Dextromethorphan Hbr/Quinidine
Brand names: Nuedexta
At a glance
- Medicare prescriptions, 2024
- 125,157
- Medicare drug cost
- $126.5M
- Average cost per prescription
- $1,011
- Clinicians who prescribed it
- 4,462
Where it is prescribed
List the prescribers in any state, county, city or ZIP code →
What it is used for
NUEDEXTA is indicated for the treatment of pseudobulbar affect (PBA). PBA occurs secondary to a variety of otherwise unrelated neurologic conditions, and is characterized by involuntary, sudden, and frequent episodes of laughing and/or crying. PBA episodes typically occur out of proportion or incongruent to the underlying emotional state. PBA is a specific condition, distinct from other types of emotional lability that may occur in patients with neurological disease or injury. NUEDEXTA is a combination product containing dextromethorphan hydrobromide (an uncompetitive NMDA receptor antagonist and sigma-1 agonist) and quinidine sulfate (a CYP450 2D6 inhibitor) indicated for the treatment of pseudobulbar affect (PBA).
From the FDA-approved prescribing information (label dated October 2025). Full labels on DailyMed (opens in a new tab)
Who prescribes it
- Family Medicine 22.0%
- Internal Medicine 21.8%
- Neurology 13.0%
- Nurse Practitioners 12.4%
- Psychiatric Nurse Practitioners 9.2%
- Psychiatry 7.0%
- Geriatric Medicine 4.2%
- Physician Assistants 3.4%
- General Practice 1.9%
- Hospitalist 1.3%
- Physical Medicine & Rehabilitation (PM&R) 1.2%
- Emergency Medicine 0.4%
All prescribers, by place, name or specialty →
Share of Medicare prescriptions written by each specialty. Select one to list its prescribers.
Trend, 2019–2024
Medicare prescriptions fell 50% from 2019 to 2024.
Biggest change by state since 2019
- Kentucky −22%
- Mississippi −29%
- Florida −32%
- Indiana −44%
- Ohio −44%
- Georgia (smallest change) −65%
- Alabama (smallest change) −63%
From CMS’s yearly state and national Part D summaries, which count every prescriber, including those CMS leaves out of its per-clinician data (fewer than 11 prescriptions). That is why these totals are higher than the count at the top of this page. Prescriptions include refills.
What it looks like
Pills from 2 makers on file. The same medicine can look different depending on who made it, so check the imprint (the letters and numbers on the pill) with your pharmacist if a refill looks different.
Avanir Pharmaceuticals, Inc.
| Strength | Looks like | Imprint |
|---|---|---|
| 20 mg / 10 mg quinidine sulfate | red capsule, 19 mm | DMQ 20 10 |
Otsuka America Pharmaceutical, Inc
| Strength | Looks like | Imprint |
|---|---|---|
| 20 mg / 10 mg quinidine sulfate | red capsule, 19 mm | DMQ 20 10 |
Source: DailyMed (U.S. National Library of Medicine), from each maker’s FDA drug listing. A few makers are shown, not every one. Never take a pill you can’t identify; ask a pharmacist.
Industry payments about this drug
Drug makers reported $8,552 in payments to clinicians that named this drug in 2025 (meals, speaking, consulting and similar).
- Otsuka America Pharmaceutical, Inc. $8,552
Source: CMS Open Payments, general payments (not research), program year 2025. A payment is not evidence of wrongdoing. Payments by doctor
Recalls and shortages
Not on the FDA drug shortage list.
1 recall since 2020
- Mar 2021 · Cardinal Health Inc. · Class II
CGMP Deviations: Intermittent exposure to temperature excursion during storage.
Recalls usually affect specific lots from one maker, not every version of a drug. Class I is the most serious; most drug recalls are Class II. FDA recalls (opens in a new tab)
Sources: CMS Medicare Part D Prescribers by Provider and Drug (2024; prescriptions include refills, and CMS hides counts under 11 per prescriber); U.S. Food and Drug Administration, openFDA (drug labels, NDC directory, enforcement reports, drug shortages); CMS Open Payments 2025; ClinicalTrials.gov. General information only, not medical advice; not yet reviewed by our medical reviewer.