Adult Dosing

Management of cough

• Alka-Seltzer Plus Mucus and Congestion
• EffervescentTABS: 2 tabs PO q4 hrs, max: 8 Tabs/day
• Note: Dissolve in water and drink plenty of water
• CAPS: 2 caps PO q4 hrs, max: 12 caps/day; give with plenty of water

• Coricidin HBP Chest Congestion & Cough
• 1-2 caps PO q4 hrs, max: 12 cap/day; give with plenty of water

• Diabetic Tussin DM, Diabetic Tussin DM Maximum Strength, Guiatuss DM
• 10 mL PO q4 hrs, max: 6 doses/day; give with plenty of water

• Mucinex DM, Mucinex DM Maximum Strength
• 1 tab (dextromethorphan 60 mg/guaifenesin 1200 mg) PO bid; max: 2 tabs/day
• 1-2 tabs (dextromethorphan 30 mg/guaifenesin 600 mg) PO bid, max: 4 Tabs/day
• Note: Do not crush, cut or chew the tablet; give with plenty of water

• Robitussin Cough & Chest Congestion DM, Robitussin Cough & Chest Congestion DM Max
• 10 mL PO q4 hrs, max: 6 doses/day; give with plenty of water

• Vicks DayQuil Mucus Control DM, Vicks Formula 44E Cough & Chest Congestion Relief Liquid
• 30 mL PO q4 hrs, max: 6 doses/day; give with plenty of water

• Vicks Formula 44 Custom Care Chesty Cough
• 15 mL PO q4 hrs, max: 6 doses/day; give with plenty of water

• Mucinex Fast-Max DM Max
• 20 ml PO q4 hrs. Max: 6 doses/day

Pediatric Dosing

Management of cough

• Alka-Seltzer Plus Mucus and Congestion
• Children >12 yrs: Effervescent TABS: 2 tabs PO q4 hrs; max: 8 tabs/day
• Note: Dissolve in water and drink plenty of water
• Children >12 yrs: CAPS: 2 caps PO q4 hrs, max: 12 caps/day; give with plenty of water

• Coricidin HBP Chest Congestion & Cough
• >12 yrs: 1-2 caps PO q4 hr, max: 12 cap/day; give with plenty of water

• Diabetic Tussin DM
• 2-6 yrs: 2.5 mL PO q4 hrs, max: 6 doses/day; give with plenty of water
• 6-12 yrs: 5 mL PO q4 hrs, max: 6 doses/day; give with plenty of water
• >12 yrs: 10 mL PO q4 hrs, max: 6 doses/day; give with plenty of water

• Diabetic Tussin DM Maximum Strength, Guiatuss DM
• >12 yrs: 10 mL PO q4 hrs, max: 6 doses/day; give with plenty of water

• Mucinex DM
• >12 yrs: 1 tab (dextromethorphan 60 mg/guaifenesin 1200 mg) PO bid; max: 2 tabs/day
• >12 yrs: 1-2 tabs (dextromethorphan 30 mg/guaifenesin 600 mg) PO bid, max: 4 tabs/day
• Note: Do not crush, cut or chew the tablet; give with plenty of water

• Mucinex DM Maximum Strength
• >12 yrs: 1 tab PO bid; max: 2 tabs/day
• Note: Do not crush, cut or chew the tablet; give with plenty of water

• Mucinex for Kids Cough
• 4-5 yrs: 2.5-5 mL PO q4 hrs, max: 6 doses/day; give with plenty of water
• 6 to 11 yrs: 5-10 mL PO q4 hrs, max: 6 doses/day; give with plenty of water
• Oral granules: 4-5 yrs: 1 pkt PO q4 hrs, max: 6 pkts/day; give with plenty of water
• Oral granules: 6-11 yrs: 1-2 pkts PO q4 hrs, max: 12 pkts/day; give with plenty of water
• Oral granules: >12 yrs: 2-4 pkts PO q4 hrs, max: 24 pkts/day; give with plenty of water

• PediaCare Children's Cough & Congestion
• 4-5 yrs: 2.5-5 mL PO q4 hrs, max: 6 doses/day; give with plenty of water
• 6 to 11 yrs: 5-10 mL PO q4 hrs, max: 6 doses/day; give with plenty of water

• Vicks Formula 44E Cough & Chest Congestion
• 4-5 yrs: 7.5 mL PO q4 hrs, max: 6 doses/day; give with plenty of water
• 6 to 11 yrs: 15 mL PO q4 hrs, max: 6 doses/day; give with plenty of water
• >12 yrs: 30 mL PO q4 hrs, max: 6 doses/day; give with plenty of water

• Robitussin Cough & Chest Congestion DM, Robitussin Cough & Chest Congestion DM Max
• >12 yrs: 10 mL PO q4 hrs, max: 6 doses/day; give with plenty of water

• Vicks DayQuil Mucus Control DM
• 6-11: 15 mL PO q4 hrs, max: 6 doses/day; give with plenty of water
• >12 yrs: 30 mL PO q4 hrs, max: 6 doses/day; give with plenty of water

• Vicks Formula 44 Custom Care Chesty Cough
• 6-11 yrs: 7.5 mL PO q4 hrs, max: 6 doses/day; give with plenty of water
• >12 yrs: 15 mL PO q4 hrs, max: 6 doses/day; give with plenty of water

• Mucinex Fast-Max DM Max
• <12 yrs; Do not use
• >12 yrs: 20 ml PO q4 hrs. Max: 6 doses/day

[Outline]

• Adult Dosing
• Pediatric Dosing

• Helps loosen phlegm (mucus) and thin bronchial secretions to rid the bronchial passageways of bothersome mucus and make coughs more productive
• Temporarily relieves cough due to minor throat and bronchial irritation that occurs with a cold or inhaled irritants
• Temporarily relieves the intensity of cough
• Temporarily relieves the impulse to cough and helps to get to sleep

• Hypersensitivity to any of the ingredients of the product
• Concomitant use of monoamine oxidase inhibitor (MAOI) or use within 2 wks of stopping MAOI

• N/A

Renal Dose Adjustment

• Renal impairment: Dose adjustments not defined

Hepatic Dose Adjustment

• Hepatic impairment: Dose adjustments not defined

• Avoid using this medication in case of persistent or chronic cough (e.g., smoking, asthma, emphysema, or chronic bronchitis) or when cough is accompanied by excessive secretions
• Not recommended if the patient is on a sodium-restricted diet
• Discontinue the drug if cough lasts more than 7 days, recurs, or occurs with fever, rash, or persistent headache; further reevaluate the patient as these could be signs of a serious condition
• Anecdotal reports of abuse may increase

Cautions: Use cautiously in

• Nephrolithiasis
• Patients <6 yrs of age

Pregnancy Category:C

Breastfeeding: Neither the excretion of dextromethorphan in milk nor its effect on breastfed infants has been studied. However, this medication can be administered to infants as young as 1 month of age. It is unlikely that with usual maternal doses amounts in milk are as high as those given directly to infants or that breastfed infants would be harmed by the drug in breastmilk, especially in infants over 1 month of age. Avoid the use of products with a high alcohol content while nursing. No studies have been conducted on excretion of guaifenesin in milk or its effect on breastfed infants. This medication can be given to infants as young as 2 month of age; it is unlikely that usual maternal doses amounts in milk are as large as those given directly to infants and would harm the breastfed infants, especially in infants over 2 months of age. Avoid the use of products with a high alcohol content while nursing. This information is based on based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 26 May 2011).

• CNS: Dizziness, headache, drowsiness
• GI: Nausea, vomiting, abdominal pain
• GU: Nephrolithiasis
• DERM: Rashes
• MISC: Serotonin syndrome, abuse potential, fatigue, fever

Dextromethorphan

• Nonnarcotic antitussive; suppresses the cough reflex by directly acting on cough center in the medulla
• Rapid absorption
• Metabolized by liver; CYP450: 2D6 substrate
• Excreted in urine
• Half life: 11 hrs

Guaifenesin

• Expectorant; acts as an irritant to gastric vagal receptors and recruits efferent parasympathetic reflexes, causing glandular exocytosis of a less viscous mucus mixture. Provokes cough, thus facilitating removal of viscous mucus and making nonproductive coughs more productive and less frequent
• Rapidly absorbed from GI tract
• Metabolized by hydrolysis
• Renally excreted mainly as metabolite
• Half-life: 1 hr

US Trade Name(s)

• Alka-Seltzer Plus Mucus & Congestion
• Coricidin HBP Chest Congestion & Cough
• Diabetic Tussin DM
• Diabetic Tussin DM Maximum Strength
• Guiatuss DM
• Mucinex DM
• Mucinex DM Maximum Strength
• Mucinex for Kids Cough
• PediaCare Children's Cough & Congestion
• Vicks Formula 44E Cough & Chest Congestion Relief Liquid
• Robitussin Cough & Chest Congestion DM
• Robitussin Cough & Chest Congestion DM Max
• Vicks DayQuil Mucus Control DM
• Vicks Formula 44 Custom Care Chesty Cough
• Mucinex Fast-Max DM Max

US Availability

Alka-Seltzer Plus Mucus & Congestion (dextromethorphan/guaifenesin)

• OTC Effervescent TABS: 10 mg/200 mg
• OTC CAPS: 10 mg/200 mg

Coricidin HBP Chest Congestion & Cough (dextromethorphan/guaifenesin)

• OTC CAPS: 10 mg/200 mg

Diabetic Tussin DM, Guiatuss DM, Robitussin Cough & Chest Congestion DM (dextromethorphan/guaifenesin)

• OTC SOLN: [10 mg/100 mg]/5 mL

Diabetic Tussin DM Maximum Strength, Robitussin Cough & Chest Congestion DM Max (dextromethorphan/guaifenesin)

• OTC SOLN: [10 mg/200 mg]/5 mL

Mucinex DM (dextromethorphan/guaifenesin)

• OTC ETABS: 30 mg/600 mg
• OTC ETABS: 60 mg/1200 mg

Mucinex DM Maximum Strength (dextromethorphan/guaifenesin)

• OTC ETABS: 60 mg/1200 mg

Mucinex for Kids Cough (dextromethorphan/guaifenesin)

• OTC GRAN: 5 mg/100 mg
• OTC SOLN: [5 mg/100 mg]/5 mL

PediaCare Children's Cough & Congestion (dextromethorphan/guaifenesin)

• OTC SOLN: [5 mg/100 mg]/5 mL

Vicks Formula 44E Cough & Chest Congestion Relief Liquid (dextromethorphan/guaifenesin)

• OTC SOLN: [20 mg/200 mg]/15 mL

Vicks DayQuil Mucus Control DM (dextromethorphan/guaifenesin)

• OTC SOLN: [10 mg/200 mg]/15 mL

Vicks Formula 44 Custom Care Chesty Cough (dextromethorphan/guaifenesin)

• OTC SOLN: [20 mg/200 mg]/15 mL

Mucinex Fast-Max DM Max (dextromethorphan/guaifenesin)

• OTC ORAL SOLN: [20 mg/ 400 mg]/20 mL

Canadian Trade Name(s)

• Balminil DM + Expectorant
• Balminil DM + Expectorant Extra Strength
• Benylin Cough & Congestion Extra Strength
• Benylin DM-E Syr
• Coricidin II Chest Congestion and Cough
• Cough and Chest Congestion Syrup
• Cough Syrup DM Expectorant
• Counteract Cough Medicine - Liq
• DM + Expectorant Extra Strength Syrup
• DM Expectorant (Extra Strength) Syrup
• DM-Expectorant Syrup
• Expectorant DM Cough Syrup
• Guaitussin DM Cough Formula Syr
• Robitussin Cough Control
• Robitussin Cough Control Extra Strength
• Robitussin Cough Control For People With Diabetes
• Vicks Custom Care Chest Congestion/Cough
• Vicks Dayquil Mucus Control DM
• Vicks Pediatric Formula 44E Liq

Canadian Availability

Balminil DM + Expectorant Extra Strength, Benylin Cough & Congestion Extra Strength, DM + Expectorant Extra Strength Syrup, DM Expectorant (Extra Strength) Syrup, Robitussin Cough Control Extra Strength (dextromethorphan/guaifenesin)

• OTC SYRUP: [15 mg/200 mg]/5 mL

Balminil DM + Expectorant, Benylin DM-E Syr, Cough and Chest Congestion Syrup, Cough Syrup DM Expectorant, DM-Expectorant Syrup, Expectorant DM Cough Syrup, Guaitussin DM Cough Formula Syr, Robitussin Cough Control (dextromethorphan/guaifenesin)

• OTC SYRUP: [15 mg/100 mg]/5 mL

Coricidin II Chest Congestion and Cough (dextromethorphan/guaifenesin)

• OTC CAPS: 10 mg/200 mg

Counteract Cough Medicine - Liq, Robitussin Cough Control For People With Diabetes (dextromethorphan/guaifenesin)

• OTC LIQ: [10 mg/100 mg]/5 mL

Vicks Custom Care Chest Congestion/Cough (dextromethorphan/guaifenesin)

• OTC LIQ: [20 mg/200 mg]/15 mL

Vicks Dayquil Mucus Control DM (dextromethorphan/guaifenesin)

• OTC LIQ: [10 mg/200 mg]/15 mL

Vicks Pediatric Formula 44E Liq (dextromethorphan/guaifenesin)

• OTC LIQ: [10 mg/100 mg]/15 mL

UK Trade Name(s)

• N/A

UK Availability

• N/A

Australian Trade Name(s)

• Robitussin Cough and Chest Congestion

Australian Availability

Robitussin Cough and Chest Congestion (dextromethorphan/guaifenesin)

• OTC SYRUP: [15 mg/100 mg]/5 mL

[Outline]

ENT

Upper Respiratory Combinations

Pulmonary

Upper Respiratory Combinations

Drug Name: Mucinex DM (dextromethorphan 30 MG / guaifenesin 600 MG) 12 HR Extended Release Tablet

Ingredient(s): Dextromethorphan mixture with Guaifenesin

Imprint: Mucinex;600

Color(s): White

Shape: Oval

Size (mm): 16.00

Score: 1

Inactive Ingredient(s): N/A

Drug Label Author:
Reckitt Benckiser, Inc.

DEA Schedule:
Non-Scheduled

Drug Name: Mucinex DM (dextromethorphan 60 MG / guaifenesin 1200 MG) 12 HR Extended Release Tablet

Ingredient(s): Dextromethorphan mixture with Guaifenesin

Imprint: Mucinex;1200

Color(s): White

Shape: Oval

Size (mm): 22.00

Score: 1

Inactive Ingredient(s): N/A

Drug Label Author:
Reckitt Benckiser, Inc.

DEA Schedule:
Non-Scheduled