Cold Medications That Are Safe To Take With Lexapro

In our latest question and answer, our pharmacist discusses over the counter cold medications that are safe to use with Lexapro (escitalopram).

Cold Medications That Are Safe To Take With Lexapro
Jan 09, 2018

Sandy asked

What safe cough and mucus medicine can I combine with Lexapro (escitalopram)?


Cold Medications That Are Safe To Take With LexaproAccording to the National Center for Health Statistics, over 13% of Americans are on antidepressant medication and the most commonly used class of antidepressants is the SSRI (selective serotonin reuptake inhibitor) class. Lexapro, a SSRI, is very effective in the treatment of depression and associated disorders. However, it does ( as do all SSRI medications) have potential side effects and drug interactions that you need to be aware of.


How to safely and effectively treat cough and cold symptoms with over the counter medicine can sometimes be difficult if you are on prescription medication, especially ones that are known to have drug interactions. You want to find the best product or products to treat your symptoms but need to keep in complications. While most over the counter medications are generally safe to use, they are not without their precautions and can interact with SSRI medications.


Below, we will discuss over the counter cough and cold medications that are considered safe to use with Lexapro (escitalopram).

OTC Medications Considered Safe With Lexapro (Escitalopram)


Antihistamines (e.g. Claritin, Zyrtec, Benadryl) are generally considered OK to use. They can help with a variety of cold symptoms such as a runny nose, post nasal drip and itchy, watery eyes. They can also help on occasion with "drying" out the sinuses and relieving congestion. 

While there are no "drug-drug" interactions between Lexapro and antihistamines, be aware that there could be a slight risk of additive adverse reactions such as dry mouth and dry eyes.


Tylenol (acetaminophen) is an analgesic used to treat pain, sore throat, fevers and muscle aches. In most cases, it is recommended over NSAID (non-steroidal anti-inflammatory) medications as those need to be used with caution in people taking Lexapro (as discussed below).


Mucinex (guaifenesin) is generally considered OK to use as there are no reported drug interactions between it and Lexapro. It is an expectorant and helps to thin out excess mucus and relieve chest congestion.​​

Zinc/Vitamin C

Lexapro is compatible with other cold remedies such as Zinc lozenges and vitamin C. Be aware that there are numerous herbal products that DO interact with Lexapro, but vitamin C and zinc are considered safe.

Cough/Cold Medications To Use With Caution

NSAIDs (e.g. Ibuprofen, Naproxen, Aspirin):

NSAIDs on their own can increase the risk for gastrointestinal bleeding.The combined use of selective serotonin reuptake inhibitors like Lexapro and NSAIDs only increases this risk. NSAID medications have known anti-platelet effects. SSRI medications, which affect serotonin, can also have blood thinning effects.

The risk of GI bleeds is especially increased if you have a history of them or ulcerations in the past. NSAIDs are often used in combination with many over the counter cold products, so be sure to read product labels. This precaution also includes bismuth subsalicylate, one of the ingredients in PeptoBismol, and aspirin containing products.

Dextromethorphan (Delsym)

Perhaps the most well known interaction in terms of OTC medication and SSRI drugs is with the cough suppressant dextromethorphan. Caution is advised when using Lexapro and dextromethorphan together. Dextromethorphan, at high doses. can increase serotonin levels in the body and has the potential of causing serotonin syndrome when used with other medications that affect serotonin. Serotonin syndrome is characterized by:

  • Rapid development of hyperthermia
  • High blood pressure
  • Mental status changes
  • Rigidity

​​​ Although uncommon, it is extremely serious if it does occur. There are cases where the combination of dextromethorphan and SSRIs can be used, but should only be considered after speaking with your doctor.

Psuedoephedrine (Sudafed) 

​Sudafed products, used for sinus and nasal congestion, can be used on occasion but must be used cautiously if you have a history of arrhythmia (e.g. QT prolongation) or other heart issues as the combination of SSRI medication and Sudafed can potentially make these conditions worse.


As you can see, you have many over the counter options for safely treating cough and cold symptoms while on Lexapro. When looking for a product to combat excess mucus specifically, it is safe to use Mucinex (guaifenesin). However, be sure to look at the product labels of your medication choice as many Mucinex products contain multiple ingredients, not just guaifenesin.

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