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Nuedexta
Nuedexta (dextromethorphan/quinidine) is a combination medication approved for the treatment of pseudobulbar affect (PBA), a condition characterized by uncontrollable episodes of laughing or crying that occur in some neurological conditions, such as multiple sclerosis and ALS (amyotrophic lateral sclerosis). Nuedexta helps to regulate mood and emotional responses.
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Frequently Asked Questions
How quickly does Nuedexta work?
Patients may begin to notice improvements in emotional regulation within a few days, but optimal effects may take longer.
Can I take Nuedexta with food?
Nuedexta can be taken with or without food, but taking it with food may help reduce gastrointestinal side effects.
What should I do if I miss a dose?
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not double up.
Is Nuedexta safe during pregnancy?
Nuedexta should be used during pregnancy only if the potential benefits justify the potential risks. Consult your healthcare provider for guidance.
What are the signs of serious side effects to watch for?
Monitor for signs of severe allergic reactions, changes in heart rhythm, or mood changes, and seek immediate medical attention if these occur.
Comprehensive Drug Guide
How Does Nuedexta Work?
- Dextromethorphan: An antitussive agent that acts on the central nervous system to suppress cough. It also has NMDA receptor antagonist properties, which may help modulate mood.
- Quinidine: A medication that inhibits the metabolism of dextromethorphan, increasing its levels in the body. Quinidine also has effects on cardiac rhythm but is primarily used here to enhance the efficacy of dextromethorphan in treating PBA.
Common Dosages
- Capsules: Typically 20 mg of dextromethorphan and 10 mg of quinidine.
Typical Dosing
- Adults: The recommended dosage is 1 capsule taken orally twice daily. Dosage adjustments may be necessary based on response and tolerability.
Typical Dosing
FDA Approved Indications
- The treatment of pseudobulbar affect (PBA).
Who Shouldn't Take Nuedexta?
- Known hypersensitivity to dextromethorphan, quinidine, or any component of the formulation
- A history of congenital long QT syndrome or other significant cardiac arrhythmias
Advice From The Pharmacist
- Take Nuedexta exactly as prescribed and do not exceed the recommended dose.
- Monitor for any changes in mood or unusual side effects, and report these to your healthcare provider.
- Be aware of potential drug interactions, especially with other medications that affect heart rhythm.
Side Effects of Nuedexta
Common Side Effects
- Diarrhea
- Dizziness
- Drowsiness
- Nausea
Uncommon/Severe Side Effects
- Severe allergic reactions (rash, itching, swelling)
- Heart rhythm disturbances (prolonged QT interval)
Risks and Warnings of Nuedexta
- Cardiac Monitoring: Caution is advised in patients with a history of heart problems; regular monitoring may be necessary.
- CNS Effects: Dizziness and drowsiness can occur; caution is advised when driving or operating heavy machinery until you know how the medication affects you.
Interactions with Nuedexta
Common Drug Interactions
- CYP2D6 Inhibitors: Quinidine is a strong inhibitor of this enzyme and can increase the levels of drugs metabolized by CYP2D6, which may require dosage adjustments of those medications.
- Antidepressants: Use with caution when combining with other medications that can affect serotonin levels.
Alternatives to Nuedexta
- Other Treatments for PBA: Other off-label medications, such as certain antidepressants, may also be considered based on the healthcare provider's evaluation.
