What Cold Medications Are Safe With Wellbutrin

In our latest question and answer, our pharmacist discusses which over the counter cough/cold medications are safe to use with Wellbutrin (buproprion).

Question

I am taking 75 mg of Wellbutrin every night and have been for 4-5 weeks. I recently came down with a pretty bad cold about 2 days ago and am looking for some relief. I understand that there are certain medications I cannot take while taking Wellbutrin (bupropion) and I was wondering if there are any cold medications that are safe to take. So far, I've been doing the homeopathic approach (steaming, lots of herbal tea, Chestal Honey for the cough, and Airborne).

Asked by Caleb On Dec 23, 2017

Answered by
Medical Content Reviewed By PharmacistAnswers Staff

On Dec 23, 2017

Yes, you can take a variety of over the counter cough/cold products with Wellbutrin (buproprion) with no concern.


As with all prescription medication, it is always a good idea to consider potential drug interactions with over the counter products. Typically, there are some concerns when combining antidepressant drugs and over the counter medication, but Wellbutrin is relatively safe. The following medications are considered safe to take with Wellbutrin (no listed drug interactions):


Cough Suppressants

The most common cough suppressant over the counter is dextromethorphan and is the active ingredient in products such as Delsym. Dextromethorphan is available in a liquid and solid dosage forms. Most sources do not list an interaction between dextromethorphan and Wellbutrin.


However, there is a theoretical interaction between the two as Wellbutrin can inhibit dextromethorphan metabolism. This is due to Wellbutrin inhibition of a liver metabolizing enzyme known as CYP2D6. 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 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 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.


Expectorant

Guaifenesin, the active ingredient in Mucinex, is an effective expectorant which 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. In addition, sedating antihistamines are a common ingredient in many night time cough/cold formulas as a sleep aide. Such antihistamines include Benadryl (diphenhydramine) and doxylamine, both of which are considered safe to use.


While most over the counter medications are OK to use, you need to use caution with the following:


Nasal Decongestants

Common nasal decongestants include phenylephrine and pseudoephedrine.  These can potentially increase the risk of side effects. Bupropion is known to increase the risk of seizures, especially with high doses. Stimulants such as pseudoephedrine can increase this risk. 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.


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

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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