dextromethorphan hydrobromide + diphenhydramine hydrochloride + levomenthol at a glance
Medicine class
Non-opioid cough suppressant combined with a sedating antihistamine and menthol.
Cough type
For a persistent, dry, irritating night-time cough—not one producing substantial phlegm.
Drowsiness
May cause sleepiness and impaired coordination. Avoid alcohol and do not drive if affected.
Age restriction
Must not be used in children under 12 years.
What is dextromethorphan hydrobromide + diphenhydramine hydrochloride + levomenthol used for?
Licensed uses include:
Night-time relief of persistent, dry, irritating cough.
Helping restful sleep when this cough is disruptive.
How does dextromethorphan hydrobromide + diphenhydramine hydrochloride + levomenthol work?
Dextromethorphan raises the threshold for the cough reflex in the brainstem. Diphenhydramine has cough-suppressing, sedating antihistamine and antimuscarinic effects. Levomenthol produces a cooling sensation and has mild local anaesthetic and decongestant properties.
How to take dextromethorphan hydrobromide + diphenhydramine hydrochloride + levomenthol
Take the syrup by mouth and follow the pack instructions. Do not combine it with another cough or cold remedy or any other diphenhydramine-containing product, including products applied over large skin areas. Avoid alcohol and never use it simply to sedate a child.
Check the ingredients of other products before combining them.
Do not drive or operate machinery until you know how the syrup affects you.
Seek advice if the cough persists, worsens, produces substantial phlegm, or occurs with asthma or chronic lung disease.
dextromethorphan hydrobromide + diphenhydramine hydrochloride + levomenthol side effects
Common or expected effects
- Drowsiness
- Dizziness or headache
- Reduced coordination
- Blurred vision
- Dry mouth or thickened bronchial secretions
- Stomach upset
- Weakness
- Difficulty passing urine
Get urgent medical advice
- Swelling affecting the face, mouth, tongue or throat; breathing or swallowing difficulty
- Severe rash, blistering, peeling or widespread hives
- Hallucinations or seizures
- Shallow breathing or respiratory depression
- Fast or irregular heartbeat
- Serotonin syndrome features such as agitation, high temperature, muscle rigidity, exaggerated reflexes or unstable blood pressure
dextromethorphan hydrobromide + diphenhydramine hydrochloride + levomenthol in pregnancy
Do not use during pregnancy unless a doctor considers the expected benefit greater than the possible fetal risk. Evidence for the complete combination is limited, and diphenhydramine crosses the placenta.
dextromethorphan hydrobromide + diphenhydramine hydrochloride + levomenthol while breastfeeding
The combination is not recommended during breastfeeding unless a clinician considers the benefit greater than the risk. Diphenhydramine enters breast milk and may cause infant drowsiness; combination products containing it are preferably avoided, particularly with a newborn or while milk supply is being established.
dextromethorphan hydrobromide + diphenhydramine hydrochloride + levomenthol interactions
Check prescribed, non-prescribed and recreational substances before use because sedation and serotonin toxicity can be clinically important.
Monoamine oxidase inhibitors
Do not combine or use within 14 days of stopping an MAOI because severe serotonin toxicity or a hypertensive reaction may occur.
Selective serotonin reuptake inhibitors
Concurrent use is contraindicated because dextromethorphan can contribute to serotonin syndrome.
CYP2D6 inhibitors
Fluoxetine, paroxetine, bupropion, quinidine or terbinafine may substantially increase and prolong dextromethorphan effects.
Common questions about dextromethorphan hydrobromide + diphenhydramine hydrochloride + levomenthol
Answers are fully visible for fast scanning and source review.
What type of cough is it for?
A persistent, dry, irritating cough at night. A cough producing substantial phlegm needs assessment rather than routine suppression with this product.
Does it cause sleepiness?
Yes. Diphenhydramine is sedating, and drowsiness is a very common effect of the combination.
Can I drive after taking it?
Do not drive until you know how it affects you, and never drive if sleepy, dizzy, blurred, poorly coordinated or unable to concentrate safely.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.