dxm hustenstiller trip

DXM (Dextromethorphan): Effects, Dosage, & Safety

Robotripping 🤖 on cough syrup.

What is DXM?

1. the first plateau, 2. the second plateau, 3. the third plateau, 4. the fourth plateau, how long do the effects of dxm last, dxm vs. ketamine, dxm vs. alcohol, dxm vs. pcp, the potential dangers of dxm:, side effects of dxm, what dxm overdose looks like, dxm drug interactions, signs of dxm addiction, is dxm legal, how dxm works, subscribe to get a weekly dose of psychedelics in your inbox.

Robotripping, skittling, dexing — whatever you want to call it — DXM (dextromethorphan) is becoming increasingly popular among young people as a cheap and legal high.

This compound is the active ingredient in over 150 different over-the-counter cough medicines in the United States.

At the recommended dose, DXM has little, if any psychoactive side effects. In higher doses, DXM can induce states of inebriation similar to alcohol, dissociative states similar to ketamine, or full-blown psychotic episodes like PCP.

In this article, we’ll cover the four different stages of effects (called plateaus), as well as some important safety information to consider before trying DXM.

DXM stands for dextromethorphan. The most common form you’re likely to find this compound is in over-the-counter cough medicines like Robitussin, NyQuil, or Coricidin.

In lower doses, DXM works great for relieving coughs during a cold or flu.

In higher doses, the effects of DXM become more psychedelic in nature. The effects of high-dose DXM feel a lot like ketamine or other dissociatives . They disconnect the mind from the body which can be both freeing and terrifying at the same time.

This compound is widely considered safe at low doses, which is why this drug remains readily available without a prescription.

However, in higher doses, DXM can become habit-forming and addictive. Very high doses (1500 mg or higher) can easily lead to psychotic episodes and permanent mental health issues.

This drug should not be taken lightly. If you plan to use DXM, it’s important you understand the risks and learn about the differences in doses for this compound.

DXM: Specs & Technical Details

What’s The Dose of DXM? (DXM Dosage Calculator)

The effects of DXM vary depending on the dose you take. There Are four levels of DXM intoxication — referred to as plateaus.

There’s a general range of doses we can give for each plateau, but it’s much better to find your individual plateau based on your body weight. The effects of DXM change dramatically depending on the dose, so it’s important to be very accurate and aim for a specific plateau.

Even if DXM is taking a while to kick in, it’s never a good idea to take a second dose of DXM.

Double-check the potency of the DXM you’re using, and look for the addition of other compounds such as acetaminophen which can cause severe liver-toxic side-effects at this dose.

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Warning: You should always check the potency of the DXM you’re using, and look for the addition of other compounds such as acetaminophen which can cause severe liver-toxic side effects in high doses.

In general, the dose for each plateau is as follow:

The dose for this plateau usually begins around 1.5 mg/kg up to 2.5 mg/kg.

This works out to somewhere between 100 and 200 mg for most people.

The first plateau produces effects similar to MDMA (ecstasy) . It’s stimulating and mildly empathogenic. People at this stage feel talkative, energetic, and euphoric. This is the level most people aim for when out at a club or party.

What The First Plateau Feels Like:

• Highly social
• Mild dissociative feeling

The dose for the second plateau is between 2.5 and 7.5 mg/kg.

This works out to between 200 and 550 mg DXM.

The second plateau is very different from the first. At this dose, the effects feel much more similar to alcohol but with a pronounced reduction in cognitive function. People at this stage feel drunk . Auditory and visual hallucinations are also possible at this stage.

What The Second Plateau Feels Like:

• Drunk sensation
• Loss of muscle coordination
• Mild hallucinations

The dose for the third plateau is between 7.5 and 15 mg/kg.

This works out to somewhere between 550 and 1000 mg of DXM.

The third plateau is where most of the dissociative effects of DXM start to appear. Most people who take this much DXM become incapacitated. In their inebriated state, it’s common to experience strong dissociative hallucinations very similar to ketamine.

People at this stage may still be in control of their bodies, but with minimal coordination. People at this level often have a “robotic walk” — stumbling around in a very mechanical motion. Others lose control of their body completely and slump down in their chair or onto the floor.

What the Third Plateau Feels Like:

• Strong hallucinations
• In and out of consciousness
• Robo-walk and mechanical muscle movements

The dose for the fourth plateau is between 15 and 20 mg/kg.

This works out to around 1000 mg of DXM or higher for most people.

This plateau is very intense — producing extreme states of dissociation or delirium similar to PCP. The effects last a very long time too — often exceeding several hours, with persistent effects lasting up to two weeks.

Most people who reach this plateau don’t report the experience as being positive. It can produce terrifying or uncomfortable visions that are very difficult to get out of. Many people become aggressive or violent in this state. The only saving grace is the total lack of coordination with the body.

What the Fourth Plateau Feels Like:

• Intense visions & hallucinations
• Aggression or frustration
• Dissociation or delirium
• Loss of consciousness

The effects of DXM usually begin about 30 minutes after taking it. Peak effects are reached somewhere between 2 and 4 hours after taking it and slowly fade out over the course of 4 to 6 hours.

In total, a DXM trip usually lasts around 6 hours — however, this can vary a lot depending on the dose.

High-dose DXM (especially plateau 4) can peak for several hours, and leave lasting effects up to 2 weeks after the initial dose.

How Strong is DXM Compared to Other Psychedelics & Dissociatives

DXM is not a strong psychedelic in the conventional sense. It only produces hallucinations and perceptual changes in higher doses which come with other effects like loss of muscle coordination and lower cognitive functioning.

In high doses (plateaus 3 and 4) are very similar to the effects of ketamine . Both drugs work through the same receptors (NMDA) and the visions are very comparable.

Ketamine is about 2 or 3 times as potent in terms of dose compared to DXM. 200 mg of ketamine is equivalent to around 500 mg of DXM.

The second plateau of DXM is most comparable in terms of effects to alcohol. The effects of DXM at this dose are very similar to being drunk. People feel inebriated, speech becomes slurred, and inhibition increases.

The highest dosage range of DXM is most comparable to PCP .

Powerful dissociative states take over, which can make it difficult to tell the difference between what’s real and what’s a hallucination. Similar to PCP, the experience is most often negative. The experience is frequently described as “terrifying.” Some people report lasting negative effects after taking doses this high — which is also common with PCP.

Is DXM Safe?

There have been very few deaths from people taking DXM, but there are some potential dangers to be aware of before you take this substance.

Any dose can lead to physical dangers such as heatstroke, respiratory depression (breathing that’s become too slow), or liver damage.

Higher doses of DXM are particularly problematic. The dissociative and deliriant effects can be very uncomfortable. Many people who are on a DXM trip can’t differentiate between what’s real and what’s a hallucination. They also lose control of their own thoughts and control of their physical body. Both of these effects can be terrifying.

Once you’re tripping on DXM there’s no way to end it. There are no safe trip killers for DXM. The best way to get through it is to try and sleep it off.

It’s very important to consider set and setting before you take DXM, and have someone you trust (and is sober) nearby. This substance can leave you in a very vulnerable state in higher doses. The lack of body control makes this a popular drug for predators as a date rape drug.

• Heatstroke and overheating
• Liver damage (from additives in some DXM formulas such as acetaminophen)
• Dangerous or reckless behavior
• High state of vulnerability to predators
• Triggering psychotic breaks in susceptible individuals

There are also a variety of potential adverse side effects from DXM to be aware of as well.

• Increased body temperature
• Loss of muscle control & coordination
• Slurred speech
• Hallucinations
• Irregular heart rate
• Slow breathing
• Lethargy or fatigue
• Temporary loss of consciousness

Unlike classical psychedelics ( LSD , DMT , psilocybin , mescaline ), it’s possible to overdose on DXM.

If you feel as though someone may be overdosing on DXM, call 911 immediately — DXM overdose can be lethal if proper medical support isn’t administered immediately.

Signs of DXM overdose include:

• Irregular or slowed breathing (less than 10 breaths per minute)
• High blood pressure (higher than 130/80)
• Increased body temperature (feels hot to the touch)
• Blurred vision
• Blue tinge around the lips or fingernails (signs of hypoxia)
• Extreme drowsiness

There are a lot of medications DXM may interact negatively with as well that can increase the chances of experiencing side effects or overdose on the drug.

In general, you should never mix any other drugs, alcohol, or prescription medications with DXM. Doing so can dramatically increase the chances of experiencing side effects or overdose.

Here are a few examples to be aware of:

• Alcohol (increased chance of overdose)
• MDMA (increased effects)
• Ketamine (increased effects)
• Opiates (increased chance of overdose)
• Cocaine (increased chance of overdose)
• PCP (increased risk of psychotic episodes)
• Acetaminophen (increased risk of liver damage)
• Antihistamines (increased chance of overdose)
• Benzodiazepines (increased chance of overdose)

Is DXM Addictive?

Yes, DXM is both physically and psychologically addictive.

The first stages of DXM addiction begin with a behavioral addiction. It can become routine to use DXM in a social setting with friends who also take DXM.

Over time, DXM can form a physical addiction as well. If you stop taking it, you’ll begin to experience the effects of withdrawal, which can only be alleviated by using more DXM.

At this point, it becomes much harder to quit using the substance. Every time you stop taking it, withdrawal symptoms start to appear — prompting you to take more of it to feel normal again.

• Compulsively using the drug despite clear negative impact on other aspects of life
• The need to use higher doses of DXM to achieve the same level of effects
• Irritability or discomfort if access to DXM is blocked
• Distancing from friends and family
• Lack of motivation in other areas of life — such as work or school

Technically, yes, DXM is legal and can be bought without a prescription from local pharmacies. The most common form of legal DXM is cough medicines, which use this compound as the active ingredient.

In the United States, DXM was specifically excluded from the Schedule II substance list. This compound is an isomer of levomethorphan — which is an opiate drug. All analogs or isomers of opiates are automatically added to the Schedule II listing. DXM was removed because it doesn’t have opiate effects, but this action had to be done through a specific exemption.

This means DXM is not considered illegal in the United States. But it doesn’t make it safe.

Most countries follow suit, with a few exceptions. DXM is specifically banned in France , Sweden , Russia , Indonesia, Estonia, Latvia, and the United Arab Emirates.

Suggested Reading: Legalization vs. Decriminalization: What’s the Difference?

DXM isn’t the active ingredient; it’s a prodrug for dextrorphan — which is what produces the majority of the effects of the drug. Once absorbed through the digestive tract, DXM is quickly converted to dextrorphan by the liver.

Its therapeutic purpose — cough suppression — works by reducing the cough reflex in the brain. This is a big advantage to other cough suppressants that work by reducing muscle movement in the lungs. DXM reduces the threshold for coughing without affecting other important functions like ciliary movement (the tiny hairs in the lungs that clear out phlegm and bacteria).

The psychedelic effects of DXM work through a similar mechanism to other dissociative drugs like ketamine and PCP. It’s a dissociative, which means it disconnects conscious thought from reality. It can force the mind into a state of altered reality and dissolve the concept of self vs. others.

DXM, like other dissociatives, works by blocking the NMDA receptors in the brain.

The NMDA receptors act as a gate for the transmission of information around the brain. They’re necessary for memory formation and retrieval, conscious thought, and much more.

Drugs like DXM block the NMDA receptors and make it more difficult for the transmission of information in the brain. This can lead to lethargic thought processes in smaller doses and complete dissociation and amnesia in higher doses.

DXM also has mild serotonin and norepinephrine reuptake inhibitors — which means it can increase the concentrations of serotonin and norepinephrine in the brain. This effect explains the euphoric effects of DXM, especially in the 1st and 2nd plateau of effects.

To summarize: The mechanisms involved with DXM include:

• NMDA receptor antagonist
• Serotonin and norepinephrine reuptake inhibition (SNRI)
• Sigma-R1 agonist
• Modifies the nicotinic acetylcholine receptors

Final Thoughts: Is DXM Safe?

DXM is used as a “legal” high in most parts of the world. It’s most popular among young people due to the relatively high availability of this drug from local pharmacies in the form of over-the-counter cough medicine.

However, this doesn’t mean DXM is safe to use. In low doses as a cough suppressant, DXM has shown very minimal side effects and a low level of risk. In higher, psychoactive doses, there are many negative side effects associated with DXM use.

It can lead to hyperthermia, loss of consciousness, lowered inhibition, and increased risk of self-inflicted or external harm.

DXM can also become addictive over time — both behaviorally and physically.

• Martinak, B., Bolis, R. A., Black, J. R., Fargason, R. E., & Birur, B. (2017). Dextromethorphan in cough syrup: the poor man’s psychosis. Psychopharmacology bulletin, 47(4), 59.
•  Bem, J. L., & Peck, R. (1992). Dextromethorphan. Drug Safety, 7(3), 190-199.
• Nicholson, K. L., Hayes, B. A., & Balster, R. L. (1999). Evaluation of the reinforcing properties and phencyclidine-like discriminative stimulus effects of dextromethorphan and dextrorphan in rats and rhesus monkeys. Psychopharmacology, 146(1), 49-59.

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N2O: Nitrous Oxide

List of All Common Dissociative Drugs & Their Effects

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This is a simple calculator designed to help you discern how much DXM you need to take reach each plateau of experience, depending on variable factors such as your weight and concentration of the product you're using. For a description of the plateau model, and the effects you can expect at each level, click here.

Dxm-containing products may also contain several potentially dangerous adulterants; you must make sure that your product contains only dxm as its active ingredient. for more information about dxm adulterants, see here., for information about combining dxm with other drugs, check out our combo chart . make sure to read the label and research the product thoroughly before using it., note: all products listed here contain dxm hbr as the sole active ingredient., i weigh in kg lbs  and i want to take , manual mode:, note: please make sure your product does not contain the following: acetaminophen(paracetamol), guaifenesin, antihistamines or pseudoephedrine. this is still intended to be used with dxm hbr product only., i weigh in kg lbs  and i want to take  mg dxm per 1 ml 3 ml 5 ml 10 ml 15 ml 20 ml.

Note: You should always start low and work your way up untill you find the doses that are right for you.

Please note, these tools were developed and tested to the best possible ability by the TripSit team, and the greatest effort has been made not to produce incorrect or misleading results, though for unforeseen reasons these may occur. Always check your maths, and be careful. If you have any questions, suggestions or error reports on this tool, you can contact us here .

See a product not listed? Contact us here with a link to your product.

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DXM Tripbericht (8xRatiopharm Hustenstiller + Ordentlich THC, Relativ ausführlich):

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Kommentar von Keinstein | 8. Mai 2021

Wie viel Mg hatte denn eine Kapsel

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Add Ratiopharm Hustenstiller #4

LunaUrsa commented Jul 14, 2022

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( Dextromethorphan , Cough Syrup, Robo, Dex)

TrippyWiki score: 3.8/10

TABLE OF CONTENTS

What is dxm.

Dextromethorphan is a cough suppressant medicine with stimulant, depressant, and dissociative qualities. Although DXM is a popular recreational drug with a relatively high potential for abuse, it remains widely available without a prescription in a variety of cough syrups.

Long-term benefits & side effects

Many of the benefits will only occur if you take this substance the right way.

• Can be an effective way to lower depression (based on anecdotal reports + the fact that the effects of DXM are comparable to ketamine and ketamine treatment’s success rate is 85% while regular antidepressants only have a success rate of 45%)
• Starts working instantly, therefore it is a great tool for preventing suicides
• Can cause temporary ego-dissolution at higher doses
• Increases neuroplasticity
• Makes you more creative and open-minded
• Helps you look at your life from a different perspective
• Allows you to heal your childhood trauma and forgive people who’ve hurt you
• Makes you more conscious and loving
• Makes you appreciate nature more
• Has some neuroprotective abilities
• May suppress cough
• Decreases pain
• Could play a role in treating diabetes
• Reduces dependence on opioids and tobacco
• Is often mixed in a cough syrup with other drugs and the combination can be lethal at strong doses (the combination has already killed multiple people)
• Can be lethal by itself at extremely high doses (LD50, the fatal dose for 50% of users, is around 7 grams)
• Might impair your memory , especially if you take the substance every week or more often
• Might speed up the onset of schizophrenia if you’re genetically predisposed to it
• Might cause bladder pain and can lead to long-term bladder-related problems
• Can cause HPPD and physical damage if you combine it with other substances (such as alcohol or stimulants)
• Could cause you trauma due to bad set and setting
• Might lead to drug-induced psychosis if you’re predisposed to it
• Can be psychologically addictive (but only if you use the psychedelic recreationally)
• Can lead to depression for those who take the substance regularly
• Causes liver damage to those who take it on a regular basis
• Can damage your kidneys over time

How to take DXM

Administration.

There are 2 main versions of DXM: HBr vs polistirex. The HBr form is shorter-acting and kicks in faster while the polistirex form lasts for longer. With polistirex, slightly less of the substance is required to reach the same state. The best way to take DXM is to take it orally. Other methods may be dangerous and cause neurotoxicity. Taking the drug orally does not lead to neurotoxicity.

• 75 mg = Threshold
• 100-200 mg = Light dose
• 200-400 mg = Regular dose
• 400-700 mg = Strong dose
• 700+ mg = High dose

LD50 (where the substance would be fatal to 50% of users) is estimated to be around 7 grams. Unlike most other dissociatives or psychedelics, the effects of DXM change greatly when you increase the dosage. This is why users use plateaus to describe different levels of experiences. Plateaus :

• Plateau 1: 1.5 to 2.5 mg/kg; 105 to 175 mg for a 70 kg person
• Plateau 2: 2.5 to 7.5 mg/kg; 175 to 525 mg for a 70 kg person
• Plateau 3: 7.5 to 15 mg/kg; 525 to 1,050 mg for a 70 kg person
• Plateau 4: Over 15 mg/kg; ~Over 1050 mg for a 70 kg person

These dosages, however, are just estimates since everyone reacts to the substance differently. If you are taking the substance for its potential benefits and you wish to minimize the side effects, never take a plateau 4 dose or higher. Plateau 4 doses are enough for you to completely dissociate from this reality and the potential insights you will receive are almost impossible to retain and incorporate into your life. Such doses can also be extremely unpleasant and dangerous if you take the substance the wrong way. Never start with a strong dose. You may be more sensitive to the substance than others and it might cause you irreversible damage if you don’t take it responsibly. Those who need less of the substance to reach desired effects include older and extremely lean people.

Safety checklist

Maximize the benefits.

Keep in mind that integration is even more important than the trip itself. Taking the drug would be almost useless if you didn’t retain any lessons in your day-to-day life. What will help you the most is contemplating about the experience – be it by journaling, thinking about the trip, or sharing your memories with a trusted friend. Distracting thoughts can get in the way, which is why you want to spend the day after your trip without TV, social media, and other distractions. If you can, spend time in silence and solitude. Me ditate, go for a walk, contemplate the experience.

Onset = 30-120 minutes Come up = 60-120 minutes Peak = 3-6 minutes Come down = 2-4 hours

What does DXM feel like?

DXM is sometimes called Robo or robotripping because it makes you move around like a robot when you’re on the substance. Blurred vision is almost inevitable and some visuals may occur, although the main visual phenomenon is that things around you will appear smaller or bigger than they actually are. The shape of objects will also seem different. The effects change as the dose increases. At lower doses, DXM mostly acts as a stimulant. Most users report having a pleasant experience at these doses because the drug is not too overwhelming. At high doses, the drug more so acts as a dissociative. You may experience depersonalization, out-of-body experiences, ego death, and gain spiritual insights at this dose. Everything may feel like a distant memory, as if it happened 100 years ago. The dissociative effects of DXM are comparable to those of ketamine . The drug is likely to make you nauseous or vomit if you eat before taking it. This is why it’s best to take DXM on an empty stomach. Other common short-term effects include:

Euphoria Increased creativity and open-mindedness Mindfulness, being present Higher capability for love and compassion Pain relief Sedation Memory suppression Visual effects (weaker than those of most other psychedelics) Confusion Inability to talk Increased body pressure Worse thermoregulation Difficulty urinating Anxiety, paranoia Vulnerability

With all that said, it is impossible to accurately describe the experience through human language. Compared to other psychedelics, DXM usually feels calm and isn’t likely to cause you an extremely unpleasant experience. Bad trips can happen but you can prevent them by following the tips below. But that doesn’t mean that everyone will enjoy the experience. around 30% of those who tried DXM did not like the state. DXM can also lead to a comedown similar to that of MDMA.

Bad trips mostly happen because people take the substance irresponsibly. If you take this psychedelic the right way, there is virtually no chance you’ll get a bad trip. In case you still do, that’s good! A “bad” trip isn’t bad, it can actually be the most healing and insightful moment of your life! During a “bad” trip, negative emotions are coming up from your subconscious mind. They have always been there whether you are aware of it or not. They have been damaging your life and a difficult trip is an opportunity to process these traumas and unpleasant feelings and let go of them. The more painful the experience, the more you can heal. So instead of calling bad trips bad, call them challenging . If you understand that bad trips are awesome in the long run, not only will you feel more comfortable diving into these challenging states, it will actually excite you!

Why they happen

The most common reasons for getting a bad trip are:

How to cope with a bad trip

How to end a bad trip.

In case you are not ready to face your inner demons yet , there are a few ways to end a bad trip. One possible way is to put on music that is familiar to you. Another way is to switch up your location and move from one place to another. This can completely change your train of thought.

Interactions

• Qualia Mind This nootropic is comprised of 28 ingredients designed to support and maximize your brain function. These ingredients act synergistically and many of them will protect you from the side effects of DXM. Qualia will also make your trips more pleasant and help you retain more benefits from them.
• Herbs Herbs can help calm you down. Herbal teas (chamomile, lemon balm, valerian root, …) are especially helpful.
• Green tea Tea makes you both more alert and calm at the same time. It also contains neuroprotective antioxidants, such as EGCG.
• CBD CBD has a calming effect.
• Weed Marijuana will intensify the effects. While some users enjoy combining weed with DXM, we have very little data on its long-term safety.
• Nitrous oxide Nitrous oxide will multiply the intensity of your trip.
• Benzodiazepines (Valium, Xanax, …) The combination may lead to a loss of consciousness and vomiting. Vomit aspiration is the most dangerous risk.
• Alcohol , GHB, GBL, Opioids Combining these with DXM can be fatal
• SSRIs or MAOIs Not only will these antidepressants greatly decrease the intensity of your trip, but they can also lead to long-lasting side effects, such as serotonin syndrome, which could be fatal.
• Stimulants The combination can easily lead to heart problems.
• Psychedelics The mix of MDMA and DXM could be fatal. That doesn’t seem to apply to tryptamines or lysergamides but the combination has lead to many terrifying trips in the past.

As of 2021, DXM is legal in every country except for UAE, France, Sweden, Estonia, and Latvia .

Regular use of DXM has been shown to cause multiple health problems. Taking the drug every 2-4 weeks is therefore a safer long-term strategy. If you suffer from depression and you’re taking DXM with a purpose of lowering it, take DXM when you feel a need to do so. Over time, you will need to use the substance less and less often. Eventually, you should get to the point where you won’t have to rely on DXM.

As NMDA receptor antagonists, dextrorphan and dextromethorphan inhibit the excitatory amino acid and neurotransmitter glutamate in the brain. This can effectively slow, or even shut down certain neural pathways, preventing areas of the brain from communicating with each other.

DXM is not recommended for kids because it may have serious health side effects, especially at higher doses. If you’re under the age of 21 or you have a kid, try to find a safer alternative to DXM.

If you are a mentally stable individual who does not suffer from psychosis or have a predisposition to schizophrenia, there is virtually no way you would develop any mental illnesses because of taking the substance.

Users report that the taste is bitter and unpleasant.

Keep your powder or liquid in a cold dark place, preferably with no air. If you don’t do this, DXM will lose potency over time.

You can microdose with DXM but drugs like LSD , psilocybin , and ibogaine are more suited for this. DXM may damage your liver if you take it on regular basis.

It is recommended to stop eating 2-3 hours before taking DXM.

• Brain cancer patients
• Those who have uncontrolled hypertension (high blood pressure)
• People with a history of heart attacks
• People with thyroid disease (hyperthyroidism and hypothyroidism)
• Immature psychonauts who are not willing to follow the safety guidelines
• People who suffer from psychosis
• People who have a familial history of schizophrenia
• Those who suffer from HPPD
• People who are going through a manic phase of bipolar disorder

You may also like:

• Magic Mushrooms
• Salvia Divinorum

Thank you for taking psychedelics responsibly, immature psychonauts are the last thing the psychedelic movement needs. And thank you for being a part of this renaissance. Together, we can change the world!

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This is automatic translated text

Hustenstiller-ratiopharm Dextromethorphan

Components:

Method of action:, treatment option:.

Medically reviewed by Oliinyk Elizabeth Ivanovna, PharmD. Last updated on 01.04.2022

Attention! Information on this page is intended only for medical professionals! Information is collected in open sources and may contain significant errors! Be careful and double-check all the information on this page!

Top 20 medicines with the same components:, top 20 medicines with the same treatments:.

For the relief of persistent dry irritant coughs.

Oral administration.

Adults, the elderly and children over 12 years: One 10ml measure up to four times daily.

Children under 12 years: Do not use

Hypersensitivity to any of the ingredients.

Taking a prescription monoamine oxidase inhibitor (MAOI), a selective serotonin reuptake inhibitor (SSRI), or other medications for depression, psychiatric, or emotional conditions, or Parkinson's disease, or for 2 weeks after stopping the medication. If you are not sure if your prescription medication contains one of these medicines, ask a doctor or pharmacist before taking this product..

Use in children under 12 years.

Patients suffering from chronic cough as occurs with smoking, asthma or patients suffering from an acute asthma attack, or where cough is accompanied by excessive secretions should be advised to consult a Healthcare Professional before use.

Causes of chronic cough should be excluded if symptoms are persistent. Any accompanying symptoms should be actively sought and appropriately investigated/ treated. Stop use and ask your healthcare professional if your cough lasts more than 7 days, comes back or is accompanied by a fever, rash or persistent headache. These could be signs of serious conditions.

Cases of dextromethorphan abuse have been reported. Caution is particularly recommended for adolescents and young adults as well as in patients with a history of drug abuse or psychoactive substances.

Dextromethorphan is metabolised by hepatic cytochrome P450 2D6.).

Keep out of the sight and reach of children.

Do not exceed recommended dose.

Excipient warnings:

- Patients with rare hereditary problems of fructose intolerance should not take this medicine because this product contains Sorbitol and Maltitol.

- This product contains Amaranth (E123), which may cause allergic reactions.

- This medicinal product contains 2.5% v/v ethanol (alcohol), up to 196 mg per dose, (equivalent to approx 1.6 ml wine per dose). Harmful for those suffering from alcoholism. To be taken into account in pregnant or breast-feeding women and high-risk groups such as patients with liver disease, or epilepsy.

This medicine can impair cognitive function and can affect a patient's ability to drive safely. This class of medicine is in the list of drugs included in regulations under 5a of the Road Traffic Act 1988. When taking this medicine, patients should be told:

- The medicine is likely to affect your ability to drive

- Do not drive until you know how the medicine affects you

- It is an offence to drive while under the influence of this medicine

- However, you would not be committing an offence (called 'statutory defence') if:

o The medicine has been prescribed taken to treat a medical problem and

o You have taken it according to the information provided with the medicine and

o It was not affecting your ability to drive safely

Adverse effects are rare, however the following side effects may be associated with dextromethorphan hydrobromide:

Gastrointestinal Disorders

Rare: Gastrointestinal upset

Nervous System Disorders

Rare: Dizziness, drowsiness, mental confusion

Immune System Disorders

Hypersensitivity

Reporting of suspected adverse reactions

Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store.

These include nausea and vomiting, CNS depression, dizziness, dysarthria (slurred speech), myoclonus, nystagmus, somnolence (drowsiness), tremor, excitation, mental confusion, psychotic disorder (psychosis), and respiratory depression.

Management:

Treatment of overdose should be symptomatic and supportive. Gastric lavage may be of use. Naloxone has been used successfully as a specific antagonist to dextromethorphan toxicity in children.

Dextromethorphan hydrobromide is a cough suppressant which has a central action on the cough centre in the medulla. It has no analgesic properties and little sedative activity.

Dextromethorphan

Pharmacotherapeutic group: Cough suppressant

ATC code: R05DA09

Dextromethorphan hydrobromide is well absorbed from the gastrointestinal tract.

Dextromethorphan undergoes rapid and extensive first-pass metabolism in the liver after oral administration. Genetically controlled O-demethylation (CYD2D6) is the main determinant of dextromethorphan pharmacokinetics in human volunteers.

It appears that there are distinct phenotypes for this oxidation process resulting in highly variable pharmacokinetics between subjects. Unmetabolised dextromethorphan, together with the three demethylated morphinan metabolites dextrorphan (also known as 3-hydroxy-N-methylmorphinan), 3- hydroxymorphinan and 3-methoxymorphinan have been identified as conjugated products in the urine.

Dextrorphan, which also has antitussive action, is the main metabolite. In some individuals metabolism proceeds more slowly and unchanged dextromethorphan predominates in the blood and urine.

There is no relevant information additional to that already contained elsewhere in the SmPC or of relevance to the prescriber.

None stated.

No special requirements

ADMINISTRATIVE DATA

References:

• https://www.drugs.com/search.php?searchterm=hustenstiller-ratiopharm-dextromethorphan
• https://pubmed.ncbi.nlm.nih.gov/?term=hustenstiller-ratiopharm-dextromethorphan

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