Author: Charles Frank

Dextromethorphan Abuse

It is considered less addictive than other common cough suppressants, such as the weak opiate codeine.[4] Since dextromethorphan also acts as a serotonin reuptake inhibitor, users report that regular recreational use over a long period of time can cause withdrawal symptoms similar to those of antidepressant discontinuation syndrome. Additionally, disturbances have been reported in sleep, senses, movement, mood, and thinking. Also, a marked difference is seen between dextromethorphan hydrobromide, contained in most cough suppressant preparations, and dextromethorphan polistirex, contained in the brand name preparation Delsym.

1. If you give these products to children 4-11 years of age, use caution and follow the package directions carefully.
2. At high doses, DXM can produce psychedelic symptoms including mania, panic, extreme agitation, and hallucinations.
3. Dextromethorphan comes as a liquid-filled capsule, a chewable tablet, a dissolving strip, a solution (liquid), an extended-release (long-acting) suspension (liquid), and a lozenge to take by mouth.

Dextromethorphan is available over the counter under many different brand and generic names. Ask your pharmacist any questions you have about this medication, especially if it is new to you. Seek emergency medical attention if you think you have used too much of this medicine. Call your doctor if you experience any unusual problems while you are taking this medication. If you are taking the liquid, do not use a household spoon to measure your dose. Use the measuring spoon or cup that came with the medication or use a spoon made especially for measuring medication.

When people take too much DXM, they might have hallucinations and “out-of-body” sensations. DXM also depresses brain function, particularly the parts of the brain that control breathing and heart function. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. © 2024 StopMedicineAbuse.org, an initiative of the Consumer Healthcare Products Association & leading makers of cough medicine. Dextromethorphan is an NMDA receptor antagonist used to treat cases of dry cough.

If you take certain products together you may accidentally take too much of this medicine. Read the label of any other medicine you are using to see if it contains dextromethorphan. Always ask a doctor before giving a cough or cold medicine to a child. Death can occur from the misuse of cough and cold medicines in very young children.

Recreational use

Recreational DXM use might not be widely appreciated because DXM has legitimate uses and is not thought of as a drug of abuse, making it difficult to assess the public health impact. Data on patterns of drug abuse usually come from reports from Poison Control and emergency physicians. Calls to Poison Control regarding DXM have increased dramatically since 2006. Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed. This medication can cause side effects that may impair your thinking or reactions.

For instance, combining it with drugs like MDMA increases the risk of hyperthermia and can lead to brain damage, seizures, a coma, and death. Do not use any other over-the-counter cough, cold, or allergy medication without first asking your doctor or pharmacist. Dextromethorphan is contained in many combination medicines available over the counter.

DXM was approved by the Food and Drug Administration (FDA) in 1958 and was deemed a safe and effective cough suppressant. Recreational abuse of DXM-containing products began shortly thereafter. In 2005, the FDA issued a warning regarding DXM abuse to increase awareness of this growing trend. This warning was in response to reports of deaths of teens that were related to the use of raw DXM purchased over the Internet. Adding to the danger is that DXM is often taken in combination with other drugs.

Dextromethorphan

This list is not complete and there are numerous other drugs that can interact with dextromethorphan. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. 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.

Check nonprescription cough and cold product labels carefully before using 2 or more products at the same time. These products may contain the same active ingredient(s) and taking them together could cause you to receive an overdose. This is especially important if you will be giving cough and cold medications to a child. When used at the dosage printed on the product label, dextromethorphan (DXM) is a fairly safe drug intended to reduce coughing. Although there is controversy about its effectiveness as a cough suppressant, the effects of DXM at high doses are well documented.

Data sources include Micromedex (updated 3 Mar 2024), Cerner Multum™ (updated 4 Mar 2024), ASHP (updated 12 Feb 2024) and others. Nonprescription cough and cold combination products, including products that contain dextromethorphan, can cause serious side effects or death in young children. If you give these products to children 4-11 years of age, use caution and follow the package directions carefully. A major metabolic catalyst involved is the cytochrome P450 enzyme known as 2D6, or CYP2D6. A significant portion of the population has a functional deficiency in this enzyme and are known as poor CYP2D6 metabolizers.

Brand names of combination products

Combining dextromethorphan with other substances can compound risks. Central nervous system (CNS) stimulants such as amphetamine and/or cocaine can cause a dangerous rise in blood pressure and heart rate. CNS depressants such as ethanol (drinking alcohol) will have a combined depressant effect, which can cause a decreased respiratory rate. Combining dextromethorphan with other CYP2D6 substrates can cause both drugs to build to dangerous levels in the bloodstream.[29][30] Combining dextromethorphan with other serotonergic drugs could possibly cause serotonin syndrome, an excess of serotonergic activity in the CNS and peripheral nervous system. It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements.

Cough suppression

These medicines come in the form of liquids, capsules, gelcaps, lozenges and tablets. Common DXM-containing cough medicines include many forms of Alka Seltzer Plus™, Comtrex™, Coricidin™, Delsym™, Dimetapp™, Mucinex DM™, Pediacare™, Robitussin™, Theraflu™,  Triaminic™, Tylenol Cough & Cold™, Vicks DayQuil™/NyQuil™, Vicks Formula 44™ and more, including store brand versions of these products. People using cold medicines to get high may not realize they are taking high doses of many drugs, not just DXM. Mixing DXM with other drugs or alcohol increases the likelihood of life-threatening conditions.

Stop Medicine Abuse

Grapefruit and grapefruit juices (especially white grapefruit juice, but also including other citrus fruits such as bergamot and lime, as well as a number of noncitrus fruits[25]) generally are recommended to be avoided while using dextromethorphan and numerous other medications. While millions of Americans safely rely on over-the-counter (OTC) cough medicine to temporarily relieve cough symptoms, approximately 1 in 31 teens reports abusing it to get high. It’s possible to overdose on too much DXM, especially if it’s in pure powder form. Someone who overdoses may have brain damage or seizures, and might even die. Taking a lot of DXM causes hallucinations and out-of-body sensations similar to the ones caused by drugs like ketamine and PCP.