Although Delsym has been available for a relatively long time, how it works is not completely known. However, medical experts believe that Delsym may work by mimicking another medication, codeine, a drug in the opioid class. Delsym may also block special proteins in the brain cells called receptors, specifically the N-methyl-D-aspartate (NMDA) and serotonin receptors. These receptors were found in clinical trials to play a role in causing coughing.
Delsym comes in either immediate-release or extended-release (slowly released in the body) formulations.
What Is Delsym Used For?
The Food and Drug Administration (FDA) approved Delsym for the temporary relief of the following:
Brand Name(s): Delsym
Administration Route(s): Oral
Drug Availability: Prescription
Therapeutic Classification: Antitussive
Available Generically: Yes
Controlled Substance: N/A
Active Ingredient: Dextromethorphan
Dosage Form(s): Syrup
Cough caused by scratchy feeling in your throat that can occur as a cold symptom Control cough to help aid in sleep
How to Take Delsym
Delsym should generally be taken by mouth every four to eight hours for immediate-release medications. Extended-release medications can be taken by mouth every 12 hours.
The specific volume will vary depending on certain characteristics like age. Dextromethorphan should not be taken if you take medications in the monoamine oxidase inhibitor (MAOI) drug class. It can lead to a condition known as serotonin syndrome.
Storage
Store Delsym in a cool, dry place. Generally, you should keep medications away from spaces that endure heat, like your car, or high humidity areas, like your bathroom. These kinds of factors can impact how well medications work. It’s also important to make sure medications are away from pets and children to avoid accidental consumption.
Off-Label Uses
Dextromethorphan has been around for a long time and has a lot of time to be studied in various other conditions.
Examples of those are listed below:
Pain reliefDiabetes complicationsCombination with quinidine to treat depressionCombination with quinidine to treat pseudobulbar affect
Pain Relief
Compared with ibuprofen, dextromethorphan was found to have no effect on overall pain relief after major surgery at low doses. However, at relatively higher doses, dextromethorphan decreased pain when given for minor surgeries. One study found that dextromethorphan may have led to a lower dose of a powerful opiate called morphine.
Diabetes Complications
Another study found that dextromethorphan might affect a diabetes complication known as macular edema. Diabetes can cause macular edema by the breakdown of the blood-brain barrier, which is a barrier that separates fluids in your brain and fluids in your spinal cord. The nature of macular edema is progressive, which means it worsens over time. This study found that people taking dextromethorphan didn’t get worse in macular edema.
Combination Treatment With Quinidine
Dextromethorphan has shown even more potential when combined with another medication, quinidine. Quinidine is a medication that is used to treat parasites, as well as treat irregular heartbeats. One study found that this combination could potentially manage the symptoms of depression.
More data show that this combination is effective in treating a disorder known as pseudobulbar affect. Pseudobulbar affect is characterized by sudden and often uncontrollable laughter or crying. The combination of dextromethorphan and quinidine was shown to have significant improvements in treating the symptoms of pseudobulbar affect.
What Are the Side Effects of Delsym?
This is not a complete list of side effects and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or a healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 1-800-FDA-1088.
Common Side Effects
The following side effects are commonly reported in those that take Delsym:
DrowsinessDizzinessFatigueNauseaStomach acheJitterinessItchiness
Severe Side Effects
Call your healthcare provider right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects can include:
Blurred vision or double vision High blood pressure Low blood pressure Sweating Abnormally large pupils Muscle spasms Difficulty urinating Difficulty breathing
Long-Term Side Effects
Delsym is a relatively well-tolerated medication.
However, when taken for a long time, Delsym can cause side effects such as:
Decreased attention span and concentrationDecreased ability to control movementsFatigueHallucinationsConfusionDepression
Dosage: How Much of Delsym Should I Take?
Modifications
Delsym is considered acceptable for use during pregnancy at standard OTC doses.
If you experience a serious side effect, you or your provider may send a report to the FDA’s MedWatch Adverse Event Reporting Program or by phone (800-332-1088).
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
For lozenge dosage form: For cough: Adults and children 12 years of age and older—5 to 15 mg every two to four hours, as needed. Children 6 to 12 years of age—5 to 15 mg every two to six hours, as needed. Children 4 to 6 years of age—5 mg every four hours, as needed. Children and infants up to 4 years of age—Use is not recommended . For syrup dosage form: For cough: Adults and children 12 years of age and older—30 mg every six to eight hours, as needed. Children 6 to 12 years of age—7 mg every four hours or 15 mg every six to eight hours, as needed. Children 4 to 6 years of age—3. 5 mg every four hours or 7. 5 mg every six to eight hours, as needed. Children and infants up to 4 years of age—Use is not recommended . For extended-release oral suspension dosage form : For cough: Adults and children 12 years of age and older—60 mg every twelve hours, as needed. Children 6 to 12 years of age—30 mg every twelve hours, as needed. Children 4 to 6 years of age—15 mg every twelve hours, as needed. Children and infants up to 4 years of age—Use is not recommended .
While using Delsym, you should avoid taking products containing alcohol. Some people are also considered “poor metabolizers,” which means they have less of an enzyme that converts and breaks down Delsym in the body. This may cause an increase in side effects while taking the medication but does not necessitate a change in dose.
Missed Dose
If you miss a dose of Delsym, it will be okay. What’s important is you take it as soon as you remember. Even if you miss a dose, continue only to take the normal recommended dose. Do not take more to make up for the missed one.
Overdose: What Happens If I Take Too Much Delsym?
There is no set dose that indicates an overdosage of Delsym. However, an overdose may cause the following symptoms:
Abnormally large pupilsHallucinationsNauseaVomitingAbnormal movementsAgitation
If you experience these symptoms or see someone experiencing these symptoms after the consumption of Delsym, it’s very important to contact a poison control center or call 911 immediately. The sooner you get treated, the less likely it will be that complications occur.
Precautions
What Are Reasons I Shouldn’t Take Delsym?
Do not take Delsym within 14 days of taking an MAOI inhibitor. If you plan on taking Delsym, you must know if you are taking a drug in that class. MAOIs can be used for depression, mood disorders, or Parkinson’s syndrome. When Delsym is taken with monoamine oxidase inhibitors, serotonin syndrome is more likely.
If you experience a serious side effect, you or your provider may send a report to the FDA’s MedWatch Adverse Event Reporting Program or by phone (800-332-1088).
Dissolve lozenges in the mouth with caution, to lessen the risk of choking.
Serotonin syndrome is a condition in which there is a dangerous increase in the concentrations of serotonin in your blood. Serotonin controls how your intestines digest food, how well your heart functions, and how you feel. However, whenever there is too much serotonin in your blood, the following symptoms may occur:
AnxietyConfusionIrregular heartbeatLoss of coordinationJerky movementsTremors
What Other Medications Interact With Delsym?
Delsym is converted in the body by a protein family known as the CYP450 family or cytochrome P450s. There are many CYP450 sub-families, including the 2D6 sub-family. Dextromethorphan is almost completely metabolized by CYP4502D6, or CYP2D6.
The medications that may interact with Delsym are drugs that impact how well CYP2D6 works. Some medications (CYP2D6 inhibitors) can decrease the action of CYP2D6, which increases the amount of Delsym in your body.
Examples of CYP2D6 inhibitors include:
Bupropion Fluoxetine Paroxetine Terbinafine Quinidine
Conversely, some medications (CYP2D6 inducers) can increase the action of CYP2D6, which decreases the Delsym in your body.
Examples of CYP2D6 inducers are below.
DexamethasoneRifampin
What Medications Are Similar?
Delsym is a very common medication used during cold and flu season, but it is not the only medication that can treat a cough. Some examples of other cough medications include:
Benzonatate Codeine Robitussin (dextromethorphan) Guaifenesin
Benzonatate, available under the brand names Tessalon Perles and Zonatuss, is a cough medication similar to dextromethorphan. Both dextromethorphan and benzonatate are unlikely to be addictive since neither is in the opioid drug class. Compared with drugs in the opioid class (like codeine), Delsym and benzonatate tend to have fewer side effects.
Codeine is part of the opioid drug class. Delsym was found to work as well, or sometimes better, than codeine in cough relief in clinical studies.
Robitussin has the same active ingredient as Delsym (dextromethorphan).
Guaifenesin, available under brand names such as Mucinex, is not a cough suppressant but is often used for cough because it helps thin mucus. Cough preparations often will have both guaifenesin and dextromethorphan together.
This list is a list of drugs also prescribed for the targeted condition(s). It is NOT a list of drugs recommended to take with Delsym. In fact, some of these drugs you should not take together. For example, Robitussin and Delsym should NOT be taken together; they both have the same active ingredient, and you risk overdose. Ask your pharmacist or a healthcare practitioner if you have questions.
How Can I Stay Healthy While Taking Delsym?
Although remembering to take a medication can be difficult at first, it’s important to take Delsym regularly to help minimize your coughing symptoms.
In addition to taking your medication, make sure to get lots of rest, stay hydrated, and eat a healthy diet. Although you may not feel the best whenever you have a cough from a cold or flu, having a healthy lifestyle can improve how quickly you recover. Contact your healthcare provider if your symptoms worsen, and OTC medications are not working.
