Tomephen

Indications

Tomephen is recommended for:

• Chronic dry cough
• Unproductive cough
• Acute dry cough that disrupts normal activities or sleep.

Please use this medication only as directed by a registered healthcare professional.

Composition

Syrup: Each 5 ml of this sugar-free syrup contains 10 mg of Dextromethorphan Hydrobromide BP.

Pharmacology

Dextromethorphan Hydrobromide acts as a cough suppressant by targeting the cough center in the medulla. While it shares structural similarities with morphine, it does not possess analgesic effects and generally exhibits minimal sedative properties. There have been no reported cases of addiction, even with high doses taken over extended periods. This compound is swiftly absorbed from the gastrointestinal tract, showing effects within 15-30 minutes post-administration. The action lasts approximately 3-6 hours with standard dosing. Dextromethorphan is largely metabolized in the liver and is eliminated through urine as unchanged Dextromethorphan and demethylated metabolites, including Dextrophan, which also contributes to cough suppression. Within 24 hours, urinary excretion of the parent compound and its metabolites can account for up to 50% of the dosage. Notably, around 8% of the dose remains unchanged in the urine within the first 6 hours.

Dosage & Administration

• Adults and Children over 12 years: 15 to 30 mg, taken three to four times daily. Doses up to 60 mg four times a day have been administered without an increase in side effects.
• Children aged 6 to 12 years: 5-15 mg, taken up to four times daily.
• Children aged 2 to 6 years: 2.5-5 mg, taken up to four times daily.

Please follow the advice of a registered healthcare professional when administering this medication.

Interactions

Two serious interactions have been noted when combining phenelzine and dextromethorphan at therapeutic doses.

Contraindications

The use of Dextromethorphan Hydrobromide is contraindicated alongside monoamine oxidase inhibitors (MAOIs). Due to extensive liver metabolism, caution is advised when prescribing this medication to patients with liver disorders.

Side Effects

Adverse reactions to Tomephen are uncommon, though some individuals may experience nausea or dizziness. The drug does not produce analgesia or lead to addiction, and it causes minimal central nervous system (CNS) depression. Overdosage may result in excitation, confusion, or respiratory depression.

Pregnancy & Lactation

Limited information is available on the use of this medication during pregnancy; therefore, it is advisable to avoid it in the first trimester. There is no data regarding the presence of dextromethorphan in breast milk, so nursing mothers should refrain from using this drug.

Precautions & Warnings

Tomephen should not be utilized to suppress a cough associated with smoking, asthma, emphysema, or a productive cough that generates sputum or phlegm.

Therapeutic Class

Cough Suppressant

Storage Conditions

Store below 30°C, protected from light and moisture. Keep out of reach of children.