1 What is Nuedexta?

Brand: Nuedexta

Generic: Dextromethorphan and Quinidine

Nuedexta is used for the treatment of pseudobulbar affect or emotional incontinence which manifest as uncontrollable, sudden, and frequent episodes of crying or laughing. This drug requires a prescription.

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2 What to Know Before Using

Before using Nuedexta, you must know all about the risks and complications associated with it. Inform your healthcare provider for any allergic reactions to these drugs or any other drugs, foods, dyes, preservatives, or animals.

Carefully read the label of non-prescription drugs for any possible allergic reaction or contraindications.

Studies in children regarding the relationship of age to the effects of dextromethorphan and quinidine combination have not been performed while the safety and efficacy have not been established.

Studies in the elderly have not demonstrated any geriatric-specific problems that would limit the utility of dextromethorphan and quinidine combination.

Adverse effects have been reported in animal studies but studies in pregnant women or animals are still inadequate. Infant risk is still undetermined when using this drug during breastfeeding.

Discuss with your healthcare professional about the potential risks and benefits of taking this drug while breastfeeding.

Drugs should not be taken together to prevent any interactions but in necessary cases inquire your healthcare provider regarding the adjustments in dosage or any other necessary precautions to prevent any unwanted side effects.

Inform your healthcare professional if you are taking any other prescription or nonprescription drugs. Intake of specific food or using alcohol or tobacco with this drug is associated with an increased risk of certain side effects.

Your healthcare professional can give you special instructions about the use of food, alcohol, or tobacco.

Inform your healthcare provider for any other medical problems such as:

  • Bone marrow problems caused by quinidine, quinine or mefloquine
  • Heart block without a pacemaker
  • Heart failure
  • Heart rhythm problems
  • Hepatitis caused by quinidine, quinine or mefloquine
  • Lupus-like syndrome caused by quinidine, quinine or mefloquine
  • Thrombocytopenia caused by quinidine, quinine or mefloquine
  • Drug abuse or dependence
  • Heart or blood vessel disease
  • Hypokalemia
  • Hypomagnesemia
  • Hypertension
  • Stroke
  • Kidney disease
  • Liver disease
  • Myasthenia gravis

3 Proper Usage

Proper usage of Nuedexta requires strict adherence to your doctor’s orders. The effects of dextromethorphan and quinidine combination may be increased by grapefruits and grapefruit juice. The dose of this drug will be variable for different patients.

The directions on the label or the prescription by your healthcare professional should be followed. The dosage of this drug you take depends on the medical problem for which you are using this drug.

Adults with PBA or emotional incontinence are given one capsule once a day for the first 7 days of treatment. Then on day 8 and onwards, the dose should be two capsules per day, taken as one capsule every 12 hours.

Each capsule contains 20 milligrams of dextromethorphan and 10 mg of quinidine. Use and dose in children must be determined by your healthcare professional.

A missed dose should be taken as soon as possible. However, skip the missed dose and go back to your regular dosing schedule if it is almost time for your next dose.

Store the drug in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing. Keep out of the reach of children. Dispose any outdated or expired drugs and ask your healthcare professional for the proper disposal of the drugs.

4 Precautions to Take

Before using Nuedexta, there are some precautions you must take. Regular visits should be made to your healthcare provider to track your progress and to monitor the effectiveness of the drug.

Report any unwanted or unusual effects to your healthcare professional. Avoid the necessary medications and activities that are advised against you to prevent unwanted effects.

Check with your healthcare professional before you take any other prescription or nonprescription drugs, and herbal or vitamin supplements.

5 Potential Side Effects

As with many medications, there are several potential side effects associated with Nuedexta. Side effects may vary for each individual and prompt medical attention should be given if they occur.

Seek advice from your healthcare professional immediately if you experience any unusual symptoms such as:

  • bladder pain
  • bloating or swelling of the face, arms, hands, lower legs or feet
  • bloody or cloudy urine
  • chills
  • cough
  • diarrhea
  • difficult, burning or painful urination
  • fever
  • frequent urge to urinate
  • the general feeling of discomfort or illness
  • headache
  • joint pain
  • loss of appetite
  • lower back or side pain
  • muscle aches and pains
  • nausea
  • rapid weight gain
  • a runny nose
  • shivering
  • a sore throat
  • sweating
  • tingling of the hands or feet
  • trouble sleeping
  • unusual tiredness or weakness
  • unusual weight gains or loss
  • vomiting
  • symptoms of overdose such as aggressive and violent behavior
  • agitation
  • blurred vision
  • change in color vision
  • change in consciousness
  • chest pain or discomfort
  • confusion
  • confusion as to time, place or person
  • continuing ringing or buzzing or other unexplained noise in the ears
  • decreased awareness or responsiveness
  • depression
  • difficulty seeing at night
  • dizziness or lightheadedness
  • dizziness, faintness or lightheadedness when getting up suddenly from a lying or sitting position
  • double vision
  • excitement
  • fainting
  • fast, pounding or irregular heartbeat or pulse
  • the feeling of constant movement of self or surroundings
  • hallucinations
  • hearing loss
  • holding false beliefs that cannot be changed by the fact
  • inability to move the eyes
  • increased blinking or spasms of the eyelid
  • increased sensitivity of the eyes to sunlight
  • irregular or slow heart rate
  • loss of consciousness
  • overactive reflexes
  • poor coordination
  • restlessness
  • seeing double
  • seizures
  • the sensation of spinning
  • severe sleepiness
  • shakiness and unsteady walk
  • shivering
  • shortness of breath
  • sticking out of the tongue
  • sweating
  • talking or acting with excitement you cannot control
  • trembling or shaking
  • trouble with breathing, speaking or swallowing
  • twitching, uncontrolled eye movements
  • uncontrolled twisting movements of the neck, trunk, arms or legs
  • unsteadiness, trembling or other problems with muscle control or coordination
  • unusual excitement
  • nervousness or restlessness
  • unusual facial expressions

Some side effects may occur that usually do not need medical attention. As your body adjusts to the drug, the side effects will slowly disappear. Ask your healthcare professional about ways to prevent or reduce some of these side effects. 

If any of the following side effects persists or are inconvenient, or if you notice any other effects, or if you have any questions about them, consult with your health care professional. Report any side effects to the FDA hotline at 1-800-FDA-1088.