Cold Medications To Avoid While Taking Adderall

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

Question

I have been prescribed 20 mg of Adderall twice daily and I have a cold. I want to take over-the-counter medicine for the cough. However, I've been reading it's not good to mix these types of medications. Is that true? What medicine is safe for me to take?

Asked by Mandy On Dec 28, 2021

Answered by
Medical Content Reviewed By HelloPharmacist Staff

On Dec 28, 2021

Key points

  • Adderall (amphetamine, dextroamphetamine salts) should be used cautiously with several over-the-counter (OTC) cough/cold medications, including dextromethorphan, pseudoephedrine, and alkalinizing agents (e.g. Tums, Rolaids). You should speak with your doctor prior to using these medications together.
  • Several OTC medications are considered safe to use with Adderall. These include antihistamines (e.g. Claritin, Zyrtec), acetaminophen, and guaifenesin (generic for Mucinex).

Hello and thanks for reaching out!

It's certainly important to know whether or not your prescription medication (Adderall in this case) can interact with an over-the-counter medication you plan on taking.

When it comes to cough and cold meds, if you take Adderall, there are a few that you should be cautious with.

What Is Adderall?

Adderall (Amphetamine, Dextroamphetamine salts) is a prescription medication indicated for the treatment of ADHD (Attention-deficit/hyperactivity disorder). Adderall works mainly by increasing two neurotransmitters in the brain:

  • Dopamine
  • Norepinephrine

In addition to the above neurotransmitters, Adderall is also thought to affect the following, although to a lesser degree:

  • Histamine
  • Serotonin

Adderall With Cold Medication

Symptomatic treatment of cold symptoms can sometimes be tricky when you take any prescription medication and Adderall is no different.

You want to find the best products to alleviate your symptoms, while at the same time keeping in the mind the potential for drug interactions with the medication you are taking.

Based on how Adderall works, there are several over-the-counter cold medications that you should avoid until you can check with your doctor, and there are others that are considered safe to use. I discuss these in the next sections.

Adderall & OTC Cold Medication: Use Caution

The following over-the-counter drugs should be used cautiously with Adderall.

Although there are cases in which the below drugs can be used together, you should speak with your doctor first before combining them.

Dextromethorphan (Delsym)

Caution should be taken when using Adderall and dextromethorphan together due to the small, but serious, risk of serotonin syndrome.

Serotonin syndrome is characterized by the rapid development of hyperthermia, high blood pressure, and mental status changes.

As mentioned, it is uncommon but it should be taken seriously.

Dextromethorphan can increase serotonin levels in the brain by inhibiting reuptake, while stimulants like Adderall cause increased serotonin release from neurons.

Several published studies list both drugs as having the potential to cause serotonin syndrome, and as a general rule of thumb, you should avoid combining drugs that cause an overall increase in serotonin.

One such study specifically states to be cautious of over the counter cough medications that contain dextromethorphan since it can interact with so many prescription drugs in this manner:

Since dextromethorphan is also a reuptake inhibitor, be cautious with cough and cold preparations that combine dextromethorphan and chlorpheniramine.

There may be times where the combination of dextromethorphan and Adderall can be used but should only be considered after speaking with your doctor.

Pseudoephedrine (Sudafed)

Sudafed products may be used on occasion but must be used cautiously.

Both Adderall (via its effects on norepinephrine) and pseudoephedrine can increase blood pressure as well as increase heart rate. In addition, there is a risk of over-stimulation when using the combination together.

It would be prudent to speak to your doctor before using both medications together and they should likely be avoided altogether if you have high blood pressure or a heart condition.

Alkalinizing agents

Over-the-counter gastrointestinal alkalinizing products (i.e. acid-reducing agents) such as Tums, Rolaids, and Alka-Seltzer can increase absorption of amphetamines.

Therefore, co-administration of Adderall and antacids is not recommended.

Taking both together could increase the potential side effects of Adderall such as increased heart rate, increased blood pressure, and sweating.

Adderall & OTC Medications: Generally Considered Safe

The following over-the-counter drugs are generally considered to be safe to use Adderall.

Antihistamines

Antihistamines are generally considered safe to use with Adderall. Antihistamines include:

They can help with a variety of cold symptoms such as a runny nose and itchy, watery eyes.

They can also help on occasion with congestion and coughing due to postnasal drip as they can have a slight drying effect. 

It is important to note that if you are taking an antihistamine for the sedative effects (e.g. with Benadryl), Adderall may counteract the sedative effects, making it less effective.

Acetaminophen

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

Mucinex (Guaifenesin)

Mucinex (guaifenesin) is generally considered OK to use. It can help thin out excess mucus and relieve chest congestion.​​

Ibuprofen/Naproxen

Both ibuprofen and naproxen are considered NSAID (non-steroidal anti-inflammatory) medications. They are considered to be safe to take with Adderall.

They may be beneficial in reducing the pain and inflammation of a consistent cough, can help to relieve a sore throat and reduce a fever.

Zinc/Vitamin C

Adderall is compatible with other cold remedies such as Zinc lozenges and vitamin C.

Cough Drops/Honey

Most varieties of cough drops are considered safe to use with Adderall. These include menthol cough drops, cough drops with honey, and cough drops that include mild numbing agents such as Cepacol and Sucrets.

Final Words

Thanks again for reaching out to us!

Please feel free to contact us again with any further questions.

References

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!

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