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Maxifed DMX and Quinidex Extentabs

Determining the interaction of Maxifed DMX and Quinidex Extentabs and the possibility of their joint administration.

Check result:

Maxifed DMX <> Quinidex Extentabs

Relevance: 26.06.2022 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

Maxifed DMX

Generic Name: dextromethorphan / guaifenesin / pseudoephedrine

Brand name: Altarussin CF, Capmist DM, Despec DM, Entre-Cough, Maxifed DMX, Robitussin Cold and Cough, Tusnel, Aldex GS DM, Desgen, Despec-DM, Maxifed DM, Anatuss DM, Ambenyl-D, Dimacol, Novahistine DMX, Ru-Tuss Expectorant, Rhinosyn-X, Sudafed Cough, Dorcol Childrens Cough, Syn-Rx DM, Guaifenex DM RX, Suda-Tussin DM, Pseudogest-DM, Robitussin Pediatric Cough and Decongestant, Benylin Multi-Symptom Cough, Sudafed Cough Syrup, Daytime Liquicap, Multi Symptom Cough and Cold, Tussin Cough and Cold, Protuss DM, Med-RX DM, Tussafed-LA, Touro CC, Balminil DM-D-E Extra Strength, Benylin DM-D-E, Benylin DM-D-E Extra Strength, Calmylin #4, Novahistine DM Expectorant with Decongestant, Medent DM, Robitussin CF, Profen Forte DM, Profen II DM, Profen II DM Liquid, S-Pak DM, Ru-Tuss DM, Dimetapp Cold and Congestion, PanMist-DM, Relacon-DM, Coldmist DM, Z-COF DM, Ambifed-G DM, Tusnel Pediatric, Touro CC-LD, Relacon-DM NR, Despec Drops, Liquicough DM, Pseudo Cough, Relasin DM, Z-Cof 12DM, Q-Tussin CF, Ambi 60/580/30, Ambi 80/780/40, Ambi 600/1000/30, Trikof-D, Pseudo DM GG, Pseudo Max DMX, SudaTex-DM, ExeFen-DMX, Medent-DMI, Donatussin DM Syrup, Ambifed DM, Tenar DM, Robitussin D, ExeClear-DM, Z-Cof 8DM, Robitussin D Cough & Cold, TL-Dex DM, Tusnel DM Pediatric Drops, Trispec PSE, Poly-Vent DM, Tusnel-DM Pediatric Drops

Synonyms: n.a.

What is Maxifed DMX?

Quinidex Extentabs

Generic Name: quinidine

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

Synonyms: n.a.

What is Quinidex Extentabs?

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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.

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