Nuedexta Capsule: Uses, Dosage, Side Effects, Precautions and Alternates

Quick overview

Nuedexta Capsule combines dextromethorphan and quinidine, classified as a miscellaneous central nervous system agent that acts as an NMDA antagonist and sigma-1 agonist along with a CYP450 2D6 inhibitor. It is a brand-name prescription capsule used to treat pseudobulbar affect (PBA), a condition that causes sudden, uncontrollable laughing or crying. It is often used in people with neurological conditions such as ALS and multiple sclerosis who experience these symptoms.

What is Nuedexta Capsule

Nuedexta is a brand-name prescription capsule that combines two medicines, dextromethorphan and quinidine. It is used to treat pseudobulbar affect, a condition that causes sudden, uncontrollable laughing or crying.

Nuedexta Capsule uses

• Pseudobulbar affect (PBA)
• Sudden, uncontrollable crying episodes
• Sudden, uncontrollable laughing episodes
• Emotional outbursts unrelated to actual feelings
• PBA symptoms associated with neurological conditions such as ALS and multiple sclerosis (MS)

Benefits of Nuedexta Capsule

• Treats pseudobulbar affect (PBA).
• Helps control sudden crying episodes.
• Helps control involuntary laughing.
• Reduces emotional outbursts associated with neurological conditions.
• Helps manage emotional expression symptoms.

How Nuedexta Capsule works

Nuedexta contains dextromethorphan, which acts on brain chemicals called neurotransmitters involved in controlling emotions, helping to calm the uncontrolled laughing or crying episodes. Quinidine is added to slow down how quickly the body breaks down dextromethorphan, so it stays active longer.

Nuedexta Capsule dosage

Take Nuedexta exactly as prescribed by your doctor and follow all directions on your prescription label. You can take it with or without food. Take each dose about 12 hours apart, and try to take it around the same times every day. Do not share this medicine with other people, even if they have the same condition. Do not take a double dose if you miss one—just take the next dose at its regular time. This medicine is not approved for use in anyone younger than 18 years old.

Available forms and strengths

• Capsule (oral)

Side effects of Nuedexta Capsule

Common

• Diarrhea
• Dizziness
• Cough
• Vomiting
• Feeling unusually weak or tired
• Fluid retention (swelling in hands, feet, or lower legs)
• Urinary tract infection
• Flu-like symptoms
• Gas and bloating
• Abnormal liver function tests

Serious

• Severely low platelet levels (thrombocytopenia) - easy bruising or bleeding, nosebleeds, bleeding that does not stop
• Immune system reactions causing inflammation of the liver, blood vessels, or lymph vessels, and lupus-like symptoms such as rash, joint pain, and fever
• Liver damage - nausea, vomiting, stomach pain, fever, weakness, itching, loss of appetite, light-colored stool, dark urine, yellowing of skin or eyes
• Heart rhythm changes (QT prolongation) - fainting, fast or skipping heartbeat, chest pain or pressure, trouble breathing
• Serotonin syndrome - agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, diarrhea
• Severe allergic reaction - hives, difficulty breathing, swelling of the face, lips, tongue, or throat

Warnings and precautions

• Do not take this medicine if you have heart failure, a serious heart rhythm problem called complete heart block (unless you have a pacemaker), or a history of long QT syndrome or dangerous heart rhythm problems.
• Do not take this medicine if you've used a medicine called an MAO inhibitor in the past two weeks, as this can cause a dangerous interaction.
• Do not take this medicine with quinidine, quinine, or mefloquine, or if you've had a serious reaction to these medicines in the past.
• This medicine can cause a serious drop in blood platelets, which increases your risk of bleeding. Stop the medicine and contact your doctor if you notice easy bruising, bleeding, or nosebleeds.
• This medicine can cause a dangerous heart rhythm problem called QT prolongation. Your doctor may check your heart rhythm before and during treatment.
• Avoid grapefruit juice while taking this medicine, as it can raise the risk of serious side effects.
• Avoid other cough or cold medicines containing dextromethorphan while on this medicine, as combining them can cause you to get too much dextromethorphan.
• This medicine can cause liver inflammation or damage, usually in the first few weeks of treatment. Contact your doctor if you have signs like fever, tiredness, nausea, stomach pain, or yellowing of the skin or eyes.
• It is not known if Nuedexta is safe to take during pregnancy. Animal studies suggest it could harm an unborn baby, so talk to your doctor about the risks and benefits if you are or could become pregnant.
• It isn't known whether Nuedexta passes into breast milk, so caution is advised if you are breastfeeding.
• No dose change is needed for mild to moderate kidney problems, but the medicine hasn't been studied in people with severe kidney impairment, who may have higher drug levels.
• No dose change is needed for mild to moderate liver problems, but people with moderate impairment had more side effects, and the medicine hasn't been studied in severe liver impairment.
• Drinking alcohol with this medicine may increase dizziness, drowsiness, and the risk of liver damage, so it's best to limit alcohol while taking it.
• This medicine can affect your alertness and coordination, so don't drive or do activities that require focus until you know how it affects you.

Storage

• Store at room temperature, between 68 F to 77 F (20 C to 25 C)
• It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C) for shorter periods of time, such as when transporting it
• Store in a cool, dry place
• Store away from moisture and heat

When to see a doctor

• Get emergency help right away if you have signs of a severe allergic reaction, such as hives, trouble breathing, or swelling of the face, lips, tongue, or throat.
• Call your doctor right away if you have fast or pounding heartbeats, fluttering in your chest, shortness of breath, or sudden dizziness like you might pass out.
• Call your doctor right away if you notice easy bruising or bleeding, such as nosebleeds or bleeding gums.
• Call your doctor right away if you have signs of liver problems, such as fever, right-sided upper stomach pain, vomiting, loss of appetite, or yellowing of your skin or eyes.
• Call your doctor right away if you have lupus-like symptoms such as muscle or joint pain, flu symptoms, chest pain, and a rash or patchy skin color that worsens in sunlight.
• Seek medical attention right away if you have symptoms of serotonin syndrome, including agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.
• If you think you or someone else has taken too much of this medicine, get medical help right away or contact a poison control center.

Alternatives

• No exact equivalent substitute
• Quinidine
• Dextromethorphan