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Coricidin HBP Chest Congestion & Cough and Quinidex Extentabs

Determining the interaction of Coricidin HBP Chest Congestion & Cough and Quinidex Extentabs and the possibility of their joint administration.

Check result:
Coricidin HBP Chest Congestion & Cough <> Quinidex Extentabs
Relevance: 06.05.2022 Reviewer: Shkutko P.M., M.D., in

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Consumer:

Using dextromethorphan together with quiNIDine may increase the effects of dextromethorphan. Contact your doctor if you experience difficulty breathing, dizziness, drowsiness, anxiety, restless feeling, nervousness, confusion, or diarrhea. If your doctor does prescribe these medications together, you may need a dose adjustment or special test to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Professional:

GENERALLY AVOID: Coadministration with potent CYP450 2D6 inhibitors (e.g., quinidine, terbinafine) may significantly increase the plasma concentrations of dextromethorphan in patients who are extensive metabolizers of this isoenzyme (approximately 93% of Caucasians and more than 98% of Asians and individuals of African descent). The proposed mechanism is inhibition of the CYP450 2D6-mediated O-demethylation of dextromethorphan. Studies in humans have shown an increase in systemic exposure of dextromethorphan of up to 43-fold when given concurrently with quinidine. Increased plasma concentrations increase the risk of dextromethorphan-related adverse effects (e.g., agitation, confusion, tremor, insomnia, diarrhea, and respiratory depression) and serotonin syndrome. However, this interaction has also been used clinically, with dextromethorphan in combination with quinidine indicated by some authorities for the treatment of pseudobulbar affect. Data evaluating the impact of this interaction in patients who are poor metabolizers of CYP450 2D6 are limited; most studies include extensive metabolizers of this isoenzyme. It is expected that poor metabolizers would have elevated dextromethorphan levels without concurrent quinidine

MANAGEMENT: The combination of dextromethorphan with potent CYP450 2D6 inhibitors should be generally avoided. Some manufacturers consider the concomitant use of dextromethorphan and selective serotonin reuptake inhibitors contraindicated. If use is considered necessary, the patient should be monitored for signs of dextromethorphan adverse effects (e.g., agitation, confusion, tremor, insomnia, diarrhea, and respiratory depression) and serotonin syndrome, and advised to notify their health care professional if these adverse effects develop or worsen. Dose reduction of dextromethorphan may also be required.

References
  • "Product Information. Nuedexta (dextromethorphan-quinidine)." Avanir Pharmaceuticals, Inc, Aliso Viejo, CA.
  • Cerner Multum, Inc. "Australian Product Information." O 0
  • Capon DA, Bochner F, Kerry N, Mikus G, Danz C, Somogyi AA "The influence of CYP2d6 polymorphism and quinidine on the disposition and antitussive effect of dextromethorphan in humans." Clin Pharmacol Ther 60 (1996): 295-307
  • Zhang Y, Britto MR, Valderhaug KL, Wedlund PJ, Smith RA "Dextromethorphan: enhancing its systemic availability by way of low-dose quinidine-mediated inhibition of cytochrome P4502D6." Clin Pharmacol Ther 51 (1992): 647-55
  • Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  • Schadel M, Wu DA, Otton SV, Kalow W, Sellers EM "Pharmacokinetics of dextromethorphan and metabolites in humans: influence of the CYP2d6 phenotype and quinidine inhibition." J Clin Psychopharmacol 15 (1995): 263-9
Coricidin HBP Chest Congestion & Cough

Generic Name: dextromethorphan / guaifenesin

Brand name: Aquatab DM, Broncotron, Coricidin HBP Chest Congestion & Cough, DayQuil Mucus Control DM, Delsym Cough Plus Chest Congestion DM, Fenesin DM IR, G-Zyncof, Mucinex DM, Phlemex, Robitussin Cough + Chest Congestion DM, Safetussin DM, Siltussin DM, TabTussin DM, Tussin DM, Zyncof, Bidex-A, Guaifenex DM, Biospec DMX, Robitussin DM, Mucinex Cough Mini-Melts, Tussi-Organidin DM-S NR, Tussi-Organidin DM NR, Gani-Tuss-DM NR, Guaibid DM, Muco-Fen DM, Guiadrine DM, Fenex-DM, Iobid DM, Q-Bid DM, Aquabid DM, Touro DM, Respa-DM, Mucobid DM, Fenesin DM, Humibid DM Pediatric, Iofen-DM NF, Phanatuss, Naldecon Senior DX, Guiatussin-DM, Halotussin DM, Guiatuss DM, Halotussin DM Sugar Free, Rhinosyn-DMX, Tuss-DM, Kolephrin GG/DM, Cheracol D Cough, Genatuss DM, Glycotuss-DM, Mytussin DM, Tolu-Sed DM, Benylin Expectorant, Vicks 44E Pediatric, Guiacough DM, Lotussin DM, Anti-Tuss DM, Biotuss DM, Cheracol-D, GG/DM, Mastussin DM, Recofen D, Recofen Plus, Ri-Tussin DM, Robafen DM, Robichem DM, T-Tussin DM, Tusscidin DM, Bidex-DM, Diabetic Suppressant, Duraganidin, G Bid DM, GG-DM SR, Humigen DM, Tussidin DM, Altarussin DM, Amibid DM, Guiat Clear DM, Cough Formula-DM, Double-Tussin DM, Guaiasorb Cough Medicine, Kita La Tos, Q-Tussin DM, Scot-Tussin DM, Nalspan Senior DX, Diabetic Tuss DM, Vicks 44E, Scot-Tussin Senior, Naldecon DX Liquigel, Safetussin 30 DM, Duratuss DM, Guiatuss Clear, Iophen DM NR, Allfen-DM, S-Pack DM, HT Tuss DM, Monafed DM, Hydro-Tuss DM, Drituss DM, Liquibid-D LA, Guaifen DM, Maxi-Tuss DM, Robitussin-SF, Su-Tuss DM, Muco-Fen 800 DM, Guai-Dex, GuaiFENesin DM, GuaiFENesin DM SR, Tussi-Bid, Sudal DM, Iophen DM, Ru-Tuss 800 DM, Mintab DM, Mindal DM, Atuss-12 DX, Z-Cof LA, Extuss LA, DuraDEX, Humibid CS, Diabetic Tuss DM Maximum Strength, Siltussin DM DAS Cough Formula, Simuc-DM, Cofex-DM, Mucus Relief DM, G-Bid DM, Relacon LAX, Ambi 1000/55, Z-Cof LAX, Robafen DM Clear, DuraDEX Forte, Robitussin DM Infant Drops, Zotex DMX, Mucinex Children's Cough, Duratuss DM 12, Robitussin Cough Sugar-Free DM, Dex-Tuss DM, Mucinex DM Maximum Strength, GuaiFENesin DM NR, Children's Mucus Relief Cough, Siltussin-DM DAS-NA, Siltussin-DM DAS-NA Maximum Strength, ExeFen-DM, Bidex-DMI, Mucinex Children's Cough Mini-Melts, Robitussin Cough & Cong, Coricidin HBP Congestion/Cough

Synonyms: n.a.

Quinidex Extentabs

Generic Name: quinidine

Brand name: Quin-G, Cardioquin, Quinora, Quinidex Extentabs, Quinaglute Dura-Tabs, Quin-Release

Synonyms: n.a.

In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.