Buy Nuedexta (dextromethorphan HBr and quinidine sulfate)

What is Nuedexta (dextromethorphan HBr and quinidine sulfate)?

Nuedexta (dextromethorphan hydrobromide [HBr] and quinidine sulfate) is a nervous system drug indicated for the symptomatic treatment of pseudobulbar affect (PBA) in adults. It is the first and only FDA-approved treatment for PBA^[2].

PBA is a neurologic condition that occurs secondary to other neurologic diseases, including but not restricted to the indications amyotrophic lateral sclerosis (ALS) and multiple sclerosis (MS). It is characterised by involuntary, sudden and frequent episodes of emotional bursts (laughing or crying). These emotional expressions are incongruent with how the patient feels or are exaggerated responses^[2].

It is available as capsules containing 20mg dextromethorphan HBr and 10mg quinidine sulfate.

How does Nuedexta (dextromethorphan HBr and quinidine sulfate) work?

Nuedexta is a combination medicine containing dextromethorphan hydrobromide and quinidine sulfate.

The exact mechanism by which Nuedexta (dextromethorphan HBr and quinidine sulfate) exerts therapeutic effects in patients with PBA is unknown^[1]. The active ingredients in Nuedexta work on the affected brain mechanisms in different ways.

Dextromethorphan HBr works by blocking sigma-1 and uncompetitive NMDA receptors, attaching to NMDA and sigma-1 receptors in the brain for the neurotransmitter glutamate as well as receptors for the neurotransmitter serotonin. Since these neurotransmitters are involved in the control of emotions, dextromethorphan helps to normalise its activity in the brain. Quinidine sulfate is used to increase plasma levels of dextromethorphan by competitively inhibiting cytochrome P450 2D61. By means of their combined action on the neural pathways involved in emotional expression, dextromethorphan HBr and quinidine sulfate may ease the symptoms of PBA^[2].

Where has Nuedexta (dextromethorphan HBr and quinidine sulfate) been approved?

Nuedexta (dextromethorphan HBr and quinidine sulfate) was approved for PBA by:

• Food and Drug Administration (FDA), USA, October 2010^[1]

Please note that this medication may have also been approved in other regions than the ones we’ve listed. If you have a question about its approval in a specific country feel free to contact our support team.

How is Nuedexta (dextromethorphan HBr and quinidine sulfate) taken?

The recommended dosage of Nuedexta (dextromethorphan HBr and quinidine sulfate) is^[1]:

• Each capsule 20 mg of dextromethorphan HBr and 10 mg of quinidine sulfate
• Starting dose: 1 capsule orally taken daily for 7 days
• Maintenance dose: after 7 days, 1 capsule every 12 hours

Adjustment in dose may be required based on symptoms and experienced side effects^[1].

Complete information about Nuedexta (dextromethorphan HBr and quinidine sulfate) dosage and administration can be found in the official prescribing information listed in our references section^[1].

Note: Please consult with your treating doctor for personalised dosing and possible drug interactions.

Are there any known side effects or adverse reactions of Nuedexta (dextromethorphan HBr and quinidine sulfate)?

 

Common adverse reactions

The most common adverse reactions listed in the prescribing information include^[1]:

• Diarrhoea
• Dizziness
• Cough
• Vomiting
• Peripheral oedema
• Urinary tract infection
• Influenza
• Asthenia
• Increased gamma-glutamyltransferase
• Flatulence

Serious adverse reactions

The serious adverse reactions listed in the prescribing information include^[1]:

• Thrombocytopenia and other hypersensitivity reactions
• Hepatotoxicity
• Cardiac effects
• Concomitant use of CYP2D6 substrates
• Dizziness
• Serotonin syndrome
• Anticholinergic effects of quinidine

Use in specific populations

Nuedexta (dextromethorphan HBr and quinidine sulfate) can be fatal for a foetus, it is advised to avoid pregnancy and breastfeeding^[1].

Safety and effectiveness in paediatric patients has not been established^[1].

For a comprehensive list of side effects and adverse reactions please refer to the official prescribing information^[1].

Please note that nudexta and neudexta are misspellings of nuedexta. These are not different medicines.

References

1. Summary of Product Characteristics [FDA]: Nuedexta (dextromethorphan HBr quinidine sulfate) [PDF]. Avanir Pharmaceuticals Inc., October 2010.

2. Avanir Pharmaceuticals, Inc. website: understanding PBA; what is PBA? Accessed June 2019.

3. Pioro EP, Brooks BR, Cummings J, et al. Dextromethorphan plus ultra low-dose quinidine reduces pseudobulbar affect. Ann Neurol. 2010;68:693-702.