Is Advil Cold & Sinus Safe With Zoloft?

Answer

Thanks for reaching out! We actually answered a question similar very recently, and that can be found here.

In that answer, we wrote that Zoloft (sertraline) should be used cautiously with both of the drugs in Advil Cold + Sinus, which contains ibuprofen and pseudoephedrine. I discuss these in more detail in the section below.

Use Zoloft Cautiously With Ibuprofen And Pseudoephedrine

The more concerning interaction here is between Zoloft (sertraline) and the ibuprofen contained in Advil Cold + Sinus.

The combined use of sertraline and NSAIDs, which ibuprofen is, can increase the risk of bleeding due to additive effects.

Clinical studies and case reports have shown an association between serotonin reuptake inhibitors (such as sertraline) and increased incidence of stomach bleeding. The same goes for NSAIDs, which are well known to increase the risk of stomach bleeds with long-term use and/or high doses.

One such study stated the following:

SSRIs increase risk of bleeding by 1.16- to 2.36-fold. The risk is synergistic between SRIs and nonsteroidal anti-inflammatory drugs (NSAIDs).

Now, even though there is an interaction here, there may be situations where your doctor recommends taking ibuprofen and Zoloft together for short periods of time. If you are suffering from a cold/flu and are having a tough time with symptoms, ibuprofen can be helpful.

You don't want to take Zoloft and ibuprofen consistently for long periods of time, but your doctor might deem the benefit is greater than the risk if you are only using ibuprofen on a very intermittent basis, and you don't have a history of stomach bleeds.

In regard to pseudoephedrine with Zoloft, the combination should be avoided if you have any pre-existing heart rhythm problems, like QT prolongation. Although the risk is quite low with Zoloft, it has been associated with causing arrhythmias, especially if used with other drugs that can do the same (like pseudoephedrine). This is a very mild interaction and is generally only of concern if you have a pre-existing condition due to its rarity.

Zoloft Information

Sertraline is used to treat depression, obsessive-compulsive disorder (bothersome thoughts that won't go away and the need to perform certain actions over and over), panic attacks (sudden, unexpected attacks of extreme fear and worry about these attacks), posttraumatic stress disorder (disturbing psychological symptoms that develop after a frightening experience), and social anxiety disorder (extreme fear of interacting with others or performing in front of others that interferes with normal life).

It is also used to relieve the symptoms of premenstrual dysphoric disorder, including mood swings, irritability, bloating, and breast tenderness. Sertraline is in a class of antidepressants called selective serotonin reuptake inhibitors (SSRIs). It works by increasing the amounts of serotonin, a natural substance in the brain that helps maintain mental balance.

Advil Cold + Sinus Information

Advil Cold + Sinus contains two drugs, ibuprofen, and pseudoephedrine.

Nonprescription ibuprofen is used to reduce fever and to relieve minor aches and pain from headaches, muscle aches, arthritis, menstrual periods, the common cold, toothaches, and backaches.

Ibuprofen is in a class of medications called NSAIDs. It works by stopping the body's production of a substance that causes pain, fever, and inflammation.

Pseudoephedrine is used to relieve nasal congestion caused by colds, allergies, and hay fever. It is also used to temporarily relieve sinus congestion and pressure.

Pseudoephedrine will relieve symptoms but will not treat the cause of the symptoms or speed recovery. It is in a class of medications called nasal decongestants. It works by causing the narrowing of the blood vessels in the nasal passages.

Final Words

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