Cold Medications To Avoid While Taking (Celexa) Citalopram

In our latest question and answer, the pharmacist discusses which cold medications to avoid and which are safe to take with Celexa (Citalopram).

Dec 17, 2017

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). 

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