Safe Cold Medications With Methylphenidate And Pristiq

In our latest question and answer, the pharmacist discusses cold medications that are safe to take with Pristiq and methylphenidate.

Apr 24, 2018

Les asked

What over the counter cold medications can you take with 54 mg meyhylphenidate ER and 25 mg desvenlafaxine ER.


Methylphenidate is a central nervous system stimulant used in the treatment of attention deficit/hyperactivity disorder and narcolepsy. Pristiq (desvenlafaxine ER) is an antidepressant that is used in the treatment of depression. There are medications used to treat a cold that can be taken depending on the symptoms you are treating. However, not all medications can be used. Below is a guide by common symptoms experienced in a cold such as fever and headache, cough and chest congestion, nasal congestion and runny nose.

Fever and Headache

Acetaminophen or Ibuprofen are commonly used for a fever reducer or pain relief of a headache. There are no interactions with acetaminophen. However, ibuprofen and desvenlafaxine ER both have the potential to increase the likelihood of bleeding. For most patients this will not be an issue. For patients on blood thinning therapy like warfarin or with other bleeding disorders, caution should be taken when taking this drugs together.

Cough and Chest Congestion

Guaifenesin is an expectorant used to help thin secretions. It is often used for a cough that is non-productive. There are no interactions between Guaifenesin and Methylphenidate or Desvenlafaxine ER. Dextromethorphan is a cough suppressant used to help control a cough. Taking Dextromethorphan with Desvenlafaxine ER may increase the chances of a patient developing Serotonin Syndrome. Serotonin Syndrome is characterized by the following:

  • Tremor
  • Sweating
  • Coordination problems
  • Involuntary muscle spasms, jerking or shaking
  • Confusion
  • Rapid heart rate and increase in blood pressure

This interaction is not contraindicated but rather one that patients should be aware of. Patients should monitor themselves for the development of the symptoms of Serotonin syndrome and contact their doctor or other health care provider immediately should any of the mentioned symptoms occur.

Nasal Congestion

Pseudoephedrine is a nasal decongestant used to treat nasal congestion and sinus pressure. Pseudoephedrine does interact with both Methylphenidate and Desvenlafaxine ER. All three medications have the potential to increase both blood pressure and heart rate. For this reason, Pseudoephedrine should NOT be taken while also taking Methylphenidate or Desvenlafaxine ER.

Some other options for relief of sinus congestion include using a warm mist humidifier, taking a steam shower or using a Neti pot or sinus rinse. Keeping the nasal passages moist can help with congestion. Should this not do the trick, then it is advised to speak to your doctor or other health care provider before taking a drug like Pseudoephedrine.

Runny Nose, Watery Eyes or Post-nasal Drip

Antihistamines like Claritin (Loratadine) or Benadryl (Diphenhydramine) can be used to help with the symptoms of runny nose, watery eyes or post-nasal drip. There are no interactions when taking these drugs with Methylphenidate or Desvenlafaxine ER. Claritin is a second generation antihistamine that typically does not cause drowsiness. While Benadryl (Diphenhydramine) is a first generation antihistamine that can cause drowsiness. Often Benadryl or another first generation anti-histamine, Doxylamine, will be found in night time formulations due to the significant drowsiness or sedation these drugs can cause.


There are options to treat cold symptoms for patients who are taking both Methylphenidate and Desvenlafaxine ER. However, drugs like Pseudoephedrine, that is used to treat nasal congestion, should not be used before talking with a doctor or other health care provider. For this reason, patients should be particularly careful when choosing multi-symptom cold products.

These products often have multiple drugs in them, some of which should not be used or are not necessary depending upon the symptoms being experienced. Your local Pharmacist is an excellent resource to helping you choose the safest, most appropriate product if there are any questions.

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