Safe Cold Medications With Methylphenidate And Pristiq

In our latest question and answer, the pharmacist discusses cold medications that are safe to take with Pristiq and methylphenidate.

Question

What over-the-counter cold medications can you take with 54 mg methylphenidate ER and 25 mg desvenlafaxine ER?

Asked by Les On Nov 08, 2022

Answered by
Medical Content Reviewed By HelloPharmacist Staff

Published Nov 08, 2022
Last updated Mar 29, 2024

Key points

  • You should always check with your doctor or pharmacist regarding whether or not over-the-counter medications are safe with your prescriptions.
  • While some cough/cold medications are safe with Pristiq and methylphenidate, others need to be used cautiously, such as ibuprofen, pseudoephedrine, and dextromethorphan.

Answer

While there are several over-the-counter medications that are safe to take with methylphenidate, a central nervous system stimulant, and Pristiq (desvenlafaxine), an antidepressant, there are a few you want to be cautious about using due to the risk of serious side effects.

Below, I discuss over-the-counter cough/cold drugs that are safe, and ones to take cautiously, with Pristiq and methylphenidate.

Fever and Headache

First up is Tylenol (acetaminophen) and Advil (ibuprofen), which are commonly used as fever reducers and pain relievers.

There are no interactions between acetaminophen and Pristiq or methylphenidate and generally, that is the pain reliever of choice due to its relative safety when compared to ibuprofen.

Ibuprofen and Pristiq should be used cautiously, however.

Both drugs have the potential to increase the likelihood of bleeding. For most individuals, this will not be an issue as the risk is low, but for some, like those on a blood thinner (e.g., warfarin), caution should be taken.

Cough and Chest Congestion

The two most common drugs in this category are:

  • Mucinex (guaifenesin)
  • Dextromethorphan

Mucinex (guaifenesin) is an expectorant used to help thin mucus secretions. It is often used for a cough that is non-productive.

There are no interactions between guaifenesin and methylphenidate or Pristiq. It is safe to use.

Dextromethorphan is a cough suppressant used to help control a cough and should be used cautiously with both drugs.

Taking dextromethorphan with either methylphenidate or Pristiq may increase the chances of a rare, but serious condition known as serotonin syndrome. Serotonin syndrome is characterized by the following:

  • Tremor
  • Sweating
  • Coordination problems
  • Involuntary muscle spasms, jerking, or shaking
  • Confusion
  • Rapid heart rate and increase in blood pressure

This interaction is not common but you should be aware of it.

It is important to monitor yourself for the development of the symptoms of serotonin syndrome if you are taking a combination of drugs increases the risk of it occurring.

If they do, you should contact your doctor or another healthcare provider immediately.

Nasal Congestion

Pseudoephedrine is a nasal decongestant used to treat nasal congestion and sinus pressure.

Pseudoephedrine does interact with both Methylphenidate and Pristiq. All three medications have the potential to increase both blood pressure and heart rate. For this reason, Pseudoephedrine should NOT be taken while also taking methylphenidate or Pristiq without talking to your doctor.

Some other options for the relief of sinus congestion that are safe include using a warm mist humidifier, taking a steam shower, or using a Neti pot or sinus rinse.

Keeping the nasal passages moist can help with congestion. Should this not do the trick, then it is advised to speak to your doctor or other health care provider before taking a drug like pseudoephedrine.

Runny Nose, Watery Eyes, or Post-nasal Drip

Antihistamines like Claritin (loratadine) or Benadryl (diphenhydramine) can be used to help with the symptoms of runny nose, watery eyes, or post-nasal drip.

There are no interactions when taking these drugs with methylphenidate or Pristiq. In fact, all antihistamines are considered safe with these drugs.

Final Words

There certainly are options to treat cold symptoms for patients who are taking both methylphenidate and Pristiq. However, drugs like pseudoephedrine, ibuprofen, and dextromethorphan should not be used before talking with a doctor or other health care provider.

For this reason, patients should be particularly careful when choosing multi-symptom cold products.

These products often have multiple drugs in them, some of which should not be used or are not necessary depending on the symptoms being experienced.

Your local pharmacist is an excellent resource to help you choose the safest, most appropriate product if there are any questions.

Thanks for reaching out to us!

References

  • Pristiq Prescribing Information, AccessFDA
  • Concerta Prescribing Information, AccessFDA
  • Pseudoephedrine—Benefits and Risks, PubMed
  • Over-the-counter ibuprofen and risk of gastrointestinal bleeding complications: a systematic literature review, AccessFDA

About the Pharmacist

Dr. Brian Staiger, PharmD

Dr. Brian has been practicing pharmacy for over 13 years and has wide-ranging experiences in many different areas of the profession. From retail, clinical, program development, and administrative responsibilities, he's your knowledgeable and go-to source for all your pharmacy and medication-related questions! Dr. Brian Staiger also has herbalist training and educational certificates in the field of medical ethnobotany. Feel free to send him an email at [email protected]! You can also connect with Dr. Brian Staiger on LinkedIn.

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