Generic Name: dextromethorphan, guaifenesin, and phenylephrine (dex troe meth OR fan, gwye FEN e sin, fen il EFF rin)
Brand names: Certuss-D, Duraphen Forte, Duraphen II DM, Sinutuss DM, ...show all 61 brand names.
What is dextromethorphan, guaifenesin, and phenylephrine?
Dextromethorphan is a cough suppressant. It affects the signals in the brain that trigger cough reflex.
Guaifenesin is an expectorant. It helps loosen congestion in your chest and throat, making it easier to cough out through your mouth.
Phenylephrine is a decongestant that shrinks blood vessels in the nasal passages. Dilated blood vessels can cause nasal congestion (stuffy nose).
The combination of dextromethorphan, guaifenesin, and phenylephrine is used to treat stuffy nose, sinus congestion, cough, and chest congestion caused by the common cold or flu.
Dextromethorphan will not treat a cough that is caused by smoking, asthma, or emphysema.
Dextromethorphan, guaifenesin, and phenylephrine may also be used for other purposes not listed in this medication guide.
What is the most important information I should know about dextromethorphan, guaifenesin, and phenylephrine?
Do not give this medication to a child younger than 2 years old. Always ask a doctor before giving a cough or cold medicine to a child. Death can occur from the misuse of cough and cold medicines in very young children. Do not use a cough or cold medicine if you have used an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days. Serious, life-threatening side effects can occur if you take cough or cold medicine before the MAO inhibitor has cleared from your body. Do not use any other over-the-counter cough, cold, allergy, or sleep medication without first asking your doctor or pharmacist. If you take certain products together you may accidentally take too much of one or more types of medicine. Read the label of any other medicine you are using to see if it contains a decongestant, expectorant, or cough suppressant. Dextromethorphan will not treat a cough that is caused by smoking, asthma, or emphysema.
What should I discuss with my healthcare provider before using dextromethorphan, guaifenesin, and phenylephrine?
Do not use a cough or cold medicine if you have used an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days. Serious, life-threatening side effects can occur if you take cough or cold medicine before the MAO inhibitor has cleared from your body. Do not use this medicine if you are allergic to dextromethorphan, guaifenesin, or phenylephrine.
Ask a doctor or pharmacist if it is safe for you to take this medication if you have emphysema or chronic bronchitis.
This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. This medication may pass into breast milk and could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.
Artificially-sweetened liquid forms of cold medicine may contain phenylalanine. This would be important to know if you have phenylketonuria (PKU). Check the ingredients and warnings on the medication label if you are concerned about phenylalanine.
How should I take dextromethorphan, guaifenesin, and phenylephrine?
Use this medication exactly as directed on the label, or as it has been prescribed by your doctor. Do not use the medication in larger amounts, or use it for longer than recommended. Cold medicine is usually taken only for a short time until your symptoms clear up.
Do not give this medication to a child younger than 2 years old. Always ask a doctor before giving a cough or cold medicine to a child. Death can occur from the misuse of cough and cold medicines in very young children.
Measure the liquid form of this medicine with a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.
Take the medication with food if it upsets your stomach. Drink extra fluids to help loosen the congestion and lubricate your throat while you are taking this medication. Do not crush, chew, or break an extended-release tablet. Swallow the pill whole. It is specially made to release medicine slowly in the body. Breaking or opening the pill would cause too much of the drug to be released at one time. Talk with your doctor if your symptoms do not improve after 7 days of treatment, or if you have a fever with a headache, cough, or skin rash.
If you need to have any type of surgery, tell the surgeon ahead of time if you have taken a cold medicine within the past few days.
Store this medicine at room temperature, away from heat, light, and moisture.
See also: Dextromethorphan, guaifenesin, and phenylephrine dosage (in more detail)
What happens if I miss a dose?
Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at your next regularly scheduled time. Do not take extra medicine to make up the missed dose.
What happens if I overdose?
Seek emergency medical attention if you think you have used too much of this medicine.
Overdose symptoms may include feeling restless or nervous.
What should I avoid while taking dextromethorphan, guaifenesin, and phenylephrine?
This medication can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert. Avoid drinking alcohol. It can increase some of the side effects of this medication.
Avoid taking diet pills, caffeine pills, or other stimulants (such as ADHD medications) without your doctor's advice. Taking a stimulant together with cough or cold medicine can increase your risk of unpleasant side effects.
Do not use any other over-the-counter cough, cold, allergy, or sleep medication without first asking your doctor or pharmacist. If you take certain products together you may accidentally take too much of one or more types of medicine. Read the label of any other medicine you are using to see if it contains a decongestant, expectorant, or cough suppressant.
Dextromethorphan, guaifenesin, and phenylephrine side effects
Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using this medication and call your doctor at once if you have any of these serious side effects:
severe dizziness, anxiety, restless feeling, or nervousness;
confusion, hallucinations; or
slow, shallow breathing.
Less serious side effects may include:
dizziness or headache,
a rash, or
nausea, vomiting, or stomach upset.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Dextromethorphan, guaifenesin, and phenylephrine Dosing Information
Usual Adult Dose for Cough and Nasal Congestion:
Dextromethorphan 15 mg/guaifenesin 100 mg/phenylephrine 5 mg/5 mL:
10 mL orally every 6 hours not to exceed 40 mL daily.
Dextromethorphan 15 mg/guaifenesin 300 mg/phenylephrine 10 mg/5 mL:
10 mL orally every 6 hours not to exceed 40 mL daily.
Dextromethorphan 20 mg/guaifenesin 100 mg/phenylephrine 10 mg/5 mL:
5 mL orally every 4 to 6 hours not to exceed 30 mL daily.
Dextromethorphan 20 mg/guaifenesin 800 mg/phenylephrine 20 mg oral tablets, extended release:
1 to 1.5 tablets orally every 12 hours not to exceed 3 tablets daily.
Dextromethorphan 30 mg/guaifenesin 900 mg/phenylephrine 30 mg oral tablets, extended release:
1 tablet orally every 12 hours not to exceed 2 tablets daily.
Dextromethorphan 25 mg/guaifenesin 175 mg/phenylephrine 12.5 mg/5 mL:
5 mL orally four times daily.
Dextromethorphan 25 mg/guaifenesin 550 mg/phenylephrine 20 mg oral tablets, and Dextromethorphan 25 mg/guaifenesin 600 mg/phenylephrine 20 mg oral tablets, extended release:
1 to 2 tablets orally every 12 hours not to exceed 3 tablets daily.
Dextromethorphan 30 mg/guaifenesin 1000 mg/phenylephrine 20 mg oral tablets, extended release:
1 tablet orally every 12 hours not to exceed 2 tablets daily.
Dextromethorphan 30 mg/guaifenesin 1200 mg/phenylephrine 30 mg oral tablets, extended release:
1 tablet orally every 12 hours not to exceed 2 tablets daily.
Dextromethorphan 30 mg/guaifenesin 600 mg/phenylephrine 10 mg oral tablets, extended release:
1 to 2 tablets orally every 12 hours not to exceed 4 tablets daily.
Dextromethorphan 40 mg/guaifenesin 200 mg/phenylephrine 20 mg/10 mL extended release suspension:
10 mL orally every 12 hours not to exceed 2 doses daily.
Dextromethorphan 45 mg/guaifenesin 1200 mg/phenylephrine 25 mg oral tablets, extended release:
1 tablet orally every 12 hours not to exceed 2 doses daily.
Dextromethorphan 60 mg/guaifenesin 600 mg/phenylephrine 40 mg oral tablets, extended release:
1 tablet orally every 12 hours not to exceed 2 doses daily.
Dextromethorphan 60 mg/guaifenesin 1000 mg/phenylephrine 40 mg oral tablets, extended release:
1 tablet orally every 12 hours not to exceed 2 doses daily.
Dextromethorphan 20 mg/guaifenesin 800 mg/phenylephrine 20 mg oral tablets, extended release:
1 to 1.5 tablets orally every 12 hours not to exceed 3 tablets daily.
Dextromethorphan 30 mg/guaifenesin 600 mg/phenylephrine 20 mg oral tablets, extended release:
1 or 2 tablets orally twice a day not to exceed 2 doses daily.
Dextromethorphan/guaifenesin/phenylephrine 14 mg-288 mg-7 mg oral capsule:
1 capsule orally every 4 to 6 hours.
Dextromethorphan 15 mg/guaifenesin 380 mg/phenylephrine 10 mg oral capsule:
1 capsule orally every 4 hours not to exceed 6 tablets daily.
Dextromethorphan 20 mg/guaifenesin 400 mg/phenylephrine 10 mg oral tablet:
1 tablet orally every 4 to 6 hours not to exceed 4 tablets in 24 hours.
Dextromethorphan 20 mg/guaifenesin 200 mg/phenylephrine 10 mg/10 mL oral liquid:
1 prefilled spoon (10 mL) orally every 4 hours.
Dextromethorphan 5 mg/guaifenesin 50 mg/phenylephrine 2.5 mg/5 mL oral liquid:
20 mL orally every 4 hours. Do not take more than 6 doses in 24 hours.
Dextromethorphan/guaifenesin/phenylephrine 15 mg-350 mg-12 mg oral tablet:
1 tablet orally every 6 hours, not to exceed 4 tablets in 24 hours.
Dextromethorphan/guaifenesin/phenylephrine 10 mg-200 mg-5 mg/5 mL oral liquid:
10 mL orally every 4 hours. Do not take more than 6 doses in 24 hours.
Dextromethorphan/guaifenesin/phenylephrine 20 mg-400 mg-10 mg/5 mL oral liquid:
5 mL orally every 4 hours. Do not take more than 6 doses in 24 hours.
Dextromethorphan/guaifenesin/phenylephrine 5 mg-75 mg-2.5 mg/5 mL oral liquid:
20 mL orally every 4 hours. Do not take more than 6 doses in 24 hours.
Dextromethorphan/guaifenesin/phenylephrine 20 mg-400 mg-10 mg/20 mL oral liquid:
20 mL orally every 4 hours. Do not take more than 6 doses in 24 hours.
Usual Pediatric Dose for Cough and Nasal Congestion:
Dextromethorphan 5 mg/guaifenesin 50 mg/phenylephrine 2.5 mg/5 mL oral liquid:
over 6 months to less than 9 months: 0.75 mL orally 4 times daily.
over 9 months to 18 months: 1 mL orally 4 times daily.
Dextromethorphan 15 mg/guaifenesin 100 mg/phenylephrine 5 mg/5 mL:
over 2 yrs to less than 6 yrs: 2.5 mL orally every 6 hours not to exceed 10 mL daily.
over 6 yrs to less than 12 yrs: 5 mL orally every 6 hours not to exceed 20 mL daily.
over 12 yrs: 10 mL orally every 6 hours not to exceed 40 mL daily.
Dextromethorphan 15 mg/guaifenesin 300 mg/phenylephrine 10 mg/5 mL:
over 6 yrs to less than 12 yrs: 5 mL orally every 6 hours not to exceed 20 mL daily.
over 12 yrs: 10 mL orally every 6 hours not to exceed 40 mL daily.
Dextromethorphan 20 mg/guaifenesin 100 mg/phenylephrine 10 mg/5 mL:
over 2 yrs to less than 6 yrs: 1.25 mL orally every 4 to 6 hours not to exceed 7.5 mL daily.
over 6 yrs to less than 12 yrs: 2.5 mL orally every 4 to 6 hours not to exceed 15 mL daily.
over 12 yrs: 5 mL orally every 4 to 6 hours not to exceed 30 mL daily.
Dextromethorphan 25 mg/guaifenesin 175 mg/phenylephrine 12.5 mg/5 mL oral syrup:
over 2 yrs to less than 6 yrs: 1.25 mL orally four times daily.
over 6 yrs to less than 12 yrs: 2.5 mL orally four times daily.
over 12 yrs: 5 mL orally four times daily.
Dextromethorphan 23 mg/guaifenesin 600 mg/phenylephrine 9 mg oral tablets, extended release:
over 6 yrs to less than 12 yrs: one half tablet orally every 12 hours not to exceed 1 tablet daily
over 12 yrs: 1 or 2 tablets orally every 12 hours not to exceed 4 tablets daily.
Dextromethorphan 20 mg/guaifenesin 800 mg/phenylephrine 20 mg oral tablets, extended release:
over 6 yrs to less than 12 yrs: 1/2 tablet orally every 12 hours not to exceed 1 tablet daily.
over 12 yrs: 1 to 1.5 tablets orally every 12 hours not to exceed 3 tablets daily.
Dextromethorphan 25 mg/guaifenesin 550 mg/phenylephrine 20 mg oral tablets, extended release:
over 6 yrs to less than 12 yrs: 1/2 tablet orally every 12 hours not to exceed 1 tablet daily.
over 12 yrs: 1 to 2 tablets orally every 12 hours not to exceed 3 tablets daily.
Dextromethorphan 25 mg/guaifenesin 600 mg/phenylephrine 20 mg oral tablets, extended release:
over 2 yrs to less than 6 yrs: 1/2 tablet orally every 12 hours not to exceed 1 tablet daily.
over 6 yrs to less than 12 yrs: 1/2 to 1 tablet orally every 12 hours not to exceed 1 1/2 tablet daily.
over 12 yrs: 1 to 2 tablets orally every 12 hours not to exceed 3 tablets daily.
Dextromethorphan 30 mg/guaifenesin 1200 mg/phenylephrine 30 mg oral tablets, extended release:
over 6 yrs to less than 12 yrs: 1/2 tablet orally every 12 hours not to exceed 1 tablet daily.
over 12 yrs: 1 tablet orally every 12 hours not to exceed 2 tablets daily.
Dextromethorphan 30 mg/guaifenesin 600 mg/phenylephrine 10 mg oral tablets, extended release:
over 6 yrs to less than 12 yrs: 1 tablet orally every 12 hours not to exceed 2 tablets daily.
over 12 yrs: 1 to 2 tablets orally every 12 hours not to exceed 4 tablets daily.
Dextromethorphan 30 mg/guaifenesin 1000 mg/phenylephrine 20 mg oral tablets, extended release:
over 6 yrs to less than 12 yrs: 1/2 tablet orally every 12 hours not to exceed 1 tablet daily.
over 12 yrs: 1 tablet orally every 12 hours not to exceed 2 tablets daily.
Dextromethorphan 40 mg/guaifenesin 200 mg/phenylephrine 20 mg/10 mL:
over 3 yrs to less than 6 yrs: 2.5 mL orally every 12 hours not to exceed 5 mL daily.
over 6 yrs to less than 12 yrs: 5 mL orally every 12 hours not to exceed 10 mL daily.
over 12 yrs: 10 mL orally every 12 hours not to exceed 20 mL daily.
Dextromethorphan 45 mg/guaifenesin 1200 mg/phenylephrine 25 mg oral tablets, extended release:
over 6 yrs to less than 12 yrs: 1/2 tablet orally every 12 hours not to exceed 2 doses daily.
over 12 yrs: 1 tablet orally every 12 hours not to exceed 2 doses daily.
Dextromethorphan 60 mg/guaifenesin 600 mg/phenylephrine 40 mg oral tablets, extended release:
over 6 yrs to less than 12 yrs: 1/2 tablet orally every 12 hours not to exceed 2 doses daily.
over 12 yrs: 1 tablet orally every 12 hours not to exceed 2 doses daily.
Dextromethorphan 60 mg/guaifenesin 1000 mg/phenylephrine 40 mg oral tablets, extended release:
over 6 yrs to less than 12 yrs: 1/2 tablet orally every 12 hours not to exceed 2 doses daily.
over 12 yrs: 1 tablet orally every 12 hours not to exceed 2 doses daily.
Dextromethorphan 5 mg/guaifenesin 100 mg/phenylephrine 2.5 mg/5 mL:
over 2 yrs to less than 6 yrs and 11 kg to 21 kg: 2.5 mL orally every 4 hours not to exceed 15 mL daily.
Dextromethorphan 30 mg/guaifenesin 900 mg/phenylephrine 30 mg oral tablets, extended release:
6 years to 12 years: 1/2 tablet orally every 12 hours not to exceed 1 tablet daily.
12 years or older: 1 tablet orally every 12 hours not to exceed 2 tablets daily.
Dextromethorphan 30 mg/guaifenesin 600 mg/phenylephrine 20 mg oral tablets, extended release:
12 years or older: 1 or 2 tablets orally twice a day not to exceed 2 doses daily.
Dextromethorphan/guaifenesin/phenylephrine 14 mg-288 mg-7 mg oral capsule:
over 12 yrs: 1 capsule orally every 4 to 6 hours.
Dextromethorphan 15 mg/guaifenesin 380 mg/phenylephrine 10 mg oral capsule:
12 years or older: 1 capsule orally every 4 hours not to exceed 6 tablets daily.
Dextromethorphan 20 mg/guaifenesin 400 mg/phenylephrine 10 mg oral tablet:
6 years to 12 years: 1/2 tablet orally every 4 to 6 hours not to exceed 2 tablets in 24 hours.
over 12 yrs 1 tablet orally every 4 to 6 hours not to exceed 4 tablets in 24 hours.
Dextromethorphan 20 mg/guaifenesin 200 mg/phenylephrine 10 mg/10 mL oral liquid:
12 years or older: 1 prefilled spoon (10 mL) orally every 4 hours.
Dextromethorphan 5 mg/guaifenesin 50 mg/phenylephrine 2.5 mg/5 mL oral liquid:
4 years to 5 years: 5 mL orally every 4 hours not to exceed 6 doses in 24 hours.
6 years to 11 years: 10 mL orally every 4 hours not to exceed 6 doses in 24 hours.
12 years or older: 20 mL orally every 4 hours not to exceed 6 doses in 24 hours.
Dextromethorphan/guaifenesin/phenylephrine 15 mg-350 mg-12 mg oral tablet:
12 years or older: 1 tablet orally every 6 hours, not to exceed 4 tablets in 24 hours.
Dextromethorphan/guaifenesin/phenylephrine 10 mg-200 mg-5 mg/5 mL oral liquid:
12 years or older: 10 mL orally every 4 hours. Do not take more than 6 doses in 24 hours.
Dextromethorphan/guaifenesin/phenylephrine 5 mg-100 mg-2.5 mg/5 mL oral liquid:
4 years to 5 years: 5 mL orally every 4 hours not to exceed 6 doses in 24 hours.
6 years to 11 years: 10 mL orally every 4 hours not to exceed 6 doses in 24 hours.
Dextromethorphan/guaifenesin/phenylephrine 20 mg-400 mg-10 mg/5 mL oral liquid:
12 years or older: 5 mL orally every 4 hours. Do not take more than 6 doses in 24 hours.
Dextromethorphan/guaifenesin/phenylephrine 5 mg-75 mg-2.5 mg/5 mL oral liquid:
2 years to 5 years: 5 mL orally every 4 hours. Do not take more than 6 doses in 24 hours.
6 years to 11 years: 10 mL orally every 4 hours. Do not take more than 6 doses in 24 hours.
12 years or older: 20 mL orally every 4 hours. Do not take more than 6 doses in 24 hours.
Dextromethorphan/guaifenesin/phenylephrine 20 mg-400 mg-10 mg/20 mL oral liquid:
12 years or older: 20 mL orally every 4 hours. Do not take more than 6 doses in 24 hours.
What other drugs will affect dextromethorphan, guaifenesin, and phenylephrine?
Before taking dextromethorphan, guaifenesin, and phenylephrine, tell your doctor if you are using any of the following drugs:
celecoxib (Celebrex);
cinacalcet (Sensipar);
darifenacin (Enablex);
imatinib (Gleevec);
quinidine (Quinaglute, Quinidex);
ranolazine (Ranexa)
ritonavir (Norvir);
sibutramine (Meridia);
terbinafine (Lamisil);
medicines to treat high blood pressure; or
antidepressant medications such as amitriptyline (Elavil, Etrafon), bupropion (Wellbutrin, Zyban), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), imipramine (Janimine, Tofranil), paroxetine (Paxil), sertraline (Zoloft), and others.
This list is not complete and there may be other drugs that can interact with dextromethorphan, guaifenesin, and phenylephrine. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.
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Compare dextromethorphan, guaifenesin, and phenylephrine with other medications
- Cough and Nasal Congestion
Where can I get more information?
- Your pharmacist can provide more information about dextromethorphan, guaifenesin, and phenylephrine.
See also: dextromethorphan, guaifenesin, and phenylephrine side effects (in more detail)
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