Dextromethorphan Interactions

492 known interactions for Dextromethorphan. Click any interaction for the full evidence-based breakdown.

⚠️ Major (11)

Dextromethorphan + CitalopramDANGEROUS — avoid DXM with any SSRI
Dextromethorphan + DesvenlafaxineDANGEROUS — avoid DXM with SNRIs
Dextromethorphan + DuloxetineDANGEROUS — duloxetine both raises DXM levels and adds serotonin
Dextromethorphan + EscitalopramDANGEROUS — avoid DXM with SSRIs
Dextromethorphan + FluoxetineFDA-documented dual interaction — pharmacokinetic (CYP2D6 inhibition) and pharmacodynamic (serotonergic). Fluoxetine is particularly dangerous with DXM compared to other SSRIs.
Dextromethorphan + FluvoxamineDANGEROUS — Fluvoxamine causes extreme DXM level elevation
Dextromethorphan + ParoxetineDANGEROUS — Paroxetine is especially risky due to strong CYP2D6 inhibition
Dextromethorphan + SertralineFDA SSRI labels list dextromethorphan as a serotonergic drug. Serotonin syndrome has been reported. Advise patients to use non-DXM cough suppressants.
Dextromethorphan + St. Johns WortDANGEROUS — avoid combining serotonergic herbs with DXM
Dextromethorphan + TramadolDANGEROUS — dual serotonergic mechanism plus opioid CNS depression
Dextromethorphan + VenlafaxineDANGEROUS — avoid DXM with SNRIs

✅ Safe (481)