DEXTROMETHORPHAN; QUINIDINE (dex troe meth OR fan; KWIN i deen) treats pseudobulbar affect (PBA). This is a condition that causes uncontrolled, frequent laughing or crying in people with conditions that affect the brain. It works by reducing the number of laughing or crying outbursts.

How should I use this medication?

Take this medication by mouth with a glass of water. Take it as directed on the prescription label at the same time every day. You can take it with or without food. If it upsets your stomach, take it with food. Keep taking it unless your care team tells you to stop. Talk to your care team about use of this medication in children. Special care may be needed.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once. NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

Where should I keep my medication?

Keep out of the reach of children and pets. Store between 15 and 30 degrees C (59 and 86 degrees F). Get rid of any unused medication after the expiration date. To get rid of medications that are no longer needed or have expired: -Take medication to a medication take-back program. Check with your pharmacy or law enforcement to find a location. -If you cannot return the medication, check the label or package insert to see if the medication should be thrown out in the garbage or flushed down the toilet. If you are not sure, ask your care team. If it is safe to put it in the trash, pour the medication out of the container. Mix the medication with cat litter, dirt, coffee grounds, or other unwanted substance. Seal the mixture in a bag or container. Put it in the trash.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.

What side effects may I notice from receiving this medication?

Side effects that you should report to your care team as soon as possible: -Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat -Anticholinergic toxicity—flushed face, blurry vision, dry mouth and skin, confusion, fast or irregular heartbeat, trouble passing urine, constipation -Heart rhythm changes—fast or irregular heartbeat, dizziness, feeling faint or lightheaded, chest pain, trouble breathing -Irritability, confusion, fast or irregular heartbeat, muscle stiffness, twitching muscles, sweating, high fever, seizure, chills, vomiting, diarrhea, which may be signs of serotonin syndrome -Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue -Lupus-like syndrome—joint pain, swelling, or stiffness, butterfly-shaped rash on the face, rashes that get worse in the sun, fever, unusual weakness or fatigue -Unusual bruising or bleeding Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome): -Cough -Diarrhea -Dizziness -Swelling of the ankles, hands, or feet -Unusual weakness or fatigue -Vomiting

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What should I tell my care team before I take this medication?

They need to know if you have any of these conditions: -Dementia -Heart disease -History of irregular heartbeat -History of low blood counts caused by a medication -Kidney disease -Liver disease -Low levels of magnesium or potassium in the blood -Myasthenia gravis -Substance use disorder -An unusual or allergic reaction to dextromethorphan, quinidine, other medications, foods, dyes, or preservatives -Pregnant or trying to get pregnant -Breast-feeding

What may interact with this medication?

Do not take this medication with any of the following: -Certain antipsychotics, such as chlorpromazine, haloperidol, pimozide, risperidone, thioridazine -Certain medications for irregular heart beat, such as dofetilide, encainide, flecainide, mexiletine, propafenone, quinidine -Cisapride -Dolasetron -Dronedarone -MAOIs, such as Carbex, Eldepryl, Marplan, Nardil, Parnate -Mefloquine -Quinine This medication may also interact with the following: -Alcohol -Aprepitant -Certain antibiotics, such as clarithromycin, erythromycin, telithromycin -Certain antivirals for HIV or hepatitis -Certain medications for depression, such as amitriptyline, citalopram, desipramine, escitalopram, fluoxetine, fluvoxamine, nefazodone, paroxetine, and sertraline -Certain medications for fungal infections, such as fluconazole, itraconazole, ketoconazole -Codeine -Digoxin -Diltiazem -Grapefruit juice -Hydrocodone -Memantine -Other medications that cause heart rhythm changes -Verapamil

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medication?

Visit your care team for regular checks on your progress. Tell your care team if your symptoms do not start to get better or if they get worse. This medication may affect your coordination, reaction time, or judgment. Do not drive or operate machinery until you know how this medication affects you. Sit up or stand slowly to reduce the risk of dizzy or fainting spells. Drinking alcohol with this medication can increase the risk of these side effects.