Yashoda Hospitals > Medicine FAQS > Dextromethorphan

Dextromethorphan: Frequently Asked Questions Answered

What is Dextromethorphan?

Dextromethorphan, referred to as DXM, is used as a cough suppressant in over-the-counter (OTC) cold and cough medicines. You can purchase it as a syrup, tablet, spray, or lozenges. It belongs to the morphine class of medications and possesses dissociative, stimulant, and sedative properties. It holds minimal interaction with opioid receptors making it safe for OTC products to relieve coughs without phlegm temporarily, i.e., dry coughs providing much-needed relief.

What are the Uses of Dextromethorphan?

An antitussive, DXM will temporarily relieve cough caused by common colds, flu, or other conditions, but not coughing caused by emphysema, smoking, chronic bronchitis, or asthma.
Approved combinations of Dextromethorphan with other drugs for use in neuropsychiatric disorders are:

DXM with Brompheniramine and Pseudoephedrine for treatment of coughs associated with allergies.
DXM/Quinidine for Pseudobulbar effects (uncontrollable laughing/crying).
DXM/Clonidine for reducing withdrawal symptoms in opioid use disorder.
DXM/Bupropion for Major Depressive Disorder.

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What are the Side Effects of Dextromethorphan?

Side effects of DXM at normal therapeutic doses may include drowsiness, dizziness, sedation, confusion, nervousness or hallucinations, body rashes/itching, nausea, vomiting, constipation, or diarrhoea. A very rare side effect is respiratory depression.
Adverse effects at 3-10 times the recommended dose include insomnia, dilated pupils, dizziness, mild nausea, restlessness, glassy eyes, and dizziness.
DXM has severe interactions with at least 36 different drugs, and moderate interactions with 38 drugs, making it imperative to discuss with a physician before taking DXM.

What is Dextromethorphan

Uses of Dextromethorphan

Side effects of Dextromethorphan

References

https://pubchem.ncbi.nlm.nih.gov/compound/Dextromethorphan

Disclaimer: The information provided herein is accurate, updated and complete as per the best practices of the Company. Please note that this information should not be treated as a replacement for physical medical consultation or advice. We do not guarantee the accuracy and the completeness of the information so provided. The absence of any information and/or warning to any drug shall not be considered and assumed as an implied assurance of the Company. We do not take any responsibility for the consequences arising out of the aforementioned information and strongly recommend you for a physical consultation in case of any queries or doubts.

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Frequently Asked Questions about Dextromethorphan

DXM is an opioid derivative, making the risk of overdosing very real, which may present as symptoms such as seizures, tachycardia, hyperexcitability, toxic psychosis, dystonia (involuntary muscle contractions), blurred vision, ataxia, nystagmus, or serotonin syndrome. There have also been cases of closed-eye hallucinations, dissociation, acute episodic psychosis, coma or deaths.

DXM does not contain alcohol but is an opioid derivative. Since both DXM and alcohol impact the central nervous system, consuming them together increases the risk of an overdose. It leads to serious health problems, such as brain lesions, memory problems, epilepsy, or permanent psychosis.

Contrary to that, DXM has been reported to induce drowsiness in therapeutic and higher than recommended doses. DXM acts as a central nervous system depressant and generates sedative, dissociative effects. Although, in cases of overdose, it is possible to observe hyperexcitability and nervousness.

DXM is a levorphanol derivative and codeine analogue belonging to the morphine class of medications. It is an agonist of the N-Methyl-D-Aspartate receptor and sigma-1 receptor. It is also an antagonist of α3/β4 nicotinic receptors, clubbing its effects to relax the central nervous symptoms and relieve coughing symptoms.

DXM has not been found to indicate safety or harm yet, as there is insufficient data. Animal studies show risk, but human studies are not available. Hence, it is recommended to consult a physician and use DXM only if the benefits outweigh the risks. It is also not known whether DXM is passed on via breastmilk.

Yes, DXM is a central nervous system depressant and can cause drowsiness due to the blockage of message transmitters in the nervous system. It has also been shown to induce sedative effects in higher doses than recommended therapeutic doses, and overdose may also lead to coma.

As a CNS depressant, DXM tends to slow down the activity of the central nervous system and numbs the sensation causing cough-like symptoms. This is one of the reasons that a higher than normal uptake of DXM causes hallucinations or withdrawal symptoms as experienced after taking drugs.

DXM is merely a cough suppressant and CNS depressant. It has no effects on blood pressure in controlled amounts. Overdosing on DXM, on the contrary, may lead to effects on blood pressure due to delayed CNS function induced by this morphine class medication.

DXM in itself has been reported to give rise to anxiety in higher-than-normal concentrations. Still, combinations of DXM with drugs like Quinidine may be key to treat anxiety or other neuropsychiatric disorders, such as depression, drug abuse, or pseudobulbar effects. There are still not enough studies supporting the use of DXM for the treatment of anxiety.

S.no	Product Name	Dosage	Form
1.	Grilinctus	Ammonium Chloride (60mg/5ml) + Chlorpheniramine Maleate (2.5mg/5ml) + Dextromethorphan Hydrobromide (5mg/5ml) + Guaifenesin (50mg/5ml)	Syrup
2.	Alex	Phenylephrine (5mg/5ml) + Chlorpheniramine Maleate (2mg/5ml) + Dextromethorphan Hydrobromide (10mg/5ml)	Syrup
3.	TusQ-DX	Phenylephrine (5mg/5ml) + Chlorpheniramine Maleate (2mg/5ml) + Dextromethorphan Hydrobromide (15mg/5ml)	Liquid