Is Coricidin Cough & Cold Safe To Take With Lexapro?
In our latest question and answer, the pharmacist describes the interaction between Lexapro and Coricidin HBP Cough and Cold.
Can I take Coricidin Cough and Cold if I am on Lexapro?
Feb 08, 2023- Dextromethorphan in Coricidin can interact with Lexapro and potentially increase the risk of serotonin syndrome, a serious condition caused by too much serotonin in the brain. While serotonin syndrome is uncommon and dextromethorphan is considered low-risk compared to other drugs, it's important to talk with your doctor before taking Coricidin with Lexapro to make sure it's safe for you. Watch for warning signs of serotonin syndrome including confusion, rapid heartbeat, muscle rigidity, tremors, and severe headache, and seek immediate medical attention if you experience any of these symptoms.
Answer
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Coricidin Cough & Cold HBP contains two drugs:
- Chlorpheniramine
- Dextromethorphan
Chlorpheniramine is an antihistamine, somewhat similar to Benadryl (diphenhydramine), but is less sedating and lasts longer, around 6-8 hours per dose.
Dextromethorphan is a cough suppressant and it is this drug that does have an interaction with Lexapro (escitalopram) that is important to be aware of.
Lexapro With Coricidin Interaction Details
Lexapro (escitalopram) is an SSRI (selective serotonin reuptake inhibitor). It works by changing the levels of a chemical called serotonin, a neurotransmitter that helps to control mood and emotion, in the brain.
Dextromethorphan, the cough suppressant in Coricidin Cough & Cold, while it doesn't directly work by affecting serotonin levels, can enhance the serotonergic effects of other drugs that work on this neurotransmitter, potentially increasing the risk of a rare, but serious, condition known as serotonin syndrome.
Serotonin syndrome is a condition that occurs when there's an excess of serotonin in the brain. It is relatively uncommon but has been reported in individuals taking multiple drugs that affect serotonin. Symptoms of serotonin syndrome include:
- Confusion and agitation
- Rapid heartbeat
- High blood pressure
- Dilated pupils
- Headache
- Muscle rigidity or spasms
- Tremors
- Sweating
- Shivering or goosebumps
- Diarrhea
- Seizures
If you are taking multiple serotonergic drugs and experience any of these symptoms, it's important to seek medical attention right away, as serotonin syndrome can be life-threatening.
Pharmacist Thoughts
Again, serotonin syndrome is relatively uncommon, but it is so important to be aware of it when taking multiple drugs that affect serotonin.
Dextromethorphan doesn't affect serotonin to the level that many other drugs do, so it's generally considered to be low on the list of dangerous drugs to combine with other serotonergic agents.
Nevertheless, there have been several published case reports where dextromethorphan was thought to be a culprit in individuals diagnosed with serotonin syndrome, including one case report where someone was thought to have experienced serotonin syndrome after taking dextromethorphan and Lexapro.
It must be said that cases of serotonin syndrome that include dextromethorphan typically involve someone taking doses of the drug that are higher than recommended.
How To Manage The Interaction
Overall, there are many drugs that can increase the activity of serotonin in the brain. When someone takes two or more of these drugs at the same time, it increases the risk of serotonin syndrome. The risk is often considered to be low, but several factors can influence this risk, such as the drugs and dosages being taken, and individual factors, like age, sex, and organ function.
Most individuals can safely take dextromethorphan with a drug like Lexapro, but I recommend first speaking with your doctor to make sure it is safe for your particular medical situation, and to be aware of the signs and symptoms of serotonin syndrome.
Final Words
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References & sources
- Serotonin syndrome caused by drug to drug interaction between escitalopram and dextromethorphan — PubMed
- The central nervous system serotonin syndrome — PubMed
- Myoclonus after dextromethorphan administration in peritoneal dialysis — PubMed
- Dextromethorphan-induced serotonin syndrome — PubMed
- The serotonin syndrome — PubMed
Glossary — Terms in This Answer
- Antihistamine
- A medication that blocks the effects of histamine in the body to relieve allergy symptoms.
- Cough suppressant
- A medication that reduces or eliminates the urge to cough.
- SSRI
- A type of antidepressant medication that increases serotonin levels in the brain by preventing its reabsorption.
- Neurotransmitter
- A chemical messenger in the brain that transmits signals between nerve cells.
- Serotonergic
- Relating to drugs or processes that affect serotonin in the brain.
- Serotonin syndrome
- A rare but serious condition caused by excess serotonin in the brain, which can result from taking multiple medications that affect serotonin.
- Muscle rigidity
- A condition where muscles become stiff and resistant to movement.
- Dilated pupils
- An abnormal widening of the pupils (the dark center of the eye).