Version May 2024
Also refer to specific product labeling.
Cough/decongestant: Oral:
Liquid:
Mucinex Fast-Max Congest Cough: Guaifenesin 400 mg, dextromethorphan 20 mg, and phenylephrine 10 mg per 20 mL: 20 mL every 4 hours (maximum: 120 mL per 24 hours).
Robitussin Peak Cold Multi-Symptom Cold: Guaifenesin 200 mg, dextromethorphan 20 mg, and phenylephrine 10 mg per 10 mL: 10 mL every 4 hours (maximum: 60 mL per 24 hours).
Tablet:
Deconex DMX: Guaifenesin 400 mg, dextromethorphan 17.5 mg, and phenylephrine 10 mg per tablet: One tablet every 4 hours (maximum: 6 tablets per 24 hours).
Mucinex Fast-Max Congest Cough: Guaifenesin 200 mg, dextromethorphan 10 mg, and phenylephrine 5 mg per tablet: Two tablets every 4 hours (maximum: 12 tablets per 24 hours).
There are no dosage adjustments provided in the manufacturer's labeling.
There are no dosage adjustments provided in the manufacturer's labeling.
Refer to adult dosing.
Also refer to specific product labeling.
Cough/decongestant: Oral:
Tablet:
Children 6 to 11 years (Deconex DMX): Guaifenesin 192.5 mg, dextromethorphan 8.75 mg, and phenylephrine 5 mg (1/2 tablet) every 4 hours; maximum: 3 tablets/24 hours.
Children ≥12 years and Adolescents: Refer to adult dosing.
Liquid (OTC labeling):
Children 4 to 5 years (Mucinex Children's Congestion & Cough): Oral: Guaifenesin 100 mg, dextromethorphan 5 mg, and phenylephrine 2.5 mg (5 mL) every 4 hours, not to exceed 30 mL/24 hours.
Children 6 to 11 years (Mucinex Children's Congestion & Cough): Oral: Guaifenesin 200 mg, dextromethorphan 10 mg, and phenylephrine 5 mg (10 mL) every 4 hours, not to exceed 60 mL/24 hours.
Children ≥12 years and Adolescents (Robitussin Peak Cold Multi-Symptom Cold): Refer to adult dosing.
There are no dosage adjustments provided in the manufacturer's labeling.
There are no dosage adjustments provided in the manufacturer's labeling.
The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified. Frequency not defined. The following adverse events have been reported with the combination product. Also see individual agents.
Cardiovascular: Circulatory shock, palpitations, tachycardia
Central nervous system: Anxiety, central nervous system depression, convulsions, dizziness, drowsiness, excitability, fear, hallucination, headache, insomnia, irritability, nervousness
Gastrointestinal: Nausea, vomiting
Neuromuscular & skeletal: Tremor, weakness
Respiratory: Dyspnea
OTC labeling: When used for self-medication, do not exceed recommended dose, do not use with or within 14 days of stopping a monoamine oxidase inhibitor (MAOI), and do not use in 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.
Special populations:
• Debilitated patients: Use with caution in debilitated, sedated and/or patients confined to the supine position.
• 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).
• Older adult: Use with caution in the elderly; may be more sensitive to adverse effects.
• Pediatric: Use with caution in atopic children.
Other warnings/precautions:
• Cough: Appropriate use: Underlying cause of cough should be determined prior to prescribing. Re-evaluate if cough persists >7 days.
• 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), cough is accompanied by excessive phlegm (mucous), heart disease, high BP, thyroid disease, diabetes, and/or trouble urinating due to an enlarged prostate gland. Discontinue use and contact health care provider if new symptoms occur, do not improve within 7 days, or are accompanied by fever, rash, or persistent headache, or if nervousness, dizziness, or sleeplessness occur.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product
Liquid, Oral:
FT Tussin CF Adult: Guaifenesin 100 mg, dextromethorphan hydrobromide 10 mg, and phenylephrine hydrochloride 5 mg per 5 mL (237 mL) [contains fd&c red #40 (allura red ac dye), menthol, propylene glycol, sodium benzoate]
GoodSense Mucus Relief Child: Guaifenesin 100 mg, dextromethorphan hydrobromide 5 mg, and phenylephrine hydrochloride 2.5 mg per 5 mL (118 mL) [gluten free; contains edetate (edta) disodium, fd&c red #40 (allura red ac dye), propylene glycol, sodium benzoate, sorbitol]
GoodSense Mucus/Congest/Cough: Guaifenesin 100 mg, dextromethorphan hydrobromide 5 mg, and phenylephrine hydrochloride 2.5 mg per 5 mL (177 mL) [contains disodium edta, fd&c blue #1 (brilliant blue), fd&c red #40 (allura red ac dye), propylene glycol, sodium benzoate, sorbitol]
Mucinex Childrens Freefrom: Guaifenesin 100 mg, dextromethorphan hydrobromide 5 mg, and phenylephrine hydrochloride 2.5 mg per 5 mL (118 mL) [alcohol free, caffeine free, dye free, no artificial color(s), no artificial flavor(s), sugar free; contains disodium edta, glycerin (soy), propylene glycol, sodium benzoate]
Mucinex Cold Childrens: Guaifenesin 100 mg, dextromethorphan hydrobromide 5 mg, and phenylephrine hydrochloride 2.5 mg per 5 mL (118 mL [DSC]) [contains edetate (edta) disodium, fd&c red #40 (allura red ac dye), propylene glycol, sodium benzoate]
Mucinex Cold Childrens: Guaifenesin 100 mg, dextromethorphan hydrobromide 5 mg, and phenylephrine hydrochloride 2.5 mg per 5 mL (118 mL, 201 mL) [contains edetate (edta) disodium, fd&c red #40 (allura red ac dye), propylene glycol, sodium benzoate; berry flavor]
Mucinex Congest & Cough Child: Guaifenesin 100 mg, dextromethorphan hydrobromide 5 mg, and phenylephrine hydrochloride 2.5 mg per 5 mL (201 mL [DSC]) [contains edetate (edta) disodium, fd&c red #40 (allura red ac dye), propylene glycol, sodium benzoate]
Mucinex Cough & Congest Child: Guaifenesin 100 mg, dextromethorphan hydrobromide 5 mg, and phenylephrine hydrochloride 2.5 mg per 5 mL (201 mL) [contains fd&c red #40 (allura red ac dye), glycerin (soy), propylene glycol, sodium benzoate, sorbitol; berry flavor]
Mucinex Fast-Max Congest Cough: Guaifenesin 100 mg, dextromethorphan hydrobromide 5 mg, and phenylephrine hydrochloride 2.5 mg per 5 mL (180 mL [DSC]) [contains edetate (edta) disodium, fd&c blue #1 (brilliant blue), propylene glycol, quinoline yellow (d&c yellow #10), sodium benzoate]
Mucinex Fast-Max Congest Cough: Guaifenesin 100 mg, dextromethorphan hydrobromide 5 mg, and phenylephrine hydrochloride 2.5 mg per 5 mL (180 mL) [contains edetate (edta) disodium, fd&c blue #1 (brilliant blue), propylene glycol, quinoline yellow (d&c yellow #10), sodium benzoate; menthol flavor]
Mucinex Fast-Max Congest Cough: Guaifenesin 100 mg, dextromethorphan hydrobromide 5 mg, and phenylephrine hydrochloride 2.5 mg per 5 mL (266 mL) [contains edetate (edta) disodium, fd&c red #40 (allura red ac dye), propylene glycol, sodium benzoate]
Mucinex Fast-Max Congest Cough: Guaifenesin 100 mg, dextromethorphan hydrobromide 5 mg, and phenylephrine hydrochloride 2.5 mg per 5 mL (180 mL) [contains edetate (edta) disodium, fd&c red #40 (allura red ac dye), propylene glycol, sodium benzoate; fruit flavor]
Mucinex Freefrom Sev Cngst/Cgh: Guaifenesin 100 mg, dextromethorphan hydrobromide 5 mg, and phenylephrine hydrochloride 2.5 mg per 5 mL (180 mL [DSC]) [alcohol free, no artificial color(s), no artificial flavor(s), sugar free; contains edetate (edta) disodium, glycerin (soy), propylene glycol, sodium benzoate]
NeoTuss-D: Guaifenesin 200 mg, dextromethorphan hydrobromide 30 mg, and phenylephrine hydrochloride 7.5 mg per 5 mL (474 mL [DSC]) [alcohol free, codeine free, dye free, sugar free; contains methylparaben, propylene glycol, propylparaben; raspberry flavor]
Robafen CF Multi-Symptom Cold: Guaifenesin 100 mg, dextromethorphan hydrobromide 10 mg, and phenylephrine hydrochloride 5 mg per 5 mL (118 mL) [alcohol free; contains fd&c red #40 (allura red ac dye), menthol, propylene glycol, sodium benzoate]
Robitussin Child Cough/Cold CF: Guaifenesin 50 mg, dextromethorphan hydrobromide 5 mg, and phenylephrine hydrochloride 2.5 mg per 5 mL (118 mL) [contains fd&c red #40 (allura red ac dye), propylene glycol, sodium benzoate]
Robitussin Peak Cold Multi-Sym: Guaifenesin 100 mg, dextromethorphan hydrobromide 10 mg, and phenylephrine hydrochloride 5 mg per 5 mL (118 mL [DSC], 237 mL) [contains fd&c red #40 (allura red ac dye), menthol, propylene glycol, sodium benzoate]
Vanacof DMX: Guaifenesin 396 mg, dextromethorphan hydrobromide 18 mg, and phenylephrine hydrochloride 10 mg per 15 mL (237 mL [DSC]) [alcohol free, dye free, gluten free, sugar free; contains menthol, propylene glycol, sodium benzoate]
Generic: Guaifenesin 200 mg, dextromethorphan hydrobromide 18 mg, and phenylephrine hydrochloride 10 mg per 15 mL (240 mL)
Tablet, Oral:
Aquanaz: Guaifenesin 400 mg, dextromethorphan hydrobromide 15 mg, and phenylephrine hydrochloride 10 mg [contains fd&c blue #2 (indigotine,indigo carmine)]
Deconex DMX: Guaifenesin 385 mg, dextromethorphan hydrobromide 17.5 mg, and phenylephrine hydrochloride 10 mg [DSC] [contains fd&c yellow #6 (sunset yellow), quinoline yellow (d&c yellow #10)]
Deconex DMX: Dextromethorphan hydrobromide 17.5 mg, guaifenesin 400 mg, and phenylephrine hydrochloride 10 mg [scored; contains fd&c yellow #6 (sunset yellow), quinoline yellow (d&c yellow #10)]
Gcon DMX: Guaifenesin 385 mg, dextromethorphan hydrobromide 17.5 mg, and phenylephrine hydrochloride 10 mg [scored; contains fd&c yellow #6 (sunset yellow), quinoline yellow (d&c yellow #10)]
Mucinex Fast-Max Congest Cough: Guaifenesin 200 mg, dextromethorphan hydrobromide 10 mg, and phenylephrine hydrochloride 5 mg [contains fd&c blue #2 (indigo carm) aluminum lake, fd&c red #40(allura red ac)aluminum lake]
Mucinex Junior Cough/Congest: Guaifenesin 100 mg, dextromethorphan hydrobromide 5 mg, and phenylephrine hydrochloride 2.5 mg [contains corn starch, fd&c blue #2 (indigo carm) aluminum lake, fd&c red #40(allura red ac)aluminum lake]
Nivanex DMX: Guaifenesin 380 mg, dextromethorphan hydrobromide 15 mg, and phenylephrine hydrochloride 10 mg [scored; contains fd&c yellow #6 (sunset yellow), quinoline yellow (d&c yellow #10)]
Generic: Guaifenesin 385 mg, dextromethorphan hydrobromide 17.5 mg, and phenylephrine hydrochloride 10 mg [DSC]
Yes
Liquid (Actinel DM Oral)
10-20-400 mg/5 mL (per mL): $0.02
Liquid (Desgen DM Oral)
5-10-100 mg/5 mL (per mL): $0.03
Liquid (Desgen Pediatric Oral)
2.5-5-50 mg/mL (per mL): $0.24
Liquid (G-Tron Ped Oral)
10-15-350 mg/5 mL (per mL): $0.05
Liquid (G-Tron Pediatric Drops Oral)
2.5-5-100 mg/mL (per mL): $0.20
Liquid (G-Tusicof Oral)
10-20-400 mg/5 mL (per mL): $0.02
Liquid (Giltuss Cough & Cold Childrens Oral)
7.5-150-5 mg/2.5 mL (per mL): $0.06
Liquid (Giltuss Cough & Cold Oral)
10-15-300 mg/5 mL (per mL): $0.06
Liquid (Mucinex Childrens Freefrom Oral)
2.5-5-100 mg/5 mL (per mL): $0.09
Liquid (Mucinex Cold Childrens Oral)
2.5-5-100 mg/5 mL (per mL): $0.09
Liquid (Mucinex Cough & Congest Child Oral)
2.5-5-100 mg/5 mL (per mL): $0.07
Liquid (Mucinex Fast-Max Congest Cough Oral)
2.5-5-100 mg/5 mL (per mL): $0.07
Liquid (Phenylephrine-DM-GG Oral)
10-18-200 mg/15 mL (per mL): $0.11
Liquid (Robitussin Child Cough/Cold CF Oral)
2.5-5-50 mg/5 mL (per mL): $0.05
Liquid (Robitussin Peak Cold Multi-Sym Oral)
5-10-100 mg/5 mL (per mL): $0.03
Liquid (Tusicof Oral)
10-20-400 mg/5 mL (per mL): $0.11
Liquid (Tusnel DM Oral)
10-20-400 mg/5 mL (per mL): $0.03
Liquid (Tusnel DM Pediatric Oral)
2.5-5-75 mg/5 mL (per mL): $0.03
Liquid (Tusnel-DM Pediatric Oral)
1.25-2.5-25 mg/mL (per mL): $0.30
Liquid (Tussi-Pres Oral)
5-10-200 mg/5 mL (per mL): $0.15
Liquid (Tussi-Pres Pediatric Oral)
2.5-5-75 mg/5 mL (per mL): $0.06
Liquid (Tusslin Oral)
10-28-388 mg/5 mL (per mL): $0.02
Liquid (Tusslin Pediatric Oral)
2.5-7.5-88 mg/mL (per mL): $0.17
Liquid (Vanacof DM Oral)
10-18-200 mg/15 mL (per mL): $0.12
Tablets (Giltuss Cough & Cold Oral)
10-28-388 mg (per each): $0.45
Tablets (Mucinex Fast-Max Congest Cough Oral)
5-10-200 mg (per each): $0.65
Tablets (Mucinex Junior Cough/Congest Oral)
2.5-5-100 mg (per each): $0.74
Tablets (Nivanex DMX Oral)
10-15-380 mg (per each): $0.60
Tablets (Tusicof Oral)
10-20-400 mg (per each): $0.45
Tablets (Vanatab DM Oral)
5-9-198 mg (per each): $1.07
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.
Oral: Only use dosing cup provided with liquid formulations.
Oral: Administer without regards to meals; if GI distress, take with food.
Liquid, syrup: Only use dosing cup provided with liquid formulations or calibrated measuring device.
Cough/decongestant: Temporary control of nasal congestion and cough due to minor throat and bronchial irritation associated with the common cold, hay fever, or other upper respiratory allergies; help loosen phlegm (mucus) and thin bronchial secretions to make coughs more productive; reduces swelling of nasal passages
Refer to individual components.
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.
Acetaminophen: May increase the serum concentration of Phenylephrine (Systemic). Risk C: Monitor therapy
Ajmaline: May increase the serum concentration of CYP2D6 Substrates (High risk with Inhibitors). Risk C: Monitor therapy
Alpha1-Blockers: May diminish the vasoconstricting effect of Alpha1-Agonists. Similarly, Alpha1-Agonists may antagonize Alpha1-Blocker vasodilation. Risk C: Monitor therapy
Artemether and Lumefantrine: May increase the serum concentration of CYP2D6 Substrates (High risk with Inhibitors). Risk C: Monitor therapy
Atomoxetine: May enhance the hypertensive effect of Sympathomimetics. Atomoxetine may enhance the tachycardic effect of Sympathomimetics. Risk C: Monitor therapy
Atropine (Systemic): May enhance the hypertensive effect of Alpha1-Agonists. Risk C: Monitor therapy
Benzylpenicilloyl Polylysine: Alpha1-Agonists may diminish the diagnostic effect of Benzylpenicilloyl Polylysine. Management: Consider delaying skin testing until alpha1-agonists are no longer required, or use of a histamine skin test as a positive control to assess a patient's ability to mount a wheal and flare response. Risk D: Consider therapy modification
Bromocriptine: May enhance the hypertensive effect of Alpha1-Agonists. Management: Consider alternatives to this combination when possible. If combined, monitor for hypertension and tachycardia, and do not coadminister these agents for more than 10 days. Risk D: Consider therapy modification
Cannabinoid-Containing Products: May enhance the tachycardic effect of Sympathomimetics. Risk C: Monitor therapy
Chloroprocaine (Systemic): May enhance the hypotensive effect of Phenylephrine (Systemic). Risk C: Monitor therapy
CloZAPine: May diminish the therapeutic effect of Phenylephrine (Systemic). Risk C: Monitor therapy
Cocaine (Topical): May enhance the hypertensive effect of Sympathomimetics. Management: Consider alternatives to use of this combination when possible. Monitor closely for substantially increased blood pressure or heart rate and for any evidence of myocardial ischemia with concurrent use. Risk D: Consider therapy modification
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
Doxofylline: Sympathomimetics may enhance the adverse/toxic effect of Doxofylline. Risk C: Monitor therapy
Ergot Derivatives (Vasoconstrictive CYP3A4 Substrates): May enhance the vasoconstricting effect of Alpha1-Agonists. Risk X: Avoid combination
FentaNYL: Decongestants may decrease the serum concentration of FentaNYL. Risk C: Monitor therapy
Guanethidine: May enhance the arrhythmogenic effect of Sympathomimetics. Guanethidine may enhance the hypertensive effect of Sympathomimetics. Risk C: Monitor therapy
Hyaluronidase: May enhance the vasoconstricting effect of Phenylephrine (Systemic). Management: Do not use hyaluronidase to enhance the dispersion or absorption of phenylephrine. Use of hyaluronidase for other purposes in patients receiving phenylephrine may be considered as clinically indicated. Risk D: Consider therapy modification
Iobenguane Radiopharmaceutical Products: Alpha1-Agonists may diminish the therapeutic effect of Iobenguane Radiopharmaceutical Products. Management: Discontinue all drugs that may inhibit or interfere with catecholamine transport or uptake for at least 5 biological half-lives before iobenguane administration. Do not administer these drugs until at least 7 days after each iobenguane dose. Risk X: Avoid combination
Kratom: May enhance the adverse/toxic effect of Sympathomimetics. Risk X: Avoid combination
Levothyroxine: May enhance the adverse/toxic effect of Sympathomimetics. Specifically, the risk of coronary insufficiency may be increased in patients with coronary artery disease. Levothyroxine may enhance the therapeutic effect of Sympathomimetics. Sympathomimetics may enhance the therapeutic effect of Levothyroxine. Risk C: Monitor therapy
Lisuride: May enhance the hypertensive effect of Alpha1-Agonists. 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
Ozanimod: May enhance the hypertensive effect of Sympathomimetics. Risk C: Monitor therapy
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
Pergolide: May enhance the hypertensive effect of Alpha1-Agonists. Risk C: Monitor therapy
Propacetamol: May increase the serum concentration of Phenylephrine (Systemic). Management: Monitor patients closely for increased side effects of phenylephrine if propacetamol is used concomitantly. Patients with underlying blood pressure issues or arrhythmias may need closer monitoring and may warrant consideration of alternative therapies. 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
Solriamfetol: Sympathomimetics may enhance the hypertensive effect of Solriamfetol. Sympathomimetics may enhance the tachycardic effect of Solriamfetol. Risk C: Monitor therapy
Sympathomimetics: May enhance the adverse/toxic effect of other Sympathomimetics. Risk C: Monitor therapy
Tedizolid: May enhance the hypertensive effect of Sympathomimetics. Tedizolid may enhance the tachycardic effect of Sympathomimetics. Risk C: Monitor therapy
Refer to individual monographs.
Refer to individual monographs.
See individual agents.
See individual agents.
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