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foster and thrive 12 hour cough relief dextromethorphan polistirex 30 mg/5mL Suspension, Extended Release

by Strategic Sourcing Services LLC · 1 BOTTLE in 1 CARTON (70677-1025-1) / 89 mL in 1 BOTTLE
NDC 70677-1025-01
🏷️ FDA NDC (as labeled) 70677-1025-1 billing pads the package segment with a zero
OTC Generic On market Non-controlled
🗂️ Data synced Jul 24, 2026 · sources: openFDA · FDA label (DailyMed) · FDA Orange & Purple Book · First Databank · CMS NADAC, ASP, Medicare & Medicaid · RxNorm
📋 All sources & update times →

This page is curated, coded, and maintained by

Compiled from public FDA, CMS, DailyMed, NADAC, and related drug data sources. Editorial policy

🆔 Identity & classification

FDA NDC (as labeled) 70677-1025-1
Product NDC 70677-1025
11-digit billing NDC 70677102501
NCPDP billing unit ML — per mL (volume)
RxCUI 1373045
UNII 9D2RTI9KYH
Application # ANDA091135
SPL Set ID db2e79f7-827f-45da-85ba-f3a774251070
Established class (EPC) Sigma-1 Agonist; Uncompetitive N-methyl-D-aspartate Receptor Antagonist
Mechanism of action Sigma-1 Receptor Agonists; Uncompetitive NMDA Receptor Antagonists
DEA schedule Non-controlled
Marketing category ANDA
Marketing status On market
FDA listing status Listed (active directory)
Marketing start 2023-09-03
Route ORAL
Dosage form SUSPENSION, EXTENDED RELEASE
Substance DEXTROMETHORPHAN HYDROBROMIDE
GPI-14 4310203060G110
GCN Seq No 004630
GCN 17802
HICL code 010295
Ingredient (HICL) Dextromethorphan Polistirex
HIC1 code H
Therapeutic class — broad (HIC1) Nervous System (Except Autonomic)
HIC2 code H6
Therapeutic class — intermediate (HIC2) Drugs Acting Principally On The Midbrain
HIC3 code H6C
Therapeutic class — specific (HIC3) Antitussives, Non-Opioid
AHFS code 48:08.00.00
AHFS class Antitussives
FDB label name FT 12-HR COUGH RLF 30 MG/5 ML
FDB brand name 12-Hour Cough Relief
Legend status O — Over-the-counter (OTC) drug or device
Why two NDCs? The FDA registers this code as 70677-1025-1 — a 5-4-1 layout, and that's what's printed on the package and shown on DailyMed. For insurance claims, every NDC is standardized to a uniform 11-digit 5-4-2 format by adding a zero to the package segment → 70677-1025-01. Same drug, same package — only the format differs.
Where does this data come from?
Identifiers from the FDA openFDA NDC Directory and Structured Product Labeling; RxCUI from RxNorm (NLM); GPI from Medi-Span; GCN / HIC / AHFS / legend from First Databank.

🏷️ RxNorm drug class

This medicine belongs to the Uncompetitive N-methyl-D-aspartate Receptor Antagonist class.

Pharmacologic class Uncompetitive N-methyl-D-aspartate Receptor Antagonist, Sigma-1 Agonist
Drug family (ATC) Other antidepressants, Opium alkaloids and derivatives
How it works Uncompetitive NMDA Receptor Antagonists, Sigma-1 Receptor Agonists
Where does this data come from?
Therapeutic classes from RxNorm RxClass (U.S. National Library of Medicine) — Established Pharmacologic Class (FDA), ATC drug family (WHO) and mechanism of action, matched by this product’s RxCUI.

🏭 Manufacturer & labeler

LabelerStrategic Sourcing Services LLC
Application holderTRIS PHARMA INC
FDA applicationANDA091135 (ANDA)
Labeler code70677
First marketedSep 2023
Product typeHuman Otc Drug
Portfolio316 products on file
The labeler markets the product; the application holder owns the FDA approval. They’re often the same company but can differ (e.g. a repackager or an authorized generic). A mailing address / phone appears here when the manufacturer includes it in the product’s FDA label (not all do).
Where does this data come from?
Labeler, application holder and registered establishment from the FDA openFDA NDC Directory and Drugs@FDA; address/contact from the product’s FDA label.

🩺 Clinical

Label name FT 12-HR COUGH RLF 30 MG/5 ML Ingredient Dextromethorphan Polistirex
📖 What it is MedlinePlus · NLM

Dextromethorphan is used to temporarily relieve cough caused by the common cold, the flu, or other conditions. Dextromethorphan will relieve a cough but will not treat the cause of the cough or speed recovery. Dextromethorphan is in a class of medications called antitussives. It works by decreasing activity in the part of the brain that causes coughing.

Read the full MedlinePlus article ↗
📗 Our plain-language guide HelloPharmacist
  • It won't necessarily silence your cough entirely, but it does temporarily suppress the cough reflex and reduce how intense and frequent your cough is. It can also help reduce that...
  • What exactly does dextromethorphan do — will it stop my cough completely?
  • It depends on your child's age and the specific product. Most dextromethorphan products should not be given to children under 4 years old without a doctor's guidance. Some products...
  • This is a really important question. If your antidepressant is an MAOI (monoamine oxidase inhibitor), you absolutely cannot take dextromethorphan — not while you're on it, and not...
📖 Read our full Dextromethorphan guide →

Supplement & herbal interactions

🌿 Drug–supplement interaction checker →
Where does this data come from?
Plain-language summary from MedlinePlus (U.S. National Library of Medicine); supplement & herbal interactions and nutrient depletion data from the Natural Medicines database; our full guide is HelloPharmacist editorial content.

🧪 Inactive Ingredients / Excipients

Inactive ingredients, also called excipients, are components of the drug product other than the active ingredient. They may include fillers, dyes, coatings, preservatives, flavors, or other formulation ingredients.

Loading inactive ingredients from the official FDA label in the background. No external source is being called by this page request.
Where does this data come from?
Source: official FDA Structured Product Labeling (SPL) via DailyMed and the openFDA label index. Structured IACT rows and label-wide narrative are kept separate; availability and product-level specificity depend on the submitted label.

Inactive ingredient FAQ

Are inactive ingredients the same for every manufacturer?
No. Inactive ingredients can differ by manufacturer, dosage form, strength, and package / product version.
Why might an inactive ingredient be missing?
Some SPLs do not provide a complete structured inactive-ingredient list, and older or unusual labels may only include the information in narrative text.
Can inactive ingredients matter?
Yes. They can matter for allergies, intolerances, dyes, gluten / lactose concerns, preservatives, and formulation differences — but confirm with a pharmacist or the manufacturer when it’s clinically important.

💲 Pricing

A drug doesn't have one price. Each row is a different public payment system, and none is what you'd pay at the counter — that depends on your insurance. The ⓘ on each row explains what it measures.

Price systemPer mLPer package
Retail pharmacies payNADAC · weekly $0.066 $5.91 / 89 ml
Medicaid paysCMS SDUD · 12 mo $0.0829 $7.38 / 89 ml
Medicare drug plans payPart D · quarterly No Part D plan price is available for this NDC in our data.
NADAC price history (per mL) — tap or hover for the price & month
Feb 2024 Feb 2026 May 2026 Sep 2026 $0.068 $0.064
▲ Up 3% over the last 11 months.
Where does this data come from?
NADAC (National Average Drug Acquisition Cost) is the CMS weekly pharmacy-acquisition-cost survey — what pharmacies pay. ASP (Average Sales Price) is the CMS Medicare Part B drug-payment file, published quarterly. Medicaid pays is computed by us from CMS State Drug Utilization Data (total reimbursed ÷ units, trailing 12 months) — gross of rebates and inclusive of dispensing fees, so it reflects what Medicaid paid, not an acquisition cost. Medicare drug plans pay is the median negotiated point-of-sale unit cost across plans listing this NDC in the CMS quarterly Prescription Drug Plan pricing files, before rebates. The VA pays is the federal contract price (FSS, and the statutory Big 4 ceiling where listed) from the VA National Acquisition Center pharmaceutical price file. All are free public government data; each measures a different payer, so the figures are not directly comparable.

🔁 Therapeutic equivalents

ProductLabelerPackNADAC/unitTEStatusPrice vs. this
Good Sense Cough DM 30 mg/5mL 00113-0958-21 L. 1 bottle $0.066 — Availability likely —
cough dm 30 mg/5mL 00904-6312-56 Major 1 bottle $0.066 — Availability likely —
dextromethorphan polistirex extended release 30 mg/5mL 45802-0433-21 Padagis 1 bottle $0.066 — Availability likely —
Good Neighbor Pharmacy Cough DM ER 30 mg/5mL 46122-0141-21 Amerisource 1 bottle $0.066 — Availability likely —
Leader Cough DM 30 mg/5mL 70000-0187-01 Cardinal 1 bottle $0.066 — Availability likely —
leader childrens cough dm 30 mg/5mL 70000-0195-01 Cardinal 1 bottle $0.066 — Availability likely —
Leader Cough DM 30 mg/5mL 70000-0302-01 Cardinal 1 bottle $0.066 — Availability likely —
foster and thrive 12 hour cough relief 30 mg/5mLthis 70677-1025-01 Strategic 1 bottle $0.066 — Availability likely —
foster and thrive 12 hour cough relief 30 mg/5mL 70677-1026-01 Strategic 1 bottle $0.066 — Availability likely —
Delsym (Dextromethorphan) 30 mg/5mL 63824-0173-63 Reckitt 1 bottle $0.102 — FDA listed +53%
Delsym (Dextromethorphan) 30 mg/5mL 63824-0177-63 Reckitt 1 bottle $0.102 — FDA listed +53%
Robitussin 12 Hour Cough Relief 30 mg/5mL 00031-8655-10 Haleon 1 bottle — — FDA listed —
Childrens Robitussin 12 Hour Cough Relief 30 mg/5mL 00031-8725-10 Haleon 1 bottle — — FDA listed —
Childrens Robitussin 12 Hour Cough Relief 30 mg/5mL 00031-8726-10 Haleon 1 bottle — — FDA listed —
Robitussin 12 Hour Cough Relief 30 mg/5mL 00031-8753-03 Haleon 1 bottle — — FDA listed —
Robitussin 12 Hour Cough Relief 30 mg/5mL 00031-8754-15 Haleon 1 bottle — — FDA listed —
Robitussin 12 Hour Cough Relief 30 mg/5mL 00031-8755-15 Haleon 1 bottle — — FDA listed —
good sense cough dm 30 mg/5mL 00113-0384-21 L. 1 bottle — — Discontinued —
Cough DM 30 mg/5mL 00363-0384-21 Walgreen 1 bottle — — FDA listed —
Cough DM 30 mg/5mL 00363-0494-21 Walgreen 1 bottle — — Discontinued —
childrens cough dm 30 mg/5mL 00363-0899-21 Walgreen 1 bottle — — FDA listed —
up and up 12 hour cough relief 30 mg/5mL 11673-0114-28 Target 1 bottle — — FDA listed —
Cough DM 30 mg/5mL 11822-0384-01 Rite 1 bottle — — Discontinued —
Cough DM 30 mg/5mL 11822-0494-01 Rite 1 bottle — — Discontinued —
Cough DM 30 mg/5mL 11822-0958-01 Rite 1 bottle — — Discontinued —
cough dm 30 mg/5mL 17856-6312-01 ATLANTIC 5 ml — — FDA listed —
signature care 12 hour cough relief 30 mg/5mL 21130-0012-21 Safeway 1 bottle — — FDA listed —
Signature Care Cough Relief 30 mg/5mL 21130-0520-21 Safeway 1 bottle — — FDA listed —
Cough Dm 30 mg/5mL 21130-0538-21 Safeway 1 bottle — — FDA listed —
signature care childrens 12 hour cough relief 30 mg/5mL 21130-0890-21 Safeway 1 bottle — — FDA listed —
Cough DM 30 mg/5mL 30142-0384-21 Kroger 1 bottle — — FDA listed —
cough dm 30 mg/5mL 30142-0494-21 Kroger 1 bottle — — FDA listed —
TopCare Cough DM 30 mg/5mL 36800-0494-21 Topco 1 bottle — — FDA listed —
Topcare Cough DM 30 mg/5mL 36800-0552-21 Topco 1 bottle — — FDA listed —
Cough DM 30 mg/5mL 37808-0384-21 H 1 bottle — — FDA listed —
equaline cough dm 30 mg/5mL 41163-0384-21 United 1 bottle — — FDA listed —
Cough DM 30 mg/5mL 41250-0384-28 Meijer 1 bottle — — FDA listed —
Cough DM 30 mg/5mL 41250-0494-28 Meijer 1 bottle — — FDA listed —
cough dm childrens 30 mg/5mL 41250-0899-28 Meijer 1 bottle — — FDA listed —
Cough DM 30 mg/5mL 41250-0958-28 Meijer 1 bottle — — FDA listed —
CareOne Cough DM 30 mg/5mL 41520-0384-21 American 1 bottle — — FDA listed —
CareOne Cough DM 30 mg/5mL 41520-0958-21 American 1 bottle — — FDA listed —
cough dm 30 mg/5mL 42507-0384-21 HyVee 1 bottle — — FDA listed —
cough dm 30 mg/5mL 42507-0494-21 HyVee 1 bottle — — FDA listed —
Equate Cough DM 30 mg/5mL 49035-0384-21 Wal-Mart 1 bottle — — FDA listed —
equate cough dm 30 mg/5mL 49035-0899-28 Wal-Mart 1 bottle — — FDA listed —
Delsym 30 mg/5mL 50090-0224-00 A-S 1 bottle — — FDA listed —
12 Hr Relief Cough Dm 30 mg/5mL 51316-0263-21 CVS 1 bottle — — FDA listed —
Childrens 12 Hr Cough Relief 30 mg/5mL 51316-0429-28 CVS 1 bottle — — FDA listed —
DG Health Cough DM 30 mg/5mL 55910-0384-21 Dolgencorp 1 bottle — — FDA listed —
DG Health Cough DM 30 mg/5mL 55910-0958-21 Dolgencorp, 1 bottle — — FDA listed —
Cough DM 30 mg/5mL 56062-0384-21 Publix 1 bottle — — FDA listed —
Dextromethorphan Polistirex 30 mg/5mL 58602-0610-05 Aurohealth 1 bottle — — FDA listed —
Dextromethorphan Polistirex 30 mg/5mL 58602-0611-05 Aurohealth 1 bottle — — FDA listed —
Dextromethorphan Polistirex 30 mg/5mL 58602-0617-05 Aurohealth 1 bottle — — FDA listed —
Dextromethorphan Polistirex 30 mg/5mL 58602-0618-05 Aurohealth 1 bottle — — FDA listed —
Cough DM 30 mg/5mL 59779-0384-21 CVS 1 bottle — — FDA listed —
Cough DM 30 mg/5mL 59779-0709-21 CVS 1 bottle — — FDA listed —
Cough DM 30 mg/5mL 59779-0958-21 CVS 1 bottle — — FDA listed —
Delsym 30 mg/5mL 63824-0171-22 Reckitt 1 cello — — FDA listed —
Delsym 30 mg/5mL 63824-0175-22 Reckitt 1 cello — — FDA listed —
Dextromethorphan Polistirex Extended-Release 30 mg/5mL 65162-0700-76 Amneal 1 bottle — — FDA listed —
Dextromethorphan Polistirex Extended-Release 30 mg/5mL 65162-0799-76 Amneal 1 bottle — — FDA listed —
dextromethorphan polistirex extended release 30 mg/5mL 72162-2281-02 Bryant 1 bottle — — FDA listed —
basic care cough dm 30 mg/5mL 72288-0384-28 Amazon.com 1 bottle — — FDA listed —
basic care cough dm 30 mg/5mL 72288-0494-28 Amazon.com 1 bottle — — FDA listed —
basic care childrens cough dm 30 mg/5mL 72288-0899-28 Amazon.com 1 bottle — — FDA listed —
basic care childrens cough dm 30 mg/5mL 72288-0958-28 Amazon.com 1 bottle — — FDA listed —
12 hr relief cough dm 30 mg/5mL 51316-0943-21 CVS 1 bottle — — FDA listed —
cough dm 30 mg/5mL 72288-0389-28 Amazon.com 1 bottle — — FDA listed —
About this product: this is a generic version of the medicine. FDA equivalence ratings are shown when available, and other versions are listed above, least expensive first.
Where does this data come from?
Equivalents are other NDCs of the same ingredient, form and route from the openFDA NDC Directory, ranked least-expensive-first by NADAC. Therapeutic-equivalence (AB) ratings come from the FDA Orange Book; biologics use the FDA Purple Book for biosimilar & interchangeable status.

⏳ Availability & generic status

🏛️
2023
On the market since
Sep 2023
📍
2026
Currently FDA-listed
3 years listed
🔓
·
Generic on the market
this product is a generic
✅This is a generic drug

This product is an FDA-approved generic. Other versions of the same drug are listed under Therapeutic equivalents, least expensive first.

Where does this data come from?
Patents and exclusivity from the FDA Orange Book (small-molecule drugs), refreshed from public FDA data. Generic launch timing is an estimate, not a guarantee.

🗺️ Medicaid utilization & spend

📍 This exact package only: Medicaid data is reported per full 11-digit NDC — labeler, product and pack size — so every number here is for 70677-1025-01, not the drug overall. Other pack sizes report separately.
💊 Pharmacy benefit only: These are Medicaid outpatient pharmacy claims, billed by NDC. They exclude the medical benefit — clinic- or hospital-administered drugs billed under HCPCS J-codes — so drugs used mostly that way (e.g. Avastin, Lucentis, Keytruda) can look low or missing here. That’s expected, not an error.
📅 Q1 2025 – Q1 2026 · 5 quarters of data
ⓘ The newest quarter is usually incomplete when first published; states restate recent quarters in later CMS releases, so the latest figures typically revise upward. State coverage-policy changes can also shift quarter-to-quarter totals.
Prescriptions last 4 qtrs
510
Units reimbursed last 4 qtrs
60.9K
Gross reimbursed last 4 qtrs
$5K
Avg / prescription
$9.89
Avg / unit
$0.0829
Latest quarter Q1 2026
166Rx
Medicaid pays / mL
$0.0829
gross reimbursed
vs
NADAC / mL
$0.0664
acquisition cost
=
Spread
+$0.0165
+25% vs cost
What Medicaid paid per mL (before rebates; includes the pharmacy’s dispensing fee) compared with NADAC — the average price pharmacies pay to buy the drug. A positive spread means Medicaid reimbursed more than the purchase price, before manufacturer rebates.
Fee-for-service vs managed care ⓘ
89% MCO
Fee-for-service · 58 Rx Managed care · 452 Rx
State Medicaid map
Alaska: no data reported AK Maine: no data reported ME Washington: no data reported WA Idaho: no data reported ID Montana: no data reported MT North Dakota: no data reported ND Minnesota: 4,805 units · 83.8 per 100k residents MN Wisconsin: no data reported WI Michigan: no data reported MI New York: 4,098 units · 20.9 per 100k residents NY Vermont: no data reported VT New Hampshire: no data reported NH Oregon: no data reported OR Nevada: no data reported NV Wyoming: no data reported WY South Dakota: no data reported SD Iowa: no data reported IA Illinois: no data reported IL Indiana: 5,044 units · 73.5 per 100k residents IN Ohio: no data reported OH Pennsylvania: no data reported PA New Jersey: 33,145 units · 357 per 100k residents NJ Massachusetts: no data reported MA California: no data reported CA Utah: no data reported UT Colorado: no data reported CO Nebraska: no data reported NE Missouri: no data reported MO Kentucky: 8,745 units · 193 per 100k residents KY West Virginia: no data reported WV Virginia: no data reported VA Maryland: no data reported MD Connecticut: no data reported CT Rhode Island: no data reported RI Arizona: no data reported AZ New Mexico: no data reported NM Kansas: no data reported KS Arkansas: no data reported AR Tennessee: no data reported TN North Carolina: no data reported NC South Carolina: no data reported SC Delaware: no data reported DE Oklahoma: no data reported OK Louisiana: no data reported LA Mississippi: 1,924 units · 65.4 per 100k residents MS Alabama: no data reported AL Georgia: 3,097 units · 28.1 per 100k residents GA D.C.: no data reported DC Hawaii: no data reported HI Texas: no data reported TX Florida: no data reported FL
Units reimbursed · per 100k residents
20.9357
gray = no data reported ⓘ
Colors are per 100,000 residents, so big states don’t automatically dominate. Tap or hover a state for its actual totals.
Tap or hover a state
…for its Medicaid breakdown
🏆 Top states by units · per 100k residents
1 New Jersey 357 /100k
2 Kentucky 193 /100k
3 Minnesota 83.8 /100k
4 Indiana 73.5 /100k
5 Mississippi 65.4 /100k
6 Georgia 28.1 /100k
7 New York 20.9 /100k
National units — by quarter
💵 About the dollar figures: “reimbursed” is what Medicaid paid pharmacies before confidential manufacturer rebates, so the program’s real net cost is lower than these numbers. Fee-for-service and managed-care claims are combined unless split above. Source: CMS State Drug Utilization Data; per-100k rates use 2023 Census population estimates.

📦 Packaging — all sizes for this product

Package NDCDescription Marketing startStatus
70677-1025-01 You're viewing this 1 BOTTLE in 1 CARTON (70677-1025-1) / 89 mL in 1 BOTTLE 2023-09-03 Active

📄 FDA label — Drug Facts FDA SPL

The complete FDA label for this product — the official Drug Facts labeling, verbatim, section by section. Jump with a chip, search within the label, or expand everything.
🎯 Indications and Usage ⏱️ Dosage and Administration ⚠️ Warnings 📦 Storage and Handling 🧪 Active Ingredient 🧪 Inactive Ingredients 🎯 Purpose
🎯 Indications and Usage 33 words ▾

Uses temporarily relieves • cough due to minor throat and bronchial irritation as may occur with the common cold or inhaled irritants • the impulse to cough to help you get to sleep

⏱️ Dosage and Administration 110 words ▾

Directions • shake bottle well before use • measure only with dosing cup provided • do not use dosing cup with other products • dose as follows or as directed by a doctor • mL = milliliter adults and children 12 years of age and over 10 mL every 12 hours, not to exceed 20 mL in 24 hours children 6 to under 12 years of age 5 mL every 12 hours, not to exceed 10 mL in 24 hours children 4 to under 6 years of age 2.5 mL every 12 hours, not to exceed 5 mL in 24 hours children under 4 years of age do not use

⚠️ Warnings 176 words ▾

Warnings Do not use if you are now taking a prescription monoamine oxidase inhibitor (MAOI) (certain drugs for depression, psychiatric or emotional conditions, or Parkinson’s disease), or for 2 weeks after stopping the MAOI drug. If you do not know if your prescription drug contains an MAOI, ask a doctor or pharmacist before taking this product. Allergy Alert: Contains sodium metabisulfite, a sulfite that may cause allergic-type reactions.

Ask a doctor before use if you have • chronic cough that lasts as occurs with smoking, asthma, or emphysema • cough that occurs with too much phlegm (mucus) Stop use and ask a doctor if • side effects occur. You may report side effects to FDA at 1-800-FDA-1088. • cough lasts more than 7 days, cough comes back, or occurs with fever, rash, or headache that lasts. These could be signs of a serious condition.

If pregnant or breast-feeding, ask a health professional before use. Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center right away (1-800-222-1222).

📦 Storage and Handling 23 words ▾

Other information • each 5 mL contains: sodium 5 mg • store at 20° to 25°C (68° to 77°F) • dosing cup provided

🧪 Active Ingredient 14 words ▾

Active ingredient (in each 5 mL) Dextromethorphan polistirex equivalent to 30 mg dextromethorphan hydrobromide

🧪 Inactive Ingredients 42 words ▾

Inactive ingredients artificial grape flavor, D&C Red #30 aluminum lake, FD&C Blue #1 aluminum lake, glycerin, high fructose corn syrup, methylparaben, polysorbate 80, polyvinyl acetate, povidone, propylparaben, purified water, sodium metabisulfite, sodium polystyrene sulfonate, sucrose, tartaric acid, tragacanth gum, triacetin, xanthan gum

🎯 Purpose 3 words ▾

Purpose Cough suppressant

Source: FDA Structured Product Labeling, mirrored from DailyMed / openFDA. Prefer the government’s original formatting? View this label on DailyMed ↗
← 70677-1024-01 · Strategic 70677-1026-01 · Strategic →
For educational and professional reference only — not medical advice. Pricing reflects published NADAC and CMS ASP (free public data) and may differ from your acquisition cost; always verify before billing or dispensing.