Dose‐response relationship of increasing doses of dextromethorphan given to children with cough

Purpose The efficacy of dextromethorphan (DM) for treating cough is uncertain, and its use is not supported by the American Academy of Pediatrics. Still, DM is often given to children as an antitussive. Dosing of DM is based on age, not weight. We sought to determine if a dose‐response relationship existed among a cohort of children given a single nocturnal dose of DM for cough due to an upper respiratory infection. Methods In a double‐masked, placebo‐controlled trial of over‐the‐counter cough medications, 33 children received DM. Dose given was based on the drug label: children 2–5 years ‐ 7.5 mg; children 6–11 years ‐ 15 mg; children 12–18 years ‐ 30 mg. This equated to a range of 0.35–0.94 mg/kg/dose. Subjective parental assessments of cough and sleep were assessed via questions using a 7‐point Likert scale that compared symptoms to the prior night without medication. Three dose ranges were compared. Results (See Table) Conclusion While no statistically significant differences were detectable for the outcomes studied, there was a trend towards improved symptom control with higher doses of DM. This should be considered in future evaluations of the efficacy of DM. Clinical Pharmacology & Therapeutics (2004) 75 , P23–P23; doi: 10.1016/j.clpt.2003.11.087 Mean Change in Symptom Scores0.30‐<0.45 mg/kg/dose n=12 0.45‐<0.60 mg/kg/dose n=13 >0.60 mg/kg/dose n=8 pCough Frequency 1.25 2.38 2.38 0.31 Cough's Effect on Child's Sleep 1.50 2.00 2.25 0.65 Cough's Effect on Parent's Sleep 1.92 3.00 2.38 0.29 Bothersome Nature of Cough 1.50 2.08 2.25 0.67 Severity of Cough 1.33 2.23 2.00 0.54TOTAL 7.50 11.69 11.25 0.43