The half-life of DXM is thought to range between 3 and 6 hours, meaning some users may eliminate it from their systems in under 17 hours, whereas other users may take around 33 hours.
Whether you are likely to eliminate DXM and its dextrorphan metabolite quickly or slowly from your system may be contingent upon certain variables. Two individuals could ingest an oral dose of 30 mg DXM, yet one user is likely to eliminate the drug along with its dextrorphan metabolite faster than the other individual. Differences in elimination speed are usually a result of individual factors.
DXM is likely metabolized at a slower rate as a result of diminishing liver function associated with old age. This means that higher levels of DXM are likely to accumulate within the plasma as a result of prolonged metabolism. In addition, distribution of various drugs such as DXM is often altered among elderly compared to younger adults due to altered concentrations of plasma proteins.
If you are a healthy, young adult, elimination of DXM should be much quicker than that of an elderly individual. However, it is important to also consider that DXM is lipophilic and may accumulate in fat stores throughout the body of a larger individual when administered over a long-term.
This increased accumulation within fat stores suggests that retention may increase and elimination may take longer than usual.
Genetics : Perhaps the biggest factor to consider in regards to how long DXM will stay in your system are your genetics. If a genetic analysis e. For this reason, any individual with hepatic impairment may exhibit poorer function of CYP2D6 isoenzymes and may retain DXM for a longer duration. Suboptimal function of CYP2D6 as a result of hepatic impairment will likely increase plasma concentrations of DXM and prolong systemic retention.
The greater the severity of the impairment, the longer DXM will likely be retained, whereas in cases of minor impairment, increases in half-life may not be clinically significant. Individuals with a high BMR are known to be utilizing more energy stores in a resting state, whereas people with a low BMR are using up less energy stores during rest. There is some evidence from hyperthyroid and hypothyroid individuals that supports the impact of BMR on elimination half-lives of drugs.
Renal function : Since a majority of DXM is processed by the kidneys and excreted via urine, impairment of renal function may compromise efficiency of DXM metabolite excretion. As a result of this compromised metabolite excretion, they may accumulate within the kidneys, sometimes to a considerable extent. Upon accumulation of DXM metabolites, some may be likely to get reabsorbed and recirculate throughout the body — leading to slower elimination.
The extent to which accumulation occurs is likely related to the degree of renal impairment. Someone with severe forms of renal impairment may experience a noticeable increase in DXM half-life, whereas an individual with minor impairment may not notice a significant difference in elimination half-life.
That said, anyone with suboptimal renal function is likely to retain DXM metabolites for slightly longer than if their kidneys were healthy. The dosage of DXM that a person ingests will likely influence how long it remains in systemic circulation.
Though elimination times are usually similar among users taking low-level medicinal dosages, elimination times may be considerably longer among those taking supratherapeutic or recreational doses. The increase in elimination half-life of DXM among those taking abnormally high doses is likely influenced by several factors. Firstly, high dosages tax enzymes in the liver to a greater extent than lower doses. As a result of the increased CYP2D6 isoenzyme workload, the efficiency of metabolism is likely to plummet, leading to increased plasma levels and protracted systemic retention of DXM.
Additionally, at high doses, a greater level of DXM metabolites such as dextrorphan circulate throughout the body. This means that high dose users may essentially accumulate more metabolites than lower dose users — further prolonging elimination.
Finally, it is necessary to consider that renal excretion may be less efficient among high dose users. It is the combination of less efficient hepatic metabolism, propensity of metabolite accumulation, and compromised renal excretion — that may extend half-life among high dose users. J Emerg Med. Massive dextromethorphan ingestion and abuse. Am J Emerg Med. Bem JL Peck R. Dextromethorphan: An overview of safety issues. Drug Saf. Serotonin release in nucleus of the solitary tract and its modulation by antitussive drugs.
Res Commun Chem Pathol Pharmacol. Browne B Linter S. Monoamine oxidase inhibitors and narcotic analgesics: A critical review of the implications for treatment. Br J Psychiatry.
Nierenberg DR Semprebon M. The central nervous system serotonin syndrome. Clin Pharm and Ther. Schwartz RH. Adolescent abuse of dextromethorphan. Clin Pediatr. Arch Fam Med. Centers for Disease Control and Prevention. Neerman MF. Drugs of abuse: Analyses and ingested agents that can induce interference or cross-reactivity.
Lab Med. The Clinical Toxicology Laboratory. The dextromethorphan defense: Dextromethorphan and the opioid screen. Acad Emerg Med. Rogowski R Krenzelok E. DXM addiction comes with many adverse effects and risks. Taking too much Dextromethorphan can significantly damage the health. Dextromethorphan was approved for use by the FDA in the s as a cough suppressant, and it was reported in that 1 out of every 27 teens abused OTC medications such as Dextromethorphan.
Furthermore, a six-year retrospective review study conducted in California in showed a ten-fold increase in teen DXM addiction rates from to In spite of government efforts to stop the abuse of Dextromethorphan cough syrup by teenagers , it is easily accessible through stores and online sources. Dextromethorphan extraction from syrups is relatively easy, making it even harder to control the abuse among teens.
It is important for parents to care for their teens by never assuming that they are too innocent to abuse this drug. DXM addiction is real and may lead to severe effects such as liver damage and respiratory complications. Furthermore, DXM can become a gateway to hard drugs for teenagers.
Taking too much Dextromethorphan can significantly damage the health nervous system , so that one may get a chemical psychosis. This may result in a mental imbalance that may require hospitalization. Poor judgment, visual distortions, and irrational behavior may also occur, putting the individual at high risk for causing or being involved in an accident.
Death is rare, but the most significant risk which may appear because of abusing Dextromethorphan. If a person is suspecting someone experiencing these dangers of DXM abuse, immediate medical treatment, care, and help must be given to avoid the possible occurrence of worse scenarios. DXM abuse will not only lead to addiction but will also lead to life-threatening overdose. Aside from the dangerous physical signs of overdose such as tachycardia and seizures, some other signs and symptoms of overdose are the following:.
Hyperexcitability and somnolence are the most common behavioral Dextromethorphan overdose symptoms. Because of this, it is important to seek emergency care or treatment whenever the signs and symptoms above are observed, as these are more likely to result in coma or death. After abusing the drug for a long time from a few months to a few years , people develop a DXM addiction. In some rare cases, the individual may establish physiological dependence as well. When this happens, the person will experience DXM withdrawal symptoms.
DXM withdrawal symptoms usually are not harmless. These can manifest as:. In most cases, the DXM withdrawal symptoms require medical attention. Therefore, the presence of a healthcare physician or rehabilitation and addiction expert during a Dextromethorphan detox and treatment is crucial.
The withdrawal timeline for Dextromethorphan always varies from case to case. While symptoms grow more gradually as compared to other drugs, conducted surveys indicate that it can last up to at least a few weeks. How long does the DXM drug stay in the system? DXM HBr is absorbed quickly and has an elimination half-life of hours. However, in extensive metabolizers, half-life time may be shorter than 2 hours. On the other hand, poor metabolizers may need up to 24 hours to eliminate Dextromethorphan from the system completely.
Another quite fascinating aspect relating to Dextromethorphan is information about its metabolism. All assays after codeine and placebo ingestion were positive and negative for opioids, respectively. Conclusion: Although dextromethorphan is structurally similar to opioid drugs, the ingestion of a single normal or even twice normal dose of dextromethorphan is not likely to produce a falsely positive six-hour urine opioid EMIT screen.
Abstract Objective: To determine whether a single oral dose of dextromethorphan produces a falsely positive qualitative urine opioid screen.
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