Cold Medications To Avoid While Taking Zoloft

In our latest question and answer, the pharmacist discusses which cold medications you can take and which you should avoid while taking the antidepressant Zoloft (Sertraline).​

Dec 21, 2017

Jen asked

I take 25mg of Zoloft (sertraline) and have come down with a cold. Is it safe to take an over the counter cold/flu nighttime syrup? I’m a female in my mid 30’s and have been on this med for about 4 months.


Zoloft (sertraline), is an antidepressant classified as an SSRI (selective serotonin reuptake inhibitor), and is one of the most commonly used drugs to treat depression and associated illnesses. Due to the widespread use of antidepressants, questions regarding drug interactions come up often.

Everyone gets sick from time to time, be it from the flu, the common cold or from a variety of other infections.  Treating the symptoms of these illnesses can sometimes be difficult if you are on prescription medication such as Zoloft. It is important to always check for potential drug interactions before using a product over the counter.

In regard to Zoloft (sertraline), there are some over the counter medications that you either want to avoid, or take caution with and use only based on the direction of your doctor:

Use Caution
  • NSAIDs (e.g. Ibuprofen, Naproxen, Aspirin): The combined use of selective serotonin re-uptake inhibitors like Zoloft and NSAIDs can increase the risk for an upper GI bleed. This is especially true if you have had a history of GI bleeds or ulcerations in the past. NSAIDs are 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 Pepto-Bismol.
  • Dextromethorphan (Delsym): Caution should be taken when using Zoloft 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. Serotonin syndrome is characterized by rapid development of hyperthermia, high blood pressure and mental status changes.​​​ Although rare, it is extremely serious. Sometimes the combination of dextromethorphan and SSRIs can be used but should only be considered after speaking with your physician.

  • Psuedoephedrine (Sudafed): ​Sudafed products 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 exacerbate these conditions.

OTC Medications Generally Considered Safe
  • Antihistamines: Antihistamines (e.g. Claritin, Zyrtec) are generally considered OK and safe 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.

  • Acetaminophen: Tylenol (acetaminophen) is in most cases a better option for a pain reliever/fever reducer than NSAID medications.

  • Guaifenesin: Mucinex (guaifenesin) is generally considered OK to use. It can help thin out excess mucus and relieve chest congestion.​​

  • Zinc/Vitamin C: Zoloft is compatible with other cold remedies such as Zinc lozenges and vitamin C.

It is important to look at the active ingredient list for any product you are considering purchasing. There are a variety of combination products that contain multiple ingredients, so you need to be aware of all the included ingredients in these products. In addition, there are many 'brand name extension' products that can contain ingredients you may not be aware of. A 'brand name extension product' uses a commonly recognized brand name but contains multiple ingredients for different indications. For example, 'Mucinex Fast Max' contains more than just Mucinex. It also contains dextromethorphan and phenylephrine.

There are a variety of safe and effective options over the counter available to you for the treatment of cough/cold symptoms. Just be sure to pick the appropriate product for your situation and read the ingredients!

Ready for a more personal experience with your meds?