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What is dm in cough medicine: DM Cough Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing


Differences, similarities, and which is better for you

Drug overview & main differences | Conditions treated | Efficacy | Insurance coverage and cost comparison | Side effects | Drug interactions | Warnings | FAQ

A cough, whether chronic or acute, has a significant impact on daily living and quality of life. A cough is said to be a primary symptom of medical importance in more than half of new clinical visits to primary care providers.

Chronic cough is thought to be caused by three primary disease processes: chronic airway disease (asthma and COPD), post-nasal drip, and gastroesophageal reflux disease (GERD). Acute cough may be related to a common cold, asthma exacerbations, or upper respiratory tract infections such as bronchitis. A cough may be dry, meaning that it does not produce mucus or phlegm, or it may be wet, meaning it brings up mucus or phlegm from the respiratory tract. Dry coughs tend to have a more consistent hoarse sound, while the sound of a wet cough may have a gurgling effect and change as the mucus moves through the airways.

Delsym (dextromethorphan) and Robitussin (dextromethorphan) are two cough suppressant medications available without a prescription to help provide temporary relief from cough. Delsym and Robitussin each belong to a line of products under the same trade name that provides combination medicines aimed at treating a variety of cough and cold symptoms including cough, chest congestion, runny nose, nasal congestion, and fever.

What are the main differences between Delsym and Robitussin?

Delsym is an over-the-counter cough relief medication. Delsym’s active ingredient is dextromethorphan, a common ingredient in many over-the-counter cough preparations. Dextromethorphan, while not an opioid, is chemically related to codeine. It retains the antitussive properties of codeine but does not display any of the other typical opiate agonist characteristics. Dextromethorphan works centrally to suppress cough by decreasing the excitability of the cough center in the brain. What makes Delsym unique is a patented time-release formulation that provides 12 hours of cough relief as compared to the typical four to six hours of relief provided by other types of cough syrup which are not time-released.

Delsym is available in a 30 mg/5 ml suspension containing a patented dextromethorphan polistirex molecule that releases the drug over time. It comes in three and five ounces in both orange and grape flavors. Delsym can be used by children 4 years of age and older.

Robitussin is also an over-the-counter cough suppressant. The active ingredient of Robitussin is also dextromethorphan.  Robitussin 12-Hour Cough is similar to Delsym in that it is a time-release formulation of dextromethorphan polistirex in a 30 mg/5 ml suspension.

Robitussin 12-Hour Cough Relief comes in three and five ounces in orange and grape flavors and can be used by children 4 years of age and older.

Main differences between Delsym and Robitussin
Drug class Non-opioid antitussive Non-opioid antitussive
Brand/generic status Brand and generic available Brand and generic available
What is the generic name?
Dextromethorphan Dextromethorphan
What form(s) does the drug come in? Extended-release suspension Extended-release suspension
What is the standard dosage? 10 ml (60 mg) every 12 hours 10 ml (60 mg) every 12 hours
How long is the typical treatment? Less than one week Less than one week
Who typically uses the medication? Children aged 4 and over, adults Children aged 4 and over, adults

Conditions treated by Delsym and Robitussin

Delsym and Robitussin are indicated in the temporary relief of cough. They are especially useful in non-productive coughs such as the common cold and bronchitis.

Dextromethorphan, the active ingredient in the brand name products Delsym and Robitussin, is used off-label to treat painful diabetic neuropathy. Off-label is a term that refers to using a drug for a purpose not officially approved by the Food and Drug Administration (FDA). Dextromethorphan blocks N-methyl-D-aspartate (NMDA) receptors in the brain and spinal cord. NMDA receptors play an important role in pain perception, especially long-term, throbbing pain. By blocking these receptors, dextromethorphan is thought to help improve pain control. By the same mechanism, dextromethorphan may increase opioid effects on pain relief.

Cough Yes Yes
Painful diabetic neuropathy Off-label Off-label

Is Delsym or Robitussin more effective?

Given that Delsym and Robitussin are both the same concentration of dextromethorphan polistirex, their efficacy is best understood as compared to other cough suppressants. In a clinical study comparing dextromethorphan to codeine, dextromethorphan produced a clinically similar level of cough suppression. In this study, patients reported a greater decrease in cough intensity with dextromethorphan as compared to codeine. Given that dextromethorphan is not an opiate, and is available without a prescription, products containing dextromethorphan are generally considered a first-line treatment.

The Journal of Family Practice published findings that dextromethorphan produces superior cough relief as compared to other remedies, including antihistamines, decongestants, and expectorants. Expectorants may be indicated in patients with a wet, productive cough to assist in being able to clear the mucus from the airway.

Dextromethorphan-containing products, such as Delsym and Robitussin, are widely regarded as a first choice in cough suppression. If your cough is long-lasting or not relieved by over-the-counter cough medicines, you should seek medical attention, as it could be a sign that there is a more severe process occurring.

Coverage and cost comparison of Delsym vs. Robitussin

Delsym and Robitussin are available without a prescription, and therefore are typically not covered by commercial insurance or Medicare programs.

Delsym may cost as much as $15 when purchased over-the-counter, but if your healthcare provider writes a prescription and you use a SingleCare savings coupon, you could pay as little as $6 at a participating pharmacy.

Similarly, Robitussin may cost over $16 when purchased without a prescription, but your SingleCare savings coupon will bring it down to as low as $6 with a prescription at participating pharmacies.

Typically covered by insurance? No No
Typically covered by Medicare Part D? No No
Standard dosage 3 oz (90 ml) 3 oz (90 ml)
Typical Medicare copay n/a n/a
SingleCare cost $6-$11 $6-$11

Common side effects of Delsym and Robitussin

Delsym and Robitussin have a similar side effect profile due to the fact that they are each long-acting formulations of dextromethorphan. Side effects and adverse events are generally limited and very mild. They may include dizziness, fatigue, and drowsiness. Patients who are allergic to dextromethorphan or any other ingredient in the suspensions could experience rash, or in extreme cases, an anaphylactic allergic reaction.

There have been reports of abuse of dextromethorphan containing cold products, especially in combination with opioid products. This is thought to be due to its potential to increase the tolerance threshold of opioids. At higher than recommended doses, dextromethorphan can produce serotonergic side effects similar to serotonin syndrome, a condition in which the body has too much free serotonin. Symptoms of this condition include confusion, excitement, restlessness, irritability, nausea, and vomiting. Delsym and Robitussin should only be used according to the directions on the package labeling and at the advice of your healthcare provider.

Side effect Applicable? Frequency Applicable? Frequency
Dizziness Yes Not defined Yes Not defined
Fatigue Yes Not defined Yes Not defined
Drowsiness Yes Not defined Yes Not defined
Confusion Yes Not defined Yes Not defined
Excitement Yes Not defined Yes Not defined
Nervousness Yes Not defined Yes Not defined
Restlessness Yes Not defined Yes Not defined
Irritability Yes Not defined Yes Not defined
Nausea Yes Not defined Yes Not defined
Vomiting Yes Not defined Yes Not defined
Slurred speech Yes Not defined Yes Not defined

Source: Delsym (DailyMed)  Robitussin (DailyMed)

Drug interactions of Delsym vs.


Delsym and Robitussin have the same profile of drug interactions given their same active ingredient. These drugs should be avoided when possible in patients taking monoamine oxidase inhibitors (MAOIs). MAOIs such as selegiline and linezolid may increase the likelihood of serotonin syndrome when used with drugs that have serotonergic activity, such as dextromethorphan products.

Memantine, a drug used in patients with dementia and Alzheimers, is an NMDA antagonist like dextromethorphan. Concurrent use of these medications could result in symptoms such as agitation and dizziness. Patients with dementia and Alzheimers may already have a tendency towards these symptoms, and drug combinations that could worsen these symptoms should be avoided.

The following list is not intended to be a complete list of drug interactions. It is best to consult your doctor or pharmacist for a complete list.

Monoamine oxidase inhibitors (MAOIs) Yes Yes
Memantine NMDA antagonist Yes Yes
Selective serotonin reuptake inhibitors (SSRIs) Yes Yes
Selective norepinephrine reuptake inhibitors (SNRIs) Yes Yes
Tricyclic antidepressants Yes Yes

Warnings of Delsym and Robitussin

Delsym and Robitussin are not indicated in the treatment of chronic cough. If you have a cough that lasts for more than one week or any cough that is accompanied by fever, rash, or nausea and vomiting, these could be signs of a more serious condition. You should consult a healthcare professional immediately.

Delsym and Robitussin do not contain an expectorant, a medication intended to break up phlegm and mucus to allow them to clear the airways. If your cough contains an excessive amount of these substances, you should consult your healthcare provider. An expectorant, such as Mucinex (guaifenesin), or other medications may be warranted.

Dextromethorphan has been linked to fatal overdoses in children. The FDA recommends that dextromethorphan, along with many other common cold remedies,  not be used in children under the age of six.

There are no well-controlled studies establishing safety in pregnant women, which has led the FDA to classify Delsym and Robitussin as pregnancy category C. While there may be limited transfer into breast milk, it is generally considered safe to take dextromethorphan while breastfeeding.

The use of dextromethorphan products at high doses to potentiate the effects of opiate-containing drugs is a cause for concern. This may be particularly true in young adults.

Frequently asked questions about Delsym vs. Robitussin

What is Delsym?

Delsym is an over-the-counter cough suppressant medication that contains a long-acting formulation of dextromethorphan. Delsym is for use in the temporary relief of cough and works in the part of the central nervous system known as the medulla to stop the cough reflex. It is available in grape and orange flavors in both a 3 oz. and 5 oz. package size.

What is Robitussin?

Robitussin is also an over-the-counter cough suppressant medication that contains a long-acting formulation of dextromethorphan. Robitussin is for use in the temporary relief of cough, and like Delysm works in the part of the central nervous system known as the medulla to stop the cough reflex. It is also available in grape and orange flavors in 3 and 5 oz. sizes.

Are Delsym and Robitussin the same?

Delsym and Robitussin 12-Hour Cough are both 12 hour release cough suppressant suspensions containing a dextromethorphan polistirex complex in a concentration of 30 mg/5 ml. Both Delsym and Robitussin belong to a family of other cough and cold products which utilize the same leading trade name but differ in ingredients.

Is Delsym or Robitussin better?

Delsym and Robitussin are both effective at suppressing temporary cough caused by acute processes such as the common cold. They are preferred over codeine-based prescription formulations because they are non-opioid and available without a prescription. Dextromethorphan products have been shown to be superior to other OTC products such as expectorants, decongestants, and antihistamines in controlling cough.

Can I use Delsym or Robitussin while pregnant?

Delsym and Robitussin are considered pregnancy category C by the FDA, meaning there is not enough evidence to establish safety for use in pregnant women. Pregnant women should seek the advice of their healthcare professional and should only use these products when the benefit clearly outweighs the risk.

Can I use Delsym or Robitussin with alcohol?

Delsym and Robitussin are both alcohol-free formulations. However, due to their potential to cause confusion, drowsiness, and other nervous system side effects which could be potentiated by alcohol, their concurrent use with alcohol should be avoided.

What is the most effective cough suppressant?

While many approaches are used to decrease cough occurrence, including the use of expectorants, decongestants, and antihistamines, the American College of Chest Physicians recommends that cough suppressive agents such as dextromethorphan or codeine-based prescription formulations are superior and should be first-line therapy for short-term cough.

Which Robitussin is best for coughing?

Robitussin 12-Hour is the best choice for a dry, non-productive cough as it provides a longer window of relief as compared to other formulations of dextromethorphan. Wet, productive coughs may need an expectorant, in which case Robitussin DM, may be the best choice. Robitussin DM is a combination of dextromethorphan with guaifenesin, an expectorant that helps break up mucus, making it easier to clear from the airways.

Does Robitussin make you stop coughing?

While Robitussin may not stop your cough completely, dextromethorphan’s actions in the cough center of your brain are expected to greatly decrease the frequency of your cough. A cough that does not decrease with cough medication, or a cough which lasts for more than one week, could be a sign of a more serious condition.

Why you should avoid some cough syrups if you think you’ve got the coronavirus

Coughing is one of the hallmark symptoms of being infected with the novel coronavirus. So it’s no surprise that many are swigging dextromethorphan, a workhorse cough suppressant, to calm those bone-rattling expulsions of germs and air.

It may be doing them more harm than good, new research suggests.

As part of an ambitious project to identify drugs that could be repurposed to treat COVID-19, an international team of scientists reported Thursday they had happened upon a surprising finding: A common active ingredient in dozens of over-the-counter cough syrups, capsules and lozenges appeared to boost replication of the SARS-CoV-2 virus when tested under laboratory conditions.

That’s a long way from concluding that cough medicines containing dextromethorphan will worsen the condition of people infected with the new coronavirus, or that it will make frightening outcomes more likely. But the researchers said the findings are concerning enough for them to advise cough sufferers who might be infected with coronavirus to avoid these medications.

Given that cough suppressants are likely to be widely used by people with coronavirus infections — whether they’ve got an official diagnosis or not — the researchers called for more research on dextromethorphan’s safety.


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Dextromethorphan stifles signals in the brain that set off the reflex to cough. It is a key ingredient of virtually all over-the-counter cough and cold formulations, including those sold as Robitussin, Benylyn, DayQuil/NyQuil, Delsym, Triaminic, and Theraflu.

In tests conducted at the Pasteur Institute in Paris, researchers found that when dextromethorphan was introduced into the cells of African green monkeys growing in petri dishes, the subsequent addition of SARS-CoV-2 resulted in more prolific viral growth.

UC San Francisco pharmacologist Nevan J. Krogan, one of the team’s leaders, said that the group had alerted officials overseeing the government’s COVID-19 response to its concerns.

The findings were reported Thursday in the journal Nature.

But the group’s discoveries raise hopes as well.

The research team, led by scientists at the Pasteur Institute and UC San Francisco, had set out to find promising potential treatments for COVID-19 among compounds that were already known to scientists, physicians and consumers. The idea was to identify drug candidates that could be deployed quickly, either separately or in combinations, to short-circuit the coronavirus’s ability to infect and sicken humans.

Their search turned up an array of drugs that have long been in use, including the antihistamine clemastine (present in Tavist and Allerhist), the antipsychotic haloperidol (marketed as Haldol), the cough medication cloparastine (which is used widely in Japan, Hong Kong and Europe), and the hormone progesterone, abundantly present in females and used in hormone replacement regimens and in reproductive and sexual-health drugs.

Other promising compounds turned up in their search are still being tested for a variety of cancers, including the experimental drug zotatifin from San Diego-based Effector Therapeutics Inc. ; plitidepsin, a substance derived from a Mediterranean marine worm that’s being tested in Spain as a treatment for multiple myeloma; and ternatin, a mushroom-derived compound in early testing for its anti-cancer properties.

In the past, drug-hunters faced with a new viral threat have found new treatments by examining the distinctive features on the virus’ surface. Then, they’d look for known chemical compounds that would latch on to those particular features and kill or weaken the virus.

The 22-person team that launched the latest search in mid-March took a starkly different approach.

Starting with the blueprints contained in the 30 genes of the new coronavirus, they built its world from the inside out. They synthesized all the proteins the virus makes and recorded how each one interacts with proteins inside a human host. Then they identified 332 distinct steps necessary to ensure the coronavirus can enter a cell, hijack its machinery, and make copies of itself.

The result was a commando’s road map. Next, they had to find any compound known to intervene somewhere in that long chain of events.

Their search turned up 69 existing drugs, experimental drugs, or compounds still on the way to becoming drugs. Collectively, they offered the possibility of disrupting the virus’ life cycle in 62 different ways.

Some of the compounds the team identified are “many times more potent” than remdesivir, a failed Ebola drug that is finding new life as a COVID-19 treatment, said Krogan, senior author of the Nature study.

Krogan and his colleagues noted that many of the compounds would probably work best in tandem with remdesivir rather than competing against it.

“A treatment that will be successful will be combinatorial,” said Krogan, a UCSF cellular molecular pharmacologist.

If scientists use his team’s insights about where and how the coronavirus might be disrupted, he added, it should help them create a potent cocktail of drugs that will attack and disrupt the virus at many points in its life cycle, he added.

GoodSense® Tussin DM Cough and Chest Congestion Liquid

Get Relief From Cough and Chest Congestion

Compare to the active ingredients in Robitussin® Cough + Chest Congestion DM. Tussin DM provides soothing action and targets the source of your cough – plus relieves your congestion.

Non-drowsy Tussin DM contains Dextromethorphan HBr, USP 20 mg and Guaifenesin, USP 200 mg, and relieves cough and chest congestion/mucus for ages 12 and over. This cherry flavored product is alcohol-free and gluten-free. Dosage cup is included.

A cold usually includes a runny nose, sore throat, sneezing, and coughing. These symptoms can last for up to two weeks. Over 200 viruses can cause the common cold. The rhinovirus is the most common type of virus that causes colds.

A cough is a natural reflex that protects your lungs. Coughing helps clear your airways of lung irritants, such as smoke and mucus (a slimy substance). This helps prevent infections. A cough also can be a symptom of a medical problem.

Prolonged coughing can cause unpleasant side effects, such as chest pain, exhaustion, light-headedness, and loss of bladder control. Coughing also can interfere with sleep, socializing, and work.

Sources: www.webmd.com; U.S. Department of Health and Human Services, National Heart, Lung, and Blood Institute, National Institutes of Health, www.nhlbi.nih.gov/health/health-topics/topics/cough

What’s Inside:

Active ingredients: Dextromethorphan HBr, USP 20 mg, cough suppressant; Guaifenesin, USP 200 mg, expectorant.

Inactive ingredients: anhydrous citric acid, FD&C red no. 40, flavor, glycerin, high fructose corn syrup, menthol, propylene glycol, purified water, sodium benzoate, sodium citrate, sucralose.


  • Do not take more than 6 doses in any 24-hour period.
  • Measure only with dosing cup provided.
  • Keep dosing cup with product.
  • mL = milliliter.
  • This adult product is not intended for use in children under 12 years of age.

Adults and children 12 years and over: 10 mL every 4 hours.

Children under 12 years: Do not use.

Side effects, images, and drug details for Promethazine DM

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Research Shows Common Cough Syrup Ingredient Makes Coronavirus Grow More

Krogan said he, himself, if he had COVID-19, would “think twice about using some of these cough syrups until more information was available to us.”

Later, Krogan softened that advice in an interview with NBC’s Today show.  “This is information we wanted to responsibly report but tempered with a strong caveat that these results were seen in the lab (and) more tests are needed, especially in humans, before any definite conclusions are drawn.”

Alexander Borowsky, a medical doctor and a professor at UC Davis’ Center for Immunology and Infectious Diseases, cautions about reading too much into the findings about dextromethorphan, which were conducted in a lab on animal cells and not as part of a clinical trial. Borowsky said it’s “possible” that within the constraints of the study, the drug “is contributing to a little more viral infectivity, but it’s impossible to know from these data whether that changes the ability of the virus to get into the cells or the ability of the virus to replicate copies of its number in a cell.”

“Sorting all that out, obviously, would be important,” he said. “But I just cannot imagine that this has a real impact on patients taking Robitussin.”

The Consumer Healthcare Products Association, an industry group representing makers of over-the-counter medications, said in a statement: “It’s important to point out that these preliminary study results demonstrating a pro-viral effect of dextromethorphan are not conclusive. The authors only examined three samples and note further study is required on dextromethorphan in the context of COVID-19.”

Promising Drugs Found

The UCSF study, which included 120 scientists from around the world, primarily examined the impact of 47 over-the-counter and prescription drugs on SARS-CoV-2. In the coming weeks, the scientists plan to examine another 28 drugs, or 75 total. Results of the study were published today in the journal Nature.

The team found several drugs already approved by the FDA and other drug compounds that could pave the way for improved treatment of COVID-19. You can read more about the study and which drugs showed promise in the San Francisco Chronicle.

The new findings come on the heels of another promising study by federal scientists into Gilead’s drug remdesivir, which found the median recovery time for patients sick with COVID-19 who took the antiviral medication was 4 days faster compared to those who received a placebo.

“Some of our drugs and compounds are many times more potent than remdesivir, at least in the laboratory setting,” Krogan said. “So we’re very excited not just to look at these drugs and compounds in isolation, but in combination with other drugs like remdesivir.”

This post has been edited to add the statements by the industry group and outside researcher.

Maximum Strength Robitussin DM | Hagens Berman


Pfizer sold and marketed to consumers an over-the-counter medication known as Maximum Strength Robitussin Cough+Chest Congestion DM, containing two active ingredients which act as a cough suppressant (Dextromethorphan HBr) and an expectorant (Guaifenesin). Pfizer has duped consumers into paying more for a product that has less medicine in it per 10ml, all branded under the false name of “Maximum Strength.”

Despite the fact that Maximum Strength Robitussin is typically more expensive than regular strength Robitussin Cough+Chest Congestion DM, Maximum Strength Robitussin contains half the amount of cough suppressant per 10 ml and the same amount of expectorant per 10 ml as Regular Strength Robitussin. Purchasers of Maximum Strength Robitussin receive 10 mg of cough suppressant per 10 ml as compared to 20 mg per 10 ml in Regular Strength Robitussin and 200 mg of expectorant per 10 ml just like in the Regular Strength Robitussin.

Based on the dosing recommendations, for the same-size four fluid ounce bottle, Maximum Strength Robitussin provides just 5.91 doses whereas Regular Strength Robitussin provides 11.8 doses. The difference in dose amount and amount of cough suppressant means consumers will buy the more expensive option more often.


The lawsuit seeks reimbursement for the price pushed onto consumers due to Pfizer’s false advertising. The lawsuit states, “By specifically naming Maximum Strength Robitussin with a plain-meaning efficacy claim, Pfizer intended that consumers believe that they would get more active ingredient than in the regular version of Robitussin.” Hagens Berman believes that those who paid for the more expensive Maximum Strength version were outright taken advantage of. We believe Pfizer did this deliberately.


Hagens Berman is one of the most successful consumer litigation law firms in the U. S. and has achieved more than $260 billion in settlements for consumers in lawsuits against food corporations, automakers, big banks and others. Your claims will be handled by attorneys experienced in consumer law.


There is no cost or fee whatsoever involved in joining this case. In the event Hagens Berman or any other firm obtains a settlement that provides benefits to class members, the court will decide a reasonable fee to be awarded to the legal team. In no case will any class member ever be asked to pay any out-of-pocket sum.

Delsym erowid

Dextromethorphan or DXM is a safe, popular ingredient in cough medicines for children and adults. It’s used in brands like Robitussin, Vicks, Triaminic, and Coricidin. Using Kratom and DXM together makes Kratom even more effective and helps provide users with the long-lasting pain relief and mental clarity they want.

Dextromethorphan Short-term Effects. “Robo-tripping,” or taking dextromethorphan in large amounts to get high, can produce short-term effect such as: Euphoria/drunk feeling. Sedation. Detachment/dissociation. Hallucinations. DXM is increasingly recognized as a problem, especially among younger users.

Erowid. DXM basics. Accessed 2015 Dec 11. Finkelstein Y, Goel G, Hutson JR, et al; Toxicology Investigators Consortium (ToxIC). Drug Misuse in Adolescents Presenting to the Emergency Department. Pediatr Emerg Care. 2017 Jul;33(7):451-456; Ganetsky M, Babu KM, Boyer EW. Serotonin syndrome in dextromethorphan ingestion responsive to propofol therapy.

Search: Erowid Meth Addiction. About Meth Addiction Erowid

I’ll be getting a few bob and having tried opiates, benzos etc. but this time, I’d like to try something more “psychedelic-ish”.I live in Ireland where Robitussin contains the active ingredient dextromethorphan at 7.5mg/5ml which means that in a 100ml bottle, the total content of dxm is 187.5mg. Is this enough or too much?

Dextromethorphan Dangers. Dextromethorphan, or DXM, an ingredient in DayQuil that helps suppress coughing, is also unsafe when combined with alcohol. Side effects of dextromethorphan can include dizziness, lightheadedness, drowsiness, nausea and vomiting — and alcohol can worsen these side effects.

every time i drink delsym i get a 5oz and pound it all at once and i weigh 180 lbs. now ik 888mg of DXM is a large dose (thats how much is in a 5 oz of delsym) but trust me you dont get it all at once so its not overly intense. the come up is peaceful and gradual, and you keep coming up for 2+ hours. every time you think you’re at the peak, you notice yourself coming up still. its kind of funny.

Dextromethorphan or DXM is a safe, popular ingredient in cough medicines for children and adults. It’s used in brands like Robitussin, Vicks, Triaminic, and Coricidin. Using Kratom and DXM together makes Kratom even more effective and helps provide users with the long-lasting pain relief and mental clarity they want.

Rewriting last section, and my reasons why. young molla baby haha im out —Preceding unsigned comment added by 75.109. 28.128 11:08, 27 January 2009 (UTC) The “Controversy” section of this article is poorly written (no offense), and is not completely accurate. For example it states “(Dextromethorphan) is a dangerous chemical compound that should always be used with caution” which is very vague …

Guaifenesin and Dextromethorphan | Memorial Sloan Kettering Cancer Center

This document, provided by Lexicomp ® , contains all the information you need to know about the drug, including the indications, route of administration, side effects and when you should contact your healthcare provider.

Trade names: USA

Altarussin DM [OTC]; Chest Congestion Relief DM [OTC]; Coricidin HBP Congestion / Cough [OTC]; Cough / Chest Congestion DM [OTC]; Delsym Cgh / Chest Cong DM Child [OTC]; Delsym Cough / Chest Congest DM [OTC]; Diabetic Siltussin-DM Max St [OTC] [DSC]; Diabetic Siltussin-DM [OTC] [DSC]; Diabetic Tussin DM [OTC]; Diabetic Tussin For Children [OTC] [DSC]; Diabetic Tussin Max St [OTC]; Double-Tussin DM [OTC]; Extra Action Cough [OTC] [DSC]; Fenesin DM IR [OTC]; Geri-Tussin DM [OTC]; GoodSense Mucus Relief DM [OTC]; Guaiasorb DM [OTC]; Guaicon DMS [OTC]; Maxi-Tuss G [OTC]; Maxi-Tuss GMX [OTC]; Mucinex Childrens Freefrom [OTC]; Mucinex Cough Childrens [OTC]; Mucinex Cough For Kids [OTC]; Mucinex DM Maximum Strength [OTC]; Mucinex DM [OTC]; Mucinex Fast-Max DM Max [OTC]; Mucosa DM [OTC] [DSC]; Mucus Relief Cough Childrens [OTC]; Mucus Relief DM Max [OTC]; Mucus Relief DM [OTC]; MucusRelief DM Cough [OTC] [DSC]; NeoTuss [OTC] [DSC]; Pediatric Formula Cough / Congst [OTC]; Pharbinex-DM [OTC]; Recofen D [OTC]; Refenesen DM [OTC]; Robafen DM Cgh / Chest Congest [OTC]; Robafen DM Cough Clear [OTC] [DSC]; Robafen DM Cough [OTC]; Robafen DM Peak Cold Cgh / Cong [OTC] [DSC]; Robafen DM [OTC] [DSC]; Robitussin Cold Cough + Chest [OTC] [DSC]; Robitussin Cough + Chest Max St [OTC] [DSC]; Robitussin Cough + Chest Cong DM [OTC]; Robitussin Peak Cold DM [OTC] [DSC]; Robitussin To Go Cgh / Chest DM [OTC] [DSC]; Safe Tussin DM [OTC]; Siltussin DM DAS [OTC]; Siltussin-DM Alcohol Free [OTC]; Tolu-Sed DM [OTC] [DSC]; Triaminic Cough & Congestion [OTC] [DSC]; Tussin DM [OTC]

What is this drug used for?

  • Helps to loosen mucus, so it can be easily removed by coughing.
  • Used to relieve coughs.

What should I tell my doctor BEFORE taking this drug?

  • If you are allergic to this drug, any of its ingredients, other drugs, foods or substances. Tell your doctor about your allergy and how it manifested itself.
  • If you have a cough with a lot of phlegm, a prolonged cough from smoking or inhalation of cigarette smoke, or lung problems such as asthma or emphysema.
  • If you have taken a drug for depression or Parkinson’s disease in the past 14 days. These include isocarboxazid, phenelzine, tranylcypromine, selegiline, or rasagiline. An episode of very high blood pressure may occur.
  • If you are taking any of the following drugs: linezolid or methylene blue.

This list of drugs and diseases that may be adversely associated with this drug is not exhaustive.

Tell your doctor and pharmacist about all the medicines you take (both prescription and over-the-counter, natural products and vitamins) and your health problems. You need to make sure that this drug is safe for your medical conditions and in combination with other drugs you are already taking. Do not start or stop taking any drug or change the dosage without your doctor’s approval.

What do I need to know or do while taking this drug?

  • Tell all healthcare providers that you are taking this drug. These are doctors, nurses, pharmacists and dentists.
  • Do not take the drug in higher doses than the doctor prescribed. Taking more than the prescribed amount of the drug increases the risk of serious side effects.
  • Do not use this drug for longer than your doctor prescribed.
  • If you are on a low sodium or salt-free diet, tell your doctor. Some of these preparations contain sodium.
  • Consult your doctor if you have PKU. Some foods contain phenylalanine.
  • Some forms of this drug may not be suitable for use in children of all ages. If you have any questions, please consult your doctor.
  • Tell your doctor if you are pregnant, planning to become pregnant, or breastfeeding.The benefits and risks for you and your child will need to be discussed.

What side effects should I report to my doctor immediately?

WARNING. In rare cases, some people with this drug can cause serious and sometimes deadly side effects. Call your doctor right away or get medical help if you have any of the following signs or symptoms, which may be associated with serious side effects:

  • Signs of an allergic reaction such as rash, hives, itching, reddened and swollen skin with blistering or scaling, possibly associated with fever, wheezing or wheezing, tightness in the chest or throat, difficulty breathing, swallowing or speaking, unusual hoarseness, swelling in the mouth, face, lips, tongue, or throat.

What are some other side effects of this drug?

Any drug can have side effects. However, many people have little or no side effects. Contact your doctor or get medical help if you are concerned about any side effects, or if the side effects are persistent.

This list of possible side effects is not exhaustive. If you have any questions about side effects, please contact your doctor.Talk to your doctor about side effects.

You can report side effects to the National Health Office.

You can report side effects to the FDA at 1-800-332-1088. You can also report side effects at https://www.fda.gov/medwatch.

What is the best way to take this drug?

Use this drug as directed by your healthcare practitioner. Read all the information provided to you.Follow all instructions strictly.

All forms of issue:

  • Take with or without food. Take with food if the medicine causes nausea.
  • Drink plenty of decaffeinated fluids, unless your doctor tells you to drink less fluids.

Tablets and capsules:

  • Take this drug with a full glass of water.


  • Doses of liquid preparation should be measured with caution.Use the dispenser that comes with the medicine. If a dispenser is not included in the package, ask your pharmacist for a dosing product for this drug.

Extended release tablets:

  • Swallow whole. Do not chew, break, or crush.
  • Take this drug with a full glass of water.


  • The contents of the bag should be poured onto the tongue and swallowed.To avoid an unpleasant aftertaste, swallow without chewing.

What should I do if a dose of a drug is missed?

  • If you are taking this medication regularly, take the missed dose as soon as you can.
  • If it is time for your next dose, do not take the missed dose and then return to your normal dose schedule.
  • Do not take 2 doses at the same time or an additional dose.
  • In most cases, this drug is used as needed.Do not take this medicine more often than prescribed by your doctor.

How do I store and / or discard this drug?

  • Store at room temperature in a dry place. Do not store in the bathroom.
  • Store all medicines in a safe place. Keep all medicines out of the reach of children and pets.
  • Dispose of unused or expired drugs. Do not empty into toilet or drain unless directed to do so.If you have any questions about the disposal of your medicinal products, consult your pharmacist. Your area may have drug recycling programs.

General information on medicinal products

  • If your health does not improve or even worsens, see your doctor.
  • You should not give your medicine to anyone or take someone else’s medicine.
  • Some medicines may have different patient information sheets.If you have questions about this drug, talk with your doctor, nurse, pharmacist, or other healthcare professional.
  • Some medicines may have different patient information sheets. Check with your pharmacist. If you have questions about this drug, talk with your doctor, nurse, pharmacist, or other healthcare professional.
  • If you think an overdose has occurred, call a Poison Control Center immediately or seek medical attention.Be prepared to tell or show which drug you took, how much and when it happened.

Use of information by the consumer and limitation of liability

This information should not be used to make decisions about taking this or any other drug. Only the attending physician has the necessary knowledge and experience to make decisions about which drugs are appropriate for a particular patient. This information does not guarantee that the drug is safe, effective, or approved for the treatment of any disease or specific patient.Here are only brief general information about this drug. It does NOT contain all available information on the possible use of the drug with instructions for use, warnings, precautions, information about interactions, side effects and risks that may be associated with this drug. This information should not be construed as a treatment guide and does not replace information provided to you by your healthcare professional. For complete information on the possible risks and benefits of taking this drug, consult your doctor.Use of this information is governed by the Lexicomp End User License Agreement available at https://www.wolterskluwer.com/en/solutions/lexicomp/about/eula.


© UpToDate, Inc. and its affiliates and / or licensors, 2021. All rights reserved.

90,000 Killing medicine. List of once popular drugs that do not cure, but cripple

Mercury salts

In the medicine of the 18th-19th centuries, not mercury itself was often used, but calomel – mercury (I) chloride.It was used as an eye ointment, for the treatment of sexually transmitted diseases, especially syphilis, as a choleretic and laxative. It is reliably known that the mortally wounded Pushkin was “treated” with calomel laxative.

“Duel of Pushkin with Dantes” by Alexei Naumov, 1884

Other preparations containing mercury salts were often used. For example, American President Abraham Lincoln fought depression with Blue Mass. As it turned out after a century and a half, high doses of mercury salts in the medicine led to sudden outbursts of rage in the president.On the one hand, you cannot call it depression, but also a cure. Who knows what Lincoln would have died of if there hadn’t been a shot in the theater?


Some of the new dangers that humanity faces are not immediately understood. This happened, for example, with radioactivity. Radium discovered by Marie Curie was not the first radioactive element to be discovered by humans, but it was certainly the most famous at the beginning of the 20th century. The radium glowed, and it was certainly fascinating.

It is not known exactly who was the first to notice the “life-giving” properties of radium, but very quickly it was believed that radium water brings relief from literally everything. In the first decades of the century, the planet was swept by a radium fever: in addition to “healing” radium water, a huge amount of drugs with radium and even radium toothpaste were produced. Glowing paints with radium were produced until the 70s of the XX century, and if you come across old glowing Christmas tree decorations, it doesn’t hurt to check them with a dosimeter.

Inscription on the jar “TO-RADIUM powder based on radium and thorium according to Alfred Curie’s formula”. Photo: Rama / wikimedia

Even Maria Curie did not know about the danger of radium: she did not know about the lethal effect of radiation on living systems, or about the fact that about 80% of the radium that entered the body accumulates in the bones. As a result, radiation sickness, osteoporosis, cancerous tumors of the bone tissue, problems with the bone marrow … The discoverer of radium, twice Nobel laureate, became a victim of her discovery, having died from constant exposure to radioactivity at the age of 66.However, there was also a benefit from radium: it was used as a source of X-rays for X-ray machines and saved many lives in the fields of the First World War.

Opium and morphine

Dried milk juice from unripe opium poppy capsules was used as a pain reliever by the father of medicine, Hippocrates. Following the example of the great doctor of antiquity, doctors have used opium for more than two millennia: it was opium drops that facilitated the last hours of the same Pushkin.

Opium poppy boxes.Photo: Smit / shutterstock

Opium does not have a single chemical formula: it contains about 20 potent substances. Most of all morphine, poppy’s strongest alkaloid. It is opium that we owe to drugs such as codeine and papaverine. The most interesting thing is that the substances obtained from the opium poppy are still used in medicine. But morphine is used only in extreme cases – for pain relief of cancer patients in the terminal stage, when the emergence of dependence on the drug, alas, is no longer a problem.Since the 19th century, opium itself has been considered exclusively a drug, and its use is a vice.


Do you know what is the fundamental difference between all modern film adaptations of works about Sherlock Holmes from the original? Anyone who has read Conan Doyle, and not only watched the on-screen adventures of Benedict Cumberbatch, Vasily Livanov or Robert Downey Jr., know that the “real” Holmes saved his brain with cocaine during periods of idleness. And in Holmes’s time there was nothing criminal or forbidden in this.The alkaloid of the leaves of the South American coca plant has been used in medicine for about half a century (since 1856) as a stimulant, a medicine for depression, and at the same time an analgesic. In 1900, in Moscow, a box of cocaine could be bought for a ruble. There were baby cocaine teething drops, and the original Coca-Cola recipe also contained this substance.

Advertising for children’s drops with cocaine for toothache, 1885

Sobering up came at the beginning of the 20th century, when it became clear that cocaine causes addiction, which is very difficult to get rid of.The “cocaine panic” began – an anti-cocaine campaign in many countries, which led to the emergence of the first true drug cartels. Cocaine is still one of the most common drugs. However, he also played a positive role: after chemists determined the chemical structure of a substance, many less dangerous and more effective painkillers, such as, for example, novocaine, were synthesized.


An amazing thing – two of the world’s most famous pharmaceuticals were created not only by one company, but also by one person.To be fair, let’s say that Felix Hoffman, a young employee at Bayer AG, was not the first to synthesize aspirin or heroin. However, it was he who received the dosage forms of both substances. Heroin – in 1898.

Heroin is a close relative of morphine, there is a difference of two acetyl groups between them. Heroin was used as a pain reliever as a safer substitute for morphine … The most common indication for heroin administration was a common cough: the drug was good at soothing the lungs. And most often heroin was prescribed to children.

A heroin drug manufactured by Bayer before World War II. Photo: Mpv_51 / wikimedia

Already in 1913, Bayer had to stop producing heroin, since 1924 it was banned in the United States, but heroin could be bought in European pharmacies back in 1971. Now the former “cough medicine” is the number one drug in the world, and the number of its victims is not decreasing.


The history of thalidomide is perhaps one of the saddest in modern pharmacology. This substance was developed by the German company Chemie Grünenthal, which was looking for a new antibiotic.The drug after tests on animals was considered harmless and after a while was recognized as one of the best sedatives. After a while, the target audience of the drug narrowed: with its help, they began to treat the nervous disorders of pregnant women. The men took the arrival of thalidomide with great relief. However, very soon the catastrophe broke out. Women who took thalidomide gave birth to children with deformities: no ears, no fingers or extra fingers, no limbs at all. In total, from eight to twelve thousand babies with physical disabilities were born, and only five thousand of them did not die in infancy.

Feet of a child born with thalidomide deformities. Photo: Otis Historical Archives National Museum of Health and Medicine / flickr

The trial led to dire conclusions. As many remember from a course in organic chemistry at school, the carbon atom, which is bound to four different molecules, does not match its mirror image. These pairs are called “left” and “right” isomers. For example, all the amino acids that make up our proteins are “left”. In this case, during ordinary organic synthesis, a mixture of “left” and “right” isomers is formed, which is very difficult to separate.Now, thalidomide has this carbon atom. And if one of the isomers heals, then the other – kills, integrating into the DNA of the embryo and preventing the normal copying of genetic information.

Nevertheless, thalidomide is now again in the arsenal of doctors. It is used to treat leprosy, and the only contraindication is pregnancy. The drug even “lit up” in one of the episodes of “House Doctor”.


In 1893, the German chemist Friedrich Stolz synthesized a new pain reliever – amidopyrine.The rearrangement of the letters in this word gave the name “pyramidon” known to the older generation. Pyramidon is often used by Bulgakov’s characters – the writer was a doctor by training, worked in his specialty for several years and also regularly took Pyramidon. The drug has been on the market for almost 90 years, but data has gradually accumulated that, firstly, taking pyramidone is associated with a large number of side effects, and secondly, regular use of the drug dramatically increases the risk of a condition called agranulocytosis.In fact, this is a decrease in the blood of one type of white blood cell, namely granulocytes (a type of white blood cell). The main function of leukocytes is to protect our body from infections, so taking pyramidon causes a kind of light version of AIDS – a nonspecific drop in immunity.

Monocytes in a blood preparation. Photo: Bobjgalindo / flickr

Alexey Paevsky

Gg-DM SR – instructions for use, dosage, composition, analogs, side effects / Pillintrip

See also:
What are the possible side effects of Gg-DM SR?

Paracetamol may cause pancreatitis, allergic reactions in the form of rash or blood disorders (including neutropenia, pancytopenia, leukopenia, agranulocytosis and thrombocytopenia).They should disappear when treatment is stopped. The rash usually presents as red patches or allergic bumps, and may be accompanied by fever and mucosal lesions.

The most common side effect of chlorpheniramine is sedation, ranging from mild drowsiness to deep sleep, including fatigue, dizziness, and poor coordination. Paradoxical stimulation of the central nervous system can occur, especially in children, with insomnia, nervousness, euphoria, irritability, tremors and, less commonly, nightmares, hallucinations, and seizures.

Other side effects may include dry mouth; thickened airway discharge and chest tightness, blurred vision, difficulty urinating and retention, constipation and increased stomach reflux. In addition, gastrointestinal disturbances such as nausea, vomiting, diarrhea, or epigastric pain may occur.

Hypersensitivity reactions may occur. Blood disorders have been reported, including agranulocytosis, leukopenia, hemolytic anemia, and thrombocytopenia.Other less common side effects include hypotension, tinnitus, headache, and paresthesias.

Chloropheniramine should be used with caution in patients with glaucoma, urinary retention, prostatic hypertrophy, or pyloroduodenal obstruction. Caution should be exercised in patients with epilepsy and severe cardiovascular disorders.

Chlorpheniramine may enhance the sedative effect of central nervous system depressants, including alcohol, barbiturates, hypnotics, analgesics, sedatives, and tranquilizers.Caution should be exercised when taking medications containing tricyclic antidepressants or atropine together.

Elderly patients are more susceptible to a central nervous system depressant and lower blood pressure exposure even at doses that are effective for treatment.

Warning signs of ototoxic drug damage may be masked by chlorpheniramine.

Other central nervous system depressants, such as alcohol, barbiturates, hyponotics, narcotic analgesics, sedatives and tranquilizers, when used together will increase the likelihood of sedation.Be careful when taking medicines containing tricyclic antidepressants or atropine together.

Pseudoephedrine hydrochloride may cause dizziness, headache, nausea, vomiting, sweating, thirst, rapid or irregular heartbeat (tachycardia, ventricular arrhythmia) heart pain (premature pain) palpitations, increased blood pressure) muscle weakness, tremors, anxiety, anxiety and inability to sleep, fear, confusion, psychotic conditions, decreased appetite, shortness of breath, sweating, hypersalivation, altered metabolism, including impaired glucose metabolism.Addiction tolerance may develop after continued use.

The effects of pseudoephedrine hydrochloride are reduced by drugs containing guanethidine, reserpine, methyldopa, and may be reduced or increased by tricyclic antidepressants. This can increase the likelihood of an irregular heartbeat in patients taking digitalis.

Pseudoephedrine can increase blood pressure, and therefore, patients receiving antihypertensive therapy are advised to take special care.