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dextromethorphan + quinidine
- Development stage
- Approved
- Lead developer
- Otsuka Holdings
- Modality
- Small Molecules
- Administration
- Oral
01
Overview
**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))
- Brand names
- Nuedexta
- Other names
- DM/QDMQNeurodexZenviadextromethorphan + quinidinedextromethorphan and quinidinedextromethorphan hydrobromide + quinidine sulfatedextromethorphan/quinidine
02
Targets
CYP2D6 (Cytochrome P450 2D6)NMDAR (Glutamate receptor ionotropic, NMDA)NET (Norepinephrine Transporter)SERT (Sodium-dependent serotonin transporter)SIGMAR1 (Sigma non-opioid intracellular receptor 1)Nicotinic Acetylcholine Receptor
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