Tussdex Syrup: Complete Medicine Guide For Patients
Clinical Reference Standards: CDSCO (Central Drugs Standard Control Organisation), Indian Pharmacopoeia (IP) & WHO | Last Updated: September 2026
When to Call Your Doctor IMMEDIATELY
- Difficulty breathing, slow or shallow breathing, or bluish lips or face.
- Severe drowsiness, confusion, or inability to stay awake.
- Seizures or convulsions.
- Rash, itching, swelling of face, lips, or throat, or difficulty swallowing.
- Fast, irregular, or pounding heartbeat.
- Yellowing of skin or eyes, or severe abdominal pain.
- Unusual bleeding or bruising, or signs of infection such as fever and sore throat.
- Hallucinations or severe agitation.
If experiencing severe symptoms, call emergency services immediately.
What is tussdex syrup used for?
This medicine is a prescription syrup containing promethazine (an antihistamine) and dextromethorphan (a cough suppressant). It is used to treat dry cough and allergy symptoms like runny nose and sneezing. It causes drowsiness and should not be used in children under 2 years. Always follow your doctor's instructions.
- Generic Name: Promethazine (5mg) + Dextromethorphan Hydrobromide (15mg)
- Manufacturer: Lark Laboratories Ltd
- Form: Allopathy
- Pregnancy Category: Consult doctor
- Prescription Required: Yes
🇮🇳 tussdex syrup के बारे में (Hindi Summary)
उपयोग: यह दवा प्रोमेथाज़िन और डेक्सट्रोमेथोर्फन का संयोजन है, जिसका उपयोग सूखी खांसी और एलर्जी के लक्षणों जैसे नाक बहना, छींक आना और आंखों में खुजली के इलाज के लिए किया जाता है। यह दवा खांसी को दबाने और एलर्जी को कम करने में मदद करती है। यह केवल डॉक्टर के पर्चे पर मिलती है और इसे डॉक्टर की सलाह के अनुसार ही लेना चाहिए। इस दवा से नींद आ सकती है, इसलिए इसे लेने के बाद वाहन न चलाएं। 2 साल से छोटे बच्चों को यह दवा न दें।
साइड इफेक्ट्स: इस दवा के सामान्य दुष्प्रभावों में नींद आना, चक्कर आना, धुंधली दृष्टि, मुंह सूखना, जी मिचलाना और कब्ज शामिल हैं। गंभीर दुष्प्रभाव दुर्लभ हैं, लेकिन एलर्जी की प्रतिक्रिया, सांस लेने में कठिनाई, तेज़ या अनियमित दिल की धड़कन हो सकती है। यदि आपको कोई गंभीर लक्षण दिखे तो तुरंत डॉक्टर से संपर्क करें।
सुरक्षा सलाह: यह दवा केवल डॉक्टर के पर्चे पर मिलती है, इसे डॉक्टर की सलाह के बिना न लें। इस दवा को लेते समय शराब न पिएं क्योंकि इससे नींद और सांस की समस्या बढ़ सकती है। वाहन चलाने या मशीन चलाने से बचें। यदि आप गर्भवती हैं, स्तनपान करा रही हैं, या 2 साल से छोटे बच्चे को देना है, तो डॉक्टर से सलाह लें। दवा को बच्चों की पहुंच से दूर रखें।
💊 tussdex syrup Uses & Benefits
[{"condition":"Dry cough","description":"This medicine helps suppress dry, irritating cough that does not produce mucus, providing temporary relief.","evidence":"Well-established for dextromethorphan component"},{"condition":"Allergic rhinitis","description":"The promethazine component helps relieve runny nose, sneezing, and itchy, watery eyes associated with allergies.","evidence":"Well-established for promethazine component"},{"condition":"Common cold symptoms","description":"This medicine may be used to relieve cough and nasal symptoms associated with the common cold.","evidence":"Commonly used, but evidence for combination is limited"},{"condition":"Cough associated with upper respiratory tract infection","description":"It provides symptomatic relief of dry cough and associated symptoms in upper respiratory infections.","evidence":"Commonly used"}]
Off-label uses: [{"condition":"Insomnia","description":"Promethazine is sometimes used off-label for short-term management of insomnia due to its sedative effects.","evidence":"Limited"},{"condition":"Nausea and vomiting","description":"Promethazine has antiemetic properties and may be used off-label for nausea, but this combination is not intended for that purpose.","evidence":"Limited"},{"condition":"Motion sickness","description":"Promethazine may be used off-label to prevent motion sickness, but this syrup is not formulated for that use.","evidence":"Limited"}]
Primary treatment for: Dry cough and allergic rhinitis
Also treats: Common cold, Upper respiratory tract infection, Allergic conjunctivitis
📋 Drug Information
| Generic Name(s) | Promethazine (5mg) + Dextromethorphan Hydrobromide (15mg) |
| Brand Name | tussdex syrup |
| Manufacturer | Lark Laboratories Ltd |
| Packaging / Form | Varies by brand (Allopathy) |
| Therapeutic Class | RESPIRATORY |
| Action Class | |
| Route of Administration | Oral |
| Storage | Store at room temperature between 15°C and 30°C (59°F to 86°F). Protect from light and moisture. Keep the bottle tightly closed. Do not freeze. Keep out of the reach of children. |
| Shelf Life | 24 months from the date of manufacture, or as printed on the packaging. |
| WHO Guideline | Not established from the available information. The World Health Organization does not have specific guidelines for this combination product. Cough suppressants and antihistamines are generally not recommended for routine use in children under 2 years. |
| ICMR Guideline | Not established from the available information. The Indian Council of Medical Research does not have specific guidelines for this combination product. Always follow your doctor's advice. |
👨⚕️ Doctor's Practical Tips
Evidence-based practical advice from experienced clinicians
🔍 Is This Medicine Right for Your Symptom?
Educational reference. Always consult a doctor for diagnosis.
🔬 How This Medicine Works (Pharmacology)
Pharmacokinetics
How It Works
This medicine combines two active ingredients with different mechanisms. Promethazine is a first-generation antihistamine that blocks histamine H1 receptors, reducing allergy symptoms. It also has anticholinergic and sedative effects by blocking muscarinic receptors and acting on the central nervous system. Dextromethorphan hydrobromide is a centrally acting cough suppressant that works in the brain to raise the cough threshold. It acts on sigma-1 receptors and possibly NMDA receptors in the cough center of the medulla oblongata, reducing the cough reflex.
Mechanism Steps
💡 How to Take tussdex syrup
Strength: Each 5 mL of syrup contains promethazine 5 mg and dextromethorphan hydrobromide 15 mg.
Dosage Information
| Adult Dosage | The usual adult dose of this medicine is 5 mL to 10 mL (1 to 2 teaspoons) every 4 to 6 hours as needed for cough and allergy symptoms, not to exceed 30 mL in 24 hours. However, the exact dose and frequency must be individualized by a qualified clinician based on the indication, age, weight, renal and hepatic function, and response to treatment. Do not self-medicate. Follow your doctor's prescription exactly. |
| Pediatric Dosage | Pediatric dosing is not established from available information. This medicine is contraindicated in children under 2 years of age due to the risk of life-threatening respiratory depression. For children 2 years and older, the dose must be determined by a pediatrician based on the child's weight and clinical condition. Do not give this medicine to children without a doctor's prescription. |
| Elderly Dosage | Elderly patients (65 years and older) are more sensitive to the sedative and anticholinergic effects of this medicine. Use with caution and consider a lower dose. The dose must be individualized by a qualified clinician based on renal and hepatic function and concurrent medications. Monitor closely for confusion, falls, and urinary retention. |
| Renal Impairment | In patients with renal impairment, the clearance of promethazine and dextromethorphan may be reduced. Dose adjustment may be necessary. The exact dose must be individualized by a qualified clinician based on the degree of renal impairment. Monitor for increased side effects. |
| Hepatic Impairment | In patients with hepatic impairment, the metabolism of promethazine and dextromethorphan may be reduced, leading to increased plasma levels and risk of toxicity. Use with caution and consider dose reduction. The dose must be individualized by a qualified clinician based on the degree of hepatic impairment. Monitor liver function. |
| Maximum Daily Dose | The maximum recommended daily dose for adults is 30 mL of this syrup in 24 hours, providing promethazine 30 mg and dextromethorphan hydrobromide 90 mg. Do not exceed this dose. For children, the maximum daily dose must be determined by a pediatrician. |
Dosage Timeline
🍽️ Food Timing Guide
⏰ What to Do If You Miss a Dose
⚠️ Side Effects of tussdex syrup
✅ Common Side Effects
🚨 Serious Side Effects
⚠️ Rare Side Effects
Consult your doctor if you experience any unusual symptoms.
🔬 Drug Interactions
| Drug | Severity | Effect |
|---|---|---|
| MAOIs | Major | |
| Alcohol | Major | |
| Opioids | Major | |
| Benzodiazepines | Major | |
| Tricyclic antidepressants | Major | |
| Fluoxetine | Major | |
| Paroxetine | Major | |
| Quinidine | Major | |
| Antihypertensives | Moderate | |
| Epinephrine | Moderate |
🚨 Major Interactions
- Monoamine oxidase inhibitors (MAOIs)
- CNS depressants (e.g., alcohol, opioids, benzodiazepines, barbiturates)
- Anticholinergic drugs (e.g., atropine, tricyclic antidepressants, antiparkinson agents)
- CYP2D6 inhibitors (e.g., fluoxetine, paroxetine, quinidine)
⚡ Moderate Interactions
- Antihypertensive drugs
- Epinephrine
- Levodopa
- Amiodarone
🍷 Alcohol Interaction
Alcohol should be completely avoided while taking this medicine. Both promethazine and dextromethorphan can cause drowsiness and slow breathing, and alcohol significantly increases these effects. Combining alcohol with this medicine can lead to severe sedation, respiratory depression, and even death. Do not drive or operate machinery after consuming alcohol while on this medicine.
🔎 Check Your Other Medicines
Educational tool. Always confirm with your doctor or pharmacist.
🛡️ Safety & Warnings
🚫 Contraindications
["Children under 2 years of age","Known hypersensitivity to promethazine, dextromethorphan, or any component of the formulation","Use within 14 days of monoamine oxidase inhibitor (MAOI) therapy","Severe respiratory depression or acute asthma attack","Narrow-angle glaucoma","Urinary retention or prostatic hypertrophy","Severe liver disease","Breastfeeding"]
⚠️ Warnings & Precautions
["May cause marked drowsiness; avoid driving or operating machinery.","Do not use in children under 2 years due to risk of fatal respiratory depression.","Avoid alcohol and other CNS depressants.","Use with caution in patients with asthma, COPD, or sleep apnea.","May cause anticholinergic effects; use with caution in patients with glaucoma, urinary retention, or constipation.","May lower seizure threshold; use with caution in patients with seizure disorders.","Prolonged use may lead to tolerance and dependence.","Do not exceed recommended dose; overdose can be fatal.","Use with caution in elderly patients due to increased risk of confusion, falls, and anticholinergic effects.","Consult doctor before use in pregnancy or breastfeeding."]
🤱 Lactation Safety
Promethazine and dextromethorphan are excreted in breast milk. Because of the potential for serious adverse reactions in nursing infants, a decision should be made whether to discontinue nursing or to discontinue the medicine, taking into account the importance of the medicine to the mother. Consult your doctor before breastfeeding.
💊 Overdose Management
Overdose of this medicine can cause severe drowsiness, confusion, hallucinations, seizures, respiratory depression, and coma. If overdose is suspected, seek emergency medical attention immediately. Treatment is supportive and symptomatic. There is no specific antidote. Gastric lavage may be considered if within 1-2 hours of ingestion. Activated charcoal may be administered. Monitor vital signs, respiratory status, and cardiac rhythm. For dextromethorphan overdose, naloxone may be used but is not always effective. For promethazine overdose, physostigmine may be used cautiously for severe anticholinergic effects, but it can cause seizures. Do not induce vomiting unless instructed by a healthcare professional.
⏰ Missed Dose
If you miss a dose of this medicine, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are unsure, consult your doctor or pharmacist.
Additional Safety Advice
This medicine is a prescription medicine and should only be taken under a doctor's supervision. Do not use it for longer than your doctor recommends, and do not take more than the prescribed dose. Avoid alcohol and other medicines that cause drowsiness, such as sleeping pills, anxiety medicines, or muscle relaxants, because they can increase sedation and breathing problems. Do not drive or operate heavy machinery until you know how this medicine affects you. If you are pregnant, planning to become pregnant, or breastfeeding, talk to your doctor before taking this medicine. Do not give this medicine to children under 2 years of age. Keep this medicine out of the reach of children. If you have asthma, glaucoma, an enlarged prostate, difficulty urinating, liver disease, or a seizure disorder, tell your doctor before taking this medicine. Do not stop taking this medicine suddenly without talking to your doctor if you have been taking it for a long time.
👴 Special Considerations for Elderly
💡 For Patients Above 65
Elderly patients are more sensitive to the sedative, anticholinergic, and hypotensive effects of this medicine. They are at higher risk of confusion, falls, urinary retention, and constipation. Use with caution and consider a lower dose. Avoid use in elderly patients with dementia or cognitive impairment. Monitor closely for side effects.
🤰 Pregnancy Planning (TTC)
If you are planning to become pregnant, consult your doctor before taking this medicine. The safety of this combination in pregnancy has not been established. Promethazine and dextromethorphan should be used during pregnancy only if clearly needed. Discuss alternative treatments with your doctor.
🏥 Post-Surgery Considerations
After surgery, this medicine should be used with caution because it can increase sedation and respiratory depression, especially if you are also taking opioid pain relievers. Inform your surgeon and anesthesiologist if you are taking this medicine. It may also interfere with certain surgical procedures. Follow your doctor's instructions.
🦷 Dental Procedures
Inform your dentist if you are taking this medicine before any dental procedure. It can cause dry mouth, which may increase the risk of dental problems. It may also interact with anesthetics or sedatives used during dental procedures. Your dentist may recommend adjusting your dose or timing.
💚 Lifestyle Tips for Better Results
🏋️ Exercise Considerations
Avoid strenuous exercise while taking this medicine because it can cause drowsiness, dizziness, and blurred vision. Light activities like walking may be okay if you feel alert, but do not engage in activities that require full concentration or physical coordination.
🥗 Diet Recommendations
💼 Impact on Daily Work & Life
This medicine can significantly affect your ability to work or perform daily activities because it causes drowsiness, dizziness, and blurred vision. Do not drive, operate heavy machinery, or perform tasks requiring mental alertness. It is best to take it when you can rest, such as at bedtime. Inform your employer if your job requires alertness, and avoid working until you know how the medicine affects you.
🛑 When to Stop This Medicine
Stop taking this medicine and consult your doctor if your cough persists for more than 7 days, if it is accompanied by fever, rash, or persistent headache, or if you experience any serious side effects. Do not stop suddenly if you have been taking it for a long time; consult your doctor for a tapering schedule. Always follow your doctor's advice on when to stop.
📅 Long-Term Use Effects
Long-term use of this medicine is not recommended. Prolonged use of promethazine can lead to tolerance, dependence, and withdrawal symptoms. It may also cause tardive dyskinesia, a movement disorder, and other extrapyramidal symptoms. Regular monitoring of liver and kidney function may be needed if used for extended periods. Consult your doctor if you need to use this medicine for more than 7 days.
🌿 Non-Medicine Approaches
These can complement medicine but do not replace prescribed treatment.
Warm fluids, honey, and steam inhalation can help soothe dry cough and throat irritation.
Evidence: LimitedHelps relieve nasal congestion and runny nose without medication.
Evidence: Well-establishedIf cough is mainly due to allergies, a non-sedating antihistamine may be sufficient.
Evidence: Well-establishedFor dry cough without allergy symptoms, dextromethorphan alone may be used.
Evidence: Well-established💉 Vaccination Considerations
💉 If You're Getting Vaccinated
There are no known interactions between this medicine and vaccines. However, if you are scheduled to receive a vaccine, inform your healthcare provider that you are taking this medicine. It is generally safe to receive vaccines while on this medicine, but your doctor will decide based on your overall health.
📦 Storage Guide
✅ DO
Store at room temperature (15-30°C)
❌ DON'T
Do not refrigerate or freeze
✅ DO
Keep in original container with cap tightly closed
❌ DON'T
Do not transfer to unmarked containers
✅ DO
Keep away from direct sunlight and moisture
❌ DON'T
Do not store in bathroom cabinet
✅ DO
Keep out of reach of children
❌ DON'T
Do not use after expiry date
✈️ Traveling with This Medicine
When traveling with this medicine, carry it in its original packaging with the prescription label intact. Bring a copy of your prescription or a letter from your doctor, especially for international travel, as promethazine and dextromethorphan may be controlled substances in some countries. Store it in your carry-on luggage to avoid temperature extremes. Keep it away from direct sunlight and moisture. If you are crossing time zones, adjust your dosing schedule gradually, but do not take extra doses. Consult your doctor before traveling if you have any concerns.
💰 Cost Analysis & Savings
👥 Real Patient Stories
Educational, anonymized scenarios. Individual results may vary.
💬 Questions Patients Often Ask
A: This medicine usually starts working within 20 to 30 minutes after taking it. The cough suppressant effect may last for 4 to 6 hours.
A: Yes, you can take this medicine with or without food. If it upsets your stomach, take it with a meal or a glass of milk.
A: If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not double dose.
A: No, you should avoid alcohol completely while taking this medicine. Alcohol increases the risk of severe drowsiness and breathing problems.
A: This medicine is not safe for children under 2 years. For older children, it should only be used under a doctor's supervision.
A: No, this medicine can cause significant drowsiness and dizziness. Avoid driving or operating machinery until you know how it affects you.
A: This medicine is for short-term use only. Do not take it for longer than your doctor recommends, usually not more than 7 days.
A: Seek immediate medical help if you experience difficulty breathing, severe drowsiness, seizures, rash, swelling of face or throat, or fast or irregular heartbeat.
🤔 Common Patient Concerns
🛑 Myths vs. Facts
- Myth: This medicine can be used for any type of cough.
Fact: This medicine is only for dry, unproductive cough. It is not effective for cough with mucus (productive cough) and may worsen it by suppressing the cough reflex. - Myth: It is safe to give this medicine to young children for cough.
Fact: This medicine is contraindicated in children under 2 years due to the risk of life-threatening respiratory depression. For older children, it should only be used under a doctor's supervision. - Myth: This medicine is not habit-forming.
Fact: Prolonged use of promethazine can lead to tolerance and dependence. It should only be used for short-term relief as prescribed. - Myth: You can take this medicine with alcohol without any problems.
Fact: Alcohol significantly increases the sedative and respiratory depressant effects of this medicine, which can be dangerous. Avoid alcohol completely.
🔄 Alternative Options
Generic Alternatives
- Promethazine and Dextromethorphan Hydrobromide Syrup
Brand Alternatives
- Tussdex Syrup