Can You Take Lexapro (Escitalopram) With Nyquil?

In our latest question and answer, the pharmacist discusses the interaction between the SSRI Lexapro (escitalopram) and Nyquil.

3 min read Updated Jun 2026 Read by 26,121 people
Can You Take Lexapro (Escitalopram) With Nyquil?
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Joe asked

Can you take Nyquil with Lexapro? I heard there is an interaction but I need something for my cough.

Sep 06, 2022
The quick answer
  • Taking Nyquil with Lexapro is not recommended because the cough suppressant dextromethorphan in Nyquil can interact with Lexapro and increase the risk of serotonin syndrome, a rare but serious condition. If you need to treat cold or cough symptoms while taking Lexapro, safer alternatives include cough drops, expectorants like Mucinex, and humidifiers. Serotonin syndrome symptoms include confusion, high blood pressure, muscle spasms, rapid heart rate, and anxiety, and require immediate medical attention if they occur.
A quick summary of Dr. Brian Staiger, PharmD's full answer below, condensed by AI from that answer only (not from any outside source). The pharmacist's answer is the source of record.

Answer

There is an interaction between one of the ingredients in Nyquil and Lexapro (escitalopram), considered to be major by most medical sources.

Due to the interaction, it is recommended to avoid combining the two medications if there are other options available to you. Taking both increases the risk of a rare, but serious condition known as serotonin syndrome.

Nyquil - Lexapro Interaction Details

Dextromethorphan, the cough suppressant in Nyquil, is known to have mild serotonergic properties. Studies aren't conclusive in regard to what doses provide serotonergic effects, but multiple case studies have been published with dextromethorphan precipitating what is known as 'serotonin syndrome' in patients who are also taking other drugs affecting serotonin.

Serotonin syndrome is a rare, but serious condition that is characterized by the following symptoms:

  • Confusion
  • Hyperthermia
  • High blood pressure
  • Muscle spasm/paralysis
  • Delerium 
  • Anxiety 
  • Increased heart rate

The incidence of serotonin syndrome is low, but extremely serious if it occurs. Most cases of serotonin syndrome are due to a patient being on more than one drug that increases serotonin. As such, it is important to limit the number of serotonergic medications you are taking and be aware of the signs and symptoms of serotonin syndrome should it occur. If it does occur, all offending agents should be stopped and immediate medical attention is required.

To decrease the risk of serotonin syndrome while on Lexapro, it is recommended to avoid over-the-counter dextromethorphan and find alternative therapies such as cough drops, expectorants (e.g. Mucinex), and humidifiers.

Nyquil Ingredients & Information

Nyquil is a combination cough/cold medication that contains the following ingredients:

  • Acetaminophen (analgesic)
  • Dextromethorphan (cough suppressant)
  • Doxylamine (sedating antihistamine)

The ingredients in Nyquil help to relieve common cold and flu symptoms such as pain, sore throat, fever, cough, post-nasal drip, and congestion.

It should be noted that there are a variety of different Nyquil products including Nyquil Cough and Nyquil Severe. However, the ingredient we are concerned about is the cough suppressant, dextromethorphan.

Lexapro Information

Lexapro (escitalopram) is an antidepressant classified as an SSRI (Selective Serotonin Reuptake Inhibitor). It works by blocking serotonin reuptake in the brain and also increases the amount of serotonin released by neurons. The net result is an increase in serotonin in the brain, a neurotransmitter thought to play a major role in treating depression.

SSRI medications, such as Lexapro, are effective in the treatment of a variety of indications including depression, anxiety, and other mood disorders. As with all medications, you need to be aware of potential interactions with Lexapro, especially with other medications that could potentially affect serotonin.

Final Words

Thanks for your question and please feel free to contact us again!

References & sources
  1. Dextromethorphan-induced serotonin syndrome — PubMed
  2. Serotonin syndrome in dextromethorphan ingestion responsive to propofol therapy — PubMed
Glossary — Terms in This Answer
Serotonin syndrome
A rare but serious condition caused by too much serotonin in the body, which can occur when taking multiple medications that increase serotonin levels.
Dextromethorphan
A cough suppressant ingredient found in Nyquil and other over-the-counter cold medicines that can interact with certain antidepressants.
Lexapro (escitalopram)
An antidepressant medication that increases serotonin levels in the brain to treat depression, anxiety, and mood disorders.
SSRI
A type of antidepressant that works by blocking the reabsorption of serotonin in the brain, allowing more serotonin to remain active.
Serotonergic
Relating to medications or substances that affect serotonin levels in the body.
Hyperthermia
A dangerously high body temperature or fever.
Neurotransmitter
A chemical messenger in the brain that helps transmit signals between nerve cells and affects mood, sleep, and other functions.
Expectorant
A type of medication that helps thin and clear mucus from the airways to relieve congestion.
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Dr. Brian Staiger, PharmD
About the pharmacist

Dr. Brian Staiger, PharmD

Clinical Pharmacy

Doctor of Pharmacy, board certified clinical pharmacist (BCPS), American Herbalist Guild, Medication Therapy Management certified

Brian Staiger, PharmD, BCPS, is a licensed pharmacist with more than 13 years of experience across retail pharmacy, clinical pharmacy, medication safety, pharmacy program development, and healthcare administration. He is the founder of HelloPharmacist.com, where he helps patients...

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