What drug, when taken with dextromorphan, causes hypotension?

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Last updated: April 13, 2025View editorial policy

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From the Research

Dextromethorphan can cause hypotension when taken together with monoamine oxidase inhibitors (MAOIs), and this combination is dangerous and should be avoided. MAOIs include medications such as phenelzine (Nardil), tranylcypromine (Parnate), isocarboxazid (Marplan), and selegiline (Emsam) 1. When dextromethorphan, a common cough suppressant found in many over-the-counter cold medications, is combined with MAOIs, it can lead to a potentially life-threatening condition called serotonin syndrome, which may include severe hypotension, high fever, muscle rigidity, confusion, and even death. This interaction occurs because both medications affect serotonin levels in the brain. MAOIs prevent the breakdown of serotonin, while dextromethorphan can inhibit serotonin reuptake and has some serotonin-releasing properties.

Some key points to consider when taking MAOIs and dextromethorphan include:

  • Patients taking MAOIs should carefully check all over-the-counter medications and avoid any products containing dextromethorphan 2.
  • Always inform healthcare providers about all medications you are taking, including over-the-counter drugs and supplements, to prevent dangerous drug interactions 1.
  • The combination of MAOIs and dextromethorphan can lead to severe hypotension, high fever, muscle rigidity, confusion, and even death, and should be avoided at all costs 3.
  • If a patient is taking MAOIs and experiences any symptoms of serotonin syndrome, such as severe hypotension, high fever, muscle rigidity, confusion, and even death, they should seek medical attention immediately 4.

It is essential to prioritize the patient's safety and well-being when taking MAOIs and dextromethorphan, and to take all necessary precautions to avoid dangerous drug interactions. By being aware of the potential risks and taking steps to mitigate them, patients can minimize their risk of adverse reactions and ensure their safety.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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