Dextromethorphan (DXM) is a cough suppressant ingredient in a variety of over-the-counter cough and cold medications including syrup, tablets, and lozenges.

DXM is a synthetic drug, chemically similar to morphine, that was approved in 1954 by the FDA to be used as a cough suppressant.

In the 1970’s, manufacturers began putting DXM in cough syrup to replace codeine.

There are 120 different products on the market containing DXM.

At doses of 4 ounces or more dextromethorphan produces dissociative effects similar to Ketamine and PCP.

Effects can last up to 6 hours and include loss of muscle control, slurred speech, diarrhea, rash, abdominal pain, fever and sweating, nausea and vomiting, high blood pressure, headache, numbness of fingers and toes, loss of consciousness, mania, brain damage, coma, cerebral hemorrhage, seizures, stroke, and death.

Many of the medications containing dextromethorphan also include acetaminophen, chlorpheniramine, and guaifenesin. These ingredients in large doses may cause the following:

Acetaminophen (Tylenol) can cause liver damage
Chlorpheniramine can cause increased heart rate, lack of coordination, seizures, and coma
Guaifenesin can cause vomiting

Robo shake is drinking a large amount of cough syrup containing DXM and then forcing vomit to absorb enough DXM through the stomach lining to achieve the desired effects while expelling out the other ingredients.

Experienced abusers use a chemical procedure to extract the DXM from other ingredients in the cough syrup to avoid side effects.

Slang term: Robo, dex, skittles, triple C, tussin