Disclaimer: This blog is for informational purposes only and should not be considered a substitute for medical advice from your healthcare provider. Discovery Institute is not a medical consultation service. However, our team is available 24/7 to assist individuals with questions related to drug rehabilitation and recovery.
It is possible to overdose on cough drops, but it is not very likely to happen. When talking about an “overdose,” it refers to ingesting too much of the menthol they contain. The lethal dose of menthol is one gram per kilogram of body weight and one typical cough drop contains about 3 to 10 milligrams. Mathematically, that means you’d have to eat many cough drops within a limited amount of time to experience menthol poisoning. If your throat is sore and cough drops are relieving the pain, your risk is low. However, that doesn’t mean there is NO risk.
At Discovery Institute in Marlboro, New Jersey, we help people suffering from addiction recover and obtain the tools and resources necessary to maintain sobriety.
How Many Cough Drops Are Too Many?
Cough drops are meant to be used occasionally when you feel sick. Although there is no specific number on how many cough drops are too many, consider some of their ingredients:
Cough drops contain a significant amount of sugar. If you eat a substantial number over some time, you could gain weight. Likewise, people with health conditions like diabetes need to be careful because cough drops could lead to spikes in their blood sugar.
Sorbitol is a sugar substitute found in sugar-free varieties of cough drops. Eating too much sorbitol can have a laxative effect including:
- Mild to severe diarrhea
- Flatulence
- Unexpected weight loss
- Stomach pain
The menthol mentioned above is meant to target nasal congestion. But too much can make your cough worse, the opposite intent of using cough drops. Other symptoms of taking too many might include:
- Stomach pain
- Nausea
- Sleepiness
- Vomiting
- Headache
- Increased heart rate
- Confusion
In addition, whether menthol cough drops are safe for use during pregnancy is unknown. It would be good to talk to your doctor before using any cough drops while pregnant.
Medicated Cough Drops
Some cough drops contain local anesthetics such as benzocaine or other medications such as dextromethorphan which can lead to more symptoms than regular cough drops.
Dextromethorphan/menthol cough drops are a combination medication that helps treat cough, and throat and mouth pain. Typically, it is dissolved slowly in the mouth every 4 hours as necessary. This particular type of cough drop isn’t recommended for children under the age of 6.
What is DXM?
Dextromethorphan belongs to a class of medications known as antitussives, Antitussives work in the body to reduce activity in the part of the brain that controls the coughing mechanism. DXM is a synthetic opioid substance and an overdose may occur when a person takes more than the normal or recommended amount, whether accidental or on purpose. Dextromethorphan may also be used to treat pain.
Using more than one medication that contains dextromethorphan can result in an accidental overdose and cause serious side effects. Call your healthcare provider immediately if you experience any of these symptoms:
Serotonin syndrome:
- Rapid heart rate
- Sweating
- Stiff muscles
- Muscle spasms
- High fever
- Confusion
- Seizures
- Hallucinations
- High blood pressure
- Irregular heart rhythm
- Loss of consciousness
Common Side Effects
- Fatigue
- Dizziness
Dextromethorphan is an ingredient in a lot of over-the-counter cough and cold medications including:
- Robitussin Long-acting Cough gels
- Robitussin
- Mucinex Sore throat and Cough relief drops
- NyQuil
- DayQuil
- Delsym Cough Relief Plus lozenges
- Cepacol Extra Strength cough drops
- Coricidin HBP tablets
- Alka-Seltzer Plus Cold and Cough
- Theraflu
DXM Addiction
DXM is often abused in high doses to get a feeling of euphoria including visual and auditory hallucinations. Some users also claim the DXM gives them a sense of awareness and an altered perception of time. Many also believe that the OTC availability adds to its abuse. This makes it especially common among teens. A recent survey reported that 2.9% of 8th graders, 4.3% of 10th graders, and 5.0% of 12th graders used DXM cough and cold medicines for non-medical purposes.
Of special concern is that DXM can also be sold online as a powder that has an unknown composition and dose. That means that people who use this form aren’t aware of what substances are in it or how much they’re using. Some DXM users even mix it with illicit drugs including ecstasy and methamphetamine.
DXM Addiction Symptoms
According to users of DXM, there are 4 levels of use:
- The first level usually happens with a dose of 100-200 mg and causes mild stimulation.
- The second level occurs at a dose of 200-400 mg and produces euphoria and hallucinations.
- Level three occurs at a dose of 300-600 mg. This is when distorted vision and loss of motor coordination happen.
- The fourth and final level is reported to happen at 500-1500 mg when dissociative sedation takes place–a feeling of floating or being disconnected from the body.
These dosages can vary depending on each individual’s body size, length of use, and the amount typically used. The typical adult dose for cough relief is 15 to 30 mg taken three to four times daily.
Street Names
Dextromethorphan is also abused and sold on the street as:
- Robo-tripping
- Poor Man’s PCP
- Triple Cs
- Skittles
- Dex
- Rojo
- Orange crush
- Red Devils
Can You Overdose on Cough Drops?
An overdose of Dextromorphan can happen if you take too much of the medication or take a large amount for a long time. This can be a serious overdose so contact medical help right away. Symptoms may vary depending on the person, so individuals who have taken the drug for a longer time at higher doses may not have as critical symptoms (because they’ve built up a high tolerance), while an overdose for a one-time user may be severe. It is important to closely watch people who may have a dependence or tolerance to dextromethorphan because overdoses can be serious.
Symptoms include:
- Slow and difficult breathing
- Shallow breathing
- No breathing (especially in children)
- Lightheadedness
- Bluish tint to lips and fingernails
- Rashes
- Blurry vision
- Constipation
- Seizures
- Hallucinations
- Unsteadiness walking
- Low or high blood pressure
- Muscle twitching
- Nausea and vomiting
- Heart palpitations
- Rapid heartbeat
- High body temperature
- Stomach and intestinal spasms
- Coma
These symptoms may be more severe or happen more frequently for people who also take other medications that affect serotonin. Serotonin is a chemical in your brain that carries messages between nerve cells in the brain and throughout your body. It plays an essential role in body functions such as:
- Mood
- Sleep
- Digestion
- Nausea
- Wound healing
- Bone health
- Blood clotting
- Sexual desire
Serotonin levels that are too high or too low can cause physical and psychological health problems.
Before Calling 911
Have this information ready when you call:
- Age, weight, and condition of the person
- Name of the product (including ingredients and strength if you know)
- The time it was taken
- Amount taken
- Whether the medicine was prescribed for the person
Poison Help Hotline
Your local poison control center can be contacted directly by calling the national toll-free hotline at !-800-222-1222. This hotline lets you speak to experts in poisoning who will provide further instructions. This number can be called from anywhere in the U.S.
Treatment for Cough Drop Overdose
In the emergency room, a healthcare professional will monitor the person’s vital signs–breathing rate, pulse, and blood pressure. Depending on the symptoms and the medication taken they may also receive:
- Activated charcoal absorbs the substance in their digestive tract
- Ventilator for breathing support
- Intravenous fluids
- Laxatives
- Drugs to promote vomiting
- Medications to reverse the effects of the drug
- Gastric lavage–emptying the stomach through a tube inserted through the mouth and into the stomach
Outlook After Overdose
Only one person has ever been reported dying of menthol poisoning. The man overdosed from inhaling menthol while cleaning a peppermint factory. There are no known cases of someone dying from overdosing on menthol or DXM cough drops.
Preventing an Overdose
You should read the label and try not to take more than the recommended dose. If you’re worried about overdosing, look for medications that don’t contain menthol or DXM. If you’ve been taking them for a sore throat or cough and you don’t feel better in 7 days, or if you get worse, see a medical professional. Be sure to keep cough drops out of the reach of children.
Discovery Institute Can Help You Recover
If you have realized that you’re struggling with an addiction to any substance, Discovery Institute is prepared to help get you back on the path of recovery and wellness. Located in Marlboro, New Jersey, we have been voted America’s Best Addiction Treatment Center in 2022.
Discovery Institute can provide residential and outpatient treatment with several holistic treatment approaches such as nutrition counseling, yoga, and meditation. To personalize your program, we offer dedicated programs for adults, young adults, and seniors. Whether you’ve been struggling for a long time or not, we can create what you need to recover. Contact us today.
Dr. Joseph Ranieri D.O. earned his BS in Pharmacy at Temple University School of Pharmacy in 1981 and His Doctorate Degree in Osteopathic Medicine at the Philadelphia College of Osteopathic Medicine in 1991. He is Board Certified by the American Board of Family Medicine and a Diplomate of the American Board of Preventive Medicine Addiction Certification. Dr. Ranieri has lectured extensively to physicians, nurses, counselors and laypeople about the Disease of Addiction throughout New Jersey and Pennsylvania since 2012.
