Comprehensive medication guide to Delsym XR including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
Not covered by standard insurance as an OTC product. HSA/FSA accounts can be used to purchase Delsym XR without a prescription under the CARES Act. Some Medicare Advantage plans include OTC benefits that may cover cough suppressants.
Estimated Cash Pricing
$8–$20 retail for the brand-name Delsym 12 Hour bottle (3–5 fl oz); as low as $5–$10 for store-brand dextromethorphan polistirex ER suspension (equivalent formula) at Walmart, Amazon, or Target; GoodRx coupons can reduce cost to as low as $7.
Medfinder Findability Score
90/100
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Delsym XR is the brand name for dextromethorphan polistirex extended-release oral suspension — an over-the-counter cough suppressant (antitussive) manufactured by RB Health (US) LLC, a subsidiary of Reckitt Benckiser. It is available in grape and orange flavors in 3 fl oz and 5 fl oz bottles. The "XR" designation refers to its extended-release formulation, which provides up to 12 hours of cough suppression per dose.
Unlike standard cough syrups that use dextromethorphan hydrobromide (HBr) and last 4 to 8 hours, Delsym XR uses dextromethorphan polistirex — dextromethorphan bound to an ion-exchange resin polymer that releases the drug slowly over 12 hours. This means just two doses per day instead of four to six doses, making it a preferred option for patients who want convenient, all-day or all-night cough coverage.
Delsym XR is indicated for the temporary relief of cough due to minor throat and bronchial irritation as may occur with the common cold, flu, or inhaled irritants. It is designed for dry, nonproductive cough and is approved for adults and children ages 4 and older.
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Delsym XR contains dextromethorphan (DXM), a centrally acting antitussive. It works primarily by blocking NMDA (N-methyl-D-aspartate) receptors and activating sigma-1 receptors in the brain's medullary cough center, raising the threshold required to trigger a cough reflex. In plain terms, it tells your brain to stop responding to minor airway irritation with a cough — without fully eliminating your protective cough reflex.
The polistirex formulation is key to the 12-hour duration. Dextromethorphan is chemically bound to an ion-exchange resin; as the suspension passes through the digestive tract, stomach acid and intestinal enzymes gradually break these bonds, releasing dextromethorphan slowly and steadily over 12 hours rather than all at once. DXM is then metabolized in the liver primarily by CYP2D6, converted to its active metabolite dextrorphan, and eliminated via urine.
At therapeutic doses, dextromethorphan does not bind to mu-opioid receptors, does not cause respiratory depression, and is not a DEA-scheduled substance. It is approximately equivalent to codeine as a cough suppressant but without narcotic properties.
30 mg/5 mL — Extended-release oral suspension (liquid)
Adults and children 12+: 10 mL (60 mg) every 12 hours. Max 20 mL/day.
30 mg/5 mL — Extended-release oral suspension (Children's)
Children 6-11: 5 mL (30 mg) every 12 hours. Children 4-5: 2.5 mL (15 mg) every 12 hours. Do not use in children under 4.
Delsym XR is generally widely available at pharmacies, grocery stores, and online retailers throughout the year. It is not on the FDA's official drug shortage list in 2026. However, it consistently experiences localized stockouts during peak cold and flu season (October through March), when seasonal demand surges and retail inventory cannot keep pace.
During these high-demand periods, availability can vary dramatically by store and ZIP code — one pharmacy may have plenty in stock while a store a few miles away is completely sold out. The specialized polistirex manufacturing process limits how quickly supply can be ramped up in response to demand spikes.
If you're having trouble finding Delsym XR in stock at your local pharmacy, medfinder can help. medfinder calls pharmacies near you to check current stock and texts you the results — no more wasted trips across town.
Delsym XR is an over-the-counter product — no prescription or physician order is required to purchase it. Any adult can buy it directly at a pharmacy or retail store. Dextromethorphan is not DEA-scheduled, so there are no special prescribing requirements or REMS restrictions.
Healthcare providers who may recommend or guide use of Delsym XR (or prescribe prescription alternatives) include:
Telehealth platforms (Teladoc, MDLive, Amazon Clinic) are available nationwide and can evaluate cough symptoms, recommend appropriate OTC products, and write prescriptions for benzonatate or other alternatives when needed — without an in-person visit.
No. Delsym XR (dextromethorphan polistirex) is not a DEA-scheduled controlled substance. It is an over-the-counter medication that can be purchased without a prescription at any pharmacy or retail store.
While dextromethorphan is structurally related to opioid compounds, it does not bind significantly to mu-opioid receptors at therapeutic doses and lacks the analgesic, sedative, or addictive properties of scheduled opioids. At supratherapeutic doses (recreational misuse), DXM can cause dissociative hallucinations — a phenomenon sometimes called 'robo-tripping.' Some states have placed age restrictions on purchasing single-ingredient DXM products due to this misuse potential.
No prescription, prior authorization, REMS program, or DEA registration is required to purchase or dispense Delsym XR.
Most people tolerate Delsym XR well at recommended doses. Common side effects include:
Serious side effects are rare at recommended doses but can occur — particularly with drug interactions:
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Robitussin 12 Hour Cough Relief
Identical active ingredient (dextromethorphan polistirex ER) — a direct therapeutic equivalent to Delsym XR.
Benzonatate (Tessalon Perles)
Prescription non-narcotic cough suppressant; works by numbing lung stretch receptors. Preferred for MAOI patients who cannot use DXM. 100-200 mg three times daily.
Guaifenesin (Mucinex)
OTC expectorant; thins and loosens mucus for productive coughs. Better choice than Delsym XR when cough is wet/productive.
Dextromethorphan HBr (DayQuil Cough, generic)
Immediate-release DXM — same active ingredient, shorter duration (4-8 hours). Requires dosing every 6-8 hours instead of every 12.
Prefer Delsym XR? We can find it.
MAOIs (phenelzine, isocarboxazid, selegiline, tranylcypromine)
majorAbsolutely contraindicated. Combination can cause serotonin syndrome, hypertensive crisis, hyperpyrexia, seizures, and death. Do not use within 14 days of MAOI discontinuation.
SSRIs (fluoxetine, sertraline, escitalopram, paroxetine)
moderateModerate interaction — both increase serotonin activity. Risk of serotonin syndrome increased, especially at higher doses. Fluoxetine and paroxetine are also potent CYP2D6 inhibitors, potentially increasing DXM blood levels.
SNRIs (duloxetine, venlafaxine)
moderateModerate interaction — both increase serotonergic activity. Monitor for serotonin syndrome symptoms.
Tramadol
majorMajor interaction — tramadol is also a serotonin reuptake inhibitor. Combination significantly elevates serotonin syndrome risk and CNS depression.
Alcohol
moderateIncreases CNS depression — dizziness, drowsiness, and overdose risk. Avoid alcohol while taking Delsym XR.
Grapefruit juice
moderateInhibits CYP3A4, increasing DXM blood levels and prolonging effects. Avoid grapefruit products while taking Delsym XR.
St. John's Wort
moderateHerbal supplement that increases serotonin activity. Combination raises serotonin syndrome risk.
Other DXM-containing products (NyQuil, Mucinex DM, Robitussin DM)
majorRisk of DXM double-dosing and overdose. Always check all cold/flu product labels for dextromethorphan content.
Diphenhydramine (Benadryl)
moderatePotent CYP2D6 inhibitor — increases DXM blood levels. Also additive CNS depression.
Delsym XR (dextromethorphan polistirex extended-release suspension) is one of the most effective and convenient OTC cough suppressants available. Its 12-hour extended-release formula means just two doses per day — a meaningful advantage for patients trying to sleep through the night or get through a workday without repeated dosing. It is alcohol-free, sulfite-free, and appropriate for adults and children ages 4 and older.
Its most important safety consideration is the MAOI interaction — Delsym XR is absolutely contraindicated within 14 days of MAOI use. Patients on SSRIs or SNRIs should use the lowest effective dose and monitor for serotonin syndrome symptoms. For patients who cannot use DXM, benzonatate is the primary prescription alternative.
When Delsym XR is hard to find at your local pharmacy, remember that store-brand dextromethorphan polistirex ER suspension (Equate, Amazon Basic Care, CVS Health) is a medically identical and more affordable alternative. And if you need help locating any medication — OTC or prescription — medfinder can check pharmacies near you and text you results without the hassle of calling pharmacy after pharmacy yourself.
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Our medication guides are researched and written to help patients make informed decisions. All content is reviewed for accuracy and updated regularly. Learn more about our standards
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