Dextromethorphan/quinidine

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Dextromethorphan/quinidine
Combination of
DextromethorphanSigma-1 receptor agonist, NMDA receptor antagonist
QuinidineAntiarrhythmic agent
Clinical data
Trade namesNuedexta
MedlinePlusa611048
Pregnancy cat.C (US)
Legal status Prescription only
RoutesOral
Identifiers
ATC code?
 
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Dextromethorphan/quinidine
Combination of
DextromethorphanSigma-1 receptor agonist, NMDA receptor antagonist
QuinidineAntiarrhythmic agent
Clinical data
Trade namesNuedexta
MedlinePlusa611048
Pregnancy cat.C (US)
Legal status Prescription only
RoutesOral
Identifiers
ATC code?

Dextromethorphan/quinidine (trade name Nuedexta) is a combination drug containing dextromethorphan and the class I antiarrhythmic agent quinidine. It is the first FDA-approved drug for the treatment of pseudobulbar affect (PBA).

Clinical studies[edit]

In a 12 week randomized, double-blind trial, amyotrophic lateral sclerosis and multiple sclerosis patients with significant PBA were given either Nuedexta 30/10 mg or placebo. In 326 randomized patients, the PBA-episode daily rate was 46.9% (p < 0.0001) lower for Nuedexta than for placebo.[1] The three deaths in each of the two drug treatment arms and the single death in the placebo arm of the study were believed to be due to the natural course of the disease.[2]

Nuedexta was approved in February 2011 and is marketed in the United States by Avanir Pharmaceuticals.

Those seemingly unrelated drugs became associated so that low-dose quinidine inhibits dextromethorphan's breakdown. The latter has shown marginal efficacy in pseudobulbar syndrom due to rapid first-pass metabolism that reduces its bioavailability.

Interactions[edit]

Contraindications[edit]

Adverse effects[edit]

Common risks and side effects include:[3][2][4]

Other possible indications[edit]

In June 2012, drug discovery and development magazine reported that Avanir Pharmaceuticals plans to test the drug for the treatment of agitation associated with Alzheimer's disease.[5]

References[edit]

  1. ^ Pioro EP, Brooks BR, Cummings J, et al (2010). "Dextromethorphan plus ultra low-dose quinidine reduces pseudobulbar affect". Ann Neurol 68 (5): 693–702. doi:10.1002/ana.22093. PMID 20839238. 
  2. ^ a b c d [1] Highlights of Prescribing Information. Retrieved 2014-01-07
  3. ^ NUEDEXTA. Avanir Pharmaceuticals. Retrieved 2013-10-28
  4. ^ [2] Nuedexta Offical FDA information, side effects and uses. Retrieved 2014-01-07
  5. ^ "NNuedexta Testing New Indication". CDrug Discovery and Development Magazine. June 13, 2011.