Flu Medications That Are Safe To Take While On Celexa (Citalopram)

In our latest question and answer, the pharmacist discusses which flu medications are safe to take while on Celexa (Citalopram) and which to avoid.

Question

I'm taking Celexa (citalopram) for depression and anxiety and now I have the flu. I have body aches and hardly can breathe with a stuffy nose. What should I take for this?

Asked by Neti On Mar 21, 2018

Answered by
Medical Content Reviewed By PharmacistAnswers Staff

On Mar 21, 2018

Flu Medications Safe WIth CelexaCelexa (citalopram) is an antidepressant medication in the SSRI  (selective serotonin reuptake inhibitor) class. It is used for a variety of indications but is most commonly prescribed for the treatment of depression.


It can sometimes be difficult to know what cold/flu medications over the counter are safe to take, and which to avoid while taking Celexa. Celexa has a wide range of effects on the body with many potential drug interactions. Ideally, you are looking for something to help alleviate flu symptoms (such as nasal congestion and body aches) but avoid anything that presents a risk of drug interactions or additive adverse effects.


Below, we list over the counter medications that are commonly used to treat cold/flu symptoms and whether or not they are safe to take while also using Celexa.


OTC Medications Generally Considered Safe

Antihistamines

Antihistamines, such as Allegra, Claritin and Zyrtec are generally considered OK and safe to use while on Celexa. They can help with a variety of flu symptoms such as a runny nose and itchy, watery eyes. They may also indirectly help with nasal congestion and post nasal drip due to their drying effects (i.e. anticholinergic effects).


It is important to note that second generation antihistamines, such as the ones mentioned above, are considered safer to use with Celexa than first generation ones like Benadryl. Although rare, Benadryl may increase the risk of certain arrhythmias while taking Celexa.


Tylenol (Acetaminophen)

Tylenol (acetaminophen) is, in most cases, a safer option for a pain reliever/fever reducer than NSAIDs as Tylenol is not associated with an increased bleeding risk. Tylenol is also beneficial for the symptoms of muscle aches and general body soreness, a common complaint of the flu.


Guaifenesin

Mucinex (guaifenesin) is considered OK to use. It can help thin out excess mucus and relieve chest congestion.​​


Zinc/Vitamin C

Celexa is compatible with other cold remedies such as Zinc lozenges and vitamin C.


Use With Caution

NSAIDs (Nonsteroidal Anti-inflammatory Drugs)

Examples of NSAIDs include:

  • Advil (Ibuprofen)
  • Aleve (Naproxen)
  • Aspirin


The combined use of selective serotonin re-uptake inhibitors, such as Celexa, and NSAIDs increases the risk for an upper GI bleed. The chance of bleeding is increased with certain risk factors such as in those with a history of GI bleeds or stomach ulcerations in the past.


Dextromethorphan (Delsym)

Caution should be taken when using Celexa and dextromethorphan together. Dextromethorphan can increase serotonin levels in the body and has the potential of causing serotonin syndrome when used with other medications that affect serotonin, such as Celexa.


Serotonin syndrome is characterized by:

  • Rapid development of hyperthermia
  • High blood pressure
  • Confusion
  • Mental status changes​​


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


Psuedoephedrine (Sudafed)

​Sudafed products can sometimes be used on occasion, but must be used cautiously, or not at all, if you have a history of arrhythmia (e.g. QT prolongation) or other heart issues as the combination of SSRI medication and Sudafed can exacerbate these conditions. This is particularly true for Celexa, which carries a higher risk of QT prolongation than other antidepressants.


Additional Information

It is important to look at the active ingredient list for any product you are considering purchasing. There are a variety of combination products available over the counter, which contain multiple ingredients. You need to be aware of all the included ingredients in these products to avoid certain ones.


Summary

  • Celexa is a SSRI antidepressant that carries potential drug interactions with over the counter cold and flu medication.
  • Over the counter medications generally considered safe with Celexa include second generation antihistamines, Mucinex and Tylenol.
  • Over the counter medications that should be used cautiously, if at all, include dextromethorphan and Sudafed.

About the Pharmacist

Dr. Brian Staiger Pharm.D

Dr. Brian Staiger is a licensed pharmacist in New York State and the founder of PharmacistAnswers.com. He graduated from the University At Buffalo with a Doctor of Pharmacy degree in 2010. He has been featured in numerous publications including the Huffington Post as well as a variety of health and pharmacy-related blogs. Please feel free to reach out to him directly if you have any inquiries or want to connect! He's answered thousands of medication and pharmacy-related questions and he's ready to answer yours! Brian.Staiger@PharmacistAnswers.com Office: 716-389-3076

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