Does Clozaril Interact With Alka-Seltzer Plus Cold And Cough?

In our latest question and answer, the pharmacist discusses the potential interaction between Clozaril (clozapine) and Alka-Seltzer Plus Cold And Cough.

Dec 25, 2017

Moe asked

Is there any interaction between Clozaril (clozapine) and Alka Seltzer Cold and Cough medication?


There is a moderate interaction between Clozaril (clozapine) and one of the ingredients contained in Alka Seltzer Cold & Cough. Caution is advised when combining the two products together.

Alka Seltzer Cold & Cough contains the following ingredients:

  • Acetaminophen
  • Chlorpheniramine
  • Dextromethorphan
  • Phenylephrine

Chlorpheniramine, an ingredeitn contained in the product, is the compeont that interacts with Clozaril. Chlorpheniramine is a sedating, first generation antihistmaine similar to Benadryl.

Interaction Between Chlorpheniramine & Clozaril

Both Clozaril and chlorpheniramine can have potent 'anticholinergic effects' (i.e. blockage of the the neurotransmitter acetylcholine). The use of both together can potentiate these effects in users. Potential anticholinergic effects include:

  • Confusion
  • Dry mouth
  • Dry eyes
  • Lethargy
  • Increased heart rate
  • Poor coordination
  • Agitation

While the combination of Clozaril and chlorpheniramine could potentially be used in some situations, it is best to check with your doctor first. In addition, you could also look for over the counter products that do not contain an antihistamine. Most other cough/cold products you find over the counter do not interact with Clozaril and are OK to use. These include:

  • Dextromethorphan (cough suppressant)
  • Guaifenisin (expectorant)
  • Acetaminophen (pain reliever)
  • Pseudoephedrine (nasal decongestant)

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