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Dextromethorphan (DXM or DM) is an antitussive (cough suppressant) drug of the morphinan class with sedative and dissociative properties. It is one of the active ingredients in many over-the-counter cold and cough medicines, including generic labels and store brands, Benylin DM, Mucinex DM, Camydex-20 tablets, Robitussin, NyQuil, Dimetapp, Vicks, Coricidin, Delsym, TheraFlu, and others. Dextromethorphan has also found numerous other uses in medicine, ranging from pain relief (as either the primary analgesic, or an opioid potentiater) over psychological applications to the treatment of addiction. It is sold in syrup, tablet, spray, and lozenge forms. In its pure form, dextromethorphan occurs as a white powder.

DXM is also used recreationally. When exceeding label-specified maximum dosages, dextromethorphan acts as a dissociative hallucinogen. Its mechanism of action is via multiple effects, including actions as a nonselective serotonin reuptake inhibitor and a sigma-1 receptor agonist. DXM and its major metabolite, dextrorphan, also act as an NMDA receptor antagonist at high doses, which produces effects similar to, yet distinct from, the dissociative states created by other dissociative anaesthetics such as ketamine and phencyclidine. As well, the metabolite 3-methoxymorphinan of dextrorphan (thus a second-level metabolite of DXM) produces local anesthetic effects in rats with potency above dextrorphan, but below that of DXM.

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Other names

(14alpha)-3-Methoxy-17-methylmorphinan (IUPAC Name); (9a,13a,14a)-3-Methoxy-17-methylmorphinan; (9alpha,13alpha,14alpha)-17-methyl-3-(methyloxy)morphinan; (9alpha,13alpha,14alpha)-3-Methoxy-17-methylmorphinan; 3-Methoxy-17-methyl-9a,13a,14a-morphinan; Balminil DM; Benylin Pediatric Cough Suppressant; Cough-X; Creo-Terpin; Delsym Cough Formula; Demorphine; Dextrometorphan; Dexyromethorphan; Diabe-Tuss DM Syrup; Dormetan; Hold DM; Koffex DM; (9Alpha,13alpha,14alpha)-3-methoxy-17-methyl-morphinan; (9-Alpha,13-alpha,14-alpha)-3-methoxy-17-methyl-morphinan; Novahistex DM; Novahistine DM; Pertussin CS Children's Strength; Pertussin DM Extra Strength; Robitussin Maximum Strength Cough Suppressant; Robitussin Pediatric; Robitussin Pediatric Cough Suppressant; Sucrets 4 Hour Cough Suppressant; Triaminic DM Long Lasting for Children; Trocal; Vicks 44 Cough Relief


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