BOOTS DRY COUGH RELIEF

Adults and children over 12 years:

A lozenge should be sucked whenever the cough is troublesome. Not more than 10 lozenges should be taken in one day. The normal adult dose is still appropriate in the elderly.

Children 6 to 12 years:

Not more than 2 lozenges within any 4 hours, and not more than 7 in any one day. 3). Children of 6-12 years of age: not to be used for more than 5 days without the advice of a doctor. Parents or carers should seek medical attention if the child's condition deteriorates during treatment.

Warning:

Do not exceed the stated dose. Keep all medicines out of the sight and reach of children.

The following side effects may be associated with the use of dextromethorphan; occasional drowsiness, dizziness, excitation, mental confusion, convulsions, respiratory depression, vomiting, gastrointestinal disturbances (nausea and diarrhoea) and skin reactions including rash.

4) General disorders and administration site conditions: Frequency unknown: drug withdrawal syndrome

Should be used with caution in atopic children due to histamine release. Ask a doctor before use if you suffer from a chronic or persistent cough, if you have asthma or are suffering from an acute asthma attack or where cough is accompanied by excessive secretions.

Do not take with any other cough and cold medicine. Use of dextromethorphan with alcohol or other CNS depressants may increase the effects on the CNS and cause toxicity in relatively smaller doses. Drug dependence, tolerance and potential for abuse For all patients, prolonged use of this product may lead to drug dependence (addiction), even at therapeutic doses.

, major depression). Drug withdrawal syndrome The drug withdrawal syndrome is characterised by some or all of the following: restlessness, lacrimation, rhinorrhoea, yawning, perspiration, chills, myalgia, mydriasis and palpitations.

Other symptoms may also develop including irritability, agitation, anxiety, hyperkinesia, tremor, weakness, insomnia, anorexia, abdominal cramps, nausea, vomiting, diarrhoea, increased blood pressure, increased respiratory rate or heart rate.

Dextromethorphan is metabolised by hepatic cytochrome P450 2D6. The activity of this enzyme is genetically determined. About 10% of the general population are poor metabolisers of CYP2D6. Poor metabolisers and patients with concomitant use of CYP2D6 inhibitors may experience exaggerated and/or prolonged effects of dextromethorphan.

5). If symptoms do not go away talk to your doctor. Serotonin Syndrome Serotonergic effects, including the development of a potentially life- threatening serotonin syndrome, have been reported for dextromethorphan with concomitant administration of serotonergic agents, such as selective serotonin re-uptake inhibitors (SSRIs), drugs which impair metabolism of serotonin (including monoamine oxidase inhibitors (MAOIs)) and CYP2D6 inhibitors.

Hypersensitivity to the active substance or any of the excipients. Dextromethorphan should not be given to subjects in, or at risk of developing respiratory failure. Should not be taken by patients with liver disease. 5). 5). Not to be used in children under the age of 6 years