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Licensed to fill prescriptions for patients in RI, MA, CT, NJ, NH, FL, ME and PA. New York patients are served on a limited basis while nonresident registration is pending.
Prepared to a prescriber's order for one patient. Not FDA-approved.
This is a compounded suppository containing dextromethorphan hydrobromide, prepared to a prescriber's order for one patient. Compounded preparations are not FDA-approved.
These listings cover every salt or ester form of each drug in the FDA National Drug Code Directory.
FDA-approved products containing dextromethorphan are listed in tablet, suspension, syrup, solution and capsule forms. It is also a component of FDA-approved kits.
Suppository bases differ, and the base used decides how USP <795> classifies the preparation for beyond-use dating. The date printed on the label is the one to follow.
Dextromethorphan is a cough suppressant and NMDA receptor antagonist that compounding pharmacies prepare by prescription in several dosage forms.
Dextromethorphan is a nonopioid morphinan cough suppressant that acts on brainstem pathways that control coughing. It is also a sigma-1 receptor agonist and an uncompetitive NMDA receptor antagonist. It is sold without a prescription in cough products such as Delsym extended-release suspension, which temporarily relieves cough from minor throat and bronchial irritation. Prescription combinations include Nuedexta (with quinidine), FDA-approved for pseudobulbar affect, and Auvelity (with bupropion), approved for major depressive disorder in adults and for agitation associated with dementia due to Alzheimer's disease. A prescriber might order dextromethorphan compounded for a strength, dosage form or allergen-free vehicle that is not manufactured. Compounded preparations are not FDA-approved and require a prescription.
Nonprescription labels say not to use dextromethorphan with an MAO inhibitor or for 2 weeks after stopping one, and to stop and ask a doctor if cough lasts more than 7 days or comes with fever, rash or lasting headache. MedlinePlus says not to give these products to children under 4 and warns that large amounts can cause serious side effects or death. Nuedexta is contraindicated with quinidine, quinine or mefloquine, a history of reactions to them such as low platelets or hepatitis, MAO inhibitor use, QT prolongation, heart failure and certain heart blocks; its warnings include serotonin syndrome and dizziness. Auvelity carries a boxed warning for suicidal thoughts and behaviors in children and young adults. LactMed says cough-syrup amounts in milk are very low, while Auvelity's maker advises avoiding breastfeeding during treatment and for 5 days afterward. Talk to your prescriber or pharmacist about side effects.
Dextromethorphan is a dextrorotatory morphinan structurally related to levorphanol with minimal mu-opioid activity; its main active metabolite, dextrorphan, is formed by CYP2D6 (StatPearls). In CYP2D6 extensive metabolizers, first-pass metabolism keeps oral bioavailability low and the median elimination half-life is about 2 to 3 hours; poor metabolizers have markedly higher exposure and a half-life of roughly 15 to 20 hours. Quinidine in Nuedexta inhibits CYP2D6 to raise and prolong dextromethorphan levels; with Auvelity, the mean dextromethorphan half-life was about 22 hours. Labeled uses: nonprescription cough relief; pseudobulbar affect (Nuedexta); major depressive disorder and agitation associated with Alzheimer's dementia (Auvelity). StatPearls describes investigational uses, including stroke, traumatic brain injury and seizures; these are not FDA-approved indications. Dosing is per prescriber. Avoid MAO inhibitors and allow 14 days between them, use caution with other serotonergic drugs, and review CYP2D6 substrates and QT risk when quinidine is part of the regimen. Monitor for sedation, dizziness and misuse.
Wash your hands. If the suppository is soft, chill it in its wrapper in the refrigerator or under cool water for a few minutes, then unwrap it. For rectal use, coat the tip with a water-soluble lubricant (not petroleum jelly), lie on your side with your upper knee bent, and insert it pointed end first past the muscle at the opening. For vaginal use, lie on your back with knees bent and insert it as far as it comfortably goes, by finger or applicator; bedtime use limits leakage, and a panty liner protects clothing. Stay lying down about 15 minutes. Wash your hands.
Suppositories are nonaqueous, so under USP <795> they can carry a beyond-use date of up to 180 days at controlled room temperature or in the refrigerator when no other stability data apply. Storage depends on the base: fatty bases can soften at room temperature and may be labeled for the refrigerator, while polyethylene glycol bases usually do not need refrigeration. Keep them cool so they do not melt, and refrigerate them if your label says to.
This formulation is compounded by Bayview Pharmacy on a prescriber's order for an individual patient. It is not an FDA-approved drug product, and the FDA has not evaluated it for safety, effectiveness, or manufacturing quality.
A valid prescription is required. Availability depends on Bayview's licensure in your state. This page is general information, not medical advice. Discuss your situation with a licensed healthcare provider.
Search by NCPDP 4106882, or by name and ZIP: Bayview Pharmacy, Warwick, RI 02886. Select it as the destination pharmacy and save it as a favorite. Click any value to copy it.
Compounded preparations have no NDC, so this formula will not appear in your EHR's drug search. Use your system's compound, non-formulary, or free-text prescription entry and name the preparation exactly as written in step 3. If your EHR forces you to pick a listed drug, pick the closest entry for the active ingredient and put the full formula in the prescription body (the Sig or directions field), not in Notes to Pharmacy.
Compounded preparations have no NDC and will not appear in your drug search. For EPCS to validate, select a drug entry your EHR recognizes as controlled, usually the bulk powder entry for the active ingredient (for example Ketamine (bulk) powder, not a branded product), then put the full formula from step 3 in the prescription body. A free-text entry that does not validate as controlled will be rejected by your EPCS module.
Quantity and directions are starting points for this dose form, not treatment recommendations. Dosing remains the prescriber's responsibility.
Transmit from your EHR. For this non-controlled preparation we also accept fax to (401) 284-4506 and phoned orders at (401) 284-4505. Order forms are on the formulation pages and in the prescriber portal.
Transmit with two-factor authentication through your EPCS-enabled EHR. No order form is offered for this preparation; e-prescribing guides for our controlled preparations are on the formulation pages.
Licensed to dispense in RI, MA, CT, NJ, NH, FL, ME, and PA; New York is served on a limited basis while nonresident registration is pending. Compounded preparations are not FDA-approved. A valid prescription is required. Full guide, including steps by EHR: How to e-prescribe to Bayview. Questions about this formula: call (401) 284-4505.
Insert 1 unwrapped suppository
