Dextromethorphan overdose
DXM overdose; Robo overdose; Orange crush overdose; Red devils overdose; Triple C's overdose
Dextromethorphan is a medicine that helps stop coughing. Dextromethorphan overdose occurs when someone takes more than the normal or recommended amount of this medicine. This can be by accident or on purpose.
This is for information only and not for use in the treatment or management of an actual overdose . DO NOT use it to treat or manage an actual overdose. If you or someone you are with overdoses, call your local emergency number (such as 911), or your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States.
Overdose
An overdose is when you take more than the normal or recommended amount of something, usually a drug. An overdose may result in serious, harmful sym...
Poisonous Ingredient
Dextromethorphan can be harmful in large amounts.
Where Found
Dextromethorphan is found in many over-the-counter cough and cold medicines, including:
- Robitussin DM
- Triaminic DM
- Rondec DM
- Benylin DM
- Drixoral
- St. Joseph Cough Suppressant
- Coricidin
- Alka-Seltzer Plus Cold and Cough
- NyQuil
- DayQuil
- TheraFlu
- Tylenol Cold
- Dimetapp DM
The drug is also abused and sold on the streets under the names:
- Orange crush
- Triple Cs
- Red Devils
- Skittles
- Dex
Other products may also contain dextromethorphan.
Symptoms
Symptoms of a dextromethorphan overdose include:
-
Breathing problems, including
slow and labored breathing
,
shallow breathing
,
no breathing
.
Slow and labored breathing
Most people take breathing for granted. People with certain illnesses may have breathing problems that they deal with on a regular basis. This arti...
Shallow breathing
Most people take breathing for granted. People with certain illnesses may have breathing problems that they deal with on a regular basis. This arti...
No breathing
Breathing that stops from any cause is called apnea. Slowed breathing is called bradypnea. Labored or difficult breathing is known as dyspnea....
-
Bluish-colored fingernails and lips
Bluish-colored fingernails and lips
Cyanosis is a bluish color to the skin or mucous membrane that is usually due to a lack of oxygen in the blood.
- Blurred vision
- Coma
- Constipation
- Convulsions (seizures)
-
Drowsiness
Drowsiness
Drowsiness refers to feeling abnormally sleepy during the day. People who are drowsy may fall asleep in inappropriate situations or at inappropriate...
- Dizziness
- Hallucinations
- High or low blood pressure
-
Muscle twitches
Muscle twitches
Muscle cramps are when a muscle gets tight (contracts) without you trying to tighten it, and it does not relax. Cramps may involve all or part of on...
- Nausea and vomiting
- Pounding heartbeat (palpitations)
- Raised body temperature
- Rapid heartbeat
-
Spasms
of the stomach and intestines
Spasms
Muscle cramps are when a muscle gets tight (contracts) without you trying to tighten it, and it does not relax. Cramps may involve all or part of on...
Home Care
This can be a serious overdose. Get medical help right away.
Before Calling Emergency
Have this information ready:
- Person's age, weight, and condition
- Name of product (ingredients and strength, if known)
- Time it was swallowed
- Amount swallowed
- If the medicine was prescribed for the person
Poison Control
Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. This national hotline number will let you talk to experts in poisoning. They will give you further instructions.
Local poison center
For a POISON EMERGENCY call:1-800-222-1222ANYWHERE IN THE UNITED STATESThis national hotline number will let you talk to experts in poisoning. This ...
This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.
What to Expect at the Emergency Room
Take the container or drug with you to the hospital, if possible.
The health care provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure. Tests may be done to check the person's heart function. Symptoms will be treated.
The person may receive:
- Activated charcoal
- Blood and urine tests
- Breathing support, including a tube through the mouth into the lungs, and breathing machine (ventilator)
- EKG (electrocardiogram, or heart tracing)
- Fluids through a vein (by IV)
- Laxative
- Medicine to reverse the effect of the narcotic in the drug (changes in mental state and behavior) and treat other symptoms
- Tube through the mouth into the stomach to empty the stomach (gastric lavage)
Outlook (Prognosis)
This medicine is safe if you take it as directed. However, many teenagers take very high amounts of this medicine to "feel good" and to have hallucinations. Like other drugs of abuse, this can be dangerous. Over-the-counter cough medicines that contain dextromethorphan often contain other medicines that can also be dangerous in an overdose.
Although most people who abuse dextromethorphan will need no treatment, some people will. Survival is based on how quickly a person receives help at a hospital.
The U.S. Food and Drug Administration (FDA) has linked the deaths of several teenagers to dextromethorphan abuse.
References
Chyka PA, Erdman AR, Manoguerra AS, et al. Dextromethorphan poisoning: An evidence-based consensus guideline for out-of-hospital management. Clin Toxicol . 2007;45(6):662-77. PMID: 17849242 www.ncbi.nlm.nih.gov/pubmed/17849242 .
Levine M, Ruha AM. Antidepressants. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice . 8th ed. Philadelphia, PA: Elsevier Mosby; 2014:chap 151.
Thornton S, Ly BT. Over-the-counter medications. In: Adams JG. Emergency Medicine . 2nd ed. Philadelphia, PA: Elsevier Saunders; 2013:chap 157.
U.S. Food and Drug Administration. FDA Warns Against Abuse of Dextromethorphan (DXM) . Rockville, MD: National Press Office; May 20, 2005. Talk Paper T05-23.
Review Date: 10/13/2015
Reviewed By: Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.