Last update April 24, 2022

Dextromethorphan

Very Low Risk

Safe. Compatible. Minimal risk for breastfeeding and infant.

Cough suppressant related with morphine and codeine (d-isomer of the codeine analog of levorphanol) which is lacking of analgesic, sedative or respiratory depression properties (Schaefer 2007, Bem 1992), except in case of overdose or abuse (Journey 2019, WHO 2012, Pender 1991). Commonly prescribed by pediatricians.

Dextromethorphan and its active metabolite, dextrorphan, are excreted in breast milk in clinically insignificant amounts. (Shum 2021) 

Because reported low toxicity and mild side effect, expert authors consider it safe, probably compatible during lactation. (Hale 2019, Briggs 2017, Schaefer 2007)

Frequently associated to caffeine and other products that are usually compatible with breastfeeding. It is advisable to avoid preparations with excessive alcohol concentration (> 20%) as excipient. (Nice 2000)

Alternatives

We do not have alternatives for Dextromethorphan since it is relatively safe.

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Dextromethorphan is also known as


Dextromethorphan in other languages or writings:

Group

Dextromethorphan belongs to this group or family:

Tradenames

Main tradenames from several countries containing Dextromethorphan in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 100 %
Molecular weight 370 daltons
Protein Binding 60 - 70 %
VD 5 - 6.7 l/Kg
pKa 9.85 -
Tmax 1 - 3 hours
3 - 6 hours
M/P ratio 1.1 - 2 -
Theoretical Dose 0.00033 - 0.0018 mg/Kg/d
Relative Dose 0.066 - 0.36 %

References

  1. Hale TW. Medications & Mothers' Milk. 1991- . Springer Publishing Company. Available from https://www.halesmeds.com Consulted on March 17, 2022 Full text (link to original source)
  2. Journey JD, Agrawal S, Stern E. Dextromethorphan Toxicity. 2021 Jun 28. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Consulted on July 24, 2021 Abstract
  3. Shum S, Yadav A, Fay E, Moreni S, Mao J, Czuba L, Wang C, Isoherranen N, Hebert MF. Infant Dextromethorphan and Dextrorphan Exposure via Breast Milk From Mothers Who Are CYP2D6 Extensive Metabolizers. J Clin Pharmacol. 2021 Dec 8. Abstract
  4. Journey JD, Stern E. Dextromethorphan Toxicity. 2019 Feb 17. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Abstract
  5. AEMPS Dextrometorfano. Ficha técnica. 2016 Full text (in our servers)
  6. WHO. Expert Committee on Drug Dependence. Dextromethorphan Pre-Review Report. WHO. 2012 Full text (in our servers)
  7. Schaefer C, Peters P, Miller RK. Drugs During Pregnancy and Lactation. Treatment options and risk assessment. Elsevier, second edition. London. 2007
  8. Nice FJ, Snyder JL, Kotansky BC. Breastfeeding and over-the-counter medications. J Hum Lact. 2000 Nov;16(4):319-31. Review. Erratum in: J Hum Lact 2001 Feb;17(1):90. Abstract
  9. Bem JL, Peck R. Dextromethorphan. An overview of safety issues. Drug Saf. 1992 Abstract
  10. Pender ES, Parks BR. Toxicity with dextromethorphan-containing preparations: a literature review and report of two additional cases. Pediatr Emerg Care. 1991 Jun;7(3):163-5. Abstract

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