A DXM overdose can be fatal when combined with other substances, including alcohol. If you suspect someone has taken too much DXM with other substances, call 911 immediately. For this reason, it’s important to check with your doctor or pharmacist before taking any of these products while taking dextromethorphan.

Mixing DXM with alcohol greatly increases the risks, leading to dangerous levels of intoxication and potentially fatal consequences. Alcohol also interacts with NMDA receptors in the brain, which is why you should avoid drinking while taking dextromethorphan. Combining two substances that affect the body in a similar manner can greatly increase the risk of overdose and exacerbate the negative effects these substances have on the body.

What should I do if I miss a dose of dextromethorphan?

An interaction can occur because one substance causes another substance to have a different effect than expected. Keep reading to learn about dextromethorphan’s possible interactions. Dextromethorphan (Delsym, Robitussin) can interact with alcohol, other medications, and some supplements. For example, dextromethorphan can interact with selective serotonin reuptake inhibitors (SSRIs). Clearly, mixing DXM and alcohol comes with a host of risks, most of them serious. Misusing either substance alone can be dangerous enough, but taking them together amplifies this risk and reinforces addictive behaviors.

One of the main safety concerns with taking cough drops while drinking alcohol is the risk of interactions with dextromethorphan (DXM). DXM is a cough suppressant that works by depressing activity in the brain centers responsible for coughing. When taken in very high doses, DXM can produce euphoric effects similar to dissociative hallucinogens. Dextromethorphan (DXM), an ingredient in some of the most widely used cold medicines, is becoming increasingly popular as a recreational drug. It’s said to induce hallucinations and happiness, and it’s often mixed with other drugs to enhance their effects.

Monitoring the weeping of young animals while they are held or not held is a simple method for objectively studying such effects. This contact comfort is partially mediated by the activation of brain opioid systems, as demonstrated by different preclinical and clinical studies 22. Neurochemicals other than opioids contribute to the sensation of contact comfort.

Does my health history affect whether I should take dextromethorphan?

Nonetheless, about 1.5 million Americans misuse DXM and other cough medications to get high. Many people use cough remedies containing dextromethorphan, also called DXM, for quick cough relief. Its effectiveness is well known in over-the-counter medicines like Robitussin, and it is a widely used ingredient in many different cough remedies. But when DXM is combined with another strong substance like alcohol, users put themselves at great risk for harm. So what is dextromethorphan, and how does combining alcohol and Robitussin affect those with substance abuse issues? Let’s look at what you need to know if you or someone you love is using alcohol and DXM.Many people use cough remedies containing dextromethorphan, also called DXM, for quick cough relief.

The concomitant use of DXM and alcohol causes easy dissociation and high‐dose usage of DXM and AWS are difficult to distinguish. We report acute psychotic dissociation induced by DXM and alcohol in a patient with alcohol dependence, which made it difficult to distinguish alcohol withdrawal symptoms with limited information. The psychotic symptoms were ameliorated by haloperidol; however, in cases of DXM abuse, haloperidol treatment should be avoided.

Health Conditions

Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Dextromethorphan may cause allergic reactions, which can be serious. Stop taking dextromethorphan and get help right away if you have any of the following symptoms of a serious allergic reaction.

• The maximum daily recommended dose of DXM is 120 milligrams (mg) taken in divided doses.
• A drug’s half-life is how long it takes half a dose to be eliminated from your body.
• When DXM is misused, larger doses are taken to get a “high” or hallucinogenic effect.
• It’s said to induce hallucinations and happiness, and it’s often mixed with other drugs to enhance their effects.

These include stimulant drugs like amphetamines and depressant drugs like benzodiazepines. Someone who is dealing with dextromethorphan and alcohol abuse will likely show signs in their physical and mental health. Seizures are sudden changes in the electrical activity of the brain, and they can cause convulsions, loss of consciousness, and death. People who abuse DXM and alcohol together in high doses are at increased risk for seizures. Delirium is a state of confusion or dissociation caused by many different things, including infection, illness, injury, and substance abuse. Delirious people may have trouble thinking clearly, they may be disoriented, and they may experience an out-of-body sensation.

Dextromethorphan Oral Forms Interactions: Alcohol, Medications, and Others

If you take dextromethorphan with a drug that affects how it’s broken down, talk with your doctor if you have side effects that are bothersome, such as nausea, drowsiness, or fatigue. If you take dextromethorphan with a drug that affects how it’s broken down, your doctor may recommend a lower dose of dextromethorphan or prescribe a lower dose of the other drug. You should not take a higher dose of either medication than what’s prescribed or recommended. If you have questions about avoiding alcohol while taking dextromethorphan, talk with your doctor or pharmacist.

Risks of Mixing Dextromethorphan and Alcohol

Tell your healthcare provider if you have any of these side effects that bother you. €œRobo-tripping” is a slang term for misusing DXM cough medicine. The drug is sometimes mixed with soda or candy to mask the unpleasant taste of cough syrup. Both DXM and alcohol also act as central nervous system depressants. Their combined use can significantly slow brain activity and reduce the function of vital organs, leading to a potentially lethal decrease in heart rate and suppressed breathing. The additive effect of mixing these substances is particularly hazardous, with the potential to lead to coma or death.

How to Get Help For a Dextromethorphan Addiction

This leads to calming effects, reduced anxiety, and impaired coordination. Taking dextromethorphan exactly as prescribed can also help prevent interactions. As with any drug or supplement, talk with your doctor before using cannabis with dextromethorphan. They both dull your senses and slow down your coordination and judgment. Mixing the two can also cause severe nausea and vomiting, sometimes lasting for hours.

DXM works by affecting the brain’s cough center in the medulla, which is responsible for triggering the cough reflex. By altering the signals sent to this area, DXM reduces the urge to cough. At higher doses, DXM acts on the NMDA (N-methyl-D-aspartate) receptors in the brain.

While the combination of DXM and promethazine is not commonly reported in drug abuse or emergency-room cases, misuse could lead to significant health risks. Stores have started to keep these cough and cold remedies behind the counter to reduce access and potential for teen abuse. Some makers of OTC medicines with DXM have put warning labels on their packaging about the potential for abuse. However, recent teen interest in abuse of combined DXM and promethazine is concerning.

The glutamatergic system has become a significant focus of research 25. Despite the existence of multiple classes of monoamine-based drugs, a considerable number of patients fail to achieve durable remission of depressive symptoms. The NDEWS recently checked for recent reports of saccharine (artificial sugar) being detected in abused drugs. Putting on their detective hats, the NDEWS team discovered that increased saccharine in drugs was caused by users adding cough syrup to promethazine. The signal for this combination was detected in more than double the number noted in early 2024.

Benadryl is a commonly used medicine for allergies that is available over the counter and with a prescription. It is a potent first-generation antihistamine that can cause drowsiness. Taking alcohol with Benadryl can increase the sedating effect and drowsiness and even lead to the danger of overdosing.

Being well-informed about potential health risks and exercising caution is key to safely using cough drops with alcohol. When in doubt, it is best to abstain from drinking when taking any kind of medication. These harmful side effects can occur at lower doses of DXM when it is mixed with alcohol. Heavy drinking should always be avoided when taking standard doses of dextromethorphan for cough suppression. Reading product labels carefully and not exceeding the recommended dosing is important. The risk of dizziness, drowsiness, or confusion may be increased if you drink alcohol while taking dextromethorphan.

For cough medicines, dextromethorphan is typically combined with complementary medications such as antihistamines, decongestants, or pain relievers as a formulation to treat multiple symptoms at once. Talk with your doctor or pharmacist about the risks and interactions of OTC and prescription medications taken with alcohol. Rehabilitation programs (inpatient or outpatient), therapy, support groups, or a combination of all three can help people recover from a substance use disorder. In some cases, medications can also alcohol and dextromethorphan help, like for alcohol use disorder. The effects of an overdose are similar to ketamine or phencyclidine (PCP), causing a floating or out-of-body sensation.