dextromethorphan
Dextromethorphan (Delsym) is an over-the-counter cough suppressant (antitussive). It helps relieve "dry" cough in adults and children by suppressing the cough reflex. Dextromethorphan (Delsym) is available as an extended-release (ER) cough syrup that's taken by mouth, typically every 12 hours. It also comes as an immediate-release (IR) caplet that's usually taken every 6 to 8 hours. Dextromethorphan might also come in additional formulations, under other brands. Some common side effects of dextromethorphan (Delsym) include nausea and stomach upset. Rarely, it can also make you sleepy.
What is Dextromethorphan (Delsym)?
What is Dextromethorphan (Delsym) used for?
- Short-term relief of cough caused by minor throat or lung irritation (e.g., common cold)
How Dextromethorphan (Delsym) works
Dextromethorphan (Delsym) is a cough suppressant. It works by lowering activity in the part of your brain that makes you cough. This helps to temporarily relieve the urge to cough.
Drug facts
Side effects of Dextromethorphan (Delsym)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Nausea
- Belly discomfort
Less Common Side Effects
- Drowsiness
- Dizziness
Dextromethorphan (Delsym) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Serotonin syndrome: fast heart rate, sweating, muscle stiffness or spasms, high fever, confusion
- Accidentally taking too much (overdose): hallucinations, fast heart beat, slow breathing, seizures
More on Dextromethorphan (Delsym) side effects
The following Dextromethorphan (Delsym) side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:
Symptoms of overdose
Blurred vision
confusion
difficulty in urination
drowsiness or dizziness
nausea or vomiting (severe)
shakiness and unsteady walk
slowed breathing
unusual excitement, nervousness, restlessness, or irritability (severe)
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Dextromethorphan (Delsym)
Pros
- Available as pills or oral liquids
- Sugar-free options available
- Available over the counter without a prescription
Cons
- Might need to take multiple times a day
- Meant for short-term treatment of cough only
- Found in many OTC products, so you can accidentally take too much
Pharmacist tips for Dextromethorphan (Delsym)
- If you're taking the dextromethorphan oral suspension, shake the bottle well to mix the medication before measuring the dose. Use the dose cup or oral syringe that's included with the packaging or provided by the pharmacy to measure out your dose. Using household spoons might cause you to take the wrong amount.
- If you have a cough that lasts for a long time or is related to cigarette smoking or a breathing problem (e.g., asthma, emphysema) or a cough with a lot of mucus, let your primary care provider know. Dextromethorphan (Delsym) might not be appropriate for your cough, and you might need more medical attention.
- Speak with your primary care provider if your cough gets worse, comes back after clearing up, or lasts more than a week. Also, let them know if you also have fever, rash, or headache. These might be signs of a more serious medical condition that can't be treated with dextromethorphan (Delsym).
- Don't take dextromethorphan (Delsym) with Nyquil products since most contain dextromethorphan. Taking too much dextromethorphan can lead to overdose symptoms, such as hallucinations, fast heartbeat, slow breathing, and seizures.
- Many combination over-the-counter cough, cold, and flu medications contain dextromethorphan, as well as other similar ingredients. To avoid taking medications with overlapping ingredients, ask your pharmacist to help you check the ingredients list.
- Dextromethorphan (Delsym) can interact with other medications. For examples, taking dextromethorphan (Delsym) along with certain medications for migraine or depression can lead to a dangerous side effect called serotonin syndrome. Let your care team know what other medications you're taking so they can help you check for interactions.
- Store dextromethorphan (Delsym) up and away and out of children's reach and sight. Always put medication away every time you use it. This prevents them from accidentally swallowing any medication that was left out and possible poisoning. If you think that your child might’ve accidentally swallowed dextromethorphan (Delsym), call your Poison Control Center at 1-800-222-1222 right away even if you aren't completely sure.
Common questions about Dextromethorphan (Delsym)
Though not common, taking dextromethorphan (Delsym) can make you feel drowsy or sleepy. If you're taking dextromethorphan (Delsym) for the first time, don't drive or do anything that needs a lot of focus and attention until you know how this medication makes you feel. Avoid drinking alcohol while taking dextromethorphan (Delsym) because doing so can worsen sleepiness. If you feel drowsy after taking dextromethorphan (Delsym), consider only taking this medication for night time cough. Ask your healthcare team about non-drowsy home remedies, such as using a humidifier or menthol rub, to help with cough during the day.
Different formulations of dextromethorphan (Delsym) have different directions, strengths, and age cut-offs. It's important to follow the instructions on the package of your specific dextromethorphan medication, or take it as directed by your healthcare team. In general, the immediate-release (IR) dextromethorphan formulations are taken by mouth every 6 to 8 hours. And the extended-release (ER) dextromethorphan formulations are taken every 12 hours. If you're not sure about your dose of dextromethorphan (Delsym), ask your care team.
Speak with your obstetrician-gynecologist (OBGYN) about the risks and benefits of taking dextromethorphan (Delsym) during pregnancy. Research suggests that dextromethorphan (Delsym) isn't likely to cause harm if taken during pregnancy. But keep in mind that certain dextromethorphan products, like the generic immediate-release suspension, might contain alcohol, which can be harmful for your unborn baby. Ask your care team about safe options to relieve your cough during pregnancy.
No, dextromethorphan (Delsym) isn't known to raise blood pressure on its own. But sometimes, dextromethorphan can be found in combination cold and flu medications along with a decongestant, such as pseudoephedrine (Sudafed); these products can raise your blood pressure. If you have high blood pressure, ask your care team which OTC medications are safe for you.
After you take a dose of dextromethorphan (Delsym), it should start to work within 15 to 30 minutes to relieve cough.
In general, it can take about half a day to a full day for most of dextromethorphan (Delsym) to leave your system after dose. This time frame is estimated based on the half-life of the medication. It can differ from person to person, based on your age and genetics. Talk with your healthcare team if you have more questions about how long dextromethorphan (Delsym) might stay in your system.
No, dextromethorphan (Delsym) isn't an antihistamine. It's an antitussive, also known as cough suppressant. If needed, your healthcare team might prescribe an antihistamine along with dextromethorphan (Delsym) if you have additional symptoms, such as runny nose.
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Risks and warnings for Dextromethorphan (Delsym)
Dextromethorphan (Delsym) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Overdose and misuse
- Risk factors: Taking other medications that contain dextromethorphan (Delsym)
Dextromethorphan is a common ingredient in many other over-the-counter products. Taking more than one product containing the same ingredients can lead to an accidental overdose and life-threatening symptoms, such as trouble breathing and seizures.
If you're not sure whether you're taking a medication with dextromethorphan, ask your pharmacist or care team to help you check for interactions. If you think that you or your child might’ve accidentally taken too much dextromethorphan (Delsym) call your Poison Control Center at 1-800-222-1222 right away.
In addition, dextromethorphan can be misused. To lower the risk of misuse, retail stores in most states restricts the purchase of dextromethorphan to people over 18 years old with a valid form of photo identification.
Medication interactions
Talk to your primary care provider first before taking dextromethorphan (Delsym) if you're taking or have taken a monoamine oxidase inhibitor (MAOIs) within the past 14 days. Also, let them know if you've taken other medications that can raise serotonin levels, such as antidepressants. These medications can interact with dextromethorphan (Delsym) and cause a serious side called serotonin syndrome and lead to serious side effects, like confusion, sweating, and fast heart rate. Your healthcare team can recommend other safer options to treat your cough.
Dextromethorphan (Delsym) dosage
Typical dosage for Dextromethorphan (Delsym)
Dextromethorphan products made by different manufacturers might have different directions and strengths. To make sure you're taking this medication correctly, follow the specific product instructions on the package, or talk with a healthcare professional about how to take it. Some examples are listed below.
Extended-release (long-acting) — generic extended-release suspension, Children's Delsym Cough suspension, Robitussin 12 Hour Cough Relief suspension
- Adults and children age 12 and older: The typical dose is 60 mg by mouth every 12 hours. Don't take more than 120 mg in a 24-hour period.
- Children age 6 to under 12 years: The typical dose is 30 mg by mouth every 12 hours. Don't take more than 60 mg in a 24-hour period.
- Children age 4 to under 6 years: The typical dose is 15 mg by mouth every 12 hours. Don't take more than 30 mg in a 24-hour period.
- Children under age 4: Don't use. Ask your child's pediatrician for other options.
Immediate-release (short-acting) — generic immediate-release suspension, Delsym Cough tablets, generic IR capsules
- Adults and children age 12 and older: The typical dose is 30 mg by mouth every 6 to 8 hours as needed for cough. Don't take more than 120 mg in a 24-hour period.
- Children under age 12: Don't use. Ask your child's pediatrician for other options.
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Interactions between Dextromethorphan (Delsym) and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Clorgyline
- Iproniazid
- Isocarboxazid
- Moclobemide
- Nialamide
- Pargyline
- Phenelzine
- Procarbazine
- Rasagiline
- Safinamide
- Selegiline
- Toloxatone
- Tranylcypromine
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Alfentanil
- Almotriptan
- Amitriptyline
- Amoxapine
- Amphetamine
- Benzhydrocodone
- Benzphetamine
- Buprenorphine
- Bupropion
- Butorphanol
- Citalopram
- Clomipramine
- Codeine
- Darunavir
- Desipramine
- Desvenlafaxine
- Dextroamphetamine
- Dihydrocodeine
- Dolasetron
- Doxepin
- Duloxetine
- Escitalopram
- Fenfluramine
- Fentanyl
- Fluoxetine
- Fluvoxamine
- Givosiran
- Granisetron
- Hydrocodone
- Hydromorphone
- Hydroxytryptophan
- Imipramine
- Lasmiditan
- Levomilnacipran
- Levorphanol
- Linezolid
- Lisdexamfetamine
- Lithium
- Lorcaserin
- Memantine
- Meperidine
- Metaxalone
- Methadone
- Methamphetamine
- Methylene Blue
- Milnacipran
- Mirtazapine
- Morphine
- Morphine Sulfate Liposome
- Nalbuphine
- Nortriptyline
- Ondansetron
- Oxycodone
- Oxymorphone
- Palonosetron
- Panobinostat
- Paroxetine
- Pentazocine
- Protriptyline
- Remifentanil
- Rolapitant
- Sertraline
- Sibutramine
- Sufentanil
- Tapentadol
- Tramadol
- Trazodone
- Trimipramine
- Venlafaxine
- Vilazodone
- Vortioxetine
- Ziprasidone
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Abiraterone Acetate
- Haloperidol
- Quinidine
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Dextromethorphan (Delsym) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Dextromethorphan (Delsym) will not be safe for you to take.
- Taking a monoamine oxidase inhibitor within 2 weeks of dextromethorphan (Delsym)
What are alternatives to Dextromethorphan (Delsym)?
