Non-opioid drug with antitussive effect. Is the right-handed isomer of levometorfan, a codeine analogue. It works centrally on the center of cough in the medulla and the nucleus of the lonely band. It has no analgesic, sedative or breath suppressive effect when used in the usual recommended antitussive doses. Dextromethorphan hydrobromide is well absorbed from the gastrointestinal tract, metabolized in the liver with the participation of polymorphic 2D6 cytochrome P450 isoenzyme (CYP 2D6). It is excreted in the urine in unchanged form as dextromethorphan and in the form of demethylated metabolites, e.g. in the form of dextrorphan, which has antitussive properties. T0,5 is 1,2-3,9 h. However, the rate of metabolism differs in individuals depending on the phenotype (patients with rapid and slow metabolism), with a half-life as long as 45 hours in patients with slower metabolism.
Contraindications:
Hypersensitivity to the active substance or to any of the excipients. A cough with a lot of secretion, bronchial asthma, respiratory failure or risk of it, severe liver failure. Do not use when taking monoamine oxidase (MAO) inhibitors, selective serotonin reuptake inhibitors (SSRIs), other medications used in depression, mental illness, mood disorders or Parkinson's disease, or within 2 weeks of stopping treatment. Children under the age of 2 years.
Precautions:
Special care should be taken when chronic cough occurs during smoking or when there is chronic lung disease such as asthma or emphysema. It is not recommended when the cough lasts longer than 7 days, recurs, accompanied by a fever, rash or permanent headache. Use with caution in patients with liver disease. The preparation contains amaranth, which may cause allergic reactions. Due to the sorbitol content (2.6 kcal / g) and maltitol (80/55 lyricin), patients with rare hereditary fructose intolerance should not use the preparation. The drug may have a slight laxative effect. In addition, the preparation contains 2.5 v / v% ethanol (alcohol), i.e. 103 mg per dose (5 ml), equivalent to 2.5 ml beer, 1 ml wine per dose - harmful to people with alcoholism; this should be taken into account when using in pregnant or breast-feeding women, children and in high-risk groups such as patients with liver disease or epilepsy. Do not exceed the recommended dose.
Pregnancy and lactation:
There are no data on the safety of use during pregnancy. The preparation should not be used in pregnant women due to the possibility of inhibiting the fetal respiratory center and the ethanol content. Do not use during breast-feeding.
Orally. Children 6-12 years: 20 ml 4 times a day (the maximum daily dose is 60 mg dextromethorphan); children 2-6 years: 10 ml 4 times a day (the maximum daily dose is 30 mg dextromethorphan). The drug is contraindicated for use in children under the age of 2 years. For children up to 12 years of age, do not use without clear doctor's instructions. Do not use doses higher than recommended.
(C)
