Safe Cold Medications With Prozac

In our latest question and answer, the pharmacist discusses over the counter cold medications that are safe to take with Prozac (fluoxetine).

Safe Cold Medications With Prozac
Apr 20, 2018

Dee asked

What cold medicine can I take while taking Prozac?

Answer

Cold Medicines With ProzacProzac (Fluoxetine) is a selective serotonin reuptake inhibitor (SSRI) used in the treatment of depression. Colds can cause a variety of symptoms including:

  • Nasal congestion
  • Sinus pressure
  • Headache
  • Cough
  • Runny nose
  • Fever and chills
  • Body aches

How to treat a cold depends upon which symptoms a patient may be experiencing. Some cold medications may be fine to take with Prozac (Fluoxetine), while others should be avoided. Below is a summary of cold medications appropriate for specific symptoms and whether or not they can be taken while on a medication like Prozac (Fluoxetine).

Fever, Headache, Chills or Body aches

Patients may experience a fever, headache, chills or body aches with a cold.  The best medication for this while on Prozac (Fluoxetine) is Acetaminophen.  There are no known interactions with Acetaminophen and Prozac (Fluoxetine).  

There are however, known drug interactions with non-steroidal anti-inflammatory drugs (NSAIDS) like Ibuprofen, Aspirin or Naproxen.  Taking Prozac (Fluoxetine) with NSAIDS or Aspirin can result in an increased risk of bleeding, like gastrointestinal bleeding.  For these reasons, Acetaminophen should be the drug of choice while on Prozac (Fluoxetine) for headaches, fever, chills or body aches.

Runny Nose, Watery Eyes or Post-Nasal Drip

An antihistamine, like Claritin (Loratadine), can be used for the treatment of a runny nose, watery eyes or post-nasal drip while on Prozac (Fluoxetine).

Claritin (Loratadine) is a second generation antihistamine that typically does not cause drowsiness.  First generation antihistamines, like Benadryl (Diphenhydramine), are sedating antihistamines that can cause a significant amount of drowsiness. They should be avoided while taking Prozac (Fluoxetine) due to the increased risk of sedation or drowsiness.  If a second generation antihistamine, like Claritin (Loratadine), is taken, patients should still be aware that drowsiness or sedation is a possibility. Caution should be taken when driving or operating machinery until the full effects of the medication are known.

Benadryl (Diphenhydramine) should also be avoided due to a potential life threatening interaction with Prozac (Fluoxetine) called drug-induced QT prolongation and Torsades de Pointes.  The combination of Benadryl (Diphenhydramine) and Prozac (Fluoxetine) may increase the risk of a patient developing life-threatening ventricular arrhythmias.  Patients should check with their doctor or other health care provider before taking Benadryl (Diphenhydramine) with Prozac (Fluoxetine).


Cough and Chest Congestion

Patients with congestion in the chest can use an expectorant such as Guaifenesin to help.  Guaifenesin is used to loosen mucus and make a cough more productive.  There are no interactions with Prozac (Fluoxetine).

 However, often products used for cough may also contain a cough suppressant such as Dextromethorphan.  Dextromethorphan should not be taken while on a SSRI, like Prozac (Fluoxetine), due to a drug interaction that could result in serotonin syndrome.  Serotonin Syndrome is characterized by the following possible symptoms:

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

A lot of times patients will experience sinus pressure or nasal congestion with a cold.  Sudafed (Pseudoephedrine) can be used while on Prozac (Fluoxetine).  Sudafed (Pseudoephedrine) is a nasal decongestant that helps relieve the pressure and congestion experienced with a cold.  

Conclusion

Patients on a SSRI, like Prozac (Fluoxetine), do have options when treating a cold.  How a patient treats a cold will depend upon which symptoms are being experienced.  

Though there are drugs that can be used safely to treat a cold, some drugs, like NSAIDS (ibuprofen, naproxen), Benadryl (diphenhydramine) and dextromethorphan, should not be used by patients taking Prozac (Fluoxetine).  For this reason, patients will need to be very careful when using multiple-symptom cold products.  These products contain multiple drugs and not all drugs will be safe to use when taking a SSRI like Prozac (Fluoxetine).  If there are any doubts whether a product is safe to take, patients should ask their local pharmacist or other health care provider before using these multi-symptom cold products. 

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