Please check your internet connection and try again.
## Overview
Tus%25252525252525252525252525252525252525252525252525252525252525252525252525252520qd is a combination product containing dextromethorphan, an antitussive, and guaifenesin, an expectorant.
## Primary Indications
* Symptomatic relief of cough and chest congestion associated with the common cold or other upper respiratory tract infections.
## Adult Dosing
* **Dextromethorphan/Guaifenesin:**
* Typically available in various strengths, e.g., 10 mg/100 mg, 15 mg/100 mg, 20 mg/200 mg per 5 mL or per tablet.
* Common dosing is 10-20 mg dextromethorphan and 100-200 mg guaifenesin every 4-6 hours as needed.
* Maximum dextromethorphan dose is typically 120 mg in 24 hours.
* Maximum guaifenesin dose is typically 1200 mg in 24 hours.
* Specific dosing depends on the product formulation and concentration. Consult the product label for precise amounts.
## Pediatric Dosing
* **Dextromethorphan/Guaifenesin:**
* Dosing in children under 12 years of age is generally not recommended due to lack of established safety and efficacy for combination products.
* For children 6-11 years: Doses are typically half of the adult dose, but specific product labeling should be followed.
* For children under 6 years: Use with extreme caution and only under medical supervision. Many formulations are not recommended for this age group.
## Dose Adjustments
* No specific dose adjustments are generally required for renal or hepatic impairment, but caution is advised. Guaifenesin is renally excreted, and prolonged use in severe renal impairment may lead to accumulation.
## Contraindications
* Hypersensitivity to dextromethorphan or guaifenesin.
* Use within 14 days of a MAOI or within 14 days of stopping an MAOI.
* Significant hepatic impairment.
* Asthma, emphysema, persistent or chronic cough, or cough accompanied by excessive secretions.
## Adverse Effects
* **Common:** Nausea, vomiting, dizziness, drowsiness, confusion.
* **Less Common:** Rash, urticaria, gastrointestinal upset, respiratory depression (at supratherapeutic doses of dextromethorphan).
## Key Drug Interactions
* **MAOIs:** Risk of hypertensive crisis.
* **SSRIs, SNRIs, Tricyclic Antidepressants, Opioids:** Increased risk of serotonin syndrome when combined with dextromethorphan.
* **CNS Depressants (e.g., alcohol, benzodiazepines, sedatives):** Additive CNS depression.
## Monitoring
* Monitor for effectiveness of cough suppression and expectoration.
* Assess for adverse effects, particularly CNS effects and respiratory depression.
## Clinical Pearls
* While guaifenesin is intended to thin mucus, its efficacy is debated and adequate hydration is often sufficient.
* Dextromethorphan can cause hallucinations and abuse potential at high doses.
* Product formulations vary widely; always confirm the exact milligrams per milliliter or per tablet.
* Discontinue use if cough persists for more than 7 days, recurs, or is accompanied by fever, rash, or persistent headache.
***
*Disclaimer: This information is intended for clinical professionals. Always consult the most current prescribing information and institutional guidelines before making any clinical decisions.*
