Drug interactions
Cocaine + Dextromethorphan
Severity: Moderate
Cocaine and Dextromethorphan: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Both agents inhibit monoamine reuptake, including serotonin, which could raise the risk of serotonin toxicity. Topical medical use gives low systemic exposure, but systemic or illicit use increases the risk, as do cardiovascular effects.
What this interaction means in plain words
Cocaine and Dextromethorphan can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Cocaine belongs to Central Nervous System; Dextromethorphan belongs to Respiratory.
Why it happens
Additive inhibition of serotonin reuptake.
What to do
Avoid concurrent systemic cocaine use; with topical anesthetic use, monitor for agitation, tremor or hyperthermia.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Cocaine and Dextromethorphan, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
Other interactions of Dextromethorphan
- Dextromethorphan + Isocarboxazid Contraindicated
- Dextromethorphan + Linezolid Contraindicated
- Dextromethorphan + Phenelzine Contraindicated
- Dextromethorphan + Rasagiline Contraindicated
- Dextromethorphan + Safinamide Contraindicated
- Dextromethorphan + Selegiline Contraindicated
Other interactions of Cocaine
- Cocaine + Isocarboxazid Contraindicated
- Cocaine + Phenelzine Contraindicated
- Cocaine + Procarbazine Contraindicated
- Amitriptyline + Cocaine Major
- Bisoprolol + Cocaine Major
- Citalopram + Cocaine Major
Frequently asked questions
Can I take Cocaine with Dextromethorphan?
MediHelp rates the interaction as moderate. Cocaine and Dextromethorphan can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Both agents inhibit monoamine reuptake, including serotonin, which could raise the risk of serotonin toxicity. Topical medical use gives low systemic exposure, but systemic or illicit use increases the risk, as do cardiovascular effects.
How serious is the interaction between Cocaine and Dextromethorphan?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid concurrent systemic cocaine use; with topical anesthetic use, monitor for agitation, tremor or hyperthermia.
What other medicines interact with Dextromethorphan?
MediHelp also lists interactions of Dextromethorphan with, for example, Isocarboxazid, Linezolid, Phenelzine. The full list is on the Dextromethorphan page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
