It is the result of O-demethylation of the prodrug by several enzymatic systems, although it is chiefly a product of the Cytochrome P450 IID6 (CYP4502D6) pathway.

Pharmacology

Being structurally similar to dextromethorphan, and it has affinity for the same receptors in the central nervous system but with a slight difference in selectivity.

Dextromethorphan is a weak non-competitive NMDA receptor antagonist but dextrorphan is a more potent antagonist. DX is a strong anti-tussive, but is slightly less effective than DM, and has no metabolites with significant therapeutic activity in such capacity and therefore is not a drug available on the market.

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