Evidence map›Paper›PMID 42778758›Full record

ArticleJournal of medical toxicology : official journal of the American College of Medical Toxicology2026

Adult U.S. Poison Center Exposure Case Trends Involving Nonprescription Dextromethorphan Amid the COVID-19 Pandemic: a Quasi-experimental Interrupted Time Series Study.

Sara Karami, Christian Angelo I Ventura, Ellen Pinnow, Nana Dwumfour, Ajoa Asonye, Gerald Dal Pan, Esther H Zhou

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Article in Journal of medical toxicology : official journal of the American College of Medical Toxicology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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3 · Its place in the literature

Who cites it

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Sara KaramiCenter for Drug Evaluation and Research (CDER), U.S. Food and Drug Administration (FDA), 10903 New Hampshire Avenue, Building 22, Silver Spring, MD, USA. Sara.Karami@fda.hhs.gov.ORCID http://orcid.org/0000-0001-7658-7977
Christian Angelo I VenturaCenter for Drug Evaluation and Research (CDER), U.S. Food and Drug Administration (FDA), 10903 New Hampshire Avenue, Building 22, Silver Spring, MD, USA.
Ellen PinnowCenter for Drug Evaluation and Research (CDER), U.S. Food and Drug Administration (FDA), 10903 New Hampshire Avenue, Building 22, Silver Spring, MD, USA.
Nana DwumfourCenter for Drug Evaluation and Research (CDER), U.S. Food and Drug Administration (FDA), 10903 New Hampshire Avenue, Building 22, Silver Spring, MD, USA.
Ajoa AsonyeCenter for Drug Evaluation and Research (CDER), U.S. Food and Drug Administration (FDA), 10903 New Hampshire Avenue, Building 22, Silver Spring, MD, USA.
Gerald Dal PanCenter for Drug Evaluation and Research (CDER), U.S. Food and Drug Administration (FDA), 10903 New Hampshire Avenue, Building 22, Silver Spring, MD, USA.
Esther H ZhouCenter for Drug Evaluation and Research (CDER), U.S. Food and Drug Administration (FDA), 10903 New Hampshire Avenue, Building 22, Silver Spring, MD, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionNonprescription dextromethorphan (DXM) is widely available in the United States and was commonly recommended for managing dry cough associated with COVID-19. This retrospective study of Poison Center data evaluated whether the COVID-19 pandemic impacted monthly adult exposure case trends involving nonprescription DXM cold and cough preparations.

methodsWe performed interrupted time series analyses using a pre-pandemic baseline period of January 2015-February 2020, and pandemic period of April 2020-April 2023. The pandemic's immediate impact (level change, March 2020) and sustained trend effects were modeled separately by exposure reason categories.

resultsMonthly nonprescription DXM exposure cases declined immediately at the pandemic's onset, and remained low for approximately one year across all age and sex subgroups. Unintentional-therapeutic error exposures subsequently rebounded for some subgroups, particularly females (+ 3 cases/month; 95% CI: 2.7-3.4; p < 0.0001), surpassing pre-pandemic levels by the study's end. Intentional-abuse/misuse exposures had been dramatically declining pre-pandemic; significant trend increase changes were observed among males (+ 0.8 cases/month; 95% CI: 0.5-1.1; p < 0.0001) and adults aged 18-29 years (+ 0.9 cases/month; 95% CI: 0.7-1.1; p < 0.0001) during the pandemic, though the absolute magnitude of these changes was small and warrant cautious interpretation.

conclusionsNonprescription DXM exposures declined sharply at the pandemic's onset, with unintentional-therapeutic errors subsequently rebounding - especially among females - surpassing pre-pandemic levels toward the end of the pandemic's public health emergency declaration, while intentional exposures showed modest changes following initial declines. These findings underscore the need for targeted prevention strategies regarding inappropriate nonprescription DXM use and enhanced medication safety messaging during prolonged public health crises.

Indexed as

Antitussive AgentsCOVID-19DextromethorphanNonprescription DrugsPoison Control CentersAdultFemaleHumansInterrupted Time Series AnalysisMaleMiddle AgedRetrospective StudiesUnited StatesYoung AdultAntitussive AgentsDextromethorphanNonprescription DrugsCOVID-19Dextromethorphan; nonprescription exposuresPoison CentersTherapeutic error

Identifiers

PMID42778758
PMCPMC13633208

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.