Cold Medications To Avoid While Taking Adderall

In our latest question and answer, the pharmacist discusses which over the counter cold medications are safe and which to avoid when taking Adderall.

Cold Medications To Avoid While Taking Adderall
Mar 02, 2018

Mandy asked

I am prescribed 20 mg of Adderall twice daily and I have a cold and want to take over the counter medicine for the cough. However I've been reading it's not good to mix these types of medications. Is that true? What medicine is safe for me to take?


Cold Medications With AdderallAdderall (amphetamine salts) is a prescription medication indicated for the treatment of ADHD (Attention-deficit/hyperactivity disorder). Adderall works mainly by increasing two neurotransmitters in the brain:

  • Dopamine
  • Norepinephrine

In addition to the above neurotransmitters, Adderall is also thought to increase the following, although to a lesser degree:

  • Histamine
  • Serotonin

Based on the effects and mechanism of action of Adderall, there are some over the counter cold medications that you should avoid and there are others that are considered safe to use.

Symptomatic treatment of cold symptoms can sometimes be tricky when you take any prescription medication and Adderall is no different. You want to find the best products to alleviate your symptoms but must also keep in the mind the potential for drug interactions with the medication you are taking.

Below, we discuss cold medications that are considered safe to use as well as cold medications you should avoid when taking Adderall unless prescribed by your doctor.

Adderall & OTC Cold Medication: Use Caution

  • Dextromethorphan (Delsym): Caution should be taken when using Adderall and dextromethorphan together. Dextromethorphan can increase serotonin levels in the body and has the potential of causing serotonin syndrome when used with other medications that affect serotonin, like Adderall. Serotonin syndrome is characterized by rapid development of hyperthermia, high blood pressure and mental status changes. Although rare, it is extremely serious. There may be times where the combination of dextromethorphan and Adderall can be used but should only be considered after speaking with your doctor.
  • Psuedoephedrine (Sudafed): ​Sudafed products may be used on occasion but must be used cautiously. Both Adderall (via its effects on norepinephrine) and pseudoephedrine can increase blood pressure as well as increase heart rate. In addition, there is a risk of over-stimulation when using the combination together.  It would be prudent to speak to your doctor before using both medications together.
  • Alkalinizing agents: Over the counter gastrointestinal alkalinizing products (i.e. acid reducing agents) such as Tums, Rolaids and Alka-Seltzer can increase absorption of amphetamines. Therefore, co-administration of Adderall and antacids is not recommended. Taking both together could increase the potential side effects of Adderall such as increased heart rate, increased blood pressure and sweating.

Adderall & OTC Medications: Generally Considered Safe ​

  • Antihistamines: Antihistamines (e.g. Claritin, Zyrtec) are generally considered OK to use. They can help with a variety of cold symptoms such as a runny nose and itchy, watery eyes. They can also help on occasion with congestion and coughing due to post nasal drip as they can have a slight drying effect. It is important to note that if you are taking an antihistamine for the sedative effects (e.g. with Benadryl), Adderall may counteract the sedative effects, making it less effective.
  • Acetaminophen: Tylenol (acetaminophen) is a safe analgesic and fever reducer to take with Adderall.
  • Mucinex (Guaifenesin): Mucinex (guaifenesin) is generally considered OK to use. It can help thin out excess mucus and relieve chest congestion.​​
  • Ibuprofen/Naproxen: Both ibuprofen and naproxen are considered NSAID (non-steroidal anti-inflammatory) medications. They are considered to be safe to take with Adderall. They may be beneficial in reducing the pain and inflammation of a consistent cough and can help to relieve a sore throat.
  •  Zinc/Vitamin C: Adderall is compatible with other cold remedies such as Zinc lozenges and vitamin C.
  • Cough Drops/Honey: Most varieties of cough drops are considered safe to use with Adderall. These include menthol cough drops, cough drops with honey and cough drops that include mild numbing agents such as Cepacol and Sucrets.

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