-methorphan works

D-methorphan is an agonist of NMDA and sigma-1 receptors. It is also an antagonist of α3/β4 nicotinic receptors.[A10589] However, the mechanism by which dextromethorphan's receptor agonism and antagonism translates to a clinical effect is not well understood.

Dosage

D-methorphan dosage

Adults and Children over 12 years: 15 to 30 mg three to four times per day. However, 60 mg doses up to four times per day have been used without increased side effects.

Children between 6 and 12 years: 5-15 mg up to four times per day.

Children between 2 and 6 years: 2.5-5 mg up to four times per day.

Side Effects

Adverse effects with D-methorphan are rare, but nausea and dizziness sometimes occur. The drug produces no analgesia or addiction and little or no CNS depression. Excitation, confusion and respiratory depression may occur after overdosage.

Toxicity

A dextromethorphan overdose may present as nausea, vomiting, stupor, coma, respiratory depression, seizures, tachycardia, hyperexcitability, toxic psychosis, ataxia, nystagmus, dystonia, blurred vision, changes in muscle reflexes, and serotonin syndrome. Overdose should be managed through symptomatic and supportive measures.

Precaution

Do not use D-methorphan to control a cough that is associated with smoking, asthma, or emphysema, or a cough that is productive (produces sputum or phlegm).

Interaction

The following medicines should be taken carefully while concomitantly use with D-methorphan: Amiodarone, Fluoexetine, Quinidine, CNS depressants and Monoamine oxidase (MAO) inhibitors.

Food Interaction

  • Take with or without food. The absorption is unaffected by food.

D-methorphan Alcohol interaction

[Moderate] GENERALLY AVOID:

The central nervous system-depressant effects of dextromethorphan and ethanol may be additive.

The combination of these agents may result in additive CNS depression and impairment of judgment, thinking, and psychomotor skills.



Patients should be cautioned about the concomitant ingestion of dextromethorphan and ethanol.

Consumption of large doses of either substance should be avoided.

D-methorphan Disease Interaction

Moderate: psychiatric conditions

Volume of Distribution

The volume of distribution of dextromethorphan is 5-6.7L/kg.

Elimination Route

A 30mg oral dose of dextromethorphan reaches a Cmax of 2.9 ng/mL, with a Tmax of 2.86 h, and an AUC of 17.8 ng*h/mL.

Half Life

D-methorphan has a half life of 3-30 hours.

Pregnancy & Breastfeeding use

Pregnancy: Adequate and well-controlled studies in human have not been done. However, D-methorphan has not been reported to cause birth defects.

Lactation: It is not known whether dextromethorphan passes into breast milk. However, D-methorphan has not been reported to cause problems in nursing babies.

Contraindication

Hypersensitivity to D-methorphan or any other component.

Acute Overdose

Symptoms: In mild overdose, tachycardia, hypertension, vomiting, mydriasis, diaphoresis, nystagmus, euphoria, loss of motor coordination, and giggling; in moderate intoxication, in addition to those listed above, hallucinations and a plodding ataxic gait; in severely intoxication, agitation or somnolence.

Management: treatment is symptomatic and supportive. Naloxone may be useful in reversing toxicity.

Storage Condition

Store at 15-30° C

Innovators Monograph

You find simplified version here D-methorphan

D-methorphan contains Dextromethorphan see full prescribing information from innovator D-methorphan Monograph, D-methorphan MSDS, D-methorphan FDA label

*** Taking medicines without doctor's advice can cause long-term problems.
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