Mixing DXM and Xanax: Can It Be a Safe Combination?

Medically Reviewed

DXM and Xanax can be a dangerous combination. There is no way to mix these drugs safely. Cold and cough medicines are available almost everywhere over-the-counter medicines are sold. Consumers trust them because they are affordable, available, and can help them deal with common ailments.

Popular cough syrups, lozenges, and capsules often contain dextromethorphan (DXM). When used as indicated, medication containing this drug helps get through the day.

Unfortunately, some people do not use DXM-containing medications as intended. The National Institute on Drug Abuse (NIDA) says DXM is one of the most popular over-the-counter medicines that is misused today.

People who misuse DXM often do so because it has the following effects:

It can be a depressant (downer), like alcohol. It can cause visual and auditory hallucinations. It can trigger feelings of detachment from one’s body.

DXM is commonly abused by taking it in large doses. When it is mixed with soda or alcohol, this is called “skittling” or “robotripping.”

It is common for people who misuse DXM to mix it with other drugs, including sedatives, illicit drugs, and even prescription medication such as Xanax (alprazolam).

NIDA states that DXM is habit-forming.

Substances Commonly Mixed With DXM

Though DXM itself can be addictive, other substances people use along with it also have their own risks. Below is a list of drugs people commonly use along with DXM and their effects.


NIDA states that DXM-containing products, such as cough syrups, are often mixed with alcohol to alter their taste.

A case study from the Psychopharmacology Bulletin discusses a 40-year-old Caucasian female patient who abused DXM and alcohol for a long time. She would take up to 1,620 mg (milligrams) of DXM and drink alcohol. This caused a decline in her mental health, and she was hospitalized for about 20 days after being admitted to a hospital due to the combined effects of both of these substances.


According to a Quora forum, DXM can be used along with marijuana. Users of this combination self-report cough syrups such as Robitussin can be used as a substitute for alcohol when smoking marijuana. One user said 4 oz (ounces) of a DXM-containing cough syrup aids their high.

Some brands to avoid mixing with marijuana are NyQuil, syrups that treat a variety of ailments (multicombination), and cough and cold syrups.


This drug is often used with medical supervision. The American Journal on Addictions says that DXM and methadone can cause delirium when used together.


Consumer Reports states that many cough suppressants with DXM may also contain other drugs. Cough syrups that also have acetaminophen as the main ingredient increase the risk of harming the liver. As such, people might not be mixing DXM and acetaminophen on purpose.


People on forums such as Reddit report mixing DXM with opioids, but more studies need to be done to show what the effects are.

XANAX This mixture is often discussed on forums such as Reddit. Mixing DXM with Xanax is thought to slow breathing.

A paper published by the Journal of Analytical Toxicology in 2009 found a case in which a teenager was found dead after taking DXM and alprazolam (Xanax). The autopsy found pulmonary edema — a buildup of fluid — in the teenager. This makes it hard for a person to breathe and can be fatal without treatment, according to MedlinePlus.

Avoid Mixing

Strictly speaking, mixing DXM with Xanax is not safe. Both substances are dangerous enough when misused on their own.

Currently, no data or scientific study has sanctioned a “safe” amount of DXM that can be combined with Xanax.

The following are adverse side effects of DXM:

  • Anxiety
  • Paranoia
  • Violence
  • Difficulty speaking
  • Increase in blood pressure
  • Lethargy
  • Loss of coordination

The following are adverse side effects of Xanax:

  • Dry mouth
  • Sleepiness
  • Changes in libido
  • Constipation
  • Nausea
  • Headaches

Both substances are known to be easy to misuse and can cause tolerance. The use of Xanax or DXM on their own can cause an overdose, but more scientific data is needed to understand the risks of combining these two substances specifically. How to Stay Safe

When taking Xanax, MedlinePlus suggests keeping track of any medications, supplements, and herbal remedies in use. Vice UK reports that 9,000 Americans died due to benzodiazepine-related overdose in 2015.

Both DXM and Xanax can cause uncomfortable feelings of withdrawal, but there are some key differences. MedlinePlus says that people should not quit using Xanax cold turkey. More studies need to be done to determine the best way to quit taking DXM. Those who take Xanax should probably avoid eating grapefruit due to the increased side effects of the drug. Similar warnings for DXM do not exist.

Though more data is needed to discuss the use of DXM along with other substances, the best way to avoid dangerous consequences is to be safe around drugs. Using over-the-counter and prescription medication only as directed can save lives.

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