GUAPHAN DM SYRUP 100ML

Indications

Approved Uses

Symptomatic (temporary) relief of cough associated with the common cold/upper respiratory tract irritation, and relief of chest congestion by loosening and thinning bronchial secretions to make coughs more productive.

Dosage & Administration

Dosing by Condition

Adults and ≥12 years: 10 mL every 4 hours as needed (max 60 mL/24 h). Children <12 years: FDA recommends against use.

Initial Dose

Adults and children ≥12 years: 10ml (200mg guaifenesin + 20mg dextromethorphan) every 4 hours

Maintenance Dose

10ml every 4-6 hours as needed in adults

Maximum Dose

Adults: 60 mL in 24 hours.

Children's Dosage

Not recommended for children under 4 years; limited data for children ≥4 years, use caution.

Dose Adjustment Notes

Hepatic impairment: no dose adjustment advised. Renal impairment: no dose adjustment advised; contraindicated in severe renal disease.

How to Take

Shake well before use. Measure doses with an accurate measuring device. May be taken with or without food. Encourage adequate fluid intake to help loosen/thin mucus.

Side Effects

Common Side Effects

Nausea, vomiting, dizziness, drowsiness, headache, gastrointestinal upset, stomach pain

Side Effect Frequency

Common: dizziness, drowsiness/somnolence, nausea, vomiting, gastrointestinal upset. Rare: rash/urticaria or other hypersensitivity; CNS excitation/confusion/hallucinations mainly with overdose; serotonin syndrome when combined with serotonergic drugs.

Safety & Warnings

Contraindications

Hypersensitivity to guaifenesin or dextromethorphan; concomitant use with MAO inhibitors or within 14 days of stopping an MAOI.

Warnings & Precautions

Do not use with MAOIs or within 14 days of stopping; avoid use for chronic/persistent cough (e.g., asthma, COPD, smoker’s cough) or cough with excessive mucus unless medically directed; seek medical advice if cough lasts >7 days, recurs, or is accompanied by fever/rash/persistent headache; avoid alcohol/other sedatives and do not exceed recommended dose; use caution in hepatic impairment and with serotonergic/CYP2D6-inhibiting drugs.

Age Restriction

Not recommended for children under 4 years of age (and avoid use under 2 years).

Drug Interactions

Drug Interactions

MAOIs (contraindicated; risk of serotonin syndrome/toxicity); other serotonergic drugs (e.g., SSRIs/SNRIs/TCAs/linezolid/triptans) increase serotonin syndrome risk; CNS depressants (alcohol, benzodiazepines, sedatives) may increase drowsiness/impairment; strong CYP2D6 inhibitors (e.g., quinidine, fluoxetine, paroxetine, bupropion) can increase dextromethorphan exposure.

Interaction Severity

MAJOR/Contraindicated: MAO inhibitors (and within 14 days of stopping) due to risk of serotonin syndrome/CNS toxicity. MODERATE: other serotonergic drugs (SSRIs/SNRIs/TCAs, linezolid, triptans) and strong CYP2D6 inhibitors (e.g., quinidine, fluoxetine, paroxetine, bupropion) increasing dextromethorphan exposure; CNS depressants/alcohol may increase sedation/impairment.

Food Interaction

No restriction

Special Populations

Children

Not recommended for children under 4 years; limited data for children ≥4 years, use caution.

Kidney Impairment

No adjustment needed.

Storage & Patient Advice

Missed Dose

Take as soon as remembered; skip if near next scheduled dose. Do not double the dose.

Stopping the Medicine

May be stopped when symptoms resolve; no taper is required when used as directed. Seek medical advice if cough persists or if the product has been used longer than recommended.

Overdose

Possible overdose effects: nausea/vomiting, dizziness, drowsiness, ataxia, agitation/confusion, hallucinations, hypertension/tachycardia, serotonin syndrome, seizures, and respiratory depression/coma (especially with dextromethorphan); seek immediate emergency care/poison center; management is supportive and may include activated charcoal if early and naloxone for significant respiratory/CNS depression.

Patient Counseling

Shake well; measure with a proper device. Do not exceed recommended dose/frequency or use multiple cough/cold products containing dextromethorphan. Avoid alcohol and other sedatives; may cause drowsiness-use caution driving. Do not use with MAOIs or within 14 days of stopping; seek advice if on antidepressants/other serotonergic drugs. Drink plenty of fluids. Seek medical care if cough lasts >7 days, recurs, or is accompanied by fever, rash, persistent headache, shortness of breath, or chronic cough (e.g., asthma/COPD). Keep out of reach of children.

Monitoring Requirements

No routine monitoring

Pharmacology

Mechanism of Action

Guaifenesin: expectorant that increases hydration of respiratory secretions and reduces mucus viscosity to aid mucociliary clearance. Dextromethorphan: centrally acting antitussive that suppresses the medullary cough center (raises cough threshold), with NMDA receptor antagonism and sigma-1 activity contributing.

Duration of Effect

4-6 hours

Bioavailability

Dextromethorphan and guaifenesin are well absorbed in the small intestine.

Excretion

Both are primarily eliminated via the kidneys as metabolites in urine (guaifenesin largely as metabolites; dextromethorphan as metabolites such as dextrorphan and conjugates).

Product Information

Available Dosage Forms

Syrup (oral).

Composition per Dose

Each 5ml: 100mg guaifenesin + 10mg dextromethorphan hydrobromide

Generic Availability

Yes

OTC Alternatives

Single-ingredient guaifenesin products and single-ingredient dextromethorphan products (and other cough/cold combinations) may be available OTC depending on local regulations; verify local scheduling because this SFDA-registered product is Prescription.

Symptom Target

Cough, Congestion, Multi-symptom

Sedating

Yes

Reviewed by Al Mujtama Pharmacy Medical Review Team. Last reviewed 21-07-2026