DEXTROMETHORPHAN AND QUINIDINE
(DEX troe meth OR fan and KWIN i deen) Brand: Nuedexta
What is the most significant information I must know about dextromethorphan and quinidine?
• You must not take dextromethorphan and quinidine if you are also taking quinidine (Quin-G), quinine (Qualaquin), or mefloquine (Lariam), or if you have ever had an allergic reaction or serious medical problem caused by taking any of these medications.
• You must not use this medicine if you are allergic to dextromethorphan or quinidine, or if you have heart failure, a serious heart condition called "AV block" (unless you have a pacemaker), or a history of Long QT syndrome or life-threatening heart rhythm disorder.
• Till you take this medicine, speak your doctor if you have slow heartbeats or any another type of heart rhythm mess, an electrolyte imbalance, bladder or bowel obstruction, myasthenia gravis, or a family history of Long QT syndrome.
• There are much another drugs that can reason serious or life threatening medical problems if you take them together with dextromethorphan and quinidine. Speak your doctor about all another medicines you use. Do not start a new medicine without telling your doctor.
What is dextromethorphan and quinidine?
• Dextromethorphan affects the signals in the brain that trigger cough reflex and is usually used as a cough suppressant.
• Quinidine affects the way that the heart beats and is usually used to in people with determined heart rhythm disorders.
• The combination of dextromethorphan and quinidine is used to treat involuntary outbursts of crying or laughing in people with determined neurological disorders, including multiple sclerosis and amyotrophic lateral sclerosis (ALS, or Lou Gehrig's disease).
• Dextromethorphan and quinidine may also be used for purposes not listed in this medicine guide.
What must I discuss with my healthcare provider till taking dextromethorphan and quinidine?
• You must not take this medication if you are also taking quinidine (Quin-G), quinine (Qualaquin), or mefloquine (Lariam), or if you have ever had hepatitis, low levels of platelets in your blood, bone marrow depression, lupus-like syndrome, or an allergic reaction caused by taking any of these medications.
• You must not use this medicine if you are allergic to dextromethorphan or quinidine, or if you have:
· heart failure;
· a history of life-threatening heart rhythm mess;
· a history of Long QT syndrome; or
· a serious heart condition called "AV block" (unless you have a pacemaker).
• Do not use dextromethorphan and quinidine if you have used an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate) in the recent 14 days. A dangerous drug interaction could occur, leading to serious side effects.
• After you stop taking dextromethorphan and quinidine, you should wait at least 14 days till you start taking an MAOI.
• There are much another drugs that can reason serious or life threatening medical problems if you take them together with dextromethorphan and quinidine. The next drugs must not be used while you are taking dextromethorphan and quinidine:
· an anti-malaria drug called chloroquine (Aralen);
· determined antidepressants: amitriptyline (Elavil, Vanatrip, Limbitrol), clomipramine (Anafranil), or desipramine (Norpramin);
· determined heart rhythm medications: quinidine (Quin-G), procainamide (Procan, Pronestyl), or propafenone, (Rythmol); or
· determined medicines to treat psychiatric disorders: chlorpromazine (Thorazine), haloperidol (Haldol), pimozide (Orap), or thioridazine (Mellaril).
• If you can't avoid taking any of the medicines listed above, your heart function may need to be tested on a regular basis while you are taking dextromethorphan and quinidine. Do not miss any follow-up visits to your doctor.
• To create certain you can safely take this medication, speak your doctor if you have any of these another conditions:
· a family history of Long QT syndrome;
· an electrolyte imbalance (such as low levels of potassium or magnesium in your blood);
· slow heartbeats or any type of heart rhythm mess;
· myasthenia gravis;
· bladder obstruction or another urination problems; or
· a bowel obstruction or intestinal disorder.
• FDA pregnancy category C. It is not known whether dextromethorphan and quinidine will harm an unborn child. Speak your doctor if you are pregnant or plan to become pregnant while using this medication.
• It is not known whether this medicine passes into breast milk or if it could harm a nursing child. Do not use this medicine without telling your doctor if you are breast-feeding a baby.
• Do not give dextromethorphan and quinidine to anyone under 18 years old without medical advice.
How must I take dextromethorphan and quinidine?
• Take exactly as predesigned by your doctor. Do not take in larger or less amounts or for longer than recommended. Follow the directions on your prescription label.
• Dextromethorphan and quinidine is generally started at a doze of 1 capsule for day for 7 days. After the first week you will take 1 capsule each 12 hours. Follow your doctor's instructions. Do not take more than 2 capsules in a 24-hour period.
• You may take dextromethorphan and quinidine with or without food.
• Your doctor will need to check your progress on a regular basis. This will help your doctor determine how long to treat you with dextromethorphan and quinidine. To be certain the medication not causing deleterious effects, your heart function may need to be checked using an electrocardiograph or ECG (sometimes called an EKG). This car measures electrical activity of the heart. Visit your doctor regularly.
• Store at room temperature away from moisture and heat.
What happens if I miss a dose?
• Take the missed doze as soon as you remember. Skip the missed doze if it is nearly time for your following scheduled doze. Do not take extra medication to create up the missed dose.
What happens if I overdose?
• Search abnormal medical attention or call the Poison Help line at 1-800-222-1222.
• Overdose can reason severe dizziness, confusion, double vision, ringing in your ears, vomiting, rapid heart course, weak or shallow breathing, a dazed feeling, or seizure (convulsions).
What must I avoid while taking dextromethorphan and quinidine?
• Avoid getting up too quick from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.
• Grapefruit and grapefruit juice may interact with dextromethorphan and quinidine and lead to potentially dangerous effects. Discuss the use of grapefruit commodity with your doctor.
• Ask a doctor or pharmacist till using any cough or cool medicine. Dextromethorphan is contained in much combination medicines. Taking determined commodity together can reason you to get too many dextromethorphan. Check the label to see if a medication contains dextromethorphan (Delsym, Robitussin Maximum Power, Vicks 44, and others).
What are the possible side effects of dextromethorphan and quinidine?
• Get abnormal medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your person, lips, tongue, or throat.
• Stop using dextromethorphan and quinidine and call your doctor at once if you have a serious side effect such as:
· severe dizziness, fainting, quick or pounding heartbeat;
· light bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin;
· pain or burning when you urinate;
· fever, chills, flu symptoms, nausea, vomiting, feeling light-headed;
· nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
· agitation, hallucinations, fever, quick heart course, overactive reflexes, nausea, vomiting, diarrhea, loss of coordination, fainting; or
· joint pain or swelling with fever, swollen glands, muscle aches, nausea, vomiting, chest pain, unusual thoughts or behavior, and/or seizure (convulsions).
• Smaller serious side effects may include:
· diarrhea, gas, mild stomach pain;
· muscle spasm;
· dizziness, weakness;
· cough; or
· swelling in your hands or feet.
• This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may message side effects to FDA at 1-800-FDA-1088.
What another drugs will affect dextromethorphan and quinidine?
• Speak your doctor about all another medicines you use, especially:
· aprepitant (Emend);
· cimetidine (Tagamet);
· digoxin (Lanoxin, Lanoxicaps);
· narcotic cough medication (codeine or dihydrocodeine);
· ADHD medicine such as atomoxetine (Strattera), dextroamphetamine (Adderall), methamphetamine (Desoxyn), methylphenidate (Ritalin, Daytrana, Metadate, Concerta);
· an antidepressant such as amitriptyline (Elavil, Vanatrip, Limbitrol), citalopram (Celexa), desipramine (Norpramin), doxepin (Sinequan), duloxetine (Cymbalta), fluoxetine (Prozac, Sarafem, Symbyax), nortriptyline (Pamelor), nefazodone, paroxetine (Paxil), sertraline (Zoloft), or venlafaxine (Effexor);
· an antibiotic such as clarithromycin (Biaxin), dalfopristin/quinupristin (Synercid), doxycycline (Doryx, Oracea, Periostat, Vibramycin), erythromycin (E.E.S., EryPed, Ery-Tab, Erythrocin, Pediazole), metronidazole (Flagyl), norfloxacin (Noroxin), telithromycin (Ketek), or tetracycline (Ala-Tet, Brodspec, Panmycin, Sumycin, Tetracap);
· antifungal medication such as fluconazole (Diflucan), itraconazole (Sporanox), ketoconazole (Nizoral), miconazole (Oravig), or voriconazole (Vfend);
· cancer medication such as doxorubicin (Adriamycin, Doxil), lomustine (CeeNU), tamoxifen (Soltamox);
· heart or blood pressure medicine such as amiodarone (Cordarone, Pacerone), betaxolol (Kerlone), captopril (Capoten), carvedilol (Coreg), diltiazem (Cartia, Cardizem), flecainide (Tambocor), labetalol (Normodyne), metoprolol (Dutoprol, Lopressor, Toprol), mexilitene (Mexitil), nicardipine (Cardene), pindolol (Visken), propranolol (Inderal), timolol (Blocadren), verapamil (Calan, Covera, Isoptin, Verelan), and others;
· HIV/AIDS medication such as atazanavir (Reyataz), delavirdine (Rescriptor), efavirenz (Sustiva, Atripla), fosamprenavir (Lexiva), indinavir (Crixivan), nelfinavir (Viracept), saquinavir (Invirase), or ritonavir (Norvir, Kaletra); or
· pain medicine such as codeine (Tylenol #3), hydrocodone (Lortab, Vicodin, Vicoprofen), oxycodone (OxyContin, Percocet), or tramadol (Ultram, Ultracet).
• This list is not complete and there are much another drugs that can interact with dextromethorphan and quinidine. Speak your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal commodity. Do not start a new medicine without telling your doctor. Hold a list of all your medicines and show it to any healthcare provider who treats you.
Where can I get more information?
• Your pharmacist can provide more information about dextromethorphan and quinidine.
Remember, hold this and all another medicines out of the reach of children, never share your medicines with others, and use this medicine only for the indication prescribed.
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