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Identification
Name Dextromethorphan
Accession Number DB00514 (APRD00655)
Type small molecule
Groups approved
Description

The d-isomer of the codeine analog of levorphanol. Dextromethorphan shows high affinity binding to several regions of the brain, including the medullary cough center. This compound is an NMDA receptor antagonist (receptors, N-methyl-D-aspartate) and acts as a non-competitive channel blocker. It is one of the widely used antitussives, and is also used to study the involvement of glutamate receptors in neurotoxicity. [PubChem]

Structure Thumb
Download: MOL | SDF | SMILES | InChI
Display: 2D Structure | 3D Structure
Synonyms
D-Methorphan
D-Methorphan Hydrobromide
Delta-Methorphan
Demorphan
Demorphan Hydrobromide
Demorphine
Destrometerfano [Dcit]
Dextromethorfan [Czech]
Dextromethorphan Bromhydrate
Dextromethorphan Bromide
Dextrometorfano [INN-Spanish]
Dextrometorphan
Dextromorphan
Dexyromethorphan
L-Methorphan
Levomethorphan
Levomethorphan [Ban:Dcf:Inn]
Levomethorphane [INN-French]
Levomethorphanum [INN-Latin]
Levometorfano [INN-Spanish]
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Salts Not Available
Brand names
Name Company
Antussan
Balminil DM
Balminil DM Children
Benylin Adult Formula Cough Suppressant
Benylin DM
Benylin DM 12 Hour
Benylin DM for Children
Benylin DM for Children 12 Hour
Benylin Pediatric Cough Suppressant
Calmylin #1
Canfodion
Cosylan
Cough-X
Creo-Terpin
Delsym
Delsym Cough Formula
Diabe-Tuss DM Syrup
Dormetan
Dormethan
Hihustan M.
Hold DM
Koffex DM
Medicon
Methorate Hydrobromide
Methorphan
Metrorat
Novahistex DM
Novahistine DM
Pertussin CS Children's Strength
Pertussin DM Extra Strength
Robitussin Maximum Strength Cough Suppressant
Robitussin Pediatric
Robitussin Pediatric Cough Suppressant
Romilar
Sucrets 4 Hour Cough Suppressant
Triaminic DM Long Lasting for Children
Trocal
Tusilan
Tussade
Vicks 44 Cough Relief
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Brand mixtures
Brand Name Ingredients
Actifed Dm Syrup Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride + Triprolidine Hydrochloride
Actifed Dm Tablets Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride + Triprolidine Hydrochloride
Antitussive Decong Antihistamine Syr Dextromethorphan Hydrobromide + Pheniramine Maleate + Phenylpropanolamine Hydrochloride + Pyrilamine Maleate
Benylin 4 Flu - Syrup Acetaminophen + Dextromethorphan Hydrobromide + Guaifenesin + Pseudoephedrine Hydrochloride
Biohisdex Dm Decongestant Dextromethorphan Hydrobromide + Diphenylpyraline Hydrochloride + Phenylephrine Hydrochloride
Biohisdine Dm Decongestant Dextromethorphan Hydrobromide + Diphenylpyraline Hydrochloride + Phenylephrine Hydrochloride
Bronchodex Fort-Dm Syr Ammonium Chloride + Dextromethorphan Hydrobromide + Menthol + Pyrilamine Maleate + Sodium Citrate
Bronchodex Pediatrique Dextromethorphan Hydrobromide + Guaifenesin + Pheniramine Maleate + Pseudoephedrine Hydrochloride
Bronchosirum Pour Enfants Dextromethorphan Hydrobromide + Pheniramine Maleate + Phenylpropanolamine Hydrochloride + Pyrilamine Maleate
Calmylin #2 Syr Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride
Calmylin #3 Syr Dextromethorphan Hydrobromide + Guaifenesin + Pseudoephedrine Hydrochloride
Calmylin #4 Syr Ammonium Chloride + Dextromethorphan Hydrobromide + Diphenhydramine Hydrochloride
Calmylin Cough and Flu Liq Acetaminophen + Dextromethorphan Hydrobromide + Guaifenesin + Pseudoephedrine Hydrochloride
Calmylin Pediatric Syrup Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride
Centracol Dm - Syr Dextromethorphan Hydrobromide + Pheniramine Maleate + Phenylpropanolamine Hydrochloride + Pyrilamine Maleate
Centracol Pediatrique - Syr Dextromethorphan Hydrobromide + Guaifenesin + Pheniramine Maleate + Pseudoephedrine Hydrochloride
Chemhisdex Dm Decongestant Dextromethorphan Hydrobromide + Diphenylpyraline Hydrochloride + Phenylephrine Hydrochloride
Chemhisdine Dm Decongestant Dextromethorphan Hydrobromide + Diphenylpyraline Hydrochloride + Phenylephrine Hydrochloride
Children's Tussin Cough Medicine Dm Antitussive Decongestant Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride
Children's Tylenol Cold Liquid with Dm Acetaminophen + Chlorpheniramine Maleate + Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride
Citron Chaud Dm Cumberland Pws Dextromethorphan Hydrobromide + Pheniramine Maleate + Phenylephrine Hydrochloride + Vitamin C
Cold Relief Dm Brompheniramine Maleate + Dextromethorphan Hydrobromide + Phenylpropanolamine Hydrochloride
Cold/Flu Relief Acetaminophen + Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride
Contac Cough Cold and Flu Caplets Acetaminophen + Chlorpheniramine Maleate + Dextromethorphan Hydrobromide + Phenylpropanolamine Hydrochloride
Cough and Flu Syrup Acetaminophen + Dextromethorphan Hydrobromide + Guaifenesin + Pseudoephedrine Hydrochloride
Cough Syrup Dm Decongestant Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride
Cough Syrup Dm Decongestant Expectorant Dextromethorphan Hydrobromide + Guaifenesin + Pseudoephedrine Hydrochloride
Cough Syrup Dm Decongestant for Children Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride
Cough Syrup Dm Expectorant Dextromethorphan Hydrobromide + Guaifenesin
Cough Syrup Dm-D-E Dextromethorphan Hydrobromide + Guaifenesin + Pseudoephedrine Hydrochloride
Cough Syrup Dm-E Dextromethorphan Hydrobromide + Guaifenesin
Cough Syrup Dm-Expectorant Dextromethorphan Hydrobromide + Guaifenesin
Cough Syrup W.Guaifenesin W.Dextromethorphan Dextromethorphan Hydrobromide + Guaifenesin
Cough, Cold & Allergy Relief Brompheniramine Maleate + Dextromethorphan Hydrobromide + Phenylephrine Hydrochloride + Phenylpropanolamine Hydrochloride
Dayquil Liquicaps Acetaminophen + Dextromethorphan Hydrobromide + Guaifenesin + Pseudoephedrine Hydrochloride
Dayquil Liquicaps - Cap Acetaminophen + Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride
Dayquil Medicine - Liq Acetaminophen + Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride
Daytime Cold & Flu Liquid Capsules Acetaminophen + Dextromethorphan Hydrobromide + Guaifenesin + Pseudoephedrine Hydrochloride
Daytime Liquid - Liq Acetaminophen + Dextromethorphan Hydrobromide + Guaifenesin + Pseudoephedrine Hydrochloride
Demdec Syr Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride
Dimetapp Children's Cough and Cold Liquid Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride
Dimetapp Cough & Cold Liqui-Gels - Cap Brompheniramine Maleate + Dextromethorphan Hydrobromide + Phenylpropanolamine Hydrochloride
Dimetapp Cough, Cold & Flu Acetaminophen + Brompheniramine Maleate + Dextromethorphan Hydrobromide + Phenylpropanolamine Hydrochloride
Dimetapp Dm Elixir Brompheniramine Maleate + Dextromethorphan Hydrobromide + Phenylephrine Hydrochloride + Phenylpropanolamine Hydrochloride
Dimetapp Dm Tab Brompheniramine Maleate + Dextromethorphan Hydrobromide + Phenylephrine Hydrochloride + Phenylpropanolamine Hydrochloride
Dm Cough Syr Ammonium Chloride + Dextromethorphan Hydrobromide + Diphenhydramine Hydrochloride
Dm Cough Syrup Decongestant Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride
Dm Cough Syrup Expectorant Dextromethorphan Hydrobromide + Guaifenesin
Dm Expectorant Cough Syrup Dextromethorphan Hydrobromide + Guaifenesin
Dm Plus Cough Syrup Ammonium Chloride + Dextromethorphan Hydrobromide + Diphenhydramine Hydrochloride
Dm Plus Decongestant Cough Syrup Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride
Dm Plus Decongestant Plus Expector.Ex.St.Syr Dextromethorphan Hydrobromide + Guaifenesin + Pseudoephedrine Hydrochloride
Dm Plus Decongestant Plus Expectorant Cough Syrup Dextromethorphan Hydrobromide + Guaifenesin + Pseudoephedrine Hydrochloride
Dm Plus Expectorant Syrup Dextromethorphan Hydrobromide + Guaifenesin
Dm Syrup Ammonium Chloride + Dextromethorphan Hydrobromide + Diphenhydramine Hydrochloride
Dm-D-Expectorant Cough and Cold Syrup Dextromethorphan Hydrobromide + Guaifenesin + Pseudoephedrine Hydrochloride
Extra Strength Cold Medication Daytime Rlf Acetaminophen + Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride
Extra Strength Daytime Cold Relief-Caplet Acetaminophen + Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride
Extra Strength Nighttime Cold Relief-Caplet Acetaminophen + Chlorpheniramine Maleate + Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride
Extra Strength Tylenol Cold and Flu Powder Acetaminophen + Chlorpheniramine Maleate + Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride
Hot Lemon Relief Dm Adult Dextromethorphan Hydrobromide + Pheniramine Maleate + Phenylephrine Hydrochloride
Koffex Dm + Decongestant + Expectorant Dextromethorphan Hydrobromide + Guaifenesin + Pseudoephedrine Hydrochloride
Koffex Dm + Decongestant + Expectorant Extra Strength Dextromethorphan Hydrobromide + Guaifenesin + Pseudoephedrine Hydrochloride
Koffex Dm + Decongestant Syrup Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride
Koffex Dm + Expectorant Dextromethorphan Hydrobromide + Guaifenesin
Koffex Dm + Expectorant Extra Strength Dextromethorphan Hydrobromide + Guaifenesin
Koffex Dm-D-E - Liq Dextromethorphan Hydrobromide + Guaifenesin + Pseudoephedrine Hydrochloride
Metrate Dextromethorphan Hydrobromide + Diphenylpyraline Hydrochloride + Potassium Iodide + Sodium Citrate
Neo Citran Daycaps Extra Strength - Caplet Acetaminophen + Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride
Nighttime Cold and Flu Liquid Capsules Acetaminophen + Dextromethorphan Hydrobromide + Doxylamine Succinate + Pseudoephedrine Hydrochloride
Nighttime Cold and Flu Relief Acetaminophen + Dextromethorphan Hydrobromide + Doxylamine Succinate + Pseudoephedrine Hydrochloride
Nitetime Cold Medicine Acetaminophen + Dextromethorphan Hydrobromide + Doxylamine Succinate + Pseudoephedrine Hydrochloride
Novahistex Dm Expectorant with Decongestant Dextromethorphan Hydrobromide + Guaifenesin + Pseudoephedrine Hydrochloride
Novahistex Dm with Decongestant Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride
Novahistine Dm Expectorant with Decongestant Dextromethorphan Hydrobromide + Guaifenesin + Pseudoephedrine Hydrochloride
Novahistine Dm with Decongestant - Liq Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride
Nyquil Liquicaps Acetaminophen + Dextromethorphan Hydrobromide + Doxylamine Succinate + Pseudoephedrine Hydrochloride
Ornade Dm 10 Liq Chlorpheniramine Maleate + Dextromethorphan Hydrobromide + Phenylpropanolamine Hydrochloride
Ornade Dm 15 Liq Chlorpheniramine Maleate + Dextromethorphan Hydrobromide + Phenylpropanolamine Hydrochloride
Ornade Dm 30 Liq Chlorpheniramine Maleate + Dextromethorphan Hydrobromide + Phenylpropanolamine Hydrochloride
Pediatric Cough Syrup Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride
Personnelle Dm Syr Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride
Pharmacol Dm Syr Dextromethorphan Hydrobromide + Pheniramine Maleate + Phenylpropanolamine Hydrochloride + Pyrilamine Maleate
Pharminicol Dm Syrup Dextromethorphan Hydrobromide + Pheniramine Maleate + Phenylpropanolamine Hydrochloride + Pyrilamine Maleate
Pharmitussin Dm Dextromethorphan Hydrobromide + Guaifenesin
Promatussin Dm Adult Formula Syr Dextromethorphan Hydrobromide + Promethazine Hydrochloride + Pseudoephedrine Hydrochloride
Promatussin Dm Children Formula Dextromethorphan Hydrobromide + Promethazine Hydrochloride + Pseudoephedrine Hydrochloride
Reg.Str.Cold Medic. Night Time Relief)Caplet (Acetaminophen + Chlorpheniramine Maleate + Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride
Regular Strength Cold Medication Daytime R.) (Acetaminophen + Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride
Regular Strength Tylenol Cold and Flu Powder Acetaminophen + Chlorpheniramine Maleate + Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride
Regular Strength Tylenol Cold Chest Congestion Acetaminophen + Dextromethorphan Hydrobromide + Guaifenesin + Pseudoephedrine Hydrochloride
Regular Strength Tylenol Cough Suspension Acetaminophen + Dextromethorphan Hydrobromide
Regular Strength Tylenol Cough Suspension with Decongestant Acetaminophen + Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride
Robitussin Honey Cough and Cold Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride
Robitussin Honey Flu Acetaminophen + Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride
Sudafed Cold and Cough Extra Strength Caplet Acetaminophen + Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride
Sudafed Cold and Flu Gel Caps Acetaminophen + Dextromethorphan Hydrobromide + Guaifenesin + Pseudoephedrine Hydrochloride
Sudafed Dm Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride
Tantacol Dm Syr Dextromethorphan Hydrobromide + Pheniramine Maleate + Phenylpropanolamine Hydrochloride + Pyrilamine Maleate
Theraflu Flu Cold and Cough Medicine Acetaminophen + Chlorpheniramine Maleate + Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride
Triaminic Dm Daytime Syr Dextromethorphan Hydrobromide + Guaifenesin + Phenylpropanolamine Hydrochloride
Triaminic Dm Expectorant Syr Chlorpheniramine Maleate + Dextromethorphan Hydrobromide + Guaifenesin + Pseudoephedrine Hydrochloride
Triaminic Dm Plus Decongestant Syrup Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride
Triaminic Dm+Decongestant Liqui-Gels Capsules Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride
Triaminicol Dm Syrup Chlorpheniramine Maleate + Dextromethorphan Hydrobromide + Pseudoephedrine Hydrochloride
Tussin Cough Medicine Dm Antitussive Expectorant Decongestant Dextromethorphan Hydrobromide + Guaifenesin + Pseudoephedrine Hydrochloride
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Categories
  • Analgesics, Opioid
  • Antitussive Agents
  • Excitatory Amino Acid Antagonists
CAS number 125-71-3
Weight Average: 271.3972
Monoisotopic: 271.193614427
Chemical Formula C18H25NO
InChI Key InChIKey=MKXZASYAUGDDCJ-CGTJXYLNSA-N
InChI
InChI=1S/C18H25NO/c1-19-10-9-18-8-4-3-5-15(18)17(19)11-13-6-7-14(20-2)12-16(13)18/h6-7,12,15,17H,3-5,8-11H2,1-2H3/t15-,17+,18+/m0/s1
Plain Text
IUPAC Name
(1R,9R,10R)-4-methoxy-17-methyl-17-azatetracyclo[7.5.3.0^{1,10}.0^{2,7}]heptadeca-2,4,6-triene
SMILES
[H][C@@]12CCCC[C@@]11CCN(C)[C@@H]2CC2=C1C=C(OC)C=C2
Plain Text
Mass Spec Not Available
Taxonomy
Kingdom Not Available
Classes Not Available
Substructures Not Available
Pharmacology
Indication For treatment and relief of dry cough.
Pharmacodynamics Dextromethorphan suppresses the cough reflex by a direct action on the cough center in the medulla of the brain. Dextromethorphan shows high affinity binding to several regions of the brain, including the medullary cough center. This compound is an NMDA receptor antagonist and acts as a non-competitive channel blocker. It is one of the widely used antitussives, and is also used to study the involvement of glutamate receptors in neurotoxicity.
Mechanism of action Dextromethorphan is an opioid-like drug that binds to and acts as antagonist to the NMDA glutamatergic receptor, it is an agonist to the opioid sigma 1 and sigma 2 receptors, it is also an alpha3/beta4 nicotinic receptor antagonist and targets the serotonin reuptake pump. Dextromethorphan is rapidly absorbed from the gastrointestinal tract, where it enters the bloodstream and crosses the blood-brain barrier. The first-pass through the hepatic portal vein results in some of the drug being metabolized into an active metabolite of dextromethorphan, dextrorphan, the 3-hydroxy derivative of dextromethorphan.
Absorption Rapidly absorbed from the gastrointestinal tract.
Volume of distribution Not Available
Protein binding Not Available
Metabolism Hepatic. Rapidly and extensively metabolized to dextrorphan (active metabolite). One well known metabolic catalyst involved is a specific cytochrome P450 enzyme known as 2D6, or CYP2D6.
Route of elimination Not Available
Half life 3-6 hours
Clearance Not Available
Toxicity Not Available
Affected organisms
  • Humans and other mammals
Pathways Not Available
Pharmacoeconomics
Manufacturers
  • Reckitt benckiser
Packagers
Dosage forms
Form Route Strength
Capsule Oral
Liquid Oral
Lozenge Oral
Strip Oral
Suspension Oral
Syrup Oral
Tablet Oral
Prices
Unit description Cost Unit
Modicon (28) 28 0.5-35 mg-mcg tablet Disp Pack 59.99 USD disp
Dextromethorphan powder 14.93 USD g
Dextromethorphan hbr powder 4.74 USD g
Dextromethorphan hbr cryst 2.06 USD g
Triaminic allergy thin strip 0.35 USD strip
Triaminic cold-stuff nose strip 0.35 USD strip
Triaminic cgh-runny nose strip 0.3 USD each
Triaminic cough strips 0.3 USD strip
Triaminic cough-cold chew 0.27 USD each
Triaminic softchew tablet 0.27 USD tablet
Robitussin coughgels 0.25 USD each
Triaminic softchews tablet 0.25 USD tablet
Childrens triaminic decon spray 0.24 USD ml
Hold 4 hour lozenge regular 0.24 USD lozenge
Hca severe cough stopper cplet 0.23 USD each
Triaminicin tablet 0.23 USD tablet
Delsym 30 mg/5 ml suspension 0.11 USD ml
Robitussin dm to go liquid 0.09 USD ml
Apap allergy sinus caplet 0.05 USD caplet
Adlt robitussin cough-cold-flu 0.04 USD ml
Adt robitussin cough-cold d lq 0.04 USD ml
Adult robitussin cough syrup 0.04 USD ml
Robitussin chest congest syrup 0.04 USD ml
Robitussin cough & cold liquid 0.04 USD ml
Robitussin cough-cold liquid 0.04 USD ml
Robitussin cough-cong syrup 0.04 USD ml
Robitussin dm max liquid 0.04 USD ml
Robitussin long-acting liq 0.04 USD ml
Robitussin pe head & chest liq 0.04 USD ml
Robitussin-cough-chest-cong lq 0.04 USD ml
Robitussin-dm cough syrup 0.04 USD ml
Triaminic chest-nasal cong liq 0.04 USD ml
Triaminic cold & cough liquid 0.04 USD ml
Triaminic cold-allergy pe liq 0.04 USD ml
Triaminic cough-nasal cong liq 0.04 USD ml
Triaminic cough-sore throat lq 0.04 USD ml
Triaminic flu cough-fever susp 0.04 USD ml
Triaminic flu-cough-fever liq 0.04 USD ml
Triaminic-d syrup 0.04 USD ml
Vicks 44 cough liquid 0.03 USD ml
Vicks 44 custom care liquid 0.03 USD ml
Guaifenesin dm syrup 0.02 USD ml
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DrugBank does not sell nor buy drugs. Pricing information is supplied for informational purposes only.
Patents
Country Patent Number Approved Expires (estimated)
United States 5980882 1997-04-16 2017-04-16
Properties
State solid
Experimental Properties
Property Value Source
water solubility 74.7 mg/L Not Available
logP 3.6 Not Available
Predicted Properties
Property Value Source
water solubility 8.51e-03 g/l ALOGPS
logP 3.75 ALOGPS
logP 3.49 ChemAxon
logS -4.5 ALOGPS
pKa (strongest basic) 9.85 ChemAxon
physiological charge 1 ChemAxon
hydrogen acceptor count 2 ChemAxon
hydrogen donor count 0 ChemAxon
polar surface area 12.47 ChemAxon
rotatable bond count 1 ChemAxon
refractivity 82.56 ChemAxon
polarizability 31.74 ChemAxon
References
Synthesis Reference Not Available
General Reference
  1. Brooks BR, Thisted RA, Appel SH, Bradley WG, Olney RK, Berg JE, Pope LE, Smith RA: Treatment of pseudobulbar affect in ALS with dextromethorphan/quinidine: a randomized trial. Neurology. 2004 Oct 26;63(8):1364-70. Pubmed
  2. Olney JW, Labruyere J, Price MT: Pathological changes induced in cerebrocortical neurons by phencyclidine and related drugs. Science. 1989 Jun 16;244(4910):1360-2. Pubmed
  3. Hargreaves RJ, Hill RG, Iversen LL: Neuroprotective NMDA antagonists: the controversy over their potential for adverse effects on cortical neuronal morphology. Acta Neurochir Suppl (Wien). 1994;60:15-9. Pubmed
  4. Carliss RD, Radovsky A, Chengelis CP, O’Neill TP, Shuey DL: Oral administration of dextromethorphan does not produce neuronal vacuolation in the rat brain. Neurotoxicology. 2007 Jul;28(4):813-8. Epub 2007 Apr 6. Pubmed
  5. Hernandez SC, Bertolino M, Xiao Y, Pringle KE, Caruso FS, Kellar KJ: Dextromethorphan and its metabolite dextrorphan block alpha3beta4 neuronal nicotinic receptors. J Pharmacol Exp Ther. 2000 Jun;293(3):962-7. Pubmed
External Links
Resource Link
KEGG Drug D03742 Link_out
KEGG Compound C06947 Link_out
ChEBI 4470 Link_out
ChEMBL 4470 Link_out
Therapeutic Targets Database DNC000541 Link_out
PharmGKB PA449273 Link_out
Drug Product Database 816000 Link_out
Drugs.com http://www.drugs.com/dextromethorphan.html Link_out
Wikipedia http://en.wikipedia.org/wiki/Dextromethorphan Link_out
ATC Codes
  • R05DA09
AHFS Codes
  • 48:16.00
  • 48:08.00
PDB Entries Not Available
FDA label Not Available
MSDS show (73.3 KB)
Interactions
Drug Interactions
Drug Interaction
Desvenlafaxine Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome.
Dihydroquinidine barbiturate Quinidine increases the toxicity of dextromethorphan
Fluoxetine Combination associated with possible serotoninergic syndrome
Isocarboxazid Possible severe adverse reaction
Moclobemide Increased CNS toxicity
Paroxetine Combination associated with possible serotoninergic syndrome
Phenelzine Possible severe adverse reaction
Quinidine Quinidine increases the toxicity of dextromethorphan
Quinidine barbiturate Quinidine increases the toxicity of dextromethorphan
Rasagiline Possible severe adverse reaction
Selegiline Combination associated with possible serotoninergic syndrome
Sibutramine Combination associated with possible serotoninergic syndrome
Terbinafine Terbinafine may reduce the metabolism and clearance of Dextromethorphan. Consider alternate therapy or monitor for therapeutic/adverse effects of Dextromethorphan if Terbinafine is initiated, discontinued or dose changed.
Tramadol Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome.
Tranylcypromine Increased risk of serotonin syndrome. Concomitant use should be avoided.
Trazodone Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome.
Trimipramine Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome.
Venlafaxine Increased risk of serotonin syndrome. Monitor for symptoms of serotonin syndrome.
Vilazodone Consideration should be given to avoiding the concomitant use of dextromethorphan and selective serotonin reuptake inhibitors (SSRI). Monitor for toxic effects of dextromethorphan (eg, CNS, Cardiovascular) if an SSRI is initiated or the dose is increased. SSRIs, other than fluoxetine and paroxetine, may be safer alternatives due to lesser CYP2D6 inhibition; however, the mechanism for the interaction is not fully understood, and caution is still advised.
Zolmitriptan Use of two serotonin modulators, such as zolmitriptan and dextromethorphan, increases the risk of serotonin syndrome. Consider alternate therapy or monitor for serotonin syndrome during concomitant therapy.
Food Interactions
  • Take without regard to meals.
Targets

1. Sigma 1-type opioid receptor

Pharmacological action: yes
Actions: agonist
Organism class: human
UniProt ID: Q99720 Link_out
Gene: OPRS1 Link_out
Protein Sequence: FASTA
Gene Sequence: FASTA
SNPs: SNPJam Report Link_out

References:
  1. Overington JP, Al-Lazikani B, Hopkins AL: How many drug targets are there? Nat Rev Drug Discov. 2006 Dec;5(12):993-6. Pubmed
  2. Imming P, Sinning C, Meyer A: Drugs, their targets and the nature and number of drug targets. Nat Rev Drug Discov. 2006 Oct;5(10):821-34. Pubmed
  3. Shin EJ, Nah SY, Chae JS, Bing G, Shin SW, Yen TP, Baek IH, Kim WK, Maurice T, Nabeshima T, Kim HC: Dextromethorphan attenuates trimethyltin-induced neurotoxicity via sigma1 receptor activation in rats. Neurochem Int. 2007 May;50(6):791-9. Epub 2007 Feb 4. Pubmed
  4. Shin EJ, Nah SY, Kim WK, Ko KH, Jhoo WK, Lim YK, Cha JY, Chen CF, Kim HC: The dextromethorphan analog dimemorfan attenuates kainate-induced seizures via sigma1 receptor activation: comparison with the effects of dextromethorphan. Br J Pharmacol. 2005 Apr;144(7):908-18. Pubmed
  5. Church AJ, Andrew RD: Spreading depression expands traumatic injury in neocortical brain slices. J Neurotrauma. 2005 Feb;22(2):277-90. Pubmed
  6. Chen X, Ji ZL, Chen YZ: TTD: Therapeutic Target Database. Nucleic Acids Res. 2002 Jan 1;30(1):412-5. Pubmed

2. Opioid receptor, sigma 1

Pharmacological action: yes
Actions: agonist
Organism class: human
UniProt ID: Q5T1J1 Link_out
Gene: OPRS1 Link_out
Protein Sequence: FASTA
Gene Sequence: FASTA
SNPs: SNPJam Report Link_out

References:
  1. Overington JP, Al-Lazikani B, Hopkins AL: How many drug targets are there? Nat Rev Drug Discov. 2006 Dec;5(12):993-6. Pubmed
  2. Imming P, Sinning C, Meyer A: Drugs, their targets and the nature and number of drug targets. Nat Rev Drug Discov. 2006 Oct;5(10):821-34. Pubmed
  3. Chou YC, Liao JF, Chang WY, Lin MF, Chen CF: Binding of dimemorfan to sigma-1 receptor and its anticonvulsant and locomotor effects in mice, compared with dextromethorphan and dextrorphan. Brain Res. 1999 Mar 13;821(2):516-9. Pubmed

3. Glutamate [NMDA] receptor subunit 3A

Pharmacological action: yes
Actions: antagonist

NMDA receptor subtype of glutamate-gated ion channels with reduced single-channel conductance, low calcium permeability and low voltage-dependent sensitivity to magnesium. Mediated by glycine. May play a role in the development of dendritic spines. May play a role in PPP2CB-NMDAR mediated signaling mechanism

Organism class: human
UniProt ID: Q8TCU5 Link_out
Gene: GRIN3A Link_out
Protein Sequence: FASTA
Gene Sequence: FASTA
SNPs: SNPJam Report Link_out

References:
  1. Overington JP, Al-Lazikani B, Hopkins AL: How many drug targets are there? Nat Rev Drug Discov. 2006 Dec;5(12):993-6. Pubmed
  2. Imming P, Sinning C, Meyer A: Drugs, their targets and the nature and number of drug targets. Nat Rev Drug Discov. 2006 Oct;5(10):821-34. Pubmed
  3. Chou YC, Liao JF, Chang WY, Lin MF, Chen CF: Binding of dimemorfan to sigma-1 receptor and its anticonvulsant and locomotor effects in mice, compared with dextromethorphan and dextrorphan. Brain Res. 1999 Mar 13;821(2):516-9. Pubmed
  4. Wong BY, Coulter DA, Choi DW, Prince DA: Dextrorphan and dextromethorphan, common antitussives, are antiepileptic and antagonize N-methyl-D-aspartate in brain slices. Neurosci Lett. 1988 Feb 29;85(2):261-6. Pubmed
  5. Kamel IR, Wendling WW, Chen D, Wendling KS, Harakal C, Carlsson C: N-methyl-D-aspartate (NMDA) antagonists—S(+)-ketamine, dextrorphan, and dextromethorphan—act as calcium antagonists on bovine cerebral arteries. J Neurosurg Anesthesiol. 2008 Oct;20(4):241-8. Pubmed

4. Neuronal acetylcholine receptor subunit alpha-2

Pharmacological action: unknown
Actions: antagonist

After binding acetylcholine, the AChR responds by an extensive change in conformation that affects all subunits and leads to opening of an ion-conducting channel across the plasma membrane

Organism class: human
UniProt ID: Q15822 Link_out
Gene: CHRNA2 Link_out
Protein Sequence: FASTA
Gene Sequence: FASTA
SNPs: SNPJam Report Link_out

References:
  1. Overington JP, Al-Lazikani B, Hopkins AL: How many drug targets are there? Nat Rev Drug Discov. 2006 Dec;5(12):993-6. Pubmed
  2. Imming P, Sinning C, Meyer A: Drugs, their targets and the nature and number of drug targets. Nat Rev Drug Discov. 2006 Oct;5(10):821-34. Pubmed
  3. Damaj MI, Flood P, Ho KK, May EL, Martin BR: Effect of dextrometorphan and dextrorphan on nicotine and neuronal nicotinic receptors: in vitro and in vivo selectivity. J Pharmacol Exp Ther. 2005 Feb;312(2):780-5. Epub 2004 Sep 8. Pubmed
  4. Lee JH, Shin EJ, Jeong SM, Kim JH, Lee BH, Yoon IS, Lee JH, Choi SH, Lee SM, Lee PH, Kim HC, Nah SY: Effects of dextrorotatory morphinans on alpha3beta4 nicotinic acetylcholine receptors expressed in Xenopus oocytes. Eur J Pharmacol. 2006 Apr 24;536(1-2):85-92. Epub 2006 Mar 2. Pubmed

5. Sodium-dependent serotonin transporter

Pharmacological action: unknown
Actions: inhibitor

Terminates the action of serotonine by its high affinity sodium-dependent reuptake into presynaptic terminals

Organism class: human
UniProt ID: P31645 Link_out
Gene: SLC6A4 Link_out
Protein Sequence: FASTA
Gene Sequence: FASTA
SNPs: SNPJam Report Link_out

References:
  1. Overington JP, Al-Lazikani B, Hopkins AL: How many drug targets are there? Nat Rev Drug Discov. 2006 Dec;5(12):993-6. Pubmed
  2. Imming P, Sinning C, Meyer A: Drugs, their targets and the nature and number of drug targets. Nat Rev Drug Discov. 2006 Oct;5(10):821-34. Pubmed
  3. Codd EE, Shank RP, Schupsky JJ, Raffa RB: Serotonin and norepinephrine uptake inhibiting activity of centrally acting analgesics: structural determinants and role in antinociception. J Pharmacol Exp Ther. 1995 Sep;274(3):1263-70. Pubmed
  4. Henderson MG, Fuller RW: Dextromethorphan antagonizes the acute depletion of brain serotonin by p-chloroamphetamine and H75/12 in rats. Brain Res. 1992 Oct 30;594(2):323-6. Pubmed

Enzymes

1. Cytochrome P450 3A4

Actions: substrate

Cytochromes P450 are a group of heme-thiolate monooxygenases. In liver microsomes, this enzyme is involved in an NADPH-dependent electron transport pathway. It performs a variety of oxidation reactions (e.g. caffeine 8-oxidation, omeprazole sulphoxidation, midazolam 1'-hydroxylation and midazolam 4- hydroxylation) of structurally unrelated compounds, including steroids, fatty acids, and xenobiotics. The enzyme also hydroxylates etoposide

UniProt ID: P08684 Link_out
Gene: CYP3A4
Protein Sequence: FASTA
Gene Sequence: FASTA
SNPs: SNPJam Report Link_out

References:
  1. Flockhart DA. Drug Interactions: Cytochrome P450 Drug Interaction Table. Indiana University School of Medicine (2007). Accessed May 28, 2010.
  2. Zhou SF, Zhou ZW, Yang LP, Cai JP: Substrates, inducers, inhibitors and structure-activity relationships of human Cytochrome P450 2C9 and implications in drug development. Curr Med Chem. 2009;16(27):3480-675. Epub 2009 Sep 1. Pubmed
  3. Preissner S, Kroll K, Dunkel M, Senger C, Goldsobel G, Kuzman D, Guenther S, Winnenburg R, Schroeder M, Preissner R: SuperCYP: a comprehensive database on Cytochrome P450 enzymes including a tool for analysis of CYP-drug interactions. Nucleic Acids Res. 2010 Jan;38(Database issue):D237-43. Epub 2009 Nov 24. Pubmed
  4. Yu A, Haining RL: Comparative contribution to dextromethorphan metabolism by cytochrome P450 isoforms in vitro: can dextromethorphan be used as a dual probe for both CTP2D6 and CYP3A activities? Drug Metab Dispos. 2001 Nov;29(11):1514-20. Pubmed

2. Cytochrome P450 2D6

Actions: substrate, inhibitor

Responsible for the metabolism of many drugs and environmental chemicals that it oxidizes. It is involved in the metabolism of drugs such as antiarrhythmics, adrenoceptor antagonists, and tricyclic antidepressants

UniProt ID: P10635 Link_out
Gene: CYP2D6 Link_out
Protein Sequence: FASTA
Gene Sequence: FASTA
SNPs: SNPJam Report Link_out

References:
  1. Zhou SF: Polymorphism of human cytochrome P450 2D6 and its clinical significance: Part I. Clin Pharmacokinet. 2009;48(11):689-723. Pubmed
  2. Flockhart DA. Drug Interactions: Cytochrome P450 Drug Interaction Table. Indiana University School of Medicine (2007). Accessed May 28, 2010.
  3. Zhou SF, Zhou ZW, Yang LP, Cai JP: Substrates, inducers, inhibitors and structure-activity relationships of human Cytochrome P450 2C9 and implications in drug development. Curr Med Chem. 2009;16(27):3480-675. Epub 2009 Sep 1. Pubmed
  4. © Tianyi Zhang, Yongxin Zhu, and Chandrani Gunaratna. Simultaneous Determination of Metabolites from Multiple Cytochrome P450 Probe Substrates by Gradient Liquid Chromatography with UV Detection. Source
  5. Preissner S, Kroll K, Dunkel M, Senger C, Goldsobel G, Kuzman D, Guenther S, Winnenburg R, Schroeder M, Preissner R: SuperCYP: a comprehensive database on Cytochrome P450 enzymes including a tool for analysis of CYP-drug interactions. Nucleic Acids Res. 2010 Jan;38(Database issue):D237-43. Epub 2009 Nov 24. Pubmed
  6. Zhang T, Zhu Y, Gunaratna C: Rapid and quantitative determination of metabolites from multiple cytochrome P450 probe substrates by gradient liquid chromatography-electrospray ionization-ion trap mass spectrometry. J Chromatogr B Analyt Technol Biomed Life Sci. 2002 Nov 25;780(2):371-9. Pubmed
  7. Yu A, Haining RL: Comparative contribution to dextromethorphan metabolism by cytochrome P450 isoforms in vitro: can dextromethorphan be used as a dual probe for both CTP2D6 and CYP3A activities? Drug Metab Dispos. 2001 Nov;29(11):1514-20. Pubmed

3. Cytochrome P450 3A5

Actions: substrate

Cytochromes P450 are a group of heme-thiolate monooxygenases. In liver microsomes, this enzyme is involved in an NADPH-dependent electron transport pathway. It oxidizes a variety of structurally unrelated compounds, including steroids, fatty acids, and xenobiotics

UniProt ID: P20815 Link_out
Gene: CYP3A5 Link_out
Protein Sequence: FASTA
Gene Sequence: FASTA
SNPs: SNPJam Report Link_out

References:
  1. Flockhart DA. Drug Interactions: Cytochrome P450 Drug Interaction Table. Indiana University School of Medicine (2007). Accessed May 28, 2010.
  2. Preissner S, Kroll K, Dunkel M, Senger C, Goldsobel G, Kuzman D, Guenther S, Winnenburg R, Schroeder M, Preissner R: SuperCYP: a comprehensive database on Cytochrome P450 enzymes including a tool for analysis of CYP-drug interactions. Nucleic Acids Res. 2010 Jan;38(Database issue):D237-43. Epub 2009 Nov 24. Pubmed

4. Cytochrome P450 3A7

Actions: substrate

Cytochromes P450 are a group of heme-thiolate monooxygenases. In liver microsomes, this enzyme is involved in an NADPH-dependent electron transport pathway. It oxidizes a variety of structurally unrelated compounds, including steroids, fatty acids, and xenobiotics

UniProt ID: P24462 Link_out
Gene: CYP3A7 Link_out
Protein Sequence: FASTA
Gene Sequence: FASTA
SNPs: SNPJam Report Link_out

References:
  1. Flockhart DA. Drug Interactions: Cytochrome P450 Drug Interaction Table. Indiana University School of Medicine (2007). Accessed May 28, 2010.
  2. Preissner S, Kroll K, Dunkel M, Senger C, Goldsobel G, Kuzman D, Guenther S, Winnenburg R, Schroeder M, Preissner R: SuperCYP: a comprehensive database on Cytochrome P450 enzymes including a tool for analysis of CYP-drug interactions. Nucleic Acids Res. 2010 Jan;38(Database issue):D237-43. Epub 2009 Nov 24. Pubmed

5. Cytochrome P450 2B6

Actions: substrate

Cytochromes P450 are a group of heme-thiolate monooxygenases. In liver microsomes, this enzyme is involved in an NADPH-dependent electron transport pathway. It oxidizes a variety of structurally unrelated compounds, including steroids, fatty acids, and xenobiotics

UniProt ID: P20813 Link_out
Gene: CYP2B6 Link_out
Protein Sequence: FASTA
Gene Sequence: FASTA
SNPs: SNPJam Report Link_out

References:
  1. Preissner S, Kroll K, Dunkel M, Senger C, Goldsobel G, Kuzman D, Guenther S, Winnenburg R, Schroeder M, Preissner R: SuperCYP: a comprehensive database on Cytochrome P450 enzymes including a tool for analysis of CYP-drug interactions. Nucleic Acids Res. 2010 Jan;38(Database issue):D237-43. Epub 2009 Nov 24. Pubmed
  2. Yu A, Haining RL: Comparative contribution to dextromethorphan metabolism by cytochrome P450 isoforms in vitro: can dextromethorphan be used as a dual probe for both CTP2D6 and CYP3A activities? Drug Metab Dispos. 2001 Nov;29(11):1514-20. Pubmed

6. Cytochrome P450 2C19

Actions: substrate

Responsible for the metabolism of a number of therapeutic agents such as the anticonvulsant drug S-mephenytoin, omeprazole, proguanil, certain barbiturates, diazepam, propranolol, citalopram and imipramine

UniProt ID: P33261 Link_out
Gene: CYP2C19 Link_out
Protein Sequence: FASTA
Gene Sequence: FASTA
SNPs: SNPJam Report Link_out

References:
  1. Preissner S, Kroll K, Dunkel M, Senger C, Goldsobel G, Kuzman D, Guenther S, Winnenburg R, Schroeder M, Preissner R: SuperCYP: a comprehensive database on Cytochrome P450 enzymes including a tool for analysis of CYP-drug interactions. Nucleic Acids Res. 2010 Jan;38(Database issue):D237-43. Epub 2009 Nov 24. Pubmed

7. Cytochrome P450 2C9

Actions: substrate

Cytochromes P450 are a group of heme-thiolate monooxygenases. In liver microsomes, this enzyme is involved in an NADPH-dependent electron transport pathway. It oxidizes a variety of structurally unrelated compounds, including steroids, fatty acids, and xenobiotics. This enzyme contributes to the wide pharmacokinetics variability of the metabolism of drugs such as S- warfarin, diclofenac, phenytoin, tolbutamide and losartan

UniProt ID: P11712 Link_out
Gene: CYP2C9
Protein Sequence: FASTA
Gene Sequence: FASTA
SNPs: SNPJam Report Link_out

References:
  1. Zhou SF, Zhou ZW, Yang LP, Cai JP: Substrates, inducers, inhibitors and structure-activity relationships of human Cytochrome P450 2C9 and implications in drug development. Curr Med Chem. 2009;16(27):3480-675. Epub 2009 Sep 1. Pubmed
  2. Preissner S, Kroll K, Dunkel M, Senger C, Goldsobel G, Kuzman D, Guenther S, Winnenburg R, Schroeder M, Preissner R: SuperCYP: a comprehensive database on Cytochrome P450 enzymes including a tool for analysis of CYP-drug interactions. Nucleic Acids Res. 2010 Jan;38(Database issue):D237-43. Epub 2009 Nov 24. Pubmed

8. Cytochrome P450 2C8

Actions: substrate

Cytochromes P450 are a group of heme-thiolate monooxygenases. In liver microsomes, this enzyme is involved in an NADPH-dependent electron transport pathway. It oxidizes a variety of structurally unrelated compounds, including steroids, fatty acids, and xenobiotics. In the epoxidation of arachidonic acid it generates only 14,15- and 11,12-cis-epoxyeicosatrienoic acids. It is the principal enzyme responsible for the metabolism the anti- cancer drug paclitaxel (taxol)

UniProt ID: P10632 Link_out
Gene: CYP2C8
Protein Sequence: FASTA
Gene Sequence: FASTA
SNPs: SNPJam Report Link_out

References:
  1. Preissner S, Kroll K, Dunkel M, Senger C, Goldsobel G, Kuzman D, Guenther S, Winnenburg R, Schroeder M, Preissner R: SuperCYP: a comprehensive database on Cytochrome P450 enzymes including a tool for analysis of CYP-drug interactions. Nucleic Acids Res. 2010 Jan;38(Database issue):D237-43. Epub 2009 Nov 24. Pubmed

9. Cytochrome P450 2E1

Actions: substrate

Metabolizes several precarcinogens, drugs, and solvents to reactive metabolites. Inactivates a number of drugs and xenobiotics and also bioactivates many xenobiotic substrates to their hepatotoxic or carcinogenic forms

UniProt ID: P05181 Link_out
Gene: CYP2E1 Link_out
Protein Sequence: FASTA
Gene Sequence: FASTA
SNPs: SNPJam Report Link_out

References:
  1. Preissner S, Kroll K, Dunkel M, Senger C, Goldsobel G, Kuzman D, Guenther S, Winnenburg R, Schroeder M, Preissner R: SuperCYP: a comprehensive database on Cytochrome P450 enzymes including a tool for analysis of CYP-drug interactions. Nucleic Acids Res. 2010 Jan;38(Database issue):D237-43. Epub 2009 Nov 24. Pubmed

Transporters

1. Multidrug resistance protein 1

Actions: inhibitor

Energy-dependent efflux pump responsible for decreased drug accumulation in multidrug-resistant cells

UniProt ID: P08183 Link_out
Gene: ABCB1 Link_out
Protein Sequence: FASTA
Gene Sequence: FASTA
SNPs: SNPJam Report Link_out

References:
  1. Wang E, Lew K, Barecki M, Casciano CN, Clement RP, Johnson WW: Quantitative distinctions of active site molecular recognition by P-glycoprotein and cytochrome P450 3A4. Chem Res Toxicol. 2001 Dec;14(12):1596-603. Pubmed

Comments
Drug created on June 13, 2005 07:24 / Updated on February 08, 2013 16:19