What are the symptoms of dextromethorphan overdose. How to recognize a DXM overdose. When to seek emergency medical help for cough medicine abuse. What products contain dextromethorphan. How to prevent accidental overdose of cough suppressants.

Understanding Dextromethorphan and Its Uses

Dextromethorphan, commonly abbreviated as DXM, is a widely used cough suppressant found in numerous over-the-counter cold and flu medications. Its primary function is to alleviate coughing by acting on the brain’s cough center. Despite its therapeutic benefits, dextromethorphan has become a subject of concern due to its potential for misuse and overdose.

DXM belongs to a class of drugs known as opioids, although it does not produce the same analgesic effects as traditional opioids like morphine. Its mechanism of action involves modulating neurotransmitter activity in the brain, specifically targeting the cough reflex pathway.

Common Products Containing Dextromethorphan

Dextromethorphan is present in a variety of over-the-counter medications, including:

• Robitussin DM
• Triaminic DM
• Rondec DM
• Benylin DM
• Drixoral
• St. Joseph Cough Suppressant
• Coricidin
• Alka-Seltzer Plus Cold and Cough
• NyQuil
• DayQuil
• TheraFlu
• Tylenol Cold
• Dimetapp DM

The widespread availability of these products makes it crucial for consumers to be aware of the potential risks associated with dextromethorphan use and misuse.

The Dangers of Dextromethorphan Abuse

While dextromethorphan is safe when used as directed, it has gained notoriety as a substance of abuse, particularly among adolescents and young adults. The drug is sometimes referred to by street names such as:

• Robo
• Tussin
• Rojo
• Orange crush
• Triple C’s
• Red Devils
• Skittles
• Dex

Abuse of dextromethorphan typically involves consuming large quantities of the drug to achieve a euphoric high or hallucinogenic effects. This practice, often referred to as “robotripping,” can lead to severe health consequences and potentially life-threatening overdoses.

Why is DXM Abused?

DXM abuse has become popular due to several factors:

1. Easy accessibility: As an over-the-counter medication, it’s readily available without a prescription.
2. Low cost: Compared to illicit drugs, DXM products are relatively inexpensive.
3. Perceived safety: Some individuals mistakenly believe that because it’s sold over-the-counter, it must be safe to use in large quantities.
4. Desired effects: At high doses, DXM can produce dissociative and hallucinogenic effects similar to those of ketamine or PCP.

It’s important to note that abusing DXM can lead to serious health risks and potential addiction.

Recognizing the Signs and Symptoms of Dextromethorphan Overdose

Identifying a dextromethorphan overdose is crucial for timely intervention and treatment. The symptoms can vary in severity and may include:

• Breathing problems: Slow, labored, or shallow breathing; respiratory depression (especially in young children)
• Cardiovascular issues: Pounding heartbeat (palpitations), rapid heartbeat, high or low blood pressure
• Neurological effects: Blurred vision, dizziness, drowsiness, hallucinations, seizures, coma
• Gastrointestinal disturbances: Nausea, vomiting, constipation, spasms of the stomach and intestines
• Physical signs: Bluish-colored fingernails and lips, raised body temperature, muscle twitches
• Motor impairment: Slow, unsteady gait

It’s important to note that these symptoms may be more severe or frequent in individuals who are also taking medications that affect serotonin levels in the brain.

When to Seek Emergency Medical Attention

If you suspect someone has overdosed on dextromethorphan, it’s crucial to seek immediate medical help. Call your local emergency number (such as 911 in the United States) or contact the Poison Control Center at 1-800-222-1222 for guidance.

Factors Influencing the Severity of DXM Overdose

The severity of a dextromethorphan overdose can be influenced by several factors:

1. Dosage: The amount of DXM consumed is directly related to the intensity of symptoms.
2. Individual tolerance: Regular users may have developed a higher tolerance, potentially leading to consumption of dangerous amounts.
3. Body weight and metabolism: These factors can affect how quickly the drug is processed and eliminated from the body.
4. Concurrent substance use: Combining DXM with alcohol, other drugs, or certain medications can exacerbate the overdose effects.
5. Underlying health conditions: Pre-existing medical issues may increase the risk of complications during an overdose.

Understanding these factors can help healthcare professionals provide appropriate treatment and highlight the importance of considering individual circumstances in overdose cases.

Emergency Response and Treatment for DXM Overdose

When responding to a suspected dextromethorphan overdose, time is of the essence. Here are the key steps in managing this medical emergency:

Immediate Actions

1. Call for emergency medical assistance immediately.
2. If the person is unconscious but breathing, place them in the recovery position to prevent choking.
3. If breathing has stopped, begin CPR if you are trained to do so.
4. Do not induce vomiting unless instructed by a medical professional.

Information to Provide to Emergency Responders

When contacting emergency services or poison control, be prepared to provide the following information:

• The person’s age, weight, and general health condition
• The name of the product ingested (including ingredients and strength if known)
• The time the substance was consumed
• The amount swallowed
• Whether the medicine was prescribed for the person

This information can be crucial in determining the appropriate course of treatment.

Medical Treatment

Upon arrival at a medical facility, treatment for DXM overdose may include:

• Activated charcoal administration to absorb remaining drug in the stomach
• Intravenous fluids to maintain hydration and support organ function
• Respiratory support if breathing is compromised
• Medications to manage specific symptoms (e.g., anti-nausea drugs, sedatives for agitation)
• Monitoring of vital signs and neurological status

In severe cases, more intensive interventions such as intubation or dialysis may be necessary.

Long-term Consequences of DXM Abuse and Overdose

While immediate treatment of a dextromethorphan overdose is critical, it’s equally important to consider the potential long-term effects of DXM abuse:

Physical Health Impacts

• Liver damage: Prolonged abuse can lead to hepatotoxicity, especially when DXM is consumed in products containing acetaminophen.
• Cognitive impairment: Regular use may result in memory problems, difficulty concentrating, and decreased cognitive function.
• Respiratory issues: Chronic abuse can lead to persistent breathing problems.
• Gastrointestinal damage: Frequent use may cause long-term digestive issues.

Mental Health Consequences

• Psychological dependence: DXM abuse can lead to addiction and compulsive drug-seeking behavior.
• Mood disorders: Prolonged use may exacerbate or trigger depression, anxiety, or other mental health issues.
• Psychosis: In some cases, heavy DXM abuse has been associated with persistent psychotic symptoms.

Recognizing these potential long-term effects underscores the importance of prevention and early intervention in cases of DXM abuse.

Prevention Strategies and Public Health Initiatives

Preventing dextromethorphan abuse and overdose requires a multifaceted approach involving education, regulation, and community involvement. Here are some key strategies:

Education and Awareness

• School-based programs: Implementing drug education curricula that specifically address over-the-counter drug abuse.
• Public health campaigns: Raising awareness about the dangers of DXM abuse through media and community outreach.
• Healthcare provider education: Ensuring medical professionals are trained to recognize and address DXM abuse.

Regulatory Measures

• Age restrictions: Some jurisdictions have implemented laws requiring purchasers of DXM products to be 18 or older.
• Sales limitations: Restricting the quantity of DXM-containing products that can be purchased at one time.
• Behind-the-counter placement: Moving DXM products behind pharmacy counters to limit access.

Community Involvement

• Parent education: Providing resources for parents to talk to their children about the risks of OTC drug abuse.
• Community coalitions: Forming local groups to address substance abuse issues, including DXM misuse.
• Safe disposal programs: Implementing initiatives for the proper disposal of unused medications.

By combining these approaches, communities can work towards reducing the incidence of DXM abuse and related overdoses.

The Role of Healthcare Providers in Addressing DXM Abuse

Healthcare professionals play a crucial role in combating dextromethorphan abuse and preventing overdoses. Their responsibilities extend beyond treating acute cases to include prevention, education, and long-term care.

Screening and Early Detection

• Routine screening: Incorporating questions about OTC drug use into regular patient assessments.
• Recognition of warning signs: Being alert to symptoms that may indicate DXM abuse.
• Utilization of drug testing: When appropriate, using toxicology screens that can detect DXM and its metabolites.

Patient Education

• Providing information: Educating patients about the proper use of cough medicines and the risks of misuse.
• Discussing alternatives: Offering information on non-pharmacological approaches to managing coughs when appropriate.
• Addressing misconceptions: Clarifying that OTC status does not equate to safety in all circumstances.

Treatment and Referral

• Addiction treatment: Referring patients with DXM abuse issues to appropriate substance abuse treatment programs.
• Mental health support: Connecting patients with mental health resources when needed.
• Follow-up care: Providing ongoing support and monitoring for patients recovering from DXM abuse.

By taking a proactive approach, healthcare providers can significantly contribute to reducing the prevalence of DXM abuse and its associated health risks.

Legal and Ethical Considerations Surrounding DXM Regulation

The regulation of dextromethorphan presents a complex challenge, balancing public health concerns with issues of personal freedom and access to medication. Several key legal and ethical considerations come into play:

Balancing Access and Safety

• Maintaining availability: Ensuring that individuals who need DXM for legitimate medical purposes can access it.
• Implementing restrictions: Determining appropriate measures to limit abuse potential without overly burdening consumers or retailers.
• Age restrictions: Debating the effectiveness and ethics of age-based purchasing limits.

Legislative Challenges

• Federal vs. state regulations: Navigating the complexities of creating consistent policies across different jurisdictions.
• Industry influence: Addressing the role of pharmaceutical companies in shaping DXM-related legislation.
• Enforcement issues: Developing practical methods for enforcing DXM regulations in retail settings.

Ethical Considerations

• Individual autonomy: Balancing personal freedom of choice with societal responsibility to prevent harm.
• Healthcare equity: Ensuring that regulations do not disproportionately affect certain populations’ access to care.
• Privacy concerns: Addressing issues related to tracking purchases or implementing electronic monitoring systems.

As the landscape of DXM use and abuse continues to evolve, ongoing dialogue between policymakers, healthcare professionals, and the public will be essential in developing effective and ethical regulatory approaches.

Future Directions in DXM Research and Policy

As our understanding of dextromethorphan abuse and its consequences grows, several areas emerge as priorities for future research and policy development:

Pharmacological Research

• Alternative formulations: Developing abuse-deterrent formulations of DXM-containing products.
• Interaction studies: Further investigating DXM’s interactions with other substances and medications.
• Long-term effects: Conducting longitudinal studies on the neurological impacts of chronic DXM abuse.

Public Health Initiatives

• Data collection: Improving surveillance systems to track DXM abuse trends more accurately.
• Prevention strategies: Evaluating the effectiveness of various educational and regulatory approaches.
• Harm reduction: Exploring potential harm reduction strategies for individuals who continue to misuse DXM.

Policy Development

• Evidence-based legislation: Crafting policies informed by the latest research findings.
• International cooperation: Collaborating on global efforts to address DXM abuse and trafficking.
• Technology integration: Exploring the use of digital tools for monitoring and preventing DXM misuse.

By focusing on these areas, researchers, policymakers, and healthcare professionals can work towards more effective strategies for preventing DXM abuse and minimizing its impact on public health.

Dextromethorphan overdose Information | Mount Sinai

DXM overdose; Robo overdose; Orange crush overdose; Red devils overdose; Triple C’s overdose

Dextromethorphan is a medicine that helps stop coughing. It is an opioid substance. Dextromethorphan overdose occurs when someone takes more than the normal or recommended amount of this medicine. This can be by accident or on purpose.

This article is for information only. DO NOT use it to treat or manage an actual overdose. If you or someone you are with has an overdose, call the local emergency number (such as 911), or the local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. 

Poisonous Ingredient

Dextromethorphan can be harmful in large amounts.

Where Found

Dextromethorphan is found in many over-the-counter cough and cold medicines, including:

• Robitussin DM
• Triaminic DM
• Rondec DM
• Benylin DM
• Drixoral
• St. Joseph Cough Suppressant
• Coricidin
• Alka-Seltzer Plus Cold and Cough
• NyQuil
• DayQuil
• TheraFlu
• Tylenol Cold
• Dimetapp DM

The drug is also abused and sold on the streets under the names:

• Robo
• Tussin
• Rojo
• Orange crush
• Triple Cs
• Red Devils
• Skittles
• Dex

Other products may also contain dextromethorphan.

Symptoms

Symptoms of a dextromethorphan overdose include:

• Breathing problems, including slow and labored breathing, shallow breathing, no breathing (especially in young children)
• Bluish-colored fingernails and lips
• Blurred vision
• Coma
• Constipation
• Seizures
• Drowsiness
• Dizziness
• Hallucinations
• Slow, unsteady walking
• High or low blood pressure
• Muscle twitches
• Nausea and vomiting
• Pounding heartbeat (palpitations), rapid heartbeat
• Raised body temperature
• Spasms of the stomach and intestines

These symptoms may occur more often or be more severe in people who also take certain other medicines which affect serotonin, a chemical in the brain.

Home Care

This can be a serious overdose. Get medical help right away.

Before Calling Emergency

Have this information ready:

• Person’s age, weight, and condition
• Name of product (ingredients and strength, if known)
• Time it was swallowed
• Amount swallowed
• If the medicine was prescribed for the person

Poison Control

Your local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. This national hotline will let you talk to experts in poisoning. They will give you further instructions.

This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.

What to Expect at the Emergency Room

Take the container or drug with you to the hospital, if possible.

The health care provider will measure and monitor the person’s vital signs, including temperature, pulse, breathing rate, and blood pressure.

Tests that may be done include:

• Blood and urine tests
• ECG (electrocardiogram, or heart tracing)

Treatment may include:

• Fluids through a vein (by IV)
• Medicine to reverse the effect of the narcotic in the drug (changes in mental state and behavior) and treat other symptoms
• Activated charcoal
• Laxative
• Breathing support, including a tube through the mouth into the lungs and connected to a breathing machine (ventilator)

Outlook (Prognosis)

This medicine is safe if you take it as directed. However, many teenagers take very high amounts of this medicine to “feel good” and to have hallucinations. Like other drugs of abuse, this can be dangerous. Over-the-counter cough medicines that contain dextromethorphan often contain other medicines that can also be dangerous in an overdose.

Although most people who abuse dextromethorphan will need no treatment, some people will. Survival is based on how quickly a person receives help at a hospital.

Aronson JK. Dextromethorphan. In: Aronson JK, ed. Meyler’s Side Effects of Drugs. 16th ed. Waltham, MA: Elsevier; 2016:899-905.

Iwanicki JL. Hallucinogens. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 150.

Last reviewed on: 11/13/2021

Reviewed by: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Dextromethorphan

pronounced as (dex troe meth or’ fan)

Brand Name(s): Delsym 12-hour Cough, Robitussin Cough Long-Acting^®, Triaminic Long-Acting Cough^®, Vicks DayQuil Cough^®, Alka-Seltzer Plus Cold and Cough Formula^® (as a combination product containing Aspirin, Chlorpheniramine, Dextromethorphan, Phenylephrine), Alka-Seltzer Plus Day and Night Cold Formulas^® (as a combination product containing Aspirin, Dextromethorphan, Phenylephrine), Alka-Seltzer Plus Day Non-Drowsy Cold Formula^® (as a combination product containing Acetaminophen, Dextromethorphan, Phenylephrine), Alka-Seltzer Plus Flu Formula^® (as a combination product containing Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylephrine), Alka-Seltzer Plus Mucus and Congestion^® (as a combination product containing Dextromethorphan, Guaifenesin), Alka-Seltzer Plus Night Cold Formula^® (as a combination product containing Aspirin, Dextromethorphan, Doxylamine, Phenylephrine), Children’s Dimetapp Cold and Cough^® (as a combination product containing Brompheniramine, Dextromethorphan, Phenylephrine), Children’s Dimetapp Multisymptom Cold and Flu^® (as a combination product containing Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylephrine), Children’s Mucinex Cough^® (as a combination product containing Dextromethorphan, Guaifenesin), Children’s Mucinex Multi-Symptom Cold^® (as a combination product containing Dextromethorphan, Guaifenesin, Phenylephrine), Children’s Robitussin Cough and Cold CF^® (as a combination product containing Dextromethorphan, Guaifenesin, Phenylephrine), Children’s Robitussin Cough and Cold CF^® (as a combination product containing Dextromethorphan, Guaifenesin, Phenylephrine), Children’s Robitussin Cough and Cold Long-Acting^® (as a combination product containing Chlorpheniramine, Dextromethorphan), Children’s Sudafed PE Cold and Cough^® (as a combination product containing Dextromethorphan, Phenylephrine), Coricidin HBP Chest Congestion and Cough^® (as a combination product containing Dextromethorphan, Guaifenesin), Coricidin HBP Cough and Cold^® (as a combination product containing Chlorpheniramine, Dextromethorphan), Coricidin HBP Day and Night Multi-Symptom Cold^® (as a combination product containing Acetaminophen, Chlorpheniramine, Dextromethorphan, Guaifenesin), Coricidin HBP Maximum Strength Flu^® (as a combination product containing Acetaminophen, Chlorpheniramine, Dextromethorphan), Coricidin HBP Nighttime Multi-Symptom Cold^® (as a combination product containing Acetaminophen, Dextromethorphan, Doxylamine), Diabetic Tussin DM^® (as a combination product containing Dextromethorphan, Guaifenesin), Dimetane DX^® (as a combination product containing Brompheniramine, Dextromethorphan, Pseudoephedrine), Mucinex Cough for Kids^® (as a combination product containing Dextromethorphan, Guaifenesin), Mucinex DM^® (as a combination product containing Dextromethorphan, Guaifenesin), PediaCare Children’s Cough and Congestion^® (as a combination product containing Dextromethorphan, Guaifenesin), PediaCare Children’s Fever Reducer Plus Cough and Runny Nose^® (as a combination product containing Acetaminophen, Chlorpheniramine, Dextromethorphan), PediaCare Children’s Fever Reducer Plus Cough and Sore Throat^® (as a combination product containing Acetaminophen, Dextromethorphan), PediaCare Children’s Fever Reducer Plus Flu^® (as a combination product containing Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylephrine), PediaCare Children’s Fever Reducer Plus Multi-Symptom Cold^® (as a combination product containing Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylephrine), Robitussin Cough and Chest DM^® (as a combination product containing Dextromethorphan, Guaifenesin), Robitussin Cough and Cold CF^® (as a combination product containing Dextromethorphan, Guaifenesin, Phenylephrine), Robitussin Cough and Cold Long-Acting^® (as a combination product containing Chlorpheniramine, Dextromethorphan), Robitussin Night Time Cough, Cold, and Flu^® (as a combination product containing Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylephrine), Sudafed PE Cold/Cough^® (as a combination product containing Acetaminophen, Dextromethorphan, Guaifenesin, Phenylephrine), Sudafed PE Day/Night Cold^® (as a combination product containing Acetaminophen, Dextromethorphan, Diphenhydramine, Guaifenesin, Phenylephrine), Theraflu Cold and Cough^® (as a combination product containing Dextromethorphan, Pheniramine, Phenylephrine), Theraflu Daytime Severe Cold and Cough^® (as a combination product containing Acetaminophen, Dextromethorphan, Phenylephrine), Theraflu Max-D Severe Cold and Flu^® (as a combination product containing Acetaminophen, Dextromethorphan, Guaifenesin, Pseudoephedrine), Triaminic Cough and Sore Throat^® (as a combination product containing Acetaminophen, Dextromethorphan), Triaminic Day Time Cold and Cough^® (as a combination product containing Dextromethorphan, Phenylephrine), Triaminic Multi-Symptom Fever^® (as a combination product containing Acetaminophen, Chlorpheniramine, Dextromethorphan), Tussin DM^® (as a combination product containing Dextromethorphan, Guaifenesin), Tylenol Cold and Cough Daytime^® (as a combination product containing Acetaminophen, Dextromethorphan), Tylenol Cold and Cough Nighttime^® (as a combination product containing Acetaminophen, Dextromethorphan, Doxylamine), Tylenol Cold and Flu Severe^® (as a combination product containing Acetaminophen, Dextromethorphan, Guaifenesin, Phenylephrine), Tylenol Cold Multi-Symptom Nighttime^® (as a combination product containing Acetaminophen, Chlorpheniramine, Dextromethorphan, Phenylephrine), Tylenol Cold and Mucus Severe^® (as a combination product containing Acetaminophen, Dextromethorphan, Guaifenesin, Phenylephrine), Vicks Children’s NyQuil Cold and Cough^® (as a combination product containing Chlorpheniramine, Dextromethorphan), Vicks DayQuil Cold and Flu Relief^® (as a combination product containing Acetaminophen, Dextromethorphan, Phenylephrine), Vicks DayQuil Cold and Flu Symptom Relief Plus Vitamin C^® (as a combination product containing Acetaminophen, Dextromethorphan, Phenylephrine), Vicks DayQuil Mucus Control DM^® (as a combination product containing Dextromethorphan, Guaifenesin), also available generically

Alka-Seltzer Plus Influenza Oral: Uses, Side Effects, Interactions and Pictures of Tablets

• Brand Names): Vicks Nykil

The display and use of drug information on this site is subject to the express terms of use. By continuing to view drug information, you agree to be bound by these Terms of Use.

• MIP05342: This medicine is a round citrus effervescent tablet.

IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT contain all information possible about this product. This information does not guarantee that this product is safe, effective or suitable for you. This information does not constitute individual medical advice and does not replace the advice of your healthcare professional. Always ask your healthcare professional for complete information about this product and your specific medical needs.

One of the ingredients in this product is paracetamol. Taking too much paracetamol can cause serious (possibly fatal) liver disease. Adults should not take more than 4,000 milligrams (4 grams) of paracetamol per day. People with liver problems and children should take less paracetamol. Ask your doctor or pharmacist how much acetaminophen is safe to take. Do not use with other medicines containing acetaminophen without first talking to your doctor or pharmacist. Acetaminophen is found in many over-the-counter and prescription medications (such as pain relievers/antipyretics or cough suppressants). Check the labels on all your medicines to see if they contain paracetamol and ask your pharmacist if you’re not sure. Seek medical attention immediately if you have taken too much paracetamol (overdose), even if you feel well. Overdose symptoms may include nausea, vomiting, loss of appetite, sweating, abdominal/abdominal pain, extreme fatigue, yellowing of the eyes/skin, and dark urine. Daily alcohol consumption, especially when combined with paracetamol, can damage your liver. Avoid alcohol.

This combination medicine is used to temporarily treat symptoms caused by colds, flu, allergies, or other respiratory problems (such as sinusitis, bronchitis). Dextromethorphan is a cough medicine that affects a specific part of the brain to reduce the urge to cough. Decongestants help relieve the symptoms of nasal and ear congestion. Acetaminophen (APAP) is an aspirin-free pain reliever and antipyretic. Antihistamines help relieve watery eyes, itchy eyes/nose/throat, runny nose, and sneezing. This medicine is not usually used for ongoing cough from smoking, asthma or other long-term breathing problems (such as emphysema) or cough with a lot of mucus, unless a doctor has prescribed them. Cough products are not safe or effective for children under 6 years of age. Therefore, do not use this product to treat cold symptoms in children under 6 years of age unless specifically directed to do so by a doctor. Some products (such as long-acting tablets/capsules) are not recommended for children under 12 years of age. For more information about the safe use of the product, ask your doctor or pharmacist. These products do not cure or shorten the duration of a cold and can cause serious side effects. To reduce the risk of serious side effects, follow all dosage instructions carefully. Do not use this product to induce sleep in a child. Do not give other cough medicines that may contain the same or similar ingredients.

See also Drug Interactions section.

Ask your doctor or pharmacist about other ways to relieve cough and cold symptoms (eg, drinking plenty of fluids, using a humidifier or saline drops/nasal spray).

See also Warning section.

If you are taking an OTC product, read and follow all directions on the package label. If your doctor has prescribed this medicine for you, take it as directed by your doctor. If you have any questions, please consult your doctor or pharmacist. Take this medicine by mouth with or without food, or as directed by your doctor. If you have an upset stomach, taking this medicine with food or milk may help. Drink plenty of fluids while using this medicine, unless your doctor tells you otherwise. The fluid will help loosen the mucus in your lungs. If you are using the liquid form of this medication, carefully measure the dose using a measuring device/spoon. Do not use a household spoon because you may get the wrong dose. If your liquid form is a suspension, shake the vial well before each dose. If you are taking extended-release capsules, swallow them whole. Do not crush or chew extended release capsules or tablets. This can result in the release of the entire drug at once, increasing the risk of side effects. Also, do not split extended release tablets unless they are marked and your doctor or pharmacist tells you to. Swallow the tablet whole or divided without crushing or chewing. If you are taking the chewable form of this medicine, chew it thoroughly before swallowing. The dosage depends on your age, medical condition and response to treatment. Do not increase your dose or take it more often or for longer than directed. Misuse of this medicine (abuse) can cause serious harm (including brain damage, seizures, death). Tell your doctor if your condition persists for more than 1 week, if it worsens, or if you develop a rash, persistent headache, or fever for more than 3 days. These may be symptoms of a serious health problem and should be checked by a doctor.

See also Warning section.

Drowsiness, dizziness, blurred vision, upset stomach, nausea, nervousness, constipation, or dry mouth/nose/throat may occur. If any of these effects persist or worsen, tell your doctor or pharmacist immediately. If your doctor has prescribed this medicine, remember that he or she has judged that the benefit to you is greater than the risk of side effects. Many people who take this medicine do not have serious side effects. Tell your doctor right away if any of these unlikely but serious side effects occur: mental/mood changes (eg, confusion, hallucinations), trembling, urinary problems. Tell your doctor right away. if you experience any of these rare but serious side effects: fast/slow/irregular heartbeat, seizures. Very serious allergic reactions to this drug are rare. However, contact your doctor immediately if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, difficulty breathing. This is not a complete list of possible side effects. consequences. If you notice other effects not listed above, contact your doctor or pharmacist. In the USA, ask your doctor for medical advice about side effects. You can report side effects to the FDA at 1-800-FDA-1088 or go to www.fda.gov/medwatch. In Canada, call your doctor for medical advice about side effects. You can report side effects to Health Canada at 1-866-234-2345.

See also Warning section.

what is Enbrel used for treatment

Tell your doctor or pharmacist if you are allergic to any of its ingredients before taking this product; or if you have other allergies. This product may contain inactive ingredients that may cause allergic reactions or other problems. Talk to your pharmacist for more details. If you have any of the following health problems, check with your doctor or pharmacist before using this medicine: breathing problems (eg, asthma, emphysema), diabetes, glaucoma, heart problems, high blood pressure, kidney problems, diseases liver, seizures, stomach/intestinal problems (such as blockage, constipation, ulcers), overactive thyroid (hyperthyroidism), urinary problems (eg, urinary problems due to prostate enlargement, urinary retention). This medicine may make you dizzy or drowsy or your vision may be blurred. Alcohol or marijuana (cannabis) can make you dizzy or drowsy. Do not drive, use machinery, or do anything that requires alertness or clear vision until you can do so safely. Avoid alcoholic drinks. Talk to your doctor if you use marijuana (cannabis). Some brands of this product may contain sugar, alcohol, or aspartame. Caution is advised if you have diabetes, alcohol dependence, liver disease, phenylketonuria (PKU), or any other condition where you must limit/avoid these substances in your diet. Ask your doctor or pharmacist about the safe use of this product. Before surgery, tell your doctor or dentist that you are taking this medicine. Older people may be more sensitive to the effects of this drug, especially dizziness, drowsiness, mental/mood changes, constipation, difficulty urinating, heart palpitations, and changes in blood pressure. Dizziness, drowsiness, and confusion may increase the risk of falling. During pregnancy, this medicine should be used only when clearly needed. Discuss the risks and benefits with your doctor. This medicine may pass into breast milk and have adverse effects on a nursing baby. Consult your doctor before breastfeeding.

See also Warning section.

Drug interactions may change how your drugs work or increase the risk of serious side effects. This document does not contain all possible drug interactions. Make a list of all the products you use (including prescription/OTC drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medication without your doctor’s approval. Taking certain MAO inhibitors with this medicine may cause serious (possibly fatal) drug interactions. Avoid taking isocarboxazid, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, selegiline, or tranylcypromine during treatment with this medicine. Most MAO inhibitors should also not be taken two weeks before treatment with this medicine. Ask your doctor when to start or stop taking this medicine. Some products that may interact with this medicine are antihistamines applied to the skin (eg, diphenhydramine cream, ointment, spray), ketoconazole, rolapitant. Tell your doctor or pharmacist if you are taking other products that cause drowsiness, such as opioid pain or cough medicines (eg, codeine, hydrocodone), alcohol, marijuana (cannabis), sleep or anxiety medications (eg, alprazolam, lorazepam, zolpidem), muscle relaxants (such as carisoprodol, cyclobenzaprine), or other antihistamines (such as cetirizine, diphenhydramine). The ingredients in this product are available in many prescription and over-the-counter products. Check the labels on all of your medications (such as pain/fever, diet, or cough/allergy medications) because they may contain the same or similar ingredients. Using these drugs with this product may increase side effects (such as rapid heartbeat, increased blood pressure, or drowsiness). Ask your pharmacist about the safe use of these products. This medicine may interfere with certain lab tests (eg, urine drug screening tests, urine 5-HIAA), which may cause false test results. Make sure lab staff and all your doctors know you are taking this drug.

If someone has overdosed and has serious symptoms such as fainting or difficulty breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Residents of Canada can call their provincial poison control center. Overdose symptoms may include: nausea, vomiting, loss of appetite, sweating, abdominal/abdominal pain, extreme fatigue, agitation, confusion, hot flashes, hallucinations, yellowing of the eyes/skin, dark urine, seizures. In children, agitation may first occur, and may be followed by: loss of coordination, drowsiness, loss of consciousness, convulsions.

Follow all regular medical and laboratory appointments. Do not take this product within a few days before an allergy test as it may affect the test results.

If you take this product regularly and miss a dose, take it as soon as you remember. If it’s close to the time of your next dose, skip the missed dose. Take your next dose at the usual time. Don’t double your dose to catch up.

Store in a tightly closed container at room temperature from 59up to 86 degrees F (15-30 degrees C) away from light and moisture. Do not store in the bathroom. Do not freeze liquid forms of this medicine. Keep all medicines out of the reach of children and pets. Do not flush medicines down the toilet or pour them down the drain unless instructed to do so. Properly dispose of this product when it has expired or is no longer needed. Consult your pharmacist or local waste disposal company for information on how to safely dispose of the product.

Last updated October 2020 Copyright (c) 2020 First Databank, Inc.

Alka-Seltzer Effervescent tablets 10 pcs

{{if type === ‘partner-stocks’}}

{{/if}}

{{/if}}
{{each list}}

${this}
{{if isGorzdrav}}

Delete

{{/if}}

{{/each}}

{{/if}}
Search by drug, disease, substance:
Vitamins, Quit smoking, Voltaren, Nurofen, Lymphomyosot

Home

Medicines

Diseases

Alcoholism

Alka-Seltzer

{{each product}}
{{tmpl({prod:this. target, type: ”}) “#productGalleryItemTemplate”}}
{{/each}}

Attention! The price of the goods is valid only when placing an order on the site

Basic

Analogues

Availability in pharmacies

Instructions

We deliver

The appearance of the product may differ from the image

Product code:
14289

Manufacturer:
BAYER

Country of origin:
Germany

Release form:
Tablets

Active ingredients:
Acetylsalicylic acid + (Citric acid + Sodium bicarbonate)

Order of issue:
Without a prescription

There are contraindications, consult your doctor

Payment and methods of obtaining

Price:

565 ₽

+6 bonuses

The price is valid only when ordering on the site

There are contraindications, consult a doctor

Manufacturer:
BAYER

Country of origin:
Germany

Release form:
Tablets

Active ingredients:
Acetylsalicylic acid + (Citric acid + Sodium bicarbonate)

Dispensing order:
Without prescription

Added to Your Shopping Cart

Buy in 1 click

See all analogues of Alka-Seltzer

Prices for Alka-Seltzer Effervescent tablets 10 pcs and availability of goods in pharmacies GORZDRAV in Moscow and the Moscow region

Listed

On the map

Featured
The closest

You can buy Alka-Seltzer Effervescent Tablets 10 pcs at the price of 565 ₽ in the pharmacies of GORZDRAV in Moscow and the Moscow region

Information

Instructions for use

Description

Combined analgesic (NSAID + antacid).

Active ingredients

Acetylsalicylic acid + (Citric acid + Sodium bicarbonate)

Brand

Alka-Seltzer

9014 8 Presentation

Tablets

Composition

1 tablet contains
Active ingredients: acetylsalicylic acid – 324 mg, dried sodium bicarbonate
(87.5% sodium bicarbonate, 12.5% ​​sodium carbonate) – 1625 mg,
citric acid – 965 mg.
Excipients: povidone 25 2 mg, dimethicone/silicate* 1 mg, sodium doss
benzoate** 0.1 mg, sodium saccharinate 2 mg, lemon flavor 1.95 mg, lime flavor
1.95 mg.
* a mixture of dimethicone and calcium silicate in a ratio of 70:30.
** mixture of docusate sodium and sodium benzoate in the ratio 85:15.

Pharmacological effect

Combined drug, the effect of which is due to its active ingredients.
Acetylsalicylic acid has an analgesic, antipyretic
anti-inflammatory effect, which is due to the inhibition of
cyclooxygenase enzymes involved in the synthesis of prostaglandins. Acetylsalicylic acid
inhibits platelet aggregation by blocking the synthesis of thromboxane A2.
Sodium bicarbonate neutralizes free hydrochloric acid in the stomach, which
reduces the irritating effect of the drug.
Citric acid promotes faster absorption of the drug.

Pharmacokinetics

After oral administration, ASA is rapidly and completely absorbed from the gastrointestinal tract. During absorption and immediately after it, ASA is converted into the main active
metabolite, salicylic acid. ASA reaches its maximum plasma concentration in 10-20 minutes, and salicylic acid – in 0.3-2 hours.
About 80% of ASA and salicylic acid binds to plasma proteins and is rapidly distributed in tissues. Salicylic acid is metabolized in the liver with the formation of metabolites – salicylurate, salicylic phenolic glucuronide, salicylacyl glucuronide, gentisic and gentisuric acids. It is excreted in breast milk and crosses the placenta.
Elimination of salicylic acid is dose-dependent. The elimination half-life varies from 2-3 hours when taking the drug at low doses to about 15 hours when using high doses. Salicylic acid and its metabolites are excreted,
mainly by the kidneys.

Indications

Symptomatic treatment of mild to moderate pain syndrome: headache (including after alcohol consumption), toothache, sore throat, back and muscle pain
, pain in the joints, pain during menstruation .
Increased body temperature in colds and other infectious and inflammatory diseases
(in adults and children over 15 years of age).

Contraindications

Hypersensitivity to acetylsalicylic acid and other NSAIDs or other components of the drug.
Erosive and ulcerative lesions of the gastrointestinal tract (in the acute phase).
Hemorrhagic diathesis.
Concomitant use of methotrexate at a dose of 15 mg per week or more.
Complete and incomplete combination of bronchial asthma, recurrent nasal polyposis and
paranasal sinuses and intolerance to acetylsalicylic acid or other
non-steroidal anti-inflammatory drugs (including history).
Pregnancy (I and III trimester), breast-feeding period. The drug is not prescribed for children under 15 years of age with acute respiratory diseases
caused by viral infections, due to the risk of developing Reye’s syndrome
3 (encephalopathy and acute fatty degeneration of the liver with acute development
liver failure).

Precautions

With concomitant anticoagulant therapy, gout, gastric and/or duodenal ulcer (history), including chronic or recurrent
course of peptic ulcer disease, or episodes of gastrointestinal bleeding, renal
and / or liver failure, deficiency of glucose-6-phosphate dehydrogenase, heart failure
, pregnancy II trimester.

Method of administration and doses

The drug is intended for adults and children over 15 years of age.
Inside, take a single dose of 1-3 tablets (the interval between doses should be 4-8 hours
). The maximum daily dose should not exceed 9tablets (3 g).
How to use: dissolve 1-3 tablets in 1 glass (200 ml) of water beforehand.
The duration of treatment (without consulting a doctor) should not exceed 5 days when prescribed as an analgesic and more than 3 days – as a
antipyretic.

Side effects

From the gastrointestinal tract: abdominal pain, heartburn, nausea, vomiting, obvious (vomiting blood, tarry stools) or hidden signs of the gastrointestinal
bleeding, which can lead to iron deficiency anemia,
erosive and ulcerative lesions (including those with perforation) of the gastrointestinal tract, isolated cases
– liver dysfunction (increased activity of “liver” transaminases).
From the side of the central nervous system: dizziness, tinnitus (usually
are signs of an overdose).
On the part of the hematopoietic system: increased risk of bleeding, which is
a consequence of the effect of acetylsalicylic acid on platelet aggregation.
Allergic reactions: skin rash, anaphylactic reactions, bronchospasm, edema
Quincke.
If such symptoms appear, it is recommended to stop taking the drug and
contact your doctor immediately.

Overdose

Symptoms.
Moderate overdose: nausea, vomiting, tinnitus, hearing loss
, headache, dizziness and confusion. These symptoms disappear with a decrease in the dose of the drug.
Severe overdose: fever, hyperventilation, ketosis, respiratory alkalosis, metabolic acidosis, coma, cardiogenic shock, respiratory failure, severe hypoglycemia.
Treatment: hospitalization, lavage, activated charcoal, monitoring of acid-base balance, alkaline diuresis in order to obtain a urine pH between 7.5-8 (forced alkaline diuresis is considered achieved if the plasma salicylate concentration is more than 500 mg/l (3.6 mmol / l) in adults or 300 mg / l (2.2 mmol / l) in children), hemodialysis, fluid replacement, symptomatic therapy.

Interactions with other drugs

Co-administration:
with methotrexate at a dose of 15 mg per week or more: increased hemolytic cytotoxicity of methotrexate (renal clearance of methotrexate decreases and methotrexate is replaced by salicylates due to plasma proteins),
with anticoagulants, such as heparin: increased risk of bleeding due to inhibition of platelet function, mucosal damage gastrointestinal tract, displacement of anticoagulants (oral) from binding to plasma proteins,
with other non-steroidal anti-inflammatory drugs, as well as with high doses of salicylates (3 g per day or more): as a result of a synergistic interaction, the risk of gastric ulcers and duodenal ulcer and bleeding from the gastrointestinal tract,
with uricosuric agents, e. g. benzbromarone: reduces the uricosuric effect,
with digoxin: the concentration of digoxin is increased due to a decrease in renal excretion,
with hypoglycemic drugs, e.g. increased bleeding,
with diuretics: reduced glomerular filtration due to reduced prostaglandin synthesis,
with systemic glucocorticosteroids, excluding hydrocortisone used as replacement therapy for Addison’s disease: when using glucocorticosteroids, the concentration of salicylates in the blood decreases due to an increase in the excretion of the latter,
with angiotensin-converting enzyme inhibitors: at a dose of 3 g per day or more, glomerular filtration decreases due to inhibition of the action of prostaglandins and, as a result, the antihypertensive effect is reduced,
with valproic acid: the toxicity of valproic acid is increased,
with ethanol: the risk of damaging effects on the mucous membrane of the gastrointestinal tract increases and bleeding time increases.

Special instructions

Acetylsalicylic acid may cause bronchospasm, asthma attack or other hypersensitivity reactions. Risk factors are the presence of bronchial asthma, nasal polyps, fever, chronic broncho-pulmonary diseases, a history of allergies (allergic rhinitis, skin rashes).
Acetylsalicylic acid may increase bleeding tendency due to its inhibitory effect on platelet aggregation. This should be taken into account when surgical interventions are required, including minor interventions such as tooth extraction. Before surgery, to reduce bleeding during surgery and in the postoperative period, you should stop taking the drug for 5-7 days and notify the doctor.
Children should not be given drugs containing acetylsalicylic acid, as in the case of a viral infection, the risk of Reye’s syndrome increases. Symptoms of Reye’s syndrome are prolonged vomiting, acute encephalopathy, liver enlargement.
If necessary, the use of the drug during lactation, breastfeeding should be discontinued.
Acetylsalicylic acid reduces the excretion of uric acid from the body, which can cause an acute attack of gout in susceptible patients.
One Alka-Seltzer effervescent tablet contains 477 mg of sodium, which should be taken into account when on a controlled sodium diet.
There was no effect of taking the drug on driving a motor vehicle and other mechanisms.

Shelf life after opening

3 years. Do not use after the expiration date.

Certificates

Q&A

How are your drugs stored?

Any goods provided by our pharmacy chain are stored in compliance with the necessary requirements and retain their quality. You can view supporting documents if you wish.

Does your network of pharmacies have loyalty programs for pensioners?

Yes, we have additional discounts and bonuses for pensioners and people over 55 years old. Moreover, our network is a participant of the program “Social longevity” from the Union of Pensioners of Russia. We organize sports days, master classes, lectures on health and its maintenance, and other events.