Safe Cold Medications With Prozac

In our latest question and answer, the pharmacist discusses over the counter cold medications that are safe to take with Prozac (fluoxetine).

Question

What cold medicine can I take while taking Prozac?

Asked by Dee On Sep 06, 2022

Answered by
Medical Content Reviewed By HelloPharmacist Staff

Published Sep 06, 2022
Last updated Sep 06, 2022

Prozac (fluoxetine) is a selective serotonin reuptake inhibitor (SSRI) used in the treatment of depression. It is inevitable that at some point, an individual taking Prozac will come down with a cold, and it's important to know what over-the-counter cough/cold medications are safe to take.

Colds can cause a variety of symptoms including:

  • Nasal congestion
  • Sinus pressure
  • Headache
  • Cough
  • Runny nose
  • Fever and chills
  • Body aches

How to treat a cold depends upon which symptoms a patient may be experiencing. Some cold medications may be fine to take with Prozac, while others should be avoided.

Below is a summary of cold medications appropriate for specific symptoms and whether or not they can be taken while on a medication like Prozac.

Fever, Headache, Chills, Body aches 

If you have a cold, you may experience a fever, headache, chills, or body aches.  The best medication for this while on Prozac is Acetaminophen.  There are no known interactions between acetaminophen and Prozac (Fluoxetine).  

There are, however, known drug interactions with non-steroidal anti-inflammatory drugs (NSAIDs) like Ibuprofen, aspirin, and naproxen.

Taking Prozac (Fluoxetine) with NSAIDs or aspirin can result in an increased risk of bleeding, like gastrointestinal bleeding. For this reason, acetaminophen should be the drug of choice while on Prozac versus other pain relievers.

Runny Nose, Watery Eyes, Post-Nasal Drip

An antihistamine, like Claritin (loratadine), can be used for the treatment of a runny nose, watery eyes, or post-nasal drip while on Prozac.

Claritin is a second-generation antihistamine that typically does not cause drowsiness. Other second-generation antihistamines that can be used as well include Zyrtec (cetirizine), Xyzal (levocetirizine), and Allegra (fexofenadine).

First-generation antihistamines, like Benadryl (Diphenhydramine), are sedating antihistamines that can cause a significant amount of drowsiness. They should generally be avoided while taking Prozac (Fluoxetine) due to the increased risk of sedation or drowsiness but can be helpful to take at nighttime if you have trouble sleeping.

If a second-generation antihistamine, like Claritin, is taken, you should still be aware that drowsiness or sedation is a possibility, although it would be uncommon. Caution should be taken when driving or operating machinery until the full effects of the medication are known.

Cough and Chest Congestion

Individuals with congestion in the chest can use an expectorant such as guaifenesin to help.  Guaifenesin is used to loosen mucus and make a cough more productive.  There are no interactions with Prozac.

However, often products used for cough may also contain the cough suppressant Dextromethorphan. Dextromethorphan should not be taken while on an SSRI, like Prozac (Fluoxetine), due to a drug interaction that could result in serotonin syndrome.  Serotonin Syndrome is characterized by the following possible symptoms:

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

The risk of serotonin syndrome with combining Prozac and dextromethorphan is thought to be low, but the combination should be avoided if there are other alternative options for you.

Natural cough suppressants (e.g. honey) and cough drugs are good alteranatives.

Nasal Congestion and Sinus Pressure

Many times, individuals will experience sinus pressure or nasal congestion with a cold.  Sudafed (pseudoephedrine) can be used while on Prozac.  Sudafed (pseudoephedrine) is a nasal decongestant that helps relieve the pressure and congestion experienced with a cold.

Nasal sprays as well are safe to use with Prozac.

Final Words

Individuals taking an SSRI, like Prozac, do have options when treating a cold.  How a patient treats a cold will depend upon which symptoms are being experienced.  

Though there are drugs that can be used safely to treat a cold, some drugs, like NSAIDs (ibuprofen, naproxen), Benadryl (diphenhydramine), and dextromethorphan, should generally not be used by patients taking Prozac (Fluoxetine) unless otherwise directed by your doctor.  

For this reason, you will need to be very careful when using multiple-symptom cold products.  These products contain multiple drugs and not all drugs will be safe to use when taking an SSRI like Prozac.  If there are any doubts about whether a product is safe to take, patients should ask their local pharmacist or other health care provider before using these multi-symptom cold products. 

References

  • Prozac Prescribing Information, AccessFDA
  • Dextromethorphan hydrobromide Monograph, PubChem
  • 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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