Polytussin DM
Polytussin DM is a combination of three medications: dextromethorphan (a cough suppressant), phenylephrine (a decongestant), and pyrilamine (an antihistamine). It's an over-the-counter medication used to ease symptoms of allergies and the common cold, such as cough, runny nose, and congestion. Polytussin DM is a liquid solution that's taken by mouth, typically every 4 hours when you have symptoms. Possible side effects of this medication include sleepiness and dizziness.
What is Polytussin DM?
What is Polytussin DM used for?
Short-term relief of symptoms from allergies and the common cold:
Runny nose
Sneezing
Itchy or watery eyes
Itching of the nose or throat
Cough from throat and lung irritation
Stuffy nose (nasal congestion)
How Polytussin DM works
Polytussin DM is a combination of three medications that work together to relieve symptoms caused by allergies and the common cold.
Dextromethorphan is a cough suppressant. It's thought to work in the brain to lower your urge to cough.
Phenylephrine is a decongestant. It's thought to work by narrowing the blood vessels in the nose to relieve sinus pressure.
Pyrilamine is an antihistamine. It blocks a natural substance in your body called histamine. In doing so, it lowers inflammation (swelling) and relieves runny nose, itchy nose, and sneezing.
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What are the side effects of Polytussin DM?
Common Side Effects
- Sleepiness
- Restlessness
- Dizziness
- Nausea
- Stomach discomfort
Other Side Effects
- Trouble sleeping
- Trouble urinating
- Headache
Serious Side Effects
- Serotonin syndrome: fast heart rate, sweating, muscle stiffness or spasms, high fever, confusion
Source:Â DailyMed
The following side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Heart palpitations—rapid, pounding, or irregular heartbeat
- Increase in blood pressure
- Sudden eye pain or change in vision such as blurry vision, seeing halos around lights, vision loss
- Trouble passing urine
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
- Anxiety, nervousness
- Confusion
- Constipation
- Dizziness
- Drowsiness
- Dry mouth
- Fatigue
Pros and cons of Polytussin DM
Pros
Taken by mouth
Available as a sugar-free, alcohol-free, dye-free flavored liquid
More convenient to take a product that's a combination of three medications
Cons
Might need to take multiple times a day
More difficult to customize the dose since Polytussin DM is a fixed combination of three medications
Older adults are at higher risk for sleepiness
Pharmacist tips for Polytussin DM
Take Polytussin DM with or without food. If it upsets your stomach, taking it with food can help might help.
Always use a medication dose cup or an oral syringe to measure out your dose of Polytussin DM. Never use household kitchen spoons because they might not be accurate and using them might cause you to take the wrong dose. Ask your pharmacist for a measuring device for your doses if the medication doesn't come with one.
Pyrilamine (antihistamine) and dextromethorphan (a cough suppressant) in Polytussin DM can make you sleepy or dizzy during the day. This might affect how well you can focus, think, and react. Don't drive or do anything that requires concentration or focus until you know how Polytussin DM affects you.
Avoid drinking alcohol while you're taking Polytussin DM because doing so can make sleepiness worse.
Although pyrilamine (antihistamine) and dextromethorphan (a cough suppressant) in Polytussin DM usually make adults sleepy, they can cause children to become overly excited or energetic. Stop Polytussin DM and speak to a pediatrician if this happens to your child.
If you're pregnant or breastfeeding, don't take Polytussin DM until you've talked to a healthcare provider first about the risks and benefits of taking this medication.
If your symptoms worsen or last longer than a week even after starting Polytussin DM, or you start to have a fever or rash, contact your primary care provider. These might be signs of a more serious condition.
Stop taking Polytussin DM and contact your primary care provider if you experience dizziness, nervousness, or trouble sleeping. These might be side effects from the phenylephrine or other medications in Polytussin DM. Depending on how severe your symptoms are, your PCP might lower your dose of Polytussin DM or recommend other medications to treat your symptoms.
Read the ingredients label on all the medications you're taking. Many over-the-counter cold and flu medications contain the same ingredients as those in Polytussin DM. Taking more than one cough suppressant, antihistamine, or decongestant at the same time can raise the risk of overdose and severe side effects, such as agitation and trouble breathing.
Don't take Polytussin DM at the same time as or within 2 weeks of taking a monoamine oxidase inhibitor (MAOI), such as selegiline. Doing so can raise your risk for severe side effects, like serotonin syndrome and dangerously high blood pressure. If needed, contact your primary care provider for other options to treat your cold or allergy symptoms.
Frequently asked questions about Polytussin DM
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What are the risks and warnings for Polytussin DM?
Polytussin DM 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.
Serotonin syndrome
Risk factors: Taking monoamine oxidase inhibitors (MAOI) 14 days before starting Polytussin DM | Taking other medications that raise serotonin levels in your brain
The dextromethorphan in Polytussin DM can raise your risk for serotonin syndrome, a rare, but potentially life-threatening side effect. Your risk is higher if you're also taking other medications that affect serotonin levels, such as certain antidepressants, MAOIs, and certain migraine medications.
Make sure your healthcare team knows about all the medications you take (including over-the-counter medications and supplements) before starting Polytussin DM so they can make sure this medication is safe for you to take. Don't start any new medications while taking Polytussin DM without letting your pharmacist or prescriber know. Symptoms of serotonin syndrome include fast heart rate, sweating, muscle stiffness or spasms, high fever, and confusion. Get medical help right away if you have any of these symptoms.
Accidental overdose
Polytussin DM contains a cough suppressant (dextromethorphan), a decongestant (phenylephrine), and an antihistamine (pyrilamine). Taking more than one medication containing an antihistamine, cough suppressant, or a decongestant can lead to an accidental overdose, which can be life-threatening.
To prevent an accidental overdose, read the medication box and package labels carefully so you're aware of the ingredients, age-cut offs, and maximum dosing of your particular product. Ask your primary care provider or pharmacist if you're not sure whether you're taking a medication that has the same or similar ingredients as Polytussin DM.
Some signs of taking too much medication can include anxiety or other behavior changes, high blood pressure, and trouble breathing. If you or your loved one experiences an accidental overdose, get medical help as soon as possible.
Worsening of certain medical conditions
Risk factors: Breathing problems | Glaucoma | Urinary problems | Cough from smoking, asthma, or emphysema | Mucus-producing cough | Heart disease or high blood pressure
Make sure your primary care provider and pharmacist know about all your medical conditions before you take Polytussin DM. Ask them whether this medication is safe and appropriate for you.
People who are 65 years of age or older are at higher risk of more severe side effects from Polytussin DM. In addition, Polytussin DM might worsen the symptoms of certain medical conditions, such as high blood pressure and glaucoma. This medication also might not be appropriate for your condition. For example, you might need other treatment if you have a cough that's lasted for a long time; a cough that occurs with smoking, asthma, or emphysema; or a cough with a lot of mucus.
Polytussin DM dosage forms
| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 480ml of 7.5mg/5mg/12.5mg/5ml | 1 bottle | $34.20 | $34.20 |
Typical dosing for Polytussin DM
Each 5 mL of Polytussin DM contains 7.5 mg of dextromethorphan, 5 mg of phenylephrine, and 12.5 mg of pyrilamine.
People ages 12 years or older: The typical dose is 10 mL by mouth every 4 hours. Don't take more than 60 mL in a 24-hour period.
Children ages 6 years to under 12 years old: The typical dose is 5 mL by mouth every 4 hours. Don't take more than 30 mL in a 24-hour period.
Children under 6 years old: Ask your child's pediatrician.
How much does Polytussin DM cost?
Polytussin DM contraindications
Currently taking or have taken a monoamine oxidase inhibitor (MAOI) in the last 14 days
What are alternatives to Polytussin DM?
Short-term relief of symptoms from allergies and the common cold:
Runny nose
Sneezing
Itchy or watery eyes
Itching of the nose or throat
Cough from throat and lung irritation
Stuffy nose (nasal congestion)
Cough from throat and lung irritation
Runny nose
Sneezing
Itchy or watery eyes
Itching of the nose or throat
Stuffy nose (nasal congestion)
Runny nose
Sneezing
Itchy or watery eyes
Itching of the nose or throat
Cough from throat and lung irritation
Stuffy nose (nasal congestion)
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References
Best studies we foundBorowy, C. D., et al. (2023). Antihistamine toxicity. StatPearls.
Department of Justice/Drug Enforcement Administration. (2020). Narcotics.
Gelotte, C. K., et al. (2015). Pharmacokinetics, safety, and cardiovascular tolerability of phenylephrine HCl 10, 20, and 30 mg after a single oral administration in healthy volunteers. Clinical Drug Investigation.
Poly Pharmaceuticals, Inc. (2024). Polytussin DM- dextromethorphan hbr, phenylephrine hcl, pyrilamine maleate syrup [package insert]. DailyMed.
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