Dextromethorphan is a common ingredient in cough medicines, but DXM and alcohol have a drug interaction that can be dangerous.

When you take cough and cold medication, one of the ingredients is likely dextromethorphan. However, mixing dextromethorphan with alcohol can be problematic in several ways. Not only do dextromethorphan and alcohol have a drug interaction that can increase your risk of side effects, but drinking alcohol while sick may prolong your illness. Understanding the risks of mixing the two substances before you drink is essential.

What Is DXM?

Dextromethorphan (DXM) is an active ingredient in many cough, cold and flu medicines. Initially approved by the FDA in 1958, the drug is one of the most common ingredients in over-the-counter medications for cough. Experts think the drug acts on the brain to suppress the cough reflex but are unsure exactly how it works. Although DXM is structurally similar to opioids, it works on different receptors in the brain than opioids. Nonetheless, about 1.5 million Americans misuse DXM and other cough medications to get high.

Dextromethorphan Side Effects

When taken as directed on the package labeling, DXM is well-tolerated. However, rarely, it can have some minor side effects, including:

• Nausea
• Stomach discomfort
• Drowsiness
• Dizziness

However, when taken in large doses in an attempt to get high (“Robo-tripping”), DXM has additional, more serious side effects. These can include:

• Sweating
• Confusion
• Laughing at inappropriate times
• Over-excitability
• Slurred speech
• Coordination problems
• Agitation
• Lethargy
• Paranoia
• Euphoria
• High blood pressure
• Nausea and vomiting
• Spasms of the eyeballs
• Feeling like you are floating
• Changes in your sense of hearing and touch
• Hallucinations

A DXM overdose can be fatal when combined with other substances, including alcohol. If you suspect someone has taken too much DXM with other substances, call 911 immediately.

Signs of DXM Misuse

When a person starts to misuse DXM, signs are often apparent. These can include:

• Exhibiting high-dose DXM side effects
• Taking DXM when not medically necessary
• Consuming higher than recommended doses of DXM
• Mixing DXM with other substances like alcohol
• Having DXM cravings

DXM misuse on its own is rarely fatal. Unfortunately, many people combine DXM with other substances, increasing the risk of severe side effects, which can be deadly in some cases.

Risks of Mixing DXM and Alcohol

Mixing DXM and alcohol can be risky. Because both alcohol and DXM act on the central nervous system, side effects can be increased when you combine the substances and may include:

• Dizziness
• Drowsiness
• Problems concentrating
• Impaired thinking and judgment

In addition, mixing alcohol and DXM can increase your risk of a potentially fatal DXM overdose. This risk can differ with the amount of alcohol and DXM you consume. Some people intentionally take too much DXM, a practice called Robotripping, dexing and skittling.

Others mix DXM and alcohol or other substances to try to get high. Every year in the U.S., around 6000 people go to the emergency room because of misusing DXM with other substances like antihistamines, alcohol, acetaminophen or pseudoephedrine.

Lastly, even those who take DXM as directed are at risk when mixing it with alcohol. Most people take DXM when they are ill. Because alcohol is an immunosuppressant, drinking when unwell can prolong and worsen your illness, keeping you sick for longer.

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How Long Should You Wait To Drink After Taking Cough Medicine?

Because alcohol is an immunosuppressant, to avoid worsening your illness, you should avoid alcohol entirely while you recover from your cough or cold. However, you should also avoid alcohol while DXM is in your system.

A drug’s half-life is how long it takes half a dose to be eliminated from your body. The half-life of DXM differs widely and can range from 2.4 hours to more than 19 hours, depending on your body chemistry. Because it takes five half-lives for a drug to be removed entirely from your system, DXM may sometimes stay in your body for almost four days.

Due to the wide variability in how long DXM lasts, it is best to consult your doctor or pharmacist before deciding to drink after taking the medication.

Treatment for Alcohol and DXM Misuse

If you struggle with drinking while taking DXM or are mixing DXM and alcohol to get high, stopping can seem overwhelming. But help is here. At The Recovery Village Kansas City, our medical detox staff can help you wean off alcohol and DXM safely and comfortably. We also have inpatient rehab, intensive outpatient treatment, partial hospitalization and aftercare programs to help support your long-term sobriety. Contact us today to get started on your recovery journey.