Details
Stereochemistry | ABSOLUTE |
Molecular Formula | C18H25NO.ClH |
Molecular Weight | 307.858 |
Optical Activity | UNSPECIFIED |
Defined Stereocenters | 3 / 3 |
E/Z Centers | 0 |
Charge | 0 |
SHOW SMILES / InChI
SMILES
Cl.[H][C@]12CCCC[C@]13CCN(C)[C@H]2CC4=CC=C(OC)C=C34
InChI
InChIKey=SNDDIRAXSDUVKW-URVXVIKDSA-N
InChI=1S/C18H25NO.ClH/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;1H/t15-,17+,18+;/m1./s1
Molecular Formula | C18H25NO |
Molecular Weight | 271.3972 |
Charge | 0 |
Count |
|
Stereochemistry | ABSOLUTE |
Additional Stereochemistry | No |
Defined Stereocenters | 3 / 3 |
E/Z Centers | 0 |
Optical Activity | UNSPECIFIED |
Molecular Formula | ClH |
Molecular Weight | 36.461 |
Charge | 0 |
Count |
|
Stereochemistry | ACHIRAL |
Additional Stereochemistry | No |
Defined Stereocenters | 0 / 0 |
E/Z Centers | 0 |
Optical Activity | NONE |
DescriptionSources: https://www.ncbi.nlm.nih.gov/pubmed/27139517Curator's Comment: Description was created based on several sources, including
https://www.ncbi.nlm.nih.gov/pubmed/2694543
http://www.who.int/medicines/areas/quality_safety/5.1Dextromethorphan_pre-review.pdf
http://www.accessdata.fda.gov/drugsatfda_docs/label/2004/21620_mucinex_lbl.pdf
https://www.ncbi.nlm.nih.gov/pubmed/25420446
Sources: https://www.ncbi.nlm.nih.gov/pubmed/27139517
Curator's Comment: Description was created based on several sources, including
https://www.ncbi.nlm.nih.gov/pubmed/2694543
http://www.who.int/medicines/areas/quality_safety/5.1Dextromethorphan_pre-review.pdf
http://www.accessdata.fda.gov/drugsatfda_docs/label/2004/21620_mucinex_lbl.pdf
https://www.ncbi.nlm.nih.gov/pubmed/25420446
Dextromethorphan is a non-narcotic morphine derivative widely used as an antitussive for almost 40 years. It has attracted attention due to its anticonvulsant and neuroprotective properties. It is a cough suppressant in many over-the-counter cold and cough medicines. In 2010, the FDA approved the combination product dextromethorphan/quinidine for the treatment of pseudobulbar affect. 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 used to study the involvement of glutamate receptors in neurotoxicity. Dextromethorphan (DM) is a sigma-1 receptor agonist and an uncompetitive NMDA receptor antagonist. The mechanism by which dextromethorphan exerts therapeutic effects in patients with pseudobulbar affect is unknown. Dextromethorphan should not be taken with monoamine oxidase inhibitors due to the potential for serotonin syndrome. Dextromethorphan is extensively metabolized by CYP2D6 to dextrorphan, which is rapidly glucuronidated and unable to cross the blood-brain barrier.
CNS Activity
Originator
Sources: https://www.ncbi.nlm.nih.gov/pubmed/24678061
Curator's Comment: # in a Swiss and US patent application from Hoffmann-La Roche in 1946 and 1947, respectively
Approval Year
Targets
Primary Target | Pharmacology | Condition | Potency |
---|---|---|---|
Target ID: CHEMBL287 Sources: https://www.ncbi.nlm.nih.gov/pubmed/15723099 |
205.0 nM [Ki] | ||
Target ID: CHEMBL4787 Sources: https://www.ncbi.nlm.nih.gov/pubmed/2897648 |
Conditions
Condition | Modality | Targets | Highest Phase | Product |
---|---|---|---|---|
Primary | MUCINEX DM Approved UseHelps loosen phlegm (mucus) and thin bronchial secretions to rid the bronchial passageways of bothersome mucus and make coughs more productive: temporarily relieves: cough due to minor throat and bronchial irritation as may occur with the common cold or inhaled irritants; the intensity of coughing; the impulse to cough to help you get to sleep Launch Date1.08319677E12 |
|||
Primary | NUEDEXTA Approved UseNUEDEXTA is indicated for the treatment of pseudobulbar affect (PBA). PBA occurs secondary to a variety of otherwise unrelated neurologic conditions, and is characterized by involuntary, sudden, and frequent episodes of laughing and/or crying. PBA episodes typically occur out of proportion or incongruent to the underlying emotional state. PBA is a specific condition, distinct from other types of emotional lability that may occur in patients with neurological disease or injury. Launch Date1.28580479E12 |
Cmax
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
4.2 ng/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/15342614/ |
45 mg 2 times / day steady-state, oral dose: 45 mg route of administration: Oral experiment type: STEADY-STATE co-administered: |
DEXTROMETHORPHAN plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
|
7.7 ng/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/15342614/ |
60 mg 2 times / day steady-state, oral dose: 60 mg route of administration: Oral experiment type: STEADY-STATE co-administered: |
DEXTROMETHORPHAN plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
|
95.5 ng/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/15342614/ |
30 mg 2 times / day steady-state, oral dose: 30 mg route of administration: Oral experiment type: STEADY-STATE co-administered: QUINIDINE |
DEXTROMETHORPHAN plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
|
15.9 ng/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/15342614/ |
30 mg single, oral dose: 30 mg route of administration: Oral experiment type: SINGLE co-administered: QUINIDINE |
DEXTROMETHORPHAN plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
|
2.9 ng/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/15342614/ |
30 mg 2 times / day steady-state, oral dose: 30 mg route of administration: Oral experiment type: STEADY-STATE co-administered: |
DEXTROMETHORPHAN plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
|
123.5 ng/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/15342614/ |
30 mg 2 times / day steady-state, oral dose: 30 mg route of administration: Oral experiment type: STEADY-STATE co-administered: QUINIDINE |
DEXTRORPHAN plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
|
124.9 ng/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/15342614/ |
30 mg single, oral dose: 30 mg route of administration: Oral experiment type: SINGLE co-administered: QUINIDINE |
DEXTRORPHAN plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
|
599 ng/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/15342614/ |
45 mg 2 times / day steady-state, oral dose: 45 mg route of administration: Oral experiment type: STEADY-STATE co-administered: |
DEXTRORPHAN plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
|
709 ng/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/15342614/ |
60 mg 2 times / day steady-state, oral dose: 60 mg route of administration: Oral experiment type: STEADY-STATE co-administered: |
DEXTRORPHAN plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
AUC
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
32 ng × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/15342614/ |
45 mg 2 times / day steady-state, oral dose: 45 mg route of administration: Oral experiment type: STEADY-STATE co-administered: |
DEXTROMETHORPHAN plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
|
52 ng × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/15342614/ |
60 mg 2 times / day steady-state, oral dose: 60 mg route of administration: Oral experiment type: STEADY-STATE co-administered: |
DEXTROMETHORPHAN plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
|
1049 ng × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/15342614/ |
30 mg 2 times / day steady-state, oral dose: 30 mg route of administration: Oral experiment type: STEADY-STATE co-administered: QUINIDINE |
DEXTROMETHORPHAN plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
|
133.3 ng × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/15342614/ |
30 mg single, oral dose: 30 mg route of administration: Oral experiment type: SINGLE co-administered: QUINIDINE |
DEXTROMETHORPHAN plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
|
17.8 ng × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/15342614/ |
30 mg 2 times / day steady-state, oral dose: 30 mg route of administration: Oral experiment type: STEADY-STATE co-administered: |
DEXTROMETHORPHAN plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
|
1000.5 ng × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/15342614/ |
30 mg 2 times / day steady-state, oral dose: 30 mg route of administration: Oral experiment type: STEADY-STATE co-administered: QUINIDINE |
DEXTRORPHAN plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
|
933.8 ng × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/15342614/ |
30 mg single, oral dose: 30 mg route of administration: Oral experiment type: SINGLE co-administered: QUINIDINE |
DEXTRORPHAN plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
|
2898 ng × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/15342614/ |
45 mg 2 times / day steady-state, oral dose: 45 mg route of administration: Oral experiment type: STEADY-STATE co-administered: |
DEXTRORPHAN plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
|
3608 ng × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/15342614/ |
60 mg 2 times / day steady-state, oral dose: 60 mg route of administration: Oral experiment type: STEADY-STATE co-administered: |
DEXTRORPHAN plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
|
68 nM*h Clinical Trial https://clinicaltrials.gov/ct2/show/NCT01361217 |
30 mg single, oral dose: 30 mg route of administration: oral experiment type: single co-administered: |
DEXTROMETHORPHAN plasma | Homo sapiens population: healthy age: adults sex: food status: |
T1/2
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
13.1 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/15342614/ |
30 mg 2 times / day steady-state, oral dose: 30 mg route of administration: Oral experiment type: STEADY-STATE co-administered: QUINIDINE |
DEXTROMETHORPHAN plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
Doses
Dose | Population | Adverse events |
---|---|---|
50 mg 4 times / day steady, oral Dose: 50 mg, 4 times / day Route: oral Route: steady Dose: 50 mg, 4 times / day Sources: |
unhealthy, 19-52 years n = 16 Health Status: unhealthy Condition: chronic intractable partial onset seizures Age Group: 19-52 years Sex: M+F Population Size: 16 Sources: |
|
960 mg 1 times / day multiple, oral Highest studied dose Dose: 960 mg, 1 times / day Route: oral Route: multiple Dose: 960 mg, 1 times / day Sources: |
unhealthy, 19-67 years n = 11 Health Status: unhealthy Condition: Huntington's disease Age Group: 19-67 years Sex: M+F Population Size: 11 Sources: |
|
120 mg single, oral Recommended |
healthy, 26.5 years n = 40 Health Status: healthy Age Group: 26.5 years Sex: M+F Population Size: 40 Sources: |
|
900 mg single, oral Overdose |
unknown, 27 years n = 1 Health Status: unknown Age Group: 27 years Sex: M Population Size: 1 Sources: |
Other AEs: Ischemic colitis... |
270 mg single, oral Overdose |
unknown, 3 years n = 1 Health Status: unknown Age Group: 3 years Sex: M Population Size: 1 Sources: |
Other AEs: Lethargy, Ataxia... Other AEs: Lethargy (1 patient) Sources: Ataxia (1 patient) Nystagmus (1 patient) |
AEs
AE | Significance | Dose | Population |
---|---|---|---|
Ischemic colitis | 1 patient | 900 mg single, oral Overdose |
unknown, 27 years n = 1 Health Status: unknown Age Group: 27 years Sex: M Population Size: 1 Sources: |
Ataxia | 1 patient | 270 mg single, oral Overdose |
unknown, 3 years n = 1 Health Status: unknown Age Group: 3 years Sex: M Population Size: 1 Sources: |
Lethargy | 1 patient | 270 mg single, oral Overdose |
unknown, 3 years n = 1 Health Status: unknown Age Group: 3 years Sex: M Population Size: 1 Sources: |
Nystagmus | 1 patient | 270 mg single, oral Overdose |
unknown, 3 years n = 1 Health Status: unknown Age Group: 3 years Sex: M Population Size: 1 Sources: |
Overview
CYP3A4 | CYP2C9 | CYP2D6 | hERG |
---|---|---|---|
OverviewOther
Other Inhibitor | Other Substrate | Other Inducer |
---|---|---|
Drug as perpetrator
Target | Modality | Activity | Metabolite | Clinical evidence |
---|---|---|---|---|
Page: 14.0 |
no | |||
Page: 14.0 |
no | |||
Page: 14.0 |
no | |||
Page: 14.0 |
no | |||
Page: 14.0 |
no | |||
Page: 14.0 |
no | |||
Page: 14.0 |
no | |||
Page: 14.0 |
no | |||
Page: 14.0 |
no | |||
Page: 14.0 |
no | |||
Page: 14.0 |
no | |||
Page: 14.0 |
no |
Drug as victim
Target | Modality | Activity | Metabolite | Clinical evidence |
---|---|---|---|---|
no | ||||
Sources: https://pubmed.ncbi.nlm.nih.gov/11602530/ Page: 2.0 |
yes |
Tox targets
Target | Modality | Activity | Metabolite | Clinical evidence |
---|---|---|---|---|
Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2010/021879Orig1s000OtherR.pdf#page=63 Page: 63.0 |
PubMed
Title | Date | PubMed |
---|---|---|
Differential effects of morphinan drugs on haloperidol-induced catalepsy in rats: a comparative study with an N-methyl-D-aspartate antagonist. | 1991 Mar-Apr |
|
Visual hallucinations after combining fluoxetine and dextromethorphan. | 1992 Oct |
|
The role of glutamatergic transmission in the pathogenesis of levodopa-induced dyskinesias. Potential therapeutic approaches. | 2001 |
|
A sensitive LC-MS/MS assay for the determination of dextromethorphan and metabolites in human urine--application for drug interaction studies assessing potential CYP3A and CYP2D6 inhibition. | 2002 Aug 22 |
|
Consultation with the specialist: the central serotonin syndrome: paradigm for psychotherapeutic misadventure. | 2002 Dec |
|
Evaluation of cytochrome P450 probe substrates commonly used by the pharmaceutical industry to study in vitro drug interactions. | 2002 Dec |
|
Non-competitive NMDA receptor antagonists moderate seizure-induced c-fos expression in the rat cerebral cortex. | 2003 Feb 15 |
|
Total and corrected antioxidant capacity in hemodialyzed patients. | 2003 Jul 1 |
|
mRNA and protein expression of dog liver cytochromes P450 in relation to the metabolism of human CYP2C substrates. | 2003 Mar |
|
Combined phenotypic assessment of cytochrome p450 1A2, 2C9, 2C19, 2D6, and 3A, N-acetyltransferase-2, and xanthine oxidase activities with the "Cooperstown 5+1 cocktail". | 2003 Nov |
|
Analysis of pharmacokinetic parameters for assessment of dextromethorphan metabolic phenotypes. | 2003 Sep-Oct |
|
Evidence of significant contribution from CYP3A5 to hepatic drug metabolism. | 2004 Dec |
|
Effect of dextromethorphan, diphenhydramine, and placebo on nocturnal cough and sleep quality for coughing children and their parents. | 2004 Jul |
|
Validated assays for human cytochrome P450 activities. | 2004 Jun |
|
Dimemorfan prevents seizures induced by the L-type calcium channel activator BAY k-8644 in mice. | 2004 May 5 |
|
Evaluation of fresh and cryopreserved hepatocytes as in vitro drug metabolism tools for the prediction of metabolic clearance. | 2004 Nov |
|
[Dextromethorphan enhances analgesic activity of propacetamol--experimental study]. | 2005 |
|
Phenotypical expression of CYP2D6 in amerindians of tepehuano origin from Durango, Mexico. | 2005 |
|
Epigenetic silencing of DSC3 is a common event in human breast cancer. | 2005 |
|
High-throughput screening of inhibitory potential of nine cytochrome P450 enzymes in vitro using liquid chromatography/tandem mass spectrometry. | 2005 |
|
The dextromethorphan analog dimemorfan attenuates kainate-induced seizures via sigma1 receptor activation: comparison with the effects of dextromethorphan. | 2005 Apr |
|
Dextromethorphan psychosis, dependence and physical withdrawal. | 2005 Dec |
|
Multiple P450 substrates in a single run: rapid and comprehensive in vitro interaction assay. | 2005 Jan |
|
MK-801 and dextromethorphan block microglial activation and protect against methamphetamine-induced neurotoxicity. | 2005 Jul 19 |
|
Cytochrome P450 2D6 (CYP2D6) inhibitory constituents of Catharanthus roseus. | 2005 Jun |
|
Side effects of dextromethorphan abuse, a case series. | 2005 Sep |
|
Randomized, controlled trial of dextromethorphan/quinidine for pseudobulbar affect in multiple sclerosis. | 2006 May |
|
Bench-to-bedside review: mechanisms and management of hyperthermia due to toxicity. | 2007 |
|
Sex differences in the potency of kappa opioids and mixed-action opioids administered systemically and at the site of inflammation against capsaicin-induced hyperalgesia in rats. | 2007 Apr |
|
Effects of dextromethorphan on dopamine dependent behaviours in rats. | 2007 Aug |
|
Comparative metabolic capabilities and inhibitory profiles of CYP2D6.1, CYP2D6.10, and CYP2D6.17. | 2007 Aug |
|
Treatment of the common cold. | 2007 Feb 15 |
|
Oral administration of dextromethorphan does not produce neuronal vacuolation in the rat brain. | 2007 Jul |
|
In vitro interaction cocktail assay for nine major cytochrome P450 enzymes with 13 probe reactions and a single LC/MSMS run: analytical validation and testing with monoclonal anti-CYP antibodies. | 2007 Jul |
|
[Simultaneous determination of the inhibitory potency of compounds on the activity of five cytochrome P-450 enzymes using a cocktail probe substrates method]. | 2007 Jun |
|
Challenges for Australia's Bio/Nanopharma Policies: trade deals, public goods and reference pricing in sustainable industrial renewal. | 2007 Jun 1 |
|
Validated method for rapid inhibition screening of six cytochrome P450 enzymes by liquid chromatography-tandem mass spectrometry. | 2007 Jun 1 |
|
Prior exposure to uninfected mosquitoes enhances mortality in naturally-transmitted West Nile virus infection. | 2007 Nov 14 |
|
Effect of sodium ozagrel on the activity of rat CYP2D6. | 2007 Nov 14 |
|
Dextromethorphan: a review of N-methyl-d-aspartate receptor antagonist in the management of pain. | 2007 Spring |
|
Mechanical aspects of a multidirectional, angular stable osteosynthesis system and comparison with four conventional systems. | 2008 Apr |
|
Sex differences in NMDA antagonist enhancement of morphine antihyperalgesia in a capsaicin model of persistent pain: comparisons to two models of acute pain. | 2008 Apr |
|
Sigma ligands, but not N-methyl-D-aspartate antagonists, reduce levodopa-induced dyskinesias. | 2008 Jan 8 |
|
Life-threatening dextromethorphan intoxication associated with interaction with amitriptyline in a poor CYP2D6 metabolizer: a single case re-exposure study. | 2008 Jul |
|
Effects of repeated cycles of sterilisation on the mechanical characteristics of titanium miniplates for osteosynthesis. | 2008 Sep |
|
Effect of fenofibrate on microcirculation and wound healing in healthy and diabetic mice. | 2009 |
|
The diagnostic role of glycosaminoglycans in pleural effusions: a pilot study. | 2009 Feb 18 |
|
Riluzole treatment, survival and diagnostic criteria in Parkinson plus disorders: the NNIPPS study. | 2009 Jan |
|
Retrospective analysis of titanium plate-retained prostheses placed after total rhinectomy. | 2009 Jan-Feb |
|
[Bone anchored hearing aids (BAHA)]. | 2009 Mar |
Sample Use Guides
In Vivo Use Guide
Curator's Comment: https://www.ncbi.nlm.nih.gov/pubmed/1503667
https://www.ncbi.nlm.nih.gov/pubmed/26000221
15-30 mg 3 to 4 times per day (cough)
20-30 mg twice daily (pseudobulbar affect)
Route of Administration:
Oral
In Vitro Use Guide
Sources: https://www.ncbi.nlm.nih.gov/pubmed/24912029
In vitro studies pre- and immature oligodendroglial (OLN-93) cells were subjected to hyperoxic conditions for 48 h after pre-treatment with increasing doses of dextromethorphan.
Substance Class |
Chemical
Created
by
admin
on
Edited
Wed Jul 05 22:46:22 UTC 2023
by
admin
on
Wed Jul 05 22:46:22 UTC 2023
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Record UNII |
351KFH969D
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Record Status |
Validated (UNII)
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Record Version |
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-
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DTXSID70940040
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351KFH969D
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267251
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SUB01646MIG
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100000087786
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DBSALT002917
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5483943
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18609-21-7
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