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# TUSQD (TUSILCOUGH QD) ## Overview Tusqd is a brand name for a combination product containing dextromethorphan hydrobromide and guaifenesin. Dextromethorphan is a cough suppressant, and guaifenesin is an expectorant. ## Primary Indications * Temporary relief of cough due to minor throat and bronchial irritation. * Helps loosen phlegm (sputum) and thin bronchial secretions to make coughs more productive. ## Adult Dosing * **Dextromethorphan/Guaifenesin:** 10 mL every 12 hours. Do not exceed 2 doses in 24 hours. ## Pediatric Dosing * **Children 6 to under 12 years:** 5 mL every 12 hours. Do not exceed 2 doses in 24 hours. * **Children under 6 years:** Use is not recommended unless directed by a healthcare provider. Safety and efficacy in this age group are not established. ## Dose Adjustments No specific dose adjustments are typically required for renal or hepatic impairment, but caution is advised and consultation with a healthcare provider is recommended due to potential accumulation of ingredients. ## Contraindications * Known hypersensitivity to dextromethorphan or guaifenesin. * Use within 14 days of starting or stopping a monoamine oxidase inhibitor (MAOI). * Use in patients with phenylketonuria (if aspartame is present in the formulation). ## Adverse Effects * **Common:** Dizziness, drowsiness, nausea, vomiting, stomach upset. * **Serious:** Serotonin syndrome (especially with concomitant serotonergic agents), respiratory depression (at supratherapeutic doses), allergic reactions. ## Key Drug Interactions * **Monoamine Oxidase Inhibitors (MAOIs):** Concomitant use can lead to serotonin syndrome, a potentially life-threatening condition. Avoid use within 14 days of MAOI discontinuation or initiation. * **Serotonergic Agents (e.g., SSRIs, SNRIs, triptans, tramadol):** Increased risk of serotonin syndrome. * **Central Nervous System (CNS) Depressants (e.g., alcohol, benzodiazepines, opioids):** Additive CNS depression. ## Monitoring * Monitor for effectiveness in reducing cough and loosening secretions. * Assess for adverse effects, particularly dizziness, drowsiness, and signs/symptoms of serotonin syndrome. ## Clinical Pearls * This medication is for symptomatic relief and does not treat the underlying cause of the cough. * Advise patients to avoid alcohol and other CNS depressants while taking this medication. * If cough persists for more than 7 days, is accompanied by fever, rash, or persistent headache, discontinue use and consult a healthcare provider. **Disclaimer:** This information is intended for clinical use and is not a substitute for professional medical advice. Always consult the most current prescribing information or your healthcare provider for complete and up-to-date drug information.