Dextromethorphan; Guaifenesin; Pseudoephedrine Oral Liquid

What is this medication?

DEXTROMETHORPHAN; GUAIFENESIN; PSEUDOEPHEDRINE (dex troe meth OR fan, gwye FEN e sin; soo doe e FED rin) is a combination of a cough suppressant, an expectorant, and a decongestant. It is used to provide relief from cough and congestion. This medicine will not treat an infection.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

COMMON BRAND NAME(S): Actinel Cough, Actinel Pediatric Cough, Broncotron D, Coldmist DM, Despec DM, Donatussin DM, ExeClear-DM, Genexpect PE, Liquicough DM, PanMist DM, Pseudo Cough, Relacon DM, Relacon DM NR, Relasin DM, Robitussin CF, Ru-Tuss-DM, TL-Dex DM, Tri Vent DM, Tri-Vent DM, TRISPEC PSE, Tusnel Pediatric Cough, Z-Cof DM, Z-Cof DMX

What should I tell my care team before I take this medication?

They need to know if you have any of these conditions:

• Diabetes
• Difficulty passing urine
• Glaucoma
• High blood pressure, heart disease
• Liver disease
• An unusual or allergic reaction to dextromethorphan, guaifenesin, pseudoephedrine, other medicines, foods, dyes, or preservatives
• Pregnant or trying to get pregnant
• Breastfeeding

How should I use this medication?

Take this medicine by mouth with a glass of water. Follow the directions on the prescription label. Use a specially marked spoon or container to measure your medicine. Household spoons are not accurate. If this medicine upsets your stomach, take with food or milk. Take your doses at regular intervals. Do not take your medicine more often than directed.

Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.

Patients over 60 years old may have a stronger reaction and need a smaller dose.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

What may interact with this medication?

Do not take this medicine with any of the following medications:

• Ergot alkaloids like dihydroergotamine, ergonovine, ergotamine, methylergonovine
• MAOIs like Carbex, Eldepryl, Marplan, Nardil, and Parnate
• Procarbazine
• Stimulant medicines for attention disorders, weight loss, or to stay awake

This medicine may also interact with the following medications:

• Caffeine
• Digoxin
• Furazolidone
• Linezolid
• Maprotiline
• Mecamylamine
• Medicines for blood pressure
• Medicines for cold, cough or allergy
• Reserpine
• Some medicines for Parkinson's disease
• St. John's wort
• Theophylline

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medication?

Tell your doctor if your symptoms do not improve within 5 days or if they get worse. If you have trouble falling asleep at night, take the last dose of the day at least a few hours before bedtime.

Drink water as instructed while you are taking this medicine to help loosen mucus.

What side effects may I notice from receiving this medication?

Side effects that you should report to your doctor or health care professional as soon as possible:

• Allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
• Breathing trouble
• Difficulty passing urine
• Dizzy, faint
• Fast or irregular heartbeat
• Fear, anxiety, restless, tremor
• Fever
• Hallucinations
• High blood pressure
• Seizure
• Unusually weak or tired

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

• Diarrhea
• Drowsiness
• Headache
• Loss of appetite
• Stomach upset, nausea

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medication?

Keep out of the reach of children.

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Protect from light. Throw away any unused medicine after the expiration date.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.

What is Robitussin CF?

Robitussin CF® is a medication that treats symptoms of a common cold, including:

• Cough
• Nasal congestion (stuffy nose)
• Chest congestion

Robitussin CF comes in different formulas that contain different active ingredients. For instance, one formula contains:

• Dextromethorphan: A cough suppressant that helps calm your cough reflex
• Guaifenesin: An expectorant that loosens mucus in your chest so it comes up and out more easily
• Pseudoephedrine: A nasal decongestant that helps you breathe more easily through your nose

(This formula is currently only sold outside the U.S.)

In the U.S., other Robitussin CF formulas are available. Some of these contain phenylephrine instead of pseudoephedrine. Phenylephrine is a medication you’ll see on the label for many cough and cold medications. It’s marketed as a decongestant. However, an advisory committee with the U.S. Food and Drug Administration (FDA) didn’t find any scientific evidence that this medication, given at the currently approved dose, will clear your stuffy nose. Taking it won’t hurt, but it also won’t help you feel better.

You can talk to a healthcare provider or pharmacist to learn more about available medications to treat cold or flu symptoms. Keep in mind that these medications won’t make the infection go away any sooner, and they won’t stop you from spreading germs to others. But they may temporarily ease your symptoms.

Dextromethorphan safety

Dextromethorphan is a cough suppressant found in many cold and flu medications, including Robitussin CF. It’s typically safe at the recommended dose (found on the label) if your healthcare provider gives you the OK for using it. However, it can become unsafe if you take more than the recommended dose.

People (including teens) have used dextromethorphan as a recreational drug. You might hear this referred to as “Robo-tripping” or “dexing.” Such medication misuse is dangerous and potentially deadly. All medications, including dextromethorphan, are toxic if you take very high amounts. Taking these medications becomes even more dangerous when you combine them with other substances, like alcohol.

Medication misuse can be hard to talk about, especially if it’s occurring in your life or the life of someone you love. But the more time that passes, the harder it can be to stop taking the substance. Early treatment is key. Talk to a healthcare provider as soon as possible to get help for yourself or a loved one.

What is the difference between Robitussin CF and Robitussin DM?

Robitussin CF and Robitussin DM® both contain guaifenesin (an expectorant) and dextromethorphan (a cough suppressant). However, Robitussin CF also contains a nasal decongestant (pseudoephedrine or phenylephrine). Robitussin DM doesn’t.

Is Robitussin CF safe during pregnancy?

Always check with a healthcare provider before taking Robitussin CF or any other medication while pregnant or breastfeeding. Different formulas contain different active ingredients. Some of those ingredients may be safe to take if you’re pregnant or nursing, while others may be unsafe.

A provider will review the list of ingredients and make sure they’re all OK for you. They may recommend alternative medications or even home remedies to help treat your symptoms.