Cold Medications Safe To Take With Adderall And Zoloft

In our latest question and answer, the pharmacist discusses which over-the-counter cold medications are safe, and which to avoid, with Zoloft and Adderall.

Question

I take Adderall in the morning for ADHD, and Sertraline at night for anxiety. I have a severe cold or possibly influenza, and want to take some sort of medicine for body aches. Looking at Alka-Seltzer and it says not to take if now taking any MAOI's ... And when I search Google I'm getting conflicting answers. I would really appreciate some help and input on these interactions and whether I can safely take cold medicine, or not. Thanks in advance!

Asked by Vickfam6 On Sep 15, 2022

Answered by
Medical Content Reviewed By HelloPharmacist Staff

Published Sep 15, 2022
Last updated Sep 15, 2022

Key points

  • Medications that should be avoided, or at the very least used cautiously with Adderall and Zoloft, include dextromethorphan, Sudafed (pseudoephedrine), NSAIDs (e.g. ibuprofen), and alkalinizing agents (e.g. Tums, Rolaids).
  • Safe medications include Tylenol (acetaminophen), Mucinex (guaifenesin), and antihistamines.

It can certainly be tricky trying to find safe over-the-counter cold medications when taking prescription drugs. This is especially true for medications such as Zoloft (sertraline) and Adderall (amphetamine salts), which affect numerous neurotransmitters in the body. 

We have written extensively on cold medication use with Adderall and Zoloft. Those articles can be found here:

Below is a short recap of those articles.

Cold Medications To Avoid On Adderall And Zoloft

It is true that the one class of medications you nearly always want to avoid are MAOI drugs, which stands for Monoamine oxidase inhibitors. Although there are a few concerns with MAOIs, we are generally most worried about hypertensive crisis (dangerously high blood pressure) when used with CNS stimulants (such as Adderall) or drugs that affect neurotransmitters (such as Zoloft).

Other medications that should be avoided, or at the very least used with extreme caution include:

  • Dextromethorphan
  • Sudafed
  • NSAIDs
  • Alkalinizing agents

Dextromethorphan

Dextromethorphan should be used cautiously with Zoloft. Dextromethorphan can have serotonergic properties (i.e. affect the neurotransmitter serotonin), especially when used in high doses. There have been rare reports of serotonin syndrome, a rare, but serious medical condition.

Although Adderall may have mild serotonergic effects too, there isn't much concern about combining it with dextromethorphan.

Sudafed

Sudafed (pseudoephedrine) should be used cautiously with both Adderall and Zoloft. Sudafed is a CNS stimulant and can raise blood pressure and increase heart rate, as Adderall can do as well. In addition, Sudafed has rare reports of QT prolongation, a type of arrhythmia. Zoloft has been associated with arrhythmia, although rarely, in certain patients.

NSAIDs

NSAIDs include Advil (ibuprofen), Motrin and Aleve. They can increase the risk of gastrointestinal bleeding when taking SSRIs, such as Zoloft.

Alkalizing agents

Antacids, such as Tums, can increase the absorption of Adderall, potentially increasing side effects.

Cold Medications Safe To Take With Adderall And Zoloft

Antihistamines

Antihistamines (e.g. Claritin, Zyrtec) are generally considered safe to use with Adderall and Zoloft. They can be beneficial for a variety of cold symptoms such as a runny nose and sneezing. Second-generation antihistamines, such as Claritin or Allegra, are a good choice for all-day relief. First-generation antihistamines, such as Benadryl, are a good option to help dry secretions and treat insomnia.

Acetaminophen

Tylenol (acetaminophen) is a safe analgesic and fever reducer to take with Zoloft and Adderall.

Mucinex (Guaifenesin)

Mucinex (guaifenesin) is generally considered safe to use with Zoloft and Adderall. It can help thin out excess mucus and relieve chest congestion.

Zinc/Vitamin C

Most prescription medications are compatible with other cold remedies such as Zinc lozenges and vitamin C.

Cough Drops/Honey

There are no reported interactions with menthol cough drops, cough drops with honey, and cough drops that include mild numbing agents, such as Cepacol and Sucrets.

Final Words

Thanks for reaching out to us! Please feel free to reach back out to us anytime.

References

  • Zoloft Prescribing Information, AccessFDA
  • Adderall Prescribing Information, AccessFDA
  • Dextromethorphan-induced serotonin syndrome, PubMed

About the Pharmacist

Dr. Brian Staiger, PharmD

Dr. Brian has been practicing pharmacy for over 11 years and has wide-ranging experiences in many different areas of the profession. From retail, clinical and administrative responsibilities, he's your knowledgeable and go-to source for all your pharmacy and medication-related questions! Feel free to send him an email at Hello@HelloPharmacist.com! You can also connect with Dr. Brian Staiger on LinkedIn.

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