What is dextromethorphan + guaifenesin?
Dextromethorphan + guaifenesin (brand name: Cough Tabs®) is a combination medication used to reduce cough in dogs and cats. Dextromethorphan has mild cough suppressant effects while guaifenesin helps to loosen chest congestion.
Its use in cats and dogs to treat compulsive behavior or cough is “off label” or “extra label”. Many drugs are commonly prescribed for off-label use in veterinary medicine. In these instances, follow your veterinarian’s directions and cautions carefully, as their directions may be significantly different from those on the label.
How is dextromethorphan + guaifenesin given?
- Dextromethorphan + guaifenesin is given by mouth in the form of a tablet.
- This medication may also be compounded into other forms.
- It may be given with or without food.
- If vomiting occurs when dosed on an empty stomach, give future doses with food or a treat.
- Follow your veterinarian’s directions and measure liquid forms of this medication carefully.
- This medication will take effect quickly, in about 1 to 2 hours, and improvement in clinical signs should follow.
What if I miss giving my pet the medication?
If you miss a dose, skip the dose you missed, give it at the next scheduled time, and return to the regular dosing schedule. Never give your pet two doses at once or give extra doses.
Are there any potential side effects?
Side effects are uncommon, but may include:
- vomiting, diarrhea, decreased appetite
- sleepiness
- drooling
- anxiety
SERIOUS ADVERSE REACTIONS associated with this drug may occur without warning and include:
- rapid heartbeat
- collapse
- muscle tension or twitching
- incoordination
- seizures
- abnormal eye movements
Contact your veterinarian immediately if you notice anything out of the ordinary and ensure all follow-up lab work and exams are completed as directed by the veterinarian.
This short-acting medication should stop working within 24 hours, although effects can be longer in pets with liver or kidney disease.
Are there any risk factors for this medication?
Do NOT use dextromethorphan + guaifenesin in pets that:
- are allergic to it
- are under 3 months old
- weigh less than 5 lb (2.27 kg)
Use dextromethorphan + guaifenesin cautiously in pets:
- with liver disease
- with skin allergies (atopy)
- with chronic cough, or wet coughs
- that have recently used products such as amitraz-containing collars or selegiline
- that are pregnant or lactating
While it is considered safe in pregnant humans, use cautiously in pregnant or lactating pets as safety has not been established.
Are there any drug interactions I should be aware of?
Certain medications may interact with dextromethorphan + guaifenesin, so it is important to tell your veterinarian about any medications (including vitamins, supplements, or herbal therapies) that your dog is taking before starting any new treatment.
Medications of concern include:
- fluoxetine (Reconcile®, Prozac®)
- metoclopramide (Reglan®)
- opioids
- selegiline (Anipryl®)
- tramadol
Is any monitoring needed with this medication?
Your veterinarian may recommend re-check examinations to ensure the medication is working adequately. At home, monitor for any side effects, such as those noted above; discontinue the medication and contact your veterinarian if these occur.
How do I store dextromethorphan + guaifenesin?
- Store in a tightly sealed container, protected from moisture.
- Store at room temperature between 68°F and 77°F (20°C and 25°C).
- Keep the container out of reach of children and pets.
- Store compounded forms of this medication according to the label.
What should I do in case of emergency?
If you suspect an overdose or an adverse reaction to the medication, call your veterinary office immediately. If they are not available, follow their directions in contacting an emergency facility.
