Dextromethorphan is available in most OTC cough medicines. The dextromethorphan class belongs to a cough category called antitussive. In a recommended DXM dose, the side effects are rarely observed. However, some adolescents used it in high doses as a recreational drug. So, it is essential to follow dextromethorphan dosage instructions printed on the product label when using a cough medicine with DXM. The use of cough medicine with this medication requires following the dosage guide to avoid DXM overdose effects. What does dextromethorphan do when misused? Learn more about the therapeutic DXM dosage, about how to measure it, and how much of dextromethorphan is needed to get high.
Table of Contents
- What Is The DXM Medical Dosage For Adults And Children?
- What Is The Dextromethorphan Maximum Recommended Dosage?
- What To Do If A Dose Is Missed?
- What Are The Recreational Doses For DXM?
- What Is Dextromethorphan Redosing?
- Microdosing DXM: Does It Have A Medical Benefit?
- What Is The DXM LD50 Dose?
- How To Keep A Safe Dextromethorphan Dosage?
Dextromethorphan Medical Dosage
How to get dextromethorphan? It is available in the form of syrup, lozenges, and DXM pills. Each product form contains different quantities, and every brand of cough medicine has its dosage recommendations. One 60 mg of DXM polistirex dosage delivers a plasma concentration equal to two 30 mg of dextromethorphan HBr dosage given every 6 hours. How to measure DXM dosage? Measure the suspension with a special dose-measuring spoon or dropper, not a regular tablespoon.
The recommended amount depends on the strength of the medicine, the number of doses each day, the number of dextromethorphan dosing intervals, patient age and weight, and other pathological conditions the patient may have.
How much of dextromethorphan is safe for patients suffering from hepatic and renal impairment? There is no need for dosage adjustment in hepatic impairment. However, it is advised to use it in low doses to avoid the risk of dextromethorphan abuse long term effects. Also, there are no available specific guidelines for dosing adjustment in renal impairment. And how much of DXM will fail a drug test? A dose of 30 mg daily can fail the test.
DXM Adult Dosage
The recommended adult dose is 30 mg taken three to four times daily. The cough-suppressing effects persist for 6 hours after ingestion. It is well absorbed from the gastrointestinal tract within 30 minutes. It is a subject to significant first-pass metabolism, causing a reduction of its bioavailability. Its half-life is 2 to 4 hours. According to a study published in the Journal of International Medical Research, using a low dose of this medication improves the hypertensive effect of Amlodipine monotherapy.
| Dosing Form |
Liquid and syrup |
Gel | Suspension | Lozenges | Strips |
|---|---|---|---|---|---|
| Pure | 30 mg every 6-8 hours |
30 mg every 6-8 hours |
60 mg every 12 hours |
5-15 mg every 2-4 hours |
30 mg every 6-8 hours |
| HBr | 10 to 30 mg orally every 4 to 8 hour |
10 to 30 mg orally every 4 to 8 hour |
10 to 30 mg orally every4 to 8 hour |
3 lozenges orally every 6 to 8 ho |
15 to 30 mg orally every 6 to 8 hours. |
| Polistirex | – | – | 60 mg orally every 12 hours | – | – |
DXM Pediatric Dosage
It is not recommended to use cough medicines containing dextromethorphan for children below 4 years. Also, it is not advised to use it as a first choice of coughing for children aged 4 years and above. Using a natural cough medicine without this drug is preferred, such as honey and ginger. According to the recommendations of The US Food And Drug Administration, the child under 6 years that suffers from coughing shouldn’t use a cough medicine containing more than one ingredient. It is necessary to follow the specific dextromethorphan pediatric dose instructions on the label to find the correct dose corresponding to the child age. Dosage by weight is used to calculate dosage in children accurately. The recommended dextromethorphan child dose is 0.5 mg/kg of body weight.
| Dosage Form | Liquid and syrup |
Gel | Extended-release suspension |
Lozenges | Strips |
|---|---|---|---|---|---|
| Children 4-6 years old | 7.5 mg every 6-8 hours |
Not recommended |
15 mg twice daily |
Not recommended |
Not recommended |
| Children 6-12 years old | 15 mg every 6-8 hours |
Not recommended |
30 mg twice daily |
5-10 mg every 1-4 hours |
15 mg every 6-8 hours |
| Children over 12 years | 10-20 mg every 4 hours |
30 mg every 6-8 hours |
60 mg twice daily |
5-15 mg every 1-4 hours |
30 mg every 6-8 hours |
Dextromethorphan Maximum Recommended Dosage
The adverse reactions occur when taken a medicine more than the recommended dosing. This can be by accident or by the misuse of medication. When not exceeding the dextromethorphan maximum recommended dosage, is safely tolerated without side effects. The max adult dose of dextromethorphan is established based on the amount of this medication in the product selected.
The dextromethorphan max dose in adults is 120 mg/24 hours beyond that, intoxication and dangerous adverse reactions begin to appear.
Moreover, the maximum recommended dosage in adolescents is 120mg DXM. How much of dextromethorphan is too much to cause adverse reactions for children? The recommended maximum dosing for children 4 to 6 y.o is 30 mg DXM daily. And the maximum dosage for 6 to 12 y.o is 60 mg DXM daily.
If Miss A Dose Of Dextromethorphan
If a dose missed, take it immediately as soon as possible. If it is nearly time for the next dosage, skip the missed one and then go back to taking the dosage normally. Do not double a dose of dextromethorphan to make compensation for a missed dose, as this increases the risk of getting unwanted adverse reactions.
Dextromethorphan Recreational Doses
How much DXM does it take to get high? The DXM recreational doses can vary and range between 100 mg to 1500 mg or more. A minor stimulation occurs in the lowest DXM recreational dosage (when daily dose exceeded 2-3 times). At high dosage (when daily dose exceeded 4-6 times) leads to ecstasy and depth perception impairment. Loss of motor dexterity and inaccurate visual perceptions occur at a dose of 300 mg DXM to 600 mg DXM. The highest recreational dose of dextromethorphan (500-1500 mg) causes dissociative sedation. Do not exceed the daily dose of DXM to avoid the harm appearance.
It is used for recreational purpose when exceeding the recommended maximum dose, especially in teenagers; however it may cause significant harm to the body, and many adverse physical and psychological effects. DXM abuse in many young users also occurs when taking it with other drugs, such as antihistamine in OTC cough medicines. Since this drug is used during a cold, it is often combined with ibuprofen, but there is no evidence about the interaction between dextromethorphan and ibuprofen in any dose. The combination with chlorpheniramine increases the recreational psychoactive effects of DXM, such as a toxidrome of psychomotor agitation, hallucinations, and paranoia. It is also not advised to use it with acetaminophen recreationally because using acetaminophen in high doses (4000 mg) can be fatal. Avoid taking it with alcohol – the DXM in combination with alcohol in any doses produces a hazardous synergistic effect.
DXM Redosing
Dextromethorphan redosing is the administration of an additional dose of the drug. The DXM redose tolerance occurs during the 12 months of its use. The DXM optimal redose is 20-30 mg, three to four times daily. The redosing DXM next day will also be right if, the drug is used at night.
Microdosing DXM
The DXM microdose is a new technique for studying the behavior of dextromethorphan in humans through the administration of very low doses of medicine. According to a study in the Journal of International Medical Research, in which spinal nerve ligation and sham animals received microdosing DXM (10 mg/kg), it has a useful effect in the treatment of neuropathic pain.
LD50 Dose For DXM
The LD50 dextromethorphan dose is the amount of medicine that is sufficient to cause death in 50 percent of the tested population within a certain time. The LD50 DXM dose is between 50 and 500 mg/kg. The LD50 for Polistirex form is about 1500 mg. And the LD50 dextromethorphan hydrobromide dose in recreational users is about 15 to 20 mg/kg.
Dextromethorphan Doses For Safe Use
Using dextromethorphan for coughing in the recommended therapeutic dose is safe, but prolonged use or taking it in high doses increase the incidence of abuse. High doses can cause tolerance, addiction, and intoxication. Using a cough medicine without dextromethorphan or a natural cough remedy is preferred, especially for children. The chances of successfully treating addiction will be higher with the help of addiction treatment programs like a dextromethorphan detox program. If assistance is needed to complete the process, start the detox off DXM. Also, seek help at the drug rehab center, where there follow-up and specialized care by specialists.
Page Sources
- Morel V, Pickering G, Etienne M, Dupuis A, Privat AM, Chalus M, Eschalier A, Daulhac L. Low doses of dextromethorphan have a beneficial effect in the treatment of neuropathic pain. 2014. https://www.ncbi.nlm.nih.gov/pubmed/24702319
- U.S. Food & Drug Administration. Use Caution When Giving Cough and Cold Products to Kids. 2018. https://www.fda.gov/drugs/special-features/use-caution-when-giving-cough-and-cold-products-kids
- Yin WH, Chen P, Yeh HI, Wang KY, Hung YJ, Tseng WK, Wen MS, Wu TC, Wu CC, Cheng SM, Chen JW. Combination With Low-dose Dextromethorphan Improves the Effect of Amlodipine Monotherapy in Clinical Hypertension: A First-in-human, Concept-proven, Prospective, Dose-escalation, Multicenter Study. 2016. https://www.ncbi.nlm.nih.gov/pubmed/27015224
