Tussin Cough Chest Liquid
It is used to thin mucus so it can be taken from the body by coughing.It is used to relieve coughing.
Drug Class
Antitussive, Expectorant
Pharmacologic Class
Antitussive (Dextromethorphan), Expectorant (Guaifenesin)
Pregnancy Category
Category C
FDA Approved
Jan 1970
DEA Schedule
Not Controlled
Overview
What is this medicine?
This medicine helps to relieve coughs and chest congestion. Guaifenesin helps to thin and loosen mucus in your lungs, making it easier to cough up. Dextromethorphan helps to calm your cough reflex.
How to Use This Medicine
Taking Your Medication Correctly
To get the most benefit from your medication, follow your doctor's instructions carefully. Read all the information provided with your prescription and follow the instructions closely. You can take this medication with or without food, but if it causes stomach upset, take it with food to help minimize discomfort.
It's essential to stay hydrated while taking this medication, so drink plenty of non-caffeinated liquids, unless your doctor advises you to limit your fluid intake. When measuring liquid doses, use the measuring device that comes with the medication. If one is not provided, ask your pharmacist for a suitable measuring device to ensure accurate dosing.
Storing and Disposing of Your Medication
Store your 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 by your doctor or pharmacist. If you're unsure about the best way to dispose of your medication, consult your pharmacist, who may be aware of drug take-back programs in your area.
What to Do If You Miss a Dose
If you take this medication on a regular schedule, take the missed dose 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 dosing 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 directed by your doctor.
To get the most benefit from your medication, follow your doctor's instructions carefully. Read all the information provided with your prescription and follow the instructions closely. You can take this medication with or without food, but if it causes stomach upset, take it with food to help minimize discomfort.
It's essential to stay hydrated while taking this medication, so drink plenty of non-caffeinated liquids, unless your doctor advises you to limit your fluid intake. When measuring liquid doses, use the measuring device that comes with the medication. If one is not provided, ask your pharmacist for a suitable measuring device to ensure accurate dosing.
Storing and Disposing of Your Medication
Store your 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 by your doctor or pharmacist. If you're unsure about the best way to dispose of your medication, consult your pharmacist, who may be aware of drug take-back programs in your area.
What to Do If You Miss a Dose
If you take this medication on a regular schedule, take the missed dose 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 dosing 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 directed by your doctor.
Lifestyle & Tips
- Drink plenty of fluids (water, juice) to help thin mucus.
- Avoid irritants like smoke, dust, and pollutants.
- Use a humidifier to moisten the air.
- Do not exceed the recommended dose.
- Do not use for chronic cough that lasts or is accompanied by smoking, asthma, chronic bronchitis, or emphysema, or if cough is accompanied by excessive phlegm (mucus), unless directed by a doctor.
Available Forms & Alternatives
Available Strengths:
Dosing & Administration
Adult Dosing
Standard Dose:
10 mL (200 mg Guaifenesin / 20 mg Dextromethorphan) every 4 hours as needed
Dose Range:
10 - 20 mg
Condition-Specific Dosing:
maxDailyDose:
Do not exceed 6 doses (1200 mg Guaifenesin / 120 mg Dextromethorphan) in 24 hours
Pediatric Dosing
Neonatal:
Not established
Infant:
Not established (Do not use in children under 4 years of age)
Child:
Children 4 to under 6 years: 2.5 mL every 4 hours (max 6 doses/24 hours); Children 6 to under 12 years: 5 mL every 4 hours (max 6 doses/24 hours)
Adolescent:
Children 12 years and over: 10 mL every 4 hours (max 6 doses/24 hours)
Dose Adjustments
Renal Impairment:
Mild:
No specific adjustment recommended for OTC use, use with caution
Moderate:
No specific adjustment recommended for OTC use, use with caution
Severe:
Use with caution; consult a healthcare professional
Dialysis:
Considerations: Not well studied for this combination; consult a healthcare professional
Hepatic Impairment:
Mild:
No specific adjustment recommended for OTC use, use with caution
Moderate:
Use with caution; consult a healthcare professional
Severe:
Use with caution; consult a healthcare professional
Pharmacology
Mechanism of Action
Guaifenesin acts as an expectorant by increasing the volume and decreasing the viscosity of secretions in the trachea and bronchi, thereby facilitating the removal of mucus. Dextromethorphan is an antitussive that acts centrally on the cough center in the medulla to elevate the cough threshold.
Pharmacokinetics
Absorption:
Bioavailability:
Not available (rapidly absorbed)
Tmax:
Guaifenesin: ~1 hour; Dextromethorphan: ~2-2.5 hours
FoodEffect:
May delay absorption slightly, but not clinically significant for efficacy
Distribution:
Vd:
Guaifenesin: Not extensively distributed; Dextromethorphan: Widely distributed
ProteinBinding:
Guaifenesin: Low (~10%); Dextromethorphan: Not extensively bound
CnssPenetration:
Dextromethorphan: Yes; Guaifenesin: Limited
Elimination:
HalfLife:
Guaifenesin: ~1 hour; Dextromethorphan: ~1.4-3.9 hours (parent drug), Dextrorphan: ~10 hours
Clearance:
Not available
ExcretionRoute:
Guaifenesin: Renal (metabolites); Dextromethorphan: Renal (unchanged drug and metabolites)
Unchanged:
Guaifenesin: Negligible; Dextromethorphan: Small amount
Pharmacodynamics
OnsetOfAction:
Guaifenesin: ~30 minutes; Dextromethorphan: ~15-30 minutes
PeakEffect:
Guaifenesin: ~1 hour; Dextromethorphan: ~2.5 hours
DurationOfAction:
Guaifenesin: ~4-6 hours; Dextromethorphan: ~5-6 hours
Confidence:
Medium
Safety & Warnings
Side Effects
Urgent Side Effects: Seek Medical Help Right Away
Although rare, this medication can cause severe and potentially life-threatening side effects. If you experience any of the following symptoms, contact your doctor immediately or seek emergency medical attention:
* Signs of an allergic reaction, including:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin (with or without fever)
+ Wheezing
+ Tightness in the chest or throat
+ Trouble 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 any side effects that bother you or do not go away, contact your doctor for advice.
Reporting Side Effects
This list is not exhaustive, and you may experience other side effects not mentioned here. If you have questions or concerns about side effects, consult your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Although rare, this medication can cause severe and potentially life-threatening side effects. If you experience any of the following symptoms, contact your doctor immediately or seek emergency medical attention:
* Signs of an allergic reaction, including:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin (with or without fever)
+ Wheezing
+ Tightness in the chest or throat
+ Trouble 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 any side effects that bother you or do not go away, contact your doctor for advice.
Reporting Side Effects
This list is not exhaustive, and you may experience other side effects not mentioned here. If you have questions or concerns about side effects, consult 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 that lasts more than 7 days, comes back, or is accompanied by fever, rash, or persistent headache.
- Signs of an allergic reaction (hives, rash, itching, swelling of face/tongue/throat, severe dizziness, trouble breathing).
- Signs of serotonin syndrome (agitation, confusion, hallucinations, fast heartbeat, sweating, muscle stiffness or twitching, loss of coordination, nausea, vomiting, diarrhea).
Before Using This Medicine
Before taking this medication, 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 you experienced, including any symptoms that occurred.
Respiratory issues, such as a cough that produces a significant amount of mucus, a chronic 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 increase the risk of severely high blood pressure.
If you are currently taking linezolid or methylene blue, as these medications can interact with this drug.
It is crucial to provide your doctor and pharmacist with a comprehensive list of all your medications, including prescription and over-the-counter drugs, natural products, and vitamins, as well as any health problems you are experiencing. This information will help your doctor determine whether it is safe for you to take this medication in conjunction with your other medications and health conditions. Never start, stop, or adjust the dosage of any medication without first consulting your doctor.
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 you experienced, including any symptoms that occurred.
Respiratory issues, such as a cough that produces a significant amount of mucus, a chronic 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 increase the risk of severely high blood pressure.
If you are currently taking linezolid or methylene blue, as these medications can interact with this drug.
It is crucial to provide your doctor and pharmacist with a comprehensive list of all your medications, including prescription and over-the-counter drugs, natural products, and vitamins, as well as any health problems you are experiencing. This information will help your doctor determine whether it is safe for you to take this medication in conjunction with your other medications and health conditions. Never start, stop, or adjust the dosage 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 can increase your chances of experiencing adverse effects. Additionally, do not take this medication for a longer duration than specified by your doctor.
If you are following a low-sodium or sodium-free diet, consult with your doctor before taking this medication, as some products may contain sodium. Similarly, if you have phenylketonuria (PKU), discuss this with your doctor, as certain products may contain phenylalanine.
Please note that some formulations of this medication may not be suitable for children of all ages. If you have any questions or concerns, consult with your doctor.
If you are pregnant, planning to become pregnant, or are breastfeeding, inform 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 can increase your chances of experiencing adverse effects. Additionally, do not take this medication for a longer duration than specified by your doctor.
If you are following a low-sodium or sodium-free diet, consult with your doctor before taking this medication, as some products may contain sodium. Similarly, if you have phenylketonuria (PKU), discuss this with your doctor, as certain products may contain phenylalanine.
Please note that some formulations of this medication may not be suitable for children of all ages. If you have any questions or concerns, consult with your doctor.
If you are pregnant, planning to become pregnant, or are breastfeeding, inform 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
- Dizziness
- Drowsiness
- Blurred vision
- Rapid heartbeat
- Agitation
- Confusion
- Hallucinations
- Unsteadiness
- Difficulty breathing
- Seizures
What to Do:
Immediately call a Poison Control Center (1-800-222-1222) or seek emergency medical attention.
Drug Interactions
Contraindicated Interactions
- Monoamine Oxidase Inhibitors (MAOIs) (concurrent use or within 2 weeks of stopping MAOIs)
Major Interactions
- Serotonergic drugs (e.g., SSRIs, SNRIs, TCAs, triptans, tramadol, linezolid, St. John's Wort) - risk of serotonin syndrome
- Other CNS depressants (e.g., alcohol, sedatives, tranquilizers) - increased CNS depression
Moderate Interactions
- CYP2D6 inhibitors (e.g., quinidine, fluoxetine, paroxetine) - may increase dextromethorphan levels
- Amiodarone, bupropion, haloperidol, propafenone, thioridazine (CYP2D6 inhibitors)
Minor Interactions
- Not available
Monitoring
Baseline Monitoring
Patient history (allergies, current medications, underlying conditions)
Rationale: To identify contraindications, potential drug interactions, and conditions that may worsen with use (e.g., chronic cough, asthma, emphysema)
Timing: Prior to initiation
Routine Monitoring
Cough symptom improvement
Frequency: Daily
Target: Reduction in cough frequency and severity
Action Threshold: If cough persists for more than 7 days, recurs, or is accompanied by fever, rash, or persistent headache, discontinue use and consult a doctor.
Adverse effects (e.g., nausea, dizziness, drowsiness)
Frequency: Daily
Target: Absence or mild, tolerable effects
Action Threshold: If severe or persistent adverse effects occur, discontinue use.
Symptom Monitoring
- Cough frequency and severity
- Sputum production and consistency
- Presence of fever, rash, or headache
- Signs of allergic reaction (hives, difficulty breathing, swelling)
- Signs of serotonin syndrome (agitation, hallucinations, rapid heart beat, fever, overactive reflexes, nausea, vomiting, diarrhea, uncoordination)
Special Patient Groups
Pregnancy
Generally considered Category C. Use only if the potential benefit outweighs the potential risk to the fetus. Consult a healthcare professional before use.
Trimester-Specific Risks:
First Trimester:
Limited data, generally avoided if possible.
Second Trimester:
Generally considered safer than first trimester, but still use with caution.
Third Trimester:
Generally considered safer than first trimester, but still use with caution.
Lactation
Guaifenesin and Dextromethorphan are excreted into breast milk in small amounts (L3 - Moderately Safe). Use with caution and observe infant for drowsiness or irritability. Consult a healthcare professional.
Infant Risk:
Low to moderate risk; potential for drowsiness or irritability in infant.
Pediatric Use
Not for use in children under 4 years of age. Dosing for children 4-12 years must be carefully followed according to product label. Overdose can be serious in children.
Geriatric Use
Use with caution in elderly patients, especially those with pre-existing conditions or taking multiple medications, due to potential for increased sensitivity to side effects (e.g., dizziness, drowsiness). Consult a healthcare professional.
Clinical Information
Clinical Pearls
- Advise patients to read the product label carefully for correct dosing, especially for children, as concentrations can vary between products.
- Emphasize the importance of not exceeding the maximum daily dose to avoid potential side effects and overdose.
- Counsel patients on the risk of serotonin syndrome when combining dextromethorphan with other serotonergic agents, including certain antidepressants.
- Remind patients that this medication treats symptoms, not the underlying cause of the cough. If symptoms persist or worsen, medical evaluation is necessary.
- Inform patients that guaifenesin works best when accompanied by adequate fluid intake.
Alternative Therapies
- Single-ingredient Guaifenesin (for expectorant effect only)
- Single-ingredient Dextromethorphan (for cough suppression only)
- Honey (for cough relief)
- Saline nasal sprays/rinses (for congestion)
- Non-pharmacological measures (e.g., steam inhalation, lozenges)
Cost & Coverage
Average Cost:
Variable, typically $5-$15 per 4 fl oz (118 mL) bottle
Generic Available:
Yes
Insurance Coverage:
Often not covered by insurance unless prescribed; typically out-of-pocket OTC purchase.
General Drug Facts
If your symptoms or health issues persist or worsen, it is 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 it's a good idea to check with your pharmacist for more information. If you have any questions or concerns about this medication, don't hesitate to discuss them with 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 taken, the amount, and the time it happened.