Version July 2025
Cough suppressant/sore throat: Oral: A total of 2 lozenges (dextromethorphan 5 mg/menthol 5 mg per lozenge) dissolved in mouth, 1 immediately after the other. May repeat every 4 hours as needed; maximum: 12 lozenges (dextromethorphan 60 mg/menthol 60 mg) daily.
Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.
Refer to adult dosing.
Cough suppressant/sore throat: Oral:
Children <6 years: Not for OTC use.
Children 6 to <12 years: One lozenge (dextromethorphan 5 mg/menthol 5 mg per lozenge) dissolved in mouth. May repeat every 4 hours; maximum: 6 lozenges (dextromethorphan 30 mg/menthol 30 mg) daily.
Children ≥12 years and Adolescents: Refer to adult dosing.
Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.
See Dextromethorphan monograph.
OTC labeling: When used for self-medication, do not use if you are taking a monoamine oxidase inhibitor (MAOI) or within 2 weeks after stopping an MAOI.
Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.
Other warnings/precautions:
• Self-medication (OTC use): When used for self-medication (OTC) contact health care provider prior to use if you have a persistent or chronic cough associated with asthma, emphysema or smoking, or if you have cough with excess phlegm; notify health care provider if symptoms do not improve within 7 days, irritation, pain or redness persist/worsen, swelling develops, or cough is accompanied by fever, rash or persistent headache. If sore throat is severe, lasts for >2 days, occurs with or is followed by fever, headache, rash, nausea, or vomiting, consult a health care provider.
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).
Dosage form specific issues:
• Propylene glycol: Some dosage forms may contain propylene glycol; large amounts are potentially toxic and have been associated hyperosmolality, lactic acidosis, seizures, and respiratory depression; use caution (AAP 1997; Zar 2007).
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Lozenge, Mouth/Throat:
Robitussin Medi-Soothers: Dextromethorphan hydrobromide 5 mg and menthol 5 mg (8 ea, 16 ea) [contains soybean lecithin]
No
Lozenge (Robitussin Medi-Soothers Mouth/Throat)
5-5 mg (per each): $0.56
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.
Allow lozenge to dissolve slowly in the mouth.
Oral: Allow lozenge to dissolve slowly in the mouth.
Cough suppressant/sore throat: Temporary relief of sore throat, sore mouth, minor throat irritation, and cough due to minor throat and bronchial irritation as may occur with the common cold.
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 drug interactions program by clicking on the “Launch drug interactions program” link above.
Ajmaline: May increase serum concentration of CYP2D6 Substrates (High risk with Inhibitors). Risk C: Monitor
Artemether and Lumefantrine: May increase serum concentration of CYP2D6 Substrates (High risk with Inhibitors). Risk C: Monitor
CYP2D6 Inhibitors (Moderate): May increase serum concentration of Dextromethorphan. Risk C: Monitor
CYP2D6 Inhibitors (Strong): May increase serum concentration of Dextromethorphan. Risk C: Monitor
Disulfiram: May increase adverse/toxic effects of Products Containing Ethanol. Management: Do not use disulfiram with dosage forms that contain ethanol. Risk X: Avoid
Mavorixafor: May increase serum concentration of CYP2D6 Substrates (High risk with Inhibitors). Risk X: Avoid
Memantine: NMDA Receptor Antagonists may increase adverse/toxic effects of Memantine. Risk C: Monitor
Methotrimeprazine: May increase CNS depressant effects of Products Containing Ethanol. Management: Avoid products containing alcohol in patients treated with methotrimeprazine. Risk X: Avoid
MetroNIDAZOLE (Systemic): May increase adverse/toxic effects of Products Containing Ethanol. A disulfiram-like reaction may occur. Risk X: Avoid
MetroNIDAZOLE (Topical): May increase adverse/toxic effects of Products Containing Ethanol. A disulfiram-like reaction may occur. Risk C: Monitor
Monoamine Oxidase Inhibitors: Dextromethorphan may increase serotonergic effects of Monoamine Oxidase Inhibitors. This may cause serotonin syndrome. Risk X: Avoid
Parecoxib: May increase serum concentration of Dextromethorphan. Risk C: Monitor
Peginterferon Alfa-2b: May decrease serum concentration of CYP2D6 Substrates (High risk with Inhibitors). Peginterferon Alfa-2b may increase serum concentration of CYP2D6 Substrates (High risk with Inhibitors). Risk C: Monitor
Secnidazole: Products Containing Ethanol may increase adverse/toxic effects of Secnidazole. Risk X: Avoid
Selective Serotonin Reuptake Inhibitors (Strong CYP2D6 Inhibitors): Dextromethorphan may increase serotonergic effects of Selective Serotonin Reuptake Inhibitors (Strong CYP2D6 Inhibitors). This could result in serotonin syndrome. Selective Serotonin Reuptake Inhibitors (Strong CYP2D6 Inhibitors) may increase 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 increase serotonergic effects 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
Warfarin: Menthol may decrease serum concentration of Warfarin. Risk C: Monitor
Refer to individual monographs.
Refer to individual monographs.
Dextromethorphan: Decreases the sensitivity of cough receptors and interrupts cough impulse transmission by depressing the medullary cough center through sigma receptor stimulation; structurally related to codeine
Menthol: Local anesthetic and counterirritant to relieve minor sore throat irritation
See Dextromethorphan monograph.
