Dextromethorphan

Evidence Level: L5

Predicted Indications: 5

Dextromethorphan

Pharmacist Assessment Report

Dextromethorphan: Sigma-1 agonist and NMDA antagonist antitussive → nasal cavity disease

One-Sentence Summary

Dextromethorphan is a centrally acting antitussive (cough suppressant) that acts as a sigma-1 agonist and NMDA receptor antagonist. The TxGNN model predicts it may be effective for nasal cavity disease, but no clinical trials and no publications were found to support this direction, so the prediction rests on model output alone.

Quick Overview

Item	Content
Original Indication	Not recorded in the local data
Predicted New Indication	nasal cavity disease
TxGNN Prediction Score	0.9998
Evidence Level	L5
India Market Status	Listed in a compiled Indian medicine price dataset (at least 20) – CDSCO approval status is not included in this data
Number of Listed Products	at least 20
Recommended Decision	Hold

Why is This Prediction Reasonable?

Detailed mechanism of action data is not available in the data compiled for this report. Dextromethorphan is generally understood as a centrally acting cough suppressant working through sigma-1 agonism and NMDA receptor antagonism. It has no established direct effect on the nasal mucosa.

The prediction most likely reflects closeness to upper respiratory conditions that dextromethorphan is associated with, such as rhinitis and nasopharyngitis. “Nasal cavity disease” is a broad category that overlaps with these terms. The link appears to come from shared parent terms in the model rather than from a distinct pharmacological mechanism. Any benefit would at most be symptomatic (for example cough relief), not treatment of the nasal disease itself.

Clinical Trial Evidence

Currently no related clinical trials registered.

Literature Evidence

Currently no related literature available.

India Market Information

Authorization Number	Product Name	Dosage Form	Approved Indication
203717	Stopper SF Syrup	Bottle of 100 ml syrup	Not recorded
40361	Corituss Syrup	Bottle of 100 ml syrup	Not recorded
46599	Cozia Tablet	Strip of 10 tablets	Not recorded
73684	Endkuf SF Syrup	Bottle of 100 ml syrup	Not recorded
94831	Glycodin Syrup	Bottle of 100 ml syrup	Not recorded

These are 5 of at least 20 valid single-ingredient registrations; the record may be partial.

Safety Considerations

Drug Interactions: 306 interactions are recorded. Major-level interactions include dexfenfluramine, dolasetron, fenfluramine, granisetron, lorcaserin, ondansetron, palonosetron and sibutramine (mainly serotonergic agents). Moderate-level interactions include bupropion, morphine, cimetidine, dronabinol, eliglustat, metoclopramide, opium and phentermine.

Package insert warnings and contraindications were not available in the data compiled for this report. Please refer to the package insert for further safety information.

Conclusion and Next Steps

Decision: Hold

Rationale: The prediction has a very high model score (0.9998) but no supporting clinical trials or publications, and no plausible direct mechanism on nasal tissue. The evidence level is L5 (model prediction only).

To proceed, the following is needed:

Mechanism of action data to assess biological plausibility
A targeted literature review for dextromethorphan in nasal and upper airway disease
Package insert warnings and contraindications for the Indian products
A review of the major serotonergic and CYP2D6-related interactions before any new-use consideration
Disclaimer

This content is for research purposes only and does not constitute medical advice. Clinical validation is required before any clinical application.