Prozac Cold Medication

Overview

Prozac (fluoxetine) is an antidepressant and is classified an a SSRI (selective serotonin re-uptake inhibitor). SSRI medications are the most commonly used class of antidepressants, which unfortunately have their fair share of drug interactions. As such, finding over the counter medication to treat cold and flu symptoms can sometimes be tricky when taking a SSRI such as Prozac. 


Based on how Prozac works in our bodies, there are some over the counter cold medications that you should avoid and there are others that are considered safe to use. Below, we discuss cold/flu medications that are considered safe to use as well as those that you should avoid when taking Prozac, unless prescribed by your doctor.


Cold/Flu Medications: Use Caution Or Avoid


NSAIDs (e.g. Ibuprofen, Naproxen, Aspirin)

The combined use of selective serotonin re-uptake inhibitors like Prozac and NSAIDs can increase the risk of upper GI bleeds. Individuals are especially at risk if they have a history of GI bleeds or ulcerations in the past. NSAIDs are commonly used in combination with many over the counter cold products so be sure to read product labels! This precaution also includes bismuth subsalicylate, one of the ingredients in Pepto-Bismol.


Dextromethorphan (Delsym)

Caution should be taken when using Prozac and dextromethorphan together. Prozac works mainly by increasing levels of the neurotransmitter serotonin in the brain. Dextromethorphan can also increase serotonin levels and has the potential of causing serotonin syndrome when used with other medications that affect serotonin.


Serotonin syndrome is characterized by rapid development of:

  • Hyperthermia
  • High blood pressure
  • Mental status changes.​​


Although rare, it is extremely serious. In many cases, the combination of dextromethorphan and SSRIs like Prozac can be used but should only be considered after speaking with your physician.


Psuedoephedrine (Sudafed)

​Sudafed products can be used on occasion but must be used cautiously if you have a history of arrhythmia (e.g. QT prolongation) or other heart issues as the combination of SSRI medication, like Prozac, and Sudafed can worsen these conditions.


Cold/Flu Medications: Considered Safe For Most


Antihistamines

Antihistamines (e.g. Claritin, Zyrtec) are generally considered OK and safe to use with Prozac. Antihistamines can help with a variety of cold symptoms such as a runny nose and itchy, watery eyes. They can also help on occasion with congestion and coughing due to post nasal drip as they can have a slight drying effect. The one precaution is with first generation antihistamines such as Benadryl, which often have a sedative effect. Prozac can sometimes cause drowsiness, which could be enhanced with the use of Benadryl.


Acetaminophen

Tylenol (acetaminophen) is in most cases a better option for a pain reliever/fever reducer than NSAID medications (as described above).


Guaifenesin

Mucinex (guaifenesin) is generally considered OK to use with Prozac. Mucinex can help thin out excess mucus and relieve chest congestion.​​ It can also help with symptoms of post nasal drip.


Zinc/Vitamin C

Prozac is considered to be compatible with other cold remedies such as Zinc lozenges and vitamin C.