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Details

Stereochemistry ABSOLUTE
Molecular Formula C18H25NO.C7H6O3
Molecular Weight 409.5179
Optical Activity UNSPECIFIED
Defined Stereocenters 3 / 3
E/Z Centers 0
Charge 0

SHOW SMILES / InChI
Structure of DEXTROMETHORPHAN SALICYLATE

SMILES

OC(=O)C1=CC=CC=C1O.COC2=CC3=C(C[C@H]4[C@H]5CCCC[C@@]35CCN4C)C=C2

InChI

InChIKey=RQQSHDDAQIDHTB-URVXVIKDSA-N
InChI=1S/C18H25NO.C7H6O3/c1-19-10-9-18-8-4-3-5-15(18)17(19)11-13-6-7-14(20-2)12-16(13)18;8-6-4-2-1-3-5(6)7(9)10/h6-7,12,15,17H,3-5,8-11H2,1-2H3;1-4,8H,(H,9,10)/t15-,17+,18+;/m1./s1

HIDE SMILES / InChI

Molecular Formula C7H6O3
Molecular Weight 138.1207
Charge 0
Count
Stereochemistry ACHIRAL
Additional Stereochemistry No
Defined Stereocenters 0 / 0
E/Z Centers 0
Optical Activity NONE

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

Description
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.

Originator

Curator's Comment: # in a Swiss and US patent application from Hoffmann-La Roche in 1946 and 1947, respectively

Approval Year

Targets

Targets

Primary TargetPharmacologyConditionPotency
205.0 nM [Ki]
Conditions

Conditions

ConditionModalityTargetsHighest PhaseProduct
Primary
MUCINEX DM

Approved Use

Helps 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 Date

2004
Primary
NUEDEXTA

Approved Use

NUEDEXTA 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 Date

2010
Cmax

Cmax

ValueDoseCo-administeredAnalytePopulation
2.9 ng/mL
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
4.2 ng/mL
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
599 ng/mL
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
7.7 ng/mL
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
709 ng/mL
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
15.9 ng/mL
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
95.5 ng/mL
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
124.9 ng/mL
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
123.5 ng/mL
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
AUC

AUC

ValueDoseCo-administeredAnalytePopulation
68 nM*h
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:
17.8 ng × h/mL
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
32 ng × h/mL
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
2898 ng × h/mL
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
52 ng × h/mL
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
3608 ng × h/mL
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
133.3 ng × h/mL
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
1049 ng × h/mL
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
933.8 ng × h/mL
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
1000.5 ng × h/mL
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
T1/2

T1/2

ValueDoseCo-administeredAnalytePopulation
13.1 h
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

Doses

DosePopulationAdverse 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
Health Status: unhealthy
Age Group: 19-52 years
Sex: M+F
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
Health Status: unhealthy
Age Group: 19-67 years
Sex: M+F
Sources:
120 mg single, oral
Recommended
Dose: 120 mg
Route: oral
Route: single
Dose: 120 mg
Sources:
healthy, 26.5 years
Health Status: healthy
Age Group: 26.5 years
Sex: M+F
Sources:
900 mg single, oral
Overdose
Dose: 900 mg
Route: oral
Route: single
Dose: 900 mg
Sources:
unknown, 27 years
Health Status: unknown
Age Group: 27 years
Sex: M
Sources:
Other AEs: Ischemic colitis...
Other AEs:
Ischemic colitis (1 patient)
Sources:
270 mg single, oral
Overdose
Dose: 270 mg
Route: oral
Route: single
Dose: 270 mg
Sources:
unknown, 3 years
Health Status: unknown
Age Group: 3 years
Sex: M
Sources:
Other AEs: Lethargy, Ataxia...
Other AEs:
Lethargy (1 patient)
Ataxia (1 patient)
Nystagmus (1 patient)
Sources:
AEs

AEs

AESignificanceDosePopulation
Ischemic colitis 1 patient
900 mg single, oral
Overdose
Dose: 900 mg
Route: oral
Route: single
Dose: 900 mg
Sources:
unknown, 27 years
Health Status: unknown
Age Group: 27 years
Sex: M
Sources:
Ataxia 1 patient
270 mg single, oral
Overdose
Dose: 270 mg
Route: oral
Route: single
Dose: 270 mg
Sources:
unknown, 3 years
Health Status: unknown
Age Group: 3 years
Sex: M
Sources:
Lethargy 1 patient
270 mg single, oral
Overdose
Dose: 270 mg
Route: oral
Route: single
Dose: 270 mg
Sources:
unknown, 3 years
Health Status: unknown
Age Group: 3 years
Sex: M
Sources:
Nystagmus 1 patient
270 mg single, oral
Overdose
Dose: 270 mg
Route: oral
Route: single
Dose: 270 mg
Sources:
unknown, 3 years
Health Status: unknown
Age Group: 3 years
Sex: M
Sources:
Overview

OverviewOther

Drug as perpetrator​

Drug as perpetrator​

TargetModalityActivityMetaboliteClinical evidence
no
no
no
no
no
no
no
no
no
no
no
no
Drug as victimTox targets

Tox targets

TargetModalityActivityMetaboliteClinical evidence
PubMed

PubMed

TitleDatePubMed
Gamma-aminobutyric acid and glutamic acid receptors may mediate theophylline-induced seizures in mice.
1999 Mar
Binding of dimemorfan to sigma-1 receptor and its anticonvulsant and locomotor effects in mice, compared with dextromethorphan and dextrorphan.
1999 Mar 13
Mimicking gene defects to treat drug dependence.
2000
Expression, purification, biochemical characterization, and comparative function of human cytochrome P450 2D6.1, 2D6.2, 2D6.10, and 2D6.17 allelic isoforms.
2002 Dec
Evaluation of cytochrome P450 probe substrates commonly used by the pharmaceutical industry to study in vitro drug interactions.
2002 Dec
Analgesic effect of dextromethorphan in neuropathic pain.
2004 Mar
Dimemorfan prevents seizures induced by the L-type calcium channel activator BAY k-8644 in mice.
2004 May 5
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
Inhibitory effects of nicardipine to cytochrome P450 (CYP) in human liver microsomes.
2005 May
Randomized, controlled trial of dextromethorphan/quinidine for pseudobulbar affect in multiple sclerosis.
2006 May
Effects of dextromethorphan on dopamine dependent behaviours in rats.
2007 Aug
Development and full validation of six inhibition assays for five major cytochrome P450 enzymes in human liver microsomes using an automated 96-well microplate incubation format and LC-MS/MS analysis.
2007 May 9
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
Ubiquitous computing for remote cardiac patient monitoring: a survey.
2008
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
Effects of common antitussive drugs on the hERG potassium channel current.
2008 Dec
Sigma ligands, but not N-methyl-D-aspartate antagonists, reduce levodopa-induced dyskinesias.
2008 Jan 8
Anti-inflammatory effects of dimemorfan on inflammatory cells and LPS-induced endotoxin shock in mice.
2008 Jul
Functional expression and comparative characterization of nine murine cytochromes P450 by fluorescent inhibition screening.
2008 Jul
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
Dextromethorphan reduces oxidative stress and inhibits atherosclerosis and neointima formation in mice.
2009 Apr 1
The diagnostic role of glycosaminoglycans in pleural effusions: a pilot study.
2009 Feb 18
Amyotrophic lateral sclerosis.
2009 Feb 3
Characterization of retrieved orthodontic miniscrew implants.
2009 Jan
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
Patents

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 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 Mon Mar 31 19:09:00 GMT 2025
Edited
by admin
on Mon Mar 31 19:09:00 GMT 2025
Record UNII
B2F298X1AJ
Record Status Validated (UNII)
Record Version
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Name Type Language
9.ALPHA.,13.ALPHA.,14.ALPHA.-MORPHINAN, 3-METHOXY-17-METHYL-, SALICYLATE
Preferred Name English
DEXTROMETHORPHAN SALICYLATE
Common Name English
D-METHORPHAN SALICYLATE
Common Name English
Code System Code Type Description
FDA UNII
B2F298X1AJ
Created by admin on Mon Mar 31 19:09:00 GMT 2025 , Edited by admin on Mon Mar 31 19:09:00 GMT 2025
PRIMARY
PUBCHEM
71587053
Created by admin on Mon Mar 31 19:09:00 GMT 2025 , Edited by admin on Mon Mar 31 19:09:00 GMT 2025
PRIMARY
CAS
23239-33-0
Created by admin on Mon Mar 31 19:09:00 GMT 2025 , Edited by admin on Mon Mar 31 19:09:00 GMT 2025
PRIMARY
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ACTIVE MOIETY