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# TUSQ QD ## Overview Tusq QD is a combination product containing **dextromethorphan** (an antitussive) and **guaifenesin** (an expectorant). ## Primary Indications * Relief of cough associated with the common cold. * Aids in loosening mucus in airways. ## Adult Dosing * **Immediate-release formulation:** 10 mL every 6 hours as needed. * **Extended-release formulation:** 10 mL every 12 hours as needed. * **Maximum daily dose:** Not to exceed 4 doses in 24 hours for immediate-release or 2 doses in 24 hours for extended-release. ## Pediatric Dosing * **Children 6 to 12 years:** * Immediate-release formulation: 5 mL every 6 hours as needed. * Extended-release formulation: 5 mL every 12 hours as needed. * **Children under 6 years:** Consult a pediatrician. Safety and efficacy have not been established in this age group. ## Dose Adjustments No specific dose adjustments are typically required for renal or hepatic impairment, but caution is advised in patients with severe dysfunction. ## Contraindications * Hypersensitivity to dextromethorphan or guaifenesin. * Use within 14 days of MAOI therapy. ## Adverse Effects * **Common:** Dizziness, drowsiness, nausea, vomiting. * **Less common:** Constipation, rash, confusion, hallucinations (especially at higher doses). ## Key Drug Interactions * **MAOIs:** Risk of serotonin syndrome, severe hypertension. * **SSRIs/SNRIs:** Increased risk of serotonin syndrome. * **CYP2D6 Inhibitors (e.g., fluoxetine, paroxetine, quinidine):** May increase dextromethorphan levels, leading to potential toxicity. * **Alcohol:** Additive CNS depression. ## Monitoring * Monitor for cough suppression and mucus expectoration. * Assess for adverse effects, particularly CNS effects and signs of serotonin syndrome if interacting medications are used. ## Clinical Pearls * Tusq QD is intended for symptomatic relief. It does not treat the underlying cause of the cough. * Dextromethorphan can be abused for its psychoactive effects at supra-therapeutic doses. * Ensure adequate hydration to help thin mucus when using guaifenesin. *** **Disclaimer:** This information is intended for healthcare professionals and is not a substitute for professional medical advice. Always consult the most current prescribing information and professional judgment before making clinical decisions. Dosing and recommendations may vary based on patient-specific factors and local guidelines.