However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses. Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing. There is a problem with information submitted for this request.
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This site complies with the HONcode standard for trustworthy health information: verify here. This content does not have an English version. See also: Recreational use of dextromethorphan. Antitussive medication of the dissociative class. Not to be confused with dextrorphan or dexamethasone. IUPAC name. DB Y. D Y. Interactive image. Main article: Recreational use of dextromethorphan. Journal of Veterinary Pharmacology and Therapeutics. PMID Medscape Reference. Retrieved 15 April August Archived from the original on Retrieved Clinical Toxicology.
S2CID May Neurochemistry International. April British Journal of Pharmacology. PMC Robin Analogue-based Drug Discovery. ISBN Australian Medicines Handbook. ISRN Psychiatry. GlobeNewswire News Room. Axsome Therapeutics, Inc. Bibcode : Sci Psychopharmacology Bulletin.
Retrieved 23 August Retrieved 14 August Experimental Neurology. January The Journal of Pharmacology and Experimental Therapeutics. June European Journal of Pharmacology. Bibcode : PLoSO Substance Abuse and Rehabilitation. Brain Research. International Society for the Study of Cough. Food and Chemical Toxicology. Drug Metabolism and Disposition. Clinical Pharmacology and Therapeutics. Journal of Clinical Pharmacology.
Archives of Organic and Inorganic Chemical Sciences. ISSN Drug Testing and Analysis. Archived PDF from the original on FDA panel: cough meds should stay over the counter. Medical News Today Website. Accessed May 18, An act to add Sections and to the Health and Safety Code, relating to nonprescription drugs.
State of California, Legislative Counsel. Archived from the original PDF on Retrieved 13 December Drugs and Chemicals of Concern. Drug Enforcement Administration. Drugs of abuse 2nd ed. Journal of Dual Diagnosis. Expert Opinion on Pharmacotherapy. Journal of Affective Disorders. Medical Hypotheses. The Mental Health Clinician. BMJ Case Reports. ISSN X. Clinical Toxicology Philadelphia, Pa. Cough and cold preparations R Recreational uses.
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Closed eye visuals are often present, consisting of usually darker colored geometric patterns, vast landscapes, and scenes. Music can greatly enhance the effect, although it can also sound tinny and distorted. Users have reported being able to break down every single fragment of a song and visualize all of it in their minds; reliving past memories has also been reported.
The third plateau is often reported to be extremely introspective and a number of users describe being inspired to improve their lives. The afterglow is reported as tiring, but a mood boost is often reported for days or weeks afterward.
Amnesia can occur, leading to memory blackouts or brownouts. Doses of DXM in this range are very dangerous and have a high risk of injury and overdose, and are therefore advised against. Fifth Plateau also known as "Plateau Sigma" - A common method to experience the so-called "Plateau Sigma" is to take second plateau dose, followed by another second plateau dose three hours later, then at the peak of the second dose, take a fourth plateau dose.
Plateau Sigma may also occur unintentionally from redosing. It is nearly always a very unpleasant and unpredictable experience. The experience can last from one day to four days. Plateau Sigma usually results in delirious hallucinations , dysphoria , delirium , psychosis , and anxiety. Plateau Sigma has high potential to cause serotonin syndrome and neurotoxicity and is therefore strongly advised against. Anecdotal reports which describe the effects of this compound within our experience index include:.
It is important not to overdose on other active ingredients or a combination of them. Common ingredients also contained in cough syrup and pills include:. Grapefruit juice is reported to be effective at potentiating the effects of DXM. For users who are drinking store bought syrup, this is useful as it means drinking less syrup. Near maximal potentiation remains for 4 hours after the drinking a cup — mL of grapefruit juice, and drinking an amount beyond that doesn't increase effects significantly.
On the other hand, frequent consumption of a cup at least three times a day, for a day or more, increases potentiation moreso than a lone even if greater quantity. After this, the potentiation also takes longer to wear off, suggesting frequent consumption of grapefruit juice has a cumulative effect. Preparation methods for this compound within our tutorial index include:.
This toxicity and harm potential section is a stub. As a result, it may contain incomplete or even dangerously wrong information! You can help by expanding upon or correcting it. Note: Always conduct independent research and use harm reduction practices if using this substance. The toxicity and long-term health effects of recreational DXM use in humans has not been studied in any scientific context and the exact toxic dosage is unknown.
Anecdotal evidence suggests that there do not seem to be any negative health effects attributed to simply trying DXM at low to moderate doses by itself and using it sparingly but nothing can be completely guaranteed. Independent research should always be done to ensure that a combination of two or more substances is safe before consumption.
Despite early speculation that DXM may cause neurotoxicity and Olney's lesions, it has not been shown to cause this effect in animals  , However, many chronic users report significant issues with memory, attention, and mood that persist for many months after stopping usage. In rats,  oral administration of dextromethorphan did not cause neurotoxic effects in laboratory tests. It is strongly advised to use harm reduction practices if using this substance.
As with other dissociatives, DXM produces dependence with chronic use and has moderate abuse potential. When dependence has developed, cravings and withdrawal effects may occur if a person suddenly stops their usage. Over a quarter reported insomnia, nightmares, inability to feel pleasure, impaired memory, attention deficit and decreased libido. Rarer side effects included panic attacks, impaired learning, tremor, yellowing of the skin, hives and muscle pain. Frequent and long-term usage at very high doses could lead to toxic psychosis and other permanent psychological problems.
Tolerance to many of the effects of DXM develops with prolonged and repeated use. This results in users having to administer increasingly large doses to achieve the same effects. After that, it takes about 3 - 7 days for the tolerance to be reduced to half and 1 - 2 weeks to be back at baseline in the absence of further consumption. DXM produces cross-tolerance with all dissociatives , meaning that after the consumption of DXM all dissociatives will have a reduced effect.
Additionally, some users report an irreversible, permanent tolerance to DXM, which develops over a long period of time and is thought to correlate with the number of doses a person has ingested throughout their lifetime. Some users claim that there is a "50 trip limit", after which the rewarding and unique effects of DXM are said to disappear permanently.
The reason for this is unknown, although it may be indicative of neurotoxicity. More serious side effects include anesthesia , respiratory depression [ citation needed ] , dangerously high fever , risk of accidental injury, self-harm and seizures. Seizures are created possibly due to hyponatremia and a general lowering of the seizure threshold. It is possible that DXM may also affect other levels like potassium, vitamins or blood sugar further contributing to seizures and other health problems in a linear fashion in terms of severity and duration.
It is also believed that extremely high and repeated doses lead to serotonin syndrome. One should not disrupt a person undergoing this experience as their delusions may cause them to respond with violence. Care should be taken as to not let the user get injured, and medical attention, or at the very least, medical surveillance should be sought to prevent severe respiratory depression, choking or organ damage. Death from DXM toxicity is rare, although most overdose cases do cite life-threatening complications, typically extremely elevated heart rate and blood pressure , urinary retention and rhabdomylosis.
Fever and seizures can lead to brain cell death. Warning: Many psychoactive substances that are reasonably safe to use on their own can suddenly become dangerous or even life-threatening when combined with certain other substances.
The following lists some known dangerous interactions although it is not guaranteed to include all of them. Always conduct independent research e. Google , DuckDuckGo , PubMed to ensure that a combination of two or more substances is safe to consume. Some of the listed interactions have been sourced from TripSit.
DXM is available either over the counter or by prescription in most countries. Some countries require the purchaser to be over 16, 18 or From PsychonautWiki. Summary sheet: Dextromethorphan Dextromethorphan. Further information: NMDA receptor antagonist. Physical effects. Visual effects. Cognitive effects. Auditory effects. Disconnective effects. Multi-sensory effects. Transpersonal effects. Antitussive drugs—past, present, and future. Pharmacological Reviews, 66 2 , Retrieved Drug Testing and Analysis.
PMID Archived PDF from the original on An act to add Sections and to the Health and Safety Code, relating to nonprescription drugs. In , Romilar was taken off the shelves after a burst in sales because of frequent misuse. A few years later, products with an unpleasant taste were introduced such as Robitussin, Vicks, and Dextrotussion , but later the same manufacturers began producing products with a better taste.
As early as , dextromethorphan hydrobromide powder could be purchased in bulk from online retailers, allowing users to avoid consuming dextromethorphan in syrup preparations. FDA panels considered moving dextromethorphan to prescription status due to its potential for abuse, but voted against the recommendation in September , citing lack of evidence that making it prescription-only would curb abuse. As of January 1, , dextromethorphan is prohibited for sale to minors in the State of California and in the State of Oregon as of January 1, , except with a doctor's prescription.
Indonesia is the only country in the world that makes single-component dextromethorphan illegal even by prescription  and violators may be prosecuted by law. National Anti-Narcotics Agency BNN RI has even threatened to revoke pharmacies' and drug stores' licenses if they still stock dextromethorphan, and will notify the police for criminal prosecution.
It has been used in counterfeit medications. Over-the-counter preparations containing dextromethorphan have been used in manners inconsistent with their labeling, often as a recreational drug. Some users report stimulant-like euphoria , particularly in response to music.
Dextromethorphan usually provides its recreational effects in a non-linear fashion, so that they are experienced in significantly varied stages. These stages are commonly referred to as "plateaus". These plateaus are numbered from one to four, with the first having the mildest effects to fourth being the most intense.
Each plateau is said to come with different related effects and experiences. The second plateau is likened to the state of being drunk and high at the same time, featuring euphoria, sedation and minor hallucinations.
The third plateau induces a significant dissociative state which can often cause anxiety in users. Reaching the fourth plateau is said to cause extreme sedation and a significant hallucinatory state as well as complete dissociation from reality. Teens tend to have a higher likelihood to use dextromethorphan-related drugs as they are easier to access, and an easier way to cope with psychiatric disorders.
From Wikipedia, the free encyclopedia. See also: Recreational use of dextromethorphan. Antitussive medication of the dissociative class. Not to be confused with dextrorphan or dexamethasone. IUPAC name. DB Y. D Y. Interactive image. Main article: Recreational use of dextromethorphan. Journal of Veterinary Pharmacology and Therapeutics. PMID Medscape Reference. Retrieved 15 April August Archived from the original on Retrieved Clinical Toxicology.
S2CID May Neurochemistry International. April British Journal of Pharmacology. PMC Robin Analogue-based Drug Discovery. ISBN Australian Medicines Handbook. ISRN Psychiatry. GlobeNewswire News Room. Axsome Therapeutics, Inc. Bibcode : Sci Psychopharmacology Bulletin. Retrieved 23 August Retrieved 14 August Experimental Neurology. January The Journal of Pharmacology and Experimental Therapeutics.
June European Journal of Pharmacology. Bibcode : PLoSO Substance Abuse and Rehabilitation. Brain Research. International Society for the Study of Cough. Food and Chemical Toxicology. Drug Metabolism and Disposition. Clinical Pharmacology and Therapeutics.
Journal of Clinical Pharmacology. Archives of Organic and Inorganic Chemical Sciences. ISSN Drug Testing and Analysis. Archived PDF from the original on FDA panel: cough meds should stay over the counter.
Medical News Today Website. Accessed May 18, An act to add Sections and to the Health and Safety Code, relating to nonprescription drugs. State of California, Legislative Counsel. Archived from the original PDF on Retrieved 13 December Drugs and Chemicals of Concern. Drug Enforcement Administration. Drugs of abuse 2nd ed. Journal of Dual Diagnosis. Expert Opinion on Pharmacotherapy.
Journal of Affective Disorders. Medical Hypotheses. The Mental Health Clinician. BMJ Case Reports. ISSN X. Clinical Toxicology Philadelphia, Pa. Cough and cold preparations R Recreational uses. Recreational drug use. Calea zacatechichi Silene capensis.
Dextromethorphan (DXM) is a medication most often used as a cough suppressant in over-the-counter cold and cough medicines. It is sold in syrup, tablet. Dextromethorphan is used to temporarily relieve cough caused by the common cold, the flu, or other conditions. Dextromethorphan will relieve a cough but. Unmetabolised dextromethorphan, together with the three demethylated morphinan metabolites dextrorphan (also known as 3-hydroxy-N-methylmorphinan).