A combination of dextromethorphan, a sigma-1 receptor agonist, NMDA receptor antagonist and Quinidine an antiarrhythmic agent.
Trade name Nuedexta
Oral agents.
A combination drug containing dextromethorphan and the class I antiarrhythmic agent quinidine.
The combination is the first FDA-approved drug for the treatment of pseudobulbar affect (PBA).
In a 12 week randomized, double-blind trial, amyotrophic lateral sclerosis and multiple sclerosis patients with significant PBA were given Nuedexta 20/10 mg or placebo and the PBA-episode daily rate was 46.9% lower for Nuedexta than for placebo.
Contraindications:
Atrioventricular (AV) block, complete, without implanted pacemaker or at high risk of complete AV block, concomitant use with drugs containing quinidine, quinine, concomitant use with drugs that both prolong the QT interval and are metabolized by CYP2D6.
Concomitant use with MAOIs or use of MAOIs within 14 days.
Heart failure
Hypersensitivity to dextromethorphan
Hypersensitivity to quinine, mefloquine, quinidine, or dextromethorphan/quinidine
QT interval, prolonged or congenital long QT syndrome or a history suggesting torsades de pointes
Common risks and side effects include:
Abdominal pain
Asthenia
Cough
Diarrhea
Dizziness
Elevated gamma glutamyltransferase
Flatulence
Influenza
Prolonged QT interval
Muscle spasm
Peripheral edema
Urinary tract infection
Vomiting