Mucinex DM Max Strength Tabs 42s
It is used to thin mucus so it can be taken from the body by coughing.It is used to relieve coughing.
Drug Class
Expectorant, Antitussive
Pharmacologic Class
Guaifenesin: Expectorant; Dextromethorphan: Cough Suppressant (NMDA receptor antagonist, sigma-1 receptor agonist)
Pregnancy Category
Category C (for both ingredients)
FDA Approved
Jan 1970
DEA Schedule
Not Controlled
Overview
What is this medicine?
Mucinex DM Max Strength is an over-the-counter medicine that helps relieve chest congestion by thinning mucus and suppresses cough. It contains guaifenesin, which helps loosen phlegm, and dextromethorphan, which helps calm your cough.
How to Use This Medicine
Taking Your Medication
To use this medication correctly, follow your doctor's instructions and read all the information provided. You can take this medication with or without food, but if it causes stomach upset, take it with food. Drink plenty of non-caffeinated liquids, unless your doctor advises you to limit your fluid intake. Swallow the medication whole with a full glass of water; do not chew, break, or crush it.
Storing and Disposing of Your Medication
Store this medication at room temperature in a dry place, avoiding the bathroom. Keep all medications in a safe location, out of the reach of children and pets. Dispose of unused or expired medications properly. Do not flush them down the toilet or pour them down the drain unless instructed to do so. If you have questions about disposing of your medication, consult your pharmacist. You may also want to check if there are drug take-back programs in your area.
Missing a Dose
If you take this medication regularly and miss a dose, take it as soon as you remember. However, if it's close to the time for your next dose, skip the missed dose and resume your regular schedule. Do not take two doses at the same time or take extra doses. If you take this medication as needed, do not take it more frequently than your doctor recommends.
To use this medication correctly, follow your doctor's instructions and read all the information provided. You can take this medication with or without food, but if it causes stomach upset, take it with food. Drink plenty of non-caffeinated liquids, unless your doctor advises you to limit your fluid intake. Swallow the medication whole with a full glass of water; do not chew, break, or crush it.
Storing and Disposing of Your Medication
Store this medication at room temperature in a dry place, avoiding the bathroom. Keep all medications in a safe location, out of the reach of children and pets. Dispose of unused or expired medications properly. Do not flush them down the toilet or pour them down the drain unless instructed to do so. If you have questions about disposing of your medication, consult your pharmacist. You may also want to check if there are drug take-back programs in your area.
Missing a Dose
If you take this medication regularly and miss a dose, take it as soon as you remember. However, if it's close to the time for your next dose, skip the missed dose and resume your regular schedule. Do not take two doses at the same time or take extra doses. If you take this medication as needed, do not take it more frequently than your doctor recommends.
Lifestyle & Tips
- Drink plenty of fluids (water, juice) to help loosen mucus.
- Avoid irritants like smoke, dust, and pollutants.
- Use a humidifier to moisten the air.
- Do not take for chronic cough due to smoking, asthma, or emphysema, or if cough is accompanied by excessive phlegm, unless directed by a doctor.
- Do not exceed recommended dose.
Available Forms & Alternatives
Dosing & Administration
Adult Dosing
Standard Dose:
1 tablet (Guaifenesin 1200 mg / Dextromethorphan 60 mg) orally every 12 hours
Dose Range:
1 - 2 mg
Condition-Specific Dosing:
Maximum daily dose:
2 tablets (2400 mg Guaifenesin / 120 mg Dextromethorphan) in 24 hours
Pediatric Dosing
Neonatal:
Not established
Infant:
Not established
Child:
Not established (Not for use in children under 12 years of age)
Adolescent:
1 tablet (Guaifenesin 1200 mg / Dextromethorphan 60 mg) orally every 12 hours (for ages 12 years and older)
Dose Adjustments
Renal Impairment:
Mild:
No specific adjustment recommended
Moderate:
No specific adjustment recommended
Severe:
Use with caution; consult healthcare provider. Accumulation of guaifenesin metabolites may occur.
Dialysis:
Not available; use with caution and monitor for adverse effects.
Hepatic Impairment:
Mild:
No specific adjustment recommended
Moderate:
Use with caution; dextromethorphan is metabolized by the liver. Monitor for increased side effects.
Severe:
Use with caution; dextromethorphan is metabolized by the liver. Consider lower doses or avoidance. Monitor for increased side effects.
Confidence:
Medium
Pharmacology
Mechanism of Action
Guaifenesin acts as an expectorant by increasing the volume and decreasing the viscosity of respiratory tract secretions, thereby facilitating their removal by ciliary action and coughing. Dextromethorphan is a centrally acting antitussive that elevates the cough threshold in the medulla oblongata.
Pharmacokinetics
Absorption:
Bioavailability:
Guaifenesin: Well absorbed; Dextromethorphan: Rapidly absorbed
Tmax:
Guaifenesin: ~1 hour (immediate release); Dextromethorphan: ~2 hours (immediate release). Extended-release formulation will prolong Tmax.
FoodEffect:
Food may slightly delay absorption but does not significantly affect extent of absorption.
Distribution:
Vd:
Guaifenesin: Not well characterized; Dextromethorphan: Large volume of distribution (Vd)
ProteinBinding:
Guaifenesin: Low (~10%); Dextromethorphan: Not extensively protein bound
CnssPenetration:
Guaifenesin: Limited; Dextromethorphan: Yes (crosses blood-brain barrier)
Elimination:
HalfLife:
Guaifenesin: ~1 hour; Dextromethorphan: 1.4-3.9 hours (extensive metabolizers), up to 45 hours (poor metabolizers)
Clearance:
Not available for combination
ExcretionRoute:
Guaifenesin: Renal (as inactive metabolites); Dextromethorphan: Renal (as unchanged drug and metabolites)
Unchanged:
Guaifenesin: Negligible; Dextromethorphan: Small amount
Pharmacodynamics
OnsetOfAction:
Guaifenesin: ~30 minutes; Dextromethorphan: ~15-30 minutes
PeakEffect:
Guaifenesin: ~1 hour; Dextromethorphan: ~2 hours
DurationOfAction:
12 hours (due to extended-release formulation)
Safety & Warnings
Side Effects
Urgent Side Effects: Seek Medical Help Right Away
If you experience any of the following symptoms, call your doctor immediately or seek emergency medical attention. Although rare, some people may have severe and potentially life-threatening side effects when taking this medication. Be aware of the following signs of a serious allergic reaction:
- Rash
- Hives
- Itching
- Red, swollen, blistered, or peeling skin (with or without fever)
- Wheezing
- Tightness in the chest or throat
- Difficulty breathing, swallowing, or talking
- Unusual hoarseness
- Swelling of the mouth, face, lips, tongue, or throat
Other Possible Side Effects
Like all medications, this drug can cause side effects. However, many people do not experience any side effects or only have mild ones. If you have side effects that bother you or do not go away, contact your doctor for advice. Not all possible side effects are listed here. If you have questions or concerns about side effects, discuss them with your doctor.
Reporting Side Effects
For medical advice about side effects, contact your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
If you experience any of the following symptoms, call your doctor immediately or seek emergency medical attention. Although rare, some people may have severe and potentially life-threatening side effects when taking this medication. Be aware of the following signs of a serious allergic reaction:
- Rash
- Hives
- Itching
- Red, swollen, blistered, or peeling skin (with or without fever)
- Wheezing
- Tightness in the chest or throat
- Difficulty breathing, swallowing, or talking
- Unusual hoarseness
- Swelling of the mouth, face, lips, tongue, or throat
Other Possible Side Effects
Like all medications, this drug can cause side effects. However, many people do not experience any side effects or only have mild ones. If you have side effects that bother you or do not go away, contact your doctor for advice. Not all possible side effects are listed here. If you have questions or concerns about side effects, discuss them with your doctor.
Reporting Side Effects
For medical advice about side effects, contact your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Seek Immediate Medical Attention If You Experience:
- Cough lasts more than 7 days, comes back, or occurs with fever, rash, or persistent headache (may be signs of a serious condition).
- Nervousness, dizziness, or sleeplessness occur.
- Symptoms worsen or new symptoms appear.
- Signs of an allergic reaction (e.g., rash, itching, swelling, severe dizziness, trouble breathing).
- Signs of serotonin syndrome (e.g., agitation, confusion, rapid heart rate, sweating, muscle stiffness, twitching, uncoordinated movements, severe nausea/vomiting/diarrhea).
Before Using This Medicine
Before Taking This Medication: Important Information to Share with Your Doctor
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the allergic reaction and its symptoms.
If you have a cough that produces a significant amount of mucus, a persistent cough caused by smoking or exposure to smoke, or lung conditions like asthma or emphysema.
If you have taken certain medications for depression or Parkinson's disease within the last 14 days, including isocarboxazid, phenelzine, tranylcypromine, selegiline, or rasagiline, as this may lead to severely high blood pressure.
If you are currently taking linezolid or methylene blue, as these medications can interact with this drug.
To ensure your safety, it is crucial to provide your doctor and pharmacist with a comprehensive list of:
All prescription and over-the-counter medications you are taking
Any natural products or vitamins you are using
* Your health problems, including any medical conditions or diseases
This information will help your doctor determine whether it is safe for you to take this medication with your other medications and health conditions. Never start, stop, or change the dose of any medication without first consulting your doctor.
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the allergic reaction and its symptoms.
If you have a cough that produces a significant amount of mucus, a persistent cough caused by smoking or exposure to smoke, or lung conditions like asthma or emphysema.
If you have taken certain medications for depression or Parkinson's disease within the last 14 days, including isocarboxazid, phenelzine, tranylcypromine, selegiline, or rasagiline, as this may lead to severely high blood pressure.
If you are currently taking linezolid or methylene blue, as these medications can interact with this drug.
To ensure your safety, it is crucial to provide your doctor and pharmacist with a comprehensive list of:
All prescription and over-the-counter medications you are taking
Any natural products or vitamins you are using
* Your health problems, including any medical conditions or diseases
This information will help your doctor determine whether it is safe for you to take this medication with your other medications and health conditions. Never start, stop, or change the dose of any medication without first consulting your doctor.
Precautions & Cautions
It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication.
To minimize the risk of severe side effects, do not exceed the dosage prescribed by your doctor. Taking more than the recommended amount may increase your chances of experiencing adverse reactions.
Adhere to the treatment duration specified by your doctor and do not take this medication for longer than prescribed.
Please note that certain formulations of this medication may not be suitable for children of all ages. If you have any concerns or questions, consult with your doctor to determine the appropriate course of action.
If you are pregnant, planning to become pregnant, or are breastfeeding, notify your doctor. It is crucial to discuss the potential benefits and risks of this medication to both you and your baby to make an informed decision.
To minimize the risk of severe side effects, do not exceed the dosage prescribed by your doctor. Taking more than the recommended amount may increase your chances of experiencing adverse reactions.
Adhere to the treatment duration specified by your doctor and do not take this medication for longer than prescribed.
Please note that certain formulations of this medication may not be suitable for children of all ages. If you have any concerns or questions, consult with your doctor to determine the appropriate course of action.
If you are pregnant, planning to become pregnant, or are breastfeeding, notify your doctor. It is crucial to discuss the potential benefits and risks of this medication to both you and your baby to make an informed decision.
Overdose Information
Overdose Symptoms:
- Nausea, vomiting, stomach pain
- Dizziness, drowsiness, confusion
- Blurred vision
- Nystagmus (involuntary eye movements)
- Ataxia (loss of coordination)
- Slurred speech
- Hallucinations, agitation, psychosis
- Respiratory depression (severe cases)
- Serotonin syndrome (in severe cases or with interactions)
What to Do:
Seek immediate medical attention or call a Poison Control Center (1-800-222-1222). Treatment is supportive and symptomatic. Naloxone may reverse respiratory depression from dextromethorphan overdose.
Drug Interactions
Contraindicated Interactions
- Monoamine Oxidase Inhibitors (MAOIs) (concurrent use or within 2 weeks of stopping MAOIs due to risk of serotonin syndrome)
Major Interactions
- Serotonergic drugs (e.g., SSRIs, SNRIs, TCAs, triptans, tramadol, fentanyl, St. John's Wort) - increased risk of serotonin syndrome with dextromethorphan
- CYP2D6 inhibitors (e.g., fluoxetine, paroxetine, quinidine, amiodarone, bupropion) - may increase dextromethorphan levels and adverse effects
Moderate Interactions
- Alcohol (may enhance CNS depression)
- Other CNS depressants (e.g., sedatives, hypnotics, anxiolytics) - additive CNS depression
Minor Interactions
- None significant for guaifenesin
Monitoring
Symptom Monitoring
- Effectiveness in reducing cough and thinning mucus
- Presence of adverse effects (e.g., nausea, vomiting, dizziness, drowsiness, headache)
- Signs of serotonin syndrome (agitation, hallucinations, rapid heart rate, fever, sweating, muscle rigidity, twitching, coordination problems, nausea, vomiting, diarrhea)
- Cough duration (if cough persists for more than 7 days, worsens, or is accompanied by fever, rash, or persistent headache, seek medical attention)
Special Patient Groups
Pregnancy
Use with caution, especially during the first trimester. Consult a healthcare provider before use. Guaifenesin and dextromethorphan are generally considered low risk in later trimesters, but always weigh benefits against potential risks.
Trimester-Specific Risks:
First Trimester:
Avoid if possible, or use only if clearly needed and directed by a doctor.
Second Trimester:
Generally considered low risk, but use with caution.
Third Trimester:
Generally considered low risk, but use with caution.
Lactation
Use with caution. Both guaifenesin and dextromethorphan are excreted into breast milk. Monitor infant for drowsiness, irritability, or feeding difficulties. Consult a healthcare provider.
Infant Risk:
Low to moderate risk. Drowsiness or irritability in the infant is possible, especially with higher doses or in poor metabolizers of dextromethorphan.
Pediatric Use
Not for use in children under 12 years of age. For ages 12 and older, follow adult dosing. Always use pediatric formulations or consult a pediatrician for younger children.
Geriatric Use
Use with caution. Elderly patients may be more sensitive to the effects of dextromethorphan, particularly CNS effects (dizziness, drowsiness). Start with the lowest effective dose and monitor closely for adverse reactions.
Clinical Information
Clinical Pearls
- Advise patients to stay well-hydrated to maximize the expectorant effect of guaifenesin.
- Remind patients that this product is for temporary relief of cough and congestion; it does not treat the underlying cause of the cough.
- Counsel patients on the potential for abuse of dextromethorphan, especially in higher doses, and to adhere strictly to recommended dosing.
- Warn about the risk of serotonin syndrome when combined with other serotonergic drugs or MAOIs.
- Patients who are known CYP2D6 poor metabolizers may experience increased and prolonged effects of dextromethorphan.
Alternative Therapies
- Single-ingredient guaifenesin (for expectorant effect only)
- Single-ingredient dextromethorphan (for cough suppression only)
- Other antitussives (e.g., benzonatate, codeine - prescription only)
- Other expectorants (e.g., saline nasal spray, steam inhalation)
- Non-pharmacological measures (e.g., honey for cough, humidifiers)
Cost & Coverage
Average Cost:
$15 - $25 per 42 tablets
Generic Available:
Yes
Insurance Coverage:
Generally not covered by prescription insurance plans; may be eligible for FSA/HSA reimbursement.
General Drug Facts
If your symptoms or health issues persist or worsen, it's essential to contact your doctor for further guidance. To ensure your safety, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so be sure to check with your pharmacist for more information. If you have any questions or concerns about this medication, don't hesitate to reach out to your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek emergency medical attention. When seeking help, be prepared to provide details about the medication, including the amount taken and the time it happened, to facilitate prompt and effective treatment.