Taking Lexapro With Robitussin DM

In our latest question and answer, the pharmacist discusses the potential drug interaction between Lexapro (escitalopram) and Robitussin DM.

Question

Is it OK to take Robitussin DM with Lexapro? I have a bad cough.

Asked by Mlp On Jun 28, 2018

Answered by
Medical Content Reviewed By PharmacistAnswers Staff

On Jun 28, 2018

Lexapro (escitalopram) and Robitussin DM (Dextromethorphan Hydrobromide, Guaifenesin) do have a potentially major interaction and should not be taken together without first consulting your prescriber.  There may be alternative treatment options they recommend as taking Lexapro and Robitussin DM together can cause a rare, but serious disorder known as serotonin syndrome. Associated symptoms include:

  • Increased blood pressure
  • Loss of coordination
  • Stiff muscles
  • Restlessness
  • Sweating
  • Tremor
  • Fever
  • Nausea
  • Vomiting


Serotonin Syndrome Risk WIth Lexapro And Robitussin DM

Both Lexapro and Robitussin DM, specifically the dextromethorphan in Robitussin DM, can increase serotonin levels. While dextromethorphan is an over the counter cough suppressant and not generally associated with changes in serotonin, multiple studies have reported serotonin syndrome occurring in individuals taking supra-therapeutic doses (i.e. overdoses). Other case reports suggest it is possible that the combination of SSRI drugs (like Lexpro) and dextromethorphan can cause serotonin syndrome.


The risk of developing serotonin syndrome on Lexapro and dextromethorphan is low, but due to the severity of the condition, it would be prudent to avoid the combination if possible. If you do take both, it is important to be aware of the symptoms of serotonin syndrome and report any that occur to your doctor immediately.

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

About Lexapro (Escitalopram)

Lexapro (escitalopram) is a selective serotonin reuptake inhibitor (SSRI) and is most commonly used for the treatment of depression. It is also used off-label for the treatment of anxiety disorders. Escitalopram is the active enantiomer of citalopram, and is generally thought to exert its antidepressant effects more quickly than citalopram. While effective, Lexapro, and all SSRI medications, is associated with a variety of potential side effects including weight fluctuations (gain and loss), headache, dizziness, QT prolongation and sexual dysfunction. Lexapro can be taken with or without food. If nausea occurs, administer after a meal.

About Dextromethorphan

Dextromethorphan is an over the counter cough medication and a common ingredient in various cough, cold and flu products. It is chemically related to opioid medications but does not exhibit their typical characteristics such as analgesia and respiratory depression. Dextromethorphan is useful in treating chronic, nonproductive cough, but it has no expectorant activity, meaning it will not thin mucus secretions. Dextromethorphan is rapidly absorbed from the GI tract after taking by mouth and will begin working within 15—30 minutes. The typical duration of action is 5 to 6 hours.

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