Commonly found in certain over the counter cough medicines. Has dissociative effects similar to ketamine or MXE, though also shares properties with opioids and alcohol. Make sure DXM is the only active ingredient in the preparation.
⚠️ See http://dxm.tripsit.me for mg/lb doses, among other things. Deaths have been reported at 25mg/kg
These combinations are considered extremely harmful and should always be avoided.
alcohol: Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. Place the affected individual in the recovery position to prevent vomit aspiration from excess. Additionally, CNS depression can lead to difficulty breathing. Avoid on anything higher than 1st plateau.
ghb/gbl: Both substances cause ataxia and bring a risk of vomiting and unconsciousness. If the individual falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position. This combination is hard to predict
maois: High risk of serotonin syndrome
mephedrone: Risk of serotonin syndrome as both drugs raise serotonin levels. In addition to concerns of high blood pressure and unnecessary strain on the heart. As well as potentially causing anxiety and greater physical discomfort due to the combination.
opioids: CNS depression, difficult breathing, heart issues, hepatoxic, just very unsafe combination all around. Additionally if one takes DXM, their tolerance of opiates goes down slightly, thus causing additional synergistic effects.
ssris: High risk of serotonin syndrome.
There is considerable risk of physical harm when taking these combinations, they should be avoided where possible.
5-meo-xxt: Little information exists about this combination.
amphetamines: Both substances raise heart rate, in extreme cases, panic attacks caused by these drugs have led to more serious heart issues.
cocaine: Both substances raise heart rate, in extreme cases, panic attacks caused by these drugs have led to more serious heart issues
dox: The DOx class as psychedelic stimulants have the potential to mask the effects of DXM and could lead to redosing to an unsafe level. DXM can also potentiate DOx resulting in an unpleasantly intense experience.
mxe: There is a risk of serotonin syndrome when combining DXM with MXE, due to DXM and MXE both being SRI’s. MXE and DXM having notable affinities for the serotonin transporter.
These combinations are not usually physically harmful, but may produce undesirable effects.
benzodiazepines: Small doses of benzos can end a bad trip, but both substances potentiate the ataxia and sedation caused by the other and this can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position.
caffeine: High doses of caffeine can potentially exacerbate anxiety, especially during a dissociative experience, due to its stimulating effects. This combination might also lead to physical discomfort. However, individual responses to caffeine can vary significantly, often influenced by factors like habitual versus occasional usage.
These drugs work together to cause an effect greater than the sum of their parts.
ketamine: Both substances primarily exert their effects through NMDA antagonism. Currently, there is no evidence regarding mechanisms that might reduce these effects.