Scott Morgan asked
What cough and cold medicines are safe to take while in 40mg Celexa? Which ones should I avoid?
Answer
Citalopram (Celexa) is a commonly used selective serotonin reuptake inhibitor (SSRI) that can be used for depression, hot flashes, and anxiety. It is always a good idea to check for drug interactions prior to adding any prescription or over the counter medications. In this case, Celexa can interact with over the counter cough and cold medications. Many of these products have multiple ingredients and it is important to read the package labeling and consult a physician or pharmacist. Below we will discuss which medications interact with Celexa.
SSRIs, such as Celexa, enhance the effect of serotonin by
blocking the reuptake at the neuronal membrane. Over time, this effect works to
improve mood disorders like depression and anxiety. Other medications that
effect serotonin can cause a condition known as serotonin syndrome. Serotonin syndrome can cause rapid elevation in
temperature, high blood pressure, rigidity, and delirium. Although serotonin
syndrome is rare, it can be an extremely severe condition that requires
emergent treatment. Serotonin syndrome is especially rare while taking just one
medication that impacts serotonin, but the risk increases with each additional
medication. Common medications that can increase the risk of serotonin syndrome
include opioids like tramadol, antipsychotics, tricyclic antidepressants, monoamine
oxidase inhibitors, dextromethorphan, and others.
Dextromethorphan
Dextromethorphan is a cough suppressant that should be
avoided with Celexa due to the increased risk of serotonin syndrome. Dextromethorphan is found in several cough and
cold medications including Delsym, Mucinex DM, and many Robitussin products. Taking
dextromethorphan for a short amount of time at recommended doses may not cause
a problem, but caution is recommended. One small study
showed that high levels of dextromethorphan were required to induce serotonin
syndrome.
Guaifenesin
There is no drug interaction between Celexa and guaifenesin
products like Mucinex. Guaifenesin is an expectorant and is good for breaking
up mucus in the chest. Be careful of combination products containing
dextromethorphan and always check the ingredients carefully.
Cough drops, throat
sprays, and lozenges
There is no drug interaction between Celexa and cough drops,
throat sprays, and lozenges containing ingredients such as benzocaine, menthol,
and phenol. These are good for numbing the throat and typically must be taken
every 2 hours for best effect.
Nonsteroidal anti-inflammatory
drugs (NSAIDs) and Aspirin
NSAIDs such as ibuprofen (Advil) and naproxen (Aleve) can increase the risk of bleeding while taking SSRIs. Both SSRIs and NSAIDs effect platelets and can therefore increase risk of bleeds, especially in the GI tract. While the absolute risk is low, it is important to monitor for this effect. Aspirin also may increase the risk of bleeding while taking Celexa.
Acetaminophen
There is no drug interaction between acetaminophen and Celexa,
however may combination products may contain products that interact with Celexa
(dextromethorphan).
