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dextromethorphan and quinidine (cont.)

What should I discuss with my healthcare provider before taking dextromethorphan and quinidine (Nuedexta)?

You should not take this medicine if you are also taking quinidine (Quin-G), quinine (Qualaquin), or mefloquine (Lariam), or if you have ever had hepatitis, low levels of platelets in your blood, bone marrow depression, lupus-like syndrome, or an allergic reaction caused by taking any of these medications.

You should not use this medication if you are allergic to dextromethorphan or quinidine, or if you have:

  • heart failure;
  • a history of life-threatening heart rhythm disorder;
  • a history of Long QT syndrome; or
  • a serious heart condition called "AV block" (unless you have a pacemaker).

Do not use dextromethorphan and quinidine if you have used an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate) in the last 14 days. A dangerous drug interaction could occur, leading to serious side effects.

After you stop taking dextromethorphan and quinidine, you must wait at least 14 days before you start taking an MAOI.

There are many other drugs that can cause serious or life threatening medical problems if you take them together with dextromethorphan and quinidine. The following drugs should not be used while you are taking dextromethorphan and quinidine:

To make sure you can safely take this medicine, tell your doctor if you have any of these other conditions:

  • a family history of Long QT syndrome;
  • an electrolyte imbalance (such as low levels of potassium or magnesium in your blood);
  • slow heartbeats or any type of heart rhythm disorder;
  • myasthenia gravis;
  • bladder obstruction or other urination problems; or
  • a bowel obstruction or intestinal disorder.

FDA pregnancy category C. It is not known whether dextromethorphan and quinidine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

It is not known whether this medication passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Do not give dextromethorphan and quinidine to anyone under 18 years old without medical advice.

How should I take dextromethorphan and quinidine (Nuedexta)?

Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Dextromethorphan and quinidine is usually started at a dose of 1 capsule per day for 7 days. After the first week you will take 1 capsule every 12 hours. Follow your doctor's instructions. Do not take more than 2 capsules in a 24-hour period.

You may take dextromethorphan and quinidine with or without food.

Your doctor will need to check your progress on a regular basis. This will help your doctor determine how long to treat you with dextromethorphan and quinidine. To be sure the medicine not causing harmful effects, your heart function may need to be checked using an electrocardiograph or ECG (sometimes called an EKG). This machine measures electrical activity of the heart. Visit your doctor regularly.

Store at room temperature away from moisture and heat.

Report Problems to the Food and Drug Administration

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.

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