Apply for Nuedexta (Dextromethorphan and Quinidine) Copay Assistance

Nuedexta has a published average wholesale price of about $2,000 for a 30-day supply at the standard dose, and generic dextromethorphan and quinidine lists at about $1,800 to $1,900. What you actually pay depends on your insurance, pharmacy and any assistance you qualify for.

A 30-day supply assumes the standard maintenance dose of one capsule every 12 hours. At QuickRx, eligible patients may pay $0 through a copay card, patient assistance or a foundation grant. Call (917) 830-2525 to find out what you qualify for.

Pricing reflects Average Wholesale Price (AWP) from Lexidrug (Medi-Span), reviewed September 25, 2026. AWP is a benchmark list price and is not a quote or a guarantee of what any patient will pay. Prices vary by pharmacy, dose, insurance and available assistance and are subject to change.

Yes. The manufacturer of Nuedexta offers a co-pay savings card for patients with private or commercial insurance, and QuickRx can apply for it on your behalf.

Copay cards like this one generally cannot be used with Medicare, Medicaid, TRICARE or VA coverage because of federal anti-kickback rules. Card terms, including any savings limits, are set by the manufacturer and can change. If you are on a government plan, QuickRx will look at foundation grants and other assistance instead. Call (917) 830-2525 to get started.

Nuedexta copay assistance is any outside help that lowers what you pay at the pharmacy, including manufacturer copay cards, patient assistance and independent foundation grants.

Each source works differently. A copay card pays part of your share after your commercial insurance pays. Foundation grants help patients, including many on Medicare, cover out-of-pocket costs when a fund is open. Patient assistance can help people who are uninsured or cannot afford treatment.

QuickRx coordinates all of them for you: we check your coverage, apply on your behalf, track approvals and handle renewals, all at no cost to you.

Most patients with a valid Nuedexta or generic dextromethorphan and quinidine prescription can qualify for some form of assistance; which one depends mainly on your insurance.

• Commercial or private insurance: may qualify for the manufacturer copay card on brand-name Nuedexta.
• Medicare or Medicaid: may qualify for independent foundation grants when a fund for your condition is open.
• Uninsured or underinsured: may qualify for patient assistance, usually based on income.

A QuickRx navigator can check all of these in one call at (917) 830-2525.

Yes, Medicare patients can often get help through independent foundation grants, even though they cannot use the manufacturer copay card.

Foundation funds open and close during the year depending on available money, so timing matters. QuickRx monitors which funds are accepting applications and applies as soon as one opens for your condition. We also review whether Extra Help (the Medicare Part D Low-Income Subsidy) may apply to you.

Yes. Generic dextromethorphan and quinidine is available in the US in the same 20 mg / 10 mg capsule strength as brand-name Nuedexta.

The generic lists at a lower wholesale price than the brand. Whether your plan covers the brand, the generic or both, QuickRx can fill the version your prescription calls for and help you find assistance for it.

No. QuickRx Specialty Pharmacy provides its copay assistance coordination free of charge.

That includes checking your eligibility, preparing and submitting applications, following up with program administrators, appeals and annual renewals. You will never receive a bill from QuickRx for this service.

Nuedexta is FDA-approved to treat pseudobulbar affect (PBA), a condition that causes sudden, uncontrollable episodes of laughing or crying that do not match how a person actually feels.

PBA usually happens alongside another neurologic condition, such as ALS, multiple sclerosis, stroke, Alzheimer disease or other dementias, Parkinson disease or a traumatic brain injury. Nuedexta is also sometimes used off-label for agitation in Alzheimer disease, based on limited clinical trial data. Your prescriber decides whether it is right for you.

Nuedexta combines two medicines: dextromethorphan, which acts on the brain to help control PBA episodes, and a low dose of quinidine, which keeps the body from breaking down dextromethorphan too quickly.

Dextromethorphan binds to sigma-1 receptors in the brain, although its exact mechanism in PBA is not fully known. Quinidine blocks the liver enzyme CYP2D6, which raises dextromethorphan levels in the blood about 20-fold. The quinidine dose in Nuedexta is only 1% to 3% of the amount used to treat heart rhythm problems.

Nuedexta is an oral capsule usually started at one capsule once a day for 7 days, then increased to one capsule every 12 hours.

Each capsule contains dextromethorphan 20 mg and quinidine 10 mg. It may be taken with or without food, and the two daily doses should be spaced about 12 hours apart. The labeled maximum is two capsules in 24 hours. Because PBA can improve on its own, your prescriber should check periodically whether you still need treatment. Always follow your prescriber’s instructions.

The most common side effect of Nuedexta is diarrhea, reported in about 13% of adults in clinical studies.

Other side effects reported in 1% to 10% of patients include dizziness (10%), vomiting (5%), weakness (5%), swelling in the legs or feet (5%), cough (5%), urinary tract infection (4%), flu (4%), gas (3%) and a rise in the liver enzyme GGT (3%). Falls, muscle spasms and QT prolongation on an ECG have also been reported.

Tell your prescriber about any side effect that bothers you or does not go away. This is not a complete list.

Yes. Nuedexta can cause heart rhythm changes, low platelet counts, liver problems and serious drug interactions, so it is not safe for everyone.

Other warnings include dizziness and falls, especially in older adults, a lupus-like syndrome, anticholinergic effects in people with myasthenia gravis, and risk of misuse in people with a history of drug abuse.

Nuedexta has many significant drug interactions, so your prescriber and pharmacist should review every medicine and supplement you take before you start.

• MAO inhibitors: must not be taken with Nuedexta or within 2 weeks of stopping one.
• QT-prolonging drugs metabolized by CYP2D6 (for example, pimozide and thioridazine): must not be combined.
• Other QT-prolonging medicines: use with caution because heart rhythm effects can add up.
• Antidepressants and other serotonergic drugs (such as SSRIs, SNRIs and triptans): can raise the risk of serotonin syndrome.
• CYP2D6 substrates (some antidepressants, antipsychotics, tamoxifen and others): quinidine can raise their levels or reduce their effect.
• Moderate or strong CYP3A4 inhibitors: may raise quinidine levels and further prolong the QT interval.
• Alcohol: may increase dextromethorphan side effects.

Avoid grapefruit juice, which can raise quinidine levels, and tonic water, which contains quinine. QuickRx pharmacists review interactions on every fill; call (917) 830-2525 with questions.

Patients at risk for heart rhythm problems should have an ECG before starting Nuedexta and again 3 to 4 hours after the first dose.

Your care team should also check potassium and magnesium before and during treatment, since low levels raise the risk of QT prolongation, along with periodic blood counts and liver and kidney function tests.

Nuedexta can be used in older adults and in people with mild to moderate kidney or liver impairment, but it calls for extra caution.

The Beers Criteria list dextromethorphan and quinidine as a medicine to use carefully in adults 65 and older because of fall, drug interaction and QTc risks, while noting it is still appropriate for treating PBA. No dose change is needed for mild to moderate kidney impairment (creatinine clearance 30 to 80 mL/minute) or mild to moderate liver impairment (Child-Pugh A or B), although side effects increase with moderate liver impairment. Severe kidney or liver impairment has not been studied.

Store Nuedexta at room temperature, 25°C (77°F), with brief excursions allowed between 15°C and 30°C (59°F to 86°F).

Keep capsules in their original container, out of reach of children and pets. Ask your QuickRx pharmacist at (917) 830-2525 how to dispose of any medicine you no longer need.

QuickRx is a URAC- and ACHC-accredited specialty pharmacy licensed in all 50 states that handles Nuedexta copay assistance for you, free of charge, and delivers to your home.

Our patient navigators work with patients and caregivers living with PBA and the neurologic conditions behind it. We apply for copay cards and grants on your behalf, manage prior authorizations, review your medicines for interactions and send refill reminders. We ship to all 50 states. Call (917) 830-2525 to get started.