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Curbing dextromethorphan abuse

January 27, 2015

Edmonton Police Service (EPS) has notified ACP that they have found Coricidin II pills in library books on library shelves. It is believed that drugs containing chlorpheniramine and dextromethorphan with or without acetaminophen have been obtained by and/or are being sold to underage individuals. 

EPS has asked that we remind pharmacists to remain vigilant when dealing with these medications and the patients purchasing them.

Dextromethorphan is a nonprescription cough suppressant available in many different preparations in Canada. Abuse of this drug is documented in the United States and Canada; mostly by teenagers because it is inexpensive and easy to obtain.

Dextromethorphan is normally taken in doses of 10-20 mg every four hours. According to the United States National Drug Intelligence Center (NDIC), abusers will sometimes ingest 250-1500 mg in a single dose. Such large dosages can cause blurred vision, body itching, rash, sweating, fever, hypertension, shallow respiration, diarrhea, toxic psychosis, coma, and an increase in heart rate, blood pressure, and body temperature. Some abusers become violent after ingesting the drug.

Monitoring and Prevention
Dextromethorphan is a Schedule 3 drug, and is to be stored either adjacent to or in the pharmacy. The standards require that pharmacists monitor sales and patient trends, and be available and accessible for consultation. We remind you to increase your awareness about dextromethorphan sales at your pharmacy and to take measures to protect your community. Should you find either that individuals are prone to purchasing large quantities, or if sales volume is inordinately high, we recommend that you limit the number of packages made available for self-selection.