service provider dextromethorphan and quinidine (Oral route) dex-troe-meth-OR-fan hye-droe-BROE-mide, KWIN-i-deen SUL-fate Overview Side Effects Dosage Professional Interactions More Pregnancy Warnings User Reviews Support Group Q & A Commonly used brand name(s) In the U.S. Nuedexta Available Dosage Forms: Capsule Therapeutic Class: Central Nervous System Agent Chemical Class: Quinidine Slideshow Binge Eating Disorder: Beyond Overeating Uses For dextromethorphan and quinidine Dextromethorphan and quinidine combination is used to treat a rare condition called pseudobulbar affect (PBA) or emotional incontinence. PBA is a nervous system disorder that is characterized by uncontrollable, sudden, and frequent episodes of crying or laughing. dextromethorphan and quinidine is available only with your doctor's prescription. Before Using dextromethorphan and quinidine In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For dextromethorphan and quinidine, the following should be considered: Allergies Tell your doctor if you have ever had any unusual or allergic reaction to dextromethorphan and quinidine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully. Pediatric Appropriate studies have not been performed on the relationship of age to the effects of dextromethorphan and quinidine combination in the pediatric population. Safety and efficacy have not been established. Geriatric Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of dextromethorphan and quinidine combination in the elderly. Pregnancy Pregnancy Category Explanation All Trimesters C Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women. Breast Feeding Studies in women suggest that this medication poses minimal risk to the infant when used during breastfeeding. Interactions with Medicines Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking dextromethorphan and quinidine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive. Using dextromethorphan and quinidine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take. Amifampridine Amisulpride Aurothioglucose Bepridil Cisapride Clorgyline Colchicine Dronedarone Fingolimod Fluconazole Grepafloxacin Iproniazid Isocarboxazid Itraconazole Ketoconazole Levomethadyl Mesoridazine Mifepristone Moclobemide Nelfinavir Nialamide Pargyline Phenelzine Pimozide Piperaquine Posaconazole Procarbazine Rasagiline Ritonavir Safinamide Saquinavir Selegiline Sparfloxacin Terfenadine Thioridazine Tipranavir Toloxatone Tranylcypromine Vernakalant Voriconazole Ziprasidone Using dextromethorphan and quinidine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines. Acetazolamide Afatinib Ajmaline Alefacept Alfentanil Alfuzosin Almotriptan Amiodarone Amitriptyline Amoxapine Amphetamine Amprenavir Anagrelide Apomorphine Aprindine Arbutamine Aripiprazole Aripiprazole Lauroxil Arsenic Trioxide Artemether Asenapine Astemizole Atazanavir Atracurium Azithromycin Bedaquiline Benzphetamine Betrixaban Blinatumomab Boceprevir Brexpiprazole Buprenorphine Bupropion Buserelin Butorphanol Ceritinib Chloral Hydrate Chloroquine Ciprofloxacin Citalopram Clarithromycin Clomipramine Clozapine Cobicistat Codeine Conivaptan Crizotinib Cyclobenzaprine Dabigatran Etexilate Dabrafenib Darunavir Dasabuvir Dasatinib Decamethonium Degarelix Delamanid Delavirdine Desipramine Deslorelin Desvenlafaxine Deutetrabenazine Dextroamphetamine Digitoxin Digoxin Dihydrocodeine Disopyramide Dofetilide Dolasetron Domperidone Donepezil Doxepin Doxorubicin Doxorubicin Hydrochloride Liposome Droperidol Duloxetine Efavirenz Eliglustat Eluxadoline Enflurane Enzalutamide Erythromycin Escitalopram Etravirine Fentanyl Flecainide Fluoxetine Fluvoxamine Fosamprenavir Foscarnet Gatifloxacin Gemifloxacin Golimumab Gonadorelin Goserelin Granisetron Guselkumab Halofantrine Haloperidol Halothane Histrelin Hydrocodone Hydromorphone Hydroquinidine Hydroxychloroquine Hydroxytryptophan Hydroxyzine Ibutilide Idelalisib Imipramine Infliximab Isavuconazonium Sulfate Isoflurane Isradipine Ivabradine Lanreotide Lapatinib Leuprolide Levofloxacin Levomilnacipran Levorphanol Lidocaine Lidoflazine Linezolid Lisdexamfetamine Lopinavir Lorcainide Lorcaserin Lumacaftor Lumefantrine Mefloquine Memantine Meperidine Methadone Methamphetamine Methylene Blue Metronidazole Mexiletine Milnacipran Mirtazapine Morphine Morphine Sulfate Liposome Moxifloxacin Nafarelin Nalbuphine Nalidixic Acid Nebivolol Netupitant Nilotinib Norfloxacin Nortriptyline Octreotide Ofloxacin Ombitasvir Ondansetron Oxycodone Oxymorphone Paliperidone Palonosetron Pancuronium Panobinostat Paritaprevir Paroxetine Pasireotide Pazopanib Pentamidine Pentazocine Pimavanserin Pirmenol Pitolisant Pixantrone Prilocaine Probucol Procainamide Prochlorperazine Propafenone Protriptyline Quetiapine Quinidine Quinine Ranolazine Remifentanil Ribociclib Salmeterol Secukinumab Sertraline Sevoflurane Sibutramine Simeprevir Sodium Phosphate Sodium Phosphate, Dibasic Sodium Phosphate, Monobasic Solifenacin Sorafenib Sotalol Spiramycin Succinylcholine Sufentanil Sulfamethoxazole Sulpiride Sunitinib Tacrolimus Tapentadol Telaprevir Telavancin Telithromycin Tetrabenazine Tizanidine Topotecan Toremifene Tramadol Trazodone Trifluoperazine Trimethoprim Trimipramine Triptorelin Tubocurarine Ulipristal Valbenazine Vandetanib Vardenafil Vasopressin Vecuronium Vemurafenib Venetoclax Venlafaxine Vilazodone Vincristine Vincristine Sulfate Liposome Vinflunine Vortioxetine Ziprasidone Zolmitriptan Zuclopenthixol Using dextromethorphan and quinidine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines. Abarelix Abiraterone Amiloride Atenolol Cimetidine Clobazam Dalfopristin Dextromethorphan Dicumarol Fosphenytoin Galantamine Haloperidol Magaldrate Magnesium Carbonate Magnesium Hydroxide Magnesium Oxide Magnesium Trisilicate Nifedipine Nisoldipine Paroxetine Phenobarbital Phenytoin Propranolol Quinidine Quinupristin Rifapentine Tolterodine Tramadol Verapamil Interactions with Food/Tobacco/Alcohol Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive. Using dextromethorphan and quinidine with any of the following may cause an increased risk of certain side effects but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use dextromethorphan and quinidine, or give you special instructions about the use of food, alcohol, or tobacco. Grapefruit Juice Other Medical Problems The presence of other medical problems may affect the use of dextromethorphan and quinidine. Make sure you tell your doctor if you have any other medical problems, especially: Bone marrow problems caused by quinidine, quinine, or mefloquine, history of or Heart block without a pacemaker or Heart failure or Heart rhythm problems (e.g., congenital long QT syndrome, prolonged QT interval, or a history of torsade de pointes) or Hepatitis caused by quinidine, quinine, or mefloquine, history of or Lupus-like syndrome caused by quinidine, quinine, or mefloquine, history of or Thrombocytopenia (low platelets in the blood) caused by quinidine, quinine, or mefloquine, history of Should not be used in patients with these conditions. Drug abuse or dependence, or history of Dependence may be more likely to develop. Heart or blood vessel disease or Hypokalemia (low potassium in the blood) or Hypomagnesemia (low magnesium in the blood) or Hypertension (high blood pressure) or Stroke, history of May increase risk for more serious side effects. Kidney disease, severe or Liver disease, severe Higher blood levels of dextromethorphan and quinidine can occur, which increases the risk of serious side effects. Myasthenia gravis (severe muscle weakness) Use with caution. May make this condition worse. Proper Use of dextromethorphan and quinidine Take dextromethorphan and quinidine exactly as directed by your doctor . Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. To do so may increase the chance of side effects. Grapefruits and grapefruit juice may increase the effects of dextromethorphan and quinidine combination by increasing the amount of dextromethorphan and quinidine in your body. You should not eat grapefruit or drink grapefruit juice while you are taking dextromethorphan and quinidine . Dosing The dose of dextromethorphan and quinidine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of dextromethorphan and quinidine. If your dose is different, do not change it unless your doctor tells you to do so. The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine. For oral dosage form (capsules): For PBA or emotional incontinence: Adults One capsule once a day for the first 7 days of treatment. Then on day 8 and onwards, dose should be two capsules per day, taken as one capsule every 12 hours. Each capsule contains 20 milligrams (mg) of dextromethorphan and 10 mg of quinidine. Children Use and dose must be determined by your doctor. Missed Dose If you miss a dose of dextromethorphan and quinidine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses. Storage Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing. Keep out of the reach of children. Do not keep outdated medicine or medicine no longer needed. Ask your healthcare professional how you should dispose of any medicine you do not use. Precautions While Using dextromethorphan and quinidine It is very important that your doctor check your progress at regular visits . This will allow your doctor to see if the medicine is working properly and to decide if you should continue to take it. Blood tests may be needed to check for unwanted effects. If your symptoms do not improve or if they become worse, check with your doctor. Do not use dextromethorphan and quinidine together with other products containing quinidine, quinine (Qualaquin ), or mefloquine (Lariam ). You should not take dextromethorphan and quinidine if you are also using pimozide (Orap ), thioridazine (Mellaril ), or an MAO inhibitor (MAOI) such as Eldepryl , Marplan , Nardil , or Parnate within the past 14 days. Also, allow at least 14 days after stopping dextromethorphan and quinidine before starting an MAO inhibitor (MAOI). Stop using dextromethorphan and quinidine and check with your doctor right away if you have the following symptoms while taking dextromethorphan and quinidine: black, tarry stools; bleeding gums; blood in the urine or stools; chills; fever; lightheadedness; nausea or vomiting; pinpoint red spots on the skin; or unusual bleeding or bruising. dextromethorphan and quinidine can cause changes in heart rhythms, such as a condition called QT prolongation. It may change the way your heart beats and cause fainting or serious side effects in some patients. Contact your doctor right away if you have any symptoms of heart rhythm problems, such as fast, pounding, or irregular heartbeats. dextromethorphan and quinidine may cause some people to become dizzy, trouble in controlling movements, or less alert than they are normally. Make sure you know how you react to dextromethorphan and quinidine before you drive, use machines, or do other jobs that require you to be alert and well-coordinated . Make sure your doctor knows about all the other medicines you are using. dextromethorphan and quinidine may cause a serious condition called serotonin syndrome when taken with medicine for depression (such as amitriptyline, clomipramine, doxepin, fluoxetine, imipramine, nortriptyline, Anafranil , Elavil , Prozac , Sinequan , or Tofranil ). Check with your doctor first before taking any other medicines . dextromethorphan and quinidine will add to the effects of alcohol and other CNS depressants (medicines that make you drowsy or less alert). Some examples of CNS depressants are antihistamines or medicine for hay fever, allergies, or colds; sedatives, tranquilizers, or sleeping medicine; prescription pain medicine or narcotics; other medicines for seizures (e.g., barbiturates); muscle relaxants; or anesthetics, including some dental anesthetics. Check with your medical doctor or dentist before taking any of the above while you are using dextromethorphan and quinidine . Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements. dextromethorphan and quinidine Side Effects Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention. Check with your doctor immediately if any of the following side effects occur: Less common Bladder pain bloating or swelling of the face, arms, hands, lower legs, or feet bloody or cloudy urine chills cough diarrhea difficult, burning, or painful urination fever frequent urge to urinate general feeling of discomfort or illness headache joint pain loss of appetite lower back or side pain muscle aches and pains nausea rapid weight gain runny nose shivering sore throat sweating tingling of the hands or feet trouble sleeping unusual tiredness or weakness unusual weight gain or loss vomiting Get emergency help immediately if any of the following symptoms of overdose occur: Symptoms of overdose Aggressive and violent behavior agitation blurred vision change in color vision change in consciousness chest pain or discomfort confusion confusion as to time, place, or person continuing ringing or buzzing or other unexplained noise in the ears decreased awareness or responsiveness depression difficulty seeing at night dizziness or lightheadedness dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position double vision excitement fainting fast, pounding, or irregular heartbeat or pulse feeling of constant movement of self or surroundings hallucinations hearing loss holding false beliefs that cannot be changed by fact inability to move the eyes increased blinking or spasms of the eyelid increased sensitivity of the eyes to sunlight irregular or slow heart rate loss of consciousness overactive reflexes poor coordination restlessness seeing double seizures sensation of spinning severe sleepiness shakiness and unsteady walk shivering shortness of breath sticking out of tongue sweating talking or acting with excitement you cannot control trembling or shaking trouble with breathing, speaking, or swallowing twitching uncontrolled eye movements uncontrolled twisting movements of the neck, trunk, arms, or legs unsteadiness, trembling, or other problems with muscle control or coordination unusual excitement, nervousness, or restlessness unusual facial expressions Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them: Less common Bloated excess air or gas in the stomach or intestines full feeling lack or loss of strength passing gas Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088. Side Effects (complete list) The information contained in the Truven Health Micromedex products as delivered by Drugs.com is intended as an educational aid only. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor, nurse or pharmacist before taking any prescription or over the counter drugs (including any herbal medicines or supplements) or following any treatment or regimen. Only your doctor, nurse, or pharmacist can provide you with advice on what is safe and effective for you. The use of the Truven Health products is at your sole risk. These products are provided "AS IS" and "as available" for use, without warranties of any kind, either express or implied. Truven Health and Drugs.com make no representation or warranty as to the accuracy, reliability, timeliness, usefulness or completeness of any of the information contained in the products. Additionally, TRUVEN HEALTH MAKES NO REPRESENTATION OR WARRANTIES AS TO THE OPINIONS OR OTHER SERVICE OR DATA YOU MAY ACCESS, DOWNLOAD OR USE AS A RESULT OF USE OF THE THOMSON REUTERS HEALTHCARE PRODUCTS. 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Next Side Effects Print this page Add to My Med List More about dextromethorphan/quinidine Side Effects During Pregnancy Dosage Information Drug Interactions Support Group En Español 13 Reviews Add your own review/rating Drug class: miscellaneous central nervous system agents Consumer resources Dextromethorphan and quinidine Other brands: Nuedexta Professional resources Dextromethorphan Hydrobromide and Quinidine Sulfate (AHFS Monograph) Dextromethorphan and Quinidine (Wolters Kluwer) Related treatment guides Pseudobulbar Affect} Drug Status Rx Availability Prescription only C Pregnancy Category Risk cannot be ruled out N/A CSA Schedule Not a controlled drug Approval History Drug history at FDA Drug Class Miscellaneous central nervous system agents Related Drugs Pseudobulbar Affect Nuedexta , dextromethorphan / quinidine , More... Dextromethorphan / quinidine Rating 13 User Reviews 8.2 /10 13 User Reviews 8.2 Rate it! Help and Support Looking for answers? 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