A combination is graded by its riskiest ingredient: each part of the score is the lowest of the ingredients' scores. This grade answers one narrow question: how strong is the public evidence and safety record behind this drug, and how clean is its money trail and court record? It is not a verdict on whether the drug is right for you.
Each ingredient has its own full page with the FDA label, side-effect reports, recalls, evidence, and payments. Open them for the detail behind this grade.
Score breakdown (83/100)
Safety ×35%
A
Evidence ×25%
F
Regulatory ×15%
A
Money & lawsuits ×15%
A
Options ×10%
A
Safety: 89
Graded by its riskiest ingredient, dextromethorphan (89)
Death appears in 2.4x the share of reports seen across all of FAERS (-11)
Evidence: 46
Graded by its riskiest ingredient, dextromethorphan (46)
157 randomized trials and 10 systematic reviews/meta-analyses indexed in PubMed
No Cochrane review found (-5)
Only 39% of completed registered trials posted results (-8)
'Drug ineffective' is the single most-reported item about this drug in FAERS (-5)
Regulatory history: 100
Graded by its riskiest ingredient, dextromethorphan (100)
No recalls on record since 2016
Money & lawsuits: 100
Graded by its riskiest ingredient, dextromethorphan (100)
Pharma paid doctors $0 tied to this drug last year: negligible
Not named in any pending federal MDL
Options: 100
Graded by its riskiest ingredient, dextromethorphan (100)
Generic versions approved (3 applications)
6 same-class alternatives exist
Money and lawsuits
In 2024, drug companies reported $0 in payments to US physicians and hospitals tied to this combination's brands across 0 transactions.
No pending federal MDL names this combination or its brands.
The ingredients' own payments and lawsuits are on their pages and already count toward this grade.
Who takes it and what it costs
9,957Medicare Part D patients (2024)
13,336prescriptions filled
$10average cost per fill
$0Mtotal Medicare spend
Questions to ask your prescriber
This is a fixed combination of dextromethorphan and promethazine. Why both together, instead of only the one I need?
The most-reported problems in FDA's adverse event data are toxicity to various agents, drug abuse, diarrhoea. How would we recognize and handle those?
Why this one over codeine, ethylmorphine, hydrocodone? What would make you pick one of those instead?
What result are we expecting, by when, and what is the plan if it does not happen?
If 100 people like me took this drug, how many would actually get better because of it, and how many would be harmed by it? (Doctors call these the number needed to treat and the number needed to harm.)
An independent reviewer (Prescrire) lists this as a drug to avoid because the harms outweigh the benefits versus alternatives. What is your view on that?
The most-reported problems in FDA's adverse event data are intentional overdose, nausea, intentional self-injury, fatigue. How would we recognize and handle those?
Why this one over bamipine, chloropyramine, chlorphenoxamine? What would make you pick one of those instead?