New Delhi:Amid rising caution over the use of the widely prescribed cough suppressant dextromethorphan, medical practitioners and pharmacies in Sri Ganganagar, Rajasthan are increasingly switching patients to alternative medicines. According to local reports, several clinics and chemists have started recommending substitutes such as levocloperastine, ambroxol, bromhexine, cetirizine + phenylephrine combinations, and herbal syrups in place of dextromethorphan. These options are being offered particularly in cases where patients are unable to tolerate the cough suppressant or where its use is considered unsafe. Among the alternatives, levocloperastine has emerged as a preferred choice due to its milder side-effect profile. Ambroxol and bromhexine, both mucolytics, are being prescribed where a productive cough needs thinning of mucus. Meanwhile, combinations of antihistamines and decongestants like cetirizine and phenylephrine are being used for patients with associated nasal congestion and postnasal drip. For those seeking gentler remedies, herbal syrups with soothing properties are being positioned as natural solutions. Clinicians note that the shift away from dextromethorphan stems from its risk of misuse and potential adverse effects on the central nervous system. As a result, many prefer to prescribe agents that not only manage cough symptoms but also contribute additional therapeutic benefits such as mucus clearance or allergy relief. Medical literature supports these practices, with levocloperastine recognised as a non-opioid antitussive with fewer sedative effects, and ambroxol/bromhexine established as standard expectorants in respiratory care. The substitution trend reflects a cautious, patient-centric approach by healthcare providers in the region, reports DainikBhaskar.