Drilldown: Medicines

Dextromethorphan / Quinidine (1)

Nuedexta (1)

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'"`UNIQ--vote-00001580-QINU`"' First FDA-approved treatment for PBA. The 10 mg quinidine daily dose is far below antiarrhythmic levels but sufficient to nearly fully inhibit CYP2D6, the basis of the combination's pharmacokinetic rationale'"`UNIQ--ref-00001581-QINU`"'. (1)

'"`UNIQ--vote-00001582-QINU`"' (1)

1 capsule (20/10 mg dextromethorphan/quinidine) PO once daily × 7 days, then 1 capsule BID (1)

None · 10 mg, 20 mg, 40 mg, 80 mg tablets · 2.5, 5, 10, 20 mg tabs · 5 mg, 10 mg tablets · 5, 10 mg tablets · 5, 10, 20, 40 mg tablets · 0.005% ophthalmic solution (50 mcg/mL); typical 2.5 mL bottle · 0.01%, 0.03% ophthalmic solution · 0.025%, 0.035% ophthalmic solutions · 0.1% (Patanol), 0.2% (Pataday once-daily original), 0.7% (Pataday 24-hour) ophthalmic solutions; 0.6% nasal spray · 0.1%, 0.15% intranasal spray; 0.05% ophthalmic solution; combination Dymista (azelastine 0.137 mg + fluticasone 50 mcg/spray) · 0.1%, 0.15%, 0.2% ophthalmic solutions; 0.33% topical gel; combinations with timolol (Combigan) and brinzolamide (Simbrinza) · 0.225%, 0.45%, 0.9%, 3%, 5% IV solutions; 0.9% nasal spray; 3% and 7% nebulizer solutions; oral tablets (1 g) · 0.25 mg, 0.5 mg, 1 mg, 2 mg tablets (immediate-release and orally disintegrating); 0.5 mg, 1 mg, 2 mg, 3 mg extended-release tablets; 1 mg/mL oral concentrate · 0.25 mg, 0.5 mg, 1 mg, 2 mg, 3 mg, 4 mg tablets · 0.25, 0.5 mcg oral capsules; 1 mcg/mL oral solution; 1 mcg/mL IV; 3 mcg/g topical ointment · 0.35 mg POP tablets; 5 mg tablets (Aygestin); component of COCs and combination HRT · 0.4 mg capsules · 0.4, 0.8, 1 mg OTC; 1 mg Rx; 5 mg/mL injection · 0.5 g, 1 g capsules

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1 capsule BID (40 mg DXM / 20 mg quinidine per day) (1)

Oral (1)

PBA episode reduction within 1-2 weeks (1)

12 hours (1)

Dextromethorphan substantially prolonged by quinidine's CYP2D6 inhibition (typical extensive metabolizers see ~10× higher AUC); quinidine ~6-8 hours'"`UNIQ--ref-00001583-QINU`"' (1)

Increased substantially via CYP2D6 inhibition'"`UNIQ--ref-00001584-QINU`"' (1)

Limited data; quinidine has been used in pregnancy as antiarrhythmic.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1)

[[USLegal:Prescription only|Rx-only]] in US. Caution with QT-prolonging medicines (quinidine itself is class IA antiarrhythmic, and the dose here, though sub-antiarrhythmic, still contributes to QT)'"`UNIQ--ref-00001585-QINU`"' (1)