Dextromethorphan: What is it? Warning, Methods of Use, Side Effects and Drug Abuse

It is a synthetic substance commonly found in a variety of over-the-counter medications.

As antitussive (cough suppressant) and expectorant (an agent that promotes the elimination of mucus from the respiratory tract).

Other medical uses of Dextromethorphan include temporary relief of sinus congestion, runny nose, coughing, sneezing, itchy nose and throat, and watery eyes caused by hay fever, allergies, colds, or flu (influenza).

Approximately 70 products containing Dextromethorphan are available to consumers. When the recommended dose is taken, it has few adverse side effects and has a long history of safety and efficacy.


Recently, reports of illicit use and abuse of Dextromethorphan have increased.

The DEA reports that the illicit use may be related to the ease of purchasing over-the-counter cough medicine from various pharmacies and internet companies.

It is a legal substance approved by the FDA and is not considered intrinsically dangerous unless the dosage exceeds the therapeutic recommendations. However, it can be a harmful substance.


Recreational users intentionally exceed the suggested doses to experience a sensation of elevated perceptual awareness, altered time perception, and visual hallucinations. In addition, users often abuse the drug in combination with other medications.

The interaction between Dextromethorphan and other substances (e.g., alcohol, paracetamol, MDMA / ecstasy, and other cough medicines) produces a synergistic effect that can be very dangerous.

The ingredients of cough medicines other than Dextromethorphan, such as paracetamol, are hazardous when consumed in high doses and can cause liver damage, heart attack, stroke, and death.

Methods of use

The licit uses of products containing Dextromethorphan adhere to the guidelines suggested by the manufacturer for the doses.

For medical reasons, users who use cough syrups containing Dextromethorphan (such as Robitussin) generally take 10 to 20 mg every four to six hours or 30 mg every six to eight hours.

On the other hand, a single dose for recreational users may vary from 240 to 1500 mg. It is known that heavier users ingest up to 3 or 4 bottles a day, an amount that can induce many adverse side effects.

According to the DEA, Internet sites inform young users to “down the syrup to absorb enough Dextromethorphan from the beverage before the imminent incidence of vomiting due to ingesting the large volume of syrup required for the intoxication.”

In addition to the traditional syrup, there is also evidence that Dextromethorphan is sold in powder, capsules, and pills through the internet.

These are inhaled or ingested orally. Powders and pills have a similar effect to syrups without consuming large amounts of the substance in a short period.

Users can also find instructions on extracting Dextromethorphan from syrups and gel capsules on the internet, allowing them to inject or orally consume this active ingredient.

Side effects

It is a dissociative anesthetic that, at high doses, can create powerful psychedelic effects. Sometimes it is compared to PCP and ketamine, also dissociative drugs. The results caused by the use of Dextromethorphan vary according to the dose.

Users often describe dose-dependent “plateaus” ranging from a mild stimulant effect with distorted visual perceptions to a sense of complete body dissociation.

The effects generally last 6 hours, but in the end, they will vary depending on the amount of Dextromethorphan ingested and if it is used in combination with other drugs or chemicals.

Other effects may include:

  • Hot flushes.
  • Nausea and dizziness
  • Lack of coordination.
  • Panic attack or seizures.
  • Dissociation of the body.
  • Visual and auditory hallucinations.
  • Deteriorated judgment and poor mental performance.
  • Perspiration.
  • Lethargy.
  • Hyperactivity
  • Hypertension (increase in blood pressure).
  • Nystagmus (rapid eye movement).
  • He retched.
  • Eruptions, red skin with spots.
  • Tachycardia (racing heartbeat).
  • Euphoria.
  • Paranoia.
  • Disorientation.
  • Tactile hallucinations.
  • Visual alterations.
  • Feelings of floating.
  • Altered perception of time.

Do not take Dextromethorphan if you:

  • It is identified as allergic to Dextromethorphan or even any of the medicine ingredients.
  • You are taking MAO inhibitors (e.g., maprotiline, moclobemide, selegiline) or have taken them in the last two weeks.
  • Has respiratory depression (respiratory rate below average).

Do not give this medication to children under six years of age.

Effects of abuse of Dextromethorphan

Several problems can occur due to abuse. The most alarming risks are severe illness or death.

The misuse of Dextromethorphan does not necessarily cause severe illness or death.

However, severe illness and death may result from Dextromethorphan with other active ingredients found in cold medications with multiple symptoms.

These ingredients include acetaminophen (Tylenol), chlorpheniramine (an antihistamine ), pseudoephedrine (a decongestant), and phenylephrine.

The abuse of medications containing these active ingredients in combination with Dextromethorphan may cause the following:

  • Attacks
  • Hyperthermia.
  • Respiratory depression

Typically, someone who has been using Dextromethorphan long term and quit smoking will experience withdrawal symptoms that include:

  • Fatigue.
  • Gastrointestinal distress (vomiting, diarrhea).
  • Insomnia.
  • Nightmares.
  • Panic attacks.
  • Intense cravings.
  • Hallucinations

Those who have abused Dextromethorphan in high doses over a long period may experience toxic psychosis and other permanent psychological problems.