Zoloft - NyQuil Interaction Question

Answer

You are correct that there is a potential interaction between Zoloft (sertraline) and NyQuil, but not due to a decongestant.

In fact, the 'original' NyQuil doesn't even contain a decongestant, only 'NyQuil Severe' does. The three drugs in the original NyQuil are:

• Acetaminophen (pain reliever)
• Doxylamine (sedating antihistamine)
• Dextromethorphan (cough suppressant)

NyQuil Severe has one additional drug, the nasal decongestant phenylephrine (which is what you mentioned you are concerned about).

The interaction between NyQuil and Zoloft is due to the cough suppressant, dextromethorphan.

Zoloft Interacts With Dextromethorphan In NyQuil

Dextromethorphan (Delsym) is a cough suppressant that is a common ingredient in several over-the-counter cough/cold products, including NyQuil.

Caution should be taken when using Zoloft and dextromethorphan together since dextromethorphan may enhance the serotonergic effects of Zoloft, increasing the risk of a rare, but serious condition known as serotonin syndrome.

Serotonin syndrome is characterized by several effects, including:

• Hyperthermia
• High blood pressure
• Confusion
• Agitation
• Sweating
• Increased heart rate
• Muscle rigidity

Again, serotonin syndrome is rare, but the risk increases when taking multiple serotonergic drugs and is a medical emergency if it occurs.

It should be noted that there is a lot of conflicting evidence regarding how likely dextromethorphan is to cause serotonin syndrome when used with other drugs that affect the neurotransmitter. Many studies have concluded that only doses of dextromethorphan that are higher than recommended are risky, but there are case reports of it happening at usual doses as well.

Decongestants Are Safe With Zoloft

You asked about decongestants in your question.

There are generally no reported interactions between Zoloft and nasal decongestants, like Sudafed (pseudoephedrine) and Sudafed PE (phenylephrine).

So, if you are simply looking for some relief from congestion, those are safe to use.

Other cough/cold medications that are safe and may help with your symptoms include Mucinex (guaifenesin) and antihistamines.

Final Words

Thanks for reaching out and please do so again anytime!