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Short-Term Effects of OTC Medicines

Dextromethorphan (DXM)

Dextromethorphan or DXM is an opioid without effects on pain reduction and does not act on the opioid receptors. Short-term effects of DXM misuse can range from mild stimulation to alcohol- or marijuana-like intoxication. Other effects can include:

  • Hyperexcitability
  • Poor motor control
  • Lack of energy
  • Stomach pain
  • Vision changes
  • Slurred speech
  • Increased blood pressure
  • Sweating

When taken in large doses, DXM causes a depressant effect and sometimes a hallucinogenic effect, similar to PCP and ketamine. A person may have hallucinations or feelings of physical distortion, extreme panic, paranoia, anxiety, and aggression.


Loperamide is an opioid designed not to enter the brain. In the short-term, loperamide is sometimes misused to lessen cravings and withdrawal symptoms. However, when taken in large amounts and combined with other substances, it may cause the drug to act in a similar way to other opioids. Other opioids, such as certain prescription pain relievers and heroin, bind to and activate opioid receptors in many areas of the brain, especially those involved in feelings of pain and pleasure. Opioid receptors are also located in the brain stem, which controls important processes, such as blood pressure, arousal, and breathing.

Loperamide misuse can lead to:

  • Euphoria
  • Fainting
  • Stomach pain
  • Constipation
  • Eye changes
  • Loss of consciousness

Loperamide can also cause the heart to beat erratically or rapidly, or cause kidney problems. These effects may increase if taken with other medicines that interact with loperamide. Other effects have not been well studied and reports are mixed, but the physical consequences of loperamide misuse can be severe.

OTC Overdose ›