How Long Does Dextromethorphan Stay in Your System?
Recent survey results show an increasing trend in the percentage of teens using cough medicine containing Dextromethorphan (DXM) to get high. In 2020, 3.7 percent of teens used over-the-counter cough medicine with DXM. This figure represents an increase of 2.8 percent in 2019. The same survey reports that the eighth graders’ use of cough medicine with DXM has consistently increased over the past five years, from 2.6% in 2016 to 4.6% in 2020. The question is – how long does Dextromethorphan stay in your system?
But before we dive deeper, let’s first understand what Dextromethorphan (DXM) is, the medications that contain this drug, and other important information.
Dextromethorphan half-life and metabolism (CYP2D6 and dextrorphan)
Dextromethorphan is broken down in the liver, largely through CYP2D6, into dextrorphan. This metabolism step is a major reason people can have very different experiences and detection times from the same product and dose. People who are CYP2D6 poor metabolizers may clear DXM more slowly, which can extend how long dextromethorphan stays in your system. This variability also helps explain why some people report stronger side effects, including drowsiness, at standard doses. When DXM is taken repeatedly or in high doses, the elimination pattern can stretch out and the risk of adverse effects increases.
What is Dextromethorphan?
Dextromethorphan (DXM) is the active ingredient found in medicines classified as a cough suppressant. It temporarily relieves a cough caused by the common cold, flu, bronchitis, allergies, and other lung disorders. However, it does not treat the cause of the cough or speed recovery.
Sold over-the-counter, DXM comes in over 100 products such as syrup, tablets, capsules, sprays, lozenge, and even dissolvable strips placed under the tongue. Besides, anyone can purchase DXM products and powder on the internet.
DXM is a popular drug of abuse among teenagers because it is accessible and does not raise suspicion.
Slang terms for DXM include:
- Black beauties
- Brownies
- Dex or Drex
- Dextro
- Drix
- Gel
- Groove
- Lean
- Mega-perls
- Orange crush
- Poor man’s Ecstasy, Poor man’s PCP, or Poor man’s X
- Red devils
- Red hots
- Robo
- Rojo
- Rome
- Skittles
- Sizzurp or syrup
- Sky
- Triple C’s or CCCs
- Tussin
- Velvet
- Vitamin D
DXM is not a scheduled drug under the Controlled Substances Act. However, the United States Drug Enforcement Administration (DEA) lists DXM as “a drug of concern” because of high dextromethorphan dependence and abuse rates.
Data from the Substance Abuse and Mental Health Services Administration (SAMHSA) and the National Institute on Drug Abuse (NIDA) indicate that the abuse of DXM typically occurs in young females under the age of 18 and males between the ages of 18 and 26 years old.
DXM may be swallowed in its original form or possibly mixed with soda for flavor, called “robo-tripping” or “skittling.” In other instances, those with substance disorder inject or use it combined with other drugs, such as alcohol and marijuana.
Is Dextromethorphan addictive?
Misuse of DXM in high doses can lead to various effects and dangers. When consumed in excessive amounts, DXM can produce intoxicating effects similar to marijuana, ketamine, or PCP, including euphoria and hallucinations. However, combining DXM with other drugs or alcohol, especially selective serotonin reuptake inhibitors (SSRI) antidepressants, can increase the risk of serotonin syndrome, a potentially life-threatening condition.
Additionally, DXM misuse in medications containing other active ingredients can cause health complications. Pseudoephedrine, found in some medications, can lead to high blood pressure, while acetaminophen can cause liver damage. Antihistamines present in certain formulations may result in central nervous system toxicity and heart damage.
Medications containing Dextromethorphan
Among the popular formulations with DXM as an ingredient include:
- Coricidin
- DayQuil
- Dimetapp DM
- NyQuil
- Robitussin DM
- Vicks Formula 44
- Robitussin CF
- Robitussin Cough and Cold
- Mucinex DM
- Store brands for cough and cold medicines
OTC DXM products: ingredient combinations that change the risk
Many OTC cough and cold products combine dextromethorphan (DXM) with other active ingredients, and those ingredients often drive the biggest safety problems. Acetaminophen overdoses can cause liver injury, and people can accidentally double-dose if they take more than one “cold/flu” product at the same time. Pseudoephedrine can raise blood pressure and heart rate, which matters for people with hypertension or certain heart conditions. Sedating antihistamines can add to drowsiness and impair driving, especially if alcohol is involved. Check the Drug Facts label for each active ingredient before taking another product, and contact Poison Control (1-800-222-1222) right away if you think you took too much.
How is Dextromethorphan usually taken?
Dextromethorphan comes as a liquid-filled capsule, a chewable tablet, a dissolving strip, a solution (liquid), an extended-release (long-acting) suspension (liquid), and a lozenge. Also, it is usually taken every 4 to 12 hours as needed. The typical adult dose for cough is 15 to 30 mg taken three to four times daily. The cough suppressing effects of DXM persist for 5 to 6 hours after ingestion.
What are the signs of Dextromethorphan withdrawal?
Listed below are the common withdrawal symptoms when one stops taking the drug.
- Bone or muscle aches.
- Cold flashes
- Craving for Dextromethorphan
- Diarrhea
- Insomnia
- Restlessness
- A significant amount of weight loss
- Vomiting
How long does Dextromethorphan stay in your system?
Dextromethorphan usually remains in the body within one to two days after your last dose. However, severe intoxication or chronic use of DXM will result in a longer elimination time.
Likewise, those with low CYP2D6 metabolism may take 4 to 5 days to eliminate DXM from their system. CYP2D6 is an enzyme that is involved in the metabolism of numerous drugs
For many people, dextromethorphan (DXM) is mostly cleared within about 1–2 days after the last dose, but the range is wider than most expect. Your liver converts DXM into dextrorphan, and CYP2D6 activity is one of the biggest drivers of how long dextromethorphan stays in your system. Higher doses, repeated dosing, and chronic misuse can extend the elimination window and increase the chance of lingering side effects. People who are CYP2D6 poor metabolizers may take several days to clear DXM compared with typical metabolizers. If your question is tied to a drug test, remember that screening tests vary and do not measure DXM the same way every time.
Factors that affect how long does Dextromethorphan stay in your system
DXM clearance varies most with dose pattern and metabolism. CYP2D6 genetics and liver function can slow the conversion of dextromethorphan to dextrorphan, which can extend both effects and detection time. Kidney function can influence how long metabolites remain measurable in urine, especially with repeated dosing. Co-administered drugs that inhibit CYP2D6, including Fluoxetine, Paroxetine, Bupropion, Quinidine, and Ritonavir, can raise DXM levels and prolong clearance. Product choice matters too, because combination cold medicines may add acetaminophen, pseudoephedrine, or sedating antihistamines that change symptoms and raise safety risks even when DXM itself is the main concern.
- User’s age. As a person ages, metabolism slows down, so DXM may remain active in the bloodstream longer in older individuals.
- Gender. Males metabolize drugs faster than females.
- Body mass. A lean individual with more muscle than fat may burn off DXM more quickly than someone with a higher fat percentage.
- Genetics. Slow metabolizers have completely inactive genes that control metabolism.
- Hepatic function. Anyone with an impaired liver will likely retain longer DXBM in his body.
- Metabolic rate. A person with a higher Basal Metabolic rate (BMR) is likely to metabolize and excrete faster DXM drugs.
- Renal function. Anyone with poor renal function is likely to retain DXM metabolites slightly longer than if his kidneys were healthy.
- Dosage. Those who take DXBM more than the recommended dosage will eliminate the drug longer.
- Co-administered drugs. Medications classified as “CYP2D6 inhibitors” interfere with CYP2D6 isoenzyme function. These drugs include Bupropion, Cinacalcet, Fluoxetine, Paroxetine, Quinidine, and Ritonavir. Meanwhile, if you’ve taken a drug classified as a “CYP2D6 inducer,” this drug may have strengthened your CYP2D6 isoenzyme function. Examples include Dexamethasone, Glutethimide, and Rifampicin.
What type of drug test can detect Dextromethorphan?
Most routine workplace testing starts with a urine immunoassay that targets specific drug classes, not every OTC ingredient. Dextromethorphan is not typically a named target on a standard 12 panel urine drug test, but some immunoassays may cross-react and produce a PCP screening result.
A screening result should be followed by confirmatory testing such as gas chromatography-mass spectrometry (GC-MS) when the result is contested, because confirmation can distinguish PCP from DXM-related compounds.
Blood testing is generally used to assess recent use and typically has a shorter detection window than urine. If you are being tested after using an OTC cough medicine, keep the packaging and ingredient list available for review.
Dextromethorphan detection time by test (urine, blood, saliva, hair)
Detection time depends on the test and what the lab is measuring. In urine, dextromethorphan (DXM) and its metabolite dextrorphan are usually most likely to be detected within the first 1–3 days, but the window can be longer after heavy use or in CYP2D6 poor metabolizers. In blood, DXM is typically detectable for a shorter period, often within about 24 hours, because blood testing tracks recent use. Saliva tests generally reflect recent use as well and may detect DXM for roughly 1–2 days, depending on dose and product formulation. Hair testing can reflect prior exposure for weeks to months, but it is less common for over-the-counter medications and depends on the specific panel ordered by the lab.
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Barbiturates Benzodiazepines Buprenorphine |
Cocaine Ecstasy Marijuana Methadone |
Opiates/Morphine Oxycodone Methamphetamine Tricyclic Antidepressants |
Some Urine Drug tests like the 12 Panel Urine drug tests detect PCP as well. You can find this on the listing for 12 Panel Urine Drug Test + PCP on 12 Panel Now’s site listing. Why is this important?
Though no studies have performed, some individuals have reported having taken Dextromethorphan and submitted a drug screen soon thereafter. Though it’s anecdotal, some have seen false positives for Opiates as well as for PCP.
Can Dextromethorphan Make You Sleepy?
Yes, dextromethorphan (DXM) can cause drowsiness in some people, especially at higher doses or when it is taken more frequently than directed. Many OTC products pair DXM with sedating antihistamines, and that combination is a common reason people feel unusually sleepy after taking “nighttime” cold and flu medicines.
Alcohol and other central nervous system depressants can intensify sedation and slow reaction time. If DXM makes you sleepy, avoid driving or operating machinery until you know how you respond. If you need a cough suppressant during the day, check the Drug Facts label to confirm whether the product contains additional sedating ingredients.
Does Dextromethorphan Cause High Blood Pressure?
Dextromethorphan (DXM), a common ingredient in over-the-counter cough medications, is generally not associated with significant effects on blood pressure when used as directed. However, the relationship between DXM and blood pressure is nuanced and worth exploring. Let’s check this out in more detail below:
- Normal Usage: At recommended doses for cough suppression, DXM typically does not cause notable changes in blood pressure for most people.
- High Doses: Excessive amounts of DXM, particularly when abused, may potentially affect blood pressure. Some reports suggest it could lead to temporary increases in blood pressure, though this is not its primary effect.
- Indirect Effects: DXM can cause nausea in some individuals. This discomfort might indirectly lead to a temporary rise in blood pressure.
- Combination with Other Ingredients: Many cough medicines contain additional active ingredients like pseudoephedrine, which can raise blood pressure. It’s important to check the full ingredient list.
- Individual Variations: As with many medications, effects can vary from person to person based on factors like overall health, age, and concurrent medications.
- Underlying Conditions: Individuals with pre-existing hypertension or heart conditions should consult their healthcare provider before using DXM-containing products.
- Interactions: DXM can interact with certain medications, including some used to treat high blood pressure. Always inform your doctor about all medications you’re taking.
While DXM itself is not primarily known for raising blood pressure, it’s essential to use it responsibly and be aware of potential effects, especially if you have concerns about your cardiovascular health.
Getting Help for Dextromethorphan Addiction
Whether your questions about how long does Dextromethorphan stay in your system relates to Dextromethorphan withdrawal, a drug test, or perhaps a combination of factors, it can linger for a long time in your body.
If you’re struggling with Dextromethorphan problems and need the instant drug test kit, contact 12 Panel Now to learn more about drug testing services.
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