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Dextromethorphan is rapidly absorbed from the gastrointestinal tract and converted into the active metabolite dextrorphan in the liver by the cytochrome P450 enzyme CYP2D6. The average dose necessary for effective antitussive therapy is between 10 and 45 mg, depending on the individual.
The drugs and the enzymes they probe are as follows - caffeine (probes CYP1A2, N-acetyltransferase 2, xanthine oxidase), midazolam (probes CYP3A), omeprazole (probes CYP2C19) and dextromethorphan (probes CYP2D6). After giving the cocktail, the concentrations of the drugs and their metabolites in plasma (for midazolam and omeprazole) and urine ...
Combining dextromethorphan with other CYP2D6 substrates can cause both drugs to build to dangerous levels in the bloodstream. [30] [31] Combining dextromethorphan with other serotonergic drugs could possibly cause serotonin syndrome, an excess of serotonergic activity in the CNS and peripheral nervous system.
The dose of bupropion in the study was lower than the target dose recommended for clinical practice. [10] In this study, dextromethorphan/bupropion showed significantly greater improvement than bupropion alone in the first two weeks of treatment but not by week 6 of treatment in people with major depressive disorder.
The recommended adult dose contains: Acetaminophen (650 mg/30 mL) (pain reliever/fever reducer) Dextromethorphan (30 mg/30 mL) (cough suppressant) Doxylamine succinate (12.5 mg/30 mL) (antihistamine/hypnotic) Alcohol (10% by volume) The LiquiCap capsule version has the following active ingredients per pill, half the recommended adult dose:
dextromethorphan 11%, quinidine 70-80%. Food has no effect on absorption. Metabolism: Liver, extensive. Dextromethorphan is catalyzed by CYP2D6. Quinidine is metabolized by CYP3A4 and competitively inhibits the metabolism of dextromethorphan to increase and prolong plasma concentrations of dextromethorphan: Elimination half-life
Quinidine is an inhibitor of the cytochrome P450 enzyme 2D6, and can lead to increased blood levels of lidocaine, beta blockers, opioids, and some antidepressants. Quinidine also inhibits the transport protein P-glycoprotein and so can cause some peripherally acting drugs such as loperamide to have central nervous system side effects, such as ...
Deudextromethorphan/quinidine (d-DXM/Q; developmental code names AVP-786, CTP-786) is a combination of deudextromethorphan (d-DXM; deuterated (d6) dextromethorphan (DXM)) and quinidine (Q) which is under development by Avanir Pharmaceuticals for the treatment of a variety of neurological and psychiatric indications.