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Not everyone likes DXM, and your experiences with it may be very unpleasant. A very few have had such intense side effects from DXM that their first trip lands them in the hospital. DXM is not a quick and easy buzz, and getting good results with it can be hard, sometimes unpleasant work.

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Do not use DXM on a constant or frequent basis! Like alcohol (and unlike marijuana), constant or frequent (more than once or twice a week) use may be dangerous. Although not everyone seems susceptible, a very few daily high-dose users may have seriously and permanently fried their brains.

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Do not use DXM if you have a any of the following medical conditions: mental illness, epilepsy, seizures, liver or kidney disorders, hypertension, heart problems, or ulcers.

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Do not use DXM if you are pregnant or nursing. All dissociatives adversely affect fetal development, and may lead to birth defects and mental retardation.

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Because some people can have severely adverse reactions to DXM, never rush into a high dose. Instead, take no more than twice your last dose, and wait at least one week between doses. Yes, it may take you a month before you get to interesting territory, but that's better than ending up in the hospital. Yes it can happen to you!

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Never exceed 20mg/kg (or 2000mg, whichever is lower) of DXM under any circumstances, and never exceed 15mg/kg (or 1500mg) unless you have a trip-sitter who is experienced and capable in the event of a medical emergency.

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Because of the potential for allergic or other adverse reactions to inert ingredients, always try a low dose first when taking a DXM product (syrup, gelcap, capsule, whatever) you haven't taken before.

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Never experiment with hallucinogens without a sober person around to help you in case you get into trouble. This goes doubly for DXM, which is much more likely to induce abnormal and dangerous behaviour than LSD.

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NEVER, EVER, EVER drive under the influence of any intoxicating drug including DXM!

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Never use a product containing acetaminophen (also called paracetamol or APAP, and known by the brand name TylenolTM). Large doses of acetaminophen can cause liver damage or death. Many cough syrups contain acetaminophen so always read the label.

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Never take DXM with yohimbine (YoconTM)! To do so may be risking permanent brain damage!

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Never take DXM if you are taking a monoamine oxidase inhibitor (MAOI). This also applies for one week before and two weeks after taking a MAOI. MAOIs include some (rarely used) prescription drugs for depression and Parkinson's disease, a few recreational ethnobotanicals (harmine and harmaline), and yohimbe bark. Mixing DXM and a MAOI has regularly been fatal.

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Do not take DXM with phentermine, fenfluramine, or the combination (phen-fen), all of which are used as prescription diet pills. This combination can cause serotonin syndrome.

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Never take DXM if you are taking, will take, or have taken within six weeks, the prescription antihistamine terfenadine (SeldaneTM), or any other prescription, non-drowsy antihistamine (e.g., ClaritinTM or HisminalTM).

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Never take DXM with the SSRI antidepressants Desyrel (trazodone) or Serzone (nefazodone); these combinations have resulted in liver damage.

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Be very careful combining DXM with SSRI and tricyclic antidepressants (i.e., those in common use), and never use DXM when taking more than one drug at a time for depression, due to the potential for serotonin syndrome.

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Avoid all products containing DXM and other active ingredients.

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Avoid BenylinTM brand products which seem to cause severe nausea. Avoid any product with castor oil. Avoid Coricidin Cough and ColdTM at upper plateau doses due to the potentially dangerous effects of antihistamine overdose.

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Remember that DXM can sometimes trigger panic attacks in susceptible individuals, especially those inexperienced with DXM. This is a major cause (if not the major cause) of tachycardia (high heart rate) from DXM. All the more reason not to rush in to anything.

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Always remember: recreational use of DXM is still a great unknown. The brain you are risking is your own.