Taking Sudafed With Lexapro

In our latest question and answer, the pharmacist discusses whether or not the nasal decongestant Sudafed (pseudoephedrine) can safely be taken with Lexapro (escitalopram).

Feb 19, 2018

Jenny asked

My nose is congested, where I can't breath through my nose. I take 10 mg of Lexapro (escitalopram). What would be the best over counter medicine to take to help me breath through my nose?


It is always a good idea to look into potential drug interactions if you are taking prescription medication and looking to add on an over the counter medication. This is especially true if you are on antidepressants, such as Lexapro (escitalopram), as they have numerous drug interactions with over the counter products.

Fortunately, Lexapro (escitalopram) is safe to take with most nasal decongestants and there is likely a safe and effective option for you to use. You are likely to get the most benefit from Sudafed (pseudoephedrine). Sudafed is safe to take with Lexapro as there is no drug interaction between the two medications.

Taking Lexapro With Nasal Decongestants

There are four commonly used nasal decongestants over the counter that have no interaction with Lexapro and are safe to use. They are:

  • Sudafed (pseudoephedrine)
  • Sudafed PE (phenylephrine)
  • Afrin nasal spray (oxymetazoline)
  • Saline nasal spray

Sudafed (pseudoephedrine) is likely the most effective nasal decongestant over the counter and it is safe to use with Lexapro. Sudafed works by shrinking swollen nasal membranes to relieve nasal congestion. Sudafed also acts to increase nasal airflow and drainage of sinus secretions.

While Sudafed is generally safe to use in most individuals, there are some contraindications (such as uncontrolled high blood pressure) so it would be prudent to speak with your doctor or pharmacist to make sure use of Sudafed is appropriate in your situation.

Sudafed PE (phenylephrine) is also safe to take with Lexapro and there is no drug interaction between the two. However, Sudafed PE, for most people, is not as effective as Sudafed.

Your other options include nasal sprays such as Afrin and saline sprays. Afrin is effective but cannot be used for more than 2 to 3 days continuously due to the risk of rebound congestion. Saline sprays can be used as often as needed.

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