What class of patients should avoid dextromethorphan usage?

Dextromethorphan is a common over-the-counter cough suppressant found in many cold and cough medications. It is important to consider safety guidelines regarding its use, especially in specific populations. Children under 4 years of age should avoid dextromethorphan because they are at greater risk for serious side effects, including respiratory depression and other adverse reactions. The nervous system of very young children is still developing, and they may not metabolize medications in the same way that older children or adults do, making them more susceptible to complications.

For the other groups mentioned, while there may be considerations for their health conditions, they are not as definitive as that for very young children. For example, patients under 18 may still take dextromethorphan with proper guidance and dosing; patients with diabetes need to watch their overall sugar intake rather than specifically avoiding dextromethorphan; and those with hypertension should monitor their blood pressure but do not have an absolute contraindication to using this medication. Thus, the primary concern and guideline for avoidance clearly focus on very young children, reflecting the increased risk associated with their age group.