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dextromethorphan

Generic Delsym
Used for Cough
Used for Cough

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.

Reviewed by:
reviewer
Ally Tsai, PharmD
reviewer
Kristianne Hannemann, PharmD
Last reviewed on April 29, 2024
BasicsSide effectsPros & consPharmacist tipsFAQsWarningsDosageInteractionsCostContraindicationsAlternativesLatest newsReferencesPricesMedicare
basics-icon

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.

When does Dextromethorphan (Delsym) start working?
Time passed since treatment started:
MINUTES
HOURS
DAYS
WEEKS
MONTHS
Initial effect
Full effect

Drug Facts

Common BrandsDelsym, Basic Care Cough DM, Robitussin 12 Hour Cough Relief
Drug ClassAntitussive
Controlled Substance ClassificationNot a controlled medication
Generic StatusLower-cost generic available
AvailabilityOver-the-counter
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What are the 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

Other Side Effects

  • Drowsiness
  • Dizziness

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

Source: DailyMed

More on Dextromethorphan (Delsym) side effects

Medication Education: Side Effects: Syrup: closeup cough medicine 980777274

7 Dextromethorphan Side Effects You Should Know About

Written by Nicole E. Cieri-Hutcherson, PharmD, BCPS, NCMP

The following 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:

Less common or rare

Confusion

constipation

dizziness (mild)

drowsiness (mild)

headache

nausea or vomiting

stomach pain

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.

pros-and-cons

Pros and cons of Dextromethorphan (Delsym)

thumbs-up

Pros

Available as pills or oral liquids

Sugar-free options available

Available over the counter without a prescription

thumbs-down

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

Pharmacist tips for Dextromethorphan (Delsym)

pharmacist

  • 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.

                faqs

                Frequently asked questions about Dextromethorphan (Delsym)

                Does dextromethorphan (Delsym) make you sleepy?
                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.
                How much dextromethorphan (Delsym) can I take?
                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.
                Can you take dextromethorphan (Delsym) while pregnant?
                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.
                Does dextromethorphan (Delsym) raise blood pressure?
                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.
                How long does it take for dextromethorphan (Delsym) to work?
                After you take a dose of dextromethorphan (Delsym), it should start to work within 15 to 30 minutes to relieve cough.
                How long does dextromethorphan (Delsym) stay in your system?
                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.
                Is dextromethorphan (Delsym) an antihistamine?
                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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                What are the 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.

                risk-warning

                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.

                  risk-warning

                  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.

                  dosage

                  Dextromethorphan (Delsym) dosage forms

                  The average cost for 180 capsules of 15mg of Dextromethorphan (Delsym) is $19.07 with a free GoodRx coupon. This is 58.74% off the average retail price of $46.22.
                  bottle of oral suspension
                  Bottle of oral suspension
                  DosageQuantityPrice as low asPrice per unit
                  30mg/5ml1 bottle$6.07$6.07
                  capsule
                  Capsule
                  DosageQuantityPrice as low asPrice per unit
                  15mg180 capsules$19.07$0.11

                  Typical dosing 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.

                  More on Dextromethorphan (Delsym) dosage forms

                  delsym: delsym dosage

                  Delsym Dosages: Your GoodRx Guide

                  Written by Kristine Foley, PharmD
                  interactions

                  Interactions between Dextromethorphan (Delsym) and other drugs

                  Dextromethorphan (Delsym) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Dextromethorphan (Delsym). Please note that only the generic name of each medication is listed below.

                  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.

                  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.

                  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.

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                  How much does Dextromethorphan (Delsym) cost?

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                  contraindications-icon

                  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.
                  alternatives

                  What are alternatives to Dextromethorphan (Delsym)?

                  There are a number of medications that your doctor can prescribe in place of Dextromethorphan (Delsym). Compare a few possible alternatives below.
                  Dextromethorphan (Delsym)
                  Used for:

                  • Short-term relief of cough caused by minor throat or lung irritation (e.g., common cold)

                  $6.07 Lowest GoodRx priceView Prices
                  Mucinex DM (guaifenesin / dextromethorphan)
                  Used for:

                  • Short-term relief of coughs caused by minor throat or lung irritation (e.g., common cold)

                  • Loosens and breaks up mucus in the airways (chest congestion)

                  $14.31 Lowest GoodRx priceView Prices
                  Benzonatate (Tessalon Perles)
                  Used for:

                  • Cough in people ages 10 years and older

                  $11.31 Lowest GoodRx priceView Prices
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                  What is the latest news about Dextromethorphan (Delsym)?

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                  GoodRx breaks down the dangers of taking too much cough syrup in an effort to get high.

                  Dextromethorphan Misuse: Understanding the Dangers of a Cough Syrup High

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                  Dextromethorphan (Delsym, Robitussin) and acetaminophen (Tylenol) are generally safe for pregnancy. See a comprehensive list of cold medications you can take (and ones you should avoid) while pregnant.

                  What Cold Medications Can You Take While Pregnant?

                  Dextromethorphan (Delsym, Robitussin) and acetaminophen (Tylenol) are generally safe for pregnancy. See a comprehensive list of cold medications you can take (and ones you should avoid) while pregnant.

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                  References

                  Best studies we found

                  Amazon.com Services LLC. (2021). BASIC CARE COUGH DM - dextromethorphan polistirex suspension, extended release [package insert]. DailyMed.

                  Centers for Disease Control and Prevention. (2023). Put your medicines up and away and out of sight.

                  Haleon US Holdings LLC. (2024). ROBITUSSIN 12 HOUR COUGH RELIEF- dextromethorphan polistirex suspension, extended release [package insert]. DailyMed.

                  View All References (9)

                  Journey, J. D., et al. (2023). Dextromethorphan Toxicity. StatPearls.

                  MotherToBaby. (2022). Dextromethorphan.

                  Oh, S., et al. (2023). Dextromethorphan. StatPearls.

                  RB Health (US) LLC. (2022). DELSYM (DEXTROMETHORPHAN) - dextromethorphan suspension, extended release [package insert]. DailyMed.

                  RB Health (US) LLC. (2023). DELSYM COUGH - dextromethorphan hydrobromide tablet [package insert]. DailyMed.

                  Safeway, Inc. (2022). ADULT COUGH RELIEF DM - dextromethorphan hbr liquid [package insert]. DailyMed.

                  Spirit Pharmaceuticals LLC. (2023). DEXTROMETHORPHAN HYDROBROMIDE- dextromethorphan hydrobromide capsule, liquid filled [package insert]. DailyMed.

                  Siu, A., et al. (2007). Dextromethorphan: A review of n-methyl-d-aspartate receptor antagonist in the management of pain. CNS Drug Reviews.

                  Spangler, D. C., et al. (2016). Dextromethorphan: a case study on addressing abuse of a safe and effective drug. Substance Abuse Treatment, Prevention, and Policy.

                  GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.
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