What Cold Medications Are Safe With Wellbutrin?

Answer

Thanks for reaching out! As with all prescription medication, it is always a good idea to consider potential drug interactions with over-the-counter (OTC) products. This is especially true with some antidepressants, especially SSRIs like Zoloft, as there are several interactions to be aware of. However, in regard to Wellbutrin (bupropion), most OTC drugs are relatively safe to use.

In the next sections, I go over which medications are considered safe to take with Wellbutrin.

Cold Medications Considered Safe To Take With Wellbutrin

Expectorants

Guaifenesin, the active ingredient in Mucinex, is an effective expectorant that helps to thin and clear out mucus that causes chest congestion. There is no listed or reported interaction between guaifenesin and Wellbutrin. They are considered to be safe to use together.

Antihistamines

Antihistamines are considered safe to use. They are used for a wide range of symptoms including post nasal drip, congestion, and allergy symptoms.

Claritin, Zyrtec, and Allegra all last 24 hours and are good options to combine with Wellbutrin if needed.

While most antihistamines are considered safe with Wellbutrin, one exception may be Benadryl. Wellbutrin can inhibit the metabolism of Benadryl (via CYP2D6 inhibition), which can lead to increased concentrations of the drug. This could potentially increase the risk of side effects such as:

• Sedation
• Dry mouth
• Dry eyes
• Constipation

If you are looking for a sedating antihistamine, Unisom, which contains doxylamine, is safe to take with Wellbutrin and does not have the interaction that Benadryl does.

Analgesics

Pain medications, like Tylenol (acetaminophen), Advil (ibuprofen), and Aleve are considered safe to take with Wellbutrin. There are no known drug interactions.

Nasal Steroids

Nasal steroids, such as Flonase, Nasacort, and Rhinocort are safe to take with Wellbutrin.

Zinc/Vitamin C/Cough Drops

Wellbutrin is safe to use with most "natural" cold remedies such as Zinc lozenges and vitamin C.

Use Caution With Wellbutrin

Cough Suppressants

The most common cough suppressant over the counter is dextromethorphan, which is the active ingredient in products such as Delsym and Robitussin DM. Dextromethorphan is available in liquid and solid dosage forms. Most sources list a mild interaction between dextromethorphan and Wellbutrin but the combination is often used together safely.

The mild interaction between the two drugs is that Wellbutrin can inhibit dextromethorphan metabolism. This is due to Wellbutrin inhibition of a liver metabolizing enzyme known as CYP2D6 (which is partly responsible for metabolizing dextromethorphan). This could potentially increase dextromethorphan concentrations.  Again, most sources list the combination as OK to take together but to monitor for side effects such as:

• Sedation

• Dizziness

• Fatigue

The above side effects are generally only associated with excessive/overdosages of dextromethorphan.

Dextromethorphan typically should not be used with SSRI (selective serotonin reuptake inhibitors) antidepressants due to a potential risk of a rare but serious condition known as serotonin syndrome. As Wellbutrin does not affect serotonin, the combination is generally considered OK. The combined use of dextromethorphan and Wellbutrin causing serotonin syndrome would be exceedingly rare.

In fact, there is an investigational drug combining Wellbutrin (bupropion) and dextromethorphan for the treatment of resistant depression.

Nasal Decongestants

Common nasal decongestants include phenylephrine and pseudoephedrine. In general, these are safe to use with Wellbutrin as long as you don't have a history or pre-existing risk of seizures.

Wellbutrin is known to increase the risk of seizures, especially with high doses. Stimulants such as pseudoephedrine can increase this risk as well. Caution should be used when combining nasal decongestants and Wellbutrin. If you do not have a history of seizures, the combination may be OK, but be sure to check with your doctor.

Final Words

As you can see, you have a variety of options to help to treat your cough and cold symptoms. If you are looking to take anything that is not listed above, please reach out to us, your pharmacist, or your doctor.