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**Dextromethorphan + quinidine** is an oral fixed-dose small-molecule combination marketed as **Nuedexta** for the treatment of pseudobulbar affect. Dextromethorphan is an uncompetitive N-methyl-D-aspartate receptor antagonist and sigma-1 receptor agonist, while low-dose quinidine inhibits cytochrome P450 2D6 to reduce dextromethorphan metabolism and sustain therapeutic dextromethorphan exposure. The U.S. product contains dextromethorphan hydrobromide 20 mg and quinidine sulfate 10 mg per capsule. It was developed by Avanir and subsequently integrated into Otsuka's U.S. pharmaceutical business. ([dailymed.nlm.nih.gov](https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=484e0918-3442-49dc-8ccf-177f1f3ee9f3))
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