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Use this medicine only as directed by your doctor or the directions on the label. Do not use more of it, do not use it more often, and do not use it for a longer time than your doctor or the label says. Although this effect has happened only rarely, dextromethorphan has become habit-forming (causing mental or physical dependence) in some persons who used too much for a long time.

Dosing

The dose of dextromethorphan will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of dextromethorphan. If your dose is different, do not change it unless your doctor tells you to do so.

The number of capsules or tablets or teaspoonfuls of suspension or syrup that you take depends on the strength of the medicine.

• For lozenge dosage form:
  • For cough:
    • Adults and children 12 years of age and older 5 to 15 mg every two to four hours, as needed.
    • Children younger than 2 years of age Use and dose must be determined by your doctor.
    • Children 2 to 6 years of age 5 mg every four hours, as needed.
    • Children 6 to 12 years of age 5 to 15 mg every two to six hours, as needed.
• For syrup dosage form:
  • For cough:
    • Adults and children 12 years of age and older 30 mg every six to eight hours, as needed.
    • Children younger than 2 years of age Use and dose must be determined by your doctor.
    • Children 2 to 6 years of age 3.5 mg every four hours or 7.5 mg every six to eight hours, as needed.
    • Children 6 to 12 years of age 7 mg every four hours or 15 mg every six to eight hours, as needed.
• For extended-release oral suspension dosage form :
  • For cough:
    • Adults and children 12 years of age and older 60 mg every twelve hours, as needed.
    • Children younger than 2 years of age Use and dose must be determined by your doctor.
    • Children 2 to 6 years of age 15 mg every twelve hours, as needed.
    • Children 6 to 12 years of age 30 mg every twelve hours, as needed.

Missed dose

If you must take this medicine regularly and you miss a dose, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

To store this medicine:

• Store away from heat and direct light.
• Keep out of the reach of children.
• Do not store the tablet form of this medicine in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
• Keep the liquid form of this medicine from freezing.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

If you are taking this medicine without a prescription, carefully read and follow any precautions on the label. For dextromethorphan, the following should be considered:

Allergies Tell your doctor if you have ever had any unusual or allergic reaction to dextromethorphan or its other ingredients such as, alcohol, artificial sweetener, benzocaine, glucose, granulated sugar, menthol, natural honey flavoring, sucralose, sucrose, or sugar. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Diet Make certain your health care professional knows if you are on a low-sodium, low-sugar, or any other special diet. Most medicines contain more than their active ingredient, and many liquid medicines contain alcohol.

Pregnancy Dextromethorphan has not been studied in pregnant women. Before taking this medicine, make sure your doctor knows if you are pregnant or if you may become pregnant.

Breast-feeding It is not known whether dextromethorphan passes into breast milk. However, dextromethorphan has not been reported to cause problems in nursing babies.

Children Although there is no specific information comparing use of dextromethorphan in children with use in other age groups, this medicine is not expected to cause different side effects or problems in children than it does in adults.

Older adults Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing use of dextromethorphan in the elderly with use in other age groups.

Other medicines Although certain medicines should not be used together at all, in other cases 2 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 dextromethorphan it is especially important that your health care professional know if you are taking any of the following:

• Amiodarone (e.g., Cordarone) or
• Fluoexetine (e.g., Prozac) or
• Quinidine Taking dextromethorphan with any of these medicines may result in increased side effects of dextromethorphan

• Central nervous system (CNS) depressants (medicines that cause drowsiness) The CNS depressant effects of either these medicines or dextromethorphan may be increased

• Monoamine oxidase (MAO) inhibitors (furazolidone [e.g., Furoxone], phenelzine [e.g., Nardil], procarbazine [e.g., Matulane], selegiline [e.g., Eldepryl], tranylcypromine [e.g., Parnate]) Taking dextromethorphan if you are taking MAO inhibitors or have taken them within the past 2 to 3 weeks may cause coma, dizziness, excited or unusual behavior, fever, high blood pressure, nausea, sluggishness, spasms, and tremors

• Smoking tobacco Since dextromethorphan decreases coughing, it makes it difficult to get rid of the mucus that may collect in the lungs and airways resulting from smoking

• Asthma Since dextromethorphan decreases coughing, it makes it difficult to get rid of the mucus that collects in the lungs and airways during asthma

• Diabetes (sugar diabetes) Some products contain sugar and may affect control of blood glucose monitoring

• Liver disease Dextromethorphan may build up in the body and cause unwanted effects

• Chronic bronchitis or
• Emphysema or
• Mucus or phlegm with cough Since dextromethorphan decreases coughing, it makes it difficult to get rid of the mucus that may collect in the lungs and airways with some diseases

• Slowed breathing Dextromethorphan may slow the rate of breathing even further