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Guaifenesin and dextromethorphan: Drug information

Guaifenesin and dextromethorphan: Drug information
(For additional information see "Guaifenesin and dextromethorphan: Patient drug information" and see "Guaifenesin and dextromethorphan: Pediatric drug information")

For abbreviations, symbols, and age group definitions used in Lexicomp (show table)
Brand Names: US
  • Altarussin DM [OTC];
  • Chest Congestion Relief DM [OTC];
  • Coricidin HBP Congestion/Cough [OTC];
  • Cough & Chest Congestion DM [OTC];
  • Cough/Chest Congestion DM [OTC] [DSC];
  • Delsym Cgh/Chest Cong DM Child [OTC];
  • Delsym Cough/Chest Congest DM [OTC];
  • Diabetic Tussin DM [OTC] [DSC];
  • Diabetic Tussin Max St [OTC] [DSC];
  • Extra Action Cough [OTC] [DSC];
  • Fenesin DM IR [OTC];
  • FT Chest Congestion Relief DM [OTC];
  • FT Mucus Relief DM [OTC];
  • FT Tussin DM Max Adult [OTC];
  • Geri-Tussin DM [OTC];
  • GoodSense Mucus Relief DM [OTC] [DSC];
  • Guaiasorb DM [OTC];
  • Guaicon DMS [OTC] [DSC];
  • Max Tussin DM Cough&Chest Cong [OTC];
  • Maxi-Tuss G [OTC];
  • Maxi-Tuss GMX [OTC];
  • Mucinex Childrens Freefrom [OTC] [DSC];
  • Mucinex Childrens [OTC];
  • Mucinex Cough & Chest Congest [OTC];
  • Mucinex Cough Childrens [OTC];
  • Mucinex Cough For Kids [OTC] [DSC];
  • 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];
  • Pharbinex-DM [OTC];
  • Refenesen DM [OTC];
  • Robafen DM Cgh/Chest Congest [OTC] [DSC];
  • Robafen DM Cough [OTC] [DSC];
  • Robafen DM Peak Cold Cgh/Cong [OTC] [DSC];
  • Robafen DM [OTC];
  • Robitussin Cold Cough+ Chest [OTC] [DSC];
  • Robitussin Cough+Chest Cong DM [OTC];
  • Robitussin Honey Cgh/Chest DM [OTC];
  • Robitussin Peak Cold DM [OTC] [DSC];
  • Safe Tussin DM [OTC] [DSC];
  • Siltussin DM DAS [OTC];
  • Siltussin-DM Alcohol Free [OTC] [DSC];
  • Tussin Cough+Chest Cong DM SF [OTC] [DSC];
  • Tussin Cough+Chest Congest DM [OTC] [DSC];
  • Tussin DM Max [OTC];
  • Tussin DM [OTC];
  • Vanacof XP [OTC]
Pharmacologic Category
  • Antitussive;
  • Expectorant
Dosing: Adult

Also refer to specific product labeling.

Cough

Cough (antitussive/expectorant): Oral:

General dosing guidelines: Guaifenesin 200 to 400 mg and dextromethorphan 10 to 20 mg every 4 hours (maximum dose: Guaifenesin 2,400 mg and dextromethorphan 120 mg per day)

MaxTussin DM Cough and Chest Congestion: 10 mL (guaifenesin 200 mg/dextromethorphan 20 mg) every 4 hours (maximum: 6 doses/24 hours).

Mucinex DM: 1 to 2 tablet every 12 hours (maximum: 4 tablets/24 hours).

Mucinex DM Maximum Strength: 1 tablet every 12 hours (maximum: 2 tablets/24 hours).

Mucinex Children’s Cough Mini-Melts: 2 to 4 packets every 4 hours (maximum: 6 doses/24 hours).

Scot-Tussin Senior SF DMEXP: 10 mL (guaifenesin 400 mg/dextromethorphan 30 mg) every 6 hours (maximum: 4 doses/24 hours).

Dosing: Kidney Impairment: Adult

There are no dosage adjustments provided in the manufacturer's labeling.

Dosing: Hepatic Impairment: Adult

There are no dosage adjustments provided in the manufacturer's labeling.

Dosing: Older Adult

Refer to adult dosing.

Dosing: Pediatric

(For additional information see "Guaifenesin and dextromethorphan: Pediatric drug information")

Note: Multiple concentrations of oral liquid formulations (liquid, solution, and syrup) exist; close attention must be paid to the concentration when ordering or administering. Refer to product-specific labeling for approved pediatric ages. Safety and efficacy for the use of cough and cold products in infants and young children is limited; the AAP warns against the use of these products for respiratory illnesses in infants and young children; the FDA does not recommend OTC use in infants and children <2 years of age due to the risk of serious and life-threatening adverse effects (including death) and recommends to use with caution in pediatric patients ≥2 years of age (Ref).

Cough

Cough (antitussive/expectorant): Oral: Note: For all immediate release products (eg, capsules, granules, liquid formulations); do not exceed 6 doses in 24 hours.

General dosing: Immediate release products:

Children 4 to <6 years: Dextromethorphan 2.5 to 5 mg with Guaifenesin 50 to 100 mg every 4 hours as needed

Children 6 to <12 years: Dextromethorphan 5 to 10 mg with Guaifenesin 100 to 200 mg every 4 hours as needed

Children ≥12 years and Adolescents: Dextromethorphan 10 to 20 mg with Guaifenesin 200 to 400 mg every 4 hours as needed

Product-specific dosing:

Capsules, liquid filled: Dextromethorphan 10 mg and Guaifenesin 200 mg per capsule: Children ≥ 12 years and Adolescents: 1 to 2 capsules every 4 hours as needed

Granules: Dextromethorphan 5 mg and Guaifenesin 100 mg per packet:

Children 4 to <6 years: 1 packet every 4 hours as needed

Children 6 to 11 years: 1 to 2 packets every 4 hours as needed

Liquid/Solution/Syrup: Note: Multiple concentrations available; close attention must be paid. Refer to product specific labeling for approved pediatric ages.

Dextromethorphan 5 mg and Guaifenesin 100 mg per 5 mL:

Children 4 to <6 years: 2.5 to 5 mL every 4 hours as needed

Children 6 to <12 years: 5 to 10 mL every 4 hours as needed

Children ≥12 years and Adolescents: 10 to 20 mL every 4 hours as needed

Dextromethorphan 10 mg and Guaifenesin 100 mg per 5 mL:

Children 2 to <6 years: 2.5 mL every 4 hours as needed

Children 6 to <12 years: 5 mL every 4 hours as needed

Children ≥12 years and Adolescents: 10 mL every 4 hours as needed

Dextromethorphan 10 mg and Guaifenesin 200 mg per 5 mL: Children ≥12 years and Adolescents: 10 mL every 4 hours as needed

Dextromethorphan 10 mg and Guaifenesin 200 mg per 15 mL:

Children 6 to <12 years: 15 mL every 4 hours as needed

Children ≥12 years and Adolescents: 30 mL every 4 hours as needed.

Dextromethorphan 20 mg and Guaifenesin 400 mg per 5 mL: Children ≥ 12 years and Adolescents: 5 mL every 4 hours as needed

Tablet, extended release:

Dextromethorphan 30 mg and Guaifenesin 600 mg per tablet: Children ≥12 years and Adolescents: 1 to 2 tablets every 12 hours as needed; do not exceed 4 tablets in 24 hours

Dextromethorphan 60 mg and Guaifenesin 1,200 mg per tablet: Children ≥12 years and Adolescents: 1 tablet every 12 hours as needed; do not exceed 2 tablets in 24 hours

Tablet, immediate release: Dextromethorphan 20 mg and Guaifenesin 400 mg per tablet:

Children 6 to <12 years: 1/2 tablet every 4 hours as needed

Children ≥12 years and Adolescents: 1 tablet every 4 hours as needed

Dosing: Kidney Impairment: Pediatric

There are no dosage adjustments provided in the manufacturer's labeling. See individual agents.

Dosing: Hepatic Impairment: Pediatric

There are no dosage adjustments provided in the manufacturer's labeling. See individual agents.

Adverse Reactions

See individual agents.

Contraindications

OTC labeling: When used for self-medication, do not use with or within 14 days of stopping a monoamine oxidase inhibitor; children <12 years of age (product specific; refer to manufacturer's labeling).

Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Warnings/Precautions

Special populations:

• CYP2D6 poor metabolizers: Dextromethorphan is metabolized by hepatic CYP2D6. Poor metabolizers of CYP2D6 may have exaggerated or prolonged effects of dextromethorphan. Increased risk may be seen with concomitant use of potent CYP2D6 inhibitors; use with caution (Abduljalil 2010; Jurica 2012; Sager 2014; Zhou 2009).

• Debilitated patients: Use with caution in patients who are sedated, debilitated or confined to a supine position.

• Pediatric: Use with caution in atopic children. Not for OTC use in children <2 years of age.

Dosage form specific issues:

• Benzyl alcohol and derivatives: Some dosage forms may contain sodium benzoate/benzoic acid; benzoic acid (benzoate) is a metabolite of benzyl alcohol; large amounts of benzyl alcohol (≥99 mg/kg/day) have been associated with a potentially fatal toxicity (“gasping syndrome”) in neonates; the “gasping syndrome” consists of metabolic acidosis, respiratory distress, gasping respirations, CNS dysfunction (including convulsions, intracranial hemorrhage), hypotension, and cardiovascular collapse (AAP ["Inactive" 1997]; CDC 1982); some data suggests that benzoate displaces bilirubin from protein binding sites (Ahlfors 2001); avoid or use dosage forms containing benzyl alcohol derivative with caution in neonates. See manufacturer's labeling.

• Phenylalanine: Some products may contain phenylalanine.

Other warnings/precautions:

• Cough: Appropriate use: Underlying cause of cough should be determined prior to prescribing.

• Self-medication (OTC use): When used for self-medication (OTC), consult health care provider prior to use if you have persistent or chronic cough (associated with asthma, chronic obstructive pulmonary disease, emphysema, or smoking) and/or cough is accompanied by excessive phlegm (mucous). Discontinue use and contact health care provider if symptoms do not improve within 7 days, or are accompanied by fever, rash, or persistent headache.

Warnings: Additional Pediatric Considerations

Safety and efficacy for the use of cough and cold products in pediatric patients <4 years of age is limited; the AAP warns against the use of these products for respiratory illnesses in young children. Serious adverse effects including death have been reported. Many of these products contain multiple active ingredients, increasing the risk of accidental overdose when used with other products. The FDA does not recommend OTC uses for these products in pediatric patients <2 years of age and recommends to use with caution in pediatric patients ≥2 years of age. Health care providers are reminded to ask caregivers about the use of OTC cough and cold products in order to avoid exposure to multiple medications containing the same ingredient (AAP 2018; CDC 2007; FDA 2017; FDA 2018). Multiple concentrations of oral liquid formulations (drops, elixir, and liquid) exist; close attention must be paid to the concentration when ordering or administering.

Some dosage forms may contain propylene glycol; in neonates large amounts of propylene glycol delivered orally, intravenously (eg, >3,000 mg/day), or topically have been associated with potentially fatal toxicities which can include metabolic acidosis, seizures, renal failure, and CNS depression; toxicities have also been reported in children and adults including hyperosmolality, lactic acidosis, seizures, and respiratory depression; use caution (AAP 1997; Shehab 2009).

Dosage Forms: US

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Capsule, Oral:

Coricidin HBP Congestion/Cough: Guaifenesin 200 mg and dextromethorphan hydrobromide 10 mg [decongestant free; contains fd&c blue #1 (brilliant blue), fd&c red #40 (allura red ac dye)]

Mucinex Cough & Chest Congest: Guaifenesin 200 mg and dextromethorphan hydrobromide 10 mg [alcohol free, decongestant free, sodium free, sugar free; contains fd&c blue #1 (brilliant blue), quinoline yellow (d&c yellow #10)]

Robitussin Cough+Chest Cong DM: Guaifenesin 200 mg and dextromethorphan hydrobromide 10 mg [contains fd&c red #40 (allura red ac dye)]

Liquid, Oral:

Delsym Cgh/Chest Cong DM Child: Guaifenesin 100 mg and dextromethorphan hydrobromide 5 mg per 5 mL (118 mL) [contains edetate (edta) disodium, fd&c red #40 (allura red ac dye), propylene glycol, sodium benzoate; cherry flavor]

Delsym Cough/Chest Congest DM: Guaifenesin 100 mg and dextromethorphan hydrobromide 5 mg per 5 mL (180 mL) [contains edetate (edta) disodium, fd&c red #40 (allura red ac dye), propylene glycol, sodium benzoate; cherry flavor]

Diabetic Tussin DM: Guaifenesin 100 mg and dextromethorphan hydrobromide 10 mg per 5 mL (118 mL [DSC]) [alcohol free, codeine free, dye free, fructose free, sodium free, sorbitol free, sugar free; contains aspartame, menthol, methylparaben]

Diabetic Tussin Max St: Guaifenesin 200 mg and dextromethorphan hydrobromide 10 mg per 5 mL (118 mL [DSC], 237 mL [DSC]) [alcohol free, dye free, fructose free, sodium free, sorbitol free, sugar free]

FT Tussin DM Max Adult: Guaifenesin 100 mg and dextromethorphan hydrobromide 5 mg per 5 mL (118 mL) [alcohol free, gluten free; contains fd&c blue #1 (brilliant blue), fd&c red #40 (allura red ac dye), menthol, polyethylene glycol (macrogol), propylene glycol, sodium benzoate]

Geri-Tussin DM: Guaifenesin 100 mg and dextromethorphan hydrobromide 10 mg per 5 mL (473 mL) [alcohol free, sugar free; contains fd&c red #40 (allura red ac dye), menthol, methylparaben, propylene glycol, propylparaben; cherry flavor]

Guaiasorb DM: Guaifenesin 100 mg and dextromethorphan hydrobromide 10 mg per 5 mL (118 mL) [alcohol free, dye free, sugar free; contains menthol, methylparaben, propylene glycol, propylparaben; cherry flavor]

Guaiasorb DM: Guaifenesin 100 mg and dextromethorphan hydrobromide 10 mg per 5 mL (118 mL) [alcohol free, sugar free; contains menthol, methylparaben, propylene glycol, propylparaben; cherry flavor]

Guaiasorb DM: Guaifenesin 100 mg and dextromethorphan hydrobromide 10 mg per 5 mL (118 mL [DSC]) [alcohol free, sugar free; contains menthol, methylparaben, propylene glycol, saccharin sodium, sodium benzoate]

Max Tussin DM Cough&Chest Cong: Guaifenesin 100 mg and dextromethorphan hydrobromide 10 mg per 5 mL (118 mL, 236 mL, 473 mL) [alcohol free, dye free, gluten free; contains menthol, propylene glycol, saccharin sodium, sodium benzoate; cherry flavor]

Max Tussin DM Cough&Chest Cong: Guaifenesin 100 mg and dextromethorphan hydrobromide 10 mg per 5 mL (118 mL, 236 mL, 473 mL) [alcohol free, dye free, gluten free, sugar free; contains menthol, propylene glycol, saccharin sodium, sodium benzoate; cherry flavor]

Maxi-Tuss G: Guaifenesin 100 mg and dextromethorphan hydrobromide 10 mg per 5 mL (473 mL) [alcohol free, dye free, sugar free; contains methylparaben, propylene glycol, propylparaben]

Maxi-Tuss GMX: Guaifenesin 200 mg and dextromethorphan hydrobromide 10 mg per 5 mL (473 mL) [alcohol free, dye free, sugar free; contains methylparaben, propylene glycol, propylparaben]

Mucinex Childrens Freefrom: Guaifenesin 100 mg and dextromethorphan hydrobromide 5 mg per 5 mL (118 mL [DSC]) [alcohol free, caffeine free, dye free, no artificial color(s), no artificial flavor(s), sugar free; contains edetate (edta) disodium, glycerin (soy), propylene glycol, sodium benzoate]

Mucinex Cough Childrens: Guaifenesin 100 mg and dextromethorphan hydrobromide 5 mg per 5 mL (118 mL) [contains edetate (edta) disodium, fd&c red #40 (allura red ac dye), propylene glycol, sodium benzoate; cherry flavor]

Mucinex Cough Childrens: Guaifenesin 100 mg and dextromethorphan hydrobromide 5 mg per 5 mL (118 mL [DSC]) [alcohol free; contains edetate (edta) disodium, fd&c red #40 (allura red ac dye), propylene glycol, sodium benzoate; cherry flavor]

Mucinex Fast-Max DM Max: Guaifenesin 100 mg and dextromethorphan hydrobromide 5 mg per 5 mL (180 mL) [contains edetate (edta) disodium, glycerin (soy), propylene glycol, sodium benzoate]

Mucinex Fast-Max DM Max: Guaifenesin 100 mg and dextromethorphan hydrobromide 5 mg per 5 mL (180 mL) [contains fd&c red #40 (allura red ac dye), propylene glycol, saccharin sodium, sodium benzoate]

Mucinex Fast-Max DM Max: Guaifenesin 400 mg and dextromethorphan hydrobromide 20 mg per 20 mL (180 mL) [contains fd&c red #40, methylparaben, propylene glycol, propylparaben, saccharin sodium]

Mucus Relief Cough Childrens: Guaifenesin 100 mg and dextromethorphan hydrobromide 5 mg per 5 mL (118 mL) [alcohol free; contains fd&c red #40 (allura red ac dye), propylene glycol, saccharin sodium, sodium benzoate]

NeoTuss: Guaifenesin 200 mg and dextromethorphan hydrobromide 30 mg per 5 mL (474 mL) [alcohol free, antihistamine free, codeine free, dye free, sodium free, sugar free; contains menthol, methylparaben, propylene glycol, propylparaben; grape menthol flavor]

Robafen DM: Guaifenesin 200 mg and dextromethorphan hydrobromide 20 mg per 20 mL (118 mL, 237 mL) [contains fd&c red #40 (allura red ac dye), propylene glycol, sodium benzoate; raspberry flavor]

Robafen DM Cgh/Chest Congest: Guaifenesin 100 mg and dextromethorphan hydrobromide 10 mg per 5 mL (118 mL [DSC]) [gluten free; contains fd&c red #40 (allura red ac dye), menthol, propylene glycol, sodium benzoate]

Robafen DM Cough: Guaifenesin 100 mg and dextromethorphan hydrobromide 10 mg per 5 mL (473 mL [DSC]) [alcohol free; contains fd&c red #40 (allura red ac dye), menthol, propylene glycol, sodium benzoate]

Robafen DM Cough: Guaifenesin 100 mg and dextromethorphan hydrobromide 10 mg per 5 mL (237 mL [DSC]) [alcohol free; contains fd&c red #40 (allura red ac dye), menthol, propylene glycol, sodium benzoate; cherry flavor]

Robafen DM Cough: Guaifenesin 100 mg and dextromethorphan hydrobromide 10 mg per 5 mL (118 mL [DSC]) [gluten free, sugar free; contains aspartame, benzoic acid, menthol, polyethylene glycol (macrogol)]

Robafen DM Peak Cold Cgh/Cong: Guaifenesin 100 mg and dextromethorphan hydrobromide 10 mg per 5 mL (118 mL [DSC]) [dye free, sugar free; contains menthol, methylparaben, polyethylene glycol (macrogol), saccharin sodium, sodium benzoate]

Robitussin Cold Cough+ Chest: Guaifenesin 100 mg and dextromethorphan hydrobromide 10 mg per 5 mL (118 mL [DSC], 237 mL [DSC]) [contains fd&c red #40 (allura red ac dye), menthol, propylene glycol, sodium benzoate]

Robitussin Cough+Chest Cong DM: Guaifenesin 200 mg and dextromethorphan hydrobromide 20 mg per 20 mL (118 mL, 237 mL) [contains fd&c blue #1 (brill blue) aluminum lake, fd&c red #40 (allura red ac dye), menthol, polyethylene glycol (macrogol), propylene glycol, sodium benzoate; raspberry flavor]

Robitussin Cough+Chest Cong DM: Guaifenesin 100 mg and dextromethorphan hydrobromide 5 mg per 5 mL (118 mL, 237 mL, 355 mL) [contains fd&c blue #1 (brilliant blue), fd&c red #40 (allura red ac dye), menthol, polyethylene glycol (macrogol), propylene glycol, sodium benzoate; berry flavor]

Robitussin Cough+Chest Cong DM: Guaifenesin 200 mg and dextromethorphan hydrobromide 20 mg per 20 mL (118 mL) [contains fd&c blue #1 (brilliant blue), fd&c red #40 (allura red ac dye), polyethylene glycol (macrogol), propylene glycol, sodium benzoate; grape flavor]

Robitussin Cough+Chest Cong DM: Guaifenesin 100 mg and dextromethorphan hydrobromide 5 mg per 5 mL (118 mL, 237 mL) [contains polyethylene glycol (macrogol), propylene glycol, sodium benzoate]

Robitussin Cough+Chest Cong DM: Guaifenesin 200 mg and dextromethorphan hydrobromide 20 mg per 20 mL (118 mL) [dye free, sugar free; contains menthol, polyethylene glycol (macrogol), propylene glycol, sodium benzoate; menthol flavor]

Robitussin Honey Cgh/Chest DM: Guaifenesin 200 mg and dextromethorphan hydrobromide 20 mg per 20 mL (118 mL) [contains polyethylene glycol (macrogol), propylene glycol, sodium benzoate]

Safe Tussin DM: Guaifenesin 100 mg and dextromethorphan hydrobromide 10 mg per 5 mL (120 mL [DSC]) [alcohol free, dye free, gluten free, sugar free; contains aspartame, benzoic acid, menthol, methylparaben, propylene glycol, propylparaben]

Siltussin DM DAS: Guaifenesin 100 mg and dextromethorphan hydrobromide 10 mg per 5 mL (118 mL) [alcohol free, dye free, sugar free; strawberry flavor]

Tussin Cough+Chest Cong DM SF: Guaifenesin 100 mg and dextromethorphan hydrobromide 10 mg per 5 mL (118 mL [DSC], 236 mL [DSC], 473 mL [DSC]) [alcohol free, dye free, gluten free, sugar free; contains menthol, saccharin sodium, sodium benzoate]

Tussin Cough+Chest Congest DM: Guaifenesin 100 mg and dextromethorphan hydrobromide 10 mg per 5 mL (118 mL [DSC], 236 mL [DSC], 473 mL [DSC]) [alcohol free, dye free, gluten free; contains menthol, saccharin sodium, sodium benzoate]

Tussin DM Max: Guaifenesin 100 mg and dextromethorphan hydrobromide 5 mg per 5 mL (237 mL) [alcohol free; contains fd&c blue #1 (brilliant blue), fd&c red #40 (allura red ac dye), menthol, methylparaben, propylene glycol, propylparaben]

Vanacof XP: Guaifenesin 396 mg and dextromethorphan 18 mg/15 mL (237 mL) [alcohol free, dye free, gluten free, sugar free; contains menthol, propylene glycol, sodium benzoate; raspberry mint flavor]

Generic: Guaifenesin 100 mg and dextromethorphan hydrobromide 10 mg per 5 mL (5 mL, 10 mL); Guaifenesin 100 mg and dextromethorphan hydrobromide 5 mg per 5 mL (5 mL)

Packet, Oral:

Mucinex Childrens: Guaifenesin 100 mg and dextromethorphan hydrobromide 5 mg per packet (12 ea) [contains aspartame; orange cream flavor]

Mucinex Cough For Kids: Guaifenesin 100 mg and dextromethorphan hydrobromide 5 mg per packet (12s) [contains magnesium 6 mg/pack, phenylalanine 2 mg/packet, sodium 3 mg/packet; orange crème flavor] (12 ea [DSC]) [contains aspartame; orange cream flavor]

Syrup, Oral:

Altarussin DM: Guaifenesin 100 mg and dextromethorphan hydrobromide 10 mg per 5 mL (120 mL, 240 mL, 480 mL, 3840 mL)

Chest Congestion Relief DM: Guaifenesin 100 mg and dextromethorphan hydrobromide 10 mg per 5 mL (473 mL) [alcohol free; contains fd&c red #40 (allura red ac dye), methylparaben, propylene glycol, propylparaben]

Cough & Chest Congestion DM: Guaifenesin 50 mg and dextromethorphan hydrobromide 5 mg per 5 mL (118 mL) [contains fd&c red #40 (allura red ac dye), propylene glycol, sodium benzoate; raspberry flavor]

Cough/Chest Congestion DM: Guaifenesin 100 mg and dextromethorphan hydrobromide 10 mg per 5 mL (118 mL [DSC]) [gluten free; contains fd&c red #40 (allura red ac dye), menthol, propylene glycol, sodium benzoate; cherry flavor]

Extra Action Cough: Guaifenesin 100 mg and dextromethorphan hydrobromide 10 mg per 5 mL (473 mL [DSC]) [contains fd&c red #40 (allura red ac dye), menthol, propylene glycol, sodium benzoate]

Geri-Tussin DM: Guaifenesin 100 mg and dextromethorphan hydrobromide 10 mg per 5 mL (473 mL) [alcohol free; contains fd&c red #40 (allura red ac dye), methylparaben, propylene glycol, propylparaben]

Guaicon DMS: Guaifenesin 100 mg and dextromethorphan hydrobromide 10 mg per 5 mL (10 mL [DSC]) [sugar free]

Robitussin Peak Cold DM: Guaifenesin 100 mg and dextromethorphan hydrobromide 10 mg per 5 mL (118 mL [DSC]) [alcohol free, sugar free; contains methylparaben, polyethylene glycol (macrogol), propylene glycol, saccharin sodium, sodium benzoate]

Siltussin-DM Alcohol Free: Guaifenesin 100 mg and dextromethorphan hydrobromide 10 mg per 5 mL (118 mL [DSC], 237 mL [DSC], 473 mL [DSC]) [alcohol free; strawberry flavor]

Tussin DM: Guaifenesin 100 mg and dextromethorphan hydrobromide 10 mg per 5 mL (118 mL, 237 mL [DSC]) [alcohol free]

Generic: Guaifenesin 100 mg and dextromethorphan hydrobromide 10 mg per 5 mL (5 mL, 10 mL, 237 mL)

Tablet, Oral:

Chest Congestion Relief DM: Guaifenesin 400 mg and dextromethorphan hydrobromide 20 mg

Fenesin DM IR: Guaifenesin 400 mg and dextromethorphan hydrobromide 20 mg

FT Chest Congestion Relief DM: Guaifenesin 400 mg and dextromethorphan hydrobromide 20 mg [dye free]

GoodSense Mucus Relief DM: Guaifenesin 400 mg and dextromethorphan hydrobromide 20 mg [DSC] [dye free, gluten free]

Mucosa DM: Guaifenesin 400 mg and dextromethorphan hydrobromide 20 mg [DSC]

MucusRelief DM Cough: Guaifenesin 400 mg and dextromethorphan hydrobromide 20 mg [DSC] [contains quinoline (d&c yellow #10) aluminum lake]

Pharbinex-DM: Guaifenesin 400 mg and dextromethorphan hydrobromide 20 mg

Refenesen DM: Guaifenesin 400 mg and dextromethorphan hydrobromide 20 mg [scored; dye free]

Generic: Guaifenesin 400 mg and dextromethorphan hydrobromide 20 mg

Tablet Extended Release 12 Hour, Oral:

FT Mucus Relief DM: Guaifenesin 600 mg and dextromethorphan hydrobromide 30 mg, Guaifenesin 1200 mg and dextromethorphan hydrobromide 60 mg [contains quinoline (d&c yellow #10) aluminum lake]

Mucinex DM: Guaifenesin 600 mg and dextromethorphan hydrobromide 30 mg [contains quinoline (d&c yellow #10) aluminum lake]

Mucinex DM Maximum Strength: Guaifenesin 1200 mg and dextromethorphan hydrobromide 60 mg [contains quinoline (d&c yellow #10) aluminum lake]

Mucus Relief DM: Guaifenesin 600 mg and dextromethorphan hydrobromide 30 mg [contains quinoline (d&c yellow #10) aluminum lake]

Mucus Relief DM Max: Guaifenesin 1200 mg and dextromethorphan hydrobromide 60 mg [contains quinoline (d&c yellow #10) aluminum lake]

Generic: Guaifenesin 1200 mg and dextromethorphan hydrobromide 60 mg

Generic Equivalent Available: US

May be product dependent

Pricing: US

Capsules (Mucinex Cough & Chest Congest Oral)

10-200 mg (per each): $0.93

Capsules (Robitussin Cough+Chest Cong DM Oral)

10-200 mg (per each): $0.31

Liquid (Delsym Cgh/Chest Cong DM Child Oral)

5-100 mg/5 mL (per mL): $0.09

Liquid (Delsym Cough/Chest Congest DM Oral)

5-100 mg/5 mL (per mL): $0.07

Liquid (Dextromethorphan-guaiFENesin Oral)

5-100 mg/5 mL (per mL): $0.44

10-100 mg/5 mL (per mL): $0.50

Liquid (Giltuss Cough & Chest Children Oral)

10-100 mg/5 mL (per mL): $0.06

Liquid (Giltuss Cough & Chest Oral)

20-200 mg/10 mL (per mL): $0.06

Liquid (Giltuss Diabetic Cough & Cold Oral)

10-100 mg/5 mL (per mL): $0.06

Liquid (Giltuss Honey Cgh/Chest Conges Oral)

20-200 mg/10 mL (per mL): $0.06

Liquid (Giltuss Honey Cgh/Chst Child Oral)

10-100 mg/5 mL (per mL): $0.06

Liquid (Max Tussin DM Cough&Chest Cong Oral)

20-200 mg/10 mL (per mL): $0.02

Liquid (Mucinex Cough Childrens Oral)

5-100 mg/5 mL (per mL): $0.09

Liquid (Mucinex Fast-Max DM Max Oral)

20-400 mg/20 mL (per mL): $0.07

Liquid (Pecgen DMX Oral)

10-187 mg/5 mL (per mL): $0.02

Liquid (Robafen DM Oral)

20-200 mg/20 mL (per mL): $0.02

Liquid (Robitussin Cough+Chest Cong DM Oral)

20-200 mg/20 mL (per mL): $0.05

20-400 mg/20 mL (per mL): $0.06

Liquid (Robitussin Honey Cgh/Chest DM Oral)

20-200 mg/20 mL (per mL): $0.05

Liquid (Sorbugen NR Oral)

15-150 mg/7.5 mL (per mL): $0.02

Liquid (Vanacof XP Oral)

18-396 mg/15 mL (per mL): $0.12

Pack (Mucinex Childrens Oral)

5-100 mg (per each): $0.85

Syrup (Dextromethorphan-guaiFENesin Oral)

10-100 mg/5 mL (per mL): $0.34 - $0.50

Syrup (G-Zyncof Oral)

20-400 mg/5 mL (per mL): $0.02

Syrup (Zyncof Oral)

20-400 mg/5 mL (per mL): $0.11

Tablet, 12-hour (DM-guaiFENesin ER Oral)

60-1200 mg (per each): $0.74

Tablet, 12-hour (Mucinex DM Maximum Strength Oral)

60-1200 mg (per each): $1.14

Tablet, 12-hour (Mucinex DM Oral)

30-600 mg (per each): $0.63

Tablets (Dextromethorphan-guaiFENesin Oral)

20-400 mg (per each): $0.09

Tablets (Fenesin DM IR Oral)

20-400 mg (per each): $0.13

Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.

Administration: Adult

Oral: Administer with water. Do not crush or chew ER or long acting formulations. Do not chew granules. Only use dosing cup provided with liquid formulations.

Bariatric surgery: Tablet, extended release: Some institutions may have specific protocols that conflict with these recommendations; refer to institutional protocols as appropriate. Switch to IR tablet, capsule, or oral solution.

Administration: Pediatric

Oral: Administer without regard to meals, with a large quantity of fluid to ensure proper effect; do not crush, chew, or break extended release tablets.

Use: Labeled Indications

Cough (antitussive/expectorant): Temporary control of cough due to minor throat and bronchial irritation associated with the common cold or inhaled irritants; help loosen phlegm (mucus) and thin bronchial secretions to make coughs more productive; temporary relief of coughing intensity and cough impulse to help fall asleep.

Medication Safety Issues
Sound-alike/look-alike issues:

Benylin may be confused with Benadryl, Ventolin

Mucinex DM may be confused with Mucinex D

Metabolism/Transport Effects

Refer to individual components.

Drug Interactions

Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the Lexicomp drug interactions program by clicking on the “Launch drug interactions program” link above.

Ajmaline: May increase the serum concentration of CYP2D6 Substrates (High risk with Inhibitors). Risk C: Monitor therapy

Artemether and Lumefantrine: May increase the serum concentration of CYP2D6 Substrates (High risk with Inhibitors). Risk C: Monitor therapy

CYP2D6 Inhibitors (Moderate): May increase the serum concentration of Dextromethorphan. Risk C: Monitor therapy

CYP2D6 Inhibitors (Strong): May increase the serum concentration of Dextromethorphan. Risk C: Monitor therapy

Disulfiram: May enhance the adverse/toxic effect of Products Containing Ethanol. Management: Do not use disulfiram with dosage forms that contain ethanol. Risk X: Avoid combination

Memantine: NMDA Receptor Antagonists may enhance the adverse/toxic effect of Memantine. Risk C: Monitor therapy

Methotrimeprazine: Products Containing Ethanol may enhance the adverse/toxic effect of Methotrimeprazine. Specifically, a disulfiram-like reaction may occur and CNS depressant effects may be increased. Management: Avoid products containing alcohol in patients treated with methotrimeprazine. Risk X: Avoid combination

Monoamine Oxidase Inhibitors: Dextromethorphan may enhance the serotonergic effect of Monoamine Oxidase Inhibitors. This may cause serotonin syndrome. Risk X: Avoid combination

Ornidazole: May enhance the adverse/toxic effect of Products Containing Ethanol. Specifically, a disulfiram-like reaction may occur. Risk X: Avoid combination

Parecoxib: May increase the serum concentration of Dextromethorphan. Risk C: Monitor therapy

Peginterferon Alfa-2b: May decrease the serum concentration of CYP2D6 Substrates (High risk with Inhibitors). Peginterferon Alfa-2b may increase the serum concentration of CYP2D6 Substrates (High risk with Inhibitors). Risk C: Monitor therapy

Secnidazole: Products Containing Ethanol may enhance the adverse/toxic effect of Secnidazole. Risk X: Avoid combination

Selective Serotonin Reuptake Inhibitors (Strong CYP2D6 Inhibitors): Dextromethorphan may enhance the serotonergic effect of Selective Serotonin Reuptake Inhibitors (Strong CYP2D6 Inhibitors). This could result in serotonin syndrome. Selective Serotonin Reuptake Inhibitors (Strong CYP2D6 Inhibitors) may increase the serum concentration of Dextromethorphan. Management: Consider alternatives to this drug combination. The dose of dextromethorphan/bupropion product should not exceed 1 tablet once daily. Monitor for signs and symptoms of serotonin syndrome/serotonin toxicity. Risk D: Consider therapy modification

Serotonergic Agents (High Risk): Dextromethorphan may enhance the serotonergic effect of Serotonergic Agents (High Risk). This could result in serotonin syndrome. Management: Monitor for signs and symptoms of serotonin syndrome/serotonin toxicity (eg, hyperreflexia, clonus, hyperthermia, diaphoresis, tremor, autonomic instability, mental status changes) when these agents are combined. Risk C: Monitor therapy

Pregnancy Considerations

Refer to individual monographs.

Breastfeeding Considerations

Refer to individual monographs.

Dietary Considerations

Some products may contain phenylalanine and/or sodium.

Mechanism of Action

Guaifenesin is thought to act as an expectorant by irritating the gastric mucosa and stimulating respiratory tract secretions, thereby increasing respiratory fluid volumes and decreasing phlegm viscosity

Dextromethorphan is a chemical relative of morphine lacking opioid properties except in overdose; controls cough by depressing the medullary cough center

Pharmacokinetics (Adult Data Unless Noted)

See individual agents.

Brand Names: International
International Brand Names by Country
For country code abbreviations (show table)

  • (AE) United Arab Emirates: Cheracol d | Mucinex cough & chest congestion;
  • (BD) Bangladesh: Dexotix | Dexpoten;
  • (BE) Belgium: Acatar;
  • (BR) Brazil: Vick xarope | Xarope 44e;
  • (CI) Côte d'Ivoire: Tussidex Enfant;
  • (CN) China: Compound dextromethorphan hydrobromide | Dextromethorphan hydrobromide and guaifenesin | Field | Guaifenesin and dextromethorphan hydrobromide | Hua fen | Hui fei xuan | Ke li ting | Ke tan | Li fan you | Robitussin xuan | Su li | Yu mei | Zai shun;
  • (CO) Colombia: Asobroncol nf | Broncopec | Bronquisol forte | Canadiol dm pediatrico | Coricidin ex | Diretos | Dristan | Guayacerol | Guayadex | Metrotox | Noglupec | Notusin infantil | Passytos | Robitussin forte | Tukol d | Tussinar;
  • (DO) Dominican Republic: Broncochem Contra la Tos | Vick formula 44e | Vick vaporub;
  • (EC) Ecuador: Broncoxpec | Diabetussin | Formula 44 | Notusin | Robitussin dm | Tussolvina | Tussolvina fit;
  • (EG) Egypt: Bronchotec | Bronchtec | Guaiadesca | Robitussin dm | Vicksolytic;
  • (ES) Spain: Benylin expectorante;
  • (GB) United Kingdom: Mucinex cough;
  • (HK) Hong Kong: Bronpect-d | Decaugh | Dexsin | Dextro G G | Robitussin dm | Vida Tussin-DM;
  • (ID) Indonesia: Dextrofort | Yekadex;
  • (IL) Israel: Alcinal plus | Robitussin dm;
  • (IN) India: Alkof-cofgel | Cledex sf;
  • (IT) Italy: Bronchenolo sedativo e fluidificante | Resyl dm | Tossemed iodosan;
  • (KR) Korea, Republic of: Coughstop;
  • (MX) Mexico: Bectosan | Bekesina | Bekidiba | Bre-a-col | Broncomed | Cheracol d | Debequin c | Derofen miel | Desenfrio tf | Desenfriol ito tf | Dextrometorfano and guaifenesina | Dextrometorfano and guaifenesina landsteiner | Exiadol | Histiacil g | Megal | Neopulmonier fournier | Palmoxan | Robitussin dm | Surdril | Tromefen | Tukol d | Vick-44 | Willydina;
  • (NG) Nigeria: Blokof adult;
  • (PE) Peru: Antitusin expectorante | Atos expectorante | Bentox composite | Benylin expectorante | Broncopulmin | Broncovet | Cheracol d | Comtrex dx | Dextro toss | Dextro toss total | Dolatos F | Farmabron expectorante | Fleytos | Meditos | Mentholatum e | Mucobrol | Nastiler | Robitussin dm | Teratos | Tossair | Tukol d | Tukol miel | Tussfedrin | Tussis om expectorante | Vick formula 44e | Wellplex;
  • (PH) Philippines: Flemex | Mucotrol | Mucotuss | Nytin;
  • (PK) Pakistan: Alpotussin dm | Expectorant;
  • (PR) Puerto Rico: Albatussin dm | Alka seltzer plus mucus & congestion | Altarussin dm | Amibid dm | Aquabid-dm | Aquatab DM | Bidex dm | Bidex-A | Broncotron | Cheracol d | Congesta DM | Coricidin hbp chest congestion and cold | Delsym cough+ chest congestion DM | Dex gg | Diabetic tussin dm | Dm/guai adult | Double Tussin DM | Duraganidin dm | Fenesin dm | Fenesin DM Ir | G Tron | G Zyncof | G-bid dm | Gani-tuss dm nr | Gfn/dm | Guaicon dm | Guaicon dms | Guaifenesin & dextromethorpane hbr | Guaifenesin and dextromethorphan hydrobromide | Guaifenex dm | Guia-d | Guiadrine dm | Guiatuss dm | Humibid cs | Humibid dm | Humigen dm | Hydro-tussin dm | Iobid dm | Mindal DM | Mintab dm | Monafed DM | Mucinex cough & chest congestion | Mucinex dm | Muco-fen 800 dm | Muco-fen dm | Mucosa DM | Mucus relief dm cough | Mytussin dm | Naldecon senior dx | Numobid DX | Pecgen DMX | Pharbinex dm | Q-bid dm | Robafen dm | Robafen DM Clear | Siltussin dm | Sorbutuss | Tussi-bid | Tussin cough & chest congestion dm | Tussin dm | Zyncof;
  • (PY) Paraguay: Broncotos nf expectorante;
  • (RU) Russian Federation: Tussin plus;
  • (SA) Saudi Arabia: Contra | Guaphan dm | Robitussin dm;
  • (SG) Singapore: Robitussin dm;
  • (SV) El Salvador: Sudagrip balsamico;
  • (TH) Thailand: Gentussin | Robitussin dm | Rodica | Tussicare dg | Tussicon | Tussidon dg | Utussin | Vicks formula 44 e;
  • (TW) Taiwan: Coslan | Decofen | Dextrolamine | Kofeifei | Menicouso | Robitussin dm | Sodicon g | Teinhsien cogen | Uncola;
  • (UA) Ukraine: Tussin plus;
  • (VE) Venezuela, Bolivarian Republic of: Robitessin dm | Robitussin cough+chest congestion dm | Vick
  1. Abduljalil K, Frank D, Gaedigk A, et al. Assessment of activity levels for CYP2D6*1, CYP2D6*2, and CYP2D6*41 genes by population pharmacokinetics of dextromethorphan. Clin Pharmacol Ther. 2010;88(5):643-651. doi: 10.1038/clpt.2010.137 [PubMed 20881950]
  2. Ahlfors CE. Benzyl alcohol, kernicterus, and unbound bilirubin. J Pediatr. 2001;139(2):317-319. [PubMed 11487763]
  3. American Academy of Pediatrics (AAP). Cough and cold medicines should not be prescribed, recommended or used for respiratory illnesses in young children. Updated June 12, 2018. Available at http://www.choosingwisely.org/clinician-lists/american-academy-pediatrics-cough-and-cold-medicines-for-children-under-four/
  4. American Academy of Pediatrics Committee on Drugs. "Inactive" ingredients in pharmaceutical products: update (subject review). Pediatrics. 1997;99(2):268-278. [PubMed 9024461]
  5. Centers for Disease Control (CDC). Neonatal deaths associated with use of benzyl alcohol—United States. MMWR Morb Mortal Wkly Rep. 1982;31(22):290-291. http://www.cdc.gov/mmwr/preview/mmwrhtml/00001109.htm [PubMed 6810084]
  6. Centers for Disease Control and Prevention (CDC). Infant deaths associated with cough and cold medications--two states, 2005. MMWR Morb Mortal Wkly Rep. 2007;56(1):1-4. [PubMed 17218934]
  7. Chest Congestion Relief DM (dextromethorphan hydrobromide and guaifenesin) [prescribing information]. Livonia, MI: Rugby Laboratories; August 2020.
  8. Children's Mucinex Mini-Melts Cough (dextromethorphan hydrobromide and guaifenesin) [prescribing information]. Parsippany, NJ: Reckitt Benckiser; accessed June 2022.
  9. Food and Drug Administration (FDA). Most young children with a cough or cold don't need medicines. July 18, 2017. Available at https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm422465.htm. Last accessed November 2, 2018.
  10. Food and Drug Administration (FDA). Use caution when giving cough and cold products to kids. Updated February 8, 2018. Available at https://www.fda.gov/drugs/resourcesforyou/specialfeatures/ucm263948.htm. Last accessed November 2, 2018.
  11. Jurica J, Bartecek R, Zourkova A, et al. Serum dextromethorphan/dextrorphan metabolic ratio for CYP2D6 phenotyping in clinical practice. J Clin Pharm Ther. 2012;37(4):486-490. doi:10.1111/j.1365-2710.2012.01333.x [PubMed 22548589]
  12. Maxi-Tuss G (dextromethorphan and guaifenesin) [prescribing information]. Brooksville, FL: MCR American Pharmaceuticals, Inc; May 2020.
  13. Maxi-Tuss GMX (dextromethorphan and guaifenesin) [prescribing information]. Brooksville, FL: MCR American Pharmaceuticals Inc; May 2020.
  14. MaxTussin DM Cough and Chest Congestion (guaifenesin and dextromethorphan) [prescribing information]. Fairfield, NJ: Akron Pharma Inc; received May 2023.
  15. Mucinex DM (dextromethorphan hydrobromide and guaifenesin) [prescribing information]. Parsippany, NJ: Reckitt Benckiser Health (US); received April 2019.
  16. Mucinex DM Maximum Strength (dextromethorphan hydrobromide and guaifenesin) [prescribing information]. Parsippany, NJ: RB Health (US); received September 2019.
  17. Mucinex Fast Max DM Max (dextromethorphan hydrobromide and guaifenesin) [prescribing information]. Parsippany, NJ: RB Health (US); January 2020.
  18. Robitussin (guaifenesin and dextromethorphan) [prescribing information]. Madison, NJ: Pfizer; received June 2017.
  19. Sager JE, Lutz JD, Foti RS, et al. Fluoxetine- and norfluoxetine-mediated complex drug-drug interactions: in vitro to in vivo correlation of effects on CYP2D6, CYP2C19, and CYP3A4. Clin Pharmacol Ther. 2014;95(6):653-662. doi: 10.1038/clpt.2014.50 [PubMed 24569517]
  20. Shehab N, Lewis CL, Streetman DD, Donn SM. Exposure to the pharmaceutical excipients benzyl alcohol and propylene glycol among critically ill neonates. Pediatr Crit Care Med. 2009;10(2):256-259. [PubMed 19188870]
  21. Zhou SF. Polymorphism of human cytochrome P450 2D6 and its clinical significance: part II. Clin Pharmacokinet. 2009;48(12):761-804. doi:10.2165/11318070 [PubMed 19902987]
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