Dextromethorphan: Difference between revisions
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| dosing = | | dosing = | ||
<titration slug="erowid-dose-oral" author="erowid-claude" | |||
title="Oral dose ladder (Erowid, HBr salt)"> | |||
Erowid's dosage documentation for oral dextromethorphan hydrobromide<ref | |||
name="erowid-dxm-dose">Erowid. DXM Dosage. Erowid.org. | |||
https://www.erowid.org/chemicals/dxm/dxm_dose.shtml. | |||
Accessed 2026-05-26.</ref> reports the following tiers: | |||
* '''Light:''' 100-200 mg | |||
* '''Common:''' 200-400 mg | |||
* '''Strong:''' 300-600 mg | |||
* '''Heavy:''' 600-1,500 mg | |||
Threshold not characterized. Duration 4 to 8 hours for standard HBr | |||
formulations; 6 to 12 hours for extended-release polistirex | |||
formulations. Erowid notes that doses are affected significantly by | |||
body weight and recommends conservative starting amounts. A critical | |||
harm note: many OTC formulations containing DXM also include | |||
acetaminophen, chlorpheniramine maleate (CPM), guaifenesin, or other | |||
active ingredients that become dangerous at the doses required for | |||
psychoactive DXM effects; use of single-ingredient preparations is | |||
essential for harm reduction. | |||
</titration> | |||
| effects = | | effects = | ||
| interactions = <pharmaInteractions/> | | interactions = <pharmaInteractions/> | ||
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}} | }} | ||
[[Category:Psychedelics]] | |||
[[Category:Dissociatives]] | [[Category:Dissociatives]] | ||
[[Category:Morphinans]] | |||
[[Category:Dissociative Anesthetics]] | |||
[[Category:NMDA receptor antagonists]] | |||
Latest revision as of 17:24, 26 May 2026
Dissociative
Dextromethorphan
DXM
Experience
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Problems
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+ Add a problemTitration strategies
Oral dose ladder (Erowid, HBr salt)0
Erowid's dosage documentation for oral dextromethorphan hydrobromide[1] reports the following tiers:
- Light: 100-200 mg
- Common: 200-400 mg
- Strong: 300-600 mg
- Heavy: 600-1,500 mg
Threshold not characterized. Duration 4 to 8 hours for standard HBr formulations; 6 to 12 hours for extended-release polistirex formulations. Erowid notes that doses are affected significantly by body weight and recommends conservative starting amounts. A critical harm note: many OTC formulations containing DXM also include acetaminophen, chlorpheniramine maleate (CPM), guaifenesin, or other active ingredients that become dangerous at the doses required for psychoactive DXM effects; use of single-ingredient preparations is
essential for harm reduction.Effects
No effects listed yet. Be the first to suggest one.
Interactions
Pharmacogenomic + mechanism interactions
Pharmacokinetic mechanismSubstrate / metabolism relationships from primary literature
FDA Drug Interactions Table: sensitive index substrate of CYP2D6.
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Clinical relevance: does this interaction matter in practice?trivialcritical
Mechanism description, if it needs work:
Is this row worth surfacing?
Your own experience with this combination:
Experience (1 a little, 5 a lot)
Outcome (-100 worst, +100 best)
Inferred from pharmacokinetic dataMaterialised by the inference engine; provenance shown per row
Quinidine inhibits CYP2D6 (inhibitor_strong, intensity 95); Dextromethorphan is a substrate_major of CYP2D6 (intensity 80). Derived: Dextromethorphan exposure raised.
⏱ reversible competitive, effect resolves over ~5 inhibitor half-livesInferred via Enzyme:CYP2D6 (exposure raised)
Rate this interaction. Reports are anonymous and help curate the page.
Clinical relevance: does this interaction matter in practice?trivialcritical
Confidence in this inference: is the inferred magnitude sound?overstatedsound
Mechanism description, if it needs work:
Kinetics annotation:
Is this row worth surfacing?
Your own experience with this combination:
Experience (1 a little, 5 a lot)
Outcome (-100 worst, +100 best)
Fluoxetine inhibits CYP2D6 (inhibitor_strong, intensity 90); Dextromethorphan is a substrate_major of CYP2D6 (intensity 80). Derived: Dextromethorphan exposure raised.
⏱ mechanism-based, interaction persists ~4-6 weeks after stopping the inhibitorInferred via Enzyme:CYP2D6 (exposure raised)
Rate this interaction. Reports are anonymous and help curate the page.
Clinical relevance: does this interaction matter in practice?trivialcritical
Confidence in this inference: is the inferred magnitude sound?overstatedsound
Mechanism description, if it needs work:
Kinetics annotation:
Is this row worth surfacing?
Your own experience with this combination:
Experience (1 a little, 5 a lot)
Outcome (-100 worst, +100 best)
Paroxetine inhibits CYP2D6 (inhibitor_strong, intensity 90); Dextromethorphan is a substrate_major of CYP2D6 (intensity 80). Derived: Dextromethorphan exposure raised.
⏱ mechanism-based, interaction persists ~4-6 weeks after stopping the inhibitorInferred via Enzyme:CYP2D6 (exposure raised)
Rate this interaction. Reports are anonymous and help curate the page.
Clinical relevance: does this interaction matter in practice?trivialcritical
Confidence in this inference: is the inferred magnitude sound?overstatedsound
Mechanism description, if it needs work:
Kinetics annotation:
Is this row worth surfacing?
Your own experience with this combination:
Experience (1 a little, 5 a lot)
Outcome (-100 worst, +100 best)
Bupropion inhibits CYP2D6 (inhibitor_strong, intensity 85); Dextromethorphan is a substrate_major of CYP2D6 (intensity 80). Derived: Dextromethorphan exposure raised.
⏱ reversible competitive, effect resolves over ~5 inhibitor half-livesInferred via Enzyme:CYP2D6 (exposure raised)
Rate this interaction. Reports are anonymous and help curate the page.
Clinical relevance: does this interaction matter in practice?trivialcritical
Confidence in this inference: is the inferred magnitude sound?overstatedsound
Mechanism description, if it needs work:
Kinetics annotation:
Is this row worth surfacing?
Your own experience with this combination:
Experience (1 a little, 5 a lot)
Outcome (-100 worst, +100 best)
Mirabegron inhibits CYP2D6 (inhibitor_moderate, intensity 55); Dextromethorphan is a substrate_major of CYP2D6 (intensity 80). Derived: Dextromethorphan exposure raised.
Inferred via Enzyme:CYP2D6 (exposure raised)
Rate this interaction. Reports are anonymous and help curate the page.
Clinical relevance: does this interaction matter in practice?trivialcritical
Confidence in this inference: is the inferred magnitude sound?overstatedsound
Mechanism description, if it needs work:
Is this row worth surfacing?
Your own experience with this combination:
Experience (1 a little, 5 a lot)
Outcome (-100 worst, +100 best)
Patient experience
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Relevant anecdote
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Relevant Literature
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Summary
Classes
Dissociative
Common uses
Pharmacy
Pharmacology
Purported mechanism
NMDA antagonist; sigma-1 agonist; serotonin reuptake inhibitor
- ↑ Erowid. DXM Dosage. Erowid.org. https://www.erowid.org/chemicals/dxm/dxm_dose.shtml. Accessed 2026-05-26.