Drug/Small Molecule:

dextromethorphan

Overview

Generic Names:	D-Methorphan; D-Methorphan Hydrobromide; Delta-Methorphan; Demorphan; Demorphan Hydrobromide; Demorphine; Destrometerfano [Dcit]; Dextromethorfan [Czech]; Dextromethorphan Bromhydrate; Dextromethorphan Bromide; Dextrometorfano [INN-Spanish]; Dextrometorphan; Dextromorphan; Dexyromethorphan; L-Methorphan; Levomethorphan; Levomethorphan [Ban:Dcf:Inn]; Levomethorphane [INN-French]; Levomethorphanum [INN-Latin]; Levometorfano [INN-Spanish]
Trade Names:	Antussan; Balminil DM; Balminil DM Children; Benylin Adult Formula Cough Suppressant; Benylin DM; Benylin DM 12 Hour; Benylin DM for Children; Benylin DM for Children 12 Hour; Benylin Pediatric Cough Suppressant; Calmylin #1; Canfodion; Cosylan; Cough-X; Creo-Terpin; Delsym; Delsym Cough Formula; Diabe-Tuss DM Syrup; Dormetan; Dormethan; Hihustan M.; Hold DM; Koffex DM; Medicon; Methorate Hydrobromide; Methorphan; Metrorat; Novahistex DM; Novahistine DM; Pertussin CS Children's Strength; Pertussin DM Extra Strength; Robitussin Maximum Strength Cough Suppressant; Robitussin Pediatric; Robitussin Pediatric Cough Suppressant; Romilar; Sucrets 4 Hour Cough Suppressant; Triaminic DM Long Lasting for Children; Trocal; Tusilan; Tussade; Vicks 44 Cough Relief
Brand Mixtures:	Actifed Dm Syrup (Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride + Triprolidine Hydrochloride); Actifed Dm Tablets (Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride + Triprolidine Hydrochloride); Antitussive Decong Antihistamine Syr (Dextromethorphan Hydrobromide + Pheniramine Maleate + Phenylpropanolamine Hydrochloride + Pyrilamine Maleate); Benylin 4 Flu - Syrup (Acetaminophen + Dextromethorphan Hydrobromide + Guaifenesin + Pseudoephedrine Hydrochloride); Biohisdex Dm Decongestant (Dextromethorphan Hydrobromide + Diphenylpyraline Hydrochloride + Phenylephrine Hydrochloride); Biohisdine Dm Decongestant (Dextromethorphan Hydrobromide + Diphenylpyraline Hydrochloride + Phenylephrine Hydrochloride); Bronchodex Fort-Dm Syr (Ammonium Chloride + Dextromethorphan Hydrobromide + Menthol + Pyrilamine Maleate + Sodium Citrate); Bronchodex Pediatrique (Dextromethorphan Hydrobromide + Guaifenesin + Pheniramine Maleate + Pseudoephedrine Hydrochloride); Bronchosirum Pour Enfants (Dextromethorphan Hydrobromide + Pheniramine Maleate + Phenylpropanolamine Hydrochloride + Pyrilamine Maleate); Calmylin #2 Syr (Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride); Calmylin #3 Syr (Dextromethorphan Hydrobromide + Guaifenesin + Pseudoephedrine Hydrochloride); Calmylin #4 Syr (Ammonium Chloride + Dextromethorphan Hydrobromide + Diphenhydramine Hydrochloride); Calmylin Cough and Flu Liq (Acetaminophen + Dextromethorphan Hydrobromide + Guaifenesin + Pseudoephedrine Hydrochloride); Calmylin Pediatric Syrup (Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride); Centracol Dm - Syr (Dextromethorphan Hydrobromide + Pheniramine Maleate + Phenylpropanolamine Hydrochloride + Pyrilamine Maleate); Centracol Pediatrique - Syr (Dextromethorphan Hydrobromide + Guaifenesin + Pheniramine Maleate + Pseudoephedrine Hydrochloride); Chemhisdex Dm Decongestant (Dextromethorphan Hydrobromide + Diphenylpyraline Hydrochloride + Phenylephrine Hydrochloride); Chemhisdine Dm Decongestant (Dextromethorphan Hydrobromide + Diphenylpyraline Hydrochloride + Phenylephrine Hydrochloride); Children's Tussin Cough Medicine Dm Antitussive Decongestant (Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride); Children's Tylenol Cold Liquid with Dm (Acetaminophen + Chlorpheniramine Maleate + Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride); Citron Chaud Dm Cumberland Pws (Dextromethorphan Hydrobromide + Pheniramine Maleate + Phenylephrine Hydrochloride + Vitamin C); Cold Relief Dm (Brompheniramine Maleate + Dextromethorphan Hydrobromide + Phenylpropanolamine Hydrochloride); Cold/Flu Relief (Acetaminophen + Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride); Contac Cough Cold and Flu Caplets (Acetaminophen + Chlorpheniramine Maleate + Dextromethorphan Hydrobromide + Phenylpropanolamine Hydrochloride); Cough Syrup Dm Decongestant (Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride); Cough Syrup Dm Decongestant Expectorant (Dextromethorphan Hydrobromide + Guaifenesin + Pseudoephedrine Hydrochloride); Cough Syrup Dm Decongestant for Children (Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride); Cough Syrup Dm Expectorant (Dextromethorphan Hydrobromide + Guaifenesin); Cough Syrup Dm-D-E (Dextromethorphan Hydrobromide + Guaifenesin + Pseudoephedrine Hydrochloride); Cough Syrup Dm-E (Dextromethorphan Hydrobromide + Guaifenesin); Cough Syrup Dm-Expectorant (Dextromethorphan Hydrobromide + Guaifenesin); Cough Syrup W.Guaifenesin W.Dextromethorphan (Dextromethorphan Hydrobromide + Guaifenesin); Cough and Flu Syrup (Acetaminophen + Dextromethorphan Hydrobromide + Guaifenesin + Pseudoephedrine Hydrochloride); Cough, Cold & Allergy Relief (Brompheniramine Maleate + Dextromethorphan Hydrobromide + Phenylephrine Hydrochloride + Phenylpropanolamine Hydrochloride); Dayquil Liquicaps (Acetaminophen + Dextromethorphan Hydrobromide + Guaifenesin + Pseudoephedrine Hydrochloride); Dayquil Liquicaps - Cap (Acetaminophen + Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride); Dayquil Medicine - Liq (Acetaminophen + Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride); Daytime Cold & Flu Liquid Capsules (Acetaminophen + Dextromethorphan Hydrobromide + Guaifenesin + Pseudoephedrine Hydrochloride); Daytime Liquid - Liq (Acetaminophen + Dextromethorphan Hydrobromide + Guaifenesin + Pseudoephedrine Hydrochloride); Demdec Syr (Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride); Dimetapp Children's Cough and Cold Liquid (Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride); Dimetapp Cough & Cold Liqui-Gels - Cap (Brompheniramine Maleate + Dextromethorphan Hydrobromide + Phenylpropanolamine Hydrochloride); Dimetapp Cough, Cold & Flu (Acetaminophen + Brompheniramine Maleate + Dextromethorphan Hydrobromide + Phenylpropanolamine Hydrochloride); Dimetapp Dm Elixir (Brompheniramine Maleate + Dextromethorphan Hydrobromide + Phenylephrine Hydrochloride + Phenylpropanolamine Hydrochloride); Dimetapp Dm Tab (Brompheniramine Maleate + Dextromethorphan Hydrobromide + Phenylephrine Hydrochloride + Phenylpropanolamine Hydrochloride); Dm Cough Syr (Ammonium Chloride + Dextromethorphan Hydrobromide + Diphenhydramine Hydrochloride); Dm Cough Syrup Decongestant (Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride); Dm Cough Syrup Expectorant (Dextromethorphan Hydrobromide + Guaifenesin); Dm Expectorant Cough Syrup (Dextromethorphan Hydrobromide + Guaifenesin); Dm Plus Cough Syrup (Ammonium Chloride + Dextromethorphan Hydrobromide + Diphenhydramine Hydrochloride); Dm Plus Decongestant Cough Syrup (Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride); Dm Plus Decongestant Plus Expector.Ex.St.Syr (Dextromethorphan Hydrobromide + Guaifenesin + Pseudoephedrine Hydrochloride); Dm Plus Decongestant Plus Expectorant Cough Syrup (Dextromethorphan Hydrobromide + Guaifenesin + Pseudoephedrine Hydrochloride); Dm Plus Expectorant Syrup (Dextromethorphan Hydrobromide + Guaifenesin); Dm Syrup (Ammonium Chloride + Dextromethorphan Hydrobromide + Diphenhydramine Hydrochloride); Dm-D-Expectorant Cough and Cold Syrup (Dextromethorphan Hydrobromide + Guaifenesin + Pseudoephedrine Hydrochloride); Extra Strength Cold Medication Daytime Rlf (Acetaminophen + Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride); Extra Strength Daytime Cold Relief-Caplet (Acetaminophen + Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride); Extra Strength Nighttime Cold Relief-Caplet (Acetaminophen + Chlorpheniramine Maleate + Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride); Extra Strength Tylenol Cold and Flu Powder (Acetaminophen + Chlorpheniramine Maleate + Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride); Hot Lemon Relief Dm Adult (Dextromethorphan Hydrobromide + Pheniramine Maleate + Phenylephrine Hydrochloride); Koffex Dm + Decongestant + Expectorant (Dextromethorphan Hydrobromide + Guaifenesin + Pseudoephedrine Hydrochloride); Koffex Dm + Decongestant + Expectorant Extra Strength (Dextromethorphan Hydrobromide + Guaifenesin + Pseudoephedrine Hydrochloride); Koffex Dm + Decongestant Syrup (Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride); Koffex Dm + Expectorant (Dextromethorphan Hydrobromide + Guaifenesin); Koffex Dm + Expectorant Extra Strength (Dextromethorphan Hydrobromide + Guaifenesin); Koffex Dm-D-E - Liq (Dextromethorphan Hydrobromide + Guaifenesin + Pseudoephedrine Hydrochloride); Metrate (Dextromethorphan Hydrobromide + Diphenylpyraline Hydrochloride + Potassium Iodide + Sodium Citrate); Neo Citran Daycaps Extra Strength - Caplet (Acetaminophen + Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride); Nighttime Cold and Flu Liquid Capsules (Acetaminophen + Dextromethorphan Hydrobromide + Doxylamine Succinate + Pseudoephedrine Hydrochloride); Nighttime Cold and Flu Relief (Acetaminophen + Dextromethorphan Hydrobromide + Doxylamine Succinate + Pseudoephedrine Hydrochloride); Nitetime Cold Medicine (Acetaminophen + Dextromethorphan Hydrobromide + Doxylamine Succinate + Pseudoephedrine Hydrochloride); Novahistex Dm Expectorant with Decongestant (Dextromethorphan Hydrobromide + Guaifenesin + Pseudoephedrine Hydrochloride); Novahistex Dm with Decongestant (Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride); Novahistine Dm Expectorant with Decongestant (Dextromethorphan Hydrobromide + Guaifenesin + Pseudoephedrine Hydrochloride); Novahistine Dm with Decongestant - Liq (Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride); Nyquil Liquicaps (Acetaminophen + Dextromethorphan Hydrobromide + Doxylamine Succinate + Pseudoephedrine Hydrochloride); Ornade Dm 10 Liq (Chlorpheniramine Maleate + Dextromethorphan Hydrobromide + Phenylpropanolamine Hydrochloride); Ornade Dm 15 Liq (Chlorpheniramine Maleate + Dextromethorphan Hydrobromide + Phenylpropanolamine Hydrochloride); Ornade Dm 30 Liq (Chlorpheniramine Maleate + Dextromethorphan Hydrobromide + Phenylpropanolamine Hydrochloride); Pediatric Cough Syrup (Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride); Personnelle Dm Syr (Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride); Pharmacol Dm Syr (Dextromethorphan Hydrobromide + Pheniramine Maleate + Phenylpropanolamine Hydrochloride + Pyrilamine Maleate); Pharminicol Dm Syrup (Dextromethorphan Hydrobromide + Pheniramine Maleate + Phenylpropanolamine Hydrochloride + Pyrilamine Maleate); Pharmitussin Dm (Dextromethorphan Hydrobromide + Guaifenesin); Promatussin Dm Adult Formula Syr (Dextromethorphan Hydrobromide + Promethazine Hydrochloride + Pseudoephedrine Hydrochloride); Promatussin Dm Children Formula (Dextromethorphan Hydrobromide + Promethazine Hydrochloride + Pseudoephedrine Hydrochloride); Reg.Str.Cold Medic. (Night Time Relief)Caplet (Acetaminophen + Chlorpheniramine Maleate + Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride); Regular Strength Cold Medication (Daytime R.) (Acetaminophen + Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride); Regular Strength Tylenol Cold Chest Congestion (Acetaminophen + Dextromethorphan Hydrobromide + Guaifenesin + Pseudoephedrine Hydrochloride); Regular Strength Tylenol Cold and Flu Powder (Acetaminophen + Chlorpheniramine Maleate + Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride); Regular Strength Tylenol Cough Suspension (Acetaminophen + Dextromethorphan Hydrobromide); Regular Strength Tylenol Cough Suspension with Decongestant (Acetaminophen + Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride); Robitussin Honey Cough and Cold (Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride); Robitussin Honey Flu (Acetaminophen + Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride); Sudafed Cold and Cough Extra Strength Caplet (Acetaminophen + Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride); Sudafed Cold and Flu Gel Caps (Acetaminophen + Dextromethorphan Hydrobromide + Guaifenesin + Pseudoephedrine Hydrochloride); Sudafed Dm (Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride); Tantacol Dm Syr (Dextromethorphan Hydrobromide + Pheniramine Maleate + Phenylpropanolamine Hydrochloride + Pyrilamine Maleate); Theraflu Flu Cold and Cough Medicine (Acetaminophen + Chlorpheniramine Maleate + Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride); Triaminic Dm Daytime Syr (Dextromethorphan Hydrobromide + Guaifenesin + Phenylpropanolamine Hydrochloride); Triaminic Dm Expectorant Syr (Chlorpheniramine Maleate + Dextromethorphan Hydrobromide + Guaifenesin + Pseudoephedrine Hydrochloride); Triaminic Dm Plus Decongestant Syrup (Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride); Triaminic Dm+Decongestant Liqui-Gels Capsules (Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride); Triaminicol Dm Syrup (Chlorpheniramine Maleate + Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride); Tussin Cough Medicine Dm Antitussive Expectorant Decongestant (Dextromethorphan Hydrobromide + Guaifenesin + Pseudoephedrine Hydrochloride)
PharmGKB Accession Id:	PA449273

Description

The d-isomer of the codeine analog of levorphanol. Dextromethorphan shows high affinity binding to several regions of the brain, including the medullary cough center. This compound is an NMDA receptor antagonist (receptors, N-methyl-D-aspartate) and acts as a non-competitive channel blocker. It is one of the widely used antitussives, and is also used to study the involvement of glutamate receptors in neurotoxicity. [PubChem]

Indication

For treatment and relief of dry cough.

ATC Therapeutic Category

• R05DA:Opium alkaloids and derivatives

Pharmacology and Interactions

Mechanism Of Action

Dextromethorphan is an opioid-like drug that binds to and acts as antagonist to the NMDA glutamatergic receptor, it is an agonist to the opioid sigma 1 and sigma 2 receptors, it is also an alpha3/beta4 nicotinic receptor antagonist and targets the serotonin reuptake pump. Dextromethorphan is rapidly absorbed from the gastrointestinal tract, where it enters the bloodstream and crosses the blood-brain barrier. The first-pass through the hepatic portal vein results in some of the drug being metabolized into an active metabolite of dextromethorphan, dextrorphan, the 3-hydroxy derivative of dextromethorphan.

Pharmacology

Dextromethorphan suppresses the cough reflex by a direct action on the cough center in the medulla of the brain. Dextromethorphan shows high affinity binding to several regions of the brain, including the medullary cough center. This compound is an NMDA receptor antagonist and acts as a non-competitive channel blocker. It is one of the widely used antitussives, and is also used to study the involvement of glutamate receptors in neurotoxicity.

Food Interactions

Take without regard to meals.

Absorption, Distribution, Metabolism, Elimination & Toxicity

Biotransformation

Hepatic. Rapidly and extensively metabolized to dextrorphan (active metabolite). One well known metabolic catalyst involved is a specific cytochrome P450 enzyme known as 2D6, or CYP2D6.

Absorption

Rapidly absorbed from the gastrointestinal tract.

Half Life

3-6 hours

Chemical Properties

Chemical Formula:

C₁₈H₂₅NO

SMILES Code:

CN1CC[C@@]23CCCC[C@@H]2[C@@H]1Cc4c3cc(cc4)OC

(Format: OpenEye Isomeric)

Molecular Weight ( average / monoisotopic )

271.3972 / 271.1936

Curated Information

The following genes are in curated knowledge about this drug.

	Gene	Relationship	Evidence
	CYP1A2	PK	Publications
	CYP2C19	PK	Publications
	CYP2C9	PK	Publications
	CYP2D6	PD PK FA GN	Publications
	CYP3A	PK	Publications
	NAT2	PK	Publications

Non-Curated Information

A list of non-curated publications that mention this drug along with other genes is available.

Metabolizing Enzymes

• CYP2D6

Drug Targets

• GRIN3A
• SLC6A4
• CHRNA2
• SIGMAR1

Non-Curated Information

A list of non-curated publications that mention this drug along with other drugs is available.

Drug Interactions

Curated Information

The following diseases are in curated knowledge about this drug.

	Disease	Relationship	Evidence
	Cystic Fibrosis	PK	Publications

Non-Curated Information

A list of non-curated publications that mention this drug along with other diseases is available.

Additional Datasets

These datasets are minimally curated and are sorted alphabetically by title.

1. The Connectivity Map: using gene-expression signatures to connect small molecules, genes, and disease

LinkOuts

Common Searches

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Non-Curated Publications

A list of non-curated publications that mention this drug is available.